Oxford Medical Case Reports最新文献

{"title":"Fibrinolytics in the Management of Complex Abdominal Collections: a case report and review of the literature.","authors":"Sultan Almuallem","doi":"10.1093/omcr/omag197","DOIUrl":"10.1093/omcr/omag197","url":null,"abstract":"<p><p>Complex intra-abdominal collections typically present management challenges, with percutaneous drainage remaining the standard of care. Fibrinolytic therapy has limited data for complex intra-abdominal collections despite solid evidence in intrapleural empyema. Here, we report a case of successful fibrinolytic therapy in a patient with persistent intra-abdominal collection. A 57-year-old woman with a history of open Roux-en-Y gastric bypass presented with a perforated marginal ulcer. Following successful surgical management, she developed a recurrent/persistent intra-abdominal collection that failed several percutaneous drainage attempts. Alteplase was administered through the abdominal drain, resulting in complete resolution of the collection. Despite limited evidence, fibrinolytic therapy for complex abdominal collections appears applicable and safe in selected cases. Further large series and randomized trials are needed to examine its efficacy and cost-effectiveness.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag197"},"PeriodicalIF":0.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217108","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":"Synchronous laryngeal squamous cell carcinoma and papillary urothelial carcinoma of the bladder: a case report and literature review.","authors":"Asmae Bali, Fatima Rezzoug, Hanan Bailal, Kaouthar Khater, Fadoua Jebrouni, Hind Chibani, Ouissam Al Jarroudi, Sami Aziz Brahmi, Said Afqir","doi":"10.1093/omcr/omag193","DOIUrl":"10.1093/omcr/omag193","url":null,"abstract":"<p><p>Synchronous primary malignancies are defined as two histologically distinct tumors arising in different anatomical sites within six months. Although tobacco exposure is a recognized shared carcinogenic factor, the coexistence of laryngeal squamous cell carcinoma and bladder urothelial carcinoma remains rare. We report the case of a 75-year-old man with a 40 pack-year smoking history who presented with progressive dysphonia. Imaging revealed a locally advanced laryngeal tumor and an incidental bladder lesion. Histopathological examination confirmed a well-differentiated laryngeal squamous cell carcinoma and a low-grade non-muscle-invasive papillary urothelial carcinoma of the bladder, fulfilling the Warren and Gates criteria for synchronous primary tumors. The patient underwent induction chemotherapy for laryngeal preservation and transurethral resection of the bladder tumor followed by surveillance. This case highlights the importance of systematic screening and multidisciplinary management in high-risk patients.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag193"},"PeriodicalIF":0.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217098","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":"Peripheral precocious puberty in a 4-month-old infant associated with an ESR1 variant: a case report.","authors":"Fadi Ayyash, Noor Alrawajfeh, Asmaa Monther Al Quraan, Hadeel Othman Alqurieny, Abdelrazaq Ahmad Alyasin, Juana Hani AbuRahmeh, Nama' Abdullah Bany Amer, Sura Al-Rawabdeh, Waseem Al Mefleh, Sondos Harahshih","doi":"10.1093/omcr/omag194","DOIUrl":"10.1093/omcr/omag194","url":null,"abstract":"<p><p>Precocious puberty (PP) refers to pubertal onset before 8 years in females and 9 years in males. We present a rare case of a 6-year and 7-month-old Jordanian girl with peripheral PP onset at 4 months of age. Clinical evaluation revealed vaginal spotting, premature thelarche, advanced bone age, and recurrent uterine bleeding requiring multiple transfusions. Imaging demonstrated a progressive cervicovaginal mass and endometrial polyps. Histopathology identified atypical hyperplasia/endometrioid intraepithelial neoplasia. Gonadotropins remained persistently suppressed, excluding central PP. Whole-exome sequencing (WES) identified a heterozygous likely-pathogenic ESR1 missense variant (NM_000125.3; c.1610A > C; p.Tyr537Ser), previously linked to estrogen-independent receptor activation in breast cancer. Tamoxifen produced partial clinical response with subsequent recurrence; the patient is now on combined letrozole-tamoxifen therapy. This case highlights the value of WES in unexplained PP and suggests that gain-of-function ESR1 variants may drive peripheral PP through receptor hypersensitivity.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag194"},"PeriodicalIF":0.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217153","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 management of high-risk proliferative diabetic retinopathy during pregnancy with intravitreal faricimab.","authors":"Sonia Scallon, Michael Rauser, Anny M S Cheng, Kakarla V Chalam","doi":"10.1093/omcr/omag195","DOIUrl":"10.1093/omcr/omag195","url":null,"abstract":"<p><p>Management of proliferative diabetic retinopathy during pregnancy requires balancing maternal vision preservation against uncertain fetal risks associated with intravitreal anti-vascular endothelial growth factor therapy. We report a 27-year-old woman with a chronic type 1 diabetes mellitus who presented at 28 weeks and 1 day of gestation with high-risk proliferative diabetic retinopathy and dense vitreous hemorrhage in the left eye, precluding panretinal photocoagulation. After multidisciplinary counseling regarding limited pregnancy safety data and treatment alternatives, a single intravitreal faricimab injection was administered at 29 weeks and 6 days of gestation. One month later, left eye visual acuity improved from counting fingers to 20/25 with substantial clearance of the vitreous hemorrhage. Cesarean delivery was performed 37 days after injection at 36 weeks and 1 day of gestation for nonreassuring fetal heart tracings. No treatment-attributable adverse event was identified. To our knowledge, this represents the first reported use of intravitreal faricimab during pregnancy.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag195"},"PeriodicalIF":0.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217118","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":"Left pulmonary aplasia with ipsilateral renal agenesis and double superior vena cava in a term neonate: a case report.","authors":"Janaa Issa, Ahmad Fasfoos, Nardeen Hroub, Doaa Alqam, Ahmad Shalaldeh, Ammar Yousef Hmidat","doi":"10.1093/omcr/omag192","DOIUrl":"https://doi.org/10.1093/omcr/omag192","url":null,"abstract":"<p><strong>Background: </strong>Unilateral pulmonary agenesis/aplasia is rare and often accompanied by extrapulmonary anomalies that affect prognosis.</p><p><strong>Case report: </strong>A term male neonate delivered by cesarean section for fetal distress required brief invasive ventilation and was subsequently stabilized. Chest radiography revealed left hemithorax opacification. Contrast-enhanced CT on day 4 demonstrated a reduced left hemithorax with an absent left pulmonary parenchyma, a blind-ending left main bronchus, and an absent ipsilateral pulmonary arterial supply, consistent with left pulmonary aplasia. Evaluation also identified left renal agenesis with compensatory right renal hypertrophy and double superior vena cava, with discordant drainage descriptions across modalities requiring confirmation. The infant transitioned to room air, established feeds, and was discharged clinically stable on day 9 after birth.</p><p><strong>Conclusion: </strong>Definitive anatomic characterization of unilateral thoracic opacity in neonates should prompt systematic cardiovascular and genitourinary screening and coordinated multidisciplinary follow-up in an outpatient setting.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag192"},"PeriodicalIF":0.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167328","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":"Hemorrhagic pancreatic schwannoma mimicking a pancreatic neuroendocrine tumor.","authors":"Ryoma Sakamoto, Ken Hayashi, Shion Ando, Yuto Kawate, Akinari Miyazaki, Hiroshi Kusanagi","doi":"10.1093/omcr/omag189","DOIUrl":"https://doi.org/10.1093/omcr/omag189","url":null,"abstract":"","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag189"},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116063","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 diagnostic dilemma: autoimmune pulmonary alveolar Proteinosis unmasked by vaping-induced lung injury.","authors":"Mohammed Najdat Seijari, Taraneh Zamani, Mohammad Nasser Affas, Souwdamini Sethuram, Marwa Alfaraj, Muhammad Umair Khawar","doi":"10.1093/omcr/omag190","DOIUrl":"https://doi.org/10.1093/omcr/omag190","url":null,"abstract":"<p><p>A 65-year-old smoker with recent vaping resumption, found to have elevated anti-GM-CSF antibodies suggestive of autoimmune pulmonary alveolar proteinosis (PAP). However, bronchoalveolar lavage and whole lung lavage were inconclusive, raising suspicion for concurrent E-cigarettes or vaping-associated lung injury (EVALI). The patient showed no clinical response to corticosteroids and eventually passed away. Post-mortem pathology confirmed surfactant accumulation and foamy macrophages but also showed features of diffuse alveolar damage. This case underscores the diagnostic and management challenges when PAP and inhalational lung injuries overlap.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag190"},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116361","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 Fabry disease revealed by early neuropathic symptoms: a case report.","authors":"Imane Mezdaoui, Abdelilah Radi, Sara Babour, Azzeddine Laaraje, Amale Hassani, Rachid Abilkassem","doi":"10.1093/omcr/omag191","DOIUrl":"https://doi.org/10.1093/omcr/omag191","url":null,"abstract":"<p><p>Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by α-galactosidase A deficiency, resulting in progressive glycosphingolipid accumulation and multisystem morbidity. Early pediatric manifestations are frequently overlooked, delaying treatment and increasing the risk of irreversible organ damage. We describe a 14-year-old boy presenting with acroparesthesia, recurrent abdominal pain, exercise intolerance, and anhidrosis since early childhood. Clinical evaluation revealed peripheral neuropathy and short stature. Biochemical testing demonstrated nearly absent α-galactosidase A activity (0.1 μmol/L/h; N > 2.8) and markedly elevated lyso-GL-3 (135.6 ng/mL; N < 3.5). Molecular analysis identified a hemizygous pathogenic variant, c.658C>T (p.Arg220^*), confirming classic FD. Comprehensive baseline assessment showed no renal, cardiac, ophthalmologic, or cerebrovascular involvement. Familial screening revealed the same mutation in his mother and a symptomatic maternal uncle. Enzyme replacement therapy (ERT) with agalsidase beta was initiated. Early recognition in childhood is critical to optimize outcomes and modify disease progression.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag191"},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116084","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":"Pyrexia as the primary paradox: celiac disease masked as fever of unknown origin.","authors":"Soufiane Abdouh, Imane Boujguenna, Soukaina Oumlil","doi":"10.1093/omcr/omag180","DOIUrl":"https://doi.org/10.1093/omcr/omag180","url":null,"abstract":"<p><p>Celiac disease (CD) can present solely with atypical extra-intestinal symptoms. We describe a 33-year-old woman hospitalized for a one-month history of fever, myalgias, and tachycardia. Extensive infectious, autoimmune, and malignancy investigations were unrevealing. However, hypochromic anemia and elevated CRP prompted serologic testing, revealing positive anti-transglutaminase IgA. Duodenal biopsy confirmed CD with Marsh IIIa villous atrophy. This case illustrates CD as a rare etiology of fever of unknown origin (FUO), emphasizing the importance of celiac serology in the differential diagnosis of prolonged unexplained fever.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag180"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116120","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":"Spontaneous Hemorrhagic thyroid cyst presenting as unilateral painful thyroiditis in primary care: early recognition of a potentially life-threating complication.","authors":"Khaled E Elzawawi, Ibrahim Elmakaty, Gaydaa Ali, Mays Al-Krosh, Saleh M H Attal, Rasha Moussa","doi":"10.1093/omcr/omag179","DOIUrl":"https://doi.org/10.1093/omcr/omag179","url":null,"abstract":"<p><p>Spontaneous hemorrhage within a thyroid nodule is an uncommon but potentially alarming condition presenting with acute neck pain, swelling, and compressive symptoms that may threaten the airway and pose diagnostic and management challenges. We describe a 35-year-old Asian woman who presented with sudden onset of severe left-sided neck pain and swelling, accompanied by dysphagia and exertional dyspnea. There was no history of trauma, anticoagulant use, or prior thyroid intervention. Physical examination revealed marked unilateral thyroid tenderness and swelling without overt airway compromise. Thyroid function tests were within normal limits. Neck ultrasonography demonstrated a complex mixed solid-cystic left thyroid nodule measuring 3.2 × 2.4 × 3.5 cm with internal echogenic septations, consistent with a hemorrhagic thyroid cyst. Initial conservative management with non-steroidal anti-inflammatory drugs provided minimal relief. The patient was subsequently treated with a short course of high-dose oral corticosteroids and underwent ultrasound-guided fine-needle aspiration, yielding 7 mL of dark brown hemorrhagic fluid. Cytological examination revealed macrophage-predominant cyst contents with no evidence of malignancy. Significant symptomatic improvement was noted following aspiration and steroid therapy. The patient was referred for endocrinology follow-up, with elective hemithyroidectomy discussed due to the potential risk of recurrence. Spontaneous hemorrhage of a thyroid nodule, although rare, should be considered in patients presenting with acute unilateral neck pain and swelling, even in the absence of identifiable risk factors. Early imaging, vigilant airway assessment, and individualized management are crucial. In clinically stable patients, conservative treatment with aspiration and corticosteroids may be effective, while surgical intervention should be reserved for recurrent cases or those with airway compromise. This case highlights the critical role of primary care physicians in early recognition and urgent referral of rare but potentially life-threatening thyroid conditions presenting with acute neck swelling.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag179"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116191","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}