World Journal of Clinical Cases

Our medical research library holds 11 studies published in World Journal of Clinical Cases (2019–2025). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 11 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Baishideng Publishing Group
• Published: 2013 to the present, United States
• Language: English
• ISSN: 2307-8960 (electronic)
• Its record in the NLM Catalog

2020s

• Early pleuroparenchymal fibroelastosis mimicking lung malignancy: A case report. H.S. Jung, H.J. Kim, K.W. Kim. 2025;13(32):111879. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Pleuroparenchymal fibroelastosis (PPFE) is a rare form of interstitial lung disease affecting the upper lobes. Its atypical radiological appearance frequently mimics lung malignancy, complicating early diagnosis. This case highlighted the importance of histopathological confirmation to differentiate PPFE from malignant lesions.

  Case Summary: A 62-year-old male with a significant smoking history presented with progressive dyspnea and a chronic nonproductive cough. High-resolution computed tomography revealed a localized fibrotic lesion in the left upper lobe with apical pleural thickening and subpleural consolidation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed moderate hypermetabolism (maximum standardized uptake value of 3.2), potentially indicating malignancy. Pulmonary function testing was deferred due to concurrent pneumothorax. The patient underwent video-assisted thoracoscopic surgery with segmental lung resection and talc pleurodesis. Histopathology confirmed dense fibroelastosis with abundant elastin deposition, minimal inflammation, and no evidence of malignancy. Differential diagnoses, including apical cap, chronic hypersensitivity pneumonitis, granulomatous infections, and asbestos-related disease were systematically excluded. Therefore, he was diagnosed with PPFE. Antifibrotic therapy with nintedanib was initiated postoperatively. At the 26-month follow-up, imaging and pulmonary function testing demonstrated stable disease with no recurrence of pneumothorax or functional decline.

  Conclusion: Histopathology is essential for distinguishing PPFE from malignancy. Early diagnosis allows individualized therapy to slow progression.

  ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.

• Positron emission tomography/computed tomography in risk-factor-negative young female with malignant pleural mesothelioma: A case report and review of literature. A. Aisikaer, M.M. Sun, J. Shen. 2025;13(32):110897. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant pleural mesothelioma (MPM), a rare aggressive malignancy, is primarily caused by asbestos exposure. MPM typically affects older adults (median age, 76 years), is uncommon in those under age 50 years and shows male predominance. Based on the American Society of Clinical Oncology guidelines, F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) is essential for initial MPM staging. Integrating quantitative FDG metabolic data with computed tomography (CT) anatomy optimizes biopsy accuracy and staging.

  Case Summary: A 21-year-old female college student presented with fever (peak 38.4 °C), cough, and white mucoid sputum after cold exposure. Initial evaluation revealed elevated C-reactive protein [C-reactive protein (CRP); 65.52 mg/L] and Mycoplasma pneumoniae IgM. Despite resolution of fever following a 14-day moxifloxacin regimen, persistent cough prompted chest CT, which demonstrated left pleural mass-like thickenings. Levofloxacin therapy for 2 weeks failed to alleviate symptoms, accompanied by 2.5-kg weight loss over 1 month. Re-evaluation showed rising CRP (88.87 mg/L) with stable CT lesions, and negative T-cell spot test for tuberculosis and tumor markers. Contrast-enhanced CT revealed heterogeneously enhancing masses, while PET/CT detected two broad-based pleural lesions with intense FDG avidity. CT-guided biopsy confirmed epithelioid MPM. Thoracoscopy exposed diffuse fragile, hemorrhagic nodules implanting on diaphragmatic and parietal pleura, confirming metastatic MPM with partial resection performed. This presentation challenges conventional imaging paradigms of MPM, underscoring its diagnostic complexity.

  Conclusion: MPM should still be considered an important differential diagnosis in young patients presenting with solitary pleural masses and no history of typical asbestos exposure. F-18 FDG PET/CT, while serving as an essential component of initial staging for MPM, has some inherent limitations.

  ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.

• Malignant pleural mesothelioma mimics thoracic empyema: A case report. Y.H. Yao, Y.S. Kuo. 2023;11(35):8372-8378. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Thoracic empyema and malignant pleural mesothelioma (MPM) are distinct medical conditions with similar symptoms, including cough, chest pain, and breathing difficulty. We present a rare MPM case mimicking thoracic empyema. Physicians must consider MPM risks for patients exposed to building material who exhibit lobulated pleural effusions, indicating thoracic empyema.

  Case Summary: A 68-year-old retired male construction worker suffered from shortness of breath and chest tightness over 10 d, particularly during physical activity. A poor appetite and 4 kg weight loss over the past 3 wk were also reported. Chest images and laboratory data concluded a tentative impression of empyema thoracis (right). Video-assisted thoracic surgery with decortication and delobulation (right) was conducted. The pathological report yielded an MPM diagnosis. Refractory pleural bilateral effusions and respiratory failure developed postoperatively, and the patient died three weeks after the operation.

  Conclusion: Thoracic empyema and MPM are distinct medical conditions that can present similar symptoms, and video-assisted thoracic surgery facilitates an accurate diagnosis. Empyema-mimicking presentations and postoperative refractory pleural effusion may indicate a poor MPM outcome.

  ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

• Zimberelimab plus chemotherapy as the first-line treatment of malignant peritoneal mesothelioma: A case report and review of literature. X.D. Peng, Z.Y. You, L.X. He, et al. 2023;11(22):5296-5302. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant peritoneal mesothelioma (MPeM) is a rare cancer with a poor prognosis at advanced stage, and the standard first-line treatment for inoperable patients is chemotherapy. Although combining programmed cell death 1 (PD-1) inhibitors with chemotherapy is generally considered safe and effective in several malignant solid tumors, there are few reports regarding initial immunochemotherapy in advanced MPeM.

  Case Summary: Here, to our knowledge, we present the first case of a patient with epithelioid subtype MPeM, who was treatment-naïve and benefited from initial PD-1 inhibitor plus standard chemotherapy with a prolonged progression-free survival (PFS) and good tolerance. A 49-year-old man was admitted to our hospital for a persistent burning sensation in the abdomen. Computed tomography revealed a solid mass in the lower abdomen, which was subsequently diagnosed histologically as epithelioid subtype MPeM by core needle biopsy. The patient received eight cycles of pemetrexed 800 mg (day 1), cisplatin 60/50 mg (day 1-2), and zimberelimab (PD-1 inhibitor) 240 mg (day 1) every 3 wk. He achieved significant reduction of peritoneal tumors with remarkable improvement in symptoms. The best tumor response was partial remission with a final PFS of 7 mo. No immune-related adverse event occurred during the combination treatment.

  Conclusion: The outcome of the present case demonstrates the promising anti-tumor activity of immunochemotherapy to treat inoperable MPeM in the future.

  ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

• Concurrent alcoholic cirrhosis and malignant peritoneal mesothelioma in a patient: A case report. L. Liu, X.Y. Zhu, W.J. Zong, et al. 2022;10(19):6716-6721. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant peritoneal mesothelioma (MPM) originates from the mesothelial and subcutaneous cells of the abdominal cavity. Its diagnose is difficult due to its nonspecific and vague symptoms, and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers. Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases. To the best of our knowledge, no case of MPM concurrent with alcoholic cirrhosis has been reported.

  Case Summary: A 63-year-old man presented to our hospital with abdominal distension for 20days. He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure. After treatment for alcoholic cirrhosis in a community hospital, his symptoms did not improve significantly. The patient underwent exploratory laparotomy and surgical resection. Pathologic examination showed an epithelioid MPM. He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery. Currently, he is in a stable condition and tumor recurrence has not occurred.

  Conclusion: Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset. Therefore, there is a need to understand. MPM in clinical practice, make the correct diagnosis, and provide timely and effective treatment.

  ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

• Immunotherapy combined with antiangiogenic agents in patients with advanced malignant pleural mesothelioma: A case report. T.T. Xuan, G.Y. Li, S.B. Meng, et al. 2022;10(23):8284-8290. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant pleural mesothelioma has limited therapeutic options and a poor outcome. Antiangiogenic agents might increase the efficacy of immunotherapy as second-line treatment of advanced-stage malignancies.

  Case Summary: A patient with stage IIIB pleural mesothelioma received second-line treatment with a combination of pembrolizumab, bevacizumab and chemotherapy following standard chemotherapy under the guidance of second-generation sequencing. He achieved a partial response after four cycles of treatment with progression-free survival of 5 mo. Pembrolizumab was suspended due to grade 2 immunerelated pneumonia, which was resolved by oral glucocorticoids. However, disease progression was observed after immunotherapy rechallenge and anlotinib therapy. The patient had disease progression, multiorgan dysfuntion and died suddenly in October 2019.

  Conclusion: The combination of immune checkpoint inhibitor, anti-angiogenic agents and chemotherapy showed effective response for advanced pleural mesothelioma, but with adverse reactions.

  ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

• Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report. X. Huang, Y. Hong, S.Y. Xie, et al. 2022;10(28):10317-10325. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, which is extremely difficult to diagnose. Herein, we reported a case of MPM in the abdominal cavity with massive short-term ascites as the first symptom.

  Case Summary: A 65-year-old woman presented to the hospital with abdominal pain, distention, and shortness of breath that persisted for 15 d. The serum CA-125 level was 1075 U/mL. The abdominal computed tomography showed massive ascites and no obvious tumor lesions. The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures. The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2 (-), WT-1 (-), Ki-67 (about 10% +), CEA (-), Glut-1 (+++), desmin (-), PD-L1 (-), and CDKN2A (P16). The final diagnosis was MPM. The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy. In the second cycle, she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites. She died of disease progression 2 mo after diagnosis.

  Conclusion: In case of massive unexplained ascites, the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.

  ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

• Primary malignant pericardial mesothelioma with difficult antemortem diagnosis: A case report. N. Oka, Y. Orita, C. Oshita, et al. 2022;10(33):12380-12387. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Primary malignant pericardial mesothelioma (PMPM) is an extremely rare malignant tumor, and it is difficult to diagnose definitively before death. We present a case in which PMPM was diagnosed at autopsy. We consider this case to be highly suggestive and report it here.

  Case Summary: A 78-year-old male presented with transient loss of consciousness and falls. The transient loss of consciousness was considered to result from complications of diastolic dysfunction due to pericardial disease, fever with dehydration, and paroxysmal atrial fibrillation. Ultrasound cardiography (UCG) and computed tomography showed cardiac enlargement and high-density pericardial effusion. We considered pericardial disease to be the main pathogenesis of this case. Cardiac magnetic resonance imaging and gadolinium contrast-enhanced T1-weighted images showed thick staining inside and outside the pericardium. Pericardial biopsy was considered to establish a definitive diagnosis, but the patient and his family refused further treatment and examinations, and the patient was followed conservatively. We noticed a thickening of the pericardium and massive changes in the pericardium on UCG over time. We performed an autopsy 60 h after the patient died of pneumonia. Giemsa staining of the autopsy tissue showed an epithelial-like arrangement in the pericardial tumor, and immunostaining showed positive and negative factors for the diagnosis of PMPM. Based on these findings, the final diagnosis of PMPM was made.

  Conclusion: PMPM has a poor prognosis, and early diagnosis and treatment are important. The temporal echocardiographic findings may provide a clue for the diagnosis of PMPM.

  ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

• Primary malignant peritoneal mesothelioma mimicking tuberculous peritonitis: A case report. L.C. Lin, W.Y. Kuan, B.H. Shiu, et al. 2022;10(10):3156-3163. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant peritoneal mesothelioma (MPM) is a rare malignancy arising in mesothelial cells in the peritoneum. It can be mistaken for many other diseases, such as peritoneal carcinomatosis and tuberculous peritonitis (TBP), because its clinical manifestations are often nonspecific. Therefore, the diagnosis of MPM is often challenging and delayed.

  Case Summary: A 42-year-old man was referred to our hospital with lower abdominal pain for 1 wk and ascites observed under abdominal sonography. His laboratory findings revealed an isolated elevated tumor marker of carcinoma antigen 125 (167.4 U/mL; normal, < 35 U/mL), and contrast enhanced computed tomography showed peritoneal thickening. Thus, differential diagnoses of TBP, carcinomatosis of an unknown nature, and primary peritoneal malignancy were considered. After both esophagogastroduodenoscopy and colonoscopy produced negative findings, laparoscopic intervention was performed. The histopathological results revealed mesothelioma invasion into soft tissue composed of a papillary, tubular, single-cell arrangement of epithelioid cells. In addition, immunohistochemical staining was positive for mesothelioma markers and negative for adenocarcinoma markers. Based on the above findings, TBP was excluded, and the patient was diagnosed with MPM.

  Conclusion: It is important to distinguish MPM from TBP because they have similar symptoms and blood test findings.

  ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

• Clinical characteristics and survival of patients with normal-sized ovarian carcinoma syndrome: Retrospective analysis of a single institution 10-year experiment. N. Yu, X. Li, B. Yang, et al. 2020;8(21):5116-5127. PubMed · Publisher · Free full text

  Abstract

  Background: Normal size ovarian cancer syndrome (NOCS) is a challenge for clinicians regarding timely diagnosis and management due to atypical clinical and imaging features. It is extremely rare with only a few cases reported in the literature. More data are needed to clarify its biological behavior and compare the differences with abnormal size ovarian cancer.

  Aim: To assess the clinical and pathological features of NOCS patients treated in our institution in the last 10 years and to explore risk factors for relapse and survival.

  Methods: Patients who were pathologically diagnosed with NOCS between 2008 and 2018 were included. Papillary serous ovarian carcinoma (PSOC) patients were initially randomly recruited as the control group. Demographics, tumor characteristics, treatment procedures, and clinical follow-up were retrospectively collected. Risk factors for progression-free survival and overall survival were assessed.

  Results: A total of 110 NOCS patients were included; 80 (72.7%) had primary adnexal carcinoma, two (1.8%) had mesotheliomas, 18 (16.4%) had extraovarian peritoneal serous papillary carcinoma, and eight (7.3%) had metastatic tumors. Carbohydrate antigen (CA)125 and ascites quantity were lower in the NOCS cohort than in the PSOC group. The only statistically significant risk factors for worse overall survival (P < 0.05) were the levels of CA199 and having fewer than six chemotherapy cycles. The 1-year, 3-year, and 5-year survival rates were 75.5%, 27.7%, and 13.8%, respectively.

  Conclusion: The clinical symptoms of the NOCS group are atypical, and the misdiagnosis rate is high. Ascites cytology and laparoscopic exploration are valuable in the early diagnosis to avoid a misdiagnosis. The level of CA199 is the most important predictor of overall survival, and more than six cycles of chemotherapy contributes to the increased survival rates of NOCS patients.

  ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

2010s

• In-vitro proliferation assay with recycled ascitic cancer cells in malignant pleural mesothelioma: A case report. T. Anayama, M. Taguchi, T. Tatenuma, et al. 2019;7(23):4036-4043. Case report PubMed · Publisher · Free full text

  Abstract

  Background: We report the first case, to the best of our knowledge, of massive ascites due to recurrent malignant pleural mesothelioma that was controlled using KM-cell-free and concentrated ascites reinfusion therapy (KM-CART). The tumor cells derived via KM-CART were utilized secondarily in an in vitro cell growth assay using the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to investigate anticancer drug susceptibility.

  Case Summary: A 56-year-old man presented with recurrent malignant mesothelioma with massive ascites; more than 4000 mL of ascitic fluid was removed, filtered, and concentrated using KM-CART, and the cell-free ascitic fluid was reinfused into the patient to improve quality of life. Cancer cells isolated secondarily in an in vitro proliferation assay using CD-DST exhibited low sensitivity to pemetrexed and high sensitivity to gemcitabine. Treatment with gemcitabine maintained stable disease for 4 mo.

  Conclusion: The combination of KM-CART and CD-DST may be a promising treatment option for malignant ascites associated with malignant mesothelioma.

  ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

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