OpenMed/multicare-articles huggingface dataset:
Beyond the Dual Paraneoplastic Syndromes of Small-Cell Lung Cancer with ADH and ACTH Secretion: A Case Report with Literature Review and Future Implications
Authors: Krishna Adit Agarwal, Myat Han Soe
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

We present a case of small-cell lung cancer (SCLC) with syndrome of inappropriate antidiuretic hormone secretion (SIADH) in which serum sodium gradually normalized with the onset of hypertension, refractory hypokalemia, and chloride-resistant metabolic alkalosis due to ectopic adrenocorticotrophic hormone (ACTH) secretion (EAS). In this case report, we discuss the diagnostic challenges of dual paraneoplastic syndromes with SIADH and EAS, management of SCLC with paraneoplastic endocrinopathies, and their prognostic impact on SCLC. In addition, we discuss neuroendocrine differentiation and ectopic hormone production in relation to intratumoral heterogeneity in SCLC and propose tumor microenvironment and hormonal and metabolic dependence as important determinants of tumor growth and survival.
Advanced Stage Breast Sarcoma Treatment in a Third World Country Public Hospital
Authors: Amanda Lino de Faria, Cinthia Moreno Garcia, Gabriela de Andrade Rodrigues, Lais Helena Dumbra Toloni Dos Santos, Gabriela B K Uyeda, Simone Elias, Marair G F Sartori, Afonso Celso Pinto Nazário, Gil Facina
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

The case reports a 49-year-old patient, drug-addicted, undernourished, and homeless, who was referred to our service presenting a diagnostic of breast sarcoma and ulcerating tumor which extended from the right breast to the right flank. She underwent hygienic mastectomy and, as it developed, she presented a range of complications, culminating in the recurrence of the tumor and pulmonary metastasis few months after her initial treatment. There is relevance in our study not only because it reports the development of the breast sarcoma, rare neoplasm, and its aggressiveness with fast recurrence, but also because it exposes the impact of biopsychosocial behavior of this patient in her clinical outcome.
Solitary Calcified Nodules as the Cause of Carpal Tunnel Syndrome: Two Case Reports and Literature Reviews
Authors: Ting-Feng Cheng, Chun-Yu Chen, Ping-Tang Liu, Shan-Wei Yang
Journal: Front Neurol (2019)
Keywords: calcified nodule, carpal tunnel syndrome, secondary cts, space-occupying lesion, ultrasound
MeSH terms: Case Reports

Solitary calcified nodule-related carpal tunnel syndrome (CTS) is rare and easy to be misdiagnosed owing to the high incidence of primary CTS. Release of the transverse carpal ligament without removal of the mass leads to persistence of the symptoms and subsequent complications like wasting of the thenar muscles. Here, we report two cases of solitary calcified nodule-related CTS and discuss the role of ultrasound in preventing misdiagnosis. Both patients reported persistent numbness over the lateral side of their palm and weakness of the right wrist with thenar muscle atrophy. One patient had undergone transverse carpal ligament release 2 years previously, and the other had received a local injection of lidocaine at the clinic. Neither patient experienced symptom relief. X-ray revealed a similar finding of nodule lesions in front of the capitate-hamate region. Solitary calcified nodule-related CTS was diagnosed, and the patients underwent nodule removal with/without transverse ligament release. The first patient was a typical case of misdiagnosed solitary calcified nodule-related CTS. The second patient had a definitive clinical sonographic diagnosis before surgery. The accurate diagnosis of secondary CTS is paramount for performing effective surgery. Thus, ultrasonography is an easy, convenient, safe, and effective method in screening for secondary CTS.
Total Knee Arthroplasty after Correction of Tibial Diaphyseal Nonunion with Clamshell Osteotomy
Authors: Pingal Desai, Vivek Sharma, Karanvir Prakash
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Total knee arthroplasty is mostly done to relieve pain and disability from a severe and degenerated knee. Deformities in the coronal and sagittal plane could be corrected with the help of cuts made in tibia and femur during total knee replacement as well as with ligament release. However, large deformities in the lower extremity particularly in the diaphysis region need correction prior to the total knee replacement. It helps to limit the amount of bone that will be cut and helps the ligament release. Several extra articular and intra-articular methods for the correction of diaphyseal deformity have been described. We present the case of clamshell osteotomy for the correction of diaphyseal deformity in the tibia and a total knee replacement after the osteotomy site healed.
A Rare Case of Hemophagocytic Lymphohistiocytosis in an Adult with Diffuse Large B-Cell Lymphoma
Authors: Chimezie Mbachi, Rita Igwilo, Estefania Flores, Ezekiel Chukwujindu, Benjamin Mba
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

A 71-year-old Indian female presented with a 3-month history of weight loss and fatigue. Further review confirmed a histological diagnosis of diffuse large B-cell lymphoma. Although bone marrow analysis did not reveal hemophagocytosis, she had some clinical and laboratory pointers to hemophagocytic lymphohistiocytosis (HLH). Her clinical state deteriorated rapidly with development of acute respiratory distress syndrome, diffuse alveolar hemorrhage, and subsequently death.
Case Report: Morbihan disease treated with tofacitinib successfully
Authors: Zi-Yun Li, Chao-Cheng Chi, Sui-Qing Cai
Journal: Front Immunol (2023)
Keywords: jak inhibitor, morbihan disease, case report, inflammation, tofacitinib
MeSH terms: Erythema / diagnosis, Janus Kinase Inhibitors / therapeutic use, Case Reports, Adult, Anti-Bacterial Agents, Edema, Female, Humans, Male, Piperidines / therapeutic use, Skin / pathology, tofacitinib, Piperidines, Anti-Bacterial Agents, Janus Kinase Inhibitors

Introduction:
To date, there is no standard treatment for Morbihan disease. Several studies have reported that Morbihan disease responds well to systemic corticosteroids (prednisone and prednisolone), systemic antibiotics (tetracyclines), antihistamines (ketotifen) and surgical therapy (Lymphaticovenous anastomosis). To our knowledge, Tofacitinib, as a Janus-activated kinase (JAK) inhibitor, plays a vital role in the treatment of inflammatory and autoimmune disorders. Therefore, Tofacitinib may be a promising medical option for patients with Morbihan disease.
Case presentation:
The first case involves a 43-year-old Chinese man who presented a 12-month history of progressive painless swelling of the left upper eyelid. According to the skin biopsy, perivascular dermal edema with dilatation of lymphatic vessels and telangiectasia was observed, accompanied by mixed lymphocyte infiltrate, including histiocytes, plasma cells, and a few eosinophils. The second case involves a Chinese female patient who presented a 2-year history of progressive left-sided facial edema, which was eventually diagnosed as Morbihan disease. The skin biopsy revealed lymphocyte infiltration in the superficial vessels of dermis and some accessories. Based on patients' clinical presentation, skin biopsy results, and exclusion of differential diagnoses such as systemic lupus erythematosus (SLE), they were diagnosed with Morbihan disease. They were both treated with Tofacitinib (5mg, po twice daily).
Outcomes:
Patient 1 underwent a trial of Tofacitinib at a dosage of 5 mg twice daily for one month, with notable improvement. His edema and erythema present on the left face were alleviated. Patient 1 reduced the dosage of Tofacitinib by half (5mg, once daily) and continued using it for 5 months. During the 6-month follow-up, the facial erythema in the patient subsided, and there was a noticeable improvement in the swelling of the left eyelid compared to before. Patient 2, her lesions gradually improved after one-week treatment. She received a one-month treatment of Tofacitinib, and during the subsequent six-month follow-up, there was no evidence of eruption recurrence.
Conclusion:
We present the first cases of two patients receiving short-term Tofacitinib as therapy for Morbihan disease and retrieving huge succession. Tofacitinib may be a promising oral alternative for patients with Morbihan disease. However, its safety and efficacy require further assessment through clinical trials.
Value of nerve biopsy in patients with latent malignant hemopathy and peripheral neuropathy: a case series
Authors: Mathilde Duchesne, Stéphane Mathis, Philippe Corcia, Laurence Richard, Karima Ghorab, Arnaud Jaccard, Laurent Magy, Jean-Michel Vallat
Journal: Medicine (Baltimore) (2015)
MeSH terms: Disease Management, Hematologic Neoplasms / diagnosis, Hematologic Neoplasms / therapy, Peripheral Nerves / pathology, Peripheral Nervous System Diseases / diagnosis, Case Reports, Aged, Biopsy, Female, Hematologic Neoplasms / pathology, Humans, Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis, Leukemia, Lymphocytic, Chronic, B-Cell / pathology, Leukemia, Lymphocytic, Chronic, B-Cell / therapy, Lymphoma, B-Cell / diagnosis, Lymphoma, B-Cell / pathology, Lymphoma, B-Cell / therapy, Lymphoma, Non-Hodgkin / diagnosis, Lymphoma, Non-Hodgkin / pathology, Lymphoma, Non-Hodgkin / therapy, Male, Middle Aged, Peripheral Nervous System Diseases / pathology

Hematological malignancies include several diseases that may affect the peripheral nervous system (PNS) through various mechanisms. A common and challenging situation is represented by the occurrence of an active peripheral neuropathy in a patient with a supposed inactive hematological disorder.We report clinical, electrophysiological, biological, and pathological data of 8 patients with latent malignant hemopathies (most were considered in remission): B-cell chronic lymphocytic leukemia in 3 patients, B-cell lymphoma in 1 patient, low-grade non-Hodgkin's lymphoma in 1 patient, Waldenström's macroglobulinemia in 1 patient, smoldering multiple myeloma in 1 patient, and monoclonal gammopathy of undetermined significance in 1 patient.In all these cases, the nerve biopsy (NB) helped to diagnose the hematological relapse or detect a pathological mechanism linked to the hematological disorder: epineurial lymphocytic infiltration in 5 patients (including one with antimyelin-associated glycoprotein antibodies), cryoglobulin deposits in 1 patient, chronic inflammatory demyelinating polyneuropathy in 1 patient, and necrotizing vasculitis in 1 patient. In each case, pathological findings were crucial to select the adequate treatment, leading to an improvement in the neurological and biological manifestations.These observations illustrate the value of NB and the need for active collaboration between neurologists and hematologists in such cases.
Adult Granulosa Cell Tumor of the Testis: A Case Report with a Review of the Literature
Authors: Klaus-Peter Dieckmann, Julia Bertolini, Christian Wülfing
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Adult granulosa cell tumor (AGCT) of the testis represents a very rare testicular neoplasm that is poorly understood clinically. Here we report the case of a 22-year-old male who presented with unspecific scrotal symptoms. Scrotal sonography disclosed a 6 mm hypoechoic intratesticular lesion. Histological examination after orchiectomy revealed a homogeneous and well demarcated neoplasm with monomorphic cells with nuclear grooving and microfollicular formation of the so-called Call-Exner bodies. Immunohistology showed positive stainings of vimentin, calretinin, and inhibin with negative stainings of the typical germ cell tumor markers. Thus, the diagnosis of a benign AGCT was made. The patient is well one year after surgery. A total of 91 previous AGCT cases were identified in the literature. Median age of the cases reported to date is 44 years, median tumor size 3.2 cm. 54.3% of the AGCT cases were located on the left side. 12 cases (13.2%) were of malignant nature. Testis-sparing surgery would be the treatment of choice, but only two of all cases had received that procedure. The present report aims to increase the clinical knowledge of AGCT and specifically to increase the clinician's vigilance with respect to testis-sparing surgery in probably benign testicular masses.
Rapid desensitization for brentuximab vedotin (Adceteris®) allergy: a case report
Authors: Attilio Di Girolamo, Marcello Albanesi, Alessandro Sinisi, Eustachio Nettis, Danilo Di Bona, Maria Filomena Caiaffa, Luigi Macchia
Journal: Clin Mol Allergy (2018)
Keywords: anti cd30, auristatin-e, desensitization, drug allergy, hodgkin lymphoma, monoclonal antibodies
MeSH terms: Case Reports

Background:
Brentuximab vedotin (BV) is an antibody-drug conjugate formed by an anti-CD30 chimeric IgG1 conjugated with monomethyl-auristatin-E. BV targets the CD30+ cells, which characterize Hodgkin lymphoma as well as anaplastic large cell lymphoma. Once bound to the CD30+ cells BV exerts its cytotoxic effect via the monomethyl-auristatin-E moiety. So far, accounts on immediate adverse reactions to BV remain anecdotal. Moreover, few reports exist on desensitization for BV.
Case presentation:
A 20-year old male patient was diagnosed with Hodgkin lymphoma in July 2014. The first line treatment with adriblastine, bleomicine, vinblastine and dacarbazine lead to a partial remission. Thus, a treatment with BV was started. However, during the second BV infusion, he developed generalized urticaria and dyspnea. In order not to discontinue the treatment with BV, we performed a thorough allergological workup and designed a 12-step rapid desensitization protocol. Overall the desensitization procedure was well tolerated and no major adverse reactions occurred.
Conclusion:
Rapid desensitization is a suitable and safe option in the case of BV allergy and prevents the BV treatment withdrawal.
Pediatric chronic myeloid leukemia with inv(3)(q21q26.2) and T lymphoblastic transformation: a case report
Authors: Margaret Lewen, Renee Gresh, Maria Queenan, Michele Paessler, Vinodh Pillai, Elizabeth Hexner, Dale Frank, Adam Bagg, Richard Aplenc, Emi Caywood, Gerald Wertheim
Journal: Biomark Res (2016)
Keywords: additional chromosomal abnormalities, blast phase, case report, chronic myeloid leukemia, mecom
MeSH terms: Case Reports

Background:
Chronic myeloid leukemia (CML) comprises ~3 % of pediatric leukemia. Although therapy with tyrosine kinase inhibitors (TKIs) is highly effective for CML, multiple factors have been identified as predictive of treatment failure. Chromosomal abnormalities involving the MECOM locus at 3q26 portend therapy resistant disease in adults, yet have never been described in pediatric patients and have not been associated with T lymphoblastic progression.
Case presentation:
We present a case of an 11-year-old boy with CML possessing the unique combination of T lymphoblastic transformation and a subclone harboring inv(3)(q21q26.2) at diagnosis. This is the first reported case of pediatric CML with inv(3)(q21q26.2) and the first case of T lymphoblastic progression associated with this karyotype. The patient was treated with single agent TKI therapy with robust initial response. Marrow histology at one month showed restoration of trilineage hematopoiesis and BCR-ABL RT-PCR at three months showed a 1.4 log reduction in transcript levels.
Conclusions:
The karyotypic abnormality of inv(3)(q21q26.2) in CML is not restricted to adult patients. Moreover, while chromosome 3 abnormalities are markers of TKI resistance in adults, our patient showed a robust early response to single agent TKI therapy. This finding suggests pediatric CML with inv(3)(q21q26.2) may have distinct features and more favorable treatment responses than those described in adults.
Uncontrolled epistaxis secondary to traumatic pseudoaneurysm of the maxillary artery
Authors: Eelam Adil, Dhave Setabutr, Michele M Carr
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500-700 micron Contour PVA followed by coiling with two 3 mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae.
Successful Treatment of Drug-Resistant Seizures Secondary to Ring 20 Mosaicism with Perampanel as an Add-On Antiepileptic Drug
Authors: Janet Ling, Wai Lan Yeung, Kam Lun Hon, Ivan F M Lo, Ho-Ming Luk, Cheuk Wing Fung, Alexander K C Leung
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

We report a girl with drug-resistant seizures, progressive behavioral changes, and cognitive decline. Investigations showed abnormal EEG with frequent high-voltage bifrontotemporal sharp and slow waves, especially during sleep. Seizures were difficult to control, despite the usage of various antiepileptic drugs. Perampanel as an add-on antiepileptic drug appeared efficacious. Due to the recognizable pattern of seizures and EEG findings, a karyotype study was performed which revealed 46 chromosomes with a ring 20 chromosome mosaicism. Ring 20 chromosome is associated with drug-resistant refractory seizures, cognitive decline, and behavioral problems. This case highlights the difficulty and challenge faced in managing drug-resistant refractory seizures associated with ring 20 chromosome. While ring 20 chromosome is often underdiagnosed, one should have a high index of awareness and suspicion of such rare epilepsy syndrome, so that an early diagnosis can be made.
Eosinophilic Asthma Secondary to Adjuvant Anti-PD-1 Immune Checkpoint Inhibitor Treatment in a Melanoma Patient
Authors: P Kissoonsingh, B Sutton, Syed U Iqbal, Lalit Pallan, Neil Steven, L Khoja
Journal: Case Rep Oncol Med (2022)
MeSH terms: Case Reports

Background:
Adjuvant immune checkpoint inhibitors are a new standard of care in melanoma. However, the immune related toxicity associated with these agents can be serious, and the long-term implications are yet to be defined especially in the adjuvant setting. We report, to our knowledge, the first case of anti-PD-1-induced eosinophilic asthma in a melanoma patient treated with adjuvant pembrolizumab. Case Presentation. A 72-year-old man commenced pembrolizumab in the adjuvant setting after resection of a stage IIIB cutaneous melanoma. The patient experienced episodes of breathlessness 4 weeks after cycle 1. These episodes were nocturnal and caused acute respiratory distress and cough, occasionally waking him up. The episodes progressed, and he was admitted after cycle 2 with a productive cough, wheeze, and breathlessness. Observations showed saturations on air of 94% and a respiratory rate of 19/min. The only laboratory abnormality was a raised eosinophil count of 1.1 × 109. Spirometry showed a FEV1 of 2.57 (91% predicted), FVC of 4.04 (108% predicted), and ratio of 64%. Peak expiratory flow rate was 94% predicted, and corrected gas transfer was 6.29 (78% predicted) with KCO 1.18 (93% predicted). FeNO was raised at 129 indicating inflammation of his airways, and peak flow was 422 l/min. CT of the chest did not show pneumonitis or other lung pathology. A diagnosis of acute eosinophilic asthma was made. Treatment with steroids and beclometasone dipropionate and formoterol inhaler produced rapid resolution of symptoms and normalisation of the eosinophil count. Pembrolizumab was safely recommenced once steroids had discontinued and symptoms had resolved.
Conclusions:
Specialist respiratory input was needed for optimal patient management and is ongoing. Although a safe rechallenge with pembrolizumab was possible, treatment in the adjuvant setting is curative in intent and long-term safety follow-up is required to assess for delayed toxicity and long-term health implications. This is likely to require large regional/national/international databases to detect, monitor, and educate the wider medical community as these patients are followed up in primary care following initial specialist follow-up.
Α very rare case of De Garengeot's hernia: Acute appendicitis within a femoral hernia
Authors: Nikolaos G Filippou, Domna Fanidou, Georgios Alvanos, Georgios Ouilson Papadopoulos, Dimitrios Filippou, Panagiotis Skandalakis
Journal: Clin Case Rep (2018)
Keywords: de garengeot, appendicitis, incarcerated femoral hernia, s hernia
MeSH terms: Case Reports

De Garengeot's hernia is a rare clinical entity. Appropriate and acute diagnosis in emergency basis is challenging (usually misdiagnosed as incarcerated femoral hernia), and the surgical management varies from case to case. This report emphasizes the importance of including De Garengeot's hernia in the differential diagnosis of incarcerated groin hernias and the need to establish a well-defined strategy regarding surgical management options.
Metastatic malignant melanoma of the inguinal lymph node with unknown primary lesion
Authors: Sherif Ali Eltawansy, Ryane Panasiti, Samaa Hasanien, Dennis Lourdusamy, David Sharon
Journal: Case Rep Med (2015)

Background. Malignant melanoma could present with metastasis with unknown primary (MUP) and this happens in 2-3% according to the studies. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. Case Report. We report a 58-year-old Caucasian male who presented with a right sided swelling in the inguinal region. Surgery was performed and biopsy showed metastatic malignant melanoma. No cutaneous lesions were identified by history or physical examination. Work up could not detect the primary lesion and patient was started on radiotherapy and immunotherapy. Conclusion. We present a case of malignant melanoma of unknown primary presenting in an unusual place which is the inguinal lymph node. Theories try to explain the pathway of development of such tumors and one of the theories mentions that it could be a spontaneous regression of the primary cutaneous lesion. Another theory is that it could be from transformation of aberrant melanocyte within the lymph node. Prognosis is postulated to be better in this case than in melanoma with a known primary.