World Journal of Clinical Cases最新文献

{"title":"Short-term spinal cord stimulation for refractory Elsberg syndrome in diabetic neuropathy: A case report.","authors":"Jia Wang, Xiao-Qian Yu, Xue-Guang Zhang, Li Song, Jun Lee","doi":"10.12998/wjcc.v13.i33.112607","DOIUrl":"10.12998/wjcc.v13.i33.112607","url":null,"abstract":"<p><strong>Background: </strong>Elsberg syndrome is a type of postinfectious lumbosacral radiculitis typically triggered by neurotropic viruses and manifests as bladder/bowel dysfunction, saddle sensory disturbances (including hypoesthesia, hyperesthesia, or dysesthesia), and variable neurological deficits. Typically self-limiting, it often responds to antiviral and neurotropic therapies. However, in patients with comorbidities that confer susceptibility to peripheral neuropathy (<i>e.g.</i>, diabetes mellitus), timely escalation to neuromodulation strategies, such as spinal cord stimulation, may be warranted to optimize functional outcomes when conservative measures are inadequate.</p><p><strong>Case summary: </strong>A 60-year-old male with diabetes mellitus presented with severe bladder and bowel dysfunction persisting for more than two months, followed by left gluteal and perianal (saddle area) herpes zoster eruption that was accompanied by significant neuropathic pain. Following a suboptimal response to conservative therapy, the patient underwent implantation of a short-term spinal cord stimulation. Following a 10-day trial of continuous tonic stimulation, the percutaneous electrode lead was removed. The patients experienced no surgical complications, and after the procedure, the patient achieved complete restoration of bladder and bowel function and significant pain alleviation. Two-month follow-up confirmed sustained full recovery.</p><p><strong>Conclusion: </strong>Early implementation of short-term spinal cord stimulation represents a promising therapeutic approach for promoting neurological recovery in patients with Elsberg syndrome refractory to conservative management, especially those with predisposing comorbidities such as diabetes mellitus.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"112607"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701913","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":"Recurrent hemoptysis after laryngectomy-acquired hemophilia induced by laryngeal cancer surgery and chemoradiotherapy: A case report.","authors":"Peng-Wei Zhao, Yan-Sheng Hu, Zheng Jiang, Mailudan Ainiwaer, Jun Liu, Fei Chen","doi":"10.12998/wjcc.v13.i33.112305","DOIUrl":"10.12998/wjcc.v13.i33.112305","url":null,"abstract":"<p><strong>Background: </strong>Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder characterized by autoantibodies against coagulation factor VIII (FVIII), leading to spontaneous bleeding in patients without a personal or family history of bleeding disorders. While AHA has been reported in association with various cancers, this case represents, to our knowledge, the first reported instance of AHA following head and neck cancer surgery and subsequent chemoradiotherapy.</p><p><strong>Case summary: </strong>We present the case of a 65-year-old male with a history of hypopharyngeal squamous cell carcinoma (T4bN2cM0, AJCC 8^th edition) who developed AHA after extensive surgical resection and chemoradiotherapy. He presented with recurrent hemoptysis and ecchymosis. Coagulation studies showed isolated prolonged activated partial thromboplastin time of 83.8 seconds that did not correct with mixing studies. FVIII activity was < 1%, and a Bethesda assay confirmed FVIII inhibitors with a titer of 18.4 Bethesda units. Hemostasis was initially achieved with tranexamic acid and batroxobin. Immunosuppression with prednisone and cyclophosphamide was started; due to gastrointestinal bleeding, rituximab was added. Treatment was later transitioned to azathioprine with prednisone, followed by tapering. FVIII activity recovered to 188.2%, and the patient remained in remission over six years without AHA or malignancy recurrence.</p><p><strong>Conclusion: </strong>This case underscores vigilance for AHA after head and neck cancer therapy to enable prompt treatment.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"112305"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701665","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":"Impact of type 2 diabetes mellitus on interstitial lung disease risk in rheumatoid arthritis.","authors":"Jacob Sutton, Georges Khattar, Fares Saliba, Omar Mourad, Laurence Aoun, Jennifer Jdaidani, Hamza Qandil, Chris Kaspar, Saif Abu-Baker, Shaza Almardini, Fadi Haddadin, Elie Bou Sanayeh, Anastasia Slobodnick","doi":"10.12998/wjcc.v13.i33.110641","DOIUrl":"10.12998/wjcc.v13.i33.110641","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the impact of type 2 diabetes mellitus (T2DM) on the risk of interstitial lung disease (ILD) and its subtypes in patients with rheumatoid arthritis (RA). RA is often complicated by ILD. T2DM has systemic proinflammatory effects, but its impact on RA-related ILD is unclear. This research aims to elucidate the interplay between these conditions to inform clinical management and patient care strategies.</p><p><strong>Aim: </strong>To determine if RA patients with T2DM have a higher occurrence of ILD compared to RA patients without T2DM.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the 2019-2020 National Inpatient Sample. Adult RA patients with and without T2DM were identified <i>via</i> International Classification of Diseases, 10^th Revision (ICD-10) codes. Propensity score matching (1:1) balanced 15+ confounders. Logistic regression assessed the association of T2DM with ILD (overall and by subtype) and secondary outcomes (acute respiratory distress syndrome, pneumothorax, pleural effusion, pulmonary hypertension). Missing data were excluded. ILD subtypes were included based on ICD-10 codes and case count.</p><p><strong>Results: </strong>Among 199380 RA inpatients, ILD was more common in those with T2DM (2.25%) <i>vs</i> without (1.11%). After matching (<i>n</i> = 121046), ILD remained higher in RA + T2DM [odds ratio (OR) = 2.02, 95%CI: 1.84-2.22, <i>P</i> < 0.001], with an absolute risk increase of about 1.14%. T2DM was associated with higher odds of ILD subtypes including usual interstitial pneumonia (OR = 3.20) and non-specific interstitial pneumonia (OR = 3.50). Other subtypes showed elevated ORs; eosinophilic pneumonia showed an inverse association (OR = 0.23). PAH and pneumothorax were also more common in RA + T2DM (OR = 1.40 and 1.85, respectively). Acute respiratory distress syndrome and pleural effusion rates did not differ by T2DM status. Rare subtype findings should be interpreted cautiously.</p><p><strong>Conclusion: </strong>T2DM increases ILD risk in RA and is linked to higher rates of pulmonary hypertension and pneumothorax, suggesting a role in exacerbating RA-related lung complications.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"110641"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702119","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":"Severe venlafaxine poisoning successfully rescued with veno-arterial extracorporeal membrane oxygenation: A case report.","authors":"Kurumi Mori, Yoshito Kamijo, Tomoki Doi, Hiroko Abe, Ichiro Takeuchi","doi":"10.12998/wjcc.v13.i33.113560","DOIUrl":"10.12998/wjcc.v13.i33.113560","url":null,"abstract":"<p><strong>Background: </strong>Venlafaxine, a serotonin-norepinephrine reuptake inhibitor, is widely prescribed for the treatment of major depressive disorder. At therapeutic dose, it is generally safe, with a low incidence of adverse effects. However, massive venlafaxine ingestion can cause serious cardiotoxicity, leading to life-threatening arrhythmias.</p><p><strong>Case summary: </strong>A 31-year-old woman with a history of depression ingested 14.8 g of venlafaxine along with 6 mg of estazolam and 6 mg of flunitrazepam. On admission, 2 hours post-ingestion, she presented only with mild QTc prolongation. At 4 hours post-ingestion, she developed a generalized tonic-clonic seizure. Following endotracheal intubation, intravenous midazolam infusion was initiated and 50 g of activated charcoal was administered <i>via</i> a nasogastric tube. At 15 hours post-ingestion, she developed ventricular tachycardia that rapidly progressed to refractory ventricular fibrillation, which was successfully treated with veno-arterial extracorporeal membrane oxygenation. Toxicological analysis revealed serum venlafaxine and O-desmethylvenlafaxine concentrations 17 µg/mL and 10 µg/mL, respectively, at 15 hours post-ingestion.</p><p><strong>Conclusion: </strong>In cases of massive venlafaxine ingestion, continuous intensive monitoring, particularly of QTc, is essential for at least 24 hours, even when initial clinical signs are mild. If refractory ventricular arrhythmias occur, prompt initiation of veno-arterial extracorporeal membrane oxygenation should be considered.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"113560"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701619","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":"When new therapies arrive, we should think more: The unseen challenges of immunotherapy-induced remodeling.","authors":"Rui Gang Wang","doi":"10.12998/wjcc.v13.i33.113216","DOIUrl":"10.12998/wjcc.v13.i33.113216","url":null,"abstract":"<p><p>The paradigm-shifting efficacy of immune checkpoint inhibitors in microsatellite instability-high colorectal cancer demands a critical appraisal of their long-term tissue effects. This editorial is a landmark case report revealing spontaneous colonic transection following pathological complete response to pembrolizumab - a first-in-medicine finding. Despite radiological resolution of disease, profound immune-mediated tissue remodeling resulted in catastrophic structural failure at the tumor site. This phenomenon exposes critical limitations in current imaging modalities to detect immunotherapy-induced bowel wall fragility and necessitates heightened awareness among surgeons. As immune checkpoint inhibitors move into neoadjuvant settings with rising complete response rates, we must reassess surgical planning, consider prophylactic interventions for high-risk anatomy, and develop biomarkers for tissue integrity. This case underscores that tumor regression does not equate to restored organ function, urging multidisciplinary vigilance against delayed structural toxicity.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"113216"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701960","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":"Lipoprotein (a) levels are elevated in psoriasis: An updated systematic review and meta-analysis.","authors":"Magdalini-Rigina Fragkouli, Anastasios Makris, Christina Mastori-Kourmpani, Nikos Karpettas, Georgios F Hadjigeorgiou, Constantinos Tsioutis, Theodosios D Filippatos, Aris P Agouridis","doi":"10.12998/wjcc.v13.i33.112045","DOIUrl":"10.12998/wjcc.v13.i33.112045","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic inflammatory condition related to an increased atherosclerotic cardiovascular disease (ASCVD) risk.</p><p><strong>Aim: </strong>To investigate whether lipoprotein (a) [Lp(a)] levels are increased in patients with psoriasis.</p><p><strong>Methods: </strong>A comprehensive literature search up to January 30, 2025 was conducted utilizing PubMed and Cochrane Library databases. A qualitative synthesis and a meta-analysis on Lp(a) mean differences (MD) between psoriasis cases and healthy controls (HC) was performed. The protocol of this meta-analysis has been registered to PROSPERO (No. CRD420250652465).</p><p><strong>Results: </strong>Eighteen studies with 1650 psoriasis patients and 1621 HC were eligible for qualitative synthesis. Pooled analysis from 16 studies (1401 psoriasis patients and 1320 HC) demonstrated that psoriasis patients had significantly higher Lp(a) levels compared with the HC group (MD: 6.72 mg/dL, 95%CI: 4.32-9.12, <i>P</i> < 0.00001, <i>I</i> ² = 71%). Sensitivity analyses according to the region of origin was also performed. The pooled analysis of the European sub-population showed a pronounced increase in Lp(a) levels in 189 patients with psoriasis <i>vs</i> 178 HC (MD: 15.86 mg/dL, 95%CI: 5.79-25.92, <i>P</i> < 0.002, <i>I</i> ² = 79%), while the pooled analysis on the Asian sub-population demonstrated a smaller but still significant difference in Lp(a) levels between 1177 psoriasis patients and 1127 HC (MD: 4.95 mg/dL, 95%CI: 2.99-6.92, <i>P</i> < 0.00001, <i>I</i> ² = 58%).</p><p><strong>Conclusion: </strong>Our findings suggest that Lp(a) levels are significantly elevated in psoriasis patients, further adding to their ASCVD risk.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"112045"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702117","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":"Gastric Crohn's disease presenting as a subepithelial tumor: A case report.","authors":"Yong Eun Park","doi":"10.12998/wjcc.v13.i33.113312","DOIUrl":"10.12998/wjcc.v13.i33.113312","url":null,"abstract":"<p><strong>Background: </strong>Submucosal tumors arise from the subepithelial layer anywhere along the gastrointestinal tract, most commonly in the stomach. A wide range of lesions, from benign to malignant, may present as gastric submucosal tumors. However, the gastric involvement of Crohn's disease (CD) is generally not considered in the differential diagnosis of such lesions.</p><p><strong>Case summary: </strong>A 23-year-old male patient presented with a gastric subepithelial tumor. The medical history included CD. Diagnostic workup revealed a 3-cm mucosal lesion with a central ulceration on the posterior wall of the distal antrum. The patient underwent laparoscopic wedge resection of stomach, and the postoperative course was uneventful. Histopathological analysis confirmed a diagnosis of gastric CD presenting as a subepithelial tumor.</p><p><strong>Conclusion: </strong>Despite its rarity, upper gastrointestinal CD can present as a gastric subepithelial tumor, warranting consideration in young patients with CD.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 33","pages":"113312"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12678960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702206","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":"Mesonephric-like adenocarcinoma presenting with malignant peritonitis and suspected to originate from the fallopian tube: A case report.","authors":"Shoko Sagawa, Fuminori Ito, Masahide Nakatani, Sonomi Kurose, Emiko Niiro, Makiko Taniguchi, Shinji Toyoda, Toshiyuki Sado, Kohei Morita","doi":"10.12998/wjcc.v13.i32.110813","DOIUrl":"10.12998/wjcc.v13.i32.110813","url":null,"abstract":"<p><strong>Background: </strong>Mesonephric-like adenocarcinoma (MLA) is a rare and highly malignant disease that occurs in the uterine body or ovaries. We report a case of a MLA that was considered to have originated in the fallopian tube and presented with malignant peritonitis.</p><p><strong>Case summary: </strong>A 57-year-old female presented with a chief complaint of abdominal pain that began 2 months prior. Cancerous peritonitis was suspected. During exploratory laparoscopy, the right fallopian tube was found to be enlarged, with widespread disseminated lesions extending from the pelvic cavity to the upper abdomen. Histopathological examination of the peritoneal tissue obtained by biopsy showed tumor cells with a high nuclear/cellular ratio and proliferation of papillary tubular to pedunculated solid nests. Immunohistochemical testing was positive for GATA-binding protein 3, thyroid transcription factor 1, cluster of differentiation 10, and paired box protein-8, and negative for estrogen receptor, Wilms' tumor 1, and wild-type p53, leading to the diagnosis of MLA. Subsequently, debulking surgery was performed, and no macroscopic residual tumors were identified. The pathological diagnosis was right tubal carcinoma, mesonephric adenocarcinoma (International Federation of Gynecology and Obstetrics stage IIIC), and pT3cNXM0. Adjuvant chemotherapy was administered postoperatively; however, recurrence was noted, and the patient died 1 year and 6 months after the initial treatment.</p><p><strong>Conclusion: </strong>MLA is a very rare disease with poor prognosis. Further studies are necessary to identify effective treatment options.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 32","pages":"110813"},"PeriodicalIF":1.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551147","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":"Early pleuroparenchymal fibroelastosis mimicking lung malignancy: A case report.","authors":"Hee Suk Jung, Hyun Jung Kim, Kwan Wook Kim","doi":"10.12998/wjcc.v13.i32.111879","DOIUrl":"10.12998/wjcc.v13.i32.111879","url":null,"abstract":"<p><strong>Background: </strong>Pleuroparenchymal fibroelastosis (PPFE) is a rare form of interstitial lung disease affecting the upper lobes. Its atypical radiological appearance frequently mimics lung malignancy, complicating early diagnosis. This case highlighted the importance of histopathological confirmation to differentiate PPFE from malignant lesions.</p><p><strong>Case summary: </strong>A 62-year-old male with a significant smoking history presented with progressive dyspnea and a chronic nonproductive cough. High-resolution computed tomography revealed a localized fibrotic lesion in the left upper lobe with apical pleural thickening and subpleural consolidation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed moderate hypermetabolism (maximum standardized uptake value of 3.2), potentially indicating malignancy. Pulmonary function testing was deferred due to concurrent pneumothorax. The patient underwent video-assisted thoracoscopic surgery with segmental lung resection and talc pleurodesis. Histopathology confirmed dense fibroelastosis with abundant elastin deposition, minimal inflammation, and no evidence of malignancy. Differential diagnoses, including apical cap, chronic hypersensitivity pneumonitis, granulomatous infections, and asbestos-related disease were systematically excluded. Therefore, he was diagnosed with PPFE. Antifibrotic therapy with nintedanib was initiated postoperatively. At the 26-month follow-up, imaging and pulmonary function testing demonstrated stable disease with no recurrence of pneumothorax or functional decline.</p><p><strong>Conclusion: </strong>Histopathology is essential for distinguishing PPFE from malignancy. Early diagnosis allows individualized therapy to slow progression.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 32","pages":"111879"},"PeriodicalIF":1.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551192","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":"Rethinking p16, p53, and HPV in HNCSCC through lessons from glioblastoma subclonal evolution toward patient-centric N-of-1 single-cell RNA sequencing paradigm.","authors":"Henry Michael Lee, Shengwen Calvin Li","doi":"10.12998/wjcc.v13.i32.104208","DOIUrl":"10.12998/wjcc.v13.i32.104208","url":null,"abstract":"<p><p>Head and neck cutaneous squamous cell carcinoma (HNCSCC) remains underexplored compared to oropharyngeal squamous cell carcinoma, particularly in relation to human papillomavirus (HPV) and molecular markers such as p16 and p53. While p16 is a well-established surrogate for HPV in oropharyngeal cancer, our review highlights its unreliable role in HNCSCC, where positivity is instead associated with recurrence and metastasis. Similarly, p53 illustrates a dual role - wild-type as a genomic safeguard, mutated as an oncogenic driver - complicating prognostication. Methodological considerations, including the limitations of immunohistochemistry for HPV detection, underscore the need for multi-method and molecular validation in future studies. Ultraviolet radiation is posited as a key modifier of p16 function, decoupling expression from tumor suppression. To contextualize these findings, we draw parallels to glioblastoma (GBM), where subclonal evolution, p53 dysfunction, and intratumoral heterogeneity drive relapse despite aggressive multimodal therapies. GBM exemplifies how bulk-level biomarker generalizations often obscure dynamic cellular ecosystems, reinforcing the necessity of single-cell and spatial approaches. Multi-omics integration - encompassing genome, transcriptome, proteome, and tumor microenvironment mapping - coupled with single-cell RNA sequencing and spatial transcriptomics, offers a path forward for resolving subclonal dynamics in both HNCSCC and GBM. These technologies provide the resolution needed to track tumor-immune-stromal co-evolution, identify therapy-resistant clones, and anticipate recurrence. We argue for a N-of-1, patient- and cell-centric paradigm that reframes biomarkers not as static surrogates but as dynamic readouts of cancer evolution across time and tissue contexts. Conceptually, we propose kinetic and microenvironmental frameworks (<i>e.g.</i>, \"load-and-lock\" barriers; dormancy and immune-synapse stabilization) as hypothesis-generating avenues to stall clonal handoffs and improve outcome prediction. Together, these perspectives argue for revised biomarker frameworks in HNCSCC and ethically inclusive, mechanism-anchored studies that bridge discovery with individualized care. By bridging insights from HNCSCC with the lessons of GBM, this review underscores the need for ethically inclusive, mechanistically informed frameworks that integrate subclonal evolution, biomarker re-interpretation, and precision-personalized hybrid models. Such an approach will be essential for advancing from one-size-fits-all strategies to individualized lifetime cancer care.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 32","pages":"104208"},"PeriodicalIF":1.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551316","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}