Case Reports in Medicine最新文献

{"title":"Early-Onset Posterior Reversible Encephalopathy Syndrome at Reduced-Dose Sunitinib in Metastatic Papillary Renal Cell Carcinoma: A Case Report.","authors":"Ferit Aslan, Burcu Erkılıç, Elif Günaydın, Onur Serdar Gençler, Hakan Taban","doi":"10.1155/carm/7058556","DOIUrl":"https://doi.org/10.1155/carm/7058556","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) is a rare but potentially life-threatening neurological complication associated with vascular endothelial growth factor (VEGF)-targeted tyrosine kinase inhibitors. Although it is typically reported after prolonged exposure and at standard or high doses, early onset at reduced dosing may occur and requires prompt recognition. We report a 64-year-old woman with metastatic papillary renal cell carcinoma who developed PRES after two months of treatment with reduced-dose sunitinib (37.5 mg daily). She presented with severe headache, nausea, vomiting, impaired consciousness, and reduced mobility, accompanied by acute hypertension (170/100 mmHg). Brain magnetic resonance imaging demonstrated bilateral vasogenic edema without diffusion restriction, consistent with PRES, and electroencephalography revealed generalized background slowing indicative of encephalopathy. Sunitinib was immediately discontinued, and the patient was treated with corticosteroids, antiepileptic therapy, and antihypertensive agents, resulting in rapid clinical improvement. Follow-up imaging confirmed complete radiological resolution. Subsequent treatment with nivolumab and axitinib achieved limited disease control, and the overall survival was 11 months. This case highlights that PRES can develop early and at reduced doses of sunitinib, may present with severe neurological impairment, and can be supported by electroencephalographic findings. Early recognition and prompt discontinuation of the offending agent are essential to prevent irreversible neurological damage.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"7058556"},"PeriodicalIF":0.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834109","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":"Effectiveness of Virtual Reality-Based Physiotherapy Interventions on Pain, Range of Motion, and Gait Function in a Juvenile Hip Arthritis Patient: A Case Report.","authors":"Satheeskumar Durairaj, Sukumar Shanmugam","doi":"10.1155/carm/5573621","DOIUrl":"https://doi.org/10.1155/carm/5573621","url":null,"abstract":"<p><p>Gamification has shown promising results in pediatric rehabilitation, but there is a lack of research specifically investigating its effects on hip juvenile idiopathic arthritis (JIA) in children. This case study aimed to explore the impact of gamification-based rehabilitation combined with conventional physiotherapy on lower limb function and walking activities in a child with hip JIA. An 11-year-old female was diagnosed with hip JIA and presented with hip joint pain and difficulty in standing and walking. She underwent a 6-month intensive conventional physiotherapy program combined with virtual reality (VR)-based gamification using the Walker View treadmill system and D-Wall digital mirror device. Each treatment session lasted 60 min and was conducted 5 times a week for 6 months. The visual analog scale (VAS), goniometry, Walker View treadmill system score, and Hip Disability and Osteoarthritis Outcome Score (HOOS-12) outcome measures were used during pretest, posttest, and follow-up assessments at 0, 6, 9, and 12 months. The combined approach of VR-based gamification and conventional physiotherapy led to significant improvements in pain, functional range of hip joint movements, and gait in this JIA patient. She also showed significant progress across all outcome measures at different timelines. This case report concludes that combining VR-based gamification with conventional physiotherapy is effective in improving hip joint function and mobility in children with hip JIA. It is recommended to combine VR-based gamification with conventional physiotherapy to enhance lower limb function and walking activities in JIA patients, and more future studies are needed to generalize this effect.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"5573621"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811502","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":"Anaplastic Thyroid Carcinoma With Predominant Intrathoracic Progression: A Case Report.","authors":"Soichiro Ueda, Jin Kagatani, Yuriko Nakamura, Yu Asami, Shingo Tsuruoka, Natsumi Yazaki, Mamoru Sasaki","doi":"10.1155/carm/2164998","DOIUrl":"https://doi.org/10.1155/carm/2164998","url":null,"abstract":"<p><p>While most thyroid cancers have a favorable prognosis, anaplastic thyroid carcinoma (ATC) is highly aggressive and results in a poor prognosis. ATC frequently arises from preexisting benign goiters or highly differentiated thyroid cancers, typically presenting with rapidly progressing local symptoms and often accompanied by distant metastasis. We report a case of ATC that rapidly progressed to intrapulmonary metastases and malignant pleural effusion. Despite a previous histological diagnosis of benign goiter and the absence of local symptoms at the final presentation, the patient died just 20 days after the onset of symptoms. In patients with thyroid tumors accompanied by rapid progression of intrathoracic lesions, ATC must be considered as a differential diagnosis, even if they were previously diagnosed with a benign goiter.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"2164998"},"PeriodicalIF":0.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763408","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":"Ceftriaxone-Associated Cholelithiasis in a Premature Toddler From Ethiopia: A Case Report.","authors":"Kaleb Assefa Berhane, Selamawit Tesfaye, Meron Zeleke, Adu Dufera Moti, Dawit Taye Endalew, Lela Alemayehu Gebeyehu, Amanuel Getu Gebreselassie","doi":"10.1155/carm/6644319","DOIUrl":"https://doi.org/10.1155/carm/6644319","url":null,"abstract":"<p><p>Ceftriaxone-associated cholelithiasis is an uncommon but well-recognized adverse effect in pediatric patients, resulting from precipitation of ceftriaxone-calcium complexes within bile. Although often asymptomatic and transient, its radiologic appearance may mimic true gallstones and lead to unnecessary surgical intervention. We report a 2-year-old male child, born prematurely at 34 weeks of gestation, who was incidentally diagnosed with gallbladder stones during follow-up evaluation after multiple hospital admissions for dehydration and presumed infections treated with high-dose intravenous ceftriaxone. The child was asymptomatic for biliary disease, with normal physical examination and laboratory findings. Abdominal ultrasonography demonstrated multiple mobile echogenic foci with posterior acoustic shadowing, the largest measuring 1.1 cm, without evidence of inflammation or biliary obstruction. Given the absence of symptoms and identifiable hemolytic or metabolic disorders, conservative management with close follow-up was adopted. Repeat ultrasonography after 12 weeks showed complete spontaneous resolution of the gallstones. This case highlights the importance of recognizing ceftriaxone-associated cholelithiasis in young children to help avoid unnecessary surgical intervention in appropriately selected asymptomatic patients through appropriate conservative management.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"6644319"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763355","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":"Pediatric Sarcoidosis With Chronic Massive Splenomegaly and Renal Involvement: A Case Report.","authors":"Golnaz Mobayen, Amirataollah Hiradfar, Azar Dastranji, Masoud Lahouty","doi":"10.1155/carm/1828310","DOIUrl":"https://doi.org/10.1155/carm/1828310","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic sarcoidosis is a rare multisystem rheumatologic disorder that is diagnosed after ruling out other granulomatous diseases. Clinical manifestations and treatment in these pediatric patients are also a challenge. Treatment is typically based on corticosteroids and cytotoxic agents; however, no organ-specific treatment currently exists. Recent studies have demonstrated the effectiveness of anti-TNF drugs in treating pulmonary and extrapulmonary sarcoidosis.</p><p><strong>Case presentation: </strong>We report the case of a 16-year-old boy who, since the age of 12, presented with cytopenia, constitutional symptoms, and abdominal pain without a definitive diagnosis. At Age 16, he developed massive splenomegaly with lung and renal involvement. A diagnosis of systemic sarcoidosis was confirmed via a spleen biopsy. He was treated with infliximab in combination with corticosteroids and a cytotoxic agent.</p><p><strong>Conclusion: </strong>This report emphasizes the importance of diagnosing sarcoidosis based on rare and nonspecific signs and symptoms and treatment choices. Early diagnosis of this disease can lead to more effective treatment and prevent multiple organ involvement. Although there is not any organ-specific treatment for systemic sarcoidosis in children, with just a few reports of effectiveness of infliximab in kidney involvement, we decided to treat our case with infliximab because of corticosteroid and cytotoxic failure. This treatment may show that infliximab plays a key role in treating corticosteroid-resistant sarcoidosis that affects certain organs, like the kidneys, or in reducing the side effects of corticosteroid drugs.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"1828310"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763456","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":"Pulmonary Thromboembolism in a Patient With Behçet's Disease: A Case Report.","authors":"Elham Kalantari, Mohammad Emami Ardestani","doi":"10.1155/carm/8323943","DOIUrl":"https://doi.org/10.1155/carm/8323943","url":null,"abstract":"<p><p>Behçet's disease (BD) is a rare, chronic, and multisystemic vasculitis characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Although vascular involvement is common in BD, pulmonary manifestations are rare and potentially fatal. Among these, pulmonary thromboembolism (PTE) represents an exceptional event, as deep vein thrombosis (DVT) in BD usually remains adherent to the vessel wall and seldom embolizes to the lungs. We report a 52-year-old male with BD who presented with a four-day history of progressive dyspnea, productive cough, and new-onset hemoptysis. He had been in clinical remission for one year after discontinuing colchicine therapy. On admission, his oxygen saturation was 90% on room air, with inspiratory crackles on auscultation. Laboratory findings revealed leukocytosis, elevated inflammatory markers, and a markedly increased D-dimer level. CT pulmonary angiography demonstrated multiple filling defects in the right main and segmental pulmonary arteries without evidence of pulmonary artery aneurysm (PAA). Anticoagulation with heparin was initiated. However, during hospitalization, the patient developed oral and genital aphthous ulcers, indicating disease relapse. Immunosuppressive therapy with cyclophosphamide and prednisolone led to significant clinical improvement. This case underscores the importance of maintaining a high index of suspicion for PTE in BD and highlights the necessity of distinguishing BD-related thrombosis from conventional embolic events, as management requires a combination of immunosuppressive and anticoagulant therapy to prevent fatal complications.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"8323943"},"PeriodicalIF":0.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763532","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":"Surgical Treatment of Saccular Extracranial Carotid Artery Aneurysm.","authors":"Henrique Salles Barbosa, Renata Salles Barbosa, Aline Cristina Pavani, Renata Sydio de Souza, Marina Tambasco Freire Vicente, Mariana Fernandes Carvalho","doi":"10.1155/carm/4459572","DOIUrl":"https://doi.org/10.1155/carm/4459572","url":null,"abstract":"<p><p>Extracranial carotid artery aneurysms (ECAAs) are an increase of 50% or more in the diameter of the carotid artery and classified by location. They are rare and most are located in the internal carotid artery or carotid bifurcation. Diagnosis is incidental or by the presentation of a pulsatile neck mass or neurological symptoms. There are no universal recommendations regarding its treatment. Male, 72 years old, with a pulsatile cervical mass on the left. No history of previous trauma. Angioresonance and angiography identified a saccular aneurysm in the carotid bulb, measuring 1 × 0.7 cm. Referred for open surgical treatment, which was performed under general anesthesia and by longitudinal anterior cervicotomy, endoaneurysmorrhaphy, and bovine pericardium patch. There was an uneventful postoperative recovery and hospital discharge on the 3rd postoperative day. ECAAs represent between 0.4% and 1.9% of all peripheral aneurysms. They are more prevalent in men, with an average age at diagnosis of 53 ± 17 years. They can be divided into fusiform or saccular. The most common etiology of ECAA is atherosclerosis (50% of cases). ECAAs can be classified according to Attigah into Types I to V, based on the segment involved. Half of the patients with ECAAs have symptoms at diagnosis. Presentation may include a pulsatile neck mass, cervical discomfort, headache, stroke, or neurological deficits. Although rare, rupture can occur. The indication for correction of ECAAs is based on the risk of cerebral ischemia. Duplex ultrasound is the first option for diagnosis. Angiotomography, angioresonance, and angiography are options as confirmatory examinations. The techniques for repairing ECAAs are endovascular, hybrid or open: stents, embolization, or correction by arterial resection and reconstruction or patch. ECAAs are rare and have potential complications due to cerebral thromboembolism. ECAA repair is possible through open or endovascular techniques.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"4459572"},"PeriodicalIF":0.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763453","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":"Intestinal Malrotation Through Acute Obstructive Abdomen in an Adolescent From Northeastern Brazil: A Case Report.","authors":"Daniel Vieira de Oliveira, Pedro Melo Toledo Nascimento, Rita de Cassia Almeida Vieira","doi":"10.1155/carm/5628089","DOIUrl":"10.1155/carm/5628089","url":null,"abstract":"<p><p>Intestinal malrotation is a congenital anomaly of the midgut resulting from abnormal embryonic rotation. Although predominantly a neonatal diagnosis, it is an extremely rare, isolated finding in adolescents, often presenting with nonspecific symptoms that lead to diagnostic delays and increased morbidity. We report a 17-year-old male presenting with acute abdominal pain, distension, and vomiting. Diagnosis was established via contrast-enhanced computed tomography (CT), which identified spiral rotation of mesenteric vessels and colonic displacement. The patient initially underwent a laparoscopic Ladd's procedure; however, postoperative complications involving duodenal stenosis and recurrent obstruction required a conversion to a Billroth II gastrojejunostomy with a Braun anastomosis. This case highlights that while the Ladd's procedure remains the surgical standard, the management of malrotation in older patients presents unique challenges compared to neonates. Unlike pediatric cases often associated with other malformations, adolescent presentation is typically isolated and insidious, making contrast-enhanced CT essential for identifying the \"whirlpool sign\" and avoiding misdiagnosis. Furthermore, this report underscores that chronic inflammation or recurrence in adults may demand surgical strategies beyond the standard procedure. In complex scenarios with recurrent obstruction, reconstructive techniques such as the Billroth II gastrojejunostomy with Braun anastomosis or Roux-en-Y gastric bypass are effective alternatives to prevent alkaline gastritis and ensure long-term symptom resolution.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"5628089"},"PeriodicalIF":0.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721685","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":"Topical Chlorhexidine-Induced Oral Allergic Reaction: A Case Report.","authors":"Matteo Zotti, Katia Rupel, Marina Diolosà, Giulia Ottaviani","doi":"10.1155/carm/2841092","DOIUrl":"https://doi.org/10.1155/carm/2841092","url":null,"abstract":"<p><p>This case report describes a rare episode of allergic reaction to the topical application of chlorhexidine gel. The patient, following the prescription from her private dentist, presented to the dental emergency unit, referring to the onset of an increasing swelling of the upper lip a few hours after the application of chlorhexidine gel. After the exclusion of a possible infective process starting from the maxillary incisors, the patient was prescribed prednisone and exhibited a quick remission of the swelling. This report aims to emphasize the importance of a correct differential diagnosis to warrant an optimal therapeutic approach to the patient, since swellings of the upper lip could be related to different conditions.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"2841092"},"PeriodicalIF":0.7,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688529","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":"Carotid Web as a Rare Cause of Stroke: A Case Report.","authors":"Jovana Ivanovic, Tamara Svabic Medjedovic, Dragoslav Nestorovic, Ivan Vukasinovic, Vladimir Cvetic, Marko Dragas, Dejana Jovanovic, Predrag Stanarcevic","doi":"10.1155/carm/6341586","DOIUrl":"https://doi.org/10.1155/carm/6341586","url":null,"abstract":"<p><p>A carotid web is a rare, focal vascular malformation at the posterior wall of the carotid bulb, which can be associated with acute ischemic stroke, especially in young patients. Also, a carotid web is associated with a high risk of stroke recurrence, despite optimal antithrombotic therapy. Our patient is a 41-year-old, previously healthy female, with a symptomatic carotid web on the right carotid artery, which led to acute embolic ischemic lesions in the right insular and frontal juxtacortical regions. She had recurrent episodes of mild left-sided hemiparesis and dysarthria, with complete spontaneous recovery. Extensive diagnostic procedures did not confirm any other cause of stroke except a symptomatic carotid web. She underwent stent placement, with no new vascular events, a normal neurological examination, and maintaining stent patency 1 year after the stroke onset. A carotid web is an important cause of stroke in young patients, potentially preventable by endovascular stent placement, alongside the best medical treatment.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"6341586"},"PeriodicalIF":0.7,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670473","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}