Surgical Case Reports最新文献

{"title":"Robotic Aortic Valve Replacement in Severe Scoliosis with Markedly Narrow Chest.","authors":"Sayaka Honda, Naonori Kawamoto, Yuki Tadokoro, Rieko Kutsuzawa, Ayumi Ikuta, Takashi Kakuta, Kota Suzuki, Kizuku Yamashita, Satsuki Fukushima","doi":"10.70352/scrj.cr.26-0336","DOIUrl":"10.70352/scrj.cr.26-0336","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted aortic valve replacement (AVR) has emerged as an extension of minimally invasive cardiac surgery, offering enhanced visualization and articulated instrument control. However, patients with severe thoracic deformities and markedly narrow chest anatomy are generally considered challenging candidates because restricted operative space may compromise annular exposure, instrument maneuverability, and aortotomy closure. Reports describing robotic-assisted AVR in such patients remain limited. We describe a successful robotic-assisted AVR in a patient with severe scoliosis and a markedly narrow thoracic cavity, highlighting technical modifications that enabled safe valve implantation.</p><p><strong>Case presentation: </strong>A 61-year-old man presented with progressive exertional dyspnea and fatigue caused by severe aortic regurgitation. CT demonstrated severe scoliosis with marked narrowing of the thoracic cavity, resulting in a sternovertebral distance of 6.5 cm. The patient also had a stable chronic type B aortic dissection extending from the descending thoracic aorta to the level of the superior mesenteric artery without involvement of the ascending aorta or aortic arch. After multidisciplinary discussion and informed consent, robotic-assisted AVR was performed using the da Vinci Xi system (Intuitive Surgical, Sunnyvale, CA, USA). Technical modifications included the placement of the service-port robotic arm in the fifth intercostal space to improve the working angle and avoid arm interference, and the creation of a longitudinal aortotomy to facilitate valve exposure in the restricted operative field. Exposure of the noncoronary and left coronary annulus was achieved through robotic retraction and bedside suction assistance. A 23-mm bioprosthetic valve was successfully implanted without intraoperative complications. The patient was extubated within 5 h and discharged on POD 20. Postoperative echocardiography demonstrated normal prosthetic valve function without paravalvular leakage.</p><p><strong>Conclusions: </strong>Robotic-assisted AVR may be feasible in carefully selected patients with scoliosis-associated narrow chest anatomy. Detailed preoperative assessment and tailored technical strategies, including longitudinal aortotomy and modified port placement, may facilitate adequate exposure and safe valve implantation in anatomically challenging cases.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580174","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":"Tailored Management of Anomalous Systemic Arterial Supply to the Basal Segment of the Lung: A Case Report and Literature Review.","authors":"Shunsuke Mori, Ken Suzawa, Koji Tomita, Haruchika Yamamoto, Kumi Nakajima, Shin Tanaka, Hidejiro Torigoe, Kazuhiko Shien, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Takao Hiraki, Shinichi Toyooka","doi":"10.70352/scrj.cr.26-0288","DOIUrl":"10.70352/scrj.cr.26-0288","url":null,"abstract":"<p><strong>Introduction: </strong>Parenchyma-preserving strategies for anomalous systemic arterial supply to the basal segment of the lung have gained increasing attention. However, pulmonary infarction of the preserved lung has been reported, and clear criteria for selecting the optimal treatment have yet to be established. We report 2 cases in which detailed preoperative imaging informed tailored management-right posterior basal segmentectomy in 1 patient and endovascular embolization of the aberrant artery in the other-both without postoperative complications. A review of the relevant literature is also provided, with an emphasis on potential selection criteria.</p><p><strong>Case presentation: </strong><b>Case 1:</b> A 20-year-old asymptomatic woman was referred after an abnormal screening chest radiograph. CT demonstrated an aberrant artery arising from the abdominal aorta supplying the right posterior basal segment (S10) with a large intravascular thrombus. The pulmonary artery showed hypoplasia limited to A10, while the other branches were normal, and no parenchymal congestion was identified. Following resection of the aberrant artery, robot-assisted right S10 segmentectomy was performed. The postoperative course was uneventful, and the patient was discharged on POD 6. <b>Case 2:</b> A 27-year-old woman was incidentally diagnosed on CT for an unrelated indication. An aberrant artery arising from the descending thoracic aorta supplied the left basal segment. Pulmonary arterial branches were preserved, with only minimal congestion in S9-10. Angiography revealed no evidence of an arteriovenous fistula. As surgical lung resection was considered unnecessary, coil embolization of the aberrant artery was performed. No complications occurred, and the patient was discharged on day 3 after the procedure.</p><p><strong>Conclusions: </strong>In patients with anomalous systemic arterial supply to the basal segment of the lung, when pulmonary arterial branches are preserved and background parenchymal congestion is minimal, parenchyma-sparing approaches should be considered.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035025","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":"Megacolon Associated with Multiple Endocrine Neoplasia Type 2B: A Case Successfully Managed with Ileostomy.","authors":"Takeshi Ikeda, Nao Hondo, Masato Kitazawa, Satoshi Nakamura, Yuta Yamamoto, Satoru Miyazaki, Masahiro Kataoka, Hirokazu Tanaka, Naoki Ishizaka, Tadaaki Shimizu, Masatsugu Kuroiwa, Naoya Yamamoto, Yuji Soejima","doi":"10.70352/scrj.cr.26-0202","DOIUrl":"10.70352/scrj.cr.26-0202","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple endocrine neoplasia type 2B (MEN2B) is a rare genetic disorder characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, and Marfanoid body habitus. Megacolon is a common non-endocrine manifestation, with approximately 75% of patients experiencing gastrointestinal symptoms, such as constipation or diarrhea, often as early clinical signs. Although these symptoms may be important diagnostic signs, there are currently no distinct therapeutic guidelines. Here, we report a case of MEN2B-associated megacolon that was managed surgically, resulting in a favorable outcome.</p><p><strong>Case presentation: </strong>A 23-year-old man with a history of chronic constipation was diagnosed with MEN2B at 14 years of age based on findings of medullary thyroid carcinoma, mucosal neuromas, and rectal biopsy-confirmed intestinal ganglioneuromatosis. He previously underwent total thyroidectomy and emergency transverse colectomy for volvulus. Progressive colonic dilatation led to abdominal distension and organ compression, prompting referral. Imaging confirmed marked colonic dilation. Laparoscopic subtotal colectomy with ileosigmoid anastomosis was performed. Postoperatively, the patient experienced recurrent ileus and required hospital readmission for small bowel obstruction. Two months postoperatively, the patient presented with a gastrointestinal perforation at the anastomotic site and underwent resection with terminal ileostomy. The postoperative course was uneventful, and the patient remained symptom-free.</p><p><strong>Conclusions: </strong>MEN2B-associated megacolon results from diffuse intestinal ganglioneuromatosis. Considering its progressive and extensive nature, decompression via stoma creation may be necessary to improve the postoperative outcomes and reduce the risk of symptom recurrence. Increased awareness and individualized surgical planning are crucial for treating this rare but serious complication of MEN2B.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869462","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 Abdominal Closure Using Endoscopic Anterior Component Separation Following Open Abdomen Management for Colon Perforation.","authors":"Chika Morita, Naoya Matsumoto, Hiroto Miyanaga, Keitaro Kakinoki, Tetsuya Sakai, Hideki Sakahira","doi":"10.70352/scrj.cr.25-0614","DOIUrl":"10.70352/scrj.cr.25-0614","url":null,"abstract":"<p><strong>Introduction: </strong>In open abdomen management (OAM), consistent early closure is crucial to avoid complications and improve short- and long-term outcomes. Open anterior component separation (OCS) has been reported to be a method for early definitive closure after OAM.Originally, OCS is a common treatment option for incisional hernias. However, a major drawback is the high incidence of surgical site occurrences (SSOs) owing to impaired blood flow. This is caused by damage to the perforating branches supplying the skin from the rectus abdominis muscle, necessitating extensive subcutaneous dissection. To overcome these limitations, endoscopic anterior component separation (ECS) was developed. By eliminating the need for extensive subcutaneous dissection, perforating branches were preserved in the abdominal wall, significantly reducing SSOs.While reports of OCS being performed for definitive closure after OAM are occasionally seen, there have been no previous case reports applying ECS. We therefore present this case.</p><p><strong>Case presentation: </strong>A man in his 50s was followed up for multiple visceral artery aneurysms. Surgery was performed for hepatic and splenic artery aneurysms. The patient developed a postoperative pancreatic fistula that progressed favorably. However, on POD 22, the patient developed colonic perforation, necessitating emergency surgery. Owing to significant intestinal edema associated with inflammation and adhesion lysis, closure was difficult, leading to OAM. A second examination was performed 2 days later, but closure remained difficult. The abdomen was closed using ECS. There were no SSOs. After treatment for an intra-abdominal abscess, the patient was discharged 40 days after initial surgery for colon perforation. Seventeen months postoperatively, the patient remained complication-free with well-maintained abdominal wall integrity.</p><p><strong>Conclusions: </strong>OCS, which enables mesh-free closure after trauma or infection surgery, is highly useful. ECS can also be applied for early definitive closure after OAM, offering potential for minimally invasive care and reduced SSO. While no previous reports exist on applying ECS after OAM, its relatively simple technique warrants wider adoption, the further accumulation of data, and an evaluation of cases.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594844","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 Gluteal Subcutaneous Metastasis after Curative Resection of Cecal Cancer: A Rare Presentation Preceding Systemic Metastasis.","authors":"Shusaku Hiyama, Ken Imaizumi, Nobuki Ichikawa, Tadashi Yoshida, Yosuke Ohno, Kengo Shibata, Shunji Sano, Honori Okubo, Zenichi Tanei, Shinya Tanaka, Akinobu Taketomi","doi":"10.70352/scrj.cr.26-0096","DOIUrl":"10.70352/scrj.cr.26-0096","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous and subcutaneous colon cancer metastases to the gluteal or perineal regions are extremely rare. Unlike the local recurrence or tumor implantation observed in rectal cancer, gluteal or perineal colon cancer metastasis likely represents a distinct pathophysiological mechanism. We report a case of a solitary subcutaneous gluteal metastasis that developed after curative resection of cecal cancer.</p><p><strong>Case presentation: </strong>A 58-year-old woman underwent laparoscopic ileocecal resection with D3 lymph node dissection for a stage IIIC cecal adenocarcinoma. Postoperative adjuvant chemotherapy with capecitabine and oxaliplatin (CAPOX) was administered for 4 cycles but discontinued owing to hepatic dysfunction. Nine months postoperatively, the tumor marker levels increased; imaging revealed a subcutaneous mass in the left gluteal region. The gluteal mass was completely resected with clear margins. The histopathological findings were consistent with metastasis from the previously resected cecal carcinoma. Adjuvant CAPOX was resumed for 4 additional cycles. Nine months after reoperation, the patient developed a solitary brain metastasis, which was surgically removed, followed by radiotherapy. Subsequently, systemic chemotherapy was initiated, and the patient remains alive without evidence of recurrence 5 months after resection of the brain metastasis.</p><p><strong>Conclusions: </strong>Gluteal or perineal subcutaneous metastases from colon cancer are rare and may represent an early manifestation of systemic disease rather than an isolated metastatic event. Even after curative resection, careful postoperative surveillance is warranted.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144804","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":"Anaplastic Carcinoma of the Pancreas Arising from Mucinous Cystic Neoplasm: A Case Report.","authors":"Shotaro Horonushi, Masashi Kudo, Ryuhei Noda, Tsuyoshi Terada, Motokazu Sugimoto, Shin Kobayashi, Naoto Gotohda","doi":"10.70352/scrj.cr.26-0405","DOIUrl":"https://doi.org/10.70352/scrj.cr.26-0405","url":null,"abstract":"<p><strong>Introduction: </strong>Mucinous cystic neoplasm (MCN) is a pancreatic cystic lesion with a generally favorable prognosis; however, malignant transformation can occur. Anaplastic carcinoma of the pancreas is a rare and highly aggressive subtype of pancreatic cancer. Anaplastic transformation arising from MCN is extremely rare, and its clinicopathological features remain unclear. Herein, we report a case in which surgical resection was performed following systemic chemotherapy, highlighting a discrepancy between tumor marker levels and tumor progression.</p><p><strong>Case presentation: </strong>A woman in her 40s presented with abdominal pain. CT revealed a 14-cm multilocular cystic lesion with a solid component in the pancreatic body and tail, accompanied by peritoneal nodules. The tumor marker carbohydrate antigen 19-9 (CA19-9) level was elevated (2100.0 U/mL). The clinical diagnosis was MCN with an associated invasive carcinoma and suspected peritoneal dissemination, and systemic chemotherapy was initiated. Following treatment, the solid component showed progressive enlargement, whereas the CA19-9 level decreased to 33.6 U/mL, and the peritoneal nodules regressed. The tumor subsequently perforated the colon and was complicated by intratumoral infection, requiring percutaneous drainage and laparoscopic ileostomy. Laparoscopic exploration revealed no obvious peritoneal dissemination, and ascitic fluid cytology was negative for malignancy (CY0). Therefore, distal pancreatectomy with partial gastrectomy and partial colectomy was performed. The resected specimen showed a 19-cm solid tumor with scattered multilocular cystic areas. Histopathology revealed highly atypical spindle, pleomorphic, and multinucleated tumor cells in the solid component, while the cystic component was lined by mucinous epithelium exhibiting carcinomatous atypia and associated ovarian-type stroma. The final pathological diagnosis was MCN with an associated invasive carcinoma with pleomorphic-type anaplastic carcinoma. Despite adjuvant chemotherapy, peritoneal recurrence occurred 3 months after surgery, and the patient died 5 months postoperatively.</p><p><strong>Conclusions: </strong>Anaplastic carcinoma arising from MCN is extremely rare and exhibits aggressive clinical behavior with a poor prognosis, even after surgical resection. Tumor markers may not accurately reflect disease activity and should be interpreted with caution.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991433","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":"Bypass Pyeloplasty for Ureteropelvic Junction Obstruction Associated with Horseshoe Kidney: A Case Report.","authors":"Tsubasa Shironomae, Keiko Ainoya, Kiyohide Sakai","doi":"10.70352/scrj.cr.25-0729","DOIUrl":"10.70352/scrj.cr.25-0729","url":null,"abstract":"<p><strong>Introduction: </strong>Horseshoe kidney (HSK) is the most common renal fusion and malrotation anomaly, and ureteropelvic junction obstruction (UPJO) due to high ureteral insertion (HUI) is frequently associated with HSK. Bypass pyeloplasty (BP) is a non-dismembered surgical technique involving a side-to-side anastomosis between the ureter just distal to the UPJO and the dependent portion of the hydronephrotic renal pelvis, and is suited for HUI. Although several procedures have been suggested for UPJO in HSK patients, BP has not been discussed much. In this case report, we describe the detailed procedure for BP successfully performed in an HSK patient with UPJO due to HUI.</p><p><strong>Case presentation: </strong>The patient was a girl aged 1 year and 10 months who had experienced intermittent abdominal pain and occasional vomiting for 1 month. She was diagnosed with dilation of the left renal pelvis and renal calyces (Society for Fetal Urology classification grade 3-4) on ultrasonography and subsequently referred to our hospital for diagnosis of left intermittent hydronephrosis. Renal scintigraphy revealed the HSK, and the differential renal function (DRF) in the left kidney was 16.3%. At 1 year and 11 months, she underwent retrograde left ureteropyelography and pyeloplasty. The retrograde left ureteropyelography showed the HUI and obstruction of the left ureter at approximately 45 mm from the cephalic edge of the umbilicus. We performed a 3.0-cm left flank incision to expose the left renal pelvis and ureter through the retroperitoneal route. HUI of the left ureter and crossing of a white cord-like structure that compressed the left ureter and renal pelvis just distal to the UPJO were identified. We divided the white cord-like structure and performed BP between the ureter just distal to the UPJO and the dependent portion of the renal pelvis. The postoperative course was good, with improvement in the renal pelvis dilation and the DRF in the left kidney. There has been no recurrence for >6 years after surgery.</p><p><strong>Conclusions: </strong>We recommend BP as a physiological and suitable surgical approach that reduces the risk of impaired blood supply and postoperative anastomotic stenosis in HSK patients with UPJO due to HUI.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781669","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":"Coexisting Sarcoid Reaction and Sarcoidosis Requiring Differentiation from Pancreatic Adenocarcinoma Recurrence: A Case Report.","authors":"Ryo Horie, Makoto Takahashi, Tatsuya Hayashi, Ryuji Takada, Taiki Tsuji, Taku Higashihara, Hideyuki Horike, Wataru Yamagata, Akihiko Wada, Naoto Yokogawa, Sachiko Izumi, Junko Araki, Haruka Okada, Iichiroh Onishi, Yasuhiro Morita","doi":"10.70352/scrj.cr.25-0670","DOIUrl":"10.70352/scrj.cr.25-0670","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is one of the most severe malignant tumors. The recurrence rate is high, even after radical surgery. A sarcoid reaction is a histological finding that occurs in the lymph nodes in response to malignant tumors, infections, or foreign substances. Its histopathology is similar to that of sarcoidosis. Here, we report a case of coexisting sarcoid reaction and sarcoidosis that required differentiation from PDAC recurrence.</p><p><strong>Case presentation: </strong>A 65-year-old woman was diagnosed with locally advanced PDAC. She underwent modified FOLFIRINOX (folinic acid, fluorouracil, irinotecan, and oxaliplatin) therapy for 6 months, after which the tumor shrunk, and there were no new metastatic lesions. Additionally, she underwent chemoradiation therapy (50 G/25 Fr and S-1), and a distal pancreatectomy with en bloc celiac axis resection and splenectomy were performed. Pathological diagnosis was PDAC, T2N0M0. Pathological findings of the regional lymph nodes showed no malignancy and noncaseating epithelioid cell granulomas, which were thought to be a sarcoid reaction. She received S-1 therapy for 6 months as adjuvant chemotherapy. On contrast-enhanced CT 1 year after the operation, enlarged para-aortic lymph nodes and multiple grainy pulmonary shadows were detected. Although recurrence was suspected, tumor marker levels did not increase. PET-CT revealed fluorodeoxyglucose accumulation in several lymph nodes, such as the para-aortic or neck, as well as in the bilateral femoral muscles. No accumulation was observed in the lung parenchyma. These findings were atypical of postoperative recurrence. Endoscopic ultrasonography-guided lymph nodes and body-surface ultrasonography-guided femoral muscle biopsies were performed. No malignancy was found in all the specimens, and noncaseating epithelioid cell granulomas were found. <i>Propionibacterium acnes</i>-specific antibody staining showed that the regional lymph nodes removed during surgery were negative, and the para-aortic lymph nodes and femoral muscles were positive. The patient was diagnosed with a sarcoid reaction to PDAC and muscular sarcoidosis. The patient remained recurrence-free for 3 years and 2 months postoperatively.</p><p><strong>Conclusions: </strong>When enlarged lymph nodes are detected after surgery for a malignant tumor, we have to consider recurrence at first; however, it is important to make careful assessments because other factors are occasionally present.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781724","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":"Emergency Double Valve Replacement for Ruptured Mitral Valve Aneurysm and Annular Abscess Caused by Gemella Morbillorum Endocarditis in a Patient with Bicuspid Aortic Valve: A Case Report.","authors":"Yoshihiko Onishi, Takayuki Abe, Yuki Hirai, Taichi Kondo, Kouan Orii","doi":"10.70352/scrj.cr.25-0659","DOIUrl":"10.70352/scrj.cr.25-0659","url":null,"abstract":"<p><strong>Introduction: </strong>Mitral valve aneurysm (MVA) is a rare but potentially fatal complication of infective endocarditis (IE), often associated with aortic valve involvement. <i>Gemella morbillorum</i>, a commensal oral bacterium, is an uncommon cause of IE. We report a rare case of MVA rupture with an aortic annular abscess caused by <i>G. morbillorum</i> IE in a patient with bicuspid aortic valve (BAV), successfully managed with emergency valve replacement.</p><p><strong>Case presentation: </strong>A 36-year-old man presented with congestive heart failure and respiratory failure. Echocardiography revealed a ruptured MVA, severe mitral and aortic regurgitation, and an annular abscess. The patient underwent emergency mitral and aortic valve replacement. Intraoperative findings included extensive destruction of the anterior mitral leaflet and a BAV. Blood cultures grew <i>G. morbillorum</i>. The patient recovered uneventfully following 6 weeks of targeted antibiotic therapy.</p><p><strong>Conclusions: </strong>Although IE caused by <i>G. morbillorum</i> is rare, it can lead to life-threatening complications such as MVA rupture and annular abscess. Early diagnosis and prompt surgical intervention are critical to achieving favorable outcomes.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781732","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":"Resection of Liver Metastasis from Lacrimal Gland Adenoid Cystic Carcinoma: A Case Report and Review of the Literature.","authors":"Takashi Sugio, Satoshi Takada, Shotaro Tokuraku, Junichi Ogawa, Naoto Nishida, Hiroaki Horio, Ryohei Takei, Kaichiro Kato, Mitsuyoshi Okazaki, Yasuhito Iwao, Shinichi Nakanuma, Isamu Makino, Masayuki Takahira, Hiroko Ikeda, Shintaro Yagi","doi":"10.70352/scrj.cr.26-0340","DOIUrl":"https://doi.org/10.70352/scrj.cr.26-0340","url":null,"abstract":"<p><strong>Introduction: </strong>Adenoid cystic carcinoma (ACC) is a rare malignancy that most commonly occurs in the major salivary and lacrimal glands. Although distant metastases frequently occur in the lungs, bones, and brain, liver metastases are uncommon, and the optimal management of metastatic lesions remains unclear. Here, we report a case of liver metastasis from a lacrimal gland adenoid cystic carcinoma (LGACC) treated with surgical resection.</p><p><strong>Case presentation: </strong>A 38-year-old man underwent tumor resection for LGACC 6 years previously. Bilateral pulmonary metastases were detected 2 years after the primary surgery and treated with partial lung resection. Two liver metastases were identified during follow-up imaging. Because curative resection was considered feasible, the patient underwent laparoscopic right anterior sectionectomy of the liver. The postoperative course was uneventful, and the patient remained recurrence-free for 11 months after hepatectomy.</p><p><strong>Conclusions: </strong>Surgical resection may be a potential treatment option for selected patients with liver metastases from ACCs.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115197","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}