OpenMed/multicare-articles huggingface dataset:
Multiple Pulmonary Artery Pseudoaneurysms Secondary to Metastatic Uterine Leiomyosarcoma
Authors: Teetawat Jearsirikul, Surajai Junnhu, Nantaka Kiranantawat
Journal: J Belg Soc Radiol (2021)
Keywords: pulmonary arterial pseudoaneurysm, leiomyosarcoma, metastasis, pulmonary metasasis, sarcoma
MeSH terms: Case Reports

Teaching point: The probable mechanism of pseudoaneurysm formation related to metastatic neoplasm is a tumor embolus penetrating and destroying the vessel wall. Pulmonary artery pseudoaneurysm (PAP) related to metastatic neoplasm is rare. We describe a unique case of multiple PAPs secondary to metastatic uterine leiomyosarcoma and demonstrate the serial chest computed tomography to support the theory that the tumor begins as a tumor embolus, followed by infiltration and breakdown of the vessel wall, leading to aneurysmal dilatation and invading the perivascular tissue.
Extensive drug resistant (XDR) Acinetobacter baumannii parappendicular-related infection in a hydrocephalus patient with ventriculoperitoneal shunt: a case report
Authors: Cucunawangsih Cucunawangsih, Akhil Deepak Vatvani, Kalis Waren
Journal: Pan Afr Med J (2020)
Keywords: acinetobacter baumanii, neurosurgery, tigecycline
MeSH terms: Acinetobacter Infections / diagnosis, Acinetobacter baumannii / isolation & purification, Ventriculoperitoneal Shunt / adverse effects, Case Reports, Acinetobacter Infections / microbiology, Adolescent, Anti-Bacterial Agents / pharmacology, Drug Resistance, Multiple, Bacterial, Female, Humans, Hydrocephalus / therapy, Anti-Bacterial Agents

Ventricular infection due to XDR-Acinetobacter baumanii (A. baumanii) is the most severe complication after neurosurgery which associated with high morbidity and mortality. Managing A. baumanii ventriculitis/shunt infection and multiple brain abscesses is challenging since its nature that tends to be pandrug resistant to all antibiotics used. Thus, we present the first such case with problems in administration based on the available data.
Severe delayed postpolypectomy bleeding in elder patient with post-polycythemia myelofibrosis
Authors: Fabrizio Cardin, Maria Luigia Randi, Marco Mosele, Claudio Terranova, Carmelo Militello
Journal: BMC Surg (2013)
MeSH terms: Colonic Diseases / etiology, Colonic Polyps / complications, Colonic Polyps / surgery, Endoscopy, Gastrointestinal / adverse effects, Gastrointestinal Hemorrhage / etiology, Polycythemia / complications, Postoperative Complications / etiology, Primary Myelofibrosis / complications, Case Reports, Aged, Female, Humans, Severity of Illness Index

Background:
The interest of the case lies in an unexpected delayed bleeding following an endoscopic procedure in a patient with post-polycythemia myelofibrosis. The case gives the opportunity to discuss the medical management and monitoring of patients with myeloproliferative disorders undergoing minimally invasive surgery interventions.
Case presentation:
A 75 years old woman affected by post-polycythemia myelofibrosis underwent endoscopy polypectomy followed by a delayed major local bleeding. At the time of the endoscopy followed by bleeding, the platelet count was 837 × 109/L, haemoglobin 113 g/L, PCV 35,2% and WBC 20.22 × 106/L. No antithrombotic prophylaxis with low molecular weight heparin was used. Antiplatelet drug was withdraw seven days before endoscopy and restarted one week after the procedure. Polyp size was 11 x 19 mm and it was located on right side of the colon.
Conclusion:
There are some patients in whom current guidelines do not apply and our case stress the importance of myeloproliferative neoplasms as a risk factor for complications of endoscopic polypectomy. The delayed haemorrhage we observed suggest to strictly control the patient for a period longer than only one week also in case of antithrombotic treatment with antiplatelet drugs.
Case Report: Intercurrent infections in COVID-19-induced sustained immunodepression: is interferon gamma a suitable drug?
Authors: Aurianne De Waard, Laurent Lefebvre, Julien Textoris, Didier Payen
Journal: Front Immunol (2023)
Keywords: ards (acute respiratory disease syndrome), covid 19, hla-dr, acute immuno-depression syndrome, interferon gamma (ifnγ)
MeSH terms: COVID-19, Coinfection / drug therapy, Case Reports, HLA-DR Antigens / metabolism, Humans, Immune Tolerance, Interferon-gamma / pharmacology, Interferon-gamma, HLA-DR Antigens

Acute immuno-depression syndrome (AIDs) had been observed in many life-threatening conditions leading to the Intensive Care Unit. and is associated with recurrent secondary infections. We report one COVID-19 patient with a severe ARDS, demonstrating acute immunodepression syndrome lasting for several weeks. The occurrence of secondary infections despite long treatment by antibiotics led to combined interferon γ (IFNγ) as reported previously. The response to IFNγ was evaluated by the flowcytometry HLA-DR expression on circulating monocytes, which was repeated from time to time. The severe COVID-19 patients responded well to IFNγ without adverse events.
A rare case of metachronous triple cancers involving the tympanic membrane
Authors: Hui-Yu Chang, Hua Jiang, Fang Zhou
Journal: Pak J Med Sci (2013)
Keywords: adenoid cystic carcinoma, maxillary sinus, metachronous triple cancers, squamous cell carcinoma, tympanic membrane
MeSH terms: Case Reports

Multiple primary malignancies are not rare. While metachronous triple cancers are rare and a triple tumor case involving maxillary sinus and tympanic membrane is exceptionally rare. We present such an extremely rare case with the index tumor of adenoid cystic carcinoma of the maxillary sinus and 14 years later esophageal cancer was observed as a metachronous tumor. One year after esophageal cancer, squamous cell carcinoma arising from tympanic membrane was detected. Before the tumor of tympanic membrane was observed, the patient had received total three radiation courses. Prior radiation therapy is suspected to be playing a role in inducing the squamous cell carcinoma of the tympanic membrane.
Echographic Evaluation of a Subconjunctival Cystic Lesion
Authors: Maddalena De Bernardo, Gennarfrancesco Iaccarino, Valeria Russo, Nicola Rosa
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Migration of intraocular silicone oil, used in the treatment of complicated retinal detachment, has been rarely described, but when it happens it can arise with a differential diagnosis with scleral buckling extrusion, tumor, dermoid, ocular cysticercosis, and abscess. The presence of silicone oil in the eye gives very ugly echographic pictures, but these kinds of pictures can be very useful in making a differential diagnosis in the above-mentioned cases. A 39-year-old white female complained of the presence of conjunctival hyperemia and tearing in the right eye (RE); her visual acuity was hand motion, and the intraocular pressure was 14 mmHg. In the upper nasal quadrant a dome shaped lesion was detected. Due to the lens opacities, the patient underwent an echographic examination, which revealed the presence of silicon oil both in the vitreous chamber and in a large subconjunctival space, corresponding to the lesion. This article in addition provides a possible explanation of such cystic formation and discusses the risk factors and the role of the echographic examination in such cases.
In-Hospital Diagnosis of Tricuspid Papillary Muscle Rupture in an Asymptomatic Patient after Blunt Chest Trauma
Authors: C S Nabzdyk, M B Tabrizi
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Tricuspid papillary muscle rupture after blunt chest trauma is an infrequent injury that often remains undiagnosed until patients become symptomatic months to years after the trauma occurred. It is imperative to diagnose patients early with this condition in order to optimize chances of successful recovery and avoidance of sequelae of long-term tricuspid regurgitation such as atrial fibrillation and right heart failure. Here we describe a case of a 58-year-old man involved in a motocross accident suffering amongst other injuries extensive bilateral rib fractures, hemopneumothoraces, and asymptomatic anterior tricuspid papillary muscle rupture. In addition, a review of the literature and an approach for the workup of trauma patients at risk for blunt cardiac injury are provided.
Anesthetic Management of a Patient with Harlequin Ichthyosis
Authors: Klint J Smart, Catherine A Gruffi, Tara M Doherty
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Harlequin ichthyosis is a severe and often fatal form of congenital ichthyosis caused by defective lipid transport which results in a dysfunctional skin barrier. Patients who survive the neonatal period are predisposed to skin infections, sepsis, impaired thermoregulation, and dehydration. The unique skin characteristics can present significant anesthetic challenges. We highlight the relevant anesthetic considerations in a 3-year-old presenting for syndactyly release of the right second and fourth digits. We describe the steps to ensure protection of the fragile skin barrier during establishment of intravenous access and airway management, therefore providing guidance for care of this vulnerable patient population.
A Novel RNF139 Mutation in Hemangioblastomas: Case Report
Authors: Ping Yang, Liang Li, Wei Zhang, Bo Liu, Ling Li, Hongxing Huang, Kun Liu, Hua Liu, Huiyong Huang, Feng Li, Shucheng Zou
Journal: Front Neurol (2019)
Keywords: rnf139, hemangioblastomas, mutation, next-generation sequencing, sanger sequencing
MeSH terms: Case Reports

Hemangioblastomas (HBs) are classified as grade I tumors with uncertain origin according to the World Health Organization's classification system. HBs are characterized by rich mesenchymal cells and abundant capillaries. It has been shown that tumorigenesis of HBs depends on mutational inactivation of Von Hippel-Lindau (VHL) tumor suppressor gene. Therefore, the majority of patients will undergo VHL single gene test, and sequencing scheme is rarely used in clinic. In this study, we described a girl and her father successively found to have HBs within half a year. The results of next-generation sequencing (NGS) and Sanger sequencing analysis showed that both of them carried heterozygous mutation of RNF139 p.Q650R. This mutation was interpreted as Pathogenic variation based on the American College of Medical Genetics and Genomics (ACMG) guideline. Sanger sequencing was performed with other family members. No mutation on rs118184842 locus of RNF139 gene was found in the samples from the girl's mother, uncle and aunt. This report supports that the novel mutation of RNF139 p.Q650R probably serve as a key role in HBs progression.
Autoamputation of Genitalia in Bipolar Patient
Authors: Vinod Sharma, Aditi Sharma
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

According to literature, genital self-mutilation (GSM) is more commonly associated with psychosis as compared with self-mutilation as a whole. There have been many case reports of GSM in psychotic disorders. We describe herein a case of a Caucasian, employed, and married male suffering from bipolar disorder type II with history of self-mutilating behavior, who amputated his penis during symptom-free phase of his illness. Several features are reflected as risky elements for genital self-mutilation, for example, homosexual and transsexual tendencies, abandonment of the male genitals, lack of competent male for identification during childhood, feeling of guilt for sexual offences, and self-injuries in anamnesis. This report will highlight various factors responsible for self-mutilation in nonpsychotic and nondelusional person.
Pneumococcal Meningitis
Authors: Kelly Di Dier, Marc Lemmerling
Journal: J Belg Soc Radiol (2022)
Keywords: computed tomography, magnetic resonance imaging, meningitis, neuroradiology, pneumocephalus
MeSH terms: Case Reports

Teaching Point: Spontaneous, atraumatic pneumocephalus is a rare presentation of pneumococcal meningitis.
Case study to assess the safety of irreversible electroporation near the heart
Authors: Katsutoshi Sugimoto, Fuminori Moriyasu, Hirohito Takeuchi, Mayumi Ando, Takatomo Sano, Toshifumi Mori, Yoshihiro Furuichi, Yoshiyuki Kobayashi, Ikuo Nakamura
Journal: Springerplus (2015)
Keywords: arrhythmia, complication, irreversible electroporation, liver, metastasis, tumor

Introduction:
Irreversible electroporation (IRE) is a promising technique for the focal treatment of soft tissue tumors. Even though the local application of an excessive electric field is a potential cause of cardiac arrhythmias, initial clinical studies have shown that IRE is generally safe when cardiac gating is employed.
Case description:
In this case report, we observed an episode of ventricular extrasystoles without hemodynamic changes during which time the synchronization device failed to operate properly, with pulses delivered not in the absolute refractory period but in the relative refractory period.
Discussion and evaluation:
At present, persons performing IRE must keep in mind that there is a small but real risk of synchronization failure even when a cardiac synchronization device is used.
Conclusion:
It is advisable to err on the side of caution when treating lesions near the heart.
Extensive-Stage Small Cell Carcinoma Transformation From EGFR Del19-Mutant Lung Adenocarcinoma on Gefitinib at the Twelfth-Year Follow-Up Case Report
Authors: Victor C Kok, Chien-Kuan Lee, Yu-Hsin Chiang, Ming-Chih Wang, Yen-Te Lu, Chiu-Chun Cherng, Pei-Yu Lee, Ke-Bin Wang
Journal: Front Oncol (2021)
Keywords: del-19 mutation, egfr-mutant lung adenocarcinoma, case report, small cell carcinoma transformation, topotecan (pubchem cid
MeSH terms: Case Reports

Introduction:
The acquired resistance mechanisms in patients with epidermal growth factor receptor (EGFR)-mutant lung cancer, particularly adenocarcinoma (ADC), following treatment with an EGFR tyrosine kinase inhibitor (TKI) have received extensive investigations. The phenotypic transformation to small cell carcinoma (SCCT) has been estimated to occur in approximately 3 to 10% of patients treated with an EGFR-TKI. The prognosis after SCCT is extremely poor.
Case study:
We report about SCCT that occurred 45 months after the initial diagnosis of ADC in an East Asian never-smoker woman with advanced-stage EGFR Del-19-mutant lung ADC treated with combined chemoradiotherapy before the era of insurance coverage for EGFR-TKIs in this country and subsequently gefitinib; deletion at codon 746-750 in exon 19 of the EGFR gene was ascertained in the original formalin-fixed paraffin-embedded lung biopsy tissue. Spinal cord compression at thoracic-12 level from SCCT was successfully relieved with neurosurgical treatment, chemotherapy with etoposide and cisplatin, and radiotherapy, while gefitinib treatment was maintained. Eleven months later, SCCT relapsed in the lung parenchyma, which was resected and was found to be sensitive to second-line weekly topotecan. Prophylactic cranial irradiation was subsequently administered. SCCT was confirmed by MALDI-TOF MS analysis of formalin-fixed paraffin-embedded tissues demonstrating the same exon 19 deletion. At the 12th-year follow-up, the patient remains relapse free with very good performance status. The novelty of this case is the successful interdisciplinary team effort to correct the spinal cord compression by maintaining the patient in an ambulatory state, non-stop use of gefitinib justified by the presence of activating EGFR mutation in SCCT tumor cells, and aggressive dose-intensive chemotherapy and radiotherapy for the SCCT that leads to an unprecedented prolonged remission and survival. This case also supports the observation that SCCT is chemotherapy sensitive, and thus, re-biopsy or complete tumor excision is recommended to understand the mutation profiles of the current tumor. Aggressive prudent administration of systemic chemotherapy obtaining optimal dose intensity leads to the successful management of the patient.
Vesicoureteral reflux in the child with lazy bladder syndrome: the infrequent voider
Authors: Marco Grasso, Fabrizio Torelli, Salvatore Blanco, Flavio Fortuna, Marco Baruffi
Journal: Adv Urol (2008)
MeSH terms: Case Reports

The Infrequent Voider Syndrome or Lazy Bladder Syndrome in children is characterized by a large capacity bladder, frequently associated with a significant volume of residual urine. Usually these patients arrive at medical examination with a history of recurrent urinary infections but without anomalies in the upper urinary tract. We report about a young girl affected by one-sided 2 degrees degree vesico-ureteral reflux due to Lazy Bladder Syndrome that had never been diagnosed before. This patient has been submitted to a prompt bladder training and seems presently to have at last gained a physiological micturition after 9 months of follow-up, without actual evidence of vesicoureteral reflux. Therefore we must stress that it is prominently important considering about infrequent micturition in a paediatric case history or a large capacity bladder, possible presence of bladder dysfunction and vesicoureteral reflux too.
Association between Postural Orthostatic Tachycardia Syndrome and Joint Hypermobility
Authors: Alexis Javier Atuesta-Rodriguez, Yimy F Medina-Velasquez, Orfa Motta, Maria Isabel Narvaez-Reyes, Federico Rondon-Herrera
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Joint hypermobility syndrome refers to increased joint flexibility beyond the normal range of motion. This syndrome has a benign form known as Ehlers-Danlos syndrome type 3. This is a disorder in which hypermobility is accompanied by clinical manifestations in the absence of any systemic disease. A clinical finding associated with this condition is postural orthostatic tachycardia syndrome. The following is a rare case of joint hypermobility syndrome and postural orthostatic tachycardia syndrome. The relevance of this case report lies in the impact that this disease had on the patient's quality of life and the limitation in the performance of activities of daily living.
Primary Pulmonary Anaplastic Large Cell Lymphoma: A Rare Malignancy and Rare Cause of the Luftsichel Sign
Authors: Elizabeth Von Ende, Travis Kauffman, Philip A Munoz, Santiago Martinez-Jiménez
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Primary pulmonary lymphomas are rare with primary pulmonary non-Hodgkin lymphoma accounting for only 0.3% of primary lung neoplasms. Of these, the large majority are made up of marginal zone B-cell lymphoma and diffuse large B-cell lymphoma. We present a case of a very rare primary pulmonary anaplastic large cell lymphoma presenting as the luftsichel sign on chest radiograph. Pertinent imaging and pathology findings are discussed.
Acute bilateral simultaneous angle closure glaucoma after topiramate administration: a case report
Authors: Kakarla V Chalam, Tina Tillis, Farhana Syed, Swati Agarwal, Vikram S Brar
Journal: J Med Case Rep (2008)

Introduction:
A case of severe acute bilateral angle closure glaucoma with complete visual loss after oral topiramate therapy.
Case presentation:
A 34 year-old woman developed bilateral severe visual loss 2 days after doubling the dosage of topiramate. Her best-corrected visual acuity (BCVA) was counting fingers in both eyes (OU). Intraocular pressures were 49 mm and 51 mm of Hg in right and left eyes respectively, with conjunctival chemosis, corneal edema, shallow anterior chamber and closed angles on gonioscopy. B-scan ultrasound revealed annular peripheral choroidal effusions in both eyes.
Conclusion:
Intraocular pressures and anterior chamber depth were normalized after discontinuation of topiramate and initiation of antiglaucoma therapy. Two weeks later, visual acuities improved to 20/25 in the right eye and 20/40 in the left eye. B-scan ultrasound showed resolution of choroidal effusion. Topiramate, an oral sulpha-derivative medication is known to cause ciliochoroidal effusions, which lead to forward rotation of the ciliary body and displacement of the lens-iris diaphragm, with resultant acute angle closure glaucoma and myopic shift.
Metastatic gallbladder carcinoma presenting as an ovarian mass
Authors: Nidhin Rehman, Harish Sadashiva, Manoj Gopal Madakshira, Deep Kumar Raman
Journal: Autops Case Rep (2021)
Keywords: carcinoma, gallbladder, immunohistochemistry, ovary
MeSH terms: Case Reports

Metastatic gallbladder carcinoma to the ovaries is occasional but a recognized entity. It can mimic, clinical and morphologically, a primary ovarian tumor, challenging the diagnosis. We present the case of a patient with a lump in the hypogastrium extending into the right iliac fossa and was found to have abdominopelvic cystic lesion with enhancing solid components and multiple sub-centimetric and ill-defined abdominal lymph nodes. Also, subpleural and parenchymal nodules in the lungs were present. She subsequently underwent a laparotomy. Cholecystectomy was also done due to pre-existing symptomatic biliary lithiasis. The histologic report described the ovarian involvement as metastases from a gallbladder carcinoma. The presentation of ovarian metastases can challenge the diagnosis. Hence, careful evaluation of the digestive tract and judicious use of immunohistochemistry should be considered in patients presenting with ovarian masses.
Biliary hyperkinesia, a new diagnosis or misunderstood pathophysiology of dyskinesia: A case report
Authors: John A Bates, Kelly Dinnan, Victoria Sharp
Journal: Int J Surg Case Rep (2019)
Keywords: biliary dyskinesia, biliary hyperkinesia, case report, normokinetic biliary dyskinesia

Introduction:
Biliary colic, characterized by intermittent right upper quadrant abdominal pain is a common complaint in the United States population. Patients whose pain is undiagnosed by ultrasound generally undergo hepatobiliary iminodiacetic acid scan with cholecystokinin stimulation (HIDA-CCK) to assess function of the gallbladder and biliary tree. Traditionally, two outcomes are possible based on a measured ejection fraction of the gallbladder: either dyskinesia or normal function is diagnosed. Biliary dyskinesia, or hypokinesia of the gallbladder, is accepted as an ejection fraction less than 35%, while an accepted normal functioning gallbladder ejection fraction is greater than 35%.
Case:
We report a case of a fifteen-year-old female who had functional gallbladder disease per Rome IV criteria due to intermittent biliary colic, with exception to the ejection fraction measurement which was elevated at 96.5%. She underwent laparoscopic cholecystectomy with complete symptom resolution.
Discussion:
As demonstrated in the literature reviewed here, these subsets of patients, who present with normal to high ejection fractions, have undergone laparoscopic cholecystectomy with resolution of pain in several case studies.
Conclusion:
Many unknown variables still exist due to lack of prospective studies, most notably the pathophysiology and definitive indications for surgical treatment. As such, we propose that surgical options should not be limited to those who display the traditional findings of biliary dyskinesia, but also patients who demonstrate typical symptoms with normal to elevated ejection fraction, following work up to rule out the extensive differential diagnoses for right upper quadrant abdominal pain.