OpenMed/multicare-articles huggingface dataset:
Appendiceal neurofibroma with low-grade appendiceal mucinous neoplasm in neurofibromatosis type 1 patient: A case report
Authors: Toshiaki Komo, Koichi Oishi, Toshihiko Kohashi, Jun Hihara, Masanori Yoshimitsu, Noriaki Tokumoto, Mikihiro Kanou, Akira Nakashima, Yoshirou Aoki, Manabu Shimomura, Masashi Miguchi, Mahito Funakoshi, Hidenori Mukaida, Mayumi Kaneko, Hiroo Matuura, Naoki Hirabayashi
Journal: Int J Surg Case Rep (2018)
Keywords: appendiceal neurofibroma, low-grade appendiceal mucinous neoplasm, neurofibromatosis type 1, von recklinghausen’s disease

Introduction:
Neurofibromas are a characteristic of the autosomal dominant disorder Neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease. Appendiceal neurofibromas are extremely rare, and low-grade appendiceal mucinous neoplasms (LAMNs) have not previously been reported in NF1.
Presentation of case:
A 62-year-old man with NF1 was scheduled for elective surgical treatment of an asymptomatic, enlarged and diffusely thickened appendix that remained after curative antimicrobial treatment of acute appendicitis. Laboratory analysis revealed all normal. Colonoscopy showed thickened appendiceal mucosa projecting into the cecum. A sample of the mucosa was found to be pathologically benign. The patient was preoperatively diagnosed with treated acute appendicitis with chronic appendiceal inflammation versus appendiceal neoplasms. Laparoscopic cecectomy was performed. Multiple neurofibromas were observed in the muscle layer, submucosa, and mucosa of the appendix on histopathological examination. Immunohistochemical examination showed positive staining for S-100. Pathologically, the patient was diagnosed with appendiceal neurofibroma consistent with NF1 with LAMNs. His postoperative course was unremarkable. He was discharged on post-operative day 3 and remained in good health 7 month after surgery.
Conclusions:
Appendiceal neurofibromas are often preoperatively diagnosed as appendicitis. Appendiceal neurofibromas should be considered in patients with NF1 who are suspected of having appendicitis.
A case report: Pavlovian conditioning as a risk factor of heroin 'overdose' death
Authors: József Gerevich, Erika Bácskai, Lajos Farkas, Zoltán Danics
Journal: Harm Reduct J (2005)

Background:
The authors present a case illustrating a mechanism leading directly to death which is not rare but has received little attention.
Case presentation:
The case was evaluated by autopsy, investigation of morphine concentration in the blood, and clinical data. The heroin dose causing the 'overdose' death of a young man who had previously been treated a number of times for heroin addiction did not differ from his dose of the previous day taken in the accustomed circumstances. The accustomed dose taken in a strange environment caused fatal complications because the conditioned tolerance failed to operate. The concentration of morphine in the blood did not exceed the level measured during earlier treatment.
Conclusion:
These results are in line with the data in the literature indicating that morphine concentrations measured in cases of drug-related death do not differ substantially from those measured in cases where the outcome is not fatal. A knowledge of the conditioning mechanism can contribute to prevention of fatal cases of a similar type. The harm reduction approach places great stress on preventive intervention based on data related to drug-related death.
Intraoperative endoprosthesis customization for repair of an aortoenteric fistula in an emergency context: a case report
Authors: Hugo Back Carrijo, Josué Rafael Ferreira Cunha, Carlos André Schuler, Marcos Aurélio Perciano Borges
Journal: J Vasc Bras (2021)
Keywords: aortic aneurysm, aortoenteric fistula, endovascular procedures, modified endografts
MeSH terms: Case Reports

Aortoenteric fistula is a severe clinical condition and its management remains a major technical challenge for surgeons. In these cases, the conventional surgical approach is associated with high rates of morbidity and mortality. Endovascular surgery is an excellent option in these cases, but considering that the aorta has been treated previously, anatomy may not be compatible with commercially available endovascular devices and so physician-modified endografts may be needed in urgent cases. The case reported involves a secondary aortoenteric fistula, treated on an emergency basis with endovascular techniques, using a physician-modified endograft.
Growth hormone deficiency in a patient with becker muscular dystrophy: a pediatric case report
Authors: Valeria Calcaterra, Annachiara Malvezzi, Rossana Toglia, Angela Berardinelli, Elena Bozzola, Mauro Bozzola, Daniela Larizza
Journal: Case Rep Endocrinol (2013)

Objective. To describe a biochemical growth hormone (GH) deficiency and to evaluate therapeutic result in a six-year-old male with Becker muscular dystrophy (BMD). Methods. GH peak was evaluated after response to arginine and insulin. Bone age was evaluated according to Greulich and Pyle method. Results. The GH-supplementary therapy was very effective in terms of growth gain. Conclusion. The possibility of a growth hormone deficiency and treatment with GH in patients with BMD cannot be excluded, especially considering the good therapeutic response.
Streptococcus constellatus Causing Septic Thrombophlebitis of the Right Ovarian Vein with Extension into the Inferior Vena Cava
Authors: Abdallah Haidar, Amy Haddad, Amir Naqvi, Ngozi U Onyesoh, Rushdah Malik, Michael Williams
Journal: Case Rep Infect Dis (2015)

Introduction. Streptococcus constellatus collectively with Streptococcus anginosus and Streptococcus intermedius constitute the Streptococcus anginosus (formerly Streptococcus milleri) group. Though they are commonly associated with abscesses, bacteremia with subsequent septic thrombophlebitis is extremely rare, and resulting mortality is infrequent. Case Presentation. We report a case of a previously healthy 60-year-old African American female who presented with Streptococcus constellatus bacteremia associated with septic thrombophlebitis to the right ovarian vein extending into the inferior vena cava. She was urgently treated with antibiotics and anticoagulation. Conclusion. Septic thrombophlebitis has a clinical presentation that is often misleading. Therefore, a high clinical index of suspicion and the use of appropriate imaging modalities (computed tomography) are essential in recognizing and confirming this diagnosis. Prompt treatment is warranted. Surgical thrombectomies have been successfully replaced by a combination of antibiotics and anticoagulation therapy.
A Rare Case of Transient Proximal Renal Tubular Acidosis in Pregnancy
Authors: Dennis Narcisse, Manyoo Agarwal, Aneel Kumar
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

Renal tubular acidosis (RTA) is a disorder that has improper function of renal acid-base regulation and is rarely encountered during pregnancy. Currently, there is no clear evidence on management and outcomes in patients with this condition. We report a case of a previously healthy 23-year-old female at 30 weeks of gestation who presented with proximal RTA and had spontaneous resolution of the condition shortly after delivery.
Acute suppurative thyroiditis caused by thyroid papillary carcinoma in the right thyroid lobe of a healthy woman
Authors: Hazuki Otani, Masakazu Notsu, Sayo Koike, Miwa Morita, Masahiro Yamamoto, Mika Yamauchi, Takahumi Fuchiwaki, Ichiro Morikura, Noriaki Aoi, Hideyuki Kawauchi, Teruaki Iwabashi, Asuka Araki, Noriyoshi Ishikawa, Riruke Maruyama, Toshitsugu Sugimoto
Journal: Thyroid Res (2018)
Keywords: acute suppurative thyroiditis, bacterial infection, fine needle aspiration, malignant tumor, papillary thyroid carcinoma, piriform sinus fistula
MeSH terms: Case Reports

Background:
The thyroid gland is resistant to microbial infection, because of its organ characteristics such as encapsulation, iodine content, and rich blood supply. Therefore, acute suppurative thyroiditis (AST), as a bacterial infection of the thyroid gland, is rarely seen. AST typically takes places on the left side the neck region in children, because of the coincidence of the left piriform sinus fistula, as a most common route of infection. AST is also usually seen in immunocompromised hosts. Herein, we report a rare case of AST in the right thyroid lobe of adult woman without any immunocompromised condition.
Case presentation:
A 59-year-old woman was introduced to our hospital for the further examination with fever, sore throat, and right anterior neck swelling. The patient appeared not to be immunodeficient. Neck ultrasonography showed a 47-mm, hypoechoic, heterogeneous nodule with ill-defined margins and irregular form, suggesting a right thyroid malignant nodule. Fine needle aspiration (FNA) biopsy specimen revealed numerous number of neutrophils in the background without nuclear atypia. Based on the clinical course and cytology, AST was confirmed to be diagnosed. Complete response was obtained by an intravenous administration of antimicrobial agents within a week. Image findings such as CT scan did not show any piriform sinus fistula. Four months later, neck ultrasonography showed a significant decrease in size of the nodule in the right thyroid gland to 27 mm, but the lesion still resembled a malignant nodule. So, FNA was repeated again and cytological examination confirmed papillary thyroid carcinoma (PTC). The patient subsequently underwent total thyroidectomy and bilateral level D1 lymph node dissection. Histological findings revealed a 20-mm PTC in the right lobe with sternothyroid muscle invasion of the tumor.
Conclusions:
This report represents a rare case of AST associated with PTC on the right side of thyroid gland, found in a healthy adult woman. The reason why AST coincided with malignant thyroid tumor is unclear. We have to take it into our account that malignant tumor may exist in the background when AST is identified on the right side of thyroid gland with a healthy subject.
Necrotizing Fasciitis Associated with Staphylococcus lugdunensis
Authors: Tony Hung, Soroush Zaghi, Jonathan Yousefzadeh, Matthew Leibowitz
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

Necrotizing fasciitis is a life-threatening soft tissue infection that results in rapid local tissue destruction. Type 1 necrotizing fasciitis is characterized by polymicrobial, synergistic infections that are caused by non-Group A streptococci, aerobic and anaerobic organisms. Type 2 necrotizing fasciitis involves Group A Streptococcus (GAS) with or without a coexisting staphylococcal infection. Here we provide the first report of necrotizing fasciitis jointly associated with the microbes Group B Streptococcus and Staphylococcus lugdunensis. S. lugdunensis is a commensal human skin bacterium known to cause often painful and prolonged skin and soft tissue infections. To our knowledge, however, this is the first case of Staph. lugdunensis-associated necrotizing fasciitis to be reported in the literature.
Spontaneous Regression of Metastatic Papillary Thyroid Cancer in a Lymph Node
Authors: Jien Shim, Jianyu Rao, Run Yu
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Spontaneous regression of cancer is defined as disappearance of cancer in the absence of specific therapy. In thyroid cancer patients with biochemically incomplete response to initial treatments, spontaneous decline in thyroglobulin levels without any cancer treatment is a well-known phenomenon; however, spontaneous regression of persistent or recurrent structural disease has not been reported. We here present a case of papillary thyroid cancer in a 58-year-old female who underwent total thyroidectomy and two radioiodine ablations. She had persistently elevated thyroglobulin levels. Six years after her initial treatments, she had biopsy-proven cervical lymph node metastasis. The patient opted not to undergo any further treatment. Over the course of the next 10 years, without any additional treatment, the lymph node disappeared and her thyroglobulin levels decreased to almost undetectable ranges, implying near-complete regression. Our case illustrates that metastatic papillary thyroid cancer in lymph nodes can regress spontaneously.
Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review
Authors: Reza Hali, Mohammadbagher Sharifkazemi, Ahmad Yaminisharif, Jamshid Bagheri, Narges Shahbazi
Journal: Front Cardiovasc Med (2023)
Keywords: viridans streptococci, anti-bacterial agents, cardiac infection, endocarditis, mycotic coronary aneurysm
MeSH terms: Case Reports

Although mycotic aneurysm is a known and important disease in the cerebrovascular system, especially the brain, there are scarce reports about coronary artery mycotic aneurysms (CAMA). CAMA can occur not only in the context of endocarditis but also as a rare adverse event of coronary artery stenting, which has been used more extensively in recent years. Accordingly, it is essential to pay greater attention to its associated presentations and clinical course. Considering the scant evidence available, reporting the disease course of each patient with CAMA can help increase the physician's knowledge about this condition, which is why we are reporting this case. A 42-year-old man with diabetes was referred to our center with embolic left cerebellar infarction 3 months earlier, as well as a 2-month history of feverishness before his referral. His blood culture was positive for Viridans Streptococci, and he had paraclinical signs of inflammation and two- and three-dimensional transthoracic and transesophageal echocardiography (2D & 3D TTE and TEE) signs of aortic and mitral valves' infective endocarditis with the destruction of the aortic valve, severe aortic and mitral regurgitation, severe pulmonary hypertension, and moderate biventricular systolic dysfunction. Regarding the obviously dilated left main coronary artery on TEE images, contrast-enhanced chest multidetector computed tomography was performed for better assessment of coronary arteries with suspicion of CAMA, which confirmed aneurysmal dilatation of the proximal left main coronary artery. The presence of bacteria was confirmed on staining the valvular tissue, resected during the surgical replacement of aortic and mitral valves. As the cardiac surgeon considered CAMA resection and coronary bypass grafting high risk for the patient, he received parenteral antibiotic therapy, for 6 weeks. At 1-year follow-up, he was doing well with no signs/symptoms of endocarditis and well-functioning mechanical prosthetic valves. This case shows the significance of considering CAMA in the setting of endocarditis, resistant to medical and/or surgical therapy or in patients with coronary aneurysm, simultaneous with active endocarditis. Therefore, more attention should be paid to this extravalvular complication of endocarditis, and its possibility should be considered and investigated in any patient presented with valvular endocarditis, especially involving the aortic valve.
Laparoscopic uteroovarian ligament truncation and uterosacral oophoropexy for idiopathic recurrent ovarian torsion: case report and review of literature
Authors: Paula C Brady, Aaron K Styer
Journal: Fertil Res Pract (2015)
Keywords: laparoscopy, oophoropexy, recurrent, torsion, uteroovarian ligament fixation
MeSH terms: Case Reports

Background:
Unilateral recurrent ovarian torsion in adults is unusual following treatment of common underlying risk factors (e.g. benign cysts). Subtle anatomic etiologies, such as an elongated uteroovarian ligament and robust ovarian volume, are commonly underappreciated and may contribute to idiopathic recurrent unilateral torsion in adults. As seen in this case, combined surgical procedures may be required to prevent recurrence.
Case:
28 year old nulligravid woman with seven episodes of right ovarian torsion (without adnexal pathology)-six of those within 18 months-refractory to a series of previous surgical interventions. Laparoscopic uteroovarian ligament truncation with interval uterosacral ligament oophoropexy was employed. Ovarian torsion has not occurred in 45 months.
Conclusion:
Uteroovarian ligament truncation and uterosacral ligament oophoropexy is a feasible and effective combined surgical approach for the prevention of recurrent idiopathic ovarian torsion in adults without obvious risk factors.
A case report of adenofibroma arising from the seminal vesicle: A rare giant pelvic mass
Authors: Youyi Lu, Di Sun, Jitao Wu
Journal: Front Oncol (2022)
Keywords: adenofibroma, case report, pelvic mass, rare, seminal vesicle, tumor
MeSH terms: Case Reports

Primary seminal vesicle tumors are extremely rare. Several rare pathological types of primary seminal vesicle tumors have been reported, such as adenocarcinoma, but there is no report on adenofibroma. We report the first case of adenofibroma arising from the seminal vesicle. A 50-year-old man, with no history or clinical evidence of any other tumors, accidentally found a pelvic mass during an ultrasound examination. As the mass grew, the patient developed mild constipation, without genitourinary or other symptoms. All laboratory examinations were normal. MRI of the pelvis revealed a mixed density, measuring 11.7×9.9×8.2cm, well circumscribed mass. The rectum, bladder, prostate and lymph nodes were normal. We successfully performed the open surgery and removed the mass. Histopathological results confirmed that the mass was a primary seminal vesicle adenofibroma. In literature, we found that for biphasic differentiated tumors, it is easy to reduce the accuracy of pathological diagnosis because of insufficient puncture. Therefore, preoperative puncture biopsy for seminal vesicle tumors should be investigated further.
Pathophysiology and management of risperidone-induced sialorrhea: case report
Authors: Tyler Torrico, Angad Kahlon
Journal: Front Psychiatry (2023)
Keywords: adverse reactions, antipsychotics, iloperidone, psychopharmacology, schizophrenia, second-generation antipsychotics
MeSH terms: Case Reports

Background:
Among antipsychotics, sialorrhea is most associated with clozapine, and when it occurs, it is uncomfortable, socially stigmatizing, and can contribute to medication non-adherence. Risperidone has a generally negligible muscarinic activity compared to clozapine, and yet, multiple reports of severe sialorrhea associated with risperidone have been reported.
Case presentation:
This case report describes risperidone-induced sialorrhea that was unintentionally masked by simultaneous clonidine administration that was intended to treat hypertension. Interestingly, sialorrhea was present but mild when clonidine was present; however, when risperidone was further titrated and clonidine removed, a significant worsening of sialorrhea developed. Sialorrhea did not respond to treatment with anticholinergic medication.
Conclusion:
The pathophysiology of antipsychotic-induced sialorrhea is complex and varies between antipsychotics. Risperidone-induced sialorrhea is suspected of having prominent adrenergic pathophysiology that is likely composed of highly viscoelastic saliva (high protein content), differing from the more commonly encountered clozapine-induced sialorrhea. Risperidone-induced sialorrhea is reported as more likely to respond to dose reduction and treatment with α2-adrenergic receptor agonists or β-adrenergic receptor antagonists and less likely to respond to anticholinergic (antimuscarinic) medications.
A case of acquired von Willebrand disease in severe pediatric pulmonary hypertension contributing to bleeding following reverse Potts shunt
Authors: Rachel T Sullivan, Clara Lo, Elisabeth Martin, Rebecca J Kameny, Rachel K Hopper
Journal: Pulm Circ (2022)
Keywords: pediatric cardiovascular disease, pulmonary arterial hypertension, von willebrand factor
MeSH terms: Case Reports

The reverse Potts shunt is increasingly used as a palliative measure for end-stage pulmonary arterial hypertension (PAH) as a means to offload the right ventricle and improve functional status. This case report describes a child who developed significant hemothorax after reverse Potts shunt that required surgical exploration, blood product administration, and prolonged intensive care hospitalization. Despite lack of preoperative bleeding symptoms, testing revealed acquired von Willebrand disease (aVWD), with subsequent resolution of bleeding. Alterations in von Willebrand factor, including aVWD, have been reported in children with severe PAH but have not previously been associated with bleeding after reverse Potts shunt procedure. As bleeding is a recognized postoperative morbidity in PAH patients undergoing reverse Potts shunt, we highlight a potential role for preoperative testing for aVWD as perioperative factor replacement therapy may improve postoperative outcomes.
Penile Keloid Successfully Cured in a Keloid High-Tendency Patient
Authors: Izzeddin J Abualjubain, Muath Mamdouh Mahmod Al-Chalabi, Shawaltul Akhma Harun Nor Rashid, Wan Azman Wan Sulaiman
Journal: Cureus (2023)
Keywords: keloid, keloid scar, keloid therapy, keloid treatment, penile keloid
MeSH terms: Case Reports

Keloid scars are a relatively common condition but extremely rare in the penis. This case aims to be added to the previous 34 cases of penile keloid reported in the literature. We present the case of a 15-year-old patient with a high keloid-forming tendency who was successfully cured of penile keloid scarring with excision alone and without any adjuvant therapy. No recurrence was reported over eight years of follow-up. In contrast, at the same time, recurrence is frequently observed in other body parts after excision, making this particular part of the body an area of less keloid occurrence and recurrence.
A new childhood ALL case with an extremely complex karyotype and acute spontaneous tumor lysis syndrome
Authors: Abdulsamad Wafa, Rami A Jarjour, Doaa Alolabi, Thomas Liehr, Othman Hamdan, Joana B Melo, Isabel M Carreira, Moneeb A K Othman, Walid Al-Achkar
Journal: Mol Cytogenet (2020)
Keywords: acute lymphoblastic leukemia (all), array comparative genomic hybridization (acgh), complex karyotype (ck), molecular cytogenetics, prognostic factors, tumor lysis syndrome (tls)
MeSH terms: Case Reports

Background:
B cell precursor acute lymphoblastic leukemia (B-ALL) is the most common malignancy of childhood, with, after corresponding treatment, an overall complete remission rate of 90%. Approximately 75% of B-ALL cases harbor recurrent abnormalities, including so-called complex karyotypes (CK). Tumor lysis syndrome (TLS) is a metabolic abnormality which may arise during cancer therapy and also, extremely rarely, as spontaneous TLS before initiation of chemotherapy in patients with ALL.
Case presentation:
Here we report a 9-year-old male, diagnosed with a de novo pre-B-ALL according to the WHO classification. Cytogenetic, molecular cytogenetic approaches and array comparative genomic hybridization analyses revealed a unique CK involving five chromosomes. It included four yet unreported chromosomal aberrations: a der(11)t(7;11)(p22.1;q24.2), a der(18)t(7;18)(q21.3;p11.22), del(11)(q24.2q25) and dup(18)(q11.1q23). Unfortunately, the patient died 3 months after the initial diagnosis.
Conclusions:
To the best of our knowledge, a comparable childhood ALL case was not previously reported. Thus, the combination of the here seen chromosomal aberrations in childhood primary ALL seems to indicate for an extremely adverse prognosis.
Early recognition of h-type tracheoesophageal fistula
Authors: Muhammad Riazulhaq, Elbagir Elhassan
Journal: APSP J Case Rep (2012)
Keywords: atresia, esophagus, h-type, tracheoesophageal fistula
MeSH terms: Case Reports

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly. Diagnosis in neonatal period is usually not made and most of the patients are treated as cases of pneumonia. A case of H-type of tracheoesophageal fistula, diagnosed within 24 hours of delivery based upon choking and cyanosis on first trial of feed, is being reported. Diagnosis was confirmed with contrast esophagram. Through cervical approach fistula was repaired and baby had uneventful post operative outcome.