OpenMed/multicare-articles huggingface dataset:
Case of Nontraumatic Rectus Sheath Hematoma from Muscle Training Mimicking Acute Abdomen
Authors: Yukino Ariyoshi, Hiromichi Naito, Hiromi Ihoriya, Tetsuya Yumoto, Noritomo Fujisaki, Kohei Tsukahara, Taihei Yamada, Yasuhiro Mandai, Takaaki Osako, Atsunori Nakao
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Rectus sheath hematoma is an unusual but well-known clinical problem. Our hospital admitted a 54-year-old woman complaining of harsh right-sided hypogastric pain that started while muscle training. Computed tomography of the abdomen and pelvis demonstrated a right rectus sheath hematoma. As the hematoma did not increase, the patient was conservatively treated. Despite increased awareness of rectus sheath hematoma, its early diagnosis and treatment still present a challenge to emergency physicians. Swift acknowledgement of this rare cause of abdominal pain may avoid more intrusive examination, unnecessary hospitalization, and laparotomy. Careful consideration of the patient's medical history and a high index of suspicion are needed to diagnose this complication.
Periodontitis and Intra-Oral Plasmacytosis in a Noonan's Syndrome Patient
Authors: Hadeel Alqatami, Khalid N Said, Adham A Ammar, Hani Nazzal
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

A 13-year-old female patient with Noonan's syndrome, intra-oral periodontitis, and associated periodontal lesions is presented in this case report. The patient suffered early onset severe molar pattern periodontitis and recurrent intra-oral inflammatory lesions, pyogenic granuloma, and plasmacytosis, which were excised and controlled using a strict oral hygiene protocol based on long-term use of chlorhexidine-based products as auxiliary aid to regular home care and brushing.
Kidney Stones in Several Spinal Abnormalities: A Challenging Treatment
Authors: Maximiliano Lopez Silva, Horacio Sanguinetti, Santiago Battiston, Patricio Alvarez, Norberto Bernardo
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Patients with severe skeletal deformities are a challenging group to treat. A female, white, 35-year-old presented with right kidney stones located in renal pelvis, lower calyx, and upper ureter. She was affected by severe spinal deformity with restrictive respiratory obstruction, caused by kyphoscoliosis. Percutaneous nephrolithotomy in supine position was performed, achieving complete removal of kidney stones. The treatment of renal stones in this patient was complex, so special attention to respiratory function was mandatory; this was a challenging but feasible situation.
A Rare Case of Solitary Kidney Metastasis Following Primary Laryngeal Squamous Cell Carcinoma
Authors: Sharon Del Vecchio, Robert Ellis, Kylie Gallagher, Keng Lim Ng, Li Ma, Geoffrey Strutton, Simon Wood
Journal: J Kidney Cancer VHL (2017)
Keywords: pet-mri, laryngeal squamous cell carcinoma, renal cell carcinoma, smoking, solitary kidney metastasis
MeSH terms: Case Reports

Laryngeal cancer is the 14th most common malignancy worldwide, and its common subtype squamous cell carcinoma (SCC) is highly associated with tobacco use and long-term alcohol consumption. The incidence of distant metastasis from a primary laryngeal cancer has been reported to be very low, between 6.5% and 8.5%, according to published tumour registry data. Distant metastases of laryngeal SCC most commonly involve the lung, liver, bone and mediastinum, seldom involving the kidney. Renal metastasis has been well established in many other cancers such as lymphoma, lung, breast and gastric carcinoma. This report discusses the rare case of a solitary renal metastasis following a primary laryngeal SCC.
Case Report: Prolonged Effects of Short-Term Transcranial Magnetic Stimulation on EEG Biomarkers, Spectral Power, and Seizure Frequency
Authors: Keith Starnes, Jeffrey W Britton, David B Burkholder, Iffat A Suchita, Nicholas M Gregg, Bryan T Klassen, Brian Nils Lundstrom
Journal: Front Neurosci (2022)
Keywords: eeg, eeg biomarkers, tms, epilepsy, non-invasive brain stimulation, spectral power
MeSH terms: Case Reports

Transcranial magnetic stimulation (TMS) is a non-invasive modality of focal brain stimulation in which a fluctuating magnetic field induces electrical currents within the cortex. It remains unclear to what extent TMS alters EEG biomarkers and how EEG biomarkers may guide treatment of focal epilepsy. We present a case of a 48-year-old man with focal epilepsy, refractory to multiple medication trials, who experienced a dramatic reduction in seizures after targeting the area of seizure onset within the left parietal-occipital region with low-frequency repetitive TMS (rTMS). Prior to treatment, he experienced focal seizures that impacted cognition including apraxia at least 50-60 times daily. MRI of the brain showed a large focal cortical dysplasia with contrast enhancement involving the left occipital-parietal junction. Stimulation for 5 consecutive days was well-tolerated and associated with a day-by-day reduction in seizure frequency. In addition, he was monitored with continuous video EEG, which showed continued and progressive changes in spectral power (decreased broadband power and increased infraslow delta activity) and a gradual reduction in seizure frequency and duration. One month after initial treatment, 2-day ambulatory EEG demonstrated seizure-freedom and MRI showed resolution of focal contrast enhancement. He continues to receive 2-3 days of rTMS every 2-4 months. He was seizure-free for 6 months, and at last follow-up of 17 months was experiencing auras approximately every 2 weeks without progression to disabling seizures. This case demonstrates that rTMS can be a well-tolerated and effective means of controlling medication-refractory seizures, and that EEG biomarkers change gradually in a fashion in association with seizure frequency. TMS influences cortical excitability, is a promising non-invasive means of treating focal epilepsy, and has measurable electrophysiologic effects.
Extra-long treatment of MDR-TB osteomyelitis of humerus due to neurotoxicity from the 2nd-line drugs: a case report
Authors: Naser Naser, Habib Abdulla, Husain Kadhem
Journal: Egypt J Intern Med (2023)
Keywords: osteomyelitis, pulmonary medicine, radiology, tuberculosis
MeSH terms: Case Reports

Infection with tuberculosis (TB) still considered a leading infectious cause of death, osteomyelitis TB rare entity, and being extraspinal MDR-TB make it very rare case; most of experience in treating osteomyelitis TB was derived from pulmonary TB experience, and we present a case of humerus MDR-TB that was treated for 5 years, with several interruption due to side effect and other causes.
Treatment of Fournier's Gangrene with Combination of Vacuum-Assisted Closure Therapy, Hyperbaric Oxygen Therapy, and Protective Colostomy
Authors: Giovanni Zagli, Giovanni Cianchi, Sara Degl'innocenti, Jessyca Parodo, Lorenzo Bonetti, Paolo Prosperi, Adriano Peris
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

Fournier's gangrene is a rare process which affects soft tissue in the genital and perirectal area. It can also progress to all different stages of sepsis, and abdominal compartment syndrome can be one of its complications. Two patients in septic shock due to Fournier gangrene were admitted to the Intensive Care Unit of Emergency Department. In both cases, infection started from the scrotum and the necrosis quickly involved genitals, perineal, and inguinal regions. Patients were treated with surgical debridement, protective colostomy, hyperbaric oxygen therapy, and broad-spectrum antibacterial chemotherapy. Vacuum-assisted closure (VAC) therapy was applied to the wound with the aim to clean, decontaminate, and avoid abdominal compartmental syndrome development. Both patients survived and were discharged from Intensive Care Unit after hyperbaric oxygen therapy cycles and abdominal closure.
What Is It? A Rare Presentation of a Meningioma
Authors: Matthew A Applebaum, Connor Barnes, Michael Harrington
Journal: Eplasty (2016)
Keywords: extracranial, meningioma, orbit, reconstruction, temporal
MeSH terms: Case Reports

Introduction: Primary extracranial meningiomas are rare manifestations of a central nervous system tumor. This article presents a case study of a soft-tissue primary extracranial tumor in the temporal region that was initially diagnosed as melanoma at an outside institution and whose definitive diagnosis proved difficult prior to successful excision. Methods: Temporal muscle biopsy, ultrasound-guided biopsy, and computed tomography were conducted at an outside institution prior to the patient's presentation to our care. Upon presenting to our institution a positron emission tomographic scan was then conducted prior to excision. After excision, the mass was sent to pathology and further immunohistochemistry was conducted. To ensure the mass was completely excised, magnetic resonance imaging was performed after its removal. Results: A 3 × 3-cm mass was excised in its entirety from the patient's temporal region and sent to pathology for immunohistochemistry and mutation testing. It proved to have the most common mutation for a primary extracranial meningioma, a neurofibromatosis type 2 frameshift. Conclusion: The presentation of a primary extracranial meningioma in the temporal region is a rare finding. Because of its slow-growing nature and generally asymptomatic presentation, it can be misdiagnosed. Utilization of radiological imaging is essential both pre- and postoperatively in order for its identification and complete excision.
Relapsed High-Risk Medulloblastoma: Stable Disease after Two Years of Treatment with Somatostatin Analog - Case Report
Authors: Luisa Galvis, Diego Gonzalez, Carlos Bonilla
Journal: Cureus (2016)
Keywords: medulloblastoma, octreotide, somatostatin
MeSH terms: Case Reports

Cerebellar medulloblastoma in adults is an uncommon disease. Therefore, most information comes from the pediatric population, and the treatment for relapses is based on series and case reports. The expression of somatostatin receptors has been identified in most medulloblastoma patients, and preclinical experience has shown a promissory response to somatostatin analogs. This report presents a female patient with a high-risk left cerebellar medulloblastoma diagnosed at age 16 years old who was treated with complete resection, cranial-spinal radiotherapy, and chemotherapy. She presented again at 18 years of age with a sustained progression of her tumor, despite radiosurgery and another line of chemotherapy. Octreotide scintigraphy at that time showed a moderate to high expression of somatostatin receptors; thus, the patient was started on monthly octreotide. She is now 20 and has achieved stable disease over more than two years of active treatment without any drug-related toxicity. Somatostatin analogs could be considered as a treatment option in selected cases of medulloblastoma. Review of the literature is presented for this unusual response.
Scapular Winging following Sports-Related Injury in a Rugby Player
Authors: Shinya Ishizuka, Akinori Kobayakawa, Hideki Hiraiwa, Hiroki Oba, Takefumi Sakaguchi, Masaru Idota, Takahiro Haga, Takafumi Mizuno, Itaru Kawashima, Kanae Kuriyama, Shiro Imagama
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.
Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report
Authors: Dina Sweed, Mohamed Ramadan El Shanshory, Eman Mohammed Elaskary, Hassnaa Atef Hassan, Enas Sweed, Eman Sweed, Shimaa Abdelsattar, Ahmed Abdelgawad, Asmaa Mosbeh, Heba Abdallah, Shereen El-Mashad, Nermine Ehsan
Journal: Egypt Liver J (2021)
Keywords: autoimmune hemolytic anemia, intracytoplasmic globules, pathology, sars-cov-2
MeSH terms: Case Reports

Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear.
Case presentation:
A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone.
Conclusions:
AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.
Case report: Preclinical efficacy of NEDD8 and proteasome inhibitors in patient-derived models of signet ring high-grade mucinous colorectal cancer from a Lynch syndrome patient
Authors: Erica Torchiaro, Consalvo Petti, Sabrina Arena, Francesco Sassi, Giorgia Migliardi, Alfredo Mellano, Roberta Porporato, Marco Basiricò, Loretta Gammaitoni, Enrico Berrino, Monica Montone, Giorgio Corti, Giovanni Crisafulli, Caterina Marchiò, Alberto Bardelli, Enzo Medico
Journal: Front Oncol (2023)
Keywords: lynch syndrome, nedd8 pathway inhibition, mucinous colorectal cancer, preclinical study, proteasome inhibition, signet ring cells
MeSH terms: Case Reports

High-grade mucinous colorectal cancer (HGM CRC) is particularly aggressive, prone to metastasis and treatment resistance, frequently accompanied by "signet ring" cancer cells. A sizeable fraction of HGM CRCs (20-40%) arises in the context of the Lynch Syndrome, an autosomal hereditary syndrome that predisposes to microsatellite instable (MSI) CRC. Development of patient-derived preclinical models for this challenging subtype of colorectal cancer represents an unmet need in oncology. We describe here successful propagation of preclinical models from a case of early-onset, MSI-positive metastatic colorectal cancer in a male Lynch syndrome patient, refractory to standard care (FOLFOX6, FOLFIRI-Panitumumab) and, surprisingly, also to immunotherapy. Surgical material from a debulking operation was implanted in NOD/SCID mice, successfully yielding one patient-derived xenograft (PDX). PDX explants were subsequently used to generate 2D and 3D cell cultures. Histologically, all models resembled the tumor of origin, displaying a high-grade mucinous phenotype with signet ring cells. For preclinical exploration of alternative treatments, in light of recent findings, we considered inhibition of the proteasome by bortezomib and of the related NEDD8 pathway by pevonedistat. Indeed, sensitivity to bortezomib was observed in mucinous adenocarcinoma of the lung, and we previously found that HGM CRC is preferentially sensitive to pevonedistat in models with low or absent expression of cadherin 17 (CDH17), a differentiation marker. We therefore performed IHC on the tumor and models, and observed no CDH17 expression, suggesting sensitivity to pevonedistat. Both bortezomib and pevonedistat showed strong activity on 2D cells at 72 hours and on 3D organoids at 7 days, thus providing valid options for in vivo testing. Accordingly, three PDX cohorts were treated for four weeks, respectively with vehicle, bortezomib and pevonedistat. Both drugs significantly reduced tumor growth, as compared to the vehicle group. Interestingly, while bortezomib was more effective in vitro, pevonedistat was more effective in vivo. Drug efficacy was further substantiated by a reduction of cellularity and of Ki67-positive cells in the treated tumors. These results highlight proteasome and NEDD8 inhibition as potentially effective therapeutic approaches against Lynch syndrome-associated HGM CRC, also when the disease is refractory to all available treatment options.
Case report: Novel frameshift mutation in LAMA2 gene causing congenital muscular dystrophy type 1A
Authors: Natalia Diaz-Lombana, Lorena Diaz-Ordoñez, Juan David Gutierrez-Medina, Harry Pachajoa
Journal: Front Genet (2023)
Keywords: case report, congenital muscular dystrophy type 1a, exome sequencing, laminin subunit alpha 2 lama2, mutation, rare diseases, sequence analysis
MeSH terms: Case Reports

Congenital muscular dystrophy type 1A (CMD1A) is a rare autosomal recessive disorder caused by mutations in the LAMA2 gene. CMD1A is characterized by peripheral hypotonia and muscle weakness from the first months of life, cerebral white matter abnormalities, and elevated creatine phosphokinase (CPK) levels. We describe an 8-year-old girl from Colombia with clinical features compatible with CMD1A, severe scoliosis corrected with surgery, and feeding difficulty corrected with a gastrostomy. Whole-exome sequencing identified two heterozygous variants: a reported nonsense variant (LAMA2 NM_000426.3:c.4198C>T) and a novel likely pathogenic variant (LAMA2 NM_000426.3:c.9227_9243dup). This is the first genetically confirmed case of CMD1A in Colombia and the first report of the c.9227_9243dup variant causing CMD1A.
Use of wide-field optical fluorescence for visualization of oral biofilm in a patient with peri-implant mucositis: a new approach
Authors: Sérgio Araújo Andrade, Sebastião Pratavieira, Vanderlei Salvador Bagnato, Fernando de Pilla Varotti
Journal: Einstein (Sao Paulo) (2021)
MeSH terms: Dental Implants / adverse effects, Mucositis, Peri-Implantitis / diagnostic imaging, Peri-Implantitis / etiology, Case Reports, Biofilms, Fluorescence, Humans, Dental Implants

Peri-implant diseases, caused by bacteria from biofilm related to dental implants, are one of the main causes of late loss of implants. In this sense, peri-implant diseases are divided into peri-implant mucositis, when it affects only the soft tissues, and peri-implantitis, when there is a bone involvement, which can lead to the failure of dental implant therapy. Thus, biofilm removal is essential for peri-implant health, allowing long-term success in implant therapy. To improve the visualization of oral biofilm, which is usually transparent or colorless, disclosing agents have been routinely used. However, disclosing agents have allergenic potential and can cause staining extrinsically in restorative and prosthetic materials, leading to aesthetic impairment. Thus, the use of fluorescence has been studied as an alternative for visualization of oral biofilm. Therefore, this report describes the use of wide-field optical fluorescence for visualization of oral biofilm associated with implants and teeth, in a routine appointment and follow-up of a partially edentulous patient with peri-implant mucositis. In addition, this report showed wide-field optical fluorescence can be used in a clinical routine of care of patients with dental implants. In this sense, wide-field optical fluorescence allowed easy and immediate visualization of the mature oral biofilm for its adequate removal, evaluation of the quality of restoration to sealing of screw access-hole of implant and identification of cariogenic lesions, without risk of allergic reactions or staining of prostheses and restorations.
Case Report: Bilateral Palsy of the Vocal Cords After COVID-19 Infection
Authors: Frederic Jungbauer, Roland Hülse, Fei Lu, Sonja Ludwig, Valentin Held, Nicole Rotter, Angela Schell
Journal: Front Neurol (2021)
Keywords: covid-19, sars-cov-2, cranial nerve, palsy, recurrens, vocal cords
MeSH terms: Case Reports

During the COVID-19 pandemic, adverse neurological effects have been described. In addition to unspecific neurological symptoms, cranial nerve deficits have appeared as part of SARS-CoV-2 infection. In this case report, we describe a 74-year-old patient who developed bilateral paralysis of the vocal cords some weeks following his dismissal in stable condition after COVID-19 pneumonia. After ruling out central lesions, peripheral tumors, and other possible causes, therapy was initiated with methylprednisolone, inhalations, and oxygen. The patient showed no improvement, so laterofixation after Lichtenberger was performed. The dyspnea worsened after several weeks, so a laser posterior cordectomy was performed with satisfactory outcome.
Trans biliary proximal and distal coil embolization of an arteriobiliary fistula: report of a case and review of literature
Authors: Faris Galambo, Majid Maybody
Journal: CVIR Endovasc (2019)
Keywords: arterial injury, hemobilia, percutaneous biliary drainage, peri catheter bleeding, retrograde arterial embolization

Background:
Hepatic arterial injury is an uncommon complication of percutaneous transhepatic biliary drainage interventions that commonly presents with hemobilia and peri catheter hemorrhage. It is classically managed with antegrade trans arterial embolization. However, this approach may not be possible due to altered anatomy and alternative techniques need to be considered. We report a case of an arteriobiliary fistula which was successfully coil embolized both distal and proximal to the lesion using a trans biliary approach. This is the first report of such method and interventionalists should be aware of this option. The literature is reviewed.
Case presentation:
We report a case of a 49-year-old male with advanced colorectal cancer presented with cholangitis. His duodenal anatomy precludes endoscopic intervention, so he underwent percutaneous biliary drainage complicated by intractable hemobilia and pericatheter bleeding. Hepatic arterial anatomy evaluated by two catheter angiographies was shown to be isolated at multiple levels by tumors and prohibited antegrade access of bleeding artery for embolization. Sheath cholangiography revealed an arteriobiliary fistula involving left hepatic arterial branches. The arterial injury was successfully treated by coil embolization distal and proximal to the lesion via a retrograde trans biliary approach, with complete resolution of hemobilia.
Conclusion:
Trans biliary proximal and distal coil embolization is a newly reported approach for treating biliary hemorrhage when traditional antegrade arterial embolization is not feasible due to preclusive anatomic factors. Interventionalists should be familiar with this management option.