OpenMed/multicare-articles huggingface dataset:
Hirsutism Caused by Pregnancy Luteoma in a Low-Resource Setting: A Case Report and Literature Review
Authors: David Hamisi Mvunta, Fatemazahra Amiji, Mubina Suleiman, Francisco Baraka, Ikrah Abdallah, Mabula Kazabula, Peter J T Wangwe, Furaha August
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Background:
Pregnancy luteomas are rare, benign, ovarian neoplasms resulting from increased androgenic activity during pregnancy. Often, they occur asymptomatically and are only diagnosed incidentally during imaging or surgery: cesarean section or postpartum tubal ligation. Most common symptoms associated with pregnancy luteoma include acne, deepening of voice, hirsutism, and clitoromegaly. Most pregnancy luteomas regress spontaneously postpartum. Thus, the management of pregnancy luteomas depends on the clinical situation.
Case:
We report a case of 28-year-old gravida 2, para 1 who presented at 39 + 1 weeks of gestation with prolonged labor and delivered by emergency cesarean. Intraoperatively, a huge left ovarian mass was identified and resected, and tissue was sent for histopathology and a diagnosis of pregnancy luteoma was made after the pathological report.
Conclusion:
The present report emphasizes that pregnancy luteoma is a benign neoplasm and imprudent surgical intervention should be reserved. Proper imaging techniques, preferably MRI or ultrasonography that visualize the size of the ovary and reproductive hormonal profiles, would suffice for the diagnosis and management of pregnancy luteoma.
Multiple Metastases of the Liver and Lung After Breast-Conserving Surgery for Ductal Carcinoma In Situ Without Microinvasion of the Breast: A Case Report and Literature Review
Authors: Zhen Wang, Xinyang Zhang, Huiyang Ren, Lei Zhang, Bo Chen
Journal: Front Oncol (2022)
Keywords: breast cancer, breast-conserving surgery, distant metastases, ductal carcinoma in situ, microinvasion
MeSH terms: Review

Background:
Ductal carcinoma in situ (DCIS) is a non-invasive disease that rarely causes distant metastasis. It is extremely rare for patients diagnosed with DCIS without microinvasion to develop distant metastasis in the absence of ipsilateral or contralateral breast recurrence. This is the first case report of multiple liver and lung metastases from DCIS after breast-conserving surgery and radiotherapy.
Case presentation:
A 45-year-old woman who was diagnosed with DCIS and received breast-conserving surgery, radiotherapy, and sequential endocrine therapy developed multiple metastases in the liver and lung despite not having bilateral breast recurrence at the 62-month follow-up. Comprehensive advanced breast cancer therapy was administered but did not prevent the progression of metastatic foci in the liver.
Conclusions:
This case shows the poor potential outcome in DCIS. Further research should be conducted on metastasis in DCIS; reexamination and monitoring are indispensable for patients diagnosed with DCIS.
Familial Russell-Silver Syndrome like Phenotype in the PCNA Domain of the CDKN1C Gene, a Further Case
Authors: A H Sabir, G Ryan, Z Mohammed, J Kirk, N Kiely, M Thyagarajan, T Cole
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

We present two half siblings with significant short stature who proved a diagnostic challenge for several years. Radiological findings included subtle epiphyseal changes. The diagnosis was made through whole genome sequencing via the 100,000 genome project. A maternally inherited pathogenic heterozygous CDKN1C variant was found in the PCNA (proliferating cell nuclear antigen) domain. Mutations of the PCNA domain of the CDKN1C gene are known to be associated with IMAGe syndrome thus with adrenal disease, although neither affected patient in our case had evidence of adrenal dysfunction. This report supports the previously reported findings of Russell-Silver syndrome (RSS) like phenotype caused by this unusual mechanism (CDKN1C mutations in the PCNA domain), highlights subtle radiological features not described previously and the phenotypic variability between two affected siblings. Additionally it reminds clinicians of the importance of considering associated adrenal disease/diabetes mellitus for variants within the PCNA domain. Finally it confirms RSS-like disorders should be considered in patients who have epiphyseal or metaphyseal changes and short stature, since CDKN1C PCNA domain mutations can result in this phenotype.
Paroxysmal Symptoms As the First Manifestation of Multiple Sclerosis Mimicking a Transient Ischemic Attack: A Report of Two Cases
Authors: Yao Zhang, Siyuan Fan, Fei Han, Yan Xu
Journal: Front Neurol (2017)
Keywords: mimic, multiple sclerosis, paroxysmal symptoms, transcranial doppler, transient ischemic attack
MeSH terms: Case Reports

Paroxysmal symptoms are unusual manifestations of multiple sclerosis (MS). When presented as the first clinical manifestation, paroxysmal symptoms may easily be mistaken for transient ischemic attack (TIA). Previously, several cases of MS that reported with paroxysmal symptoms were misdiagnosed as TIA. Here, we report two additional cases, focusing on the clinical characteristics of paroxysmal symptoms in MS. Both cases had paroxysmal symptoms as their first manifestation; one presented with transient dizziness, left face numbness, and right limb weakness, and the other presented with episodic lightheadedness, blurred vision, nausea, palpitations, and tremulousness upon standing. Both of the patients' symptoms were mistaken for TIA at first, based on microembolic signals recorded by transcranial Doppler, but were later correctly diagnosed with MS based on neuroimaging and lumbar puncture. The paroxysmal symptoms responded to carbamazepine and were relieved completely after administration of intravenous methylprednisolone and interferon. Herein, we aim to summarize the differences between paroxysmal symptoms seen in MS and TIA, to facilitate a timely differential diagnosis and recommend an early appropriate treatment.
Stumped by rapid symptomatic prostatic regrowth: A case report on a STUMP tumour of the prostate resected with HoLEP
Authors: Tareq Al Tell, Lorenzo Marconi, Paul Cathcart, Benjamin Challacombe
Journal: Int J Surg Case Rep (2019)
Keywords: benign, holep, prostate, stump, turp

Introduction:
Stromal Tumour of Undetermined malignant potential (STUMP) is a rare category of the prostate benign tumours, which has a variable clinical presentation, behavior and different approaches to manage it.
Case presentation:
A 57 year-old male presented with voiding symptoms of the urinary tract and an increased PSA (14.7 ng/ml). Ultrasound and multiparametric MRI showed an enlarged prostate of 41 ml. Transurethral resection of the prostate (TURP) was performed with 11 g benign tissue removed. The patient presented one year later with the same symptoms; further ultrasound and parametric MRI demonstrated huge recurrence in the transition zone with a new prostate size of 131 ml.
Discussion:
Despite no malignancy being identified in the initial TURP histology, the transition zone prostatic tumour behaved aggressively and recurred in just one year. For the first time in literature, the tumour recurred rapidly to three times the initial size and was removed using Holmium Laser enucleation of the prostate (HoLEP), after which no recurrence was seen in 11 months period.
Conclusion:
HoLEP can be used to successfully enucleate STUMP tumours but the clinical behavior of the STUMP in prostate is still not understood well because of its rareness.
Metastasizing pleomorphic adenoma of the parotid gland
Authors: Javier Soteldo, Nathasha Aranaga
Journal: Ecancermedicalscience (2017)
Keywords: adenoma, bibliographic review, case report, metastasizing pleomorphic adenoma, parotid gland, salivary glands
MeSH terms: Case Reports

Salivary gland tumours are estimated to represent approximately 3% of all head and neck tumours. About 70-80% of these neoplasms occur in the major salivary glands, with the parotid gland being the most commonly affected site. The metastasizing pleomorphic adenoma (MPA) has histological characteristics of pleomorphic adenoma, but it has the capacity to generate local recurrences and distant metastases (mainly bones, lungs, and lymph nodes). Despite the fact that some authors consider it to be a benign neoplasia, the 2015 World Health Organisation (WHO) classification of head and neck tumours considers it to be malignant. We present a highly unusual case of metastasizing pleomorphic adenoma of the parotid gland and a bibliographic review.
Cocaine-induced granulomatosis with polyangiitis-an under-recognized condition
Authors: Charn Gill, Joseph Sturman, Leyla Ozbek, Scott R Henderson, Aine Burns, Sally Hamour, Ruth J Pepper, Lisha McClelland, Dimitrios Chanouzas, Simon Gane, Alan D Salama, Lorraine Harper
Journal: Rheumatol Adv Pract (2023)
Keywords: anca, cocaine, drug-induced vasculitis, granulomatosis with polyangiitis, treatment

Objectives:
Cocaine and cocaine mixed with levamisole are increasingly used in the UK and result in significant direct nasal damage in addition to promoting vasculitis. Our aims were as follows: (1) to identify the main symptoms and presentation of cocaine-induced vasculitis; (2) to provide evidence regarding the best practice for the investigation and diagnosis of cocaine-induced vasculitis; and (3) to analyse the clinical outcomes of patients in order to understand the optimal management for the condition.
Methods:
We performed a retrospective case series analysis of patients presenting with cocaine-induced midline destructive lesions or vasculitis compatible with granulomatosis with polyangiitis (GPA) from two large tertiary vasculitis clinics between 2016 and 2021.
Results:
Forty-two patients (29 Birmingham, 13 London) with cocaine-induced midline lesions or systemic disease were identified. The median age was 41 years (range 23-66 years). Current cocaine use was common, and 20 of 23 samples provided were positive when routine urine toxicology was performed; 9 patients who denied ever using cocaine were identified as using cocaine based on urine toxicology analysis, and 11 who stated they were ex-users still tested positive. There was a high incidence of septal perforation (75%) and oronasal fistula (15%). Systemic manifestations were less common (27%), and only one patient had acute kidney injury. Fifty-six per cent of our patients were PR3-ANCA positive, with none testing positive for MPO-ANCA. Symptom remission required cocaine discontinuation even when immunosuppression was administered.
Conclusion:
Patients with destructive nasal lesions, especially young patients, should have urine toxicology performed for cocaine before diagnosing GPA and considering immunosuppressive therapy. The ANCA pattern is not specific for cocaine-induced midline destructive lesions. Treatment should be focused on cocaine cessation and conservative management in the first instance in the absence of organ-threatening disease.
Case report of an endovascular repair of a residual type A dissection using a not CE not FDA-approved Najuta thoracic stent graft system
Authors: N Mangialardi, S Ronchey, A Malaj, M Lachat, E Serrao, V Alberti, S Fazzini
Journal: Medicine (Baltimore) (2015)
MeSH terms: Aortic Rupture / surgery, Device Approval / legislation & jurisprudence, Endovascular Procedures / methods, Minimally Invasive Surgical Procedures / methods, Stents, Case Reports, Europe, Humans, Japan, Male, Middle Aged, Treatment Outcome, United States

This report describes an endovascular repair of a residual type A dissection using a medical device that is not marked by european conformity (CE) or Food and Drug Administration (FDA).The patient underwent ascending aortic surgery for acute type A dissection. The 2-year angio-computed tomography demonstrated patency of the residual false lumen with evolution into a 6 cm aneurysm, the extension of the dissection from the aortic arch to the aortic bifurcation with thrombosis of the right common iliac artery. There was no CE- or FDA-marked medical device indicated for this case or any other acceptable therapeutic alternative.We used the Najuta thoracic stent graft and successfully handled the pathology in a multiple-phase treatment.Technology is evolving with specific grafts for the ascending and fenestrated grafts for the aortic arch. In this single case the Najuta endograft, in spite of the periprocedural problems, was a valid therapeutic option.
A Case Series of Penile Skin Grafting in Children
Authors: Lin Qiu, Xuan Zhang, Yan Liu, Yuexian Fu, Xingang Yuan
Journal: European J Pediatr Surg Rep (2020)
Keywords: lymphedema, pediatric, penis, skin grafts
MeSH terms: Case Reports

Pediatric penile skin grafting is rarely performed. We present a case series of four pediatric patients receiving skin grafting due to the loss of penile skin. The four boys were followed up for 1 to 5 years. One full-thickness skin graft and three split-thickness skin grafts (STSGs) survived well with low Vancouver scar scale scores. One boy gradually developed lymphedema of the distal foreskin and underwent a second preputioplasty. He presented with normal erectile function and did not experience any pain. We propose thick STSGs as the most appropriate choice for pediatric penile skin reconstruction. Lymphedema of the foreskin is an important long-term complication of penile skin grafting.
Correction of Diastasis Rectus Abdominis with Tacking the Rectus Sheath and Resection of Excess Skin for Cosmesis
Authors: Kento Takaya, Noriko Aramaki-Hattori, Hanayo Yabuki, Norihito Wada, Shigeki Sakai, Keisuke Okabe, Kazuo Kishi
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Introduction:
We report a case of diastasis rectus abdominis (DRA), in which the improvement of the appearance was obtained by performing extra skin resection. Case Report. A 30-year-old woman presented persistent abdominal bulging after her second delivery. She was diagnosed as DRA by computed tomography. We underwent a surgery that tacking the anterior layer of the rectus sheath and resecting excess skin.
Results:
There has been no clinical evidence of recurrence, and the patient satisfies her abdominal appearance.
Conclusion:
Because DRA is not a true hernia, surgery for DRA should be performed in understanding how patients want to improve their aesthetic appearance.
NECROTIZING PANCREATITIS: DESCRIPTION OF VIDEOSCOPIC ASSISTED RETROPERITONEAL DEBRIDEMENT (VARD) TECHNIQUE WITH COVERED METALLIC STENT
Authors: Eduardo J Houghton, Alain A García Vázquez, Manuel E Zeledón, Andrea Andreacchio, Gabriel Ruiz, Mariano Palermo, Mariano E Gimenez
Journal: Arq Bras Cir Dig (2018)
MeSH terms: Debridement / methods, Pancreatitis, Acute Necrotizing / surgery, Stents, Case Reports, Adult, Humans, Laparoscopy, Male, Prosthesis Design, Retroperitoneal Space, Surgery, Computer-Assisted, Video Recording

Background:
Acute pancreatitis is the third most common gastrointestinal disorder requiring hospitalization in the United States, with annual costs exceeding $2 billions. Severe necrotizing pancreatitis is a life-threatening complication developed in approximately 20% of patients. Its mortality rate range from 15% in patients with sterile necrosis to up 30% in case of infected one associated with multi-organ failure. Less invasive treatment techniques are increasingly being used. These techniques can be performed in a so-called step-up approach.
Aim:
To present the technique for videoscopic assisted retroperitoneal debridement (Vard technique) with covered metallic stent in necrotizing pancreatitis.
Method:
A guide wire was inserted through the previous catheter that was removed in the next step. Afterwards, the tract was dilated over the guide wire. Then, a partially covered metallic stent was deployed. A 30 degrees laparoscopic camera was inserted and the necrosis removed with forceps through the expanded stent under direct vision. Finally, the stent was removed and a new catheter left in place.
Result:
This technique was used in a 31-year-old man with acute pain in the upper abdomen and diagnosed as acute biliary pancreatitis with infected necrosis. He was treated with percutaneous drains at weeks 3, 6 and 8. Due to partial recovery, a left lateral VARD was performed (incomplete by fixed and adherent tissue) at 8th week. As the patient´s inflammatory response was reactivated, a second VARD attempt was performed in three weeks later. Afterwards, patient showed complete clinical and imaging resolution.
Conclusions:
Videoassisted retroperitoneal necrosectomy using partially covered metallic stent is a feasible technique for necrotizing pancreatitis.
Intramural ectopic pancreatic tissue of the stomach: A case report of an uncommon origin of a non-cancerous gastric tumour
Authors: Enrica Chiriatti, Paulina Kuczma, Domenico Galasso, E Koliakos, Edgardo Pezzetta, Olivier Martinet
Journal: Int J Surg Case Rep (2020)
Keywords: abdominal surgery, case report, gastric tumour, gastrointestinal surgery, heterotopic pancreas, pancreas
MeSH terms: Case Reports

Introduction:
Ectopic pancreatic tissue is often incidentally encountered during abdominal surgery. We report a case of an incidental finding during a laparoscopic appendectomy, the approach to diagnosis and management of this. The work has been reported in line with the SCARE criteria.
Presentation of case:
A 32 year-old woman was diagnosed with an intramural pre-pyloric mass during a laparoscopic appendectomy. The lesion was identified on a subsequent computed tomography as a homogenous mass on the greater curvature. Upper esophagho-gastro-duodenoscopy was normal. The intramural mass was confirmed by an endoscopic sonography and the fine needle biopsy showed aspecific inflammatory cells. A laparoscopic wedge resection was realized. Histopathologic examination confirmed the diagnosis of an ectopic pancreatic tissue.
Discussion:
The management of ectopic pancreas poses a medical challenge. The diagnostic quiver consists of radiologic exams and endoscopy, in combination with a direct biopsy of the lesion.
Conclusion:
Despite the plethora of diagnostic modalities available, a definitive diagnosis for heterotopic pancreas often remains elusive, requiring more invasive diagnostic means. Although ample information is available in literature, there are currently no evidence-based guidelines regarding diagnosis and management of heterotopic pancreas.
A rare case of isolated mitral valve endocarditis by Gemella sanguinis: Case report and review of the literature
Authors: Antonios C Sideris, Eric Zimmermann, Takuya Ogami, Dimitrios V Avgerinos
Journal: Int J Surg Case Rep (2020)
Keywords: case report, endocarditis, gemella sanguinis, mitral valve
MeSH terms: Case Reports

Introduction:
Gemella sanguinis is an extremely rare cause of infectious endocarditis, with only 12 cases previously reported in the literature. Here we report the third known case of isolated mitral valve endocarditis secondary to G. sanguinis.
Presentation of case:
A 53-year-old man with mitral valve prolapse and history of recent dental instrumentation presented with malaise, thigh and finger pain and new pansystolic murmur. He was diagnosed with severe mitral insufficiency due to infectious endocarditis secondary to G. sanguinis. He underwent mitral valve replacement and was treated with a long course of antibiotics.
Discussion:
G. sanguinis is a rare cause of infectious endocarditis with very few reported cases in the literature. In the majority of reported cases, a strategy of valve replacement along with prolonged antibiotic course results in good outcome for the patient.
Direct comparison of different surgical approaches in a woman with bilateral osteochondrosis dissecans of her knees: a case report
Authors: Marco M Schneider, Stefan Preiss, Gian M Salzmann
Journal: J Med Case Rep (2016)
MeSH terms: Cartilage, Articular / pathology, Femur / transplantation, Knee Joint / surgery, Osteochondritis Dissecans / surgery, Weight-Bearing, Case Reports, Adult, Bone Transplantation, Female, Follow-Up Studies, Humans, Knee Joint / diagnostic imaging, Knee Joint / physiopathology, Magnetic Resonance Imaging, Osteochondritis Dissecans / diagnostic imaging, Osteochondritis Dissecans / rehabilitation, Osteogenesis, Radiography, Return to Sport, Time Factors, Transplantation, Autologous, Treatment Outcome

Background:
Osteochondrosis dissecans is a disorder of the subchondral bone potentially affecting the adjacent articular cartilage. There remains disunity with regard to treatment methods.
Case presentation:
We present the case of a 21-year-old Swiss woman who presented with clinically symptomatic bilateral osteochondrosis dissecans lesions at both medial femoral condyles. She underwent sequential surgical intervention and was prospectively monitored using clinical scores and magnetic resonance imaging. Her left knee was treated with an open refixation of the osteochondrosis dissecans lesion with two 2.0 mm screws in combination with a cancellous bone graft and subchondral drilling since the cartilage of the osteochondrosis dissecans lesion was intact. On her right knee, she underwent open removal of the defective bone and cartilage, cancellous bone graft with subchondral drilling and coverage with a bilayered collagenous membrane (autologous matrix-induced chondrogenesis technique) since the cartilage of the osteochondrosis dissecans lesion was not intact. At final follow-up 12 months after surgery her Lysholm score had improved from 79 to 95 on her left side and from 74 to 78 on her right. Magnetic resonance imaging displayed good integration of the cancellous bone graft with a slight irregularity at the articular surface on her left side (magnetic resonance observation of cartilage repair tissue (MOCART) 75). The magnetic resonance imaging of her right knee depicted satisfying bony reconstitution with yet more irregularity at the joint surface (magnetic resonance observation of cartilage repair tissue 65) in comparison to her left femoral condyle.
Conclusions:
In cases of failed conservative treatment of osteochondrosis dissecans lesions of the knee joint surgery should be taken into consideration. Considering this case, we believe that the focus should be the preservation of the cartilaginous layer whenever possible or at least replacement with high quality replacement tissue, such as autologous chondrocyte implantation.
Nontraumatic Parapharyngeal Haematoma: A Rare Lesion
Authors: Pedro Carneiro de Sousa, Inês Gambôa, Delfim Duarte, Nuno Trigueiros-Cunha
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Nontraumatic haematoma of parapharyngeal space is very rare and may cause dysphagia and dyspnea. The authors present a case report of a 74-year-old woman with sudden nontraumatic neck swelling without dyspnea and with left pharyngeal bulging and endolaryngeal displacement. Parathyroid hormone elevation and imaging exams confirmed bleeding from a parathyroid adenoma. Symptoms and signs resolved after one week of conservative treatment. There are few cases of parapharyngeal haematomas caused by parathyroid adenomas. Most patients can be managed without emergent surgery, but close airway monitoring is fundamental.