Case Reports in Surgery最新文献

{"title":"A Case of Rare Hormone-Sensitive Primary Adenoid Cystic Carcinoma of the Breast Diagnosed by Preoperative Core Needle Biopsy: A Case Report.","authors":"Keiichi Takahashi","doi":"10.1155/cris/2441220","DOIUrl":"https://doi.org/10.1155/cris/2441220","url":null,"abstract":"<p><p>Adenoid cystic carcinoma (ACC) of the breast, a special histologic subtype of invasive carcinoma, most commonly originates in the salivary glands and is also found in the cervix, skin, bronchi, kidneys, esophagus, and prostate. ACC originating in the breast is quite rare, accounting for less than 0.1% of all breast cancers. Metastasis to lymph nodes or distant sites is very rare, and the \"triple-negative\" phenotype (negativity for hormone receptors and human epidermal growth factor receptor 2 [HER2]) is often noted. However, within the high prevalence of the triple-negative phenotype, hormone-sensitive primary ACC of the breast has been extremely rare, with few cases reported. The patient presented with pain around the right nipple persisting for several years. Mammography (MMG) and ultrasonography (US) revealed a mass in the right breast. Core needle biopsy (CNB) was performed. The results demonstrated that atypical cells proliferated invasively, exhibiting mesh-like, glandular, trabecular, and other structures. Formation of glands with eosinophilic discharge and pseudoglandular cavities due to retention of a mucinous edema-like matrix was observed, suggesting ACC. Skin-sparing mastectomy of the right breast and sentinel lymph node biopsy (SSM + SLNB) were performed with simultaneous breast reconstruction by implantation of tissue expanders. The results of surgical pathology were as follows: ACC, pT2 (5.0 cm × 3.8 cm × 2.3 cm), pN0 (sn 0/2), HG2, ly1, v1, estrogen receptor (ER) 20%, progesterone receptor (PgR) <1%, HER2 1+, MIB-1 index 15%.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"2441220"},"PeriodicalIF":0.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988103","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":"An Uncommon Twist: Intussusception as a Rare Manifestation of Extramedullary Myeloma.","authors":"Quinn E, Edwards Murphy A, Duggan W, DelaHarpe Golden P, Kavanagh D","doi":"10.1155/cris/1872149","DOIUrl":"https://doi.org/10.1155/cris/1872149","url":null,"abstract":"<p><p>We present the case of a 69-year-old female with relapsed multiple myeloma (MM) who presented acutely with small bowel obstruction secondary to a jejunal intussusception. Despite a trial of conservative management the obstruction did not resolve and surgical intervention was required. Laparoscopic-assisted small bowel resection with primary anastomosis was performed. Histopathological examination revealed an extramedullary plasmacytoma with anaplastic features as the lead point of the intussusception. This case outlines the successful management of a rare but important oncological emergency and underscores the importance of considering extramedullary plasmacytoma in the differential diagnosis of bowel obstruction in patients with MM.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1872149"},"PeriodicalIF":0.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988222","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":"Temporoparietal Scalp Intravenous Schwannoma: Rare Subcutaneous Soft Tissue Mass in an Unusual Location.","authors":"Maedot A Haymete, Austin L Fitzgerald, Jane J Gay, Daniel R Tershak, Kristin B Eden, Douglas J Grider","doi":"10.1155/cris/8389899","DOIUrl":"https://doi.org/10.1155/cris/8389899","url":null,"abstract":"<p><p>Schwannomas, or neurilemmomas, are benign nerve sheath tumors of Schwann cell origin, sometimes associated with neurofibromatosis type 2 (NF2) and schwannomatosis. Intravenous schwannomas are exceedingly rare, pose diagnostic challenges due to their unusual location within blood vessels and lack of surrounding perineurium. A 69-year-old male presented with a subcutaneous mass behind the left ear in the upper temporoparietal scalp, firm and mobile, 5 × 7 cm², gradually growing for 15 years. Past physical examinations considered the lesion a cutaneous inclusion cyst. Surgical extirpation revealed a solid tumor adherent to the underlying fascia and muscle easily removed along surgical planes. Histopathology showed a well-circumscribed, spindle cell lesion, S100 protein positive, with foci of hypercellular (Antoni A) and hypocellular (Antoni B) areas, with distinctive Verocay bodies pathognomonic for schwannoma. EMA was negative at the periphery, demonstrating a lack of perineurium, supporting that the schwannoma was not within a nerve bundle. However, a Verhoeff van Gieson elastic tissue stain revealed a circumferential single internal elastic lamina, while CD31 marked the endothelial cells lining a stretched vein encasing the tumor, confirming an intravenous schwannoma.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"8389899"},"PeriodicalIF":0.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988187","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":"Large Uterine Angiolipoleiomyoma Masquerading as an Ovarian Tumor: A Case Report.","authors":"Prabineshwor Prasad Lekhak, Smriti Basnet, Hari Narayan Rai, Palistha Shakya, Tulsi Raj Khanal, Jyotsna Sharma Tiwari, Roshan Ghimire","doi":"10.1155/cris/8616290","DOIUrl":"10.1155/cris/8616290","url":null,"abstract":"<p><p>Angiolipoleiomyoma (ALLM) is a rare benign mesenchymal tumor that primarily arises in the skin and kidney, and less frequently in the uterus. The present case may represent the largest reported uterine mass described as ALLM. We present a case of a 52-year-old woman with abdominal fullness and an irregular menstrual cycle having a large cystic abdominopelvic mass initially masquerading as a large ovarian tumor. Following successful tumor resection and subsequent histopathological and immunohistochemical analysis, a definitive diagnosis of uterine ALLM was established. This case shows that uterine ALLM can present with nonspecific clinical symptoms and radiologic features that mimic other pelvic pathologies, and should be considered in the differential diagnosis when evaluating pelvic masses in female patients.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"8616290"},"PeriodicalIF":0.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954872","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":"Cholangitis, Choledocholithiasis and a Cholecystocolonic Fistula: A Case Report on a Rare Triple Surgical Challenge.","authors":"Kumail Jaffry, Anthony Tran, Deep Bhowmik, Amy Crowe, Niyaz Naqash","doi":"10.1155/cris/1989959","DOIUrl":"10.1155/cris/1989959","url":null,"abstract":"<p><p>Cholecystocolonic fistula (CCF) is an uncommon complication of gallstone disease and is usually diagnosed intraoperatively. Concomitant choledocholithiasis and acute cholangitis create competing priorities: urgent biliary drainage and definitive treatment of the fistula. A 78-year-old woman presented with 3 days of upper abdominal pain, fever, vomiting and jaundice. She was febrile and hypotensive but stabilised after intravenous fluid resuscitation without vasopressors. Laboratory and imaging findings met Tokyo Guidelines 2018 criteria for severe acute cholangitis. Computed tomography demonstrated an 11 mm impacted distal common bile duct (CBD) stone, severe biliary dilatation, pneumobilia and a large calcified gallstone in the hepatic flexure, consistent with CCF and gallstone migration. After resuscitation and correction of coagulopathy, she underwent surgery within 24 h. Laparoscopy confirmed the fistula, and intraoperative cholangiography showed multiple obstructing ductal stones. Several stones were removed transcystically; however, an impacted distal stone required conversion to open choledochotomy. Cholecystectomy, right hemicolectomy with ileocolic anastomosis, and primary CBD closure were completed during the same operation. Postoperative bilious drainage prompted further imaging and endoscopic retrograde cholangiopancreatography (ERCP). Imaging demonstrated a cystic duct stump leak, while ERCP confirmed retained choledocholithiasis. Sphincterotomy and balloon extraction achieved ductal clearance, and a plastic CBD stent was inserted. The leak subsequently resolved, and the stent was removed approximately 4 months later, with no residual choledocholithiasis identified. Histopathology excluded malignancy. This case illustrates that single-stage biliary and colonic surgery may be feasible in a resuscitated, haemodynamically stable patient with severe cholangitis when appropriate expertise is available. It also supports a low threshold for postoperative ERCP when ductal clearance remains uncertain.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1989959"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917857","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":"Dynamic Vascular Imaging Unveils Popliteal Artery Entrapment Syndrome in an Atypical Patient: A Case Report.","authors":"Elie Alam, Hadi Saada, Joya Ghaleb, Rita-Nour Awad, Nadia Katrib, Sandra Rizk, Moro Chehine, Ghassan Nabbout, Zaki Samia","doi":"10.1155/cris/9019853","DOIUrl":"10.1155/cris/9019853","url":null,"abstract":"<p><p>Popliteal artery entrapment syndrome (PAES) is a rare vascular disorder resulting from abnormal anatomical relationships between the popliteal artery and adjacent musculotendinous structures. This case highlights a 39-year-old female with a 10-year history of exertional calf pain, worsened by walking and stair descent. Multiple static imaging tests failed to diagnose her condition. However, dynamic Doppler ultrasound revealed arterial occlusion during dorsiflexion of the ankle, and dynamic arteriography confirmed PAES. Surgery uncovered a fibrous band and hypertrophied medial gastrocnemius muscle compressing the artery. She underwent fibrous band release, muscle resection, and arterial decompression, resulting in full symptom resolution and restored blood flow. This case underscores the diagnostic challenges of PAES in atypical patients, where lack of vascular risk factors and normal resting studies can mislead clinicians. Dynamic vascular imaging is vital for accurate diagnosis. PAES should be considered in all patients with unexplained exertional leg pain, and timely surgical treatment can yield excellent outcomes.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"9019853"},"PeriodicalIF":0.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911074","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":"Amyand's Hernia Presenting With Acute Enlargement of a Chronic Right Inguinal Hernia: A Case Report.","authors":"Allen Barbarovich, Christopher Staley, Christopher Soika","doi":"10.1155/cris/3262891","DOIUrl":"10.1155/cris/3262891","url":null,"abstract":"<p><p>Amyand's hernia is a rare condition characterized by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not be inflamed. We present the case of a 43-year-old male with a 3-year history of right inguinal hernia who presented to the emergency department with acute enlargement of the hernia sac and associated discomfort. A contrast-enhanced computed tomography scan of the abdomen and pelvis revealed a right inguinal hernia containing an inflamed appendix, consistent with acute appendicitis, with periappendiceal stranding but no abscess formation. The patient denied recent trauma or bowel habit changes, though he reported chronic constipation. This report highlights the importance of imaging in diagnosing rare hernia contents and discusses the management controversies associated with Amyand's hernia.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"3262891"},"PeriodicalIF":0.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911100","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 Management of Sporadic Pancreatic Insulinomas in a Resource-Limited Setting: A Report of Two Cases.","authors":"Yacine Seye, Mouhamadou Laye Diop, Mohamadou Lamine Gueye, Zeinabou Lo, Mamadou Seck, Madieng Dieng","doi":"10.1155/cris/3856631","DOIUrl":"10.1155/cris/3856631","url":null,"abstract":"<p><p>Insulinoma is the most common functional pancreatic neuroendocrine tumor, typically benign, solitary, and sporadic, with an estimated incidence of 1-4 cases per million per year worldwide. It causes recurrent hypoglycemia through inappropriate insulin secretion, classically presenting as Whipple's triad and confirmed by a prolonged supervised fasting test. Surgical enucleation remains the preferred treatment for small, well-localized benign insulinomas, allowing maximal preservation of pancreatic parenchyma. We report two cases of sporadic pancreatic insulinoma managed by open enucleation at a tertiary referral center in Senegal, West Africa, where advanced diagnostic modalities such as endoscopic ultrasound (EUS), somatostatin receptor scintigraphy, and selective arterial secretagogue injection (SASI) testing were unavailable. The first case was a 30-year-old woman presenting with a severe hypoglycemic coma complicated by status epilepticus on postpartum day 10. Abdominal CT scan identified a pancreatic head lesion. Biochemical workup confirmed insulinoma with a fasting blood glucose of 0.30 g/L (30 mg/dL; 1.7 mmol/L), elevated fasting insulin at 32.7 µU/mL, and C-peptide at 2.92 ng/mL. Open enucleation was performed; the postoperative course was complicated by a transient infectious syndrome managed with broad-spectrum antibiotics. Histopathology confirmed a well-differentiated Grade 1 neuroendocrine tumor. Complete resolution of hypoglycemic episodes was achieved with no recurrence at 1 year. The second case involved a 55-year-old man with a 12-year history of recurrent neuroglycopenic episodes. CT scan revealed an isthmic pancreatic lesion. Enucleation was performed; the postoperative course was complicated by a high-output pancreatic fistula (Grade B, ISGPS 2016 classification), managed conservatively with fasting, parenteral nutrition, and close radiological monitoring, without surgical reintervention. Histopathology confirmed a low-grade neuroendocrine tumor. No recurrence of hypoglycemia was observed at 5 months. These cases demonstrate that open enucleation is a feasible, effective, and parenchyma-sparing option for benign sporadic insulinomas, even in resource-limited settings where advanced localization and intraoperative techniques remain unavailable.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"3856631"},"PeriodicalIF":0.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911103","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":"Postoperative Cholestasis After Uncomplicated Laparoscopic Cholecystectomy: A Case Report.","authors":"Sarah Y Cao, Damien J Lazar","doi":"10.1155/cris/9983406","DOIUrl":"10.1155/cris/9983406","url":null,"abstract":"<p><strong>Introduction: </strong>In the absence of complications, transient jaundice has been observed in postoperative patients after abdominal surgery. This jaundice has been previously attributed to intrahepatic cholestasis due to oxidative stress from surgery and can be marked within the first postoperative weeks. However, this change has often been seen in patients with significant comorbidities. This report describes the case of a young, healthy patient who developed severe postoperative jaundice after a routine laparoscopic cholecystectomy with no evidence of biliary injury or obstruction, leading to endoscopic retrograde pancreatography and severe necrotizing pancreatitis.</p><p><strong>Case presentation: </strong>A 45-year-old male with no medical comorbidities presented to our hospital with signs and symptoms consistent with acute cholecystitis. He promptly underwent an uncomplicated laparoscopic cholecystectomy with routine intraoperative cholangiogram (IOC) that was unrevealing. He represented on postoperative day two to the emergency department with a severe conjugated hyperbilirubinemia with unremarkable cross-sectional imaging. He subsequently underwent endoscopic retrograde pancreatography without evidence of biliary obstruction or biliary leak, after which his hyperbilirubinemia resolved without any further intervention over the following days. As a result of the endoscopic retrograde pancreatography, he developed a complicated case of necrotizing pancreatitis, with a course including multiple operative interventions.</p><p><strong>Conclusion: </strong>In patients with severe postoperative jaundice, postoperative intrahepatic cholestasis should be considered on the differential in the absence of evidence of other surgical complication. Surgeons should be aware of potential benign causes of hyperbilirubinemia. After laparoscopic cholecystectomy, many important complications are diagnosed and treated with endoscopic retrograde pancreatography. Given its associated potential morbidity, pursuing biliary imaging should be a consideration.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"9983406"},"PeriodicalIF":0.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896510","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":"Asymptomatic Multiple Bilateral Segmental Pulmonary Embolisms Caused by Cement After Multilevel Vertebroplasty: A Case Report and Literature Review.","authors":"Elie Mokled, Anthony Sadek, Maher Ghandour, Fatima Farhat, Amer Abdallah","doi":"10.1155/cris/7151548","DOIUrl":"10.1155/cris/7151548","url":null,"abstract":"<p><p>Pulmonary cement embolization (PCE) is a recognized, often asymptomatic complication of percutaneous vertebroplasty (PVP), a procedure commonly used to stabilize vertebral compression fractures. Here, we report the case of a 58-year-old male who, after vertebroplasty for multiple acute thoracic and lumbar fractures, exhibited segmental, peripheral PCE on postoperative imaging. Despite cement leakage into the pulmonary vasculature, the patient remained asymptomatic, stable, and was discharged following brief observation. A review of the literature reveals varied management approaches for asymptomatic PCE, from conservative monitoring to anticoagulation therapy, with outcomes generally favorable regardless of intervention. Our case supports the safety of conservative management in asymptomatic PCE, highlighting the need for standardized guidelines to aid clinical decision-making. Early detection through postoperative imaging, combined with tailored patient management, may improve outcomes while minimizing unnecessary interventions for asymptomatic PCE. Emergency physicians should be aware of PCE as a potential postoperative complication of vertebroplasty, even in asymptomatic patients, to ensure timely recognition, appropriate monitoring, and avoid unnecessary interventions.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"7151548"},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873048","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}