OpenMed/multicare-articles huggingface dataset:
Low-dose PD-1 inhibitor combined with lenvatinib for preemptive treatment of recurrence after liver transplantation for hepatocellular carcinoma: Case report and literature review
Authors: Xin Jin, Kangjun Zhang, Taishi Fang, Xinchen Zeng, Xu Yan, Jianxin Tang, Ziming Liang, Linjie Xie, Dong Zhao
Journal: Front Oncol (2022)
Keywords: afp, hepatocellular carcinoma, immune checkpoint inhibitor, liver transplantation, tumor recurrence
MeSH terms: Case Reports

Orthotopic liver transplantation (OLT), as one of the curative methods for the treatment of hepatocellular carcinoma (HCC), has brought hope to patients with HCC. However, treatment options for HCC recurrence and metastasis after liver transplantation are limited. Immune checkpoint inhibitor (ICI), such as programmed cell death protein 1 (PD-1) inhibitor, have been successfully used in advanced or metastatic HCC, but the data on the safety of PD-1 inhibitor after liver transplantation is limited. In this article, we report a 47-year-old patient with acute-on-chronic liver failure and multiple HCC who was successfully treated with liver transplantation. On the 45th day after OLT, the patient's alpha fetoprotein (AFP) and lens culinaris agglutinin-reactive fraction of AFP (AFP-L3) were increased, and imaging examination showed no residual tumor. The patient had high risk factors for tumor recurrence before operation, so the possibility of tumor recurrence was considered. When the tumor markers showed an upward trend, we immediately treated the patient with lenvatinib 8 mg, after half a month, the AFP and AFP-L3 continued to increase compared with before. Then we used low-dose nivolumab 40mg, the patient's AFP and AFP-L3 gradually decreased. One month later, a second low-dose nivolumab 40mg was given, and the patient's tumor markers gradually decreased to normal. No acute rejection and other complications occurred during the treatment. So far, we have followed up this patient for 2 years, and no tumor recurrence was observed. To our knowledge, this is the first reported case using a low dose of nivolumab in combination with lenvatinib to prevent recurrence of HCC after liver transplantation.
Pink Tooth of Mummery in the Maxillary Left Canine after Fixed Partial Denture (FPD) Preparation
Authors: Eger V Korolevsky, Takashi Komabayashi, Denise Foran
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Pink tooth of Mummery is typically found after trauma. However, this case report describes an unusual occurrence of pink tooth in a 67-year-old Caucasian male after fixed partial denture (FPD) tooth preparation. Pink tooth in this case may be due to one or more factors: tooth reduction and heat generation during tooth preparation; heat generation during polymerization of provisional material; and hyperocclusion of a provisional FPD. This case highlights the importance of choosing the appropriate materials and techniques to avoid pulpal complications after dental prosthesis work.
Maxillary peripheral keratocystic odontogenic tumor. A clinical case report
Authors: María Del Carmen Vázquez-Romero, María de Los Angeles Serrera-Figallo, Javier Alberdi-Navarro, Javier Cabezas-Talavero, Manuel-María Romero-Ruiz, Daniel Torres-Lagares, Jose-Manuel Aguirre-Urizar, Jose-Luis Gutiérrez-Pérez
Journal: J Clin Exp Dent (2017)
MeSH terms: Case Reports

The keratocystic odontogenic tumor is a benign odontogenic cystic neoplasia characterized by its thin, squamous epithelium with superficial parakeratosis. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. This neoplasia is predominantly found in males and people of white origin. The mandible is the most frequently involved site, in particular the third molar region, mandibular angle, and ramus. It has a mandible-maxilla ratio of 2:1. Only about twenty cases of peripheral keratocystic odontogenic tumors (PKCOT) have been reported in the international literature. This study presents a case of PKCOT localized in the anterior region of the maxilla, on the vestibular side of the upper left lateral incisor and the upper left canine. The diagnosis and treatment procedures, as based on the literature, are also discussed. Key words:Odontogenic cysts, odontogenic tumors, keratocyst, keratocystic odontogenic tumor.
Testicular hamartomas and epididymal tumor in a cowden disease: a case report
Authors: Darshana D Rasalkar, Bhawan K Paunipagar
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Testicular hamartomas (TH) is a benign condition. An association of TH with Cowden disease (CD) is known. Ultrasound features of hamartomas are often diagnostic. We present a case of Cowden disease with TH and an epididymal tumor. Imaging features of TH and its differentials has been discussed. Although, association of Cowden disease with many malignancies have been documented, epididymal tumor has not been described. To our knowledge, this paper is the first to describe epididymal tumor in association with Cowden disease.
Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
Authors: Andres Cordova Sanchez, Maneesh Bisen, Farzam Khokhar, Adriana May, Jihad Ben Gabr
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Gout is a common inflammatory arthritis that has a high prevalence worldwide. It is characterized by monosodium urate deposition, usually affecting the joints and soft tissue of the lower extremities. Urate deposition in the axial skeleton resulting in spinal gout is rare. However, it seems to be more prevalent than usually thought, largely because it is underdiagnosed. Imaging findings are, for the most part, nonspecific and often mimic infectious etiologies. Definitive diagnosis requires pathological examination. Thus, it can be easily missed. We present a 41-year-old male with a seven-year history of untreated gout who came in with severe back pain, fevers, and radiculopathy. He was initially diagnosed with vertebral osteomyelitis. However, after a biopsy, spinal gout was confirmed. Spinal gout can be misdiagnosed as vertebral osteomyelitis given the similarities in presentation and imaging findings. This case report highlights the importance of keeping spinal gout as a differential of vertebral osteomyelitis, especially in patients with long-standing or uncontrolled gout with tophi.
Thrombogenic catheter-associated superior vena cava syndrome
Authors: Imran Shaikh, Kenneth Berg, Nicholas Kman
Journal: Case Rep Emerg Med (2013)

Superior vena cava syndrome has historically been associated with malignancy. With the increasing use of indwelling central lines, catheters, and pacemakers in the past decade, there have been an increasing number of cases associated with thrombosis rather than by direct external compression. Patients presenting to the ED with an acute process of SVC syndrome need to be assessed in a timely fashion. Computed tomography angiography (CTA) or magnetic resonance angiogram (MRA) are superb modalities for diagnosis and can quickly be used in the ED. Treatment is oriented towards the underlying cause of the syndrome. In cases of thrombogenic catheter-associated SVC syndrome, anticoagulation is the mainstay of treatment. We present a case report and discussion of a 56-year-old male with a history of metastatic colorectal cancer and an indwelling central venous port with acute signs and symptoms of superior vena cava syndrome.
Localized giant cell tenosynovial tumor seen in the knee joint
Authors: Ozan Beytemür, Cem Albay, Umit Seza Tetikkurt, Mehmet Oncü, Mehmet Ali Baran, Sever Cağlar, Mehmet Akif Güleç
Journal: Case Rep Orthop (2014)

Tenosynovial giant cell tumor is a locally aggressive tumor arising from the synovia of the fibrous tissue surrounding the joints, tendon sheaths, mucosal bursas, and tendons. Although it is often to be observed at the hand, localized form is very rare in the knee joint. In this case report, we aimed to present a very rare case of a surgically treated intra-articular giant cell tenosynovial tumor arising from the hoffa's infrapatellar fat pad of a 19-year-old male patient, by reviewing the literature. The patient we have treated with marginal excision was asymptomatic at the 14th month in the controls and recurrence was not detected.
Multimodal imaging documentation of rapid evolution of retinal changes in handheld laser-induced maculopathy
Authors: Elona Dhrami-Gavazi, Winston Lee, Chandrakumar Balaratnasingam, Larisa Kayserman, Lawrence A Yannuzzi, K Bailey Freund
Journal: Int J Retina Vitreous (2015)
Keywords: handheld laser-induced maculopathy, multimodal imaging
MeSH terms: Case Reports

Purpose:
To use multimodal imaging to document the relatively rapid clinical evolution of handheld laser-induced maculopathy (HLIM). To demonstrate that inadvertent ocular injury can result from devices mislabeled with respect to their power specifications.
Methods:
The clinical course of a 17-year-old male who sustained self-inflicted, central macular damage from a 20-25 s direct stare at a red-spectrum, handheld laser pointer ordered from an internet retailer is provided. Retrospective review of multimodal imaging that includes fundus photography, fluorescein angiography, MultiColor reflectance, eye-tracked spectral domain optical coherence tomography (SD-OCT), fundus autofluorescence, and microperimetry is used to describe the evolving clinical manifestations of HLIM in the first 3 months.
Results:
Curvilinear bands of dense hyperreflectivity extending from the outer retina and following the Henle fibers were seen on SD-OCT immediately after injury. This characteristic appearance had largely resolved by 2 weeks. There was significant non-uniformity in the morphological characteristics of HLIM lesions between autofluorescence and reflectance images. The pattern of lesion evolution was also significantly different between imaging modalities. Analysis of the laser device showed its wavelength to be correctly listed, but the power was found to be 102.5-105 mW, as opposed to the <5 mW described on the label.
Conclusion:
While the immediate SD-OCT characteristics are highly specific for handheld laser -induced maculopathy, this finding can undergo rapid resolution in the span of several days. In the absence of this finding, other multimodal imaging clues and a careful history may aid in recognizing this diagnosis. A greater awareness regarding inaccurate labeling on some of these devices could help reduce the frequency of this preventable entity.
A Triad of Congenital Diaphragmatic Hernia, Meckel's Diverticulum, and Heterotopic Pancreas
Authors: Parkash Mandhan, Amer Al Saied, Mansour J Ali
Journal: Case Rep Pediatr (2014)

Congenital diaphragmatic hernia is a common developmental anomaly encountered by paediatric surgeons. It is known to be associated with extradiaphragmatic malformations, which include cardiac, renal, genital, and chromosomal abnormalities. Herein, we report a newborn born with concurrent congenital diaphragmatic hernia, Meckel's diverticulum, and heterotopic pancreatic tissue. This is the first case report of such a triad with description of possible mechanisms of the development.
Familial urothelial cell carcinoma of the bladder with autosomal dominant inheritance and late onset phenotype
Authors: Robin Brown, Deirdre E Donnelly, Derek Allen, Maurice B Loughrey, Patrick J Morrison
Journal: Springerplus (2014)
Keywords: autosomal dominant, cancer, urothelial cell bladder
MeSH terms: Case Reports

Objective:
Familial Urothelial cell bladder cancer is rare. We report two families with urothelial cell carcinoma (UCC) of bladder with family history in other relatives, displaying probable autosomal dominant inheritance and a late onset pure UCC phenotype, and document the phenotype in each family.
Methods:
Descriptive familial study on two pedigrees over three generations.
Results:
Two families with UCC bladder were identified, and the phenotype documented, each family having three cases of late onset UCC.
Conclusion:
Some cases of UCC are hereditary and may display autosomal dominant inheritance with late onset of the cancer. Clinicians should be aware of the existence of a familial late onset UCC phenotype when managing cases of UCC.
Hyperglycemia in severe falciparum malaria: a case report
Authors: Leonardo Chianura, Isabella Corinna Errante, Giovanna Travi, Roberto Rossotti, Massimo Puoti
Journal: Case Rep Crit Care (2012)

Occasionally, malaria may present with unusual signs and symptoms. We report a case of an uncommon presentation of Plasmodium falciparum infection in a 59-year-old Ethiopian immigrant, which initially presented with hyperglycaemia and multiple organ dysfunction syndrome (MODS). Reports of unusual presentations of malaria are few and cases of severe malaria with hyperglycaemia are rarely described. As hyperglycaemia is associated to most severe malaria and high mortality, our aim is to catch the attention of the physicians on this entity.
Jejunojejunal Intussusception due to Metastatic Melanoma Seven Years after the Primer
Authors: Alexander Giakoustidis, Thomas Goulopoulos, Anastasios Boutis, George Kavvadias, Aristidis Kainantidis, Thomas Zaraboukas, Dimitrios Giakoustidis
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation. Postoperative evaluation with 18FDG-PET/CT revealed increased uptake in the thyroid gland. Subsequent total thyroidectomy revealed severe Hashimoto thyroiditis and no signs of metastasis. The patient received adjuvant immunotherapy and is healthy with no signs of recurrence 3 years after the initial diagnosis and treatment.
Functional and Aesthetic Tragal Reconstruction in the Age of Mobile Electronic Devices
Authors: Colleen F Perez, Curtis W Gaball
Journal: Case Rep Otolaryngol (2016)
MeSH terms: Case Reports

We present a method to create a tragus using the patient's conchal cartilage. It is a simplified, single-stage technique with well-hidden incisions, yet it maintains the rigidity of a natural tragus. This patient did not have a history of radiation to the area, which may compromise healing with this technique. The cosmetic importance of the tragus has been described, but its functionality in accommodating modern technology has not been previously discussed. The main treatment goal for this patient was to gain the ability to wear earphones (clinical question/level of evidence: therapeutic, V).
Autoimmune hepatitis and primary biliary cholangitis overlap syndrome after COVID-19
Authors: Marlone Cunha-Silva, Eloy Vianey Carvalho de França, Raquel Dias Greca, Daniel Ferraz de Campos Mazo, Larissa Bastos Eloy da Costa, Priscilla Brito Sena de Moraes, Clauber Teles Veiga, Guilherme Rossi Assis-Mendonça, Ilka de Fátima Santana Ferreira Boin, Raquel Silveira Bello Stucchi, Tiago Sevá-Pereira
Journal: Autops Case Rep (2023)
Keywords: covid-19, hepatitis, autoimmune, liver diseases, sars-cov-2
MeSH terms: Case Reports

COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient.
Case Report and Literature Review: Behçet's Disease With a Novel TFPI Gene Mutation
Authors: Jiewen Ma, Wengang Sun, Liang Tang, Di Yang
Journal: Front Med (Lausanne) (2022)
Keywords: behçet’s disease, tfpi, case report, mutation, thrombosis
MeSH terms: Case Reports

We report a case of Behçet's disease (BD) with a newly identified tissue factor pathway inhibitor (TFPI) gene mutation. The patient suffered from recurrent deep vein thrombosis and dural sinus thrombosis which could not be relieved by constant anticoagulation therapy. Slight relapsing oral lesion was the initial manifestation of BD but was neglected. Genital ulcers and ocular symptoms were manifest 8-month later than vascular involvement. The patient was diagnosed with BD at last and a novel mutation in TFPI was identified simultaneously. After administration with azathioprine and dexamethasone, the clinical symptoms were quickly gone and no relapse was found during 7-month follow-up.
Primary cutaneous nocardiosis: a diagnosis of consideration in a renal transplant recipient
Authors: Priyatam Khadka, Dibya Singh Shah
Journal: BMC Clin Pathol (2018)
Keywords: cutaneous nocardiosis, cutaneous tuberculosis, immunocompromised, nocardia asteroides, renal transplant, sulfamethoxazole and trimethoprim
MeSH terms: Case Reports

Background:
The cutaneous nocardiosis remains a diagnostic challenge: similar clinical presentations as of cutaneous diseases with different etiology-and the inherent difficulty in cultivating the pathogen.
Case presentation:
Herein, we describe a case of primary cutaneous nocardiosis in a renal transplant recipient; treated with anti-tubercular drugs due to misdiagnosis of cutaneous tuberculosis. On clinical examinations, a few red erythematous papules with erosions and crusting seen, over prior surgery scar of renal transplant. Multiple basophilic colonies surrounded by neutrophilic abscesses and granulation tissue were seen on histopathological examinations. The presumptive identification was done by Ziehl-neelson staining, bacterial culture, biochemical interpretations, and susceptibility pattern of the isolates to antibiotics. Radiographic imaging of brain and lungs were normal; no feature of disseminated nocardiosis seen. After 3 months of an anti-microbial therapy i.e. TMP-SMX(sulfamethoxazole and trimethoprim); the patient underwent progressive changes no relapse noted; transplant function observed in a good state, found asymptomatic with limited side effects on a regular follow up till now.
Conclusion:
Cutaneous nocardiosis can occur in the renal-transplant patient. Therefore, a high degree of clinical suspicions, extensive clinical differentiation, early detection of the pathogen, apt selection of the antimicrobial therapy, correct dosing, and treatment duration is crucial for successful outcomes.
Appendicitis with appendicular atresia: a rare presentation
Authors: Irfan Masood, Zain Majid, Ali Rafiq, Saba Fatima, Osama Bin Zia Siddiqui
Journal: Pan Afr Med J (2015)
Keywords: appendicitis, appendectomy, appendicular atresia
MeSH terms: Appendectomy / methods, Appendicitis / pathology, Appendix / pathology, Case Reports, Acute Disease, Adolescent, Appendicitis / diagnosis, Appendicitis / surgery, Appendix / surgery, Female, Humans

Acute appendicitis is the most common acute surgical condition; making appendectomy the most commonly performed emergency surgical procedure in the world. Anomalies of the appendix are relatively uncommon. However, their presence may alter the course of pre-operative diagnosis and the surgical treatment provided, leading to medico-legal issues in certain cases as well. We hereby present the case of a 17 year-old female who had the suggestive signs, symptoms and investigations of appendicular lump. She was managed according to the Ochsner-Sherren regimen and then underwent interval open appendectomy 6 weeks later. During the procedure, the findings of a 5 cm long appendix were noted. The base of the appendix was attached to the caecum, however there was complete mucosal discontinuity between the base and the remaining portion of the appendix. A fibrous strand connected the two blind ending parts together. After thorough literature search, the authors concluded that this is only the fourth reported case of appendicular atresia ever to have been reported. Considering the rarity of this finding we feel this could be of valuable interest to surgeons and readers alike.
Concomitant Vaginal Laceration and Urinary Bladder Injury With Pubic Diastasis: A Case Report on a Rare Complication During Obstructed Labor
Authors: Gaurav Kumar Malvi, Sujata K Patwardhan, Mayank Agrawal, Rajvi Goradia, Abhinav Malvi
Journal: Cureus (2023)
Keywords: labor complication, primi-gravidae, pubic symphysis diastasis, urinary bladder perforation, vaginal injury
MeSH terms: Case Reports

A serious uro-obstetric emergency is the concurrent rupture of the uterine and urine bladder following a protracted difficult delivery. In the absence of circumstances that would make the bladder more likely to cling to the lower uterine segment, the involvement of the urinary bladder in a primigravida is unique and relatively infrequent. We discuss a case of a 21-year-old patient who had an obstructed labor complicated with bladder and vaginal injury. At laparotomy, we found a pubic bone diastasis, a vaginal injury, and a bladder injury at the urethrovesical junction. As a result, bladder neck repair with urethrovesical anastomosis and vaginal repair with an external fixator were carried out for pubic bone diastasis.