OpenMed/multicare-articles huggingface dataset:
Uterine Tumor Resembling Ovarian Sex Cord Tumors Type II with Vaginal Vault Recurrence
Authors: Oriana Marrucci, Paola Nicoletti, Alessandro Mauriello, Simone Facchetti, Lodovico Patrizi, Carlo Ticconi, Francesco Sesti, Emilio Piccione
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

UTROSCTs (Uterine Tumors Resembling Ovarian Sex Cord Tumors) are rare neoplasms of unknown etiology usually occurring in middle-aged women. Less than 100 cases of UTROSCT have been reported so far. Although the typical behavior of UTROSCT is benign, metastatic and recurrent cases can occur. Here we describe an extremely rare case of vaginal vault recurrence of UTROSCT occurring 5 years after total hysterectomy with bilateral salpingo-oophorectomy. Though rare, UTROSCT should always be taken into account in the differential diagnosis of uterine masses initially considered leiomyomas.
Struggling with a Gastric Volvulus Secondary to a Type IV Hiatal Hernia
Authors: Dafnomilis George, Pappas V Apostolos, Panoutsopoulos Athanasios, Lagoudianakis E Emmanuel, Koronakis E Nikolaos, Panagiotopoulos Nikolaos, Seretis Charalampos, Karanikas George, Manouras J Andreas
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Type IV hiatal hernias are characterized by herniation of the stomach along with associated viscera such as the spleen, colon, small bowel, and pancreas through the esophageal hiatus. They are relatively rare, representing only about 5%-7% of all hernias, and can be associated with severe complications. We report a 71-year-old veteran wrestler who presented to our department with a type IV paraesophageal hernia containing a gastric volvulus and treated successfully with emergency operation.
Endocardiosis and congestive heart failure in a captive ostrich (Struthio camelus)
Authors: M A G Kubba, S A Al-Azreg
Journal: Open Vet J (2013)
Keywords: congestive heart failure, endocardiosis, myomatous valvular degeneration, ostrich
MeSH terms: Case Reports

A seven-year-old blue-necked male ostrich was found dead after a few days of illness. The animal was living in an open yard of 25 square meters along with three other females. They were given concentrate-rich ration with free access to green leaves and water. Autopsy revealed cardiac enlargement due to left ventricular hypertrophy and right ventricular dilatation. The left aterioventricular valves were irregularly thickened and contracted. The lungs were engorged with blood and the liver had nutmeg appearance. The small intestine showed segmental sub-serosal petechial hemorrhages. Histological examination revealed myxomatous degeneration of the left aterioventricular valves, pulmonary congestion and edema, congestion of periacinar hepatic zone and fatty degeneration of outer zones, renal glomerulosclerosis and arteriosclerosis. The affected parts of the small intestine showed villous atrophy with lacteal distention. The venules in the affected intestinal segment were severely dilated while the arterioles had narrow lumen and irregular wall thickening with hyaline deposition. The current article reports an endocardiosis in ostrich and discusses other vascular disorders.
Case Report: MDM4 Amplified in a Thymoma Patient With Autoimmune Enteropathy and Myocarditis
Authors: Xin Du, Lei Yu, Fei Li, Zhen Yu, Xing-Guo Yang, Yu-Xuan Jiang, Xin-Tao Yu
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: mdm4, autoimmune enteropathy, autoimmune myocarditis, drug sensitivity test, immunohistochemistry, thymoma, whole exome sequencing
MeSH terms: Cell Cycle Proteins / genetics, Myocarditis / genetics, Polyendocrinopathies, Autoimmune / genetics, Proto-Oncogene Proteins / genetics, Thymoma / genetics, Thymus Neoplasms / genetics, Case Reports, Research Support, Non-U.S. Gov't, Adult, Colon / diagnostic imaging, Colon / pathology, Humans, Intestine, Small / diagnostic imaging, Intestine, Small / pathology, Male, Myocarditis / diagnosis, Myocarditis / pathology, Polyendocrinopathies, Autoimmune / diagnosis, Polyendocrinopathies, Autoimmune / pathology, Thymoma / diagnosis, Thymoma / pathology, Thymus Neoplasms / diagnosis, Thymus Neoplasms / pathology, Young Adult, Cell Cycle Proteins, MDM4 protein, human, Proto-Oncogene Proteins, Autoimmune enteropathy

Introduction:
Thymoma is a type of mediastinal malignant tumors which always associated with autoimmune diseases. Although surgery is the predominant treatment method for thymoma, the pathogenesis of thymoma and thymoma-associated autoimmune diseases is still unknown. However, the case study here provided a possible pathogenesis and treatment to cure the thymoma with autoimmune enteropathy and myocarditis.
Case presentation:
A thymoma case with autoimmune enteropathy and myocarditis undergoing surgery was reported. The symptoms and laboratory results of the patient had dramatically fluctuated after tumor resection and gradually alleviated. The whole exome sequencing found MDM4 amplified in tumor cells. Immunohistochemistry indicated that thymoma cells were positive for MDM4. The result of drug sensitivity tests showed thymoma cells were highly sensitive to Nutlin-3a.
Conclusion:

MDM4 could play an important role in the pathogenesis of this thymoma case with autoimmune enteropathy and myocarditis. This discovery may provide a novel idea of pathogenesis and treatment for thymoma and autoimmune diseases.
Haploinsufficiency of BMP4 and OTX2 in the Foetus with an abnormal facial profile detected in the first trimester of pregnancy
Authors: Pavlina Capkova, Alena Santava, Ivana Markova, Andrea Stefekova, Josef Srovnal, Katerina Staffova, Veronika Durdová
Journal: Mol Cytogenet (2017)
Keywords: first trimester ultrasound, microdeletion 14q22q23, micrognathia, pierre robin sequence
MeSH terms: Case Reports

Background:
Interstitial microdeletion 14q22q23 is a rare chromosomal syndrome associated with variable defects: microphthalmia/anophthalmia, pituitary anomalies, polydactyly/syndactyly of hands and feet, micrognathia/retrognathia. The reports of the microdeletion 14q22q23 detected in the prenatal stages are limited and the range of clinical features reveals a quite high variability.
Case presentation:
We report a detection of the microdeletion 14q22.1q23.1 spanning 7,7 Mb and involving the genes BMP4 and OTX2 in the foetus by multiplex ligation-dependent probe amplification (MLPA) and verified by microarray subsequently. The pregnancy was referred to the genetic counselling for abnormal facial profile observed in the first trimester ultrasound scan and micrognathia (suspicion of Pierre Robin sequence), hypoplasia nasal bone and polydactyly in the second trimester ultrasound scan. The pregnancy was terminated on request of the parents.
Conclusion:
An abnormal facial profile detected on prenatal scan can provide a clue to the presence of rare chromosomal abnormalities in the first trimester of pregnancy despite the normal result of the first trimester screening test. The patients should be provided with genetic counselling. Usage of quick and sensitive methods (MLPA, microarray) is preferable for discovering a causal aberration because some of the CNVs cannot be detected with conventional karyotyping in these cases. To the best of our knowledge, this is the earliest detection of this microdeletion (occurred de novo), the first case detected by MLPA and confirmed by microarray. Literature review of the genotype-phenotype correlation in similar reports leads us to the conclusion that dosage imbalance of the chromosomal segment 14q22q23 (especially haploinsuffiency of the genes BMP4 and OTX2) contributes significantly to orofacial abnormalities. Association of the region with the Pierre Robin sequence appears to be plausible.
Lentigo maligna mimicking invasive melanoma in Mohs surgery: a case report
Authors: Teresa Tsakok, Nisith Sheth, Alistair Robson, Catherine Gleeson, Raj Mallipeddi
Journal: F1000Res (2014)

Lentigo maligna is a lentiginous proliferation of atypical melanocytes confined to the epidermis, typically on chronically sun-damaged skin. Following biopsy and exclusion of invasive disease, therapy may involve Mohs surgery, topical treatment or radiotherapy. However, lentigo maligna often involves adnexal structures, creating histological difficulty in distinguishing these foci from invasive melanoma. We present a case in which, during Mohs excision, a nodule of severely atypical melanocytes appeared to lie within the dermis, potentially altering treatment and prognosis. The use of laminin-5 provided a means of resolving this diagnostic dilemma, facilitating continuation of Mohs surgery until tumour clearance was achieved.
An Analysis of the Clinical and Radiological Prognostic Factors Affecting the Outcomes of Lumbar Intradiscal Biacuplasty
Authors: Meng-Yin Yang Md, Chin-Hwee Goh Md, Chin-Ying Wu Md, You-Pen Chiu MSc, Hui-Ru Ji MSc, I-Han Hsiao Md, Cheng-Di Chiu Md
Journal: Int J Med Sci (2023)
Keywords: disc degenerative disease, herniated intervertebral disc, intradiscal biacuplasty, lumbar magnetic resonance imaging, prognostic factor
MeSH terms: Intervertebral Disc Degeneration / complications, Intervertebral Disc Degeneration / diagnostic imaging, Intervertebral Disc Degeneration / therapy, Intervertebral Disc Displacement / diagnostic imaging, Intervertebral Disc Displacement / therapy, Low Back Pain / diagnostic imaging, Low Back Pain / etiology, Follow-Up Studies, Humans, Lumbar Vertebrae / diagnostic imaging, Lumbar Vertebrae / surgery, Prognosis, Radiography, Treatment Outcome

Purpose: Intradiscal biacuplasty (IDB) has been proven to be effective for treating lumbar degenerative disc disease (DDD). However, there has not been a reported prognostic factor for IDB. The present study meticulously evaluates the general and radiographic features that may serve as markers for predicting the therapeutic outcome of IDB. Methods: A prospective case series study was conducted, following time-series analysis moving averages models, with forty-one patients suffering from chronic discogenic lower back pain for more than six months. These patients subsequently received lumbar cool radiofrequency IDB and were enrolled in the study. Thirty-seven patients completed follow-up questionnaires at 1, 3, 6, and 12 months. The surgical outcomes were reported using visual analogue scale (VAS), Oswestry disability index (ODI), and the consumption of nonsteroidal anti-inflammatory drugs (NSAID). Furthermore, a univariate analysis was performed to identify prognostic factors associated with pain relief from age, gender, body mass index (BMI), and pre-operative lumbar magnetic resonance imaging reading. Results: Significant reductions were found in estimated VAS and ODI at the post-operative period at 1, 3, 6, and 12 months (P < 0.001). The NSAID dosage was significantly decreased at 3-month and 1-year follow-up (P < 0.05). No procedure-related complications were detected. The prognosis of IDB was not related to disc height, Pfirrmann grading or Modic endplate change. However, disc extrusions were associated with promising outcomes (VAS improvement ≥ 50%) on pain relief (P < 0.05). Conclusion: IDB is a good alternative choice for treating lumbar DDD. Patients with a painful extrusion lumbar disc may gain some benefits after receiving IDB following a period of failed conservative treatment. These findings may also add some references for physicians in the decision making when treating lumbar DDD.
Chromosome 3p Inverted Duplication with Terminal Deletion: Second Postnatal Case Report with Additional Clinical Features
Authors: Jacquelyn D Riley, Catherine M Stefaniuk, Francine Erenberg, Angelika L Erwin, Lauren Palange, Caroline Astbury
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

Distal deletions and duplications of 3p are individually well-characterized chromosome abnormalities. Here, we report an inverted duplication of 3p with an adjacent terminal 3p deletion in a 17-month-old girl who had prenatal intrauterine growth restriction and cardiac defects. Other findings included hemangiomas, neutropenia, umbilical hernia, hypotonia, gross motor delay, microcephaly, and ptosis. Family history was noncontributory. Microarray analysis revealed a 5.37 Mb deletion of chromosome bands 3p26.1 to 3p26.3 and a 13.68 Mb duplication of 3p24.3 to 3p26.1. FISH analysis confirmed that the duplication was inverted. Upon literature review, only one postnatal patient and one second trimester pregnancy have been reported with this finding. Many of our patient's features are present in both 3p deletion and 3p duplication syndromes, including congenital heart disease, growth restriction, microcephaly, hypotonia, and developmental delay. Our patient has additional features not commonly reported in 3p deletion or duplication patients, such as aortic dilation, hemangiomas, and neutropenia. The identification of this patient contributes to additional understanding of features associated with concurrent deletion and inverted duplication in the distal 3p chromosome. This report may assist clinicians working with patients who have constellations of similar features or similar cytogenomic abnormalities.
Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa
Authors: H M Senarathna, C L Fonseka, H A S Perera, P U T De Silva, T P Weerarathna
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Background:
Polyarteritis nodosa (PAN) is a form of necrotizing vasculitis affecting medium or small blood vessels with multiorgan involvement. Although myalgia is a clinical feature of PAN, severe disabling myalgia as the initial presentation is rarely noted.
Case presentation:
We present a case of 54-year-old male with recently detected chronic kidney disease admitted with progressive severe disabling muscular pains predominantly over calves with constitutional symptoms for seven weeks. He was weak to mobilize out of the bed. Later, he developed a vasculitic rash, unilateral ulnar claw, and bilateral foot drop. His skin and muscle biopsies showed evidence of vasculitis. His renal and mesenteric artery CT angiogram revealed stenosed segment of the celiac artery without evidence of visible aneurysms elsewhere. He completed six cycles of intravenous cyclophosphamide pulse therapy with high-dose oral prednisolone with good response. With continuation of aggressive immunosuppression and rehabilitation for five months, the patient improved and was able to walk without support.
Conclusion:
Musculoskeletal predominant PAN, even though rare, needs to be considered in patients presenting with disabling muscle pain and weakness. These features may herald over days to months along with constitutional symptoms before other systems getting affected. Early recognition of such symptoms and initiating specific treatment would be important for better outcomes.
Case report: Vaccine-induced immune thrombotic thrombocytopenia complicated by acute cerebral venous thrombosis and hemorrhage after AstraZeneca vaccines followed by Moderna COVID-19 vaccine booster and surgery
Authors: Quan-Ting Chen, Yi Liu, Yeu-Chin Chen, Chung-Hsing Chou, Yu-Pang Lin, Yun-Qian Lin, Ming-Chen Tsai, Bo-Kang Chang, Tsung-Han Ho, Chun-Chi Lu, Yueh-Feng Sung
Journal: Front Neurol (2022)
Keywords: moderna booster, autoimmune heparin-induced thrombocytopenia, cerebral hemorrhage, cerebral venous thrombosis, vaccine-induced thrombotic thrombocytopenia
MeSH terms: Case Reports

Vaccine-induced thrombotic thrombocytopenia (VITT) is a well-known complication of adenoviral vector COVID-19 vaccines including ChAdOx1 nCoV-19 (AstraZeneca) and Ad26. COV2.S (Janssen, Johnson & Johnson). To date, only a few cases of mRNA COVID-19 vaccine such as mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech)-induced VITT have been reported. We report a case of VITT with acute cerebral venous thrombosis and hemorrhage after a booster of mRNA-1273 (Moderna) vaccine in a patient previously vaccinated with two doses of the AstraZeneca vaccine. A 42-year-old woman presented with sudden onset of weakness of the right upper limb with focal seizure. She had received two doses of AstraZeneca vaccines and a booster with Moderna vaccine 32 days before presentation. She had also undergone a laparoscopic myomectomy 12 days previously. Laboratory examinations revealed anemia (9.5 g/dl), thrombocytopenia (31 × 103/μl), and markedly elevated d-dimer (>20.0 mg/L; reference value < 0.5 mg/L). The initial brain computed tomography (CT) was normal, but a repeated scan 10 h later revealed hemorrhage at the left cerebrum. Before the results of the blood smear were received, on suspicion of thrombotic microangiopathy with thrombocytopenia and thrombosis, plasmapheresis and pulse steroid therapy were initiated, followed by intravenous immunoglobulin (1 g/kg/day for two consecutive days) due to refractory thrombocytopenia. VITT was confirmed by positive anti-PF4 antibody and both heparin-induced and PF4-induced platelet activation testing. Clinicians should be aware that mRNA-1273 Moderna, an mRNA-based vaccine, may be associated with VITT with catastrophic complications. Additionally, prior exposure to the AstraZeneca vaccine and surgical procedure could also have precipitated or aggravated autoimmune heparin-induced thrombocytopenia/VITT-like presentation.
Renal Transplantation with Simultaneous Aortoiliac Reconstruction Using a Polytetrafluoroethylene Vascular Graft for Severe Atherosclerosis
Authors: Go Anan, Koji Nanmoku, Masaki Shimbo, Masahiko Nagahama, Takaaki Kimura, Yasunaru Sakuma, Fumiyasu Endo, Yasuhiro Komatsu, Kazunori Hattori, Takashi Yagisawa
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Studies on aortoiliac reconstruction for severe atherosclerosis with renal transplantation are limited. Here, we report a rare experience of the simultaneous reconstruction of the external iliac artery caused by severe atherosclerosis with polytetrafluoroethylene vascular graft and renal transplantation in a 55-year-old female; she was unable to undergo standard renal artery anastomosis to the right external iliac artery because of severe atherosclerosis, which would result in complete occlusion. Next, we directly anastomosed the donor renal artery to the polytetrafluoroethylene graft. After transplantation, delayed graft function occurred; therefore, the patient had to undergo hemodialysis. On day 7 after transplantation, her creatine level started to decrease. She was discharged from the hospital on the 14th day after transplantation. After 1 month, her serum creatinine level reduced to 1.12 mg/dL. After 3 years of transplantation, her serum creatinine level was 1.2 mg/dL. The simultaneous implantation of the polytetrafluoroethylene graft and renal transplantation was feasible as well as safe, with no infectious complications and stable renal function noted on long time follow-up. Although our case was rare, it emphasizes the need for transplant surgeons to gain surgical skills for vascular surgery using vascular grafts.
Acetabular Reconstruction Using a Trabecular Metal Cup with a Novel Pelvic Osteotomy Technique for Severe Acetabular Bone Defect
Authors: Keizo Wada, Tomohiro Goto, Tomoya Takasago, Takahiko Tsutsui, Koichi Sairyo
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Case:
A 79-year-old woman with an extreme bone defect after failed cementless total hip arthroplasty underwent revision arthroplasty with a novel technique that involved cutting the anterior iliac bone and sliding it distally to reconstruct the anterior acetabular wall. A three-dimensional printed bone model enabled understanding the details of the bone defect. The clinical outcome at 3 years after surgery was favorable.
Conclusion:
The advantages of this technique are twofold, namely, stable fixation of the cup sandwiched between the anterior and posterior walls and reconstruction of the anterior wall using living bone, which allows bone ingrowth into the cup.
Pulmonary embolism related to amisulpride treatment: a case report
Authors: Maria Skokou, Philippos Gourzis
Journal: Case Rep Psychiatry (2013)

Venous thromboembolism has been associated with antipsychotic drugs, but the underlying mechanisms are largely unknown. Hypotheses that have been made include body weight gain, sedation, enhanced platelet aggregation, increased levels of antiphospholipid antibodies, hyperhomocysteinemia, whereas hyperprolactinemia has recently attracted attention as a potential contributing factor. The highest risk has been demonstrated for clozapine, olanzapine, and low-potency first-generation antipsychotics; however, presently there is no data for amisulpride. In the present paper we describe a case of pulmonary embolism in a female bipolar patient, receiving treatment with amisulpride, aripiprazole, and paroxetine. Although a contribution of aripiprazole and paroxetine cannot completely be ruled out, the most probable factor underlying the thromboembolic event seems to be hyperprolactinemia, which was caused by amisulpride treatment. Increased plasma levels of prolactin should probably be taken into account during the monitoring of antipsychotic treatment as well as in future research concerning venous thromboembolism in psychiatric settings.
"Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures
Authors: Brandon Lilly, Erika Maynard, Kelly Melvin, Suzanne Holroyd
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.
Simultaneous small and large bowel obstruction as a consequence of internal hernia: A case report
Authors: Malek A Al-Omari, Mohammad A Al-Doud
Journal: Int J Surg Case Rep (2019)
Keywords: congenital trans-mesenteric hernia, internal hernia, intestinal obstruction

Introduction:
Intestinal obstruction ascribed to internal hernia is quite rare, especially in adults. There are no differentiating features in the presentation of intestinal obstruction due to internal hernia as compared to other causes. Delay in the diagnosis of this condition carries a considerable risk especially in a virgin abdomen. We report a rare case of internal hernia which presented as acute small and large bowel obstruction.
Presented case:
We report a 47- year- old male with generalized abdominal pain associated with vomiting and obstipation. The patient was in hypovolemic shock that only had a transient response to resuscitation. CT scans of the abdomen with contrast was done and showed both large and small bowel obstruction. Exploration laparotomy was done and revealed a concurrent nonviable portion of ileum and twisted sigmoid colon (volvulus) which protruded through a congenital transmesentric defect. Resection was mandatory, and repair of the defect was done.
Discussion:
Incidence of internal hernia generally does not exceed 1%. The diagnosis of congenital internal hernia relies on absence history of trauma, inflammatory process and abdominal surgery. Protrusion of simultaneous small and large bowels together through transmesenteric congenital gate is uncommon.
Conclusion:
Whether the patient presenting with intestinal obstruction has a history of undergoing previous surgeries (for any reason) or not, the diagnosis of internal hernia must be kept in mind. Coexisting involvement of both small and large bowels that need resection poses the question of the need for restoration of bowel continuity with either colostomy or ileostomy.