OpenMed/multicare-articles huggingface dataset:
Pulse Granulomas of the Gastrointestinal Tract and Gallbladder: Report of Five Cases
Authors: Tom C DeRoche, Gregory A Gates, Aaron R Huber
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Hyaline rings with admixed multinucleated giant cells characterize pulse granulomas; the term pulse refers to edible seeds of legume vegetables. The etiology has been controversial, with theories including vascular degenerative changes or a reaction to vegetable material; ultrastructural studies and experimentally induced lesions in animals favor the latter. This lesion is typically seen in the oral cavity, with only rare reports in the gastrointestinal tract and gallbladder. We herein describe five cases of pulse granulomas identified in these sites. All cases contained foreign-body giant cells and vegetable debris within or near hyaline rings. Pulse granulomas may form mass lesions but are usually an incidental finding on microscopic examination. In incidentally detected cases, recognition of pulse granulomas can suggest a mural abscess, fistula, or perforation of the gut, findings which may not be grossly apparent. The presence of vegetable material in all five cases further supports an exogenous pathogenesis.
Retroperitoneal inflammatory myofibroblastic tumor
Authors: Suresh V S Attili, C Rama Chandra, Dadhich K Hemant, Poonamalle P Bapsy, Clementeena RamaRao, G Anupama
Journal: World J Surg Oncol (2005)

Background:
Inflammatory myofibroblastic tumor (IMT) is a neoplasm of unknown etiology occurring at various sites. By definition, it is composed of spindle cells (myofibroblasts) with variable inflammatory component, hence the name is IMT.
Case presentation:
The present case is of a 46 years old woman presented with a history of flank pain, abdominal mass and intermittent hematuria for last 6 months. The initial diagnosis was kept as renal cell carcinoma. Finally, it turned out to be a case of retroperitoneal IMT. The patient was managed by complete surgical resection of the tumor.
Conclusion:
IMT is a rare neoplasm of uncertain biological potential. Complete surgical resection remains the mainstay of the treatment.
Case Report: Managing the postoperative exposure of a non-resorbable membrane surgically
Authors: Abdullah S Almutairi
Journal: F1000Res (2018)
Keywords: gbr, periodontal, bone, exposure, implant, membrane
MeSH terms: Alveolar Ridge Augmentation / methods, Guided Tissue Regeneration, Periodontal / adverse effects, Membranes, Artificial, Case Reports, Alveolar Process / abnormalities, Alveolar Process / surgery, Alveolar Ridge Augmentation / adverse effects, Bone Transplantation / methods, Dental Implants, Guided Tissue Regeneration, Periodontal / methods, Humans, Male, Middle Aged, Postoperative Complications, Dental Implants, Membranes, Artificial

Alveolar ridge deformities can be caused by several factors. Managing alveolar deformities prior to implant placement is essential to increase bone width, height or both. Several techniques and materials are now available to perform ridge augmentation procedures. The postoperative exposure of the membrane is the most frequent postoperative complications of ridge augmentation procedures. The present case describes the horizontal ridge augmentation procedure and the outcome of surgical attempt to manage post-operative membrane exposure, and shows the unpredictability of managing postoperative membrane exposure surgically.
Portal Vein Thrombosis in a 21-Year-Old Man with Membranoproliferative Glomerulonephritis and Nephrotic Syndrome
Authors: Ilya Seleznev, Dinara Jumadilova, Assiya Naushabayeva, Kairat Kabulbayev, Gulaiym Karashasheva, Francesca Cainelli
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Membranoproliferative glomerulonephritis, one of the main causes of nephrotic syndrome, is associated with a state of hypercoagulability that leads to increased risk of thrombotic events. Portosystemic collaterals may reopen due to reversal of the flow within the existing veins and be a presenting feature of thrombosis. We describe a patient who presented with large portosystemic collaterals and signs of portal hypertension and was subsequently found to be affected by membranous proliferative glomerulonephritis. Proteinuria and microscopic haematuria in a patient with signs of portal hypertension and no pre-existing liver disease should raise the suspicion of an underlying kidney disease.
Vaginal Evisceration of Small Bowel With Extraperitoneal Ileal Resection of the Herniated Loops: A Case Report
Authors: Giulia Missori, Nicolò Luigi Arrigo Marchesini, Donatella Mosca, Andrea Aurelio Ricciardolo, Francesco Serra, Roberta Gelmini
Journal: Front Surg (2022)
Keywords: emergency surgery, hernia surgery, pelvic floor disorders, pelvic organ prolapse (pop), transvaginal evisceration
MeSH terms: Case Reports

Introduction:
Vaginal evisceration is an extremely rare surgical emergency that can be described as the extrusion of abdominal viscera through a defect or a rupture of the vaginal wall. We reported the case of an acute abdomen due to small bowel evisceration secondary to vaginal vault dehiscence that required combined vaginal-abdominal approach.
Case:
We discuss the case of a 72-year-old female who presented to the emergency department for a large prolapse with visible extrusion of the small bowel per vagina. The eviscerated bowel was resected by external vaginal approach due to excessive swelling of the loops which made it impossible to reduce them through the vagina defect. A midline laparotomy was undertaken for further assessment, and the vault defect was closed by transabdominal repair.
Conclusion:
From its first description in 1864, just a few cases of vaginal evisceration had been described in the medical literature; the most common organ to eviscerate is the distal ileum, although cases of omentum, colon, fallopian tube, and appendix evisceration have also been reported. We described a rare case of transvaginal evisceration of the small bowel in our emergency department; it is a rare surgical emergency that must be managed to prevent serious consequences, such as bowel ischemia and necrosis, sepsis, and death. We suggest that a multidisciplinary approach to prompt examination and management by gynecologists and general surgeons is recommended to reduce the risk of morbidity and mortality. With this paper the authors would like to share the surgical manage of this rare emergency with other surgeons all around the world.
Durable effect of pyrotinib plus capecitabine in HER-2+ breast cancer patient undergoing peritoneal dialysis: A case report and literature review
Authors: Xiangting Jin, Min Yan, Fanfan Li
Journal: Front Oncol (2022)
Keywords: breast cancer, dose adjustment, end-stage renal disease, peritoneal dialysis, pyrotinib
MeSH terms: Case Reports

For patients with end-stage renal disease (ESRD), peritoneal dialysis (PD) and hemodialysis (HD) are important renal replacement treatments. Patients on dialysis usually have a high incidence rate of malignant tumors. In 2020, breast cancer has become the malignant tumor with the highest incidence rate in the world. Human epidermal growth factor receptor-2-positive (HER-2+) breast cancer accounts for 20%-30% of the total breast cancer patients. It is highly invasive and has a poor prognosis. Anti-HER-2 treatment is an important therapy for this type of cancer. There are few case reports of anti-HER2-targeted therapy in dialysis patients. We report a 56-year-old Chinese woman with breast cancer (cT3N1MX, Her-2+/HR-). She underwent peritoneal dialysis for 11 years since she had suffered end-stage renal disease. The clinician prescribed the regimen (pyrotinib 320mg qd + capecitabine 1g bid D1-D14 Q3W). The tumor was significantly reduced after 1 month of single administration of pyrotinib, and partially relieved after 2 months of pyrotinib + capecitabine. The main side effects were grade II hand foot syndrome and grade II diarrhea. This case shows that the combination of pyrotinib and capecitabine has potential therapeutic benefits in HER-2+ breast cancer patients with end-stage renal disease.
An Iranian man with increased thigh mass due to a hydatid cyst
Authors: Fatemeh Samiee-Rad, Ali Emami
Journal: GMS Hyg Infect Control (2020)
Keywords: echinococcosis, hydatid cyst, intramuscular, primary, thigh

Background: Hydatid cyst is a zoonotic infection caused by Echinococcosis granulosus. Primary single-intramuscular hydatid disease is rare, even in endemic regions of the world. Here we report the case of exceptional thigh mass due to a hydatid cyst in an Iranian man. Case presentation: An 86-year-old man, initially presented to Velayat teaching hospital surgery clinic in May 2017 with a single right-thigh mass, but physical examinations of other organs were unremarkable. Based on sonographic findings, the differential diagnosis was hydatid cyst. He underwent surgical resection of the cyst. Histopathological results confirmed the diagnosis. There was no evidence of recurrence of the lesion during the 23-month follow-up. Conclusion: Increase thigh mass due to a hydatid cyst is a rare event. In endemic regions with the presence of hydatid cysts, especially physicians of surgical clinics have to consider differential diagnosis of hydatid cysts in unusual locations in case of such a lesion.
AIDS Cholangiopathy Secondary to Cytomegalovirus as Possible Unmasking Immune Reconstitution Inflammatory Syndrome in Human Immunodeficiency Virus-Infected Individual: Case Report and Review of the Literature
Authors: Moiz Topiwala, Nachiket Dubale, Mahender K Medisetty, Sunil Gaikwad, Divya Patel, Sanjay Pujari
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

We present the first case report of cytomegalovirus (CMV) cholangiopathy as possible immune reconstitution inflammatory syndrome (IRIS) in a human immunodeficiency virus (HIV)-infected individual, within two months of starting effective HAART. The patient presented with abdominal pain, nausea, vomiting, decreased appetite, and jaundice. The patient was diagnosed on ERCP as AIDS cholangiopathy, and biopsy of the ampulla showed acute inflammation with CMV inclusion bodies. The patient underwent sphincterotomy with CBD stenting and HAART continued without use of ganciclovir or valganciclovir. On follow-up, the patient achieved clinical and histopathological cure, which was demonstrated on repeat ampullary biopsy.
Lactobacillus acidophilus Endocarditis Complicated by Pauci-Immune Necrotizing Glomerulonephritis
Authors: Vivian O Chukwurah, Comfort Takang, Chinelo Uche, David B Thomas, Waguih El Masry, Hakan R Toka
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Infective endocarditis (IE) is more common in patients with predisposing cardiac lesions and has many potential complications, including stroke and arterial thromboembolisms. Renal manifestations have an estimated prevalence of ∼20%. Rapidly progressive glomerulonephritis (RPGN) is a nephrological emergency manifested by autoimmune-mediated progressive loss of renal function over a relatively short period of time. Here, we report the case of a 60-year-old Caucasian male, who presented with speech impairment and was found to have multiple embolic strokes caused by aortic valve IE. His renal function declined rapidly, and his urine sediment featured hematuria and proteinuria. ANCA titer was negative by immunofluorescence (IF); however, the PR3 antibody was elevated. The renal biopsy revealed pauci-immune focally necrotizing glomerulonephritis with the presence of ∼25% cellular crescents. He was initially treated with plasmapheresis and pulse dose steroids. Hemodialysis was initiated for uremic symptoms. After four weeks of antibiotic therapy and with blood cultures remaining negative, he was treated with rituximab. Two months after discharge, his renal function showed improvement, and hemodialysis was discontinued. This case highlights several complications associated with lactobacillus endocarditis including RPGN.
Metastatic Sarcomatoid Squamous Cell Carcinoma of the Cervix Presenting with Chest Mass
Authors: Lilit Karapetyan, Manoj Rai, Om Dawani, Heather S Laird-Fick
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Background:
Sarcomatoid squamous cell carcinoma is a rare and aggressive form of cervical cancer. We report a case of metastatic sarcomatoid squamous cell carcinoma (SSCC) of cervix that presented with an anterior chest wall mass.
Case:
A 43-year-old Hispanic female presented with a two-month history of a central chest wall mass. The patient's only past medical history was SSCC of the cervix, stage IIB, diagnosed two years priorly. She underwent neoadjuvant chemoradiation therapy (CRT) with cisplatin followed by radical hysterectomy. Surgical margins were positive which led to adjuvant CRT with carboplatin and paclitaxel. PET scan 4 months after the postoperative treatment was negative for recurrence and metastatic disease. On current presentation, the CT chest revealed anterior mediastinal destructive soft tissue mass involving sternum, and the biopsy showed SSCC. The patient received palliative radiation therapy to her chest with improvement in pain and ability to swallow. After discussing the prognosis she refused further chemotherapy and decided on hospice care.
Conclusion:
Despite good response to first-line therapy, SSCC tends to recur early and does not respond to second-line therapy. Radiation therapy seems to be the most effective modality for treatment, but randomized controlled trials of therapy are impractical.
A glioneuronal tumor with CLIP2-MET fusion
Authors: Tamrin Chowdhury, Yeajina Lee, Sojin Kim, Hyeon Jong Yu, So Young Ji, Jeong Mo Bae, Jae Kyung Won, Joo Heon Shin, Daniel R Weinberger, Seung Hong Choi, Chul-Kee Park, Jong-Il Kim, Sung-Hye Park
Journal: NPJ Genom Med (2020)
Keywords: cancer genomics, oncogenesis
MeSH terms: Case Reports

We report a case of glioneuronal tumor (GNT) with a discovery of novel gene fusion of CLIP2-MET resulting from aberrant chromosome 7 abnormalities. We executed an elaborate genomic study on this case including whole-exome sequencing and RNA sequencing. Genomic analysis of the tumor revealed aberrations in chromosomes 1 and 7 and a CLIP2-MET fusion. Further analysis of the upregulated genes revealed substantial connections with MAPK pathway activation. We concluded that the chromosome 7 abnormalities prompted CLIP2-MET gene fusion which successively leads to MAPK pathway activation. We deliberated that MAPK pathway activation is one of the driver pathways responsible for the oncogenesis of GNT.
Resection of rectal GIST using a novel technique: a report of two cases
Authors: Osama Eldamshety, Islam H Metwally, Elsayed Ghoneem, Wagdi F Elkashef
Journal: Ecancermedicalscience (2017)
Keywords: gist, teo, imatinib, rectal tumour, transanal
MeSH terms: Case Reports

Rectal gastrointestinal stromal tumours (GISTs) are uncommon tumours and usually present with large sizes. We present two cases of rectal GIST. Imatinib was used in the setting of neoadjuvant and adjuvant therapy. Both tumours were resected transanally by the transanal endoscopic operation (TEO) platform. Oncosurgeons are recommended to implement sphincter-sparing surgeries for these cases.
Case Report: Cyclophosphamide in COVID-19 - when an absolute contraindication is an absolute necessity
Authors: Kamila Bołtuć, Ada Bielejewska, Alejandro Coloma-Millar, Robert Dziugieł, Arkadiusz Bociek, Agnieszka Perkowska-Ptasińska, Andrzej Jaroszyński
Journal: F1000Res (2021)
Keywords: covid-19, alveolar haemorrhage, cyclophosphamide, p-anca, vasculitis
MeSH terms: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, COVID-19, Case Reports, Adult, COVID-19 Testing, Contraindications, Cyclophosphamide / therapeutic use, Humans, SARS-CoV-2, Cyclophosphamide

Background: Despite many studies on COVID-19, our knowledge of it remains incomplete. In some cases, treating SARS-CoV-2 infection concomitant with other diseases can be particularly challenging, as finding an appropriate treatment may involve some risks. Case presentation: A 34-year-old SARS-CoV-2 positive patient admitted due to fever, dyspnoea, haemoptysis and pneumonia, developed alveolar haemorrhage and acute kidney injury. Due to his severe state, abnormalities in laboratory tests and rapidly progressing loss of kidney function, kidney biopsy, as well as antibody panel were carried out, in which perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) were found with a high titer (>200; N: <1:20). The results of kidney biopsy, combined with clinical manifestation and laboratory findings prompted the diagnosis of rapidly progressing glomerulonephritis (RPGN) in the course of p-ANCA vasculitis. Initial treatment consisted of heamodialyses, remdesivir, plasmaphereses, intravenous immunoglobulins, antibiotics, corticosteroids and nadroparin. Once the haemorrhage had subsided, kidney function had been partially retrieved and heamodialyses had no longer been necessary, cyclophosphamide treatment was initiated, despite being contraindicated in COVID-19 according to its summary of product characteristics. Immunotherapy is still continued. The patient has already received a total of 2.4g of cyclophosphamide (4 cycles of 600mg each every three weeks). Pulmonary and radiological regression, as well as improvement of renal parameters have been achieved. Conclusions: We suspect that cyclophosphamide, the drug of choice in p-ANCA vasculitis, could be a potential factor providing regression of the radiological changes in the lungs and it could have prevented the patient from developing acute respiratory distress syndrome. COVID-19 diagnosis should not exclude searching for other diseases which can have a similar course. When treating a patient in a life-threatening condition, a departure from trying to find the perfect timing of cyclophosphamide delivery should be considered, as delaying it could cause potentially greater harm.
Cutaneous adenoid cystic carcinoma with perineural invasion treated by mohs micrographic surgery-a case report with literature review
Authors: Yaohui G Xu, Molly Hinshaw, B Jack Longley, Humza Ilyas, Stephen N Snow
Journal: J Oncol (2010)
MeSH terms: Case Reports

We report a 58-year-old woman with cutaneous adenoid cystic carcinoma arising on the chest treated with Mohs micrographic surgery. The patient remained tumor-free at 24-month follow-up. To date, only six other cases of cutaneous adenoid cystic carcinoma were reportedly managed by Mohs surgery. Cutaneous adenoid cystic carcinoma has low potential for distant metastasis but is notorious for its aggressive infiltrative growth pattern, frequent perineural invasion, and high risk of local recurrence after excision. We propose that Mohs surgery is an ideal method to achieve margin-free removal of cutaneous adenoid cystic carcinoma. A brief literature review is provided.
Case report: Unusual development of hepatocellular carcinoma during immunosuppressive treatments against rheumatoid arthritis overlapping Sjögren's syndrome; cirrhotic steatohepatitis with liver inflammation and fibrosis lurks in autoimmune disorders
Authors: Shuhei Yoshida, Masashi Fujita, Teruhide Ishigame, Yasuyuki Kobayashi, Yuya Sumichika, Kenji Saito, Haruki Matsumoto, Jumpei Temmoku, Yuya Fujita, Naoki Matsuoka, Tomoyuki Asano, Shuzo Sato, Hiroshi Watanabe, Hiroshi Yoshida, Shigeru Marubashi, Yuko Hashimoto, Hiromasa Ohira, Kiyoshi Migita
Journal: Front Immunol (2023)
Keywords: sjögren’s syndrome (ss), hepatocellular carcinoma (hcc), methotrexate (mtx), non-alcoholic fatty liver disease (nafld), non-alcoholic steatohepatitis (nash), rheumatoid arthritis (ra), tumor necrosis factor inhibitors (tnfi)
MeSH terms: Arthritis, Rheumatoid, Autoimmune Diseases, Carcinoma, Hepatocellular, Hepatitis, Liver Neoplasms, Non-alcoholic Fatty Liver Disease, Sjogren's Syndrome, Case Reports, Female, Humans, Immunosuppressive Agents, Liver Cirrhosis, Middle Aged, Immunosuppressive Agents

The sequential progression from chronic liver disease to cirrhosis may be a risk factor for hepatocellular carcinoma (HCC) development. Although HCC originates from hepatitis B virus- or hepatitis C virus-associated liver cirrhosis, it has recently been reported in patients with non-alcoholic steatohepatitis (NASH) with advanced fibrosis. However, little is known about the pathophysiological mechanisms linking HCC to rheumatic disorders, including rheumatoid arthritis (RA). Herein, we describe the case of HCC with NASH complicated by RA and Sjögren's syndrome (SS). A fifty-two-year-old patient with RA and diabetes was referred to our hospital for further examination of a liver tumor. She received methotrexate (4 mg/week) for 3 years and adalimumab (40 mg/biweekly) for 2 years. On admission, laboratory data showed mild thrombocytopenia and hypoalbuminemia, with normal hepatitis virus markers or liver enzymes. Anti-nuclear antibodies were positive with high titers (x640), and anti-SS-A/Ro (187.0 U/ml; normal range [NR]: ≤6.9 U/mL) and anti-SS-B/La (320 U/ml; NR: ≤6.9 U/mL) antibodies were also high. Abdominal ultrasonography and computed tomography revealed liver cirrhosis and a tumor in the left lobe (S4) of the liver. She was diagnosed with HCC based on imaging findings, and elevated levels of protein induced by vitamin K absence- II (PIVKA-II) were detected. She underwent laparoscopic partial hepatectomy, and histopathological examination revealed steatohepatitis HCC with background liver cirrhosis. The patient was discharged on the 8th day post-operation without any complications. At the 30 months follow-up, no significant evidence of recurrence was observed. Our case suggests that clinical screening for HCC is needed in patients with RA who are at a high risk of NASH, as they may progress to HCC even without elevated liver enzymes.
Sequential Immune Thrombocytopenia (ITP) and Thrombotic Thrombocytopenic Purpura (TTP) in an Elderly Male Patient with Primary Sjogren's Syndrome: When in Doubt, Use the PLASMIC Score
Authors: Devon D Miller, Joseph A Krenzer, Vaishalee P Kenkre, William Nicholas Rose
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Introduction:
Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy due to an acquired autoantibody to ADAMTS13 that requires a boutique treatment, urgent plasma exchange. Thus, TTP is often termed a "cannot miss" diagnosis.
Case:
We report a patient with TTP who had a history of immune thrombocytopenia (ITP), had atypical demographics for TTP, and had also met criteria for primary Sjogren's syndrome. This exceedingly rare combination presented a temptation to dismiss TTP as a diagnosis. Discussion. Our case further demonstrates the practical utility of using the PLASMIC score as a tool that can help identify patients with TTP even when the patient has statistically rare characteristics.
A Case of Effective Mepolizumab Induction Therapy for Severe Eosinophilic Granulomatosis with Polyangiitis Diagnosed by Eosinophilic Cholecystitis and Interstitial Nephritis
Authors: Keita Hattori, Yuri Teramachi, Yoshinori Kobayashi, Takeshi Ito, Takatoshi Morinaga, Hirohumi Tamai, Yoshihiro Yamamoto
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

A 66-year-old man with a history of bronchial asthma and sinusitis was admitted with cholecystitis and peripheral neuropathy. The histopathological findings of the gallbladder revealed necrotic vasculitis and granulomatous inflammation with marked eosinophilic infiltration. Kidney biopsy also showed marked eosinophilic infiltration in the tubulointerstitial area and eosinophilic tubulitis. He was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) and treated with corticosteroids. However, he showed no response. Therefore, he was administered mepolizumab 300 mg, which resulted in clinical improvement, including normalization of the eosinophil and CRP levels. We herein describe the first case of successful induction therapy of EGPA using mepolizumab.