SAGE Open Medical Case Reports最新文献

{"title":"Right atrial thrombus-in-transit initially suspected as myxoma in a patient with acute pulmonary embolism: A case report.","authors":"Hanjun Zhang, Tiansheng Tang, Youshi Wu, Asif Hussain, Zakaria Saifane, Dafa Zhang, Weiyong Sheng","doi":"10.1177/2050313X261480887","DOIUrl":"10.1177/2050313X261480887","url":null,"abstract":"<p><p>A 60-year-old man presented with sudden syncope, chest pain, and dyspnea. Transthoracic echocardiography at a local hospital suggested a right atrial myxoma, and he was referred for emergency treatment. On admission, markedly elevated D-dimer and cardiac troponin I levels were accompanied by severe hypoxemia. Intraoperative transesophageal echocardiography showed a large, highly mobile, cord-like right atrial mass without a definite pedicle. Because of the patient's critical condition, emergency surgical thrombectomy and pulmonary embolectomy under cardiopulmonary bypass were undertaken, revealing right atrial thrombus-in-transit with partial incarceration through the foramen ovale into the left atrium and extensive pulmonary emboli. Histopathological examination confirmed thrombus, and postoperative ultrasonography demonstrated deep venous thrombosis in the right lower extremity. The patient recovered well with anticoagulation. This case highlights that right atrial thrombus-in-transit may mimic myxoma on echocardiography and should be strongly suspected when a right atrial mass is accompanied by severe hypoxemia and other findings suggestive of acute pulmonary embolism.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261480887"},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876095","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 cellular myxoid neurothekeoma with unusual clinicopathologic features.","authors":"Rana S Al-Zaidi","doi":"10.1177/2050313X261483464","DOIUrl":"10.1177/2050313X261483464","url":null,"abstract":"<p><p>Cellular neurothekeoma is a benign cutaneous soft tissue neoplasm that usually arises in the upper parts of the body and affects mainly young individuals with a female predominance. This type of tumor shows a spectrum of atypical or \"unusual\" pathologic features that challenge pathologists in making a correct diagnosis. Herein, we present a case of cellular neurothekeoma with prominent myxoid features and dense interstitial chronic inflammatory cell infiltrate arising in a 28-year-old female as a nodule in the left popliteal fossa. Following a thorough literature search, this case is considered to be the first report of a cellular neurothekeoma arising in the popliteal fossa. The data presented in this case expand our knowledge of the diverse anatomical distributions and wide pathologic spectrum of cellular neurothekeomas.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261483464"},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876118","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":"Congenital melanocytic nevus of the clitoral hood: A case report.","authors":"Daniel Sastoque, Julian Rojas, Angie Rachel Mora Guerrero, Cindy Morales, Alfredo Mejia","doi":"10.1177/2050313X261485062","DOIUrl":"10.1177/2050313X261485062","url":null,"abstract":"<p><p>Pigmented lesions of the vulva span a broad spectrum, from benign melanocytic nevi to melanoma. Within this region, the clitoris and clitoral hood are of particular surgical importance because of their sensory and functional roles. Congenital melanocytic nevi (CMN) of the clitoral hood are exceedingly rare, and their optimal management is not well defined. We report a 12-year-old girl with a CMN of the clitoral hood measuring 17 × 13 mm. Because of persistent local pruritus, the difficulty of reliable dermoscopic surveillance at this site, and the family's inability to guarantee periodic follow-up, an elliptical excision with 3-mm margins and immediate reconstruction using local mucocutaneous advancement flaps from the labia minora was performed. Histopathology confirmed a benign compound melanocytic nevus with clear margins. At one-month follow-up the wound had healed with preserved clitoral sensation, no scar contracture or dyschromia, and no functional impairment. This case illustrates that small CMN of the clitoral hood carry a low risk of malignant transformation and that, when excision is chosen for symptomatic or surveillance-related reasons, a conservative plastic-surgical approach can achieve complete removal while preserving genital form and function.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261485062"},"PeriodicalIF":0.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866723","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":"Nontraumatic subperiosteal orbital hematoma secondary to frontal sinus mucocele: Case report.","authors":"Hui Jin, Ruowu Liu, Claus Bachert, Luo Ba","doi":"10.1177/2050313X261485053","DOIUrl":"10.1177/2050313X261485053","url":null,"abstract":"<p><p>Nontraumatic subperiosteal orbital hematoma (NTSOH) secondary to a paranasal sinus mucocele is rare and may be mistaken for an orbital abscess. A 40-year-old man presented with acute proptosis, periorbital pain, diplopia, and reduced vision in the right eye. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a mass in the superior region of the right orbit and another mass in the right frontal sinus, hinting at NTSOH. An external approach to the frontal sinus combined with endoscopic sinus surgery (ESS) was performed for treatment. Intraoperative drainage of brown hemorrhagic fluid confirmed NTSOH associated with a frontal sinus mucocele. No recurrence of hemorrhage occurred during follow-up. This case highlights that NTSOH should be considered when an acute superior orbital mass coexists with a frontal sinus mucocele, particularly when MRI findings are compatible with evolving blood products.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261485053"},"PeriodicalIF":0.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866687","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":"Rhabdomyolysis after strenuous exercise: A case report.","authors":"Rong-Rong Zhen, Yi-Fan Shen, Guan-Cheng Li, Ying-Jie Zhu, Li-Min Zhang, Ya-Nan Zhang, Qi Hong, Xin-Lu Wang, Chao Gu, Ting Shen, Guo-Liang Yan","doi":"10.1177/2050313X261480874","DOIUrl":"10.1177/2050313X261480874","url":null,"abstract":"<p><p>Rhabdomyolysis is a syndrome characterized by necrosis and the disruption of striated muscle fibers. It is secondary to etiologies, such as trauma, ischemia, or toxin exposure. Rhabdomyolysis releases intracellular muscle constituents into systemic circulation, frequently leading to acute kidney injury. Clinical manifestations, including muscle weakness, myalgia, and dark urine, in young adults with nontraumatic etiologies are frequently underrecognized. Early diagnosis and prompt intervention are critical for mitigating complications. We report a case of a 27-year-old male who was admitted to Shanghai Municipal Hospital of Traditional Chinese Medicine in September 2024, presenting with exertional rhabdomyolysis complicated by acute kidney injury. Serum myoglobin (>12,000 ng/mL) and creatine kinase (210,000 U/L) were strikingly elevated. Therapeutic intervention consisted of vigorous fluid resuscitation, urinary alkalinization, electrolyte correction, and combined intermittent renal replacement therapy and hemoperfusion. The patient recovered uneventfully and was discharged in stable condition. It highlights the vulnerability of young individuals to rhabdomyolysis and underscores the seriousness of the condition. The adjunctive use of intermittent renal replacement therapy combined with hemoperfusion was observed to reduce circulating creatinine and myoglobin levels, which may serve as a reference for future therapeutic decision-making.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261480874"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840753","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":"Retained tunneled dialysis catheter presenting with complete exit site healing: A case report.","authors":"Matthew Ostroff, Pasha Shenasan, Dimitrio Skoutsomitis, Hossam Elzomor, John Danks","doi":"10.1177/2050313X261478714","DOIUrl":"https://doi.org/10.1177/2050313X261478714","url":null,"abstract":"<p><p>Tunneled dialysis catheter removal is a common procedure traditionally performed in interventional radiology or the operating room. Prompt removal of unnecessary or dysfunctional catheters is important to reduce the risk of catheter-related complications, including bloodstream infection and thrombosis. We report a rare case of a retained tunneled dialysis catheter presenting with no visible external catheter and a completely healed exit site. An 80-year-old female with end-stage kidney disease requiring maintenance hemodialysis presented to the emergency department with facial swelling and concern for a previously removed dialysis catheter. Physical examination revealed no visible catheter; however, chest radiography demonstrated a retained left-sided tunneled dialysis catheter. Further evaluation identified a palpable catheter cuff despite the absence of an external catheter or identifiable exit site. Computed tomography angiography demonstrated partial thrombosis of the distal left internal jugular vein and occlusion of a previously placed left axillary venous stent, supporting significant central venous disease. Following multidisciplinary consultation, the retained catheter was successfully removed at the bedside using local anesthesia and blunt dissection. Because ongoing hemodialysis access was required, a femoral tunneled dialysis catheter was subsequently placed at the bedside, allowing continuation of dialysis while a maturing arteriovenous fistula progressed to full functionality. The patient underwent successful dialysis and had the femoral catheter removed 9 days later following successful two-needle cannulation of the fistula. The patient was discharged home without complication. This case highlights the importance of meticulous physical examination, careful imaging review, and familiarity with tunneled catheter anatomy in the recognition and management of retained catheter complications. In appropriately selected patients, bedside removal and replacement of tunneled dialysis catheters may represent a feasible management strategy that facilitates timely dialysis access. Further studies are needed to evaluate the broader clinical and operational impact of this approach.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261478714"},"PeriodicalIF":0.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797655","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":"Scurvy mistaken for cutaneous vasculitis in an adult with obesity: A case report.","authors":"Pooja Khatiwala, Bethany Canver","doi":"10.1177/2050313X261478709","DOIUrl":"https://doi.org/10.1177/2050313X261478709","url":null,"abstract":"<p><p>Scurvy is an increasingly recognized but frequently overlooked nutritional deficiency in developed countries. We report a 55-year-old man with obesity and type 2 diabetes mellitus who presented with progressive petechiae and ecchymoses concerning for cutaneous vasculitis. Extensive hematologic, rheumatologic, infectious, and dermatologic evaluations, including skin biopsy, were unrevealing. Symptoms were initially attributed to aspirin use without improvement following dose reduction. Subsequent nutritional assessment revealed an undetectable plasma vitamin C level (<0.1 mg/dL) in the setting of chronically poor dietary quality with minimal fruit and vegetable intake. The patient was treated with vitamin C supplementation and nutrition counseling, with subsequent clinical improvement and normalization of vitamin C levels. This case highlights how micronutrient deficiencies may occur despite adequate food access and emphasizes the importance of dietary assessment in patients with unexplained bleeding manifestations to avoid diagnostic delay and unnecessary testing.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261478709"},"PeriodicalIF":0.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797662","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":"Successful treatment of Grover's disease with upadacitinib: A case report.","authors":"Eshan Arora, Rylee Oosterhuis, Ashley E Sutherland","doi":"10.1177/2050313X261463981","DOIUrl":"https://doi.org/10.1177/2050313X261463981","url":null,"abstract":"<p><p>Transient acantholytic dermatosis, also known as Grover's disease, is an acquired pruritic eruption commonly refractory to conventional therapies. We report a case of a 76-year-old male with Grover's disease presenting with persistent pruritus and skin lesions despite multiple treatments. Upadacitinib 15 mg once daily was initiated off-label and the patient reported marked improvement in pruritus within 2 days of treatment and substantial reduction in lesion burden after 1 month. The etiology of Grover's disease is unclear but is believed to be due in part to occlusion and damage to the sweat glands. Emerging responses to immunomodulatory therapies suggest immune dysregulation may contribute to select cases of Grover's disease. Upadacitinib, a selective Janus kinase 1 inhibitor, reduces pruritus and inflammation-associated cytokine signaling and represents a plausible therapeutic strategy. To our knowledge, this is the first reported case of Grover's disease successfully treated with Janus kinase inhibition.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261463981"},"PeriodicalIF":0.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797698","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":"Clinical features, misdiagnosis, and treatment of clinically diagnosed complete Kartagener syndrome: A three-case series for primary care.","authors":"Dashi Li, Zhifeng Wang","doi":"10.1177/2050313X261474111","DOIUrl":"https://doi.org/10.1177/2050313X261474111","url":null,"abstract":"<p><p>Kartagener syndrome (KS) is a rare autosomal recessive motile ciliopathy and a well-recognized subtype of primary ciliary dyskinesia, classically defined by the triad of situs inversus totalis, chronic sinusitis, and bronchiectasis, with frequent accompanying infertility. Because of its non-specific clinical manifestations overlapping with common respiratory disorders and limited availability of gold-standard diagnostic tools in primary care settings, KS is frequently misdiagnosed or diagnosed late. This study retrospectively analyzed the clinical data, diagnostic trajectories, and treatment outcomes of three adult patients with clinically diagnosed complete KS admitted to our institution between May 2021 and December 2022. All patients presented with long-standing recurrent cough and expectoration; two presented with hemoptysis and one with type II respiratory failure. Initial misdiagnoses included bronchiectasis, non-tuberculous mycobacterial infection, and chronic obstructive pulmonary disease. Clinical diagnosis of complete KS was established based on the classic triad on imaging combined with core clinical features, as confirmatory genetic or ultrastructural testing was not available. Pathogen testing detected <i>Acinetobacter baumannii</i> in one patient, while another patient had a coinfection of <i>Pseudomonas aeruginosa</i> and <i>Enterobacter cloacae</i>. One more patient received empirical antimicrobial therapy because their family declined bronchoscopy. After individualized treatment, clinical improvement was observed in all patients, with symptom resolution, normalized inflammatory markers, and stable disease during 6-12 months of follow-up. These findings underscore that the combined features of \"situs inversus totalis + bronchiectasis + chronic sinusitis + childlessness/infertility (when formally confirmed)\" are key diagnostic clues for KS in primary care. Primary care clinicians should strengthen awareness of this rare entity and use a multisystem diagnostic approach to prevent misdiagnosis and underdiagnosis. Prompt targeted antimicrobial therapy and sustained comprehensive long-term management were associated with favorable clinical outcomes in this small case series.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261474111"},"PeriodicalIF":0.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797636","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":"Interventional treatment of refractory pleural effusion secondary to radiotherapy-induced fibrosing mediastinitis: A case report.","authors":"Li Yang, Jianfeng Wang, Yuanhua Yang","doi":"10.1177/2050313X261472593","DOIUrl":"https://doi.org/10.1177/2050313X261472593","url":null,"abstract":"<p><p>Herein, we report a rare case of refractory pleural effusion secondary to radiotherapy-induced fibrosing mediastinitis. A male patient in his early 60s with a history of thoracic radiotherapy presented with a massive right-sided transudative pleural effusion. Imaging studies revealed occlusion of the right pulmonary vein and stenosis of the pulmonary artery, leading to a diagnosis of pleural effusion secondary to radiation-induced fibrosing mediastinitis. After unsuccessful pulmonary vein balloon dilation, an innovative approach was adopted: coil embolization of the pulmonary artery branches on the affected side. This strategy aimed to reduce visceral pleural hydrostatic pressure, thereby decreasing pleural fluid filtration. Postoperatively, the patient's shortness of breath improved, and the rate of pleural fluid accumulation slowed, demonstrating favorable short-term efficacy. When pulmonary venous intervention is ineffective, this article provides a novel interventional strategy for managing fibrosing mediastinitis-associated refractory pleural effusion.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261472593"},"PeriodicalIF":0.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797639","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}