International Journal of Surgery Case Reports最新文献

{"title":"Surgical management of a thoracic trauma caused by the penetration and retention of a knife: a case report from a resource-limited setting.","authors":"Dadiny Desrosiers, Jennifer Arlovy Honoré, Flawendjee Djaweelentz Jacques, Pierre Sonçon Prince","doi":"10.1097/RC9.0000000000000914","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000914","url":null,"abstract":"<p><strong>Introduction: </strong>Retained intrathoracic foreign bodies following penetrating chest trauma are uncommon and are associated with a high risk of major vascular or pulmonary injuries. Their management may be particularly challenging in resource-limited settings where advanced imaging and minimally invasive surgical techniques are unavailable.</p><p><strong>Presentation of case: </strong>An 18-year-old man presented to the emergency department with a knife retained in the right posterior thorax for approximately 17 hours following a stab injury. The patient was hemodynamically stable on admission. Chest radiography and ultrasonography revealed a right hemopneumothorax. Due to the prolonged retention of the foreign body, concerns about associated thoracic injuries, and limited technical resources, the patient underwent an open thoracotomy with successful removal of the knife and repair of pulmonary injuries. The postoperative course was uneventful.</p><p><strong>Discussion: </strong>Management of retained thoracic foreign bodies requires careful perioperative planning to avoid catastrophic complications during removal. In low-resource settings, surgical decision-making may rely mainly on clinical assessment, basic imaging modalities, and intraoperative exploration when advanced imaging is unavailable.</p><p><strong>Conclusion: </strong>This case highlights that open thoracotomy remains a safe and effective option for managing penetrating thoracic trauma with retained foreign bodies in resource-limited environments.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3969-3973"},"PeriodicalIF":0.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898084","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":"ICA-MCA common trunk - morphometry as well.","authors":"Bojan V Stimec, Dejan Ignjatovic","doi":"10.1097/RC9.0000000000000711","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000711","url":null,"abstract":"","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3974-3975"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897967","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 rare case of anterior inferior iliac spine osteochondroma causing external snapping hip syndrome: a case report.","authors":"Sileshi Serebe Zeleke, Getaneh Workneh Kassa, Demis Hailu Ashagrie, Wuletaw Muche Mihret, Demeke Yilkal Fentie, Gashaw Tigabu Mamo","doi":"10.1097/RC9.0000000000000877","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000877","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Osteochondroma is the most common benign bone tumor; however, involvement of the anterior inferior iliac spine (AIIS) is rare. Such lesions may lead to mechanical symptoms due to impingement on surrounding soft tissues, resulting in unusual presentations such as snapping hip syndrome.</p><p><strong>Presentation of the case: </strong>A 20-year-old male presented with a 3-year history of painful external snapping over the left hip, aggravated by movement. Physical examination revealed a firm, non-tender swelling in the left anterior groin region. Radiographs and CT imaging demonstrated a sessile bony lesion arising from the left AIIS, consistent with osteochondroma. The lesion was excised via an anterior Smith-Petersen approach. Histopathology confirmed osteochondroma. Postoperatively, the patient had complete resolution of symptoms and returned to full activity without recurrence at 1-year follow-up.</p><p><strong>Clinical discussion: </strong>An AIIS osteochondroma is an extremely rare cause of external snapping hip syndrome. The condition results from mechanical irritation of the rectus femoris due to a bony prominence at its origin. CT imaging is essential for diagnosis, while complete surgical excision remains curative with excellent functional outcomes.</p><p><strong>Conclusion: </strong>An AIIS osteochondroma should be considered in the differential diagnosis of snapping hip syndrome. Early recognition and surgical excision result in complete symptom resolution and a low risk of recurrence.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3845-3848"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898120","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":"Meso-diverticular band causing small bowel obstruction in an infant: a case report and literature review.","authors":"Wassie A Yigzaw, Woubedel Kiflu","doi":"10.1097/RC9.0000000000000892","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000892","url":null,"abstract":"<p><strong>Introduction: </strong>Meckel's diverticulum (MD) is the embryonic remnant of the omphalomesenteric duct that occurs in approximately 2% of the population. Although usually asymptomatic, it can, in some cases, cause complications in the form of ulceration, hemorrhage, intussusception, intestinal obstruction, and perforation.</p><p><strong>Case presentation: </strong>A 3-month-old male infant presented with a 4-day history of crampy abdominal pain, bilious vomiting, abdominal distension, constipation, and poor feeding. On admission, he appeared acutely ill with signs of shock. After nasogastric decompression, fluid resuscitation, and initiation of intravenous antibiotics, his clinical status improved. Laboratory studies showed mild leukocytosis and elevated blood urea nitrogen, while abdominal radiography revealed dilated bowel loops. Urgent exploratory laparotomy was performed, and intraoperatively, an 8 cm gangrenous segment of ileum was found entrapped by a meso-diverticular band arising from a 3 cm MD located 30 cm proximal to the ileocecal valve. The gangrenous ileum along with the diverticulum was resected, followed by ileal end-to-end anastomosis. The postoperative course was uneventful, and the patient was discharged in stable condition.</p><p><strong>Discussion: </strong>Unlike in adults, intestinal obstruction is not a frequent complication of MD in children. Small-bowel obstruction due to MD can occur through several mechanisms, including intussusception, volvulus, fibrous or meso-diverticular bands, internal hernias, and other uncommon causes, often presenting with nonspecific features similar to other causes of obstruction. This case is unusual because it involves a pediatric patient in whom a short meso-diverticular band alone created an internal hernia, leading to bowel entrapment, a rare mechanism of obstruction in children.</p><p><strong>Conclusion: </strong>A mesodiverticular band is a potential cause of acute intestinal obstruction in pediatric patients. Early surgical exploration remains crucial in unstable patients, as timely intervention can be lifesaving and result in favorable outcomes.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3895-3899"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898194","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":"Obstructing colonic involvement by gastric-origin adenocarcinoma during adjuvant chemotherapy after curative-intent gastrectomy: a case report with literature review.","authors":"Mohammad B Jahantab, Mahdokht Azizi, Mohammadamin Kashefi, Amirhossein Yousefian, Maral Mokhtari, Taha Negahdari","doi":"10.1097/RC9.0000000000000900","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000900","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Colonic involvement by gastric adenocarcinoma is rare and may mimic a new primary colorectal malignancy. Although clinicopathological assessment can support a gastric origin, it cannot reliably distinguish hematogenous or lymphatic dissemination and peritoneal implantation with secondary mural invasion.</p><p><strong>Presentation of case: </strong>A 52-year-old man underwent curative-intent total gastrectomy for distal gastric adenocarcinoma (pT4a pN2) in January 2024. Adjuvant folinic acid, fluorouracil, and oxaliplatin (FOLFOX) was initiated in February 2024. Approximately five months after the gastrectomy, while treatment was ongoing, he developed complete large-bowel obstruction due to a severe left-sided colonic stricture and underwent emergency left hemicolectomy. The resection contained two infiltrative lesions, including a dominant transmural lesion. Histology showed moderately differentiated adenocarcinoma. Immunohistochemistry showed CK7+, CK20+, CEA+, focal CDX2+, and SATB2-, favoring gastric-origin adenocarcinoma involving the colon over a conventional de novo colorectal primary. The route of colonic involvement remained indeterminate. The patient subsequently received palliative systemic treatment and died approximately 22 months after the initial diagnosis.</p><p><strong>Clinical discussion: </strong>This early, obstructing recurrence during active adjuvant therapy underscores the need to consider disease of gastric-origin in patients with a new colonic stricture after gastrectomy. Immunohistochemistry helps assign tumor origin, but it cannot establish the route of spread; microscopic peritoneal disease cannot be excluded despite the absence of macroscopic peritoneal disease at laparotomy.</p><p><strong>Conclusion: </strong>Gastric-origin adenocarcinoma should be considered in patients with previous gastric cancer who develop a colonic stricture. Accurate clinicopathological classification is essential for multidisciplinary treatment planning.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3952-3959"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898028","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":"C2-C3 anterolisthesis with myelopathy in a toddler with Charcot-Marie-Tooth disease: a rare case and review of syndromic pediatric C2-C3 instability.","authors":"Sadegh Bagherzadeh, Faramarz Roohollahi, Sara M Hartnett, Puya Alikhani, Zohreh Habibi, Mohsen Rostami","doi":"10.1097/RC9.0000000000000855","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000855","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Cervical instability and myelopathy are rare in young children and are frequently overlooked, particularly in those with syndromic or neuromuscular disorders, in which motor delay may be misattributed to the underlying condition. Reported cases of C2-C3 instability are extremely uncommon and have primarily been associated with syndromic diagnoses such as Down syndrome and achondroplasia. Recognizing treatable cervical pathology early is essential to prevent progressive neurological injury.</p><p><strong>Case presentation: </strong>We describe the first reported case of C2-C3 anterolisthesis and instability in a 22‑month‑old girl with Charcot-Marie-Tooth (CMT) disease, who was initially labeled as having cerebral palsy due to motor delay. Advanced imaging revealed congenital cervical anomalies, C2-C3 anterolisthesis, and significant spinal cord compression. The patient underwent surgical decompression with C1-C3 posterior fusion. Following surgery, she demonstrated progressive neurological and motor improvement.</p><p><strong>Clinical discussion: </strong>Although C2-C3 instability is exceedingly rare, the available literature indicates that it occurs most often in association with syndromic conditions and typically responds well to surgical fusion. This case reinforces the importance of considering cervical spine pathology in children with unexplained motor deficits, even when a syndromic diagnosis such as CMT is present. Early imaging and timely intervention can dramatically alter the clinical trajectory and prevent long-term disability.</p><p><strong>Conclusion: </strong>This case highlights the need for careful evaluation of cervical spine instability in pediatric patients with motor delay. Neurosurgeons should avoid prematurely attributing deficits to cerebral palsy or underlying syndromic disorders and should maintain a high index of suspicion for potentially reversible cervical pathology. Early diagnosis and surgical treatment can lead to substantial neurological recovery.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3314-3319"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897997","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":"Presumed idiopathic omental hemorrhage mimicking complicated appendicitis: a rare case report.","authors":"Ali Abd Ali, Nader Moeinvaziri, Abdallah Abd Ali, Neda Haghighat","doi":"10.1097/RC9.0000000000000896","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000896","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Acute abdominal pain is a common cause of emergency department visits. Massive presumed idiopathic omental hemorrhage (IOH) is an extremely rare condition that may clinically and radiologically resemble complicated appendicitis or malignancy and may require urgent operative exploration despite misleading initial imaging.</p><p><strong>Case presentation: </strong>A 48-year-old obese male with prediabetes presented with sudden-onset abdominal pain that was initially located in the epigastric region, then migrated to the right lower quadrant. Clinical examination and sonography suggested complicated appendicitis. A CT scan showed a mass-like lesion in the right lower quadrant, along with free intraperitoneal fluid, raising suspicion for malignancy or complicated appendicitis. An exploratory laparotomy was performed and revealed 2.5 liters of hemoperitoneum and active bleeding from the greater omentum with a normal appendix. Ligation of the bleeding vessel with partial omentectomy was performed. The WBC count dropped from 19.5 × 10³/µL preoperatively to 11.5 × 10³/µL at discharge. The patient was stable and discharged a few days after the operation.</p><p><strong>Clinical discussion: </strong>IOH is a rare and life-threatening condition that can mimic the clinical features of common causes of acute abdomen. IOH can be the result of a congenital vascular malformation, spontaneous rupture of fragile omental vessels, or intermittent omental torsion. In our case, the imaging findings were misleading and initially reported as complicated appendicitis. Early surgical intervention remains the cornerstone of the diagnosis and treatment of IOH, as delaying proper management can put the patient's life at risk.</p><p><strong>Conclusion: </strong>Although IOH is rare, it should be considered in patients presenting with an acute abdomen and atypical imaging findings. Increased awareness among surgeons can facilitate prompt intervention and improve outcomes.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3964-3968"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898211","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":"Nonaccidental penile and scrotal strangulation: a case series from Vietnam.","authors":"Ba T D Mai, Hung L Do, Doan T Q Tran, Quang T Dang, Thien T T T Truyen, Nguyen H D Le","doi":"10.1097/RC9.0000000000000872","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000872","url":null,"abstract":"<p><strong>Introduction: </strong>Penile and penoscrotal strangulation are rare but serious urologic emergencies. Delayed decompression can lead to venous obstruction, ischemia, tissue necrosis, and irreversible functional loss. This report presents four cases to illustrate management strategies for metallic constricting devices in resource-limited settings.</p><p><strong>Presentation of the cases: </strong>Four male patients, aged 28-60, presented with strangulation caused by metallic nuts or rings used for sexual enhancement or masturbation, with entrapment durations ranging from 10 hours to 1 week. Clinical findings included penile swelling, pain, and bruising, while sensation and the ability to void were preserved. Initial bedside removal attempts using lubricant were unsuccessful. All patients underwent emergency removal in the operating room with a handheld rotary electric saw, aided by continuous saline irrigation to prevent thermal injury and by a metal plate for protection. All devices were successfully removed, and postoperative recovery showed minor skin burns but no major complications.</p><p><strong>Discussion: </strong>Early recognition and prompt decompression are essential to avoid severe penile injury. Treatment should be individualized based on the constricting device's characteristics, edema level, incarceration severity, and available resources. In settings lacking standard urologic tools, nonconventional methods can be effective, and continued postoperative monitoring is crucial for detecting complications.</p><p><strong>Conclusion: </strong>Penile strangulation is an urgent condition requiring swift intervention. Early removal of the device can maintain penile function, and adaptable techniques can ensure positive outcomes even in resource-limited environments.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3282-3286"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897944","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":"Giant pulmonary hydatid cyst complicated by refractory shock and fulminant acute respiratory distress syndrome: a case report.","authors":"Mohammad Alaa Aldakak, Mohammad Abdulghani, Raneem Ahmad, Youssef Abbas, Bassam Darwish","doi":"10.1097/RC9.0000000000000901","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000901","url":null,"abstract":"<p><strong>Introduction: </strong>Giant pulmonary hydatid cysts are uncommon and may cause profound cardiopulmonary compromise through chronic lung compression and mediastinal displacement. Their surgical removal can be complicated by abrupt hemodynamic and respiratory deterioration.</p><p><strong>Case presentation: </strong>A 19-year-old woman from a rural livestock-raising region presented with progressive dyspnea, cough, and right-sided chest pain. Imaging demonstrated a solitary giant pulmonary cyst measuring approximately 40 × 25 × 25 cm, occupying almost the entire right hemithorax and markedly displacing the mediastinum. Serology for <i>Echinococcus granulosus</i> was positive. Through a right posterolateral thoracotomy, approximately 4 L of clear cyst fluid was aspirated, the endocyst was removed, bronchial openings were closed, and capitonnage was performed. Immediately after decompression, severe hypotension developed and was treated for suspected anaphylaxis with epinephrine and norepinephrine. Postoperatively, the patient remained intubated and developed early bilateral pulmonary infiltrates, severe hypoxemic respiratory failure, metabolic acidosis, and refractory shock. Echocardiography showed preserved biventricular function. Despite intensive care support, she died on the third postoperative day. The deterioration was considered multifactorial, with possible contributions from hypersensitivity, systemic inflammatory response, rapid decompression, re-expansion lung injury, and occult airway trauma.</p><p><strong>Conclusion: </strong>Giant pulmonary hydatid cysts should be regarded as high-risk physiological lesions even when surgical excision is technically successful. Controlled decompression, gradual lung re-expansion, multidisciplinary perioperative planning, and immediate access to advanced critical care are essential.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3934-3939"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898137","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":"Sinonasal osteosarcoma of the ethmoid bone with decade-later recurrence presenting as early orbital apex syndrome: an 18-year case report.","authors":"Muhammad Ehtesham, Hamza Khan Khattak, Maryam Shoaib, Imran Khan, Azam Nawaz, Kamil Ahmad Kamil","doi":"10.1097/RC9.0000000000000841","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000841","url":null,"abstract":"<p><strong>Introduction: </strong>Primary ethmoid osteosarcoma is an exceptionally rare craniofacial malignancy, characterized by aggressive local invasion of adjacent structures. While most recurrences occur within the first 2-3 years, late relapse after long-term disease-free survival is exceedingly uncommon.</p><p><strong>Case presentation: </strong>We describe an 18-year clinical course of a patient first diagnosed with ethmoidal chondroblastic osteosarcoma in childhood. He was treated with chemotherapy and radiation therapy and went into remission. Seven years later, the cancer recurred in the sinuses and lungs. He underwent surgery and more chemotherapy, then remained stable for nearly a decade. After that, he developed worsening nasal blockage, nosebleeds, eye bulging, and sudden vision loss consistent with orbital apex syndrome. Scans showed a destructive mass eroding the skull base and reaching the orbital apex. He underwent endoscopic surgery to remove the tumor, decompress the optic canal, and reconstruct the skull base. Pathology confirmed another recurrence. After surgery, his vision improved to light perception, and he started a new round of chemotherapy.</p><p><strong>Clinical discussion: </strong>This case shows that sinonasal osteosarcoma can recur very late, so lifelong monitoring with CT and MRI is necessary. Sudden ocular symptoms in these patients should be treated as emergencies to preserve vision. An endoscopic approach allowed safe access to the skull base and effective orbital decompression.</p><p><strong>Conclusion: </strong>Timely multidisciplinary care and continued follow-up are essential for rare malignancies, even after many years without disease.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 9","pages":"3536-3542"},"PeriodicalIF":0.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898150","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}