OpenMed/multicare-articles huggingface dataset:
Foreign body in the Eustachian tube: case presentation and technique used for removal
Authors: Fernando de Andrade Quintanilha Ribeiro
Journal: Braz J Otorhinolaryngol (2008)
MeSH terms: Eustachian Tube, Foreign Bodies / surgery, Case Reports, Angiography, Foreign Bodies / diagnostic imaging, Humans, Male, Middle Aged, Tomography, X-Ray Computed

Foreign bodies of the external ear are very common; the same can not be said about foreign bodies of the middle ear, especially of the Eustachian tube.
Case presentation:
Alcoholic and psychopathic patient presented a foreign body (barbecue wooden stick) purposefully introduced in his middle ear and Eustachian tube during an act of delinquency. The foreign body was stuck in the tube and could not be removed externally. It was surgically removed as described by the authors later on in the paper.
Comments:
The patient recovered well, with no sequela on the facial nerve and without important vertigo.
Postoperative cardiac arrest after heart surgery: does extracorporeal perfusion support a paradigm change in management?
Authors: Edward Gologorsky, Francisco Igor B Macedo, Enisa M Carvalho, Angela Gologorsky, Marco Ricci, Tomas A Salerno
Journal: Anesthesiol Res Pract (2010)
MeSH terms: Case Reports

Early institution of extracorporeal perfusion support (ECPS) may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU) following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes) advanced cardiac life support (ACLS) protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.
Orthodontic Fixed Retainer and Unwanted Movements of Lower Anterior Teeth: A Case Report
Authors: Maria Francesca Sfondrini, Maurizio Pascadopoli, Sergio Beccari, Giovanna Beccari, Cinzia Rizzi, Paola Gandini, Andrea Scribante
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

The use of fixed retainers at the end of an orthodontic treatment has become a standard practice. Nonetheless, orthodontic relapse can still occur, requiring retreatment in the most severe cases. This case report describes a patient with a mandibular canine to canine fixed retainer presenting uncontrolled torque on all lower anterior teeth, probably due to tongue thrust and/or activation of the wire. Multibracket orthodontic treatment was performed, and an orthodontic lingual sectional was used to control (reposition) the root movement of the lower right cuspid. This case highlights the need for clinicians and patients to be aware of the potential problems associated with bonded retainers. In addition, patients with an orthodontic fixed retainer need regular short-term observation by an orthodontist in order to detect any adverse movements and long-term control by a general dentist.
Laparoscopic Resection of Pancreatic Tail Solid Pseudopapillary Tumour in a Young Male
Authors: W G P Kanchana, R A A Shaminda, K B Galketiya, V Pinto, D Walisinghe, S Wijetunge, R Heendeniya
Journal: Case Rep Gastrointest Med (2016)

Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen. Large tumour was noted originating from the body and tail of the pancreas with dilated veins surrounding the tumour. Histology revealed a clear cell variant of solid pseudopapillary neoplasm with steatotic pattern. Resection margin was free of tumour. Discussion. Several studies have shown significant short term advantages using laparoscopic approach compared to open surgery, in terms of lower blood loss, resumption of oral intake, and hospital stay. This case and few other case reports published in world literature have shown that laparoscopic approach is safe and oncologically adequate.
Late-Onset Recurrent Femoral Cyst Formation 10 Years after ACL Reconstruction: A Case Report and Literature Review
Authors: Enrique Sanchez-Munoz, Antonio Maestro Fernández, Iván Pipa Muñiz, Nicolas Rodríguez García
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Synovial fistula and cyst formation after anterior cruciate ligament (ACL) reconstruction is very unusual and almost always affects the tibia. Only 3 cases originating in the femur have been reported. We present a rare case of late-onset femoral cyst formation related to ACL reconstruction. Ten years after successful ACL reconstruction surgery, effusion and pain at the lateral aspect of the lateral femoral condyle appeared. Symptoms persisted despite initial percutaneous drainage and conservative treatment. Surgery was carried out, with drainage and graft-fixation pin device removal, with recurrent cyst formation after the intervention. Total recovery of the patient was achieved after carrying out revision surgery consisting in bone tunnel filling using autologous bone graft and occlusion of cortical bone defect with local fascial flap. The development of this unusual complication was related to lack of absorption of the fixation device, bone burn due to drilling, and persistent synovial fluid in the femoral bone tunnel, combined with the absence of bone ingrowth.
Bilateral corneal perforation due to MRSA keratitis in a crosslinking patient
Authors: Zackery Oakey, Kevin Thai, Sumit Garg
Journal: GMS Ophthalmol Cases (2017)
Keywords: corneal collagen crosslinking, keratoconus, visual acuity
MeSH terms: Case Reports

Introduction: The cornea may become infected and perforated after epithelium-on collagen crosslinking. Case presentation: A healthy 33-year-old male who underwent corneal collagen crosslinking in both eyes developed a purulent keratitis and bilateral corneal perforations, requiring bilateral penetrating keratoplasties. He was exposed to methicillin resistant staphylococcus aureus (MRSA) by a family member with a tracheostomy and was treated with MRSA-directed antibiotics. After prolonged recovery and treatment of his infection, he had acceptable but limited uncorrected visual acuity, with excellent corrected visual acuity. Conclusion: While epithelium-on crosslinking is commonly thought to be associated with a lower risk of postoperative infection, this case illustrates that even epithelium-on treatment may present the patient with a risk of infection. Patients in higher risk groups who are exposed to infectious disease may be more predisposed.
Case Report: A Case of Renal Cell Carcinoma Unclassified With Medullary Phenotype Exhibiting a Favorable Response to Combined Immune Checkpoint Blockade
Authors: Masashi Takeda, Soki Kashima, Yasushi Fuchigami, Takayuki Yoshino, Tatsuki R Kataoka, Toshinari Yamasaki, Hiroshi Kagamu, Takashi Kobayashi, Shusuke Akamatsu
Journal: Front Immunol (2022)
Keywords: nivolumab, rccu-mp, renal cell caecinoma, case report, immune checkpoint inhibitors, ipilimumab
MeSH terms: Carcinoma, Renal Cell, Case Reports, CD8-Positive T-Lymphocytes / pathology, Humans, Immune Checkpoint Inhibitors / therapeutic use, Leukocytes, Mononuclear / pathology, Male, Phenotype, Immune Checkpoint Inhibitors

Renal cell carcinoma unclassified with medullary phenotype (RCCU-MP) is an extremely rare variant of kidney cancer with poor prognosis. Recently, immune checkpoint inhibitors (ICIs) have been the mainstay of treatment for advanced clear cell renal cell carcinoma (RCC). However, the efficacy of ICI in the treatment of RCCU-MP remains unclear. Here, we report about a 63-year-old Japanese man who was referred to our hospital with a diagnosis of RCC of the left kidney with multiple-lymph node involvement (cT3aN1M1). The patient underwent nephrectomy with lymph node biopsy, which was histopathologically diagnosed as RCCU-MP. Thereafter, he received combined immune checkpoint blockade with nivolumab and ipilimumab. After induction therapy, follow-up computed tomography revealed shrinkage of the metastatic lymph nodes. Moreover, the patient was relieved of his subjective symptoms and his performance status improved. However, after 15 months, maintenance ICI therapy was discontinued because of disease progression, and the patient died 28 months after diagnosis. Longitudinal analysis of peripheral blood mononuclear cells revealed increased stem cell memory and central memory CD8+ T-cell subsets during response to therapy and enhanced expression of exhaustion markers on CD8+ T cells upon treatment resistance. Combined immune checkpoint blockade could be effective in the treatment of metastatic RCCU-MP.
Intrahepatic Cholangiocarcinoma Masquerading as Acute Fatty Liver of Pregnancy: A Case Report and Review of the Literature
Authors: Ayman Qasrawi, Omar Abughanimeh, Mouhanna Abu Ghanimeh, Simran Arora-Elder, Osama Yousef, Tarek Tamimi
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Cholangiocarcinoma (CCA) is an uncommon cancer and accounts only for 3% of all gastrointestinal malignancies. In this report, we present a case of an intrahepatic cholangiocarcinoma masquerading as acute fatty liver of pregnancy (AFLP). A 38-year-old female who is 36-week pregnant presented with a 1-week history of headache, nausea, vomiting, and right upper abdominal pain, along with hepatomegaly. Laboratory investigations were remarkable for mild leukocytosis, hyperbilirubinemia, proteinuria, and elevated transaminases and prothrombin time. Ultrasound of the liver revealed hepatomegaly, fatty infiltration, and a right hepatic lobe mass. Based on the overall picture, AFLP was suspected, and the patient underwent delivery by Cesarean section. However, bilirubin and liver enzyme levels gradually increased after delivery. MRI revealed a large dominant hepatic mass along with multiple satellite lesions in both lobes. Biopsy revealed the presence of intrahepatic CCA. CCA presenting during pregnancy is extremely rare with only 9 other cases reported in the literature. Therefore, the signs and symptoms can be easily confused with other more common disorders that occur during pregnancy.
Prolonged fetal bradycardia as the presenting clinical sign in congenital syphilis complicated by necrotizing funisitis: a case report
Authors: Jun Kakogawa, Miyuki Sadatsuki, Norio Masuya, Hideto Gomibuchi, Shigeki Minoura, Kazuhusa Hoshimoto
Journal: ISRN Obstet Gynecol (2011)
MeSH terms: Case Reports

Syphilis remains a serious cause of neonatal morbidity and mortality worldwide. In this paper, we describe a case of congenital syphilis that was fully supported by abnormal fetal heart rate patterns and placental histopathological evidence. A 24-year-old para 4 woman, who did not attend antenatal care, was admitted to our hospital with a complaint of abdominal discomfort at an estimated 31-week gestation. Fetal heart rate monitoring showed prolonged bradycardia. A neonate weighting 1,423 g with severe birth asphyxia was immediately delivered by cesarean section. Following delivery, the mother and the neonate were diagnosed with syphilis. Histopathological examination confirmed severe chorioamnionitis and necrotizing funisitis with numerous Treponema pallidum. Conclusions. Challenges in establishing the diagnosis of necrotizing funisitis are essential for optimal management of a fetus with a systemic inflammatory response in utero.
Online Group Music-Making in Community Concert Bands: Perspectives From Conductors and Older Amateur Musicians
Authors: Audrey-Kristel Barbeau, Mariane Generale, Andrea Creech
Journal: Front Psychol (2022)
Keywords: community music, group music-making, older amateur musicians, online music, pandemic (covid-19)

At the beginning of the pandemic, many music ensembles had to stop their activities due to the confinement. While some found creative ways to start making music again with the help of technologies, the transition from "real" rehearsals to "online" rehearsals was challenging, especially among older amateur musicians. The aim of this case study was to examine the effects of this transition on three community band conductors and three older amateur musicians. Specific objectives were to explore (1) intergenerational relationships to support online group music-making; (2) digital literacy and access in later life; and (3) online music-making in a COVID-19 context. Semi-structured interviews were conducted and theoretical thematic analysis was undertaken (Braun and Clarke, 2006). Results were analyzed from the conductors' and older musicians' perspectives, and common trends were combined to facilitate interpretation. The first theme showed that being part of an intergenerational ensemble contributed positively to the learning experience online. The second theme demonstrated that because both conductors and musicians were new to the online rehearsals, it contributed to attenuate the age-related digital divide that may have been observed in other studies. Regarding access in later-life, older musicians reported benefits associated with rehearsing online, specifically in terms of distance/commute, time, energy, and cost. However, for those who did not already have internet and electronic devices, the cost of acquiring all the necessary equipment to make music online could have been too high. Finally, the third theme revealed that musicians appreciated the opportunity to make music online and indicated that it was definitely better than having nothing, especially for its social aspects. In conclusion, while participants noted several challenges associated with online music-making (e.g., zoom fatigue and technological issues), they were also appreciative of the opportunity to continue making music at a time when in-person rehearsals were not possible. Pedagogical implications are discussed, specifically the importance of the support network, of meeting people where they are, of learning to adapt, and of collaborative teaching.
Malignant psammomatous melanotic schwannoma mimicking adrenal cyst: case report
Authors: Aleksandar Zlatarov, Plamena Drenakova, Stefan Mihaylov, Neli Zgurova, Lilyana Petkova, Krasimir D Ivanov
Journal: Ann Pediatr Surg (2022)
Keywords: adrenal gland, laparoscopy, psammomatous melanotic schwannoma

Background:
Melanotic schwannoma is a melanin producing nerve sheath tumors. Rarely, it can be associated with psammoma bodies, called psammomatous melanotic schwannoma. Psammomatous melanotic schwannomas are associated in up to 10% of the cases with Carney's syndrome. The rarity of the lesion, which may present at different localizations create difficulty in placing a correct initial diagnosis. Definitive diagnosis is made after complete tumor excision and pathomorphological evaluation. The prognosis depends on the anatomical localization, local invasion and presence of a high mitotic index. The main pathomorphological differential diagnosis includes schwannomas and other melanin producing tumors as melanoma.
Case presentation:
We present a case of an 11-year-old female with cystic lesion adjacent to right adrenal gland, mimicking adrenal cyst. Ultrasound guided biopsy was undertaken due to the cystic appearance of the formation and the lack of certain diagnosis from the non-invasive diagnostic tests. No signs of cellular and nuclear atypism were observed. The diagnosis of benign endothelial cyst with spontaneous hemorrhage was suggested. The patient underwent transabdominal laparoscopic adrenalectomy en-bloc with the cyst to prevent spillage of the cyst content due to the intimate adhesion of the lesion to the adrenal gland and vena cava inferior. Pathomorphological examination revealed malignant psammomatous melanotic schwannoma. The adrenal gland was intact with no tumor infiltration. The patient was followed up on the 1st and 2nd month afterwards the surgery by MRI with no signs of local recurrence and postoperative complications.
Conclusion:
Psammomatous melanotic schwannoma near adrenal gland are rare and present difficulty with exact preoperative diagnosis. Complete resection should always be provided. Laparoscopic surgery is feasible if radical excision is not compromised. Long-term follow-up and Carney's syndrome surveillance after complete excision are recommended especially in young patients.
Novel Compound Heterozygous DST Variants Causing Hereditary Sensory and Autonomic Neuropathies VI in Twins of a Chinese Family
Authors: Jie-Yuan Jin, Pan-Feng Wu, Ji-Qiang He, Liang-Liang Fan, Zhuang-Zhuang Yuan, Xiao-Yang Pang, Ju-Yu Tang, Li-Yang Zhang
Journal: Front Genet (2020)
Keywords: dst, hsan-vi, dystonin, scoliosis, whole-exome sequencing
MeSH terms: Case Reports

Background: Hereditary sensory and autonomic neuropathies (HSANs) are a rare and severe group of sensory axonal neuropathies. HSANs have been classified into eight groups based on mode of inheritance, clinical features, and the involved genes. HSAN-VI, perhaps the most notable type, is an autosomal recessive disease, which manifests as the severely impaired pain sensitivity, autonomic disturbances, distal myopathy, spontaneous or surgical amputations, and sometimes early death. Mutations in DST have been identified as the cause of HSAN-VI. DST encodes dystonin, a member of the plakin protein family that is involved in cytoskeletal filament networks. Dystonin has seven major isoforms in nerve, muscle, and epithelium. Material and Methods: The present study investigated a Chinese family with HSAN and explored potential pathogenic variants using whole-exome sequencing (WES). Variants were screened and filtered through bioinformatics analysis and prediction of variant pathogenicity. Co-segregation analysis was subsequently conducted. Results: We identified compound heterozygous variants of DST (c.3304G>A, p.V1102I and c.13796G>A, p.R4599H) in two patients. Conclusion: We reported on a Chinese family with HSAN-VI family and detected the disease-causing variants. Our description expands the spectrum of known DST variants and contributes to the clinical diagnosis of HSAN-VI.
Long-Term Outcome of En Bloc Extensive Resection of the Penis and Prepuce Associated with a Permanent Perineal Urethrostomy in a Gelding Affected by Squamous Cell Carcinoma
Authors: Paola Straticò, Vincenzo Varasano, Gianluca Celani, Riccardo Suriano, Lucio Petrizzi
Journal: Case Rep Vet Med (2016)
MeSH terms: Case Reports

A 15-year-old gelding was referred for a florid, cauliflower-like ulcerated mass, enclosing penis and prepuce together with penile urethra showing a malodorous purulent and blood-stained discharge and larvae infestation. En bloc extensive resection of the penis and prepuce, without penile retroversion or pexy to ventral abdomen associated with a permanent perineal urethrostomy, was performed. Histology of the mass revealed a squamous cell carcinoma of penis and prepuce. The surgical technique that was adopted is a modified version of that already described that allows a more proximal resection of the penile body and is a valid option for treating advanced SCC lesions involving the penis. Early postsurgical complications (mild strangury, haemorrhage from the urethrostomy site and its partial dehiscence, and infection of the abdominal wound) were managed with a medical treatment and resolved within 5 to 12 days. Three years after surgery the horse is in good body condition and does not show any sign of recurrence or disorders related to the surgery.
Linear interictal pain in Epicrania Fugax
Authors: Juan A Pareja, Pablo Bandrés
Journal: J Headache Pain (2015)
MeSH terms: Headache / physiopathology, Case Reports, Letter, Adult, Female, Humans

Epicrania Fugax is a paroxysmal, short-lasting, head pain moving across one hemicranium, describing a linear or zag trajectory, starting and ending in territories of different nerves. Between attacks, patients are usually free of symptoms. We describe an Epicrania Fugax patient complaining of interictal pain. The interictal pain was line-shaped and extended across the usual starting and ending points of the typical Epicrania Fugax paroxysms. Although rarely encountered, persistent linear pain may be a feature of Epicrania Fugax.
Management of Pregnancy with Klippel-Trenaunay-Weber Syndrome: A Case Report and Review
Authors: Rati Chadha
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Background:
Klippel-Trenaunay-Weber syndrome is a rare neurocutaneous syndrome with vascular involvement. Given the rarity of the syndrome, its management in pregnancy is based on the outcome of a few case reports and expert opinion.
Case summary:
The management of a complicated case with its antepartum, intrapartum, and postpartum concerns has been addressed in this review.
Conclusions:
Prenatal consults with anesthesia, general surgery, intervention radiology, and internal medicine should be arranged, prior to delivery in anticipation of all the possible complications. Apart from the pregnancy management, preconceptional counselling including the genetics, prognosis, and contraception has an important role in patient management.
Abscopal effect observed in visceral and osseous metastases after liver SBRT in combination with nivolumab and relatlimab for sinonasal mucosal melanoma-a case report
Authors: Danielle Cerbon, Karen Moya-Brown, Ivaylo B Mihaylov, Benjamin Spieler
Journal: Front Oncol (2023)
Keywords: sbrt, abscopal, effect, immunotherapy, liver, radiotherapy
MeSH terms: Case Reports

Background:
Primary sinonasal mucosal melanoma (SNMM) is a rare, aggressive histology usually diagnosed at advanced stages and associated with poor prognosis. Evidence regarding etiology, diagnosis, and treatment mainly derives from case reports, retrospective series, and national databases. In the treatment of metastatic melanoma, anti-CTLA-4 and anti-PD-1 checkpoint blockade increased 5-year overall survival from ~10% (prior to 2011) to ~50% (between 2011 and 2016). In March of 2022, the FDA approved the use of relatlimab, a novel anti-LAG3 immune checkpoint inhibitor, for the treatment of melanoma.
Case presentation:
A 67-year-old woman with locally advanced SNMM underwent debulking surgery, adjuvant RT, and first-line immunotherapy (ImT) with nivolumab but developed local progression. The patient started a second course of ImT with nivolumab and ipilimumab, but this was discontinued after two cycles due to an immune-related adverse event (irAE, hepatitis with elevated liver enzymes). Interval imaging identified visceral and osseous metastases including multiple lesions in the liver and in the lumbar spine. She went on to receive a third course of ImT with nivolumab and the novel agent relatlimab with concurrent stereotactic body radiation therapy (SBRT) to the largest liver tumor only, delivered in five 10-Gy fractions using MRI guidance. A PET/CT performed 3 months after SBRT demonstrated complete metabolic response (CMR) of all disease sites including non-irradiated liver lesions and spinal metastatic sites. After two cycles of the third course of ImT, the patient developed severe immune-related keratoconjunctivitis and ImT was discontinued.
Conclusion:
This case report describes the first complete abscopal response (AR) in an SNMM histology and the first report of AR following liver SBRT with the use of relatlimab/nivolumab combination ImT for metastatic melanoma in the setting of both visceral and osseous lesions. This report suggests that the combination of SBRT with ImT potentiates the adaptive immune response and is a viable path for immune-mediated tumor rejection. The mechanisms behind this response are hypothesis-generating and remain an area of active research with exceedingly promising potential.