Diagnosing and managing small bowel neuroendocrine tumors presenting as acute obstruction in an elderly patient: A case report and comprehensive management overview.

INTRODUCTION AND IMPORTANCE: Neuroendocrine tumors (NETs) of the small bowel are rare but clinically significant due to their challenging diagnostic pathways and potential for insidious progression. Early identification is critical for effective management and improved prognosis in these cases. CLINICAL PRESENTATION: Here, we present a case of a 75-year-old patient with no significant medical history who presented acutely with diffuse abdominal pain, vomiting, and signs of bowel obstruction. Diagnostic workup, including CT imaging, revealed a distal ileal neuroendocrine mass with mesenteric lymphadenopathy, necessitating urgent surgical intervention. DISCUSSION: This case underscores the diagnostic complexities and therapeutic challenges associated with small bowel NETs. Surgical resection with meticulous lymph node dissection remains the cornerstone of treatment, aimed at achieving complete tumor excision and optimal disease control. The role of imaging modalities and biochemical markers in guiding clinical decisions and postoperative management strategies is discussed considering the patient's clinical course. CONCLUSION: Timely recognition and intervention are crucial in the management of small bowel NETs, given their potential for late presentation and nonspecific symptoms. Despite diagnostic and procedural challenges highlighted in this case, early surgical intervention and comprehensive follow-up are essential for achieving favorable outcomes and minimizing recurrence risks in patients with small bowel NETs.

Doubly complicated: A case of massive non-parasitic liver cyst presenting with dyspnea and inferior vena cava compression: A rare case report.

INTRODUCTION AND IMPORTANCE: Simple hepatic cysts, common benign liver conditions, are increasingly detected incidentally due to advancements in imaging technologies. While typically asymptomatic, complications such as compression of neighboring structures can arise, presenting unique diagnostic and management challenges. We present a doubly complicated case of a massive non-parasitic liver cyst in a 61-year-old female patient, manifesting with dyspnea and compression of the inferior vena cava. CASE PRESENTATION: A 61-year-old female with a history of treated hypertension presented with worsening dyspnea over six months. Physical examination revealed a large, painless abdominal mass, and imaging confirmed a 20 cm cystic liver mass compressing the inferior vena cava and exerting a mass effect on the diaphragm. Surgical exploration and deroofing of the cyst led to successful resolution. CLINICAL DISCUSSION: The presentation of dyspnea in non-parasitic liver cysts is rare but notable, highlighting the importance of considering hepatic etiologies in respiratory symptoms. Imaging modalities such as ultrasound and CT play crucial roles in diagnosis, while MRI aids in ruling out biliary-cystic fistulas. Surgical management, particularly subcostal laparotomy, remains a viable option for complex cases. CONCLUSION: This case underscores the need for heightened awareness of atypical presentations of non-parasitic liver cysts and the significance of imaging in diagnosis. Subcostal laparotomy, though associated with limitations, remains valuable in select cases. Further research comparing surgical approaches is warranted to optimize management strategies for symptomatic non-parasitic liver cysts.

A rare case report: Huge ileal leiomyoma: Clinical presentation, management, and implications.

INTRODUCTION AND IMPORTANCE: Leiomyomas, commonly known as fibroids, are benign soft tissue tumors mostly found in the uterus. Although predominantly uterine, they can occur rarely in other areas, notably in the gastrointestinal tract. This article emphasizes an unusual case: an ileal leiomyoma in a 54-year-old patient, showcasing the distinct diagnostic and management challenges it presents. CASE REPORT: A 54-year-old female with no prior medical history presented with a progressively enlarging, painful abdominal mass over six months. Imaging suggested a Gastrointestinal Stromal Tumor (GIST), but guided biopsy yielded an unexpected diagnosis of ileal leiomyoma. Subsequent surgical intervention successfully removed the tumor, leading to an uneventful postoperative recovery. CLINICAL DISCUSSION: This case underscores the diagnostic intricacies and clinical manifestations of ileal leiomyomas. While diagnosis can be challenging, timely histopathological evaluation is crucial. Surgical resection guided by pathological findings played a pivotal role in this patient's care, emphasizing the need for a comprehensive approach to diagnosis and treatment in unique medical cases. CONCLUSION: The rarity of ileal leiomyomas presents a substantial challenge in the medical field, where expertise can be limited. This case emphasizes the pivotal role of histopathological analysis in confirming the diagnosis and guiding effective surgical management.