Primary tuberculoma of the liver: a case report and literature review

We report the case of an immunocompetent patient with an isolated tuberculoma of the liver, which was diagnosed by percutaneous US-guided liver biopsy. The patient received an antitubercular therapy, and there has been no relapse to date

A rare cause of acute esophageal necrosis: A case report

Acute esophageal necrosis (AEN) or black esophagus is a rare entity characterized by diffuse circumferential black pigmentation of the esophageal mucosa due to ischemic necrosis. It may be lethal, especially among elderly patients with multiple comorbidities and hemodynamic instability. Diagnosis is based on gastroscopy. Treatment consists of intravenous fluids, proton pump inhibitors, and additional therapies to treat the underlying illness. We report a rare case of a woman in her 50s with cervical cancer who presented with hematemesis and sepsis. Upper gastrointestinal endoscopy showed a black esophagus and an ulcerobudding duodenal process. Few days later, she developed abdominal distension with diffuse pain. Abdominal CT scan demonstrated perforation of gastroduodenal tumor. The treatment was based on resuscitation, proton pump inhibitors, antibiotics, and surgery of the perforated tumor. Unfortunately, the patient died 2 days later because of septic shock. The black esophagus is a fatal complication, thus diagnosis at an early stage and timely management may improve survival. This is the first case reported of AEN due to perforated duodenal tumor explained by septic shock leading to an ischemic esophageal injury

A rare cause of rectal bleeding in a 48-year-old lupus patient

Cavernous hemangiomas represent a rare benign cause of rectal bleeding. It corresponds to a vascular malformation that can be located anywhere in the gastrointestinal tract. Our paper reports the case of a 48-year-old woman treated for cutaneous lupus who presented to our department with intermittent moderate rectal bleeding. The Hemoglobin level was normal. A colonoscopy showed a congestive nodular red-purple vascular formation. At Computerized tomography (CT)-Scan, the lesion appeared as an irregular thickening of the posterior rectal wall, invading the meso-rectum. Magnetic resonance imaging (MRI) showed a submucosal mass of the rectum containing phleboliths with progressive enhancement in the T2 sequence. Diagnosis of rectal cavernous hemangioma was confirmed. Surgery is the most appropriate treatment for this condition, but since bleeding was not important and had no biological repercussions, multidisciplinary experts meeting decided not to operate on the patient and continue monitoring

Primary pancreatic lymphoma: Report of 4 cases with literature review

Pancreatic cancer (PC) is ranked as the 14th most common cancer and the 7th leading cause of cancer-related deaths. The most common histological type is adenocarcinoma, other type such as primary pancreatic lymphoma (PPL) still very rare. Due to the lack of specific clinical and imaging characteristics, the diagnostic of PPL remains challenging. We report 4 cases of PPL diagnosed and managed at our gastroenterology department between 2019 and 2023. Case 1: A 16-year-old male presented with abdominal pain, jaundice, and weight loss. Imaging revealed an 8 cm tumor in the pancreas, subsequent biopsies confirming Burkitt's lymphoma. Despite chemotherapy, the patient succumbed to the disease. Case 2: A 92-year-old female with no prior medical history presented with abdominal pain, jaundice, pruritus, and weight loss. Imaging revealed a large pancreatic mass, and biopsies identified large B-cell lymphoma. Unfortunately, the patient passed away before treatment initiation. Case 3: A 63-year-old male with a history of tobacco smoking presented with abdominal pain, weight loss, and anorexia. Imaging and biopsies confirmed diffuse large cell B-phenotype lymphoma. The patient achieved complete remission after rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP) therapy. Case 4: A 67-year-old man with jaundice, abdominal pain, and weight loss was diagnosed with diffuse large cell B lymphoma through imaging and fine needle aspiration (FNA). The patient responded well to R-CHOP therapy. In conclusion, PPL is an uncommon tumor, with no specific clinical or radiological characteristics. A thorough evaluation of clinical, radiological, biological and histological data is necessary to consider it as a differential diagnosis and ensure accurate and timely management

Association between pancreatic cancer and diabetes: insights from a retrospective cohort study

Abstract Background Studies investigating the prevalence of pancreatic cancer have revealed a heightened risk of 1.5 to 2.0 times among individuals with long-standing type 2 diabetes mellitus. Aims We aimed to estimate the prevalence of diabetes among patients with pancreatic cancer, and identify the factors associated with type 2 diabetes mellitus in this population. Methods This retrospective observational and analytical study was carried out in the Department of Gastroenterology of the Mohammed VI University Hospital over a period of 5 years, between 2018 and 2022, including all patients with confirmed cases of pancreatic adenocarcinoma. Results Out of the 197 patients, 38.1% had a history of diabetes, among them, 42.7% had new-onset diabetes, while the remaining 57.3% had long-standing diabetes. Diabetic patients were significantly older than nondiabetic patients (mean age of 67.2 vs. 63, P = 0.009). Diabetes was more prevalent among obese patients (66.7%, P = 0.01), and less frequent among individuals with chronic alcohol consumption (20% vs. 80%, P = 0.04), and tobacco smokers (24.4% vs75.6%, P = 0.03). Among patients with an ECOG score ≥ 3, DM, 54.5% were DM-patients (P = 0.033). The same significant association was found for the Nutritional Risk Index, Patients who had moderate or severe malnutrition were more likely to be diabetic 74.7% (P = 0.004). Diabetic patients were less likely to undergo surgery due to comorbidities and general health deterioration. However, no significant differences were observed in sex, tumor stage or location. Conclusion Our study has shown an increased prevalence of diabetes in pancreatic cancer and highlights the importance of considering this cancer in cases of recent onset or uncontrolled diabetes, especially in elderly individuals

Acute pancreatitis related to hypercalcemia as initial manifestation of cancer: About 4 cases

Acute pancreatitis is a frequent gastrointestinal emergency seen in tertiary care hospitals. While gallstones and chronic alcohol consumption remain the most common causes, other etiologies can also be identified, notably hypercalcemia, which constitutes a rare yet deadly cause of acute pancreatitis. Herein, we report 4 cases of AP related to hypercalcemia from malignancies: 2 cases of multiple myeloma, one case of rectal malignancy, and 1 case of medullary thyroid carcinoma associated with a parathyroid adenoma. Among these cases, one patient died, one developed exocrine and endocrine pancreatic insufficiency, and another progressed to end-stage chronic renal failure. Awareness of hypercalcemia of malignancy as an exceptional etiology of AP is crucial for timely diagnosis and appropriate management of these cases

Signet-ring cell carcinoma of the caecum: A case report

Colorectal cancer (CRC) ranks as the third most prevalent cancer globally, with adenocarcinomas being the most frequent type. Signet ring cell carcinoma (SRCC) is a very rare subtype of adenocarcinoma, it commonly occurs in the stomach. However, other digestive localizations are possible including the colon, rectum, and gallbladder. Herein, we report a rare case of a metastatic caecal SRCC in a young male patient, presented to our department for abdominal diffuse pain and distention evolving for 3 months, associated with remarkable weight loss and asthenia. The clinical examination revealed abundant ascites and abdominal tenderness. Laboratory tests showed an elevated C-reactive protein at 35 mg/l (normal value: 13 g/dl), increased carcinoembryonic antigen (CEA) levels, as well as CA 19-9 and CA-125.The abdominal scan showed irregular and asymmetrical thickening with peripheral speculation of the caecum measuring 2.1 cm *5.8 cm. Additionally, adjacent adenopathies, abundant ascites, and peritoneal carcinomatosis were observed to be associated with suspicious bilateral pulmonary nodules and micronodules. The colonoscopy identified a bulging ulcerative tumor of the ileocecal valve extended to the ileum. Further histologic examination confirmed the presence of signet-ring cell carcinoma. The patient was referred to the medical oncology department to initiate palliative chemotherapy following a multidisciplinary consultation meeting. We can underline that SRCC of the caecum is a rare entity with a bad prognosis. Usually, the diagnosis is made at late stages due to the lack of obvious symptoms earlier