Kim DJ, et al. J Gastric Cancer. 2024 Dec;25:e8. https://doi.org/10.5230/jgc.2025.25.e8

Primary peritoneal serous carcinoma (PPSC) is an extremely rare malignancy that was first described in 1959. This type of cancer arises from the peritoneal epithelium and is similar to serous ovarian carcinoma. A diagnosis of PPSC is typically made based on the Gynecology Oncology Group criteria; however, a correct differential diagnosis of PPSC is difficult preoperatively. The current study describes the case of a 66 year-old female patient presenting with abdomen distension. A computed tomography (CT) scan revealed abundant ascites in the abdominal cavity and omental infiltration. The results of positron emission tomography/CT showed hot uptake in the greater omentum. Furthermore, preoperative serum cancer antigen-125 levels were 1,032 U/ml. Upon surgical exploration, a whitish mass and nodule were found in the greater omentum. Therefore, omentectomy was performed. Pathological examination of the resected specimen revealed a diagnosis of PPSC. PPSC is extremely rare with few cases cited in the current literature. The present study describes a rare case of PPSC with a review of the literature.

The gut is a complex organ that has played an important role in digestion, absorption, endocrine functions, and immunity. The gut mucosal barriers consist of the immunologic barrier and nonimmunologic barrier. During critical illnesses, the gut is susceptible to injury due to the induction of intestinal hyperpermeability. Gut hyperpermeability and barrier dysfunction may lead to systemic inflammatory response syndrome. Additionally, gut microbiota are altered during critical illnesses. The etiology of such microbiome alterations in critical illnesses is multifactorial. The interaction or systemic host defense modulation between distant organs and the gut microbiome is increasingly studied in disease research. No treatment modality exists to significantly enhance the gut epithelial integrity, permeability, or mucus layer in critically ill patients. However, multiple helpful approaches including clinical and preclinical strategies exist. Enteral nutrition is associated with an increased mucosal barrier in animal and human studies. The trophic effects of enteral nutrition might help to maintain the intestinal physiology, prevent atrophy of gut villi, reduce intestinal permeability, and protect against ischemia-reperfusion injury. The microbiome approach such as the use of probiotics, fecal microbial transplantation, and selective decontamination of the digestive tract has been suggested. However, its evidence does not have a high quality. To promote rapid hypertrophy of the small bowel, various factors have been reported, including the epidermal growth factor, membrane permeant inhibitor of myosin light chain kinase, mucus surrogate, pharmacologic vagus nerve agonist, immune-enhancing diet, and glucagon-like peptide-2 as preclinical strategies. However, the evidence remains unclear.

Common complications of chest tube thoracostomy (CTT) include lung laceration, chest wall bleeding, improper position of tube, subcutaneous emphysema, and so on. Although intra-abdominal injury because of CTT was possible in stomach, spleen, and liver, published reports are rare and no case of life-threatening hemoperitoneum because of CTT has been published in the literature. Here, we present a rare case of life-threatening hemoperitoneum and liver injury because of CTT. We successfully treated the case with emergent laparotomy. Owing to great rarity and particular rare complication of CTT, we report this case with a review of literature.

Atypical spindle cell lipomatous tumor (ASLT) is a rare soft tissue neoplasm with a low potential for malignancy. ASLT frequently occurs in the limb and limb girdles. However, large retroperitoneal ASLTs are extremely rare. There was no concrete case report of retroperitoneal ASLTs. An 18-year-old woman presented with abdominal pain and a palpable mass. Abdominal computed tomography revealed a large fatty mass that was approximately 30 cm in size and filled the entire abdominal cavity. Surgical excision was indicated. The tumor did not invade the adjacent organs. The pelvic cavity was then too narrow to dissect smoothly. The mass was successfully excised without tumor rupture or adjacent organ injury. Microscopically, the neoplasm was a well-differentiated adipocytic neoplasm. Immunohistochemical staining showed that the spindle cells were positive for CD34 and desmin, in addition to multifocal positivity for S100 protein. These histological features were consistent with an ASLT. The patient’s postoperative course was uneventful. At the 12-mo follow-up, no evidence of recurrence or metastasis was observed. To the best of our knowledge, our study is the first concrete report of a large retroperitoneal ASLT in the English literature. In the large retroperitoneal ASLT located in the pelvic cavity, which made it too narrow and tight to dissect, complete excision is difficult but very important because of recurrence risk. Although large retroperitoneal ASLTs are considered extremely rare, their detection is important for accurate evaluation and management. Owing to their significant rarity, retrospective multicenter case studies are required to determine the clinicopathologic characteristics.

Oh SE, et al. J Gastric Cancer. 2025 Apr;25(2):382-399. https://doi.org/10.5230/jgc.2025.25.e26