World Journal of Clinical Cases最新文献

{"title":"Acute purulent pericarditis secondary to community-acquired streptococcus pneumonia: A case report.","authors":"Kevan English, Noelle Pick, Allyson Schmitz","doi":"10.12998/wjcc.v13.i26.107748","DOIUrl":"10.12998/wjcc.v13.i26.107748","url":null,"abstract":"<p><strong>Background: </strong>Pericarditis is the inflammation of the pericardial sac due to a variety of stimuli that ultimately trigger a stereotyped immune response. This condition accounts for up to 5% of emergency department visits for nonischemic chest pain in Western Europe and North America. The most common symptoms of clinical presentation are chest pain and shortness of breath with associated unique electrocardiographic changes. Acute pericarditis is generally self-limited. However, some cases may be complicated by either tamponade or a large pericardial effusion, which carries a significant risk of recurrence. Risk factors for acute pericarditis include viral infections, cardiac surgery, and autoimmune disorders. A rarer cause of pericardial inflammation includes pneumonia, which can induce purulent pericarditis that has been increasingly rare since the advent of antibiotics. Purulent pericarditis carries a high fatality rate, especially in the setting of tamponade, and is invariably deadly without the administration of antibiotics. Bedside transthoracic echocardiogram is a quick and helpful method that can aid in the diagnosis and management.</p><p><strong>Case summary: </strong>We present the case of a 62-year-old woman who sought medical attention at the emergency department (ED) due to a 5-day history of chest pain, shortness of breath, and subjective fevers. Laboratory findings in the ED were significant for leukocytosis and elevated erythrocyte sedimentation rate and C-reactive protein. A chest X-ray revealed a new focal density within the left lower lung base, and a bedside point-of-care ultrasound showed a pericardial fluid collection. The patient was subsequently admitted, where she underwent pericardiocentesis. Fluid cultures from drainage grew <i>streptococcus pneumoniae</i>. She was started on broad-spectrum antibiotics immediately after the procedure. The patient was ultimately discharged in stable condition with cardiology and infectious disease follow-up.</p><p><strong>Conclusion: </strong>This case report emphasizes a unique complication of community-acquired pneumonia. Purulent pericarditis due to <i>streptococcus pneumonia</i> occurs <i>via</i> intrathoracic spread of the organism to the pericardium. This condition is virtually fatal without the administration of antibiotics. Therefore, in the context of suspected pneumonia and a new pericardial fluid collection on imaging, clinicians should suspect purulent pericarditis until proven otherwise, which requires emergent intervention.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"107748"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971552","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":"Conservative management of ischiofemoral impingement: Strengths and opportunities for future research.","authors":"Rui-Jia Ma, Ding-Wen Xu, Qin-Mei Zhu","doi":"10.12998/wjcc.v13.i26.108327","DOIUrl":"10.12998/wjcc.v13.i26.108327","url":null,"abstract":"<p><p>This commentary evaluates the case report by Mohammed <i>et al</i> on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions, telerehabilitation, dry needling, and kinesiology taping. The study demonstrated significant pain reduction and functional improvement, highlighting the feasibility of hybrid care models. However, limitations include short-term follow-up, lack of post-treatment imaging, and single-case design restricting generalizability. Future research should prioritize longitudinal studies, anatomical correlation <i>via</i> imaging, and randomized trials to validate efficacy across diverse populations. While the framework offers promising clinical utility, further investigation is critical to optimize protocols and elucidate biomechanical mechanisms underlying symptom resolution.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"108327"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971570","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":"Urothelial carcinoma arising in orthotopic ileal neobladder reconstruction: A case report.","authors":"Miki Murakami, Hirotsugu Noguchi, Ryosuke Matsushita, Shuichi Tatarano, Mari Kirishima, Takashi Tasaki, Ikumi Kitazono, Michiyo Higashi, Hideki Enokida, Akihide Tanimoto","doi":"10.12998/wjcc.v13.i26.104876","DOIUrl":"10.12998/wjcc.v13.i26.104876","url":null,"abstract":"<p><strong>Background: </strong>An ileal neobladder is a standardized form of urinary diversion that provides acceptable outcomes in terms of long-term quality of life. Urothelial carcinomas (UCs) arising in the ileal neobladder are extremely rare, and few reports on this have been published in the English language.</p><p><strong>Case summary: </strong>We report a case of UC that developed in the ileal neobladder of a 63-year-old man. The patient was diagnosed with UC <i>in situ</i> and underwent radical cystoprostatectomy and ileal neobladder creation. Ten years after the surgery and neoadjuvant chemotherapy, an UC developed in the ileal neobladder.</p><p><strong>Conclusion: </strong>Ileal neobladder urothelial carcinoma can originate from the implanted urothelium and the intestinal mucosa can migrate intraluminally.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"104876"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971580","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":"Late menstruation with an ovarian sclerosing stromal tumor: A case report.","authors":"Xu Han, Bo Zhang, Jing-Chun Gao","doi":"10.12998/wjcc.v13.i26.106999","DOIUrl":"10.12998/wjcc.v13.i26.106999","url":null,"abstract":"<p><strong>Background: </strong>Ovarian sclerosing stromal tumors (OSSTs) are found most commonly in females at 20-30 years of age. They can also occur at any point during pre-puberty, puberty, or menopause. Clinical manifestations of OSSTs include abdominal pain, an abdominal mass, menstrual abnormalities, and infertility. Infrequently, patients will experience androgen-related manifestations of masculinization, such as increased hair, acne, or a low voice. Diagnosis must be confirmed by immunohistochemical analysis of the tissue as clinical symptoms and imaging studies are unreliable.</p><p><p>CASE SUMMARYA 14-year-old female presented with amenorrhea. After a thorough medical examination, endocrine and tumor markers analysis, and imaging, a pelvic mass was discovered. The patient also exhibited endocrine dysfunction but was not positive for any tumor markers. The patient underwent surgery to remove the ovarian tumor. Immunohistochemical analysis of the resected specimen indicated an OSST. During the postoperative follow-up, the patient had attained menarche.</p><p><p>CONCLUSIONThis case's clinical manifestation of endocrine dysfunction due to OSST provides new insights that will assist clinicians in the diagnosis and treatment of this common tumor.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"106999"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971596","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":"Thoughts and challenges of giant retroperitoneal liposarcoma: A case report.","authors":"Li-Li Cheng, Biao Tang, Hui Liu, Fan Zhu, Yi-Fa Chen, Wei Zhang","doi":"10.12998/wjcc.v13.i26.108308","DOIUrl":"10.12998/wjcc.v13.i26.108308","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal liposarcoma (RPLS) is a rare malignant tumor initiated in adipocytes. It is discovered only when the tumor is large because of its deep anatomical location and insidious onset. Giant RPLS with a diameter exceeding 30 cm is extremely rare. Its diagnosis and treatment present extremely great challenges.</p><p><strong>Case summary: </strong>The patient, a 62-year-old woman, presented to the hospital complaining of abdominal distension for more than six months. Imaging examination revealed a large retroperitoneal mass. Finally, the patient was diagnosed with giant RPLS. The tumor occupied the entire abdominal cavity, severely compressed the abdominal organs, and adhered tightly to the bilateral ureters. After careful preoperative preparation (including three-dimensional visualization and bilateral ureteral stent implantation), we performed resection of the large retroperitoneal mass. The tumor was completely removed and consisted of multiple masses, with a total weight of 17 kg and the largest mass size of 35 cm × 28 cm × 14 cm. Postoperative pathological results revealed that the mass was a well-differentiated liposarcoma. The patient recovered well after surgery, and there was no sign of recurrence after 2 months of follow-up.</p><p><strong>Conclusion: </strong>Surgical resection is the only radical treatment for giant RPLS. Preoperative preparation is essential, and three-dimensional visualization reconstruction is helpful for the formulation of surgical plans. Postoperative radiotherapy and neoadjuvant therapy can be reasonably selected, but whether they can reduce the recurrence rate is still controversial.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"108308"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971602","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":"Hepatitis B virus and hepatitis D virus co-infection complicated by autoimmune hepatitis: Two case reports.","authors":"Jing Dou, Xin-Yan Zhao, Zhuan-Guo Wang, Zhong-Hui Ning, Xiao-Zhong Wang, Feng Guo","doi":"10.12998/wjcc.v13.i26.104421","DOIUrl":"10.12998/wjcc.v13.i26.104421","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis D virus-hepatitis B virus (HDV-HBV) co-infection accelerates liver disease progression and increases the risk of hepatocellular carcinoma, but the immunopathogenic mechanism of its combination with autoimmune hepatitis (AIH) has not been clarified. This study reveals for the first time that HDV may induce AIH through abnormalities in immunoregulation in two specific cases. This is the first report of HDV-HBV co-infected patients who did not receive interferon therapy and achieved serological conversion and histological remission by combining antiviral (entecavir) with immunosuppression (prednisone + azathioprine) therapy, providing new evidence of the mechanism of this complex disease.</p><p><strong>Case summary: </strong>A 40-year-old female developed malaise and jaundice with an alanine aminotransferase/aspartate aminotransferase > 20 upper limit of normal (ULN), total bilirubin: 97.20 μmol/L, immunoglobulin G (IgG) 47.1 g/L (> 3 × ULN), HDV RNA 1.6 × 10⁷ copies/mL and liver biopsy showed G3S4. Tenofovir alafenamide combined with prednisone and azathioprine was administered, and three months later the Child-Turcotte-Pugh class C was reduced to class B and IgG decreased to 13.62 g/L. Another 58-year-old male complained of pain in the liver area, anti-nuclear antibody was 1:320, IgG 22.6 g/L (> 1.3 × ULN), and liver biopsy showed G2S3. Entecavir was administered in combination with prednisone and azathioprine, and after 3 months, liver function returned to normal, and IgG reduced to 14.22 g/L.</p><p><strong>Conclusion: </strong>Patients with HDV-HBV co-infection combined with AIH can achieve clinical remission following combination therapy, and the study of immunomodulatory mechanisms should be emphasized.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"104421"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971630","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":"Solitary extramedullary plasmacytoma mimicking ocular surface squamous neoplasia in an elderly male: A case report.","authors":"Thilakraj Koppalu Lingaraju, Bijnya Birajita Panda, Madhusmita Sethy, Sri Lasya Achanta","doi":"10.12998/wjcc.v13.i26.108409","DOIUrl":"10.12998/wjcc.v13.i26.108409","url":null,"abstract":"<p><strong>Background: </strong>Conjunctival plasmacytoma is an exceedingly uncommon form of extramedullary manifestation of multiple myeloma, with only a handful of cases reported so far.</p><p><strong>Case summary: </strong>A 66-year-old male of Indian origin with multiple myeloma presented with a 1-year history of progressive pink mass associated with itching in his left eye. Examination revealed a pinkish conjunctival mass with telangiectasia extending up to the temporal limbus, mimicking ocular surface squamous neoplasia. The patient underwent successful excision of the mass and amniotic membrane grafting. Histopathological examination after excision revealed plasma cell infiltration, confirming an unusual extramedullary manifestation of multiple myeloma. The patient was followed up for one year, with no evidence of recurrence.</p><p><strong>Conclusion: </strong>This case report highlights the importance of considering multiple myeloma in the differential diagnosis of ocular masses, particularly in patients with a known history of the disease. The presentation of a conjunctival mass in a patient with multiple myeloma is rare, but it is essential to recognize this possibility to ensure timely and appropriate management.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"108409"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971549","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":"Emergency veno-arterial extracorporeal membrane oxygenation cannulation through the femoral vein with a pre-positioned inferior vena cava filter: A case report.","authors":"Fei Gao, Shan Ma, Xuan Xiao, Huai Yang, Ming-Jiang Qian","doi":"10.12998/wjcc.v13.i26.105486","DOIUrl":"10.12998/wjcc.v13.i26.105486","url":null,"abstract":"<p><strong>Background: </strong>Acute pulmonary thromboembolism is a complication of venous thrombosis. Extracorporeal membrane oxygenation (ECMO), an effective rescue measure for rapid hemodynamic recovery, can be used in patients for whom thrombolysis therapy has failed.</p><p><strong>Case summary: </strong>This case report describes an extreme rescue process for a patient with a preset inferior vena cava (IVC) filter in a relatively economically underdeveloped area with an insufficient supply of consumables. In an emergency, veno-arterial ECMO was successfully initiated by intubation through the IVC filter to the right atrial opening without displacement of the filter during the entire process.</p><p><strong>Conclusion: </strong>This study demonstrates that in resource-limited settings, femoral vein cannulation for veno-arterial ECMO is a feasible and safe option for patients with pre-implanted IVC filters.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"105486"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971595","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":"Splenic hamartoma mimicking angiosarcoma: A case report.","authors":"Su-Bin Song, Byeong Gwan Noh, Myeong Hun Oh, Myunghee Yoon, Young Mok Park, Hyung-Il Seo, Seung Baek Hong, Suk Kim","doi":"10.12998/wjcc.v13.i26.107028","DOIUrl":"10.12998/wjcc.v13.i26.107028","url":null,"abstract":"<p><strong>Background: </strong>Primary splenic lesions are rare and often detected incidentally through imaging, biopsy, or autopsy, typically without distinct clinical symptoms. Although imaging can help differentiate benign from malignant lesions, splenic hamartomas, and angiosarcomas may exhibit overlapping features, making diagnosis challenging. This report presents a case of splenic hamartoma suspected to be an angiosarcoma based on preoperative imaging. Splenic hamartomas that mimic angiosarcomas are exceedingly rare.</p><p><strong>Case summary: </strong>A 33-year-old male presented to the Department of Emergency with frank red blood hematemesis and a 1-week history of epigastric pain. On arrival, he was alert and hemodynamically stable. Contrast-enhanced abdominal computed tomography revealed splenomegaly with significant engorgement of the portal and splenic veins, along with a diffuse nodular splenic lesion measuring 8.2 cm × 6.2 cm. Following esophageal varix ligation, abdominal magnetic resonance imaging demonstrated iso- to high-signal intensity within the splenic mass and multiple hypervascular lesions in the right hepatic lobe, raising suspicion for splenic angiosarcoma with hepatic metastases. ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography showed diffusely mild increased metabolic activity in the spleen. The patient subsequently underwent splenectomy and liver biopsy. Histopathological examination revealed chronic inflammation in the liver, and the splenic lesion was confirmed to be a splenic hamartoma. The patient successfully returned to work and remains in good health.</p><p><strong>Conclusion: </strong>This rare case of splenic hamartoma mimicking angiosarcoma highlights the importance of differential diagnosis in managing splenic tumors.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"107028"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971567","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":"Clots in colitis: Thromboembolism and beyond.","authors":"Hakim Rahmoune, Nada Boutrid","doi":"10.12998/wjcc.v13.i26.102957","DOIUrl":"10.12998/wjcc.v13.i26.102957","url":null,"abstract":"<p><p>Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events, particularly venous thromboembolism (VTE), which encompasses deep vein thrombosis and pulmonary embolism. The incidence of VTE in patients with UC is significantly higher than that in the general population, and a retrospective cohort study found that patients undergoing colectomy had a notable risk of developing VTE, with rates reaching as high as 22% among patients exposed to tofacitinib within a month prior to surgery. The GETAID FOCUS study also reported a high prevalence of self-reported VTE in patients with UC, with a pooled prevalence of approximately 12% across various studies. The risk of thromboembolism in UC is multifactorial and influenced by chronic inflammation, a wide range of medications used, potential surgical interventions, and possibly genetic factors or associations that are yet to be fully defined. Recognizing the various contributing factors is crucial for developing effective preventive strategies and improving patient outcomes.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 26","pages":"102957"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971572","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}