OpenMed/multicare-articles huggingface dataset:
A Case Report of Intraductal Papillary-Mucinous Neoplasm of the Pancreas Showing Morphologic Transformation during Followup Periods
Authors: Yuichi Sanada, Shinji Osada, Yoshihiro Tanaka, Yasuharu Tokuyama, Kazuhiro Yoshida
Journal: J Oncol (2009)
MeSH terms: Case Reports

A 64-year-old man underwent MRCP for further examination of gallbladder stones and IPMN of branch-type (IPMN-Br) was pointed out. Yearly MRCP had revealed the gradual increase of the cystic components, marked dilation of the main pancreatic duct (MPD), and filling defects in the MPD. After follow-up for three years, he underwent pancreatoduodenectomy. Histologically, the dilated MPD and connecting dilated branch ducts were filled with nodular growth of tumor cells consisting of gastric-type adenoma with pyloric gland-like structures. In the MPD, a transition from gastric-type adenoma to intestinal-type carcinoma was observed. In addition, in a dilated branch duct, some components of intestinal-type carcinoma with marked arborizing structures were observed. A minimally invasion was observed around branch ducts. Immunohistochemistry revealed diffuse nuclear accumulation of PCNA and Ki67 in the tumor cells of branch dusts. Our observations suggest that the secondary infiltration to the MPD of IPMN-Br and IPMN-Br possesses malignant potential for microinvasion.
Imaging Mass Cytometry Analysis of immune Checkpoint Inhibitor-Related Pneumonitis: A Case Report
Authors: Yuan Cheng, Xiao-Ming Wang, Qin Hu, Kunyan Sun, Xiang Zhao, Meng Zhang, Guangfa Wang, He Wang, Yan Xiong
Journal: Front Immunol (2022)
Keywords: heavy-metal tagged antibodies, imaging mass cytometry, immune checkpoint inhibitor-related pneumonitis, immune-related adverse event, memory t cells
MeSH terms: Antineoplastic Agents, Immunological / adverse effects, Lung Neoplasms / pathology, Pneumonia / chemically induced, Pneumonia / diagnosis, Case Reports, Glucocorticoids / therapeutic use, Humans, Image Cytometry, Immune Checkpoint Inhibitors / adverse effects, Neoplasm Recurrence, Local / complications, Antineoplastic Agents, Immunological, Glucocorticoids, Immune Checkpoint Inhibitors

Immune checkpoint inhibitor-related pneumonitis (CIP) is a rare but well-recognized immune-related adverse event (irAE), causes 35% of irAE related deaths. However, the mechanism of CIP remains unclear and no evidence-based treatment except for glucocorticoids is available. Herein, we report the case of a patient with metastatic bladder cancer who received tislelizumab and was diagnosed with CIP. The patient underwent transbronchial cryobiopsy. The patient was treated with glucocorticoid, but CIP recurred when the glucocorticoid tapering. The paraffine-embedded lung tissue was sectioned, stained with 31 heavy-metal tagged antibodies, and analyzed using imaging mass cytometry (IMC) technology. We identified multiple immune cell subsets in the lung tissue and observed the infiltration of memory T cells and the CD4+ DC subset. The data indicated the great potential of IMC technology in the identification and characterization of irAEs. Further investigation is warranted to identify the mechanism of action of CIP.
Colonic Adenocarcinoma at Advanced Stage in Adolescence: Report of 2 Cases
Authors: Divya S Vundamati, Xiuxu Chen, Vivekanand Singh
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Background:
Carcinoma of colon is rare in children and adolescents. The staging criteria of the carcinoma is the same as those for adults. However, the pathogenetic background in pediatric cases is different from adults and usually involves mismatch repair gene mutations or familial polyposis syndromes. Case report. We describe two adolescents diagnosed with advanced stage colon carcinoma and discuss the histological appearance, testing for mismatch repair genes and contrast- it with carcinoma occurring in the setting of familial polyposis syndrome.
Conclusion:
Colonic carcinoma occurring in pediatric patients should prompt a work-up for mismatch repair gene mutation status. Despite higher stage of presentation, some of the pediatric patients may respond favorably to chemotherapy and surgical resection.
Minimally Invasive Plate Osteosynthesis for a Distal Radius Fracture with Forearm Skin Problem
Authors: Kiyohito Naito, Yoichi Sugiyama, Mayuko Kinoshita, Ahmed Zemirline, Chihab Taleb, Thitinut Dilokhuttakarn, Philippe Liverneaux, Kazuo Kaneko
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.
Misinterpretation of Psychiatric Illness in Deaf Patients: Two Case Reports
Authors: Ethan Anglemyer, Craig Crespi
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

The Deaf/hard of hearing population is growing rapidly and the medical community is facing a higher demand for this special needs group. The Deaf culture is unique in that spoken word is via sign language. What one person may see as mania or psychosis is actually a norm with Deaf individuals. The fear of the unknown language often creates immediate conclusions that are false. As such, being culturally sensitive becomes a large component of properly assessing a Deaf patient in any psychiatric situation. In the first case, the patient is a 26-year-old prelingually Deaf male, who was placed under an involuntary hold by the emergency room physician for acting erratic and appearing to respond to internal stimuli. The patient was later interviewed with an interpreter and stated he became upset because the staff was not providing him proper care as they lacked an ability to communicate with him. The patient's family was called who corroborated the story and requested he be discharged. Case two presents with a 30-year-old Hispanic male who is also prelingually Deaf. He was admitted involuntary for bizarre behavior and delusions, with a past diagnosis of schizophrenia. Upon interview, the patient endorsed delusions via written language; however, through an ASL-language interpreter he was able to convey a linear and coherent thought process. Caring for special needs patients must be in the repertoire of any trained healthcare professional. Deaf Individuals experience mental illness just like the general population. Symptoms such as auditory hallucinations are not brought up in the same manner and are thought to be a visual construct interpreted by the patient as a vocal expression. It is imperative that these subtle differences are known in order to differentiate out an actual mental illness. In any case where language is a barrier, an interpreter must be present for a thorough assessment. These cases lend further thought into policy reform for Deaf individuals within healthcare.
Coronary artery aneurysm: case report
Authors: Jeffrey E Everett, Harold M Burkhart
Journal: J Cardiothorac Surg (2008)
MeSH terms: Angioplasty / methods, Coronary Aneurysm / surgery, Coronary Artery Bypass / methods, Case Reports, Aged, Coronary Aneurysm / diagnosis, Diagnosis, Differential, Electrocardiography, Humans, Male

Introduction:
Aneurysms of the left main coronary artery are rare with an incidence of 0.1% in large angiographic series. The majority are atherosclerotic in origin. Other causes include connective tissue disorders, trauma, vasculitis, congenital, mycotic and idiopathic. The primary complication is myocardial ischemia or infarction, with rupture being rare. Treatment options include anticoagulation, custom made covered stents, reconstruction, resection, and exclusion with bypass.
Case presentation:
A 66 year-old man was referred for evaluation of a 2 x 2 centimeter saccular aneurysm originating from the distal left main coronary artery. There was associated calcification and mild stenosis of the LM. The workup was prompted by a non-ST elevation myocardial infarction suffered following a laparotomy for a ruptured appendix. The past medical history was pertinent for hypertension, hyperlipidemia, and a left carotid endarterectomy. Cardiopulmonary bypass with hyperkalemic cardioplegic arrest was utilized. The aneurysm was exposed in the atrioventricular groove. The aneurysm was resected and oversewn. Calcification precluded patch angioplasty. The patient then underwent coronary bypass grafting with the left internal thoracic artery placed to the left anterior descending artery and a reversed greater saphenous vein graft to an obtuse marginal branch of the circumflex artery. The postoperative course was uneventful and discharge to home occurred on the fourth postoperative day. Surgical pathology confirmed an atheromatous coronary artery aneurysm.
Conclusion:
Left main coronary artery aneurysms in adult patients are predominantly atherosclerotic in origin. The clinical presentation is that of myocardial ischemia, likely from associated embolism. Rupture is rare. Operative treatment is exclusion and revascularization.
Giant Mesenteric Cyst and Right Sided Syndrome in a 15-Year-Old Boy
Authors: Ayanaw Tamene, Melkam Desta, Habeneyom Tebeje, Yeshiambel Getie, Hailemariam Berhane
Journal: European J Pediatr Surg Rep (2019)
Keywords: cryptorchidism, giant mesenteric cyst, renal agenesis, right side syndrome
MeSH terms: Case Reports

Giant mesenteric cyst is a rare benign abdominal tumor. It usually arises from the mesenteric side of the small bowel. Right side syndrome is the term used for congenital absence of right kidney and right testis. We report on a 15-year-old male who presented with progressive abdominal distension, early satiety, and difficulty walking or running. Abdominal ultrasound and computed tomography (CT) revealed a giant mesenteric cyst, absence of the right kidney, and left moderate hydronephrosis. After excision of the cyst, the patient was fully recovered. Our report shows that both conditions may occur in the same patient and therefore an association of these two diseases cannot be excluded.
Congenital chikungunya in a neonate with early-onset sepsis and petechiae: An unusual case report
Authors: Sakviseth Bin, Kimyi Phou, Sethikar Im
Journal: Clin Case Rep (2023)
Keywords: chikungunya virus, congenital, mosquito‐borne disease, neonatal sepsis
MeSH terms: Case Reports

Chikungunya, a mosquito-borne disease, is posing threat to neonatal population in Cambodia because of its challenging diagnosis and insufficient attention compared with Dengue. In what follows, we present a case of serologically-confirmed congenital chikungunya in a newborn presenting early-onset sepsis, and the mother was underdiagnosed with intrapartum flu-like infection.
Traditional herbal treatment induced bilateral amputation of the feet in a five-year-old child: A case report
Authors: Komang Agung Irianto, Tri Wahyu Martanto, Rendra Praliestyo Nugroho, Oen Sindrawati, Yudhistira Pradnyan Kloping
Journal: Int J Surg Case Rep (2020)
Keywords: autoamputation, bilateral autoamputation, case report, herbal treatment, necrotizing fasciitis, traditional treatment
MeSH terms: Case Reports

Introduction:
Bilateral gangrene of both legs in a child is a rare condition which may lead to sepsis when improperly treated. In certain rare cases, autoamputation may occur instead. We report a case of bilateral symmetrical autoamputation of the feet following necrotizing fasciitis after a fall injury which was treated with herbal medicine in a five-year-old child.
Presentation of case:
A five-year-old girl fell from a bicycle and was treated by a traditional healer by wrapping her legs with herbs and leaves. Within 24 h, the skin of both lower limbs darkened. Her vital signs show tachycardia and fever. Physical examination revealed bluish black sharp discoloration of both her lower extremities. On the 3rd day of systemic antibiotic administration, her feet, distal portion of both legs, and part of the thighs darkened progressively. The parents refused any additional intervention due to financial constraints and went back to the traditional healer. A month later, the patient returned to the hospital with both lower extremities autoamputated. The parents denied further treatment. Two months later, the patient was admitted to receive prostheses funded by the city council. Debridement of necrotic bone and soft tissue and skin grafting was performed. In the present day, the patient is in a healthy condition.
Conclusion:
The rare occurrence of bilateral autoamputation without any underlying vascular or neurological disorders in this patient is likely caused by vasospasm and thrombosis induced by the herbal treatments which prevent the systemic spread of infection.
Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery
Authors: Peilin Dai, Xi Rao, Xi Zhang, Enming Qiu, Gang Wu, Yu Lin, Sitong Li, Zhou Li, Zhai Cai, Shuai Han
Journal: Front Immunol (2022)
Keywords: advanced gastric cancer, case report, complete remission, immune checkpoint inhibitor, nivolumab
MeSH terms: Liver Neoplasms / drug therapy, Liver Neoplasms / secondary, Liver Neoplasms / surgery, Stomach Neoplasms / drug therapy, Stomach Neoplasms / pathology, Stomach Neoplasms / surgery, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Humans, Male, Nivolumab / therapeutic use, Oxaliplatin / therapeutic use, Palliative Care, Oxaliplatin, Nivolumab

Metastatic advanced gastric cancer, for which treatment strategies are extremely limited, has a poor prognosis. Complete remission is rare. Patients usually lose the opportunity of therapeutic surgery because the lesions cannot be completely removed, although it can greatly prolong their survival time. Palliative surgery usually suggests bad outcomes. In recent years, the immune checkpoint inhibitor (ICI) nivolumab has shown significant efficacy in the treatment of advanced gastric cancer. However, its applicable conditions and optimal withdrawal time remain controversial owing to its low response rate and high incidence of immune-related adverse events. Herein, we introduce a 66-year-old male patient with advanced gastric cancer with multiple liver metastases who underwent laparoscopic total gastrectomy for acute gastric bleeding. The patient received eight cycles of S-1 plus oxaliplatin (SOX) and switched to eight cycles of SOX plus nivolumab combined regimen in a stable state, later achieving complete remission. There was no recurrence for 32 months after the surgery. This is the first reported case of gastric cancer with multiple liver metastases with long-term complete remission with nivolumab treatment after palliative surgery. The potential mechanism of complete remission was discussed through clinical, genomic, and immune characteristics. The patient had a history of psoriasis and was positive for programmed death ligand 1 (PD-L1), and the interaction of TP53 mutation and HER-2 (-) gene may be associated with complete remission.
Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban-A Case Report
Authors: Harish Sharma, Vincenzo Vetrugno, Peter Ludman
Journal: Front Cardiovasc Med (2020)
Keywords: bioprosthetic aortic valve, noac, rivaroxaban, thrombosis reversal, valve thrombosis
MeSH terms: Case Reports

Background: Bioprosthetic valve thrombosis (BPVT) is a rare but recognized complication causing valve dysfunction. In subacute valve thrombosis, systemic oral anticoagulation is recommended. However, there is little data comparing the efficacy of warfarin and novel oral anticoagulant (NOAC) therapy in this setting. Case Summary: A patient developed subacute BPVT 11 years post-implantation. The patient was initially treated with warfarin for a period of 6 months, with limited effect. Following replacement of warfarin with rivaroxaban, there was significant reversal of the BPVT, as represented by a reduction in transaortic maximal velocity (Vmax) from 4.1 to 3 m/s over 7 months. Discussion: Systemic oral anticoagulation can be an effective treatment for subacute valve thrombosis. Guidelines currently recommend warfarin as first line but NOACs can be considered in such patients and may be more effective than warfarin. Randomized controlled trials are required to further establish the optimal anticoagulation for patients with subacute BPVT.
Gastric hyperplastic polyp associated with proliferation of xanthoma cells observed by magnification narrow-band imaging endoscopy
Authors: Shoji Hirasaki, Motoharu Kubo, Atsushi Inoue
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

A case of gastric hyperplastic polyp with proliferation of xanthoma cells is reported. The patient was a 69-year-old man who visited our hospital for further evaluation of gastric polyps. Endoscopic examination of the upper digestive tract revealed multiple hyperplastic polyps in the gastric antrum. There was a pedunculated polyp with whitish yellow granules, 7 mm in diameter, arising from the greater curvature of the antrum. Magnification narrow-band imaging endoscopy (GIF-H260Z, Olympus) revealed long microcapillaries in the polyp but did not reveal disappearance of the mucosal microstructure or irregular branched capillaries. Endoscopic mucosal resection (EMR) was performed. Histological examination of the specimen revealed the lengthened gastric foveolae in the superficial portion and tight sheet of foamy histiocytes in the lamina propria. Diagnosis of gastric hyperplastic polyp with proliferation of xanthoma cells was made. There was no evidence of malignancy. It is necessary to know that a gastric hyperplastic polyp may associate with gastric xanthoma, although such association is very rare.
A Newly Observed Mutation of the ABCA3 Gene Causing Lethal Respiratory Failure of a Full-Term Newborn: A Case Report
Authors: Martin Jouza, Tomas Jimramovsky, Eva Sloukova, Jakub Pecl, Anna Seehofnerova, Marta Jezova, Milan Urik, Lumir Kunovsky, Katerina Slaba, Petr Stourac, Martina Klincova, Jaroslav A Hubacek, Petr Jabandziev
Journal: Front Genet (2020)
Keywords: abca3, children, respiratory distress syndrome, respiratory failure, surfactant
MeSH terms: Case Reports

Respiratory distress syndrome caused by a secondary surfactant deficiency is one of the most common diagnoses requiring admission to the Neonatal Intensive Care Unit. We illustrate the case of a term female newborn without prenatal and peripartal risks. There had been significant signs of respiratory distress 4 h after delivery. The condition gradually worsened to the point of needing oscillatory ventilation. The most common infectious and non-infectious causes were excluded. Considering the course of illness, a congenital surfactant deficiency was suspected. There nevertheless was no significant improvement after administration of surfactant. Following a short period of palliative care, the child died at 34 days of age due to respiratory failure. DNA diagnostics revealed compound heterozygosity of ABCA3 functional mutations leading to the p.Pro147Leu and p.Pro246Leu exchanges. The second identified mutation of ABCA3 c.737C>T had not to date been described in connection with primary surfactant deficiency.
Cutaneous Effects of Notch Inhibitor Therapy: A Report of Two Cases
Authors: Claire J Wiggins, Susan Y Chon
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

As aberrant Notch signaling has been linked to cancerous growth, Notch inhibitors represent a novel category of targeted oncological therapy. Notch pathways in tumor cells may contribute to proliferation or limit apoptosis and differentiation. Healthy skin differentiation and homeostasis are reliant on normal Notch expression, and disruption of this signaling has been implicated in dermatological conditions such as hidradenitis suppurativa, psoriasis, atopic dermatitis, and lichen planus. Here, we describe two cases of patients with cutaneous side effects from Notch inhibitor treatment for adenoid cyst carcinoma (ACC) and review the role of Notch signaling in skin disease. By illuminating connections between medication side effects and disease pathogenesis, our goal is to increase awareness of the cutaneous side effects of Notch inhibitor treatment.
A case report of a metastatic gastrointestinal stromal tumor occurring in femur
Authors: Chang-Kun Zheng, Wu-Sheng Kan, Peng Li
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms that most commonly affect the stomach or small intestine, but can occur anywhere throughout the gastrointestinal tract. To the best of our knowledge, few cases have been reported in the literature about the femur metastasis of GIST. This paper describes a metastasis of a gastrointestinal stromal tumour (GIST) to the femur in a 62-year-old male, 2 years after treatment for a gastric primary. There were no signs of tumor recurrence at followup after 12 mo. This case suggests that the femur can be a potential metastatic site of GIST.
Solitary pulmonary metastasis from a gingival cancer of 36 years ago: A case report
Authors: Atsushi Kamigaichi, Kei Shimizu, Yoshihiro Miki, Katsura Hakamada, Yoshiro Otsuki, Toru Nakamura
Journal: Int J Surg Case Rep (2018)
Keywords: adenoid cystic carcinoma, case report, head and neck cancer metastasis, solitary pulmonary nodule

Introduction:
Unlike a squamous cell carcinoma (SqCC), an adenoid cystic carcinoma (ACC) is an uncommon histology of all head and neck cancers. The clinical significance of a pulmonary metastasectomy differs greatly between these two types of cancers. A solitary pulmonary nodule in a patient with a history of both these different malignancies is a diagnostic and therapeutic challenge.
Presentation of case:
An 81-year-old woman presented with a right lung nodule detected by chest computed tomography (CT) one year after a tongue SqCC surgery. She had a remote history of gingival cancer 36 years prior, which was not assessed in detail during the initial work up. We suspected that the nodule was a primary lung cancer and she underwent a right basal segmentectomy. Histology revealed an ACC, which was proven to be a metastasis from the gingival cancer.
Discussion:
An ACC is an uncommon type of cancer arises mainly in the salivary glands. It is characterized by a long-term behavior and the histology of ACC is a favorable prognostic factor. With its favorable histology and disease free interval of over 30 years, a better outcome would be expected than that of a primary lung tumor or a metastasis from the tongue SqCC. Furthermore, we could have made a differential diagnosis of a metastatic ACC before the surgery with more careful research for a previous history of a gingival cancer.
Conclusion:
Our case emphasized that a precise history taking of any malignancy, even if that of more than 30 years prior, is crucial.
An acute case of herpes zoster ophthalmicus with ophthalmoplegia
Authors: Wasim Hakim, Rosalie Sherman, Tamer Rezk, Kanwar Pannu
Journal: Case Rep Ophthalmol Med (2012)
MeSH terms: Case Reports

Herpes zoster ophthalmicus (HZO) with oculomotor nerve involvement is rare, even rarer as an acute presentation rather than sequelae of HZO. In this paper we present a case of cutaneous HZO in which our patient's initial presentation was one of complete ophthalmoplegia.