OpenMed/multicare-articles huggingface dataset:
Persistent hyperparathyroidism secondary to ectopic parathyroid adenoma in lung: Case report
Authors: Majid Valizadeh, Amir Ebadinejad, Atieh Amouzegar, Anahita Zakeri
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: mibi scan, ectopic parathyroid adenoma, embryologic anomaly, hyperparathyroidism, video-assisted thoracoscopic surgery (vats)
MeSH terms: Adenoma / complications, Adenoma / diagnostic imaging, Adenoma / surgery, Hyperparathyroidism, Parathyroid Neoplasms / complications, Parathyroid Neoplasms / diagnostic imaging, Parathyroid Neoplasms / surgery, Case Reports, Female, Humans, Lung, Middle Aged, Parathyroid Glands / diagnostic imaging, Parathyroid Glands / surgery, Technetium Tc 99m Sestamibi, Technetium Tc 99m Sestamibi

Primary hyperparathyroidism (PHPT) is the most prevalent cause of hypercalcemia, affecting 0.3% of the population. The only curative procedure is parathyroidectomy. Persistent PHPT occurs in 4.7 percent of patients, even in the most skilled hands. Ectopic adenomas are challenging to localize before and during surgery and frequently result in persistent PHPT. We presented a case with persistent PHPT due to lung parathyroid adenoma that was successfully resected with video-assisted thoracoscopic surgery. A 55-year-old female patient was admitted to our endocrinology clinic with persistent PHPT after four neck explorations over 16 years. The last 99m Tc-MIBI scintigraphy with SPECT showed nothing suggestive of parathyroid adenoma, neither in the neck nor the mediastinum, but a solitary nodule as an incidental finding was reported in the lower lobe of the right lung, which was highly probable for a parathyroid adenoma in a fluorodeoxyglucose PET scan. Pathological examination ruled out parathyromatosis and lung malignancy; despite its location outside the anticipated embryonic pathway, pathology revealed the presence of an ectopic parathyroid adenoma. After the surgery, serum parathyroid hormone and calcium levels decreased, and hypoparathyroidism was corrected with calcium carbonate and calcitriol.
Group C Neisseria meningitidis as a Cause of Septic Arthritis in a Native Shoulder Joint: A Case Report
Authors: Amy J Garner, Freda Sundram, Kathryn Harris
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

Septic arthritis is an Orthopaedic emergency, threatening the joint within hours of onset. Up to 10% of cases of meningococcaemia have an associated septic arthritis. The aetiology of acute meningococcaemia in a variety of clinical syndromes is well documented in the literature. The pathogen Neisseria meningitidis can cause both primary and secondary manifestations of disseminated infection. Broad-range 16S rDNA PCR is a relatively new technique, useful in identifying aetiological agents in septic patients with negative blood cultures. Here, we describe the rare clinical scenario of a 76-year-old woman with primary meningococcal septic arthritis of a native shoulder joint without associated meningococcal bloodstream infection. We discuss the role of 16s rDNA Polymerase Chain Reaction (PCR) in the identification of the infectious agent, Neisseria meningitidis, and the role of this technique in guiding subsequent management.
Melioidosis in Mauritius
Authors: Mohammad Iqbal Issack, Chundr Dutt Bundhun, Hemraj Gokhool
Journal: Emerg Infect Dis (2005)
MeSH terms: Burkholderia pseudomallei / isolation & purification, Melioidosis / diagnosis, Case Reports, Adult, Female, Humans, Immunocompromised Host, Mauritius, Melioidosis / microbiology

We report the first case of human melioidosis from Mauritius, where Burkholderia pseudomallei has never been isolated. The patient was immunocompromised, had never traveled abroad, and had a history of regular exposure to mud. She became ill at a time when rainfall was higher than the monthly average.
Amyand's Hernia, State of the Art and New Points of View
Authors: Guido Mantovani, Michela De Angelis, Francesco Di Lecce, Annalisa Pascariello, Domenico Risio, Luigi Boccia
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Background:
Amyand's hernia (AH) is an inguinal hernia containing the vermiform appendix, with an incidence between 0.4% and 1% of all inguinal hernias. Acute or perforated appendicitis can complicate AH.
Case presentation:
A 75-year-old Caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Diagnosis was posed preoperatively with computed tomography (CT) scan. Patient underwent urgent surgery and simultaneous appendectomy and hernia repair by Bassini's technique were performed.
Conclusions:
Preoperative diagnosis of AH is rare; however it could be useful for surgeon to choose operative approach. Treatment of AH depends on grade of appendix inflammation and/or perforation. The technique utilized to repair hernia depends largely on surgeon's preferences; the presence of inflamed or perforated appendix is not an absolute contraindication for using a prosthetic mesh.
A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X-ray source: a technical and case report
Authors: Frank Schneider, Sven Clausen, Johannes Thölking, Frederik Wenz, Yasser Abo-Madyan
Journal: J Appl Clin Med Phys (2014)
MeSH terms: Breast Neoplasms / radiotherapy, Carcinoma, Ductal, Breast / radiotherapy, Mastectomy, Case Reports, Aged, Breast Neoplasms / pathology, Breast Neoplasms / surgery, Carcinoma, Ductal, Breast / pathology, Carcinoma, Ductal, Breast / surgery, Combined Modality Therapy, Female, Humans, Intraoperative Period, Magnetic Resonance Imaging, Prognosis, Radiotherapy Dosage, X-Rays

The use of IORT as a treatment modality for patients with close or positive margins has increased over the past decade. For situations where a flat area (up to 6 cm in diameter) has to be treated intraoperatively, new applicators for superficial treatment with a miniature X-ray source (INTRABEAM system) were developed. Here we report our evaluation of the dosimetric characteristics of these new applicators and their first clinical use. Each of these flat and surface applicators consists of a radiation protective metal tube and a flattening filter, which converts the spherical dose distribution of the X-ray source into a flat one. The homogeneity of each dose distribution and depth-dose measurements were evaluated using film dosimetry in a solid water phantom and a soft X-ray ionization chamber in a water tank. The first patient was treated with 5 Gy delivered in 5 mm using a 4 cm FLAT applicator over 21 minutes. The flat applicators show the maximum homogeneity, with a uniformity ratio of 1.02-1.08 in certain depths. In 1 mm depth surface applicators show a uniformity ratio of 1.15-1.28. They also show a higher dose rate and a steeper dose gradient compared to the flat applicators. The results of this investigation demonstrated that the flat and surface applicators have unique dosimetric characteristics that need to be considered during the treatment planning stages. This work also showed that it is possible to perform a superficial localized IORT which provides new application possibilities for use of the INTRABEAM system.
Almost a Near Miss: Hairy Cell Leukemia
Authors: Jasmita Parkash, Varinder Bansro, Gurdeep S Chhabra, Zainab Mujahid
Journal: Cureus (2023)
Keywords: hairy cell leukemia, massive splenomegaly, menorrhagia, purine analogues, severe iron deficiency anemia, thrombocytopenia
MeSH terms: Case Reports

Hairy cell leukemia (HCL) is an infrequently encountered chronic B-lymphocyte hematological malignancy, which is found to be more prevalent in males. HCL can present with a myriad of nonspecific symptoms involving the reticuloendothelial system. Usually, patients are diagnosed after an incidental finding of pancytopenia. In the majority of cases, HCL follows an indolent course, and many patients remain asymptomatic. Treatment with nucleoside analogs is the first line of treatment and is indicated for patients with severe anemia, thrombocytopenia, neutropenia, or severe systemic symptoms. Here, we report an atypical case of a 41-year-old Hispanic female who presented with menorrhagia and iron deficiency anemia. She was diagnosed with HCL after a bone marrow biopsy demonstrated the characteristic "hairy projections."
Recovering from a renal vascular catastrophe: Case report
Authors: Diogo Francisco, Gonçalo Pimenta, Ana Cristina Martins, Ivo Laranjinha, Hermínia Estibeiro, Célia Gil, Margarida Gonçalves, Maria Augusta Gaspar
Journal: Clin Nephrol Case Stud (2023)
Keywords: acute kidney injury, renal artery thrombosis, renal infarction
MeSH terms: Case Reports

Renal artery thrombosis is a rare vascular event that precipitates renal infarction. Although in up to one third of cases the etiology is not identified, renal artery lesions, cardioembolism and acquired thrombophilias are the main causes. A bilateral simultaneous idiopathic renal artery thrombosis is an unlikely coincidence. We present two cases of patients with acute bilateral renal artery thrombosis of unknown etiology. Cardiac embolism, acquired thrombophilia and occult neoplasm workups were negative. Both cases were temporarily hemodialysis-dependent and partially recovered renal function under conservative approach with systemic anticoagulation. Recommendations on optimal treatment for renal artery thrombosis are still lacking. We discuss the available options.
Successful pulsed methylprednisolone and convalescent plasma treatment in a case of a renal transplant recipient with COVID-19 positive pneumonia: a case report
Authors: Muharrem Bayrak, Kenan Çadirci
Journal: Pan Afr Med J (2021)
Keywords: covid-19, case report, convalescent plasma, methylprednisolone, renal transplantation
MeSH terms: COVID-19 / therapy, Methylprednisolone / administration & dosage, Pneumonia, Viral / therapy, Case Reports, COVID-19 / complications, COVID-19 / diagnosis, COVID-19 Drug Treatment, COVID-19 Serotherapy, Combined Modality Therapy, Glucocorticoids / administration & dosage, Humans, Immunization, Passive, Kidney Transplantation, Male, Middle Aged, Pneumonia, Viral / etiology, Pulse Therapy, Drug, Transplant Recipients, Treatment Outcome, Glucocorticoids, Methylprednisolone

Coronavirus 2019 disease (COVID-19) is a deadly disease that was first seen in Wuhan, China, and primarily affects the respiratory system, but also has different systemic involvements. It has caused 89 million cases and 1.9 million deaths worldwide. COVID-19 positive renal transplant recipients have a higher mortality rate than COVID-19 patients in the normal population. There is no specific treatment and follow-up protocol for COVID-19 infection in transplant recipients. COVID-19 treatment and immunosuppressive therapy choices are controversial. Recently, pulse steroid therapies have been used in cases with severe COVID-19 pneumonia. Convalescent plasma therapy is used limitedly in COVID-19 patients. Our 49-year-old male patient has been a recipient of a renal transplant from a cadaver for 6 years. We aimed to make an additional contribution by presenting our patient to the literature whose COVID-19 PCR-RT test performed in the emergency department due to the complaints of fever, shortness of breath, and cough for five days was positive and had moderate COVID-19 pneumonia in thorax tomography and had serious clinical and radiological improvement after pulsed methylprednisolone and convalescent plasma therapy in the early period.
Pleural effusion in 11:14 translocation q1 multiple myeloma in the setting of proteasome inhibitor presents therapeutic complexity
Authors: Malik Ghannam, Maria Bryan, Erik Kuross, Brent Berry
Journal: Memo (2018)
Keywords: case report, multiple relapses of mm, poor prognosis, primary myelomatous pleural effusion, proteasome inhibitors and lung damage, rare entity

Background:
Primary malignant pleural effusion has been reported in about 134 cases of multiple myeloma (MM). Associated pleural effusions in cases of MM portend a poor prognosis and identifying them is highly relevant. Reported is the case of a man diagnosed with MM who developed primary myelomatous pleural effusion in the setting of multiple relapses and subsequent mortality within 2 months of the pleural effusion diagnosis.
Presentation:
A 61-year-old African American man was diagnosed with MM in 2011. He received induction therapy of lenalidomide and dexamethasone and an autologous stem cell transplant in 2012. Over the next 5 years, the patient went through alternating periods of remission and relapse that were treated with two rounds of thoracic spine radiation therapy and chemotherapeutic agents. In September 2017, the patient presented with worsening dyspnea and was found to have pleural effusion. Fluid analysis showed plasma cell dyscrasia. Fluid drainage was performed, then the patient was discharged after 1 week which was followed by rapid re-accumulation of fluid and rehospitalization about 10 days after discharge. The patient passed away a few weeks after the second admission.
Conclusion:
Pleural effusion carries a differential diagnosis which may include malignancy but is commonly thought to be less specific to multiple myeloma but should still remain in the differential diagnosis. To our knowledge, this is the first case of myelomatous pleural effusion (MPE) that was reported after multiple relapses of MM. MPE is a very rare complication of MM, and its presence is a strong indicator of imminent mortality and need for comfort care in case of multiple relapses. End-stage pleural effusion in MM in the setting of proteasome inhibitor adds more therapeutic and diagnostic challenges.
Case Report: A case of uterine leiomyosarcoma metastasized to the vena cava, excised with the aid of preoperative CT three-dimensional imaging
Authors: Ling Long, Ling Zhou, Demei Ying, Yan Huang, Juan Yang, Lu Zhou, Sufen Li, Xuan He, Rongkai Xie
Journal: Front Oncol (2022)
Keywords: ct 3d imaging, extracorporeal circulation, metastases, uterine leiomyosarcoma, vena cava
MeSH terms: Case Reports

Leiomyosarcoma of the uterus (ULMS) is a rare malignant tumor originating from embryonic mesenchymal cells. ULMS tends to metastasize to the lungs, lymph nodes, liver, and bone. Computed tomography three-dimensional (CT 3D) imaging is an advanced diagnostic technique that can track the vessels and their relationships with tumors and reveal the invasion of vessels, including small vessels, around tumors in any slice. Here, we describe a case in which ULMS extended to the retrohepatic inferior vena cava. To date, no report has described resection of metastatic ULMS of the vena cava through supplemental CT 3D imaging. Our patient presented with right lumbar abdominal pain as the main symptom. After using CT 3D reconstruction to accurately assess the relationship between the tumor and the surrounding organs and blood vessels before the operation, the operation was successfully completed through multidisciplinary surgical collaboration.
Lesions caused by Africanized honeybee stings in three cattle in Brazil
Authors: Saulo Andrade Caldas, Flávio Augusto Soares Graça, Júlia Soares Monteiro de Barros, Márcia Farias Rolim, Tiago da Cunha Peixoto, Paulo Vargas Peixoto
Journal: J Venom Anim Toxins Incl Trop Dis (2013)
Keywords: accidents, bees, cattle, poisoning, sting
MeSH terms: Case Reports

We report three cases of stings by Africanized bees in cattle in the state of Rio de Janeiro, Brazil. Erythema, subcutaneous edema, necrosis accompanied by skin detachment, and subsequent skin regeneration were observed, especially on the head and dewlap. Histopathological examinations performed 45 days later revealed complete skin reepithelialization with moderate dermal fibrosis. The clinical picture and differential diagnosis are discussed in the present manuscript, with a focus on photosensitization, which causes cutaneous lesions on the head (sequela) with cicatricial curving of the ears and can be very similar to what is observed in cattle attacked by swarms of bees. The distinction between photosensitization and bee sting lesions can be made with a focus on history and clinical and pathological aspects.
A novel KCNT1 mutation in a Chinese family with severe autosomal-dominant nocturnal frontal lobe epilepsy
Authors: Na Xie, Weiwei Qin, Jianzhong Deng, Jinxing Qi, Dewang Niu, Guifeng Lu, Qun Wang
Journal: Transl Neurosci (2021)
Keywords: kcnt1, autosomal dominant, psychiatric symptoms, refractory epilepsy, severe adnfle
MeSH terms: Case Reports

We describe a Chinese family with severe autosomal-dominant nocturnal frontal lobe epilepsy (ADNFLE) and psychiatric problems in whom whole-exome family trio sequencing identified a heterozygous mutation in the potassium channel subfamily T, member 1 (KCNT1), a sodium-gated potassium channel gene, which was a novel missense mutation c.2153A>T (p. Asp718Val). The typical characteristics of the three patients in the family were refractory epilepsy, acquired cognitive impairment, and psychiatric problems, which include hallucinations and suicidal thoughts and behaviors. The age at onset was found to be earlier in son and daughter of the proband than that of the proband, as proven by the proband's history of an epileptic seizure at the age of 16 years and her son's and daughter's history of seizures at the age of 8 years. Magnetic resonance imaging findings were negative for any abnormalities. Because of psychiatric symptoms, these three patients were administered risperidone at different times during their illness. The protestor's son had tried fenofibrate treatment, but clinical remission was unclear. In summary, our findings broadened the mutation database in relation to KCNT1 and implicated the sodium-gated potassium channel complex in ADNFLE, more broadly, in the pathogenesis of focal epilepsies.
Spontaneous Rupture of the Anterior Vaginal Wall during the First Stage of Labour
Authors: Meleesa Joy Schultz, Triveni Nanda
Journal: Case Rep Obstet Gynecol (2012)
MeSH terms: Case Reports

The risk of uterine rupture during attempted trial of labor after caesarean delivery (TOLAC) is well documented. However, vaginal rupture (in the absence of obstructed labour) is exceptionally uncommon. Below is described the rare case of a 37-year-old multiparous woman attempting TOLAC, who suffered a vaginal-rather than uterine-rupture, during the first stage of spontaneous labour. This case is an important reminder to obstetricians that concealed ruptures of both the vagina and uterus do occur and must be considered in clinical situations where another explanation is not apparent.
Facial trauma followed by osteomyelitis - Case report
Authors: Gabriela Caovilla Felin, Cassian Taparello, Vinicios Fornari, Paulo Mesquita Filho, Júnior Grandii, Letícia Copatti Dogenski, João Paulo De Carli
Journal: Int J Surg Case Rep (2020)
Keywords: case report, debridement, facial trauma, osteomyelitis
MeSH terms: Case Reports

Introduction:
Osteomyelitis is an inflammatory-infectious state that may involve trabecular bone, cortical bone, bone marrow and periosteum. The source of the infection may be hematogenic, acquired from an adjoining infectious focus or by direct inoculation into the bone. Its treatment involves antibiotic administration and surgery, but its management remains challenging.
Presentation of case:
A 76-year-old male patient with a history of car accident 3 months earlier sought hospital care with nasal fracture and loss of substance in the right frontotemporal region, where a pectoral muscle free graft was performed to reconstruct the facial defect. The grafted region had hyperemic edges, necrotic appearance, purulent discharge and bone exposure in the nasal dorsum. The initial diagnostic hypothesis was an infectious process due to graft rejection, with likely evolution to osteomyelitis. The surgical procedure was performed by a multidisciplinary team and the patient received the antibiotic regimen according to the antibiogram, with hospital discharge after 39 days of hospitalization.
Discussion:
Treatment of osteomyelitis requires the combination of antimicrobial therapy and surgery. Despite surgical and chemotherapeutic advances, it is a difficult condition to treat and there is no universally accepted protocol for treatment.
Conclusion:
Surgical treatment was essential for stabilization of the condition. Due to the complexity of this type of infection in the craniofacial region, planning and execution must be carried out through a multidisciplinary team.
Salvage multivisceral abdominal surgery after caustic ingestion: Case report
Authors: Cristina Maggioni, Luca Voltolini, Stefano Bongiolatti, Fabio Cianchi, Francesco Coratti
Journal: Int J Surg Case Rep (2020)
Keywords: case report, caustic ingestion, caustic lesions, emergency surgery, multi-visceral surgery, suicide attempted
MeSH terms: Case Reports

Introduction:
Ingestion of caustic substances is a life-threatening medical emergency with high morbidity and mortality rate.
Case report:
We present a case report of young patient who presents to our department secondary to ingestion of caustic substances was submitted to multi-visceral resection surgery having saved his life after a long and complex multidisciplinary management.
Conclusion:
An aggressive surgical approach allows successful initial treatment of extended caustic injuries. Early surgical treatment is essential to improve the prognosis in these patients and refer the patient to large and experienced hospital represents the main goal to guarantee a surviving chance.
"U-shaped" mesoportal jump graft to manage portal vein thrombosis during liver transplantation: A case report
Authors: Damiano Patrono, Sara Salomone, Carla Guarnaccia, Francesco Tandoi, Francesco Lupo, Paolo Fonio, Renato Romagnoli
Journal: Int J Surg Case Rep (2020)
Keywords: case report, iliac bifurcation, jump graft, portal vein thrombosis, yerdel classification
MeSH terms: Case Reports

Introduction:
Once considered a contraindication to liver transplantation, portal vein thrombosis still represents a significant challenge to the liver transplant surgeon. Yerdel grade 3 thrombosis is usually managed by interposing a donor iliac vein jump graft between graft portal vein and distal superior mesenteric vein. Venous patch is normally placed in a retrogastric position to avoid its kinking.
Presentation of case:
We report a new technical variant of standard mesoportal jump graft, in which a U-shaped graft was obtained using iliac bifurcation. This technique was used to manage a case of grade 3 portal vein thrombosis in which portal vein was unsuitable due to severe pylephlebitis and pylorus dissection had to be abandoned due to inflammatory changes issue of chronic pancreatitis. The venous patch was of sufficient length and shape to bypass pancreatic head and first duodenum, avoiding the need for its retrogastric placement and pylorus dissection.
Discussion:
This case is a further demonstration that technical approach to portal vein thrombosis must be tailored according to its extent and surgical scenario. In selected cases, use of a curved U-shaped jump graft may represent a valuable option.
Conclusion:
This technical option should be included among options for the management of portal vein thrombosis and be part of the armamentarium of liver transplant surgeon.
Acquired Hemophilia A (FVIII Deficiency) Associated with Papillary Thyroid Cancer: Treatment with Recombinant Porcine FVIII
Authors: S Nguyen, P Teh, J Zhou, E Y Chang, A von Drygalski
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Acquired hemophilia A (AHA) is a rare autoimmune disorder caused by autoantibodies against Factor VIII (FVIII). It has a high mortality due to bleeding complications. FVIIa-based bypassing agents are the first line of treatment but not always effective. Recombinant porcine (rp) FVIII (Obizur®) was recently approved for rescue treatment but with little evidence-based information regarding efficacy. We report a case of papillary thyroid cancer associated with AHA malignancy that responded to a single dose of rpFVIII after failure to achieve hemostasis with FVIIa-based bypassing products.