OpenMed/multicare-articles huggingface dataset:
Osteomyelitis of the Mandible Caused by Late Fracture following Third Molar Extraction
Authors: Shinsuke Yamamoto, Naoki Taniike, Daisuke Yamashita, Toshihiko Takenobu
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The common postoperative complications of the extraction of third molars are frequently reported; however, reports about osteomyelitis of the mandible caused by late fracture following third molar extraction are rare. Here, we report a case of osteomyelitis of the mandible caused by late fracture following third molar extraction. A 38-year-old Japanese man was referred to the surgery department with chief complaints of dull pain and swelling in the right masseteric region and paresthesia of his lower lip and mental region in March 2018. A family dentist removed his lower third molar in the right side in January 2018. When the patient was chewing an innards stew 23 days after the procedure, he heard a cracking sound from the right mandible. Thus, we diagnosed the patient as having osteomyelitis of the mandible caused by late fracture following third molar extraction and performed sequestrectomy and curettage under general anesthesia in April 2018. In conclusion, it is necessary to recognize the possibility that late fracture following third molar extraction can cause osteomyelitis. Furthermore, once osteomyelitis of the mandible caused by late fracture occurred, early and appropriate treatment is necessary because the osteomyelitis may progress rapidly and in some cases may result in pathological fracture.
Tethered cord syndrome secondary to the unusual constellation of a split cord malformation, lumbar myelomeningocele, and coexisting neurenteric cyst
Authors: Humphrey Okechi, A Leland Albright, Ancent Nzioka
Journal: Case Rep Neurol Med (2012)

We describe a seminal case report of a child with a tethered cord syndrome secondary to the unusual constellation of a split cord malformation, lumbar myelomeningocele, and coexisting neurenteric cyst. A 17-year-old adolescent girl with a several-month history of myelopathy and urinary incontinence was examined whose spinal MRI scan demonstrated a type II split cord malformation with a large bone spur and an intradural neurenteric cyst in addition to lumbar myelomeningocele. Untethering of the spinal cord was achieved via a lumbar laminectomy. Pathological examination confirmed the intradural cyst to be a neurenteric cyst. Postoperatively there was stabilization of the neurological symptoms. Prophylactic surgery with total resection of the neurenteric cyst when feasible and spinal cord un-tethering appears to be associated with excellent outcomes.
Case Report of Nonfamilial Cherubism in a Toddler: Description of Clinic-Radiographic Features and Osseous-Dental Treatments
Authors: Mitra Karbasi Kheir
Journal: Case Rep Med (2016)
MeSH terms: Case Reports

Cherubism is a rare familial disease that occurs between the ages two and five years and regresses after puberty. Most of the cherubism cases show familial history, but there are some cases without familial histories of disorder. A two-year-old boy with a painless symmetrical progressive swelling of the jaws had visited maxillofacial radiology department. Panoramic radiograph revealed well-defined multilocular, radiolucent areas of both jaws. Computed tomography of the jaws showed well-defined, bilateral, multilocular, expansile lesions with thinning of cortical plate of maxilla and mandible and displacing the unerupted first molar anteriorly. Clinical, radiologic, and histopathologic characteristics confirmed the diagnosis of cherubism.
Elephantiasis neuromatosa of the lower limb in a patient with neurofibromatosis type-1: A case report with imaging findings
Authors: Shahina Bano, Akhila Prasad, Sachchida Nand Yadav, Vikas Chaudhary, Namrata Sachdeva
Journal: J Pediatr Neurosci (2010)
Keywords: computed tomography, conventional radiography, elephantiasis neuromatosa, magnetic resonance imaging, ultrasonography
MeSH terms: Case Reports

Elephantiasis neuromatosa is the most impressive manifestation of neurofibromatosis type-1 (NF-1). We report a case of NF-1 who presented with elephantiasis neuromatosa of his right leg. Cross-sectional imaging not only assists in the correct diagnosis but also aids in imaging the vasculature of a plexiform neurofibroma, which is essential for proper surgical planning.
Donor-Cell Origin High-Risk Myelodysplastic Syndrome Synchronous with an Intracranial Meningioma-Like Tumor, 8 Years after Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia
Authors: G Brás, C Pinho-Vaz, A Campos
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Secondary neoplasias are well known consequences of radiotherapy or chemotherapy for a primary cancer. In this report, we describe two rare secondary neoplasias occurring in the same patient: a meningioma-like intracranial tumor and high-risk myelodysplastic syndrome (MDS) of donor-cells origin, both diagnosed simultaneously, 8 years after an allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic lymphocytic leukemia (CLL). Due to an engraftment failure during the first allo-HSCT of a matched related donor for CLL treatment, the salvage treatment was a second allo-HSCT. At the moment of meningioma-like tumor diagnosis, the patient was pancytopenic due to high-risk MDS, so it was decided to postpone a surgical intervention until hematological improvement. For the high-risk MDS of donor-cells origin the chosen treatment was induction with intensive chemotherapy. Due to refractory disease, the patient was treated with 5-azacitidine and donor-lymphocytes infusion with no response and, finally, a third allo-HSCT of a matched unrelated donor was performed. The patient died 6 months after the third allo-HSCT, in cytogenetic remission but without hematological recovery, due to an intracranial hemorrhage with origin in the meningioma-like tumor.
A Randomized Trial of Personalized Cognitive-Behavior Therapy for Alcohol Use Disorder in a Public Health Clinic
Authors: Jason M Coates, Matthew J Gullo, Gerald F X Feeney, Ross M Young, Jason P Connor
Journal: Front Psychiatry (2018)
Keywords: cbt, rct, alcohol dependence, craving, expectancies, impulsivity, personalized
MeSH terms: Case Reports

Background: Tailored psychological interventions based on individual risk factors are likely to improve treatment for Alcohol Use Disorders (AUDs). Key risk factors for poor treatment outcome include alcohol craving, positive expectations of alcohol consumption, and impulsivity. Design: Pragmatic randomized Cognitive-Behavioral Treatment (CBT) trial. Setting: Public hospital alcohol and drug clinic. Participants: Three-hundred seventy-nine patients (65% male; AgeyearsM = 44.32, SD = 10.75) seeking treatment for AUD. Procedure: Patients were randomly allocated into treatment as usual (TAU) or targeted treatment. Patients in targeted treatment were allocated one of three treatment modules focusing on craving, positive expectancy, or impulsivity based on assessment results. Treatment included eight, 1 h sessions of CBT over 12 weeks delivered by clinical psychologists. Hypotheses: Targeted treatment was expected to have fewer drinking days and consume less alcohol during the treatment period than TAU. Improvement in targeted mechanisms was predicted to be greatest for patients within matched conditions. Results: Patients attended an average of 4.4 sessions with 93 (25%) completing the whole 12-week treatment episode. The mean proportion of drinking days between sessions was 5% with an average consumption of 64 grams of ethanol. No significant effect of targeted treatment was identified on drinking days or consumption. The craving (b = -18.97, 95% CI = -31.44, -6.51) and impulsivity (b = -26.65, 95% CI = -42.09, -11.22) modules demonstrated significant reductions in their targeted constructs over treatment, above TAU. Only reduction in craving was associated with reduced drinking days [exp(b) = 0.958, p = 0.003] and alcohol consumption [exp(b) = 0.962, p = 0.02]. Significant indirect effects for the targeted craving module through craving reduction were identified for reduction in drinking days (β = -0.72, 95% CI = -1.50, -0.158) and alcohol consumption (β = -0.78, 95% CI = -1.72, -0.11). Conclusions: In the context of a public health service, the effectiveness of individualized treatment targeting risk mechanisms identified during pre-treatment assessment was not confirmed. Some evidence was found for improved treatment response to the implementation of a manualized craving module when pre-treatment craving was high.
Intracranial Capillary Hemangioma in the Posterior Fossa of an Adult Male
Authors: Jordan Nepute, Jinping Lai, Yihua Zhou
Journal: Case Rep Radiol (2016)

Intracranial capillary hemangioma (ICH) is a rare entity, with approximately 24 reported cases in the literature. There are only three reported cases of ICH in an adult male. In this case report, we describe the fourth documented case of ICH in an adult male and, to the best of our knowledge, the first ever documented case of ICH in the posterior fossa of an adult male. We also discuss its imaging appearance and differential diagnosis.
Intra-arterial fibrinolysis for the management of acute ischemia on a below-knee amputation stump. Case report
Authors: Breno Boueri Affonso, Joaquim Maurício da Motta Leal Filho, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Journal: Einstein (Sao Paulo) (2018)
MeSH terms: Amputation Stumps / blood supply, Fibrinolytic Agents / administration & dosage, Ischemia / drug therapy, Case Reports, Acute Disease, Amputation Stumps / diagnostic imaging, Amputation Stumps / pathology, Humans, Infusions, Intra-Arterial, Ischemia / diagnostic imaging, Male, Middle Aged, Treatment Outcome, Fibrinolytic Agents

Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion. Pharmacomechanical thrombectomy, with Aspirex (rotational catheter to restore blood flow in occluded vessel, by removing occlusion material from the vessel) and recombinant tissue plasminogen activator, was performed. After 9 years of follow-up the patient remained asymptomatic, capable of independent ambulation with prosthetic limb. Intra-arterial fibrinolysis seems to be a safe and effective treatment for cases of acutely ischemic amputation stump.
Insulinoma Management in a Pregnant Woman: A Case Report
Authors: Bertha Patricia Diaz-Sangines, Julio Gonzalez-Cofrades, Eric Emilio Vazquez-Camacho, Montserrat Malfavon-Farias, Linda Garcia-Lima
Journal: Cureus (2023)
Keywords: complications, fistula, hypoglycemia, insulinoma, pregnancy
MeSH terms: Case Reports

An insulinoma is a rare tumor that originates in the β cells of the pancreas with an incidence of four cases per million people per year. To our knowledge, 40 cases of insulinoma in pregnancy have been reported. Insulinoma in pregnancy is usually diagnosed in the first trimester. Surgical treatment is advised during the second trimester with complications arising in up to 10% of cases. We present the case of a 34-year-old pregnant woman diagnosed with insulinoma during the first trimester. The patient underwent a laparoscopic resection of the tumor at 15.5 weeks of gestation. Insulinoma was resected and postoperative complications were managed, including acute pancreatitis and peripancreatic and splenorenal fluid collection, which were treated using multidisciplinary management and resolved at the end of the pregnancy at 40.1 weeks of gestation.
Rituximab Monotherapy in the Management of a Rare Case of an HIV Associated Lymphoproliferative Disorder
Authors: Jason Hew, Fauzia Rana, Louise Zhou
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Background. Castleman's disease (CD), also known as angiofollicular node hyperplasia, is a rare heterogenous lymphoproliferative disorder. This disease exists as two distinct entities: a localized or unicentric CD (UCD) which has a more benign clinical course and multicentric CD (MCD) which is a systemic disease and carries a worse prognosis. MCD is often associated with human immunodeficiency virus (HIV) infection and these patients are usually coinfected with human herpes virus-8 (HHV-8). Rituximab is an anti-CD20 monoclonal antibody that has become integral to the management of this disease. It is used alone or in combination with chemotherapy to treat MCD. Case Report. We describe a case of a 58-year-old man with HIV and HHV-8 MCD and evidence of organ failure with a poor performance status that went into complete remission after four cycles of therapy with weekly rituximab. Conclusion. HIV-MCD can be challenging to diagnose and to manage. Early recognition can reduce morbidity and mortality associated with the disease. Rituximab monotherapy can be used as a safe and effective treatment option in patients with a poor performance status.
Epispadias associated with urethral duplication: Our practice
Authors: Ramiz Polukhov, Vugar Mahammadov, Madina Baghirli
Journal: Int J Surg Case Rep (2020)
Keywords: congenital urethral anomalies, epispadias, urethral duplication
MeSH terms: Case Reports

Introduction:
Urethral duplication and epispadias are one of the rare anomalies of the genitourinary system. Sometimes, urethral duplication can also be associated with anorectal malformations, epispadias, hypospadias, bladder doubling, bladder exstrophy and other urinary excretory system anomalies.
Presentation of case:
In this article we report three years old male patient with incomplete urethral duplication and epispadias. During our examination there was detected the second - accessory urethra along with the main urethra on the dorsal surface of the penile. The accessory urethra was stripped from the surrounding tissues to the root of the penile and it became apparent that the accessory urethra was merged into the main urethra at the same level. The accessory urethra was closed by suturing and removed from that part. Then, by using 7.0 pds thread there was performed urethroplasty.
Discussions:
Urethral duplication is one of the rarely found congenital anomalies in the genitals. Duplications in the sagittal plane can be complete or incomplete, dorsal or ventral, and may be associated with other congenital urogenital anomalies. An epispadias is a rare type of malformation of the penis in which the urethra ends in an opening on the upper aspect of the penis. Despite the fact that there are many considerations about their embryology, the reason of appearance of these anomalies is still unknown.
Conclusions:
While planning of surgical treatment of such common anomalies along with the good cosmetic results the lower urinary excretory system functions should be considered as well.
May-Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males
Authors: Tay Tian En Jason, Tay Jia Sheng, Tieng Chek Edward Choke, Pooja Sachdeva
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

May-Thurner syndrome (MTS) is an underdiagnosed cause of lower limb deep vein thrombosis (DVT). The clinical prevalence of MTS-related DVT is likely underestimated, particularly in patients with other more recognisable risk factors. MTS is classically described in females between the age group of 20-50 years. In patients with acute iliofemoral thrombosis, medical treatment with anticoagulation alone has been associated with higher risk of postthrombotic syndrome (PTS) and lower iliofemoral patency rates, as compared to endovascular correction. We describe a case of MTS-related extensive iliofemoral DVT occurring in a middle age male who presented with acute onset of left lower limb swelling and pain, complicated by pulmonary embolism. Doppler compression ultrasonography of the left lower limb showed partial DVT extending from the left external iliac to the popliteal veins, and contrasted computed tomography (CT) of the thorax abdomen and pelvis established features of MTS, together with right pulmonary embolism. He was started on low molecular weight heparin (LMWH) and then underwent left lower limb AngioJet pharmacomechanical thrombolysis/thrombectomy, iliac vein stenting, and temporary inferior vena cava (IVC) filter insertion. After the procedure, the patient recovered and improved symptomatically with rapid resolution of this left lower limb swelling and pain. He was switched to an oral Factor Xa inhibitor and was subsequently discharged. After 1-month follow-up, he remained well with stent patency visualised on repeat ultrasound and underwent an uneventful elective IVC filter retrieval with subsequent plans for a 1-year follow-up.
Case Report: Aggressive neural crest tumors in a child with familial von Hippel Lindau syndrome associated with a germline VHL mutation (c.414A>G) and a novel KIF1B gene mutation
Authors: Lucie Landen, Anne De Leener, Manon Le Roux, Bénédicte Brichard, Selda Aydin, Dominique Maiter, Philippe A Lysy
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: kif1b gene, von hippel lindau, blood hypertension, neural crest tumors, pheochromocytoma
MeSH terms: Case Reports

Introduction:
Von Hippel Lindau (VHL) syndrome is caused by an autosomal dominant hereditary or sporadic germline mutation of the VHL gene with more than five hundred pathogenic mutations identified. Pheochromocytomas and rarely paragangliomas occur in 10-50% of patients with VHL syndrome usually around 30 years of age and exceptionally before the age of 10.
Case presentation:
We diagnosed a 9-year-old girl of normal appearance and severe refractory hypertension, with a norepinephrine-secreting pheochromocytoma related to VHL syndrome due to a known familial germline heterozygous mutation of VHL gene (c.414A>G), also present in three members of her family. At age 13, a pelvic tumor and a left adrenal pheochromocytoma that showed to be multi-metastatic to both lungs were discovered in the patient leading to left adrenalectomy and pelvic tumor resection. In addition to the germline VHL gene mutation, blood analysis using Next Generation Sequencing identified a novel heterozygous germline mutation of the KIF1B gene (c.3331_3332del; p.Asn1111Glnfs*21), which is only present in the girl and not the other family members. The patient is currently under steroid substitution therapy and leads a normal life.
Discussion:
This family is notable by the early age of onset of multiple neural crest tumors associated with a high propensity for malignancy and metastatic spread. Most reports in the literature associated the VHL mutation with a later onset in adulthood and a benign course, which contrast with our findings and question the role of this mutation in the phenotype expressed in this kindred. Also, the presence of concomitant mutations in two susceptibility genes for neural crest tumors poses the question of their respective roles in the development of tumors in this family. Our familial case description illustrates the potential for systematic use of targeted Next Generation Sequencing with multi-gene panels in patients with neural crest tumors to confirm the role of known susceptibility genes as well as identifying new ones, but also to contribute to comprehensive databases on gene variants and their phenotypic counterparts in this specific area of medicine.
Role of nasal endoscopy in chronic osteomyelitis of maxilla and zygoma: a case report
Authors: J S Arunkumar, Ashok S Naik, K C Prasad, S G Santhosh
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Osteomyelitis of the jaws was relatively common before the era of antibiotic therapy and preventive and restorative dentistry. Osteomyelitis is an acute or chronic inflammatory process that can involve cortical and trabecular aspects of bone or bone marrow. Cranial bones are infrequently involved, but spreading of inflammation with involvement of surrounding structures represents important risk, such as cerebral abscess, encephalitis, or meningitis. The mandible is more commonly involved than the maxilla. Dentogenic infections cause 38% of mandibular and 25% of maxillary involvement. Involvement of zygoma is very rare. Factors like viral fevers, malnutrition, malaria, anemia,tobacco chewing, immunodeficiency, osteopetrosis, Paget's disease of bone, and florid cemento-osseous dysplasia (FCOD) result in decreased vascularity of the affected bone, predisposing to the development of osteomyelitis. We present a case of osteomyelitis of left maxilla and zygoma with oroantral fistula in an immunocompetent adult male caused by dentogenic infection. The complete resolution of infection was gained with surgical treatment using nasal endoscope and antibiotic therapy. The aims of this paper are to illustrate diagnostic patterns, to report radiographic findings and surgical treatment using nasal endoscope in a case of osteomyelitis of maxilla and zygoma. The prognosis and cosmetic results are discussed.
Kienböck's disease: a case report
Authors: Youssef Omor, Ittimade Nassar, Ali Ajana, Nabil Moatassimbillah
Journal: Pan Afr Med J (2015)
Keywords: kienböck disease, lunate osteonecrosis, magnetic resonance imaging
MeSH terms: Lunate Bone / pathology, Magnetic Resonance Imaging / methods, Osteonecrosis / diagnosis, Case Reports, Adolescent, Humans, Male, Osteonecrosis / diagnostic imaging, Osteonecrosis / pathology, Radiography

Kienböck disease is a condition characterized by avascular necrosis of the lunate bone. Advanced imaging can aid in the diagnosis and staging of Kienböck disease. Magnetic resonance imaging (MRI) is an important adjunct to diagnosis. In particular, MRI is helpful early in the disease when plain radiographs may not reveal abnormalities. A 17-year-old man with Kienböck disease who underwent radiography and MR is described in this article.
A Rare Case of Carotid Web Presenting with Ischemic Stroke in a Young Woman and a Brief Review of the Literature
Authors: Kyaw Kyaw, Htun Latt, Sammy San Myint Aung, Jay Babu, Rajesh Rangaswamy
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Carotid web is a radiological description of a shelf-like intraluminal filling defect in the carotid bulb. It is histologically defined as atypical fibromuscular dysplasia (FMD), with abnormal fibrosis and smooth muscle cell hyperplasia in the tunica intima. The spur-like intraluminal protrusion can serve as a nidus for thrombus formation, which could cause systemic embolism and ischemic strokes. We report a case of a 20-year-old female patient presenting with acute ischemic stroke in the ipsilateral middle cerebral artery (MCA) territory. We also discuss the incidence, the prevalence, the pathophysiology, the treatment, and the recurrence of carotid web based on the currently available literature.
Solitary thyroid metastasis from colon cancer: a rare case report
Authors: L Nicosia, S Alessi, M Proh, E Grosso, M Ansarin, A Vingiani, E Pisa, E De Fiori
Journal: Ecancermedicalscience (2016)
Keywords: fine needle aspiration (fna), radiological follow-up, thyroid metastasis, ultrasound imaging
MeSH terms: Case Reports

Malignant metastases to the thyroid are rare and are even rarer from a colorectal primary. As these metastases are often asymptomatic, they are usually discovered incidentally on imaging performed as follow-up for the primary tumour. In this report, we present a case of metastatic sigmoid adenocarcinoma to the thyroid diagnosed and treated at our institution.