OpenMed/multicare-articles huggingface dataset:
Takayasu arteritis with pyoderma gangrenosum: case reports and literature review
Authors: Xuehan Zhang, Yang Jiao
Journal: BMC Rheumatol (2019)
Keywords: pyoderma gangrenosum, skin lesions, takayasu arteritis
MeSH terms: Case Reports

Background:
Takayasu arteritis is a rare, chronic inflammatory arteriopathy affecting mainly the aorta and its branches. Many skin manifestations have been reported in association with this disease. Pyoderma gangrenosum is a skin complication that is a neutrophilic dermatosis characterized by destructive, necrotizing and noninfective skin infiltration. However, there are no related records on these conditions in Chinese patients.
Case presentation:
We reported two Chinese female patients presenting with pyoderma gangrenosum associated with Takayasu arteritis. Pyoderma gangrenosum preceded Takayasu arteritis in both patients. Their skin lesions were diagnosed as pyoderma gangrenosum through skin biopsy and relieved after treating with steroids and immunosuppressants. During the follow-up, both patients developed symptoms caused by vascular stenosis and occlusion, such as dizziness and weakness of upper limb. The results of aortic angiography revealed multiple large arteries narrowed and blocked. According to the criteria of the American College of Rheumatology, the vasculitis in both patients were classified as Takayasu arteritis. Since there was scant evidence of active inflammation and the skin lesions were stable, neither of them was given strong immnosuppressive therapy. The PubMed database was also searched and 16 related well-documented cases of Takayasu with pyoderma gangrenosum were reviewed and summarized.
Conclusions:
Pyoderma gangrenosum could occur at any stage of the Takayasu arteritis disease process. No correlation was found between the location of the skin lesions and the clinical severity and scope of Takayasu arteritis. It is important to remember the rare possibility of Takayasu arteritis in patients with skin lesions indicative of pyoderma gangrenosum of unknown aetiology. Obtaining the relevant history and regular monitoring of the arteries are necessary.
Schwannoma Localized Retroperitoneally in a 14-Year-Old Boy
Authors: Hasan Cayirli, Halil Ibrahim Tanriverdi, Ali Aykan Ozguven, Cuneyt Gunsar, Betul Ersoy, Ali Riza Kandiloglu
Journal: Case Rep Pediatr (2016)
MeSH terms: Case Reports

Schwannomas usually occur in adults being between the second and fifth decades, and such neoplasms are extremely rare in a pediatric population. In addition, they are not normally found in the retroperitoneal region. Here, we present a pediatric case of a retroperitoneal schwannoma in an adrenal location where the tumor was not able to be preoperatively differentiated from other benign or malign adrenal gland tumors. In our opinion, this tumor can be included in the differential diagnosis of a nonfunctioning retroperitoneal adrenal mass in children.
Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Distress Syndrome Caused by Chlamydia psittaci: A Case Report and Review of the Literature
Authors: Lu Wang, Zhaokun Shi, Wei Chen, Xianjin Du, Liying Zhan
Journal: Front Med (Lausanne) (2021)
Keywords: chlamydia psittaci (c psittaci), extracorporeal membrane oxygenation (ecmo), infection, next-generation sequencing (ngs), pneumonia
MeSH terms: Case Reports

Background: Infection of Chlamydia psittaci (C. psittaci) could lead to serious clinical manifestations in humans, including severe pneumonia with rapid progression, adult respiratory distress syndrome (ARDS), sepsis, multiple organ dysfunction syndromes (MODS), and probably death. Implementation of extracorporeal membrane oxygenation (ECMO) in the patient with severe ARDS gives a promising new method for recovery. Case Presentation: We report our successful use of venovenous (VV) ECMO in a 48-year-old man who manifested with severe respiratory distress syndrome, acute kidney injury, and septic shock caused by a diagnosis of pneumonia. After the combination of therapy including anti-infection, mechanical ventilation, and continuous renal replacement therapy (CRRT), acute inflammatory syndrome developed. However, his respiratory status rapidly deteriorated. Then, venoarterial (VA)-ECMO support was placed on the patient as suddenly slowing of the heart rate. Harlequin (North-South) syndrome occurred after ECMO initiation. A series of the process could not relieve hypoxia in the upper body. At last, transition to VV-ECMO improved hypoxia. The duration of VV-ECMO was 7 days and the mechanical ventilation was weaned on the next day. On the day of ECMO weaning, nanopore targeted sequencing (NTS) of bronchoalveolar lavage fluid (BALF) reported the presence of C. psittaci. After 19 days of critical systemic rehabilitation and combination therapy, the patient fully recovered from C. psittaci. Conclusion: This is the first reported case of the patient receiving ECMO for C. psittaci pneumonia. ECMO puts the lungs on temporary rest, promotes the recovery of pulmonary function, and also wins time for finding the pathogens, which is crucial in the treatment of rare pathogens.
Human metapneumovirus-associated atypical pneumonia and SARS
Authors: Paul K S Chan, Ka-Fai To, Alan Wu, Gary M K Tse, Kui-Fat Chan, Siu-Fai Lui, Joseph J Y Sung, John S Tam, Brian Tomlinson
Journal: Emerg Infect Dis (2004)
MeSH terms: Communicable Diseases, Emerging / virology, Metapneumovirus / isolation & purification, Paramyxoviridae Infections / complications, Severe Acute Respiratory Syndrome / virology, Case Reports, Adult, China, Fatal Outcome, Humans, Male, Paramyxoviridae Infections / pathology, Severe Acute Respiratory Syndrome / complications

Acute pneumonia developed in a previously healthy man during the outbreak of severe acute respiratory syndrome (SARS) in southern China in March 2003. Antibiotic treatment was ineffective, and he died 8 days after illness onset. Human metapneumovirus was isolated from lung tissue. No other pathogen was found. Other etiologic agents should thus be sought in apparent SARS cases when coronavirus infection cannot be confirmed.
The Scatter Search Based Algorithm for Beam Angle Optimization in Intensity-Modulated Radiation Therapy
Authors: Ali Ghanbarzadeh, Majid Pouladian, Ali Shabestani Monfared, Seied Rabi Mahdavi
Journal: Comput Math Methods Med (2018)
MeSH terms: Algorithms, Radiotherapy, Intensity-Modulated, Humans, Phantoms, Imaging, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted

This article introduces a new framework for beam angle optimization (BAO) in intensity-modulated radiation therapy (IMRT) using the Scatter Search Based Algorithm. The potential benefits of plans employing the coplanar optimized beam sets are also examined. In the proposed beam angle selection algorithm, the problem is solved in two steps. Initially, the gantry angles are selected using the Scatter Search Based Algorithm, which is a global optimization method. Then, for each beam configuration, the intensity profile is calculated by the conjugate gradient method to score each beam angle set chosen. A simulated phantom case with obvious optimal beam angles was used to benchmark the validity of the presented algorithm. Two clinical cases (TG-119 phantom and prostate cases) were examined to prepare a dose volume histogram (DVH) and determine the dose distribution to evaluate efficiency of the algorithm. A clinical plan with the optimized beam configuration was compared with an equiangular plan to determine the efficiency of the proposed algorithm. The BAO plans yielded significant improvements in the DVHs and dose distributions compared to the equispaced coplanar beams for each case. The proposed algorithm showed its potential to effectively select the beam direction for IMRT inverse planning at different tumor sites.
Polysplenia syndrome revealed in adulthood by pancreatic and vascular malformations: a case report
Authors: Meryem El Mountassir, Mohamed Borahma, Imane Benelbarhdadi, Nawal Lagdali, Abdelmoughit Hosni, Fatima Zahra Ajana
Journal: Pan Afr Med J (2022)
Keywords: imaging, case report, multiple spleens, polysplenia syndrome
MeSH terms: Heterotaxy Syndrome / diagnosis, Vascular Malformations / complications, Vascular Malformations / diagnosis, Case Reports, Abdomen, Adult, Female, Humans, Infant, Newborn, Middle Aged, Pancreas / diagnostic imaging

Polysplenia syndrome (PSS) is a rare congenital disease that associates multiple spleens to other malformations, most frequently cardiac, vascular, visceral, and biliary malformations. Most patients with PSS die in the early neonatal period because the disease is often accompanied by serve cardiac and biliary abnormalities. However, some patients have only mild cardiovascular malformations or anomalies in the abdominal organs, which are typically diagnosed incidentally in adulthood. We report the case of a 54-year-old woman who consulted for chronic atypical diffuse abdominal pain. The clinical examination was normal. Abdominal computed tomography showed a total of 5 spleens with vascular and pancreatic malformations as part of polysplenia syndrome. Symptomatic treatment was instituted with good evolution. No specific therapeutic indication was indicated in our case discovered incidentally in adulthood.
Successfully Treated Lung and Renal Metastases from Primary Chondrosarcoma of the Scapula with Radiofrequency Ablation and Surgical Resection
Authors: Sho Sekito, Manabu Kato, Kouhei Nishikawa, Yuko Yoshio, Masahiro Kanai, Hideki Kanda, Kiminobu Arima, Yoshiki Sugimura
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Since chondrosarcoma is a relatively rare type of malignant bone tumors characterized by its ability to produce a cartilage matrix and aggressive behavior, a consensus clinical management strategy has not been established. We report a 55-year-old woman who presented with renal metastasis arising from chondrosarcoma of the scapula. Chondrosarcoma of the left scapula was diagnosed 15 years earlier. After surgical resection of a local recurrence in the left scapula, she received focal radiofrequency ablation (RFA). She underwent focal RFA and surgical resection for a total of 21 times for lung metastases. Because invasion of the renal pelvis was suspected from urine cytology, she underwent laparoscopic nephroureterectomy. The histopathological findings showed metastatic chondrosarcoma involving the right renal parenchyma. The patient has remained clinically stable without recurrence for 18 months. To the best of our knowledge, this is the first report of metastatic chondrosarcoma of the lung and renal parenchyma with involvement of the renal pelvis in which remission was achieved with multimodal treatment including RFA and surgical resection.
A Short-Term Efficacy of Anlotinib in the Treatment of Refractory Nasopharyngeal Inverted Papilloma: A Case Report
Authors: Pan Yang, Gang Meng, Qiuxia Shu, Yan Dong, Chong Li, Yujiao Lu, Jianjun Li
Journal: Front Oncol (2021)
Keywords: a case report, anlotinib, local canceration of refractory nasopharyngeal inverted papilloma, short-term curative effect, treat
MeSH terms: Case Reports

To our knowledge, no studies have reported the use of anlotinib in the treatment of locally cancerous nasopharyngeal inverted papillomas that cannot be operated on or treated with radiotherapy. Here, we report a case of a 53-year-old woman diagnosed with recurrent local canceration of nasopharynx papilloma. Magnetic resonance imaging (MRI) showed that the right parapharyngeal space, nasopharynx, and ethmoid sinus were changed, and recurrence was considered. There was no indication for surgery or radiotherapy. Imaging showed that the tumor had obvious enhancement and abundant blood vessels. Immunohistochemistry showed that vascular endothelial growth factor receptor (VEGFR) 2 expression was positive in papilloma tissue and in local canceration tissue of the papilloma. After the patient's consent was obtained, anlotinib treatment was started in May and ended in November 2019. Then, the patient was treated with intensity-modulated radiotherapy (IMRT) with planning gross tumor volume (PGTV) 66 Gy, planning clinical tumor volume 1 (PCTV1) 60 Gy, and planning clinical tumor volume 2 (PCTV2) 54 Gy in 33 fractions. No disease recurrence was reported at 4 months after radiotherapy.
Primary intracranial extra-skeletal myxoid chondrosarcoma of right lateral ventricle with EWSR1 gene fusion: a case report and review of literature
Authors: Vinodh Kumar Selvaraj, Deleep Kumar Gudipudi, Rachna Khera, Sudha Murthy
Journal: Ecancermedicalscience (2021)
Keywords: ewsr1 gene fusion, extra-skeletal myxoid chondrosarcoma, intracranial myxoid neoplasm, rare intracranial malignancy
MeSH terms: Case Reports

Background:
Primary intracranial malignancies with extra-skeletal myxoid chondrosarcoma (EMC) features are extremely rare. EMC constitutes a distinct genomic entity characterised by reciprocal translocation of fusion genes, most commonly EWS RNA Binding Protein 1 (EWSR1) in 22q12 with Nuclear Receptor Subfamily 4 Group A Member 3 (NR4A3) in 9q2-q31.1. It is reported to have a high propensity for local recurrence and has potential for metastasis. So far in 28 years since its first description, only 17 cases of primary intracranial EMC were reported in literature. This would be the second case of intraventricular origin and first case from lateral ventricle.
Case presentation:
A 27-year-old male presenting with complaints of headache, seizures and pain in neck was diagnosed to have a mass lesion in right lateral ventricle in Magnetic Resonance Imaging of brain. He underwent right parieto-occipital craniotomy with total excision of the lesion. Initial histopathological examination was reported as Ependymoma, WHO grade II. However, blocks and slides review with immunohistochemistry (IHC) markers revealed neoplastic aetiology with extensive myxoid changes. Hence, fluorescent in-situ hybridisation (FISH) testing was done with EWSR1 break apart probe, which demonstrated EWSR1 break apart signals. Therefore, correlating the clinical findings with morphology, IHC and FISH, the diagnosis of primary intracranial EMC was rendered. Patient received adjuvant external beam radiation of 54 Gy in 30 fractions to the post-op region. At 29-month follow-up, there was no evidence of disease recurrence.
Conclusions:
Owing to the rarity of the condition, there are no standard treatment guidelines available for primary intracranial EMC. A combined treatment approach with surgery followed by adjuvant radiotherapy provides good local control with less morbidity.
A three-generation family with idiopathic facial palsy suggesting an autosomal dominant inheritance with high penetrance
Authors: Christian Grønhøj Larsen, Mette Gyldenløve, Aia Elise Jønch, Birgitte Charabi, Zeynep Tümer
Journal: Case Rep Otolaryngol (2015)

Idiopathic facial palsy (IFP), also known as Bell's palsy, is a common neurologic disorder, but recurrent and familial forms are rare. This case series presents a three-generation family with idiopathic facial palsy. The mode of inheritance of IFP has previously been suggested as autosomal dominant with low or variable penetrance, but the present family indicates an autosomal dominant trait with high or complete penetrance. Chromosome microarray studies did not reveal a pathogenic copy number variation, which could enable identification of a candidate gene.
Normocalcemic Parathyroid Adenoma with Brown's Tumor Maxilla: A Rare Case
Authors: Aarushi Wadhawan, Nikhil Arora, Ashiya Goel, Pratik Kumar, Parmod Jangra, Aanchal Gupta
Journal: Iran J Otorhinolaryngol (2023)
Keywords: brown's tumor, maxillary tumor, normocalcemia, parathyroid adenoma, primary hyperparathyroidism
MeSH terms: Case Reports

Introduction:
Primary hyperparathyroidism due to parathyroid adenoma commonly causes raised serum calcium and focal giant cell lytic lesions in bones known as Brown's tumors. It is more common in females in the post-menopausal age group.
Case report:
We report a case of a 29-year-old female patient with Brown's tumor maxilla in a clinical setting of normocalcemic primary hyperparathyroidism. The patient presented to us with facial and palatal swelling for which FNAC was done. Cytology revealed hemosiderin-laden macrophages suspicious for Brown's tumor. On further imaging studies such as CT Neck, Tc99 Sestamibi scan, and other biochemical tests like parathyroid hormone assay and serum calcium level, the diagnosis of a hyperfunctioning parathyroid gland with normal calcium level was made. Parathyroidectomy was performed and parathyroid adenoma came out to be the primary pathology. On post-operative follow up there was regression of the swelling on the face and palate relieving the patient symptomatically.
Conclusion:
The diagnostic suspicion of primary hyperparathyroidism should be kept in mind whenever a young female presents with suspected Brown's tumor, even with normal serum calcium levels, for appropriate management. Ours was a highly uncommon case that was a diagnostic challenge and had a successful treatment outcome. Very few such cases have been reported in the literature to date to the best of our knowledge.
Primary Endoscopic Closure of Duodenal Perforation Secondary to Biliary Stent Migration: A Case Report and Review of the Literature
Authors: Samson Ferm, Constantine Fisher, Akil Hassam, Moshe Rubin, Sang-Hoon Kim, Syed Ahsan Hussain
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: biliary prosthesis, duodenum, endoscopy, perforation

Duodenal perforation due to biliary stent migration is rare, and it often requires surgical repair; however, endoscopic closure has recently become a viable option in the appropriate patients. We present the case of a 79-year-old female who underwent biliary stent placement for a common bile duct stricture, who subsequently was found to have a duodenal wall perforation secondary to stent migration. The stent was extracted endoscopically with successful defect closure using a ConMed® repositional DuraClip™. We aim to contribute to the limited body of literature that describes endoscopic repair of duodenal perforation secondary to biliary stent migration using through-the-scope endoclips.
Case Report: Surgical Closure of Chronic Soft Tissue Defects Using Extracellular Matrix Graft Augmented Tissue Flaps
Authors: Micheal N Desvigne, Krista Bauer, Kurt Holifield, Kari Day, Denise Gilmore, Ashley L Wardman
Journal: Front Surg (2021)
Keywords: chronic wounds, extracellular matrix, flap reconstruction, ovine forestomach matrix, soft tissue defects
MeSH terms: Case Reports

Chronic soft tissue defects are notoriously difficult to heal. Surgical reconstruction of chronic defects using tissue flaps is a routine approach for closure of challenging chronic defects. Due to the poor tissue quality of chronic defects and associated inflammation, infection and impaired blood supply the success of flap closure is marred by reported complication rates of 25-58%. Extracellular matrix (ECM)-based graft materials are commonly used for resolving chronic wounds and in plastic and reconstructive procedures to create a scaffold for tissue regeneration. We hypothesized combination use of ECM grafts with tissue flaps in a single-stage surgical procedure would reduce complications and improve outcomes in the closure of chronic soft tissue defects. We report a case series (n = 9) of chronic soft tissue defect reconstruction using this modified procedure of ECM graft augmented flap closure. Defects included pressure injuries and surgical dehiscence and ranged in wound age from 5 months to 7 years. Successful uncomplicated healing was achieved in six defects. Post-operative complications (dehiscence) occurred in two defects, however, these healed via secondary intention without additional surgical intervention. All healed defects exhibited acceptable cosmesis and "normal" function, with 100% patient satisfaction. Augmentation of tissue flaps with ECM graft materials in this modified single-stage procedure may improve outcomes and minimize typical complications encountered in flap closure of chronic defects attributed to inflammation, infection, hypoperfusion, and dead space.
SARS-CoV2 and Co-Infections: A Review of Two Cases
Authors: Sumit Sohal, Guillermo Rodriguez-Nava, Ramzy Khabbaz, Sana Chaudry, Clio Musurakis, Solab Chitrakar, Vishnu V Chundi, Harvey J Friedman
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

COVID-19 infection caused by SARS-CoV2 virus is an acute respiratory illness which was declared as a pandemic by the World Health Organization. Usually, SARS-CoV2 infects independently and can cause spectrum of disease ranging from mild illness to severe progressive pneumonia, multiorgan dysfunction, and death; however, co-infections with other respiratory pathogens have been noted. Here, we present 2 fatal cases with co-infection, one with parainfluenza-4 virus and other co-infection/secondary infection with Streptococcus pneumoniae bacteria. Further studies are needed to study the effect of co-infections on morbidity and mortality of patients and establish the outcome of such infections.
Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery
Authors: Puneet Tuli, Atul Parashar, Vipul Nanda, Ramesh K Sharma
Journal: Indian J Plast Surg (2009)
MeSH terms: Case Reports

Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.
First Case Report of Arrhythmogenic Right Ventricular Cardiomyopathy Showing Refractory Ventricular Tachycardia Induced by Thyroid Storm due to Graves' Disease
Authors: Masaki Matsubara, Tomohiro Tanaka, Akinori Wakamiya, Tamiko Tamanaha, Hisashi Makino, Tomonori Tanei, Takeshi Aiba, Kengo Kusano, Kiminori Hosoda
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

A 48-year-old man who was diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) due to a plakophilin 2 gene mutation developed acute both-sided heart failure with rapid atrial fibrillation and was hospitalized. After admission, sustained ventricular tachycardia, which was refractory to antiarrhythmic agents, occurred repeatedly, and required electrical cardioversion. He was diagnosed with thyroid storm due to Graves' disease, and treatment for hyperthyroidism was initiated. After the treatment, lethal arrhythmia did not reoccur, and biventricular heart failure ameliorated. To our best knowledge, this is the first report in English of a patient with ARVC showing refractory arrhythmia induced by thyroid storm due to Graves' disease.