This case study describes and analyzes the psychodynamic experiences of an adult hospitalized after an acute cardiac event. Pierre, a 46-year-old Brazilian man with a high level of education, sought medical care for chest pain and was diagnosed with acute myocardial infarction. He was immediately admitted to a hospital coronary care unit, where, after clinical stabilization, he agreed to undergo psychological assessment using self-report instruments and projective methods. While Pierre did not show clinical indicators of psychological distress on the self-report scales, his responses on the projective methods revealed signs of conflict in interpersonal relationships, with strong repression of affective experiences, suggesting difficulties in emotional management and a potential link to his physical illness. This case study, using a multimethod design, enriched the understanding of his psychological functioning and supported the identification of resources for coping with cardiac illness.

The incidence of Campylobacter jejuni enterocolitis is increasing, with this bacterium being the leading cause of acute bacterial diarrhea. However, cardiac complications associated with C. jejuni remain rare. A 47-year-old man presented with sudden chest pain and shortness of breath. Echocardiography revealed pericardial tamponade and pleural effusion over time. Despite the patient having no prior gastrointestinal complaints, Campylobacter jejuni was identified in pericardial aspirates and stool samples by microbiological analysis. Exclusive pericarditis caused by C. jejuni remains an extremely rare complication. To date, the successful isolation of the pathogen from pericardial fluid has only been reported three times. Despite being immunocompetent, relevant bacteremia appears to be a likely cause of the infection. Isolated pericarditis is a rare but serious complication of Campylobacter jejuni infection. Regarding pathogenesis, direct bacterial invasion is becoming increasingly likely. The emergence of antimicrobial-resistant strains must be considered when selecting a therapeutic regimen.

A 33-year-old woman presented with progressive dysphagia and pleuritic chest pain, initially undergoing an unrevealing cardiopulmonary evaluation. Persistent symptoms prompted upper endoscopy, which demonstrated an ulcerated gastroesophageal junction lesion, with biopsy confirming invasive moderately to poorly differentiated adenocarcinoma. Immunohistochemical studies showed intact mismatch repair protein expression and negative human epidermal growth factor receptor 2 and Claudin 18.2, while programmed death-ligand 1 expression was markedly elevated (tumor proportion score 80%; combined positive score 80). Comprehensive next-generation sequencing revealed no actionable genomic alterations. Staging positron emission tomography demonstrated widespread metastatic disease, including involvement of the regional lymph nodes, liver, and ovary. The patient was treated with combination chemotherapy and immune checkpoint inhibition. This case highlights an atypical presentation of advanced gastroesophageal junction adenocarcinoma in a young adult and underscores the importance of early endoscopic evaluation in patients with persistent dysphagia, as well as recognition of uncommon metastatic patterns and the therapeutic implications of biomarker profiling.

Uterine leiomyomas are common benign smooth muscle tumors typically confined to the uterus and hormonally responsive to estrogen and progesterone, typically regressing after menopause. Rarely, they demonstrate metastatic behavior despite benign histology, a condition known as benign metastasizing leiomyoma (BML). BML is exceedingly rare and can mimic malignancy, posing diagnostic challenges. We report a rare case of a 53-year-old woman with a history of hysterectomy for leiomyomas who presented with dyspnea and chest pain. Imaging revealed numerous bilateral pulmonary nodules, later confirmed to be smooth muscle tumors. After being lost to follow-up, she returned 2 years later with new breast and forearm masses. Imaging and biopsy confirmed metastatic smooth muscle tumors consistent with BML. Breast lesions mimicked benign cysts on ultrasound, underscoring the importance of clinical and histological correlation. The patient responded well to treatment with symptom improvement. This case highlights the rare phenomenon of BML metastasizing to multiple extrauterine sites, including the breast and soft tissues, locations infrequently reported. Imaging findings, particularly in the breast, can mimic benign lesions such as simple cysts, underscoring the need for biopsy and correlation with clinical history. BML should be considered in women with a history of uterine fibroids and indolent-appearing metastases without fludeoxyglucose uptake on positron emission tomography, computed tomography, and cystic appearance on ultrasound of breast lesions. Early recognition is crucial to avoid misclassification as malignancy and to guide effective hormonal treatment.