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Case Report | DOI: https://doi.org/10.31579/2690-4861/922
Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
*Corresponding Author: Lei Yuan, Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Citation: Hao Q. Han, Wen L. Li, Yi T. Bao, Lei Yuan, (2025), Acute Abdomen in A Woman Caused by Torsion of Pedunculated Subserosal Myoma: A Case Report and Literature Review, International Journal of Clinical Case Reports and Reviews, 33(2); DOI:10.31579/2690-4861/922
Copyright: © 2025, Lei Yuan. 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: 17 July 2025 | Accepted: 25 July 2025 | Published: 08 January 2026
Keywords: subserosal myoma; torsion; acute abdomen
Background: Torsion of pedunculated subserosal myoma is a clinically rare but potentially life-threatening disease. In patients with acute abdomen, fibroid pedicle torsion is not a routine differential diagnosis. If not timely identified and treated, fibroid torsion can lead to avascular necrosis and peritonitis. However, relevant publications have so far only been single case reports with a lack of systematic review to summarize clinical features and experience.
Case presentation: A 48-year-old woman complained of lower abdominal pain for two weeks and was initially treated as acute pelvic inflammatory disease. The patient’s inflammatory indicators returned to normal but abdominal pain persisted. Considering a pelvic mass found by imaging examination and persistent abdominal pain, a diagnostic laparoscopy was performed, which demonstrated torsion of a pedunculated subserosal myoma. The subserosal myoma and the other two fibroids were removed, and the abdominal pain was completely relieved after surgery. Postoperative pathology confirmed uterine leiomyoma with infarction.
Conclusions: Abdominal pain is the most common symptom of leiomyoma torsion. MRI shows higher accuracy and is highly recommended for preoperative diagnosis of myoma torsion. Regardless of pregnancy status, surgery is the first choice of treatment.
Torsion of pedunculated subserosal myoma is a gynecologic emergency with an incidence of less than 0.25% among surgically diagnosed uterine fibroids[1]. Although the incidence of pedunculated subserosal myoma in torsion is rare and remains largely unknown, it can lead to significant morbidity and potentially be life-threatening[2]. Most cases are diagnosed intraoperatively due to their non-specific symptoms and imaging findings. Therefore, an accurate preoperative diagnosis is challenging and once myoma torsion is suspected, surgical intervention should be considered. To our knowledge, data is limited considering the clinical features of leiomyoma torsion up till now. Herein, we reported a rare case of pedunculated subserosal myoma in torsion with a suspected diagnosis of acute pelvic inflammatory disease. We then reviewed 30 pieces of literature with a total of 34 cases to summarize the clinical characteristics and experience of torsion of pedunculated subserosal myoma.
A 48-year-old woman, gravida 1 para 1 woman came to our hospital in March 2024 complaining of lower abdominal pain for two weeks. She had a one-year history of multiple fibroids. Ten days prior to admission, the patient underwent conservative anti-inflammatory treatment for one week at a local hospital with suspicion of acute pelvic inflammatory disease indicated by elevated inflammatory markers and tenderness on gynecological examination. After treatment, inflammatory indicators returned to normal. However, the patient’s abdominal pain was not significantly relieved which resulted in her referral to our hospital. Gynecological examination revealed an enlarged uterus at 8 weeks gestation and a hard mass on the left side of the uterus with obvious tenderness, measuring about 7 cm. Transvaginal ultrasound revealed multiple fibroids (Figure 1A) and a hypoechoic solid mass measuring 7 × 5 cm closely adhered to the posterior aspect of the uterus with suspicion of leiomyoma degeneration (Figure 1B).
Figure 1: (A) Transvaginal ultrasound image demonstrating multiple leiomyomas fusing on the anterior wall of the uterus. (B) A solid mass in the posterior wall of the uterus.
An abdominal CT scan revealed a mass on the left side of the uterus, measuring approximately 72 × 46 mm, with an uncertain origin. Pelvic contrast-enhanced MRI showed a mass in the left posterior part of the uterus, measuring 5.0 × 7.6 cm, without clear demarcation from the uterine serous surface. The mass showed mixed-intensity signals on both T1- and T2-weighted imaging with well-defined margin strengthened after enhancement (Figure 2A and B).
Figure 2: Sagittal T1-weighted (A) and T2-weighted (B) images showed a mass in the left posterior part of the uterus with marginal enhancement.
Leiomyoma degeneration or torsion was first suggested by MRI, meanwhile an ovarian tumor cannot be excluded. An exploratory laparoscopy was performed considering the pelvic mass and the persistent lower abdominal pain. Moderate adhesions between the posterior wall of the uterus and rectosigmoid colon were found during intraoperative exploration (Figure 3A). After separation of pelvic adhesions, a pedunculated subserosal myoma was identified, which was dark bluish and twisted 360 degrees along its vascular pedicle (Figure 3B, 3C). Besides, two leiomyomas in the anterior wall of the uterus were found, measuring 5×4 cm and 1×2cm respectively. The subserosal myoma and two intramural fibroids were completely removed intraoperatively (Figure 3D). Pathological examination demonstrated uterine leiomyoma with infarction. Postoperatively, the abdominal pain was disappeared and the patient discharged five days after surgery. On regular follow-up, no recurrence was observed by September 2024.
Figure 3: (A) Moderate adhesions between the posterior wall of the uterus and rectosigmoid colon. (B) A pedunculated subserosal myoma on the posterior wall of the uterine was dark bluish. (C) A twisted pedicle. (D) The end of surgery.
Fibroid torsion is uncommon and rarely diagnosed preoperatively[3]. The pathogenic mechanisms and risk factors associated with the torsion of a subserosal uterine leiomyoma remain unclear. Abdominal pain is the primary complaint among patients, which poses a diagnostic challenge due to the wide range of potential pathological conditions[4]. We conducted a literature search in the PubMed database using the terms "myoma", "fibroid", "leiomyoma", and "torsion" as keywords since the year 2000. This search yielded a total of 30 articles, which included 34 cases of pedunculated subserosal myoma in torsion, identified through screening of the titles and abstracts of records retrieved from 133 gynecological literature sources[1,3,5-32] (Table 1).
Who is more likely to develop myoma torsion?
The incidence of leiomyoma torsion varies among women of different ages. The median age at diagnosis is 37.5 years, ranging from 12 to 62. Among the reported cases, the majority (20 out of 34, 59%) occurred in reproductive-age women (aged 30–49 years), while only 6 out of 34 cases (18%) were observed in perimenopausal and postmenopausal women (aged ≥ 50) with myoma torsion (Table1). Women of reproductive age exhibit the highest incidence of myoma torsion, partly because uterine fibroids are prevalent in this demographic[33]. All cases involved myomas with a maximum diameter greater than 5 cm, averaging 11.6 cm, with the largest being 25 cm in a 45-year-old woman (Table 1). Despite the shrinking of uterine fibroid lesions and decreased estrogen in women at the perimenopausal stage, it is noteworthy that 18% of women aged ≥ 50 years experienced myoma torsion with a median maximum diameter of 9.3 cm. This suggests that myoma torsion may be more related to the size of the myoma rather than hormonal changes. The diagnosis of acute pelvic pain in perimenopausal patients should take into account the physiological changes in the pelvis and the patient's clinical history. It is crucial to continue monitoring postmenopausal women with a history of fibroids, as the onset of menopause does not eliminate the risk of myoma torsion.
How to make accurate diagnosis?
The preoperative diagnosis of pedunculated subserosal leiomyoma in torsion is often challenging[18], due to its non-specific symptoms and signs as well as the absence of definitive laboratory and imaging findings. If left untreated for a prolonged period, it can lead to ischemic gangrene and subsequent peritonitis[10]. All cases presented acute abdominal pain, with nearly half (16/34, 47%) presenting to the emergency department/room for their initial consultation. One case was admitted to the surgical oncology department because of small bowel volvulus induced by myoma torsion. Therefore, an initial evaluation and differential of the patients must be considered since multiple organ systems contribute to abdominal pain[4]. In addition, most cases (22/34, 65%) showed elevated inflammatory indicators, but only a few cases (6/34, 18%) had a fever (Table 1).
| Authors | Year | Age | First consultation | Elevated inflammatory indicators | Elevated temperature (>37℃) | Maximum diameter of the myoma(cm) | Surgery approach |
| Kim et al | 2013 | 26 | ER | YES | YES | 8.4 | LA, MT |
| Yamashita et al | 2022 | 60 | ER | YES | NO | 7 | LT, MT |
| Šantak et al | 2013 | 61 | ER | YES | YES | NA | LT, HT |
| Roy et al | 2005 | 30 | ER | YES | NO | 15 | NA |
| Kim et al | 2022 | 31, P | ER | YES | NO | 7 | LA, MT |
| Thanasa et al | 2024 | 27 | ER | YES | NO | 15 | LT, MT |
| Le et al | 2020 | 58 | ER | NA | NA | 9.3 | LT, MT |
| Joseph et al | 2023 | 37, P | OB-GYN | YES | NO | 9.6 | LT, MT |
| Currie et al | 2013 | 27, P | OB-GYN | YES | NO | 8 | LA, MT |
| Miles et al | 2021 | 48 | NA | NA | NA | 19.3 | LA, MT |
| Kosmidis et al | 2015 | 31, P | ER | YES | NO | 7.7 | LA, MT |
| Fanfani et al | 2010 | 39, P | ER | NO | NO | 9 | LA, MT |
| Chang et al | 2023 | 28 | ER | YES | NO | NA | LT, MT |
| Guglielmo et al | 2017 | 45 | Surgical Oncology Department | YES | NA | 25 | LT, MT |
| Tavernaraki et al | 2020 | 50 | ER | YES | NO | 11 | LA, MT |
| Endo et al | 2020 | 44 | OB-GYN | YES | YES | 6.2 | LA, MT |
| Allameh | 2019 | 26 | OB-GYN | YES | NO | 17 | LT, MT |
| Chen et al | 2019 | 45 | ER | YES | YES | 11 | LA, MT |
| Foissac et al | 2011 | 62 | NA | YES | NO | 23 | LT, HT, BOT |
| Dhillon et al | 2023 | 28 | GE | NO | NO | 16 | LT, MT |
| Agrawal et al | 2023 | 40 | GE | YES | YES | 12 | LT, MT |
| Takeda et al | 2016 | 43 | GE | YES | NA | 5.5 | LA, MT |
| Tsai et al | 2006 | 38 | ER | YES | NO | 8 | LT, MT |
| Levai et al | 2019 | 38 | ER | YES | NO | 8.8 | MT |
| Gaym et al | 2007 | 20 | NA | NO | NO | 8 | LT, MT |
| Manchanda et al | 2020 | 12 | OB-GYN | NO | NO | 20 | LA, MT |
| Nigam et al | 2014 | 42 | NA | NO | NO | 11.7 | LT, MT |
| Basso et al | 2017 | 36, P | ER | YES | NO | 15 | LT, MT |
| Cecile et al | 2007 | 32 | ER | NO | NO | 7 | LA, MT |
| Lai et al | 2018 | 53 | OB-GYN | YES | NA | 12 | HT+BSO |
| 41 | OB-GYN | NA | NA | 13 | LT, MT | ||
| 36 | OB-GYN | NO | NO | 11 | LT, MT, ROT | ||
| 30 | OB-GYN | NO | NO | 7.5 | LA, MT | ||
| 36 | OB-GYN | NO | NA | 7 | MT |
Table 1: Literature review of torsion of pedunculated subserosal myoma.
Abbreviations: P = pregnant; ER = emergency department/room; GE = gynecology emergency; OB-GYN = obstetrics and gynecology; LT = laparotomy; LA = laparoscopy; MT = myomectomy; HT = hysterectomy; BOT = bilateral oophorectomy; BSO =bilateral salpingo-oophorectomy; ROT = right oophorocystectomy; NA = not available
Pelvic inflammatory disease and adnexal mass are the major differential diagnoses, but it is noteworthy that pregnancy status and obstetric causes should be considered[4,34]. Imaging modalities are essential for narrowing the differential diagnosis in patients with gynecologic emergencies[35]. In women presenting with pelvic pain, ultrasonography (US) is the most frequently utilized initial imaging modality[36]. However, it does not demonstrate superior accuracy in preoperative diagnosis[37]. The presence of the stalk was confirmed via ultrasound in a limited number of cases (5/30, 16.7%) (Table 2).
| Authors | Year | Pedunculated proved by US | Pedunculated proved by CT | Pedunculated proved by MRI | Imaging modalities used | Pedunculated proved by image |
| Kim et al | 2013 | NO | NA | YES | US, MRI | YES |
| Yamashita et al | 2022 | NO | YES | YES | CT, US, MRI | YES |
| Šantak et al | 2013 | NA | NO | NA | CT | NO |
| Roy et al | 2005 | NO | NO | NA | US, CT | NO |
| Kim et al | 2022 | NO | NA | NO | US, MRI | NO |
| Thanasa et al | 2024 | NO | NA | NA | US | NO |
| Le et al | 2020 | YES | YES | NA | CT, US | YES |
| Joseph et al | 2023 | NO | NA | YES | US, MRI | YES |
| Currie et al | 2013 | NO | NA | NA | US | NO |
| Miles et al | 2021 | NO | NA | YES | MRI, US | YES |
| Kosmidis et al | 2015 | NO | NA | NA | US | NO |
| Fanfani et al | 2010 | YES | NA | NA | US | YES |
| Chang et al | 2023 | NA | NO | NA | CT | NO |
| Guglielmo et al | 2017 | NA | YES | YES | X, CT, MRI | YES |
| Tavernaraki et al | 2020 | NO | NO | NA | US, CT | NO |
| Endo et al | 2020 | NO | NO | NO | US, CT, MRI | NO |
| Allameh | 2019 | NO | NA | NA | US | NO |
| Chen et al | 2019 | NO | NO | NA | US, CT | NO |
| Foissac et al | 2011 | NA | YES | NA | CT | YES |
| Dhillon et al | 2023 | YES | NA | YES | US, MRI | YES |
| Agrawal et al | 2023 | NO | YES | NA | US, CT | YES |
| Takeda et al | 2016 | YES | NA | YES | US, MRI | YES |
| Tsai et al | 2006 | NO | NA | NA | X, US | NO |
| Levai et al | 2019 | NO | YES | NA | US, CT | YES |
| Gaym et al | 2007 | NO | NA | NA | US | NO |
| Manchanda et al | 2020 | NO | NO | YES | US, CT, MRI | YES |
| Nigam et al | 2014 | YES | NA | YES | US, MRI | YES |
| Basso et al | 2017 | NO | NA | NA | US | NO |
| Cecile et al | 2007 | NO | NA | NA | US | NO |
| Lai et al | 2018 | NO | NO | NA | US, CT | NO |
| NO | NA | NA | US | NO | ||
| NO | NA | NA | US | NO | ||
| NO | NA | NA | US | NO | ||
| NO | NA | NA | US | NO |
Table 2: Imaging modalities used for cases.
Abbreviations: US = ultrasonography; CT = computed tomography; MRI = magnetic resonance imaging; NA= not available.
Conversely, computed tomography (CT) and magnetic resonance imaging (MRI) are preferred for supplementary imaging, particularly for gastrointestinal and urogenital etiologies of pelvic pain, and are especially recommended in cases of clinically suspected ovarian torsion with inconclusive ultrasound findings. MRI offers the inherent advantage of excellent soft-tissue contrast resolution allowing for the better characterization of the abnormalities[38-40]. The detection rate of pedicle for CT was 42.9% (6/14), while 81.8% (9/11) for MRI. MRI showed higher sensitivity and specificity. However, about half of all cases (41%, 14 /34) were absent of a specific pedicle in preoperative imaging examination (Table 2). Vascular pedicles are critical for the diagnosis of torsion of the leiomyoma[41], but can be challenging to detect with imaging techniques if the pedicle is thin and short[42]. Although atypical clinical symptoms and imaging modalities do not permit a precise preoperative diagnosis, they still play an important role in the detection of torsion of pedunculated subserosal myoma. Once preoperative imaging findings reach an accurate diagnosis, immediate surgical intervention is indicated, and failure to operate can lead to necrosis and sepsis[7]. Exploratory surgery should be considered even when a direct vascular pedicle is invisible, as evidenced by our case, which showed the mass in contact with the uterus. Furthermore, it can identify the source of the mass and provide early treatment for undetected malignancies[1].
What should physicians pay attention to?
Pain occurs in approximately 30% of patients with leiomyomas typically resulting from acute degeneration and is the most common complication of pregnancy[10,43,44]. Fibroid torsion has been reported in 6 cases during pregnancy. Conservative management is the first choice and most commonly used approach for pregnant patients with red degeneration[43]. However, torsion of pedunculated subserous myoma necessitates surgical intervention, and if left untreated, it is even life-threatening due to myoma necrosis, infection, resultant inflammatory peritoneal reaction, and peritonitis[17]. Therefore, it is important to consider torsion when masses are discovered in pregnant patients with severe abdominal or pelvic pain[45]. Surgery is the primary treatment option for torsion of pedunculated subserosal leiomyoma. In 13 cases, a laparoscopic approach was chosen, while laparotomy was performed in 17 cases. It is essential to carefully choose the appropriate surgical approach, especially in pregnant women. In our case, the patient was treated with anti-inflammatory therapy for one week for suspected pelvic inflammatory disease. Following this treatment, inflammatory indicators decreased back to normal values; however, the abdominal pain persisted, albeit with a decrease in intensity. Ultimately, the real cause of the patient's abdominal pain (torsion of pedunculated subserosal myoma) was finally identified by diagnostic laparoscopy. It is suggested that dynamic monitoring and assessment during clinical diagnosis and treatment is very important. In conclusion, torsion of pedunculated subserosal myoma is a rare condition. The most common symptom of leiomyoma torsion is abdominal pain. It’s difficult to distinguish from other common surgical and gynecologic acute abdomen. MRI shows higher accuracy and is highly recommended for preoperative diagnosis of myoma torsion. Regardless of pregnancy status, surgery is the first choice of treatment.
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Not applicable
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The patient provided written informed consent for publication of information and images.
Availability of data and materials
The data used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Competing interests
The authors declare that no conflicts of interest exist.
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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.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.
Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
