Surgery Case Reports最新文献

英文中文

Atypical Duplex Appendix: A Case Report 非典型双附录：1例报告

Surgery Case Reports

Pub Date : 2025-04-07 DOI: 10.1016/j.sycrs.2025.100109

Dawar Nadeem Aslam Dar , Maila Aslam , Isha Sajjad

Duplex appendix is a rare anomaly of the appendix with an incidence of 0.0004% to 0.009%. It varies in both presentation and position. Due to its rare occurrence and variable position, we present a case of duplex appendix with an atypical position in a 34-year-old male. The patient was diagnosed with acute appendicitis and underwent open appendectomy. During surgery, two appendices were observed, both arising anteriorly from cecum with one arising from taenia coli and the second arising adjacent to, medial, and parallel to the first, near ileocecal junction. Both were excised and sent for histological examination, which revealed neutrophilic infiltration in the mucosa, submucosa and muscularis propria of both appendices. Follow-up after one week was unremarkable. There are various classifications of duplex appendix but Modified Cave-Wallbridge classification is the most widely accepted. However, the position of both appendices in our case does not conform to this classification. Therefore, there may be a need to broaden this classification to incorporate the atypical cases. Additionally, in situations where a normal appendix is visualized or a previous appendectomy has been performed, and the clinical signs strongly suggest appendicitis, surgeons should consider the probability of this anomaly and look for it during surgery. Also due to its association with other anomalies, further investigations should be conducted to rule them out.

双尾是一种罕见的阑尾异常，发病率为0.0004% ~ 0.009%。它的表现形式和位置各不相同。由于其罕见的发生和可变的位置，我们提出一个双阑尾与一个不典型的位置在一个34岁的男性病例。患者被诊断为急性阑尾炎，并接受了开放式阑尾切除术。手术中，观察到两个阑尾，均起源于盲肠前部，其中一个起源于大肠带绦虫，另一个位于回盲交界处附近，内侧并平行于第一个。均行组织学检查，发现双阑尾粘膜、黏膜下层及固有肌层均有中性粒细胞浸润。一周后随访无显著差异。双阑尾有多种分类，但最被广泛接受的是修正的洞穴-壁桥分类。然而，在我们的案例中，两个附录的位置不符合这种分类。因此，可能需要扩大这一分类，以纳入非典型病例。此外，在阑尾可见正常或既往阑尾切除术，临床症状强烈提示阑尾炎的情况下，外科医生应考虑这种异常的可能性，并在手术中寻找它。此外，由于它与其他异常现象有关，应进行进一步调查以排除它们。

{"title":"Atypical Duplex Appendix: A Case Report","authors":"Dawar Nadeem Aslam Dar , Maila Aslam , Isha Sajjad","doi":"10.1016/j.sycrs.2025.100109","DOIUrl":"10.1016/j.sycrs.2025.100109","url":null,"abstract":"<div><div>Duplex appendix is a rare anomaly of the appendix with an incidence of 0.0004% to 0.009%. It varies in both presentation and position. Due to its rare occurrence and variable position, we present a case of duplex appendix with an atypical position in a 34-year-old male. The patient was diagnosed with acute appendicitis and underwent open appendectomy. During surgery, two appendices were observed, both arising anteriorly from cecum with one arising from taenia coli and the second arising adjacent to, medial, and parallel to the first, near ileocecal junction. Both were excised and sent for histological examination, which revealed neutrophilic infiltration in the mucosa, submucosa and muscularis propria of both appendices. Follow-up after one week was unremarkable. There are various classifications of duplex appendix but Modified Cave-Wallbridge classification is the most widely accepted. However, the position of both appendices in our case does not conform to this classification. Therefore, there may be a need to broaden this classification to incorporate the atypical cases. Additionally, in situations where a normal appendix is visualized or a previous appendectomy has been performed, and the clinical signs strongly suggest appendicitis, surgeons should consider the probability of this anomaly and look for it during surgery. Also due to its association with other anomalies, further investigations should be conducted to rule them out.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case report on malignant peripheral nerve sheath tumor of vagus nerve: A diagnostic challenge 迷走神经周围神经鞘恶性肿瘤1例：诊断上的挑战

Surgery Case Reports

Pub Date : 2025-04-07 DOI: 10.1016/j.sycrs.2025.100103

Muhammad Farhan , Abdur Rehman , Zainab Zahoor Butt , Anique Ahmad Jamil , Imran Khan , Muhammad Shuaib Khan , Arham Ihtesham , Shahzaib Maqbool , Sudhair Alam

Malignant Peripheral Nerve Sheath Tumor (MPNST) is a rare, aggressive neoplasm with an incidence of 0.001 % and a poor prognosis. Diagnosis is particularly challenging due to its nonspecific clinical, histopathological, and radiological features, often leading to misclassification as a benign lesion. We present the case of a 24-year-old male with a progressively enlarging left-sided neck mass, accompanied by hoarseness, dysphagia, and headaches. Imaging suggested a benign peripheral nerve sheath tumor, such as a schwannoma, and an incisional biopsy further supported this impression. However, the final excisional biopsy unexpectedly confirmed MPNST of the vagus nerve. This highlights the limitations of current diagnostic techniques in distinguishing MPNST from benign mimics and underscores the critical need for a multimodal diagnostic approach, integrating advanced imaging techniques and immunohistochemistry, to improve early and accurate detection of MPNST. Given the tumor’s aggressive nature and high risk of recurrence, early identification is essential for optimizing treatment outcomes.

恶性周围神经鞘瘤是一种罕见的侵袭性肿瘤，发病率为0.001 %，预后较差。由于其非特异性的临床、组织病理学和放射学特征，诊断尤其具有挑战性，经常导致误诊为良性病变。我们报告一个24岁男性的病例，其左侧颈部肿块逐渐增大，并伴有声音嘶哑、吞咽困难和头痛。影像学提示为良性周围神经鞘肿瘤，如神经鞘瘤，切口活检进一步支持这种印象。然而，最终的切除活检却意外地证实了迷走神经的MPNST。这突出了当前诊断技术在区分MPNST和良性模拟方面的局限性，并强调了多模式诊断方法的迫切需要，将先进的成像技术和免疫组织化学相结合，以提高MPNST的早期和准确检测。鉴于肿瘤的侵袭性和高复发风险，早期识别对于优化治疗效果至关重要。

{"title":"A case report on malignant peripheral nerve sheath tumor of vagus nerve: A diagnostic challenge","authors":"Muhammad Farhan , Abdur Rehman , Zainab Zahoor Butt , Anique Ahmad Jamil , Imran Khan , Muhammad Shuaib Khan , Arham Ihtesham , Shahzaib Maqbool , Sudhair Alam","doi":"10.1016/j.sycrs.2025.100103","DOIUrl":"10.1016/j.sycrs.2025.100103","url":null,"abstract":"<div><div>Malignant Peripheral Nerve Sheath Tumor (MPNST) is a rare, aggressive neoplasm with an incidence of 0.001 % and a poor prognosis. Diagnosis is particularly challenging due to its nonspecific clinical, histopathological, and radiological features, often leading to misclassification as a benign lesion. We present the case of a 24-year-old male with a progressively enlarging left-sided neck mass, accompanied by hoarseness, dysphagia, and headaches. Imaging suggested a benign peripheral nerve sheath tumor, such as a schwannoma, and an incisional biopsy further supported this impression. However, the final excisional biopsy unexpectedly confirmed MPNST of the vagus nerve. This highlights the limitations of current diagnostic techniques in distinguishing MPNST from benign mimics and underscores the critical need for a multimodal diagnostic approach, integrating advanced imaging techniques and immunohistochemistry, to improve early and accurate detection of MPNST. Given the tumor’s aggressive nature and high risk of recurrence, early identification is essential for optimizing treatment outcomes.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sister Mary Joseph’s nodule revealing occult breast cancer: A rare metastatic manifestation 玛丽约瑟夫修女的结节显示隐匿性乳腺癌：一种罕见的转移表现

Surgery Case Reports

Pub Date : 2025-04-06 DOI: 10.1016/j.sycrs.2025.100102

Fauziyah Ashraf , Guo Hou Loo , Khairul Anwar Abdul Rahman , Wan Izzah Wan Jaffar , Guhan Muthkumaran , Nik Ritza Kosai

Sister Mary Joseph’s nodule (SMJN) is a rare clinical finding that typically indicates metastatic intra-abdominal or pelvic malignancy, most often arising from gastrointestinal or gynecological cancers. Metastasis to the umbilicus from breast carcinoma is extremely uncommon. We report a case involving a 69-year-old woman with a history of early-stage breast carcinoma treated 15 years prior. She presented with abdominal discomfort and a new umbilical nodule. Imaging revealed small bowel obstruction, and exploratory laparotomy identified peritoneal carcinomatosis and an umbilical lesion. Histopathological examination and immunohistochemical staining confirmed metastatic breast carcinoma as the source. The immunoprofile demonstrated positivity for GATA3, estrogen and progesterone receptors, CK7, and GCDFP-15, supporting a breast origin. The patient declined chemotherapy and opted for endocrine therapy with letrozole. She remains clinically stable and functionally independent 15 months after diagnosis. This case underscores the importance of considering breast cancer in the differential diagnosis of umbilical nodules, especially in patients with a history of breast malignancy. Timely recognition and accurate histopathological workup are essential for appropriate management. Despite the generally poor prognosis associated with SMJN, selected patients may achieve meaningful survival and quality of life with tailored systemic treatment.

修女约瑟夫的结节（SMJN）是一种罕见的临床发现，通常表明转移性腹腔或盆腔恶性肿瘤，最常引起胃肠道或妇科癌症。乳腺癌转移到脐部是非常罕见的。我们报告一个69岁的女性，15年前曾接受过早期乳腺癌治疗。她表现为腹部不适和新的脐结节。影像显示小肠梗阻，剖腹探查发现腹膜癌和脐病变。组织病理学检查和免疫组化染色证实转移性乳腺癌为来源。免疫图谱显示GATA3、雌激素和孕激素受体、CK7和GCDFP-15阳性，支持乳腺起源。患者谢绝化疗，选择来曲唑内分泌治疗。患者在诊断后15个月保持临床稳定和功能独立。本病例强调了在鉴别诊断脐带结节时考虑乳腺癌的重要性，特别是在有乳腺恶性肿瘤病史的患者中。及时识别和准确的组织病理检查是适当治疗的必要条件。尽管与SMJN相关的预后通常较差，但通过量身定制的全身治疗，选定的患者可能获得有意义的生存和生活质量。

{"title":"Sister Mary Joseph’s nodule revealing occult breast cancer: A rare metastatic manifestation","authors":"Fauziyah Ashraf , Guo Hou Loo , Khairul Anwar Abdul Rahman , Wan Izzah Wan Jaffar , Guhan Muthkumaran , Nik Ritza Kosai","doi":"10.1016/j.sycrs.2025.100102","DOIUrl":"10.1016/j.sycrs.2025.100102","url":null,"abstract":"<div><div>Sister Mary Joseph’s nodule (SMJN) is a rare clinical finding that typically indicates metastatic intra-abdominal or pelvic malignancy, most often arising from gastrointestinal or gynecological cancers. Metastasis to the umbilicus from breast carcinoma is extremely uncommon. We report a case involving a 69-year-old woman with a history of early-stage breast carcinoma treated 15 years prior. She presented with abdominal discomfort and a new umbilical nodule. Imaging revealed small bowel obstruction, and exploratory laparotomy identified peritoneal carcinomatosis and an umbilical lesion. Histopathological examination and immunohistochemical staining confirmed metastatic breast carcinoma as the source. The immunoprofile demonstrated positivity for GATA3, estrogen and progesterone receptors, CK7, and GCDFP-15, supporting a breast origin. The patient declined chemotherapy and opted for endocrine therapy with letrozole. She remains clinically stable and functionally independent 15 months after diagnosis. This case underscores the importance of considering breast cancer in the differential diagnosis of umbilical nodules, especially in patients with a history of breast malignancy. Timely recognition and accurate histopathological workup are essential for appropriate management. Despite the generally poor prognosis associated with SMJN, selected patients may achieve meaningful survival and quality of life with tailored systemic treatment.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Transanal Small Bowel Prolapse in a Young Patient 自发性经肛门小肠脱垂一例年轻患者

Surgery Case Reports

Pub Date : 2025-04-06 DOI: 10.1016/j.sycrs.2025.100094

Rashed W. Alweshah , Mustafa Abdo , Ahmed Salah , Shaimaa Moustafa , Ahmed Nagi

Transanal small bowel evisceration is an exceedingly rare and life-threatening condition, predominantly affecting elderly patients with chronic rectal prolapse or pelvic floor dysfunction. However, this case report presents an unusual occurrence in a 30-year-old woman with no prior history of rectal prolapse, anorectal surgery, or other predisposing factors. She arrived at the emergency department with a visible small bowel prolapse through the anus, initially mistaking it for hemorrhoids. Emergent laparotomy was performed, involving the reduction of the prolapsed small bowel through a rectal defect, resection of ischemic segments, and primary anastomosis. A temporary diverting sigmoidostomy was created to protect the rectal repair. The patient had an uneventful recovery and was discharged on postoperative day six. We discuss pathophysiology, clinical presentation, and management strategies, emphasizing the role of fecal diversion in optimizing patient outcomes.

经肛门小肠拔出是一种非常罕见且危及生命的疾病，主要发生在慢性直肠脱垂或盆底功能障碍的老年患者中。然而，本病例报告提出了一个不寻常的发生在一个30岁的妇女，以前没有直肠脱垂的历史，肛门直肠手术，或其他易感因素。她来到急诊科时，发现肛门有明显的小肠脱垂，一开始还误以为是痔疮。我们进行了紧急剖腹手术，包括通过直肠缺损复位脱垂的小肠，切除缺血节段，并进行初级吻合。临时乙状结肠造口术以保护直肠修复。患者顺利康复，于术后第6天出院。我们讨论病理生理学，临床表现和管理策略，强调粪便转移在优化患者结果中的作用。

引用次数: 0

Intraductal papillary neoplasm of the bile duct in the middle east: Case report 中东胆管导管内乳头状肿瘤1例

Surgery Case Reports

Pub Date : 2025-04-06 DOI: 10.1016/j.sycrs.2025.100099

Khaled Demyati , Orabi Hajjeh , Amr Khaled , Usama Al Khuffash , Fathi Milhem , Ameer Awashra , Hanood Abu Rass

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare premalignant tumor characterized by papillary growth within the bile ducts, predominantly reported in East Asia. We present a 64-year-old male diagnosed with IPNB with focal stromal invasion, managed successfully with surgical resection. The case highlights unique endoscopic, imaging, and histopathological findings, and provides valuable data describing the unusual presentation of the case and the challenges faced in making the diagnosis. To our knowledge, this is the first reported case from the Middle East, emphasizing the rarity of IPNB in the region. This report underscores the importance of early diagnosis, proper imaging, and clear resection margins for optimal outcomes.

胆管内乳头状肿瘤（IPNB）是一种罕见的以胆管内乳头状生长为特征的癌前肿瘤，主要在东亚报道。我们报告一位64岁男性确诊为IPNB伴局灶性间质浸润，手术切除成功。该病例突出了独特的内窥镜、影像学和组织病理学发现，并提供了有价值的数据，描述了该病例的不寻常表现和做出诊断所面临的挑战。据我们所知，这是中东报告的首例病例，强调了IPNB在该地区的罕见性。本报告强调了早期诊断，正确的影像学检查和明确切除边缘的重要性，以获得最佳结果。

引用次数: 0

Chondromyxoid fibroma in the oro-facial region: A case report 口腔-面部软骨粘液样纤维瘤1例报告

Surgery Case Reports

Pub Date : 2025-04-05 DOI: 10.1016/j.sycrs.2025.100100

H.M. Shahriar Rubel , Mustari Nailah Tabassum , Sadia Sultana Imla , Arpita Biswangree , Esrat Jahan

Chondromyxoid Fibroma (CMF) is an uncommon, slow-growing benign chondroblast tumour with hypocellular or chondromyxoid tissue and multinucleated cells. Similar pathologies to aggressive tumours, such as chondrosarcoma, make CMFs harder to identify. This lesion may cause painful swelling or enlargement for weeks or years or may be identified accidentally during radiological scanning. A 24-year-old girl was diagnosed with CMF affecting the right upper jaw. She came with a developing mass, periodic swelling discomfort, facial asymmetry, and the H/O of surgery at the same region 5 years earlier. The patient had a right-sided Class Ⅲ Maxillectomy performed under General Anaesthesia. There were no immediate post-operative problems however, delayed issues occurred. Chondromyxoid fibroma is uncommon and has various sites, making diagnosis difficult and often exclusionary. However, it has a good prognosis with a recurrence rate of up to 80 % in curettage-only patients and a 2 % chance of malignant transformation. This example emphasizes the importance of a thorough clinical examination and histological comparison of CMFs with comparable lesions for optimal therapy. As shown in our case timely intervention can improve results and quality of life for affected cases.

软骨黏液样纤维瘤（CMF）是一种罕见的、生长缓慢的良性成软骨细胞肿瘤，伴有低细胞或软骨黏液样组织和多核细胞。与侵袭性肿瘤（如软骨肉瘤）相似的病理使CMFs更难识别。这种病变可能会引起疼痛的肿胀或扩大，持续数周或数年，也可能在放射扫描中偶然发现。一名24岁的女孩被诊断患有右上颌骨的CMF。她出现肿块发展，周期性肿胀不适，面部不对称，5年前同一区域手术的H/O。患者在全身麻醉下行右侧ClassⅢ上颌切除术。没有立即出现术后问题，但出现了延迟性问题。软骨粘液样纤维瘤是罕见的，有不同的部位，使诊断困难，往往排他性。然而，它具有良好的预后，在仅刮除的患者中复发率高达80% %，恶性转化的几率为2% %。这个例子强调了彻底的临床检查和CMFs与同类病变的组织学比较对于最佳治疗的重要性。正如我们的病例所示，及时干预可以改善受影响病例的结果和生活质量。

{"title":"Chondromyxoid fibroma in the oro-facial region: A case report","authors":"H.M. Shahriar Rubel , Mustari Nailah Tabassum , Sadia Sultana Imla , Arpita Biswangree , Esrat Jahan","doi":"10.1016/j.sycrs.2025.100100","DOIUrl":"10.1016/j.sycrs.2025.100100","url":null,"abstract":"<div><div>Chondromyxoid Fibroma (CMF) is an uncommon, slow-growing benign chondroblast tumour with hypocellular or chondromyxoid tissue and multinucleated cells. Similar pathologies to aggressive tumours, such as chondrosarcoma, make CMFs harder to identify. This lesion may cause painful swelling or enlargement for weeks or years or may be identified accidentally during radiological scanning. A 24-year-old girl was diagnosed with CMF affecting the right upper jaw. She came with a developing mass, periodic swelling discomfort, facial asymmetry, and the H/O of surgery at the same region 5 years earlier. The patient had a right-sided Class Ⅲ Maxillectomy performed under General Anaesthesia. There were no immediate post-operative problems however, delayed issues occurred. Chondromyxoid fibroma is uncommon and has various sites, making diagnosis difficult and often exclusionary. However, it has a good prognosis with a recurrence rate of up to 80 % in curettage-only patients and a 2 % chance of malignant transformation. This example emphasizes the importance of a thorough clinical examination and histological comparison of CMFs with comparable lesions for optimal therapy. As shown in our case timely intervention can improve results and quality of life for affected cases.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical excision of a lobular capillary hemangioma of the upper lip after percutaneous embolization: A case report 经皮栓塞后手术切除上唇小叶毛细血管瘤1例

Surgery Case Reports

Pub Date : 2025-04-01 DOI: 10.1016/j.sycrs.2025.100096

Paolo Appendino , Luca Guaschino , Marta Bezzi , Luciano Mosso , Ernesto Scatà

A 22-year-old male presented with a nodular subcutaneous lesion on the left upper lip. Ultrasound examination of the superficial tissues (Ecography) revealed a heterogeneously hyperechoic formation with small-caliber, high-flow vessels embedded in a probable adipose component. The suspected diagnosis was a hemangiomatous neoplasm. Given the lesion’s vascular nature and its location in a highly delicate area, a percutaneous embolization was performed prior to surgical excision to reduce intraoperative bleeding risk. Surgery was subsequently carried out without complications. Post-operative istopathological analysis confirmed the diagnosis of lobular capillary hemangioma (LCH), a benign vascular tumor that primarily affects the skin and mucous membranes. LCH is often associated with local trauma and is characterized by rapid growth, which may raise suspicion for malignancy. While surgical excision remains the definitive treatment, the vascular nature of the lesion poses a risk of significant hemorrhage, particularly in highly vascularized regions such as the face and oral cavity. This case highlights the importance of preoperative embolization as a valuable adjunct in the surgical management of LCH. By reducing blood flow to the lesion, embolization minimizes intraoperative bleeding, facilitates complete excision, and improves surgical outcomes. The use of this technique is particularly advantageous in challenging anatomical sites where excessive bleeding could complicate the procedure. Further studies are warranted to explore the broader applicability of embolization in the treatment of vascular tumors in sensitive regions.

一个22岁的男性提出了一个结节皮下病变在左上唇。浅表组织超声检查（Ecography）显示不均匀的高回声形成，小口径、高流量血管嵌入可能的脂肪成分。怀疑诊断为血管瘤性肿瘤。鉴于病变的血管性质及其位于高度脆弱的区域，在手术切除之前进行经皮栓塞以减少术中出血的风险。手术随后进行，无并发症。术后病理分析证实诊断为小叶毛细血管瘤（LCH），一种主要影响皮肤和粘膜的良性血管肿瘤。LCH通常与局部创伤有关，其特点是生长迅速，这可能引起对恶性肿瘤的怀疑。虽然手术切除仍然是最终的治疗方法，但病变的血管性质带来了严重出血的风险，特别是在高度血管化的区域，如面部和口腔。这个病例强调了术前栓塞作为LCH手术治疗中有价值的辅助手段的重要性。通过减少流向病变的血流量，栓塞可以最大限度地减少术中出血，促进完全切除，改善手术效果。使用这种技术是特别有利的挑战解剖部位，过多的出血可能使程序复杂化。栓塞治疗敏感部位血管肿瘤的适用性有待进一步研究。

{"title":"Surgical excision of a lobular capillary hemangioma of the upper lip after percutaneous embolization: A case report","authors":"Paolo Appendino , Luca Guaschino , Marta Bezzi , Luciano Mosso , Ernesto Scatà","doi":"10.1016/j.sycrs.2025.100096","DOIUrl":"10.1016/j.sycrs.2025.100096","url":null,"abstract":"<div><div>A 22-year-old male presented with a nodular subcutaneous lesion on the left upper lip. Ultrasound examination of the superficial tissues (Ecography) revealed a heterogeneously hyperechoic formation with small-caliber, high-flow vessels embedded in a probable adipose component. The suspected diagnosis was a hemangiomatous neoplasm. Given the lesion’s vascular nature and its location in a highly delicate area, a percutaneous embolization was performed prior to surgical excision to reduce intraoperative bleeding risk. Surgery was subsequently carried out without complications. Post-operative istopathological analysis confirmed the diagnosis of lobular capillary hemangioma (LCH), a benign vascular tumor that primarily affects the skin and mucous membranes. LCH is often associated with local trauma and is characterized by rapid growth, which may raise suspicion for malignancy. While surgical excision remains the definitive treatment, the vascular nature of the lesion poses a risk of significant hemorrhage, particularly in highly vascularized regions such as the face and oral cavity. This case highlights the importance of preoperative embolization as a valuable adjunct in the surgical management of LCH. By reducing blood flow to the lesion, embolization minimizes intraoperative bleeding, facilitates complete excision, and improves surgical outcomes. The use of this technique is particularly advantageous in challenging anatomical sites where excessive bleeding could complicate the procedure. Further studies are warranted to explore the broader applicability of embolization in the treatment of vascular tumors in sensitive regions.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Internal hernia through the foramen of Winslow 温斯洛孔内疝

Surgery Case Reports

Pub Date : 2025-03-31 DOI: 10.1016/j.sycrs.2025.100101

Rebecca L. Schwartz, Jessica E. Taylor

Introduction

Internal hernias through the foramen of Winslow are a rare pathology.

Case presentation

We present the case of a patient with a strangulated cecum and terminal ileum secondary to an internal hernia through the foramen of Winslow into the lesser sac.

Conclusion

Foramen of Winslow hernias are an uncommon cause of internal hernias and may be misinterpreted or not clearly delineated on imaging; prompt operative exploration is indicated.

通过温斯洛孔的内部疝是一种罕见的病理。病例介绍：我们报告一例患者的盲肠绞窄和回肠末端继发于通过温斯洛孔进入小囊的内部疝。结论Winslow疝孔是一种少见的内疝原因，在影像学上容易被误解或描述不清；提示及时手术探查。

引用次数: 0

Anterior chest wall Dermatofibrosarcoma protuberans extension to the anterior mediastinum: Case report 前胸壁皮肤纤维肉瘤隆突延伸至前纵隔1例

Surgery Case Reports

Pub Date : 2025-03-29 DOI: 10.1016/j.sycrs.2025.100097

Tesfaye Berhe , Sisay Bekele , Getnet Sahale , Enku shiferaw , Degualem Dessie , Tirsit Negash , Abeje b menjeta

Introduction

Dermatofibrosarcoma protuberans (DFSP) is a tumor of the subcutaneous tissue that grows slowly and invades locally, rarely spreading to other parts of the body but often recurring after surgery.

Case presentation

This case report presents a 59-year-old man with a recurrent, large Dermatofibrosarcoma Protuberans (DFSP) tumor. The tumor had grown significantly, extending from the anterior chest wall into the mediastinum through the foramen of Morgagni and into the left chest cavity, directly invading the left anterior chest wall. The mass was surgically removed, and the resulting chest wall defect was repaired using a latissimus dorsi muscle flap and a split-thickness skin graft. The patient was successfully discharged 10 days after surgery, following the healing of the wound and skin graft.

Clinical discussion

DFSPs represent less than 1 percent of all soft tissue tumors. Over 90 % of DFSP tumors have the chromosomal translocation t(17;22). Typically, Mohs micrographic surgery with continuous histological margin control is needed to reduce local recurrence rates. Adjuvant chemotherapy and radiation therapy may be useful.

Conclusion

Surgical approaches such as Mohs micrographic surgery or wide local excision with 5 cm negative margins are essential to prevent recurrence and minimize the overall impact of the disease. Mohs micrographic surgery is a specialized technique that aims for complete tumor removal while preserving as much healthy tissue as possible.

隆突性皮肤纤维肉瘤（DFSP）是一种生长缓慢且局部侵袭的皮下组织肿瘤，很少扩散到身体的其他部位，但经常在手术后复发。病例报告：本病例报告一例59岁男性复发性大结节性皮肤纤维肉瘤（DFSP）肿瘤。肿瘤生长明显，由胸壁前壁经Morgagni孔进入纵隔，进入左胸腔，直接侵犯左胸壁前壁。手术切除肿块，并使用背阔肌瓣和裂厚皮肤移植修复胸壁缺损。术后10天，患者顺利出院，伤口愈合，植皮。临床讨论dfsps占所有软组织肿瘤的不到1%。90%以上 %的DFSP肿瘤存在染色体易位t（17;22）。通常，需要Mohs显微手术和连续的组织边界控制来减少局部复发率。辅助化疗和放疗可能有用。结论Mohs显微手术或5 cm阴性切缘的广泛局部切除是预防复发和减少疾病整体影响的必要手术方法。莫氏显微摄影手术是一种专门的技术，旨在完全切除肿瘤，同时尽可能多地保留健康组织。

{"title":"Anterior chest wall Dermatofibrosarcoma protuberans extension to the anterior mediastinum: Case report","authors":"Tesfaye Berhe , Sisay Bekele , Getnet Sahale , Enku shiferaw , Degualem Dessie , Tirsit Negash , Abeje b menjeta","doi":"10.1016/j.sycrs.2025.100097","DOIUrl":"10.1016/j.sycrs.2025.100097","url":null,"abstract":"<div><h3>Introduction</h3><div>Dermatofibrosarcoma protuberans (DFSP) is a tumor of the subcutaneous tissue that grows slowly and invades locally, rarely spreading to other parts of the body but often recurring after surgery.</div></div><div><h3>Case presentation</h3><div>This case report presents a 59-year-old man with a recurrent, large Dermatofibrosarcoma Protuberans (DFSP) tumor. The tumor had grown significantly, extending from the anterior chest wall into the mediastinum through the foramen of Morgagni and into the left chest cavity, directly invading the left anterior chest wall. The mass was surgically removed, and the resulting chest wall defect was repaired using a latissimus dorsi muscle flap and a split-thickness skin graft. The patient was successfully discharged 10 days after surgery, following the healing of the wound and skin graft.</div></div><div><h3>Clinical discussion</h3><div>DFSPs represent less than 1 percent of all soft tissue tumors. Over 90 % of DFSP tumors have the chromosomal translocation t(17;22). Typically, Mohs micrographic surgery with continuous histological margin control is needed to reduce local recurrence rates. Adjuvant chemotherapy and radiation therapy may be useful.</div></div><div><h3>Conclusion</h3><div>Surgical approaches such as Mohs micrographic surgery or wide local excision with 5 cm negative margins are essential to prevent recurrence and minimize the overall impact of the disease. Mohs micrographic surgery is a specialized technique that aims for complete tumor removal while preserving as much healthy tissue as possible.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast abscess with intrathoracic communication 伴有胸腔内沟通的乳腺脓肿

Surgery Case Reports

Pub Date : 2025-03-27 DOI: 10.1016/j.sycrs.2025.100098

Hannah Dunlop, Simon Mbarushimana, Kevin Etherson, Palanivelraju Gopalakrishnan

We present a rare case of a breast abscess communicating with the thoracic cavity. This was discovered intra-operatively during incision and drainage of the abscess by the general surgery on-call team because of raised inflammatory markers and pyrexia. A chest x-ray was obtained intra-operatively and chest drain inserted, before transfer to cardiothoracics. The patient was subsequently discharged with no further interventions but failed to attend breast care services for follow up. This case highlights the importance of referring all breast abscesses to acute secondary care for assessment and immediate intervention if required. Onward referral to breast outpatient clinic is only appropriate in patients who are clinically well. It also raises the question of whether further imaging should be undertaken in high-risk patients before surgical intervention of acute breast abscesses. While breast abscesses are typically managed successfully in outpatient settings, rare complications, such as intra-thoracic extension into the intrapleural space, can occur. Irrespective of the underlying aetiology, this case report highlights the importance of considering rare complications in the management of breast abscesses, particularly in patients with a history of systemic upset and atypical symptoms. Prompt diagnosis, interdisciplinary collaboration, and timely surgical intervention are crucial in achieving successful outcomes in such challenging scenarios. Further studies and reports on similar cases will contribute to a better understanding of this rare complication and aid in optimising treatment strategies.

我们介绍了一例罕见的乳腺脓肿与胸腔相通的病例。由于炎症指标升高和发热，普外科值班团队在术中切开并引流脓肿时发现了这一情况。术中进行了胸部 X 光检查，并插入胸腔引流管，然后转至心胸科。患者随后出院，没有接受进一步干预，但没有到乳腺护理服务机构接受随访。该病例强调了将所有乳腺脓肿转诊至急诊二级医疗机构进行评估并在必要时立即进行干预的重要性。只有临床状况良好的患者才适合转诊至乳腺门诊。这也提出了一个问题：在对急性乳腺脓肿进行手术治疗前，是否应对高危患者进行进一步的影像学检查。虽然乳腺脓肿通常都能在门诊得到成功治疗，但也会出现罕见的并发症，如胸腔内扩展到胸膜腔内。无论病因如何，本病例报告强调了在治疗乳腺脓肿时考虑罕见并发症的重要性，尤其是对于有全身不适史和非典型症状的患者。在这种具有挑战性的情况下，及时诊断、跨学科合作和及时手术干预是取得成功结果的关键。对类似病例的进一步研究和报告将有助于更好地了解这种罕见的并发症，并有助于优化治疗策略。

{"title":"Breast abscess with intrathoracic communication","authors":"Hannah Dunlop, Simon Mbarushimana, Kevin Etherson, Palanivelraju Gopalakrishnan","doi":"10.1016/j.sycrs.2025.100098","DOIUrl":"10.1016/j.sycrs.2025.100098","url":null,"abstract":"<div><div>We present a rare case of a breast abscess communicating with the thoracic cavity. This was discovered intra-operatively during incision and drainage of the abscess by the general surgery on-call team because of raised inflammatory markers and pyrexia. A chest x-ray was obtained intra-operatively and chest drain inserted, before transfer to cardiothoracics. The patient was subsequently discharged with no further interventions but failed to attend breast care services for follow up. This case highlights the importance of referring all breast abscesses to acute secondary care for assessment and immediate intervention if required. Onward referral to breast outpatient clinic is only appropriate in patients who are clinically well. It also raises the question of whether further imaging should be undertaken in high-risk patients before surgical intervention of acute breast abscesses. While breast abscesses are typically managed successfully in outpatient settings, rare complications, such as intra-thoracic extension into the intrapleural space, can occur. Irrespective of the underlying aetiology, this case report highlights the importance of considering rare complications in the management of breast abscesses, particularly in patients with a history of systemic upset and atypical symptoms. Prompt diagnosis, interdisciplinary collaboration, and timely surgical intervention are crucial in achieving successful outcomes in such challenging scenarios. Further studies and reports on similar cases will contribute to a better understanding of this rare complication and aid in optimising treatment strategies.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Surgery Case Reports

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀