Journal of Medical Case Reports最新文献

{"title":"Severe rise in tacrolimus levels following blood orange and grapefruit juice intake in a kidney transplant recipient: a case report.","authors":"Victoria Östman, Anna-Karin Hamberg, Shinji Yamamoto, Tomas Lorant","doi":"10.1186/s13256-026-06514-w","DOIUrl":"10.1186/s13256-026-06514-w","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is a cornerstone immunosuppressant in kidney transplantation with a narrow therapeutic index and high interindividual pharmacokinetic variability, largely determined by CYP3A4, CYP3A5, and P-glycoprotein activity. Grapefruit juice is a known intestinal CYP3A4 inhibitor capable of increasing tacrolimus exposure, whereas blood orange juice has not been documented to exert such effects.</p><p><strong>Case presentation: </strong>A 33-year-old male kidney transplant recipient of Somali origin had persistently low tacrolimus trough levels, averaging about 4.5 µg/L, despite increased dosing. On postoperative day 5 (POD 5), the patient consumed approximately one liter of blood orange juice followed later the same evening by a clinically supervised 250 mL dose of grapefruit juice intended to enhance tacrolimus exposure. The following morning, his tacrolimus concentration had risen sharply sixfold to 30 µg/L, far above the increase typically associated with grapefruit juice alone. Kidney biopsy at that time showed eosinophilic infiltration, consistent with a drug-related inflammatory reaction. Tacrolimus therapy was temporarily stopped, then gradually reintroduced. His condition stabilized, and he was discharged on POD 12.</p><p><strong>Conclusions: </strong>The pronounced increase in tacrolimus exposure following sequential ingestion of blood orange and grapefruit juice suggests a potential synergistic interaction affecting tacrolimus disposition via CYP3A4, CYP3A5 and/or P-glycoprotein pathways. While causality remains unconfirmed, this case emphasizes the value of thorough dietary history in transplant care and supports further research on blood orange juice as a possible modulator of tacrolimus pharmacokinetics.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906407","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":"Residual drugs in the stomach? A case report.","authors":"Shusheng Zhang, Chenhao Wang, Haiyan Song, Zhiwei Chen, Yining Xue, Yikun Zhang, Hongzhu Wen","doi":"10.1186/s13256-026-06568-w","DOIUrl":"10.1186/s13256-026-06568-w","url":null,"abstract":"<p><strong>Background: </strong>High-density material identified in the stomach on computed tomography (CT) most commonly represents ingested drugs, oral contrast agents, or blood. Distinguishing between these is critical, as misidentifying drugs or contrast as active gastric bleeding may lead to unnecessary interventions. We report a rare cause of hyperdense gastric material on CT, other than the three etiologies mentioned above.</p><p><strong>Case presentation: </strong>A 25-year-old man with Crohn's disease presented to the gastroenterology department with suspected disease recurrence. At 11:20, a gastroscopy identified an antral ulcer, bile reflux, and a duodenal stricture, through which the gastroscope (approximately 10 mm in width) was able to pass. A subsequent CT enterography performed at 13:49 revealed several round, high-density lesions within the stomach on non-contrast and contrast CT images, which appeared distinct from the surrounding gastric mucosa. While retained oral medication was initially suspected, the patient confirmed he had ingested nothing other than a 2.5% mannitol solution, taken for CT enterography preparation following the gastroscopy. To investigate the composition of these lesions, we combined artificial gastric juice, artificial bile, and 2.5% mannitol in a test tube. This combination yielded a visible precipitate. We therefore conclude that the round lesions observed on CT most likely represent this precipitated material.</p><p><strong>Conclusion: </strong>This case highlights a fourth etiology of high-density gastric material on CT; it is important for radiologists and clinicians to be aware of this situation to prevent misinterpretation of images.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919990","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":"Intraoperative diagnosis of a giant pedunculated uterine myoma mimicking an adnexal mass presenting with acute abdomen in a resource-limited setting.","authors":"Chabeja Achangwa, Nkembe Marius Nkembe, Gilbert Mua Akwa, Fotabong Larisa Nsuya","doi":"10.1186/s13256-026-06563-1","DOIUrl":"10.1186/s13256-026-06563-1","url":null,"abstract":"<p><strong>Background: </strong>Uterine myomas are common benign tumors of the female reproductive tract and are typically diagnosed in women of later reproductive age. Presentation as an acute abdomen due to a giant pedunculated subserosa myoma is uncommon, particularly in very young women. Such cases may closely resemble adnexal pathology and lead to diagnostic uncertainty, especially in resource-limited settings where access to imaging is restricted. Reporting this case highlights an unusual clinical presentation and important diagnostic challenges, particularly in a resource-limited setting.</p><p><strong>Case presentation: </strong>A 21-year-old woman from sub-Saharan Africa with a history of primary infertility and menometrorrhagia presented with sudden-onset severe lower abdominal pain associated with a tender pelvic mass. She was managed as a case of acute abdomen. Due to the unavailability of ultrasonography, an emergency exploratory laparotomy was performed. Intraoperatively, a giant pedunculated subserosa uterine myoma was identified, with both ovaries and fallopian tubes appearing normal. A fertility-preserving myomectomy was successfully performed. Histopathological examination could not be performed, because histopathology services were unavailable. The postoperative course was uneventful, and the patient was discharged in good clinical condition on the fifth postoperative day.</p><p><strong>Conclusion: </strong>Giant pedunculated uterine myomas should be considered in the differential diagnosis of acute abdomen in women of reproductive age, including young patients. In resource-limited settings, prompt diagnosis and management may rely heavily on careful clinical assessment and timely surgical intervention, particularly in emergency situations.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989390","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":"Cataract surgery and a challenging postoperative course in a child with Blau syndrome: a case report.","authors":"Zhujun Fu, Danni Chen, Jiaqi Yao","doi":"10.1186/s13256-026-06580-0","DOIUrl":"10.1186/s13256-026-06580-0","url":null,"abstract":"<p><strong>Background: </strong>Blau syndrome is a rare NOD2-associated autoinflammatory disorder characterized by granulomatous arthritis, dermatitis, and uveitis. Ocular involvement may be severe in pediatric patients. Detailed reports on cataract surgery and postoperative management in children with Blau syndrome remain limited.</p><p><strong>Case presentation: </strong>A 7-year-4-month-old Chinese girl with genetically confirmed Blau syndrome presented with decreased vision in both eyes. Her articular manifestations were well controlled under systemic treatment, but she developed severe bilateral ocular involvement, including chronic uveitic changes, complicated cataracts, and vitreous opacities. Sequential cataract surgery with in-the-bag intraocular lens implantation, posterior capsulotomy, and anterior vitrectomy was performed in both eyes. Although visual acuity initially improved, she later developed severe postoperative inflammation, fibrocellular proliferation on the intraocular lens surface, pupillary block, iris bombe, and secondary glaucoma in the right eye. Treatment required intensified anti-inflammatory and immunomodulatory therapy and peripheral iridectomy. Short-term follow-up showed improvement in intraocular pressure and visual acuity.</p><p><strong>Conclusion: </strong>In Blau syndrome, ocular inflammation may progress despite good control of articular manifestations. Lifelong ophthalmic surveillance is essential, even when systemic disease appears well controlled. In children requiring cataract surgery, careful timing, optimized perioperative systemic and topical anti-inflammatory treatment, and close postoperative monitoring are important to reduce postoperative inflammatory complications.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182404","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":"Complete radiological and biochemical remission at 26 months in a young adult with primary mediastinal yolk sac tumor: a case report and literature review on multimodal management.","authors":"Yuanli You, Mingxing Yang, Xiuqing Wang, Wen Dong","doi":"10.1186/s13256-026-06553-3","DOIUrl":"10.1186/s13256-026-06553-3","url":null,"abstract":"<p><strong>Background: </strong>Primary mediastinal yolk sac tumor (PMYST) is an extremely rare and highly malignant germ cell tumor that predominantly affects young males and is associated with a poor prognosis.</p><p><strong>Case presentation: </strong>We present the case of a 23-year-old non-smoking male diagnosed with stage III (cT4N0M0) PMYST who received comprehensive treatment guided by a multidisciplinary team (MDT). The treatment regimen included 5 cycles of neoadjuvant chemotherapy with BEP (bleomycin, etoposide, and cisplatin), followed by radical surgery, postoperative radiotherapy, and 4 cycles of adjuvant chemotherapy. Post-treatment, the patient's serum tumor markers normalized, with a partial radiological response (PR) and sustained biochemical remission. As of the latest follow-up in August 2025 (26 months after diagnosis), the patient remains in complete radiological and biochemical remission with no signs of recurrence.</p><p><strong>Conclusions: </strong>This case demonstrates that an intensive MDT-guided multimodal approach incorporating aggressive neoadjuvant chemotherapy, radical surgery, and consolidative sequential radiotherapy and chemotherapy may lead to encouraging outcomes, including the achievement of complete radiological and biochemical remission documented at 26 months. However, this case is more reflective of individualized treatment for a specific patient, and it also highlights the need for intensified surveillance beyond two years.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148107","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":"Histopathological analysis of a retrieved cerebral thrombus revealing occult lung adenocarcinoma: a case report.","authors":"Carlota Jauregui-Larrañaga, Inés Albajar, María Aranzazu Juaristi-Abaunz, Juan Marta-Enguita","doi":"10.1186/s13256-026-06487-w","DOIUrl":"10.1186/s13256-026-06487-w","url":null,"abstract":"<p><strong>Background: </strong>Cancer-associated stroke (CAS) is a heterogeneous entity in which hypercoagulability represents the most common mechanism, whereas direct tumour embolism is rare and likely under-recognised.</p><p><strong>Case presentation: </strong>A 76-year-old white European man presented with acute left hemiplegia, hemianopsia and dysarthria (NIHSS 18). Non-contrast CT showed early ischaemic changes (ASPECTS 7), CT angiography demonstrated occlusion of the right middle cerebral artery, and CT perfusion revealed a favourable mismatch profile. Mechanical thrombectomy achieved partial recanalisation (TICI 2b). Histopathological examination of the retrieved thrombus revealed malignant epithelial cells. Immunohistochemical analysis was consistent with lung adenocarcinoma with high PD-L1 expression. Continuous cardiac monitoring and 72-h Holter-ECG showed no atrial fibrillation, and transthoracic echocardiography identified no major cardioembolic source. Laboratory testing showed only moderately elevated D-dimer levels. Subsequent chest CT identified a large necrotic mass in the left lung invading the pulmonary vein. Despite initiation of immunotherapy, the patient developed brain metastases and died 51 days after the index stroke.</p><p><strong>Conclusions: </strong>Tumour embolism is a rare but clinically relevant mechanism of ischaemic stroke. It should be considered in patients with embolic stroke of undetermined source, even in the absence of markedly elevated D-dimer levels. Histopathological analysis of thrombectomy specimens may provide clinically relevant diagnostic information and facilitate early detection of occult malignancy in selected patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850444","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":"Anterior lumbar interbody fusion augmented with anterior screw fixation for the treatment of L5/S1 spondylolisthesis: a case report.","authors":"Dapeng Feng, Hua Xiao, Jiaqi Wang, Wei Zhang, Jin Chu, Zhengwei Li","doi":"10.1186/s13256-026-06387-z","DOIUrl":"10.1186/s13256-026-06387-z","url":null,"abstract":"<p><strong>Background: </strong>Various procedures, including anterior and posterior approaches, have been shown to be effective in the treatment of lumbar spondylolisthesis. Anterior approaches, such as stand-alone anterior lumbar interbody fusion (ALIF) and ALIF augmented with posterior screw fixation (ALIF + PSF), are considered options for spondylolisthesis at the L5/S1 segment. However, stand-alone ALIF is associated with concerns of stability, and ALIF + PSF is associated with postoperative low back pain because of its impact on posterior elements. The concept of anterior screw fixation (ASF) is an innovative approach for screw insertion within the ALIF procedure. Without the need to acquire extra incisions, ALIF + ASF avoids posterior element impact and provides reliable stability. Thus, we innovatively proposed and performed ALIF + ASF for the treatment of low-grade L5/S1 spondylolisthesis.</p><p><strong>Case presentation: </strong>Two Han Chinese-descent male patients (one 60 years old and one 40 years old) underwent ALIF + ASF surgery due to L5/S1 spondylolisthesis.</p><p><strong>Conclusions: </strong>Anterior lumbar interbody fusion augmented with anterior screw fixation for the treatment of L5/S1 spondylolisthesis is feasible and effective.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794322","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":"Tick-borne tularaemia as a differential diagnosis in ulcerative skin infection and regional lymphadenopathy in children: a case report.","authors":"Piet Erik Beusker, Karen Schonhofen, Kerstin Landwehr, Eckard Hamelmann, Janina Soler Wenglein","doi":"10.1186/s13256-026-06491-0","DOIUrl":"10.1186/s13256-026-06491-0","url":null,"abstract":"<p><strong>Background: </strong>Tularaemia is a rare but re-emergent zoonosis in Germany, which reached a new peak in incidence in 2024. The infection rate of ticks in Germany with Francisella tularensis is only about 8% and the transmission of a clinically apparent infection by blood-sucking arthropods such as ticks, mosquitoes or horseflies accounts for about 30% of the infection routes in humans. Arthropod-borne tularaemia mainly presents as the glandular or ulceroglandular form. Delayed diagnosis and initiation of treatment with associated increased risk of complications are common. Those complications may include necrotizing abscess formation in up to 65% of cases. To our knowledge, only two cases of tularaemia following tick bites in children in Germany have been published to date. Both report cases of glandular tularaemia. The present case is therefore the first report of a clinically compatible, serology-supported presumptive case of ulceroglandular tularaemia following a tick bite in a child in Germany. It underscores the increasing relevance of tularaemia as a differential diagnosis in ulcerative skin lesions with regional lymphadenopathy.</p><p><strong>Case presentation: </strong>In the present clinical case, a 3-year-old white German boy presented with ulcerative skin infection, regional lymphadenopathy and fever following a tick bite. Calculated treatment with intravenous ampicill in and clindamycin as well as topical antiseptics initially did not result in lasting clinical improvement. In the course of typical clinical symptoms and indirect pathogen detection by serology, ulceroglandular tularaemia was assumed and appropriate oral treatment with ciprofloxacin was initiated, under which the symptoms resolved fast and completely.</p><p><strong>Conclusion: </strong>The combination of increasing incidence rates, often delayed diagnosis, and therefore high complication rates underscores the clinical relevance of this case, which highlights the growing importance of tularaemia as a differential diagnosis in ulcerative skin lesions with regional lymphadenopathy.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765041","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":"Mitral valve vegetations in an elderly patient with acute myeloid leukemia: navigating the overlap between infection and malignancy: a case report.","authors":"Mais Musleh, Mahmoud Alhamadeh Alswij, Khaled Omar ALdosh","doi":"10.1186/s13256-026-06409-w","DOIUrl":"10.1186/s13256-026-06409-w","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) is a hematologic malignancy that can rarely manifest with clinical features resembling infective endocarditis (IE), particularly in elderly individuals. Non-bacterial thrombotic endocarditis (NBTE), a paraneoplastic complication, may present with sterile cardiac vegetations and systemic embolic events, posing significant diagnostic challenges.</p><p><strong>Case presentation: </strong>We report the case of an 82-year-old Syrian Arab woman who presented with fever, generalized fatigue, and confusion. Transthoracic echocardiography revealed vegetations on the mitral valve, raising suspicion for IE. However, repeated blood cultures remained negative, and inflammatory markers were only mildly elevated. Laboratory investigations showed marked leukocytosis, anemia, and thrombocytopenia. Peripheral blood smear demonstrated circulating myeloblasts, and flow cytometry confirmed a diagnosis of AML. The presence of sterile vegetations, progressive leukocytosis, and absence of microbiologic evidence supported a diagnosis of NBTE as a paraneoplastic manifestation of AML.</p><p><strong>Conclusion: </strong>This case illustrates the importance of considering hematologic malignancies in the differential diagnosis of culture-negative endocarditis. NBTE should be suspected in patients with cardiac vegetations, systemic embolic signs, and unexplained leukocytosis, particularly when blood cultures are repeatedly sterile. Early recognition of this rare presentation is essential for initiating appropriate hematologic evaluation and management.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812850","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":"Simultaneous endoscopic management of prostatic and seminal vesicle abscess using holmium laser enucleation of the prostate and seminal vesiculoscopy: a case series.","authors":"Guiyang Zhang, Jingqun Wang, Wei Lu, Ruizhe Zhao","doi":"10.1186/s13256-026-06426-9","DOIUrl":"10.1186/s13256-026-06426-9","url":null,"abstract":"<p><strong>Background: </strong>Prostatic abscess (PA) is uncommon but potentially life-threatening. Secondary seminal vesicle abscess (SVA) is extremely rare and lacks standardized minimally invasive treatment. We report a case series evaluating holmium laser enucleation of the prostate (HoLEP) and seminal vesiculoscopy for the simultaneous drainage of these abscesses via a single endoscopic access.</p><p><strong>Case presentation: </strong>Two Han-Chinese men (aged 82 and 56 years) presented with LUTS, fever and imaging-confirmed PA; the younger also had a multi-loculated right SVA. The prostate volumes were approximately 75 mL (Case 1) and 50 mL (Case 2). The prostatic abscesses measured 33 × 34 mm (Case 1) and 27 × 15 mm (Case 2), with the right seminal vesicle abscess measuring 40 × 24 mm (Case 2). After culture-directed antibiotics and glycemic control, both patients underwent single-session endoscopic surgery: Case 1 HoLEP alone; Case 2 seminal vesiculoscopy followed immediately by HoLEP. Operative times were 50 minutes and 60 minutes; blood loss < 50 mL. No intraoperative or major postoperative complications were encountered (transient stress urinary incontinence in Case 1 resolved spontaneously within 1 week). Catheters were removed on postoperative days 5 and 4; Qmax improved to 20 mL/second and 22 mL/second and IPSS fell from 25 to 9 and 26 to 8 at 1 month. Imageological examination at 1 month showed complete resolution of abscess cavities with no recurrence.</p><p><strong>Conclusions: </strong>HoLEP appears to be a viable option for PA drainage and simultaneous relief of bladder-outlet obstruction. Combined HoLEP plus seminal vesiculoscopy may offer a feasible, single-access minimally invasive strategy for complex prostatovesicular abscesses, though long-term follow-up is necessary to definitively confirm efficacy and recurrence rates.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726130","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}