OpenMed/multicare-articles huggingface dataset:
IgG4-Related Disease With Testicular Involvement: A Case Report and Review of Literature
Authors: Gang Wang, Ning Zhuo, Xiaowen Luo, Feng Tian, Zhenhua Wen, Jingyang Li
Journal: Front Immunol (2021)
Keywords: igg4-related disease, clinical feature, glucocorticoids, testis, treatment
MeSH terms: Immunoglobulin G4-Related Disease / diagnosis, Immunoglobulin G4-Related Disease / etiology, Immunoglobulin G4-Related Disease / therapy, Testis / immunology, Case Reports, Review, Aged, Biomarkers, Biopsy, Diagnosis, Differential, Disease Management, Disease Susceptibility, Humans, Immunosuppressive Agents / therapeutic use, Male, Symptom Assessment, Testis / metabolism, Tomography, X-Ray Computed, Treatment Outcome, Biomarkers, Immunosuppressive Agents

Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune inflammatory disease characterized by infiltration of IgG4+ plasma cells that can simulate a tumor manifesting as a tumor-like mass. This disease involves the pancreas, biliary tract, kidneys, salivary glands, lymph nodes, aorta, and retroperitoneum amongst other organs. However, testicular involvement is a rare entity in this disease. The treatment of testicular involvement in IgG4-RD is currently controversial. We present the case of a 65-year-old man with swelling and pain in his right scrotum three months ago. On examination, a mobile mass of approximately 2 cm in diameter was found in the right scrotum. Serological tests showed elevated levels of IgG4 and negative for tumor markers. Enhanced computed tomography of the scrotum showed a nodular hyperdense shadow with a diameter of approximately 23 mm on the right epididymis. Pathological biopsy of the right epididymis showed infiltration of plasma cells, lymphocytes, and a few neutrophils. IgG4+ plasma cells stained positive, with an IgG4/IgG ratio of more than 40% and more than 30 IgG4+ plasma cells per high-power field. A diagnosis of IgG4-RD involving the testicles was made. Prednisone 30 mg/d was given for three weeks. No scrotum swelling or pain was observed at the follow-up after six months. IgG4-related disease should be considered whenever a mass-like lesion with typical histomorphologic features involving multiple organs/anatomical sites is encountered. The testicles are an important male reproductive organ, especially for young male patients with fertility requirements. For patients with IgG4-RD testicular involvement, surgical or medical treatment requires further study.
Apheresis Therapy for Steroid-Resistant Idiopathic Nephrotic Syndrome: Report on a Case Series
Authors: Hamza Naciri Bennani, Thomas Jouve, Johan Noble, Lionel Rostaing, Paolo Malvezzi, Rachel Tetaz
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Idiopathic nephrotic syndrome (INS) represents 15%-30% of adulthood glomerulopathies. Corticosteroids have been the main treatment for decades and are effective in 70% of minimal-change disease patients and ~30% of focal segmental glomerulosclerosis patients. Multidrug-resistant (steroids, calcineurin-inhibitors, cyclophosphamide, mycophenolate-mofetil, rituximab) idiopathic nephrotic syndrome is a major therapeutic challenge in nephrology. Apheresis (double-filtration plasmapheresis or semi specific immunoadsorption) could act by eliminating the circulating factor (apolipoproteinA1b, solubleCD40L, suPAR) increasing glomerular permeability seen in INS. The aim of the study was to report the outcome of three patients with multidrug-resistant INS treated successfully with apheresis.
An unusual case of gastroschisis
Authors: Bilal Mirza, Afzal Sheikh
Journal: APSP J Case Rep (2010)
Keywords: evisceration, gastroschisis, imperforate anus
MeSH terms: Case Reports

Gastroschisis is an abdominal wall defect through which intestine and rarely other organs eviscerate. It is less frequently associated with anorectal malformations. Abnormal size and shape of the defect is rarely identified in these patients. We report a case of gastroschisis with an unusual abdominal wall defect, imperforate anus and an ectopically placed vestibule. The defect was extended from right side of umbilicus to the perineum. There was evisceration of entire gastrointestinal tract (GIT), liver, gallbladder and urinary bladder. The defect was not manageable with a spring loaded silo and a sterilized blood bag was used to cover the defect. The unusual defect, associated anomalies and evisceration of unusual viscera are the main reasons for reporting the index case.
Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report)
Authors: Mayssem Gabsi, Sarra Chenik, Houaida Mahfoudhi, Karima Taamallah, Nadhem Hajlaoui, Wafa Fehri
Journal: Pan Afr Med J (2021)
Keywords: coronary artery aneurysm, case report, myocardial infarction, polyarteritis nodosa, sudden death
MeSH terms: Coronary Aneurysm / complications, Death, Sudden / etiology, Myocardial Infarction / etiology, Polyarteritis Nodosa / complications, Case Reports, Coronary Aneurysm / diagnostic imaging, Coronary Angiography, Coronary Artery Disease / complications, Coronary Artery Disease / diagnostic imaging, Humans, Male, Middle Aged, Myocardial Infarction / physiopathology, Polyarteritis Nodosa / diagnostic imaging

Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the AMI was a complication of his vasculitis. This case indicates that coronary artery involvement should be carefully monitored during the chronic phase of PAN. The pathophysiology of AMI in PAN patients should be kept in mind and the interventional approach must be performed according to the angiographic findings to avoid complications.
Epithelioid Hemangioendothelioma with WWTR1-CAMTA1 Fusion in the Parotid Gland Presenting as Bell's Palsy
Authors: Landon J Kunzelman, Shweta Agarwal, Nathan Boyd, Cory J Broehm
Journal: Case Rep Pathol (2022)
MeSH terms: Case Reports

Epithelioid hemangioendothelioma is a rare tumor of endothelial differentiation most commonly arising in soft tissue, liver, and lung, following a variable clinical course. Most cases are characterized by a t(1;3)(p36;q23-25) resulting in WWTR1-CAMTA1 fusion. Only five epithelioid hemangioendothelioma have been previously reported arising in the salivary glands. None have presented as Bell's palsy. In the current case, a 37-year-old female presented with a longstanding complaint of pain and fullness in the right preauricular region and progressive episodes of Bell's palsy and facial nerve weakness. Surgical resection showed a tumor comprised of atypical cells with occasional intracytoplasmic vacuoles in a fibromyxoid stroma. Immunohistochemical stains demonstrated the neoplastic cells expressed ERG, CD31, and CD34, confirming vascular differentiation. Fluorescence in situ hybridization revealed a t(1;3)(p36;q25), confirming a diagnosis of epithelioid hemangioendothelioma. At 12-month follow-up, the patient has no evidence of disease.
Effect of Pravastatin as an Adjunctive Therapeutic for Mitral Insufficiency with Hyperlipidemia in a Dog
Authors: Yu Sahashi, Miwako Sahashi, Yoshiaki Hikasa
Journal: Case Rep Vet Med (2021)
MeSH terms: Case Reports

Pravastatin (PS) has been found to increase left ventricle (LV) expansion capacity and decrease LV constriction and left atrial pressure in healthy dogs. To date, there are no available reports on the effects of PS in dogs with hypercholesterolemia with chronic heart failure (CHF). This case report demonstrates a successful long-term treatment plan using PS in a dog suffering from mitral insufficiency with hyperlipidemia. A 12-year-old, castrated male Chihuahua dog had mitral insufficiency with hyperlipidemia. The dog presented with symptoms of chronic coughing. PS was orally administered (1 mg/kg, SID) in addition to general treatment for mitral insufficiency. The follow-up period was 375 days. PS administration decreased the heart rate (HR), vertebral heart size (VHS), and N-terminal probrain natriuretic peptide (NT-proBNP) concentration of the dog. In addition, PS administration also improved chronic cardiac failure induced by mitral insufficiency and hyperlipidemia. This report suggests that PS can be useful as an adjunctive therapeutic for dogs with hypercholesterolemia with mitral insufficiency.
Case Report: Chronic Lymphocytic Leukemia With a Rare Translocation t(14;19)(q32;q13) Involving IGH /BCL3 Rearrangements: Report of Three Chinese Cases and Literature Review
Authors: Qinlu Li, Shugang Xing, Heng Zhang, Xia Mao, Min Xiao, Jia Wei, Ying Wang
Journal: Front Oncol (2020)
Keywords: bcl3 rearrangement, chromosome banding analysis, chronic lymphocytic leukemia, complex karyotype, fluorescence in situ hybridization
MeSH terms: Case Reports

Background:
A translocation t(14;19)(q32;q13) leading to a fusion of IGH and BCL3 which is a rare cytogenetic abnormality in CLL patients, has a more aggressive clinical course with a shorter time to first treatment (TTT) and worse overall survival (OS). To date, there is no literature reporting the identification of the t(14;19) in Chinese CLL patients and the reviewing the characteristic of all patients with this abnormality reported previously in the literature.
Patients and methods:
We first demonstrate three cases of t(14;19) translocation among the 200 CLL patients from 2017 to 2019 in our hospital. We investigated several aspects such as clinicopathologic features, cytogenetic analysis, IGHV mutations, next-generation sequencing technology (NGS), and histopathological characteristics in order to clearly define the features of this entity in Chinese patients and compare them with patients reported previously in western countries.
Results:
The clinical and pathological features of our three cases resemble those of earlier reports. All patients had atypical morphologic features and atypical immunophenotypes with low CLL scores detected by flow cytometry. All cases were unmutated in the IGHV mutations. Two cases showed complex karyotype and one case demonstrate missense mutations of TP53 and FBXW7.
Conclusion:
In conclusion, this is the first report on IGH/BCL3-positive B-CLLs in Chinese people, which provided a comprehensive analysis of clinical and pathological characteristics. In addition to some similar clinical and laboratory features reported in the previous literature, we first found that CLL with t(14;19) has a higher possibility of being accompanied with high complex karyotype (high-CK), which is now regarded as a novel negative prognostic marker. Early identification of this abnormality in CLL patients is so important that patients can benefit from the more aggressive treatments at the onset of the disease.
Optimizing anterior en masse retraction with miniscrew anchorage
Authors: Pavankumar Janardan Vibhute
Journal: Case Rep Dent (2011)
MeSH terms: Case Reports

In severely protrusive patients, skeletal anchorage from miniscrew is often used to avoid anchorage loss with preferred miniscrew location near centre of resistance (Cres) of posterior teeth. Biomechanical requirement for directing retraction force towards Cres of posterior teeth demands the insertion of miniscrew in loose mucosa, where risk of infection and failure increases. In addition, undesirable biomechanical side effects on anterior and posterior segments may be possible in all three planes, when continuous arch sliding mechanics are installed with miniscrew anchorage. This paper describes technique of molar-stabilizing power arm (MSPA) for simultaneous intrusion and retraction of anteriors with miniscrew placement at attached gingiva between 1st molar and 2nd premolar. Advantages of this technique include (i) the need of miniscrews placement in loose mucosa apically near the Cres of the posterior teeth is eliminated, (ii) the risk of infection and miniscrew failure is lowered since the miniscrew is placed in attached gingiva rather than the loose mucosa, and (iii) by adjusting vertical length or replacing MSPA, alteration of the retraction force vector is possible in all three planes; thus, need of removal and repositioning of the miniscrew (e.g., in correction of occlusal cant) can be eliminated.
Organ-Sparing Surgery for a Giant Verrucous Carcinoma of the Penile Shaft: A Case Report and Review of the Literature
Authors: Prodromos Philippou, Christos Kitsios, Maria Miliatou, Christiana Poullou, Pavlos Konstantinou
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Verrucous Carcinoma is a rare but well-differentiated variant of penile squamous cell carcinoma. Its clinical presentation is usually that of an exophytic cauliflower-like lesion with a broad-based growth pattern. We herein report the case of a 61-year-old man who presented with a giant verrucous carcinoma occupying the dorsal surface of the penile shaft. The patient underwent penile-sparing surgery, achieving both disease control and organ preservation. We discuss relevant issues, including clinical features, diagnosis, surgical management, and prognosis and we review the rather sparse literature regarding this rare lesion.
Moxifloxacin (avelox) induced thrombotic thrombocytopenic purpura
Authors: Sikander P Surana, Zahily Sardinas, Alan S Multz
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

We report a case of a 66-year-old African-American female who presented with complaints of progressively worsening weakness, shortness of breath on minimal exertion, lethargy for the last few days, and short episodes of aphasia lasting 20-30 seconds. Prior to presentation, she was treated with two courses of moxifloxacin for sinusitis. Laboratory examination was remarkable for anemia and thrombocytopenia with elevated lactate dehydrogenase and no evidence of renal failure. Peripheral smear showed numerous schistocytes and she was diagnosed with thrombotic thrombocytopenic purpura. Moxifloxacin was identified as the offending agent. The patient was treated with prednisone and plasmapheresis. To the best of our knowledge, this is the first reported case of thrombotic thrombocytopenic purpura associated with the use of moxifloxacin. Although rare, physicians should be aware of this serious complication associated with its use.
Beta-blocker therapy and hemophagocytic lymphohistiocytosis: a case report
Authors: C Müller, L B Mänhardt, C Willaschek, E M Schneider, E A Stuth, R Buchhorn
Journal: Cardiol Res Pract (2010)
MeSH terms: Case Reports

Objective. The aim of this paper is to describe a fatal case of hemophagocytic lymphohistiocytosis (HLH) in a patient with severe heart failure, who was treated with low-dose propranolol. Patient and Interventions. We report on a 7-month-old boy with Downs syndrome who was born with an unbalanced, left dominant atrioventricular septal defect and aortic coarctation. Despite coarctation repair and pulmonary artery banding he developed intractable heart failure and fever of unknown origin. Since he remained in heart failure he received a trial of low-dose propranolol to stabilize his cardiopulmonary status, which resulted in unexpected immunomodulatory effects. Measurements and Main Result. Immunoactivation was evidenced by high concentrations of procalcitonin, soluble CD 25, tumor necrosis factor alpha, and interleukin 6 and 8. Propranolol resulting in hepatic compromise as indicated by high lactate dehydrogenase and alanine aminotransferase levels. A therapeutic switch from propranolol to the beta(1)-receptor blocker metoprolol appeared to be instrumental in hemodynamic improvement and allowed discharge from hospital. However, the infant ultimately died from secondary inflammatory reactivation and intractable pulmonary obstructive disease. The autopsy results revealed HLH. Conclusion. Our case describes HLH secondary to heart failure and Downs syndrome. In this highly activated inflammatory state the beneficial hemodynamic effects of propranolol may be accompanied by immunomodulatory effects and the risk of acute liver failure. HLH occurs with a distinct pathophysiology, and specific treatment might be mandatory to increase the chance of survival.
Reversing stage III oral adenocarcinoma in a dog treated with anti-canine PD-1 therapeutic antibody: a case report
Authors: Shuo Xu, Jingshu Xie, Shuaiyu Wang, Na Tang, Junli Feng, Youhong Su, Gebin Li
Journal: Front Vet Sci (2023)
Keywords: canine, immunotherapy, monoclonal antibody, partial remission, programmed cell death receptor 1, salivary gland carcinoma
MeSH terms: Case Reports

Monoclonal antibody targeting programmed cell death-1 (PD-1) is one of the most promising treatment therapies for human cancers. Canine PD-1 antibodies used in clinical trials have also shown efficacy in treating canine cancers. An 11-year-old male intact border collie presented to us for evaluation of left cervical mass. Computed tomography (CT) examination revealed an irregular pharyngeal mass invading the surrounding soft tissue. Histological and immunohistochemical results were consistent with a diagnosis of adenocarcinoma, most likely originating from the minor salivary gland. An anti-canine PD-1 monoclonal antibody was administered. Two months after the initial treatment, the tumor reached partial remission and maintained as such for 6 months. Finally, the patient was euthanized due to reasons unrelated to cancer, with a survival time of 316 days. To our knowledge, this is the first report of response to PD-1 blockade treatment in canine adenocarcinoma.
What lies within?
Authors: Nidhi Gupta, Manohar Bhat, Rajesh Sharma
Journal: Int J Clin Pediatr Dent (2009)
Keywords: odontogenic fibroma, odontogenic tumor
MeSH terms: Case Reports

What follows is a case report of a 12 years old child who complained of gaps between teeth in the lower front region. OPG showed tooth 43 impacted and malformed with enlarged pulp chamber and a unilocular radiolucency surrounding the crown. Surgical enucleation was done under LA. Biopsy was sent for histopathological examination revealing the miracle diagnosis of "Central Odontogenic Fibroma" being a rare tumor of odontogenic tumor family and also a rare finding regard to age, site and clinical behavior of tumor is reported.
Acute Stent Thrombosis Associated with Eptifibatide-Induced Profound Thrombocytopenia
Authors: Amer Aljundi, Alaa Rahhal, Wafer Dabdoob
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Background:
Eptifibatide is an inhibitor of the platelet glycoprotein (GP) IIb/IIIa receptor that is commonly used in patients undergoing percutaneous coronary intervention (PCI).
Case:
We describe a case of a 62-year-old female patient admitted with acute ST-elevation myocardial infarction (STEMI) treated by primary coronary intervention (primary PCI) with a drug-eluting stent placement. She developed profound thrombocytopenia within 8 hours of first administration of eptifibatide and subsequent acute stent thrombosis next day. Other causes of thrombocytopenia were excluded and intravascular ultrasound (IVUS) showed good stent expansion and opposition to the coronary wall. Platelet count gradually returned to normal after discontinuation of eptifibatide.
Conclusion:
Although Eptifibatide has been associated with the development of thrombocytopenia, to the best of our knowledge, this is the first case report in the medical literature that associates acute stent thrombosis and eptifibatide-induced thrombocytopenia.
PEComa of the Upper Extremity: A Unique Case and Description of an Initial Response to Neoadjuvant Chemotherapy
Authors: D A Osei, F Alvandi, J S Brooks, C M Ogilvie
Journal: Sarcoma (2007)
MeSH terms: Case Reports

Purpose. Tumors of the perivascular epithelial cell tumor (PEComa), first described in 1992, represent a rare soft tissue neoplasm of varying malignant potential. Cases of PEComa have been previously described in a few somatic and visceral sites, most notably in the gastrointestinal tract, genitourinary tract, and one extremity case in the thigh. To date, most malignant cases of PEComa have been resistant to chemotherapy, and as such, an appropriate therapy is not known. Case report. Here we describe the first case of PEComa of the upper extremity. Open biopsy revealed a high-grade malignant lesion, and the patient subsequently underwent both neoadjuvant therapy with doxorubicin, ifosfamide and mensa, and radiation therapy prior to wide surgical resection. After six cycles of chemotherapy, the tumor underwent an 80% reduction in size. Subsequent neoadjuvant radiation therapy of 5000 cGy did not further reduce the size of the tumor. Following limb sparing radical resection, pathology showed 20% necrosis within a high-grade malignant lesion. Twenty one months after beginning treatment, the patient shows no sign of local recurrence, but metastatic disease was confirmed after resection of a lung nodule. Conclusion. Given the favorable albeit partial response seen in this patient, the course of therapy outlined here may represent a good starting point for neoadjuvant treatment in a tumor with a historically bleak prognosis. In addition, the diagnosis of PEComa must now be entertained in the differential diagnosis of upper extremity soft tissue sarcoma.
Individual management of cervical cancer in pregnancy
Authors: Thomas Hecking, Alina Abramian, Christian Domröse, Tabea Engeln, Thore Thiesler, Claudia Leutner, Ulrich Gembruch, Mignon-Denise Keyver-Paik, Walther Kuhn, Kirsten Kübler
Journal: Arch Gynecol Obstet (2016)
Keywords: case series, cervical cancer, chemotherapy, pregnancy, review, treatment
MeSH terms: Colposcopy / methods, Lymph Nodes / pathology, Neoadjuvant Therapy / methods, Pregnancy Complications, Neoplastic / pathology, Pregnancy Complications, Neoplastic / therapy, Uterine Cervical Neoplasms / pathology, Uterine Cervical Neoplasms / therapy, Review, Adult, Female, Humans, Lymph Node Excision / methods, Neoplasm Staging, Postpartum Period, Pregnancy, Pregnancy Complications, Neoplastic / diagnosis, Pregnancy Outcome, Retrospective Studies, Treatment Outcome, Uterine Cervical Neoplasms / diagnosis

Purpose:
The management of cervical cancer in pregnancy persists to be challenging. Therefore, identification of factors that influence the choice of therapeutic management is pivotal for an adequate patient counseling.
Methods:
We present a literature review of 26 studies reporting 121 pregnancies affected by cervical cancer. Additionally, we add a retrospective case series of five patients with pregnancy-associated cervical cancer diagnosed and treated in our clinic between 2006 and 2013.
Results:
The literature review revealed that the therapeutic management during pregnancy varies according to the gestational age at diagnosis, while in the postpartum period no influence on the treatment choice could be detected. Also in our case series the choice of oncologic therapy was influenced by the gestational age, the wish to continue the pregnancy and the risks of delaying definitive treatment.
Conclusions:
There are no standardized procedures concerning the treatment of cervical cancer in pregnancy. Therefore, in consultation with the patient and a multidisciplinary team, an adequate individualized treatment plan should be determined.