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Introduction: Neuroendocrine tumors (NETs) are poorly understood neoplasms that, although slow growing compared with epithelial malignancies, can behave aggressively. Bone marrow (BM) is an uncommon site of metastasis by neuroendocrine tumors (NETs), occurring in approximately 5% of the cases. Despite advanced diagnostic techniques, primary site cannot be deciphered in few patients. Case: A 46-year-old male with a recent history of myocardial infarction, rapidly worsening back pain from past two months. He was referred to us with a suspicion of multiple myeloma with multiple lytic lesions of bone. The patient underwent a BM examination, which revealed extensive infiltration of the marrow with tumor cells positive for immunohistochemical (IHC) markers of NET with high proliferation index. Thus, a diagnosis of “metastatic NET” was rendered. Conclusion: In an occult primary, a panel of IHC biomarkers are of key importance to confirm the nature and grade of the tumor. Site-specific markers may be lost in high-grade tumors. Thus, in an era of theradiagnostics, immunohistochemistry remains a tool of paramount vitality, to accurately classify these tumors, and may aide in finding the primary site of neoplasm.

Sarcocystis is an apicomplexan protozoan, such as Toxoplasma and Plasmodium. Human muscular sarcocystis infection is a rarely reported case. The rarity of the reported cases can be attributed to nonspecific symptoms and nonrecognition of the protozoa on histology. Sarcocystis infection has been catching up recognition in Southeast Asian countries. It is a food-borne zoonosis. There are more than hundred Sarcocystis spp. known and most have been isolated from muscle tissues of various intermediate hosts, including mammals, birds, and reptiles. They are parasites with dual hosts to accommodate their dual life cycles. Humans are the accidental intermediate hosts, as have been reported as intramuscular sarcocysts of unknown species. We report a similar case of 27-year-old male, who underwent wide local excision of Ewing's sarcoma of the right arm, in conjunction with which muscular sarcocystis infection was identified. We report a rare case of muscular sarcocystis in a rarer combination with Ewing's sarcoma, with no such previous case in the literature available.

Xanthogranulomatous inflammatory reaction is an uncommon nonneoplastic disease process, which is an even rarer entity in testicles. We present a similar case report of a 20-year-old male with a testicular swelling and a provisional clinical diagnosis of a testicular neoplasm. We hence present this case in view of its rarity and its nature to deceptively mimic a neoplasm.