[Cholangiocellular carcinoma of the common hepatic duct causing obstructive jaundice in a patient with metastatic colonic carcinoma within liver].

Introduction: Colorectal carcinoma, one of the most frequent carcinomas, produces liver metastasis very frequently. Surprisingly, those secondaries rarely cause obstructive jaundice. If it appears, it is usually caused by compression or infiltration of the major bile ducts close to the hepatic hilus, less frequently with bile duct obstruction by gelatinous mucus produced by the timour, much rarer by the tumour growth within the, otherwise intact, common bile duct and very rarely by metastasis into the biliary tree.

[Disseminated subcutaneous fat necrosis and elbow joint arthritis as a complication of pancreatitis].

Background: Intraabdominal fat necrosis of the retroperitoneum, mesenthery and omentum is a frequent complication of acute pancreatitis. Very rarely, during the disease multiple aseptic subcutaneous fat necrosis, polyarthritis, polyserositis, vasculitis, subcutaneous nodi and eosinophylia, isolated or in combination, may appear. They are known as "pancreatic disease syndrome".

[Giant cryptogenic pyogenic gas containing left liver abscess].

Introduction: Pyogenic gas containing liver abscesses are rare. Less than 50 cases seem to have been described so far. Most of them were localised within the right liver.

[Fibromyxoid sarcoma of the pancreas].

Introduction: Fibromyxoid sarcoma is a rare mesenchymal neoplasm, usually appearing in the soft tissue of the extremities, less frequently in the groin, trunk, neck, and upper extremities. Within the abdomen, the tumour is usually localised within the retroperitoneum.

Case Outline: We present a 56-year-old woman in whom, during the routinely performed investigation for atacks of choking with lots of bronchial secretion, and arterial hypertension, an ultrasonographer found a tumour within the head of the pancreas 6 x 6 cm in diameter.

[Mucinous cystadenoma of pancreatic head with focal malignant alteration in a 52-year-old man].

Mucinous cystadenomas of the pancreas are rare tumors appearing usually within the body and the tail of the pancreas in a young and middle-aged women. They rarely communicate with the pancreatic duct and occasionally may become malignant. The authors present a patient with a number of rare features.

[Stromal tumour of duodenal autonomous nerves (plexosarcoma)].

Gastrointestinal tumours arising from autonomous nerves of Meisner's or Auerbach's plexus (plexomas and plexosarcomas) are rare tumours in only 87 cases described in the literature up to 2001. We present a very rare case of gastrointestinal stromal tumour (plexosarcoma) of the third and fourth portion of the duodenum, 130 x 98 x 87 mm in diameter, arising from its back wall, with central necrosis of the well circumscribed tumour, which communicated with the duodenum through an ulceration of 15 x 7mm in diameter, spreading towards the great vessels of the retroperitoneum. It was gradually and carefully removed, together with 17 cm of the duodenum and few centimetres of the jejunum with end-to-end duodenojejunostomy below the Vater's papilla.

Hepatocellular adenoma with malignant alteration.

Hepatocellular adenoma is a rare benign tumor of the liver which appears almost exclusively in women taking oral contraceptives. Malignant alteration of the tumor is very rare with about 12 reported cases. Case outline.

[Somatostatinoma of the Vater's papilla in a patient with von Recklinghausen's disease].

Background: Somatostatinomas of the gastrointestinal tract secret hormon somatostatin which can cause "inhibitory syndrom" comprising diabetes mellitus, cholelithiasis and steatorrheic diarrhea. It is also secreted by the D cells of Langerhans's islands of the pancreas as well as endocrine cells of the stomack, small bowel, salivary glands and parafollicular cells of the thiroid gland. Somatostatinomas of the digestive tract appear within the pancreas and duodenum.

[Angiectatic pseudocyst of the pancreatic head].

Background: Arteriovenous malformations of the pancreas are very rare, most frequently congenital ones, but tending to increase frequency, predominantly due to the introduction and use of new diagnostic modalities. They usually present with gastrointestinal bleeding and abdominal pain.

Case Report: The autors presented a 52-year-old woman in whom, during the investigation for the abdominal pain and gastrointestinal bleeding, an ultrasonography showed a hypoechogenic lesion within the head of the pancreas 3 cm in diameter.

[Isolated metastasis of the granulosa cell tumor of the ovary in the small intestine mesentery 19 years after salpingo-oophorectomy].

Introduction: Granulosa cell tumour is uncommon malignant tumor which belongs to the sexual cord-stromal tumors of the ovary. It arises from the specialized stromal cells of the ovary. These tumors are unilateral in 95%.

[Solitary fibrous tumor of the visceral pleura of the right lung base].

Solitary fibrous tumors are relatively frequent. They may occur throughout the body. About 20% of tumors develop in the thorax, out of which vast majority is localized on its wall.

[Desmoid tumor within lesser sac].

Desmoid tumors or fibromatoses comprise a number of benign fibrous proliferative lesions that have local infiltrative growth and tendency to recur after incomplete excision. They never metastasize. The authors present a 31-year-old woman who, due to epigastric pain and palpable mass detected on presentation, underwent the excision of firm tumorous mass, 210 x 140 x 115 mm in diameter, from the lesser sac.

[Aggressive intraabdominal fibromatosis].

Background: Intraabdominal or mesenteric fibromatosis is a rare benign nonmetastatic neoplasm that appears as a sporadic lesion or in patients with familiar polyposis. Its evolution is unpredictable. About 10% of the cases shaw a very aggressive growth.

[Infected giant liver cyst].

Congenital liver cysts are not as rare as it was thought in the past. Thanks to new imaging diagnostic techniques, these cysts have been discovered with increasing frequency. Uncomplicated congenital liver cysts are usually asymptomatic or followed by mild symptoms.

[Hemangioma of the spleen].

Although the most frequent benign tumors of the spleen, hemangiomas are very rare, much rarer than hemangiomas of the liver. They manifest as localized (either single or multiple) or diffuse lesions, vary from solid to cystic, histologically from capillary to cavernous. Usually, they are small in size (1-3 cm), rarely larger and very rarely of large size.

[Isolated hydatid cyst of the adrenal gland].

Introduction: Hydatid cyst of the adrenal gland is extremely rare even in generalized hydatid disease, with less than 20 cases reported in world literature including those found in autopsy.

Case Outline: The authors present the second case of the adrenal gland hydatid cyst described in Serbian literature, in 52-year old woman. During the investigation for the epigastric pain by ultrasonography and computed tomography, calcified cyst of the sixth segment of the liver, 44x39 mm in diameter, was diagnosed.

[Inflammatory pseudotumor of the spleen].

Background: Inflammatory pseudotumors are benign tumor lesions of an unknown etiology that can appear almost at any organ, sometimes along with infectious agens, like Epstein-Barr virus. They are extremely rare in the spleen, with less than 80 cases described in the world literature. It is a single, very rarely multinodal lesion.

[Tubular adenoma of the gallbladder with squamous metaplasia].

Adenomas of the gallbladder are rare tumors. They may be papillar or tubular. Tubular adenoma appears in middle aged and older patients, although it may develop even in children.

[Lymphoepithelial cyst of the pancreas].

Lymphoepithelial cysts of the pancreas are very rare with less than 35 cases described in the literature. A 49-year old male with a cystic tumor in the tail of the pancreas of 8 cm in diameter discovered during the investigation for mild pain in the upper abdomen was presented. The tumor was easily removed during the open surgery.

[Necrosis of the duodenum resulting from acute necrotising pancreatitis and treated with complete duodenopancreatectomy].

Necrosis of the duodenum resulting from acute necrotising pancreatitis is a rare but potentially lethal complication. A small number of cases has been reported so far, the majority of which having, unfortunately, had a lethal outcome. We present the cases of two patients, a 21-year-old woman and a 54-year-old man, both suffering from extensive duodenal necrosis stemming from acute necrotising pancreatitis, and both cases involving the second and third sections of the duodenum, one of which was probably caused by the thrombosis of nutritive blood vessels, the other by an abscess of the head of the pancreas.

[Bilateral angiomyolipoma of the kidney in patient with tuberous sclerosis].

Angiomyolipomas are relatively frequent tumours of the kidney. It is believed that about 10 million people worldwide have such a tumour. About 1/10 of these 10 million are patients who suffer from tuberous sclerosis.

[Focal nodular hyperplasia].

Thanks to ultrasonography, computed tomography, and nuclear magnetic resonance, not only symptomatic but also asymptomatic liver tumours are discovered more frequently than before. Focal nodular hyperplasia (FNH) is one such tumour, most frequently an asymptomatic tumour of the liver, which predominantly appears in women during the generative period, who have taken oral contraceptives for several years. We present a 27-year-old woman, who has never taken either oral contraceptives or other hormones, in whom a left lobe liver tumour was unexpectedly discovered during a routine investigation performed for psychiatric complaints.

[Bronchogenic cyst of the abdomen].

A bronchogenic cyst is a rare congenital anomaly that appears in the thorax, usually the lungs or the mediastinum, being much rarer in the retrosternal space, within the pericardium or the diaphragm, as well as in the neck, while localisation within the abdomen is extremely rare, with only about 30 reported cases. We present the case of a 68-year-old woman. During an investigation for an epigastric pain, a cystic lesion in the area of the body and tail of the pancreas was found.

[Slip of the T tube within the common bile duct--a little known complication of the T tube drainage].

Complications related to the T tube drainage of the common bile duct are not uncommon. Some, like dislocations of the T tube out of the common bile duct, could be very serious, particularly if developed during the first few days after surgery, when the abdominal drain in the subhepatic space had been already removed.Then, an emergency reoperation might be necessary.

[Abscess of the spleen].

Splenic abscess is a rare disease but with increasing frequency. The authors present 9 patients with splenic abscess treated at the Institute of Digestive System Diseases, Clinical Centre of Serbia, in a period from January 1, 1986 to May 15, 2004. Splenic abscess was the complication of septic endocarditis in 4, trauma in 2, dental infection in 1, while in 2 cases it was the complication of chemotherapy in myeloproliferative disorders.