OpenMed/multicare-articles huggingface dataset:
Case report: Acute pancreatitis in lung adenocarcinoma with small cell transformation after multiple line targeted therapy
Authors: Yaoyao Jing, Xiaoxiao Li, Xiaoyuan Sun, Minghan Ren, Ruoxi Xiao, Jiayu Zhao, Zimin Liu
Journal: Front Oncol (2024)
Keywords: case report, lung adenocarcinoma, metastasis-induced acute pancreatitis, pancreatic metastasis, small cell lung cancer transformation
MeSH terms: Case Reports

In lung cancer, metastasis to the liver, bones, brain, and adrenal glands is more commonly observed, whereas pancreatic metastasis from lung cancer is relatively rare. We present a case of a patient with an 8-year history of lung adenocarcinoma (LUAD) who was admitted to our institution exhibiting symptoms consistent with acute pancreatitis. Subsequent histopathological examination through puncture confirmed the occurrence of pancreatic metastasis originating from small cell lung cancer (SCLC). During a multidisciplinary team discussion, we reached a consensus in diagnosing the patient with post-transformation small cell carcinoma alongside moderately severe pancreatitis, which was determined to be a consequence of pancreatic metastasis. The patient received a regimen of etoposide and cisplatin chemotherapy. This unique clinical case highlights the importance of further investigating the factors contributing to pancreatic metastasis in patients with lung cancer, as the underlying mechanisms remain unclear. Understanding these exceptional metastatic events is vital in devising effective therapeutic strategies and improving patient prognosis. Our findings emphasize the need for continued surveillance and comprehensive management of lung cancer patients, particularly those with resistant forms of the disease, to promptly identify and address the progression of metastatic events to uncommon sites such as the pancreas.
Inoperable Renal Malignant Glomus Tumor, the answers for all the "W's"?
Authors: Pushkala Surianarayanan, Arun Ramdas Menon, Shriley Sundersingh, Anand Raja
Journal: J Kidney Cancer VHL (2024)
Keywords: glomangiosarcoma, glomus tumor, kidney, nephrectomy, pericytic tumor

Glomus tumor, arising from glomus bodies (specialized neurovascular structures involved in thermoregulation), commonly occurs in extremities and rarely in viscera. The spectrum of glomus tumors range from benign tumors to tumors with uncertain malignant potential to tumors of the malignant subtype. A vast majority of visceral glomus tumors are benign. Most common visceral tumors arise in the gastrointestinal tract. Glomus tumors of the kidney are a rare entity of which malignant glomus tumors are exceedingly rare. The index patients in the existing case reports were middle-aged males. We report our experience with malignant glomus tumor of the left kidney in a 60-year-old female, with computed tomography (CT) showing involvement of renal vein and inferior vena cava (IVC). Percutaneous biopsy was performed as imaging did not conform to the appearance of a conventional renal tumor and was reported as malignant glomus tumor after immunohistochemistry. After informed decision, the patient and family elected to proceed with surgery. However, intraoperatively, the left renal mass was found to infiltrate the pancreas, duodenum, aorta, and root of the colonic mesentery due to which surgery was aborted. Biopsy obtained intraoperatively again confirmed diagnosis of left renal malignant glomus tumor. She had an uneventful postoperative recovery. Options of treatment were reviewed by a multidisciplinary board. In light of no proven benefit for systemic therapy, she was referred for supportive care. She was under follow-up and she expired after 7 months due to progressive disease. Our literature review focuses on the clinicopathologic features and the current standard of management of malignant renal glomus tumors.
A case of neoadjuvant chemotherapy-resistant muscle-invasive bladder cancer that markedly responded to pembrolizumab before conversion radical cystectomy
Authors: Ichiro Yonese, Noboru Numao, Kentaro Inamura, Yusuke Yoneoka, Ryo Fujiwara, Yosuke Yasuda, Tomohiko Oguchi, Shinya Yamamoto, Takeshi Yuasa, Junji Yonese
Journal: IJU Case Rep (2023)
Keywords: bladder cancer, conversion surgery, neoadjuvant chemotherapy, neoadjuvant immunotherapy
MeSH terms: Case Reports

Introduction:
Recently, perioperative use of immune checkpoint inhibitors has improved the prognosis of muscle-invasive bladder cancer. It is unclear whether radical cystectomy or systemic pembrolizumab is the optimal next treatment in patients with muscle-invasive bladder cancer and progressive disease in the pelvic lymph node following neoadjuvant chemotherapy (NAC).
Case presentation:
A 62-year-old woman with cT3N0M0 bladder cancer and high programmed death-ligand 1 expression developed solitary obturator lymph node metastasis following 5 cycles of neoadjuvant chemotherapy. Six subsequent cycles of pembrolizumab shrank the lymph node significantly, and conversion radical cystectomy was planned. Pathologically, only carcinoma in situ around the scar of transurethral resection of bladder tumor remained in the primary tumor, and the accumulation of foamy macrophages and fibrosis without viable tumor cells was observed in the dissected lymph node. Eighteen months passed without a recurrence following radical cystectomy.
Conclusion:
Pembrolizumab administration before radical cystectomy achieved a good response in a patient with obturator lymph node metastasis following neoadjuvant chemotherapy.
Case report: Severe asymptomatic hypertriglyceridemia associated with long-term low-dose rapamycin administration in a healthy middle-aged Labrador retriever
Authors: Jeremy B Evans, Lucy Chou, Matt Kaeberlein, Daniel E L Promislow, Kate E Creevy
Journal: Front Vet Sci (2023)
Keywords: adverse effect, dog, dyslipidemia, lipemia, side effect
MeSH terms: Case Reports

Rapamycin is an mTOR inhibitor that has been shown to extend the lifespan of laboratory model organisms. In humans, rapamycin is used at higher doses as an immunosuppressive medication to prevent organ rejection. Numerous adverse effects are seen with rapamycin treatment in humans, with one of the most common being dysregulation of lipid metabolism. In humans, this often manifests as mild to moderate serum lipid elevations, with a small subset developing extreme triglyceride elevations. This case report describes an eight-year-old, castrated male, clinically healthy Labrador retriever who developed severe hypertriglyceridemia associated with low-dose rapamycin administration over a six-month period. During this time, the dog was asymptomatic and displayed no other clinical abnormalities, aside from a progressive lipemia. Within 15 days of discontinuing rapamycin treatment, and with no targeted lipemic intervention, the dog's lipemia and hypertriglyceridemia completely resolved.
Case report: meningeal lymphangiogenesis around ependymoma forming along the dura matter
Authors: Utaro Hino, Ryota Tamura, Masahiro Yo, Yoshitaka Kase, Noboru Tsuda, Tsubasa Miyauchi, Junki Sogano, Kosuke Karatsu, Tomoru Miwa, Masahiro Toda
Journal: Front Oncol (2024)
Keywords: case report, dura, ependymoma, lymphangiogenesis, podoplanin
MeSH terms: Case Reports

Recently, there has been growing interest in the presence and function of meningeal lymphatic vessels, with no direct evidence linking these vessels to primary brain tumors. We report a unique case of recurrent ependymoma in the dura mater, showing histopathological signs of lymphatic proliferation at the tumor attachment site. The patient initially presented with a headache, and was diagnosed with ZFTA fusion-positive supratentorial ependymoma, central nervous system WHO Grade 3. Following multiple dura mater recurrences and surgery, the fifth procedure revealed numerous tumors contralateral to the original site, with genetic testing confirming ZFTA fusion positivity, indicating recurrent ependymoma. Immunohistochemical analysis showed D2-40+ lymphatic vessel proliferation around tumor attachment sites within the dura mater. Elevated expression of ZEB1, which is an epithelial-to-mesenchymal transition factor, was also observed, implicating potential involvement in the unique pathophysiology. The present case suggests a new process of metastasis through meningeal lymphatic vessels, although we were unable to visually confirm tumor cell infiltration into the lymphatic vessels. This case is the first report suggesting ependymoma metastasis through dural lymphatic vessels, underlining the need for further case accumulation and study to understand the mechanisms of this phenomenon.
Critical Case of a Preterm Infant Infected With Respiratory Syncytial Virus Managed in the Pediatric Intensive Care Unit: A Case Report
Authors: Amaal F Alshihabi, Saleh A Alnass Sr, Fatimah S Alsammak, Muhammad S Al Abdrabalnabi
Journal: Cureus (2024)
Keywords: acute bronchiolitis, high flow nasal cannula (hfnc), high-frequency oscillator ventilator (hfov), inhaled nitric oxide, non-invasive positive pressure ventilation (nippv), pediatric intensive care unit(picu), positive end-expiratory pressure (peep), pressure control ventilation method, respiratory syncytial virus (rsv), respiratory tract
MeSH terms: Case Reports

We describe a critical case of a respiratory syncytial virus (RSV) infection in a preterm infant resulting in respiratory failure with advanced respiratory interventions and discharge from our hospital without the requirement for home oxygen therapy or tube feeding. The infant, delivered at 35 weeks gestation due to a premature rupture of the membranes with a birth weight of 2 kg, initially demonstrated a stable postnatal course. The baby required no resuscitation, with Apgar scores of 8 and 9 at one and five minutes, respectively. The infant was discharged in good condition after four days of hospitalization. This report presents a critical case of RSV infection in a preterm infant requiring intensive care. The infant, born at 35 weeks gestation, initially appeared healthy but developed severe symptoms at 22 days old. The emergency evaluation revealed significant respiratory distress and confirmed RSV pneumonia. Following extensive interventions, including mechanical ventilation to manage severe symptoms, along with complications such as pneumothorax and a cardiac arrest episode, the infant exhibited a positive response to subsequent treatments. The infant responded positively to high-frequency oscillatory ventilation and inhaled nitric oxide. Gradual weaning from advanced ventilation led to successful extubation, followed by recovery with high-flow nasal cannula therapy. The case highlights the challenges of managing severe RSV infections in preterm infants and the efficacy of intensive care interventions in facilitating the infant's remarkable recovery and discharge.
Recurrent Spontaneous Pneumothorax in a Young Male With Duchenne Muscular Dystrophy Following COVID-19 Infection
Authors: Pramod Bhattarai, Monika Karki
Journal: Cureus (2024)
Keywords: chronic hypoxic respiratory failure, covid-19, duchenne muscular dystrophy (dmd), nippv, robotic thoracoscopy, secondary spontaneous pneumothorax
MeSH terms: Case Reports

Duchene muscular dystrophy (DMD) is a genetic disorder primarily affecting males. It is characterized by progressive muscle tissue degeneration. Patients with DMD are at an increased risk of respiratory infections, including coronavirus disease 20019 (COVID-19), due to weakened respiratory muscles. We present a case of a young male with DMD who experienced recurrent pneumothorax 10 months after recovering from a COVID-19 infection. The patient required prompt medical intervention, including a chest tube, multiple surgeries, and mechanical pleurodesis. This case highlights the importance of recognizing recurring pneumothorax as a potential complication of COVID-19, particularly in patients with underlying neuromuscular disorders, as it is a medical emergency requiring prompt treatment to prevent respiratory compromise.
Azacitidine induced lung injury: report and contemporary discussion on diagnosis and management
Authors: Ruah Alyamany, Ahmed Alnughmush, Malak Almutlaq, Mohammed Alyamany, Mansour Alfayez
Journal: Front Oncol (2024)
Keywords: acute lung injury, acute myeloid leukemia, azaciditine, azacitidine induced lung injury myelodysplastic syndrome, hypomethylating agents, pneumonitis
MeSH terms: Review

Azacitidine, a hypomethylating agent, has caused a paradigm shift in the outcomes of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not eligible for stem cell transplantation, particularly in combination with BCL2 and IDH inhibitors. Azacitidine and Azacitidine-based combinations have been widely considered a safe low-intensity therapy when compared to traditional conventional treatments. The development of lung toxicity from azacitidine is not a well-characterized adverse event. However, if it happens, it can be fatal, especially if not recognized and treated promptly. In this review, we aim to familiarize the reader with the presentation of azacitidine-induced lung injury, provide our suggested approach to management based on our experience and the current understanding of its mechanism, and review the literature of 20 case reports available on this topic.
Social support networks and life cycle stage of Venezuelan immigrant families
Authors: Marcela Possato Correa da Rosa, Gisele Cristina Manfrini, Janaína Medeiros de Souza, Ana Cristina Oliveira da Silva Hoffmann, Rosane Goncalves Nitschke, Ivonete Teresinha Schülter Buss Heidemann, Jaime Alonso Caravaca-Morera
Journal: Rev Bras Enferm (2023)
MeSH terms: Emigrants and Immigrants, Social Support, Child, Child, Preschool, Data Collection, Humans, Nuclear Family, Qualitative Research

Objective:
To understand the structures of social networks of interiorized Venezuelan immigrant families and the life cycle stage they are in.
Methods:
Qualitative multiple-case study with families from the Interiorization Program residing in the Greater Florianópolis, Brazil. Screening occurred through social networks and key informants. For data collection, the photovoice technique and semi-structured interviews were used, categorized with the help of the Atlas.ti software. Genograms and ecomaps were elaborated.
Results:
Of the 4 families interviewed, totaling 7 members with young children, the nuclear family was identified as the main informal support network. Formal networks included schools, churches, and civil society.
Conclusion:
Families rely heavily on their nuclear structure for support, with formal institutions acting as secondary resources. The predominant life cycle stage is focused on families with young children. More efforts are needed to strengthen formal support networks.
Can COVID-19 impact the natural history of paracoccidioidomycosis? Insights from an atypical chronic form of the mycosis
Authors: César Augusto Tomaz de Souza, Cesar Cilento Ponce, Gisele Burlamaqui Klautau, Nathan Costa Marques, Wladimir Queiroz, Rosely Antunes Patzina, Gil Benard, José Angelo Lauletta Lindoso
Journal: Rev Inst Med Trop Sao Paulo (2023)
MeSH terms: COVID-19 / complications, Paracoccidioides, Paracoccidioidomycosis / complications, Paracoccidioidomycosis / diagnosis, Case Reports, Antifungal Agents / therapeutic use, Humans, Male, Middle Aged, SARS-CoV-2, Ulcer, Antifungal Agents

Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides spp. It can occur as an acute/subacute form (A/SAF), a chronic form (CF) and rarely as a mixed form combining the features of the two aforementioned forms in an immunocompromised patient. Here, we report a 56-year-old male patient with CF-PCM who presented with atypical manifestations, including the development of an initial esophageal ulcer, followed by central nervous system (CNS) lesions and cervical and abdominal lymphatic involvement concomitant with severe SARS-CoV-2 infection. He was HIV-negative and had no other signs of previous immunodeficiency. Biopsy of the ulcer confirmed its mycotic etiology. He was hospitalized for treatment of COVID-19 and required supplemental oxygen in the intensive unit. The patient recovered without the need for invasive ventilatory support. Investigation of the extent of disease during hospitalization revealed severe lymphatic involvement typical of A/SAF, although the patient`s long history of high-risk exposure to PCM, and lung involvement typical of the CF. Esophageal involvement is rare in non-immunosuppressed PCM patients. CNS involvement is also rare. We suggest that the immunological imbalance caused by the severe COVID-19 infection may have contributed to the patient developing atypical severe CF, which resembles the PCM mixed form of immunosuppressed patients. Severe COVID-19 infection is known to impair the cell-mediated immune response, including the antiviral response, through T-lymphopenia, decreased NK cell counts and T-cell exhaustion. We hypothesize that these alterations would also impair antifungal defenses. Our case highlights the potential influence of COVID-19 on the course of PCM. Fortunately, the patient was timely treated for both diseases, evolving favorably.
TTN novel splice variant in familial dilated cardiomyopathy and splice variants review: a case report
Authors: Paul León, Paula Franco, Nicole Hinojosa, Kevin Torres, Andrés Moreano, Vanessa I Romero
Journal: Front Cardiovasc Med (2024)
Keywords: ecuador, ttn gene, case report, dilated cardiomyopathy, splicing, truncated variants
MeSH terms: Case Reports

This case report details the identification of a novel likely pathogenic splicing variant in the TTN gene, associated with dilated cardiomyopathy (DCM), in a 42-year-old male patient presenting with early-onset heart failure and reduced ejection fraction. DCM is a nonischemic heart condition characterized by left biventricular dilation and systolic dysfunction, with approximately one-third of cases being familial and often linked to genetic mutations. The TTN gene, encoding the largest human protein essential for muscle contraction and sarcomere structure, is implicated in about 25% of DCM cases through mutations, especially truncating variants. Our investigation revealed a previously unreported G > C mutation at the splice acceptor site in intron 356 of TTN, confirmed by Sanger sequencing and not found in population databases, suggesting a novel contribution to the understanding of DCM etiology. The case emphasizes the critical role of the TTN gene in cardiac function and the genetic complexity underlying DCM. A comprehensive literature review highlighted the prevalence and significance of splice variants in the TTN gene, particularly those affecting the titin A-band, which is known for its role in muscle contraction and stability. This variant's identification underscores the importance of genetic screening in patients with DCM, offering insights into the disease's familial transmission and potential therapeutic targets. Our findings contribute to the expanding knowledge of genetic factors in DCM, demonstrating the necessity of integrating genetic diagnostics in cardiovascular medicine. This case supports the growing evidence linking splicing mutations in specific regions of the TTN gene to DCM development and underscores the importance of genetic counseling and testing in managing heart disease.
Immune checkpoint inhibitors-related pancreatitis with fulminant type 1 diabetes mellitus: case report and literature review
Authors: Wei Fang, Yang Gao, Xiaoyan Shi, Xiaoran Zhang, Shan Zhou, Hongxia Zhu, Wei Yan, Huanping Wang
Journal: Front Immunol (2023)
Keywords: case report, immune checkpoint inhibitors, immune-related adverse events, immunotherapy, literature review
MeSH terms: Diabetes Mellitus, Type 1 / complications, Diabetes Mellitus, Type 1 / diagnosis, Endocrine System Diseases, Neoplasms / drug therapy, Pancreatitis / chemically induced, Pancreatitis / diagnosis, Review, Case Reports, Research Support, Non-U.S. Gov't, Acute Disease, Humans, Immune Checkpoint Inhibitors / therapeutic use, Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) are increasingly being used in the treatment of advanced human malignancies. ICIs-related adverse events, including pancreatitis and diabetes, have been individually characterized in the literature. The co-occurrence of ICIs-related pancreatitis with diabetes is rare and easily overlooked, but it is often severe or fatal. We present a patient with renal tumor resection who was treated with injection of the PD-L1 inhibitor toripalimab and eventually developed acute pancreatitis and fulminant type 1 diabetes mellitus. In addition, we conducted a literature review of ICIs-related pancreatitis with diabetes. The case in our report presented with paroxysmal abdominal pain and loss of appetite. Intravenous fluids and insulin infusion improved the patient's pancreatitis and explosive hyperglycemia. This article suggests that ICIs can affect endocrine and exocrine functions of the pancreas, while providing information and new perspectives for the diagnosis and treatment of this challenging rare disease, helping inspire clinicians for the early identification and effective management of similar cases.
Case Report: Dislocation of lateral menisci secondary to congenital lateral tibiofemoral cartilage thickening in both knees
Authors: Xingliang Zhang, Wentao Li, Zijin Li, Yibing Xie, Chenyu Zhu, Shaoyang Lei, Shuqian Zhang
Journal: Front Surg (2024)
Keywords: cartilage thickness, functional adaptation, knee joint, magnetic resonance imaging, spectral ct
MeSH terms: Case Reports

A 24-year-old male patient complained of mild knee pain after jogging. The subsequent knee MRI demonstrated bilateral lateral thickened tibiofemoral cartilages, evidenced by deformities of the bilateral subchondral bone beneath the lateral femoral condyle cartilage. The corresponding dislocations of almost all the left lateral meniscus and part of the right lateral meniscus to the center of the joint were detected. After excluding diagnoses of congenital ring-shaped meniscus, bucket handle tear of the C-shaped lateral meniscus, and central tear of the discoid meniscus, the displacement of all or part of the lateral meniscus into the intercondylar notch was considered a consequence of congenital thickening of the lateral superior and inferior cartilage. This case may report a new variant of knee joint pathology.
A Case of Congenital Nephrotic Syndrome with Crescents Caused by a Novel Compound Heterozygous Pairing of NPHS1 Genetic Variants
Authors: Kyle N Goodman, Pongpratch Puapatanakul, Kevin T Barton, Mai He, Jeffrey H Miner, Joseph P Gaut
Journal: Case Rep Nephrol (2024)
MeSH terms: Case Reports

Congenital nephrotic syndrome is an autosomal recessive inherited disorder that manifests as steroid-resistant massive proteinuria in the first three months of life. Defects in the glomerular filtration mechanism are the primary etiology. We present a child who developed severe nephrotic syndrome at two weeks of age and eventually required a bilateral nephrectomy. Genetic testing revealed compound heterozygous variants in NPHS1 including a known pathogenic variant and a missense variant of uncertain significance. Light microscopy revealed crescent formation-an atypical finding in congenital nephrotic syndrome caused by nephrin variants-in addition to focal segmental and global glomerulosclerosis. Electron microscopy showed diffuse podocyte foot process effacement. Confocal and Airyscan immunofluorescence microcopy showed aggregation of nephrin in the podocyte cell body that is not a result of diffuse podocyte foot process effacement as seen in minimal change disease. These findings confirm the novel variant as pathogenic.