Pseudomyxoma peritonei (PMP) is a rare malignant growth characterized by the production of mucin and the potential for peritoneal relapse. This study aimed to investigate the immunohistochemical and biological characteristics of mucin in patients with cellular and acellular PMP. We prospectively analyzed mucin specimens obtained from our patient cohort and described the composition and type of mucin present in each sample. A metagenomic analysis of the samples was performed to investigate the bacterial composition of the PMP microbiome. Secreted mucins 2 and 5AC and membrane-associated mucin-1 were the primary components of mucin in both cellular and acellular tumor specimens. The metagenomic study revealed a predominance of the phylum Proteobacteria and the genus Pseudomonas. Notably, Pseudomonas plecoglossicida, a species not previously reported in the human microbiome, was found to be the most abundant organism in the mucin of pseudomyxoma peritonei. Our findings suggest that the presence of MUC-2 and mucin colonization by Pseudomonas are characteristic features of both cellular and acellular disease. These results may have significant implications for the diagnosis and treatment of this rare entity.

Objectives: Inflammatory fibroid polyps, also known as Vanek’s tumors, are rare benign lesions of the gastrointestinal tract. Although the exact cause remains unclear, several theories suggest an association with inflammatory processes and genetic factors. This study aims to present the largest cohort of inflammatory fibroid polyp cases to date, analyzing their clinical presentation, diagnostic methods, and treatment approaches. Materials and methods: A retrospective multicentric analysis was conducted on 67 patients diagnosed with inflammatory fibroid polyps between 2013 and 2023 across four hospitals. Clinical data regarding tumor location, size, symptoms, and treatment were collected. Non-parametric statistical tests, including the chi-square test, Cramér’s V coefficient, and the Mann–Whitney U test, were used to identify association between tumor characteristics, location, and treatment outcomes. Results: The cohort included 67 patients (58.2% female, median age 60 years). The stomach was the most common tumor site (47.8%), followed by the colon (32.8%), and small intestine (10.4%). The majority of patients (73.1%) were asymptomatic, while 9% experienced intestinal obstruction, all of which were located in the small intestine. Endoscopic resection was successful in 77.6% of cases, but surgical intervention was more frequently required for tumors in the small intestine. A significant association was found between larger tumor size, emergency presentation, intestinal location, and the need for surgery. Conclusions: Inflammatory fibroid polyps are commonly managed with endoscopic resection, particularly in gastric and colonic locations. However, small intestinal tumors more often need surgical treatment, especially when presenting with complications like intestinal obstruction.

Background: Hepatic resection requires precise knowledge of vascular anatomy and remnant liver volume to guarantee both safety and efficacy. Three-dimensional (3D) models, either virtual or printed, have been proposed as tools to optimize surgical planning, education, and intraoperative navigation. Material and Methods: This retrospective observational study evaluated the impact of 3D model utilization (virtual and printed), in 89 patients who underwent elective hepatectomy at Infanta Elena University Hospital (Valdemoro, Madrid, Spain) between May 2018 and May 2023. The implementation of 3D modeling began to be routinely implemented as of November 2020. Patients were divided into two groups: those without 3D modeling (n = 40) and those with 3D modeling (n = 49). Results: Baseline characteristics were comparable between groups. Intraoperative blood loss was significantly lower in the 3D model group (median 175 mL vs. 262.5 mL; p < 0.001), with no statistically significant differences in operative time, complication rate (Clavien–Dindo classification), length of hospital stay, or in-hospital mortality. Multivariable analysis identified dyslipidemia, postoperative sodium delta, and postoperative increase in direct bilirubin as independent risk factors for complications, whereas albumin demonstrated a protective effect. Conclusions: Three-dimensional modeling improves anatomic orientation and reduces intraoperative blood loss, although it does not significantly modify classic perioperative outcomes. Its principal value appears to reside in preoperative planning and technical safety rather than direct clinical impact.

Pseudomyxoma peritonei (PMP) is a rare malignant growth characterized by the production of mucin and the potential for peritoneal relapse. This study aimed to investigate the immunohistochemical and biological characteristics of mucin in patients with cellular and acellular PMP. We prospectively analyzed mucin specimens obtained from our patient cohort and described the composition and type of mucin present in each sample. A metagenomic analysis of the samples was performed to investigate the bacterial composition of the PMP microbiome. Secreted mucins 2 and 5AC and membrane-associated mucin-1 were the primary components of mucin in both cellular and acellular tumor specimens. The metagenomic study revealed a predominance of the phylum Proteobacteria and the genus Pseudomonas. Notably, Pseudomonas plecoglossicida, a species not previously reported in the human microbiome, was found to be the most abundant organism in the mucin of pseudomyxoma peritonei. Our findings suggest that the presence of MUC-2 and mucin colonization by Pseudomonas is a characteristic feature of both cellular and acellular disease. These results may have significant implications for the diagnosis and treatment of this rare entity.

Background: In recent years, the use of minimally invasive approaches in pancreatic surgery has progressively increased. One of the key components of pancreaticoduodenectomy is the creation of a pancreato-enteric anastomosis, due to the high risk of postoperative complications, particularly the development of postoperative pancreatic fistula. Among the types of anastomoses, the Blumgart technique has gained popularity due to its ease of reproducibility. Methods: In this guide, we summarize and systematize step by step how to perform a feasible, reproductible and safe robotic Blumgart pancreaticojejunostomy, providing some instructions for its successful completion. Results: Despite the heterogeneity of the published data, duct-to-mucosa Blumgart anastomosis seems to be superior in terms of clinically relevant postoperative pancreatic fistula rates compared with other types of pancreato-enteric anastomosis. The advantages of robotic surgery, such as improved precision, greater control, and enhanced visualization, make robotic Blumgart anastomosis a safe, practical, and reproducible technique in the context of robotic pancreaticoduodenectomy. Conclusions: Robotic Blumgart pancreaticojejunostomy is a safe and feasible technique for pancreato-enteric anastomosis following pancreaticoduodenectomy when surgical technique is systematized step by step.

Background: Pancreatic metastases from cervical cancer are exceptionally rare, with limited cases described in the literature. Their diagnosis and management remain challenging due to the absence of standardized protocols and the often poor prognosis. Case Presentation: We report the case of a 39-year-old woman with a history of treated stage IIIB cervical squamous cell carcinoma who presented with a solitary mass in the pancreatic tail. Diagnosis was established through cross-sectional imaging, PET-CT, and EUS-guided needle biopsy. The patient underwent systemic chemotherapy and SBRT followed by surgical resection. Histopathological analysis confirmed metastatic squamous cell carcinoma associated with HPV. Despite an initially favorable recovery, peritoneal metastases developed three months later. The patient died seven months after surgery under palliative care after disease progression on immunotherapy. Methods: A systematic review following PRISMA guidelines was conducted across PubMed, Cochrane, and Embase (2000–2025) to identify case reports and series describing pancreatic metastases from cervical cancer. A total of 14 published cases, together with the present case, were analyzed for demographic, clinical, diagnostic, therapeutic, and outcome data. Results: The mean age at diagnosis was 52.5 years (range 36–70). Squamous cell carcinoma was the predominant histology (73%). The pancreatic head was the most common metastatic site (53%). Diagnosis typically relied on abdominal CT, PET-CT, and EUS-guided biopsy. Surgical resection was performed in 28.6% of cases, while systemic therapy—most commonly cisplatin, paclitaxel, and bevacizumab—remained the mainstay for inoperable patients. Conclusions: Pancreatic metastases from cervical cancer usually occur in advanced disease stages and are associated with poor outcomes. Accurate diagnosis requires integration of imaging and histopathology, with PET-CT useful for detecting additional metastases. Surgery may be beneficial in selected patients with isolated lesions, but systemic therapy remains the primary treatment for most. Emerging immunotherapies show promise but are still in early development. Multidisciplinary management and further research are needed to optimize outcomes in this rare presentation.