Sickle β⁺-thalassemia rarely manifests with acute splenic sequestration crisis in adults. We report a case of a 20-year-old female who presented with fever and left upper quadrant abdominal pain. Laboratory studies revealed hemolytic anemia. Tests for autoimmune hemolysis and hemolytic diseases were negative except for Hemoglobin (Hb) electrophoresis, which revealed sickle cell trait (Hb AS). Infectious workup was unremarkable. Computed tomography scan of the abdomen showed marked splenomegaly. The patient received blood transfusions and empiric antibiotics with no improvement; thus, splenectomy was performed. Pathology specimen revealed peripheral serpiginous infarcts alternating with surrounding acute inflammation and small capillaries plugged with sickle cell shaped red blood cells consistent with splenic sequestration. DNA test later revealed beta-globin mutations consistent with sickle cell-beta⁺ thalassemia. Post-splenectomy, there was a gradual improvement in her clinical symptoms with concomitant rise in Hb to 10.6 g/dl at discharge.

Introduction: Brain tumors pose significant diagnostic and therapeutic challenges due to their diverse treatment responses and complex imaging characteristics. Traditional MRI techniques often struggle to differentiate between tumor recurrence and post-treatment changes such as pseudoprogression and necrosis, highlighting the need for more accurate diagnostic tools. Material and Methods: This retrospective study conducted at a single tertiary care center and evaluated the diagnostic efficacy of Treatment Response Assessment Maps (TRAMs), also known as Contrast Clearance Analysis (CCA), in distinguishing between tumor recurrence and post-treatment changes in patients who underwent initial treatment for brain tumors. Data from 27 patients were analyzed, including 10 who underwent surgical resection (Group 1) and 17 who had serial images and TRAMs/CCA assessment (Group 2). Result: In Group 1, TRAMs/CCA demonstrated nine positive results, with 8 cases of tumor recurrence confirmed via biopsy. A biopsy also confirmed one negative result after a discussion with the patient. In Group 2, where patients did not undergo biopsy, TRAMs/CCA results varied but correlated with clinical outcomes, underscoring the potential utility of TRAMs/CCA in guiding treatment decisions. These findings suggest that TRAMs/CCA may have superior diagnostic performance compared to traditional MRI in differentiating between tumors. Conclusion: TRAMs/CCA represents a promising advancement in the imaging assessment of brain tumor treatment response, offering higher sensitivity than conventional MRI methods. While implementing TRAMs/CCA could potentially improve diagnostic accuracy and optimize therapeutic strategies for patients with brain tumors, the final decision remains highly dependent on patient-centered discussions.

Immune checkpoint inhibitor (ICI)-associated hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory toxicity increasingly described in solid tumors, but evidence remains limited to case reports and small series. We systematically reviewed adult cases of ICI-associated HLH in solid malignancies identified through PubMed, Cochrane Library, Google Scholar, and reference-list screening from database inception through March 3, 2026. Case-level data were extracted for tumor type, ICI regimen, timing, diagnostic findings, HLH-directed therapy, ICU-level care, and outcomes; because of heterogeneity, findings were summarized descriptively. Eighty adult cases were included. Median age was 63 years; the most common cancers were lung cancer, melanoma, breast cancer, and renal tumors. PD-1 inhibitors predominated, mainly pembrolizumab and nivolumab. Among cases with reported timing, median time from last ICI dose to HLH onset was 17 days, with most occurring within 30 days of the last dose and within the first four ICI-containing cycles. Corticosteroids were used in nearly all cases; additional therapies included tocilizumab, etoposide, anakinra, IVIG, mycophenolate, ruxolitinib, calcineurin inhibitors, and plasma exchange. ICI-associated HLH often occurs early after exposure and may mimic sepsis, malignancy progression, or other immune-related adverse events; prospective data are needed to define risk factors, diagnostic thresholds, and treatment strategies.

Eccrine carcinoma is an exceedingly rare malignancy originating from the eccrine sweat glands, representing less than 0.01% of all cutaneous malignancies. The diagnosis of eccrine carcinoma is challenging due to its rarity. Its morphological similarities with other common tumors, especially breast cancer, further complicate assessment. It is crucial to differentiate eccrine carcinoma from metastatic breast cancer. In addition, the standard treatment is also not well established. We present the case of a 66-year-old female with a lesion on her left lip. Initially identified in 2017, the lesion recurred in 2020 and 2023. Surgeries in 2017 and 2020 achieved R0 resections, while the 2023 recurrence was an R2 resection with lymph node metastasis. Pathology suggested a possible primary breast ductal carcinoma. Immunostains were positive for estrogen receptor (ER) and progesterone receptor (PR). However, positron emission tomography/computed tomography (PET/CT) did not reveal any primary breast lesion, and there was no accessory breast tissue involvement, leading to a diagnosis of primary eccrine carcinoma. The patient declined chemotherapy and radiation therapy, opting instead for treatment with letrozole and ribociclib. Six-month follow-up imaging showed reduced lymph node size, suggesting a favorable response to therapy. This case highlights the diagnostic challenges of eccrine carcinoma, given that it mimics malignancies like breast cancer. Hormone therapy may be a potential option for hormone receptor-positive cases. Further research is essential to develop clearer diagnostic tools and standardized treatment protocols for this rare malignancy.