American Journal of Case Reports最新文献

{"title":"Accelerated Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome in Response to TMP-SMX: A Case Report.","authors":"Emily J Sanchez, Elizabeth A Cheiky","doi":"10.12659/AJCR.948217","DOIUrl":"https://doi.org/10.12659/AJCR.948217","url":null,"abstract":"<p><p>BACKGROUND Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and severe hypersensitivity reaction triggered by medications, characterized by fever, rash, eosinophilia, and multi-organ involvement. While DRESS shares features with Stevens-Johnson syndrome (SJS) and fixed-drug eruption, distinguishing factors such as organ involvement, absence of mucosal lesions, and extended latency periods complicate its diagnosis. This case report aims to highlight an unusual presentation of DRESS to contribute to the growing understanding of its diagnostic and management challenges. CASE REPORT We present the case of a 25-year-old woman with DRESS attributed to trimethoprim-sulfamethoxazole (TMP-SMX) for acute pyelonephritis. Symptoms, including fever, diffuse maculopapular rash, facial edema, and lymphadenopathy, began within 6 days of drug exposure, deviating significantly from the typical 2- to 8-week latency period. Differential diagnoses, such as Stevens-Johnson syndrome and fixed-drug eruption, delayed the recognition of DRESS. A calculated RegiSCAR score of 5 indicated a probable case. Management included discontinuation of TMP-SMX, initiation of systemic corticosteroids, and supportive care. The patient experienced rapid symptom resolution without relapse, demonstrating a favorable outcome despite atypical features. CONCLUSIONS This case underscores the diagnostic complexities of DRESS, particularly in distinguishing it from other severe cutaneous drug reactions and managing atypical presentations with multiple drug exposures. It emphasizes the importance of early identification, timely cessation of the offending agent, and individualized treatment strategies. Further investigation into the role of concurrent antibiotic use in accelerating DRESS onset and exacerbating severity is warranted to enhance clinical understanding and improve patient outcomes.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948217"},"PeriodicalIF":1.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Urinary Tract Infection by Rodentibacter pneumotropicus (formerly, Pasteurella pneumotropica) in an Immunocompetent Patient.","authors":"Elena Soto-Vega, Elizabeth Bello-Rossette, María Del Carmen Cabrera-Martínez, José Carlos Arroyo Kuribreña","doi":"10.12659/AJCR.947344","DOIUrl":"https://doi.org/10.12659/AJCR.947344","url":null,"abstract":"<p><p>BACKGROUND Pasteurella pneumotropica has been reclassified as Rodentibacter pneumotropicus after advancements in genetic and phenotypic analyses revealed genetic diversity and phylogenetic distinctions within the pneumotropica complex. This reorganization resolved issues of misclassification and provided a clearer framework for understanding the epidemiology and clinical relevance of these organisms. R. pneumotropicus is a gram-negative bacillus commonly found in the respiratory tracts of mammals, particularly rodents. However, it rarely infects humans. This case is notable for presenting a urinary tract infection caused by R. pneumotropicus in an immunocompetent patient, a rare manifestation highlighting the need to consider less-common pathogens in daily clinical practice to choose the correct treatments. CASE REPORT This case describes a 37-year-old immunocompetent man who initially presented to a hospital in Mexico with gastrointestinal symptoms and later developed urinary issues following a ureteroscopy for a proximal ureteral stone. Despite initial treatment with meropenem and paracetamol, the patient had persistent fever and leukocytosis. According to the available material at the hospital, a urine culture was done subsequently and it revealed R. pneumotropicus, formerly known as Pasteurella pneumotropica, which was sensitive to fluoroquinolones. The patient underwent transurethral resection of the prostate and was treated with ciprofloxacin, leading to successful symptom resolution. CONCLUSIONS This case highlights the rarity of urinary tract infections caused by R. pneumotropicus in immunocompetent individuals. These findings underscore the importance of considering uncommon microorganisms in differential diagnoses and ensuring precise identification and sensitivity testing to guide effective treatment. Also, it provides evidence supporting the ability of R. pneumotropicus to infect immunocompetent individuals, raising several questions related to its infection mechanisms.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947344"},"PeriodicalIF":1.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Coronary Artery Dissection in a Young Man: A Case Report and Literature Review.","authors":"Ashot Batikyan, Pavel Abalyan, Hakob Harutyunyan, Aleksan Khachatryan, Vahagn Tamazyan, Pawel Borkowski, Shiny Teja Kolli","doi":"10.12659/AJCR.947717","DOIUrl":"https://doi.org/10.12659/AJCR.947717","url":null,"abstract":"<p><p>BACKGROUND Spontaneous coronary artery dissection is a rare and underdiagnosed cause of acute coronary syndrome, primarily affecting women. The occurrence of spontaneous coronary artery dissection in the context of the absence of traditional atherosclerotic risk factors raises questions about the role of physical exertion or other stressors as potential triggers. Early recognition through clinical assessment and imaging is essential, as the therapeutic approach for spontaneous coronary artery dissection differs significantly from the treatment of traditional atherosclerotic acute coronary syndrome. Conservative management is often preferred for hemodynamically stable patients because interventional procedures have increased prevalence of complications in these patients. CASE REPORT This case report highlights an uncommon presentation of spontaneous coronary artery dissection in a 28-year-old man who presented with non-ST-elevation myocardial infarction following physical exertion. The diagnosis of spontaneous coronary artery dissection was confirmed via coronary angiography, revealing the classic findings of dissection without significant atherosclerosis. Management was conservative, as the patient was hemodynamically stable, with close monitoring and medical therapy, including antiplatelet agents and beta-blockers. CONCLUSIONS This case challenges the prevailing gender assumptions associated with spontaneous coronary artery dissection and highlights the need for increased awareness of spontaneous coronary artery dissection in males. Additionally, it suggests the potential role of physical stressors in precipitating spontaneous coronary artery dissection. Further research into the pathophysiology of spontaneous coronary artery dissection in different populations is warranted.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947717"},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aripiprazole Treatment in Delusional Infestation: Resolving Atypical Presentations of Body Fluid Leakage.","authors":"Ipek Özönder Ünal, Muazzez Çiğdem Oba","doi":"10.12659/AJCR.948375","DOIUrl":"https://doi.org/10.12659/AJCR.948375","url":null,"abstract":"<p><p>BACKGROUND Delusional infestation is a rare psychiatric disorder characterized by the fixed belief of being infested with parasites or other unseen organisms. Atypical presentations, such as delusions of infectious body fluid leakage, can pose diagnostic challenges. This report describes 2 cases of women with such atypical delusions, highlighting the importance of recognizing this unusual manifestation of delusional infestation. CASE REPORT Two women, ages 57 and 41 years, presented with persistent skin lesions and intense itching, initially misdiagnosed as dermatological conditions. Detailed psychiatric interviews revealed unusual delusions of infectious body fluid leakage related to their skin. Both patients had consulted multiple specialists and received various treatments without improvement. Following a diagnosis of primary delusional infestation, both were treated with aripiprazole, resulting in significant symptom improvement and resolution of skin lesions. CONCLUSIONS These cases underscore the importance of recognizing atypical presentations of delusional infestation, including delusions of infectious body fluid leakage. The diagnosis relies on the exclusion of secondary causes of delusional infestation, such as other medical, neurological, and psychiatric conditions, along with a multidisciplinary approach among psychiatrists and dermatologists. The role of the histopathology among investigations of delusional infestation is very limited. A high index of suspicion and thorough psychiatric evaluation are crucial in cases of refractory dermatological symptoms, to ensure timely diagnosis and appropriate treatment, preventing prolonged suffering and unnecessary healthcare utilization.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948375"},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Pediatric Orthopedic Surgery: 3D Calcium-Density Models for Humerus Deformity.","authors":"Javier Gutierrez-Pereira, Eva Vera-Gimenez, Alejandro Madrigal-Quevedo, Antonio Garcia-Lopez","doi":"10.12659/AJCR.947299","DOIUrl":"https://doi.org/10.12659/AJCR.947299","url":null,"abstract":"<p><p>BACKGROUND Preoperative planning is crucial for orthopedic interventions, particularly in the correction of severe deformities. Correct implant selection, positioning, and osteotomy planning are essential to achieving optimal surgical outcomes. Recent advancements in 3D printing technology, including the development of calcium-density models, have enhanced visualization and surgical precision. This case study demonstrates the application of this innovative approach in managing a complex proximal humerus deformity in a pediatric patient. CASE REPORT We describe the case of an 8-year-old girl with a severe proximal humerus varus deformity secondary to epiphysiolysis. Her condition was characterized by a cervico-diaphyseal angle of 68° and limited shoulder abduction to 60°. A 3D calcium-density model was employed for meticulous preoperative planning, enabling precise assessment of the deformity, optimization of implant positioning, and accurate osteotomy execution. The surgical procedure consisted of a 15-mm wedge valgus osteotomy using an iliac crest graft and fixation with a PediLoc® plate. This approach achieved a correction of the cervico-diaphyseal angle to 140°, restored shoulder abduction to 180°, and limited the overall surgical time to 2 hours. CONCLUSIONS The use of 3D printing with calcium carbonate-enhanced polylactic acid (PLA) provided superior visualization, radiographic assessment capabilities, and preoperative plate contouring, enhancing surgical efficiency and improving clinical outcomes. The radiopaque properties of the material facilitated intraoperative radiological verification, ensuring precision and safety. This case underscores the potential of this technology to streamline complex pediatric orthopedic surgeries, minimize intraoperative challenges, and improving patient outcomes. Further research is warranted to validate its broader application in orthopedic practice.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947299"},"PeriodicalIF":1.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Bleeding in Hereditary Hemorrhagic Telangiectasia Accompanied with Very Severe Thrombocytopenia.","authors":"Yanbin Wei, Chuyan Chen, Peng Li, Dayong Huang, Xin Yao","doi":"10.12659/AJCR.948068","DOIUrl":"https://doi.org/10.12659/AJCR.948068","url":null,"abstract":"<p><p>BACKGROUND Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal-dominant disorder characterized by recurrent epistaxis and gastrointestinal bleeding (GIB). To our knowledge, the management of GIB in HHT patients accompanied with very severe thrombocytopenia has not been previously reported. CASE REPORT A 66-year-old woman with HHT who experienced recurrent epistaxis for over 5 years was admitted to the hospital due to intermittent hematemesis and melena for 2 weeks. Following admission, her platelet count dropped significantly to 1×10⁹/L. Following supportive treatments, a gastroscopy was performed when the platelet count reached 23×10⁹/L. The gastroscopy revealed over 50 angioectatic spots with active bleeding. These spots were treated by argon plasma coagulation and the bleeding was stopped. She had a favorable prognosis following discharge. CONCLUSIONS This case highlights the rare coexistence of HHT, GIB, and very severe thrombocytopenia, offering insights into proton pump inhibitor (PPI)-induced thrombocytopenia. Immediate discontinuation of the involved PPI is advised. Platelet transfusion (<20×109/L) combined with recombinant human interleukin-11 is recommended for patients at risk of GIB. If PPI therapy is necessary, it is a novel and effective strategy to switch to another PPI with a different chemical structure, accompanied by close platelet monitoring.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948068"},"PeriodicalIF":1.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertrichosis Induced by Minoxidil: A Case of Systemic Absorption from Scalp Occlusion.","authors":"Marwa Majzoub, Vivien Moris","doi":"10.12659/AJCR.947664","DOIUrl":"10.12659/AJCR.947664","url":null,"abstract":"<p><p>BACKGROUND Minoxidil is a widely used topical treatment for hair loss, but improper use can lead to systemic absorption and unintended adverse effects such as hypertrichosis. Identifying risk factors for increased absorption is crucial to prevent adverse reactions. CASE REPORT We report the case of a 28-year-old woman with androgenetic and traction alopecia, treated with 5% minoxidil spray twice daily, platelet-rich plasma (PRP) therapy, and LED treatment. After 2 months, she experienced significant hair regrowth but also developed excessive hair growth on her face, arms, and legs, along with morning periorbital swelling. Further investigation revealed that she wore a wig during the day and a tight night cap, creating continuous scalp occlusion, which likely increased systemic absorption of minoxidil. Given these findings, minoxidil was discontinued, and the patient underwent laser hair removal, with a gradual resolution of hypertrichosis. CONCLUSIONS This case underscores the importance of proper patient education regarding minoxidil application techniques to prevent excessive systemic absorption and hypertrichosis. Patients should be advised to avoid excessive application, prolonged occlusion, and high doses, as these factors may elevate the risk of systemic effects. Clinicians should consider scalp occlusion as a potential contributor to hypertrichosis in patients using topical minoxidil. Further studies are warranted to investigate the role of absorption-enhancing factors in minoxidil-related adverse effects.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947664"},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Retrieval of Migrated Coil Tangle in Femoral Artery Following Aneurysm Embolization: A Case Report.","authors":"Alberto Stagno, Salvatore Silipigni, Antonella Cinquegrani, Mariano Velo, Giuseppe Cicero, Carmela Visalli, Sergio Lucio Vinci, Antonio Bottari, Agostino Tessitore","doi":"10.12659/AJCR.947613","DOIUrl":"10.12659/AJCR.947613","url":null,"abstract":"<p><p>BACKGROUND Stretching of embolization coils is a known complication of embolization procedures with potential outcomes including thrombosis, embolism, or vascular occlusion. This unpredictable event occurs in 0.5% to 6% of cases and can be asymptomatic or clinically significant, especially if associated with thrombosis. CASE REPORT We describe a case involving a stretched and unraveled embolization coil that migrated from its original placement site in the middle right cerebral artery to the common femoral artery. The coil formed a tangle and became symptomatic following cerebral artery aneurysm repair. The migrated coil was identified using ultrasound and confirmed with unenhanced computed tomography. Various techniques are available to manage stretched coils, depending on the location of dislocation and the associated risks of thrombosis or bleeding. To prevent femoral axis thrombosis in this case, we opted to retrieve the migrated coil and secure it outside the vessel lumen. The procedure involved accessing the superficial femoral artery, advancing a vascular introducer sheath to the coil tangle, and using a snare-type retrieval system to capture the coil within the introducer. The coil was then cut and implanted into the subcutaneous fat outside the artery. The procedure was successfully completed without complications. CONCLUSIONS This case highlights the importance of prompt detection and management of embolization coil complications to prevent serious consequences such as thrombosis or vascular occlusion. Advanced imaging techniques, coupled with endovascular retrieval strategies, can ensure successful outcomes with minimal risks for the patient. The approach described here demonstrates an effective and safe solution for managing migrated and stretched embolization coils.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947613"},"PeriodicalIF":1.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250120","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":"A 29-Year-Old Man with Uncorrected Congenital Patent Ductus Arteriosus Presenting with Heart Failure and Pulmonary Artery Vegetations Removed During Surgery: A Case Report.","authors":"Charlotte Johanna Cool, Iwan Cahyo Santosa Putra, William Kamarullah, Norman Sukmadi, Miftah Pramudyo, Triwedya Indra Dewi, Pradana Pratomo Raharjo","doi":"10.12659/AJCR.947505","DOIUrl":"10.12659/AJCR.947505","url":null,"abstract":"<p><p>BACKGROUND Infective endocarditis (IE) involving isolated vegetations in the pulmonary artery is an exceedingly rare clinical entity. The absence of standardized guidelines regarding management and timing of intervention further complicates treatment decisions. This report describes the case of a 29-year-old man with uncorrected congenital patent ductus arteriosus (PDA) presenting with heart failure and pulmonary artery vegetations removed during PDA surgical ligation. CASE REPORT A 29-year-old man with a history of undiagnosed, untreated congenital heart disease presented with worsening symptoms of heart failure. Initial management included diuretic and empirical antibiotic therapy. Echocardiography and cardiac computed tomography revealed a large type C PDA with an 8.9 mm diameter, with multiple mobile vegetations in the pulmonary artery. Inflammatory markers and infection indicators showed significant improvement within 48 hours. On day 3, the patient underwent surgical evacuation of the pulmonary artery vegetations and PDA ligation. The surgery was successful, and vegetation cultures were negative, confirming blood culture-negative infective endocarditis. Given the potential for other difficult-to-culture bacterial infections, antibiotics were continued until 10 days postoperatively. The patient was discharged on day 10 in stable condition. Follow-up echocardiography showed significant improvement with reverse remodelling. CONCLUSIONS This case underscores the importance of aggressive surgical intervention for the removal of pulmonary artery vegetations, irrespective of their size, in reducing the risk of acute pulmonary embolism. The approach was safe, and no significant post-procedure adverse outcomes were noted, offering valuable insights into the management of IE with PDA and pulmonary artery involvement.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947505"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250084","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":"Efficacy of Hepatic Artery Infusion Chemotherapy with Bevacizumab and Sintilimab in Advanced Hepatocellular Carcinoma: A Case Report.","authors":"Chenguang Hua, Shanhe Huang, Bo Ding, Junru Chen, Chaofeng Ding","doi":"10.12659/AJCR.947317","DOIUrl":"10.12659/AJCR.947317","url":null,"abstract":"<p><p>BACKGROUND Hepatocellular carcinoma (HCC) with vascular invasion at advanced stage is not indicated for surgical options. Conversion therapy is used for unresectable HCC to downstage. Chemotherapy can be more precisely targeted to HCC by using hepatic artery infusion. Bevacizumab and sintilimab are available systemic therapies for HCC. This report describes a 50-year-old man with advanced HCC associated with multiple venous tumor thromboses treated with hepatic artery infusion chemotherapy (HAIC) combined with bevacizumab and sintilimab conversion therapy. CASE REPORT A 50-year-old man was admitted to the hospital due to elevated alpha-fetoprotein (AFP) level in July 2022. Abdominal computed tomography angiography (CTA) revealed a large HCC with multiple venous tumor thromboses. Pulmonary CTA detected arterial embolism and multiple solid nodules. He received HAIC combined with bevacizumab and sintilimab every 3 weeks, and achieved partial response after 3 cycles. However, in March 2023, levels of AFP and protein induced by vitamin K absence-II (PIVKA-II) were re-elevated, showing some pulmonary nodules were enlarged, which was confirmed as pulmonary metastases by positron emission tomography/computed tomography (PET/CT). Subsequently, transarterial chemoembolization (TACE) with bevacizumab and sintilimab was performed, and stereotactic body radiation therapy (SBRT) was used to treat pulmonary metastases. Skull metastasis appeared in March 2024, requiring further local radiotherapy. Despite this, the patient has survived for over 26 months, with a progression-free survival (PFS) of 8 months. CONCLUSIONS HAIC combined with bevacizumab and sintilimab can alleviate primary HCC and tumor thromboses, and further local radiotherapy can control the progression of distant metastases, prolonging the survival time of patients with advanced HCC.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947317"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250086","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}