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Background Gastric metastasis from melanoma is rare and often presents as an unexpected finding, rarely revealing an underlying primary skin melanoma. Case presentation We report a case of a 62-year-old male who presented with abdominal pain, dyspepsia, anorexia, and weight loss. On physical examination abdominal masses and hepatomegaly were detected. Radiological imaging showed widespread masses in the abdominal and thoracic regions. Upper gastrointestinal endoscopy identified an umbilicated protruded lesion with central dark pigmentation at the antro-fundic junction. Histopathological examination and immunohistochemical staining were consistent with melanoma. A subsequent rigorous skin examination uncovered a primary malignant skin melanoma. Due to worsening general condition, the patient received palliative hospice care. Conclusion This report highlights the critical need for vigilant skin examination when dealing with widespread metastatic disease.

Treatment of diffuse large B-cell lymphoma (DLBCL) is based on immunochemotherapy with overall good outcomes. Complications related to the treatment or the disease itself can occur during follow-up. We herein report a case of a 37-year-old male who was diagnosed with stage IV gastric DLBCL. Subsequently, he underwent R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone) chemotherapy. After six cycles of treatment, complete remission has been achieved. But afterwards, the patient presented with a symptomatic gastric obstruction related to a tight stenosis in the antro-fundic junction. Endoscopic dilation was performed and multiple macrobiopsies within the stenosis were taken. Pathological examination concluded to the fibrous character of the stricture. In cases of post-chemotherapy obstruction in gastric DLBCL, endoscopic treatment should be attempted carefully in patients with no evidence of active lymphoma. Diagnosis of fibrosis can avoid surgery and its morbidity.

Hepatic angiomyolipoma (HAML) is an uncommon primary liver tumor with limited reported cases in the literature. It is composed of varying amounts of fat, smooth muscle, and blood vessels, typically non-malignant proliferation. It usually presents diagnostic challenges due to diverse imaging characteristics. We present a case of a 50-year-old female with a small HAML causing mild abdominal pain. It displayed radiographic characteristics mimicking hepatocellular carcinoma (HCC), and subsequent diagnosis was established upon histopathological findings of liver biopsy. The patient was radiologically monitored, and then she underwent surgical resection later on because of the size increase. Follow-up showed no signs of recurrence at 3 months. This case highlights the importance of histologic diagnosis of HAML if there are suggestive imaging features, given the variety of differential diagnoses. Symptoms or tumor growth is to be considered as warning signs that should lead to surgical resection, which remains the primary treatment modality.

We report the case of a bile duct traumatic neuroma in a 76‐year‐old man who presented with obstructive jaundice one year after cholecystectomy. Despite the radiological examinations, the preoperative diagnosis was difficult. The patient underwent a biliary resection with choledoco‐duodenal anastomosis We report the case of a bile duct traumatic neuroma in a 76‐year‐old man who presented with obstructive jaundice one year after cholecystectomy. Despite the radiological examinations, the preoperative diagnosis was difficult. The patient underwent a biliary resection with choledoco‐duodenal anastomosis

We present the case of a 65‐year‐old man without a past medical history who was admitted for gastrointestinal bleeding. The case shows an acquired double pylorus due to probable pre pyloric ulcer. Gastroduodenal fistula remains a rare inexplicable entity that can be congenital or acquired. If we consider our case as acquired DP, then the association with gastrointestinal bleeding appears to be an unusual complication of peptic disease. Congenital DP may account for our finding, also observed in the absence of peptic history.

Castleman's disease is a rare disease characterized by benign lymphoepithelial proliferation. There are two forms: unicentric and multicentric Castleman's disease. Mediastinal location is the most frequent. Intra-abdominal Castleman's disease is a rare presentation. We report a case of 65-year-old female who presented with epigastric pain. Investigations revealed a retroperitoneal mass which was surgically resected. Histopathological examination showed hyaline-vascular type Castleman's disease. In conclusion, Castelman´s disease is a diagnostic challenge and it must be included in the differential diagnosis of retroperitoneal tumors.

Introduction Helicobacter pylori (H. pylori) eradication is a continuously challenging issue as antibiotic resistance is evolving and adversely affecting outcomes of previously effective treatments. Continual assessment and modification of therapeutic approaches is necessary. Aim The aim of our study was to evaluate H. pylori eradication rate in Tunisian patients treated by non-bismuth quadruple therapy and to investigate treatment failure factors. Methods We conducted a prospective multicentric study including patients with H. pylori infection. For all patients, concomitant therapy (amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg plus esomeprazole 40 mg) twice daily for 14 days was prescribed. Mutations conferring resistance of H. pylori to clarithromycin were detected using polymerase chain reaction on gastric biopsies. Eradication was assessed using the urea breath test. Results 414 patients were included. The mean age was 44.7 ± 14.3 with a sex ratio of M/F = 0.53. Mutations conferring resistance of H. pylori to clarithromycin were observed in 76 patients (18.35%). During follow-up, adverse effects to treatment occurred in 34.5% of patients. Eradication rate was 88.2% (95% CI: [85.1–91.3]) in per protocol analysis. In multivariate analysis, female gender (OR:2.924, 95% CI (1.340–6.380), p  = 0.009) and the presence of clarithromycin resistance gene (OR:4.671, 95% CI (2.444–8.925), p  < 0.001) were predictors of treatment failure. Conclusion Concomitant therapy showed an eradication rate below 90% in Tunisian patients, mainly due to clarithromycin resistance and female gender. However, non-bismuth quadruple therapy remains a viable alternative option, achieving eradication in more than 8 out of 10 patients. Clinical trial Not applicable

Abstract Background Gastric metastasis from melanoma is rare and often presents as an unexpected finding, rarely revealing an underlying primary skin melanoma. Case presentation We report a case of a 62-year-old male who presented with abdominal pain, dyspepsia, anorexia, and weight loss. On physical examination abdominal masses and hepatomegaly were detected. Radiological imaging showed widespread masses in the abdominal and thoracic regions. Upper gastrointestinal endoscopy identified an umbilicated protruded lesion with central dark pigmentation at the antro-fundic junction. Histopathological examination and immunohistochemical staining were consistent with melanoma. A subsequent rigorous skin examination uncovered a primary malignant skin melanoma. Due to worsening general condition, the patient received palliative hospice care. Conclusion This report highlights the critical need for vigilant skin examination when encountering gastric lesions with dark pigmentation, which led to the identification of initially undetected cutaneous melanoma.

Abstract Background Melanoma, an aggressive malignant skin cancer, has the ability to spread both locoregionally and to distant sites. The risk of metastasis is correlated to invasion depth and the presence of ulceration. Although gastrointestinal (GI) metastases are uncommon, gastric involvement is particularly rare. Case presentation We report a case of a 62-year-old male who presented with abdominal pain, dyspepsia, anorexia, and weight loss. On physical examination abdominal masses and hepatomegaly were detected. Radiological imaging showed widespread masses in the abdominal and thoracic regions. Upper GI endoscopy identified an umbilicated protruded lesion with central dark pigmentation at the antro-fundic junction. Histopathological examination and immunohistochemical staining were consistent with melanoma. A subsequent rigorous skin examination uncovered a primary malignant skin melanoma. Due to worsening general condition, the patient received palliative hospice care. Conclusion This report highlights the critical need for vigilant skin examination when encountering gastric lesions with dark pigmentation, which led to the identification of initially undetected cutaneous melanoma.

Abstract Background Gastric metastasis from melanoma is rare and often presents as an unexpected finding, rarely revealing an underlying primary skin melanoma. Case presentation We report a case of a 62-year-old male who presented with abdominal pain, dyspepsia, anorexia, and weight loss. On physical examination abdominal masses and hepatomegaly were detected. Radiological imaging showed widespread masses in the abdominal and thoracic regions. Upper gastrointestinal endoscopy identified an umbilicated protruded lesion with central dark pigmentation at the antro-fundic junction. Histopathological examination and immunohistochemical staining were consistent with melanoma. A subsequent rigorous skin examination uncovered a primary malignant skin melanoma. Due to worsening general condition, the patient received palliative hospice care. Conclusion This report highlights the critical need for vigilant skin examination when dealing with widespread metastatic disease.