Surgical Case Reports

A Rare Case of Gastric Aberrant Pancreas Causing Bleeding from a Gastric Ulcer

Tsuyoshi Saito, et al.

INTRODUCTION: An aberrant pancreas is pancreatic tissue lacking anatomical and vascular continuity with the normal pancreas. It typically occurs in the gastrointestinal tract, especially in the stomach, duodenum, and small intestine. Most cases are asymptomatic and discovered incidentally during imaging or surgery. Gastric aberrant pancreas rarely presents with bleeding, making diagnosis and treatment decisions challenging.

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Surgical Management of Breast Cancer Adjacent to a Calcified Ventriculoperitoneal Shunt: A Case Report

Hitomi Wake, et al.

INTRODUCTION: Breast cancer arising in tissue adjacent to a ventriculoperitoneal (VP) shunt is exceptionally rare, and there is little guidance on how to manage the shunt hardware during oncologic surgery in such cases.

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Mesenteric Steal Syndrome Caused by Abdominal Aortic Stenosis due to Takayasu Arteritis

Shoichiro Nagashima, et al.

INTRODUCTION: Chronic mesenteric ischemia (CMI) is usually caused by atherosclerotic stenosis of multiple mesenteric arteries. However, aortic stenosis secondary to Takayasu arteritis can rarely cause intestinal ischemia through hemodynamic steal from the mesenteric to lower limb circulation.

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Pathological Complete Response Achieved with Colorectal Cancer-Based Chemotherapy for Locally Recurrent Cecal Neuroendocrine Carcinoma after Surgery: A Case Report

Kana Kajisako, et al.

INTRODUCTION: Primary neuroendocrine carcinoma (NEC) of the colon is extremely rare, accounting for only 0.2% of all colorectal malignancies, and is associated with a poor prognosis. Early diagnosis is often challenging, as endoscopic biopsies are frequently misinterpreted as adenocarcinoma. Although platinum-based regimens such as etoposide plus cisplatin or irinotecan are commonly used, no standard chemotherapy protocol has been established. We report a case of locally recurrent cecal NEC that responded remarkably to a colorectal cancer–based chemotherapy regimen, achieving a pathological complete response.

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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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