American Journal of Case Reports最新文献

{"title":"Hybrid Repair of Ascending Aortic Intramural Hematoma and Arch Ulcer in a 74-Year-Old Woman - A Case Report.","authors":"Zhiqin Lin, Yi Chen, Xiaofu Dai, Liangwan Chen, Heng Lu","doi":"10.12659/AJCR.946212","DOIUrl":"https://doi.org/10.12659/AJCR.946212","url":null,"abstract":"<p><p>BACKGROUND Acute intramural hematoma (IMH) of the ascending thoracic aorta and aortic arch is a life-threatening condition, particularly in elderly patients with comorbidities, due to its risk of progression and rupture. Unlike aortic dissection, IMH lacks an intimal tear, influencing both clinical presentation and treatment strategy. This report describes a 74-year-old hypertensive woman with type A IMH and a penetrating atherosclerotic ulcer (PAU), managed with a hybrid surgical approach that combines external Dacron wrapping of the ascending aorta and endovascular stenting of the aortic arch with in-situ fenestration of the supra-aortic arteries. CASE REPORT A 74-year-old woman with a history of hypertension, insulin-dependent diabetes, chronic kidney disease, coronary artery disease, and extracardiac arteriopathy presented with chest pain and was diagnosed with type A IMH. Cardiac assessment showed a moderate left ventricular ejection fraction (45%) and New York Heart Association class III functional status, indicating high surgical risk (EuroSCORE II: 11.66). A hybrid approach was chosen, involving Dacron wrapping of the ascending aorta to reduce its diameter, followed by endovascular stent grafting of the aortic arch with in-situ fenestration to preserve supra-aortic branch blood flow. The patient recovered without complications, and 5-month follow-up imaging confirmed stable stent position, PAU exclusion, and preserved branch patency. CONCLUSIONS This case illustrates the feasibility and safety of combining off-pump external wrapping of the ascending aorta with endovascular stent grafting using in-situ fenestration, offering a promising, less-invasive alternative for high-risk patients with favorable short-term outcomes.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946212"},"PeriodicalIF":1.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972547","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":"Cowden Syndrome and Oral Lesions: A Case Report Using MLPA.","authors":"Mariana Cristina Barrón-Márquez, Rogelio González-González, Lucina Bobadilla-Morales, Victor Ulises Rodriguez-Machuca, Ronell Bologna-Molina, Nelly Molina-Frechero, Omar Alejandro Tremillo-Maldonado, Sandra López-Verdín","doi":"10.12659/AJCR.945876","DOIUrl":"https://doi.org/10.12659/AJCR.945876","url":null,"abstract":"<p><p>BACKGROUND Cowden syndrome is a genetic disorder that predisposes individuals to cancer and is characterized by hamartomas derived from 3 germ layers. Although the clinical signs can be pathognomonic, diagnosis is often aided by biopsies, histopathological examination of oral and cutaneous lesions, and genetic studies, including multiple ligation-dependent probe amplification (MLPA). CASE REPORT We report a case of a 35-year-old woman who manifested with multiple lesions in the buccal mucosa, dorsum of the tongue, and gums, along with papillomatous papules on her facial skin and the dorsal surfaces of her hands. These lesions were identified as hamartomas. Laboratory tests, including blood biometry, blood chemistry, and coagulation profiles, returned results within normal ranges. Her medical history revealed uterine fibroids, raising suspicion of Cowden syndrome. A genetic consultation confirmed the diagnosis, revealing a heterozygous PTEN deletion. CONCLUSIONS This case illustrates the importance of a multidisciplinary approach in diagnosing Cowden syndrome, especially the role of dental professionals in recognizing early clinical signs. Early diagnosis through genetic testing is crucial due to the patient's elevated risk of malignancies. Healthcare providers must remain vigilant to syndromes such as Cowden syndrome, particularly in patients with relevant family histories, to ensure timely intervention and comprehensive management.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945876"},"PeriodicalIF":1.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972546","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 Enterohepatic Fistula in Crohn's Disease: Case Analysis and Literature Synthesis.","authors":"Aline Misar, Alexis Litchinko, Florence Bloget, Michael John Chilcott, Bernhard Egger","doi":"10.12659/AJCR.945701","DOIUrl":"https://doi.org/10.12659/AJCR.945701","url":null,"abstract":"<p><p>BACKGROUND Crohn disease is a chronic inflammatory bowel disease known for causing fistulous tracts, abscesses, and bowel perforation. Enterohepatic fistulas, a rare but significant complication, are scarcely reported. This article presents the case of a hepatic abscess due to an enterohepatic fistula in a patient with long-term Crohn disease and reviews the existing literature on this phenomenon. CASE REPORT A 59-year-old female patient with a known history of Crohn disease and previous ileocolic resection due to enteroenteric fistulas presented to our Emergency Department with right-sided abdominal pain persisting for 10 days. Diagnostic investigations, including imaging, revealed an enterohepatic fistula with a 3-4 cm hepatic abscess in segment V of the liver. Initial management involved conservative treatment with radiological drainage and antibiotics, leading to the patient's discharge. An elective laparotomy was scheduled 1 month later. The patient underwent resection of the ileocolic anastomosis with ileotransverse re-anastomosis and catheter removal. Postoperative management included treatment for paralytic ileus. She was discharged in good condition on postoperative day 11. CONCLUSIONS This report highlights the range of complications that can occur in patients with Crohn disease and presents the rare association between Crohn disease and enterohepatic fistula and abscess formation. Only 2 other case reports of enterohepatic fistula due to Crohn disease exist in the literature. Given the scarcity of evidence, no standardized guidelines are available, necessitating an individualized treatment approach. Initial conservative management can be effective; however, close monitoring is crucial to determine the need for subsequent surgical intervention.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945701"},"PeriodicalIF":1.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967231","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":"Efficacy of Combined PD-1 Inhibitor and Bevacizumab in Unresectable Liver Metastasis of MSI-H Colorectal Cancer: A Case Report.","authors":"Qifan Wang, Jie Zhong, Yi Wang, Jun Bao, Sheng Li, Liu Yang","doi":"10.12659/AJCR.946757","DOIUrl":"https://doi.org/10.12659/AJCR.946757","url":null,"abstract":"<p><p>BACKGROUND Programmed death 1 (PD-1) inhibitors have demonstrated limited effectiveness in patients with microsatellite instability-high (MSI-H) colorectal cancer (CRC). Recent studies suggest that their efficacy can be enhanced when combined with anti-angiogenic agents. CASE REPORT We present a case of a 25-year-old woman with CRC harboring a KRAS mutation and MSI-H status, along with initially unresectable liver metastases. Despite receiving first-line chemotherapy combined with bevacizumab, her disease progressed. Subsequently, she was treated with a combination of a PD-1 inhibitor and bevacizumab as second-line therapy. This approach resulted in a partial response, ultimately leading to a pathological complete response after resection of the liver metastases. The patient continued with the combination therapy for over a year and showed no serious treatment-related adverse events. Postoperative follow-up imaging confirmed the absence of tumor recurrence or metastasis, and the patient remained in remission. CONCLUSIONS This case highlights the potential of combining immune checkpoint inhibitors with anti-angiogenic agents in treating patients with MSI-H metastatic CRC, particularly those with initially unresectable liver metastases. Although further research is warranted to validate this therapeutic strategy, our findings support the use of this combination as a viable option for achieving pathological complete response and improving outcomes in this patient population. Comprehensive clinical studies are needed to optimize conversion therapy regimens and enhance the likelihood of success in treating patients with MSI-H CRC with advanced disease.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946757"},"PeriodicalIF":1.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956432","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":"Pregnancy Complicated by Rapidly Progressing Vulvar Melanoma: A Case Study.","authors":"Bagas Satriyo Wicaksono, Aditiyono Aditiyono, Dina Marlina, Aditya Utomo, Putri Nadhira Adinda Adriansyah, Dody Novrial","doi":"10.12659/AJCR.944972","DOIUrl":"https://doi.org/10.12659/AJCR.944972","url":null,"abstract":"<p><p>BACKGROUND Vulvar melanoma during pregnancy is exceptionally rare. Hormonal and immunological changes in pregnancy have raised concerns about the potential for accelerated melanoma progression and poorer maternal outcomes. This case report describes an unusual presentation of vulvar melanoma in a pregnant patient, which rapidly progressed despite previous treatments, but resulted in a favorable fetal outcome. CASE REPORT A 40-year-old G3P2A0 woman at 28 weeks of gestation, with a history of vulvar malignant melanoma diagnosed 3 years prior, presented with sudden abdominal pain and hematuria. She had previously received 6 courses of chemotherapy. Physical examination revealed a 3-cm mass in the right vulva, while ultrasonography detected a hyperechoic solid mass in the cervix and elevated LDH levels. Given the advanced disease, the medical team proceeded with a cesarean hysterectomy, colpotomy for uterine corpus involvement, and bladder repair due to an iatrogenic laceration. Histopathological findings confirmed metastatic vulvar melanoma in the cervix and uterine corpus. The pregnancy was terminated at 27 weeks due to the progression of grade IV melanoma, but the neonate was delivered in stable condition. Unfortunately, the patient died 1 month after the operation. CONCLUSIONS This case underscores the potential for aggressive melanoma progression during pregnancy, likely exacerbated by physiological changes, yet highlights a successful fetal outcome. While chemotherapy can adversely affect the reproductive system and may lead to infertility, this patient was able to conceive, and the case illustrates the complex interplay of pregnancy and cancer progression.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e944972"},"PeriodicalIF":1.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962337","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 Coronary Artery Anomaly: Single Coronary Artery from Distal Circumflex Detected by CT.","authors":"Waly Niang Mboup, Jean-Francois Riviere","doi":"10.12659/AJCR.946330","DOIUrl":"https://doi.org/10.12659/AJCR.946330","url":null,"abstract":"<p><p>BACKGROUND A single coronary artery is a rare congenital anomaly of the coronary arteries distribution, with an incidence of only 0.03% in the general population undergoing coronary angiography. RCA arising from the distal circumflex artery is an extremely rare variety. CASE REPORT We report the case of a 63-year-old man who was admitted in our hospital after an inconclusive treadmill stress test. He had no cardiovascular risk factors. He was initially evaluated for palpitations. A subsequent Holter monitor showed monomorphic premature ventricular beats. His coronary artery disease (CAD) pre-test probability was low. Non-invasive exploration with 64-detector-row multi-slice computed tomography (MSCT) was performed to visualize the coronary arteries. It showed a single left coronary artery (LCA) with no significant stenosis. There was no artery emerging from the right sinus of Valsalva. The right coronary artery (RCA) had an abnormal origin, arising from the distal circumflex artery. The patient remained asymptomatic. CONCLUSIONS This case report describes an accidental discovery of an unusual variety of single coronary artery. Computed tomography angiography, very useful in patients with low pre-test probability of coronary artery disease, showed a right coronary artery from the distal circumflex artery.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946330"},"PeriodicalIF":1.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956242","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":"Primary Cardiac Myxofibrosarcoma of the Left Atrium with Heterologous Elements Mimicking a Cardiac Myxoma.","authors":"Rosario Del Carmen Medellin-Vallejo, Álvaro Barbosa-Quintana, Valeria Caballero-Malacara, Oralia Barboza-Quintana","doi":"10.12659/AJCR.946351","DOIUrl":"https://doi.org/10.12659/AJCR.946351","url":null,"abstract":"<p><p>BACKGROUND Primary cardiac malignancies are extremely rare, with an incidence of 0.07% on autopsy series. Primary sarcomas represent up to 95% of malignant neoplasms, with myxofibrosarcomas accounting for only 10%. Around 90% of patients present with unspecific symptoms and a tumor with polypoid appearance on imaging, thus frequently receiving a misdiagnosis of myxoma. CASE REPORT A 65-year-old man presented with abrupt chest pain, blood pressure of 130/80 mmHg, and heart rate of 180 beats/min. Electrocardiogram showed atrial fibrillation, and imaging revealed a polypoid tumor on the atrioventricular septum obstructing the mitral valve. The tumor was removed and sent for histopathological evaluation, revealing a multinodular pattern with spindled hypocellular areas and hypercellular areas featuring pleomorphic cells. The mitotic count was 11 in 10 high-power fields, and necrosis was present in less than 50% of the tumor area. Tumor cells were calretinin and MDM2 negative and CD34 positive. Heterologous elements, necrosis and hemorrhage, were noted. Considering these findings, this tumor was classified as intermediate-grade myxofibrosarcoma. CONCLUSIONS Due to the rarity of myxofibrosarcomas, evidence for optimal diagnostic and therapeutic management is limited. Despite being frequently polypoid, seemingly benign tumors on imaging, the extent of infiltration at their base is usually deep. Their innocent appearance can hinder adequate presurgical planning, leading to suboptimal resections. We present the example of a seemingly benign tumor as a potential pitfall in evaluating cardiac neoplasms, highlighting the importance of histopathological and immunohistochemical evaluation in their correct characterization, in order to offer the best follow-up and adjuvant treatment, when needed.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946351"},"PeriodicalIF":1.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956438","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":"Radiological and Pathological Analysis of Pembrolizumab-Associated Lung Lesions: Diagnostic Challenges and Management.","authors":"Tomohito Okano, Hajime Fujimoto, Toshiyuki Ito, Atsushi Tomaru, Haruko Saiki, Tatsuki Tsuruga, Taro Yasuma, Corina N D'Alessandro-Gabazza, Esteban C Gabazza, Tetsu Kobayashi","doi":"10.12659/AJCR.945022","DOIUrl":"https://doi.org/10.12659/AJCR.945022","url":null,"abstract":"<p><p>BACKGROUND Pembrolizumab, a programmed cell-death protein-1 (PD-1)-targeting antibody, extends survival in cancer patients but may cause lung injury as a side effect. This immunotherapy enhances the immune system's ability to recognize and eliminate cancer cells. However, its immunomodulatory action can sometimes lead to immune-related adverse events, including lung injury. CASE REPORT A 40-year-old female patient, previously managed for malignant melanoma of the left gluteal region with surgery and immune checkpoint inhibitors, was transitioned to pembrolizumab for ongoing cancer treatment. Subsequently, she was referred to our department for further evaluation due to findings on chest imaging revealing multiple nodules in the bilateral lung fields. The patient exhibited neither cough, fever, nor breathlessness. Bronchoscopic examination yielded no abnormalities. Cytological assessments were negative, as were cultures for bacteria, fungi, and acid-fast bacilli. Bronchoalveolar lavage and endobronchial ultrasound-guided transbronchial needle aspiration biopsy of the right lower lobe bronchus B9a were conducted. Pathological analysis identified a combination of acute inflammatory and chronic fibrotic lesions, primarily histiocytic, leading to a diagnosis of pembrolizumab-induced lung injury. Steroid pulse therapy followed by tapering resulted in improvement of the pulmonary shadows. The patient is currently under observation without requiring steroid therapy. CONCLUSIONS This case underscores the importance of vigilance for potential pembrolizumab-induced lung injury in patients undergoing immunotherapy for cancer treatment. Prompt recognition and appropriate management are essential for optimizing patient outcomes. Additionally, this case highlights the challenge of diagnosing lung lesions based solely on imaging, necessitating bronchoscopy with tissue sampling as a critical diagnostic tool.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945022"},"PeriodicalIF":1.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956166","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":"Malignant Cerebral Edema After Cranioplasty: A Case Report and Literature Insights.","authors":"Melanie Mandell, Fabio Grassia, Muhammad Riaz","doi":"10.12659/AJCR.946230","DOIUrl":"10.12659/AJCR.946230","url":null,"abstract":"<p><p>BACKGROUND Decompressive craniectomy is a common life-saving intervention in the setting of elevated intracranial pressure. Cranioplasty restores the calvarium and intracranial physiology once swelling recedes. Cranioplasty is often thought of as a low-risk intervention. However, numerous reports indicate that malignant cerebral edema (MCE) is an often-fatal complication of an otherwise uneventful cranioplasty. A careful review of the literature is needed to better understand this devastating condition. CASE REPORT A 41-year-old man presented after suffering a gunshot wound to the right frontal lobe. Upon initial evaluation, the patient had grossly visible brain matter, left-sided hemiparesis with a Glascow Coma Score (GCS) of 11, and vital signs concerning for elevated intracranial pressure. Computed tomography (CT) showed right-sided intraparenchymal and subarachnoid hemorrhage with a 5 mm leftward midline shift. The patient was taken to the operating room (OR) for right fronto-parietal craniectomy. Over the next 3 months, he recovered steadily and underwent PEEK cranioplasty on post-operative day 83. Pre-operative CT showed sunken skin flap syndrome with an 8-mm midline shift. Following an uneventful cranioplasty, he failed to regain consciousness. Examination revealed absent brainstem reflexes. CT showed global diffuse cerebral edema. The patient was declared brain dead. CONCLUSIONS Continued research is needed to better understand the pathophysiology of malignant cerebral edema so that future incidences may be prevented. A combination of negative-pressure suction drainage, sunken skin flap syndrome, and delayed time to cranioplasty likely play a significant role in the evolution of MCE. We urge neurosurgeons to consider the likelihood of MCE and adapt surgical planning accordingly.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946230"},"PeriodicalIF":1.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956434","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":"Pediatric Mycosis Fungoides Mimicking Benign Dermatoses: A Report of a Rare Case.","authors":"Salwa Rosli, Haizlene Abd Halim, Mazapuspavina Md-Yasin, Nur Aini Abu Bakar","doi":"10.12659/AJCR.945897","DOIUrl":"https://doi.org/10.12659/AJCR.945897","url":null,"abstract":"<p><p>BACKGROUND Primary cutaneous lymphomas (PCL) are a multifaceted spectrum of cutaneous T cell lymphoma (CTCL) and cutaneous B cell lymphomas (CBCL). Mycosis fungoides (MF) is a rare subset of CTCL that primarily affects adults, and its occurrence in children is exceedingly rare. Most pediatric MF manifests as hypopigmented patches resembling other benign dermatoses, causing diagnostic challenges. This report outlines a case of pediatric MF in a 7-year-old Malaysian boy. CASE REPORT A 7-year-old boy exhibited progressing skin lesions characterized initially by erythematous, papular rashes over the face and upper limbs, then to the whole body, becoming hypopigmented, with pruritus and scaling for 1 year. Multiple clinics treated him for eczema and pityriasis alba but he responded poorly to courses of various topical steroids and emollient treatment. Due to the refractory nature of the lesions, he was subsequently referred to a dermatology clinic, where 2 skin biopsies were performed. The first biopsy revealed epidermotropism of atypical lymphocytes, consistent with MF. Immunohistochemical analysis revealed positive CD3+ expression with slightly reduced CD4+, CD7+, and CD8+ expression, and normal CD2+ and CD5+ expression at the epidermis level. Nevertheless, due to the rarity of MF in children, a second biopsy was performed, validating the diagnosis. CONCLUSIONS Pediatric MF is a rare and challenging diagnosis. This case report highlights the importance of close monitoring of unresolved hypopigmented lesions and increased vigilance on lesions not responding to standard treatment. Timely diagnosis with support of skin biopsy is crucial to avoid potentially serious disease progression and helps provide appropriate management leading to improved outcomes.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945897"},"PeriodicalIF":1.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956436","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}