Surgical Case Reports

Apocrine Ductal Carcinoma in situ Ex Pleomorphic Adenoma of the Breast: A Rare Case Report

Tadahiro Isono, et al.

INTRODUCTION: Pleomorphic adenoma (PA) of the breast is an extremely rare benign tumor, and malignant transformation within PA is exceptional. Only a few cases have been reported, and none have described apocrine ductal carcinoma in situ (DCIS) arising in PA. We report a case of apocrine-type DCIS considered to have developed from mammary PA.

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Near-Fatal Hemodynamic Collapse during Recovery from Staged Bladder Tumor Resection in a Patient with Giant Left Atrial Myxoma: A Case for Immediate Sequential Surgery

Kazuko Tokiya, et al.

INTRODUCTION: Surgical management of a large, obstructive left atrial (LA) myxoma coexisting with an active bleeding source presents a significant clinical dilemma. The systemic heparinization required for cardiopulmonary bypass (CPB) carries a high risk of exacerbating hemorrhage, whereas delaying cardiac surgery leaves the patient vulnerable to fatal myxoma-related complications.

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Minimally Invasive Extirpation of an Eden Type II Dumbbell-Shaped Mediastinal Tumor Using a Posterior and Uniportal Thoracoscopic Approach without Changing the Patient’s Position: A Case Report

Takao Ishimura, et al.

INTRODUCTION: Dumbbell-shaped posterior mediastinal tumors, most commonly schwannomas, sometimes extend through the intervertebral foramen into the spinal canal and often require a combined posterior and thoracic approach. Although complete resection is essential, reducing surgical invasiveness remains an important clinical priority. We report a case of an Eden type II dumbbell-shaped schwannoma that was successfully resected using a minimally invasive single-stage approach combining posterior surgery and uniportal thoracoscopic surgery, performed entirely in the prone position without intraoperative repositioning.

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Anomalous Systemic Arterial Supply to the Basal Segments with an Aneurysmal Aberrant Artery Showing Advanced Wall Fragility: A Case Report and Literature Review

Shun Yorimori, et al.

INTRODUCTION: Anomalous systemic arterial supply to the basal segments (ASABS) is a rare congenital pulmonary anomaly. Considering the associated complications of pulmonary hypertension or hemoptysis, surgical lung resection is recommended. However, there is a lack of standardized surgical management guidelines. We report a case of ASABS with an aneurysmal aberrant artery, in which imaging findings suggested an increased risk of rupture. Thoracic endovascular aortic repair (TEVAR) was first performed to achieve inflow control; this strategy provided a secure setting for subsequent pulmonary resections.

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Pancreaticobiliary Fistula Caused by Intraductal Papillary Mucinous Adenoma Requiring Pancreaticoduodenectomy

Mina Nagao, et al.

NTRODUCTION: Fistula formation from the intraductal papillary mucinous neoplasm (IPMN) into neighboring organs is rare. We describe a case of pancreaticobiliary fistula with obstructive jaundice caused by an intraductal papillary mucinous adenoma (IPMA).

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Abdominal Wall Perivascular Epithelioid Cell Tumor Mimicking an Intra-Abdominal Tumor: A Case Report

Saki Kubota, et al.

INTRODUCTION: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms; those arising from the abdominal wall are exceptionally uncommon. Because imaging findings are nonspecific, an abdominal wall PEComa may be mistaken for an intra-abdominal tumor, leading to diagnostic uncertainty and challenges in surgical planning.

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Laparoscopic Cholecystectomy for Ruptured Gallbladder Varices Diagnosed by Preoperative Endoscopic Ultrasonography: A Case Report

Takahisa Hirano, et al.

INTRODUCTION: Gallbladder varices (GBV) are a rare form of ectopic varices associated with portal hypertension. They are often difficult to diagnose prior to rupture, which carries a high mortality rate. We report a case of ruptured GBV successfully treated with laparoscopic cholecystectomy following a definitive preoperative diagnosis by endoscopic ultrasonography (EUS).

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Humoral Hypercalcemia of Malignancy Caused by Parathyroid Hormone-Related Protein-Secreting Medullary Thyroid Carcinoma: A Case Report

Takuya Hirose, et al.

INTRODUCTION: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor arising from the parafollicular C cells, accounting for approximately 1.5% of all thyroid cancers. Although calcitonin secreted by the MTC typically lowers calcium levels, serum calcium concentrations usually remain within the normal range due to compensatory parathyroid hormone (PTH) secretion. Hypercalcemia of malignancy is broadly categorized as humoral hypercalcemia of malignancy (HHM), mediated by parathyroid hormone-related protein (PTHrP), or local osteolytic hypercalcemia. We report a rare case of HHM caused by a PTHrP-secreting MTC.

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BRCA2 Reversion Mutation after Neoadjuvant Dose-Dense EC and Dose-Dense Paclitaxel in Triple-Negative Breast Cancer: A Case Report and Literature Review

Hajime Hikino, et al.

INTRODUCTION: BRCA reversion mutations are known mechanisms of acquired resistance to poly (ADP-ribose) polymerase inhibitors (PARPis) and platinum agents. However, their clinical emergence without such therapies is rarely reported.

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Surgical Treatment for Bacteremia due to Translocation of Enterococcus gallinarum: A Case Report

Yoshitaka Imoto, et al.

INTRODUCTION: Bacterial translocation (BT) followed by bacteremia is usually managed with antibiotics, but some cases remain refractory. Herein, we report an immunocompromised patient with bacteremia due to the translocation of Enterococcus gallinarum, a rare pathogen among enterococcal infections, who was successfully treated with surgical intervention.

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Adult Primary Hepatic Sarcoma Presenting as a Chronic Expanding Hematoma

Takako Yamada Fujii, et al.

INTRODUCTION: Primary hepatic sarcoma is extremely rare in adults and can be difficult to distinguish from benign hemorrhagic lesions on imaging. We report a rare case of undifferentiated sarcoma (US) that initially mimicked chronic expanding hematoma (CEH) and ruptured.

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Single-Incision Laparoscopic Cholecystectomy in a Patient with a Left Ventricular Assist Device

Ayako Ishii, et al.

INTRODUCTION: Laparoscopic cholecystectomy (LC) is the standard treatment for benign gallbladder diseases, including acute cholecystitis (AC). However, performing LC in patients with a left ventricular assist device (LVAD) presents specific technical and physiological challenges related to driveline preservation and hemodynamic stability. We report the first case of single-incision laparoscopic cholecystectomy (SILC) via the right lower abdomen in a patient with an LVAD after treatment for biliary tract infection, following prior surgery for strangulated ileus and umbilical wound infection.

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