A 47-year-old patient attempted suicide by swallowing acid detergent and was diagnosed with corrosive esophagitis and gastritis at a nearby hospital. This led to severe stenosis from the pharyngoesophageal junction to the entire stomach. Since repeated endoscopic treatment resulted in no improvement, the patient was transferred to our hospital and underwent subtotal esophagectomy and total gastrectomy with esophagostomy. An esophageal stent was placed to dilate and secure the stenotic pharyngoesophageal junction after the first surgery. Two months later, reconstructive surgery using a pedicled jejunum was performed. Oral intake was initiated on postoperative day (POD) 33 and the patient was discharged on POD 54. He is doing well with no stenotic symptoms at 20 months after surgery. Dilatation by stenting after the first surgery was effective to obtain a secure anastomosis. Accessibility from the esophagostomy to adjust the position of the stent was also a favorable aspect of this approach. This case suggests that two-stage surgery combining esophageal stenting is a feasible strategy for preservation of the laryngopharynx in a case with corrosive esophagitis and pharyngoesophageal stenosis.

A 55-year-old woman was admitted to our hospital with abdominal distension. CT and MRI showed a 15-mm nodule with ring-shaped enhancement in segment 8 of the liver. FDG-PET showed strong accumulation within the lesion. No other possible primary lesion or distant metastasis was detected. The patient was diagnosed with mixed hepatocellular carcinoma based on the preoperative imaging findings and underwent laparoscopic partial hepatectomy. Histopathological examination of the operative specimen showed aggregations of proliferating, small, round, atypical cells with a high nucleus/cytoplasm ratio. Immunohistological staining revealed that the tumor was positive for the mesenchymal cell marker vimentin, leading to a diagnosis of primary sarcoma of the liver. The pathological findings did not fit any existing classifications of sarcoma. The postoperative course was good and the patient remains relapse-free 15 months after surgery. Primary hepatic sarcomas are very rare. We report this case of resection of a primary hepatic sarcoma that did not fit with existing histopathological classifications of sarcoma.

The patient was a 21-year-old female who had undergone surgery for an omphalocele with liver prolapse as a neonate. Abdominal CT showed displacement of the liver due to the previous surgery. The liver was rotated approximately 90° anteriorly ventrally and 90° clockwise. The right lobe of the liver was located cephalad, the left lobe was located caudad, and the gallbladder was dorsal. We decided that a laparoscopic approach would provide a better surgical field if the surgical position and approach were modified. Laparoscopic cholecystectomy (Lap-C) was performed. Surgery was started in the left lateral recumbent position. Ultrasound was used to assess the location of the organ before the port was inserted. Surgery was completed without intraoperative complications and the postoperative course was good. This case shows that Lap-C can be safely completed in a patient with organ malposition after umbilical hernia surgery through use of preoperative and intraoperative innovations.

A 78-year-old woman was taken to a local hospital for hematemesis. A tumor of about 50 mm on the papillary side of the descending duodenum with strong contrast at the periphery and low density inside was observed on contrast-enhanced CT. The interior of the tumor was connected to the duodenum. Esophagogastroduodenoscopy revealed bleeding from a ruptured tumor, and hemostasis via endoscopy was difficult; thus, the patient was referred for additional treatment. Vital signs were stable at the time of arrival; however, hematemesis and anemia were observed; thus, TAE was performed urgently. After TAE, the patient’s condition stabilized and hematemesis disappeared. We suspected that the hemorrhage was from a submucosal tumor in the duodenum. On the fifth hospital day, subtotal stomach-preserving pancreaticoduodenectomy was performed because of slow, progressive anemia and obstructive jaundice. The tumor was well defined with internal hemorrhagic necrosis. The histopathological diagnosis was anaplastic carcinoma with osteoclast-like giant cells. We report this case as a rare example of anaplastic carcinoma of the pancreas presenting with gastrointestinal bleeding, and we include a review of 102 cases of anaplastic carcinoma of the pancreas reported in Japan.

Abdominal extra-organ mesenteric and greater or lesser omentum hemangiomas have been described, but there are no reports of peritoneal hemangioma. We report a case of a cavernous hemangioma resected from the peritoneum. The patient was a 79-year-old man who was referred to our department after CT for constipation revealed a mass inferior to the umbilicus. The 4×3 cm mass abutted the anterior abdominal wall, and small scattered calcifications were noted. Contrast-enhanced CT showed a mildly enhanced mass with irregular margins and no increase in the surrounding lipid density, suggesting a neoplastic lesion. On T1-weighted MRI, the tumor signal was equal to that of the surrounding muscle, and T2-weighted MRI showed a high signal; however, the in-phase and opposed-phase contrast suggested the presence of internal fat. We suspected an intra-abdominal neoplastic lesion and opted for resection. The tumor was contiguous to the anterior abdominal wall, with no adhesion to the surrounding organs, and was resected with the anterior abdominal wall, rectus abdominis, and skin. The cut surface of the tumor was spongy and the tumor was soft. Histopathology revealed a diagnosis of cavernous hemangioma. Peritoneal origin was suggested since the tumor was firmly adherent to the peritoneum, with no extraperitoneal neoplastic lesions, such as in the rectus muscle or preperitoneal fat. We report this case as a rare example of a peritoneal cavernous hemangioma. This disease could be considered as a differential diagnosis in cases with similar imaging findings.

A 70-year-old woman was diagnosed with ulcerative colitis (UC) at 54 years of age. The patient had been in remission with treatment with 5-aminosalicylic acid. In June 2021, she was diagnosed with sigmoid colon cancer by lower gastrointestinal endoscopy, which was performed to investigate diarrhea. In August of the same year, laparoscopic-assisted total proctocolectomy with ileal J-pouch-anal canal anastomosis was performed. The tumor showed a mixture of carcinoma and sarcoma components, and the pathological result was carcinosarcoma, type 2, 35×30 mm, pT3(SS), INFb, Ly1a, V1b, Pn1b, pN2a, pStage IIIb (9th edition of the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma). CT performed in the first month after surgery revealed multiple liver metastases, which were not seen before surgery. Chemotherapy (mFOLFOX+panitumumab) was started in September of the same year, but the patient passed away 6 months after the surgery. This is an extremely rare case of colorectal carcinosarcoma in a patient with UC.

A 56-year-old female complaining of right lateral abdominal pain was referred to our department. Contrast-enhanced CT revealed a 10-cm mass with a cystic part at the greater omentum or mesentery and a solid part that was enhanced in the arterial phase. Thus, we suspected a gastrointestinal stromal tumor (GIST) of the mesentery or greater omentum. We did not select a puncture biopsy examination because this had a risk of rupture, but instead performed tumor resection for both definitive diagnosis and treatment. Intraoperative findings showed a tumor of size 10×7.5 cm. The cystic part was well-defined and the solid part was adherent to the greater omentum. There was no invasion into the mesentery of the transverse colon. Therefore, we considered that the mass had developed from the greater omentum. The tumor was resected without damage to the cystic lesion. The patient was subsequently diagnosed with GIST of the greater omentum by a pathohistological examination. The incidence of GIST is 1–2 per 100,000 in the general population and GIST arising from the greater omentum is extremely rare. Past reports have shown that more than 30% of GISTs of the greater omentum are accompanied by a cyst. Thus, the possibility of GIST should be kept in mind when a hypervascular tumor with a cyst is found at the greater omentum or mesentery.