OpenMed/multicare-articles huggingface dataset:
Case Report: Transcatheter interventional procedure to innominate vein turn-down procedure for failing fontan circulation
Authors: Damien Schaffner, Maria-Helena Perez, Rafael Duran, René Pretre, Stefano Di Bernardo
Journal: Front Pediatr (2024)
Keywords: case report, failing fontan, hypoplastic left heart syndrome, modified fenestration, plastic bronchitis, transcatheter interventional procedure
MeSH terms: Case Reports

Fontan physiology creates a chronic state of decreased cardiac output and systemic venous congestion, leading to liver cirrhosis/malignancy, protein-losing enteropathy, chylothorax, or plastic bronchitis. Creating a fenestration improves cardiac output and relieves some venous congestion. The anatomic connection of the thoracic duct to the subclavian-jugular vein junction exposes the lymphatic system to systemic venous hypertension and could induce plastic bronchitis. To address this complication, two techniques have been developed. A surgical method that decompresses the thoracic duct by diverting the innominate vein to the atrium, and a percutaneous endovascular procedure that uses a covered stent to create an extravascular connection between the innominate vein and the left atrium. We report a novel variant transcatheter intervention of the innominate vein turn-down procedure without creating an extravascular connection in a 39-month-old patient with failing Fontan circulation complicated by plastic bronchitis and a 2-year post-intervention follow-up.
Case report: A case of high grade serous carcinoma of peritoneal origin
Authors: Yiming Liu, Sixian Wang, Yingchao Wu, Guowei Chen, Junling Zhang, Xin Wang
Journal: Front Oncol (2024)
Keywords: peritoneal carcinoma, dignosis, emergency exploratory laparotomy, hematemesis, obstruction
MeSH terms: Case Reports

This case report describes an 80-year-old female patient admitted to the emergency department due to abdominal distension, abdominal pain, and hematemesis persisting for three days. Subsequent postoperative pathological examination confirmed the diagnosis of peritoneal cancer. The occurrence, diagnosis, treatment, and prognosis of primary peritoneal cancer (PPC) are presented in detail. PPC is a type of cancer originating from the primary peritoneal mesothelium organization, causing diffuse malignant tumors in the abdominal and pelvic regions. Due to the lack of specific clinical manifestations for this disease, the importance of early diagnosis and treatment is hereby emphasized. The article also mentions the histological source of this type of cancer and the advantages of preoperative intraperitoneal chemotherapy in improving the efficacy of PPC treatment. Finally, the importance of a comprehensive treatment approach and proficient use of targeted therapy techniques are highlighted to enhance the treatment outcomes of PPC.
Case report on meningoenceplapathy in an Indian patient post CoViD vaccination
Authors: Raj Kamal Choudhry, Amrendra Kumar Singh, Kumar Sourav, Anjum Pervez, Abilesh Kumar, Subham Kumar
Journal: Bioinformation (2023)
Keywords: covaxin, covid-19, immunization, methyl prednisolone, post vaccine meningoencephalitis

The SARS-COV-2 infection-related severe illness is prevented by vaccinations. Therefore, it is relevant to report a case of post vaccine meningoencephalitis in a 30 year old male Indian patient, who presented with weakness in all the extremities, episodes of loose stool, fever, vomiting, tachypnea and loss of consciousness immediately following the 2nd dose of the COVID vaccination (COVAXIN).
Pulmonary Crohn's Disease Masquerading as Lymphoma
Authors: William Beaty, Anila Katragadda, Rany Condos, Bari Dane, Suparna Sarkar, Emily Shaffer, Shannon Chang
Journal: ACG Case Rep J (2024)
Keywords: crohn's disease, extraintestinal manifestations, inflammatory bowel disease
MeSH terms: Case Reports

Although extraintestinal manifestations of inflammatory bowel disease (IBD) are common, pulmonary IBD is extremely rare. Owing to its nonspecific clinical, radiologic, and pathologic features, pulmonary IBD is difficult to diagnose and may mimic more concerning disease processes. We present a rare case of a patient with known Crohn's disease whose initial presentation was highly suspicious for malignancy before further investigation revealed pulmonary IBD.
A case report and a call for early recognition: post-operative Pyoderma Gangrenosum after breast-conserving surgery in a locally advanced breast tumor
Authors: Abdulrahman Hashim, Fabien Boucher
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: breast reconstruction, breast pyoderma gangrenosum, case report, post-surgical pyoderma gangrenosum
MeSH terms: Case Reports

We present a case of a patient addressed to our plastic surgery department after a breast tumor resection and subsequent necrosis and ulceration of the right breast. A diagnosis of pyoderma gangrenosum was made based on the clinical criteria, early recognition resulted in complete recovery without further reconstructive surgery.
Remarkable response to third-generation EGFR-TKI plus crizotinib in a patient with pulmonary adenocarcinoma harboring EGFR and ROS1 co-mutation: a case report
Authors: Zhiming Wu, Zelin Zhang, Dongdong Zhang, Zengyan Li
Journal: Front Oncol (2024)
Keywords: egfr, ros1, co-mutation, non-small cell lung cancer, tyrosine kinase inhibitors
MeSH terms: Case Reports

Background:
Driver oncogene mutations, such as c-ros oncogene 1 (ROS1) and epidermal growth factor receptor (EGFR) were previously believed to be mutually exclusive in non-small cell lung cancer (NSCLC). Only sporadic cases of ROS1 and EGFR co-mutations have been reported. Hence, appropriate treatment options for these patients are still controversial.
Case presentation:
A 48-year-old female patient presented at our hospital complaining of a persistent cough that had been ongoing for a month. A chest computed tomography showed a mass in the left lung along with hilar and mediastinal lymphadenopathy. Pathological analysis of bronchoscopic biopsy and lung mass puncture confirmed the presence of lung adenocarcinoma. The patient was diagnosed with stage IIIC left lung adenocarcinoma with a clinical stage of cT2N3M0. Next-generation sequencing analysis conducted at both puncture sites revealed an EFGR 19 deletion mutation combined with ROS1 rearrangement. The lung mass exhibited a higher mutation abundance. Treatment with a combination of third-generation EGFR tyrosine kinase inhibitors (TKIs) and crizotinib yielded satisfactory results. During the follow-up period, the mass significantly reduced and almost disappeared.
Conclusion:
The co-mutation of EGFR and ROS1 is a rare phenomenon. Nevertheless, the combination of EGFR-TKI and crizotinib treatment appears to hold promise in providing positive results for patients, with manageable side effects. This therapeutic approach has the potential to enhance patients' overall prognosis.
Acne fulminans treatment: case report and literature review
Authors: Julia Woźna, Katarzyna Korecka, Jan Stępka, Andrzej Bałoniak, Ryszard Żaba, Robert A Schwartz
Journal: Front Med (Lausanne) (2024)
Keywords: acne, acne fulminans, acne management, anti tnf-alfa therapy, corticosteorids, isotretinoin
MeSH terms: Case Reports

Acne fulminans (AF), a severe acne variant primarily evident in adolescent males, is characterized by the sudden onset of severe and often ulcerating acne with fever and polyarthritis. A case of a 14-year-old initially treated with clindamycin and surgical debridement, highlights the complexity of AF, including challenges in diagnosis, treatment, and the importance of early dermatological consultation. Successful management was achieved through systemic therapy with retinoids and corticosteroids, resulting in significant improvement. This case underscores the necessity of a coordinated effort among dermatologists, endocrinologists, and rheumatologists for effective AF treatment, illustrating the critical role of timely diagnosis and comprehensive care in managing this rare and challenging condition.
Case Report: Primary osteosarcoma of the kidney
Authors: Junyong Chen, Hongxian Liao, Rungen Zhan, Qiaoli Zheng, Jian Deng, Guojie Wang, Jie Zhang
Journal: Front Oncol (2023)
Keywords: ct, mri, extraosseous, kidney, osteosarcoma
MeSH terms: Case Reports

Extraosseous osteosarcoma is a rare malignant tumor, most commonly occurring in the thigh, upper limbs, and retroperitoneum. However, there are only a few reported cases of renal osteosarcoma. Herein, we present the case of a 54-year-old woman with malignant extraosseous osteosarcoma of the left kidney. CT and MR imaging revealed a soft tissue mass originating from the left kidney.
Gigantic laryngeal schwannoma: A case report with literature review
Authors: Daniel Nguyen, Nyein Nyein Htun, Cary Johnson
Journal: Rare Tumors (2024)
Keywords: schwannoma, immunohistochemistry, larynx, nerve sheath tumor, pathology
MeSH terms: Case Reports

Laryngeal schwannoma is a rare benign nerve sheath tumor that is slow growing. The diagnosis is made from a combination of clinical, radiological, and histopathological findings, and the main method of treatment is resection. We report a case of a 69-year-old presenting with a neck mass causing stridor, dysphagia, and orthopnea. CT of the neck showed an enhancing mass measuring 6.3 cm and extending superior to the larynx. Emergent tracheostomy and mass resection were performed, and histopathology and immunohistochemical findings were obtained from the specimen supporting schwannoma. In conclusion, while rare, schwannoma should always be considered as a differential diagnosis for a laryngeal mass. More studies are needed to assess the size and prognosis of the tumor.
Single-Port Robotic-Assisted Excision of the Urachal Remnant in an Adult Female: A Case Report
Authors: Kevin D Kunitsky, Mustafa Almajedi, Elizabeth Snajdar, Parker Adams, Ryan Nelson
Journal: Cureus (2024)
Keywords: intravesical urachal cyst, single-port laparoscopic surgery, surgical robotics, urachal anomalies, urachal remnant
MeSH terms: Case Reports

Urachal anomalies and their associated disease processes are quite rare in pediatric populations and even rarer in adults. Although often asymptomatic, patients with symptoms can be treated with a combination of surveillance, antibiotics, and sometimes surgical resection. In this case, we describe our experience using the single-port robotic approach for the excision of a symptomatic urachal remnant. The patient presented with a chief complaint of urinary frequency, dysuria, intermittent hematuria, and right flank pain. A CT scan of the abdomen and pelvis revealed a bladder wall thickening at the dome of the bladder measuring 2.6 x 3.6 x 1.5 cm with concerns for adenocarcinoma. The patient subsequently underwent a biopsy, which was benign. The patient's symptoms persisted, and she elected to undergo surgical resection. Postoperatively, her symptoms resolved, and she was satisfied with her treatment outcome. This case exemplifies the feasibility of the single-port robotic approach to urachal remnant excision, with further applicability to simple transabdominal robotic bladder surgery.
Case Report: Complete pathological remission of human chorionic gonadotrophin-producing gallbladder carcinoma with multiple liver metastases after treatment with chemotherapy plus an immune checkpoint inhibitor
Authors: Qianwen Wang, Yunchuan Mu, Shunxian Ji, Yang Liu, Yanbo Lou, Shumei Wei, Xin Dong, Bo Zhang
Journal: Front Immunol (2023)
Keywords: chemotherapy, gallbladder carcinoma, human chorionic gonadotrophin, immune checkpoint inhibitor, pathological complete response
MeSH terms: Gallbladder Neoplasms / drug therapy, Gallbladder Neoplasms / pathology, Liver Neoplasms / drug therapy, Liver Neoplasms / secondary, Case Reports, Research Support, Non-U.S. Gov't, B7-H1 Antigen, Chorionic Gonadotropin / metabolism, Female, Humans, Immune Checkpoint Inhibitors, Middle Aged, Phosphatidylinositol 3-Kinases, Tumor Microenvironment, Immune Checkpoint Inhibitors, B7-H1 Antigen, Phosphatidylinositol 3-Kinases, Chorionic Gonadotropin

Background:
Gallbladder carcinoma (GBC) producing human chorionic gonadotrophin (HCG) is an extremely rare and highly invasive tumor with a poor prognosis. This unfavorable clinical outcome is partly due to the aggressive nature of the tumor and its insensitivity to chemotherapy.
Case presentation:
We herein report a case of primary GBC producing HCG with liver metastases in a 58-year-old woman. The patient presented with a markedly elevated β-HCG level and a mass in the gallbladder with multiple liver metastases. A definitive diagnosis was obtained after a needle biopsy of the liver metastases, showing poorly differentiated carcinoma with large-scale necrosis and strong positivity of immunostaining for HCG in tumor cells. The patient received chemotherapy (gemcitabine plus capecitabine) combined with carrellizumab, an immune checkpoint inhibitor (ICI). Pathological complete response was achieved after eight courses of combined therapy, which was confirmed by pathological analysis of resected specimens. After surgery, two courses of chemotherapy plus ICIs were adopted again. Complete response remained for approximately 1 year up to the present. Tumor tissue was collected to perform immunostaining of PD-L1, whole-exome sequencing, and RNA-seq. Low-TMB (1.51 mut/Mb), MSS, and high PD-L1 expression (TPS ≥ 50%) were observed in the tumor. Besides, the dominant types of infiltrating immune cells were macrophage and CD4+ T cells. Compared to other gallbladder adenocarcinoma without HCG, the proportion of M1 macrophage was at a higher level and the gene sets of MYC targets v1 and PI3K/AKT/mTOR signaling were highly expressed in our case. To the best of our knowledge, this is the first case report of complete remission of HCG-producing gallbladder carcinoma with liver metastases after chemotherapy combined with an immune checkpoint inhibitor. Furthermore, this is also the first report that described the tumor genetic feature and tumor immune microenvironment atlas of HCG-producing GBC.
Conclusion:
chemotherapy plus an immune checkpoint inhibitor may provide a potentially curative option for gallbladder carcinoma with HCG production.
Blastic Plasmacytoid Dendritic Cell Neoplasm in Long-Term Complete Remission After Venetoclax Monotherapy
Authors: Yohei Sasaki, So Murai, Eisuke Shiozawa, Toshiko Yamochi, Norimichi Hattori
Journal: Cureus (2024)
Keywords: azacitidine, bpdcn, maintenance therapy, myc, venetoclax
MeSH terms: Case Reports

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematological malignancy associated with a poor prognosis and limited treatment options. Although allogeneic hematopoietic stem cell transplantation or intensive chemotherapy prolongs overall survival in patients with BPDCN, intensive chemotherapy is inappropriate for older or unfit patients. Venetoclax (VEN), an oral BCL2 inhibitor, is approved for use in patients with acute myeloid leukemia (AML). BPDCN cells require BCL2 protein and are uniformly sensitive to VEN in vivo. Moreover, patients with AML who have achieved complete remission after induction therapy are reportedly considered to receive VEN monotherapy as maintenance therapy, especially older patients. However, the efficacy of VEN monotherapy as a maintenance therapy for patients with BPDCN remains controversial. Recently, BPDCN has been classified into MYC+ and MYC- subtypes, which show clinical differences. Hence, BPDCN treatment strategies based on the MYC classification may be necessary. Here, we report a case of MYC- BPDCN in an older patient in long-term complete remission after VEN monotherapy following VEN and azacitidine induction chemotherapy.
Tailored Physical Therapy in a Case of Tenotomy Post Hip Flexion Deformity With Structural Scoliosis: A Case Report
Authors: Ritika S Bhagwani, Pratik Phansopkar, Medhavi V Jagzape, Samruddhi M Karanjkar, Roshni R Nandanwar
Journal: Cureus (2024)
Keywords: contracture, deformity, gait, physiotherapy, tumor
MeSH terms: Case Reports

Retroperitoneal tumours, mainly classified as malignant and benign, have a rare incidence. It includes major parts of the peritoneum, and surgical excision remains the optimal pathway to remove the tumour. As with any surgery, tumour resection comes with its own complications. These complications would manifest differently depending on patient adaptation or compensation for these drawbacks. Physiotherapy and its positive effects as a need after any surgical procedure become a boon when implemented as and when required. The present study describes the case of a 32-year-old woman who has complained of pain in her right hip for one year, along with forward-bending walking and difficulty sitting. The patient had a history of retroperitoneal tumour excision, after which, to compensate for the pain, she started walking by bending forward, which developed into a hip flexion deformity. The patient was managed by tenotomy and was referred to a physiotherapy outpatient (OPD) for further management. Our aim was to improve overall mobility through gait training and prevent relapses of the contracture.
Case Report: Kawasaki disease associated with acute generalized exanthematous pustulosis secondary to carbocysteine
Authors: Takashi Furuta, Hiroyuki Fukumoto, Mayu Fujiwara, Shinnosuke Fukunaga, Yuichi Ishikawa, Reiji Hirano
Journal: Front Pediatr (2024)
Keywords: kawasaki disease, acute generalized exanthematous pustulosis, damage-associated molecular patterns, microbe-associated molecular patterns, pathogen-associated molecular patterns
MeSH terms: Case Reports

Acute generalized exanthematous pustulosis (AGEP) is an uncommon eruption characterized by sterile pustules on an erythematous background, which is usually associated with drugs. AGEP is described as a self-limiting disease with favorable prognosis. We reported a case of Kawasaki Disease (KD) following AGEP. A 3-year-old male, who was admitted with pustules and five days of fever at our hospital, was diagnosed with AGEP. Despite the skin lesions and fever improving drastically after prednisolone therapy, the fever recurred on hospitalization day 5. The following symptoms suggestive of KD also appeared: bulbar conjunctival hyperemia, cervical lymphadenopathy, erythema of the lips, eruption on his trunk, and erythema and edema of the hands and feet. He was diagnosed with KD and treated with intravenous immunoglobulin. He was discharged on the thirteenth day of hospitalization without cardiac complications. Drug-induced lymphocyte stimulation test revealed carbocysteine as the suspected cause of AGEP, which consequently triggered KD. Because a mucosal lesion is uncommon in AGEP, bulbar conjunctival hyperemia suggested that KD sequentially occurred after AGEP. Since AGEP is benign and self-limited in most cases, it is necessary to differentiate other diseases, including KD, when recurrent fever or rash occurs in the course of AGEP.
Implant-Retained Prosthetic Rehabilitation of a Patient with Severe Oral Lichen Sclerosus
Authors: Tim Kluenter, Milan Stoilov
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Background:
Lichen sclerosus is a rare condition that occurs in the genital area or on the extraoral skin but can also manifest orally (oral lichen sclerosus (OLS)). The condition is associated with atrophy, scarring, and functional limitations of the tissues. In the present case, an extremely pronounced variant is described, and the oral rehabilitation of the patient is presented. Case Report. The edentulous patient showed a progressive course with severely restricted mouth opening and persistent pain. Conventional dental treatment was therefore impossible. To address this issue, two implants were placed in each jaw at the position of the lateral incisors. After osseointegration and exposure of the implants, provisional bridges made of polymethyl-methacrylate were fitted to test the new jaw relation. After a successful provisional phase, an FDP in the sense of an extreme short dental arch (ESDA) has been inserted.
Conclusion:
The experimental treatment of the patient with only a total of four implants and the ESDA concept represented a satisfactory therapy for the patient. The patient regained her chewing ability, which significantly increased her oral health-related quality of life (OHRQoL). Still, it should be noted that this is a high-risk and experimental prosthetic treatment.
Thyroid Receptor Antibody and the Development of Graves' Orbitopathy: Clinical Experience of using Radioiodine Ablation in the Management of Graves' Orbitopathy in post-iodine ablation hypothyroid patient
Authors: Edelyn Christina, Hendra Budiawan, Hapsari Indrawati, Erwin Affandi Soeriadi, Trias Nugrahadi, A Hussein Kartamihardja
Journal: Asia Ocean J Nucl Med Biol (2023)
Keywords: graves’ ophthalmopathy, graves’ orbitopathy, radioactive iodine, thyroid receptor antibody
MeSH terms: Case Reports

Graves' disease (GD) is the commonest cause of hyperthyroidism, accounted for 70-80% in iodine sufficient countries and up to 50% in iodine deficient countries. Combination of genetic predisposition and environmental factors influences the development of GD. Graves' orbitopathy (GO) represents the most common extra-thyroidal manifestation of GD with substantial impact on morbidity and quality of life. Expression of thyroid stimulating hormone receptor (TSHR) mRNA and protein in orbital tissues infiltrated by the activated lymphocytes produced by thyroid cells (Thyroid Receptor Antibody) results in the secretion of inflammatory cytokines that leads to the development of histological and clinical characteristics of GO. A subdivision of TRAb, thyroid stimulating antibody (TSAb), was found to have a close relationship with the activity and severity of GO, and suggested to be considered as a direct parameter of GO. Here, we present a 75-year-old female with a history of GD that has successfully been treated with radioiodine treatment, who developed GO 13 months after therapy while being hypothyroid with high TRAb level. The patient was given a second dose of radioiodine ablation to maintain GO with successful result.
Case report: Mononeuropathy multiplex of extranodal natural killer/T-cell lymphoma misdiagnosed as systemic vasculitis
Authors: Jiayu Shi, Jingwen Niu, Di Wu, Lei Zhang, Yangyu Huang, Hui Zhang, Hongzhi Guan, Mingsheng Liu, Yuzhou Guan
Journal: Front Neurol (2023)
Keywords: axonal neuropathy, biopsy, extranodal nk/t-cell lymphoma, immunohistochemistry, mononeuropathy multiplex
MeSH terms: Case Reports

Background:
Extranodal NK/T-cell lymphoma (ENKTL) is an aggressive non-Hodgkin lymphoma that typically develops in the upper aerodigestive tract.
Case presentation:
We encountered an ENKTL patient who presented with purpura-like rashes and foot drops as initial symptoms and later developed other peripheral nerve involvement. The nerve conduction study of both the motor nerve and the sensory nerve showed axonal damage resembling mononeuropathy multiplex. Although the initial response to steroids was encouraging, the patient's symptoms reappeared and aggravated. A biopsy of the abdominal subcutaneous fat tissue with additional immunohistochemistry revealed neoplastic NK/T lymphocytes.
Conclusion:
We reported the first case presented as mononeuropathy multiplex as the initial clinical manifestation in ENKTL patients. Lymphoma should be considered in the diagnosis of atypical mononeuropathy in multiplex patients.