OpenMed/multicare-articles huggingface dataset:
A case report of agoraphobia following right parietal lobe surgery: changes in functional and structural connectivities of the multimodal vestibular network
Authors: Iole Indovina, Alberto Cacciola, Sergio Delle Monache, Demetrio Milardi, Francesco Lacquaniti, Nicola Toschi, Jerome Cochereau, Gianfranco Bosco
Journal: Front Neurol (2023)
Keywords: agoraphobia, case report, connectivity, graph theory, parietal glioma
MeSH terms: Case Reports

Agoraphobia is a visuo-vestibular-spatial disorder that may involve dysfunction of the vestibular network, which includes the insular and limbic cortex. We sought to study the neural correlates of this disorder in an individual who developed agoraphobia after surgical removal of a high-grade glioma located in the right parietal lobe, by assessing pre- and post-surgery connectivities in the vestibular network. The patient underwent surgical resection of the glioma located within the right supramarginal gyrus. The resection interested also portions of the superior and inferior parietal lobe. Structural and functional connectivities were assessed through magnetic resonance imaging before and 5 and 7 months after surgery. Connectivity analyses focused on a network comprising 142 spherical regions of interest (4 mm radius) associated with the vestibular cortex: 77 in the left and 65 in the right hemisphere (excluding lesioned regions). Tractography for diffusion-weighted structural data and correlation between time series for functional resting-state data were calculated for each pair of regions in order to build weighted connectivity matrices. Graph theory was applied to assess post-surgery changes in network measures, such as strength, clustering coefficient, and local efficiency. Structural connectomes after surgery showed a decrease of strength in the preserved ventral portion of the supramarginal gyrus (PFcm) and in a high order visual motion area in the right middle temporal gyrus (37dl), and decrease of the clustering coefficient and of the local efficiency in several areas of the limbic, insular cortex, parietal and frontal cortex, indicating general disconnection of the vestibular network. Functional connectivity analysis showed both a decrease in connectivity metrics, mainly in high-order visual areas and in the parietal cortex, and an increase in connectivity metrics, mainly in the precuneus, parietal and frontal opercula, limbic, and insular cortex. This post-surgery reorganization of the vestibular network is compatible with altered processing of visuo-vestibular-spatial information, yielding agoraphobia symptoms. Specifically, post-surgical functional increases of clustering coefficient and local efficiency in the anterior insula and in the cingulate cortex might indicate a more predominant role of these areas within the vestibular network, which could be predictive of the fear and avoiding behavior characterizing agoraphobia.
A diffuse large B cell lymphoma emerging with breast cancer relapse
Authors: Abdulkadir Karismaz, Mehmet Hilmi Dogu, Gülben Huq, Sermin Altindal, Osman Yokus, Elif Suyani
Journal: Pan Afr Med J (2018)
Keywords: breast cancer, lymphoma, therapy-related hematological malignancies
MeSH terms: Antineoplastic Agents, Hormonal / adverse effects, Breast Neoplasms / drug therapy, Lymphoma, Large B-Cell, Diffuse / chemically induced, Tamoxifen / adverse effects, Case Reports, Adult, Antineoplastic Agents, Hormonal / administration & dosage, Biopsy, Breast Neoplasms / pathology, Female, Humans, Lymphoma, Large B-Cell, Diffuse / diagnosis, Lymphoma, Large B-Cell, Diffuse / pathology, Neoplasm Recurrence, Local, Pancytopenia / chemically induced, Tamoxifen / administration & dosage, Antineoplastic Agents, Hormonal, Tamoxifen

The prevalence of secondary cancers associated with the breast cancer treatment has increased, which is due to the administration of cytotoxic/hormonal drugs as well as radiotherapy. A 54-year-old female patient with a history of breast cancer for 4 years and receiving tamoxifen the hematology clinic with fatigue and nosebleed. Laboratory parameters were revealed pancytopenia. The bone marrow biopsy finding was compatible with CD20 positive high-grade B cell lymphoma resembling diffuse large B cell lymphoma. The patient started to receive a chemotherapy. Her hemogram values displayed an improvement after the second cycle. However, interim PET-BT, performed after the fourth cycle, showed an incomplete response in cervical lymphatic nodes. Then, a tru-cut biopsy was performed resulting in breast cancer metastasis. This is an unusual case of secondary-DLBCL presenting with pancytopenia and occuring 4 years after the diagnosis of breast cancer. In conclusion, clinicians should carefully set the dosage of chemotherapy drugs to avoid the long-term side effects associated with such drugs.
Case report: Partial cystectomy for pheochromocytoma of the urinary bladder: A case report and review of literature
Authors: Liang-Liang Hu, Zhong-Qiang Guo, Peng Dai, Gang Chen, Tao Tian
Journal: Front Cardiovasc Med (2022)
Keywords: bladder neoplasms, case report, hypertension, partial cystectomy, pheochromocytomas
MeSH terms: Case Reports

Pheochromocytomas are neuroendocrine tumors that produce catecholamines and can be difficult to diagnose. Bladder involvement is uncommon with pheochromocytoma. Hypertension (sometimes with hypertensive crisis coinciding with micturition), headache, hematuria and syncope, which are commonly associated with voiding, are the most prevalent symptoms. While transurethral resection may be performed in roughly 20% of patients, 70% require partial cystectomy and 10% require radical cystectomy. We present a case of pheochromocytoma with hypertension and syncope that was often associated with voiding, satisfactorily treated by partial cystectomy.
Ramifications of untreated hypothyroidism: case report of cognitive impairment and acute psychosis in an elderly female
Authors: Janette C Leal, Allison H Beito
Journal: Ann Gen Psychiatry (2020)
MeSH terms: Case Reports

Hypothyroidism is a common condition in the general population. While myxedema is a known complication, we present a case highlighting a late-onset presentation of psychosis with confounding cognitive impairment in a patient who believed she no longer needed thyroid replacement medication because of her advanced age.
A Rare Case of Plasma Cell Granuloma
Authors: Archana P Kanteti, W Patrick Kelsey, Ernesto Martinez Duarte
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Plasma cell granulomas (PCGs) or inflammatory pseudotumors are nonneoplastic lesions that consist of predominantly antibody-secreting plasma cells and innate immune cells such as neutrophils, macrophages, and eosinophils. Unlike in multiple myeloma, the plasma cells are polyclonal and present in a spindly fibroblast-rich stromal background. These lesions mainly occur in the lungs; however, they can arise in other organs. PCGs from the gingiva are extremely rare, and a proper diagnosis is crucial to treat these patients further. These tumors have an increased number of plasma cells that are immunoreactive with CD138 and are polyclonal for kappa and lambda light chains, confirming these proliferations' nonneoplastic nature. Surgical resection with clear margins, when possible, is the primary choice of treatment. Radiation and anti-inflammatory steroid therapy are other therapeutic approaches. Critical and careful examination by a pathologist is necessary to rule out plasma cell neoplasms. Here, we report a rare occurrence of gingival PCG in an elderly male.
Surgical management of chronic calcific deposit resembling tendon sheath infection in the index finger: A rare case report and literature review
Authors: Deming Guo, Jingjing Yang, Xiaoning Liu
Journal: Front Surg (2023)
Keywords: calcific tendonitis, case report, distal interphalangeal joint, finger, surgical treatment
MeSH terms: Case Reports

Background:
Calcific tendonitis rarely occurs in the fingers, and it is easily misdiagnosed. Herein we describe the case of a patient with multiple calcific lesions within the flexor digitorum superficialis and the extensor digitorum tendons of the distal interphalangeal joints of the right index finger, and the surgical treatment of those lesions.
Case presentation:
The patient was a 66-year-old man who reported pain and swelling in his right index finger for one year. He was diagnosed with chronic calcific tendonitis based on his symptoms and radiology images. He was successfully treated surgically, and histopathological examination confirmed the diagnosis. After one month, the patient had healed well, and there was no recurrence.
Conclusions:
This is the first report of a patient suffering from chronic calcific tendonitis in a finger who failed conservative treatment and was successfully treated with surgery. The outcome demonstrates that surgical debridement can yield a good outcome in patients with chronic calcific tendonitis.
Effective combination of photodynamic therapy and imiquimod 5% cream in the treatment of actinic keratoses: three cases
Authors: Laura Held, Thomas Kurt Eigentler, Ulrike Leiter, Claus Garbe, Mark-Jürgen Berneburg
Journal: Biomed Res Int (2013)
MeSH terms: Adjuvants, Immunologic / administration & dosage, Aminoquinolines / administration & dosage, Keratosis, Actinic / drug therapy, Skin / pathology, Case Reports, Clinical Trial, Research Support, Non-U.S. Gov't, Adjuvants, Immunologic / adverse effects, Adult, Aged, 80 and over, Aminoquinolines / adverse effects, Female, Humans, Imiquimod, Keratosis, Actinic / pathology, Male, Middle Aged, Ointments, Time Factors, Adjuvants, Immunologic, Aminoquinolines, Ointments, Imiquimod

Background:
The therapy for actinic keratoses includes photodynamic therapy (PDT) and imiquimod 5% cream. The sequential use of both could result in better clinical outcomes.
Objectives:
To enhance efficacy of therapies while improving tolerability, convenience, and patient adherence with a scheme combining two concomitant or sequential AK treatments.
Methods:
All patients underwent one session of conventional PDT. Two weeks after, the PDT imiquimod 5% cream was applied to the treatment area once daily for three days per week. One course continued for four weeks followed by a clinical evaluation and decision about further treatment. Patients who had not cleared all of their AK lesions in the treatment area in course 1 participated in a second 4-week course of treatment. Limitations. Small size of population.
Results:
Three participants were enrolled. Two patients showed complete clinical clearance of AKs. The effect was also noted after long-term followup, at months seven and eleven. No subject discontinued for an adverse event. There were severe local skin reactions in two participants which were severe erythema, scaling, and crusting. One patient showed no response to the therapy.
Conclusions:
Photodynamic therapy followed by imiquimod was well tolerated and improved reduction of actinic keratoses. This initial proof-of-concept should be studied in larger clinical trials.
Solid Pseudopapillary Neoplasm of the Pancreas in Young Male Patients: Three Case Reports
Authors: Akira Aso, Eikichi Ihara, Kazuhiko Nakamura, Irina Sudovykh, Tetsuhide Ito, Masafumi Nakamura, Tetsuo Ikeda, Nobuyoshi Takizawa, Yoshinao Oda, Shuji Shimizu
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

A preoperative diagnosis of solid pseudopapillary neoplasms (SPNs) in young male patients is difficult to achieve using radiological images. We herein present three cases of young male patients with relatively small SPNs. Endoscopic ultrasound (EUS) showed well-encapsulated, smooth-surfaced, heterogeneous solid lesions in all patients, and all preoperative diagnoses were achieved by EUS-guided fine needle aspiration (EUS-FNA). The final pathological diagnosis after surgery was an SPN with a Ki-67 labeling index of <2%. SPNs should be considered even in young male patients. EUS with EUS-FNA could be a useful diagnostic modality for SPNs even in young male patients.
CD4+ T Cell Defects in a Mulibrey Patient With Specific TRIM37 Mutations
Authors: Sara Bruzzaniti, Emilia Cirillo, Rosaria Prencipe, Giuliana Giardino, Maria Teresa Lepore, Federica Garziano, Francesco Perna, Claudio Procaccini, Luigi Mascolo, Cristina Pagano, Valentina Fattorusso, Enza Mozzillo, Maurizio Bifulco, Giuseppe Matarese, Adriana Franzese, Claudio Pignata, Mario Galgani
Journal: Front Immunol (2020)
Keywords: cd4+ t cells, mulibrey syndrome, trim37, immune response, immunological defects
MeSH terms: CD4-Positive T-Lymphocytes / immunology, Mulibrey Nanism / genetics, Mutation, Tripartite Motif Proteins / genetics, Ubiquitin-Protein Ligases / genetics, Case Reports, Research Support, Non-U.S. Gov't, CD4-Positive T-Lymphocytes / metabolism, CD8-Positive T-Lymphocytes / immunology, CD8-Positive T-Lymphocytes / metabolism, Cell Proliferation, Cells, Cultured, Child, Cytokines / metabolism, Genetic Predisposition to Disease, Heredity, Humans, Immunologic Memory, Lymphocyte Activation, Male, Mulibrey Nanism / diagnosis, Mulibrey Nanism / immunology, Mulibrey Nanism / metabolism, Pedigree, Phenotype, Cytokines, Tripartite Motif Proteins, TRIM37 protein, human, Ubiquitin-Protein Ligases

Mulibrey (muscle-liver-brain-eye) syndrome (MUL) is an autosomal recessive disorder caused by mutations in the TRIpartite motif (TRIM)37 gene, encoding for TRIM37 a member of the TRIM E3 ubiquitin ligase protein family. MUL patients are characterized by growth retardation, dysmorphic features, and a wide range of abnormalities affecting different organs. However, T-cell abnormalities have not been observed in MUL subjects, to date. Here we described the immunological features of a MUL child carrying recently identified TRIM37 mutations, a 17q22 deletion of maternal origin combined with a TRIM37 variant of paternal origin. Here we found quantitative and functional defects in CD4+ T cells from this MUL case. Low levels of TRIM37 protein were specifically detected in CD4+ T cells of MUL patient and associated with their altered proliferation and cytokine production. Of note, both CD4+ and CD8+ T lymphocytes of MUL child displayed an effector memory phenotype compared with healthy children. This clinical case research highlighted the possible role of TRIM37 in the control of immune cell number and function, especially in CD4+ T cells. Finally, this study may contribute to the novel mechanistic studies aim of identifying, in depth, the role of the TRIM37 protein in the immune system.
Atypical Presentation of IgA Nephropathy Mimicking Acute Pyelonephritis
Authors: Stamatis Karakonstantis, Despoina Galani, Dafni Korela, Sofia Pitsigavdaki, Ifigeneia Kassotaki, Despoina Arna, Dimitrios Xydakis
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Background:
IgA glomerulonephritis may present with hematuria, flank pain, and fever. This clinical presentation may be easily confused with acute pyelonephritis.
Case report:
We present the case of a 25-year-old female with a typical clinical presentation for acute pyelonephritis (high fever, left flank pain, left costovertebral angle tenderness, hematuria, elevated inflammatory markers, and a hypoenhancing region in the left kidney on contrast-enhanced computed tomography). However, urine and blood cultures were both negative, the serum creatinine was elevated, and the urinalysis revealed significant proteinuria and dysmorphic red blood cells. A kidney biopsy confirmed a diagnosis of IgA nephropathy. She was treated with a combination of lisinopril and methylprednisolone, with good response.
Conclusion:
Gross hematuria, especially in the absence of pyuria or bacteriuria, should raise the suspicion for underlying IgA nephropathy, even if the rest of the clinical presentation is typical for a urinary tract infection. The presence of significant proteinuria, red blood cell casts, and dysmorphic red blood cells are useful clues suggesting glomerular disease.
Intracranial gliofibroma: a case report and review of the literature
Authors: Patricia Gargano, Graciela Zuccaro, Fabiana Lubieniecki
Journal: Case Rep Pathol (2014)

Gliofibroma is a rare tumor with biphasic morphology, commonly occurring in the first two decades of life. Currently, the tumor is not listed as a distinct entity in the current World Health Organization (WHO) classification of central nervous system tumors. As its biological behavior, histogenesis, and prognostic factors are still debated, the aim of this paper was to describe a case of a gliofibroma and to update the data about these lesions. Hence, we present here clinical symptoms, pathological findings, and evolution observed in a child with gliofibroma. A 10-year-old girl with seizures was referred for study. Neuroimaging showed a hemispheric hyperdense tumor with little peritumoral edema and no mass effect. The tumor was totally removed. Histologically, the tumor consisted of a mixture of glial cells and collagen-rich stroma. Immunohistochemical examination revealed positive staining for GFAP, CD 99, S100, and vimentin. EMA staining showed a paranuclear dot pattern in only few cells in isolated areas. These findings of a glial component with collagenous stroma were consistent with a desmoplastic glioma. Because of the rarity of this entity, we believe it is important to report every case in order to adequately analyze and categorize the tumor in the next WHO classification.
Is there any link between tumor-induced osteomalacia and psoriasis? A case report
Authors: Mojtaba Akbari, Bagher Larijani, Sasan Sharghi, Ali Jalili, Sayed Mahmoud Sajjadi-Jazi
Journal: J Diabetes Metab Disord (2017)
Keywords: fibroblast growth factor-23, psoriasis, tumor-induced osteomalacia
MeSH terms: Case Reports

Background:
Tumor-induced osteomalacia is an uncommon paraneoplastic syndrome caused by Fibroblast growth factor-23-secreting tumors. It is characterized by phosphaturia, hypophosphatemia, and a high plasma level of alkaline phosphatase.
Case presentation:
We report a young patient with psoriasis who had suffered from bone pain and muscle weakness for more than 6.5 years. He was finally diagnosed with tumor-induced osteomalacia. However, mistakenly attributing the patient's signs and symptoms to psoriatic arthritis for a long time had resulted in multiple complications for the patient. Finally, the tumor was localized and surgically resected. This resulted in clinical improvements and the resolution of all biochemical abnormalities.
Conclusion:
To our knowledge, this is the second case of tumor-induced osteomalacia accompanied by psoriasis. There is growing evidence to suggest that Fibroblast growth factor-23 has a role in regulating immune function while an increased level of it may play a role in the pathogenesis of psoriasis. As a result, tumor-induced osteomalacia may affect the psoriasis clinical course by secreting a high amount of Fibroblast growth factor-23. On the other hand, several studies have showed an increased risk of malignancy among patients with psoriasis. Consequently, long-term psoriasis may predispose patients to Fibroblast growth factor-23-secreting tumors. Finally, as psoriasis is a common disease, this presentation may simply be a coincidence.
Primary hepatic neuroendocrine carcinoma: report of two cases and literature review
Authors: Zi-Ming Zhao, Jin Wang, Ugochukwu C Ugwuowo, Liming Wang, Jeffrey P Townsend
Journal: BMC Clin Pathol (2018)
Keywords: immunohistochemical staining, liver biopsy, primary hepatic neuroendocrine carcinoma, somatostatin analogue, transcatheter arterial chemoembolization
MeSH terms: Case Reports

Background:
Primary hepatic neuroendocrine carcinoma (PHNEC) is extremely rare. The diagnosis of PHNEC remains challenging-partly due to its rarity, and partly due to its lack of unique clinical features. Available treatment options for PHNEC include surgical resection of the liver tumor(s), radiotherapy, liver transplant, transcatheter arterial chemoembolization (TACE), and administration of somatostatin analogues.
Case presentation:
We report two male PHNEC cases and discuss the diagnosis and treatment options. Both cases presented with abdominal pain; case two also presented with symptoms of jaundice. The initial diagnosis for both cases was poorly differentiated grade 3 small-cell neuroendocrine carcinoma, based on imaging characteristics and the pathology of liver biopsies. Final diagnoses of PHNEC were arrived at by ruling out non-hepatic origins. Case one presented with a large tumor in the right liver lobe, and the patient was treated with TACE. Case two presented with tumors in both liver lobes, invasions into the left branch of hepatic portal vein, and metastasis in the hepatic hilar lymph node. This patient was ineligible for TACE and was allergic to the somatostatin analogue octreotide. This limited treatment options to supportive therapies such as albumin supplementation for liver protection. Patient one and two died at 61 and 109 days, respectively, following initial hospital admission.
Conclusions:
We diagnosed both cases with poorly differentiated grade 3 small-cell PHNEC through imaging characteristics, immunohistochemical staining of liver biopsies, and examinations to eliminate non-hepatic origins. Neither TACE nor liver protection appeared to significantly extend survival time of the two patients, suggesting these treatments may be inadequate to improve survival of patients with poorly differentiated grade 3 small-cell PHNEC. The prognosis of poorly differentiated grade 3 small-cell PHNEC is poor due to limited and ineffective treatment options.