OpenMed/multicare-articles huggingface dataset:
Hepatic splenosis mimicking HCC in a patient with hepatitis C liver cirrhosis and mildly raised alpha feto protein; the important role of explorative laparoscopy
Authors: M Abu Hilal, A Harb, B Zeidan, B Steadman, J N Primrose, N W Pearce
Journal: World J Surg Oncol (2009)
MeSH terms: Carcinoma, Hepatocellular / diagnosis, Hepatitis C, Chronic / complications, Laparoscopy, Liver Cirrhosis / complications, Liver Neoplasms / diagnosis, Splenosis / diagnosis, Splenosis / surgery, alpha-Fetoproteins / metabolism, Case Reports, Biomarkers / blood, Carcinoma, Hepatocellular / blood, Carcinoma, Hepatocellular / surgery, Diagnosis, Differential, Hepatitis C, Chronic / blood, Humans, Liver Cirrhosis / virology, Liver Neoplasms / blood, Liver Neoplasms / surgery, Male, Middle Aged, Splenosis / blood, Biomarkers, alpha-Fetoproteins

Background:
Splenosis is a heterotropic implantation of splenic fragments onto exposed vascularised peritoneal and intrathoracic surfaces, following splenic injury or elective splenectomy.
Case presentation:
A 60 year old cirrhotic patient was referred to us with a hepatic mass, suspected to be HCC in a cirrhotic liver. A computerized tomography scan (CT) demonstrated a cirrhotic liver with a 2 x 2.7 cm focal hypervascular nodule, lying peripherally at the junction of segment 7 and 8. Diagnostic laparoscopy demonstrated a 3 cm exofitic dark brown splenunculus attached to the diaphragm and indenting the surface of segment 7 of the liver. The lesion was easily resected laparoscopically and shaved from the live surface with no need for a liver resection. The histopathological assessment confirmed the diagnosis of splenunculus, with no evidence of neoplasia.
Conclusion:
Hepatic splenosis is not a rare event and should be suspected in patients with a history of splenic trauma or splenectomy. Correct diagnosis is essential and will determine subsequent management plans. In doubtful cases laparoscopic investigation can offere essential information and should be part of the standard protocol for investigating suspected splenosis.
TLE1 Positive Clear Cell Sarcoma of the Kidney: A Case Report and Review of the Literature
Authors: Rana Naous
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Clear cell sarcoma of the kidney (CCSK) is an uncommon malignant tumor of uncertain histogenesis that occurs most commonly in childhood. Histologically, CCSK can mimic myxoid variant of synovial sarcoma (SS); however, the double positivity for CD99 and TLE1 in SS helps in excluding CCSK. Herein, we report a rare case of CCSK arising in the left kidney of a 3-year-old girl. The mass grossly measured 9.5 cm in maximum dimension and histologically showed the classic arborizing fibrovascular septae and background myxoid matrix that is usually seen in CCSK. The tumor however was double positive for CD99 and TLE1 which made it difficult to discriminate it from the myxoid variant of SS based on histopathological examination and immunophenotype alone, and genetic analysis for SYT gene rearrangement was required to reach a definitive diagnosis. Although there have been previous case reports of CCSK with positive expression of CD99 and negative TLE1, to our knowledge, this is the first case of CCSK expressing both CD99 and TLE1.
Endovascular treatment of acute aortic isthmian ruptures: case study
Authors: Mohamed Rida Ajaja, Amine Cheikh, El Mehdi Moutaouekkil, Mohcine Madani, Moha Arji, Amine El Hassani, Brahim Lakhal, Anas Slaoui
Journal: Pan Afr Med J (2017)
Keywords: endovascular treatment, aortic isthmian ruptures, endovascular prosthesis
MeSH terms: Aorta, Thoracic / injuries, Aortic Rupture / surgery, Endovascular Procedures / methods, Case Reports, Adult, Aorta, Thoracic / surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation / methods, Humans, Morocco, Patient Care Team, Treatment Outcome

Traumatic rupture of the aortic isthmus is a rare lesion occurring in patients subjected to violent deceleration. Because of the forces involved, it is frequently associated with concomitant life-threatening injuries. The endovascular intervention has been described to be a feasible and efficient technique which may be proposed as a therapeutic option for patients with multiple traumas instead of delayed classical surgical repair after stabilization. We report the case of an adult who has had an accident with a traumatic rupture of the aortic isthmus associated with other lesions, our patient received endovascular treatment. The aortic prosthesis was imported from France and the surgery was done 3 days after the patient's admission. This procedure was performed for the first time in Morocco in our hospital with a multidisciplinary team. The prosthesis was implemented successfully and the result was very satisfactory on the heart level.
Case Report: Variations in the ALPL Gene in Chinese Patients With Hypophosphatasia
Authors: Qiang Zhang, Zailong Qin, Shang Yi, Hao Wei, Xun Zhao Zhou, Fei Shen
Journal: Front Genet (2021)
Keywords: alpl gene, tnsalp, abnormal bone ossification, hypophosphatasia, whole-exome sequencing
MeSH terms: Case Reports

Background: Hypophosphatasia (HPP) is an autosomal genetic disorder characterized biochemically by abnormal of bone parameters and serum alkaline phosphatase (ALP) activity as well as clinically by deficiency of teeth and bone mineralization. The clinical presentation is a continuum ranging from a prenatal lethal form with no skeletal mineralization to a mild form with late adult onset presenting with non-pathognomonic symptoms. ALP deficiency is the key to the pathogenesis of abnormal metabolism and skeletal system damage in HPP patients. Methods: We investigated five patients with skeletal dysplasia in the clinic. Whole-exome sequencing was performed in order to aid diagnosis of the patients. Results: Eight variants in the ALPL gene in the five unrelated Chinese patients (PA-1: c.649_650insC and c.707A > G; PA2: c.98C > T and c.707A > G; PA3: c.407G > A and c.650delTinsCTAA; PA4: c.1247G > T (homozygous); PA5: c.406C > T and c.1178A > G; NM_000478.5) were found. These variations caused two types of HPP: perinatal HPP and Odonto HPP. All cases reported in this study were autosomal recessive. Among the variants, c.1247G > T/p.Gly416Val (PA-4); c.1178A > G/p.Asn393Ser (PA-5) and c.707A > G/p.Tyr236Cys (PA-1, PA-2) have never been reported before. Conclusion: Clinical phenotypes of perinatal HPP (PA-1,PA-2,PA-3 and PA-4) include skeletal dysplasia, shorter long bones, bowing of long bones, tetraphocomelia, abnormal posturing and abnormal bone ossification. Odonto HPP (PA-5) only presents as dental abnormality with severe dental caries and decreased ALP activity. Our study extends the pool of ALPL variants in different populations.
Acute Marjolin's Ulcer in a Postauricular Scar after Mastoidectomy
Authors: Kholoud A Alhysoni, Sumaiyah M Bukhari, Mutawakel F Hajjaj
Journal: Case Rep Otolaryngol (2016)

Background. Marjolin's ulcer is a rare, aggressive cutaneous malignancy that arises primarily in burn scars but can occur in other types of scars. Squamous cell carcinoma is the most common variant, and while malignant degeneration usually takes a long time, it can develop acutely. Case Report. a 30-year-old man who developed Marjolin's ulcer acutely in a right postauricular scar after mastoidectomy and the incision and drainage of a mastoid abscess. To the best of our knowledge, this report is the first to describe a Marjolin's ulcer in a postauricular surgical scar. However, it has been reported in others areas in the head and neck. Conclusion. Marjolin's ulcer is most commonly observed after postburn scars, but it may be observed after any type of scars, as our patient developed an SCC with a postsurgical scar. Early diagnosis is essential, and a biopsy should be performed on any nonhealing wound or chronic wound that undergoes a sudden change. Tissue samples should be taken from both the centre and the margins of the wound.
Cardiac arrest after anesthetic management in a patient with hereditary sensory autonomic neuropathy type IV
Authors: Yakup Ergül, Bariş Ekici, Sabiha Keskin
Journal: Saudi J Anaesth (2011)
Keywords: anhydrosis, cardiac arrest, hereditary sensory autonomic neuropathy type iv, hyperprexia, self mutilation
MeSH terms: Case Reports

Hereditary sensory autonomic neuropathy type IV is a rare disorder with an autosomal recessive transmission and characterized by self-mutilation due to a lack in pain and heat sensation. Recurrent hyperpyrexia and anhydrosis are seen in patients as a result of a lack of sweat gland innervation. Self-mutilation and insensitivity to pain result in orthopedic complications and patients undergone recurrent surgical interventions with anesthesia. However, these patients are prone to perioperative complications such as hyperthermia, hypothermia, and cardiac complications like bradycardia and hypotension. We report a 5-year-old boy with hereditary sensory autonomic neuropathy type IV, developing hyperpyrexia and cardiac arrest after anesthesia.
Recurrent and progressive abdominal pain and enteritis in a Japanese patient with paroxysmal nocturnal hemoglobinuria
Authors: Akihisa Hino, Yukiko Yamashita, Mitsuhiro Yamaguchi, Yasuhiko Azenishi
Journal: Case Rep Hematol (2014)

This case report describes a young male patient with recurrent abdominal pain persisting for more than 16 months. Clinical investigations showed signs of inflammation and pancytopenia. A diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) was made 9 months after the onset of the abdominal pain, following endoscopic examinations that revealed evidence of a previously unknown hemorrhage. Regular monitoring indicated that the abdominal pain was associated with elevations in lactate dehydrogenase, C-reactive proteins, and D-dimer levels. The patient started treatment with the complement inhibitor eculizumab shortly after it was approved for use in Japanese PNH patients with hemolysis. Resolution of the abdominal pain and normalization of clinical parameters were noted within 3 weeks from treatment initiation.
Ectopic molar pregnancy: a case report
Authors: Najoua Bousfiha, Sanaa Erarhay, Adnane Louba, Hanan Saadi, Chahrazad Bouchikhi, Abdelaziz Banani, Hind El Fatemi, Med Sekkal, Afaf Laamarti
Journal: Pan Afr Med J (2012)
Keywords: ectopic molar pregnancy, ectopic pregnancy, morocco, molar pregnancy
MeSH terms: Hydatidiform Mole / diagnosis, Pregnancy, Ectopic / diagnosis, Uterine Neoplasms / diagnosis, Case Reports, Adult, Female, Humans, Hydatidiform Mole / complications, Morocco, Pregnancy, Uterine Neoplasms / complications

The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology exam of an ectopic pregnancy. We report the case of 32 years old nulliparus women who presented a vaginal bleeding, lower abdominal pain and 6 weeks amenorrhea corresponding to the last menstrual period. At the clinical examination, the arterial pressure was 100/60 mmHG. The gynecological examination was difficult because of lower abdominal pain. Serum gonadotropin activity was 3454 ui/l. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. Diagnostic laparoscopy revealed a left-sided unruptured ampullary ectopic pregnancy. A left laparoscopic salpingectomy was performed. The systematic histologic test identified an ectopic partial molar pregnancy, which was confirmed by DNA ploidy image analysis. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is pertinent that clinicians take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnose cases of ectopic molar gestations early and mount appropriate post treatment surveillance.
Case Report: A Case of Sintilimab-Induced Cystitis/Ureteritis and Review of Sintilimab-Related Adverse Events
Authors: Lingfang Tu, Yuan Ye, Xiaoping Tang, Zhen Liang, Qihan You, Jianying Zhou, Zhijie Pan
Journal: Front Oncol (2021)
Keywords: cystitis, immune checkpoint inhibitor, immune-related adverse events, sintilimab, ureteritis
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have been proven to be beneficial in multiple advanced malignancies. However, the widespread use of ICIs also occurred with various immune-related adverse events (irAEs). Here, we first report a case of sintilimab-related cystitis/ureteritis. A 53-year-old man with driver gene-negative pulmonary adenocarcinoma (cT1cN3M1c, Stage IVB) was being treated with sintilimab in combination of paclitaxel-albumin and bevacizumab as second-line treatment. He was hospitalized for haematuria, pollakiuria, painful micturition and low back pain after three courses. Urinalysis showed red blood cells (RBCs) and white blood cells (WBCs) were obviously increased, and serum creatinine (sCr) level was also significantly elevated. Urine culture and cytology were both negative, and cystoscopy revealed diffused redness of bladder mucosa. Urinary ultrasonography showed mild hydronephrosis and dilated ureter. The patient was diagnosed as immunotherapy-related cystitis/ureteritis after a multidisciplinary team (MDT) meeting. Once the diagnosis was made, corticosteroid therapy was given, which rapidly resolved the patient's symptoms and signs. Computer tomography angiography (CTA) and CT urography (CTU) was conducted after sCr level was back to normal and demonstrated ureter dilation and hydroureter. Once symptoms relieved, bladder biopsy was performed and confirmed the bladder inflammation. The patient was subsequently switched to maintenance dose of methylprednisolone and tapered gradually. Since sintilimab has been used in advanced malignancies, we first reported a rare case of sintilimab-induced cystitis/ureteritis and summarized sintilimab-related adverse events to improve the assessment and management of irAEs.
Giant left coronary artery diagonal branch left ventricular fistula: A case report and review of literature
Authors: Jingyue Wang, Huicong Zhang, Qian Tong, Quanwei Wang
Journal: Front Cardiovasc Med (2022)
Keywords: case, congenital cardiovascular disease, coronary artery fistula, diagnosis, review
MeSH terms: Case Reports

A 37-year-old Chinese man was admitted to the department of cardiology of the First Hospital of Jilin University for intermittent palpitation for 9 months, aggravating with chest pain for 3 days. After several examinations, he was diagnosed with giant left ventricular fistula of the diagonal branch of the left coronary artery. After routine treatment, which included improving circulation and administration of dual antiplatelet as well as hypolipidemic drugs among others, the patient's symptoms did not improve. The fistula was too big for transcatheter occlusion to be performed. A multi-disciplinary suggestion was that the patient be subjected to "surgical closure treatment"; however, for personal reasons, he refused the operation. After discharge, oral beta-blockers were prescribed for the patient. Incidences of congenital coronary arterial fistula in congenital cardiovascular disease are rare, and incidences of the giant fistula being located in the left heart system are even rarer. We report an adult male with a giant left anterior descending diagonal coronary artery left ventricular fistula and show various accessory examination results. Non-invasive ultrasonic cardiography was the first diagnostic option for the disease and pre-admission evaluation. Auxiliary diagnosis and exclusion value of cardiovascular magnetic resonance (CMR) were revealed for the first time. Invasive coronary angiography (ICA) was demonstrated to be the gold standard method again and it was also found that computed tomography angiography (CTA) might be used instead of ICA for determining the exact relationships among anatomic structures. Furthermore, we performed a literature review on the diagnosis and treatment of patients with this condition.
Case report and literature review: Primary leiomyosarcoma of the penis
Authors: Yichang Hao, Li Xia, Min Lu, Chenhong Liu, Fan Zhang, Ye Yan, Yi Huang, Shudong Zhang
Journal: Front Surg (2023)
Keywords: case report, leiomyosarcoma (lms), malignant mesenchymal tumors, penis, urogenital neoplasms
MeSH terms: Case Reports

Background:
Leiomyosarcoma (LMS) is a malignant spindle-cell mesenchymal tumor originating from the smooth muscle cells, which mostly affects soft tissues and abdominopelvic organs over extremities. Primary LMS of the penis is a relatively uncommon mesenchymal tissue disease and a poorly understood condition.
Case report:
A 69-year-old man presented with a growing, painless mass protruding from the penis. The irregularly lobulated lump was roughly 3 cm × 2.5 cm, with a smooth surface, tough texture, distinct boundary, and no tenderness. It was determined to be a penile tumor during the preoperative radiological evaluation. The patient underwent resection of the penile mass, followed by extended resection in the second operation. The diagnosis of LMS was verified by pathological examination. During a 20-month follow-up, the patient made a smooth recovery and remained disease-free.
Conclusion:
An immunohistochemical examination is essential for rendering this rare diagnosis. Radical excision of tumor lesions with negative cut margins is guaranteed to be the best treatment for primary penile LMS. Close follow-up should be provided due to the high rate of local recurrence.
Refractory gastric ulcer bleeding responsive to long-term octreotide
Authors: Humzah Iqbal, Dashmeet Maharaj, Hunza Chaudhry, Alakh Gulati, Marina Roytman
Journal: SAGE Open Med Case Rep (2023)
Keywords: peptic ulcer disease, endoscopic hemostasis, octreotide, refractory gastrointestinal bleed
MeSH terms: Case Reports

Upper gastrointestinal tract bleeding is a common condition that can cause hemodynamic instability and death if left untreated. Endoscopic hemostasis is often successful; however, some patients may develop refractory bleeding. Pharmacologic management with octreotide is beneficial in patients with variceal bleeding and has been shown in some studies to be effective in refractory bleeding due to angiodysplasia. There is a paucity of literature regarding the usage of long-term octreotide in refractory bleeding secondary to a peptic ulcer. We present a case of a bleeding gastric ulcer that was refractory to endoscopic management but responsive to long-term octreotide therapy.
Flecainide-Associated Cardiogenic Shock in a Patient with Atrial Fibrillation
Authors: Erind Gjermeni, Andreas Bollmann, Gerhard Hindricks, Andreas Müssigbrodt
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Flecainide is a frequently used antiarrhythmic drug, recommended by current guidelines as a first-line treatment option for restoring and maintaining sinus rhythm in patients with atrial fibrillation and no significant structural heart disease. In overdose, it can induce severe cardiogenic shock. Cardiogenic shock after a therapeutic dose of flecainide in patients without contraindication has not yet been reported in literature. Case Summary. We report a case of flecainide-associated cardiogenic shock in a 52-year-old woman with paroxysmal atrial fibrillation after a therapeutic dose of flecainide. Pharmacological cardioversion of symptomatic tachyarrhythmic atrial fibrillation with flecainide was unsuccessful and shortly after, she developed cardiogenic shock with severely reduced LVEF. Electrical cardioversion was also unsuccessful. Coronarography was unremarkable, and the cardiac MRI showed no signs of inflammation or fibrosis. After amiodarone loading, she converted to SR. This rare but severe complication despite adequate treatment could be explained by increased susceptibility to negative inotropic effect of flecainide as a consequence of marked tachycardia. Therefore, cautious monitoring after new administration of flecainide or the administration of a higher dose is advisable.
A case report of leishmaniosis with primary oral manifestation in a cat
Authors: Lisa A Mestrinho, Joana Travancinha, Cristina Sobral
Journal: Front Vet Sci (2022)
Keywords: leishmaniosis, feline, focal stomatitis, oral lesions, vector born disease
MeSH terms: Case Reports

A case of leishmaniosis with primary oral manifestations was reported in a 10-year-old neutered domestic shorthair cat. The primary lesion was a maxillary nodular lesion, painful with spontaneous bleeding associated with advanced periodontal disease, which did not resolve with tooth extraction or periodontal treatment. Biopsy revealed chronic neutrophilic and macrophagic infections and amastigote forms of Leishmania sp and molecular tests were able to identify Leishmania infantum. Oral signs resolved after the initiation of etiologic treatment with allopurinol. Distinguishing oral signs of leishmaniosis from other oral inflammatory diseases is important, especially in endemic areas, and co-infections must be considered with any oral manifestations of this disease.
Case Report: Electroencephalography in a neonate with isolated sulfite oxidase deficiency - a case report and literature review
Authors: Andreea M Pavel, Carol M Stephens, Sean R Mathieson, Brian H Walsh, Brian McNamara, Niamh McSweeney, Geraldine B Boylan
Journal: HRB Open Res (2021)
Keywords: neonatal seizures, encephalopathy, electroencephalography, sulfite oxidase deficiency, refractory seizures, brain mri, case report
MeSH terms: Case Reports

Isolated sulfite oxidase deficiency (ISOD) is a rare autosomal recessive neuro-metabolic disorder caused by a mutation in the sulfite oxidase (SUOX) gene situated on chromosome 12. Due to the deficiency of this mitochondrial enzyme (sulfite oxidase), the oxidative degradation of toxic sulfites is disrupted. The most common form of this disease has an early onset (classical ISOD) in the neonatal period, with hypotonia, poor feeding and intractable seizures, mimicking hypoxic-ischaemic encephalopathy. The evolution is rapidly progressive to severe developmental delay, microcephaly and early death. Unfortunately, there is no effective treatment and the prognosis is very poor. In this article, we described the evolution of early continuous electroencephalography (EEG) in a case of ISOD with neonatal onset, as severely encephalopathic background, with refractory seizures and distinct delta-beta complexes. The presence of the delta-beta complexes might be a diagnostic marker in ISOD. We also performed a literature review of published cases of neonatal ISOD that included EEG monitoring.
Takotsubo cardiomyopathy "variations on a theme"
Authors: Kjell Bogaard, Diego A M Odekerken, Albertus J Voogel
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

Takotsubo Cardiomyopathy (TTC) is a fairly new diagnosis in the cardiologist's repertoire. It can present itself in multiple different forms. We describe three cases of TTC with different etiologies illustrating the broad spectrum of presentations.
Efficacy of Arytenoidectomy after Suture Lateralisation Failure in Patients with Bilateral Vocal Cord Paralysis
Authors: Shinsuke Suzuki, Takechiyo Yamada
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Background:
Endolaryngeal suture lateralisation is an ideal operation for bilateral vocal fold paralysis. However, restenosis owing to breakage and slippage of suture can sometimes occur. In such a case, methods that are more effective in expanding the glottis, including arytenoidectomy, must be selected. Case Report. Herein, we report two female patients aged 86 and 54 years who presented with bilateral vocal cord paralysis and who had restenosis after suture lateralisation. Endoscopic partial arytenoidectomy was performed, and satisfactory outcomes were obtained. This method maintains the height of the arytenoid and preserves its sensation by leaving a part of the cartilage and mucous membrane.
Conclusion:
Endoscopic partial arytenoidectomy is effective for securing the airway while preserving vocal function and preventing aspiration. This technique is suitable for patients with restenosis after they have undergone endolaryngeal suture lateralisation.