Pub Date : 2024-12-15DOI: 10.1016/j.sycrs.2024.100083
Ubaid Ullah , Malik W.Z. Khan , Aamina Sher , Hammad Iftikhar , Aizaz Ali , Shandana Ali , Salman Khan , Sajjad Ullah
Background
Neural tube defects (NTDs) result from incomplete neural fold fusion during early embryonic development and can occur at various stages (gastrulation, primary, and secondary neurulation). While rare, NTDs at multiple sites require clinical and imaging assessments for management. The "Zipper closure" and "Multisite closure" theories explain these defects, though some anomalies remain unexplained, calling for more research.
Case Presentation
A two-month-old female presented with two NTDs: occipital meningoencephalocele and lumbar myelomeningocele. Both defects were successfully treated surgically, leading to positive neurological outcomes.
Conclusion
This case supports the multisite closure theory of NTDs and emphasizes the importance of early surgical intervention to prevent complications.
{"title":"Multisite neural tube defects: Management of a complex case and review of theories on neural tube closure","authors":"Ubaid Ullah , Malik W.Z. Khan , Aamina Sher , Hammad Iftikhar , Aizaz Ali , Shandana Ali , Salman Khan , Sajjad Ullah","doi":"10.1016/j.sycrs.2024.100083","DOIUrl":"10.1016/j.sycrs.2024.100083","url":null,"abstract":"<div><h3>Background</h3><div>Neural tube defects (NTDs) result from incomplete neural fold fusion during early embryonic development and can occur at various stages (gastrulation, primary, and secondary neurulation). While rare, NTDs at multiple sites require clinical and imaging assessments for management. The \"Zipper closure\" and \"Multisite closure\" theories explain these defects, though some anomalies remain unexplained, calling for more research.</div></div><div><h3>Case Presentation</h3><div>A two-month-old female presented with two NTDs: occipital meningoencephalocele and lumbar myelomeningocele. Both defects were successfully treated surgically, leading to positive neurological outcomes.</div></div><div><h3>Conclusion</h3><div>This case supports the multisite closure theory of NTDs and emphasizes the importance of early surgical intervention to prevent complications.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098712","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}
Pub Date : 2024-12-11DOI: 10.1016/j.sycrs.2024.100081
Charles Petrus Theron, Collen Sandile Nkosi , Lyndon Grant Biddulph
Pseudoaneurysms in the hands are rare entities, with only a few reported cases in English literature. The majority of these lesions arise from penetrating trauma, previous surgery, or artery puncture. Pseudoaneurysms are frequently missed, hence a strong clinical suspicion is required to make the correct diagnosis in a timely manner. We present a case of traumatic pseudoaneurysm of the superficial palmar arch in a 17-year-old CP child following a fall. The patient had a delayed presentation and was initially misdiagnosed as having a palmar abscess. We performed an ultrasound and CT angiogram to confirm the diagnosis of a superficial palmar arch pseudoaneurysm. We treated the patient surgically, and the wound healed uneventfully. Pseudoaneurysms should be included in the differential diagnosis of palmar masses.
{"title":"Traumatic pseudoaneurysm of the superficial left palmar arch: A case report","authors":"Charles Petrus Theron, Collen Sandile Nkosi , Lyndon Grant Biddulph","doi":"10.1016/j.sycrs.2024.100081","DOIUrl":"10.1016/j.sycrs.2024.100081","url":null,"abstract":"<div><div>Pseudoaneurysms in the hands are rare entities, with only a few reported cases in English literature. The majority of these lesions arise from penetrating trauma, previous surgery, or artery puncture. Pseudoaneurysms are frequently missed, hence a strong clinical suspicion is required to make the correct diagnosis in a timely manner. We present a case of traumatic pseudoaneurysm of the superficial palmar arch in a 17-year-old CP child following a fall. The patient had a delayed presentation and was initially misdiagnosed as having a palmar abscess. We performed an ultrasound and CT angiogram to confirm the diagnosis of a superficial palmar arch pseudoaneurysm. We treated the patient surgically, and the wound healed uneventfully. Pseudoaneurysms should be included in the differential diagnosis of palmar masses.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093957","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}
Pub Date : 2024-12-11DOI: 10.1016/j.sycrs.2024.100082
Irene S. Zuin , Junya Kitadani , Jessie A. Elliott , Nadia Haj Mohammad , Jan E. Freund , Jelle P. Ruurda , Richard van Hillegersberg
Background
Despite advancements in surgical techniques and perioperative care, approximately 50 % of patients treated with curative esophagectomy for esophageal cancer will develop recurrence. To date, there is an absence of guidelines for the management of regional lymph node recurrence, reflecting a lack of quality data in the literature.
Case presentation
We present the case of a 59-year-old female who experienced an oligometastatic recurrence involving the level 2 L left paratracheal and level III left cervical nodal stations, after previous perioperative chemotherapy and minimally invasive esophagectomy for esophageal adenocarcinoma four months earlier. The patient was treated with robotic-assisted paratracheal and cervical lymphadenectomy using the Da Vinci XI system. Postoperatively, the patient recovered uneventfully, and short-term follow-up demonstrated no residual disease.
Discussion
This case highlights the complexity of managing recurrent esophageal cancer and the potential role of robotic surgical strategies in improving patient outcomes in the context of oligometastatic recurrence. Additionally, it underscores the need for further research to refine surgical techniques and case selection, and to establish guidelines for the treatment of recurrent esophageal cancer.
Conclusion
Robotic-assisted lymphadenectomy represents a feasible option for managing locoregional recurrence of esophageal adenocarcinoma in select cases. Multidisciplinary team involvement remains critical to individualized treatment planning.
{"title":"Robotic thoracoscopic left paratracheal and cervical lymphadenectomy for recurrent esophageal adenocarcinoma: A case report","authors":"Irene S. Zuin , Junya Kitadani , Jessie A. Elliott , Nadia Haj Mohammad , Jan E. Freund , Jelle P. Ruurda , Richard van Hillegersberg","doi":"10.1016/j.sycrs.2024.100082","DOIUrl":"10.1016/j.sycrs.2024.100082","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in surgical techniques and perioperative care, approximately 50 % of patients treated with curative esophagectomy for esophageal cancer will develop recurrence. To date, there is an absence of guidelines for the management of regional lymph node recurrence, reflecting a lack of quality data in the literature.</div></div><div><h3>Case presentation</h3><div>We present the case of a 59-year-old female who experienced an oligometastatic recurrence involving the level 2 L left paratracheal and level III left cervical nodal stations, after previous perioperative chemotherapy and minimally invasive esophagectomy for esophageal adenocarcinoma four months earlier. The patient was treated with robotic-assisted paratracheal and cervical lymphadenectomy using the Da Vinci XI system. Postoperatively, the patient recovered uneventfully, and short-term follow-up demonstrated no residual disease.</div></div><div><h3>Discussion</h3><div>This case highlights the complexity of managing recurrent esophageal cancer and the potential role of robotic surgical strategies in improving patient outcomes in the context of oligometastatic recurrence. Additionally, it underscores the need for further research to refine surgical techniques and case selection, and to establish guidelines for the treatment of recurrent esophageal cancer.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted lymphadenectomy represents a feasible option for managing locoregional recurrence of esophageal adenocarcinoma in select cases. Multidisciplinary team involvement remains critical to individualized treatment planning.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098711","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}
Aortoenteric fistula (AEF) is a rare condition where abnormal communication exists between the abdominal aorta and any part of the GI tract, most commonly, the third/fourth part of the duodenum. The incidence rate of primary aorto-duodenal fistula (PADF) on autopsy is 0.04 to 0.7 %, and the post-operative incidence rate of a secondary AEF is 0.5 to 2.3 %. An AEF can be diagnosed using either an upper gastrointestinal endoscopy (UGIE) or a contrast-enhanced computed tomography (CECT) angiography of the abdomen, and urgent repair is required by surgical or endovascular means.
Methods
We report the case of a 64-year-old gentleman with a bleeding PADF. He was evaluated using UGIE and CT angiography of abdomen and underwent total endovascular repair of the aneurysm.
Discussion
PADF is a rare cause of GI bleeding, accounting for only 0.2 % of all GI bleeds. The patient can initially show signs of a herald bleed but can also present with the classical triad of pulsatile abdominal lump, GI bleed, and abdominal pain. Endoscopy should be the initial investigation of choice for a stable patient. A negative EGD does not rule out the possibility of a PADF. CECT abdominal angiography can also be a useful diagnostic modality; some consider it superior to UGIE or aortography.
Conclusion
PADF is a rare but life-threatening condition that requires prompt recognition and intervention, either by surgery or endovascular repair.
{"title":"Primary aorto-duodenal fistula: A case report and review of literature","authors":"Anubhavv Gupta , Deeksha Kapoor , Ravindra Vats , Suhail Naseem Bukhari , Deep Goel","doi":"10.1016/j.sycrs.2024.100080","DOIUrl":"10.1016/j.sycrs.2024.100080","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortoenteric fistula (AEF) is a rare condition where abnormal communication exists between the abdominal aorta and any part of the GI tract, most commonly, the third/fourth part of the duodenum. The incidence rate of primary aorto-duodenal fistula (PADF) on autopsy is 0.04 to 0.7 %, and the post-operative incidence rate of a secondary AEF is 0.5 to 2.3 %. An AEF can be diagnosed using either an upper gastrointestinal endoscopy (UGIE) or a contrast-enhanced computed tomography (CECT) angiography of the abdomen, and urgent repair is required by surgical or endovascular means.</div></div><div><h3>Methods</h3><div>We report the case of a 64-year-old gentleman with a bleeding PADF. He was evaluated using UGIE and CT angiography of abdomen and underwent total endovascular repair of the aneurysm.</div></div><div><h3>Discussion</h3><div>PADF is a rare cause of GI bleeding, accounting for only 0.2 % of all GI bleeds. The patient can initially show signs of a herald bleed but can also present with the classical triad of pulsatile abdominal lump, GI bleed, and abdominal pain. Endoscopy should be the initial investigation of choice for a stable patient. A negative EGD does not rule out the possibility of a PADF. CECT abdominal angiography can also be a useful diagnostic modality; some consider it superior to UGIE or aortography.</div></div><div><h3>Conclusion</h3><div>PADF is a rare but life-threatening condition that requires prompt recognition and intervention, either by surgery or endovascular repair.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093956","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}
A collision tumor involves the coexistence of two histologically distinct neoplasms in one anatomical location. These are rare in the pancreas and are associated with a poor prognosis. We present the first case of an incidentally diagnosed pancreatic collision tumor, consisting of an extraosseous Ewing-like sarcoma and a solid pseudopapillary tumor, in a 43-year-old male. This case emphasizes the diagnostic and therapeutic challenges associated with pancreatic collision tumors. It highlights the necessity of a multidisciplinary approach and adherence to treatment protocols, with a focus on prioritizing treatment based on the more aggressive histology to achieve optimal outcomes.
{"title":"Collision tumor of the pancreas: Extraskeletal Ewing-like sarcoma and solid pseudopapillary tumor","authors":"Naveen Kumar Kushwaha , Pradeep Jaiswal , Nihanthy Sreenath , Peeyush Bhatt","doi":"10.1016/j.sycrs.2024.100078","DOIUrl":"10.1016/j.sycrs.2024.100078","url":null,"abstract":"<div><div>A collision tumor involves the coexistence of two histologically distinct neoplasms in one anatomical location. These are rare in the pancreas and are associated with a poor prognosis. We present the first case of an incidentally diagnosed pancreatic collision tumor, consisting of an extraosseous Ewing-like sarcoma and a solid pseudopapillary tumor, in a 43-year-old male. This case emphasizes the diagnostic and therapeutic challenges associated with pancreatic collision tumors. It highlights the necessity of a multidisciplinary approach and adherence to treatment protocols, with a focus on prioritizing treatment based on the more aggressive histology to achieve optimal outcomes.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093952","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}
Respiratory amyloidosis manifests in three forms: focal/diffuse tracheobronchial, nodular parenchymal, and diffuse parenchymal. Surgical treatment is typically reserved for localized nodular pulmonary amyloidosis, while bronchoscopic techniques, radiotherapy, and medical therapy are preferred for other forms based on the specific subtype. We present two cases of pulmonary amyloidosis that were initially misdiagnosed as malignant based on cytology and imaging studies, but were later confirmed as amyloidosis following surgical resection. These cases highlight the potential role of surgery in such scenarios, extending its therapeutic value beyond conventional indications, as documented in the literature.
{"title":"Amyloidosis presenting as a malignancy: Two case reports and key diagnostic clues","authors":"Naveen Kumar Kushwaha , Laleng Mawia Darlong , Sunil Pasricha , Prerna Garg , Prafull Kumar Gamit","doi":"10.1016/j.sycrs.2024.100079","DOIUrl":"10.1016/j.sycrs.2024.100079","url":null,"abstract":"<div><div>Respiratory amyloidosis manifests in three forms: focal/diffuse tracheobronchial, nodular parenchymal, and diffuse parenchymal. Surgical treatment is typically reserved for localized nodular pulmonary amyloidosis, while bronchoscopic techniques, radiotherapy, and medical therapy are preferred for other forms based on the specific subtype. We present two cases of pulmonary amyloidosis that were initially misdiagnosed as malignant based on cytology and imaging studies, but were later confirmed as amyloidosis following surgical resection. These cases highlight the potential role of surgery in such scenarios, extending its therapeutic value beyond conventional indications, as documented in the literature.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156876","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}
Pub Date : 2024-11-14DOI: 10.1016/j.sycrs.2024.100070
Hanne-Eva van Bremen , Jorn P. Meekel , Steven P. Kerssemakers , Gerwin A. Fransen , Sandra Muller
Background
Core needle biopsy of the breast is a widely used technique to obtain a specimen for histopathological examination. Stereotactic biopsy occasionally result incomplications such as infection or hematoma. The development of a pseudoaneurysm after breast biopsy; however, is a rare complication.
Case presentation
A 56-year-old postmenopausal woman using a vitamin K antagonist presented with a suspicious lesion in the lateral upper quadrant of the right breast, initially classified as BI-RADS 3. After 24 months, an increase in calcification led to reclassification as BI-RADS 4, prompting stereotactic biopsy without periprocedural complications. One month later, the patient presented with continuous swelling accompanied by pain. Ultrasound and Doppler revealed a concentric collection with a to-and-fro waveform, indicating a pseudoaneurysm. Treatment with thrombin injection successfully induced thrombosis. Follow-up at six weeks demonstrated complete regression of the mass without signs of residual blood flow.
Conclusions
Thrombin injection appears to be a safe and effective treatment for the occurrence of pseudoaneurysm following stereotactic breast biopsy.
背景乳腺芯针活检是一种广泛使用的技术，用于获取标本进行组织病理学检查。立体定向活检偶尔会导致感染或血肿等并发症。然而，乳腺活检后出现假性动脉瘤是一种罕见的并发症。病例介绍 一位 56 岁的绝经后妇女在服用维生素 K 拮抗剂后出现右乳房外上象限可疑病变，最初被归类为 BI-RADS 3。一个月后，患者出现持续肿胀并伴有疼痛。超声波和多普勒显示有一个同心的集合体，波形忽高忽低，显示为假性动脉瘤。注射凝血酶的治疗成功诱导了血栓形成。结论注射凝血酶似乎是治疗乳腺立体定向活检术后假性动脉瘤的一种安全有效的方法。
{"title":"Pseudoaneurysm in the axillary tail of the breast following stereotactic biopsy: A case report and literature review","authors":"Hanne-Eva van Bremen , Jorn P. Meekel , Steven P. Kerssemakers , Gerwin A. Fransen , Sandra Muller","doi":"10.1016/j.sycrs.2024.100070","DOIUrl":"10.1016/j.sycrs.2024.100070","url":null,"abstract":"<div><h3>Background</h3><div>Core needle biopsy of the breast is a widely used technique to obtain a specimen for histopathological examination. Stereotactic biopsy occasionally result incomplications such as infection or hematoma. The development of a pseudoaneurysm after breast biopsy; however, is a rare complication.</div></div><div><h3>Case presentation</h3><div>A 56-year-old postmenopausal woman using a vitamin K antagonist presented with a suspicious lesion in the lateral upper quadrant of the right breast, initially classified as BI-RADS 3. After 24 months, an increase in calcification led to reclassification as BI-RADS 4, prompting stereotactic biopsy without periprocedural complications. One month later, the patient presented with continuous swelling accompanied by pain. Ultrasound and Doppler revealed a concentric collection with a to-and-fro waveform, indicating a pseudoaneurysm. Treatment with thrombin injection successfully induced thrombosis. Follow-up at six weeks demonstrated complete regression of the mass without signs of residual blood flow.</div></div><div><h3>Conclusions</h3><div>Thrombin injection appears to be a safe and effective treatment for the occurrence of pseudoaneurysm following stereotactic breast biopsy.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700917","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}
Pub Date : 2024-11-13DOI: 10.1016/j.sycrs.2024.100071
Tim Baumgartner, Hishaam Ismael, David Young
Small bowel diverticulosis, less common than colonic diverticulosis (incidence 1–2 %), predominantly affects males, and risk increases with age. Approximately 15 % or patients present with complications including bleeding, perforations with peritonitis, or fistulas, and these complications can be fatal with mortality rates as high as 40 % in cases of perforation. While some reports have suggested that patients can avoid surgery with bowel rest and antibiotics, or the use of CT guided aspiration of abscesses related to the disease, this case series examines 5 patients with perforated jejunal diverticulitis at a single institution successfully managed with surgical resection in the emergent and elective settings following recurrence of symptoms. There are limitations to medical management and lifestyle modifications alone, while elective surgical resection is effective in symptom management and risk reduction.
{"title":"Management of perforated jejunal diverticulitis: A case series and literature review","authors":"Tim Baumgartner, Hishaam Ismael, David Young","doi":"10.1016/j.sycrs.2024.100071","DOIUrl":"10.1016/j.sycrs.2024.100071","url":null,"abstract":"<div><div>Small bowel diverticulosis, less common than colonic diverticulosis (incidence 1–2 %), predominantly affects males, and risk increases with age. Approximately 15 % or patients present with complications including bleeding, perforations with peritonitis, or fistulas, and these complications can be fatal with mortality rates as high as 40 % in cases of perforation. While some reports have suggested that patients can avoid surgery with bowel rest and antibiotics, or the use of CT guided aspiration of abscesses related to the disease, this case series examines 5 patients with perforated jejunal diverticulitis at a single institution successfully managed with surgical resection in the emergent and elective settings following recurrence of symptoms. There are limitations to medical management and lifestyle modifications alone, while elective surgical resection is effective in symptom management and risk reduction.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748782","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}
Pub Date : 2024-11-01DOI: 10.1016/j.sycrs.2024.100077
Dima Malkawi, Janet Lee, Micheal Shane McNevin
Non-Hodgkin's lymphomas are a diverse group of immune system cancers that can affect any organ in the body. Few reports describe the development of malignant lymphoma in internal or external hemorrhoids. We present the case of a 67-year-old female with a long-standing history of non-bleeding, prolapsing hemorrhoids, and recent significant weight loss. Following an excisional hemorrhoidectomy, pathological analysis revealed high-grade diffuse large B-cell non-Hodgkin lymphoma (DLBCL) involving the mucosal hemorrhoid tissue. The case underscores the importance of considering malignancy in atypical presentations of common conditions. Treatment for anal canal lymphomas remains uncertain, with medical management generally preferred over surgery. Accurate diagnosis requires histopathologic examination due to the overlap of clinical features with other pathologies.
非霍奇金淋巴瘤是一种多种多样的免疫系统癌症，可影响身体的任何器官。很少有报告描述恶性淋巴瘤发生在内痔或外痔。我们介绍了一例 67 岁女性的病例，她长期患有不出血、脱垂的痔疮，近期体重明显下降。痔切除术后，病理分析发现高级别弥漫大 B 细胞非霍奇金淋巴瘤（DLBCL）累及痔粘膜组织。该病例强调了在常见疾病的非典型表现中考虑恶性肿瘤的重要性。肛管淋巴瘤的治疗方法仍不确定，通常首选药物治疗而非手术治疗。由于临床特征与其他病变重叠，准确诊断需要组织病理学检查。
{"title":"High-grade diffuse large B cell non-Hodgkin lymphoma involving the mucosal hemorrhoid tissue: A case report","authors":"Dima Malkawi, Janet Lee, Micheal Shane McNevin","doi":"10.1016/j.sycrs.2024.100077","DOIUrl":"10.1016/j.sycrs.2024.100077","url":null,"abstract":"<div><div>Non-Hodgkin's lymphomas are a diverse group of immune system cancers that can affect any organ in the body. Few reports describe the development of malignant lymphoma in internal or external hemorrhoids. We present the case of a 67-year-old female with a long-standing history of non-bleeding, prolapsing hemorrhoids, and recent significant weight loss. Following an excisional hemorrhoidectomy, pathological analysis revealed high-grade diffuse large B-cell non-Hodgkin lymphoma (DLBCL) involving the mucosal hemorrhoid tissue. The case underscores the importance of considering malignancy in atypical presentations of common conditions. Treatment for anal canal lymphomas remains uncertain, with medical management generally preferred over surgery. Accurate diagnosis requires histopathologic examination due to the overlap of clinical features with other pathologies.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"3 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553341","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}
Bariatric surgery has quickly emerged as one of the most effective treatments for obesity in the world and is mostly known as a safe and effective method; however, in some cases, it may lead to life-threatening complications. One of these complications is fistula, which may result in high mortality and morbidity. The treatment methods for this condition have been subject to ongoing discussion, ranging from endoscopic procedures to surgery. However, the outcome of each approach remains uncertain for both patients and surgeons. A 21-year-old man presented with pulmonary symptoms such as cough, pleuritic chest pain, and fever two months after laparoscopic sleeve gastrectomy and in further investigations, the diagnosis of gastrobronchial fistula (GBF) was confirmed. The treatment of the patient was based on endoscopic procedures and prioritizing minimally invasive methods over surgical interventions.
The treatment approach that is recommended for patients with GBF is the stepwise method, in which the next step is performed according to the patient's condition. Also, the treatment was based on minimally invasive procedures like endoscopic-based methods, also it is advisable to avoid conducting invasive treatments such as surgical procedures until the patient has shown a response to either non-invasive or minimally invasive treatments.
Conclusion
The key finding of this case report emphasizes that in situations of acute or unstable conditions or even if there is still hope for treatment, it's better to avoid invasive procedures. Rather, opting for non-invasive or minimally invasive treatments is favored to stabilize the patient's clinical or lab parameters, or to maintain a steady and consistent weight. Therefore, it is advisable to refrain from or delay surgical and invasive procedures during the acute stages or when a GBF is newly diagnosed, allowing the patient to attain a more stable clinical condition and use surgical approaches as a complementary choice besides minimally invasive procedures.
{"title":"A stepwise treatment of gastrobronchial fistula after laparoscopic sleeve gastrectomy: A case report\"","authors":"Behrouz Keleidari , Koorosh Parchami , Erfan Sheikhbahaei , Mohammad ghayoomi","doi":"10.1016/j.sycrs.2024.100076","DOIUrl":"10.1016/j.sycrs.2024.100076","url":null,"abstract":"<div><div>Bariatric surgery has quickly emerged as one of the most effective treatments for obesity in the world and is mostly known as a safe and effective method; however, in some cases, it may lead to life-threatening complications. One of these complications is fistula, which may result in high mortality and morbidity. The treatment methods for this condition have been subject to ongoing discussion, ranging from endoscopic procedures to surgery. However, the outcome of each approach remains uncertain for both patients and surgeons. A 21-year-old man presented with pulmonary symptoms such as cough, pleuritic chest pain, and fever two months after laparoscopic sleeve gastrectomy and in further investigations, the diagnosis of gastrobronchial fistula (GBF) was confirmed. The treatment of the patient was based on endoscopic procedures and prioritizing minimally invasive methods over surgical interventions.</div><div>The treatment approach that is recommended for patients with GBF is the stepwise method, in which the next step is performed according to the patient's condition. Also, the treatment was based on minimally invasive procedures like endoscopic-based methods, also it is advisable to avoid conducting invasive treatments such as surgical procedures until the patient has shown a response to either non-invasive or minimally invasive treatments.</div></div><div><h3>Conclusion</h3><div>The key finding of this case report emphasizes that in situations of acute or unstable conditions or even if there is still hope for treatment, it's better to avoid invasive procedures. Rather, opting for non-invasive or minimally invasive treatments is favored to stabilize the patient's clinical or lab parameters, or to maintain a steady and consistent weight. Therefore, it is advisable to refrain from or delay surgical and invasive procedures during the acute stages or when a GBF is newly diagnosed, allowing the patient to attain a more stable clinical condition and use surgical approaches as a complementary choice besides minimally invasive procedures.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"3 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553340","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}
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