Pediatric Focal Nodular Hyperplasia Mimicking Hepatic Metastasis from Wilms Tumor: A Case Report

Wataru Miyoshino, et al.

INTRODUCTION: Focal nodular hyperplasia (FNH) is a rare benign liver lesion in children, representing approximately 2% of pediatric liver tumors and occurring far less frequently than in adults. Preoperative diagnosis is often challenging because FNH can closely mimic malignant or metastatic liver tumors on imaging, particularly in patients with a history of malignancy. Indocyanine green (ICG) fluorescence imaging has emerged as a useful intraoperative navigation tool in pediatric liver surgery; however, its role in distinguishing FNH from metastatic lesions remains underexplored.

Minimally Invasive Cardiac Surgery for Spontaneous Coronary Artery Dissection

Rena Usui, et al.

INTRODUCTION: Published evidence on coronary artery bypass grafting for spontaneous coronary artery dissection (SCAD) is limited, and the optimal surgical strategy for SCAD has not yet been established. We herein report a case of SCAD treated with minimally invasive cardiac surgery coronary artery bypass grafting (MICS-CABG). This is the first case of SCAD treated with MICS-CABG in the literature.

A Giant Solitary Fibrous Tumor of the Pleura Exceeding 15 cm Classified as Low Risk: A Rare Case Report

Yuki Ichikawa, et al.

INTRODUCTION: Solitary fibrous tumors of the pleura (SFTPs) are rare mesenchymal neoplasms that are usually benign but may occasionally recur or undergo malignant transformation. Tumor size is an important prognostic factor; lesions larger than 10 cm are associated with recurrence and poor outcomes, and tumor size ≥15 cm is considered as a risk factor in prognostic models.

Functional Limb Preservation after Surgical Distal Venous Arterialization with Free Flap in Chronic Limb-Threatening Ischemia with Severe Foot Arterial Disease

Chihiro Nakai, et al.

INTRODUCTION: In chronic limb-threatening ischemia (CLTI), especially with diabetes and dialysis dependence, below-the-ankle arterial lesions and severe calcification often limit distal bypass options. While surgical distal venous arterialization (sDVA) can restore perfusion, achieving wound healing requires additional surgical strategies such as free flap transfer to provide adequate soft tissue coverage.

Endoscopic Mini- or Less-Open Sublay Repair in a Patient with a Reduced Pulmonary Function: A Case Report

Sakyo Ohashi, et al.

INTRODUCTION: Endoscopic mini- or less-open sublay (EMILOS) is a minimally invasive extraperitoneal repair technique through a small incision that allows wide mesh placement, which may reduce surgical site infection, postoperative pain, and respiratory compromise. In the present case, we performed umbilical hernia repair using EMILOS in an elderly patient with an impaired pulmonary function, and the procedure was performed safely without major postoperative respiratory complications.

A Rare Case of Adenomyoepithelioma of the Breast Complicated with Cyst Diagnosed by Preoperative Core Needle Biopsy: A Case Report

Keiichi Takahashi

INTRODUCTION: Adenomyoepithelioma (AME) of the breast is a rare benign disease in which glandular epithelial cells and myoepithelial cells proliferate to form a mass. Preoperative diagnosis is considered difficult, and diagnosis by core needle biopsy (CNB) is particularly difficult.

Adult Descending Colon Duplication Mimicking Colon Cancer: A Rare Case Report

Shosaburo Oyama, et al.

INTRODUCTION: Intestinal duplication is a rare congenital anomaly characterized by the presence of a segment of intestinal tissue containing both mucosal and muscular layers adjacent to the normal alimentary tract. Intestinal duplication is most commonly diagnosed in infancy and is rarely observed in adults.

Conversion Liver Resection for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus after Single Tremelimumab Regular Interval Durvalumab Regimen as a Second-Line Therapy: A Case Report

Diyar Akhmet, et al.

INTRODUCTION: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with limited treatment options for advanced, unresectable cases. Although immune checkpoint inhibitors (ICI), particularly the combination of atezolizumab plus bevacizumab (Atezo+Bev), have improved outcomes, many patients ultimately experience disease progression. The single tremelimumab regular interval durvalumab (STRIDE) regimen has emerged as a promising alternative, yet evidence of its efficacy as a second-line therapy remains limited.

A Case Requiring Differential Diagnosis of Synovitis, Acne, Pustulosis, Hyperostosis, Osteomyelitis Syndrome in the Evaluation of Bone Lesions in Early Breast Cancer

Mayuka Mori, et al.

INTRODUCTION: Synovitis, Acne, Pustulosis, Hyperostosis, Osteomyelitis (SAPHO) syndrome is a rare disorder characterized by bone lesions that primarily affect the anterior thoracic wall. These lesions can be difficult to differentiate from bone metastases of malignant tumors. Reports of SAPHO syndrome complicating breast cancer are scarce, necessitating careful diagnostic consideration.

Robot-Assisted Reinforcement with a Free Pericardial Fat Pad for Double-Lumen Tube–Related Injury of the Left Main Bronchus Incidentally Detected during Lobectomy: A Case Report

Michihito Toda, et al.

INTRODUCTION: Tracheobronchial injury associated with double-lumen tube (DLT) placement is rare and typically diagnosed postoperatively. Intraoperative detection of subtle airway lesions is extremely uncommon. We report a case of DLT-related injury of the left main bronchus that was incidentally detected during robot-assisted thoracic surgery (RATS) and successfully reinforced with a free pericardial fat pad.

Emergency Double Valve Replacement for Ruptured Mitral Valve Aneurysm and Annular Abscess Caused by Gemella Morbillorum Endocarditis in a Patient with Bicuspid Aortic Valve: A Case Report

Yoshihiko Onishi, et al.

INTRODUCTION: Mitral valve aneurysm (MVA) is a rare but potentially fatal complication of infective endocarditis (IE), often associated with aortic valve involvement. Gemella morbillorum, a commensal oral bacterium, is an uncommon cause of IE. We report a rare case of MVA rupture with an aortic annular abscess caused by G. morbillorum IE in a patient with bicuspid aortic valve (BAV), successfully managed with emergency valve replacement.

Ureteral Preservation Using Fluorescent Ureteral Catheter during Laparoscopic Resection of an Appendiceal Inflammatory Pseudotumor: A Case Report

Yudai Yagihashi, et al.

INTRODUCTION: When a bulky intra-abdominal tumor cannot be clearly distinguished from a malignancy, careful surgical planning is required to preserve adjacent organs.