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INTRODUCTION AND IMPORTANCE: Biliary tree neuroendocrine tumors (NET) are rare, with 100 cases in the literature, and have an excellent prognosis. Although they are rarely diagnosed before surgery, complete surgical excision offers optimal treatment. CASE PRESENTATION: We report a case of a 36-year-old female patient referred to the surgical team with obstructive jaundice for which she was investigated and found to have a common bile duct tumor showing proximal obstruction. Excision of the tumor with hepaticojejunostomy was done. Later on, the pathology report showed grade-1, well-differentiated neuroendocrine carcinoma, which was completely excised. No further intervention was provided to the patient. CLINICAL DISCUSSION: Complete surgical resection with excision of the extrahepatic bile ducts and portal lymphadenectomy in addition to Roux-en-Y hepaticojejunostomy or even pancreaticoduodenectomy for distal CBD neuroendocrine tumors gives sufficient treatment in the majority of cases. No evidence of the advantage of chemo-radiotherapy as part of the treatment for this tumor. CONCLUSION: Biliary tree neuroendocrine tumors are benign tumors, and it is usually difficult to ascertain the diagnosis preoperatively. However, complete surgical excision offers an optimal treatment with no evidence of chemotherapy or radiotherapy's role in the management.

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INTRODUCTION AND IMPORTANCE: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic disorder that usually affects young women with no or nonspecific clinical manifestation. It accounts for approximately 1% of pancreatic neoplasms. The incidence of SPN is increasing, owing to improved imaging techniques and better recognition of this entity. Although most patients with SPNs have a favorable prognosis after radical resection, local recurrence or metastasis still occurs after surgery. CASE PRESENTATION: We present a 15-year-old female with a small solid pseudopapillary neoplasm in the Pancreas' proximal body. The patient presented with nonspecific symptoms and was diagnosed incidentally. CLINICAL DISCUSSION: The patient underwent a central pancreatectomy and was discharged on the fifth postoperative day without complications. Central pancreatectomy may prevent devastating complications of pancreaticoduodenectomy surgery. CONCLUSION: As SPN is a rare entity of pancreatic tumors, the surgical options for management are still debated. The respect for surgery should account for the tumor site and size. Also, life expectancy and surgical complications for each choice should be considered. In localized disease, segmental resection may prevent devastating complications of radical resection.

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BACKGROUND: High numbers of violence incidents against physicians are reported annually in both developing and developed countries. In Jordan, studies conducted on healthcare workers involved small number of physicians and showed higher percentages of violence exposure when compared to other investigations from the Middle East. This is a large study aiming to comprehensively analyze the phenomenon in the physicians' community to optimize future strategies countering it. METHODS: The study has a cross sectional, questionnaire-based design. It targeted 969 doctors from different types of healthcare Jordanian institutions in Amman, between May to July, 2019. The questionnaire was designed to evaluate properties of reported abuse cases in terms of abusers, timing, and type of abuse, in addition to the consequences of this abuse. RESULTS: Prevalence of exposure to violence in the last year among doctors was 63.1% (611 doctors). 423 (67.2%) of male doctors had an experience of being abused during the last 12 months, compared to 188 (55.3%) of females (p< 0.001). Governmental centers showed the highest prevalence. Among 356 doctors working in governmental medical centers, 268 (75.3%) reported being abused (p< 0.001), and they were more abused verbally (63.5%) and physically (10.4%) compared to other medical sectors (p <0.001). The mean score of how worried doctors are regarding violence at their workplace from 1 to 5 was 3.1 ± 1.3, and only 129 (13.3%) believed that they are protected by law. CONCLUSIONS: The study emphasized on the higher rate of violence against physicians in the governmental sector, in addition to the negative effect of abuse on their performance. Moreover, male physicians had higher incidence of workplace abuse. Therefore, strategies that ease and promote the real application of anti-violence policies should become our future target.

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INTRODUCTION: Seborrheic keratosis is one of the most common benign epidermal cutaneous lesions encountered by dermatologists and plastic surgeons in their daily practice. PRESENTATION OF THE CASE: A 66-year-old man was presented with a large verrucous mass on the sacrum and perianal area of 10 years duration. After the diagnosis of SK was confirmed, a complete excision of the lesion was done with coverage of the defect with a partial thikness skin graft, with a good outcome. DISCUSSION: Giant Seborrheic keratosis are very rare, and their location on the perianal area is rarer still, with no more than 10 published cases of genital area involvement. CONCLUSION: Giant perianal seborrheic keratoses is a very rare presentation, that may resemble many of the skin disease of that area and should be managed with excision and biopsy to confirm the diagnosis.

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INTRODUCTION: Congenital pits of the lip are uncommon and may be associated with conditions such as Van der Woude syndrome. Isolated lip pits are extremely rare developmental defects. PRESENTATION OF CASE: A 7 year old Caucasian girl presented to plastic surgery clinic in Jordan University academic hospital complaining of an upper lip pit that has been present since birth. It was associated with a single episode of whitish discharge. On examination, an isolated upper lip midline sinus was found. She is otherwise fit and healthy. Surgical excision was curative with good cosmetic outcome. DISCUSSION: The prevalence of lower lip sinuses has been estimated to be about 0.00001% of the white population. Upper lip sinuses are even more uncommon. To date, there have been several case reports of upper lip sinuses and fistulas. A total of 55 cases was found upon reviewing the English literature. No similar cases were reported in Jordan. Different presentations are mentioned in this review. Several embryologic theories are presented. CONCLUSION: Upper lip sinus formations are rare developmental events, and the pathogenesis of these lesions still needs further evaluation. Simple surgical excision is the treatment of choice.

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Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999-2014. Children were either managed with bronchoscopy for removal of the foreign body or died due to FBA. A total of 103 children were seen due to FBA including 27 deaths. The majority of children were boys and were less than 3 years old. Most aspirated foreign bodies were food-related, mainly peanuts. The majority of children presented with acute choking incidents, a smaller number presented with recurrent chest infections, and few children's choking incidents were unwitnessed. X-ray had a high rate of false negatives and bronchoscopy was the gold standard technique for assessment and management. Aspiration of foreign bodies is a preventable, life-threatening condition that calls for increased parent education and awareness.

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