Small-Intestinal Metastasis from Breast Cancer Presenting with Gastrointestinal Bleeding: A Case Report

Ryo Hamaoka, et al.

INTRODUCTION: Gastrointestinal metastases from breast cancer are rare, especially in the small intestine, and diagnosis is often difficult due to nonspecific symptoms and limited detectability with standard endoscopy. Intestinal bleeding, although uncommon, may become clinically significant. We report a case of recurrent triple-negative breast cancer in which persistent anemia during sacituzumab govitecan (SG) therapy was attributed to small-bowel metastasis, and small-bowel evaluation using capsule endoscopy and balloon-assisted enteroscopy led to the diagnosis after standard upper and lower endoscopy failed to identify the source of bleeding.

A Case of Iatrogenic Benign Cyst Infection Arising at the Anastomosis after Functional End-to-End Anastomosis for Cecal Cancer

Hiromitsu Imataki, et al.

INTRODUCTION: Implantation cysts are iatrogenic cystic lesions that develop at anastomotic sites, most commonly following double-stapling technique anastomoses.

A Case of Robot-Assisted Ileocecal Resection for Ascending Colon Cancer with Ileocolic Vein Flowing into the Jejunal Vein: Case Report

Kyoko Kobayashi, et al.

INTRODUCTION: Anatomical vascular variations are frequently observed in the right colon. The ileocolic vein (ICV) typically drains directly into the superior mesenteric vein (SMV). When vascular anomalies are present, surgical procedures often differ from standard techniques, which frequently increases the difficulty of the operation. Therefore, preoperative confirmation of vascular variations is essential. Here, we present a case of ascending colon cancer in which a rare variation in the ICV was diagnosed preoperatively.

A Case with a Pathological Course Resembling Ulcerative Colitis after Rectal Cancer Surgery with Diversion

Tadaaki Shimizu, et al.

INTRODUCTION: The development of de novo ulcerative colitis (UC) is rare after colorectal cancer surgery. In contrast, diversion colitis is a common inflammatory condition of the defunctionalized colon following stoma creation, often complicating postoperative diagnosis.

A Case of Contralateral Left Main Bronchial–Esophageal Fistula Following Right Lower Lobectomy with Systematic Mediastinal Lymph Node Dissection

Toshiki Tanigawa, et al.

INTRODUCTION: Bronchial or tracheobronchial esophageal fistula following pulmonary resection is a rare complication, and involvement of the contralateral main bronchus is extremely uncommon.

Robot-Assisted Ileocecal Resection for Cecal Cancer with a Common Trunk of the Middle Colic and Ileocolic Arteries: A Case Report

Yasuki Akiyama, et al.

INTRODUCTION: Vascular variations around the superior mesenteric vessels increase the technical difficulty and risk of injury during right-sided colon surgery. We report a rare case of cecal cancer with a common arterial trunk formed by the middle colic artery (MCA) and ileocolic artery (ICA) treated by robot-assisted surgery.

Hyperprogression after Anti-Programmed Death-1 Therapy in a Case of Sigmoid Colon Cancer with Lynch Syndrome

Ryota Miura, et al.

INTRODUCTION: Lynch syndrome is a hereditary condition caused by germline defects in mismatch repair (MMR) genes, resulting in microsatellite instability-high (MSI-H) tumors. Immune checkpoint inhibitors (ICIs) have demonstrated efficacy in the treatment of MSI-H advanced cancers. However, hyperprogressive disease (HPD) following ICI therapy is a rare and paradoxical phenomenon. We report a case of advanced sigmoid colon cancer associated with Lynch syndrome that developed HPD after pembrolizumab treatment.

Radiation-Associated Angiosarcoma of the Breast: A Case Report with Review of Reported Cases in Japan

Eri Ida, et al.

INTRODUCTION: Radiation-associated angiosarcoma of the breast (RAASB) is an extremely rare but serious complication that can occur several years after breast-conserving surgery and adjuvant radiotherapy. Owing to its rarity and nonspecific cutaneous manifestations, the diagnosis of RAASB is often delayed. There is no established treatment for RAASB, and its prognosis remains poor.

First Japanese Experience of Robotic-Assisted Low Anterior Resection Using the da Vinci 5: Incorporating Force Feedback and Case Insights in Rectal Cancer Surgery

Yuka Iwami, et al.

NTRODUCTION: Colorectal cancer outcomes depend not only on disease stage but also on surgical quality, particularly in locally advanced rectal cancer. Robot-assisted surgery offers advantages over laparoscopy but lacks haptic feedback. The da Vinci 5 Surgical System introduces Force Feedback (FFB) technology, which transmits kinesthetic sensations to the surgeon and quantifies forces, as well as Case Insights, an artificial intelligence–based intraoperative data platform. To the best of our knowledge, this report describes the first case of robot-assisted low anterior resection for rectal cancer performed in Japan using da Vinci 5.

Delayed Strangulated Right Diaphragmatic Hernia after Retroperitoneal Tumor Resection with Hepatectomy: A Case Report

Naoki Kawahara, et al.

INTRODUCTION: Delayed iatrogenic diaphragmatic hernia after abdominal surgery is an uncommon complication; however, cases occurring after hepatectomy are relatively more commonly reported in the literature. Such hernias often develop after a significant latency period, but may progress to life-threatening emergencies, including bowel strangulation. Here, we report a rare case of delayed right diaphragmatic hernia following hepatectomy.

Complete Thoracoscopic Sublobar Resection for Intralobar Pulmonary Sequestration Using Indocyanine Green Fluorescence: A Case Report with Literature Review

Kaoru Kondo, et al.

INTRODUCTION: Intralobar pulmonary sequestration (IPS) is a congenital pulmonary anomaly supplied by an aberrant systemic artery. Although surgical resection is the standard treatment, complete thoracoscopic lung-preserving (sublobar) resection can be technically demanding because the border between normal and sequestrated lung may be unclear, particularly in the presence of inflammation or pleural adhesions. Indocyanine green (ICG) fluorescence imaging provides real-time perfusion-based demarcation without requiring lung inflation. We present a case of IPS treated by complete thoracoscopic sublobar resection under ICG guidance and review the literature to clarify the role of ICG in complete thoracoscopic lung-preserving surgery for IPS.

Balloon Fracture Fenestration after Frozen Elephant Trunk Deployment to Eliminate Retrograde False-Lumen Perfusion in a Type B Dissection–Complicated Arch Aneurysm

Daichi Takagi, et al.

INTRODUCTION: Arch or proximal descending aortic aneurysms complicated by Stanford type B aortic dissection (TBAD) may require extensive open repair with an open proximal anastomosis. Although a staged modified elephant trunk strategy is a reasonable option, the need to undergo two major operations is burdensome. The frozen elephant trunk (FET) technique enables concomitant treatment of the descending aorta after arch replacement; however, persistent retrograde false-lumen perfusion may result in incomplete aneurysm exclusion and inadequate aortic remodeling. We report a single-stage approach using adjunctive balloon fracture fenestration after FET deployment.