Annals of Medicine and Surgery最新文献

{"title":"Spontaneous accessory renal artery aneurysm rupture as a first presentation of polyarteritis nodosa: a case report and review of literature.","authors":"Raya N Amro, Lana Maraqa, Amal A Abo Jheasha, Essa Amro, Ruba Amro, Raghad H M Alwahsh, Saed Attawna","doi":"10.1097/MS9.0000000000003331","DOIUrl":"10.1097/MS9.0000000000003331","url":null,"abstract":"<p><strong>Introduction: </strong>Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis primarily affecting medium-sized vessels. It has several clinical manifestations, including renal, gastrointestinal, cutaneous, neurologic, and general symptoms, but it is not associated with pulmonary manifestations. PAN mainly affects individuals aged 40-60 years, with a male predominance. Although the underlying cause of this disease remains unclear, several triggers can be associated with it such as hepatitis B virus. Diagnosis typically requires an organ biopsy or angiography revealing microaneurysms or stenotic lesions. The overall prognosis can improve with early diagnosis and administration of immunosuppressants. However, it remains a potentially life-threatening diagnosis with a mortality rate of 24.6% at 5 years for severe cases. We presented a rare case of PAN with severe renal and gastrointestinal involvement at presentation.</p><p><strong>Case presentation: </strong>A 21-year-old male presented with sudden severe right flank pain radiating to the back. He was noted to have reticular purple skin lesions on his abdomen and lower legs. Clinical and laboratory findings indicated that he had a hemorrhagic shock. A contrast-enhanced computed tomography (CT) scan of the abdomen and pelvis revealed a ruptured, partially thrombosed pseudoaneurysm of an accessory right renal artery with acute retroperitoneal hemorrhage, splenic infarcts, and two lower mesenteric artery aneurysms. Selective coil embolization of the ruptured artery was successfully conducted. Notably, the patient reports a 1-year history of intermittent abdominal pain, bilateral foot pain, and livedo reticularis, alongside left testicular pain managed with varicocelectomy. During the hospital stay, the patient developed progressive bilateral lower limb weakness that nerve conduction studies revealed it as mononeuritis multiplex. These combined findings were pointing toward PAN diagnosis. Therefore, the patient was started on pulse steroid and cyclophosphamide therapy. However, his abdominal pain worsened requiring surgical exploration with extensive bowel resection, after which plasmapheresis was commenced.</p><p><strong>Discussion: </strong>After our patient presented with life-threatening retroperitoneal bleeding, CT scan revealed that an accessory renal artery had ruptured, and also revealed the hidden cause of his chronic, recurrent, self-resolving attacks of severe abdominal pain, which were investigated multiple times by endoscopy without appropriate diagnosis. The final diagnosis of PAN was supported by the presence of livedo reticularis, testicular ischemia, chronic abdominal pain, and mononeuritis multiplex, fulfilling four diagnostic criteria of the American College of Rheumatology for PAN. Renal involvement in PAN can be in up to 75% of cases. However, rupture of accessory renal artery aneurysms is infrequent and it was the first presenting symptom of our patient. Similar","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3956-3962"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246062","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 endocrine neoplasia type 2A: a diagnostic challenge case report.","authors":"Abdulrahman Ahmad Othman, Mohammad Alrzg, Amina Bitar, Anas Alramadan, Angel Nakoul, Randa Al Masri, Loulitta Melhem, Bilal Sleiay, Adnan Al Abbas, Mouhammed Sleiay","doi":"10.1097/MS9.0000000000003336","DOIUrl":"10.1097/MS9.0000000000003336","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Multiple endocrine neoplasia type 2A (MEN2A) is a rare condition that combines three different tumors: pheochromocytoma, medullary thyroid cancer and hyperparathyroidism. Genetic testing is usually the standard method of diagnosis; however, financial limitations in this case led us to forego the genetic test and rely on clinical findings.</p><p><strong>Presentation of case: </strong>A 28-year-old female presented to the surgery department with episodes of hypertension, blurred vision, redness of hands, and excessive sweating. Computed tomography confirmed multiple adrenal tumors. Combined with medullary thyroid cancer that was demonstrated in a fine needle aspiration from thyroid nodule and elevated parathyroid hormone in laboratory investigation, the diagnosis of MEN2A was made. Then the patient underwent an adrenal gland excision. This case is an interim report, but we did have a follow-up plan.</p><p><strong>Clinical discussion: </strong>A rare autosomal mutation causes MEN2A. Our patient exhibited numerous clinical manifestations of this rare condition, which led us to forego the genetic testing and make the diagnosis in order to decide the proper procedures to treat the patient's symptoms. This maneuver was necessary because of limitations due to resource constraints in diagnosis and treatment. Following that, a noticeable change in quality of life was what we aimed for, such as the absence of headaches and episodes of hypertension, sweating, and palpitations.</p><p><strong>Conclusion: </strong>This case demonstrates the need for confirming clinical criteria that consider the financial difficulties of low-income countries in order to diagnose MEN2A, which, therefore, will result in effective treatment of this case.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3980-3983"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245977","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":"Neuromyelitis optica in a young male patient: a case report and literature review.","authors":"Addisu Assfaw Ayen, Mulugeta Beyadgie Ewunetu, Tewodros Ayenew Yismaw, Azmeraw Birhan Damtew, Nibret Gedamu Firew, Hailemariam Awoke Engedaw, Mebratu Libanos Baye, Tsion Wolanewos Asfaw, Bekalu Mekonen Belay, Belayneh Dessie Kassa","doi":"10.1097/MS9.0000000000003328","DOIUrl":"10.1097/MS9.0000000000003328","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Neuromyelitis optica (NMO) is a rare immune-mediated neurologic disease with female predominance with a 9:1 ratio, with an average age of 40 years. It is uncommon in males and young patients.</p><p><strong>Case presentation: </strong>A 23-year-old male from Ethiopia presented with progressive leg weakness, which escalated to include other symptoms like cough, shortness of breath, and vision problems. Neurological exam revealed specific deficits including leg paralysis, arm weakness, and sensory loss up to the mid-chest. Based on these symptoms and magnetic resonance imaging (MRI), he was diagnosed with neuromyelitis optica spectrum disorder (NMOSD), treated successfully with steroids and azathioprine, and improved.</p><p><strong>Case discussion: </strong>NMO is rare autoimmune central nervous system disease with severe symptoms (spinal cord, optic nerve, brainstem). NMO is usually common in females (9:1) around age 40. NMOSD is rare (low incidence/prevalence), but risk varies: higher mortality/risk in African and Asian populations. The diagnosis of NMOSD can be diagnosed based on the 2015 international consensus diagnostic criteria.</p><p><strong>Conclusion: </strong>Even though Neuromyelitis Optica is a rare immune-mediated neurologic disease, and even more uncommon in young male individuals, it can occur and be diagnosed by clinical criteria with or without AQP4-antibodies plus consistent MRI findings.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3949-3955"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245981","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":"Iron chelators in breast cancer therapy: mechanisms and clinical applications - a narrative review.","authors":"Emmanuel Ifeanyi Obeagu, Anthonia Onyinye Ngwoke, Garikai Malunga","doi":"10.1097/MS9.0000000000003296","DOIUrl":"10.1097/MS9.0000000000003296","url":null,"abstract":"<p><p>Iron is an essential element for cell growth and metabolism, but its dysregulation is a key feature in the pathogenesis of various cancers, including breast cancer. Cancer cells require elevated iron levels to support their rapid growth, and as such, iron chelation has emerged as a promising therapeutic strategy. Iron chelators work by binding free iron in cancer cells, preventing its use in critical biological processes and thereby disrupting tumor cell proliferation. This review discusses the mechanisms of action of iron chelators in breast cancer therapy, highlighting how they induce oxidative stress, impair DNA repair, and alter cellular iron homeostasis, ultimately leading to cancer cell death. Iron chelation therapy has been explored in several clinical and preclinical studies for its potential to enhance the effectiveness of conventional breast cancer treatments, including chemotherapy and radiotherapy. By depleting intracellular iron, iron chelators can sensitize cancer cells to these treatments, increasing the cytotoxic effects and improving patient outcomes. Additionally, novel iron chelators with higher specificity for tumor cells are being developed, which aim to minimize off-target effects and enhance therapeutic efficacy. While iron chelation therapy has shown promise in early-phase trials, further research is needed to optimize these agents for clinical use in breast cancer treatment.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3556-3565"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246043","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 Kikuchi-Fujimoto syndrome in the pocket of a non-Hodgkin lymphoma: case report with a mini-review of the literature.","authors":"Saad Bouchlarhem, Sbai Achraf Amine, Benfadil Drissia, Lachkar Azeddine, El Ayoubi El Idrissi Fahd","doi":"10.1097/MS9.0000000000002986","DOIUrl":"10.1097/MS9.0000000000002986","url":null,"abstract":"<p><strong>Introduction: </strong>Kikuchi-Fujimoto disease is a rare, benign necrotizing lymphadenitis primarily affecting young women.</p><p><strong>Case presentation: </strong>We present the case of a 26-year-old female patient with no notable medical history, who developed a persistent right-sided lateral cervical lymphadenopathy over a 2-month period. Following a comprehensive clinical, laboratory, radiological, and histopathological evaluation, a diagnosis of Kikuchi-Fujimoto disease was confirmed. Given the rarity of this condition, clinicians should maintain a high index of suspicion to avoid misdiagnosis or delayed recognition.</p><p><strong>Clinical discussion: </strong>Kikuchi-Fujimoto disease is rare. It presents as febrile cervical lymphadenopathy and may be associated with systemic lupus erythematosus. Often mistaken for conditions such as non-Hodgkin lymphoma, its diagnosis relies on histopathological examination. Lymph node biopsy is crucial to prevent unnecessary investigations. The prognosis is generally favorable, with treatment commonly involving corticosteroids.</p><p><strong>Conclusion: </strong>While the prognosis for KFD is generally favorable, around 30% of sufferers may go on to develop systemic lupus erythematosus, underlining the need for ongoing monitoring of autoimmune markers.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3828-3832"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245970","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":"Gastric electrical stimulation versus standard medical therapies for long-term symptom control and improved quality of life in drug-refractory gastroparesis patients.","authors":"Tirath Patel, Muhammad Farhan, Gadeer H F Al Shabout, Mustafa Abdulrahman Mohammed, Zaid Abuelata, Abdulaziz Sobhi Shalaby, Abdulrhman Alkassar, Abdelmonkide Ben Khadra, Mariyam M Kuznetsova, Gayatri Misra, Abhishek Goyal, Fnu Rashi","doi":"10.1097/MS9.0000000000003321","DOIUrl":"10.1097/MS9.0000000000003321","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review and meta-analysis evaluated the effectiveness of gastric electrical stimulation (GES) in alleviating symptoms of gastroparesis (GP) compared to alternative medical therapies.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Cochrane Library, and Embase from January 2004 to October 2024 using MeSH terms and keywords related to GP and GES. The search included randomized controlled trials (RCTs) and observational studies published in English. Data extraction followed PRISMA and AMSTAR guidelines. The primary outcome was symptom control, measured using the weighted mean difference and a 95% confidence interval (CI). Statistical analysis was performed using RevMan software, and the certainty of evidence was assessed using the GRADE tool.</p><p><strong>Results: </strong>A total of 1918 articles were screened, with 4 studies included in the final analysis. The mean difference in symptom control was -0.16 (95% CI: -0.57, 0.26). Heterogeneity was assessed using the chi-square Test, and inconsistency was quantified using the I² index.</p><p><strong>Conclusions: </strong>GES provides some symptomatic relief in GP, particularly for nausea and vomiting, though the improvements were not statistically significant. Future research should focus on non-crossover RCTs to minimize bias and further explore GES efficacy in idiopathic and postsurgical gastroparesis cases.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3794-3799"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246028","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":"Safety, efficacy, and quality of life with cemiplimab treatment among non-small cell lung cancer patients: a systematic review and meta-analysis.","authors":"Abhay Mane, Rukesh Yadav","doi":"10.1097/MS9.0000000000003329","DOIUrl":"10.1097/MS9.0000000000003329","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors have shown promise in treating advanced non-small cell lung cancer and have a solid safety profile. Cemiplimab can be used as monotherapy or in combination with chemotherapy for both squamous and non-squamous cancers. We opted for a systematic review and meta-analysis to find out the efficacy outcome and safety profile along with quality-of-life data of cemiplimab for advanced non-small-cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A rigorous search of literature on PubMed, Embase, and Google Scholar was done to find relevant published publications till December 1, 2023. Outcomes like objective response rate (ORR), overall survival (OS), progression-free survival (PFS), common side effects, and quality of life among the cemiplimab and the control group were used to conduct meta-analysis using the fixed/random effect model for combined odds ratio (OR), combined hazard ratio (HR) and mean difference at confidence interval (CI) of 95%.</p><p><strong>Results: </strong>Two randomized clinical trials EMPOWER 1 and EMPOWER 3 with 1092 advanced NSCLC patients along with their follow-up studies were included. There was significantly higher OS (HR = 0.62 [0.54, 0.70], <i>P</i> < 0.0001) and PFS (HR = 0.54 [0.48, 0.60], <i>P</i> < 0.0001] in the treatment group. Similarly, the combined ORR was significantly higher in the treatment group as compared to the control group (2.63 [95% CI: 2.17-3.20, <i>P</i> ≤ 0.001]). Treatment-emergent adverse effects were not different between the groups. Finally, the quality-of-life scores between the two groups were nonsignificant.</p><p><strong>Conclusion: </strong>With regard to OS, PFS, ORR, quality of life scores, and an acceptable safety profile in advanced non-small cell lung cancer, cemiplimab showed clinically relevant and statistically significant improvements making it standard of care for such patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3800-3809"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246059","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":"Dual antiplatelet therapy in GI-bleed patients with extensive coronary artery disease history: a systematic review.","authors":"Abdulrashid Onimisi Abdulrahim, Mohannad Jawad Yahya Abd-Alhadi, Hussein Attia Hussein Mahmoud, Ayesha Sarwar, Anum Akram, Walter Jauregui Alvarado, Olamide Sadik, Srija Reddy Kesireddy, Hassan Mumtaz","doi":"10.1097/MS9.0000000000002833","DOIUrl":"10.1097/MS9.0000000000002833","url":null,"abstract":"<p><strong>Introduction: </strong>Extensive coronary artery disease whether at initial presentation or after percutaneous coronary intervention (PCI), involves the use of dual antiplatelet therapy (DAPT) as a very significant therapeutic option. There are many reasons why clinicians should weigh the risks of bleeding and cardiovascular thrombosis when deciding whether to maintain or discontinue DAPT in such patients.</p><p><strong>Methods: </strong>This comprehensive review systematically analyzed via electronic databases, a total of 39 papers most of which were on countries in Southeast Asia. The focus was on randomized control designs (RCTs) and observational studies.</p><p><strong>Results and discussion: </strong>PCI with drug eluting stents was the most common method of treating acute coronary syndrome. The study found more independent predictors of gastrointestinal (GI) bleeding in young and elderly patients from Southeast Asia. The precise DAPT score was more readily used among various bleeding risk prediction models for patients on antiplatelet therapy.</p><p><strong>Conclusion: </strong>The use of DAPT in the setting of the GI bleeding risk in patients with coronary artery disease has been studied extensively, but there are still no clearly defined strategies and very definite answers to the risk of bleeding versus cardiac event envisaged during the management of an extensive acute coronary disease mostly in southeast Asia. More studies using good study designs and statistics and establishing clinical prediction rules, are needed to fill this knowledge gap most especially in Southeast Asia and Middle East.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3715-3735"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246016","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":"Navigating the risks and benefits of newly approved Lisocabtagene Maraleucel in mantle cell lymphoma treatment.","authors":"Ayesha Khan, Maryam Khan, Muhammad Owais Rana, Md Ariful Haque","doi":"10.1097/MS9.0000000000003325","DOIUrl":"10.1097/MS9.0000000000003325","url":null,"abstract":"<p><p>Mantle cell lymphoma (MCL) is a rare disorder that comprises 5-10% of non-Hodgkin's lymphoma, with an increasing incidence of about 1-2 cases per 100 000 people. It is characterized by cyclin D1 mutation. The intricate genomic landscape and cells' proliferation history contribute to its clinical heterogeneity. Multiple treatments often result in relapse and resistance owing to various mutations. To overcome the need for therapies in patients with relapsed/refractory (R/R) МСL, amidst increasing resistance to other treatment options, the Food and Drug Administration (FDA) approved Lisocabtagene Maraleucel (Lіѕо-Сеl) on 30 May 2024. In the clinical trial, Lisocabtagene Maraleucel showcased a high response rate and a manageable safety profile. However, severe adverse events were also observed, highlighting the need for risk and mitigation analysis before administration. Additionally, long-term studies evaluating its comparative efficacy and safety against existing therapies are needed, and more defined guidelines for managing high-risk patients are required.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3073-3075"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245980","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":"Oxygen deprivation in breast cancer: mechanisms, pathways, and implications.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003334","DOIUrl":"10.1097/MS9.0000000000003334","url":null,"abstract":"<p><p>Hypoxia, a state of reduced oxygen availability, is a defining feature of the tumor microenvironment in breast cancer. It arises from the rapid proliferation of cancer cells, which outpaces the development of adequate vasculature. This oxygen deprivation triggers a cascade of molecular and cellular adaptations that enable tumor cells to survive and thrive under hostile conditions. Key among these is the stabilization of hypoxia-inducible factors, which regulate genes involved in angiogenesis, metabolic reprogramming, immune evasion, and cell survival. Hypoxia significantly influences breast cancer behavior, promoting tumor aggressiveness, therapeutic resistance, and metastatic potential. The hypoxic microenvironment fosters angiogenesis through vascular endothelial growth factor signaling, albeit leading to abnormal and inefficient vasculature. It also reprograms cancer cell metabolism towards glycolysis, supporting survival and growth in oxygen-deprived regions. Furthermore, hypoxia modulates immune responses, suppressing anti-tumor immunity while promoting the recruitment of immunosuppressive cells. These multifaceted effects underscore hypoxia's pivotal role in shaping the clinical trajectory of breast cancer.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3635-3659"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245984","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}