Primary signet-ring cell carcinoma of the cecum: A rare case report.

INTRODUCTION AND IMPORTANCE: Primary SRCC is a rare histological colorectal cancer subtype. It is characterized by distinct clinical presentation. CASE PRESENTATION: This case report describes a rare case of a Primary Signet-ring cell carcinoma of the cecum. A 37-year-old man came to the emergency department with bowel obstruction and altered general condition. The abdominal CT scan showed an intestinal occlusion upstream a thickening of the cecum. An exploratory laparotomy found a distention of the bowl with a suspect thickening of the cecum. The patient underwent a right ileo-colectomy and ileocolostomy. Histologic analysis of the operatory specimen confirmed the diagnosis of a primary Signet-ring cell carcinoma of the cecum. The recovery was uneventful, and the patient is in good health after six -months of follow-up. After completing the chemotherapy, the patient is scheduled for a colonoscopy and reversal of colostomy. CLINICAL DISCUSSION: Colorectal primary signet ring cell carcinoma (SRCC) is a rare entity, and it is associated with poor prognosis compared with common colorectal adenocarcinomas. characterized by distinct clinical presentation, with very poor response rates. CONCLUSION: Primary SRCC is an aggressive histological type of colon cancer and it is associated with a poor prognosis. There are no conclusive guidelines for the treatment of this type of tumor.

Ischemic stroke revealing COVID-19 infection: Case report.

INTRODUCTION: SARS-COV-2 viral infection primarily targets the respiratory system with a clinical picture that varies from simple symptoms to respiratory distress syndrome requiring hospitalization in the intensive care unit; SARS-CoV-2 also has neuro-invasive capabilities and could spread from the respiratory system to the central nervous system. Recently, some patients with COVID-19 have been shown to have neurological symptoms such as headache, anosmia, dysgeusia, dizziness, impaired consciousness, and ischemic stroke. CASE PRESENTATION: we describe a case of ischemic stroke as the main presentation of COVID-19 in a 68 years old man with no previous history, without any associated respiratory signs; clinical examination revealed left hemiparesis with dysarthria and left facial paralysis, NIHSS score was at 11, the brain CT scan performed 1h30min later, completed by a brain MRI that came back in favor of right frontal, temporal and parietal ischemic stroke. The decision of thrombolysis was indicated in urgency, and the patient benefited from thrombolysis, which proceeded without incidents; the outcome was favorable with regression of symptoms.Ischemic stroke has been widely described among the thromboembolic complications of COVID-19, but only a few papers have reported it as a primary manifestation of COVID-19. CONCLUSION: SARS-COV 2 infection can spread from the respiratory system to the central nervous system, resulting in an inflammatory response and excessive secretion of inflammatory markers, leading to ischemic stroke.