Pub Date : 2025-09-22DOI: 10.1016/j.hmedic.2025.100375
Amir Omar , Rayane Salameh , Tracy Zouein , Tala Charafeddine , Karam Karam , Noha Al Hachem
Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira species. It usually manifests as an acute bacterial febrile septicemia like illness that affects both humans and animals. Human infection may occur via mucosal surfaces, abraded skin, or inhalation of aerosolized contaminated water. Liver involvement is a frequent finding in leptospirosis that ranges from mild dysfunction to severe icteric illness with renal failure. We herein present a case of acute hepatitis and febrile jaundice induced by Leptospirosis. The patient had cardiac involvement but no pulmonary or renal involvement, further adding ambiguity to the diagnosis. The diagnosis of leptospirosis in this case was particularly challenging due to its atypical presentation. The unusual constellation of findings underscores the importance of considering leptospirosis in the differential diagnosis of febrile jaundice, even in the absence of classical risk factors. The initiation of potentially life-saving antibiotic treatment requires a high index of clinical suspicion.
{"title":"A-not-full-blown Weil’s disease: An atypical cause of leptospirosis-induced acute hepatitis","authors":"Amir Omar , Rayane Salameh , Tracy Zouein , Tala Charafeddine , Karam Karam , Noha Al Hachem","doi":"10.1016/j.hmedic.2025.100375","DOIUrl":"10.1016/j.hmedic.2025.100375","url":null,"abstract":"<div><div>Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira species. It usually manifests as an acute bacterial febrile septicemia like illness that affects both humans and animals. Human infection may occur via mucosal surfaces, abraded skin, or inhalation of aerosolized contaminated water. Liver involvement is a frequent finding in leptospirosis that ranges from mild dysfunction to severe icteric illness with renal failure. We herein present a case of acute hepatitis and febrile jaundice induced by Leptospirosis. The patient had cardiac involvement but no pulmonary or renal involvement, further adding ambiguity to the diagnosis. The diagnosis of leptospirosis in this case was particularly challenging due to its atypical presentation. The unusual constellation of findings underscores the importance of considering leptospirosis in the differential diagnosis of febrile jaundice, even in the absence of classical risk factors. The initiation of potentially life-saving antibiotic treatment requires a high index of clinical suspicion.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120300","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 : 2025-09-20DOI: 10.1016/j.hmedic.2025.100373
Marouane Boukroute , Abdelmajide Regragui , Soukayna Saidi , Hafsa Taheri , Hanane Saadi , Ahmed Mimouni
Adnexal torsion (AT) during pregnancy is a rare but critical condition that poses significant challenges in diagnosis and management. We present the case of a 22-year-old primigravida at 14 weeks of gestation with no predisposing factors, who presented with acute right-sided pelvic pain. Imaging, including transabdominal ultrasound and MRI, indicated a viable pregnancy with an enlarged, multifollicular right ovary, suggesting AT. The patient underwent an emergency laparoscopy, confirming right-sided adnexal torsion. After successful detorsion, postoperative recovery was uneventful, and follow-up imaging confirmed ongoing pregnancy viability with preserved ovarian function.
Given the nonspecific clinical presentation, the diagnosis of AT in pregnancy often requires high clinical suspicion supported by imaging modalities. While ultrasound remains the primary diagnostic tool, MRI can offer additional diagnostic clarity when ultrasound findings are inconclusive. The treatment of AT in pregnant women is primarily surgical, with recent guidelines favoring conservative approaches aimed at preserving ovarian function. Laparoscopy is the preferred method for pregnancies under 17 weeks, with emphasis on safety protocols. Conservative management, including detorsion, is recommended for viable ovaries, while oophorectomy is reserved for cases with necrotic tissue. Overall, the prognosis is favorable, with most cases resulting in functional ovarian recovery and continued pregnancy viability.
{"title":"Rare case of adnexal torsion in pregnancy: A comprehensive review of recent diagnostic and surgical management approaches","authors":"Marouane Boukroute , Abdelmajide Regragui , Soukayna Saidi , Hafsa Taheri , Hanane Saadi , Ahmed Mimouni","doi":"10.1016/j.hmedic.2025.100373","DOIUrl":"10.1016/j.hmedic.2025.100373","url":null,"abstract":"<div><div>Adnexal torsion (AT) during pregnancy is a rare but critical condition that poses significant challenges in diagnosis and management. We present the case of a 22-year-old primigravida at 14 weeks of gestation with no predisposing factors, who presented with acute right-sided pelvic pain. Imaging, including transabdominal ultrasound and MRI, indicated a viable pregnancy with an enlarged, multifollicular right ovary, suggesting AT. The patient underwent an emergency laparoscopy, confirming right-sided adnexal torsion. After successful detorsion, postoperative recovery was uneventful, and follow-up imaging confirmed ongoing pregnancy viability with preserved ovarian function.</div><div>Given the nonspecific clinical presentation, the diagnosis of AT in pregnancy often requires high clinical suspicion supported by imaging modalities. While ultrasound remains the primary diagnostic tool, MRI can offer additional diagnostic clarity when ultrasound findings are inconclusive. The treatment of AT in pregnant women is primarily surgical, with recent guidelines favoring conservative approaches aimed at preserving ovarian function. Laparoscopy is the preferred method for pregnancies under 17 weeks, with emphasis on safety protocols. Conservative management, including detorsion, is recommended for viable ovaries, while oophorectomy is reserved for cases with necrotic tissue. Overall, the prognosis is favorable, with most cases resulting in functional ovarian recovery and continued pregnancy viability.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100373"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120298","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 : 2025-09-17DOI: 10.1016/j.hmedic.2025.100372
Palak R. Patel, Craig Carcuffe, Benjamin Abramoff
Postoperative Guillain-Barré syndrome (GBS) is a rare and poorly understood phenomenon. We present the case of a 73-year-old female with cervical myelopathy who developed a GBS variant, acute motor axonal neuropathy (AMAN), following surgical decompression. The patient's initial presentation was consistent with cervical myelopathy, but she experienced a rapid postoperative neurological decline characterized by progressive weakness and areflexia. This unusual timeline, along with the patient having undergone an esophagogastroduodenoscopy just four days prior to her hospital admission, presents a unique clinical puzzle. This case adds to the limited literature on postoperative GBS and suggests that multiple procedures within a short timeframe may increase the risk of developing the syndrome. We emphasize the need for clinicians to consider GBS in the differential diagnosis for postoperative progressive weakness and to utilize advanced diagnostic tools like electrodiagnostic studies for prompt and accurate management.
{"title":"Postoperative Guillain-Barré syndrome following multiple procedures: A case report","authors":"Palak R. Patel, Craig Carcuffe, Benjamin Abramoff","doi":"10.1016/j.hmedic.2025.100372","DOIUrl":"10.1016/j.hmedic.2025.100372","url":null,"abstract":"<div><div>Postoperative Guillain-Barré syndrome (GBS) is a rare and poorly understood phenomenon. We present the case of a 73-year-old female with cervical myelopathy who developed a GBS variant, acute motor axonal neuropathy (AMAN), following surgical decompression. The patient's initial presentation was consistent with cervical myelopathy, but she experienced a rapid postoperative neurological decline characterized by progressive weakness and areflexia. This unusual timeline, along with the patient having undergone an esophagogastroduodenoscopy just four days prior to her hospital admission, presents a unique clinical puzzle. This case adds to the limited literature on postoperative GBS and suggests that multiple procedures within a short timeframe may increase the risk of developing the syndrome. We emphasize the need for clinicians to consider GBS in the differential diagnosis for postoperative progressive weakness and to utilize advanced diagnostic tools like electrodiagnostic studies for prompt and accurate management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120299","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 : 2025-09-15DOI: 10.1016/j.hmedic.2025.100371
Vanessa Defelícibus, Leticia Philippi, Victória Maes, Ana Paula Anzolin
Background
Facial harmonization procedures, while popular, can lead to complications such as persistent edema, nodules, and scarring with retraction. Ozone therapy, known for its anti-inflammatory, oxygenating, and regenerative properties, has emerged as a potential adjuvant treatment to improve clinical outcomes in such cases.
Case reports
Case 1 involved a 42-year-old female patient who developed persistent facial edema and nodules following an inappropriate hyaluronic acid application. Treatment included ultrasound-guided hyaluronidase injections and subcutaneous medical ozone therapy, resulting in a progressive reduction of inflammation and improved facial symmetry. Case 2 described a 48-year-old female patient with severe scar retraction of the lower eyelids after a "non-surgical blepharoplasty" using a plasma jet, leading to ectropion and ocular pain. Management combined subcutaneous ozone therapy, cyclic eyelid traction, and reconstructive surgery, achieving symptom relief, functional recovery, and anatomical stability.
Conclusion
Ozone therapy demonstrated a significant adjuvant role in managing complications from facial aesthetic procedures by modulating inflammation, enhancing tissue oxygenation, and promoting local tissue regeneration, ultimately contributing to improved clinical outcomes.
{"title":"Integrated management of facial harmonization complications using ozone therapy: A description of 2 cases","authors":"Vanessa Defelícibus, Leticia Philippi, Victória Maes, Ana Paula Anzolin","doi":"10.1016/j.hmedic.2025.100371","DOIUrl":"10.1016/j.hmedic.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>Facial harmonization procedures, while popular, can lead to complications such as persistent edema, nodules, and scarring with retraction. Ozone therapy, known for its anti-inflammatory, oxygenating, and regenerative properties, has emerged as a potential adjuvant treatment to improve clinical outcomes in such cases.</div></div><div><h3>Case reports</h3><div>Case 1 involved a 42-year-old female patient who developed persistent facial edema and nodules following an inappropriate hyaluronic acid application. Treatment included ultrasound-guided hyaluronidase injections and subcutaneous medical ozone therapy, resulting in a progressive reduction of inflammation and improved facial symmetry. Case 2 described a 48-year-old female patient with severe scar retraction of the lower eyelids after a \"non-surgical blepharoplasty\" using a plasma jet, leading to ectropion and ocular pain. Management combined subcutaneous ozone therapy, cyclic eyelid traction, and reconstructive surgery, achieving symptom relief, functional recovery, and anatomical stability.</div></div><div><h3>Conclusion</h3><div>Ozone therapy demonstrated a significant adjuvant role in managing complications from facial aesthetic procedures by modulating inflammation, enhancing tissue oxygenation, and promoting local tissue regeneration, ultimately contributing to improved clinical outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100371"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094987","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 : 2025-09-13DOI: 10.1016/j.hmedic.2025.100370
Khalid Hamdan, Kaline Maya Khoury, Nicolas Moussallem, Jessy Fadel, Karam Karam, Elias Fiani
Background
Crohn’s disease (CD), a chronic inflammatory bowel disease, has various clinical manifestations that can be treated and controlled with tumor necrosis factor-alpha (TNF-α) inhibitors, like adalimumab, as therapy of choice. Despite the number of patients that have benefited from this treatment and achieved remission of their symptoms, some experience paradoxically induced psoriatic skin lesions, a condition known as paradoxical psoriasis.
Case Presentation
We present the case of a 46-year-old Lebanese woman known to have Crohn’s disease, with a history of recurrent flares and episodes of sacroiliitis not controlled on azathioprine. Hence, we switched the patient onto adalimumab, whereby she experienced full remission of her disease associated symptoms for around a duration of five months until she developed widespread erythematous, scaly silver plaques which were determined by dermatologic assessment and biopsy to be psoriasiform dermatitis. The offending agent, adalimumab was discontinued and replaced with ustekinumab, an interleukin-12/23 inhibitor, that led to the complete disappearance of the skin lesions and subsidence of her Crohn’s related gastrointestinal and musculoskeletal symptoms.
Conclusion
When starting a patient on a TNF-α inhibitor therapy, physicians should pay close attention and participate in educating patients about possible cutaneous reactions that may occur during treatment. Early detection of these psoriasiform lesions is imperative for prompt treatment adjustments, such as switching to agents with different immunological targets, to prevent widespread of the rash and improve patient outcomes.
{"title":"Paradoxical psoriasis induced by adalimumab in a patient with Crohn’s disease and sacroiliitis: A case report","authors":"Khalid Hamdan, Kaline Maya Khoury, Nicolas Moussallem, Jessy Fadel, Karam Karam, Elias Fiani","doi":"10.1016/j.hmedic.2025.100370","DOIUrl":"10.1016/j.hmedic.2025.100370","url":null,"abstract":"<div><h3>Background</h3><div>Crohn’s disease (CD), a chronic inflammatory bowel disease, has various clinical manifestations that can be treated and controlled with tumor necrosis factor-alpha (TNF-α) inhibitors, like adalimumab, as therapy of choice. Despite the number of patients that have benefited from this treatment and achieved remission of their symptoms, some experience paradoxically induced psoriatic skin lesions, a condition known as paradoxical psoriasis.</div></div><div><h3>Case Presentation</h3><div>We present the case of a 46-year-old Lebanese woman known to have Crohn’s disease, with a history of recurrent flares and episodes of sacroiliitis not controlled on azathioprine. Hence, we switched the patient onto adalimumab, whereby she experienced full remission of her disease associated symptoms for around a duration of five months until she developed widespread erythematous, scaly silver plaques which were determined by dermatologic assessment and biopsy to be psoriasiform dermatitis. The offending agent, adalimumab was discontinued and replaced with ustekinumab, an interleukin-12/23 inhibitor, that led to the complete disappearance of the skin lesions and subsidence of her Crohn’s related gastrointestinal and musculoskeletal symptoms.</div></div><div><h3>Conclusion</h3><div>When starting a patient on a TNF-α inhibitor therapy, physicians should pay close attention and participate in educating patients about possible cutaneous reactions that may occur during treatment. Early detection of these psoriasiform lesions is imperative for prompt treatment adjustments, such as switching to agents with different immunological targets, to prevent widespread of the rash and improve patient outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060232","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 : 2025-09-12DOI: 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}
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