Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis preferentially targeting medium-sized arteries and not related with glomerulonephritis or small vessel involvement. Clinical manifestations of PAN are multisystem. The gastrointestinal, renal, cardiac, musculoskeletal, skin and central nervous systems may be involved. The aetiology remains unknown, and the ensuing vasculitis may lead to aneurysm formation and thrombosis in any organs of the body with resultant ischaemia. PAN of the intestines is a relatively common manifestation of this disease but rarely causes bowel ischaemia resulting in necrosis. Here we report a case of a young Chinese patient who presented with an acute abdomen requiring surgery and made good recovery post operatively. He remains free of symptoms while on steroid therapy. � 2017 BMJ Publishing Group Ltd.

Background: Neuroendocrine carcinoma (NEC) is a rare entity which accounts less than 2% worldwide. Its non-specific presentation posed a challenge for diagnosis. Case Presentation: We present a 53-year-old Malay lady presented with epigastric pain and constitutional symptoms. Imaging re-vealed a suspicious mass within the gall bladder. She was scheduled for a radical cholecystectomy. The tumour was found to extend beyond the liver and colon. A segmental liver resection and transverse colectomy was performed. Postoperative recovery was une-ventful. Histopathology came back as neuroendocrine tumour of the gall bladder. Conclusion: A high index of suspicion is needed to diagnose a rare entity such as this. An early detection may improve patients' survival.

We discuss a 48-year old, who presented with upper epigastrium pain associated with early satiety and significant weight loss. Physical examination revealed a thickening and darkening of skins around the skin folds, scalp, back and front of abdomen. A diagnosis of gastro-esophageal junction adenocarcinoma was confirmed by oesophagogastroduodenoscopy (OGDS) and biopsy. The biopsy of the skin lesion revealed a diagnosis of acanthosis nigricans, He underwent a total gastrectomy followed by adjuvant chemo-radiotherapy. Recovery is unremarkable. Interestingly, the skin lesions disappear following our therapy. We believe this may be attributed to the treatment of the malignancy. We highlight the interesting association, pathophysiology and therapy. � Societ� Editrice Universo (SEU).