OpenMed/multicare-articles huggingface dataset:
Resection of Thymic Neuroendocrine Carcinoma Guided by Three-Dimensional Reconstruction: A Case Report
Authors: Fang Liu, Hengxiao Lu, Liqian Chen, Junfeng Geng, Tongzhen Xu
Journal: Front Med (Lausanne) (2022)
Keywords: prognosis, surgical planning, three-dimensional reconstruction, thymic small cell neuroendocrine carcinoma, uniport video-assisted thoracoscopy, video-assisted thoracoscopy
MeSH terms: Case Reports

Primary thymic small cell neuroendocrine carcinoma (SCNEC), which possesses a more aggressive biological behaviour, including invasion of proximal structures, local recurrence, and distant metastasis, is extremely rare. According to a previous literature report, only a few patients with this disease have been reported, compared to patients with distant metastasis of bones, lungs, spleen, liver, and adrenal glands (1, 2). The report data suggest that SCNEC is a highly malignant tumour compared to most other tumours of the human body. In this study, we presented the case of a patient who underwent surgery guided by three-dimensional reconstruction modelling before the operation. We were fully prepared for the resection of this tumour using three-dimensional reconstruction modelling, even after reading the computed tomography (CT) images that showed a closed relationship with the pericardium, the vein of the right middle lung lobe, and the phrenic nerve. All these features demonstrate that SCNEC is highly malignant. To date, there are no procedural reports for three-dimensional reconstruction modelling in malignant thymus tumours.
Susac Syndrome and Pregnancy
Authors: Yazan Al-Hasan, Justin L Hoskin, John C Wolf, Saha Kamala
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Susac syndrome (SuS) is a rare poorly characterised disorder that affects the brain, retina, and cochlea. Here, we present a case of a 31-year-old pregnant female with a new diagnosis of SuS that was successfully managed to 36 weeks of gestation with minimal disease burden to both the mother and newborn. She was treated initially using intravenous methylprednisolone followed by oral prednisone, and intravenous immunoglobulin (IVIg). We stress the importance of a multidisciplinary approach, involving both neurology and maternal-fetal medicine, and provide guidance in navigating the various options for immunosuppressive therapy during pregnancy.
Case Report: Pulmonary Alveolar Calcification as a Result of Severe Hypercalcemia due to Acute Lymphoblatic Leukemia
Authors: Jose Colleti Junior, Eliana Carla Armelin Benites, Gustavo Spadaccia Dos Santos Fernandes, Norberto Antonio Freddi, Walter Koga, Werther Brunow de Carvalho
Journal: F1000Res (2015)
Keywords: acute lymphoblastic leukemia, hypercalcemia, osteolytic lesions, paediatric case report, pulmonary alveolar calcification

Severe hypercalcemia is a rare metabolic disorder in pediatric medicine. This report describes a rare case of severe hypercalcemia and its clinical manifestations in a 2-year-old toddler. The radiological findings caused by hypercalcemia and osteolysis were emblematic of the osteolytic lesions. Hypercalcemia led to massive pulmonary alveolar calcification. The hypercalcemia was successfully treated with pamidronate, a bisphosphonate drug class. Further investigation resulted in a diagnosis of acute lymphoblastic leukemia (ALL). The patient is currently on chemotherapy and has a favorable prognosis. Although severe hypercalcemia alone is an unusual finding as the first sign for ALL, this should be considered, not to mention the radiological images resulted from calcium deposits.
Incidental monotypic (fat-poor) renal angiomyolipoma diagnosed by core needle biopsy
Authors: Verena Kufer, Siegfried A Schwab, Maike Büttner, Abbas Agaimy, Michael Uder, Kerstin Amann
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

We present the case of a 55-year-old patient with a history of chemotherapy and bone marrow transplantation because of acute myeloid leukaemia. An incidental 4 × 3 cm measuring renal mass was detected while performing a magnetic resonance imaging (MRI) for lumbago. The lesion was suspected to be either a renal cell carcinoma (RCC) or a leukemic infiltration. To decide about further treatment a percutaneous core needle biopsy was performed. Histology showed a monotypic angiomyolipoma, a relatively rare benign renal lesion. Interestingly, in cross-sectional imaging, angiomyolipoma was not taken into differential diagnostic account because of lack of a fatty component. Due to bleeding after biopsy the feeding artery of the tumor was occluded by microcoils. This case demonstrates the utility of biopsy of renal tumors, in particular when small tumor-like lesions are incidentally detected to decide about the right treatment and thereby avoiding nephrectomy.
Perspectives of Migrant Youth, Parents and Clinicians on Community-Based Mental Health Services: Negotiating Safe Pathways
Authors: Lucie Nadeau, Annie Jaimes, Janique Johnson-Lafleur, Cécile Rousseau
Journal: J Child Fam Stud (2017)
Keywords: children and adolescents, collaborative care, migrants, patient perspective, youth mental health services

Youth mental health (YMH) services are greatly underutilized, particularly for migrant youth. Collaborative models of care offer promising avenues, but research on these treatment modalities is still scarce, particularly for migrants. The goal of this exploratory study is to better understand quality of care including factors improving access to care and collaborative YMH services use, efficacy and satisfaction, for this vulnerable population. This qualitative study relies on a multi-informants (youth, parents, clinicians) and multiple case study design to explore YMH collaborative services for migrant youth living in an urban setting (Montreal, Canada). Participants are five young patients (12-15 years old), one of their parents and their primary care therapist (N = 15). They come from migrant families, have a psychiatric diagnosis and have been receiving mental health services in a collaborative care setting for at least 6 months. Transcripts of semi-structured interviews for the five triads were thematically analyzed to draw similarities and contrasts between actors, across and within case-studies. Based on these findings, four themes emerged concerning the optimal care setting for collaborative YMH services for migrant families: (1) providing an equilibrium between communication, collaboration and privacy/confidentiality, (2) special attention to ensuring the continuity of care and the creation of a welcoming environment where trusting relationships can develop, (3) the inclusion of family intervention, and (4) the provision of collaborative decision-making pathways to care, addressing interprofessional and interinstitutional collaboration as well as cultural differences in explanatory models and values.
Pellagra, a re-emerging disease: a case report of a girl from a community ravaged by insurgency
Authors: Ahmadu Baba Usman, Pembi Emmanuel, Dogo Belmont Manchan, Akoma Chinyere, Ovansa Emmanuel Onimisi, Mava Yakubu, Kenji Hirayama
Journal: Pan Afr Med J (2019)
Keywords: pellagra, children, conflict, dermatitis, diarrhea, nutrition
MeSH terms: Child Nutrition Disorders / diagnosis, Niacin / deficiency, Pellagra / diagnosis, Case Reports, Child, Female, Humans, Niacin

Pellagra is a nutritional disorder of niacin deficiency which is characterized by triad of dermatitis, diarrhea and dementia. It is often seen in a state of poor nutrition among alcoholics, homeless and patients suffering from malabsorption. Though seldom occurs in children, its re-emerging is seen as a result of worsening food security in vulnerable population during conflict or insurgency. We report the case of 12-year-old female pastoralist who presented darkening and thickening of the hands, feet, ankles, neck and her upper trunk. Conflicts and insurgency usually occur in resource constraint settings where health workers are few and overworked. Therefore, continuously educating health workers and the general public regarding nutrition and its disorders like pellagra is a priority. Public Health authorities and policy makers also ought to take pediatric nutrition serious in order to avoid its escalation in internally displaced persons or children orphaned by insurgency.
Recurrent pleural effusions and cardiac tamponade as possible manifestations of pseudoprogression associated with nivolumab therapy- a report of two cases
Authors: Bhaskar C Kolla, Manish R Patel
Journal: J Immunother Cancer (2016)
Keywords: immune related adverse effects, immunotherapy, lung cancer, nivolumab, pericardial effusion, pericardial tamponade, recurrent pleural effusions
MeSH terms: Antibodies, Monoclonal / adverse effects, Antineoplastic Agents, Immunological / adverse effects, Cardiac Tamponade / diagnosis, Cardiac Tamponade / etiology, Neoplasms / complications, Pleural Effusion / diagnosis, Pleural Effusion / etiology, Case Reports, Antibodies, Monoclonal / therapeutic use, Antineoplastic Agents, Immunological / therapeutic use, Biopsy, Female, Humans, Male, Middle Aged, Molecular Targeted Therapy / adverse effects, Neoplasms / diagnosis, Neoplasms / drug therapy, Nivolumab, Pericardial Effusion / diagnosis, Pericardial Effusion / etiology, Positron Emission Tomography Computed Tomography, Recurrence, Antibodies, Monoclonal, Antineoplastic Agents, Immunological, Nivolumab

Background:
Checkpoint inhibitors are a class of agents that employ host's adaptive immune defenses in fighting cancer. With many new indications and several ongoing clinical trials in a variety of malignancies, the usage of these agents is set to increase significantly. One of the key challenges patients and physicians face while using these drugs is with the appropriate assessment of response to therapy.
Case presentation:
We are reporting two patients with lung cancer who were treated with nivolumab and experienced rapidly accumulating recurrent pleural effusions requiring multiple thoracenteses (6 and 4 times each for patient 1 and 2 respectively) with in the first few weeks of initiation of therapy and also developed pericardial effusion with cardiac tamponade requiring pericardiocentesis. Both patients had prior history of malignant spread to pleural and pericardial space in their disease course. Therapy was continued in the first patient with spontaneous resolution of effusions after 8 weeks and the disease showed near complete response to treatment on imaging at 16 weeks. Second patient declined to continue further treatment with nivolumab after 3 cycles due to recurrent effusions and cardiac tamponade, although there was some evidence of clinical response at discontinuation.
Conclusions:
Patients with history of malignant involvement of visceral spaces should be monitored closely for rapidly accumulating effusions and particularly for cardiac tamponade, after initiation of therapy with nivolumab. This presentation could represent pseudoprogression, and continuation of therapy with close monitoring is prudent as long as effusions are manageable and there is no definitive evidence of progression elsewhere.
A Rare and Lethal Complication: Cerebral Edema in the Adult Patient with Diabetic Ketoacidosis
Authors: Christopher W Meaden, Beth J Kushner, Stacey Barnes
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Commonly seen in the emergency department, diabetic ketoacidosis is a potentially lethal sequela of uncontrolled diabetes mellitus. In the adult population, a rare complication of diabetic ketoacidosis is cerebral edema. This case report discusses a 26-year-old male with new onset diabetes mellitus who developed cerebral edema leading to death.
Unique presentation of akinetic mutism and coexisting thyroid storm relating to stroke
Authors: Mohankumar Kurukumbi, Thao Dang, Najeeb Crossley, Alice Esame, Annapurni Jayam-Trouth
Journal: Case Rep Neurol Med (2014)

Akinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears awake but does not move or speak. It can be divided into two different subtypes; the most common subtypes depend on the lesion location, mesencephalic-diencephalic region, also called apathetic akinetic mutism (somnolent mutism), and those involving the anterior cingulate gyrus and adjacent frontal lobes called hyperpathic akinetic mutism. The pathway of akinetic mutism is believed to originate from circuits that link the frontal and subcortical structures. This case reports a 48-year-old African American female with bilateral anterior cerebral artery stroke and akinetic mutism with coexisting thyroid storm. This patient with bilateral anterior cerebral artery infarcts presented with characteristics that are typical for akinetic mutism such as having intact eye movements but an inability to respond to auditory or visual commands. With the incidence of bilateral anterior cerebral artery (ACA) ischemic stroke being rare and the incidence of akinetic mutism secondary to ischemic stroke even rarer, we suspect that this patient potentially had a unilateral occlusion of anomalous anterior cerebral vasculature.
Sézary Syndrome with CD4/CD8 Double-Negative Neoplastic T Cells in Peripheral Blood
Authors: Yuki Kageyama, Kenshiro Tsuda, Yuma Nato, Keiki Nagaharu, Kazutaka Suzuki, Akihiko Sawaki, Hiroyuki Miyashita
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Sézary syndrome is a rare leukemic type of cutaneous T-cell lymphoma characterized by the presence of neoplastic T cells with cerebriform nuclei (Sézary cells) in the skin, lymph nodes, and peripheral blood. Typical Sézary cells have a CD3+CD4+CD8- phenotype; however, in cases of the aberrant loss of antigens on Sézary cells, especially the loss of critically important T-cell antigens such as CD4, there is a possibility of misdiagnosing the disease or underestimating the tumor burden of the disease. Here, we report a rare case of Sézary syndrome with CD4/CD8 double-negative Sézary cells in the peripheral blood. Most of the Sézary cells in the peripheral blood had lost CD4 expression, and we diagnosed the disease and evaluated the tumor burden by multicolor flow cytometry. Intriguingly, the Sézary cells showed a typical CD4+CD8-CD7- phenotype in the skin even though the cells in the peripheral blood lacked CD4. The patient responded well to treatment with bexarotene and narrow-band ultraviolet B therapy. Analysis by multicolor flow cytometry is essential to diagnose this rare type of Sézary syndrome and evaluate the tumor burden.
Fatal Mucormycosis and Aspergillosis in an Atypical Host: What Do We Know about Mixed Invasive Mold Infections?
Authors: Maria Tsikala-Vafea, Weibiao Cao, Adam J Olszewski, John E Donahue, Dimitrios Farmakiotis
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Mixed invasive mold infections (MIMIs) are considered rare. We present a case of fatal aspergillosis and mucormycosis in an elderly host with history of chronic lymphocytic leukemia (CLL) and potential mold exposures. Notably, he had no classic risk factors for IMI other than high-dose corticosteroids, which may be an important risk factor for (M)IMI, based on the current and previous reports. There is an urgent need for studies on the "net state of immunosuppression," environmental exposure as risk factors for (M)IMIs, and noninvasive fungal diagnostics.
Recurrent Skin and Lung Infections in Autosomal Dominant Hyper IgE Syndrome with Transactivation Domain STAT3 Mutation
Authors: Chad J Cooper, Sarmad Said, German T Hernandez
Journal: Case Reports Immunol (2014)

Background. Hyper IgE is a rare systemic disease characterized by the clinical triad of high serum levels of IgE (>2000 IU/mL), eczema, and recurrent staphylococcal skin and lung infections. The presentation of hyper IgE syndrome is highly variable, which makes it easy to confuse the diagnosis with that of severe atopy or other rare immunodeficiency disorders. Case Report. A 23-year-old Hispanic presented with history of frequent respiratory and gastrointestinal infections as a child and multiple episodes of skin and lung infections (abscess) with Staphylococcus aureus throughout his adult life. He had multiple eczematous lesions and folliculitis over his entire body, oral/esophageal candidiasis, and retention of his primary teeth. The IgE was elevated (>5000 IU/mL). Genetic mutation analysis revealed a mutation affecting the transactivation domain of the STAT3 gene. Conclusion. The hallmark of hyper IgE syndrome is serum IgE of >2000 IU/mL. Hyper IgE syndrome is a genetic disorder that is either autosomal dominant or recessive. A definite diagnosis can be made with genetic mutation analysis, and in this case, it revealed a very rare finding of the transactivation domain STAT3 mutation. Hyper IgE syndrome is a challenge for clinicians in establishing a diagnosis in suspected cases.
Diagnosis and Management of a Patient with Congenitally Missing Maxillary First Permanent Molars: A Rare Case Report
Authors: Megha Gupta, Suman Panda, Fahad Ahmed Mutawwam, Fahad Musawi Mohammed Kariri
Journal: Case Rep Dent (2016)

Congenitally missing teeth are the most commonly seen dental anomalies. Agenesis of the permanent first molar has the least frequency of all the tooth types, and it usually occurs in association with oligodontia or anodontia. Thus, agenesis of the bilateral maxillary first permanent molar is an extremely rare occurrence, and no such case has been reported in ethnic Saudi Arabian population. We hereby report a case of nonsyndromic bilateral congenitally missing maxillary first permanent molar in an eight-year-old Saudi female patient. Comprehensive oral rehabilitation was done for the patient. The implications of the tooth agenesis are also discussed. The prognosis of this case is presented.
A Rare Occurrence of Bilateral Single-Rooted Mandibular First Molar
Authors: Urvashi Ujariya, Rajendra Bharatiya, Anjali Kothari, Viraj Shah, Mishri Parikh, Kruti Pandey, Dhara Mehta, Nishi Amin
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

It is essential to have an in-depth knowledge of root and root canal anatomy to prevent any iatrogenic errors. Many studies and case reports are present in the literature related to the anatomy of mandibular first molars, but most of them are on an extra number of roots and root canals. There are few studies related to a lower number of roots and root canals, but the occurrence of bilateral mandibular first and second molars with the presence of root fusion resulting in a single root is very rare. This case report presents the nonsurgical endodontic management of the left and right mandibular first molars with the presence of a single root confirmed using a CBCT and treated by placing an apical MTA plug followed by backfill using thermoplasticised gutta percha.
Extraskeletal chondrosarcoma of labium majus
Authors: Arshad S Khan, Girish D Bakhshi, Aftab Shaikh, Ashraf A Khan, Adil A Khan, Arun Chitale
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

Extraskeletal myxoid chondrosarcoma (ESMC) is a rare tumor seen more often in men. It is seen to arise from soft tissue of lower extremity or buttocks. We report a case of soft tissue swelling of left labium majus in a 66-year-old female. Patient underwent wide excision with uneventful postoperative course. Histopathology of specimen confirmed it to be ESMC. Patient refused adjuvant therapy. Followup of 1 year has shown her to be disease- and symptom- free. Only two cases arising from vulva have been reported in literature . This is the third case and first from Indian subcontinent. A brief review of clinical features, diagnosis, treatment, and outcome of patients with extraskeletal chondrosarcoma is presented.
Giant, Bleeding, and Ulcerating Proliferating Trichilemmal Cyst, With Delayed Treatment Due to Coronavirus Outbreak: A Case Report and Review of the Literature
Authors: Cecilie Mullerup Kiel, Preben Homøe
Journal: Front Surg (2021)
Keywords: case report, corona, lipoma, pilar tumour, proliferating trichilemmal cyst, trichilemmal cyst
MeSH terms: Case Reports

We report a case of a large, ulcerating proliferating trichilemmal cyst in a 76-year-old woman, with clinical, radiological, macroscopic, and microscopic correlation. The outbreak of the Coronavirus pandemic delayed her treatment. We review the literature on proliferating trichilemmal cysts, which are relatively rare tumors, which, generally, are considered benign. However, we found a high rate of malign cases, which stresses the importance of rapid surgical excision and histological diagnosis. Even though our proband had delayed treatment, the tumor did not transform into a malignant form.
Lung disease recalling paraseptal emphysema in a patient with Goltz syndrome
Authors: Rosaria Cortese, Salvatore Savasta, Silvia Di Stasi, Tiziana Boggini, Chiara Trabatti, Roberto Dore, Giulia Maria Stella
Journal: Multidiscip Respir Med (2016)
Keywords: emphysema, goltz syndrome, lung disease
MeSH terms: Case Reports

Background:
Goltz syndrome is a rare, genetic disorder mainly occurring in female patients.
Case presentation:
The case presented here is, to the best of our knowledge, the first description of the occurrence of lung parenchymal alterations in a young female patient affected by Goltz syndrome. Although pulmonary involvement is not known in patients affected by X-linked Goltz syndrome, the case here described is related to the even rarer autosomal form of the disease, as in this case. It is thus conceivable that in such different genetic setting the involvement of lung parenchyma may be unveiled through atypical emphysematous lesions.
Conclusion:
This report suggested - for the first time time - a rationale for a lung function and imaging screening in patients affected by Goltz syndrome at least in its autosomal form.
Total Hip Lithiasis: A Rare Sequelae of Spilled Gallstones
Authors: Vineet Tyagi, Daniel H Wiznia, Adrian K Wyllie, Kristaps J Keggi
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Laparoscopic cholecystectomy is a surgical treatment for acute cholecystitis or symptomatic cholelithiasis. One potential complication, the spillage of gallstones into the peritoneal cavity, can form a nidus for infection and may be associated with hepatic, retroperitoneal, thoracic, and abdominal wall abscesses. We report a case of a patient presenting with a right iliopsoas abscess and an infected right hip prosthesis status postlaparoscopic cholecystectomy. A CT demonstrated that the acetabular shell was overmedialized and perforated through the medial wall. The patient was taken to the operating room for explantation of components. A collection of gallstones was identified deep to the acetabulum during the explantation. The case highlights the importance of avoiding overmedialization of the acetabular component, which can provide a direct route for infection into the hip joint.