Clinical Case Reports最新文献

{"title":"A Case of a Metal Foreign Object Remaining in the Maxillary Bone for an Extended Period: A Case Report","authors":"Koichi Kadoya,&nbsp;Yuki Kunisada,&nbsp;Kyoichi Obata,&nbsp;Hiroaki Takakura,&nbsp;Tatsuo Ogawa,&nbsp;Soichiro Ibaragi","doi":"10.1002/ccr3.9631","DOIUrl":"https://doi.org/10.1002/ccr3.9631","url":null,"abstract":"<p>We report a rare case in which a metallic foreign body remained undetected in a patient's maxilla for nearly 40 years after a childhood bicycle accident. Despite the accident, the implant remained in place without causing infection due to the lack of imaging studies at the time. The metal was accidentally discovered during a routine dental imaging examination 40 years later and subsequently surgically removed. This case highlights the importance of comprehensive imaging and the dangers of overlooking foreign bodies, especially in the vulnerable head and neck region. The patient, 53 years old at the time of discovery, presented to the dentist due to discomfort in the palate and nasal cavity. During this visit, radiographs were taken and a foreign body was discovered. Surgical removal of the foreign body revealed significant corrosion and surrounding granulation tissue indicative of foreign body granuloma. Elemental analysis of the foreign body confirmed that it was an iron-based metal, unlike biocompatible materials such as titanium. These findings reinforce the need for close post-trauma evaluation and follow-up, especially in cases of pediatric trauma, to avoid the possibility of long-term complications arising from unnoticed foreign bodies in anatomically significant areas.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.9631","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Calcifications Guide the Diagnosis: A Case of Gorlin's Cyst","authors":"Rym Kammoun,&nbsp;Manel Gharbi,&nbsp;Rawia Jaziri,&nbsp;Nawress Ghadhab,&nbsp;Imen Chaabani,&nbsp;Touhami Ben Alaya","doi":"10.1002/ccr3.70369","DOIUrl":"https://doi.org/10.1002/ccr3.70369","url":null,"abstract":"<p>Calcified odontogenic epithelial cyst known as Gorlin's cyst is one of the benign odontogenic tumors of the maxillae. In imaging, the most revealing aspect is a well-limited osteolytic image with peripheral calcifications. The aim of the study was to highlight these radiological features to establish the correct diagnosis and appropriate treatment.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Extra-Axial Chordoma of the Anteromedial Thigh: A Case Report","authors":"Meagan E. Tibbo,&nbsp;Nishad Mysore,&nbsp;Jean Jose,&nbsp;Andrew E. Rosenberg,&nbsp;H. Thomas Temple","doi":"10.1002/ccr3.70341","DOIUrl":"https://doi.org/10.1002/ccr3.70341","url":null,"abstract":"<p>Chordomas are rare notochordal malignancies typically occurring in the axial skeleton. Less than 100 extra-axial chordomas have been reported. We describe a unique chordoma of the anteromedial thigh. The clinical presentation of extra-axial chordomas is highly variable; thus, recognizing this entity in the differential diagnoses of extra-axial bone/soft tissue tumors is important.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestation of “Wing-Beating” Tremors Along With Appearance of the “Giant Panda” Sign on Brain MRI in Neuro Wilson's Disease Due to Treatment Failure: A Case Report","authors":"Rupal Vikas Dosi,&nbsp;Kush Pankaj Shah,&nbsp;Jeel Narendra Sarvaiya,&nbsp;Dakshi Jignesh Kadakia,&nbsp;Dax Rajendra Patel,&nbsp;Aarushi Mishra","doi":"10.1002/ccr3.70456","DOIUrl":"https://doi.org/10.1002/ccr3.70456","url":null,"abstract":"<p>We report a patient of neuro Wilson's disease who presented with “wing-beating” tremors and “giant panda” sign on magnetic resonance imaging, 1 year after initiation of treatment with zinc acetate. We focus on the importance of initiating copper chelator therapy as the first line treatment as it improves the prognosis and prevents irreversible complications.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Flow Oxygen Therapy to Support Inpatient Pulmonary Rehabilitation During Very Severe Hepatopulmonary Syndrome Recovery Post Liver Transplant: A Case Report","authors":"Jack M. Reeves,&nbsp;Jessica Marouvo,&nbsp;Aveline Chan,&nbsp;Nicholas Thomas,&nbsp;Lissa M. Spencer","doi":"10.1002/ccr3.70472","DOIUrl":"https://doi.org/10.1002/ccr3.70472","url":null,"abstract":"<p>This case study reports the novel use of inpatient pulmonary rehabilitation (PR) with near-maximal high-flow oxygen therapy in a patient recovering from very severe hepatopulmonary syndrome (HPS) following liver transplantation. HPS is a rare condition where advanced liver disease alters lung microvasculature through intrapulmonary vascular dilatation (IPVD) and angiogenesis. Platypnoea–orthodeoxia (postural dyspnoea with concurrent blood oxygen desaturation) is characteristic of HPS due to redirection of blood flow to the basal lung where IPVDs are more prominent, secondary to gravity. Currently, the only definitive treatment is liver transplantation, which allows normalization of oxygenation over an extended period, typically within 1 year. Pulmonary rehabilitation is an effective intervention for improving dyspnoea, health-related quality of life (HRQoL), and exercise capacity in people with chronic respiratory disease. Despite this, little is known of the effect PR has on individuals recovering from HPS post liver transplant. The aim is to describe an inpatient PR program for a patient recovering from HPS. This case study describes a 27-year-old male with “very severe” HPS who undertook inpatient PR 5 months posttransplant. The patient completed an 8-week program of twice-weekly PR supported by high-flow oxygen therapy (fraction of inspired oxygen of 90%). He performed aerobic and resistance exercises for the upper and lower limbs in recumbent, seated, and standing positions. The patient improved in exercise capacity on the 1-min sit-to-stand test (+4 repetitions), lower limb strength on the 5-repetition sit-to-stand test (−3.4 s) and in HRQoL outcomes assessed. Following rehabilitation, the patient still had a high burden of respiratory symptoms and required continuous high-flow oxygen therapy. This case study demonstrates that inpatient PR, modified for HPS-associated platypnoea–orthodeoxia and supported by high-flow oxygen therapy, is safe and effective and therefore feasible for other HPS patients.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subependymal Gray Matter Heterotopia With Seizure in a 6-Month-Old Child","authors":"Bibek Shrestha,&nbsp;Priyesh Shrestha,&nbsp;Vivek Karn,&nbsp;Shiva Ram Ale Magar","doi":"10.1002/ccr3.70464","DOIUrl":"https://doi.org/10.1002/ccr3.70464","url":null,"abstract":"<p>A 6-month-old male presented with seizures. Non-contrast CT revealed subependymal gray matter heterotopia, corpus callosum dysgenesis, colpocephaly, and suspicious closed-lip bilateral parieto-occipital schizencephaly. Benign posterior fossa and subarachnoid space enlargement were noted. This case highlights the diagnostic value of imaging in rare neuronal migration disorders and associated structural abnormalities.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemophilia B With Intracranial Hemorrhage Rehabilitation in High-Dependency Unit: A Case Report","authors":"Xiaoyan Feng,&nbsp;Hongjun Zhu,&nbsp;Liying Han,&nbsp;Hongxing Xu,&nbsp;Lei He","doi":"10.1002/ccr3.70470","DOIUrl":"https://doi.org/10.1002/ccr3.70470","url":null,"abstract":"<p>Hemophilia B, an X-linked recessive coagulation disorder, poses significant risks of life-threatening intracranial hemorrhage (ICH). This case report details the multidisciplinary rehabilitation of a 41-year-old male with moderate hemophilia B (FIX activity: 3.9%) and ICH in a resource-limited setting. Admitted to a high-dependency unit postneurosurgical intervention, the patient received low-dose prophylactic coagulation factor IX (maintained at 34.6%–66.2%) alongside real-time coagulation monitoring. A stepwise rehabilitation protocol was implemented, including early passive joint mobilization, neuromuscular electrical stimulation, and progressive task-oriented training, tailored to minimize bleeding risk. Over 7 weeks, the patient achieved marked functional improvement: Activity of Daily Living score increased from 0 to 80, modified Rankin Scale improved from 5 to 3, and Fugl-Meyer Assessment (FMA) rose from 0 to 60, with no secondary bleeding. This case highlights the feasibility of integrating low-dose prophylaxis with early rehabilitation in developing countries, offering a cost-effective model to enhance functional recovery and reduce disability in hemophilia-related ICH.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymorphous Adenocarcinoma of the Parotid Gland: A Rare Entity in Asians With a Unique Cystic Presentation","authors":"Ibadat Preet Kaur,&nbsp;Devendra Pankaj,&nbsp;Meena Santosh,&nbsp;Jitendra Sharan,&nbsp;Neha Singh,&nbsp;Anand Marya","doi":"10.1002/ccr3.70441","DOIUrl":"https://doi.org/10.1002/ccr3.70441","url":null,"abstract":"<p>Polymorphous adenocarcinoma (PAC) of the parotid is a rare entity with minimal reported incidences in the Asian population. It generally presents as a solid tumor and is considered a diagnostic dilemma due to morphological diversity and variable histological patterns. This article reports a unique fluid-filled PAC of the parotid gland mimicking a cystic lesion in an Indian male, with a review of relevant literature. A 64-year-old male patient presented with a slow-growing swelling of the left parotid region for the last 10 years. The cytology report suggested a cystic swelling. The patient underwent superficial parotidectomy. A detailed histopathological examination confirmed it as a classical variant of PAC. He remains disease-free over 24 months post-surgery follow-up.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Velocity Tracking in the Left-Ventricular Outflow Track Using Four-Dimensional 4D Flow for the Assessment of Left Ventricular Outflow Track Obstruction","authors":"Chris Sawh,&nbsp;Pankaj Garg","doi":"10.1002/ccr3.70465","DOIUrl":"https://doi.org/10.1002/ccr3.70465","url":null,"abstract":"<p>Stress 4D flow CMR is a powerful non-invasive tool for diagnosing and localizing dynamic LVOT obstruction. By quantifying peak velocities and flow patterns under stress, it provides critical insights into hemodynamics, especially when echocardiography is limited, enabling accurate diagnosis and improved clinical decision-making in complex cases.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70465","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vagus Nerve Schwannoma: A Case Report and Literature Review","authors":"Kato Ronald,&nbsp;Kantu Ronald,&nbsp;Jacinta Ambaru,&nbsp;Dan Sekiwunga","doi":"10.1002/ccr3.70469","DOIUrl":"https://doi.org/10.1002/ccr3.70469","url":null,"abstract":"<p>Vagus schwannomas are rare, benign masses that arise in the cervical region but can develop anywhere along the Vagus nerve. In most cases, patients present in their third to sixth decades, with neck swelling and hoarseness; herein, we discuss a case report of a 41-year-old female who presented with slurred speech and locking of her tongue and was diagnosed with Vagus schwannoma. The patient had an inability to speak properly and locking of her tongue during speech, with pain to the right side of the neck as Intermittent, prompted by turning her head to the right and shooting pain to her shoulder, which is short-lived, with a sensation of difficulty swallowing and talking that is alleviated by moving her head to a neutral position. On examination, there was mild neck stiffness, fasciculations of the tongue, and left deviation of the tongue with inability to swallow. Blood pressure was 128/70 mmHg with 42 bpm bradycardia, which was persistent on several readings, with a small right neck mass measuring 1 cm × 2 cm, non-tender on palpation. Imaging studies showed a well-defined ovoid lesion centered in the right retrostyloid parapharyngeal space measuring 3.3 × 2.1 × 3.8 cm with central T2 hyperintensities representing a nerve sheath tumor that appears stable in size and morphology. The histology report typically displayed a characteristic pattern with two distinct tissue types, Antoni A and Antoni B, with tightly packed spindle cells arranged in palisades around a central verocay body and a looser arrangement of myxoid matrix. Immunohistochemistry showed lesional cells had strong immunopositivity for S100 and were negative for CD34. Hence, the conclusion of a Vagus nerve schwannoma. Patient was sent to the radiation oncology team and was started on Cyberknife 25 Gy treatment in five fractions, which were completed and sent for re-evaluation and follow-up. There was no surgical intervention in this case due to the delicate anatomical location of the mass; hence, Cyberknife radiation was the best option for treatment. Vagus schwannomas are rare, benign masses that usually develop in the cervical region but can arise anywhere along the Vagus nerve. Patients may be asymptomatic, but in most cases, they present in their third to sixth decades; hence, they should be considered in patients with otherwise unexplained bradycardia, with a history of dysphagia, slurred speech, and cervical masses.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}