OpenMed/multicare-articles huggingface dataset:
Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis
Authors: Ifeyinwa Emmanuela Obiorah, Metin Ozdemirli
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

Intravascular lymphoma is a rare type of lymphoma, characterized by growth of lymphoma cells within the microvasculature. The majority of the cases are of B-cell lineage, although rare examples of T or NK lineage have also been reported. The lymphoma is usually widely disseminated in the vascular spaces of any organ at the time of diagnosis including the skin and bone marrow. Lymph nodes are typically spared. The clinical picture depends on the specific organ involvement making the correct diagnosis very difficult. Here, we report a case of intravascular large B-cell lymphoma diagnosed postmortem on a 69-year-old African-American male who presented with unilateral proptosis and visual loss. An initial diagnosis of temporal arteritis was made and the patient received corticosteroids. However, the patient developed multiorgan failure and expired. On autopsy, there was disseminated intravascular lymphoma involving predominantly vessels within the heart, kidneys, liver, stomach, lungs, adrenal glands, small intestine, bladder, thyroid, and brain. Interestingly, there was also partial involvement of the retroperitoneal lymph nodes which is an unusual presentation in this disorder. Immunohistochemical staining showed that the lymphoma cells were positive for CD20, indicating B-cell phenotype. This case supports the "mimicking nature" of this rare entity with an unusual presentation with proptosis and visual loss, simulating temporal arteritis and a rare involvement of the retroperitoneal lymph nodes. The presentation of intravascular large B-cell lymphoma can vary, and the key to diagnosis is dependent on histopathology and immunohistochemistry. Increased awareness, early tissue diagnosis, and prompt chemotherapy are crucial for this otherwise lethal disease.
Myoepithelioma of the soft palate: a case report
Authors: Ajay Kumar Yadav, Jeyaseelan Nadarajah, S H Chandrashekhara, Vishal Dnyandeo Tambade, Sudeep Acharya
Journal: Case Rep Otolaryngol (2013)

Myoepitheliomas are rare benign tumors of myoepithelial cell origin, most commonly seen in parotid gland. These tumors are also reported in oral cavity, soft palate being the most common site of involvement. Imaging findings are nonspecific, and histopathology is necessary to differentiate from other tumors. Our case showed mildly enhancing well-circumscribed mass in soft palate with histological findings consistent with myoepithelioma. The aim of this case report is to increase the awareness about this rare benign tumor regarding its morphological, histopathological, and radiological features along with its possible differential diagnosis.
Glioblastoma with Both Oligodendroglioma and Primitive Neuroectodermal Tumor-Like Components in a Case with 9-Year Survival
Authors: Ying-Tso Chen, Shu-Shong Hsu, Chi-Man Yip, Ping-Hong Lai, Huai-Pao Lee
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Glioblastoma multiforme (GBM), the most common primary malignant brain tumor in adults, is characterized by extensive heterogeneity in its clinicopathological presentation. A primary brain tumor with both astrocytic differentiation and neuronal immunophenotype features is rare. Here, we report a long-term survival patient who presented this rare form of GBM in the disease course.
Presentation of case:
A 23-year-old woman, presenting with rapidly progressive headache and right-side weakness, was diagnosed with brain tumor over the left basal ganglion. She underwent the first craniectomy for tumor removal, and histopathology revealed classic GBM. Tumor recurrence occurred 8 years later. Another gross total resection was performed and pathology revealed GBM with the oligodendroglioma component (GBM-O). Due to disease progression, she received debulking surgery the following year. The third pathology revealed glioblastoma with primitive neuroectodermal tumor-like component (GBM-PNET).
Discussion:
GBM-PNETs are collision tumors with both neuronal and glial components. They are rare, and a few case reports have suggested that these tumors are associated with favorable outcomes but a higher risk of cerebrospinal fluid dissemination.
Conclusion:
We report a patient who developed the distinct pathologic variants of classic GBM, GBM-O, and GBM-PNET, throughout the disease course. Young age, aggressive surgical resection, and pathologic and genetic features may have contributed to the long-term survival of the patient.
Pneumomediastinum and pneumopericardium 11 days after Whipple procedure. A case report and review if the literature
Authors: Gavriella Zoi Vrakopoulou, Victoria Michalopoulou, Christina-Evaggelia Kormentza, Maria Matiatou, K George Zografos, Konstantinos G Toutouzas
Journal: Int J Surg Case Rep (2020)
Keywords: late complication after whipple, pneumomediastinum after whipple, postoperative pneumopericardium, spontaneous pneumomediastinum, spontaneous pneumopericardium
MeSH terms: Case Reports

Introduction:
Spontaneous pneumomediastinum (SPM) is a rare condition classified as free air in the mediastinum in the absence of any precipitating cause. This is the first time that a synchronous presence of pneumopericardium is described. To date, there are no clear guidelines for diagnosis and treatment.
Presentation of a case:
A 34-year old Caucasian male patient presented to our institution with a recently diagnosed pancreatic adenocarcinoma. He underwent an uneventful pancreaticoduodenectomy (Whipple procedure). Preoperative and intraoperative chest X-Ray after a central line placement were normal. The postoperative course was uneventful, but few hours before his discharge he presented an acute tachycardia and tachypnea with hypocapnia and a transient loss of consciousness. The full-body CT scan revealed a pneumomediastinum and pneumopericardium without any findings of anastomotic leak or other pathology from the abdomen. A meticulous review of the literature was conducted about the pathophysiology, treatment options and outcomes of pneumomediastinum after a surgical procedure.
Discussion:
This is the first study presenting the case of spontaneous pneumomediastinum with a synchronous pneumopericardium in the literature as a late complication of Whipple procedure. The applied diagnostic algorithm and conservative treatment are presented to extend our limited knowledge about this rare medical entity.
Conclusion:
Awareness of these medical entities is important for the adequate management and optimal outcome of patients presenting a spontaneous pneumomediastinum. As such, all cases, treatment decisions and outcomes should be reported.
Lipid Storage Myopathy in Behçet's Disease: A Rare Cause of Elevated Serum Creatine Kinases Levels
Authors: Sedat Yilmaz, Muhammet Cinar, Yıldırım Karslioglu, Ismail Simsek, Hakan Erdem, Salih Pay, Ayhan Dinc
Journal: Case Rep Rheumatol (2012)

Muscular involvement in Behçet's disease is rare and there are only a few case reports in the literature. The causes of elevated muscle enzymes in a patient with Behcet's disease are many, including myositis, drug-induced myopathy, metabolic myopathy, and the disease itself. We herein have defined an algorithmic approach to a patient with Behcet's disease and elevated muscle enzymes and report a case of coexisting of lipid storage myopathy.
Bradycardia unresponded to atropin testing was successfully treated with therapeutic plasma exchange in a patient with severe COVID-19 complicated by Guillain-Barré syndrome: A case report
Authors: Sy Duong-Quy, Duc Huynh-Truong-Anh, Quynh Tran-Xuan, Tien Nguyen-Quang, Thanh Nguyen-Thi-Kim, Thanh Nguyen-Chi, Thuy Tran-Ngoc-Anh, Nam Nguyen-Van-Hoai, Mai Do-Thi-Thu, Tram Tang-Thi-Thao, Khue Bui-Diem, Tien Hoang-Anh, Thu Nguyen-Ngoc-Phuong, Vinh Nguyen-Nhu
Journal: Front Cardiovasc Med (2023)
Keywords: covid-19, guillain-barrée syndrome, sars-cov-2, bradycardia, therapeutic plasma exchange
MeSH terms: Case Reports

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been an alarming situation worldwide for the past 2 years. The symptoms of coronavirus disease 2019 (COVID-19) are not only confined to the respiratory system but also affect a multitude of organ systems. Bradycardia associated with Guillain-Barré syndrome (GBS) is a rare autonomic and peripheral neurological complication of COVID-19. In this case report, we present the case of a 26-year-old man diagnosed with bradycardia associated with GBS after contracting COVID-19. Initially, this patient had the classical symptoms of COVID-19 and was hospitalized in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS). Then, he developed weakness in the lower extremities, diminished tendon reflexes, a loss of sensation without sphincter muscle disorders, and bradycardia. His bradycardia did not respond to atropine. The patient was treated concurrently with a high-flow nasal cannula, systemic corticosteroids, anticoagulation, and therapeutic plasma exchange (TPE) for COVID-19-induced ARDS, bradycardia, and GBS. His ARDS and bradycardia improved after the first cycle of TPE and medical treatment. After three cycles of TPE, the patient progressively recovered his muscle strength in the lower limbs and regained peripheral sensation. He was discharged from the hospital in stable condition after 4 weeks of hospitalization and was followed up after 6 months for cardiorespiratory and neurological complications. This case report elucidates the potential difficulties and challenges that physicians may encounter in diagnosing and treating COVID-19-induced bradycardia and GBS during the pandemic outbreak. However, the patient outcomes with the treatment combining the conventional treatment with therapeutic plasma exchange seem to be optimistic.
Minimally invasive approach to Herlyn-Werner-Wunderlich syndrome with giant endometriotic cyst: a case report
Authors: Saket Kumar, Madhukar Dayal, Abhay Kumar, Nidhi Singh, Vijay Prakash Singh
Journal: Pan Afr Med J (2023)
Keywords: herlyn-werner-wunderlich syndrome, renal agenesis, case report, dysmenorrhea
MeSH terms: Endometriosis / complications, Endometriosis / diagnosis, Endometriosis / surgery, Kidney Diseases / diagnosis, Kidney Diseases / surgery, Case Reports, Dysmenorrhea / etiology, Female, Humans, Menarche, Uterus / surgery, Uterine Anomalies

Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly of the Mullerian and Wolffian ductal system, manifesting as a triad of dipelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. Patients usually remain asymptomatic till menarche and experience progressive dysmenorrhea, suprapubic lump, and/or features of infection (pyometra, pelvic collection, etc.) afterward. We hereby present a case of a young lady with Herlyn-Werner-Wunderlich syndrome with a large endometriotic cyst, likely arising from the right hemiuterus. She presented with dysmenorrhea and progressive abdominal distention for seven years. She was treated by laparoscopic ovarian cyst excision and right hemihysterectomy that relieved her symptoms.
Variation in uterus position prior to brachytherapy of the cervix: A case report
Authors: M T Georgescu, R Anghel
Journal: J Med Life (2017)
Keywords: cancer brachytherapy, image-guided, position, uterus
MeSH terms: Brachytherapy, Cervix Uteri / pathology, Case Reports, Adult, Cervix Uteri / diagnostic imaging, Cervix Uteri / radiation effects, Female, Humans, Magnetic Resonance Imaging, Organs at Risk, Tomography, X-Ray Computed, Uterine Cervical Neoplasms / diagnostic imaging, Uterine Cervical Neoplasms / pathology, Uterine Cervical Neoplasms / radiotherapy

Rationale: brachytherapy is administered in the treatment of patients with locally advanced cervical cancer following chemoradiotherapy. Lack of local anatomy evaluation prior to this procedure might lead to the selection of an inappropriate brachytherapy applicator, increasing the risk of side effects (e.g. uterus perforation, painful procedure ...). Objective: To assess the movement of the uterus and cervix prior to brachytherapy in patients with gynecological cancer, in order to select the proper type of brachytherapy applicator. Also we wanted to promote the replacement of the plain X-ray brachytherapy with the image-guided procedure. Methods and results: We presented the case of a 41-year-old female diagnosed with a biopsy that was proven cervical cancer stage IIIB. At diagnosis, the imaging studies identified an anteverted uterus. The patient underwent preoperative chemoradiotherapy. Prior to brachytherapy, the patient underwent a pelvic magnetic resonance imaging (MRI), which identified a displacement of the uterus in the retroverted position. Discussion: A great variety of brachytherapy applicators is available nowadays. Major changes in uterus position and lack of evaluation prior to brachytherapy might lead to a higher rate of incidents during this procedure. Also, by using orthogonal simulation and bidimensional (2D) treatment planning, brachytherapy would undoubtedly fail to treat the remaining tumoral tissue. This is the reason why we proposed the implementation of a prior imaging of the uterus and computed tomography (CT)/ MRI-based simulation in the brachytherapy procedure. Abbreviations: MRI = magnetic resonance imaging, CT = computed tomography, CTV = clinical target volume, DVH = dose-volume histogram, EBRT = external beam radiotherapy, GTV = gross tumor volume, Gy = Gray (unit), ICRU = International Commission of Radiation Units, IGRT = image guided radiotherapy, IM = internal margin, IMRT = image modulated radiotherapy, ITV = internal target volume, MRI = magnetic resonance imaging, OAR = organs at risk, PTV = planning target volume, QUANTEC = Quantitative Analyses of Normal Tissue Effects in the Clinic.
Child-Onset Cerebellar Ataxia Caused by Two Compound Heterozygous Variants in ADPRS Gene: A Case Report
Authors: Jiehui Ma, Qiaoqiao Qian, Shuang Yan, Haoyu Dou, Cheng Li, Dan Sun
Journal: Front Genet (2022)
Keywords: adprs, condsias, compound heterozygous variant, intron retention, nonsense-mediated mrna decay
MeSH terms: Case Reports

Background: Gene variants of ADP-ribosylserine hydrosylase, also known as ADP-ribosylhydrolase-like 2 (ADPRS or ADPRLH2; OMIM: 610624), can cause stress-induced childhood-onset neurodegeneration with variable ataxia and seizures (CONDSIAS, OMIM: 618170), an ultra-rare neurodegenerative autosomal recessive disorder. ADPRS encodes ADP-ribosylhydrolase 3, which removes poly(ADP-ribose) polymers, whose posttranslational addition occurs under stressful conditions. Case Presentation: After a respiratory tract infection, a 30-month-old male patient presented with unsteady gait that rendered walking impossible without external help. Neurological examination revealed acute cerebellar ataxia, electroencephalogram results were abnormal, and brain magnetic resonance imaging revealed slightly widened cerebellar sulci. Laboratory tests showed decreased levels of thyroid-stimulating hormone, and increased levels of plasma lactic acid and serum cardiac enzymes. The cerebrospinal fluid glucose test was positive. Four months after onset, the patient died of sudden convulsions. Using whole exome sequencing, we identified two novel compound heterozygous ADPRS variants: NM_017825.3:c.580C>T (p.Gln194Ter) and NM_017825.3:c.803-1G>A. RNA sequencing indicated that the former mutation might cause nonsense-mediated mRNA decay. The c.803-1G>A variant was found to be a splice-site mutation that leads to the transcriptional retention of intron 5. According to the guidelines of the American College of Medical Genetics and Genomics, the two variants were classified as pathogenic. Conclusion: We present the first report of the existence of two compound heterozygous variants of ADPRS, which leads to CONDSIAS.
Acute miliary tuberculosis of the pharynx (Isambert disease): case report
Authors: Younes Chebraoui, Abdelfattah Aljalil, Mohamed Amine Hanine, Amine Ennouali, Haddou Ammar, Youssef Darouassi, Amine Benjelloun
Journal: Pan Afr Med J (2020)
Keywords: isambert, pharyngeal tuberculosis, miliary
MeSH terms: Antitubercular Agents / administration & dosage, Pharynx / microbiology, Tuberculosis, Miliary / diagnosis, Case Reports, Adult, Deglutition Disorders / etiology, Hearing Loss / etiology, Humans, Male, Tomography, X-Ray Computed, Tuberculosis, Miliary / drug therapy, Antitubercular Agents

Miliary pharyngeal tuberculosis or Isambert disease is a rare form of tuberculosis. It can be isolated or more often associated with lung damage. We report the case of a 25-year-old patient referred for deep asthenia with fever, sweating and weight loss, all associated with dysphagia and hearing loss. The pharyngeal examination found an oropharyngeal miliary and an involvement of the cavum. Chest computed tomography (CT) showed excavated lesions suggestive of tuberculosis. The clinical situation clearly improved with anti-tuberculous treatment. Isambert disease is a rare pharyngeal disorder occurring especially at extreme ages or in immunocompromised patients. The contamination is either direct or hematogenous. The pharyngeal examination finds grayish tubers on an often congestive mucosa. The diagnosis is bacteriological and/or histological. Treatment is mainly medical, more rarely surgical. The general assessment aims to find other locations. The miliary pharyngeal tuberculosis is rare and must make seek other locations. The diagnosis is easy and treatment mainly medical. The consequences can be significant.
Aggressive angiomyxoma of the scrotum mimicking huge hydrocele: case report and literature review
Authors: Roy Morag, Eduard Fridman, Yoram Mor
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Aggressive Angiomyxoma (AAM) is a rare mesenchymal benign myxoid tumor of the pelvis and perineum which occurs almost exclusively in adult females. We are presenting a case of 64 year old male patient with a slowly growing scrotal swelling which has been regarded as hydrocele for 2 years. The patient was referred to scrotal exploration. At surgery a huge mass adjacent to the bulbar urethra was found, not involving the testicles. The morphological picture and the special stains were compatible with aggressive angiomyxoma of the scrotum and peritoneum.
EBV-Associated Smooth Muscle Neoplasms: Solid Tumors Arising in the Presence of Immunosuppression and Autoimmune Diseases
Authors: Kimberly Moore Dalal, Cristina R Antonescu, Ronald P Dematteo, Robert G Maki
Journal: Sarcoma (2008)
MeSH terms: Case Reports

Background. Epstein-Barr virus (EBV)-related smooth muscle neoplasms (SMNs) have been associated with immune dysregulation, most notably in patients who have undergone solid organ transplantation or in patients with HIV/AIDS. Objective. to report our experience with EBV-related neoplasms as well as describing the first EBV-related SMN in the setting of administration of glucocorticoids and the tumor necrosis factor inhibitor etanercept. Design. We have case reports, of minimum 3-year follow-up, 2002-2005. Setting. It was held in an academic and tertiary referral cancer center. Patients. Patients are with dysregulated immunity after solid organ transplantation, HIV/AIDS, or with psoriasis after treatment with etanercept. Interventions. There were discontinuation of etanercept, right hepatic trisegmentectomy, and chemotherapy. Measurements. We use survival as a measurement here. Results. Patients who were able to withstand reduction in immunosuppression survived. Surgical resection or chemotherapy was successful in delaying progression of disease. Limitations. There was a relatively short follow-up for these slow-growing neoplasms. Conclusion. EBV-related SMNs have variable aggressiveness. While chemotherapy may slow disease progression, resection and improving the host immune status provide the best opportunity for primary tumor control.
Heart or head?: A depression mimic delays diagnosis-oncotic cerebral aneurysms caused by atrial myxoma
Authors: Bridgid Connolly, Simon J Prowse, Catherine E Connolly, Nicholas J Brett
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Complications of intracardiac tumours can carry significant morbidity and mortality. This article depicts the case of a female who presented with multiple oncotic intracranial aneurysms secondary to a left atrial myxoma. The clinical manifestations and pathogenesis of cardiac myxoma, as well as the imaging pathway, management and prognosis of myxomatous aneurysms will be discussed. Excision of the cardiac mass is mandatory both for symptomatic improvement and to prevent further embolic complications. Local recurrence and delayed onset cerebral complications do occur, and necessitate ongoing patient follow-up. Our report highlights several important features of the diagnostic and treatment pathway for atrial myxoma-in particular, the potentially non-specific clinical presentation, the pivotal role of cardiac MRI in the multimodality diagnostic imaging work up and the need for multidisciplinary communication to identify the diagnosis and guide appropriate management.
Herpes and Chest Pain: Two Atypical Monkeypox Cases
Authors: Devin Videlefsky, Constangela Matos Noboa, Charu Ramchandani
Journal: Cureus (2023)
Keywords: cardiac troponin, genital lesion, herpes simplex virus infection, hiv, monkeypox, mpox
MeSH terms: Case Reports

The 2022 Monkeypox Outbreak has spread globally in just a few months and has raised great concerns regarding disease recognition due to frequent atypical presentations and questions regarding the possibility of sexual transmission. In endemic countries and prior outbreaks, the clinical manifestations of monkeypox have been well documented, with cutaneous findings following a set, synchronous pattern of evolution. We present two cases of atypical monkeypox presentations in individuals living with HIV, both complicated by herpes simplex virus type 2 (HSV-2) coinfection and elevated troponins, and both demonstrating the ease with which monkeypox can be overlooked in the current outbreak.
Lateral Periodontal Cyst Treated with Enucleation and Guided Bone Regeneration: A Report of a Case and a Review of Pertinent Literature
Authors: Sundar Ramalingam, Yasser Fahad Alrayyes, Khalid Buayjan Almutairi, Ibrahim O Bello
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Lateral periodontal cyst (LPC) is an uncommon developmental odontogenic cyst arising on the lateral surface of tooth roots. Commonly reported in mandibular canine-premolar or maxillary anterior regions, it presents as a well-circumscribed or tear drop-shaped radiolucency with a sclerotic border. Associated teeth are asymptomatic and vital, and roots may be displaced without resorption. Histopathologically, cystic lining resembles reduced enamel epithelium along with glycogen-rich clear cells and epithelial plaques. Unilateral variant of LPC has low recurrence and is managed by enucleation. A 43-year-old male patient reported with asymptomatic swelling in the left mandibular canine and first premolar region. Both teeth were vital, and radiographs revealed well-circumscribed radiolucency between the roots. Following consent, surgical enucleation and guided bone regeneration (GBR) with xenograft and resorbable collagen membrane were done under local anesthesia. The immediate postoperative period was uneventful, and complete bone fill of cystic cavity and healing of periodontal tissues was observed after a one-year follow-up. Histopathologic examination confirmed the diagnosis. LPC should be a differential diagnosis in cystic lesions lateral to the surface of a tooth and without any associated inflammation. Based on this case report, unicystic LPC can be successfully managed through surgical enucleation with GBR for better periodontal healing.