Ghrelin and obestatin seem to play a significant role in IBD pathogenesis. Further studies are needed to elucidate the role of these hormones as new biological markers of activity of IBD.

We report a case of a 65-year-old woman who presented with recurrent episodes of severe, postprandial abdominal pain followed by projectile vomiting. Gastroscopy revealed a large polyp in the prepyloric region. During peristalsis, the polyp was repeatedly ‘passing’ through the pylorus into the duodenal bulb, hence obstructing the lumen. The polyp was eventually removed in a piecemeal fashion. Histopathologic examination revealed an inflammatory fibroid polyp (known also as Vanek’s tumour). A brief review on inflammatory fibroid polyps follows.

In most cases, SEMSs can be accurately and safely positioned without fluoroscopy for palliative treatment of malignant esophageal dysphagia.

No abstract

Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.

Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.

Pseudoachalasia is a rare clinical entity with clinical, radiographic, and manometric features often indistinguishable from achalasia. Primary adenocarcinomas arising at the gastroesophageal junction or a tumor of the distal esophagus are the most frequent causes of pseudoachalasia. Rarely, processes other than esophagogastric cancers including chronic idiopathic intestinal pseudo-obstruction, amyloidosis, sarcoidosis, Chagas' disease, vagotomy, antireflux surgery, pancreatic pseudocysts, von Recklinghausen's neuroinomatosis, gastrointestinal stromal tumor, and other malignancies and rare genetic syndromes, may lead to the development of pseudoachalasia. Secondary achalasia is extremely rare, with less than 100 cases reported in the literature so far. Gastrointestinal manifestations in primary or secondary amyloidosis include abdominal pain, diarrhea, constipation, malabsorption, obstruction, motility disturbance, intestinal infarction, perforation, and hemorrhage; however, gastrointestinal tract involvement is asymptomatic in most instances. We present here a rare case of multiple myeloma initially presenting with dysphagia because of esophageal amyloidosis and manometric findings typical of achalasia.

.In some rare cases coexistence of GIST with other malignancies has been reported [2][3][4][5][6] . Here we describe a case of a 74-year old male with GIST who developed multiple myeloma (MM) during the course of GIST treatment. To the best of our knowledge, the co-existence of GIST and multiple myeloma has not been reported so far. Case reportA 74-year old male was presented complaining of dyspepsia. Clinical examination revealed a palpable epigastric mass, with no other abnormal clinical findings. Computed tomography of the abdomen showed a 15 cm × 16 cm solid mass in the right side of abdomen, deriving from the gastric wall. A submucosal non-metastatic tumor was suspected ( Figure 1A). Endoscopy showed normal mucosa of the gastrointestinal tract. Laboratory tests were normal. During the surgery, a 5 cm × 11 cm mass of the posterior wall of the gastric antrum protruding from the inner muscularis propria to the mucosa was found. The mass was completely resected and the histological examination demonstrated whirling sheets of spindle cells which were stained positively for CD 117 (c-kit) and CD34, mitotic index > 10/50 HPF, while smooth muscle actin (SMA) and vimentin were focally positive, and keratine, desmin, S-100 protein were negative. This specific immunophenotype characterized GIST. No further therapy was applied. Physical examination, laboratory tests and computed tomography were performed when the patient was followed up at 3-month intervals.Fourteen months after resection, a CT scan of the abdomen showed liver metastases ( Figure 1B) and imatinib mesylate at a dose of 400 mg once daily, as the appropriate second line therapy, was administered. After one month of treatment, the patient reported persistent skeletal pain, especially on the thorax, accompanied with weakness and fatigue. X-ray bone survey showed lytic lesions. Laboratory examination revealed normocytic, normochromic anemia (Hb: 10.6 gr/dL), hypercalciemia (Ca: 11.7 mg/dL) and abnormal ESR (140 mm/h). Serum protein electrophoresis and immunofixation showed an AbstractGastrointestinal stromal tumors (GISTs) are rare tumors, which represent approximately 1% of the neoplasms of the gastrointestinal tract. These tumors rarely give extra-abdominal metastases. However, their clinical outcome is potentially adverse. In some rare cases, coexistance of GISTs with other malignancies has been reported. Here we present a case of a 74-year old male with GIST, which was managed by surgical resection. Fourteen months later, the patient presented with liver metastases and imatinib mesylated was administered. During treatment, the patient reported skeletal pain and plane X-rays revealed osteolytic bone lesions. Further investigation revealed the presence of multiple myeloma. To the best of our knowledge, this is the first report of the co-existence of multiple myeloma (MM) with GIST.