OpenMed/multicare-articles huggingface dataset:
Case report: Cutaneous metastases as a first manifestation from breast cancer with concurrent gastric metastases
Authors: Lulu Xu, Congcong Wang, Xiaoling Yang, Liangliang Dong
Journal: Front Pharmacol (2024)
Keywords: breast cancer, cutaneous metastases, endocrine therapy, gastric metastases, invasive lobular carcinoma
MeSH terms: Case Reports

Background: Breast cancer represents a leading cause of malignancy among Chinese women, posing a significant health burden. The diagnosis of metastatic breast cancer, particularly to uncommon sites like the skin and stomach, presents distinct challenges. Case introduction: This case report describes a 71-year-old Chinese women with a persistent back rash lasting more than 6 months. Physical examination revealed red papules on her back. Immunohistochemistry confirmed positive for cytokeratin 7(CK7), GATA-3 and GCDFP15, as well as negative staining of cytokeratin 20 (CK20), suggesting breast cancer metastasis. Further evaluation revealed a breast nodule and axillary lymph node enlargement, with biopsies confirming invasive lobular carcinoma (ILC). Abdominal computed tomography (CT) revealed thickening of the gastric and ascending colon walls. Gastroscopy revealed chronic superficial atrophic gastritis. However, gastric metastasis was further confirmed by pathology. The patient initiated endocrine therapy with fulvestrant and exemestane, resulting in rash resolution and stable breast and stomach lesions after 3 months. Overall, the patient is experiencing an improvement in her condition and remains stable while continuing treatment. Conclusion: This case highlights the importance of considering atypical metastatic patterns in breast cancer and the potential efficacy of endocrine therapies in managing such cases. Moreover, it emphasizes the need for vigilance in breast cancer patients, especially those with ILC, as gastrointestinal symptoms may indicate gastric metastasis (GMs). Ultimately, early detection and appropriate treatment strategies, such as endocrine therapy, can contribute to improved outcomes in these challenging cases.
Combined intravenous ribavirin and recombinant human interferon α1b aerosol inhalation for adenovirus pneumonia with plastic bronchitis in children: a case report and review of literature
Authors: Liangkang Lin, Maoting Tang, Deyuan Li, Haotian Fei, Haiyang Zhang
Journal: Front Pediatr (2024)
Keywords: case report, children, human adenovirus, plastic bronchitis, pneumonia, ribavirin
MeSH terms: Case Reports

Background:
Human adenovirus (HAdV) infections in children can lead to profound pulmonary injury and are frequently associated with severe complications, particularly in cases concomitant with plastic bronchitis. Managing this condition presents significant challenges and carries an exceptionally high fatality rate. Regrettably, there are currently no specific antiviral agents that have demonstrated efficacy in treating severe adenovirus pneumonia in children.
Case presentation:
We report a 10-month-old infant suffering from severe adenovirus pneumonia combined with plastic bronchitis (PB). He received intravenous ribavirin combined with recombinant human interferon α1b (INFα1b) aerosol inhalation and his condition eventually improved. No side effects occurred during the treatment, and the long-term prognosis was favorable.
Conclusion:
In this case, the combination therapy of intravenous ribavirin and INFα1b seems to have contributed to the resolution of illness and may be considered for similar cases until stronger evidence is generated.
Isolated cerebellar metastasis from urothelial carcinoma: A case report of a rare phenomenon
Authors: Eduard J A Verheijen, Walter Taal, Rishi D S Nandoe Tewari, Mariëtte C A Giessen, Hossain Roshani
Journal: Brain Spine (2023)
Keywords: central nervous system, isolated cerebellar metastasis, radiotherapy, tumor resection, urothelial carcinoma
MeSH terms: Case Reports

Introduction:
Although urothelial carcinoma (UC) generally is non-invasive, contrastingly in 25% of patients UC metastasizes. Isolated central nervous system (CNS) metastasis from UC without other distant metastases are considered rare. In this report we describe a patient with an isolated and solitary cerebellar metastasis from UC.
Research question:
In this case report we explore the value of histological analysis of CNS metastases, imaging, treatment options and survival.
Material and methods:
A rare case is presented of a patient diagnosed with an isolated CNS metastasis originating from UC. Through a systematic review of literature route of dissemination, current imaging and treatment options, and survival are discussed.
Results:
A 77-year-old male was diagnosed with a pT2N0M0 high-grade UC and treated with transurethral resection and chemoradiation therapy. Several months later, the patient presented with neurological symptoms, and radiological imaging revealed a solitary cerebellar mass. A body CT scan showed no other metastasis. After surgical resection, histology confirmed urothelial origin of the mass, matching his primary UC and the patient received post-operative stereotactic radiotherapy at the surgical site. Recurrence of the cerebellar mass occurred after 6 months for which the patient received re-resection. The patient died 5.5 months after re-resection.
Discussion and conclusion:
Isolated brain metastases without other distant metastases from UC are rare, so histologic confirmation of the brain metastasis is essential, particularly when the time interval between diagnosis of the UC and brain metastasis increases. Early brain CT is not recommended. PET CT may have additional value in detection of other distant metastases from UC. Despite advancements in treatments, prognosis for CNS metastasis from UC remains poor.
Ureteral duplicity with a left ureterocele: a case report
Authors: Reda Tariqi, Hamza El Abidi, Imad Boualaoui, Ahmed Ibrahimi, Hachem El Sayegh, Yassine Nouini
Journal: Pan Afr Med J (2024)
Keywords: ureteral duplicity, case report, endoscopic ureterocelotomy, ureterocele
MeSH terms: Ureter / surgery, Ureteral Obstruction / etiology, Ureterocele / complications, Ureterocele / diagnosis, Ureterocele / surgery, Case Reports, Adult, Endoscopy, Female, Humans, Kidney Pelvis

An intravesical ureterocele is a rare condition in which a terminal ureter terminates in a cystic dilation of the bladder. We present the case of a 42-year-old female who presented with irritative lower urinary tract symptoms and left lower back pain. Computed tomography (CT) urography revealed ureteral duplication with a ureterocele complicated by upper tract obstruction. Treatment involved endoscopic ureterocelotomy, which successfully relieved symptoms and resolved renal obstruction.
Case Report: Thoracoscopic treatment of infradiaphragmatic pulmonary sequestration and intrathoracic kidney associated with congenital diaphragmatic hernia
Authors: Rui Guo, Chunhua Dong, Yunpeng Zhai, Huashan Zhao, Longfei Lv, Shisong Zhang
Journal: Front Pediatr (2024)
Keywords: congenital diaphragmatic hernia, enhanced computed tomography, infradiaphragmatic pulmonary sequestration, intrathoracic kidney, thoracoscopy
MeSH terms: Case Reports

Background:
Congenital pulmonary sequestration is a rare lung anomaly that can be classified as intralobar pulmonary sequestration or extralobar lung sequestration (ELS). Infradiaphragmatic pulmonary sequestration is a rare type of ELS. Furthermore, intrathoracic kidney (ITK) is a rare disease that can be associated with a congenital diaphragmatic hernia (CHD) in 0.25% of cases. We report the first case of infradiaphragmatic pulmonary sequestration and ITK associated with CDH in a child.
Case report and management:
The patient, male, aged 6 months, visited our hospital 2 months prior due to shortness of breath. Based on chest ultrasonography and enhanced computed tomography (CT) examination, infradiaphragmatic pulmonary sequestration and ITK were considered to be associated with CDH. The patient was admitted to our hospital for treatment. After admission, his blood pressure was 85/61 mmHg, there was no hematuria or proteinuria, creatinine was 14 µmol/L, and urea nitrogen was 2.96 mmol/L, all of which showed no abnormalities. A complete preoperative examination was performed prior to surgical treatment. Thoracoscopy revealed that the right kidney had herniated into the chest cavity on the posterolateral side of the diaphragm. The right kidney was returned to the abdominal cavity, the hernia sac was opened, and a bright red lesion tissue with clear boundaries and an abnormal blood vessel supply was observed. After cutting off the abnormal blood vessels, LigaSure TM was used to remove the diseased tissue, and the renal fat sacs and renal tissue were visible. Intermittent suturing of the hernia ring was performed to seal the diaphragmatic hernia. Postoperative pathological examination revealed infradiaphragmatic pulmonary sequestration. The postoperative recovery of the patient was smooth, and a chest CT scan at 2 months showed that the right kidney had returned to the abdominal cavity and the right diaphragm was in the normal position.
Conclusion:
Infradiaphragmatic pulmonary sequestration and ITK associated with CDH is extremely rare. A diagnosis and appropriate surgical planning can be developed using enhanced CT. For infradiaphragmatic pulmonary sequestration located at the top of the hernia sac in CHD, thoracoscopic resection of the infradiaphragmatic pulmonary sequestration and repair of the diaphragmatic hernia is feasible and effective.
Role of ECG in the Accidental Finding of an Atrioventricular Septal Defect in an Asymptomatic Patient Undergoing Cosmetic Surgery
Authors: Pramod Bhattarai, Monika Karki
Journal: Cureus (2024)
Keywords: adult congenital heart disease (achd), atrioventricular septal defect (avsd), cardio thoracic surgery, primum asd, ventricular septal defect (vsd)
MeSH terms: Case Reports

Electrocardiogram (ECG) is an important diagnostic tool in identifying congenital heart disease (CHD), as demonstrated by this case of a 48-year-old female who presented for a preoperative evaluation for cosmetic surgery. ECG showed a right bundle branch block (RBBB) and first-degree atrioventricular (AV) block, and further testing revealed a primum atrial septal defect (ASD) with mitral valve anterior leaflet cleft and a membranous ventricular septal defect (VSD). She underwent successful surgical repair and was discharged home without complications. This case highlights the importance of performing additional tests like echocardiography or other imaging modalities in cases of abnormal ECG findings to accurately diagnose the underlying heart condition and ensure proper treatment.
Interpreting materia medica. A case study on Ioannes Archiatrus
Authors: Barbara Zipser, Andreas Lardos, Rebecca Lazarou, Robert Allkin, Mark Nesbitt, Andrew C Scott
Journal: Wellcome Open Res (2024)
Keywords: byzantine medicine, greek medicine, medical lexicography, botany, ethnopharmacology, geology, medical history, pharmacognosy

Background:
Premodern medical texts are an invaluable source for scholars from humanities and sciences. However, they are usually not accessible as few scientists with an interest in premodern materia medica are also qualiﬁed philologists. Therefore, a balance has to be struck to translate these texts while preserving information on how reliable we believe a given translation to be. In this paper, we conduct a case study on the vernacular version of Ioannes archiatrus.
Methods:
The present study forms part of the output of a multidisciplinary Wellcome Trust Collaborative Award combining humanities and sciences. We deployed a multi-layer tagging system to systematise pharmaceutical terminology and to translate these terms while providing conﬁdence factors for individual words. In a second step, we used AntConc, a freeware concordance software, to analyse our primary source and visualise patterns in the text.
Results:
Our methodology created a readable text that made it possible for the reader to check conﬁdence factors. It also allows our translation and tagging to be recycled for further research.
Conclusions:
Our methods provide a tool that allows to balance the need to translate and the necessary caution about translated plant and mineral names. Our approach is transferable and it can be modiﬁed to suit the needs of other primary sources.
Bullous Mastocytosis: A Rare Variant of Diffuse Cutaneous Mastocytosis
Authors: Shamma Khamis Almheiri, Jaheersha Pakran, Amani Abdulla AlFalasi, Reem El Bahtimi
Journal: Cureus (2024)
Keywords: bullous dermatosis, bullous mastocytosis, dermatology, diffuse cutaneous mastocytosis, mast cell, mast cell disorder, mastocytosis, pediatric dermatology
MeSH terms: Case Reports

Mastocytosis is a disease of the mast cells caused by an increase in the number of mast cells due to abnormal proliferation. The disease is associated with a mutation in the c-kit gene, which is a key factor in the development of mast cells. Mastocytosis is classified into two main groups, namely, cutaneous and systemic mastocytosis, based on the site of mast cell accumulation. In cutaneous mastocytosis, the cells purely gather in the skin. In contrast, systemic mastocytosis must affect an internal organ, including the bone marrow, lymph nodes, liver, spleen, and/or the gastrointestinal tract with or without skin involvement. Cutaneous mastocytosis has four distinct presentations, including urticaria pigmentosa, cutaneous mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptive perstans listed from most to least common. This case report presents a rare bullous variant of diffuse cutaneous mastocytosis.
Multiple Abscess Collections: Antibiotics or Steroids?
Authors: Philippe Raphael Dias, Levin Bolt, Christof Iking-Konert, Mattia Arrigo, Lars C Huber
Journal: Case Reports Immunol (2024)
MeSH terms: Case Reports

Aseptic abscess syndrome (AAS) is a medical rarity. The combination of multiple abscess collections in different organs, negative microbiological studies, and the association with an inflammatory bowel disease is highly suggestive for an AAS. The AAS is an acute neutrophilic dermatosis, so "generalized pyoderma gangraenosum" or "generalized bullous sweet syndrome" might be used synonymously. It is important to note that the diagnosis of an AAS can be made only after careful exclusion of an infectious disease. Of interest, despite the severity of the inflammation, patients with AAS are commonly hemodynamically stable. To date, no studies have investigated the optimal regimen, dose, and duration of therapy. Corticosteroids are the cornerstone of immunosuppression during the acute phase. After the induction phase, therapy might be switched to anakinra or infliximab.
The Ross Procedure in a Case of Baraitser-Winter Syndrome: A Case Report
Authors: Raghad A Alotabi, Orjowan Z Alamri, Shahad E Alenezi, Ihab Suliman
Journal: Cureus (2024)
Keywords: aortic valve insufficiency, baraitser-winter syndrome, bicuspid aortic valve, prolapsed mitral valve, ross procedure
MeSH terms: Case Reports

Baraitser-Winter syndrome (BRWS) is a rare genetic disorder caused by mutations in the ACTB and ACTG1 genes. It is characterized by intellectual disability, physical malformations, and dysmorphic craniofacial features. Additionally, cardiovascular abnormalities may also be present. We present a case of a 15-year-old boy with BRWS associated with congenital bicuspid aortic valve and severe aortic insufficiency which was managed successfully with Ross procedure.
18F-FDG PET/CT as a molecular biomarker in the diagnosis of amyotrophic lateral sclerosis associated with prostate cancer and progressive supranuclear palsy: A case report
Authors: Emilly A Cortés Mancera, Fabio A Sinisterra Solis, Francisco R Romero-Castellanos, Ivan E Diaz-Meneses, Nora E Kerik-Rotenberg
Journal: Front Nucl Med (2023)
Keywords: fdg, pet/ct, psma, amyotrophic lateral sclerosis, palsy, prostate cancer, supranuclear
MeSH terms: Case Reports

Introduction:
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative, multisystem disorder. Its clinical presentation typically consists of progressive focal muscle atrophy and weakness. In addition to motor disorders, the association between ALS and cancer has been researched, such as frontotemporal dementia and progressive supranuclear palsy. The diagnosis is based primarily on the clinical history, physical examination, electrodiagnostic tests (with an EMG needle), and neuroimaging, such as MRI and 18F-FDG PET/CT.
Presentation of the case:
A 67-year-old male patient was diagnosed with prostate adenocarcinoma with a clinical picture of muscle weakness in the lower limbs that caused falls and was associated with fasciculations in the thighs and arms, alterations in the tone of voice, poor memory, and difficulty articulating words. In the neurological assessment, he described walking supported by a walker with decreased strength in both lower limbs and sensitivity without alterations. The diagnoses of upper and lower motor neuron disease and probable ALS were integrated. Furthermore, the probable coexistence of frontotemporal dementia/disorder (FDD) with ALS was considered. The main findings in the 18F-FDG PET/CT study was hypometabolism in the cortex of the bilateral motor and premotor areas, the anterior cingulate, both caudate and putamen, a metabolic pattern compatible with ALS, and progressive supranuclear palsy.
Conclusion:
Through the PET/CT studies, we demonstrated a case in which ALS, prostate cancer and progressive supranuclear palsy coexisted molecularly; it was clinically difficult to diagnose. Molecular imaging has potential in the diagnostic and prognostic evaluation of ALS. It is crucial to identify the disease early and reliably through metabolic patterns that allow us to confirm the disease or differentiate it from other pathologies.
Case Report: ASXL1, RUNX1, and IDH1 mutation in tyrosine kinase-independent resistant chronic myeloid leukemia progressing to chronic myelomonocytic leukemia-like accelerated phase
Authors: Emmanuella Oyogoa, Lukas Streich, Philipp W Raess, Theodore Braun
Journal: Front Oncol (2023)
Keywords: asxl1, cml, cmml-ap, runx1, systemic inflammatory and autoimmune diseases, tyrosine kinase independent resistance, tyrosine kinase inhibitors
MeSH terms: Case Reports

Although the majority of patients with chronic myeloid leukemia (CML) enjoy an excellent prognosis tyrosine kinase inhibitor (TKI) therapy, resistance remains a significant clinical problem. Resistance can arise from mutations in the kinase domain of ABL preventing drug binding, or due to ill-defined kinase-independent mechanisms. In this case report, we describe the case of a 27-year-old woman with a long-standing history of chronic phase (CP) CML who developed kinase-independent resistance with mutations in ASXL1 and RUNX1. As a consequence of uncontrolled disease, she progressed to a chronic myelomonocytic leukemia-like (CMML) accelerated phase (AP) disease with the acquisition of a mutation in IDH1. This disease progression was associated with the development of an inflammatory serositis, a phenomenon that has been described in CMML but not in AP-CML. This case presents key features of kinase-independent resistance with insight into potential mechanisms, highlights management challenges, and describes a novel systemic inflammatory response that occurred in this patient upon disease progression.
Ascorbic acid-induced warfarin resistance after breast cancer surgery: a case report and literature review
Authors: Pingfa Gao, Yang Shen, Ping Wu, Wenjie Lv
Journal: Front Pharmacol (2024)
Keywords: ascorbic acid, case reports, pharmacodynamics, pharmacokinetics, warfarin resistance
MeSH terms: Case Reports

Warfarin is an anticoagulant that requires INR-based dosage adjustment. Ascorbic acid may impair warfarin effectiveness according to limited literature. We report a rare case of a 63-year-old woman with an aortic valve replacement history who developed warfarin resistance after taking ascorbic acid for anemia following breast cancer surgery. Despite increasing the warfarin dose from 6 mg to 10 mg daily, her INR remained below the therapeutic range. After ruling out other causes of warfarin resistance, we discontinued ascorbic acid and observed a rapid increase in INR to target values. The temporal relationship and the absence of other confounding factors confirmed the causality of ascorbic acid in this case. We recommend that patients concomitantly taking vitamin C and warfarin should monitor their INR values closely and discontinue ascorbic acid as soon as possible if they exhibit signs of warfarin resistance.
Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section
Authors: Olaf E M G Schijns, Daniel Delev, Marec von Lehe, Dirk van Roost, Karl Rössler, Tom Theys, Christian Auer, Thomas Blauwblomme, Marcelo Budke, Alexandre Rainha Campos, Santiago Candela Canto, Hans Clusmann, Christian Dorfer, Georg Dorfmüller, Arild Egge, Lorand Eröss, Sarah Ferrand-Sorbets, Flavio Giordano, Jürgen Honegger, Cihan Isler, Jugoslav Ivanovic, Thilo Kalbhenn, Atte Karppinen, Niklaus Krayenbühl, Rick H G J van Lanen, Carlo E Marras, Ioannis Mavridis, Daniel Nilsson, Julia Onken, Christian Raftopoulos, Jonathan Roth, Jordi Rumia, Thomas Sauvigny, Didier Scavarda, Karl Schaller, Christian Scheiwe, Sophie Schuind, Alexandra Seromenho-Santos, Kostas Fountas
Journal: Brain Spine (2024)
Keywords: complications, epilepsy surgery, functional hemispherotomy, hemispheric disconnection, indications, techniques

Introduction:
The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure.
Research question:
To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy.
Material and methods:
Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines.
Results:
A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported.
Discussion and conclusion:
This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe.