OpenMed/multicare-articles huggingface dataset:
Retroperitoneal lymphangioma in an adult: a case report of a rare clinical entity
Authors: Mayank Tripathi, Sanjeev Parshad, Rajender Kumar Karwasra, Ashish Gupta, Saket Srivastva, Ankush Sarwal
Journal: Case Rep Surg (2015)

Background. Retroperitoneal lymphangioma is a rare, benign mesodermal tumor arising from the retroperitoneal lymphatics which usually presents in infancy and it is worthy to report a case when it has presented in an adult. After a thorough literature search in English we concluded that less than 200 cases of adult retroperitoneal lymphangioma have been reported so far. Apart from being a rare entity it also presents as a diagnostic dilemma and final diagnosis is often made on surgical exploration. Case Presentation. We report a case of retroperitoneal lymphangioma in a 55-year-old male who presented with abdominal distension and dull aching abdominal pain. Conclusion. Retroperitoneal lymphangiomas are rare tumors of infancy but may also present in adults where they are a diagnostic challenge. Differentiating cystic lymphangiomas from other cystic growths by imaging studies alone are often inconclusive and surgery is frequently required for definitive diagnosis and to ameliorate the symptoms.
A Case of Pyriform Sinus Fistula with Respiratory Distress in the Neonatal Period
Authors: Noriko Hamaguchi, Hajime Ishinaga, Kazuki Chiyonobu, Hiroyuki Morishita, Kazuhiko Takeuchi
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Pyriform sinus fistula (PSF) is an anomaly that can arise due to failure of involution of the third or fourth branchial cleft during embryogenesis. It can manifest clinically as sinuses, cysts, or abscesses in the neck and is common in childhood. Herein, we describe a neonate who presented with neck swelling and respiratory distress, which was secondary to a fourth branchial pouch sinus. Physical examination revealed swollen areas in the posterolateral pharyngeal wall and on the external left side of the neck. Computed tomography imaging showed a left-sided mass that was filled with air and fluid. Eventually, the pyriform sinus cyst and the entire fistulous tract were excised. The postoperative course was uneventful. Follow-up after 18 months showed no recurrence.
Bladder rupture after pembrolizumab immunotherapy for bladder cancer: a case report
Authors: Ahmed Badheeb, Omar Alkhanbashi, Slah Rakrouki, Tahir Mahmood, Mashhoor Alqannas, Mohamed Badheeb, Faisal Ahmed
Journal: Pan Afr Med J (2022)
Keywords: perforation, bladder cancer, case report, pembrolizumab
MeSH terms: Antineoplastic Agents, Immunological, Carcinoma, Transitional Cell, Urinary Bladder Diseases, Urinary Bladder Neoplasms, Case Reports, Aged, Antibodies, Monoclonal, Humanized, Humans, Immunologic Factors, Immunotherapy, Male, Urinary Bladder, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, Immunologic Factors, pembrolizumab

Pembrolizumab is a promising checkpoint inhibitor for advanced urothelial carcinoma. Like other immunotherapies, it can cause rare immune-related adverse events. The spontaneous rupture of the urinary bladder after the intravenous injection of pembrolizumab is rare and has not been reported. Here, we present a 74-year-old man patient case of locally advanced transitional cell carcinoma of the urinary bladder who presented severe abdominal pain the same day of the second dose of pembrolizumab administration. The exploratory laparotomy revealed intraperitoneal rupture of the urinary bladder associated with peritonitis. After surgical repair, the patient's condition improved. The purpose of this report is to discuss the possible association of bladder perforation in bladder cancer with pembrolizumab immunotherapy, its management, and the importance of early recognition to prevent more fatal complications.
Case report: Variable response to immunotherapy in ovarian cancer: Our experience within the current state of the art
Authors: Nicoletta Provinciali, Marco Greppi, Silvia Pesce, Mariangela Rutigliani, Irene Maria Briata, Tania Buttiron Webber, Marianna Fava, Andrea DeCensi, Emanuela Marcenaro
Journal: Front Immunol (2022)
Keywords: pd-1, pd-l1, avelumab, immunotherapy, ovarian cancer
MeSH terms: Antineoplastic Agents / pharmacology, Ovarian Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal / therapeutic use, Bevacizumab, Female, Humans, Immunotherapy, Antibodies, Monoclonal, Antineoplastic Agents, Bevacizumab

Despite recent advances in ovarian cancer (OC) treatment, including the introduction of bevacizumab and PARP-inhibitors, OC remains a lethal disease. Other therapeutic options are being explored, such as immunotherapy (IT), which has been proved effective in many solid tumors. Findings about tumor-infiltrating cytotoxic and regulatory T cells, together with the expression of PD-1 on immune cells and of PD-L1 on tumor cells, gave the rationale for an attempt to the use of IT also in OC. We treated two patients with avelumab, an anti-PD-L1 monoclonal antibody, after the first line of chemotherapy: Patient A underwent 19 cycles of maintenance therapy with avelumab with a disease-free interval of 12 months, whereas patient B showed a slight progression of disease after only eight cycles. A higher PD-L1 expression in tumor cells of patient A was detected. She also underwent a genomic assessment that described the presence of a high Tumor Mutational Burden (TMB) and a status of Loss of Heterozygosity (LoH). This different response to the same treatment puts in evidence that some genomic and immune features might be investigated.
Radiation induced osteogenic sarcoma of the maxilla
Authors: Om Prakash, Bipin T Varghese, Anita Mathews, Nileema Nayak, Krishnankutty Ramchandran, Manoj Pandey
Journal: World J Surg Oncol (2005)

Background:
Radiation induced sarcoma arise as a long term complication of radiation treatment for other benign or malignant conditions. They are of very rare occurrence in jaw bones and are even rarer in maxilla.
Case presentation:
Here we report a case of radiation induced sarcoma in a patient treated for squamous cell carcinoma of buccal mucosa with radiation who developed osteosarcoma of maxillary bone after six years. The patient was treated successfully with surgery.
Conclusion:
What should be the best treatment of radiation induced sarcoma is still debatable; however, surgery offers the best chance of cure. Role of reradiation and adjuvant chemotherapy needs to be further evaluated.
Clinical, Diagnostic, and Imaging Findings in Three Juvenile Dogs With Paraspinal Hyperesthesia or Myelopathy as a Consequence of Hemophilia A: A Case Report
Authors: Kayla M Fowler, Timothy A Bolton, John H Rossmeisl, Avril U Arendse, Karen M Vernau, Ronald H L Li, Rell L Parker
Journal: Front Vet Sci (2022)
Keywords: hemophilia, hemorrhage, magnetic resonance imaging (mri), myelopathy, paraspinal hyperesthesia
MeSH terms: Case Reports

Three juvenile dogs presented with an acute onset of paraspinal hyperesthesia and/or neurologic deficits. These dogs underwent anesthesia for MRI and additional diagnostics. The thoracolumbar MRI in Dog 1 revealed an accumulation of T2-weighted (T2W) hyperintense, T1-weighted (T1W) iso- to hyperintense, contrast enhancing extradural material. The differential diagnoses were meningitis with secondary hemorrhage or empyema or late subacute hemorrhage. The initial cervical MRI in Dog 2 revealed T1W meningeal contrast enhancement suspected to be secondary to meningitis. A repeat MRI following neurologic decline after CSF sampling revealed a large area of T2W and T1W hyperintensity between fascial planes of the cervical musculature as well as T2W iso- to hyperintense and T1W iso- to hypointense extradural material at the level of C1 consistent with hemorrhage. The cervical MRI in Dog 3 revealed T2W hyperintense and T1W iso- to hypointense extradural compressive material consistent with hemorrhage. Dogs 1 and 2 underwent CSF sampling and developed complications, including subcutaneous hematoma and vertebral canal hemorrhage. Dog 3 underwent surgical decompression, which revealed a compressive extradural hematoma. In each case, a hemophilia panel including factor VIII concentration confirmed the diagnosis of hemophilia A. Dog 1 had a resolution of clinical signs for ~5 months before being euthanized from gastrointestinal hemorrhage. Dog 2 was euthanized due to neurologic decompensation following CSF sampling. Dog 3 did well for 2 weeks after surgery but was then lost to follow-up. This case series provides information on clinical signs, MRI findings, and outcome in 3 juvenile dogs with hemophilia A that developed neurologic deficits or paraspinal hyperesthesia secondary to spontaneous or iatrogenic vertebral canal hemorrhage. Hemophilia A should be considered as a differential in any young dog presenting with an acute onset of hyperesthesia with or without neurologic deficits. This diagnosis should be prioritized in young male dogs that have other evidence of hemorrhage on physical exam.
Closure of subarterial ventricular septal defect with minimally invasive surgical technique: A case report
Authors: Duc Hung Duong, Quoc Dat Pham
Journal: Int J Surg Case Rep (2019)
Keywords: case report, left parasternal thoracotomy, minimally invasive cardiac surgery, subarterial ventricular septal defect

Introduction:
Minimally invasive cardiac surgery has been applied for the treatment of ventricular septal defect (VSD) with various approaches. However, closure of subarterial VSD with minimally invasive technique via left parasternal thoracotomy is rarely reported.
Case presentation:
A 22-year-old man, weighing 65 kg, with a diagnosis of subarterial VSD underwent successful repair with minimally invasive technique via left parasternal thoracotomy through third intercostal space. The peripheral perfusion was performed with femoral arterial and venous cannulation. Myocardium was protected by warm blood cardioplegia injected directly into aortic root by a long needle and aortic clamp introduced through the thoracotomy incision.
Discussion:
The left parasternal thoracotomy through third intercostal space (ICS) allows to expose both the subarterial VSD and ascending aorta. Myocardial protection and repair of this defect can be performed merely without requirements of video assistance or unique instruments. The patient recovered rapidly and was satisfied with the cosmetic result. The primary concern of this technique is mammary tissue which can be injured by a transverse incision in female patients. In this case, we can transform into the longitudinal incision.
Conclusion:
This minimally invasive technique is feasible for the surgical treatment of subarterial VSD. Long-term follow-up and additional cases will be needed for validation of the safety and efficacy of this approach.
Rare presentation of rhino-orbital-cerebral zygomycosis: bilateral facial nerve palsy
Authors: Alireza Mohebbi, Hesam Jahandideh, Ali Amini Harandi
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Rhino-orbital-cerebral zygomycosis afflicts primarily diabetics and immunocompromised individual, but can also occur in normal hosts rarely. We here presented an interesting case of facial nerve palsy and multiple cold abscesses of neck due to rhino-orbital-cerebral zygomycosis in an otherwise healthy man. Although some reports of facial nerve paralysis in conjunction with rhino-orbital-cerebral zygomycosis exist, no case of bilateral complete facial paralysis has been reported in the literature to date.
Canalicular laceration (cheese wiring) with a silicone tube after endoscopic dacryocystorhinostomy: when to remove the tube?
Authors: Umut Karaca, Hakan Genc, Gulsah Usta
Journal: GMS Ophthalmol Cases (2019)
Keywords: canalicular laceration, dacryocystorhinostomy, removal time, silicone tube
MeSH terms: Case Reports

Objective: To discuss the removal time of a nasolacrimal silicone tube stent by reporting three cases with canalicular laceration due to prolonged indwelling of the stent. Methods: This study involved three cases of nasolacrimal duct obstruction treated by endoscopic dacryocystorhinostomy with silicone tube insertion. Results: The mean indwelling time of the silicone tube was 9.3 months and all of the patients had lower canalicular laceration near the common canaliculus. One patient presented with a complaint of canthal pain, blurred vision, and epiphora while the other two patients reported no complaint. The nasal endoscopic examination revealed a narrow fibrotic ostium below the medial concha. The silicone tubes were removed. Conclusions: To increase the success rate of the operation, the removal time for nasolacrimal silicone tubes after dacryocystorhinostomy is also important. Our findings indicate that physicians should be aware of the potential problems related to prolonged intubation.
Purple Urine Bag Syndrome: A Rare and Surprising Clinical Presentation
Authors: Nathan DeRon Jr, Carley Legan
Journal: Cureus (2023)
Keywords: pubs, purple, purple urine bag syndrome, urinary tract infection, uti
MeSH terms: Case Reports

Purple urine bag syndrome (PUBS) is a rare finding that can be very alarming to patients and physicians. PUBS has a simple visual diagnosis with clinical symptoms that can aid in a quick and appropriate treatment plan. However, a lack of physician awareness could be harmful to the patient and cause unnecessary treatment and increased morbidity and financial burden to the patient. We present a case with this surprising finding and discuss the pathophysiology and management options for this rare syndrome.
Theoretical pluralism in psychoanalytic case studies
Authors: Jochem Willemsen, Shana Cornelis, Filip M Geerardyn, Mattias Desmet, Reitske Meganck, Ruth Inslegers, Joachim M B D Cauwe
Journal: Front Psychol (2015)
Keywords: pluralism, psychoanalytic schools, single case archive, single case study, survey

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.
Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
Authors: Li Sun, Pulin Li, Bo Pang, Peipei Wu, Ran Wang
Journal: Front Med (Lausanne) (2021)
Keywords: gestational psittacosis, gestational psittacosis with secondary hemophagocytic syndrome, hemophagocytic syndrome, long-term high fever, metagenomic next-generation sequencing
MeSH terms: Case Reports

Gestational psittacosis and hemophagocytic syndrome (HPS) are rare clinical diseases. In this article, a case of gestational psittacosis concomitant with secondary HPS was reported. An analysis was performed on the clinical characteristics, signs, laboratory findings, progression, diagnosis, and treatment of a patient with gestational psittacosis concomitant with secondary HPS. Besides, the literature with respect to this disease was reviewed. This patient was definitively diagnosed through metagenomic next-generation sequencing techniques, bone marrow puncture and smear examination, and the determination of sCD25 level and natural killer (NK) cell activity. Anti-infectives such as doxycycline and etoposide combined with hormone chemotherapy achieved significant improvement in cough and expectoration, a return to normal temperature, and a significant improvement in oxygenation index. In addition, chest computed tomography revealed obvious absorption of lung lesions and a return of NK cell activity and sCD25 levels to normal ranges. Chlamydia psittaci pneumonia requires a clear determination of etiology, while HPS requires bone marrow puncture and smear examination, together with the determination of sCD25 level and NK cell activity in the blood. The findings of this study suggest that metagenomic next-generation sequencing is an effective instrument in clearly identifying pathogens that cause lung infection. Clinicians should consider atypical pathogens of lung infection in patients with poor response to empirical anti-infectives, and strive to design an effective treatment strategy as per an accurate diagnosis based on the etiology. As for patients suffering from long-term high fever and poor temperature control after broad-spectrum antibiotic treatment, non-infectious fever should be taken into account. A rapid and clear diagnosis would significantly improve patient prognosis.
Ex utero intrapartum treatment for fetal oropharyngeal cyst
Authors: Allen W Ayres, Suzanne K Pugh
Journal: Obstet Gynecol Int (2010)
MeSH terms: Case Reports

Background. A prenatally diagnosed fetal anomaly that could compromise the fetal airway at delivery can be managed safely with the ex utero intrapartum treatment (EXIT) procedure. Case. A 26-year-old healthy primigravida was diagnosed during her midtrimester anatomic ultrasound survey with a fetal oropharyngeal cystic structure located at the base of the tongue. The neonatal airway was successfully secured intrapartum using the EXIT procedure. Conclusion. Maintenance of fetoplacental circulation until the fetal airway is secured has been described for a multitude of fetal anomalies including cystic hygroma and teratoma. The literature also recounts its use for the reversal of tracheal plugging for congenital diaphragmatic hernia. A multidisciplinary approach to the antenatal and intrapartum care is essential for the successful management of these cases.
Large Rhinophyma Treated by Surgical Excision and Electrocautery
Authors: Nabeel K Al Hamzawi, Salih M Al Baaj
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Rhinophyma is a benign condition characterized by a large, bulbous nose with prominent pores. It is commonly associated with untreated cases of rosacea. The disease can carry a substantial psychological impact that causes patients to seek advice about how to improve their physical appearance. Many treatment options are available for rhinophyma, but there is no standard treatment protocol. Here, we describe the case of a 65-year-old man with a large rhinophyma that caused him cosmetic and psychosocial embarrassment. The condition was treated by surgical excision and bipolar electrocautery. No complications occurred after the procedures, and healing was completed 2 weeks later by secondary intention and reepithelialization. A simple surgical removal using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be considered as a good treatment option for rhinophyma, as it results in an excellent cosmetic outcome and has short recovery time.
Splenic artery aneurysm rupture during pregnancy: A case report of maternal and fetal survival
Authors: Manato Fujii, Suguru Yamashita, Ayako Fudono, Shuichi Yanai, Jo Tashiro, Yoshiharu Takenaka, Kazuki Yamasaki, Eisaku Ito, Yukiyoshi Masaki
Journal: Int J Surg Case Rep (2020)
Keywords: pregnancy, rupture, splenic artery aneurysm
MeSH terms: Case Reports

Introduction:
Pregnancy has been demonstrated as a significant risk factor of splenic artery aneurysm (SAA) formation and rupture. However, prompt diagnosis of SAA rupture in a pregnant patient showing acute abdomen has been practically challenging in light of its rarity and vague initial presentation.
Presentation of case:
A 40-year-old woman (gravida 1, para 0) at 35 weeks' gestation presented to the emergency department with upper abdominal pain and nausea. Because of fetal dysfunction, emergency caesarian section was performed by a Pfannenstiel incision. Following delivery, 400 g of hemorrhage was removed from the upper abdominal cavity. Computed tomography showed a 37-mm SAA associated with copious adjacent fluid. Although selective angiography did not demonstrate active extravasation, interventional isolation of the SAA was not performed because of multiple surrounding arteries. Relaparotomy with an upper midline incision was then performed. Sudden cardiac arrest occurred upon opening the lesser sac to irrigate clots, and cardiac massage and proximal and distal clamping of the SAA were required. Eventually, splenectomy with excision of the SAA and pancreatic tail was successfully performed, but gauze packing of the open surgical wound was required because of severe coagulopathy. Following removal of the packs and closure of the abdomen 2 days after splenectomy, the patient and infant satisfactorily recovered without sequelae.
Discussion:
Given continual awareness of abdominal vascular collapse during pregnancy, undelayed diagnosis and safer intervention might be achieved.
Conclusion:
Awareness at initial presentation and multidisciplinary efforts might be essential to achieve maternal and fetal survival in SAA rupture during pregnancy.
Chinese Medicine Treatment for Afatinib-Induced Paronychia
Authors: Pei-Yuu Yang, Chen-Jei Tai
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Afatinib (Gilotrif™) is widely used to treat patients with mutant activating epidermal growth factor receptor- (EGFR-) dependent lung adenocarcinoma; however, it has various adverse side effects. Here, we report a patient with afatinib-induced paronychia. After Chinese medicine treatment with the well-known anticancer Chinese herbs, Jen-Ren-Hwo-Minq-Saan, and decoction of Ban-Zhi-Lian (Scutellaria barbata) with Bai-Hua-She-She-Cao (Hedyotis diffusa Willd), patient's condition was significantly improved. This shows that these Chinese medicines can not only be used in cancer treatment but also be used in the afatinib-induced paronychia.
Case Report: Assessing the Position of Pacemaker Leads via Transthoracic Echocardiography: Additional Value of the Subcostal En Face View
Authors: Andrea Simone Deichl, Philipp Lacour, Evgeny Belyavskiy, Burkert Pieske, Elisabeth Pieske-Kraigher, Florian Blaschke, Matthias Schneider
Journal: Front Cardiovasc Med (2021)
Keywords: echocardiography, en-face imaging, pacemaker, tricuspid regurgitation, tricuspid valve
MeSH terms: Case Reports

There is an association between presence of cardiac implantable electronic devices (CIED) and development of tricuspid regurgitation (TR). Mechanisms proposed to explain CIED-induced TR can be classified as implantation-related, lead-related, and pacing-related. Lead-related TR results from the direct interaction of the lead with the tricuspid valve (TV). The localization of the lead at the TV level directly influences the probability of subsequent development of significant TR. A transthoracic subcostal en face view of the TV can be acquired in most patients through a 90° rotation from the subcostal 4-chamber view with clear anatomic delineation of the TV and the commissures including lead position. This case-series presents three examples where the transthoracic en face view could add incremental information on the position of the pacemaker leads and on the mechanism of TR. Conclusion: When performing transthoracic echocardiography in patients with trans-tricuspid CIED lead(s), an en face view of the TV with exact reporting of the position of the lead(s) should be included.