Moderated Poster Discussions - Case Reports

Monday, April 13, 2026
4:30 pm - 6:15 pm

Case Report: An article that describes and interprets an individual case, often written as a detailed story. This may include unique cases that cannot be explained by known diseases or syndromes; cases that show an important variation of a disease or condition; cases that show unexpected events that may yield new or useful information; cases in which one patient has two or more unexpected diseases or disorders.

BEYOND THE LIVER: MYOCARDIAL INFARCTION MIMICKING SPONTANEOUS CORONARY ARTERY DISSECTION (SCAD) IN YOUNG FEMALE WITH AUTOIMMUNE HEPATITIS (Cardiology / Cardiovascular Disease)
Solomon Ayua, MD, Englewood Hospital and Medical Center, Englewood, New Jersey
Myocardial infarction (MI) remains a leading cause of mortality in the United States, with rising incidence among younger adults (1). Systemic autoimmune diseases increase cardiovascular risk through chronic inflammation, endothelial dysfunction and prothrombotic states (2). Although autoimmune hepatitis (AIH) is traditionally considered organ-specific, systemic inflammatory activity may promote accelerated atherosclerosis and thrombosis. Acute coronary syndromes in AIH are rarely reported and underlying mechanisms remain poorly defined (3).
 

SILENT CULPRIT; HASHIMOTO'S THYROIDITIS PRESENTING WITH PERICARDIAL EFFUSION- AN OVERLOOKED ASSOCIATION (Cardiology / Cardiovascular Disease)
Solomon Ayua, MD, Englewood Hospital and Medical Center, Englewood, New Jersey
Hashimoto's thyroiditis affects approximately 1-2% of the U.S. population. While hypothyroidism affects multiple organ systems, cardiovascular manifestations are often subtle. A recognized but uncommon complication of severe hypothyroidism is pericardial effusion, resulting from increased capillary permeability, reduced lymphatic drainage and altered protein and salt handling (1). Although pericardial fluid may accumulate in up to one-third of patients with marked hypothyroidism, progression to tamponade physiology is rare and potentially life threatening if unrecognized (2,3).
 

INFECTIVE ENDOCARDITIS INVOLVING THE MITRAL VALVE CHORDAE IN A YOUNG WOMAN WITH TYPE 1 DIABETES MELLITUS (Cardiology / Cardiovascular Disease)
Hossam Abdel Aziz, MD, Insight Hospital and Medical Center Chicago
Heyde’s syndrome is a rare but important clinical triad linking aortic stenosis (AS), gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease (vWD) (1,2,5). Although transcatheter aortic valve replacement (TAVR) can reverse the hematologic abnormality, recurrent bleeding may persist in nearly half of patients (6). We present a case of refractory anemia due to recurrent gastrointestinal bleeding following TAVR, highlighting the need to recognize persistent Heyde’s physiology even after valve replacement.
 

ACUTE ISCHEMIC STROKE IN PATIENT PENDING STEMI TREATMENT (Cardiology / Cardiovascular Disease)
Ayra Ali, University of Missouri - Kansas City School of Medicine
Acute ischemic stroke is condition that rarely arises in the setting of an acute myocardial infarction, with the highest risk of stroke development being within 5 days of presentation. This risk has been noted to be more elevated in the setting of atrial fibrillation, ST-elevations, and history of a previous stroke1. Management of this these coexisting conditions is dependent on risk-stratification, as well as collaboration between the multidisciplinary healthcare team. We present the case of a patient with acute ST-elevation MI (STEMI) who presented with focal neurologic deficits while awaiting their cardiac workup.
 

MANAGEMENT OF GIANT CORONARY ANEURYSM IN THE SETTING OF AORTIC AND RIGHT ILIAC ARTERY ANEURYSMS (Cardiology / Cardiovascular Disease)
Ayra Ali, University of Missouri - Kansas City School of Medicine
A giant coronary aneurysm is defined as the dilation of a coronary artery which exceeds the diameter of the patient’s largest coronary vessel by a factor of 4.  Coronary aneurysms are associated with multiple complications, such as myocardial infarction, cardiac arrythmias, and sudden cardiac death. As a result, this condition must be treated promptly, especially with concomitant conditions. We present the case of a patient with a giant right coronary aneurysm diagnosed in the setting of aortic and right common iliac aneurysms.
 

REFRACTORY VENTRICULAR FIBRILLATION (VF) DURING SURGICAL AORTIC VALVE REPLACEMENT (SAVR) - WHEN NOTHING WORKS (Cardiology / Cardiovascular Disease)    Mercedes Garman, Des Moines University
Refractory ventricular fibrillation (VF) during surgical aortic valve replacement (SAVR) despite multiple defibrillation and antiarrhythmic therapy is rare. We describe a case of a 56-year-old male with symptomatic severe bicuspid aortic stenosis with the left ventricular ejection fraction of 65% and normal coronaries who was undergoing SAVR.   
 

VASCULARIZED CHEST MASS IN LEFT ATRIUM SUPPLIED BY CORONARY ARTERIES (Cardiology / Cardiovascular Disease)   
Kunal Gupta, BA, Saint Luke's Health System
Cardiac tumors that are vascularized and supplied through coronary artery perfusion are rare. Due to the vascular nature of these masses, they pose significant diagnostic and surgical implications.   
 

CLINICALLY SIGNIFICANT BRADYCARDIA DUE TO INTERDEVICE COMMUNICATION FAILURE IN DUAL LEADLESS PACEMAKERS (Cardiology / Cardiovascular Disease)
Kunal Gupta, BA, Saint Luke's Health System
Leadless pacemakers offer an alternative to transvenous pacing systems by reducing lead- and pocket-related complications. In select patients, dual leadless pacemakers may be implanted to achieve atrioventricular synchrony. However, limited experience with dual leadless pacemakers makes failure of interdevice communication a unique diagnostic and management challenge.
 

BASAL AND APICAL HYPOKINESIS WITH PRESERVED MID-VENTRICULAR FUNCTION: AN UNUSUAL PRESENTATION OF STRESS CARDIOMYOPATHY PATTERN (Cardiology / Cardiovascular Disease)
Kirtan Joshi, MD, University of Missouri-Columbia
Stress-induced cardiomyopathy (SCM), or Takotsubo syndrome, typically presents with transient left ventricular (LV) dysfunction characterized by apical akinesis, mid-ventricular hypokinesis, and basal hyperkinesis–often extending beyond a single coronary artery territory. We present a rare and unusual variant in a young female patient, demonstrating basal and apical hypokinesis with sparing of the mid-left ventricular segments.   
 

NICOLAU SYNDROME: A RARE ENTITY WITH SIGNIFICANT CLINICAL IMPLICATIONS (Dermatology)
Karla  Navarro, BA, Michigan State University
Nicolau syndrome, also referred to as embolia cutis medicamentosa, is a rare but potentially severe cutaneous adverse reaction following intramuscular, subcutaneous, or, less commonly, intravenous drug injections. First described in 1925, the syndrome is characterized by acute pain at the injection site, followed by livedoid discoloration, hemorrhagic plaques, and eventual tissue necrosis (Kim & Chae, 2015). The exact pathogenesis remains unclear, but proposed mechanisms include accidental intra-arterial injection, vascular embolization, vasospasm, and direct cytotoxicity (Nischal et al., 2009). This syndrome has been most associated with intramuscular injections of benzathine penicillin and NSAIDs, particularly diclofenac (Verma et al., 2024). However, a growing body of literature has identified subcutaneous medications such as glatiramer acetate; a disease-modifying treatment for multiple sclerosis; as potential triggers (Babaesfahani et al., 2024). Although rare, such reactions can lead to significant morbidity if misdiagnosed or inadequately managed. We present a case of Nicolau syndrome in a woman with multiple sclerosis who developed painful necrotic plaques following the administration of glatiramer acetate, a drug she had previously tolerated for years without adverse effects. This case emphasizes the need for clinician awareness of this syndrome and highlights its potential to arise even after long-term exposure to a medication.
    

WEGOVY AND THE HIDDEN DANGER: A CASE OF EUGLYCEMIC DKA IN TYPE 1 DIABETES (Diagnosis or Treatment of a Disease Process or Clinical Syndromes)
Hossam Abdel Aziz, MD, Insight Hospital and Medical Center Chicago
Euglycemic Diabetic Ketoacidosis (euDKA) is a rare but potentially life-threatening condition characterized by metabolic acidosis, ketonemia, and normal or mildly elevated blood glucose levels. It is an under-recognized complication in patients with type 1 diabetes mellitus (T1DM) using GLP-1 receptor agonists, such as semaglutide (Wegovy), which are not FDA-approved for this population.
 

TARGETED THERAPY IN METASTATIC ADENOID CYSTIC (BASAL CELL) CARCNINOMA OF THE PROSTATE: A CASE REPORT AND ANALYSIS OF GENOMIC LANDSCAPE (Hematology and Oncology / Bone Marrow Transplant)
Brittani Lubeck, MD, University of Nebraska Medical Center
Prostatic adenoid cystic (basal cell) carcinoma is a rare diagnosis with under 200 cases reported in the literature.  Chemotherapy has a role in initial management in advanced disease, however, optimal management strategies for maintenance or subsequent line therapy are not defined.  Specifically, whether early targeted therapy based upon commonly altered pathways provides optimal palliation is unknown.  The majority of reports describing possible driver mutations involve non-metastatic or indolent cases, focusing on tissue-based protein expression markers (e.g. HER2, PTEN, EGFR, MYB-NFIB, or MYB) with poor correlation between treatment outcome and expression2,3,4,5.  Nonetheless, investigation into targeted therapy remains at the forefront of viable treatment options3. Of the larger investigational studies, none have focused on mutational landscape in advanced disease.  Herein we describe a case of advanced adenoid cystic (basal cell) carcinoma of the prostate with successful targeted therapy personalized to identified tumor alterations and further analyze the current understood genomic landscape for this disease.   
 

BEYOND THE BONE: ADAMANTINOMA WITH ULTRA-RARE METASTASES (Hematology and Oncology / Bone Marrow Transplant)
Bailey Riehl, University of North Dakota
Adamantinoma is an extremely rare primary bone malignancy typically arising in the tibia. It accounts for < 0.4% of primary bone tumors [2], with only 12-29% of those metastasizing.[4] Recurrence and metastasis commonly occur several years after surgical resection of the primary tumor. While the lungs are the most common site of spread, often presenting as pleural effusions or nodules, metastasis more rarely occurs in the lymph nodes and spine. [2] Currently, there is no established treatment for metastatic disease. [3,6]   
 

COMPLEMENT-MEDIATED MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS ASSOCIATED WITH SPLENIC MARGINAL ZONE LYMPHOMA: A RARE CAUSE OF PROGRESSIVE KIDNEY FAILURE (Hematology and Oncology / Bone Marrow Transplant)
Mohammed Abdalkarim, MD, The University of Toledo
Renal involvement in splenic marginal zone lymphoma (SMZL) is uncommon and typically reflects lymphomatous infiltration or immune complex—mediated injury. However, dysregulation of the complement pathway secondary to B-cell clonal activity is rarely recognized as a mechanism of glomerular disease in SMZL. We describe a patient with SMZL who developed rapidly progressive renal dysfunction due to complement-mediated membranoproliferative glomerulonephritis (MPGN), highlighting a rare paraneoplastic complementopathy. 
 

REFRACTORY ANTIPHOSPHOLIPID SYNDROME PRESENTING AS SPLENIC INFARCTION AND MESENTERIC MASS: UNCOVERING OCCULT LYMPHOPROLIFERATIVE DISEASE (Hematology and Oncology / Bone Marrow Transplant)
Thaer Alhroob, MD, The University of Toledo Medical Center
Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder defined by venous or arterial thrombosis or pregnancy morbidity in the presence of antiphospholipid antibodies, including anticardiolipin, lupus anticoagulant, and anti-β2-glycoprotein I. APS may be primary or secondary to systemic autoimmune disease, infection, medications, or malignancy. Late-onset or refractory APS with progressive thrombosis despite appropriate anticoagulation should prompt evaluation for secondary drivers, particularly lymphoproliferative disorders. We describe a patient with refractory APS presenting with splenic infarction and a new mesenteric mass, ultimately diagnosed with splenic marginal zone lymphoma (SMZL) as the underlying cause of hypercoagulability.
 

A MYXEDEMA MYSTERY UNRAVELED: HYPOTHRYROIDISM AND PERNICIOUS ANEMIA CONVERGE TO UNLEASH A VITAMIN B12 DEFICIENCY STORM (Hematology and Oncology / Bone Marrow Transplant)
Farwah Shah, MD, MPH, Insight Hospital and Medical Center Chicago
Severe hypothyroidism is a multisystem disorder with cardiovascular, hematologic, and neurological manifestations. Cardiovascular complications include pericardial effusion, which may develop gradually and rarely progress to cardiac tamponade. Hematologic abnormalities are common, particularly iron deficiency and vitamin B12 deficiency, both of which can worsen thyroid hormone synthesis and exacerbate autoimmune processes. Vitamin B12 deficiency from pernicious anemia may further amplify neurological and hematologic dysfunction, and serum B12 can appear falsely elevated due to assay interference from anti—intrinsic factor antibodies. We present a case of severe hypothyroidism progressing to myxedema coma due to medication non-adherence, complicated by pericardial effusion, pancytopenia, and worsening neuropathy.
 

DISSEMINATED MYCOBACTERIUM CHIMAERA INFECTION PRESENTING AS MULTISYSTEM GRANULOMATOUS DISEASE (Infectious Disease / Immunization)
Sneha Kandalgaonkar, Rutgers University
Sarcoidosis is a non-caseating granulomatous disease of unclear etiology most commonly affecting the lungs, but can involve any organ system. Formal diagnosis requires biopsy and histopathological identification of non-necrotizing granulomas and exclusion of infectious causes.
 

VACTERL MEETS DRTA: A RARE COLLISION OF CONGENITAL COMPLEXITY AND  REFRACTORY HYPOKALEMIA (Nephrology)
Farwah Shah, MD, MPH, Insight Hospital and Medical Center Chicago
VACTERL association is a rare, multisystem congenital condition characterized by vertebral, anorectal, cardiac, tracheoesophageal, renal, and limb anomalies. Renal manifestations are diverse and can include distal renal tubular acidosis (dRTA), a disorder of impaired urinary acidification that predisposes patients to nephrolithiasis, recurrent infections, and severe electrolyte derangements. The combination of VACTERL association with dRTA and recurrent life-threatening hypokalemia is exceptionally uncommon and presents unique management challenges.
 

IMMUNOTHERAPY IN METASTATIC BRAIN TUMORS: MECHANISMS, CHALLENGES, AND OPPORTUNITIES FOR NEUROSURGICAL INTEGRATION: A 10-YEAR NARRATIVE REVIEW (Neurology)
Saneh Kaur, BS, Michigan State University College of Human Medicine
Brain metastases are the most common intracranial malignancy in adults and remain a major cause of morbidity and mortality despite advances in microsurgery, stereotactic radiosurgery, and radiotherapy. Immune checkpoint inhibitors targeting PD-1/PD-L1 and CTLA-4 have transformed systemic oncology and are now demonstrating clinically meaningful intracranial activity in selected patients with melanoma, non—small cell lung cancer, and renal cell carcinoma. Concurrently, the central nervous system is no longer viewed as strictly immune-privileged but rather as an immune-specialized compartment with dynamic lymphatic drainage, heterogeneous blood—brain and blood—tumor barriers, and a distinct tumor immune microenvironment. This narrative review synthesizes mechanistic, translational, and clinical evidence from the past decade to examine how immunotherapy is reshaping the management of metastatic brain tumors and the evolving role of neurosurgeons in precision neuro-immuno-oncology.
 

A RARE CASE OF DURAL VENOUS SINUS THROMBOSIS (Neurology)
Fong Bell, MD, Ascension St. Vincent Hospital (Evansville)
Dural Venous Sinus Thrombosis is a specific type of Cerebral Venous Thrombosis (CVT). CVT is a rare form of stroke, accounting for about 0.5% to 3% of all strokes [1]. Among signs and symptoms, headaches are the most common symptoms noticeable in about 90% of cases [2]. In about 25% of patients, headaches are the only reported symptom [2]. Visual impression of CVT with non-contrast Computed Tomography (CT) imaging sensitivity can range from 41% to 73% [3]. CVT has up to 50% mortality rate if left untreated, yet it drops to 10% if treated and is non-septic, 30% if is septic [4]. Current guidelines recommend starting treatment with subcutaneous low molecular weight heparin with subsequent transition to oral anticoagulation with either direct oral anticoagulants or warfarin [1].
 

NOVEL TSC2 MUTATION IN ADVANCED PROSTATE CANCER (Pathophysiology / Pathology)
Julia Yu, OMS III, Lake Erie College of Osteopathic Medicine
Prostate cancer (PCa) is the most common malignancy among men in the United States, with estimated 313,780 new diagnoses and 35,770 deaths in 2025. Approximately 8% present with advanced disease, which carries a 5-year survival rate of 38% [1], highlighting the need for improved treatments. Dysregulation of the mammalian target of rapamycin complex 1 (mTORC1) pathway contributes to various cancers. The tumor suppressor genes tuberous sclerosis complex (TSC) are critical upstream regulators of mTORC1 activity and observed in an estimated 4% of genitourinary (GU) cancers. [2]
We will discuss a case of metastatic PCa positive for a novel mutation in the TSC2 gene that may benefit from targeted therapy via mTOR inhibition.
 

REVERSIBLE PRECAPILLARY PULMONARY HYPERTENSION SECONDARY TO WHIPPLES DISEASE RAPID HEMODYNAMIC RECOVERY (Pulmonary / Critical Care)
Thaer Alhroob, MD, The University of Toledo Medical Center
Whipple's disease is a rare chronic systemic infection caused by Tropheryma whipplei. Pulmonary hypertension is an exceptionally rare manifestation classified within WHO Group 5 due to mixed or multifactorial mechanisms. Recognition of this reversible infectious cause is critical because targeted antimicrobial therapy may restore normal pulmonary vascular physiology.
 

ILLNESS BORN OF UNFIT LIVING: SEVERE LEPTOSPIROSIS WITH DIFFUSE ALVEOLAR HEMORRHAGE (WEIL'S DISEASE) (Pulmonary / Critical Care)
Jihun Hwang, MD, University of Cincinnati College of Medicine
Community-acquired pneumonia (CAP) is one of the major causes of hospitalizations among adults in the U.S., resulting from a complex interaction of infectious agents, including bacterial, viral, fungal, and mycobacterial organisms. ¹ ² Compared to common bacterial or viral pathogens ¹, less common organisms can create diagnostic challenges and impact disease severity. Leptospirosis is an infection caused by species of the genus Leptospira, a group of spirochete bacteria that can infect humans through direct or indirect contact with environments contaminated by the urine of infected animals. ³ ⁴ Leptospirosis can affect the lungs with various severities, from mild respiratory symptoms to serious complications, including diffuse alveolar hemorrhage (DAH) and acute respiratory distress syndrome. ⁵ ⁶
 

STRONGYLOIDES PNEUMONIA WITH PSEUDOMONAS AND ENTEROCOCCUS BACTEREMIA IN PATIENT WITH MALNUTRITION AFTER COMPLEX GASTROINTESTINAL ANATOMY (Pulmonary / Critical Care)
Ziyi Liu, MD, University of Cincinnati
Strongyloidiasis is caused by Strongyloides stercoralis. Immunocompetent populations are often asymptomatic, whereas immunocompromised patients are at risk of developing hyperinfection syndrome, during which larvae penetrate the intestinal mucosa and disseminate to other organs. Strongyloides has been endemic in Appalachia and the American South. Hospitalization related to strongyloidiasis remains rare1. Here, we present a case of Strongyloides pneumonia with enteric bacteremia in a patient with malnutrition and complex postoperative gastrointestinal anatomy.
 

MORE THAN A STONE: A COMPLEX CASE OF MIRIZZI SYNDROME WITH POSTOPERATIVE BILIARY LEAK (Surgery)
Patricia Martin, Burrell College of Osteopathic Medicine
Mirizzi Syndrome is a rare complication of gallstone disease caused by impaction of a stone in the cystic duct or gallbladder infundibulum, leading to extrinsic compression of the common hepatic duct. Because of its rarity and common symptom overlap, diagnoses are often not made until surgery. Patients typically present with obstructive jaundice, possible acute cholangitis, and cholestatic liver enzyme elevation. Severe local inflammation and distorted anatomy increase the risk of intraoperative complications and often necessitates subtotal cholecystectomy, which carries a higher risk of postoperative bile leak. This report presents a case of Mirizzi syndrome complicated by acute cholecystitis, indiscernible intraoperative anatomy requiring subtotal cholecystectomy, persistent high-output bile leak, and eventual need for Roux-en-Y hepaticojejunostomy.
 

ACUTE MYOCARDIAL INFARCTION AS A RARE COMPLICATION IN DIABETIC KETOACIDOSIS IN A CHILD (Endocrinology / Metabolism)
Judy Teran, MS, Michigan State University College of Human Medicine
Cardiac complications during therapy for Diabetic ketoacidosis (DK) in children with type I diabetes (T1DM) are rare. We present a case of an adolescent with T1DM who developed acute myocardial infarction (MI) during therapy for DKA. Clinical course and therapy discussed.
 

FEVERS BEYOND INFECTION: TAKAYASU VASCULITIS IS A CAUSE (Rheumatology)
Karol Velasquez, MD, AdventHealth for Children
Takayasu arteritis (TA) is a rare large-vessel vasculitis with an estimated incidence of 1—2 cases per million per year. It primarily affects the aorta and its major branches, leading to stenosis, occlusion, or aneurysmal degeneration. Early diagnosis is critical to prevent irreversible vascular damage but is very challenging in children due to nonspecific presentation. TA is uncommon in adults and even rarer in the pediatric population.