AME Case Reports最新文献

{"title":"A hepatic malignant spindle-cell neoplasm of uncertain lineage clinically favoring sarcomatoid hepatocellular carcinoma: a case report.","authors":"Haowen Li, Shengwei Li, Maohe Yu, Xin Wei, Hao Wang, Yuting Wang, Bo Liu, Lve Cheng","doi":"10.21037/acr-2026-0195","DOIUrl":"https://doi.org/10.21037/acr-2026-0195","url":null,"abstract":"<p><strong>Background: </strong>Sarcomatoid hepatocellular carcinoma (SHC) is an uncommon and aggressive variant of primary liver cancer. Its clinical and radiological features are often nonspecific, and it may mimic inflammatory liver lesions. Evidence for unresectable SHC is limited, so management is frequently individualized.</p><p><strong>Case description: </strong>A 43-year-old man with chronic hepatitis B presented with recurrent right upper abdominal discomfort and 3 kg weight loss over 1 month. He was provisionally diagnosed with a hepatic abscess at an outside hospital, and percutaneous aspiration and drainage were performed; however, microbiological confirmation and detailed treatment records were unavailable. On admission, he had no fever or jaundice. C-reactive protein (CRP) was elevated, procalcitonin (PCT) was low, serum alpha-fetoprotein (AFP) remained below 12 ng/mL, and liver function was child-pugh class A. Contrast-enhanced computed tomography (CT) showed multiple right hepatic lesions with suspected invasion of adjacent portal vein branches. Magnetic resonance imaging (MRI) demonstrated an irregular heterogeneous mass measuring approximately 88×85 mm. Because the clinicoradiological pattern was not fully consistent with simple infection, ultrasound-guided biopsy was performed. Biopsy revealed a hepatic malignant spindle-cell tumor. The initial pathological report noted limited tissue volume and atypical immunohistochemical expression, making definitive subclassification difficult. After integrated clinicopathological review, the lesion was interpreted as a malignant spindle-cell tumor clinically favoring SHC. The unresectable tumor was treated with transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC) with fluorouracil, leucovorin, and oxaliplatin (FOLFOX), lenvatinib 8 mg orally once daily, and tislelizumab 200 mg every 2 weeks. Adverse events were mainly nausea, vomiting, and right upper quadrant (RUQ) pain. Follow-up imaging showed reduction to approximately 70×58 mm and stable disease by response evaluation criteria in solid tumors (RECIST) 1.1.</p><p><strong>Conclusions: </strong>A hepatic malignant spindle-cell tumor clinically favoring SHC should be considered when a presumed liver abscess has atypical imaging findings, low infectious concordance, suspected vascular involvement, or poor diagnostic coherence. Early biopsy is critical. Multimodal therapy may be feasible in selected unresectable cases, but a single case cannot establish efficacy or define the contribution of each treatment component.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"214"},"PeriodicalIF":0.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete bilateral spontaneous pneumothorax as a sentinel event for Marfan syndrome.","authors":"Yosuke Kumaya, Yojiro Yutaka","doi":"10.21037/acr-2026-0208","DOIUrl":"https://doi.org/10.21037/acr-2026-0208","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"161"},"PeriodicalIF":0.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast reconstructive considerations in patients at increased risk for radiodermatitis: combined checkpoint inhibitor and PARP inhibitor therapy.","authors":"Arianna Sidoti, Joseph Mellia, Ron Shemtov, Jonas A Nelson","doi":"10.21037/acr-2026-0236","DOIUrl":"https://doi.org/10.21037/acr-2026-0236","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"165"},"PeriodicalIF":0.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of the inferior vena cava using the right ovarian vein following resection of renal cell carcinoma with tumor thrombus directly infiltrating the inferior vena cava: a case report.","authors":"Hongxing Luo, Minna Zhang, Qiang Li, Zhimin Tang, Haixing Lin","doi":"10.21037/acr-2026-0188","DOIUrl":"https://doi.org/10.21037/acr-2026-0188","url":null,"abstract":"<p><strong>Background: </strong>Per the 8th American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, renal cell carcinoma (RCC) with full-thickness inferior vena cava (IVC) wall invasion is staged T3c, which requires radical resection combined with venous reconstruction as the only curative treatment. Conventional synthetic vascular grafts carry prominent postoperative thrombotic risks, while reliable autologous venous alternatives specifically for female patients remain limited. This case presents an intraoperative attempt at IVC repair using fistula-dilated autologous right ovarian vein after en bloc excision of tumor and venous tumor thrombus (VTT).</p><p><strong>Case description: </strong>A 58-year-old postmenopausal woman presented with a 2-week palpable right upper abdominal mass. Preoperative imaging confirmed a 10 cm clear cell RCC complicated by level II IVC tumor thrombus and intratumoral arteriovenous fistula-induced ovarian vein dilatation. We performed en bloc resection of the tumor, thrombus and invaded IVC segment, then reconstructed the IVC with an autologous ovarian vein patch. Pathology verified R0-resected pT3cNXM0 International Society of Urological Pathology (ISUP) grade 3 RCC. Standard postoperative anticoagulation was administered. Over 2 years of surveillance, the patient remained free of venous congestion-related symptoms; however, severe imaging artifacts on all serial scans precluded objective evaluation of graft luminal patency, and high-grade IV stenosis or complete occlusion was strongly suspected. The absence of clinical swelling was attributed to compensatory dilatation of the left renal vein and mature systemic venous collateral circulation, which cannot be interpreted as evidence of unobstructed anatomical IVC lumen.</p><p><strong>Conclusions: </strong>Dilated autologous ovarian vein may serve as a graft-sparing patch material for IVC repair in highly selected female T3c RCC patients complicated by intratumoral arteriovenous fistula. Further clinical studies are needed to validate its value in patients without ovarian vein dilatation.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"213"},"PeriodicalIF":0.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges and multidisciplinary evaluation in giant non-pancreatic pseudocysts.","authors":"Yusuke Hashimoto","doi":"10.21037/acr-2026-0244","DOIUrl":"https://doi.org/10.21037/acr-2026-0244","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"164"},"PeriodicalIF":0.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete bilateral spontaneous pneumothorax at moderate altitude: emergency preparedness and diagnostic certainty beyond a rare case.","authors":"Ryusuke Sumiya, Mohamed Elbayomi","doi":"10.21037/acr-2026-0213","DOIUrl":"https://doi.org/10.21037/acr-2026-0213","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"159"},"PeriodicalIF":0.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond pneumothorax lies the real diagnosis.","authors":"Naoya Kitamura","doi":"10.21037/acr-2026-0211","DOIUrl":"https://doi.org/10.21037/acr-2026-0211","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"160"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking beyond the pneumothorax: lessons from a bilateral presentation of Marfan syndrome.","authors":"Teruaki Mizobuchi, Yuki Ito, Yuki Tada, Shiho Nishimura, Takaaki Kai","doi":"10.21037/acr-2026-0222","DOIUrl":"https://doi.org/10.21037/acr-2026-0222","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"163"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented temporary mechanical support in cardiogenic shock: do improved hemodynamics translate to recovery?","authors":"Nandini Nair, Dongping Du, Balakrishnan Mahesh","doi":"10.21037/acr-2026-0204","DOIUrl":"https://doi.org/10.21037/acr-2026-0204","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"158"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report of sequential, bilateral, robotic-assisted lung resections for severe bronchiectasis.","authors":"Alexander P Ganninger, Shadin Ghabra, Daniel M Goldstein, Shamus R Carr, Kevin P Fennelly","doi":"10.21037/acr-2025-336","DOIUrl":"https://doi.org/10.21037/acr-2025-336","url":null,"abstract":"<p><strong>Background: </strong>Resection of infected and destroyed lung tissue refractory to medical therapy can improve symptoms and prevent further spread in patients with bronchiectasis. However, bilateral resections are not recommended and recent guidelines state that surgery should only be considered for focal disease confined to a single lobe. When surgery is undertaken for bilateral disease, it is often performed months apart, risking spread of infection and requiring separate antibiotic courses.</p><p><strong>Case description: </strong>A patient with severe bronchiectasis and repeated isolation of <i>Pseudomonas</i>, <i>Stenotrophomonas</i>, and <i>Tsukamurella</i> on sputum cultures despite years of optimal medical therapy was referred to our multidisciplinary group. After one course of intensive, perioperative antimicrobials, the patient underwent sequential, robotic-assisted lobectomies-first of the right middle and then of the left lower lobe-separated by one week. She was discharged two days after each resection, and there were no complications.</p><p><strong>Conclusions: </strong>During close follow up over 38 months, her symptoms, pulmonary function, and microbiology testing have improved considerably. In select patients bilateral robotic-assisted resections performed within a week can be considered are part of the treatment paradigm of severe bronchiectasis when paired with an intense single course of appropriate antibiotics.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"212"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}