Case Reports in Oncological Medicine最新文献

{"title":"A Rare Case of TFE3-Rearranged and SMARCB1-Mutated Renal Cell Carcinoma: Diagnostic and Therapeutic Complexities.","authors":"Paul J Pecorin, Nyembezi Dhliwayo, Trevor Christ, Thomas Westbrook","doi":"10.1155/crom/6909249","DOIUrl":"10.1155/crom/6909249","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) represents the majority of kidney malignancies, with clear cell RCC being the most common subtype. However, recent advances in tumor genomics have refined RCC classification, highlighting rare molecular subtypes such as TFE3-rearranged and SMARCB1-deficient RCCs. These entities pose unique diagnostic and therapeutic challenges due to their aggressive nature and limited treatment data. We present a rare case of metastatic RCC with concurrent TFE3 translocation and SMARCB1 mutation in a 39-year-old patient. The patient underwent multiple systemic therapies, including immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs), alongside surgical and radiation interventions. Despite disease progression, a combination of lenvatinib and pembrolizumab has shown recent stabilization. This case underscores the importance of genomic profiling in identifying rare RCC subtypes and guiding treatment decisions. Given the aggressive course and lack of established guidelines, further research is needed to optimize therapeutic strategies for these molecularly defined RCC variants.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"6909249"},"PeriodicalIF":0.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289439","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":"Sustained Complete Response to Brigatinib in a Young Patient With ALK-Positive NSCLC Harboring I1171N Mutation Post-Alectinib Resistance.","authors":"Akhil Kapoor, Ajay Kumar Singh, Mahesh Chaudhary, Anuj Gupta, Bipinesh Sansar, Bal Krishna Mishra, Shashikant Patne, Arvind Suresh","doi":"10.1155/crom/7372418","DOIUrl":"10.1155/crom/7372418","url":null,"abstract":"<p><p>ALK-rearranged non-small cell lung cancer (NSCLC) represents a paradigm of precision oncology, but acquired resistance to second-generation ALK tyrosine kinase inhibitors (TKIs) such as alectinib remains inevitable. We report a young, nonsmoker male with ALK-positive metastatic NSCLC who achieved a sustained complete response (CR) to brigatinib following alectinib resistance mediated by the ALK I1171N mutation. After 22 months of response to alectinib, disease progression prompted repeat molecular profiling, which identified the I1171N alteration. Brigatinib was initiated, and a complete radiologic response was documented within 3 months and has been sustained for over 12 months, including durable intracranial disease control. Sustained CR in I1171N-mediated alectinib resistance is rare and highlights the critical role of repeat molecular testing to guide ALK TKI sequencing.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"7372418"},"PeriodicalIF":0.6,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269563","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 Cytokine Release Syndrome After CAR T Cell Therapy in a Pediatric Patient With Relapsed ALL.","authors":"Abdulrahman Alotaibi, Noura Alajmi, Mohammed Alnuhait","doi":"10.1155/crom/6680945","DOIUrl":"10.1155/crom/6680945","url":null,"abstract":"<p><strong>Background: </strong>Cytokine release syndrome (CRS) is a potentially life-threatening complication of chimeric antigen receptor (CAR) T cell therapy, particularly in pediatric relapsed acute lymphoblastic leukemia (ALL).</p><p><strong>Case presentation: </strong>A 7-year-old boy with early bone-marrow relapse of hypodiploid ALL received anti-CD19 CAR T cells and developed severe CRS with persistent fever, hypotension, hypoxemia, encephalopathy, and multiorgan dysfunction requiring pediatric intensive care.</p><p><strong>Management: </strong>He received tocilizumab, high-dose dexamethasone, continuous intravenous (IV) anakinra, and emapalumab, plus advanced supportive care (mechanical ventilation, vasopressors, and continuous renal replacement therapy). Sequential, multiagent immunomodulation was associated with transient hemodynamic stabilization.</p><p><strong>Conclusion: </strong>This case highlights practical bedside sequencing and escalation for refractory pediatric CRS and suggests a potential role for continuous IV anakinra and emapalumab when first-line therapy is inadequate.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"6680945"},"PeriodicalIF":0.6,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200273","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":"Pelvic Gastrointestinal Stromal Tumor (GIST) Mimicking Ovarian Cancer in a Kidney-Liver Transplant Recipient Under Chronic Immunosuppression.","authors":"Oyepeju F Abioye, Rachel DiLeo, Rahim Jiwani, Whitney Rich, Sharon Liang, Dulabh Monga","doi":"10.1155/crom/2158098","DOIUrl":"10.1155/crom/2158098","url":null,"abstract":"<p><p>Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that predominantly originate in the gastrointestinal tract. Extra-gastrointestinal GISTs can occur in atypical locations such as the pelvis, which may mimic gynecologic malignancies, creating diagnostic challenges. This case report presents a 39-year-old female with a history of Type 1 diabetes mellitus and prior kidney and liver transplantation who presented with progressive abdominal bloating and discomfort. Initial pelvic ultrasound revealed a large right adnexal mass (18.8 × 12.8 × 9.8 cm), suggestive of an ovarian mass. CT imaging confirmed a complex pelvic tumor exerting mass effect on surrounding organs, initially concerning for gynecologic malignancy. Following an unrevealing endoscopic evaluation, the patient underwent exploratory laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking. Intraoperative findings included a large right pelvic mass with extensive adhesions, friable tumor implants, and mesenteric lymphadenopathy. Postoperative pathology confirmed a high-grade GIST with epithelioid features, positive for DOG1 and CD117, with a Ki-67 index exceeding 30%. Molecular testing identified a KIT Exon 9 mutation, leading to initiation of imatinib therapy. Overall, this case represents an extra-GI/pelvic GIST that mimicked a primary ovarian neoplasm. We achieved a complete macroscopic cytoreduction (no gross residual disease) but explicitly note pT4 (due to intraoperative rupture), informing adjuvant KIT inhibition. This case emphasizes the diagnostic challenge of extra-GI/pelvic GISTs mimicking ovarian tumors. Studies show that GISTs mimicking primary ovarian tumors (GIST-OTs) typically occur in younger women, have lower recurrence rates (6.8% vs. 54.5% in metastatic ovarian GISTs), and achieve complete resection more frequently (> 90% vs. 57% in metastatic cases). Immunohistochemical profiling (DOG1 and CD117) and molecular testing are crucial for accurate diagnosis and treatment planning. Although imatinib remains the cornerstone of GIST management, dose adjustments based on specific mutations may be necessary, as patients with KIT Exon 9 mutations might benefit from higher dosing. Multidisciplinary approaches combining imaging, histology, and molecular profiling are essential for optimizing outcomes in these complex cases. This extra-GI/pelvic GIST occurred under chronic posttransplant immunosuppression after renal and liver transplantation; as such, we highlight the transplant-oncology interface, notably, an elevated posttransplant cancer risk, rare but documented GIST after kidney transplant, and TKI-calcineurin-inhibitor interactions that require coordinated management.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"2158098"},"PeriodicalIF":0.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123944","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":"When the Heart Is the Target: Case of Primary Pericardial Diffuse Large B-Cell Lymphoma Presenting With Tamponade.","authors":"Ameed Bawwab, Lana Khatib, Moath Ahmad Salman Albliwi, Linlin Yang, Pei Jun Zhao","doi":"10.1155/crom/9885772","DOIUrl":"10.1155/crom/9885772","url":null,"abstract":"<p><p>Diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy and the most common subtype of non-Hodgkin lymphoma, typically presenting with lymphadenopathy. Pericardial involvement is extremely rare. We report the case of a patient who presented with cough and shortness of breath and was admitted for acute hypoxic respiratory failure. During hospitalization, the patient developed atrial fibrillation with rapid ventricular response (RVR). Transthoracic echocardiography revealed a pericardial effusion, which increased in size on repeat imaging 1 week later. The patient subsequently underwent pericardiocentesis, and cytology of the pericardial fluid confirmed DLBCL, with the pericardium identified as the primary site of involvement. The patient was treated with mini-R-CHOP chemotherapy, resulting in marked clinical improvement.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"9885772"},"PeriodicalIF":0.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997657","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":"Giant Primary Hepatic Endodermal Sinus Tumor: Multidisciplinary Management and Long-Term Survival.","authors":"Katia Roque, Rossana Ruiz, Renier Cruz, Andrea Ramirez-Aramburú, Eloy Ruiz, Carlos Castaneda, Marco Galvez-Nino, Ofelia Coanqui, Natalia Valdiviezo, Mivael Olivera Hurtado de Mendoza, Ramon Andrade de Mello, Ilaria Colombo, Luis Mas","doi":"10.1155/crom/8838504","DOIUrl":"10.1155/crom/8838504","url":null,"abstract":"<p><p>The endodermal sinus tumor (EST), also known as yolk sac tumor, accounts for 20% of germ cell tumor cases, typically occurring in gonadal locations. However, 1%-5% can present with an extragonadal localization. Primary hepatic EST is an extremely rare entity and poses a diagnostic challenge for the appropriate management of this pathology. We present the case of a 34-year-old woman who presented with a single hepatic mass associated with elevated alpha-fetoprotein (AFP) levels. Initially, hepatocellular carcinoma (HCC) was suspected, leading to a right hepatectomy, which resulted in pathology findings consistent with an EST. Following surgery, the patient underwent four courses of BEP chemotherapy, showing a partial response with residual lesions. The patient received two more courses of EP chemotherapy, with a PET CT showing a complete response. At over 5 years of follow-up, the patient remains clinically stable, with negative tumor markers, no evidence of disease, and leading a normal life. Primary hepatic EST is an infrequent but important differential diagnosis of HCC, particularly in young women without cirrhosis who present with markedly elevated AFP levels. Early biopsy confirmation and multidisciplinary management are essential, as this chemosensitive tumor may achieve long-term survival with timely systemic treatment.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"8838504"},"PeriodicalIF":0.6,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951462","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":"Robotic-Assisted Cytoreductive Surgery and Hyperthermic Intrathoracic Chemotherapy in Metastatic Pleuropulmonary Leiomyosarcoma: A Case Report.","authors":"Mariana Canevari de Oliveira, Paula Duarte D'Ambrosio, David Pinheiro Cunha, Rodrigo Carvalho Marotta, Marcelo Manzano Said, Ricardo Mingarini Terra","doi":"10.1155/crom/4409000","DOIUrl":"10.1155/crom/4409000","url":null,"abstract":"<p><p>Leiomyosarcoma (LMS) is a rare and aggressive soft tissue sarcoma known for its propensity for hematogenous dissemination, frequently involving the lungs and pleura. We present a case of metastatic pleuropulmonary LMS managed with a novel combined approach: robotic-assisted cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITHOC). A 61-year-old male with high-grade LMS developed progressive pleural and pulmonary metastases following prior systemic chemotherapy and palliative radiotherapy. Diagnostic imaging showed enlarging pleural nodules and diaphragmatic thickening, with PET-CT confirming intense hypermetabolic activity confined to the right hemithorax. A multistep robotic-assisted thoracic procedure was performed, including total pleurectomy, pulmonary segmentectomy, mediastinal lymphadenectomy, and HITHOC utilizing cisplatin at 42°C. The patient achieved an uncomplicated postoperative course and reported complete symptomatic relief of pre-existing pleuritic pain. At 6-months postprocedure, follow-up imaging confirmed isolated local recurrence (two subpleural nodules). However, no regional lymphadenopathy or distant progression was detected. The patient was transitioned to pazopanib therapy, which resulted in radiological stability and maintained symptomatic control through the 12-month postoperative follow-up period. This case demonstrates the feasibility, safety, and therapeutic value of robotic cytoreduction with HITHOC in selected metastatic LMS, achieving complete macroscopic resection and sustained 12-month disease control when integrated with targeted therapy.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"4409000"},"PeriodicalIF":0.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12757727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899147","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 Rare Case of Synchronous Multiple Primary Malignancies of the Pancreas, Skin, and Thyroid.","authors":"Michael Barsoum, Crystal Antoine Pepeljugoski","doi":"10.1155/crom/9577921","DOIUrl":"10.1155/crom/9577921","url":null,"abstract":"<p><p>Multiple primary malignancies (MPMs) are defined as the occurrence of two or more distinct malignant neoplasms in a single individual, arising either simultaneously or successively. With advancements in targeted therapies and improvements in overall survival, the observed incidence of MPMs has increased, likely reflecting both improvements in oncologic treatments and enhanced surveillance. We report the case of a 63-year-old man with synchronous pancreatic neuroendocrine tumor, anal melanoma, and papillary thyroid carcinoma. His prior oncologic history is notable for prostate adenocarcinoma treated with prostatectomy and renal cell carcinoma managed with right partial nephrectomy. Over a 1-year period, he underwent surgical resection of the neuroendocrine tumor, anal melanoma, and papillary thyroid carcinoma. He is currently receiving pembrolizumab for management of anal melanoma. Germline testing using Ambry's CustomNext Cancer panel was negative across 33 genes associated with hereditary cancer predisposition syndromes. Synchronous MPMs pose substantial challenges for clinical management, including complexities in treatment prioritization, sequencing, and integration of multimodal therapies. These challenges are compounded by limited evidence to guide concurrent or sequential multicancer regimens, with implications for efficacy, toxicity, and long-term outcomes. This case underscores the need for multidisciplinary coordination, individualized risk-benefit assessment, and prospective data to inform evidence-based strategies in the care of patients with MPMs.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9577921"},"PeriodicalIF":0.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877722","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":"Exploring the Relation Between Coexisting Chronic Lymphocytic Leukemia and Lung Cancer: Two Case Reports.","authors":"Toka Amin, Gowri Swaminathan, Muhammad Haseeb Ul Rasool, Utsow Saha, Jie Huang","doi":"10.1155/crom/6589796","DOIUrl":"10.1155/crom/6589796","url":null,"abstract":"<p><p>Chronic lymphocytic leukemia (CLL) is a low-grade lymphoproliferative disorder characterized by clonal proliferation of lymphocytes. The disease is indolent but might be complicated with life-threatening cytopenias, high-grade transformation, or second primary malignancies (SPMs). The incidence of SPMs is higher in CLL compared to the normal population; however, the genetic association and predisposing factors linking CLL to SPMs remain unclear. Synchronous or metasynchronous CLL and lung cancer are relatively uncommon, and the relationship is rarely explored in the literature. We report two cases of a 77-year-old male and a 52-year-old female with a history of heavy smoking, both presenting with respiratory symptoms. Imaging revealed lung masses, hilar adenopathy, pleural effusions, and visceral metastasis. The first case's pleural fluid cytology was positive for both CLL and adenocarcinoma, while the second patient was diagnosed with a biopsy from the right supraclavicular mass revealing carcinoma. In both patients, a flow cytometry of the peripheral smear confirmed the diagnosis of CLL. Both patients had a similar outcome of death due to complicated intracerebral metastatic disease with intracranial hemorrhage and vasogenic edema within 1-2 months of diagnosis. Although incompletely understood, CLL and lung cancer share some predisposing social and biological factors, of which smoking is the most evident. It is also thought that the immunocompromised state of CLL patients is a risk factor for SPMs, given qualitative and quantitative defects in almost all immune cell lines. The cytogenetic association has been suggested but has yet to be comprehensively explored. The proposed tumor factors include HER-2/neu overexpression in lung cancer cells and Trisomy 12 in B-cell clones, which neither of our patients had. Despite suggested links, the relationship between CLL and lung cancer needs further exploration which might offer a future benefit for anticipation and earlier detection of lung cancer in CLL patients.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"6589796"},"PeriodicalIF":0.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877837","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 Rare Case of Pyoderma Gangrenosum Pointing to Waldenström Macroglobulinemia.","authors":"Laya Krishnan, Emily Vachon, Anvita Mishra, Dawn McCoy","doi":"10.1155/crom/5443156","DOIUrl":"10.1155/crom/5443156","url":null,"abstract":"<p><strong>Background: </strong>Pyoderma gangrenosum (PG) is a rare, noninfectious, truly nongangrenous, autoinflammatory condition marked by neutrophilic dermatosis. It is characterized by the rapid onset of painful, full-thickness, ulcerative skin lesions with distinctive violaceous and undermined borders. PG is commonly associated with autoimmune and hematologic disorders, namely, inflammatory bowel disease (IBD) and monoclonal gammopathy of undetermined significance (MGUS). However, it has less commonly been reported in association with lymphoplasmacytic lymphoma (LPL) and rarely with its subtype, Waldenström macroglobulinemia (WM).</p><p><strong>Case presentation: </strong>This case unfolds the story of a 72-year-old female patient with a complex medical and primarily cutaneous oncological history, who initially developed painful lesions on her shins suspected to be PG with a superimposed infection. During extensive infectious, rheumatologic, and oncologic workup revealing an IgM monoclonal gammopathy and antibiotic-resistant infections, her condition quickly deteriorated with altered mental status and eventual cardiopulmonary arrest 2 months after the initial PG diagnosis.</p><p><strong>Conclusion: </strong>This case highlights the importance of close follow-up after PG identification for unusual underlying malignancies and suggests that even an indolent malignancy like WM can contribute to aggressive clinical decline in this setting.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5443156"},"PeriodicalIF":0.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862234","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}