OpenMed/multicare-articles huggingface dataset:
Benign duodenocolic fistula: A case report and review of the literature
Authors: Zeyu Li, Wenjing Peng, Hongliang Yao
Journal: Front Surg (2023)
Keywords: barium meal, diarrhea, duodenal ulcer, duodenocolic fistula, weight loss

Duodenocolic fistula is a rare upper gastrointestinal fistula that can be benign or malignant. However, benign duodenocolic fistulas are particularly rare. Duodenocolic fistulas are often a complication of advanced colon cancer. The most common cause of benign fistulas is perforation of the duodenal ulcer. We report a case of a benign duodenocolic fistula in a patient who presented with abdominal pain, diarrhea, and weight loss. Gastroscopy and an upper gastrointestinal study confirmed the presence of the fistula. Surgery was performed, and the pathological examination demonstrated that the fistula originated from a duodenal ulcer.
Case Report: Treatment of Extremely Preterm Infants With Birthweight Below 300 g: Case Series
Authors: Yoshihiko Shitara, Satsuki Kakiuchi, Takeo Mukai, Kohei Kashima, Motohiro Kato, Naoto Takahashi
Journal: Front Pediatr (2021)
Keywords: birthweight below 300 g, en caul delivery, extremely low birthweight infants, extremely preterm infants, fetal growth restriction, obstetric complications, parental counseling
MeSH terms: Case Reports

Reports on the birth of infants weighing <300 g are quite rare and little is known about the best practices in treating such micropreemies. Therefore, we report here on three cases of low birthweight infants weighing <300 g, of whom two infants survived. The birthweights and gestational ages were ranging 279-293 g and 22 + 6/7 - 23 + 6/7 weeks, respectively. All the infants had severe fetal growth restriction and prematurity. The infant in case 1 died of hepatic rupture, perhaps due to birth trauma, which emphasized the need for less invasive obstetric procedures including en caul delivery. The infant in case 2 managed to survive through severe prematurity secondary to hydrops fetalis. However, complications followed soon as tracheal granulation tissue was formed with neurodevelopmental impairment. The infant in case 3 was born recently and her clinical course was less remarkable without severe complications, despite having the least gestational age and birthweight among the three patients. The improved care protocols for extremely low birthweight infants over these years through experiential learning including that with cases 1 and 2 may have ensured the better outcome of case 3. Accumulating evidence and recording the experience of such cases with continuous constructive discussion can contribute to better outcomes and appropriate parental counseling for extremely small babies in the future.
Askin's Tumor: A Dual Case Study
Authors: Bikash Shrestha, Bhupendra Nath Kapur, Kavita Karmacharya, Sunita Kakkar, Ranjit Ghuliani
Journal: Int J Pediatr (2011)
MeSH terms: Case Reports

Askin's tumor is a rare tumor arising from the chest wall. It is a subset of Ewing sarcoma characterized histologically by the presence of small round blue cells. It is a highly malignant tumor with guarded prognosis, which is dependent upon the extension of tumor at the time of diagnosis. A dual paper of Askin's tumors in young boys is being presented here.
Case report: Urothelial carcinoma of the renal pelvis with trophoblastic differentiation: A rare case report and review of literature
Authors: Zhuo Wang, Jinsui Wang, Wenwen Zhang, Daoying Wang, Xiaojun Wang, Xiaoqin Liang
Journal: Pathol Oncol Res (2023)
Keywords: beta-human chorionic gonadotropin, renal pelvis, syncytiotrophoblastic cells, trophoblastic differentiation, urothelial carcinoma
MeSH terms: Carcinoma, Transitional Cell / pathology, Urinary Bladder Neoplasms / pathology, Review, Case Reports, Cell Differentiation, Humans, Kidney Pelvis / pathology, Male, Middle Aged, Positron Emission Tomography Computed Tomography

We report a rare case of urothelial carcinoma (UC) of the renal pelvis with trophoblastic differentiation that occurred in a 55-year-old male patient. The patient presented with gross hematuria and paroxysmal lumbago pain 5 months ago. The enhanced computed tomography (CT) scan demonstrated a large space occupying lesion in the left kidney and multiple retroperitoneal lymph node enlargements. Histologically, high-grade infiltrating urothelial carcinoma (HGUC) contained giant cells which were positive for beta-human chorionic gonadotropin (β-hCG). Three weeks after resection, positron emission tomography and computed tomography (PET-CT) scan showed multiple nodules of metastasis in the left renal region, extensive systemic muscle, bone, lymph node, liver and bilateral lung metastases. The patient underwent bladder perfusion chemotherapy and gemcitabine combined with cisplatin chemotherapy regimens. This is the eighth documented case of UC of the renal pelvis with trophoblastic differentiation. Due to its rarity and extremely poor prognosis, it is important to clarify the characteristics of the disease and make an accurate and prompt diagnosis.
A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively
Authors: Lukas Delasos, Aakash Desai, Nerea Lopetegui Lia, Nikhila Kethireddy, Carolyn Ray
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

The advent of checkpoint inhibitor therapy in medical oncology has led to an increase in hospitalizations for immune-related adverse effects. Severe colitis has been reported in approximately 5% of patients treated with cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) inhibitors, such as ipilimumab. Standard management for those with severe colitis includes administration of systemic corticosteroids with the reservation of antitumor necrosis factor (anti-TNF) therapy, such as infliximab, if there has been no improvement. Rarely, immunotherapy-induced colitis can become life-threatening and result in bowel perforation requiring surgical intervention. Yet, there are no specific recommendations for medical management following colectomy in these situations. In cases of severe colitis from Crohn's disease, postoperative treatment with infliximab has been found to be safe when administered shortly after intestinal resection. However, there remains limited data to support administration of infliximab following bowel perforation due to immunotherapy-induced colitis. Our case illustrates management of a severe adverse reaction to checkpoint inhibitor therapy and the need to further evaluate the role of infliximab postoperatively in patients who develop colitis complicated by bowel perforation.
A 'giant' paraganglioma in the testis
Authors: Marinos C Makris, Konstantinos C Koumarelas, Apostolos S Mitrousias, Giannos G Psathas, Athanasios Mantzioros, Stratigoula P Sakellariou, Panagiota Ntailiani, Evripides Yettimis
Journal: Endocrinol Diabetes Metab Case Rep (2014)

Until now, less than ten cases of extra-adrenal chromaffin cell tumors have been reported to be localized to the spermatic cord area. All published studies report benign tumors with a diameter <2-3 cm and no invasion of the testis. In this article, we present one case of a giant malignant paraganglioma in the testis of a patient who had initially been operated for a giant mass in the scrotum. The mass developed in approximately 4 months. This is the first study reporting the following findings: i) paraganglioma was found exclusively in the testis, invading the testicle and not the spermatic cord, ii) it was malignant with lung metastasis, and iii) its size was 17.5 cm×10 cm×9.5 cm. We present the first - giant - malignant paraganglioma. Moreover, it is the first case report of a paraganglioma in the testis.
Learning points:
This is the first study reporting the following findings:Paraganglioma found exclusively in the testis, invading the testicle and not the spermatic cord.It is malignant with lung metastasis.It is of the size 17.5 cm×10 cm×9.5 cm.
DYNC1H1 variant associated with epilepsy: Expanding the phenotypic spectrum
Authors: Chi-Ting Chung, Ni-Chung Lee, Sung-Pin Fan, Miao-Zi Hung, Yen-Heng Lin, Chih-Hao Chen, Tun Jao
Journal: Epilepsy Behav Rep (2022)
Keywords: cmt, charcot–marie–tooth disease, eeg, electroencephalography, epilepsy, id, intellectual disability, intellectual disability, mcd, malformation of cortical development, mri, magnetic resonance imaging, malformations of cortical development, neurodevelopmental delay, pathogenic dync1h1 variant, smaled, spinal muscular atrophy with lower extremity-predominance
MeSH terms: Case Reports

DYNC1H1 variants are associated with peripheral neuronal dysfunction and brain morphology abnormalities resulting in neurodevelopmental delay. However, few studies have focused on the association between DYNC1H1 variants and epilepsy. Herein, we report a case of drug-resistant focal epilepsy associated with a pathogenic variant of DYNC1H1. We further summarized the clinical, genetic, and neuroimaging characteristics of patients with DYNC1H1 variant-associated epilepsy from the relevant literature. This report expands the phenotypic spectrum of DYNC1H1-related disorder to include early-onset epilepsy, which is frequently associated with neurodevelopmental delay and intellectual disability, malformations of cortical development, and neuromuscular, ophthalmic, and orthopedic involvement.
Indigenous case of disseminated histoplasmosis, Taiwan
Authors: Chung-Hsu Lai, Chun-Kai Huang, Chuen Chin, Ya-Ting Yang, Hsiu-Fang Lin, Hsi-Hsun Lin
Journal: Emerg Infect Dis (2007)
MeSH terms: Histoplasmosis / diagnosis, Histoplasmosis / epidemiology, Case Reports, Aged, Amphotericin B / therapeutic use, Antifungal Agents / adverse effects, Antifungal Agents / therapeutic use, Diagnosis, Differential, Histoplasmosis / drug therapy, Humans, Itraconazole / adverse effects, Itraconazole / therapeutic use, Male, Taiwan / epidemiology, Antifungal Agents, Itraconazole, Amphotericin B

We report the first indigenous case of disseminated histoplasmosis in Taiwan diagnosed by histopathology of bone marrow, microbiologic morphology, and PCR assay of the isolated fungus. This case suggests that histoplasmosis should be 1 of the differential diagnoses of opportunistic infections in immunocompromised patients in Taiwan.
Toxic shock syndrome and pyomyositis: about an unusual case
Authors: Mouad El Mouhtadi, Karima El Fakiri, Noureddine Rada, Ghizlane Draiss, Youssef Mouaffak, Said Younous, Mohammed Bouskraoui
Journal: Pan Afr Med J (2020)
Keywords: pyomyositis, magnetic resonance imaging, toxic shock syndrome
MeSH terms: Pyomyositis / diagnosis, Shock, Septic / diagnosis, Case Reports, Child, Humans, Magnetic Resonance Imaging, Male, Pyomyositis / physiopathology, Shock, Septic / physiopathology

Pyomyositis is a pyogenic infection of skeletal muscle with abscess formation. It is a rare disease with nonspecific symptoms which requires a rapid diagnosis and treatment. Magnetic resonance imaging is considered the gold standard for early diagnosis and to rule out other etiologies. This article reports an atypical presentation of pyomyositis revealed by a toxic staphylococcal shock syndrome in an 8-year-old boy.
Unexpected curious cause of serious air leakage after endotracheal intubation: A case report of tracheobronchomegaly and literature review
Authors: Jun Xiong, Quan Zhou, Yu Li, Yanyan Sun, Yajun Zhang
Journal: Front Surg (2022)
Keywords: mounier-kuhn syndrome, difficult airway, endotracheal intubation, orthopedic, scoliosis, tracheobronchomegaly
MeSH terms: Case Reports

Purpose:
Tracheobronchomegaly (TBM) is a rare disease with enlarged trachea and mainstem bronchi, which might not be diagnosed preoperatively because of patient's nonsymptoms or clinicians' overlook. These patients would be at fatal risk after general anesthesia endotracheal intubation due to severe peritubal leakage. This case may provide a helpful and informative resource for anesthesiologists and other clinicians, especially those managing patients' airways.
Clinical feature:
We presented a patient undergoing elective scoliosis orthopedics who was postoperatively diagnosed with TBM. After general anesthesia endotracheal intubation, difficulty in maintaining ventilation with obvious peri-cuff air leakage made this rare disease to be suspected. The peritubal leakage was resolved by relocating the endotracheal tube to the subglottic area. Fortunately, there were no air leakage and postoperative complications.
Conclusion:
Anesthesiologists should keep the possibility of the unpredicted anatomic abnormal respiratory tract in mind, such as TBM.
Conservative management of nivolumab-induced pericardial effusion: a case report and review of literature
Authors: Shagufta Shaheen, Hamid Mirshahidi, Gayathri Nagaraj, Chung-Tsen Hsueh
Journal: Exp Hematol Oncol (2018)
Keywords: corticosteroids, immune checkpoint inhibitor, nivolumab, non-small cell lung cancer, pericardial effusion
MeSH terms: Case Reports

Background:
Nivolumab is an immune checkpoint inhibitor targeting programmed death-1 protein and has been approved for the treatment of multiple advanced malignancies. Adverse effects of immune checkpoint inhibitors are distinct from conventional cytotoxic chemotherapy and can be life-threatening if left unrecognized. Here, we present a case of nivolumab-induced pericardial effusion successfully managed with high-dose corticosteroids.
Case presentation:
A 70-year-old Caucasian female with a history of 50-pack-year cigarette smoking was diagnosed of recurrent adenocarcinoma of lung after initial surgery. She progressed through multiple lines of chemotherapy and was eventually started on nivolumab. She developed a large pericardial effusion, grade 3 by Common Terminology Criteria for Adverse Events v4.0, about 4 days after receiving first nivolumab treatment. She was treated with oral prednisone at 1 mg/kg daily with gradual resolution of pericardial effusion over 5 weeks while she still received nivolumab every 2 weeks. Prednisone treatment was eventually tapered off about 10 weeks from initial nivolumab treatment. However 1 week after stopping prednisone, she again presented with shortness of breath and bilateral ankle edema, imaging confirmed recurrent pericardial effusion measuring 2.8 cm. Nivolumab was stopped and patient was again started back on prednisone 1 mg/kg daily which resulted in complete resolution of pericardial effusion in 3 weeks. Nivolumab was resumed 1 week afterwards while patient was on tapering dose of prednisone. There was no recurrent pericardial effusion when she continued low-dose prednisone during the remaining course of nivolumab treatment.
Conclusions:
With increasing use of immune checkpoint inhibitors, clinicians need to be aware of the unusual immune-related adverse events in order to provide timely management and effective patient care. To our knowledge, this is the first reported case of immune-related pericardial effusion from nivolumab successfully managed with high-dose corticosteroids. Furthermore, recurrent pericardial effusion was prevented by using low-dose corticosteroids as maintenance in order for patient to continue nivolumab treatment.
Case report: Accelerated regression of giant cardiac rhabdomyomas in neonates with low dose everolimus
Authors: Daniel Hurtado-Sierra, Judy Ximena Ramos Garzón, Lyda Z Rojas, Oscar Fernández-Gómez, Francisco Manrique-Rincón
Journal: Front Pediatr (2023)
Keywords: cardiac tumors, everolimus, infant, newborn, rhabdomyoma, tuberous sclerosis
MeSH terms: Case Reports

Cardiac rhabdomyoma (CRHM) is the principal cardiac tumor in children and is most often associated with tuberous sclerosis complex (TSC). Mutations in the TSC1 and TSC2 genes cause the overactivation of the mammalian Target of Rapamycin (mTOR). This protein family is responsible for abnormal cell proliferation leading to the formation of CRHMs and hamartomas in other organs. Despite the tendency for spontaneous regression, some CRHMs can cause heart failure and intractable arrhythmias, requiring surgical resection. In recent years, the use of everolimus and sirolimus (mTOR inhibitors) in the treatment of CRHMs has been reported. We report two cases of neonates with giant rhabdomyomas, with hemodynamic repercussions treated with low-dose everolimus (4.5 mg/m2/week). In both cases, we obtained an approximate decrease of 50% in the total area of the mass after three weeks of treatment. Despite rebound growth after stopping the drug, we were able to evidence that the use of low doses of everolimus immediately after birth is effective and safe in the treatment of giant CRHMs, avoiding surgical resection of the tumor and associated morbidity and mortality.
Misdiagnosis of a Giant Uterine Leiomyosarcoma: Clinic and Image Challenges
Authors: Jila Agah, Sedighe Karimzadeh, Fateme Moharrer Ahmadi
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

A 41-year-old woman (G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergone imaging. Ultrasonography and computed tomography (CT) scan disclosed a huge solid-cystic mass originating from the ovary. On clinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumor markers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumor with attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found. Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring 40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptoms misdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonography in patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonance imaging (MRI) could be offered to avoid misdiagnosis and mismanagement.
Primary, cardiac, fibroblastic osteosarcoma: A case report
Authors: Yangyang Li, Teng Ye, Qianru Gu, Lei Dong, Guorong Chen, Shanshan Lu
Journal: Medicine (Baltimore) (2018)
MeSH terms: Heart Neoplasms / diagnostic imaging, Myocardium / pathology, Osteosarcoma / diagnostic imaging, Case Reports, Adult, Fatal Outcome, Female, Heart Neoplasms / pathology, Humans, Osteosarcoma / pathology

Rationale:
Primary cardiac osteosarcoma is a rare tumor. To our knowledge, only 15 cases have been reported in the literature in the past 10 years. We describe a case of primary, cardiac, fibroblastic osteosarcoma in a 42-year-old woman.
Patient concerns:
A 42-year-old woman with a 10-day history of chest pain. Intraoperatively, a mass was found originating from the ostium of the left inferior pulmonary vein in the left atrium, extending to the mitral orifice. Histologically, the tumor contained variable amounts of spindle cells and osseous differentiation in different areas. Primary, cardiac fibroblastic osteosarcoma had the typical appearance of interlacing hyperchromatic spindle-shaped stromal cells associated with osseous matrix.
Diagnoses:
According to the clinicopathological features, diagnosis of primary, cardiac fibroblastic osteosarcoma was made.
Interventions:
Wide surgical excision of the mass was performed.
Outcomes:
Three months after the operation, transthoracic echocardiography demonstrated a 3.2 cm × 2 cm recurrent mass in the wall of the left atrium (LA). She died shortly afterwards as a result of the local disease recurrence.
Lessons:
In this report, we describe a rare case of primary, cardiac fibroblastic osteosarcoma, and findings are helpful for the pathologists would like to further identify the clinicopathological features of this rare tumor.
Lemierre's Syndrome: Rare, but Life Threatening-A Case Report with Streptococcus intermedius
Authors: Shalini Gupta, Shehzad S Merchant
Journal: Case Rep Med (2012)

Lemierre's syndrome (LS) is a rare, but a life-threatening complication of an oropharyngeal infection. Combinations of fever, pharyngitis, dysphagia, odynophagia, or oropharyngeal swelling are common presenting symptoms. Infection of the lateral pharyngeal space may result in thrombosis of the internal jugular vein, subsequent metastatic complications (e.g., lung abscesses, septic arthritis), and significant morbidity and mortality. LS is usually caused by the gram-negative anaerobic bacillus Fusobacterium necrophorum, hence also known as necrobacillosis. We present a case of LS caused by Streptococcus intermedius, likely secondary to gingival scraping, in which the presenting complaint was neck pain. The oropharyngeal examination was normal and an initial CT of the neck was done without contrast, which likely resulted in a diagnostic delay. This syndrome can be easily missed in early phases. However, given the potential severity of LS, early recognition and expedient appropriate antimicrobial treatment are critical. S. intermedius is an unusual cause of LS, with only 2 previous cases being reported in the literature. Therefore, an awareness of the myriad presentations of this syndrome, which in turn will lead to appropriate and timely diagnostic studies, will result in improved outcome for LS.
Multimodal imaging in a patient with Prader-Willi syndrome
Authors: Mohamed A Hamid, Mitul C Mehta, Baruch D Kuppermann
Journal: Int J Retina Vitreous (2018)
Keywords: fovea plana, macular-foveal capillaries, prader–willi syndrome, type 2 macular neovascularization
MeSH terms: Case Reports

Background:
Prader-Willi syndrome (PWS) is a genetic disease caused by loss of expression of the paternally inherited copy of several genes on the long arm of chromosome 15. Ophthalmic manifestations of PWS include strabismus, amblyopia, nystagmus, hypopigmentation of the iris and choroid, diabetic retinopathy, cataract and congenital ectropion uvea. An overlap between PWS and oculocutaneous albinism (OCA) has long been recognized and attributed to deletion of OCA2 gene located in PWS critical region (PWCR).
Case report:
A 30-year-old male patient with PWS presented with vision loss in his left eye. His right eye had normal visual acuity. Multimodal imaging revealed absence of a foveal depression and extremely reduced diameter of the foveal avascular zone in the right eye and an inactive type 2 macular neovascular lesion in the left eye.
Conclusions:
We report a presumed association of fovea plana and choroidal neovascularization with PWS. The use of multimodal imaging revealed novel findings in a PWS patient that might enrich our current understanding of the overlap between PWS and OCA.
Double Native Valve Infective Endocarditis due to Capnocytophaga canimorsus: First Reported Case Caused by a Lion Bite
Authors: Mazin Barry
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Capnocytophaga canimorsus is a Gram-negative bacilli that is part of the normal oral flora of dogs and some cats; it is well known to cause septicemia and endocarditis after their bite. This is the first reported case of infective endocarditis affecting both native mitral and aortic valves after a lion bite in a patient with heavy ethanol consumption, who ultimately died after valve replacements.