Unusual Upper Gastrointestinal Bleeding Due to a Neuroendocrine Tumor Arising in Meckel Diverticulum.

Meckel diverticulum is the most common congenital variation of the gastrointestinal tract arising from incomplete obliteration of the vitelline duct during gestation. In most cases, individuals are asymptomatic. This is a case of a 38-year-old patient with hematochezia in whom Meckel diverticulum was diagnosed. A mass was identified within the diverticulum. Histopathological and immunohistochemical studies revealed a well-differentiated neuroendocrine tumor. The development of tumors in Meckel diverticulum is rare, and when identified, only 0.5%-3.2% of these tumors are found to be malignant. Furthermore, gastrointestinal bleeding is an infrequent clinical feature of neuroendocrine tumors. A unique aspect of this case was that numerous imaging studies and endoscopic procedures were unable to definitively identify the presence of Meckle diverticulum and underlying neuroendocrine tumor. Through a high clinical suspicion and collaboration with surgical colleagues, an exploratory laparotomy was performed, which ultimately led to the identification and diagnosis of the underlying pathology.

Slow and Steady: A Slowly Progressing Neuroendocrine Tumor.

Neuroendocrine tumors (NETs) are rare malignant tumors that arise from neuroendocrine cells throughout the body, most commonly in the gastrointestinal and respiratory tracts. We report a case of well-differentiated grade 2 NET with a computed tomography scan showing multiple liver lesions consistent with the liver lesions seen 11 years before diagnosis. This case highlights the possibility of an indolent or prolonged clinical course of metastatic NET with an unknown primary vs primary hepatic NET.

Retroperitoneal Bronchogenic Cyst: A Rare Case Study.

Bronchogenic cyst usually presents along the tracheobronchial tree. Rarely, it is found inside peritoneal cavity. Here is a case of 30-year-old man who presented with concerns of abdominal pain. On evaluation, contrast-enhanced CT scan showed hypodense cystic lesion in epigastric region related to right crus of diaphragm. The patient underwent laparoscopic marsupialization/deroofing of cyst. Histopathological examination of resected specimen showed respiratory epithelium. Postoperative period was uneventful.

No lesion? No problem: case of oesophageal lichen planus in a patient without any cutaneous lesions.

Oesophageal lichen planus (ELP) is an uncommon presentation of mucocutaneous lichen planus. Due to its rare nature, it can often be misdiagnosed. As such, there can be a significant delay between symptom onset and diagnosis. ELP drastically reduces quality of life secondary to the severe dysphagia and odynophagia that typically accompany this pathogenesis. Additionally, it is important to diagnose ELP in a timely manner as ELP increases the risk of squamous cell carcinoma, with reported cases of malignant transformation. More research is needed on ELP with regard to diagnostic criteria and evidence-based therapeutic recommendations.

A Rare Case of Epididymal Cyst Due to Schistosomiasis.

Schistosomal epididymitis is a very rare condition. Worldwide, very few cases have been reported, especially in India. Here is a case of schistosomal epididymitis that was found on histopathological examination of an epididymal cyst in a 32-year-old man in India. Patient presented with concerns of a right testicular swelling. Ultrasonography of scrotum showed an ill-defined echogenic lesion just above the head of right epididymis. Excision of epididymal cyst was performed. Histopathological examination showed eggs of schistosoma surrounded by abundant inflammatory infiltrate. Post-operatively, the patient was treated with single dose of praziquantel.

Where's the ulcer? Spontaneous bleeding from Zenker's diverticulum.

An 89-year-old man with a history of coronary artery disease status post coronary artery bypass grafting and atrial fibrillation on aspirin and warfarin, presented to the emergency department with a symptom of haemoptysis. He reported a history of dysphagia for 3 months prior to presentation, but had yet to seek medical attention. On presentation, he was hypotensive and tachycardic with a haemoglobin of 6.6 g/dL and an International Normalised Ratio (INR) of 3.9. Esophagogastroduodenoscopy was performed and showed active bleeding from Zenker's diverticulum. The patient's INR was reversed with fresh frozen plasma and his anaemia was treated with packed red blood cells. The bleeding stopped after reversal of his INR. A barium swallow confirmed a 9 cm Zenker's diverticulum. The patient had a diverticulectomy and cricopharyngeal myotomy. Histology showed mild chronic inflammation of the mucosa, but no ulceration. The patient was discharged without any further bleeding episodes.

Firsts in cardiology: milestones and vital discoveries.

The modern day cardiology practice thrives on the extraordinary discoveries made in the understanding of the cardiovascular science and in the development of diagnostic and therapeutic methods. In this paper, the milestones and vital discoveries in the field of cardiology are described in chronologic order.