OpenMed/multicare-articles huggingface dataset:
Papillary thyroid cancer recurrence 43 Years following Total Thyroidectomy and radioactive iodine ablation: a case report
Authors: Yaw Amoako-Tuffour, M Elise Graham, Martin Bullock, Matthew H Rigby, Jonathan Trites, S Mark Taylor, Robert D Hart
Journal: Thyroid Res (2017)
Keywords: case report, neck dissection, papillary thyroid cancer, radioiodine ablation, recurrence, thyroidectomy
MeSH terms: Case Reports

Background:
Recurrent papillary thyroid carcinoma (PTC) beyond the first two decades of definitive treatment (i.e. total thyroidectomy and radioactive iodine ablation) is a rare occurrence.
Case presentation:
We present a case of a 71-year old Caucasian female with a distant history of PTC treated with total thyroidectomy and radioactive iodine ablation who experienced recurrence of her disease 43 years following initial diagnosis and definitive treatment. She presented with palpable left-sided neck mass and subsequently underwent a level II, III, neck dissection and adjuvant iodine ablation. This case presents the latest recurrence in papillary thyroid cancer documented to date in the literature.
Conclusion:
This case exemplifies the need for the head and neck surgeon, radiation oncologist, general practitioner and radiologist to consider new lateral neck mass as late-presenting recurrence of PTC until proven otherwise regardless of low recurrence rates beyond two decades from treatment and low prognostic risk scores.
Case Report: Insulinoma Co-Existing With Type 2 Diabetes - Advantages and Challenges of Treatment With Endoscopic Ultrasound-Guided Radiofrequency Ablation
Authors: Johnny Yau-Cheung Chang, Chariene Shao-Lin Woo, David Tak-Wai Lui, Matrix Man-Him Fung, Alan Chun-Hong Lee, Eunice Ka-Hong Leung, Yu-Cho Woo, Wing-Sun Chow, Karen Siu-Ling Lam, Kathryn Choon-Beng Tan, Chi-Ho Lee
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: continuous glucose monitoring, endoscopic ultrasound, insulinoma, radio frequency ablation, type 2 diabetes
MeSH terms: Diabetes Mellitus, Type 2 / complications, Insulinoma / complications, Insulinoma / diagnostic imaging, Insulinoma / surgery, Pancreatic Neoplasms / complications, Pancreatic Neoplasms / diagnostic imaging, Pancreatic Neoplasms / surgery, Radiofrequency Ablation, Case Reports, Blood Glucose, Blood Glucose Self-Monitoring, Humans, Ultrasonography, Interventional, Blood Glucose

The coexistence of insulinoma and type 2 diabetes is rare and the diagnostic process is often challenging. Continuous glucose monitoring system devices, which are more readily available nowadays, provide a useful tool for the diagnosis and evaluation of treatment response. Curative surgery is often the mainstay of treatment for insulinoma. Here, we report a Chinese patient with insulinoma diagnosed simultaneously with type 2 diabetes. His insulinoma was managed with endoscopic ultrasound guided-radiofrequency ablation (EUS-RFA) and the patient achieved complete resolution of hypoglycaemic episodes. The case illustrates that while EUS-RFA is an emerging non-invasive treatment modality for pancreatic lesions, limitations exist especially when histological confirmation is essential.
Endovascular retrieval of a dislocated coil in the peroneal artery with a stent retriever
Authors: Omid Nikoubashman, Rico Badenschier, Marguerite Müller, Carolin Brockmann, Gerrit Schubert, Marc-Alexander Brockmann, Georg Mühlenbruch, Hans Rainer Clusmann, Martin Wiesmann
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

We present a patient who underwent successful removal of a fully detached platinum coil from the peroneal artery using a Solitaire™ stent retriever (Covidien, Irvine, CA) that is usually used in endovascular stroke treatment.
An Unusual Presentation of a Large Calcified Thyroid Nodule
Authors: Umesh Jayarajah, Pradeep Wijerathne, Oshan Basnayake, Sanjeewa Seneviratne
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

This case highlights the rare occurrence of a large benign calcified nodule of the left lobe of the thyroid gland with associated obstructive symptoms. Unusually, the calcification was confluent with similar calcified nodules in the subcutaneous tissue plane. The symptoms were alleviated following a total thyroidectomy.
Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report
Authors: Liza Bk Tan, Jimmy By So, Asim Shabbir
Journal: J Med Case Rep (2012)

Introduction:
Laparoscopic adjustable gastric banding is the most frequently performed bariatric procedure for the treatment of morbid obesity and is associated with low morbidity and mortality. Complications related to obesity surgery are rare and their presentation is often non-specific. Thus, it is highly important for physicians who are practising bariatric surgery to be aware of complications described in single-case studies or series when they come across similar complications even years after the primary bariatric operation.
Case presentation:
We report the case of a 47-year-old Malay woman who was admitted with symptoms and signs suggesting intestinal obstruction five years after gastric band placement.
Conclusions:
In our patient, the band connection wire tube was the cause of both small bowel obstruction and colonic erosion. Computed axial tomography is the cornerstone of the investigation of such patients. After surgical removal of the connecting tube, our patient recovered without sequelae.
Eosinophilic Gastroenteritis with a Relapsing and Remitting Course with Presence of Autoimmune Antibodies
Authors: Chathuranga Lakmal Fonseka, Sunali Nanayakkara, S D A L Singhapura, H M M Herath, C K Bodinayake
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the digestive tract, which occurs due to an uncertain aetiology. Although autoimmune diseases can later present as EGE, it is unusual for EGE to have positive autoimmune antibodies without the presence of an overt autoimmune disease. Case presentation. We report a 38-year-old previously healthy man who presented with abdominal discomfort and loose stools with pleural and peritoneal effusions progressing over several weeks. His investigations revealed severe eosinophilia in peripheral blood and ascitic fluid, and a laparoscopic full-thickness biopsy from the ileum demonstrated infiltration of eosinophils in all three layers of the intestine. There were no clinical features or investigations suggestive of parasitic disease, other diseases associated with eosinophilia, or autoimmune disease. Further investigations showed a highly positive ANA, positive p-ANCA, but did not meet the criteria to diagnose a specific autoimmune disease. The eosinophilia responded to an elimination diet with gradual resolution of eosinophilia and effusions, and once it reappeared after introduction of a normal diet.
Conclusion:
EGE presenting as peripheral blood and ascitic fluid eosinophilia with the presence of pleural and/or peritoneal effusions is uncommon. Eosinophilic gastroenteritis can be associated with autoantibody positivity without any evidence of overt autoimmune disease manifestations. Elimination diet can be used as a potential option to prevent recurrences of EGE.
Assessment of Ventilation and Perfusion in Patients with COVID-19 Discloses Unique Information of Pulmonary Function to a Clinician: Case Reports of V/P SPECT
Authors: Marika Bajc, Fredrik Hedeer, Ari Lindqvist, Elin Trägårdh
Journal: Clin Med Insights Circ Respir Pulm Med (2021)
Keywords: covid-19, sars-cov-2, spect, ventilation, perfusion, pulmonary embolism
MeSH terms: Case Reports

V/P SPECT from 4 consecutive patients with COVID-19 suggests that ventilation and perfusion images may be applied to diagnose or exclude pulmonary embolism, verify nonsegmental diversion of perfusion from the ventilated areas (dead space ventilation) that may represent inflammation of the pulmonary vasculature, detect the reversed mismatch of poor ventilation and better preserved perfusion (shunt perfusion) in bilateral pulmonary inflammation and indicate redistribution of lung perfusion (antigravitational hyperperfusion) due to cardiac congestion. V/P mismatch and reversed mismatch may be extensive enough to diminish dramatically preserved matching ventilation/perfusion and to induce severe hypoxemia in COVID-19.
Orthodontic Treatment Timing and Modalities in Anterior Open Bite: Case Series Study
Authors: Wisam Al Hamadi, Fayez Saleh, Mohamad Kaddouha
Journal: Open Dent J (2017)
Keywords: adult treatment, anterior open bite, early treatment, fixed palatal crib, habit breaker, surgical correction
MeSH terms: Review

Objective:
The purpose of this study was to present early and adult cases of anterior open bite that were treated efficiently using different treatment approaches and mechanics.
Materials and methods:
Five patients of different age groups (from 7 to 27 years), suffering from a clear Anterior open bite deformity, were properly diagnosed and relevant treatment modality for each was selected.
Results:
Positive overbite was efficiently achieved for all patients.
Conclusion:
Patient compliance is a key factor in using removable habit breakers. However, fixed palatal crib gave the same results but in shorter time. Anterior open bite of skeletal components should be thoroughly evaluated before selecting camouflage or orthognathic surgery treatment modality.
The acute oncologist's role in managing patients with cancer and other comorbidities
Authors: Kate Shankland, Peter Kirkbride, Anne-Marie Bourke, James Price, Lucy Walkington, Sarah Danson
Journal: J Comorb (2012)
Keywords: acute oncologist, acute oncology, cancer, comorbidity

Background:
An Acute Oncology Service (AOS) is paramount to providing timely and improved pathways of care for patients who are admitted to hospital with cancer-related problems or suspected cancer.
Objective:
To establish an AOS pilot study to decide how best to implement such a service locally.
Methods:
The AOS, which included collaboration between the oncology and palliative care teams at the Northern General Hospital in Sheffield, UK, ensured that the majority of oncology patients in the region received timely assessment by an oncologist if they became acutely unwell as a result of their cancer or its treatment. The AOS consisted of a thrice-weekly ward round, and daily telephone advice service.
Results:
We report on patient data during the first 12 months of the pilot study. Delivery of the AOS enhanced communication between the services and provided inter-professional education and support, resulting in earlier oncological team involvement in the management of patients with cancer admitted under other teams, as well as provision of advice to patients and their caregivers and families. Provision of the AOS shortened the mean length of hospital stay by 6 days. Two case studies are presented to illustrate the typical challenges faced when managing these patients.
Conclusions:
Establishment of the AOS enabled effective collaboration between the oncology and other clinical teams to provide a rapid and streamlined referral pathway of patients to the AOS. Locally, this process has been supported by the development of acute oncology protocols, which are now in use across the local cancer network. Journal of Comorbidity 2012;2:10-17.
Previously Unidentified Gene Variation Associated with Fabry Disease: The Impact on One Family
Authors: Amaresh R Vanga, Samantha A Schrier Vergano, Jolanta Kowalewska, Thomas R McCune
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Fabry disease is an X-linked lysosomal storage genetic disorder associated with over 1000 mutations in the alpha-galactosidase-A gene region. We report here a 69-year-old male who underwent a kidney biopsy to evaluate progressive renal failure. He was found to have zebra bodies in visceral epithelial cells on biopsy, with electron microscopy showing inclusions within the cytoplasm of multiple podocytes consistent with Fabry disease. An alpha-galactosidase level was found to be 21 nm/hr/mg (normal range 50-150 nm/hr/mg). Genetic studies revealed a missense variant in the GLA gene with alanine replaced by cysteine at position 682 (c.682 A > C, p.N228H) that had not been previously associated with Fabry disease. The same variant was detected in two additional family members. The pathologic findings, clinical features, and low alpha-galactosidase level suggest that the c.682 A > C variant is associated with Fabry disease.
Successful surgical internal drainage of postoperative pancreatic pseudocyst through pancreaticojejunostomy with distal pancreatectomy: a case report
Authors: Kazuya Sakata, Daisuke Hashimoto, Katsunobu Taki, Osamu Nakahara, Masaki Ohmuraya, Akira Chikamoto, Toru Beppu, Hideo Baba
Journal: Surg Case Rep (2015)
Keywords: distal pancreatectomy, pancreatic pseudocysts, pancreaticojejunostomy

Pancreatic pseudocyst is usually treated by percutaneous external drainage, endoscopic internal or external drainage, or surgical internal drainage such as cystogastrostomy. Surgical external drainage is an option if these procedures fail. We describe a case of a 70-year-old man with a pancreatic body pseudocyst that developed postoperatively. It was improved by endoscopic external drainage, and the stent was changed to an internal stent. However, surgery was required as the pseudocyst grew again. A direct approach to the pseudocyst was not possible because of severe adhesion. A distal pancreatectomy with pancreaticojejunostomy was performed, and an external pancreatic stent tube was inserted from the cut end into the duodenum to drain the pseudocyst. One month later, the pseudocyst disappeared, and the stent was removed.
Signet cell carcinoma of colon in a nineteen-year-old patient: a case report
Authors: Ozgül Pamukçu, Fatih Selcukbiricik, Ahmet Bilici, Damlanur Sakız, Osman Ozdoğan, Fatih Borlu
Journal: Case Rep Oncol Med (2013)

Signet cell carcinoma, which is a subtype of adenocarcinoma, usually originates from the stomach. However, it can also originate from the colon, rectum, gallbladder, pancreas, urinary bladder, and breast. We represent a 19-year-old boy diagnosed with signet cell tumour while he was being evaluated for an initial diagnosis of inflammatory bowel disease.
Relapsing Polychondritis with Meningoencephalitis Refractory to Immunosuppressant Therapy
Authors: Mohammad Mousbah Al-Tabbaa, Hani Habal
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Meningoencephalitis is a rare complication of relapsing polychondritis. We report a case of a 25-year-old male who presented with visual hallucinations and symptoms of depression and anxiety, white matter changes on MRI, and CSF lymphocytosis, along with inflammatory chondritis seen in his auricle cartilage biopsy. Eventually he was given the diagnosis of RP presenting with meningoencephalitis based on CSF analysis, brain MRI findings, negative serologies, and neurologic exam findings. The patient's clinical state did not improve despite being on IV methylprednisolone for a period of 7 days; afterwards he was switched to oral prednisone with no clinical improvement. As a result, he was given cyclophosphamide and rituximab, respectively, without benefit. He also underwent craniectomy with VP shunt due to worsening hydrocephalus and a brain biopsy was done to confirm the diagnosis. He is currently on methotrexate and steroid dependent with a goal to taper down. Even though all 19 reported cases of meningoencephalitis with RP in the literature did respond to immunosuppressive therapy, in our case, however the patient did not respond to immunosuppressive treatment and currently is in mute dementia status after three years of treatment.
Pendulum swings from hypo- to hyperthyroidism: thyrotoxicosis after severe hypothyroidism following neck irradiation in a patient with a history of Hodgkin's lymphoma
Authors: Krzysztof Lewandowski, Katarzyna Dąbrowska, Jacek Makarewicz, Andrzej Lewiński
Journal: Thyroid Res (2016)
Keywords: graves’ disease, neck irradiation, thyroid antibodies, thyrotoxicosis
MeSH terms: Case Reports

Background:
A change in a thyrometabolic state from severe hypothyroidism to thyrotoxicosis is very uncommon, but possible in some circumstances.
Case presentation:
A 27-year old female presented with clinical and biochemical thyrotoxicosis with a previous history chemo- and radiotherapy (including the neck region) for a Hodgkin's lymphoma (at the age of 18). At the age of 20 this was followed by severe hypothyrodism [TSH > 100 μIU/mL (reference range: 0.27-4.2)]. She was stated on L-thyroxine, but the dose was later reduced and subsequently discontinued. She had significantly elevated titres of both anti-thyroid peroxidase antibodies and anti-TSH-receptor antibodies throughout the course of disease. Thyroid scintigraphy revealed a normal and homogenous iodine uptake.
Conclusions:
We suspect that a gradual switch from thyroid-blocking to thyroid-stimulating antibodies resulted in development of an overt thyrotoxicosis, possibly with a contributory effect of neck irradiation on her autoimmune status.
Segmental Colitis Associated Diverticulosis-A Possible Diagnosis in Teenagers
Authors: Cristina O Mǎrginean, Lorena E Meliţ, Maria O Mǎrginean
Journal: Front Pediatr (2018)
Keywords: colonic diverticulosis, pediatrics, segmental colitis, teenager, ulcerative colitis
MeSH terms: Case Reports

Segmental colitis associated with diverticulosis (SCAD) is manifested by active chronic inflammation of the colonic segments affected by diverticulosis, luminal-mucosal inflammation, independent of the presence of inflammation within and/or around the diverticula, and it usually spares the rectum. We present the case of a 15-year-old female admitted to our clinic due to lower digestive hemorrhage and abdominal pain in the previous week, associated with fever 1 day prior to admission. The patient had pallor, painful abdomen upon palpation, accelerated bowel movements, and macroscopic evidence of blood in the stools. Initial laboratory tests showed leukocytosis with neutrophilia, thrombocytosis, anemia, and elevated inflammatory biomarkers. Moreover, colonoscopy revealed multiple ulcerations, hemorrhage, and edema of the sigmoid colon; however, multiple orifices raised the suspicion of a colonic diverticulosis and this was later on confirmed through a barium enema. The histopathological examination pointed out signs of an active chronic inflammation and mucosal architectural changes associated with crypt abscesses, therefore suggesting the diagnosis of SCAD. The patient's prognosis was favorable; her condition improved following steroid and 5-aminosalicylate therapy, without any symptoms or recurrences at the 4 months follow-up. In conclusion, SCAD is a very rare disease entity that is usually confused with other inflammatory bowel conditions. Moreover, it has not been reported in the pediatric age group until now.
Cystic mesenteric lymphangioma: A case report
Authors: Ousmane Thiam, Papa Mamadou Faye, Abdou Niasse, Yacine Seye, Mohamadou Lamine Gueye, Ibrahima Sitor Sarr, Alpha Oumar Toure, Mamadou Seck, Mamadou Cisse, Madieng Dieng
Journal: Int J Surg Case Rep (2019)
Keywords: cyst lymphagioma, mesentery, rare

Introduction:
Cystic lymphangioma is a benign malformative tumor. The abdominal localization is rare. The diagnosis is not easy in preoperative period. The surgery is the choice in the abdominal and symptomatic localization.
Presentation of case:
We report a 26 years old women. She consulted with left hypochondrial pain. The exam found left hyphochondrial swelling with 10 cm of diameter. The biologic screeming was normal. The ultrasound showed a multiloculated cyst which measured 130*80 mm. the CT scan showed a mesenteri cyst mass measured 15 cm. A fine needle aspiration cytology guided by abdominal ultrasound was realized and the cytology doesn't show malignant cell. A median laparotomy found a mesenteric cystic mass measured 15 cm of diameter. A resection was realized. The histologic exam membranous fibrosis cyst limited by an endothelium.
Conclusion:
Mesenteric localization of cyst lymphagioma is rare. The surgery is safe and efficiency for the treatment.
Ureteroarterial fistula
Authors: D H Kim, A Mahdy, V Mundra, M Berman, G M Ghoniem
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Ureteral-iliac artery fistula (UIAF) is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent. CT abdomen and pelvis showed a large recurrent pelvic mass and a retained stent. The patient underwent cystoscopy which showed a normal bladder. Upon removal of the stent, brisk bleeding was noted coming from the ureteral orifice. Antegrade pyelogram was done which revealed a UIAF. Angiography was done and a covered stent was placed. Multiple treatment options are available. All must consider management of the arterial and ureteral side. The arterial side may be addressed by primary open repair, embolization with extra-anatomic vascular reconstruction, or endovascular stenting. The ureter can be managed with nephroureterectomy, ureteral reconstruction, placement of a nephrostomy tube, or ureteral stenting. Being minimally invasive, we believe that endovascular stenting should be the preferred therapeutic option as it also corrects the source of bleeding while preserving distal blood flow.
A rare embryologic variation: anterior communicating artery aneurysm associated with carotid-anterior cerebral artery anastomosis or infraoptic course of the anterior cerebral artery
Authors: Alaattin Yurt, Kubilay Uçar, Füsun Ozer, Ismail Oran, Nuri Arda
Journal: Clin Med Case Rep (2008)
Keywords: anomaly, anterior cerebral artery, cerebral aneurysms, cerebral arteries
MeSH terms: Case Reports

Aneurysms of the complex of the anterior cerebral artery are frequently associated with anatomic variations of the circle of Willis. We describe a case of aneurysmal rupture of the anterior communicating artery, a variant of the anterior cerebral artery. The aneurysm appeared to be situated on this vessel proximal to the infered site of the AcoA. Surgery was performed at the 6th day after hemorrhage. The anterior communicating artery aneurysm was clipped. The post operative course was unventful, with complete recovery. In our case, an extremely rare variation of the proximal tract of the anterior cerebral artery, i.e. an infraoptic course of the proximal precommunicating tract under the optic nerve, with the distal A1 tract anterior to the chiasm and positioned between the optic nerves, is presented.
Dental Management of a Young Child Affected by Galactosialidosis and a Gigantic Abdominal Growth
Authors: Yoselín Méndez-Salado, Paola De Ávila-Rojas, Amaury Pozos-Guillén, Raúl Márquez-Preciado, Miguel Ángel Noyola-Frías, Socorro Ruiz-Rodríguez, Arturo Garrocho-Rangel
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Galactosialidosis (GS) is a rare form of lysosomal storage disease that involves a broad spectrum of skeletal and soft tissue abnormalities. We report here on a 4-year 7-month-old boy with mild mental retardation, exhibiting multiple caries cavities and associated infectious foci and macroglossia. A huge abdominal enlargement due to peritoneal ascites was evident. Behavioral management and patient positioning on the dental chair represented a true challenge. The patient was treated under general anesthesia. However, life-threatening postoperative complications occurred because of the impossibility of extubating the patient. A very careful preanesthetic assessment is crucial in children affected by general conditions associated with airway anomalies, such as GS.