OpenMed/multicare-articles huggingface dataset:
Case report: Traumatic hemorrhagic cervical myelopathy in a dog
Authors: Koen M Santifort, Ines Carrera, Simon Platt
Journal: Front Vet Sci (2023)
Keywords: durotomy, hematomyelia, hemorrhage, recovery, short-term outcome, spinal cord
MeSH terms: Case Reports

A 1.5-year-old female entire French bulldog was referred for neurological evaluation, further diagnostic tests, and treatment 24 h after a road traffic accident. Initial emergency treatment, diagnostic tests, and stabilization had been performed by the referring veterinarian. Neurological examination revealed severe spastic non-ambulatory tetraparesis and was consistent with a C1-5 myelopathy. A magnetic resonance imaging (MRI) study revealed an irregular to elongated ovoid intramedullary lesion centered over the body of C2. The lesion showed marked signal heterogeneity with a central T2W and T2* hyperintense region, surrounded by a hypointense rim on both sequences. The lesion appeared heterogeneously T1W hypointense. The lesion was asymmetric (right-sided), affecting both white and gray matter. The C2-3 intervertebral disk appeared moderately degenerate with a Pfirrmann grade of 3. No evidence of vertebral fracture or luxation was found on radiographs or MRI of the vertebral column. Additional soft tissue abnormalities in the area of the right brachial plexus were suggestive of brachial plexus and muscle injury. A diagnosis of traumatic hemorrhagic myelopathy at the level of C2 and concurrent brachial plexus injury was formed. Conservative treatment was elected and consisted of physiotherapy, bladder care with an indwelling urinary catheter, repeated IV methadone based on pain scoring (0.2 mg/kg), oral meloxicam 0.1 mg/kg q24h, and oral gabapentin 10 mg/kg q8h. The dog was discharged after 4 days, with an indwelling urinary catheter and oral medication as described. The catheter was replaced two times by the referring veterinarian and finally removed after 10 days. Thereafter, voluntary urination was seen. During the 2 months after the road traffic accident, slow recovery of motor function was seen. The right thoracic limb recovery progressed more slowly than the left limb, also showing some lower motor neuron signs during follow-up. This was judged to be consistent with a right-sided brachial plexus injury. The dog was reported ambulatory with mild residual ataxia and residual monoparesis of the right thoracic limb at the last follow-up 3 months post-injury. This case report highlights the MRI-based diagnosis of traumatic hemorrhagic myelopathy in a dog. A fair short-term outcome was achieved with conservative treatment in this case.
Case Report: A rare case of non-small cell lung cancer with STRN-ALK fusion in a patient in very poor condition treated with first-line ensartinib
Authors: Guo-Qiang Song, Yi-Zhong Li, Weiliang Kong, Guo-Qiang Hu
Journal: Front Oncol (2023)
Keywords: nsclc, strn-alk, tkis, case report, ensartinib
MeSH terms: Case Reports

Several cases of STRN-ALK fusion have been reported, and some anaplastic lymphoma kinase (ALK) inhibitors have been shown to be effective for treatment. Nevertheless, no cases of COVID-19 leading to heart failure and respiratory failure have been reported in people older than 70 years treated with ALK inhibitors. The present case report describes a 70-year-old patient with usual chronic obstructive pulmonary disease, diabetes, depression, and carotid plaque disease. Next-generation sequencing of tissue obtained by puncture biopsy revealed a STRN-ALK mutation accompanied by a TP53 mutation. The patient was treated with ensartinib and developed COVID-19 leading to heart failure and respiratory failure; nevertheless, he had a good clinical outcome and exhibited high treatment tolerability.
Durable response to pembrolizumab in hepatic metastasis from colonic carcinoma with Lynch syndrome: a case report
Authors: Cheng Xue, Dongqing Zhu, Xin Wang, Lina Jiao, Yunhui Lu, Sanli Zhang, Jiayi Lv, Linlin Cui, Mengna Ruan, Dechao Xu, Qingyang Liu, Yun Feng, Shuqin Mei
Journal: Front Immunol (2024)
Keywords: lynch syndrome, immune-checkpoint inhibitors, metastatic colorectal cancer, mismatch repair deficiencies, treatment related adverse event
MeSH terms: Antibodies, Monoclonal, Humanized / administration & dosage, Antibodies, Monoclonal, Humanized / therapeutic use, Antineoplastic Agents, Immunological / therapeutic use, Colorectal Neoplasms, Hereditary Nonpolyposis / drug therapy, Liver Neoplasms / drug therapy, Liver Neoplasms / secondary, Case Reports, Colonic Neoplasms / drug therapy, Colonic Neoplasms / pathology, Epithelial Cell Adhesion Molecule / genetics, Humans, Male, Middle Aged, MutS Homolog 2 Protein / genetics, Treatment Outcome, pembrolizumab, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, MutS Homolog 2 Protein, MSH2 protein, human, EPCAM protein, human, Epithelial Cell Adhesion Molecule

Pembrolizumab and other immunotherapies have become central in treating metastatic colon cancer, particularly effective in patients with mismatch repair deficiencies. We report a case involving a man who initially underwent radical surgery for sigmoid colon cancer on April 27, 2011, followed by hepatic tumor resection on September 21, 2017. Post-surgery, he received eight cycles of adjuvant chemotherapy with the CAPEOX regimen and was regularly monitored through CT and MRI scans. On August 24, 2022, liver metastases were detected, and he was diagnosed with Lynch syndrome (LS) due to germline mutation in the MSH2 and EPCAM genes. He commenced treatment with 200mg of pembrolizumab intravenously every three weeks on September 2, 2022, and demonstrated a sustained response. However, after 17 cycles, he developed a treatment related adverse event (TRAE) of pancreatic endocrine dysfunction, leading to type 1 diabetes, managed with subcutaneous insulin injections. After 30 cycles of treatment, no evidence of disease was observed. This case underscores the significant clinical benefits of first-line pembrolizumab in managing hepatic metastasis in colonic carcinoma associated with LS, despite the occurrence of TRAEs. It raises critical questions regarding the optimal duration of immunotherapy following a complete or partial response and whether treatment should be discontinued upon the emergency of TRAEs. Continued research and forthcoming clinical trials with checkpoint inhibitors are expected to refine treatment protocols for LS-associated carcinoma.
A Presentation of Babesiosis in the Setting of Low-Grade Follicular B-cell Lymphoma
Authors: Erika Foerst, Karthik Shankar, Jing Zhou, Arezoo Ghaneie
Journal: Cureus (2024)
Keywords: b-symptoms, babesiosis, follicular lymphoma, hemolytic anemia, ixodes tick, lymphoma, maltese cross, non-hodgkin’s lymphomas, rituximab, tick-borne illness
MeSH terms: Case Reports

Babesiosis is a tick-borne parasitic infection seen in the Northeast and upper Midwest regions of the United States. Clinically, this intra-erythrocytic parasitic infection can present in a variety of ways, including fever, fatigue, malaise, or myalgia. Of note, these presenting symptoms are very similar to symptoms that can also be seen in patients with low-grade lymphoma. Thus, differentiating between babesiosis infection and active, symptomatic low-grade lymphoma can be difficult. We present a patient with concurrent severe babesiosis infection and follicular lymphoma. This case report provides a unique overlap of Hematology/Oncology and Infectious Disease and the ensuing diagnostic challenges when both tick-borne illnesses and low-grade lymphoma present together. We suggest including babesiosis screening in the pretreatment evaluation for the use of rituximab in patients with the above symptomatology and geography. This will help rule out alternate confounding diagnoses of babesiosis infection before initiating immunosuppressive treatment for active, symptomatic low-grade lymphoma. Using immunosuppressive agents such as rituximab to treat suspected low-grade lymphoma, before ruling out tick-borne illnesses, can be harmful. Our goal is to reduce such instances.
Case Report: A de novo NLRP3 variant resulting in autoinflammatory disease in a Chinese newborn
Authors: Mingyu Xie, Jingjing Wan, Xin Zheng, Xian Zou, Wanting Chen, Kanglin Zhang, Huiting Yuan, Zhenhong Zhang, Haisheng Zeng
Journal: Front Immunol (2023)
Keywords: nlrp3, nlrp3-aid, autoinflammatory disease, mutation, newborn
MeSH terms: Cryopyrin-Associated Periodic Syndromes / diagnosis, Cryopyrin-Associated Periodic Syndromes / drug therapy, Cryopyrin-Associated Periodic Syndromes / genetics, Urticaria / genetics, Case Reports, Child, East Asian People, Female, Humans, Infant, Newborn, Mutation, NLR Family, Pyrin Domain-Containing 3 Protein / genetics, NLR Family, Pyrin Domain-Containing 3 Protein

Background:
Cryopyrin-associated periodic syndromes (CAPS) have been considered autoinflammatory diseases resulting from NLRP3 gene mutations. In recent years, these conditions have been redefined as NLRP3-associated autoinflammatory diseases (NLRP3-AID). Our previous study highlighted a case of a Chinese individual carrying the de novo NLRP3 mutation.
Results:
A female child carrying a de novo variant (c.1718T>G, p. L573W) in the NLRP3 gene was presented in this work. The patient manifested various symptoms, including recurrent fever, a rash resembling urticaria, arthritis, physical growth retardation, a notable prominence of the forehead, and a flat nose bridge. Additionally, inflammatory markers, like WBC count, PLT count, CRP, ESR, and IL-6 showed elevated levels. Additionally, we observed interstitial pulmonary disease in the patient, which is not frequently mentioned in previous studies. Notably, the proband did not present with any ocular, auditory, or neurological symptoms. After 12 weeks of subcutaneous canakinumab injection, there was a clear improvement in the patient's clinical manifestations and inflammatory markers.
Conclusion:
Our study contributes to broadening the clinical spectrum of established pathogenic variants of NLRP3 gene, which are related to NLRP3-AID.
Swift Onset, Swift Recovery: Unusual Nonrheumatic Myocarditis in a Young Adult Post Group A Streptococcal Pharyngitis
Authors: Andres Rios, Colby Wood, Ricardo Isaiah Garcia, Emily C Mitchell, Jacob Nichols
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

This case report highlights the unusual presentation and management of nonrheumatic myocarditis in a 24-year-old male, an age demographic not commonly associated with myocardial complications following Group A streptococcal pharyngitis. The patient, devoid of any prior medical history, manifested symptoms one day after being diagnosed with Group A streptococcal pharyngitis, a stark contrast to the typical progression of myocardial complications. The swift onset of symptoms and the patient's subsequent clinical presentation necessitated a comprehensive diagnostic approach. The patient's symptoms were successfully alleviated with amoxicillin and anti-inflammatory therapy, underscoring its potential efficacy in managing nonrheumatic myocarditis. This case serves as a poignant reminder of the importance of maintaining a broad differential diagnosis, especially in atypical presentations, and the pivotal role of timely clinical intervention. The insights from this report contribute to the broader understanding of nonrheumatic myocarditis, emphasizing the significance of tailored diagnostic and therapeutic strategies to ensure optimal patient outcomes.
Struma ovarii with Hashimoto's thyroiditis: case report and review of the literature
Authors: Huayun Tan, Tingting Zhang
Journal: Front Med (Lausanne) (2024)
Keywords: ca 125, hashimoto’s thyroiditis, malignant struma ovarii, ovarian tumor, struma ovarii
MeSH terms: Case Reports

Background:
Struma ovarii, a rare ovarian neoplasm originating from germ cells within mature teratomas, typically manifests benign characteristics. However, instances of malignant transformation have been documented.
Case description:
This report discusses a 25-year-old woman who had surgery in May 2020 to remove teratomas from both ovaries. In 2023, an ultrasound showed a complex mass in her pelvis. Further imaging tests, including CT, MRI, and F-18 FDG PET/CT scans, along with high levels of the CA 125 protein, suggested a mass in her left ovary, initially thought to be ovarian cancer. However, a closer examination after surgery found thyroid tissue and several types of cell growth but no cancer, confirming the diagnosis of struma ovarii. The pathology of hypermetabolic thyroid nodules on F-18 FDG PET/CT confirmed Hashimoto's thyroiditis.
Conclusion:
This case underscores the importance of considering struma ovarii in the differential diagnosis of ovarian masses, especially in patients with a history of teratomas. It highlights the challenges in distinguishing struma ovarii from ovarian cancer due to similar clinical signs and imaging. Struma ovarii can be associated with Hashimoto's thyroiditis.
Hydrodissection as a Novel Alternative After Failed Management of a Cervical Pregnancy With Methotrexate: Case Report and Literature Review
Authors: Natalia Cárdenas-Suárez, Paulette Urrutia-Villamil, Taymara Reyes-Jimenez, Olga Pereira-Diaz
Journal: Cureus (2024)
Keywords: cervical ectopic pregnancy, cervical pregnancy, ectopic pregnancy, hydrodissection, methotrexate
MeSH terms: Case Reports

Cervical ectopic pregnancies (CEPs) are rare and life-threatening diagnoses. Risk factors have been associated with CEPs, yet their etiology and pathogenesis remain unknown. Timely intervention is vital for successful outcomes, yet it is challenged as there is no standardized approach to treatment. We present the case of a 42-year-old woman diagnosed with CEP following five weeks and one day of amenorrhea. The patient was treated with a two-dose regimen of intramuscular methotrexate (MTX) but failed to respond. Ultrasound-guided intrasac MTX injection was considered a secondary treatment. However, spontaneous expulsion was observed after administering lidocaine at different cervical points. Hydrodissection following systemic MTX could present a novel alternative for treating CEP. Expulsion of pregnancy after hydrodissection could be associated with tissue necrosis and/or destabilized implantation of pregnancy, secondary to the effects of MTX. Further research is vital for evaluating the underlying mechanisms for expulsion and the role of hydrodissection following MTX in treating CEP.
Giant Right Coronary Artery Aneurysm Incidentally Found During Stroke Evaluation Through Echocardiography
Authors: Jessica M Gonzalez, Gabriel Lowenhaar, Prasad Chalasani
Journal: Cureus (2024)
Keywords: coronary aneurysm discovered poststroke, coronary artery aneurysm, echocardiogram detecting coronary aneurysm, giant coronary artery aneursym, transthoracic echocardiogram
MeSH terms: Case Reports

Giant coronary artery aneurysms (CAAs) are rare forms of coronary artery disease. An 82-year-old man presented to the hospital with generalized weakness, arm numbness, and dizziness and was found to have a multi-infarct stroke. A transthoracic echocardiogram was obtained to determine a possible cardiovascular etiology of his stroke. However, it did not reveal thrombi or vegetation; instead, it showed a ring-like structure adjacent to the tricuspid valve that appeared to be a large right atrial cyst. A transesophageal echocardiogram was performed localizing the ring-like mass near the tricuspid annulus. Cardiac catheterization revealed aneurysms of the coronary arteries with complete distal occlusion of the left anterior descending artery (LAD), an aneurysmal left circumflex, and a right coronary artery with a very large aneurysm without signs of thrombus or flow-limiting lesion. CAAs are usually found through cardiac catheterization. Echocardiography may be a novel way of identifying CAAs.
All that Doesn't Enhance Isn't a Thrombus: Pitfalls Using Cardiac MRI TI 600 Sequence to Distinguish Between Cardiac Thrombus Versus Myxoma
Authors: Aakash D Rana, Srikanth Vallurupalli, Mark Mitchell, David Duncan, Jack Xu
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: cmr, ti 600, cardiac thrombus, myxoma
MeSH terms: Myxoma / complications, Myxoma / diagnostic imaging, Myxoma / surgery, Thrombosis / diagnostic imaging, Thrombosis / surgery, Case Reports, Contrast Media, Gadolinium, Heart Atria / diagnostic imaging, Heart Atria / surgery, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Contrast Media, Gadolinium

A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor.
Edematous Ileocecal Valve Mimicking Incomplete Reduction after Intussusception
Authors: Frédéric Marie Quatannens, Michael Aertsen, Stéphanie Braspenningx
Journal: J Belg Soc Radiol (2023)
Keywords: ileocecal valve edema, intussusception, single contrast enema
MeSH terms: Case Reports

Teaching Point: An edematous ileocecal valve may mimic a residual intussusception after reduction. Differential diagnosis is important for therapeutic implications.
Rhabdomyosarcoma of the biliary tract in a child: a case report
Authors: Tang Ran, Chen Gong, Dong Rui, Zheng Shan
Journal: Front Pediatr (2024)
Keywords: ercp, chemotherapy, pediatric, rhabdomyosarcoma of the biliary tract, surgery
MeSH terms: Case Reports

Pediatric rhabdomyosarcoma of the biliary tract (BRMS) is extremely rare. Here, we present a case of a 2-year-old child who was initially misdiagnosed with choledocholithiasis upon admission. The diagnosis was later confirmed as BRMS through endoscopic retrograde cholangiopancreatography (ERCP). The patient was cured through surgery followed by chemotherapy. Due to the lack of specific early symptoms and the challenges in imaging differentiation, particularly in pediatric patients, clinical awareness of this condition needs to be heightened. Our findings indicate that ERCP is currently the optimal diagnostic tool for this disease, and a combination of surgery and chemotherapy can yield better therapeutic outcomes.
Case Report: Adrenocortical carcinoma in children-symptoms, diagnosis, and treatment
Authors: Estera Zagojska, Magdalena Malka, Adrianna Gorecka, Iwona Ben-Skowronek
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: cushing syndrome, cushing syndrome - therapy, adrenocortical carcinoma, adrenocortical tumour, precocious puberty
MeSH terms: Adrenal Cortex Neoplasms / complications, Adrenal Cortex Neoplasms / diagnosis, Adrenal Cortex Neoplasms / genetics, Adrenal Gland Neoplasms, Adrenocortical Carcinoma / diagnosis, Adrenocortical Carcinoma / genetics, Adrenocortical Carcinoma / surgery, Cushing Syndrome / diagnosis, Cushing Syndrome / etiology, Cushing Syndrome / therapy, Puberty, Precocious, Case Reports, Review, Child, Preschool, Female, Humans

Adrenocortical carcinomas are extremely rare in the paediatric population. Most of them are hormone-secretive lesions; therefore, they should be taken into consideration in a child with signs of precocious puberty and/or Cushing's syndrome symptoms. Nonetheless, differentiation from benign adrenal tumours is necessary. We report a rare case of adrenocortical carcinoma in a girl and a literature review using the PubMed database. A four-year-old girl presented with rapidly progressing precocious puberty and signs of Cushing's syndrome. Imaging of the abdomen revealed a large heterogeneous solid mass. Histopathologic evaluation confirmed adrenocortical carcinoma with high mitotic activity, atypical mitoses, pleomorphism, necrosis, and vascular invasion. After tumourectomy, a decrease of previously elevated hormonal blood parameters was observed. Genetic tests confirmed Li Fraumeni syndrome. Adrenocortical carcinoma should be suspected in children with premature pubarche and signs of Cushing's syndrome. Diagnosis must be based on clinical presentation, hormonal tests, imaging, and histopathological evaluation. Complete surgical resection of the tumour is the gold standard. Oncological treatment in children is not yet well-studied and should be individually considered, especially in advanced, inoperable carcinomas with metastases. Genetic investigations are useful for determining the prognosis in patients and their siblings.
Case Reports: A role of postoperative radiation therapy in completely resected early stage intrathyroid thymic carcinoma: a case report and literature review of the diagnosis and treatment
Authors: Ailin Cui, Yaoqiang Du, Chunjie Hou, Lin Zhang, Litao Sun, Hongfeng He
Journal: Front Oncol (2023)
Keywords: immunohistochemistry, intrathyroidal thymic carcinoma, radiotherapy, surgery, thyroid tumor
MeSH terms: Case Reports

Background:
Intrathyroid thymic carcinoma (ITTC) is a rare malignant tumor of the thyroid, probably arising from ectopic thymus or branchial pouch remnants. Most of the literature recommended radical resection as the fundamental treatment for ITTC, and postoperative radiation appears to be able to reduce the recurrence rate in patients with advanced ITTC. However, the issue of adjuvant radiotherapy in completely resected early-stage ITTC has been controversial.
Case presentation:
Here, we reported a new case of early-stage ITTC that treated with total thyroidectomy and the right central neck dissection. Postoperative external beam radiation therapy (50.0 Gy/25 fractions) was given to the thyroid bed and bilateral cervical lymph node area since the tumor involved part of the sternal thyroid muscle. At 4-year follow-up after completion of radiotherapy, she is without evidence of locally recurrent or distant disease.
Conclusion:
Since there are no current guidelines for early-stage ITTC, in combination with this case and previous literature, we may suggest routine adjuvant radiotherapy should be considered in patients with incompletely resected tumors and extraparenchymal extension of ITTC. Moreover, we summarized comprehensive and advanced diagnosis, treatment, prognosis of ITTC and comparison between ITTC, primary squamous cell carcinoma of thyroid gland, differentiated thyroid cancer, and anaplastic thyroid cancer.
The integration of behavioral health consultants within a state-wide psychiatry consultation program: a community case study
Authors: Elizabeth Tengelitsch, Erin Hughes-Krieger, Dayna LePlatte, Samantha Shaw-Johnston, Sheila Marcus
Journal: Front Psychiatry (2023)
Keywords: behavioral health consultation, collaborative care, integrated care, mental health consultation, psychiatry access program
MeSH terms: Case Reports

This paper describes the integration and role of masters-prepared behavioral health consultants (BHCs) within a state-wide psychiatry consultation program for children, adolescents, and perinatal women. Data from the Michigan Clinical Consultation and Care (MC3) program are reviewed, with attention to the role that BHCs play in the consultation process, integrated care, screening, and their dual roles with Community Mental Health Services Programs (CMHSPs) in Michigan. Approximately 82% of MC3 services are provided by the BHCs and involve resources or integrated care. BHCs play a role in managing provider consultations and connecting patients and providers to resources in the MC3 program.