OpenMed/multicare-articles huggingface dataset:
Giant fibrolipoma of the esophagus
Authors: Ryan L Kau, Alpen B Patel, Michael L Hinni
Journal: Case Rep Otolaryngol (2012)
MeSH terms: Case Reports

Benign tumors of the esophagus are uncommon, representing <0.5% of esophageal tumors. Fibrolipomas are a subset of benign fibrovascular tumors, which present with dysphagia, odynophagia, and substernal fullness. These intraluminal tumors can become elongated and molded into a long pedunculated polyp by constant peristaltic movements. They can cause esophageal obstruction if large and long enough and can cause asphyxiation if they become lodged into the glottis. A barium swallow is the main diagnostic tool; treatment is surgical via a transoral, transcervical, or transthoracic approach. We report the excision of a large esophageal fibrolipoma through a transoral laser microsurgical approach.
Successful spinal anaesthesia for caesarean section in an African patient with Takayasu's arteritis
Authors: Mamo Woldu Kassa, Tadele Melese Benti, Alemayehu Ginbo Bedada
Journal: Pan Afr Med J (2018)
Keywords: african patient, takayasu´s arteritis, caesarean section, spinal anaesthesia
MeSH terms: Anesthesia, Spinal / methods, Cesarean Section / methods, Pregnancy Complications, Cardiovascular / physiopathology, Takayasu Arteritis / complications, Case Reports, Anesthesia, Obstetrical / methods, Female, Humans, Infant, Newborn, Male, Pregnancy, Takayasu Arteritis / physiopathology, Young Adult

Takayasu's arteritis (TA) is a rare chronic inflammatory disease affecting mainly the aorta and its main branches. We report a case of a 24-year-old primigravida, an African patient, with TA planned for caesarean section at 37 weeks of gestation. Clinically, she has involvement of aortic arch and its branches and abdominal aorta. She underwent caesarean section and delivered an alive baby boy under successful spinal anaesthesia with insignificant complications. Although it is rare in the African continent, anesthesiologists should be up-to-date with the knowledge of perioperative anesthetic management of TA in pregnant cases requiring operative delivery.
Carotid Space Mass Proximal to Vagus Nerve Causing Asystole and Syncope
Authors: Julie Leviter, Daniel H Wiznia
Journal: Case Rep Neurol Med (2016)

Manipulation of vagal nerve rootlets, whether surgical or through mass effect of a neoplasm, can result in asystole and hypotension, accompanied by ST depression and right bundle branch block. There are few case reports of a neoplasm causing these effects, and this case describes a patient with such a mass presenting with syncopal episodes. A 43-year-old man with a past medical history of HIV, bipolar disorder, and epilepsy was admitted to the neurology service for a video electroencephalogram (vEEG) to characterize syncopal episodes that were felt to be epileptic in origin. During the study, he experienced symptoms of his typical aura, which correlated with a transient symptomatic high degree AV block on telemetry, and an absence of epileptic findings on vEEG. Magnetic Resonance Imaging (MRI) of the brain showed a mass in the left posterior carotid space at the skull base. The patient underwent permanent dual chamber MRI-compatible pacemaker placement for his heart block. His syncopal episodes resolved, but presyncopal symptoms persisted. We discuss the presentation and treatment of vagal neoplasms.
Collision tumor of the appendix incidentally discovered in a patient diagnosed with an adenocarcinoma of the colon: a case report
Authors: Syrine Moussa, Salwa Nechi, Abir Chaabane, Karim Mfarrej, Amel Dougaz, Mehdi Bouassida, Slim Zribi, Hassen Touinsi, Emna Chelbi
Journal: Pan Afr Med J (2022)
Keywords: appendiceal neoplasm, case report, collision tumor, low-grade appendiceal mucinous neoplasia, neuroendocrine tumor
MeSH terms: Adenocarcinoma / complications, Adenocarcinoma / diagnosis, Adenocarcinoma / surgery, Appendiceal Neoplasms / complications, Appendiceal Neoplasms / diagnosis, Appendiceal Neoplasms / surgery, Appendix / pathology, Sigmoid Neoplasms / complications, Sigmoid Neoplasms / pathology, Case Reports, Aged, Colon, Sigmoid / pathology, Humans, Male

Collision tumor of the appendix is an extremely rare entity, defined as the coexistence of two independent tumors located in the same site without transitional changes. We describe in this report the case of a 75-year-old man who presented with an acute abdominal pain, nausea and vomiting. Physical examination revealed an abdominal distension with a hypogastric mass. Abdominal computed tomography showed colonic obstruction related to a sigmoid tumor. Therefore, a total colectomy was made. Macroscopic specimen examination showed a sigmoid tumor associated to a cystic dilatation of the appendix tip with mucoid content. Histological examination of the appendix showed the co-existence of two independent tumors located in the tip, without transitional changes: pTis low-grade appendiceal mucinous neoplasia and grade 1 neuroendocrine tumor. The latter was discovered incidentally during histological examination. We draw attention through our presentation to the importance of a thorough macroscopic and histological examination of the appendix.
Canibacter oris - a fairly unknown pathogenic agent of bite wound infections
Authors: Herbert Hof, Konrad Bode, Falko von Stillfried
Journal: GMS Infect Dis (2021)
Keywords: canibacter oris, maldi-tof, pcr, bite wound infection, class of actinobacterium
MeSH terms: Case Reports

Here, we report on the second case of bite wound infection by Canibacter oris. This bacterium belongs to the family of Microbacteriaceae in the order of Microbacterales in the class of Actinobacteria, which are prevalent in the oral flora. Possibly this bacterium has been overlooked until now, because it cannot be recognized by conventional differentiation methods. MALDI-TOF as well as PCR are able to identify this pathogen.
Bilateral synchronous carcinoma breast- a rare case presentation
Authors: Vijay Kumar Shankarrao Kappikeri, Akshay Mahesh Kriplani
Journal: Springerplus (2015)
Keywords: bilateral breast carcinoma, infiltrating ductal carcinoma, lobular carcinoma, simple mastectomy, synchronous breast carcinoma, toilet mastectomy

Introduction:
Bilateral Breast Carcinoma (BBC) is a rare entity with incidence of synchronous carcinoma being 2-5% of all breast malignancies, which is much less than metachronous carcinoma. Synchronicity/ metachronicity are usually associated with local and lymphatic spread and with blood-borne spread to lungs, bones and liver. Moreover BBC are mostly lobular carcinomas but we report a rare case of Infiltrating Ductal Carcinoma (IDC) as the primary carcinoma and Lobular Carcinoma as the secondary.
Case description:
56 year old female who presented with a Stage IIIB fungating growth around 10x8cm in the lower inner, lower outer and upper outer quadrant of right breast since 6 months and a StageIIA 4x4cm tumour felt in the left breast in the upper inner and lower outer quadrant. Wedge biopsy of the right breast fungating mass showed Ductal Carcinoma and FNAC of the left breast lump suggested Lobular carcinoma which was confirmed on Histopathology after surgery. Patient was subjected to Hormonal therapy (Tab Tamoxifen), chemotherapy (Cyclophosphamide, 5 FU, and Doxorubicin) followed by Radiotherapy. Patient recovered well and shows no recurrence or signs of metastasis in the 8 months of follow up.
Discussion and evaluation:
Different histological subtypes with different grades of tumour in both breasts suggested two different synchronous primary tumours. Early detection of the contralateral tumour is of utmost importance emphasising the significance of breast self-examination. Screening tools like MRI have a greater sensitivity compared to Mammography. There are no clear treatment guidelines for bilateral breast cancer. Patients are often treated with bilateral mastectomy, with breast conservative surgery having unclear importance.
Conclusion:
Meticulous diagnosis and appropriate management help to improve the longitivity with an improved quality of life.
Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions
Authors: Nikki Charlotta Paul Granacher, Zwi N Berneman, Wilfried Schroyens, Ann L R Van de Velde, Anke Verlinden, Alain P A Gadisseur
Journal: Exp Hematol Oncol (2017)
Keywords: adult precursor b-cell lymphoblastic leukemia, case report, hypercalcemia, osteolysis, philadelphia chromosome
MeSH terms: Case Reports

Background:
Osteolytic bone lesions and hypercalcemia without peripheral blasts B-cell acute lymphoblastic leukemia (B-ALL) is reported in children but rarely seen in adults.
Case presentation:
We describe the case of a 34-year old man presenting with hypercalcemia and symptomatic osteolytic bone lesions of vertebrae and ribs who was initially suspected as having a solid malignancy. Diagnostic work-up including peripheral blood examination, radiographic and nuclear studies could, however, not detect a primary tumor. Because of a mild thrombocytopenia and the lack of a primary focus, a bone marrow biopsy was performed leading to the diagnosis of Philadelphia chromosome positive precursor B-ALL. After correction of the hypercalcemia with intravenous fluid administration, corticoids and bisphosphonates, the patient was treated according to the HOVON 100 protocol achieving complete molecular remission after the first cycle of induction chemotherapy.
Conclusion:
Hypercalcemia and osteolytic bone lesions are rare complications of adult B-ALL and can occur in the absence of peripheral blastosis. With this case report we would like to emphasize the importance of clinical awareness. Immediate treatment of hypercalcemia and initiation of antileukemic treatment is mandatory as a delay of diagnosis might pose a real and possible life-threatening risk in these patients.
De novo podocytopathy following moderna COVID-19 vaccine: A case report and racial disproportionality in adverse effect reports
Authors: Li-Yu Hong, Chii-Hong Lee, I-Jen Chiu
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19 vaccination, adverse (side) effects, disproporionality, minimal change disease, race
MeSH terms: Case Reports

In this study, we report a case of de novo minimal change disease shortly after the second dose of the Moderna COVID-19 vaccine. A previously healthy 51-year-old Asian man presented with lower-limb edema and foamy urine 3 days after receiving the second dose of the vaccine. Laboratory data revealed the following: serum creatinine, 0.65 mg/dl; serum albumin, 1.3 g/dl; urine protein-to-creatinine ratio, 15.3 g. A renal biopsy was performed, and minimal change in the disease was confirmed. The patient achieved complete remission in the tenth week after starting treatment with prednisolone (1 mg/kg/day). Ethnic differences may influence the adverse effects of drugs and vaccines. However, there is very limited data to address the influence of ethnic diversity on disease prevalence, clinical presentation, and treatment outcomes in COVID-19 vaccine-associated glomerulonephritis.
The Robotic-Assisted Laparoscopy, Isthmusectomy, and Pyeloplasty in a Patient With Horseshoe Kidney: A Case Report
Authors: Sheng Tai, Jianzhong Wang, Jun Zhou, Zongyao Hao, Haoqiang Shi, Yifei Zhang, Chaozhao Liang
Journal: Medicine (Baltimore) (2016)
MeSH terms: Fused Kidney / surgery, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Laparoscopy, Middle Aged, Robotics

The aim of this case report was to evaluate the results of isthmusectomy and pyeloplasty of horseshoe kidney with the da Vinci robotic-assisted laparoscopy system.This case presented 1 patient with left back pain, associated with lower abdominal pain, and then she underwent the isthmusectomy and dismembered pyeloplasty using robotic-assisted laparoscopy simultaneously. The operation was performed by a transperitoneal approach using 5 ports.We cut the renal isthmus by means of bipolar scissors and then closed the renal parenchyma with 3-0 absorbed stitches. The total operation time was 123 min including simultaneous dismembered pyeloplasty. Blood loss was <50 mL. There were no complications either during or after the procedure. The oral nutrition and mobilization were included on the second day after surgery. The peritoneal drainage was removed on the eighth day. Long-term follow-up after treatment showed good results.The da Vinci robotic-assisted laparoscopy is an alternative to open surgery and laparoscopy, particularly in the correction of congenital defects of the urinary tract. Furthermore, the da Vinci robotic-assisted laparoscopy technique in isthmusectomy and pyeloplasty is safe for patient as shown by our results.
A rare case of dermatomyositis revealed during pregnancy with good outcome
Authors: Kelati Awatef, Gallouj Salim, Mernissi Fatima Zahra
Journal: Pan Afr Med J (2016)
Keywords: dermatomyositis, good outcome, pregnancy
MeSH terms: Dermatomyositis / complications, Pregnancy Complications / pathology, Pregnancy Outcome, Case Reports, Adult, Dermatomyositis / drug therapy, Dermatomyositis / pathology, Female, Glucocorticoids / therapeutic use, Humans, Immunosuppressive Agents / therapeutic use, Pregnancy, Pregnancy Complications / drug therapy, Glucocorticoids, Immunosuppressive Agents

There are only few case reports in the literature documenting outcome of pregnancy in patients with DM in contrast with those of other connective tissue diseases especially when dermatomyositis is revealed during pregnancy, most of the publications reported a poor prognosis for both the mother and the fetus, yet, in our case we confirmed the results of the rare recent cases that have tended to show a good outcome, after the treatment with glucocorticoid and immunosuppressant therapy.
First Case of Mature Teratoma and Yolk Sac Testis Tumor Associated to Inherited MEN-1 Syndrome
Authors: Sabrina Chiloiro, Ettore Domenico Capoluongo, Giovanni Schinzari, Paola Concolino, Ernesto Rossi, Maurizio Martini, Alessandra Cocomazzi, Giuseppe Grande, Domenico Milardi, Brigida Anna Maiorano, Antonella Giampietro, Guido Rindi, Alfredo Pontecorvi, Laura De Marinis, Antonio Bianchi
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: snp, hyperparathyroidism, insulinoma, menin, neuroendocrine tumor
MeSH terms: Case Reports

Introduction: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominantly inherited endocrine tumor syndrome characterized by the development of cancer in various endocrine organs, particularly in the pituitary, parathyroid and pancreas. Moreover, in some cases, also non-endocrine tumors can be diagnosed, developing atypical phenotypes. Case report: We report herein the clinical history of a patient affected by MEN-1 syndrome who developed atypical features for this disease. The patient's clinical history started in August 2015 when he was referred, at the age of 23 years, to the Emergency Department of our Hospital for the occurrence of progressive asthenia, weakness, tremors and syncope. The biochemical test documented hyper-calcemia and severe hypoglycemia. The patient was referred to our Neuroendocrine Tumor and Pituitary Unit and he was diagnosed with pancreatic insulinoma, hypercalcemic hyperparathyroidism, and a prolactin secreting pituitary adenoma. The MEN-1 syndrome was suspected and genetic tests for mutation of menin resulted positive for the pathogenic variant c1548dupG. In January 2016, the patient was diagnosed with intratubular germ cell neoplasia, consisting of a mature teratoma and yolk sac tumor and he underwent a right orchiectomy. Conclusion: This is the first case report showing the clear association of MEN-1 syndrome with yolk sac tumors and teratomas, as in our case, the c1548dupG represents a pathogenic variant rather than a SNP. This case suggests the opportunity of an accurate evaluation of the testis particularly in young MEN-1 affected patients and that a prompt screening for neoplastic disease should involve all the endocrine glands.
Case Report of a Child after Hematopoietic Cell Transplantation with Acute Aspergillus Tracheobronchitis as a Cause for Respiratory Failure
Authors: Stefanie Gauguet, Kate Madden, Jennifer Wu, Christine Duncan, Gi Soo Lee, Tonya Miller, William C Klingensmith 4th, Sandra K Burchett, Meredith van der Velden
Journal: Case Rep Pediatr (2016)

Rapid respiratory failure due to invasive mycosis of the airways is an uncommon presentation of Aspergillus infection, even in immunocompromised patients, and very few pediatric cases have been reported. Patients with Aspergillus tracheobronchitis present with nonspecific symptoms, and radiologic studies are often noninformative, leading to a delay in diagnosis. Prompt initiation of adequate antifungal therapies is of utmost importance to improve outcome. We report the case of a 9-year-old girl with chronic myelogenous leukemia who developed respiratory distress 41 days after hematopoietic cell transplantation and rapidly deteriorated despite multiple interventions and treatment modalities.
Type 3 Thyroplasty for a Patient with Female-to-Male Gender Identity Disorder
Authors: Yu Saito, Kazuhiro Nakamura, Shigeto Itani, Kiyoaki Tsukahara
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Objective:
In most cases, about the voice of the patient with female-to-male/gender identity disorder (FTM/GID), hormone therapy makes the voice low-pitched. In success cases, there is no need for phonosurgery. However, hormone therapy is not effective in some cases. We perform type 3 thyroplasty in these cases.
Method:
Hormone therapy was started in 2008 but did not lower the speaking fundamental frequencies (SFFs). We therefore performed TP3 under local anesthesia.
Results:
In our case, the SFF at the first visit was 146 Hz. The postoperative SFF was 110 Hz.
Conclusions:
TP3 was performed under local anesthesia in a patient with FTM/GID in whom hormone therapy proved ineffective. With successful conversion to a lower-pitched voice, the patient could begin to live daily life as a male. QOL improved significantly with TP3. If hormone therapy proves ineffective, TP3 may be selected as an optional treatment and appears to show few surgical complications and was, in this case, a very effective treatment.
Surgical Repair of an Atraumatic Avulsion of Patellar Tendon at the Tibial Tuberosity in an Adult Patient
Authors: Lorenzo Maria Di Giacomo, M Shahid Khan, Michele Bisaccia, R Rende, G Rinonapoli, A Caraffa
Journal: Case Rep Orthop (2015)

Atraumatic avulsion of the tibial attachment of patellar tendon in adults is a very rare injury with only few published case reports. Here we are sharing the successful management and follow-up of a similar case with a different suture material for repair of the tendon, the FiberWire. We believe that the management we are discussing allows for early return to activity with good functional outcome.
The need for preventive and curative services for malaria when the military is deployed in endemic overseas territories: a case study and lessons learned
Authors: Sumadhya Deepika Fernando, Rahuman Booso, Priyani Dharmawardena, Arunagirinathan Harintheran, Kugapiriyan Raviraj, Chaturaka Rodrigo, Manjula Danansuriya, Rajitha Wickremasinghe
Journal: Mil Med Res (2017)
Keywords: central african republic, chemoprophylaxis, imported malaria, security forces, sri lanka
MeSH terms: Endemic Diseases / prevention & control, Malaria / drug therapy, Research Support, Non-U.S. Gov't, Antimalarials / therapeutic use, Case-Control Studies, Central African Republic, Chemoprevention / methods, Cross-Sectional Studies, Disease Outbreaks / prevention & control, Disease Outbreaks / statistics & numerical data, Focus Groups, Humans, Malaria / epidemiology, Malaria / ethnology, Military Personnel / statistics & numerical data, Plasmodium falciparum / pathogenicity, Plasmodium vivax / pathogenicity, Risk Factors, Sri Lanka / epidemiology, Sri Lanka / ethnology, Surveys and Questionnaires, Antimalarials

Background:
Sri Lanka has been free from indigenous malaria since November 2012 and received the WHO certificate for malaria-free status in September 2016. Due to increased global travel, imported malaria cases continue to be reported in the country. Military personnel returning home from international peace-keeping missions in malaria endemic countries represent a key risk group in terms of imported malaria. The present study intended to characterize the potential causes of a malaria outbreak among the Sri Lankan security forces personnel deployed in the Central African Republic (CAR).
Methods:
Data were collected from a cross-sectional survey distributed among Sri Lankan Air Force personnel who had returned from United Nations peace-keeping missions in the CAR region. A pre-tested questionnaire was used for the data collection, and focus group discussions were also conducted.
Results:
One hundred twenty male Air Force personnel were interviewed (out of a group of 122 officers and airmen). All participants were deployed in the CAR for 14 months and were aware of the existence of chemoprophylaxis against malaria. The majority of the subjects (92.5%, 111/120) also knew that prophylaxis should be started prior to departure. However, the regular use of chemoprophylaxis was reported by only 61.7% (74/120) of the sample. Overall, 30.8% of the participants (37/120) had 44 symptomatic episodes of malaria during deployment, and one person succumbed to severe malaria. All cases were associated with noncompliance with chemoprophylaxis.
Conclusion:
Better coordination with overseas healthcare services and the establishment of directly observed chemoprophylaxis may help to avoid similar outbreaks in the future.
Integration of structural MRI and epigenetic analyses hint at linked cellular defects of the subventricular zone and insular cortex in autism: Findings from a case study
Authors: Emi Takahashi, Nina Allan, Rafael Peres, Alpen Ortug, Andre J W van der Kouwe, Briana Valli, Elizabeth Ethier, Jacob Levman, Nicole Baumer, Keita Tsujimura, Nauru Idalia Vargas-Maya, Trevor A McCracken, Rosa Lee, Alika K Maunakea
Journal: Front Neurosci (2023)
Keywords: dna methylation, mri, svz, autism, cortex, epigenetic

Introduction:
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction, communication and repetitive, restrictive behaviors, features supported by cortical activity. Given the importance of the subventricular zone (SVZ) of the lateral ventrical to cortical development, we compared molecular, cellular, and structural differences in the SVZ and linked cortical regions in specimens of ASD cases and sex and age-matched unaffected brain.
Methods:
We used magnetic resonance imaging (MRI) and diffusion tractography on ex vivo postmortem brain samples, which we further analyzed by Whole Genome Bisulfite Sequencing (WGBS), Flow Cytometry, and RT qPCR.
Results:
Through MRI, we observed decreased tractography pathways from the dorsal SVZ, increased pathways from the posterior ventral SVZ to the insular cortex, and variable cortical thickness within the insular cortex in ASD diagnosed case relative to unaffected controls. Long-range tractography pathways from and to the insula were also reduced in the ASD case. FACS-based cell sorting revealed an increased population of proliferating cells in the SVZ of ASD case relative to the unaffected control. Targeted qPCR assays of SVZ tissue demonstrated significantly reduced expression levels of genes involved in differentiation and migration of neurons in ASD relative to the control counterpart. Finally, using genome-wide DNA methylation analyses, we identified 19 genes relevant to neurological development, function, and disease, 7 of which have not previously been described in ASD, that were significantly differentially methylated in autistic SVZ and insula specimens.
Conclusion:
These findings suggest a hypothesis that epigenetic changes during neurodevelopment alter the trajectory of proliferation, migration, and differentiation in the SVZ, impacting cortical structure and function and resulting in ASD phenotypes.