OpenMed/multicare-articles huggingface dataset:
Cystic degeneration of hepatic adenoma: a rare complication of hepatic adenoma
Authors: Sin Yee Foo, Laura Paul, Subra Viswanathan
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

This case report describes a rare complication of hepatic adenomata in a 33-year-old female. The patient initially presented with abdominal pain, and baseline imaging demonstrated several hepatic adenomas, the largest of which (approximately 8 cm) was adjacent to the inferior vena cava. Owing to the location of this adenoma, surgical/vascular intervention was deemed inappropriate. The patient was actively observed for approximately 4 years, and managed supportively during any recurrent episodes. With follow-up CT/MRI scans, the "natural history" of this particular lesion, including haemorrhage, thrombosis and infarction, was observed. However, as intervention was unsuitable, further MRI was performed in view of these complications, allowing observation of the end-stage features of the adenoma. Appearances were consistent with a rare complication of hepatic adenoma, i.e. cystic degeneration, a process well documented in uterine leiomyoma.
Relationship between intima-media thickness of the common carotid artery and arterial stiffness in subjects with and without type 2 diabetes: a case-series report
Authors: Manuel Angel Gómez-Marcos, José Ignacio Recio-Rodríguez, María Carmen Patino-Alonso, Cristina Agudo-Conde, Leticia Gómez-Sánchez, Emiliano Rodríguez-Sánchez, Carlos Martín-Cantera, Luís García-Ortiz
Journal: Cardiovasc Diabetol (2011)
MeSH terms: Arteries / physiopathology, Carotid Artery, Common / diagnostic imaging, Diabetes Mellitus, Type 2 / complications, Diabetic Angiopathies / etiology, Hemodynamics, Tunica Intima / diagnostic imaging, Tunica Media / diagnostic imaging, Comparative Study, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Blood Pressure, Blood Pressure Monitoring, Ambulatory / instrumentation, Blood Pressure Monitors, Chi-Square Distribution, Diabetic Angiopathies / diagnostic imaging, Diabetic Angiopathies / physiopathology, Elasticity, Female, Humans, Male, Middle Aged, Pulsatile Flow, Regression Analysis, Spain, Ultrasonography

Background:
We examined the relationship between the intima-media thickness of the common carotid artery (CCA-IMT) and arterial stiffness, assessed by pulse wave velocity (PWV), the ambulatory arterial stiffness index (AASI) and the augmentation index (AIx) in subjects with and without type 2 diabetes.
Methods:
A case-series study was made in 366 patients (105 diabetics and 261-non-diabetics). Ambulatory blood pressure monitoring was performed on a day of standard activity with the SpaceLabs 90207 system. AASI was calculated as "1-slope" from the within-person regression of diastolic-on-systolic ambulatory blood pressure readings. PWV and AIx were measured with the SphygmoCor system, and a Sonosite Micromax ultrasound unit was used for automatic measurements of CCA-IMT.
Results:
PWV, AASI and CCA-IMT were found to be greater in diabetic patients, while no differences in AIx were observed between the two groups. CCA-IMT was independently correlated to the three measures of arterial stiffness in both groups. We found an increase in CCA-IMT of 0.40, 0.24 and 0.36 mm in diabetics, and of 0.48, 0.17 and 0.55 mm in non-diabetics for each unit increase in AASI, AIx and PWV. The variability of CCA-IMT was explained mainly by AASI, AIx and gender in diabetic patients, and by age, gender, AASI and PWV in non-diabetic patients.
Conclusions:
CCA-IMT showed a positive correlation to PWV, AASI and AIx in subjects with and without type 2 diabetes. However, when adjusting for age, gender and heart rate, the association to PWV was lost in diabetic patients, in the same way as the association to Alx in non-diabetic patients. The present study demonstrates that the three measures taken to assess arterial stiffness in clinical practice are not interchangeable, nor do they behave equally in all subjects.
Imaging Features of Urachal Cancer: A Case Report
Authors: Xiaoyan Chen, Chunsong Kang, Mingxia Zhang
Journal: Front Oncol (2019)
Keywords: adenocarcinoma, bladder, computed tomography, ultrasonography, urachus
MeSH terms: Case Reports

Urachal adenocarcinoma originates from the space of Retzius. It is a rare but aggressive neoplasm. Typical imaging findings of urachal cancer are difficult to find; this report provides an ultrasonographic (US) and computed tomographic (CT) description of the above. We present a case of a 45-year-old male patient presenting with painless hematuria of 1 week's duration and display the US and CT images. Imaging shows: (1) a solid, ill-defined, irregularly shaped mass invading the bladder wall located between the dome of the bladder and the abdominal wall, and which underwent significant enhancement; (2) hypo-echoic, heterogeneous echopattern with some calcifications and (3) patchy and short-line blood flow signals within the mass. Final histopathology confirmed urachal adenocarcinoma.
Ethical Analysis of the Application of Assisted Reproduction Technologies in Biodiversity Conservation and the Case of White Rhinoceros ( Ceratotherium simum) Ovum Pick-Up Procedures
Authors: Pierfrancesco Biasetti, Thomas B Hildebrandt, Frank Göritz, Robert Hermes, Susanne Holtze, Cesare Galli, Giovanna Lazzari, Silvia Colleoni, Ilaria Pollastri, Maria Michela Spiriti, Jan Stejskal, Steven Seet, Jan Zwilling, Stephen Ngulu, Samuel Mutisya, Linus Kariuki, Isaac Lokolool, Patrick Omondo, David Ndeereh, Barbara de Mori
Journal: Front Vet Sci (2022)
Keywords: ethical matrix, assisted reproduction technologies (art), biodiversity conservation, conservation breeding programs, ethical analysis, northern white rhinoceros, ovum pick-up, white rhinoceros (ceratotherium simum)
MeSH terms: Review

Originally applied on domestic and lab animals, assisted reproduction technologies (ARTs) have also found application in conservation breeding programs, where they can make the genetic management of populations more efficient, and increase the number of individuals per generation. However, their application in wildlife conservation opens up new ethical scenarios that have not yet been fully explored. This study presents a frame for the ethical analysis of the application of ART procedures in conservation based on the Ethical Matrix (EM), and discusses a specific case study-ovum pick-up (OPU) procedures performed in the current conservation efforts for the northern white rhinoceros (Ceratotherium simum cottoni)-providing a template for the assessment of ART procedures in projects involving other endangered species.
Case Report: Anti-NMDA Receptor Encephalitis With Bilateral Hearing Loss as the Initial Symptom
Authors: Hongjiang Cheng, Fengbing Yang, Jing Zhang, Lina Xu, Longbin Jia, Doudou Zhao, Wei Liu, Huimin Li
Journal: Front Neurol (2021)
Keywords: anti-nmdar encephalitis, autoimmune disease, autoimmune encephalitis, case report, hearing loss
MeSH terms: Case Reports

Introduction: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor. This paper describes a patient who presented with bilateral hearing loss as the initial symptom of anti-NMDAR encephalitis. Case Report: We describe a 31-year-old young female with anti-NMDAR encephalitis who presented with bilateral severe hearing loss after brief loss of consciousness and then accompanied by other symptoms, such as generalized tonic-clonic seizures, manic episodes, excessive salivation, severe cognitive impairment, and complex non-convulsive status epilepticus. Great improvement was achieved by a combined treatment of steroid, IVIG, and plasmapheresis, especially after surgical removal of the ovarian teratoma. When she was discharged on hospital day 43, her hearing loss obtained a significant improvement. Conclusion: This case study and literature review investigated the impairment of hearing loss and its subsequent treatment in patients with anti-NMDAR encephalitis.
Neurocysticercosis: An Uncommon Cause of Acute Supratentorial Hydrocephalus
Authors: Olaf De Weerdt, Bénédicte Dubois, Philippe Demaerel
Journal: J Belg Soc Radiol (2022)
Keywords: taenia solium, hydrocephalus, intraventricular, magnetic resonance imaging, neurocysticercosis
MeSH terms: Case Reports

We report a 29-year-old woman with acute supratentorial hydrocephalus due to intraventricular neurocysticercosis (NC). Aqueductal stenosis due to web formation and a free floating intraventricular cyst with scolex were pathognomonic and led to the diagnosis of NC. Worldwide, NC is the most important parasitic infection of the central nervous system but is very uncommon in non-endemic regions. Intraventricular abnormalities occur in approximately 30% of the patients. Magnetic resonance imaging (MRI) plays a crucial role in the diagnostic work-up and in guiding intervention. Teaching Point: Brain magnetic resonance imaging in intraventricular neurocysticercosis is pathognomonic and essential in guiding treatment.
An unusual case of obscure gastrointestinal bleeding in a patient with coeliac disease
Authors: M Gwiggner, P Patel
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

This paper describes the journey of a patient with coeliac disease who presented with overt obscure gastrointestinal bleeding. Upper and lower gastrointestinal endoscopy did not reveal a source of bleeding, but an abdominal CT scan detected abnormal lymphadenopathy and a wireless capsule endoscopy diagnosed a jejunal tumour, which was surgically removed. Gastrointestinal bleeding is rare in celiac disease. Malignant tumours of the small intestine are generally uncommon, but celiac disease represents a significant risk factor. Wireless capsule endoscopy has been a useful tool to investigate patients with obscure gastrointestinal bleeding.
Response of Patients with Taxane-Refractory Advanced Urothelial Cancer to Enfortumab Vedotin, a Microtubule-Disrupting Agent
Authors: Makito Miyake, Nobutaka Nishimura, Tatsuki Miyamoto, Takuto Shimizu, Kenta Ohnishi, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Kazumasa Torimoto, Tomomi Fujii, Kiyohide Fujimoto
Journal: Case Rep Urol (2023)
MeSH terms: Case Reports

Enfortumab vedotin (EV), a nectin-4-directed antibody conjugated to monomethyl auristatin E (MMAE), has been approved for patients with advanced urothelial carcinoma (aUC) previously treated with platinum-based chemotherapy and immune inhibitors. Taxane agents and MMAE share antitumor mechanisms through microtubule disruption, thus raising a notable concern regarding cross-resistance between these drugs. This case report describes two patients with taxane-based chemotherapy-refractory aUC who responded well to EV. A 71-year-old man (case 1) with pT3N0M0 renal pelvic UC showed a partial response to EV in metastatic lesions of the bilateral lungs and right pelvic lymph nodes after three cycles of paclitaxel plus gemcitabine chemotherapy. A 53-year-old man (case 2) with cT3bN2M0 bladder UC underwent platinum-based neoadjuvant chemotherapy and the following radial cystectomy (ypTis ypN0). He developed bilateral lung metastases and showed a complete response to EV in the metastatic lesions after 20 cycles of paclitaxel plus nedaplatin chemotherapy. Our experience of two cases demonstrated that tumor response to EV can be expected in patients with taxane-refractory aUC.
Peritoneal hydatidosis
Authors: Daniela Costamagna, Roberto Maiocchi, Annunziatino Zampogna, Amedeo Alonzo, Roberta Ambrosini, Alessandro Stecco, Francesca Mercalli
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Secondary peritoneal hydatidosis is caused by spontaneous or iatrogenic rupture of hepatic echinococcal cysts. We describe the case of a 65-year-old Tunisian male patient with previous history of liver hydatidosis who presented to our attention with subocclusive status. Imaging revealed a retrovesical hydatid cyst, adherent to the sigmoid colon. The treatment of choice was surgical removal of the cyst and the sigmoid colon. The patient is now being closely followed up.
Case Report: Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne: A Single-Center Experience and Literature Review
Authors: Yumei Wang, Na Wu, Keyi Yu, Min Shen
Journal: Front Immunol (2021)
Keywords: papa syndrome, pstpip1, autoinflammatory diseases, interleukin-1, pyoderma gangrenosum
MeSH terms: Acne Vulgaris / genetics, Adaptor Proteins, Signal Transducing / genetics, Arthritis, Infectious / genetics, Cytoskeletal Proteins / genetics, Mutation, Pyoderma Gangrenosum / genetics, Case Reports, Research Support, Non-U.S. Gov't, Systematic Review, Acne Vulgaris / diagnosis, Acne Vulgaris / drug therapy, Acne Vulgaris / immunology, Adult, Arthritis, Infectious / diagnosis, Arthritis, Infectious / drug therapy, Arthritis, Infectious / immunology, Biological Products / therapeutic use, DNA Mutational Analysis, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Phenotype, Predictive Value of Tests, Pyoderma Gangrenosum / diagnosis, Pyoderma Gangrenosum / drug therapy, Pyoderma Gangrenosum / immunology, Steroids / therapeutic use, Treatment Outcome, Adaptor Proteins, Signal Transducing, Biological Products, Cytoskeletal Proteins, PSTPIP1 protein, human, Steroids, Pyogenic arthritis, pyoderma gangrenosum, and acne

Objectives:
This study aims to describe the characteristics of patients diagnosed with pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome at a single center in China and provide an up-to-date literature review.
Methods:
The clinical data and genotype of three Chinese Han patients were carefully documented and studied. We also conducted a systematic literature review on PAPA syndrome.
Results:
A total of three patients were diagnosed with PAPA syndrome at our center from 2018 to 2020. Arthritis was observed in all three patients, while pyoderma gangrenosum (PG) was found in two patients and acne in one patient. Other manifestations included pathergy reaction, intermittent fever, oral ulcer, keratitis, proteinuria, and hematuria. The PSTPIP1 A230T mutation was identified in two patients, and a novel Y119C variation was revealed in a sporadic patient. A total of 76 patients with PAPA syndrome reported in 29 articles were included in our literature review. The classical triad of arthritis, PG, and acne was visible in only 16 (25.4%) patients, while 24 (38.1%) exhibited only one major symptom. Skin lesions were more commonly seen in patients with adult-onset disease than those with childhood-onset disease (100 vs. 83%), whereas arthritis was less common (50 vs. 98.1%). Steroid and/or biological agents were effective in most patients.
Conclusions:
The rarity and phenotypic heterogeneity associated with PAPA syndrome make the diagnosis a huge challenge to physicians, especially in adult patients. A significant portion of patients did not exhibit the full spectrum of the classical triad. Accordingly, gene testing is critically helpful for diagnosis.
The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan
Authors: S Deen, R Bedair, C J Daniels, C Swainson
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

This paper describes an unusual radiological appearance of implanted cartilage on CT scan in a patient who had recently undergone deep inferior epigastric perforator (DIEP) breast reconstruction surgery following a mastectomy for ductal carcinoma in situ. The purpose of this paper is to alert medical practitioners involved with DIEP breast reconstruction surgery, as well as general radiologists, to the possibility of surgically implanted costal cartilage undergoing calcification and then appearing on imaging studies as a malignant process. Information on the patient was gathered from clinical records, imaging reports and pathological samples. A literature search was performed to identify similar cases and the results showed that this occurrence has never before been described and therefore represents an advancement of knowledge about the imaging characteristics of reconstructed breast tissue.
Considerations Regarding Public Use of Longevity Interventions
Authors: Yasmine J Liu, Rebecca L McIntyre, Georges E Janssens
Journal: Front Aging (2022)
Keywords: aging, biological age, chronological age, geroprotectors, interventions, public

Public attention and interest for longevity interventions are growing. These can include dietary interventions such as intermittent fasting, physical interventions such as various exercise regimens, or through supplementation of nutraceuticals or administration of pharmaceutics. However, it is unlikely that most interventions identified in model organisms will translate to humans, or that every intervention will benefit each person equally. In the worst case, even detrimental health effects may occur. Therefore, identifying longevity interventions using human data and tracking the aging process in people is of paramount importance as we look towards longevity interventions for the public. In this work, we illustrate how to identify candidate longevity interventions using population data in humans, an approach we have recently employed. We consider metformin as a case-study for potential confounders that influence effectiveness of a longevity intervention, such as lifestyle, sex, genetics, age of administration and the microbiome. Indeed, metformin, like most other longevity interventions, may end up only benefitting a subgroup of individuals. Fortunately, technologies have emerged for tracking the rate of 'biological' aging in individuals, which greatly aids in assessing effectiveness. Recently, we have demonstrated that even wearable devices, accessible to everyone, can be used for this purpose. We therefore propose how to use such approaches to test interventions in the general population. In summary, we advocate that 1) not all interventions will be beneficial for each individual and therefore 2) it is imperative that individuals track their own aging rates to assess healthy aging interventions.
A Case of Rituximab Use as an Induction and Maintenance of Remission in ANCA-Associated Vasculitis
Authors: Neveen Awad, Shahd Hafiz, Abdurahman Albeity, Hani Almoallim
Journal: Case Rep Rheumatol (2016)

Antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is a multisystem autoimmune disease affecting mainly microscopic blood vessels due to circulating autoantibodies against neutrophil cytoplasmic antigens. We report a case of a 57-year-old female patient presenting with hemoptysis, sinusitis, and conjunctivitis. Based on lung biopsy, the diagnosis of antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) was established. She was put on rituximab as induction and maintenance therapy. She responded initially to rituximab as induction therapy but failed to respond in the maintenance course of the drug. Rituximab was stopped and mycophenolate mofetil was administered. She responded as laboratory c-ANCA titers turned negative and symptoms subsided. There are no randomized clinical trials addressing rituximab effect in induction and remission at the same time. This case report doubts the efficacy of the use of rituximab therapy for both induction and maintenance of remission at the same time, waiting for the results of the ongoing trials.
Acute pancreatitis followed by retroperitoneal perforation of the descending colon and a duodenal fistula: Report of a case
Authors: Kentaro Yoshikawa, Alan Kawarai Lefor, Tadao Kubota
Journal: Int J Surg Case Rep (2020)
Keywords: acute pancreatitis, colon perforation, loop ileostomy, retroperitoneal drainage
MeSH terms: Case Reports

Introduction:
There are several reports of colon perforation in patients with acute pancreatitis, but the mechanism is not understood. We describe a patient with acute pancreatitis followed by retroperitoneal perforation of the descending colon and a duodenal fistula.
Case presentation:
A 51-year-old male presented with acute pancreatitis. He was hemodynamically unstable, had respiratory failure on admission and was treated in the intensive care unit (ICU). He recovered and left the ICU on day 13. Although his general condition improved, a computed tomography (CT) scan showed air and fluid in the left retroperitoneum. Gastrografin enema and CT scan showed extraluminal leakage in the descending colon and retroperitoneal drainage was performed on day 27. After drainage, there was continuous voluminous feculent discharge, and a loop ileostomy was performed on day 34. A repeat CT scan revealed ascites. A percutaneous catheter injected with contrast showed a duodenal fistula. After drainage, the fever resolved and the patient was discharged on hospital day 106.
Discussion:
Although there is no clear mechanism of colonic perforation in patients with acute pancreatitis, one hypothesis is that ischemia secondary to inflammation caused by pancreatitis plays a role. The involved area is usually in the watershed areas of the colon. Retroperitoneal drainage of the colon perforation may have necessitated creation of a diverting loop ileostomy.
Conclusion:
Retroperitoneal colon perforation must be considered in patients with acute pancreatitis.
Mitral regurgitation due to caseous calcification of the mitral annulus: two case reports
Authors: Marcello Marcì, Francesca Lo Jacono
Journal: Cases J (2009)

Caseous calcification is a rare variant of mitral annular calcification, occurring in about 0.06% of echocardiographic studies performed. It is usually a benign lesion, but it should be differentiated by abscess and tumors. Echocardiography is the most sensitive method to identify caseous calcification which appears typically as a round, calcified mass with an echo-lucent, liquid-like inner part.
Lymphoepithelioma-like carcinoma of the skin treated with wide local excision and chemoradiation therapy: a case report and review of the literature
Authors: Theresa M Gille, Edward F Miles, Allen O Mitchell
Journal: Case Rep Oncol Med (2012)

Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare cutaneous neoplasm microscopically similar to undifferentiated nasopharyngeal carcinoma. It is typically nonaggressive and is treated with wide local excision. However, we present a case of a patient with a regional recurrence and more aggressive LELCS with perineural invasion and positive margins for which he was treated with wide local excision followed by chemoradiation. We discuss the use of chemoradiation for this patient and review the literature, specifically pertaining to treatment of more aggressive cases of LELCS.
Case Report: Petrous Apicitis and Otogenic Thrombosis of the Cavernous Sinus in a 10-Year-Old Boy
Authors: Patrick Bergsma, Seraina Kunz, Anna-Lena Kienle, Yves Brand
Journal: Front Surg (2021)
Keywords: cavernous sinus thrombosis, fusobacterium necrophorum, otitis media, otomastoiditis, petrous apicitis
MeSH terms: Case Reports

Background: Petrous apicitis and cavernous sinus thrombosis are exceedingly rare complications of acute otitis media with only few reported cases in the post-antibiotic era. Especially in children, the appropriate management is a subject of controversy. Case Presentation: We report the case of a 10-year-old boy who presented to the emergency department with left-sided otalgia, otorrhea, and hearing loss, accompanied by somnolence and high spiking fevers. CT and MRI revealed partially obstructed mastoid air cells including a pneumatized petrous apex. Furthermore, thrombosis of the cavernous sinus and vasculitis of the internal carotid artery on the left side were present. The patient was treated with antibiotics for 6 weeks and anticoagulant therapy for 3 months. Follow-up carried out 3 months post-admission showed complete recanalization of the cavernous sinus on MRI and fatigue as the only remaining symptom. Conclusion: A complicated otitis media with petrous apicitis and cavernous sinus thrombosis in a child can in some cases be managed without a surgical intervention.