OpenMed/multicare-articles huggingface dataset:
Case report: Four cases of kidney disease in Giant African Land Snails ( Lissachatina fulica)
Authors: Silvana Schmidt-Ukaj, Michaela Gumpenberger, Frank Mutschmann, Barbara Richter
Journal: Front Vet Sci (2023)
Keywords: case report, diagnostic imaging, invertebrates, kidney disease, mollusks
MeSH terms: Case Reports

Giant African Land Snails like Lissachatina fulica have become increasingly popular as pets in Europe, but little is known yet about land snail diseases and their therapy. These case reports show the history of four adult Lissachatina fulica with apathy and esophagus protrusion or prolapse in three cases and edema and mantle collapse in another case. Renomegaly and/or kidney deposits could be demonstrated in radiographic and/or CT examinations in all four cases. Necropsy and histology revealing nephropathy could be performed in three cases. With these first case reports on land snails with kidney disease, we hope to encourage diagnostic imaging and further veterinary research in land snails to improve our knowledge about their diseases.
Mammary analogue secretory carcinoma of the salivary glands
Authors: Lucas Avondet, Roque Adan, Barbara M Berenstein, Ismael Tayagui, Gonzalo Zeballos, Erica Rojas Bilbao, Fernanda Alsina, Nicolas Bustos
Journal: Ecancermedicalscience (2023)
Keywords: etv6-ntrk3 translocation, mammary secretory carcinoma, molecular pathology, salivary glands
MeSH terms: Case Reports

Background:
Mammary analogue secretory carcinoma (MASC) is a new disease among tumours affecting the salivary glands. It was first reported in 2010, and few cases have been reported worldwide. MASC is often incorrectly diagnosed as salivary gland acinic cell carcinoma. We present here the case of a patient with an asymptomatic parotid tumour who underwent a parotidectomy of the superficial lobe.
Case report:
A 78-year-old female patient came to the clinic for a tumour of approximately 2.5 × 2.5 cm and a hard, elastic consistency that had grown insidiously in the right preauricular region. Magnetic resonance imaging of the head and neck showed a heterogeneous ovoid lesion located in the lower part of the superficial lobe of the right parotid gland, measuring 29 × 27 × 27 mm. A superficial parotidectomy was performed with the facial nerve identified and preserved. Immunohistochemistry was positive for S100, mammaglobin, periodic acid Schiff (PAS) and GATA-3. Fluorescence in situ hybridisation analysis was subsequently performed and Translocation-ETS-Leukemia Virus (ETV6) gene rearrangement observed. These findings were consistent with diagnosis of a MASC. The patient then required no new interventions or adjuvant therapy. At publication, she was free of disease and continues in clinical follow-up.
Conclusion:
MASC is a tumour of the saliva glands that is recently described and rare. There are no studies that describe its biological behaviour or prognosis precisely.
Extensively Invasive Gallbladder Cancer from Intracholecystic Papillary Neoplasm Treated with Pylorus-Preserving Pancreaticoduodenectomy and Extended Cholecystectomy: A Case Report and Literature Review
Authors: Hideki Kumagai, Akira Umemura, Hiroyuki Nitta, Hirokatsu Katagiri, Masao Nishiya, Noriyuki Uesugi, Tamotsu Sugai, Akira Sasaki
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Background:
Intracholecystic papillary neoplasm (ICPN) is a rare tumor first classified by the World Health Organization in 2010. ICPN is a counterpart of the intraductal papillary mucinous neoplasm of the pancreas and intraductal papillary neoplasm of the bile duct. Previous reports on ICPN are limited; thus, the diagnosis, surgical intervention, and prognosis are controversial. Here, we report an extensively invasive gallbladder cancer arising in ICPN treated with pylorus-preserving pancreaticoduodenectomy (PPPD) and extended cholecystectomy. Case Presentation. A 75-year-old man presented to another hospital with jaundice for 1 month. Laboratory findings showed elevated total bilirubin, 10.6 mg/dL and carbohydrate antigen 19-9, 54.8 U/mL. Computed tomography showed a well-enhanced tumor located in the distal bile duct and dilated hepatic bile duct. The gallbladder wall was thickened and homogeneously enhanced. Endoscopic retrograde cholangiopancreatography revealed a filling defect in the distal common bile duct, and intraductal ultrasonography showed a papillary tumor in the common bile duct, indicating tumor invasion of the bile duct subserosa. Subsequent bile duct brush cytology revealed adenocarcinoma. The patient was referred to our hospital for surgical treatment and underwent an open PPPD. Intraoperative findings showed a thickened and indurated gallbladder wall, suggesting concurrent gallbladder cancer; thus, the patient subsequently underwent PPPD and extended cholecystectomy. Histopathological findings confirmed gallbladder carcinoma originating from ICPN, which extensively invaded the liver, common bile duct, and pancreas. The patient started adjuvant chemotherapy (tegafur/gimeracil/oteracil) 1 month after surgery and had no recurrence at follow-up after 1 year.
Conclusions:
Accurate preoperative diagnosis of ICPN, including the extent of tumor invasion is challenging. To ensure complete curability, the development of an optimal surgical strategy considering preoperative examinations and intraoperative findings is essential.
The Mutant Thyroid Hormone Receptor Beta R320P Causes Syndrome of Resistance to Thyroid Hormone
Authors: Tetsuya Kimura, Yoshitaka Hayashi, Yuka Tsukamoto, Yasuyuki Okamoto
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

A 31-year-old Japanese male patient with a history of atrial fibrillation showed elevated serum levels of free thyroxine and triiodothyronine and a normal level of thyrotropin. The same abnormal hormone pattern was also found in his son. These data indicated that the index patient and the son have thyroid hormone resistance syndrome. Exon sequencing using DNA from these two patients revealed that both patients harbored a heterozygous mutation in the THRB gene: G1244C in exon 9, which results in R320P substitution. Therefore, thyroid hormone resistance syndrome caused by THRB mutation (RTHβ) was diagnosed. The mutation of the 320th arginine to proline has not been found to date. In conclusion, herein, we have described the first case of RTHβ that is associated with R320P mutation.
Fibroblastic variant of low-grade endometrial stromal sarcoma mimicking an inflammatory pseudotumor: a case report
Authors: Anass Haloui, Nassira Karich, Achraf Miry, Amal Bennani
Journal: Pan Afr Med J (2022)
Keywords: low grade endometrial stromal sarcoma, case report, endometrial stromal sarcoma, fibroblastic variant
MeSH terms: Endometrial Neoplasms / diagnosis, Granuloma, Plasma Cell / diagnosis, Sarcoma / diagnosis, Sarcoma, Endometrial Stromal / diagnosis, Soft Tissue Neoplasms, Review, Case Reports, Adult, Female, Fibroblasts, Humans

The World Health Organization currently divides endometrial stromal sarcomas into 4 different entities, based on their clinical and pathological features: endometrial stromal nodule, low-grade endometrial stromal sarcomas (LG-ESS), High-grade endometrial stromal sarcomas, and undifferentiated uterine sarcoma. The fibroblastic variant of LG-ESS is rare and is usually made of small tumoral cells of oval to fusiform shape, demonstrating low cytologic atypia and low mitotic activity, which can lead to confusion with a benign myofibroblastic proliferation. We hereby report a rare case of a fibroblastic variant of LG-ESS in a 37-year-old woman presenting abundant metrorrhagia, which was initially misdiagnosed as an inflammatory pseudotumor before proofreading in our laboratory, along with a review of a histological and immunohistochemical findings, aiming to help pathologists avoid this diagnosis pitfall.
Superior Mesenteric Artery Syndrome: A Potentially Fatal but Reversible Gastrointestinal Manifestation of Systemic Sclerosis
Authors: Choon-Guan Chua, Gervais Khin-Lin Wansaicheong, Wee-Chian Lim, Bernard Yu-Hor Thong
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Superior mesenteric artery syndrome (SMAS) is a rare gastrointestinal disorder characterised by vascular compression of the third part of the duodenum, in the angle between the superior mesenteric artery (SMA) and the abdominal aorta. It presents as an uncommon cause of upper gastrointestinal obstruction. In patients with systemic sclerosis (SSc), gastrointestinal involvement may result in oesophageal dysmotility, gastroesophageal reflux disease (GERD), gastroparesis, small intestinal bacterial overgrowth (SIBO), chronic intestinal pseudoobstruction (CIPO), and fecal incontinence. Malnutrition may thus result in weight loss and reduced mesenteric and retroperitoneal adipose tissue, decreasing the angle between the SMA and aorta causing SMAS. Enteral or parenteral feeding can potentially reverse SMAS in SSc. We report a case of SMAS in an elderly female with SSc and concurrent gastrointestinal involvement, and discuss the important management considerations and potential adverse outcomes when untreated.
Pneumatosis Coli Formation via Counterperfusion Supersaturation in a Patient with Severe Diarrhea
Authors: Eric Vecchio, Sehrish Jamot, Jason Ferreira
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

We present the case of an elderly male patient with known multiple myeloma who was hospitalized with profuse watery diarrhea and abdominal pain after a course of induction chemotherapy. Intestinal intramural gas was found on imaging and the diagnosis of pneumatosis intestinalis was confirmed by colonoscopy. We propose counterperfusion supersaturation as the etiology for this patient's pneumatosis coli via disruption of homeostasis between nitrogen and hydrogen normally present in the bowel. His condition was successfully treated with antidiarrheal medications and inhaled oxygen as well as intravenous hydration, and he eventually completed multiple myeloma directed chemotherapy with an excellent response. In this report, we discuss how clinicians can improve management of pneumatosis intestinalis by understanding the proposed pathophysiology.
A rare complication following laparoscopic Roux & Y gastric bypass: intussusception-case report
Authors: Senol Carilli, Mustafa Arısoy, Aydin Alper
Journal: Springerplus (2015)
Keywords: bariatric surgery, complication, gastric bypass, intussusception, obesity surgery, obstruction

Obesity is a growing health problem in most parts of the world. Currently only proven long term effective treatment of obesity is bariatric surgery. Roux & Y gastric bypass together with sleeve gastrectomy are the most employed surgical techniques with acceptable metabolic and surgical complication rates. In this paper we would like to present an unexpected complication of Roux & Y gastric bypass: a retrograde intussusception located in the common limb 17 months after the surgery. As intussusception in adults usually originates from a leading point, there is no such an explanation following Roux & Y gastric bypass.
68Ga-DTPA Anti-HER2 positron emission tomography/CT successfully predicts the overexpression of human epidermal growth factor receptor in lung metastases from breast cancer
Authors: Quetzali Gabriela Pitalúa-Cortés, Francisco O García-Pérez, Yolanda Villaseñor-Navarro, Fernando Ulises Lara-Medina, Juan Antonio Matus-Santos, Irma Soldevilla-Gallardo, Fany Iris Porras-Reyes, Victor Manuel Pérez-Sánchez, Héctor Aquiles Maldonado-Martínez, Wendy Pérez-Báez, Isabel Sollozo-Dupont
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Molecular identification of a metastatic tumour without the inconvenience of a biopsy and the time required for pathological characterization is possible using molecular imaging. Here, we present the case of a patient with breast cancer in whom 68Ga-diethylenetriamine pentaacetic acid anti-human epidermal growth factor receptor 2 positron emission tomography-CT was successfully employed to characterize the expression of human epidermal growth factor receptor 2 in metastatic sites.
Surgical site infection leading to gangrene and amputation after ambulatory surgical care of an ingrown toenail: a case report
Authors: Aimé Gilbert Mbonda Noula, Joel Noutakdie Tochie, Landry W Tchuenkam, Desmond Aji Abang, René Essomba
Journal: Patient Saf Surg (2019)
Keywords: ambulatory surgery, gangrene, ingrown toenail, nail surgery
MeSH terms: Case Reports

Background:
Currently, the management of ingrown toenail (onychocryptosis) ranges from conservative medical management to surgical treatment. Surgical management is typically performed as an outpatient procedure due to it numerous advantages such as the simplicity of the technique and the low incidence of postoperative complications. The most common postoperative complications are recurrences and surgical site infections, whereas gangrene complicating a surgical site infection has been scarcely reported. We are reporting a rare complication following ambulatory surgery untimely requiring amputation.
Case presentation:
A twelve-year-old boy was referred to our orthopedic surgical department for a surgical site infection complicating an initial surgical management of a left ingrown big toenail leading to a dry gangrene of the affected toe. The gangrene toe was amputated under peripheral nerve block and the patient was discharged home the same day on antibiotics, analgesics and with sessions of rehabilitation and psychological support planned. The postoperative course was uneventful at 6 months of follow-up.
Conclusion:
The authors report this case to draw clinicians' attention, especially wound care specialists, orthopedists and podiatrists to this rare but potentially debilitating disease.
HELLP Syndrome Complicated by Subcapsular Hematoma of Liver: A Case Report and Review of the Literature
Authors: Atilla Karateke, Dilek Silfeler, Faruk Karateke, Raziye Kurt, Ayse Guler, Ismail Kartal
Journal: Case Rep Obstet Gynecol (2014)

Subcapsular liver hematoma (SLH) is a rare complication of severe preeclampsia and HELLP syndrome. These patients must be followed up in intensive care unit for advanced medical support with infused fluid, replacement of blood products, and treatment of underlying disorders. There are a lot of therapeutic options varying from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this report we aimed to present a 26-year-old woman with SLH secondary to HELLP syndrome.
Multiple hepatic aneurysms and dry gangrene of fingertips in eosinophilic granulomatosis with polyangiitis: a case report
Authors: Eunsil Koh, Noeul Kang, Jin-Young Lee, Duk-Kyung Kim, Young Soo Do, Byung-Jae Lee, Dong-Chull Choi
Journal: Allergy Asthma Clin Immunol (2020)
Keywords: aneurysm, egpa, eosinophilic granulomatosis with polyangiitis, gangrene, mepolizumab
MeSH terms: Case Reports

Background:
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis mainly affecting small-sized arteries. Involvement of medium-sized vessels is very rare in EGPA. Here we present the case of a patient with EGPA who showed multiple hepatic aneurysms and distal gangrene.
Case presentation:
A known EGPA patient visited to the emergency room (ER) with abrupt squeezing abdominal pain. She had suffered from gangrene in the fingertips of both hands for 1 year because of arterial thrombosis associated with hypereosinophilia. However, her absolute eosinophil count in the ER was 1120 cells/µL. An abdomen-pelvis CT demonstrated subcapsular hematoma in the right hepatic lobe. A celiac angiogram demonstrated multiple sized aneurysms in both hepatic lobes and some aneurysms in S7 and S8 were huge, more than 1 cm in size. The shape of the small aneurysms resembled a string of beads, as in polyarteritis nodosa. Given the clinical situation, emergency embolization was performed. Before this patient visited to the ER, she had been treated with a high dose of systemic corticosteroid, azathioprine, and cyclophosphamide. After addition of mepolizumab, the eosinophil count remained stable state with a near zero percentage of total white blood cell count.
Conclusions:
Aneurysm and gangrene resulting from the involvement of medium-sized vessels can occur in EGPA. Destruction of vessels might occur even if eosinophil count is below 1500 cells/µL. If involvement of medium-sized arteries is suspected, thorough investigation to identify the involved organs and prompt management are needed to prevent fatal complications.
Meningitis as an Initial Presentation of COVID-19: A Case Report
Authors: Sidra Naz, Muhammad Hanif, Muhammad Adnan Haider, Mukarram Jamat Ali, Muhammad Umer Ahmed, Sana Saleem
Journal: Front Public Health (2020)
Keywords: covid-19, sars-cov-2, meningitis, meningo encephalitis, neurological manifestation
MeSH terms: COVID-19, Meningitis / diagnosis, Nervous System Diseases, Case Reports, Dysgeusia, Humans, SARS-CoV-2

The common presenting symptoms of fever, fatigue, and mild respiratory symptoms like dry cough, are associated with COVID-19, however, patients can also develop neurological manifestations like headache, anosmia, hyposmia, dysgeusia, meningitis, encephalitis, and acute cerebrovascular accidents during the disease. Although very rare, these neurological manifestations are sometimes the sole initial presenting complaint of COVID-19. This case report discusses patients where the initial presenting symptoms seemed to be exclusive to meningitis but the later diagnosis was COVID-19. It is important to increase awareness of these rare presentations in physicians and healthcare workers and facilitate early diagnosis and management to prevent the horizontal spread of the disease.
A Case of Complex Partial Seizures Presenting as Acute and Transient Psychotic Disorder
Authors: Sadia Sultan, Ebtihaj Omar Fallata
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Introduction:
Complex partial seizures are focal (CPS) (i.e., start in one area of the brain) and associated with impairment in consciousness. Most of them arise in the temporal region and are characterized by aura, impaired consciousness, and automatisms. CPS that arise in temporal region are most often misdiagnosed as primary psychiatric illness.
Case report:
A 25-year-old male presented with fluctuations in consciousness, aggressive behaviour, hallucination, and delusions of grandeur lasting a few hours. He was diagnosed with acute and transient psychotic disorder according to ICD10 criteria and was treated with intramuscular haloperidol 10mg BID followed by oral olanzapine 10mg. Computed tomography of brain and electroencephalogram were normal. After 15 days he presented again to the outpatient department with complaints of aggressive behaviour and sensory misinterpretations. Video electroencephalogram was recommended, which was not done due to financial constraints. The diagnosis was reconsidered and he was started on oral carbamazepine due to high clinical suspicion, of complex partial seizures, in spite of lack of EEG evidence. He responded well to antiepileptic and symptom remission has maintained well.
Conclusion:
Patients presenting with psychosis need careful diagnostic evaluation for other possibilities.
Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab
Authors: Uroosa Ibrahim, Sara Parylo, Shiksha Kedia, Shafinaz Hussein, Jean Paul Atallah
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Large granular lymphocytic (LGL) leukemia is a rare form of low grade leukemia characterized by large cytotoxic T cells or natural killer cells on morphological examination. Immunosuppressive therapy is employed as first-line therapy. Treatment options in refractory cases include the anti-CD52 antibody alemtuzumab and purine analogues. We report a rare case that responded to the anti-CD20 monoclonal antibody rituximab. A 77-year-old female presented with complaints of fatigue, fever, and chills of 3 months' duration. A CBC showed that pancytopenia with an absolute neutrophil count (ANC) was 0. Peripheral blood flow cytometry detected increased number of T cell large granular lymphocytes and T cell receptor rearrangement study detected a clonal T cell population. Bone marrow biopsy showed peripheral T cell lymphoma, most consistent with T-large granulocytic leukemia. The patient was treated with prednisone and oral cyclophosphamide for four months with no response. Thereafter, she received four weekly infusions of rituximab with improvement in her blood counts. A response to rituximab in refractory cases such as ours has been reported and may guide us towards exploring other immune-based therapeutics in this rare disease.
Case Report: Extensive Phosphorylation of Interleukin-1 Receptor-Associated Kinase 4 in a Patient With Schnitzler Syndrome
Authors: Isabel Hodl, Philipp Bosch, Barbara Dreo, Martin H Stradner
Journal: Front Immunol (2020)
Keywords: castleman disease, schnitzler syndrome, autoinflammatory disease, flow cytometry, interleukin 1, interleukin-1 receptor associated kinase 4
MeSH terms: B-Lymphocytes / enzymology, Interleukin-1 Receptor-Associated Kinases / metabolism, Monocytes / enzymology, Schnitzler Syndrome / enzymology, Case Reports, Antirheumatic Agents / therapeutic use, B-Lymphocytes / drug effects, B-Lymphocytes / immunology, Biomarkers / metabolism, Castleman Disease / diagnosis, Castleman Disease / immunology, Castleman Disease / metabolism, Diagnosis, Differential, Diagnostic Errors, Flow Cytometry, Humans, Interleukin 1 Receptor Antagonist Protein / therapeutic use, Male, Middle Aged, Monocytes / drug effects, Monocytes / immunology, Phosphorylation, Predictive Value of Tests, STAT3 Transcription Factor / metabolism, Schnitzler Syndrome / diagnosis, Schnitzler Syndrome / drug therapy, Schnitzler Syndrome / immunology, Treatment Outcome, Antirheumatic Agents, Biomarkers, Interleukin 1 Receptor Antagonist Protein, STAT3 Transcription Factor, STAT3 protein, human, IRAK4 protein, human, Interleukin-1 Receptor-Associated Kinases, Multi-centric Castleman's Disease

Schnitzler syndrome (SchS) is a rare autoinflammatory disease, characterized by urticarial rash, recurrent fever, osteo-articular pain/arthritis with bone condensation, and monoclonal gammopathy. Diagnosis may be difficult due to overlapping signs with other diseases. Here, we describe the case of a 62-year-old man with SchS, who was initially misdiagnosed with multicentric Castleman disease (MCD). As excessive release of IL-6 is characteristic of MCD, in contrast to IL-1 in SchS, we measured the phosphorylation of intracellular signaling proteins of the respective pathways by flow cytometry. We found a distinct increase of phosphorylated IRAK-4 in our patient's B cells and monocytes while phosphorylation of STAT-3 was low, suggesting predominant IL-1 signaling. In accordance with these results and the classification criteria, we established the diagnosis of SchS instead of MCD and commenced therapy with the IL-1 receptor antagonist anakinra. We observed a rapid remission of signs accompanied by a reduction of phosphorylated IRAK-4 to normal levels. In conclusion, we propose phosphorylated IRAK-4 in B cells and monocytes as a potential marker for diagnosis of SchS and for treatment response to IL-1 blockade.