Journal Description
Reports
Reports
is an international, peer-reviewed, open access journal about the medical cases, images, and videos in human medicine, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), FSTA, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 18.6 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
0.8 (2023)
Latest Articles
Sandifer Syndrome Case Report: An Unusual Presentation with Paroxysmal Torticollis
Reports 2025, 8(1), 29; https://doi.org/10.3390/reports8010029 - 10 Mar 2025
Abstract
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Background and Clinical Significance: Sandifer syndrome is an uncommon manifestation of gastroesophageal reflux disease, characterized by paroxysmal episodes of abnormal posturing, particularly involving the neck and upper body, often associated with underlying esophageal discomfort. Case Presentation: In this report, we present
[...] Read more.
Background and Clinical Significance: Sandifer syndrome is an uncommon manifestation of gastroesophageal reflux disease, characterized by paroxysmal episodes of abnormal posturing, particularly involving the neck and upper body, often associated with underlying esophageal discomfort. Case Presentation: In this report, we present a 16-month-old infant who exhibited multiple daily paroxysmal episodes of atypical head posturing, primarily tilted to the right, each lasting less than 10 s, with spontaneous resolution. Notably, these episodes lacked other neurological or systemic symptoms, and the clinical presentation differed from classical descriptions of Sandifer syndrome, which often include more prolonged dystonic posturing or correlation with feeding. The diagnosis was supported by the resolution of symptoms following the administration of a proton pump inhibitor, highlighting the importance of recognizing this condition in infants with unexplained posturing behaviors. Conclusions: This case emphasizes the variability in clinical manifestations of Sandifer syndrome and underscores the need for a high index of suspicion, as timely management of gastroesophageal reflux disease can lead to complete symptom resolution and prevent unnecessary neurological investigations.
Full article
Open AccessCase Report
A Case Report: The Utility of Multimodality Imaging in the Diagnosis of Cardiac Sarcoidosis–Has It Surpassed the Need for a Biopsy?
by
Ali Malik, Paul Ippolito, Sukruth Pradeep Kundur and Sanjay Sivalokanathan
Reports 2025, 8(1), 28; https://doi.org/10.3390/reports8010028 - 6 Mar 2025
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Background and Clinical Significance: Cardiac sarcoidosis (CS) is a rare but life-threatening disorder, occurring in 2–5% of sarcoidosis cases, though post-mortem studies suggest a higher prevalence. It presents diagnostic challenges due to nonspecific symptoms and the low sensitivity of an endomyocardial biopsy. Recent
[...] Read more.
Background and Clinical Significance: Cardiac sarcoidosis (CS) is a rare but life-threatening disorder, occurring in 2–5% of sarcoidosis cases, though post-mortem studies suggest a higher prevalence. It presents diagnostic challenges due to nonspecific symptoms and the low sensitivity of an endomyocardial biopsy. Recent guidelines emphasize multimodal imaging, such as cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET). Given the risk of heart failure (HF) and arrhythmias, early detection is critical. This case highlights the role of non-invasive imaging in diagnosing CS and guiding treatment. Case Presentation: A 54-year-old female with asthma, hyperlipidemia, a recent diagnosis of anterior uveitis, and familial sarcoidosis presented with dyspnea, chest tightness, and worsening cough. Examination revealed anterior uveitis, erythema nodosum, jugular venous distension, and pedal edema. The electrocardiogram (ECG) demonstrated bifascicular block and premature ventricular contractions (PVCs). The brain natriuretic peptide (BNP) was 975 pg/mL, with the transthoracic echocardiogram revealing a left ventricular ejection fraction of 25–30% with global LV akinesis. Coronary computed tomography angiography (CCTA) excluded coronary artery disease. Cardiac MRI showed late gadolinium enhancement, with PET demonstrating active myocardial inflammation, supporting a >90% probability of CS. Given her clinical trajectory and risk of further decompensation, immunosuppressive therapy was initiated without pursuing a biopsy. A dual-chamber implantable cardioverter defibrillator (ICD) was placed due to risk of ventricular arrhythmias. Bronchoalveolar lavage (BAL) showed a CD4/CD8 ratio of 6.53, reinforcing the diagnosis. She responded well to treatment, with symptom improvement and repeat imaging demonstrating signs of disease remission. Conclusions: This case underscores the growing role of multimodal imaging in CS diagnosis, potentially replacing biopsy in select cases. Early imaging-based diagnosis enabled timely immunosuppression and ICD placement, improving outcomes.
Full article

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<p>Eye examination demonstrating anterior uveitis.</p> Full article ">Figure 2
<p>Electrocardiogram demonstrating right bundle branch block, left anterior fascicular block, with frequent premature ventricular contractions and a prolonged QT.</p> Full article ">Figure 3
<p>Chest X-ray demonstrating cardiomegaly and pulmonary congestion.</p> Full article ">Figure 4
<p>Cardiac MRI with multifocal LGE (arrows) consistent with an inflammatory cardiomyopathy.</p> Full article ">Figure 5
<p>PET demonstrating multi-focal FDG uptake (arrows) with associated matched perfusion abnormalities in the basal and mid-inferior and inferoseptal segments, basal anterior, basal to mid-anterolateral segments, and apical lateral and inferior segments.</p> Full article ">Figure 6
<p>FDG PET-CT showing myocardial FDG uptake (arrows).</p> Full article ">Figure 7
<p>Flowchart highlighting our stepwise approach to diagnosing CS in this case.</p> Full article ">
<p>Eye examination demonstrating anterior uveitis.</p> Full article ">Figure 2
<p>Electrocardiogram demonstrating right bundle branch block, left anterior fascicular block, with frequent premature ventricular contractions and a prolonged QT.</p> Full article ">Figure 3
<p>Chest X-ray demonstrating cardiomegaly and pulmonary congestion.</p> Full article ">Figure 4
<p>Cardiac MRI with multifocal LGE (arrows) consistent with an inflammatory cardiomyopathy.</p> Full article ">Figure 5
<p>PET demonstrating multi-focal FDG uptake (arrows) with associated matched perfusion abnormalities in the basal and mid-inferior and inferoseptal segments, basal anterior, basal to mid-anterolateral segments, and apical lateral and inferior segments.</p> Full article ">Figure 6
<p>FDG PET-CT showing myocardial FDG uptake (arrows).</p> Full article ">Figure 7
<p>Flowchart highlighting our stepwise approach to diagnosing CS in this case.</p> Full article ">
Open AccessCase Report
Long-Term Follow-Up of a Patient with Ankylosis of a Primary Incisor Caused by Trauma: A Case Report
by
Tatsuya Akitomo, Shuma Hamaguchi, Chieko Mitsuhata and Ryota Nomura
Reports 2025, 8(1), 27; https://doi.org/10.3390/reports8010027 - 26 Feb 2025
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Introduction and Clinical Significance: Tooth ankylosis is a serious complication that can occur because of the replantation of an avulsed tooth. However, few reports have investigated the follow-up of replanted or ankylosed primary incisors because the replantation of primary teeth is not recommended
[...] Read more.
Introduction and Clinical Significance: Tooth ankylosis is a serious complication that can occur because of the replantation of an avulsed tooth. However, few reports have investigated the follow-up of replanted or ankylosed primary incisors because the replantation of primary teeth is not recommended in the guidelines of the International Association of Dental Traumatology. Case Presentation: A boy aged 4 years and 8 months was referred to hospital for further evaluation of the maxillary right primary central incisor. It had been avulsed and replanted 2 years earlier. The tooth was positioned higher than the central incisor on the left side, and a metallic percussion sound was noted, leading to a diagnosis of tooth ankylosis. Long-term follow-up revealed the progression of ankylosis, and the tooth was finally extracted. At the age of 7 years and 6 months, permanent tooth eruption was detected, and no pathological finding was observed. Conclusions: In this case, root resorption of the replanted primary incisor was observed with age, but tooth ankylosis progressed, and natural exfoliation was difficult. The authors extracted the primary incisor appropriately, which aided the eruption of a successor permanent tooth. This report suggests the importance of patients visiting the dentist regularly after trauma to primary teeth and appropriate treatment by dentists to erupt the permanent teeth.
Full article

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<p>Initial examination at the age of 4 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 2
<p>Images at the age of 5 years and 2 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 3
<p>Images at the age of 5 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 4
<p>Images at the age of 6 years and 2 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 5
<p>Images at the age of 6 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 6
<p>(<b>A</b>) Photograph of the maxillary right primary incisor at the age of 6 years and 11 months and (<b>B</b>) intraoral photograph at the age of 8 years and 2 months.</p> Full article ">
<p>Initial examination at the age of 4 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 2
<p>Images at the age of 5 years and 2 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 3
<p>Images at the age of 5 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 4
<p>Images at the age of 6 years and 2 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 5
<p>Images at the age of 6 years and 8 months: (<b>A</b>) intraoral photographs and (<b>B</b>) periapical radiograph.</p> Full article ">Figure 6
<p>(<b>A</b>) Photograph of the maxillary right primary incisor at the age of 6 years and 11 months and (<b>B</b>) intraoral photograph at the age of 8 years and 2 months.</p> Full article ">
Open AccessCase Report
Systemic Signs of an Unexpected Guest in a Case of Apparent Upper Gastrointestinal Bleeding Leading to an Endoscopic Extraction of a Foreign Body: A Case Report
by
Rareș Crăciun and Cristian Tefas
Reports 2025, 8(1), 26; https://doi.org/10.3390/reports8010026 - 19 Feb 2025
Abstract
Background and Clinical Significance: Upper gastrointestinal (GI) bleeding is a common emergency, typically requiring prompt intervention. This case report presents a unique situation where apparent GI bleeding was ultimately identified as anaphylaxis triggered by accidental wasp ingestion. Such cases are rare, underscoring the
[...] Read more.
Background and Clinical Significance: Upper gastrointestinal (GI) bleeding is a common emergency, typically requiring prompt intervention. This case report presents a unique situation where apparent GI bleeding was ultimately identified as anaphylaxis triggered by accidental wasp ingestion. Such cases are rare, underscoring the need for a broad differential diagnosis in atypical presentations. Case Presentation: A 53-year-old male with a history of heavy alcohol use presented with presumed acute hematemesis, hypotension, and tachycardia. An initial examination revealed mild anemia and elevated liver enzymes. An urgent upper GI endoscopy showed severe esophagitis with no signs of active or stigmata of recent bleeding; instead, two dead wasps were found in the gastric antrum. Further inquiry revealed that the patient had recently consumed a home-brewed alcoholic beverage, likely contaminated with the wasps. The patient’s symptoms were then attributed to anaphylaxis from venom exposure rather than hemorrhagic shock. The patient’s condition improved with antihistaminic therapy, and he was discharged with follow-up recommendations. Conclusions: This case highlights the importance of considering rare but critical diagnoses, such as insect-induced anaphylaxis, in patients presenting with presumed GI bleeding. It reinforces the value of thorough history taking, prompt endoscopy, and systematic management in assessing and treating atypical emergency presentations.
Full article
(This article belongs to the Section Gastroenterology)
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<p>The endoscopic view of the gastric antrum, revealing the wasps, highlighted with a black arrow.</p> Full article ">Figure 2
<p>The endoscopic retrieval net is designed as a disposable snare with a tear-proof perforated extraction bag with a snare opening of 20–30 mm.</p> Full article ">Figure 3
<p>The wasp retrieved using the endoscopic retrieval net.</p> Full article ">
<p>The endoscopic view of the gastric antrum, revealing the wasps, highlighted with a black arrow.</p> Full article ">Figure 2
<p>The endoscopic retrieval net is designed as a disposable snare with a tear-proof perforated extraction bag with a snare opening of 20–30 mm.</p> Full article ">Figure 3
<p>The wasp retrieved using the endoscopic retrieval net.</p> Full article ">
Open AccessCase Report
Multidisciplinary Management of Acute Esophageal Necrosis Secondary to Alcoholic Lactic Acidosis: A Case Report
by
Luigi Orsini, Alberto Martino, Ornella Picascia, Marco Di Serafino and Giovanni Lombardi
Reports 2025, 8(1), 25; https://doi.org/10.3390/reports8010025 - 19 Feb 2025
Abstract
Background and Clinical Significance: Acute esophageal necrosis (AEN), or black esophagus, is an extraordinary rare source of acute upper gastrointestinal bleeding. Its pathogenesis is still poorly understood, whereas etiology seems to be multifactorial, mainly involving esophageal ischemia, increased acid reflux, and reduced
[...] Read more.
Background and Clinical Significance: Acute esophageal necrosis (AEN), or black esophagus, is an extraordinary rare source of acute upper gastrointestinal bleeding. Its pathogenesis is still poorly understood, whereas etiology seems to be multifactorial, mainly involving esophageal ischemia, increased acid reflux, and reduced mucosal defenses. Although alcohol abuse has been reported to be a common trigger factor, only one case of AEN due to severe alcoholic lactic acidosis has been described up to date. Case Presentation: Herein, we describe a case of a non-cirrhotic 61-year-old lady with a history of chronic alcohol abuse, who was admitted to the Emergency Room due to upper gastrointestinal (GI) bleeding. AEN caused by severe alcoholic lactic acidosis was promptly diagnosed by subsequent investigations, including blood test, urinalysis, computed tomography, and upper GI endoscopy. The treatment involved a multidisciplinary, aggressive medical approach, which included one hemodialysis session. Conclusions: This is the second documented case of AEN secondary to alcoholic lactic acidosis, successfully treated with a previously unreported aggressive multidisciplinary approach, involving one hemodialysis session. It highlights the value of a multidisciplinary approach in managing such complex and rare conditions.
Full article
(This article belongs to the Section Gastroenterology)
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<p>Emergent computed tomography angiography. Axial arterial (<b>A</b>) CT scan at the level of the gastro-esophageal junction and venous (<b>B</b>) CT scan at the level of lower thoracic esophagus showing circumferential thickening of the esophageal wall. Note the mucosal enhancement ((<b>A</b>); yellow arrow) with wall hypoattenuation, producing the target sign ((<b>B</b>); yellow arrow). Coronal venous CT reconstruction showing extension of esophagitis predominantly to the distal third of the esophagus, including the gastro-esophageal junction ((<b>C</b>); yellow arrows). Nasogastric tube ((<b>A</b>–<b>C</b>); yellow arrowhead).</p> Full article ">Figure 2
<p>Urgent esophagogastroduodenoscopy showing diffusely black-colored mucosa at the level of the middle and the distal esophagus, abruptly ending at the gastro-esophageal junction.</p> Full article ">Figure 3
<p>Follow-up esophagogastroduodenoscopy showing a nearly complete resolution of the esophageal necrosis, with mild hyperemia and congestion at the level of the middle and the distal esophagus.</p> Full article ">
<p>Emergent computed tomography angiography. Axial arterial (<b>A</b>) CT scan at the level of the gastro-esophageal junction and venous (<b>B</b>) CT scan at the level of lower thoracic esophagus showing circumferential thickening of the esophageal wall. Note the mucosal enhancement ((<b>A</b>); yellow arrow) with wall hypoattenuation, producing the target sign ((<b>B</b>); yellow arrow). Coronal venous CT reconstruction showing extension of esophagitis predominantly to the distal third of the esophagus, including the gastro-esophageal junction ((<b>C</b>); yellow arrows). Nasogastric tube ((<b>A</b>–<b>C</b>); yellow arrowhead).</p> Full article ">Figure 2
<p>Urgent esophagogastroduodenoscopy showing diffusely black-colored mucosa at the level of the middle and the distal esophagus, abruptly ending at the gastro-esophageal junction.</p> Full article ">Figure 3
<p>Follow-up esophagogastroduodenoscopy showing a nearly complete resolution of the esophageal necrosis, with mild hyperemia and congestion at the level of the middle and the distal esophagus.</p> Full article ">
Open AccessCase Report
Frontal Variant Alzheimer’s Disease or Primary Psychiatric Disorder? A Case Report
by
Siew Fai Liew and Weishan Li
Reports 2025, 8(1), 24; https://doi.org/10.3390/reports8010024 - 18 Feb 2025
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Background and Clinical Significance: In our case study, the patient experienced approximately a year-long delay in her diagnosis, where her initial diagnosis was mistakenly a primary psychiatric disorder, resulting in undue stress on her family. The aim of this case study is
[...] Read more.
Background and Clinical Significance: In our case study, the patient experienced approximately a year-long delay in her diagnosis, where her initial diagnosis was mistakenly a primary psychiatric disorder, resulting in undue stress on her family. The aim of this case study is to raise awareness of frontal variant Alzheimer’s dementia (fvAD) and to increase knowledge amongst clinicians about this disorder, its management and the need for long-term follow up in specialized clinics. Case Presentation: In January 2023, a 56-year-old woman first presented with a 4-month history of worsening cognitive symptoms with considerable overlapping mood symptoms. Her Mini-Mental State Examination (MMSE) score was 20/28, whereas her Frontal Assessment Battery (FAB) score was 6/18. Upon neuropsychological evaluation, she demonstrated multidomain cognitive deficits, where impairments were most prominent in executive dysfunction, learning, memory and semantic fluency. There was evidence of progressive neurodegenerative changes, with brain MRI (April 2024) showing predominant bilateral frontal and parietal volume loss, sparing the occipital and temporal lobes. Amyloid positron emission tomography (PET) was diffusely positive. A diagnosis of fvAD (frontal variant Alzheimer’s dementia) with BPSD was made. Other differential diagnoses included a major neurocognitive disorder due to multiple etiologies (AD and dementia with Lewy bodies (DLB)), frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and the psychiatric disorder of pseudodementia secondary to a mood disorder. Conclusions: This case presented significant challenges given the atypical neuropsychological profile and the complexity of the symptom presentation with significant neuropsychiatric overlay. The preliminary research findings underscore the complexity of fvAD, warranting future research using fundamental approaches.
Full article

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<p>The EEG showed intermittent slow, regional, independent results in the left and right temporal regions, as well as intermittent, generalized, slow, results which suggests bilateral temporal cortical electrophysiological dysfunction and mild diffuse encephalopathy, respectively. The overall EEG features were non-specific in nature.</p> Full article ">Figure 2
<p>(<b>a</b>–<b>c</b>): MRI FLAIR sequence (from left to right): (<b>a</b>) significant symmetrical gyral thinning in frontal and parietal lobes; (<b>b</b>) significant symmetrical gyral thinning in frontal lobes, mostly sparing the occipital lobes; (<b>c</b>) reasonably preserved hippocampal volumes bilaterally.</p> Full article ">Figure 3
<p>Amyloid PET scan. (<b>a</b>) Radiotracer uptake detected in bilateral frontal and parietal lobes; (<b>b</b>) radiotracer uptake detected in bilateral temporal lobes.</p> Full article ">Figure 4
<p>Timeline of presentation.</p> Full article ">
<p>The EEG showed intermittent slow, regional, independent results in the left and right temporal regions, as well as intermittent, generalized, slow, results which suggests bilateral temporal cortical electrophysiological dysfunction and mild diffuse encephalopathy, respectively. The overall EEG features were non-specific in nature.</p> Full article ">Figure 2
<p>(<b>a</b>–<b>c</b>): MRI FLAIR sequence (from left to right): (<b>a</b>) significant symmetrical gyral thinning in frontal and parietal lobes; (<b>b</b>) significant symmetrical gyral thinning in frontal lobes, mostly sparing the occipital lobes; (<b>c</b>) reasonably preserved hippocampal volumes bilaterally.</p> Full article ">Figure 3
<p>Amyloid PET scan. (<b>a</b>) Radiotracer uptake detected in bilateral frontal and parietal lobes; (<b>b</b>) radiotracer uptake detected in bilateral temporal lobes.</p> Full article ">Figure 4
<p>Timeline of presentation.</p> Full article ">
Open AccessCase Report
A Case Report of Median Nerve Entrapment in a Supracondylar Humeral Fracture: Diagnosis, Treatment, and Results After 5 Years of Follow-Up
by
Carlo Colonna, Joil Ramazzotti, Francesco Locatelli, Alessandro Crosio and Pierluigi Tos
Reports 2025, 8(1), 23; https://doi.org/10.3390/reports8010023 - 18 Feb 2025
Abstract
Background and Clinical Significance: Neurological complications in extension-type-III supracondylar humeral fractures (SCHFs) in children represent 11% of cases. An extension-type-III SCHF with posterolateral displacement of the distal fragment is commonly associated with damage to the median nerve and the anterior interosseous nerve
[...] Read more.
Background and Clinical Significance: Neurological complications in extension-type-III supracondylar humeral fractures (SCHFs) in children represent 11% of cases. An extension-type-III SCHF with posterolateral displacement of the distal fragment is commonly associated with damage to the median nerve and the anterior interosseous nerve (AIN). Neurological complications are often unnoticed, and their immediate postoperative diagnosis is difficult, particularly in young children. Neurapraxia, the most common complication, usually undergoes spontaneous nerve recovery. Case Presentation: We report a case of a 7-year-old patient with postoperative median nerve palsy after an SCHF (Gartland type III) who was referred to our unit from another hospital due to a lack of spontaneous recovery. In addition, motor and sensory functions were absent. As ultrasound (US) indicated nerve kinking at the fracture site, an exploration was performed. The nerve was trapped within the fracture and the callus. It was surgically extracted, and intraoperative examination with US indicated that resecting the kinked nerve, freeing the two stumps, and attempting a primary end-to-end suture represented the best course of action. We present this case with a 5-year follow-up surgery, which showed a good clinical outcome. Conclusions: This case is noteworthy because of its diagnostic and therapeutic pathways, and it is complemented by surgical and ultrasound images that can assist other surgeons in similar circumstances.
Full article
(This article belongs to the Section Orthopaedics/Rehabilitation/Physical Therapy)
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<p>Pre-operative X-rays (<b>a</b>,<b>b</b>); postoperative X-rays (<b>c</b>,<b>d</b>).</p> Full article ">Figure 2
<p>(<b>a</b>) Median nerve incarcerated in the fracture site; (<b>b</b>) extension of the median nerve glioma; and (<b>c</b>) end-to-end suture and epiperineural suture with 9–0. Furthermore, a stitch of 7–0 in the epineural part of the nerve was proximally and distally placed 2 cm from the suture site to discharge the tension at the suture site. Intraoperative US: (<b>d</b>) nerve sufferance with peripheral edema (the maximum caliber was 24 mm) and (<b>e</b>) a sudden reduction in nerve caliber and interruption of its course at the volar margin of the humeral fracture.</p> Full article ">Figure 3
<p>A five-year follow-up showing complete sensory–motor recovery of the right hand.</p> Full article ">
<p>Pre-operative X-rays (<b>a</b>,<b>b</b>); postoperative X-rays (<b>c</b>,<b>d</b>).</p> Full article ">Figure 2
<p>(<b>a</b>) Median nerve incarcerated in the fracture site; (<b>b</b>) extension of the median nerve glioma; and (<b>c</b>) end-to-end suture and epiperineural suture with 9–0. Furthermore, a stitch of 7–0 in the epineural part of the nerve was proximally and distally placed 2 cm from the suture site to discharge the tension at the suture site. Intraoperative US: (<b>d</b>) nerve sufferance with peripheral edema (the maximum caliber was 24 mm) and (<b>e</b>) a sudden reduction in nerve caliber and interruption of its course at the volar margin of the humeral fracture.</p> Full article ">Figure 3
<p>A five-year follow-up showing complete sensory–motor recovery of the right hand.</p> Full article ">
Open AccessCase Report
Cerebrovascular Thrombosis in Pediatric Ulcerative Colitis: A Case Report
by
Naire Sansotta, Fabiana Di Stasio, Angela Amoroso and Lorenzo D’Antiga
Reports 2025, 8(1), 22; https://doi.org/10.3390/reports8010022 - 14 Feb 2025
Abstract
Background and Clinical Significance: Venous thromboembolism (VTE) is a severe extra-intestinal manifestation that can complicate the course of inflammatory bowel disease (IBD). Among pediatric patients, cerebral thrombosis (CT) is the most common form of VTE associated with IBD. Magnetic resonance imaging (MRI)
[...] Read more.
Background and Clinical Significance: Venous thromboembolism (VTE) is a severe extra-intestinal manifestation that can complicate the course of inflammatory bowel disease (IBD). Among pediatric patients, cerebral thrombosis (CT) is the most common form of VTE associated with IBD. Magnetic resonance imaging (MRI) remains the gold standard for diagnosing cerebral venous thrombosis, allowing visualization of flow absence and intraluminal thrombus. Prompt initiation of treatment with low-molecular-weight heparin (LMWH) is crucial to prevent complications. Follow-up imaging is essential to evaluate venous recanalization and guide therapy duration. However, data on cerebral thrombosis in pediatric patient with IBD remain scarce. Case Presentation: We report the case of a 12-year-old boy with a known history of ulcerative colitis who presented to the emergency room (ER) with a two-day history of headache and vomiting. One month prior to the ER visit, he experienced an IBD flare confirmed through clinical, biochemical, and endoscopic evaluation and was subsequently started on oral corticosteroids. Neurological examination was unremarkable; however, given the persistence of severe headache, a brain MRI was performed, leading to a diagnosis of cerebral venous thrombosis. Anticoagulation therapy with LMWH was initiated immediately. Follow-up imaging with contrast-enhanced MR venography four months later revealed partial resolution of the thrombosis. The patient continued long-term anticoagulation therapy for a total duration of 12 months. Conclusions: Cerebral venous thrombosis is a serious complication of IBD, particularly in pediatric patients. Clinicians should consider this diagnosis in any child with IBD presenting with persistent headache, even in the absence of focal neurological signs. Early diagnosis and prompt anticoagulation therapy are key to improving outcomes in these patients.
Full article
(This article belongs to the Section Gastroenterology)
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<p>Contrast-enhanced MR venography: the red arrow shows an extensive sinus thrombosis involving the right transverse sinus.</p> Full article ">Figure 2
<p>(<b>a</b>) Follow-up contrast-enhanced MR venography at month 4. The red arrow shows partial resolution of thrombosis in the right transverse sinus. (<b>b</b>) Follow-up contrast-enhanced MR venography at month 12 demonstrates complete resolution of the thrombosis.</p> Full article ">
<p>Contrast-enhanced MR venography: the red arrow shows an extensive sinus thrombosis involving the right transverse sinus.</p> Full article ">Figure 2
<p>(<b>a</b>) Follow-up contrast-enhanced MR venography at month 4. The red arrow shows partial resolution of thrombosis in the right transverse sinus. (<b>b</b>) Follow-up contrast-enhanced MR venography at month 12 demonstrates complete resolution of the thrombosis.</p> Full article ">
Open AccessCase Report
Case Report: Giant Colonic Lipoma, a Rare Benign Tumor Mimicking Malignancy
by
Bogdan Oprita, Ioana Adriana Serban, Valentin Enache, Alina Prodan and Ruxandra Oprita
Reports 2025, 8(1), 21; https://doi.org/10.3390/reports8010021 - 11 Feb 2025
Abstract
Background and Clinical Significance: Colonic lipomas are benign tumors composed of adipose tissue, frequently asymptomatic and found incidentally on routine surveillance. Most lesions are smaller than 2 cm in diameter, while giant lipomas are characterized as over 4 cm. Giant colonic lipomas, though
[...] Read more.
Background and Clinical Significance: Colonic lipomas are benign tumors composed of adipose tissue, frequently asymptomatic and found incidentally on routine surveillance. Most lesions are smaller than 2 cm in diameter, while giant lipomas are characterized as over 4 cm. Giant colonic lipomas, though rare, may present with obstructive symptoms, gastrointestinal bleeding or intussusception and can mimic malignant lesions on imaging and endoscopic examination. Historically, the resection of these lesions has been limited to those that are larger or symptomatic. Recent observations indicate that lipomas may retain growth potential and can become symptomatic over time, though being inconsequential initially. Surgical resection is favored over endoscopic excision for lipomas above 2 cm to mitigate risks including haemorrhages and perforations. Case Presentation: We report a case of a 38-year-old female who exhibited non-specific gastrointestinal symptoms with a high suspicion of malignancy based on imaging and endoscopy but was ultimately diagnosed with a benign giant colonic lipoma. Conclusions: This case presents the challenges in diagnosing giant colonic lipomas, which, in certain cases, can mimic malignant lesions. Histopathological analysis remains the gold standard for confirming the diagnosis, especially in cases with atypical features.
Full article
(This article belongs to the Section Oncology)
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<p>Circumferential parietal thickening noted at the hepatic flexure of the colon measuring 21/45 mm, moderately iodophilic, associated with discrete linear-type densification of locoregional fat, indicative of a desmoplastic reaction.</p> Full article ">Figure 2
<p>Intralumenal mass with an axial diameter of 29/28 mm and extended cranio-caudally over a length of 27 mm, showing polycyclic contour, discretely iodophilic peripherally.</p> Full article ">Figure 3
<p>Mass resulting in filiform axial narrowing of the lumen without associated distention of the colon.</p> Full article ">Figure 4
<p>Polypoid mass at the hepatic flexure occupying more than 75% of the luminal circumference.</p> Full article ">Figure 5
<p>Polypoid mass with central ulceration.</p> Full article ">Figure 6
<p>Right hemicolectomy revealing polypoid tumor partially ulcerated.</p> Full article ">Figure 7
<p>Macroscopic examination of the polypoid tumor measuring 4 × 3 × 3 cm.</p> Full article ">Figure 8
<p>H&E stain 50× Submucosal lipoma with ulcerated colonic mucosa.</p> Full article ">
<p>Circumferential parietal thickening noted at the hepatic flexure of the colon measuring 21/45 mm, moderately iodophilic, associated with discrete linear-type densification of locoregional fat, indicative of a desmoplastic reaction.</p> Full article ">Figure 2
<p>Intralumenal mass with an axial diameter of 29/28 mm and extended cranio-caudally over a length of 27 mm, showing polycyclic contour, discretely iodophilic peripherally.</p> Full article ">Figure 3
<p>Mass resulting in filiform axial narrowing of the lumen without associated distention of the colon.</p> Full article ">Figure 4
<p>Polypoid mass at the hepatic flexure occupying more than 75% of the luminal circumference.</p> Full article ">Figure 5
<p>Polypoid mass with central ulceration.</p> Full article ">Figure 6
<p>Right hemicolectomy revealing polypoid tumor partially ulcerated.</p> Full article ">Figure 7
<p>Macroscopic examination of the polypoid tumor measuring 4 × 3 × 3 cm.</p> Full article ">Figure 8
<p>H&E stain 50× Submucosal lipoma with ulcerated colonic mucosa.</p> Full article ">
Open AccessCase Report
Multifaceted Primary Ciliary Dyskinesia—A Case Report
by
Dinnar Yahya, Miroslava Benkova-Petrova, Aleksandar Petrov and Mari Hachmeriyan
Reports 2025, 8(1), 20; https://doi.org/10.3390/reports8010020 - 9 Feb 2025
Abstract
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Background and Clinical Significance: Ciliopathies are a heterogeneous group of diseases caused by damage to the primary cilium. Disorders of ciliary motility can lead to a wide range of clinical manifestations, including infertility, lateralization defects, lung infections, and more. Some ciliopathies associated
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Background and Clinical Significance: Ciliopathies are a heterogeneous group of diseases caused by damage to the primary cilium. Disorders of ciliary motility can lead to a wide range of clinical manifestations, including infertility, lateralization defects, lung infections, and more. Some ciliopathies associated with kidney disease include nephronophthisis, polycystic disease, and renal cell carcinoma. Since they are clinically and genetically diverse, their diagnosis may require a longer time and one or more genetic assays. Case presentation: We present the case of a 43-year-old man with a wide anamnesis, including unexplained nephrolithiasis, bronchiectasis, recurrent otitis media since infancy, appendicular lithiasis, and infertility. After a long history of various clinical examinations and consultations with diverse specialists, he was referred to genetic counseling. Whole exome sequencing (WES) revealed a homozygous pathogenic variant in the RSPH3 gene—NM_031924.8:c.205-2A>G—which was later confirmed through Sanger sequencing. It is classified as pathogenic in widely used databases and is associated with primary ciliary dyskinesia. This condition can present nontypically, and the patients might suffer from an extensive diagnostic odyssey. Being mindful of its clinical and genetic heterogeneity can shorten the period until diagnosis. Conclusions: It is essential to have this condition included in differential diagnosis and involve specialists from the medical/clinical genetic department in a multidisciplinary team. Genetic confirmation through WES or another molecular genetic method is crucial for the therapeutic approach and to adequately perform genetic counseling for patients and their families.
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Open AccessCase Report
Intraoral Lipoma on the Palate of an 11-Year-Old Patient: A Case Report
by
Vasileios Zisis, Christina Charisi, Konstantinos Poulopoulos, Petros Papadopoulos and Athanasios Poulopoulos
Reports 2025, 8(1), 19; https://doi.org/10.3390/reports8010019 - 8 Feb 2025
Abstract
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Background and Clinical Significance: Lipomas, benign tumors composed of adipose tissue, are recognized as one of the two most common fat-containing soft tissue tumors, underscoring their relative prevalence among benign tumors in children. Despite their prominence, lipomas rarely occur before 20 years
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Background and Clinical Significance: Lipomas, benign tumors composed of adipose tissue, are recognized as one of the two most common fat-containing soft tissue tumors, underscoring their relative prevalence among benign tumors in children. Despite their prominence, lipomas rarely occur before 20 years of age, highlighting a discrepancy between their commonality and the age at which they typically manifest. This case report focuses on a 11-year-old patient who noticed the presence of an intraoral mass, which prompted further investigation, ultimately leading to the diagnosis of a lipoma located on the palate. Following our diagnosis, we searched for similar cases; however, the relevant literature was rather limited. There was a case report of a 4-year-old patient who presented with a lipoma on her tongue and a case report of a 6-year-old patient who presented with a lipoma on the buccal mucosa. Case Presentation: The young patient came with his parents to the Department of Oral Medicine and Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, and reported the presence of a growth in the middle of the upper jaw. A tumor, of approximately 1 cm diameter, was observed in the middle of the palate, on the border between the hard and soft palate. The surrounding mucosa appeared normal, which is critical in differentiating the tumor from more aggressive pathological entities. It was characterized by a soft and slippery consistency. The patient was referred to a cone beam computed tomography (CBCT) examination to investigate if there was any bone involvement. Based on clinical and radiographical findings, a biopsy was carried out. The tumor was initially excised in its entirety and the base was electrocauterized to avoid placing sutures. The histopathological examination that followed suggested the presence of an intraoral lipoma since lobules of mature adipose tissue in lamina propria and fatty tissue in close proximity to mucinous salivary glands were noticed. Conclusions: The development of lipomas in young patients can be attributed to a multitude of factors that interplay with one another, emphasizing the need for a comprehensive understanding of these growths. Additionally, underlying conditions such as diabetes mellitus, hypercholesterolemia, and obesity also play a crucial role, highlighting the interconnected nature of metabolic disorders and lipoma formation. The surgical approaches for the removal of oral lipomas primarily revolve around complete surgical excision, which is considered the mainstay treatment for these benign tumors.
Full article

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<p>Clinical appearance of the palatal tumor.</p> Full article ">Figure 2
<p>CBCT examination of the area under investigation. The lesion appears to be restricted solely in soft tissues.</p> Full article ">Figure 3
<p>The tumor was initially excised by a scalpel.</p> Full article ">Figure 4
<p>Following the excision, electrocautery was applied to prevent any postsurgical bleeding and avoid the placement of sutures.</p> Full article ">Figure 5
<p>Lipoma of the palate. Lobules of mature adipose tissue in lamina propria (Hematoxylin eosin stain ×40).</p> Full article ">Figure 6
<p>Lipoma of the palate. Fatty tissue in close proximity to mucinous salivary glands (Hematoxylin-eosin ×100).</p> Full article ">Figure 7
<p>Seven days after the excisional biopsy, the healing is going as expected.</p> Full article ">
<p>Clinical appearance of the palatal tumor.</p> Full article ">Figure 2
<p>CBCT examination of the area under investigation. The lesion appears to be restricted solely in soft tissues.</p> Full article ">Figure 3
<p>The tumor was initially excised by a scalpel.</p> Full article ">Figure 4
<p>Following the excision, electrocautery was applied to prevent any postsurgical bleeding and avoid the placement of sutures.</p> Full article ">Figure 5
<p>Lipoma of the palate. Lobules of mature adipose tissue in lamina propria (Hematoxylin eosin stain ×40).</p> Full article ">Figure 6
<p>Lipoma of the palate. Fatty tissue in close proximity to mucinous salivary glands (Hematoxylin-eosin ×100).</p> Full article ">Figure 7
<p>Seven days after the excisional biopsy, the healing is going as expected.</p> Full article ">
Open AccessCase Report
A Rare and Challenging Ectopic Variceal Hemorrhage: A Case Report
by
Christopher Pavel, Oana Mihaela Plotogea, Ecaterina Mihaela Rinja, Cosmin-Viorel Bogu and Andrei Turcescu
Reports 2025, 8(1), 18; https://doi.org/10.3390/reports8010018 - 6 Feb 2025
Abstract
Background and Clinical Significance: Ectopic variceal bleeding is a rare, but regrettably life-threatening, complication of hepatic cirrhosis. There is no standardized approach to this life-threatening event due to the absence of randomized controlled trials. Prompt identification of the bleeding site is crucial for
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Background and Clinical Significance: Ectopic variceal bleeding is a rare, but regrettably life-threatening, complication of hepatic cirrhosis. There is no standardized approach to this life-threatening event due to the absence of randomized controlled trials. Prompt identification of the bleeding site is crucial for timely hemostasis using endoscopic, radiologic or surgical methods. Case presentation: Throughout this paper, we present the case of a 52-year-old patient with decompensated alcoholic cirrhosis, who was admitted for melena. Upper and lower endoscopy failed to identify the source of bleeding. Ultimately, an evaluation with endoscopic capsule identified ileal varices. The patient was referred to surgery and the outcome was successful. We approached the diagnostic and therapeutic arsenals in managing ectopic varices. Conclusions: Although ectopic variceal bleeding has a substantial potential for fatal outcomes, prompt intervention in a multidisciplinary team could be the key for patient salvation.
Full article
(This article belongs to the Section Gastroenterology)
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<p>Ileal portocaval shunts. CT angiography image showing portocaval shunt in the ileum (red arrow); no active bleeding site was detected.</p> Full article ">Figure 2
<p>Ileal variceal cords with bleeding stigmata. Capsule endoscopy findings: enteral varices with recent bleeding stigmata—red dots (white arrows, left and middle image); endoscopic capsule software trajectory locator (right image)—the segment highlighted in red indicates the position of the varices—in this case pertaining to the ileum.</p> Full article ">Figure 3
<p>Intraoperative images. Active variceal bleeding during laparotomy (<b>A</b>). Successful enterectomy followed by enterorrhaphy (<b>B</b>).</p> Full article ">
<p>Ileal portocaval shunts. CT angiography image showing portocaval shunt in the ileum (red arrow); no active bleeding site was detected.</p> Full article ">Figure 2
<p>Ileal variceal cords with bleeding stigmata. Capsule endoscopy findings: enteral varices with recent bleeding stigmata—red dots (white arrows, left and middle image); endoscopic capsule software trajectory locator (right image)—the segment highlighted in red indicates the position of the varices—in this case pertaining to the ileum.</p> Full article ">Figure 3
<p>Intraoperative images. Active variceal bleeding during laparotomy (<b>A</b>). Successful enterectomy followed by enterorrhaphy (<b>B</b>).</p> Full article ">
Open AccessCase Report
Phyllodes Tumor of the Breast: A Case Report Regarding the Importance of Fast Interdisciplinary Management
by
Horia-Dan Lișcu, Andreea-Iuliana Ionescu, Iman Mologani and Nicolae Verga
Reports 2025, 8(1), 17; https://doi.org/10.3390/reports8010017 - 2 Feb 2025
Abstract
Background and clinical significance: Phyllodes tumors (PTs) are rare stromal neoplasms originating in the connective tissue of the breast, distinct from carcinomas that arise from the ducts or lobules. These tumors exhibit a broad spectrum of morphologic features and are traditionally classified as
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Background and clinical significance: Phyllodes tumors (PTs) are rare stromal neoplasms originating in the connective tissue of the breast, distinct from carcinomas that arise from the ducts or lobules. These tumors exhibit a broad spectrum of morphologic features and are traditionally classified as benign, borderline, or malignant. Case presentation: We present the case of a 71-year-old female diagnosed with a malignant PT and treated at our hospital. The patient noticed a gradually enlarging lump in her right breast over several months. Mammography was inconclusive, but an ultrasound later revealed a lobulated, firm mass, classified as BIRADS 5. Physical examination identified a 20 cm mass, and core needle biopsy suggested a borderline PT. Following lumpectomy, pathology confirmed a malignant tumor with narrow surgical margins (0.1 cm). Although mastectomy was recommended to achieve wider margins, the patient opted for adjuvant radiotherapy. She received 50 Gy in 25 fractions to the whole breast, followed by a 16 Gy boost to the tumor bed in 8 fractions. The treatment was well tolerated and completed successfully. Initially, the patient’s therapeutic management was delayed due to a combination of personal and organizational factors. However, the process was later streamlined through the use of a novel digital tool developed to facilitate the entire patient journey within our hospital system. Conclusions: This case highlights the diagnostic complexities of PTs, the critical need for effective collaboration between specialties, and the importance of timely treatment planning for optimal patient outcomes.
Full article
(This article belongs to the Section Oncology)
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<p>Picture taken after the last radiotherapy session showing grade I radiodermatitis of the right breast. The size of the breast should also be noted in comparison to the left one, considering the lumpectomy performed, which involved the removal of a large mass (>20 cm).</p> Full article ">Figure 2
<p>(<b>A</b>) Target volume delineation showing the CTV (light blue) and PTV (red) contouring for the whole breast and boost volumes. The organs at risk are contoured in yellow; and (<b>B</b>) color wash dose distribution in the PTV, in cGy. In the upper left corner of the image is represented a “color wash” scale of the distributed dose, starting with shades of red for the maximum doses administered (around 60 Gy), descending to shades of blue for low doses (around 50 Gy).</p> Full article ">Figure 3
<p>Dose–volume histogram (DVH) for the target volumes and organs at risk (OaR), in both graphical and tabular form. Red: CTV corresponding to volumes receiving 50 Gy and 66 Gy, respectively; light blue: PTV corresponding to volumes receiving 50 Gy and 66 Gy, respectively; shades of yellow: OaR doses (also illustrated in the table).</p> Full article ">Figure 4
<p>The timeline of the treatment planning for our patient, highlighting the disruptions to the scheduling of the medical care steps our patient experienced at the beginning.</p> Full article ">Figure 5
<p>The ideal course of treatment for a borderline/malignant phyllodes tumor patient at our hospital, lasting for approximately 5–6 months. Abbreviation: US, ultrasound; CNB, core needle biopsy; PT, phyllodes tumor; RT, radiation therapy. *Reconstructive surgery is optional, it is not part of the treatment plan recommendations, but it might be taken into consideration by the patient for cosmetic reasons.</p> Full article ">Figure 6
<p>(<b>A</b>) Hematoxylin and eosin staining (20× magnification) of the core needle biopsy, showing moderate stromal cellularity and marked stromal atypia. (<b>B</b>) Hematoxylin and eosin staining (20× magnification) of the resected specimen, showing stromal overgrowth, marked to moderate stromal cellularity, marked stromal atypia and mitosis, and infiltrative tumor margins.</p> Full article ">
<p>Picture taken after the last radiotherapy session showing grade I radiodermatitis of the right breast. The size of the breast should also be noted in comparison to the left one, considering the lumpectomy performed, which involved the removal of a large mass (>20 cm).</p> Full article ">Figure 2
<p>(<b>A</b>) Target volume delineation showing the CTV (light blue) and PTV (red) contouring for the whole breast and boost volumes. The organs at risk are contoured in yellow; and (<b>B</b>) color wash dose distribution in the PTV, in cGy. In the upper left corner of the image is represented a “color wash” scale of the distributed dose, starting with shades of red for the maximum doses administered (around 60 Gy), descending to shades of blue for low doses (around 50 Gy).</p> Full article ">Figure 3
<p>Dose–volume histogram (DVH) for the target volumes and organs at risk (OaR), in both graphical and tabular form. Red: CTV corresponding to volumes receiving 50 Gy and 66 Gy, respectively; light blue: PTV corresponding to volumes receiving 50 Gy and 66 Gy, respectively; shades of yellow: OaR doses (also illustrated in the table).</p> Full article ">Figure 4
<p>The timeline of the treatment planning for our patient, highlighting the disruptions to the scheduling of the medical care steps our patient experienced at the beginning.</p> Full article ">Figure 5
<p>The ideal course of treatment for a borderline/malignant phyllodes tumor patient at our hospital, lasting for approximately 5–6 months. Abbreviation: US, ultrasound; CNB, core needle biopsy; PT, phyllodes tumor; RT, radiation therapy. *Reconstructive surgery is optional, it is not part of the treatment plan recommendations, but it might be taken into consideration by the patient for cosmetic reasons.</p> Full article ">Figure 6
<p>(<b>A</b>) Hematoxylin and eosin staining (20× magnification) of the core needle biopsy, showing moderate stromal cellularity and marked stromal atypia. (<b>B</b>) Hematoxylin and eosin staining (20× magnification) of the resected specimen, showing stromal overgrowth, marked to moderate stromal cellularity, marked stromal atypia and mitosis, and infiltrative tumor margins.</p> Full article ">
Open AccessCase Report
Unmasking an Intracardiac Shunt in a Case of Persistent Unexplained Hypoxia: A Case Report
by
Sanjay Sivalokanathan, Usman Saeedullah, Auston Locke and Maria Giovanna Trivieri
Reports 2025, 8(1), 16; https://doi.org/10.3390/reports8010016 - 26 Jan 2025
Abstract
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Background and Clinical Significance: Pulmonary hypertension (PH) is characterized by an increase in mean pulmonary arterial pressure and pulmonary vascular resistance. It is frequently encountered in patients with significant intracardiac shunts, often necessitating the implementation of a closure device or surgical correction.
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Background and Clinical Significance: Pulmonary hypertension (PH) is characterized by an increase in mean pulmonary arterial pressure and pulmonary vascular resistance. It is frequently encountered in patients with significant intracardiac shunts, often necessitating the implementation of a closure device or surgical correction. Nevertheless, the occurrence of a concomitant atrial septal defect (ASD) with a right-to-left shunt inducing left ventricular dysfunction is a rare phenomenon. Case Presentation: A 69-year-old female patient with a history of heart failure (with preserved ejection fraction) and end-stage renal disease on hemodialysis presented to an outside facility, with syncope and hypoxia. She was recently diagnosed with severe pulmonary hypertension (measuring 86 mmHg). Right heart catheterization (RHC) revealed precapillary pulmonary hypertension (88/37/54 mmHg), prompting the initiation of intravenous epoprostenol. Nevertheless, the patient was persistently hypoxic, raising the possibility of a concomitant diagnosis. Upon review of the prior echocardiogram, which included a bubble study, an intracardiac shunt was identified. It was hypothesized that a combination of right ventricular failure and the right-to-left shunt resulting from the ASD contributed to the persistent hypoxemia. In light of this, prostacyclin therapy was continued alongside adjunctive vasopressors, resulting in clinical stabilization. The patient was eventually discharged with a treatment regimen that included subcutaneous Treprostinil. Conclusions: It is important to recognize that the consequences of PH are extensive, and that a rare yet significant etiology for persistent hypoxemia may be attributed to right-to-left shunting.
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<p>Electrocardiogram demonstrating right axis deviation and left atrial enlargement.</p> Full article ">Figure 2
<p>Chest X-ray showing pulmonary edema with a left-sided pleural effusion.</p> Full article ">Figure 3
<p>Computed tomography demonstrating bilateral ground glass opacities.</p> Full article ">Figure 4
<p>Continuous wave doppler showing severe pulmonary hypertension.</p> Full article ">Figure 5
<p>Transthoracic echocardiography with agitated saline study (bubble study). The red arrow illustrates agitated saline in the left ventricle.</p> Full article ">Figure 6
<p>Flowchart illustrating the clinical reasoning and steps undertaken in our case.</p> Full article ">
<p>Electrocardiogram demonstrating right axis deviation and left atrial enlargement.</p> Full article ">Figure 2
<p>Chest X-ray showing pulmonary edema with a left-sided pleural effusion.</p> Full article ">Figure 3
<p>Computed tomography demonstrating bilateral ground glass opacities.</p> Full article ">Figure 4
<p>Continuous wave doppler showing severe pulmonary hypertension.</p> Full article ">Figure 5
<p>Transthoracic echocardiography with agitated saline study (bubble study). The red arrow illustrates agitated saline in the left ventricle.</p> Full article ">Figure 6
<p>Flowchart illustrating the clinical reasoning and steps undertaken in our case.</p> Full article ">
Open AccessCase Report
Bioelectrical Impedance Analysis as a Helpful Tool in Pediatric Obesity Monitoring: A Case Report
by
Agata Przytula and Joanna Popiolek-Kalisz
Reports 2025, 8(1), 15; https://doi.org/10.3390/reports8010015 - 25 Jan 2025
Abstract
Background and Clinical Significance: Childhood obesity and its associated complications are an emerging public health problem; thus, non-communicable chronic disease prevention should be implemented as early as possible. On the other hand, obesity management in children is a challenge in terms of
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Background and Clinical Significance: Childhood obesity and its associated complications are an emerging public health problem; thus, non-communicable chronic disease prevention should be implemented as early as possible. On the other hand, obesity management in children is a challenge in terms of achieving fat tissue reduction without any adverse outcomes on overall development. This is why close cooperation with young patients and their parents is crucial for success. Moreover, non-invasive but detailed monitoring guaranties insight in this process’s progress and safety. As obesity is a chronic disease with a tendency for recurrence, further follow-up should also be considered. Case Presentation: We present a case of a 10-year-old boy who was referred to a dietitian due to concerns about a diagnosis of obesity and metabolic complications including abnormal lipid profile and liver function. During the dietary consultation, body composition assessment with bioelectrical impedance analysis was conducted, which confirmed obesity. A detailed interview allowed for the identification of improper dietary patterns. The implemented lifestyle education and qualitative diet modifications led to fat mass reduction without any significant muscle loss after just one month. The metabolic profile was also improved. The patient remained under the care of a dietitian for the next 4 years with constant body composition monitoring, which enabled the relevant parties to address if body mass gain was a part of his normal development or if he suffered from obesity recurrence. The patient and his parents benefited from an individualized, patient-centered approach including dietary education, overall lifestyle modification, and detailed body composition monitoring. This way, the patient succeeded in fat content reduction with the constant assessment of the safety of this process. Moreover, the dietary education impacted the whole family’s lifestyle. Conclusions: This case emphasizes the role of body composition assessment in children. Obesity and metabolic complications resulting from an improper lifestyle can affect pediatric patients. Bioelectrical impedance analysis is a non-invasive tool that can improve the safety and effectiveness of nutritional interventions and could be included in routine pediatric obesity assessment.
Full article
(This article belongs to the Section Paediatrics)
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<p>Measurements of BMI plotted as BMI for age on percentile grids.</p> Full article ">Figure 2
<p>Measurements of height plotted on a height-for-age percentile grid.</p> Full article ">Figure 3
<p>Measurements of body mass plotted on a body mass-for-age percentile grid.</p> Full article ">Figure 4
<p>Measurements of fat mass (FM) percentage plotted on a fat percentage-for-age percentile grid.</p> Full article ">
<p>Measurements of BMI plotted as BMI for age on percentile grids.</p> Full article ">Figure 2
<p>Measurements of height plotted on a height-for-age percentile grid.</p> Full article ">Figure 3
<p>Measurements of body mass plotted on a body mass-for-age percentile grid.</p> Full article ">Figure 4
<p>Measurements of fat mass (FM) percentage plotted on a fat percentage-for-age percentile grid.</p> Full article ">
Open AccessReview
Investigating the Role of Genetic Polymorphisms in External Apical Root Resorption Among Orthodontic Patients: Implications for Treatment Outcomes—A Literature Review
by
Christina Charisi, Vasileios Zisis, Konstantinos Poulopoulos, Stefanos Zisis, Athanasios Poulopoulos and Dieter Müßig
Reports 2025, 8(1), 14; https://doi.org/10.3390/reports8010014 - 24 Jan 2025
Abstract
Background: Among the various forms of root resorption, External Apical Root Resorption (EARR) has garnered particular attention due to its prevalence and potential complications associated with orthodontic interventions. Methods: An electronic search of literature was performed between September 2024 and December 2024 to
[...] Read more.
Background: Among the various forms of root resorption, External Apical Root Resorption (EARR) has garnered particular attention due to its prevalence and potential complications associated with orthodontic interventions. Methods: An electronic search of literature was performed between September 2024 and December 2024 to identify all articles investigating the Role of Genetic Polymorphisms in External Apical Root Resorption Among Orthodontic Patients: Implications for Treatment Outcomes. The search was conducted using MEDLINE (National Library of Medicine)-PubMed with restrictions concerning the date of publication. In particular, we focused on the period 2014–2024 using the following keywords: gene polymorphisms AND orthodontic treatment AND apical root resorption OR external apical root resorption. This was followed by a manual search, and references were used to identify relevant articles. Results: The review showed that certain variations of the following genes may be positively associated with OIEARR: Osteopontin gene, P2RX7, IL-1β, IL-6, IL1RN, OPG, RANK, STAG2, RP1-30E17.2, SSP1, SFRP2, TNFSF11, TNFRSF11A, TNFRSF11B, VDR, CYP27B1, ACT3N, TSC2, WNT3A, LRP1, LRP6. Conversely, the IRAK1 gene has a protective function against the development of OIEARR. Conclusions: Despite these advancements, it is still not feasible to establish new guidelines and clinical protocols based on the existing research findings. The integration of genetic considerations into orthodontic practice has the potential to revolutionize treatment strategies, ensuring that they are not only effective but also respectful of each patient’s unique biological landscape.
Full article
Open AccessCase Report
A Quantitative and Qualitative Analysis of the Patient and Caregiver’s Perspective on Outcomes of Intravenous Administration of Low-Dose Ketamine for C-PTSD, TBI, and Treatment Resistant MDD: A Clinical Example
by
Laura Hentig, James Hentig and Jessica M. Gill
Reports 2025, 8(1), 13; https://doi.org/10.3390/reports8010013 - 22 Jan 2025
Abstract
Background and Clinical Significance: Treatment resistant psychiatric disorders affect millions of people across the globe. Ketamine has been employed as a treatment option for those with treatment resistant depression, as well as for chronic pain and alcohol use disorder. However, case presentations
[...] Read more.
Background and Clinical Significance: Treatment resistant psychiatric disorders affect millions of people across the globe. Ketamine has been employed as a treatment option for those with treatment resistant depression, as well as for chronic pain and alcohol use disorder. However, case presentations and research has been limited on the outcomes, and furthermore there is even less on the patient or caregiver perspective on the impact of the treatment. Case Presentation: Here, we present a middle-aged male who has undergone 20 intravenous (IV) ketamine infusions to treat Complex Post-Traumatic Stress Disorder (C-PTSD) and Major Depressive Disorder (MDD). We provide both qualitative perspectives from the patient, caregiver, as well as quantitative analyses of the patient from the Patient Health Questionnaire-9 (PHQ9), Beck’s Depression Inventory (BDI), and the Neurobehavioral Symptom Inventory (NSI) following treatment and weekly (4 weeks) assessments between treatments. Conclusions: Collectively, these data provide a holistic view of the use of ketamine for this patient on a variety of mental health, physiological, and behavioral conditions.
Full article
(This article belongs to the Section Mental Health)
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<p><b>Dose Schedule.</b> Graphical representation of the subject’s ketamine dose by visit, accompanied whether the infusion began with a 5 mg bolus, the total infusion time/run rate, and whether the treatment was disrupted. Grey box; initial six treatments with a protocol of one treatment a week, blue = with bolus, black = without bolus, red = disrupted treatment.</p> Full article ">Figure 2
<p><b>Quantitative Scales.</b> (<b>A</b>–<b>C</b>) Rapid reduction in (<b>A</b>) PHQ9, (<b>B</b>) BDI, and (<b>C</b>) NSI total score was observed with progressive return near baseline by 4 weeks post infusion. (<b>D</b>) NSI-sub scores displayed similar trends over 4 weeks with somatic scores exceeding baseline.</p> Full article ">
<p><b>Dose Schedule.</b> Graphical representation of the subject’s ketamine dose by visit, accompanied whether the infusion began with a 5 mg bolus, the total infusion time/run rate, and whether the treatment was disrupted. Grey box; initial six treatments with a protocol of one treatment a week, blue = with bolus, black = without bolus, red = disrupted treatment.</p> Full article ">Figure 2
<p><b>Quantitative Scales.</b> (<b>A</b>–<b>C</b>) Rapid reduction in (<b>A</b>) PHQ9, (<b>B</b>) BDI, and (<b>C</b>) NSI total score was observed with progressive return near baseline by 4 weeks post infusion. (<b>D</b>) NSI-sub scores displayed similar trends over 4 weeks with somatic scores exceeding baseline.</p> Full article ">
Open AccessCase Report
Locally Advanced Cervical Cancer in a Patient with Epidermolysis Bullosa Treated with Concurrent Chemoradiotherapy and Electronic Brachytherapy
by
Desislava Hitova-Topkarova, Virginia Payakova, Angel Yordanov, Desislava Kostova-Lefterova and Elitsa Encheva
Reports 2025, 8(1), 12; https://doi.org/10.3390/reports8010012 - 21 Jan 2025
Abstract
Background and Clinical Significance: The purpose of this report is to investigate the feasibility of combined modality treatment in a case of locally advanced cervical cancer in a patient with inherited epidermolysis bullosa as well as to suggest a protocol for cervical
[...] Read more.
Background and Clinical Significance: The purpose of this report is to investigate the feasibility of combined modality treatment in a case of locally advanced cervical cancer in a patient with inherited epidermolysis bullosa as well as to suggest a protocol for cervical electronic brachytherapy. Case Description: The patient was treated with image-guided external beam radiotherapy and concomitant chemotherapy to a dose of 45 Gy in 25 fractions with a simultaneously integrated boost of 55 Gy in involved lymph nodes. The maximal skin dose was 34.09 Gy. Intracavitary electronic brachytherapy was applied to the uterine cervix in 4 fractions of 7 Gy and contributed no dose to the skin. Discussion: The treatment was tolerated well with no early toxicity. During the 3-month period of follow-up, no adverse events of grade 2 or higher were detected, and no exacerbation of skin lesions was noted. Conclusions: This is the first report of treatment of cervical cancer in a patient with inherited epidermolysis bullosa where combined concurrent chemoradiotherapy and intracavitary electronic brachytherapy demonstrated feasibility and safety. The followed institutional protocol for treatment planning and delivery ensured low doses to organs and risk and reproducibility.
Full article
(This article belongs to the Special Issue Case Reports in Obstetrics and Gynecology)
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<p>T2 weighted MRT images before treatment.</p> Full article ">Figure 2
<p>18-Fluorodeoxyglucose (FDG) PET/CT image before treatment.</p> Full article ">Figure 3
<p>(<b>Left side</b>): dose distribution from 55 Gy, which is 100% of the prescribed dose (in red) in boosted lymph nodes and 45 Gy (in yellow) prescribed dose in the whole PTV to 10 Gy (in white). (<b>Right side</b>): Three-dimensional reconstruction of the patient’s skin with the distribution of 10 Gy in pink. All regions of existing skin lesions were avoided and received less than 10 Gy.</p> Full article ">Figure 4
<p>T2 weighted MRT images after EBRT.</p> Full article ">Figure 5
<p>Dose distribution: prescribed dose per fraction—7 Gy (red isoline)—covers more than 90% of the CTV high risk; 50% of the prescribed dose per fraction—3.5 Gy (blue isoline)—covers more than 99% of the CTV intermediate risk. The dose on the skin surface was 0 Gy from EBT.</p> Full article ">Figure 6
<p>Dystrophic lesions on the lower extremities photographed on the last day of EBRT and after five cycles of Cisplatin.</p> Full article ">Figure 7
<p>Pubic skin area remained without any signs of infection or blistering after completion of therapy.</p> Full article ">Figure 8
<p>1 month post-treatment MRT images.</p> Full article ">
<p>T2 weighted MRT images before treatment.</p> Full article ">Figure 2
<p>18-Fluorodeoxyglucose (FDG) PET/CT image before treatment.</p> Full article ">Figure 3
<p>(<b>Left side</b>): dose distribution from 55 Gy, which is 100% of the prescribed dose (in red) in boosted lymph nodes and 45 Gy (in yellow) prescribed dose in the whole PTV to 10 Gy (in white). (<b>Right side</b>): Three-dimensional reconstruction of the patient’s skin with the distribution of 10 Gy in pink. All regions of existing skin lesions were avoided and received less than 10 Gy.</p> Full article ">Figure 4
<p>T2 weighted MRT images after EBRT.</p> Full article ">Figure 5
<p>Dose distribution: prescribed dose per fraction—7 Gy (red isoline)—covers more than 90% of the CTV high risk; 50% of the prescribed dose per fraction—3.5 Gy (blue isoline)—covers more than 99% of the CTV intermediate risk. The dose on the skin surface was 0 Gy from EBT.</p> Full article ">Figure 6
<p>Dystrophic lesions on the lower extremities photographed on the last day of EBRT and after five cycles of Cisplatin.</p> Full article ">Figure 7
<p>Pubic skin area remained without any signs of infection or blistering after completion of therapy.</p> Full article ">Figure 8
<p>1 month post-treatment MRT images.</p> Full article ">
Open AccessCase Report
The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
by
Alessandro Bergna, Jacques Megevand, Giacomo Mori, Leonardo Lenisa and Andrea Rusconi
Reports 2025, 8(1), 11; https://doi.org/10.3390/reports8010011 - 20 Jan 2025
Abstract
Background and Clinical Significance: Recto-vaginal fistulae (RVF) and fecal incontinence (FI) pose significant challenges for colorectal surgeons. Various therapeutic options have been proposed for each condition over time. Despite its procedural complexity and the risk of complications, graciloplasty remains a viable therapeutic
[...] Read more.
Background and Clinical Significance: Recto-vaginal fistulae (RVF) and fecal incontinence (FI) pose significant challenges for colorectal surgeons. Various therapeutic options have been proposed for each condition over time. Despite its procedural complexity and the risk of complications, graciloplasty remains a viable therapeutic option for both conditions, with favorable long-term results. To our knowledge, this is the first report of a case where the need to treat both conditions concurrently arose. Case Presentation: We report the case of a 54-year-old woman with severe FI and repeatedly operated on recurrent recto-vaginal fistula. The patient underwent graciloplasty to provide healthy tissue with an adequate vascular supply to both enhance the healing process of the fistula and reshape the anal canal with a circular muscular structure. Following the procedure, the patient experienced prompt symptom resolution and good clinical and functional recovery at a 1-year follow-up evaluation. Conclusions: This case report highlights the safety and effectiveness of an overlooked procedure for the treatment of large sphincter defects and concurrent recto-vaginal or recto-vaginal tears.
Full article
(This article belongs to the Section Surgery)
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Show Figures

Figure 1
Figure 1
<p>EAUS for the assessment of the anal sphincter complex. (<b>a</b>) Internal anal sphincter anterior defect of 154°; (<b>b</b>) external anal sphincter anterior defect of 145°.</p> Full article ">Figure 2
<p>Ano-vaginal fistulous tract identification.</p> Full article ">Figure 3
<p>Dissection of the right gracilis muscle. (<b>a</b>) Skin incision; (<b>b</b>) harvest of the distal tendon of the muscle.</p> Full article ">Figure 4
<p>(<b>a</b>) Skin incisions in the perianal region; (<b>b</b>) Creation of a circumferential tunnel around the anus via blunt digital dissection; (<b>c</b>) transposition of the right gracilis muscle; (<b>d</b>) wrapping of the muscle around the anus.</p> Full article ">
<p>EAUS for the assessment of the anal sphincter complex. (<b>a</b>) Internal anal sphincter anterior defect of 154°; (<b>b</b>) external anal sphincter anterior defect of 145°.</p> Full article ">Figure 2
<p>Ano-vaginal fistulous tract identification.</p> Full article ">Figure 3
<p>Dissection of the right gracilis muscle. (<b>a</b>) Skin incision; (<b>b</b>) harvest of the distal tendon of the muscle.</p> Full article ">Figure 4
<p>(<b>a</b>) Skin incisions in the perianal region; (<b>b</b>) Creation of a circumferential tunnel around the anus via blunt digital dissection; (<b>c</b>) transposition of the right gracilis muscle; (<b>d</b>) wrapping of the muscle around the anus.</p> Full article ">
Open AccessCase Report
Air Travel-Triggered Tension Pneumocephalus Caused by a Frontal Sinus Osteoma: Case Report
by
Aleksandar Djurdjevic, Milan Lepic, Jovana Djurdjevic, Svetozar Stankovic and Goran Pavlicevic
Reports 2025, 8(1), 10; https://doi.org/10.3390/reports8010010 - 18 Jan 2025
Abstract
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Show Figures
Background and Clinical Significance: Pneumocephalus, an accumulation of air within the cranial cavity, typically arises from trauma or iatrogenic causes. However, spontaneous occurrences of this are rare and linked to various pathologies affecting the paranasal sinuses, the ear, or the skull base.
[...] Read more.
Background and Clinical Significance: Pneumocephalus, an accumulation of air within the cranial cavity, typically arises from trauma or iatrogenic causes. However, spontaneous occurrences of this are rare and linked to various pathologies affecting the paranasal sinuses, the ear, or the skull base. The impact of air travel on individuals with pneumocephalus remains uncertain despite ongoing research. We report a unique case of spontaneous tension pneumocephalus attributed to a frontal sinus osteoma during air travel. Case Presentation: A 55-year-old man presented with headache and dizziness, initiated during a nine-hour international flight two weeks prior. The symptoms abated after landing but recurred on his return flight, accompanied by confusion the following day. A neurological examination revealed no deficits. CT and MRI scans indicated the presence of intraparenchymal air collection in the right frontal lobe, attributed to a frontal sinus osteoma causing a dural tear. Surgical intervention included duroplasty and osteoma removal, with postoperative recovery free of complications. Conclusions: Frontal sinus osteoma-induced tension pneumocephalus is exceedingly rare, with only limited cases reported in the literature. This case shows that air travel may exacerbate intracranial gas dynamics that lead to development of tension pneumocephalus with a potentially fatal outcome for patients.
Full article

Figure 1
Figure 1
<p>(<b>a</b>) A pre-operative sagittal CT scan with a bone window showing the osteoma in the frontal sinus that violates posterior wall of the sinus and protrudes intracranially; (<b>b</b>) a pre-operative axial CT scan with a bone window showing the osteoma located in the right frontal sinus protruding intracranially and causing pneumocephalus in right frontal lobe; (<b>c</b>) a pre-operative axial CT scan showing the intraparenchymal collection of air in the right frontal lobe that compresses the right lateral ventricle and corpus callosum, causing midsagittal displacement; (<b>d</b>) a pre-operative axial T2 Flair MR showing the intraparenchymal collection of air in the right frontal lobe.</p> Full article ">Figure 2
<p>(<b>a</b>) Frontal bone with the osteoma attached to the inner side of the frontal sinus; (<b>b</b>) dural tear above the frontal cortex caused by osteoma; (<b>c</b>) repaired dural defect with autologous muscle graft; (<b>d</b>) closure of the frontal sinus using vascularized periosteum; (<b>e</b>) frontal bone after osteoma removal.</p> Full article ">Figure 3
<p>(<b>a</b>) A post-operative CT showing the minor collection of air and blood in the operative field; (<b>b</b>) a post-operative CT showing the right frontal sinus after the removal of the osteoma.</p> Full article ">
<p>(<b>a</b>) A pre-operative sagittal CT scan with a bone window showing the osteoma in the frontal sinus that violates posterior wall of the sinus and protrudes intracranially; (<b>b</b>) a pre-operative axial CT scan with a bone window showing the osteoma located in the right frontal sinus protruding intracranially and causing pneumocephalus in right frontal lobe; (<b>c</b>) a pre-operative axial CT scan showing the intraparenchymal collection of air in the right frontal lobe that compresses the right lateral ventricle and corpus callosum, causing midsagittal displacement; (<b>d</b>) a pre-operative axial T2 Flair MR showing the intraparenchymal collection of air in the right frontal lobe.</p> Full article ">Figure 2
<p>(<b>a</b>) Frontal bone with the osteoma attached to the inner side of the frontal sinus; (<b>b</b>) dural tear above the frontal cortex caused by osteoma; (<b>c</b>) repaired dural defect with autologous muscle graft; (<b>d</b>) closure of the frontal sinus using vascularized periosteum; (<b>e</b>) frontal bone after osteoma removal.</p> Full article ">Figure 3
<p>(<b>a</b>) A post-operative CT showing the minor collection of air and blood in the operative field; (<b>b</b>) a post-operative CT showing the right frontal sinus after the removal of the osteoma.</p> Full article ">
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