World Journal of Clinical Cases最新文献

{"title":"Rare phenotype of juxtaepiphyseal osteochondroma of the proximal phalanx and its management: A case report.","authors":"Ravikiran Vanapalli, Sai Krishna Mlv, Mohammed Tahir Ansari","doi":"10.12998/wjcc.v13.i24.106459","DOIUrl":"10.12998/wjcc.v13.i24.106459","url":null,"abstract":"<p><strong>Background: </strong>Osteochondroma of the hand and phalanges is rare. Although rare, solitary phalangeal osteochondromas can result in pain, cosmetic deformity, compression of nearby neurovascular structures and tendons, or functional limitation of adjacent joints that warrant surgical correction when symptomatic. At times, involvement of the growth plate by juxtaepiphyseal exostosis can cause angulation deformity, necessitating corrective osteotomy.</p><p><strong>Case summary: </strong>We reported a case of a 3-year-old female with a right-sided painless deformity of the index finger along with swelling over the base of the index finger and its management.</p><p><strong>Conclusion: </strong>This case report focused on the natural history of phalangeal exostosis and its association with angular deformities of the fingers. We demonstrated that the timely excision of the juxtaepiphyseal exostosis would allow the surgeon to achieve acute correction of the angular deformity with full functional recovery without recurrence at the 2-year follow-up. Significant delay of excision until skeletal maturity might necessitate corrective osteotomy of the finger deformity and tendon release for intrinsic tightness.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"106459"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971691","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":"Initial misdiagnosis of gastritis cystica profunda: Two case reports.","authors":"Xiao-Li Zheng, Long Xu, Jun Wang","doi":"10.12998/wjcc.v13.i24.107098","DOIUrl":"10.12998/wjcc.v13.i24.107098","url":null,"abstract":"<p><strong>Background: </strong>Gastritis cystica profunda (GCP) is a rare gastric disorder. It is characterized by non-specific symptoms and diagnostic complexity. This case report enriches the medical literature by highlighting challenges in diagnosing and treating GCP.</p><p><strong>Case summary: </strong>Two patients presented with non-specific abdominal symptoms, such as abdominal distension and epigastric discomfort. Initial misdiagnosis occurred due to GCP's non-typical manifestations. After thorough investigations, GCP was diagnosed. Endoscopic mucosal resection and endoscopic submucosal dissection were carried out. Both patients recovered uneventfully.</p><p><strong>Conclusion: </strong>GCP diagnosis demands caution, and endoscopic treatment is effective.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"107098"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971736","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":"Combination of next-generation sequencing and traditional examinations for identifying <i>Leuconostoc garlicum</i>: A case report.","authors":"Dan-Yang Zang, Lu-Guang Li, Shu-Guang Yang, Yuan-Yuan Wang, Xue-Qing Yu","doi":"10.12998/wjcc.v13.i24.105923","DOIUrl":"10.12998/wjcc.v13.i24.105923","url":null,"abstract":"<p><strong>Background: </strong><i>Leuconostoc garlicum</i> is commonly found in fermented foods and very few infected patients have been reported, who typically present symptoms such as fever and fatigue. Conventional clinical examinations often struggle to identify this bacterium, and routine anti-infective treatments are generally ineffective. Both diagnostic challenges and therapeutic limitations pose significant difficulties for clinicians.</p><p><strong>Case summary: </strong>We report a patient ultimately diagnosed with <i>Leuconostoc garlicum</i> infection. The primary manifestations included persistent fever, cough and fatigue. These symptoms lasted for 2 months. He received anti-infective treatment at a community hospital, but this was ineffective. After inquiring about the patient's medical history and conducting a physical examination, the patient underwent laboratory tests. Complete blood count tests revealed that the patient had a high proportion of neutrophils, C-reactive protein level was 235.9 mg/L, erythrocyte sedimentation rate was 67 mm/h, respiratory pathogen testing was negative, and he was then thought to have an infectious disease. However, conventional anti-infective treatments were ineffective. After excluding infectious neurological diseases, urologic diseases and digestive problems, we ultimately focused our attention on the lungs. A lung computed tomography scan indicated pulmonary inflammation. Bronchoalveolar lavage fluid for next-generation sequencing suggested lung infection with <i>Leuconostoc garlicum.</i> The patient's symptoms gradually improved following treatment with piperacillin tazobactam and linezolid. During the follow-up period, the patient's temperature remained normal.</p><p><strong>Conclusion: </strong>For patients with suspected bacterial infection and experiencing fever, conventional anti-infective treatment can be ineffective in controlling their symptoms, and an infection due to rare bacteria or drug-resistant bacteria should be considered. Next-generation sequencing enables rapid and precise identification of infection-related pathogens in febrile patients.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"105923"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971579","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":"Mechanism of action of cuproptosis and prospects for anti-tumor therapy.","authors":"Jie Xiao, Yan Wang, Xiao-Jun Yang","doi":"10.12998/wjcc.v13.i24.104255","DOIUrl":"10.12998/wjcc.v13.i24.104255","url":null,"abstract":"<p><p>In the study published in the <i>World Journal of Clinical Cases</i> by Xu <i>et al</i>, the expression profiles of cuproptosis-related genes in esophageal cancer and their prognostic significance were investigated. Cuproptosis, a novel form of copper-dependent cell death, has garnered significant attention in cancer research due to its mechanism closely linked to mitochondrial metabolism and protein lipoylation. This research systematically analyzed the prognostic value of cuproptosis-related genes by integrating multi-omics data from 151 esophageal cancer and normal tissue samples. The study identified pyruvate dehydrogenase A1 (PDHA1) as an independent prognostic marker for esophageal cancer. Patients with high PDHA1 expression exhibited significantly lower overall survival rates. Functional enrichment analysis further revealed that cuproptosis drives tumor progression by regulating mitochondrial tricarboxylic acid cycle activity and metabolic reprogramming of glucose metabolism. Long non-coding RNAs (LncRNAs), RNA molecules exceeding 200 nucleotides that do not encode proteins, have been extensively examined in this context. In specific tumor types, certain LncRNAs play a role in regulating cuproptosis by influencing copper ion metabolism, transport, and associated signaling pathways. These LncRNAs may interact with pivotal genes involved in cuproptosis, modulating their expression levels and participating in the regulation of this process. Current research has concentrated on the correlation between cuproptosis-linked LncRNAs and diverse cancers. A comprehensive investigation into the connections among LncRNAs, cuproptosis-related genes, pathways, and their impact on tumor drug resistance holds promise for precise cancer treatment and prognosis assessment.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"104255"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971724","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":"Diagnostic dilemma of avoidant/restrictive food intake disorder after bariatric surgery: A case report and review of literature.","authors":"Kamila Cass, Adam Leggett, Dennis Glen Gibson","doi":"10.12998/wjcc.v13.i24.106941","DOIUrl":"10.12998/wjcc.v13.i24.106941","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery is an effective treatment for severe obesity but is associated with an increased risk for development of eating disorders. Indeed, numerous maladaptive eating behaviors and eating disorders have been described following bariatric surgery. However, the differentiation of pathologic eating patterns from expected dietary changes following bariatric surgery can sometimes be difficult to discern.</p><p><strong>Case summary: </strong>A female in her early 40s presented for medical stabilization of severe protein calorie malnutrition after losing 52.3 kg over the last six months after Roux-en-Y gastric bypass, with subsequent development of cyclic nausea and vomiting. Fear of these aversive physical symptoms led to further restriction of nutritional intake and weight loss. The patient was diagnosed with avoidant/restrictive food intake disorder, which has not been previously reported after bariatric surgery.</p><p><strong>Conclusion: </strong>Improvement in the diagnostic nomenclature for feeding and eating disorders is warranted for patients who have undergone bariatric surgery.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"106941"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971733","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":"Chronic renal insufficiency and <i>Nocardia brasiliensis</i> infection: A call for heightened vigilance and multidisciplinary management.","authors":"Jing Ding, Dan-Dan Shi, Ju Tian","doi":"10.12998/wjcc.v13.i24.108115","DOIUrl":"10.12998/wjcc.v13.i24.108115","url":null,"abstract":"<p><p>This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and <i>Nocardia brasiliensis</i> skin infection in the case reported by Zhang <i>et al</i>, emphasizing the diagnostic challenges and therapeutic complexities in the context of advanced age, comorbidities, and immunocompromised populations. The study's strengths included its integration of immunological profiling and precision medicine, demonstrating that a tailored low-dose trimethoprim-sulfamethoxazole regimen with pharmacokinetic monitoring can improve outcomes in geriatric patients with chronic renal insufficiency while mitigating nephrotoxicity risks. However, its limitations included a single-case design, reliance on phenotypic diagnostics, and the lack of information regarding comorbidity interactions. The findings support the use of advanced molecular tools for rapid pathogen identification and identification of co-infection. Future studies should prioritize elucidating the synergistic effects of chronic kidney disease-uremia and immunosuppression on <i>Nocardia</i> colonization, developing biomarkers for early detection, and conducting global epidemiological studies in endemic regions. This case underscores the importance of interdisciplinary collaboration and innovative diagnostics to optimize management of nocardiosis in vulnerable populations.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"108115"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971593","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":"Minimally invasive surgical approach for slipping rib syndrome: A case report.","authors":"Francesca Spinelli, Francesco Petrella, Andrea Cara, Enrico Cassina, Lidia Libretti, Emanuele Pirondini, Matilde De Simone, Ugo Cioffi, Antonio Tuoro, Gerardo Cioffi, Federico Raveglia","doi":"10.12998/wjcc.v13.i24.107384","DOIUrl":"10.12998/wjcc.v13.i24.107384","url":null,"abstract":"<p><strong>Background: </strong>Slipping rib syndrome (SRS) is caused by abnormal subluxation of floating ribs, resulting in chronic pain and possible tissue damage. Its prevalence is often overlooked, as it shares symptoms with other musculoskeletal conditions, and is more common in young females and athletes. Symptoms include pain along the lower rib margin, aggravated by trunk movements, deep breathing and coughing. Treatment usually starts conservatively with physiotherapy and analgesics. In severe cases, extrapleural rib resection may be required.</p><p><strong>Case summary: </strong>In April 2023, a 24-year-old woman presented with persistent right hemithorax pain in the eleventh rib for one year. Instrumental examinations, including ultrasonography and magnetic resonance imaging, were negative for abdominal and osteochondral abnormalities. The pain intensity, rated 8/10 on the numeric rating scale (NRS), remained unresponsive to pain therapy. After a careful literature review and discussion with the patient, we opted for a minimally invasive surgical approach. Under general anesthesia, a mini-thoracotomy was performed along the anterior course of the eleventh rib. After exposure, abnormal rib mobility was detected, which led to resection of the medial margin and anchoring to the overlying rib with nonabsorbable sutures. Histological examination revealed no abnormalities. The patient was discharged on the first postoperative day. Pain decreased significantly, reaching 1/10 on the NRS at one month. At 3 months, the patient had mild fluctuating pain (2/10) requiring occasional analgesics but did not interfere with daily activities.</p><p><strong>Conclusion: </strong>Minimally invasive rib-preserving surgery effectively reduces pain and hospitalization time, offering a valid alternative to conventional rib resection for refractory SRS.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"107384"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971647","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":"Endocrine dysfunction in homozygous beta-thalassemia: An underrecognized and undertreated consequence of prolonged survival.","authors":"Christos Savvidis, Ioannis Ilias","doi":"10.12998/wjcc.v13.i24.107612","DOIUrl":"10.12998/wjcc.v13.i24.107612","url":null,"abstract":"<p><p>The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of long-term care. While iron overload remains a central mechanism, additional contributors such as hypothalamic dysfunction, neurosecretory disturbances, and chronic inflammation have been identified. Endocrine disorders including hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, hypoparathyroidism, osteoporosis, and growth axis impairment - are prevalent and often underdiagnosed. Diagnostic challenges include normal hormone levels in early stages, necessitating the use of dynamic endocrine testing and pituitary magnetic resonance imaging to detect subclinical dysfunction. Risk is modulated by sex, age, and chelation adherence. Early identification and proactive, multidisciplinary management of endocrine sequelae are essential in reducing morbidity and maintaining functional independence in this aging patient population.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"107612"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971663","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":"Merkel cell carcinoma presenting as a nasal dorsum mass: A case report and literature review.","authors":"Abdullah Ibrahim Ali Abuharb, Abdullah Fahad Alzamil, Khalid Saad Alqarni, Ali M Alsudays, Saeed M Alqahtani, Rawan Mosleh Alahmadi, Alyaa Shojaa Al Mutairy, Fareed Ramzi Alghamdi","doi":"10.12998/wjcc.v13.i24.105244","DOIUrl":"10.12998/wjcc.v13.i24.105244","url":null,"abstract":"<p><strong>Background: </strong>Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients. Its occurrence in the nasal dorsum is extremely rare and poses significant diagnostic and therapeutic challenges.</p><p><strong>Case summary: </strong>We report the case of a 65-year-old woman with diabetes mellitus and hypertension who presented with a dorsal nasal mass. The initial differential diagnosis favored hemangioma-based clinical examination on imaging. Histopathological examination after excision revealed MCC, necessitating a complex management strategy. A 3 cm × 2 cm nasal mass, initially suspected to be a hemangioma, was excised but revealed MCC with positive margins. Positron emission tomography-computed tomography confirmed metastatic cervical lymphadenopathy. The patient underwent bilateral neck dissection, revealing metastases in seven nodes. Residual activity was treated with radiation therapy, leading to a favorable response after 6 months.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering MCC in the differential diagnosis of nasal masses, and integrated management.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"105244"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971678","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":"Managing toxic shock syndrome in immunosuppressed patient after liver transplantation from trauma to triumph: A case report.","authors":"Viktor Domislović, Maja Sremac, Iva Kosuta, Vibor Sesa, Andrijana Jovic, Kresimir Grsic, Neven Papic, Anna Mrzljak","doi":"10.12998/wjcc.v13.i24.106827","DOIUrl":"10.12998/wjcc.v13.i24.106827","url":null,"abstract":"<p><strong>Background: </strong>Streptococcal toxic shock syndrome (STSS), caused by group A Streptococcus (<i>Streptococcus pyogenes</i>), is characterized by shock and multiorgan failure and is associated with a high mortality rate. Organ transplant recipients are especially vulnerable due to immunosuppressive therapy. Although critical for graft survival, immunosuppression increases susceptibility to infections, the leading cause of morbidity and mortality early after liver transplantation.</p><p><strong>Case summary: </strong>A 69-year-old female on dual immunosuppressive regimen with mycophenolate mofetil and tacrolimus due to liver transplantation in 2010 and chronic kidney disease presented to the emergency department after tripping at home and injuring her neck with a wooden splinter from a chair. She developed progressive neck swelling and erythema with a diffuse maculopapular rash. Contrast-enhanced computed tomography scan showed a multiloculated neck abscess (59 mm × 32 mm × 85 mm). Her leucocyte count was 22.4 × 10⁹/L, C-reactive protein 327.4 mg/L, and creatinine 233 μmol/L. Microbiological analysis tested positive for group A Streptococcus, suggesting diagnosis of STSS. She developed hypotension, dyspnea and fever prompting an urgent surgical drainage. Mycophenolate mofetil was discontinued, tacrolimus was reduced and was treated with cephazolin and clindamycin. Her skin rash slowly resolved, C-reactive protein decreased to 53.0 mg/L and kidney function improved. A computed tomography scan confirmed resolution and showed no new abscess formation. After two years of follow-up, she is unremarkable.</p><p><strong>Conclusion: </strong>STSS in organ transplant recipients demands rapid managing of infections while minimizing the risk of graft rejection.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"106827"},"PeriodicalIF":1.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971680","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}