OpenMed/multicare-articles huggingface dataset:
Complete Osseointegration of a Retrieved 3-D Printed Porous Titanium Cervical Cage
Authors: Wimar van den Brink, Nancy Lamerigts
Journal: Front Surg (2020)
Keywords: 3d printed titanium implant, bone ingrowth spinal cage, cervical spine fusion, osseointegration, porous titanium alloy

Introduction: Porous 3D-printed titanium has only recently been introduced for spinal applications. Evidence around its use is currently limited to animal studies and only few human case series. This study describes the histological findings of a retrieved EIT cervical cage, explanted 2 years after insertion. Materials and Methods: The patient underwent a double level C4/C5 & C5/C6 anterior cervical decompression using EIT cervical cages without an anterior plate. Two years later the C6/7 level degenerated and began to cause myelopathic symptoms. In order to address the kyphotic imbalance of the cervical spine and fix the C6/7 level, the surgeon decided to remove the C5/6 cervical cage and bridge the fusion from C4 to C7 inclusive. The retrieved cage was histologically evaluated for bone ingrowth and signs of inflammation. Results: MRI demonstrated spinal canal stenosis at C6/C7. Plain radiographs confirmed well-integrated cervical cages at 2 years postoperative. The peroperative surgical need to use a chisel to remove the implant at C5/C6 reconfirmed the solid fusion of the segment. Macroscopically white tissue, indicative of bone, was present at both superior and inferior surfaces of the explanted specimen. Histological evaluation revealed complete osseointegration of the 5 mm high EIT Cellular Titanium® cervical cage, displaying mature lamellar bone in combination with bone marrow throughout the cage. Furthermore, a pattern of trabecular bone apposition (without fibrous tissue interface) and physiological remodeling activity was observed directly on the cellular titanium scaffold. Conclusion: This histological retrieval study of a radiologically fused cervical EIT cage clearly demonstrates complete osseointegration within a 2-year time frame. The scaffold exhibits a bone in growth pattern and maturation of bone tissue similar of what has been demonstrated in animal studies evaluating similar porous titanium implants. The complete osseointegration throughout the cage indicates physiological loading conditions even in the central part of the cage. This pattern suggests the absence, or at least the minimization, of stress-shielding in this type of porous titanium cage.
Case Report: Penile necrosis associated to paraphimosis with calciphylaxis due to terminal chronic kidney disease
Authors: J Antonio Grandez-Urbina, Elizabeth Corrales-Acosta, J Eduardo Tejeda-Mariaca, Rafael Pichardo-Rodriguez, Herney Garcia-Perdomo
Journal: F1000Res (2019)
Keywords: calciphylaxis, nephropathy, penile necrosis
MeSH terms: Calciphylaxis / complications, Kidney Failure, Chronic / complications, Paraphimosis / complications, Penile Diseases / complications, Case Reports, Humans, Male, Middle Aged, Necrosis / complications, Renal Dialysis

Background: Penile necrosis is a rare condition that may present in patients with diabetes mellitus or chronic kidney disease (CKD). The recommended treatment is controversial. We report a case of penile necrosis in a diabetic patient caused by episode of paraphimosis associated with uremic arteriopathy treated with partial amputation. Clinical Case: A 53-year-old male with a background of arterial hypertension, diabetes mellitus and CKD in hemodialysis. The patient presented with paraphimosis and glans necrosis. An emergency circumcision was carried out. A doppler ultrasound found fluid collection in the left corpus cavernosum, parietal vascular calcifications and vascular insufficiency in the corpus cavernosum that suggested necrosis. A partial amputation of the penis was carried out. After three years of follow-up, the outcome has remained favorable. Conclusions: Penile necrosis is a rare but serious complication of terminal CKD. In these patients, systemic calciphylaxis is usually observed. The main take-away lesson is that a multidisciplinary approach is necessary.
Wilson's Disease Presenting as Resistant Rickets
Authors: Jagdish P Goyal, Nagendra Kumar, Sanjeev S Rao, Vijay B Shah
Journal: Gastroenterology Res (2011)
Keywords: rickets, wilson’s disease
MeSH terms: Case Reports

Wilson's disease is most common disorder of cooper metabolism. It has varied clinical presentations. We report a 12 years old female child presenting with genu valgum progressed over 6 months. Careful examination, high index of suspicion and investigations confirmed Wilson's disease.
Pericardial Effusion: A Novel Presentation of Aplastic Anemia
Authors: Robert J Hall, Daniel F Leach 3rd, Ellery Altshuler, Robert P Seifert, Zeina A Al-Mansour
Journal: Cureus (2023)
Keywords: alkylating/hypomethylating agents, aplastic anemia, immunosuppressive therapy, myelodysplastic syndrome, pericardial effusion
MeSH terms: Case Reports

Pericardial effusion is defined as the accumulation of fluid between the visceral and parietal pericardium. The underlying etiology varies as any pathology that causes pericarditis or involves the pericardium can cause effusion. In practice, the majority of pericarditis cases are idiopathic, although these are assumed to be secondary to occult viral infection or inflammatory phenomena. Malignancy, particularly the metastatic spread of noncardiac primary tumors, has been implicated as a differential in the diagnosis of pericardial effusion. Though commonly seen in solid malignancies, effusion has been reported in hematologic malignancies such as myelodysplastic syndrome (MDS), acute leukemia, and lymphoma. Nonetheless, pericardial effusions associated with hematologic conditions are extremely rare with only one case report published describing pericardial effusion secondary to immune thrombocytopenia (ITP). We herein report the first documented case, to our knowledge, of pericardial effusion as an initial clinical manifestation of aplastic anemia in a middle-aged male presenting with pancytopenia.
Delayed Posterior Reversible Leukoencephalopathy Syndrome Triggered by FLOT Chemotherapy
Authors: Jordi Gandini, Mario Manto, Nicolas Charette
Journal: Front Neurol (2020)
Keywords: cancer, chemotherapy, posterior reversible encephalopathy syndrome, reversible encephalopathy, sepsis, sequelae
MeSH terms: Case Reports

Posterior reversible encephalopathy syndrome (PRES) is a potentially severe disorder of the autoregulation of cerebral perfusion. The major clinical manifestations are headache, seizures, altered mental status, and visual loss. The typical radiological finding is vasogenic edema predominating in the white matter of occipital and parietal lobes. PRES is increasingly recognized as a clinico-radiological entity owing to improvements and fast availability of brain imaging, especially magnetic resonance imaging (MRI). We present the exceptional case of a 67-year-old female patient with a gastric adenocarcinoma at stage IIB (T3N0M0) treated by FLOT chemotherapy (5-fluorouracil, oxaliplatin, docetaxel, and folinic acid). Two months after the unique administration of FLOT regimen, she developed sudden posterior headache and visual loss. Blood pressure values were normal. Cerebral tomography showed ischemic-like occipital bilateral lesions, and angiographic sequences revealed breakdown of the blood-brain barrier (BBB). MRI revealed bilateral parieto-occipital T1 hypointensity and T2 hyperintensity, which demonstrated vasogenic edema. The rest of the parts of the lesions were T1 hyperintensity, T2 hyperintensity, and diffusion-weighted imaging (DWI) hyperintensity, which indicate cortical laminar necrosis. After injection of gadolinium, a linear enhancement of the cortex was observed. She was treated with oral nimodipine. Follow-up was characterized by permanent visual sequelae and tetraparesis. PRES represents an urgent neurological condition. Our observation highlights that PRES should be considered in patients under chemotherapy, even when their blood pressure remains within normal range. This is the first report of PRES triggered by FLOT chemotherapy and with a silent window of 2 months between chemotherapy and PRES, widening further the spectrum of chemotherapy-induced PRES. Our case highlights the potential role of FLOT regimen in the pathogenesis of PRES and the need for a novel approach in terms of prevention of this potentially fatal complication when patients receive chemotherapy.
Permanent central diabetes insipidus with complete regression of pituitary stalk enlargement after 4 years of follow-up
Authors: Gönül Ocal, Zeynep Sıklar, Merih Berberoğlu, Pelin Bilir, Ozlem Engiz, Suat Fitoz, Serap Arıcı
Journal: J Clin Res Pediatr Endocrinol (2008)
Keywords: pituitary stalk thickness, central diabetes insipidus, multiple anterior pituitary hormone deficiency
MeSH terms: Diabetes Insipidus, Neurogenic / pathology, Pituitary Gland / pathology, Case Reports, Adolescent, Diabetes Insipidus, Neurogenic / physiopathology, Humans, Magnetic Resonance Imaging, Male, Pituitary Gland / physiopathology

A 14 year-old patient was admitted because of a history of polyuria and polydipsia. A diagnosis of central diabetes insipidus (CDI) accompanied by growth hormone (GH) and gonadotropin deficiency was made. Hypophyseal magnetic resonance imaging (MRI) of the patient demonstrated isolated pituitary stalk enlargement. Although GH deficiency and gonadotropin deficiency were transient, CDI was persistent despite the regression of the pituitary stalk enlargement over the 4 years of follow-up.
Clinicopathological features, therapeutic options, and significance of CD103 expression in 15 patients with follicular mucinosis
Authors: Jiaqi Wang, Yanqing Wang, Hongyu Zhou, Ping Wang, Mengyan Zhu, Liuyu Li, Hong Shen
Journal: Front Med (Lausanne) (2023)
Keywords: cd103, trm cell, follicular mucinosis, mycosis fungoides, tissue resident memory t cell

Background:
Follicular mucinosis (FM) is generally divided into a primary benign idiopathic form and a secondary form associated with mycosis fungoides.
Objective:
To analyze the clinical and pathological features of FM and explore the pathological significance of CD103 expression.
Methods:
In this case series, we retrospective analysis the clinical, pathological, treatment and follow-up treatment of 15 cases of FM. The expression of CD103 in all cases was detected by immunohistochemistry.
Result:
A total of 15 patients were enrolled, 7 were primary follicular mucinosis (P-FM) and 8 were mycosis fungoides-associated follicular mucinosis (MF-FM). Lesions of both P-FM and MF-FM are difficult to distinguish, present with red or dark red plaques and follicular papules. Pathologically, MF-FM showed more significant infiltrates of folliculotropic lymphoid cells, and the amount and proportion of CD103+ cells were significantly higher than that in P-FM. Follow-up data were available for 13 patients. Three cases were resolved after surgical resection, two patients were marked improved after oral administration of hydroxychloroquine and three times ALA photodynamic therapy respectively. The rest patients showed only modest efficacy.
Conclusion:
FM should be differentiated based on pathological characteristics and treatment response, CD103 is helpful in differential diagnosis of FM.
Gouty Tophus in the Scrotum: An Unusual Extra-Articular Manifestation of Gout
Authors: Fred Alain Montelongo-Rodríguez, Pedro Antonio Madero-Morales, Adrián Mauricio Martínez-Fernández, Maria Alejandra Rodríguez-Abarca, Max Molina-Ayala, Adrián Gutiérrez-González
Journal: Ochsner J (2021)
Keywords: gout, scrotum, tophus, uric acid
MeSH terms: Case Reports

Background: Gout is a chronic disorder caused by the deposition of monosodium urate crystals in soft tissues. Tophi are granulomatous inflammatory responses to the deposited crystals and manifest as subcutaneous nodules, typically in the first metatarsophalangeal joint but also in the olecranon bursa, Achilles tendon, ears, and finger pulps. Case Report: A 56-year-old male presented to an outpatient clinic with an 8-month history of an expanding scrotal lesion. The patient had no significant family history but had a history of high blood pressure and gout, diagnosed at age 24 years, without current treatment. Excisional biopsy from the ulcerated area of the scrotum was performed for confirmatory diagnosis, and pathology reported gouty tophus. Conclusion: To our knowledge, this case is the first report of a scrotal manifestation of gouty tophus and the second of genital involvement. Awareness of the possibility of genital manifestations of this disease is important because although gouty tophi are rare, they can present in patients with long-term uncontrolled gout.
Synchronous pulmonary squamous cell carcinoma and mantle cell lymphoma of the lymph node
Authors: Yu Sun, Yun-Fei Shi, Li-Xin Zhou, Ke-Neng Chen, Xiang-Hong Li
Journal: Case Rep Genet (2011)
MeSH terms: Case Reports

Synchronous occurrence of pulmonary squamous cell carcinoma and malignant lymphoma of the lymph node is not reported in the literature. We report a case of pulmonary squamous cell carcinoma coexisting with a mantle cell lymphoma involving cervical and mediastinal lymph node. It is important to recognize this synchronous occurrence histopathologically and to be aware of the existence of "in situ" MCL.
Chronic Lymphocytic Leukemia with Translocation (2;14)(p16;q32): A Case Report and Review of the Literature
Authors: Francisco Socola, Giovanni Insuasti-Beltran, Rodolfo Henrich Lobo, Shebli Atrash, Appalanaidu Sasapu
Journal: Case Rep Oncol Med (2016)

We report the case of a young African American male with no significant past medical history presenting with low back and bilateral leg pain; presenting CBC and chemistries revealed elevated white blood cell count of 250,000, with anemia (Hb 6.8 g/dL) and thrombocytopenia (platelets 9 K/μL), and elevated LDH, 1008. Physical examination findings were notable for diffuse lymphadenopathy and lower extremity skin nodules. Interestingly the bone marrow biopsy revealed involvement by CLL/SLL with translocation (2;14)(p16;q32) and trisomy 12. The patient was treated with fludarabine-based chemotherapy and steroids for CLL-related ITP with excellent response. After three cycles of chemotherapy, all the enlarged lymph nodes and skin nodules disappeared, and patient had achieved complete hematologic response. In this paper we also reviewed the available literature of CLL patients with translocation (2;14).
Excisional Biopsy of the Pyogenic Granuloma in Very High-Risk Patient
Authors: Dirceu Tavares Formiga Nery, José Ranali, Darceny Zanetta Barbosa, Helvécio Marangon Júnior, Rafael Martins Afonso Pereira, Patrícia Cristine de Oliveira Afonso Pereira
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Oral surgery to remove pyogenic granuloma in a high-risk patient is reported. A 47-year-old man with gastroesophageal reflux disease, diabetes mellitus II, dyslipidemia, and chronic coronary insufficiency (myocardial infarction within 2 years) with episodes of unstable angina was submitted to an excisional biopsy of hemorrhagic lesion in the lingual right mandibular gingiva. During dental treatment, the arterial blood pressure, oxygen saturation, heart rate, and electrocardiogram were monitored. Local anesthesia was performed with 0.45 ml of 3% prilocaine with 0.03 IU/ml felypressin. The anticoagulant therapy was not interrupted. No local or systemic complications were noticed during or after the surgery.
Treatment of locally advanced prostate cancer: a case report and narrative review
Authors: Frank Peinemann, Michael Pinkawa
Journal: Case Rep Urol (2012)

Introduction. Treatment of locally advanced prostate cancer is under discussion. Differences between clinical and pathological staging and risk factors such as positive surgical margins and seminal vesicle involvement challenge the individual treatment decisions. Case Presentation. Clinical tumor stage before treatment was assessed to be T2. After radical prostatectomy, pathological examination revealed the stage pT3b N0 M0 including positive surgical margin and seminal vesicle involvement. Early adjuvant androgen deprivation therapy and late adjuvant radiation therapy were added in response to the pathological risk factors. No evidence of disease was observed for 15 years after the treatment. The unexpected pathological findings were not explained by the physicians in charge. Discussion. A narrative review of the recent literature showed that multiple treatment modalities including adjuvant radiotherapy following radical prostatectomy are consistent with current recommendations. The multimodal approach has possibly cured a high-risk patient and may also work successfully in other patients. An alternative treatment option with better preservation of health-related quality of life might have also achieved a similar good overall survival.
Triple-negative pleomorphic lobular carcinoma and expression of androgen receptor: Personal case series and review of the literature
Authors: Kohei Taniguchi, Shinichi Takada, Masako Omori, Takuro Igawa, Midori Filiz Nishimura, Toshiaki Morito, Kouichi Ichimura, Tadashi Yoshino
Journal: PLoS One (2020)
MeSH terms: Breast / pathology, Breast Neoplasms / pathology, Carcinoma, Lobular / pathology, Receptors, Androgen / analysis, Case Reports, Review, Adult, Aged, Aged, 80 and over, Breast Neoplasms / diagnosis, Breast Neoplasms / epidemiology, Carcinoma, Lobular / diagnosis, Carcinoma, Lobular / epidemiology, Female, Humans, Japan / epidemiology, Middle Aged, Prognosis, Survival Analysis, AR protein, human, Receptors, Androgen

Pleomorphic lobular carcinoma (PLC) is a histological variant of invasive lobular carcinoma (ILC) and is associated with worse prognosis than classical ILC. It exhibits a greater degree of cellular atypia and pleomorphism and is occasionally accompanied with apocrine morphology. We investigated the immunohistochemical characteristics of samples from 31 Japanese patients with PLC to elucidate the clinicopathological characteristics of PLC including androgen receptor (AR) immunoreactivity. The surrogate molecular subtypes were luminal A-like, luminal B-like, luminal B-like/HER2, HER2-type, and triple-negative in 5, 4, 3, 5, and 14 cases, respectively. AR was positive in 92.8% (13/14) of the triple-negative PLC cases and 100% (10/10) of the non-triple-negative PLC cases. Disease-specific survival was worse in patients with histological grade 3 PLCs than in those with histological grade 2 PLCs (p = 0.007). However, there was no significant difference in the progression-free survival between the two groups (p = 0.152). No other clinicopathological characteristics were associated with prognosis. These results reveal that PLC exhibits various surrogate molecular subtypes and that the triple-negative subtype frequently expresses AR. The observed molecular apocrine differentiation implicates that triple-negative PLC can be categorized into the luminal AR subtype. Furthermore, AR-targeted therapy might be useful for patients with triple-negative PLC.
Ureteric Injury due to the Use of LigaSure
Authors: Muazzam Tahir, William Gilkison
Journal: Case Rep Urol (2013)

Background. LigaSure is a bipolar clamping device used in open and laparoscopic surgeries for producing haemostasis in vascular pedicles up to 7 mm in diameter ("Covidien LigaSure technology: consistent, reliable, trusted vessel sealing," 2012). The use of LigaSure has made securing haemostasis and tissue dissection relatively easy especially in laparoscopic surgery; however, if not used with care it can cause damage to the surrounding structures through lateral spread of energy. Case Report. This case report discusses the induction of a thermal ureteral injury associated with the use of LigaSure. An 80-year-old gentleman was operated for bowel cancer. LigaSure was used for securing haemostasis and tissue dissection. Postoperatively, he was found to have damage to the right ureter secondary to lateral spread of energy from the jaws of LigaSure with high abdominal drain output. Conclusion. Judicious and careful use of electrosurgical devices should be done to prevent inadvertent damage to the surrounding structures. Early recognition and involvement of a urologist can prevent long-term complications.
Every wheeze does not merit a puffer! Case of an overnight cure of chronic asthma
Authors: Santosh Balakrishnan, Sudeendra Doddi, Sophie Helme, Prakash Sinha
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The peril of incorrect diagnostic labelling is highlighted by this case of acute respiratory distress caused by a retrosternal recurrent goitre. An initial clinical diagnosis which cannot be fully validated on investigation with unexpected or poor response to treatment should prompt consideration and investigation for an alternative explanation.
Iatrogenic Cushing's Syndrome with Subsequent Adrenal Insufficiency in a Patient with Psoriasis Vulgaris Using Topical Steroids
Authors: Suzan Demir Pektas, Gursoy Dogan, Nese Cinar
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Iatrogenic Cushing's syndrome (ICS) is usually related to prolonged and/or high-dose oral or parenteral steroid use. Psoriasis vulgaris (PV) is chronic inflammatory disease and characterized by periods of attack and remission. Topical steroid (TS) is the first choice of treatment for localized and mild PV. The development of systemic side effects of the steroids is usually not observed after TS application. But the risk of developing ICS still exists. In the literature, there are a few adult cases who developed ICS and subsequent adrenal insufficiency associated with TS. In this article, a male patient with PV developing ICS and secondary adrenal insufficiency after treatment of TS for 12 years is presented.
Delayed presentation of jejunal atresia
Authors: Charu Sharma, Hemanshi Shah, Mukta Waghmare, Jayesh Desale, Pankaj Dwivedi
Journal: Dev Period Med (2017)
Keywords: central perforation, jejunal web, obstruction, sub-acute
MeSH terms: Intestinal Atresia / diagnosis, Jejunum / abnormalities, Case Reports, Child, Preschool, Humans, Infant, Intestinal Atresia / pathology, Intestinal Atresia / surgery, Jejunum / surgery, Male

Type I intestinal atresias (webs) are rare causes of gastrointestinal obstruction in infants, the most common site being the second portion of the duodenum. According to the Louw and Barnard classification, type 1 atresia has been defined as an intra-luminal web which results in either complete (web with no perforation) or incomplete (web with central perforation) intestinal obstruction. The jejunum is a rare site of such webs. Diagnosis of an incompletely obstructing web due to central perforation is usually difficult and challenging. We present two cases of jejunal web with a central perforation in which the presentation was delayed. Both were managed by excision of the web.