American Journal of Case Reports最新文献

{"title":"Chronic Post-Prandial Epigastric Pain Associated with Median Arcuate Ligament Syndrome and Atherosclerosis of the Celiac Trunk in An Elderly Woman: A Case Report.","authors":"Doan Duc Dung, Nguyen The Thoi, Nguyen Huu Thanh, Do Xuan Chien, Manh Duc Ngo, Nguyen Xuan Muoi","doi":"10.12659/AJCR.946075","DOIUrl":"10.12659/AJCR.946075","url":null,"abstract":"<p><p>BACKGROUND Post-prandial abdominal pain due to bowel ischemia can be caused by stenosis (atherosclerosis) or by compression of the arteries of the celiac axis. Median arcuate ligament syndrome (MALS) results from compression at the origin of the celiac trunk by the arcuate ligament. This report describes a 66-year-old woman with chronic post-prandial epigastric pain associated with atherosclerosis of the celiac trunk, managed with angioplasty and stenting combined with MALS. CASE REPORT A 66-year-old female patient with a history of dyslipidemia presented with chronic epigastric pain with post-prandial episodes for 4 years. Two years before the admission, her pain increased with meals and was not relieved by empirical treatment for gastritis. An esophagogastroduodenoscopy and colonoscopy showed chronic gastritis. One year later, a resection of the gastric submucosal tumor was performed, without improving her symptoms. In this presentation, the prompt computed tomography revealed hook-shaped stenosis of the celiac trunk and mild post-stenosis dilatation, highly suggestive of MALS. However, the patient refused to undergo surgery despite the benefit of this intervention. Concurrently, moderately severe atherosclerosis of the celiac trunk was detected during intra-vessel imaging. The patient was treated individually and underwent angioplasty with stenting. At a 5-month follow-up, the patient's condition was stable and she had no gastrointestinal symptoms. CONCLUSIONS Due to the low prevalence and nonspecific symptoms of MALS, physicians should be highly suspicious of this disease, especially in patients with post-prandial abdominal pain. Angioplasty and stenting can be performed in selected patients with MALS and atherosclerosis of the celiac trunk.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946075"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567678","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":"Non-Traumatic Thyroid Cartilage Fracture from Sudden Neck Motion: Clinical Insights.","authors":"Pierre Attal, Ben-Zion Horwitz, Jen-Yves Sichel, Chanan Shaul","doi":"10.12659/AJCR.946084","DOIUrl":"10.12659/AJCR.946084","url":null,"abstract":"<p><p>BACKGROUND The thyroid cartilage is the most prominent laryngeal cartilage located beneath the hyoid bone. Non-traumatic fractures of the larynx, including the thyroid cartilage, are rare and can occur when the glottis is closed and intrathoracic pressure suddenly increases. This report describes the case of a 42-year-old man presenting with hoarseness and pain when swallowing and a diagnosis of non-traumatic thyroid cartilage fracture following sudden neck movement, highlighting the importance of recognizing atypical mechanisms of laryngeal injury. CASE REPORT A 42-year-old healthy man experienced a \"pop\" in his neck during sudden sharp head turning while driving. Five days later, he presented to the hospital with progressive odynophagia and hoarseness. Initial diagnostic workup included computed tomography imaging, which revealed a non-displaced anterior thyroid cartilage fracture with surrounding air. Fiberoptic laryngoscopy demonstrated left vocal cord thickening with preserved mobility, and a barium swallow study was unremarkable. Based on these findings and stable airway status, conservative management was initiated with antibiotics and airway monitoring. The patient was discharged after 2 days and demonstrated complete symptom resolution at 1-month follow-up. CONCLUSIONS This report has presented a rare case of non-traumatic thyroid cartilage fracture following sudden neck motion. The case highlights the importance of careful history and imaging of the structures of the neck, particularly in patients presenting with voice changes, even without apparent trauma. Furthermore, it supports the efficacy of conservative management in stable, non-displaced laryngeal fractures.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946084"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558324","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":"Providencia rettgeri and Group G Streptococcus in Anorexia Nervosa-Related Empyema: A Case Report.","authors":"Atsunori Hiasa, Ichiro Imoto, Hideki Nomura, Toshiaki Takeuchi, Moriharu Misaki, Taro Yasuma, Corina N D'Alessandro-Gabazza, Esteban C Gabazza, Hiroyuki Nishimura","doi":"10.12659/AJCR.945029","DOIUrl":"10.12659/AJCR.945029","url":null,"abstract":"<p><p>BACKGROUND Anorexia nervosa, predominantly affecting young females, significantly compromises the immune system, rendering patients vulnerable to infections and contributing to a notably high mortality rate. The complexities involved in managing infections in immunocompromised patients with anorexia nervosa are often underappreciated. This case report aims to shed light on these challenges and the potential complications arising from treatment interventions. CASE REPORT We present the case of a 30-year-old woman with a long-standing history of anorexia nervosa, who was admitted with severe systemic symptoms, including profound weakness and numbness in her extremities. Initial laboratory tests revealed severe renal failure and marked dyselectrolytemia. On day 14 of hospitalization, the patient developed empyema thoracis, an uncommon but severe complication in patients with anorexia nervosa. The empyema was caused by Providencia rettgeri and group G Streptococcus, suggesting aspiration of oral secretion was the etiology. Despite appropriate antibiotic therapy, the condition recurred, likely exacerbated by the administration of corticosteroids to manage concurrent thrombocytopenia, which further compromised the patient's already weakened immune system. CONCLUSIONS This case underscores the critical need for careful consideration of the immunosuppressive effects of treatments like corticosteroids in anorexia nervosa patients, who are already at heightened risk for severe infections such as empyema thoracis. It highlights the importance of vigilant monitoring and tailored management strategies for infections in these patients, emphasizing a multidisciplinary approach to optimize outcomes in similar clinical scenarios. The case provides valuable insights into balancing the benefits and risks of immunosuppressive therapies in the management of anorexia nervosa and associated complications.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945029"},"PeriodicalIF":1.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543967","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":"Recognizing and Managing Post-Lobectomy Lung Torsion: A Critical Case Report.","authors":"Tinglv Fu, Ning Li, Qing Geng","doi":"10.12659/AJCR.945744","DOIUrl":"10.12659/AJCR.945744","url":null,"abstract":"<p><p>BACKGROUND Lung torsion is very rare but is a recognized postoperative complication of lobectomy of the lung. This report describes the case of a 63-year-old woman with lung torsion of the left lower lobe following left upper lobe resection for lung neoplasms who required an emergency completion pneumonectomy. CASE REPORT The patient was a 63-year-old woman who underwent thoracoscopic left upper lobectomy after excluding distant metastasis, due to a mixed-density mass in the left upper lobe of the lung. After surgery, the patient's chest pain progressively worsened. On the third postoperative day, she also had symptoms such as chest tightness, atrial fibrillation, tachycardia, and leukocytosis, but no dyspnea. Then, an urgent contrast-enhanced chest computed tomography revealed diffuse ground-glass attenuation in the left lower lobe and a left lower bronchial obstruction. It also revealed that the left inferior pulmonary artery was twisted upward with distal poor filling. A bedside electronic bronchoscopy also found that the left lower lobe bronchus was obviously narrowed and almost completely occluded. Due to high suspicion of left lower lobe torsion, emergency surgery was performed. During the operation, it was found that the left lower lobe had rotated 180° counterclockwise. After evaluating the poor lung vitality, a left lower lobectomy of the lung was performed. The patient recovered well after the operation and no complications occurred during follow-up. CONCLUSIONS This report has highlighted the importance of postoperative imaging following left upper lobectomy; although left lower lobe torsion is a rare complication, it is a potentially life-threatening condition that requires emergency pneumonectomy.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945744"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537836","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":"Valve-in-Valve Transapical Transcatheter Aortic Valve Replacement with Concomitant Percutaneous Coronary Intervention: A Case Report.","authors":"Abeline R Watkins, Ryaan El-Andari, Anoop Mathew, Jeevan Nagendran","doi":"10.12659/AJCR.946582","DOIUrl":"10.12659/AJCR.946582","url":null,"abstract":"<p><p>BACKGROUND Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is increasingly used, as older high-risk patient populations require repeat aortic valve replacements. The most common approach to ViV-TAVR is through a transfemoral approach or alternative vascular access sites, such as transcarotid or transsubclavian TAVR. Within this population, some patients become ineligible for ViV-TAVR due to contraindications, such as severe peripheral vascular disease, necessitating an alternative. Transapical TAVR allows for TAVR even in the context of severe peripheral vascular disease, although it has rarely been used in the ViV-TAVR setting, and even less frequently with concomitant percutaneous coronary intervention. CASE REPORT We present the case of a 79-year-old man with a history of coronary artery disease and aortic valve disease 9 years after coronary artery bypass grafting and aortic valve replacement presenting with progressive dyspnea on exertion. The patient was found to have severe prosthetic valve degeneration but had a high preoperative surgical risk score and severe peripheral arterial disease. Transfemoral, carotid, and subclavian access were contraindicated given the severe vascular disease, and therefore the patient underwent transapical ViV-TAVR with a 26-mm Sapien S3 valve and a left main coronary artery snorkel stent for protection of the left main coronary. CONCLUSIONS With this rare documented case of transapical ViV-TAVR, we highlight the importance of having several available alternative surgical approaches to TAVR for patients who are ineligible for transfemoral ViV-TAVR and have high preoperative risk scores.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946582"},"PeriodicalIF":1.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537838","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":"Cholecystoduodenal Fistula Due to Gallstone Disease Masquerading as a Duodenal Ulcer Bleed: A Case Report.","authors":"Jayati Churiwala, Hemant Sheth, Esam Aboutaleb","doi":"10.12659/AJCR.946743","DOIUrl":"10.12659/AJCR.946743","url":null,"abstract":"<p><p>BACKGROUND A cholecystoenteric fistula (CEF) is a rare complication of gall stone disease. While a cholecystoduodenal fistula is the most commonly occurring bilioenteric fistulous communication, cholecystocolonic, cholecystogastric and choledochoduodenal fistulas have also been described. CASE REPORT A 73-year-old woman presented with a 1-week history of melena on a background of acid reflux and no abdominal pain. A gastroscopy revealed kissing D1 ulcers with excretion of pus. Following a CT scan of the abdomen, the patient was referred to the surgical team for the management of acute cholecystitis with a cholecystoduodenal fistula. She underwent an open cholecystectomy with fistula take-down and repair of the duodenum in the same admission. Following an uneventful postoperative recovery, she was discharged on an empirical course of H. pylori eradication therapy. Recurrent episodes of acute cholecystitis or chronic cholecystitis can lead to adhesions between the gall bladder and adjacent viscus. Gall stone impaction then can cause pressure necrosis, leading to a fistulation between the gall bladder and the viscus. Rarely, this presents with massive upper-gastrointestinal bleeding. Imaging with ultrasound can reliably diagnose cholelithiasis, cholecystitis, and pneumobilia, but is unlikely to help in the definitive diagnosis of a bilioenteric fistula, which requires cross-sectional imaging. CONCLUSIONS Massive upper-gastrointestinal bleeding is a rare mode of presentation of CEF. Hemodynamic resuscitation and management of upper-GI bleed takes precedence, followed by definitive management of the CEF after establishment of the diagnosis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946743"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531991","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":"Pediatric Crohn Disease Presenting as Isolated Acute Upper-GI Bleed: A Case Report.","authors":"Logan Norris, Parker Giroux, Traci Jester, David P Galloway, Jeanine Maclin, Stephanie Saaybi, Benjamin Hill, Mariangeles Medina Perez, Chinenye R Dike","doi":"10.12659/AJCR.946099","DOIUrl":"10.12659/AJCR.946099","url":null,"abstract":"<p><p>BACKGROUND The incidence of Crohn's disease (CD) has increased worldwide. Although common presenting symptoms of CD in children include abdominal pain, diarrhea, and rectal bleeding, it can also present atypically and can have extraintestinal manifestations. Isolated upper-gastrointestinal bleed as the only manifestation of CD with ileocolonic involvement is rare. CASE REPORT We describe the case of a previously healthy, 9-year-old boy who presented to the emergency department (ED) with isolated, acute-onset hematemesis. He was evaluated in the ED, and found to be hemodynamically stable, and hematemesis had resolved upon arrival to the ED. Therefore, he was placed on a proton pump inhibitor (PPI), and discharged with a close gastrointestinal clinic follow-up, which he missed. He returned to the ED 3 weeks later with another episode of hematemesis with hemodynamic instability requiring resuscitation and intensive care unit stay. He underwent an emergency esophagogastroduodenoscopy (EGD), which revealed a bleeding gastric ulcer in the fundus. Bleeding was controlled with epinephrine injection and application of hemostatic clips. Gastric biopsies revealed granulomas. Therefore, during his hospitalization, ileocolonoscopy was completed to rule out CD. Ileocolonoscopy showed left colonic edema with ulcers and terminal ileal ulcers with exudates. Histopathology revealed granulomas in these areas. Infliximab infusions were started during the hospitalization. He is currently receiving 10 mg/kg of infliximab every 4 weeks. CONCLUSIONS This case highlights the need for increased clinician awareness of atypical presentations of inflammatory bowel disease (IBD) and maintenance of a high index of suspicion when treating children and adolescents with acute GI bleed.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946099"},"PeriodicalIF":1.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523548","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":"Management of Post-Stroke Cold Sensations: A Case Study on Sympathetic Nerve Ablation.","authors":"Haojia Li, Dejian Chen, Jiajia Deng, Lu Sun, Jianjun Zhu, Hanrui Fan, Yingjie Hua, Xiaoyan Guo, Ming Yao, Yong Fei","doi":"10.12659/AJCR.946352","DOIUrl":"10.12659/AJCR.946352","url":null,"abstract":"<p><p>BACKGROUND Stroke is a leading cause of mortality worldwide and often results in complex sequelae. Peripheral circulation disorders in paralyzed limbs are particularly challenging, presenting as persistent cold sensations and cold-induced pain that severely impair patients' quality of life. This report presents an innovative approach to managing refractory post-stroke limb coldness and pain using computed tomography (CT)-guided sympathetic nerve radiofrequency ablation. CASE REPORT We present the case of a 65-year-old woman with hemiplegia in her left extremities following a cerebral infarction 1 year earlier. Despite standardized treatment, her condition worsened after 6 months, with increased spasticity, cold-induced pain, and a significant drop in temperature in the left limbs. To address these issues, CT-guided radiofrequency ablation of the sympathetic nerve at the fourth thoracic vertebra and the third lumbar vertebral body was performed at 75°C for 3 min. The procedure significantly improved the peripheral perfusion index, increased palm and foot temperature, and reduced pain. Magnetic resonance imaging revealed improved cerebral infarction and enhanced brain function in temperature-related regions. Ethical approval and patient consent for publication were obtained. CONCLUSIONS CT-guided radiofrequency ablation of the thoracic and lumbar sympathetic nerves effectively alleviates post-stroke peripheral circulation disorders, improves limb temperature, and enhances collateral circulation. This report underscores the importance of awareness and early intervention for such post-stroke complications in patients.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946352"},"PeriodicalIF":1.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516832","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":"Successful Radiotherapy in Management of Inoperable Trichoblastic Carcinoma: A Case Report.","authors":"Sébastien Colin, Jean-Christophe Faivre, Jean-François Devoti, Florence Granel-Brocard, Sophie Renard","doi":"10.12659/AJCR.945865","DOIUrl":"10.12659/AJCR.945865","url":null,"abstract":"<p><p>BACKGROUND Trichoblastic carcinoma (TC) is a rare adnexal tumor that usually occurs on the scalp and the face. Clinical presentation is nonspecific and can simulate basal cell carcinoma (BCC). Optimal treatment and outcomes remain unclear. Surgery remains the main treatment but can be difficult or impossible in locally-advanced situations. Thus, conservative options must be developed as TC affects elder populations, and radiotherapy may be a good conservative option but its use in TC is poorly documented. CASE REPORT We report a case of an 86-year-old man with an asymptomatic 5-cm tumor of the nose, extending to the right cheek and inner canthus. He was immunodeficient on kidney transplant and was treated by prednisone and tacrolimus. Biopsy confirmed the TC diagnosis. Surgery and brachytherapy were not possible due to clinical extension, advanced age, and comorbidities. External beam radiation with intensity modulated radiotherapy on tomotherapy was attempted. Seventy Gy was delivered in 35 fractions over 2 months 5/7 days. A bolus with ball (Seemed®) was used each treatment day to deliver an adequate dose of radiotherapy to the skin. Clinical examination at 1 month did not reveal any residual lesion and the patient remains in complete remission after 9 months of follow-up. Tolerance was characterized by grade 2 (NCI CTC AE V4) radiodermatitis, mucositis, and conjunctivitis, managed by local medications. CONCLUSIONS We report a rare case of locally-advanced TC, successfully treated by external beam radiation, which may be an acceptable alternative treatment for unresectable tumors.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945865"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503805","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 40-Year-Old Woman with Inoperable Uterine Fibroids Treated with Combined Uterine Artery Embolization and Relugolix.","authors":"Livio Leo, Raphael Thomasset, Alessio Massaro, Raffaele Tinelli, Bianca Masturzo, Valentino Remorgida, Alessandro Libretti, Massimiliano Natrella","doi":"10.12659/AJCR.946334","DOIUrl":"10.12659/AJCR.946334","url":null,"abstract":"<p><p>BACKGROUND Surgery was once considered the only possible treatment for uterine fibroids. However, a more conservative treatment approach can preserve women's reproductive capacity. In recent years, uterine artery embolization (UAE) and medical treatments have been introduced as a minimally or non-invasive therapeutic option. Relugolix is a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist used to reduce the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This report presents the case of a 40-year-old woman with inoperable uterine fibroids managed with combined uterine artery embolization and Relugolix, a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist. CASE REPORT A woman in her 40s presented with recurrent menometrorrhagia and an 80-mm uterine fibroid causing bleeding and anemia. Due to her medical history and previous surgeries, surgery was deemed risky. Instead, a conservative approach involving UAE followed by Relugolix combination therapy (Relugolix-CT) was pursued before performing minimally invasive surgery. Following bilateral UAE, the ultrasound scan showed there had already been a reduction in the fibroid size. Right after the UAE, the patient was discharged with Relugolix-CT, which reduced the symptoms and helped further reduce the fibroid's size and vascularity. Six months later, a mini-resectoscopic myomectomy was performed under local anaesthesia. CONCLUSIONS This case underscores the effectiveness of UAE and Relugolix-CT as a pre-surgical strategy for large uterine fibroids in patients who are not immediately suitable candidates for major surgery. This new combined approach can lead to improved patient outcomes and reduced surgical risks.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946334"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494013","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}