OpenMed/multicare-articles huggingface dataset:
A Rare Case of Captopril-Induced Parotid Gland Enlargement
Authors: Ahmed Khan, Malak Alshehri, Ahad Babkier, Kutaiba Alahmad, Wisam Siam
Journal: Cureus (2023)
Keywords: adverse drug events, captopril, case report, parotid enlargement, rare case
MeSH terms: Case Reports

The use of captopril has been linked to scarce adverse events characterized by parotid glands enlargement. We report a case of captopril-induced parotid enlargement in a patient with uncontrolled hypertension. A 57-year-old male presented to the emergency department (ED) with an acute state of headache. The patient has a background of untreated hypertension for which he was managed in the emergency department (ED) by the administration of captopril 12.5 mg sublingually to control his blood pressure. Shortly after the drug administration, he started to experience bilateral painless enlargement of parotid glands that resolved a few hours after the drug was withdrawn.
Vesico-appendiceal fistula secondary to adenocarcinoma of the appendix: a case report and literature review
Authors: Adriá Rosat, Eduardo Pérez, Juan Manuel Sánchez, Omar Bilal Halawa González, Manuel Barrera
Journal: Pan Afr Med J (2020)
Keywords: vesico-appendiceal fistula, adenocarcinoma appendix, literature review
MeSH terms: Adenocarcinoma, Mucinous / diagnosis, Appendiceal Neoplasms / diagnosis, Urinary Bladder Fistula / diagnosis, Urinary Tract Infections / etiology, Case Reports, Review, Adenocarcinoma, Mucinous / complications, Adenocarcinoma, Mucinous / surgery, Appendiceal Neoplasms / complications, Appendiceal Neoplasms / surgery, Colectomy, Cystectomy, Female, Humans, Laparoscopy, Middle Aged, Urinary Bladder Fistula / complications, Urinary Bladder Fistula / surgery

A 50-year-old woman presented with a 5-month history of recurrent urinary tract infections. She had no complaints of any intestinal symptoms. She had been treated previously with oral antibiotics. The episodes became more frequent and she started with pain in the lower abdomen and fetid urine. Complete study lead to diagnosis of adenocarcinoma of the appendix with bladder fistula. The lesion was removed by laparoscopic right hemicolectomy and en bloc partial cystectomy. Pathological examination revealed a mucinous adenocarcinoma that had originated in the appendix and extended into the bladder wall. Six years after the operation, the patient remains asymptomatic with no evidence of recurrent or metastatic disease. Appendiceal carcinoma extending to the bladder is extremely rare and approximately 40 cases have been described. Management of recurrent urinary tract infections should not limit to empiric antibiotic therapy before the exclusion of possible organic causes. Appendiceal carcinoma may invade the bladder without intestinal symptoms but with urinary symptoms only, because of its anatomical position. The recommended treatment for non-carcinoid appendiceal tumours is right hemicolectomy and for T4 tumours en bloc resection of the involved structures. Further study is needed to determine adjuvant therapy. A literature review was made.
Fulminant Hepatic Failure after Chemosaturation with Percutaneous Hepatic Perfusion and Nivolumab in a Patient with Metastatic Uveal Melanoma
Authors: Lindsey Teal, Jeffrey Yorio
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

Immune checkpoint inhibitors, such as nivolumab, a programmed death receptor-1 (PD-1) inhibitor, have dramatically improved the treatment of advanced melanomas. Chemosaturation with percutaneous hepatic perfusion (PHP) delivers chemotherapy in high doses directly to the liver and is a potentially effective treatment modality in metastatic uveal melanoma with liver metastases. Its safety and effectiveness have not been studied in patients also receiving immunotherapy. A 46-year-old male with a history of uveal melanoma of the right eye was found to have liver metastases. He was treated with PHP using high-dose melphalan for 6 months with a partial response followed by progression. Two months after his last PHP treatment, the patient was started on nivolumab. After two doses of nivolumab, the patient developed severe hepatitis that progressed to fulminant hepatic failure and death despite treatment with high-dose corticosteroids and mycophenolate mofetil. Nivolumab and other immune checkpoint inhibitors have been effective in treating advanced melanoma and extending life. However, there are serious immune adverse events that can occur. While hepatitis after taking nivolumab has been documented, fulminant hepatic failure is rare. We believe that prior PHP treatment contributed to the severity of the hepatitis and, ultimately, fulminant hepatic failure. To our knowledge, this is the only case of fulminant hepatic failure secondary to a checkpoint inhibitor with preceding PHP. Specific precautions should be made in patients who have been exposed to PHP in the past, and further studies should be done to assess the safety of using checkpoint inhibitors after PHP.
Metastatic BRAF K601E-mutated melanoma reaches complete response to MEK inhibitor trametinib administered for over 36 months
Authors: Riccardo Marconcini, Luca Galli, Andrea Antonuzzo, Simona Bursi, Claudia Roncella, Gabriella Fontanini, Elisa Sensi, Alfredo Falcone
Journal: Exp Hematol Oncol (2017)
Keywords: braf k601e mutation, complete response, melanoma, trametinib
MeSH terms: Case Reports

Background:
The BRAF K601E mutation occurs in 5% of patients with melanoma, and is the third most common type of BRAF mutation. However, treatment with BRAF and mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors is only approved in patients with BRAF V600-positive melanoma, and patients with K601E-mutated melanoma do not have access to such drugs.
Case presentation:
A female patient was diagnosed with high tumor burden metastatic melanoma harboring the BRAF K601E mutation. After chemotherapy failure, she underwent compassionate treatment with trametinib. Trametinib showed good activity and efficacy, with 48% shrinkage of a metastatic lymphadenopathy after 4 months' treatment. However, the patient reported treatment-related skin toxicity that required dosage reduction and a personalized intermittent trametinib dosing schedule. After over 36 months from the first trametinib administration, and resection of a metastatic lymphadenopathy, the patient experienced complete response.
Conclusions:
This case report shows that trametinib could be a valid therapeutic option in patients with metastatic melanoma harboring the rare BRAF K601E mutation.
Adult-onset Still's disease after ChAdOx1 nCoV-19 vaccine: a possible association
Authors: Laíssa Fiorotti Albertino, Isac Ribeiro Moulaz, Tammer Ferreira Zogheib, Martina Zanotti Carneiro Valentim, Ketty Lysie Libardi Lira Machado
Journal: Autops Case Rep (2022)
Keywords: adenovirus vaccines, covid-19 vaccines, still's disease, adult-onset
MeSH terms: Case Reports

With emergent Sars-Cov-2, a highly transmissive virus that caused millions of deaths worldwide, the development of vaccines became urgent to combat COVID-19. Although rare, important adverse effects had been described in a hypothetical scenario of immune system overstimulation or overreaction. Still's disease is a rare inflammatory syndrome of unknown etiology. It manifests as a cytokine storm, mainly IL-18 and IL-1β, and presents itself with fever spikes, joint pain, maculopapular evanescent salmon-pink skin rash, and sore throat, among other symptoms. Here, we report a case of a 44-year-old healthy male who developed adult-onset Still's disease (AOSD) with atypical symptoms after both doses of ChAdOx1 nCoV-19 vaccine with 3 months of dose interval. The medical team suspected Still's disease and started prednisone 1 mg/kg (40mg). The next day the patient showed a marked improvement in articular and chest pains and had no other fever episodes. Therefore, he was discharged to continue the treatment in outpatient care. On the six-month follow-up, the patient was free of complaints, and the progressive corticoid withdrawal plan was already finished.
Pulmonary embolism mimicking acute myocardial infarction: a case report and review of literature
Authors: Saida Zelfani, Hela Manai, Saoussen Laabidi, Abir Wahabi, Sara Akeri, Mounir Daghfous
Journal: Pan Afr Med J (2019)
Keywords: myocardial infarction, electrocardiography, pulmonary thromboembolism
MeSH terms: Chest Pain / diagnosis, Myocardial Infarction / diagnosis, Pulmonary Embolism / diagnosis, Case Reports, Review, Adult, Chest Pain / etiology, Computed Tomography Angiography, Diagnosis, Differential, Echocardiography, Female, Humans

The diagnosis of pulmonary thromboembolism (PTE) with changes shown by electrocardiography (ECG) is a challenge in the clinical practice due to rare pathognomonic findings. We report the case of a 37-year old woman managed in out of hospital sitting for a chest pain. Electrocardiogram was suggestive of antero-septal acute myocardial infarction (AMI). Catheterization revealed non occlusive coronary disease. Transthoracic echocardiography showed an elevated pulmonary and right heart pressures. Computed tomography pulmonary angiography confirmed the diagnosis of bilateral pulmonary embolism. PTE with ECG changes should be considered in the differential diagnosis of AMI, particularly in young patients with chest pain and ST segment elevation suggestive of acute coronary syndrome.
Cleft palate-lateral synechiae syndrome: a case report
Authors: Wafa Id El Mouden, Abdellatif Daoudi, Khalila Nainia, Othmane Benhoummad, Hind Jamil, Houda Majhoul, Samira Tizki
Journal: Pan Afr Med J (2022)
Keywords: cleft palate, case report, intraoral fibrous bands, intraoral synechiae, neonate
MeSH terms: Cleft Lip / diagnosis, Cleft Lip / surgery, Cleft Palate / complications, Cleft Palate / diagnosis, Cleft Palate / surgery, Iris Diseases, Jaw Abnormalities / complications, Mouth Abnormalities / complications, Mouth Abnormalities / surgery, Case Reports, Female, Humans, Infant, Newborn, Tissue Adhesions / complications, Cleft Palate-Lateral Synechia Syndrome

Cleft palate-lateral synechiae syndrome (CPLSS) is an extremely rare congenital malformation syndrome with undetermined etiology, characterized by a cleft palate and lateral intraoral synechiae linking the free borders of the palate to the mouth floor. We report a case of a female neonate, admitted for suckling difficulties with a cleft lip and palate associated to multiple lateral intraoral synechiae. Resection of the synechiae allowed oral feeding. Cleft palate-lateral synechiae syndrome is an exceptional syndrome as only seventeen cases have been reported in the literature. Synechiae can be isolated or more frequently in association with other congenital anomalies such as cleft lip and/or palate. These synechiae can cause functional deficits, especially in the respiratory and feeding tracts, language disorders or recurrent otitis. Although it is exceptional, this malformative entity must be known by medical practitioners in order to set up a well-adapted therapeutic protocol.
Observation of Intramural Fibroid Expulsion on MRI after Uterine Artery Embolization
Authors: Hisakazu Matsushima, Ken Kageyama, Akira Yamamoto, Atsushi Jogo, Etsuji Sohgawa, Takehito Nota, Kazuki Murai, Satoyuki Ogawa, Mariko Nakano, Taro Shimono, Yukio Miki
Journal: Case Rep Radiol (2021)
MeSH terms: Case Reports

Uterine artery embolization (UAE) is a type of noninvasive treatment for symptomatic uterine fibroids. One of the complications of UAE is fibroid expulsion. Here, we report a case of a 45-year-old woman who underwent UAE for an intramural fibroid, which resulted in fibroid expulsion. To the best of our knowledge, there are only few reports of expulsion of intramural fibroids. The process of fibroid protrusion from the myometrium into the uterine cavity was depicted on magnetic resonance imaging (MRI) in this case. We discuss the risk factors and mechanisms of fibroid expulsion after UAE.
Leclercia adecarboxylata Bacteremia in a Patient with Ulcerative Colitis
Authors: Amir Kashani, Morteza Chitsazan, Kendrick Che, Roger C Garrison
Journal: Case Rep Gastrointest Med (2014)

Patients with inflammatory bowel disease (IBD) are a high risk population for bacteremia. Derangement in the mucosal architecture of the gastrointestinal (GI) tract and frequent endoscopic interventions in immunocompromised individuals are considered primary causes. Isolation of opportunistic microorganisms from the bloodstream of IBD patients has been increasingly reported in recent years. Leclercia adecarboxylata is a ubiquitous, aerobic, motile, gram-negative bacillus. The human GI tract is known to harbor this rarely pathogenic microorganism. There are only a few case reports of bacteremia with this microorganism; the majority are either polymicrobial or associated with immunocompromised patients. We describe a case of monomicrobial L. adecarboxylata bacteremia in a 43-year-old female who presented with bloody diarrhea. Colonoscopy revealed diffuse colonic mucosal inflammation with numerous ulcers, and histopathology revealed crypt abscesses. Following an episode of rectal bleeding, two sets of blood cultures grew L. adecarboxylata, which was treated with intravenous ceftriaxone. After a complicated hospital course, she was eventually diagnosed with ulcerative colitis and enteropathic arthritis, treated with intravenous methylprednisolone, mesalamine, and infliximab which resulted in resolution of her symptoms. In our previously immunocompetent patient, derangement of the gut mucosal barrier was the likely cause of bacteremia, yet performing endoscopic intervention may have contributed to bacterial translocation.
A Case of Castleman's Disease during the Long-Term Course of Membranous Nephropathy
Authors: Shuhei Nakajima, Kei Nagai, Akiko Sakata, Joichi Usui, Kunihiro Yamagata, Atsushi Ueda
Journal: Case Rep Nephrol (2023)
MeSH terms: Case Reports

Concomitant with nephrotic syndrome and multicentric castleman's disease (MCD) has only been described in a limited number of small studies and case reports. Among those, none confirmed the renal pathology prior to the onset of MCD, and none of the cases had a history of nephrotic syndrome. A 76 year-old Japanese man visited a nephrologist because of incident nephrotic syndrome. He had previously experienced three episodes of nephrotic syndrome, the last one 13 years ago, and had been diagnosed with membranous nephropathy by renal biopsy. Apart from these previous episodes, he also suffered from systemic lymphadenopathy, anemia, elevated C-reactive protein, polyclonal hypergammopathy, and elevated interleukin (IL)-6. An inguinal lymph node biopsy revealed CD138-positive plasma cells in the interfollicular region. Based on these findings, MCD was diagnosed. Renal biopsy indicated primary membranous nephropathy with spike lesions and bubbling in the basement membranes and deposition of immunoglobulin (Ig) G, IgA, IgM, and phospholipase A2 receptor along the glomerular basement membrane. Corticosteroid monotherapy successfully reduced the edema, proteinuria, and IL-6, but hypoalbuminemia was not sufficiently improved due to castleman's disease and remission of the nephrotic syndrome was not achieved. Later, tocilizumab was administered for remission induction in another facility. To the best of our knowledge, this represents the first report of Castleman's disease with previously diagnosed membranous nephropathy. This case does not provide a causal mechanism for the pathophysiology, but it may be worth suggesting possible involvement of MCD as a trigger for recurrence of membranous nephropathy.
Electromagnetic Interference from Left Ventricular Assist Device (LVAD) Inhibiting the Pacing Function of an Implantable Cardioverter-Defibrillator (ICD) Device
Authors: Sebhat Erqou, Robert L Kormos, Norman C Wang, Dennis M McNamara, Raveen Bazaz
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

There is an increasing prevalence of patients with concomitant implantable cardioverter-defibrillators (ICDs) and left ventricular devices (LVADs). The potential for negative interactions between these continually evolving technologies is a valid concern. Previously reported interactions include inappropriate ICD therapy and interference with ICD telemetry function. Understanding the nature of such interactions and developing a comprehensive strategy to approach such situations are important. In this report, we describe a case of electromagnetic interference from LVAD inhibiting the pacing function of an ICD that was corrected by reprograming the device. We would encourage investigators to review patients with ICD and LVAD in their institutions in order to help assess the frequency and nature of these and other interactions.
Acute Severe Calculous Cholecystitis with Multiorgan Failure Complicated by Scrub Typhus
Authors: Suman Acharya, Jayant Kumar Yadav, Nischal Khanal, Raju Bhandari, Bikal Ghimire
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Scrub typhus is a febrile illness and can present with manifestations ranging from subclinical symptoms to multiorgan failure and death. Scrub typhus is a rare etiology of acute cholecystitis. A patient presenting with the features of acute cholecystitis who does not respond to standard treatment should be screened for scrub typhus in a typhus endemic region. We report a case of a 70-year-old female with acute severe calculous cholecystitis with multiorgan failure complicated by scrub typhus. She improved remarkably after starting doxycycline for scrub typhus. Scrub typhus should be considered as a trigger in a patient presenting with cholecystitis in a typhus endemic region.
Primary carcinoid or sex cord-stromal tumor of the testis: A case report
Authors: Ali Emadi Torghabeh, Mahmood Dolati, Masoumeh Gharib, Hamidreza Saghafi, Mohammadreza Saghafi
Journal: Caspian J Intern Med (2023)
Keywords: neuroendocrine tumor, sertoli, sex cord-stromal tumor of the testis, testicular cancer leydig, testicular swelling, and granulosa cells
MeSH terms: Case Reports

Background:
Carcinoid tumors of the testis are rare and orchiectomy is the preferred treatment. This type of testis tumors is rare and their differentiation from sex cord-stromal tumors is difficult.
Case presentation:
A 29‑year‑old man presented with right testicular mass and underwent radical orchidectomy. Histological examination showed neuroendocrine tumor, confirmed by immunohistochemistry and electron microscopy (Ethic code: IR.MUMS.REC.1400.237).
Conclusion:
Primary testicular neuroendocrine tumor is very rare. It is crucial to submit the entire gross specimen for histopathologic examination to rule out an existing of other germ cell elements. Our patient had a well-differentiated carcinoid tumor and after two years of follow-up (every three months), there was no recurrence or metastasis.
Indocyanine-Green Fluorescence-GUIDED Liver Resection of Metastasis from Squamous Cell Carcinoma Invading the Biliary Tree
Authors: Sara Benedicenti, Sarah Molfino, Marie Sophie Alfano, Beatrice Molteni, Paola Porsio, Nazario Portolani, Gian Luca Baiocchi
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Background. The concept of fluorescence-guided navigation surgery based on indocyanine green (ICG) is a developing interest in many fields of surgical oncology. The technique seems to be promising also during hepatic resection. Case Presentation. We reported our experience of ICG-fluorescence-guided liver resection of metastasis located at VIII Couinaud's segment from colon squamous cell carcinoma of a 74-year-old male patient. Results. After laparotomy, the fluorescing tumour has been clearly identified on the liver surface. We have also identified that a large area of fluorescent parenchyma that gets from the peripheral of the lesion up to the portal pedicle such as the neoplasia would interest the right biliary tree in the form of neoplastic lymphangitis. This datum was not preoperatively known. Conclusion. Fluorescent imaging navigation liver resection could be a feasible and safe technique helpful in identifying additional characteristics of lesion. It could be a powerful tool but further studies are required.
Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas diagnosed by endoscopic ultrasound guided biopsy
Authors: Daniela Speisky, Mariano Villarroel, Félix Vigovich, Alejandro Iotti, Teresa Adriana García, Luciana Bella Quero, Mariano Bregante, Maria Teresa García de Dávila
Journal: Ecancermedicalscience (2020)
Keywords: endoscopic ultrasound, giant cell tumours, osteoclastic giant cells, pancreas, undifferentiated carcinoma
MeSH terms: Case Reports

Undifferentiated pancreatic carcinoma with osteoclast-like giant cells is a rare tumour that has been published under a wide variety of names, including pleomorphic carcinoma, giant cell carcinoma, sarcomatoid carcinoma and carcinosarcoma, among others. For these reasons and its low frequency, the reports of these tumours are scarce and frequently lead to confusion with other entities which present with giant cells. We present the case of a patient with obstructive jaundice and a mixed cystic and solid pancreatic mass, accompanied by multiple hepatic lesions. The histological study of the material obtained by endoscopic ultrasound guided biopsy demonstrated a proliferation of atypical epithelioid cells, accompanied by a spindle cell component with marked pleomorphism and numerous osteoclast-like giant cells. The epithelioid component showed positive immunostaining with cytokeratin cocktail and cytokeratin 7. The spindle cell component showed coexpression of cytokeratins and vimentin. The osteoclast-like giant cells were positive for CD68. Protein p53 was overexpressed in both epithelial and spindle cell neoplastic components, and was negative in the giant cells. These findings permitted the diagnosis of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. This case outlines the effectiveness of endoscopic ultrasound-guided biopsy and the importance of morphological and immunohistochemical examination in the diagnosis of different types of pancreatic tumours, especially when they are in advanced stages and are not suitable for surgical treatment.