OpenMed/multicare-articles huggingface dataset:
Case report: Massive hepatocellular carcinoma with complete response to the non-surgical systematic treatment strategy
Authors: Yun Li, Yanzhen Lai, Xuqiang Luo, Jian Wu, Kunpeng Wu, Haiqing Ma
Journal: Front Oncol (2024)
Keywords: anlotinib, complete response, hepatocellular cancer, radiotherapy, sindilizumab
MeSH terms: Case Reports

Background:
The five-year recurrence rate of hepatocellular carcinoma (HCC) remains as high as 70%. A complete clinical response has not been observed without surgical resection. Here, we report a rare case of clinical complete response and long-term survival in a patient with massive HCC receiving treatment with immunotherapy, anti-angiogenic therapy, and radiotherapy.
Case description:
A 38-year-old woman presented to our hospital for abdominal pain that persisted for 3 months. She was diagnosed as Barcelona Clinic Liver Cancer(BCLC) stage A, with a Cancer of the Liver Italian Program (CLIP) score of 3, American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging systems stage IB. She refused surgical resection and trans-arterial chemoembolization and accepted a non-invasive systematic treatment strategy involving immunotherapy, anti-angiogenic therapy, and radiotherapy. Her tumor burden decreased, and she experienced partial response before radiotherapy. Following radiotherapy, she experienced a complete clinical response and has been alive for more than 36 months after her initial presentation. She is currently alive.
Conclusion:
A non-invasive systematic treatment strategy is a potential radical treatment option for patients with massive HCC.
Disseminated Nasal subtype Extranodal NK/T-cell lymphoma and its diagnostic difficulties in antemortem biopsies
Authors: Aravind Sekar, Siddharth Jain, Jaimanti Bakshi, Suneel Rachagiri, Harish Bhujade, Rajender Kumar, Amanjit Bal
Journal: Autops Case Rep (2023)
Keywords: autopsy, epstein-barr virus infections, hard palate
MeSH terms: Case Reports

Extranodal NK/T- cell lymphoma (ENKTCL) is an aggressive lymphoma driven by Epstein-Barr virus (EBV) infection in genetically susceptible individuals. It was historically called a lethal midline granuloma. Due to the angio-destructive nature of ENKTCL, lymphoma cells are often accompanied and masked by necrosis and dense inflammation in the biopsy. Further, the biopsy may show vasculitis, which can mimic granulomatosis with polyangiitis. Due to these masquerades, ENKTCL is often misdiagnosed in the biopsy. Several biopsies may be required to establish the diagnosis. We describe the clinical course and autopsy findings of a young female who presented with a hard-palate ulcer. Antemortem biopsies failed to establish the diagnosis. The autopsy revealed an advanced nasal subtype of Extranodal NK/T-cell lymphoma with dissemination to the kidneys, adrenals, liver, spleen, and small intestine.
Case Report: Misdiagnosis of a lipofibromatosis-like neural tumor of the dorsal skin as dermatofibrosarcoma protuberans
Authors: Xiaowei Zhang, Chen Yan, Tingting Xu, Jiajia Ying
Journal: Front Surg (2024)
Keywords: case report, lipofibromatosis-like neural tumor, misdiagnosis, skin, soft tissue tumor
MeSH terms: Case Reports

Background:
Lipofibromatosis-like neural tumors (LPF-NT), which have only recently been established, are intermediate soft tissue tumors with neurotrophic tropomyosin receptor kinase 1 (NTRK1) gene alterations and are typically misdiagnosed as dermatofibrosarcoma protuberans, low-grade malignant peripheral nerve sheath tumors, or spindle cell lipoma due to their histopathological and immunohistochemical expression of CD34 and S-100.
Case presentation:
The patient was admitted to our hospital with a painless back mass that had appeared more than 4 years prior to admission. Physical examination revealed a subcutaneous mass on the back, approximately 1.5 cm in diameter and protruding into the skin, with clear boundaries and no tenderness. The tumor was surgically resected. The postoperative pathological results suggested a spindle cell soft tissue tumor, and dermatofibrosarcoma protuberan was initially considered. After consultation at a provincial hospital, the patient was diagnosed with a cutaneous lipofibromatosis-like neural tumor of the back. A second extended resection was then performed. Intraoperative rapid freezing examination revealed negative incision margins.
Conclusion:
Histological and immunohistochemical detections aid in the differential diagnosis of LPF-NTs. Complete surgical resection is the preferred treatment for LPF-NTs.
Examining the Role of Third Sector Organization Volunteers in Facilitating Hospital-to-Home Transitions for Older Adults - a Collective Case Study
Authors: Michelle L A Nelson, Marianne Saragosa, Hardeep Singh, Juliana Yi
Journal: Int J Integr Care (2024)
Keywords: transitions, case study, hospital discharge, intermediate care, person centred care, third sector

Introduction:
With increasing attention to models of transitional support delivered through multisectoral approaches, third-sector organizations (TSOs) have supported community reintegration and independent living post-hospitalization. This study aimed to identify the core elements of these types of programs, the facilitators, and barriers to service implementation and to understand the perspectives of providers and recipients of their experiences with the programs.
Methods and analysis:
A collective case study collected data from two UK-based 'Home from Hospital' programs. An inductive thematic analysis generated rich descriptions of each program, and analytical activities generated insights across the cases.
Results:
Programs provided a range of personalized support for older adults and addressed many post-discharge needs, including well-being assessments, support for instrumental activities of daily living, psychosocial support, and other individualized services directed by the needs and preferences of the service user. Results suggest that these programs can act as a 'safety net' and promote independent living. Skilled volunteers can positively impact older adults' experience returning home.
Conclusions:
When the programs under study are considered in tandem with existing evidence, it facilitates a discussion of how TSO services could be made available more widely to support older adults in their transition experiences.
Laryngeal non-Hodgkin lymphoma: Report of four cases and review of the literature
Authors: Xin Tang, Dingting Wang, Huajun Feng, Gang Qin
Journal: Open Life Sci (2024)
Keywords: malt lymphoma, chemotherapy, larynx, radiotherapy, surgery
MeSH terms: Case Reports

Non-Hodgkin lymphoma (NHL) limited to the larynx is very rare. The authors present the clinical diagnosis and treatment of four patients with laryngeal NHL. Case 1 was diagnosed with glottic, subglottic, and tracheal mucosa-associated lymphoid tissue (MALT) lymphoma, and was treated with radiotherapy and chemotherapy after surgery. Case 2 was diagnosed with laryngeal MALT lymphoma and underwent radiotherapy. Case 3 was diagnosed with angioimmunoblastic T-cell lymphoma, and was treated with radiotherapy and chemotherapy. Case 4 had MALT lymphoma in the glottic area with a malignant thyroid tumor, and was treated with radiotherapy and chemotherapy after surgery. More reports and research on this disease are needed.
Overlap of membranous nephropathy and IgA nephropathy in a patient with Kimura's disease: a case report and literature review
Authors: Géssica Sabrine Braga Barbosa, Precil Diego Miranda de Menezes Neves, Sara Mohrbacher, André Néder Ramires Abdo, Lívia Barreira Cavalcante, Yara de Menezes, Victor Augusto Hamamoto Sato, Érico de Souza Oliveira, Leonardo Victor Barbosa Pereira, Alessandra Martins Bales, Marcella Martins Frediani, Pedro Renato Chocair, Américo Lourenço Cuvello-Neto
Journal: Front Immunol (2024)
Keywords: iga nephropathy, kimura’s disease, kidney biopsy, membranous nephropathy, nephrotic syndrome
MeSH terms: Glomerulonephritis, IGA / complications, Glomerulonephritis, IGA / diagnosis, Glomerulonephritis, IGA / drug therapy, Glomerulonephritis, Membranous / diagnosis, Glomerulonephritis, Membranous / drug therapy, Glomerulonephritis, Membranous / immunology, Kimura Disease / complications, Kimura Disease / diagnosis, Kimura Disease / drug therapy, Case Reports, Review, Adult, Biopsy, Humans, Kidney / pathology, Male

Introduction:
Kimura's disease (KD) is a rare chronic inflammatory disorder characterized by subcutaneous lymphoid hyperplasia with peripheral eosinophilia. Kidney involvement is reported in 15%-18% of adult patients with KD, in many cases as nephrotic syndrome. We present a case of overlapping membranous nephropathy and IgA nephropathy associated with KD.
Case report:
A 27-year-old man was admitted with a history of bilateral leg edema for the last 2 months and concomitant progressive increase of cervical mass and fever. Laboratory findings were as follows: peripheral leukocyte count, 10,080/mm³; eosinophils, 3,200/mm³ (31.7%); serum creatinine, 0.83 mg/dL; and eGFR: 140 mL/min per 1.73 m2. Urinalysis revealed the presence of hematuria and proteinuria and the following results: 24-h proteinuria, 12.9 g; serum albumin, 1.3 g/dL; and elevated IgE level, 750 kU/L. Serologies for hepatitis B, hepatitis C, HIV, and VDRL were all negative. Complement C3 and C4 levels were normal. No monoclonal protein was detected in blood and urine. Parasite infestation was discarded. A biopsy of the cervical lymph node revealed eosinophilic lymphoid hyperplasia, suggesting KD. A kidney biopsy revealed findings consistent with the overlapping of membranous nephropathy with IgA nephropathy. The patient was treated for KD with prednisone 1 mg/kg/d with progressive dose tapering and posterior association of methotrexate 15 mg/week. A renin-angiotensin system inhibitor was prescribed for nephrotic syndrome. The cervical mass regressed, and proteinuria achieved partial remission, with an increase in serum albumin level and normalization of eosinophils and IgE levels.
Conclusion:
Although uncommon, kidney involvement must be considered in patients with KD. Glomerular diseases are the most frequent form of kidney injury.
Case report: Sequential treatment strategy for advanced basal cell carcinoma in Gorlin-Goltz syndrome: integration of vismodegib, radiotherapy, surgery, and high-intensity focused ultrasound
Authors: Jacek Calik, Małgorzata Oślizło, Beata Słocka-Romaniuk, Ahmed Elsaftawy, Natalia Sauer
Journal: Front Oncol (2024)
Keywords: gorlin-goltz syndrome, hifu, basal cell carcinoma (bcc), high-intensity focused ultrasound (hifu), skin cancer
MeSH terms: Case Reports

Managing advanced basal cell carcinoma (BCC) in patients with Gorlin-Goltz syndrome presents unique clinical challenges due to the tumor's aggressive nature and potential for widespread metastasis. This case study details a sequential treatment regimen for a 68-year-old female patient with an extensive, inoperable BCC. Employing a multimodal approach that integrates radiotherapy, the Hedgehog pathway inhibitor vismodegib, and High-Intensity Focused Ultrasound (HIFU), we demonstrate the potential for nearly complete remission in a patient with advanced BCC. Initial treatment with radiotherapy and vismodegib reduced tumor size significantly, but the largest mass displayed resistance over time, signifying the need for innovative therapies. Subsequent HIFU treatment targeted individual lesions, showcasing a non-invasive method that provided precise treatment while mitigating systemic side effects. The case emphasizes the necessity of continual adaptation in treatment plans to address the development of resistance and underscores the importance of incorporating new technologies and targeted therapies for complex BCC cases. The successful outcome of this integrated strategy suggests a promising direction for future research and highlights the importance of multidisciplinary approaches that tailor treatment to individual patient needs, tumor characteristics, and evolving therapeutic landscapes.
Primary Aorto-Enteric Fistula With a Subsequent Secondary Aorto-Enteric Fistula
Authors: Iris Kärjä, Venla Soini, Olli Hautero, Maarit Venermo
Journal: EJVES Vasc Forum (2024)
Keywords: abdominal aorta, aorto-enteric, digestive system fistula, gastrointestinal bleeding, primary aorto-enteric fistula, secondary aorto-enteric fistula
MeSH terms: Case Reports

Objective:
Primary aorto-enteral fistula (PAEF) is a connection between the gastrointestinal tract and the aorta that occurs without previous aortic surgery. The aetiological factors include, but are not limited to, aneurysm, infection, and tumours. It is a life threatening condition if untreated and requires emergency vascular surgical repair. A secondary aorto-enteric fistula (AEF) can occur to a previously reconstructed aorta. This case report presents a unique case of a male patient who developed a primary AEF and subsequent secondary AEF with successful surgical outcomes, suggested to be due to tuberculous aortitis.
Report:
The patient was diagnosed and treated for tuberculosis and developed a saccular aneurysm within six months. The PAEF was surgically corrected with a tube graft using a bovine pericardial patch, the defect in duodenum was sutured, and a retrocolic omental flap was created between the duodenum and aorta. He developed a small stable pseudoaneurysm during follow up, and then a secondary AEF two and a half years later, in which a connection between the pseudoaneurysm and duodenum was corrected using a new bovine aorto-aortic interposition graft using a bovine pericardium patch. The defect in the duodenum was also sutured in two layers and a new omental flap was created.
Discussion:
The mortality rate of AEF is high and it is very unlikely that a patient will survive two AEFs without major complications. It is believed that there are extremely few double AEF cases described in the literature. The aetiological factor in the development of PAEF in this case was most likely the patient's aortic aneurysm, which was most likely of mycotic origin due to tuberculosis. The patient developed a pseudoaneurysm during follow up and it is uncertain whether the pulsatile pressure of the pseudoaneurysm led to the recurrence of the AEF.
Chylothorax Chronicles: Tubercular Lymphadenopathy and Hemophagocytic Lymphohistiocytosis
Authors: Souvik Sarkar, Ulhas Jadhav, Pankaj Wagh, Babaji Ghewade
Journal: Cureus (2024)
Keywords: bilateral chylothorax, hemophagocytic lymphohistiocytosis (hlh), multi-disciplinary team, rare cause of pleural effusion, thoracic duct, thoracic duct embolization, tuberculous adenopathy
MeSH terms: Case Reports

Chylothorax delineates a state marked by the accumulation of chyle, an opalescent fluid laden with lipids, within the pleural cavity. This occurrence commonly ensues from the seepage of chyle originating from the thoracic duct, occasioned by trauma, surgical interventions, or underlying pathological conditions. This phenomenon induces respiratory distress, necessitating intricate and tailored interventions for its resolution. In this report, we present the case of a 27-year-old male who was admitted with a two-month history of symptoms, including dry cough, weakness, weight loss, and intermittent fever. Previously treated for pleural effusions and ascites, he was referred to our hospital with an intercostal drainage tube in place. Initial examinations revealed respiratory distress, fever, and bilateral pleural effusions. Laboratory results and fluid analysis indicated significant abnormalities, prompting further investigations, including CT scans and biopsies. The patient was diagnosed with chylothorax with chylous ascites due to abdominal tubular lymphadenopathy and hemophagocytic lymphohistiocytosis (HLH) and started on anti-tubercular therapy (AKT4) and octreotide. The patient was also initially managed with non-invasive ventilatory (NIV) support, intravenous antibiotics, nebulizations, an intercostal chest drain (ICD), and a thoracic duct embolization (TDE). Regular monitoring and collaboration between specialties were crucial, ultimately resulting in the removal of the drainage tube and the patient's stable discharge.
Prune Belly Syndrome in a Female Newborn following In Vitro Fertilization-Induced Pregnancy: A Case Report and Literature Review
Authors: Ibraheem M Alkhawaldeh, Jaber H Jaradat, Mohammad Al-Jafari, Abdulqadir J Nashwan, Samer Irshaid Alrahamneh
Journal: Case Rep Urol (2023)
MeSH terms: Case Reports

Prune belly syndrome (PBS) is a rare congenital anomaly characterized by a triad of abdominal flaccidity, varying degrees of urinary system involvement, and cryptorchidism. The exact cause of PBS is unknown. Clinical symptoms can range from stillbirth to significant renal and respiratory abnormalities to almost normal children. Treatment typically involves surgical repair of the abdominal wall defect and urinary tract abnormalities, early orchiopexy, and supportive management of related problems. We report the first case of a female newborn with PBS following in vitro fertilization-induced pregnancy with a comprehensive systematic review of all relevant cases.
Early Small Bowel Obstruction Caused by Surgical Drain Following Rectal Cancer Surgery: A Case Report
Authors: Tariq Bouhout, Ayoub Kharkhach, Abdelbassir Ramdani, Abdelhakim Harouachi, Badr Serji
Journal: Cureus (2024)
Keywords: abdominal drain, obstruction, rectal cancer, small bowel, small bowel obstruction
MeSH terms: Case Reports

The abdominal drains are commonly used and could be a source of several complications, including infection and small bowel obstruction. We report the case of a 70-year-old male patient with intestinal obstruction related to abdominal drainage after rectal surgery. Acute bowel obstruction remains a rare complication of abdominal drains. Surgeons should be aware of this situation and use drains with caution. The treatment options include conservative treatment or surgery either a laparoscopic approach or laparotomy.
Sjögren's Syndrome and Devic's Disease: A Synchronised Saga
Authors: Saket Toshniwal, Jiwan Kinkar, Yatika Chadha, Sourya Acharya, Sunil Kumar
Journal: Cureus (2024)
Keywords: autoimmune overlap, devics disease, neurological manifestation, neuromyelitis optica, sjogrens syndrome
MeSH terms: Case Reports

Devic's disease, commonly known as neuromyelitis optica (NMO), is a rare relapsing autoimmune illness of the central nervous system. Occasionally, it is associated with other autoimmune diseases such as Sjögren's syndrome (SS). Dry mouth and dry eyes are two symptoms of SS, a chronic autoimmune condition marked by inflammation and dysfunction of the exocrine gland. While SS primarily affects the exocrine glands, it can also manifest with a range of extraglandular features, including neurological manifestations, as in our case where the patient initially presented with neurological symptoms and was diagnosed with NMO. Owing to the persistent relapses along with sicca symptoms that occurred late, SS was diagnosed on further evaluation. Although the association of SS with NMO is not very common, the initial presentation of SS with neurological symptoms, as in our case, is what makes it more unique.
Coexistence of primary thyroid diffuse large B cell lymphoma and papillary thyroid carcinoma in a patient with Hashimoto's thyroiditis: a case report and literature review
Authors: Juncheng Li, Shengdong He, Juan Xu, Gang Xue
Journal: Front Oncol (2023)
Keywords: case report, coexistence, diffuse large b-cell lymphoma, papillary thyroid carcinoma, primary thyroid lymphoma
MeSH terms: Case Reports

Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid malignancy and also has an excellent prognosis. Primary thyroid lymphoma (PTL) is rare and has a poor prognosis. The co-occurrence of both malignancies is extremely rare, and the preoperative diagnosis is rather difficult. We report the case of a patient with both PTC and PTL in the setting of Hashimoto's thyroiditis (HT). A 59-year-old female patient was referred to our department for progressive enlargement of the thyroid gland over a few months. The imaging results demonstrated an enlarged thyroid and a mass in the thyroid. Total thyroidectomy and bilateral central neck node dissection were conducted. The final diagnosis of the coexistence of thyroid diffuse large B cell lymphoma and PTC was confirmed by histopathology and immunohistochemistry. The patient received radiation therapy and six cycles of chemotherapy combined with targeted therapy, including rituximab, cyclophosphamide, doxorubicin, vindesine, and prednisone (R-CHOP). After 6 months of follow-up, neither tumor has recurred. It is important for physicians to keep PTL in mind for differential diagnosis in HT patients with sudden thyroid enlargement.
Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) coinfected with COVID-19 complicated by hemophagocytic lymphohistiocytosis: a case report
Authors: Mengmeng Li, Furong Li, Yang Dai, Yunou Zhang Zeng, Xiaomei Chen
Journal: Front Immunol (2024)
Keywords: cmv, covid-19, drug reaction with eosinophilia and systemic symptoms, ebv, hemophagocytic lymphohistiocytosis
MeSH terms: COVID-19 / complications, COVID-19 / immunology, Coinfection / drug therapy, Drug Hypersensitivity Syndrome / diagnosis, Drug Hypersensitivity Syndrome / etiology, Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / drug therapy, Lymphohistiocytosis, Hemophagocytic / etiology, SARS-CoV-2, Sulfasalazine / adverse effects, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Male, Middle Aged, Sulfasalazine

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is characterized by a widespread maculopapular rash, lymphadenopathy, fever, and multisystem involvement. Conversely, hemophagocytic lymphohistiocytosis (HLH) is an infrequent yet critical condition presenting with fever, hepatosplenomegaly, cytopenias, coagulation abnormalities, and elevated inflammatory markers. The overlapping clinical and laboratory features between DRESS and HLH poses a significant diagnostic challenge. Secondary HLH (sHLH) typically occurs in adults triggered by viral infections, malignancies, rheumatologic diseases, or immune deficiencies. Recently, COVID-19 has also been identified as one of the triggers for sHLH. Herein, we present a case of Sulfasalazine-induced DRESS coinfected with COVID-19 that subsequently progressed into HLH. Our patient exhibited common hepatorenal and splenic involvement along with rare cholecystitis and appendicitis. However, a significant improvement was observed upon the addition of etoposide and azathioprine. We hypothesize that excessive activation of the immune system and cytokine storm due to DRESS combined with COVID-19 infection led to more extensive systemic damage resulting in HLH development. This highlights the potential for severe consequences when DRESS coincides with HLH during a COVID-19 infection.