OpenMed/multicare-articles huggingface dataset:
Gastrointestinal Stromal Tumor (GIST) and Synchronous Intra-Abdominal Liposarcoma: A Report of Two Rare Cases and Literature Review
Authors: Alexandros Diamantis, Athina A Samara, Ioannis Baloyiannis, Dimitrios Symeonidis, Andreas-Marios Diamantis, Maria Tolia, Konstantinos Bouliaris, Georgios Koukoulis, Konstantinos Tepetes
Journal: Int J Surg Oncol (2021)
MeSH terms: Gastrointestinal Stromal Tumors / diagnostic imaging, Gastrointestinal Stromal Tumors / surgery, Liposarcoma / diagnostic imaging, Liposarcoma / surgery, Retroperitoneal Neoplasms / diagnostic imaging, Retroperitoneal Neoplasms / surgery, Stomach Neoplasms, Case Reports, Review, Adenocarcinoma, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged

Introduction:
Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare.
Methods:
We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma.
Results:
A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study.
Conclusion:
Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.
Treatment of Severe Japanese Encephalitis Complicated With Hashimoto's Thyroiditis and Guillain-Barré Syndrome With Protein A Immunoadsorption: A Case Report
Authors: Qiuling Zang, Yating Wang, Junshuang Guo, Liyang Long, Shuyu Zhang, Can Cui, Dandan Song, Boguang Yu, Fenlan Tang, Junfang Teng, Wang Miao
Journal: Front Immunol (2022)
Keywords: guillain-barré syndrome, hashimoto’s thyroiditis, japanese encephalitis, case report, protein a immunoadsorption
MeSH terms: Encephalitis, Japanese / diagnosis, Encephalitis, Japanese / therapy, Guillain-Barre Syndrome / complications, Hashimoto Disease / complications, Plasmapheresis / methods, Staphylococcal Protein A, Case Reports, Research Support, Non-U.S. Gov't, Adult, Biomarkers, Disease Management, Encephalitis, Japanese / complications, Female, Guillain-Barre Syndrome / diagnosis, Hashimoto Disease / diagnosis, Humans, Magnetic Resonance Imaging, Severity of Illness Index, Symptom Assessment, Tomography, X-Ray Computed, Treatment Outcome, Biomarkers, Staphylococcal Protein A

A severely comatose female patient was diagnosed with Japanese encephalitis (JE). Her condition was complicated by Hashimoto's thyroiditis (HT) and Guillain-Barré syndrome (GBS). After antiviral, glucocorticoid, and immunoglobulin treatment, the patient's consciousness was restored, and she could breathe spontaneously. Following this, new-onset, primarily demyelinating GBS developed, which progressed to demyelination combined with axonal injury. The patient was switched to protein A immunoadsorption (PAIA) therapy, and her Hughes score decreased rapidly, from 4 to 1 after 6 months. This patient is the first to receive PAIA combined with an antiviral-glucocorticoid-immunoglobulin regimen to treat encephalitis, meningitis, HT, and GBS caused by JE infection, thereby reflecting the importance of clinical application of PAIA in the treatment of immunological complications of JE.
Detection and Management of Intraoperative Pneumothorax during Laparoscopic Cholecystectomy
Authors: Mohammed Heyba, Areej Rashad, Abdul-Aziz Al-Fadhli
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

Intraoperative pneumothorax is a rare but potentially lethal complication during general anesthesia. History of lung disease, barotrauma, and laparoscopic surgery increase the risk of developing intraoperative pneumothorax. The diagnosis during surgery could be difficult because the signs are often nonspecific. We report a case of a middle-aged gentleman who developed right pneumothorax during an elective laparoscopic cholecystectomy. The patient had no risk factors for adverse events during the preoperative assessment (ASA1). The patient underwent general anesthesia and was put on mechanical ventilation. The first signs of abnormality immediately after surgical port insertion were tachycardia and low oxygen saturation in addition to sings of airway obstruction. The diagnosis of pneumothorax was made clinically by chest auscultation and later confirmed by intraoperative chest radiograph. Supportive treatment was started immediately through halting the surgery and manually ventilating the patient using 100% oxygen. Definitive treatment was then done by inserting an intercostal tube. After stabilizing the patient, the surgery was completed; then, the patient was extubated and shifted to the surgical ward. Postoperative computed tomography (CT) scan was done and showed only minimal liver laceration. The patient was discharged after removing the intercostal tube and was stable at the follow-up visit. Therefore, it is important to have a high index of suspicion to early detect and treat such complication. In addition, good communication with the surgeon and use of available diagnostic tools will aid in the proper management of such cases.
Clinical Advantages and Limitations of Monolithic Zirconia Restorations Full Arch Implant Supported Reconstruction: Case Series
Authors: Joao Carames, Loana Tovar Suinaga, Yung Cheng Paul Yu, Alejandro Pérez, Mary Kang
Journal: Int J Dent (2015)

Purpose. The purpose of this retrospective case series is to evaluate the clinical advantages and limitations of monolithic zirconia restorations for full arch implant supported restorations and report the rate of complications up to 2 years after insertion. Materials and Methods. Fourteen patients received implant placement for monolithic zirconia full arch reconstructions. Four implants were placed in seven arches, eleven arches received six implants, two arches received seven implants, two arches received eight implants, and one arch received nine implants. Results. No implant failures or complications were reported for an implant survival rate of 100% with follow-up ranging from 3 to 24 months. Conclusions. Monolithic zirconia CAD-/CAM-milled framework restorations are a treatment option for full arch restorations over implants, showing a 96% success rate in the present study. Some of the benefits are accuracy, reduced veneering porcelain, and minimal occlusal adjustments. The outcome of the present study showed high success in function, aesthetics, phonetics, and high patient satisfaction.
Plasmablastic Lymphoma with Coexistence of Chronic Lymphocytic Leukemia in an Immunocompetent Patient: A Case Report and Mini-Review
Authors: Eleftheria Hatzimichael, Konstantina Papathanasiou, Ioannis Zerdes, Stefanos Flindris, Alexandra Papoudou-Bai, Eleni Kapsali
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Background:
Plasmablastic lymphoma (PBL) is a rare, aggressive B-cell lymphoma with poor prognosis usually found in the oral cavity of HIV-positive patients. Chronic lymphocytic leukemia (CLL) is an indolent B-cell lymphoma with a variable clinical course. Transformation of CLL to PBL as Richter's syndrome is rare while coexistence of CLL and PBL at diagnosis is even rarer.
Case report:
We describe a case of a male immunocompetent patient with an ileum-cecum valve mass and a soft tissue mass at the left humerus with histologic evidence of PBL with coexistence of CLL in the bone marrow and peripheral blood. Amputation of the patient's left arm was inevitable, and the patient was started on bortezomib and dexamethasone. However, prolonged hospitalization was complicated by aspiration pneumonia, and the patient passed away.
Conclusions:
No standard of care exists for patients with PBL, and prognosis remains dismal. Concomitant presentation of hematological malignancies becomes increasingly recognized, and further insight is needed in order to delineate whether they originate from the same clone or from different ones.
Fibrodysplasic aneurysms of the extracranial internal carotid artery: a new case report
Authors: Hamid Jiber, Youssef Zrihni, Hamza Naouli, Abdellatif Bouarhroum
Journal: Pan Afr Med J (2017)
Keywords: extracranial internal carotid artery aneurysm, fibromuscular dysplasia, surgical treatment
MeSH terms: Anastomosis, Surgical / methods, Aneurysm / surgery, Carotid Artery Diseases / surgery, Carotid Artery, Internal / surgery, Case Reports, Aged, Aneurysm / pathology, Carotid Artery Diseases / pathology, Carotid Artery, Internal / pathology, Female, Humans

The other reports a case of fibrodysplasic aneurysm of the extracranial internal carotid artery that was successfully treated by resection and direct end-to-end anastomosis of the internal carotid artery.
Case Report: Graft Versus Tumor Effect After Non-Myeloablative Allogeneic Stem-Cell Transplantation in a Patient With Brentuximab-Vedotin Refractory Sezary Syndrome
Authors: Georg-Nikolaus Franke, Konstantin Dumann, Madlen Jentzsch, Astrid Monecke, Christine Doehring, Claudia Nehring-Vucinic, Sebastian Schwind, Dietger Niederwieser, Uwe Platzbecker, Mirjana Ziemer, Vladan Vucinic
Journal: Front Oncol (2021)
Keywords: sezary syndrome, allogeneic hematopietic stem cell transplantation, brentuximab vedodin, graft vs leukemia effect, non-myeloablative conditioning
MeSH terms: Case Reports

Sezary Syndrome (SS) is a rare leukemic variant of primary cutaneous T-cell lymphoma. Relapsed or refractory disease is generally considered incurable by conventional therapeutic approaches, although durable responses can be achieved with novel monoclonal antibodies. Allogeneic hematopoietic stem cell transplantation (alloHSCT) may have potential value by inducing graft vs-lymphoma (GvL) effects, but there is currently no consensus regarding the timing of alloHSCT or type of conditioning regimen. Here we present the case of a male patient who achieved a complete remission (CR) of primary refractory SS after non-myeloablative alloHSCT. Patient: Two years prior to HSCT, the patient had been refractory to CHOEP-based chemotherapy, interferon, extracorporeal photopheresis (ECP), and bexarotene. Directly prior to alloHSCT brentuximab-vedotin (BV) was applied resulting in a partial remission of the skin compartment and overall in a stable disease. Prior to HSCT, flow cytometry of the bone marrow and peripheral blood showed an infiltration with T-cells positive for CD5, CD4, low CD3, low CD2 and negative for CD7, CD38, HLA-DR and CD8. The trephine biopsy showed a 7% infiltration of SS cells. The CD4:CD8 ratio in peripheral blood (pb) was massively increased at 76.67, with 63.5% of white blood cells expressing a SS immune phenotype. The conditioning regimen included 30 mg/m2 fludarabine on days -5, -4 and -3 and total body irradiation with 2 Gy on day -1. Immunosuppression consisted of cyclosporine A from day-1 and mycophenolate mofetil from day 0. The patient received 6.55x106 CD34+ cells and 1.11x108 CD3+ cells/kg body weight. Bone marrow evaluation on day 28 still showed persistent SS cells by flow cytometry. After tapering immunosuppression until day 169, the CD4:CD8 ratio in pb normalized. CR was documented on day 169 after alloHSCT and is now ongoing for almost 3 years after alloHSCT. Conclusions: We confirm that an alloHSCT can be a curative option for refractory patients with SS. The achievement of a CR after tapering the immunosuppressive therapy indicates a significant role of the GvL effect. In present treatment algorithms for patients with SS, the timing of an alloHSCT and the intensity of conditioning should be further explored.
Neuroendocrine tumour arising inside a retro-rectal tailgut cyst: report of two cases and a review of the literature
Authors: F Spada, G Pelosi, M Squadroni, K Lorizzo, A Farris, F de Braud, N Fazio
Journal: Ecancermedicalscience (2011)
MeSH terms: Case Reports

Tailgut cysts (or retro-rectal cyst-hamartomas (RCHs)) are developmental abnormalities consisting of multiloculated cysts lined by squamous, transitional or glandular epithelium which, albeit rarely, may give rise to malignant transformations. Carcinoid tumours arising in the presacral region are extremely rare and usually benign, and only a few are described in the literature. Case 1: A 63-year-old female diagnosed as having bilateral ovarian cysts underwent surgery to remove a right adnexial mass that was histopathologically diagnosed as a well-differentiated carcinoid tumour. She is currently disease free after 18 months of follow-up. Case 2: A 41-year-old-female diagnosed with hepatic metastases and a solid pelvic mass arising from a moderately differentiated neuroendocrine carcinoma is currently alive with disease after having undergone surgical removal of the mass and several medical treatments. We here describe two different clinical histories of well- and moderately differentiated neuroendocrine tumours (NETs) arising from tailgut cysts in the prerectal space together with a review of the relevant literature.
Could Hallucinogens Induce Permanent Pupillary Changes in (Ab)users? A Case Report from New Zealand
Authors: Ahmed Al-Imam
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

An eighteen-year-old female patient of the Caucasian ethnicity from Australasia presented with a persistently dilated pupil causing her discomfort and occasional burning sensation when she is outdoors due to oversensitivity to sunlight. However, her pupillary reaction to light (pupillary light reflex) was intact. The patient is a known user of psychedelic substances (entheogens) including LSD, NBOMe, psilocybin, and DMT. The condition affects both eyes to the same extent. Thorough medical, neurological, and radiological examinations, including an EEG and an MRI of the head and neck region, were completely normal. All these tests failed to detect any pathophysiological or anatomical abnormalities. The patient is a known case of chronic endogenous depression in association with attention deficit hyperactivity disorder, for which she is taking citalopram and Ritalin, respectively. There was neither a family history nor a similar congenital condition in her family.
Case Report - Multinodular goiter in a patient with Congenital Hypothyroidism and Bannayan-Riley-Ruvalcaba syndrome: the possible synergic role of TPO and PTEN mutation
Authors: Gaia Vincenzi, Ilenia Teresa Petralia, Marco Abbate, Giulia Tarantola, Silvia Laura Carla Meroni, Riccardo Maggiore, Gilberto Mari, Maria Grazia Patricelli, Marco Schiavo Lena, Graziano Barera, Maria Cristina Vigone
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: pten hamartoma tumor syndrome, tpo, case report, congenital hypothyroidism, goiter
MeSH terms: Congenital Hypothyroidism / complications, Congenital Hypothyroidism / genetics, Goiter / complications, Goiter / genetics, Goiter / surgery, Hamartoma Syndrome, Multiple / complications, Hamartoma Syndrome, Multiple / genetics, Hamartoma Syndrome, Multiple / pathology, Thyroid Neoplasms, Case Reports, Child, Female, Humans, Mutation, PTEN Phosphohydrolase / genetics, PTEN protein, human, PTEN Phosphohydrolase

We report the case of a paediatric female patient affected by Bannayan-Riley-Ruvalcaba syndrome (BRRS) and congenital hypothyroidism (CH) with homozygous mutation of the TPO gene. She underwent total thyroidectomy at the age of seven years because of the development of a multinodular goiter. BRRS patients present an increased risk of benign and malignant thyroid disease since childhood because of inactivating mutation of PTEN, an onco-suppressor gene. Instead, homozygous mutations in the TPO gene can be associated with severe forms of hypothyroidism with goiter; previous studies have described cases of follicular and papillary thyroid cancer in CH patients with TPO mutation despite a perfectly controlled thyroid function with Levothyroxine therapy. To our knowledge, this is the first case that describes the possible synergic role of coexisting mutation of both TPO and PTEN in the development of multinodular goiter underlining the importance of a tailored surveillance program in these patients, especially during childhood.
Rheumatoid Meningitis Occurring during Etanercept Treatment
Authors: Koji Tsuzaki, Takashi Nakamura, Hiroyuki Okumura, Naoko Tachibana, Toshiaki Hamano
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

We report a 65-year-old man who had repetitive seizures 6 months after receiving etanercept, methotrexate, and prednisolone for rheumatoid arthritis. Mononuclear cells were mildly increased in the cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) showed high intensity along sulci of the frontal and parietal lobes. Brain biopsy revealed lymphocyte and plasma cell infiltration in the meninges, confirming the diagnosis of rheumatoid meningitis. After steroid pulse therapy, seizures resolved and clinical findings improved. When etanercept was replaced by tocilizumab, rheumatoid meningitis did not recur. Although TNF-α inhibitors can control joint symptoms of rheumatoid arthritis, they may induce rheumatoid meningitis.
Volvulus of small bowel in a case of simple meconium ileus
Authors: Kanchan Kayastha, Bilal Mirza, Afzal Sheikh
Journal: APSP J Case Rep (2011)
Keywords: complications, meconium ileus, volvulus
MeSH terms: Case Reports

Meconium ileus is one of important causes of neonatal intestinal obstruction. Many patients respond well to nonsurgical management with enemas, however, few patients may develop complications in the postnatal period thus requiring urgent operation. A 2 day old newborn presented with clinical features of intestinal obstruction. There was a suspicion of meconium ileus. Contrast x-ray with gastrografin enema was suggestive of unused colon with beaded appearance. Patient had to be surgery as repeated enemas did not improve the condition and progressive abdominal distension occurred. At exploration twist of the dilated, meconium filled loop of small bowel found. De-twisting of the volvulus done and Bishop Koop ileostomy fashioned. Patient made an uneventful recovery. Stoma was closed six months later.
Mitochondrial DNA 3243A>T mutation in a patient with MELAS syndrome
Authors: Takahiro Ikeda, Hitoshi Osaka, Hiroko Shimbo, Makiko Tajika, Masayo Yamazaki, Ayako Ueda, Kei Murayama, Takanori Yamagata
Journal: Hum Genome Var (2018)
MeSH terms: Case Reports

Approximately 80% of cases of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) harbor a heteroplasmic m.3243A>G transition in the tRNALeu (UUR) (MTTL1) gene. We report a MELAS case with a rare heteroplasmic m.3243A>T mutation found by direct sequencing of MTTL1. This mutation has been previously reported in 5 cases, of which 2 cases had the MELAS phenotype. Our case also strengthens the hypothesis that the m.3243A>T mutation can cause the MELAS phenotype.
Case report of a pituitary thyrotropin-secreting macroadenoma with Hashimoto thyroiditis and infertility
Authors: Jiaqi Li, Jianwei Li, Shu Jiang, Ruichao Yu, Yerong Yu
Journal: Medicine (Baltimore) (2018)
MeSH terms: Adenoma / complications, Hashimoto Disease / complications, Infertility, Male / etiology, Pituitary Neoplasms / complications, Thyrotropin / metabolism, Case Reports, Adenoma / diagnosis, Adenoma / metabolism, Adenoma / surgery, Adult, Female, Humans, Infertility, Male / therapy, Male, Pituitary Neoplasms / diagnosis, Pituitary Neoplasms / metabolism, Pituitary Neoplasms / surgery, Pregnancy, Thyrotropin

Rationale:
Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma.
Patient concerns:
This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility.
Diagnoses:
Examinations revealed pituitary thyrotropin-secreting macroadenoma.
Interventions:
We conducted trans-sphenoidal surgery. Human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) were used for reproductive reconstruction after surgery.
Outcomes:
This patient successfully fathered a child.
Lessons:
To date, the multidisciplinary team treatment of TSHoma was rare, TSHomas are often misdiagnosed as macroadenomas, because the clinical features are varied and it often takes a long time to be diagnosed. So the purpose of this case report is to attract attention to the manifestation of increased thyroid stimulating hormone (TSH) concentration and discuss MDT treatment for TSH-secreting adenoma.
Bilateral Posterior Uveitis and Retinal Detachment During Immunotherapy: A Case Report and Literature Review
Authors: Ling Peng, Qi-Qi Mao, Bo Jiang, Jin Zhang, Yi-Lei Zhao, Xiao-Dong Teng, Jin-Song Yang, Yang Xia, Shi-Qing Chen, Justin Stebbing, Hai Jiang
Journal: Front Oncol (2020)
Keywords: anti-angiogenesis, immune checkpoint inhibitor, immunotherapy, pembrolizumab, retinal detachment
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) cause fewer toxicities than conventional chemotherapy. Although most of the immune-related adverse events (irAEs) are mild, reversible, and manageable, potentially severe and rare irAEs remain relevant. We present a 24-year-old man with advanced hereditary renal cancer who developed bilateral posterior uveitis and retinal detachment after systematic treatment of ICI and an anti-angiogenic drug. Axitinib and pembrolizumab were administered with a partial response and following the severe ocular irAE and systemic corticosteroid treatment was initiated. Our case indicates that ocular irAEs may occur rapidly. To the best of our knowledge, this is the first case of posterior uveitis and retinal detachment in hereditary renal cancer patients treated with ICI and anti-angiogenic drugs.
Reverse Takutsubo Cardiomyopathy in a Patient with Phlegmasia Cerulea Dolens
Authors: Gift Echefu, Daniel Hammett, Amir Ausef, Lance LaMotte
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Reverse takotsubo cardiomyopathy (rTTC) is a rare variant of takotsubo cardiomyopathy (TTC) which is characterized by reversible left ventricular (LV) dysfunction. Emotional and physical stress have been implicated in triggering TTC especially in postmenopausal women. TTC and its variants are becoming more recognized due to the widespread adoption of early coronary angiography in the setting of acute coronary syndromes. A man in his late 50s presented to the emergency department with left lower extremity pain, swelling, and cyanosis. Clinical assessment was consistent with phlegmasia cerulea dolens, with deep venous thrombosis detected by venous duplex ultrasound. During his admission, he developed clinical and EKG findings suggestive of acute coronary syndrome. Emergent coronary angiography and ventriculography revealed basal and midventricular hypokinesis with hyperdynamic left ventricular apex, depressed LV dysfunction without coronary artery obstruction diagnostic of reverse takotsubo cardiomyopathy. Venous thromboembolism is a rare finding but has been associated with takotsubo cardiomyopathy and should be considered in the appropriate setting.