OpenMed/multicare-articles huggingface dataset:
Thyroseq V3 Molecular Profiling for Tailoring the Surgical Management of Hürthle Cell Neoplasms
Authors: Sarah Pearlstein, Arash H Lahouti, Elana Opher, Yuri E Nikiforov, Daniel B Kuriloff
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Hürthle cell predominant thyroid nodules often confound the diagnostic utility of fine needle aspiration biopsy (FNAB) with cytology often interpreted as a Hürthle cell lesion with an indeterminate risk of malignancy, Bethesda category (BC) III or IV. Molecular diagnostics for Hürthle cell predominant nodules has also been disappointing in further defining the risk of malignancy. We present a case of a slowly enlarging nodule within a goiter initially reported as benign on FNAB, BC II but on subsequent FNAB suspicious for a Hürthle cell neoplasm, BC IV. The patient had initially requested a diagnostic lobectomy for a definitive diagnosis despite a higher risk of malignancy based on the size of the nodule > 4 cm alone. To better tailor this patient's treatment plan, a newer expanded gene mutation panel, ThyroSeq® v3 that includes copy number alterations (CNAs) and was recently found to have greater positive predictive value (PPV) for identifying Hürthle cell carcinoma (HCC), was performed on the FNAB material. Molecular profiling with ThyroSeq® v3 was able to predict a greater risk of carcinoma, making a more convincing argument in favor of total thyroidectomy. Surgical pathology confirmed a Hürthle cell carcinoma with 5 foci of angioinvasion and foci of capsular invasion.
A giant spontaneous subcapsular hematoma of the liver revealing a COVID-19 infection, a coincidence? (A case report)
Authors: Anisse Tidjane, Amel Laredj, Nabil Boudjenan-Serradj, Salim Bensafir, Benali Tabeti
Journal: Pan Afr Med J (2021)
Keywords: sars-cov-2, angiotensin-converting enzyme 2, case report, hemorrhage, infectious pandemic
MeSH terms: COVID-19 / diagnosis, Hematoma / diagnosis, Liver Diseases / diagnosis, Case Reports, Adult, COVID-19 / complications, Female, Hematoma / pathology, Hematoma / virology, Humans, Liver Diseases / pathology, Liver Diseases / virology, Reverse Transcriptase Polymerase Chain Reaction, Tomography, X-Ray Computed

Hemorrhagic manifestations during COVID-19 infections are increasingly described in the literature. We report the first case of spontaneous subcapsular hematoma of the liver revealing a COVID-19 infection in a 44-year-old woman with no underlying health condition history, a computerized tomography evaluation showed an aspect of lung ground-glass opacities, with moderate impairment estimated at about 20%. Reverse transcription-polymerase chain reaction confirmed the diagnosis of COVID-19 infection. During the COVID-19 pandemic, non-traumatic bleeding such as spontaneous hematomas in patients with no coagulation disorder could be a manifestation of COVID-19 infection.
Emphysematous Aortitis due to Clostridium septicum in an 89-Year-Old Female with Ileus
Authors: Susana Urgiles, Harold Matos-Casano, Kyaw Zin Win, Jeronimo Berardo, Utpal Bhatt, Jilan Shah
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Emphysematous aortitis is a rare but lethal form of infectious vasculitis. This condition was found incidentally on computed tomography of the chest during the evaluation of a patient presenting with pneumonia coincident with adynamic ileus. The patient did not have a history of malignancy. While colon cancer could not be ruled out, it is possible that ileus may have contributed to or resulted in bacterial translocation in this case. Appropriate investigations and empirical therapy against Clostridium septicum should be initiated in the presence of clinical and radiological findings suggestive of emphysematous aortitis.
A case study of recurrent myocardial infarction secondary to socioeconomic challenges and nonadherence: Pre-discharge screening
Authors: Revanth Kosaraju, Sami Natour, Stanley Yuan, Geoffrey Cho
Journal: SAGE Open Med Case Rep (2023)
Keywords: stemi, adherence, screening, socioeconomic status
MeSH terms: Case Reports

Medication nonadherence following myocardial infarction (MI) is prevalent and increases the risk of recurrent cardiovascular events. Socioeconomic factors including medication cost, financial insecurity, and poor health literacy are associated with nonadherence. We present a patient with a history of recurrent MI who was nonadherent due to socioeconomic challenges. Our patient subsequently developed ST-elevation MI secondary to in-stent thrombosis. This case illustrates the importance of pre-discharge screening for barriers to adherence.
Case report: Cystic fibrosis with kwashiorkor: A rare presentation in the era of universal newborn screening
Authors: Annemarie G Wolfe, Stephanie P Gilley, Stephanie W Waldrop, Christina Olson, Emma Harding, Kaitlin Widmer, Lindsey B Gumer, Matthew Haemer, Jordana E Hoppe
Journal: Front Pediatr (2023)
Keywords: cystic fibrosis - cf, kwashiorkor, missed diagnosis, newborn screening (nbs), pancreatic insufficiency
MeSH terms: Case Reports

Background:
Universal newborn screening changed the way medical providers think about the presentation of cystic fibrosis (CF). Before implementation of universal screening, it was common for children with CF to present with failure to thrive, nutritional deficiencies, and recurrent infections. Now, nearly all cases of CF are diagnosed by newborn screening shortly after birth before significant symptoms develop. Therefore, providers often do not consider this illness in the setting of a normal newborn screen. Newborn screening significantly decreases the risk of complications in early childhood, yet definitive testing should be pursued if a patient with negative newborn screening presents with symptoms consistent with CF, including severe failure to thrive, metabolic alkalosis due to significant salt losses, or recurrent respiratory infections.
Case presentation:
We present a case of a 6-month-old infant male with kwashiorkor, severe edema, multiple vitamin deficiencies, hematemesis secondary to coagulopathy, and diffuse erythematous rash, all secondary to severe pancreatic insufficiency. His first newborn screen had an immunoreactive trypsinogen (IRT) value below the state cut-off value, so additional testing was not performed, and his growth trajectory appeared reassuring. He was ultimately diagnosed with CF by genetic testing and confirmatory sweat chloride testing, in the setting of his parents being known CF carriers and his severe presentation being clinically consistent with CF. Acutely, management with supplemental albumin, furosemide, potassium, and vitamin K was initiated to correct the presenting hypoalbuminemia, edema, and coagulopathy. Later, pancreatic enzyme supplementation and additional vitamins and minerals were added to manage ongoing deficiencies from pancreatic insufficiency. With appropriate treatment, his vitamin deficiencies and edema resolved, and his growth improved.
Conclusion:
Due to universal newborn screening, symptomatic presentation of CF is rare and presentation with kwashiorkor is extremely rare in resource-rich communities. The diagnosis of CF was delayed in our patient because of a normal newborn screen and falsely reassuring growth, which after diagnosis was determined to be secondary to severe edematous malnutrition. This case highlights that newborn screening is a useful but imperfect tool. Clinicians should continue to have suspicion for CF in the right clinical context, even in the setting of normal newborn screen results.
Pulmonary Artery Intimal Sarcoma: A Diagnostic Challenge Using a Multimodal Approach
Authors: Rima Nakrani, Ho-Man Yeung, Jin Sun Kim, Bhishak Kamat, Maruti Kumaran
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Pulmonary artery intimal sarcoma (PAIS) is a rare tumor without clear syndromic presentation other than nonspecific symptoms of cough, dyspnea, and weight loss. This diagnosis is difficult due to challenging radiographic interpretations of multiple imaging modalities. We present a case of a 60-year-old male, who presented to his pulmonologist and underwent a CT chest with IV contrast that initially suggested primary lung carcinoma. CT angiogram showed significant vascular filling defects suspicious of an intravascular mass, rather than vascular invasion by lung lesions. The PET/CT scans further suggested a malignant process, but indistinguishable between an extravascular or intravascular etiology. Taking these results together, they suggested an intravascular malignancy, prompting a tissue biopsy, which ultimately led to a diagnosis of PAIS with metastases. Establishing a definitive diagnosis is essential as treatment and prognosis are different for sarcoma compared to carcinoma. There is no standard treatment to date, and management often includes a multidisciplinary approach involving surgery, radiation, chemotherapy, and targeted therapy. PAIS is a rare entity that cannot be diagnosed clinically and needs a multimodality approach for its diagnosis.
Successful management of primary non Hodgkins lymphoma of the cranial vault
Authors: Zouhour Fadoukhair, Issam Lalya, Mounia Amzerin, Basma Elkhanoussi, Yassir Sbitti, Saber Boutayeb, Hind M'rabti, Noureddine Benjaafar, Hassan Errihani
Journal: Pan Afr Med J (2011)
Keywords: b-cell lymphoma, cranial vault, extranodal lymphoma, primary bone lymphoma
MeSH terms: Lymphoma, Large B-Cell, Diffuse / therapy, Parietal Bone / pathology, Skull Neoplasms / therapy, Case Reports, Adult, Antineoplastic Agents / therapeutic use, Biopsy, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lymphoma, Large B-Cell, Diffuse / diagnosis, Lymphoma, Large B-Cell, Diffuse / pathology, Magnetic Resonance Imaging, Skull Neoplasms / diagnosis, Skull Neoplasms / pathology, Tomography, X-Ray Computed, Treatment Outcome, Antineoplastic Agents

Primary bone lymphoma (PBL) is a relatively uncommon entity. However, involvement of the cranial vault is an unusual manifestation of aggressive non-Hodgkin's lymphoma. We report the case of a 42-year old immunocompetent woman who presented with an enlarging mass involving the right parietal bone. Magnetic resonance imaging (MRI) of the brain revealed an expansive tumor that affects the right parietal bone. Computed tomographic (CT) scans of the abdomen, chest and pelvis were negative for lymphadenopathy or organomegaly. Biopsy of the mass showed diffuse large B-cell non-Hodgkin's lymphoma confirmed by immunohistochemical study. The patient had a complete response after 4 cycles of chemotherapy followed by external beam radiotherapy. After a follow-up of more than 9 months the patient is still in good local control without distant metastasis. The aim of our work is to report a case of Primary bone lymphoma of the cranial vault with good response to treatment combining sequential chemotherapy and radiotherapy.
Gastric Duplication Cyst in Association with Duodenal Atresia in a Neonate
Authors: Javad Ghoroubi, Alireza Mirshemirani, Fatollah Roshanzamir, Sajad Razavi, Mehdi Sarafi
Journal: APSP J Case Rep (2016)
Keywords: duodenal atresia, gastric duplication, neonate
MeSH terms: Case Reports

Concurrence of duodenal atresia and gastric duplication cyst is extremely rare entity. We report a 6-day-old female neonate who presented with neonatal intestinal obstruction. X-ray abdomen showed double bubble sign. At laparotomy, a huge cystic structure attached to greater curvature of the stomach along with duodenal atresia of second part of duodenum was found. The cystic structure was excised and duodeno-duodenostomy performed. Histopathology report confirmed it gastric duplication cyst.
Concomitant in situ and in transit right heart thrombi: a case report
Authors: Najlaa Belharty, Rania El Azouzi, Yassmine Chafai, Najat Mouine, Aatif Benyass
Journal: Pan Afr Med J (2020)
Keywords: multiple thrombi, case report, in situ thrombosis, right cardiac chambers, thrombus in transit
MeSH terms: Heart Atria / diagnostic imaging, Thrombosis / diagnostic imaging, Vena Cava, Inferior / diagnostic imaging, Case Reports, Aged, 80 and over, Echocardiography, Transesophageal, Heart Atria / pathology, Humans, Male, Thrombosis / pathology, Vena Cava, Inferior / pathology

Right heart thrombi can form in situ or lodge in the right cardiac chambers, originating from deep venous thrombosis. The latter carries a poor prognosis, taking into account the very high mortality rate. We herein report a case of an 83-year-old man who developed thrombus in the inferior vena cava that extended up to the right atrium, along with two distinct masses attached to the right ventricle wall.
External Genitalia Myiasis in a 40-Year-Old Woman
Authors: Ghazal Mansouri, Leila Allahqoli, Hamid Salehiniya, Ibrahim Alkatout
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Human myiasis is an infestation produced by fly larvae invading the tissues. We present a case of a 40-year-old virgin woman with vulvar myiasis. She reported at the gynecology clinic with a bloody discharge, severe pain, and swelling of the genital area for six days. Her menstrual history revealed the use of folded clothes. She had no specific gynecological disease. At the examination of the external genitalia, a tender mass measuring 6 cm × 4 cm and an ulcer measuring 1 cm × 1 cm on the surface of the labia majora were found. The patient was hospitalized. Serology, blood, and urine tests were requested; all laboratory tests were normal. The patient was transferred to the operating room (OR) with the diagnosis of necrotizing fasciitis. In the OR, we performed a longitudinal incision on the mass and removed nearly 30 visible maggots. After washing with normal saline, the patient was transferred to the ward without wound suturing. Debridement of the necrotic vulvar mass along with daily washing was performed for 7 days. The wound was sutured on the seventh day at the OR. Antibiotic therapy was continued for 4 days, and the patient was discharged with normal laboratory tests on the eleventh day after admission. We believe that poor sanitary hygiene was the cause of vulvar myiasis in our patient. We conclude that appropriate measures must be taken to reduce the risk of human myiasis, especially in tropical rural regions.
Proximal tibiofibular dislocation: a case report of this often overlooked injury
Authors: Benjamin Martin, James Corbett, Alastair Littlewood, Rupert Clifton
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Tibiofibular dislocation is a condition that is a recognized cause of lateral knee pain in trauma patients and can occur in isolation or as a part of multiple injuries. There is usually prominence of the fibular head on clinical examination, with tenderness to palpation. Radiological investigation can confirm the diagnosis, and in the case or our patient, both plain radiographs and MRI were performed. MRI permitted pre-reduction assessment of the intrinsic knee ligaments, as well as the common peroneal nerve. The dislocated fibular head was successfully relocated under general anaesthesia as a closed reduction.
Circulating angiogenic factors in a pregnant woman on intensive hemodialysis: a case report
Authors: Ayub Akbari, Michelle Hladunewich, Kevin Burns, Felipe Moretti, Rima Abou Arkoub, Pierre Brown, Swapnil Hiremath
Journal: Can J Kidney Health Dis (2016)
Keywords: chronic kidney disease, dialysis, placental growth factor, pregnancy, soluble fms-like tyrosine kinase
MeSH terms: Case Reports

Background:
Pregnancy in patients on chronic hemodialysis therapy, though unlikely, does happen rarely. Intensive hemodialysis is thought to offer a better survival advantage to the unborn child. Circulating angiogenic factors are helpful for prognostication of pregnant patients with chronic kidney disease who are not on dialysis. Data on their utilization in dialysis patients, however, are limited.
Case presentation:
We report the case of a patient with a history of interstitial nephritis who had a kidney transplant that failed after 8 years due to membranous nephropathy. She was initiated on hemodialysis three sessions per week and conceived after being on dialysis for 6 weeks. She was switched to intensive hemodialysis at 8 weeks of gestation and had a C-section because of hypertension at 35 weeks, with delivery of a healthy girl weighing 2012 g. Serum angiogenic factors (placental growth factor and soluble fms-like tyrosine kinase) were measured at 32, 33, and 34 weeks of gestation and at 1, 2, and 3 weeks postpartum. Serum angiogenic factors were similar to what has been reported for patients with chronic kidney disease and were not consistent with preeclampsia.
Conclusions:
Our case report expands on the literature regarding intensive hemodialysis and angiogenic factor utilization in pregnant dialysis patients. Our case report suggests that starting intensive dialysis early in pregnancy is safe and concentration of angiogenic factors are similar to those reported for patients without kidney disease, except for PIGF levels, which are somewhat higher.
Case report: SARS-CoV-2 infection as a trigger for diabetic ketoacidosis and newly detected pancreatic autoantibodies
Authors: Rahul Mishra, Ghada Elshimy, Lakshmi Kannan, Aasems Jacob, Rishi Raj
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: covid – 19, sars – cov – 2, autoantibodies, autoimminity, type 1 diabetes (t1d)
MeSH terms: COVID-19, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Ketoacidosis, Case Reports, Adult, Autoantibodies, Female, Humans, Pancreatic Hormones, SARS-CoV-2, Autoantibodies, Pancreatic Hormones

A 39-year-old-woman with a past medical history of type 2 diabetes mellitus (T2DM) on oral hypoglycemic agents presented to the emergency room with nausea, vomiting, shortness of breath, and altered mental status. Seven days prior to presentation, she was diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Laboratory workup on presentation confirmed the diagnosis of diabetic ketoacidosis (DKA) (blood glucose 523 mg/dl, beta-hydroxybutyrate 8.91 mmol/l, pH 6.9, bicarbonate 11 mEq/l, anion gap 25 mEq/l, and HbA1c 10.8%). She was managed for DKA with hydration and insulin drip and discharged home. However, to our surprise, at the 2-week follow-up visit, she was found to have positive antibodies for zinc transporter 8 (ZnT8) (samples were collected on day of presentation). The rest of her antibodies associated with T1DM were negative. She was therefore started on a basal-bolus regimen and managed as type 1 diabetes mellitus (T1DM). Our case illustrates that there is an increased risk of T1DM following infection with SARS-CoV-2.
Case report: Gene mutation analysis and skin imaging of isolated café-au-lait macules
Authors: Zhenyu Zhong, Tianhui Yang, Siqi Liu, Shan Wang, Shan Zhou, Shuli Du, Liyun Zheng, Xiuli Wang, Hui Wang, Yifan Wang, Min Gao
Journal: Front Genet (2023)
Keywords: nf1, dermoscopy, genetic testing, isolated café-au-lait macules(calms), mutation, reflectance confocal microscopy
MeSH terms: Case Reports

Background: Café-au-lait macules (CALMs) are common birthmarks associated with several genetic syndromes, such as neurofibromatosis type 1 (NF1). Isolated CALMs are defined as multiple café-au-lait macules in patients without any other sign of NF1. Typical CALMs can have predictive significance for NF1, and non-invasive techniques can provide more accurate results for judging whether café-au-lait spots are typical. Objectives: The study aimed to investigate gene mutations in six Chinese Han pedigrees of isolated CALMs and summarize the characteristics of CALMs under dermoscopy and reflectance confocal microscopy (RCM). Methods: In this study, we used Sanger sequencing to test for genetic mutations in six families and whole exome sequencing (WES) in two families. We used dermoscopy and RCM to describe the imaging characteristics of CALMs. Results: In this study, we tested six families for genetic mutations, and two mutations were identified as novel mutations. The first family identified [NC_000017.11(NM_001042492.2):c.7355G>A]. The second family identified [NC_000017.11(NM_001042492.2):c.2739_2740del]. According to genotype-phenotype correlation analyses, proband with frameshift mutation tended to have a larger number of CALMs and a higher rate of having atypical CALMs. Dermoscopy showed uniform and consistent tan-pigmented network patches with poorly defined margins with a lighter color around the hair follicles. Under RCM, the appearance of NF1 comprised the increased pigment granules in the basal layer and significantly increased refraction. Conclusion: A new heterozygous mutation and a new frameshift mutation of NF1 were reported. This article can assist in summarizing the properties of dermoscopy and RCM with CALMs.
Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis
Authors: Cassandra C Lautredou, Joshua S Hardin, John R Chancellor, Sami H Uwaydat, Abdallah A Ellabban, Ahmed B Sallam
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

Purpose:
To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis.
Methods/patients:
An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME) was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants.
Results:
Treatment led to the resolution of CME and improvement in visual acuity.
Conclusions:
Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.
Pure SILS Floppy Nissen Fundoplication with Hiatal Repair: A Case Report
Authors: Umut Barbaros, Tugrul Demirel, Aziz Sumer, Ugur Deveci, Mustafa Tukenmez, Mehmet Ibrahim Cansunar, Murat Kalayci, Ahmet Dınccag, Ridvan Seven, Selcuk Mercan
Journal: ISRN Gastroenterol (2011)
MeSH terms: Case Reports

Background. Single-incision laparoscopic surgery has recently became popular on behalf of inventing less invasive procedures. In this paper, we present a case of Pure SILS Nissen Fundoplication. Patient and Methods. In February 2010 a 29-year old male patient with a 4 cm sliding hiatus hernia presenting with reflux symptoms had undergone a standard floppy Nissen Fundoplication with a hiatus repair via single 2 cm incision in umbilicus. Results. The procedure had obeyed the standard natural orifice surgery rules, and no needlescopic assistance for any stage of the operation was used so to be a pure single-incision procedure. The operation lasted for 120 minutes without any need of conversion, and the patient was discharged the following day of operation. Conclusion. In the recent time, hybrid single incision laparoscopy techniques have been defined with the use of extra-abdominal supplements for retraction of liver or stomach for Nissen procedure. In addition the main issue in single-incision upper GI and/or hiatus surgery is still the retraction of liver. We succeeded to retract the left lobe of liver through the incision and completed the operation without any need for supplemental access besides the umbilical incision till the end. SILS Hiatus Surgery can be safely and effectively done but the issue needs further clinical studies to state the efficacy when compared to standard laparoscopy.