{"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}
Nico Lumintang , Sherly Tandililing , Maturia I. Aruperes
{"title":"Transoral endoscopic thyroidectomy vestibular approach (TOETVA) procedure, a single-center case series of thyroid procedure, and what do we learn?","authors":"Nico Lumintang , Sherly Tandililing , Maturia I. Aruperes","doi":"10.1016/j.sycrs.2025.100104","DOIUrl":"10.1016/j.sycrs.2025.100104","url":null,"abstract":"<div><h3>Background</h3><div>The transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers the most direct access to the thyroid gland due to its proximity to the oral cavity and bilateral reach. Additionally, this technique provides the best cosmetic outcome as it avoids visible scarring. This study presents a case series of TOETVA at Prof. Dr. R. D. Kandou General Hospital, a single-center institution.</div></div><div><h3>Methods</h3><div>Eight patients were included in this study. All patients who underwent the TOETVA procedure and were informed of their surgical options, the risks, and benefits associated with the technique, and each patient signed an informed consent form. These patients had a preoperative assessment, including a thyroid hormone level test, neck ultrasound examination, and fine-needle aspiration.</div></div><div><h3>Result</h3><div>Six out of eight cases in this study were female. The patient's ages ranged from 22 to 58 years. The maximum nodule diameter in this study was 4.98 cm. The shortest operative time in this study was 230 minutes, while the longest was 540 minutes. The estimated blood loss ranged from 50 to 120 ml, and the length of hospital stay was 48–120 hours.</div></div><div><h3>Conclusion</h3><div>TOETVA has been demonstrated to be a safe and effective procedure, offering several advantages over traditional/classic techniques, including minimal tissue dissection, improved cosmetic outcomes, reduced postoperative pain, and high patient satisfaction. With increasing surgical expertise and technological advancements, TOETVA is expected to become a preferred approach for select thyroidectomy cases, further improving surgical outcomes and patient quality of life.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107082","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}
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}
{"title":"Ovarian sex cord-stromal tumor: A case report and review of literature","authors":"Soukayna Bourabaa , Mohamed Taimi , Doaa Riali , Hajar Kandoussi , Youssef Mahdi , Basma El Khannoussi , Hatim Essaber , Rachida Latib , Fouad Tijami , Hafid Hachi , Nezha Elbahaoui","doi":"10.1016/j.sycrs.2025.100107","DOIUrl":"10.1016/j.sycrs.2025.100107","url":null,"abstract":"<div><div>Ovarian sex cord-stromal tumors are rare neoplasms, constituting approximately 7 % of all primary ovarian tumors. They are categorized into three main types: pure sex cord tumors, pure stromal tumors, and mixed sex cord stromal tumors. Among these, adult granulosa cell tumors are the most prevalent malignant variant. Unlike the more common ovarian epithelial cancers, sex cord stromal tumors often present in younger patients and are typically diagnosed at earlier stages, generally leading to more favorable outcomes. However, these tumors have the potential for late recurrence, with some cases reappearing up to 30 years after initial treatment. Although most sex cord stromal tumors exhibit indolent growth patterns, a subset can exhibit more aggressive behavior. This article presents a case of a 71-year-old native Moroccan woman who presented with abdominal pain and metrorrhagia and was found to have a 15 cm solid ovarian mass.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833495","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}
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}
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}
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}
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}
Rashed W. Alweshah , Mustafa Abdo , Ahmed Salah , Shaimaa Moustafa , Ahmed Nagi
{"title":"Spontaneous Transanal Small Bowel Prolapse in a Young Patient","authors":"Rashed W. Alweshah , Mustafa Abdo , Ahmed Salah , Shaimaa Moustafa , Ahmed Nagi","doi":"10.1016/j.sycrs.2025.100094","DOIUrl":"10.1016/j.sycrs.2025.100094","url":null,"abstract":"<div><div>Transanal small bowel evisceration is an exceedingly rare and life-threatening condition, predominantly affecting elderly patients with chronic rectal prolapse or pelvic floor dysfunction. However, this case report presents an unusual occurrence in a 30-year-old woman with no prior history of rectal prolapse, anorectal surgery, or other predisposing factors. She arrived at the emergency department with a visible small bowel prolapse through the anus, initially mistaking it for hemorrhoids. Emergent laparotomy was performed, involving the reduction of the prolapsed small bowel through a rectal defect, resection of ischemic segments, and primary anastomosis. A temporary diverting sigmoidostomy was created to protect the rectal repair. The patient had an uneventful recovery and was discharged on postoperative day six. We discuss pathophysiology, clinical presentation, and management strategies, emphasizing the role of fecal diversion in optimizing patient outcomes.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800138","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}
Khaled Demyati , Orabi Hajjeh , Amr Khaled , Usama Al Khuffash , Fathi Milhem , Ameer Awashra , Hanood Abu Rass
{"title":"Intraductal papillary neoplasm of the bile duct in the middle east: Case report","authors":"Khaled Demyati , Orabi Hajjeh , Amr Khaled , Usama Al Khuffash , Fathi Milhem , Ameer Awashra , Hanood Abu Rass","doi":"10.1016/j.sycrs.2025.100099","DOIUrl":"10.1016/j.sycrs.2025.100099","url":null,"abstract":"<div><div>Intraductal papillary neoplasm of the bile duct (IPNB) is a rare premalignant tumor characterized by papillary growth within the bile ducts, predominantly reported in East Asia. We present a 64-year-old male diagnosed with IPNB with focal stromal invasion, managed successfully with surgical resection. The case highlights unique endoscopic, imaging, and histopathological findings, and provides valuable data describing the unusual presentation of the case and the challenges faced in making the diagnosis. To our knowledge, this is the first reported case from the Middle East, emphasizing the rarity of IPNB in the region. This report underscores the importance of early diagnosis, proper imaging, and clear resection margins for optimal outcomes.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808169","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}