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Annual out-of-pocket expenditures for patients with inflammatory bowel disease (IBD) are estimated to be as high as $41,000, with medications, such as biologics, being one of the main cost contributors. Although biologics have revolutionized IBD management, these medications are costly owing to their molecular makeup and manufacturing processes. Biosimilars, which are biologic medications that are highly similar to the US Food and Drug Administration (FDA)-approved reference product with no clinically meaningful differences in safety, purity, or potency, offer the same therapeutic benefits at a reduced cost. Other additional benefits offered with biosimilars include increased treatment access and fostered development of new therapeutic options. Despite the expansion of biosimilars in IBD, their adoption and utilization have been suboptimal in the United States. This article provides an overview of the biosimilar landscape in IBD, including FDA-approved biosimilars available, and a clinical guide to navigate switching to biosimilars in various clinical scenarios based on current evidence. [ABSTRACT FROM AUTHOR]

Sialocutaneous fistula is an epithelialized tract between the skin and salivary gland. Parotid tuberculosis is a rare form of extra-pulmonary tuberculosis. It is rare even in an endemic country like India. It presents as a swelling or abscess in the parotid region. Drainage of such abscess may lead to formation of discharging sinus. We present a case of a 37-year-old female who presented with complaints of discharge from the left parotid region. She gave a past history of swelling in the left parotid region, for which she had undergone incision and drainage. Contrast-enhanced computed tomography neck was suggestive of left sialocutaneous fistula with inflammation of superficial lobe of parotid, for which she underwent fistulectomy. Histopathology was suggestive of sialocutaneous fistula with tubercular etiology and was managed with anti-tubercular treatment. [ABSTRACT FROM AUTHOR]

Intracholecystic papillary neoplasm of the gallbladder is a rare and relatively new entity in the fifth edition of the World Health Organization classification of tumors of the digestive system. It mainly occurs in elderly women. It is an exophytic, granular, and friable mass seen in gallbladder mucosa, often mistaken clinically as sludge. We report a middle-aged female with abdominal pain and a vague mass in the right hypochondrium. A computed tomography scan of the abdomen and pelvis showed a heterogeneously enhancing lesion in the gallbladder lumen extending from the fundus to the neck, causing an irregular luminal obstruction. Histopathological examination of the cholecystectomy specimen showed features of intracholecystic papillary neoplasm of biliary and oncocytic type with low-grade dysplasia. [ABSTRACT FROM AUTHOR]

Leiomyosarcoma (LMS) represents one of the most common soft tissue sarcomas, involving various anatomical sites like the retroperitoneum, genitourinary tract, and extremities. LMS of the bone is extremely rare, with a 0.7% incidence of all primary malignant bone tumors. They are histologically identical to the leiomyosarcomas of other sites but pose a diagnostic dilemma due to their rarity and varied presentation when it manifests as a bony lesion. [ABSTRACT FROM AUTHOR]