OpenMed/multicare-articles huggingface dataset:
Schwannoma of the descending loop of the hypoglossal nerve: case report
Authors: Nadia M Jahad, Mohamed Ridal, Houda Chafai, Amal Douida, Hammas Naoual, Aamal Akamar, Mustapha Maaroufi, Mohamed Nourredine El Alami
Journal: Pan Afr Med J (2020)
Keywords: schwannoma, descending loop, hypoglossal nerve
MeSH terms: Cranial Nerve Neoplasms / diagnosis, Hypoglossal Nerve Diseases / diagnosis, Neurilemmoma / diagnosis, Case Reports, Adult, Cranial Nerve Neoplasms / pathology, Cranial Nerve Neoplasms / surgery, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Hypoglossal Nerve Diseases / pathology, Hypoglossal Nerve Diseases / surgery, Magnetic Resonance Imaging, Neurilemmoma / pathology, Neurilemmoma / surgery, Tomography, X-Ray Computed

Schwannomas of the descending loop of the hypoglossal nerve are very rare. Existing literature of the schwannoma of the descending loop of the hypoglossal nerve is limited to two previously reported case. They are slow-growing tumors that may masquerade a carotid body tumor. We herein described a rare case of schwannoma of the descending loop of the hypoglossal nerve in the s right latero-cervical region with diagnostic imaging and histopathological findings. A 37-years-old woman has had a palpable firm, mobile mass in the right latero-cervical region, of imaging, MR images showed homogeneous hypointensity on T1-weighted imaging (T1-WI), heterogeneous hyperintensity on T2-WI, and heterogeneous enhancement on contrast-enhanced T1-WI. Diagnostic imaging using computed tomography (CT) and magnetic resonance imaging (MRI) was suspected of Chemodectoma or neurogenic tumor. At operation, a 4 cm mass arising from the descending loop of the hypoglossal nerve of was resected en bloc with the loop itself; Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings. Postoperative course was uneventful and the patient is free from disease recurrence at tree-year follow-up. En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, besides requiring reintervention, it may harbor a malignant evolution towards sarcoma. Schwannomas of the descending loop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.
The Eight and a Half Year Journey of Undiagnosed AD: Gene Sequencing and Funding of Advanced Genetic Testing Has Led to Hope and New Beginnings
Authors: Illana Gozes, Marc C Patterson, Anke Van Dijck, R Frank Kooy, Joseph N Peeden, Jacob A Eichenberger, Angela Zawacki-Downing, Sandra Bedrosian-Sermone
Journal: Front Endocrinol (Lausanne) (2017)
Keywords: activity-dependent neuroprotective protein, autism spectrum disorder, case study, motor delays, mutation, nonsense
MeSH terms: Case Reports

Background:
Activity-dependent neuroprotective protein (ADNP) is one of the most prevalent de novo mutated genes in syndromic autism spectrum disorders, driving a general interest in the gene and the syndrome.
Aim:
The aim of this study was to provide a detailed developmental case study of ADNP p.Tyr719* mutation toward improvements in (1) diagnostic procedures, (2) phenotypic scope, and (3) interventions.
Methods:
Longitudinal clinical and parental reports.
Results:
AD (currently 11-year-old) had several rare congenital anomalies including imperforate anus that was surgically repaired at 2 days of age. Her findings were craniofacial asymmetries, global developmental delay, autistic behaviors (loss of smile and inability to make eye contact at the age of 15 months), and slow thriving as she gradually matures. Comprehensive diagnostic procedures at 3 years resulted in no definitive diagnosis. With parental persistence, AD began walking at 3.5 years (skipping crawling). At the age of 8.5 years, AD was subjected to whole exome sequencing, compared to the parents and diagnosed as carrying an ADNP p.Tyr719* mutation, a causal recurring mutation in ADNP (currently ~17/80 worldwide). Brain magnetic resonance imaging demonstrated mild generalized cerebral volume loss with reduced posterior white matter. AD is non-verbal, communicating with signs and word approximations. She continues to make slow but forward developmental progress, and her case teaches newly diagnosed children within the ADNP Kids Research Foundation.
Conclusion:
This case study emphasizes the importance of diagnosis and describes, for the first time, early motor intervention therapies. Detailed developmental profile of selected cases leads to better treatments.
The Replanting of a 1.1 from an Ectopic Position during the Course of Orthodontic Therapy: Follow-Up at 8 Years
Authors: Michele M Figliuzzi, Maria Altilia, Simone Altilia, Amerigo Giudice, Leonzio Fortunato
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The case that is reported here describes the replanting of a 1.1 from an ectopic position during orthodontic therapy. The 9-year-old patient suffered from class 2 type malocclusion with the upper maxilla contracted, right-left posterior cross-bite. The clinical case presented the following details: in the upper incisor group, the 1.1 was overlapping the 1.2 and was distalised and completely vestibularised, whilst in the place of the 1.1, a 1.1 supernumerary persisted in occlusion. Following several medical investigations, such as OPT and, most importantly, TC cone beam investigation, the dangerous position of the dental element became clear. This did not present vestibular cortical bone but only gingival mucosa. Following these investigations, the difficulty in bringing the dental element into its natural position through orthodontic treatment became obvious since the natural position was without sufficient bone support. From this, it became obvious that surgery and replanting of the 1.1 immediately after the extraction of the supernumerary 1.1 was the only choice available.
Identify travel and health factors influencing well-being of the older adults-a case study in China
Authors: Yi Zhu, Qian Zhu, Yongfeng Ma, Shuyan Chen, Hongcheng Meng, Muhammad Zubair
Journal: Front Public Health (2023)
Keywords: gini index, accessibility, embedded feature selection, older adults, relative importance, transportation mobility, travel well-being
MeSH terms: Dimenhydrinate, Travel, Research Support, Non-U.S. Gov't, Aged, Humans, Quality of Life, Transportation, Travel-Related Illness, Dimenhydrinate

Objective:
With the increase in aging populations worldwide, the travel well-being of the elders has gained attention. The objective of this study is to examine the nonlinear relationships between the well-being of the older people in China and factors associated with travel and health.
Method:
Based on the data collected in China, combined embedded feature selection and decision tree built by Gini index were utilized to screen for influential factors and to determine the importance of the features selected. Tamhane's T2 was used to study the differences in the important factors among older people with different levels of travel well-being.
Results:
This study found that the travel well-being of older adults depends mainly on accessibility to public places, such as schools and medical facilities, and the availability of bus services. Out of expectation, the most important influential factor of travel well-being of older people is the distance from home to high school. This is related to the traditional Chinese concept of education. In addition, it was found that the body mass index is more important than self-perceived health as an influence factor of travel well-being of the elders in China. Social skills are important factors too.
Conclusion:
This study investigated various health-related and travel-related factors and their impacts on the travel well-being of older adults Chinese with the overall goal to improve the quality of life of the elders in China. The findings may provide a theoretical basis for the implementation of various transportation management and urban planning and design -related policies to improve the travel well-being of older adults in China.
Case Report: Torsade de Pointes Induced by the Third-Generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Osimertinib Combined With Litsea Cubeba
Authors: Xia-Yan Zhang, Cha-Bin Wu, Cai-Xia Wu, Li Lin, Yue-Juan Zhou, Yan-Yan Zhu, Wei-Qiang Tian, Song-Mei Luo
Journal: Front Cardiovasc Med (2022)
Keywords: litsea cubeba, qt prolongation, adverse events, osimertinib, torsade de pointes
MeSH terms: Case Reports

Torsades de Pointes (TdP) occurred in a 68-year-old female with epidermal growth factor receptor (EGFR) mutant lung cancer administered osimertinib, the third-generation EGFR tyrosine kinase inhibitor (TKI). Electrocardiogram (ECG) recorded at Tdp showed QT prolongation (QTc = 515 ms), to which a Traditional Chinese Medicine (TCM) named "Litsea Cubeba" may have contributed. After discontinuation of osimertinib and Litsea Cubeba, magnesium supplementation, potassium supplementation, lidocaine infusion, and the pacemaker frequency adjustment, Tdp terminated. However, QT prolongation sustained at discharge (QTc = 528 ms), partly because of the emergency use of amiodarone. Osimertinib may prolong the QT interval leading to TdP, especially when multiple risk factors to lengthen QT interval are incidentally overlapped. Thus, regular monitoring of ECG and appropriate management of concomitant drugs are highly recommended.
The use of anterior segment optical coherence tomography (ASOCT) in demonstrating recurrence of vitreoretinal lymphoma (VRL) in the anterior vitreous
Authors: Vlad Diaconita, Heba Rihani, Virginia Mares, Marcio B Nehemy, Sophie J Bakri, Jose S Pulido
Journal: Int J Retina Vitreous (2019)
Keywords: asoct, anterior segment oct, cns lymphoma, primary vitreoretinal lymphoma, vrl, vitreoretinal lymphoma
MeSH terms: Case Reports

Background:
Primary vitreoretinal lymphoma (VRL) is a rare disease with 30-380 new cases in the United States per year. Its insidious process and spread to the central nervous system (CNS) leads to a mean 5-year survival rate from 41.4 to 71%. Medical treatment of VRL has been summarized extensively in the literature and involves intraocular rituximab and methotrexate as first line agents in unilateral VRL, with systemic chemotherapy to be considered in bilateral or CNS-involving disease. In addition, therapeutic "debulking" vitrectomy has been reported in the literature, with some limited success. Despite this, recurrence rate is high and should always be suspected in the setting of new inflammation. Anterior segment optical coherence tomography (ASOCT) has not been previously used to image VRL recurrence in the anterior vitreous.
Case presentation:
A 63-year-old man, with VRL was found to have cells and debris in the anterior vitreous, 10 months after his first vitrectomy, intravitreal rituximab and methotrexate. Since the patient was phakic at the time of initial vitrectomy, the anterior vitreous had not been removed. ASOCT confirmed the findings. Subsequent surgery removed the lens and debris. Both the patient's vision and ASOCT improved.
Conclusions:
We suggest that ASOCT of the anterior segment is a useful diagnostic tool to monitor for recurrence of VRL. In biopsy-proven VRL, phakic patients who undergo therapeutic vitrectomy, should also be considered for lens extraction and anterior vitrectomy to limit recurrences.
Abnormal Auditory Brainstem Response (ABR) Findings in a Near-Normal Hearing Child with Noonan Syndrome
Authors: Bahram Jalaei, Mohd Normani Zakaria, Dinsuhaimi Sidek
Journal: Iran J Otorhinolaryngol (2017)
Keywords: audiological evaluation, auditory brainstem response (abr), hearing loss, noonan syndrome
MeSH terms: Case Reports

Introduction:
Noonan syndrome (NS) is a heterogeneous genetic disease that affects many parts of the body. It was named after Dr. Jacqueline Anne Noonan, a paediatric cardiologist.
Case report:
We report audiological tests and auditory brainstem response (ABR) findings in a 5-year old Malay boy with NS. Despite showing the marked signs of NS, the child could only produce a few meaningful words. Audiological tests found him to have bilateral mild conductive hearing loss at low frequencies. In ABR testing, despite having good waveform morphology, the results were atypical. Absolute latency of wave V was normal but interpeak latencies of wave's I-V, I-II, II-III were prolonged. Interestingly, interpeak latency of waves III-V was abnormally shorter.
Conclusion:
Abnormal ABR results are possibly due to abnormal anatomical condition of brainstem and might contribute to speech delay.
Acute myocardial infarction caused by tumor embolus originating from upper tract urothelial carcinoma: a case report
Authors: Taku Yasui, Yohei Okuda, Wataru Shioyama, Toru Oka, Tatsuya Nishikawa, Risa Kamada, Koji Hatano, Kazuo Nishimura, Masashi Fujita
Journal: Cardiooncology (2020)
Keywords: aspiration, coronary occlusion, neoplasm, paradoxical embolism, patent foramen ovale

Coronary emboli from malignant tumors rarely cause acute myocardial infarction. We report the case of a patient with tumor embolism from an upper tract urothelial carcinoma that caused acute myocardial infarction via a patent foramen ovale. Coronary blood flow was restored by embolus aspiration without stenting. Clinicians must consider malignant tumor embolism as a possible cause of acute myocardial infarction.
Tension Pneumothorax, Pneumoperitoneum, and Cervical Emphysema following a Diagnostic Colonoscopy
Authors: Ali Pourmand, Hamid Shokoohi
Journal: Case Rep Emerg Med (2013)

Colonoscopy is currently a widespread procedure used in screening for colorectal cancer. Iatrogenic colonic perforation during colonoscopy is a serious and potentially life-threatening complication that can cause significant morbidity and mortality. "Triple pneumo" (a combination of pneumothorax, pneumomediastinum, and pneumoperitoneum) following colonoscopy is a rare but a serious condition requiring immediate diagnosis and emergent intervention. In majority of these cases a colonic perforation is the initial injury that is followed by pneumothorax and pneumomediastinum through the potential anatomical connection with retroperitoneal and mediastinal spaces. In this rare case report we are presenting a case of "triple pneumo" with no evidence of colonic perforation. This patient developed a simultaneous pneumoperitoneum, pneumomediastinum, and a tension pneumothorax requiring immediate tube thoracostomy. This case may raise the awareness on the likelihood of these serious complications after colonoscopy.
Programmed chemotherapy for patients with metastatic unresectable gastric cancer
Authors: Masataka Shinoda, Takafumi Ando, Emad M El-Omar, Hitomi Takashi, Takahisa Suzuki, Mutsumi Murayama, Kazuhiro Morise, Hidemi Goto
Journal: PLoS One (2012)
MeSH terms: Adenocarcinoma / drug therapy, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Liver Neoplasms / drug therapy, Stomach Neoplasms / drug therapy, Case Reports, Adenocarcinoma / mortality, Adenocarcinoma / secondary, Aged, Aged, 80 and over, Cisplatin / administration & dosage, Clinical Trials, Phase II as Topic, Drug Combinations, Female, Humans, Liver Neoplasms / mortality, Liver Neoplasms / secondary, Male, Middle Aged, Oxonic Acid / administration & dosage, Prognosis, Stomach Neoplasms / mortality, Stomach Neoplasms / pathology, Survival Rate, Tegafur / administration & dosage, Drug Combinations, S 1 (combination), Tegafur, Oxonic Acid, Cisplatin

Background:
Recent advances in the treatment of metastatic unresectable gastric cancers (MGC) include the development of new antitumor drugs and new regimens for their use. However, the selection of individually designed regimens by gastric cancer (GC) subtype remains problematic. Here, we investigated the clinical usefulness of programmed chemotherapy.
Methodology/principal findings:
MGC patients were classified into three groups by clinical condition. We implemented a chemotherapy program consisting of S-1 combination regimens. Median survival time (MST) of level 1 patients was 416 days (95% CI: 313-506 days), with an overall response rate of 47%. MSTs of level 2 and 3 patients were 208 (95% CI: 153-287 days) and 95 days (95% CI: 28-136 days), respectively. Grade 3-4 toxicities were neutropenia in 12% and anorexia in 6%. All treatment- related toxicities were resolved, and no treatment-related deaths occurred.
Conclusions/significance:
This program provided reasonable selection of case-matching regimens and may improve the survival of patients with MGC. Further, it may represent the first clinical tool to provide efficient chemotherapy course selection for MGC. Ongoing analysis of newly developed drugs and regimens will allow the efficacy of this chemotherapy program to be improved.
Intradural extramedullary spinal cord meningioma with a rare extradural foraminal extension: A case report
Authors: Faisal Almatrafi, Majed Alomair, Abdulrazaq Alojan, Mohammed Alkhaldi, Noor Alsafwani, Abdullah Aseeri, Abdulelah Alshahrani, Sultan Alsalmi, Mohammad Alqahtani
Journal: Front Surg (2023)
Keywords: case report, extradural, extramedullary, intradural, meningioma, spinal, tumor
MeSH terms: Case Reports

Background:
Meningiomas are mostly benign and slow-growing neoplasms of the central nervous system. Spinal meningiomas account for up to 45% of all intradural spinal tumors in adults and up to 25%-45% of all spinal tumors. Spinal extradural meningiomas are rare and may be easily confused with malignant neoplasms.
Case description:
A 24-year-old woman was presented to our hospital with paraplegia and loss of sensation in the T7 dermatome and lower body. MRI findings showed T6-T7 right-sided intradural extramedullary and extradural lesion, measuring 1.4 cm × 1.5 cm × 3 cm, extending to the right foramen, compressing the spinal cord, and displacing it to the left. Hyperintense lesion on T2 and hypointense lesion on T1 were observed. The patient reported improvement after surgery and during follow-up. We recommend maximizing the decompression during surgery to achieve better clinical outcome. Extradural meningiomas represent 5% of all meningiomas; therefore, having an intradural on top of extradural meningioma with extraforaminal extensions makes this a unique and rare case.
Conclusion:
Meningiomas can be easily missed in diagnosis depending on imaging and the pathognomonic pattern it represents, which can mimic other pathologies, such as schwannomas. Therefore, surgeons should always suspect their patient having a meningioma even if the pattern is not typical. Moreover, preoperative preparation, such as navigation and defect closure, must be taken in case it turns out be a meningioma instead of the presumed pathology.
Relevance of frozen sections and serum markers in invasive squamous cell carcinoma arising from ovarian mature cystic teratoma: two case reports
Authors: Yuki Tazo, Yoshihiro Yoshimura, Takashi Shoda, Noriyuki Kyushima, Takemichi Okada, Hitoshi Yamazaki
Journal: J Med Case Rep (2016)
MeSH terms: Antigens, Neoplasm / blood, Biomarkers, Tumor / blood, Carcinoma, Squamous Cell / pathology, Frozen Sections / methods, Ovarian Neoplasms / pathology, Serpins / blood, Teratoma / pathology, Case Reports, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Carcinoma, Squamous Cell / blood, Carcinoma, Squamous Cell / drug therapy, Female, Humans, Middle Aged, Ovarian Neoplasms / blood, Ovarian Neoplasms / drug therapy, Teratoma / blood, Teratoma / drug therapy, Treatment Outcome, Antigens, Neoplasm, Biomarkers, Tumor, Serpins, squamous cell carcinoma-related antigen, Teratoma, Ovarian

Background:
Ovarian mature cystic teratoma (MCT) is a common neoplasm in women. While malignant transformation of MCT is relatively rare, squamous cell carcinoma is the most frequent malignant neoplasm arising from MCT. Some tumor markers have been reported to be useful for prediction of MCT malignant transformation prior to operation. However, widely accepted use of these markers remains to be established. In the present study, we report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.
Case presentation:
We present two cases of squamous cell carcinoma arising from ovarian MCT. The first case was a 45-year-old Asian woman referred to our hospital after her periodical company medical checkup, due to possible ovarian tumor. Image analysis suggested a dermoid cyst, and left salpingo-oophorectomy was performed. Because the cyst was histologically diagnosed as an invasive squamous cell carcinoma arising from an MCT, our patient underwent an additional preventative operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively. The second case was a 53 -year-old Asian woman who visited our hospital due to complaints of abdominal pain and urinary retention. Image analysis and laboratory data showing high serum levels of SCC antigen (normal range: < 1.5 ng/mL) and CA19-9 (normal range: < 37 U/mL), which strongly suggested malignant transformation of MCT. Frozen sections obtained during the operation were histologically analyzed to confirm malignancy, and our patient underwent an additional operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively.
Conclusions:
We report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.
Plasmacytoid Urothelial Carcinoma of the Urinary Bladder Metastatic to the Duodenum: A Case Report-Diagnostic Relevance of GATA3 Immunohistochemistry
Authors: Hermann Brustmann
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Plasmacytoid urothelial carcinoma (PUC) of the urinary bladder is a rare and aggressive subtype of urothelial carcinoma. Its deceptive morphology is characterized by a discohesive growth of cells with plasmacytoid morphology. Since this tumor might be confused with plasmacytoma, lymphoma, or carcinoma variants, appropriate diagnosis in small biopsy samples could be challenging. This study reports the case of a 53-year-old man who presented with frequent nocturnal urgency, without hematuria. A transurethral bladder and a prostate resection specimen displayed infiltration of neoplastic cells in a spray-like discohesive pattern with occasional formation of small irregular nests and cord-like arrangements. The basic morphology of the tumor cells was plasmacytoid, with eccentric nuclei and eosinophilic cytoplasm. Tumor cells grew through the lamina muscularis mucosae, with splintering of the bladder wall musculature and infiltration of prostatic tissue. They displayed strong and diffuse nuclear reactivity for p53 and GATA3. Eight months after surgery, the patient experienced upper abdominal discomfort. A duodenal biopsy showed infiltration of plasmacytoid atypical cells strongly immunoreactive for GATA3, consistent with the previously diagnosed PUC. The patient died eleven months after the primary diagnosis of his PUC of tumor cachexia losing about 50% of his original body weight, furthermore, with ascites and intraperitoneal tumor spread.