International Journal of Surgery Case Reports最新文献

{"title":"Case report of an omental metastasis of melanoma in a patient with abdominal pain.","authors":"Jonathan Sabah, Alexis Marouk, Louis Vallois, Chérif Akladios","doi":"10.1016/j.ijscr.2025.110988","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110988","url":null,"abstract":"<p><strong>Introduction: </strong>Choroidal melanoma primarily metastasizes to the liver, but rare sites like the omentum can also be affected, making this case educational due to its uncommon presentation. The decision to pursue surgical treatment for metastatic melanoma remains controversial.</p><p><strong>Case presentation: </strong>A woman in her 60s, with a history of a stable choroidal nevus, experienced rapid lesion growth, leading to enucleation and radiotherapy. Two years later, she developed severe epigastric pain. Imaging revealed peritoneal nodules, and histopathology confirmed metastatic choroidal melanoma. Molecular analysis identified a GNAQ G48L mutation.</p><p><strong>Discussion: </strong>Omental metastasis in choroidal melanoma is rare, and while surgery is uncommon for metastatic melanoma, it was performed to alleviate symptoms and improve functionality. Following omentectomy and immunotherapy, her condition remained stable for two years.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of recognizing atypical metastatic sites in melanoma. Surgical intervention, though rare, can be beneficial for symptom relief in selected cases, improving outcomes when combined with targeted treatments.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110988"},"PeriodicalIF":0.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramural jejunal hematoma following abdominal trauma as a rare cause of small bowel obstruction in an adult male: A case report.","authors":"Bikash Chaudhary, Alisha Yadav, Abhishek Mahato, Aakash Deo, Bikal Ghimire, Prasan Bir Singh Kansakar","doi":"10.1016/j.ijscr.2025.110966","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110966","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Occurrence of intramural jejunal hematoma is rare condition, mostly seen among patients with bleeding disorders, warfarin toxicity and abdominal trauma. It is seen mostly among children than adults. In this report, we present a case of jejunal hematoma that occurred following a minor abdominal trauma. The incidence of jejunal hematoma as a result of trauma is exceedingly uncommon.</p><p><strong>Case presentation: </strong>We present a case of 48-year-male with history of abdominal trauma one year back presented with features of intestinal obstruction. Abdominal CT scan revealed intestinal obstruction at the level of the jejunum and was planned for surgery. During exploratory laparotomy, blood was seen in the peritoneum with the hemorrhagic mass at the jejunum. Resected specimen was sent for histopathology which showed hematoma involving submucosa, muscular, and peri-muscular fibrous tissue. Hence the diagnosis of jejunal hematoma was made.</p><p><strong>Clinical discussion: </strong>Jejunal hematoma following trauma is a rare condition as compared to duodenal hematoma due to its relatively fixed position. Here in our case, abdominal trauma is the probable cause of jejunal hematoma. The symptoms range from mild abdominal pain to intestinal obstruction with acute abdomen. A coagulation profile should be done to rule out bleeding disorders which is one of the common causes of jejunal hematoma.</p><p><strong>Conclusion: </strong>This rare case report guides healthcare professionals to include jejunal hematoma as a differential for a patient presenting with the symptoms of intestinal obstruction.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110966"},"PeriodicalIF":0.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary small rectal neuroendocrine tumor with pelvic lateral lymph nodes metastasis: A case report and review of literature.","authors":"Lihong Li, Ziyue Chen, Dajian Zhu, Qianbao Lv, Tianpeng Zhang, Jinsong Lai","doi":"10.1016/j.ijscr.2025.110963","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110963","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Neuroendocrine tumors (NETs) can occur in almost any organ of the body, and they vary in size and volume. The small tumors may be <1 cm in size, but the large ones can exceed 20 cm. The probability of developing NETs in different organs varies greatly, but rectal NETs are relatively common. Our aim is to tell the surgeon that rectal NETs metastasize to the pelvic lateral lymph nodes even in the early stages and small sizes.</p><p><strong>Case presentation: </strong>In this report, we present the case of a 47-year-old man who was asymptomatic and incidentally diagnosed with a small NET in the rectum during an enteroscopy for physical examination. The diagnosis was confirmed by pathological examination of the biopsy. The CT of the patient was performed pre-hospital for daily physical examination, but nothing could be seen in the rectum from the CT. Then, the diagnostic local resection and a wide free margin was performed on the patient, and a second operation (radical resection of rectal cancer and extensive lateral pelvic lymphadenectomy) was performed due to the post-operative pathological report and the discovery of enlarged pelvic lymph node by PET-CT (positron emission tomography CT). After the surgery, the patient is in good condition and have no other symptoms except for a slight feeling of defecating.</p><p><strong>Clinical discussion: </strong>NETs could metastasize to the pelvic lateral lymph nodes, if so, the Total mesorectal excision (TME) should be performed, and the invasion and metastatic spread in NETs have to do with the regulatory factor named snail1 and Foxc2. We find that there is no standardized treatment approach for rectal NETs, which should be neither overtreated nor undertreated as far as possible, so the timing of surgery plays an important role, and long-term follow-up of the patients is extremely important.</p><p><strong>Conclusion: </strong>The purpose of the presentation of this case is to highlight the potential for rectal NETs to metastasize to the pelvic lateral lymph nodes even in the early stages and small sizes, without muscular layer or neurovascular invasion, and lateral lymph node dissection were necessary, emphasizing the importance of timing for surgery.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110963"},"PeriodicalIF":0.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submandibular schwannoma - A diagnostic dilemma: A rare case report.","authors":"Anu Singh, Charanjeet Ahluwalia, Sana Ahuja","doi":"10.1016/j.ijscr.2025.110995","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110995","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Schwannomas are benign tumors originating from Schwann cells, responsible for myelin sheath formation around peripheral nerves. Although primarily found in the head and neck, submandibular gland schwannomas are exceedingly rare.</p><p><strong>Case presentation: </strong>This report details a 39-year-old male with progressively enlarging neck swelling over three months, associated with mild pain during eating. Physical examination revealed a firm, non-tender swelling, and radiological investigation through ultrasound showed a large, well-defined hypoechoic lesion in the right submandibular fossa. Fine-needle aspiration cytology initially suggested sialadenosis due to the presence of grape-like clusters of salivary gland acini in a hemorrhagic background. The patient underwent local excision of the tumor and submandibular gland, with histopathological examination confirming the diagnosis of schwannoma. The tumor exhibited characteristic Antoni A and B areas and Verocay bodies, with strong S100 positivity on immunohistochemistry.</p><p><strong>Clinical discussion: </strong>This case underscores the challenge of diagnosing schwannomas in the submandibular region, where FNAC and ultrasonography may be inadequate.</p><p><strong>Conclusion: </strong>MRI and histopathology are crucial for accurate diagnosis, differentiating schwannomas from other submandibular swellings such as pleomorphic adenomas.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110995"},"PeriodicalIF":0.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intradural extramedullary epidermoid cyst at cauda equina level in 2-years female child: A rare case report.","authors":"Aristianti Aristianti, Sinta Wiranata, Dewa Putu Wisnu Wardhana","doi":"10.1016/j.ijscr.2025.110986","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110986","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal epidermoid cysts are noncancerous growths that comprise fewer than 1 % of the abnormalities found in the spine. An epidermoid cyst in the intradural extramedullary region, without any associated dysraphism, trauma, or syndromic conditions, and its subsequent successful identification and surgical removal without any adverse effects on the patient, is a highly uncommon event.</p><p><strong>Case presentation: </strong>A 2-year-old female visited the outpatient clinic with a skin fold on the back that has been present since birth, without any abnormalities in the spinal cord or any injuries. The patient had no impairments and was in good condition, displaying satisfactory feeding and playing behavior. An intradural extramedullary lesion indicating the presence of several epidermoid cysts at the L3-L4 level of the cauda equina was identified in the lumbosacral MRI. The patient underwent a surgical procedure called laminectomy and durotomy to remove a tumor. The histological examination confirmed the diagnosis of an epidermoid cyst.</p><p><strong>Discussion: </strong>Epidermoid cysts are infrequently found in the intradural extramedullary region of the spinal canal. A laminectomy procedure was conducted to excise a tumor in this patient. The patient experienced neurogenic bladder dysfunction following surgery, necessitating a consultation with the urologist. The patient has returned to baseline with no signs of deterioration.</p><p><strong>Conclusion: </strong>Surgery by total removal is the treatment of choice for spinal ECs, providing a disease-free outcome and preventing further neurological deficits.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110986"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ-preserving surgery for male distal primary urethral carcinoma: A case report from a tertiary hospital in Ethiopia.","authors":"Alemu Bedeado Hirpo, Sena Sefara Akasa, Mensur Mohammed Ahmed, Masresha Solomon Dino, Wondweson Alemu Molla, Mintesnot Yitagesu Kidane","doi":"10.1016/j.ijscr.2025.110983","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110983","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Primary urethral carcinoma (PUC) is a rare cancer, comprising less than 1 % of all genitourinary malignancies, with a male predominance (3:1 ratio), and typically affects those over 75 years of age. PUC shows varied histological subtypes based on their location and sex. The prognosis depends on age, tumor grade, TNM stage, histology, and site. Organ-preserving surgery is for distal disease becoming a preferred option.</p><p><strong>Case presentation: </strong>We report the surgical management of a male patient presenting with a history of urethral meatal ulcer, bloody urethral discharge, dysuria, and urine spraying, initially misdiagnosed as a persistent herpes ulcer. Examination revealed a 1 × 2 cm erythematous plaque over the urethral meatus. Pelvic magnetic resonance imaging (MRI) showed a 1.7 × 1.7 cm lesion in the distal penile urethra invading the corpus spongiosum, and a biopsy confirmed squamous carcinoma in situ. The patient underwent partial glansectomy and anterior urethrectomy, but pathology showed well-differentiated squamous cell carcinoma with positive margins. The patient was successfully treated with a total anterior urethrectomy, partial glansectomy, and augmented perineal urethrostomy.</p><p><strong>Clinical discussion: </strong>PUC (primary urethral carcinoma) presents nonspecifically, requiring high suspicion for diagnosis. Historically, treatment included total penectomy with cystoprostatectomy for proximal tumors and partial or radical penectomy for distal tumors. Distal tumors often have better outcomes, and organ preservation surgery is possible for selected patients, with no local recurrence in those treated with additional surgery or adjuvant radiation for positive margins.</p><p><strong>Conclusions: </strong>PUC is a rare urological malignancy that is challenging to diagnose and treat. Clinical stage and tumor location are critical prognostic factors for urethral carcinoma in men. Organ-preserving surgery is the preferred treatment for distal disease, with a 5-year overall survival rate of approximately 50 %.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110983"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful pregnancy and delivery after post burn abdominal wall reconstruction using tensor fascia lata fasciocutaneous flap and split-thickness skin graft: A case report.","authors":"Bethlehem Aliye Asfaw, Anteneh Gebru Gebremedhen, Asratu Getnet Amare, Solomon Berhe Wubneh, Mequanint Melese Bicha, Gebrehiwot Aderaw Workneh","doi":"10.1016/j.ijscr.2025.110980","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110980","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal wall contractures following burn injuries can cause both maternal and fetal complications during pregnancy like maternal disfigurement, breathing difficulties, scar site pain, fetal distress, premature labor, scar breakdown, and keloid formation.</p><p><strong>Case presentation: </strong>A 26-year-old female presented with second-degree flame burns to her anterior abdomen, perineum, and bilateral proximal thighs, resulting in 18 % TBSA involvement from a cooking accident. She received debridement, wound care, and supportive treatment, and was discharged in improved condition. Four years later, she developed significant abdominal wall scarring with umbilical retraction and thigh contractures, limiting thigh abduction. Contracture release and abdominal wall reconstruction with bilateral fascia lata faciocutaneos flaps and split-thickness skin grafts were performed. The patient later had a successful pregnancy with normal delivery, experiencing no complications except mild stretching sensations at the surgical site.</p><p><strong>Discussion: </strong>Burn in the perineum is rare due to its protected location, making perineal contracture uncommon. While one case documented severe contractures affecting both the trunk and perineum, leading to fetal distress and emergency cesarean, our patient experienced similar contractures but had successful surgical release and autologous abdominal wall reconstruction prior to pregnancy, avoiding complications. Various surgical options, including expansion abdominoplasty, modified abdominoplasty, and anterolateral thigh flaps, have proven effective in improving outcomes for pregnant women with post-burn abdominal contractures.</p><p><strong>Conclusion: </strong>An individualized approach is crucial, as evidenced by our use of tensor fascia lata faciocutaneous flap and split-thickness skin grafts, improving both maternal and fetal health.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110980"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of gallstone ileus caused by biliary-intestinal fistula: Multidetector computed tomography features analysis.","authors":"Meimei Gao, Gang Chen, Juanqin Niu, Yonghua Huang, Wei Xue","doi":"10.1016/j.ijscr.2025.110993","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110993","url":null,"abstract":"<p><strong>Introduction and significance: </strong>Gallstone ileus is a mechanical intestinal obstruction caused by gallstones or stones from the common bile duct entering the intestinal canal through a biliary-intestinal fistula and becoming impacted. Multidetector computed tomography (MDCT) scanning is the most important auxiliary diagnostic method for this disease.</p><p><strong>Case presentation: </strong>We report a rare case of gallstone ileus involving an elderly female patient and analyze the characteristics of the MDCT images: atrophic cholecystitis, gallstones, the formation of a local duodenal-gallbladder fistula, pneumatosis in the intrahepatic bile ducts of the left lobe of the liver and some extrahepatic bile ducts, intestinal mechanical obstruction, and the presence of an ectopic stone. A partial small bowel resection was performed and the stone was removed.</p><p><strong>Clinical discussion: </strong>Gallstone ileus is a rare disease that often occurs in elderly women. It has no specific clinical symptoms and is prone to delayed diagnosis and treatment. MDCT scanning is the most sensitive and accurate diagnostic method for gallstone ileus, once the disease is clearly diagnosed, surgical treatment is recommended as soon as possible.</p><p><strong>Conclusion: </strong>The aim of this study is to elevate the understanding and treatment of gallstone ileus.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110993"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare pediatric case: Budd-Chiari Syndrome and upper gastrointestinal bleeding in a 5-year-old boy.","authors":"Mohamed Ismail Ibrahim, Ahmed Abdi Aw Egge, Omar Ali Elmi, Mohamoud Hashi Abdi, Mohamed Ali Abdilahi, Abdirahman Omer Ali","doi":"10.1016/j.ijscr.2025.110992","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110992","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Budd-Chiari Syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction, often presenting with ascites, hepatomegaly, and abdominal pain. The diagnosis and management of BCS, especially in resource-limited settings, pose significant challenges that can lead to poor patient outcomes.</p><p><strong>Case presentation: </strong>This case report describes a previously healthy individual presenting with progressive abdominal distention, hematemesis, and right upper quadrant pain. The patient had a history of trauma and underwent subsequent percutaneous drainage for ascites. Imaging studies revealed non-opacified hepatic veins, splenomegaly, ascites, and a \"nutmeg liver\" pattern, confirming the diagnosis of BCS. The patient received blood transfusions, diuretics, and nutritional support. A Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure was planned but ultimately hindered by financial constraints.</p><p><strong>Clinical discussion: </strong>This case highlights the challenges of managing BCS in resource-limited settings, particularly regarding access to specialized treatments like TIPS. It emphasizes the need for early diagnosis, multidisciplinary care, and the development of cost-effective treatment strategies to improve patient outcomes.</p><p><strong>Conclusion: </strong>The management of Budd-Chiari Syndrome is complex, particularly in settings with limited resources. This case underscores the importance of timely intervention and the need for innovative approaches to healthcare delivery that can accommodate financial barriers while ensuring patient safety and care quality.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110992"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary retroperitoneal synovial sarcoma (RSS): A case report.","authors":"Sarra Ben Rejeb, Safia Sakly, Majdi Ben Romdhane, Mehdi Charfi, Adnen Chouchen","doi":"10.1016/j.ijscr.2025.110982","DOIUrl":"https://doi.org/10.1016/j.ijscr.2025.110982","url":null,"abstract":"<p><strong>Introduction: </strong>Leiomyosarcoma and lipomsarcoma account for the majority of retroperitoneal soft tissue sarcomas. Synovial sarcoma (SS) in this location is exceptionally uncommon, with fewer than 30 cases reported. Misdiagnosis is frequent due to its rarity and overlapping histological features with other sarcomas.</p><p><strong>Case presentation: </strong>We reported the case of a 38-year-old woman who presented with a retroperitoneal mass. Initial imaging revealed a large, heterogeneous tumor displacing adjacent organs. A fine-needle biopsy was inconclusive, and laparoscopic resection was performed. Histopathology initially suggested leiomyosarcoma based on spindle cell morphology and immunopositivity for caldesmon and SMA. Two years later, the tumor recurred, exhibiting increased cellularity and mitotic activity. Further immunohistochemistry revealed positive staining for BCL2, EMA, and TLE1, raising suspicion of SS. Molecular analysis confirmed the SS18-SSX translocation, diagnosing high-grade monophasic synovial sarcoma. Despite surgical interventions, the patient experienced rapid recurrence and passed away within 6-months.</p><p><strong>Discussion: </strong>RSS poses significant diagnostic challenges due to its rarity and overlapping features with more common sarcomas like leiomyosarcoma. Immunohistochemical panels including TLE1, BCL2, and EMA are critical for differential diagnosis. Molecular confirmation via the SS18-SSX fusion is necessary for definitive diagnosis. In our case, initial misdiagnosis delayed appropriate management. This highlights the importance of considering SS in young adults with retroperitoneal tumors.</p><p><strong>Conclusion: </strong>RSS, though rare, should be part of the differential diagnosis for spindle cell tumors in this location. Morphology, aided by thorough immunohistochemical and molecular analyses, is crucial to avoid diagnostic errors and improve patient outcomes.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"127 ","pages":"110982"},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}