OpenMed/multicare-articles huggingface dataset:
Intradural Extramedullary Nerve Sheath Myxoma of the Cervical Spine: A Case Report and Review of Literature
Authors: Fangfang Xu, Ying Jin, Qian Li, Fei Dong, Liangji Lu, Qingfeng Cui, Chao Wang
Journal: Front Surg (2022)
Keywords: diagnosis, extramedullary tumor, magnetic resonance imaging, nerve sheath myxoma, spinal tumor
MeSH terms: Case Reports

Background: Nerve sheath myxoma is a rare benign soft tissue tumor. Intraspinal nerve sheath myxomas are rare. Only 8 cases of intraspinal nerve sheath myxoma have been reported to date, and no case of nerve sheath myxoma has been reported in the cervical spinal canal. Herein, we reported the first case of intradural extramedullary nerve sheath myxoma in the cervical spinal canal of a 57-year-old man, including its complete clinical course and radiological findings. Case Presentation: A 57-year-old male patient presented with numbness in his left finger without any obvious inducement for 3 years. CT and contrast-enhanced magnetic resonance imaging (MRI) of the spine were performed. Based on the radiological examinations, a diagnosis of schwannoma was initially made. However, nerve sheath myxoma was finally confirmed by histopathological and immunohistochemical examinations. Complete tumor excision at the C1-2 level was performed. Then, the patient recovered well, and the numbness of his left finger disappeared during the later follow-up after the surgery. Conclusion: Nerve sheath myxoma should receive diagnostic consideration for an extramedullary subdural lesion that is a clear boundary mass characterized by isointensity on T1-weighted images, heterogeneous intensity on T2-weighted images, obvious peripheral enhancement, and a growing tendency toward the intervertebral foramen.
Airway Management during Thyroidectomy for a Giant Goitre due to McCune-Albright Syndrome
Authors: Hiroyuki Nakao
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

There have been no case reports to date describing the technical aspects of tracheal intubation in a patient with a goitre associated with McCune-Albright syndrome (MAS), even though goitre is frequently observed in this condition. I describe a case of resection of a giant goitre in a patient with MAS, with difficult airway management. Preoperative investigation showed that the trachea was shifted to the right by the goitre, with the narrowest part of the tracheal lumen 4 mm in diameter. There was dome-shaped protuberance of the posterior pharyngeal wall into the airway. The patient had an S-shaped total spine, a short neck, and a relatively large jaw, which interfered with airway visualisation during intubation. Anaesthesia was induced with light sedation and supplemental oxygen. Endotracheal intubation was successfully performed using a fiberoptic laryngoscope and a flexible, spiral-wound, obtuse-tipped tracheal tube.
Intradural lumbar disc herniation of L2-L3: A case report and literature review
Authors: Xipeng Chen, Yuanpei Cheng, Han Wu
Journal: Front Surg (2023)
Keywords: case report, intradural lumbar disc herniation, lower back pain, lower extremity weakness, lumbar disc herniation
MeSH terms: Case Reports

Background:
Intradural lumbar disc herniation (ILDH), especially upper lumbar intradural disc herniation, is a rare type of lumbar disc herniation (LDH). However, it may have severe and complex symptoms, causing serious impact on the patients. Additionally, it is difficult to be diagnosed with limited experience. Few studies on L2-L3 ILDH have been reported in the literature. This study presents such a case and reviews the incidence, etiology, symptoms, diagnosis and treatment of this disease, so as to provide guidance and experience for clinicians.
Case presentation:
A 27-year-old male patient had a one-month history of severe lower back pain and left lower extremity weakness after lumbar sprain. He could not walk due to progressive symptoms. Physical examination revealed that straight leg raising and femoral nerve stretch tests on the left side were positive. Magnetic resonance imaging of lumbar showed an intradural disc protruding into the ventral dural sac at the L2-L3 level. He was diagnosed ILDH of L2-L3, finally. An urgent operation was performed to remove the intradural disc fragment. The patient's symptoms improved significantly, postoperatively. After eight months of follow-up, he returned to normal life with only slight lower back pain.
Conclusions:
ILDH at the L2-L3 level is an extremely rare type of LDH. Its diagnosis often requires a combination of symptom, physical examination, and imaging examination due to no typical symptoms or imaging features. A detailed preoperative plan including the definition of the position, calcification, migration, and adhesion of intradural intervertebral discs to decrease the risk of surgery, prevent the occurrence of complications, and promote postoperative prognosis of patients.
Ureteral Strangulation by Fibrosis: A Cold Case Report of Ormand's Disease
Authors: Amarpreet Sandhu, Leslea Brickner, Mark Chen
Journal: Case Rep Nephrol (2011)
MeSH terms: Case Reports

Retroperitoneal fibrosis or Ormand's disease is rare in incidence and clinically elusive to diagnosis until obstructive uropathy clinically manifests by the mechanism of ureteral fibrotic strangulation and acute renal failure. We encountered a 50-year-old woman with months of nonspecific abdominal pain and presented with signs and symptoms of acute renal failure. Laboratory data was significant for blood urea nitrogen 47 mg/dL and creatinine of 8.47 mg/dL. Renal ultrasound revealed bilateral hydronephrosis and an abdominal computed tomogram confirmed an abnormal soft tissue retroperitoneal confluence that encased the pelvic vessels. Urologic consultation was requested and bilateral ureteral stents were placed with relief of her obstructive uropathy. Five days after ureteral stenting her creatinine dropped to 1.64 mg/dL. One month later patient underwent ureterolysis with biopsy showing fibroblast proliferation consistent with acute and chronic inflammation. By ruling out infections and malignancy, the final diagnosis was made to be idiopathic retroperitoneal fibrosis.
Case Report: Rare comorbidity of celiac disease and Evans syndrome: The rare correlation of Celiac and Evans syndrome
Authors: Syed Mohammad Mazhar Uddin, Aatera Haq, Zara Haq, Uzair Yaqoob
Journal: F1000Res (2019)
Keywords: celiac disease, evans syndrome, autoimmune disease
MeSH terms: Anemia, Hemolytic, Autoimmune / complications, Celiac Disease / complications, Thrombocytopenia / complications, Case Reports, Adult, Child, Comorbidity, Female, Humans, Young Adult, Evans Syndrome

Background: Celiac disease is an immune-mediated enteropathy due to permanent sensitivity to gluten in genetically predisposed individuals. Evans syndrome is an autoimmune disorder designated with simultaneous or successive development of autoimmune hemolytic anemia and immune thrombocytopenia and/or immune neutropenia in the absence of any cause. Case Report: We report a rare case of Celiac disease and Evans syndrome in a 20-year-old female who presented to us with generalized weakness and shortness of breath. Her examination finding included anemia, jaundice, and raised jugular venous pulse. Her abdominal exam revealed hepatosplenomegaly. Her laboratory values showed microcytic anemia, leukocytosis and thrombocytopenia. To rule out secondary causes of idiopathic thrombocytopenia purpura, we tested viral markers for Human immunodeficiency virus, Epstein bar virus, Cytomegalovirus and performed a Helicobacter pylori test, all of which were negative. We also ruled out idiopathic thrombocytopenia purpura associated with any thyroid disorder. For celiac disease, we took anti-tissue transgulataminase titers of IgA and IgG which confirmed the diagnosis of celiac disease. For the diagnosis of Evans syndrome, despite a negative serum coombs test initially, her bone marrow sample showed a positive Coombs test along with immune mediated hemolytic anemia and immune mediated thrombocytopenia. The patient was treated with prednisone which was tapered off and counseling was provided regarding a gluten free diet. Conclusion: Although rare, tests for Evans syndrome (and other coexisting autoimmune problems) should be performed in patients with celiac disease.
Management of Suspected Bladder Injury and Capsular Perforation After Holmium Laser Enucleation of the Prostate
Authors: Aye Lwin, Kieran Hynes, David Tzou, Joel Funk
Journal: J Endourol Case Rep (2018)
Keywords: bph, holep, capsular perforation
MeSH terms: Case Reports

Background: Holmium laser enucleation of the prostate (HoLEP) is an attractive and well-studied alternative to transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia. There remains an established steep learning curve with relatively few complications described in the literature. A unique risk of HoLEP is injury of the bladder during morcellation of the adenoma and potential iatrogenic intraperitoneal bladder rupture. We present a rare complication of HoLEP demonstrated by two patients in which capsular perforation resulted in subsequent abdominal distention secondary to a large amount of irrigation fluid that leaked into the extraperitoneal space. Uniquely, these cases were managed differently, and serve as guidance to the HoLEP practitioner in postoperative management. Case Presentations: The first case involved a 74-year-old male who was found to have significant abdominal distention at the end of the procedure. Given an acute change in stability and concern for bladder injury during morcellation, a minilaparotomy was performed only to reveal extraperitoneal extravasation without intraperitoneal bladder injury or perforation. In the second case, a 78-year-old male undergoing HoLEP had a similar presentation of significant abdominal distention at the conclusion of morcellation. Given a low suspicion for any bladder injury, the patient was managed conservatively with diuretics. He was subsequently discharged on postoperative day 1. Conclusion: Capsular perforation is not a rare phenomenon that occurs during HoLEP. Rarely, perforations can lead to extravasation of irrigation fluid into the extraperitoneal space masquerading as a potential bladder injury related to morcellation because of the associated abdominal distention. This presentation can occur in large glands or early in a surgeon's learning curve when operative times are longer. When there is clear evidence to suggest there is no bladder injury, these cases can be managed conservatively and avoid the morbidity of an abdominal exploration.
Successful treatment of pulmonary embolism in a patient with polycythemia vera by rheolytic thrombectomy
Authors: Tufan Çinar, Mert İlker Hayıroğlu, Ahmet Oz
Journal: J Cardiovasc Thorac Res (2019)
Keywords: acute pulmonary embolism, contraindication, polycythemia vera, rheolytic thrombectomy
MeSH terms: Case Reports

Acute pulmonary embolism (APE) may lead to life-threatening conditions such as cardiac death and congestive heart failure. Thus, a proper diagnosis and management play a crucial role to prevent such complications. Moreover, APE is a rare clinical onset of chronic myeloproliferative disease. We herein describe a 67-year-old patient with polycythemia vera presented to our cardiology clinic with pulmonary embolism despite the fact that an intense antiplatelet treatment started secondary to acute myocardial infarction prior. Because the patient had hypotension and head trauma, rheolytic thrombectomy was performed successfully to restore adequate pulmonary perfusion.
Continuous Hepatogonodal and Splenogonogal Fusion: A Rare Cause of Bilateral Intra-Abdominal Testis in an 18-Month-Old Boy
Authors: Gül Durmuş, Ozlem Boybeyi-Turer, Hatice Nursun Özcan, Onur Gözmen, Hüseyin Demirbilek, Tutku Soyer
Journal: European J Pediatr Surg Rep (2022)
Keywords: hepatogonadal fusion, splenogonadal fusion, undescended testis
MeSH terms: Case Reports

The fusion of gonadal structures with internal organs is very rare. The close proximity between the left gonad and spleen during embryogenesis may result in splenogonadal fusion (SGF). Moreover, the trapping of hepatocyte-destined mesenchyme cells in gonads is defined as hepatogonadal fusion (HGF). The fusion of gonads with intra-abdominal organs may be continuous and may impair testicular descent during the prenatal period. We herein report an 18-month-old boy presented with bilateral nonpalpable testis due to concomitant continuous HGF and SGF. To our knowledge, this is the first case of concomitant HGF and SGF in a boy with bilateral intra-abdominal testis. Laparoscopic excision of fibrous cords and orchidopexy can be achieved despite continuous fusions.
Neisseria meningitidis W135, Turkey
Authors: Levent Doganci, Mehmet Baysallar, Mehmet Ali Saracli, Gulsen Hascelik, Alaaddin Pahsa
Journal: Emerg Infect Dis (2004)
MeSH terms: Meningitis, Meningococcal / epidemiology, Neisseria meningitidis, Serogroup W-135 / classification, Neisseria meningitidis, Serogroup W-135 / isolation & purification, Case Reports, Adult, Cerebrospinal Fluid / microbiology, Humans, Male, Meningitis, Meningococcal / microbiology, Neisseria meningitidis, Serogroup W-135 / genetics, Turkey / epidemiology

We describe the first case of Neisseria meningitidis W135 meningitis in Turkey. The strain was genotypically unrelated to the clone (W)ET-37, isolated from Hajj pilgrims in 2000.
Beyond the Syndrome: Extensive Congenital Abnormalities in an Infant With Trisomy 21
Authors: Jeremy D Ward, Mahesh S Sharma, Matthew F Pizzuto, Vincent J Moylan, Frederic B Askin, David G Kaufman
Journal: Clin Pathol (2022)
Keywords: down syndrome, trisomy 21, abnormal intestinal villi formation, abnormal tracheal bronchus, atrioventricular septal defect, bowel adhesions, necrotizing enterocolitis, tetralogy of fallot
MeSH terms: Case Reports

Herein we discuss the clinical course and subsequent autopsy of a female infant with trisomy 21 with balanced Rastelli Type "C" complete atrioventricular septal defect (AVSD), tetralogy of Fallot and right aortic arch with mirror image branching pattern who underwent a palliative right modified Blalock-Taussig-Thomas shunt (mBTTS) for hypoxemia from progressive right ventricular outflow tract obstruction. The baby was found to have multiple concomitant pathologic findings not typically seen with this constellation of cardiac anatomy. Autopsy revealed significant abdominal adhesions with near-complete stenosis of the transverse colon. In addition, the infant was found to have significantly elongated villi within the small and large bowel and a relatively large collagenous polyp in the small bowel. The decedent also had an abnormal tracheal bronchus, characterized by an additional superior right-sided bronchus, which is an extremely rare abnormality. Her clinical course was complicated by severe pulmonary hypertensive arteriolar changes out of proportion to what would be typical for her age, trisomy 21 status, and degree of left to right intracardiac shunting. Furthermore, she had refractory anasarca and recurrent chylous pleural effusions without gross lymphatic abnormalities that may have been secondary to systemic capillary leak syndrome (SCLS) versus severe pulmonary hypertension. Due to the aforementioned findings, the family elected for comfort care and the baby expired shortly after extubation. Overall, the infant had multiple, rare coexisting congenital abnormalities that likely represents an extreme phenotype of trisomy 21 that has not been described in the literature to date.
Efficacy of Carfilzomib, Lenalidomide, and Dexamethasone for Extramedullary Intracranial Localization of Multiple Myeloma
Authors: Giuseppe Mele, Domenico Pastore
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

EMD of myeloma usually occurs several years after diagnosis and is associated with a very poor OS of <6 months due to the fact that there are no efficient treatment options. In rrMM with EMDs, the most effective treatment is a lymphoma-like polychemotherapy regimen such as PACE, Dexa-BEAM, and HyperCVAD followed by ASCT or allogeneic SCT. RT of soft-tissue plasmacytoma is the further treatment choice and results in a high rate of local control and a prolonged disease-free survival. We report the case of a 41-year-old man affected by ultra-high-risk symptomatic IgAλ MM with extramedullary intracranial soft-tissue relapsed after VTD-PACE followed by ASCT. The salvage program with KRd regimen determines a second biochemical and haematological remission and a gradual reduction in size of the extramedullary intracranial soft-tissue even in the absence of local aggressive radiotherapy, suggesting that carfilzomib and lenalidomide together could be effective also in this critical situation.
Unilateral Levator Aponeurosis Excision for Marcus Gunn Syndrome and Risk Factors of Residual Jaw Winking
Authors: Qingyao Ning, Jing Cao, Jiajun Xie, Qi Gao, Changjun Wang, Juan Ye
Journal: J Ophthalmol (2019)

Purpose:
To investigate the association of ptosis, levator, and jaw winking in Marcus Gunn jaw-winking synkinesis (MGJWS), and the risk factor of preservation and outcomes of the unilateral levator excision and frontalis suspension.
Methods:
Clinical features of MGJWS case series from 2011 to 2018 were retrospectively reviewed. Association between jaw winking and ptosis/levator function was statistically analyzed. The patients underwent unilateral levator excision and frontalis suspension using silicone rod or autogenous fascia lata. Clinical outcomes were evaluated in operated patients and the independent risk factors of residual jaw winking were investigated after a long follow-up.
Results:
There were 42 MGJWS patients in 2011 to 2018, accounting for 2.87% of all congenital blepharoptosis. 80% of mild jaw winking was accompanied with mild ptosis and fair levator function, and moderate-to-severe jaw winking was often accompanied with moderate-to-severe ptosis and poor levator function (P < 0.05). Ptosis showed a strong association with excursion of jaw winking (R = 0.785, P < 0.01). Jaw winking was resolved in all 34 operated patients with good correction of ptosis. Severity of jaw winking is an independent risk factor for the residual synkinesis after surgery. Severe preoperative jaw winking had an 18.05 times increased risk of postoperative residual synkinesis compared with moderate jaw winking (P < 0.05).
Conclusions:
In MGJWS eyelid excursion of jaw winking has a direct correlation with ptosis and dysfunction of levator muscle. Unilateral levator aponeurosis excision and frontalis suspension is an efficient approach for MGJWS. Severe jaw winking is a risk factor of residual eyelid synkinesis after surgery.
Imaging Features of Breast Periductal Stromal Tumor: A Case Report
Authors: Ning Ding, Ying Jiang, Haimin Liu, Fuling Zheng, Shenling Zhu, Ming Wang, Meng Yang, Lingyan Kong, Huadan Xue, Zhengyu Jin
Journal: Front Oncol (2021)
Keywords: breast periductal stromal tumor, digital breast tomosynthesis, imaging, mammography, ultrasonography
MeSH terms: Case Reports

Breast periductal stromal tumor (PDST) is a rare biphasic tumor, with both benign ductal epithelium and non-phyllodes sarcomatous stroma. Its imaging features were rarely reported due to the rarity. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the right breast. Presurgery imaging evaluations of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and ultrasonography (US) were performed. The imaging features include the following: 1. multiple solid lobulated lesions comprising nearly the entire right breast; 2. hypoechoic heterogeneous masses with internal separations and abundant blood flow; 3. FFDM and DBT showed multiple irregular high-density masses with lobulated margin, partially integrated. The patient underwent extended mastectomy of the right breast. The surgical pathology confirmed a PDST. After excision of the mass, she was followed up in the outpatient clinic for 25 months without local recurrence or distant metastasis.
Obturator Compartment Syndrome Secondary to Pelvic Hematoma After Robot-Assisted Laparoscopic Radical Prostatectomy
Authors: Jun H Song, Joshua R Kaplan, Daniel Abbott, Eric Gewirtz, Ellen Hauck, Daniel D Eun
Journal: J Endourol Case Rep (2016)
Keywords: ralp, prostate cancer, robotics
MeSH terms: Case Reports

Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits. Our patient's clinical vignette illustrates the importance of considering postsurgical hematoma in the differential diagnosis when patients present with signs and symptoms of obturator neurapraxia after RALP.
Case Report: Congenital Perineal Lipoma Associated With Additional External Genitalia Anomalies
Authors: Francesca Tocchioni, Chiara Caporalini, Annamaria Buccoliero, Flavio Facchini, Marco Ghionzoli, Francesco Morini
Journal: Front Pediatr (2022)
Keywords: accessory scrotum, children, labioscrotal fold, lipoma, perineal mass
MeSH terms: Case Reports

Perineal lipoma is an uncommon congenital benign tumor sometimes associated with genitourinary or anorectal malformations. Accessory scrotum and accessory labioscrotal fold are infrequent features, often concurrent with perineal tumors. We describe a single institution experience with three consecutive cases of perineal lipoma associated with external genital anomalies, and a literature review.
Advanced primary vaginal squamous cell carcinoma: A case report and literature review
Authors: Yue Shen, Xiangkai Meng, Lili Wang, Xiaoxiao Wang, Hua Chang
Journal: Front Immunol (2022)
Keywords: case report, chemotherapy, immune checkpoint inhibitors, radiotherapy, tyrosine kinase inhibitors, vaginal squamous cell carcinoma
MeSH terms: Carcinoma, Immune Checkpoint Inhibitors, Review, Case Reports, Research Support, Non-U.S. Gov't, China, Humans, Middle Aged, Immune Checkpoint Inhibitors

Background:
Vaginal carcinoma is a gynecological malignancy with low incidence, and there are few relevant and specific guidelines for vaginal cancer in our country and abroad. Here, we report the case who was diagnosed with advanced, primary vaginal squamous cell carcinoma and underwent integrated treatment successfully.
Case introduction:
A 64-year-old Chinese woman underwent subtotal hysterectomy for uterine fibroids in 1998 and laparoscopic extensive residual cervical resection, bilateral ovarian salpingectomy, and pelvic lymph node dissection for residual cervical adenocarcinoma (stage IB1) in the First Affiliated Hospital of China Medical University in 2018. There was no postoperative review. The patient experienced vaginal discharge in March 2020, and vaginal bleeding occurred in July 2020. Our patient was diagnosed with stage IVA vaginal squamous cell carcinoma, based on a gynecological examination, colposcopy biopsy with histopathological examination, computed tomography scan, and tumor marker levels by two professors. After three phases of treatment (sequential treatment with chemotherapy plus radiotherapy, chemotherapy combined with immune checkpoint inhibitors, and immune checkpoint inhibitors combined with tyrosine kinase inhibitors therapy), her condition improved. Her current state is generally good, and she has achieved complete remission.
Conclusion:
We report a rare case of a patient with primary advanced vaginal carcinoma combined with cervical adenocarcinoma. The patient was treated for approximately 2 years, and her personalized treatment showed promising results. We will continue to follow up with the patient and monitor her response to the current treatment process.