Case Reports in Oncology最新文献

{"title":"Thrombotic Thrombocytopenic Purpura Triggered by Chronic Lymphocytic Leukemia: A Case Report.","authors":"Isabela Chang, Surhbi Shah, Leslie Padrnos, Zoey Harris","doi":"10.1159/000546300","DOIUrl":"10.1159/000546300","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic lymphocytic leukemia (CLL) is an incurable lymphoproliferative disorder characterized by the accumulation of mature malignant B cells in the blood, bone marrow, and secondary lymphoid tissues. While it has a heterogenous clinical course, individuals with CLL are at increased risk for autoimmune complications, infections, and secondary non-hematologic secondary malignancies. Peripheral autoimmune cytopenias are a well-known phenomenon in CLL. However, other autoimmune complications, including immune thrombotic thrombocytopenic purpura (TTP), are rare and less investigated. We hereby report the first case of a patient with TTP triggered by CLL.</p><p><strong>Case presentation: </strong>A 74-year-old male presented with fatigue, cough, left upper quadrant abdominal pain, and diffuse petechiae over the proceeding several weeks. The initial laboratory work was suggestive of anemia and thrombocytopenia with hemoglobin of 9.4 g/dL and platelets at 6 × 10⁹/L. He was initially started on corticosteroids and intravenous immunoglobulin. Additional laboratory studies revealed a microangiopathic hemolytic with lactate dehydrogenase 1,124 U/L; total bilirubin 3.9; haptoglobin undetectable. The direct Coombs test was negative, and review of peripheral smear showed 5-6 schistocytes per high power field. Leukocyte count 15.6 × 10⁹/L with absolute lymphocyte count of 4.0 K/µL. ADAMTS13 activity was <9%. A diagnosis of TTP was made, and he was initiated on directed therapy. A bone marrow biopsy was ultimately performed, given the concern of immune-mediated- or disease-related cytopenias, and for confirmation of CLL. Subsequent bone marrow biopsy and flow cytometry confirmed the diagnosis of CLL.</p><p><strong>Conclusion: </strong>Our case illustrates the first case of TTP precipitated by CLL. This case highlights the immune dysregulation underlying CLL and the autoimmune phenomena that may develop as a result.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"1021-1027"},"PeriodicalIF":0.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741303","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":"Naproxen in High-Temperature Neoplastic Fever: A Case Report Highlighting Its Distinctive Profile among Nonsteroidal Anti-Inflammatory Drugs.","authors":"Rui Li, Yong Chen, ChangYu Deng, Yue Li","doi":"10.1159/000547114","DOIUrl":"10.1159/000547114","url":null,"abstract":"<p><strong>Introduction: </strong>Neoplastic fever (NF) is a relatively common yet frequently underrecognized complication in patients with advanced malignancies. NF is characterized by persistent low-grade fever (typically <38.5°C) driven by tumor-associated cytokine release rather than by infectious or autoimmune causes. As a leading contributor to fever of unknown origin in oncology patients, NF is often difficult to diagnose because of its nonspecific clinical presentation and reliance on exclusion criteria. This case illustrates the diagnostic complexity of NF and highlights the clinical value of targeted antipyretic strategies to support timely oncologic decision-making.</p><p><strong>Case presentation: </strong>A 41-year-old male with stage IVC sigmoid colon adenocarcinoma presented with recurrent high-grade fever (up to 40.4°C), chills, and markedly elevated inflammatory markers (C-reactive protein [CRP]: 202.0 mg/L; procalcitonin: 3.44 ng/mL) over a 2-week period. Comprehensive infectious evaluations, including cultures, antigen testing, and imaging, were all negative. Empirical antibiotics and conventional nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, diclofenac) failed to achieve sustained defervescence. After ruling out infectious and autoimmune causes and considering chemotherapy-induced tumor lysis, NF was suspected. Administration of 500 mg of naproxen (suppository) led to rapid normalization of temperature (36.4°C) and sustained defervescence. A corresponding decrease in inflammatory markers (CRP: 51.6 mg/L; procalcitonin: 1.70 ng/mL) further confirmed the diagnosis.</p><p><strong>Conclusion: </strong>This case underscores the importance of NF in cancer patients with persistent high-grade fevers who are unresponsive to antimicrobial and standard antipyretic therapies and further demonstrates the distinctive efficacy of naproxen in managing such fevers compared with conventional NSAIDs. Specifically, the rapid and sustained defervescence observed following naproxen administration not only supported the diagnosis but also facilitated the timely continuation of anticancer treatment. Therefore, early recognition of NF and appropriate use of the naproxen test may help avoid unnecessary interventions and ultimately improve patient outcomes.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"1004-1011"},"PeriodicalIF":0.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728139","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":"Spontaneous Necrosis of Hepatocellular Carcinoma in Viral B Cirrhosis: A Case Report.","authors":"Yasmine Hidous, Abdelwaheb Nakhli, Emna Mrabet, Nesrine Hemdani, Zeineb Benzarti, Bochra Bouchabou, Rym Ennaifer","doi":"10.1159/000546699","DOIUrl":"10.1159/000546699","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide and its prognosis largely depends on the stage at diagnosis and the feasibility of curative treatments. Spontaneous necrosis of HCC is an extremely rare phenomenon with an unclear pathophysiology. Various mechanisms, including vascular disturbances, immune-mediated response, and recurrent infection, have been considered. This case report presents a rare case of spontaneous necrosis of a small HCC in a patient with hepatitis B-related cirrhosis.</p><p><strong>Case presentation: </strong>A 63-year-old male with compensated hepatitis B-related cirrhosis was under routine surveillance when a suspicious liver lesion was detected on ultrasound. Subsequent contrast-enhanced computed tomography (CT) confirmed the presence of an 18-mm HCC in segment VIII, corresponding to Barcelona Clinical Liver Cancer stage A. Due to limited curative treatment options, transarterial chemoembolization was considered. However, a follow-up CT scan was performed 2 weeks before the procedure unexpectedly revealed complete regression of arterial enhancement, suggestive of spontaneous tumor necrosis. The patient remained asymptomatic, with stable liver function and mild biological inflammatory markers. No evidence of vascular thrombosis or significant systemic inflammation was noted, suggesting localized vascular disturbances or intrinsic tumor factors might have precipitated the necrosis.</p><p><strong>Conclusion: </strong>This case highlights the exceptional occurrence of spontaneous necrosis in a small HCC. While the underlying mechanisms remain speculative, further documentation and research on similar cases may provide insights into HCC pathophysiology and potential implications for future therapeutic strategies.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"1028-1033"},"PeriodicalIF":0.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752515","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":"Administration of a Single Dose of Pembrolizumab, Docetaxel, and Cisplatin Leads to Complete Disappearance of a Locally Advanced Hypopharyngeal Squamous Cell Carcinoma: A Case Report.","authors":"Basil Alzahrani, Mohammed Albin Ahmed, Anas Alzahrani, Abbas Alhejji, Ali Al Zahrani","doi":"10.1159/000547116","DOIUrl":"10.1159/000547116","url":null,"abstract":"<p><strong>Introduction: </strong>Immune-checkpoint inhibition has improved the outcomes of patients with a metastatic squamous cell carcinoma in the head and neck. The combination of pembrolizumab, platinum agent, and 5-fluorouracil had been shown to improve the survival of patients with a positive programmed death ligand 1 (PD-L1) test and had become the standard treatment. Patients with a high combined positive score (CPS) of >20 can be treated solely with pembrolizumab. The treatment is usually continued until disease progression. Induction immunotherapy has also shown benefits.</p><p><strong>Case presentation: </strong>We present a case of a locally advanced hypopharyngeal squamous cell carcinoma in a 63-year-old Arabic man who was started on pembrolizumab, docetaxel, and cisplatin for the first treatment cycle, but he failed to show up for the subsequent cycles due to the coronavirus disease 2019 pandemic restrictions. He came back after 10 months with complete clinical and radiological response.</p><p><strong>Conclusion: </strong>The present report may possibly be the first to report a case of locally advanced squamous cell carcinoma of the hypopharynx that showed complete clinical and radiological response to a single dose of pembrolizumab, docetaxel, and cisplatin.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"1012-1020"},"PeriodicalIF":0.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741302","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":"Changes in the Skin Microbiome of a Patient with Head and Neck Cancer with Severe Radiodermatitis: A Case Report.","authors":"Nao Miyamae, Kazuhiro Ogai, Mao Kunimitsu, Shigefumi Okamoto, Masayuki Fujiwara, Makoto Nagai, Mayumi Okuwa, Makoto Oe","doi":"10.1159/000546634","DOIUrl":"10.1159/000546634","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying the skin microbiome associated with severe radiodermatitis could lead to the development of preventive care strategies and early healing interventions, which are currently lacking. In this study, we investigated changes in the skin microbiome of a patient with head and neck cancer who developed severe radiodermatitis from the initiation of radiation therapy to the resolution of dermatitis.</p><p><strong>Case presentation: </strong>An 82-year-old male underwent chemoradiotherapy with cisplatin (69.96 Gy/33 fractions) for recurrent laryngeal cancer after a total laryngectomy. At baseline, <i>Cutibacterium</i> accounted for 64.3% of the skin microbiome and <i>Staphylococcus</i> for 23.2%. During the occurrence of moist desquamation associated with severe radiodermatitis, <i>Cutibacterium</i> decreased sharply to 0.2%, whereas <i>Staphylococcus</i> increased to 91.0%. Species-level analysis revealed that <i>Staphylococcus aureus</i> was dominant at 50.6%, whereas <i>Staphylococcus hominis</i> and <i>Staphylococcus epidermidis</i> were identified at 0.4% and 1.7%, respectively.</p><p><strong>Conclusion: </strong>These findings demonstrated that changes in the skin microbiome occur during the progression of severe radiodermatitis. The reduction in <i>Cutibacterium</i> and overgrowth of <i>Staphylococcus</i>, particularly <i>Staphylococcus aureus</i>, suggest their involvement in the development of severe radiodermatitis in patients with head and neck cancer.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"958-964"},"PeriodicalIF":0.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641897","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":"Neurofibromatosis Type 1 with Relapsed/Refractory Precursor B-Lymphoblastic Lymphoma: Case Report and Literature Review.","authors":"Hongjuan Li, Yanli Leng, Yan Gu, Yan Han, Yuqi Zhao, Guoyu Ding, Hongmei Wang","doi":"10.1159/000546996","DOIUrl":"10.1159/000546996","url":null,"abstract":"<p><strong>Introduction: </strong>Concomitant occurrence of B-lymphoblastic lymphoma (B-LBL) and neurofibromatosis type 1 (NF1) is rare.</p><p><strong>Case presentation: </strong>We diagnosed and treated a child presenting with NF1 and relapsed B-LBL and reviewed the relevant literature through the last 8 years. Stage IV precursor B-LBL with central nervous system 3 was identified in this patient, with pain and activity abnormalities in both lower limbs. NF1 was diagnosed based on physical examination, brain magnetic resonance imaging, genetic testing, and family history. The patient relapsed after chemotherapy and was given blinatumomab. After 1 week of blinatumomab treatment, the lower limb pain was relieved. The child underwent umbilical cord blood transplantation after completing two sessions of blinatumomab therapy and is still disease-free to date.</p><p><strong>Conclusion: </strong>The findings from this study will offer valuable empirical references for peers treating NF1 associated with refractory/relapsed B-LBL.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"994-1003"},"PeriodicalIF":0.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682106","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":"Long-Term Survival for Locally Advanced Adenosquamous Carcinoma Colon Cancer in Ulcerative Colitis: A Case Report.","authors":"Abdulrahman Alotaibi","doi":"10.1159/000546931","DOIUrl":"10.1159/000546931","url":null,"abstract":"<p><strong>Introduction: </strong>Adenosquamous carcinoma (ASC) of the colon is an exceedingly rare and aggressive subtype, with limited data available on long-term survival, particularly among patients with ulcerative colitis (UC).</p><p><strong>Case presentation: </strong>We present a 39-year-old male with a 9-year history of UC who experienced severe anemia and hematochezia. Imaging and histopathological analysis confirmed a diagnosis of stage IIIB ASC of the right colon. The patient underwent total colectomy followed by adjuvant chemotherapy (XELOX), ileoanal pouch reconstruction, and stoma closure. After 56 months of follow-up, he remains disease-free with good pouch function.</p><p><strong>Conclusion: </strong>This case underscores the prognosis and the need for further research in UC-ASC subtype.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"988-993"},"PeriodicalIF":0.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673993","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 Fatal Case of Infection-Induced Neurofibromatosis Type 1 in an Adult.","authors":"Lingyun Cui, Yi Guo","doi":"10.1159/000546973","DOIUrl":"10.1159/000546973","url":null,"abstract":"<p><strong>Background: </strong>Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor disorder caused by mutations in the <i>NF1</i> gene. It typically manifests in childhood with diverse clinical features, while adult-onset cases are relatively uncommon. In most instances, untreated neurofibromas pose minimal life-threatening risks even in the late stages of disease progression. However, severe multisystem complications may arise, leading to fatal outcomes.</p><p><strong>Case description: </strong>A 61-year-old male presented with a 2-month history of fever, abdominal pain, and bloating, which worsened over 4 days, accompanied by erythematous skin lesions and blisters. Despite multiple medical consultations and symptomatic treatment, his condition deteriorated, with recurrent fever and diarrhea. Upon admission to the emergency department, rapidly progressing skin lesions were noted. A preliminary diagnosis of intestinal obstruction, sepsis, and fixed drug eruption was considered, and the patient was transferred to the intensive care unit for further management. Comprehensive assessments, including thoracoabdominal CT imaging, microbiological testing, and skin lesion biopsy, were performed. Empirical antimicrobial therapy and supportive care were initiated, but microbiological tests remained negative. Histopathological examination of multiple skin biopsies confirmed neurofibromas. The patient experienced progressive enlargement of skin lesions, persistently elevated inflammatory markers, and rapid clinical deterioration, ultimately resulting in death.</p><p><strong>Conclusion: </strong>This case illustrates a rare presentation of adult-onset NF1 with an aggressive disease course and a severe systemic inflammatory response. The rapid progression underscores the underestimated risk of critical complications and mortality in adult patients with NF1.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"979-987"},"PeriodicalIF":0.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673991","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":"Kaposi Sarcoma Presenting as Retroperitoneal Lymphadenopathy: A Case Report.","authors":"Karam Elsolh, Kevin Zbuk, Haroon Yousuf","doi":"10.1159/000545827","DOIUrl":"10.1159/000545827","url":null,"abstract":"<p><strong>Introduction: </strong>Kaposi sarcoma is a mesenchymal vascular tumor caused by human gammaherpesvirus 8. Kaposi sarcoma is typically associated with immunocompromise and HIV, and has a classical form seen in elderly men of Mediterranean or Eastern European ethnic origin. We herein present an atypical case of Kaposi sarcoma presenting as retroperitoneal adenopathy in an immunocompetent, non-Mediterranean patient.</p><p><strong>Case presentation: </strong>A previously healthy 53-year-old patient presented to the emergency department with lower abdominal pain and was found to have isolated retroperitoneal lymphadenopathy on abdominal imaging, later confirmed to be Kaposi sarcoma on biopsy. The patient presented without typical cutaneous findings of Kaposi sarcoma or any risk factors for the disease, including HIV, immunocompromise, or Mediterranean descent. The patient was referred to medical oncology and has had spontaneous regression of adenopathy in the absence of any treatment.</p><p><strong>Conclusion: </strong>Our review of the case and of the literature demonstrates the many atypical ways in which KS can present. Our case highlights the importance of considering KS in the differential diagnosis for visceral lymphadenopathy in the absence of solid tumor pathology. Lastly, our case brings to light the variable clinical course of KS, which can range from minimal to explosive growth to spontaneous regression.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"900-904"},"PeriodicalIF":0.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599546","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":"Beta-Catenin Positive Giant Cell Tumor of Bone with Pathological Fracture Treated with Neoadjuvant Denosumab Therapy for Visualizing Extraskeletal Lesions.","authors":"Itaru Ogawa, Yoichi Kaneuchi, Michiyuki Hakozaki, Shunsuke Sato, Takeo Suzuki, Shoki Yamada, Osamu Hasegawa, Takuya Nikaido, Yoshihiro Matsumoto","doi":"10.1159/000546985","DOIUrl":"10.1159/000546985","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumors of bone (GCTBs) are locally aggressive tumors that can induce pathological fractures. Previous reports suggest that denosumab induces intratumoral ossification in β-catenin positive GCTB. However, its effect on the complete resection of GCTB with extraskeletal lesions remains unclear.</p><p><strong>Case presentation: </strong>A 45-year-old woman with a pathological fracture of the left distal femur was diagnosed with GCTB based on the biopsy findings, which revealed both H3.3 G34W and nuclear β-catenin positivity. Eight courses of neoadjuvant denosumab therapy were administered to visualize the extraskeletal lesions; subsequently, en bloc resection with megaprosthetic reconstruction was successfully performed. Pathological examination revealed intratumoral ossification without osteoclastic giant cells. Two years after the surgery, no evidence of local recurrence was recorded.</p><p><strong>Conclusion: </strong>Neoadjuvant denosumab therapy is an effective approach for managing β-catenin positive GCTB with pathological fractures as it promotes intratumoral ossification and facilitates complete resection of GCTB, including extraskeletal lesions.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"972-978"},"PeriodicalIF":0.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648678","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}