OpenMed/multicare-articles huggingface dataset:
A rare presentation of hepatocellular carcinoma in non-cirrhotic liver
Authors: Lamia Kabbage, Meryem El Kouhen, Ahmed Taghy, Kaoutar Znati, Nawal Kabbaj
Journal: Pan Afr Med J (2017)
Keywords: gist, hepatocellular carcinoma, non cirrhotic liver
MeSH terms: Abdominal Pain / etiology, Carcinoma, Hepatocellular / diagnosis, Liver Neoplasms / diagnosis, Case Reports, Carcinoma, Hepatocellular / pathology, Female, Gastrointestinal Neoplasms / diagnosis, Gastrointestinal Stromal Tumors / diagnosis, Humans, Laparotomy / methods, Liver Neoplasms / pathology, Middle Aged, Tomography, X-Ray Computed

Hepatocellular carcinoma is the most frequent type of liver malignancy. Most cases of hepatocellular carcinoma are secondary to either viral hepatitis (hepatitis B, C) or alcoholic cirrhosis. Liver cirrhosis due to any other causes is considered as a risk factor for development of hepatocellular carcinoma; however, hepatocellular carcinoma in non cirrhotic livers remains a rare condition. The present case report describes a 59-year-old woman patient admitted to explore right hypochondriac and epigastric pain, with no evidence of pre-existing liver disease and with a good general condition. The computed tomography was very suggestive of a gastro-intestinal stromal tumor. But, at laparotomy, a huge hepatic tumor was discovered. Histopathological study confirmed the presence of primary hepatocellular carcinoma. Hepatocellular carcinoma occurs more frequently on a cirrhotic liver. However, it can occur on a non cirrhotic liver and remains and extremely rare case.
Successful Pelvic Resection for Acetabular Hydatidosis
Authors: Canoville Daniel, Hannebicque Matthieu, Rochcongar Goulven, Michon Jocelyn, Dumaine Valérie, Hulet Christophe
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Background:
Hydatidosis of the bone is a rare occurrence (0.9 to 2.5% of all localization of the disease). In those occurrences, the pelvic bone is the second most frequent localization. Curative treatment of pelvic bone hydatidosis is difficult and a consensus is yet to be found.
Clinical case:
We report a case of hydatidosis of the ischium, extended to the homolateral hip. The patient was treated through hip resection using patient-specific cutting guides, followed by total hip reconstruction. Albendazole was administered to the patient for two months before the surgery and for three months following the surgery.
Conclusions:
In a young patient, hydatidosis of the pelvic bone can be treated with satisfying results through wide resection of the hip coupled with an antiparasitic treatment administered before and after the surgery. Prosthetic reconstruction, similar to what is done in cancer surgery, restores good functions.
Case Report: Role of an Iodinated Rectal Hydrogel Spacer, SpaceOAR Vue™, in the Context of Low-Dose-Rate Prostate Brachytherapy, for Enhanced Post-Operative Contouring to Aid in Accurate Implant Evaluation and Dosimetry
Authors: Andrew Gross, Jiankui Yuan, Daniel Spratt, Elisha Fredman
Journal: Front Oncol (2021)
Keywords: spaceoar vue, brachytherapy, prostate cancer, radiation, toxicity
MeSH terms: Case Reports

We present a case series of 13 consecutive patients with prostate cancer treated with low-dose-rate (LDR) brachytherapy, utilizing SpaceOAR Vue™, the recent iodinated iteration of the SpaceOAR™ hydrogel rectal spacer. Low- and favorable intermediate-risk patients receiving monotherapy and unfavorable intermediate- and high-risk patients undergoing a brachytherapy boost were included. Permanent brachytherapy can result in subacute and late rectal toxicity, and precise contouring of the anterior rectal wall and posterior aspect of the prostate is essential for accurate dosimetry to confirm a safe implant. Clearly visible on non-contrast CT imaging, SpaceOAR Vue™ can substantially aid in post-implant contouring and analysis. Not previously described in the literature in the context of LDR brachytherapy, we demonstrate the added clinical benefit of placing a well-visualized rectal spacer.
An Unusual Subcutaneous Mass in an Otherwise Healthy Patient: A Case Report of Localized Histoplasmosis Diagnosed on Excisional Biopsy
Authors: Brendon M Esquibel, Christine J Waller, William A Agger
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Patients are commonly referred to general surgery clinics for evaluation of soft-tissue masses of the trunk and extremities. The primary goal of surgical referral is to confirm the presence of a mass, to assess the need for additional imaging and/or testing, and to gauge amenability to surgical biopsy, whether incisional or excisional. This is a case of a 67-year-old woman who was referred to surgery clinic for a small soft-tissue mass near her left elbow that had increased in size and pain over the past year. The mass had been present for several years. After MRI imaging revealed a nonspecific process, an excisional biopsy was performed. Following a careful review of the patient's history, risk factors, and histological results, a diagnosis of localized subcutaneous Histoplasma capsulatum var. capsulatum infection was made. Without signs or symptoms of active, systemic disease, no further treatment was recommended. The patient was provided risk factor counseling for symptoms or signs of active histoplasmosis and outpatient follow-up. Histologically, most masses will return as benign and mesenchymal in origin. However, soft-tissue masses may arise from uncommon etiologies and a broad differential is needed to ensure appropriate management and recommendations.
An incidentally detected hepatic subcapsular hematoma in a very low birth weight newborn: a case report
Authors: Hye Shin Ahn, Yun-Woo Chang, Dong Whan Lee, Kui Hyang Kwon, Seung Boo Yang
Journal: Cases J (2010)

Introduction:
A hepatic subcapsular hematoma in a neonate shows a non-specific presentation such as the presence of an abdominal mass without symptoms of hemorrhage and is clinically less distinguished as compared to cases detected during an autopsy.
Case presentation:
A neonate was delivered by vaginal delivery after 29 weeks and three days gestation with breech presentation. In a laboratory study, there were slightly increased levels of liver enzymes but the platelet count and hemoglobin level were normal. An abdomen ultrasonography and CT image demonstrated the cystic mass containing an internal thin septum with compression of the lateral margin of the right hepatic lobe and Morison's pouch. A CT image showed an irregular low-density lesion in the dome of liver that was suspected parenchymal laceration.
Conclusion:
We have described the sonographic and CT findings of an incidentally detected subcapsular hematoma of the liver in a neonate who showed a breech presentation, very low birth weight and was premature.
Diverticulum, or not Diverticulum, That Is the Question! Discussing About a Case of Left Ventricular Outpouching Associated With Bicuspid Aortic Valve Assessed by Cardiac Magnetic Resonance
Authors: Raffaella Capasso, Maria Panelo, Andrea Fiorelli, Iacopo Carbone, Nicola Galea
Journal: J Cardiovasc Thorac Res (2015)
Keywords: aortic valve, congenital heart disease, diverticulum, heart aneurysm, magnetic resonance imaging
MeSH terms: Case Reports

Congenital left ventricular outpouchings (LVOs) are infrequent myocardial malformations, comprising various overlapping abnormalities, whose characterization is often intricate in clinical practice using traditional non-invasive techniques. We describe a rare case of LVO associated with bicuspid aortic valve incidentally found in an asymptomatic adult patient. The LVO was located at basal level of the chamber, crescent-shaped with its largest diameter in short-axis view and presented a thin hypo-contractile wall without hyperintense areas on late gadolinium enhanced (LGE) images. This description corresponds to an overlap between usual definition of aneurism, fibrous and muscular diverticulum. The LVO was evaluated according with a classification recently proposed by Malakan Rad. In this case ventricular geometry was not respected, wall thickness was reduced and wall motion compromised therefore corresponding to a small IIc-type, which is considered having the poorest prognosis. Furthermore, the association with bicuspid aortic valve is very unusual. The patient refused surgery and preferred follow-up.
A Case of Syrian Child with Cerebral Infarction as an Extraintestinal Manifestation of Ulcerative Colitis
Authors: Riham Salloum, Nawras Alhalabi, Mohamad Anas Almidani
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Thromboembolic complications are rare but well-recognized manifestation of ulcerative colitis, especially because of their associated high mortality. We report a case of a Syrian child admitted to Damascus Hospital with a one-day complaint of sudden onset of numbness followed by weakness in the left lower and upper limbs, right mouth angle deviation, and loss of sphincters' control. Earlier, she was diagnosed with ulcerative colitis and treated with immunosuppressants. CT and MRI scans revealed focal infarction around the M2-M3 segments of the right middle cerebral artery; she was treated with Aspirin. On discharge, she had significant improved neurological examination and was able to walk. Subsequent proctocolectomy was performed. We highlight the importance of thromboembolism in ulcerative colitis as there is paucity in the literature regarding its management and its symptoms may be overlooked especially in high-load central hospitals. We conducted a brief literature search and summarized findings of similar reported cases.
A case report of mantle cell lymphoma presenting as intussuscepting colon mass
Authors: Brandon M Smith, Kyle Reilly, Elena Baker, Amy Deeken, Adrian G Dan
Journal: Int J Surg Case Rep (2020)
Keywords: case report, colo-colonic intussusception, mantle cell lymphoma, primary gi lymphoma
MeSH terms: Case Reports

Introduction:
Mantle Cell Lymphoma (MCL) is a non-Hodgkin lymphoma accounting for 2.5% of lymphoid neoplasms in the United States. Primary gastrointestinal (GI) lymphomas account for 1-4% of all GI malignancies, with few reports of primary mantle cell lymphoma presenting as a single colonic mass and none to our knowledge with colon-colonic intussusception as the presenting finding. Accurate and timely diagnosis is imperative because MCL has rapid progression and early chemotherapeutic intervention results in improved patient outcomes. This work is reported in line with the SCARE criteria [1] for case report publication.
Presentation of case:
A 61-year-old male presented with 1 month history of nonspecific right sided abdominal pain. Computed Tomography (CT) of the abdomen identified an intussuscepting mass in the proximal ascending colon and an additional 8 mm hepatic lesion. Colonoscopy identified a large mass in the corresponding area of colon identified on CT. Histology and immunohistochemistry of biopsied specimen diagnosed MCL.
Discussion:
Planned surgical intervention was deferred and the patient was referred for oncologic treatment. We report the first case to our knowledge of MCL presenting as colon-colonic intussusception and discuss the work-up of this rare lymphoma that clinicians may be required to diagnose and manage.
Conclusion:
This report serves as a reminder to maintain a broad differential inclusive of uncommon diseases and unanticipated pathology. Practicing with a thorough understanding of medical principles and clinical acumen is essential for optimal patient care and, as demonstrated in this case, preventing a potentially unnecessary surgical intervention thus delaying appropriate chemotherapy.
Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation
Authors: Benjamin J Lichtbroun, Brian Shinder, Tina Gowda Sara, Arnav Srivastava, Biren Saraiya, Tina M Mayer, Ryan Cristelli, Evita Sadimin, Robert E Weiss, Eric A Singer
Journal: J Kidney Cancer VHL (2023)
Keywords: chromophobe renal cell carcinoma, immune checkpoint inhibitors, kidney cancer, sarcomatoid
MeSH terms: Case Reports

Chromophobe renal cell carcinoma (chRCC) is one of the less common types of kidney cancer and generally portends a more favorable prognosis. RCC with sarcomatoid differentiation has a more aggressive clinical course with poor outcomes. Four cases of chRCC with varying degrees of sarcomatoid differentiation were retrospectively reviewed at our institution, and clinicopathologic data as well as clinical courses were reported. Patients with higher degrees of sarcomatoid differentiation and larger tumors at presentation generally had and worse overall survival. chRCC with sarcomatoid differentiation portends a poor prognosis with limited data on systemic treatment options for metastatic disease.
Macroglossia associated with 271 bp deletion in exon 50 of dystrophin gene
Authors: Hardeep Singh Malhotra, Ratish Juyal, Kiran Preet Malhotra, Rakesh Shukla
Journal: Ann Indian Acad Neurol (2011)
Keywords: dystrophin, genetics, muscular dystrophy
MeSH terms: Case Reports

Macroglossia is rare in patients of Duchenne muscular dystrophy (DMD), and its occurrence without any endocrinologic abnormality, seizures or an abnormal karyotype is even rarer. We describe a patient of DMD with isolated macroglossia with 271 bp deletion in exon 50 of the dystrophin gene and speculate a relationship in this regard.
The gap between desired and expected fertility among women in Iran: A case study of Tehran city
Authors: Maryam Hosseini, Udoy Saikia, Gouranga Dasvarma
Journal: PLoS One (2021)
MeSH terms: Fertility / physiology, Research Support, Non-U.S. Gov't, Age Factors, Educational Status, Employment, Female, Humans, Iran, Male, Marriage, Multivariate Analysis, Parity, Parturition, Pregnancy, Regression Analysis

The 2016 Iranian Census reveals that 14 of the country's 31 provinces have sub-replacement fertility. The province of Tehran, where a woman on average gives birth to 1.5 children during her reproductive period, has the lowest fertility in Iran. However, the 'two-child' norm prevails in the country and even a woman of young reproductive age still values having at least two children on average. In other words, there exists a gap between a woman's actual and desired fertility. This paper examines the demographic and socio-economic factors influencing the gap between actual and desired fertility in Tehran city based on a sample survey of 400 married women aged 15-49 years, conducted in 2015. The findings of the study reveal that the women of Tehran would be able to meet their fertility desires of two or more children if they were able to achieve their intended number of children they stated in the survey. However, should these women face any socio-economic constraint, they would be very likely to restrain their fertility desires and have fewer additional children than they initially intended, and thus continue with the sub-replacement fertility as being observed in Iran today.
Composite tumor of the larynx: A Case Report
Authors: Madhu Rajeshwari, Pirabu Sakthivel, Rijendra Yogal, Smriti Panda, Chirom Amit Singh, Deepali Jain
Journal: JNMA J Nepal Med Assoc (2020)
MeSH terms: Carcinoma, Neuroendocrine / pathology, Carcinoma, Neuroendocrine / physiopathology, Carcinoma, Small Cell / pathology, Carcinoma, Small Cell / physiopathology, Carcinoma, Small Cell / therapy, Carcinoma, Squamous Cell / diagnosis, Chemoradiotherapy / methods, Laryngeal Neoplasms / pathology, Laryngeal Neoplasms / physiopathology, Laryngeal Neoplasms / therapy, Larynx / pathology, Neoplasm Recurrence, Local / pathology, Neoplasm Recurrence, Local / physiopathology, Neoplasm Recurrence, Local / surgery, Case Reports, Administration, Metronomic, Fatal Outcome, Humans, Male, Methotrexate / administration & dosage, Middle Aged, Neoplasm Staging, Neoplasms, Complex and Mixed / pathology, Palliative Care / methods, Positron-Emission Tomography / methods, Tracheostomy, Methotrexate

Composite tumor of larynx, a recently included entity in the current WHO classification, is often a difficult pathological diagnosis, especially in small biopsies. We report a case of laryngeal composite tumor, initially misdiagnosed as squamous cell carcinoma, which later turned out to be composite in nature, with associated neuroendocrine (small cell carcinoma) component. This report emphasizes the need for obtaining deeper biopsies and their thorough pathological examination to improve the diagnostic accuracy. Keywords: combined small cell carcinoma; composite tumor; larynx; small cell carcinoma; squamous cell carcinoma.
The return from underperformance to sustainable world-class level: A case study of a male cross-country skier
Authors: Rune Kjøsen Talsnes, Einar Flaktveit Moxnes, Trond Nystad, Øyvind Sandbakk
Journal: Front Physiol (2023)
Keywords: xc skiing, endurance training, non-functional overreaching, overtraining syndrome, performance development, relative energy deficiency in sports, training load

Purpose: To determine the main factors associated with unexpected underperformance and prospectively describe the holistic process of returning to sustainable world-class level in a male cross-country skier. Methods: Longitudinal training data was retrospectively analyzed across nine seasons (2012-2013 to 2020-2021), and categorized into training forms (endurance, strength, and speed), intensities [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and modes (specific and non-specific). Performance data was obtained from the International Ski and Snowboard Federation. Following two seasons of unexpected underperformance (2019-2020 and 2020-2021), the participant was prospectively followed in the process of returning to sustainable world-class level (2021-2022). Day-to-day training data and physiological tests were analyzed, and interviews with the participant and the head coach conducted. Results: Longitudinal training data from 2012-2013 to 2018-2019 demonstrated a non-linear 30% increase in total training volume (from 772 to 1,002 h), mainly caused by increased volume of ski-specific endurance training without changes in intensity distribution. Coincidingly, the participant gradually reached a world-class performance level. After two seasons of unexpected underperformance with relatively similar training volumes and intensity distributions as in the preceding seasons, the possible contributing factors were identified: lack of training periodization, limited monitoring and intensity control, particularly in connection with a "extreme" regime of training with low carbohydrate availability and days including two MIT sessions, as well as lack of systematic technique training and follow-up by coaches on a daily basis. Consequently, the return to world-class level included the introduction of a clear micro-cycle periodization, more systematic physiological monitoring and testing, more accurate intensity control, increased carbohydrate intake during and between sessions, as well as increased emphasize on technique training and an assistant coach present during day-to-day training. Conclusion: These longitudinal data describe the main factors leading to unexpected underperformance, in addition to providing unique insights into the corresponding process of returning to sustainable world-class level in a male cross-country skier. The holistic approach described in this case study may serve as a theoretical framework for future studies and practical work with underperforming endurance athletes.
First Prenatal Diagnosis of a Niemann-Pick Disease Type C2 Revealed by a Cystic Hygroma: A Case Report and Review of the Literature
Authors: Liana Ples, Romina-Marina Sima, Florina Nedelea, Marius Moga
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: niemann–pick disease, cystic hygroma, homozygous mutation, prenatal diagnosis, unusual association
MeSH terms: Case Reports

Background:
The importance of fetal nuchal translucency was highlighted in the early 1990s as a useful first-trimester marker to identify fetal chromosomal abnormalities. Here, we report the prenatal diagnosis of a fetus with Niemann-Pick disease type C initially identified by first-trimester ultrasonographic markers and eventually confirmed by extensive genetic evaluation.
Case presentation:
The fetus of a 30-year-old woman exhibited a cystic hygroma in the first trimester of pregnancy. The woman underwent chorionic villus sampling with extensive genetic investigations to identify the genetic cause of the ultrasonographic findings. Owing to normal karyotype results, further evaluation of 1,024 genes underlying structural abnormalities was performed. This test identified a homozygous mutation of the NPC2 gene (OMIM 601015), which has been reported to be pathogenic and responsible for Niemann-Pick disease type C2 (NPD-C2). Genetic evaluation of the parents found them to be carriers. Considering the poor prognosis, the parents decided to terminate the pregnancy. Ultrasonographic screening during the subsequent pregnancy showed normal findings; however, molecular testing for the previous familial mutation c.441 + 1G>A identified the fetus as homozygous for this mutation. Therefore, the parent chose to terminate the subsequent pregnancy as well.
Conclusion:
We report the first prenatal diagnosis of NPD-C2 based on a cystic hygroma found during the first trimester of pregnancy as the sole indicator.
Case Report: Severe rash/desquamation induced by sorafenib in an uHCC patient and its clinical management
Authors: Yan Lin, Ping-Yu Liu
Journal: Front Pharmacol (2022)
Keywords: ctcea grade 3, case report, severe rash/desquamation, sorafenib, unresectable hepatocellular carcinoma
MeSH terms: Case Reports

Background: Sorafenib-related dermatological toxicity is a well-known adverse reaction that can severely affect therapeutic outcomes. Rash/desquamation with its variable manifestations is one of the common clinical presentations. Currently, no standard continuum of care for sorafenib-related rash/desquamation has been established. Case summary: A 75-year-old woman with colorectal cancer who developed unresectable hepatocellular carcinoma (uHCC) received, six years later, sorafenib 400 mg twice daily. She developed a Grade-3 Common Terminology Criteria for Adverse Events (CTCEA) rash and bullae bilaterally on her lower extremities after 2 weeks of sorafenib use. Rash and blisters began to appear on the left calf and then merged as large bullae full of liquid and spread to both lower extremities. The bullae then erupted and skin began to slough off, which affected the patient's normal daily functioning. To lessen the condition, sorafenib was stopped permanently and dexamethasone intravenous (IV) infusion at 5 mg daily for 3 days and piperacillin/tazobactam were used. The skin dried without exudate or ulcerations after a month. Conclusion: For severe (CTCAE Grade 3 or above) sorafenib-related rash/desquamation, short-term corticosteroid pulse therapy at large doses is usually effective with routine skin care, and antibiotics can be considered if infection is present. Permanent cessation of sorafenib should be considered if severe manifestations such as erythema multiforme (EM) and Steven-Johnson syndrome (SJS) are suspected.