Surgical Case Reports最新文献

{"title":"Reconstruction of a Complex Posterior Tracheal Wall Defect via Transtracheal Running Suture and Pedicled Pectoralis Major Muscle Flap.","authors":"Tomoyuki Nakagiri, Alaa Selman, Tobias Goecke, Hayan Merhej, Akylbek Saipbaev, Arjang Ruhparwar, Patrick Zardo","doi":"10.70352/scrj.cr.24-0009","DOIUrl":"10.70352/scrj.cr.24-0009","url":null,"abstract":"<p><strong>Introduction: </strong>A tracheal membranous injury is a known complication of tracheostomy. After esophageal resection, such injury may prove fatal. No natural buttressing of the lesion occurs, and severe sepsis and mediastinitis may occur. In these situations, a circumferential tracheal resection is the treatment of choice, sometimes on cardiopulmonary bypass. However, the outcome is not always favorable.</p><p><strong>Case presentation: </strong>We report a case of a long tracheal membranous wall defect (> 7cm) after esophageal resection. We successfully performed a transtracheal direct repair of the defect through a partial sternotomy, and reconstructed the ventrolateral wall with a muscle flap using the right pectoralis major muscle.</p><p><strong>Conclusion: </strong>Tracheal reconstruction through a T-shaped incision and anastomotic buttressing using a pectoralis major muscle flap could prove to be useful when reconstructing a posterior tracheal wall injury, especially after esophageal resection.</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/PMC11850052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493532","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 Laparoscopic Resection of Gastric Cancer Using Novel Laparoscopic Fluorescence Spectrum System and Near-Infrared Fluorescent Clips.","authors":"Shion Uemura, Yuma Ebihara, Kazuya Konishi, Satoshi Hirano","doi":"10.70352/scrj.cr.24-0028","DOIUrl":"10.70352/scrj.cr.24-0028","url":null,"abstract":"<p><strong>Introduction: </strong>In laparoscopic gastrectomy, accurate marking of the lesion site is essential in determining the resection line of the stomach, owing to the lack of haptics and the direct link between negative pathological margins and prognosis. Intraoperative endoscopy may require personnel and prolong the operation time, whereas preoperative endoscopic tattooing using India ink faces problems related to the spread of ink and visibility. ZEOCLIP FS (Zeon Medical, Tokyo, Japan) is a clip made of fluorescent resin, covered by insurance since March 2019. It can be visualized from the serosal side using a near-infrared scope; however, its weak fluorescence intensity often poses viewing difficulties. Lumifinder (ADVANTEST, Tokyo, Japan) is a laparoscopic fluorescence spectrum system available for clinical use since February 2023. It can measure fluorescence intensity using a near-infrared laser and detect weak fluorescent signals. We report a case of gastric cancer in which the location of the lesion was confirmed intraoperatively using ZEOCLIP FS and Lumifinder.</p><p><strong>Case presentation: </strong>A man in his 80s was diagnosed with gastric cancer following an examination for anemia. Two lesions were found: a 0-IIc type (cT1) at the lesser curvature of the gastric angle and a type 1 tumor (cT2) at the anterior wall of the upper gastric body. The preoperative assessment indicated no lymph node or distant metastasis. The tumor was diagnosed as cStage I and laparoscopic distal gastrectomy was planned. Two ZEOCLIP FS clips were placed on the oral side of the tumor on the anterior wall of the upper gastric body on the day before surgery. During surgery, fluorescent signals from the clips were detected using Lumifinder, enabling easy confirmation of the lesion location and determination of the gastric resection line.</p><p><strong>Conclusions: </strong>The combined use of ZEOCLIP FS and Lumifinder was a useful new method for identifying the appropriate resection line of the stomach. We plan to evaluate this method further in additional cases to enhance the detection efficacy.</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/PMC11842931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Segmentectomy in a Patient with a Displaced Left Upper Division Bronchus and Fused Fissure.","authors":"Hironobu Wada, Ryo Karita, Yuki Hirai, Yuki Onozato, Toshiko Kamata, Hajime Tamura, Takashi Anayama, Ichiro Yoshino, Shigetoshi Yoshida","doi":"10.70352/scrj.cr.25-0039","DOIUrl":"10.70352/scrj.cr.25-0039","url":null,"abstract":"<p><strong>Introduction: </strong>In thoracic surgery, anatomical anomalies and a fused fissure can cause inaccurate intraoperative recognition of anatomy and lead to accidental injury of pulmonary vessels and bronchi that should be preserved. A displaced left upper division bronchus (B¹⁺²⁺³), also known as a left eparterial bronchus, is a rare anomaly that can present in combination with abnormal pulmonary arteries positioning and lobulation. Herein, we report a case of lung cancer in S¹⁺² of the left fused lung that was successfully resected by robotic left upper division segmentectomy following a detailed preoperative simulation using 3-dimensional computed tomography.</p><p><strong>Case presentation: </strong>A female octogenarian presented for the treatment of simultaneous bilateral lung cancer. Three months after surgery for right lung cancer, a surgery for left lung cancer was performed. Preoperative computed tomography identified several broncho-arterial anomalies and a completely fused fissure, including a displaced left upper division bronchus and a pulmonary artery running anteriorly to the left main bronchus, similar to those in the right lung. Robotic left upper division segmentectomy with lymph node dissection was performed using a \"hilum first, fissure last\" approach with fine dissection of the hilar structures and minimal bleeding. The postoperative course was uneventful.</p><p><strong>Conclusions: </strong>Preoperative simulation and robotic-assisted thoracoscopic surgery enabled the safe and precise anatomical pulmonary segmentectomy for a patient with lung cancer, despite several bronchial and arterial anomalies, including a displaced left upper division bronchus.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confronting Upside-Down Video-Assisted Thoracic Surgery Approach for Hemorrhagic Bronchogenic Cyst Manifested by Sudden Back Pain.","authors":"Masato Kambe, Tomonari Oki, Shuhei Iizuka, Yoshiro Otsuki, Toru Nakamura","doi":"10.70352/scrj.cr.24-0126","DOIUrl":"10.70352/scrj.cr.24-0126","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchogenic cysts, arising from an aberrant bronchial primordium inclusion during the fetal period, are typically located in the mediastinum but can develop in ectopic regions. While generally asymptomatic, these cysts may become symptomatic due to infection or, rarely, hemorrhage. This report details a case of a hemorrhagic bronchogenic cyst in the supradiaphragmatic region, successfully resected using video-assisted thoracic surgery (VATS) with a confronting upside-down monitor setting.</p><p><strong>Case presentation: </strong>An 18-year-old female presented with a fever and sudden left-sided back pain. Blood tests revealed leukocytosis and an elevated C-reactive protein. Imaging studies identified a well-circumscribed cyst along the left diaphragm, suspected to be an infected bronchogenic cyst. Magnetic resonance imaging 2 days later indicated disease progression with concomitant empyema, prompting emergency surgery. Using the confronting upside-down monitor setting, the cyst was resected. Thoracoscopic findings revealed a dark red cyst and bloody pleural effusion. The surgery was uneventful, and the patient was discharged on postoperative day 2. Bacterial cultures of the pleural effusion and cystic content were negative, and histopathological analysis confirmed the diagnosis of a hemorrhagic bronchogenic cyst.</p><p><strong>Conclusions: </strong>Hemorrhagic bronchogenic cysts should be considered in the differential diagnosis of intrathoracic cysts presenting with sudden pain. Upfront surgery is recommended for symptomatic bronchogenic cysts, irrespective of the location or etiology. VATS via the confronting upside-down monitor setting is the feasible option alongside the conventional approach.</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/PMC11861584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516781","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":"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}