OpenMed/multicare-articles huggingface dataset:
PD-1 inhibitor combined with radiotherapy and GM-CSF in MSS/pMMR metastatic colon cancer: a case report
Authors: Jiabao Yang, Pengfei Xing, Yuehong Kong, Meiling Xu, Liyuan Zhang
Journal: Front Oncol (2023)
Keywords: gm-csf, mss/pmmr, case report, colorectal cancer, immunotherapy, radiotherapy
MeSH terms: Case Reports

Patients with chemo-refractory metastatic colorectal cancer (mCRC) have poor prognoses. The application of programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors encouragingly improved the survival of mCRC patients with microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR). Unfortunately, it was ineffective for mCRC with microsatellite-stable (MSS)/proficient mismatch repair (pMMR), which accounted for 95% of mCRC. Radiotherapy can promote local control by directly killing tumor cells and inducing positive immune activities, which might help synergistically with immunotherapy. We present the report of an advanced MSS/pMMR mCRC patient who had progressive disease (PD) after first-line chemotherapy, palliative surgery and second-line chemotherapy combined with targeted therapy. Then the patient received the therapy of PD-1 inhibitor combined with radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF). According to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST1.1), the patient showed a complete response (CR) after triple-combined therapy with progression-free survival (PFS) for more than 2 years so far. The patient had no other significant adverse reactions except for fatigue (Grade 1). The triple-combination therapy provided a promising strategy for metastatic chemo-refractory MSS/pMMR mCRC patients.
Treatment of a Complex Personality Disorder Using Repeated Doses of LSD-A Case Report on Significant Improvements in the Absence of Acute Drug Effects
Authors: Felix Müller, Markus Mühlhauser, Friederike Holze, Undine E Lang, Marc Walter, Matthias E Liechti, Stefan Borgwardt
Journal: Front Psychiatry (2020)
Keywords: lsd, case report, depression, hallucinogen, personality disorder, treatment
MeSH terms: Case Reports

A 39-year-old female patient suffering from severe, treatment-resistant depression and other symptoms associated with a complex personality disorder was admitted to our open psychiatric ward for an experimental treatment with lysergic acid diethylamide (LSD). The substance was administered in repeated weekly and ascending doses. Curiously, there were no substantial acute subjective effects of the drug despite adequate dosing, which was also confirmed by plasma drug concentration monitoring. However, the patient showed rapid and significant improvement with most notable changes in depressed mood, emotional instability, loss of energy, and suicidal ideations. Additionally, the SCL-90 questionnaire indicated significant decreases in global severity and in various psychopathological subscales. Improvements persisted for ~7 days after each administration. Due to the severe course of the illness and the resistance to previous treatment it was decided to continue this experimental approach with weekly repeated doses of LSD. The patient will be observed closely with regard to somatic and mental side effects. Two features of this case are remarkable: Firstly, administration of LSD was associated with significant improvements in various symptoms of a condition usually difficult to treat. Secondly, symptom reductions occurred in the absence of acute drug effects. Therefore, the mechanism of action seemed to deviate from the concept that improvements after administration of drugs like LSD are due to experiences during the acute drug effects. This case might indicate that LSD can induce rapid but transient beneficial effects on several psychopathological symptoms. The time course of these improvements resembled antidepressant effects seen after administration of ketamine.
Risk Factors for Anaplastic Thyroid Carcinoma: A Case Series From a Tertiary Referral Center for Thyroid Surgery and Literature Analysis
Authors: Giuseppa Graceffa, Giuseppe Salamone, Silvia Contino, Federica Saputo, Alessandro Corigliano, Giuseppina Melfa, Maria Pia Proclamà, Pierina Richiusa, Sergio Mazzola, Roberta Tutino, Giuseppina Orlando, Gregorio Scerrino
Journal: Front Oncol (2022)
Keywords: anaplastic thyroid carcinoma, multinodular goiter, prognosis, risk factors, thyroidectomy

Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive disease with a very poor prognosis. Several risk factors have been hypothesized, but there is no clear-cut literature data on it. We reviewed the literature concerning risk factors for ATC and analyzed the institutional database from 2005 to 2022. In total, 15 papers were suitable for review, while the retrospective data collection search, conducted on our institutional database, provided 13 results. In our experience, in agreement with literature data, ATC seems to be a neoplasm peculiar to old age (in our database, mean age is 72 years), with a higher prevalence in subjects with a low level of education and a long history of multinodular goiter (MNG). The role of cigarette smoking and blood group, hypothesized on some literature data, was more uncertain, although the small sample size evaluated probably had a great influence on these results. The higher incidence of the disease in individuals with a history of MNG could suggest more aggressive choices in the treatment of a benign disease, in contrast to current practice. However, this may be a highly questionable point considering that ATC accounts for no more than 2% of all thyroid neoplasms in surgical departments, even those dedicated to endocrine neck surgery. Further studies are therefore necessary for a step forward in this direction.
Case Report: Reconstruction After Anterior Pubic Hemipelvectomy
Authors: Benjamin Murphy, Tharsa Thillainadesan, Kerian Robinson, Anita Clarke, Peter Choong
Journal: Front Surg (2021)
Keywords: anterior hemipelvectomy, chondrosarcoma, pubic resection, reconstruction of anterior pelvis, type iii hemipelvectomy
MeSH terms: Case Reports

We report on a case of a large atypical cartilaginous tumor of the pelvis and its novel surgical resection with an anterior hemipelvectomy and reconstruction with an iliac crest graft. Surgical intervention is the mainstay treatment of pelvic chondrosarcomas. However, there have been reports of concern regarding preventing pelvic visceral herniation and adequately reconstructing the pelvis. This report is unique within the literature and has yielded good functional outcomes whilst achieving satisfactory surgical margins and minimizing morbidity.
Microgallbladder: Self-Remitting Acute Cholecystitis-Like Condition Unique to Patients with Cystic Fibrosis
Authors: Mina S Mousa, John C Feldman, Paresh Mahajan
Journal: Case Rep Radiol (2019)
MeSH terms: Case Reports

Microgallbladder is a nonsurgical medical condition characterized by chronic inflammation and atrophy of the gallbladder, which is considered a highly specific imaging finding unique to patients with cystic fibrosis (CF), and has been incidentally reported on abdominal imaging in up to 45% of cases with CF. The impairment of exocrine water efflux in CF leads to the production of hyperviscous biliary secretions, cholestasis, and transient cystic duct obstruction of the microgallbladder causing microcholecystitis-interestingly a self-remitting acute cholecystitis-like condition without surgical intervention. We present a case report of a 22-year-old male patient with history of CF with multiple hospital admissions for unexplained chronic abdominal pain found to be caused by microgallbladder, which was managed conservatively.
Auto-Administered Photobiomodulation on Diabetic Leg Ulcers Treatment: A New Way to Manage It?
Authors: Elisabetta Merigo, Lixin Tan, Zengyi Zhao, Jean-Paul Rocca, Carlo Fornaini
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Peripheral arterial disease is a dramatic consequence of an uncontrolled diabetic condition causing an increase of morbidity and mortality and its treatment is currently medical or surgical, finally requiring, in the 7-20% of cases, major or minor amputation. Photobiomodulation therapy (PBM) is a laser treatment used in medicine, thanks to its ability to stimulate the wound healing, the acceleration of inflammatory process, and the modulation of pain. Recently, the self-administration of the treatment has been suggested for different purposes in medicine and dentistry with a great number of advantages and no side effects.
Methods:
A 84-year-old woman affected by diabetes type 2 and positive for diabetes complications had diagnosis for an ulcerative lesion of 1 cm diameter on her right leg and started a treatment of the lesion applying the B-Cure Laser Pro (Erika Carmel, Haifa, Israel) on her own with a fluence per minute of 3.2 J/cm2 for 2 sessions of 15 minutes by cutaneous application.
Results:
After a week of treatment, the ulcer dried and crusted, finally providing complete healing after 30 days of treatment.
Conclusion:
With this short case report, we think to add a further contribution by suggesting this kind of treatment for successful management of the leg ulcers in diabetic patients.
Case Report: Twin Pregnancy Gives Birth to a Girl with Partial Trisomy 21 Mosaicism after in vitro Fertilization and Embryo Transfer
Authors: Zhenglong Guo, Bing Kang, Dong Wu, Hai Xiao, Leilei Hao, Bingtao Hao, Shixiu Liao
Journal: Front Genet (2022)
Keywords: ivf-et, nipt, case report, chromosome defects, down syndrome, twin pregnancy
MeSH terms: Case Reports

Objective: To report a rare case in which an IVF-ET twin pregnancy gave birth to a partial trisomy 21 chimera girl. Design: Case report. Setting: University hospital. Patient: A girl with partial trisomy 21 mosaicism after in vitro fertilization and embryo transfer. Interventions: In vitro fertilization (IVF) and embryo transfer (ET). Main Outcome Measure: Karyotype analysis, Copy Number Variation sequencing (CNV-seq), stLFR-WGS, and Short Tandem Repeat (STR) analysis. Results: Being assisted with IVF and EF technology, the couple successfully gave birth to twin sisters at 37 weeks of gestational age. The NonInvasive Prenatal Testing (NIPT) and Nuchal Translucency (NT) examination showed no detectable genetic abnormalities during pregnancy. However, the younger infant displayed growth retardation and feeding difficulties after birth, which was not observed in her twin sister. Further genetic counseling and diagnosis suggested that she is a Chimera with complex partial trisomy 21. The stLFR-WGS assay showed multiple CNV variations in Chr21 and STR analysis confirmed the paternal origin of the additional fragments. Conclusion: It is rare for IVF-ET-assisted twin pregnancy to give birth to a girl with a complex combination of abnormal Chr21, which might result from paternal chromosome rearrangement during meiosis and mitosis.
Case Report: Extrinsic Compression of the Left Main Coronary Artery by a Giant Sinus of Valsalva Aneurysm
Authors: Feifei Ning, Manyun Tang, Mengjie Wang, Joseph B Muhlestein, John D Day, Guoliang Li, Yang Yan
Journal: Front Cardiovasc Med (2021)
Keywords: angina pectoris, case report, myocardial ischemia, sinus of valsalva aneurysm, surgical treatment, syncope episodes
MeSH terms: Case Reports

Sinus of Valsalva aneurysm (SoVA) is an uncommon clinical entity, which is present in roughly 0. 09% of the general population. The cause can either be acquired or congenital. Clinically the SoVA of unruptured status are rarely captured or even diagnosed due to atypical clinical presentations. Here, we present a rare case of exertional angina pectoris and recurrent syncope due to an extrinsically compressed left coronary artery by a giant SoVA in a 50-year-old female patient. This SoVA was successfully repaired by the surgical exclusion and the patient was still doing well after 2 years of follow-up.
Evidence for Underregistration of Suicide
Authors: M A Riedinger, R F P de Winter
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

In this case report, we will present two cases in which the Dutch municipal coroner registered a natural death, but treating psychiatrists doubted the validity of this decision on the grounds of clinical data and investigation. For both cases, we present evidence that deaths likely resulted from suicide, raising serious doubts about the accuracy of the registered cause of death. According to the WHO bulletin on suicide prevention, the national registration of suicide is unsatisfactory in many countries. The Netherlands is listed by the WHO as having one of the most accurate registration procedures. Nevertheless, there are indications that national registration, even in the Dutch system, is not infallible. In this case report, we present several ways in which the registration process is liable to error and evidence for underregistration of suicide rates.
Case Report: Combining liver partition and portal vein ligation after thrombectomy for tumor isolation (CLAPT) to treat advanced hepatocellular carcinoma with portal vein tumor thrombosis
Authors: Zongrui Jin, Guolin Wu, Banghao Xu, Jilong Wang, Hai Zhu, Ya Guo, Minhao Peng, Tao Peng, Zhang Wen
Journal: Front Surg (2022)
Keywords: associating liver partition and portal vein ligation for staged hepatectomy, combining liver partition and portal vein ligation after thrombectomy for tumor isolation, future liver remnant, hepatocellular carcinoma, portal vein tumor thrombosis

Background:
Primary liver cancer is the third leading cause of cancer-related deaths worldwide in 2020, and hepatocellular carcinoma (HCC) is the major pathological type. Patients with HCC complicated with portal vein tumor thrombosis (PVTT) have a poor prognosis, and controversies regarding treatment options exist among international scholars. Patients with VP4 or Cheng's type III classification are generally considered ineligible for surgical treatment.
Methods:
We retrospectively analyzed three cases of HCC with PVTT who underwent a novel modified surgical procedure. The procedure included portal vein thrombectomy and portal vein ligation with liver parenchymal separation for the resection of the tumor thrombus involving the main portal vein trunk and for the isolation of the giant tumor. The three cases were then treated with targeted drugs postoperatively.
Results:
One case developed acute renal failure in the perioperative period, and the renal function gradually recovered after the treatment. The two remaining cases recovered uneventfully postoperatively. The prognosis of the three patients was encouraging. Only one patient died of lung metastasis after 13 months, and the remaining patients were still alive after 41 and 21 months, respectively.
Conclusions:
We provide a new possible surgical option for patients with advanced HCC with PVTT. The surgical procedure was inspired by associating liver partition with portal vein ligation for staged hepatectomy and portal vein thrombectomy. The survival time was significantly prolonged after the patients underwent thrombectomy, tumor isolation, and postoperative nonsurgical treatment. Hence, the combination of liver partition and portal vein ligation after thrombectomy for tumor isolation has the potential for the treatment of advanced HCC with PVTT.
The Effectiveness of Hepatic Arterial Infusion Chemotherapy with 5-Fluorouracil/Cisplatin and Systemic Chemotherapy with Ramucirumab in Alpha-Fetoprotein-Producing Gastric Cancer with Multiple Liver Metastases
Authors: Yasuhiro Doi, Yasushi Takii, Kenji Mitsugi, Koichi Kimura, Yutarou Mihara
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Alpha-fetoprotein- (AFP-) producing gastric cancer (AFPGC) is characterized by a high incidence of liver and lymph node metastases and poor prognosis. Although several case reports have described successful multidisciplinary treatment, there are currently no standard therapies for AFPGC. A 57-year-old man presented with upper abdominal pain. His serum AFP level was extremely high (588.9 ng/mL). Computed tomography (CT) revealed multiple liver metastases with several lesions at an imminent risk of rupture. Five days after admission to our hospital, one lesion ruptured. Transarterial chemoembolization (TACE) of the ruptured tumor was performed, and hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil (5-FU)/cisplatin (CDDP) to the other liver metastases was administered. The patient's AFP levels decreased to 297.1 ng/mL. Gastrointestinal endoscopy revealed Borrmann type 2 lesion in the pyloric portion. Pathological examination indicated hepatoid adenocarcinoma of the stomach and metastatic liver. The final diagnosis was AFPGC and multiple liver metastases. The patient underwent systemic chemotherapy with capecitabine/CDDP (cape/CDDP) for three months. His AFP level increased extremely, and CT revealed progression of the liver metastases. TACE was performed, and HAIC (5FU/CDDP) was administered to the progressive lesion of the liver. Originating from the gastric lesion, a distal gastrectomy and D2 + α lymph node resection were performed. One month after the operation, the patient underwent systemic chemotherapy with paclitaxel/ramucirumab (PTX/RAM). After eight cycles of chemotherapy, his AFP level had declined, and CT showed a complete response. After three months of drug withdrawal, the patient has undergone maintenance treatment with RAM. It has been two years since the recurrence. Our experience suggests that HAIC with 5-FU/CDDP and systemic chemotherapy with a regimen including RAM may be an effective treatment for AFPGC.
Hypophysitis following Treatment with Ustekinumab: Radiological and Pathological Findings
Authors: Ana M Ramos-Leví, Manuel Gargallo, Ana Serrano-Somavilla, Miguel A Sampedro-Núñez, Javier Fraga, Monica Marazuela
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: autoimmunity, hypophysitis, pituitary, psoriasis, ustekinumab
MeSH terms: Case Reports

Context:
Ustekinumab is a human IgG1 monoclonal antibody that targets interleukin (IL)-12 and IL-23, which may be useful in the treatment of autoimmune conditions such as psoriasis, psoriatic arthritis, and Crohn's disease. Hypophysitis is an immune-derived inflammatory condition of the pituitary gland that may lead to pituitary dysfunction. With the increasing use of immunotherapy, it is possible that this and other new immune-related adverse events (IRAEs) arise, although the mechanisms involved are still incompletely defined.
Case description:
A 35-year-old male, with a previous history of severe plaque-psoriasis who had started treatment with ustekinumab 4 months before, complained of progressive and persistent headache. Brain magnetic resonance imaging (MRI) was unremarkable. One year later, a new MRI was performed due to headache persistence, which revealed a homogenous and diffuse pituitary enlargement, with suprasellar extension and optic chiasm involvement, blurring of the pituitary stalk, absence of clear differentiation between the anterior and posterior lobes, and no signs of hemorrhage or adenomas. Endocrine evaluation was consistent with panhypopituitarism. Work-up of infiltrative and infectious diseases was negative. Follow-up MRI revealed an increase in the pituitary enlargement and transsphenoidal surgery was performed. Pathological findings revealed an intense fibrosis and a chronic inflammatory infiltrate, but no evidence of adenoma, granuloma, or acid fast bacilli. Immunohistochemical staining showed a combined T-cell (CD3+, CD4+) and B-cell (CD19+, CD20+) phenotype.
Conclusion:
We suggest a novel IRAE of ustekinumab, with full radiological and immunopathological iconography, which may be mediated by the complex interaction between different immunological processes.
A novel variant in FN1 in a family with fibronectin glomerulopathy
Authors: Nabeel Aslam, Anshika Singh, Cherise Cortese, Douglas L Riegert-Johnson
Journal: Hum Genome Var (2019)
MeSH terms: Case Reports

Glomerulopathy with fibronectin deposits (GFND) is a rare glomerular disorder. We report a 28-year-old male diagnosed with GFND by mass spectrometry on kidney biopsy tissue. Whole-exome sequencing (WES) identified that a previously undescribed FN1 gene mutation (c.3051G > T, p.W1017C) was likely responsible for this patient's fibronectin glomerulopathy. We discuss the implications of this novel variant of FN1 and the importance of WES to identify a mutation in a gene of interest.
Rupture of ectopic varices of the ascending colon occurring after pancreatic cancer surgery: A case report and literature review
Authors: Yushi Inomata, Takeo Naito, Takashi Hiratsuka, Yusuke Shimoyama, Rintaro Moroi, Hisashi Shiga, Yoichi Kakuta, Kimiko Kayada, Yuki Ohara, Naoki Asano, Shuichi Aoki, Michiaki Unno, Atsushi Masamune
Journal: DEN Open (2023)
Keywords: ascending colon varices, colon varices, ectopic varices, left‐sided portal hypertension, pancreatic cancer
MeSH terms: Case Reports

A 69-year-old woman, a long-term survivor of subtotal stomach-preserving pancreatoduodenectomy with the splenic vein resection for pancreatic cancer, visited our hospital with a chief complaint of bloody stools. Previously, she was diagnosed with varices in the ascending colon due to left-sided portal hypertension after pancreatoduodenectomy by computed tomography and colonoscopy. After emergency hospitalization, she went into shock, and blood tests showed acute progression of severe anemia. Computed tomography showed a mosaic-like fluid accumulation from the ascending colon to the rectum. She was diagnosed with ruptured varices in the ascending colon. Emergency colonoscopy was performed, and treatment with endoscopic injection sclerotherapy using N-butyl-2-cyanoacrylate was successful. Ectopic varices occur at any location other than the esophagus and stomach, and colonic varices are rare among them. They are mostly caused by portal hypertension due to liver cirrhosis. However, with the trend of improving the prognosis for patients with pancreatic cancer, we should occasionally pay attention to the development of ectopic varices including colonic varices in patients who have undergone pancreatoduodenectomy with superior mesenteric and splenic veins resection. Treatment methods for colonic varices varied from case to case, including conservative therapy, interventional radiology, and endoscopic procedure. In this case, endoscopic injection sclerotherapy was successfully performed without any complications. To the best of our knowledge, this is the first study to report successful treatment with endoscopic injection sclerotherapy for varices in the ascending colon caused by left-sided portal hypertension after pancreatoduodenectomy. Colonic varices should be considered in patients with obscure gastrointestinal bleeding after pancreatoduodenectomy.
Splenic hydatid disease in pregnancy
Authors: Kirstie F Thomson, Florence Mahlobo, Denasha L Reddy
Journal: South Afr J HIV Med (2022)
Keywords: cystic echinococcosis, hydatid disease, pregnancy, spleen, splenomegaly
MeSH terms: Case Reports

Introduction:
Hydatid disease in the South African setting remains an important differential diagnosis in many appropriate clinical presentations, such as splenomegaly. Splenic hydatid disease in pregnancy is a rare and complex disease to manage.
Patient presentation:
In this case report we describe a case of isolated splenic hydatid disease in an HIV-positive woman presenting in her third trimester of pregnancy.
Management and outcome:
A multidisciplinary team consisting of specialists from the high-risk maternity unit, hepatobiliary surgery and infectious diseases planned the management of the patient, which included pre-operative albendazole and elective caesarean section with assisted forceps delivery at 36 weeks' gestation. An elective splenectomy in the post-partum period was planned for definitive management.
Conclusion:
Our aim is to highlight the unique treatment challenges of hydatid disease in pregnancy and the need for a multidisciplinary team approach when managing complex cases of hydatid disease.