OpenMed/multicare-articles huggingface dataset:
Explant of a Chronic Atlantoaxial Implant Infection in a Dog
Authors: Thao Vo, Gabriel Garcia, Sheila Carrera-Justiz
Journal: Case Rep Vet Med (2023)
MeSH terms: Case Reports

An 11-year-old male neutered Yorkshire Terrier was presented with a cervical mass that developed a draining tract. Aside from the dysphagia reported by the owner, his neurologic exam was normal. Three years prior, the patient was diagnosed with an atlantoaxial subluxation that was ventrally stabilized with polymethylmethacrylate (PMMA) and self-tapping titanium screws. There were no postoperative complications until presenting with the cervical mass and dysphagia. Computerized tomography (CT) of the cervical spine confirmed caudal migration of the PMMA and screws with an abscess surrounding the implant. A surgical explant of the PMMA and screws was performed without complication. The atlantoaxial joint remained normally aligned on postoperative radiographs. Cultures of the implant grew Streptococcus bovis. He was treated with cephalexin (22 mg/kg PO BID) for 30 days. At the time of his one-month recheck, he was swallowing normally with no neurologic deficits. He remains normal at the time of this report (17 months later). This case reports a successful explant of a chronic atlantoaxial implant infection.
Case Report: Identification of a novel NTRK3-AJUBA fusion co-existing with ETV6-NTRK3 fusion in papillary thyroid carcinoma
Authors: Qing-Xiang Yu, Wen-Jun Zhao, He-Yue Wang, Lei Zhang, Lan Qin, Jian-Li Han
Journal: Front Oncol (2023)
Keywords: etv6-ntrk3, ngs, ntrk3-ajuba, fusion, papillary thyroid carcinoma
MeSH terms: Case Reports

NTRK fusions are validated oncogenic drivers of various adult and pediatric tumor types, including thyroid cancer, and serve as a therapeutic target. Recently, tropomyosin receptor kinase (TRK) inhibitors, such as entrectinib and larotrectinib, display promising therapeutic efficacy in NTRK-positive solid tumors. Although some NTRK fusion partners have been identified in thyroid cancer, the spectrum of NTRK fusion is not fully characterized. In this study, a dual NTRK3 fusion was identified by targeted RNA-Seq in a 47-year-old female patient with papillary thyroid carcinoma. The patient harbors a novel in-frame fusion between NTRK3 exon 13 and AJUBA exon 2, co-existing with a known in-frame fusion between ETV6 exon 4 and NTRK3 exon 14. The dual NTRK3 fusion was validated by Sanger sequencing and fluorescence in situ hybridization (FISH) but lack TRK protein expression as defined by pan-TRK immunohistochemistry (IHC). We supposed the pan-TRK IHC result to be falsely negative. In conclusion, we present the first case of a novel NTRK3-AJUBA fusion co-existing with a known ETV6-NTRK3 fusion in thyroid cancer. These findings extend the spectrum of translocation partners in NTRK3 fusion, and the effect of dual NTRK3 fusion on TRK inhibitor therapy and prognosis needs long-term follow-up.
Disseminated Tuberculosis Mimicking as Crohn's Disease in a Paediatric Patient
Authors: Elizabeth Feenstra, Yentl Driesen, Nicolette Moes, Nathalie Jouret, Koen Vanden Driessche
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Tuberculosis is an important infectious disease for children worldwide. The clinical presentation of tuberculosis in children is diverse and, depending on the affected organs, it is often accompanied with nonspecific symptoms that can mimic other diseases. In this report, we present a case of disseminated tuberculosis in an 11-year-old boy with intestinal followed by pulmonary involvement. The diagnosis was delayed for several weeks due to the clinical picture which was mimicking Crohn's disease, the known difficulties in diagnostic tests and the improvement on meropenem. This case demonstrates the importance of a detailed microscopic examination of gastrointestinal biopsies and the tuberculostatic effect of meropenem which physicians should be aware of.
Locally recurrent subcutaneous and muscular hydatid cysts of the leg: an unusual case report
Authors: Redouane Ouakrim, Zouhir Amziane, Ouchrif Younes, Issam Eloukili, Mohammed Kharmaz, Moulay Omar Lamrani, Ahmed Elbardouni, Mustapha Mahfoud, Berrada Mohammed Saleh
Journal: Pan Afr Med J (2015)
Keywords: recurrent, anthelmanthic chemotherapy, muscular hydatid cyst, radical excision, subcutaneous hydatid cyst
MeSH terms: Anthelmintics / administration & dosage, Echinococcosis / diagnosis, Leg / parasitology, Case Reports, Combined Modality Therapy, Echinococcosis / drug therapy, Echinococcosis / surgery, Female, Humans, Leg / surgery, Magnetic Resonance Imaging, Middle Aged, Muscle, Skeletal / parasitology, Muscle, Skeletal / surgery, Recurrence, Anthelmintics

We report a rare case of 50-year-old Moroccan woman with local recurrence of a subcutaneous hydatid cyst in proximity to the medial surface of the tibia and another cyst at the tibialis posterior muscle in the absence of liver, lung und spleen involvement. The first surgery was done in another hospital three years ago; no adjuvant treatment was performed after surgery. Recurrence was diagnosed according to the MRI appearance, serological and pathological findings. The patient underwent complete excision of the subcutaneous cyst with two centimeters of the medial gastrocnemius muscle; the tibialis posterior muscle cyst was intraoperatively drained and irrigated with scolicidal agent as it was next to the posterior tibial pedicle. A periopertive anthelmintic chemotherapy was administered. Two years after the patient showed no recurrence. This case report and literature review describe an approach to the diagnosis and management of this pathological entity.
Cysticercosis: hooked by a hooklet on fine needle aspiration cytology-a case report
Authors: Manav Sawhney, Shubhra Agarwal
Journal: Case Rep Infect Dis (2013)

Cysticercosis is a systemic parasitic disease caused by the larval form of cestode T. solium. It has a worldwide distribution and is potentially harmful with variable clinical manifestations. The patient most commonly presents with subcutaneous and muscle involvement in the form of nodular lesions. The other most commonly involved sites include eye, brain, bladder wall, and heart. Cysticercosis can be diagnosed on serology, and radiologically but confirmatory diagnosis is based on histopathological examination of the involved tissue biopsy specimen. Fine needle aspiration cytology is a useful low-cost outpatient procedure tool for preoperative diagnosis of cysticercosis and is absolutely essential for diagnosis of the parasitic lesions in a peripheral hospital, one like ours.
Solely MRI-Guided Cardiac Catheterization for Assessment of Pulmonary Hypertension in a Pregnant Lady with Undiagnosed Congenital Heart Disease
Authors: Aphrodite Tzifa, Ioannis Polymerou, Dimitra Loggitsi
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Pregnancy in women with complex congenital heart disease (CHD) can be poorly tolerated. Amongst pregnant women with CHD and pulmonary hypertension (PH), the mortality rate can be as high as 30%. Cardiac catheterization procedures for assessment of haemodynamics and pulmonary vascular resistance (PVR) are often required in this patient population for risk stratification. However, during the first few weeks of pregnancy, this should better be avoided due to the known adverse effects of the ionizing radiation to the immature fetus. In this setting, a solely MRI-guided catheterization may present as a better alternative.
Apple Watch-guided diagnosis of AVNRT in a pregnant woman-A case report and literature review
Authors: Maja Hawryszko, Grzegorz Sławiński, Dariusz Kozłowski, Ewa Lewicka
Journal: Front Cardiovasc Med (2022)
Keywords: avnrt, apple watch, arrhythmia, mobile health (mhealth), pregnancy
MeSH terms: Case Reports

Cardiac arrhythmias occurring during pregnancy pose a therapeutic problem as antiarrhythmic drugs can be potentially harmful to the fetus. A 35-years-old woman in the 20th week of pregnancy was admitted to the Department of Cardiology due to the first episode of arrhythmia in her life. During the event, the patient was wearing an Apple Watch Series 6, which records a 30-sec single-channel ECG. The recording showed narrow QRS complex tachycardia of 216 bpm, and short RP interval and atrioventricular nodal reentrant tachycardia (AVNRT) was recognized. Due to the mild nature of the arrhythmia, antiarrhythmic pharmacotherapy was not initiated. The use of mobile health (mHealth) devices such as wearables and health monitoring applications is now a valuable addition to routine cardiac diagnostics for patients of all ages and levels of cardiovascular risk.
Mind the gap! Extraluminal percutaneous-endoscopic rendezvous with a self-expanding metal stent for restoring continuity in major bile duct injury: A case series
Authors: Jessica Lindemann, Christo Kloppers, Sean Burmeister, Marc Bernon, Eduard Jonas
Journal: Int J Surg Case Rep (2019)
Keywords: bile duct injury, endoscopic percutaneous rendezvous, minimally invasive, self expanding metal stent

Introduction:
Treatment of major iatrogenic and non-iatrogenic bile duct injury (BDI) often requires delayed surgery with interim external biliary drainage. Percutaneous transhepatic cholangiography (PTC) with biliary catheter placement and endoscopic retrograde cholangiography (ERC) with stent placement have been used to bridge defects. In some patients, bridging the defect cannot be achieved through ERC or PTC alone.
Materials and methods:
Two patients with major BDIs, one iatrogenic and one non-iatrogenic underwent an extraluminal PTC/ERC rendezvous with placement of a fully covered self-expandable metal stent (SEMS) for the acute management of BDI with substantial loss of bile duct length.
Results:
In both patients the intraperitoneal PTC/ERC rendezvous with SEMS placement was successful with no complications after 12 and 18 months follow-up, respectively.
Discussion:
This study is the first to report a standardized approach to the acute management of iatrogenic and non-iatrogenic major BDIs using extraluminal intraperitoneal PTC/ERC rendezvous with placement of a fully covered SEMS. The described technique may serve as a "bridge to surgery" strategy for patients where definitive management of BDIs are deferred. However, long-term data of the success of this technique, specifically the use of a SEMS to bridge the defect, are lacking and further investigation is required to determine its role as a definitive treatment of BDIs with substance loss.
Conclusion:
PTC/ERC rendezvous with restoration of biliary continuity and internalization of bile flow is particularly useful for patients who have previously failed ERC and/or PTC alone, and in whom immediate surgical repair is not an option.
Vaginal metastasis of pancreatic cancer
Authors: Khadija Benhayoune, Hinde El Fatemi, Meryem El Ghaouti, Abdelaziz Bannani, Abdelilah Melhouf, Taoufik Harmouch
Journal: Pan Afr Med J (2015)
Keywords: vagin, metastases, pancreatic cancer
MeSH terms: Adenocarcinoma, Mucinous / secondary, Pancreatic Neoplasms / pathology, Vaginal Neoplasms / secondary, Case Reports, Adenocarcinoma, Mucinous / chemistry, Adenocarcinoma, Mucinous / complications, Adenocarcinoma, Mucinous / pathology, Aged, Biomarkers, Tumor / analysis, Biopsy, Female, Hemorrhage / etiology, Humans, Keratin-19 / analysis, Keratin-20 / analysis, Pancreatic Neoplasms / diagnostic imaging, Tomography, X-Ray Computed, Vagina, Vaginal Neoplasms / chemistry, Vaginal Neoplasms / complications, Vaginal Neoplasms / pathology, Biomarkers, Tumor, Keratin-19, Keratin-20

Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic adenocarcinoma discovered of symptoms from a vaginal metastasis.
Endoscopic Endonasal Supraoptic and Infraoptic Approaches for Complex "Parasuprasellar" Lesions: Surgical Anatomy, Technique Nuances, and Case Series
Authors: YouYuan Bao, YouQing Yang, Lin Zhou, ShenHao Xie, Xiao Wu, Han Ding, Jie Wu, Limin Xiao, Le Yang, Bin Tang, Tao Hong
Journal: Front Oncol (2022)
Keywords: anterior clinoid process, endoscopic endonasal approach, internal carotid artery, optic canal, parasuprasellar area, surgical technique

Objective:
The surgical management of lesions involving the lateral area of the suprasellar region, including the lateral aspect of the planum sphenoidale and the tight junction region of the optic canal (OC), anterior clinoid process (ACP), and internal carotid artery (ICA) and its dural rings, is extremely challenging. Here, these regions, namely, the "parasuprasellar" area, are described from the endonasal perspective. Moreover, the authors introduce two novels endoscopic endonasal supraoptic (EESO) and endoscopic endonasal infraoptic (EEIO) approaches to access the parasuprasellar area.
Methods:
Surgical simulation of the EESO and EEIO approaches to the parasuprasellar area was conducted in 5 silicon-injected specimens. The same techniques were applied in 12 patients with lesions involving the parasuprasellar area.
Results:
The EESO approach provided excellent surgical access to the lateral region of the planum sphenoidale, which corresponds to the orbital gyrus of the frontal lobe. With stepwise bone (OC, optic strut and ACP) removal, dissociation of the ophthalmic artery (OA) and optic nerve (ON), the EEIO approach enables access to the lateral region of the supraclinoidal ICA. These approaches can be used independently or in combination, but are more often employed as a complement to the endoscopic endonasal midline and transcavernous approaches. In clinical application, the EESO and EEIO approaches were successfully performed in 12 patients harboring tumors as well as multiple aneurysms involving the parasuprasellar area. Gross total and subtotal tumor resection were achieved in 9 patients and 1 patient, respectively. For two patients with multiple aneurysms, the lesions were clipped selectively according to location and size. Visual acuity improved in 7 patients, remained stable in 4, and deteriorated in only 1. No postoperative intracranial infection or ICA injury occurred in this series.
Conclusions:
The EESO and EEIO approaches offer original treatment options for well-selected lesions involving the parasuprasellar area. They can be combined with the endoscopic endonasal midline and transcavernous approaches to remove extensive pathologies involving the intrasellar, suprasellar, sphenoid, and cavernous sinuses and even the bifurcation of the ICA. This work for the first time pushes the boundary of the endoscopic endonasal approach lateral to the supraclinoidal ICA and ON.
Comorbid Major Depressive Disorder and Obstructive Sleep Apnea
Authors: Chotiman Chinvararak, Diego Garcia-Borreguero
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Introduction:
Major depressive disorder (MDD) and obstructive sleep apnoea (OSA) are prevalent in the general population. Moreover, early studies found that the two conditions are associated bidirectionally and lead to poor health outcomes. The prevalence of comorbid MDD in OSA patients could be as high as two-thirds. A sedentary lifestyle and psychological stress in the globalisation age may increase the risk of MDD and OSA.
Method:
We reported a case of an MDD patient with OSA as well as discussed the assessment method and also reviewed the treatment of both conditions. We aimed to raise awareness for psychiatrists to differentiate other medical conditions when the symptomatology of MDD is atypical and unresponsive to standard psychiatric treatment.
Conclusion:
Early detection and effective treatment for MDD and OSA are essential to achieve patient outcomes. Furthermore, it can reduce complications from both conditions. Therefore, a comprehensive evaluation should be made to determine the diagnoses when physicians suspect overlapping MDD and OSA.
Surgical treatment of the severe thoracic gastrocutaneous fistula by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma: A case report
Authors: Dongmin Yu, Zizi Zhou, Xiaoming Zhang
Journal: Int J Surg Case Rep (2019)
Keywords: case report, muscle flap, oesophagectomy, thoracic gastrocutaneous fistula, thoracoplasty, tracheostenosis

Background:
Thoracic anastomotic fistula (TAF) is a severe postoperative complication of oesophagectomy, and its occurrence coupled with a thoracic gastrocutaneous fistula (TGCF) and tracheostenosis is very unusual and may lead to a fatal consequence.
Case presentation:
We describe a case of an old female diagnosed with mid-oesophageal carcinoma, who presented with a TAF after oesophagectomy, which was healed by an effective treatment, while a severe TGCF and tracheostenosis appeared one month postoperation. The complications were detected by gastroscopy, barium oesophagogram and thoracic computed tomography (CT). Through surgical treatments, including pedicled muscle flap filling and thoracoplasty, and a correlated corrective procedure, the patient completely recovered and was discharged six months after the admission.
Conclusion:
Treatment by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma can be a curative alternative for the severe thoracic gastrocutaneous fistula.
Eustachian Tube Foreign Body with Endoscopic-Assisted Surgical Removal
Authors: Phillip R Purnell, Adam Bender-Heine, Habib Zalzal, Abdul R Tarabishy, Adam Cassis
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Objectives:
Foreign bodies of the external and middle ear are not uncommon; however, foreign bodies in the eustachian tube are rare. Here we describe the presentation, imaging, and endoscopic-assisted surgical management of a case of eustachian tube foreign body.
Methods:
A 34-year-old male was seen for evaluation of foreign body of the left eustachian tube while working with metal at a machine shop. Imaging and surgical management are highlighted and review of available literature regarding foreign bodies of the eustachian tube is presented.
Results:
A CT scan revealed a foreign body present approximately 1 cm into the bony eustachian tube. The patient underwent middle ear exploration which required endoscopic assistance to adequately visualize the foreign body. The foreign body was unable to be removed and required the creation of a bony tunnel lateral to the eustachian tube for visualization and access to the foreign body.
Conclusions:
This report presents a rare case of eustachian tube foreign body. Use of the endoscope during the surgical removal greatly enhanced the ease and safety of removal. This report also highlights the importance of ear protection with any machining and welding work.
Bilateral deep peroneal nerve paralysis following kerosene self-injection into external hemorrhoids
Authors: Khalil Rostami, Esmaeil Farzaneh, Hassan Abolhassani
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Along with conventional therapies, some abrogated traditional treatment had been used for hemorrhoids like local Kerosene injection especially for extremely irritated external hemorrhoids. We report a rare case of Kerosene self-injection into the hemorrhoid. Despite antibiotics therapy, extent debridement, and colostomy, the patient died after 24 hours because of heart attack. Moreover, we discuss here the case with contact or injection of hydrocarbon materials and early care action to decrease the extensions of injury and side effects.
Cutaneous metastasis of occult breast cancer: a case report
Authors: Rafael Everton Assunção Ribeiro da Costa, Cristiane Amaral Dos Reis, Rafael de Deus Moura, Ana Lúcia Nascimento Araújo, Fergus Tomás Rocha de Oliveira, Sabas Carlos Vieira
Journal: Pan Afr Med J (2021)
Keywords: breast neoplasms, case report, neoplasm metastasis, skin neoplasms, unknown primary
MeSH terms: Anastrozole / administration & dosage, Breast Neoplasms / diagnosis, Skin Neoplasms / diagnosis, Case Reports, Aged, Antineoplastic Agents, Hormonal / administration & dosage, Biopsy, Breast Neoplasms / drug therapy, Breast Neoplasms / pathology, Female, Humans, Prognosis, Skin Neoplasms / drug therapy, Skin Neoplasms / secondary, Treatment Outcome, Antineoplastic Agents, Hormonal, Anastrozole

Occult breast cancer (OBC) is characterized by metastatic presentation of undetectable breast tumor on imaging exams. OBC is a rare disease (accounting for 0.3% to 1.0% of all breast cancers) that represents a major diagnostic challenge. The aim of this study was to report a case of OBC with primary presentation of multiple cutaneous metastases with subsequent emergence of bone metastasis. A 70-year female patient had multiple cutaneous metastatic lesions in the left cervical region, left breast, left axillary region, left subscapular region, in three chirodactylus of the right hand and three chirodactylus of the left hand. Imaging tests (mammogram, ultrasonography and magnetic resonance imaging of the breast) did not show alterations. Biopsy, histology sections and immunohistochemistry of the left cervical cutaneous lesion were compatible with OBC. After two years of anastrozole treatment (1mg/day), there was regression of all cutaneous lesions and stabilization of bone metastasis. OBC has a better prognosis. It may exhibit spontaneous regression or respond to less aggressive treatment strategies, as described in this case.
Ulnar paddlefish carpometacarpal dislocation of the three lesser fingers: a case report
Authors: Lassaad Hassini, Thabet Mouelhi, Mohamed Ali Khalifa, Mourad Mtaoumi, Mohamed Laaziz Ben Ayeche
Journal: Pan Afr Med J (2017)
Keywords: carpometacarpal dislocation, paddlefish, reduction, ulnar
MeSH terms: Accidents, Occupational, Carpometacarpal Joints / injuries, Fracture Dislocation / surgery, Joint Dislocations / surgery, Case Reports, Carpometacarpal Joints / surgery, Female, Fracture Dislocation / diagnosis, Fracture Dislocation / etiology, Hand Injuries / diagnosis, Hand Injuries / etiology, Hand Injuries / surgery, Humans, Joint Dislocations / diagnosis, Joint Dislocations / etiology, Young Adult

The long fingers' paddlefish carpometacarpal (CMC) dislocation is exceptional. Most dislocations occur after high energy trauma. Untreated, these lesions can result in chronic instability of the CMC joints and early osteoarthritis. We report the case of a 20-year-old patient presenting with an ulnar paddlefish CMC fracture-dislocation of the three lesser fingers resulting from a hand trauma in the context of an occupational accident. Treatment is usually surgical though no strict consensus can be found upon literature review. If diagnosed early and no associated fractures are found, CMC dislocation could benefit from conservative treatment.
Regenerative therapy as an adjunct to periapical surgery: a case report
Authors: Vivek Chaturvedy, Shefali Chaturvedy
Journal: Int J Clin Pediatr Dent (2012)
Keywords: apicoectomy, bone graft, radicular cyst
MeSH terms: Case Reports

Large periapical defects may adversely affect the success rate of endodontic surgery. Use of regenerative therapy may enhance the prognosis of such teeth. A case of traumatized upper anterior teeth with infected radicular cyst and associated sinus tract reported to the dental hospital. A periradicular surgical procedure was performed to remove the nonhealing pathological tissue. To augment the repair a bioactive bone graft material was placed. Six months interim results showed positive outcome of application of graft. How to cite this article: Chaturvedy V, Chaturvedy S. Regenerative Therapy as an Adjunct to Periapical Surgery: A Case Report. Int J Clin Pediatr Dent 2012;5(1):75-77.