Oxford Medical Case Reports最新文献

{"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}

{"title":"Adjuvant volumetric modulated arc therapy for incompletely resected type II pleuropulmonary blastoma: a case report.","authors":"Salma Ichou, Ihsane Skitioui, Amine Lachgar, Karima Nouni, Hanan El Kacemi, Tayeb Kebdani, Khalid Hassouni","doi":"10.1093/omcr/omag183","DOIUrl":"https://doi.org/10.1093/omcr/omag183","url":null,"abstract":"<p><strong>Background: </strong>Pleuropulmonary blastoma (PPB) is a rare and aggressive pediatric thoracic malignancy within the DICER1 syndrome spectrum. Despite well-established multimodal treatment based on surgery and chemotherapy, evidence guiding the use of adjuvant radiotherapy remains scarce, given the rarity of this tumor.</p><p><strong>Case report: </strong>A 3-year-old girl with type II PPB, presenting with recurrent pyopneumothorax, achieved a 76% tumor reduction after seven cycles of IVADo chemotherapy, allowing incomplete surgical resection with residual viable tumor. Adjuvant VMAT (45 Gy/25 fractions) achieved excellent target coverage with organ sparing and was well tolerated (grade 2 radiodermatitis only), and the patient remained disease-free at 9 months.</p><p><strong>Conclusion: </strong>This case highlights the feasibility of modern VMAT-based adjuvant radiotherapy for incompletely resected type II PPB and illustrates how advanced treatment planning can optimize local control while limiting radiation exposure to critical organs.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag183"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116328","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":"Keratinizing squamous cell carcinoma of the distal Esophagus in a young adult woman with celiac disease: a case report.","authors":"Samiullah Shaikh, Sidra Samad, Muhammad Saad, Areeba Ali Khan, Faizan Shaikh, Riaz Ahmed, Kamil Ahmad Kamil","doi":"10.1093/omcr/omag178","DOIUrl":"https://doi.org/10.1093/omcr/omag178","url":null,"abstract":"<p><p>Esophageal squamous cell carcinoma (ESCC) usually affects the upper or middle esophagus and is strongly associated with tobacco and alcohol use. We report a 28-year-old woman with longstanding celiac disease who presented with progressive dysphagia, weight loss, retrosternal pain, and melena. Endoscopy showed a partially obstructing distal esophageal mass; biopsy confirmed moderately differentiated keratinizing ESCC, while duodenal biopsy showed active celiac disease. CT and PET imaging revealed regional lymphadenopathy without distant metastasis. She underwent feeding jejunostomy, nutritional support, and neoadjuvant chemoradiotherapy, but follow-up imaging showed interval disease progression. The patient's young age, squamous cell histology in a distal esophagus, and the absence of conventional risk factors make this an unusual presentation. This case emphasizes the need for high clinical suspicion and early endoscopic evaluation in young patients with celiac disease presenting with alarming symptoms, even in the absence of classic risk factors for esophageal cancer.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag178"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116078","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":"Pulsatile vessel causing Esophageal compression and dysphagia: a rare complication of anterior cervical discectomy and fusion.","authors":"Obada Daaboul, Muhammed Yaman Swied, Muhammad Anas Abdulrazzak, Muaataz Azzawi, Ramprasad Jegadeesan","doi":"10.1093/omcr/omag182","DOIUrl":"https://doi.org/10.1093/omcr/omag182","url":null,"abstract":"","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag182"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116169","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":"Recurrent myocarditis masquerading as acute myocardial infarction: unmasking Behçet's disease.","authors":"Mohamed Atta, Fadel Alqatati, Mohammed Alkhanafsa, Kholoud Riyad Jaber, Mhd Baraa Habib","doi":"10.1093/omcr/omag186","DOIUrl":"https://doi.org/10.1093/omcr/omag186","url":null,"abstract":"<p><p>Myocarditis can closely mimic acute myocardial infarction (AMI), particularly in young patients without atherosclerotic risk factors. We report a 27-year-old man with recurrent severe chest pai7n, transient ST-segment elevations, and markedly elevated high-sensitivity troponin-T, in whom coronary angiography was repeatedly normal. Serial cardiac magnetic resonance and 18F-fluorodeoxyglucose positron-emission tomography revealed a migratory pattern of myocardial inflammation, with new lesions emerging as earlier ones resolved, fulfilling criteria for recurrent myocarditis. Recurrent oral ulcers, folliculitis, arthralgias, and pathergy-like skin reactions raised suspicion for Behçet's disease. Treatment with vasodilators, colchicine, corticosteroids, and azathioprine produced sustained clinical and biochemical remission. This case highlights the importance of considering myocarditis in young patients with recurrent angina-like symptoms and normal coronaries, the value of serial multimodal imaging in detecting migratory inflammation, and the recognition of Behçet's disease as a rare underlying cause of recurrent myocarditis.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag186"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116163","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":"An elusive cause of recurrent hypoglycemia: delayed diagnosis of insulinoma treated with curative distal pancreatectomy in a resource-limited setting.","authors":"Yitagesu Aberra Shibiru, Shale Ali Kemal, Abenizer Berhanu Tulu, Dawit Dagne Moges","doi":"10.1093/omcr/omag188","DOIUrl":"https://doi.org/10.1093/omcr/omag188","url":null,"abstract":"<p><p>A 43-year-old woman presented with recurrent hypoglycemia and episodes of loss of consciousness. On admission, her blood glucose was 37 mg/dL (reference range: 70-99 mg/dl), with recovery after intravenous dextrose, fulfilling Whipple's triad. She had a two-year history of dizziness, fatigue, diaphoresis, and neuroglycopenic symptoms, often relieved by frequent soft drink intake, leading to weight gain. She was previously misdiagnosed with a neurologic disorder, resulting in delayed evaluation. Laboratory findings showed elevated serum insulin levels of 65 μU/mL (reference range: 2.6-24.9 μU/mL) during hypoglycemia. Contrast-enhanced CT identified a 1.7 × 1.3 cm mass in the pancreatic body without metastasis. The patient underwent distal pancreatectomy with splenectomy. Postoperatively, hypoglycemic episodes resolved completely. Histopathology confirmed insulinoma. This case highlights the importance of considering insulinoma in patients with recurrent hypoglycemia. Delayed diagnosis may occur due to nonspecific symptoms and misdiagnosis. Careful clinical assessment, basic biochemical testing, and imaging can facilitate timely diagnosis and effective surgical management in resource-limited settings.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag188"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115758","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":"Primary Intratesticular glomus tumor: a rare mesenchymal neoplasm and a diagnostic challenge.","authors":"Zahra Aminparast, Payam Nikjo, Donya Rahmati, Paria Nikjo","doi":"10.1093/omcr/omag075","DOIUrl":"10.1093/omcr/omag075","url":null,"abstract":"<p><strong>Background: </strong>Glomus tumors are rare mesenchymal neoplasms of perivascular origin, most commonly found in the dermis or subcutis of distal extremities. Testicular involvement is exceptionally uncommon and poses a diagnostic challenge due to histopathologic similarities with other intratesticular tumors.</p><p><strong>Case presentation: </strong>We describe an 85-year-old man with a painless, gradually enlarging left testicular mass. Imaging and tumor markers were inconclusive. Radical orchiectomy revealed a well-circumscribed intratesticular lesion. Histology showed uniform round cells with eosinophilic cytoplasm arranged around vascular spaces. Immunohistochemistry demonstrated strong positivity for SMA and negativity for germ cell, stromal, neuroendocrine, and melanocytic markers, confirming the diagnosis of a primary intratesticular glomus tumor.</p><p><strong>Conclusion: </strong>This case underscores the need to consider rare mesenchymal tumors in the differential diagnosis of testicular masses in elderly patients and highlights the pivotal role of immunohistochemistry in establishing an accurate diagnosis.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 10","pages":"omag075"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225232","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 precursor B-cell acute lymphoblastic Leukemia and metastatic neuroblastoma in a child: a rare diagnostic challenge.","authors":"Tala Dakkak, Leyla Mosalmani, Amaal Adnan, Maysaa Alshamandi, Abdullatif Alfarhan, Aliaa Alrifai, Roline Zedan, Arwa Yousef Wassouf, Othman Hamdan","doi":"10.1093/omcr/omag143","DOIUrl":"https://doi.org/10.1093/omcr/omag143","url":null,"abstract":"<p><p>The synchronous occurrence of hematologic and solid malignancies in children is rare and poses diagnostic challenges. We report a 5-year-old boy with intermittent fever, hepatosplenomegaly, and a large abdominal mass. Initial laboratory investigations revealed severe anemia, and bone marrow flow cytometry demonstrated an abnormal blast population consistent with precursor B-cell acute lymphoblastic leukemia. Abdominal imaging revealed a heterogeneous right adrenal mass with internal calcifications suggestive of neuroblastoma. Due to the discrepancy between hematologic findings and radiologic features, a bone marrow biopsy showed small round blue cells with rosette-like structures. Immunohistochemistry, elevated neuron-specific enolase and urinary vanillylmandelic acid supported metastatic neuroblastoma. Bone scintigraphy demonstrated uptake in lumbar vertebrae. The patient was diagnosed with precursor B-cell acute lymphoblastic leukemia and stage IV metastatic neuroblastoma. This case highlights the importance of considering synchronous malignancies when clinical and radiologic findings are discordant, as early recognition is essential for accurate diagnosis and optimal management.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 9","pages":"omag143"},"PeriodicalIF":0.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065012","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":"Bilateral proptosis as the initial manifestation of multiple myeloma with orbital involvement: case report and literature review.","authors":"Sarra Chadli, Mouna Maamar, Hajar Khibri, Wafa Ammouri, Naima Moatassim, Hamza Retal, Zoubida Tazi Mezalek, Hicham Harmouche","doi":"10.1093/omcr/omag176","DOIUrl":"https://doi.org/10.1093/omcr/omag176","url":null,"abstract":"<p><p>Orbital plasmacytoma (OP) is a rare extramedullary manifestation of multiple myeloma (MM), typically presenting unilaterally during the course of previously diagnosed disease. Bilateral OP as the initial manifestation of MM is exceedingly uncommon. We report a 40-year-old woman who presented with rapidly severe bilateral proptosis, visual impairment, and ocular surface damage. Cranio-orbital imaging demonstrated bilateral extraconal masses and diffuse lytic lesions. Immunoelectrophoresis identified monoclonal IgA kappa, and bone marrow aspiration showed 48% dystrophic plasma cells. Histopathological examination of a conjunctival biopsy confirmed extramedullary plasmacytoma, establishing the diagnosis of IgA kappa MM with bilateral OP. Despite a marked early local response after one month of treatment with high-dose corticosteroids and immunochemotherapy, the patient died shortly after. This case highlights an exceptionally rare and aggressive initial presentation of MM with bilateral OP, underscoring the high tumor burden and poor prognosis associated with this unusual manifestation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 9","pages":"omag176"},"PeriodicalIF":0.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064968","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":"Descending necrotizing mediastinitis after pharyngeal fish bone impaction: a case report.","authors":"Es-Sddik El Bakri, Maryeme Lahjaouj, Maryeme Loudghiri, Walid Bijou, Yassine Oukessou, Sami Rouadi, Redallah Abada, Mohamed Roubal, Mohamed Mahtar","doi":"10.1093/omcr/omag177","DOIUrl":"https://doi.org/10.1093/omcr/omag177","url":null,"abstract":"<p><p>Descending necrotizing mediastinitis (DNM) is an uncommon but severe complication of deep neck infection. Most cases arise from odontogenic sources, whereas pharyngeal fish bone impaction is rare. We report the case of a 54-year-old man with poorly controlled type 2 diabetes mellitus who developed DNM 10 days after endoscopic removal of a fish bone lodged in the right vallecula. Flexible nasofibroscopy showed a residual vallecular mucosal lesion with marked supraglottic oedema, and contrast-enhanced cervicothoracic CT demonstrated extensive cervical infection with mediastinal spread. The patient underwent emergency cervicotomy with cervical and mediastinal drainage through a cervical approach, followed by broad-spectrum antibiotics, tracheostomy, and intensive care. He improved gradually with multidisciplinary care. This case underscores the need for early recognition, urgent surgical drainage, and coordinated management, especially in patients with poorly controlled diabetes, even after apparently successful foreign body removal.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 9","pages":"omag177"},"PeriodicalIF":0.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064990","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}