OpenMed/multicare-articles huggingface dataset:
Ovarian Steroid Cell Tumor (Not Otherwise Specified): A Case Report of Ovarian Hyperandrogenism
Authors: Hadjkacem Faten, Ghorbel Dorra, Charfi Slim, Safi Wajdi, Charfi Nadia, Chaabene Kais, Boudawara Tahia, Abid Mohamed
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Steroid cell tumors (SCTs) (not otherwise specified (NOS)) are rare sex cord-stromal tumors of the ovary. These are associated with hormonal disturbances resulting in menstrual bleeding patterns and androgenic effects. We report the case of a 36-year-old female presented with hirsutism, signs of virilization, and elevated androgen levels. Transvaginal ultrasound showed a solid-appearing right ovarian mass. She underwent fertility-sparing surgery with a laparoscopic left oophorectomy. Histological examination showed a benign steroid cell tumor, NOS. These tumors often small can then present a problem of positive diagnosis responsible for a delay in the diagnosis.
Severe acute respiratory syndrome: lessons from Singapore
Authors: Kamaljit Singh, Li-Yang Hsu, Jorge S Villacian, Abdulrazaq Habib, Dale Fisher, Paul A Tambyah
Journal: Emerg Infect Dis (2003)
MeSH terms: Disease Outbreaks / prevention & control, Severe Acute Respiratory Syndrome / epidemiology, Case Reports, Adult, Aged, Aged, 80 and over, Cross Infection / diagnosis, Cross Infection / epidemiology, Cross Infection / prevention & control, Cross Infection / transmission, Female, Humans, Infection Control / methods, Infectious Disease Transmission, Patient-to-Professional, Male, Middle Aged, Severe Acute Respiratory Syndrome / diagnosis, Severe Acute Respiratory Syndrome / prevention & control, Severe Acute Respiratory Syndrome / transmission, Singapore / epidemiology, Triage / methods

An outbreak of severe acute respiratory syndrome (SARS) occurred in Singapore in March 2003. To illustrate the problems in diagnosing and containing SARS in the hospital, we describe a case series and highlight changes in triage and infection control practices that resulted. By implementing these changes, we have stopped the nosocomial transmission of the virus.
(18)FDG-PET at 1-Month Intervals Is a Better Predictive Marker for GISTs That Are Difficult to Be Diagnosed Histopathologically: A Case Report
Authors: Kazunori Otsuka, Masahiro Takahashi, Hiroshi Nanjo, Hideaki Miyazawa, Masatake Iida, Yuki Abe, Mario Jin, Hirohide Onishi, Manabu Hashimoto, Yuzo Yamamoto, Hiroyuki Shibata
Journal: Case Rep Oncol Med (2011)
MeSH terms: Case Reports

Imatinib mesylate is a tyrosine kinase inhibitor of c-KIT and PDGFRA. Imatinib mesylate is an effective drug that can be used as a first-choice agent for treatment of GISTs. Prior to treatment, molecular diagnosis of c-KIT or PDGFRA is necessary; however, in some types of GISTs, it is impossible to obtain a sufficient amount of specimen for diagnosis. An inoperable or marginally resectable GIST in a 79-year-old female was difficult to be diagnosed at a molecular pathological level, and hence, exploratory treatment was initiated using imatinib combined with (18)FDG-PET evaluation at 1-month intervals. PET imaging indicated a positive response, and so we continued imatinib treatment in an NAC setting for 4 months. As a result, curative resection of the entire tumor was successfully performed with organ preservation and minimally invasive surgery. (18)FDG-PET evaluation at 1-month intervals is beneficial for GISTs that are difficult to be diagnosed histopathologically.
The Three P's: Parotid, PD-L1, and Pembrolizumab
Authors: Amanda Wiggins, Zhaohui Arter, Tamie Kerns
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

We present a case of recurrent, platinum-refractory undifferentiated carcinoma of the parotid which was treated with checkpoint inhibitor, Pembrolizumab, and achieved a complete response to therapy. We review the literature of checkpoint inhibitor use in undifferentiated carcinoma of the parotid.
Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report
Authors: Ramtin Chitsazha, Masoumeh Faramarzi, Negin Firouzi
Journal: J Adv Periodontol Implant Dent (2020)
Keywords: case report, excisional biopsy, free gingival graft, reactive lesion
MeSH terms: Case Reports

Reactive lesions of soft tissue are common oral lesions that are usually non-neoplastic growths without pain; however, they can interfere with oral hygiene and plaque control, and if present in the anterior segment, they can cause esthetics problems. In this case, there was a reactive lesion at the gingiva of the left maxillary central incisor area. The particular consideration about this case was the recurrence of a peripheral ossifying fibroma as a pyogenic granuloma, indicating the association between reactive gingival lesions. The history of several recurrences due to incomplete removal shows the importance of complete excision for preventing recurrence. Therefore, the lesion was completely excised, and the mucogingival defect was successfully augmented with periodontal plastic surgery.
Case Report: Anterior Scleritis Presenting as a Primary Ocular Manifestation in Multisystem Inflammatory Syndrome in Children With COVID-19
Authors: Daisuke Matsubara, Daisuke Tamura, Yuka Kasuya, Yoshitaka Mizobe, Mami Hiwada, Mitsuru Seki, Shinji Makino, Takanori Yamagata
Journal: Front Pediatr (2022)
Keywords: covid-19, kawasaki disease, case report, conjunctivitis, fundus findings, multisystem inflammatory syndrome in children, ophthalmological examinations, scleritis
MeSH terms: Case Reports

Multisystem inflammatory syndrome in children (MIS-C) is a newly defined hyperinflammatory disease linked to antecedent coronavirus disease 2019. Patients with MIS-C present with various symptoms, and ocular findings such as mild bilateral conjunctivitis are relatively common. However, detailed descriptions of severe ocular reports associated with MIS-C are scarce in the current literature. Here we report a case of MIS-C in a Japanese boy, with severe eye manifestations in the form of anterior scleritis as the primary MIS-C symptom. Detailed ocular examinations by ophthalmologists may be key for clarifying the pathophysiology of MIS-C.
Simpson grade 3 resection does not improve clinical outcome in neglected thoracic psammomatous spinal meningioma? A case report
Authors: Azharuddin Azharuddin, Muhammad Bayu Zohari Hutagalung, Reno Keumalazia Kamarlis
Journal: Int J Surg Case Rep (2019)
Keywords: intramedullary, neglected, psammomatous, resection, spinal meningioma

Introduction:
Thoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure.
Presentation of case:
A 42-year-old female complaining of back pain for one year and progressive weakness and numbness of both lower limbs with urinary incontinence and constipation for two months. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. The patient underwent laminectomy at D3-D5 level, revealing dural bulge. A midline durotomy performed. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Simpson grade 3 resection was performed. Pedicle screw and rod was placed for posterior stabilization. Histopathological examination demonstrated a psammomatous spinal meningioma. Despite the pain and the sensory sensation was improved, the motoric and autonomic function still showed no significant improvement in the early postoperative period.
Discussion:
The preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. Meanwhile, the prognosis for recovery depends mainly on two factors: the severity of the neurological deficit and the duration of the deficit before decompression.
Conclusion:
Surgical resection of the tumor may relieve the spinal cord compression in a neglected case. Even though the neurologic function after surgery rarely returns to the functional stage due to chronic neural tissue damage.
Bilateral Simultaneous Tibial Tubercle Avulsion in an Adolescent Football Player with Previous Bilateral Osgood-Schlatter Disease
Authors: Jaime Dalla Rosa Nogales, José Juan Nogales Zafra
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Tibial tubercle avulsion fractures are a very uncommon injury, accounting between 0.4 and 2.7% of all epiphyseal injuries. Bilateral lesions are extremely rare with only 20 cases described in the literature. They occur more frequently in male adolescents and during sport activities that require jumping and sprinting, such as football or basketball. We report the case of a 13-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed bilateral Osgood-Schlatter disease.
New Onset Refractory Status Epilepticus in a Young Man with H1N1 Infection
Authors: Faisal Ibrahim, Naim Haddad
Journal: Case Rep Neurol Med (2014)

Objective. To report a case of refractory status epilepticus (SE) as an unusual early manifestation of H1N1 influenza infection. Introduction. H1N1 neurological complications have been reported and consist mainly of seizures or encephalopathy occurring in children. However, we only found a single report of an adult developing complex partial SE with H1N1 infection. Case Report. A 21-year-old previously healthy man was brought to the emergency room (ER) after a witnessed generalized tonic clonic seizure (GTCS). He was fully alert and afebrile upon ER arrival, but a second GTCS prompted treatment with Lorazepam and Fosphenytoin. The initial EEG showed diffuse slowing, but a repeat one requested as the patient failed to regain consciousness revealed recurrent focal seizures of independent bihemispheric origin, fulfilling the criteria for nonconvulsive SE. Chest X-ray, followed by chest CT scan, showed a left upper lobe consolidation. H1N1 infection was confirmed with PCR on bronchoalveolar lavage material. Despite aggressive treatment with Midazolam, Propofol, and multiple high dose antiepileptic drugs, the electrographic seizures recurred at every attempt to reduce the intravenous sedative drugs. The patient died two weeks after his initial presentation. Conclusion. H1N1 should be added to the list of rare causes of refractory SE, regardless of the patient's age.
Capillary hemangioma of the middle ear: one case report and review of the literature
Authors: H Nouri, A Harkani, M Elouali Idrissi, Y Rochdi, L Aderdour, A Oussehal, A Raji
Journal: Case Rep Otolaryngol (2012)
MeSH terms: Case Reports

Hemangiomas are rare benign vascular tumors; there are several types including the capillary hemangiomas, we present the case of an exceptional localization of capillary hemangioma in the middle ear. We report the case of a 60-year-old female which consults for episodes of pulsatile tinnitus, otorragies, and hearing loss of the left ear. The clinical examination revealed a reddish polypoid mass in the left external auditory canal, the radiological tests showed a vascular mass in the middle left ear. The tumor was surgically removed, the histological study revealed a capillary hemangioma. The incidence of hemangiomas in the temporal bone, especially in the middle ear, is exceptional. Medical imaging guides to the vascular nature of these tumors that make confusion with other vascular tumors such as tympanic paragangliomas. The management is often surgical and the final diagnosis is histological.
Bronchoscopy-guided bronchial epithelium sampling as a tool for selecting the optimal biologic treatment in a patient with severe asthma: a case report
Authors: Chin-Wei Kuo, Xin-Min Liao, Yi-Ching Huang, Han-Yu Chang, Chi-Chang Shieh
Journal: Allergy Asthma Clin Immunol (2019)
Keywords: bronchial epithelium sampling, omalizumab, severe asthma
MeSH terms: Case Reports

Background:
There are numerous biologics for treating patients with severe asthma. A cost-effective method for selecting the most appropriate biologic therapy for a patient is thus important. Bronchoscopy-guided bronchial epithelium sampling may provide information for determining the type of inflammation in the airways of severe asthma patients through immunochemical analysis and thus help clinicians select the correct biologics.
Case presentation:
We report the case of a female with severe asthma and eosinophilia who initially responded to omalizumab treatment. She developed an allergic reaction after four injections of omalizumab. Omalizumab desensitization was successfully conducted. To select an appropriate biologic agent after this hypersensitivity episode, we performed bronchoscopy-guided bronchial epithelium sampling. Omalizumab treatment was resumed based on the findings of immunohistochemical staining after a successful desensitization procedure, leading to long-term control of her severe asthma.
Conclusions:
Selecting an adequate biologic agent for severe, uncontrolled asthma is a challenge in clinical medical practice. Although phenotypes, blood eosinophils, and serum IgE levels have been proposed for use as a reference, there is a dissociation between the blood immune-cell level and the airway epithelium immune reaction, as confirmed in previous studies. Airway epithelium immunohistochemistry staining for targeted immune cells has been used to determine various types of airway inflammation; however, this technique is rarely used in a clinical setting. Previous studies have revealed the relative safety of performing bronchoscopy biopsies for patients with severe asthma. Among the sampling techniques used for tissue diagnosis, including nasal biopsies, nasal or bronchial brushing, and bronchoalveolar lavage, bronchoscopy-guided bronchial epithelium sampling provides more accurate information about the epithelial and inflammatory cells in the tissue context. It is thus a powerful tool for selecting the most suitable biologics in difficult clinical conditions.
Traumatic floating clavicle: a case report and literature review
Authors: Mohamad Gouse, Korula Mani Jacob, Pradeep Mathew Poonnoose
Journal: Case Rep Orthop (2013)

Bipolar fracture dislocations of the clavicle are rare injuries, usually the result of high-energy direct trauma. Since the original description by Porral in 1831, only a handful of individual case reports and case series by Beckman and Sanders have been reported in the literature. Management of these injuries has remained controversial ranging from nonoperative to aggressive surgery. We report on the case of a young army cadet who had a fracture of the lateral end of the clavicle, with an anterior dislocation of the sternoclavicular joint. Despite being planned for surgery, at the patients request, it was decided to manage the lesion conservatively with graded physiotherapy. At one-year follow-up, he had full pain-free, functional range of movement of the shoulder. This young high demand patient had a good outcome with conservative management, despite going against the current trend towards surgical treatment. We present this case with a review of the literature, highlighting the various management options for this rare lesion.
Primary Small Cell Carcinoma of the Hypopharynx: A Case Report of a Rare Tumor
Authors: Ali Bayram, Ebru Akay, Sema S Göksu, İbrahim Özcan
Journal: Case Rep Otolaryngol (2015)

Introduction. Primary hypopharynx involvement of small cell carcinoma is very rare and very few cases have been reported in the literature. Here, we report a case of primary small cell carcinoma of the hypopharynx in a male patient. Case Report. A 50-year-old man presented with a 6-month history of sore throat and swellings in the right side of the neck. Direct laryngoscopy and biopsy revealed small cell carcinoma of the hypopharynx located in the right pyriform sinus. Discussion. Small cell carcinoma of the hypopharynx has no clear treatment modality due to the rarity of the disease. Systemic chemotherapy and radiotherapy should have priority among the therapy regimens because of the high metastatic potential of the tumor.
Granulomatosis with Polyangiitis in Adolescence: Two Distinct Presentations
Authors: Rafael Figueiredo, Inês Pires Duro, António Marinho, Conceição Mota, Margarida Guedes, Carla Zilhão
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Introduction. Granulomatosis with polyangiitis (GPA) is a rare disease in pediatric age. We report two cases with distinct presentations. Case Reports. A seventeen-year-old male with prolonged febrile syndrome, cough, and constitutional symptoms. CT-scan showed cavitated lesions of the lung and bronchial biopsy a necrotizing inflammatory process. The remaining investigation revealed hematoproteinuria and positive C-ANCA and anti-PR3. Complications: Bilateral acute pulmonary thromboembolism, splenic infarction, and extensive popliteal and superficial femoral deep vein thrombosis. He was treated with corticosteroids, immunoglobulin, rituximab, and anticoagulation. Rituximab was maintained every six months during the first two years. Control angio-CT was performed with almost complete resolution of previous findings. In a twelve-year-old female with inflammatory signs of the limbs, investigation showed myositis of the thigh and tenosynovitis of the wrist, normocytic normochromic anemia (Hg 9.4 g/dL), mild elevation of inflammatory markers, and high creatine kinase. During hospitalization, she presented an extensive alveolar hemorrhage associated with severe anemia and positive C-ANCA and anti-PR3. Clinical deterioration prompted intravenous methylprednisolone pulses and plasmapheresis. Induction therapy with rituximab and prednisolone showed good results. Rituximab was maintained every six months, for 18 months, with gradual tapering of corticoids. Discussion. GPA is a systemic disease with variable clinical presentation and severity. Pediatric patients have similar clinical manifestations to adults but different frequencies of organ involvement; constitutional symptoms are also more common. We highlight the different presentation of these two cases, as well as the need for an individualized approach. Rituximab has been used for both induction-remission and maintenance therapy, with good results, particularly in young patients.
Acute Thrombotic Occlusion of the Popliteal Artery following Knee Dislocation: A Case Report of Management, Local Unit Practice, and a Review of the Literature
Authors: Anthony Dean Godfrey, Fadi Hindi, Callum Ettles, Mark Pemberton, Perbinder Grewal
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Arterial complications following traumatic knee injury are relatively rare but mandate timely recognition and treatment to avoid significant comorbidity and medicolegal ramifications. In this report we describe a case of acute thrombotic occlusion of the popliteal artery occurring after knee dislocation, successfully repaired by intimal fixation and a limited venous patch reconstruction. We present a review of local practice in screening vascular injuries following knee dislocation, aligned with a review of the literature and considerations for practice.
Intraosseous Mucoepidermoid Carcinoma in the Mandible
Authors: George Borja de Freitas, Arthur José Barbosa de França, Stefanny Torres Dos Santos, Miqueias Oliveira de Lima Júnior, Adilis Stepple da Fonte Neto, Paula Bernardon
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Although it is a rare neoplasm, intraosseous mucoepidermoid carcinoma is the most common and well-recognized intraosseous salivary gland tumor. Usually, it presents as an asymptomatic volume increase and most patients perceive the presence of the lesion within a year or less of evolution. They are more common in middle-aged adults and have a slight female predilection. They are three times more common in the mandible than in the maxilla and are most often found in the area of the molars and mandibular ramus. The most frequently present symptom is cortical bulging, although some lesions may be discovered as an accidental finding on radiographs. The main modality of treatment for patients with this neoplasm is radical surgical resection, offering a greater chance of cure than the more conservative procedures, such as enucleation or curettage, due to the great possibility of recurrence and tumor metastasis. This paper reports a rare case of intraosseous mucoepidermoid carcinoma occasionally discovered after panoramic radiography of the jaws, which was treated with segmental resection through hemimandibulectomy.
New Methods of Reconstruction for Old Challenges: The Use of the Integra Graft in Necrotizing Soft Tissue Infections of the Male Genitalia
Authors: Katharina Mitchell, Chad Crigger, Chad Morley, John Barnard, Vidas Dumasius
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

In this paper, we describe two cases of Fournier's gangrene (FG) in which Integra grafting was used for reconstruction. FG is a progressive necrotizing infection occurring in the perineal region and on the external genitalia. Reconstructive options using local tissue are limited due to the destruction this infection imposes on the soft tissue. Integra graft is a bilaminate artificial dermis made of shark chondroitin 6-sulfate and bovine collagen. It is applied to the wound bed after debridement and establishment of a healthy, well-vascularized wound base. The patients in this case series had large defects which could not be closed primarily with tissue beds and would not have been appropriate for skin grafting. Therefore, an Integra graft was placed. In both patients, the wound beds were appropriate for skin grafting after three weeks. Without the Integra graft, both of our patients would have needed to wait a considerable amount of time prior to reconstruction. Our case series further illustrates and supports the use of Integra grafts in such a scenario following Fournier's gangrene which has only previously been published on three occasions, all of which demonstrated successful outcomes.
The Insidious Cardiac Tumor: A Primary Left Atrium Intimal Cardiac Sarcoma in a Young Patient
Authors: Chika-Nwosuh Ogechukwu, Nnaoma Christopher, Sossou Christoph, Okundaye Etinosasere, Bustillo Jose
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

This case presentation discusses a rare cardiac malignancy initially thought to be a benign tumor. A 36-year-old presented with syncope, dyspnea, Computed Tomography Pulmonary angiography study obtained was negative for pulmonary emboli but revealed a left atrial mass. A transesophageal echocardiogram (TEE) confirmed a mass with multiple lobes and a broad base attached to the septum, encroaching into the right atrium, aortic root wall, base of the anterior mitral leaflet flowing to the mitral orifice in diastole also obstructing the right pulmonary vein. Despite a quick diagnosis and plan to begin treatment, the patient rapidly declined owing to the extent and aggressive nature of this cardiac malignancy. This case reports the insidious nature of these tumors as well as how challenging and life threatening they are at the time of their clinical manifestation.