OpenMed/multicare-articles huggingface dataset:
Spontaneous heterotopic pregnancy, simultaneous ovarian, and intrauterine: a case report
Authors: Francesca Basile, Cristina Di Cesare, Lorena Quagliozzi, Laura Donati, Marina Bracaglia, Alessandro Caruso, Giancarlo Paradisi
Journal: Case Rep Obstet Gynecol (2012)

Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. The occurrence of an ovarian heterotopic pregnancy is a singular event as it comprises only 2.3% of all heterotopic pregnancies, extremely rare among women who conceive naturally. A case of a 28-year old patient was treated for spontaneously conceived heterotopic pregnancy. The patient was admitted to our center with lower abdominal pain and amenorrhoea. A transvaginal ultrasound scan showed an ovarian and an intrauterine heterotopic pregnancy. This was managed laparoscopically. Considering spontaneous pregnancies, every physician treating women of reproductive age should be aware of the possibility of heterotopic pregnancy. It can occur in the absence of any predisposing risk factors; only with an early diagnosis and treatment the intrauterine pregnancies will reach viability with a great chance of a favorable obstetric outcome.
Acute myocardial infarction complicated by purulent pericarditis: A case report
Authors: Yamato Tamura, Takehisa Abe
Journal: Clin Case Rep (2023)
Keywords: methicillin‐sensitive staphylococcus aureus, purulent pericarditis, sudden cardiac tamponade
MeSH terms: Case Reports

A man with persistent dyspnea was brought to our hospital in an emergency. Cardiac catheterization revealed right coronary artery occlusion. The patient went into shock on the second day of treatment due to rapid pericardial effusion. The pericardial fluid was cloudy and non-bloody, which was judged to indicate purulent pericarditis.
Idiopathic Harlequin Syndrome Manifesting during Exercise: A Case Report and Review of the Literature
Authors: Hussein Algahtani, Bader Shirah, Raghad Algahtani, Abdulah Alkahtani
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and sweating with contralateral anhidrosis induced by exercise, heat, and emotion. It is usually idiopathic but could be the first manifestation of several serious underlying medical conditions. Medical or surgical treatments are not required for idiopathic Harlequin syndrome, but social and psychological factors may indicate sympathectomy or botulinum toxin injection. In this article, we report a case of idiopathic Harlequin syndrome and review the literature.
Spontaneous perforation of Meckel's diverticulum: a case report and review of literature
Authors: Robleh Hassan Farah, Prude Avala, Driss Khaiz, Fatmazahra Bensardi, Khalid Elhattabi, Rachid Lefriyekh, Saad Berrada, Abdelaziz Fadil, Najib Ouariti Zerouali
Journal: Pan Afr Med J (2015)
Keywords: acute appendicitis, meckel′s diverticulum (md), perforation, peritonitis
MeSH terms: Abdominal Pain / etiology, Ileostomy / methods, Meckel Diverticulum / pathology, Peritonitis / diagnosis, Case Reports, Review, Abdomen, Acute / diagnosis, Abdomen, Acute / etiology, Adult, Diagnosis, Differential, Humans, Intestinal Perforation / diagnosis, Intestinal Perforation / surgery, Laparotomy, Male, Meckel Diverticulum / surgery, Peritonitis / etiology

Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Hemorrhage, obstruction and inflammation are the three main categories of complications resulting from Meckel's diverticulum. Spontaneously perforation of Meckel's diverticulum is very rare and mimics acute appendicitis. We report a case of 26 year-old male, who presented since 5 days worsening abdominal pain predominantly in the right iliac fossa associated with high grade fever. On physical examination his abdomen was distended with guarding and rigidity. A provisional diagnosis of appendiculaire peritonitis was made. Our patient had an emergency laparotomy, where a perforated Meckel's diverticulum and advanced peritonitis were discovered. A diverticulectomy with ileostomy were performed. Heterotopic mucosa of diverticulitis was confirmed on histopathology. The patient made an uneventful recovery postoperatively and ileostomy reconstruction was done two months later. This case report is an interesting and unusual case of Meckel's diverticulum complications and highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.
The Closed-Loop System Improved the Control of a Pregnant Patient with Type 1 Diabetes Mellitus
Authors: Guillermo E Guzmán Gómez, Julian A Viggiano, A Silva-De Las Salas, Veline Martínez, María A Urbano Bonilla
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Objective:
Closed-loop insulin systems represent a technological advance in diabetes management but have rarely been studied in pregnancy. We report a case of a patient with type 1 diabetes mellitus who was previously a user of the Paradigm VEO pump and then migrated to Medtronic 670G. Research Design and Methods. We reviewed the case of a G1P0 patient with type 1 diabetes, treated with the Medtronic 670G system during pregnancy; a comparison with current literature was done.
Results:
The patient achieved improved glycemic control as measured by time spent in different ranges as follows: <70 mg/dL, 8-4% and 70-180 mg/dL, 83-94%. Secondary outcomes included reduction of stress, anxiety, fear of hypoglycemia, and the psychological burden related to the disease. There were no obstetric or neonatal complications.
Conclusion:
The Medtronic 670G closed-loop system was used safely in a pregnant woman; nevertheless, further research is needed to validate this system in this patient population.
Pilomatrixoma of earlobe
Authors: Mohamed Jallouli, Houssem Yengui, Abdelmajid Khabir, Riadh Mhiri
Journal: J Cutan Aesthet Surg (2009)
Keywords: calcification, earlobes, pilomatrixoma
MeSH terms: Case Reports

Pilomatrixomas are uncommon in children and are frequently misdiagnosed preoperatively. We report a two-year-old female patient with an unusual localization in the earlobe. The lesion was treated by simple enucleation and in two years of follow-up there has been no evidence of recurrence. The case is being reported in view of its rarity and unusual location.
Feasibility of dual-task gait training for community-dwelling adults after stroke: a case series
Authors: Prudence Plummer, Raymond M Villalobos, Moira S Vayda, Myriam Moser, Erin Johnson
Journal: Stroke Res Treat (2014)

This case series explored the feasibility and efficacy of cognitive-motor dual-task gait training in community-dwelling adults within 12 months of stroke. A secondary aim was to assess transfer of training to different dual-task combinations. Seven male participants within 12 months of stroke participated in 12 sessions of dual-task gait training. We examined single and dual-task performance in four different dual-task combinations at baseline, after 6 and 12 sessions, and if possible, at 1-month followup. Feasibility was assessed by asking participants to rate mental and physical fatigue, perceived difficulty, anxiety, and fear of falling at the end of each session. Five of the seven participants demonstrated reduced dual-task cost in gait speed in at least one of the dual-task combinations after the intervention. Analysis of the patterns of interference in the gait and cognitive tasks suggested that the way in which the participants allocated their attention between the simultaneous tasks differed across tasks and, in many participants, changed over time. Dual-task gait training is safe and feasible within the first 12 months after stroke, and may improve dual-task walking speed. Individuals with a combination of physical and cognitive impairments may not be appropriate for dual-task gait training.
Oncocytic Tumors: An Uncommon Benign Adrenal Gland Lesions With Features of Malignancy
Authors: Zineb Elazime, Lamiaa Elazizi, Hayat Aynaou, Houda Salhi, Hanan Elouahabi
Journal: Cureus (2023)
Keywords: adrenal incidentaloma, adrenal oncocytoma, malignancy, oncocytoma, rare tumors
MeSH terms: Case Reports

Oncocytic cell neoplasms are usually found in the thyroid or salivary glands and the kidneys. Adrenal oncocytoma (AO) is an extremely rare localization. It is often non-functional and the suspicion of malignancy is considered when the size of an adrenal incidentaloma is greater than 4 cm. These adrenal oncocytomas, however, are large, round, and encapsulated with a benign presentation and evolution. We report on a 40-year-old male patient. Upon suspicion of a SARS-CoV-2 infection, the general physician instructed a chest CT scan, which, fortuitously, revealed a suspicious left adrenal lesion measuring 62x45mm. A biochemical investigation was negative for either pheochromocytoma or Cushing's syndrome, allowing the recommended surgery to be performed. The anatomopathological analysis showed an uncommon benign adrenal lesion, an adrenal oncocytoma.
De novo chronic lymphocytic leukemia/prolymphocytic leukemia or B-cell prolymphocytic leukemia? The importance of integrating clinico-morphological and immunophenotypic findings in distinguishing chronic lymphoproliferative diseases with circulating phase
Authors: Zachariah Chowdhury, Yookarin Khonglah, Susmita Sarma, Pranjal Kalita
Journal: Autops Case Rep (2020)
Keywords: immunophenotyping, leukemia, lymphoid, lymphadenopathy
MeSH terms: Case Reports

B-cell prolymphocytic leukemia (B-PLL) is an extremely rare disease, accounting for approximately 1% of the lymphocytic leukemias. B-PLL generally occurs in older people. It is characterized by the presence of more than 55% prolymphocytes in the peripheral blood (PB), no or minimal lymphadenopathy, massive splenomegaly, and very high white blood cell counts. The prognosis of B-PLL patients is generally poor, with a median survival of 3 years, although a subset of patients may show a prolonged survival. Herein, we report a case of a 70-year-old male with weakness, generalized lymphadenopathy, and moderate splenomegaly at the initial presentation. Hematologic examination revealed lymphocytic leukocytosis, favoring a chronic lymphoproliferative disorder (CLPD). The key to decoding the precise CLPD was a combination of the clinical profile, morphologic findings on the peripheral blood and the bone marrow, immunophenotypic analysis, and cytogenetic study. The best diagnosis proffered was a de novo chronic lymphocytic leukemia/prolymphocytic leukemia. There was no prior history of lymphoproliferative disorder or lymphocytic leukocytosis. Discriminating this entity from other lymphoproliferative disorders is crucial as the treatment and prognosis are varied compared to the other lymphoproliferative disorders. The diagnostic conundrum encountered and the incredible utility of ancillary studies in such a scenario are highlighted in this study.
Anaplastic large cell lymphoma associated with breast implants
Authors: Shalini Ravi-Kumar, Omid Sanaei, Mohammad Vasef, Ian Rabinowitz, Mohammad Houman Fekrazad
Journal: World J Plast Surg (2012)
Keywords: anaplastic, breast, implant, large cell lymphoma
MeSH terms: Case Reports

A forty two years old woman with a history of bilateral breast augmentation for cosmetic reasons was presented for poor healing of the surgical site. Tissue and periprosthetic fluid were removed from the wound site revealing an atypical lymphoid infiltrate. Subsequently the patient developed axillary lymph adenopathy. Excisional biopsy was performed. Flow cytometry was non-diagnostic. She continued to heal poorly and eventually had removal of implant during a simple mastectomy. A nodular area in the breast specimen showed ALK negative anaplastic large cell lymphoma (ALCL). The patient was treated in the private section, with only a pathology consultation being done at our institution (Figures 1-3).
Case Report: Identification of a novel CASK missense variant in a Chinese family with MICPCH
Authors: Runfeng Zhang, Peng Jia, Yanyi Yao, Feng Zhu
Journal: Front Genet (2022)
Keywords: cask gene, mental retardation, mutation, spinocerebellar ataxia, whole-exome sequencing
MeSH terms: Case Reports

Mental retardation and microcephaly with pontine and cerebellar hypoplasia (MICPCH) is a rare genetic disorder that results in varying levels of pontocerebellar hypoplasia, microcephaly, and severe intellectual disabilities. Prior genetic analyses have identified the CASK gene as a driver of MICPCH. Herein, we analyzed a Chinese family with MICPCH. The index patient was an 8-year-old male. He and his 3-year-old brother suffered from microcephaly, pontocerebellar hypoplasia, serious mental retardation, ataxia, gait disorder, and inability to speak. Through a combination of whole-exome sequencing and subsequent Sanger sequencing, a novel X-linked missense mutation, c.1882G>C (p.D628H) in the CASK gene, was identified in two siblings, as well as their mother and grandmother, who exhibited mild mental retardation. Other family members with negative genetic testing were normal. In silico analyses indicated that this missense mutation was predicted to reduce CASK protein stability, disrupt the SRC homology 3 (SH3) domain, and abolish its function. In summary, we identified a novel missense variate in CASK associated with MICPCH. Our work facilitates the diagnosis of the disease in this family and broadens the gene variant spectrum of the CASK in MICPCH patients.
Case report: CAR-T cell therapy-induced cardiac tamponade
Authors: Sacha Sarfati, Misa Eugène Norbert, Antoine Hérault, Marion Giry, Jade Makké, Maximilien Grall, Arnaud Savouré, Vincent Camus, Mustafa Alani, Fabienne Tamion, Jean-Baptiste Latouche, Christophe Girault
Journal: Front Cardiovasc Med (2023)
Keywords: car-t cell, crs, icu, cardiac tamponade, case report, pericardial effusion, pericarditis
MeSH terms: Case Reports

CD19-specific chimeric antigen receptor T (CAR-T) cell therapy has recently been shown to improve the prognosis of refractory diffuse large B-cell lymphoma (DLBCL). However, CAR-T cells may induce numerous adverse events, in particular cytokine release syndrome (CRS) which is frequently associated with cardiovascular manifestations. Among the latter, acute pericardial effusion represents less than 1% of cases and cardiac tamponade has only been reported once. The management and outcome of these severe complications are not well established. We report here, a case of cardiac tamponade associated with CRS in a context of CAR-T cell therapy, which required urgent pericardiocentesis.
Case summary:
A 65-year-old man with refractory DLBCL was treated with CAR-T cell therapy. He had a history of dilated cardiomyopathy with preserved ejection fraction and transient atrial fibrillation. A pericardial localization of the lymphoma was observed on the second relapse. One day after CAR-T cell infusion the patient was diagnosed with grade 1 CRS. Due to hypotension, he was treated with tocilizumab and dexamethasone, and then transferred to intensive care unit (ICU). Echocardiography performed at ICU admission showed acute pericardial effusion with signs of right ventricular heart failure due to cardiac tamponade. It was decided to perform pericardiocentesis despite grade IV thrombocytopenia in a context of aplasia. Analysis of pericardial fluid showed a large number of lymphoma cells and 73% of CAR-T cells amongst lymphocytes, a level that was similar in blood. Hemodynamic status improved after pericardiocentesis, and no recurrence of pericardial effusion was observed. The presence of a high count of activated CAR-T cells in the pericardial fluid as well as the short interval between CAR-T cells injection and the symptoms appear as potential arguments for a direct action of CAR-T cells in the mechanism of this adverse event. The patient was discharged from ICU after two days and initially exhibited a good response to DLBCL treatment. Unfortunately, he died fifty days after starting CAR-T cell therapy due to a new DLBCL relapse.
Conclusion:
Patients with a pericardial localization of DLBCL should be assessed for a risk of cardiac tamponade if receiving CAR-T cell therapy and presenting CRS. In this case, cardiac tamponade seems directly related to CAR-T cell expansion. Pericardiocentesis should be considered as a feasible and effective treatment if the risk of bleeding is well controlled, in association with anti-IL6 and corticosteroids.
Case report: A rare combination of right aortic arch with right patent ductus arteriosus and right tracheal bronchus causing impaired respiratory function
Authors: Xingchen Lian, Ning Wang, Chuan Bai, Ping Wen, Yuhang Liu
Journal: Front Cardiovasc Med (2022)
Keywords: case report, right aortic arch, right patent ductus arteriosus, right tracheal bronchus, tracheobronchial stenosis
MeSH terms: Case Reports

A right aortic arch with concomitant right patent ductus arteriosus and right tracheal bronchus is a rare congenital anomaly. Herein, the respiratory and circulatory functions of the child were normal at early ages, and imaging examination indicated that conservative treatment was suitable. However, with the growth and development of the child, the right tracheal bronchus was oppressed by the right arterial duct. We performed a cut and ligation of the right patent ductus arteriosus to relieve the pressure on the right tracheal bronchus. At the 6-month follow-up, the child had recovered well and exhibited no symptoms of respiratory restriction. Therefore, we believe that early interventions should be considered for this rare anatomic presentation to benefit the patient's respiratory and circulatory systems. Our experience provides a foundational reference for future cases.
Case report: Chronic granulomatous disease presenting with early-onset inflammatory bowel disease and normal oxidative burst testing
Authors: Sanjib Mondal, Pandiarajan Vignesh, Sathish Kumar Loganathan, Kanika Arora, Jhumki Das, Amit Rawat, Surjit Singh
Journal: Front Pediatr (2023)
Keywords: chronic granulomatous disease, colitis, dihydrorhodamine, nitroblue tetrazolium, residual nadph oxidase
MeSH terms: Case Reports

Background:
Due to the lack of widespread availability of flow cytometry services for immunodeficiency, nitroblue tetrazolium test (NBT) is the commonly used screening modality to identify patients with chronic granulomatous disease (CGD) in developing countries.
Procedure:
We report a child with X-linked CGD with residual NADPH oxidase activity who had an indeterminate NBT result even in the presence of classical manifestations of CGD.
Results:
A 7-year-old boy presented with recurrent episodes of inflammatory colitis and Burkholderia cepacia septicaemia at the age of 3 years. He also had cervical adenitis due to Mycobacterium tuberculosis. NBT performed on multiple occasions was not suggestive of CGD. Dihydrorhodamine (DHR) test using phorbol myristate acetate (PMA) as a stimulant revealed a small blunt peak suggestive of AR-CGD; however, significant reduction in NADPH oxidase activity was noted with milder stimulants such as Escherichia coli and Staphylococcus aureus. Genetic analysis revealed a hemizygous pathogenic variant in CYBB. Flow cytometry showed diminished gp91phox expression in the patient's neutrophils suggestive of X-linked CGD.
Conclusion:
Our case highlights that early-onset inflammatory bowel disease can be a presenting manifestation of CGD and diagnosis of CGD can be missed if NBT alone is used for screening, especially in the presence of NADPH oxidase activity. Diagnosis of "CGD with residual NADPH oxidase activity" requires a high degree of clinical suspicion, and performing DHR with different stimulants can unravel the diagnosis.
Double intussusception secondary to Meckel's diverticulum in a seventeen-year-old female: a case report
Authors: Feras Sendy, Thibaut D'escrivan, Anthony Joubert, Nicolae Fetche
Journal: Pan Afr Med J (2020)
Keywords: intussusception, meckel’s diverticulum and laparoscopy
MeSH terms: Abdominal Pain / etiology, Intussusception / etiology, Meckel Diverticulum / complications, Case Reports, Adolescent, Female, Humans, Intussusception / diagnosis, Intussusception / surgery, Laparoscopy, Laparotomy, Meckel Diverticulum / diagnosis, Meckel Diverticulum / surgery

Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. It rarely presents in adults and is usually asymptomatic. Attention to clinical history, examination and imaging studies are crucial for a successful diagnosis. A 17-year-old female presented with vomiting and acute peri-umbilical abdominal pain. Ultrasound examination showed an intussusception measuring 3.2cm in diameter and over 8cm in length. Exploratory laparoscopy showed two ileal intussusceptions. The first was reduced via laparoscopy; the second appeared suspicious for MD and ultimately required a mini-laparotomy for reduction and resection of the MD. Ultrasonography is a useful modality in the presence of perforation, occlusion, hemorrhage, neoplasia, or fistula and avoids exposure to radiation. Laparoscopic or laparoscopic-assisted mini-laparotomy is the route for the resection of MD. The choice depends on the clinical presentation and surgeon expertise. A careful history and physical examination are vital factors in diagnosis and treatment MD.
A hepatic sclerosing hemangioma emerged in the postoperative course of multiple gastric carcinoid tumors masquerading as metachronous liver metastasis
Authors: Ryota Koyama, Nozomi Minagawa, Yoshiaki Maeda, Toshiki Shinohara, Tomonori Hamada
Journal: Int J Surg Case Rep (2019)
Keywords: gastric carcinoid, hepatic sclerosing hemangioma, metachronous liver metastasis

Introduction:
Hepatic sclerosing hemangiomas are rare tumors whose appearance on imaging is similar to that of malignant tumors. The resulting difficulties in preoperative diagnosis frequently lead to surgical resection in order to accurately identify the tumor.
Case presentation:
A 68-year-old man was diagnosed with multiple gastric carcinoid tumors (T1N1M0, pStage IIIB) after total gastrectomy with D2 lymph node dissection. Enhanced computed tomography of the abdomen 2 years after the initial surgery revealed a novel solid lesion with ring enhancement measuring 22 × 15 mm at S5 of the liver. Metachronous liver metastasis from multiple gastric carcinoid tumors was suspected, and partial hepatectomy of S5 was successfully performed. Histopathological diagnosis was sclerosing hemangioma with no malignant findings.
Discussion:
Ours is the first reported case of a newly appearing sclerosing hemangioma excised and diagnosed histopathologically. Hepatic sclerosing hemangiomas are rarely observed, but they are often resected under a preoperative diagnosis of malignant lesion due to the similarity on imaging studies.
Conclusion:
Surgeons must consider that a hepatic tumor may be a sclerosing hemangioma, particularly when the lesion appears to be ring enhanced.