OpenMed/multicare-articles huggingface dataset:
Metastatic adult Wilms' tumor managed by chemotherapy, immunotherapy and target therapy: a case report
Authors: Qian Zhao, Qi Xiong, Qi Song
Journal: Future Sci OA (2024)
Keywords: adult wilms' tumor, vegf-a-targeted therapy, chemotherapy, immunotherapy
MeSH terms: Case Reports

Wilms' tumor is a rare type of tumor in adult. Herein, we reported a case of 37-year-old female with adult Wilms' tumor (AWT) admitted in our institution. After a multidisciplinary team discussion, she underwent receiving immunotherapy plus chemotherapy and VEGF-targeted therapy. The tumor got smaller obviously after eight cycles of treatment. Our present case suggested that immunotherapy and anti-angiogenesis combined with chemotherapy is promising new approach for treating AWT. Moreover, we review the literatures reporting AWT with the purpose to improve the understanding of AWT treatment.
Cases of Patients Treated in Countries With Limited Resources and Discussed by Experts of the International CML Foundation (iCMLf)-Case No. 1: A Boy Presenting With Priapism and Loss of Vision
Authors: Nirmalya Roy Moulik, Arlene Harriss-Buchan, Guiseppe Saglio, Nicola Evans, Meinolf Suttorp
Journal: Case Rep Oncol Med (2024)
MeSH terms: Case Reports

Pediatric chronic myeloid leukemia (pCML) is a rare malignancy accounting for only 2%-3% of all childhood leukemias. Due to this rarity, familiarity with pCML is limited among most pediatric practitioners, including even pediatric hemato-oncologists. In low- and middle-income countries (LMICs), limited financial resources and limited data specific to pCML represent obstacles that healthcare providers must face in diagnosing and treating this rare condition in children. The International CML Foundation (iCMLf) is improving outcomes for people with CML in these countries where resources, diagnostics, and access to medicines may be limited (https://www.cml-foundation.org/lmic-programs.html). Virtual meetings with the purpose of teaching participating pediatricians from LMICs of defined geographical regions were organised by the iCMLf in 2023. At a virtual meeting of the South Asia region, the case of a 14-year-old Indian boy was presented diagnosed with CML in a chronic phase complicated by priapism and loss of vision in his left eye due to hyperleukocytosis. Key aspects of this case are discussed in-depth from the perspective of (i) a pediatric hemato-oncologist practicing in a high-income country, (ii) a pediatric hemato-oncologist practicing in a LMIC, (iii) an adult CML hematologist, and (iv) from the iCMLf in improving the care of children with CML worldwide. Thus by discussing a multifaceted complicated case of pCML in written form as well as pointing to the pediatric module of the iCMLf Knowledge Centre will hopefully contribute to minimize existing knowledge gaps in a rare pediatric malignancy.
Toxic Epidermal Necrolysis after COVID-19 mRNA-1237 Vaccination
Authors: Nicole Hehr, Benjamin P Davis
Journal: Case Reports Immunol (2023)
MeSH terms: Case Reports

This letter illustrates a case of toxic epidermal necrolysis (TEN) after COVID-19 mRNA-1273 vaccination, which corresponds with the existing published data and contributes detailed knowledge of TEN reaction after vaccination. Interestingly, the reaction started at the site of vaccination and the patient went on to tolerate a major excipient of the vaccine suggesting the reaction may be associated with the mRNA itself or is triggered by the immunostimulatory action of the vaccine.
Infected Walled-Off Necrosis Following COVID-19-Associated Acute Pancreatitis
Authors: Shota Yagi, Hideki Miwa, Yosuke Kobayashi, Kenta Mitsusada
Journal: Cureus (2024)
Keywords: acute pancreatitis, covid-19, idiopathic pancreatitis, sars-cov-2, walled-off necrosis
MeSH terms: Case Reports

A 54-year-old man was admitted for fever and dyspnea. He presented with severe COVID-19 pneumonia and elevated amylase and lipase levels. He received treatment for COVID-19 and possible acute pancreatitis (AP). Although pneumonia and amylase levels improved, a high-grade fever persisted. On day 39, abdominal CT revealed heterogenous liquid and non-liquid components with a well-defined wall around the pancreas, and he was diagnosed with infected walled-off necrosis (WON) after AP. It was concluded to be associated with COVID-19 because there were no identifiable causes, such as alcohol consumption, gallstones, or other viral infections. The necrotic collection and fever improved after endoscopic transgastric drainage and necrosectomy. SARS-CoV-2 is becoming recognized as a new etiological infectious factor for AP, and COVID-19-associated AP shows higher severity and mortality. Clinicians should evaluate COVID-19 patients for concomitant AP, and if it is present, they should carefully monitor the development of local complications, including WON.
Pediatric pulmonary infection caused by oral obligate anaerobes: Case Series
Authors: Lai Zhijun, Yang Wenhai, Zeng Peibin, Luo Qingming
Journal: Front Pediatr (2023)
Keywords: children, lung infection, next-generation sequencing, obligate anaerobes, oral hygiene
MeSH terms: Case Reports

Background:
Pneumonia is quite common in people with chronic bedridden, severe malnutrition and underlying diseases of cerebral palsy. Although poor oral hygiene and inadequate airway protection are risk factors, case reports of childhood pneumonia caused by oral obligate anaerobes are rare.
Introduction:
We reported 4 cases of oral anaerobic pneumonia and empyema diagnosed by the pediatric intensive care unit (PICU) of our hospital.
Discussion:
No bacteria were detected in sputum bacterial culture, pleural water bacterial culture and blood culture of the four children. Considering that multiple sputum cultures were negative, the pleural effusion and bronchoalveolar lavage fluid were subjected to next-generation sequencing (NGS) to identify the pathogen causing pneumonia. The results found oral obligate anaerobes represented by Parvimonas micra and Porphyromonas gingivalis. After identifying the pathogenic bacteria, we changed to piperacillin tazobactam combined with metronidazole for anti-infection treatment, and the pneumonia in the above patients was improved. In addition, all four patients had different basic medical histories, and long-term bed rest, severe malnutrition, poor oral hygiene and insufficient airway protection were all high risk factors for oral anaerobic pneumonia in these children.
Conclusion:
Oral obligate anaerobes are one of the pathogens to consider for pneumonia in the elderly, but they may be easily overlooked in pediatric groups. Therefore, when receiving children with high-risk factors, we should be alert to the possibility of oral obligate anaerobic bacteria infection. Educating family members to pay attention to children's oral hygiene plays an important role in preventing oral obligatory anaerobic bacteria pneumonia. NGS can be used as a rapid diagnostic method when sputum culture cannot distinguish between pathogens.
Waugh's Syndrome in an Adult Patient: A Case Report and a Review of the Literature
Authors: Khaled Afasha, Nada Alabdulwahid, Atif Dawood
Journal: Cureus (2024)
Keywords: cystic fibrosis, intestinal obstruction, intussusception, malrotation, waugh's syndrome
MeSH terms: Case Reports

Waugh's syndrome is a rare disease that typically presents as acute-onset intussusception caused by gut malrotation. This disease, while generally reported during infancy or childhood, can also affect adults. This case report describes the rare case of Waugh's syndrome in an adult with cystic fibrosis. The patient, a 19-year-old male, was admitted one week after the onset of pain and distention in the abdomen, with vomiting alternating with constipation. He had visited emergency rooms in the past and was taking symptomatic treatment, but on arrival at our facility, he developed a tonic-colonic convulsion. The evaluation showed respiratory acidosis, severe hyponatremia, and abdominal distension with an empty rectum. The patient was discovered to have colo-colonic intussusception by imaging, and he was admitted into the intensive care unit before exploratory surgery. Surgical findings showed intestinal malrotation with the cecum lying in the left upper quadrant and ilio-colic intussusception extending to the mid-rectum. A distal ileal resection was required for partial reduction, leaving a residual segment needing an ileostomy. Histopathology performed after surgery found a blocked lumen, edema hemorrhage, and necrosis. Following discharge, the patient's recovery was hampered by a high-volume stoma. He had to be readmitted for electrolyte correction and hydration as well as preparation of the normal passage of foods through his system. Later follow-up showed that the output of the stoma had been brought under control, and nutritional status greatly improved. The patient planned to have a stoma reversal after three months. This case emphasizes the need for a multidisciplinary approach to treating Waugh's syndrome in adult patients.
Case Report: Fluoroless implantation of left branch bundle pacing in a pregnant patient
Authors: Jun Li, Xiaofang Li, Anxin Zhang, Fanqi Li, Haixiong Wang
Journal: Front Cardiovasc Med (2023)
Keywords: 3d cardiac model, fluoroless implantation, left branch bundle pacing, pacemaker, pregnant patient
MeSH terms: Case Reports

A pregnant patient had symptomatic atrial standstill and indications for pacing therapy with an expected high ventricular pacing ratio. With the consideration of potential pacing-induced cardiomyopathy in the future we conducted zero-fluoro left bundle branch pacing (zLBBP) implantation for heart failure prevention. An ex vivo 3D cardiac model (Medtronic, USA) was used preoperatively to simulate the zLBBP implantation to improve procedure safety and efficiency. Intraoperatively, the simulation steps were followed, and a combination of electroanatomic navigation systems (EANS) and intracardiac echocariography (ICE) were used to ensure that the procedure was performed efficiently and safely.
Surgical management of a foramen magnum tumor via a far-lateral approach using an oblique straight incision: a case series report and technique note
Authors: Jie Bai, Zhi-Heng Jian, Peng Chen, Ye Cheng, Ya-Ming Wang, Gang Chen, Xin-Ru Xiao
Journal: Front Oncol (2024)
Keywords: complication, far lateral approach, incision, microsurgery, suboccipital triangle

Objective:
To review our single-institution experience in the surgical management of foramen magnum tumors via a far-lateral approach using an oblique straight incision.
Methods:
From October 2023 to January 2024, four cases of tumors in the foramen magnum area treated at the Capital Medical University-affiliated XuanWu hospital neurosurgery department were involved in this study. All cases were managed with a far-lateral approach using an oblique straight incision. We retrospectively reviewed the clinical and imaging data, as well as the surgical strategies employed.
Results:
Three cases of foramen magnum meningiomas and one case of glioma of the ventral medulla. All cases underwent a far-lateral approach using an oblique straight incision; all cases had a gross total resection, and the wounds healed well without cerebral fluid leakage or scalp hydrops. Except for one case of right foramen magnum meningioma, which had dysphagia and pneumothorax, the other cases were without any postoperative complications.
Conclusion:
A far-lateral approach using an oblique straight incision can preserve muscle integrity and minimize subcutaneous exposure, allowing for complete anatomical reduction of muscles. This craniectomy method is simple and replicable, making it worthy of further clinical practice.
Acute spinal cord infarction secondary to ankylosing spondylitis: a case report and literature review
Authors: Wenjuan Li, Jia Guo, Lei Wang, Tinghua Zhang, Tian Li
Journal: Front Neurol (2023)
Keywords: taylor’s approach, ankylosing spondylitis, autoimmune disease, spinal cord infarction, vascular disease
MeSH terms: Case Reports

Introduction:
Spinal cord infarction secondary to ankylosing spondylitis is a rare but severe disorder.
Case presentation:
Here we present a case of acute spinal cord infarction in a 54 years-old man with a medical history of ankylosing spondylitis, scoliosis, and hypotension. The patient complained of a sudden onset of lower limb weakness. A physical examination showed that he suffered from a dissociative sensory disorder, paralysis, and concomitant sphincter disturbances. After undergoing a whole-spine MRI, he was diagnosed with an acute ischemic injury from T2 to T5. As he did not treat his ankylosing spondylitis, it later caused a spinal deformity, making the lumbar puncture technically challenging. However, using Taylor's approach, a CSF sample was successfully obtained. A CSF biochemical test ruled out myelitis, NMOSD, and MS. After receiving treatment with low-molecular-weight heparin, atorvastatin calcium, and methylprednisolone, his sphincter function gradually recovered, but his strength was only partially restored.
Conclusion:
Although this is a rare entity, it is necessary for physicians to consider it when evaluating patients with a sudden loss of sensation and strength in their lower limbs.
Combined Papillectomy and Autologous Conjunctival Membrane Graft as Management of Giant Papillae for Severe, Refractory Palpebral Vernal Keratoconjunctivitis-A Case Report
Authors: Devina Nur Annisa, Hernawita Suharko, Hasiana Lumban Gaol, Viona Viona
Journal: Case Rep Ophthalmol Med (2024)
MeSH terms: Case Reports

Introduction: Vernal keratoconjunctivitis (VKC) is an allergic disease that predominantly affects young individuals, with a higher incidence among males. Traditionally seen as a condition of childhood that resolves at puberty, recent studies have shown persistent cases in some individuals, potentially influenced by hot and dry tropical environmental conditions. VKC is more prevalent in regions with a hot and humid climate and a high presence of airborne allergens, leading to significant morbidity and impacting the quality of life for affected individuals. Severe and chronic cases can lead to vision-threatening corneal complications, making effective management crucial. Although the clinical profile of VKC varies geographically, comprehensive studies in specific regions remain limited. Case Presentation: In this case report, we present an 18-year-old male patient with severe and refractory VKC. Despite initial treatments, including topical and oral medications, recurrent episodes occurred every 6 months, accompanied by giant papillae (GP) formation and corneal ulcers. The patient had a history of triamcinolone injection and papillectomy combined with amnion membrane transplantation, but presented with a refractory disease in a year. Surgical intervention involving papillectomy and autologous conjunctival membrane graft was performed, leading to a smooth upper tarsal conjunctiva during the 2-year follow-up period, without GP recurrence and maintaining a clear cornea. The patient's symptoms were effectively managed with topical medications. Conclusion: The management of VKC necessitates a comprehensive approach involving preventive measures, pharmacological treatment, and surgical interventions for refractory cases. This case highlights the potential benefits of surgical techniques, such as papillectomy and autologous conjunctival membrane graft, in managing severe and refractory VKC cases with a history of previous surgical procedure failure. However, it is essential to recognize that exposure avoidance and allergic control remain fundamental in VKC management. Further research and larger studies are required to validate the efficacy of these surgical techniques in managing VKC.
Primary leiomyosarcoma of the small finger treated with ray amputation: A case report
Authors: Jacob Mushaben, Robin Evans
Journal: Int J Surg Case Rep (2024)
Keywords: case report, primary leiomyosarcoma, ray amputation, small finger
MeSH terms: Case Reports

Introduction:
Malignant sarcomas of the upper extremity are rare tumors that can have an overwhelming impact on a patient's function, quality of life, and life expectancy. Rarer still is the malignant tumor of the hand or digits, which represent an incredibly small percentage of upper extremity tumors. This paucity of cases can lead to difficult decision making and treatment options that may not always have clearly established results and outcomes.
Case:
In this case, we present a young, otherwise healthy patient that was diagnosed with a primary leiomyosarcoma of the small finger. After her diagnosis, she underwent extensive oncologic workup, and subsequently underwent successful ray amputation with an excellent outcome. She remains disease free.
Discussion:
Leiomyosarcoma is a malignant cancer that can be troublesome to diagnose in the extremities, as it is usually found in the smooth muscle of organs and the pelvis. Local control of the tumor is critical to successful, disease free treatment. Good functional and clinical outcomes can be attained with ray amputation, as seen in this patient.
Conclusion:
This case demonstrates a successful treatment approach to the patient with a primary malignant soft tissue sarcoma who was treated with a ray amputation. The clinician and surgeon must maintain a high index of suspicion of soft tissue malignancies, as a prompt diagnosis and treatment is critical to a good outcome and survival.
Case report: persistent double dorsal aorta
Authors: Paulo Henrique Alves Togni, Ernani Alves de Oliveira, Eduardo Milani Mora, Paulo Eduardo Borher Moreira, Bruno Previdelli Coghi, Guilherme Augusto Paro
Journal: J Vasc Bras (2024)
Keywords: abdominal aorta, anatomic variant, computed tomography, congenital anomaly
MeSH terms: Case Reports

Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.
Xanthogranulomatous Endometritis with calculus formation in setting of prolapsed uterus
Authors: Nikhil Kumar, Prima Shuchita Lakra, Ranwir Kumar Sinha, Asitava Deb Roy, Debarshi Saha, Jitendra Kumar Sinha
Journal: Autops Case Rep (2023)
Keywords: endometritis, endometrium, histiocytes, uterine prolapse
MeSH terms: Case Reports

Xanthogranulomatous inflammation is a rare benign inflammatory lesion characterized by sheets of lipid-laden foamy histiocytes. It has been reported in various organs, mainly the kidney and gall bladder. Xanthogranulomatous endometritis (XGE) is sporadic, with only a few cases reported in the English medical literature. Herein, we report a case of xanthogranulomatous endometritis with the formation of stones in a 50-year-old female patient with a prolapsed uterus. Grossly the endometrium was irregular, and the uterine cavity was filled with a yellow friable material, a polypoid growth, and yellowish stones. The microscopy showed sheets of histiocytes with few preserved endometrial glands. In this case, the xanthogranulomatous inflammation may mimic a clear cell carcinoma involving the endometrium and myometrium. One of the important differential diagnoses is malakoplakia. Immunohistochemistry and special stains are helpful in diagnosis.
Case report and literature review: plexiform schwannoma in the penile and inguinal region in a child
Authors: Xiaoying Qi, Yifei Tan, Yanru Feng, Dan Ma, Ling Wang, Houqing Pang
Journal: Front Oncol (2024)
Keywords: children, inguinal region, penis, plexiform, schwannoma
MeSH terms: Case Reports

Penile schwannoma is an uncommonly seen peripheral nerve tumor, of which penile plexiform schwannomas (PS) is extremely rare that has only been reported in several adults. We present a case of penile PS with a similar lesion in inguinal region in a 9-year-old child, which appeared as painless masses and rapidly growing within one year. Penile ultrasonography suggested well-defined lesions with limited vascularity. Both masses presented with low-to-intermediated signal intensity and no definite enhancement in computed tomography. The lesions were completely resected with minimal intraoperative bleeding, and a diagnose of benign PS was confirmed based on H&E staining and positive S-100 expression in immunohistochemistry. There was no evidence of tumor recurrence or metastasis after 6 months of follow-up. Only 6 cases of penile schwannoma in children were recorded, of which 5 were malignant, and none was PS. The malignancy rate of penile schwannoma in children may be overestimated due to delayed diagnose of benign ones. A rapidly growing penile mass with a suspected metastatic lesion in inguinal region could be easily misdiagnosed as malignant. This case report and literature review is expected to assist clinicians in getting a comprehensive understanding of children penile schwannomas and choosing the best management strategy when faced with this rare condition.
Surgical outcomes following resection in patients with language dominant posterior quadrant epilepsy
Authors: Satvir Saggi, Joseph H Garcia, Faraz Behzadi, Arka N Mallela, Paul A Garcia, Edward F Chang, Robert C Knowlton
Journal: Epilepsy Behav Rep (2024)
Keywords: epilepsy, posterior cortex, refractory, resection
MeSH terms: Case Reports

Posterior quadrant epilepsy surgery, involving the occipital lobe, parietal lobe, or the posterior border of the temporal lobe, accounts for a small percentage of focal resections for medically refractory epilepsy. Prior studies investigating seizure control from posterior quadrant epilepsy surgery are limited. In this study, a retrospective database of patients undergoing surgery for left sided posterior cortex epilepsy at a single large level 4 epilepsy center was analyzed between August 2008 to April 2021 in order to characterize seizure control outcomes. Nine patients presented with epileptogenic foci in the left posterior cortex with a malformation of cortical development deemed as the etiology of seizures for all but one patient. Absolute seizure freedom (Engel I) was achieved in 4 of 9 patients, with the remaining 5 patients achieving an improvement in the frequency of seizures (Engel II/III). Complete resection of the anatomic and physiologic abnormalities was performed in 3 of 4 patients with Engel 1 outcomes and 1 of 5 patients with Class II/III outcomes. Five patients developed new right sided visual field defects, all of which were expected based on the sub-lobar, occipital localization and were viewed as acceptable by the patients and did not interfere with activities of daily living. Overall, our study demonstrates the potential for surgical resection to yield excellent seizure-control outcomes with anticipated, tolerable neurological deficits. This information is important for patients with disabling seizures who may not benefit sufficiently from palliative procedures.