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Reversible visual field loss in glaucoma following ventriculoperitoneal shunting for normal pressure hydrocephalus. 脑室腹腔分流治疗常压脑积水后青光眼的可逆性视野丧失。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-27 DOI: 10.1136/bcr-2026-275027
Victoria Tang, Jamie E Craig
{"title":"Reversible visual field loss in glaucoma following ventriculoperitoneal shunting for normal pressure hydrocephalus.","authors":"Victoria Tang, Jamie E Craig","doi":"10.1136/bcr-2026-275027","DOIUrl":"10.1136/bcr-2026-275027","url":null,"abstract":"<p><p>We report a case of visual field deterioration in previously stable open-angle glaucoma which resolved upon ventriculoperitoneal shunting (VPS) for coexisting normal pressure hydrocephalus (NPH). A woman in her 80s with bilateral open-angle glaucoma developed apparent progression of existing glaucomatous field defects, despite stable disease and consistent intraocular pressure control following bilateral trabeculectomies over a decade prior. She was concurrently diagnosed with NPH and underwent VPS. Following VPS, visual fields returned to a previously stable baseline.Visual field fluctuations may occur concurrently with NPH, a condition affecting intracranial pressure (ICP). Here, we report visual field worsening temporally associated with NPH onset and a rare association between VPS and field improvement in the context of prior trabeculectomy. VPS may improve visual fields in post-trabeculectomy eyes by reducing ICP, thereby narrowing the translaminar pressure gradient. Unexplained visual field changes in well-controlled glaucoma should prompt consideration of pathologies affecting ICP.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839135","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}
引用次数: 0
Lesions above and below palate: dual pathologies appearing as single lesion. 上颚上下病变：双重病理表现为单一病变。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-27 DOI: 10.1136/bcr-2025-265345
Rajeshwary Aroor, Priya Chakravarthy, Sanabel Gloria Dsouza
{"title":"Lesions above and below palate: dual pathologies appearing as single lesion.","authors":"Rajeshwary Aroor, Priya Chakravarthy, Sanabel Gloria Dsouza","doi":"10.1136/bcr-2025-265345","DOIUrl":"https://doi.org/10.1136/bcr-2025-265345","url":null,"abstract":"<p><p>Both fungal sinusitis and radicular cysts are relatively common conditions; however, their simultaneous occurrence can pose diagnostic and therapeutic challenges, particularly when a radicular cyst is in the upper alveolus. We report a patient with a palatal radicular cyst associated with carious maxillary teeth, presenting mainly with cosmetic deformity. CT demonstrated a well-defined cystic lesion extending into the palate and anterior maxillary wall, along with heterogeneous opacification of the left maxillary sinus consistent with fungal involvement. This coexistence raised important considerations regarding surgical sequencing and the feasibility of a combined approach. The patient underwent a single-stage procedure comprising complete cyst excision, endoscopic middle meatal antrostomy and extraction of all non-restorable teeth. This case highlights the diagnostic challenges, radiological interpretation and operative decision-making required in managing this rare dual pathology.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mild form of aromatic L-amino acid decarboxylase deficiency. 轻度芳香l -氨基酸脱羧酶缺乏症。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2025-269867
Viktorija Kenina, Mikus Dīriks, Elīna Pūcīte, Daiga Mūrmane, Baiba Lace
{"title":"Mild form of aromatic L-amino acid decarboxylase deficiency.","authors":"Viktorija Kenina, Mikus Dīriks, Elīna Pūcīte, Daiga Mūrmane, Baiba Lace","doi":"10.1136/bcr-2025-269867","DOIUrl":"10.1136/bcr-2025-269867","url":null,"abstract":"<p><p>Aromatic L-amino acid decarboxylase (AADC) deficiency (Online Mendelian Inheritance in Man #608643) is a rare autosomal recessive neurometabolic disorder caused by pathogenic variants in the <i>DDC</i> gene, leading to impaired enzyme activity. Affected individuals typically develop symptoms in early infancy, including truncal hypotonia, global developmental delay and oculogyric crises, and the condition is generally associated with a severe clinical course and poor prognosis.We report a patient with a mild and atypical phenotype of AADC deficiency complicated by sensorineural hearing loss and oculocutaneous albinism. The clinical course and response to treatment are described. This unusual presentation raises the possibility of coexisting conditions contributing to the phenotype.This case highlights the clinical variability of AADC deficiency and underscores the importance of comprehensive genetic and biochemical investigations to achieve an accurate diagnosis and inform personalised management.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824959","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}
引用次数: 0
Oral mycosis fungoides. 口腔蕈样真菌病。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2025-270779
David Byrne, Sheila Galvin, Peter Molony, C M Healy
{"title":"Oral mycosis fungoides.","authors":"David Byrne, Sheila Galvin, Peter Molony, C M Healy","doi":"10.1136/bcr-2025-270779","DOIUrl":"10.1136/bcr-2025-270779","url":null,"abstract":"<p><p>Mycosis fungoides (MF) is the most common subtype of cutaneous T cell lymphoma. Oral presentation is both rare and highly variable, often denoting advanced disease stage. A female patient in her 70s was referred regarding painful recurrent palatal ulceration of 6 months' duration, which was significantly impacting her quality of life. She had known MF treated with oral bexarotene, electron beam therapy and localised radiotherapy. Oral examination revealed two shallow palatal ulcers, and incisional biopsy revealed an atypical stromal and intraepithelial CD3+ T lymphocyte population with a predominance of CD8+ T cells; PCR revealed T cell receptor gene rearrangements demonstrating a monoclonal population whose profile was identical to that in a recent skin biopsy, indicating oral MF. Unfortunately, the patient succumbed to her disease 7 months after presentation to our unit. This case highlights that oral involvement can develop in MF and can have a significant impact on a patient's quality of life.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mantle cell lymphoma presenting as bullous pemphigoid: a rare paraneoplastic syndrome. 套细胞淋巴瘤表现为大疱性类天疱疮：一种罕见的副肿瘤综合征。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2026-274014
Avi Harisingani, Nishant Tiwari, Taylor Zak, Nikita Gupta, Priyanka Dudani, Patrick Hagen
{"title":"Mantle cell lymphoma presenting as bullous pemphigoid: a rare paraneoplastic syndrome.","authors":"Avi Harisingani, Nishant Tiwari, Taylor Zak, Nikita Gupta, Priyanka Dudani, Patrick Hagen","doi":"10.1136/bcr-2026-274014","DOIUrl":"https://doi.org/10.1136/bcr-2026-274014","url":null,"abstract":"<p><p>A 60-year-old man presented with severe, treatment-refractory bullous pemphigoid and was subsequently diagnosed with stage IV pleomorphic variant mantle cell lymphoma (MCL). Direct immunofluorescence and histopathology confirmed bullous pemphigoid, while peripheral blood smear abnormalities and cross-sectional imaging prompted further workup. Lymph node biopsy demonstrated a monotypic CD20+, PAX5+, CD5+, cyclin D1+B cell lymphoproliferative disorder, with CCND1::IGH fusion confirmed by fluorescence in situ hybridisation. The temporal association between cutaneous disease onset and lymphoma diagnosis, together with improvement of bullous pemphigoid following MCL-directed therapy, supports a paraneoplastic relationship. Bullous pemphigoid is most commonly idiopathic but is recognised in association with haematological malignancies. Its occurrence with MCL is exceedingly rare, with only two prior cases in the literature. This case reinforces the importance of screening for occult malignancy in patients with atypical, severe or refractory bullous disease.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mediastinal tuberculous lymphadenitis causing a broncho-mediastinal-oesophageal fistula. 纵隔结核性淋巴结炎引起支气管-纵隔-食道瘘。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2025-265975
Sara-Jane Horne, Anuradha Alwis, Cyrus Daneshvar, Gemma Hayes, Arun Ariyarathenam
{"title":"Mediastinal tuberculous lymphadenitis causing a broncho-mediastinal-oesophageal fistula.","authors":"Sara-Jane Horne, Anuradha Alwis, Cyrus Daneshvar, Gemma Hayes, Arun Ariyarathenam","doi":"10.1136/bcr-2025-265975","DOIUrl":"10.1136/bcr-2025-265975","url":null,"abstract":"<p><p>Mediastinal tuberculous lymphadenitis and tuberculous fistulae are recognised complications of pulmonary tuberculosis (TB); however, we could find no documented cases of broncho-mediastinal-oesophageal fistulae.We describe the case of a patient in their early 20s from a South Asian country with endemic TB who presented to a UK hospital with a productive cough, fevers, reduced appetite, inter-scapular pain and feeling generally unwell. They were initially diagnosed with community-acquired pneumonia but their symptoms were refractory to antibiotic therapy. Following CT and endoscopy with biopsies, they were diagnosed with TB with a complex broncho-mediastinal-oesophageal fistula secondary to mediastinal tuberculous lymphadenitis.They were treated with anti-TB therapy and resumed on oral intake 201 days after initial admission. A multidisciplinary approach was required to address multiple medical and surgical issues, including nutrition and delivery of anti-TB therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Large gastric glomus tumour mimicking a gastrointestinal stromal tumour: a diagnostic challenge. 模拟胃肠道间质瘤的大胃球囊瘤：一个诊断挑战。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2025-269740
Amber Parwaiz, Kislay Kant, Punam Prasad Bhadani, Md Kashif Rizwi, Tarun Kumar
{"title":"Large gastric glomus tumour mimicking a gastrointestinal stromal tumour: a diagnostic challenge.","authors":"Amber Parwaiz, Kislay Kant, Punam Prasad Bhadani, Md Kashif Rizwi, Tarun Kumar","doi":"10.1136/bcr-2025-269740","DOIUrl":"https://doi.org/10.1136/bcr-2025-269740","url":null,"abstract":"<p><p>Gastric glomus tumour (GGT) is a mesenchymal tumour composed of modified smooth muscle cells, which is the neoplastic counterpart of perivascular glomus bodies. Preoperative diagnosis of GGT is challenging due to its clinical and imaging similarities with other common submucosal tumours, such as gastrointestinal stromal tumours (GISTs). We report a case of a woman in her early 40s with a large well-defined submucosal gastric tumour. Imaging studies and preoperative clinical diagnosis suggested GIST. Surgical resection revealed a tumour measuring 17 cm in greatest dimension, one of the largest GGTs documented in the English literature. Histopathology showed tumour cells forming nests or trabeculae and surrounding dilated thin-walled vessels. Immunohistochemistry was positive for smooth muscle actin and vimentin and negative for desmin, CD117 and DOG1, confirming a diagnosis of GGT. While most GGTs are benign, close follow-up is crucial for large tumours for early detection of recurrence or metastasis.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Severe multivessel coronary artery spasm presenting as very high-risk acute coronary syndrome. 严重的多支冠状动脉痉挛表现为非常高风险的急性冠状动脉综合征。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-26 DOI: 10.1136/bcr-2025-271866
George Abou Deb, Amitkumar Sharma, Michael Fisher, Khaled Albouaini
{"title":"Severe multivessel coronary artery spasm presenting as very high-risk acute coronary syndrome.","authors":"George Abou Deb, Amitkumar Sharma, Michael Fisher, Khaled Albouaini","doi":"10.1136/bcr-2025-271866","DOIUrl":"10.1136/bcr-2025-271866","url":null,"abstract":"<p><p>Coronary artery spasm is an important cause of myocardial ischaemia and acute coronary syndrome in the absence of obstructive coronary artery disease. Simultaneous multivessel epicardial coronary artery spasm is an uncommon presentation and may closely mimic severe three-vessel coronary artery disease. We report a man in his early 60s presenting with acute coronary syndrome associated with profound hypoxaemia and systemic prodromal symptoms. Coronary angiography demonstrated severe, diffuse smooth narrowing of all three major epicardial coronary arteries with critically impaired flow, initially suggestive of advanced multivessel disease. Intracoronary nitrate administration resulted in rapid and near-complete resolution of the coronary narrowing with restoration of normal flow. Optical coherence tomography showed only mild non-obstructive atheroma without plaque rupture or thrombus, confirming multivessel coronary artery spasm. The patient developed a small spasm-related myocardial infarction and recovered well following optimisation of vasodilator therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advanced mucinous adenocarcinoma of the ascending colon with duodenal invasion: a surgical and diagnostic challenge. 晚期升结肠粘液腺癌伴十二指肠侵犯：外科和诊断的挑战。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-25 DOI: 10.1136/bcr-2026-273239
Mohammad Abuassi, Toufic Dabit, Bellal Alfar, Anwar Jarrad, Aiman Obed
{"title":"Advanced mucinous adenocarcinoma of the ascending colon with duodenal invasion: a surgical and diagnostic challenge.","authors":"Mohammad Abuassi, Toufic Dabit, Bellal Alfar, Anwar Jarrad, Aiman Obed","doi":"10.1136/bcr-2026-273239","DOIUrl":"10.1136/bcr-2026-273239","url":null,"abstract":"<p><p>Mucinous adenocarcinoma (MAC) is a distinct subtype of colorectal cancer that is more often diagnosed at an advanced stage and has been associated with greater local invasiveness and a less favourable response to chemotherapy. We report a man in his 80s who presented with progressive weight loss, abdominal pain and altered bowel habits. Diagnostic evaluation revealed a large ascending colon mass extending to the hepatic flexure, with direct duodenal invasion causing high-grade obstruction. The patient underwent an en bloc extended right hemicolectomy with duodenal resection and reconstruction. Histopathological examination confirmed a moderately differentiated MAC, pathological stage pT4bN0. He subsequently received adjuvant capecitabine and remained under follow-up for approximately 3 years. This case highlights the aggressive nature of MAC and its uncommon but recognised extension into the duodenum.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conservative management of an isolated near-complete distal biceps femoris tendon rupture in an elite football player. 一例优秀足球运动员股骨二头肌远端肌腱孤立性近乎完全断裂的保守治疗。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-25 DOI: 10.1136/bcr-2026-273376
Silke Bijnens, Peter Wildiers, Kristin Suetens, Brahim Hacene
{"title":"Conservative management of an isolated near-complete distal biceps femoris tendon rupture in an elite football player.","authors":"Silke Bijnens, Peter Wildiers, Kristin Suetens, Brahim Hacene","doi":"10.1136/bcr-2026-273376","DOIUrl":"10.1136/bcr-2026-273376","url":null,"abstract":"<p><p>This case report presents an adolescent elite football player who sustained an isolated, near-complete rupture of both the long and short heads of the distal biceps femoris tendon, with approximately 20 mm tendon retraction and no associated bony avulsion or posterolateral knee injury. The injury occurred during a forceful cross-kick and was initially challenging to characterise because of conflicting ultrasound and MRI findings. Given the preserved clinical function, limited retraction and evidence of residual tendon continuity, the medical team opted for conservative management, without bracing or surgery. The athlete completed a structured criterion-based rehabilitation programme with close clinical, imaging and load monitoring. Progressive tendon healing was demonstrated on serial MRI, and the player achieved full return to play within 22 weeks. This case highlights that non-operative management of high-grade distal biceps femoris tendon ruptures may represent a feasible alternative to surgery in carefully selected athletes.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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