Pub Date : 2025-09-12DOI: 10.1016/j.hmedic.2025.100369
Daria Hoang , Farzana Hoque
Herpes zoster ophthalmicus (HZO) is a potentially vision-threatening reactivation of varicella zoster virus involving the ophthalmic branch of the trigeminal nerve. Immunocompromised patients are at higher risk for complications, including keratitis, vision loss, and central nervous system (CNS) involvement. We present a case of HZO in an immunocompromised female with metastatic breast cancer and multiple comorbidities, who developed keratoconjunctivitis, preseptal cellulitis, and concurrent HSV-1 and VZV meningitis, which is exceedingly rare. Lumbar puncture confirmed co-infection of the CNS. Notably, the patient developed permanent vision loss despite early initiation of antiviral therapy. The case highlights the importance of prompt recognition and a low threshold for escalating treatment in patients with disorientation and neurological symptoms, as well as the need for vaccination, especially in at-risk patient groups.
{"title":"Herpes zoster ophthalmicus with concurrent HSV/VZV meningitis","authors":"Daria Hoang , Farzana Hoque","doi":"10.1016/j.hmedic.2025.100369","DOIUrl":"10.1016/j.hmedic.2025.100369","url":null,"abstract":"<div><div>Herpes zoster ophthalmicus (HZO) is a potentially vision-threatening reactivation of varicella zoster virus involving the ophthalmic branch of the trigeminal nerve. Immunocompromised patients are at higher risk for complications, including keratitis, vision loss, and central nervous system (CNS) involvement. We present a case of HZO in an immunocompromised female with metastatic breast cancer and multiple comorbidities, who developed keratoconjunctivitis, preseptal cellulitis, and concurrent HSV-1 and VZV meningitis, which is exceedingly rare. Lumbar puncture confirmed co-infection of the CNS. Notably, the patient developed permanent vision loss despite early initiation of antiviral therapy. The case highlights the importance of prompt recognition and a low threshold for escalating treatment in patients with disorientation and neurological symptoms, as well as the need for vaccination, especially in at-risk patient groups.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100369"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1016/j.hmedic.2025.100368
Jahnavi Ethakota , Haseeb Khan Tareen , Sakshi Bai , Haris Bin Tahir , Muhammad Fawad Ashraf , Hafsa Ahmed , Hafsa Fayyaz
Cardiac metastasis from neuroendocrine tumors (NETs) is exceptionally rare and poses diagnostic and therapeutic challenges. We report this case to highlight that cardiac metastases from NETs can be entirely silent yet clinically significant, with early recognition relying on vigilant, multimodal imaging rather than symptom-driven evaluation. We present the case of a 73‑year‑old man who was incidentally found to have a right ventricular mass during lung cancer screening. Imaging studies, including CT, cardiac MRI, and Ga‑68 DOTATATE PET‑CT, revealed a right ventricular apical mass with attachment to the interventricular septum, mesenteric primary tumor, and hepatic metastases. Pathological analysis confirmed a well‑differentiated NET with strong synaptophysin positivity. Despite asymptomatic presentation, he was initiated on octreotide therapy for stage IV disease. Six‑month follow‑up demonstrated stable disease. This case adds to the very limited literature on asymptomatic cardiac metastases from NETs by uniquely demonstrating an incidentally detected right ventricular lesion identified on screening CT rather than targeted cardiac evaluation, with no evidence of carcinoid valvular involvement. In particular, the septal attachment without valvular disease contrasts with most previously reported cardiac NET metastases, which commonly involve valvular structures. Furthermore, this case demonstrates the importance of multimodal imaging in detecting occult cardiac metastasis and highlights the role of somatostatin analogs in managing metastatic NETs. These findings highlight the importance of systematically reviewing cardiac structures during routine imaging to enhance early detection of clinically silent cardiac metastases in NETs.
神经内分泌肿瘤（NETs）的心脏转移异常罕见，给诊断和治疗带来了挑战。我们报告这个病例是为了强调net的心脏转移可以完全沉默但具有临床意义，早期识别依赖于警惕，多模式成像而不是症状驱动的评估。我们提出的情况下，73岁的男子谁是偶然发现有一个右心室肿块在肺癌筛查。影像学检查，包括CT、心脏MRI和Ga - 68 DOTATATE PET - CT，显示右室根尖肿块附着于室间隔、肠系膜原发肿瘤和肝转移。病理分析证实为分化良好的NET，突触素阳性。尽管无症状表现，他开始奥曲肽治疗IV期疾病。6个月的随访显示病情稳定。本病例为net无症状性心脏转移的有限文献增加了新的内容，它独特地展示了CT筛查中偶然发现的右室病变，而不是靶向心脏评估，没有证据表明类癌瓣膜受累。特别是，无瓣膜疾病的室间隔附着与大多数先前报道的心脏NET转移形成对比，后者通常涉及瓣膜结构。此外，该病例证明了多模态成像在检测隐匿性心脏转移中的重要性，并强调了生长抑素类似物在转移性NETs管理中的作用。这些发现强调了在常规影像学检查中系统检查心脏结构的重要性，以加强早期发现临床无症状的NETs心脏转移。
{"title":"Right ventricular metastasis in a patient with stage iv small bowel neuroendocrine tumor – a case report","authors":"Jahnavi Ethakota , Haseeb Khan Tareen , Sakshi Bai , Haris Bin Tahir , Muhammad Fawad Ashraf , Hafsa Ahmed , Hafsa Fayyaz","doi":"10.1016/j.hmedic.2025.100368","DOIUrl":"10.1016/j.hmedic.2025.100368","url":null,"abstract":"<div><div>Cardiac metastasis from neuroendocrine tumors (NETs) is exceptionally rare and poses diagnostic and therapeutic challenges. We report this case to highlight that cardiac metastases from NETs can be entirely silent yet clinically significant, with early recognition relying on vigilant, multimodal imaging rather than symptom-driven evaluation. We present the case of a 73‑year‑old man who was incidentally found to have a right ventricular mass during lung cancer screening. Imaging studies, including CT, cardiac MRI, and Ga‑68 DOTATATE PET‑CT, revealed a right ventricular apical mass with attachment to the interventricular septum, mesenteric primary tumor, and hepatic metastases. Pathological analysis confirmed a well‑differentiated NET with strong synaptophysin positivity. Despite asymptomatic presentation, he was initiated on octreotide therapy for stage IV disease. Six‑month follow‑up demonstrated stable disease. This case adds to the very limited literature on asymptomatic cardiac metastases from NETs by uniquely demonstrating an incidentally detected right ventricular lesion identified on screening CT rather than targeted cardiac evaluation, with no evidence of carcinoid valvular involvement. In particular, the septal attachment without valvular disease contrasts with most previously reported cardiac NET metastases, which commonly involve valvular structures. Furthermore, this case demonstrates the importance of multimodal imaging in detecting occult cardiac metastasis and highlights the role of somatostatin analogs in managing metastatic NETs. These findings highlight the importance of systematically reviewing cardiac structures during routine imaging to enhance early detection of clinically silent cardiac metastases in NETs.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100368"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis is an adverse reaction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Here, we report a case of cerebral arteriovenous malformation (AVM) rupture due to draining vein thrombosis after SARS-CoV-2 vaccination.
Observations
A 17-year-old girl received the Pfizer BioNTech vaccine for the first time. Three days later, the patient presented with a headache. Nine days later, she experienced worsening symptoms, left sensory disturbance, and dysarthria. Computed tomography showed a subcortical hemorrhage in the right parietooccipital lobe, and cerebral angiography revealed an AVM located mainly in the right parietooccipital lobe. She underwent AVM resection on the 5th day of hospitalization, and the postoperative course was uneventful. Histopathological examination revealed a thrombus containing fibrin in the varix. It was suggested that thrombosis was induced by vaccination and that the thrombus in the outflow vein caused congestion in the nidus, resulting in hemorrhage.
Conclusions
Venous thrombosis associated with vaccination may affect AVM hemodynamics. Therefore, patients with known AVMs should be aware of the appearance of symptoms after vaccination.
{"title":"Cerebral arteriovenous malformation rupture due to thrombosis induced by coronavirus disease 2019 vaccine: A case report","authors":"Genki Chikamatsu , Tsuyoshi Izumo , Eri Shiozaki , Yuka Ogawa , Shota Yoshimura , Ayaka Matsuo , Kazuaki Okamura , Ryotaro Takahira , Eisaku Sadakata , Yoichi Morofuji , Takeshi Hiu , Takayuki Matsuo","doi":"10.1016/j.hmedic.2025.100367","DOIUrl":"10.1016/j.hmedic.2025.100367","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Thrombosis is an adverse reaction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Here, we report a case of cerebral arteriovenous malformation (AVM) rupture due to draining vein thrombosis after SARS-CoV-2 vaccination.</div></div><div><h3>Observations</h3><div>A 17-year-old girl received the Pfizer BioNTech vaccine for the first time. Three days later, the patient presented with a headache. Nine days later, she experienced worsening symptoms, left sensory disturbance, and dysarthria. Computed tomography showed a subcortical hemorrhage in the right parietooccipital lobe, and cerebral angiography revealed an AVM located mainly in the right parietooccipital lobe. She underwent AVM resection on the 5th day of hospitalization, and the postoperative course was uneventful. Histopathological examination revealed a thrombus containing fibrin in the varix. It was suggested that thrombosis was induced by vaccination and that the thrombus in the outflow vein caused congestion in the nidus, resulting in hemorrhage.</div></div><div><h3>Conclusions</h3><div>Venous thrombosis associated with vaccination may affect AVM hemodynamics. Therefore, patients with known AVMs should be aware of the appearance of symptoms after vaccination.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100367"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-07DOI: 10.1016/j.hmedic.2025.100366
Haris Khan , Ahsan Khurshid , Hafiz Ahmad Iqrash Qureshi , Romaisa Malik
Dengue fever is a mosquito-transmitted fever, resulting from infection by an RNA virus. Each year, almost 100–400 million new cases of dengue are reported across the globe, with 25 % of them producing symptoms. WHO 2009 classification categorizes dengue into three groups: dengue without warning signs (mild symptoms without plasma leakage), dengue with warning signs (mucosal bleeding, rising hematocrit and thrombocytopenia), and severe dengue (severe bleeding, shock or organ impairment). Although in most cases, it presents with fever, body aches and a maculopapular rash (typical presentation), atypical manifestation of this condition can also be rarely encountered. Here, we present a case of a 20-year-old male, who demonstrated an atypical presentation of dengue fever, confirmed by positive IgM serology. He had developed progressive shortness of breath, in addition to fever and body pains. Later, chest x-ray and thoracentesis revealed a massive hemothorax. He was managed with tube thoracostomy and intravenous fluids, which lead to a gradual improvement of his condition. Through this case, we highlight the significance of early recognition of the atypical presentations of dengue fever.
{"title":"Atypical presentation of dengue fever with unilateral massive hemothorax: A case report","authors":"Haris Khan , Ahsan Khurshid , Hafiz Ahmad Iqrash Qureshi , Romaisa Malik","doi":"10.1016/j.hmedic.2025.100366","DOIUrl":"10.1016/j.hmedic.2025.100366","url":null,"abstract":"<div><div>Dengue fever is a mosquito-transmitted fever, resulting from infection by an RNA virus. Each year, almost 100–400 million new cases of dengue are reported across the globe, with 25 % of them producing symptoms. WHO 2009 classification categorizes dengue into three groups: dengue without warning signs (mild symptoms without plasma leakage), dengue with warning signs (mucosal bleeding, rising hematocrit and thrombocytopenia), and severe dengue (severe bleeding, shock or organ impairment). Although in most cases, it presents with fever, body aches and a maculopapular rash (typical presentation), atypical manifestation of this condition can also be rarely encountered. Here, we present a case of a 20-year-old male, who demonstrated an atypical presentation of dengue fever, confirmed by positive IgM serology. He had developed progressive shortness of breath, in addition to fever and body pains. Later, chest x-ray and thoracentesis revealed a massive hemothorax. He was managed with tube thoracostomy and intravenous fluids, which lead to a gradual improvement of his condition. Through this case, we highlight the significance of early recognition of the atypical presentations of dengue fever.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100366"},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastrointestinal stromal tumors (GISTs) are rare tumors, accounting for approximately 1 % of digestive cancers. Among them, rectal GISTs are unusual (< 5 % of GISTs). Their metastatic form, particularly with liver involvement, is even rarer and poses diagnostic and therapeutic challenges.
Case report
A 73-year-old ASA II patient presented with rectal discharge and mild abdominal discomfort. Colonoscopy revealed a 5.2 × 4.7 cm lesion in the lower rectum, 3 cm from the anal margin. Histological and immunohistochemical analysis confirmed a high-risk spindle cell GIST (mitotic index: 8/50 HPF). Extension workup showed five liver metastases (segments VI–VIII), the largest measuring 3.8 cm. According to AJCC 2017 staging, the patient was classified as Stage IV. After multidisciplinary team discussion including oncologists, surgeons, and radiologists, imatinib therapy (400 mg daily) was initiated. Six-month follow-up showed a 30 % reduction in both primary tumor and metastatic lesions, with continued imatinib therapy and no surgical intervention to date.
Discussion
Metastatic rectal GIST with liver involvement requires a specific therapeutic approach. Imatinib is the reference treatment, enabling disease stabilization in approximately 80 % of cases. Close monitoring is essential, and surgery may be considered for responsive cases. Multidisciplinary management optimizes outcomes, with rectal GIST management differing from other GI locations due to anatomical challenges.
Conclusion
Rectal GIST metastatic to the liver is a complex pathology requiring an individualized strategy. Treatment with imatinib, combined with regular assessment, improves tumor control and prognosis, with some patients achieving long-term disease control exceeding 5 years.
{"title":"Gastrointestinal rectal stromal tumor with hepatic metastases: A case report","authors":"Rabti Souphia , Mejri Khouloud , Ben Hassine Basma , Kthiri Seif , Ben Marzouk Saoussen , Farjaoui Wael , Khalifa Mohamed Bechir","doi":"10.1016/j.hmedic.2025.100364","DOIUrl":"10.1016/j.hmedic.2025.100364","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastrointestinal stromal tumors (GISTs) are rare tumors, accounting for approximately 1 % of digestive cancers. Among them, rectal GISTs are unusual (< 5 % of GISTs). Their metastatic form, particularly with liver involvement, is even rarer and poses diagnostic and therapeutic challenges.</div></div><div><h3>Case report</h3><div>A 73-year-old ASA II patient presented with rectal discharge and mild abdominal discomfort. Colonoscopy revealed a 5.2 × 4.7 cm lesion in the lower rectum, 3 cm from the anal margin. Histological and immunohistochemical analysis confirmed a high-risk spindle cell GIST (mitotic index: 8/50 HPF). Extension workup showed five liver metastases (segments VI–VIII), the largest measuring 3.8 cm. According to AJCC 2017 staging, the patient was classified as Stage IV. After multidisciplinary team discussion including oncologists, surgeons, and radiologists, imatinib therapy (400 mg daily) was initiated. Six-month follow-up showed a 30 % reduction in both primary tumor and metastatic lesions, with continued imatinib therapy and no surgical intervention to date.</div></div><div><h3>Discussion</h3><div>Metastatic rectal GIST with liver involvement requires a specific therapeutic approach. Imatinib is the reference treatment, enabling disease stabilization in approximately 80 % of cases. Close monitoring is essential, and surgery may be considered for responsive cases. Multidisciplinary management optimizes outcomes, with rectal GIST management differing from other GI locations due to anatomical challenges.</div></div><div><h3>Conclusion</h3><div>Rectal GIST metastatic to the liver is a complex pathology requiring an individualized strategy. Treatment with imatinib, combined with regular assessment, improves tumor control and prognosis, with some patients achieving long-term disease control exceeding 5 years.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100364"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-05DOI: 10.1016/j.hmedic.2025.100365
Maher Salloum , Batoul Abbas , Michael Khoury , Zaki Samia , Mona Youssef , Karam Karam , Maroun Abou-Jawde
Angiosarcoma is a rare and aggressive malignant neoplasm that originates from the endothelial cells lining blood vessels. It can occasionally arise as a complication of both functional and nonfunctional arteriovenous fistulas. This paper will present a documented case of angiosarcoma developing from a nonfunctioning fistula in a 36-year-old male who underwent kidney transplantation and was on immunosuppressive therapies. The clinical manifestations, management strategies, and a comprehensive review of the literature on this uncommon disease will be discussed.
{"title":"Angiosarcoma unveiled: A rare case of arteriovenous fistula post kidney transplantation","authors":"Maher Salloum , Batoul Abbas , Michael Khoury , Zaki Samia , Mona Youssef , Karam Karam , Maroun Abou-Jawde","doi":"10.1016/j.hmedic.2025.100365","DOIUrl":"10.1016/j.hmedic.2025.100365","url":null,"abstract":"<div><div>Angiosarcoma is a rare and aggressive malignant neoplasm that originates from the endothelial cells lining blood vessels. It can occasionally arise as a complication of both functional and nonfunctional arteriovenous fistulas. This paper will present a documented case of angiosarcoma developing from a nonfunctioning fistula in a 36-year-old male who underwent kidney transplantation and was on immunosuppressive therapies. The clinical manifestations, management strategies, and a comprehensive review of the literature on this uncommon disease will be discussed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Langerhans cell histiocytosis (LCH) is a rare neoplasm of myeloid dendritic cells that often presents diagnostic challenges due to its variable clinical manifestations. It is most commonly seen in the first three years of life. LCH with isolated scalp involvement in children, particularly adolescents, remains underreported.
Case presentation
We report a case of a 12-year-old boy who presented with a painless swelling on the left frontal scalp. Imaging revealed a lytic bone lesion in the frontal bone. Fine needle aspiration cytology of the mass suggested a benign histiocytic lesion consistent with Langerhans cell histiocytosis. The mass was completely excised, and subsequent histopathologic examination confirmed the diagnosis of LCH. Immunohistochemistry showed that the neoplastic cells were diffusely positive for Langerin and CD1a, further supporting the diagnosis.
Conclusion
LCH should be considered as a differential diagnosis in children presenting with a lytic scalp mass. Histopathology combined with immunohistochemistry is crucial for definitive diagnosis.
{"title":"Unifocal scalp langerhans cell histiocytosis in an adolescent child: A case report","authors":"Sisay Abush Mulisa , Tsion Haile Woldemariam , Birhanu Kassie Reta , Robel Tibebu Kasaye , Asonya Abera Akuma , Adem Reshid Abdella , Fadil Nuredin Abrar , Hidaya Yahya Mohammed , Yemane Leake Gebremichael","doi":"10.1016/j.hmedic.2025.100362","DOIUrl":"10.1016/j.hmedic.2025.100362","url":null,"abstract":"<div><h3>Introduction</h3><div>Langerhans cell histiocytosis (LCH) is a rare neoplasm of myeloid dendritic cells that often presents diagnostic challenges due to its variable clinical manifestations. It is most commonly seen in the first three years of life. LCH with isolated scalp involvement in children, particularly adolescents, remains underreported.</div></div><div><h3>Case presentation</h3><div>We report a case of a 12-year-old boy who presented with a painless swelling on the left frontal scalp. Imaging revealed a lytic bone lesion in the frontal bone. Fine needle aspiration cytology of the mass suggested a benign histiocytic lesion consistent with Langerhans cell histiocytosis. The mass was completely excised, and subsequent histopathologic examination confirmed the diagnosis of LCH. Immunohistochemistry showed that the neoplastic cells were diffusely positive for Langerin and CD1a, further supporting the diagnosis.</div></div><div><h3>Conclusion</h3><div>LCH should be considered as a differential diagnosis in children presenting with a lytic scalp mass. Histopathology combined with immunohistochemistry is crucial for definitive diagnosis.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100362"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.hmedic.2025.100358
Mia van der Kop , Anna Mia Ekström , Eman Al-Raddadi
Creatine is a naturally occurring compound that is synthesized endogenously and obtained through dietary consumption. Oral supplementation with creatine monohydrate (CM) is commonly used to enhance exercise performance. There is increasing interest in the use of creatine supplementation to improve cognitive processing and in neurodegenerative disorders. Epilepsy is one of the most common, serious neurological conditions, and one-third of patients continue to have seizures despite treatment. Pre-clinical studies suggest that creatine may have a potential role as an anticonvulsant, however no studies in adult humans have been done. Here, we present a case in which a patient with drug-resistant epilepsy had a marked reduction in seizure frequency after supplementing with 5 g/day of creatine monohydrate. This case, together with pre-clinical evidence, provides preliminary clinical support for further exploration of creatine as a low-risk, adjunctive therapy in epilepsy, particularly for patients with drug-resistant forms.
{"title":"Reduced seizure frequency with oral creatine supplementation: A case report","authors":"Mia van der Kop , Anna Mia Ekström , Eman Al-Raddadi","doi":"10.1016/j.hmedic.2025.100358","DOIUrl":"10.1016/j.hmedic.2025.100358","url":null,"abstract":"<div><div>Creatine is a naturally occurring compound that is synthesized endogenously and obtained through dietary consumption. Oral supplementation with creatine monohydrate (CM) is commonly used to enhance exercise performance. There is increasing interest in the use of creatine supplementation to improve cognitive processing and in neurodegenerative disorders. Epilepsy is one of the most common, serious neurological conditions, and one-third of patients continue to have seizures despite treatment. Pre-clinical studies suggest that creatine may have a potential role as an anticonvulsant, however no studies in adult humans have been done. Here, we present a case in which a patient with drug-resistant epilepsy had a marked reduction in seizure frequency after supplementing with 5 g/day of creatine monohydrate. This case, together with pre-clinical evidence, provides preliminary clinical support for further exploration of creatine as a low-risk, adjunctive therapy in epilepsy, particularly for patients with drug-resistant forms.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.hmedic.2025.100363
Farah Tarek Shaalan , Israa Ahmed Qutob
Background
Breast cancer is the most common malignancy in women and is known to metastasize to distant organs, including the lungs, liver, bone, and brain. However, metastasis to the parotid glands is an exceedingly rare occurrence, often posing a diagnostic challenge. Parotid metastasis can mimic primary salivary gland tumors, inflammatory conditions, or neurological disorders such as Bell's palsy, leading to delays in diagnosis and treatment. This case report presents an unusual instance of bilateral parotid metastasis from breast cancer and highlights the diagnostic and management challenges associated with this rare phenomenon.
Case presentation
A 46-year-old premenopausal woman with a history of invasive ductal carcinoma (IDC) of the right breast, diagnosed in 2018, presented in January 2021 with progressive bilateral parotid swelling, peripheral facial paralysis, and difficulty closing her left eye. She had previously undergone mastectomy, chemotherapy, radiotherapy, and endocrine therapy. Imaging, including ultrasound-guided biopsy and CT scans, confirmed metastatic ductal carcinoma in both parotid glands. Immunohistochemistry results were consistent with the patient's original breast cancer diagnosis, demonstrating estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, and HER2-negative tumors. Despite receiving palliative chemotherapy and radiotherapy, the patient's condition worsened, and she passed away one year after the diagnosis of parotid metastasis.
Conclusion
Parotid gland metastasis from breast cancer is a rare but clinically significant manifestation. Due to its rarity, it is often under-recognized, and early diagnosis can be challenging. Advanced imaging techniques such as PET/CT and MRI play a critical role in detecting these rare metastases, though they require careful interpretation. While treatment remains primarily palliative due to the poor prognosis, early recognition and timely palliative care can improve patient quality of life. This case investigates the importance of heightened clinical awareness and advanced imaging in the management of metastatic parotid lesions in breast cancer patients.
{"title":"Unusual bilateral parotid metastasis from breast cancer: A case report","authors":"Farah Tarek Shaalan , Israa Ahmed Qutob","doi":"10.1016/j.hmedic.2025.100363","DOIUrl":"10.1016/j.hmedic.2025.100363","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most common malignancy in women and is known to metastasize to distant organs, including the lungs, liver, bone, and brain. However, metastasis to the parotid glands is an exceedingly rare occurrence, often posing a diagnostic challenge. Parotid metastasis can mimic primary salivary gland tumors, inflammatory conditions, or neurological disorders such as Bell's palsy, leading to delays in diagnosis and treatment. This case report presents an unusual instance of bilateral parotid metastasis from breast cancer and highlights the diagnostic and management challenges associated with this rare phenomenon.</div></div><div><h3>Case presentation</h3><div>A 46-year-old premenopausal woman with a history of invasive ductal carcinoma (IDC) of the right breast, diagnosed in 2018, presented in January 2021 with progressive bilateral parotid swelling, peripheral facial paralysis, and difficulty closing her left eye. She had previously undergone mastectomy, chemotherapy, radiotherapy, and endocrine therapy. Imaging, including ultrasound-guided biopsy and CT scans, confirmed metastatic ductal carcinoma in both parotid glands. Immunohistochemistry results were consistent with the patient's original breast cancer diagnosis, demonstrating estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, and HER2-negative tumors. Despite receiving palliative chemotherapy and radiotherapy, the patient's condition worsened, and she passed away one year after the diagnosis of parotid metastasis.</div></div><div><h3>Conclusion</h3><div>Parotid gland metastasis from breast cancer is a rare but clinically significant manifestation. Due to its rarity, it is often under-recognized, and early diagnosis can be challenging. Advanced imaging techniques such as PET/CT and MRI play a critical role in detecting these rare metastases, though they require careful interpretation. While treatment remains primarily palliative due to the poor prognosis, early recognition and timely palliative care can improve patient quality of life. This case investigates the importance of heightened clinical awareness and advanced imaging in the management of metastatic parotid lesions in breast cancer patients.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-03DOI: 10.1016/j.hmedic.2025.100360
Naqiuddin Mohd Fazali , Zaitul Azra Mohd Nasir , Mohamed Ashraf Mohamed Daud , Wan Fatihah Wan Sohaimi , Nur Asma Sapiai
Background
Double-J ureteral stents are often utilised in urology and have become an essential component of urologic practice. The primary function is to facilitate urine outflow from the kidney to the urinary bladder. As the usage of stent grows, so do the number of issues.
Case presentation
We present a case of a 54-year-old man with neglected right double J stent for thirteen years after right pyelolithotomy. He skipped follow up and then later, presented with painless haematuria. Abdominal radiograph revealed bilateral nephrolithiasis and vesicolithiasis with broken right double J stent.
Conclusion
To avoid this circumstance, patients should be taught about the difficulties that might occur if the stent is not removed within a short period of time. This instance highlights the need of giving enough information and understanding about the insertion of a ureteral stent.
{"title":"The forgotten double J ureteral stent complicated with large urinary bladder calculus formation: A case report","authors":"Naqiuddin Mohd Fazali , Zaitul Azra Mohd Nasir , Mohamed Ashraf Mohamed Daud , Wan Fatihah Wan Sohaimi , Nur Asma Sapiai","doi":"10.1016/j.hmedic.2025.100360","DOIUrl":"10.1016/j.hmedic.2025.100360","url":null,"abstract":"<div><h3>Background</h3><div>Double-J ureteral stents are often utilised in urology and have become an essential component of urologic practice. The primary function is to facilitate urine outflow from the kidney to the urinary bladder. As the usage of stent grows, so do the number of issues.</div></div><div><h3>Case presentation</h3><div>We present a case of a 54-year-old man with neglected right double J stent for thirteen years after right pyelolithotomy. He skipped follow up and then later, presented with painless haematuria. Abdominal radiograph revealed bilateral nephrolithiasis and vesicolithiasis with broken right double J stent.</div></div><div><h3>Conclusion</h3><div>To avoid this circumstance, patients should be taught about the difficulties that might occur if the stent is not removed within a short period of time. This instance highlights the need of giving enough information and understanding about the insertion of a ureteral stent.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100360"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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