OpenMed/multicare-articles huggingface dataset:
Hemobilia following Percutaneous Liver Biopsy in the Setting of Malignancy (with Video): Diagnosis and Management of a Rare Cause of Upper Gastrointestinal Bleeding
Authors: B Pabla, M Porayko
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

A 57-year-old gentleman with a past medical history of well-differentiated pancreatic neuroendocrine tumor (NET) with liver metastases was transferred to our hospital with abdominal pain. He underwent percutaneous liver biopsy three days prior to admission as a part of a study protocol for treatment of his progressive NET. He developed gastrointestinal bleeding and was found to have a distended gallbladder filled with high density material on ultrasound. During initial upper endoscopy, it was noted that he had blood emanating from the duodenal papilla consistent with hemobilia and he was ultimately diagnosed with post-liver biopsy hemorrhage. At first, he was managed conservatively with supportive care, but bleeding persisted resulting in the need for arterial embolization as a more effective treatment modality. Hemobilia is a rare entity and in the modern era it is most commonly the result of iatrogenic injury. Appropriate management depends on the underlying etiology with most cases resolving with conservative management. The avoidance of unnecessary surgery and the use of embolization are key principles in management.
Use of Biologically Active 3D Matrix for Extensive Skin Defect Treatment in Veterinary Practice: Case Report
Authors: Elena Yu Zakirova, Dmitry V Shalimov, Ekaterina E Garanina, Margarita N Zhuravleva, Catrin S Rutland, Albert A Rizvanov
Journal: Front Vet Sci (2019)
Keywords: 3d matrix, fgf2, vegf165, fibrin glue, mesenchymal stem cells

Objectives: Large full-thickness skin defects represent a serious veterinary problem. Methods: We have developed novel bioactive 3D-matrixes based on fibrin glue Tissucol (Baxter), containing the combination of the adenoviral constructs with genes vascular endothelial growth factor 165 (VEGF165) and fibroblast growth factor two (FGF2; construct Ad5-VEGF165 + Ad5-FGF2) or multipotent mesenchymal stem cells, genetically modified with these constructs. Results: In vitro studies confirmed the biosynthesis of VEGF165 and FGF2 mRNA in the transduced cells. Ad5-VEGF165 + Ad5-FGF2- transduced multipotent mesenchymal stem cells showed an enhanced capacity to form capillary-like tubes in vitro. Bioactive 3D-matrix application enhanced granulation tissue formation and epithelialization of non-healing, large bite wounds in a dog. Successful wound healing was observed with a positive clinical outcome for the canine patient. This research and application of regenerative gene therapy alongside a novel bioactive 3D-matrix shows promising clinical applications for the future in both dogs and other mammals including humans.
Novel variant in HHAT as a cause of different sex development with partial gonadal dysgenesis associated with microcephaly, eye defects, and distal phalangeal hypoplasia of both thumbs: Case report
Authors: Noelia Baz-Redón, Laura Soler-Colomer, Mónica Fernández-Cancio, Sara Benito-Sanz, Marta Garrido, Teresa Moliné, María Clemente, Núria Camats-Tarruella, Diego Yeste
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: 46,xy different sexual development, hhat, case report, minigene studies, syndromic dsd
MeSH terms: Gonadal Dysgenesis, Microcephaly / complications, Microcephaly / genetics, Case Reports, Research Support, Non-U.S. Gov't, Acyltransferases / genetics, Hedgehog Proteins / genetics, Hedgehog Proteins / metabolism, Humans, Sexual Development, Thumb, Hedgehog Proteins, HHAT protein, human, Acyltransferases

The palmitoylation of the Hedgehog (Hh) family of morphogens, named sonic hedgehog (SHH), desert hedgehog (DHH), and Indian hedgehog (IHH), is crucial for effective short- and long-range signaling. The hedgehog acyltransferase (HHAT) attaches the palmitate molecule to the Hh; therefore, variants in HHAT cause a broad spectrum of phenotypes. A missense HHAT novel variant c.1001T>A/p.(Met334Lys) was described in a patient first referred for a 46,XY different sexual development with partial gonadal dysgenesis but with microcephaly, eye defects, and distal phalangeal hypoplasia of both thumbs. The in silico analysis of the variant predicted an affectation of the nearest splicing site. Thus, in vitro minigene studies were carried out, which demonstrated that the variant does not affect the splicing. Subsequent protein in silico studies supported the pathogenicity of the variant, and, in conclusion, this was considered the cause of the patient's phenotype.
Jejunojejunal intussusception induced by a gastrointestinal stromal tumor
Authors: Ali H Zakaria, Salam Daradkeh
Journal: Case Rep Surg (2012)

Background. Adult intussusception is a rare entity representing less than 1% of all intestinal obstructions. Diagnosis of the condition is difficult requiring a high index of suspicion and the utilization of imaging studies, especially CT scans. Diagnostic laparoscopy and/or exploratory laparotomy can be used as a diagnostic and therapeutic intervention. In over 90% of cases, an underlying lead point is identified. In the patient described here, it was a gastrointestinal stromal tumor (GIST), a relatively rare mesenchymal tumor comprising only 0.2-1.0% of the gastrointestinal tract neoplasms and believed to originate from neoplastic transformation of the interstitial cells of Cajal. GISTs may occur anywhere along the gastrointestinal tract, but most commonly arise in the stomach and small intestine. Literature review revealed only few cases reporting GISTs as a leading point of adult's intussusception. Case Presentation. In this report, we are presenting a rare case of jejunojejunal intussusception in a 78-year-old female patient with a GIST located in the terminal jejunum being the leading point, demonstrating the importance of imaging studies, especially CT scan, laparoscopy, and exploratory laparotomy as diagnostic and therapeutic interventions.
Robot-Assisted Removal of a Broken Scalpel Blade following Discectomy
Authors: Christos Koutserimpas, Argyrios Ioannidis, Michael Konstantinidis, Panagiotis Athanasopoulos, Fotios Antonakopoulos, Konstantinos Konstantinidis
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

The risk of a broken scalpel blade during discectomy is considered extremely rare, while no guidelines exist regarding this complication. We report a case of a robotic broken blade removal following lumbar discectomy. A 52-year-old female was subjected to L4-L5 discectomy. During the annulus resection, the scalpel blade broke and was retained within the disc space. The broken blade migrated towards the abdominal cavity and viscera. Emergency CT angiography scan revealed that the main vessels were intact, while the broken surgical knife was located anterior to the lumbar spine at the L4/L5 level, to the left of the aorta and superiorly of the left common iliac artery. At that point, robot-assisted laparoscopy was performed. The broken instrument was located and carefully removed. It seems more proper that such foreign bodies should be removed, while robotic surgery may play a significant role in cases that the foreign body is near major vessels.
Toxoplasmosis chorioretinitis mimicking cytomegalovirus retinitis in an immunocompromised pediatric patient following bone marrow transplantation
Authors: Anubhav Garg, Bryon R McKay, Carolina L M Francisconi, Rajeev H Muni
Journal: GMS Ophthalmol Cases (2022)
Keywords: bone marrow transplant, chorioretinitis, cytomegalovirus, immunocompromised, pediatric, toxoplasmosis
MeSH terms: Case Reports

Objective:
To review a case of toxoplasmosis chorioretinitis mimicking cytomegalovirus retinitis in an immunocompromised patient following bone marrow transplantation.
Methods:
Retrospective chart review of a 14-year-old female who had a history of leukemia and allogeneic bone marrow transplants prior to her ocular symptoms.
Results:
Anterior chamber fluid analysis was positive for Toxoplasma gondii. The patient responded well when cytomegalovirus retinitis treatment was switched to intravitreal clindamycin with systemic sulfadiazine and prednisone.
Conclusions:
This case demonstrates the challenges of diagnosing and treating retinal infections in immunocompromised patients as they may present with atypical findings that mimic other pathologies and may have contraindications against standard treatment.
Her-2 positive gastric cancer presented with thrombocytopenia and skin involvement: a case report
Authors: Deniz Arslan, Mukremin Uysal, Ali Murat Tatlı, Seyda Gunduz, Sema Sezgin Goksu, Cumhur İbrahim Başsorgun, Hasan Senol Coskun, Hakan Bozcuk, Burhan Savaş
Journal: Case Rep Oncol Med (2014)

Gastric cancer is the 5th most frequent cancer around the world and the 3rd most frequent reason of deaths due to cancer. Every year, about 1 million new cases are taking place, with varying geographical distribution. Gastric cancer is often metastatic to liver, lungs, and bones in hematogenous way, to peripheral lymph nodes in lymphogenous way, and to peripheral tissues in adjacency way, yet bone marrow (BM) and cutaneous metastasis are quite seldom. Pancytopenia is a more frequent finding identified in BM metastasis of solid organ cancers, and isolated thrombocytopenia is less often. The human epidermal growth factor 2 (HER-2) is positive in gastric cancer at a rate of 7-34%. Here, we have presented our HER-2 positive gastric cancer incident which presented with BM and cutaneous metastasis, and has no 18F-fluoro-2-deoxi-D-glucose (FDG) involvement except bone metastases.
Bemoan My Collarbone: A Case of Costocondral Junction Syndrome Complicated by Methicillin Sensitive Staphylococcus aureus Sternoclavicular Osteomyelitis and Septic Arthritis
Authors: Vashistha M Patel, Shreya V Patel, Lauren Pacheco
Journal: Cureus (2023)
Keywords: clavicular osteomyelitis, costochondral junction syndrome, intravenous drug use (ivdu), mssa sternoclavicular septic arthritis, teitze syndrome
MeSH terms: Case Reports

A 35-year-old female with a past medical history of untreated Hepatitis-C, and a history of intravenous (IV) drug use initially presented to the emergency department with chief complaints of gradual worsening sharp, constant left-sided chest pain with no radiation starting three weeks before presentation. In the emergency department (ED), she was afebrile, normotensive, and tachycardia with 99% oxygen saturation on room air. A physical exam revealed a well-developed Caucasian female, alert and oriented with moderate distress. Respiratory exam with symmetrical bilateral excursions without wheezes, crackles, or rhonchi. On cardiovascular exam, she was tachycardic with a regular rhythm without murmurs, rubs, or gallops. There was a 2 x 2 cm tender erythematous swelling on the left sternal border inferior to the clavicle. The neck was supple and negative for Jugular Venous Distension (JVD). Neurologically grossly intact. Abnormal laboratory findings included leukocytosis with neutrophilic predominance. The patient received intravenous (IV) antibiotics with broad-spectrum vancomycin, cefepime, and azithromycin and underwent computed tomography angiography (CTA) chest, revealing a 26.8 mm x 26.5 mm left anterior subapical pleural-based pulmonary mass-like lesion with central hypoattenuation in surrounding ground-glass changes. Biopsy of the left subapical pulmonary lesion results showed chronic inflammatory infiltrate. Unfortunately, the patient left the hospital against medical advice after supportive care and pain control. Our patient's history of intravenous drug use and active Hepatitis-C infection were typical risk factors associated with invasive infections. In the clinical context, leukocytosis with hypo-attenuated pulmonary lesion should raise suspicion for septic emboli, localized abscess pocket, infection by atypical organisms, infective endocarditis, and malignancy which was considered upon initial assessment.
Functional parathyroid cyst: a rare cause of malignant hypercalcemia with primary hyperparathyroidism-a case report and review of the literature
Authors: Areej Khan, Yusra Khan, Shahzad Raza, Ghulam Akbar, Monis Khan, Nauman Diwan, Wajih Rizvi
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Parathyroid cysts are rare lesions found in the neck and anterior mediastinum. They are often nonfunctional (>90%) and rarely in the functional form. This paper discusses a case of severe hypercalcemia (23 mg/dL) secondary to a rare functional parathyroid cyst. The patient was later found to have a hemorrhagic cyst with compression of the right recurrent laryngeal nerve. Preoperative diagnosis of the lesion was parathyroid carcinoma. However, reexploration of the parathyroid mass along with microscopic study confirmed the diagnosis of a parathyroid cyst. Following cystectomy, the patient restored her baseline functional status with preservation of the right recurrent laryngeal nerve. Postoperative followup three years later showed no evidence of cyst recurrence. This paper illustrates the rare presentation of parathyroid functional cysts with severe hypercalcemia and primary hyperparathyroidism. Physicians should be aware of the presence of hemorrhage, inflammation, and compressive symptoms in these cysts which mimic parathyroid carcinoma. These patients should be managed with aggressive medical and surgical intervention.
Traumatic hepatic arteriohepatic venous fistula managed with selective coil embolization: a case report
Authors: Rajsekar Chandrasekharan, Sreekumar Kp, Srikanth Moorthy, Chinmay Kulkarni
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Hepatic arterioportal fistulae are frequent vascular complications due to neoplasm, trauma and iatrogenic injury. On the other hand, fistulae between the hepatic arteries and hepatic veins (arteriohepatic venous fistula) are rare. We report the case of a 45-year-old male who suffered from a blunt abdominal trauma with abdominal distension. Initial cross-sectional imaging revealed laceration of the right lobe of liver with an arteriovenous fistula and hemoperitoneum. The diagnosis of arteriohepatic venous fistulae was confirmed on digital subtraction angiography (DSA) and treated angiographically with superselective coil embolization. Post-embolization angiogram showed complete occlusion of arteriovenous fistulae. We emphasis on the management part of the fistulae and endovascular treatment.
Late Prevertebral and Spinal Abscess following Chemoradiation for Laryngeal Squamous Cell Carcinoma
Authors: Jawad Hindy, Ilan Shelef, Yuval Slovik, Ben-Zion Joshua
Journal: Case Rep Otolaryngol (2014)

Objective. Advanced primary supraglottic tumors (i.e., T3 or T4) have traditionally been treated surgically and postoperative radiotherapy. In the last 2 decades, some patients were treated with chemoradiation avoiding surgery. Case Report. We describe a 55-year old female who presented with respiratory distress and paraplegia seven years after treatment for a T3N0M0 supraglottic squamous cell carcinoma. CT scan showed prevertebral and intraspinal air descending from C4 to D3 vertebras. Epidural and prevertebral abscesses were confirmed by neck exploration. Necrosis was observed in the retropharyngeal, prevertebral, and vertebral tissues. Conclusion. Prevertebral and spinal abscess may result from chemotherapy and radiotherapy to the head and neck. Physicians caring for head and neck cancer patients treated with chemotherapy and radiation should be aware of this rare severe complication.
Clinical Impact of Consolidative and Salvage Radiotherapy for Lymph Node Metastasis in Upper Urinary Tract Urothelial Carcinoma
Authors: Hideyuki Kondo, Suguru Shirotake, Takashi Okabe, Soichi Makino, Koshiro Nishimoto, Masafumi Oyama
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

A 75-year-old Japanese male was referred to our institution for the evaluation of a left ureteral tumor in the ureterovesical junction. Computed tomography and pathologic examination under ureteroscopy revealed an invasive left ureteral urothelial carcinoma with left obturator nodal metastasis without distant metastasis. First, the patient underwent systemic chemotherapy (gemcitabine and cisplatin chemotherapy). We then performed left radical nephroureterectomy and extended lymph node dissection. Pathological examination revealed that the tumor was a high-grade invasive urothelial carcinoma with left common iliac and pelvic lymph node metastasis (pT3N2). Unfortunately, metastases appeared in the common iliac and para-aortic lymph nodes immediately after the operation; therefore, the previous first-line chemotherapy was readministered and second-line chemotherapy (gemcitabine and paclitaxel chemotherapy) was also performed. We also performed consolidative radiotherapy and salvage radiotherapy (boost, 20 Gy/10 fractions to the inferior para-aortic, and left common iliac regions containing swollen lymph nodes). The patient has shown no evidence of recurrence or metastasis even approximately 4 years after the initial diagnosis of advanced UUT-UC with lymph node metastasis. Our case suggests that consolidative or salvage radiotherapy combined with surgery and chemotherapy may provide clinical benefit for selected cases of advanced UUT-UC with lymph node metastasis.
Case Report: Clinical application of immunotherapy-based combination regimen in primary osteosarcoma of the uterus
Authors: Jing Yang, Xiaowen Chen, Xiaofang Li, Wenci Liu, Sihai Liao, Yuzhou Wang, Yufang Zuo
Journal: Front Oncol (2023)
Keywords: chemotherapy, immunotherapy, osteosarcoma, sarcomas, targeted therapy
MeSH terms: Case Reports

Primary osteosarcoma of the uterus is an extremely rare pure heterologous sarcoma of the uterus. The relevant available information is limited to case reports. To date, only 31 cases of this type of cancer have been reported. Here, we report the first clinical experience with the administration of an immunotherapy-based combination regimen for multiple metastatic primary osteosarcomas of the uterus. The patient had undergone multiple treatments prior to this regimen, but her condition continued to progress. However, after 3 cycles of immunotherapy combined with targeted therapy and chemotherapy, a review showed that the disease was stable and even in partial remission. The patient has a good quality of life, and long-term survival is expected.
Case of Superficial Cancer Located at the Pharyngoesophageal Junction Which Was Dissected by Endoscopic Laryngopharyngeal Surgery Combined with Endoscopic Submucosal Dissection
Authors: Kenro Kawada, Tatsuyuki Kawano, Taro Sugimoto, Kazuya Yamaguchi, Yuudai Kawamura, Toshihiro Matsui, Masafumi Okuda, Taichi Ogo, Yuuichiro Kume, Yutaka Nakajima, Andres Mora, Takuya Okada, Akihiro Hoshino, Yutaka Tokairin, Yasuaki Nakajima, Ryuhei Okada, Yusuke Kiyokawa, Fuminori Nomura, Takahiro Asakage, Ryo Shimoda, Takashi Ito
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Aims. In order to determine the indications of transoral surgery for a tumor located at the pharyngoesophageal junction, the trumpet maneuver with transnasal endoscopy was used. Its efficacy is reported here. Material and Methods. An 88-year-old woman complaining of dysphagia, diagnosed with cervical esophageal cancer, and hoping to preserve her voice and swallowing function was admitted to our hospital. Conventional endoscopy showed that the tumor had invaded the hypopharynx. When inspecting the hypopharynx and the orifice of the esophagus, we asked the patient to blow hard and puff her cheeks with her mouth closed (trumpet maneuver). After the trumpet maneuver, the pharyngeal mucosa was stretched out. The pedicle of the tumor arose from the left-anterior wall of the pharyngoesophageal junction, so we decided to perform endoscopic resection. Result. Under general anesthesia, the curved laryngoscope made it possible to view the whole hypopharynx, including the apex of the piriform sinus and the orifice of the esophagus. The cervical esophageal cancer was pulled up to the hypopharynx. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en bloc by endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection. Conclusion. Transnasal endoscopy using the trumpet maneuver is useful for a precise diagnosis of the pharyngoesophageal junction. Close collaboration between head and neck surgeons and endoscopists can provide good results in treating tumors of the pharyngoesophageal junction.
Perventricular device closure of a large residual perimembranous interventricular septal defect after previous surgical correction
Authors: Edvin Prifti, Arben Baboci, Edvin Dado, Efrosina Kajo
Journal: J Cardiothorac Surg (2014)
MeSH terms: Cardiac Surgical Procedures / methods, Heart Septal Defects, Ventricular / physiopathology, Heart Septal Defects, Ventricular / surgery, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Sternotomy, Young Adult

A 21 years albanian patient was referred with important residual left to right shunt. He was undergone 7 years before conventional surgical correction of a perimembranous ventricular septal defect (VSD). The patient underwent sternotomy and perventricular device closure of the residual employing a 16 mm multifenestrated atrial septal defect occlude, which was positioned through the anterior wall of the right ventricle. across the defect. The previous autologous pericardial patch was compressed into the double umbrella device. We may conclude that perventricular device closure can employed successfully in patients with residual perimembranous VSD after previous surgical repair as an alternative to the conventional surgery with excellent hemodynamic and postoperative outcome. Such a technique should be part of the surgical armamentarum.
Visual impairment from fibrous dysplasia in a middle-aged African man: a case report
Authors: Charles O Bekibele, Olubayo A Fasola, Vickie N Okojie, Opeyemi O Komolafe, Olayiwola A Oluwasola, Jude K Emejulu, Ayotunde I Ajaiyeoba, Aderonke M Baiyeroju
Journal: J Med Case Rep (2009)

Introduction:
Fibrous dysplasia is a benign tumour of the bones and is a disease of unknown aetiology. This report discusses a case of proptosis and visual deterioration with associated bony mass involving the right orbit.
Case presentation:
A 32-year-old Nigerian man of Yoruba ethnic origin presented to the eye clinic of our hospital with right-eye proptosis and visual deterioration of 7-year duration. Presentation was preceded by a history of trauma. Proptosis was preceded by trauma but was non-pulsatile with no thrill or bruit but was associated with bony orbital mass. The patient reported no weight loss. Examination of his right eye showed visual acuity of 6/60 with relative afferent pupillary defect. Fundal examination revealed optic atrophy. Computed tomography showed an expansile bony mass involving all the walls of the orbit. The bony orbital mass was diagnosed histologically as fibrous dysplasia. Treatment included orbital exploration and orbital shaping to create room for the globe and relieve pressure on the optic nerve.
Conclusion:
Fibrous dysplasia should be considered in the differential diagnosis of slowly developing proptosis with associated visual loss in young adults.