Surgical Case Reports最新文献

{"title":"Gastrointestinal stromal tumor in Carney's triad with laparoscopic total gastrectomy: a case report.","authors":"Hajime Midoritani, Hironori Kawada, Kosuke Kaneda, Shuichiro Toda, Kento Awane, Keisuke Tanino, Kaichiro Harada, Keigo Tachibana, Masahiko Honjo, Koji Kitamura, Mami Yoshitomi, Yoshiharu Shirakata, Ryuta Nishitai","doi":"10.1186/s40792-024-02041-2","DOIUrl":"https://doi.org/10.1186/s40792-024-02041-2","url":null,"abstract":"<p><strong>Introduction: </strong>Carney's triad is a rare syndrome characterized by the co-occurrence of gastric gastrointestinal stromal tumor (GIST), pulmonary chondroma, and extra-adrenal paraganglioma. We present a case of a young woman with GISTs associated with this triad.</p><p><strong>Case presentation: </strong>A 28-year-old woman was identified with multiple gastric tumors and a right lung nodule during a routine health check-up. CT scans and upper gastrointestinal endoscopy revealed a 50 mm mass on the lesser curvature of the stomach, along with two additional gastric lesions and a 20 mm nodule in the right lung. The patient had a history of right middle lobectomy at the age of 19 for pulmonary chondroma. During surgery, enlarged lymph nodes were observed, indicating metastasis, which necessitated a total gastrectomy with radical (D2) lymph node dissection. Pathological examination confirmed seven GISTs, with immunohistochemical staining positive for KIT (+), DOG1 (+), and negative for SDHB (-). The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. Despite opting out of adjuvant imatinib therapy, she remains disease-free 2 years postoperatively.</p><p><strong>Conclusions: </strong>This case underscores the necessity of total gastrectomy with lymph node dissection due to the high incidence of metastasis in GISTs associated with Carney's triad. Further research is required to determine the optimal extent of lymph node dissection in such cases.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"240"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508383","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":"Lobar graft evaluation in cadaveric lobar lung redo transplantation after living-donor lobar lung transplantation: a case report.","authors":"Yui Watanabe, Tatsuaki Watanabe, Takashi Hirama, Sho Murai, Kazunori Ueda, Hisashi Oishi, Miki Akiba, Toshikazu Watanabe, Takaya Suzuki, Hirotsugu Notsuda, Ken Onodera, Takeo Togo, Hiromichi Niikawa, Masafumi Noda, Yoshinori Okada","doi":"10.1186/s40792-024-02046-x","DOIUrl":"https://doi.org/10.1186/s40792-024-02046-x","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation is a vital option for patients with end-stage lung disease. However, it faces a significant challenge due to the shortage of compatible donors, which particularly affects individuals with small chest cavities and pediatric patients. The novel approach of cadaveric lobar lung transplantation is a promising solution to alleviate the donor shortage crisis. Both the mid-term and long-term outcomes of lobar lung transplantation are comparable to those of standard lung transplantation. However, patients undergoing lobar lung transplantation reported a significantly higher rate of primary graft dysfunction compared to patients undergoing standard lung transplantation. Therefore, careful donor selection is critical to improve outcomes after lobar transplantation. However, no established method exists to evaluate each lung lobar graft of deceased donors. This case report describes a case of cadaveric lobar lung transplantation to overcome size mismatch and donor shortage, with particular emphasis on lobar graft evaluation.</p><p><strong>Case presentation: </strong>A 39-year-old woman with scleroderma-related respiratory failure was listed for deceased donor lung transplantation due to a rapidly progressing disease. Faced with a long waiting list and impending mortality, she underwent bilateral living-donor lobar lung transplantation donated by her relatives. Post-transplant complications included progressive pulmonary vein obstruction and pleural effusion, which ultimately required retransplantation. An oversized donor with pneumonia in the bilateral lower lobes was allocated. Lung ultrasound was used to evaluate each lung lobar graft during procurement. The right upper and middle lobes and left upper lobe were confirmed to be transplantable, and lobar lung redo transplantation was performed. The patient's post-transplant course was uneventful, and she was discharged home and returned to her daily activities.</p><p><strong>Conclusions: </strong>This case highlights the clinical impact of cadaveric lobar lung transplantation as a feasible and effective strategy to overcome the shortage of donor lungs, especially in patients with small thoracic cavities. By establishing donor lung evaluation techniques and overcoming anatomical and logistical challenges, cadaveric lobar lung transplantation can significantly expand the donor pool and offer hope to those previously considered ineligible for transplantation.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"238"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508384","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":"Thoracoscopic and endoscopic cooperative surgery for esophageal gastrointestinal stromal tumor: a case report.","authors":"Ryo Kanoda, Tomohiro Kikuchi, Akihito Utsumi, Shotaro Mochizuki, Akira Matsuishi, Akinao Kaneta, Azuma Nirei, Hiroyuki Hanayama, Zenichiro Saze, Takuto Hikichi, Yuko Hashimoto, Koji Kono","doi":"10.1186/s40792-024-02045-y","DOIUrl":"https://doi.org/10.1186/s40792-024-02045-y","url":null,"abstract":"<p><strong>Background: </strong>Esophageal gastrointestinal stromal tumors (GISTs) are relatively rare, accounting for 2-5% of all GISTs. Typically, the treatment is surgery in nature. However, no standard procedure established for esophageal GISTs, and in many cases, subtotal esophagectomy or local resection via thoracoscopy or mediastinoscopy is performed. Thoracoscopic and endoscopic cooperative surgery (TECS) is a surgical approach similar to laparoscopic and endoscopic cooperative surgery used for gastric GIST; however, no reports of its use for esophageal GIST have been published to date. We herein report such a case along with a review of past literature.</p><p><strong>Case presentation: </strong>The patient was a 60-year-old man. Upper gastrointestinal contrast imaging revealed a subepithelial lesion in the esophagus. An 18 × 17 mm subepithelial lesion was identified in the left wall, 35 cm from the upper incisors, during upper gastrointestinal endoscopy, and was diagnosed as a GIST through endoscopic ultrasound-guided fine needle biopsy. TECS was therefore performed. The patient was placed in a prone position with his face to the left. After confirming the lesion under endoscopy and left thoracoscopy, the periesophageal area of the lesion was dissected under thoracoscopy. Subsequently, an endoscopic full-layer resection was performed. Finally, the excision site of the lesion was sutured under thoracoscopy. The operation took a total of 3 h and 22 min, with a blood loss of 50 mL.</p><p><strong>Conclusions: </strong>The appropriate surgical procedure for esophageal GIST should be considered according to the location and size of the lesion. TECS ensures that the resection margins are secured using an endoscopic or thoracoscopic approach. Furthermore, TECS is minimally invasive, avoiding esophagectomy and reconstruction, which makes it a potential surgical option for esophageal GISTs.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"237"},"PeriodicalIF":0.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475247","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":"Laparoscopic repair of gastric conduit obstruction after robot-assisted minimally invasive esophagectomy: a case report.","authors":"Toshiyuki Moriuchi, Yuki Katsura, Yasuhiro Shirakawa, Ayane Uehara, Kazuki Matsubara, Michihiro Ishida, Yasuhiro Choda, Hiroaki Mashima, Hiroyuki Sawada, Masanori Yoshimitsu, Hiroyoshi Matsukawa, Shigehiro Shiozaki","doi":"10.1186/s40792-024-02038-x","DOIUrl":"https://doi.org/10.1186/s40792-024-02038-x","url":null,"abstract":"<p><strong>Background: </strong>Gastric conduit obstruction (GCO) is a known complication after esophagectomy. Laparoscopic revision surgery for GCO is relatively rare, with limited reports in the literature. Here, we report a case of GCO after robot-assisted subtotal esophagectomy and posterior mediastinal gastric conduit reconstruction, which was successfully repaired laparoscopically.</p><p><strong>Case presentation: </strong>A 66-year-old man presented with a passage disorder that became noticeable 14 months after surgery. Fluid passage was difficult, and the patient opted for revision surgery. The conduit had entered and deflected into the mediastinum; it also twisted due to band formation. The revision surgery was performed laparoscopically through five ports. The bands were dissected, esophageal hiatus was sutured, and conduit re-fixed. The intraoperative endoscopy was used to confirm that the obstruction had been released. The lack of adhesion of the posterior half of the gastric conduit wall, combined with postoperative weight loss leading to a decrease in omental volume, as well as inadequate fixation during the initial surgery, are believed to have contributed to the ease of the conduit deviation into the intrathoracic cavity. In addition, the twisting of the conduit due to band formation exacerbated the obstruction.</p><p><strong>Conclusions: </strong>Laparoscopic revision surgery may become an effective treatment option as the number of minimally invasive esophagectomies is expected to increase in the future. Furthermore, the fixation method during initial surgery should be carefully considered and optimized to prevent gastric conduit obstruction. Additionally, the use of intraoperative endoscopy to evaluate the lumen of the conduit during surgery proved beneficial in this case, highlighting its potential value in identifying and addressing obstruction.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"236"},"PeriodicalIF":0.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475246","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":"Management of gastroschisis in an extremely low birth weight infant: report of a case.","authors":"Noboru Oyachi, Fuminori Numano, Tamao Shinohara, Yasushi Murakami, Atsushi Nemoto, Atsushi Naito","doi":"10.1186/s40792-024-02028-z","DOIUrl":"10.1186/s40792-024-02028-z","url":null,"abstract":"<p><strong>Background: </strong>Gastroschisis is a rare congenital anomaly in which abdominal organs herniate through a defect in the abdominal wall. Managing gastroschisis in extremely low birth weight (ELBW) infants presents significant challenges because of their immature physiologies and increased risk of complications.</p><p><strong>Case presentation: </strong>This report discusses the case of a female ELBW infant born via an emergency cesarean section at 29 weeks of gestation, weighing 768 g, who had a prenatal diagnosis of gastroschisis. Postnatal management included immediate surgical intervention using a hand-made silo manufactured from expanded polytetrafluoroethylene (ePTFE) sheets that were sutured to the patient's abdominal wall to accommodate her small abdominal cavity and preserve mesenteric blood flow. Necrotizing enterocolitis with bowel perforation emerged as a complication, which led to the excision of a 10 cm segment of the ileum and the creation of an ileostomy. The infant experienced insufficient weight gain and liver dysfunction. However, she was eventually discharged on day 142 of life, weighing 2774 g, on oral feeding, without significant complications.</p><p><strong>Conclusions: </strong>This case emphasizes how prematurity significantly affected the patient's clinical outcomes, and highlights the importance of individualized management strategies. Our experience demonstrates that custom silo placement allows for the size to be adapted to the abdominal defect, and highlights the critical need to prioritize postnatal bowel perfusion in ELBW infants with gastroschisis.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"235"},"PeriodicalIF":0.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393519","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":"Primary breast lymphoma mimicking triple-negative breast cancer: a case report with clinical and pathological implications.","authors":"Toyoaki Sawano, Masahiro Wada, Akihiko Ozaki, Akinori Hashiguchi, Shinichi Hirooka, Tetsuya Tanimoto","doi":"10.1186/s40792-024-02032-3","DOIUrl":"10.1186/s40792-024-02032-3","url":null,"abstract":"<p><strong>Background: </strong>Primary breast lymphoma (PBL) is a rare type of extranodal lymphoma, the diagnostic process for which presents significant challenges owing to an overlap in clinical and pathological features with those observed in triple-negative breast cancer (TNBC). However, the current literature reveals a paucity of information regarding the ramifications of potential diagnostic errors, particularly in the context of emergent therapeutic strategies for TNBC. Thus, we present a unique report of a case of PBL.</p><p><strong>Case presentation: </strong>A 76-year-old female with no past medical or family history presented to the hospital with the chief complaint of a mass in the right breast. Two masses were palpated in the right breast: one 56 mm mass (No. 1) located at 10 o'clock, and a 21 mm large, elastic, hard mass (No. 2) at 4 o'clock. Needle biopsy was performed only on the larger 56 mm mass (No. 1). The results showed invasive carcinoma that was negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2. The preoperative diagnosis was right breast cancer (T3N0M0 Stage IIB) of the TNBC subtype. The patient refused the preoperative chemotherapy recommended by the treatment team; therefore, right breast mastectomy and sentinel lymph-node biopsy were performed instead. The histopathological diagnosis of the first mass was diffuse large B-cell lymphoma (DLBCL); that of the second mass (No. 2) was an invasive breast carcinoma of no special type. Postoperative treatment consisted of endocrine therapy (letrozole) for breast cancer, while the DLBCL was treated with chemotherapy and three courses of intrathecal chemotherapy. At the time of this report, the patient is still living, and neither tumor had recurred in the 2 years following surgery.</p><p><strong>Conclusions: </strong>On rare occasions, PBL can preoperatively mimic TNBC. While this case did not lead to serious consequences, because surgery was eventually selected as the first therapy, clinicians should be aware that the diagnosis of PBL is challenging using only a core-needle biopsy and can often be misdiagnosed as TNBC.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"234"},"PeriodicalIF":0.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393520","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":"Laparoscopic abdominoperineal resection and myocutaneous flap reconstruction for anal fistula cancer arising from complicated anal fistula: two case reports.","authors":"Hidemichi Kuroiwa, Yuki Nakamura, Kenji Matsuda, Hiromitsu Iwamoto, Yasuyuki Mitani, Kazuki Shimomura, Norio Takemoto, Toshihiro Sakanaka, Masato Tamiya, Takahiko Hyo, Manabu Kawai","doi":"10.1186/s40792-024-02037-y","DOIUrl":"10.1186/s40792-024-02037-y","url":null,"abstract":"<p><strong>Background: </strong>Anal fistula cancer is rare and definitive treatment has not yet been established. Laparoscopic abdominoperineal resection is generally the first choice of treatment if the cancer is determined to be resectable. However, complicated anal fistula cancer often requires extensive resection. Using a myocutaneous flap for reconstruction after resection in such cases, radical resection can be performed regardless of the size of the anal fistula cancer.</p><p><strong>Case presentation: </strong>We report two cases in which we performed laparoscopic abdominoperineal resection with extensive buttock resection and myocutaneous flap reconstruction for widespread anal fistula cancer. One of the cases was reconstruction with a posterior thigh flap, the other was with a bilateral expanded gluteus maximus flap. Both cases were anal fistula cancers that developed from complicated anal fistulas.</p><p><strong>Conclusions: </strong>If the size of anal fistula cancer is large and extended buttock resection is necessary, radical resection of anal fistula cancer is possible using myocutaneous flap for reconstruction after extended abdominoperineal resection.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"233"},"PeriodicalIF":0.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393518","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":"Surgery for non-Meckel's small-bowel diverticular perforation: two case reports and a literature review.","authors":"Naoki Matsuya, Akifumi Kuwabara, Nobuhiro Morioka, Tadashi Tanabe, Nobuyuki Musha, Ken Nishikura, Toshihiro Tsubono","doi":"10.1186/s40792-024-02000-x","DOIUrl":"10.1186/s40792-024-02000-x","url":null,"abstract":"<p><strong>Background: </strong>Similar to colonic diverticula, small-intestinal diverticula are often asymptomatic, but may cause life-threatening acute complications. Non-Meckel's small-bowel diverticular perforation is rare, and the rate of mortality is high. However, there is currently no consensus regarding its therapeutic management.</p><p><strong>Case presentation: </strong>Case 1: A 73-year-old Japanese man with localized lower abdominal pain was referred to our hospital. Enhanced computed tomography (CT) revealed diverticulitis of the small intestine, which was managed conservatively. Four days after admission, abdominal pain worsened, and repeat CT revealed extraintestinal gas. Emergency surgery was performed for the segmental resection of the perforated jejunum with anastomosis. Case 2: A 73-year-old Japanese woman was transferred to our hospital with small-bowel perforation. CT revealed scattered diverticula in the small intestine and extraintestinal gas around the small-intestinal diverticula. Emergency surgery was performed for the segmental resection of the perforated jejunum with anastomosis.</p><p><strong>Conclusions: </strong>Conservative treatment for small-bowel diverticular perforation may be attempted in mild cases; however, surgical intervention should not be delayed. Segmental resection of the affected intestinal tract with an anastomosis is the standard treatment. Residual diverticula should be documented because of the possibility of diverticulosis recurrence.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"232"},"PeriodicalIF":0.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393522","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":"RAS mutant transverse colon cancer with multiple liver metastases achieving long-term disease-free survival with postoperative maintenance therapy with aflibercept + FOLFIRI and four repeated radical resections: a case report.","authors":"Yasushi Tanaka, Ryota Nakanishi, Shota Sato, Akihiko Otake, Keiichiro Ryujin, Shinichiro Ikeda, Yuho Ebata, Tomoya Harima, Keita Natsugoe, Takayuki Yoshiyama, Yuki Shin, Tetsuro Kawazoe, Kensuke Kudo, Yoko Zaitsu, Yuichi Hisamatsu, Koji Ando, Yuichiro Nakashima, Shinji Itoh, Eiji Oki, Yoshinao Oda, Tomoharu Yoshizumi","doi":"10.1186/s40792-024-02033-2","DOIUrl":"10.1186/s40792-024-02033-2","url":null,"abstract":"<p><strong>Background: </strong>Management of patients with colorectal liver metastases (CRLMs) requires a multidisciplinary approach. For patients with progression of RAS mutant tumors, the choice of angiogenesis inhibitors can be controversial. Here, we report a patient with RAS mutant CRLMs achieving long-term disease-free survival with repeated R0 resections and perioperative treatment, especially aflibercept + FOLFIRI (5-fluorouracil, levofolinate, irinotecan), which may have prevented long-term recurrence.</p><p><strong>Case presentation: </strong>The patient was a 37 year-old woman diagnosed with RAS mutant transverse colon cancer with 19 LMs. As the metastases were limited to the liver, we introduced systemic chemotherapy aiming at conversion surgery. After six cycles of bevacizumab + FOLFOXIRI (5-fluorouracil, levofolinate, oxaliplatin, irinotecan), we performed partial hepatectomy for all LMs, and left hemicolectomy for the primary tumor after another four cycles of bevacizumab + FOLFIRI. Three months after surgery, the patient presented with massive ovarian metastases with carcinomatous ascites. We conducted bilateral oophorectomy, and initiated aflibercept + FOLFIRI therapy considering the possibility of resistance to bevacizumab. The patient was recurrence-free for 2 years during aflibercept + FOLFIRI treatment. After its discontinuation, two distant metastases developed. Both were resectable and the patient achieved recurrence-free survival of 2 years and 3 months after the last operation (6 years since initiation of treatment), without additional chemotherapy.</p><p><strong>Conclusions: </strong>We believe that multidisciplinary treatment aimed at complete resection could lead to long-term survival even in patients with repeated recurrence of CRLMs. Aflibercept + FOLFIRI could be effective in controlling metastasis of RAS mutant colon cancer even after treatment with bevacizumab.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"231"},"PeriodicalIF":0.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393521","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":"Primary ileal myeloid sarcoma presenting with bowel obstruction: a case report.","authors":"Hitoshi Minagi, Nobuhiko Kanaya, Yoshitaka Kondo, Yoshihiko Kakiuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Satoru Kikuchi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara","doi":"10.1186/s40792-024-02030-5","DOIUrl":"10.1186/s40792-024-02030-5","url":null,"abstract":"<p><strong>Background: </strong>Myeloid sarcoma (MS) is an extramedullary tumor constituted by myeloid blasts or immature myeloid cells. It frequently occurs in conjunction with acute myeloid leukemia (AML); however, it can exceptionally manifest in patients without leukemia. Here, we present a rare case of primary MS originating in the small bowel without evidence of bone marrow involvement.</p><p><strong>Case representation: </strong>A 33 year-old female with no relevant medical history was admitted to our hospital with recurrent abdominal pain. Computed tomography (CT) revealed bowel obstruction due to thickening of the ileum wall, which was suspected to be an ileal tumor. Initially, ectopic endometriosis was suspected because of abdominal pain associated with the menstrual cycle and changes observed on a follow-up CT scan. The lesion could not be detected by double-balloon endoscopy. Despite conservative treatment, the obstruction persisted, and laparoscopic partial ileal resection was performed, which revealed extensive involvement of the ileum and mesentery. Additionally, the mesentery of the resected ileum was extremely thickened. Histopathological and immunohistochemical examinations of the surgical specimen indicated ileal MS. Bone marrow aspiration after discharge was negative for cytological findings of leukemia, leading to a final diagnosis of primary ileal MS. Her postoperative course was uneventful, and she is currently undergoing systemic chemotherapy tailored to AML at another hospital.</p><p><strong>Conclusions: </strong>Even though MS of the small bowel is rare and may not be considered preoperatively, similar surgical treatment to that of other small bowel malignancies can ensure proper postoperative diagnosis and appropriate chemotherapy. Given the potential need for chemotherapy, ensuring surgical safety that allows for its rapid initiation is critical.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"229"},"PeriodicalIF":0.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372918","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}