OpenMed/multicare-articles huggingface dataset:
An Unusual Case of Breast Implant-Associated Anaplastic Large Cell Lymphoma
Authors: Sarah Premji, Andreia Barbieri, Christine Roth, Eric M Rohren, Gustavo Rivero, Sravanti P Teegavarapu
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Introduction:
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare disease entity associated with textured breast implants. Though the clinical course is typically indolent, BIA-ALCL can occasionally invade through the capsule into the breast parenchyma with spread to the regional lymph nodes and beyond including chest wall invasive disease.
Case:
We present the case of a 51-year-old female with a history of bilateral silicone breast implants placed approximately twenty years ago who presented with two months of progressively enlarging right breast mass. Ultrasound-guided biopsy of right breast mass and right axillary lymph node showed CD 30-positive ALK-negative anaplastic large cell lymphoma, and staging work up showed extension of the tumor to chest wall and ribs consistent with advanced disease. She received CHP-BV (cyclophosphamide, doxorubicin, prednisone, and brentuximab vedotin) for six cycles with complete metabolic response. This was followed by extensive surgical extirpation and reconstruction, radiation for residual disease and consolidation with autologous stem cell transplant. She is currently on maintenance brentuximab vedotin with no evidence of active disease post autologous stem cell transplant.
Conclusion:
Treatment guidelines for advanced chest wall invasive BIA-ALCL are not well defined. Lack of predictive factors warrants mutation analysis and genetic sequencing to identify those at highest risk of progression to chest wall invasive disease. This rare case highlights the need for definitive consensus on the optimal management of chest wall invasive BIA-ALCL.
Case of Hereditary Papillary Renal Cell Carcinoma Type I in a Patient With a Germline MET Mutation in Russia
Authors: Dmitry S Mikhaylenko, Alexey V Klimov, Vsevolod B Matveev, Svetlana I Samoylova, Vladimir V Strelnikov, Dmitry V Zaletaev, Ludmila N Lubchenko, Boris Y Alekseev, Marina V Nemtsova
Journal: Front Oncol (2020)
Keywords: met gene, germline mutation, hereditary cancer syndrome, kidney cancer, papillary renal cell carcinoma
MeSH terms: Case Reports

Hereditary papillary renal carcinoma (HPRC) is a rare autosomal dominant disease characterized by the development of multiple papillary type I renal cell carcinomas. This hereditary kidney cancer form is caused by activating mutations in MET. Descriptions of patients with HPRC are scarce in the world literature, and no cases have been described in open sources in Russia. Here, we describe a 28-year-old female Russian patient with 7 and 10 primary papillary renal cell carcinomas in the left and right kidneys, respectively. The patient did not have a family history of any of the known hereditary cancer syndromes. A comprehensive medical examination was performed in 2016 including computed tomography and pathomorphological analysis. The observed tumors were resected in a two-step surgical treatment. In February 2019, no sign of disease progression was detected in follow-up medical examination. Molecular genetic analysis revealed the germline heterozygous missense variant in MET: c.3328G>A (p.V1110I; CM990852). We have discussed the biological effects of the detected mutation and the utility of DNA diagnostics for treating patients with HPRC.
Unexpected anal squamous cells carcinoma after open hemorrhoidectomy
Authors: Navarra Luca, Abruzzese Valentina, Sista Federico, Pietroletti Renato
Journal: Case Rep Surg (2015)

We report a case of unexpected anal squamous cells carcinoma found in hemorrhoidectomy specimen. The patient had a 3-year history of prolapsing hemorrhoids. A prolapsing hemorrhoid was present at eleven o'clock in lithotomy. Milligan-Morgan was performed and gross examination of the specimen was unremarkable. Histopathologic evaluation showed noninvasive squamous cells carcinoma. The present case report evidences the opportunity of routine histopathologic analysis of hemorrhoidal specimens particularly in case of long-standing prolapse. Questions arise in the option of those techniques where no specimens are collected or tissue is excised far from deceased area.
Abdominal Wall Endometrioma: A Diagnostic Enigma-A Case Report and Review of the Literature
Authors: Ketan Vagholkar, Suvarna Vagholkar
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Abdominal wall endometriomas are quite uncommon. They are usually misdiagnosed by both the surgeon and the gynaecologist. Awareness of the details of this rare condition is therefore essential for prompt diagnosis and adequate treatment.
Introduction:
Endometriosis though a condition commonly seen in the pelvic region can also occur at extrapelvic sites giving rise to a diagnostic dilemma. Abdominal wall endometrioma is one such complex variant of extrapelvic endometriosis with an incidence of less than 2% following gynaecologic operations.
Case report:
A case of abdominal wall endometrioma diagnosed clinically and treated by wide surgical resection is presented to highlight the importance of clinical evaluation in the diagnosis of this condition.
Discussion:
The etiopathogenesis, presentation, investigations, and management are discussed briefly.
Conclusion:
Clinical evaluation confirmed by supportive imaging is diagnostic. Wide local excision is the mainstay of treatment.
Case Report: Two cases of survival after complete transection of the left common carotid artery
Authors: Xin Yang, Zhonglu Liu, Qi Sun, Yakui Mou, Chuanliang Jia, Wenbin Zhang, Fei Song, Wen Li, Hua Zhang, Xicheng Song
Journal: Front Surg (2023)
Keywords: cta, cta complete common carotid artery transection, complete common carotid artery transection, left common carotid artery, survival, trauma
MeSH terms: Case Reports

Penetrating carotid artery traumas are rare yet fatal injuries with a high rate of mortality, and survivors may live with neurological sequelae. Of all the types of penetrating carotid artery traumas, the total transection of the common carotid artery (CCA) may be the most serious, can lead to death quickly, and has few reports of survivors. We described two cases of patients with complete CCA transections who survived without any neurological sequelae. The penetrating neck traumas of both patients were confirmed as complete CCA severance by CT and surgical exploration. Case 1 received the insertion of an interposition polytetrafluoroethylene graft to reconstruct the CCA, with postoperative ultrasound and CT angiography (CTA) verifying the total occlusion. Case 2 underwent nonoperative management under close observation and did not develop delayed active bleeding or neurological symptoms. Both patients recovered well, and no nervous system sequelae appeared during the follow-up period. A carotid artery injury cannot be ruled out in an asymptomatic penetrating neck injury. If CTA is feasible given the patient's hemodynamic condition, then it should be used as a routine examination to evaluate cervical vascular injury in patients with penetrating neck trauma. Management for hemodynamically stable carotid artery injuries remains controversial. These two cases of transverse carotid artery injury have caused us to further consider the principles of this kind of case management.
Giant Dermatofibroma: A Rare Presentation as a Large Scaly Plaque
Authors: T Iqbal, V Mudaliar
Journal: Case Rep Dermatol Med (2022)
MeSH terms: Case Reports

A rare form of dermatofibroma (DF) is described in the literature as giant dermatofibroma. Due to the rarity and distinct presentation that can be confused with more sinister skin tumours, these can cause diagnostic uncertainty and require clinicopathologic correlation. Familiarity with this rare presentation of an otherwise common entity is required to prevent unnecessary clinical doubt and excessive interventions. We report a case of giant dermatofibroma on the leg of a 29-year-old healthy male that presented with a 7 cm, nonulcerated pink, brown plaque, adding to the limited literature of less than 30 known cases.
Two Cases of Dedifferentiated Endometrioid Carcinoma: Case Presentation and Brief Review of the Literature
Authors: Sachiko Morioka, Yasuhito Tanase, Ryuji Kawaguchi, Tomoko Uchiyama, Hiroshi Kobayash
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Endometrioid carcinoma is the most common histological type of uterine endometrial cancer and particularly dedifferentiated endometrioid carcinomas (DEC) are less commonly observed. Silva et al. reported the biological features of UC based on the undifferentiated component of DEC, although the component represented only 20% of undifferentiated carcinoma. In this study, we report two cases of DEC with different presentation. Case 2 presented with the invasion to the bladder, rectum, and LN metastases. In contrast, the tumor in case 1 advanced into the endometrial cavity, similar to an endometrial polyp, without myometrial invasion. Hence, the diagnosis was established early. While we strive to improve the diagnosis of DEC, it is also crucial to better assess the prognosis and the appropriate treatment for the patients with established diagnosis of DEC.
Seizures and Blurred Vision as Initial Presentation of Intracerebral Schwannoma: A Rare Tumor of the Brain
Authors: Mohammad Alayyaf, Nour Taher Nasir
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Schwannomas are the most common tumor of peripheral nerves which are arising from Schwann cells and are benign in their nature. Intracranial schwannoma accounts for between 5 and 8% of intracranial tumors, whereas intracerebral schwannoma, a rare disease, accounts for <1% of intracranial schwannomas. Intracerebral schwannoma has no specific clinical manifestation, and it is not classified by age. Here, we are reporting a case of an 18-year-old male who presented with attacks of seizures. MR imaging studies were done and showed right parieto-occipital cortical and subcortical mass lesion with intense enhancement and significant vasogenic oedema with mass effect on the subjacent sulci. The tumor was surgically removed through a right occipital craniotomy. Histological findings confirmed the diagnosis of schwannoma.
Not Your Common Athletic Heart Problem: Using Coronary CTA to Visualize Spontaneous Coronary Artery Dissection
Authors: Padma Shenoy, Taher Tayeb, Pedro Covas, Nardos Temesgen, Cynthia Tracy
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

A 19-year-old healthy male collegiate athlete presented with typical anginal symptoms after running a 5K race. He had complained of similar symptoms off and on for the past month. On presentation, troponin was 0.12 ng/ml (reference value < 0.01 ng/ml), which peaked at 17.7 ng/ml and CK-MB was 28.71 IU/L (reference value < 25 IU/L). ECG showed diffuse biphasic T-waves. Coronary computed tomography angiogram (cCTA) demonstrated a 1.5 cm dissection in the left anterior descending artery and a 1.9 × 1.8 cm attenuation defect in the left ventricular apex consistent with thrombus. Subsequent coronary catheterization confirmed dissection of the left anterior descending artery. Spontaneous coronary artery dissection (SCAD) is a rare phenomenon. Diagnosis can be made through noninvasive measures but is usually done through left heart catheterization. In young patients who present with an NSTEMI, clinical suspicion for SCAD among other conditions should be raised. Additionally, recognizing that complications such as intracardiac thrombi can occur in SCAD is critical in ensuring appropriate therapy.
Gingival Reactive Lesions in Orally Rehabilitated Patients by Free Revascularized Flap
Authors: Gianluca Tenore, Ahmed Mohsen, Giorgio Pompa, Edoardo Brauner, Andrea Cassoni, Valentino Valentini, Antonella Polimeni, Umberto Romeo
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

The aim is to discuss four cases of gingival reactive hyperplastic lesions in patients with a history of excision of oral neoplastic lesions and rehabilitation by a free revascularized flap of the iliac crest. One female and 3 male patients were referred due to the presence of exophytic lesions at the rehabilitated sites. The clinical examination revealed that the poor oral hygiene was the common trigger factor in all the cases, in addition to trauma from the upper left second molar in the first case, pericoronitis related to a partially erupted lower right third molar in the third case, and poor stability of an upper removable partial denture in the fourth case. All the cases were subjected to elimination of these suspected triggering factors, exclusion of dysplasia, excisional biopsy by CO2 laser, and five follow-up visits. The histological examination of all the cases confirmed the diagnosis of pyogenic granuloma. These presented cases suggest that the limitations in oral functions and maintaining the oral hygiene measures following the free revascularized flap reconstruction surgery probably played a role in the development of gingival reactive hyperplastic lesions with presence of trigger factors such as local trauma, chronic infection, or inadequate prosthesis.
Acute Unilateral Renal Infarction in the Setting of an Inherited Thrombophilia and Atrial Septal Defect
Authors: Siavash Piran, Sam Schulman
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

We present a case of renal infarction in a 43-year-old female with history of stroke at age 14. She was found to be heterozygous for the prothrombin G20210A gene mutation. Loop monitoring revealed no atrial fibrillation. Transthoracic and transesophageal echocardiograms showed no thrombus. However, there was a small shunt due to an atrial septal defect (ASD). She was treated with warfarin and had device closure of her ASD. This was a suspected case of paradoxical embolism through an ASD leading to renal infarction.
Case Report: A New Geographic Area for the Presence of the Zoonotic Ocular Nematode, Onchocerca lupi in Romania
Authors: Georgiana Deak, Serenela Toader, Diana Gabriela Soare, Angela Monica Ionică, Marian Taulescu, Andrei Daniel Mihalca
Journal: Front Vet Sci (2022)
Keywords: onchocerca lupi, romania, dogs, new location, zoonosis
MeSH terms: Case Reports

Introduction:

Onchocerca lupi is a zoonotic parasite of carnivores reported in countries from Europe, North America, Asia and Africa. In Romania, canine ocular onchocercosis was first reported in dogs in 2016 from Târgovişte (Dâmboviţa County) and Oneşti (Bacău County) and more recently, it was detected in an adult stray dog exported to UK from an unspecified location in Romania.
Methods:
A 4-years old male mongrel dog was referred to a private veterinary clinic in Năvodari (Constanţa County), Romania due to ocular disorders. The dog was originally from a public dog shelter in Balş (Olt County) and transferred in June 2020 to a dog shelter in Medgidia (Constanţa County). A cytological examination followed by surgical removal of the granuloma localized at the internal angle of the right eye, and molecular identification of the extracted nematode were done.
Results:
The cytological examination confirmed a parasitic granuloma. Skin biopsy and PCR confirmed the infection with O. lupi. Two doses of moxidectin and imidacloprid were administered after the surgery. No relapse observed after a period of follo-up of 11 months.
Conclusion:

Onchocerca lupi is present in dogs from Romania with its actual distribution remaining unknown.
Aortic Arch Floating Thrombus Complicated by Distal Embolization in a Patient with Malignancy
Authors: Konstantinos Tigkiropoulos, Dimitrios Karamanos, Marianthi Tympanidou, Nikolaos Saratzis, Ioannis Lazaridis
Journal: Case Rep Vasc Med (2018)
MeSH terms: Case Reports

Free floating thrombus of aortic arch in a minimally atherosclerotic or nonaneurysmal aorta is a rare disease entity which carries a potential risk of distal embolization with catastrophic consequences. We present the case of a 52-years-old patient with ovarian cancer and aortic arch floating thrombus who initially managed with low molecular weight heparin and eventually undergone surgical thrombectomy of left external iliac and common femoral artery due to acute ischemia of left lower leg.
Acute thyrotoxic bulbar myopathy with encephalopathic behaviour: an uncommon complication of hyperthyroidism
Authors: Neeraja J Boddu, Sridhar Badireddi, Karl David Straub, John Schwankhaus, Rajani Jagana
Journal: Case Rep Endocrinol (2013)

Objective. Acute thyrotoxic bulbar palsy is rare, severe, and rapidly progressive. We describe a case of thyrotoxicosis with bulbar palsy, encephalopathy, and pyramidal tract dysfunction. Case Report. 64-year-old white male with toxic multinodular goiter presented with rapid atrial fibrillation. He had mild tremor, normal cranial nerve examination, 4/5 strength in all extremities, normal reflexes, and down going plantars. TSH was low at 0.09 (normal: 0.34-5.6 uIU/mL), and free T4 was high at 5.22 (normal: 0.47-1.41 ng/dL). Despite optimal AV nodal blockade, he had persistent rapid atrial fibrillation. He later developed cervical dystonia, rigidity, clonus, dysarthria, dysphagia, vocal cord palsy, and absent gag reflex. Thyroid storm was suspected. Neuroimaging and cerebrospinal fluid cultures were nondiagnostic. Acetylcholine receptor antibodies were negative. Swallow ability was impaired with heavy secretions. Remarkable improvement in symptoms was noted after initiation of treatment for thyroid storm. Conclusion. Pyramidal tract symptoms and bulbar palsy may occur with thyrotoxicosis. Cranial nerve involvement and encephalopathy raise a question of primary brain mechanism causing bulbar palsy. This is reversible with prompt treatment of thyroid storm.
Severe rhabdomyolysis and acute renal failure secondary to the use of simvastatin in undiagnosed hypothyroidism
Authors: F A Qari
Journal: Indian J Nephrol (2008)
Keywords: creatine kinase, acute renal failure, hypothyroidism, rhabdomyolysis, simvastatin
MeSH terms: Case Reports

A 52-year-old Indian woman with underlying diabetes mellitus, hyperlipidemia and undiagnosed hypothyroidism presented with generalized musculoskeletal pain and oliguria for three days. The patient was taking 80 mg of simvastatin (initiated 20 days before) after cardiac catheterization for an inferior myocardial infarction. Laboratory evaluation revealed the following serum levels: creatine kinase, 81,660 U/L; aspartate aminotransferase, 2,497 U/L; alanine aminotransferase, 1,304 U/L; blood urea nitrogen, 88 mg/dL; creatinine, 5.1 mg/dL; free thyroxine (FT(4)), 12.6 Pmol/L and thyroid stimulating hormone, 22.7 uIU/L. Simvastatin was discontinued and the patient was administered forced alkaline diuresis. Her hypothyroidism was treated with thyroxine, which was continued after discharge. Her renal function recovered within two months. This case report discusses the higher incidence of rhabdomyolysis in patients with undiagnosed hypothyroidism receiving large doses of simvastatin.
Osteoblastic Metastases Mimickers on Contrast Enhanced CT
Authors: Fahad Al-Lhedan, Sam Samaan, Wanzhen Zeng
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Secondary osseous involvement in lymphoma is more common compared to primary bone lymphoma. The finding of osseous lesion can be incidentally discovered during the course of the disease. However, osseous metastases are infrequently silent. Detection of osseous metastases is crucial for accurate staging and optimal treatment planning of lymphoma. The aim of imaging is to identify the presence and extent of osseous disease and to assess for possible complications such as pathological fracture of the load-bearing bones and cord compression if the lesion is spinal. We are presenting two patients with treated lymphoma who were in complete remission. On routine follow-up contrast enhanced CT, there were new osteoblastic lesions in the spine worrisome for metastases. Additional studies were performed for further evaluation of both of them which did not demonstrate any corresponding suspicious osseous lesion. The patients have a prior history of chronic venous occlusive thrombosis that resulted in collaterals formation. Contrast enhancement of the vertebral body marrow secondary to collaterals formation and venous flow through the vertebral venous plexus can mimic the appearance of spinal osteoblastic metastases.
Immune Modulation for Enzyme Replacement Therapy in A Female Patient With Hunter Syndrome
Authors: Daniel C Julien, Kara Woolgar, Laura Pollard, Holly Miller, Ankit Desai, Kristin Lindstrom, Priya S Kishnani
Journal: Front Immunol (2020)
Keywords: mps ii, enzyme replacement therapy, hunter syndrome, immune modulation, neutralizing antibodies
MeSH terms: Enzyme Replacement Therapy / methods, Iduronate Sulfatase / therapeutic use, Immunoglobulins, Intravenous / therapeutic use, Mucopolysaccharidosis II / therapy, Rituximab / therapeutic use, Case Reports, Antibodies, Neutralizing / metabolism, Child, Preschool, Female, Humans, Iduronate Sulfatase / genetics, Iduronate Sulfatase / immunology, Immune Tolerance, Mucopolysaccharidosis II / immunology, Sequence Deletion, Antibodies, Neutralizing, Immunoglobulins, Intravenous, Rituximab, Iduronate Sulfatase

A 3.5 year old Hispanic female presented with signs and symptoms concerning for MPS II (Hunter Syndrome). The diagnosis of MPS II was confirmed by enzyme and molecular testing. Genetic evaluation revealed undetectable plasma iduronate-2-sulfatase enzyme activity and an inversion between intron 7 of the IDS gene and a region near exon 3 of IDS-2. This inversion is the molecular cause for ~8% of cases of MPS II and often results in a severe phenotype. X-inactivation studies revealed an inactivation ratio of 100:0. Given the patient's undetectable enzyme level, in combination with a severe IDS gene mutation, classic features at time of presentation, and the significantly skewed X inactivation, there was concern that she was at high risk of developing high and sustained antibody titers to idursulfase which would limit her benefit from enzyme replacement therapy (ERT). Anti-drug neutralizing antibodies to idursulfase have been associated with reduced systemic exposure to idursulfase and poorer clinical outcomes. Therefore, the decision was made to concurrently treat the patient with immune tolerance induction therapy during the first month of treatment with idursulfase in order to decrease the risk of developing high sustained antibody titers. The immune tolerance induction protocol consisted of rituximab weekly for 4 weeks, methotrexate three times a week for 3 weeks and monthly IVIG through B-cell and immunoglobulin recovery. Immune tolerance induction was initiated concurrently with the start of ERT. The patient had no significant adverse effects related to undergoing immune tolerance induction therapy and two and half years later is doing well with significantly reduced urine glycosaminoglycans and very low anti-drug antibody titers. This immune tolerance induction protocol could be considered for other patients with MPS II as well as patients with other lysosomal storage disorders who are starting on enzyme replacement therapy and are at high risk of developing neutralizing anti-drug antibodies.