OpenMed/multicare-articles huggingface dataset:
Surgical Management of Unilateral Soft Tissue Swelling around the Proximal Interphalangeal Joint in an Adolescent: A Case Report of Pachydermodactyly
Authors: Naoki Kato, Mamoru Niitsu, Tetsuya Kawabe, Eiichi Arai, Keizo Fukumoto
Journal: Case Rep Orthop (2015)

Pachydermodactyly (PDD) is a rare and benign acquired form of digital fibromatosis, characterized by asymptomatic fusiform soft tissue hypertrophy of the lateral aspect of the proximal interphalangeal (PIP) joints of the fingers. The etiology of PDD remains unknown, but it usually affects healthy males around the age of puberty. It can be misdiagnosed as inflammatory rheumatic diseases, especially as juvenile chronic arthritis. Here, we report a case of PDD in an 18-year-old man who had progressive fusiform swelling of the PIP joint on his left middle finger. Although he had no pain or functional limitation of movement, he chose to undergo surgical resection of the lesion to obtain a conclusive diagnosis and to rectify the deformity's appearance. Histologically, the lesion was characterized by coarse fibrosis in the adipose tissue, peripheral nerve fibers, and eccrine glands; this is compatible with a diagnosis of PDD.
Multimodality management of leiomyosarcoma of the cervix
Authors: Vijaya Kumar Jayaram, J Parikshith, Geeta Sowmya Narayanan, Richa Tiwari, R Veena, S Prathima, M S Ganesh, Chattakonda Sai Snehith, Esther Praisy
Journal: Ecancermedicalscience (2018)
Keywords: leiomyosarcoma, multimodality management, young age
MeSH terms: Case Reports

We present the case of a young female patient who presented to the outpatient department with a history of bleeding per vagina, diagnosed with leiomyosarcoma of the cervix; the patient underwent total abdominal hysterectomy with pelvic lymph node dissection. In this article, we mainly discuss multimodality therapy in the management of an unusual variety of tumour in the uterine cervix.
Rapidly progressive necrotizing pneumonia: remember the Streptococcus anginosus group!
Authors: Biplab Kumar Saha
Journal: Pan Afr Med J (2020)
Keywords: necrotizing pneumonia, streptococcus anginosus group, lung abscess, pyopneumothorax
MeSH terms: Pneumonia, Bacterial / diagnosis, Pneumonia, Necrotizing / diagnosis, Streptococcal Infections / diagnosis, Streptococcus anginosus / isolation & purification, Case Reports, Disease Progression, Humans, Male, Middle Aged, Pneumonia, Bacterial / microbiology, Pneumonia, Necrotizing / microbiology, Streptococcal Infections / microbiology

Acute necrotizing pneumonia in an immunocompetent host is uncommon and usually caused by Staphylococcus aureus infection. Streptococcus anginosus group (SAG) is a less recognized cause of rapidly destructive lung infection resulting in significant patient morbidity and mortality. Unlike many other bacterial infections, SAG can cross fascial planes and cause fulminant infections. Necrotizing pneumonia and lung abscesses due to SAG often fails conservative therapy with antimicrobials and requires definitive surgical intervention. Consideration of SAG as a potential etiology might help to institute definitive therapy earlier and prevent complications.
Sinus Bradycardia in an Adolescent Taking Lamotrigine
Authors: Genevieve Davis, Kristen Ward, Sarah Mohiuddin
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Lamotrigine is commonly prescribed for the treatment of neurological conditions and is increasingly being prescribed for psychiatric conditions as well. Although largely well tolerated, it is known to have a number of potential side effects, and in March 2021, the FDA issued its most recent warning for the medication due to its increased risk of cardiac arrhythmias. In this report, we describe a case in which an adolescent patient was found to be bradycardic after starting lamotrigine for antidepressant augmentation, with a gradual return to normal heart rate as the medication was subsequently tapered and discontinued. Further research is needed to more accurately estimate the risk of cardiac side effects and to establish appropriate monitoring guidelines for cardiac arrhythmias in those taking lamotrigine.
Importance of Both Internal and External Iliac Artery Interrogation in Pelvic Trauma as Evidenced by Hemorrhage from Bilateral Corona Mortis with Unilateral Aberrant Origin off the External Iliac Artery
Authors: Michael Herskowitz, James Walsh, Meghan Lilly, Kimberly McFarland
Journal: Case Rep Radiol (2019)
MeSH terms: Case Reports

Transcatheter angiography and embolization has long been recognized as the gold standard for patients with hemodynamic instability secondary to blunt pelvic trauma. While often the bleeding source can be readily localized based on the distribution of extravasation on preprocedural Computed Tomographic Angiography, one should be cautious in assessment for aberrant anatomy. A variant obturator artery originating from the inferior epigastric branch of the external iliac artery is commonly referred to as the corona mortis. We present a case of blunt pelvic trauma in which a patient demonstrated extravasation in the anterior distributions of both internal iliac arteries. Following embolization of bilateral internal iliac arteries, identification and embolization of bilateral corona mortis branches was crucial to achieving hemodynamic stability in this patient.
Primary Gastrointestinal Involvement in a Case of Extranodal-Extranasal Natural Killer T Cell Lymphoma
Authors: Somayeh Lookzadeh, Mihan Pourabdollah Toutkaboni, Hamidreza Jamaati, Mitra Rezaei, Mehran Marashian
Journal: Tanaffos (2020)
Keywords: extranasal, extranodal, lymphoma, natural killer cell, t cell
MeSH terms: Case Reports

Extra-nasal types of Extra-nodal natural killer cell lymphoma (ENKL) have been known with poorer prognoses than nasal type with the worst responses to treatment. The current work introduces a case of ENKL with GI involvement with no nasal manifestations. We report a 56-year male farmer with fever, productive cough, dyspnea, anorexia, vomiting and chill in addition to malaise and cachexia of three months duration referred to a hospital with acute abdominal pain, and was diagnosed as peritonitis due to perforated terminal ileum ulcer before experiencing surgery as a case of acute abdomen. The pathologic study of the relevant biopsy showed "ulceration and necrosis with dense fibrinoleukocytic exudation and granulation tissue formation. CT scan determined a bilateral mass like haziness which was more likely to be metastatic. The review of the previous pathologic specimens raised Natural Killer/T cell Lymphoma (NKTL), the reason for which we focused on the patient's sinuses and nasal area as well as nasopharynx. There was no finding in examination and endoscopy of sinuses. Pathology also found malignant high grade non-Hodgkin T cell lymphoma in specimens obtained from debridement of ulcer at terminal ileum. It also showed that most of the tumor cells were positive for CD3, CD56, CD8, and LCA but negative for CD19, CD20 and AE1/AE3. Positive reactions for CD30 were shown by some cells. CD56, CD3, and CD8 were expressed by neoplastic cells and CD30 were positive in few cells. Proliferative activity (Ki67 index) was high (60-70%). This was the main base to diagnose an extra-nodal extra-nasal NK/T cell lymphoma. In conclusion, Intestinal changes at middle age, especially in men with nonspecific clinical manifestations is highly advised to be studied pathologically and genetically for T cell types like CD30 positive T cells which are usually engaged in ENKTL.
A neovascularized left atrial mass
Authors: Rania Hammami, Leila Abid, Souad Mallek, Ilyes Kharrat, Mariem Ellouz, Mourad Hentati, Imed Frikha, Samir Kammoun
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Background. The discovery of a large left atrial mass through echocardiography obliges the clinician to perform a differential diagnosis to distinguish tumor from thrombus. The neovascularization of the mass could be helpful to predict the type of the malformation and whether it is in favour of a vacular tumour rather than a thrombus . Observation. A 43-years-old man who had no cardiac antecedent reported that he have had dyspnea and palpitation since 10 months. The cardiac auscultation, revealed an irregular rhythm with diastolic murmur at the apex. The electrocardiogram showed an atrial fibrillation. The transthoracic echocardiography revealed a severe mitral stenosis with a huge left atrial mass, confirmed through transesophageal echocardiography. After 4 weeks of an efficient anticoagulant treatment, the mass was still persistent in the echocardiography. So we decided to resect the mass and to achieve a mitral valve replacement. The preoperative coronarography showed neovascularization among the mass and fistula from the circumflex artery. Considering the characteristic of the mass (neovascularization and resistance to anticoagulant), we strongly suspected a vascular tumor especially myxoma, but the histological exam revealed an organized thrombus. Conclusion. Coronary neovascularization is a specific sign for left atrial thrombus in mitral stenosis, but surgery is the best way to confirm diagnosis.
Case Report: Transoral Endoscopic Thyroidectomy via Vestibular Approach in Pediatric Thyroid Cancer
Authors: Duy Q Ngo, Duong T Le, Giap N Hoang, Quy X Ngo, Quang V Le
Journal: Front Pediatr (2021)
Keywords: toetva, pediatric thyroid cancer, thyroid cancer in children, transoral approach, transoral thyroidectomy
MeSH terms: Case Reports

Background: Transoral endoscopic thyroidectomy via vestibular approach (TOETVA) is a new technique that has become more popular worldwide because of its many advantages. However, this novel approach for thyroid cancer treatment in children is highly challenging, even for high-volume surgeons. In our study, we report our experiences with TOETVA for pediatric patients with thyroid cancer. Patients and Methods: This study included four pediatric patients who underwent TOETVA performed by a single surgeon between June and December 2020. Patient demographics and surgical outcomes including operative time, incidence of complications, and length of hospital stay were evaluated. Results: Four patients successfully underwent TOETVA with no complications. All patients were girls, aged from 13 to 18. Three patients underwent lobectomy and isthmusectomy, plus prophylactic unilateral central neck dissection. One patient had a total thyroidectomy, plus prophylactic bilateral central neck dissection. The mean operative time was 85 min for the lobectomy and 120 min for total thyroidectomy plus central neck dissection. The median hospital stay was 4.1 days. No drains were used. The histological examination showed four cases of malignant disease (papillary thyroid carcinoma). The mean number of harvested lymph nodes was 4.2 (ranged 3 to 8). Conclusion: In the hands of a high-volume surgeon, TOETVA is a novel, feasible, and safe approach for treating selected pediatric patients with thyroid cancer.
An unusual case of serotonin syndrome with oxycodone and citalopram
Authors: Clare Walter, David Ball, Mary Duffy, James D Mellor
Journal: Case Rep Oncol Med (2012)
MeSH terms: Case Reports

A 77-year-old female with recurrent non-small-cell lung cancer presented to a hospital outpatient clinic with tremor, weakness, inability to coordinate motor movements, and confusion. It was suspected that the symptoms were due to possible central nervous system metastases; however, a CT scan of her head was unremarkable. The lung clinic liaison pharmacist took a medication history from the patient, complimented by extra information from the patient's community pharmacy. The pharmacist suspected the rare side effect of serotonin syndrome was responsible for the patient's presenting symptoms caused by the combination of oxycodone and citalopram. The patient's symptoms resolved soon after oxycodone was changed to morphine.
Endoscopic detection of the gastric lesions of peripheral T-cell lymphoma
Authors: Masaya Iwamuro, Kosuke Kimura, Eisei Kondo, Takahiro Nada, Eri Nakamura, Katsuyoshi Takata, Takehiro Tanaka, Fumio Otsuka, Tadashi Yoshino, Hiroyuki Okada
Journal: Ecancermedicalscience (2016)
Keywords: gastric neoplasms, gastrointestinal endoscopes, gastrointestinal lymphoma, microsurface structures, peripheral t-cell lymphoma
MeSH terms: Case Reports

An 82-year-old Japanese man presented with a gastric involvement of peripheral T-cell lymphoma, not otherwise specified. Although gastrointestinal lesions were not detected on computed tomography, oesophagogastroduodenoscopy revealed a slight elevation of the gastric mucosa, with changes in mucosal colour and the presence of abnormal microvessels. This led to the prompt detection of gastric involvement in lymphoma. This case highlights the usefulness of detailed observation of the gastric mucosa for the endoscopic detection of gastric involvement of peripheral T-cell lymphoma.
Synchronous bilateral tonsil carcinoma: case presentation and review of the literature
Authors: M-N Theodoraki, J A Veit, T K Hoffmann, J Greve
Journal: Infect Agent Cancer (2017)
Keywords: bilateral tonsillar carcinoma, bilateral tonsillectomy, cancer of unknown primary, head and neck malignancy, squamous cell carcinoma
MeSH terms: Review

Background:
The incidence of synchronous bilateral tonsil carcinoma seems to be underreported. For adequate oncologic treatment, it is mandatory to remove all primaries to prevent recurrence or metachronic disease. The purpose of this manuscript is to provide a comprehensive review on this topic and to emphasize the need of bilateral tonsillectomy in cases of cancer of unknown primary (CUP) as well as in the case of a unilateral tonsillar carcinoma.
Material and methods:
A systematic review of the literature was performed for "bilateral tonsillar neoplasm", "synchronous cancer of the oropharynx" and "cancer of unknown primary in head and neck".
Results:
We present a clinical case with bilateral tonsillar carcinoma in initially suggested cancer of unknown primary. Clinically, both tonsillar sites were unsuspicious, but in PET/CT an ipsilateral enhancement of the tonsil area was detected. The pathological work up of bilateral tonsillectomy specimens revealed bilateral squamous cell carcinoma with HPV-type 16 positivity. The review of the literature revealed 29 cases of bilateral tonsil cancer.
Conclusion:
The handling of tonsillar tissue in the frame of panendoscopy in the case of CUP is still controversial. We recommend a bilateral tonsillectomy as a routine procedure for cancer of unknown primary as well as unilateral tonsillar carcinoma. Herewith the detrimental consequences of occult metachronous contralateral tonsillar carcinoma can be prevented.
Malignant peripheral nerve sheath tumor of the nasal cavity and nasopharynx in a child: A case report
Authors: Qian Li, Hongguang Pan, Lan Li, Juan Cao
Journal: Medicine (Baltimore) (2019)
MeSH terms: Nasopharyngeal Neoplasms / pathology, Nerve Sheath Neoplasms / pathology, Nose Neoplasms / pathology, Case Reports, Child, Female, Humans, Nasal Cavity

Rationale:
Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms with only a few reported cases affecting the nasal cavity, paranasal sinuses, and anterior skull base.
Patient concerns:
A 12-year-old girl with a mass in her nose was admitted to the Department of Otorhinolaryngology of Shenzhen Children's Hospital. She had a 4-month history of progressive, unilateral right nasal obstruction, unilateral mucopurulent rhinorrhea, foul nasal odor, snoring, hyposmia, occasional epistaxis, and no headache, no facial numbness, without eye swelling and vision loss.
Diagnose:
A computed tomography (CT) scan of the paranasal sinuses showed a mass (right inflammatory polyp and calcification) involving the nasal cavity, the right maxillary sinusitis, ethmoid sinusitis. There was no nasal septum, orbital, or skull base involvement. On the basis of pathological and immunohistological findings, the tumor was diagnosed as an MPNST with heterogeneous components (cartilage and bone) mesenchymal differentiation after the operation.
Interventions:
The girl was treated by surgery and chemotherapy.
Outcomes:
The postoperative course was uneventful. There was no recurrence observed during the 3-year follow-up.
Lessons:
The primary MPNST in the nasal cavity is rare, if nasal neoplasms do not respond well to vasoconstrictors and glucocorticoids in children, the possibility of a tumor should be considered. If new organisms grow rapidly with hemorrhagic necrosis, the possibility of a malignant tumor is greater.
Thromboembolism in renal transplant artery due to atrial fibrillation
Authors: Janina Müller-Deile, Anke Schwarz, Jan Menne
Journal: Clin Nephrol Case Stud (2013)
Keywords: atrial fibrillation, kidney transplantation, thromboembolization
MeSH terms: Case Reports

Background:
Central and peripheral arterial thromboembolisms are well known complications of atrial fibrillation. We report the first case of thromboembolism in a renal transplant due to atrial fibrillation after changing anticoagulation treatment.
Case presentation:
A 79-year-old woman who had undergone kidney transplantation in 2001 presented herself with abdominal pain and oliguria. Serum creatinine had been stable (130 - 150 µmol/l) since transplantation, and, because of atrial fibrillation, the patient received oral anticoagulation treatment for many years until it was switched to aspirin 100 mg due to a cholecystectomy in 2012. Three weeks thereafter is when the patient was admitted to our unit. In a computed tomography scan of the abdomen, multiple renal infarcts were detected. The thromboembolism resulted in a complete loss of transplant function. As the patient remained anuric, the transplant was declared to be lost, immunosuppression was reduced, and renal replacement therapy was commenced over a central catheter. However, the patient died the next day.
Conclusion:
Our case highlights the fact that changing anticoagulation treatment should be performed carefully and can be detrimental. The location of thromboembolism in renal transplant artery makes this case unique and has not ever been described thus far. As renal transplantation and risk factors for thromboembolism i.e., atrial fibrillation are increasing, embolization in renal transplant artery is a potential reason for abdominal pain and anuria; physicians should take this into consideration when treating transplanted patients.
Marcus Gunn Jaw-Winking Phenomenon and Monocular Elevation Deficiency in Association With Congenital Ptosis
Authors: Chrisann Saldanha, Sachin Daigavane
Journal: Cureus (2023)
MeSH terms: Case Reports

Marcus Gunn jaw winking (MGJW) is an uncommon entity and is associated with congenital ptosis. It is a neurogenic congenital ptosis, which is also called the Marcus Gunn phenomenon, trigeminal-oculomotor synkinesis, or pterygoid-levator synkinesis. Congenital ptosis can be associated with MGJW syndrome, blepharophimosis syndrome, and monocular elevation deficiency (MED). MED is a condition where there is a unilateral congenital abnormality in the elevation of the eye in abduction and adduction. The MGJW phenomenon, congenital ptosis, and double-elevator palsy may be associated with and represent a congenital misdirection syndrome. Together, it can be challenging, and surgery is recommended in severe cases, depending on the degree of ptosis and jaw winking. We hereby want to bring to light one such case of a 14-year-old female with congenital ptosis, MGJW, and double-elevator palsy and want to highlight how both MGJW and double-elevator palsy are both parts of the same disease spectrum and how such cases can be treated.
Cellulitis Caused by Hirudo orientalis Bites That Lead to an Allergic reaction
Authors: Mohsen Najjari, Rahmat Solgi, Amir Tavakoli Kareshk
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

The allergic reaction due to leech bites is frequently reported due to complications of leech therapy and also unwanted leech infestation. Regularly, the urticarial papules are common, and itching lasts less than 24 h. In the case of leech biting, dermal infection could be caused by leech gut bacterial flora such as Aeromonas spp and histamine from leech saliva. In this case report, a 30-year-old diabetic woman, who works in the field of leech breeding, was bitten by Hirudo orientalis during breeding. Her clinical signs were inflammation, swelling, pain, and redness in the back of her left hand. A microbiological examination revealed that the isolated leech was infected with Aeromona hydrophila. The risk of death due to anaphylactic shock and sepsis is high in some cases of underlying diabetes and immunocompromised individuals. The study pointed out the hazards of leech bites and proposed preventative measures such as using gloves and boots for farm workers.
Case report: Disseminated Scedosporium apiospermum infection with invasive right atrial mass in a heart transplant patient
Authors: Baudouin Bourlond, Ana Cipriano, Julien Regamey, Matthaios Papadimitriou-Olivgeris, Christel Kamani, Danila Seidel, Frederic Lamoth, Olivier Muller, Patrick Yerly
Journal: Front Cardiovasc Med (2022)
Keywords: lomentospora prolificans, pet/ct, scedosporium apiospermum, heart failure, heart tranplantation, infective endocarditis, mycoses
MeSH terms: Case Reports

Scedosporium apiospermum associated endocarditis is extremely rare. We report a case of a disseminated S. apiospermum infection with an invasive right atrial mass in a 52-year-old male, 11 months after heart transplantation, referred to our institution for an endogenous endophthalmitis with a one-month history of diffuse myalgias and fatigue. The patient had been supported two times with extracorporeal membrane oxygenation (ECMO) during the first three postoperative months. The echocardiography on admission revealed a mass in the right atrium attached to a thickened lateral wall. The whole-body [18F]FDG PET/CT revealed systemic dissemination in the lungs, muscles, and subcutaneous tissue. Blood cultures were positive on day three for filamentous fungi later identified as S. apiospermum. The disease was refractory to a 3-week dual antifungal therapy with voriconazole and anidulafungin in addition to reduced immunosuppression, and palliative care was implemented.