OpenMed/multicare-articles huggingface dataset:
Eumycetoma caused by Cladophialophora bantiana in the United States
Authors: Thomas J Gniadek, Mark A Cappel, Nancy L Wengenack, Claudia R Libertin
Journal: Access Microbiol (2019)
Keywords: cladophialophora bantiana, eumycetoma, antifungal medication
MeSH terms: Case Reports

A female presented in the sixth decade of life with a history of undifferentiated small cell carcinoma of the right breast in clinical remission, status-post chemotherapy and resection 6 years previously, presented with a chronic anterior knee skin nodule that grew in size over the prior 5-6 weeks. She had no history of opportunistic infections or recent immunosuppression. As it grew, the nodule became tender to touch. Examination revealed a 4-6 mm superficial purple-red nodule. Also, a similar lesion was present on the dorsum of her left foot for the past year, which also recently grew and became tender. The patient did report frequently kneeling on soil when gardening in Florida. She reported no other symptoms. Due to a concern for cutaneous metastasis of the patient's previously diagnosed small cell carcinoma of the breast, the anterior knee lesion was biopsied. Histology revealed histocyte-rich inflammation with foci of acute inflammation as well as pigmented fungal forms. Subsequent fungal culture of excised tissue grew Cladophialophora bantiana, identified by ribosomal gene DNA sequencing.
A Large Substernal Goiter that Extended to Both Sides of the Thorax
Authors: Hirotaka Nakayama, Motohiko Goda, Kaori Kohagura, Nobuyasu Suganuma, Hiroyuki Iwasaki, Haruhiko Yamazaki, Soji Toda, Katsuhiko Masudo, Yasushi Rino, Munetaka Masuda
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Most substernal goiters can be managed through the transcervical approach, but a sternotomy is required in some cases. This report is about a large substernal goiter, which was resected via a transcervical and full sternotomy approach. The patient was a 57-year-old female, who visited our hospital for surgical treatment for a large substernal goiter. Computed tomography of the neck and chest revealed that the substernal goiter extended to both sides of the thorax and had compressed the trachea. We performed total thyroidectomy safely via a transcervical and full sternotomy approach. No postoperative complications occurred, except transient hypocalcemia. A histopathological examination did not reveal any malignancy, and the lesion was diagnosed as an adenomatous goiter. Most substernal goiters can be managed through the transcervical approach, but a full sternotomy is required when a substernal goiter extends to both sides of the thorax and/or has a larger diameter than the thoracic inlet or airway constriction is revealed. A full sternotomy provides excellent exposure and can help reduce the risk of complications, such as recurrent laryngeal nerve palsy and injuries to major blood vessels.
Case report: Imaging features of aorta-right atrial tunnel in a dog using two-dimensional echocardiography and computed tomography
Authors: Geunha Kim, Yewon Ji, Ho-Gyun Jeong, Taekwon Lee, Kichang Lee, Hakyoung Yoon
Journal: Front Vet Sci (2023)
Keywords: valsalva, aorta-ra shunt, aorta-ra tunnel, aortic root, canine, cardiovascular anomaly, right atrium, right coronary sinus
MeSH terms: Case Reports

A 7-year-old castrated male Pomeranian dog weighing 5 kg presented with a right-sided continuous murmur without any clinical signs. Thoracic radiographs indicated cardiomegaly and right atrial (RA) bulging. Echocardiography revealed a tunnel originating from the right coronary sinus of Valsalva and terminating in the RA. Contrast echocardiography revealed pulmonary arteriovenous anastomoses. Computed tomography (CT) demonstrated a tortuous shunting vessel that originated from the aorta extending in a ventral direction, ran along the right ventricular wall, and was inserted into the RA. Based on these diagnostic findings, the dog was diagnosed with the aorta-RA tunnel. At the 1-year follow-up visit without treatment, the dog showed no significant change except for mild left ventricular volume overload and mildly decreased contractility. To the best of our knowledge, this is the first case report of an aorta-RA tunnel that has been described in detail using echocardiography and CT in a dog. In conclusion, the aorta-RA tunnel should be included in the clinical differential diagnoses if a right-sided continuous murmur is heard or shunt flow originating from the aortic root is identified.
Potential Adverse Consequences of Combination Therapy with Gabapentin and Pregabalin
Authors: Muhammad Nabeel Ghayur
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Gabapentinoids comprise the medications gabapentin and pregabalin. These were designed to not only look chemically like the central inhibitory neurotransmitter gamma-aminobutyric acid (GABA) but also act like it. The prototype gabapentin was primarily introduced to be used as antiepileptic medication. Today, both chemicals are not only utilized as adjunct antiepileptics in focal (aware and impaired awareness) seizures but are also used in several neuropathic pain conditions and other clinical indications. Their use has skyrocketed in the past few years and this has brought forward more instances of adverse effects and errors in prescribing practices. We describe here a case of a female patient with a history of diabetes, diabetic neuropathy, and hypertension being prescribed both gabapentin and pregabalin concomitantly which led to adverse effects like drowsiness, dizziness, fatigue, and ataxia. Once the patient medication profile was revisited, the pharmacy staff was able to identify the therapeutic duplications (gabapentin and pregabalin). The physician was contacted and pregabalin was discontinued. This led to the disappearance of the adverse effects. The dose of the existing gabapentin was increased to control the symptoms of diabetic neuropathy. This report sheds light on the importance of responsible prescribing, efficient checking of medication profiles on the level of dispensing pharmacies, and timely follow-up to patients to keep the patients safe and their medical conditions under check.
An unusual case of spleen metastasis from carcinoma ex pleomorphic adenoma of the parotid gland
Authors: Luigi Rossi, Erika Giordani, Antonella Fontana, Claudio Di Cristofano, Giuseppe Cavallaro, Oreste Bagni, Luca Filippi, Loredana Bianchi, Giulia Rinaldi, Francesca Perrone Congedi, Anselmo Papa, Davide Caruso, Monica Verrico, Gianfranco Silecchia, Silverio Tomao
Journal: World J Surg Oncol (2014)
MeSH terms: Adenocarcinoma / pathology, Adenoma, Pleomorphic / pathology, Parotid Neoplasms / pathology, Splenic Neoplasms / secondary, Case Reports, Adenocarcinoma / surgery, Adenoma, Pleomorphic / surgery, Aged, Humans, Male, Parotid Neoplasms / surgery, Prognosis, Splenic Neoplasms / surgery

Carcinoma ex pleomorphic adenoma is a rare tumor arising from the salivary glands that spreads through direct extension, through the lymphatic vessels, and, rarely, hematogenously. When distant metastases have been found, they have been reported mainly in the lung. We present an unusual case of carcinoma ex pleomorphic adenoma of the parotid gland with splenic metastases. The patient presented with a primary carcinoma ex pleomorphic adenoma of the parotid gland and he underwent a total parotidectomy with laterocervical lymphadenectomy ipsilateral and adjuvant radiation therapy to the right parotid area. One year later, the patient showed an ipsilateral supraclavicular lymph node recurrence, treated with surgery and radiation therapy. Two more years later, the patient developed lung and splenic lesions, detected through CT and PET. He underwent splenectomy and pathologic assessment of the specimen showed metastatic carcinoma ex pleomorphic adenoma. To our knowledge, there is no reported case of a carcinoma ex pleomorphic adenoma metastasizing to the spleen. Patients treated for carcinoma ex pleomorphic adenoma should be investigated for distant metastases with a long-term follow-up examination for local and distant metastases and new splenic lesions in these patients should be investigated.
Infantile hemangiomas masquerading as other periocular disorders
Authors: Jennifer Hsu, Brian G Mohney
Journal: Case Rep Pediatr (2012)
MeSH terms: Case Reports

Periocular tumors are common in infancy. The most common periocular tumors are capillary hemangiomas, which are present in 1-2% of newborns and develop in 10%-12% of children by the age of 1 year old. Deep capillary hemangiomas may be more challenging to diagnose than superficial capillary hemangiomas and can be confused with other orbital lesions. Deep orbital hemangiomas can mimic teratoma, lymphangioma, rhabdomyosarcoma, metastatic neuroblastoma, and granulocytic sarcoma. In this paper, we describe 2 pediatric cases where previously diagnosed dermoid cyst and dacrocystocele were found to be capillary hemangiomas upon biopsy. Approaches to distinguish capillary hemangiomas from other periocular tumors are further discussed. To our knowledge, this is the first case report of periocular hemangiomas imitating a dermoid cyst and a dacrocystocele. These cases emphasize the importance of including infantile hemangiomas in the differential diagnosis of subcutaneous periocular abnormalities.
Radium-223 dichloride bone-targeted alpha particle therapy for hormone-refractory breast cancer metastatic to bone
Authors: Amol Takalkar, Scott Adams, Vivek Subbiah
Journal: Exp Hematol Oncol (2014)
Keywords: alpha particle, bone metastases, breast cancer, exceptional responder, outlier responder, radium 223, unusual responder, xofigo

Background:
Hormone-refractory breast cancer metastatic to bone is a clinically challenging disease associated with high morbidity, poor prognosis, and impaired quality of life owing to pain and skeletal-related events. In a preclinical study using a mouse model of breast cancer and bone metastases, Ra-223 dichloride was incorporated into bone matrix and inhibited proliferation of breast cancer cells and differentiation of osteoblasts and osteoclasts (all P values < .001) in vitro. Ra-223 dichloride also induced double-strand DNA breaks in cancer cells in vivo.
Methods:
The US Food and Drug Administration recently approved radium-223 (Ra-223) dichloride (Ra-223; Xofigo injection) alpha-particle therapy for the treatment of symptomatic bone metastases in patients with castration-resistant prostate cancer. On the basis of a strong preclinical rationale, we used Ra-223 dichloride to treat bone metastases in a patient with breast cancer.
Results:
A 44-year-old white woman with metastatic breast cancer who was estrogen receptor-positive, BRCA1-negative, BRCA2-negative, PIK3CA mutation (p.His1047Arg) positive presented with diffuse bony metastases and bone pain. She had hormone refractory and chemotherapy refractory breast cancer. After Ra-223 therapy initiation her bone pain improved, with corresponding decrease in tumor markers and mixed response in (18)F-FDG PET/CT and (18)F-NaF bone PET/CT. The patient derived clinical benefit from therapy.
Conclusion:
We have shown that Ra-223 dichloride can be safely administered in a patient with hormone-refractory bone metastasis from breast cancer at the US FDA-approved dose for prostate cancer. Furthermore, because the treatment did not cause any drop in hematologic parameters, it has the potential to be combined with other radiosensitizing therapies, which may include chemotherapy or targeted therapies. Given that Ra-223 dichloride is already commercially available, this case report may help future patients and provide a rationale for initiating clinical research in the use of Ra-223 dichloride to treat bone metastasis from breast cancer. A randomized clinical trial is needed to provide evidence of efficacy, safety, and good outcomes.
A Large Lumbar Adnexal Neoplasm Presenting Characteristics of Eccrine Poroma and Poroid Hidradenoma
Authors: Adamantios Michalinos, Dimitrios Schizas, Antonios Sarakinos, Georgios Athanasiadis, Eleftherios Spartalis, Dimitrios Vlachodimitropoulos, Theodore Troupis
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Poroma is a rare benign neoplasm that derives from eccrine sweat glands epithelium. Its histological subtypes, with respect to its position within skin layers, are eccrine poroma, hidroacanthoma simplex, poroid hidradenoma, and dermal duct tumor. Poromas commonly exhibit benign clinical behavior as they are usually small and asymptomatic and do not exhibit malignant behavior. Although their histological subtypes share similar histological characteristics, they rarely coexist in the same tumor. In this report we present the case of an unusual poroma in terms of histological and clinical behavior as it was large and presented histological characteristic of both eccrine poroma and poroid hidradenoma. Coexistence of different histologic subtypes in the same tumor indicates simultaneous tumorigenesis, differentiation from one cell type to another, or parallel differentiation from a common progenitor cell. Implications in treatment remain unknown partly due to the rarity of such cases.
Sequential Kinase Inhibition (Idelalisib/Ibrutinib) Induces Clinical Remission in B-Cell Prolymphocytic Leukemia Harboring a 17p Deletion
Authors: H Coelho, M Badior, T Melo
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

B-cell prolymphocytic leukemia (B-PLL) is a rare lymphoid neoplasm with an aggressive clinical course. Treatment strategies for B-PLL remain to be established, and, until recently, alemtuzumab was the only effective therapeutic option in patients harboring 17p deletions. Herein, we describe, for the first time, a case of B-cell prolymphocytic leukemia harboring a 17p deletion in a 48-year-old man that was successfully treated sequentially with idelalisib-rituximab/ibrutinib followed by allogeneic hematopoietic stem cell transplant (allo-HSCT). After 5 months of therapy with idelalisib-rituximab, clinical remission was achieved, but the development of severe diarrhea led to its discontinuation. Subsequently, the patient was treated for 2 months with ibrutinib and the quality of the response was maintained with no severe adverse effects reported. A reduced-intensity conditioning allo-HSCT from a HLA-matched unrelated donor was performed, and, thereafter, the patient has been in complete remission for 10 months now. In conclusion, given the poor prognosis of B-PLL and the lack of effective treatment modalities, the findings here suggest that both ibrutinib and idelalisib should be considered as upfront therapy of B-PLL and as a bridge to allo-HSCT.
Metastatic Melanoma to the Urinary Bladder of Ocular Origin Accompanied with Primary Cutaneous Melanoma: Diagnostic Challenge-A Report of a Case
Authors: Constantine Theocharides, Kyriakos Chatzopoulos, Dimitrios Papanikolaou, Vasileios Siokas, Ioannis Amplianitis, Athanasios Papanikolaou
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Metastases of melanoma to the urinary bladder are infrequent. Even rarer are metastases to the urinary bladder from uveal melanoma, with only 3 cases published in the literature so far. Herein we present a case of a 77-year-old male patient who presented with metastatic melanoma to the urinary bladder. The patient's history included the diagnoses of uveal melanoma treated with radiation 25 years ago, as well as that of cutaneous melanoma diagnosed 7 years ago. The molecular study of the urinary bladder tumor specimen identified mutation of the GNAQ gene, which has been suggested to be an early molecular event in the pathogenetic course of over 80% of uveal melanomas. Therefore, the diagnosis of uveal melanoma metastatic to the urinary bladder was made.
Optimization of re-irradiation using deformable registration: a case study
Authors: Raphaël Jumeau, Nicolas Péguret, Cédric Zulliger, Raphaël Moeckli, Jean Bourhis, Esat-Mahmut Ozsahin
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Re-irradiation is frequently performed in radiotherapy (RT) departments. We present an optimization methodology that takes the previous irradiation into account. A 68-year-old female patient suffering from rectal adenocarcinoma, who had previously undergone RT for metastases to the right iliac bone, presented with a recurrence of metastasis to the L5 and the left sacroiliac joint. Re-irradiation was performed using volumetric modulated arc therapy (VMAT). We proceeded to a registration of the previous RT planning CT and RT doses to the new planning CT. Virtual volumes corresponding to the intersection of the small bowel (SB) and each isodose structure were created. We calculated the maximal dose (Dmax) that each virtual structure could receive and considered them as constraints. We called this technique modified VMAT. We compared this technique with a standard VMAT plan and a three-dimensional RT plan. Using the modified VMAT technique, a total dose of 20 Gy in five fractions of 4 Gy was delivered to the planning target volume without any acute toxicity. A composite dosimetry was realized with each technique to compare the dose given to the already irradiated SB. We calculated the Dmax received by the already irradiated SB in equivalent dose of 2 Gy fractions. The Dmax was 46.8, 60 and 52 Gy for modified VMAT, standard VMAT and three-dimensional RT, respectively. Dose deformation was used to create new constraint structures to optimize the dose delivered to surrounding tissues. This methodology is readily feasible in clinical routine to optimize the re-irradiation process.
Hereditary Leiomyomatosis and Renal Cell Cancer-Recognizing Patterns May Save Lives
Authors: Tavares Catarina, Maria Sofia Quental, José Ricardo Brandão, Miguel Silva-Ramos
Journal: J Kidney Cancer VHL (2022)
Keywords: hlrcc, fumarate hydratase, hereditary renal cell cancer, renal cell carcinoma
MeSH terms: Case Reports

In 2001, Finish investigators described a rare familiar syndrome characterized by an inherited susceptibility to cutaneous leiomyomas, uterine leiomyomas, and renal cell carcinoma (RCC). Hereditary leiomyomatosis and renal cell cancer (HLRCC) is now linked to a germline mutation in the fumarate hydratase (FH) gene that encodes a Krebs cycle enzyme, transforming fumarate to malate. The accumulation of fumarate, an oncometabolite, promotes tumorigenesis. We present a case of a 41-year-old female diagnosed with HLRCC after a radical nephrectomy due to renal cell cancer. Genetic analyses confirmed a novel FH mutation. Close follow-up allowed for a precocious diagnosis of a metachronous renal tumor and later a hepatic metastasis. Her family was also counseled and offered genetic testing. As observed in this case, the diagnosis of HLRCC is of paramount importance for patients and their families: there is a 15% cumulative lifetime risk of developing RCC, which frequently occurs in young patients and metastasizes at an early stage. Implementing a regular follow-up with adequate imaging examinations may help save lives.
Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment
Authors: Gregory W Charville, Sukhmani K Padda, Richard K Sibley, Ajithkumar Puthillath, Paul Y Kwo
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Targeted cancer treatments offer the prospect of precise inhibition of tumor growth without the untoward off-target toxicity of traditional chemotherapies. Still, unintended, often idiosyncratic side effects, such as drug-induced liver injury, can occur. We discuss the case of a 26-year-old female with a history of ROS1-rearranged lung adenocarcinoma, undergoing treatment with the tyrosine kinase inhibitor crizotinib, who presented to our hospital with abdominal pain and scleral icterus. Liver chemistries were notable for hyperbilirubinemia (5 mg/dL total) and marked transaminasemia (AST 1736 U/L, ALT >3500 U/L); liver biopsy demonstrated acute hepatitis with extensive necrosis. There was no evidence of an infectious or autoimmune etiology. It was discovered that the patient was taking a 500 mg once daily dose of crizotinib, in lieu of the intended dose of 250 mg twice daily. After immediate cessation of crizotinib therapy upon hospital admission, there was complete biochemical resolution of the hepatitis. This case highlights the potential reversibility of fulminant crizotinib-associated hepatoxicity, possibly related to supratherapeutic dosing, when managed with abrupt stoppage of the drug and initiation of supportive care.
Epibulbar osseous choristoma
Authors: Tolga Bicer, Hasan Soylemez
Journal: Case Rep Ophthalmol Med (2014)

The topic of this case report is a rare subconjuctival osseous choristoma that corresponded to the left lateral sunconjunctiva and canthus. A 20-year-old man was asymptomatic when he arrived for the examination. His full ophthalmic examination was normal. Orbital computerized tomography was concordant with osseous lesion. Osseous choristomas are the rarest forms of ocular choristomas, they are usually being defined as sporadic, and they are found at the superior temporal region of the episclera. In our case, choristoma was in the lateral canthus of the left eye. We had administered surgical excision by reason of the patient's cosmetic requirement. We had noted that the lesion was adherent to conjunctiva but not to the sclera and the muscles. After surgical treatment, we saw mature heterotrophic osseous tissue in subconjunctival area and Haversian canals in compact bone tissue.
Worsening of Primary Raynaud's Phenomenon During Episodes of Pyrexia and Rigors in SARS-CoV-2 Infection
Authors: Ciara J Bansal, Kirollos Kamel
Journal: Cureus (2023)
Keywords: coronavirus, coronavirus disease, covid-19, digital ischemia, mechanism, pyrexia, raynaud disease, raynaud phenomenon, rigors, sars-cov-2
MeSH terms: Case Reports

Acute SARS-CoV-2 infection is associated with several cutaneous manifestations, including vasculitic digital ischemia. The reversal of digital ischemia in the primary Raynaud phenomenon (RP) arises from endothelial hypersensitivity to circulating adrenaline and noradrenaline and diminished vasodilatory innervation. SARS-CoV-2 can infect endothelial cells and be associated with raised adrenaline levels, reduced microvascular dilatory responses, and exaggerated clotting mechanisms. We report worsened RP in a patient with previously mild winter-time primary RP during the periods of fever and rigors from an acute SARS-CoV-2 infection contracted in a warm summer period. This reverted to the mild phenotype after recovery, and we discussed possible mechanisms for the brief exacerbation.
Magnet-retained facial prosthesis combined with maxillary obturator
Authors: Mahnaz Hatami, Hamid Badrian, Siamak Samanipoor, Marcelo Coelho Goiato
Journal: Case Rep Dent (2013)

Prosthetic rehabilitation of the midfacial defects has always perplexed prosthodontists. These defects lead to functional and esthetic deficiencies. The purpose of this clinical case report was the presentation of the prosthetic rehabilitation of an extraoral-intraoral defect using two-piece prosthesis magnetically connected. This prosthesis has dramatically improved the patient's speech, mastication, swallowing, and esthetic.