OpenMed/multicare-articles huggingface dataset:
Catatonia and melancholia interface: exploring a new paradigm for evaluation and treatment. A case series and literature review
Authors: Yassir Mahgoub, Aum Pathare, Dallas Hamlin, Hassaan Gomaa, Sean Nutting, Charles Mormando, Andrew Francis
Journal: Front Psychiatry (2024)
Keywords: bipolar disorder, catatonia, depression, lorazepam, melancholia

Background:
Catatonia has been increasingly associated with mood disorders and is recognized as a specifier in the DSM-5 and DSM-5-TR. The DSM-5-TR recognizes melancholia as a specifier for depressive episodes in major depressive disorder and bipolar disorder. It is characterized by severe anhedonia, lack of reactivity, excessive or delusional guilt, and significant vegetative symptoms. As the conceptualization of melancholia expanded beyond its mood components to include psychomotor disturbances, its overlap with psychomotor symptoms or catatonia becomes evident. This overlap was also described in Kahlbaum's original literature, where he describes the transition between states of melancholia, mania, and catatonia.
Method:
Case summary of six patients with major depressive disorder or depressed phase of bipolar disorder who were admitted for severe depression, anhedonia, intense anxiety, psychomotor agitation or retardation, indecisiveness, perseveration, and vegetative symptoms such as poor sleep, appetite, and significant weight loss.
Results:
All patients demonstrated rapid and complete resolution of their mood and psychomotor symptoms, indecisiveness, perseveration, as well as psychosis shortly after administration of lorazepam, with recurrence of the above symptoms upon lorazepam discontinuation and resolution upon resumption, in an on-and-off manner.
Conclusion:
The present study argues for a closer relationship between melancholia and catatonia based on our case series, historical review, overlap in phenomenology, and response to treatment. We propose provisional [Mahgoub] criteria for patients with severe depression and melancholia. The role of GABA agonists, such as lorazepam, can be explored as an option for patients with treatment-resistant depression who meet these criteria for melancholia.
Limitations:
Absence of a standardized, systematic assessment tool and a small sample size.
Case report: Characteristics and nature of primary cardiac synovial sarcoma
Authors: Tomonori Kawasaki, Tomomi Nakajima, Tomoaki Torigoe, Kojiro Onohara, Kentaro Ishii, Satoshi Kanno, Chisako Muramatsu, Rikito Tatsuno, Takahiro Jubashi, Jiro Ichikawa
Journal: Front Oncol (2024)
Keywords: cardiac tumor, chemotherapy, diagnosis, fluorescence in situ hybridization, immunohistochemistry, radiotherapy, ynovial sarcoma
MeSH terms: Case Reports

Primary malignant cardiac tumors rarely occur, and cardiac synovial sarcoma (SS) is especially rare among such tumors. Herein, we present the case of a 35-year-old female with primary cardiac SS treated with surgery, chemotherapy, and radiotherapy. She presented with chest symptoms and underwent imaging examinations. A cardiac tumor was suspected, and an open biopsy was performed. The pathological findings suggested cardiac SS. Next, we performed a resection, and the tumors persisted at a macroscopic level. Immunohistochemistry was negative for SS18-SSX and positive for the SSX C-terminus and cytokeratin CAM5.2, a reduction of SMARCB1/INI1 was observed, and fluorescence in situ hybridization showed positive SS18 split staining. Owing to the FNCLCC grade 3 tumor and R2 margins, adjuvant chemotherapy with ifosfamide, doxorubicin, and radiotherapy was initiated, and the patient was diagnosed with cardiac SS. The differences in patients with cardiac SS compared with general SS include male predominance, larger tumor size, and poorer prognosis. Pathological findings of immunohistochemistry and fluorescence in situ hybridization were found to be more reliable than imaging findings for a correct diagnosis. Additionally, because incomplete resection is frequently performed, adjuvant therapy, including chemotherapy and radiation therapy, may be performed. The findings indicate that multiple therapies, including surgery, chemotherapy, and radiotherapy, are essential treatment strategies for improving the prognosis of patients with cardiac SS.
Single metachronous bone metastasis following rectal adenocarcinoma: A case report
Authors: Belén Matías-García, Fernando Mendoza-Moreno, Manuel Díez-Alonso, Enrique Ovejero-Merino, Cristina Vera-Mansilla, Alma Blázquez-Martín, Ana Quiroga-Valcárcel, Rubén Jiménez-Martín, Rebeca D'amico, Inmaculada Lasa-Unzúe, Alberto Gutiérrez-Calvo
Journal: Med Int (Lond) (2024)
Keywords: kras, bone metastases, colorectal cancer, liver, lung, survival
MeSH terms: Case Reports

Colorectal cancer (CRC) ranks as the third leading cause of cancer-related mortality in developed countries. While its incidence in early stages has increased due to screening programs, a significant number of patients experience the development of metastases either at the time of diagnosis or during follow-ups. Unlike certain other types of cancer, such as breast, prostate, or lung cancer, where bone tissue is a common site for secondary dissemination, CRC primarily spreads to the lymph nodes, liver and lungs. The occurrence of bone metastases from CRC is rare and usually coincides with tumor involvement in other locations. Risk factors for bone metastases include the location of the primary tumor, the age of the patients, KRAS mutations and the degree of tumor differentiation. Unlike metastases to the liver and lungs, bone metastases tend to be symptomatic, affecting the patient's quality of life and resulting in a poorer prognosis with shorter survival rates. The approach to patient management needs to be personalized. The present study describes the of a patient who underwent surgery for stage IV rectal adenocarcinoma and later developed a metastasis in the costal wall 79 months post-intervention, with no evidence of recurrence at other sites.
Left Upper Extremity Pain, Right Coronary Artery Culprit: A Puzzling Path to Aneurysm Discovery
Authors: Moath Said Alfawara, Vivek Modi, Min-Fang Chao, Malek Nayfeh, Fares Alahdab, Mahmoud Alrifai, Mouaz Al-Mallah
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: atherosclerosis, giant coronary artery aneurysm, multimodality cardiac imaging, right coronary artery
MeSH terms: Atherosclerosis, Coronary Aneurysm / diagnostic imaging, Coronary Aneurysm / etiology, Coronary Aneurysm / therapy, Case Reports, Adult, Child, Coronary Vessels, Humans, Pain, Upper Extremity

Giant coronary artery aneurysm (GCA) is a rare disease afflicting 0.2% of the population. It is primarily attributed to atherosclerosis in adults and Kawasaki disease in children. Other uncommon etiologies include Takayasu arteritis and post-percutaneous coronary intervention.1,2 GCA lacks a universally accepted definition, with proposed criteria including a diameter exceeding 2 cm, 5 cm, or four times the normal vessel size.3 While the majority of GCAs are asymptomatic, a subset of patients present with angina, myocardial infarction from embolization or compression, heart failure due to fistula formation, or even sudden death.1 We report a case of an adult harboring a GCA involving the right coronary artery.
Physiotherapy case reports on three people with progressive supranuclear palsy
Authors: Mariana Mateus, Alexandre Castro Caldas
Journal: Front Aging Neurosci (2023)
Keywords: falls, functionality, physiotherapy, progressive supranuclear palsy, quality of life

Introduction:
Progressive supranuclear palsy (PSP) is a neurodegenerative brain disease that affects patient's functionality and quality of life. Physiotherapy should be recommended at the time of diagnosis to slow the progression of disability and enhance the quality of life of these patients.
Clinical presentation:
Here, we describe three cases of patients with PSP, outlining their motor and non-motor symptoms and examining their clinical progression with physiotherapy intervention. During the initial intervention years, a reduction in the number of falls was achieved, along with improvements in gait and balance.
Conclusion:
Exercise and physiotherapy appear to be beneficial for patients with PSP by enhancing their functionality and quality of life. Controlling or reducing the number of falls should be the primary goal of any intervention for patients with PSP.
Case report: Nutritionally supported perioperative chemo-immunotherapy for advanced gastric cancer with incomplete pyloric obstruction
Authors: Mi Jian, Zhensong Yang, Xue Hu, Xixun Wang, Zhenbin Zhang, Yifei Zhang, Xinna Song
Journal: Front Oncol (2024)
Keywords: gastric cancer, immunotherapy, nutritional intervention, perioperative treatment, pyloric obstruction
MeSH terms: Case Reports

This case describes the benefits of perioperative chemo-immunotherapy for advanced gastric cancer and incomplete pyloric obstruction, supplemented with nutritional support. Early parenteral nutrition to stabilize nutritional status and mitigate nutrition impact symptoms, and in addition, throughout the chemo-immunotherapy perioperative period also maintained oral nutrition support and a tailored dietary plan. Above nutritional support maintained the patient's physical condition during immunotherapy. Eventually, this combination therapy plan leads to a partial response. On the other hand, a combination of therapies that focus more on immune checkpoint inhibitor may be able to mitigate the side effects of chemotherapy. Such findings may yield novel prospects for patients with advanced gastric cancer and incomplete pyloric obstruction, enabling them to achieve better outcomes.
Accelerated atherosclerosis in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: case report
Authors: Natalia Andrea Uribe Ruíz, María Paulina Villa, Alberto Álzate Gutiérrez, Clara Inés Saldarriaga Giraldo, José Gregorio Thorrens Ríos
Journal: Arch Peru Cardiol Cir Cardiovasc (2024)
Keywords: anti-neutrophil cytoplasmic antibody-associated vasculitis, atherosclerosis, microscopic polyangiitis, myocardial infarction
MeSH terms: Case Reports

Accelerated atherosclerosis has been identified as a complication of multiple autoimmune diseases, among which Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis stands out. We describe the case of a 60-year-old patient with a history of hypertension, diabetes mellitus, and chronic kidney disease of unknown etiology, who presented two acute coronary syndromes with only a six-month difference. Rapid progression of coronary involvement was evidenced, along with increased markers of inflammatory response, usual interstitial pneumonia on tomography, and positive anti-myeloperoxidase antibodies (anti-MPO), leading to the diagnosis of microscopic polyangiitis (MPA). In these cases, timely diagnostic suspicion is crucial, as early treatment significantly impacts the course and prognosis of the disease.
Case report: A challenging case of severe Cushing's syndrome in the course of metastatic thymic neuroendocrine carcinoma with a synchronous adrenal tumor
Authors: Lukasz Dzialach, Agnieszka Wojciechowska-Luzniak, Maria Maksymowicz, Przemysław Witek
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: adrenal tumor, cortisol, ectopic acth syndrome, etomidate, thymic neuroendocrine carcinoma
MeSH terms: Adrenal Gland Neoplasms / complications, Adrenal Gland Neoplasms / pathology, Adrenal Gland Neoplasms / secondary, Carcinoma, Neuroendocrine / complications, Carcinoma, Neuroendocrine / pathology, Carcinoma, Neuroendocrine / secondary, Carcinoma, Neuroendocrine / surgery, Cushing Syndrome / etiology, Cushing Syndrome / pathology, Thymus Neoplasms / complications, Thymus Neoplasms / pathology, Thymus Neoplasms / surgery, Case Reports, ACTH Syndrome, Ectopic / diagnosis, ACTH Syndrome, Ectopic / etiology, ACTH Syndrome, Ectopic / pathology, Adrenalectomy, Adult, Female, Humans, Neoplasms, Multiple Primary / complications, Neoplasms, Multiple Primary / pathology

Ectopic ACTH syndrome (EAS) remains one of the most demanding diagnostic and therapeutic challenges for endocrinologists. Thymic neuroendocrine tumors account for 5%-10% of all EAS cases. We report a unique case of a 31-year-old woman with severe EAS caused by primary metastatic combined large-cell neuroendocrine carcinoma and atypical carcinoid of the thymus. The patient presented with severe hypercortisolemia, which was successfully controlled with continuous etomidate infusion. Complex imaging initially failed to detect thymic lesion; however, it revealed a large, inhomogeneous, metabolically active left adrenal mass infiltrating the diaphragm, suspected of primary disease origin. The patient underwent unilateral adrenalectomy, which resulted in hypercortisolemia resolve. The pathology report showed an adenoma with adrenal infarction and necrosis. The thymic tumor was eventually revealed a few weeks later on follow-up imaging studies. Due to local invasion and rapid progression, only partial resection of the thymic tumor was possible, and the patient was started on radio- and chemotherapy.
A Case of Odontoid Osteomyelitis
Authors: Etaro Hashimoto, Kenji Miyazaki, Kazuhito Hirose, Tetsuhiro Maeno
Journal: Cureus (2024)
Keywords: calcium pyrophosphate deposition disease, crowned dens syndrome, odontoid osteomyelitis, posterior neck pain, spinal epidural abscess, staphylococcus aureus infection
MeSH terms: Case Reports

Odontoid osteomyelitis is a rare infectious disease that manifests as fever and posterior neck pain, while crowned dens syndrome is a relatively common inflammatory disorder with similar signs and symptoms. We describe the case of a 90-year-old woman presenting with fever, posterior neck pain, throat pain, and headache. Crowned dens syndrome was initially diagnosed based on the clinical picture and calcification around the odontoid process on cervical spine CT. However, the diagnosis was revised to odontoid osteomyelitis following the detection of Staphylococcus aureus in blood cultures that were performed due to the presence of headache. Infectious complications included spinal epidural abscess extending to the hypoglossal canal and osteomyelitis spreading to the clivus. Nonetheless, the patient achieved complete recovery after 13 weeks of antimicrobial therapy. No reports of odontoid osteomyelitis with calcification around the odontoid process have been reported. This case underscores the importance of avoiding a hasty diagnosis of crowned dens syndrome when calcification around the odontoid process is observed in patients presenting with fever and posterior neck pain. It is crucial to perform a thorough medical history review and physical examination to exclude other conditions. In cases where infection is suspected, blood cultures and cervical spine MRI are essential to investigate odontoid osteomyelitis and other complications.
Rare Presentation and Diagnostic Challenge of a Germ Cell Tumor of the Yolk Sac Type
Authors: Inês Gomes, Emanuel Jesus, Gabriela M Sousa
Journal: Cureus (2024)
Keywords: chemotherapy, germ cell tumor, neurologic disorder, opsoclonus-ataxia, yolk sac tumor
MeSH terms: Case Reports

Opsoclonus-ataxia paraneoplastic syndrome (OAPS) is a rare neurological disorder often associated with malignancies. This case report highlights an unusual instance of OAPS linked to a yolk sac (germ cell) tumor, a correlation underrepresented in the medical literature. The patient presented with distinct neurological symptoms alongside mediastinal lymphadenopathies. The subsequent diagnostic journey revealed a yolk sac germ cell tumor. Following incisional biopsies and treatment, the patient experienced fluctuations in mental status, leading to challenges in initiating chemotherapy. Despite these complications, a multidisciplinary approach involving neurologists, oncologists, and hematologists was pivotal. The case emphasizes the complexities of managing OAPS in tandem with a germ cell tumor, underscoring the need for further research and highlighting the significance of specialized neurological evaluation in similar cases.
Case report: Ultrasound diagnosis of a complicated case of gastric lymphoma misdiagnosed as cirrhosis
Authors: Dayan Yang, Lini Gao
Journal: Front Oncol (2024)
Keywords: ceus, cirrhosis, diagnosis, gastric lymphoma, ultrasound
MeSH terms: Case Reports

The gastrointestinal (GI) tract is the most common primary site for extranodal lymphomas. The use of ultrasonography for diagnosing gastric lymphomas can be challenging, but ultrasonography still offers some unique advantages in the diagnosis of GI lymphomas. Here, we report a case of gastric lymphoma in a patient with an extensive lesion in which the tumor was complexed with the abdominal organs. CT and endoscopy failed to definitively diagnose the condition in a timely manner. The gastric lymphoma was finally diagnosed with ultrasonography and a treatment plan was implemented.
Case report: Systemic presentation of ALK-positive Histiocytosis
Authors: Yongbao Wei, Ruochen Zhang, Deng Lin, Xiaoyan Chen, Lizhi Li, Haijian Huang
Journal: Front Oncol (2024)
Keywords: alk, alk-positive histiocytosis, kif5b, male genitourinary system, rare disease
MeSH terms: Case Reports

ALK-positive Histiocytosis (ALK-HSs) is a recently identified rare clinical entity characterized by tissue histiocytic alterations associated with ALK gene rearrangement. Clinical presentations can be solitary, multifocal, or systemic (involving multiple sites and organs). Due to limited reported cases, there is inadequate understanding of this disease. This report presents a case of ALK-HSs in a 71-year-old male patient who presented with hematuria for one week. Imaging studies conducted at an external hospital showed multiple lesions in the penis, bilateral testes, back skin, and the third lumbar vertebra. Histopathological findings included spindle and histiocytic cell proliferation with mild or indistinct cellular atypia, interstitial infiltration of lymphocytes, plasma cells, foamy histiocytes, and fibrous tissue proliferation. Immunohistochemistry of the lesion cells revealed positivity for CD68, CD163, ALK1, ALK (D5F3), and Vimentin. FISH testing indicated ALK gene separation in the lesion cells. NGS testing identified the fusion genes KIF5B(NM_004521) and ALK(NM_004304) in the lesion cells. We combined the characteristics of this case with a review of the literature to enhance our understanding of this rare clinical entity.
Acetabular Reconstruction in a Rare Case of Ligamentum Teres Tenosynovial Giant Cell Tumour (TGCT) Causing Extensive Destruction
Authors: Georgios Douvlis, Christothea-Alexandra Tsiridis, Zakareya Gamie, Antonia Mpintoudi, Nikolaos Milonakis, Eustathios Kenanidis, Eleftherios Tsiridis
Journal: Cureus (2024)
Keywords: acetabular reconstruction, cementless total hip arthroplasty, ligamentum teres, pigmented villonodular tendosynovitis(pvns), tenosynovial giant cell tumour
MeSH terms: Case Reports

Tenosynovial giant cell tumour (TGCT), previously called pigmented villonodular tenosynovitis (PVNS), is a rare benign, locally aggressive condition that primarily affects the synovial lining of large joints, such as the knee, the hip, and the ankle. TGCT of the hip joint is a relatively scarce entity, and its diagnosis is often challenging. This article reports a case of TGCT affecting the left acetabulum, the left femoral head, and the ligamentum teres of the hip joint in a 39-year-old woman who presented to our clinic three months after the onset of symptoms. The patient underwent a biopsy, computer tomography (CT), and magnetic resonance imaging (MRI). All tests were inconclusive. Total hip arthroplasty (THA) was subsequently performed, leading to healing of the lesion previously present. Following surgery, a second biopsy classified this lesion as TGCT. By sharing our experience with this rare manifestation, we aim to contribute to the growing body of knowledge on the diagnosis and management of TGCT, specifically when it occurs in the hip joint.
Case Report: IgG4-related kidney disease complicated by interstitial pneumonia
Authors: Akira Mima, Rina Lee, Ami Murakami, Hidemasa Gotoda, Ryosuke Akai, Shinji Lee
Journal: F1000Res (2023)
Keywords: igg4-related kidney disease, interstitial pneumonia, prednisolone, tubulointerstitial nephritis
MeSH terms: Case Reports

Immunoglobulin G4 (IgG4)-related disease is a systemic inflammatory disorder characterized by tubulointerstitial nephritis with IgG4-positive plasma cell infiltration. We report the case of an 84-year-old male who presented with a history of dyspnea on exertion and cough. The lymph nodes were palpated in the axilla. Urinalysis revealed mild proteinuria and increased levels of NAG and β2-microglobulin. Blood tests showed hyperglobulinemia with a marked elevation of serum IgG4 levels. Chest computed tomography showed bilateral ground-glass and reticular opacities in the lower and peripheral portions of the lungs. Ga-67 scintigraphy showed kidney uptake. The patient was diagnosed with IgG4-related kidney disease based on the renal pathology indicative of typical tubulointerstitial nephritis with extensive IgG4-positive plasma cell infiltration. The patient was treated with prednisolone and showed a prompt response in his clinical condition. The patient achieved normalization of serum IgG4 levels 6 months after the initiation of treatment. Although IgG4-related disease is thought to be potentially associated with organ fibrosis, there are few reports on combination of interstitial pneumonia and IgG4-related kidney disease. Our case report presents a possible pattern of IgG4-related disease.
Malignant transformation of primary ameloblastoma of skull: case report and review of current literature
Authors: Haitong Xu, Jialiang Tan, Dongxiang Fu
Journal: Front Oncol (2024)
Keywords: ameloblastic carcinoma, ameloblastoma, malignant transformation, planning target volume, stereotactic radiotherapy
MeSH terms: Case Reports

Background:
Since 1964, there has been a scarcity of reported cases of primary ameloblastoma (AM) or ameloblastic carcinoma (AMCa) of the skull. The clinical presentation and distinctive features of this uncommon condition at specific anatomical sites remain unclear. We report a case of malignant transformation of a primary AM of the skull situated in the frontal-temporal-parietal region and highlight its similarities to other cases reported in the literature.
Clinical presentation:
A 53-year-old female patient presented with a 20-day history of headaches and bilateral lower limb weakness for 10 days. Physical examination revealed slow and unsteady gait. An occupying lesion was observed in the right frontal-temporal-parietal region of the skull on the Cranial imaging. A right cranial bone tumor margin expansion resection was performed. The patient's motor functions recovered normally after surgery. Postoperative imaging examinations showed10 tumor resection. Follow-up imaging examinations showed tumor recurrence. The patient underwent resection of the recurrent tumor. Postoperative pathological analysis revealed malignant transformation of the AM.Follow-up imaging examinations showed tumor recurrence again. The patient was admitted for stereotactic radiotherapy. Follow-up imaging examinations demonstrated no evidence of tumor recurrence and subsequent chest CT revealed no signs of metastasis.
Conclusion:
Primary AM or AMCa of the skull is increasingly being described in the literature, but detailed reports on the malignant transformation of primary AM of the skull are lacking. The pathogenesis of this condition remains unclear. Aggressive treatment and close follow-up may be crucial for preventing disease recurrence and malignant transformation.