{"title":"Surgical Resection of a Pseudoaneurysm of the First Dorsal Metatarsal Artery after Unsuccessful Embolization: A Case Report and Literature Review.","authors":"Hiroto Yasumura, Kenichi Arata, Goichi Yotsumoto, Hideyuki Satozono, Koichiro Shimoishi, Yoshihiro Fukumoto, Yuki Ogata, Tomoyuki Matsuba, Yoshiharu Soga","doi":"10.70352/scrj.cr.24-0020","DOIUrl":"10.70352/scrj.cr.24-0020","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysms of peripheral foot arteries are extremely rare. Dorsalis pedis artery aneurysms account for 0.5% of peripheral artery aneurysms of the lower limbs. Here, we present a case of pseudoaneurysm of the first dorsal metatarsal artery of the foot and discuss the therapeutic strategy based on a literature review.</p><p><strong>Case presentation: </strong>A 76-year-old man with no history of foot trauma presented with pain and a pounding mass in the dorsum of the left foot. Echography revealed a 29 × 18 × 20 mm saccular aneurysm with to-and-fro blood flow. Contrast-enhanced computed tomography revealed an aneurysm in the first dorsal metatarsal artery. Angiography of the aneurysm revealed no arterial drainage. Embolization was subsequently performed only for the feeding artery, which was the proximal first dorsal metatarsal artery, using the 2 Target nanocoils (Stryker; Boston, MA, USA), resulting in successful occlusion. However, echography performed a few months after embolization revealed a recurrence of blood flow and enlargement of the coiled aneurysm. Nine months after embolization, the pain in the dorsum of the foot recurred. Therefore, we performed a surgical resection of the dorsal metatarsal artery aneurysm (38 × 26 × 26 mm) under general anesthesia. The first distal dorsal metatarsal artery exhibited pulsatile bleeding, and angiography of the distal dorsal metatarsal artery revealed a patent pedal arch and posterior tibial artery. Therefore, revascularization was not performed. The postoperative course was uneventful. The pathological examination indicated that the mass was a pseudoaneurysm.</p><p><strong>Conclusions: </strong>The treatments for peripheral foot artery aneurysms include observation, thrombin injection, ultrasound compression, embolization, surgical excision, and ligation. As the long-term outcomes of embolization for such aneurysms are unknown and cases are limited, surgical excision that is safe and definitive is recommended as the first-line treatment.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459414","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 Appendicitis Due to Burkitt Lymphoma Masking the Systemic Symptoms of Rapidly Progressing Burkitt Lymphoma.","authors":"Tomoya Masuda, Ryoma Sugimoto, Kenta Kobashi, Hiroshi Ishii, Kensuke Tsunemitsu","doi":"10.70352/scrj.cr.24-0178","DOIUrl":"10.70352/scrj.cr.24-0178","url":null,"abstract":"<p><strong>Introduction: </strong>Primary malignant lymphoma of the appendix is a rare disease, and primary Burkitt lymphoma of the appendix has been reported very rarely in Japan. Burkitt lymphoma is an aggressive lymphoma that progresses more rapidly than other malignant lymphomas, making it sometimes difficult to distinguish between systemic symptoms, such as fever associated with lymphoma progression and fever caused by appendicitis.</p><p><strong>Case presentation: </strong>A 21-year-old man underwent open appendectomy after antibiotic treatment for acute appendicitis proved ineffective. Postoperative pathological findings confirmed acute appendicitis. Antibiotics were continued after surgery, and the patient's fever and abdominal symptoms gradually improved. However, abdominal distension recurred on the 18th day of hospitalization. Blood tests showed a re-elevation of the white blood cell count, suggesting a postoperative intraperitoneal abscess. Despite further antibiotic treatment, fever and leukocytosis persisted. On the 28th day of hospitalization, abnormal lymphocytes were detected in the peripheral blood, and we realized that the persistent fever was due to systemic symptoms of malignant lymphoma rather than a complication of appendicitis. On the 30th day, the patient was referred to the hematology department and subsequently diagnosed with Burkitt lymphoma. Chemotherapy was initiated on the 40th day of hospitalization. At the time of this writing, the patient had remained alive without recurrence for 4 years 3 months postoperatively.</p><p><strong>Conclusion: </strong>In this case, symptoms of acute appendicitis and systemic symptoms of malignant lymphoma appeared simultaneously. As a result, the systemic symptoms of malignant lymphoma were misdiagnosed as postoperative complications, leading to a delay in diagnosis. Primary appendiceal Burkitt lymphoma is extremely rare, and its clinical features remain unknown. It is important to recognize that primary appendiceal Burkitt lymphoma can present with systemic symptoms concurrently with appendicitis. Surgeons should be aware of the clinical features of appendicitis caused by Burkitt lymphoma, which differ from those caused by other appendiceal tumors or malignant lymphoma.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558035","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}
Surgical Case ReportsPub Date : 2025-01-01Epub Date: 2025-02-06DOI: 10.70352/scrj.cr.24-0079
Stéphane Kohpe Kapseu, Venant Tchokonte-Nana
{"title":"Meckel's Diverticulum Mimicking a Postoperative Flange with Acute Intestinal Obstruction and Midgut Volvulus: A Case Report.","authors":"Stéphane Kohpe Kapseu, Venant Tchokonte-Nana","doi":"10.70352/scrj.cr.24-0079","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0079","url":null,"abstract":"<p><strong>Introduction: </strong>The interest of this case lies in the exceptional and rare character of the observed association.: Meckel's diverticulum (MD) mimicking a postoperative flange complicated by acute intestinal obstruction and malrotation by midgut volvulus.</p><p><strong>Case presentation: </strong>A 17-year-old black male student, with a body mass index of 28 kg/m<sup>2</sup> was admitted to the emergency department of a 4th category rural hospital, with paroxystic abdominal pain and vomiting. Medical history revealed an abdominal surgery for an umbilical hernia 3 years earlier. There was no malformation such as imperforate anus, Hirschsprung's disease, esophageal tracheal fistula, or cardiac anomaly in the medical history. An abdominal X-ray confirmed an acute intestinal obstruction showing hydroaeric levels. The diagnosis of acute intestinal obstruction on a flange was retained. A median laparotomy was performed; a solid mass-like lengthy structure mimicking postoperative flange was seen associated with midgut volvulus, while a malposition of the intestine was observed with a mesenteric band, as well as a hyperemic appendix. A 90° rotation stop of the midgut also called a complete common mesentery was in place; we then carried out a Ladd procedure. Morpho-pathological examination of the surgical specimens revealed the following: richly vascularized fibro-adipose tissues with no evidence of malignancy in the diverticular specimen, and acute pan-appendicitis with no evidence of malignancy in the appendicular specimen. The patient started to ingest food orally on the third postoperative day, and he was discharged uneventfully on the fifth day.</p><p><strong>Conclusion: </strong>MD, although generally a tubular structure, may sometimes appear as a non-tubular mass during clinical examination. Intestinal obstruction due to MD associated with midgut volvulus is exceptional. Management of this association should be based on accurate knowledge of the morpho-embryological specificities during gut development.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543581","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":"Impact of Right Top Pulmonary Vein Location on Subcarinal Lymph Node Dissection in Thoracoscopic Esophagectomy: A Case Report and Literature Review.","authors":"Takeshi Horaguchi, Yuta Sato, Yuji Hatanaka, Yoshihiro Tanaka, Noriki Mitsui, Masahiro Fukada, Itaru Yasufuku, Ryuichi Asai, Jesse Yu Tajima, Nobuhisa Matsuhashi","doi":"10.70352/scrj.cr.24-0093","DOIUrl":"10.70352/scrj.cr.24-0093","url":null,"abstract":"<p><strong>Introduction: </strong>The right top pulmonary vein (RTPV) is a rare anatomical variant that arises independently of the right superior lobe. It drains behind the right main bronchus or bronchus intermedius and into the left atrium or another pulmonary vein. This anomaly poses challenges during subcarinal lymph node dissection in thoracic surgery, such as esophagectomy, owing to the risk of vascular injury. The RTPV is mainly located behind the right main bronchus and right intermediate bronchus; however, reports of subcarinal dissection focusing on these sites are lacking. Herein, we present a case of esophageal cancer with an RTPV that was treated with thoracoscopic esophagectomy and propose a convenient classification for the anatomical findings and RTPV site.</p><p><strong>Case presentation: </strong>A 71-year-old man underwent a thoracoscopic esophagectomy for esophageal cancer (T1bN0M0) during a routine medical checkup. A preoperative computed tomography scan revealed an anomaly in which the RTPV drained into the left atrium behind the right main bronchus. Radical subcarinal lymphadenectomy was performed while preserving the RTPV, using 3 dimensions for preoperative simulation and intraoperative navigation. The operation lasted 6 h and 42 min, and the blood loss volume was 30 mL. The patient's postoperative course was uneventful, and he was discharged on postoperative day 21.</p><p><strong>Conclusions: </strong>In a retrospective review of esophageal cancer surgery cases at our hospital, RTPV was observed in 17/314 cases (5.4%). The most common inflow site was the inferior pulmonary vein (IPV) (9 cases), followed by the left atrium (5 cases), superior pulmonary vein (2 cases), and superior branch of the IPV (1 case). The inflow site was behind the right main bronchus and the right intermediate bronchus in 4 and 13 cases, respectively. Compared to past reviews, the inflow site varied somewhat; however, the vascular location remained the same. By classifying the areas behind the right main and right intermediate bronchi as Zones 1 and 2, respectively, cases in which the RTPV runs through Zone 1, as identified on preoperative computed tomography, should be manipulated with caution due to the risk of injury during lymph node dissection beneath the tracheal bifurcation.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543579","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":"Extracorporeal Membrane Oxygenation-Assisted Thoracic Surgery: A Series of 10 Cases.","authors":"Yuzu Harata, Kazuhiro Imai, Shinogu Takashima, Shoji Kuriyama, Hidenobu Iwai, Haruka Suzuki, Ryo Demura, Sumire Shibano, Yoshihiro Minamiya","doi":"10.70352/scrj.cr.24-0004","DOIUrl":"10.70352/scrj.cr.24-0004","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membrane oxygenation (ECMO) is a type of extracorporeal circulation used to divert blood from and deliver blood to peripheral blood vessels. Recently, the use of ECMO has been reported in various non-transplant surgeries. Particularly in tracheal surgeries, ECMO provides an unobstructed surgical field and enables safe induction of general anesthesia in difficult intubation cases. Here, we report on 10 cases of thoracic surgery in which ECMO was employed at our institution.</p><p><strong>Case presentation: </strong>These 10 cases comprise 4 tracheal cancer surgeries, 2 lung cancer surgeries, and 1 case each of surgery for thyroid cancer, mediastinal cancer, tracheomalacia, and tracheobronchial injury. Veno-venous (VV)-ECMO is most often selected, but veno-arterial (VA)-ECMO is chosen when recirculation with VV-ECMO is unacceptable, when pulmonary artery bleeding needs to be controlled, or when cardiac support is necessary. Among the 10 presented cases, VV-ECMO was used in 8, while VA-ECMO was employed in 2. Three of these cases involved ECMO bailout due to dyspnea caused by airway stenosis. Six of the patients did not receive heparin maintenance. Of those, 1 was maintained on nafamostat mesilate, 2 were maintained on nafamostat mesilate after receiving a single dose of heparin, and 3 received only a single dose of heparin. In none of those cases did ECMO fail to maintain flow due to thrombus formation. A postoperative hemothorax occurred as one of the ECMO-related complications in Case 4. There were no perioperative cardiopulmonary complications, in-hospital deaths, or deaths within 30 days after surgery. One patient died from metastatic recurrence of non-small cell lung cancer 5 months after surgery, another from progression of disease in mediastinal anaplastic cancer 4 months after surgery, and the 3rd from upper gastrointestinal bleeding 2 years after surgery. The other 7 patients remain alive.</p><p><strong>Conclusions: </strong>ECMO is useful in tracheal surgery and in cases where intubation is difficult or dangerous, because it facilitates safe and accurate surgery. We also believe that individualized anticoagulant strategies can be safely implemented.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692848","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 Total Proctocolectomy for Familial Adenomatous Polyposis with Multiple Colorectal Cancers Using the Hugo RAS System.","authors":"Yu Yoshida, Yuki Aisu, Yoshiro Itatani, Koya Hida, Ryosuke Okamura, Masahiro Maeda, Nobuaki Hoshino, Hisatsugu Maekawa, Atsushi Ikeda, Keiko Kasahara, Hiromitsu Kinoshita, Shigeo Hisamori, Shigeru Tsunoda, Kazutaka Obama","doi":"10.70352/scrj.cr.25-0035","DOIUrl":"10.70352/scrj.cr.25-0035","url":null,"abstract":"<p><strong>Introduction: </strong>Experience with the Hugo RAS system in robot-assisted colorectal surgery is limited. This is particularly noticeable when focusing on complex procedures, such as total proctocolectomy (TPC). This study aimed to demonstrate the feasibility and safety of using the Hugo RAS system for TPC.</p><p><strong>Case presentation: </strong>A 27-year-old woman with multiple colorectal cancers with a background of familial adenomatous polyposis underwent robot-assisted TPC, including lymph node dissection of the entire colorectal region using the Hugo RAS system. The robotic procedure was divided into 3 steps: 1) Trendelenburg position to perform ascending colon complete mesocolic excision (CME) to the hepatic flexure, 2) descending colon CME and total mesorectal excision with D3 lymph node dissection, and 3) flat position to perform central vessel ligation along the superior mesenteric artery. After undocking, the specimen was extracted transanally, and an ileal pouch was constructed from a small laparotomy at the umbilical incision, followed by ileal pouch-anal anastomosis. The operative time was 632 min, and the estimated blood loss was minimal. The postoperative period was uneventful.</p><p><strong>Conclusions: </strong>Robot-assisted TPC using the Hugo RAS system is safe and feasible. The flexibility of Hugo, which is carried by a modular-type surgical robot with multiple independent arms, enables safe and effective advanced procedures.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731639","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}
Surgical Case ReportsPub Date : 2025-01-01Epub Date: 2025-02-18DOI: 10.70352/scrj.cr.24-0112
Kanji Ishizu, Kanta Araki, Koji Kagisaki, Hideto Ozawa
{"title":"The Usefulness of Intraoperative Indocyanine Green Fluorescence Imaging in Surgical Treatment of Refractory Chylothorax in Pediatric Patients: A Case Report.","authors":"Kanji Ishizu, Kanta Araki, Koji Kagisaki, Hideto Ozawa","doi":"10.70352/scrj.cr.24-0112","DOIUrl":"10.70352/scrj.cr.24-0112","url":null,"abstract":"<p><strong>Introduction: </strong>Chylothorax is one of the complications in cardiovascular surgery. Although prolonged chylothorax leads to critical status and is associated with high mortality, its treatment has not been well established. We present a successful case of surgical treatment of chylothorax in a neonate using indocyanine green to identify the site of lymphatic leakage.</p><p><strong>Case presentation: </strong>The patient with complete atrioventricular septal defect, patent ductus arteriosus, pulmonary hypertension, and chromosomal abnormality with trisomy 21 underwent pulmonary artery banding and patent ductus arteriosus ligation through median sternotomy. The postoperative course was complicated with chylothorax; conservative treatment was not effective, so surgical treatment was selected. Indocyanine green was injected subcutaneously between the first and second toes on the left side 30 min before surgery to identify the site of leakage. We could detect the lymphatic leakage from the para-aortic lymph node by indocyanine green camera in the left thoracic cavity, and the leakage sites could be closed with interrupted sutures.</p><p><strong>Conclusion: </strong>Identification of lymphatic leakage sites using indocyanine green could be an effective technique in the surgical treatment of chylothorax in pediatric patients.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493538","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":"Long-Term Survival after Treatment with Induction Therapy and Surgery for Mediastinal Carcinoma of Unknown Primary.","authors":"Yasushi Sakamaki, Naoya Takada, Yuya Kogita, Nanami Hiraiwa","doi":"10.70352/scrj.cr.24-0011","DOIUrl":"10.70352/scrj.cr.24-0011","url":null,"abstract":"<p><strong>Introduction: </strong>Carcinoma of unknown primary (CUP) is rarely located in the mediastinum. Most cases are revealed to be metastatic lymph node carcinoma, which carries a poor prognosis. The optimal treatment for CUP confined to the mediastinum is yet to be established, and the long-term outcome of induction therapy in combination with surgery for mediastinal CUP is unclear.</p><p><strong>Case presentation: </strong>A 46-year-old man with no history of malignancy was diagnosed with anterior mediastinal adenocarcinoma through biopsy. The patient underwent chemoradiation for the tumor, which was initially suspected as invasive T4 lung cancer. After a favorable response to presurgical therapy, the tumor was deemed more likely a mediastinal tumor, and it was completely resected simultaneously with the thymus, the partial left lung, and the partial left innominate vein. The tumor contained histologic features identifiable as a lymph node tissue and lacked any thymic tissue, which led to the final diagnosis as metastatic lymph node adenocarcinoma; however, its origin was unknown. No signs of recurrence were detected for 13 years after surgery.</p><p><strong>Conclusions: </strong>Our case suggests that even patients with mediastinal CUP deemed an advanced disease can achieve long-term survival after undergoing induction therapy and definitive surgery.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524503","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}
Surgical Case ReportsPub Date : 2025-01-01Epub Date: 2025-02-21DOI: 10.70352/scrj.cr.24-0037
Andreas R R Weiss, Georg F Weber, Maximilian Brunner, Robert Grützmann, Abbas Agaimy, Christian Krautz
{"title":"A Unique Case of Intra-Abdominal Diffuse Lymphangiomatosis Mimicking a Pseudomyxoma Peritonei.","authors":"Andreas R R Weiss, Georg F Weber, Maximilian Brunner, Robert Grützmann, Abbas Agaimy, Christian Krautz","doi":"10.70352/scrj.cr.24-0037","DOIUrl":"10.70352/scrj.cr.24-0037","url":null,"abstract":"<p><strong>Introduction: </strong>Localized cystic lymphangiomas (CL) are rare benign tumors deriving from the lymphatic system. CL is diagnosed more frequently in children than in the adult population and, although commonly affecting the cervical and axillary regions, can develop in various parts of the body. Abdominal cystic lymphangioma (ACL) comprises less than 5% of all CL cases.</p><p><strong>Case presentation: </strong>A 35-year-old female patient with a history of benign appendectomy in childhood was transferred to our tertiary center for the operative management of a suspected extensive pseudomyxoma peritonei (PMP). In accordance with the multidisciplinary team discussion, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was planned. Intraoperatively, a typical \"jelly belly\" with high disease burden throughout the abdominal cavity and the small pelvis was found. A multi-visceral resection with complete cytoreduction (CCR 0) was performed. The postoperative histopathological findings revealed a diffuse, partially cystic lymphangiomatosis involving the peritoneum extensively without evidence of PMP or malignancy.</p><p><strong>Conclusions: </strong>ACLs are uncommon in the adult population, and diffuse peritoneal involvement is even rarer. Surgical management with complete resection is the preferred treatment option. Other benign cysts, as well as infectious diseases and malignancy, should be considered during the preoperative workup.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524502","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 Induction Chemoimmunotherapy and Sleeve Lobectomy to Avoid Pneumonectomy for Central Squamous Cell Lung Cancer.","authors":"Ayaka Asakawa, Ryota Ishizawa, Yukitaka Sato, Yuya Ishikawa, Ryo Wakejima, Hironori Ishibashi, Kenichi Okubo","doi":"10.70352/scrj.cr.24-0069","DOIUrl":"10.70352/scrj.cr.24-0069","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, neoadjuvant immunotherapy plus chemotherapy has been provided for patients with stage II-III resectable lung cancer. We report a case in which a pneumonectomy was avoided by administrating neoadjuvant chemoimmunotherapy.</p><p><strong>Case presentation: </strong>An 81-year-old man presented with a cough. Examination showed squamous cell lung cancer in the right lower lobe extending to the central side of the upper lobe, which would have required a pneumonectomy for complete resection. Neoadjuvant chemoimmunotherapy was administered to reduce the extent of pulmonary resection due to the patient's advanced age and impaired pulmonary function. Post-treatment examination showed tumor size reduction, and bronchoscopy showed disappearance of right upper bronchial erythema and persistent erythema of the bronchus intermedius. A sleeve right lower lobectomy was performed. Histopathological findings revealed complete resection of the cancerous lesion and a major pathological response.</p><p><strong>Conclusions: </strong>Sleeve lobectomy after preoperative chemoimmunotherapy for an elder patient with low pulmonary function was safe and efficient.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558039","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}