Recurrence of Transverse Colon Cancer in Diverticulum 14 Years after Endoscopic Mucosal Resection: A Case Report

Kazuki Shimomura, et al.

INTRODUCTION: Carcinoma arising from a colonic diverticulum is extremely rare, with only 21 cases being reported in the literature. Accurate pathological assessment of lesions within diverticula is often challenging due to distortion or discontinuity of the muscularis mucosae, which may lead to misjudgment of invasion depth and inappropriate therapeutic decisions.

A Case of Sigmoid Colon Cancer with Patent Foramen Ovale and Left-Sided Inferior Vena Cava Initially Detected during the Workup for Cerebral Infarction

Yusuke Yoshida, et al.

INTRODUCTION: Patent foramen ovale (PFO) is present in approximately 25% of adults, whereas a left-sided inferior vena cava (IVC) is a rare congenital vascular anomaly. Both conditions are associated with thromboembolic risk; however, their coexistence in patients with colorectal cancer has not been reported. We report a rare case of sigmoid colon cancer complicated by PFO and left-sided IVC, initially detected during the diagnostic workup for cerebral infarction.

Rapid Development of Diffuse-Type Remnant Pancreatic Cancer Following Obstructive Pancreatitis after Pancreaticoduodenectomy for Distal Bile Duct Carcinoma: A Case Report

Atsushi Tomioka, et al.

INTRODUCTION: Distal bile duct carcinoma (DBDC) and pancreatic ductal adenocarcinoma (PDAC) are aggressive malignancies; however, their metachronous occurrence within a short postoperative timeframe is extremely rare. We present an extremely rare case of diffuse-type PDAC that rapidly developed only 16 months after curative resection of DBDC.

Robot-Assisted Distal Pancreatectomy for Pancreatic Cancer with Type IIIa Portal Annular Pancreas Using a Novel Strategy of Ventral Pancreas Preservation: A Case Report

Toru Noso, et al.

INTRODUCTION: Portal annular pancreas (PAP) is a rare congenital anatomical variation, first reported in 1987, characterized by an uncinate process encircling the portal vein and fusing with the pancreatic body. While often asymptomatic, the presence of PAP poses a significant technical challenge during pancreatectomy because of its altered anatomy and the elevated risk of postoperative pancreatic fistula (POPF). Consensus is lacking on the optimal pancreatic transection method (1- or 2-cut margin approach) to minimize this complication. We report the first documented case of robot-assisted distal pancreatectomy (DP) for pancreatic cancer in a patient with PAP, highlighting a novel surgical strategy for pancreatic division.

Surgical Management of a Left Main Coronary Trunk-Adjacent Functional Cardiac Paraganglioma Using Proactive Coronary Artery Bypass Grafting: A Case Report

Kenichi Morimoto, et al.

INTRODUCTION: Cardiac paragangliomas are exceptionally rare and often functional tumors that frequently arise near the aortic root and proximal coronary arteries. Complete excision is the only potentially curative treatment, but lesions adjacent to the left main coronary trunk (LMT) pose a major surgical dilemma: achieving oncologic radicality while preserving coronary perfusion and controlling massive bleeding.

Simultaneous Celiac and Pancreaticoduodenal Artery Aneurysms in Median Arcuate Ligament Syndrome: Successful Long-Term Management via Staged Hybrid Treatment

Shoji Takagi, et al.

INTRODUCTION: Median arcuate ligament syndrome (MALS) is characterized by chronic mesenteric ischemia resulting from external compression of the celiac artery (CA). While rare, this compression can alter local hemodynamics, potentially leading to the formation of visceral artery aneurysms. Although pancreaticoduodenal artery (PDA) aneurysms are a known collateral complication, the concurrent presentation of a poststenotic CA aneurysm and a collateral PDA aneurysm is exceedingly rare. We report the long-term outcomes of a patient with MALS complicated by simultaneous aneurysms of both the CA and the PDA.

Synchronous Double Primary Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: A Case Report

Takahiro Yoshimura, et al.

INTRODUCTION: Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) are the most common and second most common primary liver cancers, respectively. In contrast, double primary hepatic cancer (DPHC), the synchronous occurrence of these two tumors in different locations of the liver, is an uncommon pathology, occurring in less than 0.8% of all liver malignancies.

Quintuple Primary Cancers Including Intraductal Papillary Mucinous Carcinoma: A Case Report

Taiki Mori, et al.

NTRODUCTION: The incidence of multiple primary malignancies has increased owing to advances in cancer screening and treatment. However, cases involving five distinct primary cancers remain extremely rare. Intraductal papillary mucinous neoplasms (IPMNs) are known to be associated with extrapancreatic malignancies. We report a very uncommon case of quintuple primary cancers, including noninvasive intraductal papillary mucinous carcinoma (IPMC), and discuss its clinical implications.

A Rare Case of Small Bowel Volvulus with Chylous Ascites Presumed to Be Caused by Multiple Congenital Adhesions in a Virgin Abdomen: A Case Report and Literature Review

Takahiko Omameuda, et al.

INTRODUCTION: Chylous ascites is an uncommon condition resulting from triglyceride-rich lymphatic fluid leakage into the peritoneal cavity and is typically diagnosed when the ascitic triglyceride level is ≥200 mg/dL. Small bowel volvulus is an uncommon surgical emergency, and its coexistence with chylous ascites is particularly rare. Postoperative adhesions are a common cause of small bowel volvulus; however, small bowel volvulus caused by adhesions presumed to be congenital in a virgin abdomen is infrequently reported. Herein, we report a case of small bowel volvulus associated with chylous ascites in which the adhesions were most consistent with congenital origin, although definitive differentiation was not possible.

Efficacy of a Laparoscopic Approach in Treating Gangrenous Ischemic Colitis: A Case Report

Megumi Sugai, et al.

INTRODUCTION: Ischemic colitis (IC) is one of the most common ischemic disorders of the gastrointestinal tract. Although most cases can be managed conservatively, some progress to the gangrenous form requiring surgical intervention. Emergency surgery for gangrenous IC has typically been performed via laparotomy.

A Case of Paget’s Disease of the Breast without a Nipple Lesion

Yukari Koga, et al.

INTRODUCTION: Paget’s disease of the breast is generally associated with breast cancer involving the epithelium of the nipple and frequently extends into the areola or surrounding epidermis. Although it classically presents as a nipple lesion, recent diagnostic frameworks recognize that Paget’s disease may rarely occur without overt nipple involvement. We report a rare case of Paget’s disease of the breast without a nipple lesion.

Coexisting Sarcoid Reaction and Sarcoidosis Requiring Differentiation from Pancreatic Adenocarcinoma Recurrence: A Case Report

Ryo Horie, et al.

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) is one of the most severe malignant tumors. The recurrence rate is high, even after radical surgery. A sarcoid reaction is a histological finding that occurs in the lymph nodes in response to malignant tumors, infections, or foreign substances. Its histopathology is similar to that of sarcoidosis. Here, we report a case of coexist ing sarcoid reaction and sarcoidosis that required differentiation from PDAC recurrence.