OpenMed/multicare-articles huggingface dataset:
A Contemporary Retrospective Study of Survival in Dogs With Primary Lung Tumors: 40 Cases (2005-2017)
Authors: Ruth J Rose, Deanna R Worley
Journal: Front Vet Sci (2020)
Keywords: canine, lymph node, metastasis, primary lung, survival

Objective: To report the median survival time in a contemporary cohort of dogs with primary lung tumors and intrathoracic nodal metastasis. Design: Retrospective Case Series. Animals (or sample): Dogs with primary lung tumors treated with lung lobectomy and lymph node biopsy. Procedures: The medical record database at Colorado State University was queried for dogs with primary lung tumors from January 1, 2005 to December 31, 2017. Patients were identified for inclusion if they had lung lobectomy and an intrathoracic lymph node biopsy performed. The median survival time (MST) for lymph node positive (LN+) and negative dogs (LN-) was calculated as well as the MST in dogs that did or did not receive adjuvant chemotherapy. Differences were compared between groups with significance set at p < 0.05. Results: The MST in LN+ dogs (n = 11) was 167 days which was not statistically different from LN- dogs (n = 29) at 456 days (p = 0.2407). No significant difference in the MST in LN+ dogs was identified between dogs that received adjuvant chemotherapy (n = 4; 110 days) and those that did not receive adjuvant chemotherapy (n = 6; 125 days) (p = 0.4409). There was no difference in survival time in LN- dogs receiving chemotherapy (n = 12; 335 days) as compared to those LN- dogs (n = 10) that did not receive adjuvant chemotherapy (258.5 days; p = 0.6475). Conclusions and Clinical Relevance: The survival of primary pulmonary neoplasia in dogs with intrathoracic nodal metastasis is longer than previously reported in this contemporary cohort. Chemotherapy did not appear to improve survival in LN+ or LN- dogs. The combination of tumor size between 100 and 999 cm3 and positive lymph node status significantly reduced survival.
The Value of Cytology Smears for Acanthamoeba Keratitis
Authors: Sangita P Patel, Jamie L Schaefer, Ryan Jaber, Joyce Paterson, Weiguo Liu, Federico Gonzalez-Fernandez
Journal: Case Rep Ophthalmol Med (2016)

Purpose. Acanthamoeba keratitis remains a difficult diagnosis despite advances in genetic and imaging technologies. The purpose of this paper is to highlight the utility of cytology smears for diagnosis of Acanthamoeba keratitis. Methods. This is a case study of the diagnostic course for a patient with suspected Acanthamoeba keratitis. Results. A 40-year-old male with poor contact lens hygiene presented with severe left eye pain. Slit lamp examination showed two peripheral ring infiltrates without an epithelial defect. The epithelium over both infiltrates was removed with a Kimura spatula. Half of the sample was smeared on a dry microscope slide and the other half was submitted for Acanthamoeba culture and PCR. Both culture and PCR were negative for Acanthamoeba, but hematoxylin and eosin stain of the smear revealed double-walled cysts. Conclusion. H&E staining of corneal cytology specimens is an efficient and readily available test for diagnosis of Acanthamoeba keratitis.
Chromosomal Abnormalities in Syndromic Orofacial Clefts: Report of Three Children
Authors: Rathika Damodara Shenoy, Vijaya Shenoy, Vikram Shetty
Journal: Case Rep Genet (2018)
MeSH terms: Case Reports

This case series of three children reports clinical features and chromosomal abnormalities seen in a craniofacial clinic. All presented with orofacial cleft, developmental or intellectual disability, and dysmorphism. Emanuel syndrome or supernumerary der (22)t(11; 22), the prototype of complex small supernumerary marker disorders, was seen in one child. Duplication 4q27q35.2 with concomitant deletion 21q22.2q22.3 and duplication 12p13.33p13.32 with concomitant deletion 18q22.3q23 seen in the remaining two children are not reported in literature. Maternal balanced translocation was established in both of these children.
Small intestine metastasis from cervical cancer with acute abdomen: A case report
Authors: Hui Qiu, Limei Yuan, Yangwen Ou, Yan Zhu, Conghua Xie, Gong Zhang
Journal: Oncol Lett (2015)
Keywords: acute abdomen, cervical cancer, metastasis, small intestine

Cervical cancer metastasis to the small intestine is a rare occurrence that is easily misdiagnosed as a small bowel obstruction. The present study reports the case of a 46-year-old cervical cancer patient with metastasis to the small intestine, which presented as an acute abdomen due to intestinal obstruction. Enteroscopy revealed no primary intestinal tumors. The patient underwent exploratory laparotomy and resection of the tumor of the small intestine. Pathology revealed the mass to be squamous cell carcinoma, limited to the outer muscular layer and serosa. This case demonstrates that small intestine seeding must be considered in the differential diagnosis of acute abdomen in patients with cervical cancer.
Effects of Mifepristone on Nonalcoholic Fatty Liver Disease in a Patient with a Cortisol-Secreting Adrenal Adenoma
Authors: Enzo Ragucci, Dat Nguyen, Michele Lamerson, Andreas G Moraitis
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Cushing syndrome (CS), a complex, multisystemic condition resulting from prolonged exposure to cortisol, is frequently associated with nonalcoholic fatty liver disease (NAFLD). In patients with adrenal adenoma(s) and NAFLD, it is essential to rule out coexisting endocrine disorders like CS, so that the underlying condition can be properly addressed. We report a case of a 49-year-old woman with a history of hypertension, prediabetes, dyslipidemia, biopsy-confirmed steatohepatitis, and benign adrenal adenoma, who was referred for endocrine work-up for persistent weight gain. Overt Cushing features were absent. Biochemical evaluation revealed nonsuppressed cortisol on multiple 1-mg dexamethasone suppression tests, suppressed adrenocorticotropic hormone, and low dehydroepiandrosterone sulfate. The patient initially declined surgery and was treated with mifepristone, a competitive glucocorticoid receptor antagonist. In addition to improvements in weight and hypertension, substantial reductions in her liver enzymes were noted, with complete normalization by 20 weeks of therapy. This case suggests that autonomous cortisol secretion from adrenal adenoma(s) could contribute to the metabolic and liver abnormalities in patients with NAFLD. In conclusion, successful management of CS with mifepristone led to marked improvement in the liver enzymes of a patient with long-standing NAFLD.
Case Report: A Preferred Reconstructing Modality to Restore Neoplastic Nasal Alar Subunit Defects: Sequential Facial Artery Perforator Flaps
Authors: Bihua Wu, Sanhong Yang, Hai Li, Tianhua Zhang, Shune Xiao, Zairong Wei, Chengliang Deng
Journal: Front Surg (2022)
Keywords: facial artery perforator flap, nasal alar, nasal alar subunit, nasolabial groove, neoplastic nasal alar defects
MeSH terms: Case Reports

Background:
Achieving perfect repair of a nasal defect with the recovery of cosmetic subunits has become a challenge to plastic, dermatologic, and head and neck surgeons. The study aimed to evaluate the effect of reconstructing neoplastic nasal alar subunit defects with sequential facial artery perforator flaps produced from nasolabial groove tissue.
Methods:
A retrospective analysis of 20 patients who had undergone reconstruction for neoplastic nasal alar defects with this technique from January 2017 to October 2019 was performed. The reconstruction procedure used sequential facial artery perforator flaps. The surgical procedure used and follow-up results achieved have been documented photographically for all patients.
Results:
The aesthetic and functional results of surgery were satisfactory in all the 20 patients. After all surgeries, the reconstructed alar tissues were compliant, bilateral symmetries of the alae and nasolabial grooves were satisfactory, and no patients exhibited color mismatches between the flaps and surrounding tissues. During a mean follow-up period of 22 months, none of the patients exhibited alar retraction, inferior displacement, deformation, or hypertrophic scarring.
Conclusions:
The sequential facial artery perforator flap technique created with nasolabial groove tissue to reconstruct neoplastic nasal alar defects is a simple single-stage procedure that provides excellent surgical outcomes.
Giant asymptomatic left renal oncocytoma in a 40-year-old man: a case report
Authors: Sultan Qaid, Radman Ghaleb, Faisal Ahmed, Ebrahim Al-Shami, Qasem Alyhari, Saleh Al-Wageeh, Mohammad Reza Askarpour
Journal: Pan Afr Med J (2022)
Keywords: giant, case report, central stellate scar, renal oncocytoma
MeSH terms: Adenoma, Oxyphilic / diagnostic imaging, Adenoma, Oxyphilic / surgery, Carcinoma, Renal Cell / diagnosis, Kidney Neoplasms / diagnostic imaging, Kidney Neoplasms / surgery, Case Reports, Adult, Humans, Male, Nephrectomy / methods, Oncocytoma, renal

Renal oncocytoma is a benign tumor that arises from epithelial cells of the distal renal tubules. It is naturally presented with a small-sized mass, and giant oncocytoma is uncommon. Renal oncocytoma is frequently asymptomatic and challenging to distinguish preoperatively from renal cell carcinoma (RCC). We present a 40-year-old man who presented with intermittent abdominal pain in the last two years. Abdominal computed tomography (CT) scan showed a large, heterogenous left renal mass measured 15 x 16 x 19.5 cm and associated with central calcifications suspected of RCC. The patient underwent a left radical nephrectomy without complication. The histopathological study revealed typical oncocytoma features. There was no detected recurrence or distant metastasis on six months follow-up. In conclusion, it is challenging to distinguish renal oncocytoma from RCC via preoperative radiology images, especially when a giant mass is present. The only histopathology examination of the removed specimen can provide a definitive diagnosis.
Mesenteric fibromatosis presenting as a diagnostic dilemma: a rare differential diagnosis of right iliac fossa mass in an eleven year old-a rare case report
Authors: Abhinav Mahajan, Mohinder Singh, Anoop Varma, Gunjeet Singh Sandhu, Malwinder Singh, Rupesh Nagori
Journal: Case Rep Surg (2013)

An eleven-year-old boy presented with a mass in the right iliac fossa for the last 21 days associated with pain, fever, anorexia, and nausea. The patient was thoroughly investigated and contrast-enhanced CT abdomen revealed a well-defined mass in the region of right iliac fossa. Exploratory laparotomy was done and a mass measuring 10 cm in diameter arising from mesentery of proximal ileum and adherent with the wall of ileum was seen. Resection and anastomosis were done. Histopathological examination showed mesenteric fibromatosis. Postoperatively, patient was well and 3-month followup showed normal recovery.
Unilateral Nonconfluent Cluster of Micronodules: Atypical Radiologic Appearance of Pulmonary Tuberculosis in an Immunocompetent Patient
Authors: Bushra Johari, Mohammad Hanafiah
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Active pulmonary tuberculosis involving the lung parenchyma is typically seen on CT as consolidation, centrilobular nodules with tree-in-bud branching, cavitating lesions, and miliary nodules. However, some atypical CT patterns of granulomatous disease including tuberculosis have been recently described, namely, clusters of nodules without confluence or with confluence. We present a case of a patient who was found to have nonconfluent clusters of micronodules in the right lung with negative sputum culture for tuberculosis. There were also incidental findings of the partial duplex system of the left kidney with mild-to-moderate hydronephrosis in the lower moiety with proximal hydroureter. The urine culture was then positive for mycobacterium tuberculosis; hence, he was commenced on antituberculous medications. A repeated CT scan revealed significant improvement of the aforementioned clusters of micronodules and left hydronephrosis. In the present case, we would like to highlight the atypical appearances of pulmonary tuberculosis in the form of nonconfluent micronodules on HRCT despite negative sputum workup, with the concurrent active genitourinary tuberculosis.
Leptomeningeal carcinomatosis associated with papillary renal cell carcinoma
Authors: Abhishek Chilkulwar, Ramya Pottimutyapu, Fawng Wu, Keerthi R Padooru, Sai Ravi Pingali, Mohammed Kassem
Journal: Ecancermedicalscience (2014)
Keywords: leptomeningeal carcinomatosis, leptomeningeal metastasis, neoplastic meningitis, papillary renal cell carcinoma
MeSH terms: Case Reports

Leptomeningeal carcinomatosis (LMC), or neoplastic meningitis, occurs in about 5-20% of patients with metastatic cancer, depending on the type of the primary malignancy and kind of treatment received. The association of LMC with renal cell carcinoma (RCC) is a rare entity, and only two cases of papillary renal cell cancer with leptomeningeal metastasis have been reported. Leptomeningeal spread usually confers a poor prognosis despite the use of modern treatment strategies as compared to patients with extracranial metastases. We report a case of papillary RCC, a less common type of RCC presenting with LMC.
Case report: Multimodal neoadjuvant and adjuvant chemotherapy for hepatic undifferentiated embryonal sarcoma in a young adult
Authors: Rosemary Vergara, Sarah Khalil, Gitonga Munene
Journal: Front Oncol (2022)
Keywords: uesl, embryonal sarcoma of adult liver, hepatectomy, neoadjuvant chemotherapy, undifferentiated embryonal hepatic sarcoma
MeSH terms: Case Reports

Hepatic undifferentiated embryonal sarcoma of the liver (UESL) is a rare hepatic malignancy found more commonly in pediatric patients. It has been associated with poor outcomes in adults and the role and timing of systemic therapy is unclear. There have been very few case reports detailing combination neoadjuvant and adjuvant chemotherapy use for hepatic undifferentiated embryonal sarcoma in adults. In this report, a 22-year-old male admitted with right upper quadrant pain was diagnosed with a 20 x 10 x 10 cm well-circumscribed, highly vascularized hepatic mass in the entirety of the left lobe. Biopsy confirmed the diagnosis of UESL. PET/CT showed no evidence of metastatic disease, and he received four cycles of Doxorubicin and Ifosfamide with demonstrated reduction in size and decrease in PET avidity. He underwent left hepatectomy with periportal lymphadenectomy, cholecystectomy, and partial gastrectomy with negative margins and received adjuvant Doxorubicin, Ifosfamide and Mesna. At 48 months, the patient was alive without evidence of disease. We hereby emphasize the potential advantages of combination chemotherapy and surgical resection in the management of UESL in adults.
Reconstruction of Extensive Calvarial Exposure After Major Burn Injury in 2 Stages Using a Biodegradable Polyurethane Matrix
Authors: John Edward Greenwood, Marcus James Dermot Wagstaff, Michael Rooke, Yugesh Caplash
Journal: Eplasty (2016)
Keywords: biodegradable polyurethane, burns, dermal matrix, scalp reconstruction, synthetic
MeSH terms: Case Reports

Objectives:
To share our experience of an extensive calvarial reconstruction in a severely burn-injured, elderly patient in a 2-stage procedure utilizing a novel biodegradable temporizing matrix (NovoSorb BTM), followed by autograft.
Materials and methods:
A 66-year-old patient with 75% full-thickness burns, including 7% total body surface area head and neck, with calvarial exposure of approximately 350 cm(2), complicated by acute renal failure and smoke inhalation injury. Exposed calvarium was burred down to diploe and biodegradable temporizing matrix was applied. Over the next 29 days, the biodegradable temporizing matrix integrated by vascular and tissue ingrowth from the diploe. Delamination and grafting occurred, however, at 43 days postimplantation of biodegradable temporizing matrix due to skin graft donor-site constraints.
Results:
Graft take was complete, yielding a robust and aesthetically pleasing early result (26 days post-graft application).
Conclusions:
Biodegradable temporizing matrix offers an additional resource for reconstructive surgeons faced with fragile patients and complex wounds.
A case of acute promyelocytic leukemia variant with derivative chromosome 3 der(3)t(3;8) associated with 8q partial gain
Authors: Filomena Nozza, Gabriella Vona, Stefania Trino, Fiorella D'Auria, Francesco La Rocca, Vitina Grieco, Luciana Possidente, Luciana De Luca, Pellegrino Musto
Journal: Mol Cytogenet (2019)
Keywords: acute promyelocytic leukemia, chromosome 8, fish, molecular cytogenetics, painting, c-myc gene
MeSH terms: Case Reports

Background:
Acute promyelocytic leukemia (APL) is characterized by fusion of PML/RARα genes as a result of t(15;17)(q24;q21). APL is now one of the curable hematological malignancies thanks to molecularly targeted therapies based on all-trans retinoic acid (ATRA) and arsenic trioxide (ATX). Extramedullary (EM) relapse is a rare event in APL, ear involvement being even more infrequent, with only six cases so far described. About 30-35% of patients with newly diagnosed APL have additional cytogenetics abnormalities, whose prognostic significance is still controversial. The most common additional aberration is trisomy 8 or partial gain 8q.
Case presentation:
We describe here a novel unbalanced translocation der(3)t(3;8)(q29;q23.3-q24.3) associated with 8q partial gain in a 41 year-old man affected by APL in molecular remission after first line treatment, who had a responsive EM relapse in the auditory canal.
Conclusions:
EM relapse is a rare event in APL and ear involvement is even more infrequent. To our knowledge, this is the first reported case of APL with a new der(3)t(3;8)(q29;q23.3-q24.3) and 8q partial gain associated with t(15;17)(q24;q21). Despite the recurrence of the disease at EM level, the clinical outcome of this patients was favorable.
The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review
Authors: Nidrit Bohra, Abigayle Sullivan, Haseeb Chaudhary, Trudy Demko
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Hydrothorax is a well-known but rare complication of peritoneal dialysis (PD), with an average incidence of 2% mainly in cases of continuous ambulatory peritoneal dialysis (CAPD). In more than 80% of these cases, the hydrothorax is attributed to an abnormal pleuroperitoneal communication. It commonly manifests as unilateral effusion, predominantly on the right. A thoracentesis to determine pleural glucose has been a diagnostic aid well relied on, as the dextrose rich dialysate raises the pleural fluid glucose. A pleural fluid glucose to serum glucose gradient greater than 50 mg/dL is suggestive of a leak with a specificity of 100% according to some studies; however, its sensitivity is variable. Our case illustrates a diagnostic dilemma due to a relatively low pleural fluid to serum glucose gradient of 21 mg/dL that caused a delay in diagnosis. A pleural fluid to serum glucose ratio >1.0 was used as a diagnostic marker that pointed toward a peritoneal leak. For confirmation, a peritoneal scintigraphy with nuclear technetium 99 scan was performed that revealed a pleuroperitoneal fistula as the source of the recurring hydrothorax in the setting of automated peritoneal dialysis (APD). The hydrothorax completely resolved with termination of APD on follow-up as the patient was transitioned to intermittent hemodialysis (HD).
Inverted Yoga and Near Syncope: An Unusual Diagnosis of Right Ventricular Myxoma
Authors: Wadie David, Narmeen Rehman, Robby Singh, Shukri David
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Primary cardiac tumors are extremely rare and are difficult to diagnose. Although usually benign in nature, myxomas require surgical resection due to their increased risk of embolic and cardiac complications, with the timing of resection dependent on the presentation and size of the tumor. However, if diagnosed early, patients with primary benign cardiac tumors have excellent prognosis following surgery. Therefore, a high index of suspicion and a wide differential diagnosis are very important in detecting rare conditions that can affect otherwise healthy individuals. We present an uncommon case of a right ventricular myxoma that was discovered when the patient was performing inverted yoga and experienced a near syncopal episode. Patient subsequently underwent an echocardiographic evaluation and was found to have a right ventricular myxoma that was excised. Although recurrence is rare, it is important for physicians to remain vigilant and continue careful and consistent follow-up for patients with a history of a cardiac myxoma.
Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren's Syndrome: A Case Report and Literature Review
Authors: Shigekazu Kurihara, Makoto Harada, Tohru Ichikawa, Takashi Ehara, Mamoru Kobayashi
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Background:
Renal tubular acidosis and tubulointerstitial nephritis constitute the primary renal complications associated with Sjögren's syndrome (SjS), and glomerulonephritis and nephrotic syndrome are rare.
Case presentation:
A 79-year-old Japanese woman presented with bilateral leg edema and weight gain and was diagnosed with nephrotic syndrome. In addition, she reported a 5-year history of dryness of mouth and was diagnosed with SjS. Renal biopsy revealed segmental glomerulosclerosis, with some specimens showing collapse of the glomerular capillary loops, proliferation of glomerular epithelial cells, and sclerotic lesions at the tubular poles, without spike formation, double contour lesions, or any other changes of the glomerular basement membrane. Immunofluorescence staining showed no immune complex (immunoglobulin IgG, IgA, or IgM) or complement (C3) deposition in the glomerular capillary walls. Based on these findings, she was diagnosed with focal segmental glomerulosclerosis (FSGS). The administration of steroid and cyclosporine achieved complete remission of nephrotic syndrome.
Conclusion:
Although glomerular diseases are rare, a variety of glomerular lesions including FSGS are reported in patients with SjS. Therefore, renal biopsy is warranted in patients with SjS presenting with severe urinary abnormalities.