Reports

12 pages, 6846 KiB

Open AccessCase Report

A Second Chance: Managing Late Implant Failure from Peri-Implantitis with Computer-Guided Bone Regeneration—A Clinical Case Report

by Marco Tallarico, Silvio Mario Meloni, Carlotta Cacciò, Francesco Mattia Ceruso and Aurea Immacolata Lumbau

Reports 2025, 8(3), 118; https://doi.org/10.3390/reports8030118 - 22 Jul 2025

Abstract

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case [...] Read more.

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

(This article belongs to the Section Dentistry/Oral Medicine)

► Show Figures

Figure 1

10 pages, 965 KiB

Open AccessReview

High-Stakes Hormone: Vasopressin Use as a Last-Line Therapy for Shock in Pediatrics—A Narrative Review

by Marcin Sota, Daria Bramnik, Olivia Gudziewski, Ithamar Cheyne and Małgorzata Mikaszewska-Sokolewicz

Reports 2025, 8(3), 117; https://doi.org/10.3390/reports8030117 - 21 Jul 2025

Abstract

Background and Clinical Significance: Shock in pediatric patients remains a leading cause of morbidity and mortality, with refractory cases posing significant challenges. While catecholamines like norepinephrine and epinephrine are standard vasopressors, vasopressin (AVP) has emerged as a potential adjunct therapy. However, its role [...] Read more.

Background and Clinical Significance: Shock in pediatric patients remains a leading cause of morbidity and mortality, with refractory cases posing significant challenges. While catecholamines like norepinephrine and epinephrine are standard vasopressors, vasopressin (AVP) has emerged as a potential adjunct therapy. However, its role in pediatric shock remains controversial due to concerns about efficacy, safety, and appropriate use. This review assesses the current evidence on AVP in pediatric shock. Methods and Results: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published in the last five years to capture recent advancements. Articles on AVP’s mechanism of action, pharmacokinetics, clinical applications, and safety were included. For background information, studies were not limited by publication date. AVP increases mean arterial pressure (MAP) and systemic vascular resistance (SVR) yet does not significantly reduce mortality. While AVP may be useful in catecholamine-resistant vasoplegia, its advantage over conventional vasopressors remains uncertain. Concerns about ischemic complications, myocardial dysfunction, and thrombocytopenia further limit its routine use. Conclusions: AVP may serve as an adjunct therapy in catecholamine-resistant vasoplegia, but safety concerns and unclear benefits restrict its routine use. Further research is needed to determine the optimal dosing, patient selection, and long-term outcomes. Until then, AVP should remain a last-line therapy when conventional vasopressors fail. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

► Show Figures

Figure 1

9 pages, 1276 KiB

Open AccessCase Report

“An Unusual Case of Bilateral Sudden Mixed Hearing Loss with Complete Remission”: A Case Report and Pathophysiological Considerations

by Musat Gabriela Cornelia, Codrut Sarafoleanu, Lucia Radu, Ovidiu Musat and Ionut Tanase

Reports 2025, 8(3), 116; https://doi.org/10.3390/reports8030116 - 21 Jul 2025

Abstract

Background: Sudden-onset bilateral mixed hearing loss in adults is an extremely rare condition but challenging to diagnose and treat. Conductive hearing loss is associated with otitis media, while the simultaneous presence of a sensorineural component requires supplementary investigation for possible shared pathophysiological mechanisms. [...] Read more.

Background: Sudden-onset bilateral mixed hearing loss in adults is an extremely rare condition but challenging to diagnose and treat. Conductive hearing loss is associated with otitis media, while the simultaneous presence of a sensorineural component requires supplementary investigation for possible shared pathophysiological mechanisms. Case Presentation: We report the case of a 41-year-old male who was admitted to our hospital with a 48 h history of bilateral, fast progressive hearing loss following a viral illness. The audiologic testing revealed bilateral severe mixed hearing loss. Tympanometry indicated the presence of middle-ear effusion, and myringotomy confirmed the existence of pressurized serous fluid. Treatment consisted of systemic and intratympanic corticosteroids, antibiotics, and supportive therapy. The patient had an unexpected full recovery of auditory function within one month. Discussion: Multiple hypotheses were considered. We hypothesized the coexistence of unrelated conductive and sensorineural hearing loss or a unifying pathological process. Theories discussed include a direct viral insult to the cochlear structures or even pressure-mediated damage to the basal cochlea due to the simultaneous inward displacement of the oval and round windows. The complete resolution of hearing loss is the indicator of a reversible etiology, possibly due to transient inner ear dysfunction secondary to middle-ear pathology or viral infection. Conclusions: This case illustrates the complexity of diagnosing acute mixed hearing loss. This report emphasizes a rare case of sudden-onset bilateral mixed hearing loss with a complete recovery, contributing valuable insight into under-reported and diagnostically complex presentations. Full article

(This article belongs to the Section Otolaryngology)

► Show Figures

Figure 1

9 pages, 832 KiB

Open AccessCase Report

Rituximab Therapy in Refractory Ocular Cicatricial Pemphigoid: A Case Report

by Sania Vidas Pauk, Antonela Geber, Iva Bešlić, Ines Lakoš-Jukić and Tomislav Kuzman

Reports 2025, 8(3), 115; https://doi.org/10.3390/reports8030115 - 20 Jul 2025

Abstract

Background and Clinical Significance: Ocular cicatricial pemphigoid (OCP) is a rare autoimmune disease affecting the conjunctiva and oral mucosa. Chronic inflammation causes conjunctival scarring, leading to symblepharon, trichiasis, corneal damage, and possible blindness. Diagnosis is clinical, supported by biopsy and immunofluorescence. Treatment [...] Read more.

Background and Clinical Significance: Ocular cicatricial pemphigoid (OCP) is a rare autoimmune disease affecting the conjunctiva and oral mucosa. Chronic inflammation causes conjunctival scarring, leading to symblepharon, trichiasis, corneal damage, and possible blindness. Diagnosis is clinical, supported by biopsy and immunofluorescence. Treatment includes systemic corticosteroids, immunosuppressants, and biologics in refractory cases. Case Presentation: A 64-year-old male presented with ocular irritation, trichiasis, and counting fingers (CF) visual acuity in the left eye. Slit-lamp examination revealed conjunctival inflammation, corneal epithelial defect, and symblepharon in the left eye. Biopsy confirmed ocular cicatricial pemphigoid (OCP). He was treated with topical steroids, cyclosporine, subconjunctival injections, and systemic corticosteroids, followed by surgery, which improved BCVA to 0.10 logMAR. Two years later, disease progression resulted in severe inflammation and visual decline in both eyes. Systemic azathioprine and corticosteroids achieved partial control. Due to insufficient response, rituximab therapy was initiated, leading to significant reduction in inflammation and stabilization of disease. Right eye BCVA improved to 0.16 logMAR; the left remained at CF. The patient continues to receive rituximab during exacerbations and is under regular follow-up. Conclusions: Early diagnosis and timely systemic treatment are essential in preventing vision loss in OCP. In refractory cases, biologic agents like rituximab may offer effective disease control. Full article

(This article belongs to the Section Ophthalmology)

► Show Figures

Figure 1

6 pages, 2238 KiB

Open AccessCase Report

Bilateral Diffuse Uveal Melanocytic Proliferation in a Patient with Chronic Myelomonocytic Leukemia: A Rare Case and Literature Review

by Dolika D. Vasović, Miodrag Lj. Karamarković, Miroslav Jeremić and Dejan M. Rašić

Reports 2025, 8(3), 114; https://doi.org/10.3390/reports8030114 - 19 Jul 2025

Abstract

Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome characterized by bilateral uveal melanocyte proliferation and progressive visual disturbance. While most commonly associated with solid tumors, its occurrence in hematologic malignancies is exceedingly rare. We report a case of BDUMP in [...] Read more.

Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome characterized by bilateral uveal melanocyte proliferation and progressive visual disturbance. While most commonly associated with solid tumors, its occurrence in hematologic malignancies is exceedingly rare. We report a case of BDUMP in a 64-year-old male recently diagnosed with chronic myelomonocytic leukemia (CMML), who presented with subacute, painless bilateral blurred vision. Multimodal imaging revealed suggestive features of BDUMP, including orange-red subretinal patches, retinal pigment epithelium mottling, and diffuse choroidal thickening, consistent with early structural involvement despite preserved central vision. No intraocular mass or signs of inflammation were observed. The patient did not receive specific treatment for BDUMP, and visual acuity remained stable during follow-up. This case underscores the importance of considering BDUMP in the differential diagnosis of bilateral visual symptoms in patients with hematologic malignancies. Although rare, BDUMP may occur in the context of CMML. Recognition through multimodal imaging and interdisciplinary collaboration is essential, and further research is needed to clarify its pathogenesis and improve management strategies. Full article

► Show Figures

Figure 1

16 pages, 424 KiB

Open AccessCase Report

Reattribution of Auditory Hallucinations Throughout Avatar Therapy: A Case Series

by Sabrina Giguère, Mélissa Beaudoin, Laura Dellazizzo, Kingsada Phraxayavong, Stéphane Potvin and Alexandre Dumais

Reports 2025, 8(3), 113; https://doi.org/10.3390/reports8030113 (registering DOI) - 18 Jul 2025

Abstract

Background and Clinical Significance: Avatar Therapy (AT) for individuals with treatment-resistant auditory verbal hallucinations (AVHs) in schizophrenia aims to address emotional responses, beliefs about voices, self-perception, and coping strategies. This study focuses on three participants who, during AT, shifted their belief about the [...] Read more.

Background and Clinical Significance: Avatar Therapy (AT) for individuals with treatment-resistant auditory verbal hallucinations (AVHs) in schizophrenia aims to address emotional responses, beliefs about voices, self-perception, and coping strategies. This study focuses on three participants who, during AT, shifted their belief about the origin of their most distressing voice from an external source to a self-generated one. Case Presentation: The objective of this study was to explore the evolution of the reattribution of the participants’ most distressing voice to oneself during AT and the patients’ perception of this reattribution. Immersive sessions and semi-structured interviews were transcribed and qualitatively described to provide a session-by-session account of the evolution of each participant’s AVH reattribution to themselves during the course of AT, along with their perceptions of this reattribution. This process led to the recognition that initially perceived as external voices were internally generated thoughts, reflecting how participants viewed themselves. Two participants reported a reduction in AVH severity. All three described positive changes in how they related to their voices and self-perception. Additional improvements were observed in emotional regulation, social functioning, and engagement in personal projects. Conclusions: This reassignment of the voice from an external source to an internal one suggests that AT can modify how individuals relate to their voices and may empower them to regain control over their hallucinations. However, given the exploratory nature of this study, the results should be interpreted as examples. Full article

(This article belongs to the Section Mental Health)

► Show Figures

Figure 1

10 pages, 3685 KiB

Open AccessCase Report

Giant Atypical Neurofibroma of the Calf in Neurofibromatosis Type 1: Case Report and Literature Review

by Lyubomir Gaydarski, Georgi P. Georgiev and Svetoslav A. Slavchev

Reports 2025, 8(3), 112; https://doi.org/10.3390/reports8030112 - 17 Jul 2025

Abstract

Neurofibromatosis type 1 (NF1) predisposes individuals to various peripheral nerve sheath tumors (PNSTs), including benign neurofibromas, malignant peripheral nerve sheath tumors (MPNSTs), and intermediate lesions known as atypical neurofibromatous neoplasms of uncertain biologic potential (ANNUBP), previously often termed atypical neurofibroma. These atypical lesions [...] Read more.

Neurofibromatosis type 1 (NF1) predisposes individuals to various peripheral nerve sheath tumors (PNSTs), including benign neurofibromas, malignant peripheral nerve sheath tumors (MPNSTs), and intermediate lesions known as atypical neurofibromatous neoplasms of uncertain biologic potential (ANNUBP), previously often termed atypical neurofibroma. These atypical lesions are considered premalignant precursors to MPNST.4 We present the case of a 33-year-old male with NF1 who developed a rapidly growing, painful mass in his right calf. Clinical examination revealed signs consistent with NF1. Magnetic resonance imaging showed a large, heterogeneous mass in the lateral compartment. Biopsy revealed a neurofibroma with hypercellularity, moderate atypia, scarce S100 positivity, focal CD34 positivity, and an elevated Ki-67 proliferation index of 10–12%, consistent with ANNUBP. The patient underwent wide surgical resection, including the fibula and peroneal muscles. At the 30-month follow-up, there was no local recurrence, though the patient had a mild residual limp. This case highlights the clinical presentation, diagnostic features, and management considerations for ANNUBP in NF1, emphasizing the importance of recognizing warning signs and the role of pathology in guiding treatment for these high-risk precursor lesions. Full article

(This article belongs to the Section Oncology)

► Show Figures

Figure 1

7 pages, 1770 KiB

Open AccessCase Report

The Diagnostic Challenges of Disseminated Nocardiosis in a Post-Renal Transplant Patient: A Case Report

by Yi Lin, Minqi Xu, Helen Genis, Nisha Andany and Lina Chen

Reports 2025, 8(3), 111; https://doi.org/10.3390/reports8030111 - 17 Jul 2025

Abstract

Disseminated nocardiosis is a rare, life-threatening infection, often misdiagnosed due to its resemblance to other conditions. We report a case of disseminated nocardiosis in a 62-year-old post-renal transplant patient presenting with pulmonary, hepatic, and pancreatic lesions. Despite multiple negative bacterial cultures, a histopathological [...] Read more.

Disseminated nocardiosis is a rare, life-threatening infection, often misdiagnosed due to its resemblance to other conditions. We report a case of disseminated nocardiosis in a 62-year-old post-renal transplant patient presenting with pulmonary, hepatic, and pancreatic lesions. Despite multiple negative bacterial cultures, a histopathological examination of the liver revealed necrotizing granulomas with filamentous microorganisms, ultimately identified as Nocardia. This case highlights diagnostic challenges and the importance of integrating microbiological, pathological, and radiographical findings to manage and diagnose disseminated nocardiosis infections in immunocompromised individuals. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

8 pages, 1643 KiB

Open AccessCase Report

Neuromyelitis Optica Diagnosis in Two Elderly Patients with Systematic Lupus Erythematosus: A Case Series

by Kyriaki Astara, Maria Lypiridou, Konstantinos Kalafatakis, Georgios Nikolaou and Georgios Stouraitis

Reports 2025, 8(3), 110; https://doi.org/10.3390/reports8030110 - 16 Jul 2025

Abstract

Background and Clinical Significance: Neuromyelitis optica (NMO) is a chronic demyelinating inflammatory disease of the central nervous system (CNS), mediated by autoantibodies against aquaporin-4 (AQ4) receptors. In the spectrum of NMO, other autoimmune diseases also coexist, though their association with systemic lupus erythematosus [...] Read more.

Background and Clinical Significance: Neuromyelitis optica (NMO) is a chronic demyelinating inflammatory disease of the central nervous system (CNS), mediated by autoantibodies against aquaporin-4 (AQ4) receptors. In the spectrum of NMO, other autoimmune diseases also coexist, though their association with systemic lupus erythematosus (SLE) is rare. Case Presentation: We present two cases of patients in their 70s who were diagnosed with NMO in the context of SLE. The first case concerns a 78-year-old woman with drug-induced SLE and thoracic myelitis who developed T4-level incomplete paraplegia over three weeks. The second case involves a 71-year-old woman with a history of SLE and myasthenia gravis, presenting with cervical myelitis with progressive worsening of walking and C4-level paraparesis over two months. In both cases, elevated serum anti-AQ4 titers were detected, establishing the diagnosis of NMO and differentiation from an atypical manifestation of SLE-related myelitis. High doses of intravenous corticosteroids with gradual tapering, along with cyclophosphamide, followed by rituximab, were administered in both patients. The first patient showed a poor response, while the second showed improvement. Conclusions: The coexistence of NMO with SLE is rare, but the occurrence of myelitis in patients with connective tissue diseases should raise the suspicion of NMO, especially in elderly women and several years after the diagnosis of SLE. Time to treatment is critical, as delays in treating NMO can result in cumulative and disabling damage. Full article

(This article belongs to the Section Allergy/Immunology)

► Show Figures

Figure 1

13 pages, 7203 KiB

Open AccessCase Report

Wide Complex Irregular Rhythm in a Paced Patient: A Clinical Approach

by Haralambie Macovei, Andrei Mihordea, Cristina Andreea Adam, Lucia Corina Dima-Cozma, Elena-Andreea Moales, Maria-Magdalena Leon and Florin Mitu

Reports 2025, 8(3), 109; https://doi.org/10.3390/reports8030109 - 16 Jul 2025

Abstract

Background and Clinical Significance: Evaluating wide complex rhythms in patients with permanent pacemakers can be a diagnostic challenge, particularly when the rhythm is irregular. While pacemaker-mediated rhythms are typically regular and predictable, the appearance of wide complex irregular rhythms raises concerns ranging from [...] Read more.

Background and Clinical Significance: Evaluating wide complex rhythms in patients with permanent pacemakers can be a diagnostic challenge, particularly when the rhythm is irregular. While pacemaker-mediated rhythms are typically regular and predictable, the appearance of wide complex irregular rhythms raises concerns ranging from lead malfunction to life-threatening arrhythmias, such as ventricular tachycardia. Understanding the interplay between intrinsic cardiac activity and device function is crucial for timely and accurate diagnosis in this increasingly common clinical scenario. Case presentation: We report on a 74-year-old female with a VVI pacemaker implanted for binodal disease, who presented with intermittent palpitations and an irregular rhythm. The patient has a recent history of falling on her right shoulder, which is also the site of the device implantation. We used a clinical step-by-step approach to rule out pacemaker malfunction and to establish the need for an unscheduled device interrogation. Conclusions: This case presentation highlights the important role of clinical reasoning and the approach to such a patient, especially when a key method of pacemaker evaluation, such as device interrogation, is not readily available. Full article

(This article belongs to the Section Cardiology/Cardiovascular Medicine)

► Show Figures

Figure 1

7 pages, 1735 KiB

Open AccessCase Report

A Case Report of a Child with Constipation Diagnosed with Acquired Myenteric Hypoganglionosis

by Niharika Singh, James Petrancosta, Elizabeth O’Daniel, Samuel Nurko and Kristen Calabro

Reports 2025, 8(3), 108; https://doi.org/10.3390/reports8030108 - 15 Jul 2025

Abstract

Background and Clinical Significance: Acquired myenteric hypoganglionosis is a rare dysmotility disorder that can present in childhood and adulthood, characterized by a reduced number of ganglion cells within Auerbach’s plexus. Due to the rarity of the pathology, few case reports of acquired myenteric [...] Read more.

Background and Clinical Significance: Acquired myenteric hypoganglionosis is a rare dysmotility disorder that can present in childhood and adulthood, characterized by a reduced number of ganglion cells within Auerbach’s plexus. Due to the rarity of the pathology, few case reports of acquired myenteric hypoganglionosis in adolescents have been described. This case report explores the presentation, risk factors, and surgical complications associated with the ultimate diagnosis of myenteric hypoganglionosis. Case Presentation: We present a case of a 12-year-old male with a history of constipation and achalasia, presenting with constipation and abdominal distention, who underwent a colonoscopy, which was converted to an exploratory laparotomy with loop ileostomy creation due to persistent significant abdominal distention. This was complicated by colonic perforation, most likely secondary to stercoral colitis, requiring takeback to the operating room on postoperative day 11 for an exploratory laparotomy with bowel resection and mucous fistula creation. The patient was then referred to Boston Children’s Hospital for motility studies, which revealed poor colonic motility and plans to reassess motility in 1 year. Conclusions: Although rare, it is important to have high clinical suspicion for acquired myenteric hypoganglionosis in children, especially males, with severe constipation. Full article

► Show Figures

Figure 1

8 pages, 5147 KiB

Open AccessCase Report

A 91-Year-Old Female with Recurring Coma Due to Atypical Hyperammonemia

by Manuel Reichert

Reports 2025, 8(3), 107; https://doi.org/10.3390/reports8030107 - 14 Jul 2025

Abstract

Background and clinical significance: Acute reduction in vigilance is a frequent reason for emergency department admissions, especially among the elderly. While intracranial causes or infections with fluid depletion are often responsible, there remain cases where imaging, laboratory tests, and clinical examination fail to [...] Read more.

Background and clinical significance: Acute reduction in vigilance is a frequent reason for emergency department admissions, especially among the elderly. While intracranial causes or infections with fluid depletion are often responsible, there remain cases where imaging, laboratory tests, and clinical examination fail to provide a clear diagnosis. Case presentation: A 91-year-old woman was presented to the emergency department with recurrent episodes of somnolence to deep coma. On admission, her vital signs were stable, and cerebral CT imaging revealed no intracranial pathology. Laboratory analyses, including blood gas measurements, were unremarkable. Empirical treatment for possible intoxications with benzodiazepines or opioids using flumazenil and naloxone had no effect. An Addison’s crisis was considered but excluded following methylprednisolone administration without improvement in consciousness. Eventually, an isolated elevation of serum ammonia was identified as the cause of the reduced vigilance. Further investigation linked the hyperammonemia to abnormal intestinal bacterial colonization, likely due to a prior ureteroenterostomy. There was no evidence of liver dysfunction, thus classifying the condition as non-hepatic hyperammonemia. Therapy was initiated with rifaximin, supported by aggressive laxative regimens. Ammonia levels and vital parameters were closely monitored. The patient’s condition improved gradually, with serum ammonia levels returning to normal and cognitive function fully restored. Conclusions: This case highlights an uncommon cause of coma due to non-hepatic hyperammonemia in the absence of liver disease, emphasizing the diagnostic challenge when standard evaluations are inconclusive. It underscores the need for broad differential thinking in emergency settings and the importance of considering rare metabolic disturbances as potential causes of altered mental status. Full article

► Show Figures

Figure 1

11 pages, 2247 KiB

Open AccessCase Report

Extremely Rare Case of a Giant Paratubal Cyst, Coexisting with a Mucinous Cystadenoma, Surgically Treated Through Laparoscopy—A Case Report and Review of the Literature

by Tudor Andrei Butureanu, Ana-Maria Apetrei, Ioana Pavaleanu, Ana-Maria Haliciu, Razvan Socolov and Raluca Balan

Reports 2025, 8(3), 106; https://doi.org/10.3390/reports8030106 - 14 Jul 2025

Abstract

Background and Clinical Significance: A paratubal cyst, which makes up about 10% of all adnexal masses, is a specific type of adnexal cyst that develops from the mesothelium in the broad ligament located between the fallopian tube and the ovary. Interestingly, the [...] Read more.

Background and Clinical Significance: A paratubal cyst, which makes up about 10% of all adnexal masses, is a specific type of adnexal cyst that develops from the mesothelium in the broad ligament located between the fallopian tube and the ovary. Interestingly, the majority of paratubal cyst cases are initially misidentified as ovarian cysts, with suspicion arising in only 1 out of every 15 patients before undergoing surgery. Case Presentation: We report a case of a giant paratubal cyst mimicking an ovarian cyst in a 21-year-old woman supported by some representative images along with a literature review. The cyst’s therapeutic management was surgical removal of the adnexa and the final postoperative histopathological diagnosis was that of a benign paratubal cyst. Conclusions: This case highlights the need to include a paratubal cyst in the differential diagnosis of pelvic masses, especially in women of reproductive age. To the best of our knowledge, this represents the largest paratubal cyst reported in the literature to date, based on overall dimensions and the highest recorded volume of aspirated fluid, successfully managed via laparoscopy. A further notable aspect of this case is the coexistence of the giant paratubal cyst with an ovarian mucinous cystadenoma. Full article

(This article belongs to the Section Obstetrics/Gynaecology)

► Show Figures

Figure 1

13 pages, 8971 KiB

Open AccessCase Report

The Role of Digital Workflow in Creating a New, Esthetic and Functional Smile in a Periodontally Compromised Patient: A Case Report

by Carlotta Cacciò, Marco Tallarico, Aurea Immacolata Lumbau, Francesco Mattia Ceruso and Milena Pisano

Reports 2025, 8(3), 105; https://doi.org/10.3390/reports8030105 - 8 Jul 2025

Abstract

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in [...] Read more.

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. Case Presentation: This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow—including intraoral scanning, aesthetic previewing, and mandibular motion analysis—was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. Conclusions: At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome. Full article

(This article belongs to the Section Dentistry/Oral Medicine)

► Show Figures

Figure 1

12 pages, 591 KiB

Open AccessArticle

Characterization of Pseudomonas kurunegalensis by Whole-Genome Sequencing from a Clinical Sample: New Challenges in Identification

by David Badenas-Alzugaray, Laura Valour, Alexander Tristancho-Baró, Rossi Núñez-Medina, Ana María Milagro-Beamonte, Carmen Torres-Manrique, Beatriz Gilaberte-Angós, Ana Isabel López-Calleja and Antonio Rezusta-López

Reports 2025, 8(3), 104; https://doi.org/10.3390/reports8030104 - 3 Jul 2025

Abstract

Backgoround: The genus Pseudomonas encompasses metabolically versatile bacteria widely distributed in diverse environments, including clinical settings. Among these, Pseudomonas kurunegalensis is a recently described environmental species with limited clinical characterization. Objective and Methods: In this study, we report the genomic and phenotypic characterization [...] Read more.

Backgoround: The genus Pseudomonas encompasses metabolically versatile bacteria widely distributed in diverse environments, including clinical settings. Among these, Pseudomonas kurunegalensis is a recently described environmental species with limited clinical characterization. Objective and Methods: In this study, we report the genomic and phenotypic characterization of a P. kurunegalensis isolate, Pam1317368, recovered from a catheterized urine sample of a post-renal transplant patient without symptoms of urinary tract infection. Initial identification by MALDI-TOF MS misclassified the isolate as Pseudomonas monteilii. Whole-genome sequencing and average nucleotide identity (ANI) analysis (≥95%) confirmed its identity as P. kurunegalensis. The methodology included genomic DNA extraction, Illumina sequencing, genome assembly, ANI calculation, antimicrobial susceptibility testing, resistance gene identification and phylogenetic analysis. Results: Antimicrobial susceptibility testing revealed multidrug resistance, including carbapenem resistance mediated by the metallo-β-lactamase gene VIM-2. Additional resistance determinants included genes conferring resistance to fluoroquinolones and aminoglycosides. Phylogenetic analysis placed the isolate within the P. kurunegalensis clade, closely related to environmental strains. Conclusions: Although the clinical significance of this finding remains unclear, the presence of clinically relevant resistance genes in an environmental Pseudomonas species isolated from a human sample highlights the value of genomic surveillance and accurate species-level identification in clinical microbiology. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

7 pages, 1272 KiB

Open AccessCase Report

Extraovarian Brenner Tumor in the Vagina: A Case Report and Review of Literature

by Angel Yordanov, Milen Karaivanov, Stoyan Kostov, Vanya Savova and Vasilena Dimitrova

Reports 2025, 8(3), 103; https://doi.org/10.3390/reports8030103 - 29 Jun 2025

Abstract

Background and Clinical Significance: Brenner tumors are rare epithelial tumors that can occur in both males and females. They consist of ovarian transition cells surrounded by dense fibrous tissue and can be classified as benign, borderline, or malignant. While most commonly found in [...] Read more.

Background and Clinical Significance: Brenner tumors are rare epithelial tumors that can occur in both males and females. They consist of ovarian transition cells surrounded by dense fibrous tissue and can be classified as benign, borderline, or malignant. While most commonly found in the ovary, extraovarian Brenner tumors (EOBTs) have been reported in the uterus, vagina, broad ligament, and omentum. Case Presentation: A 71-year-old postmenopausal woman presented with a polypous formation on the upper third of the posterior vaginal wall, which was found at a routine health check. Macroscopically, the lesion appeared as a solid, polypoid mass with a yellowish-gray cut surface, measuring approximately 25 × 20 mm. Histological examination revealed a polypoid formation covered by stratified squamous epithelium, with a dense fibrous stroma (Van Gieson [VG]+) and tubular structures lined by clear epithelial cells. Parenchymal cells showed low proliferative activity, with Ki-67 expression in less than 5% of cells, also Cytokeratin (CK) 7/+/p63:/+/ CK AE1/AE3: /+/ Estrogen Receptor (ER): /+/ and Progesterone Receptor (PR)/−/; CK20/-/; p53/−/, Wilms’ Tumor (WT)-1/−/; Prostate-Specific Acid Phosphatase (PSAP)/−/. The final diagnosis was an extraovarian Brenner tumor. The patient was monitored for two months post-excision, with no signs of recurrence. Conclusions: EOBTs are extremely rarely seen and vaginal involvement is far less common. Due to their rarity, these tumors may be confused with other benign or malignant vaginal lesions. In order to differentiate EOBTs from other neoplasms, histological analysis is crucial due to their characteristic transitional-type epithelium and large fibrous stroma. Further studies are required to understand the origin and clinical behavior of EOBTs. Long-term monitoring should be performed to look for any recurrence or malignant change, even though benign Brenner tumors usually have a good prognosis. Awareness of EOBTs and their possible locations is essential for accurate diagnosis and appropriate management. Full article

(This article belongs to the Section Obstetrics/Gynaecology)

► Show Figures

Figure 1

7 pages, 5073 KiB

Open AccessCase Report

Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note

by Iván N. Camal Ruggieri, Guenther C. Feigl, Gavin W. Britz, Dzmitry Kuzmin and Daniel Staribacher

Reports 2025, 8(3), 102; https://doi.org/10.3390/reports8030102 - 26 Jun 2025

Abstract

Background and Clinical Significance: Traumatic brain injury (TBI) represents a major public health concern due to its profound neurological, psychological, and socioeconomic consequences. Effective management is essential to optimize patient outcomes and reduce healthcare burden. In cases involving extensive bone loss or complex [...] Read more.

Background and Clinical Significance: Traumatic brain injury (TBI) represents a major public health concern due to its profound neurological, psychological, and socioeconomic consequences. Effective management is essential to optimize patient outcomes and reduce healthcare burden. In cases involving extensive bone loss or complex fractures, particularly when decompressive craniectomy (DC) is considered, secondary cranial reconstruction is typically required. However, DC is associated with prolonged hospitalization, multiple surgical interventions, an increased risk of complications, and higher costs. Case Presentation: We present the case of a 59-year-old male involved in a high-energy bicycle accident, sustaining severe craniofacial trauma with multiple midface fractures, a multifragmented left cranial fracture, and a left-sided epidural hematoma with brain compression. Hematoma evacuation and immediate primary reconstruction of the fractured skull using autologous bone were successfully performed, avoiding the need for DC. The patient recovered under intensive care and was transferred to a neurorehabilitation center. Conclusions: Primary reconstruction of large skull fractures using autologous bone should remain the goal, whenever possible, in order to avoid additional costs, risks, and complications. Full article

(This article belongs to the Section Orthopaedics/Rehabilitation/Physical Therapy)

► Show Figures

Figure 1

7 pages, 898 KiB

Open AccessCase Report

Osimertinib-Induced Hepatitis Following Immunotherapy in a Patient with Lung Adenocarcinoma Harboring De Novo EGFR Exon 19 Deletion and T790M Mutations: A Case Report

by Bradley Steiner, Amanda Edmond, Monica Camou, Taylor Praska and Jiaxin Niu

Reports 2025, 8(3), 101; https://doi.org/10.3390/reports8030101 - 26 Jun 2025

Abstract

Background and Clinical Significance: Non-small-cell lung cancer (NSCLC) with EGFR mutations, particularly de novo compound mutations such as exon 19 deletions (Ex19del) with T790M substitutions, present a significant clinical challenge due to resistance to many treatments. While treating these patients, the administration of [...] Read more.

Background and Clinical Significance: Non-small-cell lung cancer (NSCLC) with EGFR mutations, particularly de novo compound mutations such as exon 19 deletions (Ex19del) with T790M substitutions, present a significant clinical challenge due to resistance to many treatments. While treating these patients, the administration of osimertinib, a third-generation EGFR inhibitor, after immunotherapy can lead to unique immune-related adverse events (irAEs), such as pneumonitis and, rarely, hepatitis. Case Presentation: A 36-year-old Filipino woman presented with metastatic NSCLC harboring de novo Ex19del and T790M mutations. Despite initial therapy with carboplatin and paclitaxel, followed by chemoimmunotherapy, the patient’s disease progressed. She subsequently developed severe hepatitis from osimertinib after her prior immunotherapy with pembrolizumab. After the hepatitis resolved with high-dose steroids, osimertinib was switched to afatinib, but her disease rapidly progressed with new metastases. A second attempt at osimertinib rechallenge, with concomitant prednisone, resulted in substantial disease control, including improved leptomeningeal disease (LMD) and no recurrence of hepatitis. Conclusions: This case underscores the feasibility of rechallenging with osimertinib in patients who experience adverse events such as hepatotoxicity, provided that appropriate management strategies, such as steroid therapy, are employed. The successful rechallenge in this case highlights the potential of osimertinib as a viable option in advanced EGFR-mutant NSCLC, even after prior treatment-related complications. Full article

(This article belongs to the Section Oncology)

► Show Figures

Figure 1

9 pages, 1633 KiB

Open AccessCase Report

Case Report of Successful Extracorporeal CPR (eCPR) in Refractory Cardiac Arrest Caused by Fulminant Pulmonary Embolism with Remarkable Recovery

by Lukas Harbaum, Klevis Mihali, Felix Ausbüttel, Bernhard Schieffer and Julian Kreutz

Reports 2025, 8(3), 100; https://doi.org/10.3390/reports8030100 - 25 Jun 2025

Abstract

Background and Clinical Significance: Fulminant pulmonary embolism (PE) leading to an out-of-hospital cardiac arrest (OHCA) is associated with a high mortality rate and cardiopulmonary resuscitation (CPR) frequently failing to achieve return of spontaneous circulation (ROSC). Extracorporeal CPR (eCPR) has emerged as a [...] Read more.

Background and Clinical Significance: Fulminant pulmonary embolism (PE) leading to an out-of-hospital cardiac arrest (OHCA) is associated with a high mortality rate and cardiopulmonary resuscitation (CPR) frequently failing to achieve return of spontaneous circulation (ROSC). Extracorporeal CPR (eCPR) has emerged as a potential life-saving intervention. Case Presentation: A 66-year-old woman suffered an OHCA due to massive PE, presenting with pulseless electrical activity (PEA). After 90 min of pre- and in-hospital CPR without sustained ROSC, venoarterial extracorporeal membrane oxygenation (va-ECMO) was initiated as eCPR upon arrival at the hospital. Even after implantation of the va-ECMO, there was initially a pronounced acidosis (pH 6.9) with a high elevated lactate level (>30 mmol/L); these factors, together with the prolonged low-flow period, indicated a poor prognosis. Further diagnostic tests revealed intracranial hemorrhage (subdural hematoma), and systemic lysis was not possible. With persistent right heart failure, surgical thrombectomy was performed during hospitalization. Intensive multidisciplinary management finally led to successful therapy and weaning from mechanical ventilation, as well as to complete neurological recovery (CPC-Score 1-2). Conclusions: This case illustrates that eCPR can facilitate survival with good favorable neurological outcomes despite initially poor prognostic predictors. It underscores the importance of refining patient selection criteria and optimizing management strategies for eCPR in refractory cardiac arrest secondary to PE. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

► Show Figures

Figure 1

Journal Description

Reports

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI