American Journal of Case Reports美国病例报告杂志
American Journal of Case Reports(英文缩写 AM J CASE REP),ISSN 1941-5923,eISSN 1941-5923,中文译名:美国病例报告杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
American Journal of Case Reports 最新收录文献
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1. Pure Red Cell Aplasia Following Neoadjuvant Docetaxel/Carboplatin/Trastuzumab (TCbH) in a 45‑Year‑Old Woman With Breast Cancer Successfully Treated With Cyclosporine.
PMID:日期:2026-09-25BACKGROUND Human epidermal growth factor receptor 2 (HER2)-positive breast cancer is commonly treated with docetaxel/carboplatin/trastuzumab (TCbH). While anemia is a common complication, progression to pure red cell aplasia (PRCA) is extremely rare. This report presents the case of a 45-year-old woman with right breast ductal carcinoma (cT3N2M0, HER2-positive) who developed PRCA following neoadjuvant TCbH and was effectively treated with cyclosporine. CASE REPORT A 45-year-old woman with right breast invasive ductal carcinoma (cT3N2M0, HER2-positive) received neoadjuvant TCbH. After the sixth cycle, she developed progressive anemia refractory to erythropoietin, with hemoglobin (Hb) decreasing to 34.2 g/L. After transfusion, she underwent modified radical mastectomy with pathological complete response. Postoperatively, anemia worsened with marked reticulocytopenia (reticulocytes 3.8×10⁹/L; 0.2%). Bone marrow examination revealed markedly reduced erythroid precursors. Acquired PRCA was diagnosed after excluding iron deficiency, megaloblastic anemia, hemolytic anemia, hematologic malignancies, autoimmune disorders, aplastic anemia, thymoma, and infections. Oral cyclosporine (100 mg twice daily) induced complete hematologic remission at 7 weeks and was tapered over 2 years. During the adjuvant trastuzumab/pertuzumab (HP) treatment, Hb remained ≥110 g/L. A heterozygous germline BRCA1 mutation (c.788delG) was identified. At the 4.5-year follow-up, there is no recurrence of either breast cancer or anemia. CONCLUSIONS This case highlights PRCA as a severe complication of TCbH therapy. Reticulocytopenia with refractory anemia warrants timely bone marrow examination. In this patient, cyclosporine was effective; after anemia correction, HP was tolerated. The observed gBRCA1 mutation is a hypothesis-generating finding requiring further validation.
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2. Fourteen-Year Course of Multiple Recurrent and Distantly Metastatic Hepatic Epithelioid Hemangioendothelioma With Serial Ki-67 Evolution: A Case Report.
PMID:日期:2026-09-25BACKGROUND Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor of endothelial origin with variable clinical behavior, posing significant diagnostic and therapeutic challenges. Due to its nonspecific presentation and diverse imaging features, it is frequently misdiagnosed. We present a unique case of HEHE with recurrent liver involvement and distant metastases over a 14-year period, emphasizing diagnostic markers, treatment strategies, and the prognostic value of serial biomarker assessment. CASE REPORT A 48-year-old woman underwent right partial hepatectomy in 2011 after a routine health check-up incidentally revealed a liver lesion. Histological examination revealed characteristic epithelioid and dendritic tumor cells, confirmed by immunohistochemistry (CD31+, CD34+, Ki-67 5%). Postoperative surveillance detected tumor recurrence 7 years later in the left lobe, necessitating laparoscopic left partial hepatectomy. In 2020, further progression to the caudate lobe and regional lymph nodes prompted complex resection, with Ki-67 rising to 15%. Serial Ki-67 assessments across sequential specimens demonstrated a progressive increase in proliferative activity: 5% (2011), 15% (2020), and ultimately 40% in a pleural metastasis biopsy (2024), correlating closely with clinical progression. The patient received repeated surgical resections and adjuvant interferon alpha-2b, with palliative nab-paclitaxel attempted during the terminal stage but proving ineffective. The patient died in August 2025, approximately 14 years after initial diagnosis. CONCLUSIONS This case highlights the importance of the Ki-67 index as a dynamic biomarker for monitoring tumor evolution and guiding treatment decisions in recurrent HEHE. Regular long-term follow-up and a multidisciplinary approach are crucial for managing this unpredictable neoplasm, given its potential for late recurrence and metastasis.
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3. Atypical Foster Kennedy Syndrome With Orbital Apex Involvement Secondary to Intracranial Meningiomatosis: A Case Report.
PMID:日期:2026-09-24BACKGROUND Foster Kennedy syndrome is a rare neuro-ophthalmologic entity classically associated with anterior cranial fossa tumors, particularly meningiomas. Its slow evolution often leads to insidious, initially asymptomatic visual loss, resulting in delayed diagnosis. We describe an atypical presentation with unusual clinical features and a complex pathophysiological mechanism. CASE REPORT A 43-year-old man presented with left conjunctival chemosis as the initial clinical manifestation. His history was notable for long-standing endocrine abnormalities without prior specialized evaluation. Ophthalmologic examination additionally revealed bilateral proptosis, left complete ophthalmoplegia with ipsilateral optic atrophy, and contralateral optic disc edema. Neuroimaging demonstrated intracranial meningiomatosis; all of these findings were consistent with type 1 Foster Kennedy syndrome. The chemosis was attributed to meningioma extension into the left cavernous sinus and orbital apex, resulting in orbital apex syndrome. Contralateral papilledema reflected intracranial hypertension due to impaired dural venous outflow via superior sagittal sinus obstruction. A conservative approach was used, including corticosteroids to reduce mass effect and acetazolamide to decrease intracranial pressure, aiming to preserve optic nerve function. The clinical evolution was favorable. CONCLUSIONS This case illustrates an atypical form of Foster Kennedy syndrome with distinctive etiopathogenic and pathophysiological features. Hormonal disturbances may have contributed to meningiomatosis development and growth, while orbital apex involvement suggests a complex mechanism beyond isolated optic nerve compression. Conservative management remains appropriate first-line therapy in multifocal disease with intracranial hypertension, with the goal of preserving visual function.
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4. Giant Well-Differentiated Liposarcoma of the Spermatic Cord Associated With Inguinal Hernia: Clinical Insights From a Case Report.
PMID:日期:2026-09-24BACKGROUND Spermatic cord liposarcoma is a rare adipocytic malignancy, with fewer than 200 cases described worldwide. Due to its rarity and nonspecific clinical presentation, it is frequently misdiagnosed as more common inguinoscrotal conditions such as hernia or hydrocele. Histologically, liposarcomas comprise several subtypes with varying prognoses. Accurate diagnosis is often challenging preoperatively and typically relies on imaging and definitive histopathological evaluation. CASE REPORT We present the case of an 87-year-old man with a progressively enlarging, painless mass in the left inguinoscrotal region, significantly impairing mobility. Computed tomography revealed a large, well-circumscribed mass originating from the spermatic cord, with both cystic and fatty components, along with a concurrent inguinal hernia and hydrocele. No metastatic spread was identified. The patient underwent complete surgical excision of the tumor with simultaneous orchiectomy and inguinal herniotomy. Histopathological analysis confirmed a well-differentiated liposarcoma (G1) with negative surgical margins (R0 resection). Given the patient's advanced age and comorbidities, no adjuvant therapy was indicated. The postoperative course was uneventful. CONCLUSIONS Spermatic cord liposarcoma remains a diagnostic and therapeutic challenge due to its rarity and clinical resemblance to benign conditions. Radical surgical excision with negative margins is the cornerstone of treatment and offers favorable outcomes, particularly in well-differentiated, low-grade tumors. However, the high rate of local recurrence necessitates long-term follow-up. The role of adjuvant therapies such as radiotherapy or chemotherapy remains unclear and should be individualized based on tumor characteristics. Increased awareness and reporting of such cases are essential to improve diagnostic accuracy and optimize management strategies.
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5. Refractory Chylous Ascites After Robot-Assisted Radical Prostatectomy With Sequential Anatomically Distinct Lymphatic Leak Sites Identified by Repeat Lymphangiography.
PMID:日期:2026-09-23BACKGROUND Chylous ascites is a rare, potentially life-threatening complication of pelvic surgery, characterized by progressive malnutrition, immune dysfunction, and massive fluid accumulation. When the condition is refractory, its management represents a complex challenge requiring sequential escalation across multiple therapeutic modalities. CASE REPORT A 72-year-old man developed refractory chylous ascites after robot-assisted radical prostatectomy with extended pelvic lymph node dissection for high-grade prostate cancer (Gleason score 5+4=9). Despite conservative measures, consisting of low-fat diet and continuous subcutaneous octreotide infusion, the ascites persisted. Repeated large-volume paracentesis with cell-free concentrated ascites reinfusion therapy (CART) and total parenteral nutrition (TPN) were required to manage worsening malnutrition. Lymphangiography and N-butyl cyanoacrylate (NBCA) embolization provided no sustained relief. Subsequent surgical lymphatic ligation identified active leakage alongside floating solidified NBCA in the internal iliac region, confirming the prior embolization site. Although the leak was temporarily controlled by ligation, chylous drainage recurred on postoperative day 2. Repeat lymphangiography revealed a new, anatomically distinct leak in the external iliac region, suggesting dynamic redistribution of lymphatic flow through a collateral pathway. Repeat NBCA embolization of this secondary site achieved definitive resolution. Supported by TPN and CART, the patient was discharged on postoperative day 117 with improved nutritional status. He had no recurrence over a 5-year follow-up, with clinical and laboratory assessment every 3 months. CONCLUSIONS This case suggests that lymphatic leak sites may shift during treatment. Repeat lymphangiography may be considered when chylous drainage recurs after apparently successful intervention. Multidisciplinary management, including TPN and CART, was integral to sustaining this patient through a prolonged and complex treatment course.
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6. Epidermoid Cyst of the Ureter Mimicking Recurrent Urothelial Carcinoma: A Case Report and Brief Literature Review.
PMID:日期:2026-09-23BACKGROUND Epidermoid cysts are benign, slow-growing lesions lined by keratinizing stratified squamous epithelium. Although they are among the most common cutaneous cysts, their occurrence within the urinary tract is exceptionally rare. In patients under oncologic surveillance, a new ureteral filling defect presents a significant diagnostic challenge, as benign lesions may closely mimic tumor recurrence and potentially lead to overtreatment or radical surgery. CASE REPORT We report the case of a 79-year-old man with a history of high-grade papillary urothelial carcinoma treated with transurethral resection of bladder tumor (TURBT), intravesical Bacillus Calmette-Guerin (BCG), chemotherapy, and immunotherapy. He remained in remission until a CT scan in 2026 showed a proximal right ureteral filling defect suspicious for recurrence. Given the high-risk oncologic context, malignancy was strongly suspected. Flexible ureteroscopy with complete endoscopic excision was performed. Histopathology demonstrated a keratinizing squamous-lined cyst with laminated keratin and no atypia. Immunohistochemistry confirmed a benign epidermoid cyst of urothelial origin, with no evidence of malignancy. CONCLUSIONS Ureteral epidermoid cysts are exceedingly rare benign lesions that can closely mimic urothelial carcinoma on imaging, particularly in patients with prior malignancy. This case highlights that imaging findings alone are insufficient for diagnosis in this context, and that definitive histopathological and immunohistochemical evaluation is essential. Accurate tissue diagnosis enabled minimally invasive management and avoided unnecessary radical surgical intervention. This diagnostic dilemma underscores the importance of considering benign etiologies in ureteral filling defects during oncologic surveillance.
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7. Dual-Site Postsurgical Pyoderma Gangrenosum of the Breast and Back With Delayed Diagnosis: A Case Report.
PMID:日期:2026-09-22BACKGROUND Postsurgical pyoderma gangrenosum is a rare neutrophilic dermatosis that can mimic infection, wound dehiscence, malignancy, foreign-body reaction, or impaired surgical healing. Diagnostic delay is common and may lead to repeated debridement, which can worsen ulceration through pathergy. This case highlights the diagnostic challenge of multifocal postsurgical pyoderma gangrenosum involving anatomically distinct sites after procedures initially performed for presumed benign lesions. CASE REPORT A 70-year-old woman with celiac disease and prior left breast cancer treated with lumpectomy, chemotherapy, radiation, and implant reconstruction developed nonhealing ulcers of the left superior breast and left lower back after surgical treatment of benign lesions. Initial evaluation favored retained cyst lining, foreign-body reaction, infection, impaired wound healing, and possible implant-related complications. Despite advanced wound therapies, antimicrobials, and biologic wound products, both lesions progressively enlarged. Biopsies demonstrated abscess formation, multinucleated giant cells, and sinus tract formation without malignancy. Wound cultures and pulmonary findings complicated the diagnostic course, but neither targeted antimicrobial nor prolonged antifungal therapy produced sustained improvement. The diagnosis was clinically supported by worsening after procedural intervention, exclusion of malignancy and persistent infection, multifocal involvement, and rapid response after initiation of topical and intralesional corticosteroid therapy. CONCLUSIONS This case supports considering postsurgical pyoderma gangrenosum in refractory postsurgical wounds that worsen despite local wound-directed interventions, particularly when lesions involve multiple anatomically distinct surgical sites. The complete resolution of both lesions after topical and intralesional corticosteroid therapy further supports the importance of recognizing an inflammatory, pathergy-driven process once infection, malignancy, and other local causes have been reasonably excluded. Earlier recognition may help avoid repeated procedural trauma, unnecessary treatment escalation, and prolonged morbidity.
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8. Ulcerative Bullosis Diabeticorum in a Man With Chronic, Uncontrolled Diabetes, Uncontrolled Erectile Dysfunction, and Significant Social Barriers to Care.
PMID:日期:2026-09-22BACKGROUND Bullosis diabeticorum (BD) is a dermatologic, often acral, complication of diabetes, with a reported prevalence of approximately 0.16% to 0.5% among diabetic individuals in the United States. This case reports a man whose presentation was atypical in location and severity, progressing to ulceration. CASE REPORT A 41-year-old man with a history of poorly controlled type 2 diabetes mellitus (T2DM) complicated by stage II chronic kidney disease and chronic erectile dysfunction presented for ongoing management. His HbA1c values ranged from >14% to 7.8%, often influenced by social determinants. Two months later, he presented with blisters with a non-erythematous base (no surrounding erythema) that were non-painful, non-itchy, non-pruritic, and easily ruptured, forming scabs. The largest wound measured 7.2×3.6×0.1 cm, containing yellow slough, consistent with ulcerative BD. Labs showed elevated albumin-to-creatinine ratio and decreased estimated glomerular filtration rate, a measure of kidney function. Diabetes management included metformin and basal insulin titration, while erectile dysfunction treatment included phosphodiesterase-5 inhibitors. With no signs of infection, wound cultures were not obtained and antibiotic therapy was not initiated. Testing excluded neuropathy and venous-related ulcerations. However, as no biopsy or direct immunofluorescence testing was performed, the diagnosis was clinical, and based on a history of uncontrolled diabetes. Wound care transitioned the patient to twice daily quarter-strength Dakin's solution moist-to-dry dressings after initial non-adherence. One month later, the patient's wounds and fasting glucose showed improvement. CONCLUSIONS This case highlights the risks of uncontrolled T2DM with complications, particularly when compounded by social determinants.
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9. EVT-Inspired Simplified Negative-Pressure Nasoesophageal Drainage for Cervical Abscess Secondary to Esophageal Perforation.
PMID:日期:2026-09-21BACKGROUND Esophageal foreign body perforation is a critical emergency needing prompt diagnosis and intervention. The innovative esophageal vacuum therapy (EVT) has been proven effective in the treatment of esophageal perforations and fistulas. However, its high cost and technical complexity limit its widespread use in primary care facilities. CASE REPORT A 52-year-old man presented after 4 days of odynophagia and 1 day of fever following accidental fish bone ingestion. Computed tomography (CT) demonstrated cervical esophageal perforation with soft-tissue emphysema. Endoscopy revealed a 5-mm penetrating ulcer on the left esophageal wall, 20 cm from the incisors, with purulent discharge. The patient initially declined nasogastric decompression and was treated conservatively with nil per os, intravenous antibiotics, proton pump inhibitors, and parenteral nutrition. After 48 hours, clinical deterioration occurred with worsening pain. The patient then consented to EVT-inspired simplified negative-pressure nasoesophageal drainage: a 16-Fr nasogastric tube with 3 side holes was blindly inserted to the mid-esophagus and connected to a disposable negative pressure drainage ball. A second CT performed the same day confirmed abscess expansion (43×20×48 mm) and tube positioning. Daily drainage decreased and symptoms improved. Eight days later, CT confirmed abscess resolution. Endoscopy revealed perforation epithelialization, and a residual ulcer was closed with 1 clip. The patient resumed oral intake and was discharged on day 18. CONCLUSIONS In this case, EVT-inspired simplified negative-pressure nasoesophageal drainage demonstrated effectiveness in controlling local infection and avoiding surgery for cervical esophageal perforation with a contained abscess. This easily reproducible technique may serve as a temporary bridging therapy when standard EVT or surgery is unavailable.
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10. Simultaneous Thyroid Eye Disease and IgG4-Related Orbital Disease in a Patient With Diabetes Mellitus: A Case Report.
PMID:日期:2026-09-21BACKGROUND Thyroid eye disease (TED) and IgG4-related orbital disease are distinct inflammatory conditions that rarely occur simultaneously. Their coexistence can pose diagnostic and therapeutic challenges, particularly in patients with systemic comorbidities. This report describes a rare case of concurrent TED and IgG4-related orbital disease in a patient with diabetes mellitus and details the surgical approach and postoperative results. CASE REPORT A 72-year-old man with a history of TED and diabetes had been experiencing progressive proptosis and orbital swelling for approximately 17 years. Despite consulting several doctors, he was refused surgery due to the associated high risks. He had facial changes, exophthalmos, and dry eyes, which led him to visit our clinic. Clinical evaluation and orbital imaging revealed changes consistent with TED, along with a localized orbital tumor extending into the deep orbital region. To alleviate the proptosis, we first performed an orbital tumor resection, along with orbital fat and bone decompression surgery. Five months later, we conducted an additional surgical resection of the residual right superior orbital tumor. Histopathological examination and immunohistochemical staining of the resected tissue, together with serological findings, confirmed the diagnosis of IgG4-related orbital disease. CONCLUSIONS This case highlights the importance of considering multiple etiologies in patients with atypical or long-standing TED. While orbital decompression is commonly performed for TED-associated proptosis, the presence of a localized IgG4-related orbital lesion can require surgical excision. This report suggests that combined surgical management can be considered in selected cases.