{"title":"A slow and silent return: a case of renal cell carcinoma recurring as gastrointestinal bleeding and small bowel obstruction.","authors":"Lan Nguyen, Eric Weiss, Matthew Hudson","doi":"10.1093/jscr/rjag834","DOIUrl":"10.1093/jscr/rjag834","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) can metastasize years after treatment, with small bowel involvement being exceedingly rare. We report a 74-year-old man with RCC treated with nephrectomy and immunotherapy who presented ten years after clinical and radiologic remission with manifestations of metastatic disease in the small bowel. Specifically, he developed intussusception from a lead point lesion, followed by subsequent gastrointestinal (GI) bleeding and small bowel obstruction from another synchronous lesion. Each presentation required a distinct diagnostic and therapeutic approach. This case highlights the unpredictable course of RCC, underscoring the importance of comprehensive evaluation when patients with prior RCC develop new GI symptoms, regardless of time since treatment and historical remission.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag834"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026348","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}
Natasha L Frontera, Carlos Diaz Rivera, Fabiola A Ortega-Guzman, Agustin A Rodriguez Lopez, Luis A Santiago-Sulsona, Claudia B Sotomayor Rivera, Pablo Rodríguez-Ortiz
{"title":"When the colon takes a hit: a rare case of acute colonic intramural hematoma after blunt abdominal trauma.","authors":"Natasha L Frontera, Carlos Diaz Rivera, Fabiola A Ortega-Guzman, Agustin A Rodriguez Lopez, Luis A Santiago-Sulsona, Claudia B Sotomayor Rivera, Pablo Rodríguez-Ortiz","doi":"10.1093/jscr/rjag849","DOIUrl":"10.1093/jscr/rjag849","url":null,"abstract":"<p><p>Acute colonic intramural hematomas are rare but clinically significant. They are associated with anticoagulation use, coagulopathies, and trauma. We report a case of a 20-year-old male who was referred to the trauma hospital from an outside institution with right lower quadrant pain and a palpable mass the day of a motor vehicle accident. Computed tomography and magnetic resonance imaging showed an intramural colonic hematoma (measuring 8.3 cm AP × 10.7 cm TR × 13.8 cm long). The patient was initially managed conservatively due to stable hemodynamic status and normal hemoglobin levels. However, the patient's clinical status deteriorated and therefore underwent surgical intervention. Exploratory laparotomy confirmed a large intramural hematoma with a ruptured lateral cecal/ascending colonic wall. An open right hemicolectomy with ileocolonic anastomosis was performed. The final pathologic diagnosis was a hemorrhagic infarction of the colon. The patient recovered well and was discharged home 7 days after surgery.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag849"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026414","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":"Successful repeat carotid artery replacement using vascular grafts in a case with recurrent dedifferentiated liposarcoma: a case report.","authors":"Ayano Tamura, Ryuhei Okada, Ryo Wakejima, Susumu Kirimura, Kazuchika Ohno, Toshifumi Kudo, Kentaro Tanaka, Kenichi Okubo, Takahiro Asakage","doi":"10.1093/jscr/rjag837","DOIUrl":"10.1093/jscr/rjag837","url":null,"abstract":"<p><p>Dedifferentiated liposarcoma is prone to local recurrence, and complete resection remains the treatment of choice. We report a 70-year-old man who underwent carotid artery replacement with vascular grafts on two occasions for recurrent disease. A recurrent tumor invading the right common carotid and subclavian arteries was resected with vascular graft replacement. After 2 years and 7 months, recurrence developed around the carotid artery anastomosis. En bloc tumor resection with repeat carotid artery replacement using a prosthetic vascular graft was successfully performed. The patient was discharged on postoperative Day 9 without postoperative neurological deficits. Postoperative radiotherapy was administered following both operations. He remains free of recurrence more than 2 years after the most recent surgery. This case suggests that repeat carotid artery replacement using a vascular graft may be a feasible treatment option for selected patients with recurrent dedifferentiated liposarcoma.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag837"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026445","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":"Surgical resection and full-thickness skin grafting for sebaceoma extending into the external auditory canal: a case report.","authors":"Minami Yoshimura, Makoto Omori","doi":"10.1093/jscr/rjag836","DOIUrl":"10.1093/jscr/rjag836","url":null,"abstract":"<p><p>Sebaceoma is a rare benign cutaneous adnexal neoplasm with sebaceous differentiation that typically occurs in the head and neck region of elderly individuals. Sebaceoma extending into the external auditory canal is extremely uncommon. We report the case of an 85-year-old woman who presented with an enlarging mass involving the left tragus and extending into the external auditory canal. Histopathological examination demonstrated dermal nests of basaloid cells with sebaceous differentiation, and immunohistochemical analysis showed focal positivity for epithelial membrane antigen and Ber-EP4, leading to a diagnosis of sebaceoma. Complete excision and reconstruction with a full-thickness skin graft were performed. The postoperative course was uneventful, with complete graft survival, preservation of external auditory canal patency, and no evidence of recurrence at 6 months postoperatively. This case highlights the rarity of sebaceoma involving the external auditory canal and the importance of considering possible associations with Muir-Torre syndrome.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag836"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026471","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 spontaneous acalculous gallbladder perforation difficult to diagnose on computed tomography.","authors":"Manabu Sato, Kazuki Hayashi, Akihiro Kobayashi, Koichiro Kubo, Nobuyoshi Yamazaki, Ryosuke Kobayashi, Fumitake Suzuki, Daichi Asai, Yuta Sannomiya, Naohiro Tomita, Noriko Yamada, Tomohiro Watanabe, Masaki Kakimoto, Kei Hasegawa, Kenji Ogata","doi":"10.1093/jscr/rjag824","DOIUrl":"10.1093/jscr/rjag824","url":null,"abstract":"<p><p>Gallbladder perforation is a rare and life-threatening event. Accurately diagnosing gallbladder perforation without cholecystitis or gallstones is difficult. The patient was admitted with abdominal pain and was diagnosed with diffuse peritonitis the following day via computed tomography (CT). Laparoscopic findings revealed the accumulation of bile-like ascites and a thinned and soft gallbladder with slight leakage of bile juice from a pinhole perforation. Laparoscopic cholecystectomy and peritoneal lavage were then performed. In the present case, it was difficult to diagnose gallbladder perforation because of the lack of cholecystitis and gallstones in the CT findings. If preoperative CT shows an acute abdomen with peritoneal effusion, especially accumulated around the gallbladder, then gallbladder perforation may be considered as a primary lesion.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag824"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026314","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}
Van Trung Hoang, The Huan Hoang, Vichit Chansomphou, Phu Cuong Pham
{"title":"Staged management of a giant adult Todani type IVa choledochal cyst mimicking gallbladder hydrops.","authors":"Van Trung Hoang, The Huan Hoang, Vichit Chansomphou, Phu Cuong Pham","doi":"10.1093/jscr/rjag833","DOIUrl":"10.1093/jscr/rjag833","url":null,"abstract":"<p><p>Choledochal cysts are uncommon congenital bile duct dilatations, and adult presentation is often complicated by obstruction, cholangitis, pancreatitis, stones, or malignant transformation. We report a 53-year-old woman with obstructive jaundice and severe hepatobiliary injury. Ultrasonography and contrast-enhanced computed tomography showed a giant extrahepatic bile duct cyst measuring ~15-16 cm, marked intrahepatic duct dilatation, gallbladder distension, and enhancing biliary walls without a visible obstructing stone, consistent with a Todani type IVa choledochal cyst complicated by cholangitis. Ultrasound-guided percutaneous biliary drainage was performed, with marked biochemical improvement. Definitive open surgery included cholecystectomy, complete extrahepatic cyst excision, and Roux-en-Y hepaticojejunostomy. This case highlights a surgical pitfall in which a giant bile duct cyst mimics gallbladder hydrops and supports staged decompression before definitive biliary reconstruction when cholangitis is present.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag833"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026356","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":"Ischiorectal abscess with fistulization into the thigh, the 'perfect storm' patient.","authors":"Konstantina Kostara, Erica Kozorosky, Shaban Gheith, Constantine Baltzis, Vasileios Kostaras","doi":"10.1093/jscr/rjag840","DOIUrl":"10.1093/jscr/rjag840","url":null,"abstract":"<p><p>Ischiorectal abscesses are a common encounter, both for general surgeons and for colorectal specialists. The formation of an ischiorectal fistula into the posterior thigh is an atypical extension that is rarely reported. In this case, the patient's HIV history and prior chemoradiation for anal squamous cell carcinoma contributed to this unique presentation. This case highlights the importance of heightened clinical suspicion, thorough imaging, and individualized operative management in high-risk patients presenting with a seemingly straight-forward pathology.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag840"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026351","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}
Ahmad D Rifa'i, Hashfi F Raz, Muhammad H Duha, Noel M I Sihombing, Muhammad Fadli P Pahlevi
{"title":"Restoring thoracic stability with rigid titanium rib reconstruction after radical forequarter and upper chest wall resection for T4 chondrosarcoma.","authors":"Ahmad D Rifa'i, Hashfi F Raz, Muhammad H Duha, Noel M I Sihombing, Muhammad Fadli P Pahlevi","doi":"10.1093/jscr/rjag845","DOIUrl":"10.1093/jscr/rjag845","url":null,"abstract":"<p><p>Extensive anterior chest wall involvement in chondrosarcoma presents major reconstructive challenges following radical oncologic resection. A 55-year-old man with cT4N0M0 chondrosarcoma involving the right shoulder girdle, ribs 1-4, and right upper lobe underwent en bloc extended forequarter amputation, multilevel rib resection, and right upper lobe segmentectomy. Chest wall reconstruction was performed using a titanium-based RibLoc plating system with vascularized soft-tissue flap coverage. Postoperatively, chest wall stability was preserved without paradoxical motion, and radiographs confirmed appropriate implant positioning. The patient was successfully weaned from mechanical ventilation on postoperative day two and transferred from the intensive care unit on day three without major complications. Rigid titanium rib fixation provided effective structural restoration and favorable early postoperative outcomes following extensive anterior chest wall resection for advanced chondrosarcoma.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag845"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026307","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}
Mazin Ahmed Subhy Alsheikhly, Shafik Samir Mansour, Hussam Telfah, Ahmed Elaffandi
{"title":"Ectopic Cushing's syndrome. A metastatic hepatic neuroendocrine tumour: case report and literature review.","authors":"Mazin Ahmed Subhy Alsheikhly, Shafik Samir Mansour, Hussam Telfah, Ahmed Elaffandi","doi":"10.1093/jscr/rjag848","DOIUrl":"10.1093/jscr/rjag848","url":null,"abstract":"<p><p>This report describes a rare instance of an adrenocorticotropic hormone (ACTH)-secreting metastatic hepatic neuroendocrine tumour (MHNET) exhibiting as an ectopic Cushing's syndrome. A 41-year-old woman with a history of supraglottic neuroendocrine tumour presented with rapid weight gain, severe hypokalemia, and hypercortisolism. Pituitary imaging was unremarkable. However, the DOTATATE PET/CT showed a large liver lesion. Initiating etomidate infusion caused a rapid drop in cortisol, leading to severe vasoplegic and septic shock, which delayed the surgery. The patient required intensive care stabilization pre-operatively and treatment with osilodrostat, which was then followed by surgical management: left lateral hepatectomy and gastric wedge resection. ACTH levels markedly decreased postoperatively, reflecting successful management. This emphasizes that careful medical management and multidisciplinary collaboration are essential in treating severe, potentially life-threatening ectopic hypercortisolism.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag848"},"PeriodicalIF":0.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018318","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}
Van Trung Hoang, Hien Nguyen, Hoang Anh Van, The Huan Hoang, Vichit Chansomphou, Duc Thanh Hoang
{"title":"A rare case of epiploic appendagitis of the vermiform appendix.","authors":"Van Trung Hoang, Hien Nguyen, Hoang Anh Van, The Huan Hoang, Vichit Chansomphou, Duc Thanh Hoang","doi":"10.1093/jscr/rjag456","DOIUrl":"10.1093/jscr/rjag456","url":null,"abstract":"<p><p>Epiploic appendagitis is a rare and often overlooked cause of acute abdominal pain that can mimic more common surgical conditions such as acute appendicitis or diverticulitis. Most reported cases involve the sigmoid or descending colon, whereas epiploic appendagitis occurring near the vermiform appendix is extremely rare. We report the case of a 57-year-old woman who presented with acute right lower quadrant pain initially suspected to be acute appendicitis. Computed tomography revealed inflammation of the epiploic appendage adjacent to the base of the appendix, with mild reactive appendicitis. The patient underwent surgery successfully, which confirmed torsion and necrosis of the appendiceal epiploic appendage. Early and accurate diagnosis of this condition is crucial to guide appropriate management.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 9","pages":"rjag456"},"PeriodicalIF":0.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018224","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}