{"title":"A Rare Case of Primary Small Cell Carcinoma of the Esophagus.","authors":"Jiya Mulayamkuzhiyil, Justeena Joseph, Anchita Agrawal, Tommy Ojukwu Perdomo, Sanjeev Jain","doi":"10.1177/23247096251363010","DOIUrl":"10.1177/23247096251363010","url":null,"abstract":"<p><p>Small cell carcinoma of the esophagus is a rare and aggressive variant of esophageal cancer. We report a case of a 69-year-old female who presented with dysphagia to solid food for 6 months and underwent esophagogastroduodenoscopy, which revealed an ulcerated mass in the proximal esophagus. Biopsy findings were consistent with esophageal small cell cancer. The patient was found to have distant metastasis to the gastric lymph nodes on staging studies. She was treated with chemotherapy, resulting in initial disease resolution, but 4 years later, she presented with metastatic disease to the lungs and brain. This case underscores the need to establish treatment guidelines for this malignancy with a poor prognosis, given the paucity of randomized clinical trials.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251363010"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775641","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}
Emmanuel Daniel, Mohammed El-Nayir, Thomas Dougan, Priyata Dutta, Paul Nona
{"title":"A Rare Complication Unveiled: Ostial Left Main Stenosis Post SAVR-A Case Report.","authors":"Emmanuel Daniel, Mohammed El-Nayir, Thomas Dougan, Priyata Dutta, Paul Nona","doi":"10.1177/23247096251358675","DOIUrl":"10.1177/23247096251358675","url":null,"abstract":"<p><p>Iatrogenic coronary artery obstruction is one of many life-threatening complications associated with aortic valve replacement. Although very few cases of ostial coronary artery occlusion following cardiac surgery are reported, the consequences can be catastrophic due to increased risk of mortality. Due to the rarity, prompt investigation and early management are crucial to manage this catastrophic sequelae. We report a case in which a 61-year-old female presented with acute coronary syndrome 4 months after surgical aortic valve replacement and was found to have 99% left main ostial coronary artery occlusion.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251358675"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637231","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":"A Case of Rafiq Syndrome (MAN1B1-CDG) in a Palestinian Child, With Brief Literature Review of 44 Cases.","authors":"Reema Iskafi, Bahaa AbuRahmeh, Roa'a Aljuneidi, Hidaya AlShweiki, Siraj Abdelnabi, Anas Abukhalaf, Bara' Maraqa","doi":"10.1177/23247096251313731","DOIUrl":"10.1177/23247096251313731","url":null,"abstract":"<p><p>Rafiq syndrome, MAN1B1-CDG, was described in 2010 and associated with genetic mutation in MAN1B1 gene in 2011. The disorder follows an autosomal recessive pattern of inheritance and typically presents with specific facial dysmorphism, intellectual disability, developmental delay, obesity, and hypotonia. The syndrome belongs to a group of metabolic disorders called Congenital Glycosylation Disorders (CGD). In this study, we discuss a 5-year-old male from Palestine who presented with developmental delay, hypotonia, characteristic facial dysmorphisms, impulsive behaviors, inability to speak, cryptorchidism, and other manifestations. This constellation of manifestations raised suspicion of a genetic disorder, prompting whole exome sequencing (WES), which revealed the presence of a homozygous likely pathogenic variant in the MAN1B1 gene (c.1976T>G)(p.Phe659Cys). We also reviewed all previously documented cases and compared the clinical features among them. After reviewing the family pedigree and its suspected cases, we found that the 2 most frequent features among them are intellectual disability and facial dysmorphism, whereas the least frequent one is truncal obesity. We discussed the importance of providing genetic counseling to parents of children with this and other rare, autosomal recessive disorders to prevent new cases from appearing.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251313731"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006799","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}
Mikayla Myers, Bassel Dakkak, Swapna Sirigireddy, Ibrahim Shanti, Drew Ferguson, Abdelwahap Elghezewi, Mustafa Ben Khayal, Zakaria Alagha, Ahmed Sherif, Eva-Pattont Tackett
{"title":"Follicular Lymphoma of the Gallbladder in an Octogenarian: A Case Report and Literature Review.","authors":"Mikayla Myers, Bassel Dakkak, Swapna Sirigireddy, Ibrahim Shanti, Drew Ferguson, Abdelwahap Elghezewi, Mustafa Ben Khayal, Zakaria Alagha, Ahmed Sherif, Eva-Pattont Tackett","doi":"10.1177/23247096251342035","DOIUrl":"10.1177/23247096251342035","url":null,"abstract":"<p><p>Primary follicular lymphoma (PFL) is an indolent subtype of non-Hodgkin lymphoma that typically involves lymphoid tissues. Gallbladder involvement is exceedingly rare and poses significant diagnostic challenges. Few cases in the literature describe gallbladder follicular lymphoma, particularly in elderly male patients, leaving notable gaps in clinical understanding and management. Herein, we present the case of an 82-year-old male who presented with acute abdominal pain and unintentional weight loss. Initial imaging, including contrast-enhanced computed tomography, ultrasound, and magnetic resonance imaging, revealed a suspicious gallbladder mass with wall thickening and regional lymphadenopathy, raising concern for malignancy. Endoscopic ultrasound-guided fine needle aspiration and subsequent immunophenotyping confirmed a diagnosis of PFL. The patient underwent radical cholecystectomy with lymphadenectomy, and histopathological examination corroborated the diagnosis of gallbladder follicular lymphoma. During follow-up, the patient developed complications, yet no evidence of lymphoma recurrence was observed. A literature review identified 8 similar cases, further emphasizing the rarity of this presentation. Future research should focus on optimizing diagnostic techniques, refining therapeutic strategies, and conducting longer-term follow-up studies to better assess patient outcomes in such a rare disease. This case highlights the need for heightened clinical suspicion and comprehensive evaluation in atypical presentations of extranodal lymphoma.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251342035"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158723","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}
Michael Ke, Neeki Ettefagh, Ahmet Semih Topbas, Mehdi Kazemi
{"title":"<i>Cryptococcus neoformans</i> Meningoencephalitis in a Young Immunocompetent Patient.","authors":"Michael Ke, Neeki Ettefagh, Ahmet Semih Topbas, Mehdi Kazemi","doi":"10.1177/23247096251334235","DOIUrl":"10.1177/23247096251334235","url":null,"abstract":"<p><p>Cryptococcal meningitis is mainly seen in immunocompromised patients, but in recent years, there has been an increase in cases involving patients with no known immunodeficiencies. These patients have symptomatic presentations that range from indolent and mild to typical and severe. We present a case of cryptococcal meningitis in an immunocompetent young patient with a chronic headache. The patient underwent imaging which showed diffuse leptomeningeal enhancement and a lumbar puncture which confirmed <i>Cryptococcus neoformans</i>. She underwent guideline-based treatment for cryptococcal meningitis and improved clinically. Cryptococcal meningitis should be considered in immunocompetent patients who present with typical signs of symptoms of meningitis, particularly chronic headaches and altered mental status.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251334235"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027051","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}
Kinh Kha Nguyen, Dinh Kinh Hoang, Quoc Trung Lam, Thanh Phong Lenh
{"title":"Sacral Metastasis in Follicular Thyroid Carcinoma: Cytology Pitfalls and Serum Thyroglobulin Utility.","authors":"Kinh Kha Nguyen, Dinh Kinh Hoang, Quoc Trung Lam, Thanh Phong Lenh","doi":"10.1177/23247096251336659","DOIUrl":"https://doi.org/10.1177/23247096251336659","url":null,"abstract":"<p><p>Sacral bone metastasis from primary follicular thyroid carcinoma (FTC) is rare. Most reported cases include factors indicative of thyroid origin, such as a history of treated thyroid cancer or newly identified thyroid nodules with malignant cytology. We herein report a 57-year-old woman with a metastatic sacral lesion of thyroid origin, initially misdiagnosed due to a false-negative fine-needle aspiration (FNA) cytology result of a thyroid nodule. The diagnosis was suspected based on an abnormally elevated serum thyroglobulin (sTg) level and confirmed through repeat core biopsy with thyroid-specific immunohistochemistry. This case highlights the limitations of FNA cytology in large thyroid nodules and underscores the potential role of sTg in diagnosing metastatic FTC in certain clinical scenarios. Thyroid carcinoma should be considered in the differential diagnosis of sacral metastases when the primary tumor is unknown.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251336659"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029827","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}
Dilara Hatipoglu, Arsia Jamali, Emily Sheng, K Rajender Reddy
{"title":"Rapid Onset Liver Injury Due to Azacitidine Through Possibly a Unique Mechanism of Hypoperfusion of the Liver.","authors":"Dilara Hatipoglu, Arsia Jamali, Emily Sheng, K Rajender Reddy","doi":"10.1177/23247096251344720","DOIUrl":"10.1177/23247096251344720","url":null,"abstract":"<p><p>Azacitidine and venetoclax are important anti-neoplastic agents used in the treatment of acute myeloid leukemia. Azacitidine has been implicated to cause nonhepatic ischemic injury. Here we report a case of severe, short latency drug-induced liver injury following the infusion of azacitidine and venetoclax in a patient which was subsequently mitigated through pretreatment with a vasodilatory agent.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251344720"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110939","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}
Mark A Colantonio, Danielle Sblendorio, Elizabeth Hart, Tiffany Caza, Vincent Melemai, Joshua Wiley
{"title":"Persistent Left Superior Vena Cava in the Setting of <i>Granulicatella adiacens</i> Bactermia and Crescentic Glomerulonephritis.","authors":"Mark A Colantonio, Danielle Sblendorio, Elizabeth Hart, Tiffany Caza, Vincent Melemai, Joshua Wiley","doi":"10.1177/23247096251381174","DOIUrl":"10.1177/23247096251381174","url":null,"abstract":"<p><p>Persistent left superior vena cava is a rare congenital condition, that is, commonly found to be asymptomatic in affected patients. Such pathology can lead to dilatation of the coronary arteries, creating a favorable environment for bacterial growth. We present a case of <i>Granulicatella adiacens</i> bacteremia ultimately leading to renal failure in the setting of an IgA-dominant infection-associated glomerulonephritis. Our case highlights the importance of multimodal imaging for the diagnosis of this unusual vascular anomaly, as well as the management of this atypical etiology of high-grade bacteremia.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251381174"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175981","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}
Ahmed Aldolly, Saja Karaja, Hazem Arab, Yousef Alsaffaf, Saleh Takkem
{"title":"Asymptomatic Isolated Congenitally Corrected Transposition of the Great Arteries in a 25-Year-Old Male: A Case Report.","authors":"Ahmed Aldolly, Saja Karaja, Hazem Arab, Yousef Alsaffaf, Saleh Takkem","doi":"10.1177/23247096251331840","DOIUrl":"https://doi.org/10.1177/23247096251331840","url":null,"abstract":"<p><p>Congenitally corrected transposition of the great arteries (ccTGA) is a complex cardiac abnormality that represents less than 1% of all congenital heart defects. It is characterized by a unique pathophysiology involving both atrioventricular and ventriculoarterial discordance and may occur with or without cardiac abnormalities such as ventricular septal defects, pulmonary stenosis, or tricuspid valve anomalies. A man in his 20s presented with a 3-week history of mild dyspnea during strenuous activities. The patient was diagnosed with isolated ccTGA based on electrocardiogram and echocardiogram findings. However, as a long-term complication of ccTGA, the patient exhibited mild tricuspid regurgitation, mild mitral regurgitation, and right ventricular hypertrophy. The dyspnea was explained by the failing systemic right ventricle. Despite his cardiac anomaly, the patient leads a normal lifestyle, with ongoing monitoring to ensure optimal management of his condition. ccTGA is even rarer in the absence of additional cardiac abnormalities, and its diagnosis could be delayed due to being asymptomatic. Patients must avoid risk factors and that could potentially aggravate their condition. Regular surveillance is imperative for the early detection of potential complications.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251331840"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017640","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}
Abdul Muhsen Abdeen, Jowan Al-Nusair, Malik Samardali, Mohamed Alshal, Amro Al-Astal, Zeid Khitan
{"title":"Complement-Mediated Hemolytic Uremic Syndrome Due to MCP/CD46 Mutation: A Case Report.","authors":"Abdul Muhsen Abdeen, Jowan Al-Nusair, Malik Samardali, Mohamed Alshal, Amro Al-Astal, Zeid Khitan","doi":"10.1177/23247096251316364","DOIUrl":"10.1177/23247096251316364","url":null,"abstract":"<p><p>Thrombotic microangiopathy (TMA) is a severe condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage, often involving the kidneys. Complement-mediated hemolytic uremic syndrome (cHUS), a rare form of TMA, arises from dysregulated alternative complement pathway activation, frequently due to genetic mutations. We report the case of a 23-year-old male presenting with TMA secondary to a heterozygous mutation in the membrane cofactor protein (MCP/CD46) gene. The patient exhibited severe renal and cardiovascular complications, including acute kidney injury requiring hemodialysis, uremic pericarditis, and persistent anemia. Diagnostic evaluation confirmed complement dysregulation, and management with eculizumab, plasmapheresis, and hemodialysis was initiated. Renal biopsy revealed classic TMA features, and genetic testing identified the MCP mutation, underscoring the importance of genetic predispositions in guiding diagnosis and therapy. This case emphasizes the critical role of genetic testing in TMA evaluation and highlights the potential for improved outcomes through targeted complement inhibition and individualized care strategies.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251316364"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052688","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}