OpenMed/multicare-articles huggingface dataset:
An Unusual Case of Mandibular Squamous Cell Carcinoma in Intimacy with an Impacted Wisdom Tooth
Authors: Johnson Cheung, Ayham Al Afif, Martin Joseph Bullock, Chad Robertson, Robert Hart, Reginald Goodday
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Squamous cell carcinoma is the most common head and neck malignancy. It can occur in the mandible or maxilla without a preexisting oral mucosal lesion. Often, the clinical and radiographic presentation of SCC directs the clinician to favour malignancy over other pathological conditions. However, SCC may also mimic an infectious condition and therefore can pose a diagnostic challenge even for the most experienced clinicians. Herein, we report a case of mandibular squamous cell carcinoma in a 53-year-old male who presented with symptoms of right facial swelling, trismus, pain, and right-sided lip paresthesia. The patient underwent a surgical removal of the presumed infected third molar of the right mandible, but histopathological analysis of the associated soft tissue unexpectedly yielded squamous cell carcinoma. Given the biopsy-proven diagnosis, the patient received a mandibular resection of the tumor followed by primary reconstruction with a fibular free flap. Patients presenting with symptoms mimicking odontogenic infections should receive vigilant attention by clinicians with regard to the disease history, clinical signs, radiographic evidence, and decision for histopathological analysis. This is especially true in the context of impacted dentition, where malignancy must be considered when formulating a differential diagnosis.
Case Report: A Case Report of a Histological Transformation of ALK-Rearranged Adenocarcinoma With High Expression of PD-L1 to Squamous Cell Carcinoma After Treatment With Alectinib
Authors: Yan Zhang, Yaping Qin, Hongen Xu, Qihui Yao, Yalan Gao, Yushu Feng, Jingli Ren
Journal: Pathol Oncol Res (2021)
Keywords: alk-rearranged adenocarcinoma, pd-l1, alectinib, histological transformation, squamous cell carcinoma
MeSH terms: Adenocarcinoma of Lung / drug therapy, Anaplastic Lymphoma Kinase / genetics, B7-H1 Antigen / metabolism, Carbazoles / adverse effects, Carcinoma, Squamous Cell / pathology, Gene Rearrangement, Lung Neoplasms / drug therapy, Piperidines / adverse effects, Case Reports, Adenocarcinoma of Lung / genetics, Adenocarcinoma of Lung / pathology, B7-H1 Antigen / genetics, Carcinoma, Squamous Cell / chemically induced, Humans, Lung Neoplasms / genetics, Lung Neoplasms / pathology, Male, Middle Aged, Prognosis, Protein Kinase Inhibitors / adverse effects, B7-H1 Antigen, CD274 protein, human, Carbazoles, Piperidines, Protein Kinase Inhibitors, ALK protein, human, Anaplastic Lymphoma Kinase, alectinib

We report an anaplastic lymphoma kinase (ALK)-positive patient shows a poor response to the ALK inhibitor alectinib due to the high expression of programmed death-ligand 1 (PD-L1). After treatment with alectinib, the pathological form changed from adenocarcinoma into squamous cell carcinoma without novel genetic changes. This case may reveal a direct relationship between ALK mutation and a high level of PD-L1 expression.
Faecopneumothorax Caused by Perforated Diaphragmatic Hernia
Authors: Kristina Necke, Nickolaus Heeren, Francesco Mongelli, Maurice FitzGerald, Jürgen Fornaro, Fabrizio Minervini, Jürg Metzger, Jörn-Markus Gass
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Incarcerated diaphragmatic hernias with intrathoracic perforation of the colon is a very rare but serious surgical emergency. A 78-year-old male patient presented to our emergency department with severe abdominal pain. A computer tomography (CT) scan revealed herniation of the left transverse colon and spleen into the thorax with colon perforation and fecal contents in the thoracic cavity. An emergent laparotomy confirmed the radiological diagnosis and showed a 6 cm dehiscence of the left diaphragm with strangulation of the left transverse colon as well as the spleen. A left-sided hemicolectomy with terminal transversostomy and splenectomy were performed. The diaphragm was closed with interrupted nonabsorbable sutures. We abstained from reinforcement of the suture line with a mesh because of the feculent contamination of the abdominal cavity. After extensive thoracoscopic lavage and insertion of two chest tubes, the patient was transferred to the intensive care unit. Diaphragmatic hernia even after a mild chest trauma can cause fatal complications. Diagnosis and treatment can be challenging and an interdisciplinary approach is recommended. Due to the associated comorbidity and long-lasting sequelae, we believe the awareness of this rare pathology as a differential diagnosis is important; both as an abdominal and thoracic emergency.
Surgical treatment and functional outcome of bilateral symmetrical hip dislocation and Pipkin type II femoral head fracture: a 5-year follow-up case report and literature review
Authors: Sujan Shakya, Jialei Chen, Fei Xing, Zhou Xiang, Xin Duan
Journal: Front Surg (2023)
Keywords: pipkin fracture, direct anterior approach pipkin fracture, femoral head fracture, posterior hip dislocation
MeSH terms: Case Reports

Background:
Bilateral posterior hip dislocation and femoral head fracture are rare injuries, which may be the earliest case report that focuses on treatment with open reduction via the direct anterior approach (DAA) for bilateral symmetrical Pipkin type II fracture within 5 years of the follow-up period.
Case report:
We present a case of bilateral posterior dislocation with a femoral head fracture (Pipkin II) of the hip in 47-year-old woman caused by a high-velocity accident. The dislocation was successfully reduced under general anesthesia at a local hospital and transferred to a tertiary center for surgical management. She was surgically treated with internal fixation using three Herbert screws on the bilateral hips. The DAA was used during surgery. Follow-up for 5 years was performed, and functional outcomes were evaluated using the D'Aubigné range of motion and modified Harris hip score. The range of motion in the bilateral hip was satisfactory, with no signs of post-traumatic arthritis, heterotopic ossification, or avascular necrosis of the femoral head.
Conclusion:
Surgical management of bilateral Pipkin type II fractures was performed successfully with open reduction and internal fixation using a safe and reliable direct anterior approach, with good functional outcomes at 5-year follow-up.
Primary Central Nervous System Lymphoma in an Immunocompetent Patient Presenting as Multiple Cerebellar Lesions: A Case Report and Review of Literature
Authors: Gliceida M Galarza Fortuna, Kathrin Dvir, Christopher Febres-Aldana, Michael Schwartz, Ana Maria Medina
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: cd10, brain tumor, cerebellar tumor, lymphoma, primary cns lymphoma
MeSH terms: Breast Neoplasms / drug therapy, Central Nervous System Neoplasms / pathology, Cerebellum / pathology, Lymphoma, Large B-Cell, Diffuse / pathology, Case Reports, Review, Aged, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Central Nervous System Neoplasms / therapy, Cerebellum / diagnostic imaging, Chemoradiotherapy, Female, Humans, Immunocompetence, Lymphoma, Large B-Cell, Diffuse / therapy, Magnetic Resonance Imaging, Neprilysin / metabolism, Neprilysin

Primary central nervous system (CNS) lymphoma (PCNSL) is an uncommon extranodal non-Hodgkin lymphoma often presenting as a single brain lesion within the CNS. On histopathological evaluation of PCNSL a positive CD10, which is frequently observed in systemic diffuse large B-cell lymphoma, is present in approximately 10% of PCNSL. We describe a case of CD10-positive PCNSL presenting with multiple posterior fossa enhancing lesions in an immunocompetent older woman with a history of breast cancer successfully treated by the RTOG 0227 protocol consisting of pre-irradiation chemotherapy with high-dose methotrexate, rituximab, and temozolomide for 6 cycles, followed by low-dose whole-brain radiation and post-irradiation temozolomide.
Intracranial Hemorrhage Following Oral Low-Dose Methotrexate After Multiple Toxicities Caused by High-Dose Methotrexate in Childhood Acute Lymphoblastic Leukemia
Authors: Ning Xin, Zhou Fen, Cheng Li, Xiao Yan, Jin Runming
Journal: Front Pharmacol (2019)
Keywords: acute lymphoblastic leukemia, intracranial hemorrhage, methotrexate, neurotoxicity, toxicity
MeSH terms: Case Reports

An 11-year-old male patient with the deletion of IKZF1 (Ikaros family zinc finger 1) and positive Breakpoint Cluster Region-C-Abelson oncogene 1(BCR-ABL1) acute lymphoblastic leukemia developed mucositis, gastrointestinal toxicity, hepatotoxicity, myelosuppression, and severe dermatologic toxicity during the first and second courses of high-dose methotrexate. The patient recovered completely after therapy. However, intracranial hemorrhage (ICH) occurred following oral methotrexate at a dose of 25 mg/m2 in maintenance treatment, and he had neurological sequelae including hemiplegic paralysis.
Case Report: Multiple colorectal cancers in a patient with Ulcerative colitis and Lynch syndrome: Is there a role for prophylactic colectomy? A short report and review of literature
Authors: Adewale Adeoba Ayeni, Peter Waterland, Matthew Evans, Shika Singhal, Rajan Kumar Patel, Akinfemi Akingboye
Journal: Front Oncol (2022)
Keywords: hnpcc
MeSH terms: Case Reports

It is a known fact that Lynch syndrome (LS) and Ulcerative colitis (UC) are individually associated with increased risk of colorectal cancer. While there is no conclusive evidence to demonstrate a cumulative risk when these two conditions coexist, available data suggest early onset and synchronous cancers are synonymous to this group. We have reported an unusual case of multiple synchronous colorectal cancers in a young man with ulcerative colitis and Lynch syndrome also known as Hereditary Nonpolyposis Colorectal Cancer (HNPCC) gene mutation. We propose that conducting a detailed genetic mutation profile in LS patients may play a key role in guiding the intensity of endoscopic surveillance and that a concerted, pragmatic, patient guided approach should be adopted on the subject of prophylactic colectomy when UC and LS co-exist.
Case report: One child with an autism spectrum disorder who had chronically elevated serum levels of CK and CK-MB
Authors: Ping Rong, Shuyi Zhao, Qianfang Fu, Mengrui Chen, Libin Yang, Yifei Song, Xilian Zhang, Rong Ma
Journal: Front Psychiatry (2022)
Keywords: autism (asd), biomarkers, case report, creatine kinase, traditional chinese medicine
MeSH terms: Case Reports

Some patients with autism spectrum disorder (ASD) exhibit elevated serum creatine kinase levels, which are believed to be associated with mitochondrial dysfunction. Although a few articles have reported this situation in the past and the increase mostly ranges from 100 to 300 U/L, there is a paucity of previous study focusing on the serum creatine kinase MB isoenzyme. This article discusses a 5-year-old girl with ASD, whose serum creatine kinase and creatine kinase MB isoenzyme have been rising for nearly 2 years, fluctuating at 584-993 and 111-625 U/L respectively. Except for behavioral and language symptoms associated with ASD, the child appears normal in other aspects. The child's laboratory tests showed no abnormality, except that the serum levels of lactic acid was slightly higher than normal (1.89 mmol/L, normal 1.33-1.78 mmol/L). The child was prescribed with a traditional Chinese medicine during the process and the serum creatine kinase MB isoenzyme level decreased dramatically to 111 U/L after the treatment. This study firstly recorded the serum creatine kinase levels and the MB isoenzyme in patients with autism spectrum disorder for nearly 2 years, indicating that patients with ASD may experience long-term increases in serum creatine kinase and creatine kinase MB isoenzyme, and that the traditional Chinese medicine decoction Xinfukang can temporarily reduce the serum creatine kinase MB isoenzyme level in patients. Nevertheless, the effect is not sustained. Therefore, it is of great importance to conduct long-term longitudinal studies so as to elucidate the potential mechanism responsible for long-term elevation of serum creatine kinase level.
Deep fibrous histiocytoma of the index finger: a case report
Authors: Hiroki Shibayama, Yuichiro Matsui, Daisuke Kawamura, Daisuke Momma, Takeshi Endo, Yuki Matsui, Yasutaka Yawaka, Kanako C Hatanaka, Emi Takakuwa, Hirokazu Sugino, Yutaka Hatanaka, Tadashi Hasegawa, Norimasa Iwasaki
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: deep fibrous histiocytoma, case report, fusion gene analysis, immunohistochemistry, soft tissue tumor in the hand
MeSH terms: Case Reports

Our patient presented with an elastic soft mass of his left index finger. Hematoxylin and eosin staining showed a high cellular density with spindle-shaped cells in a storiform pattern. Immunohistochemical staining was positive for CD68, factor XIIIa and α-smooth muscle actin, and negative for CD34, STAT6, S100 protein, and desmin.
A Modern Approach to Minimally Invasive Surgery and Laparoscopic Sterilization in a Chimpanzee
Authors: Laura K Newcomb, Meghan A Kruse, Larry J Minter, Craig J Sobolewski
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

We present the case of Ruby, a 21-year-old hand-reared chimpanzee (Pan troglodytes) who had an obstetric history significant for a premature stillborn infant that was conceived while on oral contraceptive pills, followed by a full term healthy delivery complicated by neonatal demise attributed to inappropriate maternal care. She was recommended for permanent sterilization due to her history of conception while on oral contraceptives. She underwent uncomplicated laparoscopic bilateral tubal ligation. Due to the similar anatomy to humans, human OB/GYN surgical consultants were used. The objective of this case report is to describe a modern technique for approaching and employing laparoscopic surgery in primates. Minimally invasive surgery allows for faster recovery and fewer complications, and has become the preferred approach for surgical intervention in many animals. The information presented in this case report can be expanded to benefit not only Chimpanzees but other large primate species as well. However, subtle anatomical differences among species must be recognized in order to be carried out safely.
Adrenal Rest Tumor of the Liver Preoperatively Diagnosed as Hepatocellular Carcinoma
Authors: Megumu Enjoji, Katsuya Sanada, Ryota Seki, Takashi Ito, Masato Maeda
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Background:
Hepatic adrenal rest tumors are rare and show similar findings to hepatocellular carcinoma (HCC). It is difficult to distinguish an adrenal rest tumor from HCC due to radiological similarity. We report a case of an adrenal rest tumor in the liver that mimicked HCC radiologically.
Case presentation:
A 67-year-old female was referred to our hospital due to the finding of a hepatic mass. Enhanced computed tomography revealed a 17 mm well-defined tumor that was enhanced in the arterial phase and washed out in the portal and delayed phase in the posterosuperior subsegment of the right hepatic lobe, and HCC was suspected. We performed a subsegmental resection of the liver. Microscopic findings showed that the tumor was composed of pale cells, and tumor cells were aligned in alveolar or fascicular arrangements in a similar manner to features of adrenocortical tissue. Immunohistochemically, the tumor expressed synaptophysin and CD56. The final histopathologic diagnosis in this case was an adrenal rest tumor of the liver.
Conclusions:
An adrenal rest tumor is similar to HCC in radiological findings. This hepatic tumor should be added to the list of radiological differential diagnoses of hypervascular hepatic tumors.
Video-assisted thoracoscopic surgery for intrathoracic extramedullary hematopoiesis
Authors: E Giblin, K Frankel, K Mortman
Journal: J Minim Access Surg (2007)
Keywords: hematopoiesis, mediastinal mass, posterior mediastinum, thalassemia, thoracoscopy, thoracotomy
MeSH terms: Case Reports

Extramedullary hematopoiesis is a rare cause of an intrathoracic mass in individuals with hemolytic disorders. It can be clinically confused with other tumors of the mediastinum. While radiologic studies often demonstrate findings suggesting intrathoracic extramedullary hematopoiesis, histology is usually required for diagnostic purposes. Thoracotomy was the mainstay procedure for obtaining tissue diagnosis and resection. However, video-assisted thoracoscopy (VATS) is an amendable and less-invasive means of tumor removal. We report a case of a posterior mediastinal extramedullary hematopoietic mass in a forty-two year old male in which VATS was utilized for diagnosis and resection.
Giant Complex Odontoma of Mandible: A Spectacular Case Report
Authors: Narjiss Akerzoul, Saliha Chbicheb, Wafaa El Wady
Journal: Open Dent J (2017)
Keywords: benign tumors, complex odontoma, hamartomas, mandible, odontogenic tumors
MeSH terms: Case Reports

Introduction:
Odontomas are considered as benign tumors of odontogenic tissue origin and are more over non-aggressive. They can also be categorized as hamartomas and are a result of developmental malformation of odontogenic tissues. As the name suggests, they are composed of mature tooth substances. They possess limited and slow growth potential and are well differentiated. They can be ectodermal, mesodermal or mixed in origin. Mixed variety may be further divided into compound or complex depending upon their radio-graphical resemblance to the tooth. Compound odontomes are reported to be twice more common than complex odontomes. Among them, complex odontomes are asymptomatic unless they cause bony expansion of the jaws.
Case report:
This paper aims to report and discuss a case of complex odontoma with unusually large size leading to gross facial asymmetry. Further this paper will highlight the important information the general dental practitioner must possess to diagnose such lesions at an early stage.
Conclusion:
Odontomas are benign odontogenic tumors with unusually large size leading to gross facial asymmetry. The general dental practitioners must possess the knowledge and important information to diagnose such lesions at an early stage.
Direct long bone invasion by Basal cell carcinoma: a case report and review of the literature
Authors: Badr M Al Majed, Stephanie L Koonce, Dustin L Eck, Peter Murray, Galen Perdikis
Journal: Eplasty (2013)
Keywords: basal cell carcinoma, bone invasion, long bone invasion, nonmelanoma skin cancer, skin cancer

Introduction:
Basal cell carcinoma is the most prevalent form of cancer worldwide, usually arising in the head and neck region, which is cured by surgical excision and rarely invades or metastasizes. Many reports exist of bony invasion in the head and neck but very rarely into long bones.
Methods:
We report an unusual case of basal cell carcinoma that despite surgical excision, directly invaded the left humerus. This article also includes a literature review with possible explanations for the occasionally aggressive behavior of basal cell carcinoma.
Results:
This 68-year-old patient underwent wide resection of the affected left upper arm skin, tissue, and diaphyseal segment with clear margins. The defect was reconstructed with a vascularized free fibula bone graft, pedicled latissimus muscle flap, and split-thickness skin graft.
Conclusions:
Long bone invasion by BCC is extremely rare and not well reported. There are more biologic explanations for overtly aggressive behavior that BCC may exhibit such as in this case.
Surgical treatment of an invasive thymoma extending into the superior vena cava and right atrium
Authors: Yong-Qiang Dong, Jiang-Shui Liang, Xiao-Ming Zhang, Shui-Bo Zhu, Jia-Hang Xu, Tao Ji, Gui-Lin Yin
Journal: World J Surg Oncol (2014)
MeSH terms: Heart Atria / surgery, Superior Vena Cava Syndrome / surgery, Thymoma / surgery, Thymus Neoplasms / surgery, Case Reports, Aged, Follow-Up Studies, Heart Atria / pathology, Humans, Male, Neoplasm Invasiveness, Prognosis, Superior Vena Cava Syndrome / pathology, Thymoma / pathology, Thymus Neoplasms / pathology, Tomography, X-Ray Computed

Although invasive thymoma commonly infiltrates neighbouring mediastinal structures, its extension into the superior vena cava (SVC) and consequent SVC occlusion are rare. In such cases, the urgent removal of the thymoma and radical resection of the infiltrated SVC representreasonable options, since induction therapy is time-consuming and useless for symptom resolution. A case of invasive thymoma extending into the SVC and right atrium (RA) with SVC syndrome is reported. The patient underwent a combined resection of the invasive tumor and SVC under cardiopulmonary bypass (CPB), and the SVC and bilateral brachiocephalic vein (BCV) were reconstructed with an autologous pericardial 'Y' conduit. After 40 months of follow-up, the patient showed a patent graft and no tumor recurrence.
Symptomatic sinus bradycardia: A rare adverse effect of intravenous ondansetron
Authors: Md Shahnawaz Moazzam, Farah Nasreen, Shahjahan Bano, Syed Hussain Amir
Journal: Saudi J Anaesth (2011)
Keywords: adverse effect, ondansetron, sinus bradycardia
MeSH terms: Case Reports

Ondansetron is a serotonin receptor antagonist which has been used frequently to reduce the incidence of post-operative nausea and vomiting in laparoscopic surgery. It has become very popular drug for the prevention of post-operative nausea and vomiting due to its superiority in-terms of efficacy as well as lack of side effects and drug interactions. Although cardiovascular adverse effects of this drug are rare, we found a case of symptomatic sinus bradycardia in a 43-year-old female patient, going for laparoscopic cholecystectomy, who developed the same after she was given intravenous ondansetron in operation theater during premedication. Hence, we report this case, as the rare possibility of encountering bradycardia effect after intravenous administration of ondansetron should be born in mind.
Breath Hydrogen Gas Concentration Linked to Intestinal Gas Distribution and Malabsorption in Patients with Small-bowel Pseudo-obstruction
Authors: Yoshihisa Urita, Toshiyasu Watanabe, Tadashi Maeda, Yosuke Sasaki, Susumu Ishihara, Kazuo Hike, Masaki Sanaka, Hitoshi Nakajima, Motonobu Sugimoto
Journal: Biomark Insights (2009)
Keywords: breath hydrogen gas, intestinal gas volume, malabsorption, plain abdominal radiograph
MeSH terms: Case Reports

Background:
The patient with colonic obstruction may frequently have bacterial overgrowth and increased breath hydrogen (H2) levels because the bacterium can contact with food residues for longer time. We experienced two cases with intestinal obstruction whose breath H2 concentrations were measured continuously. CASE 1: A 70-year-old woman with small bowel obstruction was treated with a gastric tube. When small bowel gas decreased and colonic gas was demonstrated on the plain abdominal radiograph, the breath H2 concentration increased to 6 ppm and reduced again shortly. CASE 2: A 41-year-old man with functional small bowel obstruction after surgical treatment was treated with intravenous administration of erythromycin. Although the plain abdominal radiograph demonstrated a decrease of small-bowel gas, the breath H2 gas kept the low level. After a clear-liquid meal was supplied, fasting breath H2 concentration increased rapidly to 22 ppm and gradually decreased to 9 ppm despite the fact that the intestinal gas was unchanged on X-ray. A rapid increase of breath H2 concentration may reflect the movement of small bowel contents to the colon in patients with small-bowel pseudo-obstruction or malabsorption following diet progression.
Conclusions:
Change in breath H2 concentration had a close association with distribution and movement of intestinal gas.