Surgical Case Reports最新文献

{"title":"Hilar Cholangiocarcinoma with Para-Aortic Lymph Node Metastasis Treated with Chemoimmunotherapy and Conversion Surgery: A Case Report.","authors":"Yuma Yasui, Koichi Kimura, Norifumi Iseda, Yoshinari Nobuto, Hiroko Yano, Yuichiro Kajiwara, Takuro Watanabe, Fang Cao, Michiko Amano, Takaaki Tanaka, Hironori Ochi, Nobuaki Azemoto, Kazuhito Minami, Ryosuke Minagawa, Tomoyuki Yokota, Takashi Nishizaki","doi":"10.70352/scrj.cr.25-0023","DOIUrl":"10.70352/scrj.cr.25-0023","url":null,"abstract":"<p><strong>Introduction: </strong>Cholangiocarcinoma (CC) has a poor prognosis and few treatment options. Conversion surgery for unresectable CC has been frequently reported; however, there are almost no reports of conversion surgery after durvalumab plus gemcitabine and cisplatin therapy. In this study, we report the case of a patient with unresectable hilar CC who received durvalumab plus gemcitabine and cisplatin therapy and achieved a pathological complete response after conversion surgery.</p><p><strong>Case presentation: </strong>A 70-year-old man was diagnosed with hilar CC (cT3N1M0, Stage III C) based on biopsy of the common bile duct stenosis and computed tomography (CT) and magnetic resonance cholangiopancreatography scans. Initially, a right lobe hepatectomy and subtotal stomach-preserving pancreatoduodenectomy were planned. However, there were concerns about an insufficient functional remnant liver volume. Trans-ileocolic portal embolization of the right portal vein branch was performed. On a preoperative CT scan 1 month later for liver volumetry, swelling of the para-aortic lymph nodes was observed, which was judged as distant metastasis, and radical resection could not be performed. After 8 courses of durvalumab plus gemcitabine and cisplatin therapy, vanishing fluorodeoxyglucose accumulation in the para-aortic lymph nodes was observed on positron emission tomography-CT. The possibility of resection was reevaluated, and a right lobe hepatectomy and extrahepatic biliary reconstruction were performed as conversion surgeries. Histological examination confirmed the absence of residual tumors or lymph node metastases. Ten months after surgery, the patient was free of recurrence.</p><p><strong>Conclusions: </strong>Chemoimmunotherapy with durvalumab as a first-line treatment for unresectable CC has shown promising results. Immunotherapy with durvalumab, followed by conversion surgery, may improve the prognosis of patients with unresectable CC.</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/PMC11925595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671051","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 Robotic Pancreaticoduodenectomy Case Involving a Meandering Main Pancreatic Duct Coursing Posterior to a Replaced Common Hepatic Artery and in Front of the Portal Vein.","authors":"Yui Sawa, Yosuke Inoue, Kosuke Kobayashi, Atsushi Oba, Yoshihiro Ono, Hiromichi Ito, Yu Takahashi","doi":"10.70352/scrj.cr.24-0184","DOIUrl":"10.70352/scrj.cr.24-0184","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomical anomalies, such as branches of the celiac artery and superior mesenteric artery (SMA), and pancreatic malformations, including the annular pancreas, are important during pancreaticoduodenectomy (PD). Here, we report a case of an anomaly of the artery and main pancreatic duct (MPD) in which the pancreatic parenchyma surrounded the replaced common hepatic artery (rCHA), and the meandering main pancreatic duct (MMPD) ran behind the rCHA.</p><p><strong>Case presentation: </strong>A 71-year-old woman was diagnosed with intraductal papillary mucinous neoplasm (IPMN) of pancreatic body and the dilation of MPD to 13 mm, which was a factor of high-risk stigmata. Preoperative computed tomography (CT) showed that the rCHA branched from the superior mesenteric artery (SMA) and the pancreatic parenchyma surrounded the rCHA. Moreover, the MPD meandered and ran behind the rCHA. PD was performed. At the time of dissection between the rCHA and pancreatic parenchyma, we had to divide not only the cranial part of the pancreatic parenchyma along the rCHA but also the MPD. The postoperative course was uneventful.</p><p><strong>Conclusion: </strong>This is the first report of the rCHA surrounded by pancreatic parenchyma and MMPD running behind the rCHA and in front of the portal vein.</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/PMC11936723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721304","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":"Axillo-Femoral Bypass Followed by Pelvic Exenteration for Locally Advanced Sigmoid Colon Cancer Invading the Common Iliac Artery.","authors":"Moe Enari, Kay Uehara, Takeshi Yamada, Aitsariya Mongkhonsupphawan, Sho Kuriyama, Yasuyuki Yokoyama, Hiromichi Sonoda, Yuji Maruyama, Yosuke Ishii, Hiroshi Yoshida","doi":"10.70352/scrj.cr.24-0001","DOIUrl":"10.70352/scrj.cr.24-0001","url":null,"abstract":"<p><strong>Introduction: </strong>Initially, unresectable locally advanced colorectal cancers are still not uncommon. Despite recently developed systemic treatment has extended the survival of patients with unresectable and recurrent disease, surgical resection offers the chance for a cure or long-term survival. Recently, with improvement in the safety of major vascular reconstruction, several reports have suggested that extended pelvic tumor resection with vascular reconstruction with curative intent can be performed safely; however, the indications for arterial vascular reconstruction remain controversial and are reported with a literature review.</p><p><strong>Case presentation: </strong>A 73-year-old male patient whose fever was greater than 40° was admitted to the emergency department of our hospital. Computed tomography (CT) revealed a large mass on the left side of the aortic bifurcation, and a diagnosis of unresectable sigmoid colon cancer was made (cT4bN1M0). The tumor had substantially invaded the iliopsoas muscle and intramuscular abscess, left hydronephrosis due to left ureteral invasion, invasion of the left common and external iliac artery, and congestive edema of the left leg were observed. Transverse colostomy and left nephrostomy were created and percutaneous drainage of the iliopsoas abscess was performed. Four cycles of FOLFOX + bevacizumab were administered after the systemic infection had resolved. The tumor volume decreased, and no new lesions were observed. The patient underwent left axillo-femoral bypass followed by total pelvic exenteration, combined left common and external iliac artery resection, and right ureterocutaneostomy. His postoperative course was uneventful. Pathology revealed ypT4b (bladder) N0M0, ypStage II disease. The patient was followed without adjuvant chemotherapy and had no recurrence as of 10 months after surgery.</p><p><strong>Conclusions: </strong>We experienced a case of total pelvic exenteration combined with the common and external iliac artery and reconstruction via axillo-femoral bypass. When treating complicated cases that cannot be cured by a single operation, it is necessary to carefully consider the optimal pathway for radical resection and to be very familiar with perioperative treatment and reconstructive methods.</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/PMC11936760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721308","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":"Successful Conversion Surgery for Locally Advanced Pancreatic Neuroendocrine Carcinoma: A Case Report.","authors":"Yuuko Tohmatsu, Mihoko Yamada, Nobuyuki Ohike, Tomoko Norose, Hidemasa Kubo, Ryo Ashida, Katsuhisa Ohgi, Shimpei Otsuka, Yoshiyasu Kato, Hideyuki Dei, Katsuhiko Uesaka, Takashi Sugino, Teiichi Sugiura","doi":"10.70352/scrj.cr.24-0064","DOIUrl":"10.70352/scrj.cr.24-0064","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic neuroendocrine carcinoma (panNEC) is a poorly differentiated, highly malignant neoplasm with an extremely poor prognosis. This tumor often presents as locally advanced or unresectable at the initial diagnosis.</p><p><strong>Case presentation: </strong>A 72-year-old woman presented to our hospital with weight loss. A computed tomography scan showed an enhanced tumor measuring 32 mm in the pancreatic head region, with contact to the common hepatic artery over 180°. The pathological findings from the specimens obtained via endoscopic ultrasonography-guided fine-needle aspiration identified small cell-type NEC with extensive necrosis, leading to a diagnosis of locally advanced unresectable panNEC. Accordingly, she began a course of carboplatin and etoposide therapy. After 7 courses, given the significant shrinkage of the tumor, we performed a pancreatoduodenectomy as a conversion surgery. Pathological examination revealed a localized, residual nodule of NEC, consisting mainly of large neoplastic cells, with carcinoma <i>in situ</i> components scattered within and around the nodule. In addition, the diffuse membrane expression of somatostatin receptor 2 was observed in NEC components. Each component showed the same type of <i>KRAS</i> mutation (p.G12V) and was considered to originate from a single primary tumor in the pancreas. She received 3 courses of the same regimen as adjuvant chemotherapy and has remained recurrence-free for 24 months.</p><p><strong>Conclusion: </strong>This is a rare case of successful conversion surgery for locally advanced, unresectable panNEC after chemotherapy, providing several important histopathological and molecular insights.</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/PMC11933743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710939","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":"Robotic Segmentectomy in a Patient with a Displaced Left Upper Division Bronchus and Fused Fissure.","authors":"Hironobu Wada, Ryo Karita, Yuki Hirai, Yuki Onozato, Toshiko Kamata, Hajime Tamura, Takashi Anayama, Ichiro Yoshino, Shigetoshi Yoshida","doi":"10.70352/scrj.cr.25-0039","DOIUrl":"10.70352/scrj.cr.25-0039","url":null,"abstract":"<p><strong>Introduction: </strong>In thoracic surgery, anatomical anomalies and a fused fissure can cause inaccurate intraoperative recognition of anatomy and lead to accidental injury of pulmonary vessels and bronchi that should be preserved. A displaced left upper division bronchus (B¹⁺²⁺³), also known as a left eparterial bronchus, is a rare anomaly that can present in combination with abnormal pulmonary arteries positioning and lobulation. Herein, we report a case of lung cancer in S¹⁺² of the left fused lung that was successfully resected by robotic left upper division segmentectomy following a detailed preoperative simulation using 3-dimensional computed tomography.</p><p><strong>Case presentation: </strong>A female octogenarian presented for the treatment of simultaneous bilateral lung cancer. Three months after surgery for right lung cancer, a surgery for left lung cancer was performed. Preoperative computed tomography identified several broncho-arterial anomalies and a completely fused fissure, including a displaced left upper division bronchus and a pulmonary artery running anteriorly to the left main bronchus, similar to those in the right lung. Robotic left upper division segmentectomy with lymph node dissection was performed using a \"hilum first, fissure last\" approach with fine dissection of the hilar structures and minimal bleeding. The postoperative course was uneventful.</p><p><strong>Conclusions: </strong>Preoperative simulation and robotic-assisted thoracoscopic surgery enabled the safe and precise anatomical pulmonary segmentectomy for a patient with lung cancer, despite several bronchial and arterial anomalies, including a displaced left upper division bronchus.</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/PMC11949726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754575","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":"Sebaceous Carcinoma of the Breast in a Japanese Male with a <i>BRCA2</i> Pathogenic Variant: Report of an Exceedingly Rare Case and Review of the Literature.","authors":"Mamika Kuribayashi, Tadahiro Isono, Yuichi Satake, Yuta Yokochi, Tomoki Kawamura, Ryosuke Kishi, Ryohei Koreyasu, Konomi Sakyo, Takahiro Watanabe, Takeshi Ueda, Masashi Nozawa, Mitsuhiro Tachibana, Kei Tsukamoto, Kazuyasu Kamimura, Hidetoshi Wada","doi":"10.70352/scrj.cr.24-00543","DOIUrl":"10.70352/scrj.cr.24-00543","url":null,"abstract":"<p><strong>Introduction: </strong>Sebaceous carcinoma (SC) is a malignant neoplasm differentiated from the mature sebocyte and occurs mainly in the periorbital area. However, SC of the breast is extremely rare. We report a case of sebaceous breast carcinoma in a Japanese man with a <i>BRCA2</i> pathogenic variant.</p><p><strong>Case presentation: </strong>A 77-year-old Japanese man had been aware of a mass in his right breast for about a year and had visited his previous physician for a follow-up. Over the next year, the mass grew, and the last doctor he visited referred him to our hospital for further examination and treatment. Physical examination revealed a palpable 3-cm-large mass of the right breast. There was no skin invasion, and core needle biopsy revealed invasive ductal carcinoma cT2N1M0 cStage IIB, estrogen receptor (+)/progesterone receptor (+)/HER2/<i>neu</i> (-)/Ki-67 labeling index: 27.8%. His daughter had a history of breast cancer, and he had a <i>BRCA2</i> pathogenic variant. The patient underwent a total right mastectomy and axillary lymph node dissection. Pathological diagnosis was primary SC of the breast, pT2N0M0, pStage IIA. His postoperative clinical course was good. Postoperatively, the patient received endocrine therapy and S-1 for 1 year and is currently receiving endocrine therapy alone. One year and 5 months have passed since the operation, with no recurrence or metastasis noted.</p><p><strong>Conclusions: </strong>The prognosis of SC of the breast has not been elucidated. As cases of SC with a <i>BRCA2</i> pathogenic variant are exceedingly rare, it will be necessary to continue accumulating cases in the future to understand this disease further. This research is essential to elucidating SC.</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/PMC11842163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468928","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":"Improvement of Oral Intake after Treatment Using Enteral Feeding Tube for Large Advanced Gastric Cancer Invading Proximal Stomach: A Case Series of 20 Patients.","authors":"Koichi Hayano, Yoshihiro Kurata, Yasunori Matsumoto, Ryota Otsuka, Nobufumi Sekino, Takeshi Toyozumi, Akira Nakano, Tadashi Shiraishi, Masaya Uesato, Gaku Ohira, Hisahiro Matsubara","doi":"10.70352/scrj.cr.24-0143","DOIUrl":"10.70352/scrj.cr.24-0143","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with large Stage IV gastric cancer (GC) invading the proximal stomach find it difficult to receive not only bypass surgery but also S-1-based chemotherapy. This study aimed to show our treatment results for those GC patients using elementary diet (ED) tubes, which enabled S-1-based chemotherapy and nutrition support.</p><p><strong>Case presentation: </strong>We evaluated 20 patients (13 men and 7 women; median age 70 years) with large Stage IV GCs (8.7-21.9 cm) invading the proximal stomach, who were admitted due to inability to eat, treated with S-1-based chemotherapy using an ED tube. The duration from the initiation of the chemotherapy to the improvement of oral intake, changes in nutritional status, and disease-specific survival (DSS) were retrospectively investigated. Two of the 20 patients failed to complete even one cycle of chemotherapy due to severe nausea or diarrhea. The other 18 patients improved oral liquid intake after 47.5 ± 18.8 days, and 17 patients improved oral solid food intake after 54.5 ± 19.6 days from the start of chemotherapy. In addition, three patients (16.7%) could receive conversion surgery after improvement of oral intake. The median DSS of those 18 patients was 13.1 months. Serum albumin level and prognostic nutritional index (PNI) were significantly improved after about 1 month of the treatment (both <i>P</i> <0.0001). Improvement of serum albumin level and PNI during the first 1 month of the treatment significantly correlated with better DSS (<i>P</i> = 0.006, 0.01, respectively).</p><p><strong>Conclusions: </strong>Given a high oral intake success rate, S-1-based chemotherapy using an ED tube can be a promising treatment option for large Stage IV GC with poor oral intake.</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/PMC11842876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484034","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":"Hybrid Extended Totally Extraperitoneal Transversus Abdominis Release for Ruptured Incisional Hernia Etiologically Very Similar to Flood Syndrome: A Case Report.","authors":"Mariko Sambommatsu, Taketo Matsubara, Gen Shimada, Toshimi Kaido","doi":"10.70352/scrj.cr.24-00447","DOIUrl":"10.70352/scrj.cr.24-00447","url":null,"abstract":"<p><strong>Introduction: </strong>The rupture of an umbilical hernia, which is known as Flood syndrome, is a rare and life-threatening complication of liver cirrhosis. Herein, we report the successful repair of a ruptured incisional hernia accompanied by liver cirrhosis.</p><p><strong>Case presentation: </strong>A female in her 40s with a history of alcoholic cirrhosis and ruptured acute umbilical hernia treated by primary closure 6 months earlier presented with ascites leakage from abdominal skin. She was diagnosed with a ruptured incisional hernia accompanied by massive ascites. We started preoperative management with topical corticosteroids and oral diuretics. Nine months after the first visit, hybrid herniorrhaphy, extended totally extraperitoneal transversus abdominis release (eTEP-TAR) was performed. The patient has since been well without any sign of recurrence for 2 years.</p><p><strong>Conclusions: </strong>We experienced a successful treatment of a ruptured incisional hernia accompanied by liver cirrhosis. Preoperative management and surgical strategies are important for the treatment of ruptured incisional hernia and Flood syndrome.</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/PMC11836010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459095","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 Pleomorphic Adenoma and Ductal Carcinoma In Situ in the Same Mammary Gland.","authors":"Shiho Nagasawa, Koshi Matsui, Misato Araki, Emi Kanaya, Kohji Takagi, Ryo Muranushi, Yoshihiro Shirai, Toru Watanabe, Takeshi Miwa, Katsuhisa Hirano, Shinichi Sekine, Kazuto Shibuya, Isaya Hashimoto, Isaku Yoshioka, Kenichi Hirabayashi, Tsutomu Fujii","doi":"10.70352/scrj.cr.24-0100","DOIUrl":"10.70352/scrj.cr.24-0100","url":null,"abstract":"<p><strong>Introduction: </strong>Pleomorphic adenoma is a benign tumor that frequently occurs in the salivary glands; however, it occurs in the breast rarely. There have been few reports of breast cancer complicated by pleomorphic adenoma of the mammary gland.</p><p><strong>Case presentation: </strong>A 70-year-old woman was found to have a mass lesion in her left breast during a medical examination. A needle biopsy was performed, and a diagnosis of pleomorphic adenoma was made. We performed a partial mastectomy with a margin of several millimeters from the tumor. Pathological examination revealed a diagnosis of pleomorphic adenoma with ductal carcinoma in situ. The resection margin was sufficient, and the patient was followed up.</p><p><strong>Conclusions: </strong>Pleomorphic adenoma arising in the mammary gland is difficult to differentiate from adenomyoepithelioma, mucocele-like tumor, and metaplastic carcinoma. Since the tumor can become malignant, resection with a narrow margin is recommended, along with special efforts not to damage the capsule at diagnosis.</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/PMC11851019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504256","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":"Multiple Desmoplastic Small Round Cell Tumor in the Intestine: A Case Report.","authors":"Naoto Tsujimura, Mitsuyoshi Tei, Daisuke Umeda, Koki Ishimaru, Shoko Minamiura, Takehiro Yamamoto, Soichiro Mori, Kentaro Nishida, Yukihiro Yoshikawa, Masatoshi Nomura, Koki Tamai, Takuya Hamakawa, Daisuke Takiuchi, Hironao Yasuoka, Masanori Tsujie, Yusuke Akamaru","doi":"10.70352/scrj.cr.24-0135","DOIUrl":"10.70352/scrj.cr.24-0135","url":null,"abstract":"<p><strong>Introduction: </strong>Desmoplastic small round cell tumor (DSRCT) is a highly malignant sarcoma and an extremely rare tumor, predominantly found in the abdominal and pelvic regions. Here, we report the case of a patient who underwent surgical treatment for multiple desmoplastic round cell tumor in the intestine.</p><p><strong>Case presentation: </strong>A 38-year-old male patient visited our hospital after a health check revealed positive occult blood in his stool and a colonoscopy revealed tumors in descending colon and sigmoid colon. Biopsy results revealed poorly differentiated adenocarcinoma. Chest and abdominal enhanced computed tomography revealed 3 tumors from descending colon to sigmoid colon and numerous peritoneal disseminations. Based on these findings, we diagnosed multiple colon cancers and performed a laparoscopic left hemicolectomy. Hematoxylin-Eosin (H&E) staining showed that in all tumors, atypical cells with large and small swollen nuclei formed irregular solid nests of various sizes against a background of extensive desmoplastic or myxomatous stroma. Immunohistochemistry showed that tumor cells were AE1/3 (+), S-100 (-), Desmin (-), WT1 (-). Genetic analysis detected the Ewing's sarcoma and Wilms tumor fusion gene at another inspection agency. Histopathological examination identified desmoplastic small round cell tumor. The patient was discharged on the 19th postoperative day without postoperative complications. He will undergo chemotherapy at another hospital.</p><p><strong>Conclusions: </strong>We experienced a very rare case of DSRCT. DSRCT is a fatal disease that primarily affects adolescent and young adult males. Currently, there is no proven treatment. More case reports are essential to improve management of this disease.</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/PMC11873736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543584","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}