OpenMed/multicare-articles huggingface dataset:
Unintentional retinal artery amputation during macular peeling
Authors: Yoshiaki Shimada
Journal: GMS Ophthalmol Cases (2020)
Keywords: amputation, avulsion, macular peeling, retinal artery, vitrectomy
MeSH terms: Case Reports

Objective: To report a case of unintentional retina artery amputation during macular peeling. Methods: Observational case report Results: A 73-year-old female underwent surgery to treat epiretinal membrane (ERM) associated with severe staphyloma in her left eye. While the ERM/posterior hyaloid membrane visually enhanced with triamcinolone (TA) was peeled, a movement of the forceps unintentionally involved the inferior temporal branch artery near the inner edge of the staphyloma. The artery was avulsed and amputated. Oozing from the retinal cleft that had once enfolded the artery and microscopic bleeding from the amputation stump were observed. The vitreous hemorrhage obscured a view of the fundus more than 4 weeks after the surgery. After 8 weeks, postoperative visual acuity was improved; however, the superior nasal visual field was lost, and the patient was aware of the broken vessel as a floater in her vision. Conclusions: Macular peeling is technically challenging, so meticulous attention must be paid to avoid any damage on vessels. The retina tissue was stretched in a staphyloma and vessels were bulged into the vitreous space especially at the inner edge of the staphyloma. High levels of TA dye here buried the texture of the retina. Excessive TA should be removed prior to macular peeling.
Contemporaneous Insufficiency Fractures of Bilateral Femoral Necks in an Older Patient Taking Bisphosphonate: A Case Report and Literature Review
Authors: Hiroaki Tagomori, Nobuhiro Kaku, Shota Sato, Tsuguaki Hosoyama, Hiroshi Tsumura
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

We report, to the best of our knowledge, the first case of simultaneous insufficiency fracture of the bilateral femoral neck in an older patient taking bisphosphonate. Femoral neck fractures frequently occur in older individuals because of traumatic incidents, such as a fall. A 74-year-old woman with osteoporosis was taking raloxifene hydrochloride and bisphosphonate for approximately 5 and 3 years, respectively. Despite no history of falls or any other traumatic incidence, the patient reported cooccurrence of pain on both sides of the hip. Imaging revealed bilateral femoral neck fractures. Bipolar hemiarthroplasty and internal fixation were conducted on the right and left hips, respectively. At 6 months postoperatively, the patient reported gradual disappearance of left hip pain, and a radiograph revealed that the fracture had healed. Overall, clinical and histological findings suggested an atypical fracture, thereby proving that this type of fracture can occur in areas other than the femoral shaft.
Symptomatic Apical Periodontitis of the Mandibular First Molar with the Accessory Canal in the Furcation Area Mimicking Furcation Perforation
Authors: Alexei Bolyachin, Zurab Khabadze, Oleg Mordanov, Magomed Gasbanov, Takhir Teberdiev
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Apical periodontitis frequently presents as a chronic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations and evaluate the clinical presentation. Knowledge of the root canal morphology is a prerequisite for effective nonsurgical endodontic treatment. The internal morphological features of the pulp chamber are variable and complex. This case report describes the treatment and outcome of symptomatic apical periodontitis of a mandibular first molar with the accessory (chamber) canal. The applied treatment fully contributed to the periapical lesion regression as shown in the four-year recall periapical radiography.
Novel Melanocortin 2 Receptor Variant in a Chinese Infant With Familial Glucocorticoid Deficiency Type 1, Case Report and Review of Literature
Authors: Kuerbanjiang Abuduxikuer, Zhong-Die Li, Xin-Bao Xie, Yu-Chuan Li, Jing Zhao, Jian-She Wang
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: adrenocorticotropic hormone (acth), cholestasis, cortisol, familial glucocorticoid deficiency (fgd) type 1, hypoglycemia, linear overgrowth, melanocortin 2 receptor (mc2r), skin hyperpigmentation
MeSH terms: Case Reports

Familial glucocorticoid deficiency type 1 (FGD1) is an autosomal recessive disorder caused by mutations in the melanocortin 2 receptor (MC2R) gene, characterized by a low or undetectable serum cortisol level and a high adrenocorticotropic hormone (ACTH) level. Clinical manifestations include hypoglycemia, seizure, skin hyperpigmentation, hyperbilirubinemia, cholestasis, and a tall stature. Some dysmorphic features such as, a prominent forehead, hypertelorism, a broad nasal bridge, and small tapering fingers, have been reported. Children with FGD1 may have other isolated endocrine abnormalities. To date, no patient with FGD1 has been reported in mainland China. Here we report on a Chinese patient with FGD1 having a novel MC2R gene variant, a mild transverse palm crease, hypertelorism, and subtle/transient endocrine abnormalities relating to all three zones of the adrenal cortex and thyroid gland. We also reviewed cases with dysmorphic features or additional endocrine abnormalities.
Mammary-like adenocarcinoma of the vulva associated to Paget's disease: a case report
Authors: Sawsen Meddeb, Mohamed Salah Rhim, Sarra Mestiri, Mouna Kouira, Mohamed Bibi, Hedi Khairi, Mohamed Tahar Yacoubi
Journal: Pan Afr Med J (2014)
Keywords: mammary-like adenocarcinoma, paget′s disease, vulva
MeSH terms: Adenocarcinoma / pathology, Mammary Glands, Human / pathology, Paget Disease, Extramammary / pathology, Vulvar Neoplasms / pathology, Case Reports, Adenocarcinoma / diagnosis, Adenocarcinoma / etiology, Adult, Female, Humans, Paget Disease, Extramammary / diagnosis, Tunisia, Vulvar Neoplasms / diagnosis, Vulvar Neoplasms / etiology

Mammary-like adenocarcinoma of the vulva associated to Paget's disease is exceedingly rare. So, it is very important to perform all the pathological and immunohistochemical investigations to achieve differential diagnosis from both a metastatic lesion from an orthotopic breast cancer and a vulvar adnexal tumor. This report describes a case of vulvar Paget's disease associated with underlying mammary-like adenocarcinoma diagnosed in the Department of Obstetrics and Gynecology of Farhat Hached university hospital of Sousse in Tunisia. We also review previously reported cases of primary breast-like carcinoma of the vulva with or without Paget's disease.
Hyperreactio luteinalis incidentally found in the second trimester of pregnancy with normal hCG levels: a case report
Authors: Sawssan Ben Halima, Hana Hakim, Sahbi Kebaili, Nadia Ben Jdidia, Khaled Trigui, Kais Chaabane
Journal: Pan Afr Med J (2021)
Keywords: hyperreactio, case report, luteinalis, ovaries, pregnancy
MeSH terms: Chorionic Gonadotropin / blood, Ovarian Cysts / diagnostic imaging, Pregnancy Complications / diagnostic imaging, Case Reports, Abnormalities, Multiple / diagnostic imaging, Adult, Female, Humans, Incidental Findings, Pregnancy, Pregnancy Trimester, Second, Ultrasonography, Prenatal, Chorionic Gonadotropin

Hyperreactio luteinalis (HL) is a rare entity in which both ovaries are multicystic and enlarged under the action of human chorionic gonadotropin (hCG), mostly seen in the third trimester of pregnancy. This benign condition is usually asymptomatic and doesn't need any specific treatment, as the ovaries spontaneously reduce in size after birth. This is a case report of a 33-year-old woman diagnosed with hyperreactio luteinalis during the second trimester of her induced pregnancy. An ultrasound scan at 22 weeks of gestation revealed bilateral multicystic enlarged ovaries along with multiple fetal malformations and hydropsfetalis. Usually, HL is most commonly seen in situations in which there are high levels of hCG, but our patient had normal levels of hCG during all her pregnancy, which makes our case even rarer. In conclusion, the most important challenge when faced with HL is to differentiate between it and other differential diagnosis especially malignant tumors, because unlike them, this benign condition doesn't need surgical treatment.
Cystic tumour of the atrioventricular node: case report and literature review
Authors: Stephen D Cohle
Journal: Forensic Sci Res (2019)
Keywords: av node tumour, forensic sciences, cardiac arrhythmias, cystic tumour of the av node, forensic pathology, sudden cardiac death
MeSH terms: Case Reports

Cystic tumour of the atrioventricular node is the smallest tumour that can cause sudden cardiac death. This lesion arises from foregut endodermal rests which become enfolded into the heart during embryogenesis. Typically causing heart block, the tumour can cause sudden death despite pacemaker placement. Sudden death in such cases can be caused by arrhythmogenic ectopic foci arising from impaired electrical impulse propagation through the abnormal atrioventricular junction conducting tissue.
An Interesting Association of Cystic Hygroma of the Neck and Lymphangioma Causing a Paediatric Swollen Tongue
Authors: A N Beech, J N Farrier
Journal: Case Rep Pediatr (2016)

Up to 75% of lymphatic malformations occur in the head and neck region. Of these, cystic hygromas and lymphangiomas have been widely reported; however they rarely occur in the same patient. We report the case of a 5-year-old girl who presented to the Department of Paediatrics of a district general hospital with a short history of recurrent, painful swelling of the anterior one-third of her tongue. She was reviewed under the joint care of the Oral and Maxillofacial Surgery and Otolaryngology Teams. Relevant past medical history included a previously excised cystic hygroma from her right neck when she was aged 2 years. Diagnosis of lymphangioma was made and of the potential management options available active monitoring was favoured due to the patient's age. To our knowledge the occurrence of both tongue lymphangioma and cystic hygroma has not been previously reported in a paediatric patient. This case report therefore shows a rare association between a cystic hygroma of the neck and lymphangioma of the tongue.
Lymphocyte-Rich Hepatocellular Carcinoma with Multiple Lymphadenopathy and Positive Epstein-Barr Virus Encoding Region
Authors: Pin-Yi Wang, Yu-Hsuan Kuo, Ming-Jen Sheu, Hsing-Tao Kuo, Wen-Ying Lee, Yu-Ting Kuo, Su-Hung Wang
Journal: Case Reports Hepatol (2023)
MeSH terms: Case Reports

Lymphocyte-rich hepatocellular carcinoma (HCC) represents the rarest subtype among the various subgroups of HCC, and limited clinical data are available for this particular subtype. It is commonly observed as a solitary lesion and tends to present at an early stage. Histopathological examination typically reveals tumor cells infiltrated by a lymphocyte-rich background, leading to its designation as lymphoepithelioma-like HCC. Unlike other lymphoepithelioma-like tumors associated with the Epstein-Barr virus (EBV), lymphocyte-rich HCC is predominantly negative for EBV. This subtype is characterized by more favorable clinical outcomes and prognosis compared to conventional HCC. Here, we present a case of lymphocyte-rich hepatocellular carcinoma (HCC) characterized by the presence of bilateral hepatic tumors and concurrent multiple lymphadenopathy. Interestingly, contrary to previous literature, the examination for the Epstein-Barr virus (EBV) revealed a positive result in this particular case.
Urinary retention due to mesenteric cyst: An extremely unusual presentation of a rare complication
Authors: B Ghazimoghadam, S Rajaie
Journal: Indian J Nephrol (2008)
Keywords: acute urinary retention, abdominal mass, mesenteric cyst
MeSH terms: Case Reports

Mesenteric cysts are rare intra-abdominal masses, presenting with various clinical signs and symptoms. Mesenteric cysts presenting with a sudden onset of urinary retention is extremely rare. There are no cases reported in the English literature. Here, we report a very rare case of urinary retention, due to mesenteric cyst in a 19-year-old man. The patient presented with abdominal distention with a sudden onset of urinary retention. Ultrasonography and computed tomography scan of the abdomen revealed a huge cystic mass above the bladder that was completely separated from the kidney and bladder. The cyst was removed surgically. The patient experienced no urological difficulty after the surgery. Histological examination confirmed the diagnosis of a mesenteric cyst.
A case of pulmonary tuberculosis with hemoptysis from a peripheral pulmonary aneurysm
Authors: Kodai Furuyama, Noriyuki Hirama, Shigeyuki Fukushima, Minoru Inage, Hiroki Ota, Kento Sato, Keiko Yamauchi, Masamichi Sato, Akira Igarashi, Sumito Inoue, Masafumi Watanabe
Journal: EXCLI J (2021)
Keywords: hemoptysis, pulmonary aneurysm, pulmonary tuberculosis
MeSH terms: Case Reports

An 88-year-old woman visited our hospital for hemoptysis due to ruptured peripheral pulmonary aneurysm diagnosed by contrast computed tomography (CT) and angiography. Her bleeding was stopped by interventional radiology vascular embolization. She was diagnosed with pulmonary tuberculosis due to a positive acid-fast bacillus (AFB) smear test following admission and the positive polymerase chain reaction for tuberculosis, despite no obvious cavity lesions or scatter shadows on CT. The causes of hemoptysis due to pulmonary tuberculosis are known to be Rasmussen aneurysm, in which the blood vessel wall adjacent to the lung cavity is thinned to form an aneurysm, or bleeding from the bronchial artery. In this case, it was considered that the inflammation caused by pulmonary tuberculosis spread directly to the pulmonary artery and formed a pulmonary aneurysm without forming a cavity. Similar cases have been rarely reported. Clinicians need to consider pulmonary tuberculosis as the cause of pulmonary aneurysm, even without cavity lesions in the lungs. It is important to perform AFB examination to diagnose pulmonary tuberculosis.
Understanding the Impact of Omega-3 Rich Diet on the Gut Microbiota
Authors: Blanca S Noriega, Marcos A Sanchez-Gonzalez, Daria Salyakina, Jonathan Coffman
Journal: Case Rep Med (2016)

Background. Recently, the importance of the gut microbiota in the pathogenesis of several disorders has gained clinical interests. Among exogenous factors affecting gut microbiome, diet appears to have the largest effect. Fatty acids, especially omega-3 polyunsaturated, ameliorate a range of several diseases, including cardiometabolic and inflammatory and cancer. Fatty acids associated beneficial effects may be mediated, to an important extent, through changes in gut microbiota composition. We sought to understand the changes of the gut microbiota in response to an omega-3 rich diet. Case Presentation. This case study investigated changes of gut microbiota with an omega-3 rich diet. Fecal samples were collected from a 45-year-old male who consumed 600 mg of omega-3 daily for 14 days. After the intervention, species diversity was decreased, but several butyrate-producing bacteria increased. There was an important decrease in Faecalibacterium prausnitzii and Akkermansia spp. Gut microbiota changes were reverted after the 14-day washout. Conclusion. Some of the health-related benefits of omega-3 may be due, in part, to increases in butyrate-producing bacteria. These findings may shed light on the mechanisms explaining the effects of omega-3 in several chronic diseases and may also serve as an existing foundation for tailoring personalized medical treatments.
Lacerations to Zones VIII and IX: It Is Not Just a Tendon Injury
Authors: Charla R Fischer, Peter Tang
Journal: Adv Orthop (2011)
MeSH terms: Case Reports

Extensor tendon injuries are widely believed to be straightforward problems that are relatively simple to manage. However, these injuries can be complex and demand a thorough understanding of anatomy to achieve the best functional outcomes. When lacerations occur in the forearm as in Zones VIII and IX injury, the repair of the extensor tendon and muscle, and posterior interosseous nerve (PIN) is often challenging. A review of the literature shows little guidance and attention for these injuries. We present four patients with injuries to Zones VIII and IX as well as a review of surgical technique, postoperative rehabilitation, and pearls that may be of benefit to those managing these injuries.
Inflammatory myofibroblastic tumor of the right atrium
Authors: Neerod K Jha, Michel Trudel, Gregory P Eising, Peter Lange, Awatif Al Sousi, Wael Al Mahmeed, Javed A Khan, Moataz A Saleh, Friederike Von Canal, Virendra K Misra, Norbert Augustin
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Cardiac inflammatory myofibroblastic tumor (IMT) is a rare entity and is associated with distinct clinical, pathological and molecular features. The clinical behavior, natural history, biological potential, management and prognosis of such tumors are unclear. We present herewith an adolescent girl who presented with similar entity involving the junction of the right atrium and the inferior vena cava (IVC) in association with thrombocytosis and IVC thrombosis leading to obstruction of blood flow. Diagnostic tools included imaging and immuno-histopathology studies. Surgical management included resection of the tumor and thrombo-embolectomy of the IVC under cardiopulmonary bypass. This case is unique due to association of complete obstruction of IVC caused by the strategic location of the tumor, thrombosis of vena cava and association of thrombocytosis. These features have not been reported yet in relation to the cardiac IMT. This report will help in better understanding and management of similar cases in terms of planning cannulation of femoral veins or application of total hypothermic circulatory arrest during cardiopulmonary bypass and prompt us to look for recurrence or metastasis during follow up using echocardiography and laboratory investigations. The possibility of IMT should be kept in the differential diagnosis of cardiac tumors especially in children and adolescents.
Nocardia transvalensis Disseminated Infection in an Immunocompromised Patient with Idiopathic Thrombocytopenic Purpura
Authors: Jorge García-Méndez, Erika M Carrillo-Casas, Andrea Rangel-Cordero, Margarita Leyva-Leyva, Juan Xicohtencatl-Cortes, Roberto Arenas, Rigoberto Hernández-Castro
Journal: Case Rep Infect Dis (2016)

Nocardia transvalensis complex includes a wide range of microorganisms with specific antimicrobial resistance patterns. N. transvalensis is an unusual Nocardia species. However, it must be differentiated due to its natural resistance to aminoglycosides while other Nocardia species are susceptible. The present report describes a Nocardia species involved in an uncommon clinical case of a patient with idiopathic thrombocytopenic purpura and pulmonary nocardiosis. Microbiological and molecular techniques based on the sequencing of the 16S rRNA gene allowed diagnosis of Nocardia transvalensis sensu stricto. The successful treatment was based on trimethoprim-sulfamethoxazole and other drugs. We conclude that molecular identification of Nocardia species is a valuable technique to guide good treatment and prognosis and recommend its use for daily bases diagnosis.
The treatment of large extraskeletal chondrosarcoma of the leg: comparison of IMRT and conformal radiotherapy techniques
Authors: M F Chan, C S Chui, K Schupak, H Amols, C Burman, C C Ling
Journal: J Appl Clin Med Phys (2001)
MeSH terms: Chondrosarcoma / radiotherapy, Leg, Radiotherapy, Conformal / methods, Radiotherapy, High-Energy / methods, Soft Tissue Neoplasms / radiotherapy, Case Reports, Comparative Study, Adult, Humans, Radiotherapy Dosage, Radiotherapy, Computer-Assisted / methods

Extraskeletal chondrosarcoma of the leg is a rare, malignant neoplasm with very few cases having been reported in the literature. In this study we investigate the possibility of using intensity modulated radiotherapy (IMRT) for this type of disease and demonstrate its advantages over conventional three-dimensional (3D) conformal treatment. A case was presented of a patient with extraskeletal chondrosarcoma of the lateral compartment of the leg in which the target volume was 50 cm in length and twisted around the surrounding bones. Both the 3D conformal plan and IMRT plan were designed using the Memorial Sloan-Kettering Cancer Center planning system. The IMRT plan produced a superior dose distribution to the patient as compared to the 3D conformal plan both in terms of dose conformity and homogeneity in the target volumes, and reduction of the maximum dose to the bone. The planning time of the IMRT plan was about 3-5 times shorter than that of the 3D conformal plan. It was demonstrated that the IMRT technique can be used not just for small tumors, but also for large and spiral-shaped tumors close to critical organs. The IMRT method requires less planning time, and provides better target coverage with more sparing of critical structures. When planning patients with multiple target volumes receiving different prescribed doses, the IMRT technique can more easily meet this requirement.
Acute Thyroiditis in a Patient with Neck Trauma
Authors: Pearl Marian A Peralta, Jeryl Ritzi T Yu, Edrome F Hernandez, Evangeline B Dela Fuente
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

The management of patients with major depressive disorder who present with self-injurious behavior is best optimized through a collaborative interprofessional approach. We describe a case of a 27-year-old woman without personal or family history of thyroid pathology who presented at the emergency department due to a suicide attempt by hanging. On examination, she was tachycardic with palpitations which persisted despite administration of analgesics and anxiolytics. Left temporal area swelling, left otorrhagia, and neck contusion were noted, involving consults with the Trauma, Neurosurgery, and Otorhinolaryngology teams. She was admitted to the psychiatric ward on account of persistent suicidal ideations. As part of the workup, thyroid function tests were done to rule out hypothyroidism as a cause of depressive symptoms. Results instead showed suppressed thyroid stimulating hormone and elevated free T4. Endocrinology service was consulted, and further workup showed absence of avid uptake of both thyroid glands on thyroid scan and undetectable thyrotropin receptor antibody level, supportive of a diagnosis of trauma-induced thyroiditis. This case increases awareness that trauma-induced thyroid dysfunction should be considered in patients with symptoms including, but not limited to, tachycardia and palpitations after a traumatic neck injury such as hanging.