OpenMed/multicare-articles huggingface dataset:
Case Report: Two Cases of Salivary Duct Carcinoma in Workers With a History of Chromate Exposure
Authors: Imran Seçin, Maike J M Uijen, Chantal M L Driessen, Carla M L van Herpen, Paul T J Scheepers
Journal: Front Med (Lausanne) (2021)
Keywords: hexavalent chromium, occupation, paint, salivary duct carcinoma, salivary gland cancer
MeSH terms: Case Reports

Background: Salivary duct carcinoma (SDC), one subtype of the 22 different salivary gland cancers, is a rare malignancy. Risk factors for the development of salivary gland cancer and SDC are largely unknown, although pollution has been described as one of the risk factors. In other cancers, especially in lung cancer, the carcinogenicity of chromium VI [Cr(VI)] is well-known. Here we report on two SDC patients who were occupationally exposed to Cr(VI) and discuss a potential relation between their Cr(VI) exposure and the occurrence of SDC. Case Presentation: The work history of two SDC patients was analyzed for chemical exposures. Both patients had a history of Cr(VI) exposure, with maintenance of military equipment considered as the source for this exposure. Inhalation of Cr(VI) containing particles from the removal of old paint by mechanical abrasion was identified as a probable source of exposure for both patients, and one of these patients also applied new paint. Both patients reported not to have used any respiratory protection which may have resulted in substantial inhalation of Cr(VI)-containing chromates. Furthermore, in one patient inhalation of fumes from soldering may have resulted in relevant co-exposure. Conclusion: A causal relation between Cr(VI) exposure and SDC, a rare cancer, cannot be demonstrated on an individual basis but detection in a population-based study is also unlikely because of the extremely low prevalence. Nevertheless, the work history is considered a relevant risk factor in the onset of SDC as occupational exposures to Cr(VI) occurred in poorly ventilated working environment and without using appropriate respiratory protective equipment.
Multiple myeloma of the thyroid cartilage
Authors: Peter Kalina, Jeffrey B Rykken
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

A 60-year-old male presented with hoarseness. His past medical history was remarkable for a plasmacytoma of the left maxillary sinus having been resected without systemic evidence of plasma cell myeloma (PCM), also known as multiple myeloma (MM), at the time. This maxillary sinus disease recurred and was treated with radiation. Workup for PCM was conducted. Treatment included melphalan and autologous stem cell transplant. Because of the therapeutic and prognostic implications, a Plasma cell neoplasm (PCN) in a neck mass must be carefully evaluated by clinical and pathological criteria in order to distinguish plasmacytoma from PCM. PCN involvement of the thyroid cartilage is very rare, with only 5 previously reported cases.
Non-invasive urine testing of EGFR activating mutation and T790M resistance mutation in non-small cell lung cancer
Authors: David Berz, Victoria M Raymond, Jordan H Garst, Mark G Erlander
Journal: Exp Hematol Oncol (2016)
Keywords: cell free dna, circulating tumor dna, diagnostics, egfr, liquid biopsy, lung cancer, targeted therapy, urine, ctdna
MeSH terms: Case Reports

Background:
The increasing understanding of non-small cell lung cancer (NSCLC) biology over the last two decades has led to the identification of multiple molecular targets. This led to the development of multiple targeted therapies in the primary and secondary resistance setting and the epidermal growth factor receptor (EGFR) gene remains the most frequently observed molecular target in NSCLC. Tissue biopsies remain the standard for the identification of such EGFR mutations. Obtaining serial tissue biopsies, especially in the secondary resistance setting is associated with multiple medical and logistical challenges. Utilizing circulating tumor DNA (ctDNA) fragments for molecular analysis can overcome these challenges and aid in therapeutic decision-making.
Case presentation:
Here we present a present a 72-year-old Korean woman with metastatic, EGFR L858R mutated bronchogenic adenocarcinoma. She developed skeletal progression on treatment with first and second generation tyrosine kinase inhibitors (TKIs). Repeated biopsies failed to provide informative molecular test results. A novel urine ctDNA assay was utilized and confirmed T790M positive status. The patient was started on a third generation TKI, which led to a measurable clinical response.
Conclusions:
Utilization of urine liquid biopsies for EGFR diagnostics are feasible and provided critical clinical information in this patient's case. Urine liquid biopsy represents a viable alternative to tissue biopsy, particularly in the secondary resistance setting, when tissue is not available for molecular testing.
Non-Hodgkin's Lymphoma Presenting as Isolated Peritoneal Lymphomatosis: A Case Report and Literature Review
Authors: Min Zhu, Zhixuan Wu, Zhaoxia Yang, Bo Ning, Shengjie Yu, Xiling Gu, Huihong Yu
Journal: Front Oncol (2021)
Keywords: case report, diagnosis, non-hodgkin’s lymphoma, peritoneal carcinomatosis, peritoneal lymphomatosis
MeSH terms: Case Reports

Peritoneal lymphomatosis is extremely rare and associated with poor prognosis. Most practitioners only pay more attention to peritoneal carcinomatosis. However, peritoneal lymphomatosis can be neglected and misdiagnosed. We report a teenager with 10 days of abdominal distension and pain accompanied by computed tomography scan suggesting diffuse thickening of the peritoneum and omentum and abdominopelvic effusion. Tuberculous peritonitis and peritoneal carcinomatosis were initially suspected. However, it was finally confirmed as non-Hodgkin's B-cell lymphoma by omentum biopsies. He achieved complete remission after chemotherapy and autologous stem cell transplantation. But unfortunately, he suffered a relapse and died 10 months after diagnosis. Following a review of the literature, it can be concluded that the discovery of lymphomatosis in peritoneum is a rare finding. Lymphoma should be considered in the differential diagnosis of unexplained peritoneal thickening on computed tomography, and this case emphasizes the importance of early pathological diagnosis to make sure that the right treatment can be started opportunely.
Successful Cardiopulmonary Resuscitation in a Sevoflurane Anaesthetized Horse That Suffered Cardiac Arrest at Recovery
Authors: Clara Conde Ruiz, Stéphane Junot
Journal: Front Vet Sci (2018)
Keywords: cpr, anaesthesia, bezold jarisch, cardiac arrest, complications, horse
MeSH terms: Case Reports

A 17-year-old mare undergoing dental surgery suffered a cardiac arrest while being transferred from the surgical theatre to the recovery box. This complication was diagnosed early, thus allowing a prompt start to the cardiopulmonary resuscitation maneuvers. External thoracic compressions, intermittent positive pressure ventilation, and adrenaline administration were at the core of this successful resuscitation. Although it was not possible to confirm the cause of cardiac arrest in this horse, a Bezold-Jarisch reflex due to potential decrease on venous return because of postural change and drug interactions was hypothesized. Based on this report, it appears advisable to smoothly change the position of anaesthetized patient; furthermore, the administration of drugs affecting cardiovascular hemodynamics or sympatho-vagal balance to animals while changing their recumbency should be avoided.
Easily Missed: A Case Series of New Heart Failure in Young Adults
Authors: Eric J Hall, Jonathan Menachem, Lynne Warner Stevenson, Jessica Huston
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background. While uncommon, heart failure (HF) can present in young adults from a variety of causes. Identifying HF in a young patient presents many challenges, the foremost of which is recognition of the signs and symptoms of HF. Case Summary. We present four cases of new diagnosis of HF (due to familial cardiomyopathy, tachycardia-induced cardiomyopathy, spontaneous coronary artery dissection, and peripartum cardiomyopathy) to highlight the range of etiologies and presentations requiring recognition in this patient population. Discussion. A high index of suspicion is needed to diagnose HF in young adults, who may not present with classic signs and symptoms. Young adults represent a unique patient population that differs from the older patients with HF. Young adults with newly diagnosed HF should be promptly referred to a center offering full diagnostic capabilities and advanced cardiac therapies.
Marked QTc Prolongation and Torsades de pointes in Patients with Chronic Inflammatory Arthritis
Authors: Pietro Enea Lazzerini, Pier Leopoldo Capecchi, Iacopo Bertolozzi, Gabriella Morozzi, Sauro Lorenzini, Antonella Simpatico, Enrico Selvi, Maria Romana Bacarelli, Maurizio Acampa, Deana Lazaro, Nabil El-Sherif, Mohamed Boutjdir, Franco Laghi-Pasini
Journal: Front Cardiovasc Med (2016)
Keywords: chronic inflammatory arthritis, interleukin-6, psoriatic arthritis, rheumatoid arthritis, sudden death, systemic inflammation, torsades de pointes
MeSH terms: Case Reports

Mounting evidence indicates that in chronic inflammatory arthritis (CIA), QTc prolongation is frequent and correlates with systemic inflammatory activation. Notably, basic studies demonstrated that inflammatory cytokines induce profound changes in potassium and calcium channels resulting in a prolonging effect on cardiomyocyte action potential duration, thus on the QT interval on the electrocardiogram. Moreover, it has been demonstrated that in rheumatoid arthritis (RA) patients, the risk of sudden cardiac death is significantly increased when compared to non-RA subjects. Conversely, to date no data are available about torsades de pointes (TdP) prevalence in CIA, and the few cases reported considered CIA only an incidental concomitant disease, not contributing factor to TdP development. We report three patients with active CIA developing marked QTc prolongation, in two cases complicated with TdP degenerating to cardiac arrest. In these patients, a blood sample was obtained within 24 h from TdP/marked QTc prolongation occurrence, and levels of IL-6, TNFα, and IL-1 were evaluated. In all three cases, IL-6 was markedly elevated, ~10 to 100 times more than reference values. Moreover, one patient also showed high circulating levels of TNFα and IL-1. In conclusion, active CIA may represent a currently overlooked QT-prolonging risk factor, potentially contributing in the presence of other "classical" risk factors to TdP occurrence. In particular, a relevant role may be played by elevated circulating IL-6 levels via direct electrophysiological effects on the heart. This fact should be carefully kept in mind, particularly when recognizable risk factors are already present and/or the addition of QT-prolonging drugs is required.
Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report
Authors: Giustino Parruti, Giuseppe Marani Toro
Journal: BMC Infect Dis (2005)
MeSH terms: Anti-HIV Agents / administration & dosage, Anti-HIV Agents / adverse effects, HIV Infections / drug therapy, HIV-Associated Lipodystrophy Syndrome / chemically induced, HIV-Associated Lipodystrophy Syndrome / pathology, Case Reports, Adult, Antiretroviral Therapy, Highly Active / adverse effects, Female, HIV Infections / complications, HIV-Associated Lipodystrophy Syndrome / complications, HIV-Associated Lipodystrophy Syndrome / physiopathology, Humans, Time Factors, Anti-HIV Agents

Background:
HIV-infected patients on long-term highly active antiretroviral therapy often present peculiar patterns of fat redistribution, referred to as lipodystrophy. In spite of recent investigations, it is not known whether and to what extent the main features of lipodystrophy--that is lipoatrophy of peripheral fat at face, limbs and buttocks, as well as fat accumulation at breasts, abdomen and the dorso-cervical region--can be reversible once clinically manifest.
Case presentation:
A 35 year old Caucasian HIV infected female developed severe diffuse lipodystrophy while on highly active antiretroviral therapy. A remarkable increase of breast size, fat accumulation at waist, and a fat pad on her lumbar spine were paralleled by progressive and disfiguring lipoatrophy of face, limbs and buttocks. The patient decided to interrupt her therapy after 20 months, with a stably suppressed viremia and a CD4 lymphocyte count > 500/microL. She could carry on a safe treatment interruption for longer than 4 years. Most sites of fat accumulation switched to nearly normal appearance, whereas lipoatrophy was substantially unchanged at all affected sites.
Conclusion:
our observation provides pictorial evidence that lipoatrophy may not be reversible even under ideal circumstances. Therefore, strategies to prevent lipoatrophy should be considered when defining therapeutic regimens for HIV infected patients, especially those at high risk.
Spontaneous bowel perforation in a neonate with anorectal malformation
Authors: Gursev Sandlas, Paras Kothari, Dinesh Sarda, Parag Karkera
Journal: Saudi J Gastroenterol (2011)
MeSH terms: Intestinal Perforation / diagnosis, Intestinal Perforation / etiology, Case Reports, Anorectal Malformations, Anus, Imperforate / complications, Anus, Imperforate / diagnosis, Anus, Imperforate / therapy, Humans, Infant, Newborn, Intestinal Perforation / therapy, Meconium, Peritonitis / diagnosis, Peritonitis / etiology, Peritonitis / therapy

Gastrointestinal perforation in neonates with anorectal malformations is extremely uncommon. Delayed patient presentation is an important factor that demands special attention. We present a neonate with anorectal malformation and meconium peritonitis following spontaneous bowel perforation. A day 1 neonate was referred with features suggested of peritonitis. After adequate resuscitation and drainage under local anesthesia, patient was successfully operated for a sigmoid perforation and is now awaiting definitive surgery for the anorectal malformation.
Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury
Authors: Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.
Antisecretory Factor May Reduce ICP in Severe TBI-A Case Series
Authors: David Cederberg, Hans-Arne Hansson, Edward Visse, Peter Siesjö
Journal: Front Neurol (2020)
Keywords: icp reduction, anti-inflammatory therapy, intracranial hypertension, novel treatments against traumatic brain edema, therapeutic agents per oral treatment, traumatic brain injury
MeSH terms: Case Reports

Traumatic brain injury (TBI) constitutes a global epidemic. Overall outcome is poor, with mortality ranging from 10 to 70% and significant long-term morbidity. Several experimental reports have claimed effect on traumatic edema, but all clinical trials have failed. Antisecretory factor, an endogenous protein, is commercially available as Salovum®, which is classified as a medical food by the European Union and has been proven effective in experimental trauma models. It has, however, previously not been tested in humans with severe TBI. We hereby report a case series of five adult patients with severe TBI, treated with Salovum. The objective of the intervention was to evaluate safety and, if possible, its effect on intracranial pressure and outcome. Patients received 1 g Salovum per kilo of body weight divided into six doses per 24 h. Each dose was administered through the nasogastric tube. Patients were scheduled for 5 days of treatment with Salovum. Intracranial pressure was controlled in all patients. In three of five patients, intracranial pressure could be controlled with Salovum and deep sedation (no barbiturates), except during periods of gastroparesis. Five of five patients had a favorable short-term outcome, and four of five patients had a favorable long-term outcome. No toxicity was observed. We conclude that at least three of the five treated patients experienced an effect of Salovum with signs of reduction of intracranial pressure and signs of clinical benefit. In order to validate the potential of antisecretory factor in TBI, a prospective, randomized, double-blind, placebo-controlled trial with Salovum has been initiated. Primary outcome for the trial is 30-day mortality; secondary outcomes are treatment intensity level, intracranial pressure, and number of days at the neurointensive care unit.
Apical ballooning syndrome after attempted suicidal hanging
Authors: Jose Chacko, Gagan Brar, Ashok Elangovan, Ramanathan Moorthy
Journal: Indian J Crit Care Med (2011)
Keywords: apical ballooing, left ventricular dysfunction, suicidal hanging
MeSH terms: Case Reports

We report a case of "Apical Ballooning Syndrome" following attempted suicidal hanging. Our patient developed retrosternal chest pain and ischemic changes on electrocardiography (ECG), a day after the suicidal attempt. She underwent an angiogram considering the possibility of acute coronary syndrome. However, her coronary arteries were normal; the left ventricle showed the typical ballooning pattern characterized by hypokinesia of the distal septum and apex. On follow-up a week later, she remained asymptomatic; her ECG changes had reversed and the left ventricular contractility was normal on echocardiography.
Pneumomediastinum, pneumopericardium and subcutaneous emphysema following acute lymphoblastic leukemia and chemotherapy: A case report
Authors: Mohammad Kajiyazdi, Amir Hossein Norooznezhad
Journal: Caspian J Intern Med (2021)
Keywords: acute lymphoblastic leukemia, pneumomediastinum, pneumopericardium, subcutaneous emphysema
MeSH terms: Case Reports

Background:
Pneumomediastinum and subcutaneous emphysema are mostly detected in non-malignant conditions such as certain infections, thoracic surgeries, and trauma. Although this condition is asymptomatic in most cases, sometimes it could be symptomatic and may even be lethal in some patients.
Case presentation:
This letter reports a 9-year-old girl with acute lymphoblastic leukemia (ALL) on chemotherapy who developed pneumothorax with the clinical feature of respiratory distress for that a chest tube was inserted immediately. Following the insertion, pneumomediastinum and pneumopericardium developed in the patient. As the next step, a pericardium window was inserted by an expert heart surgeon. During these procedures, all the evaluations for any bacterial or fungal infection were negative. Unfortunately, the patient expired before any further complementary evaluations and it was not clear that the mentioned situation was a result of chemotherapy or ALL.
Conclusion:
Although pneumomediastinum and subcutaneous emphysema are rare in patients with ALL, authors strongly suggest clinicians consider them in any similar patients presenting respiratory signs/symptoms for faster onset of action.
Familial Bell's Palsy: A Case Report and Literature Review
Authors: Mark Kubik, Liliana Robles, Doris Kung
Journal: Case Rep Neurol Med (2012)

Objective. To describe a unique case of familial Bell's palsy and summarize the current literature regarding possible hereditary influences. Design. Case report. Main Outcome Measures. Clinical exam, CSF analysis, and family history provided per the patient. Results. We report the case of a 58-year-old female who presented with recurrent and bilateral episodes of facial palsy. The patient underwent multiple CSF investigations to rule out a possible infectious and rheumatologic etiology that were all negative. Further questioning revealed she was one of seven family members with a history of unilateral facial nerve paralysis. Conclusion. The sheer number of similar case studies to date suggests that familial clustering of Bell's palsy is a real, noncoincidental phenomenon. Our case represents a unique and perplexing example of one such family. Familial Bell's palsy may represent an autoimmune disease secondary to inherited HLA alloantigens or a structural predisposition to disease based on the dimensions of the facial canal.
Compound Heterogeneous Sickle Cell-B+ Thalassemia Incidentally Discovered Through Cytological Examination of a Fine-Needle Aspiration Specimen from an Aneurysmal Bone Cyst in a Young Child: A Case Report
Authors: Abdelrazak Meliti, Salmin Muftah, Daniyah Saleh, Nasrulla Habibullah
Journal: Cureus (2023)
Keywords: aneurysmal bone cyst, fine needle aspiration, hemoglobinopathies, sickle cell crisis, sickle β thalassemia
MeSH terms: Case Reports

Sickle cell beta-thalassemia (S/β) is a rare inherited variant of sickling disorders, usually occurring due to the inheritance of two abnormal genes, namely, the sickle cell gene, and the beta-thalassemia gene. There are two types of sickle cell β-thalassemia: (S/β+) and (S/β0), based on a decrease or complete absence of beta-globin synthesis, respectively. Skeletal complications, such as osteonecrosis, osteomyelitis, and septic arthritis, are well-known sequelae in sickle cell patients due to vaso-occlusive events. Nevertheless, the occurrence of aneurysmal bone cysts in patients with sickle cell hemoglobinopathy is an exceptional phenomenon. Herein, we report a case of a young boy who presented with nonspecific clinical symptoms over a few years. The patient was referred to our institution as a case of short stature with recurrent joint pain. A clinical workup was done and an aneurysmal bone cyst (ABC) of the left humerus was discovered radiologically with incidental detection of sickle cells through cytological evaluation of the cyst fluid. Further clinical investigation, including molecular and additional laboratory tests, confirmed the diagnosis of compound heterogeneous sickle cell-B+ thalassemia. Unfortunately, neither was the underlying pathology detected nor was the precise clinical diagnosis attained at the outside primary healthcare facility.