International Journal of Surgery Case Reports最新文献

{"title":"Primary ovarian solid pseudopapillary neoplasm with CTNNB1 c.94G > T (p.D32Y) mutation: a case report","authors":"Mengfei Xu ,&nbsp;Xiao Wang ,&nbsp;Wanrun Lin ,&nbsp;Feng Zhou","doi":"10.1016/j.ijscr.2025.111952","DOIUrl":"10.1016/j.ijscr.2025.111952","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary solid pseudopapillary neoplasm originating in the ovary (SPN-O) is extremely rare, with only 15 reported cases in the English literature; of these, three harbor <em>CTNNB1</em> mutations similar to pancreatic SPN. Here, we present a fourth SPN-O case with confirmed <em>CTNNB1</em> mutation.</div></div><div><h3>Case presentation</h3><div>A 45-year-old woman presented with a 6 cm left ovarian mass. Gross examination revealed a predominantly cystic neoplasm. Microscopy demonstrated solid nests and pseudopapillary structures of uniform tumor cells with eosinophilic, foamy, or vacuolated cytoplasm. Mitotic activity and atypia were minimal. Ki-67 index was very low. Immunohistochemistry showed strong nuclear and cytoplasmic positivity for β-catenin and negativity for E-cadherin. Genetic analysis revealed a c.94G &gt; T (p.D32Y) mutation in exon 3 of <em>CTNNB1</em>. Four years postoperatively, there was no recurrence or metastasis. These findings align with pancreatic SPN, supporting the theory of a shared Wnt/β-catenin oncogenic pathway.</div></div><div><h3>Discussion</h3><div>The findings of this case reinforce the morphological, immunohistochemical, and molecular parallels between SPN-O and its pancreatic counterpart (SPN-P). The presence of a pathogenic <em>CTNNB1</em> c.94G &gt; T (p.D32Y) mutation—previously unreported in SPN-O—further supports the central role of Wnt/β-catenin dysregulation in tumorigenesis across anatomical sites. The absence of recurrence in this case aligns with most documented SPN-O outcomes, though metastatic potential underscores the need for long-term surveillance.</div></div><div><h3>Conclusions</h3><div>Primary ovarian SPN is an exceedingly rare tumor showing significant similarity to pancreatic SPN in morphology, immunophenotype, and molecular alterations.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111952"},"PeriodicalIF":0.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108084","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 on acute cystoid macular edema days after YAG laser capsulotomy","authors":"Amera Gamela Khalaff ,&nbsp;Barry Emara","doi":"10.1016/j.ijscr.2025.111960","DOIUrl":"10.1016/j.ijscr.2025.111960","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>We report a unique case of cystoid macular edema occurring immediately after Neodymium-doped yttrium aluminum garnet (Nd: YAG) laser capsulotomy.</div></div><div><h3>Case presentation</h3><div>A 62-year-old gentleman began seeing wavy lines and a black dot located in his central visual field two days post-YAG. Diagnosis of cystoid macular edema was confirmed by Optical Coherence Tomography (OCT) and was treated with prednisolone acetate eye drops four times a day and Bromfenac eye drops once daily. One month post-treatment, the vision improved to a corrected distance visual acuity (CDVA) of 20/70, with the macula appearing normal and the cystoid macular edema slowly improving. There was some macular sheen present. The medication was changed to Difluprednate twice daily along with previously prescribed Bromfenac once daily, as a stronger steroid was required. On the two-month follow-up, CDVA improved to 20/25, and the CME had resolved. The patient was advised to continue prescribed medications until finished and to repeat OCT in a month. OCT was done three months post-operatively and was essentially normal with some residual perifoveal edema.</div></div><div><h3>Clinical discussion</h3><div>This case highlights the possibility of CME occurring immediately after YAG laser capsulotomy, resulting in sudden decrease of vision. CME is more common after cataract surgery than after YAG, and this appears to be a unique case of immediate CME post-YAG laser capsulotomy.</div></div><div><h3>Conclusion</h3><div>Our experience suggests that colleagues should consider NSAIDS pre- and post- YAG laser capsulotomy to prevent CME. This case highlights the importance of following appropriate management for CME regardless of timeframe of presentation to ensure results.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111960"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109973","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":"Christmas tree pattern ileal atresia with intestinal malrotation in a 15-day-old infant: A rare dual congenital anomaly in the pediatric population – A case report","authors":"Mathayo Shadrack ,&nbsp;Mwajabu Rashidi Mbaga ,&nbsp;Sylvanus Christopher ,&nbsp;Linda Kalisti Tilisho ,&nbsp;Ibrahim Mkoma ,&nbsp;Victor Ngotta","doi":"10.1016/j.ijscr.2025.111948","DOIUrl":"10.1016/j.ijscr.2025.111948","url":null,"abstract":"<div><h3>Background</h3><div>Intestinal atresia is a common cause of neonatal intestinal obstruction. Type IIIb, also known as “Christmas Tree” or “Apple Peel” atresia, is a rare and severe variant characterized by the absence of the mesentery and a distal small bowel coiled around a single arterial vessel. Its incidence is low, accounting for 5–10 % of small bowel atresias. Intestinal malrotation, occurs due to failure of normal embryological gut rotation, is also rare and can predispose to volvulus and duodenal obstruction. The coexistence of both anomalies is extremely uncommon.</div></div><div><h3>Case presentation</h3><div>We report a 15-day-old-male neonate with progressive abdominal distension, bilious vomiting, and hyperkalemia. Abdominal radiographs showed features of small bowel obstruction, while ultrasound was inconclusive. Exploratory laparotomy revealed type IIIb ileal atresia with the classical “Christmas Tree” configuration and collapsed distal bowels. Additionally, incomplete intestinal rotation was identified with a free-floating cecum and right-sided duodenojejunal junction. Surgical resection of the distal collapsed ileum, cecum, and part of the ascending colon was performed, followed by creation of a double stoma (ileostomy and colostomy). The postoperative period was uneventful with good stoma function.</div></div><div><h3>Discussion</h3><div>This case highlights the diagnostic and surgical challenges posed by a rare dual congenital anomaly. The Christmas Tree pattern increases the risk of short bowel syndrome, while malrotation adds potential for volvulus. Early operative intervention is essential, especially in resource-limited settings.</div></div><div><h3>Conclusion</h3><div>Clinicians must consider coexisting anomalies when evaluating neonatal intestinal obstruction. Prompt surgery and individualized management can lead to favorable outcomes even in complex cases.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111948"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108080","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":"Adventitial dissection with advanced vessel-sealing for carotid body paraganglioma: A 2-year recurrence-free case report and technical note","authors":"Werda Majd ,&nbsp;Amouri Salim ,&nbsp;Chaabouni Mohamed Amine ,&nbsp;Medhioub Fatma ,&nbsp;Charfeddine Ilheme","doi":"10.1016/j.ijscr.2025.111950","DOIUrl":"10.1016/j.ijscr.2025.111950","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Carotid body paragangliomas present unique surgical challenges due to their hypervascular nature and proximity to critical neurovascular structures. Subadventitial dissection combined with vessel-sealing techniques represents a technical option to achieve complete resection while minimizing complications, though long-term outcome reports remain limited.</div></div><div><h3>Case presentation</h3><div>A 52-year-old male presented with a 2-month history of a pulsatile left cervical mass associated with chronic neck pain. Examination revealed classic clinical signs (Kocher's and Fontaine's positive). Imaging demonstrated a 3.5 cm Shamblin I tumor at the carotid bifurcation with with &lt;180° arterial contact (Arya I) and preserved vascular anatomy. Biochemical testing confirmed a non-secreting profile. The patient underwent en bloc resection via subadventitial dissection and vessel-sealing, achieving complete tumor removal without vascular reconstruction or nerve injury.</div></div><div><h3>Clinical discussion</h3><div>This case highlights several key technical considerations in carotid body tumor management. The subadventitial plane provides a dissection barrier, facilitating hemostasis and vascular preservation. Vessel-sealing devices may complement traditional techniques for vascular control. The 2-year recurrence-free outcome supports this approach for selected tumors, though longer follow-up is needed. Cranial nerve preservation highlights the importance of meticulous dissection.</div></div><div><h3>Conclusion</h3><div>Subadventitial dissection with vessel-sealing can achieve favorable outcomes in Shamblin I carotid body paragangliomas, enabling complete resection with neurovascular preservation. Further evaluation in larger cohorts is warranted.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111950"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108082","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 huge forgotten retrosternal goiter causing a superior vena cava syndrome after 20 years of thyroidectomy: A case report","authors":"Mohamad Yousef Almawaz ,&nbsp;Alyaa Kheirbek ,&nbsp;Naya Al aeddin ,&nbsp;Fadi obaied alahmar","doi":"10.1016/j.ijscr.2025.111953","DOIUrl":"10.1016/j.ijscr.2025.111953","url":null,"abstract":"<div><h3>Introduction</h3><div>Retrosternal goiters are thyroid enlargements that extend into the mediastinum and may compress adjacent structures. Although uncommon, residual thyroid tissue after total thyroidectomy can remain asymptomatic for years and present later with serious complications such as superior vena cava (SVC) syndrome.</div></div><div><h3>Case presentation</h3><div>A 51-year-old woman presented with progressive facial swelling, neck vein distension, and dyspnea. She had undergone total thyroidectomy 20 years prior for multinodular goiter. Physical examination revealed facial plethora and a positive Pemberton's sign. CT imaging demonstrated a large heterogeneous mediastinal mass compressing the SVC and deviating the trachea, consistent with a retrosternal goiter. The mass was excised through a cervical approach. Histopathology confirmed benign nodular thyroid tissue. The patient had full resolution of symptoms postoperatively.</div></div><div><h3>Discussion</h3><div>This case highlights a rare but significant delayed complication of thyroidectomy. Despite previous total thyroidectomy, remnant or ectopic thyroid tissue can persist and enlarge silently over decades. Clinical clues such as Pemberton's sign are essential in recognizing thoracic inlet obstruction. Imaging confirms diagnosis and aids surgical planning. While SVC syndrome is often associated with malignancy, benign causes like substernal goiter must remain in the differential, especially in patients with thyroid surgery history.</div></div><div><h3>Conclusion</h3><div>Forgotten retrosternal goiters may present decades after thyroidectomy with life-threatening complications like SVC syndrome. Awareness of this entity, combined with careful clinical assessment and imaging, is critical to timely diagnosis and effective, minimally invasive surgical management.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111953"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108079","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 clitoral hood cyst in a pediatric patient with acute lymphoblastic leukemia and a review of the literature","authors":"Zeeshan Zubair ,&nbsp;Mary B. Ross ,&nbsp;Janeen Buonaccorsi ,&nbsp;Ali El Ghazzaoui","doi":"10.1016/j.ijscr.2025.111930","DOIUrl":"10.1016/j.ijscr.2025.111930","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Clitoral cysts are a rare cause of clitoromegaly in the female pediatric population, with the majority of reported cases linked to trauma or genital mutilation. The epidermoid subtype is the most common histological type, and surgical excision is generally the preferred treatment. This case is unique as it represents the first reported instance of a clitoral cyst in a pediatric patient undergoing chemotherapy for Acute Lymphoblastic Leukemia (ALL). We highlight the importance of early surgical intervention in immunocompromised patients and add to the limited literature guiding management of genital cysts in pediatric oncology.</div></div><div><h3>Presentation of case</h3><div>A 4-year-old girl with ALL was admitted for high-dose methotrexate chemotherapy. During Foley catheter insertion, a mobile, non-tender clitoral mass was found near the urethra. Surgical excision was performed due to diagnostic uncertainty and immunosuppressed status, and histopathology confirmed an epidermal cyst. Chemotherapy was delayed for two weeks to allow healing, and the patient recovered fully, with no recurrence at follow-up.</div></div><div><h3>Clinical discussion</h3><div>A broad differential diagnosis, including hormonal and non-hormonal causes like epidermal cysts, is essential when evaluating pediatric clitoral masses, particularly in patients with complex conditions. Early recognition and timely management are critical to avoid diagnostic delays and treatment interruptions.</div></div><div><h3>Conclusion</h3><div>This case illustrates the importance of considering rare, non-hormonal causes of clitoromegaly in pediatric patients, particularly those with immunocompromised states. Key takeaways include maintaining a broad differential, prioritizing timely multidisciplinary care, and recognizing when surgical intervention may prevent complications and avoid chemotherapy delays.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111930"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208026","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":"Lateral ankle ligament reconstruction using free split peroneal brevis tendon and fibula bone pegs: A case report","authors":"Ryogo Furuhata,&nbsp;Yuki Yamai,&nbsp;Yoshihiko Kamikawa,&nbsp;Atsushi Tanji","doi":"10.1016/j.ijscr.2025.111955","DOIUrl":"10.1016/j.ijscr.2025.111955","url":null,"abstract":"<div><h3>Introduction</h3><div>Ankle sprain is a frequent soft-tissue injury; however, chronic pain sometimes persists, requiring surgery. Tenodesis repair using free tendon graft provides satisfactory outcomes in cases where no viable ligament structure is available. However, rupture of the graft tendon can occur postoperatively, causing recurrent ankle instability. We report a case of lateral ligament reconstruction using fibula bone pegs to enhance the graft tendon fixation strength for a chronic calcaneofibular ligament injury.</div></div><div><h3>Presentation of case</h3><div>A 44-year-old male presented with right ankle pain that had persisted since a fall one year earlier. Magnetic resonance imaging revealed a rupture of the right calcaneofibular ligament. Conservative treatment failed to improve pain, necessitating surgery. We made a curvilinear incision over the lateral ankle and harvested the anterior half of the peroneus brevis tendon. A bone tunnels of the fibula and the calcaneus was created, and the graft tendon was passed through it. Two bone pegs were harvested from the distal fibula, and inserted into the bone tunnel to fix the graft tendon. Postoperatively, ankle pain improved without any complications.</div></div><div><h3>Discussion</h3><div>Lateral ligament reconstruction using fibula bone pegs provided satisfactory short-term outcomes. The use of fibula pegs, rather than special synthetic implants, allows for secure fixation of the tendon using the patient's own bone and eliminates the risk of foreign body reactions.</div></div><div><h3>Conclusion</h3><div>This report presents a new fixation procedure on the lateral ankle ligament reconstruction using free graft tendon, which can improve physiological fixation strength of the graft tendon.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111955"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108081","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":"Esophageal duplication cyst mimicking type I achalasia in an adult female: A rare case report with diagnostic challenges","authors":"Mohammad Alaa Aldakak ,&nbsp;Abdulkader Mehli ,&nbsp;Nizar Alabdullah ,&nbsp;MHD-Fadi Alshurbaji ,&nbsp;Eias Abazid ,&nbsp;Abdulghani Alshalabi","doi":"10.1016/j.ijscr.2025.111954","DOIUrl":"10.1016/j.ijscr.2025.111954","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal duplication cysts (EDCs) are rare congenital anomalies typically diagnosed in infancy. Adult presentations are uncommon and may mimic other esophageal pathologies, including motility disorders such as achalasia, posing diagnostic challenges.</div></div><div><h3>Case presentation</h3><div>We report the case of a 45-year-old Arab female with a seven-year history of progressive dysphagia, halitosis, and retrosternal burning. Radiological and manometric findings were initially suggestive of type I achalasia. However, intraoperative findings revealed an esophageal diverticulum containing purulent material, and histopathological analysis confirmed a duplication cyst lined by respiratory-type epithelium with a well-formed muscular wall. The cyst was successfully resected laparoscopically, and symptoms resolved postoperatively.</div></div><div><h3>Clinical discussion</h3><div>Although achalasia has a well-defined manometric profile, rare structural anomalies such as duplication cysts can mimic its presentation. The absence of pathognomonic imaging findings, combined with non-specific clinical symptoms, may result in misdiagnosis. High-resolution manometry, while useful, may not distinguish between primary motility disorders and extrinsic or intramural mechanical causes. Surgical exploration remains the definitive diagnostic and therapeutic step in atypical or unresponsive cases.</div></div><div><h3>Conclusion</h3><div>Esophageal duplication cysts should be considered in the differential diagnosis of achalasia-like presentations, especially when findings are atypical or symptoms progress despite standard evaluation. Early recognition and surgical resection are key to definitive management and symptom resolution.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111954"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109423","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":"Noninvasive blood pressure measurements demonstrated a significant underestimation of blood pressure in a patient with severe preeclampsia: a case report","authors":"Yan Zhang ,&nbsp;Juan Gu ,&nbsp;Chao Yu","doi":"10.1016/j.ijscr.2025.111956","DOIUrl":"10.1016/j.ijscr.2025.111956","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Accurate diagnosis and management of preeclampsia rely on reliable blood pressure (BP) measurements. This report highlights a case where non-invasive BP monitoring underestimated maternal BP in a patient with severe preeclampsia.</div></div><div><h3>Case presentation</h3><div>At 27 weeks' gestation, a 33-year-old gravida 1, para 0 presented with blurred vision, diagnosed with chronic hypertension and preeclampsia, incomplete HELLP (elevated liver enzymes and lower platelet count syndrome), and abnormal umbilical artery Doppler. Magnesium sulfate and dexamethasone were administered for fetal lung maturity and maternal seizure prophylaxis. Oral labetalol, nitroglycerin, and urapidil were continuously infused to control non-invasive blood pressure (NIBP), and an emergency cesarean section was planned. Upon arrival in the operating room, left radial intra-arterial blood pressure (RIBP) was recorded as 190/112 mmHg, whereas the NIBP of the left arm was 155/105 mmHg. Intraoperative BP management was guided by RIBP. When the patient was transferred from the transport bed to the intensive care unit bed, the NIBP showed 120/70 mmHg, while the RIBP remained elevated at 180/110 mmHg. Subsequently, interventions including spasmolytic therapy, antihypertensive medications, and sedation were initiated, leading to a progressive reduction in the discrepancy between NIBP and RIBP.</div></div><div><h3>Discussion</h3><div>NIBP may underestimate actual BP in severe preeclampsia, particularly when maternal BP is poorly controlled. In these patients, invasive blood pressure monitoring may be useful for assessing rapid changes in cardiovascular status.</div></div><div><h3>Conclusion</h3><div>NIBP may significantly under-estimated actual BP in severe preeclampsia patients with poorly controlled maternal BP. Further research is needed to assess its impact on outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111956"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108083","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":"Incidental finding of ovarian mucinous cystadenoma with stromal Leydig cell hyperplasia during cesarean section: A rare case report","authors":"Maysam Jehad Yousef Hamarsheh ,&nbsp;Layan Melhem ,&nbsp;Raed Nazzal ,&nbsp;Asmaa Ghannam","doi":"10.1016/j.ijscr.2025.111947","DOIUrl":"10.1016/j.ijscr.2025.111947","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Mucinous cystadenoma of the ovary is a benign epithelial tumor. Its coexistence with stromal Leydig cell hyperplasia during pregnancy is extremely rare. Hormonal shifts during gestation may contribute to stromal changes, yet the clinical significance of such findings remains unclear.</div></div><div><h3>Case presentation</h3><div>A 21-year-old gravida 2, para 1 woman at 38 + 4 weeks' gestation underwent elective cesarean section. Intraoperatively, a 7 × 5 cm left ovarian cyst was identified and excised. The contralateral ovary appeared normal. Histopathology confirmed mucinous cystadenoma with stromal Leydig cell hyperplasia. The patient was asymptomatic, with no signs of virilization. No serum androgen testing was performed, and she recovered uneventfully postpartum.</div></div><div><h3>Clinical discussion</h3><div>Mucinous cystadenomas are common benign ovarian tumors, while stromal Leydig cell hyperplasia is rare and often hormonally active. Their coexistence in a pregnant patient without androgenic symptoms is highly unusual. Human chorionic gonadotropin (hCG), known for its LH-like activity, may stimulate Leydig cell proliferation. The absence of clinical virilization could be attributed to low androgen output or increased sex hormone-binding globulin levels in pregnancy.</div></div><div><h3>Conclusion</h3><div>This case emphasizes the need for vigilance during cesarean sections, the value of histopathological evaluation in incidental adnexal findings, and raises questions about hormonal influences on rare ovarian stromal pathologies in pregnancy.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111947"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109970","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}