OpenMed/multicare-articles huggingface dataset:
Case report: Spinal cord stimulation for pain relief in two patients with locally recurrent pelvic malignancy
Authors: Yousif Salem, Charles T West, Malcolm West, Hideaki Yano, Paul Fernandes, Girish Vajramani, Alexander Mirnezami
Journal: Front Oncol (2024)
Keywords: locally recurrent anal cancer, locally recurrent rectal cancer, pain relief, palliative therapy, spinal cord stimulation
MeSH terms: Case Reports

Introduction:
Chronic cancer-related pain from locally recurrent infiltrative cancers within the bony confines of the pelvis is a devastating and hard to manage condition that can be refractory to many conventional pain management methods. Spinal cord stimulation (SCS) is an evolving and safe method of pain management and can be trialled in a quick and well-tolerated operation under local anaesthesia. To date, this has not been reported in the setting of locally recurrent inoperable pelvic cancers.
Case description:
In the present study, we report two cases of patients with severe back and lower limb pain resulting from recurrent anal and rectal cancers involving the right lumbar and sacral nerve roots as well as the bony sacrum, which severely affected quality of life and daily functioning.
Discussion:
Following successful SCS, effective pain relief was observed.
Conclusion:
SCS could represent an effective supplementary or alternative technique to conventional pain management in this challenging group of patients, especially if other available methods have been exhausted.
Case report: A rare immune-related adverse effect: hepatic cavernous hemangioma induced by camrelizumab
Authors: Chuantao Zhang, Guanqun Wang, Ning Liu, Tianjun Li, Jingjuan Zhu, Helei Hou
Journal: Front Immunol (2024)
Keywords: adverse event, camrelizumab, case report, immunotherapy, visceral hemangioma
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, Antibodies, Monoclonal, Humanized / therapeutic use, Hemangioma, Cavernous / chemically induced, Liver Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Aged, Female, Humans, Immune Checkpoint Inhibitors / adverse effects, Male, Middle Aged, Retrospective Studies, camrelizumab, Antibodies, Monoclonal, Humanized, Immune Checkpoint Inhibitors

Background:
Camrelizumab, a programmed death 1 (PD-1) inhibiting antibody, has demonstrated efficacy in various malignancies and received approval in multiple countries. Despite its therapeutic benefits, camrelizumab is associated with a unique spectrum of immune-related adverse effects (irAEs), predominantly reactive cutaneous capillary endothelial proliferation (RCCEP). However, visceral manifestations of such endothelial proliferations, particularly hepatic cavernous hemangiomas, have not been extensively documented.
Methods:
This case series retrospectively reviews six patients who developed hepatic hemangiomas following treatment with camrelizumab in combination with other chemotherapeutic agents. The series highlights the clinical course, imaging findings, management strategies, and outcomes associated with this complication. A detailed analysis was conducted to discern the potential causal relationship between camrelizumab therapy and the development of hepatic hemangiomas.
Results:
All six patients, after varying cycles of camrelizumab-based therapy, presented with hepatic lesions identified as cavernous hemangiomas on imaging. These findings were atypical for metastatic disease and were further complicated by significant clinical events, including massive intra-abdominal bleeding post-biopsy. Discontinuation of camrelizumab led to a reduction in the size of the hemangiomas in two cases, suggesting a potential link between the drug and the development of these vascular lesions. The incidence of RCCEP remained high, and the use of other agents such as bevacizumab did not mitigate the occurrence of hepatic hemangiomas, indicating a possible unique pathogenic mechanism associated with camrelizumab.
Conclusion:
Hepatic cavernous hemangioma may represent a rare but clinically significant irAE associated with camrelizumab therapy. This series underscores the importance of vigilant monitoring and a high index of suspicion for atypical hepatic lesions in patients undergoing treatment with PD-1 inhibitors. Further studies are warranted to elucidate the pathophysiology of this complication and to establish guidelines for the management and surveillance of patients receiving camrelizumab.
Ultrasound Doppler findings of a Twin Reversed Arterial Perfusion Sequence (TRAP)
Authors: Saba A Abdulmalik Amer, Sultan Abdulwadoud Alshoabi, Abdulaziz A Qurashi, Fahad H Alhazmi, Rawda Yehia Al-Rudini
Journal: Pak J Med Sci (2024)
Keywords: monoamniotic twin (share an amniotic sac) acardiac fetus, monochorionic twin (share a single placenta), pump fetus, twin reversed arterial perfusion sequence
MeSH terms: Case Reports

Twin reversed arterial perfusion (TRAP) sequence is a rare pregnancy complication occurs in an identical twin pregnancy that share a single placenta. TRAP sequence is a twin's pregnancy includes a normal-developed viable pump fetus and an abnormal usually nonviable acardiac fetus. The nonviable acardiac fetus depends on the pump fetus for his blood supply and put the pump fetus at risk of high cardiac output heart failure and congenital anomalies with high mortality rate. Gray-scale ultrasound and color and pulsed Doppler imaging is a noninvasive accessible imaging modality for the diagnosis of TRAP sequence. Early diagnosis of such conditions is mandatory in order to apply the proper therapeutic measures and to help the normal developed pump fetus to survive. The main goal of management is to interrupt blood supply to the nonviable acardiac fetus to reduce the strain on the heart of the pump fetus thus, increase the chance of survival.
Ranolazine as a First-Choice Anti-anginal Medication for Patients With Coronary Artery Ectasia: A Case Series
Authors: Juwayria A Ahmed, Khudheeja A Ahmed, Mohammed Habeeb Ahmed
Journal: Cureus (2024)
Keywords: aneurysmal coronary artery disease, angina pectoris, coronary artery ectasia (cae), coronary slow flow phenomenon, ranolazine
MeSH terms: Case Reports

Coronary artery ectasia (CAE) is characterized by the abnormal dilation of coronary arteries, resulting in disturbed or slow blood flow, which causes angina pectoris-the most prevalent symptom of CAE. To date, there is no consensus on the therapeutic management of CAE due to its rarity and the scarcity of research. We present a case series of five patients with different ethnicities, including both men and women, whose CAE was successfully managed by the administration of ranolazine. All five patients were found to have CAE by coronary angiography, which was also associated with slow blood flow. Clinically, the patients had accelerating angina. They were prescribed an initial dose of 500 mg of ranolazine twice daily, which led to the resolution of their anginal symptoms. They have been clinically and hemodynamically stable for the last several years. In light of these results, we propose that ranolazine be considered as a first-choice anti-anginal medication for patients with CAE.
Unloading of the Left Ventricle With More Delayed Reperfusion May Reduce Reperfusion Injury
Authors: Sara Hazaveh, Haroon Faraz
Journal: Cureus (2024)
Keywords: acute st-elevation myocardial infarction, cardiac catherization, door to balloon time, left ventricular unloading, reperfusion injury
MeSH terms: Case Reports

Early reperfusion therapy is crucial and the standard of care for the management of acute ST-elevation myocardial infarction (STEMI). We report a case of STEMI with unloading followed by more delayed reperfusion, which challenges current clinical practice. It also highlights the importance of more translational research to better understand STEMI on a mechanistic level including the crucial role of mitochondria and anaerobic respiration during vessel occlusion and ischemia. This can also help in preventing post-myocardial infarction complications such as reperfusion injury, which leads to the development of heart failure.
Diagnosis of a Rare Rickettsia felis Infection Complicated with Unusual Pericardial Effusion and Cardiac Tamponade Using an mNGS Test
Authors: Tien-Lung Po, Chien-Hsien Huang, Chia-Hsun Lin, Huei-Fong Hung
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

The occurrence of sporadic rickettsial infections has been consistently undervalued and overlooked, primarily owing to a limited emphasis on routine examinations for rickettsioses in clinical practice. At present, the immunofluorescence assay is the prevailing diagnostic method for suspected rickettsioses that enables the detection of specific antibodies against rickettsia in human serum. Herein, we present an exceptional instance of rickettsial infection that was characterized by a rare manifestation of extensive pericardial effusion leading to dyspnea and cardiac tamponade. A diagnosis of chronic fibrosing pericarditis was established based on pericardium tissue obtained through pericardiotomy, and a conclusive metagenomic next-generation sequencing test confirmed the presence of Rickettsia felis infection. The cat flea, scientifically known as Ctenocephalides felis, is the predominant carrier of R. felis. An escalating incidence of human R. felis infections has raised concerns, particularly in light of the burgeoning population of domesticated animals in many contemporary societies.
Nephrotic Syndrome Associated With Heavy Metals Exposure: A Case Report and Literature Review
Authors: Petros Kalogeropoulos, Aggeliki Sardeli, George Liapis, Panagiotis Giannakopoulos, Sophia Lionaki
Journal: Cureus (2024)
Keywords: environmental exposure, lead, nephrotic syndrome, steroid-resistant, toxicity
MeSH terms: Case Reports

Heavy metals are found in many products used in everyday life. In addition, many workers are exposed to higher concentrations of such metals in their work environment. Many of these metals may cause toxic effects in humans and there are many reports relating them to the occurrence of kidney disorders such as nephrotic syndrome. In this study, we present a case of a 38-year-old woman with nephrotic syndrome suspected to be related to heavy metal toxicity, after ruling out all other secondary causes. At the same time, she proved refractory to multiple therapies. Furthermore, a related literature review regarding the occurrence of nephrotic syndrome in patients with heavy metal exposure is presented with emphasis on the importance of considering them as a secondary cause, especially in cases that appear resistant to treatment.
Simultaneous occurrence of extralobar pulmonary sequestration, esophageal duplication, and bronchogenic cysts in a Chinese child: a rare case report
Authors: Huashan Zhao, Yunpeng Zhai, Rui Guo, Hongxiu Xu, Sai Huang, Longfei Lv, Shisong Zhang
Journal: Front Pediatr (2024)
Keywords: chinese children, bronchogenic cyst, esophageal duplication, extralobar pulmonary sequestration, mediastinum
MeSH terms: Case Reports

The occurrence of simultaneous extralobar pulmonary sequestration, esophageal duplication, and bronchogenic cysts is relatively low. We report the case of a 9-month-old Chinese child who had a right lung cyst, detected in utero and was closely monitored until birth. At age 9 months, contrast-enhanced computed tomography revealed right mediastinal extralobar pulmonary sequestration and two cysts. The patient did not exhibit any abnormalities. However, the parents were concerned about the disease. Following positive psychological counseling to the parents, surgery was the strong desire. Subsequently, successful thoracoscopic surgery was performed, excising the three lesions. No postoperative complications occurred. Postoperative pathology confirmed extralobar pulmonary sequestration syndrome combined with esophageal duplication and bronchogenic cysts. The patient was followed-up at 1 and 12 months postoperatively and recovered well with no abnormal space occupation. In such cases, preoperative imaging examinations should be carefully performed, and intraoperative exploration should correspond to that before surgery to avoid lesion omission.
Inferior vena cava thrombosis extension into the right atrium: An unusual case report of renal cell carcinoma
Authors: Mara Trifoi, Marc Levine, Andrew Kim, Brandon Eden, Adam Albert
Journal: SAGE Open Med Case Rep (2023)
Keywords: inferior vena cava thrombosis, renal cell carcinoma
MeSH terms: Case Reports

Inferior vena cava filling defects are common findings on computed tomography and magnetic resonance imaging, and accurate determination of pseudo, benign, or malignant thrombus is essential for clinical management. Inferior vena cava thrombosis involvement extending into the right atrium is a rare presentation of renal cell carcinoma. The degree of inferior vena cava and right atrium involvement is critical in determining management and prognosis of patients. Inferior vena cava thrombosis surgical thrombectomy is often a risky procedure due to the intraoperative determination of inferior vena cava thrombosis involvement. Accurate recognition of inferior vena cava thrombosis with right atrial involvement is critical in determining appropriate treatment options and preoperative level of involvement for surgical intervention. This case features a unique presentation of inferior vena cava thrombosis in renal cell carcinoma with right atrial involvement.
A Case Report of Fedratinib-Associated Uveitis
Authors: William Evans, Christina Mathew, James Richardson-May, Rashi Arora
Journal: Cureus (2024)
Keywords: adverse drug event, drug induced uveitis, fedratinib, hypopyon, myelofibrosis
MeSH terms: Case Reports

Drug-induced uveitis is a rare but important subgroup of uveitis particularly among newer drugs in the market. Establishing a diagnosis can be challenging and requires the physician to have a high index of suspicion and a holistic approach with consideration being afforded to history, clinical examination, and investigations. In this case report, we describe a case of hypopyon uveitis in a 64-year-old male with a background of myelofibrosis for which he was started on fedratinib. A thorough history, negative investigation panel, and temporal association between the start of the drug and uveitis helped establish the diagnosis. A literature review showed no other published cases of uveitis secondary to fedratinib. While he could not be withdrawn from the drug, collaboration with the medical team enabled close monitoring and follow-up. He recovered following a course of steroids and remains under observation.
Lymphomonocytic inflammatory infiltrate with numerous eosinophilic granulocytes in the interstitium in a surviving heart transplant recipient: a case report
Authors: Silvia Placidi, Paola Francalanci, Rachele Adorisio, Katia Girardi, Luciana Vinti, Mario Panebianco, Micol Rebonato, Antonio Amodeo, Giorgia Grutter
Journal: Front Cardiovasc Med (2024)
Keywords: arteriovenous extracorporeal membrane oxygenation, case report, endomyocardial biopsy, heart transplantation, lymphomonocytic inflammatory infiltrate
MeSH terms: Case Reports

Findings of eosinophilic and lymphomonocytic inflammatory infiltrates in endomyocardial biopsies (EMBs) may help in myocardial disease diagnosis identification. Eosinophilic myocarditis (EM), a rare condition, is fatal if left untreated and has rarely been described in heart transplant recipients. An extensive work up is necessary to achieve an early etiological diagnosis; however, the underlying cause remains unexplained in nearly one-third of the patients. The cornerstone of treatment is corticosteroids, comprehensive therapy and heart failure management (including advanced mechanical support for fulminant myocarditis). We have described the case of a 17-year-old heart transplant recipient who presented with a cardiogenic shock. He was admitted to our intensive care unit and treated with inotropic drugs, such as milrinone, adrenaline, vasopressin, and levosimendan; the doses of these drugs were in accordance with our internal protocol. The patient underwent cardiac catheterization, coronarography, and right ventricular EMB. EMB revealed inflammatory lymphomonocytic and eosinophil granulocyte infiltrates; thus, steroid therapy was initiated, with complete recovery achieved after 15 days. Performing an early differential diagnosis among eosinophilic infiltration, acute cellular rejection (ACR), and possible chemotherapeutic damage is emerging as an important challenge. To our knowledge, this is the first reported case of a lymphomonocytic inflammatory infiltration with numerous eosinophilic granulocytes in the interstitium in a surviving heart transplant recipient.
Cold Atmospheric Plasma Is a Promising Alternative Treatment Option in Case of Split Skin Graft Failure
Authors: Aydar Khabipov, Andre Schreiber, Stephan Kersting, Richard Hummel, Johannes Höhn, Lars-Ivo Partecke, Sander Bekeschus, Anne Glitsch, Wolfram Keßler
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Cold atmospheric plasma (CAP) has shown promising potential in promoting wound healing. This case report presents the successful application of CAP in a 42-year-old female patient with extensive wound healing disorders and superinfections following the excision of an abscess in the left thoracic region. After several failed split skin graft attempts, the implementation of CAP led to significant improvements in wound healing. This report highlights the wound healing-promoting effects of CAP and discusses its potential mechanisms of action.
Primary mediastinal Ewing's sarcoma presenting with sudden and severe chest pain: a case report
Authors: Chen Su, Xiaobo Zhu, Junjie Zhang
Journal: Front Oncol (2024)
Keywords: ewing’s sarcoma, case report, chest pain, mediastinum, thoracic cancer
MeSH terms: Case Reports

Ewing's sarcoma, characterized by small round cell morphology, is a rare malignancy, with mediastinal Ewing's sarcoma being even less common. This case describes a distinctive presentation of primary mediastinal Ewing's sarcoma in a 32-year-old male presenting with sudden and severe chest pain. Initial evaluation excluded cardiac and pulmonary emergencies, revealing a posterior mediastinal mass through advanced imaging. The patient's clinical symptoms significantly improved following the complete resection of the tumor via thoracoscopy. Subsequent analysis incorporating imaging, histological, immunohistochemical and genetic findings led to the conclusive diagnosis of primary mediastinal Ewing's sarcoma.
Polymyxin-induced neuromuscular weakness: a case report
Authors: Amanda X Y Chin, Kay W P Ng, Yee Cheun Chan, Yihui Goh, Rahul Rathakrishnan
Journal: Front Neurol (2024)
Keywords: multi-drug resistance, neuromuscular blockade, neurotoxicity, polymyxin, renal impairment, respiratory failure
MeSH terms: Case Reports

Polymyxin-induced neuromuscular blockade is a rare but potentially fatal condition, with majority of cases that were reported between 1962 and 1973. We describe a patient who developed hypercapnic respiratory failure after initiation of polymyxin for multi-drug resistant Escherichia Coli bacteremia, due to polymyxin-induced neuromuscular dysfunction. After cessation of polymyxin, he regained full strength, had complete resolution of ptosis, and was successfully extubated. In light of the renewed use of polymyxin in this era of antimicrobial-resistance, this case aims to raise awareness about this rare but life-threatening condition, which is easily reversible with early recognition and prompt discontinuation of the drug.
Comprehensive genomic profiling of a metastatic small cell lung carcinoma with a complete and long-term response to atezolizumab: A case report
Authors: Kresimir Tomic, Dragana Karan Krizanac, Faruk Skenderi, Kristina Krpina, Andrea Carapina Bilic, Kristina Galic, Zoran Gatalica, Semir Vranic
Journal: Respir Med Case Rep (2023)
Keywords: atezolizumab, genomic profiling, immunotherapy, lung cancer, small cell lung cancer
MeSH terms: Case Reports

Small cell lung cancer (SCLC) is a highly aggressive malignancy with a poor outcome. We present the case of a 57-year-old male patient with extensive-stage (ES-SCLC) treated with chemotherapy and atezolizumab. A complete response was achieved with a long remission of ∼three years. Comprehensive genomic profiling (CGP) of the tumor revealed high tumor mutation burden (13 mutations/Mb) and mutations of TP53, RB1 and ERCC4 genes. This case study confirms that a complete response to chemoimmunotherapy may be achieved in the case of ES-SCLC. It further provides the additional value of CGP and predictive testing in the management of ES-SCLC.
Case report: Tolosa-Hunt syndrome-expanding the neuromyelitis optica spectrum disorder phenotype?
Authors: Soo-Hyun Park, Soo-Im Jang, Eun-Ja Lee, Nam-Hee Kim
Journal: Front Neurol (2024)
Keywords: aqp4-immunoglobulin g, tolosa-hunt syndrome, abducens palsy, aquaporin-4 antibody, neuromyelitis optica spectrum disorder, optic neuritis
MeSH terms: Case Reports

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy caused by the autoantibody of aquaporin-4 (AQP4). Herein, we report a case of Tolosa-Hunt syndrome presenting with abducens palsy and AQP4 antibodies. This was a rare case of AQP4-immunoglobulin G seropositivity in a patient with Tolosa-Hunt syndrome. Our findings may expand the clinical phenotype of NMOSD and indicate that clinicians should consider testing for AQP4 antibodies in patients with Tolosa-Hunt syndrome.
Case report: Reassessing guidelines for safe resumption of diving after spinal decompression sickness: insights from a challenging case
Authors: Arnaud Druelle, Jean-Eric Blatteau, Lucile Daubresse Duchadeuil, Jean Morin, Romain Roffi, Pierre-Louis Dufresne, Henri Lehot, Olivier Castagna
Journal: Front Med (Lausanne) (2024)
Keywords: dcs recurrence, decompression sickness, neurological dcs, patent foramen ovale, right-to-left shunt, spinal cord compressive factors
MeSH terms: Case Reports

Background:
Recreational divers who have experienced Spinal Decompression Sickness (DCS) often aspire to return to their diving activities. Traditionally, it is recommended to observe a waiting period of several months before contemplating a return to unrestricted diving, particularly when clinical symptoms are absent, spinal cord Magnetic Resonance Imaging shows no anomalies, and the evaluation for Patent Foramen Ovale (PFO) returns negative results.
Methods:
This article presents a compelling case study involving a 51-year-old recreational scuba diver who encountered two episodes of spinal decompression illness within a two-year timeframe. Notably, the search for a PFO produced negative results. The primary objective of this article is to underscore the critical importance of a meticulously planned approach to resuming diving after DCS incidents, emphasizing the potential for recurrence and the essential preventive measures.
Conclusion:
We delve into the intricate decision-making process for returning to diving, emphasizing the significance of clinical evaluations, PFO assessments, spinal cord Magnetic Resonance Imaging, and the absence of clinical symptoms. By recognizing the risk of recurrence and the need for proactive prevention measures, we provide recommendations for both medical professionals and divers, with the ultimate goal of enhancing safety and informed decision-making within the diving community.