OpenMed/multicare-articles huggingface dataset:
Primary Bilateral Non-Hodgkin's Lymphoma of the Adrenal Gland: A Case Report
Authors: Ahmed Amine Bouchikhi, Mohamed Fadl Tazi, Driss Amiroune, Soufiane Mellas, Jalaledine El Ammari, Abdelhak Khallouk, Mohammed Jamal El Fassi, Moulay Hassan Farih
Journal: Case Rep Urol (2012)

Primary bilateral non-Hodgkin's lymphoma (NHL) of the adrenal gland is a very rare entity. Indeed less than 60 cases have been reported in the literature. Hence, we report a case of high-grade lymphoma of both adrenal glands that was found in a young patient of 32 years of age. The patient was admitted in the emergency department of our hospital with a profile of hemorrhagic shock. After stabilization, the imaging investigations demonstrated large bilateral adrenal masses. The CT-scan guided biopsy of both adrenal glands allowed the diagnosis of primary bilateral adrenal NHL. The patient died after the first chemotherapy session. The presence of bilateral adrenal masses associated with a rapid increase of volume should raise the diagnosis of primary adrenal non-Hodgkin's lymphoma.
The role of high mobility group box chromosomal protein 1 expression in the differential diagnosis of hepatic actinomycosis: a case report
Authors: Chuan-Xin Wu, Hui Guo, Jian-Ping Gong, Qi Liu, Hang Sun
Journal: J Med Case Rep (2013)

Introduction:
Primary hepatic actinomycosis is a rare disease, but is important in the differential diagnosis of hepatoma in endemic areas. As high mobility group box chromosomal protein 1 plays an important role in the pathogenesis of both acute and chronic inflammatory conditions, we postulate that high mobility group box chromosomal protein 1 may have a possible pathogenic role in hepatic actinomycosis. To the best of our knowledge, our report is the first to detect an association between highly elevated high mobility group box chromosomal protein 1 expression and hepatic actinomycosis.
Case presentation:
A 67-year-old Chinese man was admitted to our hospital with a three-month history of epigastric pain, anorexia, and subjective weight loss. Ultrasonography and computed tomography of the patient's abdomen confirmed a hypodense mass measuring seven cm in diameter in the left lateral segment of his liver. A hepatic tumor was suspected and surgical resection was scheduled. Histopathologic examination revealed that the overall features of the hepatic tissues were consistent with hepatic actinomycosis. Whole blood and hepatic tissue samples of the patient, of patients who had hepatocellular carcinoma and of healthy donors were collected. Serum high mobility group box chromosomal protein 1 concentration in actinomycosis was 8.5ng/mL, which was higher than the hepatocellular carcinoma level of 5.2ng/mL and the normal level of <three ng/mL. High mobility group box chromosomal protein 1 messenger ribonucleic acid levels and high mobility group box chromosomal protein 1 protein content in the affected tissues of this patient with hepatic actinomycosis were higher than those of the control and hepatocellular carcinoma tissues. The results of immunohistochemistry showed the following: in the control tissues, high mobility group box chromosomal protein 1 was distributed mainly in the cytoplasm; in the hepatocellular carcinoma tissues, high mobility group box chromosomal protein 1 was distributed primarily in the nucleus; and in the actinomycosis tissues, high mobility group box chromosomal protein 1 was increased in both the cytoplasm and nucleus.
Conclusion:
High mobility group box chromosomal protein 1 may have a potent biological effect on the pathogenesis of hepatic actinomycosis as a novel cytokine and may be a useful marker in the differential diagnosis of hepatic actinomycosis.
Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: a case report
Authors: Morgan Le Guen, Catherine Beigelman, Belaid Bouhemad, Yang Wenjïe, Frederic Marmion, Jean-Jacques Rouby
Journal: Crit Care (2007)
MeSH terms: Bronchi / injuries, Bronchography / methods, Case Reports, Adult, Bronchi / surgery, Bronchoscopy, Humans, Radiographic Image Interpretation, Computer-Assisted, Rupture / diagnostic imaging, Rupture / surgery, Treatment Outcome

Introduction:
Unnoticed bronchial injury during the early stage of resuscitation of multiple trauma is not rare and increases mortality and morbidity.
Methods:
Three-dimensional reconstruction of the airways using a workstation connected to a multidetector chest computed tomography (CT) scanner may change the diagnostic strategy in patients with blunt chest trauma with clinical signs evocative of bronchial rupture.
Results:
In this case report of a young motor biker, a complete disruption of the intermediary trunk was first misdiagnosed using standard chest helical CT and bronchoscopy. Postprocessing procedures including three-dimensional extraction of the tracheobronchial tree were determinants for establishing the diagnosis, and emergent surgical repair was successfully performed. Follow-up using CT with three-dimensional reconstructions evidenced a bronchial stenosis located at the site of the rupture.
Conclusion:
The present study demonstrates the potential interest of performing three-dimensional reconstructions by extraction of the tracheal-bronchial tree in patients with severe blunt chest trauma suspected of bronchial rupture.
Long-term cure of soft tissue sarcoma with pegylated-liposomal doxorubicin after doxorubicin and ifosfamide failure
Authors: Malvi Savani, Paari Murugan, Keith M Skubitz
Journal: Clin Sarcoma Res (2019)
Keywords: doxorubicin, pegylated-liposomal doxorubicin, sarcoma
MeSH terms: Case Reports

Background:
Doxorubicin is one of the most active drugs available for the treatment of sarcoma. Pegylated-liposomal doxorubicin (PLD) is a formulation of doxorubicin in which the doxorubicin is encapsulated in liposomes coated with methoxypoly (ethylene glycol); this formulation results in decreased uptake by the reticuloendothelial system, higher concentrations of drug in tumor, and less toxicity, including reduced cardiotoxicity, nausea, alopecia, and myelosuppression. No premedication is necessary. While PLD has a better toxicity profile than free doxorubicin, there is no consensus on the relative efficacy of PLD and free doxorubicin in sarcoma.
Case presentation:
In this report, we describe a patient with high-grade metastatic soft tissue sarcoma with rapid recurrence after adjuvant treatment with free doxorubicin, cisplatin, ifosfamide, and dacarbazine. Second-line treatment with PLD resulted in long-term disease remission during a 20-year follow-up period. Mucositis and hand-foot syndrome were controlled by adjustment of dose and treatment interval.
Conclusions:
This case illustrates the curative potential of PLD after failure of free doxorubicin and the absence of long term cardiotoxicity with PLD. As with all drugs, individual adjustment of dose and treatment interval is important.
Idiopathic segmental infarction of the omentum mimicking acute appendicitis: A case report
Authors: Rahul Gupta, Waad Farhat, Houssem Ammar, Mohamed Azzaza, Sami Lagha, Yesser Ben Cheikh, Mohamed Ben Mabrouk, Ali Ben Ali
Journal: Int J Surg Case Rep (2019)
Keywords: appendicitis, infarction, laparoscopy, omentum

Introduction:
Omentum is a well vascularized organ. Omentum infarction is uncommon. Most of the cases are secondary due to torsion, intra-abdominal infections and vascular thrombosis. Primary idiopathic segmental omental infarction is rare.
Presentation of case:
A 26-year-old male presented with acute onset right iliac fossa pain mimicking acute appendicitis. On radiological imaging, early acute appendicitis was suspected. On diagnostic laparoscopy, appendix appeared normal and there was idiopathic infarction of a part of the greater omentum lying close to the cecum. Patient underwent laparoscopic appendectomy with excision of the diseased segment of the omentum and had uneventful recovery.
Conclusion:
Idiopathic omental infarction should be included in the differential diagnoses while treating patient with acute abdomen.
Diagnosis and Treatment of Cerebral Syphilitic Gumma: A Report of Three Cases
Authors: Xuefei Shao, Di Qiang, Yinhua Liu, Quan Yuan, Jin Tao, Bihua Ji
Journal: Front Neurosci (2018)
Keywords: cerebral gumma, diagnosis, neurosyphilis, operation, treatment
MeSH terms: Case Reports

Cerebral syphilitic gumma is very rare and is often pathologically confirmed following surgery. This study reports three patients with cerebral syphilitic gumma. The first case was a 62-year-old man who was admitted to our hospital due to speech arrest for 10 hours. Head MRI showed a nodular signal shadow with a significant enhancement and a significant centerline shift. He subsequently received surgery, and cerebral syphilitic gumma was confirmed by postoperative pathology. The second patient was a 66-year-old man who was admitted to our hospital due to complaints of gradually decreasing right eye vision and headache for nearly 50 days. Enhanced MRI at admission indicated irregular clumping of high-signal mixed with low-signal foci on the frontal lobe. Subsequently, he was operatively treated and was confirmed to have cerebral syphilitic gumma by postoperative pathology. The third patient was a 37-year-old man who was admitted to our hospital due to dizziness for approximately 15 days. Head MRI indicated a slightly abnormal lamellar and longer T1, T2 signal shadow on the left side. He did not receive surgery, and his symptoms disappeared after anti-syphilitic treatment. Hence, we recommend a critical interpretation of preoperative imaging data, understanding the unique changes that arise in the brain that can be detected through imaging, and an analysis of the patient history and laboratory tests to re-evaluate the value of surgery, with the ultimate goal of performing a stabilizing treatment for cerebral syphilitic gumma.
Sudden Death Due to Rupture of Ectopic Pregnancy in a Young Lactating Mother
Authors: Atul S Keche, Poovaragavan V, Sravan Js
Journal: Cureus (2023)
Keywords: lactational amenorrhoea, reproductive age, ruptured ectopic pregnancy, sudden death, young mother
MeSH terms: Case Reports

The incidence of ectopic pregnancy in India is increasing over time along with a considerable mortality rate. The common site for ectopic pregnancy is the fallopian tubes and is also associated with a higher incidence of mortality following the tubal rupture. Even though lactational amenorrhea prevents pregnancy to some extent, the probability of pregnancy increases when the frequency of lactation decreases. Rupture of ectopic pregnancy can occur abruptly without any serious symptoms as well. One should not ignore even mild symptoms in females of reproductive age group especially those who are sexually active. A 25-year-old female with an alleged history of sudden onset of severe abdominal pain was taken to AIIMS Bhopal, where she was declared brought dead and her body was sent for autopsy. She got married at the age of 23 years and was still breastfeeding her 11-month-old child. The autopsy revealed 2.2 liters of fluid and clotted blood in the peritoneal cavity. The right fallopian tube enlarged along with a tear of size 1cm x 1cm evident on the anterior aspect. Meticulous dissection revealed a membranous sac of size 4cm x 2cm x 2cm containing a placenta of size 1cm x 1cm and an embryo of size 2cm x 1cm. All other organs were pale and normal. The uterine cavity was found empty. The cause of death was attributed to ruptured ectopic pregnancy.
Cytotoxic and targeted therapy for treatment of pseudomyogenic hemangioendothelioma
Authors: Jason Joseph, Wei-Lien Wang, Madhavi Patnana, Naveen Ramesh, Robert Benjamin, Shreyaskumar Patel, Vinod Ravi
Journal: Clin Sarcoma Res (2015)
Keywords: hemangioendothelioma, pseudomyogenic, sarcoma, soft tissue tumor, mtor inhibitor
MeSH terms: Case Reports

Pseudomyogenic hemangioendothelioma (PMH) is a recently described, indolent vascular tumor that usually presents in the distal extremities. PMH typically has a multi-focal presentation and can involve several tissue planes including the dermis, subcutis, muscle, and bone. This soft tissue tumor predominantly affects men between 20 and 50 years of age. PMH tumors typically are resected but frequently recur locally; thus, more efficacious treatment options are needed. Herein, we report two cases of patients with PMH who were treated with systemic therapy. To the best of our knowledge, our report is the first to describe a response of PMH either to gemcitabine/taxane cytotoxic chemotherapy or to a mammalian target of rapamycin inhibitor. In the first case, a 45-year-old man with PMH of the right ilium was treated with gemcitabine plus docetaxel. Although chemotherapy was ultimately halted owing to gemcitabine-induced pulmonary toxicity, positron emission tomography-computer tomography scans taken after three cycles of gemcitabine plus docetaxel illustrated a noticeable response to the regimen. In the second case, a 22-year-old man with PMH of the right distal femur and metastases in the left ilium showed no response to gemcitabine plus docetaxel therapy, but underwent surgical resection after cisplatin and doxorubicin resulted in stable disease. DNA sequencing of his tumor revealed the presence of a tuberous sclerosis 1 (TSC1) mutation, so daily everolimus, which inhibits mammalian target of rapamycin, was started. Two months after beginning everolimus, the patient underwent magnetic resonance imaging of the pelvis, which revealed mild shrinkage of PMH metastases in the left iliac bone. Despite the apparent heterogeneity of response to gemcitabine/taxane chemotherapy in our two patients, these two cases indicate that gemcitabine/taxane and mammalian target of rapamycin inhibitor may serve as systemic treatment options for PMH and warrant further investigation.
Treatment of Enteropathogenic Escherichia coli Diarrhea in Cancer Patients: A Series of Three Cases
Authors: James D Denham, Sowmya Nanjappa, John N Greene
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Enteropathogenic Escherichia coli (EPEC) is a common cause of watery diarrhea in children in the developing world and an infrequent cause of significant diarrhea in adult patients. EPEC diarrhea, while not commonly seen in cancer patients, can cause significant distress to patients, and antimicrobial choice for this condition in this patient population is not clearly delineated in the literature. We report 3 cases of EPEC diarrhea in cancer patients and discuss the use of azithromycin for successful treatment of these patients. Positive outcomes were seen while using azithromycin in our first two patients and ciprofloxacin in our third patient.
Recurrence of Primary Synovial Chondromatosis (Reichel's Syndrome) in the Ankle Joint following Surgical Excision
Authors: Thomas Gatt, Mark Portelli
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Primary synovial chondromatosis, or Reichel's syndrome, is a rare benign tumour arising from the synovial lining of a joint. We present the case of a 25-year-old male with Reichel's syndrome of the ankle, with subsequent recurrence following open retrieval of loose bodies. The initial presentation was of lateral malleolus discomfort which limited moderately strenuous exercise. Clinical examination showed a mild effusion and pain on extremes of movement. Imaging confirmed the presence of multiple loose bodies within the anterior and anterolateral recesses of the ankle. Open removal of 27 loose bodies from the joint was performed, with good postoperative recovery. He represented with pain 9 months later, with imaging of the ankle showing reaccumulation of loose bodies to a lesser extent. A trial of conservative management was opted for. Reichel's syndrome confined to the ankle is an exceedingly rare diagnosis, with few cases reported in the literature. This case saw the recurrence of the disease in a short time period despite successful surgery in the first instance. Management options to treat recurrence include repeat retrieval of foreign bodies, synovectomy, radiotherapy, or arthrodesis. While the prognosis is favourable, a low risk of malignant potential warrants adequate patient follow-up.
Non-Hodgkin lymphoma presenting as acute pancreatitis: A rare occurrence
Authors: Mitchell M Pitlick, Jithma P Abeykoon, Linda N Dao, Carrie A Thompson
Journal: Clin Case Rep (2018)
Keywords: cd20, extranodal manifestation, non‐hodgkin lymphoma, pancreatitis
MeSH terms: Case Reports

Lymphoma often presents with extranodal manifestations. However, pancreatic involvement resulting in pancreatitis is rare. CD20-negative variants of diffuse large B-cell lymphoma are also rare and are more likely to present with extranodal involvement. Lymphoma should be considered in patients presenting with pancreatitis without traditional risk factors.
Pasireotide for Refractory Hypoglycemia in Malignant Insulinoma- Case Report and Review of the Literature
Authors: Sandrine Oziel-Taieb, Jemima Maniry-Quellier, Brice Chanez, Flora Poizat, Jacques Ewald, Patricia Niccoli
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: malignant insulinoma, neuroendocrine tumor, pancreatic neuroendocrine cancer, pasireotide, refractory hypoglycemia
MeSH terms: Hypoglycemia / drug therapy, Hypoglycemia / etiology, Insulinoma / complications, Insulinoma / drug therapy, Insulinoma / pathology, Pancreatic Neoplasms / complications, Pancreatic Neoplasms / drug therapy, Pancreatic Neoplasms / pathology, Case Reports, Review, Female, Humans, Middle Aged, Somatostatin / analogs & derivatives, Somatostatin / therapeutic use, Somatostatin, pasireotide

Malignant insulinomas are functional neuroendocrine tumors of the pancreas and the primary cause of tumor-related hypoglycemia. Malignant insulinoma is rare and has a poor prognosis. We report a case of metastatic malignant insulinoma in a 64-year-old female patient with severe and refractory hypoglycemia. After several ineffective locoregional and systemic therapeutic lines for the secretory disease, the introduction of pasireotide, a second-generation somatostatin analog, provided an improved clinical and secretory evolution both quickly and sustainably, with an excellent safety profile. Pasireotide is an effective and well-tolerated therapy in the treatment of refractory hypoglycemia in metastatic insulinoma.
Bilateral subdural hematoma caused by spontaneous intracranial hypotension originating from a discogenic microspur successfully treated with duraplasty: A case report
Authors: Andrea Casanova, László Entz, Simon Weinmann, Isabel Wanke, Robert Reisch
Journal: Brain Spine (2022)
Keywords: cerebrospinal fluid leak, discogenic microspur, duraplasty, spontaneous intracranial hypotension, subdural hematoma
MeSH terms: Case Reports

Introduction:
Discogenic microspurs are calcified outgrowths from the intervertebral disc which can perforate the dura, causing a leak of cerebrospinal fluid (CSF). Spontaneous leaks of the CSF present a recognized cause of spontaneous intracranial hypotension (SIH). Moreover, subdural hematomas (SDH) are a potentially severe complication of SIH.
Research question:
We present a case of a bilateral subdural hematoma without orthostatic headaches caused by a discogenic microspur protruding from the T1-2 intervertebral disc. The microspur is conjectured to be the culprit of the leak by ventrally perforating the dura and catalyzing the causal chain leading to the formation of the subdural hemorrhage.
Material and methods:
A 79-year woman noticed a progressive gait disturbance accompanied by a decline of short-term memory over several months without experiencing orthostatic headaches. Magnetic resonance imaging (MRI) showed extensive bilateral subdural fronto-parietal hematoma, signs of CSF hypotension (dilated venous compartments), and computed tomography (CT) myelography revealed a CSF leak originating at the T1-2 level.
Results:
The leakage site was treated with microsurgical duraplasty leading to a regression of the symptoms and complete resolution of the subdural hematomas within five postoperative months.
Discussion and conclusion:
Discogenic microspurs can perforate the dura causing a CSF leak, leading to spontaneous intracranial hypotension, finally resulting in a bilateral subdural hematoma. This constellation of symptoms does not necessarily induce orthostatic headaches and can be treated with microsurgical duraplasty.
Urethral Caruncle Presented as Premature Menarche in a 4-Year-Old Girl
Authors: Manori Gamage, D Beneragama
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Urethral caruncle (UC) is a benign fleshy outgrowth at the urethral meatus. It was first described by Samuel Sharp in 1750 and occurs mainly at the posterior lip of the urethra, and the exact aetiology is still uncertain. More often it was seen in the postmenopausal women, and only few cases are reported in young girls. Patients may be asymptomatic and could find this as an incidental finding or they may present with symptoms such as dysuria, bleeding per vagina, haematuria, a mass protruding through vagina, and acute retention of urine. Here, we report the case history of a 4-year-old girl presented with vaginal bleeding which was taken as she has attended menarche and found to have urethral caruncle which was the cause for bleeding. Histology confirmed the diagnosis, and girl was completely cured following surgical excision.
Traumatic Cervical Spondyloptosis in a Neurologically Stable Patient: A Therapeutic Challenge
Authors: Sunil Munakomi, Binod Bhattarai, Iype Cherian
Journal: Case Rep Crit Care (2015)

This is a case report of a neurologically intact patient following posttraumatic cervical spondyloptosis. We discuss the disease, management protocol and some surgical nuances to prevent any damage to the cord during different stages of its treatment.
Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases
Authors: Giulia Frauenfelder, Annamaria Maraziti, Vincenzo Ciccone, Giuliano Maraziti, Oliviero Caleo, Francesco Giurazza, Bruno Beomonte Zobel, Mattia Carbone
Journal: J Clin Imaging Sci (2019)
Keywords: abdominal pain, common bile duct, computed tomography, lemmel syndrome, periampullary duodenal diverticula
MeSH terms: Case Reports

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.