Surgery Case Reports最新文献_第2页

Chronic osteomyelitis due to retained war-time shrapnel after 16 years: Case report 16年后遗留战争弹片导致慢性骨髓炎：病例报告

Surgery Case Reports Pub Date : 2025-04-17 DOI: 10.1016/j.sycrs.2025.100111

Madhawa Sasanka Rathnaweera , Kasun Bandara Ekanayake , Sunanda Udagedara

{"title":"Chronic osteomyelitis due to retained war-time shrapnel after 16 years: Case report","authors":"Madhawa Sasanka Rathnaweera , Kasun Bandara Ekanayake , Sunanda Udagedara","doi":"10.1016/j.sycrs.2025.100111","DOIUrl":"10.1016/j.sycrs.2025.100111","url":null,"abstract":"<div><div>Shrapnel, commonly associated with war-related trauma, is often retained without surgical removal due to its inert nature. However, these retained foreign bodies pose a risk of long-term complications, including chronic osteomyelitis (COM). This case report presents a rare instance of COM caused by retained shrapnel 16 years after a combat injury sustained during the Sri Lankan Civil War. A 55-year-old former soldier presented with fever, right thigh pain, and swelling. He had suffered a right femoral shaft open fracture in a mortar artillery blast in 2008, which was treated with intramedullary nailing. The implant was removed the following year due to infection. Imaging revealed multiple shrapnel fragments and osteomyelitic changes in the right distal femur, with one metal fragment causing erosion of the anterior cortex of the femur. The culture of an abscess of the right anterior thigh yielded methicillin-resistant <em>Staphylococcus aureus</em>, sensitive to vancomycin. The patient underwent abscess drainage, surgical retrieval of some shrapnel, and a 6-week course of oral linezolid. Although retained shrapnel is generally inert, its potential to cause COM necessitates a high index of suspicion. Timely imaging, microbiological cultures, and appropriate surgical and antibiotic management are critical in preventing severe long-term complications.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary adrenal angiosarcoma: Insights into an exceptionally rare malignancy 原发性肾上腺血管肉瘤：一种罕见的恶性肿瘤

Surgery Case Reports Pub Date : 2025-04-16 DOI: 10.1016/j.sycrs.2025.100110

Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher

{"title":"Primary adrenal angiosarcoma: Insights into an exceptionally rare malignancy","authors":"Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher","doi":"10.1016/j.sycrs.2025.100110","DOIUrl":"10.1016/j.sycrs.2025.100110","url":null,"abstract":"<div><div>Primary adrenal angiosarcoma is a high-grade vascular malignancy. This case describes a 78-year-old female who presented with left upper quadrant abdominal pain, early satiety, nausea, weight loss, and a feeling of being “cold all the time.” Computed tomography of the abdomen and pelvis demonstrated a 15 cm× 13 cm x 16 cm heterogeneous, enhancing mass with interspersed calcifications, originating from the left adrenal gland. Adrenal labs were collected and were not consistent with a functional adrenal lesion, and lymphoma was ruled out. The patient underwent an exploratory laparotomy with resection of the left retroperitoneal mass, left adrenalectomy, splenectomy, and left partial nephrectomy due to the tumor impeding surrounding structures. All surgical margins were negative, with no evidence of metastatic disease. Immunohistochemical staining showed the tumor to be strongly and diffusely positive for cytokeratin, CD31, and ERG, while negative for CD34. Additional staining for FLI1 was positive. Based on these findings, a final pathological diagnosis of primary epithelioid angiosarcoma of the adrenal gland was made. The patient received asplenia vaccines and was discharged on postoperative day three without complications and was seen two weeks postoperatively in clinic. Recommendations were made in agreement with surgical and medical oncology for surveillance imaging, including computed tomography of the chest, abdomen, and pelvis every three months for a minimum of five years.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epithelial-myoepithelial carcinoma of the parotid: A needle in a haystack of carcinomas 腮腺上皮-肌上皮癌：癌堆中的一针

Surgery Case Reports Pub Date : 2025-04-11 DOI: 10.1016/j.sycrs.2025.100105

K.G. Dharma Kumar , Matthew Antony Manoj , Varun Sarodaya , Chinmayee Mayekar

{"title":"Epithelial-myoepithelial carcinoma of the parotid: A needle in a haystack of carcinomas","authors":"K.G. Dharma Kumar , Matthew Antony Manoj , Varun Sarodaya , Chinmayee Mayekar","doi":"10.1016/j.sycrs.2025.100105","DOIUrl":"10.1016/j.sycrs.2025.100105","url":null,"abstract":"<div><div>Epithelial Myoepithelial Carcinoma (EMC) is an extremely rare biphasic malignant tumour accounting for less than one percent of all salivary gland neoplasms. EMC is usually seen in the parotid gland but has also been reported in the submandibular gland, minor salivary glands and extraoral sites. It is commonly seen during the sixth and seventh decade of life, occurring more frequently in females. Here, we present the case of a 48-year-old female with a prior history of parotid carcinoma treated by local excision at a hospital two months ago. She presented to our hospital for follow-up. On examination, there was a 3 cm scar near the pre-auricular region with a suture hatch-mark present. Histopathology revealed multiple whitish tissue bits, the largest measuring 1 × 0.8 × 0.5 cm. On microscopy, salivary gland tissue with an infiltrating neoplasm was noted. Magnetic resonance imaging (MRI) revealed no residual disease; however, enlarged lymph nodes were present on the right side, with the largest in level 1B. The patient was taken up for right superficial parotidectomy with excision of the previous scar and right selective neck dissection (Level I–IV). Post-operative histopathology revealed neither residual disease nor involvement of the 32 lymph nodes dissected. Following this, adjuvant radiation therapy was initiated to help sterilize the region. The patient recovered well and has been on regular follow-up for the past two years with no evidence of recurrence. This case highlights the importance of thorough evaluation and multidisciplinary management in rare salivary gland malignancies.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endovascular aneurysm repair for abdominal aortic aneurysm: Overcoming anatomical challenges related to horseshoe kidney 腹主动脉瘤的血管内修复：克服与马蹄肾相关的解剖学难题

Surgery Case Reports Pub Date : 2025-04-10 DOI: 10.1016/j.sycrs.2025.100106

Siong Teng Saw, Mei Fong Tang, Feona Sibangun Joseph, Benjamin Dak Keung Leong

{"title":"Endovascular aneurysm repair for abdominal aortic aneurysm: Overcoming anatomical challenges related to horseshoe kidney","authors":"Siong Teng Saw, Mei Fong Tang, Feona Sibangun Joseph, Benjamin Dak Keung Leong","doi":"10.1016/j.sycrs.2025.100106","DOIUrl":"10.1016/j.sycrs.2025.100106","url":null,"abstract":"<div><div>A 70-year-old high-risk male with an asymptomatic 64 mm infrarenal abdominal aortic aneurysm (AAA) and an Eisendrath Type IV horseshoe kidney (HSK) underwent endovascular aneurysm repair (EVAR). Preoperative computed tomography angiography (CTA) revealed accessory renal arteries (ARAs) originating from the iliac arteries and aneurysm sac, necessitating selective preservation. EVAR successfully excluded the aneurysm while maintaining perfusion through a right common iliac artery-derived ARA supplying the renal isthmus. Smaller ARAs (<3 mm) were excluded to reduce endoleak risk. Postoperative imaging confirmed aneurysm exclusion without endoleak, though asymptomatic isthmus infarction occurred due to occlusion of a left iliac ARA. Renal function remained stable at three-year follow-up (2022–2025). This case supports EVAR as a feasible option for complex AAA-HSK anatomy, emphasizing meticulous preoperative planning and selective vessel preservation to balance aneurysm exclusion and renal perfusion. Individualized strategies are critical in anatomically challenging scenarios.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ovarian sex cord-stromal tumor: A case report and review of literature 卵巢性索间质瘤1例报告及文献复习

Surgery Case Reports Pub Date : 2025-04-09 DOI: 10.1016/j.sycrs.2025.100107

Soukayna Bourabaa , Mohamed Taimi , Doaa Riali , Hajar Kandoussi , Youssef Mahdi , Basma El Khannoussi , Hatim Essaber , Rachida Latib , Fouad Tijami , Hafid Hachi , Nezha Elbahaoui

引用次数: 0

Thoracic surgical approach for retrosternal ectopic thyroid tissue after cervical total thyroidectomy: Case Report and Review of literature. 宫颈甲状腺全切除术后胸骨后异位甲状腺组织的胸外科入路：病例报告及文献复习。

Surgery Case Reports Pub Date : 2025-04-09 DOI: 10.1016/j.sycrs.2025.100108

Chiara Scorziello , Maria Carola Borcea , Marco Biffoni , Giuseppe De Ruggeri , Alessia Galvano , Eva Iannuzzi , Rossella Melcarne , Luca Ventrone , Cosimo Durante , Fabrizio Consorti , Tiziano De Giacomo , Laura Giacomelli

{"title":"Thoracic surgical approach for retrosternal ectopic thyroid tissue after cervical total thyroidectomy: Case Report and Review of literature.","authors":"Chiara Scorziello , Maria Carola Borcea , Marco Biffoni , Giuseppe De Ruggeri , Alessia Galvano , Eva Iannuzzi , Rossella Melcarne , Luca Ventrone , Cosimo Durante , Fabrizio Consorti , Tiziano De Giacomo , Laura Giacomelli","doi":"10.1016/j.sycrs.2025.100108","DOIUrl":"10.1016/j.sycrs.2025.100108","url":null,"abstract":"<div><div>Thyroidal organogenesis is controlled by specific transcription factors; alterations in their ex-pression can cause developmental abnormalities like ectopia of the gland. Ectopic thyroid tissue can be found anywhere along the line of the obliterated thyroglossal duct, from the tongue to the diaphragm. The thoracic cavity is the most common non-cervical location. We describe the case report of a \"forgotten goiter\", a retrosternal ectopic thyroid tissue, detected after a cervical total thyroidectomy. Due to the size of the lesion, anatomical localization, and presence of calcifications, the patient underwent a complete surgical resection of the mass via sternotomy. The histological examination showed benign mediastinal ectopic thyroid tissue. The postoperative course was uneventful and without complications. Any surgical initiative in patients with retrosternal ectopic thyroid tissue must be individualized and based upon the size of the goiter, the characteristics of the mediastinal goiter and its anatomical relationships, the risk of complications and reoperations, the experience of the surgeon, the comorbidities of the patient, and the trajectory of growth in active surveillance. To date, there is no universal consensus on the best surgical approach.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atypical Duplex Appendix: A Case Report 非典型双附录：1例报告

Surgery Case Reports Pub Date : 2025-04-07 DOI: 10.1016/j.sycrs.2025.100109

Dawar Nadeem Aslam Dar , Maila Aslam , Isha Sajjad

{"title":"Atypical Duplex Appendix: A Case Report","authors":"Dawar Nadeem Aslam Dar , Maila Aslam , Isha Sajjad","doi":"10.1016/j.sycrs.2025.100109","DOIUrl":"10.1016/j.sycrs.2025.100109","url":null,"abstract":"<div><div>Duplex appendix is a rare anomaly of the appendix with an incidence of 0.0004% to 0.009%. It varies in both presentation and position. Due to its rare occurrence and variable position, we present a case of duplex appendix with an atypical position in a 34-year-old male. The patient was diagnosed with acute appendicitis and underwent open appendectomy. During surgery, two appendices were observed, both arising anteriorly from cecum with one arising from taenia coli and the second arising adjacent to, medial, and parallel to the first, near ileocecal junction. Both were excised and sent for histological examination, which revealed neutrophilic infiltration in the mucosa, submucosa and muscularis propria of both appendices. Follow-up after one week was unremarkable. There are various classifications of duplex appendix but Modified Cave-Wallbridge classification is the most widely accepted. However, the position of both appendices in our case does not conform to this classification. Therefore, there may be a need to broaden this classification to incorporate the atypical cases. Additionally, in situations where a normal appendix is visualized or a previous appendectomy has been performed, and the clinical signs strongly suggest appendicitis, surgeons should consider the probability of this anomaly and look for it during surgery. Also due to its association with other anomalies, further investigations should be conducted to rule them out.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case report on malignant peripheral nerve sheath tumor of vagus nerve: A diagnostic challenge 迷走神经周围神经鞘恶性肿瘤1例：诊断上的挑战

Surgery Case Reports Pub Date : 2025-04-07 DOI: 10.1016/j.sycrs.2025.100103

Muhammad Farhan , Abdur Rehman , Zainab Zahoor Butt , Anique Ahmad Jamil , Imran Khan , Muhammad Shuaib Khan , Arham Ihtesham , Shahzaib Maqbool , Sudhair Alam

{"title":"A case report on malignant peripheral nerve sheath tumor of vagus nerve: A diagnostic challenge","authors":"Muhammad Farhan , Abdur Rehman , Zainab Zahoor Butt , Anique Ahmad Jamil , Imran Khan , Muhammad Shuaib Khan , Arham Ihtesham , Shahzaib Maqbool , Sudhair Alam","doi":"10.1016/j.sycrs.2025.100103","DOIUrl":"10.1016/j.sycrs.2025.100103","url":null,"abstract":"<div><div>Malignant Peripheral Nerve Sheath Tumor (MPNST) is a rare, aggressive neoplasm with an incidence of 0.001 % and a poor prognosis. Diagnosis is particularly challenging due to its nonspecific clinical, histopathological, and radiological features, often leading to misclassification as a benign lesion. We present the case of a 24-year-old male with a progressively enlarging left-sided neck mass, accompanied by hoarseness, dysphagia, and headaches. Imaging suggested a benign peripheral nerve sheath tumor, such as a schwannoma, and an incisional biopsy further supported this impression. However, the final excisional biopsy unexpectedly confirmed MPNST of the vagus nerve. This highlights the limitations of current diagnostic techniques in distinguishing MPNST from benign mimics and underscores the critical need for a multimodal diagnostic approach, integrating advanced imaging techniques and immunohistochemistry, to improve early and accurate detection of MPNST. Given the tumor’s aggressive nature and high risk of recurrence, early identification is essential for optimizing treatment outcomes.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sister Mary Joseph’s nodule revealing occult breast cancer: A rare metastatic manifestation 玛丽约瑟夫修女的结节显示隐匿性乳腺癌：一种罕见的转移表现

Surgery Case Reports Pub Date : 2025-04-06 DOI: 10.1016/j.sycrs.2025.100102

Fauziyah Ashraf , Guo Hou Loo , Khairul Anwar Abdul Rahman , Wan Izzah Wan Jaffar , Guhan Muthkumaran , Nik Ritza Kosai

{"title":"Sister Mary Joseph’s nodule revealing occult breast cancer: A rare metastatic manifestation","authors":"Fauziyah Ashraf , Guo Hou Loo , Khairul Anwar Abdul Rahman , Wan Izzah Wan Jaffar , Guhan Muthkumaran , Nik Ritza Kosai","doi":"10.1016/j.sycrs.2025.100102","DOIUrl":"10.1016/j.sycrs.2025.100102","url":null,"abstract":"<div><div>Sister Mary Joseph’s nodule (SMJN) is a rare clinical finding that typically indicates metastatic intra-abdominal or pelvic malignancy, most often arising from gastrointestinal or gynecological cancers. Metastasis to the umbilicus from breast carcinoma is extremely uncommon. We report a case involving a 69-year-old woman with a history of early-stage breast carcinoma treated 15 years prior. She presented with abdominal discomfort and a new umbilical nodule. Imaging revealed small bowel obstruction, and exploratory laparotomy identified peritoneal carcinomatosis and an umbilical lesion. Histopathological examination and immunohistochemical staining confirmed metastatic breast carcinoma as the source. The immunoprofile demonstrated positivity for GATA3, estrogen and progesterone receptors, CK7, and GCDFP-15, supporting a breast origin. The patient declined chemotherapy and opted for endocrine therapy with letrozole. She remains clinically stable and functionally independent 15 months after diagnosis. This case underscores the importance of considering breast cancer in the differential diagnosis of umbilical nodules, especially in patients with a history of breast malignancy. Timely recognition and accurate histopathological workup are essential for appropriate management. Despite the generally poor prognosis associated with SMJN, selected patients may achieve meaningful survival and quality of life with tailored systemic treatment.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Transanal Small Bowel Prolapse in a Young Patient 自发性经肛门小肠脱垂一例年轻患者

Surgery Case Reports Pub Date : 2025-04-06 DOI: 10.1016/j.sycrs.2025.100094

Rashed W. Alweshah , Mustafa Abdo , Ahmed Salah , Shaimaa Moustafa , Ahmed Nagi

引用次数: 0