OpenMed/multicare-articles huggingface dataset:
Treatment of giant prostatic urethral stone with prostatolithotomy case report
Authors: Yunus Erol Bozkurt, Caner Buğra Akdeniz, Bilali Habeş Gümüş
Journal: Int J Surg Case Rep (2024)
Keywords: case report, giant stone, prostate, urethral stone
MeSH terms: Case Reports

Introduction:
The patient with prostatic urethral stones of the size mentioned in the case report is very rare, and there is no standard surgical procedure for patients with giant stones in the prostatic urethra.
Presentation of case:
A 62-year-old male patient presented to the emergency department with complaints of dysuria and hematuria. Computed tomography showed a prostatic urethral stone measuring 78x48x56 mm. Open prostatolithotomy was performed by extending the bladder incision towards the prostate capsule and the stone was removed.
Discussion:
Prostate stones can be classified into two types: true prostate stones, which form within the prostate's tissues, and urethral stones, which develop in the prostatic urethra. Urethral stones can be primary (forming in the urethra) or secondary (migrating from the upper urinary tract).
Conclusion:
Treatment options vary based on stone size and patient history, with endoscopy recommended as the primary approach. However, in cases with large stone burdens, open surgical methods may be preferred.
Mucin-producing urothelial-type adenocarcinoma of the prostate with sarcomatoid features and novel molecular phenotype
Authors: Pranav S Renavikar, Thomas J Auen, David G Wagner, Subodh M Lele
Journal: IJU Case Rep (2023)
Keywords: psa, mucin‐producing, mutations, prostate, urothelial
MeSH terms: Case Reports

Introduction:
Mucin-producing urothelial-type adenocarcinoma of the prostate is a rare tumor that may not elevate serum prostate-specific antigen, creating significant diagnostic and monitoring challenges. We evaluate our case in detail and review prior studies to demonstrate that the pathologic and molecular features of this tumor are distinct from conventional prostate adenocarcinoma.
Case presentation:
Our patient had a remote history of radiation-treated conventional prostate adenocarcinoma and presented many years later with an abscess-like prostate mass leading to urinary obstruction and hematuria. Biopsy revealed mucin-producing urothelial-type adenocarcinoma of the prostate with concurrent sarcomatoid features. Molecular studies showed a unique phenotype involving alterations in the KRAS, PTEN, RAD21, and TP53 genes.
Conclusions:
To our knowledge, this is the first report that describes sarcomatoid features and molecular mutations in mucin-producing urothelial-type adenocarcinoma of the prostate.
A Rare Case of Dissecting Superior Mesenteric Artery Aneurysm in Granulomatosis with Polyangiitis
Authors: Shinichi Tanaka, Takahiro Ohmine, Takashi Maeda
Journal: Ann Vasc Dis (2023)
Keywords: granulomatosis with polyangiitis, stent-graft, superior mesenteric artery aneurysm
MeSH terms: Case Reports

An asymptomatic dissecting superior mesenteric artery (SMA) aneurysm in granulomatosis with polyangiitis (GPA), historically termed Wegener's granulomatosis, is rare. We herein describe a 68-year-old man who was diagnosed with GPA based on a high level of proteinase 3 (PR3)-antineutrophil cytoplasmic antibody (ANCA). One year after remission of GPA, the patient developed pyelonephritis, and his PR3-ANCA level increased again. Computed tomography showed a rapid increase in the size of the dissecting SMA aneurysm. The patient underwent successful endovascular stent-graft repair. At the time of this writing, 3 years had passed since the surgery and the clinical course was good.
To PLEX or Not to PLEX for Amiodarone-Induced Thyrotoxicosis
Authors: Tania Ahuja, Olivia Nuti, Cameron Kemal, Darren Kang, Eugene Yuriditsky, James M Horowitz, Raymond A Pashun
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Amiodarone-induced thyrotoxicosis (AIT) carries significant cardiovascular morbidity. There are two types of AIT with treatment including antithyroid medications and corticosteroids and treatment of ventricular arrhythmias. Therapeutic plasma exchange (TPE) also known as "PLEX" may help remove thyroid hormones and amiodarone. We report a case of PLEX in an attempt to treat cardiogenic shock secondary to AIT. This case highlights the robust rapidly deleterious demise of AIT, specifically in patients with decompensated heart failure. The decision to PLEX or not to PLEX for AIT should be individualized, prior to definitive therapy.
A Case Report of Occult Breast Cancer Detected by Diagnostic Laparoscopy for Suspected Ovarian Cancer
Authors: Arisa Egami, Yosuke Tarumi, Ayaka Okamura, Kohei Aoyama, Hisashi Kataoka, Tetsuya Kokabu, Kaori Yoriki, Fumitake Ito, Taisuke Mori
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

Diagnostic laparoscopy is useful in the management of gynecological cancers; however, it can occasionally result in the detection of other malignancies. Occult breast cancer (OBC) is metastatic breast cancer without a recognized primary breast lesion. We report a rare case of OBC that was detected laparoscopically. A 64-year-old female presented to our hospital with back pain. Magnetic resonance imaging (MRI) revealed a 50 mm multicystic tumor with an internal nodule in the right ovary. Positron emission tomography/computed tomography showed abnormal accumulation in multiple lymph nodes, moderate accumulation in the ovarian tumor nodule, and no accumulation in the breasts. Ovarian cancer was suspected, and a diagnostic laparoscopy was performed. Laparoscopically, a cystic tumor in the right ovary and 10 mm nodule in the right round ligament were observed and partially resected. Immunohistopathologically, the nodules of the round ligament exhibited features consistent with those of breast cancer, but the ovarian tumor was a seromucinous borderline tumor. MRI revealed no breast lesions. Therefore, the malignancy was diagnosed as an OBC.
A rare presentation of childhood interstitial lung disease attributed to KDM3B gene mutation: a case report
Authors: Zaineb Benslimane, Sinan Yavuz, Nader Francis
Journal: Pan Afr Med J (2023)
Keywords: children interstitial lung disease (child), kdm3b mutation, sin3a mutation, case report, pulmonary artery hypertension
MeSH terms: Hypertension, Pulmonary, Lung Diseases, Interstitial / diagnosis, Lung Diseases, Interstitial / genetics, Case Reports, Child, Genotype, Humans, Jumonji Domain-Containing Histone Demethylases / genetics, Male, Mutation, Phenotype, KDM3B protein, human, Jumonji Domain-Containing Histone Demethylases

Childhood Interstitial Lung Disease (chILD) encompasses various respiratory conditions affecting children's lung airspaces and tissues, with diverse causes. One rare cause involves structural vascular changes. We describe a case of a 10-year-old boy diagnosed with chILD who exhibited specific dysmorphic features, developmental delay, and intellectual disability. He was diagnosed with severe pulmonary arterial hypertension (PAH) due to venous thromboembolic disease, an unusual underlying condition for chILD. A Whole Exome Sequence showed mutations in KDM3B and SIN3A genes, respectively responsible for Diets-Jongmans syndrome (DIJOS) and Witteveen-Kolk syndrome (WITKOS). Both syndromes can explain our patient´s phenotype and KDM3B mutation has been previously described to be associated with PAH. Our case suggests a potential association between KDM3B mutation and PAH leading to chILD. It also enriches the knowledge of genotypic diversity in KDM3B and SIN3A genes as well as the spectrum of clinical associations with DIJOS and WITKOS syndromes.
A case report of neurosyphilis coexisting with a positive MOG antibody manifested as optic neuritis
Authors: Min Shi, Danqing Luo, Zhaoying Li, Man Li, Shuoguo Jin, Dongdong Yang, Jun Guo, Guo Chen
Journal: Front Neurol (2023)
Keywords: mog, mogad, treponema pallidum, neurosyphilis, optic neuritis
MeSH terms: Case Reports

Background:
Neurosyphilis refers to an infection of the central nervous system by Treponema pallidum. The clinical manifestations of neurosyphilis are diverse, making it easy to miss or misdiagnose. Anti-myelin oligodendrocyte glycoprotein antibody-associated disease is a recently defined immune-mediated inflammatory demyelinating central nervous system disease. Few studies have reported the coexistence of the two diseases.
Case presentation:
This case report presents a 37 years-old male patient with neurosyphilis manifested as optic neuritis with a positive myelin oligodendrocyte glycoprotein (MOG) antibody. This patient received intravenous administration of 3.2 million units of procaine penicillin every 4 h for 2 weeks, followed by a two-week intramuscular injection of benzathine penicillin. Additionally, methylprednisolone sodium succinate was administered intravenously at 1,000 mg/day, gradually reduced to 500 mg/day and 240 mg/day every 3 days. Subsequently, prednisone tablets at a dosage of 60 mg/day were orally administered, with a gradual reduction of 5 mg/day every 3 days until reaching a dosage of 30 mg/day. The patient's visual acuity was improved after 26 days of hospitalization. However, the visual field and color vision did not. At 3 months of follow-up, the symptoms remained unchanged despite the patient continued taking oral prednisone tablets at a dosage of 30 mg/day.
Conclusion:
Neurosyphilis could be a potential triggering factor for MOGAD. In patients with neurosyphilis, it is strongly recommended to perform testing for MOG antibody along with other brain disease antibodies.
Intestinal Spirochetosis: To Treat or Not to Treat
Authors: Kimberly Ho, Joseph Xu, Seymour Katz, Suparna A Sarkar, Ateeqa Mujeeb Ullah
Journal: Cureus (2024)
Keywords: helicobacter pylori, inflammatory bowel diseases, intestinal spirochetosis, management, metronidazole, ulcerative colitis
MeSH terms: Case Reports

Spirochete colonization of the gastrointestinal tract is a poorly understood phenomenon presenting with varying signs and symptoms. Due to the lack of a unified approach and its varying presentations, the management decision for intestinal spirochetosis (IS) has always been challenging. While metronidazole is the commonly preferred antimicrobial treatment, it remains unclear if therapeutic intervention is indicated for everyone, especially asymptomatic patients. We present three patients, diagnosed with IS. They presented with varying demographics, clinical presentations, and past medical histories and underwent different clinical managements. Our decisions for treatment not only included presenting symptoms but also factors like history of pre-existing gastrointestinal diseases, age, and immune status.
Improvement of Recalcitrant Dissecting Cellulitis of the Scalp After a Trial of Upadacitinib
Authors: Zahidul Islam, Michelle Toker, Isha M Gandhi, Ariel Sher, Kristina Campton
Journal: Cureus (2024)
Keywords: dissecting cellulitis of scalp, follicular occlusion tetrad, folliculitis decalvans, hidradenitis suppurativa, jak inhibitor, upadacitinib
MeSH terms: Case Reports

Dissecting cellulitis of the scalp (DCS) is a rare condition characterized by painful inflammatory nodules and abscesses on the scalp, often leading to sinus tracts and scarring alopecia. We present a case of DCS in a 26-year-old male who experienced significant clinical improvement following a short course of upadacitinib, a Janus kinase (JAK) inhibitor. The patient received multiple standard treatments such as topical antimicrobials, oral antibiotics, corticosteroids, and intralesional triamcinolone injections, with limited success. However, following the initiation of upadacitinib, the patient reported reduced pain, pustular draining, and bleeding, with significantly improved quality of life. To our knowledge, there is currently a paucity of literature documenting the use of JAK inhibitors for DCS. This case aims to highlight the potential of JAK inhibitors as a therapy for refractory DCS, a condition with limited treatment options.
Recurrent Acute-on-Chronic Pancreatitis in a Chronic Alcoholic With Pancreatic Divisum: A Complex Case
Authors: Sarang S Raut, Sourya Acharya, Sunil Kumar, Vinit Deolikar, Manjeet Kothari
Journal: Cureus (2024)
Keywords: chronic calcific pancreatitis, endoscopic retrograde cholangiopancreatography, pancreatic divisum, pancreatic lithotripsy, recurrent acute pancreatitis
MeSH terms: Case Reports

Pancreatic divisum, a rare developmental anomaly of the pancreas, is infrequently observed in young individuals and is a recognized cause of recurrent acute pancreatitis, ultimately progressing to chronic pancreatitis. Chronic alcoholism is a prevalent and significant etiological factor contributing to both recurrent acute pancreatitis and chronic pancreatitis. This case report details the presentation of a 28-year-old patient with a history of chronic alcoholism, exhibiting recurrent acute pancreatitis evolving into chronic pancreatitis. Diagnostic evaluation revealed the presence of pancreatic divisum with associated pancreatic intraductal calculi, a common trigger for pancreatitis. The patient underwent successful management through endoscopic retrograde cholangiopancreatography, pancreatic lithotripsy, and pigtail pancreatic stent placement. This case highlights the complex interplay between chronic alcoholism leading to recurrent acute pancreatitis and pancreatic divisum, a rare congenital anomaly, which is found later in this case, complicating the disease.
Case report: Splenic inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS): a trial of immunotherapy and review of the literature
Authors: K A Resnick, C Monroe, I Siddiqi, E Tam
Journal: Front Oncol (2024)
Keywords: ipt-like fdcs, case report, immunotherapy, inflammatory pseudotumor-like follicular dendritic cell sarcoma, recurrence
MeSH terms: Case Reports

Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a rare malignancy with fewer than 150 cases in the literature. IPT-like FDCS follows an indolent course with most cases definitively managed with surgical resection. We present a case of IPT-like FDCS with multiple recurrences with a trial of immunotherapy. The patient initially presented with splenic involvement requiring splenectomy, subsequently recurring in the liver requiring hepatic resections. Afterwards, there was recurrence with pelvic/small bowel involvement for which treatment was trialed with ipilimumab and nivolumab. The patient progressed despite dual immune checkpoint inhibitor therapy requiring a small bowel resection. To date, this is the first case of immunotherapy use in IPT-like FDCS. Therefore, more evidence is needed to support additional treatments in recurrent IPT-like FDCS after resection.
An overview of case reports and case series of pulmonary actinomycosis mimicking lung cancer: a scoping review
Authors: Amin Khoshbayan, Nour Amirmozafari, Shiva Mirkalantari
Journal: Front Med (Lausanne) (2024)
Keywords: actinomyces species, actinomycosis, diagnosis, lung cancer, pulmonary actinomycosis
MeSH terms: Systematic Review

Background:
Pulmonary actinomycosis (PA) is a rare type of Actinomyces infection that can be challenging to diagnose since it often mimics lung cancer.
Methods:
Published case reports and case series of PA in patients with suspicion of lung cancer were considered, and data were extracted by a structured search through PubMed/Medline.
Results:
After analyzing Medline, 31 studies were reviewed, from which 48 cases were extracted. Europe had the highest prevalence of reported cases with 45.1%, followed by Asia (32.2%), America (19.3%), and Africa (3.2%). The average age of patients was 58.9 years, and 75% of all patients were above 50 years old. Male patients (70%) were predominantly affected by PA. The overall mortality rate was 6.25%. In only eight cases, the causative agent was reported, and Actinomyces odontolyticus was the most common isolated pathogen with three cases. Based on histopathological examination, 75% of the cases were diagnosed, and the lobectomy was performed in 10 cases, the most common surgical intervention. In 50% of the cases, the selective antibiotics were intravenous and oral penicillin, followed by amoxicillin (29.1%), amoxicillin-clavulanic acid, ampicillin, levofloxacin, and doxycycline.
Conclusion:
The non-specific symptoms resemble lung cancer, leading to confusion between PA and cancer in imaging scans. Radiological techniques are helpful but have limitations that can lead to unnecessary surgeries when confusing PA with lung cancer. Therefore, it is important to raise awareness about the signs and symptoms of PA and lung cancer to prevent undesirable complications and ensure appropriate treatment measures are taken.
Limbal reconstruction in uveitic glaucoma patient with exposed Ahmed valve coincident with corneal melting and iris prolapse using multiple corneoscleral allografts
Authors: Stylianos Artemios Kandarakis, Leonidas Doumazos, Marios Timpilis, Georgia Karageorgiou, Petros Petrou, Ilias Georgalas
Journal: Rom J Ophthalmol (2024)
Keywords: ahmed tube, corneoscleral graft, glaucoma, tube exposure
MeSH terms: Corneal Ulcer, Glaucoma / complications, Glaucoma / diagnosis, Case Reports, Allografts, Cornea, Ethanol, Humans, Iris, Middle Aged, Ethanol

Aim: To present a complex case of Ahmed tube exposure 6 months after the implantation associated with corneal melting and iris prolapse, and the surgical reposition that required multiple allografts and limbal reconstruction. Methods: A 60-year-old patient arrived at the emergency room with tube exposure combined with corneal melting and iris prolapse from a previously placed Ahmed valve 6 months prior. Our approach was to use one corneoscleral graft to repair the melted cornea and avoid further iris prolapse and a second scleral graft to cover the repositioned tube. Upon completion of conjunctival dissection, cleaning and deepithelization of the melted cornea and the tube by application of alcohol 100% followed. A new entry point was made for the tube and was covered using an alcohol-preserved scleral allograft and the previous entry point was repaired using a corneoscleral allograft with the corneal aspect restoring the limbus and avoiding further iris protrusion. Results: 6 months follow-up of the patient showed excellent recovery, anatomical restoration, and IOP normalization. Conclusion: Surgical repair of these cases can be very demanding, and requires surgical improvisation and prolonged surgical time. The literature remains very limited on how a surgeon should approach similar cases, which are the crucial tips, and which are the missteps that should be avoided. In this case, we used multiple scleral/corneoscleral allografts in a specific orientation and different sutures to reconstruct the damaged limbal area and restore the anatomy. Abbreviations: VA = Visual Acuity, GDD = Glaucoma Drainage Device, IOP = Intra Ocular Pressure.
Synchronous multiple primary cancers involving rectal cancer and pelvic classical hodgkin lymphoma: the first case report
Authors: Shiyue Liu, Hong Li, Youhong Dong, Dongdong Zhang
Journal: Front Oncol (2023)
Keywords: hodgkin lymphoma, diagnostic evaluation, multiple primary cancers, rectal cancer, surgical treatment
MeSH terms: Case Reports

Multiple primary cancers (MPC) are characterized by the presence of synchronous and metachronous occurrence of two or more distinct histological tumor types. In this study, an exceptional clinical case was presented, demonstrating the coexistence of rectal adenocarcinoma and pelvic classical Hodgkin lymphoma (cHL). A 65-year-old male patient with a 2-year history of persistent mucous bloody stools was admitted to our hospital. Colonoscopy and subsequent biopsy confirmed the diagnosis of rectal adenocarcinoma. The patient underwent laparoscopic abdominoperineal resection of the rectum and regional lymph node dissection. Postoperative histopathological analysis not only substantiated the presence of rectal adenocarcinoma, but also unexpectedly identified pelvic lymph nodes harboring the features of cHL.
Multiple Epidermal Inclusion Cysts of the Female Breast Coexisting With Fibroadenoma: A Case Report of an Incidental Finding
Authors: Babatope L Awosusi
Journal: Cureus (2024)
Keywords: breast lump, epidermal inclusion cyst, fibroadenoma, histopathologic evaluation, keratin
MeSH terms: Case Reports

This report discusses a case of a 27-year-old female with histopathological examination results of multiple epidermal inclusion cysts (EICs) coexisting with fibroadenoma without any involvement of breast skin. EIC should be considered as one of the differential diagnoses for benign breast lesions. Radiological evaluation, with surgical excision and histopathologic examination, remains the gold standard for the management of EIC. This report aims to increase the level of awareness on the existence of EIC in the breast parenchyma and the possibility of it coexisting with or arising from other benign breast lesions like fibroadenoma.
Abdominal pseudohernia in a child after surgical correction of congenital scoliosis: case report
Authors: Nurbek Nadirov, Sergey Vissarionov, Nikita Khusainov, Alexandra Filippova, Vitaliy Sazonov
Journal: Front Pediatr (2024)
Keywords: case report, children, complications, congenital scoliosis, hernia of the abdominal wall, pseudohernia
MeSH terms: Case Reports

Abdominal wall relaxation is a rare complication of various surgical procedures or diseases, when the intercostal or upper lumbar nerves are affected, and the innervation of the muscles of the abdominal wall is damaged. The result is a mass that can visually mimic a ventral hernia. We present a clinical case and the results of a literature review on this topic.
Clinical case:
The 2 years 5 months patient diagnosed with a congenital deformity of the spine (posterolateral hemivertebra) underwent extraction of the hemivertebra from the retroperitoneal approach. In the postoperative period, a pseudohernial protrusion of the anterior abdominal wall was observed. 4.5 months later the protrusion resolved spontaneously.
Discussion:
Abdominal wall relaxation is studied worldwide and is presented primarily as clinical case reports, mainly in older patients with neurological diseases. Single cases of this pathology are described among children. The Th10-Th12 roots are most often affected. Possible manifestations include: bloating and abdominal pain, pseudo-obstruction of the small and/or large intestine, and constipation. In the described case, only unilateral bloating at rest was observed, which increased with crying and strain. The natural course and prognosis of this diagnosis are usually favorable-the recovery period, according to the literature, takes an average of 4-5 months, which also coincided with our case.
Conclusion:
Pseudohernias are a rare complication and may can occur during correction of spinal deformities in children. This condition is a transient disorder of the anterior abdominal wall muscles, the cause of which may be neuropathy caused by infection, metabolic disorders, or mechanical damage. The main principles of treatment of this condition include active observation and symptomatic therapy. The prognosis is usually favorable.