OpenMed/multicare-articles huggingface dataset:
PAX5-Negative Classical Hodgkin Lymphoma: A Case Report of a Rare Entity and Review of the Literature
Authors: Elham Vali Betts, Denis M Dwyre, Huan-You Wang, Hooman H Rashidi
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Classical Hodgkin lymphoma (CHL) is recognized as a B-cell neoplasm arising from germinal center or postgerminal center B-cells. The hallmark of CHL is the presence of CD30 (+) Hodgkin and Reed-Sternberg (HRS) cells with dim expression of PAX5. Nearly all of the HRS cells are positive for PAX5. However, a small minority of HRS cells may lack PAX5 expression, which can cause a diagnostic dilemma. Herein we describe two cases of PAX5-negative CHL and review of the English literature on this very rare entity. It is crucial to be aware of this phenomenon, which in some cases may lead to misdiagnosis and may ultimately adversely affect patient's management.
Omental cyst: a case report and review of the literature
Authors: Keenan J Robbins, Ryan M Antiel, Baddr A Shakhsheer
Journal: Ann Pediatr Surg (2021)
Keywords: cyst, omental, pediatric

Background:
Omental cysts are rare, predominantly occur in children, and often initially present with symptoms masquerading as other more common intra-abdominal pathologies. In this case report, we present the case of a child with an omental cyst that originated from the lesser sac. Due to the location of this cyst, resection presented unique technical challenges that have not been described in existing literature.
Case presentation:
A 4-year-old male patient presented with symptoms initially concerning for appendicitis. Ultrasound showed a normal appendix but a large volume of complex intraperitoneal fluid. Computed tomography subsequently demonstrated a large cystic structure spanning from the stomach to the bladder. The patient was taken to the operating room where a large omental cyst was found to originate from the lesser sac. The resection was difficult due to the thin wall of the cyst and the intimate association of the superior-most aspect of the cyst with the tail of the pancreas, but was ultimately successful.
Conclusions:
Omental cysts are rarely suspected before detection on abdominal imaging. Surgical resection is the treatment of choice, and complete resection can result in a recurrence-free postoperative course. Laparoscopic resection has been reported, but laparotomy is reasonable when a minimally invasive approach may not allow for a safe resection without rupture of the cyst. Anatomical characteristics of the cyst, as demonstrated in our case, can present challenges in the treatment of this otherwise benign entity.
Risk of Thromboembolism With Eltrombopag: A Case Report of Deep Vein Thrombosis and Bilateral Pulmonary Embolism
Authors: Ghulam Mujtaba Ghumman, Huda Fatima, Gunbir Singh, Taha Khalid, Mohamed Ayoubi
Journal: Cureus (2023)
Keywords: chronic itp, eltrombopag, platelets, thrombocytopenia, thrombosis
MeSH terms: Case Reports

Eltrombopag is a second-line therapy for refractory thrombocytopenia from immune thrombocytopenic purpura (ITP). The medication is generally well tolerated but can lead to adverse thromboembolic complications in rare instances. We present a case of lower extremity deep vein thrombosis with bilateral pulmonary embolism in an ITP patient receiving eltrombopag. The patient underwent catheter-directed thrombolysis for pulmonary embolism. Eltrombopag was stopped on discharge, considering the potential cause of venous thrombosis.
Long-term outcome of lymph vessel transplantation after chronic lymphorrhea
Authors: Cecilia Dahlbäck, Rüdiger Baumeister, Magnus Åberg, Björn Arnljots, Lieselotte Frost Arner, Håkan Brorson
Journal: Case Reports Plast Surg Hand Surg (2021)
Keywords: lymph, fistula, lymph node, lymph vessel transplantation, lymphedema, transplantation
MeSH terms: Case Reports

A 52-year-old male patient developed a chronic fistula with excessive lymph leakage in the left axilla following removal of an enlarged lymph node with chronic local adipose tissue inflammation due to infection. After multiple surgeries, treatment with lymphatic vessel transplantation was successful. No recurrence occurred over 20 years of follow-up.
Perioperative care of an adolescent with postural orthostatic tachycardia syndrome
Authors: Scott Kernan, Joseph D Tobias
Journal: Saudi J Anaesth (2010)
Keywords: dysautonomia, pots, postural orthostatic tachycardia syndrome
MeSH terms: Case Reports

Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by postural tachycardia in combination with orthostatic symptoms without associated hypotension. Symptoms include light-headedness, palpitations, fatigue, confusion, and anxiety, which are brought on by assuming the upright position and usually relieved by sitting or lying down. Given the associated autonomic dysfunction that occurs with POTS, various perioperative concerns must be considered when providing anesthetic care for such patients. We present an adolescent with POTS who required anesthetic care during posterior spinal fusion for the treatment of scoliosis. The potential perioperative implications of this syndrome are discussed.
A patient with relapsed high-grade serous ovarian carcinoma with somatic RAD51C mutations treated with PARPi monotherapy: a case report
Authors: Siew-Fei Ngu, Hextan Y S Ngan, Karen K L Chan
Journal: Cancer Drug Resist (2022)
Keywords: brca, ovarian cancer, parp inhibitor, rad51c
MeSH terms: Case Reports

We report our experience in the management of a relapsed ovarian cancer patient with somatic RAD51C mutation, treated with olaparib monotherapy. The patient was diagnosed with stage 4 high-grade serous ovarian carcinoma and was treated with neoadjuvant chemotherapy, cytoreductive surgery, and postoperative chemotherapy. After a second cancer recurrence, she underwent FoundationOne CDx testing following disease progression on multiple lines of chemotherapy. Based on the FoundationOne CDx results, olaparib monotherapy was started. After 13 months of therapy, all lesions responded to the treatment, and she achieved complete response as demonstrated by normalization of the levels of CA125 and positron emission tomography-computed tomography (PET-CT). We plan to continue olaparib monotherapy until disease progression.
Prenatal diagnosis of 1p34.3 interstitial microdeletion by aCGH in a fetus with jaw bone abnormalities
Authors: Themistoklis Dagklis, Elena Papageorgiou, Elisavet Siomou, Vassilis Paspaliaris, Christina Zerva, Panagiotis Chatzis, Loretta Thomaidis, Emmanouil Manolakos, Ioannis Papoulidis
Journal: Mol Cytogenet (2016)
Keywords: array-based comparative genomic hybridization array (a-cgh), chromosome 1, genotype-phenotype correlation, microdeletions, prenatal diagnosis
MeSH terms: Case Reports

Background:
Interstitial microdeletions in 1p are extremely rare, as very few cases have been reported postnatally and only one prenatally, yet. There is a variability of phenotypic findings such as hypotonia, facial dysmorphisms, mild microcephaly, with being most common developmental delay.
Case presentation:
The present case involved a female fetus with an interstitial deletion on 1p, presenting with micrognathia in the 2nd trimester routine ultrasound examination. Array-based comparative genomic hybridization (a-CGH) revealed a 2,7 Mb deletion located on 1p34.3 which could not be detected by standard karyotyping.
Conclusions:
This is the first prenatal case of an interstitial deletion in 1p34.3 with facial dysmorphism detected by a-CGH. Due to the use of a-CGH techniques submicroscopic imbalances could be detected, and a refined genotype-phenotype correlation could be achieved.
Thyroid Langerhans cell histiocytosis concurrent with papillary thyroid carcinoma: A case report and literature review
Authors: Bin Mi, Di Wu, Yue Fan, Benjamin Ka Seng Thong, Yudong Chen, Xue Wang, Chaofu Wang
Journal: Front Med (Lausanne) (2023)
Keywords: braf gene mutations, hashimoto’s thyroiditis (ht), langerhans cell histiocytosis (lch), lymph node metastasis, papillary thyroid carcinoma (ptc)
MeSH terms: Case Reports

Langerhans cell histiocytosis (LCH) is a clonal neoplasm of myeloid dendritic cells, rarely involving the thyroid gland. Papillary thyroid carcinoma (PTC) is the most common histological subtype of thyroid cancer. We report a rare case of a 34-year-old Chinese woman who has LCH with PTC and cervical lymph node metastasis of LCH, with a review of the literature. The patient has thyroid nodules and cervical lymph node enlargement detected by neck ultrasound during physical examination. Fine needle aspiration cytology (FNAC) showed PTC with Hashimoto's thyroiditis and BRAF V600E mutation after thyroidectomy and lymph node dissection. Histopathological examination suggests that LCH was concurrent with classical PTC, accompanied by LCH cervical lymph node metastasis. No BRAF, HRAS, and TERT promoter mutations were detected in LCH metastatic lesions. The patient is in stable clinical condition currently.
Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence
Authors: Rika Tsukii, Yuka Kasuya, Shinji Makino
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

To report a patient with nonarteritic anterior ischemic optic neuropathy (NA-AION) occurring soon after the COVID-19 vaccination. A 55-year-old woman presented with a 4-day history of inferior visual field disturbance in the right eye 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Examination revealed a best-corrected visual acuity of 20/20 in both eyes. A relative afferent pupillary defect was observed in the right eye. Fundoscopy revealed diffuse optic disc swelling in the right eye, which was prominent above the optic disc. Goldmann visual field testing identified an inferior altitudinal visual field defect with I/2 isopter in the right eye. Although typical complete inferior visual field defect was not detected, a diagnosis of NA-AION was made. The patient was followed without any treatment. During the 2-month follow-up period, the optic disc swelling was gradually improved, and visual acuity was maintained 20/20; however, the optic disc looked diffusely pale in the right eye. Although it is uncertain whether the development of NA-AION after COVID-19 vaccination was consequential or coincidental, we speculate that the close temporal relationship with COVID-19 vaccination suggests the possibility of vasculopathy on the microvascular network of optic nerve head as background of inflammatory or immune-mediated element to the timing of the onset of NA-AION. The aim of this case report is to present this biological plausibility and to elucidate potential ophthalmological complications.
Rapidly increasing prostheto-prosthetic pseudo aneurysm 26 years after cabrol procedure in a patient with Marfan syndrome: a case report
Authors: Othmane Haddani, Besart Cuko, Frederic Vanden Eynden
Journal: Pan Afr Med J (2023)
Keywords: cabrol procedure, marfan syndrome, case report, prostheto-prosthetic pseudoaneurysm, reoperation
MeSH terms: Aneurysm, Aneurysm, False / diagnostic imaging, Aneurysm, False / etiology, Aneurysm, False / surgery, Aortic Valve Insufficiency / etiology, Aortic Valve Insufficiency / surgery, Marfan Syndrome / complications, Case Reports, Anastomosis, Surgical, Female, Humans, Middle Aged

A 63-year-old female with Marfan syndrome had undergone an initial operation of replacement of the ascending aorta and aortic valve with a composite graft and reconstruction of the coronary artery by the Cabrol procedure for aortic root dilatation and aortic valve regurgitation. During a follow-up of 16 years, a decreased ejection fraction was observed on transthoracic echocardiography with the onset of chest pain and dyspnea. Computer tomography angiography revealed a prostheto-prosthetic pseudoaneurysm, initially measured 21x16x23 mm, rapidly increased at 1-year follow-up at 27x24x33 mm. Coronary angiography showed the presence of turbulent flow inside the pseudoaneurysm with a decreased coronary perfusion. We resected the pseudoaneurysm and a new prostheto-prosthetic anastomosis was performed. The postoperative course was uneventful without any complications. We report this case because in literature there has been few reports regarding prostheto-prosthetic pseudoaneurysm after Cabrol procedure.
Case report: A case report and literature review about Pathological transformation of lung adenosquamous cell carcinoma
Authors: Liang Ge-Ge, Geng Cuicui, Li Leiqiang, Tian Yongcang, Ma Jiangang, Ou Yiwen, Sun Li-Zhe
Journal: Front Oncol (2022)
Keywords: egfr-tki, cardiac metastasis, case report, lung cancer, pathological transformation
MeSH terms: Case Reports

Background:
Lung adenosquamous carcinoma is a relatively rare pathological type in lung cancer. The incidence of gene mutation is lower than that of lung adenocarcinoma. However, the cases of pathological transformation after targeted treatment of EGFR gene mutation are more rare.
Case introduction:
A 55 year old female was diagnosed with lung cancer and underwent surgical treatment.The pathology suggested adenosquamous cell carcinoma. Genetic test was EGFR-L858R. After surgery, she was treated with gefitinib targeted therapy. After 2 years of surgery, she developed brain metastasis. surgery was performed again. The pathology suggested squamous cell carcinoma. She continued to take gefitinib targeted therapy orally. After one month later since brain metastasis, she was found to have heart cavity metastasis and surgery was performed for the third time. Besides, the pathology suggested adenosquamous cell carcinoma. Genetic test was EGFR-p E746_ A750del, T790M (-), and we replaced with the second-generation EGFR-TKI afatinib targeted therapy. Up to now, no recurrence or metastasis has been found.
Conclusion:
We now report a rare case of lung adenosquamous carcinoma with pathological transformation during targeted therapy, which is intended to provide therapeutic ideas for the treatment of lung adenosquamous carcinoma in clinical practice. In addition, we reviewed previously reported tumor heterogeneity in the literature.
Intraoperative evaluation of cervical nerve root avulsion using ultra-high-frequency ultrasound system
Authors: Daniel Boczar, Antonio J Forte, Jeremie D Oliver, Robert L McClain, Peter Murray, Steven R Clendenen
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: brachial plexus, imaging, innovation, microsurgery, peripheral nerve, plastic surgery, spinal cord, technology, ultrasound, ultra–high-frequency
MeSH terms: Case Reports

Avulsion of C5 and C7 nerve roots was confirmed intraoperatively in a 21 year old male presenting after motor vehicle accident with confirmed absence of somatosensory evoked potentials upon stimulation via ultra-high-frequency ultrasound (70 MHz). Ultra-high-frequency ultrasound can be used as a reliable tool to directly visualise nerve injury.
First Report on Fetal Cerebral Polyglucosan Bodies in Mucopolysaccharidosis Type VII
Authors: Hazim Kadhim, Valérie Segers, Catheline Vilain, Julie Désir, Nicky D'Haene
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

We report on the detection of discordant inclusions in the brain of a 25-week female fetus with a very rare lysosomal storage disease, namely, Sly disease (mucopolysaccharidosis (MPS) type VII), presenting with nonimmune hydrops fetalis. Besides vacuolated neurons, we found abundant deposition of polyglucosan bodies (PGBs) in the developing brain of this fetus in whom MPS-VII was corroborated by lysosomal beta-glucuronidase-deficiency detected in fetal blood and fetal skin-fibroblasts and by the presence of a heterozygous pathogenic variant in the GUSB gene in the mother. Fetal/neonatal metabolic disorders with PGB-deposition are extremely rare (particularly in relation to CNS involvement) and include almost exclusively subtypes of glycogenosis (types IV and VII). The accumulation of PGBs (particularly in the fetal brain) has so far not been depicted in Sly disease. This is the first report on such "aberrant" association. Besides, the detection of these CNS inclusions at such an early developmental stage is remarkably unique.
Ultrasound-Guided Percutaneous Drainage of Abdominal Abscess in a Patient With Crohn's Disease: A Case Report
Authors: Radmila V Karpova, Ksenia S Russkova, Roman N Komarov, Arina A Petrova
Journal: Front Surg (2021)
Keywords: crohn's disease, abdominal abcess, immunomodulatory therapy, percutaneous drainage, ultrasound
MeSH terms: Case Reports

Introduction: The autoimmune process in Crohn's disease exacerbates destructive changes in the intestinal wall and leads to complications such as bleeding (21. 9%), strictures (21.6%), and abscesses (19.7%). Case Presentation: The case of a 32-year-old male patient with an 8-year history of Crohn's disease is presented. He was admitted for emergency indications with severe pain in the right lower quadrant, chills, and a fever reaching 39.0°C. The patient had anemia, hypocoagulation and immunodeficiency. Ultrasound and CT scans of the abdominal organs revealed an abscess in the right iliac region. It was immediately drained under ultrasound control and X-ray. A fistulogram showed the fistula between the abscess and the ileum. Routine antibiotic therapy selected in accordance with the sensitivity of the microflora and sanitization of the abscess cavity were not effective. The immunomodulatory therapy, intravenous administration of cryoprecipitate, and the introduction of fibrin glue into the abscess cavity were added to the treatment. After the treatment, the patient's immune status corresponded to normal, the abscess healed, and the fistula was closed. Conclusion: In patients suffering from Crohn's disease with the formation of an abscess and a long-term non-healing intestinal fistula, it is essential that the diagnostic algorithm includes the examination of the immune status. Treatment should include immunomodulators, intravenous administration of cryoprecipitate. To close the fistula in these patients, it is advisable to use fibrin glue that has a local immunomodulatory effect.
Cerebrovascular accidents associated with sorafenib in hepatocellular carcinoma
Authors: Muhammad W Saif, Iris Isufi, Jennifer Peccerillo, Kostas N Syrigos
Journal: Gastroenterol Res Pract (2011)
MeSH terms: Case Reports

Sorafenib is an oral angiogenetic multikinase inhibitor approved in the treatment of renal and hepatocellular carcinoma. Bleeding and venous thrombotic events have been described with angiogenetic agents but cerebrovascular accidents are rarely reported. We report two cases of patients with hepatocellular carcinoma who developed a cerebrovascular accident while on sorafenib. Neither patient had any risk factors for the cerebrovascular events apart from gender and age in the second patient. Laboratory data were noncontributory. The head CT scan did not reveal acute abnormalities. No hemodynamically significant stenosis was visible in the carotid ultrasound, and the echocardiogram showed normal size of the heart chambers and normal systolic function of the left ventricle. Sorafenib was discontinued in both cases. Physicians should monitor patients receiving sorafenib for neurologic symptoms, and in the absence of other etiology, prompt discontinuation of this drug should be considered.
Tenofovir and Severe Symptomatic Hypophosphatemia
Authors: Asim Kichloo, Savneek Singh Chugh, Sanjeev Gupta, Jay Panday, Ghazaleh Emedis Goldar
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: fanconi’s syndrome, hypophosphatemia, tenofovir, tubular acidosis
MeSH terms: Acidosis, Renal Tubular / chemically induced, Anti-HIV Agents / adverse effects, Hypophosphatemia / chemically induced, Tenofovir / adverse effects, Case Reports, Anti-HIV Agents / therapeutic use, Fanconi Syndrome, Female, HIV Infections / drug therapy, Humans, Kidney Tubules, Proximal / drug effects, Middle Aged, Tenofovir / therapeutic use, Anti-HIV Agents, Tenofovir

Tenofovir is a broadly used drug used for the treatment of human immunodeficiency virus (HIV). Although the initial results of the clinical trials supported the renal safety of Tenofovir, clinical use of it has caused a low, albeit a significant, risk of renal damage either in the form of AKI or CKD. The pathophysiology has been linked to the effect of this medication on the proximal tubular cell. Although the exact mechanism is unknown, studies have suggested that Tenofovir accumulates in proximal tubular cells which are rich in mitochondria. It is both filtered in the glomerulus and actively secreted in the tubules for elimination and is excreted unchanged in the urine. Studies have shown an active transportation of 20-30% of this drug into the renal proximal tubule (PCT) cells via the organic anion transporters in the baso-lateral membrane (primarily hOAT1, and OAT3 to a lesser extent) and ultimate excretion of the drug into the tubular lumen via the transporters in the proximal tubular apical membrane MRP4 and MRP2 (multidrug resistance-associated proteins 2 & 4). Subsequently, the mitochondrial injury caused by Tenofovir can lead to the development of Fanconi's syndrome which causes renal tubular acidosis, phosphaturia, aminoaciduria, glucosuria with normoglycemia, and tubular proteinuria. Here we present a case where Tenofovir treatment resulted in severe hypophosphatemia requiring hospitalization for parentral phosphate repletion.
Bib Sign in Proximal Descending Thoracic Aorta Rupture on CT Angiography: Presentation of a Paradigmatic Case
Authors: Antonio Pierro, Alessandro Posa, Luca Iorio, Alessandro Tanzilli, Lucia Cucciolillo, Fabio Quinto, Mariacarmela Sciandra, Roberto Iezzi, Savino Cilla
Journal: Case Rep Radiol (2022)
MeSH terms: Case Reports

Thoracic aortic rupture may present with subtle clinical and CT-angiography findings. Recognition of the imaging features of early rupture is key for timely diagnosis and treatment. This report presents a new sign of incipient proximal thoracic aortic rupture on CT-angiography.
Case Report: Interstitial-intralesional laser therapy and laser-assisted new attachment procedure for the treatment of alveolar bone loss provoked by an aggressive pyogenic granuloma
Authors: Anon Akkarapatum, Poramaporn Klanrit, Sajee Sattayut
Journal: F1000Res (2022)
Keywords: lanap, diode laser, interstitial-intralesional laser therapy, photocoagulation, pyogenic granuloma, tooth preservation
MeSH terms: Alveolar Bone Loss / complications, Alveolar Bone Loss / surgery, Granuloma, Pyogenic / etiology, Granuloma, Pyogenic / pathology, Granuloma, Pyogenic / surgery, Laser Therapy / adverse effects, Laser Therapy / methods, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Humans, Lasers, Semiconductor / therapeutic use, Male, Molar / pathology

Background: A pyogenic granuloma (PG) is a common benign vascular lesion found in the oral cavity. The gold standard treatment of this lesion, comprising surgical excision and the elimination of etiological factors, cannot avoid tooth loss in the case of an aggressive pyogenic granuloma. Because of the prominent properties of 980 nm and 635 nm diode lasers in photocoagulation and photobiomodulation, we applied these wavelengths in the treatment of a large pyogenic granuloma with alveolar bone loss. Case presentation: Our objective was to use a combination of interstitial-intralesional laser therapy, photocoagulation and laser-assisted new attachment procedure (LANAP) to preserve the teeth and periodontal tissue in a case of an aggressive pyogenic granuloma. Results: The patient was a 13-year-old Thai male with a pyogenic granuloma involving the interdental papilla and lingual gingiva of the lower left first and second molars. The teeth were also displaced by the lesion. After treatment with three sessions of photocoagulation, three sessions of interstitial-intralesional laser therapy and two sessions of LANAP, the lesion was completely resolved. The periodontal status of the teeth was improved at the six-month follow-up. Conclusion: The combination of interstitial-intralesional laser therapy, photocoagulation and LANAP was able to treat an aggressive pyogenic granuloma with tooth preservation.