Search Results (718)

Background: Odontogenic keratocysts are developmental cysts of the jaws that often remain asymptomatic until they reach considerable size and are most frequently located in the mandibular angle and ramus regions. Due to their high recurrence potential, the optimal treatment approach remains controversial. The aim of this study was to evaluate treatment modalities associated with lower recurrence rates in odontogenic keratocysts. Material and Methods: Patients diagnosed with odontogenic keratocyst between 2000 and 2024 at the Department of Oral and Maxillofacial Surgery, Gazi University, were retrospectively evaluated. Associations between gender, age, lesion localization, histological subtype, treatment modality, and recurrence were analyzed. Statistical analyses were performed using SPSS for Windows (version 27). Results: A total of 291 cases were included, with an overall recurrence rate of 16.2%. The highest recurrence rate was observed in patients treated with enucleation (19.2%), whereas a lower recurrence rate was found in cases treated with marsupialization (5%). No recurrence was observed in patients who underwent resection. A statistically significant association was found between treatment modality and recurrence (p = 0.014). Conclusions: Treatment selection for odontogenic keratocysts should be carefully planned. In the present study, marsupialization was associated with a lower recurrence rate than enucleation in selected cases. However, because of the retrospective design and non-randomized treatment allocation, these findings should be interpreted with caution and should not be considered evidence of a causal relationship. Long-term clinical and radiological follow-up remains essential because of the potential for late recurrence. Full article

Background/Objectives: Non-small cell lung cancer (NSCLC) remains associated with high mortality, frequent late-stage diagnosis, biological heterogeneity, and recurrence after treatment. Although molecular and immunohistochemical biomarkers have transformed treatment selection, there remains a need for accessible, repeatable, and clinically practical circulating biomarkers that may support prognosis and post-treatment monitoring. This review discusses prolactin (PRL) as a candidate supplementary biomarker in NSCLC, with particular emphasis on its biological rationale, potential prognostic relevance, and possible role in personalized risk stratification after systemic therapy. Methods: This narrative review summarizes current evidence on established biomarkers in NSCLC, the physiology and regulation of PRL, PRL/PRLR signaling in cancer biology, mechanisms of PRL dysregulation in lung cancer, and available clinical observations concerning PRL alterations in NSCLC. Particular attention is given to the distinction between prognostic and predictive biomarkers, longitudinal monitoring, pituitary involvement, immune checkpoint inhibitor-related endocrine effects, and biological, pharmacological, and analytical confounders affecting PRL interpretation. Results: Current evidence suggests that PRL may be biologically relevant in NSCLC through its involvement in pathways related to cell proliferation, survival, angiogenesis, invasion, epithelial–mesenchymal transition, immune modulation, and possible therapy resistance. Clinical observations indicate that altered PRL levels may occur in advanced disease, pituitary involvement, systemic inflammation, stress, or during anticancer and supportive treatment. However, PRL lacks cancer specificity and is influenced by multiple confounders, including circadian rhythm, stress, endocrine disorders, macroprolactin, cachexia, medications, and assay variability. Available clinical data remain limited and are largely derived from small studies or case-based evidence. Conclusions: PRL should not currently be considered a standalone diagnostic, predictive, or treatment-selective biomarker in NSCLC. Its most realistic potential role is as a supplementary circulating marker within multimarker prognostic and monitoring models. Prospective validation with standardized sampling, assay procedures, and confounder adjustment is required before clinical implementation. Full article

Introduction: Elasmobranchs are key components of marine ecosystems but are particularly vulnerable to fishing pressure due to their life-history traits, including slow growth, late maturity, and low fecundity. The Gulf of Cádiz supports a diverse assemblage of coastal and deep-water elasmobranch species, many of which are subject to incidental capture in demersal fisheries. Reliable fishery-independent information on their distribution, relative abundance, and biomass is essential to assess population status and to inform ecosystem-based fisheries management in the northeastern Atlantic. This study aims to provide an updated overview of the composition, relative abundance, biomass, and occurrence of elasmobranch species in the Gulf of Cádiz, contributing baseline information for monitoring and conservation purposes. Methodology: Data were obtained from the ARSA bottom trawl survey carried out in March 2026 using a stratified random sampling design by depth. A total of 45 valid hauls were performed. Results: A total of 29 elasmobranch species belonging to Rajiformes, Carcharhiniformes, Squaliformes, Myliobatiformes, Hexanchiformes, and Torpediniformes were identified. Small demersal sharks and skates dominated the assemblage. Scyliorhinus canicula was the most frequent and abundant species, occurring in 37 hauls and showing the highest mean abundance and biomass. Other recurrent taxa included Torpedo marmorata, Etmopterus spinax, Leucoraja naevus, and Raja clavata. Several species of conservation concern, such as Rostroraja alba, Centrophorus uyato, and Galeorhinus galeus, were recorded at low frequencies and abundances, highlighting their rarity in survey catches. The assemblage reflected a clear dominance of shelf and upper-slope species with occasional captures of deep-water taxa. Conclusions: The ARSA survey provides a valuable snapshot of the current elasmobranch community in the Gulf of Cádiz, confirming the prevalence of small-bodied, benthic species and the low occurrence of large or vulnerable taxa. These results underscore the importance of continued standardized surveys to detect temporal trends and support management strategies aimed at the conservation of elasmobranch diversity in the gulf. Full article

Purpose: Adjuvant radiotherapy (RT) for ductal carcinoma in situ (DCIS) remains a widely discussed topic. While it has been shown to significantly reduce recurrence rates, it does not improve overall survival (OS) and may therefore lead to overtreatment in some cases. This study aimed to assess patient acceptance, quality of life (QoL), and decisional regret (DR) in relation to late adverse effects. Methods: Clinical data from patients who underwent RT for DCIS between 2008 and 2020 were retrospectively collected, while follow-up questionnaires evaluated QoL and DR. High-risk DCIS was defined as tumor size ≥ 2.5 cm, poor differentiation (G3), age ≤ 50, and symptomatic diagnosis. Low-risk disease was defined as tumor size < 2 cm, G1/G2, age > 50, and mammographic diagnosis. Patients who did not meet all criteria for either category were classified as intermediate risk, therefore reflecting everyday work and clinical practice. Questionnaire data were analyzed using both scale-level and item-level approaches and Ipsilateral breast recurrence-free survival (IBRFS) rates were calculated using the Kaplan–Meier method. Results: Among 307 cases offered RT, only 24 declined, indicating high treatment acceptance; an additional 20 cases lacked sufficient documentation, did not receive RT at our center despite acceptance, or discontinued RT prematurely. During the study period, late toxicities occurred at acceptable frequencies: fibrosis in 6.1%, hyperpigmentation in 6.8%, telangiectasia in 8%, and edema in 1.5% of cases with excellent control rates of 90.0%. The response rate to the EORTC QLQ-C30 and Ottawa Decisional Regret Scale (DRS) was 35.4%, of whom 70 cases belonged to the intermediate-risk group. These respondents reported high QoL and low levels of DR. Conclusions: RT for intermediate grade DCIS is accepted and tolerated well, and neither late adverse effects nor QoL outcomes were associated with DR. These findings support recommending RT in this borderline-indication group. Full article

Background: Previous work from our group demonstrated an association between immunohistochemical detection of Human cytomegalovirus (HCMV) late antigen and poor event-free survival (EFS) in pediatric medulloblastoma. Whole-genome sequencing (WGS) further identified increased abundance of HCMV-aligned reads at the UL88 locus, particularly in Group 3 tumors, a molecular subgroup associated with aggressive clinical behavior and poor prognosis. Methods: We performed an integrated multi-omics analysis of pediatric medulloblastoma using WGS (n = 39) and RNA sequencing (RNA-seq; n = 28) datasets. RNA-seq data were filtered using stringent alignment criteria (MAPQ ≥ 20) and compared with fetal brain (n = 12), adult brain (n = 12), and HCMV-infected cell culture controls (n = 3). Only high-confidence uniquely aligned reads were retained to reduce nonspecific and multi-mapped viral alignments. Sequencing reads were aligned to the HCMV Merlin reference genome (NC_006273.2) using a standardized analytical pipeline. A subset of 28 cases with matched tumor WGS, tumor RNA-seq, and germline WGS data was used for integrated multi-omics analyses. Orthogonal validation analyses were performed in Group 3 tumors using independent genomic and transcriptomic approaches. Exploratory survival analyses were conducted in a combined cohort (n = 84) integrating genomic and immunohistochemical datasets. Results: Recurrent low-level HCMV-aligned molecular signals were identified across medulloblastoma datasets. Reads aligning to UL76, UL88, and UL99 were the most consistently detected HCMV-associated late-gene signals across RNA-seq and WGS datasets. A composite HCMV late-gene signature (UL76–UL88–UL99) showed higher levels in Group 3 tumors than in other molecular subgroups (p < 0.05 in WGS analyses). Orthogonal analyses demonstrated concordant low-level HCMV-associated genomic and transcriptomic signals enriched in tumors with MYC-associated activation and chromosome 17 imbalance. In the combined cohort (n = 84), elevated HCMV-associated signal assessed by immunohistochemistry and genomic profiling was associated with reduced EFS (median 55 vs. 147 months; log-rank p < 0.001). The subgroup classified as HCMV-high Group 3 demonstrated the strongest association with adverse outcome in exploratory multivariable analyses (HR = 6.43, p = 0.002). Conclusions: This study identifies recurrent low-level HCMV-associated genomic and transcriptomic signals across pediatric medulloblastoma datasets, with preferential enrichment in biologically aggressive Group 3 tumors. Although the extremely low abundance of viral-aligned reads precludes definitive evidence of productive viral infection, the reproducible detection of HCMV-associated molecular signatures across independent sequencing platforms supports further investigation into a potential oncomodulatory association in pediatric medulloblastoma. Additional validation using optimized viral detection methodologies, independent cohorts, and mechanistic studies will be necessary to clarify the biological and clinical significance of these findings. Full article

Background: Sport-related injuries are common, and often recurrent, among female college soccer players. This exploratory cohort study investigated whether perceptual decision efficiency and sleep quality could discriminate between injured and uninjured players. Methods: Twenty-seven NCAA Division I women’s soccer players (19.5 ± 1.3 years) completed a perceptual response training program, administered through an immersive virtual reality system, across a 13-week season. Players completed 11 training sessions progressing through four levels of task difficulty, with conjugate eye movements, neck rotation, and whole-body lunge-reach responses measured for each trial. Four metrics, elapsed time, rate correct per second, across-trials variability, and an efficiency index, were calculated for each of three defined time segments: perceptual decision, action initiation, and perceptual–motor response. The Pittsburgh Sleep Quality Index (PSQI) and Global Well-Being Index (GWBI) were administered prior to the first practice session, and all subsequent time-loss injuries were documented. Receiver operating characteristic analyses, Kaplan–Meier survival analysis, and classification tree modeling were used to evaluate injury discrimination. Results: Twelve time-loss injuries, including five concussions and seven lower extremity musculoskeletal injuries, were sustained by 10 of the 27 players. Optimal discrimination between injured and uninjured players was derived from the perceptual decision efficiency (PDE) metric for the most difficult perceptual response training task (AUC = 0.682–0.794), with a binary cut point of ≤6.02 yielding an odds ratio of 5.60 (95% CI: 1.02, 30.90; Mantel–Cox log rank p = 0.025). All five concussions occurred in players classified as high-risk by a suboptimal PDE value. Pre-participation PSQI demonstrated an AUC of 0.735. Notably, no player with both an optimal PDE value and a favorable sleep quality score (PSQI < 4) sustained a time-loss injury. Moderate-to-large training-related improvements in perceptual decision metrics were observed for the least challenging task from early- to late-season sessions. Conclusions: Optimal values for PDE and sleep quality together characterized female college soccer players who avoided injury. Both factors appear to be modifiable, suggesting that perceptual response training combined with interventions to enhance sleep quality may enhance injury resistance. Independent validation in larger, diverse athlete cohorts is warranted. Full article

Background: Smooth muscle tumors of uncertain malignant potential (STUMPs) are rare uterine neoplasms occupying the diagnostic continuum between benign leiomyoma and overtly malignant leiomyosarcoma. Their preoperative identification remains beyond the capability of current imaging modalities, and the diagnosis is almost invariably established through postoperative histopathological examination. The natural history of STUMP is highly variable, with recurrence rates ranging from approximately 7–27% and a documented potential for malignant transformation, underscoring the need for accurate pathological classification and long-term surveillance. Case Presentation: A 40-year-old woman with a history of hypertension presented with a 5-month history of progressive lower abdominal distension, urinary frequency, and menorrhagia. Transabdominal ultrasonography identified a large uterine fundal mass measuring approximately 10.89 × 8.96 cm. Preoperative laboratory findings demonstrated microcytic anemia. She underwent laparo-endoscopic single-site supracervical hysterectomy with bilateral salpingectomy. Histopathological examination revealed spindle cells with bland to mildly atypical nuclei, a mitotic count of <10/10 high-power fields, and focal necrosis, consistent with a diagnosis of STUMP. The patient remained free of recurrence over a 2-year follow-up period. Conclusions: This case illustrates the diagnostic challenge posed by STUMP in the preoperative setting and highlights the critical importance of thorough histopathological evaluation of all uterine smooth muscle tumor specimens. Minimally invasive hysterectomy with in-bag morcellation represents a feasible surgical approach, and long-term oncological surveillance is warranted given the risk of late recurrence and malignant transformation. Clinicians should maintain a heightened index of suspicion for borderline smooth muscle tumors when evaluating large or symptomatic uterine masses in premenopausal women. Full article

Background: Cryoablation is a minimally invasive technique that is being investigated as an alternative to surgery for early-stage breast cancer. Its potential advantages include outpatient treatment under local anaesthesia, favourable cosmetic outcomes, and possible immunologic synergy. However, its oncologic efficacy and long-term effectiveness are yet to be determined. Methods: We conducted a systematic review in accordance with PRISMA 2020 and the Cochrane Handbook, registered on PROSPERO (CRD420251137549). Databases searched were PubMed/MEDLINE, Scopus, and CENTRAL, from inception to August 2025. Eligible studies included women with unifocal, node-negative invasive ductal carcinoma ≤ 2 cm treated with percutaneous cryoablation. Outcomes of interest were residual disease, ipsilateral breast tumour recurrence, procedural and late complications, and cosmetic or patient-reported outcomes. Results: From 1074 records, 15 unique studies (17 reports) were included, comprising cryoablation-only studies (n = 7), treat-and-resect studies (n = 6), and comparative studies versus surgery (n = 2). Studies containing overlapping pathology validation and comparative components were classified within a single category to avoid duplication. Across treat-and-resect cohorts, complete tumour necrosis was reported in 88–95% of cases, with residual invasive carcinoma (RIC) ranging from 5% to 12%. In cryoablation-only cohorts, IBTR rates ranged from 0% to 4.3%, with follow-up durations spanning 2 months to 8 years. The largest study (ICE3, n = 194) reported a 5-year recurrence rate of 4.3%. Procedural complications were infrequent and self-limiting, most commonly bruising, oedema, or superficial frostbite. No major adverse events were reported. Validated quality-of-life instruments reported high patient satisfaction, with favourable results in selected comparative domains. Most included studies were of moderate methodological quality. Conclusions: Cryoablation appears technically feasible, safe, and cosmetically favourable in well-selected low-risk early-stage breast cancers. Oncologic outcomes are encouraging, with reported local recurrence rates in carefully selected low-risk populations being low, although direct comparison with breast-conserving surgery remains limited by the small number of comparative studies and substantial heterogeneity across the evidence base. Rigorous multicentre randomised trials with long-term follow-up and validated patient-reported outcomes are needed before cryoablation can be considered for routine clinical adoption. Full article

We investigated the autumn-to-winter evolution of water-mass structure and nutrient concentrations in Funka Bay, southwestern Hokkaido, Japan, from October to February (2012–2019). Hydrographic and biogeochemical profiles show a recurrent seasonal transition from strongly stratified conditions in October, with low surface nutrients and bottom enrichment, to increasingly homogeneous distributions by mid-winter as vertical mixing intensifies. Depth-averaged nutrient concentrations generally decreased from October to December and increased from December to February, except during December 2015–February 2016. To assess whether February nutrient levels can be explained by Oyashio supply alone, we calculated February nutrient concentrations using a two-endmember mixing model (Oyashio endmember and December Funka Bay water) with an additional regeneration term that assumes nutrients consumed during the October–December autumn bloom were fully regenerated during December–February and redistributed by winter mixing. Under this framework, the expected February concentrations agreed with observations in all winters except 2015, when observed nutrients were lower than expected nutrients, consistent with additional biological drawdown after the early onset of the bloom by late February. These results indicate that the pre-bloom winter nutrient environment in Funka Bay is shaped by variable Oyashio intrusion superimposed on seasonal mixing and internal regeneration processes. Full article

Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) of the central nervous system is a rare mesenchymal neoplasm with a propensity for late recurrence and distant metastasis. Pancreatic metastasis from intracranial SFT/HPC is exceptionally uncommon and may mimic primary pancreatic neoplasms, particularly pancreatic neuroendocrine tumor (PanNET). We report a 52-year-old man with a documented history of recurrent intracranial SFT/HPC, historically diagnosed as hemangiopericytoma, who developed a hypervascular pancreatic tail lesion 11 years after the initial intracranial tumor diagnosis. Contrast-enhanced imaging and endoscopic ultrasound-guided fine-needle aspiration initially suggested a primary pancreatic neoplasm, including solid pseudopapillary neoplasm or PanNET, and a definitive preoperative diagnosis could not be established. Following laparoscopic resection, histopathological examination revealed a spindle-cell tumor with a rich vascular pattern. Immunohistochemistry documented STAT6 positivity, together with vimentin and Bcl-2 positivity, supporting the diagnosis of pancreatic metastasis from SFT/HPC. The patient later developed unresectable recurrent pancreatic disease and underwent stereotactic radiotherapy, showing radiological disease control at follow-up. This case highlights that pancreatic metastasis from intracranial SFT/HPC, although extremely rare, may occur after a prolonged latency period and mimic a hypervascular primary pancreatic neoplasm. In patients with a history of intracranial SFT/HPC, late metastatic disease should be considered, and definitive diagnosis relies on histopathological examination and targeted immunohistochemistry. Full article

The routine culling of day-old male chicks represents a major ethical concern in the poultry industry. This practice has been banned in Germany, and a similar ban is being considered by the European Union. Each year, hundreds of millions of day-old male chicks are culled in the EU, with several billion culled worldwide. Various methods have been developed to determine the sex of chicks before hatching; however, most are invasive and identify sex relatively late, potentially after the onset of pain perception in embryos. Existing approaches include polymerase chain reaction analysis, spectroscopy, analysis of volatile organic compounds, morphological analysis, and machine vision. Previous studies have shown that machine vision can achieve accuracies of up to 89.25% by analyzing blood vessel patterns during early incubation. Despite this potential, research remains limited, particularly regarding different chicken breeds and the temporal development of embryos. In this study, we investigate the impact of both breed variation and temporal information on early-stage sex identification. Image data were collected on incubation days 4, 5, and 6 from a total of 208 chicken eggs. A convolutional neural network (CNN) and a hybrid convolutional neural network–recurrent neural network (CNN–RNN) model were evaluated to analyze spatial and temporal features. The results show that the CNN model achieved an accuracy of up to 71.43%, while the hybrid CNN–RNN model reached 67.85%. These findings indicate that incorporating temporal information did not improve performance compared to the baseline CNN. However, due to the limited size and quality of the dataset, no definitive conclusions can be drawn. Full article

Cross-condition remaining useful life (RUL) prediction of rolling bearings is affected by distribution shifts between operating conditions, limited labeled target-domain degradation samples, and interference from long stationary healthy stages. Under an offline full-life retrospective analysis protocol, this paper proposes a Degradation-Stage-Aware Transformer-GRU (DSA-TGRU) method. First, a health indicator is constructed from selected multidimensional degradation features by principal component analysis (PCA-HI), and an adaptive threshold moving rate of change (ATMROC) criterion is used to identify the transition from the healthy stage to the degradation stage, defined as the first prognostic time (FPT), i.e., the degradation-start time. Only post-FPT windows are then used to construct RUL labels for model training and evaluation. The prediction model combines a Transformer encoder for long-range sequence dependencies with gated recurrent units for temporal degradation evolution. The model is pretrained on source-domain bearings and then fine-tuned using a small number of labeled target-domain degradation samples available under the offline protocol. Stage-binned sampling and late-stage linear weighting are treated as auxiliary training strategies rather than universally effective modules. Experiments on the XJTU-SY and PHM2012 datasets show that post-FPT degradation modeling and target-domain fine-tuning play major roles in reducing cross-condition errors. The proposed method achieves average normalized MAE values of 0.0492 and 0.0738 and average normalized RMSE values of 0.0626 and 0.0928 on the two datasets, respectively, and generally outperforms several transfer-learning baselines in normalized error metrics. Ablation results further indicate that the benefits of stage-binned sampling and late-stage weighting are dataset- and task-dependent. The current version is not designed for online RUL prediction from incomplete target-bearing trajectories. Full article

Background: Pathological T0 (pT0) prostate cancer following radical prostatectomy is uncommon, and its prognostic significance remains unclear, particularly after neoadjuvant hormonal therapy (NHT). We investigated the incidence of pT0 disease in a multicenter Japanese cohort and described postoperative biochemical recurrence (BCR) outcomes. Methods: This retrospective study analyzed 3079 patients who underwent robot-assisted radical prostatectomy at nine Japanese centers between 2011 and 2021. Patients were classified as having pT0 or non-pT0 disease. Because only four pT0 cases occurred without NHT, these are summarized descriptively. Exploratory Kaplan–Meier and log-rank analyses of biochemical recurrence-free survival (BRFS) were performed for the NHT subgroup. Results: Twenty-seven pT0 cases (0.9%) were identified, and 85.2% were identified after NHT. Overall, 399 patients (13.0%) developed BCR. Among patients who did not undergo NHT, the 1- and 2-year BRFS rates were 100% and 100%, respectively, in the pT0 group and 92.4% and 88.1%, respectively, in the non-pT0 group. In the NHT subgroup, the corresponding rates were 92.9% and 92.7%, versus 91.8% and 85.5%, respectively (p = 0.651). Conclusions: pT0 disease after robot-assisted radical prostatectomy is rare and occurs predominantly after NHT. Given the possibility that late-onset recurrences may have been overlooked, the results of this trial should be understood as providing evidence from the short- to intermediate-term perspective. Full article

Background/Objectives: We evaluated perioperative morbidity, recurrence patterns and survival outcomes following pelvic exenteration (PE) at a tertiary referral centre. Methods: A retrospective observational study was conducted in women undergoing PE from 2004 to 2024. We collected demographics, performance status (PS), comorbidities, body mass index (BMI), tumour histology, intraoperative details, postoperative morbidity (Clavien–Dindo classification), mortality, length of stay (LOS), recurrence patterns and cancer-related death. Descriptive statistics were performed alongside Kaplan–Meier survival analysis. Results: Forty-seven patients underwent PE; median PS was 0 [interquartile range (IQR) 0–0]. Median ages at diagnosis and surgery were 55 (IQR 49–66) and 60 (IQR 50–68) years, respectively, with a median follow-up of 26 months (IQR 12–64). Thirty-two procedures (68%) were performed for recurrent and N = 15 (32%) for primary disease. Histology included N = 17 endometrial (36%), N = 10 vulval (23%), ovarian (15%), N = 5 cervical (11%) and N = 7 vaginal (15%) cases. Eighteen patients (38%) underwent total PE, N = 15 (32%) anterior PE and N = 14 (30%) posterior PE. Median blood loss was 1.5 L (IQR 0.85–2.0) and median operative time was 391 mis (IQR 313–482). Median HDU stay was 4 days (IQR 2–5) and LOS was 17 days (IQR 13–31). One postoperative death occurred. Major complications (Clavien–Dindo ≥3) occurred in 15 patients (32%). Late complications occurred in n = 17 (36.2%) women. Nineteen patients (41%) remained recurrence-free; N = 4 (9%) developed local and N = 24 (51%) distant recurrence. Mean overall survival time post-surgery for curative intent PE (N = 46) was 94 months (95%CI = 57–131 months); for primary tumours this was 51.6 (95%CI = 31–72) vs. 99 (56.01–142) for recurrent disease (p > 0.05). Conclusions: Pelvic exenteration is associated with acceptable morbidity and mortality in carefully selected patients, offering excellent locoregional disease control. Full article

Recurrent pericarditis (RP) remains challenging, especially in tuberculosis (TB)-endemic regions where empirical anti-TB therapy is often unnecessarily prolonged. We report a 35-year-old woman with three RP episodes over six months, presenting with pleuritic chest pain, elevated inflammatory markers, and moderate-to-large pericardial effusion. Extensive infectious (including TB), autoimmune, and malignancy workups were negative. Cardiac magnetic resonance revealed persistent pericardial late gadolinium enhancement despite clinical remission. Whole-exome sequencing identified a heterozygous MEFV c.442G>C (p.Glu148Gln) variant, suggesting an autoinflammatory predisposition. Although the patient finally achieved sustained symptom-free status for six months on a standardized low-dose colchicine regimen, still over 10% of patients have recurrent symptoms receiving colchicine in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen. This case highlights the shifting paradigm from an infection-centered to an autoinflammatory framework for RP in TB-endemic countries, underscores the role of MEFV variants in idiopathic recurrent pericarditis, and illustrates the real-world gap between genetic insights and therapeutic accessibility to IL-1 inhibitors in resource-limited settings. Full article