Reports (MDPI)最新文献

{"title":"Kaposi's Varicelliform Eruption in a Child with Atopic Dermatitis: A Case Report.","authors":"Alfonso Lendínez-Jurado, Ana García-Ruiz, Viviane Ruiz-Dassy","doi":"10.3390/reports9030275","DOIUrl":"10.3390/reports9030275","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Eczema herpeticum (EH), or Kaposi's varicelliform eruption, is a dermatologic emergency characterized by the abrupt onset of painful monomorphic vesiculopustules with potential for rapid dissemination. Atopic dermatitis (AD) is the main predisposing condition due to skin barrier dysfunction and impaired antiviral immunity. Early recognition is essential because delayed treatment may result in avoidable complications, including ocular involvement and systemic disease. Current recommendations emphasize immediate systemic acyclovir based on clinical suspicion, without awaiting laboratory confirmation. <b>Case Presentation:</b> A 4-year-old boy with moderate AD presented with a 6-day history of fever, malaise, and a rapidly progressive vesiculopustular eruption involving both eczematous and previously unaffected skin. The patient had a recent AD flare, molluscum contagiosum, and had initially received oral amoxicillin-clavulanate for presumed bacterial superinfection without improvement. Physical examination revealed widespread painful monomorphic umbilicated vesiculopustules with hemorrhagic crusts and mild bilateral conjunctival injection. Oral acyclovir was initiated within one hour of evaluation. Laboratory investigations showed mild inflammatory abnormalities without renal or hepatic involvement. Because lesional PCR was unavailable, complementary blood-based investigations were performed; HSV-1 IgM serology and blood PCR provided additional retrospective findings compatible with HSV-1 infection, while Gram stain and bacterial cultures were negative. Fever resolved within 24 h, no new lesions developed after day 3, and complete re-epithelialization was achieved after a 10-day course of acyclovir. <b>Conclusions:</b> This case highlights the importance of bedside recognition of eczema herpeticum in children with atopic dermatitis, particularly when painful monomorphic vesiculopustules are accompanied by fever and rapid dissemination. Early initiation of systemic acyclovir based on clinical suspicion remains the cornerstone of management. While PCR from vesicular lesions is the preferred diagnostic test when available, laboratory confirmation should not delay treatment. This report also illustrates common real-world challenges, including initial misdiagnosis as bacterial infection and limited access to optimal virological testing.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835612","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":"Pulmonary Metastases from a Hemangiopericytoma/Solitary Fibrous Tumor Spectrum Neoplasm in a Patient with a Poorly Documented Thigh Tumor: A Case Report.","authors":"Justina Antonela Dragomir, Alexandru Stoichiță, Silviu Gabriel Vlăsceanu, Radu Matache, Beatrice Mahler","doi":"10.3390/reports9030274","DOIUrl":"10.3390/reports9030274","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Solitary fibrous tumor (SFT), historically termed hemangiopericytoma (HPC), is a rare fibroblastic mesenchymal neoplasm with variable biological behavior. Pulmonary involvement is uncommon and may represent either a primary thoracic tumor or metastatic disease from an extrapulmonary site. Its clinical course ranges from indolent, surgically curable disease to aggressive malignancy with local recurrence and distant dissemination. In this retrospective case, confirmatory STAT6 immunohistochemistry was unavailable; therefore, the tumor is described as a hemangiopericytoma/solitary fibrous tumor spectrum neoplasm. <b>Case Presentation:</b> We report the case of a 33-year-old woman who presented with sudden-onset hemoptysis and was found to have two large, well-defined bilateral pulmonary masses. Initial clinical and radiological evaluation raised suspicion of primary pulmonary tumors or other benign lesions. Because both lesions were considered resectable, staged pulmonary resections were performed. Subsequent reassessment of the patient's medical history revealed previous surgeries for a poorly documented recurrent thigh tumor, later confirmed to represent the primary malignant hemangiopericytoma/solitary fibrous tumor spectrum neoplasm. Despite staged pulmonary resections, systemic chemotherapy, and further oncologic management, the disease progressed rapidly, with cerebral, bilateral pulmonary, mediastinal, and subcutaneous metastases. The patient died within 18 months of the initial pulmonary diagnosis. <b>Conclusions:</b> This case highlights the diagnostic difficulty of metastatic pulmonary hemangiopericytoma, particularly when the primary soft tissue tumor is inadequately documented. It emphasizes the importance of detailed clinical history, retrieval of previous histopathological reports, and long-term surveillance in patients with soft tissue tumors, even when initially considered benign.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835610","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":"Page Kidney: An Unusual Cause of Acute Onset Hypertension-A Case Report.","authors":"Konstantinos Koutsoulas, Evangelos Karagiannis, Dimitrios Kouroupis, Ioannis Vlachos, Spyros Papadopoulos, Panagiotis Pateinakis, Athina Pyrpasopoulou, Ioannis Vouros, Ioannis Goulis","doi":"10.3390/reports9030273","DOIUrl":"10.3390/reports9030273","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Renal disease is the leading cause of secondary hypertension in children and adolescents. Among younger patients presenting with severe hypertension, renovascular and renal parenchymal disorders should be considered promptly; <b>Case presentation</b>: We describe the case of a 16-year-old male who presented with severe fatigue and was found to have resistant arterial hypertension (180/120 mmHg). His medical history was notable for blunt epigastric trauma sustained during football training approximately 6 months before presentation. Magnetic resonance imaging of the kidneys and retroperitoneum demonstrated a large right-sided perinephric hematoma compressing the kidney. Plasma renin activity and aldosterone levels were markedly elevated, establishing the diagnosis of Page kidney. Percutaneous drainage was performed by placement of a drainage catheter into the perinephric collection, resulting in evacuation of a substantial volume of liquefied hematoma. Following the procedure, arterial blood pressure gradually normalized, accompanied by resolution of the hormonal abnormalities; <b>Conclusions</b>: Page kidney is a rare but important cause of secondary hypertension resulting from activation of the renin-angiotensin-aldosterone system due to external renal compression and impaired intrarenal perfusion. Although its clinical presentation may be insidious, delayed recognition can lead to severe cardiovascular and renal complications. Management includes percutaneous drainage or surgical decortication of the affected kidney, together with antihypertensive treatment targeting the renin-angiotensin-aldosterone system. Early diagnosis and treatment are essential to optimize clinical outcomes and preserve renal function.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835580","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 Report of Eosinophilic Sialodochitis with Right Submandibular Sialolithiasis and Hyperattenuating Material Along Wharton's Duct.","authors":"Tomohiro Kawasumi, Takao Hamamoto, Takashi Ishino, Tsutomu Ueda, Sachio Takeno","doi":"10.3390/reports9030272","DOIUrl":"10.3390/reports9030272","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Eosinophilic sialodochitis (ES), also known as sialodochitis fibrinosa, is a rare disorder characterized by recurrent salivary gland swelling caused by intraductal eosinophilic mucous plugs. Typical histopathological findings include eosinophils and Charcot-Leyden crystals within ductal secretions, and characteristic imaging findings include salivary duct dilatation and glandular swelling. Although rare cases associated with sialolithiasis or calcification have been reported, high-attenuation material within the salivary duct on computed tomography (CT) has not been clearly described in ES. <b>Case Presentation</b>: A 56-year-old woman with allergic rhinitis presented with recurrent swelling and pain in the right submandibular area. CT and ultrasonography revealed a large sialolith in the right submandibular gland and dilatation of Wharton's duct. She underwent right submandibular gland excision for presumed chronic obstructive submandibular sialadenitis with a sialolith. Soon after surgery, she developed recurrent swelling of the right floor of the mouth, and CT showed persistent high-attenuation material along Wharton's duct without residual sialolith. Ductal massage discharged a brownish gelatinous material. Histopathological examination revealed numerous eosinophils and Charcot-Leyden crystals in both the discharged mucous plug and decalcified sialolith, fulfilling Baer's diagnostic criteria for ES. Physical extraction and anti-allergic medications were insufficient, whereas ductal irrigation with saline and triamcinolone acetonide markedly reduced mucous plug discharge. Symptoms were controlled during 18 months of follow-up. <b>Conclusions</b>: Retained eosinophilic mucin in ES may appear as high-attenuation ductal material on CT and contribute to salivary stasis and sialolith formation.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing the Benign Behind Worrisome Histology: A Case Report of Proliferative Fasciitis.","authors":"Catalin-Bogdan Satala, Valerica Valentin Zaharia, Alina-Mihaela Gurau, Cristina-Mihaela Popescu, Robert Daniel Ciortan, Daniela Mihalache","doi":"10.3390/reports9030271","DOIUrl":"10.3390/reports9030271","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Proliferative fasciitis (PF) is an infrequent benign fibroblastic/myofibroblastic proliferation that may closely resemble a soft tissue sarcoma, creating a diagnostic dilemma out of proportion to its biological behaviour. Because no single clinical, histological or immunohistochemical feature is diagnostic, accurate classification depends on the integration of complementary findings. We describe a challenging case of PF involving the lower leg and present a practical clinicopathological approach to its evaluation. <b>Case Presentation</b>: A 34-year-old man presented with a painless subcutaneous nodule on the lateral aspect of the left lower leg, discovered incidentally. Clinical examination suggested a benign superficial soft-tissue lesion, and because no features raised suspicion for malignancy, complete excision was performed without preoperative imaging. Gross examination revealed a 1.9 × 1.6 × 0.7 cm fascial-based lesion composed of spindle cells and scattered ganglion-like cells within a variably myxoid stroma. Focal nuclear pleomorphism, typical mitotic activity (2 mitoses/10 high-power fields), and limited extension into adjacent adipose tissue broadened the differential diagnosis. Immunohistochemistry demonstrated focal SMA positivity, weak focal desmin and S100 expression, absence of CD31 and CD34 staining, and a low Ki-67 proliferative index (approximately 2-3%). Negative surgical margins, together with integration of the clinical presentation, gross findings, histomorphology, and immunophenotype, supported the diagnosis of proliferative fasciitis. The patient remains free of local recurrence four months after surgery. <b>Conclusions</b>: PF should be considered in the differential diagnosis of superficial spindle-cell proliferations showing deceptively aggressive histological features. Careful clinicopathological correlation remains the cornerstone of diagnosis and helps distinguish this benign entity from its malignant mimics. The clinicopathological framework proposed in this report may assist pathologists in the systematic evaluation of similar diagnostically challenging lesions.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835601","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":"From Disease Control to Long-Term Stability: Regenerative and Prosthetic Management of Peri-Implantitis-A Five-Year Case Report.","authors":"Jakub Kwiatek, Oskar Barczak, Marcin Lenkowski, Justyna Kaczewiak, Mateusz Tarnowski","doi":"10.3390/reports9030270","DOIUrl":"10.3390/reports9030270","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Peri-implantitis is an inflammatory condition associated, among other factors, with biofilm accumulation, affecting peri-implant soft and hard tissues and potentially leading to implant loss. Its treatment remains challenging because no single decontamination or regenerative protocol has demonstrated clear superiority. This case report describes a comprehensive surgical and regenerative approach aimed at preserving an affected implant and restoring peri-implant tissue stability; <b>Case Presentation</b>: A systemically healthy 30-year-old patient presented with peri-implant bone loss around an implant in position 25, restored with a lithium disilicate crown and functioning for three years. Treatment included flap elevation, mechanical debridement and air-polishing of the implant surface, followed by thorough irrigation with sterile saline to remove residual abrasive particles and debris, photodynamic antimicrobial therapy, and laser therapy. Bone regeneration was performed using a bone substitute combined with injectable platelet-rich fibrin to produce sticky bone, which was covered with an advanced platelet-rich fibrin membrane. A provisional crown was placed without occlusal contact. After four months, a definitive crown with a modified emergence profile was delivered to improve hygienic access and reduce biofilm retention. Clinical and radiographic follow-up over five years demonstrated stable peri-implant tissues and maintained bone levels; <b>Conclusions</b>: The combined use of surgical decontamination, PRF-assisted regeneration, sticky bone, and prosthetic modification resulted in stable clinical and radiographic outcomes over five years. Identification and elimination of contributing factors were essential for long-term treatment success.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835577","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 Novel Preparation-Free Palatal Veneer Technique with Incisal Seating Lugs for Management of Tooth Surface Loss: A Case Report.","authors":"Fahad BaHammam","doi":"10.3390/reports9030269","DOIUrl":"10.3390/reports9030269","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Tooth surface loss is the irreversible loss of dental hard tissue caused by non-carious processes. Restoration of affected teeth can be challenging, especially on the palatal surfaces of maxillary anterior teeth when severe palatal hard-tissue loss is present without marked clinical crown shortening. In such cases, clinicians must preserve the remaining enamel for predictable adhesive bonding while ensuring accurate seating, complete adaptation, and controlled cementation of thin indirect restorations. To address these challenges, this case report describes a novel preparation-free approach in which two temporary incisal seating lugs were incorporated into the design of indirect resin-based composite palatal veneers; <b>Case Presentation</b>: A 35-year-old male patient was referred by his general dentist for management of extensive erosive tooth surface loss. Clinical examination revealed generalized tooth surface loss, with a distinctive pattern of severe palatal hard-tissue loss affecting the maxillary anterior teeth without marked clinical crown shortening. Restorative treatment was planned at a 2 mm increase in occlusal vertical dimension. The maxillary anterior teeth were restored with preparation-free indirect resin-based composite palatal veneers, each incorporating two temporary incisal seating lugs to provide a positive seating stop during cementation; the lugs were removed after cementation. Other affected teeth were restored using directly placed resin-based composite restorations. At six months, the veneers remained clinically acceptable, with stable occlusion, maintained pulp sensibility, no postoperative sensitivity, and high patient satisfaction; <b>Conclusions</b>: This technique may facilitate restoration positioning during cementation and may represent a useful clinical alternative when seating preparation-free palatal veneers is challenging.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834849","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":"Case Report: Acute Testicular Pain as the Initial Manifestation of a Ruptured Common Iliac Artery Aneurysm.","authors":"Cristina Valeria Tandara, Alexandru Cristian Cindrea, Adina Maria Mârza, Lucian Adrian Tandara, Ovidiu Alexandru Mederle","doi":"10.3390/reports9030266","DOIUrl":"10.3390/reports9030266","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Ruptured common iliac artery aneurysms may mimic urological disease, particularly when retroperitoneal bleeding causes ureteral compression and secondary hydronephrosis. This case is clinically relevant because the first symptom was acute stabbing testicular pain, followed by lumbar discomfort and ultrasound findings suggestive of obstructive uropathy. <b>Case Presentation</b>: A 73-year-old man with arterial hypertension and active smoking presented to the Emergency Department with sudden left lumbar pain that initially radiated to, or was perceived in, the left testicle. The testicular pain resolved spontaneously, but persistent poorly localized lumbar pain continued. He was afebrile and initially hemodynamically stable. Point-of-care ultrasound showed left hydronephrosis, while the abdominal aorta appeared unremarkable. Because the patient looked clinically unwell and the abrupt, stabbing onset was not fully explained by uncomplicated renal colic, contrast-enhanced abdominal and pelvic computed tomography was performed. CT revealed a fissured saccular aneurysm of the left common iliac artery with active contrast extravasation and a large retroperitoneal hematoma compressing the ipsilateral ureter, thereby causing secondary hydronephrosis. The patient underwent urgent endovascular treatment with percutaneous transluminal angioplasty and Bentley stent. Post-revascularization CT showed no further contrast extravasation, and the patient was discharged after seven days without complications. <b>Conclusions:</b> In older patients with cardiovascular risk factors, sudden testicular, flank, or lumbar pain may warrant consideration of retroperitoneal vascular emergencies, even when initial ultrasound suggests a urological diagnosis. In this patient, discordance between the clinical presentation and the initial ultrasound findings prompted contrast-enhanced CT, which enabled diagnosis and timely vascular management.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835482","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":"Secondary Hemophagocytic Lymphohistiocytosis Triggered by Visceral Leishmaniasis Due to <i>Leishmania infantum</i>: A Case Report.","authors":"Christina Velliou, Anna Varouktsi, Iraklis Leonidis, Anastasia Sarvani, Nikoleta Moutsou, Theocharis Koufakis, Dimitrios Patoulias","doi":"10.3390/reports9030268","DOIUrl":"10.3390/reports9030268","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome characterized by uncontrolled activation of macrophages and cytotoxic lymphocytes. Secondary HLH is most commonly associated with infections, malignancies, and autoimmune disorders. Visceral leishmaniasis (VL) is an uncommon infectious trigger of HLH, and the considerable overlap in clinical manifestations frequently delays diagnosis. Early recognition of the infectious trigger is essential, because prompt targeted therapy may prevent the need for prolonged immunosuppressive treatment and substantially improve outcomes. <b>Case Presentation:</b> A 68-year-old livestock farmer from northern Greece presented with a one-month history of persistent fever, fatigue, and night sweats. Laboratory evaluation demonstrated pancytopenia, severe hyperferritinemia, hypertriglyceridemia, and elevated soluble interleukin-2 receptor (sCD25) levels. After extensive, relevant screening for other underlying etiologies, which proved to be negative, bone marrow examination revealed hemophagocytosis, while anti-<i>Leishmania</i> serology and polymerase chain reaction (PCR) analysis of bone marrow aspirate confirmed infection with <i>Leishmania infantum</i>. Treatment with liposomal amphotericin B along with intravenous dexamethasone resulted in rapid clinical and laboratory improvement. Serial ferritin and sCD25 measurements closely paralleled clinical recovery, supporting their potential usefulness as biomarkers of treatment response. The patient remained asymptomatic at one-month follow-up. <b>Conclusions:</b> Secondary HLH associated with VL is rare, but potentially fatal. Clinicians should maintain a high index of suspicion in patients presenting with prolonged fever, splenomegaly, cytopenia, and marked hyperferritinemia, particularly in endemic regions. Early diagnosis and prompt initiation of targeted therapy are associated with favorable outcomes.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835578","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 p16-Negative Oropharyngeal Squamous Cell Carcinoma and High-Grade Small-Cell Neuroendocrine Carcinoma of the Head and Neck: A Case Report.","authors":"Francesco Chiari, Cecilia Dalmazzini, Ludovica Borgia, Claudio Donadio Caporale, Pierre Guarino","doi":"10.3390/reports9030267","DOIUrl":"10.3390/reports9030267","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Oropharyngeal squamous cell carcinoma (OPSCC) and small-cell neuroendocrine carcinoma (SCNEC) are biologically distinct entities with markedly different prognostic and therapeutic implications. While HPV-negative OPSCC carries worse outcomes than HPV-positive disease, SCNEC is exceedingly rare, highly aggressive, and prone to early systemic dissemination. Their synchronous occurrence in the head and neck (HN) is exceptional and poses major diagnostic and therapeutic challenges. <b>Case Presentation</b>: A 54-year-old male, smoker and alcohol consumer, presented with a left tonsillar lesion and cervical lymphadenopathy. Biopsy confirmed p16-negative OPSCC. He underwent transoral robotic surgery with modified radical neck dissection. Histopathology unexpectedly revealed two distinct malignancies: keratinizing OPSCC in the tonsil and high-grade SCNEC in a cervical lymph node, confirmed by immunohistochemistry (synaptophysin, CD56, Ki-67 80%). Postoperative FDG-PET/CT performed within two months showed rapid systemic spread, including paravertebral, pulmonary, and pelvic nodal metastases. Despite recommendation for systemic therapy, the patient deteriorated quickly and died shortly thereafter. <b>Conclusions</b>: This study reports coexistence of p16-negative OPSCC and high-grade SCNEC in the HN. It highlights the diagnostic complexity, staging limitations, and therapeutic dilemmas of discordant histologies, while illustrating the fulminant clinical course typical of SCNEC of unknown origin. Early recognition, comprehensive pathology, and multidisciplinary management are essential, although prognosis remains dominated by the aggressive neuroendocrine component.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835116","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}