A giant adrenal cyst with an uncertain preoperative diagnosis causing a dilemma in management.

Giant Adrenal cysts are rare differentials of retroperitoneal cysts that often present dilemma in diagnosis. A man presented with a huge retroperitoneal cyst and an uncertain preoperative diagnosis. Initial working diagnosis of urinoma and an attempt at drainage had to be abandoned for complete excision before obtaining a histological diagnosis.

Rare huge retroperitoneal cystic lymphangioma presenting as acute abdomen in an adult.

Cystic lymphangiomas are rare benign tumors. Most are diagnosed in childhood and their presentation in adults is rare. Retroperitoneal cystic lymphangiomas constitute only 1% of lymphangiomas. Unfortunately the differentiation between cystic lymphangiomas and other cystic tumors is often not possible and surgery with histology is essential for confirmation of diagnosis. A 20-year-old lady with retroperitoneal cystic lymphangioma presented with acute abdomen. In the diagnosis of this patient, abdominal Ultrasound, CT and MRI scans were obtained.

Solitary massive lipoma in the planter aspect of great toe presenting as two masses.

Lipoma is rare in the planter aspect of the toes, and only few cases of massive lipoma have been reported in this site. The differential diagnosis of masses in the foot and toes is wide, and clinical diagnosis may be challenging. Access to magnetic resonance imaging, a standard diagnostic investigation for such soft tissue masses of the foot and toes, may be limited in some practice, requiring a reliance on clinical signs. We report a solitary massive lipoma in the planter aspect of the right great toe that appeared as two masses and with modification of typical clinical signs of lipoma.

Rare small intestinal volvulus from entrapment in hepato-diaphragmatic adhesions in a 45-year-old lady.

Small intestinal volvulus is rare in adults and rarely caused by string adhesions between the liver and the diaphragm. Similar adhesions were described in Fitz-Hugh-Curtis syndrome. We report a 45-year-old lady with small intestinal volvulus from entrapment of a loop in string adhesions between the liver and the diaphragm. Her plain radiographs showed a significant shadow of the trapped loop.

Huge mucinous cystadenoma of the pancreas mistaken for a pseudocyst.

Cystic tumors of the pancreas are rare and can be confused with pseudocysts.We present a 50 year old woman with a huge mucinous cystadenoma of the pancreas initially diagnosed and managed with a cystojejunostomy and cyst wall biopsy. She required another laparotomy and tumor excision after histological diagnosis. Sensitivity of radiological imaging in differentiating between cystic pancreatic tumors and pseudocysts is limited. Cyst wall histology is diagnostic and biopsy of cyst wall should be done in cases with inconclusive preoperative diagnosis or questionable operative findings.