SAGE Open Medical Case Reports最新文献

{"title":"Aggressive metastatic parotid squamous cell carcinoma with pulmonary, cerebral, and hepatic metastases: A radiologic case report.","authors":"James Alex Sumawe","doi":"10.1177/2050313X261458910","DOIUrl":"10.1177/2050313X261458910","url":null,"abstract":"<p><p>Parotid gland malignancies are rare and represent less than 5% of all head and neck cancers. Squamous cell carcinoma of the parotid gland is an uncommon subtype and is often associated with aggressive clinical behavior. While regional lymphatic spread is common, distant metastases to organs such as the lungs, brain, and liver are rare but indicate advanced disease and poor prognosis. We report a 60-year-old male with primary right parotid squamous cell carcinoma who initially presented with facial nerve paralysis and locally advanced infiltrative disease requiring debulking parotidectomy followed by chemoradiotherapy. Despite multimodal treatment, the patient developed progressive metastatic disease with respiratory symptoms, ocular pain, and worsening clinical status. Computed tomography imaging revealed extensive metastatic involvement including multiple bilateral pulmonary nodules with a dominant left perihilar mass, multiple cerebral metastases demonstrating ring-enhancing lesions with marked surrounding vasogenic edema, pleural metastatic involvement, and multiple hepatic hypodense lesions. An incidental left thyroid lobe nodule was also identified and subsequent fine-needle aspiration cytology confirmed benign colloid goiter. The patient received palliative chemotherapy with carboplatin and paclitaxel alongside supportive therapy. This case highlights the aggressive metastatic potential of parotid squamous cell carcinoma, the possibility of progressive systemic dissemination despite multimodal therapy, and the importance of comprehensive imaging in detecting disease progression and guiding management.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261458910"},"PeriodicalIF":0.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346159","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":"Angiomatoid fibrous histiocytoma with CDK4 and MDM2 expression misdiagnosed as dedifferentiated liposarcoma: The first case report and literature review.","authors":"Jiaodi Cai, Feng Jiang, Li Xiao, Wenqin Zhang","doi":"10.1177/2050313X261460565","DOIUrl":"10.1177/2050313X261460565","url":null,"abstract":"<p><p>Angiomatoid fibrous histiocytoma is a rare intermediate soft tissue tumor with uncertain differentiation and prone to misdiagnosis because of atypical morphology and aberrant biomarker expression. Herein, we report a unique case of occipital scalp angiomatoid fibrous histiocytoma in a 33-year-old female, which presented with rapid tumor growth, marked nuclear pleomorphism, elevated mitotic activity, and atypical positive expression of CDK4 and MDM2 immunohistochemically, leading to an initial misdiagnosis of dedifferentiated liposarcoma. Preoperative routine blood tests, biochemical examinations, and inflammatory biomarker detection, including C-reactive protein, erythrocyte sedimentation rate, and interleukin-6, were performed, and all hematological indicators were within normal reference ranges without systemic inflammatory or hematological abnormalities. The patient underwent complete marginal resection of the tumor, and no adjuvant radiotherapy or chemotherapy was administered postoperatively because of the absence of high-risk malignant features, residual lesions, and distant metastasis. Molecular testing confirmed EWSR1 gene rearrangement without CDK4 or MDM2 gene amplification, which confirmed the final diagnosis of angiomatoid fibrous histiocytoma. The patient achieved a favorable prognosis with no recurrence or metastasis during 20 months of postoperative follow-up. Distinct from previously reported conventional angiomatoid fibrous histiocytoma cases with low proliferative activity and negative liposarcoma-related markers, the present case is characterized by atypical dual positive expression of CDK4/MDM2 and a markedly elevated Ki-67 proliferation index, which fills the clinical data gap of atypical angiomatoid fibrous histiocytoma with liposarcoma-mimicking immunophenotype. This study further clarifies the differential diagnostic criteria between angiomatoid fibrous histiocytoma and dedifferentiated liposarcoma, verifies that isolated CDK4/MDM2 immunohistochemical positivity cannot independently support the diagnosis of liposarcoma, and highlights the irreplaceable value of molecular testing in the definitive diagnosis of atypical angiomatoid fibrous histiocytoma, providing a reliable reference for pathologists to avoid diagnostic errors in similar rare soft tissue tumors.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261460565"},"PeriodicalIF":0.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346172","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":"Advanced tubal pregnancy with a live birth at 42 + 0 weeks gestation in Tanzania: A case report.","authors":"Charlotte M Nelen, Ezra S Bitabo, Gerald G Kulikiza, Balthazar S Gumodoka","doi":"10.1177/2050313X261457207","DOIUrl":"10.1177/2050313X261457207","url":null,"abstract":"<p><p>This report describes a rare case of a woman whose tubal pregnancy was unexpectedly identified during a caesarean section, resulting in the delivery of a live infant at a gestational age of 42 + 0 weeks. Despite multiple antenatal visits, three ultrasound examinations, and the presence of clinical signs, the tubal pregnancy was not recognized preoperatively. This case highlights the diagnostic challenges of advanced tubal pregnancy, the clinical overlap with abdominal pregnancies, and the importance of careful abdominal examination and improved ultrasonographic awareness, particularly in low-resource settings.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261457207"},"PeriodicalIF":0.6,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332646","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":"Delayed diagnosis of ocular myasthenia gravis in a patient with aponeurotic ptosis: A case report.","authors":"Jiajun Xie, Huina Zhang, Juan Ye","doi":"10.1177/2050313X261459530","DOIUrl":"10.1177/2050313X261459530","url":null,"abstract":"<p><p>Acquired ptosis may result from multiple etiologies, including aponeurotic, neurogenic, myogenic, traumatic, and mechanical causes. When structural eyelid abnormalities are prominent, the clinical signs of underlying neuromuscular disorders may be physically masked and difficult to recognize. A patient in her 70s presented with an acute onset of unilateral ptosis. Neuroimaging revealed an incidental aneurysm of the left middle cerebral artery that was anatomically independent of the oculomotor nerve. Ophthalmic examination suggested aponeurotic ptosis, and surgical repair restored eyelid height immediately. However, fluctuating ptosis with diurnal variation was observed 1 week postoperatively. Electromyography showed a postsynaptic neuromuscular junction disorder. Together with positive acetylcholine receptor antibodies, ocular myasthenia gravis was diagnosed. Treatment with oral pyridostigmine resulted in marked clinical improvement. Severe aponeurotic disinsertion can obscure the fatigability typical of ocular myasthenia gravis and delay recognition of the underlying disorder. In patients with atypical presentations such as acute-onset ptosis, additional evaluation, including electrophysiological testing, is essential to identify coexisting neuromuscular dysfunction.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261459530"},"PeriodicalIF":0.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318474","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":"Treatment failure in suspected community-acquired pneumonia revealing a pulmonary abscess.","authors":"Sindhuja Earagolla, Noah Karnath, Sravya Borra, Bernard Karnath","doi":"10.1177/2050313X261456973","DOIUrl":"10.1177/2050313X261456973","url":null,"abstract":"<p><p>Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality, with <i>Streptococcus pneumoniae</i> as a leading cause. Chest radiography, the standard initial imaging modality, can miss early complications, which lead to delays in diagnosis and treatment. Computed tomography (CT) provides greater detail in identifying complications. We report a 67-year-old male with chest pain who was treated in an outpatient setting with oral antibiotics for suspected CAP; however, he experienced clinical deterioration, including fever, cough, weight loss, and worsening respiratory symptoms. Repeat chest X-ray revealed increased lung opacities, prompting a CT thorax, which revealed a large pulmonary abscess not visualized on prior imaging. Failure of outpatient management required inpatient admission with intravenous antibiotics and CT-guided percutaneous drainage. A total of 450 mL of purulent fluid was drained, and cultures grew <i>Streptococcus intermedius</i>. The patient improved and was given targeted antibiotics. This case highlights the importance of considering less common pathogens such as <i>S. intermedius</i> in patients with prolonged symptoms or failure of outpatient therapy. CT imaging should be considered in patients who fail to improve, thus expediting diagnosis and guiding management. <i>S. pneumoniae</i> typically causes acute pneumonia with lobar consolidation. <i>S. intermedius</i> often causes necrotizing abscesses and empyema, often with a longer, more subacute presentation. Differentiating the two on initial presentation is quite difficult, as in our patient's case.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261456973"},"PeriodicalIF":0.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272634","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":"Recovery of functional ambulation through stepwise rehabilitation treatment in a patient with encephalomyeloradiculoneuropathy: A case report.","authors":"Koshiro Sawada, Fukiko Morii, Norikazu Hishikawa, Hiroshi Maeda, Yuki Iwasaki, Misaki Nakamura, Yuki Shimizu, Yuta Kojima, Tomoyuki Ohara, Yasuo Mikami","doi":"10.1177/2050313X261456977","DOIUrl":"10.1177/2050313X261456977","url":null,"abstract":"<p><p>Encephalomyeloradiculoneuropathy is a rare inflammatory disorder for which rehabilitation strategies and functional prognosis are not well established. This report describes the clinical course of a patient with severe lower-limb paralysis caused by encephalomyeloradiculoneuropathy. A man in his 50s developed a fever, impaired consciousness, and respiratory failure requiring mechanical ventilation. Based on the combined involvement of the central and peripheral nervous systems, a clinical diagnosis of encephalomyeloradiculoneuropathy was made. Rehabilitation treatment was initiated early during mechanical ventilation in the acute-care hospital, at a time when he required total assistance for ambulation. Despite immunotherapy, near-complete paralysis of the trunk and bilateral lower limbs persisted with orthostatic hypotension. Rehabilitation treatment was continued in acute-care and rehabilitation hospitals with monthly goal setting. At 8 months, he achieved independent outdoor ambulation.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261456977"},"PeriodicalIF":0.6,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265444","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 lung nodular aspergilloma mimicking tumor metastasis accompanied by pulmonary embolism in a gastric cancer patient in remission.","authors":"Ali Osman Kaya, Aysun Kaya, Cemal Gundogdu","doi":"10.1177/2050313X261454857","DOIUrl":"10.1177/2050313X261454857","url":null,"abstract":"<p><p>Lung aspergilloma is a noninvasive form of fungal infection of the <i>Aspergillus</i> species and usually presents radiologically as nodular masses in the lungs of patients with pulmonary tuberculosis, chronic obstructive pulmonary disease, and immunosuppressed patients. It may mimic lung metastatic nodules or primary lung cancer. A 57-year-old male patient who underwent surgery for stomach cancer was admitted to our hospital with complaints of shortness of breath, fatigue, and weight loss. Chest computed tomography scan revealed a new nodular lesion measuring 16 × 14 mm in diameter in the upper lobe of the right lung and an embolism in the left pulmonary artery. Wedge resection of the solitary pulmonary nodular was performed. After pathological evaluation, it was interpreted as aspergilloma. Here, we report a case of pulmonary aspergilloma that was followed up with the diagnosis of gastric cancer in remission and underwent resection due to the suspicion of lung metastasis.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261454857"},"PeriodicalIF":0.6,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264948","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":"Case report: Subcutaneous emphysema following postoperative nausea.","authors":"Neil Ming, Taha Ghouleh, Brian Ford, Steven Wang, Puhan He","doi":"10.1177/2050313X261458036","DOIUrl":"10.1177/2050313X261458036","url":null,"abstract":"<p><p>Subcutaneous emphysema is a rare but potentially serious complication in dentistry and oral surgery resulting from the introduction of air into soft tissues. Although commonly associated with forward venting air-driven handpieces, cases have also been reported in the absence of an identifiable air source. We report an 18-year-old female who developed extensive subcutaneous emphysema following routine extraction of four third molars performed without the use of forward venting air-driven instruments, after multiple episodes of postoperative retching and emesis. She presented with progressive facial swelling and was transferred to a tertiary care center. Imaging demonstrated widespread air tracking within the masticator and submandibular spaces without abscess. The patient was managed conservatively with intravenous antibiotics, sinus precautions, and supportive care, with gradual resolution. Although uncommon, subcutaneous emphysema warrants vigilance due to risks of mediastinal spread and airway compromise. This case highlights that postoperative nausea and emesis may introduce air into unhealed extraction sites and emphasizes the importance of early recognition and prompt management.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261458036"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252364","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":"Reversed sequence radiation therapy for treatment of primary central nervous system choriocarcinoma prioritizing for bleeding control: A case report.","authors":"Anita Zhou, Joseph Carmicheal, Nicole A Shonka, Chi Zhang","doi":"10.1177/2050313X261426770","DOIUrl":"10.1177/2050313X261426770","url":null,"abstract":"<p><p>Primary central nervous system choriocarcinoma is a non-germinomatous germ cell tumor with a highly malignant character, comprising up to 5% of all central nervous system germ cell tumors. Locations affected can include suprasellar or pineal locations most commonly, with others including the basal ganglia and lateral ventricles. Guidelines do not specify an optimal radiation regimen but recommend proceeding with maximally safe resection if feasible and then chemotherapy before radiotherapy. Radiation is often comprised of craniospinal irradiation with subsequent tumor bed boost. We present a case of an adult male with a primary central nervous system choriocarcinoma who underwent reversed sequence radiation therapy with photon tumor bed boost before proton craniospinal irradiation due to recurrent intracranial hemorrhages with long-term control of cancer and no subsequent hemorrhages. This case highlights the excellent outcome and feasibility of reversed sequence radiotherapy on choriocarcinoma in hemorrhage and tumor control.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261426770"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252396","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":"Persistent ST-segment elevation mimicking ST-elevation myocardial infarction.","authors":"Yoshiyasu Aizawa, Takumi Matsumoto","doi":"10.1177/2050313X261458029","DOIUrl":"10.1177/2050313X261458029","url":null,"abstract":"<p><p>ST-segment elevation on electrocardiography is classically associated with acute myocardial infarction and often prompts urgent invasive evaluation. However, non-ischemic causes may complicate diagnostic decision-making, particularly in elderly patients with acute non-cardiac illnesses. We report a 95-year-old woman admitted with COVID-19-associated pneumonia and aspiration pneumonia, whose admission electrocardiogram demonstrated ST-segment elevation with T-wave inversion in the lateral precordial leads, mimicking ST-elevation myocardial infarction. She had no chest pain, no elevation of cardiac biomarkers, and preserved left ventricular systolic function without regional wall motion abnormalities on echocardiography. Review of prior records revealed that similar electrocardiographic abnormalities had been consistently present for more than a decade. Serial imaging demonstrated no overt structural heart disease. However, the electrocardiographic pattern-localized and persistent ST-segment elevation with repolarization abnormalities-is most consistent with chronic localized myocardial remodeling, possibly related to unrecognized myocardial fibrosis. This case highlights the importance of integrating clinical presentation, biomarkers, and longitudinal electrocardiographic findings. Persistent ST-segment elevation does not always indicate acute coronary occlusion, but may reflect an underlying structural myocardial substrate not detectable by routine imaging.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261458029"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252401","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}