OpenMed/multicare-articles huggingface dataset:
Chondro-Osseous Metaplasia in Ependymoma: A Rare Histopathological Finding
Authors: Ali Alkhaibary, Fahd AlSufiani, Ali H Alassiri, Makki Almuntashri, Salma Tarik Al Qutub
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Ependymoma is a circumscribed glioma composed of uniform glial cells with bland nuclei in a fibrillary matrix. It is characterized by the presence of perivascular pseudorosettes. Unusual histopathological findings have rarely been reported in ependymomas, 0.5% of all diagnosed cases. Such unusual and exceedingly rare histological findings include osseous or chondroid metaplasia. To the best of our knowledge, only 15 cases of osseocartilaginous ependymomas have been reported in English literature. We report a 3-year-old boy who presented with ataxia, vomiting, and headache for three months. Radiological imaging revealed a posterior fossa lesion. Histopathological examination of the lesion confirmed a posterior fossa ependymoma with chondro-osseous metaplasia. The present case outlines the clinical presentation, histopathological findings, and outcome of chondro-osseous metaplasia in ependymomas. To date, the etiology of chondro-osseous metaplasia in ependymomas remains uncertain. Further research exploring such phenomenon is of paramount importance to explain how these tumors develop.
A true aneurysm of the zygomatic orbital artery: first case report in the literature
Authors: Valentina Molinaro, Elisa Pagliasso, Gianfranco Varetto, Claudio Castagno, Lorenzo Gibello, Pietro Rispoli
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

A 33-year-old man presented with a pulsatile mass in the left temporal region; about 1 year before the current presentation, the swelling had arisen on the upper lateral border of the orbital arch and increased in recent months. His medical history was negative for accidental or iatrogenic head injury. Color echo Doppler and angio-computed tomography demonstrated a fusiform aneurysm of the zygomatic orbital artery, a branch of the superficial temporal artery. Blood tests were negative for human immunodeficiency virus (HIV), hepatitis C (HCV), and hepatitis B (HBV) markers. Aneurysmectomy under local anesthesia was performed. Histology of the surgical specimen confirmed the diagnosis of a true aneurysm measuring 8.4 × 5.7 mm, which showed no atherosclerotic degeneration of the vessel walls; the lumen was filled by a recent thrombus but without inflammatory cells. Surgical treatment is indicated for the prevention of rupture, the relief of pain when present, and the removal of facial defects. To the authors' knowledge, this is the first case in the literature of a true aneurysm of the zygomatic orbital artery.
Reactive Eccrine Syringofibroadenoma on the Heel, Clinically Mimicking Squamous Cell Carcinoma
Authors: Yuri Sugita, Teruhiko Makino, Kotaro Matsui, Tadamichi Shimizu
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

The authors present a case of eccrine syringofibroadenoma that clinically mimicked squamous cell carcinoma and briefly comment on the current knowledge about its clinical and histopathological features and therapeutic options.
A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
Authors: Shahzad Khan, Athanasios Smyrlis, Dmitry Yaranov, David Oelberg, Eric Jimenez
Journal: Case Rep Cardiol (2015)

Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.
Case Report: Notoedric Mange and Aelurostrongylidosis in Two Domestic Cats From Rural Environment in Romania
Authors: Adriana Györke, Mirabela Oana Dumitrache, Aurora Livia Ursache, Gianluca D'Amico, Viorica Mircean
Journal: Front Vet Sci (2022)
Keywords: aelurostrongylus, notoedres, cat, lungworm, mange
MeSH terms: Case Reports

This article describes two cases of notoedric mange concurrent with aelurostrongylidosis in two domestic-owned cats from a rural environment in Romania. Two European shorthair cats originating from the same litter were referred to our clinic, at 2 months apart, with a history of skin lesions, pruritus, weight loss, and respiratory signs. Cats lived mainly outdoor together with the queen and a third littermate. The latter two expressed the same clinical signs and had died before the presentation of the first cat. None of the four cats was vaccinated, dewormed, or treated for external parasites. Coat brushing, skin scrapings, skin cytology, earwax direct microscopic examination, and coproparasitological techniques (flotation and Baermann methods) were used as laboratory procedures. A blood sample was also collected for hematology, blood biochemistry, and feline immunodeficiency virus/feline leukemia virus (FIV/FeLV) test. Notoedres cati mites in high numbers were identified by all complementary tests, alongside fleas and Aelurostrongylus abstrusus first-stage larvae. The blood analysis revealed neutrophilia, and the FIV/FeLV fast test was negative. The cats were successfully treated off-label with selamectin spot-on formulation (Stronghold®, Zoetis) three times at 1- or 4-week intervals. Furthermore, they were treated with amoxicillin trihydrate/clavulanic acid, housed indoor, and fed with a commercial diet. Before presentation to the clinic, the female cat was unsuccessfully treated with a combination of fipronil, S-methoprene, eprinomectin, and praziquantel. During this period, the female cat remained outdoor and fed with home wastes. The cats become negative for A. abstrusus L1 larvae after 2-4 months of treatment. The owners developed pruritic skin lesions 1 month after introducing the first cat in the house. In conclusion, notoedric mange and aelurostrongylidosis can be treated successfully with selamectin as a spot-on formulation and the treatment must be continued until no parasite will be detected through specific techniques. The success of treatment depends on improving the quality of animal life (nutrition and hygiene) and treatment of secondary complications.
Intravenous thrombolysis with rt-PA in stroke: experience of the moroccan stroke unit
Authors: Naima Chtaou, Lamyae Rachdi, Aouatef El Midaoui, Zouhair Souirti, Nils Wahlgren, Mohammed Faouzi Belahsen
Journal: Pan Afr Med J (2016)
Keywords: intravenous thrombolysis, rt-pa, stroke
MeSH terms: Brain Ischemia / drug therapy, Fibrinolytic Agents / administration & dosage, Stroke / drug therapy, Tissue Plasminogen Activator / administration & dosage, Administration, Intravenous, Atrial Fibrillation / complications, Brain Ischemia / etiology, Female, Humans, Hypertension / complications, Male, Middle Aged, Morocco, Risk Factors, Stroke / etiology, Time Factors, Treatment Outcome, Fibrinolytic Agents, Tissue Plasminogen Activator

The majority of strokes are due to blockage of an artery in the brain by a blood clot. Prompt treatment with thrombolytic drugs can restore blood flow before major brain damage has occurred. We report the case series of all patients who were treated with rt-PA at Stroke Unit of HASSAN II University hospital between 2010 and 2013. There were 52 patients treated with intravenous rtPA during the study period. The mean age was 63 years with the no gender predominance (sex ratio 1.02). Hypertension was the most common vascular risk factor (31%) and 17% of patients suffered from atrial fibrillation. 17 of 52 patients (32.7%) were treated within a 3 hours window of stroke onset and 35 of 52 (67.3%) patients were treated within 3-4.5 h. Twenty five patients (48%) had significant early improvements within 24 hours and twenty one (40.3%) patients had good outcomes at 3 months and fifteen patients (29%) died within the same period.
Local resection by combined laparoendoscopic surgery for duodenal gastrointestinal stromal tumor
Authors: Motohiko Kato, Kiyokazu Nakajima, Toshirou Nishida, Makoto Yamasaki, Tsutomu Nishida, Shusaku Tsutsui, Hideharu Ogiyama, Shunsuke Yamamoto, Takuya Yamada, Masaki Mori, Yuichiro Doki, Norio Hayashi
Journal: Diagn Ther Endosc (2011)
MeSH terms: Case Reports

Combined laparoendoscopic surgery is a novel surgical method which consists of both endoscopic surgery from inside the gastrointestinal tract and laparoscopic surgery from the outside. We report a case of duodenal GIST, in which combined laparoendoscopic local resection was attempted. The lesion was resected endoscopically using endoscopic submucosal dissection technique under laparoscopic assistance. Laparoscope was used for originating the orientation of the tumor, intra-operative EUS, and monitoring serosal injury from the peritoneal cavity. Postoperative hemorrhage occurred; however, precise orientation of the lesion helped us to manage the patient with minimal invasive reoperation. And thus, the bowel integrity was completely preserved, by avoiding segmental duodenal resection and pancreaticoduodenectomy. This novel, less invasive surgical procedure may become an attractive option for the lesions originating in the anatomically challenging portion of the GI tract for endoscopic or laparoscopic surgery alone.
Unique ECG Findings in Acute Pulmonary Embolism: STE with Reciprocal Changes and Pathologic Q Wave
Authors: Amanda Grant-Orser, Brennan Ballantyne, Wael Haddara
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

A 68-year-old male presented to the emergency department with retrosternal chest pain, presyncope, and then a pulseless electrical activity cardiac arrest. An ECG prior to his arrest revealed ST elevations in leads V1-V3, Q waves in lead V2, and reciprocal ST depressions in the lateral and inferior leads. He received thrombolytic therapy for a presumptive diagnosis of ST elevation myocardial infarction. Return of spontaneous circulation was achieved and he underwent a coronary angiogram. No critical disease was found and his left ventriculogram showed normal contraction. His ongoing metabolic acidosis and dependence on an intra-aortic balloon pump, despite adequate cardiac output, prompted a CT pulmonary angiogram which showed multiple segmental filling defects. He was treated for a pulmonary embolism and was discharged 5 days later. Acute pulmonary embolism (APE) has variable clinical presentations. To our knowledge, this is the first case report of an APE presenting with these ECG findings suggestive of myocardial ischemia. In this case report, we discuss the underlying physiological mechanisms responsible and offer management suggestions for emergency department and critical care physicians to better expedite the treatment of APE mimicking acute coronary syndrome on ECG.
High grade myofibroblastic sarcoma of paratesticular soft tissues
Authors: Ioannis Anastasiou, Panagiotis K Levis, Ioannis Katafigiotis, Georgios Karaolanis, Viktoria-Varvara Palla, Evangelos Felekouras, Antonios Athanasiou, Marina Perdiki, Dionysios Mitropoulos, Constantinos A Constantinides
Journal: Case Rep Oncol Med (2014)

Tumors of the paratesticular region most often arise from the soft tissue surrounding the spermatic cord and the epididymis or from the soft tissue (dartos muscle) of the scrotal wall. Paratesticular tumors, despite their rarity, present a high incidence of malignancy (30%), and the therapeutic approach of choice is surgical resection with negative margin. The grade, the histology type, the presence of metastases during the diagnosis, the size of the tumor, the age of the patients, and the surgical margins are all important prognostic factors. We present a case report of a 86-year-old patient with a high grade paratesticular and scrotum sarcoma of soft tissues which was presented as a hard painful mass of the scrotum. The patient was subjected to high ligation of the spermatic cord and received no further treatment and 6 months after the operation no local or systematic recurrence was observed.
Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature
Authors: Giulio Frontino, Raffaella Di Tonno, Valeria Castorani, Andrea Rigamonti, Elisa Morotti, Federica Sandullo, Francesco Scialabba, Francesca Arrigoni, Riccardo Foglino, Benedetta Dionisi, Chiara Irene Carla Ferri, Salvatore Zirpoli, Graziano Barera, Franco Meschi, Riccardo Bonfanti
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: dka (diabetic ketoacidosis), t1dm (type 1 diabetes mellitus), acute kidney injury, hyperosmolar (hyperglycemic) coma, insulin pump (csii
MeSH terms: Diabetes Mellitus, Type 1 / complications, Diabetic Ketoacidosis / complications, Diabetic Ketoacidosis / diagnosis, Mesenteric Ischemia / complications, Mesenteric Ischemia / etiology, Case Reports, Review, Abdominal Pain / complications, Adolescent, Child, Female, Humans

Introduction:
Despite the use of technology, recurrent diabetic ketoacidosis (DKA) prevention remains an unmet need in children and adolescents with T1D and may be accompanied by life-threatening acute complications. We present a rare case of non-occlusive mesenteric ischemia (NOMI) with overt manifestation after DKA resolution and a discussion of recent literature addressing DKA-associated NOMI epidemiology and pathogenesis in children and adolescents.
Case presentation:
A 13-year-old female with previously diagnosed T1D, was admitted at our emergency department with hypovolemic shock, DKA, hyperosmolar state and acute kidney injury (AKI). Mildly progressive abdominal pain persisted after DKA correction and after repeated ultrasound evaluations ultimately suspect for intestinal perforation, an intraoperative diagnosis of NOMI was made.
Conclusion:
The diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.
Symptoms of Chronic Dysphagia Secondary to Multiple Cervical Inlet Patches and Esophageal Stricture
Authors: Davong D Phrathep, Stefan Anthony, Kevin D Healey, Ivanna Ward, Michael Herman
Journal: Cureus (2023)
Keywords: cervical inlet patch, endocopic dilation therapy, esophageal stricture, progressive dysphagia, upper endoscopy
MeSH terms: Case Reports

Ectopic gastric mucosa can be present throughout the gastrointestinal tract; however, when located within the upper esophagus, it is termed an esophageal inlet patch. To the best of our knowledge, most esophageal inlet patches occur as a single area of gastric mucosa. Here, we present a 44-year-old female who suffered from symptoms of chronic dysphagia and globus sensation for two years due to multiple inlet patches located in the cervical area of the upper esophagus with an associated cervical esophageal stricture. The patient underwent esophageal dilation and proton pump inhibitor therapy, resulting in a resolution of her symptoms. Our case demonstrates the appropriate clinical management of patients suffering from symptoms of chronic dysphagia due to multiple esophageal inlet patches. We recommend routine examination of the cervical esophagus in developing a differential diagnosis of inlet patch, especially in patients with chronic upper dysphagia.
Chest pain and costochondritis associated with vitamin d deficiency: a report of two cases
Authors: Robert C Oh, Jeremy D Johnson
Journal: Case Rep Med (2012)

Vitamin D is integral for bone health, and severe deficiency can cause rickets in children and osteomalacia in adults. Although osteomalacia can cause severe generalized bone pain, there are only a few case reports of chest pain associated with vitamin D deficiency. We describe 2 patients with chest pain that were initially worked up for cardiac etiologies but were eventually diagnosed with costochondritis and vitamin D deficiency. Vitamin D deficiency is known to cause hypertrophic costochondral junctions in children ("rachitic rosaries") and sternal pain with adults diagnosed with osteomalacia. We propose that vitamin D deficiency may be related to the chest pain associated with costochondritis. In patients diagnosed with costochondritis, physicians should consider testing and treating for vitamin D deficiency.
Lumbosacral Soft Tissue Mass in a Newborn: A Clinical Case with a Difficult Diagnosis
Authors: Simone Ceratto, Maria Eleonora Basso, Francesco Savino
Journal: Front Pediatr (2017)
Keywords: lumbosacral region, neoplasms, newborn, pediatric oncology, soft-tissue lesions
MeSH terms: Case Reports

Many types of dorsal neoplasm of early infancy are described in literature ranging from benign to aggressive. Some are more common while others quite unusual. Here, we describe a newborn with a lumbosacral soft tissue mass. Positivity of S-100 and vimentin was compatible with the neural cell line and the high proliferation rate of major activity cells (biopsy Ki67 20%) suggests an aggressive nature. An exclusively surgical approach was chosen and no clinical or radiological signs of recurrence have been observed after 2 years of follow-up. This case is atypical for location, histological pattern, radiological aspect, and clinical behavior. Diagnosis is hard to define and limited to a mesenchymal neoplasia with myxoid tracts. The described aspects raise concerns about clinical and therapeutic approach, classification, and radiological follow-up of sacral tissue masses in newborns.
Myeloid Clonal Infiltrate Identified With Next-Generation Sequencing in Skin Lesions Associated With Myelodysplastic Syndromes and Chronic Myelomonocytic Leukemia: A Case Series
Authors: Grégoire Martin de Frémont, Pierre Hirsch, Santiago Gimenez de Mestral, Philippe Moguelet, Yoan Ditchi, Jean-François Emile, Patricia Senet, Sophie Georgin-Lavialle, Thomas Hanslik, François Maurier, Amir Adedjouma, Noémie Abisror, Thibault Mahevas, Florent Malard, Lionel Adès, Pierre Fenaux, Olivier Fain, François Chasset, Arsène Mekinian
Journal: Front Immunol (2021)
Keywords: chronic myelomonocytic leukemia, clonal hematopoiesis, myelodysplastic syndrome, next-generation sequencing, skin
MeSH terms: Leukemia, Myelomonocytic, Chronic / complications, Leukemia, Myelomonocytic, Chronic / pathology, Myelodysplastic Syndromes / complications, Myelodysplastic Syndromes / pathology, Myeloid Cells / pathology, Skin Diseases / diagnosis, Skin Diseases / etiology, Case Reports, Aged, Aged, 80 and over, Biopsy, Bone Marrow / pathology, Bone Marrow Cells / metabolism, Bone Marrow Cells / pathology, Clonal Evolution / genetics, Disease Management, Female, Gene Expression Profiling, High-Throughput Nucleotide Sequencing, Humans, Leukemia, Myelomonocytic, Chronic / etiology, Male, Middle Aged, Myelodysplastic Syndromes / etiology, Symptom Assessment

Background:
Myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML) are associated with cutaneous manifestations. Next-generation sequencing (NGS) is a tool capable of identifying clonal myeloid cells in the skin infiltrate and thus better characterize the link between hematological diseases and skin lesions.
Objective:
To assess whether skin lesions of MDS/CMML are clonally related to blood or bone marrow cells using NGS.
Methods:
Comparisons of blood or bone marrow and skin samples NGS findings from patients presenting with MDS/CMML and skin lesions in three French hospitals.
Results:
Among the 14 patients recruited, 12 patients (86%) had mutations in the skin lesions biopsied, 12 patients (86%) had a globally similar mutational profile between blood/bone marrow and skin, and 10 patients (71%) had mutations with a high variant allele frequency (>10%) found in the myeloid skin infiltrate. Mutations in TET2 and DNMT3A, both in four patients, were the most frequent. Two patients harbored a UBA1 mutation on hematopoietic samples.
Limitations:
Limited number of patients and retrospective collection of the data. Blood and skin sampling were not performed at the exact same time point for two patients.
Conclusion:
Skin lesions in the setting of MDS/CMML are characterized by a clonal myeloid infiltrate in most cases.
Steroid Pulse Therapy for Severe Central Nervous System Involvement in Shiga Toxin-Producing Escherichia coli-Related Hemolytic Uremic Syndrome
Authors: Chiara Rosazza, Alberto M Cappellari, Cristiano Gandini, Elisa Scola, Gianluigi Ardissino
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

We report on the case of a 7-year-old boy with Shiga toxin-producing Escherichia coli-related hemolytic uremic syndrome (STEC-HUS), initially presenting with abdominal pain as the only clinical feature and thus requiring differential diagnosis with a surgical emergency. Diagnosis of STEC-HUS was made with the appearance of bloody diarrhea and renal function impairment, and the clinical picture rapidly progressed to multiorgan failure. Relatively late and severe central nervous system (CNS) involvement was present, characterized by subacute encephalitis progressing to coma, which became apparent when the acute phase of thrombotic microangiopathy was resolving. Therefore, neurologic manifestations were thought to be related to reperfusion damage to the CNS and high-dose IV steroid pulse therapy was empirically administered. Following this therapeutic scheme, neurologic involvement resolved with no sequelae. This case offers several points of discussion on the clinical presentation and the diagnostic approach to STEC-HUS, on the related neurologic complications, and on a novel approach to their management.