OpenMed/multicare-articles huggingface dataset:
Encapsulated Papillary Carcinoma: A Case Report and Review of the Literature
Authors: Aikaterini Athanasiou, Fathi Khomsi, Bouquet de Joliniere, Anis Feki
Journal: Front Surg (2022)
Keywords: biopsy, breast cancer, encapsulated breast cancer, fibrovascular cores, receptors, sentinel lymph node
MeSH terms: Case Reports

Papillary neoplasms are a distinct assemblage of breast lesions whose main characteristic is the presence of fibrovascular cores which are surrounded by epithelial cells. Papillary lesions are of heterogenous nature, with similar clinical behavior and histomorphologic characteristics. Their biological patterns, however, can be quite different. According to the World Health Organization (WHO) (2019), breast tumors have been recently classified into five subdivisions of papillary neoplasms. They are namely: intraductal papilloma, papillary ductal carcinoma in situ, encapsulated papillary carcinoma (EPC), solid-papillary carcinoma and invasive papillary carcinoma. Despite the papillary architecture being easily recognized, histological variations are diagnostically challenging. The presence or absence of myoepithelial cells in the papillary cores can distinguish the malignant from the benign lesions respectively. EPC is a rare, histologically unique carcinoma type whose main characteristic is a thick fibrous capsule at the periphery and a prolific cell structure with fibrovascular stalk support. A characteristic feature is the absence of myoepithelial cells at the surrounding thick fibrous capsule. Usually, EPC maintains a slowly developing tumor despite the absence of myoepithelial cells. An EPC case presents diagnostic difficulties since it bears close resemblance to malignant and benign papillary breast lesions. Upon a clinical and radiological evaluation, EPC commonly appears as a benign lump. In mammography, the tumor is frequently found in a retroareolar position as a well-defined mass. On the other hand, in an ultrasound, the tumor will appear as a cystic lesion characterized by solid components. The clinical picture of EPC is usually an asymptomatic benign mass which at times can be felt through auto-palpation or screening mammography. A bloody nipple discharge is regarded as a common symptom. We report a case of an EPC of a 81-year-old woman who presented with a mass in the left breast.
Surgical Removal of a Calcified Right Atrial Mass Related to Venous Access Port: A Case Report
Authors: Joseph G Brungardt, Anup K Kasi, Jeffrey B Kramer
Journal: Int J Surg Case Rep (2020)
Keywords: atrial mass, cardiotomy, case report, port-a-cath, thrombus
MeSH terms: Case Reports

Introduction:
Intracardiac masses pose a difficult diagnostic and therapeutic dilemma. Indwelling catheters can lead to thrombus calcification causing untoward sequelae.
Case presentation:
We report on a patient who presented after computed tomography identified a large calcified right atrial mass. Her history included treatment for rectal cancer and breast cancer, thus we feared the mass could represent metastasis. The intracardiac mass was successfully resected via a right atriotomy. Her postoperative course was uneventful and the histopathology revealed a calcified thrombus.
Discussion:
In this report we discuss our findings and pre- and intraoperative considerations, as well as suggestions for management of implantable venous catheters. This is a rare complication of an indwelling catheter.
Conclusion:
Operative management of intracardiac lesions is the standard of care. When related to implantable catheters, the best patient care would be prevention of such lesions. This would include routine flushing of the indwelling catheters and prompt removal once not in use.
Case Report: Rapid Progression of Cognitive Dysfunction as an Initial Feature of Systemic Lupus Erythematosus With Leukoencephalopathy: A Case Report and Literature Review
Authors: Yukun Feng, Teng Yu, Qin Xiao, Xiaodong Yang
Journal: Front Neurol (2022)
Keywords: mri, diffusion-weighted image (dwi), leukoencephalopathy syndrome, neuropsychiatric systemic lupus erythematosus (npsle), rapidly progressive dementia (rpd)
MeSH terms: Case Reports

Neuropsychiatric systemic lupus erythematosus (NPSLE) has been considered to have high morbidity and mortality. Thus, earlier recognition and treatment are of great importance. However, the rapid progression of cognitive dysfunction with leukoencephalopathy as an initial presentation in SLE is rarely described. We report a case in which an elderly man experienced rapidly progressive cognitive impairment with bilateral, symmetric, and diffuse leukoencephalopathy with lasting diffusion-weighted image hyperintensity. An immunological workup showed low complement levels and positivity for antinuclear antibody -speckle and Coombs tests in the patient's serum samples. He had an appropriate improvement in cognitive function after receiving a combination of various immunotherapies. Long-term follow-up showed clinical improvement, including rheumatological labs and neuroimaging. A review of the literature on NPSLE with leukoencephalopathy and a summary of all reported cases to date are also presented. Our case indicated that isolated leukoencephalopathy in NPSLE, as an indicator of severe NPSLE, can be recognized early. Immunotherapy is warranted given the possibility of clinical improvement.
Idiopathic gingival hyperplasia: a case report with a 17-year followup
Authors: Bien Lai, Joseph Muenzer, Michael W Roberts
Journal: Case Rep Dent (2011)
MeSH terms: Case Reports

This is a case report of a patient with idiopathic gingival hyperplasia and an undiagnosed genetic disorder that demonstrated static encephalopathy, mental retardation, developmental delay, seizures, hypotonia, and severe gingival hypertrophy. The clinical dental management and attempts to obtain a genetic diagnosis are described.
Pregnancy in an Asymptomatic Woman with Porencephalic and Arachnoid Cysts
Authors: Franco Pepe, Gianmarco Marchese, Gabriele Giuseppe Pepe, Elisabetta Zambrotta, Giulio Insalaco, Claudia Garraffo, Valeria La Rosa
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

A 25-year-old woman presented to the obstetric clinic in her first pregnancy. The patient was accompanied by her mother who reported an episode of intracerebral hemorrhage after birth and also remembered access to the emergency department after generalized tonic-clonic seizure as an infant. She was not able to describe the therapy for seizure preventions and even when and why it was suspended, but she affirmed that no residual neurological consequences were detected in the following years. Actually, the pregnant woman was in good health without neurological symptoms nor assumed any therapy. A neurologist reviewed the patient's CT scan in which arachnoid cyst and porencephalic cyst were evident, and he assessed that no abnormalities were found in motor, sensory, and mental state examination. EEG did not show any epileptiform or seizure-like activity. No antiepileptic drug was prescribed due to the absence of symptoms since many years. The patient had no neurological symptoms during pregnancy or obstetric complications and delivered at term a healthy baby through a caesarean section. She breastfed, and after two years, the patient and the baby are healthy. The association of porencephalic and arachnoid cyst in pregnancy is an extremely rare neurological condition that needs a multidisciplinary counseling in pregnancy, but an uneventful course is possible.
Successful Treatment of Chidamide and Cyclosporine for Refractory/Relapsed Angioimmunoblastic T Cell Lymphoma With Evans Syndrome: A Case Report With Long-Term Follow-Up
Authors: Fang Zhu, Qiuhui Li, Huaxiong Pan, Yin Xiao, Tao Liu, Xinxiu Liu, Juan Li, Gang Wu, Liling Zhang
Journal: Front Oncol (2020)
Keywords: evans syndrome, angioimmunoblastic t cell lymphoma, case report, chemotherapy, chidamide, cyclosporine
MeSH terms: Case Reports

Background:
Refractory/relapsed angioimmunoblastic T cell lymphoma (AITL) with Evans syndrome is a very rare condition with a poor prognosis. There is no evidence-based treatment strategy for refractory/relapsed AITL with Evans syndrome.
Case presentation:
A 51-year-old female was admitted to our hospital with multiple enlarged bilateral cervical lymph nodes, more than 1 week-long chest distress, and night sweats in July 2014. An excision biopsy of the left cervical enlarged lymph node revealed AITL. However, the patient showed resistance to the first-line chemotherapy for AITL and was diagnosed with refractory AITL. Complete remission was achieved after the salvage treatment with the combination of chemotherapy, radiotherapy, and immunomodulatory agent lenalidomide. Unfortunately, 12 months later, the patient suffered from disease progression and was diagnosed as refractory/relapsed AITL with Evans syndrome according to the laboratory findings and imaging. With the diagnosis of refractory/relapsed AITL with Evans syndrome, the patient received the first-line treatment for Evans syndrome including prednisone and intravenous immunoglobulin. The response to the first-line treatment for Evans syndrome was poor. The combination regimen of chidamide (30 mg, po, biw) and cyclosporine were administrated considering the treatment targeting simultaneously both refractory/relapsed AITL and Evans syndrome. The efficacy evaluation was complete remission. The last follow-up of the patient was April 30th, 2020, and no evidence of disease progression was observed. The overall survival of the patient was more than 70 months.
Conclusion:
The treatment for refractory/relapsed AITL combined with Evans syndrome remains challenging to patients and physicians. The combination of chidamide and cyclosporine may be an effective and tolerable regimen for the intractable AITL with Evans syndrome case and more observations are necessary to identify the efficacy and safety in the future.
A Rare Case of Cutaneous Plasmacytosis in a Korean Male
Authors: Corey Georgesen, Meenal Kheterpal, Melissa Pulitzer
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Cutaneous and systemic plasmacytosis are reactive disease processes that occur in middle-aged Japanese and Chinese men. Systemic plasmacytosis, defined by plasmacytic infiltration of two organ systems, might rarely progress to lymphoma. Cutaneous plasmacytosis, however, is chronic and benign and is characterized by the development of multiple plasma cell-rich infiltrates in the skin. We present a case of cutaneous plasmacytosis in a 46-year-old Korean male. The patient demonstrated classic features of the disease entity, including disseminated red-brown plaques, differentiated plasmacytoid infiltrates on biopsy, hypergammaglobulinemia, and the absence of systemic disease.
Primary hepatic neuroendocrine tumor: A case report and literature review
Authors: Adriano C Costa, Fernando Santa-Cruz, Henrique Guimarães, Alexandre R Paz, Eduardo A C Costa, José-Luiz Figueiredo, Álvaro A B Ferraz
Journal: Int J Surg Case Rep (2020)
Keywords: diagnostic imaging, immunohistochemistry, liver neoplasms, neuroendocrine tumors
MeSH terms: Case Reports

Introduction:
Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare, having less than 200 cases reported in the literature.
Presentation of case:
A 51-year-old woman presenting with mild intensity sharp pain in the upper abdomen that started 4 years ago. Preoperative Magnetic Resonance Imaging (MRI) suggested hepatocellular adenoma. Surgical exploration found a tumor occupying the whole segment IV of the liver, therefore a left hepatectomy was performed. Pathology and immunohistochemistry indicated to be a low-grade neuroendocrine tumor of the liver. The patient is enjoying a good quality of life, free of disease, presenting no signs of recurrence nor metastases 12 months after the procedure.
Conclusion:
The clinical presentation of PHNETs is non-specific and its radiologic features are intensely diversified, frequently leading to misdiagnosis of other hepatic neoplasms.
Management of Primary Squamous Cell Carcinoma of the Pancreas: A Case Report
Authors: Danling Guo, Chao Chen, Sangying Lv, Guanzuan Wu, Wei Shi, Huaifeng Li, Hongjie Hu
Journal: Front Surg (2021)
Keywords: mri, carcinoma, pancreas, response, squamous cell, treatment strategy
MeSH terms: Case Reports

Introduction: Primary squamous cell carcinoma of the pancreas (SCCP) is a rare malignant tumor that has been reported in individual case reports only. The clinical data on primary SCCP treatment are limited. Therefore, the appropriate management strategy for this disease should be standardized. Case Presentation: We present the case of a 63-year-old man admitted to our hospital for upper left abdominal pain for 2 months without weight loss or jaundice. Enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen revealed a mixed solid and cystic lesion in the pancreatic tail, measuring 35 × 37 mm in maximum diameter with enhancement. The patient was diagnosed with primary SCCP without metastasis, based on radiological and pathological findings. He did not receive neoadjuvant therapy postoperatively and was followed up by CT and MRI for 18 months without recurrence or metastasis. Result: Complete resection is the most effective treatment for early stage primary SCCP. Abdominal MRI is an effective imaging tool for preoperative evaluation and postoperative follow-up of primary SCCP. The need for neoadjuvant therapy depends on various factors. Conclusion: Primary SCCP is a tumor with poor prognosis. Risk factor control, early accurate radiologic evaluation, and individualized treatment strategies improve the quality of life and prolong the overall survival period of patients.
Annular pigment band on the posterior capsule following blunt ocular trauma: a case report
Authors: Aashish Anand, Rosalind J Harrison
Journal: BMC Ophthalmol (2005)
MeSH terms: Eye Injuries / complications, Lens Capsule, Crystalline / injuries, Lens Capsule, Crystalline / pathology, Lens Diseases / etiology, Pigmentation Disorders / etiology, Wounds, Nonpenetrating / complications, Case Reports, Adult, Humans, Ligaments / pathology, Male

Background:
To report an unusual case of annular pigment band on the posterior capsule following blunt ocular trauma.
Case presentation:
We describe an annular pigment band on the posterior capsule following blunt ocular trauma in a 28-year old male patient. Repeat examinations revealed no evidence of other signs of blunt ocular trauma or pigment dispersion syndrome in either eye.
Conclusion:
The annular pigment band in this case corresponds to the adherence of the hyaloideocapsulare ligament to the posterior capsule and reconfirms its rare visualization in the living eye. This finding may be an isolated sign of blunt ocular trauma and a compromised integrity of the vitreolenticular interface should be strongly suspected. We recommend careful documentation in context of future cataract surgery in these eyes.
Delusional parasitosis with hyperthyroidism in an elderly woman: a case report
Authors: Eylem Ozten, Ali Evren Tufan, Cem Cerit, Gökben Hızlı Sayar, Irem Yalug Ulubil
Journal: J Med Case Rep (2013)

Introduction:
Delusional parasitosis is a rare, monosymptomatic psychosis involving a delusion of being infested with parasites. It is commonly observed among female patients over the age of 50. It is classified as a 'delusional disorder' according to the 10th revision of the International Classification of Diseases and as a 'delusional disorder - somatic type' according to the Diagnostic and Statistical Manual, Fourth Edition. Delusional parasitosis was reported to be associated with physical disorders such as hypoparathyroidism, Huntington's chorea and Alzheimer's disease, among others. Other than vitamin deficiencies however, a causal relationship has not to date been identified. We present this case due to the rarity of Turkish patients with this condition, its duration of follow-up, and its temporal pattern of symptoms paralleling thyroid function tests.
Case presentation:
Our patient was a 70-year-old white Anatolian Turkish woman with primary school education who had been living alone for the past five years. She presented to our psychiatry department complaining of 'feeling large worms moving in her body'. The complaints started after she was diagnosed with hyperthyroidism, increased when she did not use her thyroid medications and remitted when she was compliant with treatment. She was treated with pimozide 2mg/day for 20 months and followed-up without any antipsychotic treatment for an additional nine months. At her last examination, she was euthyroid, not receiving antipsychotics and was not having any delusions.
Conclusion:
Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the etiology and that atypical antipsychotics may help in the management of primary delusional parasitosis. Further studies on the relationship between thyroid hormones and dopaminergic neurotransmission may be warranted.
The Influence of Liver Transplant on Serum Cholinesterase Levels: A Case Report
Authors: George Stancu, Elena Laura Iliescu
Journal: Cureus (2023)
Keywords: alcohol related cirrhosis, liver failure, liver function, liver transplant recipients, serum cholinesterase
MeSH terms: Case Reports

Cholinesterase is a serum enzyme synthesized mainly by the hepatocyte. Serum cholinesterase levels tend to decrease in time in patients with chronic liver failure and can indicate the intensity of liver failure. The lower the value of serum cholinesterase, the higher the possibility of liver failure. A reduction in liver function induced a drop in the level of serum cholinesterase. We present a patient with end-stage alcoholic cirrhosis and severe liver failure that received a liver transplant from a deceased donor. We compared blood tests and serum cholinesterase before and after the liver transplant. The hypothesis is that the value of serum cholinesterase increases after a liver transplant, and we noticed a significant increase in cholinesterase levels after the transplant. Serum cholinesterase activity increases after a liver transplant and it indicates that the liver function reserve will reach a higher level after the transplant, according to the new liver function reserve.
Autobullectomy with COVID-19 in a patient with chronic obstructive pulmonary disease
Authors: Shinya Yokoe, Daisuke Kinose, Yasumitsu Ueki, Shogo Okuda, Tsukasa Nakanishi, Tomoko Iriyama, Akio Yamazaki, Satoru Kawashima, Yasuki Uchida, Hiroaki Nakagawa, Masafumi Yamaguchi, Yasutaka Nakano
Journal: Respir Med Case Rep (2023)
Keywords: autobullectomy, chronic obstructive pulmonary disease, coronavirus disease 2019
MeSH terms: Case Reports

A 72-year-old man with chronic obstructive pulmonary disease (COPD) was admitted for coronavirus disease 2019 (COVID-19). He was discharged on day 30; however, he was readmitted 6 days later due to a left lung organizing pneumonia secondary to COVID-19. After methylprednisolone treatment, the patient was discharged on day 15. One year later, computed tomography showed shrinkage of emphysematous lesions, and both total lung capacity measured using computed tomography and fraction of low attenuation volume decreased in the left lung compared to that before COVID-19. Here, we report a rare case of autobullectomy with COVID-19 in a patient with COPD.
Self-inflicted strangulation of prepuce in a child
Authors: Fikret Halis, Mehmet Inci, Matthew T Freier, Ahmet Gokce
Journal: APSP J Case Rep (2013)
Keywords: foreskin, trauma, penis
MeSH terms: Case Reports

Penile trauma is an uncommon but potentially serious injury presenting to pediatric emergency room. Strangulation injuries of the penis can be self-inflicted or occur accidentally. However, self-inflicted strangulation of the foreskin in children is rare. This is a case of 7-year-old uncircumcised boy who himself tied foreskin of prepuce with a cotton thread. The thread was cut and circumcision performed to remove the damaged foreskin.
Perthes Disease in a Child With Osteogenesis Imperfecta From a Rare Genetic Variant: A Case Report
Authors: Pan Hong, Xiaolong Zhao, Ruikang Liu, Saroj Rai, Yingying Song, Ruijing Xu, Jin Li
Journal: Front Genet (2022)
Keywords: col1a1 gene, legg-calve-perthes disease, perthes disease, case report, osteogenesis imperfecta
MeSH terms: Case Reports

Background: Although certain genetic components have been reported as contributing factors for Perthes disease, its etiology remains unclear. We present a rare case of Perthes disease in a child with osteogenesis imperfecta (OI) caused by a mutation in the COL1A1 gene (NM_000088):exon25:c.1726C>T, (p.Gln576X). Case presentations: A 7-year-old boy was initially treated at our medical facility in March 2016 with a history of chronic pain in right hip joint and limping for a year. He was diagnosed as Perthes disease in the right hip joint. He underwent acetabular osteotomy and ipsilateral proximal femoral varus osteotomy for better containment. During the follow-ups, the right hip demonstrated a normal range of motion without pain, and the pelvic X-ray demonstrated Stulberg Type II hip joint with a round femoral head. In the latest admission in 2022, he suffered from a right femoral shaft fracture after petty violence. After reviewing his medical history, he was suspected of having OI. The whole exome sequencing demonstrated a gene mutation in COL1A1 (OMIM 166200) and confirmed the diagnosis of OI. Telescopic nailing was used to treat the femoral shaft fracture. After the nailing of the right femur, the appearance of the lower extremity seemed normal and symmetrical. Conclusion: This study revealed that there might be an association between OI and Perthes disease. Our case report enriches the phenotypes of osteogenesis imperfecta and provides insight into the pathogenesis of LCPD.
An unusual cause of dysphagia in ductal breast cancer due to submucosal oropharyngeal metastatic spread: a case report
Authors: Dorothy M Gujral, Mara Quante, Richard Aj Simcock
Journal: Cases J (2009)

Introduction:
Invasive ductal and lobular carcinomas represent 67.9% and 6.3% of breast carcinoma, respectively. Metastatic breast cancer typically involves the lungs, bones, brain, and liver. Studies have shown differing patterns of metastatic spread between ductal and lobular carcinoma. Lobular carcinoma is more likely to metastasise to the gastrointestinal tract.
Case presentation:
We report the case of a 49 year old white woman with invasive ductal carcinoma with lobular differentiation who developed submucosal oropharyngeal metastases nearly two years after her original diagnosis after presenting with odynophagia and dysphagia. The patient's symptoms preceded any associated radiological or endoscopic abnormalities by at least 9 months. Repeat computed tomography scan and eventual oropharyngeal biopsy confirmed submucosal metastatic invasive ductal carcinoma, suggesting occult submucosal spread.
Conclusion:
This case illustrates the importance of maintaining a high index of suspicion for metastatic disease in patients with invasive breast cancer who present with unusual symptoms and a careful search for metastatic sites.