OpenMed/multicare-articles huggingface dataset:
Revised management of advanced primary colon cancer: Case series of 2 patients
Authors: Paul H Sugarbaker, Mohamed T Hassanein
Journal: Int J Surg Case Rep (2019)
Keywords: ct, case series, colonoscopy, epic, early postoperative intraperitoneal chemotherapy, hipec, hyperthermic intraperitoneal chemotherapy, local recurrence, peritoneal metastases, peritonectomy

Background:
The resection of a primary colon cancer has the opportunity to cure the patient of cancer by complete clearance and absolute containment of disease. Alternatively, if the cancer resection does not provide clearance and containment it will eventuate in local recurrence and peritoneal dissemination.
Methods:
Culpability of recurrence of colorectal cancer is difficult to determine. Are the management strategies of the primary cancer evaluation and treatment at fault or is the underlying disease process is to be held responsible? The clinical and radiologic findings that could have been evaluated by a multidisciplinary team (MDT) were critically evaluated in 2 patients with right colon adenocarcinoma. Strategies to accomplish complete clearance and absolute containment of the primary malignancy as resectable for cure were suggested.
Results:
Clinical evaluation of these 2 patients suggested that more knowledgeable preoperative evaluation by the multidisciplinary team (MDT) should have placed them in a high risk group for local recurrence and/or peritoneal dissemination. High carcinoembryonic antigen (CEA) tumor marker and by CT a large primary cancer infiltrating adjacent structures can be used to select advanced pre- and intraoperative treatment strategies.
Conclusions:
Two patients who had an approximately 50% possibility of long-term survival with optimal preoperative evaluation and expert surgical resection techniques may have been converted to a greatly reduced survival because of tumor dissemination and positive margins of resection at the time of primary cancer resection. Neither patient was evaluated by an MDT preoperatively. It is possible that these two patients entered the operating room with a contained malignancy but as result of suboptimal pre- and intraoperative management left the operating room with disseminated intraperitoneal disease.
Case report: Individualized treatment of advanced breast cancer with the use of the patient-derived tumor-like cell cluster model
Authors: Wenjie Xia, Wuzhen Chen, Shan Fang, Jun Wu, Jingxia Zhang, Hongjun Yuan
Journal: Front Oncol (2022)
Keywords: breast cancer, case report, drug testing, individualized treatment, patient-derived tumor model
MeSH terms: Case Reports

Breast cancer is one of the most common tumors in women. Despite various treatments, the survival of patients with advanced breast cancer is still disappointing. Furthermore, finding an effective individualized treatment for different kinds of patients is a thorny problem. Patient-derived tumor-like cell clusters were reported to be used for personalized drug testing in cancer therapy and had a prediction accuracy of 93%. However, there is still a lack of case reports about its application in the individualized treatment of breast cancer patients. Here, we described four cases of individualized treatment for advanced breast cancer using the patient-derived tumor-like cell cluster model (PTC model). In these four cases, the PTC model showed a good predictive effect. The tumor size was reduced significantly or even disappeared completely through clinical, radiological, or pathological evaluation with the help of the PTC model for selecting an individualized therapy regimen. Furthermore, the drug sensitivity test results of the PTC model were consistent with pathological molecular typing and the actual clinical drug resistance of the patients. In summary, our case report first evaluated the application value of the PTC model in advanced breast cancer, and the PTC model might be used as an efficient tool for drug resistance screening and for selecting a better personalized treatment, although further study is needed to prove the validity and stability of the PTC model in drug screening.
Transient Arterial Hypertension Induced by Gonadotropin-Releasing Hormone Agonist Treatment for Central Precocious Puberty
Authors: Loukia Sifaki, Francois Cachat, Gerald Theintz, Hassib Chehade
Journal: Front Pediatr (2019)
Keywords: gonadotrophin releasing hormone agonist, arterial hypertension, central precocious puberty, child—age, triptorelin
MeSH terms: Case Reports

Background: Gonadotropin-releasing hormone agonists (GnRHa) are a safe and effective treatment for precocious puberty. Triptorelin is one of the long lasting GnRHa, which reversibly suppresses the pituitary-gonadal axis. Triptorelin-induced hypertension (HTN) has rarely been reported in the literature. Clinical Case/Methods: We report a 10-year-old girl with central precocious puberty who, during treatment with triptorelin, developed an asymptomatic stage II HTN. Initial workup showed no renal, thyroid, or electrolytes abnormalities. The renal ultrasound showed no parenchymal disease and no increased renal resistance index suggestive of a renal artery stenosis. Echocardiography and ocular fundoscopy were normal. HTN (stage II) was confirmed with ambulatory blood pressure monitoring (ABPM). After extensive literature review, we found 3 other cases of HTN secondary to GnRHa, improving with endocrine treatment cessation. Therefore, antihypertensive treatment was not started immediately in our patient. Indeed, after completion of her treatment with triptorelin, we observed a complete normalization of her blood pressure (confirmed with ABPM) without any medication. Conclusion: Concomitantly to GnRHa treatment, our patient developed HTN, which completely subsided after stopping triptorelin. The complete normalization of her blood pressure, together with a negative workup for HTN strongly speaks for a causal effect of her endocrine treatment. In this setting, estrogen depletion might play a role, although this remains debated.
Intramural Esophageal Hematoma With Associated Hemothorax
Authors: Zilan X Lin, Aaron Weiss, Bo Li, Shireen Pais
Journal: ACG Case Rep J (2023)
Keywords: esophageal hematoma, esophageal obstruction, hemoptysis, hemothorax
MeSH terms: Case Reports

Intramural esophageal hematoma (IEH) is a rare manifestation of esophageal wall injury with nonspecific symptoms. It may be caused by trauma or occur spontaneously. IEH is often discovered on computed tomography or esophagogastroduodenoscopy and is typically managed conservatively with supportive care to allow healing. It is frequently an isolated finding in the esophagus and seldom involves any other organ. We report a rare case of a patient discovered to have an obstructing IEH with associated hemothorax after an unrelated surgical admission.
Multiple rare organisms causing ventriculoperitoneal shunt infection and brain abscess
Authors: Omar M Shihadeh, Hayel Amin, Firas Hammadi
Journal: Qatar Med J (2023)
Keywords: ventriculoperitoneal shunt infection meningitis abscess neurosurgery complications
MeSH terms: Case Reports

Ventriculoperitoneal shunts (VPS) are inserted to treat issues with CSF flow dynamics, such as obstructions causing CSF build up which raises the intracranial pressure. A major complication of this procedure is VPS infections. Vast majority of VPS infections are monomicrobial and may occur in the first two years of insertion due to contiguous or hematogenous spread. Here, we report a rare case of polymicrobial VPS infection with 5 pathogens. One of these organisms (Citrobacter werkmanii) has been reported as a cause of meningitis for the first time in this report. The other organism (Enterococcus casseliflavus) has been reported as a cause only one other time. Hence, we recommend considering these newly emerging organisms when dealing with meningitis.
Concomitant Laparoscopic Burch Urethropexy and Combined Vaginal-Laparoscopic Mesh Sling Removal (x2) for Pain and Persistent Stress Urinary Incontinence
Authors: Sarah A Huber, LaChanda Dunlap-Wright, John R Miklos, Robert D Moore
Journal: Case Rep Urol (2016)

Although midurethral mesh tape slings are considered the standard of care in the treatment of female stress urinary incontinence (SUI), complications such as pain, dyspareunia, or erosion are known to occur in addition to persistent incontinence. The management of these types of mesh sling complications can be very complex, especially when the pain is not just isolated to the vagina but extends into other areas, such as the abdomen which requires a much more extensive dissection. Additionally, if a mesh sling needs to be removed, the patient will most likely have a return of her SUI that often necessitates subsequent treatment. Vaginal and/or laparoscopic removal or revision of mesh tape slings should be considered in patients presenting with complications such as vaginal pain, abdominal pain, dyspareunia, or urinary obstructive symptoms. In those patients who demonstrate persistent SUI, concomitant laparoscopic Burch urethropexy can be considered and can safely be performed at the time mesh removal. In this case report we present a patient who required a dual-approach removal of two painful midurethral slings in addition to concomitant treatment of persistent SUI with a laparoscopic Burch urethropexy procedure.
A Rare Case of Urinary Tract Fungal Ball Leading to Fungemia and Bilateral Chorioretinitis
Authors: Christopher Ferari, Chad Crigger, Chad Morley
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Background:
Fungemia due to obstructive urinary tract fungal ball is exceedingly rare. These patients often have multiple predisposing conditions, including diabetes or antimicrobial exposure. While candiduria can be relatively common in this population, urinary tract fungal balls are a rare entity. Hospitalists should be aware of this rare complication in patients presenting with funguria. Case Presentation. We present a case of a 44-year-old male with type II diabetes, chronic hepatitis C secondary to injection drug use, and chronic kidney disease who developed a urinary tract fungal ball leading to fungemia and subsequent bilateral chorioretinitis, additionally complicated by emphysematous cystitis and pyelonephritis. Additional invasive treatment options beyond typical antifungals are often required in the case of urinary tract fungal ball, and in this case, bilateral nephrostomy tubes and micafungin were employed. Hospital course was complicated by C. tropicalis fungemia with subsequent bilateral fungal chorioretinitis on dilated fundus exam. This was effectively treated with cyclogyl and prednisolone drops along with bilateral voriconazole injections. Follow-up imaging and cultures showed resolution of fungemia, urinary tract masses, and chorioretinal infiltrates; however, recurrent polymicrobial UTIs continue to be an issue for this patient.
Conclusions:
Special multidisciplinary management is required in the treatment of urinary tract fungal balls with subsequent fungemia, including nephrostomy tubes, antifungal irrigation, ureterorenoscopy, and more powerful antifungals such as amphotericin B and 5-flucytosine. This management draws from a myriad of specialties, including urology, infectious disease, and interventional radiology. Additionally, the literature has demonstrated that only approximately half of patients with fungemia receive an ophthalmologic evaluation. Ophthalmologic and urologic cooperation is essential in the case of obstructive uropathy leading to fungemia as the obstructive uropathy must be relieved and these patients should receive a dilated fundus exam.
A huge verrucous carcinoma of the lower lip reconstructed by double Abbe flap: A case report and literature review
Authors: Ke Chai, Jinbing Liu, Rong Xiao, Guiying Zhang, Yi Zhan
Journal: Front Oncol (2023)
Keywords: case report, decision optimization, differential diagnosis, double abbe flap reconstruction, lip verrucous carcinoma
MeSH terms: Case Reports

Lip verrucous carcinoma is a rare low-grade neoplasm, with an unsightly appearance and locally aggressive nature. Treatment of verrucous carcinoma is as yet challenging, no well-defined guidelines for effective and safe management of this disease are available. A case of a patient with a huge verrucous carcinoma of the lower lip successfully treated by surgical excision and double Abbe flap reconstruction technique is presented, and striking features of lip locations of this tumor as well as their management are discussed.
A new case of radiation-induced breast angiosarcoma
Authors: Vincenzo Verdura, Bruno Di Pace, Marina Concilio, Antonio Guastafierro, Gabriella Fiorillo, Luigi Alfano, Giovanni Francesco Nicoletti, Clementina Savastano, Anna Maria Cascone, Corrado Rubino
Journal: Int J Surg Case Rep (2019)
Keywords: angiosarcoma, breast-conserving surgery, radiotherapy

Introduction:
Radiation-induced breast angiosarcoma is a severe but rare late complication in the breast-preserving management of breast cancer through surgery and radiotherapy. Often the initial diagnosis is complex given its relatively anodyne nature and the fact that it usually presents in the form of typically multifocal reddish-purple papular skin lesions.
Presentation of the case:
We describe the clinical and pathologic findings of a 79-year-old woman, who developed a radiation-induced breast angiosarcoma after around 8 years. She initially refused a mastectomy leading to an adaptation in the management of this cancer.
Discussion:
The average latency of secondary angiosarcoma of the breast following radiation therapy is around six years. Breast angiosarcoma is typically considered to affect the dermis, and is therefore cutaneous in origin. An incisional biopsy of the discoloured skin and underlying mass is necessary. The treatment is surgical resection. The role of chemotherapy has not been clearly defined. Most data originate from retrospective case series studies suggesting that angiosarcomas are relatively sensitive to taxanes and anthracyclines.
Conclusion:
The preferred treatment is always aggressive surgical removal and, as our atypical clinical case suggests, neoadjuvant chemotherapy in very high doses is also needed. A biopsy of any suspicious breast skin lesion after radiotherapy is recommended. Despite the treatment challenges, our case provides enlightening details on the management of such a rare cancer even when faced with unplanned events which do not always allow for a textbook approach.
Salmonella osteomyelitis of the distal radius in a healthy pregnant woman
Authors: Akio Sakamoto, Yoshitsugu Chigusa, Takashi Noguchi, Shuichi Matsuda
Journal: J Bone Jt Infect (2020)
MeSH terms: Case Reports

Although characteristic, Salmonella is a rare cause of osteomyelitis, especially in healthy individuals. A 25-year old primigravida at 29 weeks' gestation noticed pain and swelling in her right wrist. Her leukocyte count was normal, but her C-reactive protein level was slightly elevated, at 1.1 mg dL - 1 (normal range, < 0.2 mg dL - 1 ). Plain radiography showed an osteolytic lesion in the distal radius, and magnetic resonance imaging (MRI) showed an extraosseous fluid collection with bone edema in addition to the osseous lesion. After a needle biopsy was performed, the skin overlying the lesion became ulcerated at the site of the needle tract. We drained whitish pus from the site; both this pus and the original biopsy specimen grew Salmonella on culture. We diagnosed Salmonella osteomyelitis and began intravenous antibiotic therapy, avoiding oral quinolones to prevent fetotoxicity. Her symptoms resolved, as did the bone edema and fluid collection. Ossification occurred at the site of osteolysis, with localized abnormal signal intensity persisting on MRI. This rare case of Salmonella osteomyelitis was treated without surgery; the patient's pregnancy influenced the treatment course.
Surgical Outcomes of Clival Chordoma Through Endoscopic Endonasal Approach: A Single-Center Experience
Authors: Ge Chen, Mingchu Li, Wenlong Xu, Xu Wang, Ming Feng, Renzhi Wang, Xiaohai Liu
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: clival chordoma, endoscopic transnasal approach, single center experience, surgical complications, surgical outcome
MeSH terms: Chordoma / pathology, Chordoma / surgery, Skull Base Neoplasms / pathology, Skull Base Neoplasms / surgery, Cranial Fossa, Posterior / pathology, Cranial Fossa, Posterior / surgery, Humans, Retrospective Studies, Treatment Outcome

Objective:
Clival chordoma is a locally aggressive tumor with low metastatic potential. In the past decade, endoscopic endonasal approach (EEA) for clival chordoma has had a higher resection rate and a lower morbidity rate than transcranial approaches. Here, we present our initial single-center experience after EEA of clival chordomas.
Patients and methods:
This study retrospectively analyzed 17 consecutive patients with clival chordoma who received EEA in our department between March 2015 and September 2021. The operation was performed by a single surgeon with EEA. The clinical and pathological characteristics were analyzed along with the surgical outcomes and complications.
Results:
A total of 17 consecutive patients with clival chordoma received EEA with a median follow-up of 29.2 months (range 1-79). Gross total resection (GTR) was performed in 7 cases (41%), subtotal resection (STR) in 7 case (41%) and partially resection (PR) in 3 cases (18%). Cerebrospinal fluid leakage occurred in 2 cases (12%) and meningitis developed in 3 patients (18%) which were all successfully treated with intravenous antibiotics without any complications. There were no perioperative deaths or new focal neurological deficits postoperatively. Four in 7 patients with STR have had radiotherapy while the other three chose to be monitored. Till the last follow-up, three patients in STR group who received radiotherapy (3 in 4) had no tumor regrowth, while one in STR group with radiotherapy (1 in 4) showed tumor progression. Two patients in STR group without radiotherapy (2 in 3) showed stable tumor while the left one (1 in 3) showed tumor progression. One patient in the PR group died of tumor progression 2 years postoperation and the other one showed tumor progression and died of lung cancer 1 year postoperation. In addition, 1 in 7 patients with GTR had tumor recurrence in situ after 10 months and developed surgical pathway seeding in the spinal canal in C1 after 16 months. No recurrence occurred in the other 6 cases with GTR during the follow-up.
Conclusion:
Although more cases are needed, our case series showed EEA is a safe and reliable method for clival chordoma with high resection rates and low morbidity rates. GTR without tumor residuum would improve the outcome.
Obstetrical Complications and Outcome in Two Families with Hereditary Angioedema due to Mutation in the F12 Gene
Authors: Olivier Picone, Anne-Claire Donnadieu, François G Brivet, Catherine Boyer-Neumann, Véronique Frémeaux-Bacchi, René Frydman
Journal: Obstet Gynecol Int (2010)
MeSH terms: Case Reports

Backgroud. Hereditary angioedema (HAE) is characterized by recurrent swelling of the skin, the abdomen (causing severe acute pain), and the airways. A recently discovered type caused by mutations in the factor XII gene (designated as HAE type III) occurs mainly in women. Estrogens may play an important role, but few obstetrical complications have been reported. Case. We report the symptoms and obstetrical complications of women in two families with HAE attributable to the p. Thr328Lys mutation in the F12 gene. Clinical manifestations included acute and severe maternal abdominal pain, with transient ascites, laryngeal edema, and fetal and neonatal deaths. Patients had normal C4 levels and a normal C1 inhibitor gene. Administration of C1-inhibitor concentration twice monthly decreased the attack rate in one mother, and its predelivery administration (1000 U) led to the delivery of healthy girls. Conclusions. Obstetricians and anesthesiologists should be aware of this rare cause of unexplained maternal ascites and in utero or fetal death associated with edema.
Human parechovirus meningoencephalitis
Authors: Pokhraj P Suthar, Kathryn Hughes, Geetanjalee Kadam, Miral Jhaveri, Santhosh Gaddikeri
Journal: SA J Radiol (2023)
Keywords: csf, mri, human parechovirus, meningoencephalits, neonate
MeSH terms: Case Reports

Human parechovirus-3 (HPeV-3) infection is one of the differential diagnoses of neonatal meningoencephalitis. A 13-day-old full-term female neonate presented with a seizure. Brain MRI showed classic imaging findings of the meningoencephalitis which was confirmed on cerebrospinal fluid analysis.
Contribution:
The HPeV-3 is an emerging pathogen for neonatal meningoencephalitis. The case in this study is unique with classic imaging findings, which are not routinely encountered in day-to-day practice. This case raises reader awareness.
Gastric Necrosis and Perforation Following Massive Gastric Dilatation in an Adolescent Girl: A Rare Cause of Acute Abdomen
Authors: Zlatan Zvizdic, Asmir Jonuzi, Aleksandra Djuran, Semir Vranic
Journal: Front Surg (2019)
Keywords: acute abdomen, gastric dilatation, gastric perforation, necrosis, pathological aerophagia
MeSH terms: Case Reports

Gastric necrosis with perforation is a rare and potentially life-threatening condition in childhood beyond the neonatal period. We report a case of gastric necrosis and perforation of a portion of the great curvature due to a massive gastric dilatation caused by pathological aerophagia in a 13-years-old, mentally impaired adolescent girl. Despite the successful surgical treatment, the patient's condition rapidly deteriorated post-operatively and she died due to the multisystem organ failure and multiple infections. In addition, we surveyed the literature on this rare condition and assessed the preventive actions to reduce this life-treating condition.
Diffuse idiopathic skeletal hyperostosis of cervical spine - An unusual cause of difficult flexible fiber optic intubation
Authors: Vaibhavi Baxi, Sucheta Gaiwal
Journal: Saudi J Anaesth (2010)
Keywords: cervical spine, dish, difficult intubation, fiberoptic intubation
MeSH terms: Case Reports

This is a report of anterior osteophytes on the cervical vertebra resulting in distortion of the airway and leading to difficulty during intubation. The osteophytes associated with the syndrome of diffuse idiopathic skeletal hyperostosis were at the C2-3 and C6-7, T1 level and resulted in anterior displacement of the pharynx and the trachea respectively.
Sex cord tumor with annular tubules: an incidental finding in an endometriotic cyst--the first known cooccurrence
Authors: Meeta Singh, Shramana Mandal, Kaushik Majumdar
Journal: Biomed Res Int (2014)
MeSH terms: Cysts / pathology, Endometriosis / pathology, Sex Cord-Gonadal Stromal Tumors / pathology, Case Reports, Adult, Endometriosis / complications, Female, Humans, Incidental Findings, Ovarian Neoplasms / complications, Ovarian Neoplasms / physiopathology, Peutz-Jeghers Syndrome / complications, Peutz-Jeghers Syndrome / physiopathology, Sex Cord-Gonadal Stromal Tumors / complications

Sex cord tumor with annular tubules (SCTATs) is a relatively rare ovarian neoplasm often having a syndromic association with Peutz-Jeghers syndrome (PJS). Other associations described with this rare neoplasm include adenoma malignum of cervix, Turners syndrome, dysgerminoma, gonadoblastoma, endometrial carcinoma, and endometriosis of fallopian tube. We describe for the first time to the best of our literature search the incidental detection of SCTAT coexisting with an endometriotic cyst of ovary. Meticulous histological scanning and awareness is mandatory for detection of such unusual incidental lesions. Non-PJS SCTATs tend to be larger and could be more prone to distant metastasis, warranting subsequent follow-up.