Gastrointestinal stromal tumors are uncommon when compared to all gastrointestinal neoplasms but are the most common mesenchymal tumors of the gastrointestinal tract. The largest gastrointestinal stromal tumor ever recorded in literature weighed approximately 6.1 kg and measured 39 cm × 27 cm × 14 cm. About two-thirds of GISTs are malignant. The tumor size, mitotic rate, cellularity, and nuclear pleomorphism are the most important parameters when considering prognosis and recurrence. The definitive treatment for these tumors is resection. In the year 2000, the first patient was treated with the tyrosine kinase inhibitor imatinib and since then, gastrointestinal stromal tumors with high-risk features have been treated successfully with tyrosine kinase inhibitors. We present the largest gastrointestinal stromal tumor recorded in medical literature measuring 42.0 cm × 31.0 cm × 23.0 cm in maximum dimensions and weighing in at approximately 18.5 kg in a 65-year-old African-American male who presented with increased abdominal distention. The mass was successfully excised, and the patient was treated with imatinib without local or distant recurrence 1.5 years postoperatively.

Accounting for approximately 0.4-0.6% of all inguinal hernias, Amyand's hernia is a rare condition in which a vermiform appendix is found in an inguinal hernia sac. It is most commonly found in males and in the pediatric population. Since Claudius Amyand's first reported case in 1736, there have only been a total of 228 documented cases of the Amyand's hernia. Due to its rarity, the pathophysiology and risk factors of the condition are still unclear. Some theorize that it is secondary to a patent processus vaginalis or perhaps the presence of a fibrous band between the hernia sac and testes. Amyand's hernia usually presents as an incarcerated or strangulated hernia, but its presentation can be quite variable. We report an unusual case of an Amyand's hernia presenting as an enlarging painful mass on the right lateral edge of the mons pubis, resembling an abscess.

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This trauma center is in a unique position to highlight a national problem. Over half (52%) of the patients had an orthopaedic injury defined as a fracture or dislocation. Before measures can be implemented to effect change, we must first be aware of the exact nature and spectrum of injuries associated with ATV use.

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