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Case Report | DOI: https://doi.org/10.31579/2690-4861/977
1Department of Urology, University Hospital of La Palma, Santa Cruz of Tenerife, Spain. https://orcid.org/0000-0001-9694-5268
2Specialist in Family and Community Medicine. Emergency Service Santa Cruz of La Palma, Santa Cruz of Teneride, Spain. https://orcid.org/0009-0001-6805-190X
3Specialist in Family and Community Medicine. Emergency Service Santa Cruz of La Palma, Santa Cruz of Teneride, Spain. https://orcid.org/0009-0004-4037-0847
4Specialist in Family and Community Medicine. Healt Center of Tijarafe. La Palma, Santa Cruz of Teneride, Spain. https://orcid.org/0009-0006-8494-9986
5Specialist in Family and Community Medicine. Healt Center of Arico. Santa Cruz of Teneride, Spain. https://orcid.org/0009-0005-9251-5662
6Specialist in Family and Community Medicine. Emergency Service University Hospital of La Palma. Santa Cruz of Teneride, Spain. https://orcid.org/0009-0004-3598-959X
7Radiology resident, University of Helsinki, Finland. https://orcid.org/0000-0002-7164-7325
8Department of Urology, University Hospital of La Palma, Santa Cruz of Tenerife, Spain. https://orcid.org/0000-0002-7363-4499-3483
9Nursing Degree. Specialist in Family and Community Nursing. La Palma, Santa Cruz of Tenerife, Spain. https://orcid.org/0009-0008--2206-3439
10Nursing Degree. Specialist in Family and Community Nursing. La Palma, Santa Cruz of Tenerife, Spain. https://orcid.org/0009-0005-4541-7170
*Corresponding Author: José Alberto Hermida Pérez, Department of Urology, University Hospital of La Palma, Santa Cruz de Tenerife, Spain.
Citation: Hermida Pérez JA, Ana Laura Mesa Hernández AL, Cabrera Martin MY, Vilar Camacho M, Medina Santos AR, Roman Pereira Y, Buduen Nuñez AA, Pérez Rodriguez E, Cabrera Crespo A, Ramos Gutierrez CJ. (2025), ), Invasive Urothelial Carcinoma of the Renal Pelvis, Staghorn Calculus, Right Renal Pyo nephrosis, and Hepatic Necrosis: Review and Case Report, International Journal of Clinical Case Reports and Reviews,31(1); DOI:10.31579/2690-4861/977
Copyright: © 2025, José Alberto Hermida Pérez. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 22 September 2025 | Accepted: 09 October 2025 | Published: 30 October 2025
Keywords: urothelioma; invasive; lithiasis; staghorn; pyonephrosis; liver; necrosis
Upper urinary tract urothelial carcinoma is less common than bladder carcinoma, although it shares nearly identical risk factors and generally carries a worse prognosis. We report the clinical case of a 56-year-old female patient who presented to the hospital with right flank pain. Laboratory tests showed a leukocytosis, acidosis, and elevated infection-related blood parameters. A Computed Tomography scan shows the presence of a large staghorn calculus, pelvicalyceal dilatation, functional exclusion of the right kidney, hypoenhancing focal hepatic lesions. Is inserted a percutaneous nephrostomy drainage catheter. An urgent nephroureterectomy was performed. Histopathological examination of the surgical specimen revealed a staghorn calculus, and a conventional invasive urothelial carcinoma of the renal pelvis. Postoperatively, the patient was transferred to the ICU, where she experienced an unfavorable clinical course and subsequently died.
The etiopathogenic and risk factors are: smoking, exposure to carcinogens, lithiasis, obstruction, inflammation, chronic infections, alcohol use, unhealthy diet, sedentary, chromosomal alterations, radiotherapy and immunosuppressants treatment used as therapy in other diseases. The radical nephroureterectomy is the standard treatment.
Upper urinary tract urothelial carcinoma (UUTUC) is less common than bladder carcinoma. Although both share identical risk factors, UUTUC typically carries a worse prognosis. The standard diagnostic approach involves imaging of the upper urinary tract using computed tomography urography (CT-IVU). In cases of diagnostic uncertainty, ureterorenoscopy with biopsy, along with urine cytology, may be performed. Treatment primarily depends on tumor stage and grade. Based on the extent and location of the disease, either organ-sparing approaches or radical nephroureterectomy may be indicated. In high-risk UUTUC, perioperative systemic therapy can be administered in both neoadjuvant and adjuvant settings. However, current evidence on neoadjuvant chemotherapy and immunotherapy does not yet support a standardized approach. For metastatic disease, a multimodal treatment strategy may include cisplatin- or carboplatin-based chemotherapy, immunotherapy, and treatment with enfortumab vedotin. In selected cases, salvage surgery, radiotherapy, or metastasectomy may also be considered [1, 2, 3].
Between 22% and 47% of patients with upper urinary tract urothelial carcinoma (UUTUC) develop bladder cancer (BC) recurrence following radical nephroureterectomy. Moreover, the impact of surgical treatment for UUTUC-associated BC has not been well validated. The aim of this study was to assess the effect of a standard primary BC surgical strategy on the survival of patients diagnosed with UUTUC-associated BC [1, 2, 3].
Perioperative systemic treatment for high-risk UUTUC may be administered in both neoadjuvant and adjuvant settings. However, current evidence on neoadjuvant chemotherapy and immunotherapy does not yet support standardized application. For metastatic disease, a multimodal treatment approach may include cisplatin- or carboplatin-based chemotherapy, immunotherapy, and treatment with enfortumab vedotin and pembrolizumab. In selected cases, salvage surgery, radiotherapy, and metastasectomy may also be considered [1, 2, 3].
A 56-year-old female with a medical history of hypertension, hypercholesterolemia, and overweight presented to the emergency department with right flank pain for approximately 2 months. Initially, the pain was mild, dull, and continuous, progressively increasing in intensity, without associated fever.
Laboratory results: Glucose: 125 mg/dL, Creatinine: 0.95 mg/dL, C-reactive protein: 29.90 mg/dL, Leukocytes: 10.7 × 10³/µL, Hemoglobin: 11.5 g/dL, Platelets: 489 × 10³/µL, Urine analysis: Leukocytes 100, Hematuria 250, Proteins 150, Urine culture: Negative (15 days prior).
Physical examination: Positive right renal punch percussion.A large mass palpated in the right flank, suggestive of an enlarged kidney. Positive renal ballottement, slightly painful
Plain abdominal X-ray (Figure. 1) showed right kidney (RK) enlargement with a large staghorn calculus.
Figure 1: Plain abdominal X-ray: Right kidney enlargementwith a large staghorn calculus (black arrows).
The patient was admitted to the Urology department for further investigation and treatment, where she developed worsening pain and fever of 38-39ºC. An abdominopelvic CT scan with intravenous contrast (Figure. 2) revealed a large staghorn calculus in the RK with significant
pelvicalyceal dilation. No contrast elimination was observed. Inflammatory changes in the perirenal fat were noted. A portocaval adenopathy conglomerate was present. Several hypoenhancing hepatic lesions were identified.
Figure 2: Abdominopelvic CT scan with intravenous contrast staghorn calculus in the RK, significant pelvicalyceal dilation. Inflammatory changes in the perirenal fat (green arrows). A portocaval adenopathy conglomerate (red arrow). Hypoenhancing hepatic lesions (yellow arrows).
Broad-spectrum antibiotic therapy was initiated (Meropenem 1 gram IV every 8 hours) pending results of blood and urine cultures, with pain control and hydration. Interventional Radiology performed an urgent nephrostomy (Figure. 3).
Figure 3: Nephrostomy drainage. (black arrows)
Due to the presence of pyonephrosis, worsening clinical condition, right hypochondrial pain, and deteriorating laboratory parameters with elevated acute phase reactants and acidosis, a repeat CT scan with contrast (arterial and portal phases) was performed to rule out complications, comparing it with the previous study (Figure. 4).
Figure 4: Uro CT scan: Enlarged necrotic portocaval lymph node cluster (red arrow). Multiple hypodense liver lesions (yellow arrow) consistent with abscessed lesions.
The findings were as follows: RK: 14 cm, globular with large staghorn calculus, nephrostomy catheter in the middle calyceal group. Persistent calyceal dilation in other calyceal groups. Multiple cortical abscesses and significant reduced enhancement and cortical differentiation compared to the previous study. Increased necrotic portocaval adenopathy, marked right adrenal thickening of recent onset. Hepatic lesions: Normal liver size and morphology, with multiple new hypodense lesions, the largest being heterogeneous and irregular in segment IV (yellow arrows). These lesions suggest hepatic abscesses given the clinical context, though other causes cannot be excluded. Perihepatic free fluid, in both paracolic gutters and pelvis. Normal left kidney (LK) and bladder, no significant findings in
gynecological structures. Multiple micronodules in the pulmonary bases, new and diffuse, not seen in prior studies. Probable xanthogranulomatous pyelonephritis on the right, with hepatic lesions suggestive of abscesses, and newly appearing micronodules in the lung bases.
Right nephroureterectomy was performed. The macroscopic description of the surgical specimen is as follows:
Macroscopic Description: RK: Nephrectomy specimen measuring 20 x 13.5 x 10.2 cm, including a 10 cm ureteral segment. The specimen is difficult to decapsulate and weighs 1134 g. On sectioning, there is marked dilation of the pelvicalyceal system, with a yellowish staghorn calculus of approximately 4 cm, impacted. The specimen contains abundant purulent and hematic coagulated material within the lumen of the pelvicalyceal system. The kidney shows whitish areas and yellowish regions. In the renal pelvis, there is a somewhat raised, papillary lesion, dark brown in appearance, measuring 5.3 x 3 cm. This lesion has a moderate consistency and whitish section planes, appearing to respect the renal parenchyma. Two possible lymphadenopathies are identified in the perirenal fat. A whitish nodule of 0.8 x 0.8 cm is observed in the periarterial zone.
Microscopic description: NephroureterectomyRight. Tumor localization: Renal pelvis. Tumor size: 5.3 x 3 cm. Histological type: Invasive urothelial carcinoma, conventional. Histological grade: High grade. Tumor extension: Invades renal parenchyma. Lymphovascular invasion: Present (abundant), involving both large and small vessels. Tumor configuration: Papillary (non-invasive component). Margins: Renal surface: Free of tumor. Ureteral margin: No signs of tumor. Hilar margin: Affected by carcinoma (perivascular invasion). Lymph nodes: Not sent or isolated in the sample. Pathological staging: pT3. Other findings: Chronic pyelonephritis, renal parenchyma with atrophic and hyalinized areas.
Extensive necrotic zones. Nephrolithiasis. Comments: Extensive perineural and perivascular invasion observed.
In the postoperative period, the patient was transferred to the ICU where her condition worsened, and she died.
The etiopathogenic factors for UUTUC are the same as those for ureteral and bladder tumors. The risk increases with age. Tobacco use, particularly cigarette smoking, is a major risk factor for these tumors. Tobacco contains carcinogenic substances, which, after being excreted by the kidney, accumulate in the urine. This exposes the urothelium to high concentrations of these carcinogenic substances, which damage the DNA of the urothelial lining cells, favoring tumor development. Thus, the prevention and attempt to modify these unhealthy lifestyle habits plays a key role in this process, where primary care physicians (PCP) have a fundamental role. Other risks factors are alcohol use, unhealthy diet, sedentary lifestyle and lack of physical activity, environmental factors, Evidence and recommendations for cancer prevention strategies through screening in asymptomatic patients, as well as early detection of signs and symptoms in the average and high-risk population, are important [4]. The global incidence of cancer has continued to increase due to the aging of the population and the growing trend toward unhealthy lifestyles [5, 6, 7]. Also associated risks factors are: Family history of urothelial tumors, chromosomal alterations of various genes, among which we have HRAS (Harvey rat sarcoma), RB1 (retinoblastoma gene), PTEN / MMAC1 (phosphatase and tensin homolog / Mouse Monoclonal Antibody), NAT2 (Network Address Translation) and GSTM1 (Glutathione-S-transferase) [8], exposure to various industrial aromatic amines in workers in the paint, dye, metal or petroleum products industry, radiotherapy treatment in the pelvis, immunosuppressants used in the therapy against other cancers: cyclophosphamide and ifosfamide, consumption of Aristolochia fangchi, (herb native to China), consumption of water with high concentrations of arsenic [9], Schistosomiasis caused by the parasite Schistosoma haematobium, common in Africa and the Middle East, but uncommon in the United States and Europe, urinary catheterization and lithiasis long-standing, due to the irritating factor it causes in the urothelium [10]. UUTUC is a rare malignancy, accounting for approximately 5% to 10% of all urothelial carcinomas (UC), with a higher prevalence in males and older adults. It includes various histological subtypes and, unlike bladder UC, more frequently presents as invasive disease at diagnosis. Molecular studies have identified frequent mutations in FGFR3 (fibroblast growth factor receptor 3) and TP53 (tumor protein p53, a 53 kDa tumor suppressor), which are increasingly guiding therapeutic decisions. Lynch syndrome (LS), a hereditary cancer predisposition syndrome, is a significant risk factor for UUTUC, particularly in younger patients. Current treatment strategies emphasize platinum-based chemotherapy following surgical resection, although immunotherapy has shown promise, especially in patients with LS-associated UUTUC. Continued molecular research is essential to improve diagnostic accuracy and optimize individualized treatment approaches [11,12,13]. Although data are accumulating, in many areas there is still insufficient high-level evidence to provide solid recommendations regarding the therapeutic management of UUTUC. Patient stratification based on histology and clinical examination (including imaging) and assessment of patients at risk for LS will aid management. Renal sparing management should be offered as a primary treatment option for patients with low-risk UUTUC and two functioning kidneys. Particularly for patients with high-risk or metastatic UUTUC, new treatment options have become available. In high-risk UUTUC, platinum-based chemotherapy after radical nephroureterectomy and adjuvant nivolumab for patients unfit or who refuse chemotherapy are options. For metastatic disease, gemcitabine/carboplatin chemotherapy is recommended as first-line treatment for patient’s ineligible for cisplatin. Patients with PD-1/PD-L1 (programmed death ligand 1)-positive tumors should be offered a checkpoint inhibitor: pembrolizumab or atezolizumab, agents that inhibit PD-L1, found on the surface of tumor cells, and PD-1, found on activated T and B cells and macrophages. This immunotherapy treatment can help halt or slow the growth of many types of cancer that have PD-L protein. These drugs are capable of blocking the PD-1 receptor present on the surface of lymphocytes, or the PD-L1 and PD-L2 ligands expressed by cancer cells. This would prevent the two from binding, blocking the immunomodulatory signal and allowing T cells to remain active against the tumor. The therapeutic target of pembrolizumab and nivolumab is PD-1, the PD-L1 receptor protein on immune cells [14, 15, 16, 17], An evaluation of the pathological factors for prognosis, intravesical recurrence and distant metastasis of UUTUC was carried out, concluding that it is necessary to take into account the specific clinical characteristics of each patient are key to determining the optimal treatment regimen based on the risk stratification of these tumors. UUTUC is rare, but since 60% of these tumors are invasive at the time of diagnosis, a timely and accurate diagnosis is crucial. There are several known risk factors: High-grade tumors have a poor prognosis and often develop distant metastases, suggesting the need for careful postoperative follow-up. Those with lymphatic invasion or tumors 3 cm or larger in diameter frequently develop intravesical recurrence and distant metastases, respectively, indicating the need for close follow-up [14, 15, 16, 17]. The European Association of Urology (EAU) guidelines panel on UUTUC has updated the guidelines to aid clinicians in evidence-based management of UUTUC. Even though data are accruing, for many areas there is still insufficient high-level evidence to provide strong recommendations. Patient stratification on the basis of histology and clinical examination (including imaging) and assessment of patients at risk of LSwill aid management. Kidney-sparing management should be offered as a primary treatment option to patients with low-risk UUTUC and two functional kidneys. In particular, for patients with high-risk or metastatic UUTUC, new treatment options have become available. In high-risk UUTUC platinum-based chemotherapy after radical nephroureterectomy, and adjuvant nivolumab for unfit or patients who decline chemotherapy, are options. For metastatic disease, gemcitabine/carboplatin chemotherapy is recommended as first-line treatment for cisplatin-ineligible patients. Patients with PD-1/PD-L1-positive tumours should be offered a checkpoint inhibitor (pembrolizumab or atezolizumab) [18].
UUTUC and his relation with the litiasis:
Cases of association of renal pelvis tumors with urolithiasis have been published.
One clinical case of a patient with squamous cell carcinoma (ECC) in a duplicated renal pelvis, after percutaneous nephrolithotomy. The ECC of the renal pelvis is a rare tumor with poor prognosis, associated with stone disease and chronic infection. Taking biopsies from suspicious lesions during percutaneous nephrolithotomy may help early diagnosis and improve survival [19].
Other case of a well-differentiated mucoproducing adenocarcinoma of the right renal pelvis in a patient treated for a right renal pelvis lithiatis who was subsequently diagnosed with ultrasound and CT scan showed a hypodense tumor in the lower pole with hyperdense areas in the interior of the right renal pelvis. A right nephrectomy was performed. Biopsy showed a well-differentiated mucoproducing adenocarcinoma of the right renal pelvis [20].
There is some controversy in the terminology used for transitional cell tumors with mucinous differentiation. A 50-year-old male with history of recurrent lithiasis whose radological tests discovered a heterogeneous renal pelvis lesion. The histologic study of the lesions determined the diagnosis of transitional cell carcinoma of the renal pelvis with ample mucinous differentiation. They are rare tumors in such location and the mucinous differentiation does not seem to influence prognosis [21].
Cancer is one of the leading causes of morbidity and mortality. Environmental factors, along with lifestyle factors, tobacco and alcohol use, unhealthy diet, sedentary lifestyle, and lack of physical activity are some of the risk factors that have led to an increase in cancer. Evidence and recommendations for cancer prevention strategies through screening in asymptomatic patients, as well as early detection of signs and symptoms in the average- and high-risk population, are important. The global incidence of cancer has continued to increase due to the aging of the population and the growing trend toward unhealthy lifestyles [22]. Tobacco is the leading cause of cancer and cancer-related death. The decline in smoking rates and the increase in obesity rates suggest that obesity will displace tobacco as the main preventable cancer risk factor in the coming decades. Notable risk factors include exposure to occupational carcinogens, air pollution, infectious agents, and certain aspects of sexual and reproductive life. Given this complex landscape of threats to population health, disease prevention and the promotion of healthy lifestyles are presented as fundamental and essential measures, which must be promoted at the political and economic levels, and not only by scientific societies or the healthcare system. Furthermore, it is essential that they involve the entire community. Therefore, the role of community-based strategies (based on evidence and measurable with objective indicators) is essential [23, 24].
UUTUC and bladder urothelial carcinomas share many common biological pathways. However, UUTUC is more frequently associated with specific conditions such as Balkan endemic nephropathy and hereditary non-polyposis colorectal cancer (HNPCC or Lynch syndrome), the molecular mechanisms of which are increasingly being elucidated (25). A wide range of potential biomarkers have been investigated in an effort to identify reliable prognostic indicators for UUTUC. Ongoing advances in our understanding of UUTUC biology may, in the future, facilitate the discovery of novel druggable targets, the development of clinically applicable biomarkers, and the optimization of treatment strategies for this rare but aggressive malignancy [26, 27, 28].
UUTUC have a high potential for aggressiveness and an unfavorable prognosis. The standard diagnostic test is imaging of the upper urinary tract using CT scan-IVC. in cases with diagnostic uncertainty, the ureterorenoscopy with biopsy and urine cytology can be performed. The gold standar treatment is e radical nephroureterectomy. Is important to consider to be aware of the risk factors for this disease, they are the same for bladder tumor: smoking, alcohol, healthy lifestyle and work with, exposure to carcinogens, environmental pollution, hereditary syndromes (LS), family history of urothelial tumors, chromosomal alterations of various genes, lithiasis, obstruction, inflammation, infection (bacterial, parasitic) chronics, radiotherapy treatment in the pelvis, immunosuppressants used in the therapy against other cancers, Health prevention activities are also of great importance. The radical nephroureterectomy It is the standard treatment, as well as perioperative systemic treatment for high-risk UUTUC (the neoadjuvant and adjuvant chemotherapy and immunotherapy, but do not yet allow for standard application. For metastatic disease, a multimodal treatment consisting in cisplatin or carboplatin chemotherapy, immunotherapy, and treatment with enfortumab vedotin and Pembrolizumab can be considered. In rare cases, salvage surgery, radiotherapy and metastasectomy are available.
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Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
