Surgical Case Reports最新文献

{"title":"Rare Case of Additional Ileocecal Resection for Ascending Colon Cancer with R1 Resection due to Advanced Perineural Invasion.","authors":"Yoshiaki Kanemoto, Tomonari Amano, Tomohiro Kurokawa, Tetsuya Tanimoto, Masahiro Amano, Kunihisa Miyazaki","doi":"10.70352/scrj.cr.25-0016","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0016","url":null,"abstract":"<p><strong>Introduction: </strong>Perineural invasion (PNI) has been cited as an independent prognostic factor in colorectal cancer. We report the first case of an additional resection after ileocecal resection due to advanced lateral extension of PNI, with a review of the literature.</p><p><strong>Case presentation: </strong>A 67-year-old woman underwent colonoscopy due to positive fecal occult blood. Biopsy revealed a 20-mm type 2 tumor in the ascending colon near the ileocecal valve, which was a poorly differentiated adenocarcinoma. She underwent laparoscopic-assisted ileocecal resection and D3 dissection, and the surgery was completed routinely in which functional end-to-end anastomosis (FEEA) was performed extracorporeally. Postoperative course was good and she was discharged one week postoperatively. The pathology showed AI, type 3, 30 × 23 mm, 40%, por2>sig>tub2, pT3a (SS), int, INFb, v2, ly3, Pn1b, PM1, DM0, pN1. There was widespread cancerous extension along the intermuscular plexus within the intrinsic muscular layer of the ileum, and although grossly separated from the tumor by about 80 mm, the tumor was R1 resected with positive oral margins. Additional anastomotic resection was performed by laparotomy. Intraoperatively, the resected section was submitted to a rapid examination, which was confirmed to be negative, and the surgery was completed. The pathological examination revealed that the resected specimen showed an adenocarcinoma on the ileum side of the anastomosis, which infiltrated and proliferated within the intermuscular plexus by about 15 mm, although the tumor was not visually recognized on the resection specimen. Both bilateral margins were negative, resulting in R0 resection. Postoperative adjuvant chemotherapy was not requested by the patient. Thereafter, periodic imaging follow-up was performed and, nine months after the initial diagnosis, there was no increase in tumor markers and no evidence of recurrence on imaging.</p><p><strong>Conclusions: </strong>Preventing R1 resection due to lateral extension of advanced PNI, which is very rare as in this case, is practically difficult given its frequency and residual bowel function. Instead, prompt additional resection and adjuvant therapy (which was not performed in this case) are essential to minimize the risk of recurrence.</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/PMC12061511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019682","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":"General Anesthesia Surgery for Early Breast Cancer in a Patient with Severe Heart Failure due to Dilated Cardiomyopathy: A Case Report.","authors":"Tomohiro Oshino, Karin Shikishima, Yumi Moriya, Mitsuchika Hosoda, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai, Masato Takahashi","doi":"10.70352/scrj.cr.25-0034","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0034","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative mortality is significantly higher in cases of heart failure with severe left ventricular ejection fraction (LVEF) reduction, making it challenging to decide whether to proceed with surgery for early-stage breast cancer, which is not immediately fatal. However, the prognosis of heart failure has improved and breast cancer is increasingly becoming a prognostic factor. Herein, we report the case of a breast cancer patient with severe heart failure due to dilated cardiomyopathy (DC), who was deemed fit to undergo surgery under general anesthesia after obtaining sufficient informed consent and achieving improvement in heart failure symptoms during endocrine therapy.</p><p><strong>Case presentation: </strong>A 64-year-old female with a history of DC and sustained ventricular tachycardia, who had received cardiac resynchronization therapy with defibrillator implantation, underwent breast cancer surgery. She had been repeatedly hospitalized for heart failure with an LVEF of 19% and New York Heart Association (NYHA) Class III status, and heart transplant surgery was considered. However, a screening computed tomography scan revealed right breast cancer, and neither heart transplantation nor breast cancer surgery was performed. Endocrine therapy was initiated and failed 48 months after administration. Although the LVEF remained low at 21%, the NYHA classification improved to Class II, and she had not been hospitalized for heart failure for an extended period since her breast cancer diagnosis. Therefore, breast cancer surgery was performed under general anesthesia and no postoperative complications were observed throughout the course of the surgery.</p><p><strong>Conclusion: </strong>Given that the prognosis for heart failure may statistically be better than that for breast cancer, early breast cancer surgery should be performed in patients with stable heart failure symptoms.</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/PMC12006746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062270","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 Unresectable Hepatocellular Carcinoma Treated with Spacer Placement Surgery with Bioabsorbable Spacer and Subsequent Proton Beam Therapy.","authors":"Toru Takahashi, Shohei Komatsu, Yusuke Demizu, Keisuke Arai, Nobuaki Ishihara, Akihiro Fujisawa, Hidetoshi Gon, Hirochika Toyama, Sunao Tokumaru, Takumi Fukumoto","doi":"10.70352/scrj.cr.25-0026","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0026","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) often requires repeated therapy and poses challenges in treatment selection, particularly in patients with impaired liver function. Although hepatic resection, radiofrequency ablation, and liver transplantation are standard local curative therapies, the position of radiotherapy, including proton beam therapy (PBT), remains relatively underexplored. Herein, we report an illustrative case of unresectable HCC treated with spacer placement surgery using a bioabsorbable spacer, followed by PBT.</p><p><strong>Case presentation: </strong>We report the case of a 77-year-old male patient diagnosed with a 6 cm HCC in segment 8, accompanied by impaired liver function, precluding hepatic resection. PBT was planned; however, because of the proximity of the gastrointestinal tract to the tumor, spacer placement was deemed necessary, and a bioabsorbable polyglycolic acid spacer was placed, followed by PBT. Owing to the sufficient space provided by the spacer, curative doses of PBT could be delivered to the tumor, and the patient survived for 26 months after spacer placement surgery without any sign of recurrence.</p><p><strong>Conclusions: </strong>Bioabsorbable spacer placement surgery and subsequent PBT are feasible and promising treatment options for unresectable HCC with impaired liver function.</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/PMC12022998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023764","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":"Delayed Hemorrhage Following Needle Aspiration for a Mediastinal Cyst: The Significance of Confronting Upside-Down Video-Assisted Thoracic Surgery Under Two-Lung Ventilation.","authors":"Eri Ueda, Tomonari Oki, Shuhei Iizuka, Yoshifumi Kunii, Yoshiro Otsuki, Toru Nakamura","doi":"10.70352/scrj.cr.25-0134","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0134","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical resection remains the gold standard for managing mediastinal cysts, including bronchogenic cysts, whereas needle aspiration serves as an alternative option that can facilitate preoperative volume reduction or, in certain selected cases, serve as a definitive treatment. However, it may lead to rare but potentially life-threatening complications such as mediastinitis; therefore, its indication should be carefully considered. This report details a case of a delayed intracystic hemorrhage 3 days after an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), requiring emergency surgery with venoarterial extracorporeal membrane oxygenation (V-A ECMO) on standby, which was successfully managed using a confronting upside-down video-assisted thoracoscopic surgery (VATS) approach.</p><p><strong>Case presentation: </strong>A 64-year-old woman with exertional dyspnea was diagnosed with a superior mediastinal cyst compressing the trachea and esophagus. Preoperative EUS-FNA was performed to reduce the cyst volume and any mitigate potential complications during anesthesia induction. Three days later, she developed dyspnea due to a delayed intracystic hemorrhage, necessitating emergency surgery. VATS with a confronting upside-down monitor setup was performed under standby V-A ECMO. Despite a limited surgical field under 2-lung ventilation, a confronting upside-down VATS approach allowed sufficient visualization and maneuverability. The patient had an uneventful recovery, with no recurrence at 3 months.</p><p><strong>Conclusions: </strong>A delayed intracystic hemorrhage is a potential risk following an EUS-FNA for mediastinal cysts. A confronting upside-down VATS approach provides sufficient maneuverability even for superior mediastinal tumors, despite a limited surgical field due to inadequate 1-lung ventilation. Placement of the camera port in the higher intercostal space was deemed particularly crucial.</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/PMC12056370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027888","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":"Navigating the Challenges of Persistent Left Superior Vena Cava in the Catheterization of Peripherally Inserted Central Catheter Port: A Case Study.","authors":"Takeshi Nakayama, Shinichiro Kobayashi, Shunsuke Murakami, Takahiro Enjoji, Hanako Tetsuo, Yusuke Inoue, Taichiro Kosaka, Akihiko Soyama, Tomohiko Adachi, Kazuma Kobayashi, Kengo Kanetaka, Susumu Eguchi","doi":"10.70352/scrj.cr.24-0088","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0088","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent left superior vena cava (PLSVC), which is asymptomatic and occurs in 0.3%-0.5% of the general population, is typically detected incidentally but can complicate cardiac procedures owing to its potential to cause arrhythmias. This condition involves an additional venous return pathway to the right atrium, which can alter the cardiac anatomy and is associated with other cardiac aortic anomalies.</p><p><strong>Case presentation: </strong>A 75-year-old male patient required a central venous port for chemotherapy and radiation therapy for mid-thoracic esophageal cancer. Preoperative computed tomography images revealed that the PLSVC ran ventrally to the aortic and left pulmonary arteries, directly communicating with the right atrium. A peripherally inserted central catheter (PICC) port was planned. The catheter tip of the PICC port was placed within the left superior vena cava instead of the more common right superior vena cava, because the appropriate vessels could not be identified in the right upper arm. This anomaly necessitated a review of findings on the preoperative imaging and underscored the importance of early detection through echocardiography and radiographic guidance to prevent procedural complications. Reconstructed three-dimensional images and radiography-guided catheterization support the navigation of PICC port insertion.</p><p><strong>Conclusions: </strong>PLSVC, which is often asymptomatic, requires careful preprocedural planning and imaging to ensure safe PICC port insertion.</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/PMC12055441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048949","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 Large Gastrointestinal Stromal Tumor under the Disguise of a Gastric Diverticulum: Report of a Case and Review of the Literature.","authors":"Vasileios I Lagopoulos, Eleni Gigi, Stavros Savvakis, Maria Sidiropoulou, Ioannis Gkoutziotis, Panagiotis-Konstantinos Emfietzis","doi":"10.70352/scrj.cr.24-0133","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0133","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal stromal tumors (GISTs) are a relatively rare clinical entity. They usually appear as solid masses in numerous locations throughout the gastrointestinal tract, varying in size and typically exhibiting extraluminal expansion along with a range of nonspecific symptoms. The exophytic growth pattern of these tumors may occasionally complicate the differential diagnosis from other medical conditions with similar clinical and imaging findings.</p><p><strong>Case presentation: </strong>We describe a case of a 46-year-old male patient who presented to the emergency department with symptoms of upper gastrointestinal tract hemorrhage. Initial endoscopic findings suggested a large gastric diverticulum. Surprisingly, further investigation with computed tomography and a second endoscopy with biopsy sampling revealed that the stomach wall outpouching was actually a disguised, oversized gastric GIST. The patient underwent a posterior wall sleeve gastrectomy en bloc with the mass, the spleen, and the tail of the pancreas and recovered uneventfully. Daily administration of imatinib as adjuvant therapy was included in the treatment plan. No recurrence was observed even up to the 4-year follow-up period.</p><p><strong>Conclusions: </strong>GISTs are uncommon tumors with the ability to masquerade as gastrointestinal tract diverticula, causing diagnostic confusion. Nevertheless, high clinical suspicion combined with a thorough clinical and imaging evaluation can ultimately lead to the correct diagnosis and an appropriate treatment plan.</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/PMC11994293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043012","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 Intra-Pouch Mucosal Bridge Formation in a Child with Ulcerative Colitis.","authors":"Yuhki Koike, Koki Higashi, Yuki Sato, Shinji Yamashita, Yuka Nagano, Tadanobu Shimura, Takahito Kitajima, Kohei Matsushita, Yoshinaga Okugawa, Yoshiki Okita, Yuji Toiyama","doi":"10.70352/scrj.cr.25-0045","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0045","url":null,"abstract":"<p><strong>Introduction: </strong>Restorative proctocolectomy with construction of an ileal J-pouch anal anastomosis is an established gold standard procedure for managing ulcerative colitis. One of the reported complications is a residual mucosal bridge as a result of leaving an apical bridge remnant when constructing the ileal J-pouch. However, now that the surgical procedure is well established, such complications rarely occur.</p><p><strong>Case presentation: </strong>A 12-year-old girl presented to our hospital because of anal pain. She had undergone three-stage surgery for ulcerative colitis refractory to medical therapy, the third stage (stoma closure) having been performed 1 month before the present admission. A computed tomography scan to investigate the possibility of a perianal or pelvic abscess showed no abscess, but revealed what appeared to be a thickening of the wall of the J-pouch, suggestive of pouchitis. Endoscopy revealed a mucosal bridge crossing the anterior and posterior walls of the J-pouch, with a stapler line near the posterior wall's root; however, there was no evidence of pouchitis. While creating the J-pouch (during the second stage of surgery for ulcerative colitis), we had ensured that an apical bridge was eliminated with a linear stapler. Moreover, a contrast enema of the J-pouch during the present admission demonstrated interruption of contrast in the J-pouch. These findings led us to conclude that the mucosal bridge had probably formed postoperatively, after J-pouch creation. The patient underwent endoscopic resection of the mucosal bridge in the J-pouch using an XXS wound retractor transanally. Both ends of the bridge were cut three times with a 5-mm stapler and the bridge was resected. The patient was discharged after surgery, having experienced immediate resolution of anal pain and no complications. Pathological examination of the resected specimen showed that the ileal wall had bent toward the J-pouch lumen with fibrous adherence on the serosal side, indicating that the mucosal bridge had developed unintentionally post-stoma closure. Preoperative computed tomography showed limited pouch expansion, whereas postoperative computed tomography showed sufficient expansion.</p><p><strong>Conclusion: </strong>If anal pain develops following radical ulcerative colitis surgery (after ileal stoma closure), postoperative mucosal bridge formation should be included in the differential 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/PMC12055236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038865","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":"Worsening Ileal Stenosis Caused by Multiple Ectopic Gastric Mucosa Lesions in an Elderly Patient: A Novel Case with a Long Observation Period.","authors":"Ryozan Naito, Etsuko Hisanaga, Ikuma Shioi, Nobuhiro Hosoi, Takayoshi Watanabe, Yuta Shibasaki, Nobuhiro Nakazawa, Katsuya Osone, Takuhisa Okada, Takuya Shiraishi, Akihiko Sano, Makoto Sakai, Hiroomi Ogawa, Makoto Sohda, Yoshihiro Ohno, Ken Shirabe, Hiroshi Saeki","doi":"10.70352/scrj.cr.24-0120","DOIUrl":"10.70352/scrj.cr.24-0120","url":null,"abstract":"<p><strong>Introduction: </strong>Ectopic gastric mucosa (EGM) is a hyperplastic primitive gut epithelium found in tissues other than the stomach. EGM in the small intestine, distal to the ligament of Treitz (EGMdT), is uncommon. EGMdT without congenital anomalies has rarely been reported. Most reported cases are diagnosed in youth, with a single lesion and urgent symptoms requiring emergency surgery. Herein, we report a unique case of multiple EGMdTs without congenital anomalies that caused progressive ileal stenosis in an elderly patient with an observation period of 11 years.</p><p><strong>Case presentation: </strong>The patient was a 77-year-old man. On a medical exam 11 years before arrival at our hospital, the patient was diagnosed with EGMdT in the terminal ileum without stenosis. Five years after the initial diagnosis of EGMdT, the patient experienced his first episode of bowel obstruction, which was treated conservatively. The patient experienced three episodes of bowel obstruction, all of which were treated conservatively. The patient was then referred to our hospital for further examination and treatment. Colonoscopy at our hospital showed an EGMdT that protruded from the Bauhin's valve. Double-balloon colonoscopy revealed a lymph follicle-like elevation 20 cm from the Bauhin's valve with obvious stenosis. No malignancies were found on lesion biopsy. The fluoroscopic gastrointestinal series showed five lesions on the oral side of the Bauhin's valve. Based on these findings, the patient's symptoms were considered as the outcome of ileal stenosis caused by multiple EGMdTs; therefore, surgical resection was recommended. Laparoscopic resection of the lesion was performed. Intraoperative findings were not suspicious of malignancy. There were five erosions in the resected specimen, and all lesions were diagnosed as EGMdTs without malignancies. The patient was discharged on the 7th postoperative day without any complications. The patient had no recurrent symptoms after discharge.</p><p><strong>Conclusions: </strong>Based on the present case, we recommend that clinicians consider surgical resection for symptomatic EGMdT, even without malignancy, and screen for multiple lesions to avoid residual EGMdT.</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/PMC12120499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182827","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":"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}