Gastrointestinal stromal tumors (GIST) are uncommon mesenchymal spindle-cell or epithelioid neoplasms, located mainly with higher frequency in the stomach and small bowel. GISTs represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein a transmembrane tyrosine kinase receptor for stem cell factor. Extra-gastrointestinal stromal tumors tend to present In fewer than 5% of cases; they originate primarily from the mesentery, omentum or peritoneum. Furthermore, these extra-gastrointestinal tumors (EGIST) tend to be more common in patients over the age of 50 years. EGISTs are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall. We describe here a rare case of EGIST of the lesser omentum and report the clinical, macroscopic, immunohistological and radiological features of an EGIST arising in the lesser omentum of a 63-year old man. Clinical course and the prognostic factors of such lesions will also be discussed. EGISTs in the lesser omentum can grow slowly and remain silent despite a large tumor size. In most cases, a pre-operative diagnosis is not possible, and the patient undergoes a surgical operation for the generic diagnosis of abdominal mass. During the intervention it is important to achieve a complete removal of the mass and to examine every possible adhesion to the gastrointestinal wall.
Metastatic lesions of the pancreas are uncommon, accounting for approximately 2% of pancreatic malignancies. Many tumours involve the pancreas secondarily and may manifest with different clinical and imaging characteristics. Although many patients have widespread disease, isolated metastases can be found. Surgical management is associated with improved survival in these cases. The experience of the pancreatic surgery unit and imaging department of our hospital in many patients presenting with pancreatic metastases is presented, and a review of the recent literature is undertaken. Main Messages• The early recognition of secondary pancreatic tumours on US, CT and MRI is extremely important.• Pancreatic metastases may mimic primary pancreatic adenocarcinoma or induce acute pancreatitis.• Most pancreatic metastases are discovered on a CT examination performed for follow-up.
Different types of renal lesions in patients with AIP are relatively common, appearing as multiple nodules with decreased enhancement. These findings support the proposed concept of an IgG4-related systemic disease. Autoimmune disease should be suspected in cases of renal involvement in association with pancreatic focal or diffuse enlargement.
Introduction: Primary hepatic carcinoid tumours (PHCTs) are extremely rare neuroendocrine neoplasms. Only 58 cases have been reported in the literature and less than 10 cases were functional.
BackgroundActinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult.PurposeTo describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases.Material and MethodsIn our study we analyzed 18 patients (15 women, 3 men; age range, 25–75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT.ResultsThe sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination.ConclusionActinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation.
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