Neuroendocrine carcinomas (NECs) of the gallbladder are very rare and aggressive tumors with poor prognosis. Most of them are poorly differentiated and belong to the small cell type. We report a case of a 59-year-old woman who presented with abdominal pain and distension. Contrast-enhanced computed tomography revealed a large heterogeneous mass in the liver, adjacent to the gallbladder, and omental nodules. CA 19-9 level was elevated and ascitic fluid cytology was suspicious for malignancy. Percutaneous biopsy of the liver mass confirmed the diagnosis of small cell NEC of the gallbladder. The patient was considered inoperable and planned for chemotherapy, but she died 20 days after admission. This case illustrates the diagnostic challenges and the dismal outcome of small cell NEC of the gallbladder. Early detection and multimodal treatment are essential for improving the survival of these patients.

Castleman disease is a rare proliferation disorder of the lymphatic system. Castleman Disease occurs less frequently in the mesenteric-paraduodenal localization. Surgical complete resection is recommended for the diagnosis and treatment of symptomatic paraduodenal masses. The number of reported cases of laparoscopic resection of Castleman's Disease located in the paraduodenal region is quite low in the literature. This article aims to present a rare case with characteristic histological and radiological findings treated with a laparoscopic approach.

Objective COVID -19 placed a tremendous and unforeseen burden on the health system worldwide. In addition to the general surgery practice, the approach to emergency surgery cases, and patients’ admissions to the hospitals were also seriously affected by this unexpected consequence. Herein we aim to pay attention to the notable decrease in cases requiring urgent surgical intervention in our city and to try to explain this upshot. Methods In this multicenter retrospective study, emergency general surgical interventions performed in the 3rd and 2nd stage private and public hospitals, before the pandemic (January 2020- February 2020), and acute phase of the pandemic (Mid-March 2020 - Mid-May 2020) in Sakarya province were compared. Results The distribution of patients before pandemic by gender was 53.1% in male patients, 46.9% in female patients, while 61.6% in male, and 38.4% in female patients during the pandemic respectively. The mean age of patients was 54.72±3.65 before pandemic and 38.54±2.32 during the pandemic, and there was a statistically significant difference in terms of the age distribution of patients undergoing emergency surgery (p<0.05). During the two months before the pandemic, a total of 290 emergency surgeries were performed, while in the acute pandemic period, 164 emergency operations were performed in the same time interval. There was a statistically significant decrease in the number of patients undergoing emergency surgery during the pandemic period compared to non-pandemic (p= 0.012). Conclusion Although the causes for the decrease in cases requiring emergency surgery may be partially defined. However, the disease groups whose alteration reasons cannot be explained at the moment may need further detailed strategic preparation in order not to encounter undesired results in the future.

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms characterized by histologically and immunohistochemically distinctive epithelioid or spindle cells. These tumors express both smooth muscle markers and melanocytic markers. They can arise in various anatomical locations throughout the body, including the gastrointestinal tract, genitourinary system, retroperitoneum, and soft tissues. The exact cell of origin for these tumors remains unidentified. Clinical outcomes vary widely, spanning benign to malignant behavior, with the potential for local recurrence and metastasis. The management of PEComas typically involves surgical resection, though use of adjuvant chemotherapy and immunotherapy has been reported. The high recurrence rate of PEComas highlights the necessity for long-term surveillance and a multidisciplinary approach to treatment. We present the case of a 47-year-old female with a previous abdominal PEComa, who presented to our clinic with an enlarged recurrent abdominal tumor. Confirmation of recurrence was obtained through ultrasound and PET-CT imaging. Additionally, post-operative pathology findings supported the diagnosis.