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Bloody nipple discharge in young children: mammary duct ectasia as a benign, self-limiting condition. 幼儿乳头溢血:乳管扩张是一种良性、自限性疾病。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag028
Mohammed Al Blooshi, Dalia D Abdulrahman, Wisam Salih Saad, Usman Javaid, Vipul Gupta

Bloody nipple discharge in children is rare and often alarms families because of its malignant associations in adults. We describe two prepubertal boys (3 and 5 years) with unilateral, spontaneous, painless bloody nipple discharge without trauma, infection, systemic symptoms, or exogenous hormone exposure. Examinations showed only mild unilateral breast change, with no masses, skin or nipple abnormalities, or lymphadenopathy. Breast ultrasonography was the primary investigation: one child had retroareolar ductal dilatation with cystic change consistent with mammary duct ectasia; the other had normal breast architecture. When obtained, laboratory, microbiologic, and cytologic studies were unremarkable. Both patients were managed conservatively with caregiver counseling and structured clinical/sonographic follow-up. Discharge resolved spontaneously within 14 and 8 months, respectively, with complete clinical and imaging resolution and no recurrence. These cases support ultrasound-based assessment and expectant management when no concerning features are present.

带血的乳头溢液在儿童中是罕见的,并且经常引起家庭的警惕,因为它在成人中有恶性关联。我们描述了两个青春期前男孩(3岁和5岁)单侧,自发,无痛血性乳头溢液,无创伤,感染,全身性症状,或外源性激素暴露。检查显示只有轻微的单侧乳房改变,没有肿块,皮肤或乳头异常,或淋巴结病变。乳房超声检查为主要调查:1例患儿乳晕后导管扩张伴囊性改变,符合乳腺导管扩张;另一组乳房结构正常。当获得时,实验室、微生物学和细胞学的研究结果并不显著。两例患者均采用保守治疗,包括护理人员咨询和结构化的临床/超声随访。分别于14个月和8个月自行消退,临床和影像学完全消退,无复发。当没有相关特征时,这些病例支持基于超声的评估和预期管理。
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引用次数: 0
Small bowel obstruction from jejunal gastrointestinal stromal tumour in a young adult with neurofibromatosis type 10: a case report. 年轻成人10型神经纤维瘤病空肠胃肠道间质瘤引起的小肠梗阻1例报告。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag030
Anaan Fareed, Jordan Barrett, Ali Al-Mashat, Sanjaya Karunaratne

Neurofibromatosis type 1 is an autosomal dominant disorder associated with an increased risk of tumours, including gastrointestinal stromal tumours. These are usually asymptomatic and discovered incidentally. Small bowel obstruction due to gastrointestinal stromal tumour in neurofibromatosis 1 is rare, especially in young adults. We report a 24-year-old man with neurofibromatosis type 1 who presented with right upper quadrant pain and biochemical features of acute cholecystitis. During laparoscopic cholecystectomy, unexpected small bowel dilatation prompted conversion to laparotomy, revealing obstruction from a large multifocal jejunal gastrointestinal stromal tumour. This case highlights the rarity of such a presentation and the importance of surgical adaptability intraoperatively.

1型神经纤维瘤病是一种常染色体显性遗传病,与肿瘤风险增加相关,包括胃肠道间质瘤。这些通常是无症状的,是偶然发现的。神经纤维瘤病1中由胃肠道间质肿瘤引起的小肠梗阻是罕见的,特别是在年轻人中。我们报告一位24岁的男性1型神经纤维瘤病患者,表现为右上腹部疼痛和急性胆囊炎的生化特征。在腹腔镜胆囊切除术中,意外的小肠扩张促使转为剖腹手术,发现一个大的多灶空肠胃肠道间质肿瘤阻塞。这个病例强调了这种表现的罕见性和术中手术适应性的重要性。
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引用次数: 0
Neuroendocrine tumor arising in Meckel's diverticulum presenting with bowel obstruction. 发生于梅克尔憩室的神经内分泌肿瘤,表现为肠梗阻。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag025
Jillian C Dawley, James H McClenathan, Belinda L Sun

Meckel's diverticulum (MD) is a common developmental abnormality of the gastrointestinal tract that, in adults, is usually asymptomatic but can present with complications including malignancy. Although malignancy in MD is rare overall, MD is recognized a high-risk site for tumorigenesis compared to the surrounding ileum. Neuroendocrine neoplasms are the most common malignancy arising in MD and are often associated with nodal metastases, even if the primary tumor is small. We report the case of a 66-year-old male who underwent exploratory laparotomy for small bowel obstruction and was intraoperatively found to have MD causing an internal hernia. Pathologic examination of the diverticulectomy specimen revealed a well-differentiated neuroendocrine tumor, grade 1, pathologic stage pT2. The case highlights the role of resection for incidentally found and symptomatic MD due to the elevated risk of malignancy at this site.

梅克尔憩室(MD)是一种常见的胃肠道发育异常,在成人中通常无症状,但可出现包括恶性肿瘤在内的并发症。虽然MD的恶性肿瘤总体上是罕见的,但与周围的回肠相比,MD被认为是肿瘤发生的高风险部位。神经内分泌肿瘤是MD中最常见的恶性肿瘤,即使原发肿瘤很小,也常伴有淋巴结转移。我们报告一例66岁男性,因小肠梗阻行剖腹探查术,术中发现MD引起内疝。憩室切除标本病理检查显示为分化良好的神经内分泌肿瘤,1级,病理分期pT2。该病例强调了由于该部位恶性肿瘤风险升高,对偶然发现的有症状的MD进行切除的作用。
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引用次数: 0
Staged phalloplasty in a transgender male: a complex case report. 变性男性分阶段阴茎成形术:一个复杂的病例报告。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag019
Yasmine Ibrahim, Maxwell Zywica, Michael R DeLong

We present a novel local groin flap approach for phalloplasty with minimal visible scarring. The presented patient is a 32-year-old transgender male with a prior metoidioplasty. He desired phalloplasty to optimized standing micturition and sexual function but was unwilling to undergo standard radial forearm or anterolateral thigh due to high visible scar burden. A staged approach to phalloplasty was employed, using a lower abdominal random pattern flap to construct the phallus. Once healed, future stages will create a urethral channel with full thickness skin graft from the thigh to maintain a low scar burden. Although this technique does not provide an option for direct neurotization of the construct, burial of the clitoral structures is expected to provide adequate sexual function. This technique can be considered for patients who do not desire the typical visible scarring with traditional phalloplasty methods.

我们提出了一种新的局部腹股沟皮瓣的方法阴茎成形术最小的可见疤痕。本病例为32岁变性男性,既往行过子宫内膜成形术。他希望阴茎成形术来优化站立排尿和性功能,但不愿意接受标准前臂桡骨或大腿前外侧,因为可见疤痕负担高。采用分阶段的方法来阴茎成形术,使用下腹部随机皮瓣来构建阴茎。一旦愈合,未来的阶段将建立一个尿道通道,从大腿移植全层皮肤,以保持低疤痕负担。虽然这项技术不能提供直接神经化结构的选择,但阴蒂结构的埋藏有望提供足够的性功能。对于那些不希望在传统阴茎成形术中留下明显疤痕的患者,可以考虑采用这种技术。
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引用次数: 0
Recurrent abdominopelvic solitary fibrous tumours with Doege-Potter syndrome successfully treated with surgical resection following embolization: a case report. 栓塞后手术切除成功治疗复发性多吉-波特综合征腹腔孤立性纤维肿瘤1例。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-28 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag014
Yuka Yanagida, Akihiro Cho, Yukiko Niwa, Takeshi Ishita, Toshihiko Mori, Moe Tanemura, Atsushi Oda, Ryota Higuchi, Masaho Ota, Satoshi Katagiri, Tadao Nakazawa

Solitary fibrous tumours can cause non-islet cell tumour-induced hypoglycaemia, a paraneoplastic syndrome resulting from extrapancreatic tumours secreting insulin-like growth factor -II. This is also known as Doege-Potter syndrome. A male patient in his 70s presented to our hospital with loss of consciousness because of a second relapse of the solitary fibrous tumour with Doege-Potter syndrome. A third surgery was performed after transcatheter arterial embolization. After surgery, blood glucose levels stabilized. Repeated relapses can occur in solitary fibrous tumours even after the complete resection. Embolization of the feeding arteries before resection may be effective in avoiding massive haemorrhage and reducing complications.

孤立的纤维肿瘤可引起非胰岛细胞肿瘤诱导的低血糖,这是一种由胰腺外肿瘤分泌胰岛素样生长因子-II引起的副肿瘤综合征。这也被称为多吉-波特综合症。一位70多岁的男性患者因孤立性纤维性肿瘤第二次复发并伴有多格-波特综合征而丧失意识。经导管动脉栓塞后进行第三次手术。手术后,血糖水平稳定下来。即使在完全切除后,单发纤维性肿瘤也可能反复复发。在切除前对供血动脉进行栓塞可以有效地避免大出血和减少并发症。
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引用次数: 0
Schistosomal appendicitis: a case series. 血吸虫性阑尾炎:一个病例系列。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-28 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag007
Eyad A Hijan, Mohammed N AlAli, Abdullah S Al-Darwish, Sadiq M Amer, Muath Alasheikh, Muath AlRashed, Saud K Aldeghaither, Mohamed S Essa

Schistosomiasis is a neglected tropical disease with significant morbidity, yet appendicitis secondary to schistosomal infestation remains rare, even in endemic regions. We report a series of five cases of acute appendicitis in adult patients, where histopathological examination revealed schistosomal appendicitis. All patients presented with classical features of acute appendicitis, underwent appendectomy, and recovered uneventfully. One case demonstrated mural calcifications on preoperative imaging, raising suspicion of schistosomiasis preoperatively. Histology confirmed the diagnosis in all cases. This report highlights the importance of routine histopathological examination of appendectomy specimens in endemic areas, as schistosomiasis may mimic common surgical emergencies and requires targeted antiparasitic treatment postoperatively to prevent further complications.

血吸虫病是一种被忽视的热带疾病,发病率很高,但即使在流行地区,继发于血吸虫感染的阑尾炎仍然很少见。我们报告了5例急性阑尾炎的成人患者,其中组织病理学检查显示血吸虫阑尾炎。所有患者均表现出急性阑尾炎的典型特征,均行阑尾切除术,并顺利康复。1例术前影像学显示壁钙化,术前怀疑为血吸虫病。组织学证实了所有病例的诊断。本报告强调了在流行地区对阑尾切除标本进行常规组织病理学检查的重要性,因为血吸虫病可能类似于常见的外科急诊,需要术后有针对性的抗寄生虫治疗,以防止进一步的并发症。
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引用次数: 0
Incidentally discovered developmental venous anomaly with an associated white matter changes in a 7-year-old girl: a case report and literature review. 偶然发现发育静脉异常与相关的白质改变在一个7岁的女孩:一个病例报告和文献复习。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-28 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag009
Khulood K AlRaddadi, K K Alraddadi, Nouf Koshak, N Koshak, Wael Alshaya, W Alshaya

Developmental venous anomalies (DVAs) are the most common cerebral vascular malformation, with age-dependent prevalence variation in the pediatric population. We report a case of an incidentally discovered left anterior temporal DVA with associated white matter changes in a previously healthy 7-year-old girl following minor head trauma. Initial computed tomography revealed a temporal lobe hypodensity, prompting magnetic resonance imaging (MRI), which demonstrated a classic DVA with adjacent T2/Fluid-Attenuated Inversion Recovery (FLAIR) hyperintense white matter changes without restricted diffusion, blooming susceptibility, or abnormal enhancement. The patient remained asymptomatic throughout follow-up, with serial magnetic resonance imaging showing stability of both the DVA and parenchymal abnormalities. The association of DVAs with white matter changes is attributed to chronic venous hypertension or altered hemodynamics. While generally benign, DVAs can occasionally cause seizures or rarely hemorrhage in children. This case highlights the characteristic imaging features and typically benign course of DVAs with white matter changes in children, supporting conservative management with clinical and radiological surveillance.

发育性静脉异常(DVAs)是最常见的脑血管畸形,在儿童人群中具有年龄依赖性的患病率变化。我们报告一例偶然发现的左颞前DVA与相关的白质改变在一个以前健康的7岁女孩轻微的头部创伤。最初的计算机断层扫描显示颞叶低密度,提示磁共振成像(MRI),显示典型的DVA伴邻近的T2/流体衰减反转恢复(FLAIR)高强度白质改变,没有限制扩散,开花敏感性或异常强化。患者在随访期间无症状,连续磁共振成像显示DVA和实质异常稳定。DVAs与白质改变的关联归因于慢性静脉高压或血流动力学改变。虽然dva通常是良性的,但在儿童中偶尔会引起癫痫发作或罕见的出血。本病例突出了儿童DVAs伴白质改变的特征性影像学特征和典型的良性病程,支持在临床和放射监测下进行保守治疗。
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引用次数: 0
Bronchiolo-arterial fistula management in a patient with Loeys-Dietz syndrome using a multidisciplinary approach. 采用多学科方法治疗Loeys-Dietz综合征患者的细支气管动脉瘘。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-27 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag006
Meredith Otley, Muhanned Kheder, Jeremy Wood, Chris Lightfoot, Michael Rivers-Bowerman, Mathieu Castonguay, Daniel French

Bronchiolo-arterial fistulae are rare occurrences that can lead to hemoptysis. In general, persistent hemoptysis has a broad range of causes and management options. Surgery is often used in cases where conservative approaches have failed. In this case study, we present a 43-year-old woman with Loeys-Dietz syndrome, a connective tissue disorder, who developed chronic persistent hemoptysis after multiple aortic operations. The hemoptysis did not resolve with antibiotics, corticosteroids, and coil embolization. Based on multidisciplinary consensus, a left upper lobectomy was performed, with no recurrence of hemoptysis after 2 years of follow-up. Pathology revealed a bronchiolo-arterial fistula.

细支气管动脉瘘是罕见的,可导致咯血。一般来说,持续性咯血有广泛的原因和管理选择。手术通常用于保守方法失败的病例。在这个病例研究中,我们报告了一位43岁的女性,患有Loeys-Dietz综合征,一种结缔组织疾病,在多次主动脉手术后出现慢性持续性咯血。咯血不能解决抗生素,皮质类固醇和线圈栓塞。基于多学科共识,行左上肺叶切除术,随访2年后无咯血复发。病理显示细支气管动脉瘘。
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引用次数: 0
A rare case of deep fibrous histiocytoma with low-grade myxoid and dedifferentiated liposarcoma features: clinical, radiological, and histopathological insights. 深层纤维组织细胞瘤合并低级别黏液样和去分化脂肪肉瘤的罕见病例:临床、放射学和组织病理学分析。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-27 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag015
Alessandro Verbo, Mattia Angelo Bez, Danilo Di Giorgio, Iacopo Verbo

Deep fibrous histiocytoma (DFH), also termed deep benign fibrous histiocytoma, is an uncommon fibroblastic neoplasm that typically arises in the dermis or subcutis. Occurrence in deep soft tissues is rare and retroperitoneal presentation is exceptional. Distinguishing DFH from soft tissue sarcomas can be challenging when lesions show atypical morphology or focal lipogenic change. We report a giant retroperitoneal DFH displaying low-grade myxoid and dedifferentiated liposarcoma-like area and summarize diagnostic pearls and management considerations. A 53-year-old man presented with postprandial dyspepsia and increased bowel movements. Imaging revealed a multilobulated retroperitoneal mass (35 × 32 × 18 cm) displacing the inferior vena cava, aorta, and bowel loops, with the left kidney ectopically located in the right paramedian pelvis. Through a xipho-pubic laparotomy, a well-encapsulated 12-kg tumor was excised en bloc without rupture. Histology showed a spindle-cell proliferation with storiform and meningothelial-like architecture consistent with DFH, with foci of low-grade myxoid change and areas mimicking dedifferentiated liposarcoma. Immunohistochemistry demonstrated CD34 positivity and negativity for S100 and smooth muscle actin in the fibrohistiocytic component. The early postoperative course was uneventful. Retroperitoneal DFH is a diagnostic mimic of liposarcoma and other sarcomas. Correlation of morphology with an appropriate immunophenotype and clinical-radiologic context is essential to avoid overtreatment. Complete surgical excision is the mainstay of therapy; long-term surveillance is advisable given the deep location and size.

深层纤维组织细胞瘤,也称为深层良性纤维组织细胞瘤,是一种罕见的纤维母细胞肿瘤,通常发生在真皮或皮下。发生在深部软组织是罕见的,腹膜后表现是例外。当病变表现为非典型形态或局灶性脂肪变性时,将DFH与软组织肉瘤区分是具有挑战性的。我们报告一个巨大的腹膜后DFH,显示低级别粘液样和去分化脂肪肉瘤样区域,并总结诊断要点和治疗注意事项。53岁男性,餐后消化不良,排便增多。影像学显示腹膜后多分叶肿物(35 × 32 × 18 cm)取代下腔静脉、主动脉和肠袢,左肾异位位于右侧骨盆旁位。通过刀-耻骨剖腹手术,我们切除了一个包裹良好的12公斤肿瘤,没有破裂。组织学显示纺锤状细胞增生,呈故事状和脑膜样结构,与DFH一致,伴低级别黏液样病变灶和类似去分化脂肪肉瘤的区域。免疫组化显示S100和平滑肌肌动蛋白在纤维组织细胞成分中呈CD34阳性和阴性。术后早期过程平安无事。腹膜后DFH是脂肪肉瘤和其他肉瘤的诊断模拟物。形态学与适当的免疫表型和临床放射学背景的相关性对于避免过度治疗至关重要。完全手术切除是治疗的主要方法;考虑到深的位置和大小,长期监视是可取的。
{"title":"A rare case of deep fibrous histiocytoma with low-grade myxoid and dedifferentiated liposarcoma features: clinical, radiological, and histopathological insights.","authors":"Alessandro Verbo, Mattia Angelo Bez, Danilo Di Giorgio, Iacopo Verbo","doi":"10.1093/jscr/rjag015","DOIUrl":"https://doi.org/10.1093/jscr/rjag015","url":null,"abstract":"<p><p>Deep fibrous histiocytoma (DFH), also termed deep benign fibrous histiocytoma, is an uncommon fibroblastic neoplasm that typically arises in the dermis or subcutis. Occurrence in deep soft tissues is rare and retroperitoneal presentation is exceptional. Distinguishing DFH from soft tissue sarcomas can be challenging when lesions show atypical morphology or focal lipogenic change. We report a giant retroperitoneal DFH displaying low-grade myxoid and dedifferentiated liposarcoma-like area and summarize diagnostic pearls and management considerations. A 53-year-old man presented with postprandial dyspepsia and increased bowel movements. Imaging revealed a multilobulated retroperitoneal mass (35 × 32 × 18 cm) displacing the inferior vena cava, aorta, and bowel loops, with the left kidney ectopically located in the right paramedian pelvis. Through a xipho-pubic laparotomy, a well-encapsulated 12-kg tumor was excised en bloc without rupture. Histology showed a spindle-cell proliferation with storiform and meningothelial-like architecture consistent with DFH, with foci of low-grade myxoid change and areas mimicking dedifferentiated liposarcoma. Immunohistochemistry demonstrated CD34 positivity and negativity for S100 and smooth muscle actin in the fibrohistiocytic component. The early postoperative course was uneventful. Retroperitoneal DFH is a diagnostic mimic of liposarcoma and other sarcomas. Correlation of morphology with an appropriate immunophenotype and clinical-radiologic context is essential to avoid overtreatment. Complete surgical excision is the mainstay of therapy; long-term surveillance is advisable given the deep location and size.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2026 1","pages":"rjag015"},"PeriodicalIF":0.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12840576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094664","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
Case series: oncologic patients in remission with giant ventral hernia treated with botulinum toxin and component separation. 病例系列:肿瘤患者缓解与巨大腹疝治疗肉毒杆菌毒素和成分分离。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-27 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag013
Luis Muñoz-Andrade, Francisco Nevárez, Sandra Chalén, Yanalín Mantuano

Giant ventral hernia represents a surgical challenge, particularly in oncologic patients in remission, due to large fascial defects and loss of domain. Botulinum toxin has been incorporated as an adjuvant to facilitate fascial closure through chemical relaxation of the abdominal wall. We describe four oncologic patients in remission with giant ventral hernia treated with preoperative botulinum toxin and repair using component separation with retromuscular polypropylene mesh placement. The procedures were performed without intraoperative complications or early recurrence. The technique allowed tension-free fascial closure with favorable postoperative outcomes. Botulinum toxin appears to be a useful and safe tool for the repair of complex ventral hernias in oncologic patients in remission, promoting fascial approximation and reducing the need for more invasive procedures.

巨大腹疝是一个手术挑战,特别是在肿瘤患者缓解期,由于大的筋膜缺损和领域的丧失。肉毒杆菌毒素已被纳入作为佐剂,通过化学松弛腹壁来促进筋膜闭合。我们描述了四个肿瘤患者缓解与巨大腹疝术前肉毒杆菌毒素治疗和修复使用组件分离与肌肉后聚丙烯补片放置。所有手术均无术中并发症和早期复发。该技术使无张力的筋膜闭合具有良好的术后效果。肉毒杆菌毒素似乎是一个有用的和安全的工具,用于修复复杂的腹疝在缓解的肿瘤患者,促进筋膜逼近和减少需要更多的侵入性手术。
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引用次数: 0
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Journal of Surgical Case Reports
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