A Neglected Case of Multifocal Liposarcoma Presented in Five Different Sites in a Syrian Woman: A case report.

INTRODUCTION: Multifocal soft tissue sarcoma is a rare clinical entity occurring in 1 % of patients with extremity soft tissue sarcoma and in 4.5 % of patients with liposarcoma. Multifocal disease may arise either synchronously or metachronously and has been associated with poor prognosis. CASE PRESENTATION: Herein, we report a rare case of a Syrian woman patient with six different foci of liposarcoma in five sites at the time of diagnosis. DISCUSSION: Liposarcomas are currently classified into four different subtypes based on histologic or genetic analysis according to the World Health Organization (WHO), including cell-differentiated, dedifferentiated, myxoid, and pleomorphic. In the present work, we report a neglected patient with a multicentric round cell liposarcoma in five different sites. CONCLUSION: Medicine cannot provide much care for these advanced cases of multicentric liposarcoma so far. Therefore, more research should be conducted to improve the ability to manage these entities and to identify potential novel therapies.

Small bowel obstruction due to a phytobezoar thirty years after Roux-en-Y gastrojejunostomy: A case report.

INTRODUCTION: We present a case of a delayed small bowel obstruction due to a phytobezoar in a patient with a previous surgical history. PRESENTATION OF CASE: A 73-year-old male patient presented with vomiting and obstipation for a week. His past surgical history included a Roux-en-y gastrojejunostomy due to a surgical management for peptic ulcer disease 30 years ago. Abdominal computed tomography demonstrated a dilation of small bowel with air-fluid levels. He was diagnosed with acute bowel obstruction. On exploration, we found a compressible mass 150 cm from the jejunojejunostomy anastomosis. An enterotomy was performed and the mass was milked back. It was a phytobezoar. After the bezoar removal, his complaints relieved completely. DISCUSSION: Small bowel obstruction after abdominal surgery (Roux-en-y gastrojejunostomy) is a complication that may present early or late for many causes. One of the unusual underlying causes is phytobezoar. CONCLUSION: This case aims to raise awareness of phytobezoar as a cause of small bowel obstruction even in delayed presentation.