AME Case Reports最新文献

{"title":"ALK-rearranged lung adenocarcinoma transforming to mucoepidermoid carcinoma in a 45-year-old female: a case report.","authors":"Yachen Liu, Xi Liu, Hongmeng Ma, Wenxin Li","doi":"10.21037/acr-2026-0062","DOIUrl":"10.21037/acr-2026-0062","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucoepidermoid carcinoma (PMEC) accounts for less than 1% of pulmonary malignancies and is predominantly primary, exhibiting distinct clinical manifestations and treatment responses compared to lung adenocarcinoma (LUAD). Although the incidence of histological transformation from non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC) following tyrosine kinase inhibitor (TKI) therapy is approximately 3-14%, transformation from LUAD to PMEC is an extremely rare event. Currently, there is a lack of unified understanding and diagnostic/therapeutic guidelines concerning its mechanism, clinical features, treatment strategies, and prognosis. This article reports a case of HT from LUAD to PMEC following anaplastic lymphoma kinase (<i>ALK</i>)-TKI therapy, aiming to enhance clinicians' awareness of this rare condition and provide preliminary reference for the diagnosis and management of similar cases.</p><p><strong>Case description: </strong>This report describes a 45-year-old female patient who was admitted to the hospital with a chief complaint of \"persistent cough, sputum production, and dyspnea for 2 years, accompanied by chest tightness for 1 week\". She was diagnosed with <i>ALK</i> exon 20 mutation-positive left LUAD (cT1N1M1, stage IV). After 28 months of first-line <i>ALK</i>-TKI alectinib therapy, the patient experienced disease progression. Repeated pathological biopsy confirmed a transition from LUAD to PMEC, with persistent <i>ALK</i> mutation. Subsequent treatment included lorlatinib and third-line chemotherapy (pemetrexed/carboplatin regimen for four cycles), achieving acceptable disease control. The progression-free survival (PFS1) prior to transformation was 8 months, and the patient is currently receiving palliative care.</p><p><strong>Conclusions: </strong>Tumors that undergo LUAD-to-PMEC transformation after <i>ALK</i>-TKI therapy exhibit persistently low levels of <i>ALK</i> fusion and characteristic immunohistochemical alterations [deletion of thyroid transcription factor-1 (TTF-1)/Napsin A, upregulated expression of CK5/6/P40], along with inherent resistance to <i>ALK</i>-TKIs. When heterogeneous resistance emerges during TKI therapy, prompt repeat biopsy with concurrent pathological and next-generation sequencing (NGS) testing is recommended. If confirmed, immediate transition to phenotype-specific therapy should be initiated. Although this is a single-case observation requiring validation in larger cohorts, these findings provide preliminary guidance for clinical identification and management of such rare transformations.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"137"},"PeriodicalIF":0.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725955","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":"Carina™ modular robotic-assisted left lower lobectomy after neoadjuvant chemoimmunotherapy for stage IIIA squamous cell lung cancer: a case report.","authors":"Hao Chen, Hancheng Yin, Bin Zheng, Chi Xu, Chun Chen, Guobing Xu","doi":"10.21037/acr-2026-0009","DOIUrl":"10.21037/acr-2026-0009","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoimmunotherapy has become a standard approach for locally advanced non-small cell lung cancer (NSCLC), enhancing resectability. However, it also increases surgical complexity because of treatment-induced fibrosis-a challenge well addressed by robotic-assisted thoracic surgery (RATS). This report demonstrates the successful application of a modular robotic platform for post-neoadjuvant left lower lobectomy in a patient with stage IIIA squamous NSCLC, highlighting its precision and feasibility in complex oncologic resections.</p><p><strong>Case description: </strong>A 51-year-old man was diagnosed with squamous cell carcinoma of the left lower lobe (cT2aN2M0) and achieved a partial response following pembrolizumab plus chemotherapy. After completing neoadjuvant chemoimmunotherapy, robot-assisted left lower lobectomy with systematic lymph node dissection was performed using the Carina™ Modular Robotic System (Ronovo Surgical, Shanghai, China) because of anticipated pleural adhesions and the complex anatomical location of enlarged lymph nodes. The robotic platform demonstrated excellent outcomes: 20 mL blood loss, 5-minute docking time, and 141-minute console time. Intraoperatively, severe pleural adhesions were encountered but successfully managed with robotic assistance, enabling complete dissection and safe tumor resection. The patient recovered rapidly, with chest tube removal by postoperative day 5 and discharge on day 7. Pathology revealed a major pathological response (MPR) with negative bronchial margins.</p><p><strong>Conclusions: </strong>This case demonstrates the technical feasibility of the Carina™ system for complex post-neoadjuvant lobectomy in a patient with stage IIIA squamous NSCLC. Acceptable short-term perioperative outcomes were observed despite pleural adhesions and nodal complexity. Further experience and larger studies are needed to evaluate the potential role of this platform in thoracic surgery.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"136"},"PeriodicalIF":0.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727841","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":"Robot-assisted vesical neck h-shaped flap plasty for vesicourethral anastomotic stenosis: a case report.","authors":"Xingyuan Xiao, Kuibiao Wang, Qiuxuan Yu, Hang Yin, Mengxin Lu, Xincheng Gao, Bing Li","doi":"10.21037/acr-2026-0084","DOIUrl":"10.21037/acr-2026-0084","url":null,"abstract":"<p><strong>Background: </strong>Vesicourethral anastomotic stenosis (VUAS) is a challenging complication, occurring in 2%-7% of patients following radical prostatectomy. Endoscopic treatment fails in some patients, severely impairing their quality of life. Open reconstructive surgery is technically demanding with a long learning curve. Thus, to address a complication known as vesicourethral anastomotic stenosis following radical prostatectomy, we propose a new robot-assisted vesical neck H-shaped plasty.</p><p><strong>Case description: </strong>A 57-year-old patient with prostate cancer developed vesicourethral anastomotic stenosis (with a stenosis segment length of 2 cm) 4 months after laparoscopic radical prostatectomy. Following short-term recurrence of the condition after three transurethral incisions for VUAS, the patient received robot-assisted vesical neck H-shaped plasty for posterior urethral reconstruction. The surgical technique primarily involves constructing an H-shaped bladder flap, tubularizing it to reconstruct a funnel-shaped posterior urethra, performing a tension-free anastomosis between the vesical neck and the posterior urethra, and constructing a retrocurvature structure of the urethra. Treatment success was defined by both anatomical and functional criteria, unobstructed passage of a 17 Fr cystoscope or a urinary flow rate >15 mL/s. The patient in this study achieved adequate early urinary patency and no related complications.</p><p><strong>Conclusions: </strong>Based on short-term follow-up, robot-assisted vesical neck H-shaped flap plasty is feasible for vesicourethral anastomotic stenosis, but long-term follow-up is needed for verification.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"135"},"PeriodicalIF":0.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722315","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":"Staged transition from veno-arterial extracorporeal membrane oxygenation to left ventricular assist device using Extra-VAD in acute myocardial infarction cardiogenic shock: a case report of individualized management.","authors":"Lu Tong, Cheng Zhou, Ping Li, Nianguo Dong, Fei Li","doi":"10.21037/acr-2026-0127","DOIUrl":"10.21037/acr-2026-0127","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) and cardiogenic shock (CS) in patients requiring veno-arterial extracorporeal membrane oxygenation (V-A ECMO) are life-threatening, with extremely high mortality and complication rates due to hemodynamic instability and multiple organ dysfunction. A durable left ventricular assist device (LVAD) is a viable therapeutic option for these patients with severely impaired cardiac function who have failed attempts to wean from V-A ECMO. However, accurate assessment of right heart function during V-A ECMO and the complication rates associated with prolonged V-A ECMO support limit its long-term use. The MoyoAssist^® Extra-VAD enables preoperative assessment by simulating the hemodynamic profile of a permanent LVAD, thereby helping to avoid complications associated with prolonged V-A ECMO support, bridging therapy decision-making and mitigating the risk of postoperative right ventricular failure (RVF) after LVAD.</p><p><strong>Case description: </strong>A 58-year-old male was diagnosed with AMI accompanied by CS requiring V-A ECMO and intra-aortic balloon pump (IABP) assistance. Due to low left ventricular ejection fraction (LVEF) and difficulty in weaning from V-A ECMO, the patient was transferred to our hospital via ambulance on day 14 after V-A ECMO assistance. Despite optimization of medical therapy for heart failure following admission, ventricular function remained poor. Moreover, the IABP was removed on day 18 because of abdominal pain and marked leukocytosis. Over time, the sequelae of extended V-A ECMO support became apparent, characterized by systemic inflammation, impaired multi-organ perfusion, and the emergence of typical device-related complications. In response to this deterioration, an interventional Extra-VAD was implanted on day 19. Following several days of Extra-VAD support, despite improvement in general condition and organ function, left ventricular function remained poor. Thus, on day 25, our team proceeded with definitive LVAD implantation and removal of the Extra-VAD. The patient was discharged with LVAD support on postoperative day 38 and transitioned to outpatient follow-up care.</p><p><strong>Conclusions: </strong>This case demonstrates a staged bridging strategy from V‑A ECMO and Extra‑VAD to definitive LVAD therapy for acute circulatory failure. This approach achieves hemodynamic stability and organ protection in critically ill patients with shock and multi‑organ injury, provides a crucial time window for subsequent treatment, and underscores the value of a staged, minimally invasive, and individualized mechanical circulatory support strategy.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"134"},"PeriodicalIF":0.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726761","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":"Erratum: Immunoglobulin G4-related disease manifesting as a sino-orbital mass: a comprehensive case report and review of literature.","authors":"","doi":"10.21037/acr-20262-02","DOIUrl":"10.21037/acr-20262-02","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/acr-2025-148.].</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"124"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259849","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":"Avoiding pneumonectomy in chronic complete lung atelectasis: sleeve right upper lobectomy for right main bronchus obstruction-case report.","authors":"Lukadi Joseph Lula, Michel Pipo Tshiasuma, Irina Strambu, Alphonse Mosolo, Crispin Kasonga, Paul Kambala, Valentin Kazadi, Ciprian Bolca","doi":"10.21037/acr-2026-0026","DOIUrl":"10.21037/acr-2026-0026","url":null,"abstract":"<p><strong>Background: </strong>Complete lung atelectasis resulting from main bronchial obstruction may arise from both benign and malignant etiologies. Diagnosis is often delayed, particularly in younger patients, leading to prolonged lung collapse and compensatory hemidiaphragmatic elevation. Pneumonectomy is traditionally considered in such cases, lung-sparing resections should be preferred, especially in young individuals. The indication for sleeve resection in the setting of long-standing complete atelectasis remains controversial.</p><p><strong>Case description: </strong>We report the clinical presentation, surgical management, and outcomes of two patients with chronic dyspnea and presented with long-standing complete right lung atelectasis secondary to right main bronchus obstruction, treated with lung parenchyma-sparing procedures. A 30-year-old woman with post-tuberculosis bronchial stenosis (treated in 2018 at the Institute of Pneumonology \"Marius Nasta\", Bucharest) and a 34-year-old man with a typic endobronchial carcinoid tumor (treated in 2025 at the Centre Hospitalier Monkole, Kinshasa) were included. Both patients underwent right upper sleeve lobectomy by lateral thoracotomy. They were discharged on day 6, with an uneventful short- and long-term outcomes, including rapid improvement of pulmonary function.</p><p><strong>Conclusions: </strong>Even in cases of prolonged complete lung atelectasis due to main bronchial obstruction, lung-sparing resection is feasible and effective. It avoids pneumonectomy and is not associated with increased perioperative or long-term complications.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"119"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259831","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":"Mechanical thrombectomy for acute ischemic stroke secondary to left atrial myxoma combined with lower-extremity arterial embolism: a case report.","authors":"Mingzhu Feng, Wenjun Liang, Zile Yan, Songli Zhao, Jinmian Wu, Shuiquan Yang, Gan Chen","doi":"10.21037/acr-2026-0041","DOIUrl":"10.21037/acr-2026-0041","url":null,"abstract":"<p><strong>Background: </strong>Cardiac myxoma (CM) is the most common primary benign cardiac tumor and is a recognized cause of systemic embolism, particularly ischemic stroke. Although cerebral embolic events are relatively common in patients with CM, the simultaneous occurrence of intracranial and peripheral arterial embolism is exceedingly rare and poses substantial diagnostic and therapeutic challenges.</p><p><strong>Case description: </strong>A 43-year-old woman presented with sudden loss of consciousness and vomiting. Neurological examination revealed severe deficits, and imaging demonstrated acute infarctions involving the cerebellum and pons secondary to basilar artery occlusion. Because intravenous thrombolysis was contraindicated, emergency mechanical thrombectomy was performed, resulting in complete reperfusion. Following neurological improvement, further examination revealed acute ischemia of the left lower extremity. Vascular imaging confirmed multiple arterial occlusions involving the popliteal and tibial arteries, and successful reperfusion was achieved through a second thrombectomy procedure. Histopathological analysis of the retrieved embolic material demonstrated myxomatous tissue. Subsequent transthoracic echocardiography identified a mobile left atrial mass, and surgical resection was performed. Postoperative pathology confirmed the diagnosis of left atrial myxoma. The patient recovered well after multidisciplinary management and achieved complete neurological recovery without residual disability at the 3-month follow-up.</p><p><strong>Conclusions: </strong>CM can cause extensive and simultaneous embolization involving both cerebral and peripheral arterial circulations. In patients with CM-related stroke, clinicians should maintain a high index of suspicion for embolic events in other vascular territories and perform comprehensive vascular assessment when appropriate. Mechanical thrombectomy may represent an effective treatment strategy for selected patients, while timely surgical resection of the primary tumor is essential for preventing recurrent embolic events and improving clinical outcomes.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"117"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259771","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":"Fertility outcomes and management of long-term pubertal testosterone replacement sequelae in Oliver-McFarlane syndrome: a case report and literature review.","authors":"Shlomi Moshe, Yoram Dekel, Galia Oron, Maharan Kabha","doi":"10.21037/acr-2026-0024","DOIUrl":"10.21037/acr-2026-0024","url":null,"abstract":"<p><strong>Background: </strong>Oliver-McFarlane syndrome (OMCS) is an extremely rare autosomal recessive disorder caused by biallelic mutations in the <i>PNPLA6</i> gene, characterized by retinal dystrophy, trichomegaly, neurodevelopmental impairment, and combined pituitary hormone deficiencies. Hypogonadotropic hypogonadism (HH) is a frequent endocrine manifestation; however, the long-term reproductive consequences and fertility potential in affected males have not been previously described.</p><p><strong>Case description: </strong>We report the case of a 33-year-old man with genetically confirmed OMCS who presented with primary infertility and non-obstructive azoospermia following prolonged testosterone replacement therapy initiated in childhood for pubertal induction. The patient exhibited congenital HH, evidenced by micropenis in infancy, absent spontaneous puberty, persistently low gonadotropins, and severely reduced testicular volume. After discontinuation of exogenous testosterone, prolonged combined gonadotropin therapy with human chorionic gonadotropin and recombinant follicle-stimulating hormone resulted in partial testicular growth and biochemical response but failed to induce sperm in the ejaculate. Following nearly two years of optimized hormonal stimulation, microdissection testicular sperm extraction (micro-TESE) was performed, revealing focal spermatogenesis with successful retrieval and cryopreservation of motile spermatozoa for intracytoplasmic sperm injection.</p><p><strong>Conclusions: </strong>This case represents, to our knowledge, the first report of fertility management and successful surgical sperm retrieval in a male patient with OMCS. It highlights the potential reversibility of infertility in syndromic congenital HH and underscores the critical impact of pubertal management strategies on long-term reproductive outcomes. Early consideration of gonadotropin-based therapy, multidisciplinary follow-up, and fertility-preserving approaches may be essential to optimize future reproductive potential in patients with OMCS and related disorders.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"116"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259807","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 the evolving landscape of tinea infections.","authors":"Jeremy A W Gold, Shari R Lipner","doi":"10.21037/acr-2026-0064","DOIUrl":"10.21037/acr-2026-0064","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"80"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259789","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":"Atrial septal defect assessment: challenges of 4D cardiac computed tomography.","authors":"Aeos Gaea Baldevia, Douglas Corsi, Yasmin S Hamirani","doi":"10.21037/acr-2026-0073","DOIUrl":"10.21037/acr-2026-0073","url":null,"abstract":"","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"83"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259776","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}