Gastrointestinal stromal tumors (GISTs) occurring outside the gastrointestinal tract are known as extragastrointestinal stromal tumors (EGIST). They share some common histopathologic and molecular characteristics. This report describes two female patients who were suspected of having a mesenteric GIST, but opted for surveillance rather than definitive treatment. Upon reassessment, both patients demonstrated increased tumor mass with no evidence of distant metastasis. The intraoperative findings confirmed the conclusion of clinical and imaging studies performed preoperatively and radical excisions were performed. Histopathological examination (spindle cell neoplasm) and immunohistochemistry (CD117) confirmed EGIST. Both patients underwent Imatinib therapy following surgery with no evidence of disease recurrence or metastasis upon follow up. Although sharing histologic features with GIST, EGIST frequently demonstrates distinct characteristics that facilitate the proper diagnosis and management of EGIST. Since it is a rare and aggressive disease with a poor outcome, early detection and curative surgical resection remains the mainstay of treatment.

Highlights Chronic partial jejunal obstruction leading to various non specific abdominal symptoms since 40 years. The first reported case of Lapsi seed stones causing partial jejunal obstruction. No change in morphological features of Lapsi seed stones when resided for long within human Gastrointestinal tract. First demonstration of radiological features of Lapsi seed stones both in vivo as well as in vitro. When patient not evaluated by non-physician and non-surgeon could delay diagnosis and improper treatment.

Hypertriglyceridemia led acute pancreatitis secreted exudative fluid tacked to the right iliac fossa may cause irritation of retroperitoneum leading to acute periappendicular inflammation and acute appendicitis.

Introduction: Skeletal tuberculosis accounts for approximately two percent of all infected tuberculosis (TB). Magnetic resonance imaging (MRI) due to its inherent soft tissue contrast is a very good tool to diagnose the condition and look for its extent and deformities. This study aims to study the MRI findings in a patient with diagnosed case of spinal tuberculosis. Methods: The study was carried out in a referral diagnostic imaging center in western Nepal. All MRI studies of the spine performed in a patient with diagnosed spinal tuberculosis during the study period were included in the study. Patients lacking microbiological or pathological diagnoses of spinal tuberculosis were excluded from the study. Results: A total of 70 patients were included in the study. The mean age of the patients was 45.6 ± 16.8 years. All patients in the study had a spondylodiscitis pattern of involvement. Single intervertebral disc and adjacent vertebrae were involved in 85.7% and multiple contiguous vertebrae and IV discs were involved in 14.3% of cases. Gibbus deformity was seen in 17.1% of cases. Pre/paravertebral and Epidural collections were seen in 95.7% and 72.9% of patients respectively, whereas psoas abscess was seen in 28.6% of patients. Cord compression with myelopathy was seen in 8.6% of patients. Involvement of posterior elements was seen in 27.1% of patients. Conclusion: MRI is an excellent tool to see the extent, deformity, and abscess in spinal tuberculosis. Most patients with tuberculosis present late with collections and deformities.