A rectosigmoid haemangioma: A rare etiology of rectal bleeding.

Cavernous haemangiomas of the rectosigmoid colon are rare benign vascular neoplasms of the GI tract. Patients usually present at a younger age with various degree of rectal bleeding ranging from mild painless episodic bleeding to life-threatening hemorrhage. High index of suspicion and early diagnosis is crucial to avoid unnecessary biopsy and inappropriate management. We report a case of a 26-year-old male patient with a long history of recurrent rectal bleeding. Contrast-enhanced CT scan of the abdomen and pelvis and MRI confirmed the diagnosis of cavernous hemangioma. Further surgical treatment with rectosigmoid resection and colo-anal anastomosis represents the optimum path of management for our patient.

Giant appendiceal mucocele as a first manifestation in a patient with silent ulcerative colitis: A case report.

Appendiceal mucocele (AM) is a rare lesion found in only 0.3% of all appendectomies and it is characterized by distention of the appendix by the accumulating intraluminal mucinous material. Four main histopathological subtypes of appendiceal mucocele has been described including: retention cyst, mucosal hyperplasia, mucinous cystadenoma, and cystadenocarcinoma. We report a case of 48-year-old middle eastern female, previously healthy, presented to the primary health center with right iliac fossa discomfort, and referred to our hospital for further evaluation. Contrast enhanced computed tomography of the abdomen and pelvis and focused ultrasonography over the right iliac fossa showed the characteristic CT and sonographic appearance of appendiceal mucocele. An additional incidental note of lack of colonic haustral pattern involving the rectum and descending colon was noted on abdominal CT raising the suspicion of Ulcerative Colitis which was then confirmed by colonoscopy and histopathology. Although no causal relationship between appendicular mucocele and inflammatory bowel disease has been established yet and few case reports had reported appendicular mucocele in patients with ulcerative colitis, close surveillance in these patients, and early recognition of the characteristic imaging features is crucial in preventing dreadful complications like pseudomyxoma peritonei.

A rare case of pleuropulmonary synovial sarcoma of the chest wall: A case report and a literature review.

Pleuropulmonary synovial sarcoma is a subtype of synovial sarcomas that commonly arises from the chest wall, pleura, lungs and the heart. They are extremely rare, with only a few cases reported in the literature. It usually affects young and middle-aged adults with no gender predilection. Chest radiographs usually show a pleural-based mass, parenchymal consolidation, or a near complete opacification of the hemithorax. On contrast-enhanced CT, synovial sarcomas of the chest wall typically appear as a well-defined, heterogeneously enhancing mass with bone destruction and infiltration of chest wall musculature. MRI usually demonstrates a heterogeneous mass with areas of both high and low T1 signal intensities representing areas of hemorrhage and necrosis. We report a case of a 39- year old African male patient who presented to our hospital complaining of chest pain of 4 months duration. The plain chest radiograph showed complete opacification of the left hemithorax. Contrast-enhanced CT and MRI were then performed revealing a large left-sided heterogeneous mass. PET-CT demonstrated avid FDG uptake in the solid components of the mass with no evidence of distant metastasis.. An ultrasound-guided biopsy was performed, and histopathology revealed a locally advanced primary synovial sarcoma of the chest wall. Treatment consisted of neoadjuvant chemotherapy followed by surgical resection.