OpenMed/multicare-articles huggingface dataset:
Placenta Accreta Spectrum with Ureteral Invasion due to Progression of Cesarean Scar Pregnancy
Authors: Nana Yara, Yoshino Kinjyo, Yukiko Chinen, Tadatsugu Kinjo, Keiko Mekaru
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Expectant management is not recommended for cesarean scar pregnancies because they are often associated with placenta accreta, cesarean hysterectomy, and massive life-threatening hemorrhages during delivery. Herein, we report a case of placenta accreta spectrum with ureteral invasion due to the progression of a cesarean scar pregnancy. Case. A 41-year-old woman, with a history of three cesarean sections and two miscarriages, was referred to our hospital at 25 weeks of gestation with a diagnosis of placenta accreta spectrum and bladder invasion. Although the gestational sac was located anterior to the lower uterine segment, a cesarean-scar pregnancy was not diagnosed. A cesarean hysterectomy was performed at 31 weeks of gestation with the placement of an aortic balloon. The placenta was found to adhere to the ureter with more than the expected parenchymal tissue displacement (FIGO Classification 3b). The ureter was not obstructed and was preserved by leaving the placenta slightly on the ureteral side. Postoperatively, a ureteral stent was placed because of the ureteral stricture in the area where the placenta had adhered. Two months after surgery, the ureteral stent was removed after observing an improvement in stenosis. An adherent placenta due to continued cesarean scar pregnancy should be managed by assuming placental invasion beyond the parenchyma into the ureter.
Intestinal T-cell lymphoma not otherwise specified: a case report and literature review
Authors: Sarra Laabidi, Rabeb Hamouga, Sirine Bouslama, Rym Sellami, Soumoud Shimi, Asma Labidi, Jalel Boubaker
Journal: Future Sci OA (2024)
Keywords: extranodal non-hodgkin's lymphoma, intestinal t-cell lymphoma not otherwise specified, intestinal tumor
MeSH terms: Case Reports

Intestinal T-cell lymphoma, not otherwise specified (ITCL, NOS), primarily affects the small bowel but can involve the stomach and large bowel. This report presents an uncommon case of ITCL, NOS in a patient affecting the large bowel, supported by a literature review. An 87-year-old female presented with abdominal pain, fever, vomiting and weight loss. Imaging revealed nodular thickening of the transverse and right colon, confirmed as polypoid mass lesions with ulceration through colonoscopy and biopsy, indicating ITCL, NOS. CT scan showed adrenal nodes classifying it as stage VI. The patient was referred for palliative care and passed away 40 days later, likely due to tumor progression. This case underscores the rarity of large bowel ITCL, NOS and the diagnosis challenge.
18F-FDG PET/CT assists the diagnosis of primary pancreatic lymphoma: Two case reports and literature review
Authors: Jian Wang, Yujing Zhou, Hongwei Liu, Jianli Zhou, Xin Li
Journal: Front Med (Lausanne) (2024)
Keywords: 18f-fluorodeoxyglucose positron emission tomography/computed tomography, case report, pancreatic carcinoma, primary pancreatic lymphoma, therapeutic efficacy
MeSH terms: Case Reports

Primary pancreatic lymphoma (PPL) is a rare malignancy, which is defined as a mass centered in pancreas with involvement of contiguous lymph nodes and distant spread may exist. Accurate diagnosis of PPL prior to pathological confirmation remains challenging, underscoring the critical significance of preoperative imaging assessments. This case report collected two instances of PPL that underwent initial evaluation via 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) between August 2021 and July 2022. Correspondingly, pertinent literature encompassing 18F-FDG PET/CT data related to PPL was meticulously reviewed. Including our aforementioned pair of cases, a cumulative total of 25 instances of PPL were assembled. The distinctive profile of 18F-FDG PET/CT images of PPL predominantly manifests as hypermetabolic lesions with diminished density. Primarily characterized by singular lesions and comparatively substantial volumetric dimensions, a total of eleven cases revealed contiguous lymph node engagement, with five instances displaying distant dissemination encompassing lymph nodes in multiple locations. Amongst these, ten patients underwent sequential 18F-FDG PET/CT follow-up post-intervention. In comparison to pancreatic carcinoma, PPL lesions exhibited heightened hypermetabolism, augmented volumetric proportions, and distinct patterns of distant metastasis. This study indicates that the pivotal role of 18F-FDG PET/CT in the diagnosis and assessment of therapeutic efficacy in PPL is unequivocal. Combined with the clinical attributes of patients, the integration of 18F-FDG PET/CT augments the differential diagnostic capacity differentiating PPL from pancreatic carcinoma.
Primary cardiac lymphoma presenting with cardiac tamponade and complete heart block: case report
Authors: Ruth Kelleher, Brian Healey Bird, Tríona Hayes, Crochan J O'Sullivan
Journal: Eur Heart J Case Rep (2023)
Keywords: cardiac tamponade, case report, complete heart block, endomyocardial biopsy, multimodality cardiac imaging, primary cardiac lymphoma
MeSH terms: Case Reports

Background:
Primary cardiac lymphoma (PCL) is rare and its presentation can be variable. Thorough workup of suspected PCL or other cardiac tumours typically incorporates a range of imaging techniques and laboratory investigations but ultimately diagnosis is confirmed by histological analysis of myocardial tissue.
Case summary:
An 80-year-old Caucasian female presented with complete heart block and symptomatic cardiac tamponade. A pericardiocentesis was performed and a dual-chamber permanent pacemaker was implanted for the management of her complete heart block. Subsequently, a right atrial mass was discovered on imaging and the patient underwent endomyocardial biopsy of the mass. Histological analysis of the sample confirmed a primary cardiac lymphoma. The patient opted to forgo treatment with chemotherapy and died from her disease 1 month later.
Discussion:
Cardiac arrhythmias can occur in PCL due to infiltration of conduction pathways. Characterization of cardiac masses on various imaging modalities and laboratory tests guides diagnosis. Tissue diagnosis is required to confirm PCL. The location of a cardiac mass may present technical challenges when undertaking a biopsy, so the best approach to tissue sampling should be considered on an individual basis. Without treatment survival is less than one month but with modern chemoimmunotherapy five-year survival may exceed 50%.
Mitochondrial DNA Missense Mutations ChrMT: 8981A > G and ChrMT: 6268C > T Identified in a Caucasian Female with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Triggered by the Epstein-Barr Virus
Authors: Gaoyan G Tang-Siegel, David W Maughan, Milah B Frownfelter, Alan R Light
Journal: Case Rep Genet (2024)
MeSH terms: Case Reports

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multisystem disabling disease with unclear etiology and pathophysiology, whose typical symptoms include prolonged debilitating recovery from fatigue or postexertional malaise (PEM). Disrupted production of adenosine triphosphate (ATP), the intracellular energy that fuels cellular activity, is a cause for fatigue. Here, we present a long-term case of ME/CFS: a 75-year-old Caucasian female patient, whose symptoms of ME/CFS were clearly triggered by an acute infection of the Epstein-Barr virus 24 years ago (mononucleosis). Before then, the patient was a healthy professional woman. A recent DNA sequence analysis identified missense variants of mitochondrial respiratory chain enzymes, including ATP6 (ChrMT: 8981A > G; Q152R) and Cox1 (ChrMT: 6268C > T; A122V). Protein subunits ATP6 and Cox1 are encoded by mitochondrial DNA outside of the nucleus: the Cox1 gene encodes subunit 1 of complex IV (CIV: cytochrome c oxidase) and the ATP6 gene encodes subunit A of complex V (CV: ATP synthase). CIV and CV are the last two of five essential enzymes that perform the mitochondrial electron transport respiratory chain reaction to generate ATP. Further analysis of the blood sample using transmission electron microscopy demonstrated abnormal, circulating, extracellular mitochondria. These results indicate that the patient had dysfunctional mitochondria, which may contribute directly to her major symptoms, including PEM and neurological and cognitive changes. Furthermore, the identified variants of ATP6 (ChrMT: 8981A > G; Q152R) and Cox1 (ChrMT: 6268C > T; A122V), functioning at a later stage of mitochondrial ATP production, may play a role in the abnormality of the patient's mitochondria and the development of her ME/CFS symptoms.
Case report: Rare heterozygous variant in the NR5A1 gene causing 46,XY complete gonadal dysgenesis with a non-communicating rudimentary uterus
Authors: Toru Sasaki, Shinji Suzuki, Masanori Ono, Akiko Yamamoto, Masato Bingo, Gaku Yamanaka, Masahiko Kuroda, Natsuko Inagaki, Hirotaka Nishi
Journal: Front Med (Lausanne) (2024)
Keywords: case report, complete gonadal dysgenesis, disorder of sex development, genomic structural variants, pathogenicity
MeSH terms: Case Reports

The nuclear receptor subfamily 5 group A member 1 (NR5A1) gene encodes NR5A1, also known as steroidogenic factor 1, a crucial transcriptional factor regulating adrenal and gonadal development and function. Although pathogenic variants in NR5A1 are known to cause a spectrum of disorders of sex development (DSD), individuals with 46,XY DSD with fully female internal and external genitalia are relatively rare. Herein, we present the case of a patient with 46,XY complete gonadal dysgenesis (CGD) who had a non-communicating rudimentary uterus due to a c.132_134del (p.Asn44del) heterozygous in-frame-deletion in NR5A1 that was diagnosed while treating a pelvic mass in which gynecological malignancy could not be disregarded. Unlike two previous cases with the p.Asn44del variant, this case presented with CGD, a severe DSD phenotype, and we found that the oligogenic inheritance of DSD-causative genes such as SRY, DHX37, SLC26A8, and CFTR may have affected the severity of the clinical phenotype.
Autoimmune encephalitis followed by hemophagocytic lymph histiocytosis: a case report
Authors: Li Huang, Jie Tan, Peihao Lin, Zixuan Chen, Qihua Huang, Haiyan Yao, Lihong Jiang, Baoyi Long, Youming Long
Journal: Front Immunol (2024)
Keywords: autoantibody, autoimmune encephalitis, hemophagocytic lymphohistiocytosis, lymphoma, paraneoplastic neurologic syndromes
MeSH terms: Encephalitis / diagnosis, Encephalitis / immunology, Hashimoto Disease / complications, Hashimoto Disease / diagnosis, Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / etiology, Case Reports, Adult, Autoantibodies / blood, Autoantibodies / cerebrospinal fluid, Autoantibodies / immunology, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Retrospective Studies, Autoantibodies, Hashimoto's encephalitis

Objective:
This study aims to report three cases of autoimmune encephalitis followed by hemophagocytic lymphohistiocytosis.
Methods:
Data of relevant patients treated between 2019 and 2022 were retrospectively collected from the Department of Neurology at the Second Affiliated Hospital of Guangzhou Medical University.
Results:
The age at onset of the three patients was 37, 63, and 36 years, respectively. All three patients were female and presented with cognitive dysfunction and seizures. Behavioral and psychological symptoms were also observed in two cases. All patients were positive for autoantibodies in both the cerebrospinal fluid and serum, while two showed multiple abnormal brain signals on magnetic resonance imaging. All patients exhibited hypocytosis and elevated soluble CD25 and serum ferritin levels. The final diagnoses in two cases were lymphomas, while the remaining case without tumors suffered from a severe infection. All patients received immunotherapy, and the two with lymphoma received anti-tumor treatment. The patient with infection died, and two patients with tumors improved after chemotherapy.
Conclusion:
Autoimmune encephalitis followed by hemophagocytic lymphohistiocytosis is a rare and severe condition. Prompt attention should be paid to the decline in blood cell counts, particularly in patients who show a slight improvement after immunotherapy or have a risk of lymphoma. Screening for potential tumors and infections and early treatment may help these patients.
Small bowel obstruction in adults, Ladd's band is an exceptional cause: a case report
Authors: Jaouad Naddouri, Rachid Khouah, Hamza Sekkat, Younes Bakali, Mouna M'hamdi El Alaoui, Mohamed Raiss, Farid Sabbah, Abdelmalek Hrora
Journal: Pan Afr Med J (2024)
Keywords: intestinal volvulus, ladd’s band, case report, laparotomy, small bowel
MeSH terms: Abdomen, Acute / surgery, Intestinal Obstruction / etiology, Intestinal Obstruction / surgery, Intestinal Volvulus / complications, Intestinal Volvulus / diagnosis, Intestinal Volvulus / surgery, Laparoscopy / methods, Case Reports, Adolescent, Adult, Child, Preschool, Female, Humans, Intestine, Small, Pregnancy

Malrotation of the gut is a congenital anomaly of foetal intestinal rotation and it's principally discovered in early childhood as acute intestinal obstruction. This condition is veritably rare and constantly silent in adults. Intestinal malrotation in adults is frequently asymptomatic and is diagnosed as a casual finding during a radiological examination performed for other reasons. Infrequently, it can be diagnosed in adults, associated with an acute abdomen. Adult patients rarely present with acute midgut volvulus or internal hernias caused by Ladd's bands. We present a case of an admitted 18-year-old female with a small bowel obstruction due to an intestinal volvulus complicating intestinal malrotation in the presence of Ladd's band. Laparotomic Ladd's procedure was performed successfully with division of Ladd's band, adhesiolysis, appendicectomy, and reorientation of the small bowel on the right and the cecum and colon on the left of the abdominal cavity; the postoperative evolution was favorable. Although it is a rare pathology, it should be kept in mind in cases of patients presenting small bowel obstruction.
Case report: Success of allogeneic hematopoietic stem cell transplantation for refractory systemic-onset juvenile idiopathic arthritis
Authors: Camille Beaufils, Catherine Proulx, Annaliesse Blincoe, Pierre Teira, Henrique Bittencourt, Sonia Cellot, Michel Duval, Marie-Paule Morin, Jean Jacques De Bruycker, Julie Couture, Kathryn Samaan, Hélène Decaluwe, Niina Kleiber, Ramy El-Jalbout, Fabien Touzot, Elie Haddad, Julie Barsalou
Journal: Front Med (Lausanne) (2023)
Keywords: allogeneic hematopoietic stem cell transplantation, bone marrow transplantation, juvenile idiopathic arthritis, pediatric rheumatic disease, systemic-onset juvenile idiopathic arthritis
MeSH terms: Case Reports

Objectives:
This study reports cases of systemic-onset juvenile idiopathic arthritis (sJIA) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at our center and reviews published outcomes of allo-HSCT in sJIA.
Methods:
We present a case report of two patients with sJIA who underwent allo-HSCT at a tertiary pediatric hospital. Each patient's disease course and allo-HSCT protocol/outcome are described. Outcomes of published cases of allo-HSCT in sJIA were compared to our experience.
Results:
Two patients with sJIA had allo-HSCT. Both failed multiple lines of disease-modifying anti-rheumatic drugs and experienced severe disease/treatment-related complications. Despite post-HSCT complications, both recovered without sequelae. Five years post-HSCT, patient 1 is in complete remission (CR) and is off medications. Patient 2 was in CR until 11 months post-HSCT after which he developed three disease flares. At 4 years post-HSCT he is currently in CR on Adalimumab monotherapy. Engraftment was excellent with a donor chimerism of 100% for patient 1 and 93% for patient 2. In the literature, the outcome of allo-HSCT is reported in 13 sJIA patients. When merging those with our 2 patients, 1/15 patients died and 13/14 achieved CR, of which 12 are off medications (median [range] follow-up: 2.2 [0.2-7.0] years). Extended follow-up data on 11 of the 13 reported sJIA patients showed that an additional 3 patients flared at 3, 4, and 10 years post-HSCT.
Conclusion:
We report two patients with severe/refractory sJIA who underwent successful allo-HSCT and achieved CR. Allo-HSCT is a potential curative option for severe/refractory sJIA. It should be considered only after failure of conventional sJIA treatments and when an HLA-matched donor is available in order to lower transplant-related mortality. The outcomes of reported sJIA patients who received allo-HSCT are encouraging but long-term follow-up data are needed to better characterized the risk-benefit ratio of this procedure.
Carpometacarpal Osteoarthritis Pain of the Thumb Can Be Relieved by Commercial Beverage Carbonated Water
Authors: Masaaki Nakajima
Journal: Case Rep Anesthesiol (2024)
MeSH terms: Case Reports

Thumb carpometacarpal (CMC) arthropathy pain is treated using carbonated water-a commercially available beverage. The right hand (affected side) was bathed once daily in carbonated beverage water (37°C) for 20 min. Prior to treatment, the visual analogue scale score of pain was 73 mm; 1 week after the treatment, it was 0 mm. Commercial carbonated water immersion was effective for thumb CMC arthropathy pain. Commercial carbonated water is inexpensive and easy to obtain, making it suitable for home carbonation therapy.
Case report: A rare case of left ventricular noncompaction in two Chinese siblings with becker muscular dystrophy caused by deletion of exons 10 to 12 in the DMD gene
Authors: Jingdong Li, Wanyue Zhu, Guanhua Su, Feng Zhu, Xinxin Shuai, Yidi Meng, Jiaming Zhang, Hao Chen
Journal: Front Cardiovasc Med (2023)
Keywords: becker muscular dystrophy, cardiomyopathy, heart failure, heart transplantation, left ventricular noncompaction
MeSH terms: Case Reports

Background:
Becker muscular dystrophy (BMD) is an inherited X-linked recessive condition resulting from mutations of the DMD gene encoding dystrophin. Left ventricular noncompaction (LVNC) is a rare cardiomyopathy morphologically characterized by abnormal myocardial trabeculae and deep recesses in the left ventricle. LVNC in BMD patients has only rarely been reported.
Case report:
In the present study, we identified a deletion mutation in exons 10 to 12 (EX10_12 del) of the DMD gene (reference sequence NM_004006.2) in two Chinese siblings with BMD and LVNC by high throughput targeted next-generation sequencing (NGS) and quantitative polymerase chain reaction (qPCR). The proband was a 22-year-old man admitted with dyspnea, abdominal distention, and polyserositis. It is noteworthy that both the proband and his younger brother manifested progressive muscular atrophy and creatine kinase (CK) elevation. Light and electron microscopy examination of muscle biopsies showed the typical features of dystrophinopathies. Cardiac magnetic resonance imaging and echocardiography demonstrated that both brothers had an enlarged left ventricle, LVNC, and reduced left ventricular ejection fraction. Finally, the proband underwent heart transplantation at age 26 with an event-free follow-up over 4 years post-transplantation.
Conclusion:
This case further enriches our knowledge of the symptoms, genotype, cardiac performance, management, and prognosis of BMD patients complicated by LVNC. It is recommended that early comprehensive cardiac evaluation should be considered for patients with BMD to exclude LVNC, as this may have a significant impact on their prognosis.
Unusual Presentation of Reversible Transient Vision Loss After Caesarean Section Under Subarachnoid Block: A Case Report
Authors: Abhishek Chatterjee, Pratap Rudra Mahanty, Deb Sanjay Nag, Nilanjan Sarkar
Journal: Cureus (2024)
Keywords: caesarean section, loss of vision, posterior reversible encephalopathy syndrome, pregnancy, pres
MeSH terms: Case Reports

A transient vision loss is not commonly encountered during the postoperative period following a caesarean section. Although numerous causes have been suggested for transient vision loss, when loss of vision is associated with seizures and headaches, the differential diagnoses include hemolysis, elevated liver enzymes, low platelet syndrome, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome (PRES), dural venous thrombosis, and central retinal arteriolar occlusion. We report a case of a 35-year-old patient who underwent an elective caesarean section under spinal anaesthesia and developed a headache followed by loss of vision and seizures during the postoperative period. An MRI scan of the brain on the same day revealed subtle hyperintensity in bilateral parieto-occipital lobes in the cortical and subcortical areas and bilateral cerebral hemispheres, which indicates PRES. Rapid and complete resolution of symptoms was observed with supportive treatment. Therefore, prompt suspicion and effective management of PRES are of paramount importance to prevent short- and long-term neurological deficits.
Primary Nonseminomatous Germ Cell Tumor of Kidney: An Uncommon Renal Neoplasm
Authors: Sonu Plash, Deepti Soni, Sramana Mukhopadhyay, Moorat Singh Yadav, Devashish Kaushal, Ketan Mehra
Journal: J Kidney Cancer VHL (2024)
Keywords: extragonadal germ cell tumor, germ cell tumor, kidney tumor, nonseminomatous tumor, renal neoplasm
MeSH terms: Case Reports

Germ cell tumor (GCT) is a neoplasm typically found in childhood, commonly originating from the testis or ovary. While there have been reported cases of GCT occurring in various extragonadal sites, primary intrarenal GCT is exceptionally rare. We present a case of 37-year-old male who presented with right upper abdomen pain. Imaging revealed a sizable mass within the right kidney. The patient underwent surgical resection of the renal mass during which there was perirenal infiltration into the duodenum and dense desmoplastic reaction all around. Subsequent histopathology confirmed the diagnosis of primary intrarenal nonseminomatous germ cell tumor (NSGCT). The patient underwent four cycles of adjuvant bleomycin, etoposide, and cisplatin (BEP) chemotherapy; at 6 months of follow-up, he is fine. The objective of this case report is to underscore the importance of considering NSGCT as a potential rare differential diagnosis in cases of renal neoplasms and further plan for the management.
Emergent airway recanalization of the left main bronchus due to obstructive adenoid cystic carcinoma enables achievement of radical resection
Authors: Makoto Takahama
Journal: Respirol Case Rep (2023)
Keywords: adenoid cystic carcinoma, bronchoplasty, rigid bronchoscopy
MeSH terms: Case Reports

Malignant airway obstruction is a life-threatening condition that can cause suffocation and recurrent infections due to lung atelectasis. Adenoid cystic carcinoma is a rare and slow-growing tumour of low-grade malignancy. We report the case of a 69-year-old female who presented with severe chest pain, orthopnea, and a 1-month history of progressively worsening difficulty in breathing. Emergent rigid bronchoscopy revealed a polypoid tumour originating in the proximal end of the left main bronchus that was obstructing the left main bronchus. Debulking of the tumour using rigid bronchoscopy was performed to restore ventilation to collapsed lung and obtain histopathological examination. Histological analysis revealed a diagnosis of adenoid cystic carcinoma. The patient underwent radical sleeve resection of the left main bronchus without sacrificing lung parenchyma via left posterolateral thoracotomy. No postoperative complications or disease recurrence was found at the 5-year follow-up. This case emphasizes the pivotal role of rigid bronchoscopic intervention in malignant central airway obstruction.