OpenMed/multicare-articles huggingface dataset:
Cervical spine injury in children: a case report and literature review
Authors: Tahir Nebhani, Hicham Bakkali, Lahcen Belyamani
Journal: Pan Afr Med J (2015)
Keywords: cervical, children, injury, spine
MeSH terms: Neck Injuries / complications, Spinal Cord Injuries / etiology, Case Reports, Review, Accidents, Traffic, Age Factors, Cervical Vertebrae, Child, Preschool, Cross Infection / complications, Dyspnea / etiology, Fatal Outcome, Female, Humans, Hypotension / etiology, Immobilization, Magnetic Resonance Imaging, Morocco / epidemiology, Neck Injuries / epidemiology, Pneumonia / complications, Quadriplegia / etiology, Respiration, Artificial, Shock, Septic / etiology, Spinal Cord Injuries / epidemiology

Traumatic injuries of the cervical spine are less common in children than in adults. But may be associated with significant disability and mortality. Pediatric victims of blunt trauma have mechanisms of injury, developmental and anatomic characteristics different than the adults. The purpose of this observation is to highlight the differences between the adult and pediatric cervical spine. We report below the case of spinal cord cut occurs to a very young girl after a motor vehicle accident.
Infantile Abdominal and Pelvic Lipoblastomas: A Case Series
Authors: Riccardo Guanà, Salvatore Garofalo, Luisa Ferrero, Maria Grazia Cortese, Luca Lonati, Elisabetta Teruzzi, Eleonora Basso, Isabella Morra, Riccardo Lemini, Nicola Sardi, Fabrizio Gennari
Journal: European J Pediatr Surg Rep (2019)
Keywords: children, lipoblastoma, surgery
MeSH terms: Case Reports

Lipoblastomas are rare benign mesenchymal tumors that arise from embryonal fat cells. They are usually discovered in infants and children under 3 years of age, and mostly occur in the trunk (from 10 to 60%, depending on the study) and extremities (from 40 to 45%), while head and neck localizations are rare, with only five cases described to date. We report on three cases of lipoblastomas in infants younger than 4 years, with unusual localizations: one intra-abdominal, discovered during a laparotomy for an intussusception; one pelvic, misdiagnosed as an ovarian mass; and one gluteal with a pelvic extension. All children underwent magnetic resonance imaging as preoperative workup. All tumors were completely resected with free surgical margins and ultrasonographic follow-up was uneventful for all patients.
Case Report: Intra-Tumoral Vaccinations of Quadrivalent HPV-L1 Peptide Vaccine With Topical TLR-7 Agonist Following Recurrence: Complete Resolution of HPV-HR-Associated Gynecologic Squamous Cell Carcinomas in Two Patients
Authors: Mark Reedy, Shirisha Jonnalagadda, Komaraiah Palle
Journal: Pathol Oncol Res (2021)
Keywords: human papilloma virus high-risk variant, immunotherapy, intratumoral injection, quadrivalent hpv-l1 vaccine, radiation refractory squamous cell carcinoma, toll-like receptor 7 agonist
MeSH terms: Antineoplastic Agents / therapeutic use, Carcinoma, Squamous Cell / therapy, Genital Neoplasms, Female / therapy, Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / therapeutic use, Imiquimod / therapeutic use, Case Reports, Adult, Aged, 80 and over, Carcinoma, Squamous Cell / pathology, Carcinoma, Squamous Cell / virology, Female, Genital Neoplasms, Female / pathology, Genital Neoplasms, Female / virology, Humans, Neoplasm Recurrence, Local / therapy, Papillomavirus Infections / complications, Papillomavirus Infections / therapy, Salvage Therapy / methods, Toll-Like Receptor 7 / agonists, Antineoplastic Agents, Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18, TLR7 protein, human, Toll-Like Receptor 7, Imiquimod

The human papilloma virus (HPV) high-risk variants (HPV-HR) such as HPV16 and HPV18 are responsible for most HPV related cancers, including anogenital and head and neck cancers. Here, we present two patients with HPV-HR-associated gynecological malignancies who, after failing radiation therapy, were treated with experimental salvage immunotherapy regimen resulting in complete, durable responses in both patients. Each patient was diagnosed with recurrent, radiation-refractory, HPV-HR positive, squamous cell carcinoma of the lower genital tract. Patient A was a 90-year-old, African American, with metastatic vulvar cancer to the right inguinal-femoral triangle and pulmonary metastases. Patient B was a 41-year-old, Caucasian, with a central-recurrence of cervix cancer. Each patient received at least two intratumoral quadrivalent HPV-L1 vaccine (Gardasil™) injections and daily topical TLR-7 agonist (imiquimod) to the tumor surface 2 weeks apart. This combination of intratumoral vaccinations and topical TLR-7 agonist produced unexpected complete resolution of disease in both patients. The importance of radiation therapy, despite being considered a treatment failure by current definitions, cannot be understated. Radiation therapy appears to have offered a therapeutic immune advantage by modifying the tumor microenvironment. This immune protocol has potential to help patients with advanced HPV-HR-related malignancies previously considered incurable.
Torsion of a huge subserosal uterine leiomyoma: A challenging case of acute abdomen
Authors: Mankirat S Dhillon, Anju Garg, Apoorva Sehgal, Sangeeta Bhasin
Journal: SA J Radiol (2023)
Keywords: acute abdomen, fibroid, magnetic resonance imaging, pedunculated fibroid, subserosal, torsion, ultrasound, uterine leiomyoma
MeSH terms: Case Reports

Torsion of a uterine leiomyoma is an extremely rare, albeit life-threatening surgical emergency. A 28-year-old woman presented with acute abdominal pain. Imaging revealed a torsed subserosal uterine leiomyoma which was managed surgically and the diagnosis confirmed intraoperatively as well as on histopathology.
Contribution:
While intraoperative findings remain the primary means of diagnosis, radiologists should be familiar with the potential imaging findings of leiomyoma torsion as timely intervention can greatly improve patient outcome.
Melanotic oncocytic metaplasia of the nasopharynx as a benign mimicker of malignant melanoma: a case report
Authors: Takeshi Kondo, Kiyoshi Mori, Shiori Oka, Setsuko Morinaka
Journal: Diagn Pathol (2010)
MeSH terms: Melanins / analysis, Melanoma / diagnosis, Nasopharyngeal Diseases / diagnosis, Nasopharyngeal Neoplasms / diagnosis, Nasopharynx / pathology, Case Reports, Aged, Biopsy, Diagnosis, Differential, Endoscopy, Humans, Immunohistochemistry, Male, Metaplasia, Nasopharyngeal Diseases / metabolism, Nasopharyngeal Diseases / pathology, Nasopharynx / chemistry, Predictive Value of Tests, Staining and Labeling, Melanins

Introduction:
Melanotic variant of oncocytic metaplasia of the nasopharynx is an extremely rare condition.
Case report:
A 73-year-old Japanese man presented with nasal congestion and chill. Nasoscopic examination revealed multiple black nodules around the bilateral torus tubarius. The nodules were biopsied to determine the histology. The clinical differential diagnosis was malignant melanoma or hemangioma. Microscopically, there were oncocytic plump cells with abundant brown pigmented granules showing glandular pattern. No significant atypia was found. The pigment was positive for Fontana-Masson staining, and negative for Berlin blue staining, showing that it was melanin pigment. Immunohistochemically, S100-positive HMB45-negative dendritic cells were also found.
Conclusion:
Such a pigmented variant of benign oncocytic lesion is very rare, and only 15 cases have been reported in the English literature. As a benign mimicker of malignant melanoma, melanocytic oncocytic metaplasia should be always taken into consideration in the clinical setting.
Tetanus Complicated by Dysautonomia: A Case Report and Review of Management
Authors: Nishant Sharma, Si Li, Metlapalli Venkata Sravanthi, Dan Kazmierski, Yichen Wang, Amit Sharma, Pragya Dhaubhadel
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Tetanus is a life-threatening infectious neurological disorder that is now a rare disease due to the institution of wide-spread vaccination strategies. We present an uncommon case of generalized severe tetanus with consequent respiratory failure requiring mechanical ventilation, which was associated with dysautonomia. A 20-year-old unvaccinated female presented with neck stiffness and diffuse muscle spasms following a laceration sustained 3 weeks prior. She was admitted to the intensive care unit for mechanical ventilation and was treated with immunoglobulin, tetanus toxoid, metronidazole, and high doses of sedatives. She also developed dysautonomia, with alternating bradycardia and tachycardia, as well as fluctuating blood pressure. She was successfully extubated and discharged. We also review the epidemiology, pathophysiology, and management of tetanus and discuss dysautonomia in the setting of tetanus.
Mediastinal Hematoma and Tracheal Compression following Transradial Percutaneous Coronary Intervention
Authors: Nathaniel R Smilowitz, Muhamed Saric, Michael J Attubato, James N Slater
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Vascular complications from transradial percutaneous coronary intervention (PCI) are rare. We report an unusual case of stridor after PCI due to brachiocephalic artery perforation, pseudoaneurysm formation, and development of a large mediastinal hematoma with tracheal compression. Endovascular repair of the brachiocephalic artery was achieved with covered stent placement at the neck of the pseudoaneurysm. This case highlights the importance of careful guide catheter placement from the right radial approach. Ultimately, rapid diagnosis of vascular perforation, appropriate airway management, and prompt endovascular repair of the injured vessel is critical to the successful management of this life-threatening condition.
Removal of broken reamer stuck into femoral shaft in implanting PFNA: a case report
Authors: Gang-Qiang Jiang, Ya-Di Zhang, Yun-Qiang Zhuang
Journal: SICOT J (2018)

Femoral intertrochanteric fracture is very common in elderly population. The usual treatment for these patients is intra-extramedullary fixation. In normal situations, expand medullary cavity is needed, in order to implant various intramedullary implants. On rare occasion, which will in turn lead to the reamer is stuck into the medullary cavity of femoral shaft. Open or closed technique for moving of the broken nails had been reported before. We firstly report a novel technique by using handy tool which included in orthopaedic instrument set to remove the broken reamer stuck into femoral cavity when implanting a PFNA.
Metastatic Mons Pubis Soft Tissue Mass
Authors: Nadezda Buntic, Taylor Brown, Muhammad Raafey, Christopher Yeary
Journal: Cureus (2023)
Keywords: cutaneous mass, cutaneous metastasis, endometrial adenocarcinoma, endometrial cancer, gynecological cancer
MeSH terms: Case Reports

Cutaneous spread of solid malignancies is rare. We present the case of a 61-year-old woman with a history of endometrial adenocarcinoma, presenting two years after a total abdominal hysterectomy with bilateral salpingo-oophorectomy with a mass on her mons pubis. The mass was found to be an adenocarcinoma favoring a gynecological origin.
Haplotype Analysis of the First A4V- SOD1 Spanish Family: Two Separate Founders or a Single Common Founder?
Authors: Cecilia Garcia, Jose Manuel Vidal-Taboada, Enrique Syriani, Maria Salvado, Miguel Morales, Josep Gamez
Journal: Front Genet (2019)
Keywords: a4v, als1, sod1, amyotrophic lateral sclerosis, familial amyotrophic lateral sclerosis, founder effect, pa5v
MeSH terms: Case Reports

Despite the genetic heterogeneity reported in familial amyotrophic lateral sclerosis (ALS) (fALS), Cu/Zn superoxide-dismutase (SOD1) gene mutations are the second most common cause of the disease, accounting for around 20% of all families (ALS1) and isolated sporadic cases (sALS). At least 186 different mutations in the SOD1 gene have been reported to date. The possibility of a single founder and separate founders have been investigated for D90A (p.D91A) and A4V (p.A5V), the most common mutations worldwide. High-throughput single nucleotide polymorphism genotyping studies have suggested two founders for A4V (one for the Amerindian population and another for the European population) although the possibility that the two populations are descended from a single ancient founder cannot be ruled out. We used 15 genetic variants spanning the human chromosome 21 from the SOD1 gene to the SCAF4 gene, comparing them with the population reference panels, to demonstrate that the first A4V Spanish pedigree shared the genetic background reported in the European population.
McArdle Disease vs. Stiff-Person Syndrome: A Case Report Highlighting the Similarities Between Two Rare and Distinct Disorders
Authors: Kerilyn Godbe, Giovanni Malaty, Alyssa Wenzel, Sahana Nazeer, Douglas J Grider, Adrienne Kinsey
Journal: Front Neurol (2020)
Keywords: mcardle disease, stiff person syndrome, autoimmune disease, case report, diagnostic workup
MeSH terms: Case Reports

McArdle disease is a rare autosomal recessive disorder of muscle glycogen metabolism that presents with pain and fatigue during exercise. Stiff-Person Syndrome is an autoimmune-related neurologic process characterized by fluctuating muscle rigidity and spasm. Reported is a 41-year-old male who presented to the emergency department due to sudden-onset weakness and chest pain while moving his refrigerator at home. Cardiac workup was non-contributory, but a creatine kinase level > 6,000 warranted a muscle biopsy. The biopsy pathology report was misinterpreted to be diagnostic for McArdle disease given the clinical presentation. After 4 years of treatment without symptomatic improvement, a gradual transition of symptoms from pain alone to pain with stiffness was noted. A positive glutamic acid decarboxylase antibody test resulted in a change of diagnosis to Stiff-Person Syndrome. This is the first known case that highlights the similarities between these two rare and distinct disease processes, highlighting the necessity for thorough history taking, maintenance of a broad differential diagnosis, and knowledge of how best to interpret complex pathology reports.
Schwannoma of the tongue in a paediatric patient: a case report and 20-year review
Authors: Nitin Bhola, Anendd Jadhav, Rajiv Borle, Gaurav Khemka, Umesh Bhutekar, Sanatan Kumar
Journal: Case Rep Dent (2014)

Schwannomas (Neurilemmomas) are benign, encapsulated, slow-growing, and usually solitary tumours originating from Schwann cells of the peripheral nerve sheath with uncertain etiology. Approximately 25-48% of cases are seen in the head and neck region, of which 1% appears in the oral cavity. Lingual schwannoma can affect all age groups with peak incidence between the third and sixth decade. We report a rare case of lingual schwannoma in a 14-year-old girl complaining of asymptomatic swelling over lateral border of tongue since two years. Clinical examination revealed a nodule 1.5 × 1 cm in size, rubbery, nontender, smooth at right lateral border of tongue covered by normal mucosa, with no cervical lymphadenopathy. Excisional biopsy of the lesion was done under local anaesthesia. The histological sections spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence-free after one year.
Severe refeeding syndrome after starvation ketoacidosis requiring stopping feeds
Authors: Bana Hadid, Farid Arman, Shayan Shirazian
Journal: Clin Nephrol Case Stud (2023)
Keywords: npo, electrolyte imbalance, refeeding syndrome, starvation ketoacidosis, stop feeds
MeSH terms: Case Reports

Introduction:
Starvation ketoacidosis (SKA) is a rare cause of ketoacidosis in the general population but can be seen with malignancy. Patients often respond well to treatment, but some rarely develop refeeding syndrome (RFS) as their electrolytes drop to dangerous levels causing organ failure. Typically, RFS can be managed with low-calorie feeds, but sometimes patients require a halt in feeds until their electrolyte imbalances are managed.
Case report:
We discuss a woman with synovial sarcoma on chemotherapy who was diagnosed with SKA and then developed severe RFS after treatment with intravenous dextrose. Phosphorus, potassium, and magnesium levels dropped precipitously and remained fluctuant for 6 days. She also developed normal sinus ventricular tachycardia, premature ventricular beats, and bigeminy. She could not tolerate calorie supplementation at that time. She was managed with electrolyte repletions until clinically stable and then progressed to a liquid diet.
Discussion:
We present a unique case of severe SKA that resulted in RFS requiring nihil per orem (NPO) treatment for 6 days. There are no specific guidelines for SKA or RFS management. Patients with pH < 7.3 may benefit from baseline serum phosphorus, potassium, and magnesium levels. Clinical trials are needed to further study which patients may benefit from starting at a low-calorie intake versus those that require holding nutrition until clinically stable.
Conclusion:
Completely stopping caloric intake until a patient's electrolyte imbalance improves is an important management aspect of RFS to underscore and study, as grave complications can occur even with cautious refeeding regimens.
Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence
Authors: Yaser Jenab, Malihe Rezaee, Kaveh Hosseini, Homa Ghaderian, Raymond N Haddad, Ali N Zaidi
Journal: Front Cardiovasc Med (2022)
Keywords: aortopulmonary shunt, central shunt, percutaneous intervention, stent, systemic-to-pulmonary shunt
MeSH terms: Review

Background:
Patients with cyanotic complex congenital heart defects (CHDs) commonly undergo palliation with interposition of systemic-to-pulmonary shunts (SPSs). These palliative shunts are rarely found in adults with CHDs and can be complicated with progressive obstruction or total occlusion during follow-up. The best treatment option for shunt re-permeabilization is challenging and case-oriented because most patients are high risk candidates for redo surgeries. We aimed to review the current evidence on percutaneous stent implantation to treat failed SPSs.
Methods:
We performed a comprehensive literature review on percutaneous stent implantation to treat failed and occluded SPSs. We also reported the case of a 33-year-old man with cyanotic CHD and a occluded central aorto-pulmonary shunt, who was successfully treated with percutaneous balloon dilatation and subsequently stent implantation at our institution.
Result:
We identified and included 31 articles reporting on 150 patients and 165 stent implantations in failed SPSs. The age of patients at the time of stent implantation ranged from 6 days to 47 years. The time between the surgical shunt creation and transcatheter intervention ranged from 1 day to 17 years. Overall, 161/165 (97.5%) stent implantations were successful. The most common clinical presentation was cyanosis and decreased atrial oxygen saturations and the indication for stent implantation was shunt obstruction and stenosis.
Conclusion:
This review highlights the benefits of endovascular stenting to permeabilize failed SPSs in children and adults with complex CHD who are classified as poor candidates for re-surgical repair.
Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome
Authors: Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque
Journal: Case Rep Neurol Med (2016)
MeSH terms: Case Reports

Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA). Bilateral EDAS was done in the same year, after which his symptoms improved and patient had moderate functional recovery. Conclusion. A rare disease, moyamoya has been left unexplored in Pakistan; physicians and surgeons when dealing with cases in the pediatric population presenting with symptoms of stroke, signs of generalized weakness, and seizures should consider moyamoya disease as a possibility. Furthermore, this case demonstrates the effectiveness of EDAS procedure for the treatment of moyamoya disease.
Case Report: GABAergic and Serotoninergic Agents for the Treatment and Prevention of Prolonged Dissociative Stupor
Authors: Daisuke Yoshioka, Masaaki Iwata, Koichi Kaneko
Journal: Front Psychiatry (2021)
Keywords: gaba, amygdala, dissociation, freezing, serotonin, stupor, tonic immobility
MeSH terms: Case Reports

Dissociative stupor is a common psychiatric disease lacking an established standard treatment. The lack of therapeutic options may be due to the spontaneous and quick complete remission of most patients. However, since some patients experience multiple relapses and prolonged stupor, investigating potential prevention and treatment options is critical. We reported the case of a 61-year-old Japanese woman who presented with intermittent dissociative stupor for several months. Despite her prolonged symptoms, the administration of lorazepam, escitalopram, and aripiprazole, which selectively enhance GABAergic and serotoninergic activity, improved her stupor and prevented relapse. These findings may help with the treatment of persistent dissociative stupor.
A Rare Case of Fibrous Hamartoma of Infancy: A Clinicopathological Diagnosis at a Tertiary Hospital, Eastern Nepal
Authors: G Lama, P Upadhyaya, B Adhikari, M Adhikari, S Dhakal
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Background:
Fibrous hamartoma of infancy is a rare soft tissue lesion of infants and young children with characteristic triphasic morphology.
Case description:
An 18-month-old female child was presented with complaints of swelling over right leg shin since birth. On examination, a lump of size 7x3 cm was identified which was mobile and nontender. Local excision was performed and tissue sent for histopathological examination. On gross examination, a globular, capsulated, firm to hard tissue had cut section revealing solid grey-white to grey-brown lesion with myxoid areas identified. Microscopic examination revealed a poorly circumscribed lesion comprising intersecting trabeculae of fibrous tissue, areas of immature oval and stellate cell within myxoid matrix, and varying amounts of interspersed mature fat cells.
Conclusion:
Even though fibrous hamartoma of infancy is a rare benign entity with limited clinical knowledge, proper diagnosis is mandatory as its prognosis is excellent.