OpenMed/multicare-articles huggingface dataset:
Successful removal of a penile constriction ring in a 14-year-old male
Authors: Timothy K Suttle, Blake Palmer, Jonathan E Heinlen, Christopher C Roth, William G Reiner, Dominic Frimberger
Journal: Adv Urol (2009)
MeSH terms: Case Reports

Penile strangulation is a rarely described medical emergency, especially in the adolescent population. This case demonstrates the successful removal of a constricting metal ring from the penis of a 14-year-old male with a diamond blade equipped orthopedic oscillating saw while under ketamine anesthesia in the emergency department.
Dexmedetomidine infusion associated with transient adrenal insufficiency in a pediatric patient: a case report
Authors: Elizabeth W Tucker, David W Cooke, Sapna R Kudchadkar, Sybil Ann Klaus
Journal: Case Rep Pediatr (2013)

Dexmedetomidine is a highly selective α 2-adrenoceptor agonist used for sedation due to its anxiolytic and analgesic properties without respiratory compromise. Due to its structural similarity to etomidate, there has been concern that dexmedetomidine may cause adrenal insufficiency. This concern was initially supported by animal studies, but subsequent human studies demonstrated mixed results. We describe the case of transient adrenal insufficiency in a 1-year-old male who presented with 24% total body surface 2nd degree burns. He required sedation with a prolonged, high-dose dexmedetomidine infusion with a peak infusion dose of 2.7 mcg/kg/hr and duration of 6.5 days. The patient developed lethargy and hypotension four days after discontinuation of his infusion. He had a random cortisol level which was low at 0.4 mcg/dL, and the concern for adrenal suppression was confirmed with an ACTH stimulation test with the baseline cortisol of 0.4 mcg/dL and inappropriate 60 minute post-ACTH stimulation cortisol of 7.8 mcg/dL. While further studies will be needed to clarify the risk of adrenal suppression secondary to dexmedetomidine, this case suggests that caution should be taken when administering dexmedetomidine to pediatric patients and highlights the need for future studies to look at appropriate dosing and duration of dexmedetomidine infusions.
Multiple intracranial meningiomas: a review of the literature and a case report
Authors: F Koech, J Orege, F Ndiangui, B Macharia, N Mbaruku
Journal: Case Rep Surg (2013)

Multiple intracranial meningiomas are a condition where there is more than one meningioma in several intracranial locations in the same patient without signs of neurofibromatosis. Incidence varies from 1 to 10%. The prognosis of multiple intracranial meningioma does not differ from benign solitary meningiomas despite the multiplicity. However, the simultaneous occurrence of different grades of malignancy is observed in one-third of multiple meningiomas. Surgery remains the best option for treatment of symptomatic lesions. Our case review aims to present and discuss a 75-year-old female patient diagnosed with multiple intracranial meningiomas, describing their clinical, radiological, histological characteristics. It also highlights the fact that the patient had two tumours, underwent surgery, and so far has a good quality of life.
Localized advanced hürthle cell carcinoma with symptomatic intrathoracic goiter
Authors: Kabir Ahmed, Darren Swartz, Deepu Daniel, Craig Crespi, Andrew Rosenthal, Joseph Decostanza
Journal: Case Rep Surg (2011)
MeSH terms: Case Reports

INTRATHORACIC GOITERS ARE DIVIDED INTO TWO CATEGORIES: primary and secondary. Intrathoracic goiters (IG) can cause upper airway obstruction. The presence of obstructive symptoms secondary to increased thyroid growth and tracheal compression is major indication for surgery; however, goiters do not always require immediate surgical attention. In addition, although some diagnostic tests indicate upper airway obstruction, many patients remain asymptomatic. Surgeries to remove IG are performed routinely however, they are not without risk. In some cases, intrathoracic goiters present as thyroid cancers. Very rare cancers such as Hürthle cell carcinoma (HCC) can create a challenge for the surgeon when surgical intervention is vital.
Multiple Xanthogranulomas in an Adult Patient with Myelodysplastic Syndrome
Authors: Marta Martínez-García, Nicolás Silvestre-Torner, Antonio Aguilar-Martínez, Fernando Burgos-Lázaro
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Adult multiple xanthogranuloma (XG) is a rare late-onset variant of juvenile XG. It is characterized by the appearance of papules or nodules located preferably on the trunk. A case of a 54-year-old man with myelodysplastic syndrome is presented as a history of interest, who consulted due to the appearance of multiple brownish papules distributed mainly in the trunk. So far, there are only 22 cases of this clinical form reported in the literature, 9 of them associated with malignant hematological processes. We highlight the importance of this entity as a possible cutaneous marker of blood dyscrasias.
Inferior Olivary nucleus degeneration does not lessen tremor in essential tremor
Authors: Elan D Louis, Daniel Trujillo Diaz, Sheng-Han Kuo, Shi-Rui Gan, Etty P Cortes, Jean Paul G Vonsattel, Phyllis L Faust
Journal: Cerebellum Ataxias (2018)
Keywords: cerebellum, essential tremor, inferior olivary nucleus, neurodegenerative, pathology, purkinje cell
MeSH terms: Case Reports

Background:
In traditional models of essential tremor, the inferior olivary nucleus was posited to play a central role as the pacemaker for the tremor. However, recent data call this disease model into question.
Case presentation:
Our patient had progressive, long-standing, familial essential tremor. Upper limb tremor began at age 10 and worsened over time. It continued to worsen during the nine-year period he was enrolled in our brain donation program (age 85 - 94 years), during which time the tremor moved from the moderate to severe range on examination. On postmortem examination at age 94, there were degenerative changes in the cerebellar cortex, as have been described in the essential tremor literature. Additionally, there was marked degeneration of the inferior olivary nucleus, which was presumed to be of more recent onset. Such degeneration has not been previously described in essential tremor postmortems. Despite the presence of this degeneration, the patient's tremor not only persisted but it continued to worsen during the final decade of his life.
Conclusions:
Although the pathophysiology of essential tremor is not completely understood, evidence such as this suggests that the inferior olivary nucleus does not play a critical role in the generation of tremor in these patients.
Docetaxel-Induced Systemic Sclerosis with Internal Organ Involvement Masquerading as Congestive Heart Failure
Authors: Bumsoo Park, Raghavendra C Vemulapalli, Amit Gupta, Maria E Shreve, Della A Rees
Journal: Case Reports Immunol (2017)
MeSH terms: Case Reports

Systemic sclerosis, or scleroderma, is a complex medical disorder characterized by limited or diffuse skin thickening with frequent involvement of internal organs such as lungs, gastrointestinal tract, or kidneys. Docetaxel is a chemotherapeutic agent which has been associated with cutaneous side effects. An uncommon cutaneous side effect of docetaxel is scleroderma-like skin changes that extend from limited to diffuse cutaneous systemic sclerosis. Several case reports have been published regarding the association of docetaxel and systemic sclerosis. However, those reports demonstrated the association between docetaxel and scleroderma-like skin changes without internal organ involvement. Here, we report a case of systemic sclerosis with pulmonary arterial hypertension and a microangiopathic kidney involvement induced by docetaxel chemotherapy. After an exhaustive literature review, this could be the first case of docetaxel-induced systemic sclerosis involving internal organs.
Laryngeal Inflammatory Pseudotumour Secondary to Mycobacterium kansasii
Authors: Saif Al-Zahid, Tanwen Wright, Philip Reece
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Background:
Inflammatory pseudotumours (IPT) are rare benign tumours characterised by spindle-shaped histiocyte proliferation often mimicking a soft tissue sarcoma. They can occur in different parts of the body and various aetiological factors have been proposed. To our knowledge this is the first case report of IPT of the larynx caused by mycobacterial disease.
Case report:
We report a case of IPT of the larynx in an immunocompromised 81-year-old lady presenting with stridor and dysphagia with known disseminated Mycobacterium kansasii of the lungs.
Conclusion:
This case demonstrates both the clinical and histological difficulties in making the diagnosis of IPT. A high index of suspicion is needed, and the importance of a multidisciplinary approach in the work-up, diagnosis, and management is highlighted.
Surgery, adjuvant immunotherapy plus chemotherapy and radiotherapy for primary malignant melanoma of the parotid gland (PGMM): A case report
Authors: Qiang Zhao, Zhi-Ke Li, Yan Gui, Dai-Yuan Ma, Guo-Bo Du, Xian-Fu Li
Journal: Open Life Sci (2023)
Keywords: adjuvant immunotherapy, combination therapy, parotid gland, primary malignant melanoma, radiotherapy
MeSH terms: Case Reports

Primary malignant melanoma of the parotid gland (PGMM) is extremely rare, with a poor prognosis. Surgery is the main treatment option followed by adjuvant treatments such as radiotherapy, but which adjuvant treatment to be optimal is still controversial. In this case, a 63-year-old male PGMM patient was first misdiagnosed as a "myoepithelial tumor" and then treated with surgery, postoperative immunotherapy (sintilimab), chemotherapy, and radiotherapy successfully. The progression free survival was more than 19 months without signs of metastasis or recurrence to date. To our best knowledge, this is the first report of postoperative immunotherapy combined with chemotherapy and radiotherapy for PGMM. Our case indicated that combination therapy including surgery, adjuvant immunotherapy (sintilimab) combined with chemotherapy and radiotherapy may be a potential treatment option for PGMM, which needs further research.
Rare congenital chromosomal aberration dic(X;Y)(p22.33;p11.32) in a patient with primary myelofibrosis
Authors: Lenka Pavlistova, Silvia Izakova, Zuzana Zemanova, Lucie Bartuskova, Martina Langova, Pavlina Malikova, Kyra Michalova
Journal: Mol Cytogenet (2016)
Keywords: klinefelter syndrome variant, léri-weill dyschondrosteosis, dic(x, y)(p2233, p1132)
MeSH terms: Case Reports

Background:
Constitutional translocations between sex chromosomes are rather rare in humans with breakpoints at Xp11 and Yq11 as the most frequent. Breakpoints on the short arm of the Y chromosome form one subgroup of t(X;Y), giving rise to a derived chromosome with the centromeres of both the X and Y chromosomes, dic(X;Y). Here, we report a rare congenital chromosomal aberration, 46,X,dic(X;Y)(p22.33;p11.32)[20]/45,X[10], in an adult male.
Case presentation:
Primary myelofibrosis, a malignant haematological disease, was diagnosed in a 63-year-old man following liver transplantation after hepatocellular carcinoma. By the analysis of the bone marrow sample, the karyotype 46,X,dic(X;Y)(p22.33;p11.32) was detected in all the mitoses analysed and verified with multicolour fluorescence in situ hybridization (mFISH). A cytogenetic examination of stimulated peripheral blood cells revealed the constitutional karyotype 46,X,dic(X;Y)(p22.33;p11.32)[20]/45,X[10]. The cell line 45,X was confirmed with FISH in 35 % of interphase nuclei. The SRY locus was present on the dicentric chromosome. A CGH/SNP array (Illumina) revealed a gain of 153,7 Mbp of the X chromosome and a 803-kbp microdeletion (including the SHOX gene), which were also confirmed with FISH. SHOX encodes a transcriptional factor that regulates the growth of the long bones. The deletion of the SHOX gene together with the Madelung deformity of the forearm and the short stature of the proband led to a diagnosis of Léri-Weill dyschondrosteosis (LWD). The gain of almost the whole X chromosome (153,7 Mbp) was considered a variant of Klinefelter syndrome (KS). The levels of gonadotropins and testosterone were consistent with gonadal dysfunction. A malformation of the right external ear was detected.
Conclusions:
We have reported a structural aberration of the sex chromosomes, dic(X;Y)(p22.33;p11.32). The related genomic imbalance is associated with two known hereditary syndromes, LWD and a KS variant, identified in our proband at an advanced age. Because the breakpoints did not involve cancer genes, we inferred that the two malignancies in the proband were not caused by this abnormality. The possible influence of SHOX haploinsufficiency on the growth regulation of auricular chondrocytes is discussed.
A Rare Anomaly of Biliary System: MRCP Evidence of a Cystic Duct Cyst
Authors: Cemil Goya, Mehmet Serif Arslan, Alpaslan Yavuz, Cihad Hamidi, Suzan Kuday, Mehmet Hanifi Okur, Bahattin Aydogdu
Journal: Case Rep Radiol (2014)

Cystic duct cysts are a rare congenital anomaly. While the other bile duct cysts (choledochus and the intrahepatic bile ducts) are classified according to the classification described by Tadoni, there is no classification method described by the cystic duct cysts, although it is claimed that the cystic duct cysts may constitute a new "Type 6" category. Only a limited number of patients with cystic duct cysts have been reported in the literature. The diagnosis is usually made in the neonatal period or during childhood. The clinical symptoms are nonspecific and usually include pain in the right upper quadrant and jaundice. The condition may also present with biliary colic, cholangitis, cholelithiasis, or pancreatitis. In our case, the abdominal ultrasonography (US) performed on a 6-year-old female patient who presented with pain in the right upper quadrant pointed out an anechoic cyst at the neck of the gall bladder. Based on the magnetic resonance cholangiopancreatography (MRCP) results, a cystic dilatation was diagnosed in the cystic duct. The aim of this case-report presentation was to discuss the US and MRCP findings of the cystic dilatation of cystic duct, which is an extremely rare condition, in the light of the literature information.
Pulmonary blastoma: a case report and brief review of the literature of tumor-induced hypoglycemia
Authors: Mohammad Reza Mohajeri Tehrani, Ali Ghorbani Abdehgah, Behnam Molavi, Salma Sefidbakht, Ali Reza Maleki, Amir Reza Radmard
Journal: J Diabetes Metab Disord (2016)
Keywords: case report, pulmonary blastoma, tumor induced hypoglycemia
MeSH terms: Case Reports

Background:
Tumor induced hypoglycemia (TIH) is a rare clinical entity that can be caused by different mechanisms such as secretion of various substances, autoimmune disorders, massive tumoral infiltration of liver, and pituitary or adrenal glands destruction by tumors. Furthermore, any type of neoplasms can cause TIH.
Case presentation:
The patient presented with a case of classic biphasic pulmonary blastoma (CBPB) with hypoglycemia. Chest CT scan showed 2 huge masses in the right hemi-thorax and multiple smaller masses located in the left hemi-thorax. The patient underwent surgery, and was referred to an oncologist for adjuvant therapy.
Conclusion:
CBPB is a rare primary lung tumor with poor prognosis. They are classically large, symptomatic tumors with lymph node metastasis. Surgical resection at early stages has been more effective than other treatments; however, there is no standard treatment in unresectable cases. Adjuvant treatments have been temporarily effective.
A Patient-Matched Entire First Metacarpal Prosthesis in Treatment of Giant Cell Tumor of Bone
Authors: Thipachart Punyaratabandhu, Boonrat Lohwongwatana, Chedtha Puncreobutr, Arkaphat Kosiyatrakul, Puwadon Veerapan, Suriya Luenam
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Giant cell tumor of the bones occurring in the first metacarpals frequently requires entire metacarpal resection due to the aggressive nature and high rate of recurrence. Bone reconstruction can be performed with autogenous bone grafts. Here we describe a new technique of reconstruction using a patient-matched three-dimensional printed titanium first metacarpal prosthesis. This prosthesis has a special design for ligament reconstruction in the proximal and distal portions. Good hand function and aesthetic appearance were maintained at a 24-month follow-up visit. This reconstructive technique can avoid donor-site complications and spare the autogenous bone grafts for revision options.
Interstitial Lung Disease-Complicated Anti-MDA5 Antibody in Clinically Amyopathic Dermatomyositis Patients: Report of Two Cases With Distinct Clinical Features
Authors: Laurence Pacot, Jacques Pouchot, Nicolas De Prost, Marie Senant, Eric Tartour, Françoise Le Pimpec-Barthes, Dominique Israel-Biet, Marie-Agnes Dragon-Durey
Journal: Front Med (Lausanne) (2020)
Keywords: anti-mda5, anti-rejection therapy, autoantibodies, dermatomyositis, interstitial lung disease, lung transplantation, skin rash
MeSH terms: Case Reports

Two patients presented simultaneously to our hospital with distinct clinical features associated with the presence of anti-MDA5 antibodies: the first one was admitted for a skin rash resembling to a toxic epidermal necrosis (Lyell syndrome) and the second one presented with pulmonary manifestations attributed to a diffuse fibrosing interstitial pneumonitis on chest CT-scan. In addition to the skin lesions involving 40% of the body surface area, the first patient developed a rapid diffuse interstitial pneumonitis with respiratory distress justifying the initiation of a systemic immunosuppressive treatment. However, she died 3 weeks after her admission from mesenteric thrombosis associated with septic shock. The second patient respiratory condition worsened despite an intensive immunosuppressive treatment with high doses of intravenous methylprednisolone and cyclophosphamide and plasmapheresis, and required lung transplantation. Anti-MDA5 antibody titer declined and disappeared on anti-rejection treatment. These two cases underline the diagnostic conundrum and the therapeutic difficulties in patients with anti-MDA5 antibodies and clinically amyopathic dermatomyositis (CADM) or interstitial lung disease (ILD), who may undergo rapidly-progressive and fatal outcome. Presence of anti-MDA5 antibodies should always be suspected when confronted to CADM patients with cutaneous ulcerations or ILD to allow a rapid and adapted treatment initiation.
Camptocormia in an Adolescent: A Case Report and Review of the Literature
Authors: Laura Kaplan, Erik Aurigemma, Timothy Sullivan, Richard Sidlow
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Camptocormia, or bent-spine syndrome, is an entity with a long history and many etiologies. We discuss below both the history of this diagnosis in light of a rare case of psychogenic camptocormia and the recent changes in nosology regarding this disorder.
Complex balanced chromosomal translocation t(2;5;13) (p21;p15;q22) in a woman with four reproductive failures
Authors: Ewelina Lazarczyk, Malgorzata Drozniewska, Magdalena Pasinska, Beata Stasiewicz-Jarocka, Alina T Midro, Olga Haus
Journal: Mol Cytogenet (2014)
Keywords: balanced complex translocation (bct), complex chromosome rearrangement (ccr), conventional cytogenetics (cc), fluorescence in situ hybridization (fish), reciprocal chromosomal translocation (rct), reproductive failure
MeSH terms: Case Reports

Background:
Balanced complex translocations (BCTs) are rare events, they may result in reproductive failures: spontaneous abortions, missed abortions, stillbirths, congenital malformations in children, and male infertility. BCTs belong to the group of complex chromosome rearrangements (CCRs) - up to date about 260 cases were described.
Results:
The described patient and her husband were referred to genetic counseling clinic because of four reproductive failures. GTG-banded chromosome analysis revealed presence of apparently balanced complex translocation t(2;5;13), which was verified and confirmed by molecular cytogenetics with single copy probes. This complex aberration was most likely responsible for reproductive failures in our patient. Since no high resolution molecular karyotyping (microarrays) was used, this rearrangement can only be considered to be balanced at cytogenetic level.
Discussion:
Due to small number of reported cases of CCRs/BCTs and individual as well as unique character of such rearrangements, genetic counseling for CCRs carriers is complex and requires detailed pedigree analysis, as well as extended clinical and genetic testing.
Cholecystomegaly: A Case Report and Review of the Literature
Authors: Mohammad Bagher Jahantab, Vahid Salehi, Saadat Mehrabi, Lotfolah Abedini, Mohammad Javad Yavari Barhaghtalab
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Chronic cholecystitis or symptomatic gallbladder is a prolonged mechanical or functional disorder of abnormal gallbladder emptying. Most of the patients have recurrent pain attacks (acute biliary colic), but when pain lasts more than 24 hours, it requires urgent surgical intervention (acute cholecystitis). The length of a fully distended gallbladder is about 7 to 10 cm. We report a case of a huge and severely inflamed gallbladder, as we have just found only a few previous case reports of the huge gallbladder in the literature. This case report and review may help to find a mechanism for the development of a giant gallbladder. The patient was a 36-year-old woman, who had been known to have a symptomatic gallstone for at least three years. The patient underwent laparotomy, and a giant 22 cm roundish severely inflamed and overdistended gallbladder with wall thickening and tight adhesion to adjacent organs was found under the right liver lobe. Femininity and diabetes seem to be risk factors for developing a huge gallbladder, and several hypotheses are encountered: (1) a long-lasting obstructed cystic duct or biliary tree, and accumulation of mucosal secretion from the gallbladder epithelium, (2) an obstructed hepatic/cystic duct junction with a stone acting like a check valve and bile trapping mechanism, and (3) gallbladder dysfunction and cholecystoparesis affecting through reduced cholecystokinin and celiac parasympathetic nerve disturbance in diabetes and diabetic autonomic neuropathy. Open cholecystectomy is the technique of choice in surgical excision of a huge gallbladder; however, laparoscopy could be performed by expert hands.
Prolonged central nervous system and respiratory depression in preterm neonates after exposure to brimonidine tartrate and timolol maleate ophthalmic drops
Authors: Corrina P Azarcon, Darby E Santiago
Journal: GMS Ophthalmol Cases (2020)
Keywords: apnea, brimonidine tartrate, central nervous system depression, preterm neonates, timolol maleate
MeSH terms: Case Reports

Objective: We report three cases of preterm neonates who presented with central nervous system (CNS) and respiratory depression after inadvertent exposure to brimonidine tartrate 0.2% and timolol maleate 0.5% fixed-combination ophthalmic drops. Case descriptions: CNS and respiratory depression were observed in the three neonates within two hours of administration of brimonidine tartrate 0.2% and timolol maleate 0.5% eye drops. Respiratory support was initiated upon admission to the neonatal intensive care unit (NICU). The effects of the drug combination lasted for 24 to 48 hours. Conclusion: This case series suggests that the drug combination of brimonidine tartrate and timolol maleate causes a prolonged depression of the central nervous and respiratory systems in preterm neonates.