Caecal diverticulosis is a rare cause of ileocoecal pain in western population. It represents 3.6% of all colonic diverticular disease. Signs and symptoms of this disease may mimic acute appendicitis and it is found in one in every 300 appendicectomies. Giving its low incindence the correct diagnosis is usually intraoperative. Eighty-three years old male presented to the surgical admission unit with a two days long history of pain in ileocaecal region. The pain started suddenly, it was constant and worsened on cough and excertion. He was afebrile, denied nausea and vomiting, changes in bowel movements and urination. The abdomen was not distended, it was soft and tender in low right quadrant, without organomegaly. Renal sucussion was negative. There were no signs of hernias. There were traces of normal stool on the rectal examination. Blood tests revealed an elevated total leukocyte count with granulocytosis and elevated parametrs of inflamation. A provisional diagnosis of acute appendicitis was made. Taking into consideration the atypical presentation we decided to do the multislice computed tomography (MSCT) of the abdomen. It revealed a heterogenous soft tissue mass in the area of right hemicolon infiltrating the surrounding fat tissue. The patient was operated on the same day. The procedure revealed a normal looking appendix and caecal diverticulum with an inflamed wall with localized perforation. We performed a right hemicolectomy. The postoperative course was uneventful and the patient made a full recovery. Caecal diverticulosis, although a rare disease in the westwrn world should be taken into consideration in patients with pain in right lower quadrant of the abdomen. The management of this disease should be individual, depending on patient's health status and the stage of disease in the moment of diagnosis. Management of patients with confirmed caecal diverticulitis can be conservative or surgical. Surgical treatment include diverticulectomy, ileocaecal resection and right hemicolectomy.

Retroperitoneal sarcomas are mesodermic origin and include less than 1% of all malignant tumors. The most frequent histological type of sarcoma are liposarcomas. Most commonly they are located in lower extremitetes while intraabdominal findigs are rare. Early diagnosis is quite challenging because the first symptoms occur only in advanced stages of disease. The gold standard for diagnosing is MSCT. The therapeutic approach is surgical by combining radiation therapy in case of recurrence and excision was not comletly. The chemotherapy is still controversial, and most authors consider that it is not adequate way of treatment. Seventy years old woman was admitted to the department of surgery because of the pain located in theleft half of the abdomen. It lasts for 3 monthsand in recent times became stronger and accompanied by nausea. Stooll and urin were regular . Physical examination revealed painfully formation. Velaues of blood examples were within normal range. US and MSCT of the abdomen were made before operation. MSCT showed retroperitoneal TU formation size 52x35cm. The findings were confirmed during the operation. Tumor weight was 9250g. Histopathological examination showed that it was a low-grade myxoid liposarcoma. One year after surgery, there was a recurrence. The first symptoms of abdominal liposarcoma manifests only in advanced stages of the disease. Radical surgical excision first choice in treatment. If the excsion lines could not be clear radiotherapy should be added.

Renocelularni karcinom (RCC) je najčešći maligni tumor bubrega kod odraslih. Čini oko 3% adultnih maligniteta i 90-95% neoplazmi bubrežnog porekla. Renocelularni karcinom može biti asimtomatski tokom najvećeg dela svoje evolucije a klasična trijada koja obuhvata lumbalni bol, hematuriju i lumbalnu masu je neuobičajena. RCC se karakteriše čestom pojavom paraneoplastičnog sindroma. Muškarac starosti 46 godina se žalio na uporan kašalj koji je trajao oko godinu dana. Negirao je druge tegobe i nije uzimao blokatore angiotenzin konvertujućeg enzima. Fizikalni nalaz po sistemima je bio u granicama normale. Rezultati laboratorijskih analiza su ukazali na ubrzanu sedimentaciju (SE 92 mm/1.h), leukocitozu i sideropenijsku anemiju (hemoglobin 103 g/L, serumsko gvožđe 4.3 μmol/l). Radiografija srca i pluća i spirometrija su bili uredni. Test na okultno krvarenje u stolici je bio negativan a vrednosti tumor markera su bile u referentnim granicama. Ultrazvuk abdomena je pokazao postojanje tumorske mase duž desnog bubrega. Kompjuterizovana tomografija abdomena je potvrdila postojanje tumorske mase veličine 93x72 mm duž celog desnog bubrega bez znakova invazije okolnih organa. Postavljena je radna dijagnoza renocelularnog karcinoma i izvršena je otvorena desna radikalna nefrektomija. Postoperativni tok je protekao uredno uporni kašalj je nestao 2 dana nakon operacije sa brzim poboljšanjem anemije i normalizacijom SE a uporni kašalj je nestao 2 dana nakon operacije. Tri meseca nakon operacije pacijent nije imao nikakve tegobe niti je bilo znakova rekurencije tumora. Veoma je važno imati u vidu čitav spektar simptoma i znakova kojima se renocelularni karcinom može prezentovati.