OpenMed/multicare-articles huggingface dataset:
Inferior vena cava resection and reconstruction with a peritoneal patch for a leiomyosarcoma: A case report
Authors: Matteo Risaliti, Laura Fortuna, Ilenia Bartolini, Antonio Taddei, Paolo Muiesan
Journal: Int J Surg Case Rep (2020)
Keywords: inferior vena cava, leiomyosarcoma, peritoneal patch, vascular reconstruction
MeSH terms: Case Reports

Introduction:
Leiomyosarcomas (LMs) of the inferior vena cava (IVC) are very rare neoplasms seldom reported in the literature. The majority of patients does not present with specific abdominal pain and IVC LMs are used to become symptomatic with the increase of tumor volume. The role of chemotherapy or radiotherapy is not yet defined and surgical resection seems to be the only chance to improve survival rates.
Presentation of case:
We present a case of a 58-year-old female with a recent diagnosis of IVC LM who underwent surgery with a partial resection of the anterior wall of the vein using a lateral and partial vein clamping. The primary repair of the defect could result in stricture of the vein, so a parietal peritoneum patch was used for the vein reconstruction. The postoperative course was uneventful.
Discussion:
Actual evidence suggests that vascular sarcomas have limited responsiveness to cytotoxic chemotherapy and chemoradiotherapy, so surgery is the treatment of choice. Major surgery entailing multivisceral and complex vascular resection is usually necessary to achieve negative margins and accurate vascular reconstruction techniques are mandatory to avoid serious circulatory complications. Different kinds of graft (biological or synthetics) are available for the reconstruction, with intrinsic advantages and limitations. The use of peritoneal patches seems a valid and cheap option for vascular reconstruction and it is gaining great attention in recent years.
Conclusion:
This case demonstrates that peritoneal graft could be a safe option to manage IVC defects in expert hands. A brief review of literature is also included.
Nectarivorous Bird Emphysematous Ingluvitis (NBEI): A Novel Disease in Loriinae Birds Associated With Clostridium perfringens Infection
Authors: Andrew F Rich, Flavia Zendri, Taiana Costa, Dorina Timofte, Gabby J Drake, Hannah Rowland, Ian Ashpole, Andrew Moore, Julian Chantrey
Journal: Front Vet Sci (2020)
Keywords: clostridium perfringens, emphysematous ingluvitis, lorikeet, lory, nectarivorous
MeSH terms: Case Reports

A retrospective study revealed ten cases of emphysematous ingluvitis in Loriinae birds from two zoological collections between 2009 and 2020. Common clinical features were sudden death with gas distention of the crop, subcutaneous cervical emphysema and poor body condition, but also included collapse, hypothermia and abandonment. Macroscopic examination revealed moderate crop enlargement, distention and thickening with minimal intraluminal content, and moderate to severe submucosal to transmural gas-filled cysts (emphysema). Histopathology identified widespread transmural multifocal to coalescing empty pseudo-cystic cavities with lytic necrosis, pyo-/granulomatous inflammatory infiltrates, epithelial ulceration, parakeratotic hyperkeratosis, epithelial ballooning degeneration, and occasional intralesional rod-shaped bacteria. The lesion may have impaired the birds' ability to ingest food, resulting in suboptimal body condition. Necrotizing to granulomatous aspiration pneumonia was also a feature in some cases. Anaerobic bacterial culture of four crops identified Clostridium perfringens with associated toxin genes for alpha and occasionally beta2 toxin (cpa and cpb2 genes respectively), by PCR analysis of bacterial isolates cultured from fresh or frozen tissue. C. perfringens was identified as the common etiological agent of emphysematous ingluvitis in crop and/or liver (six out of ten birds), and type A was confirmed in five birds. C. perfringens was not detected in the crop nor liver of two unaffected Loriinae birds. This is the first publication that characterizes nectarivorous bird emphysematous ingluvitis (NBEI), attributes C. perfringens as an etiological agent, and highlights this novel disease as an important cause of death in Loriinae birds, particularly in nestling and fledgling stage of development, but also in older lorikeets and lories.
Subthreshold Autism Spectrum in a Patient with Anorexia Nervosa and Behçet's Syndrome
Authors: L Dell'Osso, B Carpita, I M Cremone, F Mucci, A Salerni, D Marazziti, C Carmassi, C Gesi
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Recently, increasing research stressed the presence of subthreshold autistic traits in patients with other psychiatric conditions. In this framework, a significant relationship between anorexia nervosa (AN) and the autism spectrum has been frequently reported, in particular among female samples, to the point that AN has been hypothesized to be a female phenotype of autism spectrum disorder (ASD). On the other hand, among subjects with ASD has been reported a higher prevalence of immune diseases and altered immune functions. While these reports seem to support an association between neurodevelopmental and immune system alterations in ASD, the relationship between the immune system and the broader autism spectrum, including its subthreshold manifestations, remains poorly investigated. In this report, we described the presence of autistic traits in a male inpatient with AN and separation anxiety disorder, who also show a diagnosis of Behçet's syndrome (BS). This case seems to further stress the association between AN and the autism spectrum, which may not be limited to the female gender. Moreover, it further suggests a deeper link between neurodevelopmental and immune system alterations. Implications are discussed in light of the more recent neurobiological and psychopathological hypothesis about the autism spectrum.
Somatostatin Receptors in Merkel-Cell Carcinoma: A Therapeutic Opportunity Using Somatostatin Analog Alone or in Association With Checkpoint Inhibitors Immunotherapy. A Case Report
Authors: Michele Guida, Alessandro D'Alò, Anita Mangia, Federica Di Pinto, Margherita Sonnessa, Anna Albano, Angela Sciacovelli, Artor Niccoli Asabella, Livia Fucci
Journal: Front Oncol (2020)
Keywords: merkel carcinoma, merkel cell carcinoma (mcc), immunothearpy, somatostatin analog, somatostatin—receptor
MeSH terms: Case Reports

Background: Merkel-cell carcinoma (MCC) is a rare, highly aggressive skin cancer typically involving elderly people. Surgery is usually the first treatment for primary tumor. In adjuvant setting, radiotherapy is effective in reducing local recurrence and in improving overall survival. Regarding advanced disease, systemic chemotherapy ended up disappointing results whereas antiPD1/antiPD-L1 immunotherapy recently gave relevant clinical benefits. Interestingly, about the half of MCC patients expresses high somatostatin receptors (SRs) to possibly represent a target for the therapeutic use of somatostatin analogs (SSAs). Nevertheless, SSAs have been little studied in MCC and cases treated with SSAs in association with checkpoint inhibitor immunotherapy have not been published yet. Case Report: We report the case of a 73-year-old man affected by metastatic MCC of right arm previously treated with surgery and adjuvant radio and chemotherapy. Three years later the patient presented loco-regional relapse involving lateral-cervical, mediastinal, and submandibular lymph nodes with high value of chromogranin A and neuron specific enolase. Due to the high expression of SRs at octreoscan and immunoistochemistry, patient started octreotide 30 mg i.m. every 28 days with a good control of disease for about 2 years. A widespread progression of disease was reported afterwards. The patient started the antiPD-L1 avelumab immunotherapy, only recently available in Italy, while still taking SSA. The patient showed an impressive regression of the disease after only four cycles of avelumab until complete remission. Conclusions: SSA could be a valid therapeutic option in patients with MCC with high SR expression. When combined with PD-1/PD-L1 immune-checkpoint inhibition, SSA is likely to enhance antiproliferative activity. Our case report provides the rationale to conduct a prospective trial and translational research to verify the efficacy and safety of combined SSA and checkpoint inhibitors for advanced MCC.
Early Detection and Management of Massive Intraoperative Pulmonary Embolism in a Patient Undergoing Repair of a Traumatic Acetabular Fracture
Authors: Tobechi E Okoronkwo, XueWei Zhang, Jessica Dworet, Matthew Wecksell
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

A 73-year-old male with history of hyperlipidemia and osteoarthritis was transferred from an outside hospital after a fall from a ladder at home. He sustained a severe right sided acetabular fracture involving the femoral head, requiring operative repair. Preoperative evaluation was unremarkable except for oxygen saturation < 95 %. After induction of anesthesia and surgical positioning, the patient went into cardiac arrest. After intraoperative cardiopulmonary resuscitation (CPR) and placement on extracorporeal membrane oxygenation (ECMO), the patient stabilized. Cardiac catheterization revealed a large left pulmonary embolism. Here, we discuss the etiology and management of intraoperative pulmonary embolism.
Amyloidosis Localized to the Sinonasal Tract: From the Diagnosis to Management of Disease
Authors: Sara Gomes, Sara Santos, Monica Silva, Joana Ferreira, Teresinha Ponte
Journal: Cureus (2023)
Keywords: amyloidosis, localized amyloidosis, nasal congestion, nasopharyngeal amyloidosis, tinnitus
MeSH terms: Case Reports

Amyloidosis is a mainly systemic rare disease and its localized presentation is even less frequent. Systemic forms are often associated with other conditions or entities (such as neoplasms), and a correct etiological study of patients with this disease is essential. A localized presentation has a better prognosis compared to systemic forms, which underlines the importance of a correct diagnosis. Primary localized amyloidosis in the head and neck region is a rare entity. Primary amyloidosis localized to the sinonasal tract is extremely rare. Although uncommon, case reports have been increasing in the face of new endoscopic and imaging techniques, and the report of these cases is crucial for a better characterization of this entity. Symptoms may include epistaxis, nasal obstruction, facial deformity, and vision changes. A 72-year-old female with a history of frequent nasal congestion with two years' duration showed no improvement following symptom management. She was referred for nasal endoscopy and biopsy, thereby confirming the diagnosis of amyloidosis. Further diagnostic testing did not show evidence of systemic disease. This case report was previously presented as a poster presentation at the 19th European Congress of Internal Medicine in March 2021.
INCIDENCE OF HIGH GRADE QTCF PROLONGATION AND ITS MANAGEMENT AMONG PATIENTS UNDERGOING TREATMENT FOR DRUG RESISTANT TUBERCULOSIS (DR-TB): CASE SERIES
Authors: Meseret T Asfaw, David L Holtzman, Gene F Kwan, Lawrence T Oyewusi, Carole D Mitnick, Kwonjune J Seung
Journal: Afr J Infect Dis (2021)
Keywords: bedaquiline, delamanid, drug resistant tuberculosis, qt-interval prolongation

Background:
The World Health Organization (WHO) has approved the use of two new drugs, namely Bedaquiline (Bdq) and Delamanid (Dlm), for treatment of Drug Resistant Tuberculosis (DR-TB). One of the concerns raised with the use of these drugs was QT-interval prolongation. This condition could be serious and life threatening. Hence, knowing the magnitude and its management is very important. This case series identifies the incidence and discusses the management of clinically significant QT-interval prolongation amongst a cohort of patients who have been on these medicines.
Materials and methods:
Patients with reports of high grade QT-Interval prolongation (i.e. Grade-3 and Grade-4) were identified from the cohort of 265 patients enrolled on bedaquiline and/or delamanid and discussion is made on the pattern, severity and management of each cases identified.
Results:
Only 4 (1.5%) out of all 265 patients enrolled on Bedaquiline and/or Delamanid have developed high grade QT-Interval prolongation. And all are managed without permanent discontinuation of both drugs.
Conclusion:
The Incidence of clinically significant QTcF-interval prolongation among DR-TB patients taking bedaquiline and /or delamanid in Lesotho is low. And almost all cases can be managed with more frequent Electrocardiogram (ECG) monitoring and management of other possible causes of QT-interval prolongation without the need to stop one or both drugs permanently.
Cerebral nocardiosis with osteomyelitis of skull vault complicating a primary neck lesion in an immunocompetent patient: a case report
Authors: Wafa Marrakchi, Abir Aouam, Ikbel Kooli, Hajer Ben Brahim, Adnene Toumi, Mohamed Chakroun
Journal: Pan Afr Med J (2021)
Keywords: nocardiosis, case report, immunocompetent, osteomyelitis, skull vault
MeSH terms: Anti-Bacterial Agents / administration & dosage, Nocardia Infections / diagnosis, Osteomyelitis / diagnosis, Skull / pathology, Case Reports, Doxycycline / administration & dosage, Humans, Male, Middle Aged, Nocardia Infections / complications, Nocardia Infections / drug therapy, Osteomyelitis / drug therapy, Osteomyelitis / microbiology, Skull / microbiology, Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage, Anti-Bacterial Agents, Trimethoprim, Sulfamethoxazole Drug Combination, Doxycycline

Nocardia infection is an uncommon and rare condition in immunocompetent patient. A case of cutaneous nocardiosis complicated with osteomyelitis of the vault scalp in a 64-year-old man, with no remarkable past medical history, is reported. Treatment with trimethoprime-sulfamethoxazole than doxycycline for 12 months led to complete resolution and no evidence of recurrence was noted. Nocardia infection should be considered even in immunocomptent patients and doxycycline is a good alternative for treatment.
Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy
Authors: Natalie E Cookson, Reza Mirnezami, Paul Ziprin
Journal: Case Rep Gastrointest Med (2015)

Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation "clip cholelithiasis". Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT) imaging revealed hyperdense material in the common bile duct (CBD) compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP) revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient's jaundice and sepsis. Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.
At the Heart of the Diagnosis: A Case of Systemic Lupus Erythematosus Presenting as Cardiac Tamponade
Authors: Jose Gomez Casanovas, Mery Bartl, Laura Rincon-Rueda, Christine E Loftis, Emilia Dulgheru
Journal: Cureus (2023)
Keywords: hispanic population, pericardial effusion cardiac tamponade, pericardial window, sle-associated pah, systemic lupus erythema
MeSH terms: Case Reports

Systemic lupus erythematosus (SLE) is a heterogenous, systemic disease characterized by the production of pathogenic autoantibodies against nuclear antigens. Although the most common cardiac manifestation of SLE is pericardial effusions, their progression to cardiac tamponade is rare and has an incidence between 1-3%. We describe a case of a 42-year-old Hispanic woman who presented with severe shortness of breath, vague chest pain, and hemodynamic compromise secondary to cardiac tamponade. The patient's underlying etiology of cardiac tamponade was attributed to a new diagnosis of SLE based on the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology classification (EULAR/ACR) criteria for SLE. The patient's treatment consisted of a pericardial window and immunosuppressive therapy with corticosteroids, Mycophenolate, and hydroxychloroquine. This case aims to increase awareness of SLE as a possible differential diagnosis of cardiac tamponade in the appropriate clinical setting.
Sarcoidosis and Histoplasmosis: Is One a Consequence of the Other? A Case Report and Review of the Literature
Authors: Anupam Bansal, Rupali Drewek
Journal: Case Rep Rheumatol (2015)

Sarcoidosis involves abnormal collections of inflammatory cells (granulomas) which may form as nodules in multiple organs. 90% of affected patients have respiratory tract abnormalities. We present a 61-year-old male with sarcoidosis who was admitted for respiratory distress. Fibrosing mediastinitis was seen in the chest computograph. Management was conservative and included steroids, antibiotics, and oxygen therapy. Sarcoidosis and fibrosing mediastinitis are rare. Fibrosing mediastinitis is more commonly seen with histoplasmosis. We explore the clinical similarities between histoplasmosis and sarcoidosis. We also explore the potential cause and effect relationship and workup for each disease entity.
Truncal necrobiosis lipoidica diabeticorum: A first case report
Authors: Maram Alkhatieb, Hatan Mortada
Journal: Int J Surg Case Rep (2020)
Keywords: case report, diabetes mellitus, granulomatous dermatitis, necrobiosis lipoidica diabeticorum, skin lesion, truncal
MeSH terms: Case Reports

Introduction:
Necrobiosis lipoidica (NL) is a known chronic rare granulomatous dermatitis. NL typically occurs in the lower extremity, there have only been previously reported cases of NL on the face, scalp, forearms, and dorsum of the hands. However, truncal NL is not a typical location.
Presentation of case:
A 67-year-old man known to have diabetes type 2, presented with a 3-year history of painful and itchy skin lesions on the right lateral chest wall. On clinical examination, he had a red discolored patch with superficial capillaries and yellow discoloration at the center. Based on the histological examination, necrobiosis lipoidica was confirmed. Initial treatment with clobetasol propionate, tacrolimus, and topical corticosteroid cream was unsuccessful, and further NL lesions developed on the lower limb.
Discussion:
NL rash is characterized by its location in the lower limbs and rarely involves fingers, hands, scalp, or face. It is noteworthy that the patient presented with NL skin lesions bon the trunk, which is outside the usual presentation. The prevalence of NL ranges from 0.3% to 1.2% among patients with diabetes mellitus. The treatment of NL is usually difficult. Initial management includes smoking cessation and proper diabetes control. In addition, intralesional and topical corticosteroids might be effective. In this case report, there was no improvement in NL despite the use of topical corticosteroids.
Conclusion:
Immediate diagnosis and treatment of NL may prevent disease progression; therefore, the diagnosis of NL should be considered, even in an unusual location.
Use of a partial humeral head resurfacing system for management of an osseous mechanical block to glenohumeral joint range of movement secondary to proximal humeral fracture malunion
Authors: Kyriacos Eleftheriou, Nawfal Al-Hadithy, Vinay Joshi, Daniel Rossouw
Journal: Int J Shoulder Surg (2011)
Keywords: shoulder hemicap malunion humerus fracture
MeSH terms: Case Reports

Malunion of proximal humeral fractures can lead to a severely impaired shoulder function. Loss of motion is often the main issue in patients and can be secondary to osseous, soft-tissue as well as neurological damage to the shoulder. Malunion of the articular surface of the humeral head can lead to pain, chronic degenerative changes secondary to joint incongruity and mechanical block to the range of movement. A 46-year-old otherwise healthy male chef presented with malunion and collapse of his previous plate fixation for a four-part proximal humerus fracture. We describe the first documented case of the use of a focal resurfacing system for dealing with such an osseous mechanical block in the presence of an otherwise preserved articular surface in a high-demand patient. HemiCAP can be successfully used in proximal humeral fracture malunion where there is a localized cartilage defect, allowing restoration of joint congruity while preserving the bone stock.
Case Report: Expanding the Genetic and Phenotypic Spectrum of Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay
Authors: Parham Habibzadeh, Zahra Tabatabaei, Soroor Inaloo, Muhammad Mahdi Nashatizadeh, Matthis Synofzik, Vahid Reza Ostovan, Mohammad Ali Faghihi
Journal: Front Genet (2020)
Keywords: arsacs, early-onset ataxia, hypokinesia, recessive ataxia, rigidity, spastic ataxia
MeSH terms: Case Reports

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare neurodegenerative disorder caused by biallelic mutations in the SACS gene. Once thought to be limited to Charlevoix-Saguenay region of Quebec, recent evidence has indicated that this disorder is present worldwide. It is classically characterized by the triad of ataxia, pyramidal involvement, and axonal-demyelinating sensorimotor neuropathy. However, diverse clinical features have been reported to be associated with this disorder. In this report, we present the first Iranian family affected by ARSACS with unique clinical features (mirror movements, hypokinesia/bradykinesia, and rigidity) harboring a novel deletion mutation in the SACS gene. Our findings expand the genetic and phenotypic spectrum of this disorder.
Isolated Pheochromocytoma in a 73-Year-Old Man With No Clinical Manifestations of Type 1 Neurofibromatosis Carrying an Unsuspected Deletion of the Entire NF1 Gene
Authors: Stefanie Parisien-La Salle, Nadine Dumas, Geneviève Rondeau, Mathieu Latour, Isabelle Bourdeau
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: deletion, hypertension, neurofibromatosis, phenotype, pheochromocytoma
MeSH terms: Case Reports

Pheochromocytomas (PHEOs) are a rare cause of endocrine hypertension that requires genetic counseling since at least 30% of PHEOs are associated with a germline mutation in a susceptibility gene. Neurofibromatosis type 1, NF1 is amongst the 16 known causing genes for pheochromocytomas/paragangliomas. We report a case of a 73-year-old man with PHEO in whom genetic testing revealed a large pathogenic heterozygous deletion of 1.14 Mb encompassing the entire coding sequence of the NF1 gene while the patient showed no signs of clinical NF1.This case illustrates that the diagnosis of NF1 should not be excluded in patients with PHEO in the absence of clinical diagnosis of the disease and support that older patients with PHEO should also be offered genetic counseling.