OpenMed/multicare-articles huggingface dataset:
Late-Onset Isolated Corticotrope Deficiency in a Woman with Down Syndrome
Authors: Ibtissem Oueslati, Marwa Ben Jemaa, Meriem Yazidi, Fatma Chaker, Melika Chihaoui
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Isolated corticotrope deficiency is a rare cause of secondary adrenocortical insufficiency. Its occurrence in patients with Down syndrome is exceptional. Herein, we report a case of an isolated corticotrope deficiency diagnosed at the age of 33 years in a woman with Down syndrome and discuss its possible mechanisms. A 33-year-old woman with Down syndrome was referred to our department for the investigation of low blood pressure. She complained of asthenia, dizziness, and palpitation with arterial hypotension for the past 4 years. The thyroid function was normal and anti-thyroperoxidase antibodies were negative. The peak of cortisol level in response to the insulin-induced hypoglycemia test was 9.4 μg/dl. ACTH level was normal, indicating corticotrope deficiency. Other pituitary hormones were normal. Magnetic resonance imaging scan revealed a partially empty sella turcica. Genetic analysis showed no mutations and no copy number variants of the TBX19 and NFKB2 genes. The mechanism of isolated corticotrope deficiency is unclear, but it may be induced by autoimmune mechanism in similar to other disorders of patients with Down syndrome.
Management of a giant perineal condylomata acuminata
Authors: Evelyn Hemper, Mathias Wittau, Johannes Lemke, Marko Kornmann, Doris Henne-Bruns
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2016)
Keywords: condylomata acuminata, human papillomaviridae
MeSH terms: Case Reports

A condylomata acuminata infection is caused by human papillomaviridae (HPV). This sexually transmitted condition most often affects the perineal region. Importantly, infections with types 16 and 18 are associated with an increased risk for anal and cervix cancer. In most cases topical therapy is sufficient for successfully treating condylomata acuminata. Here, we report the case of a 51-year old patient who suffered from a giant perianal located condylomata acuminata which had developed over a period of more than 10 years. Imaging by MRI revealed a possible infiltration of the musculus sphincter ani externus. Because a topical treatment or a radiotherapy was considered unfeasible, a surgical treatment was the only therapeutic option in this unusual case. First, a colostomy was performed and subsequently a resection of the tumor in toto with circular resection of the external portion of the musculus sphincter ani externus was performed. The large skin defect was closed by two gluteus flaps. The rectum wall was reinserted in the remnant of the musculus sphincter ani externus. Postoperatively, parts of the flaps developed necrosis. Therefore, a vacuum sealing therapy was initiated. Subsequently, the remaining skin defects were closed by autologous skin transplantation. Six months later the colostomy could be reversed. To date, one year after first surgery, the patient has still a normal sphincter function and no recurrence of the condylomata acuminata. This case report demonstrates how giant condylomata acuminata can be successfully treated by extended surgical procedures including colostomy and plastic reconstruction of resulting defects upon resection.
Anaplastic large cell lymphoma associated with breast implant: a case report
Authors: Afsaneh Rajabiani, Hosein Arab, Abolhasan Emami, Ali Manafi, Navid Bazzaz, Hiva Saffar
Journal: World J Plast Surg (2012)
Keywords: anaplastic large cell lymphoma, anaplastic lymphoma kinase, silicone breast implant
MeSH terms: Case Reports

Primary breast lymphoma represents less than 1% of all primary breast malignancies and most primary breast lymphomas are of B-Cell origin. The association of anaplastic lymphoma kinase (ALK) negative anaplastic large cell lymphoma (ALCL), a very rare form of primary breast lymphoma, with silicone-filled breast implants has been suggested and several case reports supported this proposal, especially in Western countries. Here we describe one of the first cases of primary breast ALK-negative ALCL in association with saline-filled silicone breast implants evaluated in Iran, where the rising number of breast reconstructive and aesthetic surgeries would commit both surgical pathologists and plastic surgeons to be familiar with this entity.
Rare gastric inflammatory myofibroblastic tumor in an adult woman: a case report with review of the literature
Authors: Maxwel Capsy Boga Ribeiro, Luiz Roberto Lopes, João Coelho de Souza Neto, Luciana Rodrigues Meirelles, Rita Barbosa de Carvalho, Nelson Adami Andreollo
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 37-year-old woman with a gastric IMT. She presented epigastric pain since 2 months, anemia and weight loss associated. Physical examination showed cutaneous pallor and mild abdominal tenderness in the epigastrium. Abdominal ultrasonography showed a tumor near the pancreas and the CT scan revealed that the lesion was arising from the stomach. Upper endoscopy showed a submucosal lesion of approximately 7.5 cm located in the posterior wall of the gastric body such as a gastrointestinal stromal tumor (GIST). The patient underwent a subtotal gastrectomy and Billroth I reconstruction. The histopathological and immunohistochemical analysis revealed an IMT that originated from the gastric wall.
Ovarian lymphoma
Authors: Julian A Crasta, Elizabeth Vallikad
Journal: Indian J Med Paediatr Oncol (2009)
Keywords: ovary, lymphoma
MeSH terms: Case Reports

The involvement of the ovary in lymphomatous processes is rare. Such an involvement can occur in 2 ways, either primary or secondary, which usually presents with abdominal or pelvic complaints. We present a case of secondary involvement of the ovary with occult extra-ovarian nodal disease and discuss the histogenesis of ovarian lymphomas with criteria for diagnosis and differential diagnosis.
NTRK1-related Hereditary Sensory and Autonomic Neuropathy Type 4: The Role of the Histamine Challenge Test
Authors: Amytice Mirchi, Julie Richer, Maryam Oskoui, Hugh J McMillan
Journal: Child Neurol Open (2022)
Keywords: ntrk1 protein, congenital insensitivity to pain with anhidrosis, hereditary sensory and autonomic neuropathy type 4, histamine phosphate, human, intradermal tests, small fiber neuropathy
MeSH terms: Case Reports

Hereditary sensory and autonomic neuropathies (HSAN) are rare, genetically inherited disorders characterized by impaired unmyelinated nerve fiber function. Here we report a patient with self-mutilation behavior and decreased response to pain, suggestive of an underlying small fiber neuropathy. Nerve conduction studies were normal but sympathetic skin response was absent at the left arm. Intradermal histamine challenge test was performed to evaluate the function of small unmyelinated nerve fibers and revealed absence of a flare response. Using whole genome sequencing, a novel variant in the neurotrophic tyrosine kinase type 1 gene was identified, expanding the known disease-causing variants associated with HSAN type 4. Through this case, we demonstrate the role of the histamine challenge test in patients suspected to have a small fiber neuropathy where electrophysiological testing may be normal and who may present with non-specific symptoms including hypotonia and failure to thrive. The information gained can guide genetic testing and contribute to interpretation of new variants identified.
Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenomation
Authors: Joshua Strommen, Farshad Shirazi
Journal: Case Rep Emerg Med (2015)

The authors present a case report of a 17-month-old female child who ingested a large amount of methamphetamine that looked very similar clinically to a scorpion envenomation specific to the southwestern United States by the species Centruroides sculpturatus. The child was initially treated with 3 vials of antivenom specific for that scorpion species and showed a transient, though clinically relevant neurologic improvement. Her clinical course of sympathomimetic toxicity resumed and she was treated with intravenous fluids and benzodiazepines after blood analysis showed significant levels of d-methamphetamine. This case report is to specifically underline the clinical confusion in discerning between these two conditions and the realization of limited and/or expensive resources that may be used in the process.
Unusually isolated Staphylococcus arlettae in intra-oral sutures - Case series
Authors: Radhika Sunil Kherdekar, Ashutosh Dixit, Ashish Kothari, Kamal Prasad Pandey, Hoshang Advani, Amit Gaurav, Balram Ji Omar
Journal: Access Microbiol (2023)
Keywords: staphylococcus arlettae, intra-oral sutures, periodontal, scanning electron microscopy, surgical site infection
MeSH terms: Case Reports

Introduction:
The human oral cavity comprises various niches such as teeth, gingiva, tongue, soft and hard palate, and various dental prostheses, all inhabited by different bacterial species. Although more than 600 taxa belong to the oral cavity, identifying Staphylococcus arlettae , an incompletely understood bacterium, has been rare.
Methods:
Three patients who underwent periodontal flap surgeries were reported with the incidental finding of S. arlettae associated with the intra-oral sutures placed. Environmental sampling was performed, to establish the exact source of this bacterium.
Results:

Staphylococcus arlettae was isolated in three patients' intra-oral sutures. All environmental samples were negative for the presence of the bacterium.
Conclusion:
. To this date, no studies have identified such an occurrence of Staphylococcus arlettae with intra-oral sutures. Its identification in association with foreign materials, such as sutures, can be considered a potential for surgical site infections and requires further investigation.
Nutritional vulnerability: An assessment of the 2010 feeding food programme in Mbire district, Zimbabwe, and its impact on pregnant women
Authors: Alice Ncube, Olivia Kunguma, Moddie Nyahwo, Stella Manombe
Journal: Jamba (2017)

Malnutrition contributes significantly to Zimbabwe's high maternal mortality rate. The prevalence of malnutrition among vulnerable pregnant women in the Mbire district of Zimbabwe was studied to establish why they remained vulnerable despite benefiting from the Vulnerable Group Feeding Programme, a subsidiary of the World Food Programme. A case study on the demographic characteristics, nutritional provision of the programme and the vulnerable pregnant women benefiting from the programme was conducted. One hundred women were purposively sampled at health centres in the district. A two-stage sampling procedure was then utilised to select the most food-insecure wards. The two most food-insecure wards, namely Angwa and Chapoto, were chosen because of their proximity to each other. A questionnaire was administered to the pregnant women to collect their demographic information. Practising nurses at the health centres determined the women's nutritional status and anthropometrics, and they also assessed the food baskets. Permission to conduct the study was obtained from the relevant authorities. The results indicated that the food hamper provided by the World Food Programme was complementary food aid given to all vulnerable members of the community regardless of the nutritional demands. The supplements that the pregnant women received were also inadequate to cater for their nutritional needs or those of the foetuses. It was therefore recommended that the government, through the Ministry of Health, should make more provisions available for vulnerable pregnant women in order to reduce the risks facing pregnant women in the country.
Use of a Free Vascularized Medial Femoral Condyle Flap for Revision Surgery in a Pediatric Patient with Congenital Pseudarthrosis of the Clavicle
Authors: Atsuro Murai, Kaoru Tada, Mika Nakada, Masashi Matsuta, Katsuhiro Hayashi, Hiroyuki Tsuchiya
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

The most common surgical treatment for congenital pseudarthrosis of the clavicle (CPC) is resection of the pseudarthrosis, placement of an autologous bone graft, and Kirschner wire or plate fixation. However, in some cases, bone fusion cannot be achieved at the first surgery, and an additional surgery is required. We present a case report of a boy with a right CPC who failed radiographic bone union after the first surgery. He subsequently underwent revision surgery with resection of the pseudarthrosis, plate fixation, and establishment of a vascularized medial femoral condyle (MFC) flap to ensure bone union. Three months after the revision surgery, a radiographic bone union was achieved, and no symptoms were observed for one year after the operation. There have been no previous reports of the use of a vascularized MFC flap as a treatment for CPC. We believe that this technique effectively ensures bone union during revision surgery for CPC.
Surgical Treatment of Idiopathic Enlargement of the Right Atrium
Authors: Francesca Chiara Surace, Federica Iezzi, Massimo Colaneri, Marco Pozzi
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Idiopathic enlargement of the right atrium (IERA) is a very rare abnormality. Approximately one-half (48%) of the patients with a congenital enlargement of the right atrium have no symptoms. When they occur, symptoms include shortness of breath (28% of cases), palpitations (17%), arrhythmias (12%), and in rare cases, right heart failure and extreme tiredness. We report one such case of a young man with a disproportionally enlarged right atrium. The basal transthoracic echocardiogram demonstrated a huge right atrium with a thick smoke pattern and mild tricuspid regurgitation in the absence of congenital heart disease. Magnetic resonance imaging confirmed the right atriomegaly, with initial compression of the right ventricle, and excluded congenital heart defects or absence of pericardium. The patient underwent surgical resection of the right atrial wall and the atriotomy was closed, leaving an atrial chamber of normal consistency and size. The resected atrium had normal and homogeneous wall thickness without significant fibrosis which confirmed the diagnosis of an idiopathic enlargement of the right atrium.
Uveal coloboma: about 3 cases at the University Teaching Hospital, Yaounde, Cameroon
Authors: Kagmeni Giles, Cheuteu Raoul, Bilong Yannick, Wiedemann Peter
Journal: Pan Afr Med J (2016)
Keywords: uveal coloboma, congenital eye malformation, retinal detechment
MeSH terms: Coloboma / diagnosis, Retinal Detachment / prevention & control, Uvea / abnormalities, Case Reports, Adolescent, Cameroon, Child, Coloboma / complications, Coloboma / pathology, Female, Hospitals, University, Humans, Middle Aged, Retinal Detachment / etiology

Uveal coloboma is a rare eye malformation caused by failure of the optic fissure to close during the fifth to seventh weeks of foetal life. The risk of retinal detachment increases with age in colobomatous eyes. Preventive measures such as early detection of the retinal break, prophylactic laser photocoagulation along the coloboma margin, confer a significant benefit in reducing this risk of retinal detachment. Difficulties linked to the diagnosis and management of uveal colobomas in developing countries setting are presented in this study.
Sarcoidosis with heart involvement: a rare association of terrible prognosis, a report of two cases
Authors: Asma Kefi, Nadia Ben Abdelhafidh, Sameh Sayhi, Rim Abid, Faida Ajili, Janet Laabidi, Salah Othmani
Journal: Pan Afr Med J (2015)
Keywords: cardiac sarcoidosis, sarcoidosis, ventricular arrhythmias
MeSH terms: Heart Diseases / etiology, Sarcoidosis / complications, Case Reports, Adult, Female, Heart Diseases / physiopathology, Humans, Middle Aged, Prognosis, Sarcoidosis / physiopathology

Sarcoidosis is a multisystemic disorder of unknown etiology which is characterized by the formation of non-caseating granulomas in involved tissues. Cardiac involvement is one of the least common manifestations and it can occur at any point of time during the course of sarcoidosis. Here we present the case of 2 patients with known sarcoidosis who develop cardiac abnormalities in the absence of known primary cardiac cause. In our report, we would like to draw attention to the importance of considering heart involvement in any case with systemic sarcoidosis especially in young age.
Evolution of visual art with dopaminergic therapy
Authors: Ruth H Walker
Journal: J Clin Mov Disord (2016)
Keywords: art, attention, dopamine, parkinson’s disease
MeSH terms: Case Reports

A patient with right-side-predominant Parkinson's disease presented visual artwork which improved in resemblance to the model which he was copying with increasing doses of levodopa. I propose that increased dopaminergic replacement resulted in improved attention to detail, mediated by circuitry in the left hemisphere.
Prenatal Diagnosis of Isolated Agnathia-Otocephaly: A Case Report and Review of the Literature
Authors: Kazuhiro Kajiwara, Tomohiro Tanemoto, Chie Nagata, Aikou Okamoto
Journal: Case Rep Obstet Gynecol (2016)

Agnathia is a rare disease characterized by the absence of a mandible. Few cases of prenatally diagnosed isolated agnathia have been reported. We present a case report and review of the literature of prenatally diagnosed agnathia. A 38-year-old woman (gravida 0, para 0) was referred to our hospital at 28 weeks and 3 days of gestation for fetal evaluation because of polyhydramnios and suspected facial anomalies. Three-dimensional ultrasonography and MRI indicated agnathia. Premature rupture of the membranes occurred before the parents could reach a decision on the postnatal treatment. We performed emergency cesarean section on the second day of the 33rd week of gestation. The neonate was deemed nonresuscitable and he died of airway obstruction shortly after birth. Because agnathia is associated with very poor prognosis, accurate prenatal diagnosis and detailed counseling should be promptly provided before unexpected delivery to the parents for the determination of postnatal treatment.
Nasogastric Tube Feeding-Induced Esophageal Bezoar: Case Description
Authors: Jad A Degheili, Mikhael G Sebaaly, Ali H Hallal
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Background. Bezoars are well established entities causing gastrointestinal obstructions. Depending on the prominent constituent of these bezoars, the latter are divided into four subtypes: pharmacobezoars, lactobezoars, trichobezoars, and phytobezoars. Less frequently reported types of bezoars are reported including those formed secondary to nasogastric tube feeding with casein-based formulas. Case Presentation. A 69-year-old male presented following cardiac arrest postmyocardial infarction. Patient sustained anoxic brain injury after resuscitation, rendering him ventilator dependant along with nasogastric tube feeding, initially. Dislodging of the nasogastric tube at one time rendered it difficult to reinsert it, with investigation showing the presence of calcified material within the distal oesophagus, mainly composed of casein-based products secondary to enteral feeding. Conclusion. Bezoars are well known to cause gastrointestinal obstructions due to their indigestible characteristics within the alimentary tract. More rare causes of bezoars include those formed from casein-based feeding formulas administered to patients with sustained enteral feeding. Esophageal obstruction, secondary to casein-based bezoars, occurs due to multiple risk factors, especially in those necessitating intensive care. Approach in such scenarios requires a multiteam approach.
Interference with pulse oximetry by the Stealth Station™ Image Guidance System
Authors: Junichi Saito, Masato Kitayama, Ryutaro Kato, Kazuyoshi Hirota
Journal: JA Clin Rep (2017)
Keywords: a pulse oximetry, neuro-navigation system, the infrared light

Background:
A pulse oximeter is one of the most important monitors to save patients undergoing anesthesia and monitored sedation. The authors report a case of orthopedic surgery, in which interference of pulse oximetry occurred when using a Stealth Station™ navigation system (Medtronic Sofamor Danek, Memphis, TN). Applying a black plastic shield (Masimo Ambient Shield: Masimo Corporation, Irvine, CA) completely eliminated the interference.
Case presentation:
A 37-year-old male patient with a giant cell tumor of the left femur was scheduled to undergo curettage of the femur using an intraoperative CT three-dimensional imaging system (O-arm™) and Stealth Station™ navigation system. During the surgery, the SpO2 value, which was maintained between 97 and 99% until the time, disappeared suddenly with abnormal pulse wave. Because a distortion in the SpO2 value was reproduced by repeated movement of cameras on the head of the Stealth Station™ navigation system, we recognized that the interference signal was coming from the navigation system. To eliminate the infrared light, the pulse oximetry probe was covered with a black plastic shield and the interference was completely eliminated.
Conclusions:
The Stealth Station™ navigation system was found to interfere with the SpO2 value, and a black plastic shield was useful for eliminating the interfering signal. Anesthesiologists should understand the risk of interference by the neuro-navigation system and know how to solve the problem.
Retroperitoneal Cystic Nodal Metastasis of Renal Cell Carcinoma
Authors: Takahisa Yamashita, Makoto Morozumi, Morihiro Higashi, Shuji Momose, Jun-Ichi Tamaru
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Cystic nodal metastasis of renal cell carcinoma is very rare. The pathogenesis of cystic nodal metastasis is thought to involve obstruction of a lymphoid vessel draining the kidney by tumor cells and retrograde metastasis from the primary site to the lymph node along the lymphatic vessels. In this study, a surgical case of small renal cell carcinoma with retroperitoneal cystic nodal metastasis is reported.
Gastric Xanthoma: A Rare Case Report
Authors: Pummi Kumari, Ruchi Sinha, Nisha Khanna, Tanmoy Maji
Journal: Iran J Pathol (2023)
Keywords: altered lipid profile, stomach, xanthoma
MeSH terms: Case Reports

Xanthomas are characterized by the presence of foamy lipid-laden macrophages. The gastrointestinal tract is an uncommon site for xanthoma, with the stomach being the most favored location. They have been associated with various premalignant and malignant conditions of the stomach. We present a case of a 21-year-old female patient with dyspepsia of 4 months duration. Her lipid profile was mildly altered. On upper gastrointestinal endoscopy, multiple discrete yellow patches were found in the antrum, diagnosed as gastric xanthoma on microscopy. Various published literature has emphasized the frequent association of gastric xanthomas with gastritis, gastric atrophy, intestinal metaplasia, and gastric cancer. Hence, there is a necessity for early recognition, treatment of any coexistent pathology, and close clinical follow-up.
Case Report: DSM-5 misses an edge case in tic disorders nosology
Authors: Kevin J Black
Journal: F1000Res (2020)
Keywords: dsm-5, tourette syndrome, case report, nosology, tic disorders
MeSH terms: Diagnostic and Statistical Manual of Mental Disorders, Tic Disorders / diagnosis, Tics / diagnosis, Tourette Syndrome / diagnosis, Case Reports, Research Support, N.I.H., Extramural, Child, Humans, Male

A boy with multiple phonic tics, one lifetime motor tic, and no impairment or marked distress does not meet criteria for any DSM-5 tic disorder diagnosis. The next version of the Diagnostic and Statistical Manual should adjust the criteria for Tourette's Disorder and/or for "other specified tic disorder" and "unspecified tic disorder."