OpenMed/multicare-articles huggingface dataset:
Grover's Disease after Heart Transplantation: A Case Report
Authors: Giovanbattista Ippoliti, Marco Paulli, Marco Lucioni, Andrea Maria D'Armini, Marinella Lauriola, Rany Mahrous Haleem Saaleb
Journal: Case Rep Transplant (2012)

Grover's disease is a transient acantholytic dermatosis of unknown cause, manifesting clinically as a papular skin eruption that is usually located on the anterior chest and abdomen. Histologically characterized by an acantholytic pattern, it has been associated with numerous disorders, including hematologic malignancies, chronic renal failure, and HIV infection, as well as with chemotherapy and bone marrow and/or kidney transplant. Evaluation of followup and treatment is often complicated by spontaneous remission and the occasionally fluctuant course of the disease. Here we report the case of a patient with sudden onset of Grover's disease after heart transplantation. To the best of our knowledge, this is the first observation of Grover's disease as diagnosed after heart transplantation.
Intraoperative Kirschner Wire Migration during Robotic Minimally Invasive Spine Surgery
Authors: Ashley Peterson, Lynn K Ngai, Mark A Burbridge
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

We present the case of a 58-year-old woman who underwent a minimally invasive robotic-assisted L4-S1 instrumentation and fusion which was complicated by a Kirschner wire (K-wire) fracture and migration into the abdominal cavity necessitating emergent exploratory laparotomy. Retrieval of the K-wire proceeded without incident, and the patient had an otherwise uneventful surgery and recovery. This is the first such case description reported in the literature. As minimally invasive robotic-assisted spine procedures become more common, it is essential for the anesthesiologist to be familiar with potential complications to manage such patients in the perioperative period optimally.
Robot-Assisted Retroperitoneoscopic Surgery for Synchronous Contralateral Ureteral Metastasis of Renal-Cell Carcinoma
Authors: Kau Han Lee, Wei-Hong Lai, Allen Wen-Shien Chiu, Chih-Cheng Lu, Steven Kuan-Hua Huang
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Renal-cell carcinoma (RCC) with synchronous metastasis to contralateral ureter is extremely rare with only four cases reported in the literature. We report a case of synchronous metastatic RCC to the contralateral ureter with effective robot-assisted retroperitoneoscopic nephron-sparing surgery that leads to favorable oncologic and functional outcome.
Intracardiac echocardiography to guide transseptal catheterization for radiofrequency catheter ablation of left-sided accessory pathways: two case reports
Authors: Rodolfo Citro, Valentino Ducceschi, Alessandro Salustri, Michele Santoro, Michele Salierno, Giovanni Gregorio
Journal: Cardiovasc Ultrasound (2004)
MeSH terms: Cardiac Catheterization / methods, Catheter Ablation / methods, Echocardiography / methods, Heart Conduction System / diagnostic imaging, Heart Conduction System / surgery, Tachycardia, Supraventricular / surgery, Ultrasonography, Interventional / methods, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Heart Ventricles / innervation, Heart Ventricles / surgery, Humans, Male, Middle Aged, Treatment Outcome

Intracardiac echocardiography (ICE) is a useful tool for guiding transseptal puncture during electrophysiological mapping and ablation procedures. Left-sided accessory pathways (LSAP) can be ablated by using two different modalities: retrograde approach through the aortic valve and transseptal approach with puncture of the fossa ovalis. We shall report two cases of LSAP where transcatheter radiofrequency ablation (TCRFA) was firstly attempted via transaortic approach with ineffective results. Subsequently, a transseptal approach under ICE guidance has been performed. During atrial septal puncture ICE was able to locate the needle tip position precisely and provided a clear visualization of the "tenting effect" on the fossa ovalis. ICE allowed a better mapping of the mitral ring and a more effective catheter ablation manipulation and tip contact which resulted in a persistent and complete ablation of the accessory pathway with a shorter time of fluoroscopic exposure. ICE-guided transseptal approach might be a promising modality for TCRFA of LSAP.
Laparoscopic cholecystectomy for severe acute cholecystitis in a patient with situs inversus totalis and posterior cystic artery
Authors: Theodoros E Pavlidis, Kyriakos Psarras, Apostolos Triantafyllou, Georgios N Marakis, Athanasios K Sakantamis
Journal: Diagn Ther Endosc (2008)
MeSH terms: Case Reports

Situs inversus totalis is an inherited condition characterized by a mirror-image transposition of thoracic and abdominal organs. It often coexists with other anatomical variations. Transposition of the organs imposes special demands on the diagnostic and surgical skills of the surgeon. We report a case of a 34-year-old female patient presented with left upper quadrant pain, signs of acute abdomen, and unknown situs inversus totalis. Severe acute cholecystitis was diagnosed, and an uneventful laparoscopic cholecystectomy was performed. A posterior cystic artery was identified and ligated. Laparoscopic cholecystectomy is feasible in patients with severe acute calculus cholecystitis and situs inversus totalis; however, the surgeon should be alert of possible anatomic variations.
Laparoscopic bipolar coagulation of hypogastric artery in postpartum haemorrhage: a case report
Authors: Enrico Panuccio, Eugenio Volpi, Annamaria Ferrero, Piero Sismondi
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

Background. Postpartum haemorrhage (PPH) is a significant contributor to worldwide maternal morbidity and mortality. When PPH continues despite aggressive medical treatment, early consideration should be given to surgical intervention. Various surgical interventions may be used but conservative interventions are recommended primarily. Case. This case report describes laparoscopic coagulation of hypogastric artery technique in a patient with PPH. Conclusions. Laparoscopic ligature of the hypogastric artery for PPH treatment can be a valid alternative to laparotomy in patients with vaginal delivery.
A Rare Case of Sunitinib-Induced Rhabdomyolysis in Renal Cell Carcinoma
Authors: Andrew D Liman, Vida A Passero, Agnes K Liman, Jenna Shields
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

We report a rare case of metastatic renal cell carcinoma (RCC) in a patient who developed rhabdomyolysis while on sunitinib. He was admitted to the hospital due to muscle weakness, fatigue, poor oral intake, and difficulty swallowing in March 2017. He was found to have pancytopenia, liver failure, kidney failure, high uric acid, and increased creatine phosphokinase of more than 5000. He quickly developed lactic acidosis and acute respiratory failure. He was transferred to the ICU, but his condition declined rapidly. He died 3 days later. In this article we discussed about sunitinib-mediated inhibition of adenosine monophosphate kinase (AMPK) as a possible pathophysiology of rhabdomyolysis. Our case is the third sunitinib-induced rhabdomyolysis reported in the literature.
Management of Testicular Silicone Gel-Filled Prosthesis Rupture: Case Report of a Rare Event and a Review of the Literature
Authors: Quang-Bao Phan, Nicolas Koutlidis, Céline Duperron, Eric Mourey, Frédéric Michel, Luc Cormier
Journal: Case Rep Urol (2016)

Introduction. We report a case of spontaneous rupture of a single testicular prosthesis in a patient who had undergone bilateral orchiectomy and silicone gel-filled prosthesis insertion. The consequences of this rare event are discussed. There is no management algorithm. Case Presentation. A 55-year-old man presented to our outpatient department with altered consistency in his right testicular prosthesis and a painful right hemiscrotum with no systemic symptoms thirty-three years after the implantation of the prosthesis. We removed this implant without replacement, in accordance with the patient's wishes. Conclusion. The long time between the implantation and the spontaneous rupture is remarkable and was never before described. The removal of the prosthesis was straightforward and it would have been possible to implant a new prosthesis after taking into account the condition of the skin.
Gemella endocarditis
Authors: Hussein Rabah, Khalil El Gharib, Marc Assaad, Ali Kassem, Neville Mobarakai
Journal: IDCases (2022)
Keywords: antibiotic therapy, blood culture, echocardiogram, infective endocarditis, mitral valve, valvular disease
MeSH terms: Case Reports

We herein present the case presenting to our facility complaining of a fever of two months duration, who underwent dental procedure. Patient was diagnosed with infective endocarditis secondary to an uncommon bacteria: Gemella haemolysans. Patient was found to have concomitant severe mitral valve regurgitation. Our patient did not have any comorbidity or risk factor beside his dental procedure. Our patient received intravenous antibiotic therapy for six weeks and was scheduled for mitral valve replacement.
Transformation of an Unclassified Myeloproliferative Neoplasm with a Rare BCR-JAK2 Fusion Transcript Resulting from the Translocation (9;22)(p24;q11)
Authors: A N Chamseddine, P Etancelin, D Penther, F Parmentier, C Kuadjovi, V Camus, N Contentin, P Lenain, C Bastard, H Tilly, F Jardin
Journal: Case Rep Hematol (2015)

BCR-ABL1 negative myeloproliferative neoplasms (MPNs) are known to contain alterations of the tyrosine kinase JAK2 (located on 9p24) that result in constitutive activation of the encoded protein. JAK2 fusions are reported in acute and chronic leukemias of myeloid and lymphoid phenotypes. Here, we report an unclassified case of MPN (MPN-U) showing a t(9;22)(p24;q11), which generates a BCR-JAK2 fusion gene by fusing the BCR at intron 13 to JAK2 at intron 17 on the derivative chromosome 22. Most reported JAK2 fusions cases reveal an aggressive clinical course and long-term remissions have only been achieved after allogeneic stem cell transplantation (ASCT). To the best of our knowledge, this is the thirteenth case reported worldwide to describe a BCR-JAK2 fusion transcript in MPN-U. The present report revealed a sustained complete clinical, hematologic, and cytogenetic remission 35 months after diagnosis and ~24 months after ASCT. Regarding BCR-ABL1 negative MPN patients this case report provides strong support for a role of JAK2 activation in the oncogenesis and suggests a possible diagnostic and therapeutic target that should be investigated.
Very High Dose Epinephrine for the Treatment of Vasoplegic Syndrome during Liver Transplantation
Authors: M B Khosravi, S Milani, S Ghaffaripour, A Sahmeddini, M H Eghbal, S A Malek-Hosseini
Journal: Int J Organ Transplant Med (2013)
Keywords: epinephrine, hepatocellular carcinoma, liver transplantation, vasoplegia
MeSH terms: Case Reports

A 55-year-old man with hepatitis B and hepatocellular carcinoma was treated with liver transplantation without veno-venous bypass. During the procedure his arterial blood pressure remained at 55/30 mm Hg and did not respond to increasing doses of norepinephrine. Vasoplegia was managed aggressively with the intravenous infusion of high doses of epinephrine.
Pediatric Acute Promyelocytic Leukemia Presenting to the Emergency Department as Refusal to Ambulate
Authors: Kevin R Schwartz, Jennifer M Hanson, Alison M Friedmann
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

A previously healthy 10-year-old girl presented to the emergency department (ED) with a headache and vomiting which resolved with oral NSAIDs. The patient returned two days later unable to ambulate with mental slowing and lower extremity bruising. Labs demonstrated marked leukocytosis, severe anemia and thrombocytopenia, and disseminated intravascular coagulation (DIC). Brain MRI showed multiple intracranial hemorrhages. A peripheral blood smear demonstrated blasts with many Auer rods. A diagnosis of acute promyelocytic leukemia (APL) was made and therapy including all-transretinoic acid (ATRA) was initiated. Neurologic status returned to baseline within 1 week in the pediatric intensive care unit.
Multi-phasic life-threatening anaphylaxis refractory to epinephrine managed by extracorporeal membrane oxygenation (ECMO): A case report
Authors: Juergen Grafeneder, Florian Ettl, Alexandra-Maria Warenits, Nina Buchtele, Elisabeth Lobmeyr, Thomas Staudinger, Michael Schwameis, Wolfgang R Sperr, Georg Gelbenegger, Christian Schoergenhofer, Bernd Jilma
Journal: Front Allergy (2022)
Keywords: mcas, anaphylactic shock, bronchospasm, epinephrine resistance, extracorporeal membrane oxygenation (ecmo), mastocytosis, respiratory failure

We present a case of a 52-year-old patient suffering from multi-phasic life-threatening anaphylaxis refractory to epinephrine treatment. Extracorporeal membrane oxygenation (ECMO) therapy was initiated as the ultima ratio to stabilize the patient hemodynamically during episodic severe bronchospasm. ECMO treatment was successfully weaned after 4 days. Mastocytosis was diagnosed as the underlying condition. Although epinephrine is recommended as a first-line treatment for anaphylaxis, this impressive case provides clear evidence of its limited therapeutic success and emphasizes the need for causal therapies.
Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review
Authors: Hidenori Yokoi, Yuichi Terado, Masachika Fujiwara, Yuma Matsumoto, Tetsuya Ikeda, Koichiro Saito
Journal: BMC Clin Pathol (2018)
Keywords: biphasic tumor, immunohistochemistry, nasopharyngeal papillary adenocarcinoma, spindle cell component, thyroid transcription factor-1
MeSH terms: Case Reports

Background:
Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is distinctly rare. We report a patient with a uniquely biphasic LGNPPA; additionally, we review similar tumors reported in the literature.
Case presentation:
A 56-year-old man presented with an asymptomatic pedunculated tumor in the vault of the nasopharynx, at the junction of the nasal septum and the roof, which was discovered during screening for laryngeal cancer. To obtain a definitive diagnosis, the patient underwent endoscopic endonasal surgery under general anesthesia. Immunohistochemical analysis of the tumor revealed it to be an LGNPPA with a prominent spindle cell component.
Conclusion:
To our knowledge, this is the fourth reported LGNPPA exhibiting a spindle cell component and the second with a prominent pathological condition. The prognosis of LGNPPA is usually excellent. Therefore, it is important for clinicians to scrutinize the lesion's pathology to avoid unnecessary, disfiguring surgery.
Case Report: Giant Paraganglioma of the Skull Base With Two Somatic Mutations in SDHB and PTEN Genes
Authors: Ailsa Maria Main, Götz Benndorf, Ulla Feldt-Rasmussen, Kåre Fugleholm, Thomas Kistorp, Anand C Loya, Lars Poulsgaard, Åse Krogh Rasmussen, Maria Rossing, Christine Sølling, Marianne Christina Klose
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: head and neck paraganglioma (hnpgl), sdhb gene, alpha blockade, catecholamine, multidisciplinary approach, neuroendochrine tumor, paraganglioglioma, rehabilitation
MeSH terms: Labetalol, Paraganglioma / genetics, Paraganglioma / surgery, Case Reports, Adult, Female, Humans, Mutation, Normetanephrine, PTEN Phosphohydrolase, Skull Base, Succinate Dehydrogenase, Normetanephrine, SDHB protein, human, Succinate Dehydrogenase, PTEN Phosphohydrolase, PTEN protein, human, Labetalol

Head and neck paragangliomas (HNPGLs) are neuroendocrine tumors. They arise from the parasympathetic ganglia and can be either sporadic or due to hereditary syndromes (up to 40%). Most HNPGLs do not produce significant amounts of catecholamines. We report a case of a giant paraganglioma of the skull base with an unusually severe presentation secondary to excessive release of norepinephrine, with a good outcome considering the severity of disease. A 39-year-old Caucasian woman with no prior medical history was found unconscious and emaciated in her home. In the intensive care unit (ICU) the patient was treated for multi-organ failure with multiple complications and difficulties in stabilizing her blood pressure with values up to 246/146 mmHg. She was hospitalized in the ICU for 72 days and on the 31st day clinical assessment revealed jugular foramen syndrome and paralysis of the right n. facialis. A brain MRI confirmed a right-sided tumor of the skull base of 93.553 cm3. Blood tests showed high amounts of normetanephrine (35.1-45.4 nmol/L, ref <1.09 nmol/L) and a tumor biopsy confirmed the diagnosis of a paraganglioma. Phenoxybenzamine and Labetalol were used in high doses ((Dibenyline®, 90 mg x 3 daily) and labetalol (Trandate®, 200 + 300 + 300 mg daily) to stabilize blood pressure. The patient underwent two tumor embolization procedures before total tumor resection on day 243. Normetanephrine and blood pressure normalized after surgery (0.77 nmol/L, ref: < 1.09 nmol/L). The damage to the cranial nerve was permanent. Our patient was comprehensively examined for germline predisposition to PPGLs, however we did not identify any causal aberrations. A somatic deletion and loss of heterozygosity (LOH) of the short arm (p) of chromosome 1 (including SDHB) and p of chromosome 11 was found. Analysis showed an SDHB (c.565T>G, p.C189G) and PTEN (c.834C>G, p.F278L) missense mutation in tumor DNA. The patient made a remarkable recovery except for neurological deficits after intensive multidisciplinary treatment and rehabilitation. This case demonstrates the necessity for an early tertiary center approach with a multidisciplinary expert team and highlights the efficacy of the correct treatment with alpha-blockade.
Regionally Metastatic Merkel Cell Carcinoma Associated with Paraneoplastic Anti- N-methyl-D-aspartate Receptor Encephalitis
Authors: Sophia Z Shalhout, Kevin S Emerick, Peter M Sadow, Jenny J Linnoila, David M Miller
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine cancer with a high risk of recurrence and metastasis. MCC is generally associated with advanced age, fair skin, sun exposure, immunosuppression, and in the majority of cases, the Merkel cell polyomavirus. Neuroendocrine malignancies are associated with a variety of paraneoplastic neurological syndromes (PNS), characterized as autoimmune responses to malignancy-associated expression of neural antigens. Our literature review underscores previous case reports of MCC-associated PNS with voltage-gated calcium channel (VGCC) and anti-Hu (or ANNA-1) autoantibodies. We present the case of a 59-year-old male with regionally metastatic Merkel cell carcinoma complicated by the paraneoplastic manifestation of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. His primary lower neck subcutaneous MCC and metastasis were initially treated with surgery. Additional recurrent lymph node metastases were successfully treated with definitive intensity-modulated radiation therapy. His PNS improved with rituximab therapy. Although rare, this case highlights that in the setting of seizures and prominent psychiatric symptoms accompanying an MCC diagnosis, evaluation for autoimmune paraneoplastic encephalitis is warranted. Awareness and detection of preexisting PNS are crucial in the era of immune checkpoint inhibitors (ICI) for advanced MCC, where treatment with ICI has the potential to exacerbate preexisting autoimmune PNS and lead to worsened or even lethal neurologic immune-related adverse events (nirAEs).
Relapsed mantle cell lymphoma presenting as "sister Mary joseph nodule"
Authors: Jennifer E Vaughn, Ajay K Gopal
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The finding of umbilical metastasis has historically been called a "Sister Mary Joseph Nodule". A few case reports of lymphoma presenting in this manner have been documented. We report a case of relapsed mantle cell lymphoma (MCL) presenting as a Sister Mary Joseph's nodule. Although the few reports of lymphoma exhibiting umbilical metastasis suggest that patients may still expect a reasonable response to chemotherapy, this patient experienced multiple relapses, despite aggressive chemotherapy regimens. This clinical course is characteristic of the mantle cell form of non-hodgkin's lymphoma and illustrates a need to seek out more effective therapies.
Case report: Expanding the phenotype of ARHGEF17 mutations from increased intracranial aneurysm risk to a neurodevelopmental disease
Authors: Ethiraj Ravindran, Noor Ullah, Shyamala Mani, Elaine Guo Yan Chew, Moses Tandiono, Jia Nee Foo, Chiea Chuen Khor, Angela M Kaindl, Saima Siddiqi
Journal: Front Neurol (2022)
Keywords: arhgef17, microcephaly, missense mutation, motor dysfunction, neurodevelopmental disorder
MeSH terms: Case Reports

RhoGTPase regulators play a key role in the development of the nervous system, and their dysfunction can result in brain malformation and associated disorders. Several guanine nucleotide exchange factors (GEF) have been linked to neurodevelopmental disorders. In line with this, ARHGEF17 has been recently linked as a risk gene to intracranial aneurysms. Here we report siblings of a consanguineous Pakistani family with biallelic variants in the ARHGEF17 gene associated with a neurodevelopmental disorder with intellectual disability, speech delay and motor dysfunction but not aneurysms. Cranial MRI performed in one patient revealed generalized brain atrophy with an enlarged ventricular system, thin corpus callosum and microcephaly. Whole exome sequencing followed by Sanger sequencing in two of the affected individuals revealed a homozygous missense variant (g.11:73021307, c.1624C>T (NM_014786.4), p.R542W) in the ARHGEF17 gene. This variant is in a highly conserved DCLK1 phosphorylation consensus site (I/L/V/F/M]RRXX[pS/pT][I/L/M/V/F) of the protein. Our report expands the phenotypic spectrum of ARHGEF17 variants from increased intracranial aneurysm risk to neurodevelopmental disease and thereby add ARHGEF17 to the list of GEF genes involved in neurodevelopmental disorders.
Rapid Growth of Pelvic Cyst during Pregnancy: A Case Report
Authors: Yoko Fujimoto, Hironori Takahashi, Kenji Horie, Takeo Nakaya, Toshiro Niki, Hiroyuki Fujiwara, Shigeki Matsubara
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

We describe a patient with bilateral cystic tumors of the pelvis. The left one rapidly grew during pregnancy and combined with the right one, whose clinical course made diagnosis difficult. A pregnant woman with a history of laparotomy was referred to us due to suspected bilateral pelvic cysts. The left-sided cyst had rapidly grown to 27 cm in diameter and merged with the right cyst, forming a large cyst occupying the entire pelvic cavity in the third trimester. Considering this rapid growth, cesarean section and resection of the cyst were performed at 37th week. The resected cyst consisted of two components: a large unilocular cyst containing serous fluid and a multilocular cyst suggestive of ovarian mucinous cystadenoma in the right ovary. The wall of the former largely lacked lining epithelium, but it was partly continuous with the latter mucinous epithelium. Immunohistochemically, estrogen and progesterone receptors were focally positive in the cyst wall, suggesting that pregnancy-associated sex-hormones may have contributed to the rapid growth of the cyst. We diagnosed this condition as a peritoneal inclusion cyst margining with a right ovarian mucinous cystadenoma. Peritoneal inclusion cyst should be considered in the differential diagnosis of a rapidly growing pelvic mass during pregnancy.