Background and Objectives: Excessive use of the knee in patients with immature locomotor systems leads to a whole spectrum of morphological changes with possible consequences in adulthood. This study aimed to examine the morphological pattern in magnetic resonance imaging (MRI) that is associated with recurrent pain due to increased physical activity in children. Materials and Methods: This was a retrospective study conducted among pediatric patients treated at the University Children’s Hospital in Belgrade in 2018 and 2019. MRI findings of patients who reported recurrent pain in the knee joint during physical activity and who were without any pathological findings on both clinical examination and knee radiographs were included in the study. Results: MRI findings of 168 patients (73 boys and 95 girls, mean age 14.07 ± 3.34 years) were assessed. Meniscus and cartilage lesions were the most commonly detected morphological findings: meniscus lesions in 49.4%, cartilage ruptures in 44.6%, and cartilage edema in 26.2% of patients. The medial meniscus was more often injured in girls (p = 0.030), while boys were more prone to other joint injuries (p = 0.016), re-injury of the same joint (p = 0.036), bone bruises (p < 0.001), and ligament injuries (p = 0.001). In children older than 15 years, tibial plateau cartilage edema (p = 0.016), chondromalacia patellae (p = 0.005), and retropatellar effusion (p = 0.011) were detected more frequently compared to younger children. Conclusions: Children reporting recurrent knee pain due to increased physical activity, without any detected pathological findings on clinical examination and knee radiography, may have morphological changes that can be detected on MRI. Timely diagnosis of joint lesions should play a significant role in preventing permanent joint dysfunction in the pediatric population as well as in preventing the development of musculoskeletal diseases in adulthood.

Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in patients with malignancy. Biomarkers of hypercoagulability and thromboinflammation may improve risk stratification and support personalised thromboprophylaxis, but evidence remains heterogeneous, particularly in cervical cancer. A systematic review was conducted according to PRISMA 2020. PubMed/MEDLINE, Scopus, Embase, and Web of Science were searched for studies published between January 2009 and March 2025 evaluating biological, molecular, genetic, and imaging biomarkers associated with hypercoagulability and thromboinflammation in women withcervical cancer. Evidence from breast cancer and broader CAT studies was incorporated to provide translational context. Owing to substantial methodological heterogeneity, findings were synthesised qualitatively. Twenty-five cervical cancer studies met eligibility criteria. D-dimer was the most extensively investigated biomarker and was consistently associated with VTE risk, although specificity was limited. Biomarkers of thrombin generation and fibrinolytic activation, including thrombin–antithrombin complexes, prothrombin fragment 1+2, and plasmin–α2-antiplasmin complex, demonstrated greater mechanistic specificity. Multimarker panels integrating coagulation, fibrinolysis, endothelial injury, platelet activation, and inflammation showed superior predictive performance compared with single biomarkers. Emerging biomarkers, including circulating tumour DNA, extracellular vesicles, and microRNAs, further supported tumour-driven thromboinflammation. SERPINE1 and F2 gene variants were associated with thrombotic risk and adverse prognosis. Current evidence supports further evaluation of integrated multimodal biomarker strategies for CAT risk assessment, but prospective, standardised, tumour-specific studies are required before biomarker-guided approaches can be implemented in clinical practice.

Introduction. Immune checkpoint inhibitors have improved outcomes in triple-negative breast cancer but may trigger immunerelated adverse events involving multiple organs. Pancreatic toxicity is uncommon but clinically important, and its recognition is challenging because of broad differential diagnoses. Case Report. We report the case of a 44-year-old woman with a first relapse of triple-negative breast cancer after seven years of disease-free follow-up. Germline testing revealed a mutation in the breast cancer susceptibility gene 1. First-line systemic therapy with pembrolizumab combined with weekly paclitaxel was initiated, resulting in a radiologically confirmed partial response. During the fifth treatment cycle, the patient developed upper abdominal discomfort, and endoscopy identified fibrin-covered “kissing” duodenal bulb ulcers, suggestive of possible immune-mediated duodenitis. Symptoms improved with proton pump inhibitors and supportive care. After reintroduction of therapy, the patient subsequently presented with recurrent symptoms. Laboratory evaluation revealed markedly elevated pancreatic enzymes, while imaging confirmed acute pancreatitis. Alternative aetiologies were excluded. Pembrolizumab was permanently discontinued, and corticosteroid therapy was initiated, resulting in gradual clinical and biochemical recovery. Maintenance therapy with a poly adenosine diphosphate-ribose polymerase inhibitor was introduced. At 10 months of follow-up, the patient remained asymptomatic, with preserved pancreatic function and sustained partial response. Conclusion. This case highlights an uncommon presentation of pembrolizumab-associated pancreatic and duodenal toxicity in a patient with triple-negative breast cancer. Awareness of rare irAEs is crucial to ensure timely diagnosis and effective management. Multidisciplinary collaboration and individualised therapeutic planning enabled both toxicity resolution and continued oncological disease control in this patient.