OpenMed/multicare-articles huggingface dataset:
A Case of Amelanotic Malignant Melanoma of the Lingual Base That Was Diagnosed Based on a Biopsy of Late Metastasis to a Lumbar Vertebra after Being Misdiagnosed as HPV-Positive Oropharyngeal Anterior Wall Squamous Cell Carcinoma
Authors: Takumi Okuda, Shinsuke Ide, Kei Kajihara, Tetsuya Tono
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

We report a case of amelanotic malignant melanoma (AMM) in a 66-year-old female. AMM of the lingual base was diagnosed based on a biopsy of late metastasis to the bone marrow of the L4 lumbar vertebra. The patient was initially treated with chemoradiotherapy after being misdiagnosed with poorly differentiated human papillomavirus- (HPV-) related squamous cell carcinoma of the oropharyngeal anterior wall. p16 immunostaining is used to diagnose HPV-related oropharyngeal cancer. However, while p16 expression is used as a surrogate marker of HPV infection, it is important to be aware that p16 protein overexpression can also be caused by other factors. Malignant melanoma is known to express the p16 protein. Morphologically differentiating between AMM and poorly differentiated squamous cell carcinoma based on hematoxylin-eosin staining is difficult. Therefore, in cases that are pathologically diagnosed as p16-positive poorly differentiated oropharyngeal squamous cell carcinoma, it is important to rule out AMM.
Cor Triatriatum Sinister: An Unusual Cause of Atrial Fibrillation in Adults
Authors: Christopher Hayes, Shuangbo Liu, James W Tam, Malek Kass
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Cor triatriatum is a rare congenital heart defect that is associated with an increased risk for developing atrial fibrillation. We report a case of a healthy 38-year-old man who presented in decompensated heart failure and atrial fibrillation with a rapid ventricular response. A transthoracic echocardiogram (TTE) demonstrated severe biventricular dysfunction and dilatation in addition to cor triatriatum sinister. He was diuresed with resolution of his symptoms and spontaneously converted back to sinus rhythm. There is limited evidence in the literature surrounding anticoagulation and associated left ventricular dysfunction in the setting of cor triatriatum which posed difficult therapeutic decisions.
Lactulose to the Rescue: A Case of Toxic Hepatic Encephalopathy Caused by Portosystemic Shunting and Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia
Authors: Ruchit N Shah, Michael Makar, Nasir Akhtar, Erin Forster
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

Hereditary hemorrhagic telangiectasia (HHT) is an uncommon autosomal dominant disorder characterized by telangiectasias and arteriovenous malformations. Multiple organ systems are involved including the skin, lungs, gastrointestinal tract, and brain. Hepatic encephalopathy is an extremely rare complication of HHT and early diagnosis and treatment can be life-saving. We present a rare case of hepatic encephalopathy caused by HHT-induced portosystemic shunting treated with lactulose.
An Unconcealed Reservoir: Case Report of Erosion of Inflatable Penile Implant Reservoir through the Anus
Authors: Mark Arthur, Jonathan Canete, Charles Welliver
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Inflatable penile prosthesis (IPP) involves placement of the fluid reservoir into an abdominal or pelvic location. While the space of Retzius (SOR) was the preferred site for many years, the change from open to robotic prostatectomy made this space less desirable due to the violation of the peritoneum with the robotic approach. Other factors like previous abdominal or pelvic surgeries (particularly inguinal hernia repair with mesh) may also require a change in location of the reservoir during IPP placement. In this report, we discuss a previously undescribed result of alternative reservoir placement (ARP) with erosion of the reservoir through the colon and out of the anus in a man with multiple previous abdominal surgeries. Management of this clinical problem is also discussed.
Network-based machine learning and graph theory algorithms for precision oncology
Authors: Wei Zhang, Jeremy Chien, Jeongsik Yong, Rui Kuang
Journal: NPJ Precis Oncol (2017)
MeSH terms: Review

Network-based analytics plays an increasingly important role in precision oncology. Growing evidence in recent studies suggests that cancer can be better understood through mutated or dysregulated pathways or networks rather than individual mutations and that the efficacy of repositioned drugs can be inferred from disease modules in molecular networks. This article reviews network-based machine learning and graph theory algorithms for integrative analysis of personal genomic data and biomedical knowledge bases to identify tumor-specific molecular mechanisms, candidate targets and repositioned drugs for personalized treatment. The review focuses on the algorithmic design and mathematical formulation of these methods to facilitate applications and implementations of network-based analysis in the practice of precision oncology. We review the methods applied in three scenarios to integrate genomic data and network models in different analysis pipelines, and we examine three categories of network-based approaches for repositioning drugs in drug-disease-gene networks. In addition, we perform a comprehensive subnetwork/pathway analysis of mutations in 31 cancer genome projects in the Cancer Genome Atlas and present a detailed case study on ovarian cancer. Finally, we discuss interesting observations, potential pitfalls and future directions in network-based precision oncology.
First report of Leishmania (Viannia) lindenbergi causing tegumentary leishmaniasis in the Brazilian western Amazon region
Authors: Lilian Motta Cantanhêde, Cristiane Batista Mattos, Camila de Souza Ronconi, Camila Patrício Braga Filgueira, Cipriano Ferreira da Silva Júnior, Claudino Limeira, Helen Paula de Jesus Silva, Gabriel Eduardo Melim Ferreira, Renato Porrozzi, Ricardo de Godoi Mattos Ferreira, Elisa Cupolillo
Journal: Parasite (2019)
MeSH terms: Leishmania / isolation & purification, Leishmaniasis, Cutaneous / diagnosis, Skin / pathology, Case Reports, Adult, Brazil, Female, Humans, Leishmania / classification, Leishmania / genetics, Male, Middle Aged, Polymerase Chain Reaction, Polymorphism, Restriction Fragment Length, Skin / parasitology

Tegumentary Leishmaniasis (TL) in the Brazilian Amazon region is associated with several Leishmania species. In this report, we describe two cases of TL related to Leishmania lindenbergi occurring in different locations of Rondônia state. After clinical diagnosis, lesion samples were collected for parasitological diagnoses via direct microscopic visualization, parasite isolation, and PCR. PCR reactions were positive in both clinical samples. Parasite isolation was possible for both patients, and isolates were submitted to species identification by isoenzyme electrophoresis and DNA sequencing. This report is the first to describe human infections caused by L. lindenbergi since the initial description and record of human infection by this species in 2002.
Teriparatide Replacement Therapy for Hypoparathyroidism During Treatment With Lenvatinib for Advanced Thyroid Cancer: A Case Report
Authors: Tommaso Porcelli, Francesca Sessa, Angela Caputo, Christian Catalini, Domenico Salvatore
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: lenvatinib, metastatic thyroid cancer, postsurgical hypoparathyroidism, recombinant human parathyroid hormone (1–34), targeted therapy, teriparatide, tyrosine kinase inhibitors
MeSH terms: Case Reports

Thyroid cancer metastasizes in 4% of cases. Approximately two-thirds of these patients are refractory to radioactive iodine-131 (RAI) therapy and have a poor 10-year survival prognosis. Treatment with tyrosine kinase inhibitors (TKIs) may be administered in selected RAI-refractory patients. However, these agents are often associated with adverse events, including vomiting. We report the case of a patient affected by RAI-refractory thyroid cancer with lung and intracranial metastases undergoing treatment with the antiangiogenic TKI lenvatinib, and with teriparatide replacement therapy for postsurgical hypoparathyroidism. Due to lenvatinib-related vomiting, which did not respond to therapy, conventional oral calcium supplementation failed to maintain normal serum calcium levels and the patient had repeated episodes of hypocalcemia. Subcutaneous teriparatide injections restored serum calcium levels, and thus lenvatinib therapy could be continued. This experience indicates that hormone replacement with teriparatide is a feasible option for cancer patients affected by hypoparathyroidism not treatable with oral calcium supplementation.
Primary follicular lymphoma of the conjunctiva in a 12 year-old male
Authors: Sh Taghipour Zahir, S A Miratashi, M Nazemian, S Zand
Journal: Iran J Ped Hematol Oncol (2013)
Keywords: conjunctiva, follicular, lymphoma
MeSH terms: Case Reports

Background:
Follicular lymphoma (FL) is the second most common adnexal lymphoma of the eye that almost all of them are reported in elderly patients. Primary FL of the eye has been reported in only two children. Pediatric FL appears to be biologically distinct from typical adult FL. In cases without other organ involvement excision alone with close monitoring is a treatment of choiceand the prognosis is excellent.
Case presentation:
A 12 year -old male with a nodular lesion involving the inner can thus of the right eye was admitted to ophthalmology clinic. The lesion was painless and the nodule size gradually increased over a period of 6 months.Excisional biopsy demonstrated follicular lymphoma composed of neoplastic lymphoid cells which arranged in follicular pattern without germinal centers. Neoplastic cells were positive for Bcl2 and CD20.
Conclusion:
Although follicular lymphoma of the conjunctiva is rare in childhood but it could be considered as one of the differential diagnosis in this age group.
The efficiency of subconjunctival bevacizumab in refractory glaucoma - case report
Authors: V Popescu, C Leasu, D Stana, C Alexandrescu, A Dumitrescu
Journal: J Med Life (2015)
Keywords: bevacizumab, glaucoma, trabeculectomy, vascular endothelial growth factor
MeSH terms: Angiogenesis Inhibitors / therapeutic use, Bevacizumab / pharmacology, Bevacizumab / therapeutic use, Conjunctiva / drug effects, Glaucoma / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, Angiogenesis Inhibitors / pharmacology, Conjunctiva / pathology, Female, Glaucoma / pathology, Humans, Neovascularization, Pathologic / drug therapy, Angiogenesis Inhibitors, Bevacizumab

Anti-vascular endothelial growth factor (anti-VEGF) therapy used as adjunctive to glaucoma filtration surgery may help filtering bleb survival because vascular endothelial growth factor has an important role in the angiogenesis of new vessels and in the fibrogenesis, which lead to scar formation and bleb failure. Bevacizumab is a non-selective monoclonal antibody against all isoforms of VEGF-A. We present the case of an inflammatory glaucoma of a 67-year-old female, with uncontrolled intraocular pressure on maximal tolerable medical treatment, who underwent trabeculectomy and received 1.25 mg/0.05 ml of bevacizumab (Avastin) subconjunctivally at the end of the surgery and an additional injection one month later. Right eye intraocular pressure (IOP) was 26 mm Hg at preoperative visit and after surgery, it decreased and remained normal at each postoperative examination with no additional IOP-lowering medication. A localized avascular bleb with moderate elevation was observed six months postoperatively.
Appendicitis-Like Picture Induced by Foreign Body in a 2-Year-Old Boy
Authors: Sadi A Abukhalaf, Rami A Misk, Hussam I Alzeerelhouseini, Ismaeel M Irziqat, Abdulrahman H Asaferah, Osama Y Aljabarein, Khalil N Abuzaina
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Background and Aim. Appendicitis is unusual in toddlers and foreign body- (FB-) induced appendicitis is rare. We present a FB-induced appendicitis in a toddler with no suggestive history of FB ingestion. Case Presentation. A 2-year-old healthy boy presented to the emergency department with irritability for 3 days duration associated with fever of 39°C, nausea, anorexia, and vomiting. There was no history of foreign body ingestion. The abdomen was distended and diffusely tender. An abdominal ultrasound (US) was suggestive of perforated appendicitis with appendicular mass formation. An abdominal X-ray showed a pin-like foreign body in the abdomen. An emergent appendectomy was performed. Intraoperatively, a sealed small cecal perforation was noticed. A 5 cm pin-like metallic foreign body was found to obstruct the appendicular lumen. The appendix was grossly normal without inflammatory changes. Conclusion. FB-induced perforations or appendicitis albeit in patients with no history of FB ingestion or infants and toddlers need a high clinical suspicion to prevent the delay in diagnosis and the subsequent complications.
Torsades de Pointes due to Excessive Marijuana Use in a Susceptible Patient
Authors: Vivek D Shah, Adeba Mohammad, Shuktika Nandkeolyar, Liset Stoletniy, Tahmeed Contractor
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

There are several recent reports of tetrahydrocannabinol vaping-related sudden cardiac arrest, and the mechanisms are unclear. We report a unique case of a 19-year-old female who suffered documented prolonged QTc leading to Torsades de pointes and cardiac arrest in the setting of frequent marijuana wax vaping. While she demonstrated normal baseline QTc measurements years earlier, she was found to have a genetic predisposition to QTc prolongation (genetic mutation, family history of prolonged QTc), suggesting that specific patient populations are at higher risk of these adverse events. The patient was acutely managed with isoproterenol to increase the heart rate and was discharged on nadolol after placement of an implantable cardioverter-defibrillator. Marijuana wax vaping and dabbing may cause fatal Torsades de pointes in susceptible patients, and further research is required to identify these patients a priori.
Complete Heart Block as a Clinical Feature in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series of Three Cases
Authors: Farook Ahmad, Priti Gandre, Julien Nguekam, Alanna Wall, ShiYu Ong, Abdul N Karuppamakkantakath, Konstantinos Tasopoulos, Muhammad Athar Sadiq, Sazzli Kasim, Jeronimo M Cuesta
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Background. Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. However, there have been very few reports on complete heart block (CHB) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of critically ill COVID-19 patients complicated by CHB. Case Summary. We present three cases of new-onset CHB in critically ill COVID-19 patients. Patient 1 is a 41-year-old male with well-documented history of Familial Mediterranean Fever (FMF) who required mechanical ventilator support for acute hypoxic respiratory failure from severe COVID-19 pneumonia. He developed new-onset CHB without a hemodynamic derangement but subsequently had acute coronary syndrome complicated by cardiogenic shock. Patient 2 is a 77-year-old male with no past medical history who required intubation for severe COVID-19 pneumonia acute hypoxic respiratory failure. He developed CHB with sinus pause requiring temporary pacing but subsequently developed multiorgan failure. Patient 3 is 36-year-old lady 38 + 2 weeks pregnant, gravida 2 para 1 with no other medical history, who had an emergency Lower Section Caesarean Section (LSCS) as she required intubation for acute hypoxic respiratory failure. She exhibited new-onset CHB without hemodynamic compromise. The CHB resolved spontaneously after 24 hours. Discussion. COVID-19-associated CHB is a very rare clinical manifestation. The potential mechanisms for CHB in patients with COVID-19 include myocardial inflammation or direct viral infiltration as well as other causes such as metabolic derangements or use of sedatives. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and hemodynamic instability.
A child with anorexia nervosa presenting with severe infection with cytopenia and hemophagocytosis: a case report
Authors: Masao Suda, Shinichiro Nagamitsu, Masahiro Kinosita, Michiko Matsuoka, Shuichi Ozono, Yasushi Otsu, Yushiro Yamashita, Toyojiro Matsuishi
Journal: Biopsychosoc Med (2017)
Keywords: acinetobacter baumannii, anorexia nervosa, hemophagocytosis, severe infection
MeSH terms: Case Reports

Background:
Patients with anorexia nervosa in the acute phase have physical complications, such as infectious disease. Although hemophagocytic syndrome due to infection is a rare complication in anorexia nervosa, early identification for hemophagocytosis is important for avoiding a life-threatening condition.
Case presentation:
We report a case of a 12-year-old girl with anorexia nervosa presenting with infection with cytopenia and hemophagocytosis during initial nutritional therapy. She developed pyrexia, abdominal pain, and diarrhea during inpatient treatment. Although intravenous antibiotics were administered, the symptoms persisted. Acinetobacter baumannii was detected in blood culture. Hemophagocytosis was present in the bone marrow. Gamma globulin therapy was effective, with improvement in symptoms and cytopenia.
Conclusions:
Although our case did not fulfill the criteria of hemophagocytic syndrome, clinicians should consider severe infection in anorexia nervosa with cytopenia and hemophagocytosis.
A case report of malignant melanoma of the sphenoid sinus
Authors: Kiyoaki Tsukahara, Kazuhiro Nakamura, Ray Motohashi, Minoru Endo, Hiroki Sato
Journal: Case Rep Otolaryngol (2013)

Malignant melanoma of the sphenoid sinus is a very rare disease, and only 6 cases have previously been reported. The present case involved a 74-year-old woman who was examined for visual disturbance of the left eye. Computed tomography revealed a soft tissue shadow, but only mucosal hypertrophy was found on opening the sphenoid sinus under general anesthesia. One month postoperatively, visual disturbance of the right eye and paresis of cranial nerve III appeared. Malignant melanoma was diagnosed from biopsy. Multiple bone metastases were identified, but the patient declined active treatment. As a result, palliative care was provided and she died 3 months later. When there is no improvement in postoperative visual acuity as in this case, in consideration of the possibility of neoplastic lesions, rigorous followup including monitoring for neurological symptoms is warranted.
Group A Streptococcus Necrotizing Lymphadenitis: A Case Report
Authors: Nathalie De Paz, Arian Pupo, Lexi R Frankel, Summer L Roorda, Robert Hernandez
Journal: Cureus (2023)
Keywords: bacterial lymphadenitis, group a streptococcus, infectious disease, necrotizing lymphadenitis, pathology, systemic lupus erythematosus
MeSH terms: Case Reports

Necrotizing lymphadenitis (NL) is a rare entity that can occur as a complication of bacterial cervical lymphadenitis (CL) and is characterized by unilateral or bilateral cervical lymphadenopathy. NL most commonly presents in females and most reports have been in Japan. In this case, we present a 37-year-old male with no significant past medical history who presented with an unusual presentation and clinical course of NL. Initial workup for Epstein-Barr Virus (EBV) and other infectious etiology was negative. Yet, aspiration later revealed Group A Streptococcus. When the patient's pain and swelling did not subside with the initial antibiotic and supportive treatment, the patient underwent a repeat aspiration and biopsy that revealed a necrotic mass or lymph node. NL is uncommon and rarely due to infectious etiology. However, this marks a case in which a Group A Streptococcus was shown to be associated with subsequent necrotic lymph nodes and should allow practitioners to further consider an infectious etiology in the differential diagnosis of NL.
Refractory Spontaneous Bacterial Empyema in Cirrhotic Patient
Authors: Erica Chow, Bashar Khiatah, Amanda Frugoli
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Spontaneous bacterial empyema (SBEM), also called spontaneous bacterial pleuritis, is an infection of the pleural space that arises in the setting of cirrhosis and, by definition, the absence of pneumonia. It is likely underdiagnosed as its symptoms are nonspecific and it lacks standardized diagnostic and therapeutic recommendations. SBEM represents a distinct complication of hepatic hydrothorax with different pathogenesis, presentation, and treatment strategy from those of empyema secondary to pneumonia. Surprisingly, nearly 40% of episodes of spontaneous empyema are not associated with spontaneous bacterial peritonitis. Although SBEM is amenable to prompt antibiotic therapy, it has a high rate of mortality and morbidity. A high clinical suspicion is crucial for patient survival and timely initiation of appropriate antibiotics. Increased understanding, recognition, and standardization of treatment would help alleviate the relatively high burden of SBEM. In this case vignette, we provide a review of the relevant literature, and we describe a rare case of SBEM in a patient with a history of alcohol-associated liver cirrhosis and prior episode of spontaneous bacterial peritonitis (SBP). SBEM was diagnosed with thoracentesis and analysis of the aspirate, and he was treated with ceftriaxone with resolution of his presenting abdominal pain and leukocytosis.
Medical Approach to Right Colon Diverticulitis with Perforation
Authors: James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast. Right-sided diverticulitis often presents in a manner similar to appendicitis. In the absence of peritonitis, conservative treatment may be possible. It is predictable that as the population ages, the incidence of right-sided diverticular disease will increase and will result in more presentations of acute right-sided diverticulitis to the emergency department (ED). The aim of this case report is to increase awareness of the incidence, pathophysiology, presentation, work-up (laboratory studies and imaging), and management (medical and surgical) of right-sided diverticulitis among emergency physicians.