OpenMed/multicare-articles huggingface dataset:
Thrombosis of Abdominal Aorta and Bilateral Renal Arteries: Endovascular Treatment in Takayasu Disease
Authors: Ahmed Albaqshi, Mahdi Aljawad, Sara Alrasheed, Abeer Alshaia, Shaker Alshehri
Journal: Cureus (2023)
Keywords: abdominal aorta, case report, endovascular procedures, renal arteries, takayasu disease, thrombosis
MeSH terms: Case Reports

Takayasu arteritis is an idiopathic vasculitis that typically involves the aorta and its major branches. It is more common in women and has the highest prevalence in Asia. Imaging studies are crucial for establishing the diagnosis and for determining the extent of the disease. We present the case of a 47-year-old man who presented with a complaint of anuria and generalized weakness for the last three days. He reported a history of generalized abdominal pain for the last two weeks. His vital signs were within normal limits, but the systolic blood pressure in the lower limb was lower by 60 mmHg compared with that of the upper limb. Notably, the pulses were very faint on palpation. Laboratory investigations revealed deranged renal function parameters. Ultrasound examination showed increased renal parenchymal echogenicity bilaterally with elevated peak systolic velocity of the main renal artery on spectral Doppler. Further investigation by computed tomography demonstrated near-complete thrombosis of the abdominal aorta distal to the origin of the celiac artery and extending to the common iliac arteries with the involvement of bilateral renal arteries. Immunological investigations, including antinuclear antibody (ANA), double-stranded deoxyribonucleic acid (dsDNA), cyclic antineutrophil cytoplasmic antibody (c-ANCA), and perinuclear antineutrophil cytoplasmic antibody (p-ANCA), revealed negative results. However, the positron emission tomography showed markedly diffuse and circumferential increased uptake in the walls of the aorta, subclavian arteries, and femoral arteries. The patient underwent successful endovascular treatment with catheter-directed thrombolysis. High clinical suspicion is required to identify renal artery thrombosis since the clinical symptoms are non-specific. Early diagnosis is crucial to allow for prompt therapeutic interventions.
Gastric Adenocarcinoma of the Fundic Gland Type Treated by Endoscopic Mucosal Resection: A Case Report and Review of the Literature
Authors: Eleanor Lewin, Philip Daroca, Sanjay Sikka, Tong Wu, Yukihiro Nakanishi
Journal: Case Rep Pathol (2016)

Gastric adenocarcinoma of the fundic gland type (GA-FG) is a rare entity that has only recently been described and defined. There is ongoing controversy regarding the malignant potential of this lesion. We report the case of a GA-FG in a 49-year-old Caucasian man who was referred to endoscopy for management of an incidentally found gastric polyp. Endoscopy showed a single polypoid lesion in the gastric fundus which was successfully removed with endoscopic resection. Grossly, the polyp measured 1.1 cm in greatest dimension. Microscopic examination showed irregularly branched neoplastic glands covered with a nonneoplastic foveolar epithelium. The continuity between the neoplastic glands and the fundic glands is clearly identified, indicating the tumor arose from the fundic glands. The tumor cells exhibited occasional oxyntic cytoplasm with enlarged atypical nuclei. The tumor invaded the submucosa with complete disruption of the muscularis mucosae and mild lymphocytic and fibroblastic stromal reaction. No necrosis, mitosis, or lymph-vascular invasion was identified. Although some authors have proposed reclassification of GA-FGs as oxyntic gland polyps/adenomas, in light of several reported cases with submucosal invasion as well as lymphatic invasion, we maintain that this neoplasm is best categorized as an extremely well-differentiated adenocarcinoma to reflect its invasive potential.
Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis
Authors: Hisaki Aiba, Hiroaki Kimura, Satoshi Yamada, Hideki Okamoto, Katsuhiro Hayashi, Shinji Miwa, Yohei Kawaguchi, Shiro Saito, Takao Sakai, Tsutomu Tatematsu, Ryoichi Nakanishi, Hideki Murakami
Journal: PLoS One (2021)
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / adverse effects, Indazoles / adverse effects, Lung Neoplasms / drug therapy, Pneumothorax / epidemiology, Pyrimidines / adverse effects, Soft Tissue Neoplasms / drug therapy, Sulfonamides / adverse effects, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols / administration & dosage, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Incidence, Indazoles / administration & dosage, Lung / drug effects, Lung / pathology, Lung Neoplasms / secondary, Male, Middle Aged, Pleura / drug effects, Pleura / pathology, Pneumothorax / chemically induced, Pneumothorax / diagnosis, Pneumothorax / pathology, Pyrimidines / administration & dosage, Retrospective Studies, Risk Assessment / statistics & numerical data, Risk Factors, Soft Tissue Neoplasms / pathology, Sulfonamides / administration & dosage, Time Factors, Indazoles, Pyrimidines, Sulfonamides, pazopanib

To investigate pneumothorax patterns in pazopanib treatment by focusing on the positional relationship between the visceral pleura and metastatic lung tumor, we examined 20 patients with advanced soft tissue tumors who developed lung metastases and underwent pazopanib treatment between 2012 and 2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; and central type, >5 mm from the pleura. We investigated the rates of pneumothorax and the associated risk factors. Five patients experienced pneumothorax (three subpleural and two central types). Cavitation preceded pneumothorax in 83% of patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in the shorter term in patients with the subpleural type. Conversely, a more gradual increase in the cavity size and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after initiating pazopanib and intervention before pazopanib, either ablation or surgery. The location of the metastatic lesions was not a risk factor for the occurrence of pneumothorax. In conclusion, pneumothorax is an adverse event associated with pazopanib treatment. Therefore, attention must be paid to predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions to the lungs. Moreover, because subpleural pneumothorax tends to occur earlier than the central type, a different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.
High-resolution adaptive optics findings in talc retinopathy
Authors: Mohamed K Soliman, Salman Sarwar, Mostafa Hanout, Mohammad A Sadiq, Aniruddha Agarwal, Vikas Gulati, Quan Dong Nguyen, Yasir J Sepah
Journal: Int J Retina Vitreous (2015)
Keywords: adaptive optics, crystalline retinopathy, talc retinopathy
MeSH terms: Case Reports

Talc retinopathy is a recognized ocular condition characterized by the presence of small, yellow, glistening crystals found inside small retinal vessels and within different retinal layers. These crystals can be associated with retinal vascular occlusion and ischemia. Different diagnostic modalities have been used previously to characterize the retinal lesions in talc retinopathy. Adaptive optics, a high resolution imaging technique, is used to evaluate the location, appearance and distribution of talc crystals in a case of talc retinopathy.
Invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia manifesting as a collision breast tumor: A case report and literature review
Authors: Xiaowen Chen, Jianli Chen, Sihai Liao, Yuwen Cao
Journal: Open Life Sci (2021)
Keywords: sll/cll, breast carcinoma, collision tumor, invasive ductal carcinoma, lymphoma
MeSH terms: Case Reports

Collision breast tumors, consisting of breast cancer (BC) and non-Hodgkin's lymphoma (NHL), are extremely rare. Here we report the case of a 64-year-old woman with a collision tumor in her left breast mass that was composed of invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia. In addition, we reviewed the published comparable English-language literature. Collision breast tumor composed of BC and NHL is extremely rare. For that reason, there is a lack of consensus about the underlying mechanism, and diagnosing it without delay remains a complex clinical challenge. We found that post-menopausal, age-related estrogen levels changes and Epstein-Barr virus infection are possible pathogenic factors. However, the symptoms are almost identical, and it is difficult to distinguish a simple breast tumor from a breast collision tumor. In this study, we reviewed the clinical features of all patients with BC and NHL colliding breast tumors; this information might enable early identification and prevention of misdiagnosis.
A fatal case of nafcillin-induced hepatotoxicity: a case report and the literature review
Authors: Mian Bilal Alam, Amin Kadoura, Magesh Sathaiah
Journal: Case Rep Med (2012)

Background. Drug-induced hepatotoxicity (DIH) is quite common, and there are several recommendations for its treatment based upon its etiology. DIH may range from mild and subclinical to fulminant liver failure and death. Even though there is extensive list of drugs causing DIH, antibiotics, as a class of drugs, are the most common cause of DIH. Here, we present a fatal case of nafcillin-induced hepatotoxicity confirmed by liver biopsy, with total bilirubin peaking to 21.8 mg/dl and subsequent further extensive evaluation for hepatic injury turning out to be negative.
Hypopharyngeal Ulcers in COVID-19: Histopathological and Virological Analyses - A Case Report
Authors: Andrea Porzionato, Elena Stocco, Aron Emmi, Martina Contran, Veronica Macchi, Silvia Riccetti, Alessandro Sinigaglia, Luisa Barzon, Raffaele De Caro
Journal: Front Immunol (2021)
Keywords: covid-19, hsv, gastrointestinal tract, histopathology, inflammation, molecular analysis, mucosal injury
MeSH terms: COVID-19 / complications, Hypopharynx / pathology, SARS-CoV-2 / isolation & purification, Ulcer / pathology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antigens, CD / metabolism, Antigens, Differentiation, Myelomonocytic / metabolism, Autopsy, Blood Platelets / metabolism, Blood Platelets / pathology, COVID-19 / mortality, COVID-19 / pathology, COVID-19 / physiopathology, Gastrointestinal Tract / pathology, Herpesvirus 1, Human / genetics, Herpesvirus 1, Human / isolation & purification, Humans, Hypopharynx / virology, Immunohistochemistry, Inflammation / immunology, Inflammation / metabolism, Inflammation / virology, Lymphocytes / metabolism, Monocytes / metabolism, Mucous Membrane / pathology, Muscle, Skeletal / pathology, Necrosis / pathology, SARS-CoV-2 / genetics, Spike Glycoprotein, Coronavirus / metabolism, Thrombosis / pathology, Ulcer / virology, Antigens, CD, Antigens, Differentiation, Myelomonocytic, CD68 antigen, human, Spike Glycoprotein, Coronavirus, spike protein, SARS-CoV-2

In coronavirus disease 2019 (COVID-19), ulcerative lesions have been episodically reported in various segments of the gastrointestinal (GI) tract, including the oral cavity, oropharynx, esophagus, stomach and bowel. In this report, we describe an autopsy case of a COVID-19 patient who showed two undiagnosed ulcers at the level of the anterior and posterior walls of the hypopharynx. Molecular testing of viruses involved in pharyngeal ulcers demonstrated the presence of severe acute respiratory syndrome - coronavirus type 2 (SARS-CoV-2) RNA, together with herpes simplex virus 1 DNA. Histopathologic analysis demonstrated full-thickness lympho-monocytic infiltration (mainly composed of CD68-positive cells), with hemorrhagic foci and necrosis of both the mucosal layer and deep skeletal muscle fibers. Fibrin and platelet microthrombi were also found. Cytological signs of HSV-1 induced damage were not found. Cells expressing SARS-CoV-2 spike subunit 1 were immunohistochemically identified in the inflammatory infiltrations. Immunohistochemistry for HSV1 showed general negativity for inflammatory infiltration, although in the presence of some positive cells. Thus, histopathological, immunohistochemical and molecular findings supported a direct role by SARS-CoV-2 in producing local ulcerative damage, although a possible contributory role by HSV-1 reactivation cannot be excluded. From a clinical perspective, this autopsy report of two undiagnosed lesions put the question if ulcers along the GI tract could be more common (but frequently neglected) in COVID-19 patients.
Subacute Sensory Ataxic Neuronopathy With Thymoma Presenting Marked Improvement After Steroid Therapy
Authors: Haruo Nishijima, Ken Onodera, Nobuyuki Sato, Tatsuya Ueno, Hiroki Hikichi, Rie Haga, Akira Arai, Chieko Suzuki, Jin-Ichi Nunomura, Masayuki Baba, Masahiko Tomiyama
Journal: Front Neurol (2019)
Keywords: nerve conduction study, paraneoplastic neurological syndrome, steroid, subacute sensory ataxic neuronopathy, thymoma
MeSH terms: Case Reports

Subacute sensory ataxic neuronopathy is a well-known form of paraneoplastic syndrome. Most sensory neuronopathies are associated with small cell lung cancer and anti-Hu antibodies, and usually show only slight improvement with immunotherapy. To date, there have been few reports of neuropathy associated with thymoma and no treatment strategy has been established for thymoma-related neuropathy. Here, we provide the first report of a case of sensory ataxic neuronopathy with thymoma that showed marked improvement after steroid therapy, even though preceding intravenous immunoglobulin treatments and tumor resection were less effective. A 57-year-old Japanese man was referred to our hospital with a 6-week history of distal paresthesia in his four limbs and an unsteady gait. He presented with left-dominant ataxia in his four limbs due to reduced sensation in his extremities. He also complained of constipation, difficulty urinating, and erectile dysfunction. Upon investigation, including electrodiagnostic studies, the patient was diagnosed as having sensory ataxic neuronopathy with invasive thymoma. A first round of intravenous immunoglobulin therapy, a following thymectomy, and a second round of intravenous immunoglobulin therapy after the surgery were not effective in treating his neurological symptoms. Subsequently, oral steroid therapy was started, which brought about a remarkable improvement; 6 weeks after the beginning of the steroid therapy, his neurological symptoms were resolved, except for slight distal paresthesia in his feet. Although rarely reported, thymoma can underlie sensory neuronopathy, and the response of thymoma-associated sensory neuronopathy to immunotherapy might be better than that of anti-Hu antibody-related neuropathies. Even if the first immunotherapy is not effective in treating neuropathy with thymoma, further immunomodulatory treatment should be tried after treating the tumor.
Synchronous Ipsilateral Wilms' Tumor and Neuroblastoma in an Infant
Authors: Yogesh Kumar Sarin, Nirali Chirag Thakkar, Shalini Sinha
Journal: APSP J Case Rep (2016)
Keywords: neuroblastoma, synchronous, wilm's tumor
MeSH terms: Case Reports

Wilms' tumor (WT) and neuroblastoma (NB), the two most common extra-cranial solid malignant tumors, are seldom seen together in the same patient. A 10-month girl presented with a right retroperitoneal mass. A preoperative diagnosis of Wilms' tumor (WT) was made. She was given preoperative chemotherapy followed by surgery. At surgery a renal mass (WT) and a suprarenal mass (neuroblastoma - NB) were removed. She finally succumbed to metastatic NB in the postoperative period.
In-Flight Hypoxemia in a Tracheostomy-Dependent Infant
Authors: Jason Quevreaux, Christopher Cropsey
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. The patient had an underlying congenital muscular disorder and was mechanically ventilated while at altitude. Although pressurized, cabin barometric pressure while at altitude is less than at sea level. Due to this environment patients with underlying pulmonary or cardiac pathology might not be able to tolerate commercial flight. The Federal Aviation Administration (FAA) has mandated a specific set of medical supplies be present on all domestic flights in addition to legislature protecting "Good Samaritan" providers.
Leiomyosarcoma of the Rectum as a Radiation-Induced Second Malignancy after Cervical Cancer Treatment: Case Report with Review of the Literature
Authors: Dmytro E Makhmudov, Olena O Kolesnik, Natalia N Lagoda, Maryna O Volk
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Background:
Incidence of cervical cancer among women of reproductive age still remains significantly high. In regard to prognostic features and risk factors, the standard treatment for most types of cervical cancer represents a combination of surgical treatment and radiation therapy, such as external beam radiation therapy and brachytherapy. Despite significant advances of long-term oncological outcomes, radiation-induced secondary malignancies among cervical cancer survivors are still an issue. Current case report describes an incredibly rare case of radiation-induced leiomyosarcoma of the rectum, which occurred 32 years after cervical cancer treatment.
Case presentation:
A 62-year-old female had a past medical history of FIGO stage IIB cervical cancer (squamous cell carcinoma pT2bN0M0). In 1987, she underwent radical hysterectomy with bilateral iliac lymph node dissection, followed by adjuvant radiation therapy-70 Gy external beam pelvic irradiation followed by 30.5 Gy of brachytherapy. Thirty-two years later, she presented with signs of rectal bleeding. Regarding past medical history, radiologic, endoscopic, and pathologic data, the patient was initially diagnosed with a malignant nonepithelial lower rectal tumor of the unknown origin and staged as mrT3a mrN0 cM0. Total mesorectal excision with complete mesocolic excision and central vascular ligation (CME/CVL) carried by an open approach was carried out. In an attempt to identify the tissue of origin, an immunohistochemistry assay had been performed. Tumor cells showed a high rate of mitotic activity with a 45% rate of Ki-67 expression, positive reaction for desmin, and SMA in all samples. Negative reaction for CD117 and S100 was observed. As a conclusion, the immunophenotype was identified as a grade 3 leiomyosarcoma (ISD-code 8890/3).
Conclusions:
We suggest that up to date, radical surgery with curative intent, as it was performed in our study, is the most evidence-based treatment option for patients with radiation-induced sarcomas of the rectum.
Pseudotumoral tracheobronchial amyloidosis mimicking asthma: a case report
Authors: Mounia Serraj, Imane Kamaoui, Kawtar Znati, Salma Kouara, Ferdaous Sahnoune, Bouchra Amara, Mohammed El Biaze, Siham Tizniti, Afaf Amarti, Mohammed Chakib Benjelloun
Journal: J Med Case Rep (2012)

Introduction:
Tracheobronchial amyloidosis is an uncommon localized form of amyloidosis that can simulate a tracheal tumor. Clinical signs are not specific and the diagnosis is rarely given before performing a bronchoscopy with multiples biopsies.
Case presentation:
We report the case of a 60-year-old Moroccan woman, complaining of dyspnea and wheezing for three years, who was treated at our institution for management of severe asthma. A bronchoscopy revealed a tumor formation of her trachea; multiples biopsies were performed and a diagnosis made of amyloid light-chain amyloidosis. She successfully received an endoscopic resection.
Conclusion:
This case highlights the importance of routinely carrying out an endoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma. Tracheal amyloidosis is a rare disease, confirmed by histological examination of bronchial biopsies, and the treatment of choice is based on the bronchoscopic resection.
Reversible Valproate-Induced Subacute Encephalopathy Associated With a MT-ATP8 Variant in the Mitochondrial Genome
Authors: Giovanna De Michele, Pierpaolo Sorrentino, Claudia Nesti, Anna Rubegni, Lucia Ruggiero, Silvio Peluso, Antonella Antenora, Mario Quarantelli, Alessandro Filla, Giuseppe De Michele, Filippo M Santorelli
Journal: Front Neurol (2018)
Keywords: mt-atp8, ammonia, metabolic encephalopathy, mitochondria, valproate
MeSH terms: Case Reports

Introduction: There are several reported cases of patients developing motor and cognitive neurological impairment under treatment with valproic acid (VPA). We describe a woman who developed a subacute encephalopathy after VPA intake, harboring a mitochondrial DNA variant, previously described as causing VPA sensitivity in one pediatric patient. Material and Methods: A 65-year old woman developed a progressive, severe neurological deterioration after a 3 month treatment with valproate sodium, 800 mg daily. Magnetic resonance spectroscopy (MRS), muscle histochemical analysis and assay of mitochondrial enzymatic activities, and mitochondrial DNA sequencing were performed. Results: Neurological examination showed drowsiness, vertical gaze palsy, inability to either stand or walk, diffuse weakness, increased tendon reflexes. Blood lactate was increased, EEG showed diffuse theta and delta activity, MRI subcortical atrophy and leukoencephalopathy, MRS marked reduction of the NAA spectrum, with a small signal compatible with presence of lactate. Muscle biopsy evidenced presence of ragged red fibers (20%) and reduced COX reactivity. Assay of the muscle enzymatic activities showed multiple deficiencies of the electron transport chain and reduced ATP production. The mt.8393C>T variant in the MT-ATP8 gene was found in homoplasmy. The patient considerably improved after valproate withdrawal. Conclusion: The variant we found has been reported both as a polymorphism and, in a single patient, as related to the valproate-induced encephalopathy. The present case is the first bearing this mutation in homoplasmy. In case of neurological symptoms after starting VPA therapy, once hyperammonemia and liver failure have been ruled out, mtDNA abnormalities should be considered.