Primary Pancreatic Choriocarcinoma Presenting as Pancreatitis

Context Pancreatic cancers can present with pancreatitis or its complications. Pancreatic choriocarcinoma is an extremely rare disease to involve pancreas. Case report A 27-year-old married woman presented to our facility with abdominal pain and fullness of 20-day duration. She was clinically diagnosed as acute pancreatitis with pseudocyst as a complication. Serum amylase was elevated with CT scan of abdomen showing a cystic lesion involving the pancreas. We approached the cyst with endoscopic ultrasonography and cyst fluid was aspirated and analyzed. Cyst fluid amylase was elevated and cytology revealed germ cell tumor. Serum beta human chorionic gonadotropin was elevated. She had a swelling over the jaw which also revealed choriocarcinoma in histopathological examination. Patient was started with chemotherapy. Conclusion We report this case of pancreatic choriocarcinoma due to its extreme rarity and the diagnostic dilemma it posed

Interesting Cystic Lesions of Pancreas in Septuagenarians

Intraductal papillary mucinous neoplasms are rare pancreatic tumours which can mimic more common diagnoses like pancreatic pseudocysts or pancreatic mass. Here we describe two of our cases who presented with abdominal pain and weight loss and were diagnosed to have Intraductal Papillary Mucinous Neoplasm (IPMN) after Endoscopic Ultrasound-guided Fine Needle Aspiration (EUS FNA) which was crucial in clinching the diagnosis

Multicentric ameboma of the colon mimicking Crohn℉s disease

Entamoeba histolytica infection can lead to colitis, colonic perforation abscess, and ameboma formation. Amebic colitis is common in developing countries, with its varied and nonspecific symptoms. Amebomas can occur rarely due to the formation of excess granulation tissue which usually occurs in cecum and ascending colon. A 64-year-old lady presented with abdominal pain and mass in the right side of abdomen. Imaging showed multicentric colonic masses. On colonoscopy multiple stricturizing ulcerated lesions involving cecum, ascending, proximal transverse colon, and splenic flexure were seen, which were suggestive of Crohn′s disease or multicentric neoplasm. Histopathological examination revealed multicentric lesion with focal necrosis and trophozoites of E. histolytica. Diagnosis of ameboma was made and antiamoebic treatment was started. She had full resolution of symptoms. We present this case since it is a case of ameboma, a rare complication of amebic colitis with an extremely rare presentation of multiple ulcerated stricturizing lesions, involving cecum, ascending, transverse colon, and splenic flexure which typically resembled Crohn′s disease

Esophagojejunal anastomotic leak managed with self expandable metallic stent

Esophagealjejunal anastomotic leak after gastrectomy is a serious surgical emergency with high mortality. This report describes a 57-year-old male with esophagojejunal anastomotic leak following total gastrectomy for gastric cancer and was managed successfully with self-expandable metallic stent. To our knowledge this is the first such report from India. This case report highlights the need of interdisciplinary coordination in managing this difficult clinical situation. Endotherapy with self-expandable metallic stent (SEM) provided twin benefits of improving respiratory embarrassment and the joy of eating. Therapy of such difficult cases must be individualized; however, and SEM stent usage is a viable optio