Foreign body (FB) ingestion is a common condition encountered in clinical practice, especially among the pediatric age group; however, this occurrence is rare among adults. Some FBs can induce the perforation of the gastrointestinal tract, including fish bones, chicken bones and toothpicks. The ingestion of FBs is rarely associated with bowel perforation, and most FBs are passed spontaneously. The ingestion of sharp and pointed objects typically produces adverse events related to the upper gastrointestinal system, and FBs are rarely retained in the colon. Bowel perforation caused by the ingestion of FBs should be diagnosed and treated in a timely manner. Here, we present the unusual case of a 51-year-old male who presented to the emergency room with complaints of acute abdominal pain secondary to fish bone ingestion, which triggered cecum perforation.

Background: The differentiation of surgical from nonsurgical adult intussusception may enable the appropriate selection of management strategies. Objective: This study aimed to investigate the diagnostic potential of multidetector computed tomography (MCDT) features to differentiate surgical from nonsurgical adult intussusception and develop a diagnostic model. Methods: A retrospective study was performed on 96 patients with intussusceptions at the University Medical Center Hospital between January 2014 and January 2020. Two radiologists reviewed all images, and intussusception characteristics were documented. The location of intussusception, length, diameter, interposed fat thickness, lead point, and complications were evaluated. Based on the results, a diagnostic tree model was developed to differentiate between surgical and nonsurgical adult intussusception. Results: A total of 99 intussusceptions in 96 patients (mean age: 53.0 ± 16.5 years), including 35 (35.3%) enteroenteric, 27 (27.3%) enterocolic, and 37 (37.4%) colocolic lesions, were evaluated. Of the enteroenteric intussusceptions, 22 (62.9%) were surgical, including 19 (79.2%) with lead points. Among colon intussusceptions, 63 (98.4%) were surgical, and 100% had lead points. The characteristics used to predict surgical intussusceptions included lead point presence, length ≥ 5.0 cm, diameter ≥ 3.2 cm, interposed fat thickness ≥ 0.5 cm, and complications (p < 0.001). Based on these features, we established a diagnostic tree model that correctly classified 96 (97%) of 99 lesions. Conclusion: Our study reinforces the importance of MDCT for the diagnosis and guided management of adult intussusceptions. The characteristics that predicted surgical intussusceptions included lead points, length, diameter, interposed fat thickness, and complications. A systematic approach using this diagnostic tree model could be used to distinguish surgical and nonsurgical adult intussusception.

Inflammatory pseudotumor (IPT) of the kidney is a rare benign disorder with unknown etiology. In IPT patients, some nonspecific symptoms might present, such as fever, hematuria, and back pain. As it can appear on computed tomography and magnetic resonance imaging as a hypovascular mass with surrounding fat stranding, IPT can be misdiagnosed as a primary tumor. Since the clinical symptoms, radiographic features, and preoperative findings can be inconsistent, it is imperative to confirm IPT based on histopathological assessment. In the present study, we describe a case of renal IPT in a 13-year-old girl. The patient was treated with nephrectomy of the right kidney since the preoperative diagnosis was renal carcinoma. Pathological examination revealed an IPT. This article emphasizes the importance of preoperative definitive diagnosis in avoiding unnecessary nephrectomy.

Summary Primary hepatic neuroendocrine tumor (PHNET) is a rare type of neuroendocrine tumor (NET) that is also a primary hepatic tumor. Patients are present with almost no specific clinical symptoms and typically present with negative test results and atypical imaging characteristics; therefore, the differentiation of PHNET from other types of primary hepatic masses can be very difficult. In this article, we describe a case of PHNET that mimicked a liver helminth infection in a 57-year-old man. The diagnosis of PHNET in this patient was challenging, and the final diagnosis was based on imaging, histopathology features, and long-term follow-up. Learning points An uncommon type of neuroendocrine tumor (NET) is a primary hepatic neuroendocrine tumor (PHNET). Primary hepatic neuroendocrine tumors are rare NET lesions found in the liver, characterized by non-specific clinical and imaging results, which can be easily confused with other liver lesions, including HCC and parasitic lesions. To have a conclusive diagnosis and classification, a mixture of many medical assessment techniques, such as imaging, gastrointestinal endoscopy, nuclear medicine, anatomy, including histopathology, and immunohistochemistry, is essential.

Pleuropulmonary blastoma is a rare, aggressive, malignant tumor of the lungs or pleura that primarily affects children. Pleuropulmonary blastoma is classified into 3 types based on morphology, including cystic (type I), mixed (type II), or solid (type III). These morphological types correlate with prognosis. In this article, we present a case of type III pleuropulmonary blastoma in a 2-year-old girl. The patient was treated with tumoral resection and chemotherapy; however, she experienced local recurrence and spinal metastasis after 5 months of treatment.

Acute renal failure due to primary renal Burkitt lymphoma in children is extremely rare. We report a case with acute secondary renal failure in a 4-year-old boy who presented with abdominal pain, anorexia, and vomiting. Abdominal computed tomography scans showed bilateral nephromegaly with multiple hypoenhancing regions. Renal biopsy confirmed Burkitt lymphoma. There was no lymphadenopathy or evidence of other solid organ involvement. The patient was responsive to treatment using the EPOCH-R protocol (etoposide, prednisone, vincristine, cyclophosphamide , doxorubicin, and rituximab). Here, we describe the clinical and imaging features associated with this rare entity.

Mucoepidermoid carcinoma (MEC) is a common type of salivary gland malignancy; however, rarely, MEC can arise from the lung. This disease has a non-specific presentation and is often overlooked. Histologically, MEC can be classified into low-grade and high-grade forms. Surgical resection is the optimal treatment for low-grade tumors. In this article, we report a case of MEC in a 5-year-old girl who was initially misdiagnosed with pneumonia. The histological results revealed MEC. Thus, clinicians and radiologists should consider the possibility of this rare entity in patients who fail to respond to antibiotic treatments, even among the pediatric population.

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