OpenMed/multicare-articles huggingface dataset:
Giant right atrium in a child with dilated cardiomyopathy: A case report
Authors: Benzhen Wang, Guangsong Shan, Zhen Bing, Qi Zhang, Quansheng Xing, Zipu Li
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac surgery, cardiomyopathy, heart failure, pediatrics, right atrium
MeSH terms: Case Reports

Dilated cardiomyopathy (DCM) is one of the leading causes of heart failure in children with diverse clinical characteristics. To date, DCM with a giant atrium as the first manifestation is rare and has not been reported in previous literature. We report a case of a male infant born with a significantly enlarged right atrium. Due to worsened clinical symptoms and the risk of arrhythmias and thrombosis, we performed the surgical reduction of the right atrium. Unfortunately, DCM and a progressive re-enlargement of the right atrium appeared during midterm follow-up. The mother's echocardiogram also suggested DCM, and the patient was eventually considered for a diagnosis of familial DCM. This case may expand the clinical spectrum of DCM and reminds us of the importance of good follow-up of children with idiopathic dilatation of the right atrium.
Secretory carcinoma of the breast containing the ETV6-NTRK3 fusion gene in a male: case report and review of the literature
Authors: C Arce, D Cortes-Padilla, D G Huntsman, M A Miller, A Dueñnas-Gonzalez, A Alvarado, V Pérez, D Gallardo-Rincón, F Lara-Medina
Journal: World J Surg Oncol (2005)

Background:
Secretory carcinoma (SC) of the breast is a rare and indolent tumor. Although originally described in children, it is now known to occur in adults of both sexes. Recently, the tumor was associated with the ETV6-NTRK3 gene translocation.
Case presentation:
A 52-year-old male was diagnosed with secretory breast carcinoma and underwent a modified radical mastectomy. At 18 months the tumor recurred at the chest wall and the patient developed lung metastases. He was treated concurrently with radiation and chemotherapy without response. His tumor showed the ETV6-NTRK3 translocation as demonstrated by fluorescent in situ hybridization (FISH).
Conclusion:
SC is a rare slow-growing tumor best treated surgically. There are insufficient data to support the use of adjuvant radiation or chemotherapy. Its association with the ETV6-NTRK3 fusion gene gives some clues for the better understanding of this neoplasm and eventually, the development of specific therapies.
Extended infusion of dexmedetomidine to an infant at sixty times the intended rate
Authors: Bryan A Max, Keira P Mason
Journal: Int J Pediatr (2010)
MeSH terms: Case Reports

Dexmedetomidine is an α2 adrenergic agonist which has recently been approved in the United States for procedural sedation in adults. This report describes an infant who inadvertently received an intravenous infusion of dexmedetomidine at a rate which was 60 times greater than intended. We describe the hemodynamic, respiratory, and sedative effects of this overdose.
Saccharomyces cerevisiae Laryngitis and Oral Lesions in a Patient with Laryngeal Carcinoma
Authors: Jumanah N Algazaq, Kevan Akrami, Fernando Martinez, Allen McCutchan, Ajay R Bharti
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Saccharomyces cerevisiae is increasingly being promoted as a nutritional supplement by health food enthusiasts and is also recommended as prophylaxis against antibiotic-associated diarrhea. However, severe opportunistic infections due to S. cerevisiae have been reported in patients with chronic disease, cancer, and immunosuppression. Fungemia, endocarditis, pneumonia, peritonitis, urinary tract infections, skin infections, and esophagitis have been described. It is important to consider infections due to S. cerevisiae in appropriate clinical settings. Here, we describe the first case of S. cerevisiae laryngitis in a patient with a history of laryngeal carcinoma who also had oral lesions.
Congenital Aneurysm of the Right Atrium: Two Cases Report
Authors: Halyna Melo, Fernando Moraes Neto, Cleusa Lapa, Carlos R Moraes
Journal: Braz J Cardiovasc Surg (2019)
MeSH terms: Heart Aneurysm / congenital, Heart Aneurysm / surgery, Case Reports, Adolescent, Dilatation, Pathologic, Echocardiography, Electrocardiography, Female, Heart Aneurysm / diagnostic imaging, Heart Atria / abnormalities, Heart Atria / diagnostic imaging, Heart Atria / surgery, Humans, Infant, Male, Radiography, Thoracic, Treatment Outcome

Congenital aneurysm or enlargement of the right atrium is a rare condition. Two children operated on at the age of 14 months and 11 years old for congenital aneurysm of the right atrium are reported. Both presented cardiomegaly and symptoms of paroxysmal supraventricular tachycardia. Diagnosis was established by echocardiography. Surgical resection was successful. Both patients are free of symptoms and their chest X-ray and echocardiogram are normal. The first patient is now in her 17th postoperative year. The patients' evolution suggests that the surgery is a curative procedure.
Twenty-Eight-Day-Long Delirium Tremens
Authors: Paritosh Kafle, Amrendra Kumar Mandal, Binav Shrestha, Bikash Bhattrai, Manjul Bhandari, Shambhu Bhagat, Bijoy Shankar Kar, Dikshya Sharma, Vijay Gayam
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: dt, benzodiazepines, delirium tremens, midazolam, phenobarbitone, prolonged delirium tremens
MeSH terms: Alcohol Withdrawal Delirium / diagnosis, Alcohol Withdrawal Delirium / rehabilitation, Case Reports, Benzodiazepines / administration & dosage, Brain / diagnostic imaging, Diagnosis, Differential, Humans, Hypnotics and Sedatives / administration & dosage, Male, Midazolam / administration & dosage, Middle Aged, Phenobarbital / administration & dosage, Tomography, X-Ray Computed, Hypnotics and Sedatives, Benzodiazepines, Midazolam, Phenobarbital

Refractory alcohol withdrawal delirium is uncommon in day-to-day clinical practice. This case report presents a rare case of delirium tremens of unusually long duration that was complicated by the difficulty in tapering down benzodiazepines despite adding midazolam drip as well as phenobarbitone to the management regimen and excluding other possible diagnoses.
MitraClip for Severe Mitral Regurgitation from Chordal Rupture during Balloon Aortic Valvuloplasty
Authors: Akiva Rosenzveig, Syed Zaid, Joshua Hsu, Hasan Ahmad, Joshua Goldberg
Journal: Methodist Debakey Cardiovasc J (2022)
Keywords: mitraclip, aortic stenosis, chordal rupture, mitral regurgitation, paravalvular leak, transcatheter aortic valve replacement
MeSH terms: Aortic Valve Insufficiency / surgery, Aortic Valve Stenosis / complications, Aortic Valve Stenosis / diagnostic imaging, Aortic Valve Stenosis / surgery, Heart Valve Prosthesis / adverse effects, Mitral Valve Insufficiency / diagnostic imaging, Mitral Valve Insufficiency / etiology, Mitral Valve Insufficiency / surgery, Transcatheter Aortic Valve Replacement / adverse effects, Case Reports, Aged, 80 and over, Aortic Valve / diagnostic imaging, Aortic Valve / surgery, Humans, Male, Prosthesis Design, Retrospective Studies, Risk Factors, Treatment Outcome

Transcatheter aortic valve replacement (TAVR) has become an established alternative to surgical aortic valve replacement for high-, intermediate-, and low-risk patients. Paravalvular leak (PVL) is a complication of TAVR that can be effectively treated with balloon dilation and vascular plugs. We report a case of an 86-year-old male presenting with symptomatic severe aortic stenosis. After the index TAVR procedure, mild-to-moderate PVL was noted. Two years post-operation, the patient presented with symptomatic severe PVL, which was initially treated by balloon dilation with additional volume. During balloon dilation, the balloon slipped into the left ventricle and tore a chord, leading to new severe mitral regurgitation (MR) while the PVL remained unchanged. Subsequently, an Amplatzer vascular plug II (Abbott) was successfully used to reduce the PVL to mild, and a MitraClip NTR (Abbott) was used to successfully reduce the MR to trivial. Although balloon dilation can be an effective method for reducing PVL, mitral valve chordal rupture is a rare complication if the wire is entrapped in the chordae and the balloon slips into the ventricle.
Type 1-3 Canal Configuration in the Buccal Root of a Maxillary Second Molar
Authors: Hui Li, Qiang Wang, Mingwen Fan, Qingan Xu
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Objectives:
A major challenge in root canal treatment is the complex and variable root canal system. There are several methods of classification of root canal systems. Herein, we report a case of a maxillary second molar, the root canal system of which could not be classified according to any of the previous methods. Case Report. Cone-beam computed tomography (CBCT), used to visualize the root canal system of a maxillary left second molar with fused roots, revealed a type 1-3 root canal system in the buccal root and a type 1-1 root canal system in the palatal root. A dental operating microscope was used throughout the treatment, and the root canals were successfully obturated.
Conclusion:
To the best of our knowledge, this is the first report on the classification of buccal roots of maxillary second molars. Clinical Significance. A dental operating microscope and CBCT play a vital role in mapping the root canal system to ensure that no canal is missed.
Drug-induced CYP induction as therapy for tacrolimus intoxication
Authors: John M Hoppe, Alexander Holderied, Ulf Schönermarck, Volker Vielhauer, Hans-Joachim Anders, Michael Fischereder
Journal: Clin Nephrol Case Stud (2022)
Keywords: enzyme-induction, kidney transplantation, phenytoin, rifampin, tacrolimus/toxicity
MeSH terms: Case Reports

Management of calcineurin inhibitor (CNI) therapy in kidney transplant recipients may be complicated due to polypharmacy. As CNI undergo extensive metabolism by cytochrome-P450 enzymes (CYP), drug-mediated CYP inhibition poses a risk for elevated CNI blood concentrations. Here, we report on 2 kidney transplant recipients treated with tacrolimus who presented with signs of tacrolimus intoxication at admission. Patient A was started on antiviral medication ombitasvir, paritaprevir, ritonavir, and dasabuvir for hepatitis C virus treatment 3 days prior to hospitalization. Patient B was treated with clarithromycin for pneumonia. Both therapies cause drug-mediated CYP inhibition, and both patients displayed highly elevated tacrolimus serum concentrations and acute kidney injury (Table 1). After application of the CYP-inducing agents rifampicin and phenytoin, respectively, tacrolimus levels were rapidly reduced, and renal function recovered. Treating severe CNI intoxication is an infrequent yet emergent condition. These results add to the knowledge of therapeutic drug-induced CYP induction as rescue therapy.
Synovial sarcoma mimicking haemophilic pseudotumour
Authors: Haroon A Mann, Andrew Hilton, Nicholas J Goddard, Michael A Smith, Brian Holloway, Christine A Lee
Journal: Sarcoma (2006)
MeSH terms: Case Reports

This is a case of a 36-year-old gentleman with haemophilia A who was presented with an acute atraumatic soft tissue swelling in the right thigh. Open biopsy was performed with the resultant diagnosis of a synovial cell sarcoma. Although the clinical findings were nonspecific they could easily have been found in a bleeding haemophilic pseudotumour. The findings reported on MRI scan initially were highly consistent with those present in patients with mild haemophilia. An important part of orthopaedic management in haemophilia is concerned with intraarticular and intramuscular bleeding. Haematomas are common and sarcomas are rare. However the absence of trauma should alert the clinician to the possibility that the abnormality may represent haemorrhage into a tumour and not just haematoma, even in a haemophilic patient.
Case report: A case of duodenal adenocarcinoma achieving significantly long survival treating with immune checkpoint inhibitors and chemotherapy without positive biomarkers
Authors: Xian Chen, Rui Zhou, Yong Li, Xin Qu, Yan-Chun Qu, Wen-Zhu Li, Yong-Song Ye, Li-Rong Liu, Yan-Juan Zhu, Hai-Bo Zhang
Journal: Front Immunol (2022)
Keywords: icis, chemotherapy, duodenal adenocarcinoma, immunotherapy, small bowel adenocarcinoma
MeSH terms: Adenocarcinoma / genetics, Immune Checkpoint Inhibitors / therapeutic use, Case Reports, Biomarkers, Tumor / genetics, Humans, Microsatellite Instability, Mutation, Immune Checkpoint Inhibitors, Biomarkers, Tumor

Small bowel adenocarcinoma (SBA), particularly duodenal adenocarcinoma (DA), is a rare gastrointestinal cancer with a dismal prognosis. Data on SBA treatments are limited, and the therapeutic strategy remains uncertain. Currently, chemotherapy is the most used treatment; however, it has a poor median progression-free survival (mPFS) of no more than five months in the second-line setting. We report a case with DA that responded well to the immune checkpoint inhibitor (ICI) tislelizumab plus irinotecan in the second-line treatment. To our knowledge, this is the first report of administering ICIs plus chemotherapy to SBA. Despite the absence of microsatellite instability-high (MSI-H) and high tumor mutational burden (TMB), the patient with TP53/KRAS mutation achieved a significantly long PFS of 17 months, and the benefit is still ongoing. The mechanism of this remarkable efficacy might be associated with an increase in tumor immunogenicity after chemotherapy. The current study presents a promising effect of ICIs plus chemotherapy on SBA, affirming the need to investigate the clinical value of this combination in SBA and the underlying mechanism behind it.
Case report: A case of renal arcuate vein thrombosis successfully treated with direct oral anticoagulants
Authors: Mahsa Torabi Jahromi, Jamshid Roozbeh, Fatemeh Masjedi, Sahand Mohammadzadeh, Seyed Sajjad Tabei, Maryam Shafiee, Nakisa Rasaei
Journal: Front Med (Lausanne) (2023)
Keywords: apixaban, acute kidney injury, direct oral anticoagulants, renal arcuate vein thrombosis, thromboembolism
MeSH terms: Case Reports

A rare case of a 35 years old woman presented with renal arcuate vein thrombosis (RAVT) and acute kidney injury (AKI) following upper respiratory tract symptoms and toxic substance ingestion. Histopathological evaluation of the patient's kidney tissue indicated a rare venous thrombosis in the renal arcuate veins. Anticoagulation with Apixaban, a direct oral anticoagulant (DOAC), was commenced, and the patient's symptoms resolved during the hospital stay. Hitherto, a limited number of studies have shown the concurrent presentation of RAVT and overt AKI in patients following ingestion of nephrotoxic agents. Further studies are necessary to elucidate the etiology, clinical presentation, and treatment of RAVT. We suggest that Apixaban be studied as a suitable alternative to conventionally used anti-coagulants such as Warfarin in patients who lack access to optimal health care facilities.
Gestational Pseudoangiomatous Stromal Hyperplasia Presenting as Gigantomastia: A Case Report of a Rare Breast Entity with Clinical Recommendations by a Multidisciplinary Team
Authors: S Jennifer Wang, Shivi Maheswaran, Rosemary Reiss, Leah H Portnow, Jane Brock, Lara Novak, Jessica Erdmann-Sager, Thanh U Barbie
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Introduction:
Pseudoangiomatous stromal hyperplasia (PASH) presenting as gigantomastia is rare in pregnancy but can result in severe clinical consequences for both mother and fetus. Case Presentation. A 43-year-old female with a history of biopsy-proven bilateral PASH presented at 22 3/7 weeks gestation with massive bilateral breast enlargement that was symptomatic. After multidisciplinary care, she underwent bilateral mastectomies and delivered at term with no additional complications.
Conclusion:
Pregnant women who undergo mastectomies for PASH-induced gigantomastia during their second trimesters will likely recover quickly, and fetal risks are low. Given the rarity of this breast entity, management guidelines are sparse. Our case report is an effort to comprehensively review this condition and share the clinical recommendations made by our institution's multidisciplinary team.
Hair barrette induced cochlear implant receiver stimulator site infection with extrusion
Authors: Trung N Le, Jordan Hochman, Darren Leitao
Journal: Case Rep Otolaryngol (2015)

Background. Cochlear implant infections and extrusion are uncommon but potentially devastating complications. Recent literature suggests conservative management can be employed. Local measures inclusive of aggressive surgical debridement with vascularized flaps and parenteral antibiotics represent a viable option and often permit device salvage. However, explantation should be considered if there is evidence of systemic, intracranial, or intractable infection. Method. A Case report and literature review. Case Report. This case illustrates a complicated local wound infection associated with cochlear implantation due to transcutaneous adherence of a ferrous hair barrette to a cochlear implant magnet. Reconstruction of computed tomography (CT) data with 3D volume rendering significantly improved the value of the images and facilitated patient counseling as well as operative planning. Conclusion. Cochlear implant infections can be associated with foreign bodies. CT images are beneficial in the evaluation of cochlear implant complications. 3D CT images provide a comprehensive view of the site of interest, displaying the relationship of the hardware to the skull and soft tissues, while minimizing associated artifacts. Cochlear implant patients should consider use of nonmetallic hair devices.
Recurrent Solitary Fibrous Tumor in Intradural Extramedullary Space: Case Report and Review of the Literature
Authors: Neris Dincer, Melisa Bagci, Metin Figen, Adem Yilmaz, Ahmet Mesrur Halefoglu, Canan Tanik, Esengul Kocak Uzel
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare neoplasm arising from spindle cells and most commonly arising from pleura. Spinal SFT/HPC is a rare entity; hence, it is not on the top of the differential diagnosis list when a clinician faces a spinal lesion. In the review of the literature, there exist less than 50 case reports of intradural extramedullary SFT/HPC. Here, we present a 54-year-old female patient who underwent subtotal surgical excision of an intradural extramedullary spinal mass pathologically reported to be SFT/HPC and had symptomatic recurrence in the 3rd year of follow-up. Surgical intervention was unachievable and the patient was given 45 Gy to the surgical cavity followed by a 5.4 Gy boost to visible tumor with external radiotherapy. Patient reported significant relief of her symptoms. We aim to contribute to the formation of a treatment algorithm for this rare entity.
Case report: NUT carcinoma with MXI1::NUTM1 fusion characterized by abdominopelvic lesions and ovarian masses in a middle-aged female
Authors: Huahua Jiang, Chao Wang, Zheng Hou, Yuxiang Wang, Jie Qiao, Huajun Li
Journal: Front Oncol (2023)
Keywords: nut carcinoma, nut rearrangement, case report, ovarian neoplasms, undifferentiated pelvic neoplasms
MeSH terms: Case Reports

Background:
Nuclear protein of the testis (NUT) carcinoma is a rare subset of poorly differentiated, highly aggressive malignancy defined by NUTM1 gene rearrangements. Only three NUT cases of probable ovarian origin have been reported.
Case presentation:
We report a case of NUT carcinoma in a 53-year-old female who presented with extensive abdominopelvic lesions and bilateral ovarian masses suggestive of advanced ovarian cancer. This patient was admitted to our hospital due to abdominal pain and distension for over two months. Imaging examinations suggested a possible malignancy of bilateral adnexal origin. This patient first underwent diagnostic laparoscopy. After receiving neoadjuvant chemotherapy, she underwent cytoreductive surgery. Surgical pathology showed infiltration of monotonous round tumor cells with no apparent differentiation characteristics. Immunohistochemistry (IHC) revealed nuclear expression of the NUT protein. And MXI1::NUTM1 fusion was identified by next-generation sequencing (NGS). Herein, we introduce an unusual NUT carcinoma and describe the clinical, imaging, and pathological features. In addition, we briefly reviewed the published literature and discussed the possibility of primary gynecological NUT carcinoma.
Conclusions:
Identifying a NUT carcinoma arising from the abdominopelvic cavity is essential, and we underscore the need for NUT testing in undifferentiated malignant neoplasms that appear in this clinical setting. Although it is unclear from which origin this tumor arose, proper classification is essential for treatment planning.
A rare presentation of Klebsiella pneumoniae endogenous panophthalmitis with optic neuritis and orbital cellulitis from a urinary tract infection
Authors: Soumaya Bouhout, Magaly Lacourse, Annie-Claude Labbé, Marie-Josée Aubin
Journal: IDCases (2021)
MeSH terms: Case Reports

This case illustrates the rare presentation of endogenous Klebsiella pneumoniae endophthalmitis with concomitant orbital cellulitis from an acute pyelonephritis. A 59-year-old Caucasian female with type 2 diabetes mellitus was transferred from a regional hospital with decreased visual acuity, periorbital edema, photophobia, proptosis and pain of the right eye, as well as suprapubic discomfort. Initial ocular examination and B-scan ultrasonography were consistent with endophthalmitis and orbital cellulitis which lead to a vitreous tap and intravitreal antibiotics injection and systemic antibiotherapy. Vitreous and blood cultures confirmed Klebsiella pneumoniae as the causative organism. An orbital MRI showed a panophthalmitis with optic neuritis and further imaging confirmed a concomitant pyelonephritis secondary to a septic nephrolithiasis. The patient was given treatment with high-does intravenous antibiotics, oral and topical corticotherapy, and an early core pars plana vitrectomy (PPV), performed 5 days after presentation with repeat injections of antibiotics and dexamethasone. Unfortunately, two weeks following PPV, despite an initial stable postoperative course, the patient deteriorated and presented with purulent discharge from one of the vitrectomy port incision site. An emergency evisceration was performed in order to control the infection, revealing a large subretinal abscess and necrosed sclerotic tissue around the prior vitrectomy incision sites. Conclusion: This is the first case report of Klebsiella pneumoniae endophthalmitis or panophthalmitis presenting with orbital cellulitis and optic neuritis from an urinary tract infection. Prognosis is poor despite treatment including early vitrectomy.
Case Report: Extrapelvic Endometriosis in the Medial Thigh
Authors: Erica Pascoal, Stacey Rogers, Mathew Leonardi, Nicholas Leyland
Journal: Front Reprod Health (2021)
Keywords: endometriosis, extrapelvic, musculoskeletal, pathophysiology, surgery
MeSH terms: Case Reports

Extrapelvic endometriosis, although rare, can present in the musculoskeletal system of reproductive-age women and cause significant pain and morbidity. The pathophysiology of this disease is not well understood. In this study, we described the case of a 39-year-old women with an inner-thigh mass causing catamenial pain. Core-biopsy of the mass confirmed endometriosis and she was referred to minimally-invasive gynecology for management. Surgical excision was performed by a multidisciplinary team and she remains pain-free postoperatively on hormonal therapy. Unique to this case, the patient had a history of pelvic fracture. Through this case report, we discuss possible pathophysiologic mechanisms of extrapelvic musculoskeletal endometriosis including the stem/progenitor cell theory and the role that musculoskeletal trauma may have in the development of this condition. Gynecologists play an important role in the recognition, diagnosis, and management of musculoskeletal endometriosis.