Clinical Medicine Insights. Case Reports最新文献

{"title":"Treatment of Hyperkalemia-Induced-Cardiac-Arrest by Dynamic Electrocardiogram and Point-of-Care-testing Potassium: A Case Report.","authors":"Jiaozhen Chen, Jizhen Chen, Xinran Dang, Jiali Chen, Yusuo Chen, Yuanli Lei","doi":"10.1177/11795476261457670","DOIUrl":"10.1177/11795476261457670","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia is one of the more common acute life-threatening metabolic emergencies. Although only a small proportion of cases progress to cardiac arrest (CA), early detection and timely intervention often yield excellent outcomes. Dynamic and characteristic ECG manifestations combined with point-of-care testing (POCT) potassium management provide timely evidence for hyperkalemia treatment. Wide QRS complex rhythms blended with T waves are extremely high-risk signals for CA due to hyperkalemia.</p><p><strong>Case presentation: </strong>We report a 68-year-old male patient who presented to the hospital with syncope. ECG findings included peaked T waves, loss of P-waves, sinoventricular conduction, and a wide QRS complex rhythm. Shortly after admission, the patient experienced CA. POCT potassium levels were 9.0 mmol/L. With the help of ECG and POCT potassium results, the patient achieved return of spontaneous circulation (ROSC) after 32 minutes of CPR without residual neurological deficits.</p><p><strong>Conclusion: </strong>This paper highlights the role of dynamic ECG monitoring and POCT potassium management in rescuing patients with lethal hyperkalemia.Through POCT potassium monitoring, identification of high-risk ECG signals, combined with effective pharmacological intervention and high-quality CPR, the success rate of rescue treatment can be significantly improved, and patient prognosis can be enhanced.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457670"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155543","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":"No Identifiable Primary, Only Metastases: Case Report of a Small Round Blue Cell Tumor Consistent With Ewing Sarcoma Presenting With Multisystem Spread in a Young Woman.","authors":"Simra Irfan, Ahmed Muneeb, Mallick Muhammad Zohaib Uddin, Muhammad Ahmed, Saba Akram, Abdullah Muhammad, Wasim Memon, Uffan Zafar","doi":"10.1177/11795476261457179","DOIUrl":"10.1177/11795476261457179","url":null,"abstract":"<p><p>Ewing sarcoma is the second most common malignant bone tumor in children and adolescents but remains rare and highly aggressive. We present the case of a 31-year-old woman with widespread metastatic disease suggestive of Ewing sarcoma, including lung, spinal, and brain involvement at presentation; however, no dominant primary lesion was identified despite extensive imaging. The patient's clinical course was complicated by neuropathic pain, seizures, and severe treatment-related infections. She was managed with multi-agent chemotherapy and supportive care but ultimately left against medical advice due to socioeconomic constraints. This case illustrates the diagnostic and therapeutic challenges of Ewing sarcoma in low-resource settings and underscores the importance of early detection, molecular confirmation, and multidisciplinary management.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457179"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155450","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":"Steroid-Responsive Bradycardia in a Patient with Presumptive Isolated Intestinal Tuberculosis: A Case Report.","authors":"Farzana Islam, Shaila Rahman, Md Salman Karim, Mehreen Salim Aurpa, Mostofa Kamal Chowdhury","doi":"10.1177/11795476261453439","DOIUrl":"10.1177/11795476261453439","url":null,"abstract":"<p><p>Intestinal tuberculosis (TB) typically presents with gastrointestinal symptoms, and cardiac conduction abnormalities associated with isolated intestinal TB have rarely been reported. We describe a 37-year-old male presenting with abdominal pain, constipation, and significant weight loss, with epidemiological exposure to cattle and raw milk. During hospitalization, he developed sinus bradycardia with a lowest corrected heart rate of approximately 46 beats per minute. The bradycardia persisted despite treatment with propantheline and atropine. Colonoscopy revealed terminal ileitis, and histopathology demonstrated nonspecific chronic ileitis without granuloma formation. Cardiac evaluation including echocardiography, troponin levels, electrolytes, and serum cortisol was unremarkable. Hydrocortisone administration was temporally associated with improvement in heart rate within 48 hours. Empirical anti-tuberculosis therapy was subsequently initiated, and the patient demonstrated sustained clinical improvement. Although causality cannot be definitively established, this case illustrates a rare temporal association between presumptive intestinal tuberculosis and steroid-responsive bradycardia. The report highlights the importance of considering systemic inflammatory processes in unexplained bradycardia, particularly in tuberculosis-endemic settings.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261453439"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155394","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":"Lyme Disease Presenting as Rupture Baker's Cyst: Case Report and Literature Review.","authors":"Abdullah Ghali, Neal Mody-Bailey, Mohamad Jabin, Marwa Abdou, Momin Hussain, Amr Abdelgawad","doi":"10.1177/11795476261457180","DOIUrl":"10.1177/11795476261457180","url":null,"abstract":"<p><p>Baker's cysts, also known as popliteal cysts, are fluid-filled sacs that are found in the posterior region of the knee, behind the medial head of the gastrocnemius and the semimembranosus. The prevalence has been found to increase with age, with some ultrasonographic studies showing a prevalence as high as 25% of adults with knee pain. We discuss an interesting case of a 14-year- old male with a ruptured cyst found to be secondary to Lyme disease. The patient was treated with clindamycin and his symptoms had resolved. We discuss cases of ruptured baker's cysts in the literature found to be secondary to Lyme disease with their respective treatments and outcomes.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457180"},"PeriodicalIF":0.6,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148610","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":"Parotid Mucoepidermoid Carcinoma Radiologically Mimicking a Benign Postauricular Epidermoid Cyst: A Case Report.","authors":"Loubna Taali, Abderrahim Bourial, Zineb Dahbi, Said Anajar, Amal Hajjij","doi":"10.1177/11795476261457178","DOIUrl":"10.1177/11795476261457178","url":null,"abstract":"<p><strong>Background: </strong>Mucoepidermoid carcinoma of the parotid gland may occasionally present with cyst-like or deceptively benign radiologic features, even when the final histopathological architecture is predominantly solid. Diagnostic difficulty increases when the lesion appears separated from the parotid gland and mimics a superficial postauricular cyst.</p><p><strong>Case presentation: </strong>We report the case of a 49-year-old patient presenting with a painful left postauricular swelling associated with ipsilateral House-Brackmann grade III peripheral facial paralysis. Ultrasound and MRI suggested a well-circumscribed benign cystic lesion, interpreted as a remodeled epidermoid cyst, located in the retroparotid/postauricular region. However, the clinical red flags prompted surgical management. Histopathological examination considered most compatible with a mucoepidermoid carcinoma involving the parotid/posterior parotid region, with dermal extension. The patient subsequently underwent total parotidectomy and cervical lymph node dissection, followed by adjuvant radiotherapy after multidisciplinary tumor board discussion.</p><p><strong>Conclusion: </strong>This case highlights that any postauricular or parotid-region mass associated with facial nerve dysfunction should be considered malignant until proven otherwise, even when imaging suggests a benign cystic lesion. Radio-clinical discordance should prompt an oncologic diagnostic strategy and careful histopathological evaluation.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457178"},"PeriodicalIF":0.6,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142921","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":"Neonatal Hypoganglionosis Mimicking Hirschsprung Disease in a Resource-Limited Setting: A Case Report.","authors":"Imad Afara, Hussein Akil, Tammy Gebara, Marilynn Zalal, Ali Afara, Hamad Hassan, Karim Hassan","doi":"10.1177/11795476261457677","DOIUrl":"10.1177/11795476261457677","url":null,"abstract":"<p><strong>Background: </strong>Neonatal pediatric intestinal pseudo-obstruction (PIPO) is rare and may closely mimic Hirschsprung disease, particularly when caused by enteric neuropathies.</p><p><strong>Case presentation: </strong>We report the case of an 18-day-old female neonate who presented with delayed passage of meconium, persistent bilious vomiting, progressive abdominal distension, and significant weight loss since birth. Initial imaging demonstrated dilated bowel loops without evidence of mechanical obstruction. A rectal biopsy suggested distal aganglionosis, and a colostomy was performed. Despite anatomically appropriate diversion, the patient continued to have bilious gastric output, abdominal distension, and an inability to tolerate enteral feeds. Further surgical evaluation was therefore undertaken, and multi-level full-thickness intestinal biopsies were obtained. Histopathological analysis revealed a reduced density and abnormal morphology of ganglion cells within the myenteric plexus, consistent with hypoganglionosis, establishing the diagnosis of pediatric intestinal pseudo-obstruction (PIPO).</p><p><strong>Conclusions: </strong>This case demonstrates how neonatal hypoganglionosis can follow a Hirschsprung-like diagnostic pathway yet fail to respond to diversion, underscoring the limitations of suction biopsy when clinical evolution is discordant with initial histological findings. Prolonged dependence on parenteral nutrition and limited access to advanced therapeutic options further illustrate the challenges of managing severe neonatal PIPO in resource-limited settings.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457677"},"PeriodicalIF":0.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136741","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":"Spontaneous Tumor Lysis Syndrome as the Initial Presentation of Chronic Lymphocytic Leukemia: A Case Report.","authors":"Mihret D Asfaw, Chernet T Mengistie, Abrham W Azale, Mikias E Gebre, Abiy B Assefa, Froom G Deye, Dereje G Andargie","doi":"10.1177/11795476261457182","DOIUrl":"10.1177/11795476261457182","url":null,"abstract":"<p><strong>Background: </strong>Tumor lysis syndrome (TLS) is an oncologic emergency that most commonly follows cytotoxic treatment of highly proliferative hematologic malignancies; spontaneous TLS as the presenting manifestation of chronic lymphocytic leukemia (CLL) is rare but can cause life-threatening metabolic disturbance and acute kidney injury (AKI).</p><p><strong>Case presentation: </strong>A 68-year-old man from rural Oromia presented with 48 hours of progressive weakness, oliguria, and confusion, and a several-month history of weight loss and painless lymphadenopathy. Initial testing showed leukocytosis (WBC 148 ×10⁹/L; absolute lymphocyte count 130 ×10⁹/L), marked hyperuricaemia (14.5 mg/dL), hyperphosphataemia (8.5 mg/dL), severe hyperkalaemia (6.8 mmol/L) with peaked T-waves, elevated LDH (980 U/L), and AKI (serum creatinine 4.9 mg/dL). Flow cytometry confirmed CLL; there was no prior cytotoxic therapy.</p><p><strong>Management and outcome: </strong>The patient received emergent cardioprotective and potassium-lowering measures, aggressive isotonic fluids, serial monitoring, and oral allopurinol. Oliguria and progressive uraemia prompted urgent haemodialysis on the day of admission. Rasburicase was not available. After stabilization, inpatient cytoreduction with oral chlorambucil and a short steroid taper was started on day 8. The patient was discharged clinically improved on day 10 with monitoring and outpatient follow-up. Renal function and metabolic parameters progressively normalized, with serum creatinine 1.4 mg/dL and marked hematologic improvement at 6 weeks.</p><p><strong>Conclusion: </strong>This case illustrates that spontaneous TLS can unmask previously undiagnosed CLL and cause severe, but potentially reversible, AKI. Early recognition, prompt metabolic stabilization, and timely renal replacement therapy, adapted to local resource availability, are critical to optimize renal and overall outcomes.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457182"},"PeriodicalIF":0.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136772","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":"Probable Pleural-Based Pulmonary Tuberculoma Mimicking Lung Malignancy: A Case Report.","authors":"Tej Nath Nepal, Arindam Mondal, Sriniket Raghavan, Subhalakshmi Sengupta, Nidup, Ejaz Ahmad Bari, Arnab Bera, Geeta Pradhan, Sonam Yoezer","doi":"10.1177/11795476261457184","DOIUrl":"10.1177/11795476261457184","url":null,"abstract":"<p><p>Pleural-based lung masses can mimic lung cancer and differentiating malignancy from other causes remains a diagnostic challenge. We report a case of a 50-year-old man who presented with an acute onset pleuritic chest pain and a history of weight loss. Chest radiography and computed tomography scan showed a solitary pleural-based lung lesion that was suspicious for malignancy. Two sessions of computed tomography guided biopsies yielded only necrotic tissue. An endobronchial ultrasound-guided transbronchial needle aspiration showed inflammatory cells but was non-diagnostic. Video-assisted thoracoscopic surgery wedge resection of the lesion provided tissue revealing a chronic granulomatous mass which showed caseous necrosis and Langhans type giant cells on histopathology. A probable diagnosis of tuberculoma was made based on these findings when other investigations did not reveal a definitive diagnosis and the patient was treated with antitubercular medicines. This case report highlights the challenges encountered in diagnosing a pleural-based solitary lung mass. The key lesson learnt is that tuberculosis should remain in the differential diagnosis of pleural-based lung mass in endemic settings, especially when repeated biopsies show necrosis without malignant cells.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457184"},"PeriodicalIF":0.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136719","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":"The Great Imitator: A Case Report of Mirizzi Syndrome Misdiagnosed as Cholangiocarcinoma Bismuth Type II.","authors":"Anthony Bedran, Joanna Kreidi, Philippe Attieh, Lynn Ezzeddine, Karam Karam, Khalil Bedran","doi":"10.1177/11795476261457172","DOIUrl":"10.1177/11795476261457172","url":null,"abstract":"<p><strong>Background: </strong>An unusual complication of gallstone diseases is Mirizzi syndrome. This disorder is characterized by jaundice, fever and right upper quadrant pain. It is defined by an obstruction of the common hepatic duct due to an extrinsic compression from a stone in the gallbladder infundibulum or the cystic duct. It should be identified as soon as possible in order to prevent complications, notably biliary sepsis.This disorder can sometimes mimic the symptoms of cholangiocarcinoma (CCA).</p><p><strong>Case summary: </strong>We present the case of a 69 years old male presenting for painless jaundice and dark urine of 1 week duration. Upon several abdominal imaging and laboratory examinations, the patient was diagnosed with CCA Klatskin tumor type II. The patient was referred for a bile duct resection with caudate lobectomy and Roux-en-Y hepticojejunostomy. However, during surgery, the patient was found to have 2 large stones at the base of gallbladder, obstructing the common bile duct, directing the diagnosis towards Mirizzi syndrome (MS).The uniqueness of the case lies in the patient's presentation, as well as the thorough investigation which were in favor of the Klatskin tumor.</p><p><strong>Conclusion: </strong>MS is a very rare complication of gallstone diseases. It can sometimes present similarly to CCA. Therefore, a more precise and accurate diagnostic tools should be employed in order to be able to differentiate between these two entities.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457172"},"PeriodicalIF":0.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136793","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":"Pedunculated Pleomorphic Adenoma With Adipocytic Metaplasia of the Hard Palate: A Case Report.","authors":"Fakhreddine Alouane, Lilia Ben Zid, Oussema Belkacem, Raouaa Belkacem Chebil, Nabiha Douki","doi":"10.1177/11795476261457176","DOIUrl":"10.1177/11795476261457176","url":null,"abstract":"<p><strong>Background: </strong>Salivary gland tumors represent less than 4% of all head and neck tumors, with pleomorphic adenoma (PA) being the most common among them. The palate represents the most frequent site of occurrence. Although typically presenting as a firm and sessile mass, PA may occasionally exhibit unusual clinical or histological features that complicate diagnosis.</p><p><strong>Case presentation: </strong>We describe an unusual case of a 46-year-old woman presenting with a pedunculated PA of the hard palate, exhibiting superficial ulceration and mild pressure induced bone erosion detected radiographically. The lesion was completely excised under local anesthesia. Histopathological examination confirmed the diagnosis of PA with adipocytic metaplasia, an uncommon finding that may mimic malignant transformation. Healing occurred uneventfully and no recurrence was observed after a 12 month follow up.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing atypical clinical and histological variants of pleomorphic adenoma and establishing an appropriate differential diagnosis. Accurate diagnosis and optimal management require careful correlation of clinical, radiological, and histopathological findings. Long term follow up remains essential to ensure early detection of potential recurrence or malignant transformation.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"19 ","pages":"11795476261457176"},"PeriodicalIF":0.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136755","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}