{"id":"https://openalex.org/W4401028601","doi":"https://doi.org/10.1177/2050313x241264952","title":"Atypical hepatic metastases of pancreatic adenocarcinoma unveiled through persistent and unresolved pyrexia: Case report","display_name":"Atypical hepatic metastases of pancreatic adenocarcinoma unveiled through persistent and unresolved pyrexia: Case report","publication_year":2024,"publication_date":"2024-01-01","ids":{"openalex":"https://openalex.org/W4401028601","doi":"https://doi.org/10.1177/2050313x241264952","pmid":"https://pubmed.ncbi.nlm.nih.gov/39071196","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/11282560"},"language":"en","primary_location":{"id":"doi:10.1177/2050313x241264952","doi":"https://doi.org/10.1177/2050313x241264952","is_oa":true,"landing_page_url":"https://doi.org/10.1177/2050313x241264952","pdf_url":null,"source":{"id":"https://openalex.org/S2764719888","display_name":"SAGE Open Medical Case Reports","issn_l":"2050-313X","issn":["2050-313X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAGE Open Medical Case Reports","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1177/2050313x241264952","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Chamod Nirmal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210088145","display_name":"National Hospital of Sri Lanka","ror":"https://ror.org/011hn1c89","country_code":"LK","type":"healthcare","lineage":["https://openalex.org/I4210088145"]}],"countries":["LK"],"is_corresponding":false,"raw_author_name":"Chamod Nirmal","raw_affiliation_strings":["University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I4210088145"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083870450","display_name":"Umesh Jayarajah","orcid":"https://orcid.org/0000-0002-0398-5197","observed_orcids":["https://orcid.org/0000-0002-0398-5197"]},"institutions":[{"id":"https://openalex.org/I4210088145","display_name":"National Hospital of Sri Lanka","ror":"https://ror.org/011hn1c89","country_code":"LK","type":"healthcare","lineage":["https://openalex.org/I4210088145"]},{"id":"https://openalex.org/I90678064","display_name":"University of Colombo","ror":"https://ror.org/02phn5242","country_code":"LK","type":"education","lineage":["https://openalex.org/I90678064"]}],"countries":["LK"],"is_corresponding":false,"raw_author_name":"Umesh Jayarajah","raw_affiliation_strings":["Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka"],"raw_orcid":"https://orcid.org/0000-0002-0398-5197","affiliations":[{"raw_affiliation_string":"Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I90678064"]},{"raw_affiliation_string":"University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I4210088145"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063328674","display_name":"Harshima Disvini Wijesinghe","orcid":"https://orcid.org/0000-0002-2847-1440","observed_orcids":["https://orcid.org/0000-0002-2847-1440"]},"institutions":[{"id":"https://openalex.org/I90678064","display_name":"University of Colombo","ror":"https://ror.org/02phn5242","country_code":"LK","type":"education","lineage":["https://openalex.org/I90678064"]}],"countries":["LK"],"is_corresponding":false,"raw_author_name":"Harshima Wijesinghe","raw_affiliation_strings":["Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I90678064"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110919490","display_name":"Nilesh Fernandopulle","orcid":"https://orcid.org/0000-0002-2169-8394","observed_orcids":["https://orcid.org/0000-0002-2169-8394"]},"institutions":[{"id":"https://openalex.org/I4210088145","display_name":"National Hospital of Sri Lanka","ror":"https://ror.org/011hn1c89","country_code":"LK","type":"healthcare","lineage":["https://openalex.org/I4210088145"]},{"id":"https://openalex.org/I90678064","display_name":"University of Colombo","ror":"https://ror.org/02phn5242","country_code":"LK","type":"education","lineage":["https://openalex.org/I90678064"]}],"countries":["LK"],"is_corresponding":false,"raw_author_name":"Nilesh Fernandopulle","raw_affiliation_strings":["Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I90678064"]},{"raw_affiliation_string":"University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I4210088145"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5036656507","display_name":"Duminda Subasinghe","orcid":"https://orcid.org/0000-0002-7342-0220","observed_orcids":["https://orcid.org/0000-0002-7342-0220"]},"institutions":[{"id":"https://openalex.org/I4210088145","display_name":"National Hospital of Sri Lanka","ror":"https://ror.org/011hn1c89","country_code":"LK","type":"healthcare","lineage":["https://openalex.org/I4210088145"]},{"id":"https://openalex.org/I90678064","display_name":"University of Colombo","ror":"https://ror.org/02phn5242","country_code":"LK","type":"education","lineage":["https://openalex.org/I90678064"]}],"countries":["LK"],"is_corresponding":true,"raw_author_name":"Duminda Subasinghe","raw_affiliation_strings":["Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka"],"raw_orcid":"https://orcid.org/0000-0002-7342-0220","affiliations":[{"raw_affiliation_string":"Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I90678064"]},{"raw_affiliation_string":"University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka","institution_ids":["https://openalex.org/I4210088145"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5036656507"],"corresponding_institution_ids":["https://openalex.org/I4210088145","https://openalex.org/I90678064"],"apc_list":{"value":2000,"currency":"USD","value_usd":2000},"apc_paid":{"value":2000,"currency":"USD","value_usd":2000},"fwci":0.1829,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.50133093,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":92,"max":95},"biblio":{"volume":"12","issue":null,"first_page":"2050313X241264952","last_page":"2050313X241264952"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10231","display_name":"Pancreatic and Hepatic Oncology Research","score":0.9653000235557556,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10231","display_name":"Pancreatic and Hepatic Oncology Research","score":0.9653000235557556,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10760","display_name":"Pancreatitis Pathology and Treatment","score":0.007600000128149986,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12992","display_name":"Metastasis and carcinoma case studies","score":0.0071000000461936,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pancreatic-ductal-adenocarcinoma","display_name":"pancreatic ductal adenocarcinoma","score":0.9929999709129333},{"id":"https://openalex.org/keywords/liver-metastases","display_name":"liver metastasis","score":0.7369999885559082},{"id":"https://openalex.org/keywords/fever-of-unknown-origin","display_name":"fever of unknown origin","score":0.8980000019073486},{"id":"https://openalex.org/keywords/neoplastic-fever","display_name":"neoplastic fever","score":0.8679999709129333},{"id":"https://openalex.org/keywords/atypical-presentation","display_name":"atypical presentation","score":0.7699999809265137},{"id":"https://openalex.org/keywords/surgical-resection","display_name":"surgical resection","score":0.531000018119812},{"id":"https://openalex.org/keywords/palliative-chemotherapy","display_name":"palliative chemotherapy","score":0.9900000095367432},{"id":"https://openalex.org/keywords/fever-management","display_name":"fever management","score":0.7630000114440918}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9417641162872314},{"id":"https://openalex.org/C2781182431","wikidata":"https://www.wikidata.org/wiki/Q356033","display_name":"Adenocarcinoma","level":3,"score":0.6456917524337769},{"id":"https://openalex.org/C2778764654","wikidata":"https://www.wikidata.org/wiki/Q9618","display_name":"Pancreas","level":2,"score":0.5812253355979919},{"id":"https://openalex.org/C2779013556","wikidata":"https://www.wikidata.org/wiki/Q181876","display_name":"Metastasis","level":3,"score":0.4921554923057556},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.4802848994731903},{"id":"https://openalex.org/C2777766500","wikidata":"https://www.wikidata.org/wiki/Q360841","display_name":"Liver biopsy","level":3,"score":0.4307236671447754},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4169749319553375},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.4143562912940979},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4135104715824127},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.4102594256401062},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.33010879158973694},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.15600404143333435},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C151730666","wikidata":"https://www.wikidata.org/wiki/Q7205","display_name":"Paleontology","level":1,"score":0.0}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1177/2050313x241264952","doi":"https://doi.org/10.1177/2050313x241264952","is_oa":true,"landing_page_url":"https://doi.org/10.1177/2050313x241264952","pdf_url":null,"source":{"id":"https://openalex.org/S2764719888","display_name":"SAGE Open Medical Case Reports","issn_l":"2050-313X","issn":["2050-313X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAGE Open Medical Case Reports","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11282560","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11282560","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11282560/pdf/10.1177_2050313X241264952.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAGE Open Med Case Rep","raw_type":"Text"},{"id":"pmid:39071196","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/39071196","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAGE open medical case reports","raw_type":"Case Reports"},{"id":"pmh:oai:doaj.org/article:b6207623501a4727ba3cd314bd3d1b0c","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/b6207623501a4727ba3cd314bd3d1b0c","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"SAGE Open Medical Case Reports, Vol 12 (2024)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1177/2050313x241264952","doi":"https://doi.org/10.1177/2050313x241264952","is_oa":true,"landing_page_url":"https://doi.org/10.1177/2050313x241264952","pdf_url":null,"source":{"id":"https://openalex.org/S2764719888","display_name":"SAGE Open Medical Case Reports","issn_l":"2050-313X","issn":["2050-313X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAGE Open Medical Case Reports","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4401028601.pdf","grobid_xml":"https://content.openalex.org/works/W4401028601.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W1576111023","https://openalex.org/W1981488923","https://openalex.org/W2005089069","https://openalex.org/W2016617199","https://openalex.org/W2032938314","https://openalex.org/W2136584776","https://openalex.org/W2166858780","https://openalex.org/W2222135509","https://openalex.org/W2223737571","https://openalex.org/W2513753699"],"related_works":["https://openalex.org/W2513753699","https://openalex.org/W7149350246","https://openalex.org/W6946879397","https://openalex.org/W2341871175","https://openalex.org/W4316085404","https://openalex.org/W2977274489","https://openalex.org/W2921304029","https://openalex.org/W2592436459","https://openalex.org/W2016000637","https://openalex.org/W2593937267"],"abstract_inverted_index":{"Diagnosing":[0],"neoplastic":[1],"fever":[2,192],"requires":[3],"excluding":[4],"identifiable":[5],"causes,":[6],"making":[7],"it":[8,173],"a":[9,14,51,63,109],"diagnostic":[10],"challenge.":[11],"Fever":[12],"as":[13,41],"primary":[15],"manifestation":[16],"of":[17,35,43,65,77,94,134,152,182,191],"pancreatic":[18,37,122,154,184],"adenocarcinoma":[19,38,123],"is":[20,144,169,174],"uncommon":[21],"with":[22,56,62,113,124,132,163],"few":[23],"cases":[24],"reported":[25],"in":[26,137,179],"the":[27,75,92,95,103,142,153,180],"literature.":[28],"Here":[29],"we":[30],"present":[31,131],"an":[32],"unusual":[33],"case":[34],"metastatic":[36,165,183],"primarily":[39],"manifesting":[40],"pyrexia":[42],"unknown":[44],"origin.":[45],"A":[46],"63-year-old":[47],"Sri":[48],"Lankan":[49],"male,":[50],"non-smoker":[52],"who":[53],"was":[54,98,105],"diagnosed":[55],"diabetes,":[57],"hypertension":[58],"and":[59,68,86,148,188],"dyslipidaemia":[60],"presented":[61],"history":[64],"fever,":[66],"anorexia":[67],"weight":[69],"loss":[70],"for":[71,79,82,146],"2":[72],"months.":[73],"Despite":[74],"completion":[76],"treatment":[78],"positive":[80],"serology":[81],"paratyphi,":[83],"his":[84],"symptoms":[85],"inflammatory":[87],"markers":[88],"remained":[89],"elevated":[90],"while":[91],"rest":[93],"infectious":[96],"screening":[97],"negative.":[99],"On":[100],"further":[101],"evaluation,":[102],"patient":[104],"found":[106],"to":[107],"have":[108],"hypodense":[110],"distal":[111],"pancreas":[112],"ring-enhancing":[114],"multiple":[115],"liver":[116,125,128,164],"lesions":[117],"on":[118],"imaging.":[119],"Histology":[120],"confirmed":[121],"metastasis.":[126],"Atypical":[127],"metastases":[129],"may":[130],"evidence":[133],"ring":[135],"enhancement":[136],"computed":[138],"tomography":[139],"imaging;":[140],"thus,":[141],"biopsy":[143],"mandatory":[145],"diagnosis":[147],"decision-making.":[149],"Usually,":[150],"tumours":[151],"tail":[155],"are":[156,161,193],"resectable":[157],"but":[158],"if":[159],"they":[160],"associated":[162],"disease,":[166],"surgical":[167],"resection":[168],"not":[170,175],"recommended":[171],"because":[172],"potentially":[176],"curative.":[177],"Therefore,":[178],"context":[181],"adenocarcinoma,":[185],"palliative":[186],"chemotherapy":[187],"pharmacological":[189],"management":[190],"required.":[194]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2024-07-27T00:00:00"}