OpenMed/multicare-articles huggingface dataset:
Long-term tumour control in sacral chordoma following high-dose palliative image-guided intensity-modulated radiotherapy (IG-IMRT)
Authors: Amy Jackson, Sarah Scott, Marina Romanchikova, David J Noble, Neil G Burnet
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Chordomas can present a challenge to the radiation oncologist and surgeon owing to the proximity to neurological structures. We describe a case of long-term tumour control in a chordoma of the lumbar spine following high-dose palliative radiotherapy. Image-guided intensity-modulated radiotherapy with photons provided a good solution to deliver 65 Gy to the tumour in a technically challenging case, and local control has been sustained over a period of years.
Emergently Alteration of Procedural Strategy During Transcatheter Aortic Valve Replacement to Prevent Coronary Occlusion: A Case Report
Authors: Hanyi Dai, Dao Zhou, Jiaqi Fan, Lihan Wang, Abuduwufuer Yidilisi, Gangjie Zhu, Jubo Jiang, Huajun Li, Xianbao Liu, Jian'an Wang
Journal: Front Cardiovasc Med (2022)
Keywords: aortic valve stenosis, emergent, pre-dilatation, procedural strategy, transcatheter aortic valve replacement
MeSH terms: Case Reports

Background:
Coronary occlusion is an uncommon but fatal complication of transcatheter aortic valve replacement (TAVR) with a poor prognosis.
Case presentation:
A patient with symptomatic severe bicuspid aortic valve stenosis was admitted to a high-volume center specializing in transfemoral TAVR with self-expanding valves. No anatomical risk factors of coronary occlusion were identified on pre-procedural computed tomography analysis. The patient was scheduled for a transfemoral TAVR with a self-expanding valve. Balloon pre-dilatation prior to prosthesis implantation was routinely used for assessing the supra-annular structure and assessing the risk of coronary occlusion. Immediately after the tubular balloon inflation, fluoroscopy revealed that the right coronary artery was not visible, and the flow in the left coronary artery was reduced. The patient would be at high-risk of coronary occlusion if a long stent self-expanding valve was implanted. Therefore, our heart team decided to suspend the ongoing procedure. A transapical TAVR with a 23 mm J-valve was performed 3 days later. The prosthesis was deployed at a proper position without blocking the coronary ostia and the final fluoroscopy showed normal flow in bilateral coronary arteries with the same filling as preoperatively.
Discussion:
Our successful case highlights the importance of a comprehensive assessment of coronary risk and a thorough understanding of the TAVR procedure for the heart team. A short-stent prosthesis is feasible for patients at high risk of coronary occlusion. Most importantly TAVR should be called off even if the catheter has been introduced when an extremely high risk of coronary obstruction is identified during the procedure and no solution can be found.
Case report: Multiple brain intravascular papillary endothelial hyperplasia: incidence, diagnostic challenges, and management approach
Authors: Elena Anghileri, Bianca Pollo, Paolo Ferroli, Domenico Aquino, Greta Demichelis, Marco Schiariti, Francesco Ferrau, Luisa Chiapparini, Valeria Cuccarini
Journal: Front Neurol (2023)
Keywords: masson's tumor, cerebral, interferon, intravascular papillary endothelial hyperplasia (ipeh), sirolimus
MeSH terms: Case Reports

Multiple hemorrhagic brain lesions are mainly diagnosed based on clinico-radiological features integrated with histological data. Intravascular papillary endothelial hyperplasia (IPEH), or Masson's tumor, is a very rare entity, particularly when localized in the brain. In this study, we describe a case of multiple recurrent brain IPEHs and provide details on the diagnostic phase, therapeutic approaches, and related challenges. A 55-year-old woman presented with a relapsing neurological deficit. Brain magnetic resonance imaging (MRI) revealed a hemorrhagic right frontal-parietal lesion. When new neurological symptoms occurred, subsequent MRI scans detected more bleeding cerebral lesions. She underwent a series of single hemorrhagic lesion debulking. For any samples that underwent histopathological examination, the first results were not informative; the second and the third results revealed hemangioendothelioma (HE); and the fourth results led to the IPEH diagnosis. Interferon alpha (IFN-α) and subsequently sirolimus were prescribed. Both were well tolerated. Clinical and radiological features remained stable 43 months after starting sirolimus therapy and 132 months after the first diagnosis. To date, 45 cases of intracranial IPEH have been reported, mostly as single lesions without parenchymal location. They are usually treated by surgery and sometimes by radiotherapy upon recurrence. Our case is notable for two main reasons: because of the consecutive recurrent multifocal exclusively cerebral lesions and the therapeutic approach we used. Based on multifocal brain recurrence and good performance, we propose pharmacological therapy, including IFN-α and sirolimus, to stabilize IPEH.
Case report: Lung transplantation for treatment of paraquat intoxication: timing of transplantation
Authors: Congcong Li, Hongfei Cai, Fanyu Meng, Fanjie Meng, Ze Tang, Ying Tang, Ying Chen, Youbin Cui, Yang Li
Journal: Front Pharmacol (2023)
Keywords: ecmo, pls, bronchial infection, herbicide poisoning, lung transplantation
MeSH terms: Case Reports

Objective: To analyze the optimal timing of lung transplantation and summarize postoperative complications and their management after paraquat poisoning. Methods: Here, we present the clinical course of a 17-year-old boy with paraquat poisoning, in whom bilateral lung transplantation (LT) was performed. We reviewed the eight previously published articles relevant to LT after paraquat poisoning to summarize the therapeutic strategy. Results: A 17-year-old boy was admitted to the hospital after ingestion of 30-50 mL 25% paraquat. Mechanical ventilation was initiated on the 25th day after intoxication. Venovenous extracorporeal membrane oxygenation was initiated on the 26th day. Sequential bilateral LT was performed on the 27th day. Several complex postoperative complications occurred and the patient was discharged on the 50th day postoperatively. Eight case reports were included in the literature review, including 11 patients with paraquat poisoning undergoing LT. Three patients died due to paraquat poisoning leading to fibrosis in the transplanted lungs or postoperative complications. Eight patients survived during follow-up. Conclusion: LT after herbicide poisoning should be planned when hepatorenal function starts to recover, and waiting for complete recovery is unnecessary. Prevention of infection before surgery is important to reduce the incidence of postoperative infection. Complex perioperative complications caused by the herbicide itself or the late timing of transplantation can be successfully managed by a multidisciplinary team.
Transient Antenatal Bartter's Syndrome: A Case Report
Authors: Michelle Meyer, Margarita Berrios, Christina Lo
Journal: Front Pediatr (2018)
Keywords: melanoma-associated antigen d mutation, polyhydramnios, polyuria, prematurity, transient antenatal bartter’s syndrome
MeSH terms: Case Reports

Antenatal Bartter's syndrome is a rare inherited disorder characterized by fetal polyhydramnios and polyuria that is usually detected between 24 and 30 weeks of gestation. However, a rare, severe, but transient form of antenatal Bartter's syndrome due to an x-linked melanoma-associated antigen D2 (MAGED2) mutation has recently been described. This transient type results in the earlier onset of severe polyhydramnios and preterm birth, but spontaneously resolves postnatally. Here, we present a case of a 29-week gestation male born to a mother with severe polyhydramnios, who was subsequently found to have a novel mutation for MAGED2 not previously reported. This is the first and only case not to be treated with indomethacin, yet still resulted in spontaneous resolution of symptoms. Our case suggests the need for awareness of and testing for this new mutation in cases of severe antenatal polyhydramnios and discusses the perinatal treatment of this condition.
A Novel Case Report of Severe Aplastic Anemia with COVID Infection
Authors: Fatemeh Nejatifar, Ezat Hesni, Ali Akbar Samadani
Journal: Ethiop J Health Sci (2023)
Keywords: covid-19, severe aplastic anemia, hematopoietic system, supportive treatment
MeSH terms: Anemia, Aplastic / complications, Anemia, Aplastic / therapy, COVID-19 / complications, Case Reports, Adolescent, Female, Humans, Immunosuppression Therapy / adverse effects

Aplastic anemia is a rare disease of the hematopoietic system. Although some viral agents have been implicated, the association between COVID-19 and aplastic anemia is unclear. In this way, several cases of aplastic anemia have been reported following infection with COVID-19. Importantly, we reported a 16-year-old girl with severe aplastic anemia with no history of disease following an Omicron infection who did not respond well to treatment despite supportive treatment and immunosuppression.
Radium-223 Therapy for Patients with Metastatic Castrate-Resistant Prostate Cancer: An Update on Literature with Case Presentation
Authors: Nghi C Nguyen, Muhammad Shah, Leonard J Appleman, Rahul Parikh, James M Mountz
Journal: Int J Mol Imaging (2016)
MeSH terms: Review

Background and Purpose. Radium-223 dichloride (Xofigo®, Bayer HealthCare Pharmaceuticals Inc.) is the first α-particle emitter therapeutic agent approved by the FDA, with benefits in overall survival and delay in symptomatic skeletal event for patients with metastatic castrate-resistant prostate cancer (CRPC). Recent post hoc analyses of the phase III ALSYMPCA trial support the previously established safety profile as well as therapeutic effect and clinical outcome of Radium-223. Currently, Radium-223 is approved as a single agent therapy for metastatic CRPC. Clinical trials are currently investigating Radium-223 in additional clinical settings such as earlier asymptomatic disease and in combination with other agents including hormonal therapeutic agents and immunotherapeutic as well as chemotherapeutic agents. Trials are also ongoing in patients with other primary cancers such as breast cancer, thyroid cancer, and renal cancer metastatic to bone. In this article, the physics and radiobiology, as well as a literature update on the use of Radium-223, are provided along with case presentations, aiming at a better appreciation of research data as well as the assimilation of research data into clinical practice.
Retroperitoneal vascular malformation mimicking incarcerated inguinal hernia
Authors: Indu Bhushan Dubey, Anuj Sharma, Ajay Kumar Singh, Debajyoti Mohanty
Journal: J Emerg Trauma Shock (2011)
Keywords: adult, incarceration, inguinal hernia, venous malformation
MeSH terms: Case Reports

A 30-year-old man presented to the Department of Surgery with a painful groin swelling on right side. Exploration revealed a reddish-blue hemangiomatous mass in the scrotum extending through inguinal canal into the retroperitoneum. On further dissection swelling was found to be originating from right external iliac vein. The swelling was excised after ligating all vascular connections. The histopathological examination of excised mass confirmed the diagnosis of venous variety of vascular malformation. This is the first reported case of vascular malformation arising from retroperitoneum and extending into inguinoscrotal region, presenting as incarcerated inguinal hernia.
Atrophic Pigmented Dermatofibrosarcoma Protuberans: A Case Report and Literature Review
Authors: Juan Bai, Bin Liu, Taoming Liu, Jianjun Qiao, Hong Fang
Journal: Front Oncol (2021)
Keywords: atrophic, bluish-black, dermatofibrosarcoma protuberans, pigmentation, sarcoma
MeSH terms: Case Reports

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma characterized by the proliferation of spindle cells arranged in a storiform pattern. Here we report a case of DFSP presenting as a bluish-black atrophic plaque. The tumor had the histopathologic characteristics of both the pigmented and atrophic variants of DFSP. We describe the histopathologic, molecular, and imaging features of this patient and review other cases of DFSP that have been reported in the literature. Early identification of this DFSP variant can help clinicians implement clinical management strategies to prevent recurrence.
Splenomesenteric bypass as revascularisation technique after iatrogenic injury of the superior mesenteric artery during radical nephrectomy: A case report
Authors: Catarina Afonso, Jorge Pereira, Pedro Eufrásio, Júlio Constantino, Paulo Rebelo
Journal: Int J Surg Case Rep (2019)
Keywords: nephrectomy, renal tumor, splenomesenteric bypass, superior mesenteric artery injury

Introduction:
Iatrogenic vascular injuries during radical nephrectomy are rarely reported. In the case of an injury of the superior mesenteric artery, the consequences for the patient are potentially catastrophic. It occurs more frequently in patients with large renal tumors, due to the presence of bulky perihilar adenopathies, or in cases of pyelonephritis. In most cases, the inadvertent injury of the artery occurs due to the difficulty in distinguishing it from the left renal artery.
Case:
69-year-old male, with a malignant neoplasm of the left kidney with the involvement of the tail of the pancreas, tumor thrombus in the left renal vein and multiple left para-aortic adenopathies, whose histological examination revealed to be a renal sarcomatoid carcinoma pT4N1M0G3. A radical nephrectomy was performed with caudal splenopancreatectomy and left paraaortic lymphadenectomy, with an iatrogenic injury of the superior mesenteric artery at its origin. A terminoterminal anastomosis was performed from the proximal stump of the splenic artery. The postoperative period went uneventfully. Control imaging in the follow-up showed permeability of the celiac trunk and the superior mesenteric artery.
Conclusions:
Intra-operative superior mesenteric artery injury should be promptly identified and repaired to prevent gut ischemia and all its dire consequences. There are different repair options, and the technique should be chosen according to the degree of injury. The splenomesenteric bypass has numerous advantages.
Targeted Anterior Cervical Epidural Blood Patch in a Patient with Spontaneous Intracranial Hypotension
Authors: Ravindra Singh Shekhawat, Ming Hui Yong, Si Ying Julienne Keong, Kunihiko Chen, Chow Wei Too, Shahul Hameed
Journal: Case Rep Neurol Med (2022)
MeSH terms: Case Reports

A 45-year-old male was admitted with severe orthostatic headache secondary to spontaneous intracranial hypotension. He had the site of cerebrospinal fluid (CSF) leakage identified at the anterolateral aspect of the C7-T1 spinal level. He first underwent a conventional posterior-approach cervical epidural blood patch (EBP) which provided immediate relief to the patient's symptoms; however, his symptoms recurred two days later. To better target the anterolateral leakage site, we employed an anterior-approach EBP under computed tomography (CT) guidance. After this attempt, the patient experienced complete relief of his symptoms, and the headache eventually resolved.
Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation
Authors: Tian-Tian Qin, Li-Ting Cao, Li-Xia Lu, Xiu-Li Wang, Jiu-Cong Zhang, Bin Li, Xiao-Hui Yu, Xiao-Long Ren
Journal: Open Life Sci (2023)
Keywords: case report, hepatic retiform hemangioendothelioma, microwave ablation, ultrasound
MeSH terms: Case Reports

Retiform hemangioendothelioma (RH) is a type of low-grade malignant angiosarcoma. It commonly involves the skin and subcutaneous tissue of the lower extremities, but a few cases have been reported in the gut. However, hepatic RH has not been previously reported. This report presents the case of RH of the liver in a 61-year-old woman who was admitted to the hospital having presented with liver space-occupying lesions of 2 months evolution. The patient underwent an abdominal ultrasound examination, which indicated a hemangioma, but abdominal computed tomography diagnosed a liver abscess. In order to determine the nature of the lesion, an ultrasound-guided liver biopsy was performed, after which a pathological diagnosis confirmed the presence of RH in the liver. The patient underwent ultrasound-guided microwave ablation three times and has been followed up for 8 years with no tumor recurrence or metastasis. Surgical excision is still the first choice for the treatment of hepatic RH. As shown in this case, however, for patients who refuse to undergo surgery or have surgical contraindications, ultrasound-guided microwave ablation is an alternative treatment option. The report of this case expands the scope of liver tumors to a certain extent and provides a reference for clinical diagnosis and treatment.
Genome sequences of two clinical Escherichia coli isolates harboring the novel colistin-resistance gene variants mcr- 1.26 and mcr- 1.27
Authors: Bernd Neumann, Wiebke Rackwitz, Klaus-Peter Hunfeld, Stephan Fuchs, Guido Werner, Yvonne Pfeifer
Journal: Gut Pathog (2020)
Keywords: colistin-resistance, escherichia coli, incx4, mcr-1
MeSH terms: Case Reports

Background:
Colistin is still a widely used antibiotic in veterinary medicine although it is a last-line treatment option for hospitalized patients with infections caused by multidrug-resistant Gram-negative bacteria. Colistin resistance has gained additional importance since the recent emergence of mobile colistin resistance (mcr) genes. In the scope of a study on colistin resistance in clinical Escherichia coli isolates from human patients in Germany we characterized the mcr-1 gene variants.
Results:
Our PCR-based screening for mcr-carrying E. coli from German patients revealed the presence of mcr-1-like genes in 60 isolates. Subsequent whole-genome sequence-based analyses detected one non-synonymous mutation in the mcr-1 gene for two isolates. The mutations were verified by Sanger sequencing and resulted in amino acid changes Met1Thr (isolate 803-18) and Tyr9Cys (isolate 844-18). Genotyping revealed no relationship between the isolates. The two clinical isolates were assigned to sequence types ST155 (isolate 803-18) and ST69 (isolate 844-18). Both mcr-1 variants were found to be located on IncX4 plasmids of 33 kb size; these plasmids were successfully conjugated into sodium azide resistant E. coli J53 Azir in a broth mating experiment.
Conclusions:
Here we present the draft sequences of E. coli isolate 803-18 carrying the novel variant mcr-1.26 and isolate 844-14 carrying the novel variant mcr-1.27. The results highlight the increasing issue of transferable colistin resistance.
A Rare Variation of Transverse Testicular Ectopia (TTE) in a Young Adult as an Incidental Finding during Investigation for Testicular Pain
Authors: Chrysovalantis Gkekas, Evangelos N Symeonidis, Ioannis Tsifountoudis, Christos Georgiadis, Vasileios Kalyvas, Apostolos Malioris, Michail Papathanasiou
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Transverse testicular ectopia (TTE) with fused vas deferens is an extremely rare clinical entity. Herein, we present a case of a 19-year-old patient with persistent left testicular pain lasting for a week. Clinical examination revealed an empty right hemiscrotum, a normal left-sided descended testis, and in close proximity a mass-like structure resembling testicular parenchyma. Laboratory tests were significant for elevated follicle-stimulating hormone (FSH), while sperm count revealed azoospermia. Ultrasound imaging (US) of the scrotum demonstrated the presence of both testes in the same left hemiscrotum with varicocele and no signs of inguinal hernia. Magnetic resonance imaging (MRI) of the penis and scrotum revealed TTE with a single, fused vas deferens, and hypoplastic seminal vesicles. Surgical intervention by means of microsurgical sperm retrieval and transseptal orchidopexy were considered but not performed, primarily owing to the patient's unwillingness and to a lesser extent due to the restriction that the short and fused vas would pose in an attempt to transpose the ectopic testis. Therefore, an annual follow-up was recommended.
C2 Solitary Bone Plasmacytoma Curettage and Vertebral Augmentation in an 83-Year-Old Female: Case Report and Review of Surgical Treatment Approaches in the Spine
Authors: Matthew J Yousif, Taha A Faruqi, Rakesh Ramakrishnan, Nilesh M Patel
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Surgically, solitary bone plasmacytoma (SBP) of the craniocervical junction (CCJ) is typically treated with cement augmentation and occipital-cervical stabilization (OCS). In the orthopedic spine literature, various surgical treatment options have been described for SBP, but only a few studies exist describing SBP of the CCJ with treatment involving cement augmentation alone. We report the case of an 83-year-old female found to have C2 SBP that was successfully treated with curettage and cement augmentation alone.
Efficacy of Electroconvulsive Therapy for Neuropathic Pain Comorbid with Major Depression
Authors: Masashi Ueda, Yuki Konishi, Kohei Sakurai, Atsuko Ikenouchi, Reiji Yoshimura
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

We report a case of a 41-year-old male with postinjury neuropathic pain comorbid with major depression in which electroconvulsive therapy (ECT) was effective in relieving both neuropathic pain and major depression. A total of 12 sessions of bilateral ECT were performed using a Thymatron® (Somatics LLC; Lake Bluff, IL). After ECT, the patient was subsequently maintained on paroxetine, eszopiclone (2 mg/day), and alprazolam. There was no relapse for at least one year after the last ECT. This case indicates that ECT might be an alternative treatment for major depression associated with chronic neuropathic pain after traumatic injury.
Pancreatic mass with an unusual pathology: a case report
Authors: Andrew J Healey, Anna Reed, Long R Jiao
Journal: HPB Surg (2008)

Intra-abdominal abscesses formation in patients with no preceding symptoms is rare. Infection of the pancreas occurs in 5-9% of patients with acute pancreatitis, more commonly as a complication of necrotising or severe pancreatitis. We have reported a case of a 64-year-old almost entirely asymptomatic man who underwent a Whipple's procedure following extensive investigation of a pancreatic mass. The pathology and histology showed no evidence of malignancy, and instead a true pancreatic abscess, centred around an impacted cholesterol calculus in the distal CBD. Of suspicious pancreatic masses that are resected, chronic choledocholithiasis is the aetiology in less than 5% of nonmalignant or "false positives." This report describes such a case.