OpenMed/multicare-articles huggingface dataset:
A rare case of primary cardiac diffuse large B-cell lymphoma imaged with 18F-FDG PET/CT: a case report and literature review
Authors: Wenpeng Huang, Zuohuan Zheng, Yongbai Zhang, Yongkang Qiu, Yushuo Peng, Qi Yang, Wei Wang, Lei Kang
Journal: Front Med (Lausanne) (2024)
Keywords: 18f-fdg pet/ct, case report, computed tomography, diffuse large b-cell lymphoma, malignant lymphoma, primary cardiac lymphoma
MeSH terms: Case Reports

Background:
One of the exceptionally rare forms of non-Hodgkin's lymphoma (NHL) is primary cardiac lymphoma (PCL). The principal clinical manifestation in patients with PCL involves cardiac symptoms resulting from myocardial infiltration by lymphoma, including arrhythmias, heart failure, and chest pain. 18F-FDG PET/CT serves as a reliable and indispensable imaging modality for assessing clinically staging NHL.
Case report:
We present a rare case involving a 72-year-old woman diagnosed with primary intracardiac diffuse large B-cell lymphoma. For further staging, the patient underwent 18F-FDG PET/CT, revealing multiple nodular soft tissue density lesions in the heart and pericardium exhibiting increased FDG metabolism (SUVmax = 12.1). The supradiaphragmatic and infradiaphragmatic segments of the inferior vena cava exhibited irregular morphology with localized nodular changes and increased FDG metabolism in the surrounding area (SUVmax = 9.7). Additionally, multiple enlarged lymph nodes were identified in the left axilla, mediastinum, and adjacent to the abdominal aorta, displaying heterogeneous FDG uptake with an SUVmax of 9.3, indicating lymphoma involvement. The above imaging findings suggested that the mass was a PCL. Hence, the patient underwent a combination of chemotherapy and immunotherapy using R-CDOP (rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, and prednisone). Following two courses of treatment within a span of 2 months, there was a partial remission observed in the cardiac lymphoma and the enlarged lymph nodes.
Conclusion:
The case elucidated in this report contributes to an enhanced understanding of the disease for clinicians, with 18F-FDG PET/CT providing comprehensive insights into the extent of cardiac involvement, as well as the engagement of extracardiac organs and pathologic lymph nodes. The 18F-FDG PET/CT examination not only visually delineates the lesion's location and extent but also serves as a cornerstone for clinical tumor staging, offering valuable support for treatment monitoring and subsequent follow-up.
An elderly patient with depression and a suicide attempt during the COVID-19 pandemic: a case report
Authors: Hajar Mohd Salleh Sahimi, Marhani Midin, Jane Tze Yn Lim, Mohd Wafiy Ariffin Anwar, Farah Deena Abdul Samad, Nurul Ain Mohamad Kamal
Journal: Front Psychiatry (2023)
Keywords: covid-19, geriatric depression, geriatric suicide, lockdown, pesticide poisoning
MeSH terms: Case Reports

Objective:
Elderly individuals are among the age groups with the highest risk of suicide. The coronavirus (COVID-19) pandemic forced isolation and resulted in an increased risk of depression, hopelessness, and perceived burdensomeness among the elderly, thereby increasing the risk of suicide.
Methods:
This is a case report of an elderly single retired school principal with obsessive-compulsive personality traits who developed depression with psychotic symptoms after being isolated following the movement control order (MCO) during the COVID-19 pandemic. The social isolation led to feelings of loneliness and hopelessness. The patient's depressive symptoms worsened after he developed physical illnesses, such as eye floaters, that affected his daily activities. This caused him to have suicidal ideation to the extent that he attempted suicide by ingesting 90 mL of pesticide. Two weeks prior to the attempt, he updated his will and asked his friend to keep it. After the suicide attempt, he vomited and had diarrhea and epigastric pain. He called his friend, who brought him to the hospital emergency room (ER). He was resuscitated and subsequently admitted to the intensive care unit (ICU). After being medically stabilized, he was transferred to the psychiatric ward, where further treatment was administered for his depression. His depressive symptoms and suicidal ideation improved after he was administered antidepressants and psychotherapy.
Results:
The impact of the COVID pandemic has led to a surge in mental health issues such as anxiety and depression. The elderly are among the highest-risk groups of individuals to contract or die of COVID-19 infection, and they are also the most likely to develop mental health issues related to the pandemic. Furthermore, the risk of death by suicide is highest in this age group due to physical illness, social isolation, and the lack of a support system. This case also highlights the need for awareness of suicidal ideation screening among non-medical healthcare professionals and religious organizations to avoid the treatment gap.
Conclusion:
It is essential to enhance suicide risk assessment and management among the elderly after the COVID-19 pandemic.
Case report: pathological complete response after S-1/oxaliplatin regimen combined with trastuzumab and tislelizumab in patients with locally advanced gastric cancer
Authors: Chenglou Zhu, Mingxu Da, Yaoqi Li, Lingzhi Peng
Journal: Front Oncol (2024)
Keywords: sox regimen, advanced gastric cancer, neoadjuvant chemotherapy, tislelizumab, trastuzumab
MeSH terms: Case Reports

Background:
The efficacy of a regimen combining Tegafur, Gimeracil and Oteracil Potassium Capsules (S-1), oxaliplatin (SOX) with trastuzumab and tislelizumab chemotherapy for advanced gastric cancer (GC) has not been reported.
Case summary:
A 56-year-old male was diagnosed with GC combined with peripheral lymph node metastasis. The patient received neoadjuvant chemotherapy, including SOX, tislelizumab and trastuzumab. After 4 cycles of chemotherapy, the tumor shrank significantly, and radical surgery was performed with good clinical results. To date, the patient has been followed up for 6 months with no significant side effects.
Conclusion:
In this study, the patient received combination chemotherapy with SOX trastuzumab and tislelizumab and successfully underwent radical surgery with good clinical outcomes. Combined SOX with trastuzumab and tislelizumab may be an effective neoadjuvant chemotherapy regimen.
Joint DNA-RNA-based NGS for diagnosis and treatment of a rare CD47-MET fusion lung adenocarcinoma which was immunoresistant and savoltinib-sensitive: a case report
Authors: Rulan Wang, Yanyang Liu, Xuejiao Yu, Weiya Wang, Jiewei Liu
Journal: Front Immunol (2024)
Keywords: cd47-met fusion, met p d1228h, case report, immune microenvironment, non-small cell lung cancer, savolitinib
MeSH terms: Adenocarcinoma of Lung / diagnosis, Adenocarcinoma of Lung / drug therapy, Adenocarcinoma of Lung / genetics, Adenocarcinoma of Lung / immunology, Adenocarcinoma of Lung / therapy, High-Throughput Nucleotide Sequencing, Lung Neoplasms / diagnosis, Lung Neoplasms / drug therapy, Lung Neoplasms / genetics, Lung Neoplasms / therapy, Proto-Oncogene Proteins c-met / genetics, Case Reports, Adult, Drug Resistance, Neoplasm / genetics, Female, Humans, Immune Checkpoint Inhibitors / therapeutic use, Oncogene Proteins, Fusion / genetics, Proto-Oncogene Proteins c-met, MET protein, human, Oncogene Proteins, Fusion, Immune Checkpoint Inhibitors

Targeted therapy and immunotherapy are both important in the treatment of non-small-cell lung cancer (NSCLC). Accurate diagnose and precise treatment are key in achieving long survival of patients. MET fusion is a rare oncogenic factor, whose optimal detection and treatment are not well established. Here, we report on a 32-year-old female lung adenocarcinoma patient with positive PD-L1 and negative driver gene detected by DNA-based next-generation sequencing (NGS). A radical resection of the primary lesion after chemotherapy combined with PD-1 checkpoint inhibitor administration indicated primary immuno-resistance according to her pathological response and rapid relapse. A rare CD47-MET was detected by RNA-based NGS, which was confirmed by fluorescence in situ hybridization. Multiplex immunofluorescence revealed a PD-L1 related heterogeneous immunosuppressive microenvironment with little distribution of CD4+ T cells and CD8+ T cells. Savolitinib therapy resulted in a progression-free survival (PFS) of >12 months, until a new secondary resistance mutation in MET p.D1228H was detected by re-biopsy and joint DNA-RNA-based NGS after disease progression. In this case, CD47-MET fusion NSCLC was primarily resistant to immunotherapy, sensitive to savolitinib, and developed secondary MET p.D1228H mutation after targeted treatment. DNA-RNA-based NGS is useful in the detection of such molecular events and tracking of secondary mutations in drug resistance. To this end, DNA-RNA-based NGS may be of better value in guiding precise diagnosis and individualized treatment in this patient population.
Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review
Authors: Juan Wang, Yan Zheng, Ying Xiong
Journal: Front Oncol (2024)
Keywords: alk-positive histiocytosis, children, imaging features, magnetic resonance imaging, nervous system

Background:
ALK-positive histiocytosis is an exceptionally rare neoplasm of histiocytes that predominantly involves the nervous system and can also affect the skin and other parts of the body. Previous relevant literature has provided limited information regarding the imaging manifestations of this disease with neurological involvement.
Methods:
We reported a case of ALK-positive histiocytosis with multisystem involvement. Together with a comprehensive literature review, the imaging characteristics of this disease in the nervous system were summarized.
Results:
A 3-year-old girl with abdominal pain and ambulation difficulty checked in at the Department of Pediatric Neurology. The initial diagnosis was "acute cerebellitis with ataxia" based on the elevated protein level in the cerebrospinal fluid (CSF). However, despite 3 months of treatment, her condition deteriorated. MRI showed an oval-shaped, intradural extramedullary nodule at the T6-T7 level. The patient was ultimately diagnosed as ALK-positive histiocytosis, accompanied by cauda equina and skin involvement. The literature review showed a total of 23 patients who had involvement of the nervous system and provided imaging descriptions. Together with our case, the imaging features were summarized as follows: iso-dense or slightly hyperdense on computed tomography (CT), isointense or iso-hypointense on T2-weighted imaging (T2WI), moderate homogeneous enhancement with mildly/markedly punctate enhancement or/and smooth ring enhancement on contrast-enhanced T1-weighted imaging (T1WI), restricted diffusion on diffuse weighted imaging (DWI), and elevated fluorodeoxyglucose (FDG) uptake on positron-emission tomography/computed tomography (PET/CT).
Conclusion:
The multimodal imaging findings of ALK-positive histiocytosis exhibit distinct characteristics, familiarity with which will enhance radiologists' expertise and facilitate accurate diagnosis of this disease.
Case report: Presentations and cytokine profiles of inflammatory non-pulmonary COVID-19 and related diseases in children
Authors: Yen-Chun Chao, Horng-Woei Yang, Lung Chang, Chih-Wen Tseng, Li-Ching Fang, Che-Sheng Ho, Hsin Chi, Kuender D Yang
Journal: Front Pediatr (2023)
Keywords: sars-cov-2, acute necrotizing encephalopathy, coronavirus disease 2019, meningoencephalitis, multisystem inflammatory syndrome in children, non-pulmonary covid-19
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) pandemic has evolved to dynamic waves of different SARS-CoV-2 variants. Initially, children diagnosed with COVID-19 presented pulmonary involvement characterized by mild diseases. In the later waves of the COVID-19 pandemic, life-threatening non-pulmonary inflammatory diseases such as (1) aseptic meningoencephalitis (ME), (2) acute necrotizing encephalopathies (ANE), and (3) multisystem inflammatory syndrome in children (MIS-C) have been reported, affecting the pediatric population. To alert timely identification and prevention of the life-threatening non-pulmonary COVID-19, we present the cases of ME, ANE, and MIS-C in terms of clinical manifestation, cytokine profile, and follow-up consequences. Based on the immunopathogenesis and risk factors associated with non-pulmonary COVID-19, we delineate strategies for an early diagnosis and treatment to reduce morbidity and mortality in children.
Primary or metastatic branchial cleft carcinoma?: a case report
Authors: Yang Ma, Hangyu Liu, Lijing Yang, Shijie Tang, Lungang Shi
Journal: Front Surg (2023)
Keywords: branchial cleft carcinoma, head and neck (h&n) cancer, head and neck tumor, metastatic branchial cleft carcinoma, primary branchial cleft carcinoma
MeSH terms: Case Reports

The brachial cleft carcinoma is an extremely rare head and neck facial malignancy, and there is some disagreement about its differential diagnosis. In this paper, we report a 63-year-old male patient who had a mass on the left side of the neck and diagnosed as the brachial cleft carcinoma by intraoperative biopsy pathology. However, this patient was diagnosed with the carcinoma of the left soft palate more than 20 days after surgery and esophageal cancer 2 years later, and was treated accordingly. Therefore, it is hard to confirm whether the branchial cleft carcinoma is primary or metastatic. In fact, the diagnostic criteria for primary squamous cell carcinoma of branchial cleft cysts are very rigorous. Confirmation of the diagnosis is based on pathological examination of the branchial cleft cyst epithelium lined with squamous cells, meanwhile, a thorough examination should also be performed to exclude the presence of other primary cancers.
A novel approach with tofacitinib for the management of keratoderma blennorrhagicum in reactive arthritis: a case report
Authors: Maierhaba Maitiyaer, Yu Liu, Nueramina Keyimu, Yueqiang Wen, Zhiping Liu, Wenhui Huang, Shuilian Yu
Journal: Front Immunol (2024)
Keywords: jak inhibitors, reiter’s syndrome, keratoderma blennorrhagicum, reactive arthritis, tofacitinib
MeSH terms: Arthritis, Reactive / drug therapy, Arthritis, Reactive / etiology, Piperidines / therapeutic use, Pyrimidines / therapeutic use, Case Reports, Adult, Antirheumatic Agents / therapeutic use, Female, Humans, Janus Kinase Inhibitors / therapeutic use, Male, Protein Kinase Inhibitors / therapeutic use, Treatment Outcome, tofacitinib, Piperidines, Pyrimidines, Antirheumatic Agents, Protein Kinase Inhibitors, Janus Kinase Inhibitors

Reactive arthritis(ReA), a form of arthritis occurring post-infection, manifests with antecedent infection symptoms, arthritis, and extra-articular manifestations, categorizing it as spondyloarthritis. "Keratoderma blennorrhagicum" (characterized by pustular hyperkeratosis on palms and soles, resembling pustular psoriasis) represents the most typical skin manifestation of ReA, occurring in acute or chronic phases. Severe lesions necessitate systemic disease modifying anti-rheumatic drugs (DMARDs) or biologic therapies. This article reports a case of ReA with sacroiliitis and widespread pustular eruptions following a urinary tract infection. Treatment with sulfasalazine and thalidomide significantly improved sacroiliitis, but the skin rash remained persistent and recurring. Subsequent use of adalimumab and secukinumab resulted in worsening skin rash, prompting a switch to tofacitinib, leading to a remarkable improvement in pustular eruptions after 20 days of treatment. This case demonstrates successful application of tofacitinib in treating severe keratoderma blennorrhagicum refractory to conventional DMARDs and biologics, offering insights into JAK inhibition for challenging rheumatic diseases with skin involvement.
Doege-Potter Syndrome; A Case of Solitary Fibrous Pleura Tumor Associated with Severe Hypoglycemia: A Case Report in Internal Medicine
Authors: Viviana Castaldo, Daniela Domenici, Mauro Valentino Biscosi, Paolo Ubiali, Cesare Miranda, Giorgio Zanette, Cinzia Mazzon, Maurizio Tonizzo
Journal: Endocr Metab Immune Disord Drug Targets (2023)
Keywords: hypoglycemia, igf-2, stat6, doege-potter syndrome, non-islet cell tumor hypoglycemia, solitary fibrous tumor
MeSH terms: Hypoglycemia / diagnosis, Hypoglycemia / etiology, Solitary Fibrous Tumor, Pleural / diagnosis, Solitary Fibrous Tumor, Pleural / diagnostic imaging, Case Reports, Humans, Male, Middle Aged, Pleura / pathology, Syndrome, Hereditary renal agenesis, Renal Adysplasia

Background:
Doege-Potter syndrome is a rare paraneoplastic entity that is often diagnosed incidentally during the work-up of hypoglycemia of unclear etiology. It is characterized by a non-islet cell tumor hypoglycemia mostly associated with solitary fibrous tumors. These uncommon tumors have been reported in <5% of solitary fibrous tumors. Although not unique in its kind, this case is extremely important as this syndrome often conceals unrecognized tumors that can be surgically resolved.
Case presentation:
We present the case of a 59-year-old non-diabetic man with a 2-month history of severe and recurrent fasting hypoglycaemia presenting with severe dyspnea and sweating. Further workup revealed low insulin, C-peptide, and IGF-1 levels and a large right in-trathoracic solitary fibrous tumor. Unfortunately, bioassays for IGF-2 were unavailable at our hos-pital. Nevertheless, as hypoglycemia completely resolved after resection of the mass, Doege-Potter syndrome was highly suspected.
Conclusion:
Doege-Potter syndrome is a complication of rare tumors. If hy-poglycemia is unexplained, this syndrome should always be suspected, and the presence of un-known masses should be investigated.
Case report and literature review of rezvilutamide in the treatment of hormone-sensitive prostate cancer
Authors: Chunlei Zhang, Jie Ren, Yindong Kang, Dehui Chang
Journal: Front Oncol (2024)
Keywords: androgen deprivation therapy (adt), genetic testing, metastatic hormone-sensitive prostate cancer (mhspc), prostate cancer, rezvilutamide
MeSH terms: Case Reports

Background:
Prostate cancer represents a major health concern worldwide, with the treatment of metastatic hormone-sensitive prostate cancer (mHSPC) and locally advanced prostate cancer posing a particular challenge. Rezvilutamide, a new androgen receptor antagonist from China, has shown early promise; however, its real-world effectiveness and safety profile require further evidence. This case series evaluates the preliminary clinical outcomes of rezvilutamide in combination with androgen deprivation therapy (ADT), focusing on PSA response and radiological findings across various stages of prostate cancer in four patients.
Case description:
Case 1 details a 68-year-old male with low-volume mHSPC who exhibited a positive therapeutic response, demonstrated by decreasing PSA levels and improved radiographic results, despite experiencing mild side effects related to the drug. Case 2 describes a 71-year-old male with high-volume mHSPC who had a favorable outcome, with no significant changes in tumor size or metastatic spread and no negative reactions to the drug. Case 3 involves a 55-year-old male with locally advanced prostate cancer, who saw a reduction in PSA levels and a small decrease in tumor volume, yet with ongoing bladder involvement. Genetic testing showed no significant mutations. Case 4 presents a 74-year-old male with extensive metastatic disease who initially responded to the treatment but later exhibited disease advancement and an ATM gene mutation, signaling a shift to metastatic castration-resistant prostate cancer (mCRPC). This finding underscores the crucial role of genetic testing in directing future treatment, with therapies such as olaparib or chemotherapy being advised.
Conclusions:
Rezvilutamide has shown a potential benefit in the management of mHSPC and locally advanced prostate cancer, generally with a mild safety profile. Initial positive responses, particularly in PSA decline and radiographic progression, are promising. Nevertheless, the varying responses, notably concerning genetic mutations, highlight the necessity for tailored treatment approaches. Due to the small cohort and brief follow-up period, more extensive research with larger populations and prolonged monitoring is essential to conclusively determine the benefits and safety of rezvilutamide. The utilization of genetic insights is key to refining treatment decisions and enhancing outcomes for patients with advanced prostate cancer.
Upadacitinib sustained-release tablets for the treatment of chronic refractory gouty arthritis: a case report and literature review
Authors: Lishi Yu, Weidong Huang, Honghua Lv, Lie Jin, Wenhui Lei
Journal: Front Med (Lausanne) (2024)
Keywords: arthritis, gout, gouty arthritis, treatment, upadacitinib sustained-release tablets
MeSH terms: Case Reports

Background:
Gouty arthritis (GA) is a crystal-related joint disease caused by the deposition of monosodium urate (MSU) crystals, directly associated with hyperuricemia resulting from purine metabolism disorder and/or reduced uric acid excretion. Acute attacks of typical gouty arthritis are generally relieved through the clinical use of NSAIDs, colchicine, or glucocorticoids. However, managing patients with chronic refractory gout poses challenges due to complications such as multiple tophi, gouty nephropathy, diabetes, and gastrointestinal bleeding. While there have been numerous studies on gout in recent years, research specifically regarding chronic refractory gout remains limited. The management of such cases still faces several unresolved issues, including recurrent disease flare-ups and poor patient compliance leading to inadequate drug utilization and increased risk of side effects. In this report, we present a case of successful improvement in chronic refractory gouty arthritis using the biologic agent upadacitinib sustained-release tablets.
Case presentation:
Our case report involves a 53 years-old Asian patient with recurrent gouty arthritis who had a history of over 20 years without regular treatment, presenting with tophi and an increasing number of painful episodes. During hospitalization, various analgesics and anti-inflammatory drugs provided inadequate relief, requiring the use of steroids to alleviate symptoms. However, tapering off steroids proved challenging. We decided to add upadacitinib sustained-release tablets to the treatment regimen, which ultimately improved the patient's condition. After 6 months of follow-up, the patient has not experienced any further acute pain episodes.
Conclusion:
This case highlights the potential therapeutic effect of upadacitinib sustained-release tablets during the acute phase of chronic refractory gouty arthritis.