Infant with Intralobar and Extralobar Bilateral Pulmonary Sequestration Requiring Simultaneous Resection: A Case Report

Kan Suzuki, et al.

INTRODUCTION: Coexisting bilateral intralobar and extralobar pulmonary sequestration has rarely been reported, with no previous reports indicating that simultaneous resection is necessary because of a common drainage vein.

A Case of Right Hepatic Vein Thrombus with Spontaneous Peripheral Shunt Successfully Treated via Left Trisectionectomy with Bile Duct Resection

Takahiro Shoda, et al.

INTRODUCTION: Left trisectionectomy with bile duct resection is a high-risk procedure that requires thorough preoperative evaluation to prevent postoperative liver failure. In addition, there are a few reports of highly invasive hepatectomy in cases where hepatic vein thrombosis is present preoperatively.

A Case of Esophageal Penetration of a Fish Bone into the Left Atrium Rescued by Urgent Surgery

Norihiko Sakamoto, et al.

INTRODUCTION: Esophageal penetration due to accidental foreign body ingestion is relatively rare but has a poor prognosis. Penetration into the left atrium is extremely rare, and only a few cases have been reported. A case of foreign body penetration into the left atrium is reported.

A Case of Breast Cancer with Cystic Axillary Lymph Node Metastasis

Mariko Yoshino, et al.

INTRODUCTION: Encapsulated papillary carcinoma (EPC) is a relatively rare form of breast cancer and is often low grade. Even in cases of EPC with invasion, it rarely metastasizes. We herein report a case of EPC with invasion that presented with a cystic axillary lymph node metastasis that was highly characteristic on imaging.

Ischiorectal Mass Excision Using Ultrasound-Guided, Wire-Needle Localization

Michael H. Froehlich, et al.

INTRODUCTION: In this work, we describe an unusual presentation of a nuchal-type fibroma, presenting as a mass in the ischiorectal space in an adult male. Since this lesion was not palpable and was in close proximity to the anal sphincter complex, we describe a novel multidisciplinary approach using wire-needle localization with interventional radiology to allow for a directed dissection, similar to an approach used in breast partial mastectomy surgeries.

Hepatocellular Carcinoma Confined to the Bile Duct without Hepatic Mass or Jaundice: A Case Report

Yuto Aoki et al.

INTRODUCTION: Hepatocellular carcinoma (HCC) presents as a hepatic mass and may involve vascular invasion or extrahepatic spread. However, intraductal growth within the intrahepatic bile duct is rare and is often associated with obstructive jaundice. HCCs confined to the intrahepatic bile duct without detectable hepatic mass or jaundice are rare, and diagnosis is often difficult due to clinical and radiological resemblance to perihilar cholangiocarcinoma. Moreover, such cases generally carry a poor prognosis. We report a rare case of HCC that developed exclusively within the intrahepatic bile ducts, without forming a detectable mass in the liver or causing jaundice.

Paradoxical Elevation of Parathyroid Hormone Levels following Preoperative Native Vitamin D Supplementation in a Patient with Graves’ Disease Undergoing Total Thyroidectomy: A Case Report

Hiroyuki Yamashita, et al.

INTRODUCTION: Hypocalcemia is a common complication after total thyroidectomy, particularly in patients with Graves’ disease and high bone turnover. Preoperative vitamin D deficiency is a known risk factor for postoperative hypocalcemia; however, the effects of vitamin D supplementation remain controversial. This is the first study to document a paradoxical increase in parathyroid hormone (PTH) levels after preoperative vitamin D supplementation in a patient undergoing total thyroidectomy.

Left Lower Lobectomy for Lung Cancer Complicated by Unilateral Absence of the Left Pulmonary Artery: A Case Report

Sakiko Sato, et al.

INTRODUCTION: Unilateral absence of the pulmonary artery (UAPA) is a rare congenital vascular anomaly, often diagnosed in childhood but sometimes remaining asymptomatic until adulthood. Its coexistence with primary lung cancer is exceptionally uncommon. Surgical resection in such cases poses risks due to absence of the pulmonary artery and hypertrophied systemic vessels, which may lead to bleeding or ischemic complications.

Anatomical Hepatectomy in a Patient with Situs Inversus Totalis and Right-Sided Round Ligament

Makoto Shinzeki, et al.

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital anomaly characterized by mirror-image reversal of the entire thoracoabdominal viscera. Right-sided round ligament (RSRL) is another rare congenital anomaly often associated with intrahepatic vascular variations. The coexistence of these 2 anomalies is extremely rare and presents a significant challenge for hepatectomy. Here, we report a case of anatomical hepatectomy performed in a patient with SIT and RSRL.

Extremely Rare Co-occurrence of Left Gastroschisis-Like Abdominal Wall Defect and an Omphalocele in a Very Low Birth Weight Infant: A Case Report

Teizaburo Mori, et al.

INTRODUCTION: Gastroschisis is almost always a small, right-sided, periumbilical, abdominal wall defect, and its occurrence on the left side of the umbilicus is extremely rare. Furthermore, omphaloceles and gastroschisis usually do not co-occur. The present report is the 2nd worldwide to describe the co-occurrence of an omphalocele and left gastroschisis-like abdominal wall defect.

The First Case of Liver–Intestine En-Bloc Transplantation in Japan

Hiroyuki Ogasawara, et al.

INTRODUCTION: Simultaneous liver–intestine transplantation is indicated for intestinal failure associated liver disease (IFALD), which can be caused by conditions such as intestinal motility disorders or short bowel syndrome. Currently, the most common grafts for liver–intestine transplantation are multivisceral transplantation (MVT) grafts consisting of the liver, stomach, duodenum, pancreas, small intestine, and colon, or liver–intestine grafts derived from the MVT graft but without the stomach. However, at the time of transplantation in the present case, Japanese regulations did not permit simultaneous pancreas transplantation in a non-diabetic recipient, which is generally required for this type of graft. Therefore, in the 2 previously reported domestic cases, the liver and intestine grafts were transplanted separately as non-composite grafts. Early in the development of MVT, liver–intestine grafts, excluding the stomach, duodenum, and pancreas, were used. We adopted this graft configuration for a 14-year-old female with megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) complicated by IFALD and performed, for the 1st time in Japan, a composite liver–intestine transplantation under existing regulations.

Multidisciplinary Treatment for Cecal Cancer and Metachronous Liver Metastases in a Patient with Primary Autoimmune Neutropenia

Kyoichi Okawa et al.

INTRODUCTION: Autoimmune neutropenia (AIN) is a rare disease that causes neutropenia due to autoantibodies directed against neutrophils. Neutropenia is associated with an increased risk of infection, such as surgical site infection or febrile neutropenia. To our knowledge, however, there are few reports of surgical or neoadjuvant chemotherapeutic treatments for colorectal cancer with AIN. Herein, we present a case with AIN undergoing multidisciplinary treatment of cecal cancer and metachronous liver metastases.