OpenMed/multicare-articles huggingface dataset:
Paratesticular metastasis from colorectal adenocarcinoma presenting as hydrocele: a rare case report and literature review
Authors: XiaoJun Huang, KeLi Xu, Yin Zhao, MinHui Chen, ZheYang Li
Journal: Front Oncol (2024)
Keywords: case report, colorectal neoplasm, neoplasm metastasis, paratesticular metastasis, testicular hydrocele, testicular neoplasm, therapeutics
MeSH terms: Case Reports

Colorectal cancer, with the liver being the most common site of distant metastasis, followed by the lungs and bones. Although reports of metastasis to the testis exist, paratesticular metastasis is extremely rare. A 37-year-old male presented with scrotal swelling. Ultrasound revealed hydrocele of the tunica vaginalis. The patient underwent routine surgical treatment, and postoperative pathology of the tunica vaginalis indicated adenocarcinoma of gastrointestinal origin. Colonoscopic biopsy confirmed adenocarcinoma of the sigmoid colon. After six months of systemic therapy, tumor reduction surgery was performed in conjunction with tunica vaginalis excision. Postoperative pathology suggested histological similarity in both sites, with immunohistochemistry results supporting the diagnosis of sigmoid colon adenocarcinoma metastasizing to the tunica vaginalis. We conducted a literature review, summarizing and discussing clinical presentations, metastatic pathways, and diagnostic approaches.
IgG4-related diseases involving pleura: a case report and literature review
Authors: Anli Zuo, Xinyi Liu, Zihan Guo, Yunxiu Jiang, Degan Lu
Journal: Front Med (Lausanne) (2023)
Keywords: igg4-related disease, case report, diagnosis, idiopathic pleural lesions, pleural effusion, treatment
MeSH terms: Case Reports

Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibro-inflammatory disease with the potential to involve virtually all organs, including the pancreas, kidneys, lungs, and pleura, amongst others. IgG4-RD pleural involvement may cause diverse complications such as pleural effusion, pleural thickening, pleural nodules, and additional lesions, which can be presented in many clinical diseases. However, isolated cases of pleurisy are still rare in IgG4-RD. We report a 72-year-old patient who was admitted to our hospital with cough, expectoration, and fatigue. He had a right-sided pleural effusion, and the tissue evaluation of the pleural biopsy by medical thoracoscopy met the diagnostic criteria of IgG4-RD. His serum IgG4 levels were elevated and he was finally diagnosed with IgG4-RD pleural involvement. He was subsequently started on prednisone 40 mg daily and his pleural effusion was almost disappeared 2 weeks later. This paper reported a case of IgG4-RD who had exclusive involvement of the pleura and highlighted the significance of considering IgG4-RD as a potential diagnosis in patients with unexplained pleural effusion.
Case report: Cerebral amyloid angiopathy-related inflammation in a patient with granulomatosis with polyangiitis
Authors: Rebecca M Seifert, Michael Rauch, Randolf Klingebiel, Lennart-Maximilian Boese, Isabell Greeve, Martin Rudwaleit, Wolf-Rüdiger Schäbitz
Journal: Front Neurol (2023)
Keywords: case report, cerebral amyloid angiopathy-related inflammation, granulomatosis with polyangiitis, magnetic resonance imaging, neuroinflammation amyloid, vasculitis
MeSH terms: Case Reports

Background:
Cerebral amyloid angiopathy-related inflammation (CAA-ri) defines a subacute autoimmune encephalopathy, which is presumably caused by increased CSF concentrations of anti-Aβ autoantibodies. This autoinflammatory reaction is temporally and regionally associated with microglial activation, inflammation and radiological presence of vasogenic edema. Clinical characteristics include progressive demential development as well as headache and epileptic seizures. In the absence of histopathologic confirmation, the criteria defined by Auriel et al. allow diagnosis of probable resp. possible CAA-ri. CAA-ri shows responsiveness to immunosuppressive therapies and a possible coexistence with other autoinflammatory diseases.
Methods:
We present a case report and literature review on the diagnosis of CAA-ri in a patient with known granulomatosis with polyangiitis (GPA).
Results:
Initially, the presented patient showed neuropsychiatric abnormalities and latent arm paresis. Due to slight increase in CSF cell count, an initial antiviral therapy was started. MR tomography showed a pronounced frontotemporal edema as well as cerebral microhemorrhages, leading to the diagnosis of CAA-ri. Subsequent high-dose steroid treatment followed by six intravenous cyclophosphamide pulses resulted in decreased CSF cell count and regression of cerebral MRI findings.
Conclusion:
The symptoms observed in the patient are consistent with previous case reports on CAA-ri. Due to previously known GPA, we considered a cerebral manifestation of this disease as a differential diagnosis. However, absence of pachymeningitis as well as granulomatous infiltrations on imaging made cerebral GPA less likely. An increased risk for Aβ-associated pathologies in systemic rheumatic diseases is discussed variously.
Decompression of a Dentigerous Cyst Treatment in Mixed Dentition: A Case Report with 5 Years Follow-Up
Authors: Antoine Berberi, Georges Aad, Marise Nassar, Gwenaëlle Maalouf, Nabih Nader
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Among developmental odontogenic cysts, the dentigerous type is the second most prevailing one. It is a benign intraosseous lesion commonly affecting the mandibular region. Dentigerous cysts present a high prevalence in children as they can be caused by the eruption of permanent teeth or the infection of deciduous ones. The adopted treatment modalities include enucleation (cystectomy), marsupialization, and decompression. Decompression maintains communication between the cyst and the oral medium through a sutured fixed device, namely an acrylic stent or a pretrimmed disposable suction tube. In the mixed dentition, the extraction of the affected primary teeth and the decompression approach is recommended, especially since children and parents are more tolerant of conservative treatments. We report in this study, a case of a 9-year-old boy complaining of a painful swelling in the left mandibular region. Intraoral and radiological examination revealed an expansion of the buccal and lingual cortical plates associated with teeth #73, #74, and #75 and a well-limited, unilocular radiolucent image extending from the distal aspect of tooth #31 to the mesial aspect of tooth #36 involving the crowns of the unerupted teeth #33, #34, and #35. The preliminary diagnosis was in favor of a dentigerous cyst. The treatment was to extract the deciduous teeth and to use a sterile tube for decompression. The patient was followed up for 5 years, a complete remission of the cyst was observed and the teeth #33, #34, and #35 re-erupted normally on the mandibular arch.
Acute Cardiomyopathy in a Prisoner on a Hunger Strike
Authors: Tenes J Paul, Glenn Stokken
Journal: Cureus (2024)
Keywords: acute myocardial injury, anorexia nervosa (an), cardiac mri (cmr), heart failure with reduced ejection fraction, hunger strike, male prisoner, short-term starvation, stress-induced cardiomyopathy, sudden cardiac death, takotsubo cardiomyopathy
MeSH terms: Case Reports

Chronic starvation and its associated metabolic derangements are known to have dangerous cardiovascular implications in the long term, but less is known about the cardiovascular consequences of acute starvation, such as in the context of a hunger strike. This case describes a patient who presented with signs and symptoms of acute coronary syndrome which began two weeks into a hunger strike and was ultimately found to have stress cardiomyopathy with complete resolution on subsequent imaging.
Reversible splenial lesion syndrome in children: a retrospective study of 130 cases
Authors: Hui Chen, Xiongying Yu, Yong Chen, Huaping Wu, Zhuqiang Wu, Jianmin Zhong, Zhenyu Tang
Journal: Front Neurol (2023)
Keywords: children, convulsions, infection, magnetic resonance imaging, reversible splenial lesion syndrome

Background:
Reversible splenial lesion syndrome (RESLES) is a new clinico-radiological syndrome. We retrospectively analyzed the clinical features of 130 children with RESLES in China, which is the largest case series available in the literature.
Methods:
The clinical data of children diagnosed as RESLES in Jiangxi Provincial Children's Hospital between 2017 and 2023 were retrospectively analyzed. The 130 cases were divided into two groups: ≤ 3 years old group (group A) (n = 83) and > 3 years old group (group B) (n = 47). The chi-squared test or Fisher's test was used to evaluate the data.
Results:
The vast majority of patients (127/130 cases, 97.7%) had prodromal symptoms of infection. Preceding infections of the gastrointestinal tract were statistically more significant in group A (60/83, 72.3%) than in group B (11/47, 23.4%) (P < 0.05). Preceding infections of the respiratory tract were statistically more significant in group B (33/47, 70.2%) than in group A (17/83, 20.5%) (P < 0.05). Seizures were statistically more significant in group A (82/83, 98.8%) than in group B (24/47,51.1%) (P < 0.05). The disturbance of consciousness and headache/dizziness were statistically more significant in group B (27/47, 57.4%; 37/47, 78.7%) than in group A (3/83, 3.6%; 1/83, 1.2%), respectively (P < 0.05). Convulsions with mild gastroenteritis (CwG) were statistically more significant in group A (50/83, 60.2%) than in group B (8/47, 17.0%) (P < 0.05). However, encephalitis/encephalopathy was statistically more significant in group B (20/47, 42.6%) than in group A (10/83, 12.0%) (P < 0.05). MRI showed cytotoxic edema in typical locations (RESLES type-1 limited to the splenium of the corpus callosum and RESLES type-2 spread to the entire corpus callosum, adjacent white matter, or both). There was full recovery of the lesions of MRI in all cases from 3 days to 50 days after the initial examinations. All the children showed normal neurodevelopment.
Conclusion:
Infection was the most common cause of RESLES. Infections of the gastrointestinal tract are common in ≤ 3 years old children, while infections of the respiratory tract are common in >3 years old children. Younger patients are more likely to develop convulsions, and older children were more likely to have symptoms with disturbance of consciousness and headache/dizziness. RESLES has characteristic MRI manifestations and a good prognosis.
Stick to your role! Stability of personal values expressed in large language models
Authors: Grgur Kovač, Rémy Portelas, Masataka Sawayama, Peter Ford Dominey, Pierre-Yves Oudeyer
Journal: PLoS One (2024)
MeSH terms: Language, Humans, Surveys and Questionnaires

The standard way to study Large Language Models (LLMs) through benchmarks or psychology questionnaires is to provide many different queries from similar minimal contexts (e.g. multiple choice questions). However, due to LLM's highly context-dependent nature, conclusions from such minimal-context evaluations may be little informative about the model's behavior in deployment (where it will be exposed to many new contexts). We argue that context-dependence should be studied as another dimension of LLM comparison alongside others such as cognitive abilities, knowledge, or model size. In this paper, we present a case-study about the stability of value expression over different contexts (simulated conversations on different topics), and as measured using a standard psychology questionnaire (PVQ) and behavioral downstream tasks. We consider 21 LLMs from six families. Reusing methods from psychology, we study Rank-order stability on the population (interpersonal) level, and Ipsative stability on the individual (intrapersonal) level. We explore two settings: with and without instructing LLMs to simulate particular personalities. We observe similar trends in the stability of models and model families-Mixtral, Mistral, GPT-3.5 and Qwen families being more stable than LLaMa-2 and Phi-over those two settings, two different simulated populations, and even on three downstream behavioral tasks. When instructed to simulate particular personas, LLMs exhibit low Rank-Order stability, and this stability further diminishes with conversation length. This highlights the need for future research directions on LLMs that can coherently simulate a diversity of personas, as well as how context-dependence can be studied in more thorough and efficient ways. This paper provides a foundational step in that direction, and, to our knowledge, it is the first study of value stability in LLMs. The project website with code is available at https://sites.google.com/view/llmvaluestability.
Physiotherapy Intervention Focusing on Proprioceptive Retraining for Tibial Pseudoarthrosis Patients Operated With Ilizarov External Fixator: A Case Report
Authors: Anushka Rohankar, Vaishnavi M Thakre, Maithili M Deshpande
Journal: Cureus (2024)
Keywords: case report, ilizarov’s fixator, physiotherapy, pseudoarthrosis, rehabilitation, tibia
MeSH terms: Case Reports

Pseudoarthrosis of the tibia is an uncommon condition that occurs due to non-union of bone and typically requires surgery. It may cause fractures that develop spontaneously or after minor trauma. Physiotherapy is an excellent treatment for this uncommon condition. The tibia of the affected limb becomes malformed and bends backwards. This case report outlines the interdisciplinary programme adopted to successfully manage a 23-year-old female patient with right-sided tibial pseudoarthrosis. Following the implantation of Ilizarov's external fixator to correct the deformity, the patient was referred to the physiotherapy department for post-operative management. After the implementation of a tailor-made physiotherapy protocol focusing on proprioceptive retraining, significant improvements were seen in her joint proprioception, muscular strength and range of motion.
Diagnosis and Treatment of Metastatic Colon Cancer in Pregnancy First Presenting as Multiple Liver Masses: A Case Report
Authors: Mengjia Wu, Koji Otsuka, Yoshiaki Furusawa, Isao Otsuka, Tokumasa Suemitsu
Journal: Cureus (2024)
Keywords: colorectal cancer, diagnosis, multidisciplinary team, pregnancy, treatment
MeSH terms: Case Reports

Colorectal cancer (CRC) is the second most common cancer in women in Japan. However, it is uncommon during pregnancy. CRC diagnosis during pregnancy is often complicated and delayed due to the overlapping of symptoms, such as abdominal pain and nausea, with those of pregnancy and the limitations placed on potential diagnostic imaging and testing because of concerns for the fetus. A 39-year-old woman was referred from a local hospital at 32 weeks gestation after persistent right abdominal pain, which prompted an ultrasound that showed multiple liver lesions suggestive of malignancy. A combination of non-contrast computed tomography, non-contrast magnetic resonance imaging, contrast-enhanced ultrasound, and colonoscopy was utilized to make a definitive diagnosis; ultimately, colonoscopy confirmed the diagnosis of colon cancer with liver metastasis. A discussion within a multidisciplinary team led to the decision to deliver at 34 weeks by cesarean section and a left hemicolectomy was performed after delivery. The neonate was admitted to the neonatal intensive care unit due to prematurity but had no other complications. Chemotherapy was promptly initiated, and treatment was continued on an outpatient basis. Diagnostic algorithms for CRC during pregnancy are not yet well-established; however, the prognosis of CRC during pregnancy is poor, and clinicians should not hesitate to perform the necessary testing and consult experts in fields such as neonatology, medical oncology, internal medicine, and gastrointestinal surgery. Early diagnosis and intervention are essential for optimizing outcomes for both the mother and the fetus.
Successful dabrafenib and trametinib combination therapy in a patient with recurrent BRAFV600E-mutant non-small-cell lung cancer and coexisting radiation pneumonitis
Authors: Eriko Nakamura, Masahide Ota, Ryosuke Matsuda, Maiko Takeda, Tomomi Fujii, Yoshifumi Yamamoto, Shigeto Hontsu, Motoo Yamauchi, Masanori Yoshikawa, Shigeo Muro
Journal: Respirol Case Rep (2024)
Keywords: braf, dabrafenib, non‐small‐cell lung cancer, radiation pneumonitis, trametinib
MeSH terms: Case Reports

There have been several reports of drug-induced lung injury caused by molecular-targeted agents. Additionally, medical history of interstitial lung disease and chest irradiation are established risk factors for the development and progression of drug-induced lung injury. Moreover, the presence of fibrosis on chest computed tomography before treatment is a predictive factor for the appearance of pneumonia induced by anticancer drugs. Accordingly, patients with a history of interstitial lung disease or pneumonitis were excluded from clinical trials of dabrafenib and trametinib combination therapy for patients with previously treated BRAF V600E-mutant metastatic non-small-cell lung cancer. This article presents a case of successful dabrafenib and trametinib combination therapy in a patient with BRAF V600E-mutant non-small-cell lung cancer who had a history of radiation pneumonitis and developed recurrence after conventional chemoradiotherapy.
Biphasic Peritoneal Mesothelioma Is a Rare Tumor and a Diagnostic Challenge: A Case Report
Authors: Eihab A Subahi, Abdalla Fadul, Abdelaziz Mohamed, Ahmed Alsayed, Elrazi A Ali, Sagda Sayed, Salma Mustafa, Bara Wazwaz, Mohamed H Fadul
Journal: Cureus (2024)
Keywords: biphasic mesothelioma, case report, malignant mesothelioma, mesothelioma histopathology, peritoneal mesothelioma
MeSH terms: Case Reports

Malignant peritoneal mesothelioma (MPM) is a rare subtype of mesothelioma. There are three main histological subtypes of mesothelioma: epithelioid, sarcomatoid, and biphasic (mixed). Risk factors include asbestos exposure, previous radiation, and some germline mutations. Treatment includes surgical resection of amenable tumors or cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. We present a 34-year-old male who presented with weight loss, night sweats, and pleuritic chest pain and was found to have ascites with peritoneal nodularity on abdominal imaging. He had a history of tuberculosis contact, but no history of asbestos exposure. After a long challenging and interesting diagnostic process, he was subsequently diagnosed with biphasic MPM. The diagnostic challenge stems from not only the rarity of the tumor but also from the absence of risk factors, the unavailability of some special laboratory investigations, in addition to the potentially misleading effect of tuberculosis exposure history, a top differential diagnosis in the case. This is a case report of a really challenging and totally unexpected diagnosis of biphasic peritoneal mesothelioma in a patient with tuberculosis exposure, constitutional symptoms, but no history of asbestos exposure. It highlights the diagnostic process as well as the importance of early diagnosis to improve the overall survival of such malignancies.
Fibroblast growth factor receptor 1 gene mutation as a potential risk factor for spontaneous intracranial hemorrhage in pediatric low-grade glioma patients
Authors: Maxine Gonzalez-Vega, Brittany M Lebert, Stephani Campion, Aaron Wagner, Ana Aguilar-Bonilla, Amy A Smith
Journal: Neurooncol Adv (2024)
Keywords: fgfr1, lgg, ptpn11, spontaneous hemorrhage

Background:
Fibroblast growth factor receptor 1 (FGFR1) mutations have been associated with poorer prognoses in pediatric central nervous system tumor patients. A recent study highlighted a link between FGFR1 mutations and spontaneous intracranial hemorrhage (ICH), demonstrating that all patients with an FGFR1 alteration experienced hemorrhage at some point during their course of treatment.
Methods:
The current study examined 50 out of 67 pediatric patients with low-grade gliomas (LGGs) who had genomic testing between 2011 and 2022 at our institution to determine whether a correlation exists between FGFR1 mutations and spontaneous ICH.
Results:
We found that of the 50 patients with genomic data, 7 (14%) experienced ICH, and an additional spontaneous hemorrhage was recorded; however, no genomic testing was performed for this case. Five of the seven patients (71.4%) had an FGFR1 modification. In our patient population, 6 expressed a detectable FGFR1 mutation (66.7% [4/6] had N546K alteration, 16.7% [1/6] FGFR1 exons duplication, and 16.7% [1/6] had a variant of unknown significance [VUS]). The patient with the FGFR1 VUS had no reported spontaneous hemorrhage. Statistical analysis found a significant association between FGFR1 and spontaneous intracranial hemorrhage (P-value = < .0001). In the patient population, all cases of PTPN11 alterations (n = 3) co-occurred with FGFR1 mutations.
Conclusions:
Our case series highlights this link between the FGFR1 mutation and spontaneous intracranial hemorrhage in pediatric LGGs.
Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
Authors: Caroline S Jansen, Yujin Choi, Sean T Evans, Rachel Greenwald, Joseph A Behnke, Caitlin Hartman, Haydn Kissick, Lara R Harik, Mehmet Asim Bilen
Journal: Front Oncol (2023)
Keywords: cabozantinib, case report, extrarenal clear cell renal cell carcinoma, immunotherapy, nivolumab, splenic renal cell carcinoma, targeted therapy, tyrosine kinase
MeSH terms: Case Reports

Extrarenal clear cell renal cell carcinoma (eccRCC) is a rare type of RCC that arises in areas other than the kidney. Given its rarity, consensus guidelines for optimal treatment of eccRCC have not been established, and the literature is lacking any reports of patient response to systemic therapy and any reports of administration of immunotherapy to patients with ecRCC. Here, we present the case of a patient in their 60s with eccRCC arising in the spleen. The patient underwent splenic resection and then received systemic therapy, due to disease recurrence, with a combination of immunotherapy (IO) and tyrosine kinase inhibitor targeted therapy (VEGF-TKI). The patient had an excellent and durable response to this therapeutic regimen with minimal adverse effects, completing 2 years of therapy of nivolumab and cabozantinib. At the time of this report, the disease remains stable. This case demonstrates that combination therapy with IO+VEGF-TKI represents a reasonable and well-tolerated treatment option with activity in eccRCC and reveals interesting correlative data, including nests of stem-like CD8+T-cell infiltration in tumor tissue, which provide important biological context to this patient's exceptional therapeutic response.