OpenMed/multicare-articles huggingface dataset:
Primary Ewing's Sarcoma of the Kidney in a 73-Year-Old Man
Authors: T B Wedde, I V K Lobmaier, B Brennhovd, F Lohne, K S Hall
Journal: Sarcoma (2011)
MeSH terms: Case Reports

Objective. Ewing's sarcoma of the kidney is rare and is usually found in young adults. We present here a single case study of Ewing's sarcoma found in an elderly man. Material and methods. A 73-year-old man underwent routine surgery for hydrocoele of the testis. He developed urinary obstruction symptoms, and radiological examinations revealed a tumour in the right kidney. Results. Microscopical, immunohistochemical, and molecular pathological analysis of the tumour was consistent with Ewing's sarcoma. FISH showed rearrangement of chromosomes 22q12 (EWSR1). The patient subsequently underwent nephrectomy followed by 6 adjuvant chemotherapy cycles. Follow-up after 7 months shows no recurrence. Conclusion. This case report presents not only the rare finding of Ewing's sarcoma in the kidney, but also the occurrence of this tumour entity in an elderly patient. Treatment options for the different types of renal tumours are vastly different and the need for a correct diagnosis is, therefore, vital.
Pediatric Scurvy: When Contemporary Eating Habits Bring Back the Past
Authors: Alice Brambilla, Cristina Pizza, Donatella Lasagni, Lucia Lachina, Massimo Resti, Sandra Trapani
Journal: Front Pediatr (2018)
Keywords: eating disorders, malnutrition, pediatric nutrition, scurvy, vitamin c deficiency
MeSH terms: Case Reports

Vitamin C deficiency is anecdotal in developed countries, mainly associated with underling clinical morbidities as autism or neurological impairment. Chronic insufficient dietary supply is responsible for vascular fragility and impaired bone formation, resulting in gingival bleeding, petechial lesions, articular and bone pain or limb swelling. Children may present anorexia, irritability, failure to thrive, limping or refusal to walk. Accordingly, pediatric scurvy is frequently misdiagnosed with osteomyelitis, septic arthritis, bone and soft tissue tumor, leukemia, bleeding disorders, and rheumatologic conditions. We report the case of a 3-years old child developing scurvy as consequence of strict selective diet; extensive and invasive investigations were undertaken before the correct diagnosis was considered. Despite being considered a rare condition, scurvy still exists nowadays, even in children with no apparent risk factors living in wealthy families. The increasing popularity of dietary restriction for children, especially those with allergies, may potentially enhance the occurrence of scurvy in apparently healthy children. Appropriate dietary anamnesis is fundamental in order to highlight potential nutritional deficit and to avoid unnecessary invasive diagnostic procedures. Patients without considerable risk factors may benefit from psychological support in order to investigate possible eating disorders.
Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
Authors: Ankur Sinha, Hitesh Raheja, Vinod Namana, Sunil Abrol, Stephan Kamholz, Vijay Shetty
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

A 49-year-old African American male patient with no past medical history was admitted because of 3 months of difficulty swallowing solid and liquid foods. He had constant retrosternal discomfort and appeared malnourished. The chest radiograph revealed a right sided aortic arch with tracheal deviation to the left. A swallow study confirmed a fixed esophageal narrowing at the level of T6. Contrast enhanced Computed Tomography (CT) angiogram of the chest and neck revealed a mirror image right aortic arch with a left sided cardiac apex and a prominent ductus diverticulum (measuring 1.7 × 1.8 cm). This structure extended posterior to and indented the mid esophagus. A left posterolateral thoracotomy was performed and the ductus diverticulum was resected. A retroesophageal ligamentum arteriosum was found during surgery and divided. This rare combination of congenital anatomical aberrations led to severe dysphagia in our patient. Successful surgical correction in the form of resection of the ductus diverticulum and division of the retroesophageal ligamentum arteriosum led to complete resolution of our patient's symptoms.
First Case of Lung Abscess due to Salmonella enterica Serovar Abony in an Immunocompetent Adult Patient
Authors: Vassiliki Pitiriga, John Dendrinos, Emanuel Nikitiadis, Georgia Vrioni, Athanassios Tsakris
Journal: Case Rep Infect Dis (2016)

In healthy individuals, nontyphoidal Salmonella species predominantly cause a self-limited form of gastroenteritis, while they infrequently invade or cause fatal disease. Extraintestinal manifestations of nontyphoidal Salmonella infections are not common and mainly occur among individuals with specific risk factors; among them, focal lung infection is a rare complication caused by nontyphoidal Salmonella strains typically occurring in immunocompromised patients with prior lung disease. We describe the first case of a localized lung abscess formation in an immunocompetent healthy female adult due to Salmonella enterica serovar Abony. The patient underwent lobectomy and was discharged after full clinical recovery. This case report highlights nontyphoidal Salmonellae infections as a potential causative agent of pleuropulmonary infections even in immunocompetent healthy adults.
A 22-year-old female with invasive epithelioid angiomyolipoma and tumor thrombus into the inferior vena cava: case report and literature review
Authors: Campbell Grant, John M Lacy, Stephen E Strup
Journal: Case Rep Urol (2013)

A 22-year-old female presented with back pain and was discovered to have a right-sided abdominal mass. Computed tomography (CT) scan revealed a 9 cm enhancing right upper pole renal mass with suspicion for tumor thrombus into the right renal vein and possibly the inferior vena cava (IVC). Magnetic resonance imaging (MRI) confirmed tumor thrombus into the inferior vena cava approximately 3 cm below the hepatic venous confluence. Open right radical nephrectomy with inferior vena cava thrombectomy was performed with removal of right kidney and tumor thrombus en bloc. Pathology revealed malignant epithelioid angiomyolipoma (EAML or PEComa). Epithelioid angiomyolipoma is a rare tumor of mesenchymal tissue that has the potential for local invasion and disease progression. Diagnosis of EAML was confirmed by pathology and immunohistochemistry. She was referred to medical oncology for discussion of surveillance versus potential adjuvant therapy and ultimately opted for close surveillance.
Arena-Anchored Urban Development Projects and the Visitor Economy
Authors: Taryn Barry, Daniel S Mason, Robert Trzonkowski
Journal: Front Sports Act Living (2022)
Keywords: arenas, cities, placemaking, stadiums, visitor economy

Cities of all sizes are actively engaged in developing various urban infrastructure projects. A common strategy used in larger North American cities is employing arena-anchored urban development projects, where a professional sports team is used as an anchor tenant of a sports facility to generate development in the city. One means of relocating economic activity is to increase visitation to the desired redevelopment area. In this paper we used the visitor economy as a lens to explore how arena-anchored projects and the professional sports teams that play there fit into a local city's tourism economy. To conduct this study, a multi case study design was used to draw data from two cities: Columbus, Ohio, and Detroit, Michigan. Interviews were goal directed and conducted in person with leaders in Columbus (n = 9) and Detroit (n = 10), and inductive and deductive approaches to coding were undertaken in the form of content analysis. The results indicate that growing the visitor economy through arena anchored urban development relies on planned placemaking via the strategic approach of bundling diverse amenities together. These findings provide valuable feedback to those cities considering arena development projects, and how the arenas may be combined with other civic amenities to undergird the local visitor economy.
Transumbilical Surgery for Duodenal Stenosis in a Child with Situs Inversus: The First Report
Authors: Isamu Saeki, Yu Ueno, Wataru Mukai, Reisuke Imaji, Takashi Akiyama
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Background. Situs inversus is a rare congenital anomaly with a reported incidence of only 1 in 5,000 to 10,000 live births. Congenital duodenal stenosis complicated with situs inversus is an even rarer entity. Case Presentation. A 1-year-old girl with situs inversus who had undergone a hemi-Fontan procedure against a single ventricle in our hospital was referred to our department for vomiting and failure to thrive. An upper gastrointestinal contrast study and endoscopy revealed duodenal stenosis. A transumbilical radical operation as a minimally invasive surgery was successfully performed. After the surgery, she stopped vomiting, and the postoperative course was uneventful with good cosmetic results. Conclusions. To our knowledge, this is the first report of transumbilical surgery for congenital duodenal stenosis with situs inversus as minimally invasive surgery. Transumbilical surgery to situs inversus patient can be performed safely and lead to good cosmetic outcome.
Deep Brain Stimulation during Pregnancy and Delivery: Experience from a Series of "DBS Babies"
Authors: Emma Scelzo, Jan H Mehrkens, Kai Bötzel, Paul Krack, Alexandre Mendes, Stéphan Chabardès, Mircea Polosan, Eric Seigneuret, Elena Moro, Valerie Fraix
Journal: Front Neurol (2015)
Keywords: parkinson disease, tourette’s syndrome, deep brain stimulation, dystonia, obsessive compulsive disorder, pregnancy, teratogenicity
MeSH terms: Case Reports

Introduction:
Deep brain stimulation (DBS) is widely used to improve quality of life in movement disorders (MD) and psychiatric diseases. Even though the ability to have children has a big impact on patients' life, only a few studies describe the role of DBS in pregnancy.
Objective:
To describe risks and management of women treated by DBS for disabling MD or psychiatric diseases during pregnancy and delivery.
Methods:
We report a retrospective case series of women, followed in two DBS centers, who became pregnant and went on to give birth to a child while suffering from disabling MD or psychiatric diseases [Parkinson's disease, dystonia, Tourette's syndrome (TS), Obsessive Compulsive Disorder (OCD)] treated by DBS. Clinical status, complications and management before, during, and after pregnancy are reported. Two illustrative cases are described in greater detail.
Results:
DBS improved motor and behavioral disorders in all patients and allowed reduction in, or even total interruption of disease-specific medication during pregnancy. With the exception of the spontaneous early abortion of one fetus in a twin pregnancy, all pregnancies were uneventful in terms of obstetric and pediatric management. DBS parameters were adjusted in five patients in order to limit clinical worsening during pregnancy. Implanted material limited breast-feeding in one patient because of local pain at submammal stimulator site and led to local discomfort related to stretching of the cable with increasing belly size in another patient whose stimulator was implanted in the abdominal wall.
Conclusion:
Not only is it safe for young women with MD, TS and OCD who have a DBS-System implanted to become pregnant and give birth to a baby but DBS seems to be the key to becoming pregnant, having children, and thus greatly improves quality of life.
Management of Intracranial Metastases in EGFR-Mutated NSCLC: A Review of Literature following an Unusual Case Report
Authors: Víctor Albarrán, Javier Pozas, Juan José Soto, Jorge Esteban, Elena Corral, Yolanda Lage, Pablo Gajate, Pilar Garrido
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

The arrival of subsequent generations of tyrosine-kinase inhibitors (TKIs) has significantly broaden the EGFR-mutated lung cancer therapeutic landscape. Results from the FLAURA clinical trial have pushed osimertinib to the first-line treatment for patients with advanced-stage disease, showing outstanding control rates of intracranial metastases, considerably higher than those of the first and second-generation EGFR TKIs. A progressively better knowledge of short and long-term neurocognitive side effects of radiotherapy, as well as the lack of evidence about the benefit of its combination with TKIs, has opened a debate about its indication at diagnosis of intracranial disease, at least before the response to targeted therapy has been evaluated. However, there is a small percentage of primarily resistant cases to osimertinib, mainly due to histologic transformation, acquired EGFR mutations and off-target genetic resistances that lead to a scenery of poor clinical prognosis in which radiotherapy may have a higher relevance for the management of brain metastases. We offer a review of the current recommendations for the management of intracranial metastases in EGFR-mutated NSCLC and the resistance mechanisms to third-generation TKIs, following the report of an unusual clinical case with a rapid progression to osimertinib.
Anogenital Ulcers: An Unusual Manifestation of Invasive Aspergillosis
Authors: Pablo Vargas, Fernando Valenzuela, Viera Kaplan, Jacob Yumha, Montserrat Arceu, Claudia Morales
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Aspergillus spp. is one of the most ubiquitous fungi but generally does not cause disease in immunocompetent patients. It is the second most frequent agent of opportunistic fungal infections, after Candida albicans, with a rise in its incidence on recent years. Invasive fungal diseases represent an important cause of morbidity and mortality. Its origin can be primary, in relation to a cutaneous injury, or secondary, by extension from contiguous tissues, or by hematogenous spread, usually in the context of pulmonary aspergillosis. In this report, we describe the case of an elderly woman with invasive aspergillosis that manifested with anogenital and skin ulcers, with unfavorable outcome, despite intensive therapy and intravenous antifungals.
An unusual intracranial metallic foreign bodies and panhypopituitarism
Authors: Mohammed Lakouichmi, Hicham Baïzri, Abdelilah Mouhsine, Abderrahmane Boukhira, Ali Akhaddar
Journal: Pan Afr Med J (2014)
Keywords: panhypopituitarism, intracranial, migraine headaches
MeSH terms: Foreign Bodies / complications, Head Injuries, Penetrating / complications, Hypopituitarism / etiology, Sinusitis / etiology, Case Reports, Foreign Bodies / diagnosis, Head Injuries, Penetrating / diagnosis, Headache / etiology, Humans, Hypopituitarism / diagnosis, Male, Middle Aged, Sinusitis / diagnosis, Combined Pituitary Hormone Deficiency

A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors.
A Rare Presentation of Lisegang Rings in Adrenal Cavernous Hemangioma : Case Report and Literature Review
Authors: Wejdan Almotairi, Abdullah Alhamam, Aali Alotaibi, Tarek El Sharkawy, Hind S Alsaif, Abdulatif Almousa, Ossamah Alsowayan, Hamed Eldarawany, Kamel Fadaak
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Background:
Adrenal cavernous hemangiomas (AH) are benign nonfunctional vascular tumors rarely discovered as incidental findings on imaging studies or autopsies. This study presents a single case report of AH with another rare finding of the Liesegang ring. Also, we reviewed 73 case reports of cavernous adrenal hemangioma to provide an overview of AH's clinical characteristics. Case Report. A nonfunctional AH was incidentally discovered in a 59-year-old morbidly obese female patient with a 10-year history of hypertension and thyroidectomy. An abdominal computed tomography (CT) scan showed a left suprarenal mass of ∼16 cm in diameter. While the patient had no clinical manifestations from the hemangioma, all laboratory tests were within the normal values with no indication of a functional adrenal tumor. The mass was removed by open left adrenalectomy. The microscopic histological examination revealed a laminated structure with wide blood-filled spaces with a central core of necrotic and hemorrhagic changes, characteristic of a cavernous AH with the presence of a rare Liesegang ring.
Conclusion:
Although rare, AH should be considered as a differential diagnosis for adrenal masses. This is the first reported case of a cavernous AH with rare microscopic findings of the Liesegang ring.
Hypertrophic nonunion humerus mimicking an enchondroma
Authors: N K Magu, Amanpreet Singh, Reetadyuti Mukhopadhyay, Jitendra Wadhwani, Paritosh Gogna, Rohit Singla, Sahil Arora, Pragnashree Mukhopadhyay Chatterjee
Journal: Case Rep Orthop (2014)

Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face.
A dental nightmare, resolved: what a radiologist needs to know when consulted about ingestion of dental foreign body material
Authors: Mark Guelfguat, Jason Dipoce, James Dipoce
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Ingestion of dental foreign bodies, while relatively rare, may cause serious, and occasionally fatal, injuries to the airways and gastrointestinal tract. Numerous case reports are available describing the clinical course of such ingestions. The aim of this paper is to develop concise, practical recommendations to aid radiologists in providing clinically relevant diagnostic information, thereby accelerating detection and management of acute ingestion of dental material.
Functional Cerebral Specialization and Decision Making in the Iowa Gambling Task: A Single-Case Study of Left-Hemispheric Atrophy and Hemispherotomy
Authors: Varsha Singh, Kapil Chaudhary, S Senthil Kumaran, Sarat Chandra, Manjari Tripathi
Journal: Front Psychol (2020)
Keywords: iowa gambling task, decision making, hemispheric specialization, lateralized function, valence

The Iowa Gambling Task (IGT) is a decision-making task that preferentially involves the right prefrontal cortex (PFC). However, the performance of the task is driven by two attributes: intertemporal (long vs. short-term) and frequency-based processing of rewards-punishments, and differs over the two phases of uncertainty (early trials) and risk (later trials). Although intertemporal decision making involves the right PFC, the extent of hemispheric specialization in attribute and phase-specific decision making is unknown. Therefore, the current study assessed decision making in a patient with a uni-hemispheric disease, who underwent hemispherotomy surgery, comparing pre-surgical IGT performance (3 days prior to surgery) with post-surgical performance (1 month, and 12 months post-surgery). The patient's pre- and post-surgical IGT performances were analyzed to examine changes in attribute and phase-specific decision making, including the widely reported deck B phenomenon. The results for the two attributes of deck selection at the pre- and post-surgical assessments suggested marked changes in the two IGT phases of risk and uncertainty. Pre-surgery, the patient made more intertemporally disadvantageous choices, and task-progression contributed to it; within 1 month of surgery, intertemporal disadvantageous deck choices were contingent on task progression, after 1 year, disadvantageous choices were independent of task progression. Intertemporal attribute alteration was unresponsive to uncertainty and risk phase. The effect of task progression on frequency attribute remained unchanged before and immediately after the surgery, and preference for infrequent decks was observed only after 1 year. Further, pre and post surgery alteration in frequency attribute was phase-specific: within 1 month of surgery, infrequent deck choices decreased in uncertainty and increased in risk, whereas the reverse was observed after 12 months. Deck B choice increase was in the uncertainty phase. Results are discussed in reference to valence-linked hemispheric specialization and its potential role in attribute and phase-specific IGT decision making.
Ventricular noncompaction in a female patient with nephropathic cystinosis: a case report
Authors: Ibrar Ahmed, Thanh Trung Phan, Graham W Lipkin, Michael Frenneaux
Journal: J Med Case Rep (2009)

Introduction:
We report an unusual and interesting case of a 24-year-old woman with nephropathic cystinosis in association with concomitant isolated noncompaction of the left ventricle. Left ventricular noncompaction usually presents with reduced exercise tolerance as a consequence of ventricular dysfunction, the result of embolus or with palpitations and syncope due to arrhythmia. There is no specific treatment directed at isolated noncompaction. Treatment is focused on the cause of presentation, with medication aimed at improving ventricular dysfunction, as well as treating and preventing thrombosis and arrhythmia.
Case presentation:
Our patient presented with an episode of decompensated heart failure. Trans-thoracic echocardiography demonstrated excessive trabeculation with inter-trabecular recesses in the left ventricle typical of noncompaction of the left ventricle. The patient's admission was complicated by a cardiac arrest precipitated by ventricular tachycardia for which she subsequently underwent implantation of an automatic implantable cardioverter defibrillator.
Conclusion:
This is, as far as we know, the first case report of the co-existence of nephropathic cystinosis and isolated noncompaction of the left ventricle. It highlights the importance of being vigilant to the diagnosis of left ventricular noncompaction.