Case Reports in Oncology最新文献

{"title":"Late Recurrence of Mucinous Adenocarcinoma after Lung Transplantation: A Case Report and Literature Review.","authors":"Eveline Claeys, Nico De Crem, Pierre Van Mol, Arno Vanstapel, Laurens Joseph Ceulemans, Dirk Van Raemdonck, Christophe Dooms, Walter De Wever, Christophe Michel Deroose, Isabelle Vanden Bempt, Birgit Weynand, Robin Vos, Els Wauters","doi":"10.1159/000545190","DOIUrl":"10.1159/000545190","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive mucinous adenocarcinoma (IMA) of the lung has a less aggressive behavior than other adenocarcinoma subtypes. Overall, the propensity for nodal and distant metastases is low, but spread throughout the lungs is frequent. The radiographic \"ground glass\" presentation makes differentiation between infectious and inflammatory consolidations challenging, and the diagnosis of malignancy is often unexpected.</p><p><strong>Case presentation: </strong>A 50-year-old patient underwent double lung transplantation (LTx) in July 2018 for progressive fibrosing interstitial lung disease (ILD). IMA was unexpectedly found in the explant lungs. Pre-transplant PET-CT scans suggested inflammatory ILD without malignancy. Endobronchial ultrasound-guided transbronchial fine needle aspiration of the enlarged mediastinal lymph nodes demonstrated no evidence of malignancy. Post-transplant pathology confirmed stage IVA IMA with a KRAS G12D mutation. After 3 years, recurrent IMA was detected. The asymptomatic patient remains under close surveillance with stable lung function, and tailored treatment will be considered if progression occurs.</p><p><strong>Conclusion: </strong>IMA is currently rarely considered an indication for LTx. The risk of recurrence after transplantation is substantial, and recurrence negatively impacts long-term post-transplant prognosis. Incidental adenocarcinoma in explant lungs will remain a complication of imperfect transplant recipient selection. A high index of suspicion of disease recurrence in the donor lungs should be maintained in these patients. Further research is required to understand the optimal screening, treatment, and follow-up of these patients.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"646-652"},"PeriodicalIF":0.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172725","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":"An Intrauterine Case of Explosive Growth of Neurofibromatosis during Pregnancy with Fetal Death in Mid-Pregnancy: A Case Report.","authors":"Xiyan Ouyang, Yanli Li, Xin Li, Lingna Chai, Jie Shi, Han Gao","doi":"10.1159/000545803","DOIUrl":"10.1159/000545803","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofibromatosis type 1 (NF1) is one of the most prevalent autosomal dominant inherited diseases, with an incidence rate of 1/3,000. The hallmark clinical features of NF1 include coffee milk spots, multiple neurofibromas, and freckles in the armpit or groin. Numerous studies have indicated a higher incidence of pregnancy-related complications in patients with NF1, including fetal growth restriction and preeclampsia.</p><p><strong>Case presentation: </strong>This case study describes a pregnant woman with NF1 who unfortunately experienced intrauterine fetal death during her second trimester and developed preeclampsia and HELLP syndrome.</p><p><strong>Conclusion: </strong>This case highlights the need for close monitoring and management of patients with NF1 during pregnancy and the critical role of multidisciplinary collaboration and follow-up of MDT.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"630-637"},"PeriodicalIF":0.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172724","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":"Sequential Myelomatous Pleural and Pericardial Effusions in Multiple Myeloma: A Case Report Demonstrating Extended Survival with Teclistamab.","authors":"Deena Mudawi, Abdulrahman F Al-Mashdali, Ahmad Tawalbeh, Lajos Szabados, Dina Sameh Soliman, Shehab Fareed","doi":"10.1159/000545930","DOIUrl":"10.1159/000545930","url":null,"abstract":"<p><strong>Introduction: </strong>Myelomatous pleural effusion (MPE) and pericardial involvement are rare manifestations of multiple myeloma (MM), occurring in less than 1% of cases and carrying historically poor prognoses. We present a unique case where both these rare serous cavity manifestations occurred sequentially in the same patient, demonstrating the evolving treatment landscape with novel targeted therapies.</p><p><strong>Case presentation: </strong>A 42-year-old Asian female presented with left shoulder pain and swelling, leading to the diagnosis of IgG lambda MM with extensive extramedullary disease. After initial partial response to D-VRD therapy, she developed MPE with complete left lung collapse. Following failure of second-line KPD-PACE therapy, she received teclistamab, achieving complete metabolic and morphological response documented by PET-CT. After maintaining remission for 10 months, she experienced relapse with pericardial involvement presenting as cardiac tamponade.</p><p><strong>Conclusion: </strong>The patient demonstrated an unprecedented response to BCMA-targeted therapy with teclistamab, achieving complete remission that lasted 10 months - more than doubling the historical median survival of 4 months for MPE. Flow cytometry proved instrumental in rapid diagnosis, showing 11% lambda monotypic plasma cells in the pleural fluid. The subsequent pericardial involvement after initial complete response highlighted the persistent challenges in managing extramedullary disease. This case represents the first documented instance of sequential MPE and pericardial involvement in MM, demonstrating the potential of novel targeted therapies, particularly BCMA-directed approaches, in extending survival and improving outcomes in these rare but aggressive disease manifestations.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"620-629"},"PeriodicalIF":0.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149360","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":"Extensive Bone Marrow Involvement by <i>BRAF</i> ^V660E-Mutated Bi-Phenotypic Erdheim-Chester Neoplasm/Rosai-Dorfman Disease (Mixed Histiocytic Neoplasm) with Atypical Histological Features and Fulminant Hemophagocytosis.","authors":"Dina Soliman, Firyal Ibrahim, Hasan Rizvi, Mahir Petkar, Zsolt Lengyel, Aliya Habib Sange, Awni Alshurafa, Ruba Yasin","doi":"10.1159/000545775","DOIUrl":"10.1159/000545775","url":null,"abstract":"<p><strong>Background: </strong>Erdheim-Chester disease (ECD) is a recently recognized clonal hematopoietic neoplasm characterized by activating alterations in the MAPK pathway. It involves multi-organ accumulation of abnormal histiocytes, leading to nonspecific clinical manifestations due to inflammation and fibrosis caused by histiocytic infiltration.</p><p><strong>Case presentation: </strong>We present a 45-year-old male with nonspecific clinical symptoms and progressive skin and abdominal lesions. Multiple tissue biopsies revealed fibrohistiocytic infiltration but provided an inconclusive diagnosis. Imaging studies showed extensive fibrosis in the perinephric regions on CT and sclerotic foci in long and pelvic bones on PET/CT. Bone marrow biopsy revealed abnormal histiocytes with multinucleated giant forms, prominent emperipolesis, active hemophagocytosis, and condensed hemosiderin deposition. Immunohistochemistry showed positive histiocytes for CD68, CD163, and partially for S-100. Molecular analysis confirmed the <i>BRAFV660E</i> mutation, establishing a diagnosis of ECD with atypical histologic features and findings overlapping with Rosai-Dorfman (mixed histiocytosis). The diagnosis was challenging due to extensive fibrosis, the lack of typical histopathologic features of ECD, in addition to concurrent involvement by Rosai-Dorfman cells (mixed histiocytosis), activated macrophages, and dense hemosiderin deposition - a morphologic characteristic not previously described in ECD. Unfortunately, the diagnosis was delayed by 6 years, which tragically led to a fatal outcome.</p><p><strong>Conclusion: </strong>The case highlights the need to recognize that ECD diagnosis requires integrating histopathology with clinical and radiographic findings. It emphasizes the importance of awareness of mixed histiocytosis features and the role of detecting BRAF mutations, even through immunohistochemistry, in suspected histiocytic neoplasms. Extensive bone marrow involvement by ECD is rarely described. To our knowledge, there are no prior reports of bi-phenotypic (concurrent) ECD/RDD mixed histiocytosis affecting the bone marrow.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"602-612"},"PeriodicalIF":0.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149354","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 Century of Hypomethylating Agent: A Remarkable Response to Azacitidine Monotherapy for Relapsed Acute Myeloid Leukemia - A Case Report.","authors":"Chetan Jeurkar, Amry Majeed, Lindsay Wilde, Gina Keiffer, Margaret Kasner","doi":"10.1159/000545569","DOIUrl":"https://doi.org/10.1159/000545569","url":null,"abstract":"<p><strong>Introduction: </strong>Acute myeloid leukemia (AML) is a disease of the elderly with a median age at diagnosis of 68 and with a very poor prognosis outside of those patients who have cytogenetic and/or molecular findings which confer a better prognosis. Most fit patients are treated with chemotherapy and then allogeneic hematopoietic stem cell transplant if they are intermediate or poor risk by ELN 2022 criteria (aSCT). aSCT is the mainstay of curative treatment although many patients are not candidates due to age, performance status, and comorbidities. In patients who are not candidates for curative treatment, low-intensity chemotherapy regimens, including monotherapy with hypomethylating agents (HMAs) such as azacitidine or decitabine, may be trialed with a palliative intent. In patients who have relapsed disease, responses to therapy are generally dismal and overall survival is extremely low.</p><p><strong>Case presentation: </strong>We report a 73-year-old male patient who was initially diagnosed with inversion 16 AML, underwent induction chemotherapy with 7 + 3 and then consolidation with 4 cycles of high-dose cytarabine. He was found to have relapse after consolidation but did not elect to undergo allogeneic bone marrow transplant and so was given palliative single-agent azacitidine. He has since received over 100 cycles of azacitidine and remains in remission.</p><p><strong>Conclusion: </strong>To our knowledge, no other reports describe relapsed AML treated with HMA monotherapy achieving such exceptional survival. The remarkable response duration suggests mechanisms beyond cytotoxicity. Further research should explore HMA monotherapy's effects across AML subgroups, including inv(16).</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"575-581"},"PeriodicalIF":0.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Primary Squamous Cell Carcinoma of the Small Intestine: A Case Report.","authors":"Guangxing Li, Chuanji Han, Jin Cao, Yongcun Zhu, Shengbo Sun","doi":"10.1159/000545101","DOIUrl":"10.1159/000545101","url":null,"abstract":"<p><strong>Introduction: </strong>Primary squamous cell carcinoma (SCC) of the small intestine is an exceptionally rare malignancy, with limited cases reported in the literature. The rarity of this condition, combined with nonspecific clinical manifestations, poses significant diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>We report the case of a 47-year-old woman who presented with a 2-month history of left lower abdominal pain and discomfort. Imaging studies, including enhanced abdominal CT and PET-CT, revealed a suspicious mass in the jejunum. Comprehensive diagnostic evaluations excluded metastatic origins, and a diagnosis of primary small intestinal SCC was confirmed by histopathology and immunohistochemistry. The patient underwent radical surgical resection, which revealed a poorly differentiated SCC invading the serosa and regional lymph nodes. Postoperative management included infection prevention and fluid rehydration, with recommendations for adjuvant chemotherapy and immunotherapy based on multidisciplinary consultation. Despite the advanced disease stage, the patient recovered well post-surgery and is undergoing regular follow-up.</p><p><strong>Conclusion: </strong>This case underscores the importance of thorough diagnostic evaluation to distinguish primary SCC from metastatic lesions. Early surgical intervention is critical for improving prognosis of this rare malignancy. The findings contribute to the limited knowledge of the primary SCC of the small intestine and emphasize the need for further research to guide optimal management strategies.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"582-592"},"PeriodicalIF":0.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126863","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":"MRI-Guided Adaptive Radiation Therapy for Oligometastatic Prostate Cancer Involving the Adrenal Gland: A Case Report and Literature Review.","authors":"Fabian J Bolte, Christopher K Luminais, Matthew Mistro, Michael E Devitt","doi":"10.1159/000545983","DOIUrl":"10.1159/000545983","url":null,"abstract":"<p><strong>Introduction: </strong>Metastasis-directed therapy is an evolving treatment modality for patients with oligometastatic prostate cancer. Although the microenvironment of the adrenal glands is enriched in androgen precursors, isolated adrenal metastases are rare. The application of stereotactic ablative radiotherapy (SBRT) to oligometastatic adrenal lesions has been limited due to toxicity concerns.</p><p><strong>Case presentation: </strong>We report a patient with castration resistant prostate cancer and oligometastatic disease recurrence to the adrenal gland who underwent MRI-guided adaptive radiotherapy, which allowed accurate delivery of SBRT while minimizing exposure to adjacent radiosensitive organs. This approach was safe and resulted in long-term local and systemic disease control.</p><p><strong>Conclusion: </strong>This case highlights the potential role for MRI-guided SBRT in selected patients with oligometastatic prostate cancer to the adrenal glands.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"638-645"},"PeriodicalIF":0.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172726","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":"Obinutuzumab-Induced Inflammatory Bowel Disease-Like Colitis.","authors":"Nadav Weijel, Safwat Odeh, Amjad Mousa, Nina Nazarov, Olga Zelman, Ilana Levy Yurkovski","doi":"10.1159/000545677","DOIUrl":"10.1159/000545677","url":null,"abstract":"<p><strong>Introduction: </strong>Obinutuzumab, an anti-CD20 antibody, is widely used in the treatment of B-cell lymphomas. While diarrhea is a known side effect, obinutuzumab-induced inflammatory bowel disease (IBD)-like conditions are rarely reported. Here, we present a case of obinutuzumab-induced pancolitis.</p><p><strong>Case presentation: </strong>A 69-year-old male with stage IV follicular lymphoma, treated with obinutuzumab-CHOP and subsequent obinutuzumab maintenance therapy, developed non-bloody diarrhea after his third maintenance dose. Endoscopic and histological findings mimicked Crohn's disease, leading to a diagnosis of obinutuzumab-induced pancolitis. Obinutuzumab was discontinued, and the patient was transitioned to infliximab therapy, leading to partial improvement.</p><p><strong>Conclusion: </strong>This case demonstrates a severe instance of obinutuzumab-induced pancolitis with IBD-like features, emphasizing the need for clinicians to consider drug-induced etiologies in patients presenting with new gastrointestinal symptoms during obinutuzumab therapy. Timely diagnosis and a multidisciplinary approach are crucial for effective management. Further reports are needed to better understand the full spectrum of gastrointestinal toxicity associated with obinutuzumab and guide future treatment.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"613-619"},"PeriodicalIF":0.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149357","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":"Cushing's Syndrome due to a Renal Neuroendocrine Tumor: A Case Report.","authors":"Vicka Poudyal, Marianne S Elston, Saleen Nottingham, Michael J Swarbrick, Adam Davies, Veronica Boyle","doi":"10.1159/000545734","DOIUrl":"10.1159/000545734","url":null,"abstract":"<p><strong>Introduction: </strong>Cushing's syndrome (CS) due to ectopic adrenocorticotrophic hormone (ACTH) is rare and usually due to neuroendocrine neoplasia (NEN). Primary renal NEN is exceptionally rare but may be a cause of rapidly progressive CS.</p><p><strong>Case presentation: </strong>A 51-year-old man presented with profound hypokalemia, cellulitis, and new-onset type 2 diabetes and hypertension with 1 month of muscle weakness, labile mood, and insomnia. CS due to ectopic ACTH production was confirmed. Biochemical control was achieved using a \"block-and-replace\" regimen with dual blockade with ketoconazole and metyrapone and hydrocortisone replacement in addition to mineralocorticoid receptor blockade using spironolactone. CT and ultrasound demonstrated a 24 mm right renal lesion with features concerning for renal cell carcinoma. Right laparoscopic nephrectomy was performed. Histology demonstrated a WHO grade one NEN with ACTH staining.</p><p><strong>Conclusion: </strong>In CS, where the source of ectopic ACTH production is unable to be identified, a renal source should be considered. Diagnosis may be difficult as there are no reliable radiological characteristics to distinguish renal NENs from renal cell carcinomas, so a high degree of suspicion is required.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"593-601"},"PeriodicalIF":0.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Immune-Related Adverse Events, Including Myasthenia Gravis, Myositis, and Myocarditis, during Avelumab and Axitinib Combination Therapy.","authors":"Jurii Karibe, Ryohei Horiguchi, Yohei Hanajima, Akihito Hashizume, Daiji Takamoto, Takashi Kawahara, Kimito Osaka, Jun-Ichi Teranishi, Naohisa Ueda, Hiroji Uemura","doi":"10.1159/000545733","DOIUrl":"https://doi.org/10.1159/000545733","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors are the mainstay of treatment for unresectable or metastatic renal cell carcinoma (RCC). However, they can cause immune-related adverse events (irAEs), and the management of these irAEs is critical. The combination of myasthenia gravis, myositis, and myocarditis, which are irAEs, is rare, and it has not been reported to occur with avelumab. This report aimed to present a rare case of RCC metastasis that developed irAEs during avelumab and axitinib combination therapy.</p><p><strong>Case presentation: </strong>A 76-year-old woman who underwent radical nephrectomy for clear cell RCC (pT1bN0M0 Grade 3 INFb) at the age of 67 years presented to our hospital after her family doctor noted a pancreatic tumor. She was diagnosed with pancreatic metastasis of RCC based on histopathological examination, and avelumab and axitinib combination therapy was initiated. She developed irAEs, including myasthenia gravis, myositis, and myocarditis, which were treated with steroid pulse therapy. The patient recovered after treatment and was discharged without sequelae.</p><p><strong>Conclusion: </strong>Myasthenia gravis, myositis, and myocarditis can occur during avelumab and axitinib combination therapy for RCC. Prompt diagnosis, treatment, and collaboration with other departments are extremely important for managing irAEs.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"563-569"},"PeriodicalIF":0.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977579","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}