Necrotic Thymoma Discovered Due to Subjective Symptoms: A Report of Three Cases

Takuya Tokunaga, et al.

INTRODUCTION: Thymomas are solid tumors that usually grow slowly and rarely cause symptoms or spontaneously regression. We have observed three cases of thymoma in which the patient presented with fever and chest pain, and pathological examination showed relatively extensive necrosis. The tumors spontaneously shrank during the course of the diseases.

Successful Emergency Stenting of a Visceral Branch Prior to Central Aortic Repair in Type A Aortic Dissection with Mesenteric Malperfusion: A Case Report

Sho Akita, et al.

INTRODUCTION: Stanford Type A acute aortic dissection (AAD) complicated by mesenteric malperfusion has a mortality rate exceeding 60%. Conventional immediate central aortic repair may be inadequate in such complex cases. Emerging evidence suggests that a staged approach may improve outcomes.

Evaluating Tumor Dynamics Using Circulating Tumor DNA in the Rare Cancer Anorectal Malignant Melanoma: A Report of Two Cases

Goro Takahashi et al.

INTRODUCTION: Anorectal malignant melanoma (ARMM) is an extremely rare and aggressive cancer that lacks specific tumor markers, making tumor dynamics difficult to monitor. Circulating tumor DNA (ctDNA), which contains cancer-specific gene mutations, has emerged as a promising biomarker for monitoring various malignant tumors. We herein report the clinical utility of ctDNA measurements in 2 patients with ARMM.

A Case of Ascending Colon Perivascular Epithelioid Cell Tumor Presenting with Intestinal Intussusception: Case Report

Mitsuki Yokota, et al.

INTRODUCTION: Perivascular epithelioid cell tumors (PEComas) arising from the colon are uncommon. This case report describes a 40-year-old woman who presented with lower abdominal pain and was subsequently diagnosed with a colonic PEComa causing intestinal intussusception.

Middle Pancreatectomy for Traumatic Main Pancreatic Duct Injury with Delayed Presentation: Two Case Series

Yuki Itagaki, et al.

INTRODUCTION: Pancreatic trauma is an uncommon, yet potentially lethal condition, with main pancreatic duct (MPD) disruption guiding surgical management. Middle pancreatectomy (MP) with Roux-en-Y pancreatojejunostomy (PJ) offers an organ-preserving alternative to distal pancreatectomy, particularly for young patients. However, the extent of its applicability and the specific surgical techniques—including key technical tips—remain unclear in the context of traumatic pancreatic injury. This is especially true in cases of delayed presentation, where severe intra-abdominal inflammation further complicates surgical intervention.

Spontaneous Rupture of Solid Pseudopapillary Neoplasm of the Pancreas: A Case Report and Literature Review

Yuta Nakaguchi, et al.

INTRODUCTION: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare tumors, accounting for 1%–3% of all pancreatic tumors, with a predilection for young women. Owing to their often asymptomatic nature, SPNs are typically discovered incidentally. Spontaneous rupture of SPNs is extremely rare, with few reported cases. Herein, we report a case of spontaneous SPN rupture and review the literature on similar cases.

Immune Checkpoint Inhibitors for Microsatellite Instability High Unresectable Obstructive Colon Cancer: A Report of Two Cases

Goro Takahashi, et al.

INTRODUCTION: Patients with obstructive colon cancer (OCC) with distant metastases often present with a poor general condition, including malnutrition, anemia, and systemic inflammation. Traditionally, these patients undergo stoma creation and/or primary tumor resection followed by systemic chemotherapy. However, for patients with DNA mismatch repair-deficient/microsatellite instability high (dMMR/MSI-H) colorectal cancer, the emergence of immune checkpoint inhibitors (ICIs) has revolutionized treatment strategies, with remarkable antitumor effects. We report two cases of successful management of MSI-H OCC, achieving curative resection while avoiding decompressive procedures, including colostomy creation.

Laparoscopic Hiatal Repair and Gastropexy without Fundoplication of Hiatal Hernia in Elderly Patients with High Dysphagia Score: A Case Series of Four Patients

Shinya Urakawa, et al.

INTRODUCTION: Hiatal repair with fundoplication for hiatal hernia (HH) could cause postoperative dysphagia. In the aging society, the number of patients with HH type III/IV and severe dysphagia is increasing. In this case, the surgical priority is to resolve the dysphagia. Recent papers have reported that laparoscopic hiatal repair without fundoplication can be an alternative procedure. Nevertheless, the indication for hiatal repair without fundoplication should be carefully considered.

Successful Prevention of Bronchopleural Fistula in Single-Stage Esophagectomy and Right Lower Lobectomy: A Case Report

Tomonari Oki, et al.

INTRODUCTION: Bronchopleural fistulae (BPFs) following pulmonary resection are potentially fatal complications, with right lower lobectomy being the most susceptible among lobectomies. As esophagectomy also increases the risk of tracheobronchial ischemia and postoperative malnutrition, performing a single-stage esophagectomy combined with right lower lobectomy may further elevate the risk of BPFs, underscoring the need for meticulous preoperative planning.

A Synchronous Gastric Intramural Metastasis from Multiple Gastric Cancers

Daisuke Horikawa et al.

INTRODUCTION: Although intramural metastasis has been reported in esophageal cancer, it is extremely rare in gastric cancer. In this report, we describe a case of gastric intramural metastasis in a patient with multiple gastric cancers.

Laparoscopic Surgery via an Inferior Pancreatic Border Approach for Median Arcuate Ligament Syndrome after Distal Gastrectomy: A Case Report

Kazuki Nishino et al.

INTRODUCTION: Median arcuate ligament syndrome (MALS) is a relatively rare condition characterized by compression of the celiac artery and neural plexus by the median arcuate ligament. The definitive treatment is surgical division of the median arcuate ligament, which can be performed via open, laparoscopic, or retroperitoneoscopic surgery. In laparoscopic surgery, this approach commonly involves reaching the root of the celiac artery from the superior border of the pancreas to divide the median arcuate ligament. We herein report a case of MALS following gastrectomy, in which the median arcuate ligament was successfully divided using a laparoscopic approach from the inferior border of the pancreas.

Malignant Triton Tumor of the Ileocolic Mesentery with Neurofibromatosis Type 1: A Case Report and Literature Review

Kenichi Ishibayashi, et al.

INTRODUCTION: Malignant triton tumors (MTTs) are rare tumors histologically defined as malignant peripheral nerve sheath tumors with additional rhabdomyoblastic differentiation. MTTs occur more frequently in patients with neurofibromatosis type 1 (NF1). MTTs are most commonly found in the extremities, head and neck, and trunk; however, no cases in the mesentery have been reported. In this report, we describe a case of primary MTT of the mesentery in a patient with NF1.