Pub Date : 2025-04-23DOI: 10.1016/j.sycrs.2025.100120
Afaq Ahmad , Lal Rehman , Uswa Hasana , Humaira Bashir , Muhammad Uzair , Maria Amin
A giant occipital encephalocele involves the herniation of brain tissue through a skull defect—a condition that poses significant surgical challenges and demands detailed planning. A 20-day-old neonate, born to non-consanguineous parents, presented with an occipital swelling measuring 21 × 18 cm. CT imaging confirmed the diagnosis of encephalocele. Guided by thorough preoperative imaging and planning, the surgical team carefully excised the dysplastic brain tissue. The operation proceeded without any complications. This case highlights the critical importance of precise anesthesia management and surgical planning, particularly in positioning the neonate in a way that safeguards the airway. It also reinforces the preventive value of folic acid supplementation during the pre-conception and early pregnancy periods to help lessen the risk of neural tube defects.
{"title":"Giant occipital encephalocele in a 20-day old neonate: A case report","authors":"Afaq Ahmad , Lal Rehman , Uswa Hasana , Humaira Bashir , Muhammad Uzair , Maria Amin","doi":"10.1016/j.sycrs.2025.100120","DOIUrl":"10.1016/j.sycrs.2025.100120","url":null,"abstract":"<div><div>A giant occipital encephalocele involves the herniation of brain tissue through a skull defect—a condition that poses significant surgical challenges and demands detailed planning. A 20-day-old neonate, born to non-consanguineous parents, presented with an occipital swelling measuring 21 × 18 cm. CT imaging confirmed the diagnosis of encephalocele. Guided by thorough preoperative imaging and planning, the surgical team carefully excised the dysplastic brain tissue. The operation proceeded without any complications. This case highlights the critical importance of precise anesthesia management and surgical planning, particularly in positioning the neonate in a way that safeguards the airway. It also reinforces the preventive value of folic acid supplementation during the pre-conception and early pregnancy periods to help lessen the risk of neural tube defects.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report highlights a rare instance of fibrosarcomatous dermatofibrosarcoma protuberans of the scalp with extension to the brain. Dermatofibrosarcoma protuberans is a slow-growing, locally aggressive soft tissue tumor. Fibrosarcomatous dermatofibrosarcoma protuberans is a rare and more aggressive variant of dermatofibrosarcoma protuberans. Fibrosarcomatous transformation in dermatofibrosarcoma protuberans is observed in only 5 % of cases. Although the recurrence rate is higher, metastasis and local extension are rarely seen, and intracranial extension is also uncommon. Clinically, fibrosarcomatous dermatofibrosarcoma protuberans is indistinguishable from classical dermatofibrosarcoma protuberans; hence, histopathological examination remains the cornerstone for definitive diagnosis. Histopathological examination reveals that areas of classical dermatofibrosarcoma protuberans show tumor cells arranged in a monotonous storiform pattern with a lack of circumscription, while areas with fibrosarcomatous transformation exhibit spindle cells arranged in a herringbone pattern, which are negative for CD34 on immunohistochemistry.
{"title":"Fibrosarcomatous dermatofibrosarcoma protuberans of the scalp, extending to the brain – A rare case report","authors":"Kavya Varshney , Naveen Kumar , Charanjeet Ahluwalia , Sunil Ranga","doi":"10.1016/j.sycrs.2025.100113","DOIUrl":"10.1016/j.sycrs.2025.100113","url":null,"abstract":"<div><div>This case report highlights a rare instance of fibrosarcomatous dermatofibrosarcoma protuberans of the scalp with extension to the brain. Dermatofibrosarcoma protuberans is a slow-growing, locally aggressive soft tissue tumor. Fibrosarcomatous dermatofibrosarcoma protuberans is a rare and more aggressive variant of dermatofibrosarcoma protuberans. Fibrosarcomatous transformation in dermatofibrosarcoma protuberans is observed in only 5 % of cases. Although the recurrence rate is higher, metastasis and local extension are rarely seen, and intracranial extension is also uncommon. Clinically, fibrosarcomatous dermatofibrosarcoma protuberans is indistinguishable from classical dermatofibrosarcoma protuberans; hence, histopathological examination remains the cornerstone for definitive diagnosis. Histopathological examination reveals that areas of classical dermatofibrosarcoma protuberans show tumor cells arranged in a monotonous storiform pattern with a lack of circumscription, while areas with fibrosarcomatous transformation exhibit spindle cells arranged in a herringbone pattern, which are negative for CD34 on immunohistochemistry.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-17DOI: 10.1016/j.sycrs.2025.100112
Kerim Deniz Batun , Ahmet Akmercan , Tayfun Akmercan , Muhammer Ergenç , Tevfik Kıvılcım Uprak
One of the most common aneurysms in the abdomen is the splenic artery aneurysm (SAA). Ruptured SAAs have a significant morbidity and mortality risk, especially for pregnant women and, consequently, for fetuses. The first patient was a twenty-eight-year-old female who, during the 30th week of pregnancy, underwent an urgent cesarean section. Postoperatively, on the 7th day, she developed severe abdominal pain. After the rapid deterioration, imaging revealed SAA rupture, and she underwent an explorative laparotomy and splenectomy. The second patient is thirty-two years old and has had non-cirrhotic portal vein hypertension since the age of 10. During her 28th week of pregnancy, she was admitted to the emergency department with complaints of severe abdominal pain and vomiting, consequently hemorrhagic shock. The imaging revealed massive intraperitoneal fluid and the SAA rupture. She underwent an emergency laparotomy, splenectomy, and cesarean section. Uncommon but has a significant mortality rate for both mother and fetus, and rupture must be considered for any pregnant woman with sudden abdominal pain and hemodynamic instability. Prompt evaluation and intervention are critical for both fetal and maternal morbidity and mortality.
{"title":"Splenic artery aneurysm rupture during pregnancy: A report of two cases","authors":"Kerim Deniz Batun , Ahmet Akmercan , Tayfun Akmercan , Muhammer Ergenç , Tevfik Kıvılcım Uprak","doi":"10.1016/j.sycrs.2025.100112","DOIUrl":"10.1016/j.sycrs.2025.100112","url":null,"abstract":"<div><div>One of the most common aneurysms in the abdomen is the splenic artery aneurysm (SAA). Ruptured SAAs have a significant morbidity and mortality risk, especially for pregnant women and, consequently, for fetuses. The first patient was a twenty-eight-year-old female who, during the 30th week of pregnancy, underwent an urgent cesarean section. Postoperatively, on the 7th day, she developed severe abdominal pain. After the rapid deterioration, imaging revealed SAA rupture, and she underwent an explorative laparotomy and splenectomy. The second patient is thirty-two years old and has had non-cirrhotic portal vein hypertension since the age of 10. During her 28th week of pregnancy, she was admitted to the emergency department with complaints of severe abdominal pain and vomiting, consequently hemorrhagic shock. The imaging revealed massive intraperitoneal fluid and the SAA rupture. She underwent an emergency laparotomy, splenectomy, and cesarean section. Uncommon but has a significant mortality rate for both mother and fetus, and rupture must be considered for any pregnant woman with sudden abdominal pain and hemodynamic instability. Prompt evaluation and intervention are critical for both fetal and maternal morbidity and mortality.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shrapnel, commonly associated with war-related trauma, is often retained without surgical removal due to its inert nature. However, these retained foreign bodies pose a risk of long-term complications, including chronic osteomyelitis (COM). This case report presents a rare instance of COM caused by retained shrapnel 16 years after a combat injury sustained during the Sri Lankan Civil War. A 55-year-old former soldier presented with fever, right thigh pain, and swelling. He had suffered a right femoral shaft open fracture in a mortar artillery blast in 2008, which was treated with intramedullary nailing. The implant was removed the following year due to infection. Imaging revealed multiple shrapnel fragments and osteomyelitic changes in the right distal femur, with one metal fragment causing erosion of the anterior cortex of the femur. The culture of an abscess of the right anterior thigh yielded methicillin-resistant Staphylococcus aureus, sensitive to vancomycin. The patient underwent abscess drainage, surgical retrieval of some shrapnel, and a 6-week course of oral linezolid. Although retained shrapnel is generally inert, its potential to cause COM necessitates a high index of suspicion. Timely imaging, microbiological cultures, and appropriate surgical and antibiotic management are critical in preventing severe long-term complications.
{"title":"Chronic osteomyelitis due to retained war-time shrapnel after 16 years: Case report","authors":"Madhawa Sasanka Rathnaweera , Kasun Bandara Ekanayake , Sunanda Udagedara","doi":"10.1016/j.sycrs.2025.100111","DOIUrl":"10.1016/j.sycrs.2025.100111","url":null,"abstract":"<div><div>Shrapnel, commonly associated with war-related trauma, is often retained without surgical removal due to its inert nature. However, these retained foreign bodies pose a risk of long-term complications, including chronic osteomyelitis (COM). This case report presents a rare instance of COM caused by retained shrapnel 16 years after a combat injury sustained during the Sri Lankan Civil War. A 55-year-old former soldier presented with fever, right thigh pain, and swelling. He had suffered a right femoral shaft open fracture in a mortar artillery blast in 2008, which was treated with intramedullary nailing. The implant was removed the following year due to infection. Imaging revealed multiple shrapnel fragments and osteomyelitic changes in the right distal femur, with one metal fragment causing erosion of the anterior cortex of the femur. The culture of an abscess of the right anterior thigh yielded methicillin-resistant <em>Staphylococcus aureus</em>, sensitive to vancomycin. The patient underwent abscess drainage, surgical retrieval of some shrapnel, and a 6-week course of oral linezolid. Although retained shrapnel is generally inert, its potential to cause COM necessitates a high index of suspicion. Timely imaging, microbiological cultures, and appropriate surgical and antibiotic management are critical in preventing severe long-term complications.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-16DOI: 10.1016/j.sycrs.2025.100110
Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher
Primary adrenal angiosarcoma is a high-grade vascular malignancy. This case describes a 78-year-old female who presented with left upper quadrant abdominal pain, early satiety, nausea, weight loss, and a feeling of being “cold all the time.” Computed tomography of the abdomen and pelvis demonstrated a 15 cm× 13 cm x 16 cm heterogeneous, enhancing mass with interspersed calcifications, originating from the left adrenal gland. Adrenal labs were collected and were not consistent with a functional adrenal lesion, and lymphoma was ruled out. The patient underwent an exploratory laparotomy with resection of the left retroperitoneal mass, left adrenalectomy, splenectomy, and left partial nephrectomy due to the tumor impeding surrounding structures. All surgical margins were negative, with no evidence of metastatic disease. Immunohistochemical staining showed the tumor to be strongly and diffusely positive for cytokeratin, CD31, and ERG, while negative for CD34. Additional staining for FLI1 was positive. Based on these findings, a final pathological diagnosis of primary epithelioid angiosarcoma of the adrenal gland was made. The patient received asplenia vaccines and was discharged on postoperative day three without complications and was seen two weeks postoperatively in clinic. Recommendations were made in agreement with surgical and medical oncology for surveillance imaging, including computed tomography of the chest, abdomen, and pelvis every three months for a minimum of five years.
原发性肾上腺血管肉瘤是一种高度的血管恶性肿瘤。这个病例描述了一位78岁的女性，她表现为左上腹腹痛，早期饱腹感，恶心，体重减轻，感觉“一直很冷”。腹部和骨盆的计算机断层扫描显示一个15 cm× 13 cm × 16 cm的非均匀强化肿块，伴有分散的钙化，起源于左肾上腺。肾上腺实验室收集和不一致的功能肾上腺病变，淋巴瘤被排除。由于肿瘤阻碍周围结构，患者行探查性剖腹手术切除左侧腹膜后肿物、左侧肾上腺切除术、脾切除术和左侧部分肾切除术。所有手术切缘均为阴性，无转移性疾病的证据。免疫组化染色显示肿瘤细胞角蛋白、CD31和ERG呈强烈弥漫性阳性，CD34呈阴性。FLI1的附加染色呈阳性。基于这些发现，最终病理诊断原发性肾上腺上皮样血管肉瘤。患者接种了健脾疫苗，术后第三天出院，无并发症，术后两周就诊。建议与外科和内科肿瘤学一致进行监视成像，包括每三个月对胸部、腹部和骨盆进行计算机断层扫描，至少持续五年。
{"title":"Primary adrenal angiosarcoma: Insights into an exceptionally rare malignancy","authors":"Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher","doi":"10.1016/j.sycrs.2025.100110","DOIUrl":"10.1016/j.sycrs.2025.100110","url":null,"abstract":"<div><div>Primary adrenal angiosarcoma is a high-grade vascular malignancy. This case describes a 78-year-old female who presented with left upper quadrant abdominal pain, early satiety, nausea, weight loss, and a feeling of being “cold all the time.” Computed tomography of the abdomen and pelvis demonstrated a 15 cm× 13 cm x 16 cm heterogeneous, enhancing mass with interspersed calcifications, originating from the left adrenal gland. Adrenal labs were collected and were not consistent with a functional adrenal lesion, and lymphoma was ruled out. The patient underwent an exploratory laparotomy with resection of the left retroperitoneal mass, left adrenalectomy, splenectomy, and left partial nephrectomy due to the tumor impeding surrounding structures. All surgical margins were negative, with no evidence of metastatic disease. Immunohistochemical staining showed the tumor to be strongly and diffusely positive for cytokeratin, CD31, and ERG, while negative for CD34. Additional staining for FLI1 was positive. Based on these findings, a final pathological diagnosis of primary epithelioid angiosarcoma of the adrenal gland was made. The patient received asplenia vaccines and was discharged on postoperative day three without complications and was seen two weeks postoperatively in clinic. Recommendations were made in agreement with surgical and medical oncology for surveillance imaging, including computed tomography of the chest, abdomen, and pelvis every three months for a minimum of five years.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epithelial Myoepithelial Carcinoma (EMC) is an extremely rare biphasic malignant tumour accounting for less than one percent of all salivary gland neoplasms. EMC is usually seen in the parotid gland but has also been reported in the submandibular gland, minor salivary glands and extraoral sites. It is commonly seen during the sixth and seventh decade of life, occurring more frequently in females. Here, we present the case of a 48-year-old female with a prior history of parotid carcinoma treated by local excision at a hospital two months ago. She presented to our hospital for follow-up. On examination, there was a 3 cm scar near the pre-auricular region with a suture hatch-mark present. Histopathology revealed multiple whitish tissue bits, the largest measuring 1 × 0.8 × 0.5 cm. On microscopy, salivary gland tissue with an infiltrating neoplasm was noted. Magnetic resonance imaging (MRI) revealed no residual disease; however, enlarged lymph nodes were present on the right side, with the largest in level 1B. The patient was taken up for right superficial parotidectomy with excision of the previous scar and right selective neck dissection (Level I–IV). Post-operative histopathology revealed neither residual disease nor involvement of the 32 lymph nodes dissected. Following this, adjuvant radiation therapy was initiated to help sterilize the region. The patient recovered well and has been on regular follow-up for the past two years with no evidence of recurrence. This case highlights the importance of thorough evaluation and multidisciplinary management in rare salivary gland malignancies.
{"title":"Epithelial-myoepithelial carcinoma of the parotid: A needle in a haystack of carcinomas","authors":"K.G. Dharma Kumar , Matthew Antony Manoj , Varun Sarodaya , Chinmayee Mayekar","doi":"10.1016/j.sycrs.2025.100105","DOIUrl":"10.1016/j.sycrs.2025.100105","url":null,"abstract":"<div><div>Epithelial Myoepithelial Carcinoma (EMC) is an extremely rare biphasic malignant tumour accounting for less than one percent of all salivary gland neoplasms. EMC is usually seen in the parotid gland but has also been reported in the submandibular gland, minor salivary glands and extraoral sites. It is commonly seen during the sixth and seventh decade of life, occurring more frequently in females. Here, we present the case of a 48-year-old female with a prior history of parotid carcinoma treated by local excision at a hospital two months ago. She presented to our hospital for follow-up. On examination, there was a 3 cm scar near the pre-auricular region with a suture hatch-mark present. Histopathology revealed multiple whitish tissue bits, the largest measuring 1 × 0.8 × 0.5 cm. On microscopy, salivary gland tissue with an infiltrating neoplasm was noted. Magnetic resonance imaging (MRI) revealed no residual disease; however, enlarged lymph nodes were present on the right side, with the largest in level 1B. The patient was taken up for right superficial parotidectomy with excision of the previous scar and right selective neck dissection (Level I–IV). Post-operative histopathology revealed neither residual disease nor involvement of the 32 lymph nodes dissected. Following this, adjuvant radiation therapy was initiated to help sterilize the region. The patient recovered well and has been on regular follow-up for the past two years with no evidence of recurrence. This case highlights the importance of thorough evaluation and multidisciplinary management in rare salivary gland malignancies.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.sycrs.2025.100104
Nico Lumintang , Sherly Tandililing , Maturia I. Aruperes
Background
The transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers the most direct access to the thyroid gland due to its proximity to the oral cavity and bilateral reach. Additionally, this technique provides the best cosmetic outcome as it avoids visible scarring. This study presents a case series of TOETVA at Prof. Dr. R. D. Kandou General Hospital, a single-center institution.
Methods
Eight patients were included in this study. All patients who underwent the TOETVA procedure and were informed of their surgical options, the risks, and benefits associated with the technique, and each patient signed an informed consent form. These patients had a preoperative assessment, including a thyroid hormone level test, neck ultrasound examination, and fine-needle aspiration.
Result
Six out of eight cases in this study were female. The patient's ages ranged from 22 to 58 years. The maximum nodule diameter in this study was 4.98 cm. The shortest operative time in this study was 230 minutes, while the longest was 540 minutes. The estimated blood loss ranged from 50 to 120 ml, and the length of hospital stay was 48–120 hours.
Conclusion
TOETVA has been demonstrated to be a safe and effective procedure, offering several advantages over traditional/classic techniques, including minimal tissue dissection, improved cosmetic outcomes, reduced postoperative pain, and high patient satisfaction. With increasing surgical expertise and technological advancements, TOETVA is expected to become a preferred approach for select thyroidectomy cases, further improving surgical outcomes and patient quality of life.
{"title":"Transoral endoscopic thyroidectomy vestibular approach (TOETVA) procedure, a single-center case series of thyroid procedure, and what do we learn?","authors":"Nico Lumintang , Sherly Tandililing , Maturia I. Aruperes","doi":"10.1016/j.sycrs.2025.100104","DOIUrl":"10.1016/j.sycrs.2025.100104","url":null,"abstract":"<div><h3>Background</h3><div>The transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers the most direct access to the thyroid gland due to its proximity to the oral cavity and bilateral reach. Additionally, this technique provides the best cosmetic outcome as it avoids visible scarring. This study presents a case series of TOETVA at Prof. Dr. R. D. Kandou General Hospital, a single-center institution.</div></div><div><h3>Methods</h3><div>Eight patients were included in this study. All patients who underwent the TOETVA procedure and were informed of their surgical options, the risks, and benefits associated with the technique, and each patient signed an informed consent form. These patients had a preoperative assessment, including a thyroid hormone level test, neck ultrasound examination, and fine-needle aspiration.</div></div><div><h3>Result</h3><div>Six out of eight cases in this study were female. The patient's ages ranged from 22 to 58 years. The maximum nodule diameter in this study was 4.98 cm. The shortest operative time in this study was 230 minutes, while the longest was 540 minutes. The estimated blood loss ranged from 50 to 120 ml, and the length of hospital stay was 48–120 hours.</div></div><div><h3>Conclusion</h3><div>TOETVA has been demonstrated to be a safe and effective procedure, offering several advantages over traditional/classic techniques, including minimal tissue dissection, improved cosmetic outcomes, reduced postoperative pain, and high patient satisfaction. With increasing surgical expertise and technological advancements, TOETVA is expected to become a preferred approach for select thyroidectomy cases, further improving surgical outcomes and patient quality of life.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.sycrs.2025.100106
Siong Teng Saw, Mei Fong Tang, Feona Sibangun Joseph, Benjamin Dak Keung Leong
A 70-year-old high-risk male with an asymptomatic 64 mm infrarenal abdominal aortic aneurysm (AAA) and an Eisendrath Type IV horseshoe kidney (HSK) underwent endovascular aneurysm repair (EVAR). Preoperative computed tomography angiography (CTA) revealed accessory renal arteries (ARAs) originating from the iliac arteries and aneurysm sac, necessitating selective preservation. EVAR successfully excluded the aneurysm while maintaining perfusion through a right common iliac artery-derived ARA supplying the renal isthmus. Smaller ARAs (<3 mm) were excluded to reduce endoleak risk. Postoperative imaging confirmed aneurysm exclusion without endoleak, though asymptomatic isthmus infarction occurred due to occlusion of a left iliac ARA. Renal function remained stable at three-year follow-up (2022–2025). This case supports EVAR as a feasible option for complex AAA-HSK anatomy, emphasizing meticulous preoperative planning and selective vessel preservation to balance aneurysm exclusion and renal perfusion. Individualized strategies are critical in anatomically challenging scenarios.
{"title":"Endovascular aneurysm repair for abdominal aortic aneurysm: Overcoming anatomical challenges related to horseshoe kidney","authors":"Siong Teng Saw, Mei Fong Tang, Feona Sibangun Joseph, Benjamin Dak Keung Leong","doi":"10.1016/j.sycrs.2025.100106","DOIUrl":"10.1016/j.sycrs.2025.100106","url":null,"abstract":"<div><div>A 70-year-old high-risk male with an asymptomatic 64 mm infrarenal abdominal aortic aneurysm (AAA) and an Eisendrath Type IV horseshoe kidney (HSK) underwent endovascular aneurysm repair (EVAR). Preoperative computed tomography angiography (CTA) revealed accessory renal arteries (ARAs) originating from the iliac arteries and aneurysm sac, necessitating selective preservation. EVAR successfully excluded the aneurysm while maintaining perfusion through a right common iliac artery-derived ARA supplying the renal isthmus. Smaller ARAs (<3 mm) were excluded to reduce endoleak risk. Postoperative imaging confirmed aneurysm exclusion without endoleak, though asymptomatic isthmus infarction occurred due to occlusion of a left iliac ARA. Renal function remained stable at three-year follow-up (2022–2025). This case supports EVAR as a feasible option for complex AAA-HSK anatomy, emphasizing meticulous preoperative planning and selective vessel preservation to balance aneurysm exclusion and renal perfusion. Individualized strategies are critical in anatomically challenging scenarios.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.sycrs.2025.100108
Chiara Scorziello , Maria Carola Borcea , Marco Biffoni , Giuseppe De Ruggeri , Alessia Galvano , Eva Iannuzzi , Rossella Melcarne , Luca Ventrone , Cosimo Durante , Fabrizio Consorti , Tiziano De Giacomo , Laura Giacomelli
Thyroidal organogenesis is controlled by specific transcription factors; alterations in their ex-pression can cause developmental abnormalities like ectopia of the gland. Ectopic thyroid tissue can be found anywhere along the line of the obliterated thyroglossal duct, from the tongue to the diaphragm. The thoracic cavity is the most common non-cervical location. We describe the case report of a "forgotten goiter", a retrosternal ectopic thyroid tissue, detected after a cervical total thyroidectomy. Due to the size of the lesion, anatomical localization, and presence of calcifications, the patient underwent a complete surgical resection of the mass via sternotomy. The histological examination showed benign mediastinal ectopic thyroid tissue. The postoperative course was uneventful and without complications. Any surgical initiative in patients with retrosternal ectopic thyroid tissue must be individualized and based upon the size of the goiter, the characteristics of the mediastinal goiter and its anatomical relationships, the risk of complications and reoperations, the experience of the surgeon, the comorbidities of the patient, and the trajectory of growth in active surveillance. To date, there is no universal consensus on the best surgical approach.
{"title":"Thoracic surgical approach for retrosternal ectopic thyroid tissue after cervical total thyroidectomy: Case Report and Review of literature.","authors":"Chiara Scorziello , Maria Carola Borcea , Marco Biffoni , Giuseppe De Ruggeri , Alessia Galvano , Eva Iannuzzi , Rossella Melcarne , Luca Ventrone , Cosimo Durante , Fabrizio Consorti , Tiziano De Giacomo , Laura Giacomelli","doi":"10.1016/j.sycrs.2025.100108","DOIUrl":"10.1016/j.sycrs.2025.100108","url":null,"abstract":"<div><div>Thyroidal organogenesis is controlled by specific transcription factors; alterations in their ex-pression can cause developmental abnormalities like ectopia of the gland. Ectopic thyroid tissue can be found anywhere along the line of the obliterated thyroglossal duct, from the tongue to the diaphragm. The thoracic cavity is the most common non-cervical location. We describe the case report of a \"forgotten goiter\", a retrosternal ectopic thyroid tissue, detected after a cervical total thyroidectomy. Due to the size of the lesion, anatomical localization, and presence of calcifications, the patient underwent a complete surgical resection of the mass via sternotomy. The histological examination showed benign mediastinal ectopic thyroid tissue. The postoperative course was uneventful and without complications. Any surgical initiative in patients with retrosternal ectopic thyroid tissue must be individualized and based upon the size of the goiter, the characteristics of the mediastinal goiter and its anatomical relationships, the risk of complications and reoperations, the experience of the surgeon, the comorbidities of the patient, and the trajectory of growth in active surveillance. To date, there is no universal consensus on the best surgical approach.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian sex cord-stromal tumors are rare neoplasms, constituting approximately 7 % of all primary ovarian tumors. They are categorized into three main types: pure sex cord tumors, pure stromal tumors, and mixed sex cord stromal tumors. Among these, adult granulosa cell tumors are the most prevalent malignant variant. Unlike the more common ovarian epithelial cancers, sex cord stromal tumors often present in younger patients and are typically diagnosed at earlier stages, generally leading to more favorable outcomes. However, these tumors have the potential for late recurrence, with some cases reappearing up to 30 years after initial treatment. Although most sex cord stromal tumors exhibit indolent growth patterns, a subset can exhibit more aggressive behavior. This article presents a case of a 71-year-old native Moroccan woman who presented with abdominal pain and metrorrhagia and was found to have a 15 cm solid ovarian mass.
{"title":"Ovarian sex cord-stromal tumor: A case report and review of literature","authors":"Soukayna Bourabaa , Mohamed Taimi , Doaa Riali , Hajar Kandoussi , Youssef Mahdi , Basma El Khannoussi , Hatim Essaber , Rachida Latib , Fouad Tijami , Hafid Hachi , Nezha Elbahaoui","doi":"10.1016/j.sycrs.2025.100107","DOIUrl":"10.1016/j.sycrs.2025.100107","url":null,"abstract":"<div><div>Ovarian sex cord-stromal tumors are rare neoplasms, constituting approximately 7 % of all primary ovarian tumors. They are categorized into three main types: pure sex cord tumors, pure stromal tumors, and mixed sex cord stromal tumors. Among these, adult granulosa cell tumors are the most prevalent malignant variant. Unlike the more common ovarian epithelial cancers, sex cord stromal tumors often present in younger patients and are typically diagnosed at earlier stages, generally leading to more favorable outcomes. However, these tumors have the potential for late recurrence, with some cases reappearing up to 30 years after initial treatment. Although most sex cord stromal tumors exhibit indolent growth patterns, a subset can exhibit more aggressive behavior. This article presents a case of a 71-year-old native Moroccan woman who presented with abdominal pain and metrorrhagia and was found to have a 15 cm solid ovarian mass.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号