Surgical Case Reports

Ventricular Septal Perforation Associated with Takotsubo Syndrome and Its Pathogenic Mechanisms

Masaru Yoshikai, et al.

INTRODUCTION: Takotsubo syndrome (TTS), once considered a benign self-limiting disease, is now recognized to have substantial short-term morbidity and mortality. During the acute phase, it can result in severe heart failure, cardiogenic shock, arrhythmias, cardiac rupture, ventricular septal perforation (VSP), and thromboembolic events, with in-hospital mortality rates comparable to those observed in acute coronary syndrome. Although VSP is rare, it represents a potentially lethal complication of TTS. Herein, we present a case of VSP associated with TTS and discuss a mechanism for the development of VSP in TTS.

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Posterior Single-Direction Approach for Thoracoscopic Combined S2+S6 Segmentectomy in Fused Fissure: A Case Report

Yasuhiro Nakashima, et al.

INTRODUCTION: Segmentectomy in cases with fused fissures poses technical challenges due to increased risks of air leakage, as reported in lobectomy. The single-direction approach avoids fissure manipulation through hilar-first dissection but has been rarely reported for posterior segments. We report the first case of a posterior single-direction approach for combined S2+S6 segmentectomy in a patient with a tumor located in an incomplete right interlobar fissure.

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A Novel Approach of Pericardial Suspension Method Combined with Tracheobronchial Stent Placement: A Life-Saving Case for Right Main Bronchial Stenosis

Ryota Nagashima, et al.

INTRODUCTION: There is no consensus regarding surgery and endotracheal treatment for bronchial stenosis. We report a case of right main bronchus stenosis treated using a novel approach of mediastinal mobilization with pericardial suspension.

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Laparoscopic Abdominoperineal Resection for Ischemic Colitis after Laparoscopic Partial Resection of the Descending Colon: Case Report

Mitsuki Yokota, et al.

INTRODUCTION: With advances in laparoscopic surgery, more sophisticated vessel-preserving techniques have become standardized. Laparoscopic partial colectomy aimed at maximizing colonic preservation is now widely performed. Along with this trend, cases of ischemic colitis developing after colorectal cancer surgery have occasionally been reported; however, cases requiring surgical resection remain exceedingly rare. Here, we report a case of ischemic colitis that developed 2 years and 2 months after partial laparoscopic resection of the descending colon, necessitating laparoscopic abdominoperineal resection.

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Primary Gastric Adenocarcinoma with Thyroid Transcription Factor-1 Positivity Mimicking Gastric Metastasis from Lung Cancer: A Case Report

Yoshihito Iijima, et at.

INTRODUCTION: Thyroid transcription factor-1 (TTF-1) is a well-established immunohistochemical marker for tumors of lung and thyroid origin. Metastatic adenocarcinomas are often tested for TTF-1 expression to identify their primary site. Herein, we report a rare case of TTF-1–positive primary gastric adenocarcinoma that was initially misdiagnosed and treated as postoperative gastric metastasis from primary lung cancer.

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Unicentric Castleman Disease Presenting with a Ruptured Pseudoaneurysm within the Tumor: A Case Report

Toshiki Matsui, et al.

INTRODUCTION: Castleman disease is a lymphoproliferative disorder of unknown etiology, typically reported as a hypervascular tumor. Here, we report the first known case of unicentric Castleman disease in which a pseudoaneurysm developed within the tumor and ruptured spontaneously.

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Spontaneous Regression of Intrahepatic Adenocarcinoma after Needle Biopsy: A Case Report and Literature Review

Koetsu Inoue, et al.

INTRODUCTION: Spontaneous tumor regression (STR) is a rare phenomenon in which cancer cells partially or completely disappear without treatment. We report a case of intrahepatic cholangiocarcinoma demonstrating STR following endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA).

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Fulminant Food Aspiration-Induced Pneumonia Leading to Tension Pyopneumothorax after Proctectomy: An Autopsy Case

Ryuta Nakao, et al.

INTRODUCTION: Postoperative aspiration pneumonia is an uncommon but severe pulmonary complication, particularly in older adults with cognitive impairment. We report an autopsy case of fulminant aspiration pneumonia, caused by food aspiration following colorectal cancer surgery, that progressed to tension pyopneumothorax.

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Robotic-Assisted Sigmoidectomy with D3 Lymphadenectomy for Sigmoid Colon Cancer in a Patient with Situs Inversus Totalis: A Case Report

Kazuhito Minami, et al.

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital anomaly characterized by complete mirror-image transposition of thoracic and abdominal organs. Although laparoscopic colectomy in SIT has been increasingly reported, the reversed anatomy and inherent limitations of laparoscopy make such procedures technically demanding. Robotic-assisted surgery may overcome these issues by providing enhanced ergonomics and intuitive instrument control, yet reports in SIT remain scarce.

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Jejunogastric Intussusception after Pylorus Resecting Pancreaticoduodenectomy: A Rare Case Report and Review of the Literature

Yuma Tamaki, et al.

INTRODUCTION: Jejunogastric intussusception is a rare complication that can occur following gastrectomy or gastric bypass surgery. The occurrence of intestinal intussusception after pancreaticoduodenectomy (Child reconstruction) has been reported in very few cases in the literature.

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Squamous Cell Carcinoma Originating from a Dermoid Cyst Located between the Upper Rectum and Prostate: A Case Report

Takao Tsukahara, et al.

INTRODUCTION: Pelvic squamous cell carcinoma (SCC) originating from a dermoid cyst (DC) is extremely rare. Here, we report the first case of SCC that developed in the anterior rectal area.

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Laparoscopic Resection of a Large Jejunal Diverticulum-Like Gastrointestinal Stromal Tumor: A Case Report

Ryosuke Mizuno, et.al

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) that present as large jejunal diverticulum-like lesions are exceedingly rare, with only 8 cases reported in the English literature to date. Notably, all previously documented cases were treated via open surgery. To our knowledge, this is the first report of successful laparoscopic resection of such a lesion. This case contributes novel insight into the management of rare GIST presentations and demonstrates the potential applicability of minimally invasive surgery.

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