Schwannomas are benign peripheral nerve tumors, with gastrointestinal involvement being rare and ileal origin exceptionally uncommon. Their nonspecific symptoms often mimic acute abdominal conditions, complicating preoperative diagnosis. A 40-year-old female presented with acute right iliac fossa pain, nausea, vomiting, and fever, initially suggestive of acute appendicitis. Ultrasonography showed a blind-ending tubular structure. During emergency appendicectomy, the appendix appeared normal, but an exophytic ileal mass was identified. Segmental ileal resection with primary anastomosis was performed. Histopathology revealed spindle cells with Antoni A and B areas, and immunohistochemistry was strongly positive for S-100, confirming schwannoma. Postoperative computed tomography of abdomen and pelvis showed no additional lesions. The patient also had multiple cutaneous lesions and was referred to dermatology for further evaluation. Ileal schwannoma is a rare cause of acute abdomen and may mimic appendicitis. Histopathology and immunohistochemistry are essential for diagnosis, while complete surgical excision is curative. Postoperative imaging ensures comprehensive assessment.

Giant uterine leiomyomas (>10 cm) are uncommon in the modern imaging era and may mimic ovarian malignancy due to their size and heterogeneous appearance, posing a diagnostic and therapeutic challenge. A 34-year-old nulliparous woman presented with progressive abdominal distension and pelvic pressure. Imaging revealed a 19 × 14 cm multinodular uterine mass with heterogeneous features and preserved surrounding fat planes. Given the patient's strong desire for uterine preservation, an open abdominal myomectomy was performed. A highly vascular, multicompartmental leiomyoma arising from the uterine body was successfully enucleated with vasopressin-assisted hemostasis and meticulous multilayer myometrial reconstruction. Estimated blood loss was 1000 ml without transfusion. Histopathology confirmed a benign leiomyoma. The postoperative course was uneventful. This case highlights that, despite their size and complexity, giant multicompartmental leiomyomas can be safely managed with uterine-preserving myomectomy in carefully selected patients. Adequate preoperative assessment, intraoperative vascular control, and advanced reconstructive techniques are critical to guide surgical decision-making and optimize outcomes.

Aggressive pelvic angiomyxoma (APA) is a rare, locally infiltrative mesenchymal tumor that primarily affects women of reproductive age. Surgical resection remains the treatment of choice. The high local recurrence rate and insidious growth pattern of APA make preoperative diagnosis crucial for optimal surgical planning. Careful radiological evaluation is vital to determine the full extent of the tumor and to minimize the risk of recurrence. This article presents 3 cases of APA highlighting the radiological characteristics and pathological findings. In all cases, magnetic resonance imaging (MRI) was essential for diagnosis, with typical findings including a hyperintense mass on T2-weighted (T2WI) images with low-signal bands creating a distinctive laminated pattern. This case series emphasizes the importance of recognizing the specific MRI features of APA to guide clinical management and improve patient outcomes.

This study aimed to develop a supine exercise program that promotes coordination between trunk stability and lower extremity control, and to evaluate its short-term effects on balance and physical function in healthy young adults. In human postural control, vertical alignment of the head, thorax, and pelvis-segments with relatively high mass-is essential for biomechanical stability. This alignment is regulated through coordinated activity of the lower limbs in bipedal standing and movement. Thus, exercise interventions that integrate trunk and lower extremity function may improve movement efficiency and postural control. Using an experimental framework modeled on clinical study design, we conducted two separate studies to assess the short-term effects of a supine exercise program designed to link trunk stability with coordinated lower extremity control. The program consisted of a series of movements performed in a supine position to facilitate integrated neuromuscular control between the trunk and lower limbs. Experiment 1 was a randomized crossover trial involving 17 healthy males. Participants completed both intervention and control phases, with physical function assessed via six tests (grip strength, sitting trunk flexion, sit-ups, standing long jump, side-step, and 50-meter run) and static balance evaluated using stabilometry. Experiment 2 used a pre-post design with 22 healthy males and females, assessing dynamic balance through kinematic analysis of the side-step task. In both experiments, participants performed a 10-minute supine coordination-focused exercise program once daily for two weeks. Results showed significant improvements in static balance, side-step kinematics, and sitting trunk flexion. No significant changes were observed in muscle strength or power-related performance tests. These findings suggest that this short-duration exercise program in a biomechanically safe supine position may enhance postural control and flexibility in healthy individuals. The approach may also be useful for fall prevention and early-stage rehabilitation. Trial Registration This study was registered with the UMIN Clinical Trials Registry (UMIN000057589 and UMIN000057597).

A Sister Mary Joseph nodule (SMJN) is a rare cutaneous manifestation of metastatic intra-abdominal or pelvic malignancy and typically indicates advanced disease. We report the case of a 48-year-old female patient who presented to our dermatology clinic with a three-month history of a painless, skin-colored umbilical mass with intermittent foul-smelling serosanguinous drainage. Her medical history was noteworthy for metastatic adenocarcinoma of the colon diagnosed five years earlier, initially treated with subtotal colectomy and adjuvant chemotherapy, followed by recurrence with ovarian involvement consistent with a Krukenberg tumor and subsequent immunotherapy-induced remission. Physical examination and histopathologic findings were consistent with the diagnosis of an SMJN of colorectal origin, supported by immunohistochemical staining confirming metastatic adenocarcinoma of the colon. This case highlights the diagnostic value of a dermatologic evaluation and a timely biopsy in identifying SMJN and guiding appropriate staging and management.

ObjectiveTo analyze pelvic floor dysfunction heterogeneity by identifying distinct clinical subtypes using unsupervised machine learning in a nationally representative cohort.MethodsThis cross-sectional study analyzed 7291 women from the National Health and Nutrition Examination Survey (NHANES 2005-2012). K-means clustering was applied to pelvic floor dysfunction-positive women to identify latent subtypes based on physiological features. Supervised machine learning models were subsequently developed to predict subtype membership, with SHapley Additive exPlanation analysis used to identify key predictors.ResultsTwo distinct subtypes emerged. Phenotype 1 ("metabolic-inflammatory") was characterized by severe central obesity (mean body mass index, 36.1 kg/m2), diabetes, and hypertension. Conversely, Phenotype 2 ("metabolically-healthy") revealed pelvic floor dysfunction symptoms but maintained a healthy metabolic profile indistinguishable from the controls. A neural network model accurately differentiated these groups (area under the curve = 0.848), identifying waist circumference as the primary predictive factor.ConclusionsPelvic floor dysfunction is not a single disorder but includes a distinct "metabolic-inflammatory" phenotype strongly associated with systemic metabolic disease. This data-driven classification challenges traditional paradigms, suggesting "subtype-specific" strategies for precision management.

Urine analysis remains a fundamental tool for diagnosing renal and urothelial diseases. Although urinary sediment microscopy is primarily used to detect haematuria, leukocyturia, and other formed elements, it may occasionally reveal exfoliated malignant cells that prompt further diagnostic investigation. The detection of Upper Tract Urothelial Carcinoma (UTUC) through routine urinary sediment examination is uncommon, as voided urine samples typically show limited sensitivity for tumours arising in the upper urinary tract. We report the case of a 42-year-old woman who initially presented with persistent dysuria and abdominal discomfort and was treated empirically for a suspected urinary tract infection. Despite antibiotic therapy, symptoms persisted and urine culture remained negative. Subsequent urinalysis revealed proteinuria, haematuria, and leukocyturia. Microscopic examination of the urinary sediment demonstrated atypical cells characterized by nuclear membrane irregularity, coarse chromatin, prominent nucleolus, and an unusual cytoplasmic protrusion. These cytomorphological findings prompted further investigation with urine cytology, which was positive for malignant cells. Cystoscopy showed no abnormalities, leading to additional evaluation with computed tomography urography. Imaging revealed a large intraluminal mass occupying the left renal pelvis with associated hydronephrosis and para-aortic lymphadenopathy. Ureteroscopy with selective cytology and subsequent multidisciplinary assessment confirmed the diagnosis of high-grade UTUC. This case highlights the diagnostic value of meticulous urinary sediment examination. Although routine sediment analysis is not a substitute for cytology or imaging, careful morphological assessment may provide an early clue to underlying malignancy and trigger appropriate diagnostic pathways, particularly in patients with persistent urinary symptoms and negative urine cultures.

This report describes a rare and complex case in which a patient, due to personal beliefs, persistently refused surgery, allowing a uterine leiomyoma to grow to 27.5 × 19.1 × 23.1 cm. This led to a series of life-threatening complications, including pseudo-Meigs syndrome (PMS) with massive pleural and ascitic effusions, 90% atelectasis of the right lung, left lower limb deep vein thrombosis (DVT) and pulmonary embolism (PE), an umbilical hernia, and severe pelvic organ prolapse (POP). Through multidisciplinary team (MDT) collaboration and a staged management strategy-involving initial inferior vena cava filter placement, nutritional support, and drainage of pleural and ascitic fluid, followed by successful tumor resection-the patient recovered. Postoperative pathology confirmed a cellular leiomyoma. This case profoundly illustrates the "cascade effect" whereby a massive pelvic mass, through mechanical compression and a sharp increase in intra-abdominal pressure, can lead to multi-system dysfunction.