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Key Clinical Message The differential diagnoses of popliteal ganglion cysts include Baker's cysts, popliteal artery aneurysms, popliteal tendinitis, popliteal lymphadenopathy, lipomas, and synovial sarcoma.

Key Clinical Message Timely recognition, accurate diagnosis, and proper management are vital for preventing complications and improving outcomes in polycystic liver disease. Abstract Polycystic liver disease is an uncommon genetic condition characterized by the presence of over 20 liver cysts. It is symptomatic in only 5% of cases. Surgical intervention remains the primary treatment approach for managing symptoms in affected patients. Herein, we report a case of PLD revealed by severe abdominal pain.

Background: Patients with neurofibromatosis type I (NF1) have an increased risk of developing soft-tissue sarcomas, particularly those related to the nervous system. Epithelioid sarcoma (ES) is an exceptionally rare subtype of soft-tissue sarcoma, with limited knowledge about its clinical presentation and optimal management in NF1. This report aims to provide insights into the characteristics and outcomes of ES in NF1 patients. Case description: A 37-year-old man with a history of NF1 presented with a progressively worsening mass on his right inner thigh. An MRI scan revealed a well-defined tissue mass originating from the adductor magnus muscle, later confirmed as ES through histopathology and immunohistochemistry. Considering poor local and general prognosis, the multidisciplinary team recommended salvage hip disarticulation, however the patient refused and opted for palliative marginal resection to reduce the tumour size. The patient’s condition declined rapidly, and he succumbed six days after the surgery. Conclusion: This case highlights the rarity of ES in NF1 patients and underscores the potential for malignant tumour development in this population. Further research is needed to improve our understanding and management of sarcomas in the context of NF1.

Key Clinical Message Inguinal swelling should raise suspicion for hip joint osteochondromatosis. Early recognition, accurate diagnosis, and prompt surgical intervention are essential for optimizing patient outcomes.

Key Clinical Message Adenosarcoma of the uterine cervix should be considered in the evaluation of post‐menopausal bleeding, as it can be a potential underlying cause. Timely diagnosis and appropriate management are essential to optimize patient outcomes. Abstract Adenosarcoma is a biphasic neoplasm comprising both a benign epithelial component and a typically low‐grade sarcomatous stromal component. Adenosarcoma mainly affects the endometrium (71%), with a lesser incidence in the cervix (2%). Herein, the authors report a case of adenosarcoma of the uterine cervix with distinct gross features.

Key Clinical Message Pathologists should consider the differential diagnoses of placental chorioangioma, which encompass chorangiosis, chorangiomatosis, chorangiocarcinoma, intervillous thrombus, and placental infarct. Abstract Chorioangiomas are rare non‐trophoblastic vascular neoplasms of the placenta, occurring in approximately 1% of pregnancies. Large chorioangiomas (>4 cm) are infrequent and associated with an increased risk of pregnancy complications. There are limited reports in the literature regarding uncomplicated cases of large placental chorioangiomas.

Key Clinical Message Primary hydatid cyst of the thigh is a rare condition requiring prompt recognition and accurate diagnosis for timely management and prevention of complications. Abstract Muscular hydatid cysts are rare, with a frequency ranging from 1% to 5% even in endemic areas. The clinical presentation of muscular hydatidosis is typically subtle and lacks specific features, frequently resulting in delayed diagnosis. Herein, the authors describe a case of a primary hydatid cyst located in the thigh.

Key clinical message The coexistence of hepatic mucinous cystic neoplasm and ovarian serous cystadenoma is rare and can only be confirmed by histological examination of the surgical specimen. Complete surgical resection is the optimal treatment. Abstract Mucinous cystic neoplasms (MCN) of the liver are rare premalignant lesions that account for less than 5% of all hepatic cysts. The synchronous occurrence of hepatic MCN with ovarian cystadenomas is rare. Herein, we report a case of a hepatic MCN coexistent with a serous ovarian cystadenoma.

Key Clinical Message The differential diagnoses of solid pseudopapillary neoplasm of the pancreas include cystic pancreatic neuroendocrine tumor, acinar cell carcinoma, and pancreatoblastoma. Abstract Solid pseudopapillary neoplasm (SPN) is a low‐grade malignant pancreatic tumor which accounts for 0.9%–2.7% of all exocrine pancreatic neoplasms. It predominantly affects young females (90%) and less frequently occurs in male patients. Its prognosis after surgical resection remains excellent. Herein, we report a case of SPN in a male patient.

Abstract Paratubal cysts are almost always benign, with rare reports of paratubal serous borderline tumors (PSBT). Only 10 cases of PSBT have been reported in the literature. Their treatment in young patients relies on fertility‐preserving surgery. Herein, the authors report a case of PSBT revealed by chronic pelvic pain.

Abstract Colorectal invasive micropapillary carcinoma (MPC) is a rare and distinct variant of adenocarcinoma with high incidence of lymph node metastasis. The differential diagnoses of MPC include extensive lymphovascular invasion, metastatic MPC, and retraction artifacts.

Abstract Uterine lipoleiomyomas are rare variants of leiomyomas that usually occur in postmenopausal women. Their incidence ranges from 0.03% to 0.2%. Few cases of laparoscopically resected lipoleiomyomas have been reported in the literature. Further accumulation of lipoleiomyomas could help establish an accurate preoperative diagnosis of this uncommon and benign mesenchymal tumor.

Abstract Sarcomatoid carcinoma is a rare type of gallbladder cancer with less than 100 cases reported in the literature. Preoperative diagnosis is difficult due to nonspecific clinical and radiological findings. Its prognosis is poor due to rapid progression and a high short‐term recurrence rate. The definitive diagnosis relies on histopathological examination.

Abstract Goblet cell adenocarcinomas (GCA) are infrequent neoplasms of the digestive system that exhibit both mucinous and neuroendocrine differentiation. They predominate in the appendix and rarely involve the colon. Herein, the authors report a case of GCA involving the ascending colon in a 60‐year‐old woman who presented with severe anemia.

Abstract Mucinous carcinoma of the breast is rare representing 2% of all breast carcinomas. It can be classified as either a pure or a mixed type. Pure mucinous breast carcinoma has a less aggressive behavior compared with mixed breast mucinous carcinoma. The latter shows frequent neuroendocrine differentiation.

Abstract Some Aspergillus species produce oxalic acid, which reacts with tissue calcium or blood to precipitate calcium oxalate. Oxalate crystals can induce lung and kidney damage. The presence of oxalate crystals can suggest the diagnosis of aspergillosis, even when Aspergillus hyphae are absent on microscopic slides.

Abstract Superficial acral fibromyxoma (SAF) is a rare and benign soft tissue tumor that has a predilection to develop in acral sites. Its treatment is surgical excision. Follow‐up is recommended due to the risk of recurrence. The purpose of this case is to raise awareness of this recently described neoplasm.

Abstract Cocoon abdomen is an uncommon condition characterized by bowel entrapment in a cocoon‐like membrane. Its clinical presentation is usually non‐specific. Rarely, it may present with perforation peritonitis. The therapeutic approach depends on the stage of the disease. Surgery is essentially reserved for those with acute surgical complications.

Metastatic small bowel tumors are rare. They often present with small bowel occlusion, bleeding, perforation, or intestinal intussusception. Pulmonary adenocarcinoma with metastasis to the small intestine causing intussusception is exceedingly rare. A 72-year-old male patient with a past medical history of left lung adenocarcinoma, presented to the emergency department with abdominal pain and vomiting. On admission, an X-ray of the abdomen without preparation showed some hydroaeric levels on the small intestine. The abdominopelvic computed tomography (CT) scan revealed an ileo-ileal invagination, with an image of the invagination rod. The patient underwent a surgical resection of the small bowel with the removal of the ischemic areas and immediate anastomosis. Macroscopic examination of the surgical specimen revealed five tumor masses varying in size between 1 and 4 cm. The histological examination of the samples taken from these tumors, coupled with an immunohistochemical study confirmed the diagnosis of intestinal metastases of pulmonary origin expressing cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1) but negative for CK20, chromogranin, and synaptophysin. The postoperative course was uneventful, and the symptoms transiently recovered. However, the patient died 3 months later. We should consider multiple metastatic lesions in adult intussusception, especially in patients with a past medical history of lung cancer.

Abstract Pseudoxanthomatous salpingitis (PXS) is an uncommon condition characterized by the presence of pigment‐laden histiocytes within the lamina propria of the fallopian tube. Less than 30 cases of PXS have been reported in the literature. We herein report a case of PXS associated with an endometriotic cyst.

Abstract Gastric carcinoma with lymphoid stroma is a rare variant of gastric carcinoma accounting for 1%–7% of gastric carcinomas. Its association with gastric leiomyoma and ectopic pancreas is extremely rare. We herein report an unusual simultaneous occurrence of gastric carcinoma with lymphoid stroma, calcified leiomyoma, and ectopic pancreas.

Abstract Adenosquamous carcinoma of the pancreas is a rare and aggressive histological subtype of pancreatic adenocarcinoma, which accounts for 1% to 4% of the exocrine pancreatic malignancies. Its diagnosis relies on histological examination revealing the coexistence of ductal adenocarcinoma and squamous carcinoma with the latter representing ≥30% of the tumor.

Abstract Intracholecystic papillary‐tubular neoplasms are rare precancerous and polypoid lesions of the gallbladder, found in nearly 0.4% of cholecystectomy specimens. They follow the adenoma‐carcinoma sequence. About half the cases are associated with invasive carcinoma. Their diagnosis relies on histopathological examination with extensive sampling of the surgical specimen.

Abstract Craniorachischisis totalis is an uncommon and severe form of neural tube defect. It is characterized by anencephaly and spina bifida throughout the vertebral column accompanied by herniation of neural tissue and meninges. Hepatic calcification in the fetus is rare and its clinical significance is not fully established.

Abstract Elastofibroma dorsi is an uncommon benign soft‐tissue tumor with uncertain pathogenesis (Medicina (Kaunas), 2021; 57, 370). Surgical excision is the therapeutic option for symptomatic patients. A pathological study confirms the diagnosis after surgery. The prognosis is excellent with extremely rare recurrence cases (Anticancer Res, 2021, 41, 2211).

Abstract Hepatic epithelioid angiomyolipomas are uncommon mesenchymal neoplasms. They are difficult to diagnose by imaging, especially when the fatty component is scant or absent. The gold standard for the diagnosis is histologic examination coupled with an immunohistochemical study. Positive HMB45 immunostaining of the myoid cells is a major diagnostic feature.

Abstract Carcinosarcomas are aggressive biphasic neoplasms composed of high‐grade, malignant, epithelial, and mesenchymal elements. They usually occur in the uterus and rarely involve the ovaries. Only 10% of them are bilateral. Their diagnosis relies on histological examination coupled with immunohistochemistry.

Abstract Ovarian teratomas with an extensive solid component in patients aged more than 40 years should raise the suspicion of malignancy. Such specimens should be thoroughly sampled, and the patient must be followed up for a long period.

Abstract Pure and mixed fibrolamellar hepatocellular carcinomas display distinct clinical presentations and epigenetic backgrounds leading to different prognoses and as such may be regarded as separate clinical entities.

Parosteal osteosarcoma is a low-grade, bone-forming neoplasm that arises on the surface of bone. It accounts for about 4% of all osteosarcomas. An 18-year-old male patient with no particular past medical history, consulted for a painless mass in the right thigh that had appeared at the age of 17 years and progressively increased in volume. The physical examination revealed a 6 cm mass at its largest above the right popliteal fossa with knee flexion slightly limited. The X-ray revealed a well-limited mass in the lower third of the femur that was dense and attached to the metaphyseal cortex by a wide base. Histological examination of the biopsy specimen established the diagnosis of parosteal osteosarcoma. The patient underwent wide resection of the femoral tumor (A) preceded by a course of first-line chemotherapy. Histological examination showed a malignant mesenchymal proliferation, moderately cellular, made up of long, linear and eosinophilic material, sometimes calcified with no osteoblastic cells in the periphery (B). The tumor cells were spindle-shaped, with little eosinophilic cytoplasm and a long or ovoid, hyperchromatic, and moderately atypical nucleus. Mitoses were rare. There were no areas of dedifferentiation. Postoperative course was uneventful. During the one-year follow-up period, there was no recurrence or metastasis of the tumor. Parosteal osteosarcoma is characterized by its insidious growth and favorable prognosis. It rarely leads to metastasis. Its treatment is mainly surgical.

Abstract The rare histological features of hepatocholangiocarcinoma require a thorough sampling of the surgical specimen and the application of immunohistochemical techniques to confirm the diagnosis.

Abstract Misdiagnosis of mucinous cystic neoplasms of the liver may have serious consequences due to their premalignant potential. A thorough understanding of their characteristic features and a high index of suspicion are mandatory (Mod Pathol, 24, 2011, and 1079).

Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign proliferation of fibrous stroma, containing slitlike pseudovascular spaces lined by myofibroblasts. Less than 200 cases of PASH have been described in the English literature with the largest series including 40 cases. A 48-year-old woman with no particular past medical history, presented with a complaint of a slow, progressive, painless left breast mass. The patient underwent mammography which revealed a well delineated left breast nodule with microcalcifications classified BI-RADS 4. An excisional biopsy was performed on the mass to confirm the histological diagnosis. The specimen was a well-circumscribed whitish tumor measuring 3 x 3 cm with several microcysts (A). Histological examination revealed proliferation of fibrous stroma, with spindle cells and a network of slit-like empty clefts within acellular hyalinized stroma (B). The spindle cells were positive for CD34 and smooth muscle actin but were negative for Factor VIII. The final pathological diagnosis was nodular PASH. Postoperative course was uneventful and the patient is still being followed-up.

Cystic pancreatic neuroendocrine tumor accounts for 13-17% of pancreatic neuroendocrine tumors and 9-10% of resected cystic tumors. This unusual variant can make clinical diagnosis particularly challenging. A 28-year-old female patient presented with abdominal pain and dyspepsia. General and physical examination was unremarkable. On computed tomography scan a 7.5,5.4,5.2cm thick-walled cystic lesion was noted in the tail region of the pancreas in the stomach bed (A). On the basis of the above findings, the radiologist reported it as suggestive of solid pseudopapillary neoplasm and advised pathological correlation. No abdominal lymphadenopathy was noted. The patient underwent laparoscopic removal of a pancreatic cyst. Intraoperatively, a large cyst was seen located posterior to the stomach in retroperitoneum and was intimately related to the tail of the pancreas. The cyst could be enucleated. On histopathological examination, the sections from the cyst wall showed collagen-rich fibrous tissue in which were embedded small clusters and nests of round cells (B). The cells were monotonous, small to medium in size with amphophilic cytoplasm with indistinct cell borders. The nucleus showed typical stippled nuclear chromatin and no mitoses were noted (C). There was no capsular invasion. Neuroendocrine nature of these round cells was confirmed by performing immunohistochemistry with synaptophysin and chromogranin A (C). Ki67 stained 3% of the cells. These findings corroborated the benign nature of the disease indicating a very good prognosis. Postoperative recovery of the patient was uneventful.

Young people under the age of 40 with colorectal cancer represent a distinct subgroup with a more aggressive disease behaviour compared to older patients. This study aim to provide an updated overview on clinicopathological features, treatment and outcome of colorectal cancer in young adults under the age of 40. In our retrospective study, we reviewed 32 cases of colorectal cancer in young adults aged less than 40 years that were diagnosed at the pathology department of Mongi Slim hospital over a fifteen-year period (April 2000 - November 2014). Our study group included 13 male and 19 female patients (sex-ratio M/F = 0,68) between 17 and 39 years of age (mean = 31,25 years). The presenting clinical symptoms were dominated by altered bowel habits (n=17), followed by bleeding per rectum (n=16). Histopathological examination of the surgical and biopsy specimens established the diagnosis of mucinous adenocarcinoma in nine cases, well-differentiated adenocarcinoma in 11 cases, moderately differentiated adenocarcinoma in six cases, poorly differentiated adenocarcinoma in four cases and signet ring cell carcinoma in two cases. The tumours were classified after surgery as stage I (n = 2) (6%), stage IIA (n = 7) (22%), stage IIB (n=4) (13%), stage IIC (n=1) (3%), stage IIIB (n=8) (25%), stage IIIC (n= 4) (12%), stage IVA (n=4) (13%) and stage IVB (n=2) (6%). During the follow-up period which ranged between one month and 9 years, local recurrence of the tumour occurred in six cases, seven patients had hepatic metastases and seven patients died after a mean follow-up period of seven months. Molecular genetic studies are increasing the understanding of the pathobiology of colorectal cancer and may ultimately allow at-risk patients to be identified at an earlier stage.

Neoadjuvant chemotherapy of colorectal liver metastases can induce hepatotoxicity in noncancerous liver. The aim of the present study was to describe the chemotherapy-induced major changes in the hepatic parenchyma and their prognostic impact. We undertook a retrospective study of 48 cases of colorectal liver metastases treated with neoadjuvant therapy followed by liver resection. These cases were collected at the Pathology Department of Mongi Slim Hospital over a 2-year period (July 2015-February 2018). Our series consisted of 27 men and 21 women with a sex-ratio (M/F = 1.28). The average age of our patients was 57.68 years old with extremes ranging from 30 to 75 years old. All patients received chemotherapy with FOLFOX. From a total of 48 operative specimens examined, we found 24 cases (50%) of non-systematized steatosis, grade 1 sinusoidal obstruction syndrome (n = 12) and grade 2 sinusoidal obstruction syndrome (n = 12), regenerative nodular hyperplasia (n = 3), portal and/or lobular inflammatory infiltrate (n = 6). In three cases, no abnormalities were reported in the liver parenchyma. Surgical margins were 1 mm in seven cases and were invaded in four cases. Preoperative chemotherapy is associated with regimen-specific liver injury. The presence of such an injury may have a negative impact on the functional reserve of the liver, thereby increasing the risk of surgical morbidity and mortality.

The pancreas is an unusual site for tumor metastasis, accounting for only 2 to 5% of all malignancies affecting the pancreas. A 67-year-old woman with a past medical history of right renal nephrectomy for renal cell carcinoma, eleven years ago, presented with nausea, diarrhea and vertigo. On admission, the patient was pale. Laboratory tests showed a low hemoglobin level (6,4 grams per deciliter). Abdominal ultrasonography revealed a well-defined, hypoechoic, homogeneous, vascular, lobulated mass in the tail of the pancreas. Computed tomography scan demonstrated a hypervascularized tumor of the pancreatic tail. The patient subsequently underwent a distal pancreatectomy with splenectomy. Grossly, the pancreatic mass was well-delineated and encapsulated measuring 9,5 x 6,5 cm and showed extensive hemorrhage (A). Histological examination of the surgical specimen revealed that the pattern of the tumour growth was predominantly solid, with formation of large nests and acini of tumor cells separated by a stroma that was endowed with prominent sinusoid-like vessels (B). The tumour cells were large ranging from optically clear, with sharply outlined boundaries, to eosinophilic tumour cells. The final pathological diagnosis was metastatic clear-cell renal carcinoma to the pancreas. Four peripancreatic lymph nodes were free of the tumor but the pancreatic resection margins were invaded by the tumour. Postoperative course was uneventful. Renal cell carcinoma metastasis should be considered in patients with a pancreatic mass as it gives the past history of renal cell carcinoma. Awareness of this entity and a high index of suspicion would help in proper diagnosis and treatment.

Gallbladder adenomas are rare, but well-documented benign epithelial tumors. They are usually found incidentally in cholecystectomy specimens or during preoperative imaging studies. Although they are usually asymptomatic, they may present as a result of associated symptomatic gallstones, or from cystic duct obstruction due to large adenoma. Three subtypes of adenoma are defined: tubular, papillary and tubulopapillary and they are further classified histopathologically as pyloric gland, intestinal and biliary types. Most adenomas found in the gallbladder are pyloric gland type. A 52-year-old woman suffering from aspecific upper abdominal pain was admitted in the surgery department of our hospital. Physical examination did not reveal any abnormalities nor did routine blood testing. Abdominal ultrasonography showed a polypoid lesion in the gallbladder measuring 1.5cm long. Laparoscopy was performed showing normal anatomy of the gallbladder and surroundings. The gallbladder as well as the Mascagni lymph node were removed. Macroscopic examination of the gallbladder revealed a polypoid lesion in the gallbladder body measuring 1.5cm in diameter (A). On microscopy, the polypoid lesion was almost entirely made up of tightly packed pyloric type tubular glands with little intervening stroma (B). In the background gallbladder epithelium there were no abnormalities. Recovery after surgery was uneventful and the symptoms did not recur.

Solid pseudopapillary tumour (SPT) is an unusual pancreatic neoplasm which predominantly affects young women. Less than 10% of patients with SPT in the reported literature were male. In this paper, the authors report two new cases of SPT that occurred in two male patients aged respectively 25 and 20 years old. Abdominal computed tomography scan showed a well-defined heterogeneous mass involving respectively the tail and the body of the pancreas with peripheral calcifications in the first case. The two patients underwent distal splenopancreatectomy. Histopathological examination of the surgical specimen coupled with immunohistochemical study was compatible with solid pseudopapillary tumour. On postoperative day 8, the first patient developed abdominal wall abscess and peritoneal collection. Postoperative course was uneventful for the second patient. In summary, a large, well-encapsulated cystic mass in the pancreas of a young man should raise suspicion of solid pseudopapillary tumour.

Hepatocellular carcinoma (HCC) is the most common of all liver cancers and is a major worldwide public health problem. The aim of this study was to provide an updated overview on clinicopathological features, treatment and outcome of HCC. In our retrospective study, we reviewed 64 cases of HCC that were diagnosed at the pathology department of Mongi Slim hospital over a fifteen-year period (2000- 2014). Relevant clinical information and microscopic slides were retrospectively reviewed. Our study group included 38 men and 26 women (sex ratio M/F = 1,26) aged between 8 and 83 years (mean = 56,64 years). The presenting clinical symptoms were dominated by abdominal pain (n=34), followed by altered general health (n=25) and jaundice (n=4). Fifty-five patients underwent surgical treatment. Liver transplantation was performed in two cases and transarterial chemoembolization was achieved in seven cases. Histopathological examination of the surgical or biopsy specimen established the diagnosis of conventional HCC in 55 cases, fibrolamellar carcinoma in 6 cases and clear cell HCC in 3 cases. Seven patients with HCC died postoperatively. Local recurrence of the tumour occurred in three cases and two patients had distant metastases postoperatively. The other patients are still being followed-up. Hepatocellular carcinoma is associated with a high rate of mortality because of early invasion, widespread metastasis and lack of effective therapeutic modalities. Accurate diagnosis and staging of these tumours is critical for optimal treatment planning and for determining prognosis.

Un homme âgé de 30 ans sans antécédents pathologiques notables, avait consulté pour l'apparition trois mois auparavant d'une lésion cornéenne de l'éil droit. Dès l'examen par la simple inspection, une lésion saillante, accrochée au limbe temporal masquait la partie temporale de la cornée. Cette image se voyait confirmée par l'examen à la lampe à fente, la lésion était finement polylobée et avait un contour irrégulier vers la cornée. Elle empiétait à la fois sur la cornée et sur le versant limbique de la conjonctive (A). L'acuité visuelle était à 10/10. Le reste de l'examen ophtalmologique était normal. Devant cet aspect clinique évocateur d'une lésion tumorale de la surface oculaire droite, il fut proposé au patient une exérèse chirurgicale réglée. L'exérèse fut donc réalisée sous anesthésie locale sous microscope opératoire permettant une excision complète de la lésion. L'examen histologique a confirmé le diagnostic de carcinome in situ (B). Les suites opératoires immédiates étaient simples. Cependant, l'évolution a été marquée par la survenue six mois plus tard, d'une récidive locale imposant une réintervention chirurgicale.

A 36 year-old female patient gravida 2 para 1, with no particular past medical history consulted her gynecologist at 14 weeks' gestation for pelvic pain. Her first pregnancy was uneventful and she did not take any specific drugs prior or during her pregnancy. Consanguinity and hereditary diseases were denied. Ultrasonography revealed a retention image measuring 67,2 mm with no cardiac pulsations (A). A male cyclopean fetus was delivered by induced labour. The fetus weighed 13,5 g and the placenta 45,4 g. On examination, the fetus was monophtalmic with completely fused eyes (B). In the face was a central proboscis located above the single orbital cavity (B). It had a rhombic form presenting with two lateral commissures and one caruncle at the inferior point of union. There was one lacrimal punctum in the midline and no median cleft. The nasal structures were absent. The upper lip looked normal with both, philtrum and tuberculum labii superioris. The lower lip and the mandible were normal. The brain and the rest of the organs were macerated. The examination of the placenta did not disclose any anomaly. Genetic analysis was not performed.

Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. Coexistence of schistosomiasis with Crohn's disease is very rare. To the best of our knowledge, this association has been described in literature only once. A 20-year-old male patient with a past medical history of appendectomy and ileocecal Crohn's disease, presented with abdominal pain and vomiting. Ileocolonoscopy showed an ulcerated and congested appearance of the upper rectum and sigmoid. Computed tomography scan revealed a circumferential thickening of the terminal ileum with luminal stenosis. Histopathological examination of the biopsy specimens revealed a focally ulcerated colonic epithelium. The lamina propria was fibrous harbouring a polymorphic inflammatory infiltrate including lymphocytes and plasma cells organized in lymphoid follicles admixed with eosinophils and neutrophils. In the submucosa, there were two well-preserved schistosoma eggs surrounded by a thick shell with a barely visible terminal spine. The final pathological diagnosis was colonic schistosomiasis associated with Crohn's disease. The patient underwent an ileocecal resection for stenosis of the terminal ileum complicated with enterocutaneous fistula. The postoperative course was uneventful. A stool examination and serology tests were planned for this patient who was lost to follow-up.

Splenosis is an uncommon benign condition resulting from heterotopic autotransplantation of splenic tissues onto exposed vascularised intra- and extraperitoneal surfaces following splenic trauma and surgeries. Splenosis may be mistaken for carcinomatosis upon standard imaging techniques. A 69-year-old female patient with a past medical history of hypertension and splenic trauma, underwent total esophagectomy with polar gastrectomy for adenocarcinoma of the gastric cardia. Macroscopic examination of the surgical specimen disclosed a tumour of the cardia measuring 5 cm in greatest diameter and several dark brown nodules of the greater omentum ranging in size between 2 mm and 12 mm. Histological examination of these nodules confirmed the diagnosis of peritoneal splenosis. The authors emphasize that in patients with a previous history of splenic trauma or surgery, clinicians must consider the existence of splenosis.

Calcinosis cutis is a term used to describe a group of disorders in which calcium deposits form in the skin and may be classified as dystrophic, metastatic, idiopathic or iatrogenic calcification, and calciphylaxis. Idiopathic calcinosis cutis occurs without any underlying tissue damage or metabolic disorder. In this paper, the authors report a new case of idiopathic calcinosis involving the medial canthus of the left eye that was mistaken for milia. An 18-year-old previously healthy male patient, presented with an asymptomatic whitish solitary tumour of the medial canthus of the left eye. The patient had no systemic or trauma history, and the serum levels of calcium and phosphorous were normal. An excisional biopsy was performed and histopathologic examination revealed subepidermal calcinosis. Calcinosis cutis is a rare condition that should be included in the differential diagnosis of a benign-appearing lesion of the face. While it can occur in patients with a history of inflammation, trauma, or hypercalcemia, its etiology can also be idiopathic.

AbstractBackground:Orbital hydatidosis is rare, accounting for only 1% of all hydatid cysts. Herein we report a case and review the sparse literature.Methods:Case report and review of pertinent literature.Results:A 74-year-old farmer presented with progressive proptosis and loss of vision of the left eye. Evaluation revealed a hydatid cyst of the orbit. Orbital hydatidosis is usually unilateral and unaccompanied by cysts elsewhere in the body. Most affected are children and young adults. Although there is no gender predominance, orbital hydatidosis may affect the left eye preferentially. Onset is usually insidious over several months. Serologic testing is unreliable, and imaging by computed tomography or magnetic resonance imaging is now standard. Surgical resection is curative, but albendazole must be administered postoperatively if there is spillage intraoperatively.Conclusions:Hydatid cysts should be included in the differential diagnosis of unilateral proptosis in patients from regions where echinococcosis is endemic. [ABSTRACT FROM AUTHOR]