World Journal of Clinical Cases最新文献

{"title":"Application of circulating tumor DNA liquid biopsy in nasopharyngeal carcinoma: A case report and review of literature.","authors":"Xin-Yao Zhou, Yuan-Jun Jiang, Xiao-Ming Guo, Dong-Hui Han, Yao Liu, Qiao Qiao","doi":"10.12998/wjcc.v13.i21.105066","DOIUrl":"10.12998/wjcc.v13.i21.105066","url":null,"abstract":"<p><strong>Background: </strong>Circulating tumor DNA (ctDNA)-based liquid biopsy has been found to be effective for the detection of minimal residual disease and the evaluation of prognostic risk in various solid tumors, with good sensitivity and specificity for identifying patients at high risk of recurrence. However, use of its results as a biomarker for guiding the treatment and predicting the prognosis of nasopharyngeal carcinoma (NPC) has not been reported.</p><p><strong>Case summary: </strong>In this case study of a patient with stage IVb NPC, we utilized ctDNA as an independent biomarker to guide treatment. Chemotherapy was administered in the early stages of the disease, and local intensity-modulated radiation therapy was added when the patient tested positive for ctDNA, while radiation therapy was stopped and the patient was observed when the ctDNA test was negative. During the follow-up period, ctDNA signals became positive before tumor progression and became negative again at the end of treatment. We also explored the potential of ctDNA in combination with Epstein-Barr virus (EBV) DNA status to predict the prognosis of NPC patients, as well as the criteria for selecting genetic mutations and the testing cycle for ctDNA analysis.</p><p><strong>Conclusion: </strong>The results of ctDNA-based liquid biopsy can serve as an independent biomarker, either independently or in conjunction with EBV DNA status, to guide the treatment and predict the prognosis of NPC.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"105066"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low salivary uric acid levels are independently associated with periodontitis.","authors":"Leonardo Lorente, Esther Hernández Marrero, Pedro Abreu-Gonzalez, Angel Daniel Lorente Martín, Agustín F González-Rivero, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Alejandro Jiménez, Cándido Manuel Hernández Padilla","doi":"10.12998/wjcc.v13.i21.105911","DOIUrl":"10.12998/wjcc.v13.i21.105911","url":null,"abstract":"<p><strong>Background: </strong>Lower salivary uric acid concentrations, the most abundant antioxidant agent in saliva, have been observed in patients with periodontitis compared to individuals with periodontal health. However, the independent association of salivary uric acid levels with periodontitis, accounting for other risk factors, as well as its association with periodontitis severity, has not been investigated.</p><p><strong>Aim: </strong>To the independent association of salivary uric acid levels with periodontitis and the association of salivary uric acid levels with the severity of periodontitis.</p><p><strong>Methods: </strong>This observational and prospective study measured salivary uric acid levels in subjects with periodontitis (characterized by periodontal loss of tissue) and in subjects without periodontitis (periodontal health or localized gingivitis in < 30% of sites). Multivariate regression analysis was performed to determine independent factors associated with periodontitis. Spearman's rho correlation coefficient was used to assess the relationship between salivary uric acid levels and periodontitis severity. A receiver operating characteristic analysis was carried out to evaluate the diagnostic performance of salivary uric acid levels in periodontitis, reporting the area under curve (AUC) and its 95%CI.</p><p><strong>Results: </strong>We included 121 subjects, 61 of them with periodontitis and 60 without periodontitis (39 with periodontal health and 21 with local gingivitis). Subjects with periodontitis compared to those without periodontitis were older (<i>P</i> < 0.001), had higher salivary uric acid levels (<i>P</i> = 0.002), higher rate of arterial hypertension history (<i>P</i> = 0.001) and higher rate of never-smoker history (<i>P</i> < 0.001). The AUC for periodontitis diagnosis by salivary uric acid levels was 66% (95%CI: 57%-75%; <i>P</i> < 0.001) and the better cut-off point was 111 nmol/mL. Multiple logistic regression analysis showed an independent association of salivary uric acid levels < 111 nmol/mL (OR = 6.14; 95%CI: 2.015-18.721; <i>P</i> = 0.001) with periodontitis after controlling for age, never-smoker history and arterial hypertension. A negative correlation of salivary uric acid levels and periodontitis severity was observed (rho = -0.32; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The two novel findings of our research were, first, that low salivary uric acid concentrations are independently associated with periodontitis, even after accounting for established risk factors. Second, salivary uric acid levels show a negative correlation with periodontitis severity.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"105911"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian vein thrombosis mimicking acute appendicitis: A case report.","authors":"Sabtain Ali, Ayyub Anjum, Khalid Mahmood Nasir, Abdul Rauf Khalid, Faizan Shahzad, Abdulqadir J Nashwan","doi":"10.12998/wjcc.v13.i21.103525","DOIUrl":"10.12998/wjcc.v13.i21.103525","url":null,"abstract":"<p><strong>Background: </strong>Ovarian vein thrombosis (OVT) is a rare condition that most commonly affects postpartum women. It is particularly prevalent in the first 10 days postpartum, a period when women are more prone to developing this condition. The right ovarian vein is often affected due to its tortuous nature and less competent valves. OVT presents similarly to acute abdominal conditions, such as acute appendicitis, especially when the right ovarian vein is involved. Given the overlap in clinical presentation, diagnosis requires high-quality imaging techniques and a high degree of suspicion.</p><p><strong>Case summary: </strong>Herein, we report a rare case of OVT in a young postpartum female who presented to the emergency department with signs and symptoms of acute abdomen. The patient had a history of pulmonary tuberculosis treatment. A provisional diagnosis of a perforated appendix was made, and a lower midline exploratory laparotomy was planned. During surgery, the appendix and intestines appeared normal, but a distended and thrombosed right ovarian vein was found. The affected ovarian vein was excised, and the patient was placed on anticoagulants postoperatively. The recovery was unremarkable, and anticoagulants were continued for six months.</p><p><strong>Conclusion: </strong>OVT is most commonly seen in the early postpartum period, especially within the first 10 days. Due to its anatomical characteristics, the right ovarian vein is more commonly involved. The clinical presentation of OVT can closely mimic acute abdomen or acute appendicitis, making diagnosis challenging. Accurate diagnosis requires a high index of suspicion and advanced imaging techniques to differentiate OVT from other conditions with similar presentations.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"103525"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary alpha tryptasemia and clinical implications.","authors":"Ece Tüsüz Önata, Öner Özdemir, Süreyya Savaşan","doi":"10.12998/wjcc.v13.i21.104723","DOIUrl":"10.12998/wjcc.v13.i21.104723","url":null,"abstract":"<p><p>Hereditary alpha tryptasemia was first described in 2016 and is the most common (up to 72%) cause of elevated serum basal tryptase (TPS). The clinical presentation of this condition, which is caused by copy number gains in the <i>TPSAB1</i> gene encoding serum α TPS, is variable for each patient. Some patients are asymptomatic, whereas in others, especially those with increased mast cell activation, it has been associated with a higher risk of anaphylaxis. Better characterization of this entity is important to identify at-risk patients and to develop new treatment strategies. This review provided an overview of hereditary alpha tryptasemia and increased awareness of this condition by discussing the current information in the literature.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"104723"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean medicine combination treatment for chronic tinnitus unresponsive to conventional treatment: A case report and review of literature.","authors":"Gawon Choe, Ji Hye Hwang","doi":"10.12998/wjcc.v13.i21.103200","DOIUrl":"10.12998/wjcc.v13.i21.103200","url":null,"abstract":"<p><strong>Background: </strong>Tinnitus is a common condition in otolaryngology; however, its pathophysiological mechanisms remain incompletely elucidated. Recent efforts have focused on improving individual treatment efficacy by combining different treatment approaches. Therefore, this study aimed to reveal the efficacy of Korean medicine (KM) combination therapy in treating chronic tinnitus unresponsive to conventional Western treatments.</p><p><strong>Case summary: </strong>A 35-year-old female patient with over 10 years of left-sided tinnitus, accompanied by left eye twitching, headache, neck pain, and premenstrual syndrome, was diagnosed with liver qi stagnation. She underwent 11 sessions involving acupuncture-related treatments and Chuna therapy as part of KM treatment. From the 9^th session onward, temporomandibular joint balancing therapy was incorporated. Following the treatment, tinnitus, headache, and neck pain resolved, while other symptoms improved, as reflected in the rating scores (tinnitus handicap inventory: 68 to 0, headache impact test-6: 64 to 36, neck disability index: 21 to 0). Significant improvement in tinnitus, headache, and neck pain was observed after just two KM treatment sessions; intermittent tinnitus ceased entirely after the 9th session, and improvements were maintained at the 2-month follow-up.</p><p><strong>Conclusion: </strong>In conclusion, personalized treatment with a combination and modification of various KM therapies based on individual pattern diagnosis effectively alleviated daily life discomfort in a patient with chronic tinnitus, unresponsive to conventional treatments. This led to a rapid resolution of symptoms within a relatively short timeframe.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"103200"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent thrombolysis followed by percutaneous coronary intervention for the simultaneous acute cardio-cerebral ischemic attack: A case report.","authors":"Wen-Xue Zheng, Ling-Yu Liu","doi":"10.12998/wjcc.v13.i21.105816","DOIUrl":"10.12998/wjcc.v13.i21.105816","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous acute ischemic stroke (AIS) and myocardial infarction (cardiocerebral ischemic attack) have rarely been reported in the literature. Currently, no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.</p><p><strong>Case summary: </strong>We present the case of a 27-year-old Chinese man who simultaneously experienced acute concomitant cerebrocardiac infarction (CCI) and painless ST-elevation myocardial infarction. The patient was successfully treated with elective percutaneous coronary intervention (PCI) after receiving urgent systemic thrombolysis at the standard dose for AIS.</p><p><strong>Conclusion: </strong>Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"105816"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CXCR4 expression and clinicopathological features of endometrial endometrioid carcinoma with the microcystic, elongated, and fragmented pattern.","authors":"Ji-Xian Wang, Dan-Hua Shen, Xiao-Bo Zhang","doi":"10.12998/wjcc.v13.i21.103841","DOIUrl":"10.12998/wjcc.v13.i21.103841","url":null,"abstract":"<p><strong>Background: </strong>The microcystic, elongated, and fragmented (MELF) pattern of invasion in endometrioid endometrial carcinoma (EEC) is a special mode of myometrial invasion that has been recently recognized by the pathology community. Overexpression of CXC chemokine receptor 4 (CXCR4) in tumor cells contributes to tumor growth, invasion, angiogenesis, metastasis, and recurrence.</p><p><strong>Aim: </strong>To explore the correlation between CXCR4 expression in EEC and MELF invasion and clinicopathological features.</p><p><strong>Methods: </strong>A total of 205 EEC patients treated at Peking University People's Hospital from June 2020 to December 2021 were selected (60 cases with MELF invasion, 145 cases without). The clinicopathological features of the two groups were compared, and expression of CXCR4 protein, estrogen receptor, and progesterone receptor was detected and compared by immunohistochemistry.</p><p><strong>Results: </strong>EEC with MELF invasion was significantly associated with low tumor grade, lymphovascular space invasion, deep myometrial invasion, cervical stromal involvement, and lymph node metastasis. There was a difference in CXCR4 expression between the two groups, with the MELF group having a significantly higher expression than the non-MELF group.</p><p><strong>Conclusion: </strong>CXCR4 expression is significantly increased in EEC with MELF invasion and in the MELF invasion area, which may promote tumor invasion and metastasis and has some value for prognostic assessment.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"103841"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypophosphatasia: A case report.","authors":"Angad Singh Gill, Pallavi Sharma, Mahmoud Nassar, Erlin Marte","doi":"10.12998/wjcc.v13.i21.103642","DOIUrl":"10.12998/wjcc.v13.i21.103642","url":null,"abstract":"<p><strong>Background: </strong>Hypophosphatasia (HPP) is a rare metabolic disorder caused by low tissue-nonspecific alkaline phosphatase (ALP) activity, presenting symptoms from bone demineralization to tooth loss. It affects multiple systems and is diagnosed based on clinical symptoms, radiological findings, and lab tests. This case report emphasizes considering HPP in patients with unexplained bone pain and low ALP levels, especially with underlying osteopenia or osteoporosis. It highlights the importance of genetic testing and counseling for early diagnosis and treatment, aiming to raise clinician awareness.</p><p><strong>Case summary: </strong>We present a case of a 65-year-old female patient who was referred to our endocrinology clinic for complaints of generalized bone pain and hypothyroidism. Initial evaluation revealed osteopenia, managed with calcium and vitamin D supplementation. Persistently low ALP levels and elevated vitamin B6 levels led to the diagnosis of HPP, confirmed by genetic testing identifying a pathogenic <i>ALPL</i> gene variant [c.119C>T (p.Ala40Val)]. Despite conservative treatment, her bone density declined, although remaining in the osteopenic range. The Fracture Risk Assessment score indicated a low risk of major osteoporotic and hip fractures, not warranting immediate treatment. Plans are underway to initiate enzyme replacement therapy with asfotase alfa.</p><p><strong>Conclusion: </strong>Recognizing HPP is crucial, as early diagnosis and treatment can significantly improve patient outcomes and prevent complications.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"103642"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-threatening vascular injury in an elderly patient with isolated pubic ramus fracture: A case report.","authors":"Evangelos Sakellariou, Evangelia Argyropoulou, Athanasios Galanis, Meletis Rozis, Dimitrios Zachariou, Iordanis Varsamos, Nicolaos Parchas, Dimitrios Kalavrytinos, Panagiotis Karampinas, Elias S Vasiliadis, John Vlamis, Spiros Pneumaticos","doi":"10.12998/wjcc.v13.i21.103786","DOIUrl":"10.12998/wjcc.v13.i21.103786","url":null,"abstract":"<p><strong>Background: </strong>Pubic ramus fractures are generally considered fragility fractures in the elderly population, commonly deriving from a low-impact fall. Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent. Notwithstanding, patients with copious comorbidities should be carefully monitored for potential vascular injury.</p><p><strong>Case summary: </strong>This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture. The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission, necessitating urgent intervention. A computed tomography angiography revealed active bleeding, leading to the embolization of the medial femoral branch. The patient was stabilized hemodynamically and was discharged after 15 days, with recommendations for home-based follow-up care.</p><p><strong>Conclusion: </strong>This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively, but need prompt monitoring for occult vascular injuries that can be fatal.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"103786"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic surgical approaches for various locations of gastrointestinal stromal tumours.","authors":"Li-Quan Chen, Chu-Ying Wu, Si-Jia Wu, Kai Ye","doi":"10.12998/wjcc.v13.i21.105559","DOIUrl":"10.12998/wjcc.v13.i21.105559","url":null,"abstract":"<p><p>Gastrointestinal stromal tumours (GISTs) are tumours that originate from mesenchymal tissue, are predominantly located in the stomach, and typically do not metastasize to the lymph nodes. Surgical intervention remains the primary treatment modality for GISTs. Historically, open surgery was the predominant approach; however, advancements in medical technology have led to laparoscopic surgery becoming the standard practice. Compared with traditional open surgical techniques, laparoscopic surgery is less invasive and facilitates more rapid postoperative recovery. Given that GISTs can arise at any location within the gastrointestinal tract, the specific surgical methods employed vary according to both the tumour's anatomical site and its growth characteristics. The aim of this review is to examine laparoscopic surgical strategies for managing GISTs across different regions of the gastrointestinal tract by synthesizing recent research trends and relevant evidence-based medical literature.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 21","pages":"105559"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}