OpenMed/multicare-articles huggingface dataset:
Early resolution of subretinal fluid without high-dose corticosteroids in a pregnant patient with Vogt-Koyanagi-Harada disease: a case report
Authors: Keijiro Sugita, Kyoichi Mizumoto, Nahoko Kato, Masahiro Zako
Journal: J Ophthalmic Inflamm Infect (2015)
Keywords: high-dose corticosteroids, pregnancy, vogt-koyanagi-harada disease

Background:
At present, there is no standard of treatment using systemic high-dose corticosteroids in cases of pregnant women with Vogt-Koyanagi-Harada (VKH) disease. Although high-dose systemic corticosteroid treatment is often used for VKH disease during pregnancy, it also poses a risk to the fetus.
Findings:
A 29-year-old woman in the 34th week of pregnancy experienced bilateral metamorphopsia. She had been receiving 5 mg of prednisolone daily for the past 8 years as treatment for rheumatoid arthritis. In order to prevent progression of bilateral serous retinal detachment caused by VKH disease, we recommended the use of high-dose systemic corticosteroids but the patient refused. Thus, we administered only topical ophthalmic betamethasone for mild anterior uveitis. Surprisingly, however, the bilateral bullous retinal detachment healed in just 19 days after the onset of symptoms. A healthy baby was born 1 month later, and sunset glow fundus was subsequently observed without any recurrence of uveitis.
Conclusions:
We report a case in which bilateral subretinal fluid caused by VKH disease in a young woman during late pregnancy resolved without high-dose corticosteroid treatment. Pregnancy may have had a beneficial effect on uveitis activity caused by VKH disease. To our knowledge, this report describes the shortest healing period for bilateral bullous retinal detachment in a pregnant woman with VKH disease.
A Multidimensional, Multisensory and Comprehensive Rehabilitation Intervention to Improve Spatial Functioning in the Visually Impaired Child: A Community Case Study
Authors: Federica Morelli, Giorgia Aprile, Giulia Cappagli, Antonella Luparia, Francesco Decortes, Monica Gori, Sabrina Signorini
Journal: Front Neurosci (2020)
Keywords: cognition, development, multisensory, rehabilitation, spatial cognition, visually impaired children

Congenital visual impairment may have a negative impact on spatial abilities and result in severe delays in perceptual, social, motor, and cognitive skills across life span. Despite several evidences have highlighted the need for an early introduction of re-habilitation interventions, such interventions are rarely adapted to children's visual capabilities and very few studies have been conducted to assess their long-term efficacy. In this work, we present a case study of a visually impaired child enrolled in a newly developed re-habilitation intervention aimed at improving the overall development through the diversification of re-habilitation activities based on visual potential and developmental profile, with a focus on spatial functioning. We argue that intervention for visually impaired children should be (a) adapted to their visual capabilities, in order to increase re-habilitation outcomes, (b) multi-interdisciplinary and multidimensional, to improve adaptive abilities across development, (c) multisensory, to promote the integration of different perceptual information coming from the environment.
Spindle cell carcinoma of the tongue: a rare variant of squamous cell carcinoma
Authors: Manisha V Biradar, Sunita S Dantkale, Rahul S Abhange, Hemlata T Kamra, Khushboo Birla
Journal: Ecancermedicalscience (2014)
Keywords: biphasic, epithelial, mesenchymal, spindle cell, squamous
MeSH terms: Case Reports

Spindle cell carcinoma (SpCC), a rare, aggressive variant of squamous cell carcinoma (SCC), is characterised by proliferation of epithelial and mesenchymal components. It is important to diagnose this variant of SCC, because of its tendency to recur and early metastasis. It accounts for 1% of all tumours in the oral cavity. In this paper, we have reported a case of SpCC of the tongue in a 65-year-old male who presented with a polypoidal growth over the lateral border of his tongue with a short history of one month. Immunohistochemical expression of cytokeratin was strongly positive in the epithelial component and focally in the spindle cell component. The spindle cell component showed a strong positivity for vimentin.
Premature Moustache As Presenting Symptom of Nonclassic Congenital Adrenal Hyperplasia due to 2 Uncommon Mutations of the CYP21A2 Gene
Authors: Guy Massa, Philippe Gillis, Marianne Schwartz
Journal: Case Rep Genet (2011)
MeSH terms: Case Reports

A Turkish boy was referred at the age of 3 6/12 years for the evaluation of a premature moustache. No other signs of virilisation were present. The endocrine evaluation led to the diagnosis of nonclassic congenital adrenal hyperplasia. Genetic analysis revealed 2 rare mutations of the CYP21A2 gene, the gene encoding for the 21-hydroxylase enzyme: a recently reported R132C mutation in exon 3 and a R339H mutation in exon 8, both reported in the nonclassic CAH. An early moustache, for which the term premature moustache can be coined, can be the presenting symptom of nonclassic CAH. In all children presenting with a sex or age inappropriate development of a moustache, an endocrine evaluation is indicated.
Case Report: A Case Report of Neurosyphilis Mimicking Limbic Encephalitis
Authors: Haibing Liao, Yajing Zhang, Wei Yue
Journal: Front Neurol (2022)
Keywords: case report, encephalitis, leucine-rich glioma inactivated 1 protein, neurosyphilis, penicillin
MeSH terms: Case Reports

Neurosyphilis (NS) is an infection of the central nervous system caused by Treponema pallidum. It mimics various neurological and psychiatric diseases. In recent years, there have been several NS cases that manifest as limbic encephalitis (LE). Therefore, the diagnosis of neurosyphilis in the early stages is difficult. Here, we present a case of an NS patient who presented with LE manifestation. The 62-year-old woman presented with acute clinical manifestations of gibberish speech, poor memory, and seizures. Brain MRI showed abnormal signals on the right medial temporal lobe. In addition, the patient had a positive serum leucine-rich glioma inactivated 1 (LGI1) antibody with a titer of 1:16. Therefore, an initial diagnosis of anti-LGI1 encephalitis was made. However, further tests carried out showed positive rapid plasma reagin (RPR), and treponema pallidum particle agglutination (TPPA) tests both in the serum and the cerebrospinal fluid (CSF). Therefore, uncertainty arose as to whether the patient had both anti-LGI1 encephalitis and NS or whether the LGI1 antibody and LE manifestations were due to the NS. The patient was initiated on the recommended dose of penicillin G sodium. Following treatment, the patient reported a significant improvement in clinical symptoms, normal signals in the right temporal lobe, and a negative serum LGI1 antibody. These findings suggested that NS induced the LE manifestations and the production of the LGI1 antibody. This case demonstrates that testing syphilis in patients with LE is important and positive autoimmune encephalitis (AE) antibodies in NS patients need to be viewed and interpreted with greater caution.
Diagnostic Challenges of an Abdominal Pregnancy in the Second Trimester
Authors: Niccole Ranaei-Zamani, Tetyana Palamarchuk, Swena Kapoor, Mandeep K Kaler, Favour Atueyi, Rebecca Allen
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Abdominal pregnancies are a rare form of ectopic pregnancy, which presents a significant risk of maternal morbidity and mortality. We describe an unusual case of a late diagnosis of an abdominal pregnancy in the second trimester, which due to diagnostic challenges, was not detected on 1st trimester and subsequent antenatal ultrasound scans (USS). The abdominal pregnancy was later diagnosed at the repeat anomaly scan and confirmed with a pelvic MRI. This case of abdominal pregnancy is unique when compared to other reported cases, as the fetus was initially enclosed within the amniotic sac with normal liquor volume. Both transvaginal and transabdominal scans appeared to demonstrate an intrauterine pregnancy. The diagnosis of abdominal pregnancy was only made possible following rupture of the amniotic sac, leading to anhydramnios, which resulted in the repositioning of the fetus to the upper maternal abdomen. This case represents the challenges faced by obstetricians in diagnosing, managing, and counselling a woman when faced with an abdominal pregnancy.
Large mediastinal mass diagnosed as Nocardia infection by endobronchial ultrasound-guided transbronchial needle aspiration in a ceramic worker: A case report
Authors: Xiaoshan Su, Lin Chen, Zesen Zhuang, Yixiang Zhang, Xiaoping Lin, Jiaming Huang, Zhixing Zhu, Huaping Zhang, Weijing Wu
Journal: Front Surg (2023)
Keywords: ebus-tbna, mngs, mediastinal mass, nocardia, weakly acid-fast stain
MeSH terms: Case Reports

Background:
Nocardia is a ubiquitous soil saprophyte transmitted through airborne or direct cutaneous inoculation routes. Although Nocardia is more common in immunocompromised patients, Nocardia may also arise in apparently immunocompetent patients.
Case presentation:
We report a rare case of Nocardia infection presenting as a large mediastinal mass in an immunocompetent ceramic worker. A 54-year-old man with no previous history of immune dysfunction, a ceramic worker by profession, was referred and admitted to our hospital because of a persistent fever for 19 days. Chest CT showed a large middle mediastinal mass. However, conventional anti-infective treatment was ineffective. Under the guidance of the Virtual bronchoscopic navigation (VBN) system, he underwent Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The purulent exudate obtained by EBUS-TBNA was further identified as Nocardia by weak acid-fast and metagenomic next-generation sequencing (mNGS). He was subsequently treated with intravenous imipenem/amikacin, switched to intravenous imipenem and oral trimethoprim/sulfamethoxazole, and the clinical symptoms were significantly improved.
Conclusions:
Even in immunocompetent patients, Nocardiosis cannot be excluded. For the public, especially soil contact workers, precautions should be taken to avoid Nocardia infection from occupational exposure. This rare case may provide a diagnosis and treatment reference for clinicians.
Delayed Diagnosis of McCune-Albright Syndrome
Authors: Bereket Fantahun, Seblewongel Desta
Journal: Case Rep Genet (2021)
MeSH terms: Case Reports

Background:
McCune-Albright syndrome (MAS) is a rare heterogeneous genetic disorder that is characterized by a triad of polyostotic fibrous dysplasia (FD), café au lait spots (CAL), and multiple hyperfunctional endocrinopathies. In general, it is diagnosed clinically. From the triads, two of the findings are enough to make the diagnosis, but genetic testing can be done if it is available. Case Presentation. We report a female child who was symptomatic since the neonatal period with skin hyperpigmentation, breast enlargement, and vaginal bleeding. She was diagnosed with MAS at the age of five years. She had pathological fractures at multiple sites and had raised thyroid hormones since the age of 3½ years. The child developed severe morbidity as the result of delayed diagnosis and currently became wheelchair dependent.
Conclusion:
Thorough patient evaluation and appropriate interpretation of findings are crucial steps for timely diagnosis of MAS and better patient care outcomes.
Leukocytoclastic vasculitis in a patient with type 1 cryoglobulinemia
Authors: Paul Y Liu, Pamela E Prete, Gary Kukes
Journal: Case Rep Rheumatol (2011)
MeSH terms: Case Reports

Cutaneous manifestations of type 1 cryoglobulinemia are usually related to vascular occlusion by noninflammatory thrombosis; rarely is leukocytoclastic vasculitis seen in type 1 cryoglobulinemia. We report the case of a 64-year-old male who presented with isolated cutaneous leukocytoclastic vasculitis that was initially attributed to essential mixed cryoglobulinemia after thorough diagnostic evaluation. A lack of adequate clinical response to therapy prompted further investigation, including cryoprecipitate electrophoresis and immunofixation, which revealed an IgM kappa monoclonal gammopathy consistent with type 1 cryoglobulinemia. A renewed search for an underlying malignancy led to the discovery of early Waldenstrom's macroglobulinemia. Although leukocytoclastic vasculitis is more characteristic of mixed cryoglobulinemia, it can be a presenting manifestation of type 1 cryoglobulinemia.
Interdisciplinary Management of Bilateral Congenital Lateral Incisor Agenesis
Authors: Margaux Vignon, Typhaine Bensaidani, Serge Soliveres, Philippe Bousquet
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Management of lateral incisor agenesis is a real challenge and needs a strong collaboration between surgical, aesthetic, and orthodontic dentistry. This case report managed upper lateral incisor agenesis with an orthodontic treatment leading to open spaces and placement of cuspids in lateral incisor area to avoid implant placement in maxillary anterior region. Temporary rehabilitation phase, using resin injected tray and removable partial denture, has been placed to maintain mesiodistal dimensions and restore aesthetic during pre-implant analysis and osseointegration. Once osseointegration was fully obtained, keratinized tissue augmentation has been obtained using connective tissue graft. Then, temporary implant fixed crowns allowed soft tissue modeling during interim rehabilitation. Finally, screw-retained permanent crowns were placed to fully restore aesthetic and function. This case goal was to optimize final results and reach patient complete satisfaction using orthodontic treatment combined with implant rehabilitation, and coupled with interdisciplinary management and well-time sequencing treatment.
Acute Aflatoxicosis Resulting in Fulminant Hepatic Failure and Rhabdomyolysis
Authors: Nir Samuel, Yosef Ezri, Raymond Farah, Vacksman Igor, Amer Hussein, Orit Rubinshtein, Nimer Assy
Journal: Gastroenterology Res (2009)
Keywords: aspergillus, aflatoxicosis, aflatoxin, fulminant hepatic failure, rhabdomyolysis
MeSH terms: Case Reports

Background:
Aflatoxins are known contaminants of foods. High dose exposure, particularly to Aflatoxin B1 (AFB1) may cause acute aflatoxicosis. Outbreaks have been reported in developing nations but are virtually un-documented in the developed world.
Case report:
A 28 year old, healthy male presented with nausea, vomiting and abdominal pain. The patient deteriorated rapidly to a state of agitation and shock. The clinical picture, encephalopathy and laboratory results indicated fulminant hepatic failure, rhabdomyolysis and multi-system organ failure. Canned food the patient consumed almost exclusively contained AFB1 at a level of 19.6 ppb. Alternate diagnoses were ruled out and a presumptive diagnosis of acute aflatoxicosis was made. After 45 days of intensive supportive therapy, the patient was discharged with no significant sequels.
Conclusions:
The diagnosis of aflatoxicosis was based on the clinical picture, the finding of high levels of AFB1 in foods the patient consumed, and after alternate diagnoses' were sufficiently excluded. We conclude that chronic exposure to moderately elevated levels of aflatoxin B1 may result in acute aflatoxicosis and fulminant hepatic failure.
Ulcer like projection: a case report and follow up
Authors: Zairi Ihsen, Khadija Mzoughi, Jnifene Zouhaier, Ben Moussa Fathia, Sonia Segaier, Sofiene Kamoun, Sana Fennira, Sondos Kraiem
Journal: Pan Afr Med J (2016)
Keywords: aorta, aortic intramural hematoma, surgery, tomography, transesophageal
MeSH terms: Aortic Diseases / therapy, Hematoma / therapy, Case Reports, Aortic Diseases / diagnosis, Aortic Diseases / pathology, Female, Follow-Up Studies, Hematoma / diagnosis, Hematoma / pathology, Humans, Middle Aged, Treatment Outcome

Here we report the case of a 57-year-old female with an aortic intramural hematoma that was treated with medical approach. Follow confirmed the favorable clinical evolution.
Transcatheter arterial chemoembolization with spherical embolic material for locally advanced breast cancer: first report of HepaSphere™ treatment for primary breast cancer
Authors: Norifumi Kennoki, Shinichi Hori, Atsushi Hori, Yuki Takeo, Hisashi Oshiro
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 57-year-old female was diagnosed as having primary breast cancer (invasive carcinoma of no special type), which was immunohistochemically negative for oestrogen receptor, androgen receptor and human epidermal growth factor receptor Type 2. The main tumour was 54 × 35 mm in size and was located in the internal upper area of the left breast. The tumour had markedly invaded the skin and a daughter nodule was observed in the external upper area of the ipsilateral breast. An enlarged lymph node measuring 12mm in diameter was present in the axilla and an affected parasternal lymph node was also observed. A blood test showed no abnormalities and the patient was negative for tumour markers. We performed three sessions of transcatheter arterial chemoembolization with docetaxel-loaded HepaSphere™. The treatment procedure was successfully performed in all the three sessions. No adverse events higher than Grade 3 were observed. The sizes of the primary lesion and axillary lymph node decreased to 26 × 14 mm (37% reduction) and 10mm, respectively. The parasternal lymph node completely resolved. 2 months later, left total mastectomy and axillary lymph node dissection were performed. The histopathological post-therapy effect was considered to be a mild response (Grade 1a) in the breast lesion and a complete response (Grade 3) in the axillary lymph node. The mean±standard deviation of the minor axis of the vessels embolized with spherical particles was 183.0±96.5 μm. Our results indicate that transcatheter arterial chemoembolization used together with HepaSphere can be an alternative and effective therapy for locally advanced breast cancer.
Unique Case Report of a Meningeal Sarcoma Arising during Ongoing Treatment for Progressing Intraparenchymal Glioma
Authors: Richard A Peterson, Bhavani Kashyap, Pamala A Pawloski, Anna C Forsberg, Leah R Hanson
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Radiation-induced sarcomas in the brain are extremely rare, usually occur with an average latency of 9 years, and are associated with poor outcomes. Latency periods shorter than 1 year may indicate a genetic predisposition such as Li-Fraumeni syndrome. A 34-year-old man underwent initial tumor resection and radiation therapy for a World Health Organization (WHO) Grade II Astrocytoma. Within 6 months, the tumor recurred as WHO Grade III and was treated with temozolomide and then bevacizumab. Despite the patient's apparent improving condition, MRI revealed new dural-based lesions 10 months after radiation therapy and identified as high-grade sarcoma. The patient resumed bevacizumab, began NovoTTF treatment for progressing glioma, and ifosfamide/doxorubicin for the sarcoma. Genetic testing revealed no pathogenic mutation in the TP53 gene. Ultimately, treatment was unsuccessful and the patient succumbed to glioma and sarcoma within 2 years of initial diagnosis. This case was unique due to the rapidly progressing glioma and sudden appearance of a high-grade sarcoma. It is unusual to have two separate intracranial primary cancers with each requiring a different chemotherapy regimen. We discuss the difficulty of simultaneously treating with separate chemotherapy regimens. It remains unclear whether the sarcoma was induced by the radiation treatment or a genetic predisposition.
Case report: Ectopic thyroid tissue found in a liver with hepatocellular carcinoma
Authors: Zhanbo Wang, Jing Yuan, Jie Li
Journal: Front Surg (2022)
Keywords: ectopic thyroid tissue, glypican3, hepatocellular carcinoma, thyroid follicular carcinoma, thyroid transcription factor-1
MeSH terms: Case Reports

Background:
Concomitant intrahepatic ectopic thyroid is rare in patients with hepatocellular carcinoma. Thyroid follicular structures outside the hepatocellular carcinoma lesions are regarded as satellite nodules or intrahepatic metastases of hepatocellular carcinoma, which often leads to misdiagnosis and overtreatment of hepatocellular carcinoma patients.
Case presentation:
We report the case of an 83-year-old man with moderately differentiated hepatocellular carcinoma (2.5 cm) whose liver contained ectopic thyroid tissue. An encapsulated, multinodular grayish-yellow mass and multiple satellite nodules were detected and removed by right hepatic lobectomy. Microscopically, the main tumor displayed a predominant trabecular, cord-like structure. Liver tissue 0.5 cm from the tumor had a benign-appearing follicular thyroid structure. The follicles contained colloid tissue and were lined with low cuboidal cells with scant cytoplasm; lymphatic tissue was also present in the area. The hepatocellular carcinoma cells were positive for hepatocyte antigen and glypican-3 and negative for cytokeratin 19. The follicular thyroid cells expressed thyroglobulin, PAX8, and thyroid transcription factor-1. A metastatic thyroid neoplasm was excluded clinically and by ultrasound and computed tomography. One month after surgery, all of the patient's serological markers were normal; no tumor recurrence or metastasis has been detected for 7 postoperative months.
Conclusions:
The finding of ectopic thyroid tissue in the liver of a patient with hepatocellular carcinoma is very rare. The possibility of hepatocellular carcinoma forming satellite nodules and intrahepatic metastasis should be ruled out first and immunohistochemistry may be definitive in making the diagnosis. Further examination is needed to exclude thyroid cancer liver metastases.
Case Report: Pott's Edematous Tumor: Complicated Frontal Sinusitis - An Unremembered Diagnosis
Authors: Ana Cristina Veiga Silva, Camila Mendonça Lins, Renan Furtado de Almeida Mendes, Marcelo Henrique Simões Silva, Joaquim Fechine de Alencar Neto, Caio César Maia Lopes, Gabriela Lisboa de Souza Ferraz, Diego Felipe Rodrigues de Sousa, Luiz Severo Bem Junior, Marcelo Moraes Valença, Hildo Rocha Cirne de Azevedo-Filho
Journal: Front Surg (2022)
Keywords: pott’s puffy tumor, pott’s edematous tumor, forehead swelling, osteomyelitis, sinusistis
MeSH terms: Case Reports

Pott's Puffy tumor, also called Pott's edematous tumor (PET), is a subperiosteal abscess of the frontal bone, associated with osteomyelitis of the frontal bone. In this paper, we report the case of a 16-year-old patient who presented with headache associated with progressive forehead swelling and fever. Clinical and imaging exams pointed to the hypothesis of PET associated with brain abscess. Patient was submitted to surgical excision of the abscess and treatment of osteomyelitis, with intraoperative findings corroborating the condition. There was a good clinical-radiological recovery associated with prolonged antibiotic therapy and satisfactory follow-up after hospital. PET, which often results from an underdiagnosed or partially treated frontal sinusitis, is a condition that must be promptly recognized and directed to an adequate therapeutic approach due to the risk of serious complications that it entails.