Archive of clinical cases最新文献

{"title":"Persistent elevation of procalcitonin following resolution of presumed community-acquired pneumonia revealing sporadic medullary thyroid carcinoma.","authors":"Shin Yee Tang, Shaikh Abdul Matin Mattar","doi":"10.22551/2026.52.1303.10346","DOIUrl":"https://doi.org/10.22551/2026.52.1303.10346","url":null,"abstract":"<p><p>Procalcitonin (PCT) is widely utilized as a biomarker of bacterial infection and sepsis and is expected to decline following successful treatment. Persistent elevation in the absence of ongoing infection should prompt consideration of alternative diagnoses. Medullary thyroid carcinoma (MTC), a rare neuroendocrine malignancy arising from parafollicular C-cells, is increasingly recognized as a non-infectious cause of elevated PCT. A 67-year-old woman presented with palpitations, exertional dyspnea, and dizziness. Initial investigations demonstrated a markedly elevated PCT level of 11.7 ng/mL and chest radiographic findings suggestive of community-acquired pneumonia. She responded well to antibiotic therapy; however, serial monitoring over seven months revealed persistently elevated PCT ranging from 9.5-12.9 ng/mL, despite normal C-reactive protein and no identifiable infectious focus. Computed tomography identified an incidental thyroid nodule, and a dedicated thyroid ultrasound demonstrated a Thyroid Imaging Reporting and Data System (TI-RADS) 4 lesion measuring approximately 1.6 cm. Fine needle aspiration cytology was Bethesda category V, suspicious for MTC. Serum calcitonin was markedly elevated at 899 pg/mL. The patient underwent total thyroidectomy with bilateral central neck dissection and histopathological examination confirmed a 1.8 cm unifocal MTC (pT1bN0) with lymphatic invasion and minimal extrathyroidal extension. Postoperatively, calcitonin decreased to 71.4 pg/mL. This case highlights that persistent elevation of PCT following apparent resolution of infection served as the clinical trigger for further diagnostic evaluation, ultimately revealing occult MTC. Clinicians should investigate persistent biomarker abnormalities when clinical and biochemical trajectories diverge, as this may facilitate early diagnosis of an underlying malignancy.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 3","pages":"87-93"},"PeriodicalIF":0.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992670","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":"AdVance™ XP male sling implantation for stress urinary incontinence after orthotopic ileal neobladder reconstruction.","authors":"Marta Pezzoli, Mattia Lo Re, Elettra Fuligni, Gianni Vittori, Malte W Vetterlein, Paul Neuville, Andrea Minervini, Andrea Cocci","doi":"10.22551/2026.52.1303.10347","DOIUrl":"https://doi.org/10.22551/2026.52.1303.10347","url":null,"abstract":"<p><p>Stress urinary incontinence (UI) after radical cystectomy with orthotopic ileal neobladder reconstruction remains a challenging condition in men, with very limited evidence regarding surgical management. Specifically, experience with male sling implantation in this setting is limited to a few published cases. We report a 63-year-old male with mixed UI using three pads per day and ICIQ-SF 15, unresponsive to conservative therapy. An AdVance™ XP sling was implanted via transobturator approach. At six months, pad use decreased to 1-2 per day and ICIQ-SF improved to 7, with complete resolution of the stress component and persistence of urgency UI alone. Post-void residual volumes remained low, and no complications were observed. Male sling implantation may represent a less invasive alternative to the artificial urinary sphincter in carefully selected patients, although careful tensioning is essential to avoid urinary retention. This case adds to the scarce published evidence supporting the feasibility of AdVance™ XP sling implantation in men with orthotopic ileal neobladders, although further studies are needed to confirm its long-term safety and effectiveness.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 3","pages":"94-97"},"PeriodicalIF":0.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992700","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":"Multiple surgical interventions for refractory subcostal pain in hypermobile Ehlers-Danlos syndrome: a case report spanning vascular, skeletal, and nerve entrapment diagnoses.","authors":"Silvia Šišková, Talal Ali, Diana Deáková, Ilkin Bakirli, Marta Ščipáková, Jozef Živčák, Jaroslav Majernik","doi":"10.22551/2026.52.1303.10348","DOIUrl":"https://doi.org/10.22551/2026.52.1303.10348","url":null,"abstract":"<p><p>Refractory subcostal and abdominopelvic pain in undiagnosed hypermobile Ehlers-Danlos syndrome (hEDS) may lead to prolonged diagnostic odysseys and repeated surgery. We report a 48-year-old woman who met the 2017 clinical criteria for hEDS and developed persistent subcostal pain despite multiple operations for gynecologic disease, posterior Nutcracker syndrome, median arcuate ligament syndrome, xiphoid deformity, and slipping rib syndrome; anterior cutaneous nerve entrapment syndrome was later diagnosed. Imaging demonstrated a retro-aortic left renal vein, celiac trunk compression, and hypermobile false ribs. Pain recurred or persisted after each intervention, with only transient improvement after xiphoid resection and initial improvement after rib fixation followed by relapse. This case illustrates a multi-compression/multi-entrapment phenotype in hEDS, in which connective tissue laxity may reduce the durability of anatomically targeted procedures. Early recognition of hEDS should prompt hypermobility-aware assessment and favor conservative, multidisciplinary management before further invasive treatment. Dynamic evaluation may help identify overlapping pain generators more accurately.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 3","pages":"98-102"},"PeriodicalIF":0.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992722","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":"Glutaric acidemia type 2 presenting as a surgical acute abdomen: a case of unnecessary exploratory laparotomy in an adult.","authors":"Pınar Karabak Bilal, Süheyla Karadağ Erkoç, Büşra Polat, İrem Erdoğmuş, Mustafa Kemal Bayar","doi":"10.22551/2026.52.1303.10350","DOIUrl":"https://doi.org/10.22551/2026.52.1303.10350","url":null,"abstract":"<p><p>Glutaric acidemia type 2 (GA2), also known as multiple acyl-CoA dehydrogenase deficiency (MADD), is a rare inherited disorder of mitochondrial energy metabolism in which catabolic stress may precipitate severe metabolic decompensation. We report a 25-year-old man with childhood-diagnosed GA2/MADD who had been outside metabolic follow-up and untreated for approximately 21 years. Following a dental abscess and tooth extraction, his oral intake was markedly reduced for approximately one week. He presented with abdominal pain, vomiting, progressive abdominal distension, profound hypoglycemia, and severe high-anion-gap metabolic/lactic acidosis. An outside-hospital computed tomography scan raised concern for a possible defect in gastric antral/pyloric wall integrity, although the examination was suboptimal because oral contrast could not be administered. In the setting of hemodynamic instability, marked abdominal findings, and a presumed gastrointestinal perforation, emergency exploratory laparotomy was performed; no perforation or other intra-abdominal pathology was identified. Postoperatively, persistent life-threatening metabolic acidosis, circulatory failure, and recurrent hypoglycemia prompted intensive care management with continuous veno-venous hemodiafiltration, intravenous glucose, riboflavin, levocarnitine, and nutritional therapy aimed at reversing catabolism. Clinical and biochemical abnormalities resolved rapidly. During nine months of follow-up, the patient remained under endocrinology and metabolic disease care with dietary management, experienced no recurrent metabolic crisis, and required no further renal replacement therapy. This case highlights hypoketotic hypoglycemia in association with severe metabolic acidosis as an important diagnostic clue to metabolic decompensation and illustrates how MADD may closely resemble a surgical acute abdomen.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 3","pages":"108-111"},"PeriodicalIF":0.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992735","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 hypothermia associated with atypical antipsychotics: a diagnostic challenge in a medically complex patient.","authors":"Cláudia Sousa Reis, Filipa Santos Martins, Alzira Silva","doi":"10.22551/2026.52.1303.10349","DOIUrl":"https://doi.org/10.22551/2026.52.1303.10349","url":null,"abstract":"<p><p>Antipsychotic-associated hypothermia is a rare but potentially life-threatening adverse effect that remains underrecognized in clinical practice. This case adds evidence of recurrent hypothermia associated with two different atypical antipsychotics in a medically complex patient with multiple predisposing factors for thermoregulatory dysfunction. It also raises the possibility of a bidirectional interaction between hypothermia and acute kidney injury (AKI). We report the case of a 55-year-old woman with tuberous sclerosis, epilepsy, intellectual disability, and chronic kidney disease who developed recurrent episodes of hypothermia in temporal association with risperidone and subsequently olanzapine, with several episodes also accompanied by bradycardia, hypotension, and AKI. Extensive evaluation excluded common causes of hypothermia, including infection, endocrine dysfunction, hypoglycemia, and structural hypothalamic lesions. Recurrent episodes with a consistent clinical pattern resolved following substitution of atypical antipsychotics with haloperidol, supporting a probable drug-induced etiology. No further episodes of hypothermia, bradycardia, hypotension, or AKI occurred during two years of follow-up. Antipsychotic-associated hypothermia requires a high index of clinical suspicion, as diagnosis can be challenging in medically complex patients. This report highlights the importance of recognizing this rare adverse effect and ensuring careful monitoring and timely adjustment of psychotropic treatment. The temporal association with AKI also raises the possibility of a bidirectional interaction, although the underlying mechanisms remain incompletely understood.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 3","pages":"103-107"},"PeriodicalIF":0.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992748","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":"Extranodal NK/T-cell lymphoma, nasal type, presenting as a necrotic palatal ulcer.","authors":"Mahdiyeh Zarei, Arghavan Tonkaboni, Parastoo Sabouri","doi":"10.22551/2026.51.1302.10343","DOIUrl":"10.22551/2026.51.1302.10343","url":null,"abstract":"<p><p>Extranodal natural killer/T-cell lymphoma (ENKTL), nasal type, is an aggressive Epstein-Barr virus (EBV)-associated lymphoma that predominantly involves the nasal cavity and upper aerodigestive tract. Primary oral manifestations are rare and may clinically mimic benign inflammatory or infectious conditions, resulting in delayed diagnosis. This report presents a rare case of ENKTL initially manifesting as a rapidly progressive necrotizing palatal ulcer. A 44-year-old man presented with a three-week history of a necrotic ulcer on the posterior hard palate. Imaging revealed extensive midfacial destruction, including palatal perforation, nasal septal erosion, turbinate destruction, ethmoidal involvement, and medial orbital wall extension. Histopathologic examination demonstrated atypical large lymphoid cells with extensive necrosis and infiltration into adipose and muscle tissue. Immunohistochemical staining demonstrated diffuse expression of LCA and CD3, focal expression of CD30, absence of CD20, ALK, and CD56 expression, and a high proliferative activity, as evidenced by a Ki-67 index of approximately 90%. Based on the histomorphologic and immunophenotypic features, extranodal NK/T-cell lymphoma was suspected. Chromogenic in situ hybridization (CISH) for Epstein-Barr virus-encoded RNA (EBER) demonstrated strong nuclear positivity in atypical lymphoid cells, confirming the diagnosis of ENKTL, nasal type. The patient achieved complete remission after chemotherapy; however, eight months later, the patient developed a systemic relapse that was diagnosed as peripheral T-cell lymphoma. This case highlights the diagnostic complexity of ENKTL presenting as a destructive palatal lesion. Comprehensive histopathologic evaluation, detailed immunophenotyping, and EBV confirmation by EBER are essential for accurate diagnosis and timely oncologic management. ENKTL should be considered in the differential diagnosis of rapidly progressive oral necrotic lesions unresponsive to conventional therapy.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 2","pages":"67-73"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674479","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":"ESA-induced pure red cell aplasia presenting as a precipitous hemoglobin drop in end-stage renal disease.","authors":"James Seng Koon Mui","doi":"10.22551/2026.51.1302.10339","DOIUrl":"10.22551/2026.51.1302.10339","url":null,"abstract":"<p><p>Anemia is a nearly universal complication of chronic kidney disease (CKD). While erythropoiesis-stimulating agents (ESAs) are the standard of care, they rarely induce acquired pure red cell aplasia (PRCA) via neutralizing anti-erythropoietin (anti-EPO) antibodies. Diagnosis is often delayed as clinical focus frequently shifts toward more common causes of acute anemia, such as hemorrhage. An 88-year-old male on maintenance hemodialysis presented with a precipitous hemoglobin drop to 6.8 g/dL. Investigation revealed replete hematinics but profound reticulocytopenia. After excluding occult gastrointestinal bleeding, hemolysis, and nutritional deficiencies, a bone marrow biopsy demonstrated isolated erythroid aplasia with preserved myeloid and megakaryocytic lineages, leading to a diagnosis of PRCA. Anti-EPO antibody testing was not performed, which limits definitive etiological confirmation. Due to the high risk of immunosuppression in an elderly patient and the limited accessibility of hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs), management was restricted to ESA cessation and supportive transfusions. This case highlights the diagnostic approach for severe anemia and the significance of profound reticulocytopenia in PRCA. The definitive hallmark remains the detection of circulating anti-EPO antibodies paired with a bone marrow study demonstrating near-total depletion of erythroid precursors, but preserved myeloid and megakaryocyte lineages. Management includes the permanent cessation of ESAs, immunosuppression to reduce circulating antibodies, and supportive blood transfusions. In chronic hemodialysis patients, early recognition of iatrogenic PRCA is essential to prevent the continued administration of potentially harmful ESAs and to facilitate a transition toward alternative therapies, such as HIF-PHIs.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 2","pages":"38-42"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674527","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":"Melkersson-Rosenthal syndrome in an allergic patient successfully treated with fresh frozen plasma.","authors":"Delia Urdea, Florentina Severin, Victor V Costan, Deniss V Mereuta","doi":"10.22551/2026.51.1302.10337","DOIUrl":"10.22551/2026.51.1302.10337","url":null,"abstract":"<p><p>Melkersson-Rosenthal syndrome (MRS) is a rare and often challenging condition of unknown etiology, typically defined by a clinical triad of peripheral facial nerve palsy, recurrent orofacial edema, and fissured tongue. Its variable presentation and overlap with allergic reactions, mast cell-mediated disorders, and drug hypersensitivity reactions can delay diagnosis and appropriate management. We report the case of a 43-year-old man with a personal long-standing history of recurrent hemifacial and lip swelling associated with facial nerve palsy and a plicated tongue, fulfilling the complete clinical triad of MRS. Extensive laboratory, immunological, infectious, and allergological investigations ruled out alternative diagnoses, including hereditary angioedema and drug hypersensitivity. Histopathological examination of a lip biopsy did not reveal granulomatous inflammation. The disease was refractory to multiple standard therapies, including antihistamines, corticosteroids, epinephrine, antibiotics, and immunomodulatory agents. Administration of fresh frozen plasma at a dose of 10 ml/kg resulted in a rapid and marked clinical improvement within 6 hours. This case highlights a rare complete presentation of MRS and underscores the challenges in diagnosis and management. The favorable response to fresh frozen plasma suggests a potential therapeutic option in refractory cases; however, further studies are required to clarify its role and mechanism of action in Melkersson-Rosenthal syndrome.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 2","pages":"26-29"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674610","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":"Interobserver variability in colonoscopy quality assessment: a retrospective standardized multicenter video-based study.","authors":"Radu Alexandru Vulpoi, Tudor-Ştefan Rotaru, Mihaela Luca, Adrian Ciobanu, Cristian Gheorghe, Eugen Dumitru, Oana-Bogdana Bărboi, Diana-Elena Floria, Vadim Roşca, Gheorghe Bălan, Andrei Olteanu, Vasile Liviu Drug","doi":"10.22551/2026.51.1302.10338","DOIUrl":"10.22551/2026.51.1302.10338","url":null,"abstract":"<p><strong>Background and aims: </strong>Colonoscopy quality assessment is essential for adequate bowel preparation and complete examination, yet even validated tools such as the Boston Bowel Preparation Scale (BBPS) remain partly subjective. We assessed interobserver variability in expert evaluation using a standardized multicenter video dataset.</p><p><strong>Methods: </strong>This retrospective multicenter study included 64 anonymized complete colonoscopy videos from two academic centers. Eight experienced gastroenterologists independently evaluated recordings in randomly assigned pairs. Videos were assessed by five reviewer-pair combinations; individual reviewers evaluated between 10 and 33 examinations, and each pair assessed between 10 and 23 videos. Assessments included segmental and total BBPS scores, bowel preparation adequacy, and recognition of key anatomical landmarks: ileocecal valve, appendiceal orifice, hepatic and splenic flexures, and anal verge. Interobserver agreement was assessed using linear weighted Cohen's kappa for segmental BBPS scores, intraclass correlation coefficient (ICC) for total BBPS score, and Cohen's kappa with overall percent agreement for bowel preparation adequacy and anatomical landmark recognition. Because reviewer pairs varied across examinations, agreement measures were interpreted as pooled pairwise agreement across independent expert assessments. The Wilcoxon signed-rank test was retained as a complementary analysis for paired BBPS score differences.</p><p><strong>Results: </strong>Significant inter-reviewer variability was observed in BBPS scoring. Differences were found for the right colon, transverse colon, left colon, and total BBPS score: 2.42 vs 1.91, p<0.01; 2.47 vs 2.11, p<0.01; 2.44 vs 2.22, p<0.05; and 7.33 vs 6.23, p<0.01, respectively. Overall, bowel preparation adequacy classification did not differ significantly, although discordant judgments occurred in 34% of examinations. Anatomical landmark recognition also varied, particularly for the appendiceal orifice and colonic flexures.</p><p><strong>Conclusions: </strong>Expert-based assessment may show clinically relevant variability despite standardized review conditions, supporting the need for more objective and reproducible approaches to colonoscopy quality control.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 2","pages":"30-37"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674531","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":"Clinical outcomes and left ventricular recovery in patients with solid malignancies developing Takotsubo syndrome: a retrospective cohort study.","authors":"Airton Leonardo de Oliveira Manoel, Aida Malik Al Kindy, Waleed Dawelbeit, Marwa Makhlouf, Ahmed Mustafa Basuoni","doi":"10.22551/2026.51.1302.10341","DOIUrl":"10.22551/2026.51.1302.10341","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy (TTS) is an acute heart failure syndrome characterized by transient left ventricle (LV) systolic dysfunction, often triggered by physical or emotional stress. Although several registries, observational studies, and meta-analyses have demonstrated an association between malignancy and adverse outcomes in Takotsubo syndrome, data describing the interplay between cancer stage, treatment exposure, ventricular recovery, and mortality in patients with solid malignancies remain limited. <b>Material and methods:</b> We retrospectively analyzed adult patients with solid malignancies treated at a Comprehensive Cancer Center between November 2021 and December 2025 who developed Takotsubo syndrome. TTS was diagnosed according to the InterTAK Diagnostic Score together with characteristic echocardiographic findings and, when indicated, additional anatomical or tissue characterization. Demographic characteristics, cancer type and stage, clinical presentation, electrocardiogram and biomarkers findings, imaging results, and outcomes were collected. Primary outcome was all-cause mortality. Secondary outcomes included cause-specific mortality, recovery of left ventricular systolic function, and resumption of cancer therapy. <b>Results:</b> A total of 26 consecutive patients developed TTS during the study period. Median age 64.5 years (IQR 52.2 - 69.5); 61.5% were female. Advanced or metastatic cancer was present in 42.3% of patients. Sepsis occurred in 50.0%, and major cancer-related surgery in 30.8%. The median InterTAK Diagnostic Score was 75.5 (IQR 64.5-80.0); 73.1% of patients had scores ≥70. Overall mortality was 38.5% (10/26), and all deaths were attributed to cancer-related causes; no cardiac-related deaths occurred. Advanced/metastatic disease was associated with higher mortality (80.0% vs. 18.8%, p = 0.015), and all deaths occurred in patients receiving non-curative treatment. In exploratory multivariable analysis, advanced/metastatic cancer was associated with increased odds of death (adjusted OR 11.49, p = 0.021). Follow-up echocardiography was available in 18 patients; all demonstrated normalization of left ventricular systolic function (LVEF ≥50%), with a median time to documented recovery of 10 days (IQR 6-21). <b>Conclusions:</b> Takotsubo cardiomyopathy syndrome in patients with solid malignancies was associated with high cancer-related mortality, whereas left ventricular dysfunction was largely reversible among survivors. Outcomes appeared to be more associated with oncologic disease burden than with cardiac dysfunction.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"13 2","pages":"47-55"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674537","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}