OpenMed/multicare-articles huggingface dataset:
From Bilateral Periorbital Necrotic Wound to Fungal Brain Abscess: A Complicated Case of COVID-19-Associated Mucormycosis
Authors: Bahram Eshraghi, Nastaran-Sadat Hosseini, Rasoul Mohammadi, Seyed Hamid Reza Abtahi, Alireza Ramezani-Majd, Roya Azad, Mohsen Pourazizi
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

COVID-19-associated mucormycosis (CAM) is categorized as rhinocerebral-orbital (RCOM), pulmonary, gastrointestinal, cutaneous, and disseminated mucormycosis. An alarming surge in morbidity and mortality attributed to mucormycosis concurrent with coronavirus disease 2019 (COVID-19) has emerged as a cause for concern during the current outbreak of COVID-19. The global incidence of CAM has been attributed to environmental, host, and iatrogenic factors. Further, Mucorales interacting with epithelial cells followed by endothelium invasion are pivotal in developing mucormycosis in patients with COVID-19. In essence, CAM is an emerging condition that requires increased vigilance in all COVID-19 patients, including those who have recovered. In this case report, we describe a rare case of CAM in a 33-year-old immunocompetent man who developed bilateral periocular pain and a small area of cutaneous necrosis in both medial canthi associated with impaired vision, which progressed into a fungal brain abscess formation in the post-COVID period. Furthermore, this case aims to illustrate the potential underlying risk factors of CAM other than known risk factors, especially in immunocompetent individuals.
Endovascular treatment of intrarenal aneurysms bleeding and angiomyolipomas in a patient with tuberous sclerosis and polycystic kidney disease
Authors: Túlio Leite, Lucas Vatanabe Pazinato, Maria Juliana de Aquino Vidal, Danielo de Freitas, Joaquim Mauricio da Motta Leal Filho
Journal: J Bras Nefrol (2023)
MeSH terms: Angiomyolipoma / complications, Angiomyolipoma / therapy, Kidney Neoplasms / complications, Polycystic Kidney Diseases / complications, Polycystic Kidney Diseases / therapy, Polycystic Kidney, Autosomal Dominant / complications, Tuberous Sclerosis / genetics, Case Reports, Hematuria / complications, Hemorrhage / etiology, Hemorrhage / therapy, Humans

Tuberous sclerosis complex (TSC) and autosomal dominant polycystic kidney disease (ADPKD) are conditions related to renal failure that can rarely occur in association as a contiguous gene syndrome. Angiomyolipomas (AMLs) are renal tumors strongly related to TSC that may rupture and cause life-threatening bleedings. We present a patient with TSC, ADPKD, and renal AMLs with persistent hematuria requiring blood transfusion. The persistent hematuria was successfully treated through endovascular embolization, a minimally invasive nephron sparing technique.
Hexaminolevulinate Blue-Light Cystoscopy in a Patient with Metastatic Melanoma of the Bladder
Authors: Anant Shukla, Jonathan T Wingate, Karen C Baker, Timothy C Brand
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Background:
Although bladder cancer is one of the most frequently diagnosed tumors worldwide, metastatic melanoma of the bladder is a rare occurrence with only 29 cases reported in the literature.
Case presentation:
We present the case of a 60-year-old male with a medical history significant for metastatic melanoma, who was referred to the urology department for gross hematuria. Transurethral resection of bladder tumor (TURBT) was performed with the assistance of hexaminolevulinate acid (HAL) with blue-light cystoscopy (BLC). Subsequent histopathologic analysis of the specimen confirmed a diagnosis of metastatic melanoma of the bladder. To our knowledge, this is the first reported case of metastatic bladder melanoma diagnosed with the assistance of HAL-BLC in a patient undergoing a TURBT.
Conclusion:
Although HAL-BLC is only indicated for use in the cystoscopic detection of papillary nonmuscle invasive bladder cancer, it may aid in the detection of nonconventional bladder pathologies, such as melanoma.
Clinical, Cytogenetic, and Molecular Findings in Two Cases of Variant t(8;21) Acute Myeloid Leukemia (AML)
Authors: Lindsay Wilde, Jillian Cooper, Zi-Xuan Wang, Jinglan Liu
Journal: Front Oncol (2019)
Keywords: acute myeloid leukemia, core binding factor, cytogenetics, t(8, 21), variant
MeSH terms: Case Reports

t(8;21)(q22;q22) is present in ~5-10% of patients with de novo acute myeloid leukemia (AML) and is associated with a better overall prognosis. Variants of the t(8;21) have been described in the literature, however, their clinical and prognostic significance has not been well-characterized. Molecular profiling of these cases has not previously been reported but may be useful in better defining the prognosis of this subset of patients. We present two cases of variant t(8;21) AML including clinical, cytogenetic, and molecular data.
Portomesenteric Thrombosis Secondary to Acute Cholecystitis: A Case Report
Authors: Haseeb Ahmad Chaudhary, Ibrahim Yusuf Abubeker, Kamran Mushtaq, Khaldun Obeidat, Anand Kartha
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Portomesenteric venous thrombosis (PMVT) is an uncommon clinical problem. Common risk factors include intra-abdominal infections, abdominal surgeries, malignancy, cirrhosis, and inherited thrombophilia. Early recognition and treatment of PMVT are important to avoid serious complications like mesenteric ischemia and infarction. Acute cholecystitis is a clinical condition encountered daily but rarely may be complicated by development of portomesenteric venous thrombosis. Only few cases have been reported of superior mesenteric vein thrombosis secondary to cholecystitis. We report a case of a forty-one-year-old male patient who developed partial portal and superior mesenteric vein thrombosis after mild acute cholecystitis for which surgery had been deferred. Patient had no other identifiable risk factors for thrombosis. Patient was successfully treated with 6 months of anticoagulation with warfarin and complete recanalization of portomesenteric veins was achieved at the end of treatment.
Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
Authors: Atsuro Murai, Kaoru Tada, Tadahiro Nakajima, Mika Akahane, Masashi Matsuta, Yuta Nakamura, Hiroyuki Tsuchiya
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: atypical fracture, bone metastases, denosumab, prophylactic fixation, severely suppression of bone turnover, ulna
MeSH terms: Adenocarcinoma, Follicular / drug therapy, Bone Density Conservation Agents / adverse effects, Bone Neoplasms / drug therapy, Bone Plates, Denosumab / adverse effects, Fracture Fixation / methods, Prophylactic Surgical Procedures / methods, Thyroid Neoplasms / pathology, Ulna Fractures / prevention & control, Case Reports, Adenocarcinoma, Follicular / secondary, Aged, Bone Neoplasms / secondary, Female, Humans, Ulna Fractures / chemically induced, Ulna Fractures / diagnostic imaging, Ulna Fractures / surgery, Bone Density Conservation Agents, Denosumab

Patients with bone metastases are treated with long-term bone resorption inhibitors such as bisphosphonates and denosumab. However, resorption inhibitors have been known to cause fractures, such as atypical femoral fractures (AFFs). In recent years, there have been an increasing number of reports of atypical ulna fractures (AUFs) caused by bone resorption inhibitor usage. Treatment of AUFs is complicated, especially when they occur in patients with bone metastases, because it is difficult to discontinue bone resorption inhibitor treatment without the risk of aggravating metastatic lesions. Prophylactic surgery is recommended in AFFs when fractures are predicted, but there are few reports of prophylactic surgery for AUFs. Here, we report a case of incomplete AUF in a 74-year-old woman which was surgically treated with prophylactic plate fixation. The patient had been using denosumab for 6 years to treat bone metastases due to thyroid cancer. After surgery, no fractures were observed for 2 years without discontinuing denosumab, and her forearm function was adequate. AUFs are rare and difficult to treat, so oncologists who treat bone metastases need to pay special attention to diagnose this incomplete AUF before the fracture worsens. We believe that detection of a possible fracture and prophylactic surgery can improve prognosis.
Rapidly Progressive Emphysematous Pancreatitis With Massive Hemorrhage and Multi-Organ Failure: A Severe Sequela of COVID-19
Authors: Raghav Bassi, Hamza Alzghoul, Kipson Charles, Ariel Ruiz de Villa, Charles R Russell, Peters Okonoboh
Journal: Cureus (2023)
Keywords: acute necrotizing pancreatitis, acute respiratory distress syndrome [ards], coronavirus disease (covid-19), hemorrhagic pancreatitis, multiorgan system failure, severe sepsis
MeSH terms: Case Reports

The COVID-19 global pandemic continues to wreak havoc on a number of affected patients and poses a significant burden on the healthcare system. Even though it has been over two years since the pandemic emerged, clinical presentations in affected patients continue to appall clinicians. Emphysematous pancreatitis is a rare, fatal complication of acute necrotizing pancreatitis presenting with a high mortality rate. This rare entity stems from superinfection of acute necrotizing pancreatitis with gram-negative bacteria, most commonly from Escherichia coli (E. coli), among others. Herein, we present a rare case of acute necrotizing pancreatitis complicated by emphysematous necrosis with hemorrhagic conversion and E. coli septicemia in a 60-year-old morbidly obese male patient without any underlying risk factors. He presented with respiratory failure in the setting of COVID-19 and was subsequently diagnosed with acute necrotizing pancreatitis complicated by emphysematous necrosis. To our knowledge, emphysematous pancreatitis in the setting of COVID-19 with no other attributable causes for pancreatitis was not previously reported in the literature. This article aims to report an unusual association between COVID-19 infection and acute emphysematous pancreatitis with evidence of hemorrhagic conversion. Furthermore, given the neoteric nature of this viral infection, we hope to promote sensitivity toward capturing additional clinical features associated with active COVID-19 infection, with the goal to keep clinicians abreast with its many possible sequelae.
Complete Pathological Response to Neoadjuvant Pembrolizumab in a Patient With Chemoresistant Upper Urinary Tract Urothelial Carcinoma: A Case Report
Authors: Daiki Ikarashi, Shigehisa Kitano, Kazuyuki Ishida, Tetsuya Nakatsura, Hitoshi Shimodate, Takashi Tsuyukubo, Daichi Tamura, Renpei Kato, Tamotsu Sugai, Wataru Obara
Journal: Front Oncol (2020)
Keywords: chemoresistant, neoadjuvant, pathological complete response, pembrolizumab, ureteral carcinoma

Treatment options as second-line therapy for advanced ureteral carcinoma are limited, and patients experiencing recurrence after first-line cisplatin-based chemotherapy have a poor prognosis. Recently, the programmed death-1 (PD-1) inhibitor pembrolizumab provided a better survival benefit with a complete response rate (9.2%) for chemoresistatant urothelial carcinoma. However, the dynamic changes of the cancer microenvironment about the cases of complete response are still unknown. We herein report a case of a 57-year-old man who had been diagnosed with localized, non-muscle-invasive bladder cancer (pT1N0M0, high grade), for which he underwent transurethral resection of the bladder cancer twice. Given that gemcitabine plus carboplatin as first-line neoadjuvant chemotherapy was unable to control left vesico-ureteral junction recurrence with muscle invasion (T3N0M0, high grade), the patient received the PD-1 inhibitor pembrolizumab as second-line neoadjuvant therapy in an attempt to stop tumor growth, which promoted dramatic tumor shrinkage without serious adverse effects and allowed subsequent nephroureterectomy and lymphadenectomy. To the best of our knowledge, this has been the first study to report that pembrolizumab administration before surgery for chemotherapy-resistant ureteral carcinoma promoted a pathological complete response, providing a better understanding of the cancer microenvironment after immunotherapy.
Flexible Bronchoscopy Combined with Rigid Bronchoscopy for Treatment of Scarring in the Bronchus Caused by a Foreign Body
Authors: Lei Wu, Yuanjian Sheng, Xuefeng Xu, Zhimin Chen, Qiang Wang, Zhifang Wang, Yu Yin
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Foreign body (FB) aspiration into the tracheobronchial tree is an emergency in the pediatric department, particularly in children aged <3 years. FB granulation tissue is commonly found in children with FB aspiration. However, scarring in the bronchus caused by a FB is rare. We herein report a case involving aspiration of a plastic whistle toy with scarring in the bronchus. The scar tissue was successfully removed by interventional bronchoscopy combined with a flexible electrosurgery probe and carbon dioxide cryotherapy.
Vulvar leiomyoma: a case report
Authors: Safaa Ammouri, Chourouk Elkarkri, Najia Zeraidi, Amina Lakhdar, Abdelaziz Baydada
Journal: Pan Afr Med J (2019)
Keywords: leiomyoma, large lip, vulva
MeSH terms: Leiomyoma / diagnosis, Vulvar Neoplasms / diagnosis, Case Reports, Adult, Female, Follow-Up Studies, Humans, Leiomyoma / pathology, Leiomyoma / surgery, Vulvar Neoplasms / pathology, Vulvar Neoplasms / surgery

Leiomyomas represent about 3.8% of all benign soft tissue tumors. Vulvar localization is very rare. We present a case of a vulvar leiomyoma and discuss diagnostic and therapeutic features of this disease. A 30-year-old female patient with no medical history, had a 5cm mass located in the left large lip causing a discomfort at the perineum especially in sitting and walking. She underwent a complete surgical excision of the mass. The pathological examination confirmed the diagnosis of a leiomyoma. There was no recurrence after 24-months' follow-up. The vulvar leiomyoma is a rare benign tumor. The diagnosis is made only postoperatively after resection of the mass. The treatment is essentially based on total excision of the mass with a good prognosis.
Dramatic Clinical Response of Relapsed Metastatic Extramammary Paget's Disease to Trastuzumab Monotherapy
Authors: S Wakabayashi, Y Togawa, K Yoneyama, K Suehiro, N Kambe, H Matsue
Journal: Case Rep Dermatol Med (2012)
MeSH terms: Case Reports

We report the first case of 68-year-old Japanese woman with metastatic HER2-positive extramammary Paget's disease that showed the validity of trastuzumab monotherapy. We administered trastuzumab at a loading dose of 8 mg/kg i.v., followed by a 6 mg/kg maintenance dose every three weeks according to a protocol for HER2-positive metastatic breast cancers and a near-complete response was achieved after the tenth infusion. The patient experienced a moderate headache and flushing during the first infusion, but had no advanced effects during subsequent infusions with ibuprofen and d-chlorpheniramine maleate. Given the dramatic response, the patient has had 17 infusions of trastuzumab with no disease progression. Thus, trastuzumab has few side effects and is well tolerated for elderly patients. It may become a new choice of the adjubant therapy of this disease.
Multiple myeloma remission following COVID-19: an observation in search of a mechanism (a case report)
Authors: Daniel Antwi-Amoabeng, Mark Bilinyi Ulanja, Bryce David Beutler, Suresh Vodur Reddy
Journal: Pan Afr Med J (2021)
Keywords: covid-19, cancer, case report, coronavirus, hematologic malignancy
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / administration & dosage, COVID-19 / physiopathology, Multiple Myeloma / drug therapy, Case Reports, Aged, Female, Humans, Multiple Myeloma / pathology, Remission Induction

Coronavirus disease 2019 (COVID-19) represents a major challenge in the management of patients with hematologic malignancies. Individuals with plasma cell dyscrasias, including multiple myeloma, are at increased risk of developing severe disease. Furthermore, immunosuppressant agents, which represent an important component of multiple myeloma treatment, may increase the risk of serious infection; thus, treatment regimens may need to be modified in some patients. The pathogenesis of COVID-19 is incompletely understood and much remains to be established regarding cancer care in the setting of this new global health threat. We report a case of multiple myeloma remission that occurred after a single cycle of chemotherapy in a patient with COVID-19. In addition, we discuss possible mechanisms underlying this surprising observation. The findings warrant further investigation and may have important implications for the management of multiple myeloma and other plasma cell dyscrasias in the age of COVID-19.
Optic Nerve Sheath Diameter as a Bedside Assessment for Elevated Intracranial Pressure
Authors: Peter Williams
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

A previously fit and healthy 26-year-old lady with no significant medical history presented with a two-month history of headaches. The headaches were prolonged, generalised, and unusually severe for the patient. Examination revealed papilloedema. The patient's optic nerve sheath diameter was measured 3 mm posterior to the globe and found to be 7.5 mm. The patient subsequently had computed tomography scan of her brain that showed an optic nerve sheath diameter of 7.56 mm as measured 3 mm posterior to the globe. After an obstructive lesion was ruled out on the computed tomography scan, a lumbar puncture was then performed and cerebrospinal fluid was drained. An ultrasound of the optic nerve sheath diameter was repeated showing a reduced diameter of 5.6 mm. The patient was admitted to the neurology unit and ultimately diagnosed with idiopathic intracranial hypertension. This case report highlights the potential of rapidly identifying elevated intracranial pressure using a noninvasive method.
Molecular Profile of a Pituitary Rhabdomyosarcoma Arising From a Pituitary Macroadenoma: A Case Report
Authors: Jinci Lu, Liam Chen
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: atrx, lztr1, nf1, tp53, pituitary adenoma, rhabdomyosarcoma
MeSH terms: Adenoma / genetics, Pituitary Neoplasms / genetics, Rhabdomyosarcoma / genetics, Case Reports, Adenoma / metabolism, Adenoma / therapy, Aged, Combined Modality Therapy, Gene Expression Profiling, Humans, Incidental Findings, Magnetic Resonance Imaging, Male, Mutation / genetics, Optic Chiasm / pathology, Pituitary Neoplasms / metabolism, Pituitary Neoplasms / therapy, Rhabdomyosarcoma / metabolism, Rhabdomyosarcoma / therapy

Pituitary sarcoma arising in association with pituitary adenoma is an uncommon finding. Most cases of secondary sarcoma have been noted to arise with a median interval of 10.5 years post radiation. In this case report, we describe a 77-year-old man with an incidental discovery of a pituitary macroadenoma on magnetic resonance imaging (MRI) and underwent radiotherapy. Three years after radiation treatment, there was an acute change in clinical symptoms and increase in tumor size and mass effect on the optic chiasm which prompted surgical resection. A pituitary adenoma along with a separate spindle-cell sarcomatous component was identified in histology. Immunohistochemical stain for muscle markers confirmed a development of pituitary rhabdomyosarcoma (RMS). Molecular profiling of the tumor identified mutations in TP53, ATRX, LZTR1, and NF1. Despite its rarity, characterization of pituitary RMS with immunohistochemistry and molecular studies may provide an insight to its pathophysiological relationship with pituitary adenoma.
What Happens When I Watch a Ballet and I Am Dyskinetic? A fMRI Case Report in Parkinson Disease
Authors: Sara Palermo, Rosalba Morese, Maurizio Zibetti, Alberto Romagnolo, Edoardo Giovanni Carlotti, Andrea Zardi, Maria Consuelo Valentini, Alessandro Pontremoli, Leonardo Lopiano
Journal: Front Psychol (2020)
Keywords: dlpfc, parkinson’s disease, action observation, case report, fmri, mirror neuron system, superior precentral gyrus, thalamus
MeSH terms: Case Reports

Background:
The identical sets of neurons - the mirror neuron system (MNS) - can be activated by simply observing specific, specific movements, decoded behaviors and even facial expressions performed by other people. The same neurons activated during observation are those recruited during the same movements and actions. Hence the mirror system plays a central role in observing and executing movements. Little is known about MNS in a neurodegenerative motor disorder, such as Parkinson's Disease (PD) is.
Methods:
We explored the neural correlates potentially involved in empathy and embodiment in PD through complex action observation of complex behaviors like the choreutical arts. An integrated multidisciplinary assessment (neurological, neuropsychiatric, and neuropsychological) was used for the selection of the PD candidate for the neuroimaging experimental acquisition. For the first time in literature the famous Calvo-Merino's paradigm was administered to a PD subject.
Key points:
Functional magnetic resonance imaging (fMRI) exploratory analysis shows the recruitment of the left thalamus, the right dorsolateral prefrontal cortex, and the bilateral superior precentral gyrus (one of the main hubs of the MNS). If the observed choreic movement becomes part of the observer's motor repertoire experience, mirror neurons might activate stimulating affective empathy and making the understanding of movement an own proper body experience (cognitive embodiment).
Main lessons:
Our study sheds light on a possible use of complex action observation to improve or slow the deterioration of motor abilities and levodopa-induced dyskinesias in PD patients. Indeed, the modulation of the neural area involved in complex action observation could be considered a promising target for neuro-rehabilitative intervention mediated by the elicitation of the MNS.
Transvenous embolization of hemorrhagic brain arteriovenous malformations: Case reports and literature review
Authors: Xiheng Chen, Longhui Zhang, Haoyu Zhu, Yajie Wang, Liwei Fan, Leying Ni, Linggen Dong, Ming Lv, Peng Liu
Journal: Front Neurol (2022)
Keywords: brain arteriovenous malformations, endovascular treatment, hemorrhage, obliteration, transvenous embolization

Introduction:
Transvenous embolization (TVE) has been proven to be safe and feasible as an alternative management of brain arteriovenous malformations (AVMs). We presented four patients with a hemorrhagic brain AVM who underwent TVE and reviewed the relevant literature.
Methods:
Four patients underwent TVE of a hemorrhagic brain AVM in our center between July 2019 and July 2020. We retrospectively collected and analyzed the clinical and imaging data of these patients and those reported in previously published studies.
Results:
Four patients with a hemorrhagic brain AVM were included. Nidus sizes ranged from 0.79 to 2.56 cm. Spetzler-Martin grade ranged from grade II to grade III. The AVM nidus was located in a deep brain region in three patients. One patient underwent TVE alone and three underwent combined transarterial and transvenous approaches. Digital subtraction angiography (DSA) demonstrated complete obliteration of the vascular malformation after embolization in all four patients. Three patients were independent [modified Rankin Scale (mRS) score ≤ 2] at discharge. All four patients were independent at the last follow-up. AVM obliteration was confirmed in all four patients at the last angiographic follow-up.
Conclusion:
Transvenous embolization can be used as an alternative treatment for contemporary management of brain AVMs, appropriate patient selection is essential to achieve a good clinical outcome.