OpenMed/multicare-articles huggingface dataset:
Primary gastric choriocarcinoma: A case report
Authors: Zhang Xusheng, Yan Yuke, Meng Yun, Guo Huijun, Peng Jiangshan, Du Xueqin, Yang Xiaojun
Journal: Front Surg (2022)
Keywords: case report, choriocarcinoma, pathology, primary gastric choriocarcinoma, treatment
MeSH terms: Case Reports

Background:
Choriocarcinoma is a malignant tumour of trophoblastic origin. Most are gestational choriocarcinomas, which usually occur in women with an epithelial origin of the placental chorionic villi and are associated with pregnancy. It mainly originates in the gonads such as the ovaries and testes. However, it rarely occurs in the stomach and is known as primary choriocarcinoma (PGC).
Case presentation:
A 69-year-old man complained of abdominal distention for 3 years, which worsened 1 week later. Gastroscopy showed chronic atrophic gastritis C1 (C1: indicates atrophic gastritis involving the sinus region); the pathology report of the gastroscopic specimen showed high-grade epithelial tumours in the mucosal glands. We diagnosed an occupying lesion in the stomach and performed a laparoscopically assisted distal gastrectomy and Billroth type 1 anastomosis. Postoperative pathology showed "gastric choriocarcinoma with cancerous tissue invading the entire gastric wall". The patient was discharged on the 11th postoperative day as there were no postoperative complications. The patient was followed up until June 2022 with a good recovery and no recurrence.
Conclusion:
We encountered a case of Primary Gastric Choriocarcinoma, where the cancerous tissue invades the full thickness of the gastric wall.
Case Report: Circulating Tumor Cells as a Response Biomarker in ALK-Positive Metastatic Inflammatory Myofibroblastic Tumor
Authors: Paolo Bonvini, Elisabetta Rossi, Angelica Zin, Mariangela Manicone, Riccardo Vidotto, Antonella Facchinetti, Lucia Tombolan, Maria Carmen Affinita, Luisa Santoro, Rita Zamarchi, Gianni Bisogno
Journal: Front Pediatr (2021)
Keywords: alk, ctc, cellsearch, imt, liquid biopsy, metastasis
MeSH terms: Case Reports

Inflammatory myofibroblastic tumors (IMTs) are locally aggressive malignancies occurring at various sites. Surgery is the mainstay of treatment and prognosis is generally good. For children with unresectable or metastatic tumors, however, outcome is particularly severe, limited also by the lack of predictive biomarkers of therapy efficacy and disease progression. Blood represents a minimally invasive source of cancer biomarkers for real-time assessment of tumor growth, particularly when it involves the analysis of circulating tumor cells (CTC). As CTCs potentially represent disseminated disease, their detection in the blood correlates with the presence of metastatic lesions and may reflect tumor response to treatment. Herein, we present a case report of a 19-year-old boy with an ALK-positive IMT of the bladder, proximal osteolytic and multiple bilateral lung lesions, who received ALK inhibitor entrectinib postoperatively and underwent longitudinal CTC analysis during treatment. Antitumor activity of entrectinib was demonstrated and was accompanied by regression of lung lesions, elimination of CTCs from the blood and no development of relapses afterwards. Therapy continued without any clinical sign of progression and 24 months since the initiation of treatment the patient remains symptom-free and disease-free.
Osteosarcoma of the maxilla: a rare case with unusual clinical presentation
Authors: Pouyan Amini Shakib, Ramin Foroughi, Maryam Seyedmajidi
Journal: J Dent Res Dent Clin Dent Prospects (2013)
Keywords: osteosarcoma, bone tumor, maxilla
MeSH terms: Case Reports

Osteosarcoma (OS) is a malignant mesenchymal tumor, which rarely occurs in the maxilla. Although variable histologic and radiographic features of OS have been reported previously, in the majority of the cases painful swelling of the jaw is mentioned as the first clinical presentation. Furthermore, early diagnosis and wide surgical resection of the tumor are the most important determinant factors of prognosis. Therefore, the unusual clinical presentations of OS should be considered meticulously to expedite the diagnosis process. We describe a case of OS of the maxilla with extremely unusual presenta-tion in a 42-year-old female, that was initially designated as "epulis fissuratum". Here, we highlight the importance of com-bining the clinical, radiographic and histopathologic examination to obtain a definitive diagnosis and also the significance ofearly effective surgical intervention in evaluation of pathologic lesions.
CASE REPORT Pharyngocutaneous Fistula Closure Using Autologous Fat Grafting
Authors: Geoffrey E Hespe, Claudia R Albornoz, Babak J Mehrara, Dennis Kraus, Evan Matros
Journal: Eplasty (2013)

Objective:
Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive treatment approaches designed to reverse tissue damage or promote spontaneous healing would represent an important medical advance. Autologous fat grafts have been previously shown to promote healing of persistent wounds and improve the quality of radiation-damaged tissue. In this report, successful closure of a persistent pharyngocutaneous fistula with use of autologous fat grafting is described.
Method:
The history and details of pharyngocutaneous fistula closure in a patient with recurrent head and neck cancer are reported.
Result:
A 67-year-old patient with recurrent head and neck cancer and prior radiotherapy underwent reresection including partial pharyngectomy with pectoralis major myocutaneous flap closure. Postoperatively, he developed an enterocutaneous fistula, which failed to close with conservative measures including 8 months of nothing per os. Two rounds of autologous fat grafting were performed with successful fistula healing.
Conclusion:
Autologous fat grafting is a useful treatment for closure of persistent pharyngocutaneous fistulas. Autologous fat grafting should be considered in poor surgical candidates, particularly in the setting of extensive radiation-induced tissue damage.
Emergency laparoscopic splenectomy for torsion of wandering spleen in a geriatric patient: A case report
Authors: Novia Ayuning Nastiti, Muhammad S Niam, Phong Jhiew Khoo
Journal: Int J Surg Case Rep (2019)
Keywords: acute abdomen, geriatric, laparoscopic, splenectomy, torsion, wandering spleen

Introduction:
Wandering spleen (WS) is an uncommon congenital or acquired condition where the spleen is displaced from its normal position at the left hypochondrium to anywhere within the abdominal or pelvic cavity. The incidence is extremely rare in the geriatric population.
Presentation of case:
We present a rare case of WS torsion in a 69-year-old elderly patient who presented with an acute abdomen. Physical examination revealed a tender right lower quadrant abdominal mass. Imaging studies confirmed the diagnosis of WS torsion with features of infarction. Subsequently, an emergency laparoscopic splenectomy was performed.
Discussion:
A WS occurs due to the hypermobility of the spleen secondary to the absence or laxity of splenic suspensory ligaments. It is more commonly seen in children and adults in the third decade of life. Symptoms are usually attributed to the consequences of splenic vascular pedicle torsion. Exhibited symptoms might be unspecific; thus, radiological modalities are essential to determine the diagnosis and aid in planning its management. The treatment of choice is either open or laparoscopic splenopexy or splenectomy.
Conclusion:
Due to potentially life-threatening consequences and the rarity of such cases, a thorough history, detailed physical examination, and objective investigation are the pillars to attain a prompt diagnosis for appropriate management to be conducted as soon as possible to minimise complications.
Clinical manifestation and treatment of small intestinal lymphangioma: A single center analysis of 15 cases
Authors: Zhen-Zhen Wang, Ling-Yan Shen, Jing-Jing Zhou, Jia-Li Tang, Li-Ping Ye, Chen-Bo Shen, Shao-Wei Li, Xian-Bin Zhou
Journal: Front Med (Lausanne) (2022)
Keywords: diagnosis, endoscope, lymphangioma, small intestine, treatment

Background:
Small intestinal lymphangioma is a very rare benign lesion. Thus far, the literature on small intestinal lymphangioma has mainly involved case reports. The present study retrospectively examined the clinical features of patients with a pathological diagnosis of small intestinal lymphangioma.
Materials and methods:
From January 2010 to January 2021, 15 patients were pathologically diagnosed with small intestinal lymphangioma. The age, gender, clinical manifestation, computed tomography (CT) findings, endoscopic findings, localization of the lesion, treatment method, complications, and follow-up were retrospectively analyzed.
Results:
Most of the patients had no symptoms, and those with symptoms had melena or abdominal pain. Lymphangioma was located in the duodenum in nine cases (60.0%), jejunum in two (13.3%), jejunal-ileal junction with mesentery involvement in one (6.7%) and ileum in three (20.0%). Three cases (20.0%) had multiple lesions, and the other 12 (80.0%) had single lesions. The median size of the lesions was 0.8 cm. Thirteen cases were found by endoscopy, and nine cases of them had white-colored spots on the surface. Ten cases (66.7%) underwent endoscopic treatment, three (20.0%) underwent surgical treatment, and two (13.3%) were followed up. Postoperative acute pancreatitis developed in one patient after endoscopic resection of duodenal papillary lymphangioma; postoperative abdominal bleeding occurred in one patient with jejunal lymphangioma who underwent partial small bowel resection.
Conclusion:
Small intestinal lymphangioma is extremely rare, and its clinical manifestations are non-specific. Endoscopy is of great value in the diagnosis of small intestinal lymphangioma. Depending on the clinical manifestations, the size, location and scope of the lesions, follow-up, endoscopic treatment and surgery can be selected.
Clinical Application of the Socket-Shield Concept in Multiple Anterior Teeth
Authors: G Esteve-Pardo, L Esteve-Colomina
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

A case of rehabilitation of the upper front teeth is presented. To prevent bone resorption following extractions, a socket-shield technique on all the extracted teeth was performed. The combination of a staged extraction approach, the sequence of provisionals together with the minimal bone loss of vestibular volume, allowed solving this high aesthetic demanding case in a satisfactory way for the patient both in duration of the treatment and in its final outcome.
A Complicated Course of a Coronal Shear Fracture Type IV of the Distal Part of Humerus Resulting in Resurfacing Radiocapitellar Joint Replacement
Authors: Ingo Schmidt
Journal: Open Orthop J (2017)
Keywords: coronal shear fracture, elbow, headless compression screw, posttraumatic osteoarthritis, radiocapitellar joint, unicompartmental resurfacing joint arthroplasty
MeSH terms: Case Reports

Background:
Coronal shear fracture type IV of the distal part of humerus is a very rare injury with articular complexity potentially leading to posttraumatic osteoarthritis. One option for surgical treatment of advanced unicompartmental radiocapitellar osteoarthritis is resurfacing radiocapitellar joint replacement.
Method:
A 62-year- old female sustained a coronal shear fracture type IV of the distal part of left humerus that was primarily treated with open reduction and internal fixation using headless compression screws. Three years postoperatively, there was a migration of one screw into radiocapitellar joint that led to circular deep cartilage defect of radial head. Four years after ORIF, a distinctive radiocapitellar osteoarthritis has evolved leading to a resurfacing radiocapitellar joint replacement using the Lateral Resurfacing ElbowTM (LRE) system.
Result:
At the 2-year follow-up after that procedure, there was an excellent subjective and functional outcome. Radiographically, no loosening or subsidence of implant without any signs of overstuffing could be found. The patient reported that she would have the same procedure again.
Conclusion:
The goal of unicompartmental radiocapitellar replacement is to obtain stability in elbow joint by avoiding cubitus valgus with subsequent instability of the distal radioulnar joint, and it does not alter the unaffected ulnohumeral joint. Additionally, the feature of the LRETM system is that the radial head is not excised, and so will receive the anatomical length of the overall radius articulating with the capitellum by preserving the annular ligament. In the literature only three publications could be found in which short-term results with the use of the LRETM system have been described. Hence, further studies are needed to validate this concept.
Isolated cardiophrenic angle node metastasis from ovarian primary. report of two cases
Authors: Mark Ragusa, Jacopo Vannucci, Rosanna Capozzi, Niccolò Daddi, Nicola Avenia, Francesco Puma
Journal: J Cardiothorac Surg (2011)
MeSH terms: Adenocarcinoma, Papillary / secondary, Lymph Nodes / pathology, Ovarian Neoplasms / pathology, Pleural Neoplasms / secondary, Case Reports, Adenocarcinoma, Papillary / diagnosis, Adenocarcinoma, Papillary / surgery, Diagnosis, Differential, Female, Humans, Lymph Nodes / diagnostic imaging, Lymphatic Metastasis, Middle Aged, Ovarian Neoplasms / diagnostic imaging, Pleural Neoplasms / diagnosis, Pleural Neoplasms / surgery, Radiography, Radionuclide Imaging, Thoracic Surgery, Video-Assisted

Ovarian cancer is the most lethal gynaecologic malignancy. It usually spreads out of the abdomen involving thoraco-abdominal organs and serosal surface. This disease is poorly curable and surgery, at early stage, is supposed to achieve the best survival outcome. In systemic dissemination, chemotherapy is indicated, sometimes with neoadjuvant aim. The most common clinical expressions of advanced ovarian carcinoma are multiple adenopathy, neoplastic pleuritis, peritoneal seeding and distant metastasis, mainly hepatic and pulmonary. Isolated adenopathy of the mediastinum is rare and isolated bilateral have never been described before. We report two cases of isolated bilateral cardiophrenic angle lymph node metastasis from ovarian carcinoma, without peritoneal and pleural involvement. Both patients were successfully resected through minimally invasive thoracic surgery. About the role of surgery, few data are available but survival seems to be longer after resection thus, more investigation is required to make the indication to surgery more appropriate in advanced cases.
Translabyrinthine Petrous Apex Cholesteatoma Surgery with Hearing Preservation
Authors: Holger Sudhoff, Randolf Klingebiel, Lars-Uwe Scholtz, Ingo Todt
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Objective:
To introduce a novel surgical approach to petrous apex lesion (PA) with superior semicircular canal plugging for hearing preservation. Patient. A 63-year-old patient presented with a recurrent cholesteatoma of the left petrous apex. The patient had a long-term history of cholesteatoma and MRI with diffusion-weighted imaging (DWI) detected a suspicious lesion in the left petrous apex on follow-up. Intervention. The cholesteatoma could be completely removed from the petrous apex with partial superior semicircular canal plugging and removal with hearing preservation. Outcomes. Cholesteatomas of the temporal bone are managed by surgery with complete excision of the lesion.
Results:
The translabyrinthine approach, generally useful in nonhearing ears, could be utilized with the additional technique of superior semicircular canal plugging to preserve hearing in this patient.
Conclusions:
This case highlights the possibility of a hearing preservation strategy for PA cholesteatomas using a translabyrithine approach.
An Exceptional Case of Light Chain Only Variant of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits Secondary to Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature
Authors: José C De La Flor, Jacqueline Apaza, Francisco Díaz, Edna Sandoval, Tania Linares, Alexander Marschall, Patricia Núñez, Andrea Cecilia Rivas-Nieto, Elisa Ruiz
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

We present the case of an 86-year-old Caucasian male with an 11-year history of low-grade chronic lymphocytic leukemia (CLL) presenting with nephrotic syndrome (NS). Renal biopsy findings showed a diffuse mesangial and endocapillary proliferative glomerulonephritis (GN) lesion with fine granular deposits, consistent with a rare morphologic variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID)-lambda light chain (LC) only. Monthly combination therapy of rituximab (500 mg/m2 on day 1), fludarabine (30 mg/m2 on days 1-3), and cyclophosphamide (750 mg/m2 on days 1-3) was administered. Five courses of this regimen resulted in hematological remission, as well as a partial renal response with a reduction in the spot urine protein-to-creatinine ratio (UPCR) of 815.3 mg/g (reduction > 50% proteinuria without improvement in kidney function). This condition is a rare morphological variant of PGNMID, poorly described in CLL patients. We review the literature and suggest that this case provides sheds light on the unknown pathophysiological mechanisms of monoclonal immunoglobulins (MIg)-mediated glomerular damage in CLL patients, and may be helpful for the investigation of a more effective treatment.
Thoracoscopic lobectomy for pulmonary vein occlusion after radiofrequency catheter ablation of atrial fibrillation
Authors: Chien-Ming Lo, Hung-I Lu, Yen-Yu Chen, Jen-Ping Chang
Journal: J Cardiothorac Surg (2016)
MeSH terms: Atrial Fibrillation / surgery, Catheter Ablation / adverse effects, Pneumonectomy / methods, Pulmonary Veno-Occlusive Disease / surgery, Case Reports, Female, Humans, Middle Aged, Pulmonary Veins / surgery, Pulmonary Veno-Occlusive Disease / diagnostic imaging, Pulmonary Veno-Occlusive Disease / etiology, Thoracoscopy / methods, Tomography, X-Ray Computed

Background:
Radiofrequency catheter ablation for paroxysmal atrial fibrillation is well established but not drawback free. Pulmonary vein stenosis is one of the complications and usually treated with stenting with the disadvantages of high re-stenosis rate and anticoagulant dependence.
Case presentation:
Herein, we present the case of a 47 year-old lady, who suffered from fever and hemoptysis due to right inferior pulmonary vein occlusion after radiofrequency catheter ablation for paroxysmal atrial fibrillation. Eventually, thoracoscopic right lower lung lobectomy was inevitable with satisfactory result.
Conclusions:
Pulmonary vein stenosis is a major complication after radiofrequency ablation of atrial fibrillation. High suspicion and early detection in patients with pulmonary manifestations are mandatory for salvage the injured lung in early. If delayed, surgical resection of the involved lung, especially through the thoracoscopic approach will eradicate the problem with minimal complication.
Thoracic Aortic Aneurysm Presenting as a Subacute Cough
Authors: Eduardo Diaz, Hanan Atia, Brian Kohen, Seth Lotterman
Journal: POCUS J (2023)
Keywords: suprasternal aortic view, aortic aneurysm
MeSH terms: Case Reports

The suprasternal aortic notch cardiac point of care ultrasound (POCUS) window is a useful view for evaluating thoracic aortic pathologies. However, it is not routinely included in the standard cardiac POCUS exam despite its ability to capture emergent pathologies such as aortic dissection and thoracic aortic aneurysm (TAA). Ruptured aortic aneurysms can present with sudden, severe chest or back pain, as well as hemodynamic instability, resulting in a high mortality. We present an atypical case of a patient with hemoptysis who was found to have a contained aortic rupture. In this case, POCUS, specifically the suprasternal aortic notch view, was used to expedite definitive care.
Anticoagulant Related Nephropathy Induced by Dabigatran
Authors: Nazia Sharfuddin, Mahra Nourbakhsh, Alan Box, Hallgrimur Benediktsson, Daniel A Muruve
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

We describe a case of biopsy-proven dabigatran related nephropathy in a patient without underlying IgA nephropathy. To date, dabigatran related nephropathy was only reported in patients with concurrent or undiagnosed IgA nephropathy, suggesting that it may predispose patients to dabigatran associated injury. The patient is an 81-year-old woman with multiple medical comorbidities, including nonvalvular atrial fibrillation, who was anticoagulated with dabigatran. She presented to hospital with acute kidney injury in the setting of volume overload. Her estimated glomerular filtration rate decreased from a baseline of 57 mL/min/1.73 m2 to 4 mL/min/1.73 m2, necessitating hemodialysis. Renal ultrasound findings, fractional excretion of sodium, and urinalysis suggested acute kidney injury. Renal biopsy showed acute tubular injury, tubular red blood cell casts, and an absence of active glomerulonephritis, similar to the pathological findings of warfarin related nephropathy. A diagnosis of anticoagulant related nephropathy secondary to dabigatran was therefore established. This case demonstrates that dabigatran, like warfarin, may increase tubular bleeding risk in patients, irrespective of underlying kidney or glomerular disease.
Potentially life-threatening phosphate diabetes induced by ferric carboxymaltose injection: a case report and review of the literature
Authors: Xavier Vandemergel, Frédéric Vandergheynst
Journal: Case Rep Endocrinol (2014)

We report the case of a 45-year-old female patient who developed phosphate diabetes after administration of ferric carboxymaltose. Ten days after the second dose, she complained of intense fatigue and blood analysis showed a phosphate plasma level of 0.93 mg/dL with phosphate excretion rate of 23%. She received phosphate supplementation which resulted in phosphate clearance improvement which persisted for two months. We reviewed other cases described in the literature and would draw attention to this rare but potentially life-threatening side effect.
Longitudinally Extensive Transverse Myelitis (LETM) Following Varicella Infection in a 13-Year Immunocompetent Child
Authors: Virender Kumar Gehlawat, Jaya Shankar Kaushik, Poonam Mehta, Geeta Gathwala, Rachana Dubey
Journal: Iran J Child Neurol (2019)
Keywords: chickenpox, transverse myelitis, varicella
MeSH terms: Case Reports

Varicella infection in children is a common self-limited illness with neurological complications in less than 0.1% of cases. Longitudinally extensive transverse myelitis (LETM) is uncommon in children following infection with varicella-zoster virus. We describe a case of 13-yr immunocompetent girl with LETM following varicella infection shown a dramatic clinical response to a combination of acyclovir and pulse steroids.