Surgical Case Reports最新文献

{"title":"Two Cases of Mediastinal Non-Seminomatous Germ Cell Tumor with Complete Resection by Robot-Assisted Thoracoscopic Surgery after Induction Chemotherapy: Techniques for Identification and Preservation of the Phrenic Nerve.","authors":"Ryuji Nakamura, Katsuhiro Okuda, Kensuke Iguchi, Shin Hosokawa, Emi Hagui, Kensuke Chiba, Tsutomu Tatematsu, Keisuke Yokota","doi":"10.70352/scrj.cr.25-0383","DOIUrl":"10.70352/scrj.cr.25-0383","url":null,"abstract":"<p><strong>Introduction: </strong>Mediastinal non-seminomatous germ cell tumors (NSGCTs) are rare tumors. Neoadjuvant chemotherapy followed by complete surgical resection of residual masses is recommended, and is often performed through a median sternotomy or thoracotomy with regard to the influence of induction chemotherapy and tumor size. We herein report 2 cases of mediastinal NSGCT that were surgically resected by robot-assisted thoracoscopic surgery (RATS) using the subxiphoid approach.</p><p><strong>Case presentation: </strong>Case 1: A 23-year-old man was diagnosed with an anterior mediastinal mass measuring 95 × 73 × 73 mm while undergoing an examination due to fever. He was diagnosed with a yolk sac tumor based on percutaneous needle biopsy. After 4 cycles of neoadjuvant chemotherapy, the patient underwent tumor resection combined with wedge resection of the left upper lung via a robot-assisted subxiphoid approach. It was particularly difficult to identify the left phrenic nerve because of stiff adhesions and thickening of the tissue. Therefore, we decided to perform dissection of tissue other than that surrounding the left phrenic nerve. Subsequently, the thymus and tumor were flipped into the left thoracic cavity, and the left phrenic nerve was easily identified and preserved from the pericardial side. The patient was discharged without any postoperative complications. Case 2: An 18-year-old man was diagnosed with a yolk sac tumor measuring 86 × 68 × 150 mm during an examination to investigate intermittent right chest pain. After 4 cycles of neoadjuvant chemotherapy, the patient underwent anterior mediastinal tumor resection via a robot-assisted subxiphoid approach. The tumor was close to the right pulmonary hilum, and the inflammation was so intense that it was difficult to identify the right phrenic nerve. In this case, indocyanine green fluorescence imaging was helpful for identifying the right phrenic nerve. The tumor was completely resected. The patient was discharged on POD 6 without any postoperative complications.</p><p><strong>Conclusions: </strong>We report 2 cases of mediastinal NSGCT after induction chemotherapy that were completely resected using RATS. The use of techniques to accurately identify the phrenic nerve and the advantages of robot-assisted surgery via the subxiphoid approach enabled safe and minimally invasive surgical 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/PMC12460031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150840","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":"Aberrant Right Subclavian Artery-Induced Esophageal Stenosis Successfully Treated with Vascular Reconstruction: A Pediatric Case Report.","authors":"Wataru Sumida, Kazuya Nagayabu, Kazuki Ota, Yuki Imai, Yasuyuki Ono, Hiroomi Murayama","doi":"10.70352/scrj.cr.25-0182","DOIUrl":"10.70352/scrj.cr.25-0182","url":null,"abstract":"<p><strong>Introduction: </strong>Aberrant right subclavian artery (ARSA) is the most common congenital anomaly of the subclavian artery, occurring in 0.2%-1.5% of the population. While typically asymptomatic, ARSA can cause dysphagia in older patients due to esophageal compression. In pediatric cases, it is less frequent and usually presents with chronic respiratory symptoms resulting from tracheal compression. Acute respiratory failure as a presentation of ARSA is extremely rare. This case report describes a pediatric patient with ARSA-associated esophageal stricture, leading to severe respiratory distress following food intake and requiring surgical treatment.</p><p><strong>Case presentation: </strong>A 1.8-year-old girl developed an inspiratory stridor after eating. Initial inhalation therapy provided temporary relief, but persistent respiratory distress prompted further evaluation. CT revealed an esophageal foreign body, which was successfully extracted using a balloon catheter. However, continued respiratory distress necessitated intubation and intensive care. Bronchoscopy and enhanced CT confirmed tracheal compression due to ARSA, along with esophageal stenosis. Despite initial medical management, recurrent respiratory distress and feeding difficulties required surgical intervention. A right thoracotomy was performed to reposition the aberrant artery anterior to the trachea, alleviating the vascular compression. Postoperatively, the patient made a full recovery, resumed a normal diet, and remained symptom-free at the 6-month follow-up.</p><p><strong>Conclusions: </strong>Symptomatic ARSA is rare in pediatric patients but can cause severe respiratory distress due to esophageal and tracheal compression. In cases of recurrent or severe symptoms, surgical intervention is essential to prevent life-threatening complications. This case highlights the importance of considering ARSA in pediatric patients with unexplained respiratory distress, especially when associated with feeding difficulties.</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/PMC12479170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201380","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":"Adult Cystic Intestinal Duplication of the Ileum Laparoscopically Resected after Preoperative Diagnosis with Cine Magnetic Resonance Imaging and Abdominal Ultrasound: A Case Report.","authors":"Takashi Takeda, Katsuki Danno, Tadafumi Fukata, Itsuko Nakamichi, Kei Yamamoto, Masaya Higashiguchi, Kozo Noguchi, Takafumi Hirao, Mitsugu Sekimoto, Yoshio Oka","doi":"10.70352/scrj.cr.25-0015","DOIUrl":"10.70352/scrj.cr.25-0015","url":null,"abstract":"<p><strong>Introduction: </strong>Small bowel duplication in adults is an uncommon congenital anomaly that often presents with nonspecific symptoms, such as abdominal pain, vomiting, or constipation, which complicates diagnosis. Imaging techniques such as computed tomography (CT) and ultrasonography are commonly used, and cine magnetic resonance imaging (MRI) has emerged as a promising modality for diagnosing duplication cysts by capturing peristaltic movements. Surgical resection is the definitive treatment for preventing complications such as obstruction, infection, or malignant transformation.</p><p><strong>Case presentation: </strong>A woman in her thirties visited the emergency department with persistent lower abdominal pain. Physical examination and laboratory tests, including those for tumor markers, were unremarkable. CT revealed a cystic mass near the uterus, and pelvic MRI revealed a cystic lesion that had migrated during follow-up imaging. Cine MRI showed peristaltic movements within the lesion, and abdominal ultrasonography confirmed a cystic structure with wall movements resembling intestinal peristalsis. Based on these findings, the diagnosis of a noncommunicating small bowel duplication cyst was made.The patient underwent a laparoscopic single-port partial resection of the ileum. A cystic lesion located 75 cm proximal to the terminal ileum was excised along with a segment of the small intestine. Histopathological examination revealed a duplicated cyst lined with the small intestinal mucosa, confirming the diagnosis. The postoperative course was uneventful, and the patient was discharged 1 week postoperatively.</p><p><strong>Conclusion: </strong>This case highlights the utility of cine MRI and ultrasonography in the preoperative diagnosis of small bowel duplication cysts. In particular, cine MRI provides dynamic visualization of peristaltic movements within the cyst, enabling a confident diagnosis. The migration of the cyst observed on serial MRI examinations further corroborated the origin of this duplication. These findings emphasize the importance of advanced imaging modalities in the diagnosis of rare intestinal anomalies. Preoperative diagnosis of small bowel duplication cysts can be significantly enhanced by using cine MRI and ultrasonography to detect peristaltic movements. These modalities offer critical insights that aid timely surgical intervention and improve outcomes.</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/PMC11973249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804009","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":"Sclerosing Angiomatoid Nodular Transformation of the Laparoscopically Resected Spleen: Case Reports and Review of the Literature.","authors":"Shingo Yamasaki, Hiroto Nishino, Takayuki Anazawa, Yuki Teramoto, Takahiro Nishio, Shoichi Kageyama, Kazuyuki Nagai, Yoichiro Uchida, Hironori Haga, Etsuro Hatano","doi":"10.70352/scrj.cr.24-0057","DOIUrl":"10.70352/scrj.cr.24-0057","url":null,"abstract":"<p><strong>Introduction: </strong>Most splenic tumors are benign; however, it is essential to differentiate them from malignant tumors, such as malignant lymphoma and metastatic tumors. Sclerosing angiomatoid nodular transformation (SANT) is a relatively rare benign tumor that has been reported recently. Splenectomy is performed in most cases of SANT because of the challenges associated with a definitive diagnosis. However, in some cases, SANT can be diagnosed through endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and these cases are subsequently followed up. In this report, we present 2 cases of splenic SANT that underwent laparoscopic resection. In Case 1, atypical imaging findings required EUS-FNA for further evaluation. Case 2 exhibited typical imaging findings of SANT, and therefore, EUS-FNA was not performed.</p><p><strong>Case presentation: </strong>Case 1: A 47-year-old female was found to have a 26 mm tumor in the spleen on abdominal ultrasonography during follow-up for gallbladder polyps. Abdominal computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-CT were performed. EUS-FNA was performed because of the high surgical risk associated with pulmonary hypertension and because hemangioendothelioma, an intermediate malignancy, was suspected. Subsequently, laparoscopic splenectomy was performed, and SANT was diagnosed. Case 2: A 46-year-old female had an incidental detection of a tumor in the spleen on CT. SANT was suspected based on CT and MRI findings. Malignancy could not be completely ruled out owing to the gradual growth of the mass; therefore, the patient was referred to our hospital for surgery. Laparoscopic splenectomy was performed, and SANT was subsequently diagnosed.</p><p><strong>Conclusion: </strong>SANT is a benign tumor that is difficult to diagnose; however, in some cases, it can be diagnosed using EUS-FNA. We report 2 cases of SANT of the spleen that underwent laparoscopic resection. In cases where the diagnosis is confirmed through imaging or histological examination, disease management with follow-up and without surgery is a possible alternative.</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/PMC11973248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 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":"Pneumatocele Development after Deceased-Donor Liver Transplantation for Multiple Hepatic Cysts due to Autosomal Dominant Polycystic Kidney Disease: A Case Report.","authors":"Atsushi Yoshiyama, Mitsuaki Kawashima, Sodai Nagata, Takahito Fukushima, Koji Aze, Yue Cong, Keita Nakao, Masayuki Nakao, Gouji Toyokawa, Chihiro Konoeda, Kiyoshi Hasegawa, Masaaki Sato","doi":"10.70352/scrj.cr.24-0005","DOIUrl":"10.70352/scrj.cr.24-0005","url":null,"abstract":"<p><strong>Introduction: </strong>A pneumatocele is a cystic change in the lung that can develop as a sequelae of infection, inflammation, positive-pressure ventilation, thoracic trauma, and rarely after lung resection. Pneumatocele development triggered by an extrathoracic etiology is rare. Herein, we report a case of a pneumatocele that developed after a deceased-donor liver transplantation.</p><p><strong>Case presentation: </strong>A 57-year-old woman with a diagnosis of autosomal dominant polycystic kidney disease underwent deceased-donor liver transplantation for polycystic liver disease. She did not have any background lung disease, although her right lower lobe was mostly atelectatic due to a remarkably elevated diaphragm. The liver transplant itself was uneventful. A small hole was made in the right diaphragm during the dissection of the liver, but it was successfully repaired without any injury to the lung. On postoperative day 1, the chest radiograph revealed a round hypertranslucency on the right side, which was initially considered subphrenic air retention, and no further evaluation was made at that time. Given that the hypertranslucency persisted, follow-up computed tomography was performed on postoperative day 18, and revealed an air-fluid level above the diaphragm in the right thoracic cavity. Thoracoscopic investigation revealed an intrathoracic hematoma within a pneumatocele in the right lower lobe, which was not detected in the pretransplant computed tomography. The hematoma was removed, and the pneumatocele was resected.</p><p><strong>Conclusions: </strong>We experienced a case of a pneumatocele that developed after deceased-donor liver transplantation for multiple hepatic cysts due to autosomal dominant polycystic kidney disease. Although the mechanisms are speculative, the pneumatocele might have been triggered by the sudden alleviation of the elevated diaphragm and reinflation of the atelectatic lung.</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/PMC11937134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721311","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":"Postoperative Solitary Brain Metastasis from Residual Gastric Cancer: A Rare Case Report.","authors":"Masaya Matsumoto, Kojiro Eto, Satoshi Ida, Hiroki Tsubakihara, Keisuke Kosumi, Kazuto Harada, Yuji Miyamoto, Ken Uekawa, Akitake Musaka, Masaaki Iwatsuki","doi":"10.70352/scrj.cr.25-0306","DOIUrl":"10.70352/scrj.cr.25-0306","url":null,"abstract":"<p><strong>Introduction: </strong>Brain metastasis from gastric cancer is rare (0.5%) and often occurs with metastasis to other organs. We herein describe a very rare patient with a solitary brain metastasis from residual gastric cancer with no metastasis to other organs.</p><p><strong>Case presentation: </strong>The patient was an 82-year-old man who visited a previous institution for anemia. Upper gastrointestinal endoscopy revealed a type 2 tumor extending from the esophagogastric junction to the upper part of the residual gastric body. Biopsy revealed tubular differentiated adenocarcinoma, and he was referred to our institution. He had a history of distal gastrectomy for a gastric ulcer in his 30s. After contrast-enhanced CT, we diagnosed residual gastric cancer (cT4aN + M0 cStage III). After three courses of preoperative chemotherapy with S-1 plus oxaliplatin, the patient underwent open total resection of the residual stomach, lower esophagectomy, D2 dissection, and Roux-en-Y reconstruction and was discharged without postoperative complications. Six months after surgery, thoracic and abdominal contrast-enhanced CT showed no apparent recurrence. However, 1 month later, he began to experience speech difficulties and mobility issues, and head CT revealed a 3-cm tumor in the left frontal lobe. After whole-body contrast-enhanced CT and PET-CT, the brain tumor was confirmed as a solitary lesion with no metastasis to other organs. The patient underwent open brain tumor resection, and pathology diagnosed brain metastasis from residual gastric cancer. Postoperatively, he underwent radiation therapy (40 Gy in 8 fractions) to the tumor cavity. At the time of writing, 24 months have passed since the gastrectomy and 16 months have passed since the removal of the brain tumor, with no significant neurological damage or other evidence of distant metastasis.</p><p><strong>Conclusions: </strong>We experienced an extremely rare case of a solitary brain metastasis after residual gastric cancer surgery. Our findings suggest that aggressive local treatments for brain metastasis, including surgical resection and radiotherapy, may contribute to improvements in symptoms and prognosis.</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/PMC12414610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024252","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":"Curative Gastrectomy for Advanced Gastric Cancer in a Patient with Idiopathic Multicentric Castleman Disease: A Rare Case Report.","authors":"Ryohei Kawabata, Yuki Ushimaru, Hisashi Hara, Tomohira Takeoka, Yumiko Yasuhara, Terukazu Yoshihara, Akihiro Kitagawa, Takashi Takeda, Hideo Tomihara, Atsushi Naito, Masahiro Murakami, Shingo Noura, Atsushi Miyamoto","doi":"10.70352/scrj.cr.25-0318","DOIUrl":"10.70352/scrj.cr.25-0318","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder characterized by systemic inflammation and chronic immunosuppression. When solid malignancies such as gastric cancer arise in patients with iMCD, perioperative management becomes particularly challenging due to nutritional decline, reactive lymphadenopathy, and elevated surgical risk.</p><p><strong>Case presentation: </strong>A 75-year-old man with a 26-year history of suspected iMCD treated with low-dose corticosteroids presented with epigastric discomfort. Endoscopy revealed a Borrmann type 2 lesion, and biopsy confirmed poorly differentiated adenocarcinoma. CT showed mild lymphadenopathy along the lesser curvature and left gastric artery, as well as systemic involvement. Inguinal node biopsy confirmed polyclonal plasma cell proliferation consistent with iMCD. The patient also met the Asian Working Group for Sarcopenia (AWGS) criteria for severe sarcopenia. A multidisciplinary team initiated preoperative respiratory rehabilitation, nutritional support, and resistance exercise therapy. Curative distal gastrectomy with D2 lymphadenectomy was performed without complications. Histopathology revealed pT2N0M0 (pStage IB) disease. Tocilizumab was started 3 months postoperatively, and the patient remains recurrence-free at 24 months.</p><p><strong>Conclusions: </strong>This case highlights that, even in patients with long-standing iMCD and sarcopenia, carefully staged multimodal perioperative care-including accurate nodal evaluation and individualized systemic therapy-can enable successful curative surgery for advanced gastric cancer.</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/PMC12226139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561207","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":"Gastroduodenal Intussusception with Gastric Adenocarcinoma: A Case Report and Review of the Literature.","authors":"Ryota Omura, Satoshi Ida, Hiroki Tsubakihara, Keisuke Kosumi, Kazuto Harada, Kojiro Eto, Yuji Miyamoto, Masaaki Iwatsuki","doi":"10.70352/scrj.cr.25-0184","DOIUrl":"10.70352/scrj.cr.25-0184","url":null,"abstract":"<p><strong>Introduction: </strong>Intussusception in adults is a rare condition, and gastric cancer prolapsing into the duodenum is an even rarer phenomenon. We present a case of early gastric cancer originating in the gastric body with duodenal intussusception and discuss the clinical considerations based on the patient's overall condition and existing literature.</p><p><strong>Case presentation: </strong>A 69-year-old man with a 30-mm tumor arising from the posterior wall of the gastric body was scheduled for elective surgery. During hospitalization for diabetes mellitus management, he developed sudden epigastric pain and nausea. Upper gastrointestinal endoscopy revealed tumor prolapse into the duodenum, leading to a diagnosis of ball valve syndrome. After successful endoscopic reduction, open local gastrectomy was performed. Pathological examination confirmed a well-differentiated tubular adenocarcinoma, classified as pT1b (SM2) N0M0, pStage IA.</p><p><strong>Conclusions: </strong>Gastric cancer with duodenal intussusception is often early-stage and characterized by well-differentiated tubular adenocarcinoma. Depending on the patient's condition, endoscopic resection or limited surgical resection may be viable treatment options for this rare condition.</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/PMC12226140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561208","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":"Congenital Pulmonary Airway Malformation with Pulmonary Arteriovenous Malformation in Adulthood: A Case Report.","authors":"Takehiro Suzuki, Naohiro Kobayashi, Yohei Yatagai, Shinsuke Kitazawa, Hideo Ichimura, Yukio Sato","doi":"10.70352/scrj.cr.25-0176","DOIUrl":"10.70352/scrj.cr.25-0176","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital pulmonary airway malformation (CPAM) is a congenital condition rarely detected in adults because most cases of CPAM are found through prenatal testing or through testing for recurrent pneumonia or lung abscesses in childhood. Pulmonary arteriovenous malformation (PAVM) is an abnormal vascular connection between the pulmonary arteries and veins, which is often related to hereditary hemorrhagic telangiectasia, but can also be induced by infections, trauma, or thoracic surgery. Herein, we report an adult case of coexisting CPAM and PAVM.</p><p><strong>Case presentation: </strong>The patient was a 26-year-old woman. A medical checkup chest X-ray showed abnormalities. The patient had no past medical history, including of bleeding tendency or repeated pneumonia, and no familial history of CPAM and PAVM. A chest CT revealed multiple lung cysts (maximum diameter of 40 mm) in the left lower lobe of the lung, and congenital pulmonary cysts were suspected. The chest CT also showed two PAVMs (vessel diameters of 6 mm and 4 mm) in the same left lower lobe. Serum tests were positive for <i>Aspergillus</i>-specific antibodies and β-D-glucan, and pulmonary aspergillosis was diagnosed. An antifungal agent (itraconazole) was administered. However, consolidations had developed 9 months after, and the antifungal agent was changed to voriconazole. Then, the consolidations diminished slightly but nevertheless remained, and one of the PAVMs increased in diameter from 6 mm to 10 mm. A left lower lobectomy under thoracoscopy was performed owing to the uncontrolled infection and the risk of complications with PAVMs. The pathological diagnosis of the pulmonary cysts was CPAM type 1. The patient had no symptoms or complications after the surgery.</p><p><strong>Conclusions: </strong>Cases of CPAM with PAVM are rare, especially in adults. CPAM often leads to pulmonary infection, and the pulmonary infection is known to be one of the causes of PAVM. In our case, <i>Aspergillus</i> might have infected the pulmonary cysts and affected the enlargement of the vascular diameter of PAVM. If CPAM and PAVM are present simultaneously, surgical treatment should be considered to prevent complications associated with CPAM and PAVM.</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/PMC12145924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249702","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}