OpenMed/multicare-articles huggingface dataset:
An atypical suicide attempt: self-inflicted intra-cardiac injury with sewing needle
Authors: Nazila Shahmansouri, Mahmood Shirzad, Sam Zeraatiannejad Davani, Fetemeh Heidari
Journal: Iran J Psychiatry Behav Sci (2014)
Keywords: atypical suicide, self-inflicted injury, surgery
MeSH terms: Case Reports

Atypical cases of suicide are less likely to be seen in general hospitals, nonetheless require further investigation into the precipitating factors as well as proper follow-up. This paper illustrates a 61-year-old woman with major depressive disorder who experienced auditory hallucinations during delirious periods of taking low-dose benzodiazepines, who referred to the hospital with a sewing needle stuck in her chest wall. The needle was successfully removed. Psychiatric problems are often underdiagnosed, therefore undertreated in general hospitals. Thus close monitoring of the patients during the hospitalization and after discharge is crucial.
Unusual case of papillary thyroid carcinoma mimicking paraganglioma in a 16-year-old girl
Authors: Saima Ahmad
Journal: Int J Surg Case Rep (2019)
Keywords: immunohistochemistry, papillary carcinoma, paraganglioma, thyroid

Background:
Papillary thyroid carcinoma is a common neoplasm arising from follicular cells of the thyroid. Differentiating the neck mass between thyroid paraganglioma and papillary thyroid carcinoma is often difficult.
Case report:
We report a 16-year-old girl with painless neck mass. Physiological goiter was suspected initially but we found papillary thyroid carcinoma.
Results:
CT neck revealed hyper vascular lesions in bilateral lobes of thyroid. DSA imaging was done for further evaluation which showed high flow fistulous type of lesion supplying from superior thyroidal artery raising suspicion of paraganglioma. Postoperative biopsy ultimately revealed papillary carcinoma of thyroid in the background of hashimotos' thyroiditis with metastatic deposits in neck lymph nodes.
Conclusion:
Thyroid paraganglioma is a rare type of tumor, it arises from inferior laryngeal paraganglioma within thyroid capsule and is as thus difficult to distinguish from thyroid carcinomas. A biopsy is the best diagnostic choice but immunohistochemistry is the only investigation which is considered as the gold standard for distinguishing between these two diseases.
Varying Phenotypes of Leydig Cell Hyperplasia of the Ovary: Two Case Reports
Authors: Margaret Caulkins, Jason Ricciuti, Mohamed Desouki, Katherine LaVigne Mager
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Leydig cell hyperplasia (LCH) is a rare cause of hyperandrogenism that has been described only in case reports. The cases presented herein contrast the traditional presentation of LCH with an affected asymptomatic individual. The first case involves a 74-year-old woman presenting with symptomatic hyperandrogenism, whose symptoms resolved after bilateral salpingo-oophorectomy (BSO). The second patient presented with postmenopausal bleeding and an abdominal mass. Following total abdominal hysterectomy (TAH) and BSO, pathology showed ovarian LCH with concomitant endometrial cancer. The diagnosis of LCH is complex and requires careful investigation of many differential diagnoses. Incidentally discovered LCH may shed light on evolution and disease progression. Cases of LCH found in the setting of endometrial pathology may have implications on other states of testosterone excess.
Case report: Asp194Ala variant in MFN2 is associated with ALS-FTD in an Italian family
Authors: C Vinciguerra, A Di Fonzo, E Monfrini, D Ronchi, S Cuoco, G Piscosquito, P Barone, M T Pellecchia
Journal: Front Genet (2023)
Keywords: amyotrophic lateral sclerosis (als), charcot marie tooth (cmt), frontotemporal dementia (ftd), mitofusin 2-gene (mfn2), whole exom sequencing
MeSH terms: Case Reports

Background: MFN2 gene encodes the protein Mitofusin 2, involved in essential mitochondrial functions such as fusion, trafficking, turnover, and cellular interactions. We describe a family carrying a novel MFN2 mutation associated with ALS-frontotemporal dementia (FTD) clinical phenotype in the mother and Charcot-Marie-Tooth disease type 2A (CMT2A) in her son. Case presentation: The mother, a 67-year-old woman, referred to us for a three year-history of mood disturbance and gait impairment, and a more recent hypophonia, dysarthria, dysphagia, and diffuse muscle wasting. Family history was positive for psychiatric disorders and gait disturbances. Brain 18F-FDG PET showed severe hypometabolism in the fronto-temporal brain cortex bilaterally. Electrodiagnostic studies (EDX) showed severe motor axonopathy in the bulbar, cervical and lumbosacral districts. Her 41-year-old son had a history of mood depression and sensory disturbances in the limbs, along with mild muscle wasting, weakness, and reduced reflexes. Nerve conduction studies revealed a moderate sensory-motor polyneuropathy, while brain MRI was normal. Whole exome sequencing of the patients' DNA identified the novel MFN2 (NM_014874.4) variant c.581A>C p.(Asp194Ala). Conclusion: Our findings provide evidence of heterogenous clinical manifestations in family members sharing the same MFN2 molecular defect. Additionally, we present the first documented case of ASL-FTD associated with an MFN2 mutation, thereby expanding the range of MFN-related disorders. Further research involving larger cohorts of patients will be needed to better understand the role of MFN2 as a contributing gene in the development of ALS-FTD.
Transient lingual papillitis: A retrospective study of 11 cases and review of the literature
Authors: Eleni-Marina Kalogirou, Konstantinos I Tosios, Nikolaos G Nikitakis, Georgios Kamperos, Alexandra Sklavounou
Journal: J Clin Exp Dent (2017)
MeSH terms: Case Reports

Background:
Transient lingual papillitis (TLP) is a common, under-diagnosed, inflammatory hyperplasia of one or multiple fungiform lingual that has an acute onset, and is painful and transient in nature.
Material and methods:
Eleven cases of TLP were diagnosed based on their clinical features. Information on demographics, clinical characteristics, symptoms, individual or family history of similar lesions, medical history, management and follow-up were extracted from the patients' records. The English literature was reviewed on TLP differential diagnosis, pathogenesis and management.
Results:
The study group included 8 females and 3 males (age: 10-53 years, mean age 31.7±12.88 years). Seven cases were classified as generalized form of TLP and 4 as localized form. Nine cases were symptomatic. Time to onset ranged from 1 to 14 days. A specific causative factor was not identified in any case and management was symptomatic.
Conclusions:
Although TLP is not considered as a rare entity, available information is limited. Diagnosis is rendered clinically, while biopsy is required in cases with a differential diagnostic dilemma. TLP should be included in the differential diagnosis of acute, painful tongue nodules. Key words:Transient lingual papillitis, fungiform papillary glossitis, tongue, nodules.
Ex Vivo Liver Resection and Autotransplantation as Surgical Option for Zone II-III Leiomyosarcoma of IVC: A Case Report and Literature Review
Authors: Tuerhongjiang Tuxun, Tao Li, Shadike Apaer, Yi-Biao He, Lei Bai, Shen-Sen Gu, Zhi-Peng Wang, Qiang Huo, Jiang Wang, Jin-Ming Zhao
Journal: Front Oncol (2021)
Keywords: ex vivo liver resection and auto transplantation, leiomyosarcoma, recurrence, surgery, survival

We report the first documented case of leiomyosarcoma at zone II-III of inferior vena cava with thrombi in three hepatic veins undergoing ex vivo liver resection and autotransplantation (ELRA) and hepatic veins thrombectomy. A 33-year-old female patient presented with abdominal distention and lower extremities edema. Abdominal wall varicosis and shifting dullness were positive on physical examination. Her liver function was classified as Child-Pugh B and a solid tumor at retro-hepatic vena cava extending to right atrium with thrombi in three hepatic veins were confirmed. The diagnosis of leiomyosarcoma with Budd-Chiari syndrome was highly suspected with preoperative ultrasound, echocardiogram, CT scan, and three-dimensional reconstruction. A zone II-III leiomyosarcoma of IVC origin was confirmed at surgery and ex vivo liver resection and autotransplantation, and hepatic vein thrombectomy with atrial reconstruction were performed under cardiopulmonary bypass (CPB). Operative time, anhepatic time, and CPB time were 12 h, 128 min, and 84 min, respectively. The patients experienced post-operative liver dysfunction and was cured with conservative therapy. Hepatic recurrence two years after surgery was managed with radiofrequency. The patient was alive with liver metastasis three years after surgery. Despite being regarded as an extremely aggressive procedure, ELRA could be considered in the treatment of advanced leiomyosarcoma with Budd-Chiari syndrome and hepatic vein thrombi.
Distended bladder presenting with constipation and venous obstruction: a case report
Authors: Anu Sharma, Vijay Naraynsingh
Journal: J Med Case Rep (2012)

Introduction:
A distended urinary bladder has been known to cause venous obstruction or rarely bowel obstruction. We report the first case in the literature in which urinary bladder distension presented with both venous obstruction and constipation. This is an unusual presentation of urinary bladder distension and serves to broaden our differential diagnoses for a patient with clinical venous obstruction.
Case presentation:
An 83-year-old man of African descent presented with constipation and bilateral lower limb edema. A huge abdominal mass was evident which was a large, distended urinary bladder confirmed by computed tomography. Promptly after urethral catheterization, both constipation and lower limb edema resolved.
Conclusions:
To the best of our knowledge distended urinary bladder causing both constipation and lower limb edema has never previously been reported. Analysis of the literature revealed several factors resulting in the patient's presentation. A high level of suspicion for urinary bladder distension must be maintained for prompt diagnosis and to avoid improper management.
ST elevation myocardial infarction during head-up tilt testing
Authors: Lucas Simonetto Faganello, Mauricio Pimentel, Ana Paula Arbo Magalhães, Leandro Ioschpe Zimerman
Journal: J Cardiovasc Thorac Res (2020)
Keywords: head-up tilt testing (hutt), st elevation myocardial infarction, syncope
MeSH terms: Case Reports

We report a case of ST elevation myocardial infarction (STEMI) during head-up tilt testing (HUTT). A 54-year-old man was admitted to our emergency department after four episodes of syncope. Treadmill test and electrophysiological study were normal. During passive HUTT, the patient had inferolateral ST elevation. Coronary angiography showed two severe lesions in the right coronary artery and circumflex artery.
Breaking the unbreakable: A paediatric case of dolutegravir resistance from KwaZulu-Natal
Authors: Sibongiseni Malinga, Aabida Khan, Moherndran Archary
Journal: South Afr J HIV Med (2023)
Keywords: dtg, hiv, adolescence, dolutegravir, paediatrics, resistance
MeSH terms: Case Reports

We report a case of dolutegravir resistance in KwaZulu-Natal in a 13-year-old male two years after starting dolutegravir. Resistance most likely developed due to poor adherence as a result of psychosocial issues. This case highlights the importance of the role of the family unit in impacting adherence and close monitoring of treatment-experienced patients with virologic failure following switching to dolutegravir-based regimens.
Spinal myxopapillary ependymoma in an adult male presenting with recurrent acute low back pain: a case report
Authors: Dean Petersen, Reidar P Lystad
Journal: Chiropr Man Therap (2016)
Keywords: chiropractic, filum terminale, myxopapillary ependymoma, neoplasm, spinal cord

Background:
Spinal intramedullary ependymomas are very rare and occur more commonly in the cervical and upper thoracic regions. These neoplasms tend to manifest in young adulthood, and patients typically present with mild clinical symptoms without objective evidence of neurologic deficits. The mean duration of symptoms is 40 months until the lesion is diagnosed.
Case presentation:
A 48-year-old male police officer was referred to a chiropractic clinic by a general practitioner for the evaluation of recurrent acute low back pain (LBP). Although the first episode of LBP was resolved, the clinical examination during the second episode revealed subtle changes that warranted referral to magnetic resonance imaging (MRI). The MRI revealed a spinal myxopapillary ependymoma.
Conclusion:
Because the primary symptoms of spinal intramedullary ependymomas can mimic ordinary LBP presentations, in particular lumbar intervertebral disc herniations, clinicians need to be sensitive to subtle changes in the clinical presentation of LBP patients. Prompt referral to advanced medical imaging such as MRI and early neurosurgical intervention is key to achieve best possible outcomes for patients with spinal intramedullary ependymomas.
Antepartum Diagnosis and Management of Lamin A/C Disease
Authors: Nosheen Reza, Jessica L Chowns, Amy Marzolf, Jessica Kim, Lisa D Levine, Gregory Supple, Anjali Tiku Owens
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Lamin A/C cardiac disease is a genetic cardiomyopathy and arrhythmia syndrome caused by alterations in the function of the nuclear lamin A and C proteins. It is inherited in an autosomal dominant manner and usually presents in mid- to late adulthood with atrioventricular conduction abnormalities, atrial and ventricular arrhythmias, biventricular dysfunction, and advanced heart failure. While rare, women of childbearing age can exhibit an aggressive disease course, and appropriate risk stratification and management are critical. Here, we present a case of newly diagnosed lamin A/C cardiac disease in a pregnant woman.
Transtibial Amputation with Removal of the Tibial Intramedullary Nail: Hardware Removal in a Retrograde Manner
Authors: Youn-Ho Choi, DoJoon Park
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Transtibial amputation is the preferred strategy for treating a diabetic foot with an infection and necrosis. However, if a tibial intramedullary nail was previously inserted into the ipsilateral lower extremity, the nail must be removed to perform the transtibial amputation. In this special situation, the removal of the tibial intramedullary nail can cause various complications after transtibial amputation. We present a case and surgical technique report of a 46-year-old male with an uncontrolled diabetic foot with tibial intramedullary nail insertion. With the nail and ankle fixed by distal interlocking screws, a below-knee amputation was performed by removing the nail and the amputated limb together. This surgical method is expected to reduce postoperative complications such as infections and patella instability after the amputation of a diabetic foot.
Microcystic Stromal Tumor with Predominant Bizarre Nuclei of Ovary in a Pregnant Woman
Authors: Tip Pongsuvareeyakul, Chalita Kingnate, Kornkanok Sukpan, Surapan Khunamornpong
Journal: Case Rep Pathol (2022)
MeSH terms: Case Reports

Microcystic stromal tumor (MST) is a rare type of pure stromal tumor in the category of ovarian sex cord-stromal tumors. It is characterized by a distinctive microcystic appearance with bland tumor cells. Although the pathological diagnosis can be straightforward based on the typical histomorphology in most MSTs, the cases with morphologic variation can pose a diagnostic challenge due to unfamiliarity of pathologists with the histologic spectrum of MST and its negativity for inhibin and calretinin, the commonly used sex cord-stromal markers. The coexistence between MST and mucinous epithelial tumor is extremely rare. We present the first case, to our knowledge, of ovarian MST with predominant bizarre nuclei coexisting with mucinous cystadenoma in a pregnant woman. The histomorphology in this case presents a diagnostic challenge and raises differential diagnosis for a wide variety of ovarian malignant neoplasms including nonneoplastic lesions.
Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults
Authors: Kun Xue, Yuwei Liu, Kia Nøhr Iversen, Mohsen Mazidi, Zheng Qu, Chenglin Dong, Tayi Jin, Göran Hallmans, Per Åman, Anders Johansson, Gengsheng He, Rikard Landberg
Journal: Front Nutr (2021)
Keywords: c-reactive protein, helicobacter pylori, ldl cholesterol, cardiovascular disease, cereal fiber, inflammation, rye, wholegrain
MeSH terms: Case Reports

Background: High dietary fiber intake has been associated with reduced risk of Helicobacter pylori infection and co-morbidities such as gastric cancer but also with reduced risk of cardiovascular disease. It has been suggested that fermented rye could affect Helicobacter pylori bacterial load and that high- fiber rye may be superior to wheat for improvement of several cardiometabolic risk factors, but few long-term interventions with high fiber rye foods have been conducted. Objective: To examine the effect of high-fiber wholegrain rye foods with added fermented rye bran vs. refined wheat on Helicobacter pylori infection and cardiometabolic risk markers in a Chinese population with a low habitual consumption of high fiber cereal foods. Design: A parallel dietary intervention was set up and 182 normal- or overweight men and women were randomized to consume wholegrain rye products containing fermented rye bran (FRB) or refined wheat (RW) for 12 weeks. Anthropometric measurements, fasting blood sample collection and 13C-urea breath test (13C-UBT) were performed at baseline and after 6 and 12 weeks of intervention as well as 12 weeks after the end of the intervention. Results: No difference between diets on Helicobacter pylori bacterial load measured by 13C-UBT breath test or in virulence factors of Helicobacter pylori in blood samples were found. Low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the FRB group, compared to the RW group after 12 weeks of intervention. The intervention diets did not affect markers of glucose metabolism or insulin sensitivity. Conclusions: While the results of the present study did not support any effect of FRB on Helicobacter pylori bacterial load, beneficial effects on LDL-C and hs-CRP were clearly shown. This suggest that consumption of high fiber rye foods instead of refined wheat could be one strategy for primary prevention of cardiovascular disease. Clinical Trial Registration: The trial was registered at www.clinicaltrials.gov, Identifier: NCT03103386.
Case report: Right ventricular outflow tract obstruction caused by multicomponent mesenchymal tumor
Authors: Shengyuan Huang, Shiye Wang, Zhixiang Tang, Yinghuan Dai, Long Song
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac tumor, case report, hemangioma, histopathology, right ventricular outflow tract obstruction (rvoto)
MeSH terms: Case Reports

Right ventricular outflow tract obstruction (RVOTO) is a cause of hemodynamic instability that can lead to right ventricular dysfunction. Cardiac tumors located in the right ventricle or surrounding structures can cause RVOTO. Herein, we present a rare case of a 21-year-old male with palpitations due to RVOTO caused by a cardiac multicomponent mesenchymal tumor. The tumor was localized in the right ventricular outflow tract, resulting in right side heart enlargement, tricuspid regurgitation, and RVOTO. Hence, tumor resection was performed. The patient was in a stable condition and discharged home on the 6th post-operative day. However, histopathological examination of the tumor specimen suggested a three-component mesenchymal tumor containing mucinous components, formed blood vessels, and fibrous tissue, which is like an atypical capillary hemangioma. After seven years of follow-up, the patient had no right heart enlargement, tricuspid regurgitation, and tumor recurrence. We believe surgical treatment is effective, and this case will provide a reference for clinicians to treat and evaluate the prognosis of similar three-component mesenchymal cardiac tumor cases in the future.
Recurrent Respiratory Papillomatosis (RRP)-Juvenile Onset
Authors: Sara W Dyrstad, Krishna A Rao
Journal: Clin Med Oncol (2008)
Keywords: cancer, human papilloma virus, respiratory papillomatosis
MeSH terms: Case Reports

In this article, we describe the treatment of long standing juvenile-onset recurrent respiratory papillomatosis (JORRP) with eventual transformation to carcinoma in a patient who lived to the age of 73. Treatment modalities consisted of bronchoscopy and local excision initially. Later, YAG and CO2 laser debulking were used. Radiotherapy, chemotherapy with carboplatin (300 mg/m2) and 5-FU (600 mg/m2), oral methotrexate (5-7.5 mg/week), pegylated Interferon, indole-3-carbamide, and intralesional cidofovir were also utilized in the treatment of this patient. Except for methotrexate, each of the treatment regimens used in this patient, initially decreased growth of the papillomas and improved symptoms experienced by the patient. Interestingly, we found that this patient's long standing JORRP initially responded to a chemotherapy regimen of 4 cycles of carboplatin (300 mg/m2) and 5-FU (600 mg/m2) as well. Ultimately, the disease became resistant to all forms of treatment and progressed. The patient eventually succumbed to the disease after an approximate 77 year course.