OpenMed/multicare-articles huggingface dataset:
Pitfall of I-131 whole body scan: a mucinous adenocarcinoma of the ovary
Authors: Ali Sellem, Issam Msakni, Wassim Elajmi, Hatem Hammami
Journal: Pan Afr Med J (2020)
Keywords: thyroid cancer, false positive, mucinous adenocarcinoma, ovary, radioiodine
MeSH terms: Adenocarcinoma, Mucinous / diagnosis, Ovarian Neoplasms / diagnosis, Whole Body Imaging, Case Reports, Adenocarcinoma, Mucinous / pathology, False Positive Reactions, Female, Humans, Iodine Radioisotopes, Middle Aged, Ovarian Neoplasms / pathology, Thyroid Cancer, Papillary / surgery, Thyroid Neoplasms / surgery, Thyroidectomy, Iodine Radioisotopes, Iodine-131

False positive radioiodine uptake following thyroidectomy for differentiated thyroid cancer has been reported in some cases. A 57-year-old female patient was referred for ablative radioiodine treatment four weeks after undergoing total thyroidectomy for papillary thyroid carcinoma. Posttherapeutic I-131 scintigraphy showed uptake in the neck and large focus in the lower abdomen and pelvis. Pathology revealed a mucinous adenocarcinoma of the right ovary.
Evidence-based case report: How to deal with unpredicted endometriosis nodule closed to ureter and rectum during laparoscopy
Authors: Sigit Purbadi, Bella Aprilia, Lisa Novianti
Journal: Int J Surg Case Rep (2019)
Keywords: laparoscopy, rectovaginal endometriosis, surgical ablation

Introduction:
Endometriosis is characterized by the growth of endometrial-like tissue within and outside the pelvic cavity. Peritoneum nodules invaded more than 5 mm representing the commonest form of deep infiltrating endometriosis nodules might challenge inexperienced operator due to its location near ureter and the rectum. The aim is to provide important steps on how to deal with unexpected peritoneal endometrial nodules located closed to ureter and rectum.
Presentation of case:
A 43-year-old female underwent laparoscopic cystectomy after being diagnosed to have right endometriosis cyst. The researchers found multiple endometriosis nodules located closed to rectum and ureter after performing cystectomy. A search was conducted on PubMed® with the keywords of "Peritoneal endometriosis nodule" AND "rectovaginal endometriosis nodule" AND "Surgical ablation" OR "Surgical excision" AND "Laparoscopy" AND "Pelvic pain". Reference lists of relevant articles were searched for other possible relevant studies. After selecting the articles, the critical review was performed based on a standardized appraisal form for the treatment study.
Discussion:
Three eligible studies were appraised to assess the surgery outcome (dyspareunia), based on ablation and excision criteria. The pain was decreased during 6 months of follow up, with no difference in both techniques. The minimal requirement to remove the posterior nodules is knowledge of pelvic retroperitoneal anatomy.
Conclusion:
In all endometriosis cases which require surgery will need to be performed by an experienced operator. If rectovaginal endometriosis nodule was unexpectedly found during intraoperative and recognition of rectum and ureter must be done, knowledge of retroperitoneal anatomy is required.
Congenital Thrombotic Thrombocytopenic Purpura: Atypical Presentation and New ADAMTS 13 Mutation in a Tunisian Child
Authors: A Borgi, M Khemiri, A Veyradier, K Kazdaghli, S Barsaoui
Journal: Mediterr J Hematol Infect Dis (2013)
MeSH terms: Case Reports

Background:
Congenital deficiency of ADAMTS13 is characterized by systemic platelet clumping, hemolytic anemia and multiorgan failure. Although, more than 100 mutations have been reported, atypical clinical presentation may be involved in diagnostic difficulties.
Case report:
A 2 year old Tunisian child presented with chronic thrombopenic purpura which failed to respond to corticosteroids. Hemolytic anemia with schistocytes, occurred ten months later, with no previous history of diarrhea or any neurological abnormality. Renal function and coagulation screening tests were normal. The count of platelet improved after fresh frozen infusion (FFP). Extensive investigations revealed a severe deficiency of ADAMTS 13 activity (level< 5%). Gene sequencing identified mutation in exon 18 of ADAMTS 13 gene. Prophylactic regimen with regular infusions of FFP was associated to favorable outcome.
Conclusion:
Early ADAMTS 13 activity testing and gene sequencing associated to precocious plasmatherapy are recommended to reduce morbidity and mortality of congenital TTP.
Obstructive small bowel metastasis from uterine leiomyosarcoma: a case report
Authors: Mutahir A Tunio, Mushabbab Alasiri, Rasha M Saleh, Shomaila Amir Akbar, Nagoud M Ali, Mohamed Abdalazez Senosy Hassan
Journal: Case Rep Obstet Gynecol (2014)

Background. Uterine leiomyosarcoma is a rare and aggressive gynecologic malignancy with an overall poor prognosis. Lungs, bones, and brain are common sites of metastases of uterine leiomyosarcoma. Metastases of uterine leiomyosarcoma to the small bowel are extremely rare, and only four case reports have been published to date. Case presentation. A 55-year-old Saudi woman diagnosed with a case of uterine leiomyosarcoma treated with total abdominal hysterectomy (TAH) and bilateral salpingooophorectomy (BSO) presented in emergency room after sixteen months with acute abdomen. Subsequent work-up showed a jejunal mass for which resection and end-to-end anastomosis were performed. Biopsy confirmed the diagnosis of small bowel metastasis from uterine leiomyosarcoma. Further staging work-up showed wide spread metastasis in lungs and brain. After palliative cranial irradiation, systemic chemotherapy based on single agent doxorubicin was started. Conclusion. Metastatic leiomyosarcoma of small bowel from uterine leiomyosarcoma is a rare entity and is sign of advanced disease. It should be differentiated from primary leiomyosarcoma of small bowel as both are treated with different systemic chemotherapeutic agents.
Severe Disfiguring Scalp and Facial Oedema due to Henoch-Schönlein Purpura in a Child
Authors: Visvalingam Arunath, Arjuna Salinda Athapathu, Thabitha Jebaseeli Hoole, Heshan Aruppala, Asanka Rathnasri, Randula Ranawaka, Sachith Mettananda
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Henoch-Schönlein purpura is a small vessel vasculitis that usually presents with palpable purpura, arthritis, abdominal pain, and nephritis. Subcutaneous oedema of dependent areas is common; however, oedema in the scalp is extremely rare especially in children older than two years. Here, we report a child with massive disfiguring scalp and facial oedema due to Henoch-Schönlein purpura. An eight-year-old boy presented with characteristic palpable purpuric rash and extensive disfiguring scalp and facial swelling for five days. He complained of blurred vision, vomiting, and severe headache on the day of admission. Examination revealed an ill child with extensive oedema of the face and scalp that was tender on palpation. His blood pressure was above the 99th percentile, and he had exaggerated deep tendon reflexes and extensor plantar responses. All biochemical investigations including renal function tests were normal. Noncontrast CT head showed normal brain, with marked soft tissue swelling of the scalp. Ultrasonography showed soft tissue oedema within and surrounding facial muscles without evidence of neck vessel compression. Urine analysis revealed microscopic haematuria on day 14 of the illness, and immunohistochemical staining of renal biopsy confirmed Henoch-Schönlein purpura nephritis. In conclusion, this case report presents a child with severe, disfiguring scalp and facial oedema due to Henoch-Schönlein purpura. It highlights that severe subcutaneous oedema of Henoch-Schönlein purpura can involve any part of the body not limiting to dependent areas.
Co-occurrence of a novel PDGFRB variant and likely pathogenic variant in CASR in an individual with extensive intracranial calcifications and hypocalcaemia
Authors: Natasha N DeMeo, Jeremy D Burgess, Patrick R Blackburn, Jennifer M Gass, John Richter, Herjot K Atwal, Jay A van Gerpen, Paldeep S Atwal
Journal: Clin Case Rep (2017)
Keywords: casr, fahr's syndrome, pdgfrb, autosomal dominant, hypocalcaemia, primary familial brain calcification, whole‐exome sequencing
MeSH terms: Case Reports

This case report describes an individual with brain calcifications, cognitive decline, motor dysfunction, and hypocalcaemia. Exome sequencing revealed a previously reported variant in the CASR gene and a variant of uncertain significance in PDGFRB. The clinical phenotype is likely explained by the CASR variant, but we discuss how the PDGFRB variant could also participate in the phenotype.
Recurrent meningeal hemangiopericytoma with multiple metastasis and hypoglycemia: a case report
Authors: Jammy Kin Iong Chan, Wah Cheuk, Luen Cheong Ho, Jian-Ming Wen
Journal: Case Rep Med (2012)

Aims. We report on the unusual case of a 43-year-old man who developed recurrent meningeal hemangiopericytoma and presented with hypoglycemia 6 years after excision of the tumor. Methods and Results. We utilized computed tomography to assure multiple tumor metastasis and cranial recurrence of previous meningeal hemangiopericytoma and clinical laboratory tests and immunohistochemical staining to characterize this case. Magnetic resonance imaging and computed tomography showed the recurrent tumor at original torcular site was increased in size. Abnormal low levels of growth hormone, insulin, and insulin-like growth factor-I except insulin-like growth factor-II were detected in the serum. By immunohistochemistry, the neoplastic cells characteristically express diffusely CD99, bcl2, and variable CD34. After radio- and chemotherapy, serum glucose level of the patient returned to normal. Conclusions. Comparing other brain tumors, meningeal hemangiopericytoma has a higher recurrent and metastatic rate, but this tumor with hypoglycemia is very rare.
Occurrence-regression-recurrence of hepatocellular carcinoma without any intervention: A case report
Authors: Weinan Li, Yongfu Xiong, Xia Shu, Jingdong Li
Journal: Front Surg (2022)
Keywords: case report, hepatocellular carcinoma, immune response, ischemia, spontaneous regression
MeSH terms: Case Reports

Background:
Spontaneous regression of primary liver cancer is a rare event, and currently the exact pathogenesis of spontaneous tumor regression remains unclear.
Case description:
Clinical information was collected from a patient with spontaneous regression of liver cancer at our center. The patient was a 41-year-old male. He was admitted to the hospital on 3 May 2019, due to aversion to fatty or greasy food, anorexia, loss of appetite, and abdominal distension. Laboratory examination results included hepatitis B surface antigen positivity, hepatitis B e antigen positivity, and hepatitis B core antibody positivity and tumor marker levels of alpha-fetoprotein 142,938.20 µg/L, abnormal prothrombin 4,599.91 mAU/ml, and carbohydrate antigen 19-9 82.05 U/ml. Upper abdominal enhanced computed tomography indicated right hepatocellular carcinoma with portal vein tumor thrombus formation. The patient declined any treatment. The tumor in the right lobe of the liver completely regressed after 1 year, and the patient is still undergoing follow-up.
Conclusions:
We encountered a hepatocellular carcinoma patient who underwent spontaneous regression, but the exact pathogenesis remains unknown. Understanding the pathogenesis of spontaneous regression of hepatocellular carcinoma has the potential to contribute to the development of an effective treatment for hepatocellular carcinoma.
Smoking behavior and hypertension among health workers during the COVID-19 pandemic: a case study in Java and Bali-Indonesia
Authors: Misnaniarti, Wahyu Pudji Nugraheni, Zainul Khaqiqi Nantabah, Fraschiska Rizky Restuningtyas, Risky Kusuma Hartono, Tety Rachmawati, Rofingatul Mubasyiroh, Asep Kusnali
Journal: Front Cardiovasc Med (2023)
Keywords: covid-19, java and bali, health worker smoking, health workers, hypertension, smoking

Background:
Health workers who should be role models for the community not to smoke and live a healthy life are still consuming cigarettes. Java and Bali (especially Java) are the biggest contributors to health worker deaths due to COVID-19 in Indonesia. This study aims to determine the association of smoking behavior and hypertension among health workers in Java and Bali. The researchers conducted this study in 2021 and designed it with a cross-sectional design. Data was collected online using the Lime Survey as a data collection tool. The data analysis used was logistic regression to determine the association of smoking and hypertension.
Result:
A number of 7.6% of health workers were still smoking and 10.4% were suffering from hypertension during the COVID-19 pandemic. This study shows that the proportion of health workers with hypertension is two times that of smokers (18.0%) compared to non-smokers (9.8%). Logistic regression showed that smoking has a 20% higher risk of developing hypertension (OR = 1.97; 95%CI = 1.01-1.41; p = 0.034).
Conclusion:
Among health workers on the islands of Java and Bali, there are still many who smoke, and this puts them at a higher risk of experiencing hypertension.
A Rare Case Presentation: Intravesical Catheter Knotting
Authors: Enis Kervancioglu
Journal: J Endourol Case Rep (2018)
Keywords: knotting, urethral catheterization, voiding cystourethrography
MeSH terms: Case Reports

Urethral catheterization is a common invasive procedure applied for several purposes on children. Voiding cystourethrogram (VCUG) is a diagnostic fluoroscopic procedure, which is commonly used in assessing urinary tract infections in children and which requires urethral catheterization. We report a case of intravesical catheter knotting, which is a rare complication of VCUG.
Improvement of Cardiac Vegetations in Antiphospholipid Syndrome with Enoxaparin and Corticosteroids after Rivaroxaban Failure
Authors: Eric Granowicz, Kiyon Chung
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Cardiac disease is a well-known complication of antiphospholipid syndrome (APS), with many patients presenting with valvular thickening or vegetations, referred to as Libman-Sacks endocarditis (LSE). Because cases of APS with cardiac involvement are relatively rare, paucity of large clinical trials studying this complication has made management challenging. In the absence of acute heart failure and embolic events, a medical approach is usually selected, consisting of anticoagulation and possibly corticosteroids when another underlying autoimmune disease is present. However, the role of various anticoagulant classes and the duration of steroid therapy continue to be debated. Here, we present a 45-year-old woman who developed two vegetations in the setting of secondary APS while taking rivaroxaban before experiencing marked improvement with the use of enoxaparin and steroids.
Heterozygous Hemoglobin Sherwood Forest Causing Polycythemia
Authors: Vikram M Raghunathan, James N Butera, Diana O Treaba
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Hemoglobin (Hb) Sherwood Forest is a rare high-affinity hemoglobin first described in 1977, arising from an Arg to Thr substitution at codon 104 of the beta chain. This hemoglobin variant has been identified in few individuals and has been associated with a compensatory erythrocytosis in the homozygous state. Prior scarce case reports have noted that heterozygotes for this variant are phenotypically normal. Here we present a patient who was evaluated in our hematology clinic for chronic erythrocytosis and was found to be heterozygous for Hb Sherwood Forest. No other primary or secondary cause of his polycythemia was identified. This is the first described case of heterozygous Hemoglobin Sherwood Forest causing erythrocytosis.
Case report: Corticosteroids as an adjunct treatment for the management of liver abscess in Papillon-Lefèvre syndrome: A report on two cases
Authors: Suprit Basu, Reva Tyagi, Ankur Kumar Jindal, Apurva Medha, Aaqib Zaffar Banday, Alisha Babbar, Apoorva Sharma, Rahul Mahajan, Pandiarajan Vignesh, Amit Rawat
Journal: Front Pediatr (2022)
Keywords: papillon–lèfevre syndrome, staphylococcus aureus, corticosteroids, liver abscess, surgical management
MeSH terms: Case Reports

Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder characterized clinically by palmoplantar keratoderma, periodontitis, and recurrent pyogenic infections. Liver abscess is rarely reported in patients. The use of corticosteroids for the treatment of liver abscess akin to chronic granulomatous disease (CGD) has not been reported previously. Here, we report 2 cases of liver abscess in PLS that responded to corticosteroids.
Case Report: An incidental finding of an metastases noted in a "cancer to cancer adrenal tumor " from a large malignant nerve sheath tumor of the thigh
Authors: Matthew D Shaines, Shitij Arora
Journal: F1000Res (2017)
Keywords: adrenal, lung, metastasis, nerve sheath tumor

Current guidelines are vague for the management of soft tissue sarcomas, specifically malignant peripheral nerve sheath tumors (MPNST), regarding staging the disease with the use of routine abdominal imaging. The most recent guidelines from the National Comprehensive Cancer Network (NCCN) recommends to "consider" abdominal/pelvic CT imaging for certain sub groups of sarcomas (e.g., myxoid/round cell liposarcoma, epithelial sarcoma, angiosarcoma, leiomyosarcoma), but provide no guidance on other sarcoma subtypes regardless of tumor size. We report a case of a very large large MPNST in a 40 year-old-female with neurofibromatosis type 1 who was incidentally found to have adrenal metastasis.
Colon cancer patient with long-term colon stent placement: Case report and literature review
Authors: Qing Huang, Min-Hong Zou, Wen-Long Liang, Jian-Chang Wei, Jie-Feng Xie, Yong-Qiang Li, Wang-Lin Li, Jie Cao
Journal: Front Oncol (2022)
Keywords: colon cancer, colon stent, elderly, radical resection, self-expandable metal stent (sems)
MeSH terms: Case Reports

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer mortality globally. Large bowel obstruction (occurring in 15-30% of patients with CRCs) accounts for approximately 80% of medical emergencies related to CRC. Currently, there is no standard treatment of this condition. The European Society of Gastrointestinal Endoscopy (ESGE) recommends self-expandable metal stent (SEMS) as a bridge (two weeks) to surgery for left-sided obstructing colon cancer. In the present report, we describe an 81-year-old male with colon cancer who underwent colon stent placement for 32 months, but later underwent radical resection. A follow-up of more than four-months revealed that his condition was normal. The history as well as application and advantages of SEMS are discussed in this report.
Exploring interprofessional, interagency multimorbidity care: case study based observational research
Authors: Eileen M McKinlay, Sonya J Morgan, Ben V Gray, Lindsay M Macdonald, Susan R H Pullon
Journal: J Comorb (2017)
Keywords: communication, collaboration, consultation, coordination, interagency, interprofessional interactions, multimorbidity

Background:
The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care.
Objective:
To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care.
Design:
Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration.
Results:
The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals.
Conclusion:
Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them.
Superior Semicircular Canal Ampullae Dehiscence As Part of the Spectrum of the Third Window Abnormalities: A Case Study
Authors: Eugen Constant Ionescu, Nasser Al Tamami, Alexandra Neagu, Aicha Ltaief-Boudrigua, Stephane Gallego, Ruben Hermann, Eric Truy, Hung Thai-Van
Journal: Front Neurol (2017)
Keywords: ampullar dehiscence, sound-induced falls, superior canal dehiscence syndrome, third window syndrome, tullio phenomenon
MeSH terms: Case Reports

A 60-year-old man was referred to the ENT department for intense episodic vertigo triggered by loud sounds. Pure tone audiometry and otoneurological assessment, including videonystagmography using auditory stimulation and cervical vestibular evoked myogenic potential measures, conducted to the hypothesis of a third window syndrome in the left ear. Results from the high-resolution computed tomography of the petrous bone confirmed the hypothesis and revealed the presence of a submillimeter semicircular canal dehiscence, located between the left lateral and superior semicircular canal ampullae on the left side.