OpenMed/multicare-articles huggingface dataset:
Delayed presentation of spinal cord injury without radiographic abnormality (SCIWORA): a case report
Authors: Hedhli Hana, Hedia Gnena, Othmani Safia, Ben Kaddour Rym, Asma Jendoubi, Zoubli Aymen, Fares Ouni, Sarra Jouini
Journal: Pan Afr Med J (2023)
Keywords: case report, degenerative disc disease, magnetic resonance imaging, spinal cord injury, trauma
MeSH terms: Spinal Cord Injuries / diagnostic imaging, Spinal Cord Injuries / etiology, Case Reports, Adult, Cervical Vertebrae / pathology, Humans, Magnetic Resonance Imaging, Male, Methylprednisolone, Middle Aged, Skin, Spinal Cord / pathology, Methylprednisolone

Spinal Cord Injury without Radiographic Abnormality (SCIWORA) is an unprecedented event to occur in adults but may lead to serious complications including permanent neurological impairments and death. In this article, we report a case of a 60-year-old male presenting to the emergency for a head and neck trauma after a motorbike accident, who reported only a neck ache and a normal primary neurological exam. The evolution was marked by the occurrence of paraplegia with a diminished sphincter tone and hypoesthesia beneath the T12 dermatome level after six hours, confirmed by the Magnetic Resonance Imaging (MRI). He underwent a deferred laminectomy within 30 days after receiving methylprednisolone, with partial neurological improvement after two months. An early recognition of the diagnosis was challenge for the emergency physician, given the wide variability of clinical presentations. Magnetic resonance imaging (MRI) is a key examination to guide the diagnosis and the management of these patients.
The Role of Surgery to Relieve Symptomatic Cutaneous T-Cell Lymphoma Refractory to Medical Treatments
Authors: Wesley Q Zhang, Emily E Hecox, Shireen Dogar, Marc E Walker
Journal: Case Rep Oncol Med (2024)
MeSH terms: Case Reports

Background: Though mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), it has no curative treatment. The aim of current topical and systemic treatment is centered around relieving symptoms and optimizing disease-free time. The use of surgical management to achieve the same goals of symptomatic reduction is not well described in the current literature. Methods: We present a case of refractory MF that failed chemotherapy, radiotherapy, and UV light therapy. Despite medical management, the tumor burden progressed to significant compression neuropathy of the ulnar and median nerves. Results: To reduce tumor burden and attempt to provide symptomatic relief, a surgical plan was developed to include radical resection of the tumor of the left upper extremity (LUE) with release of the cubital tunnel, carpal tunnel, Guyon canal, and coverage with split-thickness skin graft. The patient reported decreased symptomatology interfering with her daily activities and, overall, a better quality of life postoperatively. Conclusion: Surgical intervention, in addition to established medical standards of care, for symptomatic relief of compression neuropathy from tumor mass effect for refractory CTCL should be considered to achieve quality of life goals for patients.
Metastatic Breast Cancer Presenting As Neck Pain in a Pregnant Patient
Authors: Eric Chun-Pu Chu, Steve Ming Hei Yun
Journal: Cureus (2024)
Keywords: breast cancer, chiropractic, chiropractor, neck pain, pregnancy
MeSH terms: Case Reports

Breast cancer metastasizing to the spine during pregnancy is a rare occurrence. A 36-year-old woman experienced persistent neck pain during the third trimester of pregnancy. The pain continued until the postpartum period, severely affecting quality of life (QOL). Physical examination revealed a restricted cervical range of motion. Spinal lesions were detected on magnetic resonance imaging. Metastatic breast cancer was confirmed through a biopsy. The patient underwent radiation therapy for spinal metastasis, chemotherapy for breast cancer, and nonsteroidal anti-inflammatory drug therapy for pain. She was referred for chiropractic care and physical rehabilitation. After six weeks of collaborative treatment, the patient experienced significant pain relief and improvement in strength, mobility, and QOL. This case report highlights the need to evaluate unexplained symptoms in pregnant and postpartum women to exclude sinister pathologies. It demonstrates the need for a multidisciplinary approach that combines oncological, chiropractic, and rehabilitative care to optimize the outcomes in patients with complex presentations.
Case report: A rare cause of intestinal perforation in a third-trimester pregnant woman
Authors: Clemens Stiegler, Christopher Kapitza, Florian Weber, Wladimir Patalakh, Claus Schäfer
Journal: Front Med (Lausanne) (2024)
Keywords: pocus, appendicitis, endometriosis, intestinal perforation, peritonitis, point-of-care ultrasound, pregnancy, sonography
MeSH terms: Case Reports

Background:
An acute abdomen is a medical emergency that requires early diagnosis and treatment. In pregnancy, this process is significantly more challenging, and radiological findings are sometimes unclear due to the enlarged uterus displacing other structures. Moreover, endometriosis-related complications are rare, and the disease is often undiagnosed.
Case presentation:
We report a case of acute perforation of the cecum and appendix during pregnancy (35 weeks of gestation) caused by a previously unknown, deep infiltrating endometriosis with focal ulceration of the affected bowel wall, which sonographically seemed to be acute appendicitis.
Conclusion:
Despite the relatively low risk, clinicians should be aware of possible endometriosis-associated complications in pregnancy with potentially life-threatening events, even in previously unknown endometriosis. Further studies should evaluate intestinal complications during pregnancy in relation to previous treatment of intestinal endometriosis (conservative vs. surgical).
IgLON5 autoimmunity in a patient with Creutzfeldt-Jakob disease: case report and review of literature
Authors: Xiaofeng Li, Yimin Chen, Le Zhang, Wei Zhang, Bin Li, José Fidel Baizabal-Carvallo, Xingwang Song
Journal: Front Neurol (2024)
Keywords: creutzfeldt–jakob disease, iglon5 antibodies, autoimmune encephalitis, neurodegenerative disease, rapid progressive dementia
MeSH terms: Case Reports

Objective:
We present the case of a patient with clinical and imaging features of sporadic Creutzfeldt-Jakob disease (sCJD) and positive IgLON5 antibodies (Abs) in the serum and CSF.
Case report:
A 66-year-old Chinese man presented to the hospital with a stroke-like episode, followed by rapidly progressive cognitive decline, mutism, and parkinsonism. The MRI results showed a cortical ribboning sign in diffusion-weighted MRI, periodic triphasic waves with a slow background in EEG, and positive protein 14-3-3 in CSF. There were matching IgLON5 Abs in the serum and CSF. A literature review showed positive autoimmune encephalitis Abs or autoimmune inflammatory disease between 0.5 and 8.6% among patients with clinical suspicion of CJD, most commonly anti-voltage-gated potassium channel (VGKC) complex and anti-N-methyl-D-aspartate receptor (NMDAR) Abs; however, IgLON5 autoimmunity in CJD has been rarely reported. This is an intriguing association as both conditions have been associated with brain deposits of phosphorylated tau protein.
Conclusion:
IgLON5 Abs may be observed in patients with a diagnosis of CJD; it is unknown whether a synergistic effect of IgLON5 Abs with CJD exists, increasing neurodegenerative changes.
Urgent Transcatheter Mitral Valve-in-Valve Replacement With Venoarterial Extracorporeal Membrane Oxygenation Support: Case Report and Review of the Literature
Authors: Mohammad Abdel Jawad, Cyrus M Munguti, Abdullah Abu Kar, Venkata Boppana, Zaher Fanari
Journal: Cureus (2024)
Keywords: cardiogenic shock, failed bioprosthetic valves, mechanical circulatory support, mitral valve-in-valve replacement, severe mitral stenosis
MeSH terms: Case Reports

Critical mitral valve stenosis due to a failed bioprosthetic valve is associated with significant morbidity and mortality, with the transcatheter Valve-in-Valve (ViV) approach becoming a popular treatment option. We present a case of cardiogenic shock secondary to a stenotic mitral bio-prosthetic valve. The Heart team was consulted; the patient was a high-risk surgical candidate for valve replacement. He required venoarterial extracorporeal membrane oxygenation as a bridge to definitive therapy. The patient underwent a successful urgent transcatheter mitral ViV procedure with a trans-septal approach. Follow-up echocardiography showed significant improvement in mitral valve dynamics. Recently emerging transcatheter approaches for mitral ViV implantation after balloon valvuloplasty into a failed mitral valve prosthesis are technically feasible in high-risk patient populations and should be considered over re-operative mitral valve surgery.
Non-typhoidal Salmonella causing urinary tract infection in a young male with renal calculi - a case report and comprehensive review
Authors: Lavanya Sriramajayam, Krishna Mohan Boopathy Vijayaraghavan, Boppe Appalaraju, Sankarganesh Jeyaraj
Journal: Access Microbiol (2023)
Keywords: salmonella enteritidis, non typhoidal salmonella, phimosis, urinary tract infection
MeSH terms: Case Reports

Introduction:
Non-typhoidal Salmonella (NTS) causes urinary tract infections infrequently and are usually associated with presence of genitourinary abnormalities.
Case presentation:
We report a case of immunocompetent male in his early 20 s with phimosis presented with history of dysuria and burning micturition for 4 months. A renal ultrasonography showed presence of bilateral intrarenal calculi. Urine analysis revealed presence of non-typhoidal Salmonella. Automated identification systems performed poorly in identification of serotype. On serotyping, it was identified as Salmonella enteritidis in the referral centre. The patient was managed with oral antibiotics.
Conclusion:
This report highlights the issues of inaccurate identification of NTS even with advanced automated systems and early initiation of therapy based on the knowledge of local susceptibility patterns. UTI in immunocompetent individuals by non-typhoidal Salmonella should always be investigated further to rule out genitourinary abnormalities and appropriate antibiotics must be started to avoid chronicity and complications.
A case report of AQP4-IgG-seropositive refractory neuromyelitis optica spectrum disorder patient with Sjögren's syndrome and pancytopenia treated with inebilizumab
Authors: Shasha Li, Yuting Gao, Yang He, Zhaoxu Zhang
Journal: Front Neurol (2024)
Keywords: sjögren’s syndrome, aquaporin-4, case report, inebilizumab, neuromyelitis optica spectrum disorder, pancytopenia
MeSH terms: Case Reports

Patients with neuromyelitis optica spectrum disorder (NMOSD) coexisting with both Sjögren's syndrome (SS) and pancytopenia are exceptionally rare. There is no study on the treatment of such patients. We presented a case of AQP4-IgG seropositive refractory NMOSD patient combined with SS and pancytopenia with significant response to inebilizumab. In 2017 the 49-year-old female patient was diagnosed with SS and pancytopenia without any treatment. In August 2022, she had a sudden onset of lower limbs weakness, manifested as inability to walk, accompanied by urinary incontinence. After receiving methylprednisolone and cyclophosphamide, she regained the ability to walk. In February 2023, she suffered from weakness of both lower limbs again and paralyzed in bed, accompanied by retention of urine and stool, and loss of vision in both eyes. After receiving methylprednisolone and three plasmapheresis, the condition did not further worsen, but there was no remission. In March 2023, the patient was admitted to our hospital and was formally diagnosed with AQP4-IgG seropositive NMOSD combined with SS and pancytopenia. After receiving two 300 mg injections of inebilizumab, not only the symptoms of NMOSD improved significantly, but also the symptoms of concurrent SS and pancytopenia. In the cases of AQP4-IgG seropositive NMOSD who have recurrent episodes and are comorbid with other autoimmune disorders, inebilizumab may be a good choice.
Combining Novel Thrombectomy Devices for Intracardiac Mass Extraction: The Kong and Godzilla of Mass Extraction
Authors: Hussam Al Hennawi, Ahmad Abulshamat, Ali Sheikh, Hisham Qandeel, Kiril Zakharov, Appa Bandi, Mohammed Qintar
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: angiovac, inari flowtriever, intracardiac mass, transcatheter thrombectomy
MeSH terms: Cardiac Catheterization / instrumentation, Heart Neoplasms / diagnostic imaging, Heart Neoplasms / surgery, Thrombectomy / instrumentation, Case Reports, Cardiac Catheters, Echocardiography, Transesophageal, Equipment Design, Female, Heart Atria / diagnostic imaging, Heart Atria / surgery, Humans, Male, Treatment Outcome

Transcatheter extraction of an intracardiac mass is a newer approach that may lead to nonsurgical treatment of complex cardiac masses. We present a case in which thrombectomy devices were combined to extract a right atrial mass, which highlights new frontiers in the treatment of complex transcatheter mass extraction. The combined use of two transcatheter thrombectomy devices (Kong and Godzilla) may provide a powerful addition to the existing armamentarium.
Case report: Dual dabrafenib and trametinib therapy for treating BRAF V600E mutated lung adenocarcinoma with BRCA2 germline mutation post multiline progression
Authors: Huimin Zhang, Xiaofeng Cong, Jiaxin Yin, Chen Chen, Ziling Liu
Journal: Front Oncol (2024)
Keywords: braf v600e mutation, brca2 germline mutation, dabrafenib, lung adenocarcinoma, trametinib
MeSH terms: Case Reports

The v-raf murine sarcoma viral oncogenic homolog B1 (BRAF) V600E is a rare mutation that functions as an oncogenic driver in patients with non-small cell lung cancer (NSCLC) leading to the overactivation of the RAS-RAF-MEK-ERK (MAPK) pathway and the subsequent uncontrolled cell proliferation. Understanding the mechanism behind BRAF mutation, its inhibition, and relationship to the upstream and downstream effector is essential for advancing treatment strategies for NSCLC patients with the BRAF V600E mutation. Next-generation sequencing studies have identified the presence of breast cancer susceptibility gene 1/2 (BRCA1/2) mutations in NSCLC patients, which are pathogenic variants associated with breast, ovarian, and prostate cancers. Although poly ADP-ribose polymerase (PARP) inhibitors are currently an approved treatment option for malignant tumors linked to BRCA1/2 pathogenic variants, the therapeutic potential of PARP inhibitors in NSCLC remains unclear. The development of genetic testing provides a platform for investigating the pathophysiological mechanisms of genetic mutations above. Here, we report a novel case of a middle-aged non-smoking female diagnosed with BRAF V600E and BRCA2 germline mutated lung adenocarcinoma, who had previously undergone a diverse array of cancer-targeted therapies, including PARP inhibitor, before the identification of the BRAF V600E mutation. Following this, a combination of dabrafenib and trametinib was administered and induced a rapid and positive response within two months. Our case not only highlights the importance of dynamic and repetitive genetic testing in managing patients, but contributes to the growing body of clinical evidence supporting the efficacy of BRAF/MEK co-inhibition in patients harboring a BRAF V600E mutation and provokes thinking for further research into the impact of PARP inhibitors in BRCA1/2-mutated NSCLC.
Case Report: Radiation necrosis mimicking tumor progression in a patient with extranodal natural killer/T-cell lymphoma
Authors: Boxiao Chen, Yili Fan, Luyao Wang, Jiawei Zhang, Dijia Xin, Xi Qiu, Huawei Jiang, Baizhou Li, Qin Chen, Chao Wang, Xibin Xiao, Liansheng Huang, Yang Xu
Journal: Front Radiol (2023)
Keywords: extranodal natural killer/t-cell lymphoma, radiation necrosis, radiation therapy, radiological examination, secondary central nervous system lymphoma
MeSH terms: Case Reports

Radiation-induced cerebral necrosis, also known as radiation encephalopathy, is a debilitating condition that significantly impacts the quality of life for affected patients. Secondary central nervous system lymphoma (SCNSL) typically arises from highly aggressive mature B-cell lymphoma, but rarely from extranodal natural killer T-cell lymphoma (ENKTL). Treatment will be guided by differentiation between lymphoma progression from brain necrosis, and is particularly important for critically ill patients in an acute setting. However, differential diagnosis remains challenging because they share similar clinical manifestations and have no specific imaging features. We present the case of a 52-year-old man with ENKTL who suffered an emergency brain herniation secondary to massive radiation necrosis. The diagnosis established by brain biopsy ultimately led to appropriate treatment. The importance of the diagnostic biopsy is highlighted in this case for distinguishing between radiation necrosis and SCNSL.
Left Vertebral Artery Arising Directly From the Arch of the Aorta With a Prevailing Vascular Problem: A Case Report
Authors: Magda A Eldomiaty, Mostafa M Elnaggar, Emad A Albadawi
Journal: Cureus (2024)
Keywords: abnormal origin, arch of aorta, brachiocephalic trunk, left common carotid artery, left vertebral artery
MeSH terms: Case Reports

Aberrant origin of the vertebral artery is a rare case. Due to its important clinical significance during operations in the superior mediastinum and the root of the neck, the variations of this artery should be clarified, and any cadaveric case should be explored specifically if accompanied by any vascular problem. In this cadaveric case, the embalmed male cadaver was found to have a pacemaker wire inserted in the heart through the superior vena cava, denoting a vascular incompetence due to sinus arrhythmia. The left vertebral artery was found to originate from the aortic arch, positioned between the left common carotid artery and the left subclavian artery. It traveled upward behind the left common carotid artery, passing in front of the stellate ganglion and the ventral rami of cervical spinal nerves before entering the left foramen transversarium of the C6 vertebra. This atypical left vertebral artery, which had an unusual origin from the arch of aorta, was distinct from the right vertebral artery, that typically arises from the right subclavian artery. Also, the left atypical artery was found to be narrower and longer than the right one. Additionally, the left common carotid artery exhibited an unusual origin from the beginning of the brachiocephalic trunk. The present case report would be of significance for vascular surgeons in designing surgical intervention in the root of the neck and for clinicians responsible for monitoring patients with variant vertebral arteries to effectively manage potential vascular complications.
Case report: Two pediatric cases of long-term leukemia-free survival with relapsed acute T-lymphoblastic leukemia treated with donor CD7 CAR-T cells bridging to haploidentical stem cell transplantation
Authors: Yanzhi Song, Zhanxiang Liu, Qi Wang, Kong Gao, Tong Wu
Journal: Front Immunol (2024)
Keywords: cd7 car-t, t-lymphoblastic leukemia, allogeneic stem cell transplantation, leukemia-free survival, long-term survival
MeSH terms: Hematopoietic Stem Cell Transplantation / methods, Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Receptors, Chimeric Antigen, Case Reports, Acute Disease, Child, Humans, Male, Quality of Life, T-Lymphocytes, Receptors, Chimeric Antigen

Introduction:
Patients with relapsed/refractory (r/r) acute T-lymphoblastic leukemia (T-ALL) have a poor prognosis. We developed donor CD7 chimeric antigen receptor T (CAR-T) cells to salvage r/r T-ALL patients and obtained encouraging results. Patients who had not received allogeneic (allo-) hematopoietic stem cell transplantation (HSCT) before CAR-T therapy would develop pancytopenia and immunodeficiency for a long period after CD7 CAR-T therapy; therefore, allo-HSCT is needed in these patients. Here, we report two pediatric r/r T-ALL patients who received donor CD7 CAR-T bridging to allo-HSCT with leukemia-free survival (LFS) and sustained negative minimal residual disease for >2 years.
Case presentation:
Patient 1 was a 10-year-old boy who visited our hospital because of a T-ALL relapse with multiple lymphadenopathies without discomfort. The patient did not achieve remission after one course of induction chemotherapy. The patient then received donor (his father) CD7 CAR-T cells and achieved complete remission (CR). Thirty days after the first CAR-T cell infusion, he received allo-HSCT, and his father was also the donor. His LFS was >3 years. Patient 2 was an 8-year-old boy who was admitted to our hospital with relapsed T-ALL with fever, cough, and mild dyspnea. He did not achieve remission after one course of induction chemotherapy; therefore, he received donor (his father) CD7 CAR-T cells and achieved CR. Twenty-six days after CAR-T cell infusion, the patient received allo-HSCT, with his father as the donor. He has survived for >2 years free of leukemia. At the last follow up, both patients were alive and presented a good quality of life.
Conclusion:
The long-term survival of these two patients supports the use of CD7 CAR-T therapy bridging to allo-HSCT as an effective and safe treatment with the capacity to make r/r T-ALL a curable disease, similar to r/r acute B-lymphoblastic leukemia.
Sacituzumab govitecan response in extensive leptomeningeal carcinomatosis from triple-negative breast cancer: a case report
Authors: Jesús Yaringaño, María Roca-Herrera, Simeón Eremiev, Pau Mascaró-Baselga, Pau Benito, Fidel Núñez, Sergi Benavente, Isabel Pimentel
Journal: Front Oncol (2024)
Keywords: antibody-drug conjugate, leptomeningeal carcinomatosis, partial response, sacituzumab govitecan, triple-negative breast cancer
MeSH terms: Case Reports

Sacituzumab govitecan (SG), a Trop-2-directed antibody-drug conjugate (ADC), was the first ADC approved for patients with metastatic triple-negative breast cancer (mTNBC) who had received at least two prior lines of therapy for advanced disease. Although SG has shown promising clinical activity in treating brain metastases in both ASCENT randomized trials and real-world analysis, its utility in leptomeningeal carcinomatosis (LC) remains underexplored. We report the diagnostic and therapeutic process of a patient who develops extensive LC from TNBC treated with SG. She presented a clinical response after the first cycle of SG with a PFS of 6 months. This case report highlights the need for further inquiry into the use of SG in LC.