OpenMed/multicare-articles huggingface dataset:
Splenic epithelial cyst mistaken with Hydatid cyst: A case report
Authors: Youssef A Sleiman, Ali Bohlok, Melody El-Khoury, Pieter Demetter, Marc Zalcman, Issam El Nakadi
Journal: Int J Surg Case Rep (2018)
Keywords: hydatid cyst, spleen conserving surgery, splenic epithelial cysts

Introduction:
Cystic lesions of the spleen are infrequent and usually diagnosed incidentally. These lesions are rare and their differential diagnosis is very wide. Splenic epithelial cysts are the most common type of primary splenic cyst (4%). Surgical treatment is indicated for cysts larger than 5 cm or symptomatic. Nowadays, spleen preserving surgery is the gold standard treatment considering the immunologic role of the spleen and the increased risk of post-splenectomy infections.
Case presentation:
A 17 year old girl presented to the outpatient clinic with moderate left upper quadrant abdominal pain of 2 weeks duration with loss of appetite and denied fever, chills, sweating and jaundice. Abdominal examination showed tender splenomegaly. The abdominal imaging (Ultrasound, CT SCAN, MRI) was suggestive of hydatid cyst of the spleen, for which she received Albendazole for 1 month and then operated by laparotomy with partial resection and un-roofing of the splenic cyst. The pathology report showed a splenic epithelial cyst (SEC).
Conclusion:
SEC is a rare pathology that could mimic splenic hydatid cyst. The clinical and radiological pictures may be commonly misleading and non-conclusive. Definitive diagnosis is made on histopathology. Spleen conserving surgery, when possible, is the preferred modality for treatment.
Cocaine-Induced Giant Bullous Emphysema
Authors: Steven Douedi, Vandan D Upadhyaya, Ishan Patel, Usman Mazahir, Eric Costanzo, Mohammad A Hossain
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Emphysematous bullae, defined as airspaces of greater than or equal to one centimeter in diameter, have a variety of etiologies such as tobacco use and alpha-1 antitrypsin being the most common. Emphysematous bullae have also been reported in patients using cocaine usually involving the lung periphery and sparing the central lung parenchyma. We present a case of a male with a history of cocaine abuse found to have a singular giant emphysematous bulla occupying >95% of the right hemithorax requiring video-assisted thoracic surgery (VATS) with a favorable outcome. Case Presentation. A 50-year-old male with a history of chronic cocaine abuse was found unresponsive in the field and given multiple doses of naloxone without any improvement in mental status. On presentation to the emergency department, chest X-ray as well as CT scan of the chest were performed which were suggestive of an extensive pneumothorax of the right lung requiring placement of a chest tube. The patient was subsequently intubated and underwent bronchoscopy with right chest VATS which found a giant bulla encasing the entire right pleural cavity. During the procedure, he underwent resection of the bullae and a partial right pleurodesis. After the procedure, patient's respiratory status significantly improved, and he was discharged in a stable condition.
Conclusion:
Cocaine use is a rare but identifiable factor that can cause giant bullous emphysema (GBE) resulting in severe complications and even death. The purpose of this case presentation is to support early identification and treatment of GBE using bullectomy with VATS, improving outcomes and decreasing morbidity and mortality.
Metachronous, Single Metastasis to the Parotid, from Primary Breast Cancer: A Case Report and Review of the Literature
Authors: Michel Kmeid, François G Kamar, Selim Nasser, Nabil Moukarzel
Journal: Case Rep Oncol Med (2016)

Background. The parotid gland is an unusual site for metastatic disease and when metastasis occurs, it commonly originates from head and neck primaries. Spread from distant infraclavicular sites such as the breast, into the parotid, is even more unusual with very few cases reported in the literature. Case Report. We describe the case of a 65-year-old woman presenting for a rapidly enlarging right parotid mass. She had a history of an invasive ductal carcinoma of the right breast and was disease-free in the past 6 years prior to her presentation. She was thereafter diagnosed as having a solitary parotid metastasis from breast origin. A total parotidectomy was done and she was referred for adjuvant radiotherapy. Conclusion. Any parotid metastasis should be investigated, especially in patients with a prior history of cancer where the possibility of metastasis, even if improbable, should be kept in mind. Fine needle aspiration biopsy (FNAB) is the first diagnostic procedure to be done and immunocytochemistry can provide valuable information even if it is not always needed for diagnosis. Superficial parotidectomy when feasible with adjuvant radiotherapy is the preferred approach for solitary metastasis of the parotid. The prognosis, however, remains poor regardless of the treatment modality used.
Complicated enterocele: timely resolution with bowel resection via a vaginal approach: case report
Authors: Paola Abis, Clelia Madeddu, Giovanni Magro Malosso, Gabriele Sole, Alessia Mereu, Giorgia Locci, Antonio Macciò
Journal: Front Surg (2023)
Keywords: bowel resection, case report, enterocele, evisceration, gynecology, minimally invasive surgery
MeSH terms: Case Reports

Background:
Enterocele is an uncommon, serious condition that requires accurate and early diagnosis to prevent complications such as intestinal obstruction, incarceration, and strangulation, with consequent intestinal ischemia, necrosis, and evisceration. We report a rare case of a patient with a voluminous enterocele and initial signs of intestinal ischemia who underwent urgent vaginal surgery.
Case description:
An 80-year-old woman presented with a voluminous mass protruding from the vagina, associated abdominopelvic pain, a 10-day history of bowel sub-occlusion, and numerous episodes of profuse vaginal bleeding. She was diagnosed with an enterocele with early signs of complications. Owing to her advanced clinical condition and comorbidities, we opted for an urgent vaginal procedure. Intestinal loops with initial signs of ischemia were resected via a transvaginal approach, leading to good clinical outcomes. She was discharged on postoperative day 5.
Conclusions:
This rare case highlights a surgical emergency that was managed with transvaginal resection of the intestine. Early identification of the initial signs of complications allowed for this less invasive approach, resulting in reduced morbidity and length of hospital stay.
Suprasellar Ganglioglioma: Expanding the Differential Diagnosis
Authors: Isabella Tondi Resta, Arminder Singh, Bruce C Gilbert, Mumtaz V Rojiani, Cargill Alleyne, Amyn M Rojiani
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

This case study describes a young man with symptoms suggestive of the presence of a space-occupying lesion within the cranial cavity. Imaging studies confirmed a lesion in the suprasellar region and surgical intervention to remove the tumor yielded an unexpected diagnosis. Neuroimaging characteristics and histopathology including immunohistochemistry are described. Gangliogliomas are uncommon CNS neoplasms and are most commonly found in the temporal and frontal lobes of young, male adults. They are rarely seen in the suprasellar region and only a handful of cases have been reported to date. The differential diagnoses associated with these suprasellar region lesions can be dependent on the age of the patient and neuroimaging characteristics. The present report highlights the importance of histopathological examination and the need to consider a wide range of diagnostic entities in the differential diagnosis of lesions in this topographic distribution, including rarely encountered tumors such as gangliogliomas.
Case report: Sublingual mucinosis in a dog
Authors: Debora Tinto, Chiara Tassani, Matteo Di Benedetto, Silvia Sabattini, Ombretta Capitani
Journal: Front Vet Sci (2022)
Keywords: shar-pei, case report, ialuronic acid, mucinosis, ranula, sublingual swelling
MeSH terms: Case Reports

A 11-month-old male intact Shar-Pei (26. 5 kg) was presented for a bilateral sublingual swelling of 4 months duration. The exploration of the oral cavity highlighted the presence of bilateral sublingual swellings, primarily consistent with bilateral ranula. The bilateral disease was treated with two subsequent surgeries 4 weeks apart. During the surgery, after removing an elliptical portion of the mucosa of the sublingual swelling, the presence of gelatinous tissue was visualized, and no saliva was present. The result of histological exam was oral mucinosis. At the subsequent follow-up the dog was in excellent conditions, without any symptoms. 1 month after the last operation, the dog underwent a visit in sedation to better evaluate the oral cavity. Both surgical sites were well-healed and without the presence of relapses. Upon 8 months follow-up the patient remained free of disease. This is the first reported case of oral mucinosis in sublingual mucosa in dogs. In this case the surgical treatment was curative.
Staphylococcus aureus Colonization Modulates Tic Expression and the Host Immune Response in a Girl with Tourette Syndrome
Authors: Costantino Eftimiadi, Gemma Eftimiadi, Piergiuseppe Vinai
Journal: Front Psychiatry (2016)
Keywords: aso, pandas, staphylococcus aureus, streptococcus pyogenes, tourette syndrome, dopamine receptor autoantibodies, nasal carriage
MeSH terms: Case Reports

A 9-year-old girl with Tourette syndrome (TS) and increased antibody levels against Streptococcus pyogenes was monitored longitudinally for the presence of nasopharyngeal bacteria, specific antibody titers, and autoimmunity directed against brain antigens. Microbiological monitoring indicated that the child was an intermittent Staphylococcus aureus nasopharyngeal carrier. Clinical improvements in motor tic frequency and severity were observed during the S. aureus colonization phase and were temporally correlated with the downregulation of anti-streptococcal and anti-D1/D2 dopamine receptor antibody production. After decolonization, clinical conditions reverted to the poor scores previously observed, suggesting a possible role of the immune response in bacterial clearance as a trigger of symptom recrudescence. These findings imply that a cause-effect relationship exists between S. aureus colonization and tic improvement, as well as between bacterial decolonization and tic exacerbation. Understanding the impact of S. aureus on the host adaptive immune response and the function of autoantibodies in the pathogenesis of TS may alter approaches for managing autoimmune neuropsychiatric and tic disorders.
A case report of adalimumab-associated optic neuritis
Authors: Alice Kim, Norman Saffra
Journal: J Ophthalmic Inflamm Infect (2012)

Purpose:
To describe a case of retrobulbar optic neuritis that presented within 3 weeks of adalimumab treatment initiation.
Methods:
This index case was evaluated with visual field testing, brain magnetic resonance imaging, lumbar puncture, and laboratory evaluation, and treated with intravenous methylprednisolone followed by a steroid taper.
Results:
Our patient made a full visual recovery, but was found to have extensive T2/FLAIR foci of hyperintensities that enhanced and had restricted diffusion on magnetic resonance imaging (MRI). Six months later, these demyelinating lesions still persisted and our patient was initiated on immunomodulatory treatment.
Conclusion:
With the extensive burden of disease at presentation and persistence of lesions on follow-up MRI, this unusual case seems to suggest an unmasking of an underlying demyelinating process by adalimumab. The clinician should be mindful of this association and monitor for any manifestations and treat appropriately.
A case report of multinodular hepatic steatosis mimicking pseudotumors of the liver
Authors: Pavel Burko, Nitin Juggath, Ruslan Iliasov, Mariya Fedorova, Natalia Nazarova
Journal: SA J Radiol (2022)
Keywords: computed tomography, fatty liver disease, hepatic steatosis, liver, magnetic resonance imaging, pseudotumours
MeSH terms: Case Reports

Fatty liver disease (FLD) is a common, benign pathology often found incidentally. We present a clinical case in which metastatic liver disease was suspected on initial imaging studies. Following further investigations, a diagnosis of 'non-alcoholic fatty liver disease (NAFLD), multinodular type' was postulated. Subsequent histology confirmed the presence of liver steatosis. Multinodular type hepatic steatosis is a rare, but clinically important pathology to identify and differentiate from other multifocal lesions of the liver parenchyma.
Case Report: Anlotinib combined with PD-1 inhibitor and sequential GA regimen or FOLFIRINOX Chemotherapy in treatment of KRAS G12V mutated pancreatic ductal adenocarcinoma with liver metastasis: A case and literature review
Authors: Yunpeng Wang, Bofang Wang, Lin Xiang, Junge Deng, Bo Xu, Puyi He, Weigao Pu, Haiyun Wang, Yong Fan, Hao Chen
Journal: Front Immunol (2022)
Keywords: anlotinib, kras, pd-1 inhibitor, case report, chemotherapy, metastatic pancreatic ductal adenocarcinoma
MeSH terms: Carcinoma, Pancreatic Ductal / drug therapy, Carcinoma, Pancreatic Ductal / genetics, Liver Neoplasms / drug therapy, Liver Neoplasms / genetics, Pancreatic Neoplasms / drug therapy, Pancreatic Neoplasms / genetics, Pancreatic Neoplasms / pathology, Review, Case Reports, Research Support, Non-U.S. Gov't, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Humans, Immune Checkpoint Inhibitors / therapeutic use, Proto-Oncogene Proteins p21(ras) / genetics, folfirinox, Immune Checkpoint Inhibitors, anlotinib, Proto-Oncogene Proteins p21(ras), KRAS protein, human, Pancreatic Carcinoma

There is a high mortality rate associated with pancreatic cancer, and the incidence has been rising globally in recent decades. When patients are diagnosed, there is little chance that surgery will be beneficial. Systemic chemotherapy is the currently accepted treatment option for patients with metastatic advanced pancreatic cancer. However, a very limited survival improvement is possible with chemotherapy for advanced pancreatic cancer, and chemotherapy resistance plays a significant role in poor prognosis. Despite the fact that targeting growth factor receptor inhibitors such as anti-vascular endothelial growth factor (VEGFR) antibodies significantly improves survival in pancreatic cancer, only a very small number of patients benefit from the treatment. As emerging drugs, immune checkpoint inhibitors (ICIs) have demonstrated significant therapeutic effects in several tumor types, but monotherapy is not effective in pancreatic cancer. In the first-line treatment of solid tumors, combination therapy may result in remarkable outcomes. Here in, we have reported a younger patient with pancreatic ductal adenocarcinoma with liver metastasis (PDACLM) who had a long-term partial response and good tolerance to the combination of anlotinib and programmed cell death protein 1 (PD-1) inhibitor and chemotherapy. Gene analysis suggested only one mutation in the Kirsten rat sarcoma viral oncogene (KRAS) G12V gene. Consequently, there is some hope for patients with pancreatic cancer, especially for KRAS G12V gene mutated patients. Upon reviewing the literature, this patient's combination therapy is the first to have been reported.
Case report: Denosumab-associated acute heart failure in patients with cardiorenal insufficiency
Authors: Yuexian Xing, Sicong Ju, Mengyu Sun, Shoukui Xiang
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: cardiorenal insufficiency, denosumab, heart failure, hypocalcemia, osteoporosis
MeSH terms: Heart Failure / complications, Heart Failure / drug therapy, Hypocalcemia / chemically induced, Hypocalcemia / complications, Osteoporosis, Case Reports, Research Support, Non-U.S. Gov't, Calcium, Denosumab / adverse effects, Female, Humans, Vitamin D, Vitamin D, Denosumab, Calcium

Denosumab is a pivotal treatment for postmenopausal women with osteoporosis. Although its clinical use is generally well tolerated by patients, denosumab in patients with renal insufficiency may increase the risk of hypocalcemia. Thus, we have to consider the population of denosumab in the treatment of osteoporosis and preventive measures for related complications. In a patient with cardiorenal insufficiency, we reported a case of denosumab-induced hypocalcemia complicated by acute left heart failure due to delayed administration of active vitamin D and calcium supplements. The patient's symptoms did not improve after anti-heart failure treatment. However, after adequate calcium and vitamin D supplementation subsequently, the patient's symptoms of heart failure were rapidly relieved, and the serum calcium level returned to normal within three weeks. Therefore, our case showed that the application of denosumab in patients requires assessment of cardiac and renal function, timely calcium and vitamin D supplementation, and enhanced monitoring of serum calcium levels to prevent acute left heart failure induced by denosumab-related hypocalcemia.
Renal Agenesis, Extramural Ectopic Ureter, and Nonfunctioning Urinary Bladder: A Difficult Clinical Case with an Innovative Approach
Authors: Armands Vekšins, Laura Voiko, Charlotte Sandersen, Ilze Dūzena, Olga Rabočaja
Journal: Case Rep Vet Med (2023)
MeSH terms: Case Reports

Summary. A 7-month-old female Jack Russell Terrier weighing 4.6 kg was referred to a veterinary hospital for persistent urinary incontinence. Blood test results and vital signs were within the normal range. Computed tomography allowed the diagnosis of extramural ectopic ureter and unilateral renal agenesis. After the first neoureterocystostomy surgery, the dog had severe complications, such as hydroureter and hydronephrosis, so a second surgery was performed. A commercial ureteral stent was not an option, and it was decided to fabricate a homemade stent to avoid euthanasia. The stent used was a soft, DEHP-free PVC tube with a lumen of 3 × 4.1 mm and a length of approximately 40 mm that connected the ureter to the urinary bladder. Two years after surgery, the dog is in good general condition, and the results of regularly performed blood and urine tests are within the normal range for dogs.
Megacystis-microcolon-intestinal hypoperistalsis syndrome: a case report
Authors: Mehmet Melek, Yesim Edirne, Burhan Beger, Mecnun Cetin
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

Megacystis Microcolon Intestinal Hypoperistalsis Syndrom (MMIHS) is a quite rare congenital and fatal disease which was firstly defined by Berdon and his colleagues. It appears through a widely enlarged bladder and microcolon and its cause is unknown (Berdon et al., 1976; Carmelo et al., 2005; Makhija et al., 1999; Loening-Baucke and Kimura 1999; Redman et al., 1984; Hsu et al., 2003; Yigit et al., 1996; Srikanth et al., 1993). The disease is found in females three or four times more than in males (Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). Most of the cases die within the early months of their lives (Yigit et al., 1996; Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). We present the case of a female newborn with antenatal ultrasound revealing intestinal mass and bilateral hydroureteronephrosis. The case was admitted for intestinal obstruction after birth.
Two Cases of Periprosthetic Atypical Femoral Fractures in Patients on Long-Term Bisphosphonate Treatment
Authors: Takanori Miura, Hiroaki Kijima, Takayuki Tani, Toshihito Ebina, Naohisa Miyakoshi, Yoichi Shimada
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

The current definition of atypical femoral fractures (AFFs) excludes periprosthetic fractures. However, a few cases of bisphosphonates (BPs) -associated periprosthetic atypical femoral fractures (PAFFs) have been reported in the literature. Here, we report two rare cases of PAFFs that fulfilled the major criteria for AFFs in patients with prolonged use of BPs. Both cases progressed to a complete fracture with minor trauma from an incomplete fracture at the distal tip of the well-fixed femoral stem. The femoral stem effect on lateral femoral cortical bone, together with the decreased bone elastic resistance induced by BPs, was considered the cause of onset. In each case, we performed open reduction and internal fixation using a locking plate with cable grip and postoperatively prescribed teriparatide and low-intensity pulsed ultrasound (LIPUS). Both cases had a good clinical course. However, as conservative treatment was not effective in these cases, treatment such as non-weight-bearing exercises during hospitalization or prophylactic surgery may be necessary. Further studies are needed to determine the optimal treatment strategy.
SDH-deficient renal cell carcinoma associated with biallelic mutation in succinate dehydrogenase A: comprehensive genetic profiling and its relation to therapy response
Authors: Christopher R McEvoy, Lisa Koe, David Y Choong, Huei San Leong, Huiling Xu, Deme Karikios, Jeffrey D Plew, Owen W Prall, Andrew P Fellowes, Stephen B Fox
Journal: NPJ Precis Oncol (2018)
MeSH terms: Case Reports

Succinate dehydrogenase (SDH)-deficient renal cell carcinoma (RCC) is a rare RCC subtype that is caused by biallelic mutation of one of the four subunits of the SDH complex (SDHA, B, C, and D) and results in inactivation of the SDH enzyme. Here we describe a case of genetically characterized SDH-deficient RCC caused by biallelic (germline plus somatic) SDHA mutations. SDHA pathogenic variants were detected using comprehensive genomic profiling and SDH absence was subsequently confirmed by immunohistochemistry. Very little is known regarding the genomic context of SDH-deficient RCC. Interestingly we found genomic amplifications commonly observed in RCC but there was an absence of additional variants in common cancer driver genes. Prior to genetic testing a PD-1 inhibitor treatment was administered. However, following the genetic results a succession of tyrosine kinase inhibitors were administered as targeted treatment options and we highlight how the genetic results provide a rationale for their effectiveness. We also describe how the genetic results benefited the patient by empowering him to adopt dietary and lifestyle changes in accordance with knowledge of the mechanisms of SDH-related tumorigenesis.
The bee sting that was not: an unusual case of hymenoptera anaphylaxis averted in a patient treated with omalizumab for asthma
Authors: Evelyn M Slaughter, Nathan Boyer, Steven Bennett
Journal: Case Rep Med (2014)

This paper presents a case of hymenoptera venom anaphylaxis averted by omalizumab, a monoclonal antibody to IgE antibody. This case suggests a novel and unintentional effect of this therapy. Currently omalizumab is only FDA approved for the treatment of moderate-persistent allergic asthma. However case reports, such as ours have illustrated omalizumab's efficacy in the treatment of a myriad immunologic and allergic diseases. These outcomes have broadened the understanding of omalizumab's complex mechanism of action.