Surgical Case Reports

Robot-Assisted Abdominoperineal Resection for Anal Fistula Cancer in a Patient with Situs Inversus Totalis: A Case Report

Yoshiaki Kita, et al.

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital condition characterized by a complete mirror-image reversal of thoracic and abdominal organs. This anatomic anomaly poses technical challenges in abdominal surgery, particularly in oncologic procedures requiring precise orientation and dissection. Robot-assisted surgery (RS) offers advantages such as stable visualization and enhanced dexterity, which may facilitate safe and effective surgery even in patients with reversed anatomy. However, reports of using RS for colorectal cancer in the setting of SIT remain scarce.

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Hybrid Operation Comprising Hepatic Artery Reconstruction and Endovascular Treatment for a Common-Proper Hepatic Artery Aneurysm Derived from Segmental Arterial Mediolysis

Shinya Hayami, et al.

INTRODUCTION: The location and size of our patient’s hepatic artery aneurysm might suggest the possible inadequacy of endovascular treatment (EVT) only. We therefore devised a hybrid operation that included microscopic arterial reconstruction after dividing the hepatic artery with simultaneous EVT.

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A Case Report of Surgical and Postoperative Treatment for Thyroid Angiosarcoma with Pulmonary Metastasis

Gai Inaguma, et al.

INTRODUCTION: Thyroid angiosarcoma (TAS) is an extremely rare and highly aggressive cancer, representing less than 1% of all sarcomas. Typically diagnosed in individuals aged 50–80, with a higher incidence in women, TAS has a poor prognosis due to its tendency to metastasize, leading to a low 5-year survival rate. Due to its rarity, standardized treatment approaches are lacking, often involving a combination of surgery, chemotherapy, and radiation. This report presents TAS in a Japanese male.

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Intrathoracic Vagal Schwannoma Mimicking Metastatic Lymphadenopathy with a Positional Shift

Rina Takahashi, et al.

INTRODUCTION: Schwannomas are benign tumors originating from peripheral nerve sheaths and are most commonly found in the head, neck, and extremities. Intrathoracic schwannomas, particularly those arising from the vagus nerve, are relatively rare. Despite their benign nature, schwannomas often exhibit fluorodeoxyglucose (FDG) uptake on PET scans, potentially leading to diagnostic confusion. This report presents a case initially suspected to be a metastatic lymph node but later diagnosed as a schwannoma from the intrathoracic vagus nerve, highlighting the diagnostic challenges associated with thoracic nodal lesions.

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A Case of Ascending Colon Cancer Resected by Laparoscopic Right Hemicolectomy with Intracorporeal Anastomosis after Total Gastrectomy: A Case Report

Atomu Suzuki, et al.

INTRODUCTION: There are few reports of treatment strategies for ascending colon cancer after total gastrectomy. We report a case of intracorporeal anastomosis was performed for ascending colon cancer after total gastrectomy with Roux-en-Y reconstruction.

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Intraoperative Asystole during Thoracoscopic Left Lung Upper Lobectomy: A Case Report

Yu Sugimoto et al.

INTRODUCTION: Intraoperative asystole is a rare but potentially life-threatening complication of lung cancer surgery. Various factors, including cardiac conditions, hemorrhage, anesthetic effects, and neural reflexes, may contribute to this phenomenon. Herein, we report a case of intraoperative asystole triggered by a vagal reflex during thoracoscopic left upper lobectomy.

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Peritoneovenous Shunting to Manage Chylous Ascites Following Liver Resection for Cholangiocarcinoma: A Case Report

Mizuki Nakajima, et al.

INTRODUCTION: Liver resection has rarely been reported as a cause of chylous ascites. Such ascites, consisting mainly of hepatic lymph, is usually caused by injury to the lymphatic system between the hepatic hilum and the hepatoduodenal ligament. We report a patient who developed chylous ascites after liver resection and required a peritoneovenous shunt.

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Laparoscopic Common Bile Duct Exploration for Choledocholithiasis in a Patient with Situs Inversus Totalis and Prior Total Gastrectomy with Roux-en-Y Reconstruction: A Case Report

Tomoyuki Nagata, et al.

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital condition characterized by mirror-image transposition of the thoracic and abdominal viscera. Herein, we report a rare case of laparoscopic common bile duct exploration with choledochotomy and stone extraction in a patient with SIT and a history of total gastrectomy with Roux-en-Y (R-Y) reconstruction.

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Emergency Surgical Management of Chemotherapy-Induced Tumor Rupture in a Patient with MYCN-Amplified Neuroblastoma: A Case Report

Katsuhiro Ogawa, et al.

INTRODUCTION: Tumor rupture with neuroblastoma is an uncommon but serious complication, particularly in high-risk cases involving MYCN amplification. When rupture occurs soon after induction chemotherapy is initiated, rapid deterioration and abdominal compartment syndrome (ACS) may develop. Early identification of high-risk patients and their readiness for surgical management are essential to optimizing outcomes.

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Combined Laparoscopic and Posterior Approach Resection of Presacral Neuroblastoma with Rectobulbar Urethral Fistula

Takashi Kobayashi, et al.

INTRODUCTION: We herein report a case of presacral neuroblastoma (NB) with a rectobulbar urethral fistula. We successfully resected the tumor with a combined laparoscopic and posterior approach and simultaneously performed posterior sagittal anorectoplasty (PSARP).

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Long-Term Survival Achieved with Multimodal Therapy and Multiple Hepatic Resections for Pancreatic Primary Mixed Neuroendocrine–Non-Neuroendocrine Neoplasm Comprising Acinar Cell Carcinoma and Neuroendocrine Carcinoma: A Case Report

Hiroto Arino, et al.

INTRODUCTION: In the 2019 World Health Organization (WHO) classification, tumors comprising ≥30% of both neuroendocrine and non-neuroendocrine components are defined as mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs). Acinar cell carcinoma (ACC) constitutes <1% of pancreatic tumors, while neuroendocrine carcinoma (NEC) accounts for 1%–2%, making MiNENs with both characteristics extremely rare. The role of surgical resection in resectable NEC remains unclear; however, it is generally recommended as part of multimodal therapy. This case presents a pancreatic mixed acinar–NEC successfully managed with multimodal therapy, including repeated liver metastasis resections, achieving long-term disease control.

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Metastasis of Ovarian Cancer to the Duodenum: A Case Report

Hiromitsu Maehira et al.

INTRODUCTION: Ovarian cancer remains a leading cause of cancer-related mortality. Although the peritoneum and abdominal lymph nodes are the most common sites of metastasis, duodenal metastasis is extremely rare. We report a rare case of duodenal metastasis from ovarian clear cell carcinoma (OCCC) that initially presented with gastrointestinal bleeding and was successfully treated with curative resection.

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