Case Reports in Oncology最新文献

{"title":"Right Upper Lobe Large Cell Neuroendocrine Carcinoma with Atypical Carcinoid Features: Case Report.","authors":"Yelim Lee, Ryan Rodrigs, William Dean Wallace, Sean C Wightman","doi":"10.1159/000540889","DOIUrl":"https://doi.org/10.1159/000540889","url":null,"abstract":"<p><strong>Introduction: </strong>Large cell neuroendocrine carcinoma (LCNEC) and atypical carcinoid (AC) tumor are two distinct types of pulmonary neuroendocrine tumors (NETs) that are considered genetically unrelated. AC is categorized as a well-differentiated NET, while LCNEC is considered a poorly differentiated NET with a significantly poorer prognosis.</p><p><strong>Case presentation: </strong>In this case report, we present an 83-year-old male who presented with 2-day history of hemoptysis and subsequently diagnosed with a right upper lobe carcinoid tumor on pre-excision biopsy. After evaluation of the entire excised specimen, the tumor was subsequently reclassified as LCNEC. This case is rare as the tumor displayed pathologic features of AC (areas with low mitotic activity and punctate necrosis) alternating with areas of LCNEC (high mitotic activity with sheets of necrosis). Subsequent molecular studies were more characteristic of AC, with no mutations detected in Rb1 or p53. The patient underwent surgical resection (right upper lobectomy with bronchoplasty and mediastinal lymph node dissection) to remove the tumor.</p><p><strong>Conclusion: </strong>This report outlines the clinical presentation and the underlying pathology of this rare case, which underscores the complex molecular landscape of neuroendocrine neoplasms and the need for nuanced molecular analyses in refining diagnostic approaches.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1042-1049"},"PeriodicalIF":0.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543979","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":"Three Cases of Immune Myocarditis Associated with Camrelizumab Use.","authors":"Wen Ji, Qingwang Wei, Zhenguo Tang, Wen Zhang","doi":"10.1159/000540891","DOIUrl":"https://doi.org/10.1159/000540891","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Immune checkpoint inhibitors can cause immune-related adverse events in various organ systems, with myocarditis being the most serious and life-threatening. This article reports three cases of immune myocarditis induced by camrelizumab, detailing the diagnostic and treatment process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case report: &lt;/strong&gt;Three cases of immune-related myocarditis caused by the use of camrelizumab are reported. Three patients (case 1, male, 44 years old; case 2, male, 69 years old; and case 3, male, 53 years old) were treated with the immune checkpoint inhibitor, camrelizumab 200 mg, intravenously for nasopharyngeal and esophageal cancers. In case 1, 18 days after the 3rd cycle of immunotherapy, the patient's troponin levels were elevated. In case 2, 1 day after the 1st cycle of treatment, troponin levels were elevated. The electrocardiogram showed right bundle branch block with left anterior branch block and abnormal ST-T segments in the lower wall, and the echocardiogram showed segmental ventricular dyskinesia and thickening of the myocardium of the left and right ventricles. In case 3, 12 days after the 3rd cycle of treatment, the patient developed chest tightness and breathlessness, and cardiac biomarkers were elevated. The electrocardiogram showed borderline QT interval prolongation and extensive ST-T segment changes, and cardiac ultrasound showed thinning of the myocardium in the middle and lower left ventricular anterior and lower posterior walls and loss of motility. All 3 patients were diagnosed with immune-associated cardiomyositis induced by camrelizumab, and camrelizumab was discontinued. In case 1, methylprednisolone succinate was administered as an intravenous infusion of 500 mg once a day for 4 days, and the patient's troponin levels gradually decreased. In case 2, following the administration of intravenous methylprednisolone succinate sodium (500 mg) once daily for 5 consecutive days, the patient experienced gastrointestinal bleeding. The hormone dose was then reduced, and intravenous immune globulin (IVIG) 10 g/day was added. Treatment continued for 3 days after the patient's death due to immune myocarditis and heart failure combined with gastrointestinal bleeding. Case 3 underwent a tracheotomy and received methylprednisolone sodium succinate (240 mg) intravenous drip daily for 7 days. Camrelizumab was discontinued. Although troponin and NT-proBNP levels remained elevated with an upward trend 7 days after starting treatment, they decreased after adding IVIG 20 g/day for 3 days. Treatment continued for another 3 days after improvement in cardiac biomarkers. After gradually reducing the hormone dose over 5 days following the stabilization of the patient's condition, he was discharged from the hospital. The patient's follow-up status is good.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Emphasizing the importance of baseline assessment, early detection and timely intervention, standardized use of glucocorticost","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1034-1041"},"PeriodicalIF":0.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543989","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":"Metastatic SMARCB1-Deficient Renal Medullary Carcinoma without Hemoglobinopathy with Durable and Dramatic Response to Pembrolizumab plus Lenvatinib: Case Report.","authors":"William McCamy, Maryam Yousefiasl, Maria Tretiakova, Minal Jagtiani, Evan Hall","doi":"10.1159/000540937","DOIUrl":"https://doi.org/10.1159/000540937","url":null,"abstract":"<p><strong>Introduction: </strong>Renal medullary carcinoma (RMC) is a rare form of renal cell carcinoma (RCC) that is typically associated with a loss of function in SMARCB1 and diagnosis of sickle cell or other hemoglobinopathy. In rare cases, this disease can be seen in patients without hemoglobinopathy and is classified as \"SMARCB1-deficient RMC without hemoglobinopathy\" or referred to as \"RCC unclassified with medullary phenotype\" in some of the literature. Platinum-based cytotoxic chemotherapy is currently the recommended first-line treatment for this rare disease.</p><p><strong>Case presentation: </strong>Here we report a 53-year-old male who was diagnosed with metastatic SMARCB1-deficient RMC without hemoglobinopathy after presenting with left flank and abdominal pain. After initiating first-line pembrolizumab and lenvatinib systemic therapy, imaging showed regression at 6 weeks. To date, this patient continues to show a near complete response to this treatment regimen.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first documented case of SMARCB1-deficient RMC without hemoglobinopathy to receive this treatment regimen and show such a response.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1025-1033"},"PeriodicalIF":0.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543965","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":"Sotorasib in <i>KRAS</i> p.G12C-Mutated Pulmonary Sarcomatoid Carcinoma: Therapeutic Efficacy of a <i>KRAS</i> Inhibitor in Symptomatic Brain Metastases.","authors":"Jonas Frederik Schmidt, Dominik Entz, Frank Brasch, Martin Goerner","doi":"10.1159/000540675","DOIUrl":"https://doi.org/10.1159/000540675","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary sarcomatoid carcinomas (PSCs) are a rare subgroup of non-small cell lung cancer (NSCLC). In contrast to other NSCLCs, PSCs have a poor prognosis due to limited efficacy of radiation and chemotherapy. Therefore, other therapeutic approaches are needed. <i>KRAS</i> mutations occur in PSC with a significant proportion of 30%, and most of them are G12C with the therapeutic option of sotorasib.</p><p><strong>Case report: </strong>Here, we describe the case of a patient with PSC and pleural metastases. After first-line chemotherapy, the patient presented with new neurological symptoms such as a hemiparesis of the right arm and focal seizures. Following the detection of new brain metastases, we switched the therapy to sotorasib due to the presence of a <i>KRAS</i> G12C mutation. During treatment with sotorasib, the patient's condition worsened progressively and his neurological symptoms got more severe. A CCT performed during the course of treatment showed progression of the brain metastases. After 48 days being on drug, decision to discontinuate therapy with sotorasib due to patient's inability to take oral medication and change to a best supportive care concept was made. The patient died few weeks after termination of therapy with rapidly progressive disease.</p><p><strong>Discussion/conclusion: </strong>This case emphasizes the poor prognosis of patients with PSC due to a lack of therapeutic response to chemotherapy, radiation, and, as seen in this case, current targeted therapy as well. Our case emphasizes the need to further evaluate therapeutic responses of targeted therapy in this rare subtype of NSCLC.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1019-1024"},"PeriodicalIF":0.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543982","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":"Feasible Nipple Preservation Techniques for Breast Cancer with Slight Nipple Retraction.","authors":"Hitomi Matsuki, Shoji Oura","doi":"10.1159/000540892","DOIUrl":"https://doi.org/10.1159/000540892","url":null,"abstract":"<p><strong>Introduction: </strong>Nipple retraction has long been regarded as an absolute contraindication factor for nipple preservation in breast cancer surgery.</p><p><strong>Case presentation: </strong>A 62-year-old woman was referred to our hospital for the treatment of breast cancer with slight nipple retraction. Imaging findings showed neither direct cancer infiltration to the nipple-areolar complex nor lymphadenopathy. Due to the patient's strong preference, we attempted to preserve the nipple-areolar complex as follows. First, we made a quasi-complete skin flap except for the nipple-areolar complex area in a thick flap manner. Second, we fully skeletonized the sub-nipple mammary gland. Next, we pinched the skeletonized sub-nipple mammary gland with the scissors and pushed the scissors toward the nipple base as close as possible with the blades kept open. After that, we resected the nipple base using the scissors on pulling the mammary gland toward the opposite direction of the nipple. Frozen section and postoperative pathological study showed clear surgical margins and no lymph node metastasis. The patient developed temporary superficial dermal necrosis of the nipple but healed without leaving any sequelae in the nipple-areolar complex. The patient has been well for 20 months without any recurrences.</p><p><strong>Conclusion: </strong>Our nipple-preserving techniques enable safe nipple preservation even for breast cancer patients with slight nipple retraction.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1014-1018"},"PeriodicalIF":0.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543957","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":"JAK 2-Positive Diseases and Spontaneous Coronary Artery Dissection: Case Series.","authors":"Ahmed K A Yasin, Shehab Fareed Mohamed, Elmustafa Abdalla, Girish Rao, Abdulaziz M Alkhulaifi, Mohamed A Yassin, Deena Mudawi, Abdulrahman Fadhl Al-Mashdali, Samah Kohla, Feryal A Ibrahim, Dina Soliman, Cornelia S Carr","doi":"10.1159/000541036","DOIUrl":"https://doi.org/10.1159/000541036","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic myeloproliferative neoplasms (MPNs) such as polycythaemia vera (PV) and essential thrombocytosis are associated with atherosclerosis and cardiovascular events, especially if JAK2 mutation is there. In rare cases, also spontaneous coronary artery dissection (SCAD) can be seen.</p><p><strong>Case presentation: </strong>This case series describes two case reports of MPNs in which SCAD was found in both of them in addition to standard atherosclerosis. First one was about a 42-year-old man who was admitted for acute myocardial infarction (MI) and was later found to have PV and SCAD. The second one was about a 52-year-old man who was also admitted for acute MI and was later found to have SCAD and essential thrombocythemia. JAK2V617F missense mutation was found in both cases.</p><p><strong>Conclusion: </strong>MPNs with JAK2 mutations are associated with SCAD in addition to usual atherosclerosis. This association needs further research.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1008-1013"},"PeriodicalIF":0.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543963","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":"Severe Thrombocytopenia from Trastuzumab and Pertuzumab Combination Therapy in a Patient with HER2-Positive Metastatic Rectal Cancer.","authors":"Dai Okemoto, Toshifumi Yamaguchi, Mariko Yamaguchi, Toru Kadono, Hiroki Yukami, Elham Fakhrejahani, Hiroki Nishikawa","doi":"10.1159/000540980","DOIUrl":"https://doi.org/10.1159/000540980","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, trastuzumab and pertuzumab have been used in treatment protocols for patients with HER2-positive colorectal cancer. Although severe thrombocytopenia is an uncommon side effect of anti-HER2 antibody therapy, we present the first patient with HER2-positive metastatic rectal cancer who developed significant thrombocytopenia after trastuzumab and pertuzumab administration.</p><p><strong>Case presentation: </strong>The condition was identified as drug-induced immune thrombocytopenia associated with trastuzumab and pertuzumab. Despite the discontinuation of anti-HER2 treatment and administration of corticosteroids, and in addition to frequent platelet transfusions, a low platelet count persisted. Consequently, we determined that the patient presented with a condition similar to immune thrombocytopenic purpura (ITP) and selected a treatment approach consisting of eltrombopag, a thrombopoietin receptor agonist. Subsequently, the patient's platelet count did not decrease further but rather improved.</p><p><strong>Conclusion: </strong>Although uncommon, anti-HER2 antibodies can cause severe thrombocytopenia. Furthermore, if thrombocytopenia persists after treatment discontinuation and the administration of corticosteroids, exploring treatment options aligned with managing ITP is essential.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"1001-1007"},"PeriodicalIF":0.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543980","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":"Is Magnetic Resonance Imaging Able to Provide Specific Diagnoses? A Case Report of Clear Cell Sarcoma of Soft Tissue in the First Metacarpal of the Hand.","authors":"Yunxin Li, Ranran Huang, Aijie Wang, Guowei Zhang, Yongbin Su","doi":"10.1159/000540745","DOIUrl":"https://doi.org/10.1159/000540745","url":null,"abstract":"<p><strong>Introduction: </strong>Clear cell sarcoma (CCS) of the soft tissue is a type of tumor that primarily affects the deep soft tissues of the extremities and trunk. We report a case of CCS of soft tissue arising in the first metacarpal of the hand, focusing on the imaging features of CCS combined with the clinicopathological and immunological results.</p><p><strong>Case presentation: </strong>In this case, computed tomography images showed a soft tissue mass at the first metacarpal, with heterogeneous density, unclear boundaries, and bone destruction. On magnetic resonance imaging (MRI), the mass showed slightly higher signal intensity on T1-weighted images and mixed hyperintensity on T2-weighted images, with inhomogeneous enhancements. On both T1-weighted and T2-weighted sequences, there were some hypointense strips. No significant enhancements were found in these hypointense strips.</p><p><strong>Conclusion: </strong>We suggest that hypointense strips on MRI should lead to the inclusion of CCS in differential diagnoses.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"995-1000"},"PeriodicalIF":0.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543962","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":"Disseminated Actinomyces Case Report: A Mimicker of Advanced Ovarian Malignancy.","authors":"Maria D'Iorio, Olivia D Lara, Kari E Hacker","doi":"10.1159/000540798","DOIUrl":"https://doi.org/10.1159/000540798","url":null,"abstract":"<p><strong>Introduction: </strong>Disseminated actinomyces is a rare infection that presents with subtle symptoms and radiographic findings. Patients frequently complain of pelvic pain and nonspecific gastrointestinal symptoms. Imaging can reveal a tumor-like mass and mimic malignancy. Here we discuss a patient who presented with abdominal pain, and computerized tomography (CT) imaging revealed a pelvic mass and features suggestive of carcinomatosis concerning for ovarian cancer.</p><p><strong>Case presentation: </strong>A 55-year-old woman presented with 1 week of abdominal pain and 5 months of increasing abdominal girth. CT imaging was concerning for an advanced ovarian cancer and demonstrated a pelvic mass, peritoneal nodularity, and omental thickening. She subsequently underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and abdominal washout with pathology and cultures revealing disseminated actinomyces. She fully recovered after receiving a long course of antibiotics.</p><p><strong>Conclusion: </strong>This case adds to the limited literature illustrating that disseminated actinomyces can present similarly to ovarian cancer. The diagnosis may only be elucidated upon histologic examination of surgical specimens. Consideration of pelvic actinomyces should be entertained in all women presenting with pelvic tumors on imaging and intrauterine devices in place.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"982-987"},"PeriodicalIF":0.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550045","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":"Challenges in the Management of Stage IV Clear Cell Sarcoma of Soft Tissue in Young Adults: Case Report and Review of the Literature.","authors":"Diana Iordache, Anita-Andrea Kövendi, Zsolt Fekete, Raluca Popița, Iunia Patricia Cebotaru, Annamaria Patka, Ioana Cristina Năstase, Cristina Ligia Cebotaru","doi":"10.1159/000540084","DOIUrl":"https://doi.org/10.1159/000540084","url":null,"abstract":"<p><strong>Introduction: </strong>Clear cell sarcoma (CCS) of soft tissue is a rare type of soft tissue sarcoma affecting usually lower extremities in young adults. The main challenges in the management of this disease include difficulties in diagnosis, aggressiveness of the cancer with rapid progression, and inadequate treatment, especially in small centers with few cases.</p><p><strong>Case presentation: </strong>We present a case of a young woman diagnosed with CCS of soft tissue, stage IV. The patient benefited from a multidisciplinary approach including radiation therapy, surgery, chemotherapy, and targeted therapy with disease progression regardless of the therapeutic act. Despite all the efforts, the patient died from complications overlapping progression of the disease.</p><p><strong>Conclusion: </strong>The rarity of this sarcoma limits the amount of information available on the diagnosis and treatment process. The particularity of this case is the difficulty met in maintaining the disease under control using all the resources available due to lack of compliance of the patient in carrying out amputation at diagnosis, thus modifying the entire treatment algorithm. Targeted therapy showed promising results in the literature, however in our case resulted in an unexpected, rare adverse event aggravating the patient's condition. In conclusion, patients with CCS should be referred to specialized centers for adequate multidisciplinary management and, if available, inclusion in clinical trials. New agents are needed to improve the survival of these patients.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"17 1","pages":"988-994"},"PeriodicalIF":0.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543932","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}