OpenMed/multicare-articles huggingface dataset:
An interesting case of likely BRCA2 related bilateral breast cancer with metastasis in the fimbrial part of fallopian tube
Authors: Lučka Boltežar, Gorana Gašljević, Srdjan Novaković, Vida Stegel, Erik Škof
Journal: Hered Cancer Clin Pract (2020)
Keywords: brca2, breast cancer, fimbrial part of fallopian tube, oligometastatic, receptor conversion
MeSH terms: Case Reports

Background:
In a patient with a germline BRCA2 pathogenic variant with breast cancer, an adnexal mass can represent either a metachronous primary tumor or a metastasis of the breast cancer. A clear distinction between those two possibilities is crucial since treatments differ substantially and so does survival of the patient.
Case presentation:
We present a case of a 47-year-old patient with bilateral breast carcinoma with a germline BRCA2 pathogenic variant. The first manifestation of the disease was a lump in her left breast in 1998, histological report was invasive ductal carcinoma, triple-negative. She was treated with surgery, chemotherapy and radiotherapy. In 2011 a new occult carcinoma was found in her right axilla, however the specimen was estrogen receptor (ER) and progesterone receptor (PgR) positive. She was treated as a new primary occult carcinoma of the right breast with surgery, radiotherapy and adjuvant hormonal treatment. In 2016 a mass in the left adnexa was found with imaging techniques. She underwent surgery as if it was primary ovarian cancer, yet histology revealed it was a metastasis of a triple-negative breast carcinoma in the fimbrial part of the left Fallopian tube. She received adjuvant chemotherapy after surgery and is now in complete remission.
Conclusion:
We present an interesting and quite rare case of two primary breast carcinomas in a patient with a known BRCA2 pathogenic variant with metastasis in the fimbrial part of the left Fallopian tube. We conclude that there were two primary breast tumours and the one from 2011 spread into the fimbrial part of the left Fallopian tube in 2016. Despite the fact that molecular analyses could not confirm the joint tumour origin, we believe that there was a receptor status conversion over time explaining different receptor status. The possibility of a triple-negative metastasis from the tumour treated in 1998 is less probable. With both of aforementioned possibilities being prognostically unfavourable, the patients' outcome is so far excellent and she was in complete remission at the time of writing this article.
Acute Pancreatitis Induced by Diabetic Ketoacidosis with Major Hypertriglyceridemia: Report of Four Cases
Authors: Karama Bouchaala, Mabrouk Bahloul, Sabrine Bradii, Hela Kallel, Kamilia Chtara, Mounir Bouaziz
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Acute pancreatitis (AP) is a real clinical challenge. Acute pancreatitis remains a common cause of emergency department consultations and a major cause for hospitalization. Gallstones and drinking a lot of alcohol are the most frequent causes of AP. Moreover, AP can be induced by diabetic ketoacidosis (DKA) complicated by hypertriglyceridemia. We report 4 cases of DKA with hypertriglyceridemia complicated by AP in previously undiagnosed diabetes patients. All of our patients presented to the emergency ward with abdominal pain. Their physical exam showed epigastric tenderness. An abdominal CT scan was performed for each patient, showing an AP grade E. Laboratory samples showed high serum glucose levels. They had metabolic acidosis with elevated anion gap. They had high lipasemia and amylasemia. Their lipid panel was disturbed with a high level of cholesterol (from 12.8 mmol/l to 33 mmol/l) and triglyceridemia (from 53 to 133 mmol/l). Our patients were admitted into our ICU where they received fluid resuscitation and intravenous insulin, and their triglycerides rates decreased gradually. Two patients recovered to a good health state, and the two others developed septic shock, requiring the use of large-spectrum antibiotics, and acute kidney injury (AKI) with refractory metabolic acidosis, requiring hemodialysis. Despite the intensive treatment, they developed an unrecoverable multiorgan failure. Through our case series, we aim to highlight the importance of making an early diagnosis, which can be difficult in some situations due to overlapping signs; however, it is crucial for a good recovery. A good understanding of the pathway of hypoinsulinemic states causing hypertriglyceridemia then AP is important because it is the key to best management.
Exacerbation of Congenital Hydronephrosis as the First Presentation of COVID-19 Infection in Children
Authors: Masoumeh Mohkam, Mahnaz Jamee, Farshid Kompani, Mitra Khalili, Atena Seifi, Leily Mohajerzadeh
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Background:
Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. Case Presentations. Here, we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultrasonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis, or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection.
Conclusions:
Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.
A patient of lupus presenting with myocarditis and overlapping autoimmune hepatitis
Authors: P Chattopadhyay, D Dhua, C A Philips, J Ghosh
Journal: Case Rep Rheumatol (2011)
MeSH terms: Case Reports

Systemic lupus erythematosus has myriad presentations. Symptomatic myocarditis and/or symptomatic autoimmune hepatitis associated with lupus are rare at presentation. Here we report a young Asian girl, who presented to us with features of symptomatic myocarditis and overlapping autoimmune hepatitis. She was eventually diagnosed to be harboring systemic lupus erythematosus, in whom rigorous management led to gratuitous recovery.
Ingestion of Bell Clappers by a Shaman in Jumla, Nepal: A Case Report
Authors: Niresh Thapa, Subi Basnyat, Muna Maharjan
Journal: JNMA J Nepal Med Assoc (2019)
MeSH terms: Foreign Bodies / complications, Intestinal Obstruction / etiology, Intestinal Perforation / etiology, Peritonitis / etiology, Case Reports, Foreign Bodies / surgery, Humans, Ileum / injuries, Ileum / surgery, Intestinal Obstruction / surgery, Intestinal Perforation / surgery, Laparotomy, Male, Middle Aged, Nepal

Accidental foreign body ingestion is a common problem encountered in Emergency. Deliberate foreign body ingestion may result due to an act of insanity or an act of daring. A shaman locally known as Dhami was brought to Emergency with the history of ingestion of bell clappers. He denied the history of psychiatric illness or substance abuse. On physical examination, there were signs of peritonitis. Laparotomy was done to remove the foreign bodies. Post-operative period was uneventful. Apart from the surgical intervention, psychological counselling was given to him. This is a rare interesting case due to the fact that the 15 cm long foreign bodies passing all the way through without significant injury and finally causing obstruction in ileocecal junction and perforation in the distal ileum. Keywords: foreign bodies; Nepal; shaman.
Pulmonary embolism in a woman taking oral contraceptives and valdecoxib
Authors: Elizabeth J Westgate, Garret A Fitzgerald
Journal: PLoS Med (2005)
MeSH terms: Contraceptives, Oral / adverse effects, Ethinyl Estradiol / adverse effects, Isoxazoles / adverse effects, Norgestrel / analogs & derivatives, Pulmonary Embolism / chemically induced, Pulmonary Embolism / etiology, Sulfonamides / adverse effects, Case Reports, Adult, Contraceptives, Oral / administration & dosage, Cyclooxygenase Inhibitors / pharmacology, Drug Combinations, Drug Interactions, Ethinyl Estradiol / administration & dosage, Female, Humans, Isoxazoles / administration & dosage, Norgestrel / administration & dosage, Norgestrel / adverse effects, Sulfonamides / administration & dosage, Contraceptives, Oral, Cyclooxygenase Inhibitors, Drug Combinations, Isoxazoles, Sulfonamides, norgestimate, ethinyl estradiol drug combination, valdecoxib, Norgestrel, Ethinyl Estradiol

A 25-y-old woman, who had been on an oral contraceptive pill for 3 years, presented with pulmonary embolism. One month prior to presentation she had been started on valdecoxib for neck pain.
Case Report: Can we differentiate mesothelioma from inflammatory pericardial constriction preoperatively?
Authors: Syed Shahmeer Raza, Irfan Ullah, Saira Kainat Awan, Muhammad Daniyal Nadeem, Gulsam Bashir
Journal: F1000Res (2020)
Keywords: cardiac surgery, mesothelioma, pericarditis
MeSH terms: Case Reports

Primary malignant pericardial mesothelioma (PMPM) is a rare cardiac tumor. The patient usually presents with pericardial constriction, usually misdiagnosed and wrongly managed. We present the case of a 21-year-old woman with a history of pericarditis and cardiac tamponade. The patient was referred from a clinic due to nausea, vomiting and ascites with lower extremity edema, soft and watery diarrhea, and right upper quadrant pain. Surgery (sternotomy and partial pericardiectomy) was proposed after looking at the different relevant investigations; it was not until that the patient was operated on that it was established that this wasn't a mere constriction but a malignancy. The patient shortly died after the operation. Pathology made a diagnosis of PMPM. Along with the classical symptoms those who present with level 1 thoracic adenopathy a decision to operate should be very carefully made, this may lead to a misdiagnosis of PMPM which postoperatively results in patient's death.
Bilateral Neck Pyomyositis Caused by Staphylococcus capitis and Staphylococcus saccharolyticus in a Diabetic Adult
Authors: Nicholas Young, Hasan Bhally
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

We report a case of pyomyositis of the paraspinal neck muscles caused by two coagulase-negative staphylococci: Staphylococcus capitis and Staphylococcus saccharolyticus. Inflammation in the spermatic cords was an additional feature of this infection. Treatment with six weeks of first-generation cephalosporin therapy resulted in complete clinical and radiological resolution.
A Rare Case of Blastic Plasmacytoid Dendritic Cell Neoplasm Occurred in Postchemotherapy of Breast Cancer
Authors: Jiankun Tong, Sergei Aksenov, Beth M Siegel, Lihong Wei, William H Rodgers
Journal: Case Rep Hematol (2023)
MeSH terms: Case Reports

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and highly aggressive hematologic malignancy that arises from plasmacytoid dendritic cells. BPDCN typically presents with skin lesions and may involve peripheral blood, bone marrow, lymph nodes, or extranodal sites. It usually arises de novo, and some BPDCN cases are associated with or develop into myeloid neoplasms. Here, we report a case of a 57-year-old female presenting with cervical lymphadenopathy and skin rashes during the COVID-19 pandemic in 2021 following multiple types of postmastectomy therapy for breast cancer. The patient was ultimately diagnosed with BPCDN by lymph node biopsy. To the best of our knowledge, this is the first case report of BPDCN occurring postchemotherapy of breast cancer.
A case of subarachnoid hemorrhage revealed by an acute coronary syndrome (ACS)
Authors: Abdedaim Hatim, Wafae El Otmani, Mehdi Ait Houssa, Noureddine Atmani, Younes Moutakiallah, Charqui Haimeur, Mohammed Drissi
Journal: Pan Afr Med J (2015)
Keywords: subarachnoid hemorrhage, acute coronary syndrome, acute neurogenic pulmonary edema, cardiogenic shock, catecholamine discharge
MeSH terms: Acute Coronary Syndrome / diagnosis, Pulmonary Edema / diagnosis, Shock, Cardiogenic / diagnosis, Subarachnoid Hemorrhage / diagnosis, Case Reports, Acute Coronary Syndrome / physiopathology, Humans, Male, Middle Aged, Pulmonary Edema / pathology, Shock, Cardiogenic / pathology, Subarachnoid Hemorrhage / pathology

The subarachnoid hemorrhage (SAH) is definitely the best descriptive model of the interaction between cardiovascular system and cerebral damage. The underlying mechanism of cardiovascular alterations after SAH is linked to the adrenergic discharge related to aneurysm rupture. Cardiac and pulmonary complications are common after severe brain injury, especially the aneurismal subarachnoid hemorrhage. Acute neurogenic pulmonary edema is not exceptional; it may occur in 20% of cases and commonly follows a severe subarachnoid hemorrhage. Severe myocardial damage with cardiogenic shock may possibly reveal the SAH (3% of cases) and mislead to wrong diagnosis of ACS with dramatic therapeutic consequences. The contribution of CT and cerebral angiography is essential for diagnosis and treatment. Surgical or endovascular treatment depends on location, size and shape of the aneurysm, on patient's age, neurological status and existence of concomitant diseases. We report the case of a 58 years old patient, with a past medical history of diabetes and hypertension, admitted for acute pulmonary edema with cardiogenic shock. This case illustrates an unusual presentation of aneurismal SAH in a patient presenting with an acute coronary syndrome.
Pancreas as delayed site of metastasis from papillary thyroid carcinoma
Authors: Mutahir A Tunio, Mushabbab Alasiri, Khalid Riaz, Wafa Alshakweer
Journal: Case Rep Gastrointest Med (2013)

Introduction. Follicular variant (FV) papillary thyroid carcinoma (PTC) has aggressive biologic behavior as compared to classic variant (CV) of PTC and frequently metastasizes to the lungs and bones. However, metastasis to the pancreas is extremely rare manifestation of FV-PTC. To date, only 9 cases of PTC have been reported in the literature. Pancreatic metastases from PTC usually remain asymptomatic or manifest as repeated abdominal aches. Associated obstructive jaundice is rare. Prognosis is variable with reported median survival from 16 to 46 months. Case Presentation. Herein we present a 67-year-old Saudi woman, who developed pancreatic metastases seven years after total thyroidectomy and neck dissection followed by radioactive iodine ablation (RAI) for FV-PTC. Metastasectomy was performed by pancreaticoduodenectomy followed by sorafenib as genetic testing revealed a BRAF V600E mutation. She survived 32 months after the pancreatic metastasis diagnosis. Conclusion. Pancreatic metastases are rare manifestation of FV-PTC and are usually sign of extensive disease and conventional diagnostic tools may remain to reach the diagnosis.
A case of giant Ewing's sarcoma (EES)/primitive neuroectodermal tumor (PNET) of the cervicothoracic junction in children with incomplete paralysis of both lower limbs: Case report and literature review
Authors: Gong-Heng Zhang, Jun-Ming Lin, Zhen-Yu He, Xiao-Jun Yuan, Guang Li, Xin-Rong Gan, Wen-Hua Xu, Sheng-Sheng Cao
Journal: Front Surg (2023)
Keywords: case report, cervicothoracic junction, children, extraosseous ewing's sarcoma/primitive neuroectodermal tumor, paralysis
MeSH terms: Case Reports

Background:
Extraosseous Ewing's sarcoma/primary neuroectodermal tumor (EES/PNET) is a rare, malignant, small round blue cell tumor, which usually involves the larynx, kidneys, and esophagus. The most common metastatic sites are lung and bone. The incidence of epidural EES/PNET was 0.9%, and a detailed search of the PubMed literature found only 7 case reports of epidural ESS/PNET at the cervicothoracic junction in children.
Case description:
We report a case of epidural ESS/PNET at the cervicothoracic junction in a child with chest and back pain as the first symptom, which worsened after half a year and developed incomplete paralysis of both lower extremities and urinary incontinence. She underwent emergency surgery, chemotherapy and radiotherapy, and died of lung metastases 8 months after surgery.
Conclusion:
Primary epidural tumors are mostly benign, such as spinal meningiomas and neuromas. Contrary to what has been previously thought, we report a case of malignant epidural EES/PNET at the cervicothoracic junction without bone destruction; The rarity of epidural EES/PNET at the cervicothoracic junction in children has led to a lack of data, particularly on prognostic factors and recurrence patterns. Due to the difficulty of early diagnosis and high mortality, spine surgeons must explore and increase their awareness of this disease.
The First Molecular Genotyping of Naegleria fowleri Causing Primary Amebic Meningoencephalitis in Thailand With Epidemiology and Clinical Case Reviews
Authors: Pannathat Soontrapa, Anupop Jitmuang, Pichet Ruenchit, Supathra Tiewcharoen, Patsharaporn T Sarasombath, Chatchawan Rattanabannakit
Journal: Front Cell Infect Microbiol (2022)
Keywords: naegleria fowleri, naegleria spp, pam, free-living ameba, genotyping, meningitis, meningoencephalitis, primary amebic meningoencephalitis
MeSH terms: Central Nervous System Protozoal Infections / epidemiology, Naegleria fowleri / genetics, Research Support, Non-U.S. Gov't, Genotype, Humans, Phylogeny, RNA, Ribosomal, 16S, Retrospective Studies, Thailand / epidemiology, RNA, Ribosomal, 16S

Primary amebic meningoencephalitis (PAM) is a rare and fatal central nervous system infection caused by Naegleria fowleri, a free-living amoeba found in the environment. To date, eight pathogenic N. fowleri genotypes have been reported worldwide. We aimed to explore the genotypes of N. fowleri that cause primary amebic meningoencephalitis in Thailand. In 2021, the 17th PAM case was reported, and a retrospective literature search of PAM cases in Thailand from 1982 through April 2021 was performed. Phylogenetic and genotyping analyses of the two mitochondrial (12S rRNA and 16S rRNA) and nuclear (ITS1 and 5.8s rRNA) genes of N. fowleri were performed on four available clinical isolates. Based on the mitochondrial and nuclear genes, N. fowleri genotype T3 was found to cause PAM in three out of four cases. However, disagreement between the genotype based on the mitochondrial and nuclear genes was found in one of the PAM cases, in which the 12S rRNA locus suggested the causative genotype as T1, while the ITS1 implied genotype T4. The discrepancy between the mitochondrial and nuclear genome was previously observed, which suggests the possible horizontal gene transfer among N. fowleri species. Based on the ITS1 gene, two N. fowleri genotypes, T3 and T4, were found to be the genotypes causing PAM in this study. In addition, N. fowleri genotype T2 was previously reported in a traveler who was infected in Thailand. Thus, at least three genotypes (T2, T3, and T4) of N. fowleri are found to be associated with PAM in Thailand.
Copycat suicidal attempt by a 7 year old boy after watching homicidal behavior in media: a case report
Authors: Ahmad Ghanizadeh
Journal: Cases J (2009)

Introduction:
Suicidal behavior in media may promote others towards suicide. No published study was found about suicidal attempt in children less than 10 years old after watching a homicidal behavior.
Case presentation:
This is a report of a 7 year old boy referred because he hanged himself after watching homicidal behavior of hanging in a fictional movie.
Discussion:
To the author's knowledge, there was no published report of copycat suicidal attempt in a 7 year old child after watching a homicidal behavior in media. This report warns about an imitative effect of movie watching of homicidal behavior on suicidal attempt.
Case report: Hemorrhagic fever with renal syndrome presenting as hemophagocytic lymphohistiocytosis
Authors: Maarten A J De Smet, Simon Bogaert, Alexander Schauwvlieghe, Amélie Dendooven, Pieter Depuydt, Patrick Druwé
Journal: Front Med (Lausanne) (2022)
Keywords: communicable diseases puumala virus-associated hemophagocytosis, critical care, hantavirus, hemophagocytic lymphohistiocytosis, hemorrhagic fever with renal syndrome
MeSH terms: Case Reports

Hemophagocytic lymphohistiocytosis may occur in patients with genetic predisposition and in sporadic cases due to malignancy or infection. We describe a 49-year old man with hemorrhagic fever, type 1 respiratory insufficiency and acute kidney injury. Diagnostic work up showed a hyperinflammatory syndrome, hypertriglyceridemia, hemophagocytosis, very high ferritin and significantly elevated sCD25. The findings were compatible with hemophagocytic lymphohistiocytosis based on the HLH-2004 criteria. Serological testing indentified Puumala virus as the causal pathogen. The patient was successfully treated with pulse corticosteroids, intravenous immunoglobins and supportive therapy.
Iatrogenic Delayed Pneumothorax After Transbronchial Biopsy
Authors: Kartikeya Rajdev, Dustin N Herring, Shubham Lahan, Kyle Wilson, Peter J Murphy
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: delayed complication, iatrogenic, pneumothorax, transbronchial biopsy
MeSH terms: Biopsy / adverse effects, Bronchoscopy / adverse effects, Pneumothorax / etiology, Case Reports, Adult, Humans, Iatrogenic Disease, Immunocompromised Host, Male, Pneumothorax / diagnostic imaging, Radiography, Thoracic, Tomography, X-Ray Computed

Transbronchial biopsy (TBB) is one of the commonly performed procedures by pulmonologists in everyday practice. Although the procedure has a very low-risk profile, complications often develop in certain patients. Pneumothorax is one such complication pertaining to TBB. As only a small percent of procedures get complicated by pneumothorax, handful of cases have been reported with its delayed occurrence in the past 5 decades. The purpose of our report is to highlight another uncommon yet interesting case of delayed iatrogenic pneumothorax in an immunocompromised patient after TBB. Although the chain of events behind the pathophysiology of delayed pneumothorax largely remain a mystery, its development has been linked to altered immune mechanics as they are frequently recognized in immunocompromised patients.
Virological and Serological Discordant Profiles in COVID-19 Pneumonia: Two Atypical Clinical Cases
Authors: Martina Ranzenigo, Claudia Pastori, Gabriel Siracusano, Elena Pariani, Caterina Uberti-Foppa, Lucia Lopalco
Journal: Front Immunol (2020)
Keywords: covid-19, np, pcr, sars-cov-2, antibodies, neutralizing antibodies, spike protein, viral rna
MeSH terms: Antibodies, Viral / blood, Coronavirus Infections / diagnosis, Pneumonia, Viral / diagnosis, RNA, Viral / analysis, Case Reports, Aged, Antibodies, Neutralizing / blood, Antibodies, Neutralizing / immunology, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections / immunology, Coronavirus Infections / virology, Female, Humans, Male, Nasal Mucosa / virology, Pandemics, Pneumonia, Viral / immunology, Pneumonia, Viral / virology, Real-Time Polymerase Chain Reaction, Serologic Tests, Antibodies, Neutralizing, Antibodies, Viral, RNA, Viral

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is primarily diagnosed through viral RNA positivity in nasopharyngeal swabs, and it is associated with the early detection of specific immunoglobulins to SARS-CoV-2 proteins. We describe two moderate coronavirus disease 2019 (COVID-19) patients with WHO score 4/5 at the time of hospitalization, pneumonia, and oxygen saturation <94% and with a strong discrepancy between viral RNA and antibodies to SARS-CoV-2. One patient was positive for viral RNA but completely negative for binding and neutralizing antibodies, whereas the second patient was negative for viral RNA but with high levels of both neutralizing and binding antibodies. This observation is relevant to better understand the pathogenesis of this novel infection.