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Surgical Case Reports

Taishi Yamane, Katsunori Imai, Naoki Umezaki, Takanobu Yamao, Takayoshi Kaida, Shigeki Nakagawa, Yo-Ichi Yamashita, Akira Chikamoto, Takatoshi Ishiko, Hideo Baba
BACKGROUND: Several reported complications associated with radiofrequency ablation for liver tumors are due to thermal damage of neighboring organs. We herein report a first case of esophageal perforation due to thermal injury of laparoscopic radiofrequency ablation (RFA). CASE PRESENTATION: A 75-year-old woman was treated repeatedly with RFA (percutaneous and laparoscopic) and transcatheter arterial chemoembolization for hepatocellular carcinoma. One week after laparoscopic RFA for recurrent HCC located in segment 2 of the liver, dysphagia and thoracic pain occurred...
October 10, 2018: Surgical Case Reports
Kazuhiko Morikawa, Shinsuke Takenaga, Koichi Masuda, Asami Kano, Takao Igarashi, Hiroya Ojiri, Kaoru Ueda, Mamoru Ishiyama, Nei Fukasawa
BACKGROUND: A solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs mostly in pleural sites, and an SFT occurring in the ischiorectal fossa is extremely rare. Because of the rarity, there are few reports detailing an SFT in the ischiorectal fossa. CASE PRESENTATION: A pararectal tumor was incidentally found in a 42-year-old man during a routine medical examination. The patient had no symptoms and no previous medical history. In the physical examination, a smooth-margined and hard elastic mass was felt, and in a digital rectal examination, the rectal mucosa appeared normal...
October 3, 2018: Surgical Case Reports
Seita Hagihara, Tetsunosuke Shimizu, Yoshihiro Inoue, Mitsuhiro Asakuma, Fumitoshi Hirokawa, Kohei Taniguchi, Michihiro Hayashi, Kazuhisa Uchiyama
BACKGROUND: Primary duodenal adenocarcinoma (PDC) is a rare and lethal disease, and cases with nodal or distant metastasis have a poor prognosis. There are several reports of unresectable duodenal adenocarcinoma responding to systemic chemotherapy. However, there is little data on conversion surgery for PDC with distant metastasis. CASE PRESENTATION: We report a 55-year-old man with unresectable PDC with liver and nodal metastases responding to systemic chemotherapy with capecitabine and oxaliplatin (XELOX)...
September 29, 2018: Surgical Case Reports
Ryo Muranushi, Hideyuki Saito, Asuka Matsumoto, Toshihide Kato, Naritaka Tanaka, Kenji Nakazato, Nobuhiro Morinaga, Yoshinori Shitara, Masatoshi Ishizaki, Takatomo Yoshida, Shinichi Aishima, Ken Shirabe
BACKGROUND: Intracholecystic papillary neoplasm (ICPN) is defined as papillary tumors detected macroscopically in the gallbladder. We report a case of ICPN which exhibited the atypical form like a submucosal tumor. CASE PRESENTATION: A 70-year-old man was admitted to our hospital because of hepatic disorder. Computed tomography and magnetic resonance imaging showed irregular thickening of the wall within the gallbladder fundus. Because the lesion might have been malignant, we performed laparoscopic cholecystectomy and liver bed resection...
September 27, 2018: Surgical Case Reports
Daigo Kobayashi, Mariko Masubuchi, Tsunenobu Takase, Takahiro Ichikawa, Tomohiro Deguchi, Toyohisa Yaguchi
BACKGROUND: Fournier's gangrene is a necrotizing fasciitis of the genital and perineal region. It may progress, affecting the groin, the thigh, or even the abdominal wall. Despite adequate treatment (debridement and antibiotics), the mortality rate is very high, reaching 20-35%. Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy is very rare. We report this case with a review of the literature. CASE PRESENTATION: A 68-year-old man visited the emergency room due to perineal pain during which he accepted the chemotherapy for locally advanced rectal cancer...
September 26, 2018: Surgical Case Reports
Kanako Kurata, Keisei Anan, Nami Ishikawa, Kenichiro Koga, Michiyo Saimura, Kazuyoshi Nishihara, Toshimitsu Iwashita, Shoshu Mitsuyama, Sadafumi Tamiya, Hideyuki Watanabe, Yutaka Koga, Hidetaka Yamamoto, Yoshinao Oda, Toru Nakano
BACKGROUND: Primary sarcomas of the breast are rare and account for less than 1% of all primary breast malignancies. We experienced a case of extraskeletal osteosarcoma of the breast that had a unique clinical course and remarkable findings of mammography and magnetic resonance imaging (MRI). A review of the case reports published in the past few decades showed no reports of a case in which a calcified lesion was followed up three different times on mammography, making this a valuable case report...
September 19, 2018: Surgical Case Reports
Tsubasa Aiyoshi, Toshihiro Muraji, Isho Izumi, Miki Toma, Kazuto Suda, Toshihiro Yanai, Kouji Masumoto
BACKGROUND: Currently, there is no consensus regarding the optimal therapeutic strategy for the management of an ectopic lingual thyroid. A surgical approach is suggested when airway obstructive symptoms cannot be tolerated at all, or when bleeding or malignancy occurs. However, for patients in whom ectopic thyroid is the only functioning thyroid tissue, complete surgical excision needs to be followed by lifelong hormone replacement therapy. We report the case of an infant with ectopic lingual thyroid obstructing the airway that was treated using our novel surgical procedure...
September 19, 2018: Surgical Case Reports
Osamu Nakahara, Hideo Baba
BACKGROUND: Phosphoglyceride crystal deposition disease (PGDD) is characterized by phosphoglyceride crystal deposition that simulates neoplasia in soft tissue scars or bone. Reports of PGDDs are rare. Here, we present the case of a patient with PGDD in the abdominal wall. CASE PRESENTATION: A 57-year-old Japanese man with worsening right lower abdominal pain had no significant family or occupational history. Laboratory data showed elevated inflammatory markers with a white blood cell count of 14,400 × 109 /L and C-reactive protein of 11...
September 19, 2018: Surgical Case Reports
Hiroyuki Kumata, Ryuichi Nishimura, Chikashi Nakanishi, Chihiro Inoue, Yuta Tezuka, Hidenori Endo, Shigehito Miyagi, Teiji Tominaga, Michiaki Unno, Takashi Kamei
BACKGROUND: Ganglioneuroblastomas, particularly those that produce catecholamine, are extremely rare in adults. Here, we report an interesting surgical case of an adult patient with a catecholamine-producing ganglioneuroblastomas in her adrenal gland, suspected to be a pheochromocytoma, and with a cerebral aneurysm. CASE PRESENTATION: The patient was a 73-year-old woman under treatment for hypertension. During a health check-up, a cystic retroperitoneal tumor was incidentally found in the superior pole of her right kidney...
September 17, 2018: Surgical Case Reports
Ritsuko Sasaki, Yoshiya Horimoto, Ju Mizuno, Yoko Edahiro, Tsukasa Ohmori, Norio Komatsu, Mitsue Saito
BACKGROUND: Acquired von Willebrand syndrome (aVWS) is a rare bleeding disorder with laboratory findings similar to those of congenital von Willebrand disease (VWD). Patients with aVWS may require prophylactic treatment to prevent excessive bleeding following surgery. To our knowledge, to date, there have been no reports on perioperative management for breast cancer patients with aVWS. CASE PRESENTATION: A 60-year-old woman with breast cancer was diagnosed with aVWS due to polycythemia vera...
September 17, 2018: Surgical Case Reports
Sota Kimura, Hiroyuki Iida, Naoto Gunji, Takeshi Gohongi, Takesaburo Ogata
BACKGROUND: Intestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism. CASE PRESENTATION: A 19-year-old man was admitted to our hospital for intermittent abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region...
September 15, 2018: Surgical Case Reports
Takashi Harino, Yoshito Tomimaru, Kozo Noguchi, Hirotsugu Nagase, Takayuki Ogino, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Shingo Noura, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Masashi Yamamoto, Tsutomu Nishida, Hiromi Tamura, Shiro Adachi, Keizo Dono
BACKGROUND: Intraductal papillary-mucinous neoplasms (IPMNs) are potentially malignant intraductal epithelial neoplasms that sometimes penetrate into other organs. To the best of our knowledge, no report has yet described a case with penetration into the spleen. We recently encountered a case of IPMN with penetration of the stomach and spleen that was successfully treated by total pancreatectomy. CASE PRESENTATION: A 70-year-old female visited our hospital with a complaint of fever and abdominal pain...
September 15, 2018: Surgical Case Reports
Makoto Kawamoto, Yoshiyuki Wada, Norihiro Koya, Yuko Takami, Hideki Saitsu, Naoki Ishizaki, Mineo Tabata, Hideya Onishi, Masafumi Nakamura, Takashi Morisaki
BACKGROUND: Gallbladder cancer (GBC) is one of the refractory diseases. Multidisciplinary approach including immunotherapy for such cancers has received much attention in recent years. CASE PRESENTATION: A 59-year-old man underwent an extended cholecystectomy for GBC (pathological stage II, T2 N0 M0, [per UICC 7th edition]) that was incidentally found during cholelithiasis surgery, and was then treated with adjuvant gemcitabine (GEM). Three months later, when a recurrence-suspected lesion was detected in segment 5 (S5) of his liver, we started adoptive immunotherapies with cytokine-activated killer (CAK) cell infusions, combined with chemotherapy...
September 15, 2018: Surgical Case Reports
Takeshi Fujishiro, Taro Mashiko, Yosihito Masuoka, Misuzu Yamada, Daisuke Furukawa, Naoki Yazawa, Yohei Kawashima, Masami Ogawa, Kenichi Hirabayashi, Toshio Nakagohri
BACKGROUND: Pancreatic cancer has a very high mortality rate worldwide, and about 30-40% of all patients have extensive vascular involvement at initial diagnosis that precludes surgical intervention. Here, we describe our experience in a patient with locally advanced pancreatic cancer (LAPC) who underwent R0 conversion surgery after undergoing a combination of chemotherapy and carbon-ion radiotherapy (CIRT), which led to long-term relapse-free survival (23 months). CASE PRESENTATION: A 41-year-old woman presented a month ago with epigastralgia referred to our facility and was subsequently diagnosed with pancreatic cancer cStage III (Ph, TS2 (35 mm), cT4, cCH1, cDU1, cS1, cRP1, cPL1, cVsm0, cAsm1, cN0, cM0) that was also categorized as an unresectable LAPC...
September 10, 2018: Surgical Case Reports
Akiyoshi Nomura, Koji Fukumoto, Masaya Yamoto, Toshiaki Takahashi, Kengo Nakaya, Akinori Sekioka, Yutaka Yamada, Naoto Urushihara
BACKGROUND: A pyriform sinus fistula (PSF) is a rare branchial anomaly that causes recurrent cervical infections. Open neck surgery has widely been accepted as a definitive treatment for PSFs, and endoscopic surgery has been reported in recent years. However, both approaches are not satisfactory because of high recurrence rates and postoperative complications. Microlaryngoscopic surgery (MLS) is a transoral surgical technique involving the use of an operating microscope. In this report, we present a new procedure involving MLS for resection and closure of a PSF without a skin incision...
September 10, 2018: Surgical Case Reports
Sho Endo, Yusuke Watanabe, Yuji Abe, Tomohiko Shinkawa, Sadafumi Tamiya, Kazuyoshi Nishihara, Toru Nakano
BACKGROUND: Hepatic inflammatory pseudotumor (IPT) is a rare benign lesion. Because there is no specific laboratory marker or radiographic appearance, the majority of reported cases of hepatic IPT have been diagnosed after surgery or at autopsy. The etiology of hepatic IPT remains unclear but several mechanisms have been postulated such as infection or immune reaction. CASE PRESENTATION: A 79-year-old woman had been seeing her family doctor for hypertension, and she had been diagnosed with liver dysfunction for about 10 years...
September 10, 2018: Surgical Case Reports
Yuki Nakamura, Kenji Matsuda, Shozo Yokoyama, Koichi Tamura, Yasuyuki Mitani, Hiromitsu Iwamoto, Yuki Mizumoto, Daisuke Murakami, Masakazu Fujimoto, Hiroki Yamaue
BACKGROUND: Alpha-fetoprotein (AFP) is produced by some tumors, such as hepatocellular carcinoma and yolk sac tumors, leading to an increase in serum AFP level. However, AFP in colorectal cancer is extremely rare. Treatment for AFP-producing cancer is often performed according to conventional methods, but oncological outcomes of both surgery and chemotherapy are poor. We report a case of a patient with AFP-producing rectal cancer which successfully responded to preoperative chemoradiotherapy...
September 6, 2018: Surgical Case Reports
Yuya Nobori, Takahiro Amano, Mieko Ochi, Toshio Kumasaka, Eiji Sunami
BACKGROUND: Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract. It is associated with a high risk of malignancy in the gastrointestinal tract, as well as in other organs. We report a case of colon cancer at the anastomotic site that occurred 18 years after high anterior resection of the rectum for intussusception caused by Peutz-Jeghers polyposis. CASE PRESENTATION: A 31-year-old man with PJS, who had undergone high anterior resection of the rectum for intussusception at the age of 12, presented to our hospital complaining of hematochezia...
September 5, 2018: Surgical Case Reports
Toshiaki Takahashi, Hiroshi Nouso, Masaya Yamoto, Koji Fukumoto, Naoto Urushihara
BACKGROUND: Primary adenocarcinoma of the appendix is a rare disease in clinical practice. Moreover, primary adenocarcinoma of the appendix in the pediatric age group is even rarer with very little cases being published. Here, we report a case of primary adenocarcinoma of the appendix with local invasion into adjacent organs in a child who was initially diagnosed as having an acute appendicitis. CASE PRESENTATION: A 13-year-old girl presented with abdominal pain of 3-month duration...
September 4, 2018: Surgical Case Reports
Tetsuya Mochizuki, Tomoyuki Abe, Hironobu Amano, Kenji Nishida, Takuya Yano, Hiroshi Okuda, Tsuyoshi Kobayashi, Hideki Ohdan, Shuji Yonehara, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Portal vein tumor thrombosis from colorectal cancer is rare, and this recurrence pattern was mainly reported in patients with renal cell carcinoma and hepatocellular carcinoma. Furthermore, the recurrence pattern of portal vein tumor thrombosis without liver parenchymal invasion from colorectal carcinoma has not been previously reported. Herein, we present a patient with progressive portal vein tumor thrombosis without liver parenchymal invasion following curative resection...
September 4, 2018: Surgical Case Reports
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