Case Reports in Gastrointestinal Medicine最新文献

{"title":"Rare Case of Duodenal Metastasis From Colon Cancer: Review of Literature and Insights on Novel Therapies.","authors":"Ammar Ismail, William K B Boateng, Amira Alnakeb, Youssef Botros, Allan L Cruz","doi":"10.1155/crgm/8864636","DOIUrl":"https://doi.org/10.1155/crgm/8864636","url":null,"abstract":"<p><p>Metastasis to the duodenum from colorectal cancer is exceptionally rare and presents significant diagnostic and therapeutic challenges. We describe a 68-year-old female with right colon adenocarcinoma, who developed a duodenal metastasis despite treatment with FOLFOX chemotherapy. Transition to FOLFIRI yielded limited success, emphasizing the need for innovative approaches. Genetic analysis revealed a KRAS G12D mutation, for which targeted therapies are not yet approved. Immunohistochemistry confirmed the gastrointestinal origin of the duodenal mass. Literature indicates that surgical resection can offer curative potential in select cases, although it was not viable here. Emerging KRAS-targeted agents, such as MRTX1133, represent promising options for addressing this mutation. This case underscores the challenges of managing rare metastatic patterns, the potential of personalized therapies, and the necessity for further research into innovative treatments for advanced colorectal cancer. It highlights the importance of developing targeted strategies to improve outcomes for patients with such complex metastatic diseases.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"8864636"},"PeriodicalIF":0.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754777","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 Case of Ventricular Arrhythmia in a Patient With HER2-Positive Gastric Cancer Receiving Trastuzumab.","authors":"Naoto Takahashi, Hitoshi Fujii, Tomohiro Iwasa, Yuka Koizumi, Yukihiro Minagawa, Chihiro Tono","doi":"10.1155/crgm/2752788","DOIUrl":"10.1155/crgm/2752788","url":null,"abstract":"<p><p><b>Background:</b> Human epidermal growth factor receptor 2 (HER2)-positive gastric cancer accounts for approximately 15% of gastric cancer cases. Trastuzumab (Trz), a monoclonal antibody targeting HER2, has been shown to improve overall survival when combined with chemotherapy. However, while Trz-induced cardiotoxicity (TIC) is a well-recognized adverse effect in breast cancer chemotherapy, reports on its occurrence in gastric cancer treatment remain limited. <b>Case Presentation:</b> An 80-year-old Japanese male with HER2-positive advanced gastric cancer (cStage III) developed ventricular arrhythmia and heart failure during postoperative chemotherapy with the Trz + SOX regimen (Trz, oxaliplatin, and TS-1). The patient initially underwent distal gastrectomy with D1+ lymphadenectomy for anemia and pyloric stenosis. Metastasis to the #8a lymph node (anterior superior lymph node of the common hepatic artery) and pancreatic invasion via lymph nodes were treated with two cycles of the Trz + SOX regimen, leading to a partial response. However, after the 11th cycle, he developed ventricular tachycardia and heart failure. Cardiac imaging and laboratory findings revealed no coronary artery disease or structural abnormalities, suggesting TIC as the underlying cause. Antiarrhythmic therapy with pharmacological agents led to symptom resolution, and no recurrence of arrhythmia or heart failure was observed. <b>Discussion:</b> This case highlights the potential cardiotoxicity associated with nonanthracycline-based Trz regimens for gastric cancer. Pathophysiologically, HER2 signaling inhibition in cardiomyocytes may impair stress responses and repair mechanisms. The patient's advanced age, history of hypertension and anemia, and cumulative exposure to chemotherapy may have contributed to increased cardiac vulnerability. Careful monitoring of cardiac function is essential in elderly and comorbid patients undergoing Trz-based therapy for gastric cancer to mitigate the risk of cardiotoxicity. <b>Conclusion:</b> Trz-based chemotherapy for HER2-positive gastric cancer, even without anthracyclines, may pose a risk of cardiotoxicity, particularly in elderly or comorbid patients. Further research is warranted to elucidate underlying mechanisms and optimize monitoring and prevention strategies in this population.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"2752788"},"PeriodicalIF":0.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691909","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":"Clear Cell Carcinoma: A Rare Variant of Cholangiocarcinoma Case Report and Systematic Review.","authors":"Salah Abdel Jalil, Majd M AlBarakat, Ghazi Abu Afifeh, Rana B Altawalbeh, Ala Abdel-Jalil","doi":"10.1155/crgm/1716741","DOIUrl":"10.1155/crgm/1716741","url":null,"abstract":"<p><p><b>Background:</b> Cholangiocarcinoma (CCA) is a rare malignancy of the biliary epithelium, accounting for approximately 3% of gastrointestinal cancers. The clear-cell variant of CCA is rare, with only nine documented cases worldwide. This case report describes a unique presentation of clear-cell intrahepatic (or peripheral) cholangiocarcinoma (ICC), highlighting its clinical course, histopathological features, and management. <b>Case Presentation:</b> A 56-year-old female with no significant medical history presented with postprandial right upper quadrant and epigastric pain. Following an initial diagnosis of gallbladder stones, laparoscopic cholecystectomy was performed. However, persistent epigastric pain, nausea, and vomiting led to further evaluation, revealing a 2.7 × 2.5 cm mass in the gallbladder bed compressing the common bile duct with associated intrahepatic biliary dilation. Endoscopic retrograde cholangiopancreatography confirmed the findings, and the patient underwent a left hemihepatectomy with radical choledectomy and biliary reconstruction. Histopathology demonstrated clear-cell ICC. Postoperatively, the patient received adjuvant chemotherapy and remained disease free at 14 months' follow-up. <b>Methods:</b> A systematic review and meta-analysis were conducted according to PRISMA guidelines and the Cochrane Handbook. A comprehensive search of PubMed and SCOPUS was performed without restrictions until December 2024 to identify case reports and case series of clear-cell CCA. Data on clinical presentation, diagnostic findings, treatment modalities, and outcomes were extracted and analyzed. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. <b>Results:</b> The systematic review included 7 studies reporting 9 cases of clear-cell CCA. The mean patient age was 59.7 years, and 77.8% of the cases underwent surgical intervention. Outcomes varied, with disease-free survival ranging from 7 to 30 months in the reported cases. Factors such as tumor size and the presence of metastasis influenced prognosis. <b>Conclusion:</b> Clear-cell CCA, though rare, should be considered in the differential diagnosis of biliary masses. Early surgical intervention is pivotal for improved outcomes, but further studies are needed to develop consensus treatment guidelines. Reporting additional cases is essential to enhance understanding and optimize management of this rare malignancy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"1716741"},"PeriodicalIF":0.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576549","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":"Small Bowel Stricture in a Crohn's Patient: An Unrelated Etiology.","authors":"Dhiraj K Peddu, Matthew Kubina, Ankit Mishra, Molly Stone, Winnie Zou, Jiaqi Shi, David C Kestenbaum, Scott E Regenbogen, Jeffrey A Berinstein","doi":"10.1155/crgm/6697889","DOIUrl":"10.1155/crgm/6697889","url":null,"abstract":"<p><p>Small bowel strictures are a common complication of Crohn's disease (CD), which can lead to obstruction, perforation, and fistula formation. However, strictures can stem from other etiologies in CD patients, including malignancy, prior surgery, radiation, and ischemia. We present a patient who developed a new long-segment jejunal and ileal stricture within 2 months after ileocolic resection. What was initially treated as worsening CD was ultimately an unrelated ischemic stricture due to suspected superior mesenteric artery thrombosis following ileocolic resection. The contrasting location of the stricture compared to her previous disease, timing of progression, and lack of response to anti-inflammatory treatment prompted a reassessment of the underlying disease process.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6697889"},"PeriodicalIF":0.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545426","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":"Development of Ulcerative Colitis in a Patient With Human Immunodeficiency Virus.","authors":"Clive Jude Miranda, Murad Hayatt Ali, Nariman Hossein-Javaheri, Farhan Azad, Marcellus Anthony Singh, Navpreet Kaur Rana, Nakul Anush Ravish, Thomas Christopher Mahl","doi":"10.1155/crgm/2362039","DOIUrl":"10.1155/crgm/2362039","url":null,"abstract":"<p><p>The relationship between the human immunodeficiency virus (HIV) and inflammatory bowel disease (IBD) is poorly understood. The coexistence of the two conditions is uncommon with scattered retrospective studies in the literature. Whereas HIV was initially thought to propagate IBD flares and increase disease severity, more studies are coming out showing that HIV may actually be protective against IBD development and relapse, particularly due to the depletion of CD4 lymphocytes. We present a HIV-positive female with new onset ulcerative colitis at the age of 42. Her HIV was poorly controlled for 25 years but with new gastrointestinal symptoms for 9 months, an endoscopic evaluation was done which revealed a new inflammatory bowel disease diagnosis, which warranted immediate therapy. In describing this patient's case, we discuss the uncommon coexistence of HIV and IBD and investigate potential relationships between the two conditions.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"2362039"},"PeriodicalIF":0.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498343","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":"Late Onset of Pseudoachalasia in Anti-Hu-Associated Syndrome.","authors":"Jens Jaekel, Christian Jürgensen, Frank Tacke, Christoph Jochum, Gianluca Barbone","doi":"10.1155/crgm/6627099","DOIUrl":"10.1155/crgm/6627099","url":null,"abstract":"<p><p><b>Background:</b> Pseudoachalasia is a rare manifestation of anti-Hu-associated syndrome. We present the case of a 61-year-old female patient presenting primarily with progressive pain and sensory disturbance of all limbs. Neurological symptoms progressed after the primary treatment response and onconeural anti-Hu-antibodies were tested positive, which is often a surrogate to paraneoplastic syndrome. Subsequently, after repeated imaging, a lung carcinoid tumor was resected without detectable recurrence after surgery. Nearly 90 months after the first neurological manifestation, the patient developed dysphagia and the diagnosis of pseudoachalasia was established by esophageal manometry. Due to recurrence after pneumatic dilatation, endoscopic botulinum toxin injection provided good clinical results for the patient. <b>Purpose:</b> This case illustrates that anti-Hu-associated paraneoplastic pseudoachalasia may occur late in the clinical course, indicating that new-onset dysphagia in anti-Hu-positive individuals should be thoroughly investigated by imaging, endoscopy, manometry, and histology.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6627099"},"PeriodicalIF":0.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477246","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":"Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Following Initiation of Sulfasalazine for Ulcerative Colitis: A Yearlong Clinical Challenge.","authors":"Michael B Andrews, Michael V Patrone, Stephen J Bickston","doi":"10.1155/crgm/8870613","DOIUrl":"10.1155/crgm/8870613","url":null,"abstract":"<p><p>Sulfasalazine, a commonly prescribed medication for treating ulcerative colitis, can cause a severe yet rare adverse drug reaction known as drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. In this case, a female patient experienced a severe flare of her ulcerative colitis, accompanied by sulfasalazine-induced DRESS syndrome. The ulcerative colitis flare and acute liver injury resolved with a treatment regimen of high-dose steroids and cyclosporine. However, she continued to have treatment-resistant dermatologic changes and delayed organ involvement, including the development of hyperthyroidism that required close multidisciplinary follow-up. IVIG was used to successfully wean steroids and cyclosporine after a year of therapy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"8870613"},"PeriodicalIF":0.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369397","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":"Epidermoid Cyst of the Cecum Treated by Laparoscopic Colectomy: A Case Report With Histopathology and Literature Review.","authors":"Ada Firrincieli, Eleonora Nardi, Lavinia Pugliese, Chiara Marconcini, Giovanni Alemanno, Luca Messerini","doi":"10.1155/crgm/6326844","DOIUrl":"10.1155/crgm/6326844","url":null,"abstract":"<p><p><b>Introduction:</b> Cecal epidermoid cyst (CEC) is a rare and benign lesion; the origin can be acquired or congenital, but the pathogenesis remains unclear. We present a case report of a patient with a cecal cyst treated by hemicolectomy. Histopathology revealed an epidermoid cyst (EC) of the cecum. <b>Case Presentation:</b> A 28-year-old woman was admitted to the hospital with abdominal pain, without significant past medical history. CT and MRI scans were performed, and a large cystic mass in the anterior portion of the pelvic region was detected. Imaging techniques managed to localize the site and dimensions of the neoplasm; however, they did not provide a conclusive diagnosis. The differential diagnosis was made with appendiceal mucocele, duplication cyst, or endometriotic cyst formation. Laparoscopic right hemicolectomy was performed; the mass did not present with any adhesions with the surrounding organs. Macroscopically, the mass appears as irregular extraluminal cystic lesion arising from the cecal wall of 104 × 83 × 68 mm. Microscopically, the cystic wall was lined by keratinized stratified squamous epithelium. No malignant findings were identified. Thus, the histopathologic evaluation leads to the final diagnosis of EC. <b>Conclusions:</b> ECs are rare benign neoplasms that can be acquired or congenital. They can vary both in their clinical and imaging presentation; the lesion can be associated with nonspecific symptoms or be asymptomatic. A wide heterogeneity both in sex distribution and age is observed. Imaging techniques are useful, but the final diagnosis can be made only after the complete surgical excision of the neoplasm and its histopathological examination.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6326844"},"PeriodicalIF":0.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369398","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 Pouchitis Uncovering De Novo Celiac Disease.","authors":"Chakib Khoury, Rebal Nahas, Emanuel Youssef Dib, Karam Karam, Elias Fiani","doi":"10.1155/crgm/2060709","DOIUrl":"10.1155/crgm/2060709","url":null,"abstract":"<p><p>We present the case of a 39-year-old woman with a history of severe ulcerative colitis (UC) that was refractory to 5-aminosalicylates, corticosteroids, and biologics, and who subsequently underwent total colectomy with ileal pouch-anal anastomosis (IPAA). She developed chronic antibiotic-refractory pouchitis (CARP) characterized by recurrent abdominal pain, cramping, and diarrhea unresponsive to standard treatments. A comprehensive workup, including testing for anti-tissue transglutaminase IgA antibodies, led to the diagnosis of de novo celiac disease, confirmed by endoscopic and histopathologic findings. Initiation of a gluten-free diet resulted in the resolution of symptoms, with no relapse observed during a 9-month follow-up. Our case highlights the importance of considering secondary etiologies such as celiac disease in patients with chronic refractory pouchitis and emphasizes the need for tailored management strategies.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"2060709"},"PeriodicalIF":0.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369399","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 Case of Strangulated Intestinal Obstruction Caused by Acquired Ileal Diverticulum.","authors":"Zhong-Yu Wang, Zhe Han, Hong-Fei Pang, Yu-Hang Liu, Ming Wei, Yuan-Yuan Wang","doi":"10.1155/crgm/5634075","DOIUrl":"10.1155/crgm/5634075","url":null,"abstract":"<p><p><b>Background:</b> Acquired ileal diverticulum is an extremely rare condition that occurs in the ileum and is caused by acquired factors. Strangulated intestinal obstruction, a life-threatening variant of bowel obstruction, is associated with exceedingly high mortality rates. Here, we present a case of acquired ileal diverticulum causing strangulated intestinal obstruction, which was treated at our hospital. <b>Case Report:</b> A 65-year-old female with no previous history of intestinal obstruction presented with acute abdominal pain. An exploratory laparotomy revealed an acquired ileal diverticulum and an internal hernia. <b>Conclusion:</b> Acquired ileal diverticulum leading to strangulated intestinal obstruction is rare. Clinicians should consider the possibility of this disease when encountering intestinal obstruction patients with no history of abdominal surgery.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"5634075"},"PeriodicalIF":0.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369396","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}