Dermatomyositis (DM) is an autoimmune inflammatory myopathy characterized by proximal muscle weakness and distinctive cutaneous manifestations. While dysphagia is a well-recognized otolaryngologic feature of DM, dysphonia-particularly as an early or isolated manifestation-remains under-recognized and may be overlooked, especially in professional voice users. Maria Callas, one of the most influential opera singers of the twentieth century, experienced a rapid and controversial vocal decline at the peak of her career, the etiology of which has long been debated.

There has been a growing interest in the nutritional care of patients with Parkinson's disease (PD). The nutritional domain can be considerably affected by the disease, its treatment, and progression, particularly by motor symptoms and levodopa-related complications, which are responsible for important energy imbalances. However, gastrointestinal dysautonomia symptoms (sialorrhea, dysphagia, and constipation) and dysfunction are also major issues, and their evaluation and monitoring are recommended. Nutritional status, nutrition-related complications, and geriatric syndromes also play a role in disease management and prognosis. Patients can take advantage of various interventions, which can be (i) general and applicable to all, or (ii) tailored to specific conditions. Their orientation is both for treatment and prevention, focusing on the maintenance of nutritional and functional status and quality of life, avoidance of nutritional deficiencies, management of gastrointestinal dysfunction, and optimization of pharmacological treatments, particularly levodopa-based regimes. The basic principles of nutritional care for PD have here been summarized to provide a guidance paper to all clinicians dealing with these patients. Attention was focused on basic assessment procedures, evidence-based interventions, expert-based recommendations, and new potential strategies. Therefore, some spotlights on therapeutic options deserving further investigation have been provided.

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.

Pontine and brainstem tumors during pregnancy are rare. However, they carry a high maternal mortality risk due to symptom overlap with common pregnancy-related conditions. Diagnosis and management are often delayed and remain challenging. This study presented two cases of pregnant patients with brainstem tumors. The first case involved an 18-week pregnant woman presenting with otitis-like symptoms, facial palsy, right-sided paresthesia, and paralysis. By the time a definitive diagnosis was established, the tumor had become inoperable, and the patient died from tumor-related complications. The second case involved a 23-week pregnant woman who presented with headache, nausea, vomiting, dysphagia, and significant weight loss. The pregnancy ended shortly after admission due to preterm premature rupture of membranes, and the patient subsequently died following tumor resection as a result of massive intracranial hemorrhage. These cases highlighted the high risk of misdiagnosis due to overlap with common pregnancy-related symptoms and highlighted the importance of early neurological evaluation to ensure accurate diagnosis and timely management.