OpenMed/multicare-articles huggingface dataset:
Intussuscepted Metachronous small bowel tumor after treatment for colorectal adenocarcinoma
Authors: Yuhamy Curbelo-Peña, David Saavedra-Perez, Tomas Stickar, Joan Molinas-Bruguera, Jordi De Cozar-Duch, Xavier Quer-Vall, Helena Vallverdú-Cartie
Journal: Int J Surg Case Rep (2019)
Keywords: adenocarcinoma, intestinal tumor, small bowel, small bowel resection

Introduction:
Small Bowel adenocarcinoma (SBA) is a rare malignant neoplasm without specific signs or symptoms. It's been associated with late stage disease presentations. Midterm outcomes have suggested that after successful removal of colorectal carcinoma, there is higher risk for developing a further primary (metachronous) colorectal tumor. However when it comes to small bowel, metachronous carcinomas are unusual.
Case presentation:
A 46-year-old female who underwent an emergency Hartmann's procedure two years previously and treatment of adjuvant chemotherapy for adenocarcinoma of the sigmoid colon at stage IIB with loco-regional recurrence. The patient presented with bowel obstruction secondary to a small bowel intussusception, confirmed by computed tomography. An emergent exploratory laparotomy was performed and confirmed of an ileal tumor as the cause of small bowel intussusception and clinical bowel obstruction. Histopathology confirmed a primary small bowel mucinous adenocarcinoma with node metastasis (T3N1M0, stage IIIB).
Discussion and conclusion:
Patients who develop a small or large bowel adenocarcinoma have high risk of presenting a second tumor at both sites. Since data available to guide therapeutic decisions for patients presenting with small bowel metachronic tumors are scarce, the role of adjuvant therapy in patients who undergo curative resection remains unclear. The aim of this manuscript is present a case report of a patient admitted for a rare obstructive small bowel intussusception therefore underwent surgery for metachronic small bowel carcinoma from colorectal primary witch previously treated by surgery and adjuvant chemiotherapy. Studies about strategies for detection at an earlier stage, optimal treatment and prognosis are mandatory for this disease.
Surgical treatment of giant gist with acute gastrointestinal bleeding: Case report
Authors: Catarina Melo, Carolina Canhoto, Fernando Manata, António Bernardes
Journal: Int J Surg Case Rep (2018)
Keywords: emergency surgery, gastrointestinal bleeding, gastrointestinal stromal tumor, jejunal tumor

Introduction:
Gastrointestinal stromal tumors represent about 1% of the tumors of digestive tract. Their presentation consists often of indolent symptoms. However, they can present as surgical emergencies in rare cases. This work presents a case of a giant jejunal GIST that required emergent surgical treatment.
Case presentation:
A 60-year-old male presented with abdominal pain and acute low gastrointestinal bleeding. During observation a palpable mass was detected in the periumbilical region, left hypochondrium and left flank. A non-total colonoscopy was inconclusive. An Angio-CT showed a large exophytic tumor arising from the 4th duodenal segment and first jejunal segment with approximately 20 × 14 x 13 cm, with apparent intratumoral bleeding. Due to haemodynamic instability, the patient was submitted to emergency laparotomy, in which a large tumor was found arising from the first jejunal segment. A segmental enterectomy was performed and the post-operative period ran without complications. The histopathologic exam showed a gastro-intestinal stromal tumor of epithelioid cell nature, with low mitotic count (<5 per 50HPF), categorized as T4N0 stage IIIA. The imunohistochemical analysis revealed positivity for CD117 (c-kit) and DOG-1. The patient started Imatinib therapy, and is free of disease recurrence for 3 years.
Conclusions:
This case pretends to review an unusual presentation of a giant jejunal intestinal GISTs as well as its management in an emergent context.
Spinal Tuberculosis and Cold Abscess without Known Primary Disease: Case Report and Review of the Literature
Authors: Rima Patel, Vedavyas Gannamani, Emily Shay, David Alcid
Journal: Case Rep Infect Dis (2016)

Extrapulmonary tuberculosis (TB) is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative for Mycobacterium tuberculosis. The diagnosis was confirmed weeks later when cultures demonstrated Mycobacterium tuberculosis. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis.
Micronodular pattern of organizing pneumonia: Case report and systematic literature review
Authors: François Lebargy, Davy Picard, Jean Hagenburg, Olivier Toubas, Jeanne-Marie Perotin, Sebastian Sandu, Gaëtan Deslee, Sandra Dury
Journal: Medicine (Baltimore) (2017)
MeSH terms: Cryptogenic Organizing Pneumonia / pathology, Lung / pathology, Case Reports, Review, Systematic Review, Adult, Cryptogenic Organizing Pneumonia / diagnosis, Humans, Male

Rationale:
Organizing pneumonia (OP) is a clinicopathological entity characterized by granulation tissue plugs in the lumen of small airways, alveolar ducts, and alveoli. OP can be cryptogenic (primary) (COP) or secondary to various lung injuries.
Patient concerns:
We report the case of a 38-year-old male smoker with COP presenting in the form of diffuse micronodules on computed tomography (CT) scan and describe the clinical, radiological, and functional characteristics of micronodular pattern of organizing pneumonia (MNOP) based on a review of the literature including 14 cases.Patients were younger (36.3 ± 15.5 years) than those with the classical form of OP. The clinical presentation was subacute in all cases with a mean duration of symptoms before admission of 14.5 ± 13.2 days. The radiological pattern was characterized by centrilobular nodules and "bud-in-tree" sign in 86.7% of patients. The diagnosis was based on histological examination of transbronchial (28.6%) or surgical biopsies (71.4%).
Diagnosis:
An associated condition was identified in 65% of cases and included illicit substance abuse (44.5%), myeloproliferative disease (33.5%), and infections (22%).
Outcomes:
Steroid therapy was effective in all patients with improvement of symptoms and documented radiologic resolution. No relapse was recorded.
Lessons:
MNOP should be recognized and distinguished from other diagnoses, mainly infectious bronchiolitis and disseminated tumor, as it requires early specific steroid therapy.
Radiation-Induced Sarcoma following Prolonged Coronary Stent Placement
Authors: Eric J Vick, Christopher T Clark, James M Lewis
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Radiation exposure for the average coronary stent placement varies based on a number of factors but typically amounts to 6-11 mSv per patient (compared to 3 mSv background). As with all procedures which utilize radiation, there is an inherent risk of genetic mutation and the possible development of malignancy. Here, we present the case of a 75-year-old male who presented with an exophytic mass on his back following prolonged coronary catheterization with a radiation burn seven years prior. Biopsy of the lesion revealed the mass was consistent with an undifferentiated pleomorphic sarcoma emanating from the site of the radiation burn. After staging studies demonstrated no evidence of metastatic disease, radical excision with negative margins was performed. This case demonstrates that despite the rarity of radiation injury, each incidence necessitates strict monitoring of radiation exposure and continual follow-up due to the risk of malignancy.
Relation of Nonrecurrent Laryngeal Nerve with Zuckerkandl's Tubercle
Authors: Carlos Alberto Ferreira de Freitas, Maria Margarida Morena Domingos Levenhagen, Isabela Salvador Constantino, Amauri Ferrari Paroni, Marcelo Resende Martins
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

The nonrecurrent laryngeal nerve (NRLN) is a rare anatomical variation of the recurrent laryngeal nerve (RLN) that may hinder the identification and preservation of this nerve during surgery and is associated with increased iatrogenic risks. Zuckerkandl's tubercle (ZT) is considered a useful reference for locating the RLN during thyroid surgery. We report the case of an asymptomatic patient with a 23 mm uninodular goitre suspicious for cancer. Ultrasound examination showed a hypoechoic nodule with regular contours and microcalcifications. The patient had normal thyroid-stimulating hormone and thyroxine levels, and aspiration biopsy was suspicious for follicular cancer. She was treated with total thyroidectomy after the intraoperative examination confirmed the presence of a papillary thyroid carcinoma. The standard approach to the RLN below the inferior thyroid artery was used on both sides. The nerve displayed anatomical variation in the nonrecurrent form (NRLN) on the right side and was associated with another variation that was not found in the consulted literature. It was completely surrounded by thyroid tissue in the region of ZT, and the surgeon was forced to remove it from within the thyroid tissue. This combination of anatomical variations seems to be quite rare. Knowledge of the anatomy of the RLN and its variations, as well as its identification and careful dissection, is essential to avoid injury to the nerve during surgical procedures.
A Wilms' Tumor with Spinal Cord Compression: An Extrarenal Origin?
Authors: Audrey Petit, Amandine Rubio, Chantal Durand, Christian Piolat, Cécile Perret, Anne Pagnier, Dominique Plantaz, Hervé Sartelet
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Spinal cord compression in Wilms' tumor (WT) is an extremely rare event that can have a very poor prognosis if not taken care of rapidly. Most cases reported in the literature involve widely metastatic patient with bone or paraspinal metastases or occasionally intradural metastasis. Here, we present the case of a 3-year-old girl of WT confirmed by biopsy, with spinal cord compression due to the direct contiguous spread of a tumor through 2 vertebral foramina. Abdominal ultrasonography and magnetic resonance imaging performed for an abdominal mass revealed a large heterogeneous tumor near the upper pole of the left kidney. A nodular infiltration extended through the T11-L1 and L1-L2 neural foramina, forming an intraspinal mass that compressed the spinal cord. Major paresthesia subsequently occurred, requiring urgent treatment with corticosteroids and chemotherapy. The evolution was rapidly satisfying. After six courses of chemotherapy, a left nephrectomy was performed. Macroscopic examination identified a large tumor attached to the kidney without renal infiltration. Microscopical examination concluded to a nephroblastoma with regressive changes, of intermediate risk. Evolution at 6 months is satisfactory, with no neurological deficit. The histological aspect of the tumor and the clinical outcome suggest that she had an extrarenal WT that spread through the vertebral foramina and was secondarily attached to the kidney.
Trigeminal trophic syndrome: Strange evolution of maxillofacial surgery
Authors: Francesca Zotti, Giorgia Capocasale, Fabio Lonardi, Tiziano Zambotti, Riccardo Nocini, Massimo Albanese
Journal: EXCLI J (2019)
Keywords: allergy, osteolysis, skin ulcer, trigeminal nerve injury
MeSH terms: Case Reports

Trigeminal trophic syndrome (TTS) is a rare facial/cranial affection that arises in ulcerations, itch and paresthesia. Etiology is debated, however trigeminal nerve damage seems to be frequent in pathogenetic patterns. The disease may affect any region innervated by the trigeminal nerve, especially the maxillary branch. A case of TTS, trigged by allergic reaction to osteosynthetic materials and involving infraorbital nerve, was presented. The feature that makes this case one-off in the literature is the association with osteolytic lesion surrounding infraorbital nerve. Diagnosis and treatment were difficult and multidisciplinary approach was required. Treatments administered were satisfying and signs and symptoms remitted, however patient quitted follow-up. TTS is a rare disease, diagnosis is difficult to be performed and it is often a diagnosis of exclusion. Treatment is challenging and it requires a multidisciplinary approach and a great compliance of patients.
Innovative Uses of Condom Uterine Balloon Tamponade for Postpartum Hemorrhage in India and Tanzania
Authors: Jennifer Makin, Daniela I Suarez-Rebling, Poonam Varma Shivkumar, Vincent Tarimo, Thomas F Burke
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Background:
Postpartum hemorrhage is the most common cause of maternal deaths worldwide, the majority of which occur in low-resource settings. Uterine balloon tamponade (UBT) is an effective method of addressing uncontrolled postpartum hemorrhage (PPH) from uterine atony; however, UBT devices are often not affordable. We report on three novel uses of an ultra-low-cost condom uterine balloon tamponade (ESM-UBT) device.
Cases:
ESM-UBT devices were used in innovative ways to arrest severe uncontrolled pregnancy-related hemorrhage among three women in India and Tanzania. The first had sustained deep vaginal lacerations, the second a cervical pregnancy, and the third a complete molar pregnancy.
Conclusion:
The ESM-UBT device may be useful for control of obstetric hemorrhage caused by complex vaginal tears as well as cervical and molar pregnancies.
Cystic lymphangioma as a cause of massive abdominal hemorrhage
Authors: E Consuegra Llapur, J M López Alvarez, O Pérez Quevedo, M Valerón Lemaur, S Pavlovic Nesic, X García Urgellés
Journal: Case Rep Crit Care (2011)
MeSH terms: Case Reports

We report the case of two-year-old girl with hypovolemic shock caused by bleeding from an abdominal cystic lymphangioma. The whole blood was contained within a large omental bag that could be completely removed. There were no associated anomalies. The child progressed satisfactorily.
Prenatal and Postnatal Sonographic Confirmation of Congenital Absence of the Ductus Venosus in a Child with Noonan Syndrome
Authors: Christopher L Newman, Matthew R Wanner, Brandon P Brown
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

The ductus venosus serves as an important vascular pathway for intrauterine circulation. This case presents a description of an absent ductus venosus in a female patient with Noonan syndrome, including both prenatal and postnatal imaging of the anomaly. In the setting of the anomalous vascular connection, the umbilical vein courses inferiorly to the iliac vein in parallel configuration with the umbilical artery. This finding was suspected based on prenatal imaging and the case was brought to attention when placement of an umbilical catheter was thought to be malpositioned given its appearance on radiography. Ultrasound imaging confirmed the anomalous course. This is in keeping with prior descriptions in the literature of an association between Noonan syndrome and aberrant umbilical venous drainage. This case illustrates the need for awareness of this condition by the radiologist, allowing for identification on radiographs and the recommendation for further confirmatory imaging. Further, the case illustrates the value of paying particular attention to the fetal course of the umbilical vessels in patients with suspected Noonan syndrome, as this population is particularly at risk for anomalous vasculature.
A Unique Case of Systemic Lupus Erythematosus Pelvic Vasculitis
Authors: Pamela Traisak, Shristi Basnyat, Hala Eid, Patrick Cronin, Halyna Kuzyshyn, David Feinstein
Journal: Case Rep Rheumatol (2016)
MeSH terms: Case Reports

The clinical presentation of Systemic Lupus Erythematosus (SLE) is diverse and vasculitis can be a potential manifestation. Cutaneous lesions involving small vessels are the most frequent presentation. However, medium and large vessel vasculitis may present with life-threatening visceral manifestations. We present a unique case of pelvic vasculitis mimicking a pelvic mass as an initial presentation of SLE. There are case reports of systemic vasculitis involving the female genital tract with giant cell arteritis (GCA), polyarteritis nodosa (PAN), and granulomatous with polyangiitis and microscopic polyangiitis (GPA/MPA), among others, but only a few cases attributed to SLE. Awareness of this condition and a prompt diagnosis are warranted as this is a severe and potentially life-threatening condition.
A Novel del(20q) in Aggressive Nodal Marginal Zone Lymphoma
Authors: Jason B Kern, Deiter J Duff, Jamie L Odem, Magda Esebua, Lisa R Smith, Donald Doll, Michael Wang
Journal: Case Rep Pathol (2013)

This is a case report of a previously undescribed 20q chromosomal deletion (del(20q)) in marginal zone lymphoma (MZL). A 54-year-old Caucasian male presented with an enlarging neck mass and multiple violaceous skin nodules over his chest. Biopsy of the neck mass and cervical lymph nodes revealed MZL. Cytogenetic evaluation of both lymph node and bone marrow tissue revealed del(20q). This was an unexpected finding, as del(20q) is associated with myelodysplastic syndromes and myeloproliferative neoplasms and rarely seen in diffuse large B-cell lymphoma, follicular lymphoma, and T-cell lymphoma, but has not previously been described in MZL. We describe the case presentation and histologic findings and discuss the significance of this novel finding.
A 58-Year Old Male with Cognitive Deteriorations Caused by Septum Pellucidum Cyst: A Case Report
Authors: Li-Ming Chen, Ming-Xin Zhu, Yu-Fen Zhang, Se-Hui Ma, Yao Yi, Lie-Xin Xia, Yan Wu, Lei Pei
Journal: Front Aging Neurosci (2017)
Keywords: cognitive impairment, dementia, mini-mental state exam, montreal cognitive assessment, neuroendoscopy, septum pellucidum cyst

Dementia is known to be induced by vascular dementia and certain neurodegenerative diseases. The presenting features of disordered memory, intellect and personality often result in referral to a neurologist initially. Septum pellucidum cyst (SPC) is a rare clinical finding and defined as a cystic structure between the lateral ventricles. SPC induced memory disorder and dementia has been seldom reported in which the clinical features are atypical and can be misdiagnosed. The main difficulty is to establish a correlation between symptoms and the cyst. When indicated, the treatment is essentially surgical and the ideal operative technique is also a matter of debate. Here, we reported a 58-year-male Chinese patient who presented with memory impairment 1 year ago. Both the physical and laboratory examinations were performed to evaluate the general conditions of the patient. Brain magnetic resonance imaging (MRI) was applied to observe SPC and the neighboring brain structures. Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The results of the patient's laboratory examinations were normal. However, the patient exhibited severe sleeplessness along with cognitive deteriorations despite short-term (less than 2 weeks) use of benzodiazepines with regular dose. MRI fulfills the consensus criteria for clinical diagnosis of SPC. Furthermore, the results of MMSE and MoCA were showed mild cognitive impairment (MCI) before the treatment of SPC. After neuroendoscopic fenestration of SPC, the patient's syndromes were disappeared, and his cognitive function was improved. In conclusion, the patient's symptoms were due to a secondary lesion attributed to the cyst. Comprehensive clinical evaluation and MRI help diagnose SPC induced dementia.
Ureteric Trauma following Stent Removal in Kidney Transplant Recipient: A Unique Case of Prolonged Morbidity
Authors: Ahmad Mirza, Imran Gani, Andy Shi Huang, Ravi Mallavarapu, Laura Mulloy, Muhammad Saeed, Rajan Kapoor
Journal: Case Rep Transplant (2021)
MeSH terms: Case Reports

A 52-year-old African-American male patient with end-stage renal disease due to hypertension underwent deceased donor kidney transplant procedure with no immediate complications. The postprocedure complications, interventions, and course were abstracted by chart review. The ureteric stent was removed with flexible cystoscopy on postoperative day (POD) 24. 24 hours later, the patient presented with abdominal pain and inability to urinate. An urgent ultrasound and noncontrast CT scan showed grade 4 hydronephrosis of the transplanted kidney. A percutaneous nephrostomy stent was placed for urinary diversion. A large ureteric hematoma filling the lumen of the mid to distal ureter was identified on the nephrostogram and was evacuated. A follow-up nephrostogram on POD 44 revealed a distal ureter stricture and persistent well-formed midureter filling defect. A repeat nephrostogram performed at POD 72 was done with stricture dilatation, internalization of stents, and removal of a percutaneous nephrostomy tube. The patient was maintained on antibiotics for UTI prophylaxis throughout the course.
EMDR in Competition with Fate: A Case Study in a Chinese Woman with Multiple Traumas
Authors: Maggie Wai-Ling Poon
Journal: Case Rep Psychiatry (2012)
MeSH terms: Case Reports

This paper described the application of eye movement desensitization reprocessing (EMDR) for addressing the posttraumatic stress disorder (PTSD) symptoms in a Chinese woman who had experienced multiple traumas in her childhood. EMDR is an integrative therapeutic intervention that uses a standardized eight-phase approach to treatment. It is also a proven, effective, and efficient treatment for trauma. In this client with multiple traumas, the etiological event that lay the foundation of her dysfunctional responses was reprocessed first. The successful resolution of this event allowed the positive treatment effects to transfer to other traumatic events of a similar theme. This case also illustrates the importance of identifying a culturally appropriate positive cognition (PC) in contributing to the success of the treatment.
Real-time 3-dimensional ultrasound-assisted infraclavicular brachial plexus catheter placement: implications of a new technology
Authors: Steven R Clendenen, Christopher B Robards, Nathan J Clendenen, James E Freidenstein, Roy A Greengrass
Journal: Anesthesiol Res Pract (2010)
MeSH terms: Case Reports

Background. There are a variety of techniques for targeting placement of an infraclavicular blockade; these include eliciting paresthesias, nerve stimulation, and 2-dimensional (2D) ultrasound (US) guidance. Current 2D US allows direct visualization of a "flat" image of the advancing needle and neurovascular structures but without the ability to extensively analyze multidimensional data and allow for real-time manipulation. Three-dimensional (3D) ultrasonography has gained popularity and usefulness in many clinical specialties such as obstetrics and cardiology. We describe some of the potential clinical applications of 3D US in regional anesthesia. Methods. This case represents an infraclavicular catheter placement facilitated by 3D US, which demonstrates 360-degree spatial relationships of the entire anatomic region. Results. The block needle, peripheral nerve catheter, and local anesthetic diffusion were observed in multiple planes of view without manipulation of the US probe. Conclusion. Advantages of 3D US may include the ability to confirm correct needle and catheter placement prior to the injection of local anesthetic. The spread of local anesthetic along the length of the nerve can be easily observed while manipulating the 3D images in real-time by simply rotating the trackball on the US machine to provide additional information that cannot be identified with 2D US alone.