OpenMed/multicare-articles huggingface dataset:
Metastatic diffuse follicular variant papillary thyroid cancer without cervical lymph node metastasis presenting with symptoms related to hypopituitarism
Authors: Muhammed Kızılgül, Ömer Bayır, Bekir Uçan, Pınar Akhanlı, Hakan Düğer, Muhammed Erkam Sencar, Hayri Kertmen, Demet Yılmazer, Doğan Yazılıtaş, Güleser Saylam, Mehmet Hakan Korkmaz, Erman Çakal
Journal: Einstein (Sao Paulo) (2023)
MeSH terms: Hypopituitarism / diagnostic imaging, Hypopituitarism / etiology, Hypopituitarism / surgery, Thyroid Neoplasms / complications, Thyroid Neoplasms / diagnostic imaging, Thyroid Neoplasms / pathology, Case Reports, Aged, Humans, Iodine Radioisotopes, Lymphatic Metastasis, Male, Sorafenib, Thyroid Cancer, Papillary / complications, Thyroid Cancer, Papillary / surgery, Thyroidectomy / methods, Sorafenib, Iodine Radioisotopes

In this article, we present a case of diffuse follicular variant papillary thyroid carcinoma with pituitary metastasis, which is a rare cause of pituitary metastasis. The follicular variant of papillary thyroid carcinoma is an uncommon variant of papillary carcinoma. A 74-year-old male was presented with weakness, fatigue, and a decreased appetite. The patient was diagnosed with secondary adrenal and thyroid insufficiencies. Imaging revealed a pituitary mass with suprasellar extension, right cavernous sinus invasion, and optic chiasm compression. Thyroid ultrasonography revealed a nodule with a maximum size of 7.2cm in the right lobe. Cytological examination via fine-needle aspiration suggested papillary thyroid cancer. Total thyroidectomy with central and right lateral neck dissection confirmed the diagnosis of diffuse follicular variant of papillary thyroid carcinoma. Owing to visual field defects, the patient underwent transsphenoidal surgery. Histological and immunohistochemical evaluations confirmed pituitary metastasis from the papillary thyroid cancer. Radioactive iodine treatment and gamma knife radiotherapy of the pituitary gland were performed. The initiation of sorafenib treatment was deemed appropriate during the follow-up. A significant decrease in the thyroglobulin levels was observed after sorafenib treatment. Pituitary metastasis should be considered in patients diagnosed with hypopituitarism and pituitary lesions at initial evaluation. The presence of visual field defects may be an indication for neurosurgical intervention and guide both diagnosis and treatment. The management of papillary thyroid cancer and the role of treatment modalities in prognosis depend on the biological behavior of the tumor. Early diagnosis and multidisciplinary management are crucial for the treatment of these patients.
In situ reconstruction of vascular inflow/outflow to left lateral liver section, ex-vivo liver resection and autologous liver transplantation of remaining liver remnant for hepatic alveolar echinococcosis
Authors: Yu Zhang, Eric C H Lai, Chong Yang, Hongji Yang, Jun Liu, Guo Zhou, Di Xian, Shaoping Deng, Wan Yee Lau
Journal: Int J Surg Case Rep (2020)
Keywords: auxiliary autologous liver transplantation, ex-vivo liver resection, hepatic alveolar echinococcosis, hepatic vein reconstruction
MeSH terms: Case Reports

Objective:
This is a case report on a patient with advanced hepatic alveolar echinococcosis (HAE) treated with autologous liver transplantation without any veno-venous bypass using the modified technique of ex vivo liver resection and autologous liver transplantation (the ERAT technique).
Method:
A 27-year old male with advanced HAE underwent in situ reconstruction of vascular inflow/outflow to left lateral liver section, ex-vivo liver resection and autologous liver transplantation of remaining liver remnant (the modified ERAT technique). The operation consisted of hepatotomy along the right border of the falciform ligament, reconstruction of portal vein supplying the left lateral liver section, reconstruction of left hepatic vein, followed by removal of liver segments S1, S4 to S8, ex vivo resection of all involved tissues within these liver segments in the liver remnant, and autologous liver transplantation of the resected liver remnant. The whole surgical procedure lasted for 12 h, and the blood lost was 800 mL. The patient recovered uneventfully in the post-operation period.
Conclusion:
The in situ reconstruction of the vascular inflow/outflow of left lateral liver section maintained the PV circulation and provided liver functional support during the operation. The subsequent autologous liver transplantation provided additional liver functional tissues, thus reduced the risk of post-hepatectomy liver failure. This surgical procedure did not require any veno-venous bypass.
DYSTROPHIC CALCIFICATION OF MAXILLARY SINUS IN PEDIATRIC PATIENTS WITH LIVER TRANSPLANTATION AND PIGMENTATION OF DENTAL ORGAN
Authors: Adriana Furtado de Macedo, Claudio Costa, Regina Helena Guedes da Motta Mattar, Ramiro Anthero de Azevedo
Journal: Rev Paul Pediatr (2017)
MeSH terms: Bilirubin, Calcinosis / pathology, Liver Transplantation, Maxillary Sinus / pathology, Paranasal Sinus Diseases / pathology, Pigmentation, Postoperative Complications / pathology, Tooth Diseases / pathology, Case Reports, Calcinosis / complications, Calcinosis / diagnostic imaging, Child, Female, Humans, Paranasal Sinus Diseases / complications, Paranasal Sinus Diseases / diagnostic imaging, Postoperative Complications / diagnostic imaging, Tooth Diseases / complications, Bilirubin

Objective:
To report a case of severe dystrophic calcification in maxillary sinus of a child with liver transplantation and dental organs pigmented by hyperbilirubinemia.
Case description:
female patient, 12 years old, with liver transplantation performed at the age of 7 due to extrahepatic biliary atresia (EHBA). The patient was receiving the immunosuppressant tacrolimus (2 mg daily). Intraoral clinical exam showed tooth green pigmentation by bilirubin. Cone-beam volumetric computed tomography (CT) was performed to verify radiographic density of pigmented dental elements. Hounsfield scale measurement did not show changes in radiographic density of dental structures. However, CT scan showed intense dystrophic calcification in the maxillary sinus region.
Comments:
CT scan indicated relevant radiographic findings, with radiopacity of the maxillary sinus due to fungal or non-fungal sinusitis. This case report highlights the presence of radiographic image associated with acute infectious processes that could compromise the systemic state of immunosuppressed patients.
Characteristic Poses in Ballet in the Case of a Retired Classical Ballerina after Bilateral THA: A Case Report and Review of Literature
Authors: Futoshi Morio, Shigeo Fukunishi, Tomokazu Fukui, Makoto Kanto, Kenta Amai, Shinichi Yoshiya, Toshiya Tachibana
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Background:
Ballet dance involves extreme range of motion (ROM) in the hip joint. This ROM can cause injuries including labral strain, tears, and subluxation episodes. Case Presentation. A 69-year-old female classical ballet dance instructor presented bilateral hip pain. The plain radiograph showed end-stage osteoarthritic change in the bilateral hip. She could neither dance nor perform daily activities. Bilateral hybrid total hip arthroplasty (THA) was performed. After surgery, she was able to demonstrate the split position on the floor as an active classical ballerina. The plain radiograph was taken in the split position, and the radiograph did not show any characteristics of impingement or subluxation of the femoral head.
Conclusion:
She was able to continue working as a classical ballet instructor after bilateral THA. Additionally, any characteristics of impingement or subluxation of the femoral head were not revealed in the postoperative radiograph in the split position.
Peripheral retinal nonperfusion using widefield imaging with von Hippel-Lindau disease
Authors: Jose S Pulido, Lauren A Dalvin, Timothy W Olsen, Fukutaro Mano, Michael Yu, Carol L Shields
Journal: Int J Retina Vitreous (2018)
Keywords: eye, fluorescein angiography, hemangioblastoma, nonperfusion, tumor, von hippel-lindau
MeSH terms: Case Reports

Background:
To describe a case of von Hippel-Lindau disease with peripheral retinal nonperfusion.
Case presentation:
A 66-year-old female with known cerebellar and midbrain hemangioblastomas was evaluated for a retinal hemangioblastoma in the right eye. She underwent widefield fluorescein angiography, which showed hyperfluorescence localized to the hemangioblastoma surrounded by peripheral retinal nonperfusion in the same quadrant.
Conclusions:
Further widefield imaging studies are required to determine if peripheral retinal nonperfusion is a common finding in von Hippel-Lindau disease.
G-CSF-Associated Bone Marrow Necrosis in AML after Induction Chemotherapy
Authors: Ikenna Osuorji, Lyle Goldman
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

Bone marrow necrosis (BMN) is defined as necrosis of the myeloid tissues and stroma without involvement of the cortical bone. We report a case of 66-year-old male with AML-M4 (FAB classification) who was given induction chemotherapy with cytarabine and daunorubicin. Filgrastim at 480 micrograms was administered on days 15-19 to shorten the duration of neutropenia. Consequently patient developed severe pelvic bone pain, leukoerythroblastosis, and severe leukocytosis. Repeat bone marrow aspiration and biopsy on day 21 confirmed bone marrow necrosis. These manifestations responded quickly to discontinuation of filgrastim. Subsequently, he recovered full myelopoiesis. We suggest that there may be more cases of BMN associated with G-CSF that are undiagnosed.
An Intratumoral Aneurysm and an Extrarenal Synchronous Cystic Tumour in a Case of a Renal Cell Carcinoma
Authors: Supun De Silva, Lalani De Silva, Susantha De Silva, Priyani Amarathunga
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Background:
Renal cell carcinoma is a heterogeneous group of malignant tumors originating from the kidney. We report a case of a renal cell carcinoma with two very rare associates, i.e., a large intratumoral aneurysm and a synchronous extrarenal cystic tumor outside the main tumor. Case Presentation. A 31-year-old woman, who presented with painless hematuria and loin pain, was diagnosed to have a large renal mass measuring 15 × 9 × 8.5 cm with an intralesional arterial aneurysm measuring 4.5 × 3.5 cm on radiological examination. During surgery, a separate cystic tumor measuring 5 × 4.5 × 4 cm with distinct vascular supply was noted anteromedial to the kidney, in addition to the renal mass. The histology of the main tumor was compatible with t(6:11) type microphthalmia-associated transcription factor (MiT) family translocation RCC. The aneurysm was of venous origin histologically, and a radiologically demonstrable arteriovenous fistula was recognized retrospectively. The extrarenal cyst has also showed similar histology to that of main tumor and had no evidence of a degenerated lymph node. Discussion. Although few cases were reported with various vascular anomalies associated with a renal tumor, this is the first ever case to find an arteriovenous fistula with a secondary venous aneurysm located inside a malignant renal mass. Similarly, no solid RCC is reported to present with an extrarenal malignant cystic nodule. The prognostic and oncological significance of the extrarenal malignant cyst is unclear. Both of these extraordinary features of this case were not properly identified on preoperative imaging. Reviewing the preoperative imaging when pathology reports are available helps to overcome difficulties in making the final diagnosis of complex cases.
Conclusion:
RCCs can house vascular anomalies like arteriovenous fistula and venous aneurysms and can exist with concomitant extrarenal malignant cystic nodules.
Riedel's Thyroiditis: Report of Two Cases and Literature Review
Authors: Victor Manuel Blanco, Camilo Andrés Páez, Angela María Victoria, Luis Guillermo Arango, Ana María Arrunategui, Juliana Escobar, Veline Martínez, Guillermo Edinson Guzmán
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Riedel's thyroiditis is a rare entity consisting of a fibrotic process of the thyroid which can generate gland destruction, infiltration of cervical structures and even airway obstruction. It has been associated with systemic fibrotic disorders, autoimmune diseases, and more recently with spectrum of diseases related to excess of Immunoglobulin G type 4 (IgG4). Two cases of Riedel's thyroiditis by IgG4, confirmed by immunohistochemistry and was managed surgically with favorable results during the follow-up time, are presented. These case descriptions highlight the diagnostic challenge of this disease, describe the response with surgical management, and make a brief update on the subject.
Long-term survival in a patient with progressive multifocal leukoencephalopathy after therapy with rituximab, fludarabine and cyclophosphamide for chronic lymphocytic leukemia
Authors: Heidys Garrote, Adolfo de la Fuente, Raquel Oña, Inmaculada Rodríguez, Juan E Echevarría, Juan M Sepúlveda, Juan F García
Journal: Exp Hematol Oncol (2015)
Keywords: demyelization, immune system suppression, john cunningham virus, progressive multifocal leukoencephalopathy
MeSH terms: Case Reports

A 50-year-old male with chronic lymphocytic leukemia (CLL) was treated with fludarabine, cyclophosphamide and rituximab, which produced a complete remission. Eight months after the last dose of rituximab he had visual disturbance, diminished muscular strength in the right arm and vesicular-papular lesions in the left ophthalmic branch region of the V cranial nerve. These were initially interpreted as herpes virus encephalopathy (HVE), but brain magnetic resonance imaging (MRI) showed evidence of demyelination consistent with progressive multifocal leukoencephalopathy (PML). Cerebrospinal fluid (CSF) analysis was negative for varicella zoster virus (VZV) and John Cunningham virus (JCV) DNA. The clinical suggestion of PML prompted us to perform a brain biopsy and to start treatment with mefloquine. In the brain biopsy, histopathological features of demyelination were described and the polymerase chain reaction (PCR) identified JCV, confirming the diagnosis of PML. Treatment with mefloquine (250 mg/week) and dexamethasone (4 mg/day) was started and maintained for 6 months. A year later there was an almost complete resolution of the MRI lesions and the patient achieved a stable clinical state with persisting motor impairment and severe epilepsy. The patient is alive 38 months after diagnosis of PML, which is the longest known survival to date.
Resection and Resolution of Bone Marrow Lesions Associated with an Improvement of Pain after Total Knee Replacement: A Novel Case Study Using a 3-Tesla Metal Artefact Reduction MRI Sequence
Authors: Thomas Kurien, Robert Kerslake, Brett Haywood, Richard G Pearson, Brigitte E Scammell
Journal: Case Rep Orthop (2016)

We present our case report using a novel metal artefact reduction magnetic resonance imaging (MRI) sequence to observe resolution of subchondral bone marrow lesions (BMLs), which are strongly associated with pain, in a patient after total knee replacement surgery. Large BMLs were seen preoperatively on the 3-Tesla MRI scans in a patient with severe end stage OA awaiting total knee replacement surgery. Twelve months after surgery, using a novel metal artefact reduction MRI sequence, we were able to visualize the bone-prosthesis interface and found complete resection and resolution of these BMLs. This is the first reported study in the UK to use this metal artefact reduction MRI sequence at 3-Tesla showing that resection and resolution of BMLs in this patient were associated with an improvement of pain and function after total knee replacement surgery. In this case it was associated with a clinically significant improvement of pain and function after surgery. Failure to eradicate these lesions may be a cause of persistent postoperative pain that is seen in up to 20% of patients following TKR surgery.
Lupus Nephritis in an Adolescent Girl With Hyper-Immunoglobulin E
Authors: Ghadeer G Alahmadi, Sherif M El-Desoky, Reem A Al Zahrani, Jameela A Kari
Journal: Cureus (2023)
Keywords: hyper ige syndrome, immune complexes, immune dysregulation, lupus nephritis, systemic lupus erythematosus
MeSH terms: Case Reports

We report the case of an adolescent girl with frequent hospital admissions for severe eczematous skin rashes with recurrent epistaxis and chest infections. Investigations revealed persistent severely elevated serum total immunoglobulin E (IgE) levels but normal levels of other immunoglobulins, suggesting hyper-IgE syndrome. The first skin biopsy revealed superficial dermatophytic dermatitis (tinea corpora). Another biopsy performed after six months revealed a prominent basement membrane with dermal mucin, suggesting an underlying autoimmune disease. Her condition was complicated by proteinuria, hematuria, hypertension, and edema. A kidney biopsy revealed class IV lupus nephritis, according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS). Based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria, she was diagnosed with systemic lupus erythematosus (SLE). She was first administered with intravenous pulse methylprednisolone (600 mg/m2) for three consecutive days, followed by oral prednisolone (40 mg/m2) daily, mycophenolate mofetil tablets (600 mg/m2/dose) twice daily, hydroxychloroquine (200 mg) once daily, and three classes of antihypertensive medications. She maintained normal renal functions with no lupus morbidity for 24 months, then rapidly progressed to end-stage kidney disease, and was then started on three to four sessions of regular hemodialysis per week. Hyper-IgE is known to be a marker of immune dysregulation as it facilitates the generation of immune complexes (ICs) that mediate lupus nephritis and juvenile SLE. Regardless of the different factors that are impacting the production of IgE, the present case illustrated that juvenile patients with SLE may have increased IgE levels, indicating that higher IgE levels might have a role in lupus pathogenesis and prognosis. The mechanisms regarding the increased levels of IgE in subjects with lupus need further investigation. Further studies are thus required to assess the incidence, prognosis, and possible new specific management for hyper-IgE in juvenile SLE.
Lymphangiomatous Polyp Presenting as Tonsillar Mass
Authors: Ashish Dhakal, Sameer Karmacharya, Sandhya Shrestha
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

A 19-year-old female presented to ENT OPD of Dhulikhel Hospital, Kathmandu University Hospital, with history of foreign body sensation in throat for 2 weeks and mass in left tonsil for 1 week. There is no history of difficulty swallowing or recurrent throat infection. Physical examination revealed a pedunculated mass arising from upper pole of left tonsil. Bilateral tonsillectomy was done under general anaesthesia. Grossly, 2.5 × 1.5 × 1 cm polypoidal mass, soft in consistency, was found to be attached to left tonsil. Histopathology report was consistent with lymphangiomatous polyp of tonsil. Postoperative period was uneventful and she was normal during her follow-up at 1 month with bilateral healthy tonsillar fossa.
An unusual case of acute foot drop caused by a pseudoaneurysm
Authors: Christopher J Wong, Eric E Kraus
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Lower extremity neurologic symptoms are a common presenting problem. Here we report the case of a 73-year-old man who developed acute right foot pain and foot drop. History, physical examination, and electrodiagnostic studies were consistent with a lumbosacral plexopathy. Imaging studies revealed an internal iliac artery pseudoaneurysm, a rare cause of acute foot drop.
Congenital segmental dilatation of the jejunum in an African child: a case report
Authors: Trésor Kibangula Kasanga, Florent Tshibwid Zeng, Stéphane Jampy-Biaya, Anatole Nyembwe Mbuyi, Sébastien Mbuyi-Musanzayi
Journal: Pan Afr Med J (2021)
Keywords: congenital segmental dilatation, case report, children, intestine, jejunum
MeSH terms: Anastomosis, Surgical / methods, Jejunal Diseases / diagnosis, Jejunum / abnormalities, Case Reports, Abdominal Pain / etiology, Constipation / etiology, Dilatation, Pathologic / congenital, Dilatation, Pathologic / diagnosis, Dilatation, Pathologic / surgery, Female, Humans, Infant, Jejunal Diseases / congenital, Jejunal Diseases / surgery, Jejunum / surgery

Congenital segmental dilatation of the intestine is a rare disease. It is rarely located in the jejunum and its etiology is still unknown despite many theories suggesting its mechanism. We report a case of a 17 months girl who experienced nonspecific symptoms (abdominal pain, constipation and loss of appetite) since early her infancy. She had no growth retardation and had moderate abdominal distension on physical examination. Investigations undertaken could not increase suspicion of congenital segmental dilatation of the intestine (CSDI). The diagnosis was made peroperatively and a resection was done, followed by end-to-end jejunal anastomosis. There were no postoperative complications and the patient is doing well after four months. One should think of CSDI in children with chronic subocclusion or digestive hemorrhage.
Streptococcus pseudoporcinus: Case Reports and Review of the Literature
Authors: Shanza Khan, Ting Ting Wong, Nishant Prasad, Benjamin Lee, Carl Urban, Sorana Segal-Maurer, Glenn Turett
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Streptococcus pseudoporcinus is a beta-hemolytic Gram-positive, catalase-negative, nonmotile coccus arranged in short chains, usually found in the female genitourinary tract and differentiated from Streptococcus porcinus in 2006. Only two human infections associated with this organism have been reported to date: one in a patient with a first digit wound infection and another with lower extremity cellulitis. We describe two novel cases of Streptococcus pseudoporcinus causing endocarditis in one and pneumonia with empyema in another, illustrating the potential of these bacteria to cause severe invasive and life-threatening disease.
Immune Thrombocytopenia and Cerebral Venous Sinus Thrombosis Following COVID-19 Vaccination: A Case Report
Authors: Saurabh Kataria, Rezaur Rahman Reza, Adesola A Agboola, Khalid H Mohamed, Alaa S Mohamed, Nimra Zahid, Muhammad Haseeb, Hira Nasir
Journal: Cureus (2023)
Keywords: cerebral venous sinus thrombosis (cvst), covid associated thrombocytopenia, covid-2019, vaccine-induced prothrombotic immune thrombocytopenia, vaccine-induced thrombocytopenia
MeSH terms: Case Reports

Mass vaccination against coronavirus disease 2019 (COVID-19) has been safe and effective. The ongoing emergence of vaccine-induced complications has challenged the public trust in vaccination programs and, though uncommon, can lead to significant morbidity and mortality. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare and fatal complication of the COVID-19 vaccine. We present a rare case of VITT in a young female who presented with worsening headache, body rash with deteriorating neurological deficit after 12 days of the second dose of the ChAdOx1 COVID-19 vaccine. Initial blood tests showed thrombocytopenia with deranged clotting time and D-dimer levels. Her computed tomography venogram showed thrombosis in the left transverse sinus, and she was diagnosed with a provisional diagnosis of VITT. She initially managed with dexamethasone, intravenous immunoglobulins, and apixaban to reverse the autoimmune process. Our case highlights the clinical course, diagnosis, and management of VITT, which will assist physicians in the timely recognition and adequate management of VITT.