Laparoscopic Distal Gastrectomy Using Multimodal Visualization in a Patient with Situs Inversus Totalis and a Duplicated Portal Vein: A Case Report

Takahiro Otani, et al.

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital condition characterized by the complete mirror-image transposition of the thoracic and abdominal organs. Although arterial anomalies in SIT have been reported, venous anomalies, particularly those involving the portal venous system, are extremely rare and may increase the technical difficulty of minimally invasive surgery. We report a case of laparoscopic distal gastrectomy in a patient with SIT accompanied by a duplicated portal vein (DPV).

Epidermoid Cysts in an Intrapancreatic Accessory Spleen Mimicking Pancreatic Neoplasms: Two Case Reports and a Literature Review of Japanese Cases

Xiufeng Li, et al.

INTRODUCTION: Epidermoid cyst(s) arising in an intrapancreatic accessory spleen (ECIPAS) are rare benign lesions that often mimic pancreatic cystic neoplasms on imaging studies. Owing to their rarity and nonspecific radiological features, ECIPAS are frequently misdiagnosed preoperatively, leading to unnecessary pancreatic resections.

Mesenteric Fat Necrosis Mimicking a Malignant Mesenteric Tumor: A Case Report

Aoki Uchikoshi, et al.

INTRODUCTION: Mesenteric fat necrosis, an uncommon benign condition, can present as a mass-forming lesion and can closely mimic malignant mesenteric disease on imaging. Because its radiologic findings may overlap with those of malignant mesenteric tumors, preoperative diagnosis can be challenging, particularly when tissue sampling is difficult. This report describes a rare case of mesenteric fat necrosis, presenting as an enlarging mesenteric mass suspicious for malignancy

Tailored Management of Anomalous Systemic Arterial Supply to the Basal Segment of the Lung: A Case Report and Literature Review

Shunsuke Mori, et al.

INTRODUCTION: Parenchyma-preserving strategies for anomalous systemic arterial supply to the basal segment of the lung have gained increasing attention. However, pulmonary infarction of the preserved lung has been reported, and clear criteria for selecting the optimal treatment have yet to be established. We report 2 cases in which detailed preoperative imaging informed tailored management—right posterior basal segmentectomy in 1 patient and endovascular embolization of the aberrant artery in the other—both without postoperative complications. A review of the relevant literature is also provided, with an emphasis on potential selection criteria.

Preperitoneal Myelolipoma Occurring after Video-Assisted Thoracoscopic Surgery for Thymoma: A Case Report

Chikara Nakagami, et al.

INTRODUCTION: Myelolipoma is a benign tumor composed of mature adipose tissue and hematopoietic elements that typically arises in the adrenal glands, and involvement of the anterior abdominal region is extremely uncommon. We report a rare case of myelolipoma arising in the subxiphoid preperitoneal region adjacent to the site where a sternum-lifting device had been placed during previous surgery.

Mediastinoscopic Esophagectomy for Esophageal Cancer with Right Aortic Arch: A Case Report

Ryoma Taketo et al.

INTRODUCTION: Esophageal cancer with a right aortic arch (RAA) is rare and technically demanding because anomalous vascular anatomy and altered recurrent laryngeal nerve (RLN) courses complicate safe dissection. While thoracoscopic approaches have been reported, this is the first report of mediastinoscopic esophagectomy for thoracic esophageal cancer with an RAA and a Kommerell’s diverticulum (KD).

Utility of Narrow-Band Imaging during Intraoperative Colonoscopy for Colon Tumor Localization: A Report of Two Cases

Mitsuki Nakazawa, et al.

INTRODUCTION: Accurate intraoperative localization of colonic tumors is essential to ensure appropriate resection margins, particularly in laparoscopic surgery where tactile feedback is limited. Intraoperative colonoscopy combined with narrow-band imaging (NBI) may facilitate precise delineation of tumor borders, but its clinical utility remains underreported.

Chronic Thrombosed Abdominal Aortic Aneurysm Treated by Endovascular Aneurysm Repair Using Bifurcated Endograft: A Case Report

Mitsuru Nakanishi, et al.

INTRODUCTION: Thrombosed abdominal aortic aneurysms (AAAs) are rare. Owing to technical difficulties and concerns regarding inadequate device deployment, open surgical repair (OSR) has traditionally been performed rather than endovascular aneurysm repair (EVAR).

Primary Extrahepatic Biliary Mucinous Cystic Neoplasm Suspected Preoperatively and Treated by Robotic Pancreaticoduodenectomy: A Case Report

Yukihiro Shimogata, et al.

INTRODUCTION: Biliary mucinous cystic neoplasm (MCN) is a cystic tumor characterized by ovarian-like stroma and is recognized as a neoplasm with the potential for invasive carcinoma. While MCNs predominantly occur in the pancreas, primary occurrence in the extrahepatic bile duct is exceedingly rare. Most reported cases are diagnosed postoperatively due to the lack of specific clinical symptoms, the difficulty in preoperative differentiation from other cystic diseases, such as intraductal papillary neoplasm of the bile duct, and the strict requirement of pathological evaluation for definitive diagnosis.

Upfront Cytoreductive Surgery as a Bridge to Systemic Therapy for Recurrent Peritoneal Dissemination of Ovarian Angiosarcoma: A Pediatric Case Report

Masanaga Matsumoto, et al.

INTRODUCTION: Ovarian angiosarcoma is exceptionally rare, especially considering those few pediatric cases that have been reported, and displays a poor outcome. Recurrent peritoneal dissemination of ovarian angiosarcoma is generally managed with systemic therapy, but refractory malignant ascites may compromise performance status and hinder treatment delivery. Herein, we report a pediatric case in which upfront cytoreductive surgery (CRS) controlled refractory ascites and enabled subsequent systemic therapy for recurrent peritoneal dissemination.

High-Resolution CT–Based Virtual Simulation of an Unruptured Sinus of Valsalva Aneurysm for Aortic Root Reimplantation: A Case Report

Haruo Yamauchi, et al.

INTRODUCTION: Valve-sparing aortic root replacement (VSRR) for sinus of Valsalva aneurysm (SVA) is rarely reported due to technical challenges. In this case report, high-resolution CT data were used for 3D computer graphics (3DCG) visualization and precise measurement of aortic root geometry, facilitating VSRR in a patient with a markedly disproportionate, unruptured SVA.

Coexistence of Primary Colorectal Cancer and Multiple Colonic Metastases from Pancreatic Tail Cancer: A Case Report

Marina Uemura, et al.

INTRODUCTION: Colonic metastasis from pancreatic cancer is extremely rare. Distinguishing metastatic pancreatic cancer from primary colorectal cancer is clinically important because the therapeutic strategies differ substantially. We report an exceptionally rare case of pancreatic tail cancer with multiple colonic metastases coexisting with primary colorectal cancer.