This paper focuses on the evolution of the genre of medical case reports, examining how different contextual aspects influenced its formation. Specifically, it analyzes (1) the use of courtesies in the 19th-century reports, (2) the role of conventionalized language in the 20th-century reports, and (3) the impact of the Medicine 2.0 movement on on-line reports during the last several years. The analysis demonstrates that the genre does not remain fixed over time but is shaped by the socio-historical contexts in which the authors live.