OpenMed/multicare-articles huggingface dataset:
A rare case of solitary plasmacytoma mimicking submucosal lesion of ascending colon: a case report and literature review
Authors: Alessandra Carella, Francesco Spannella, Sonia Morè, Riccardo Grifoni, Carlo Romano Settanni, Alessandra Mandolesi, Alessandra Filosa, Gaia Goteri, Gianfranco Boccoli, Giammarco Fava
Journal: Front Oncol (2024)
Keywords: colonoscopy, digestive endoscopy, gastrointestinal tumors, plasmacytoma, submucosal lesion
MeSH terms: Case Reports

Solitary primary extraosseous plasmacytoma is a rare disease in the gastrointestinal tract, recently classified as an "exceptional" tumor of the colon site. The real incidence (one case/population/year) is unknown but reasonably less than 1/10,000,000 cases/year with very few descriptions in the literature. The rare cases described in the literature are often diagnosed after surgery for perforation and with predominant localization of the left colon. The main endoscopic presentation mimics colon carcinoma with ulcerated mass and obstructing lumen. In this paper, we report a rare case of isolated mass mimicking a submucosal lesion of the ascending colon diagnosed in an older female patient by colonoscopy. The patient was almost asymptomatic; she reported only a history of hematochezia without anemia. This mass was successfully treated by surgery and followed by hematological investigations, including bone marrow biopsy, specific laboratory tests, and CT/PET scan, which confirmed primary isolated plasmacytoma of the colon.
Posterior sternoclavicular joint dislocation in a young male: a case report
Authors: William Ngatchou, Michèle Ngassa Fosso, Virginie Guimfacq Djumegue, Ion-Rares Surdeanu, Patrice Jissendi, Pierre Youatou Towo
Journal: Pan Afr Med J (2024)
Keywords: posterior luxation, case report, clavicle, impact injury, sternoclavicular
MeSH terms: Joint Dislocations / surgery, Sternoclavicular Joint / injuries, Sternoclavicular Joint / surgery, Case Reports, Bone Wires, Humans, Male, Young Adult

The traumatic dislocation of the posterior sternoclavicular joint is a serious injury with possibly severe complications and therefore has to be managed with the greatest caution. We report the case of a young male with a posterior dislocation of the medial clavicle with compression of the brachiocephalic artery as well as the esophagus. Open reduction and placement of a wire cerclage were performed with a good postoperative outcome.
Brain Abscess due to Streptococcus intermedius after Spontaneous Esophageal Perforation in an Adolescent
Authors: Sandra Mabel Camacho-Gomez, Javier Monagas, Robert Adam Noel, Luis Castagnini
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Streptococcus intermedius is an inhabitant of the oral cavity and gastrointestinal tract, known to cause deep-seated abscesses. Thereby, we present a previously healthy adolescent with esophageal perforation (EP) and secondary mediastinal and brain abscesses due to Streptococcus intermedius. EP is a potentially life-threatening condition that requires a prompt diagnosis.
Case Report: Left ventricular apical hypertrophy in a patient with Leopard syndrome mimicking a cardiac tumor: a diagnostic challenge resolved by multimodality imaging
Authors: Hui Liu, Yue Zheng, Huaibi Huo, Xin Peng, Jun Yang, Chunyan Ma, Ting Liu
Journal: Front Cardiovasc Med (2024)
Keywords: leopard syndrome, cardiac magnetic resonance, coronary artery dilatation, left ventricular apical hypertrophy, multimodality imaging
MeSH terms: Case Reports

Background:
LEOPARD syndrome (LS) is a rare genetic disorder presenting various clinical manifestations from childhood, complicating its diagnosis. In this study, we aim to refine the imaging presentation of LS and emphasize the importance of multimodality imaging in enhancing diagnostic accuracy and preventing serious cardiovascular events.
Case:
A 41-year-old woman was admitted to hospital with a suspected apical tumor detected by a transthoracic echocardiogram (TTE), which was later identified as apical myocardial hypertrophy through cardiac magnetic resonance imaging (CMR). She had abnormal electrocardiograms from the age of 2 years and freckles around the age of 4 years. In recent years, she has been experiencing exertional dyspnea. Supplemental coronary computer tomography angiography (CCTA) revealed diffuse coronary dilatation. Both multimodality imaging and clinical manifestations led to a suspicion of LS, which was confirmed by subsequent genetic testing. The patient declined further treatment. A 3-month follow-up CMR showed no significant change in the lesion.
Conclusion:
This report elucidates the diagnostic transition from an initial suspicion of an apical tumor by TTE to a definitive diagnosis of left ventricular apical hypertrophy by CMR in a 41-year-old woman with LS. It underscores the value of multimodality imaging (TTE, CCTA, CMR) in unraveling unusual cardiac manifestations in rare genetic disorders such as LS.
Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
Authors: Jundong Huang, Wei Shi
Journal: Front Med (Lausanne) (2023)
Keywords: jak inhibitor, case report, nail lichen planus, review, tofacitinib
MeSH terms: Case Reports

Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement.
Case Report: A neonatal case of cryopyrin-associated periodic syndrome with severe funisitis and neonatal asphyxia
Authors: Yuri Hayashida, Maho Hatano, Kazuyuki Ito, Manabu Sugie, Junko Kunieda, Masaki Shimizu, Tomohiro Morio, Chikako Morioka
Journal: Front Pediatr (2024)
Keywords: cinca syndrome/nomid, cryopyrin-associated periodic fever syndrome, funisitis, neonatal asphyxia, umbilical cord rupture
MeSH terms: Case Reports

Cryopyrin-associated periodic syndrome (CAPS) is a genetic disorder and autoinflammatory disease characterized by chronic inflammation throughout the body. The most severe form of CAPS, Chronic Infantile Neurologic Cutaneous, and Articular (CINCA) syndrome, also known as Neonatal Onset Multisystem Inflammatory Disease (NOMID), has three main features: skin rash, CNS involvement, and joint symptoms. Although these symptoms are typically reported shortly after birth, there have been a few reports of prenatal inflammation. Here, we report our experience managing a case of a CAPS infant born in severe neonatal asphyxia due to a ruptured cord associated with severe funisitis. The baby was born at 38 weeks and 6 days of gestation, weighing 2,898 g, through an ultra-emergency Caesarian section prompted by variable deceleration. The Apgar score was 1 point at 1 min and 4 points at 5 min, necessitating intensive care due to hypoxic-ischemic encephalopathy. Upon delivery, it was observed that the umbilical cord had partially ruptured at the site of attachment to the baby, accompanied by arterial hemorrhage. Umbilical cord rupture was considered to be the cause of the sudden decrease in fetal heart rate. Pathological examination also showed that the inflammation of the cord was more severe on the side attached to the fetus and on the arterial side, suggesting that the inflammation had extended from the fetus. The father carried a genetic mutation associated with CINCA syndrome/NOMID (NLRP3 c.2068G>A p.Glu690Lys Hetero), which was also found in the child. Histopathologic examination of the placenta and umbilical cord can provide crucial insights into the intrauterine onset of inflammation, which is the first manifestation of CINCA syndrome/NOMID in newborns. It should be noted that births with a genetic predisposition to CAPS may have complications related to the placenta and umbilical cord.
Tracking Endometrial Malacoplakia Through the Evolution of 2D and 3D Ultrasound and Histopathological Features
Authors: Antonella Vimercati, Francesca Cirignaco, Rosalba De Nola, Marco Cerbone, Tommaso Difonzo, Pietro Quarto, Fabiana Divina Fascilla, Ettore Cicinelli, Leonardo Resta, Gerardo Cazzato
Journal: Cureus (2024)
Keywords: endometrium, inflammatory pathology, malacoplakia, michaelis–gutmann bodies, ultrasound
MeSH terms: Case Reports

Malacoplakia is an uncommon disease characterized by chronic and granulomatous inflammation, which rarely involves the female genital tract. We describe the ecographic and histological evolution of the first case of a patient developing endometrial malacoplakia as a complication after a cesarean section. The patient, a 43-year-old woman, presented with pelvic pain one month after delivering by cesarean section and the initial suspicion was of retention of placental rests. We discuss the diagnostic challenges for this rare disease, highlighting the importance of considering endometrial malacoplakia as a possible diagnosis in patients with similar clinical presentations and the important role of 2D and 3D ultrasound in the diagnostic pathway. In literature, ultrasound findings in cases of endometrial malacoplakia are represented by hypoechoic thickening of the endometrial lining; hyperechoic thickening of the myometrium, and the presence of masses, nodules, cystic areas, or anechoic fluid within the endometrium. For the first time, we describe the evolution of endometrial malacoplakia through both ultrasound, 2D and 3D, and histopathological findings, from the acute to chronic stage of the disease.
A case report: Management of carbamazepine intoxication using hemodialysis followed by continuous venovenous hemodialysis
Authors: Heshu Abdullah-Koolmees, Vivian Cc Mekel, Agnes I Veldkamp, Martine G Caris, Eleonora L Swart
Journal: SAGE Open Med Case Rep (2024)
Keywords: cvvhd, carbamazepine, hemodialysis, intoxication
MeSH terms: Case Reports

An 18-year-old woman presented to the emergency department. She had ingested 43 extended-release tablets of carbamazepine 400 mg. Although the patient had high carbamazepine plasma levels and classified as severe intoxication, her clinical symptoms were less severe than expected. With the combination of hemodialysis and continuous venovenous hemodialysis in addition to usual care, including multiple-dose activated charcoal, a fast decrease (within 3 days) in carbamazepine plasma levels to levels in the therapeutic range was achieved. Only one session of hemodialysis was performed because the clinical status of the patient stabilized. In retrospect, the patient did not suffer severe toxicological symptoms from carbamazepine. Therefore, continuous venovenous hemodialysis could have been discontinued earlier. On the other hand, the fast decrease in carbamazepine plasma levels during extracorporeal treatment may have prevented the development of severe or rebound toxicological symptoms. This case report adds evidence to the successful management of carbamazepine intoxication using hemodialysis followed by continuous venovenous hemodialysis.
Insulin Edema Associated With Glargine
Authors: Jessica Wood, Varun Samji, Francesco S Celi, Priyanka Majety
Journal: JCEM Case Rep (2023)
Keywords: edema, glargine, insulin, type 2 diabetes mellitus
MeSH terms: Case Reports

Insulin edema is a poorly understood complication of insulin therapy. It has been reported in patients with both type 1 and 2 diabetes mellitus and typically occurs in patients with newly diagnosed or poorly controlled diabetes mellitus either after initiation or intensification of insulin therapy. A 20-year-old man presented with anorexia, polydipsia, and weight loss. Serum glucose on admission was 824 mg/dL (45.8 mmol/L) and hemoglobin A1c was >14.0. Additional workup was notable for positive anti-IA2 antibodies and low C-peptide of 0.5 ng/mL (1.1-4.4 ng/mL). He was diagnosed with type 1 diabetes mellitus and was started on insulin therapy with glargine and lispro. Within 4 days after insulin initiation, he developed bilateral leg swelling and reported a 25-pound (11.3-kg) weight gain over the next 10 days. After excluding other systemic causes of edema such as heart failure, renal failure, and liver failure, a diagnosis of insulin edema was made. Insulin glargine was switched to insulin degludec. Complete resolution of edema occurred within 3 days of switching the insulins. Insulin edema is a diagnosis of exclusion. Insulin's role in renal sodium handling, vasodilation, and increased vascular permeability have been postulated as possible mechanisms. Clinicians should be aware of this rare complication.
Acute liver failure caused by lymphocyte-depleted Hodgkin lymphoma in tuberculosis and HIV-infected patient
Authors: Mayur Parkhi, Madhumita Premkumar, Amanjit Bal, Ashim Das, Sanjay Jain, Suvradeep Mitra
Journal: Autops Case Rep (2024)
Keywords: hiv, hodgkin lymphoma, liver failure, acute, tuberculosis
MeSH terms: Case Reports

The lymphocyte-depleted classic Hodgkin lymphoma (LDCHL), the rarest subtype of classic Hodgkin lymphoma (CHL), is usually diagnosed at an advanced stage (stage IV) and one that unusually involves the liver, causing a rapidly progressive clinical course. We describe a 40-year-old immunocompromised man presenting with a progressive non-cholestatic jaundice and intermittent fever. The abdominal ultrasonography revealed a nodular liver with coarse echotexture and periportal hypodensities. The thoracic and abdominal contrast-enhanced computed tomography revealed right cervical and paraaortic lymphadenopathy, hepatosplenomegaly, diffuse mural thickening of duodenal and jejunal loops, and bilateral lobulated kidneys. Subsequently, he succumbed to his illness secondary to refractory septic shock. On postmortem examination, he was diagnosed with classic Hodgkin lymphoma (lymphocyte-depleted type) involving paraaortic and mediastinal lymph nodes based on morphology and immunochemistry findings. The lymphomatous process involved the liver (causing multiacinar confluent hepatic necrosis) and spleen, both showing tuberculous foci. This autopsy case depicts an uncommon case of acute liver failure due to infiltration of the liver by LDCHL in an HIV-infected patient. The findings of angiotropism and angioinvasion establish the pathological mechanism of liver failure (hepatocellular necrosis) in such cases.
Toxic Erythema of Chemotherapy, Vasculitic Eruption With Malignant Intertrigo Characteristics, and Superimposed Infection Post-bevacizumab Initiation
Authors: Kristin N Slater, Trevor Nessel, Francisca Kartono
Journal: Cureus (2024)
Keywords: adverse drug reaction, alk+ non-small cell lung carcinoma, bevacizumab, drug reaction, lorlatinib, malignant intertrigo, nsclc, tec, toxic erythema of chemotherapy, vasculitis
MeSH terms: Case Reports

Drug reactions are a known risk in combined anti-cancer therapy. Less commonly recognized risks of chemotherapies and targeted immunotherapies include toxic erythema of chemotherapy reactions. With the immunosuppressive quality of cancer combined with anti-cancer treatments, patients are also susceptible to increased infection. We report a rare case of combined targeted anti-cancer treatment with bevacizumab and lorlatinib, and an associated transformation of an eczematous process into a toxic erythema of chemotherapy vasculitic eruption, with combined malignant intertrigo characteristics and superimposed infection following the initiation of bevacizumab.
Acute retinal necrosis in a patient with cervical malignant tumor treated with sintilimab: a case report and literature review
Authors: Pei Wang, Ming An, Mengmeng Zhang, Xiaoran Yan, Nianting Tong
Journal: Front Immunol (2024)
Keywords: acute retinal necrosis, cervical malignant tumor, immune checkpoint inhibitor (ici), sintilimab, varicella-zoster virus (vzv)
MeSH terms: Antibodies, Monoclonal, Humanized, Herpes Simplex, Retinal Necrosis Syndrome, Acute / diagnosis, Retinal Necrosis Syndrome, Acute / drug therapy, Uterine Cervical Neoplasms, Review, Case Reports, Research Support, Non-U.S. Gov't, Female, Herpesvirus 3, Human, Humans, Middle Aged, sintilimab, Antibodies, Monoclonal, Humanized

Acute retinal necrosis (ARN) is an inflammatory disease that is primarily caused by herpesvirus infection, most commonly varicella-zoster virus (VZV), followed by herpes simplex virus (HSV) and occasionally cytomegalovirus (CMV). Sintilimab is an immune checkpoint inhibitor (ICI) that can enhance the body's anti-tumor immune response. However, treatment with ICIs may lead to reactivation of the VZV. Here, we present a case of ARN caused by VZV infection in a patient receiving sintilimab for cervical cancer. A 64-year-old female patient developed vision loss and floaters with left eye redness for one week after 22 cycles of sintilimab for cervical cancer. Based on clinical manifestations, ophthalmological examination, and vitreous humor biopsy, the patient was diagnosed with acute retinal necrosis syndrome secondary to VZV. After receiving systemic antiviral and anti-inflammatory therapy, retinal necrosis lesions and visual function improved. In conclusion, clinicians should be aware of the risk of ARN when using sintilimab and should actively monitor patients for prompt diagnosis and optimal management of this rare adverse drug reaction.
Increasing safe clinical spaces and the efforts of clinical research for uninsured and underinsured LGBTQIA2+ patients: A case study of the Rainbow Clinic - a student-run free LGBTQIA2+ clinic
Authors: Gabriel Alexander Lee, Jessica Fritter, Courtney DuBois Shihabuddin
Journal: J Clin Transl Sci (2023)
Keywords: hiv/aids, lgbt+ health, lgbt+ research, free clinic, gender affirming care, trauma-informed care, underinsured

LGBTQIA2+ patients often experience discrimination and hostility in healthcare spaces. Negative perceptions of healthcare can contribute to poor health outcomes in LGBTQIA2+ patients. This population is rarely included in clinical trials through a lack of inclusion in study protocols, informed consent, and trials not addressing their needs and demographics. Many clinical institutions have created LGBTQIA2+-specific clinics; however, few have successfully developed a free clinic dedicated to this population. A Rainbow Clinic was formed at an established student-run free clinic, utilizing the existing infrastructure. Dissemination of this clinic's creation can help others replicate similar initiatives.
Case report: Imaging of septic arthritis in the hip joint of a calf treated with femoral head ostectomy
Authors: Takeshi Tsuka, Yoshiharu Okamoto, Atsushi Nishiyama, Yuji Sunden, Takehito Morita
Journal: Front Vet Sci (2024)
Keywords: calf, computed tomography, femoral head ostectomy, hip arthritis, ultrasonography
MeSH terms: Case Reports

A 24-day-old male Japanese Black calf presented with weight-bearing lameness in the left hind limb and a swollen pelvis. Ultrasonography revealed the accumulation of fluidity materials with a mixture of hyper- and hypo-echogenicity, enclosed by 5-10-mm-thick capsular structures. On the ventral-dorsal radiograph of the pelvis, irregular and radiolucent osseous changes were evident in the femoral head and acetabulum within the swollen hip joint, with soft-tissue density. Computed tomography (CT) confirmed the relationship between the bony and soft tissue lesions, which was suspected following ultrasonography and radiography, and provided additional findings, such as intra-articular accumulation of gas and the degree of osteolytic changes. Based on the imaging findings and cytology of the arthrocentesis specimen, the patient was diagnosed with hip arthritis and osteomyelitis of the femoral head. Additionally, the severity of the lesions supported our decision to perform a femoral head ostectomy. The postoperative radiographic and CT findings of the treated pelvis were helpful in evaluating the efficacy of this technique. Following treatment, the animal could walk and showed normal development, although it was three postoperative months before weight-bearing lameness improved. To the best of our knowledge, this is the first report to describe the combined use of ultrasonography, radiography, and CT in the diagnosis, preoperative planning, and evaluation of the postoperative effects of bovine hip arthritis. Additionally, this report details the therapeutic efficacy of femoral head ostectomy for bovine hip arthritis, a technique that has not been reported previously.
De novo dedifferentiated SDH-deficient gastrointestinal stromal tumor with MDM2 amplification: case report and literature review
Authors: Qi-Xing Gong, Ying Ding, Wei-Ming Zhang, Jia-Wen Zhang, Zhi-Hong Zhang
Journal: Front Oncol (2023)
Keywords: mdm2, sdh, dedifferentiation, gastrointestinal stromal tumor, p53
MeSH terms: Case Reports

The dedifferentiation of the gastrointestinal stromal tumors (GISTs) has been reported in a small number of cases, usually under the pressure of the tyrosine kinase inhibitor (TKI) treatment. Herein, we described a de novo dedifferentiated GIST with the SDH deficiency in a 32-year-old Chinese woman. The tumor was located on the lesser curvature of the gastric antrum, measuring 4.1x9.1 cm2. Microscopically, the tumor was composed of 2 distinct morphological populations, mild epithelioid cells arranged in the multinodular growth pattern and hyperchromatic spindle cells arranged in the fascicular or sheet-like architecture. The two zones showed different immunophenotypes. The former proved to be an epithelioid GIST with the positive expression for C-KIT, DOG-1, and CD34, and the latter expressed the CKpan and P53, but negative for the C-KIT, DOG-1, and CD34. However, the SDHB staining was negative in both areas. Genetically, the next-generation sequencing (NGS) analysis showed the SDHC mutation (p.S48*) in both components and the MDM2 amplification was only in the spindle cell area. The lesion was diagnosed as the SDH-deficient GIST with the epithelial cell dedifferentiation. We proposed that the P53 associated gene alteration or other alternative escape mechanisms for the KIT-independent signaling pathways might play a role in the dedifferentiation.