OpenMed/multicare-articles huggingface dataset:
Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature
Authors: Mohammed AlKindi, Sundar Ramalingam, Lujain Abdulmajeed Hakeem, Manal A AlSheddi
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Salivary gland tumors (SGT) comprise 3% of all head and neck tumors, are mostly benign, and arise frequently in the parotid gland. Pleomorphic adenoma (PA) is the commonest SGT, representing 60-70% of all benign parotid tumors. Clinically, parotid PA presents as irregular, lobulated, asymptomatic, slow-growing preauricular mass, involving both superficial and deep lobes, and could grow to gigantic proportions. Histologically, PA has epithelial and mesenchymal elements in chondromyxoid matrix and is managed surgically. Based on a review of 43 cases reported in English literature since 1995, giant parotid PA is reported as large as 35 cm (diameter) and 7.3 kg (resected weight). Although rare, 10 cases of malignant transformation were reported in the review. Surgical management included extracapsular dissection (ECD), superficial parotidectomy, and total parotidectomy for benign tumors, and adjuvant radiation or chemotherapy for malignant tumors. We further present the case of a 36-year-old healthy male with slow-growing and asymptomatic giant parotid PA, of 4-year duration. The patient presented with firm, lobulated preauricular swelling, provisionally diagnosed as PA based on radiographic and cytological findings. The tumor was resected through ECD, and the patient had uneventful postoperative recovery and a 7-year recurrence-free follow-up period. Histological examination revealed epimyoepithelial proliferation punctuated by chondromyxoid areas, with extensive squamous metaplasia and keratin cysts. To the best of knowledge from indexed literature, giant parotid PA is rarely reported in Saudi Arabia. In addition to its rarity, this case is reported for its benign nature despite atypical histological presentation, successful surgical management without complications, and long-term recurrence-free follow-up. Based on this report, clinicians must be aware of atypical histological presentations associated with PA and plan suitable surgical management and follow-up to avoid morbidity. Nevertheless, attempts must be made to diagnose and manage these lesions at an early stage and before they reach gigantic proportions.
Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination
Authors: Samy Hakroush, Björn Tampe
Journal: Front Immunol (2021)
Keywords: anca-associated vasculitis (aav), acute kidney injury (aki), anti-neutrophil cytoplasmic antibody (anca), coronavirus disease 2019 (covid-19), pauci-immune crescentic glomerulonephritis (gn), rhabdomyolysis, vaccination
MeSH terms: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / pathology, COVID-19 Vaccines / adverse effects, Glomerulonephritis / pathology, Rhabdomyolysis / pathology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / diagnosis, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / immunology, Antibodies, Antineutrophil Cytoplasmic / blood, Antibodies, Antineutrophil Cytoplasmic / immunology, BNT162 Vaccine, COVID-19 / prevention & control, COVID-19 Vaccines / immunology, Female, Glomerulonephritis / diagnosis, Glomerulonephritis / immunology, Humans, RNA, Messenger / immunology, Rhabdomyolysis / diagnosis, Rhabdomyolysis / immunology, Antibodies, Antineutrophil Cytoplasmic, COVID-19 Vaccines, RNA, Messenger, BNT162 Vaccine

As the coronavirus disease 2019 (COVID-19) pandemic is ongoing and new variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are emerging, there is an urgent need for COVID-19 vaccines to control disease outbreaks by herd immunity. Surveillance of rare safety issues related to these vaccines is progressing, since more granular data emerge with regard to adverse events of COVID-19 vaccines during post-marketing surveillance. Interestingly, four cases of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) presenting with pauci-immune crescentic glomerulonephritis (GN) after COVID-19 mRNA vaccination have already been reported. We here expand our current knowledge of this rare but important association and report a case of AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN after Pfizer-BioNTech COVID-19 mRNA vaccination. As huge vaccination programs are ongoing worldwide, post-marketing surveillance systems must continue to assess vaccine safety important for the detection of any events associated with COVID-19 vaccination. This is especially relevant in complex diseases where diagnosis is often challenging, as in our patient with AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN.
Central retinal vein occlusion with therapeutic level of anticoagulation
Authors: Sarwat Salim, Wai-Ching Lam, Wahid Hanna
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Purpose. To describe a patient with two episodes of deep venous thrombosis and factor V Leiden mutation who presented with central retinal vein occlusion (CRVO) despite prophylactic use of warfarin sodium (Coumadin). Methods. A case report of a 44-year-old woman with a history of recurrent deep venous thrombosis and Factor V Leiden mutation was placed on lifelong prophylactic therapy with warfarin. The patient presented with CRVO in the left eye despite therapeutic levels of warfarin. Results. Extensive systemic evaluation disclosed high titers for antinuclear antibody (ANA). Conclusion. Systemic anticoagulation with warfarin may not preclude further thrombotic episodes. In younger patients presenting with retinal vein occlusion and pre-existing multiple thrombophilic risk factors, a multidisciplinary approach is recommended to explore other therapeutic options to avoid further thromboembolic complications.
Cosmetic "Gold Thread Therapy": A Nuisance That Decreases the Diagnostic Quality of a Dental Panoramic Image
Authors: Mah Eng Ching, Lim Zhi Yin Joan, Phrabhakaran Nambiar
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

During routine imaging of the craniofacial region, it is recognised that some "cosmetic" procedures with metallic insertions can be revealed radiographically. These objects however make it difficult to obtain a good interpretation of anatomical structures for management of diseases. A 58-year-old female patient visited a private dental facility in Kuala Lumpur for prosthodontic replacement of missing teeth. The dental panoramic image revealed generalized bone loss and numerous unusual multiple thread-like radioopacities. These gold threads made radiographic evaluation difficult and complicated the process of treatment planning for dental implant placement advocated for this patient.
Vicia faba Hypersensitivity and ASA Intolerance in a Farmer: A Case Report
Authors: Elisabetta Damiani, Anna Maria Aloia, Maria Giovanna Priore, Angela Pastore, Stefania Nardulli, Cristina Lippolis, Luigi Macchia, Antonio Ferrannini
Journal: J Allergy (Cairo) (2011)
MeSH terms: Case Reports

The IgE-mediated allergic reactions to food are caused, generally, by ingestion. However, they can be rarely induced by exposure to airborne food particles through the handling or the cooking. Vicia faba is a vegetable which belongs to Legumes or Fabaceae family, Fabales order. Allergic reactions after ingestion of legumes and cases of asthma after exposure to the cooking vapors have been reported in the literature. A paper assessed the volatile substances (insect repellents) released by V. faba. The authors demonstrated that this plant produces several chemical substances, such as small quantities of methyl salicylate. We describe a case of occupational allergy, induced by handling during picking up of fresh broad beans, in a farmer with history of adverse reaction after eating the cooked and raw vegetable.
Hyporegenerative anemia and other complications of rhesus hemolytic disease: to treat or not to treat is the question
Authors: Aqeel Abdullah Alaqeel
Journal: Pan Afr Med J (2019)
Keywords: rhesus haemolytic disease, erythropoietin, hyporegenerative anaemia
MeSH terms: Anemia / therapy, Erythroblastosis, Fetal / therapy, Erythropoietin / administration & dosage, Rh Isoimmunization / complications, Case Reports, Anemia / etiology, Blood Transfusion / methods, Hemoglobins / metabolism, Humans, Infant, Newborn, Male, Recombinant Proteins / administration & dosage, Time Factors, EPO protein, human, Hemoglobins, Recombinant Proteins, Erythropoietin

Rhesus hemolytic disease of the newborn is rarely found after the implementation of anti-D immunoglobulin prophylaxis. However, it may lead to cholestasis, elevated liver transaminases, iron overload and late hyporegenerative anemia when it occurs. Etiology of this type of anemia is not defined yet and treatment is controversial. It is typically recognized after two weeks of life which is characterized by low hemoglobin and reticulocyte count. We have reported a case of a neonate with Rh hemolytic disease with late hyporegenerative anemia that was noted at day 18 of life. We treated this anemia by erythropoietin (EPO) 250 U/kg three times per week. Two weeks after initiation of erythropoietin treatment, a stable hemoglobin was noted along with an increased reticulocyte count. The patient required one further blood transfusion in the third week of therapy. Other associated findings were self-limited. A year of follow-up showed an appropriate development for age.
Axial Spondyloarthritis and Autosomal Dominant Polycystic Kidney Disease in Two Siblings: A Rare Cooccurrence
Authors: Ozan Volkan Yurdakul, Abdulkerim Furkan Tamer, Okan Küçükakkaş, Aylin Rezvani
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

Autosomal dominant polycystic kidney disease (ADPKD) is the most frequently occurring hereditary kidney disease, and axial spondyloarthritis (SpA) is one of the most frequently occurring rheumatic diseases. Treatment-related decisions for axial SpA may pose a challenge in case of renal involvement. The authors describe two siblings with cooccurrence of these two diseases. The association of these two diseases is not well known. Practitioners should monitor renal function in SpA patients and take treatment-related decisions regarding renal involvement. Antitumor necrosis factor-alpha (anti-TNF-α) agents may be used in case nonsteroidal anti-inflammatory drugs (NSAIDs) cannot be utilized.
Hypertrophic pyloric stenosis case series in twins and first cousins: genes, feeding patterns or both? (a case report)
Authors: Konstantinos Skarentzos, Maria Aggelidou, Deftereos Savas, Konstantina Bekiaridou, Katerina Kambouri
Journal: Pan Afr Med J (2021)
Keywords: pyloric stenosis, case report, first cousins, twins
MeSH terms: Bottle Feeding, Pyloric Stenosis, Hypertrophic / diagnosis, Pyloromyotomy / methods, Case Reports, Family, Humans, Infant, Infant, Newborn, Male, Pyloric Stenosis, Hypertrophic / etiology, Pyloric Stenosis, Hypertrophic / surgery, Risk Factors, Twins, Dizygotic

We present two cases of dizygotic male twins and two cases of male first cousins with infantile hypertrophic pyloric stenosis (IHPS). All patients were treated with open pyloromyotomy. No complications were reported. The patients had the same risk factors for IHPS. First, all patients were first-born white males. Second, the twins were preterm (35 weeks). Third, the twins and the first cousins were exclusively bottle feeding. Thus, a combination of genetic and environmental factors may have contributed to the appearance of IHPS.
Case report: Camrelizumab associated with central retinal vein occlusion
Authors: Yixiang Zhan, Weipeng Zhao, Kemin Ni, Zhaoce Liu, Yanjun Su, Xichuan Li, Heng Zhang, Chunze Zhang
Journal: Front Immunol (2022)
Keywords: camrelizumab, case report, central retinal vein occlusion, immunotherapy, lung cancer, vitreous hemorrhage
MeSH terms: Melanoma / drug therapy, Retinal Vein Occlusion / diagnosis, Retinal Vein Occlusion / drug therapy, Case Reports, Eye, Humans, Immunotherapy, Male, Middle Aged, Vitreous Hemorrhage

Immunotherapy has revolutionized cancer treatment and become one of the five pillars of cancer therapy. The clinical applications of immunotherapy have been adapted to range from the management of melanoma to most tumor types. As the clinical applications of cancer immunotherapies expand, understanding the treatment-related adverse events of these drugs becomes critical in clinical practice. We report a rare case of ocular immune-related side effects associated with camrelizumab that resulted in vision loss. A 56-year-old male patient was diagnosed with small cell lung cancer. The tumor involved the porta pulmonis and mediastinum upon initial diagnosis; therefore, surgery was not possible. Upon receiving the 10th immunotherapy session with camrelizumab 200 mg, the patient's visual acuity began to decrease in his right eye and a central retinal vein occlusion. Optical coherence tomography revealed significant cystoid exudation in the macular area and vitreous hemorrhage. The patient underwent vitrectomy, phacoemulsification and intraocular lens implantation after symptom onset. Following surgery, the patient's vision was limitedly restored. This is the first clinical report in China of central retinal vein occlusion and vitreous hemorrhage associated with anti-PD-1 therapy, ultimately leading to blindness. Although rare, clinical practitioners should be concerned about ocular adverse events associated with anti-PD-1 immunotherapy and develop a high index of suspicion for this possibility since ophthalmic manifestations that are rapidly detected, closely monitored, and appropriately managed are treatable.
A Long-Term Survivor with Tetralogy of Fallot Treated Only with the Classical Blalock-Taussig Shunt
Authors: Yu Yamada, Tomoko Ishizu, Hidekazu Tsuneoka, Yutaka Eki, Hitoshi Horigome
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

The prognosis of tetralogy of Fallot (TOF) treated only with Blalock-Taussig shunt (BTS) operation is unclear. A woman with TOF underwent classic BTS operation at 10 years of age. Despite no medication, she delivered two children and worked without apparent heart failure. At 72 years of age, she complained of dyspnea on exertion and leg edema. The cardiac angiogram revealed a well-patent BTS and severely stenotic right ventricular outflow tract. Right heart catheterization showed adequately maintained pulmonary blood flow with slight pulmonary arterial hypertension. Her unexpected yet favorable outcome reaffirms the importance of structural and functional self-adaptation even with cyanosis. If she had undergone a valve-sparing corrective surgery in adolescence, much better quality of life and outcome could have been expected.
The Enigma behind Pituitary and Sella Turcica
Authors: Umarevathi Gopalakrishnan, Lodd Mahendra, Sumanth Rangarajan, Ramasamy Madasamy, Mohammad Ibrahim
Journal: Case Rep Dent (2015)

The pituitary gland's role as a functional matrix for sella turcica has not been suggested in orthodontic literature. This paper is an attempt to correlate the role of pituitary gland in the development of sella turcica. A case report of dwarfism associated with hypopituitarism is presented to highlight the above hypothesis.
Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion
Authors: Julien Pauchot, Emilie Ducroux, Grégoire Leclerc, Laurent Obert, Anne Pauline Sergent
Journal: Eplasty (2015)
Keywords: free flap, knee dislocation, microsurgery, omentum, vascular bypass
MeSH terms: Case Reports

Objective:
To report on the original surgical management of a patient with severe trauma of both legs involving anastomosis of an omentum free flap with an emergency vascular bypass.
Methods:
After stabilization of the knee with an external fixator, a femoral-tibial bypass graft was performed to revascularize the leg with the contralateral great saphenous vein. Ten days later, an omentum free flap was used with an end-to-side arterial anastomosis between the right gastroepiploic artery and bypass graft to cover the loss of leg substance.
Discussion:
Anastomosis of a free flap with a single axis exposes the patient to risks of thrombosis and amputation. Lengthening of the arterial pedicle of the flap by venous graft or vascular loop might have allowed for avoidance of connection to the bypass. Nevertheless, the saphenous vein, generally used in these indications, was already harvested. The transitional anastomosis of the flap to the contralateral leg could not be considered because of the leg amputation. End-to-side anastomosis to the bypass presents many advantages: anastomosis with a healthy vessel without posttraumatic vascular disease, the superficial characteristics of the bypass, and lower incongruence of the thickness between the vessels compared with an anastomosis performed directly on the superficial femoral artery.
Conclusion:
A free flap anastomosed to an emergency arterial bypass is a rare situation, which is not without risk, but it is an option that is justified by its technical simplicity. However, it should only be considered in exceptional circumstances.
Acquired Factor VIII Deficiency Presenting as Gross Hematuria in a Hispanic, Pregnant Patient with Previously Undiagnosed Connective Tissue Disease
Authors: Christine Loftis, Emilia C Dulgheru, Rosa White
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Acquired factor VIII deficiency is a bleeding disorder caused by the presence of autoantibodies against clotting factor VIII. We report a case of a 24-year-old pregnant woman who presented with gross hematuria secondary to acquired factor VIII deficiency in the presence of a previously undiagnosed connective tissue disease. This article includes a literature review of pregnancy-related cases of acquired factor VIII deficiency. We also reviewed various therapeutic approaches for the management of the acquired factor inhibitor which include achieving hemostasis and elimination of the inhibitor via immunosuppressive agents. This case report describes the rare presentation of acquired factor VIII deficiency related to pregnancy and highlights the importance of considering a factor VIII inhibitor in the differential diagnosis of patients who present with bleeding and prolonged PTT during the peripartum and postpartum periods.
Cerebral vein thrombosis misdiagnosed and mismanaged
Authors: P K Sasidharan
Journal: Thrombosis (2012)

Cerebral venous thrombosis (CVT) should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management.
Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural
Authors: Alqasem Fuad H Al Mosa, Mohammed Ishaq, Mohamed Hussein Mohamed Ahmed
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Chest tube malpositioning is reported to be the most common complication associated with tube thoracostomy. Intraparenchymal and intrafissural malpositions are the most commonly reported tube sites. We present a case about a 21-year-old patient with cystic fibrosis who was admitted due to bronchiectasis exacerbation and developed a right-sided pneumothorax for which a chest tube was inserted. Partial initial improvement in the pneumothorax was noted on the chest radiograph, after which the chest tube stopped functioning and the pneumothorax remained for 19 days. Chest computed tomography was done and revealed a malpositioned chest tube in the right side located inside the thoracic cavity but outside the pleural cavity (intrathoracic, extrapleural). The removed chest tube was patent with no obstructing materials in its lumen. A new thoracostomy tube was inserted and complete resolution of the pneumothorax followed.
Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report
Authors: Iven-Alex von Mücke-Heim, Isabelle Walter, Sandra Nischwitz, Angelika Erhardt
Journal: Front Psychiatry (2022)
Keywords: applied tension, blood-injury-injection phobia, distress tolerance skills, fainting, individualization, psychogenic non-epileptic seizures, psychotherapy (exposure)
MeSH terms: Case Reports

Background:
Anxiety disorders are the most frequent mental disorders. Among the different subtypes, specific phobias are the commonest. Due to the ongoing SARS-CoV-19 pandemic, blood-injury-injection phobia (BII) has gained wider attention in the context of large-scale vaccination campaigns and public health. In this BII phobia mini-review and case report, we describe the successful treatment of a severe BII phobia case with combined fainting and psychogenic non-epileptic seizures (PNES) and demonstrate the role of specialized outpatient care.
Case report:
The patient was a 28-year-old woman. She suffered from intense fear and recurrent fainting with regard to needles, injections, injuries, and at the sight of blood since early childhood. Medical history revealed infrequent events suggestive of PNES following panic attacks after sustained exposure to phobic stimuli. Family history was positive for circulation problems and BII fears. Psychopathological evaluation confirmed BII phobia symptoms and diagnosis was made according to the DSM-5. The Multidimensional Blood/Injury Phobia Inventory short version (MBPI-K) revealed severe manifestation of the disease. Neurological examination was ordinary. Repeated electroencephalography detected no epileptic pattern. Cranial magnetic resonance imaging showed normal morphology. Treatment was carried out by a seasoned, multidisciplinary team. Cognitive behavior therapy and exposure were performed. Modification of standard treatment protocol was necessary due to hurdles posed by recurrent fainting and a severe panic-triggered dissociative PNES during in vivo exposure. Modification was implemented by limiting in vivo exposure intensity to moderate anxiety levels. In addition to applied muscle tension and ventilation techniques, increased psychoeducation, cognitive restructuring, and distress tolerance skills (e.g., ice pack, verbal self-instructions) were used to strengthen the patient's situational control during in vivo exposure. A total of 15 sessions were performed. Therapy success was proven by 83% reduction in MBPI-K rating, SARS-CoV-19 vaccination, and a blood draw without psychological assistance, fainting, or seizure.
Conclusion:
Taken together, this case demonstrates the potential of and need for specialized outpatient care and individualized treatment for severe BII phobia patients in order to provide them the perspective to have necessary medical procedures done and get vaccinated.