A Rare Case of Solitary Primary and Recurrent Hepatic Epithelioid Hemangioendothelioma Undergoing Repeat Liver Resections

Yuhi Yoshizaki, et al.

INTRODUCTION: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor. Treatment strategy remains controversial because of its rarity. Liver resection is considered as the optimal treatment for solitary HEHE, while a small subset of patients have a solitary tumor. We present the rare case of a patient with solitary primary HEHE who experienced solitary recurrence following liver resection and underwent subsequent liver resection.

Severe Mitral Stenosis and Regurgitation Due to Bioprosthetic Valve Failure with Massive Pannus

Ryota Hara, et al.

INTRODUCTION: Bioprosthetic valve failure after mitral valve replacement is a well-recognized phenomenon, with pannus overgrowth being one notable cause. The standard treatments include redo surgical mitral valve replacement and the less invasive transcatheter treatment, mitral valve-in-valve. However, the feasibility and safety of performing mitral valve-in-valve when pannus overgrowth has reduced the valvular opening to a mere pinhole remains uncertain.

A Rare Case of Ampullary Carcinoma with Complete Duodenal Obstruction as the Initial Manifestation

Yuta Kakizaki, et al.

INTRODUCTION: Obstructive jaundice is often the first symptom of ampullary carcinoma, with a straightforward preoperative diagnosis. We report a rare case of ampullary carcinoma without jaundice as the initial symptom.

Recurrence of Primary Pulmonary Meningioma 10 Years after Surgery: A Case Report

Ting Fang, et al.

INTRODUCTION: Primary pulmonary meningioma (PPM) is an exceptionally rare form of ectopic meningioma, with few cases documented in the literature, and even fewer reports of recurrence following surgical resection.

A Case of Obturator Hernia Involving the Urinary Bladder Discovered Following a Femoral Incarcerated Hernia

Nobuhiro Naito, et al.

INTRODUCTION: Obturator hernias are rare, accounting for 0.05%–1.4% of all hernias, and typically affect elderly, thin women. Bladder hernias, though uncommon, comprise 1%–4% of groin hernias, with bladder herniation through the obturator foramen being extremely rare. We report a case of an obturator hernia involving the urinary bladder, which was incidentally discovered during femoral hernia repair.

Laparoscopic Distal Pancreatectomy for Lymph Node Metastasis around Splenic Artery from Hepatocellular Carcinoma in a Patient with Portal Annular Pancreas

Kyosuke Habu, et al.

INTRODUCTION: Lymph node metastases after hepatocellular carcinoma (HCC) resection exist, although they are not common. However, solitary metastasis to the splenic artery lymph node with suspected pancreatic invasion after HCC resection is rare. In certain cases, surgical resection is performed to improve patient outcomes. We report a case of lymph node metastasis resected by laparoscopic distal pancreatectomy (LDP) in a patient with a unique anatomical anomaly known as portal annular pancreas (PAP).

Surgical Management for Acute Ischemic Colitis Associated with Decompression Sickness

Daisaku Kamiimabeppu, et al.

INTRODUCTION: Ischemic colitis secondary to decompression sickness (DCS) is rare. Here, we present a case of ischemic colitis resulting in bowel necrosis following DCS.

Primary Pulmonary Myxoid Sarcoma Located in the Left Lung Parenchyma: Case Report with a Review of Literature

Keisuke Hanawa, et al.

INTRODUCTION: Primary pulmonary myxoid sarcoma (PPMS) is a very rare low-grade sarcoma. It is known to have a characteristic chromosomal translocation at t(2;22)(q33;q12) and a distinctive genetic alteration, Ewing sarcoma breakpoint region 1 (EWSR1):cAMP response element binding protein 1 fusion. Most cases of PPMS reported so far have been found in the bronchi or bronchioles, and there are only a few cases of them arising from the peripheral lung parenchyma.

Successful Conversion Surgery Following S-1 Plus Oxaliplatin Combined with Nivolumab Therapy for a Preoperatively Diagnosed Gastric Adenocarcinoma with Enteroblastic Differentiation: A Case Report

Mizuki Fukuda, et al.

INTRODUCTION: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare subtype of gastric cancer known for its aggressive nature compared to conventional gastric adenocarcinoma. Due to its rarity and high malignancy, reports of successful medication therapy for Stage IV GAED are scarce. In this case, we report a GAED patient with peritoneal dissemination who responded well to combination chemotherapy with nivolumab, leading to the possibility of conversion surgery.

Gastric Epithelioid Mesenchymal Tumor with the <i>EWSR1::CREM</i> Fusion Gene: A Case Report

Nao Yoshizawa, et al.

INTRODUCTION: In recent years, new molecularly defined tumor groups have been reported among tumors previously considered unclassifiable. Among them, gene fusions involving the CREB family of transcription factors, including cAMP-responsive element modulator (CREM), with genes encoding FET family RNA-binding proteins, such as Ewing sarcoma breakpoint region 1 (EWSR1), have recently been shown to be implicated in driving the pathogenesis of various tumor types. Here, we report our experience with a gastric mesenchymal tumor with epithelioid histology and an EWSR1::CREM fusion, which is rare but requires caution.

General Anesthesia Surgery for Early Breast Cancer in a Patient with Severe Heart Failure due to Dilated Cardiomyopathy: A Case Report

Tomohiro Oshino, et al.

INTRODUCTION: Perioperative mortality is significantly higher in cases of heart failure with severe left ventricular ejection fraction (LVEF) reduction, making it challenging to decide whether to proceed with surgery for early-stage breast cancer, which is not immediately fatal. However, the prognosis of heart failure has improved and breast cancer is increasingly becoming a prognostic factor.

En bloc Right Hemicolectomy with Pancreaticoduodenectomy for Advanced Ascending Colon Cancer

Hiroyuki Takeda, et al.

INTRODUCTION: While simultaneous complex surgical procedures such as right hemicolectomies with pancreaticoduodenectomies (RHPD) may increase overall surgical complexity, complications, and risk of death, it is the only cure for advanced ascending colon cancer (AACC) that has directly invaded the duodenum/pancreas. There are a few reports, especially from Japan. Here, we report an extremely rare case of a patient who underwent RHPD for AACC with direct invasion to the duodenum and liver and describe the patient’s long-term survival after en bloc resection.