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Human papillomavirus-associated rectal adenocarcinoma. 人乳头瘤病毒相关的直肠腺癌。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag017
Andrew T Myers, Suzan A Bilgesu

Human papillomavirus (HPV)-mediated rectal adenocarcinoma is a rare variant of colorectal adenocarcinoma that has only been described in a few case reports and series, with most originating from South America and the Middle East. This report, from North America, details the presentation, workup, and management of a 59-year-old Caucasian female who initially presented to her primary care with rectal bleeding who underwent interval colonoscopy and was found to have a T2 or early T3 rectal adenocarcinoma 1.2 cm from her anal verge. The tumor's unique pathologic feature demonstrated adenocarcinoma strongly positive for p16 protein, suggesting mediation by HPV. She is currently undergoing total neoadjuvant chemotherapy and radiation for this pathology-proven, HPV-mediated low rectal adenocarcinoma. Based on a thorough literature review, she is likely one of the first patients with HPV-mediated adenocarcinoma to be managed with total neoadjuvant chemotherapy and radiation with hopes for a complete clinical response.

人乳头瘤病毒(HPV)介导的直肠腺癌是一种罕见的结直肠腺癌变体,仅在少数病例报告和系列中被描述,大多数起源于南美洲和中东。本报告来自北美,详细介绍了一位59岁白人女性的表现、检查和处理,她最初因直肠出血就诊,接受间歇结肠镜检查,发现离肛门边缘1.2 cm处有T2或早期T3直肠腺癌。肿瘤独特的病理特征表明腺癌p16蛋白强烈阳性,提示HPV介导。她目前正在接受全新辅助化疗和放疗,病理证实,hpv介导的低位直肠腺癌。基于全面的文献综述,她可能是第一批接受完全新辅助化疗和放疗的hpv介导腺癌患者之一,希望有完全的临床反应。
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引用次数: 0
Ultra low pressure robotic assisted radical prostatectomy (RARP) with pelvic lymph node dissection performed as a day case: first reported case in the UK. 超低压机器人辅助根治性前列腺切除术(RARP)伴盆腔淋巴结清扫作为一天的病例进行:在英国首次报道的病例。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag032
Mayas Rddah, Leo Kretzmer, Gabriel Sullivan, Nicola Milton, Abdoulai Samateh, Edward Calleja

A man in his sixties with locally advanced prostate cancer underwent ultra-low pressure robotic-assisted radical prostatectomy (RARP) with pelvic lymph node dissection (PLND) and was safely discharged the same day. This is the first reported UK case of day-case RARP with PLND performed at 6 mmHg. The patient experienced no complications and reported minimal discomfort postoperatively. We highlight that, with appropriate patient selection, patient's counselling, perioperative optimization, and ultra-low pressure techniques, same-day discharge after RARP with PLND is feasible, safe, and potentially scalable within NHS pathways.

一名60多岁的局部晚期前列腺癌患者接受了超低压机器人辅助根治性前列腺切除术(RARP)和盆腔淋巴结清扫术(PLND),并于当天安全出院。这是英国报道的第一例在6 mmHg时进行PLND的日间RARP病例。患者无并发症,术后不适感最小。我们强调,通过适当的患者选择,患者咨询,围手术期优化和超低压技术,在RARP合并PLND后当天出院是可行的,安全的,并且可能在NHS途径中扩展。
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引用次数: 0
A case of gastric gastrointestinal stromal tumour with two rare metastases after laparoscopic resection and imatinib therapy. 胃胃肠道间质瘤经腹腔镜切除及伊马替尼治疗后2例罕见转移。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag024
Nathan J Bui, Hai T Bui

We report the case of a 70-year-old man with a gastric gastrointestinal stromal tumour who subsequently developed two rare metastatic recurrences to the subcutaneous tissue and skeletal muscle following initial curative resection and adjuvant imatinib therapy. This case illustrates the potential for atypical metastatic patterns in gastrointestinal stromal tumour and emphasizes the importance of long-term surveillance, even after extended disease-free intervals.

我们报告的情况下,70岁的男子与胃肠道间质瘤谁随后发展两个罕见的转移复发到皮下组织和骨骼肌最初的治愈性切除和辅助伊马替尼治疗。本病例说明了胃肠道间质瘤非典型转移模式的可能性,并强调了长期监测的重要性,即使在延长无病间隔后也是如此。
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引用次数: 0
Mammary malignant peripheral nerve sheath tumor in a 93-year-old male: case report. 93岁男性乳腺恶性周围神经鞘肿瘤1例。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag029
Badria Eid Aljohani, Duaa Salem Alkhayat, Rouz Faisal Abu Sulami, Abdullah Khalid Aljohani

Breast sarcomas are rare malignancies, accounting for <1% of all breast malignancies and <5% of all soft tissue sarcomas. Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas that arise from peripheral nerves. Their occurrence in the breast is exceedingly rare. This is the fourth published case of mammary MPNST in a male patient. We present a case of a 93-year-old male with a three-year history of a progressively enlarging and painful right breast mass. Examination revealed a 20 × 30 cm immobile, fungating, and ulcerating mass with purulent discharge. Histopathological assessment confirmed a high-grade spindle cell sarcoma, and immunohistochemistry revealed positivity for vimentin, S100 protein, and p63 in a focal pattern, confirming the diagnosis of MPNST. The patient underwent a right mastectomy, achieving a surgical clearance. After 3 months, he passed away with malignant pleural effusion due to lung metastasis.

乳腺肉瘤是罕见的恶性肿瘤,占
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引用次数: 0
Rapunzel syndrome: emergency laparoscopic management. 莴苣综合征:急诊腹腔镜治疗。
IF 0.5 Q4 SURGERY Pub Date : 2026-01-30 eCollection Date: 2026-01-01 DOI: 10.1093/jscr/rjag010
Raul Yepez Adrianzen, Alejandro Irrazabal Ampuero, Angie Mariños Claudet

Rapunzel syndrome is a rare form of trichobezoar, typically associated with an underlying and often untreated psychiatric disorder such as trichotillomania. This case report describes a 24-year-old female patient previously diagnosed with trichotillomania and trichophagia, who presented with abdominal distension and vomiting due to a large gastric bezoar extending into the duodenum. Diagnostic evaluation included upper endoscopy and computed tomography, confirming complete upper gastrointestinal obstruction. Emergency laparoscopic management was successfully performed, allowing complete extraction of the trichobezoar, followed by gastric repair. Postoperative recovery was favorable, and psychiatric follow-up was initiated to address the underlying condition and reduce the risk of recurrence. Timely diagnosis enables successful minimally invasive surgical treatment and underscores the need for coordinated multidisciplinary management.

长发公主综合征是一种罕见的拔毛症,通常与一种潜在的、经常未经治疗的精神疾病有关,比如拔毛癖。本病例报告描述了一名24岁的女性患者,之前被诊断为拔毛癖和拔毛癖,由于胃牛粪延伸到十二指肠而出现腹胀和呕吐。诊断评估包括上消化道内窥镜检查和计算机断层扫描,确认完全性上消化道梗阻。急诊腹腔镜治疗成功,完全取出毛粪,随后进行胃修复。术后恢复良好,并开始进行精神病学随访,以解决潜在疾病并降低复发风险。及时的诊断使微创手术治疗成功,并强调了协调多学科管理的必要性。
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引用次数: 0
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
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Journal of Surgical Case Reports
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