OpenMed/multicare-articles huggingface dataset:
CASE REPORT Rotational Vascularized Tibiaplasty After Oncologic Resection and Major Wound Healing Problems: A Novel Technique
Authors: Cornelius Dieter Schubert, Frank J Frassica, Samer Attar, E Gene Deune
Journal: Eplasty (2013)

Objective:
To describe a novel method to reconstruct, with a vascularized rotational tibiaplasty, a complex femoral defect in an adolescent.
Methods:
After a femoral osteosarcoma resection, allograft reconstruction, and chemotherapy, an 11-year-old girl developed recurrent thigh wound infections and femoral allograft osteomyelitis despite multiple operative interventions. At the age of 13, she presented to our center with a complex right thigh wound and an unstable lower extremity secondary to a segmental femoral loss. To reestablish thigh stability and function and to avoid amputation at the hip, the authors performed a rotational vascularized tibiaplasty. The tibia was rotated 180° with the pivot at the knee. The distal tibia was internally stabilized to the residual proximal femur.
Results:
Ten years later, the patient had a stable thigh, a functional hip, no evidence of infection or sarcoma, and a Toronto Extremity Salvage Score of 92.5 (minimal disability).
Conclusions:
In this patient, the tibial rotationplasty provided a vascularized bone strut mimicking the resected femur; saved the hip; obviated an allograft bone; and created a functional, biologic, stable, and durable thigh that allowed full weight bearing on a prosthesis, with a low physical disability level. We conclude that, for patients with complex femoral defects, a vascularized rotational tibiaplasty should be considered a feasible option before amputation.
Gonorrhea vaginitis in a pediatric patient: a case report
Authors: Ayu Wulansari Bambang, Idrianti Idrus, Safruddin Amin, Muji Iswanty
Journal: Pan Afr Med J (2021)
Keywords: gonorrhea vaginitis, case report, prepubertal child
MeSH terms: Anti-Bacterial Agents / administration & dosage, Gonorrhea / diagnosis, Neisseria gonorrhoeae / isolation & purification, Vaginosis, Bacterial / diagnosis, Case Reports, Ceftriaxone / administration & dosage, Child, Preschool, Female, Gonorrhea / drug therapy, Humans, Polymerase Chain Reaction, Vaginosis, Bacterial / drug therapy, Vaginosis, Bacterial / microbiology, Anti-Bacterial Agents, Ceftriaxone

Gonorrhea is all diseases caused by Neisseria gonorrhoeae. Prepubertal child is more susceptible to N. gonorrhoeae infection because the vagina is alkaline and contains no estrogen. Gonorrhea vaginitis is the most common form of gonorrhoea in prepubertal children beyond neonatal period. Transmission in child can be through sexual contact (abuse) or non-sexual contact. Gonorrhea vaginitis in children more often asymptomatic, with clinical manifestation such as mucopurulent discharge, vaginal pruritus and vulval erythema. Supporting examination comprise of gram staining from vaginal discharge, culture and nucleic acid amplification testing (NAAT). Ceftriaxone is drug of choice gonorrhea without complication in children. We report a case of 4 year and 9-month female girl that was diagnosed by history taking and supporting examination from gram staining and polymerase chain reaction (PCR) from vaginal discharge, and then treated with single dose ceftriaxone 125 mg intramuscular that gave clinical improvement.
Post-operative ctDNA monitoring in stage I colon cancer: A case report
Authors: Stephanie L Alden, Harmeet Dhani, Charuta C Palsuledesai, Shifra Krinshpun, Adham Jurdi, Eric Christenson, Ilene Browner, Samuel Rosner
Journal: Front Oncol (2022)
Keywords: case report, circulating tumor (ctdna), colon cancer, molecular residual disease, recurrence, stage i
MeSH terms: Case Reports

Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient's imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.
Laparoscopic patch repair of recurrent anterior diaphragmatic hernia in a child with SMA
Authors: Noemi Cantone, Francesca Destro, Michele Libri, Stefania Pavia, Mario Lima
Journal: Springerplus (2014)
MeSH terms: Case Reports

An anterior congenital diaphragmatic hernia (CDH) is a diaphragmatic defect that allows the passage of abdominal organs into the thorax. It is typically asymptomatic (the diagnosis is incidental) and it requires surgical correction. In this paper we present a 6 year-old girl affected by spinal muscular atrophy (SMA) who was diagnosed with anterior CDH. Four years after laparoscopic closure of the defect by interrupted suture the girl returned for hernia recurrence. Another laparoscopic procedure was performed and the defect was closed using a GORE-TEX patch. We postulate a mechanism of altered respiratory dynamic and increased abdominal pressure related to scoliosis favouring CDH recurrence in patients with neuromuscular pathologies such as SMA. In these patients patch interposition should be considered in the first place in order to reduce tension over margins. Laparoscopy is a safe and feasible procedure for CDH correction also in case of recurrence and when the interposition of a patch is required.
CT-guided fine needle aspiration cytology diagnosis of extra-adrenal pheochromocytoma
Authors: M Rangaswamy, Sandeep P Kumar, M Asha, Gv Manjunath
Journal: J Cytol (2010)
Keywords: ct-guided fnac, paraganglia, pheochromocytoma, retroperitoneal
MeSH terms: Case Reports

Pheochromocytoma is a rare tumor, accounting for <0.1% of the hypertensive population. Extra-adrenal pheochromocytomas (EAPs) are rarer still, accounting for 10% of all pheochromocytomas. Pheochromocytomas are functional catecholamine-secreting tumors of the paraganglionic chromaffin cells found in the adrenal medulla and the extra-adrenal paraganglia cells. EAPs are readily detected by computed tomography (CT) as soft tissue masses closely associated with the entire length of the abdominal aorta. Here, we present a rare case of EAP in a 45-year-old male hypertensive patient diagnosed by CT-guided fine needle aspiration cytology. The smears showed loosely cohesive tumor cells with prominent anisokaryosis and abundant eosinophilic, granular cytoplasm. The diagnosis was later confirmed by histopathology. The present case also highlights the fact that fine needle aspiration of pheochromocytoma is not necessarily contraindicated.
Chronic cluster headache and the pituitary gland
Authors: Annelien De Pue, Bart Lutin, Koen Paemeleire
Journal: J Headache Pain (2016)
Keywords: cluster headache, pituitary gland, secondary headache
MeSH terms: Adenoma / complications, Central Nervous System Cysts / complications, Cluster Headache / etiology, Dopamine Agonists / therapeutic use, Ergolines / therapeutic use, Pituitary Gland / pathology, Pituitary Neoplasms / complications, Case Reports, Adenoma / drug therapy, Adenoma / pathology, Cabergoline, Central Nervous System Cysts / drug therapy, Central Nervous System Cysts / pathology, Cluster Headache / drug therapy, Cluster Headache / pathology, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Neoplasms / drug therapy, Pituitary Neoplasms / pathology, Sumatriptan / therapeutic use, Treatment Outcome, Verapamil / therapeutic use, Dopamine Agonists, Ergolines, Sumatriptan, Verapamil, Cabergoline

Background:
Cluster headache is classified as a primary headache by definition not caused by an underlying pathology. However, symptomatic cases of otherwise typical cluster headache have been reported.
Case presentation:
A 47-year-old male suffered from primary chronic cluster headache (CCH, ICHD-3 beta criteria fulfilled) since the age of 35 years. A magnetic resonance imaging (MRI) study of the brain in 2006 came back normal. He tried several prophylactic treatments but was never longer than 1 month without attacks. He was under chronic treatment with verapamil with only a limited effect on the attack frequency. Subcutaneous sumatriptan 6 mg injections were very effective in aborting attacks. By February 2014 the patient developed a continuous interictal pain ipsilateral to the right-sided cluster headache attacks. An indomethacin test (up to 225 mg/day orally) was negative. Because of the change in headache pattern we performed a new brain MRI, which showed a cystic structure in the pituitary gland. The differential diagnosis was between a Rathke cleft cyst and a cystic adenoma. Pituitary function tests showed an elevated serum prolactin level. A dopamine agonist (cabergoline) was started and the headache subsided completely. Potential pathophysiological mechanisms of pituitary tumor-associated headache are discussed.
Conclusion:
Neuroimaging should be considered in all patients with CCH, especially those with an atypical presentation or evolution. Response to acute treatment does not exclude a secondary form of cluster headache. There may be shared pathophysiological mechanisms of primary and secondary cluster headache.
Bone wax in the treatment of partial epiphysiodesis of distal femoral growth plate: Case report at 10-year follow-up
Authors: Luca Basiglini, Angelo Gabriele Aulisa, Diletta Bandinelli, Renato Maria Toniolo, Francesco Falciglia
Journal: Front Surg (2022)
Keywords: bone wax, case reports, epiphysiodesis, growth arrest, growth plate, long follow-up, physeal injury, polytrauma
MeSH terms: Case Reports

The growth plate is the weakest structure in the skeleton of a child and a frequent site of injury or fracture; physeal injuries represent 15%-30% of all fractures in children. Of all growth plate fractures, the incidence of growth arrest and disorders is around 15%. Here, we discuss a female patient who, at the age of 5 years, was treated for a polytrauma that involved a complex lesion of the growth plates of the knee. Four days after trauma, she underwent closed reduction surgery and internal fixation with cannulated screws for femoral and tibial fractures of the growth plate. A 20° valgus deviation of the left knee was found at 3-month postoperative clinical check-up likely as a result of a growth disorder of the femur. She was diagnosed with valgus knee secondary to epiphysiodesis of the lateral portion of the femoral physis and she was readmitted to the hospital. In the operating theater, an open femoral de-epiphysiodesis was performed with a burr; the drilled hole was then filled with bone wax. At 20-month post-trauma follow-up, the left knee was still valgus about 20° relative to the other side. During follow-up, a slow but progressive improvement in the axis of the lower limbs was noted. Clinical and radiographic control 10 years after the trauma showed a complete recovery of the axis of the lower limbs. In the initial stages, the presence of bone wax in the area of de-epiphysiodesis allowed for stabilization of the deformity on the 20° of preoperative valgus. The interpretation of the growth cartilage activity occurred in an asymmetrical way such as to realign the femoral load axis, it can be based on the different mechanical stimulus on the two knee areas due to the preexisting deformity. There is no unanimous evidence in the literature in terms of management of growth disorders resulting from this type of injury. Bone wax resulted in effectively filling the hole of de-epiphysiodesis in the distal femoral growth plate and allowed us to obtain the response of the growth plate and to improve the recovery time in young children.