We present herein the rare case of a 48-year-old man in whom an abdominal mass, revealed by celiotomy to be a solid tumor of the mesoappendix, was histologically diagnosed as having a venous hemangioma. To our knowledge, only 18 cases of mesenteric hemangioma have been reported in Japan, including the present case. However, establishing a correct diagnosis preoperatively is extremely difficult despite advanced imaging techniques. In fact, a mesenteric mass was diagnosed preoperatively in only 3 of these 18 cases. Complete excision with or without bowel resection was performed in 16 cases. Interestingly, the histological diagnosis of all the previous cases was cavernous hemangioma, confirming that this report documents the first case of venous hemangioma of the mesentery in the Japanese literature.

This report describes an unusual case of mammary intraductal papillomas coexistent with sentinel lymph node papilloma. A 47-year-old Japanese female underwent 5 needle manipulations and 2 surgical biopsies for recurring papillomas in the right breast over 5 years before having a simple mastectomy. During the mastectomy, the ipsilateral sentinel node was found to be extensively occupied by completely benign papilloma that measured 6 mm in its greatest dimension. The clinical history led us to put forward the working hypothesis that the nodal papillary lesion may develop from the epithelial cells that are displaced from the mammary papillomas during needle procedures and mechanically transported to the sentinel lymph node. To test the hypothesis, we retrieved surgical biopsies (dochectomy and excisional biopsy), mastectomy, and sentinel lymph node specimens for histopathologic, immunohistochemical, and molecular studies. The presence of myoepithelial layer in each papillary tumor was confirmed by immunostains with specific myoepithelial markers, p63 and CD10. The excisional biopsy specimen exhibited displaced fragments of benign epithelial cells within granulation tissue at the needle manipulation site, indicating that iatrogenic epithelial cell displacement did occur in this case. However, loss of heterozygosity at 16p13 and 16q21 was only observed in the papillomas of the dochectomy and the excisional biopsy; no loss of heterozygosity was detected in the papillomas of the mastectomy and the sentinel lymph node. It remains undetermined whether the nodal papilloma was derived from the papilloma of the mastectomy or if it arose de novo from the breast tissue inclusion of the sentinel node.

Internal herniation through defects in the gastrocolic ligament and lesser omentum is extremely rare. This type of transomental hernia differs from herniation through the greater omentum alone both in terms of the site and direction of the herniation. One such case is presented, together with a brief review of the available literature. The pathogenesis of the omental aperture and the etiological mechanism are briefly discussed.

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