OpenMed/multicare-articles huggingface dataset:
Successful treatment of lipofibromatosis-like neural tumor of the lumbar spine with an NTRK-fusion inhibitor
Authors: Megan Dupuis, Yulei Shen, Christian Curcio, Jeanne M Meis, Wei-Lien Wang, Behrang Amini, Laurence Rhines, Jacquelyn Reuther, Angshumoy Roy, Kevin E Fisher, Anthony P Conley, J Andrew Livingston
Journal: Clin Sarcoma Res (2020)
Keywords: entrectinib, lpf-nt, lipofibromatosis-like neural tumors, ntrk
MeSH terms: Case Reports

Background:
Lipofibromatosis-like neural tumors (LPF-NT) are a newly identified class of rare mesenchymal neoplasms. Current standard of care therapy is surgical resection alone; there are no chemotherapies or molecular targeted therapies that have been shown to be effective in patients who are not surgical candidates due to either tumor bulk or location. Most LPF-NT harbor NTRK fusions, although the therapeutic significance of these fusions has not been previously demonstrated in this malignancy. Here, we present the first case of a patient with surgically-unresectable LPF-NT successfully treated with medical therapy, specifically the TRK fusion-protein inhibitor entrectinib.
Case presentation:
The patient is a 21 year old man with no co-morbidities who presented for evaluation due to intermittent abdominal pain and was found to have a mass spanning from T12-L2. Biopsy revealed a mesenchymal spindle cell neoplasm and S100 positivity pointed to possible nerve sheath origin. The sample was ultimately found to have an LMNA-NTRK1 fusion, confirming the diagnosis of LP-NFT. Unfortunately, due to the bulk and location of the tumor, surgery was felt to be exceptionally morbid and the patient was treated in a clinical trial with the NTRK inhibitor entrectinib. Surprisingly, he had such a robust clinical response that he was ultimately deemed a surgical candidate and he was successfully taken to surgery. Post-operative pathology revealed > 95% necrosis, demonstrating exceptional sensitivity to the targeted therapy. The patient remains NED and on entrectinib 12 months post-operatively.
Conclusions:
The exceptional treatment response of this patient suggests that NTRK fusions are true drivers of the disease. Thus, all patients should be evaluated for NTRK fusions using sensitive methodologies and treatment with TRK fusion-protein inhibitors should be considered in patients who are not candidates for oncologic resection.
Is mammary not otherwise specified-type sarcoma with CD10 expression a distinct entity? A rare case report with immunohistochemical and ultrastructural study
Authors: Guang-Zhi Yang, Jing Li, Hua Jin, Hua-Ye Ding
Journal: Diagn Pathol (2013)
MeSH terms: Biomarkers, Tumor / analysis, Breast Neoplasms / immunology, Breast Neoplasms / ultrastructure, Immunohistochemistry, Neprilysin / analysis, Sarcoma / immunology, Sarcoma / ultrastructure, Case Reports, Research Support, Non-U.S. Gov't, Breast Neoplasms / surgery, Cell Differentiation, Diagnosis, Differential, ErbB Receptors / analysis, Female, Fibroblasts / immunology, Fibroblasts / ultrastructure, Humans, Microscopy, Electron, Middle Aged, Neoplasm Grading, Predictive Value of Tests, Sarcoma / surgery, Vimentin / analysis, Biomarkers, Tumor, Vimentin, EGFR protein, human, ErbB Receptors, Neprilysin

Mammary sarcoma is extremely rare and the diagnosis is established only after metaplastic carcinomas and malignant phyllodes tumours are excluded. A rare case of not otherwise specified-type sarcoma with CD10 expression in the left breast in a 45-year-old female was presented. It was a high-grade tumour composed of spindle cells histologically. The immunohistochemical results showed that CD10, vimentin and EGFR were positive diffusely and SMA presented focally, whereas epithelial markers and other myoepithelial or myogenic markers were all negative. The electron microscope investigation demonstrated fibroblast-like features. The exact entity of the tumour remains to be studied because it resembles undifferentiated sarcoma or sarcomatoid metaplastic carcinoma to some degree, as well as high-grade malignant phyllodes tumour in particular.
Virtual slides:
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9019879588725702.
Ultrasound-guided transversus abdominis plane block as an effective anesthetic technique for transverse colostomy in a high-risk elderly patient: A case report
Authors: Chao Li, Jingpu Shi, Huiqun Jia
Journal: Front Med (Lausanne) (2023)
Keywords: case report, elderly, transverse colostomy, transversus abdominal plane block, ultrasound
MeSH terms: Case Reports

Ultrasound-guided transversus abdominis plane (TAP) block is considered to be one of most prevalent and effective adjuvant analgesic methods for various abdominal surgeries. However, whether TAP blocks can be used alone as an effective anesthetic technique in minor abdominal operations has rarely been reported. Here we presented a 66-year-old male who had sustained right somatic dysfunction and mild brain dysfunction caused by cerebral infarctions and poorly treated hypertension. The patient received a confine operation of transverse colostomy to alleviate an intestinal obstruction caused by rectal cancer. A 22G needle was advanced in the plane under ultrasound guidance until it reached the TAP. A total of 10 mL 0.375% ropivacaine with 5 mg dexamethasone and 10 μg dexmedetomidine was injected into the TAP. The operation went stably and smoothly without any complaints. After the operation, the patient returned to the care of the surgical recovery staff with patient-controlled intravenous analgesia (PCIA) containing 0.7 mg/kg oxycodone and 2.5 μg/kg dexmedetomidine. During the perioperative period, the elderly patient did not experience apparent or unbearable pain. All these evidences indicated the ultrasound-guided subcostal and lateral TAP block was a simple and effective procedure for transverse colostomy in a high-risk elderly patient.
Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix
Authors: Talal Al-Nahlawi, Maisour Ala Rachi, Amjad Abu Hasna
Journal: Int J Dent (2021)

Endodontic perforations are common accidents that occasionally happen as a result of misuse or difficult anatomy of some teeth; it may lead to teeth loss unless a good management is provided. Bioceramic (silicate-based) cements like mineral trioxide aggregate have a big role in management of such accidents. This case report aimed to evaluate the ability of five mineral oxides cement "5MO" in sealing two root canal perforations (furcation and postdrill perforations) and inducing clinical and radiographic healing in the periodontal tissues with/without the use of collagen sponge matrix. A 58-year-old healthy female was referred to our dental office complaining of severe pain in the upper left premolars' region. Periapical radiographic examination revealed unsatisfactory root canal treatment of the teeth #24 and #25 with a furcation perforation and a postdrill perforation, respectively. Cone-beam computed tomography "CBCT" scans confirmed the findings of the periapical radiography and revealed the presence of radiolucent lesions surrounding the apex of both teeth #24 and #25. The treatment plan was a nonsurgical root canal retreatment by endodontic access through the full-ceramic crowns. After three years of follow-up, CBCT scans revealed a complete healing and bone formation on both premolars. This case report indicates the use of 5MO cement for endodontic perforations management.
Spontaneous bacterial peritonitis caused by Edwardsiella tarda: A case report
Authors: Hirokatsu Hayashi, Yusuke Murase, Hitoya Sano, Kimitosi Nishio, Iwao Kumazawa
Journal: Int J Surg Case Rep (2020)
Keywords: cirrhosis, edwardsiella tarda, spontaneous bacterial peritonitis
MeSH terms: Case Reports

Introduction:
Edwardsiella tarda is a member of the Enterobacteriaceae family of gram-negative bacilli isolated from animals. Gastroenteritis is the most common manifestation of E. tarda infection. However, extraintestinal infections can occur in immunocompromised hosts as well as patients with hepatobiliary disease, malignancy, and/or diabetes mellites. The prognosis of sepsis caused by E. tarda is extremely poor, with a mortality rate of 38%. Here we report the occurrence of spontaneous bacterial peritonitis associated with E. tarda infection.
Presentation of case:
An 87-year-old man with Child-Pugh A cirrhosis secondary to hepatitis C virus infection presented with diarrhea and sudden-onset pain in the abdomen. On arrival, guarding and rebound tenderness were observed over the entire abdomen. Computed tomography revealed circumferential thickening of the cecum and a small volume of ascites in the pelvic cavity. A diagnosis of peritonitis was made, and surgery was performed. Surgical findings included redness and thickening of the cecal wall and purulent ascites without intestinal contents. Peritoneal fluid culture revealed E. tarda as the sole pathogen. The abdominal cavity was washed, a drain was placed in the pelvic cavity, and postoperative intravenous antibiotic therapy was initiated. The postoperative course was uneventful.
Discussion:
E. tarda infection in the presence of an underlying disease such as hepatobiliary disease, malignancy, and/or diabetes mellitus has a poor prognosis.
Conclusion:
Although E. tarda infection is extremely rare, it is a life-threatening illness that can cause intestinal and extraintestinal infections. If necessary, early surgical intervention should be considered for cases of extraintestinal infection.
Implementation of eMental health technologies for informal caregivers: A multiple case study
Authors: Sofia Bastoni, Lisette van Gemert-Pijnen, Robbert Sanderman, Anne van Dongen
Journal: Front Digit Health (2023)
Keywords: cfir, business modeling, ehealth, emental health, implementation, informal care, stakeholder involvement, values

Introduction:
Informal caregivers offer continuous unpaid support to loved ones who are unable to live independently. Providing care can be a very burdensome commitment, that heavily impacts informal caregivers' mental health. eMental health is a possible, yet challenging, solution to improve caregivers' mental health and their overall experience of caregiving. In fact, eMental health technologies often face challenges of implementation. The present work gathers knowledge on how to best deal with these challenges by collecting testimonies of implementation experts of eight eMental health technologies for informal caregivers with the aim of comparing them and extracting lessons learned.
Methods:
For this multiple case study, technologies were selected (through informal suggestions and independent search) according to the following inclusion criteria: they were intended for informal caregivers as main user group, were aimed at improving informal caregivers' mental wellbeing and caregiving experience and were available and running in real life settings in Europe. Ten interviews were conducted (two pilots and eight included cases). The interviewees were asked to provide a description of the technology and its aims and their implementation approach, method and frameworks used. Finally, determinants of implementation, the influence of the Covid-19 pandemic on implementation processes and lessons learned were investigated.
Results:
The results highlight key differences between technologies developed within academia and the industry regarding efficacy testing and use and use and choice of frameworks. Also, similarities in terms of recognized barriers such as financing are illustrated.
Discussion:
Possible ways to overcome main barriers and examples of best practices, such as structuring a business model and discussing tool maintenance and long-term hosting in advance, are discussed.
Surgical Application of the Suboccipital Subtonsillar Approach to Reach the Inferior Half of Medulla Oblongata Tumors in Adult Patients
Authors: Alejandra T Rabadán, Alvaro Campero, Diego Hernández
Journal: Front Surg (2016)
Keywords: brainstem, medulla oblongata, subtonsillar approach, surgery, tumors
MeSH terms: Case Reports

Medulla oblongata (MO) tumors are uncommon in adults. Controversies about their treatment arise regarding the need for histological diagnosis in this eloquent area of the brain, weighing benefits of a reliable diagnosis, and the potential disadvantages of invasive procedures. As a broader variety of pathological findings could be found in this localization, the accurate histopathological definition could not only allow an adequate therapy but also can prevent the disastrous consequences of empiric treatments. There are few publications about their surgical management and all belongs to small retrospective cohorts. In this scenario, we are reporting two patients with exophytic or focal lesions in the inferior half of the medulla, who underwent surgery by suboccipital midline subtonsillar approach. This approach was not specifically described to reach MO before, and we found that the lesions produced a mild elevation of the tonsils providing a wide surgical view from the medulla to the foramen of Luchska laterally, and up to the middle cerebellar peduncle, offering a wide and safe access.
Case Report: Protein-Losing Enteropathy in Association With Tuberculosis-Related Constrictive Pericarditis
Authors: Yue Xi, Zhi Chen, Kun Hao, Xiaorong Liu
Journal: Front Pediatr (2022)
Keywords: constrictive pericarditis, hematuria, hypoalbuminemia, intestinal lymphangiectasia, protein-losing enteropathy
MeSH terms: Case Reports

Protein-losing enteropathy (PLE) is a clinical disorder in which an excessive amount of serum protein is lost into the gastrointestinal tract, resulting in hypoproteinemia and malnutrition. PLE is associated with a wide range of gastrointestinal disorders and the rare complication of constrictive pericarditis. We report a case in which pericardiectomy achieved marked improvement of extremely severe hypoalbuminemia caused by PLE associated with tuberculosis-related constrictive pericarditis. The formation of diarrhea and edema was aggravated by PLE, resulting in hypoalbuminemia. Cardiac computed tomography showed a calcified pericardium. Echocardiography showed decreased cardiac function underlying PLE. Functional imaging with technetium-99m serum albumin identified the region of protein leakage as the intestine. After pericardiectomy, the diarrhea ceased completely. Serum albumin concentrations were increased (3.3-3.7 g/dL), which indicated resolution of the PLE.
Overlapping Phenotypes in Osteopetrosis and Pycnodysostosis in Asian-Indians
Authors: Parminder Kaur, Inusha Panigrahi, Harleen Kaur, Thakurvir Singh, Chakshu Chaudhry
Journal: Case Rep Genet (2021)
MeSH terms: Case Reports

Osteopetrosis is a disorder characterized by high bone density, hepatosplenomegaly, visual and hearing loss, and anemia. Pycnodysostosis presents with short stature, acroosteolysis, and dense bones. We, hereby, present here a family with autosomal dominant osteopetrosis and also children with recessive osteopetrosis and pycnodysostosis. The molecular confirmation was done in 3 cases. Genetic heterogeneity in clinical presentation is discussed here. Further studies will help in identifying epigenetic alterations and population-specific variants and also developing targeted therapies.
Waldenström macroglobulinemia in hepatitis C: case report and review of the current literature
Authors: Ryan Nipp, Aaron Mitchell, Allyson Pishko, Ara Metjian
Journal: Case Rep Oncol Med (2014)

Background. Recent literature has associated hepatitis C virus with the development of non-Hodgkin lymphoma. Hepatitis C virus infection appears to promote lymphoproliferation, providing a plausible mechanism for a causative association; however, despite prior reports of patients with comorbid hepatitis C infection and Waldenström macroglobulinemia, the literature is in disagreement regarding whether there exists an association between these two conditions. Case Presentation. This case report describes a 57-year-old African-American male with chronic hepatitis C infection and cryoglobulinemia who presented with several episodes of transient confusion and paralysis and was found to have symptomatic hyperviscosity. The recognition of his condition was facilitated by characteristic findings on ophthalmologic examination. He was subsequently diagnosed with Waldenström macroglobulinemia on bone marrow biopsy. Conclusions. An up to date, comprehensive review of the literature suggests an association between hepatitis C and Waldenström macroglobulinemia. Data on optimal treatment of patients with comorbid hepatitis C infection and Waldenström macroglobulinemia is limited. We have provided a comprehensive review of previously explored treatment options to guide management of other similar patients. Our patient has since been treated with repeated plasmapheresis with a plan to pursue antiviral therapy.
Cecal Volvulus as a Rare Complication of Osimertinib Dosed at 160 mg in Patients With EGFR-Mutant Non-small Cell Lung Cancer
Authors: Tejas Patil, Jose M Pacheco, Anastasios Dimou, William T Purcell, Candice Rossi, Paul A Bunn, Robert C Doebele, D Ross Camidge, Lisa Ferrigno
Journal: Front Oncol (2020)
Keywords: egfr, nsclc, osimertinib, tyrosine kinase inhibitor, volvulus
MeSH terms: Case Reports

Background: Osimertinib is a 3rd-generation tyrosine kinase inhibitor (TKI) that blocks the epidermal growth factor receptor (EGFR) in non-small lung cancer (NSCLC) and has dramatically improved outcomes for patients with EGFR mutations. While gastrointestinal complications such as diarrhea have been reported with EGFR inhibitors (due to off-target interactions with EGFR receptors within the gut lining), cecal volvulus is an extremely rare complication in advanced malignancy. To date, there are no reported cases associating cecal volvulus with any EGFR TKIs. Case Presentation: In this case series, we present three cases of cecal volvulus among patients with EGFR-positive NSCLC patients treated with osimertinib dosed at double the standard 80 mg dose (160 mg daily). No patient was receiving concurrent chemotherapy or bevacizumab at the time of this described complication. In two cases where pathology was available for review, peritoneal carcinomatosis or intra-abdominal spread was not observed. In a retrospective evaluation of 101 patients treated with osimertinib in our institution, there was a statistically significant difference in the incidence of cecal volvulus among patients receiving osimertinib at 160 mg vs. patients receiving the 80 mg dose (27 vs. 0%; p < 0.001). Conclusions: To our knowledge, these are the first cases to highlight a potentially important and serious gastrointestinal complication associated with the 160 mg dose of osimertinib.
Pox-like lesions and haemorrhagic fever in two concurrent cases in the Central African Republic: case investigation and management in difficult circumstances
Authors: Guenter Froeschl, Pitchou Kasongo Kayembe
Journal: Pan Afr Med J (2015)
Keywords: central african republic, pox-like lesions, fever, haemorrhage, monkeypox
MeSH terms: Hemorrhagic Fevers, Viral / diagnosis, Monkeypox / diagnosis, Monkeypox virus / isolation & purification, Case Reports, Adult, Central African Republic, Humans, Male, Monkeypox / virology

Cases of monkeypox in humans are frequently reported from the Democratic Republic of Congo. The few reports from the Central African Republic have been limited to cases in the far South closely bordering the Congos. Team members of an international medical organisation have suspected clinically two human cases of MPX, associated with clinical signs of coagulopathy and haemorrhage in the North of the country. Key findings were history of a squirrel, fever and vesicular dermal eruptions. Subsequently patients developed profuse epistaxis and hematemesis, associated with clinical signs of shock. Both patients were isolated and treated symptomatically. Samples were sent to a regional reference laboratory, who initially issued a confirmation of the suspected diagnosis of MPX in both cases. The result was later revised, and additional analyses of samples could not confirm the diagnosis.
Subchondral fracture caused by unevenly stiffened meniscus after radiofrequency-assisted arthroscopic knee meniscectomy: A case report and review of the literature
Authors: Kiyokazu Fukui, Akihiro Shioya, Yoshiyuki Tachi, Katsutaka Yonezawa, Hiroaki Hirata, Norio Kawahara
Journal: Int J Surg Case Rep (2019)
Keywords: postarthroscopic osteonecrosis of the knee, radiofrequency-assisted arthroscopic knee meniscectomy, spontaneous osteonecrosis of the knee, subchondral fracture

Introduction:
Causality for postarthroscopic osteonecrosis of the knee is unknown, and related mechanisms have been poorly characterized.
Presentation of case:
This report describes a case of a 69-year-old man with subchondral fracture occurring after arthroscopic meniscectomy using a radiofrequency assisted shaver. The patient experienced increasingly intense knee pain 10 months after the meniscectomy. MR imaging revealed postarthroscopic osteonecrosis of the knee in the femoral medial condyle, requiring unicompartmental knee arthroplasty. A mid-coronal cut section of the resected medial femoral condyle showed a linear fracture line parallel to the subchondral bone endplate. Histopathological examination showed prominent callus formation on both sides of the fracture, comprised of reactive woven bone and granulation tissue. The middle portion of the resected medial meniscus was of uneven height, with significant stiffening of the higher side. The stiffened region of the medial meniscus corresponded to the subchondral fracture in the medial femoral condyle.
Discussion:
The etiology of post-arthroscopic osteonecrosis of the knee is controversial, but it seems possible that altered knee biomechanics after meniscectomy may predispose patients to osteonecrosis. The findings of the current case suggested that uneven stiffening of the meniscus caused concentration of stress that resulted in postarthroscopic subchondral fracture.
Conclusion:
Subchondral insufficiency fracture following arthroscopy may be underdiagnosed. Surgeons need to carefully consider the risk of subchondral fracture following uneven stiffening of the meniscus when to use radiofrequency in the debridement of a torn meniscus.
Antenatal urolithiasis: A case report
Authors: Sumona Bose, Arpana Iyengar, Attibele Mahadevaiah Shubha
Journal: Front Pediatr (2022)
Keywords: antenatal, hydronephrosis, obstructive calculus, surgery, surveillance
MeSH terms: Case Reports

Introduction:
Although pediatric urolithiasis is an established entity, its antenatal diagnosis is rare. We hereby report a case detected at 20 weeks gestation and discuss the etiopathogenesis, predisposition, and surveillance following intervention.
Case report:
A 2-year-old girl with left renal pelvic calculus detected antenatally at 20 weeks was evaluated. Left hydronephrosis, obstructive pelvic calculus with a decrease in differential renal function on ethylene dicysteine (EC) renogram was confirmed. The metabolic workup was normal. Following stone extraction by left pyelolithotomy, a left ureteropelvic junction obstruction secondary to a mucosal valve was apparent which was excised and left pyeloplasty was done. Stone analysis revealed 100% cystine. Differential renal function and drainage improved post-surgery. The child, however, did not have a follow-up in the interim and presented with a recurrent stone one and a half years later.
Conclusion:
Knowledge of antenatal urolithiasis ensures continued follow-up, evaluation for metabolic disorders, and associated structural defects, especially with increasing stone size and increasing hydronephrosis. This helps in timely intervention and continued surveillance.