OpenMed/multicare-articles huggingface dataset:
Pancreatic ACTH Hypersecretion and Pituitary Macroadenoma
Authors: Chiara M Bettale, Jason W Allen, Zaid K Mahdi, Adriana G Ioachimescu
Journal: JCEM Case Rep (2023)
Keywords: cushing syndrome, ectopic acth syndrome, neuroendocrine tumor, pancreatic neuroendocrine neoplasm, pituitary adenoma
MeSH terms: Case Reports

A 55-year-old woman admitted for hypertensive emergency and myocardial infarction reported weight gain, muscle weakness, easy bruising, and recent-onset diabetes in the past 3 to 12 months. Urinary and salivary cortisol and adrenocorticotropin hormone (ACTH) levels were elevated. Pituitary imaging detected a macroadenoma. ACTH and cortisol did not increase after corticotropin-releasing hormone administration. Imaging revealed a large pancreatic mass. Pathology indicated a well-differentiated World Health Organization (WHO) grade 2 distal pancreatic neuroendocrine neoplasm which stained for ACTH by immunohistochemistry. Postoperatively, Cushing manifestations resolved, ACTH and cortisol levels became low, and patient required hydrocortisone replacement for 7 months. During the 3.5 years of follow-up, the pituitary macroadenoma size remained stable and pituitary hormone axes other than ACTH remained normal. This extremely rare case of ectopic ACTH-secreting pancreatic neuroendocrine tumor coexisting with a nonfunctioning pituitary macroadenoma illustrates the importance of dynamic endocrine testing in Cushing syndrome.
Rare Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) Finding in a 9/11 World Trade Center Survivor: A Case Report
Authors: Sophia B Bellegarde, Vanessa Gibson, Shahriyour Andaz, Rose Purrazella, Eric Robinson, Pharlin Noel, Lauren Punter, Donald Tofuah, Abubakar Gapizov, Chukwuyem Ekhator
Journal: Cureus (2024)
Keywords: carcinoid tumors, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (dipnech), lung tumor, neuroendocrine tumors, pulmonary nodule
MeSH terms: Case Reports

Bronchial carcinoid tumors represent a relatively uncommon category within lung neoplasms, originating from neuroendocrine cells. The exact cause of these pulmonary tumors remains not fully understood. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is characterized by widespread hyperplasia of these neuroendocrine cells, essential for regulating air and blood flow in response to stimuli such as hypoxia, dyspnea, and chronic obstructive pulmonary disease (COPD). The prognosis for bronchial carcinoid tumors hinges on factors such as grade and stage, with lung resection being the preferred treatment. A chest computed tomography (CT) scan unveiled diffuse bilateral pulmonary nodules with ground-glass opacities, leading to a right video-assisted thoracoscopic surgery (VATS) wedge resection. Immunohistochemical examination confirmed neuroendocrine differentiation, describing a lung wedge measuring 9 × 4 × 1.5 cm with spongy parenchyma and scattered white nodules.
Dipyrone (Metamizole)-Induced Stevens-Johnson Syndrome
Authors: Sérgio Gomes Ferreira, Luís Fernandes, Sara Santos, Sofia Ferreira, Joana Sequeira
Journal: Cureus (2024)
Keywords: adverse reactions, drug-induced allergic response, metamizole, rare skin disease, stevens-johnson-syndrome
MeSH terms: Case Reports

Stevens-Johnson Syndrome (SJS), a severe mucocutaneous hypersensitivity reaction primarily triggered by drugs, poses a low-incidence, high-mortality challenge. This report explores its clinical nuances and emphasizes supportive care as the mainstay of treatment. A 74-year-old female, burdened with a complex medical history, presented with a non-pruritic macular rash escalating to skin and oral mucosal involvement. A recent introduction of dipyrone (metamizole) implicated drug-induced SJS. Histopathological confirmation guided treatment involving supportive care, corticosteroids, and wound care, resulting in clinical improvement. The case underscores the significance of histopathological confirmation and thorough medication history in navigating SJS complexities, especially in patients with comorbidities like connective tissue disease. A successful multidisciplinary approach and the decision for post-discharge monitoring highlight the intricate management challenges. This case illuminates the intricate interplay of medication-induced hypersensitivity, comorbidities, and management challenges in SJS. Optimal outcomes require prompt diagnosis, trigger identification, and a multidisciplinary treatment approach, emphasizing ongoing research and clinical vigilance.
Anticardiolipin Antibody Determination to Guide Q Fever Treatment
Authors: Diogo Costa Oliveira, José Guilherme Assis, Fernanda Linhares, Paulo Carrola
Journal: Cureus (2024)
Keywords: anticardiolipin antibodies, coxiella burnetii, endocarditis, hydroxychloroquine, q fever, zoonosis
MeSH terms: Case Reports

Query (Q) fever is a worldwide infectious disease with acute and chronic manifestations caused by Coxiella burnetii. The clinical manifestations are so variable that the disease is often only diagnosed if systematically considered as a differential diagnosis. Here, we present a case of a 39-year-old man who lived in a countryside house, with cattle and sheep in his field, with acute Q fever hepatitis with the typical granulomatous arrangement in the liver biopsy. The diagnosis was confirmed by polymerase chain reaction (PCR) assay in a serum sample and the presence of phase II antibodies. Anticardiolipin antibody (aCL) determination at diagnosis of acute Q fever and during follow-up was made to persecute early identification and to guide the treatment and prophylaxis of possible complications, such as endocarditis.
Rare Image of Epidural Catheter Fracture in Lumbar Analgesia
Authors: Fiacro Jiménez-Ponce, Ylián Ramírez-Tapia, Erick Ariñez-Barahona, Jorge A Nava-López, Sai Naveen Alla
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

Objective:
Accidental fracture of epidural analgesia catheters has a very low incidence of 2.5 per 100,000 anesthesia. A rare image of the fracture is reported.
Methods:
A 42-year-old female patient was attending a cesarean section eight years earlier to her consult. In the cesarean section, she received regional epidural anesthesia, and the main complaint was low back pain, specifically between the spinous processes L2 and L3. The somatic pain had been presenting intermittently for eight years. The sagittal section of magnetic resonance imaging of the lumbar spine showed a "golf club" image from the midline to the laminae of L2 and L3 with the subcutaneous tissue.
Results:
A small right hemilaminectomy was performed to remove the complete catheter, which did not adhere, but was coiled in the S-shape. The catheter was trapped between the left facets of L2 and L3 laterally than through the midline. Several risk factors and therapeutic procedures have been proposed.
Conclusion:
In a systematic review, 24 articles were reported on this specific issue. No surgical procedure and follow-up were informed by 8 authors. Surgical remotion by laminectomy was used in 9 articles, surgical explanation by skin incision was reported by 4 authors, and remotion by endoscopy was reported in 1 article. Two articles not reported solution.
Detection of benign granular cell tumor of the breast via 18F-PSMA-PET/CT in a patient with very high-risk prostate cancer: A case report
Authors: Kamyar Ghabili, Rushi Rajyaguru, Alexandra De La Plante, Kristine L Widders, Alison L Chetlen, Angela I Choe, Claudia J Kasales
Journal: SAGE Open Med Case Rep (2024)
Keywords: breast, granular cell tumor, positron emission tomography, prostate cancer, prostate-specific membrane antigen
MeSH terms: Case Reports

Incidental extra-prostatic prostate-specific membrane antigen (PSMA) uptake on initial staging positron emission tomography/computed tomography (PET/CT) scans poses diagnostic challenges, as it can be associated with various benign and malignant lesions. We present the case of a 68-year-old man with very high-risk prostate cancer who was incidentally discovered to have a benign granular cell tumor in the breast initially detected on PSMA-PET/CT. Imaging studies and biopsy were pivotal in the diagnosis, as the tumor's appearance was concerning for breast carcinoma. Recognizing extra-prostatic PSMA uptake in the breast, particularly in patients with prostate cancer, is crucial for guiding appropriate management, accurately interpreting subsequent imaging findings, and assessing radiologic-pathologic correlation.
Large anterior congenital urethral diverticulum in an infant: a case report
Authors: Mohammed A Hassan, Rawa Bapir, Ismaeil Aghaways, Nali H Hama, Mohammed Fahad Raheem, Wirya N Sabr, Bilal A Mohammed, Honar Othman Kareem, Ayman M Mustafa, Fahmi H Kakamad
Journal: Front Surg (2024)
Keywords: anterior urethral valve, congenital anterior urethral diverticulum, management, urethrocystoscopy, urinary tract infection
MeSH terms: Case Reports

Introduction:
A Urethral diverticulum can be defined as sac-like dilation lined with epithelial tissue, which may be congenital or acquired. It usually develops in the penoscrotal angle region but can also be observed in the penile urethra. It usually occurs in female teenagers. This report aims to discuss a male infant with a large urethral diverticulum.
Case presentation:
A 5-month-old male presented to the urological department at Sulaimani Teaching Hospital with a penile swelling that had been noticeable since birth. Clinical examination revealed a ventral cystic penile shaft swelling, which would fill with fluid during urination. A urethrocystoscopy was performed and showed a wide cystic ventral diverticulum. Diverticulectomy was performed as a surgical approach to remove the diverticulum.
Discussion:
Congenital anterior urethral diverticulum is an uncommon condition that typically begins in early life. It can manifest with various symptoms, like recurrent infections of the urinary tract, painful urination, and post-void urine dribbling. Diagnosis involves imaging, with urethrocystoscopy, to rule out other potential diagnoses. Different surgical techniques exist that show promising results in preventing recurrence. The current case involved diverticulectomy and multi-layered wound closure with a dartos flap.
Conclusion:
Large anterior diverticulum in early infancy is rare but possible; operation is the preferred intervention method.
Case report: Paroxysmal nocturnal hemoglobinuria presenting with hemorrhagic esophageal varices
Authors: Runsen Du, Lihua Zheng, Peng Liu, Yaheng Zhao, Yan Yang, Lei Zhang, Zengren Zhao
Journal: Front Med (Lausanne) (2023)
Keywords: tips, esophageal varices, hemorrhagic esophageal varices, paroxysmal nocturnal hemoglobinuria, portal vein thrombosis
MeSH terms: Case Reports

We report the case of a female who was cured of hemorrhagic esophageal varices caused by paroxysmal nocturnal hemoglobinuria (PNH) through transjugular intrahepatic portosystemic shunt (TIPS) treatment. PNH complicated by portal vein and visceral veins thrombosis without hepatic veins is extremely rare, and as such, it is easy to incorrectly treat due to lack of awareness. Hemorrhagic esophageal varices due to PNH with PVT have been reported in one case in 1974, and here, we report the second.
An interesting twist: 90 year-old female with acute small bowel obstruction due to midgut volvulus
Authors: Hillary M Jackson, Khaled Saed, Turner Adams, Matthew B Maturasingh, Fallon D Vedros, Mohammad M Masri
Journal: J Surg Case Rep (2024)
Keywords: ladd’s bands, adult malrotation, adult midgut volvulus, malrotation, small bowel obstruction
MeSH terms: Case Reports

We report an exceptionally rare presentation of midgut volvulus secondary to malrotation in a nonagenarian female. According to our extensive literature review, this 90-year-old female is the oldest reported case of midgut volvulus. This patient presented with acute recurrent emesis. Imaging showed midgut volvulus with associated small bowel obstruction. The patient underwent an exploratory laparotomy that revealed midgut volvulus because of congenital malrotation and Ladd's bands, necessitating a modified Ladd's procedure. The patient had an uneventful postoperative course. Congenital malrotation with Ladd's bands was likely asymptomatic throughout this patient's life. Our case adds to the scarce instances where midgut volvulus with malrotation is identified in elderly patients, underscoring the importance of considering this diagnosis irrespective of age. We recommend including midgut volvulus because of malrotation in a differential list of atypical small bowel obstruction in elderly patients.
Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy
Authors: Göker Değer, Ahmet Burak Demirdas, Derya Akbaba, Muhammed Yusuf Afacan
Journal: Cureus (2024)
Keywords: allergic contact dermatitis, compartment syndrome, distal radius fracture, plaster cotton allergy, plaster of paris, short arm splint, undercast cotton padding
MeSH terms: Case Reports

Allergic contact dermatitis (ACD) after splint or cast application (plaster of Paris) is infrequently encountered in orthopedic and traumatology clinical practice. This case study aims to elucidate the identification of ACD after splint application, highlight the conditions that warrant vigilance, and outline the precautions and optional treatment methods available in such instances. A 56-year-old right-hand dominant female presented to the emergency department after a fall on her right hand, manifesting pain, swelling, and tenderness without neurovascular injury. Radiographs revealed a distal radius fracture, leading to the application of a plaster of Paris splint. Within one day, she returned to the emergency department with severe itching and burning in the right arm. The splint was removed, and a dermatology consultation confirmed ACD due to undercast cotton padding. After splint removal, the patient's fracture treatment continued using a shoulder-arm sling until the lesion healed. Topical antihistamine ointment and oral corticosteroids were prescribed. Regular follow-up revealed the healing and union of the fracture by the fifth week, with minimal residual skin color changes. This case underscores the importance of prompt diagnosis and appropriate treatment in managing such occurrences. A key takeaway is the crucial need to schedule a follow-up appointment with the patient within one day of applying the cast or splint. Skin problems can emerge rather than neurovascular issues following casts or splints. Educating patients on warning signs, including skin irritation, neurovascular deficits, and symptoms of compartment syndrome, ensures the timely identification of significant issues. Healthcare practitioners should inquire about patients' histories of allergic skin reactions, taking a proactive approach to prevent ACD through early intervention and preventive measures.
A female case report of LGMD2B with compound heterozygous mutations of the DYSF gene and asymptomatic mutation of the X-linked DMD gene
Authors: Xiaojie Cao, Li Zeng, Zhijie Lu, Jin Fan, Song Tan, Mingjie Zhang, Zegang Yin
Journal: Front Neurol (2023)
Keywords: dmd/bmd, dysf gene, lgmd, case report, dysferlin, dysferlinopathy
MeSH terms: Case Reports

We report the case of a 31-year-old Chinese woman with a chief complaint of weakness in the lower limbs, which was diagnosed as limb-girdle muscular dystrophy 2B (LGMD2B) with compound heterozygous mutations of the DYSF gene. Meanwhile, this woman is an asymptomatic carrier with the mutation of the X-linked DMD gene. The electromyography, muscle MRI, and muscle biopsy indicated a chronic myogenic injury with dysferlin deletion. As a result of genetic testing, compound heterozygous G-to-T base substitution at position 5,497 in exon 49 of the DYSF gene, leading to a codon change from glutamic acid to termination codon at position 1,833, and a heterozygous C-to-G base change at position 4,638 + 8 in intron 42 of the DYSF gene with a consequence of splice, which has never been reported, were identified as candidate causative mutations. Unfortunately, DMD gene mutation c.3921+12A>G of the DMD gene on the X chromosome was also found in this patient. Finally, the patient was diagnosed as LGMD2B clinically and genetically. In the previous 2 years, the patient's lower limb weakness became slightly worse, resulting in even the total distance walked than before. Fortunately, during the follow-up, her son had not shown slowness or limitation of movement. Genetic testing by next-generation sequencing confirmed the final diagnosis of LGMD2B, and we identified the novel compound heterozygous variants in the DYSF gene, which is of great significance to the accurate diagnosis of genetically coded diseases. Much attention needs to be paid in clinics toward hereditary neuromuscular diseases with multiple pathogenic gene mutations. Genetic counseling and clinical follow-up should be the priorities in future, and promising treatments are also worth exploring.
Extrapyramidal Syndrome due to Aripiprazole Overdose in a Young Woman: An Unusual Case Report
Authors: Homa Talabaki, Ensiyeh Taghizadeh, Zakaria Zakariaei
Journal: Case Rep Med (2024)
MeSH terms: Case Reports

Aripiprazole is an atypical antipsychotic medication indicated for the treatment of schizophrenia and bipolar disorders. The drug has been shown to exhibit acceptable efficacy and is often preferred as a first-line psychiatric treatment option owing to its lower incidence of adverse effects. While first-generation antipsychotics are associated with extrapyramidal syndrome (EPS), atypical antipsychotics such as aripiprazole are generally associated with a lower frequency of EPS. In this case, we present a 31-year-old woman with a history of bipolar disorder who developed EPS after ingesting 200 mg of aripiprazole. Fortunately, her symptoms improved with the administration of biperiden, and she was discharged five days after ingestion. This case highlights the potential for significant consequences associated with aripiprazole, even within its therapeutic index.
Traumatic Globe Luxation and Optic Nerve Avulsion: A Case Report and Literature Review
Authors: Kevin Kwan Joo Ern, Julieana Muhammed, Nurul Huda Amin, Safiyah Jameelah
Journal: Cureus (2024)
Keywords: enucleation, globe luxation, le fort fracture, motor vehicle accident, optic nerve avulsion
MeSH terms: Case Reports

Traumatic globe luxation associated with optic nerve avulsion is rare. We describe a case of a 42-year-old Indian gentleman who was involved in a motor vehicle accident (MVA). He sustained a deep laceration wound from the right side of the nose extending to the left medial canthal region and left eyelid. The left globe was not visualized, and only the left optic nerve stump was seen. A computerized tomography (CT) scan showed a left globe dislocated inferotemporal with discontinuity of the left optic nerve, inferior rectus, and lateral rectus muscle. There were also comminuted fractures at the floor and lateral wall of the left orbit with significant lateral displacement of the bone fragments. He underwent left eye enucleation, toilet, and suturing of the laceration wounds and open reduction internal fixation (ORIF) of the fractures. We report this case as it is not commonly seen in Malaysia.
The Intriguing Case of Impacted Teeth 11, 12, and 13: Unveiling the Dental Dilemma
Authors: Dhwani Suchak, Ranjit Kamble, Jeni Mathew, Rutuja Ragit, Japneet Kaiser, Nishu Agarwal, Ruchika Pandey
Journal: Cureus (2024)
Keywords: comprehensive treatment, impacted teeth, missing teeth, supernumerary teeth, surgical exposure
MeSH terms: Case Reports

This case study offers a rare and difficult condition involving the impaction of teeth 11, 12, and 13, providing a severe dental challenge. A thorough examination was performed on the patient, which included clinical evaluations and radiographic examinations. Because the impacted teeth were causing discomfort and functional impairment, a multidisciplinary approach was required, which included surgical exposure followed by traction forces to level and align the impacted teeth. The abstract emphasizes the case's complexity, digging into the diagnosis process and the establishment of a personalized treatment strategy. The complexities of handling many impacted teeth are explored in length, including surgical intervention, orthodontic considerations, and postoperative care.
Case report: Therapy-related myeloid neoplasms in three pediatric cases with medulloblastoma
Authors: Li Shun Mak, Xiuling Li, Wilson Y K Chan, Alex W K Leung, Daniel K L Cheuk, Liz Y P Yuen, Jason C C So, Shau Yin Ha, Anthony P Y Liu
Journal: Front Oncol (2024)
Keywords: li-fraumeni syndrome, alkylating agent, case report, chemotherapy, genetic predisposition, medulloblastoma (mb), therapy-related myelodysplastic syndrome/acute myeloid leukemia
MeSH terms: Case Reports

Introduction:
Medulloblastoma is the most common malignant brain tumor in children, often requiring intensive multimodal therapy, including chemotherapy with alkylating agents. However, therapy-related complications, such as therapy-related myeloid neoplasms (t-MNs), can arise, particularly in patients with genetic predisposition syndromes. This case report presents three pediatric cases of medulloblastoma with subsequent development of t-MNs, highlighting the potential role of genetic predisposition and the importance of surveillance for hematological abnormalities in long-term survivors.
Case presentation:
We describe three cases of pediatric medulloblastoma who developed t-MNs after receiving chemotherapy, including alkylating agents. Two of the patients had underlying genetic predisposition syndromes (TP53 pathologic variants). The latency period between initial diagnosis of medulloblastoma and the development of secondary cancer varied among the cases, ranging from 17 to 65 months. The three cases eventually succumbed from secondary malignancy, therapy-related complications and progression of primary disease, respectively.
Conclusions:
This report highlights the potential association between genetic predisposition syndromes and the development of therapy-related myeloid neoplasms in pediatric medulloblastoma survivors. It underscores the importance of surveillance for hematological abnormalities among such patients.
Role of molecular adsorbent recirculating system in methotrexate-induced acute liver failure: a case report and literature review
Authors: T Corbisier, André O Von Bueren, W B Breunis, S Grazioli
Journal: Front Pediatr (2024)
Keywords: acute kidney injury, acute liver failure, case report, extracorporeal treatment, methotrexate toxicity
MeSH terms: Case Reports

We describe the case of a 14-year-old girl with osteosarcoma who was treated with high-dose methotrexate (12 g/m2). Twenty-four hours after the infusion, her plasma methotrexate concentration was elevated at 937 μmol/L (normal < 10 µmol/L). She exhibited severe signs of methotrexate toxicity, including encephalopathy, acute liver failure (ALF), and acute kidney injury. In this case report, we highlight the severe and rare adverse effects secondary to methotrexate administration and the efficacity of molecular adsorbent recirculating system and continuous venovenous hemodiafiltration to recover from multiple organ failure.