Surgical Case Reports最新文献

{"title":"Small bowel intussusception due to adenocarcinoma of ectopic pancreas in the jejunum: a case report.","authors":"Kota Yamamoto, Takahiro Ishimori, Taiki Okada, Takeshi Sasaki, Yumi Mikajiri, Takahiro Terashima, Shunji Kawamoto","doi":"10.1186/s40792-024-02060-z","DOIUrl":"10.1186/s40792-024-02060-z","url":null,"abstract":"<p><strong>Introduction: </strong>We encountered a case of adenocarcinoma of the ectopic pancreas, causing intussusception.</p><p><strong>Case presentation: </strong>A 76-year-old man presented with complaints of abdominal distention and vomiting to the emergency department in March 2022. Computed tomography showed that the small bowel piled up approximately 20 cm from the ligament of the traits. Endoscopic repair was challenging; therefore, laparoscopic repair and partial resection of the small bowel were performed. The specimen showed a mass in the small bowel arising from an ectopic pancreas that had caused accumulation. Pathological examination revealed ectopic pancreatic cancer. Two years postoperatively, no apparent recurrence has been observed. We report a relatively rare case of a cancerous ectopic jejunal pancreas causing a mass, with a discussion in the literature.</p><p><strong>Conclusions: </strong>Detection typically requires surgery due to advanced-stage intestinal obstruction or accumulation, as observed in the present case. However, preoperative diagnosis and early detection of ectopic pancreatic cancer are challenging. The disease progresses similarly to pancreatic cancer, highlighting the need for early detection methods. Additionally, accumulating more case reports is essential for establishing an effective treatment strategy.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"264"},"PeriodicalIF":0.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669248","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}

{"title":"Solitary fibrous tumor of the gallbladder: a case report.","authors":"Kiwako Sekine, Yuichi Nakaseko, Keigo Nakashima, Teppei Kamada, Junji Takahashi, Manabu Koja, Naoko Fukushima, Ryota Iwase, Teruyuki Usuba, Masaichi Ogawa, Yutaka Suzuki","doi":"10.1186/s40792-024-02057-8","DOIUrl":"10.1186/s40792-024-02057-8","url":null,"abstract":"<p><strong>Background: </strong>Primary solitary fibrous tumors (SFTs) of the gallbladder are rare. Here, we report the case of a patient who underwent surgical treatment for a primary SFT originating in the gallbladder.</p><p><strong>Case presentation: </strong>A 48-mm gallbladder tumor was detected in a 70-year-old man using abdominal ultrasonography at a primary hospital, and he was subsequently referred to our department. A 50-mm enhanced tumor in the gallbladder was identified using computed tomography. Magnetic resonance imaging revealed a smooth-marginated tumor with hyperintensity on T2-weighted imaging. 18F-Fluorodeoxyglucose positron emission tomography confirmed high-level fluorodeoxyglucose uptake in the gallbladder tumor in the early phase without increasing uptake in the later phase. Surgical resection was planned to evaluate the tumor diagnosis. Initially, we performed open cholecystectomy with wedge resection of the gallbladder bed. Intraoperative pathological examination suggested gallbladder cancer; therefore, we performed radical surgery, including resection of the common bile duct, extended radical lymphadenectomy, and choledochojejunostomy. Ultimately, the final pathological examination revealed an SFT originating from the gallbladder with a negative surgical margin. Postoperatively, the patient developed bile leakage that was treated with tube drainage. The patient recovered satisfactorily and was discharged on postoperative day 20. At 24 months postoperatively, the patient was in good general condition without recurrence.</p><p><strong>Conclusions: </strong>We report a rare case of a primary SFT originating in the gallbladder. Clinicians should be aware that SFT can be found in the gallbladder, and when it is difficult to make a preoperative diagnosis, surgical treatment should be considered.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"263"},"PeriodicalIF":0.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648444","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}

{"title":"Appendiceal neurofibroma after resection of multiple gastrointestinal stromal tumors of the small intestine in a patient with neurofibromatosis type 1: a case report.","authors":"Katsuya Sakashita, Shoichi Manabe, Akio Shiomi, Hiroyasu Kagawa, Yusuke Yamaoka, Shunsuke Kasai, Yusuke Tanaka, Takuma Oishi, Teiichi Sugiura","doi":"10.1186/s40792-024-02062-x","DOIUrl":"10.1186/s40792-024-02062-x","url":null,"abstract":"<p><strong>Background: </strong>Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is an autosomal dominant disorder that can affect multiple organs. Although gastrointestinal manifestations, such as neurofibromas and gastrointestinal stromal tumors (GISTs), can occur, appendiceal neurofibromas are extremely rare, with no documented cases of their occurrence following other gastrointestinal lesions. Herein, we report a case of an appendiceal neurofibroma following the resection of multiple small intestinal GISTs.</p><p><strong>Case presentation: </strong>A 68-year-old man with NF1 presented with melena and was diagnosed with anemia due to bleeding from multiple small intestinal GISTs. Laparoscopic three partial resection of the small intestine was performed to control the bleeding. Histopathologic examination revealed the proliferation of spindle cells that are positive for c-kit and Discovered on GIST-1, confirming the diagnosis of GIST. Two years later, a follow-up computed tomography (CT) scan revealed a progressively enlarging mass in the appendix with suspected invasion into the small intestine. Positron emission tomography/CT showed fludeoxyglucose accumulation in the tumor. Therefore, considering the possibility of malignancy, laparoscopic ileocecal resection with lymph node dissection was performed. Postoperatively, melena was observed, but the anemia did not progress and improved with fasting and hemostatic therapy. The patient was eventually discharged on postoperative day 8. Histopathologic examination revealed spindle cell proliferation with positivity for S-100, confirming the diagnosis of neurofibroma.</p><p><strong>Conclusions: </strong>Patients with NF1 can develop a variety of gastrointestinal lesions. Appendiceal neurofibroma can be difficult to diagnose preoperatively and differentiate from malignancy. Hence, surgical resection should be considered.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"262"},"PeriodicalIF":0.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628695","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}

{"title":"Intussusception of the appendix secondary to endometriosis: a case report.","authors":"Yuta Kawaguchi, Kyoichiro Maekawa, Toshiaki Hashimoto, Mizuki Kitagawa, Shigetoshi Urabe, Emi Yoshimura, Takashi Goto, Mihoko Rikitake, Tohru Iwata","doi":"10.1186/s40792-024-02054-x","DOIUrl":"10.1186/s40792-024-02054-x","url":null,"abstract":"<p><strong>Background: </strong>Intussusception of the appendiceal endometriosis is rare. Although approximately 200 cases of appendiceal intussusception have been reported in the literature, very few have ever been diagnosed preoperatively. Here, we report the case of intussusception of the appendiceal endometriosis with laparoscopic ileocecal resection.</p><p><strong>Case presentation: </strong>A woman in her 50s presented to the out-patients clinic with epigastric pain lasting for a several month. Contrast-enhanced computed tomography (CT) scanning revealed ileocolic intussusception in which a cecum polypoid mass lesion extended to the hepatic flexure of the ascending colon. A colonoscopy showed a large pedunculated polyp in the cecum. Laparoscopic ileocecal resection was performed. Pathology confirmed an invaginated appendix demonstrating endometriosis implants.</p><p><strong>Conclusions: </strong>Possible intrinsic causes of intussusception are varied, appendiceal intussusception secondary to endometriosis is extremely rare. Intussusception of the appendix is a rare finding, often mistaken for a polyp. We suggest considering inverted appendix as a differential diagnosis when investigating cecal lesions.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"261"},"PeriodicalIF":0.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628700","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}

{"title":"Hepatic methotrexate-associated lymphoproliferative disease: a case report and literature review.","authors":"Shinya Sakamoto, Motoyasu Tabuchi, Rika Yoshimatsu, Manabu Matsumoto, Jun Iwata, Takehiro Okabayashi","doi":"10.1186/s40792-024-02065-8","DOIUrl":"10.1186/s40792-024-02065-8","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate-associated lymphoproliferative disease (MTX-LPD) is a rare and life-threatening complication of MTX administration. MTX-LPD features more extranodal lesions than malignant lymphoma; however, the liver is an extremely rare organ that develops LPD. Herein, we present a case of hepatic MTX-LPD treated with surgical resection. We also reviewed the literature on hepatic MTX-LPD.</p><p><strong>Case presentation: </strong>A 66-year-old man with a history of rheumatoid arthritis (RA) was admitted to our department for the treatment of hepatic solitary liver tumor. The patient had been receiving MTX (14 mg/week) for RA for 6 years. MTX was withdrawn and salazosulfapyridine was prescribed 3 weeks prior to admission because of mediastinal MTX-LPD. Abdominal contrast-enhanced computed tomography showed a slightly ring-like enhanced hypovascularized mass (80 mm) in the lateral section of the liver. Carbohydrate antigen 19-9 (78.1 U/mL) level was elevated. No evidence was observed on esophagogastroduodenoscopy or colonoscopy. The tumor was suspected to be an intrahepatic cholangiocarcinoma. The patient underwent hepatic lateral sectionectomy and lymphadenectomy. Pathological examination revealed that the hepatic mass was coagulative necrosis of the CD20-positive B-cell lymphocytes. These histological findings were similar to those of rapid necrotic lymphoma. MTX-LPD is known to spontaneously regress after withdrawing MTX, and the patient was diagnosed with hepatic MTX-LPD.</p><p><strong>Conclusions: </strong>MTX-LPD can occur in the liver. Clinician should suspect hepatic MTX-LPD when a liver mass is detected in patient who had been treating with MTX for RA.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"260"},"PeriodicalIF":0.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628697","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}

{"title":"Left-sided portal hypertension caused by a solid pseudopapillary neoplasm of pancreas tail: a pediatric case report.","authors":"Toko Sihnkai, Kouji Masumoto, Yohei Sanmoto, Akio Kawami, Miki Ishikawa, Shunsuke Fujii, Tsukasa Saida, Toshitaka Ishiguro, Noriaki Sakamoto","doi":"10.1186/s40792-024-02034-1","DOIUrl":"10.1186/s40792-024-02034-1","url":null,"abstract":"<p><strong>Background: </strong>Solid pseudopapillary neoplasm (SPN) is a low-grade malignant tumor that occurs in 60% of all pediatric pancreas tumors. Radical tumor resection is essential; however, spleen preservation is also crucial to prevent overwhelming post-splenectomy infection. In contrast, spleen preservation is not always possible, because left-sided portal hypertension (LSPH) can cause splenic vein stenosis or occlusion induced by pancreatic tumor. We herein report on a pediatric patient of LSPH due to SPN in the pancreatic tail.</p><p><strong>Case presentation: </strong>A 12-year-old girl was admitted to our hospital with left upper quadrant abdominal pain. A solid mass was palpated in the left costal region. The patient showed slight anemia (Hb: 11.8 g/dL) and elevation of inflammatory reaction (CRP: 5.98 mg/dL) without positive tumor markers. A radiological examination revealed that a 9 cm-sized mass with hemorrhagic necrosis in the pancreatic tail. Splenic venous flow was not detected and collateral draining into the left gastric vein and left renal veins were developed with splenomegaly. LSPH was involved at the time of diagnosis. The tumor was diagnosed with SPN, hence tumor resection with spleen preservation was performed. Six months after surgery, the patient developed a left quadrant abdominal pain that worsened during exercise. There was no improvement of splenic venous flow and splenomegaly. LSPH remained with splenomegaly, which possibly triggered the patient's abdominal pain. The patient underwent splenectomy 9 months after the tumor resection. After the splenectomy, the patient's abdominal pain disappeared without any recurrence 8-year post-surgery.</p><p><strong>Conclusions: </strong>LSPH has not been a major focus in previous SPN pediatric patients, although most symptomatic LSPH patients required splenectomy. Careful post-operative observation for LSPH is important for pediatric SPN patients.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"256"},"PeriodicalIF":0.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628702","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}

{"title":"The enhanced-view totally extraperitoneal repair of abdominal bulge after DIEP flap breast reconstruction for breast cancer: a case report.","authors":"Masami Yako, Yoshiro Imai, Yusuke Suzuki, Kosei Kimura, Mitsuhiro Asakuma, Hideki Tomiyama, Mitsuhiko Iwamoto, Sang-Woong Lee","doi":"10.1186/s40792-024-02056-9","DOIUrl":"10.1186/s40792-024-02056-9","url":null,"abstract":"<p><strong>Background: </strong>The deep inferior epigastric perforator (DIEP) flap for autologous breast reconstruction is associated with higher patient satisfaction and fewer abdominal morbidities at the donor site than the transverse rectus abdominis myocutaneous flap. However, abdominal bulging occurs at a certain frequency, and there is no established treatment. Here, we present a case of laparoscopic hernia repair using the enhanced-view totally extraperitoneal (eTEP) method in a patient with a lower abdominal bulge after DIEP flap reconstruction.</p><p><strong>Case presentation: </strong>A 53-year-old woman underwent left nipple-sparing mastectomy, left axillary lymph node dissection, and breast reconstruction with a DIEP flap for left breast cancer 3 years previously. We performed an eTEP method for an abdominal bulge. The absence of a hernia sac facilitated dissection of the retrorectal space, and a left-sided transversus abdominis release was performed, followed by mesh placement. No postoperative abdominal bulging was observed.</p><p><strong>Conclusions: </strong>Using the eTEP method for repairing an abdominal bulge after DIEP flap reconstruction is advantageous because it facilitates a relatively straightforward dissection of a wide area of the retrorectal space without a hernia sac.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"259"},"PeriodicalIF":0.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628713","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}

{"title":"Robot-assisted laparoscopic hepatectomy for liver metastasis from clitoral malignant melanoma: a case report.","authors":"Hitoshi Iwasaki, Shinji Itoh, Norifumi Iseda, Yuriko Tsutsui, Takuma Izumi, Yuki Bekki, Shohei Yoshiya, Takamichi Ito, Takeo Toshima, Takeshi Nakahara, Tomoharu Yoshizumi","doi":"10.1186/s40792-024-02058-7","DOIUrl":"10.1186/s40792-024-02058-7","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant melanomas occur most commonly in the skin, mucous membranes, or choroid. Clitoral malignant melanomas are extremely rare. Stage IV malignant melanomas have a poor prognosis, and molecularly targeted agents or immune checkpoint inhibitors are recommended. However, surgical resection is reportedly a valid option for improving the prognosis of patients with oligometastases, defined as a small number of metastases that can be completely resected. In this report, we describe hepatic resection for a recurrent liver metastasis in a patient who had undergone removal of a clitoral malignant melanoma 9 years previously.</p><p><strong>Case presentation: </strong>An 82 year-old woman presented with a black nodule on her clitoris. Total resection of the nodule resulted in a diagnosis of clitoral malignant melanoma (pT4bN0M0, pStage IIC; UICC 8th edition). A follow-up computed tomography scan 4 years later revealed a single 5 mm mass in the lower lobe of the right lung, prompting partial resection of the right lung. Pathological examination of the operative specimen revealed a pulmonary metastasis of malignant melanoma. The patient was treated with pembrolizumab monotherapy as adjuvant chemotherapy for 1 year. A follow-up computed tomography scan 9 years after surgical removal of the primary lesion revealed an 18 mm mass in segment II of the liver, prompting robot-assisted laparoscopic left lateral sectionectomy. The provisional diagnosis of metastatic malignant melanoma in the liver was confirmed by histopathological examination of the operative specimen. The patient was treated with pembrolizumab monotherapy as postoperative adjuvant chemotherapy for 1 year. No further recurrence was detected at the 1.5 year follow-up.</p><p><strong>Conclusion: </strong>We performed hepatectomy for oligometastasis of clitoral malignant melanoma, an extremely rare entity. Surgery has the potential to prolong the prognosis of patients with oligometastasis.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"258"},"PeriodicalIF":0.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628703","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}

{"title":"A case of intraoperative detection of a central venous catheter in azygos vein arch during esophageal cancer surgery.","authors":"Katsuhiko Murakawa, Koichi Ono, Yoshiyuki Yamamura","doi":"10.1186/s40792-024-02055-w","DOIUrl":"10.1186/s40792-024-02055-w","url":null,"abstract":"<p><strong>Background: </strong>Central venous catheter (CVC) is often used in the perioperative management of esophageal cancer. The position of the CVC tip has been reported to shift with body positioning and, although infrequent, may traverse into the azygos vein arch. Herein, we describe a case where a migrated CVC tip in the azygous vein arch was identified during esophageal cancer surgery, preventing CVC dissection concurrent with azygous vein arch resection.</p><p><strong>Case presentation: </strong>A 65-year-old man was diagnosed with advanced esophageal cancer and was referred to our department for surgery after undergoing neoadjuvant chemotherapy. He underwent robot-assisted subtotal esophagectomy, followed by gastric conduit reconstruction via the posterior sternal route. Thoracic manipulation was performed with the patient in the prone position. During the surgery, a foreign body was found in the azygos vein arch, indicating that a central venous catheter had inadvertently entered the azygos vein arch. The catheter was retracted by 5 cm, and after confirming that no catheter remained in the azygos arch, the azygos vein arch was separated using an autosuture device.</p><p><strong>Conclusions: </strong>Central venous catheter migration can occur in a various vessels. During prone esophageal cancer surgery, elevating the right upper extremity may alter the catheter tip's position from its the preoperative position. CVC amputation should be observed because the azygos vein arch is often amputated to facilitate upper mediastinal dissection during esophageal cancer surgery.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"257"},"PeriodicalIF":0.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628693","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}

{"title":"Granulomatous mastitis forming a well-defined large mass diagnosed by surgical excision: a case report.","authors":"Chisaki Hao, Yoshiya Horimoto, Toshitaka Uomori, Akihiko Shiraishi, Gotaro Orihata, Hiroko Onagi, Takuo Hayashi, Junichiro Watanabe, Goro Kutomi","doi":"10.1186/s40792-024-02059-6","DOIUrl":"10.1186/s40792-024-02059-6","url":null,"abstract":"<p><strong>Background: </strong>Granulomatous mastitis is a relatively rare benign inflammatory disease of the breast, but it is sometimes difficult to distinguish from breast cancer by imaging. We experienced a case that was definitively diagnosed as granulomatous mastitis from the surgical specimen. The mass appeared as a large cystic lesion on imaging, which is unusual for granulomatous mastitis, and was initially suspected to be an encapsulated papillary carcinoma.</p><p><strong>Case presentation: </strong>A 43-year-old woman presented with a painful mass in her right breast. Ultrasonography revealed a cystic mass lesion with internal solid components, with partially indistinct cyst walls and abundant blood flow. Additionally, lymphadenopathy of one axillary lymph node was observed. Magnetic resonance imaging findings showed irregularly spreading enhanced nodules within the cystic lesion, raising the suspicion of encapsulated papillary carcinoma. Although the histological findings from a needle biopsy were consistent with granulomatous mastitis, the possibility of malignancy could not be ruled out based on imaging, prompting a diagnostic probe lumpectomy. However, the surgical specimens did not reveal any tumorous lesions, and we reached a final diagnosis of granulomatous mastitis. Postoperatively, the patient was followed-up without steroid therapy and has been free from recurrence of mastitis for 22 months after surgery.</p><p><strong>Conclusions: </strong>We report a case of granulomatous mastitis that was detected as a large cystic lesion with a well-defined border on imaging and a definitive diagnosis was made from a surgical specimen.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"255"},"PeriodicalIF":0.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606469","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}