Objectives: Granulosa cell tumors (GCTs) are rare ovarian tumors with a high rate of late recurrence, which can present a significant challenge for surgical management. This study aims to evaluate the outcomes of debulking surgery for recurrent GCTs that involve major abdominal vessels and the liver.
Methods: We present a retrospective case series of three patients with recurrent GCTs who were treated at our reference center between 2024 and 2025. We collected data on patient demographics, medical history, recurrence location, treatment details, and follow-up. All data are presented descriptively.
Results: The patients' ages ranged from 53 to 70 years. The time from initial surgery to the first recurrence ranged from 6 to 26 years. Two patients experienced extra-pelvic recurrences in the retroperitoneal space, while one had a pelvic recurrence. All three patients underwent debulking surgery, with two patients experiencing second recurrences and one patient experiencing a third. One patient required anterior wall resection and reconstruction of the Inferior Vena Cava (VCI). Notably, two patients had elevated levels of CEA and CA-125 that peaked before recurrence.
Conclusion: Our findings suggest that the number of GCT recurrences is not as critical as the ability to perform a complete, safe resection. Surgery alone, with a focus on radical resection of recurrent foci, appears to be the primary determinant of favorable patient survival, even when it involves complex procedures like oncovascular resection. Repeated resections, even for multiple recurrences, can lead to favorable long-term outcomes.

Gallbladder cancer carries a poor prognosis, with surgical resection being the only curative option. However, complex anatomy can lead to serious postoperative complications.
We present a case of a 58-year-old male who developed a hepatic artery pseudoaneurysm following radical laparoscopic cholecystectomy for gallbladder cancer. The procedure was complicated by an aberrant bile duct injury, requiring hepaticoduodenostomy. He had a high-flow biliary fistula postoperatively. On postoperative day 7, he presented with hemorrhage and hemodynamic instability. CT angiography revealed a pseudoaneurysm of hepatic artery, and emergency surgical exploration was performed after failed coil embolization. The pseudoaneurysm was repaired, and segment 6 resection was performed for anastomotic dehiscence and necrosis. The patient recovered, received adjuvant chemotherapy, and experienced no further complications.
This case emphasizes the need for multidisciplinary management in complex biliary surgery and highlights the potential for rare but serious complications like pseudoaneurysms.

Mucinous cystic neoplasms (MCNs) are rare hepatic lesions with malignant potential, most commonly occurring in middle-aged women. Due to the lack of specific diagnostic tests and pathognomonic radiologic findings, establishing a preoperative diagnosis is challenging. The recommended primary treatment is complete surgical resection, while definitive diagnosis is typically made through histopathological evaluation.
A 24-year-old female patient, initially operated on with a preoperative diagnosis of hydatid cyst, was found on imaging to have a 9 × 4.5 cm cystic mass predominantly located in segment 4B of the liver, with partial extension toward segment 5. The patient underwent a left hepatectomy. Her postoperative course was uneventful, and histopathological analysis revealed a low-grade MCN. There is limited information in the literature regarding MCNs of the liver. Accurate management of these patients is crucial due to their potential association with invasive carcinoma. Therefore, this entity should be considered in the differential diagnosis of hepatic cystic lesions, and curative surgical resection should be pursued whenever feasible.

Left isomerism, a subtype of heterotaxy marked by multiple spleens and abnormal organ positioning, poses additional complexity when coexisting with biliary atresia, the leading cause of neonatal cholestasis and pediatric liver transplantation. We report a 5-month-old male infant with biliary atresia and left isomerism, presenting with persistent jaundice, acholic stools, and dark urine. Despite undergoing Kasai portoenterostomy at one month, clinical and laboratory parameters did not improve. Cardiac assessment revealed left atrial isomerism, atrioventricular septal defect, pulmonary atresia, and patent ductus arteriosus. Abdominal CT showed a midline liver, polysplenia, absent inferior vena cava with azygos-hemiazygos continuation, preduodenal portal vein, intestinal malrotation, and visceral heterotaxy. Laboratory tests indicated severe cholestasis, hepatocellular injury, and impaired liver function. The patient was evaluated and listed as a liver transplant candidate. The coexistence of biliary atresia and left isomerism complicates both diagnosis and treatment. Early imaging, multidisciplinary management, and timely transplantation are essential to improve outcomes. This case underscores the importance of a comprehensive, individualized approach in managing biliary atresia with complex congenital anomalies.

Wolman's disease, an infantile form of lysosomal acid lipase deficiency, is very rare and usually fatal in infancy. In this article we present two infants with Wolman's disease associated with cytomegalovirus infection, one with surrenal calcifications and the other with histopathological liver calcifications and haemophagocytic lymphohistiocytosis.
Both cases had complaints of vomiting and fever for two months. A family history of consanguinity and infant deaths of unknown cause was reported. Physical examination revealed jaundice and hepatosplenomegaly. Cytomegalovirus infection, unresponsive to ganciclovir treatment, was diagnosed in both cases. While haemophagocytic lymphohistiocytosis and histopathological calcifications in the liver were observed in the first case, classical surrenal calcifications were seen in the second case.
It is not clear whether the presence of cytomegalovirus infection in both cases and haemophagocytic lymphohistiocytosis in one case are coincidental. Furthermore, histopathological calcification in the liver appears to be a diagnostic criterion, as is adrenal calcification, although it has never been reported before.

Hepatocellular carcinoma (HCC) stands as a primary contributor to cancer-related mortality across the globe. While intrahepatic vascular invasion is a frequent finding in individuals with HCC, the progression of a tumor thrombus through the inferior vena cava (IVC) and into the right atrium is an infrequent event. This report details the surgical handling of a 72-year-old male patient diagnosed with HCC in the right hepatic lobe, which was complicated by a tumor thrombus extending into the inferior vena cava and approaching the right atrium. The patient successfully underwent a right hepatectomy combined with thromboendovenectomy and had an unremarkable postoperative course. At a 10-month follow-up, no signs of recurrence were detected. This case under-scores the beneficial effect of meticulously planned surgical procedures on the survival of patients with advanced HCC and brings attention to the value of employing aggressive surgical strategies.

Alveolar echinococcosis (AE) is a rare, chronic, and invasive parasitic zoonosis caused by the larval stage of the helminth Echinococcus multilocularis, which can often mimic malignancy. While this disease particularly affects the liver, pulmonary involvement is less commonly seen. Bilateral pulmonary involvement has been reported in a very limited number of cases in the literature.
In this study, we present a 45-year-old male patient with liver and bilateral pulmonary involvement. Imaging studies of the patient who presented with abdominal pain revealed an irregularly bordered mass in the right hepatic lobe, a lobulated contoured lesion approximately 2x3 cm in size with calcified areas in the center located subpleurally in the right upper lung lobe, and a lesion approximately 1x2 cm in size in the left lower lung lobe were detected. Under multidisciplinary council management, uniportal VATS wedge resection was applied to the left lower lobe, and the pathology was confirmed as echinococcus alveolaris. Subsequently, wedge resection was performed to the right upper lobe and right hepatectomy was performed for liver involvement.
Following surgical treatment with multidisciplinary approach, the patient was discharged with recovery.