{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:15:57Z","timestamp":1791530157233,"version":"4.3.4"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Metastasis of renal cell carcinoma (RCC) most frequently occurs in the lungs, bones, liver, and brain. Breast metastasis from RCC is exceedingly rare, particularly in male patients presenting with a breast mass as the initial manifestation. We report a 54-year-old man who presented with a breast nodule that, upon excision, was pathologically confirmed as metastatic Clear cell RCC. Abdominal computed tomography (CT) revealed a primary lesion in the left kidney. One month and nine months after laparoscopic partial nephrectomy, recurrent metastatic lesions were detected in the breast. After two subsequent excisions of the breast metastases, the patient was treated with lenvatinib in combination with tislelizumab. However, treatment was discontinued due to intractable diarrhoea. Three months after treatment cessation, follow-up CT imaging revealed widespread systemic metastases. The patient is currently maintained on sunitinib monotherapy. The total duration of follow-up was 30 months. This case, together with a review of earlier reported cases of RCC with breast metastasis, reveals the interesting observation that female patients with RCC appear to be more susceptible to \u201cdelayed\u201d breast metastasis compared with male patients. Our analysis underscores the need for thorough evaluation of breast nodules in patients with an RCC history, even absent classic signs like nipple retraction or discharge. These findings may contribute to the future development of effective management guidelines for breast metastases from RCC and help clinicians better recognize this clinical entity.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1729630","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:19:32Z","timestamp":1774858772000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case report: Renal clear cell carcinoma presenting with metastatic nodules in the male breast: a case and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Yangcai","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenqiang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Army Medical University","place":["Chongqing, China"]},{"name":"Department of Medicinal Chemistry, College of Pharmacy, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00917-6","article-title":"Renal cell carcinoma","volume":"404","author":"Young","year":"2024","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12929-024-01111-9","article-title":"Tumor-initiating and metastasis-initiating cells of clear-cell renal cell carcinoma","volume":"32","author":"Pham","year":"2025","journal-title":"J BioMed Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.21869","article-title":"Evaluation of clear cell, papillary, and chromophobe renal cell carcinoma metastasis sites and association with survival","volume":"4","author":"Dudani","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3322\/caac.21254","article-title":"Cancer statistics, 2015","volume":"65","author":"Siegel","year":"2015","journal-title":"CA Cancer J Clin"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1148\/rg.230036","article-title":"Extramammary metastases to the breast","volume":"43","author":"Li","year":"2023","journal-title":"Radiographics"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1070744","article-title":"Breast metastasis from endometrial clear cell carcinoma: a case report and review of the literature","volume":"12","author":"Choo","year":"2023","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1053\/adpa.2001.21476","article-title":"Metastases to breast simulating ductal carcinoma in situ: report of two cases and review of the literature","volume":"5","author":"Gupta","year":"2001","journal-title":"Ann Diagn Pathol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231161711","article-title":"Case report of renal cell carcinoma metastasis to the breast","volume":"89","author":"Breese","year":"2023","journal-title":"Am Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1111\/j.1464-410x.1995.tb07846.x","article-title":"Breast lump--an unusual presentation of renal cell carcinoma","volume":"76","author":"Gibbons","year":"1995","journal-title":"Br J Urol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.12892\/ejgo200505547","article-title":"Metastatic disease in the breast from nonmammary neoplasms","volume":"26","author":"Smymiotis","year":"2005","journal-title":"Eur J Gynaecol Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13050991","article-title":"Secondary breast Malignancy from renal cell carcinoma: challenges in diagnosis and treatment-case report","volume":"13","author":"Spasic","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.48352","article-title":"Clinically silent, metastatic renal cell carcinoma detected on routine screening mammogram: a report of a rare case and review of literature","volume":"15","author":"Pernicone","year":"2023","journal-title":"Cureus"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2021.02.006","article-title":"Metastatic renal cell carcinoma initially presenting as a unilateral breast lump","volume":"16","author":"Khurram","year":"2021","journal-title":"Radiol Case Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2015.12.005","article-title":"Intramammary metastasis of renal cell carcinoma: a diagnostic trap","volume":"44","author":"Koch","year":"2016","journal-title":"Gynecol Obstet Fertil"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2012.07.022","article-title":"A case of renal cell carcinoma metastasizing to invasive ductal breast carcinoma","volume":"113","author":"Chen","year":"2014","journal-title":"J Formos Med Assoc"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-12-00019.1","article-title":"A mammary nodule mimicking breast cancer","volume":"99","author":"Solaini","year":"2014","journal-title":"Int Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/1742-6413.131737","article-title":"Fine-needle aspiration of metastatic renal cell carcinoma to a male breast: a rare initial presentation","volume":"11","author":"Saluja","year":"2014","journal-title":"Cytojournal"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2012.15.2.244","article-title":"Breast metastasis from renal cell carcinoma: rare initial presentation of disease recurrence after 5 years","volume":"15","author":"Mahrous","year":"2012","journal-title":"J Breast Cancer"},{"key":"B19","article-title":"Metastatic renal cell carcinoma presenting as a breast lump in a treated breast cancer patient","volume":"50","author":"Durai","year":"2009","journal-title":"Singapore Med J"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2008.00606.x","article-title":"Renal cell carcinoma presenting as a solitary breast mass. a diagnostic pitfall on aspiration cytology of clear cell tumors of the breast","volume":"14","author":"Daneshbod","year":"2008","journal-title":"Breast J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-5-25","article-title":"Breast metastasis from a renal cell cancer","volume":"5","author":"Alzaraa","year":"2007","journal-title":"World J Surg Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2007.00433.x","article-title":"Renal cell carcinoma metastasis to the breast: mammographic, sonographic, CT, and pathologic correlation","volume":"13","author":"Lee","year":"2007","journal-title":"Breast J"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1075-122X.2005.00057.x","article-title":"Renal cell carcinoma metastatic to the breast and breast cancer metastatic to the kidney: two rare solitary metastases","volume":"11","author":"Gacci","year":"2005","journal-title":"Breast J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1023\/a:1017990625298","article-title":"Solitary breast metastases from a renal cell carcinoma","volume":"68","author":"Vassalli","year":"2001","journal-title":"Breast Cancer Res Treat"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1097\/00005392-200004000-00041","article-title":"Abnormal mammogram as the presenting sign of renal cell carcinoma","volume":"163","author":"Grossklaus","year":"2000","journal-title":"J Urol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1992.11701351","article-title":"Metastatic renal cell carcinoma presenting as a breast mass","volume":"91","author":"Lesho","year":"1992","journal-title":"Postgrad Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2017.08.008","article-title":"Breast metastasis nine years after nephrectomy for renal cell carcinoma: a case report","volume":"39","author":"Ishigaki","year":"2017","journal-title":"Int J Surg Case Rep"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjac116","article-title":"Breast metastasis 18 years after nephrectomy for renal cell carcinoma: a case report","volume":"2022","author":"Elouarith","year":"2022","journal-title":"J Surg Case Rep"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6625689","article-title":"Renal cell carcinoma metastasis to the breast: a rare presentation","volume":"2021","author":"Ali","year":"2021","journal-title":"Case Rep Radiol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.10428","article-title":"Renal cell carcinoma diagnosis after initial detection on screening mammogram","volume":"12","author":"Nguyen","year":"2020","journal-title":"Cureus"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.eucr.2017.11.032","article-title":"Sporadic breast metastasis derived from renal cell carcinoma: a case report","volume":"16","author":"Ikarashi","year":"2017","journal-title":"Urol Case Rep"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12837","article-title":"Isolated breast metastasis 4 years after nephrectomy","volume":"24","author":"Amadu","year":"2018","journal-title":"Breast J"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-219124","article-title":"Renal cell carcinoma with isolated breast metastasis","volume":"2017","author":"Dhannoon","year":"2017","journal-title":"BMJ Case Rep"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-013-0026-9","article-title":"Breast metastasis from clear cell renal cell carcinoma","volume":"16","author":"Botticelli","year":"2013","journal-title":"J Ultrasound"},{"key":"B35","article-title":"Metastatic renal cell cancer presenting as a breast mass","volume":"10","author":"Pathe","year":"2012","journal-title":"Clin Adv Hematol Oncol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.5334\/jbr-btr.699","article-title":"Metastatic renal cell carcinoma presenting as a breast mass in a woman with history of primary breast cancer","volume":"94","author":"Balliauw","year":"2011","journal-title":"JBR-BTR"},{"key":"B37","article-title":"Breast metastasis from a renal cell carcinoma","volume":"10","author":"Bortnik","year":"2008","journal-title":"Isr Med Assoc J"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2005.09.009","article-title":"Solitary breast mass as initial presentation of clinically silent metastatic renal cell carcinoma","volume":"15","author":"McLauglin","year":"2006","journal-title":"Breast"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1201\/9781003032106-3","article-title":"Metastasis to the breast of a renal carcinoma: a clinical case","volume":"3","author":"Forte","year":"1999","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/s0748-7983(96)92632-3","article-title":"Metastatic renal adenocarcinoma presenting in a breast screening programme","volume":"22","author":"Bowditch","year":"1996","journal-title":"Eur J Surg Oncol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1990.tb07372.x","article-title":"Hypernephroma presenting as a lump in the breast","volume":"60","author":"Masters","year":"1990","journal-title":"Aust N Z J Surg"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050111","article-title":"Renal carcinoma: bilateral breast metastases in a child","volume":"27","author":"Pursner","year":"1997","journal-title":"Pediatr Radiol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.06.2008.0239","article-title":"Bilateral breast metastases of a renal carcinoma: a case report and review of the literature","volume":"2008","author":"Ganapathi","year":"2008","journal-title":"BMJ Case Rep"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.1998.tb08902.x","article-title":"Bilateral breast metastases from a renal carcinoma","volume":"52","author":"Heggarty","year":"1998","journal-title":"Int J Clin Pract"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.4176\/090510","article-title":"Breast and axillary lymph nodes metastasis five years after radical nephrectomy for renal cell carcinoma a case report and review of the literature","volume":"4","author":"Hairulfaizi","year":"2009","journal-title":"Libyan J Med"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-0339(199805)18:5<343::aid-dc7>3.0.co;2-b","article-title":"Fine-needle aspiration of metastatic renal-cell carcinoma masquerading as primary breast carcinoma","volume":"18","author":"Kannan","year":"1998","journal-title":"Diagn Cytopathol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s13000-017-0666-8","article-title":"Renal clear cell carcinoma metastasis to the breast ten years after nephrectomy: a case report and literature review","volume":"12","author":"Xu","year":"2017","journal-title":"Diagn Pathol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0b013e3181f89400","article-title":"The use of immunohistochemistry in the diagnosis of metastatic clear cell renal cell carcinoma: a review of PAX-8, PAX-2, hKIM-1, RCCma, and CD10","volume":"17","author":"Sangoi","year":"2010","journal-title":"Adv Anat Pathol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0072-OA","article-title":"PAX2 and PAX8 expression in primary and metastatic renal tumors: a comprehensive comparison","volume":"136","author":"Ozcan","year":"2012","journal-title":"Arch Pathol Lab Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/BF02914791","article-title":"Renal cell carcinoma metastasis to breast","volume":"172","author":"O'Sullivan","year":"2003","journal-title":"Ir J Med Sci"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1093\/omcr\/omaf029","article-title":"Rare metastasis of renal cell carcinoma to the breast: a case report","volume":"2025","author":"Sahoo","year":"2025","journal-title":"Oxf Med Case Rep"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-0339(199911)21:5<324::aid-dc5>3.0.co;2-q","article-title":"Fine-needle aspiration cytology of renal-cell adenocarcinoma metastatic to the breast: a report of three cases","volume":"21","author":"Chhieng","year":"1999","journal-title":"Diagn Cytopathol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199608)15:2<139::AID-DC12>3.0.CO;2-I","article-title":"Metastatic neoplasms of the breast: fine-needle aspiration cytology of two cases","volume":"15","author":"Ferrara","year":"1996","journal-title":"Diagn Cytopathol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2025.104630","article-title":"Optimization of immunotherapy-based combinations for metastatic renal cell carcinoma: a network meta-analysis","volume":"208","author":"Park","year":"2025","journal-title":"Crit Rev Oncol Hematol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1159\/000325765","article-title":"Sarcomatoid renal cell carcinoma metastatic to the breast: report of a case with diagnosis on fine needle aspiration cytology","volume":"51","author":"Ding","year":"2007","journal-title":"Acta Cytol"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2025.04.001","article-title":"Management of metastatic renal cell carcinoma: guideline updates","volume":"11","author":"Barragan-Carrillo","year":"2025","journal-title":"Eur Urol Focus"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.02.020","article-title":"European association of urology guidelines on renal cell carcinoma: the 2025 update","volume":"87","author":"Bex","year":"2025","journal-title":"Eur Urol"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1223929","article-title":"Comparative safety of tyrosine kinase inhibitors in the treatment of metastatic renal cell carcinoma: a systematic review and network meta-analysis","volume":"14","author":"Krawczyk","year":"2023","journal-title":"Front Pharmacol"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/TRRM4238","article-title":"Lenvatinib plus pembrolizumab for untreated advanced renal cell carcinoma: a systematic review and cost-effectiveness analysis","volume":"28","author":"Fleeman","year":"2024","journal-title":"Health Technol Assess"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.10.034","article-title":"Evidence and clinical relevance of tumor flare in patients who discontinue tyrosine kinase inhibitors for treatment of metastatic renal cell carcinoma","volume":"68","author":"Iacovelli","year":"2015","journal-title":"Eur Urol"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-12-1459","article-title":"Mind the gap: potential for rebounds during antiangiogenic treatment breaks","volume":"18","author":"Ebos","year":"2012","journal-title":"Clin Cancer Res"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00793-8","article-title":"Temporary treatment cessation versus continuation of first-line tyrosine kinase inhibitor in patients with advanced clear cell renal cell carcinoma (STAR): an open-label, non-inferiority, randomised, controlled, phase 2\/3 trial","volume":"24","author":"Brown","year":"2023","journal-title":"Lancet Oncol"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26440","article-title":"Phase II trial of continuous once-daily dosing of sunitinib as first-line treatment in patients with metastatic renal cell carcinoma","volume":"118","author":"Barrios","year":"2012","journal-title":"Cancer"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyr151","article-title":"Response rates and adverse effects of continuous once-daily sunitinib in patients with advanced renal cell carcinoma: a single-center study in Turkey","volume":"41","author":"Yildiz","year":"2011","journal-title":"Jpn J Clin Oncol"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15204934","article-title":"Comprehensive systematic review of biomarkers in metastatic renal cell carcinoma: predictors, prognostics, and therapeutic monitoring","volume":"15","author":"Dani","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B66","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1038\/s41467-022-29577-x","article-title":"A proteogenomic analysis of clear cell renal cell carcinoma in a Chinese population","volume":"13","author":"Qu","year":"2022","journal-title":"Nat Commun"},{"key":"B67","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12943-024-02059-y","article-title":"PD1\/PD-L1 blockade in clear cell renal cell carcinoma: mechanistic insights, clinical efficacy, and future perspectives","volume":"23","author":"Zhu","year":"2024","journal-title":"Mol Cancer"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.02.008","article-title":"Single-cell deconvolution of a specific Malignant cell population as a poor prognostic biomarker in low-risk clear cell renal cell carcinoma patients","volume":"83","author":"Saout","year":"2023","journal-title":"Eur Urol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1729630\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:19:54Z","timestamp":1774858794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1729630\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":68,"alternative-id":["10.3389\/fimmu.2026.1729630"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1729630","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"article-number":"1729630"}}