OpenMed/multicare-articles huggingface dataset:
Persistently elevated CKMB and negative troponin T in a patient at ischaemic risk with chest pain
Authors: D Schulenburg, W De Lange, H Van Jaarsveld, J M Kuyl
Journal: Cardiovasc J Afr (2010)
MeSH terms: Chest Pain / etiology, Creatine Kinase, MB Form / blood, Myocardial Ischemia / blood, Troponin T / blood, Case Reports, Artifacts, Biomarkers / blood, Chest Pain / blood, Electrocardiography, Female, Humans, Middle Aged, Myocardial Ischemia / complications, Myocardial Ischemia / diagnosis, Predictive Value of Tests, Reproducibility of Results, Time Factors, Up-Regulation, Biomarkers, Troponin T, Creatine Kinase, MB Form

Analytical interference in laboratory assays is not only unpredictable but also an underestimated problem. Not recognising these interferences can lead to misdiagnosis and mismanagement of patients. We present a case of a patient with chest pain and ischaemic risk factors with incongruent biochemical results. These results were discovered to be due to the presence of macro-creatine kinase (macro-CK) in vivo interfering with the CKMB activity assay.
Acute Hydrops with Total Corneal Edema in a Very Young Child with Keratoconus: The Youngest Age Reported Case
Authors: Mohammad-Reza Sedaghat, Hamed Momeni-Moghaddam, Michael W Belin, Maryam Savardashtaki, Shehzad A Naroo, Hassan Robabi
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

Purpose:
To present the youngest age ever reported for acute corneal hydrops with total corneal edema in a child with advanced bilateral keratoconus.
Methods:
Patient presentation in ophthalmic clinic. The patient underwent various clinical tests and examinations including anterior segment optical coherence tomography (AS-OCT) and Scheimpflug corneal tomography.
Results:
A 5-year-old girl presented with uncorrected distance visual acuity (UDVA) of 0.4 in the right eye and nonmeasurable UDVA associated with severe photophobia in her left eye of a 3-day duration. Intraocular pressure using the iCare tonometer was 14 and 5 mmHg in the right and left eyes, respectively. An old corneal hydrops scar and posterior subcapsular cataract (PSC) in the right eye and a total limbus to limbus corneal hydrops in the left eye were observed on slit-lamp examinations. Scheimpflug corneal tomography was possible in the right eye but, due to excessive irregularity and scaring, was not possible in the left eye. Corneal thinning and scarring were evident in the anterior segment optical coherence tomography in the right eye and very edematous cornea associated with stromal cleft and epithelial bullae in the left eye. A management plan consisting of topical hypertonic solution and ointment was started to reduce her symptoms.
Conclusion:
Acute corneal hydrops may be the presenting sign of keratoconus; however, extensive hydrops involving the total cornea area at a very young age is very rare and has not been previously reported in the literature.
CUP-syndrome: Inguinal high grade serous ovarian carcinoma lymph node metastases with unknown primary origin - a case report and literature review
Authors: Stefano Restaino, Jessica Mauro, Silvia Zermano, Giulia Pellecchia, Laura Mariuzzi, Maria Orsaria, Francesca Titone, Anna Biasioli, Monica Della Martina, Claudia Andreetta, Elena Poletto, Martina Arcieri, Alessandro Buda, Lorenza Driul, Giuseppe Vizzielli
Journal: Front Oncol (2022)
Keywords: cup syndrome, groin recurrence, high grade ovarian cancer, inguinal lymph node, recurrence
MeSH terms: Review

Objective:
High-grade serous ovarian carcinoma (HGSC) often presents lymph node involvement. According to the paths of lymphatic drainage, the most common site of nodal metastasis is in the aortic area. However, pelvic lymph nodes are also involved and inguinal metastases are less frequent.
Methods:
Our report concerns the case of a 78-year-old woman with an inguinal lymph node relapse of HGSC, with the prior positivity of a right inguinal lymph node, after the primary surgery. Ovaries and tubes were negative on histological examination. A comprehensive search of the literature published from January 2000 to October 2021 was conducted on PubMed and Scopus. The papers were selected following the PRISMA guidelines. Nine retrospective studies were evaluated.
Results:
Overall, 67 studies were included in the initial search. Applying the screening criteria, 36 articles were considered eligible for full-text reading of which, after applying the exclusion criteria, 9 studies were selected for the final analysis and included in the systematic review. No studies were included for a quantitative analysis. We divided the results according to the relapse location: loco-regional, abdominal, and extra-abdominal recurrence.
Conclusions:
Inguinal node metastasis is a rare but not unusual occurrence in HGSC. A reasonable level of suspicion should be maintained in patients with inguinal adenopathy and high CA125 values, especially in women with a history of gynecologic surgery, even in the absence of negative imaging for an ovarian origin.
Primary Mediastinal Choriocarcinoma in an Elderly Patient with Concurrent Goserelin-Treated Prostate Adenocarcinoma
Authors: Rasmus Røge, Carsten Simonsen, Astrid Christine Petersen
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Mediastinal pure choriocarcinomas are exceedingly rare representations of germ cell tumours and are associated with a poor prognosis. To date, fewer than 20 cases have been reported. This current report describes an elderly patient who developed a large rapidly growing mediastinal tumour. Unfortunately, the patient expired before a definitive diagnosis could be reached. An autopsy revealed that the histomorphological features of the tumour showed two distinct tumour cell populations (syncytio- and cytotrophoblasts), and the diagnosis of choriocarcinoma was made. Immunohistochemical analysis showed a characteristic staining pattern in agreement with published studies. Here, we report a case of primary mediastinal choriocarcinoma in an elderly male with concurrent metastasizing prostate adenocarcinoma treated with long-term goserelin deposits, which, as we speculate, could have induced the choriocarcinoma.
Atypical Left Ventricular False Chordae Tendineae
Authors: Amr Darwish, Priscilla Wessly, Nadeen Faza
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: 3-dimensional transesophageal echocardiography, lv false chord, lv false tendon, chordae tendineae, mitraclip
MeSH terms: Atrial Fibrillation, Mitral Valve Insufficiency, Case Reports, Review, Aged, 80 and over, Echocardiography / methods, Female, Heart Ventricles / diagnostic imaging, Humans, Mitral Valve / diagnostic imaging

An 81-year-old female patient with a history of severe secondary mitral regurgitation, hypertension, and paroxysmal atrial fibrillation was seen by the valve team to determine candidacy for transcatheter edge-to-edge repair of the mitral valve. Two-dimensional biplane imaging showed a transverse basal left ventricle false tendon attached to papillary muscles. The position was concerning for interference during deployment of the mitral clip.
Restorative Management of Severe Localized Tooth Wear Using a Supraoccluding Appliance: A 5-Year Follow-Up
Authors: Tsz Leung Wong, Michael George Botelho
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

This case report illustrates a novel conservative restorative management of a patient with bulimia nervosa who presented with severe localized upper palatal tooth wear and an anterior reverse overjet. This was achieved by using a localized bite raising or supraoccluding appliance, cemented on the lingual side of the lower anterior teeth to create interocclusal space, obviating the need for tooth reduction of the eroded upper palatal and incisal tooth surfaces. Surgical crown lengthening was performed to create a better aesthetic gingival architecture. All-ceramic restorations were provided on the upper anterior teeth to restore the tooth surface loss and provide a positive overbite and overjet. There was no complication or other observable biological change detected at the 5-year follow-up. The use of an appliance applying the supraoccluding technique, or Dahl concept, is a safe, conservative, and useful treatment option in the management of localized tooth wear.
Essential Palatal Tremor Managed by Cognitive Behavioral Therapy
Authors: Tomohisa Kitamura, Tsuyoshi Sato, Naoki Hayashi, Yosuke Fukushima, Tetsuya Yoda
Journal: Case Rep Dent (2015)

Background. Essential palatal tremor is a disorder of unknown etiology involving involuntary movement of the uvula and soft palate. Treatment attempts including drugs or surgery have been conducted to cease the rhythmical movement. Case Report. A 55-year-old female visited our department complaining of a sudden, noticeable, intermittent, and rhythmical clicking noise in her throat for five years. Oral examination revealed rhythmical contractions of the soft palate with clicking at the frequency of 120 per min. Magnetic resonance imaging (MRI) examination of the brain performed after consulting with the department of neuropathic internal medicine showed no abnormalities. Thus, essential palatal tremor was diagnosed. The symptoms improved with cognitive behavioral therapy without drugs or surgical treatments. The patient is now able to stop the rhythmical movement voluntarily. Discussion. Cognitive behavioral therapy might be suitable as first-line therapy for essential palatal tremor because the therapy is noninvasive.
IFN-α induced systemic lupus erythematosus complicated with hemophagocytic lymphohistiocytosis: a case report and literature review
Authors: Zhipeng Zeng, Wei Tu, Bai Ji, Jie Liu, Kecheng Huang, Daan Nie, Liu Yang
Journal: Front Immunol (2023)
Keywords: hemophagocytic lymphohistiocytosis (hlh), peg-infα-2b, hepatitis b virus (hbv), interferon-α, systemic lupus erythematosus (sle)
MeSH terms: Autoimmune Diseases, Lupus Erythematosus, Systemic / complications, Lupus Erythematosus, Systemic / diagnosis, Lupus Erythematosus, Systemic / drug therapy, Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / drug therapy, Lymphohistiocytosis, Hemophagocytic / etiology, Review, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Interferon-alpha / adverse effects, Macrophages, Male, Interferon-alpha

Hemophagocytic lymphohistiocytosis (HLH) is a severe and life-threatening hyperinflammatory condition characterized by excessive activation of macrophages and T cells and resulted in multi-organ dysfunction. HLH can be a primary disease or secondary to infections, malignancy, and some autoimmune diseases, including adult-onset Still's disease (AOSD) and systemic lupus erythematosus (SLE). However, it is rare for HLH to occur as a secondary condition to drug-induced lupus erythematosus (DILE). In this report, we present a case of HLH as an unusual complication during SLE treatment in a 31-year-old male patient. The patient initially suffered from active chronic hepatitis B (CHB) and was treated with pegylated INFα-2b (Peg-INFα-2b), tenofovir disoproxil and lamivudine. After 19 months, CHB obtained biochemical and virological response with HBsAg positive to HBsAb. The patient developed fever, headache, and cytopenia after Peg-INFα-2b treatment for 33 months, and laboratory studies revealed that ANA and anti dsDNA were positive. He displayed 5 features meeting the HLH-2004 criteria for diagnosis including fever, pancytopenia, hyperferritinemia, high levels of soluble CD25, and hemophagocytosis on bone marrow biopsy. The patient was initiated with a combination treatment of intravenous methylprednisolone pulse therapy, oral cyclosporine, and etoposide (VP-16), which was followed by a course of oral prednisolone, intravenous cyclophosphamide pulse therapy, and entecavir with complete response. To our knowledge, this is the first report of IFN-α induced SLE complicating with HLH. Physicians should consider the potential autoimmune side effects of IFN-α therapy and be alert to insidious HLH in patients diagnosed with SLE.
Organophosphate or organochlorines or something else....?
Authors: Ritesh Aggarwal, Shekhar Diddee
Journal: Indian J Crit Care Med (2009)
MeSH terms: Case Reports

Deltamethrin belongs to the pyrethroids group of insecticides. Poisoning due to pyrethroids clinically resembles poisoning due to other common insecticides like organophosphates. This overlap of presentations can lead to misdiagnosis. We present here such a case of deltamethrin poisoning.
Case report: Metastatic myxoid liposarcoma arising from the right atrium extends as cardiac tamponade-A rare case of atrial oncology
Authors: Muralidharan Thoddi Ramamurthy, Vinod Kumar Balakrishnan, Sini Sunny, Abinayaa Rajkumar, Sandhya Sundaram, Preetam Krishnamurthy, Nagendra Boopathy Senguttuvan, Arunan Murali, J D Roy Santhosham, Kalaiselvi Periandavan, Namakkal S Rajasekaran
Journal: Front Cardiovasc Med (2023)
Keywords: fdg (18f-fluorodeoxyglucose)-pet/ct, cardiac tamponade, cardiac tumor diagnosis, liposarcoma—diagnosis, right atrium (ra)
MeSH terms: Case Reports

The reported incidence of liposarcomas in ~2,000 cases annually results in about 30% of myxoid liposarcomas. Cardiac myoxid liposarcomas are very rare; their presentation could be cardiac tamponade, due to direct compression of the tumor and/or pericardial effusion. In this report, we describe a patient who presented with pericardial effusion secondary to myoxid liposarcomas from the right atrium, an extremely rare presentation of liposarcomas in the heart. We also present non-invasive imaging through echocardiography, CECT thorax and FDG PET scans, followed by a CT-guided mass biopsy. Histopathology of the right atrial mass demonstrated myxoid liposarcoma positive for the S100 tumor marker.
Acute esophageal necrosis: Case report of an unknown entity
Authors: A Maubert, S Frey, A Rahili, J Filippi, E Benizri
Journal: Int J Surg Case Rep (2019)
Keywords: acute esophageal necrosis, black esophagus, endoscopy, esophagus

Introduction:
Acute Esophageal Necrosis Syndrome (AENS) is a rare and unknown clinical entity, defined as a diffuse circumferential black-appearing friable esophageal mucosa going from the distal esophageal mucosa to the gastroesophageal (GE) junction. Esophagogastroduodenoscopy (EGD) remains the gold standard in making diagnosis.
Presentation of case:
We report here the case of a 45-year-old man with necrosis of the esophagus treated conservatively. Regression of the lesion but persistence of ulcerations were seen on the endoscopic follow-up. Distal esophageal stenosis was then diagnosed and treated by endoscopic dilation.
Discussion:
Diagnosis of AENS must be considered when an old patient, with multiple comorbidities, presents an upper digestive hemorrhage. Upper endoscopy is mandatory. Treatment is in most of the cases conservative. Esophageal stenosis is a frequent complication.
Conclusion:
Although AENS is a rare clinical entity, it should not be dismissed by doctors, avoiding useless surgical management. This pathology remains nevertheless associated with a considerable mortality rate.
An Extrafollicular Adenomatoid Odontogenic Tumor Mimicking a Periapical Cyst
Authors: Farzaneh Mosavat, Roxana Rashtchian, Negar Zeini, Daryoush Goodarzi Pour, Shabnam Mohammed Charlie, Nazanin Mahdavi
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Adenomatoid odontogenic tumor (AOT) is a rare noninvasive odontogenic tumor that occurs mostly in the second decade of life. Based on its tooth association, AOT can be classified into three categories of follicular, extrafollicular, and peripheral types; the follicular classification is considered as the most common type of AOT. This study reported a large extrafollicular case of AOT in a 40-year-old female. She was asymptomatic and tumor was detected accidentally by her dental practitioner. Since the panoramic radiograph showed a well-defined unilocular radiolucent lesion, we observed radiopaque spots within the lesion by using cone beam computed tomography. The extrafollicular type can mimic a periapical radiolucent lesion.
Concomitant factors leading to an atypical osteonecrosis of the jaw in a patient with multiple myeloma
Authors: Jaume Miranda-Rius, Lluís Brunet-Llobet, Eduard Lahor-Soler, Josep Anton Giménez-Rubio
Journal: Case Rep Med (2014)

Osteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The risk factors for ONJ include bisphosphonates treatments, head and neck radiotherapy, dental procedures involving bone surgery, and trauma. Management of ONJ has centred on efforts to eliminate or reduce severity of symptoms, to slow or prevent the progression of disease, and to eradicate diseased bone. This case describes a rare case of ONJ in a 64-year-old Caucasian male diagnosed with multiple myeloma stage III. The lesion was related to a traumatic injury during mastication. Eighteen months ago in the same area the molar 37 was extracted, achieving a complete satisfactory healing, when only 2 doses of zoledronic acid had been administered. Actinomyces bacterial aggregates were also identified in the microscopic analysis. The management of this osteonecrotic lesion included antibiotic treatment and chlorhexidine topical gel administration. The evolution was monitored every two weeks until patient's death. The authors provide a discussion of the etiology, pathogenesis, diagnosis, and management. This case report may shed light on the controversies about concomitant factors and mechanisms inducing ONJ.
Regression of metastatic colon tumour from primary adenocarcinoma of the lung due to fistulisation to the bowel lumen
Authors: Masaya Iwamuro, Yoshio Miyabe, Kai Hanae, Kawai Yoshinari, Takata Katsuyoshi, Toshi Murakami, Mifune Hirofumi, Kazuhide Yamamoto
Journal: Ecancermedicalscience (2014)
Keywords: colonic metastasis, lung cancer, pulmonary adenocarcinoma, tumour-bowel fistula
MeSH terms: Case Reports

An 80-year-old Japanese male was diagnosed with pulmonary adenocarcinoma. The patient exhibited extensive extra pulmonary involvement in the bone, adrenal gland, abdominal lymph nodes, and sigmoid colon. A single course of chemotherapy with carboplatin and pemetrexed was administered as the first-line treatment. Subsequently, the patient received pemetrexed monotherapy. Two months after the diagnosis, rapid regression of the metastatic tumour in the sigmoid colon was observed. Based on the findings of CT scanning and colonoscopic examination, tumour-bowel fistulisation was considered to be a cause of the rapid regression. This case report illustrates a tumour-bowel fistula of a colonic metastatic tumour in a patient with lung cancer. Radiographic and endoscopic features of the rare manifestation are presented.
A Combined Bony and Soft Tissue, Thoracic Chance Fracture: Late Displacement following Conservative Treatment
Authors: James Thomas Bourne, Alexander David Laing Baker, Manoj Khatri
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We report the first case of a combined bony and soft tissue Chance fracture in the thoracic spine, with late presenting displacement following conservative management. Chance fractures are flexion-distraction injuries to the spine. They consist of disruption and longitudinal separation of the posterior elements of the vertebra, with the fracture extending through the pedicles and into the vertebral body. Both bony and soft tissue Chance fractures of the lumbar spine have been reported, as well as bony Chance fractures in the thoracic spine. This case suggests that this type of fracture is unstable and is an indication for operative management. It is also important to note that the displacement of the fracture occurred at more than eight weeks after injury, suggesting that instability may not present immediately.
Fatal and Rapid Progressive Isolated Cerebral Mucormycosis Involving the Bilateral Basal Ganglia: A Case Report
Authors: Gao-Jia Zhang, Shao-Ke Zhang, Zan Wang, Yi-Xin Zhu, Jun Kong, Li-Li Huang, Yi-Jing Guo, Yan-Juan Wang, Rong-Cheng Zou, Chun-Ming Xie
Journal: Front Neurol (2020)
Keywords: rhizopus microspores, cerebrospinal fluid, histopathological examination, isolated cerebral mucormycosis, next-generation sequencing technology
MeSH terms: Case Reports

Isolated cerebral mucormycosis is a clinical type of mucormycosis that is estimated to account for 8% of all mucormycosis cases. The clinical symptoms of isolated cerebral mucormycosis are elusive, and thus conventional techniques often lake sensitivity and specificity. Moreover, cultures are often negative, even when direct microscopy examination is positive. Although histopathology will probably remain the gold standard for the diagnosis of mucormycosis, obtaining a biopsy specimen is not always feasible in most vulnerable populations. Thus, molecular approaches are currently used as an advantageous assistant examination method to improve the early identification of the causative agent and subsequently guide therapy to improve the prognosis of patients. Here, we report a case of isolated cerebral mucormycosis caused by Rhizopus microspores in a healthy young adult that was identified using next-generation sequencing technology.
Two case reports of bilateral vertebral artery tortuosity and spiral twisting in vascular vertigo
Authors: Zhang Hong-tao, Zhang Shu-ling, Zhang Dao-pei
Journal: BMC Neurol (2014)
MeSH terms: Arteries / abnormalities, Joint Instability / diagnostic imaging, Skin Diseases, Genetic / diagnostic imaging, Vascular Malformations / diagnostic imaging, Vertebral Artery / diagnostic imaging, Vertigo / diagnostic imaging, Case Reports, Research Support, Non-U.S. Gov't, Aged, Female, Humans, Joint Instability / complications, Male, Radiography, Skin Diseases, Genetic / complications, Vascular Malformations / complications, Vertigo / complications, Arterial Tortuosity Syndrome

Background:
Tortuous blood vessels are commonly seen in the cerebral arteries. The association between vertebrobasilar artery tortuosity and vascular vertigo remains obscure.
Case presentation:
We describe two patients with vascular vertigo who had bilateral curving and spiral looping in multiple segments of the vertebral arteries and also exhibited basilar artery tortuosity. Both patients had cerebrovascular risk factors and exhibited clinical features of vertigo with high severity, slow recovery, and recurrent tendencies. Contrast enhanced magnetic resonance angiography of the neck showed bilateral tortuosity in the V2 segments and spiral twisting in the V4 segments of the vertebral arteries, and basilar artery curving. No obvious sign of atherosclerotic stenosis was found in the vertebrobasilar arteries and no abnormalities were observed in the internal carotid arteries. Transcranial Doppler ultrasound showed decreased blood flow in tortuous vertebrobasilar arteries. Brainstem auditory evoked potentials showed that the interpeak latencies (IPL) of waves III-IV were prolonged, with a ratio of IPL III-V/IPL I-III > 1.
Conclusions:
Vertebrobasilar tortuosity in combination with cerebrovascular risk factors may lead to vascular vertigo in these patients.