OpenMed/multicare-articles huggingface dataset:
Syringomatous carcinoma: case report of a rare tumor entity
Authors: Basma El khannoussi, Hajar Hechlaf, Issam Lalya, Mohamed Oukabli, Abderrahman Al Bouzidi, Nicolas Ortonne
Journal: Pan Afr Med J (2012)
Keywords: syringomatous carcinoma, differential diagnosis, histopathology, immunohistochemistry
MeSH terms: Skin Neoplasms / pathology, Sweat Gland Neoplasms / pathology, Syringoma / pathology, Case Reports, Aged, Female, Humans, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Skin Neoplasms / diagnosis, Sweat Gland Neoplasms / diagnosis, Syringoma / diagnosis

Syringomatous carcinoma is a rare cutaneous neoplasm, most frequently situated on the face and scalp and histologically characterised by an infiltrative pattern of basaloid or squamous cells, a desmoplastic stromal reaction and keratin filled cysts. We report the case of a 76-year-old woman who presented an ulcerative interscapular lesion measuring 3x4cm. After resection, the histological examinations of the specimens have identified a basal cell carcinoma. However, a local recurrence was observed 18 months later; histopathological findings showed a syringomatous pattern and neoplastic epithelial cells arranged in interconnecting cords with microcystic areas. Nests, cords, and tubules of the tumour extended into the dermis and into the adjacent muscle. Sclerosis of stroma around the cords was present. Tumour cells were not connected to the epidermis. The immunohistochemical analysis showed positivity for anti-CK7, AE1/AE3 and negativity for anti CEA and anti CK20. These histological and immunohistochemical analyses were consistent with the diagnosis of syringomatous eccrine carcinoma. Syringomatous carcinoma is an extremely invasive tumor, locally destructive and slowly growing adnexal tumour, derived from eccrine sweat glands. It is often mistaken, both clinically and microscopically, for other benign and malignant entities. The tumour recurrence is high due to extensive perineural invasion, but regional or distant metastases are rare. The local aggressive nature of the tumour and the high recurrence rate may necessitate mutilating procedures. Optimal treatment consists of a complete microscopically controlled surgical excision with clear surgical margins.
Hereditary Angioedema Type II: First Presentation in Adulthood with Recurrent Severe Abdominal Pain
Authors: Mohamed Abuzakouk, Nada AlMahmeed, Esat Memisoglu, Martine McManus, Aydamir Alrakawi
Journal: Case Reports Immunol (2018)
MeSH terms: Case Reports

A 27-year-old Emirate man presented to Cleveland Clinic Abu Dhabi emergency department with a 4 year history of recurrent episodes of severe swellings affecting different parts of his body. He used to get 2 swelling episodes every week affecting either his face, hands, feet or scrotum and severe abdominal pain twice a week. Abdominal CT scan and a colonoscopy showed bowel wall oedema. There was no family history of similar complaint or of hereditary angioedema (HAE). Complement studies confirmed the diagnosis of HAE type II. He was commenced on danazol 100 mg twice daily and his symptoms resolved. This case report highlights the importance of considering HAE in patients with recurrent unexplained abdominal pain even in the absence of positive family history of HAE.
Huge Retroperitoneal Cyst Masquerading as Ovarian Tumour: A Case Report
Authors: Syamim Johan, Muhammad Firdaus Hassan, Firdaus Hayati, Nornazirah Azizan, Alvin Oliver Payus, Un Hean Edwin See
Journal: Front Surg (2020)
Keywords: case report, cystadenoma, diagnostic dilemma, radiography, retroperitoneal neoplasms
MeSH terms: Case Reports

Retroperitoneal cystic mass is a rare surgical condition that is often misdiagnosed preoperatively. Here, we report a case of a 56-year-old woman who presented with abdominal swelling for a 1-year duration, which was associated with lower abdominal pain for 6 months. Her abdominal radiograph showed a huge radiopaque lesion, and contrast-enhanced computed tomography scan of the abdomen reported it as a left ovarian serous cystadenoma causing local mass effect to the left ureter leading to mild left hydronephrosis. She underwent exploratory laparotomy and noted there was a huge retroperitoneal cystic mass. The histopathological assessment finding was consistent with a benign retroperitoneal cyst. This case report aims to share the rare case of primary retroperitoneal lesions, which can cause a diagnostic challenge preoperatively to all clinicians despite advanced achievement in medical imaging.
Acute Mesenteroaxial Volvulus in the Setting of Chronic Paraesophageal Hernia: A Case Report
Authors: Yu An Lin, William J Berglind, Robert Cromer
Journal: Cureus (2023)
Keywords: case report, chronic abdominal pain, fundoplication, gastric volvulus, paraesophageal hernia
MeSH terms: Case Reports

Hiatal hernia is a common finding in radiologic and gastroenterology evaluations. Here, we present a patient with an uncommon paraesophageal subtype who was managing her hiatal hernia symptoms conservatively and eventually developed the rare complication of mesenteroaxial gastric volvulus. The chronic history of this patient's hiatal hernia with classic complaints suggestive of gastric ischemia prompted clinical suspicion of volvulus. Here, we discuss the initial clinical presentation of this patient, imaging study, and emergent surgical intervention by robot-assisted laparoscopic gastric volvulus reduction, hiatal hernia repair, and Nissen fundoplication. Although the size and axis of rotation of this patient's volvulus made this case challenging, the prompt intervention prevented complications associated with volvulus and ischemia.
Ketamine Infusion Associated with Improved Neurology in a Patient with NMDA Receptor Encephalitis
Authors: Michael MacMahon, Morag R Naysmith, Stephanie McCallion, Jonathan Rhodes
Journal: Case Rep Crit Care (2013)

A young lady was ventilated on intensive care for a prolonged period with NMDA receptor encephalitis. She had undergone steroid, immunoglobulin, and plasmapheresis with no evidence of recovery. Her main management issue was the control of severe orofacial and limb dyskinesia. Large doses of sedating agents had been used to control the dystonia but were ineffective, unless she was fully anaesthetised. The introduction of a ketamine infusion was associated with a dramatic improvement in her symptoms such that it was possible to remove her tracheostomy two days after commencement. She was discharged shortly after that and is making a good recovery. The successful use of ketamine has not previously been described in this context, and we hope this case report will provide some insight into the management of this rare but serious condition.
Emergency escape surgery for a gastro-bronchial fistula with respiratory failure that developed after esophagectomy
Authors: Yuta Ibuki, Yoichi Hamai, Jun Hihara, Junya Taomoto, Ichiko Kishimoto, Yoshihiro Miyata, Morihito Okada
Journal: Surg Today (2015)
MeSH terms: Bronchial Fistula / surgery, Esophagectomy, Gastric Fistula / surgery, Postoperative Complications / surgery, Respiratory Insufficiency / surgery, Case Reports, Bronchial Fistula / etiology, Duodenum / surgery, Emergencies, Esophageal Neoplasms / surgery, Esophagostomy, Gastric Fistula / etiology, Gastrostomy, Humans, Male, Middle Aged, Plastic Surgery Procedures, Pneumonia / etiology, Pneumonia / surgery, Postoperative Complications / etiology, Respiratory Insufficiency / etiology, Treatment Outcome

A gastro-bronchial fistula (GBF) is a rare complication after esophageal reconstruction using a gastric tube, but it can cause severe pneumonia, and the surgical procedure is challenging. We herein describe a patient who was successfully managed using a two-stage operation for a GBF. Because the patient had life-threatening pneumonia and respiratory failure caused by the GBF, we first transected the duodenum, established a cervical esophagostomy and gastrostomy and placed a decompression catheter in the gastric tube without a thoracotomy. The patient recovered from pneumonia after the resolution of the salivary inflow and digestive juice reflux into the lungs through the GBF. Two months later, an esophageal bypass was achieved by reconstructing the esophagus using a long segment of pedicled jejunum. The patient was discharged 38 days thereafter. Appropriate treatment for GBF should be tailored to individual patients based on their current status and disease severity.
Case Report: Administration of Amniotic Fluid-Derived Nanoparticles in Three Severely Ill COVID-19 Patients
Authors: Maria Ines Mitrani, Michael A Bellio, Anthony Sagel, Marie Saylor, William Kapp, Kathryn VanOsdol, Gwendolyn Haskell, Danique Stewart, Zanub Abdullah, Ivan Santos, Julian Milberg, Alissa Arango, Albert Mitrani, George C Shapiro
Journal: Front Med (Lausanne) (2021)
Keywords: ards (acute respiratory distress syndrome), covid-19, amniotic fluid (af), critical care, exosomes, extracellular vesicles
MeSH terms: Case Reports

Rationale/Objectives: A human coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak worldwide. There is an urgent need to develop new interventions to suppress the excessive immune response, protect alveolar function, and repair lung and systemic organ damage. Zofin (previously known as Organicell Flow) is a novel therapeutic that is derived from the soluble and nanoparticle fraction (extracellular vesicles and exosomes) of human amniotic fluid. Here within, we present the clinical outcomes after Zofin treatment in three critically ill patients suffering from severe, multi-organ complications induced by COVID-19 infection. All patients were diagnosed with COVID-19, developed respiratory failure, and were hospitalized for more than 40 days. Methods: Zofin was administered to patients concurrently with ongoing medical care who were monitored for 28-days post-therapy. SOFA score assessment, chest X-rays, and inflammatory biomarker testing was performed. Main Results: There were no adverse events associated with the therapy. The patients showed improvements in ICU clinical status and experienced respiratory improvements. Acute delirium experienced by patients completely resolved and inflammatory biomarkers improved. Conclusions: Primary outcomes demonstrate the therapy was safe, accessible, and feasible. This is the first demonstration of human amniotic fluid-derived nanoparticles as a safe and potentially efficacious therapeutic treatment for respiratory failure induced by COVID-19 infection.
Ellis-van Creveld Syndrome: A Case Report
Authors: Subash Singh, Vandana Arya, M Jonathan Daniel, Vijeev Vasudevan
Journal: Int J Clin Pediatr Dent (2012)
Keywords: chondroectodermal dysplasia, congenital heart disease, polydactyly
MeSH terms: Case Reports

Ellis-van Creveld syndrome also known as chondroectodermal dysplasia or mesoectodermal dysplasia; a rare genetic disorder of the skeletal dysplasia. 'Six-fingered dwarfism' (digital integer deficiency) was an alternative designation used for this condition when it was being studied in the Amish. It is characterized by short-limb dwarfism, polydactyly, malformation of the bones of the wrist, dystrophy of the fingernails, partial hare-lip, cardiac malformation and often prenatal eruption of the teeth. A typical case of Ellis-van Creveld syndrome is reported in the present article. How to cite this article: Singh S, Arya V, Daniel MJ, Vasudevan V. Ellis-van Creveld Syndrome: A Case Report . Int J Clin Pediatr Dent 2012;5(1):72-74.
Emphysema after Sinus Grafting: Importance of Patient's Information, Early Diagnosis, and Management
Authors: Marc El Hage, Nathalie Nurdin, Mark Bischof, Rabah Nedir
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The sinus elevation procedure is a safe and predictable technique that allows the placement of implants in atrophic posterior maxillae. However, some recommendations have to be followed by the patient to ensure reliable healing. It is particularly important to avoid inducing trauma in the region concerned and through the sinuses. This report describes a rare complication that occurred after the grafting of a sinus, which was attributed to a violent sneeze a few hours after the intervention. The diagnosis of emphysema following air entry was confirmed by the suddenness of the swelling and associated crepitation, and by the radiographic observation of a delimited radiolucent zone in the grafted sinus. The immediate diagnosis and subsequent management prevented further adverse events. This case report supports the need for complete comprehensive instruction of patients after oral surgery, swift diagnosis, and management of emphysema.
Case report: Cochlear implantation was effective for progressive bilateral severe hearing loss associated with Kawasaki disease
Authors: Daichi Murakami, Takahito Kimura, Masamitsu Kono, Akihiro Sakai, Tomohiro Suenaga, Masanobu Hiraoka, Hideki Sakatani, Makiko Ohtani, Hiroyuki Suzuki, Daisuke Tokuhara, Muneki Hotomi
Journal: Front Pediatr (2023)
Keywords: kawasaki disease, cochlear implantation, hearing loss, speech development, systemic vasculitis
MeSH terms: Case Reports

Sensorineural hearing loss associated with Kawasaki disease has been increasingly reported, but its etiology remains unclear. Most reported cases of sensorineural hearing loss associated with Kawasaki disease have been mild and reversible during acute or subacute phases. However, bilateral severe hearing loss as a complication of Kawasaki disease can cause delays in cognitive and speech development. A 4-year-old Japanese boy treated for Kawasaki disease had right-side moderate and left-side profound sensorineural hearing loss on the 141st day after onset of Kawasaki disease. Despite systemic steroid pulse treatment, hearing loss remained in both sides. After the recurrence of Kawasaki disease, hearing on the right side progressively worsened, meaning there was now severe hearing loss on both sides. Left cochlear implantation performed on the 1065th day after the onset of Kawasaki disease improved the patient's hearing and his ability to communicate. Sensorineural hearing loss associated with Kawasaki disease may progress over a long period and cause bilateral severe hearing loss, although past reports showed occurrence during acute or subacute phases. The clinical course of our patient suggests that intense inflammation caused by Kawasaki disease could be related to prolonged hearing loss. Cochlear implantation seems to be effective for sensorineural hearing loss associated with Kawasaki disease.
Linezolid is associated with serotonin syndrome in a patient receiving amitriptyline, and fentanyl: a case report and review of the literature
Authors: Lampros Samartzis, Paraskevi Savvari, Sofoklis Kontogiannis, Stavros Dimopoulos
Journal: Case Rep Psychiatry (2013)

We report a unique case of an adverse interaction between the oxazolidinone antibiotic linezolid, the tricyclic antidepressant amitriptyline and the opioid analgesic fentanyl in a 68-year-old woman with advanced ischemic peripheral arterial disease and sepsis, under empirical antibiotic treatment. We also summarize the current relevant literature as identified via PubMed, EMBASE, and PsycINFO as well as reference sections of selected articles.
Evaluating Complications of Chronic Sinusitis
Authors: Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness. After further investigation he was diagnosed with a mixed anaerobic epidural abscess. The evaluation and management of chronic sinusitis are based on the presence of symptoms concerning for complication. Prompt investigation of complicated sinusitis is essential in preventing debilitating and fatal sequelae. Our case study underscores the importance of early diagnosis and appropriate management.
Management of large and surrounding tissue infiltrative anal fistula cancer: Two case reports
Authors: Sang Hyun An, Ik Yong Kim
Journal: Int J Surg Case Rep (2020)
Keywords: abdominoperineal resection, adenocarcinoma, anal fistula
MeSH terms: Case Reports

Introduction:
Adenocarcinoma originating from chronic perianal fistulas is a rare disease. Due to the lack of evidence of this malignancy, no definitive diagnostic and treatment guidelines have been established. We present two cases of anal fistula cancer and discuss the diagnostic and treatment strategies.
Presentation of case:
A 79-year-old man was referred for a perianal mass. The patient had a history of chronic perianal fistula and was diagnosed with adenocarcinoma originating from a long-standing perianal fistula. The patient underwent laparoscopic abdominoperineal resection (APR) without any adjuvant therapy. The second case was a 42-year old man, who was referred for a prolapsed anal mass. The patient had recurrent perianal fistula over several years. He was diagnosed with mucinous adenocarcinoma originating from a long-standing perianal fistula, but he initially refused surgical treatment. Two years later, the patient revisited with a huge overgrown tumor and underwent laparoscopic APR with wide perineal skin excision, wound debridement and coverage with a bilateral V-Y advancement flap via a one-step procedure.
Discussion:
High degree of clinical suspicion is crucial to diagnose this rare disease that can easily be missed at an early stage. Depending on the disease stage, surgical treatment, chemotherapy, and radiotherapy can be considered.
Conclusion:
Histopathological evaluation should be performed on recurrent and incurable anal fistulas over a long period of time. Intensive surgical treatment with or without neoadjuvant and adjuvant therapy should be considered in advanced cases.
Does meconium peritonitis pseudo-cyst obstruct labour?
Authors: Khalil Al Tawil, Walid Salhi, Safiah Sultan, Mohammad Namshan, Saeed Mohammed
Journal: Case Rep Obstet Gynecol (2012)
MeSH terms: Case Reports

Meconium peritonitis pseudo-cyst is very rare. Its perinatal management is controversial and can be associated with increased fetomaternal morbidity and mortality. A 34-week gestation infant with large meconium peritonitis pseudo-cyst, detected by intrapartum fetal ultrasound study, had abnormally increased ratio of fetal abdominal circumference to head circumference. Intrapartum aspiration of the pseudo-cyst was performed and was followed by a smooth vaginal delivery. The postnatal course of the baby showed that early laparotomy was essential for stabilisation of the infant's general condition.
Case Report: Response to ALK-TKIs in a metastatic lung cancer patient with morphological heterogeneity and consistent molecular features
Authors: Yu Yang, Han Liu, Tao-Hua Liu, Xi-Run Zheng, Bin Wu, Dong-Jing Zhou, Guang-Juan Zheng, Xiao-Shu Chai
Journal: Front Oncol (2023)
Keywords: alk rearrangement, adenosquamous carcinoma, histomorphology, metastasis lung cancer, targeted therapy
MeSH terms: Case Reports

Lung adenosquamous carcinoma (ASC) is a rare heterogeneous tumor containing two distinct components of adenocarcinoma (ADC) and squamous cell carcinoma (SQCC). The limited biopsy sampling of the primary tumor might have overlooked either the ADC component or the SQCC component, resulting in a misdiagnosis of pure histology. Genotyping for driver mutations is now routinely performed in clinical settings to identify actionable oncogenic mutations and gene arrangements. Additionally, somatic mutations can potentially serve as a marker of clonal relationships. We report a rare case of ASC lung cancer, in which metastases were identified as ADC, while the primary was initially diagnosed as SQCC based on a fibrobronchoscope brush biopsy. The primary and metastatic tumors shared ALK rearrangement and other mutations support they were derived from a single clone origin. Our hypothesis is that the primary tumor contained a minor component of ADC that was not present in the histologic sections of lung biopsy. After sequential ALK-tyrosine kinase inhibitor (TKI) targeted therapy, both the patient's primary lung tumor and the site of metastatic subcutaneous nodules decreased in size, with the metastatic sites demonstrating more noticeable shrinkage. However, after 11 months of targeted therapy, the patient was found to be resistant to ALK-TKIs. Subsequently, the patient's respiratory status deteriorated rapidly, and a cycle of immunotherapy and chemotherapy did not show efficacy. To the best of our knowledge, this is a very rare case of lung ASC, disseminated metastasizing, with distinct morphology between the primary and metastases. Different therapeutic effects of ALK-TKIs were observed in two different morphological sites, with the metastatic cutaneous lesions shrinking more significantly than the primary lung lesions, though they both harbor the same EML4-ALK rearrangement. This case may provide diagnostic and therapeutic insights into lung ASC.
Successful treatment of COVID-19-associated collapsing glomerulopathy: 22 months of follow-up
Authors: Pulkit Gandhi, Caoimhe Sorcha Dowling, Anjali Satoskar, Ankur Shah
Journal: Clin Nephrol Case Stud (2023)
Keywords: covan, covid-19, fsgs, acute kidney injury, hematuria, nephrotic range proteinuria, steroids
MeSH terms: Case Reports

The term COVAN (COVID-19-associated nephropathy) has been used to describe collapsing focal segmental glomerulosclerosis (FSGS) in individuals who have been infected with the SARS-CoV-2. This helps differentiate it from the majority of cases of acute kidney injury in COVID-19 patients, which are typically caused by acute tubular injury. The exact pathophysiology is unclear but is proposed to involve pro-inflammatory cytokines such as type 1 interferons, which are thought to increase expression of the APOL1 gene in glomerular epithelial cells. This triggers a cascade of inflammatory events that cause damage to the epithelia and underlying podocytes. The treatment of COVAN is centered on general supportive measures including dietary sodium restriction, optimization of hyperlipidemia and hypertension, RAAS blockade, and diuresis for edema. There is limited data to support the use of glucocorticoids in COVAN; however, the mechanism of podocytopathy is similar to that in HIVAN (HIV-associated nephropathy), with high disease burden in those with APOL1 gene mutation. Based on previous experience, treatment of HIVAN with glucocorticoids is beneficial and safe in selected patients. Here we present a case of COVAN which was successfully treated with glucocorticoids, and at 22-month follow-up patient remained in full remission (proteinuria < 1,000 mg/g) with stable kidney function.