OpenMed/multicare-articles huggingface dataset:
Complete Spontaneous Bone Regeneration following Surgical Enucleation of a Mandibular Cemento-Ossifying Fibroma
Authors: Saeed Shirafkan, Mehdi Gholamian, Ali Rohani, Sadaf Sadat Mahmoudinezhad, Mahshid Razavi, Kooshan Moradi
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Background:
Cemento-ossifying fibroma (COF) is a type of benign fibro-osseous tumor that mainly occurs in the maxillofacial region. Bone reconstruction after the surgery is often performed with bone transplantation. However, the present case report describes the accurate diagnosis and successful surgical resection of a COF with periosteum preservation, after which the defect was completely and spontaneously filled with the newly formed bone through a natural process. Case Presentation. A 32-year-old Iranian female patient presented with a history of gradual development of painful swelling, spontaneous pain, and lower lip and chin hypoesthesia in the lower third of the left side of her face. The dome-shaped swelling was tender. The patient was suffering from renal infection and urethral prolapse and was taking folic acid. She also mentioned a positive family history of similar swellings in her mother and uncle. Intraoral examination indicated a lesion in buccal and lingual vestibules extending from the first premolar to the third molar teeth. It had a firm consistency, and the covering mucosa was normal in terms of color and texture. The aspiration test was negative. The lesion had caused severe mobility of the second premolar and first and second molar teeth. Panoramic radiography revealed an extensive well-defined unilocular radiolucency. Significant knife-edge resorption of the first and second molar roots at the involved site and thinning of the alveolar crest and inferior border of the mandible were also clear. Cone-beam computed tomography showed severe expansion in the buccal and moderate expansion in the lingual aspect, causing thinning of both the buccal and lingual cortical plates. Histopathological analysis revealed neoplastic tissue mixed with fibrous connective tissue and several round and oval-shaped calcification foci. Immunohistochemical analysis confirmed the final diagnosis (COF) with the presence of SMA-8. The lesion was removed by enucleation and curettage, while the periosteum was carefully preserved. Fixation with screw and plate was also performed.
Conclusions:
Correct diagnosis of COF and precise implementation of the periosteal osteogenesis technique, in this case, resulted in entirely and spontaneously bone regeneration, which was a rare and favorable outcome with minimum cost and complications for the patient.
Sigmoid carcinoma in an inguinal hernia: a blessing in disguise?
Authors: P B Salemans, G F Vles, S A F Fransen, R M Smeenk
Journal: Case Rep Surg (2013)

Colorectal cancer is a rising problem, as the incidence increases with age. In most cases the goal of treatment is oncological resection followed by adjuvant chemotherapy in order to optimize the survival. In this case report we present a 93-year-old patient with a sigmoid carcinoma inside an irreducible inguinal hernia, which was diagnosed prior to surgery. We chose to perform a sigmoid resection through an oblique inguinal incision as a safer alternative to laparotomy.
Case report: A novel FARS2 deletion and a missense variant in a child with complicated, rapidly progressive spastic paraplegia
Authors: Elena Panzeri, Andrea Citterio, Andrea Martinuzzi, Vera Ancona, Eleonora Martini, Maria Teresa Bassi
Journal: Front Genet (2023)
Keywords: fars2, spg77, complicated spastic paraplegia, deletion, severe
MeSH terms: Case Reports

Defects in FARS2 are associated with either epileptic phenotypes or a spastic paraplegia subtype known as SPG77. Here, we describe an 8-year-old patient with severe and complicated spastic paraplegia, carrying a missense variant (p.Pro361Leu) and a novel intragenic deletion in FARS2. Of note, the disease is unexpectedly progressing rapidly and in a biphasic way differently from the previously reported cases. Our study provides the first detailed molecular characterization of a FARS2 deletion and its underlying molecular mechanism, and demonstrates the need for combining different tools to improve the diagnostic rate.
Case Report: Tocilizumab for Acute Kidney Graft Dysfunction in Patient Affected by COVID-19
Authors: Infante Barbara, Mercuri Silvia, Troise Dario, Castellano Giuseppe, Giovanni Stallone
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, acute kidney injury, graft dysfunction, tocilizumab, transplantation
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was isolated in January 2020 and, on March, the WHO declared the status of a pandemic. It causes a cytokine release syndrome, called "cytokine storm," characterized by systemic inflammation involving elevated levels of cytokines and hyperactivation of immune cell; this profound alteration in the immune system led to an overshooting inflammatory response contributing to morbidity and mortality. Solid organ transplant recipients are at particularly higher risk of developing critical coronavirus disease 2019 (COVID-19) due to chronic immunosuppression; in fact, establishing the balance between infection and rejection in any transplant recipient is the principal aim when prescribing immunosuppression. Tocilizumab, a humanized monoclonal antibody against interleukin-6 (IL-6) receptor widely adopted in adult rheumatoid arthritis, is used as rescue therapy for chronic antibody-mediated rejection in kidney transplantation. Data about the use of tocilizumab for treating acute kidney graft dysfunction in a setting of kidney-transplanted patients affected by COVID-19 are lacking. In this case study, we discuss the case of kidney transplant recipient with proven SARS-CoV-2 infection that develops acute graft dysfunction and the management of immunosuppression with concomitant tocilizumab administration.
Modified Unna Boot and Pinch Grafting for Chronic Non-healing Venous Leg Ulcer
Authors: D N Balaraju, Chakravarthi R Srinivas, Sanjay V Mukhi
Journal: J Cutan Aesthet Surg (2008)
Keywords: glycerine, unna’s boot, venous ulcer, zinc oxide
MeSH terms: Case Reports

Venous ulcers cause considerable morbidity. A 45-year-old man reported with non healing ulcer since 15 years. Patch tests revealed multiple sensitivity. Infection was first controlled with antibiotics and antiseptics. Dressing with modified Unna's boot made with zinc oxide 40% and glycerine paste 60% resulted in formation of healthy granulation tissue. Pinch grafting was subsequently done to promote epithelization. We recommend the use of Unna's paste instead of more expensive synthetic and occlusive and semi occlusive dressing to promote granulation tissue and pinch grafting after bed is ready to hasten epithelization.
Novel ENAM and LAMB3 mutations in Chinese families with hypoplastic amelogenesis imperfecta
Authors: Xin Wang, Yuming Zhao, Yuan Yang, Man Qin
Journal: PLoS One (2015)
MeSH terms: Amelogenesis Imperfecta / genetics, Asian People / genetics, Cell Adhesion Molecules / genetics, Dental Enamel Hypoplasia / genetics, Extracellular Matrix Proteins / genetics, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Amelogenesis Imperfecta / pathology, Base Sequence, Cell Adhesion Molecules / chemistry, Child, China, Dental Enamel / pathology, Dental Enamel Hypoplasia / pathology, Extracellular Matrix Proteins / chemistry, Female, Humans, Male, Models, Molecular, Molecular Sequence Data, Mutation, Pedigree, Cell Adhesion Molecules, ENAM protein, human, Extracellular Matrix Proteins, kalinin

Amelogenesis imperfecta is a group of inherited diseases affecting the quality and quantity of dental enamel. To date, mutations in more than ten genes have been associated with non-syndromic amelogenesis imperfecta (AI). Among these, ENAM and LAMB3 mutations are known to be parts of the etiology of hypoplastic AI in human cases. When both alleles of LAMB3 are defective, it could cause junctional epidermolysis bullosa (JEB), while with only one mutant allele in the C-terminus of LAMB3, it could result in severe hypoplastic AI without skin fragility. We enrolled three Chinese families with hypoplastic autosomal-dominant AI. Despite the diagnosis falling into the same type, the characteristics of their enamel hypoplasia were different. Screening of ENAM and LAMB3 genes was performed by direct sequencing of genomic DNA from blood samples. Disease-causing mutations were identified and perfectly segregated with the enamel defects in three families: a 19-bp insertion mutation in the exon 7 of ENAM (c.406_407insTCAAAAAAGCCGACCACAA, p.K136Ifs*16) in Family 1, a single-base deletion mutation in the exon 5 of ENAM (c. 139delA, p. M47Cfs*11) in Family 2, and a LAMB3 nonsense mutation in the last exon (c.3466C>T, p.Q1156X) in Family 3. Our results suggest that heterozygous mutations in ENAM and LAMB3 genes can cause hypoplastic AI with markedly different phenotypes in Chinese patients. And these findings extend the mutation spectrum of both genes and can be used for mutation screening of AI in the Chinese population.
Anesthetic Considerations in a Patient with Myotonic Dystrophy for Hip Labral Repair
Authors: Ramon Go, David Wang, Danielle Ludwin
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Myotonic Dystrophy (DM) affects multiple organ systems. Disorders such as hyperthyroidism, progressive musculoskeletal weakness, cardiac dysrhythmias, hypoventilation, and cognitive-behavioral disorders may be present in these patients. Thorough preoperative assessment and anesthetic planning are required to minimize the risk of anesthetic complications. Patients with DM can exhibit exquisite sensitivity to sedatives, neuromuscular blocking agents, and volatile anesthetics, resulting in potential postoperative complications. There is limited literature available on successful anesthetic techniques for the DM patient. We present this case report to add to our current fund of knowledge.
Oral treatment with 10% potassium iodide solution for refractory cutaneous-disseminated sporotrichosis in an immunocompetent adult: Case report
Authors: Kaiwen Zhuang, Yaling Dai, Yike Zhou, Yujing Ke, Xin Ran, Yuping Ran
Journal: Front Microbiol (2022)
Keywords: sporothrix globosa, cutaneous disseminated sporotrichosis, itraconazole, potassium iodide, voriconazole (vcz)
MeSH terms: Case Reports

Sporotrichosis has multiple clinical manifestations, and its cutaneous-disseminated form is uncommon and, in most cases, related to immunosuppressive conditions. We report the case of a 47-year-old male patient who presented with multiple cutaneous nodules and ulcers on the left upper limb and the right thigh, with no other comorbidities. Until the diagnosis was confirmed, the patient was initially given empiric antifungal treatment with itraconazole, which showed unsatisfactory results at a local hospital. Then, he was treated with voriconazole, which led to the slow improvement of his skin lesions. At one point during the voriconazole treatment course, the patient briefly self-discontinued voriconazole for economic reasons, and the lesions recurred and worsened. The patient was finally diagnosed with cutaneous-disseminated sporotrichosis based on the isolation and identification of Sporothrix globosa. Susceptibility testing revealed that the isolate was resistant to itraconazole, fluconazole, voriconazole, terbinafine, and amphotericin. Considering the patient's poor financial condition, potassium iodide was administered. After 1-month of therapy with potassium iodide, he reported rapid improvement of his skin lesions. The patient continued potassium iodide treatment for another 5 months until the full resolution of lesions was achieved.
Varicella Zoster Virus Meningitis with Absence of Rash in an Immunocompetent Child
Authors: Mariam Lagrine, Karima El Fakiri, Noureddine Rada, Ghizlane Draiss, Nabila Soraa, Mohammed Bouskraoui
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Only a few cases in the literature have ever reported the reactivation of the varicella zoster virus (VZV) in children especially in the case of immunocompetent patients. It is an uncommon situation that may lead to several neurological complications. We report varicella zoster virus (VZV) meningitis in a 14-year-old healthy boy with no antecedent of rash. On his cerebrospinal fluid (CSF) examination, VZV DNA was detected. The rapid HIV test was negative. The treatment using acyclovir (20 mg/kg/8h) was effective, and the child's clinical condition rapidly improved.
Be careful, mom and doc: hepatotoxicity associated with prescribed medications in young infants
Authors: Kam-Lun Ellis Hon, Alexander K C Leung
Journal: Int J Pediatr (2009)
MeSH terms: Case Reports

Accidental poisonings in young infants are relatively uncommon, and the careless caregiver is usually the culprit. We report two cases of hepatotoxicity due to prescribed medications. An infant was given 15 mL instead of 1.5 mL of paracetamol by his mother because she omitted the decimal point on the label of the drug bottle. The infant became symptomatic, and liver enzyme and clotting profile were abnormal, necessitating treatment with N-acetyl cysteine. Another infant was prescribed oral ketoconazole for thrush, resulting in elevation of liver enzymes. The serum alanine aminotransferase levels were transiently elevated but returned to normal, and both infants recovered uneventfully. This report serves to alert the doctor to avoid using decimal points in drug labeling and to avoid prescribing excessive amount of drug for trivial acute illness. Thrush in infancy is common and usually treated with oral nystatin. Other oral antifungals such as ketoconazole may be associated with liver derangement and should be avoided in infants.
Perineal body squamous cell carcinoma treated with radical radiotherapy - a case report
Authors: Nikunj Patil, Shirley Lewis, Chethana B Udupa, Rajagopal K V, Krishna Sharan
Journal: Ecancermedicalscience (2023)
Keywords: imrt, case report, perianal cancer, perineal body, radiotherapy
MeSH terms: Case Reports

Introduction:
Perianal tumours are a rare site of malignancy, and tumours primarily involving the perineal body without vaginal and anal canal involvement are uncommon.
Case summary:
A 67-year-old woman presented with a lesion involving the perineum and rectovaginal septum without extension into vaginal or anorectal mucosa and with skip lesions in the vulva. Biopsy was confirmative of squamous cell carcinoma, with p16 positive. A complete metastatic workup with MRI of the pelvis and CECT thorax and abdomen was done. She was diagnosed with perianal carcinoma stage cT2N0M0 Stage II (American Joint Committee on Cancer 8th Edition of Cancer Staging) since the lesion reached the anal verge. Given the location of the tumour (perineal body), comorbidities and advanced age, she received radical radiotherapy with an intensity-modulated radiotherapy technique - 56 Gy in 28 fractions with the intention of organ preservation. The response assessment with MRI at 3 months showed a complete tumour response. She has been disease-free for 3 years and is on regular follow-ups.
Conclusion:
Isolated perineal body squamous cell carcinomas are unusual, and synchronous vulvar skip lesion makes this case unique. Radical radiotherapy achieved organ preservation with tumour control and minimal toxicity in an elderly frail patient.
Malignant transformation six months after removal of intracranial epidermoid cyst: a case report
Authors: Fayçal Lakhdar, El Mehdi Hakkou, Rachid Gana, Rachid My Maaqili, Fouad Bellakhdar
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

Intracranial epidermoid cysts are uncommon benign tumors of developmental origin; malignant transformation of benign epidermoid cysts is rare, and their prognosis remains poor. We report a case of squamous cell carcinoma arising in the cerebellopontine angle. A 52-year-old man presented with left facial paralysis and cerebellar ataxia. He had undergone total removal of a benign epidermoid cyst six months previously. Postoperative magnetic resonance imaging of the brain revealed a heterogeneous and cystic lesion in the left cerebellopontine angle with hydrocephalus. The cyst wall was enhanced by gadolinium. He underwent ventricle-peritoneal shunt and removal again; the histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity. The presence of contrast enhancement at the site of an epidermoid cyst combined with an acute, progressive neurological deficit should alert the neurosurgeon to the possibility of a malignant transformation.
Fatal Disseminated Tuberculous Peritonitis following Spontaneous Abortion: A Case Report
Authors: Munire Erman Akar, Tayfun Toptas, Havva Sutcu, Haney Durmus, Murat Ozekinci, Melike Cengiz, Gulgun Erdogan
Journal: Case Rep Obstet Gynecol (2014)

We describe a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. Clinical and laboratory findings were initially unremarkable. She underwent diagnostic laparoscopy which revealed numerous tiny implants on the peritoneum and viscera. Histopathology showed chronic caseating granulomas, and the tissue culture grew Mycobacterium tuberculosis. At fifth day of the antituberculous treatment multiorgan failure occurred in terms of pulmonary, hepatic, and renal insufficiency. She developed refractory metabolic acidosis with coagulopathy and pancytopenia, and she died of acute respiratory distress syndrome and septic shock on her twelfth day of hospitalization.
A case report of primary multiple hydatid cysts of psoas muscle: An exceptional location
Authors: Mohamed Ali Chaouch, Bilel Faidi, Maher Hdira, Jihed Rebhi, Nada Feki, Roua Meghri, Aymen Kawach
Journal: IDCases (2022)
Keywords: hydatid cyst, hydatidosis, psoas muscle, surgery
MeSH terms: Case Reports

The psoas muscle localization is even more exceptional when they are multiple. The clinical and radiological features were often misleading. This case report aimed to highlight the difficulties of radiological diagnosis and the dilemma of choosing the best operative approach. A 27 year-old-men with no past medical history has been consulted for right down abdominal quadrant pain. Physical examination revealed a painless abdominal mass. An abdominal CT Scan concluded with the presence of two multisectional cystic lesions. The first cystic lesion had an exophytic development, and the second cystic lesion was in the posterior and lateral sides of the psoas muscle. The hemaglutinin reaction and the Western blot were positive. A laparotomy was done. The exploration objective is a first psoas muscle hydatid cyst of 5 cm with an exophytic development just behind the vermiform appendix with a second hydatid cyst of 15 cm. The puncturing and aspiration of the cystic fluid bring a clear hydatid fluid. Parasitic sterilization was performed by injecting a scoliosis solution, hypertonic serum, into the cystic lesion. After ten minutes, we resected the two cystic lesions' protruding dome. We have aspirated the fluid and all the daughter hydatid cysts from the two hydatid cysts. The postoperative follow-up was uneventful. The primary hydatid cyst of the psoas muscle often causes a problem of its hydatid nature. Surgery remains the only curative treatment. It avoids the risk of complications such as peritoneal rupture, which can modify the surgical therapeutic strategy.
Ticagrelor-Induced Prolongation of the QTc Interval
Authors: Avik Ray, Ahmad Najmi, Gaurav Khandelwal, Balakrishnan Sadasivam
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Background:
Ticagrelor has been accepted as a class I antiplatelet agent in patients undergoing percutaneous coronary angioplasty (PTCA). There have been cases reported on ticagrelor being associated with various cardiac conduction defects. But there is no evidence of QTc prolongation associated with the drug as of yet.
Case presentation:
A 64-year-old male who underwent PTCA was given ticagrelor. A baseline electrocardiogram (ECG) showed a QTc of 402 ms. He returned after 1.5 months with complaints of shortness of breath. An ECG revealed a prolonged QTc of 468 ms. Ticagrelor was discontinued in view of ticagrelor-induced dyspnea and the patient was started on clopidogrel. The other medications were kept unchanged. The patient returned after a month without any complaints. A follow-up ECG showed a reduced QTc of 425 ms.
Conclusion:
We present a case of ticagrelor-induced QTc prolongation. To our knowledge, this is the first case to be reported on the same. The Naranjo algorithm for causality assessment gave a total score of 6 indicating that the adverse drug reaction falls under the probable category.
Multi-Step Combined Upfront Surgery for Locally Advanced Paravertebral Sarcoma: A Case Report
Authors: Umberto Cariboni, Nicolò Gennaro, Francesco Costa, Salvatore Lorenzo Renne, Pierluigi Novellis, Andrea Marrari, Alexia Francesca Bertuzzi, Efrem Civilini
Journal: Front Surg (2021)
Keywords: ups, aorta–thoracic, multidisciplinary (treatment), sarcoma, surgery, vertebra bone
MeSH terms: Case Reports

Background: Paravertebral localization of primary undifferentiated pleomorphic sarcoma (UPS) with bone and vascular involvement is infrequent and challenging. Multi-step surgical procedure has been described as a feasible and effective option to achieve sustained local tumor control. Methods: We report on a 62-year old man with paravertebral UPS infiltrating the aortic wall and the 9th thoracic vertebra who underwent a multi-step surgical procedure aimed at achieving oncologic radicality through a coordinated effort between thoracic, vascular and spinal surgeons. After balancing the risks and benefits of perioperative therapies, upfront surgery was performed including aortic resection with bypass grafting followed by a triple en bloc vertebrectomy with tumor excision. Mid-term follow-up (22 months) is then provided. Results: The combined procedure achieved oncological radicality and no local recurrence in the mid-term. No major complications occurred. Conclusions: Multi-step and multi-specialty surgery is a feasible and effective strategy to treat primary UPS in unfavorable localization. A strategic cooperation between surgeons and a multidisciplinary tumor board is required to define an optimal, personalized treatment strategy in sarcoma patients.
Rare Primary Pulmonary Marginal Zone Lymphoma Presenting with Incidental Pulmonary Nodules
Authors: Saad Ullah, Mirza Ali, Mingchen Song
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Pulmonary malignancies carry a significant morbidity and mortality and are one of the leading causes of cancer-related deaths worldwide. Primary pulmonary lymphoma is a rare malignancy which should be considered in the differential of solitary pulmonary nodule or lung mass especially in a low-risk patient presenting with constitutional symptoms. Here, we describe a case of an elderly male who presented to our clinic with incidental pulmonary nodules and subsequent workup revealed low grade B cell non-Hodgkin's lymphoma consistent with diagnosis of primary pulmonary marginal zone lymphoma.