Louisiana Via Research Day Book 2026

Case Studies: Section 1

Case Studies: Section 1

Carson Cox, OMS-III, Stephanie Aldret, DO VCOM-Louisiana 37 A REVIEW OF UCL TEARS IN THROWING ATHLETES AND THE CURRENT TREATMENTS

Justin Bejcek, MS 1 ; Dhanushya Battepati, MD 2 ; Lancaster Weld, DO 3 ; Megan Lewis, DO 3 1 VCOM-Louisiana; 2 Division of Internal Medicine, Dept. of Medicine, BSW Medical Center, Temple, Texas; 3 Division of Gastro & Hepatology, Dept. of Medicine, BSW Medical Center, Temple, Texas 38 INVASION OF THE LYMPHOCYTES: A RARE CASE OF ATYPICAL THYMOMA DISCOVERED IN THE COLON

Background: The incidence of Ulnar Collateral Ligament (UCL) injuries continues to rise among youth, collegiate, and professional throwing athletes as a result of repetitive, high-tensile valgus stress placed on the medial elbow. The UCL—particularly its anterior bundle—plays a critical role in resisting valgus load during overhead throwing and is therefore vulnerable to cumulative microtrauma and acute failure. Injury grading guides treatment, which may include rest, rehabilitation, and kinetic-chain optimization for lower-grade injuries, or surgical repair and reconstruction for complete tears. Advances in imaging, biologic adjuncts such as platelet-rich plasma, and refined surgical techniques have expanded diagnostic accuracy and treatment efficacy. This review synthesizes current understanding of UCL anatomy, biomechanics, clinical evaluation, imaging modalities, management strategies, and rehabilitation considerations, as well as areas of ongoing research.

Context: Thymomas are an exceptionally rare tumor, and depending on the type, do not typically metastasize beyond the anterior mediastinum. Thymomas are classified into distinct types, including A, atypical A, AB, B1, B2, and B3, most of which grow slowly and rarely metastasize, unlike thymic carcinomas. The classification of thymomas remains a topic of debate among different iterations of the WHO classification, which are distinguished by cell morphology, lymphocytic involvement, histologic stains, and markers. This study represents a unique case of gastrointestinal malignancy from a primary thymic tumor. Case Presentation: A 43-year-old woman with stage IV B3 atypical thymoma, initially diagnosed in 2011 with metastatic involvement of the liver, pleura, left supraclavicular lymph nodes, and mediastinum, presented with anemia and recurrent melena. Over more than a decade, she underwent multiple lines of systemic therapy, including cisplatin/etoposide, carboplatin/paclitaxel, sunitinib, pemetrexed, CAP therapy (cyclophosphamide, doxorubicin, carboplatin), lenvatinib, and pembrolizumab, along with radiation to chest and flank masses

and surgical resection of pleural-based tumors. Treatment modifications were frequently required due to toxicity or disease progression. Results: She developed progressive dysphagia in 2021, prompting gastroenterological evaluation; endoscopy revealed no acute findings, and empiric esophageal dilation was performed. Subsequent evaluation for persistent iron-deficiency anemia and melena led to EGD and colonoscopy in March 2024, which identified a friable, necrotic, exophytic mass in the descending colon. Biopsy confirmed metastatic thymoma to the colon. Conclusions: From mid-2024 onward, the patient experienced recurrent hospitalizations for complications, including acute hypoxic respiratory failure, worsening anemia, hemoptysis, and hypotension. In January 2025, she was admitted for hemoptysis and was found to have progressive tumor burden, causing severe narrowing of the left mainstem bronchus, with bronchoscopy revealing friable mucosa. Given continued progression despite extensive multimodal therapy, the patient elected for hospice care and died in March 2025.

Discussion: Type B3 thymomas are a rare extrathoracic tumor with a high potential of malignancy, especially when compared to other thymoma types. Thymic tumors have metastatic potential but have rarely been documented in the lower gastrointestinal tract. This case provides a significantly rare metastasis of a primary thymoma to the descending colon.

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2026 Research Recognition Day