OpenMed/multicare-articles huggingface dataset:
Bilateral transient visual loss and meningeal irritation signs following retrobulbar anesthesia
Authors: Melih Ustaoglu, Nilgun Solmaz, Feyza Onder
Journal: GMS Ophthalmol Cases (2017)
Keywords: bilateral transient visual loss, meningeal irritation signs, optic nerve sheath penetration, retrobulbar anesthesia
MeSH terms: Case Reports

A 62-year-old man underwent an uneventful cataract surgery in the left eye following retrobulbar anesthesia. Fifteen minutes after the surgery, the patient had visual loss in his right (unoperated) eye, headache, dizziness, nausea, and vomiting. The bandage on the left (operated) eye was removed and the initial ophthalmic examination revealed bilateral dilated pupils with absence of light perception. His fundus examination and vital signs were unremarkable. Immediately, a computerized tomography (CT) was performed to scan both orbit and brain. The orbit CT revealed air bubbles within the left optic nerve sheath, which confirmed inadvertent injection and administration of anesthetic medications into the optic nerve sheath. Within three hours, meningeal irritation signs recovered spontaneously and visual acuity improved to 20/20 in the right eye and 20/40 in the left eye.
Retained Foreign Body Causing a Liver Abscess
Authors: Guek Gwee Sim, Sujata Kirtikant Sheth
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Introduction:
A liver abscess caused by fishbone ingestion is extremely rare in the Emergency Department.
Case report:
We report a case of a middle-aged female who presented to the Emergency Department with nonspecific symptoms. Computed tomography showed a liver abscess that had formed secondary to a fishbone. The patient was treated conservatively initially and subsequently with percutaneous drainage and finally with open drainage. Her condition improved and she was discharged from the hospital with the foreign body still in-situ.
Conclusion:
This case is one of six cases in literature where the patient has been discharged successfully from the hospital with a retained fishbone. It also demonstrates the difficulty of diagnosing a foreign body causing a liver abscess and the multiple treatment modalities used to treat a liver abscess caused by fishbone.
Diagnosis and treatment of nonadjacent cryptococcal infections at the L1 and S1 vertebrae
Authors: Qi Lai, Yuan Liu, Xionglong Yu, Xin Lv, Qiang Wang, Yibiao Zhou, Runsheng Guo, Bin Zhang
Journal: Orthopade (2017)
Keywords: bacterial infections and mycoses, bone diseases, cancer, cryptococcosis, spine
MeSH terms: Cryptococcosis / diagnosis, Cryptococcosis / drug therapy, Lumbar Vertebrae / diagnostic imaging, Sacrum / diagnostic imaging, Spondylitis / diagnosis, Spondylitis / drug therapy, Case Reports, Adult, Cryptococcosis / microbiology, Diagnosis, Differential, Humans, Lumbar Vertebrae / microbiology, Male, Sacrum / microbiology, Spondylitis / microbiology, Treatment Outcome

Cryptococcal spine infections are rare infections that are easy to misdiagnose and difficult to cure. Therefore, we report the case of a 25-year-old man who presented with nonspecific spinal lesions at L1 and S1. The patient underwent surgical removal of the lesions, and specimens were submitted for microbial identification, which identified a cryptococcal infection that was susceptible to amphotericin B. The patient exhibited marked improvement after receiving intravenous amphotericin B and remained asymptomatic (no back pain, fever, or other symptoms) at the 3‑ and 9‑month follow-ups. Similar cases of cryptococcal spine infections are rare, and we believe that our diagnostic findings and treatment experience may help improve the management of this rare disease.
Efficacy of subcutaneous tocilizumab in patients with rheumatoid arthritis and systemic sclerosis overlap syndrome: a report of two cases and review of the literature
Authors: Hiroki Wakabayashi, Hitoshi Kino, Makoto Kondo, Keiichi Yamanaka, Masahiro Hasegawa, Akihiro Sudo
Journal: BMC Rheumatol (2019)
Keywords: interleukin-6, rheumatoid arthritis, systemic sclerosis, tocilizumab
MeSH terms: Case Reports

Background:
The details of two rheumatoid arthritis (RA) patients with systemic sclerosis (SSc) who were administered tocilizumab, an anti-interleukin-6 receptor antibody, are reported, along with a review of the literature.
Case presentation:
Two RA patients with SSc with inadequate responses to disease-modifying antirheumatic drugs (DMARDs) were given tocilizumab 162 mg every 2 weeks for 18 months. RA disease activity was evaluated by the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR) and the clinical disease activity index (CDAI). The skin condition of SSc was evaluated by pinching the skin according to the modified Rodnan total skin thickness score (mRSS). Softening of the skin and improvements of arthritis and the patient global assessment were observed during tocilizumab treatment, with reduction of not only RA disease activity, but also of the mRSS.
Conclusion:
Tocilizumab may be effective in patients with RA and SSc overlap syndrome for which conventional treatment is inadequate. Further research is needed because this report included only two patients.
Olanzapine and pulmonary embolism, a rare association: a case report
Authors: Julian Fz Maempel, Geraldine Darmanin, Kashif Naeem, Mehool Patel
Journal: Cases J (2010)

Venous thromboembolism is a very common pathological process for which there are many well known (and less well-known) predisposing factors. Likewise, olanzapine is a commonly used anti-psychotic medication.We present the case of a young Somali gentleman who developed venous thromboembolic disease after an overdose of olanzapine. The diagnosis was only made 48 hours after admission, due to the non-specific presentation of the pulmonary embolus and the fact that the link between olanzapine and pulmonary embolus was not previously widely described and therefore it did not immediately figure in the differential diagnosis. The patient made a full recovery.There is an increasing body of circumstantial evidence linking olanzapine to pulmonary embolus. Clinicians should bear this possible association in mind when prescribing the drug and when faced with clinical situations where venous thromboembolism (VTE) is a possible diagnosis. VTE has occasionally been described in therapeutic dose olanzapine therapy, but never in the context of an acute overdose. Khat, a recreational drug, has been linked to arterial, but not venous thrombosis.It is hoped that this case report will further encourage research into these associations, which remain to be proven and quantified.In the context of changing population demographics and increasing global migration, a greater awareness of the potential effects of endemic practices and their potential consequences is essential to the modern-day doctor working in a multi-cultural society.
Severe cutaneous toxicity following treatment with radiotherapy and cetuximab: a case report
Authors: Arun Azad
Journal: Cases J (2009)

While the addition of cetuximab to radiotherapy improves clinical outcomes in locoregionally advanced head and neck squamous cell cancers, there are a small number of reports of severe radiation dermatitis occurring with this therapeutic combination. We present the case of a 69 year old male who developed severe radiation dermatitis following treatment with cetuximab and radiotherapy for a locoregionally advanced head and neck squamous cell cancer.
Cardiac surgery in 260 octogenarians: a case series
Authors: Anna Mara Scandroglio, Gabriele Finco, Marina Pieri, Roberto Ascari, Maria Grazia Calabrò, Daiana Taddeo, Francesca Isella, Annalisa Franco, Mario Musu, Giovanni Landoni, Ottavio Alfieri, Alberto Zangrillo
Journal: BMC Anesthesiol (2015)
Keywords: anesthesia, cardiac surgery, complications, intensive care, mortality, octogenarian
MeSH terms: Cardiac Surgical Procedures / statistics & numerical data, Outcome Assessment, Health Care / statistics & numerical data, Postoperative Complications / epidemiology, Research Support, Non-U.S. Gov't, Aged, 80 and over, Cardiac Surgical Procedures / adverse effects, Cardiac Surgical Procedures / mortality, Female, Hospital Mortality, Humans, Italy / epidemiology, Male, Retrospective Studies

Background:
The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period.
Methods:
A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period).
Results:
Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality.
Conclusions:
Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.
Case Report: PD-1 Blockade Combined Autologous Hematopoietic Stem Cell Transplantation With Modified BEAM Regimen Containing High-Dose Cytarabine to Treat R/R Hodgkin's Lymphoma
Authors: Xiaoqi Wang, Kaniel Cassady, Zhongmin Zou, Xi Zhang, Yimei Feng
Journal: Front Med (Lausanne) (2021)
Keywords: hodgkin's lymphoma, pd1, autologous stem cell transplantation, beam, case report
MeSH terms: Case Reports

The emergence of new drugs has provided additional options in the treatment of relapsed and refractory (R/R) Hodgkin's lymphoma (HL). However, the use of autologous stem cell transplantation (ASCT) has not been completely replaced in this setting. The use of anti-programmed death-1 (PD-1) antibody bridging to ASCT and as maintenance after transplantation is a novel approach in HL treatment. In this case, we report that PD-1 monoclonal antibody (mAb) plus ASCT with modified BEAM regimen (carmustine + etoposide + cytarabine + melphalan) containing high-dose cytarabine to treat R/R HL may represent a promising regimen in this difficult-to-treat setting.
Left Atrial Myxoma Presenting as Lateral Medullary (Wallenberg's) Syndrome
Authors: Simran Gupta, Ricky Ayala, Aakash Desai, Viraj I Modi, Robert J Nardino
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Myxomas are benign, primary tumors of the heart. Atrial myxomas can present with a variety of clinical features including dyspnea, orthopnea, pulmonary edema, and pulmonary or systemic emboli. Constitutional symptoms such as fever and weight loss may also be present. We report the case of a young female presenting with headache, facial numbness, and vertigo, who was found to have a posterolateral medullary stroke secondary to a large left atrial cardiac myxoma.
Synchronous Laparoscopic Radical Nephrectomy Left and Contralateral Right Hemicolectomy during the Same Endoscopic Procedure
Authors: G M Veenstra, L M C L Fossion, K de Laet, A A P M Luijten
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Synchronous renal cell carcinoma in patients with colorectal carcinoma is reported in various percentages ranging from 0.03 up to 4.85% (Halak et al. (2000), Capra et al. (2003)). When surgical treatment is indicated usually two separate operations are planned for resection. In open surgery, in such cases simultaneous resection is recommended if possible. Few reports have described the resection of colorectal and renal cell carcinoma in a single laparoscopic procedure. We have shown that combining left radical nephrectomy and right hemicolectomy is technically feasible, safe and that overall operative time can be limited. In our case operative time was 210 minutes, blood loss 100 milliliters, and duration of hospital stay was 8 days. Adequate port placement, preoperative scheduling, and surgical experience are essential to achieve this goal.
Crohn's disease presenting with pyogenic liver abscess: a case report
Authors: Sharon McGreal, Rupert Sayers, Peter Wurm, Kevin West
Journal: Case Rep Gastrointest Med (2012)

Pyogenic liver abscess (PLA) is a rare extraintestinal complication of Crohn's disease (CD), and the clinical and laboratory findings may emulate the reactivation of CD, therefore, delaying diagnosis. In this paper the patient presented with PLA as the initial manifestation of CD and experienced severe disease. The finding of PLA was established by computed tomography and initial treatment involved percutaneous drainage and antibiotics. The diagnosis of CD was made after colonoscopy and histological investigations.
A healthy individual with a homozygous PTCH2 frameshift variant: Are variants of PTCH2 associated with nevoid basal cell carcinoma syndrome?
Authors: M Altaraihi, K Wadt, J Ek, A M Gerdes, E Ostergaard
Journal: Hum Genome Var (2019)
MeSH terms: Case Reports

Variants in PTCH2 have been described to be associated with Nevoid Basal Cell Carcinoma Syndrome (NBCCS). We report a family with a healthy female who is homozygous for a frameshift variant, c.269delG, p.(Gly90Alafs*4), in PTCH2 and her heterozygous daughter. The variant predicts a frameshift and a premature stop codon. A summary of reported heterozygous individuals with germline PTCH2 variants along with the existence of a healthy homozygous individual question whether variants in PTCH2 are associated with NBCCS.
A case report of anal canal cancer with pagetoid spread requiring differential diagnosis
Authors: Ryohei Yukimoto, Shiki Fujino, Norikatsu Miyoshi, Takayuki Ogino, Hidekazu Takahashi, Mamoru Uemura, Atsushi Tanemura, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Yuichiro Doki, Hidetoshi Eguchi
Journal: Int J Surg Case Rep (2020)
Keywords: anorectal cancer, case report, diagnosis, paget’s disease
MeSH terms: Case Reports

Introduction:
Paget's disease is an intraepithelial invasion by a malignant tumour and is characterised by erythema and inflammation. It can manifest as mammary or extramammary Paget's disease (EMPD), with the latter often developing in the perianal area. Anorectal cancer can cause transepithelial invasion into the epidermis, resulting in an appearance similar to that of EMPD. This is called pagetoid spread (PS), which is completely different from EMPD. These two conditions are difficult to differentiate because of the nature of intricacy and requirements of histopathology.
Presentation of case:
We present a case in which differential diagnosis between these two conditions was not possible during the preoperative examination, resulting in difficulties in treatment. The patient was a 70-year-old woman who experienced pain in the anus since the previous month and presented with red, flat and elevated lesions.
Discussion:
Treatment for dermatitis was ineffective, and endoscopic examination did not indicate rectal or anal cancer. However, immunohistochemical examination of the biopsy specimen suggested PS. Thus, two-stage operation was planned. Transanal surgery was performed to confirm the diagnosis of PS and intersphincteric resection was allowed as a radical surgery.
Conclusion:
Thus, when differentiation between EMPD and PS is intricacy, two-stage operation is useful in selecting an appropriate radical surgery method, leading to preservation of anal function.
Proximal Myopathy due to m.5835G>A Mutation in Mitochondrial MT-TY Gene
Authors: C Simoncini, V Montano, G Alì, R Costa, G Siciliano, M Mancuso
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Mitochondrial (mt) tRNA (MTT) gene mutations are an important cause of mitochondrial diseases and are associated with a wide range of clinical presentations. Most mutations fall into three mitochondrial tRNAs (tRNAIle, tRNALeu (UUR), and tRNALys) and are responsible for half of the mitochondrial diseasees associated with tRNA mutation, with MERRF, MELAS, mitochondrial myopathy, and Leigh syndrome being the most frequent phenotypes. More than 100 tRNA pathogenetic mutations are described, showing little correlation between the observed clinical phenotype and a specific mitochondrial tRNA mutation. Furthermore different mutation can manifest with similar clinical phenotypes, making the genotype-phenotype correlation difficult. Here we report the case of an Italian 53-year-old woman presenting with a proximal myopathy and the m.5835G>A mutation in MT-TY gene coding for the mitochondrial tRNA Tyrosine gene.
Primary Well-Differentiated Neuroendocrine Tumor of the Kidney
Authors: Vishnu Prasad, Charakkulam Vijay Sreelakshmi, K Ravi Chandran, Shashank Agrawal, Ginil Kumar Pooleri, Amrita Sao
Journal: J Kidney Cancer VHL (2023)
Keywords: immunohistochemistry, neuroendocrine tumor, radical nephrectomy
MeSH terms: Case Reports

Primary neuroendocrine tumors (NET) of the kidney are rare. They present with varied symptoms, making their diagnosis difficult clinically as well as pathologically. We present to you the case of a renal NET, which presented in a young female patient. A 48-year-old female patient came with an incidentally detected right renal mass during the evaluation of a nonspecific gynecological problem. She underwent contrast-enhanced computed tomography (CT) of the abdomen, which showed a 57*45*34 mm mass with enlarged retrocaval and aortocaval nodes (25*12 mm). Renal cell carcinoma was suspected as per the CT findings, and metastatic workup in the form of FDG PET CT was done in view of the unusually enlarged nodes. She underwent robot-assisted radical nephrectomy along with lymph node dissection. Surgery was uneventful, and she recovered well in the postoperative period. In the final pathology, there was confusion regarding the diagnosis, and further immunohistochemistry (IHC) was recommended by the pathologist. IHC showed synaptophysin positive, chromogranin negative, CD56 focally positive with Ki-67 of 2-3%, which was suggestive of low-grade NET of the kidney. Lymph nodes were negative. She was kept on follow-up and a Ga 68-DOTANOC scan at 3 months showed no evidence of disease. Diagnosis and management of NET of the kidney still remains a debatable and controversial topic in view of its rarity. High index of suspicion needs to be observed in patients presenting with carcinoid syndrome and a renal mass. Nuclear scans like PET scan and DOTANOC scan can accurately stage the disease. Management includes partial or radical nephrectomy depending on the tumor characteristics. Further studies are required to optimize the treatment protocols for these patients.
Spontaneous splenic rupture in pregnancy
Authors: Adil Elghanmi, Jou Mohamed, Samira Khabouz
Journal: Pan Afr Med J (2015)
Keywords: splenic rupture, hypovolemic shock, pregnancy
MeSH terms: Abdominal Pain / etiology, Hemoperitoneum / etiology, Pregnancy Complications / diagnosis, Splenic Rupture / diagnosis, Case Reports, Adult, Cesarean Section / methods, Female, Humans, Laparotomy / methods, Morocco, Pregnancy, Pregnancy Complications / pathology, Rupture, Spontaneous, Shock / etiology, Splenic Rupture / complications, Splenic Rupture / surgery

Splenic rupture during pregnancy is a rare and can frequently be a misdiagnosed pathology. This rupture is associated with a high maternal and fetal mortality rate. A 26 years old Moroccan woman para II gravida II presented at the third stage of pregnancy with acute onset of severe abdominal pain. She developed immediately a hypovolemic shock. After both a physical and sonographical exam, it was revealed that it was due to a massive hemoperitoneum. Therefore, an emergent laparotomy and cesarean delivery with abdominal exploration were performed; also, an active bleeding was identified at the splenic hilum consistent with splenic rupture. Through this case report, we want to raise awareness of this surgical emergency that requires immediate recognition because any delay can lead to catastrophic consequences.
First Report of Sorafenib in Patients With Acute Myeloid Leukemia Harboring Non-Canonical FLT3 Mutations
Authors: Naval Daver, Allyson Price, Christopher B Benton, Keyur Patel, Weiguo Zhang, Marina Konopleva, Naveen Pemmaraju, Koichi Takahashi, Michael Andreeff, Gautam Borthakur
Journal: Front Oncol (2020)
Keywords: aml, flt3 mutation, flt3-n676, flt3-v592, tki, sorafenib
MeSH terms: Case Reports

The prognostics implications of patients with acute myeloid leukemia harboring non-canonical FLT3 is unknown. The use of tyrosine kinase inhibitors in this patient population has not been previously reported. We report successful targeted therapy against non-ITD, non-D835 driver FLT3 alterations in two patient case studies with acute myeloid leukemia.
Day care general anaesthesia for a child with bardet-biedl syndrome
Authors: Suresh Chittoodan, Suzanne Crowe
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Bardet-Biedl syndrome is a very rare autosomal-recessive disorder with pan-systemic effects. The perioperative period may be hazardous for patients with this disorder. We describe the presenting features and management of a child who was scheduled for elective ambulatory general anesthesia and discuss the relevant points for the busy anesthesiologist.
Undifferentiated Pleomorphic Sarcoma of the Duodenal Papilla: A Rare Case and Worth Discussing History
Authors: Jianlong Wang, Bin Liu, Jiachao Hou, Tao Li
Journal: Front Surg (2022)
Keywords: case report, duodenal papilla, duodenal papillectomy, duodenoscopy, undifferentiated pleomorphic sarcoma
MeSH terms: Case Reports

Background:
Undifferentiated pleomorphic sarcoma (UPS) is a malignant tumor that originates in the mesenchymal tissue and is common in the extremities and retroperitoneum. Primary UPS of the duodenal papilla is rare and a distinct clinical entity.
Case presentation:
In this report, a 48-year-old Chinese man was admitted to our hospital with symptoms of melena. The patient underwent choledochectomy and choledochaljejunostomy for obstructive jaundice 8 years before admission. Endoscopic examination after admission confirmed a mass located at the duodenal papilla. Then, the duodenal papilla and tumor resection were performed, and the histopathology report confirmed the diagnosis of UPS. The patient refused further treatment and died 2 months later due to local recurrence and intrahepatic metastasis.
Conclusions:
It is rare that the mass in the duodenal papilla is diagnosed as UPS. The unpredicted behavior of these tumors warrants a careful plan considering their indolent nature and possible recurrence and metastasis. The prognosis was poor despite the early complete resection.