OpenMed/multicare-articles huggingface dataset:
Tenosynovial giant cell tumour in Hoffa fat pad: a case report
Authors: Youssef Othman, Yahia Aloui, Firas Chaouch, Saber Rabhi, Makram Zrig, Abderrazek Abid
Journal: Pan Afr Med J (2022)
Keywords: giant cell tumour, hoffa fat pad, case report, knee
MeSH terms: Giant Cell Tumor of Tendon Sheath / diagnosis, Giant Cell Tumor of Tendon Sheath / pathology, Giant Cell Tumor of Tendon Sheath / surgery, Lipoma / pathology, Case Reports, Adipose Tissue, Adult, Humans, Knee Joint / pathology, Knee Joint / surgery, Magnetic Resonance Imaging / methods

Giant cell tumour is a benign lesion classified as a fibrocystic tumour whose localization in Hoffa's fat pad is very rare. Clinical symptoms are insidious and non-specific causing a frequent confusion and delay in diagnosis therefore it should be distinguished radiologically from other similar conditions such as Hoffa´s disease and lipomas. We report a case of a 37-year-old patient, with no relevant history, who complained of a right knee pain for 5 years. Magnetic resonance imaging showed a small nodular mass in Hoffa's pad which was excised through a direct approach. Histologic examination of the specimen revealed a giant cell tenosynovial tumour. One year after surgery, the patient was asymptomatic with no local recurrence. The surgical removal of the tumour is the ideal treatment. The choice between open surgery and endoscopy depends on the site, size, and extent of the tumour.
Pembrolizumab-induced myasthenia gravis with myositis and presumable myocarditis in a patient with bladder cancer
Authors: Maki Todo, Gou Kaneko, Suguru Shirotake, Yuki Shimada, Shintaro Nakano, Takashi Okabe, Shiho Ishikawa, Masafumi Oyama, Koshiro Nishimoto
Journal: IJU Case Rep (2019)
Keywords: myasthenia gravis, myocarditis, myositis, pembrolizumab
MeSH terms: Case Reports

Introduction:
Pembrolizumab cause immune-related adverse events. We herein report a case of advanced bladder cancer, who treated with pembrolizumab and exhibited intriguing clinical course.
Case presentation:
A 63-year-old man with bladder carcinoma was treated by radical cystectomy, however, the bladder carcinoma recurred and invaded to the rectum. He was treated by combination therapy using gemcitabine and cisplatin, which were not effective for the tumor. He subsequently underwent treatment with pembrolizumab. In several 30 days, he suffered from the symptoms of myasthenia gravis. Serum levels of creatine kinase, its isozyme creatine kinase-myocardial band, and troponin I were elevated. Electrocardiography showed a right bundle branch block. These findings suggested that he was myasthenia gravis with general myositis and presumable myocarditis. Oral prednisolone administration significantly attenuated these findings. The tumor drastically shrunk only by the single injection of pembrolizumab.
Conclusion:
Early intervention with corticosteroid was effective for neuromuscular complications due to pembrolizumab.
Recurrent Hepatitis in Two Iranian Children: A Novel (Q166R) Mutation in EIF2AK3 Leading to Wolcott-Rallison Syndrome
Authors: Babak Behnam, Marjan Shakiba, Ali Ahani, Maryam Razzaghy Azar
Journal: Hepat Mon (2013)
Keywords: diabetes mellitus, spondyloepiphyseal dysplasia, wolcott-rallison syndrome
MeSH terms: Case Reports

Early-onset diabetes, liver dysfunction, growth retardation, spondyloepiphyseal dysplasia, and tendency to skeletal fractures due to osteopenia are characteristics of Wolcott-Rallison syndrome (WRS). Eukaryotic translation initiation factor 2α kinase (EIF2AK3) is the only known gene, which is responsible for this rare autosomal recessive disorder. Here, we report two siblings a girl and a boy with diabetes mellitus (DM) who presented in one and two months of age respectively. Recurrent self-limiting hepatitis developed later, and severe hepatic failure resulted in death of the first child. The second child visited was a 7.75 year old boy who had spondyloepiphyseal dysplasia and subclinical hypothyroidism besides DM and recurrent hepatitis. We suggested WRS for this patient, and it was confirmed by identification of a novel homozygous missense mutation (Q166R) in exon 3 of the EIF2AK3 gene. The aim of this report is to remind the possibility of WRS in isolated neonatal diabetes; while, the other clinical manifestations of this syndrome including its major symptom of recurrent hepatitis may appear later.
First molecular detection of Leishmania (Leishmania) infantum chagasi in a domestic cat ( Felis catus) from an urban area in eastern Amazon
Authors: Délia Cristina Figueira Aguiar, Daniela de Nazaré Dos Santos Nascimento, Dinaiara Fragoso Penner, Brena do Socorro Lima de Castro, Rodrigo Rodrigues Virgolino, Alan Marcel Pamplona Neves, Andrei Dos Santos Siqueira, Evonnildo Costa Gonçalves
Journal: J Venom Anim Toxins Incl Trop Dis (2023)
Keywords: amazon region, eastern amazon, feline leishmaniasis, leishmania (leishmania) infantum chagasi, molecular diagnostic, state of pará
MeSH terms: Case Reports

Background:
Domestic cats have been implicated as accidental hosts of Leishmania sp. However, in recent years, the recurrent description of new cases in endemic and nonendemic areas draw attention to the potential epidemiological role of cats as reservoir hosts. Although dogs are considered urban reservoirs, cats could act as a secondary natural reservoirs in these areas. Thus, feline leishmaniasis has become an emerging disease in several countries worldwide.
Case presentation:
This study aimed to describe the first case of feline leishmaniasis in a stray animal that presented lesions compatible with the disease in Belém, Pará, Brazil, an important urban area in eastern Amazon. Serological tests for Leishmania infantum (ELISA and IFA) were nonreactive, whereas histopathological examination indicated infectious dermatitis caused by Leishmania spp. or Toxoplasma gondii. Cytopathological study of lesion aspirate confirmed the presence of Leishmania sp. amastigotes within macrophages. Finally, molecular analyses revealed that the feline infection was caused by Leishmania (Leishmania) infantum chagasi.
Conclusion:
To the best of the authors' knowledge, this study reports the first case of natural infection by Leishmania (Leishmania) infantum chagasi in a feline from eastern Amazon. These findings suggest domestic cats as potential secondary reservoir hosts of Leishmania spp. in Belém, which reinforces the importance of further epidemiological investigation of feline leishmaniasis, especially in urban areas with human cases.
Surgery After Surgery for Vestibular Schwannoma: A Case Series
Authors: Łukasz Przepiórka, Przemysław Kunert, Wiktoria Rutkowska, Tomasz Dziedzic, Andrzej Marchel
Journal: Front Oncol (2020)
Keywords: facial nerve, gross total resection, revision, surgery, vestibular schwannoma

Objective:
We retrospectively evaluated the oncological and functional effectiveness of revision surgery for recurrent or remnant vestibular schwannoma (rVS).
Methods:
We included 29 consecutive patients with unilateral hearing loss (16 women; mean age: 42.2 years) that underwent surgery for rVS. Previous surgeries included gross total resections (GTRs, n=11) or subtotal resections (n=18); mean times to recurrence were 9.45 and 4.15 years, respectively. House-Brackmann (HB) grading of facial nerve (FN) weakness (grades II-IV) indicated that 22 (75.9%) patients had deep, long-lasting FN paresis (HB grades: IV-VI). The mean recurrent tumor size was 23.3 mm (range: 6 to 51). Seven patients had neurofibromatosis type 2.
Results:
All patients received revision GTRs. Fourteen small- to medium-sized tumors located at the bottom of the internal acoustic canal required the translabyrinthine approach (TLA); 12 large and small tumors, predominantly in the cerebellopontine angle, required the retrosigmoid approach (RSA); and 2 required both TLA and RSA. One tumor that progressed to the petrous apex required the middle fossa approach. Fifteen patients underwent facial neurorrhaphy. Of these, 11 received hemihypoglossal-facial neurorrhaphies (HHFNs); nine with simultaneous revision surgery. In follow-up, 10 patients (34.48%) experienced persistent deep FN paresis (HB grades IV-VI). After HHFN, all patients improved from HB grade VI to III (n=10) or IV (n=1). No tumors recurred during follow-up (mean, 3.46 years).
Conclusions:
Aggressive microsurgical rVS treatment combined with FN reconstruction provided durable oncological and neurological effects. Surgery was a reasonable alternative to radiosurgery, particularly in facial neurorrhaphy, where it provided a one-step treatment.
Concurrent Angiomyolipoma and Clear Cell Renal Cell Carcinoma in the Same Kidney: A Rare Finding in a Patient without Tuberous Sclerosis
Authors: Amal Fekkar, Kaoutar Znati, Fouad Zouaidia, Hafsa Elouazzani, Zakia Bernoussi, Ahmed Jahid
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Synchronous renal cell carcinomas (RCC) and angiomyolipomas (AML) occurring in the same kidney are rare. Cases in the setting of tuberous sclerosis (TS) have been reported in the literature. However, the association of these tumors in the same kidney without TS is even more rare. We report here a case of a clear cell renal cell carcinoma (CCRCC) associated with an AML in the same kidney in a 42 years old female lacking the TS diagnostic criteria. The patient underwent a radical nephrectomy. Six months after surgery, the patient is healthy without signs of tumor recurrence or distant metastasis.
Work-Related De Quervain's Tensosynovitis (DQT): The Diagnosis Dilemma
Authors: Faisal Al Badri
Journal: Cureus (2023)
Keywords: de quervain’s tenosynovitis, ergonomic hazards, exposure assessment, occupational, work-related
MeSH terms: Case Reports

A female presented with right wrist pain for nine months. The diagnosis was De Quervain's tenosynovitis; her condition was initially managed conservatively, but later she needed surgery due to the lack of improvement. No workplace intervention had been implemented because her hand surgeons did not consider her occupational exposures. It was later discovered that there was significant exposure to ergonomic hazards at her workplace. She received accommodations in her workplace that led to reduction of exposure to ergonomic hazards and the subsequent dramatic improvement in her condition. This case report indicates that some orthopedists do not appreciate the role of occupational exposure to ergonomic hazards in the pathogenesis of similar conditions. Occupational medicine specialists and orthopedists should, therefore, communicate with each other to reach a consensus regarding the association between occupational exposures to ergonomic hazards and work-related upper limb disorders (WRULDs).
Refractory cardiopulmonary failure after glyphosate surfactant intoxication: a case report
Authors: Chirn-Bin Chang, Chia-Chu Chang
Journal: J Occup Med Toxicol (2009)

Background:
Glyphosate is an herbicide considered to be of low toxicity to humans because its effects are specific to plants. However, fatal reactions to glyphosate have been reported after the ingestion of large amounts. Pulmonary edema, shock, and arrhythmia were the reported causes of mortality.
Case presentation:
We present the case of a 57-year-old woman who was admitted to the emergency department unconsciousness after ingestion of glyphosate surfactant in a suicide attempt. Metabolic acidosis, refractory respiratory failure, and shock developed during hospitalization. Despite aggressive supportive care, the patient died in the hospital.
Conclusion:
The toxicokinetics of glyphosate surfactant is complicated. Respiratory failure, metabolic acidosis, tachycardia, elevated creatinine, and hyperkalemia are poor prognostic factors if presented. Physicians should consider using hemodialysis early to improve the outcome of patients with glyphosate surfactant intoxication.
Radial Nerve Neuropraxis due to Compression by C-Arm Fluoroscopy in Spine Surgery: A Case Report
Authors: João Bragança, Matthieu Hanauer, Guillaume Racloz
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Introduction:
Peripheral nerve injury is a well-known surgical complication related to the position of the patient. Moreover, in spine surgery, prone position for prolonged period places the patient at increased risk. The aim of this study was to report a case of a radial nerve neuropraxis due to compression by C-arm fluoroscopy during spine surgery. Case Presentation. An 81-year-old-female underwent a posterior spinal fixation L2-S1 due to lumbar spinal stenosis. In the recovery room, she presented an hematoma at the posterolateral part of her arm associated with a wrist drop due to radial nerve neuropraxis. The patient was referred to an occupational therapist and fully recovered four months later. After analysis of the patient positioning during the intervention, we came to the conclusion that this radial nerve injury was very possibly due to a compression by the C-arm fluoroscopy during the surgery.
Conclusion:
Our case describes a rare case of compression of the radial nerve during lumbar spine surgery, which is an unexpected complication as the site of the nerve injury is not at all related to the surgery itself, but to the position of the patient. Although C-arm fluoroscopy is essential, spine surgeons should be aware of this possible complication related to its use in order to avoid it.
Endoscopic Endoluminal Radiofrequency Ablation and Single-Operator Peroral Cholangioscopy System (SpyGlass) in the Diagnosis and Treatment of Intraductal Papillary Neoplasm of the Bile Duct: A Case Report and Literature Review
Authors: Wei Tang, Jian-Guo Qiu, Xu-Fu Wei, Heng Xiao, Xin Deng, Shao-Dong Wang, Cheng-You Du, Qiao Wu
Journal: Front Med (Lausanne) (2021)
Keywords: case report, endoscopic endoluminal radiofrequency ablation, intraductal papillary neoplasm of the bile duct, single-operator peroral cholangioscopy system, spyglass
MeSH terms: Case Reports

Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare biliary benign tumor with atypical clinical features and is frequently misdiagnosed. Its treatment is limited and surgical resection is thought to be the only therapeutic option in patients with IPNB. With the aim of increasing the early diagnosis rate of IPNB and providing more therapeutic options for surgeons, we innovatively put forward the concept of combined utilization of SpyGlass and endoscopic endoluminal radiofrequency ablation (ERFA) in the diagnosis and treatment of IPNB. Case Presentation: An 85-year-old woman was referred to our hospital due to right upper quadrant abdominal pain. The image examinations indicated suspicious filling defects at the upper common bile duct. Further evaluation of SpyGlass cholangioscopy showed multiple reddish villous lesions at the left hepatic duct, and SpyBite biopsy under direct visualization demonstrated papillary low-grade dysplasia. In consideration of the advanced age and preference of the patient, the novel ERFA therapy was performed. The procedure was successful without periprocedural complications; the patient recovered uneventfully and was discharged 2 days after the operation. Upon follow-up, the patient was asymptomatic and in good physical condition at 8 months postoperatively. Conclusion: Preliminarily, we demonstrate that the strategy of a combination of SpyGlass and ERAF seems to be a promising, feasible, well-tolerated, and safe management for patients with IPNB. However, more data with larger patient volumes are needed to evaluate its outcomes further.
Ectopic thymic tissue in subglottis of children: evaluation and management
Authors: Yihang Lin, Junyang Li, Lianyan Xue, Peixuan Sun, Qiao He, Youjin Li
Journal: Braz J Otorhinolaryngol (2023)
Keywords: congenital anomaly, ectopic thymus, subglottis
MeSH terms: Airway Obstruction, Laryngeal Diseases / surgery, Larynx, Case Reports, Review, Child, Child, Preschool, Diagnosis, Differential, Humans, Laryngoscopy / methods, Male

Objectives:
Ectopic thymic tissue in the subglottis is an extremely rare disease that causes airway obstruction. Few cases reported were accurately diagnosed before surgery.
Methods:
A case of a 2-year-old boy with airway obstruction caused by a left subglottic mass was reported. The presentation of radiological imaging, direct laryngoscopy and bronchoscopy, pathology, and surgical management were reviewed. An extensive search in PubMed, EMBASE, Web of Science, Google Scholar, and EBSCO of English literature was performed without a limit of time.
Results:
Besides our case, only six cases were reported since 1987. The definitive diagnosis on these patients were made with the findings of pathology, of which, five were ectopic thymus and two were ectopic thymic cysts. Our case was the only one with a correct suspicion preoperatively. Four cases underwent open surgical resection, and two cases underwent microlaryngeal surgery, while one deceased after emergency tracheostomy. No recurrences were found by six patients during the follow-up after successful treatments.
Conclusion:
Ectopic thymus is a rare condition, infrequently considered in the differential diagnosis of subglottic masses. Modified laryngofissure may be an effective approach to removing the subglottic ectopic thymus and reconstructing the intact subglottic mucosa.
Granular Cell Tumor over the Mons Pubis: An Uncommon Tumor
Authors: M Patabendige, D J Wickramasooriya, L Dasanayake
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Granular cell tumors are uncommon, usually benign, soft tissue neoplasms of neural origin. They occur throughout the body; vulval involvement is uncommon and labium majus is the commonest site in vulva. Complete surgical excision is the preferred treatment of choice to prevent recurrence. Here, we present a benign granular cell tumor over the mons pubis of vulva in a 27-year-old woman.
Visualization of Heart Rate Variability of Long-Term Heart Transplant Patient by Transition Networks: A Case Report
Authors: Joanna Wdowczyk, Danuta Makowiec, Karolina Dorniak, Marcin Gruchała
Journal: Front Physiol (2016)
Keywords: arrhythmias, cardiac autonomic modulation, heart rate variability, heart transplantation, hearth rhythm dynamics, reinnervation

We present a heart transplant patient at his 17th year of uncomplicated follow-up. Within a frame of routine check out several tests were performed. With such a long and uneventful follow-up some degree of graft reinnervation could be anticipated. However, the patient's electrocardiogram and exercise parameters seemed largely inconclusive in this regard. The exercise heart rate dynamics were suggestive of only mild, if any parasympathetic reinnervation of the graft with persisting sympathetic activation. On the other hand, traditional heart rate variability (HRV) indices were inadequately high, due to erratic rhythm resulting from interference of the persisting recipient sinus node or non-conducted atrial parasystole. New tools, originated from network representation of time series, by visualization short-term dynamical patterns, provided a method to discern HRV increase due to reinnervation from other reasons.
Acute abdomen in adult revealing unusual complicated epiploic appendagitis: A case report
Authors: Y Charifi, Y Lamrani, L Chbani, M Maaroufi, B Alami
Journal: Int J Surg Case Rep (2020)
Keywords: abscess, ct scan, epiploic appendagitis
MeSH terms: Case Reports

Introduction:
Epiploic appendagitis is a torsion of fatty appendages of ligamentum trees (1), it's a rare cause of abdominal pain that usually manifests by right or left iliac fossa pain, reminding of appendicitis, diverticulitis or ischemia of the omentum.
Case presentation:
We report the case of a 56 years old male patient admitted for an epigastric pain and a right-upper quadrant abdominal pain, for whom he underwent an abdominal ultrasound and a CT-scan who shown an abscessed mass under colic transverse to the unusual seat.
Discussion:
CT scan is still the key modality for diagnosis, avoiding unnecessary surgery. Complications of primary epiploic appendagitis have rarely been described in the literature (Hwang et al., 2013; Hasbahceci et al., 2012). Another more rare complication is appendagitis with associated abscess, in this condition, we must also think about complicated diverticulitis. The treatment of uncomplicated forms is generally conservative, however, some authors have suggested a surgical method (Saad et al., 2014). For therapeutic management of its complication, there has been much interest in the use of minimally invasive techniques such as percutaneous drainage to minimize the morbidity and mortality that is associated with surgery (Evidence National Guideline Centre (UK), 2019).
Conclusion:
The diagnosis of epiploic appendagitis is still uncommon, CT scan can eliminate other diagnosis of acute abdominal pain such as diverticulitis and appendicitis. It also allows the diagnosis of the rare complicated forms such as abscesses associated with epiploic appendagitis. The treatment of typical forms is usually conservative, while the complicated form requires surgery because of the potential associated pathology.
Internuclear Ophthalmoplegia Secondary to Cocaine Abuse
Authors: Richard L Rabin, Azeem Wasay, Nicolas Biro, Marcelle Morcos
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Purpose. To report a case of internuclear ophthalmoplegia (INO) caused by cocaine. Method. We report a case of a 54-year-old female who presented with a left INO three days after snorting cocaine, and we review the literature. Results. MRI of the brain demonstrated several small abnormal foci in the pons on FLAIR and diffusion weighted imaging consistent with ischemic infarction. The patient's symptoms remained stable throughout her hospitalization. She was sent to a rehabilitation facility and was lost to follow-up. Conclusion. In cases of extraocular movement abnormalities, it is important to inquire about recreational drug use.
Stanford type A aortic dissection after urgent prosthetic valve replacement: case reports
Authors: Yoshihiro Suematsu, Sei Morizumi, Kenichi Okamura, Mitsuhiro Kawata
Journal: J Cardiothorac Surg (2014)
MeSH terms: Aortic Aneurysm, Thoracic / etiology, Aortic Dissection / etiology, Aortic Valve Insufficiency / surgery, Heart Valve Prosthesis Implantation / adverse effects, Mitral Valve Insufficiency / surgery, Vascular Surgical Procedures / methods, Case Reports, Acute Disease, Angiography, Aortic Aneurysm, Thoracic / diagnosis, Aortic Aneurysm, Thoracic / surgery, Aortic Dissection / diagnosis, Aortic Dissection / surgery, Echocardiography, Humans, Male, Middle Aged, Reoperation, Tomography, X-Ray Computed

Occurrence of acute aortic dissection after aortic valve replacement is rare, however, it is associated with high mortality and morbidity rates. We report two Asian cases in which acute aortic dissection occurred after urgent aortic valve replacement for infective endocarditis. Successful graft replacement was carried out with preservation of the prosthetic valves in both cases. Our experience with these cases suggests that, even in urgent or emergent situations, surgical intervention for associated aortic dilatation should be considered when aortic valve replacement is performed.