OpenMed/multicare-articles huggingface dataset:
Case report: Advanced primary squamous cell carcinoma in the periampullary area with upregulation of programmed cell death-ligand 1 expression and response to sintilimab immunotherapy
Authors: Baoshan Wang, Dazhou Li, Dehua Zeng, Wen Wang, Chuanshen Jiang
Journal: Front Immunol (2023)
Keywords: immunotherapy, periampullary, primary, programmed cell death-ligand 1, sintilimab, squamous cell carcinoma
MeSH terms: B7-H1 Antigen / metabolism, Carcinoma, Squamous Cell / drug therapy, Carcinoma, Squamous Cell / metabolism, Case Reports, Research Support, Non-U.S. Gov't, Apoptosis, Female, Humans, Immunotherapy, Ligands, Middle Aged, Up-Regulation, sintilimab, B7-H1 Antigen, Ligands

Primary squamous cell carcinoma (SCC) of the periampullary area is exceedingly rare. We report a case of a 45-year-old woman who presented with progressive upper abdominal pain and melena. Laboratory testing revealed an elevated level of carcinoembryonic antigen. Esophagogastroduodenoscopy revealed a very large irregular ulcerated tumor in the periampullary area. Contrast-enhanced computed tomography (CT) of the chest, abdomen, and pelvis, 18 F-fluorodeoxyglucose positron emission tomography/CT, and thin-prep cytologic test excluded metastasis of the primary tumor to the periampullary area from other sites. Immunohistochemistry revealed positive p40 and cytokeratin (CK)5/6, indicating SCC. The expression of programmed cell death-ligand 1 (PD-L1) in tumor cells was upregulated, and the patient responded well to chemotherapy combined with immunotherapy. To the best of our knowledge, this is the first reported case of advanced primary SCC in the periampullary area with high expression of PD-L1.
Rectal Mucinous Adenocarcinoma Invading Retrorectal Dermoid Cysts: A Case Report
Authors: Rui Wang, Zhaopeng Yan
Journal: Front Oncol (2019)
Keywords: developmental cyst, rectal cancer, retrorectal cyst, retrorectal space, tailgut cyst
MeSH terms: Case Reports

Rectal mucinous adenocarcinoma is a subtype of colorectal adenocarcinoma, which is more aggressive and prone to invade adjacent normal organs or tissues compared with non-mucinous adenocarcinoma. Retrorectal dermoid cyst is a rare congenital disease, which usually are benign but with a potential for malignant degeneration. In this article, we report a case which presented a rectal mucinous adenocarcinoma invading into retrorectal dermoid cysts, indicating that besides adjacent normal organs or tissues, malignancies can also invade adjacent tumors, making their diagnosis and management more complicated. In such cases, double primary tumors should be considered, and they should be removed surgically.
Fast-Track in Minimally Invasive Gynecology: A Randomized Trial Comparing Costs and Clinical Outcomes
Authors: Shahzia Lambat Emery, Philippe Brossard, Patrick Petignat, Michel Boulvain, Nicola Pluchino, Patrick Dällenbach, Jean-Marie Wenger, Georges L Savoldelli, Benno Rehberg-Klug, Jean Dubuisson
Journal: Front Surg (2021)
Keywords: fast-track, hospital costs, hospital stay, laparoscopic hysterectomy (lh), pain assessment, post-operative morbidity
MeSH terms: Case Reports

Study Objective: Evaluate the effects of a fast-track (FT) protocol on costs and post-operative recovery. Methods: One hundred and seventy women undergoing total laparoscopic hysterectomy for a benign indication were randomized in a FT protocol or a usual care protocol. A FT protocol included the combination of minimally invasive surgery, analgesia optimization, early oral refeeding and rapid mobilization of patients was compared to a usual care protocol. Primary outcome was costs. Secondary outcomes were length of stay, post-operative morbidity and patient satisfaction. Main Results: The mean total cost in the FT group was 13,070 ± 4,321 Euros (EUR) per patient, and that in the usual care group was 3.5% higher at 13,527 ± 3,925 EUR (p = 0.49). The FT group had lower inpatient surgical costs but higher total ambulatory costs during the first post-operative month. The mean hospital stay in the FT group was 52.7 ± 26.8 h, and that in the usual care group was 20% higher at 65.8 ± 33.7 h (p = 0.006). Morbidity during the first post-operative month was not significantly different between the two groups. On their day of discharge, the proportion of patients satisfied with pain management was similar in both groups [83% in FT and 78% in the usual care group (p = 0.57)]. Satisfaction with medical follow-up 1 month after surgery was also similar [91% in FT and 88% in the usual care group (p = 0.69)]. Conclusion: Implementation of a FT protocol in laparoscopic hysterectomy for benign indications has minimal non-significant effects on costs but significantly reduces hospital stay without increasing post-operative morbidity nor decreasing patient satisfaction. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04839263.
A novel and easy technique for restoring grossly decayed mandibular molar with a modified cast-post
Authors: Tej Jitesh Joshi, Gaurang Mistry, Devanand Shetty, Omkar Shetty, Sahil Singh, Shraddha Rumde
Journal: Pan Afr Med J (2018)
Keywords: cast post, sliding pre-fabricated post, zirconia
MeSH terms: Dental Caries / pathology, Dental Impression Technique, Post and Core Technique, Tooth Preparation, Prosthodontic / methods, Case Reports, Adult, Dental Implantation / methods, Follow-Up Studies, Humans, Male, Molar, Treatment Outcome

The article addresses the difficulty of restoring a grossly carious molar tooth, where very little tooth structure is left after caries excavation. When enough sound tooth structure is missing for satisfying the ferrule effect, a clinician can follow this technique and easily restore such teeth. A step by step procedure, including instrumentation and materials and a new impression technique, is described in detail, with clinical photographs. This technique results in the fabrication of a robust and extremely retentive post and core on which to place fixed prosthodontic restorations. A 2 and half year study showed that the tooth well in function with no signs of any problem. The author has restored around many decayed molars using this technique. Over a period of three years, no failure was reported. With an increasing demand on the dentist for restoring a structurally compromised teeth, this technique provides the patients with a robust prosthodontic solution.
Case report: Fully endoscopic microvascular decompression for glossopharyngeal neuralgia
Authors: Haotian Jiang, Dewei Zhou, Pan Wang, Longwei Zeng, Jie Liu, Chao Tang, Gang Zhang, Xiaorong Tan, Nan Wu
Journal: Front Surg (2023)
Keywords: endoscopy, functional neurosurgery, glossopharyngeal neuralgia, microvascular decompression, suboccipital retrosigmoid approach
MeSH terms: Case Reports

With the advances in endoscopic technology, endoscopy is widely used in many neurosurgical procedures, such as microvascular decompression, which is an effective method to treat glossopharyngeal neuralgia, trigeminal neuralgia, and facial spasm. The purpose of this study was to determine the efficacy of fully endoscopic microvascular decompression in the treatment of glossopharyngeal neuralgia. We managed a patient with glossopharyngeal neuralgia in our department, whose main clinical manifestation was recurrent left ear and facial pain for 3 years. The patient underwent a fully endoscopic microvascular decompression. The pain in the left ear and face was significantly relieved postoperatively, and there was no recurrence at the 6-month follow-up evaluation. We describe a case of glossopharyngeal neuralgia that was successfully treated by fully endoscopic microvascular decompression, which showed that endoscopy has advantages in microvascular decompression, and fully endoscopic microvascular decompression is an effective method for glossopharyngeal neuralgia.
New Diagnosis of AIDS Based on Salmonella enterica subsp. I ( enterica) Enteritidis (A) Meningitis in a Previously Immunocompetent Adult in the United States
Authors: Andrew C Elton, James Levin, Matthew P Lazio
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation. A lumbar puncture showed cloudy CSF with Gram negative rods. He was admitted to the ICU. CSF culture confirmed Salmonella enterica subsp. I (enterica) Enteritidis (A). Based on this finding, a 4th-generation HIV antibody/p24 antigen test was sent. When this returned positive, a CD4 count was obtained and showed 3 cells/mm3, confirming AIDS. The patient ultimately received 38 days of ceftriaxone, was placed on elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (Genvoya) for HIV/AIDS, and was discharged neurologically intact after a 44-day admission.
Recurrent neurotropic chloroma: report of a case and review of the literature
Authors: Richard Bakst, Ann Jakubowski, Joachim Yahalom
Journal: Adv Hematol (2011)
MeSH terms: Case Reports

We are reporting a case of a young woman with acute myelogenous leukemia status postallogeneic transplantation who developed multiply recurrent chloromas occurring along peripheral nerves in the absence of bone marrow relapse, all treated with radiation therapy. The patient is currently free of disease nearly four years after her first posttransplant chloroma. The case presented is unique for its isolated peripheral nervous system involvement, rare posttransplant occurrence, and indolent course without marrow relapse despite multiple extramedullary recurrences.
Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone
Authors: Corina Marilena Cristache
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Despite numerous advantages over multislice computed tomography (MSCT), including a lower radiation dose to the patient, shorter acquisition times, affordable cost, and sometimes greater detail with isotropic voxels used in reconstruction, allowing precise measurements, cone beam computed tomography (CBCT) is still controversial regarding bone quality evaluation. This paper presents a brief review of the literature on accuracy and reliability of bone quality assessment with CBCT and a case report with step-by-step predictable treatment planning in esthetic zone, based on CBCT scans which enabled the clinician to evaluate, depending on bone volume and quality, whether immediate restoration with CAD-CAM manufactured temporary crown and flapless surgery may be a treatment option.
Posttraumatic true aneurysm of the axillary artery following blunt trauma
Authors: Tugrul Goncu, Faruk Toktas, Osman Tiryakioglu, Gunduz Yumun, Sinan Demirtas, Senol Yavuz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The majority of the axillary artery aneurysm cases arise as pseudoaneurysms secondary to blunt or iatrogenic trauma. Isolated traumatic true axillary artery aneurysm is a relatively unusual disorder and generally occurs with repetitive blunt trauma. A 22-year-old female patient with distal axillary artery true aneurysm due to simple blunt axillothoracic trauma is presented. The aneurysm was excised with subpectoral-axillary approach and saphenous vein graft interposition was applied. Long-term follow-up with the patient was uneventful.
An unusual presentation of desmoplastic small round cell tumour of the abdomen: morphological, immunohistochemical, ultrastructural, and molecular studies
Authors: Preethika Angunawela, Alhossain A Khalafallah, Karen Wolfswinkel, David Seaton, Terry Brain
Journal: Case Rep Oncol Med (2011)
MeSH terms: Case Reports

Desmoplastic small round cell tumour (DSRCT) is an aggressive and a rare neoplasm. We report on a 34-year-old male who had abdominal discomfort with a large intraperitoneal mass. Histological examination of the tumour biopsy revealed sheets of small round cells. The cells were positive with vimentin and desmin (with occasional dot positivity) and negative for WT1 and CD 99 with immunohistochemistry. Cytogenetics showed a translocation disrupting the EWSR 1 gene on 22 q 12 consistent with DSRCT. Electron microscopic examination showed sparse cytoplasmic organelles. The patient succumbed 34 months from disease presentation after multiple chemotherapies and thereafter radiotherapy. In summary, our case exemplifies that it is crucial to combine clinical, histological, and molecular aspects in diagnosing DSRCT especially when characteristic dot positivity with desmin is weak along with deficient marking of WT1 and CD99 by immunohistochemistry. Histology was also less clear than published examples of this entity with a poor desmoplastic response. A multidisciplinary approach including early referral to specialised centres is recommended in these cases as tertiary referral centres will be required to substantiate the diagnosis.
Recurrent multifocal adult rhabdomyoma in an elderly woman diagnosed with Birt-Hogg-Dubé syndrome: A case report
Authors: Ulrik Ørsø Andersen, Marie Røsland Rosenørn, Preben Homøe
Journal: Front Surg (2022)
Keywords: birt-hogg-dubé (bhd), multifocal, oral cavity, recurrent, rhabdomyoma (mesh)
MeSH terms: Case Reports

Birt-Hogg-Dubé syndrome (BHD) is a rare inherited autosomal dominant condition caused by a mutation in the tumor suppressor gene FLCN. This mutation predisposes the carrier to multiple pulmonary cysts, recurrent pneumothorax, renal tumors and benign skin tumors. Since the first description of BHD, additional clinical signs have been added to the syndrome and a large variety of benign tumors, such as rhabdomyomas (RM), have been linked with the FLCN gene mutation. RMs are rare tumors derived from striated muscle. The adult extracardiac rhabdomyoma occurs mostly in elderly patients, with a male predominance. It is most often located in the head and neck area and it has a potential of recurrence. We report a case of recurrent multifocal ARM in the oral cavity, present in an elderly woman with BHD and treated surgically. This could add support to RMs being linked to BHD.
Case report: Amisulpride therapy induced reversible elevation of creatine kinase-MB and bradycardia in schizophrenia
Authors: Ze-Rui Hu, Zhen-Zhen Yang, Xu-Bo Wang, Hong-Shuo Chu, Chuan-Xin Liu
Journal: Front Psychiatry (2022)
Keywords: amisulpride, bradycardia, case report, schizophrenia, serum myocardial enzyme spectrum
MeSH terms: Case Reports

Introduction:
Schizophrenia is regarded as one of the most severe, disabling, and costly mental illnesses. Hence, early effective prevention and treatment are critical to the prognosis of patients. Amisulpride, a first-line atypical antipsychotic medication that acts as a blocker of the D2 and D3 dopamine receptors, is used in varying doses for the treatment of both positive and negative symptoms of schizophrenia. Reversible amisulpride-induced elevation of the myocardial enzyme spectrum with bradycardia is a rare condition.
Case presentation:
We report a 26-year-old patient diagnosed with first-episode schizophrenia. This patient was treated with amisulpride (400 mg/d), but no clinical benefits were obtained. Meanwhile, amisulpride caused elevation of the myocardial enzyme spectrum with asymptomatic bradycardia. After stopping the medication, these parameters normalized.
Conclusion:
We described a rare side reaction of amisulpride. Psychiatrists should take this side effect seriously in the clinical setting. The mechanism of this adverse reaction warrants further investigation and debate. When this side effect occurs during treatment, reducing the dosage of amisulpride and subsequently discontinuing medication, along with monitoring the electrocardiogram and serum myocardial enzymes, may be the most appropriate treatment protocol.
A Rare Presentation of Small Bowel Diverticulosis Causing Chronic Obstruction and Malnutrition: A Case Study with Review of Literature
Authors: Y Mathangasinghe, U M J E Samaranayake, J D Jayasinghe, A S K Banagala
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Small bowel diverticulosis is an uncommon entity. Clinical presentation of small intestinal diverticulosis is variable. A high mortality is associated with complications such as chronic malnutrition, haemorrhage, intestinal obstruction, and perforation. We report a case of a 63-year-old female with multiple small bowel diverticuli spanning from the first part of the duodenum to the proximal ileum presenting with chronic malnutrition and subacute intestinal obstruction. Although exploratory laparotomy was performed, we opted for a totally conservative treatment in order to avoid complications such as short gut syndrome and anastomotic leakage.
Retrorectal Schwannomas: Atypical Presentation and Controversial Surgical Management
Authors: Wided Trimech, Farouk Ennaceur, Hiba Ben Hassine, Hanen Zneti, Faouzi Noomen, Khadija Zouari
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Schwannomas also known as neurilemomas are benign tumors. Retrorectal schwannomas are extremely rare, accounting for 1 to 5% of all schwannomas. They are mostly asymptomatic but may present with symptoms such as pelvic pain, back pain, lower extremities pain, or constipation. Physical examination is often poor. Imaging (CT, MRI) and fine needle biopsy can often help orient the diagnosis. The treatment of choice is monoblock resection of the mass. The prognosis is good. Recurrence has been reported especially after intralesional enucleation. We report a case of a 41-year-old male patient consulting for chronic low back pain eventually diagnosed with retrorectal schwannoma. We performed a surgical resection and the histological examination was consistent with the diagnosis of benign (ancient) schwannoma.
Bilateral Conjunctival Infiltration as an Extramedullary Relapse of AML
Authors: Zahra Mozaheb, Alireza Khooei
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Acute myelogenous leukemia (AML) accounts for 1.2% of all cancer deaths. Relapse is the major cause of treatment failure in acute myeloid leukemia (AML) patients. AML rarely presents as ocular manifestation in relapse or at presentation. The M4 subtype of AML is most commonly presented with extramedullary involvement. In this report, we presented a young female with AML who was diagnosed and treated for AML about 40 months ago. She did not transplant because she did not have a full-match donor. About 4 months ago, she visited with a red eye and conjunctival infiltration. She was referred to an ophthalmologist for a biopsy, and the pathology report showed the relapse of AML which was treated with systemic chemotherapy. Red eyes with subconjunctival nodules in patients with a history of previous AML should raise the suspicion for recurrent disease that warrants urgent biopsy and systemic treatment. Eye involvement with leukemia is usually responsive to systemic chemotherapy.
Combined Nasal, Oropharyngeal Povidone Iodine Plus Glycyrrhizic Acid Sprays, Accelerate Clinical and Laboratory Recovery and Reduces Household Transmission of SARS-CoV-2: A Randomized Placebo-Controlled Clinical Trial
Authors: Hazem E Elsersy, Magdy A H Zahran, Abd-Elazeem Elbakry, Mohamed Abd-Elwahab, Mohamed Milegy Ahmed, Mohamed Salah Elgandy, Eman H M Mohammed, Nourhan M Elewa
Journal: Front Med (Lausanne) (2022)
Keywords: sars-cov-2, acid glycyrrhizic, antiviral, iodine povidone, nasal spray, oropharyngeal spray
MeSH terms: Case Reports

The COVID-19 pandemic is still posing challenging health and economic problems. Effective broad-spectrum antiviral therapy is urgently needed for the control of early SARS-CoV-2 infection to limit its spread and mutations. In this randomized placebo-controlled clinical study, we tested the effects of intranasal and oropharyngeal delivery of a compound of povidone-iodine 0.5% and glycyrrhizic acid 2.5 mg/ml on the laboratory (PCR) and clinical recovery from SARS-CoV-2 patients and their household contacts. 353 patients suspected of having COVID-19 infection were screened by chest CT and nasopharyngeal swab tests (PCR). 200 patients were randomly allocated to two equal groups: treatment and placebo groups. Treatment accelerated the recovery of PCR on days 4, 7, and 10, as evidenced by PCR-positive patients (70, vs. 99%, 20 vs. 65%, 1 vs. 10%) in both the treated and placebo groups, respectively. Treatment enhanced the early recovery of symptoms [day 7.6 ± 2 (CI 7:8.3) vs. 8.9 ± 2 (CI 8.3:9.6)]. Treatment promoted early recovery of anosmia and ageusia [5.6 ± 1 (CI, 4.8:6.4) vs. 11 ± 3 days, (CI, 10.8:12)] in both the treated and control groups (P < 0.0001). There was a notable reduction in transmission of the virus among the household close contacts in the treatment group (4%) vs. 76% in the placebo group. Combined PVI-GA nasal and oropharyngeal spray accelerates both laboratory and clinical recovery of SARS-CoV-2 infected patients in the early phases of the disease and reduces the household spread of the virus; thus, it may play an important role in controlling coronavirus outbreaks.
Clinical trial registration:
https://pactr.samrc.ac.za, PACTR202101875903773.
Retroperitoneal urinoma spontaneously drained in the scrotum repaired with gracilis muscle flap: a case report
Authors: Emanuela Altobelli, Alfredo Maria Bove, Federico Sergi, Maurizio Buscarini
Journal: Case Rep Urol (2012)

Aim. To report a unique case of retroperitoneal urinoma extending to the scrotum through the spermatic cord and successfully treated with nephrostomy, drainage, and gracilis muscle flap.
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) in association with an adenocarcinoma: a case report
Authors: Arne Warth, Esther Herpel, Astrid Schmähl, Konstantina Storz, Philipp A Schnabel
Journal: J Med Case Rep (2008)

Introduction:
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare disorder and information on this disease is limited, especially with regard to its management and prognosis. It has become generally accepted that DIPNECH is a precursor lesion to pulmonary carcinoid tumors.
Case presentation:
Here we report on a 60-year-old female patient with DIPNECH and an associated pulmonary adenocarcinoma.
Conclusion:
This case contributes to a better understanding of the disorder and its associated pathologies.