OpenMed/multicare-articles huggingface dataset:
Rheumatoid Meningitis Presenting With Acute Parkinsonism and Protracted Non-convulsive Seizures: An Unusual Case Presentation and Review of Treatment Strategies
Authors: David Pellerin, Michael Wodkowski, Marie-Christine Guiot, Hisham AlDhukair, Andrea Blotsky, Jason Karamchandani, Evelyne Vinet, Anne-Louise Lafontaine, Stuart Lubarsky
Journal: Front Neurol (2019)
Keywords: corticosteroids, immunosuppressant, parkinsonism, rheumatoid arthritis, rheumatoid granuloma, rheumatoid meningitis, seizure, vasculitis
MeSH terms: Case Reports

Rheumatoid meningitis is a rare complication of rheumatoid arthritis (RA). It is associated with substantial morbidity and mortality. The condition may present in a variety of ways and is therefore diagnostically challenging. Uncertainty still exists regarding the optimal treatment strategy. Herein, we describe the case of a 74-year-old man with a history of well-controlled seropositive RA on low-dose prednisone, hydroxychloroquine, and methotrexate. The patient presented with a several-month history of multiple prolonged episodes of expressive aphasia, right hemiparesis, and encephalopathy. Although no epileptiform activity was recorded on repeated electroencephalography, the symptoms fully resolved following treatment with antiepileptic drugs. He subsequently developed acute asymmetrical parkinsonism of the right hemibody. Magnetic resonance imaging revealed subtle enhancement of the leptomeninges over the left frontoparietal convexity. Cerebrospinal fluid analysis revealed a mild lymphocytic pleocytosis and elevated proteins. Histopathologic analysis of a meningeal biopsy revealed nodular rheumatoid meningitis. The patient was treated with corticosteroids and cyclophosphamide, following which he incompletely recovered. This is the first description of rheumatoid meningitis manifesting with acute parkinsonism and protracted non-convulsive seizures. A summary of cases reported since 2005, including data on pathology, therapy and outcomes, along with a discussion on the efficacy of different treatment strategies are provided.
Cholangiocarcinoma in a Child with Progressive Abdominal Distension and Secondary Hypercalcemia
Authors: Chalinee Monsereenusorn, Kantang Satayasoontorn, Piya Rujkijyanont, Chanchai Traivaree
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Cholangiocarcinoma is extremely rare in childhood and has been reported in association with other underlying diseases. The survival and prognosis are dismal especially in patients with unresectable or advanced stage cholangiocarcinoma. Overall survival in patients with metastatic cholangiocarcinoma could be increased by using combination chemotherapy with cisplatin and gemcitabine. A case of childhood cholangiocarcinoma was hereby reported.
Vanishing spleen syndrome post right partial nephrectomy in a sicklemic patient
Authors: Khuram Khan, Ofelia Leroux, Saqib Saeed, Farhana Iqbal, Leaque Ahmed, Brian Davis-Joseph
Journal: Pan Afr Med J (2018)
Keywords: splenic infarction, laparoscopic renal surgery, right partial nephrectomy, sickle cell disease
MeSH terms: Anemia, Sickle Cell / complications, Laparoscopy / methods, Nephrectomy / methods, Splenic Infarction / diagnosis, Case Reports, Female, Hemoglobins / metabolism, Humans, Laparoscopy / adverse effects, Middle Aged, Nephrectomy / adverse effects, Parenchymal Tissue / blood supply, Parenchymal Tissue / pathology, Splenic Infarction / etiology, Syndrome, Hemoglobins

Splenic infarction after contralateral laparoscopic renal surgery has not, to our knowledge, been reported. The spleen is the most affected organ in sickle cell disease and the mechanism of auto infarction is thought to result from the crystallization of abnormal hemoglobin during periods of hypoxia or acidosis resulting in parenchymal ischemia and ultimately tissue necrosis. We report a case of 45 year old female with sickle cell disease who had an unremarkable spleen at the time of a laparoscopic right partial nephrectomy and was subsequently found to have marked diminution in her splenic volume.
Best management in isolated right ventricular hypoplasia with septal defects in adults
Authors: Zahra Khajali, Maedeh Arabian, Maryam Aliramezany
Journal: J Cardiovasc Thorac Res (2020)
Keywords: adult congenital heart disease, atrial septal defect, cyanosis, right ventricular hypoplasia
MeSH terms: Case Reports

Hypoplastic right ventricle is a rare congenital disease usually associated with pulmonary atresia or tricuspid atresia. Isolated right ventricular hypoplasia is a rare anomaly without important valvular abnormalities. It is associated with inter atrial septal defects leading to the right-to-left shunting of blood. Patients with isolated right ventricular hypoplasia usually have different and variable courses. In some patients, it is recognized in the perinatal period and necessitates prompt intervention; nonetheless, there are some reports of this anomaly in old age with no significant symptoms. In this report, we describe the clinical data and management of 6 adult cases with isolated right ventricular hypoplasia treated medically or surgically based on the severity of the disease and symptoms and then offer an in-depth discussion regarding this rare anomaly.
Carcinoid tumor of the verumontanum (colliculus seminalis) of the prostatic urethra with a coexisting prostatic adenocarcinoma: a case report
Authors: Maxwell Smith, M Scott Lucia, Priya N Werahera, Francisco G La Rosa
Journal: J Med Case Rep (2010)

Introduction:
Urethral carcinoid tumors are very rare tumors with only four cases described in the literature.
Case presentation:
We present the case of a 61-year-old man with a primary carcinoid tumor of the verumontanum (colliculis seminalis) portion of the prostatic urethra with a coexisting prostatic adenocarcinoma. In addition to whole mount hematoxylin and eosin staining, special immunoperoxidase staining specific for chromogranin A, neuron specific enolase, synaptophysin, pan-cytokeratin and PSA, and a special combined staining for racemase (alpha-methyl CoA) antigen and p63 antigen were performed. A review of the literature is included.A single focus of invasive prostatic adenocarcinoma was identified in the periphery of the mid-left, posterior quadrant of the prostate. Approximately 17 mm from this adenocarcinoma, within the verumontanum of the prostatic urethra, there was a 3 mm maximal dimension carcinoid tumor.
Conclusion:
Based on different histological features and antigenic profiles, we concluded that the two tumors were distinct.
Nutritional management of glycogen storage disease type III: a case report and a critical appraisal of the literature
Authors: Elena Massimino, Anna Paola Amoroso, Roberta Lupoli, Alessandro Rossi, Brunella Capaldo
Journal: Front Nutr (2023)
Keywords: cardiomyopathy, continuous glucose monitoring (cgm), dietary intervention, glycogen storage disease, high-fat diet, myopathy
MeSH terms: Case Reports

Glycogen storage disease Type III (GSD III) is an autosomal recessive disease due to the deficiency of the debranching enzyme, which has two main consequences: a reduced availability of glucose due to the incomplete degradation of glycogen, and the accumulation of abnormal glycogen in liver and cardiac/skeletal muscle. The role of dietary lipid manipulations in the nutritional management of GSD III is still debated. A literature overview shows that low-carbohydrate (CHO) / high-fat diets may be beneficial in reducing muscle damage. We present a 24-year GSD IIIa patient with severe myopathy and cardiomyopathy in whom a gradual shift from a high-CHO diet (61% total energy intake), low-fat (18%), high-protein (21%) to a low-CHO (32 %) high-fat (45%) / high-protein (23%) diet was performed. CHO was mainly represented by high-fiber, low glycemic index food, and fat consisted prevalently of mono and polyunsaturated fatty acids. After a 2-year follow-up, all biomarkers of muscle and heart damage markedly decreased (by 50-75%), glucose levels remained within the normal range and lipid profile was unchanged. At echocardiography, there was an improvement in geometry and left ventricular function. A low -CHO, high-fat, high-protein diet seems to be safe, sustainable and effective in reducing muscle damage without worsening cardiometabolic profile in GSDIIIa. This dietary approach could be started as early as possible in GSD III displaying skeletal/cardiac muscle disease in order to prevent/minimize organ damage.
Peculiar type 1 congenital pyloric atresia: a case report
Authors: Enrico Zecca, Mirta Corsello, Claudio Pintus, Lorenzo Nanni, Susanna Zecca
Journal: Ital J Pediatr (2010)
MeSH terms: Intestinal Atresia / diagnosis, Pylorus / abnormalities, Case Reports, Anastomosis, Surgical, Diagnosis, Differential, Duodenum / surgery, Female, Follow-Up Studies, Humans, Infant, Newborn, Intestinal Atresia / surgery, Laparotomy, Pylorus / surgery, Radiography, Abdominal

Pyloric atresia (PA) is a very rare condition. Its incidence is approximately 1 in 100,000 newborns and constitutes about 1% of all intestinal atresias. We describe the neonatal course of a peculiar case of type 1 pyloric atresia, in which the pyloric membrane was connected to a second duodenal membrane through a virtual duodenal lumen in a premature newborn. The atypical variant required an unusual side to side gastroduodenostomy. We emphasize the importance of a prompt diagnosis to avoid potentially fatal complications and to warrant a good outcome even in the presence of a strange form of PA in the neonatal period.
Osteoma presenting as a painless solitary mastoid swelling
Authors: Hazem M Abdel Tawab, Ravi Kumar V, Salim M Sloma Tabook
Journal: Case Rep Otolaryngol (2015)

Introduction. Osteoma of the temporal bone is a very uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid bone. Case Report. A 36-year-old male presented to our department with a hard swelling behind the right ear diagnosed as osteoma. Complete excision was done through a postauricular approach. Histopathology confirmed the diagnosis of osteoma. Conclusion. Osteomas, although rare, should be considered when dealing with any hard mastoid swelling. Complete removal can be ensured by drilling till the normal cortical bone is reached to avoid recurrence. A cortical mastoidectomy should be done if the mastoid air cell system is involved.
Case report: Successful administration of cariprazine in a young, severely ill patient with recurrent relapses of schizophrenia and persistent negative symptoms
Authors: Jelena Vrublevska
Journal: Front Psychiatry (2023)
Keywords: antipsychotic combination, cariprazine, case report, psychotic relapse, schizophrenia
MeSH terms: Case Reports

The present case report describes a young man diagnosed with schizophrenia and presents a "revolving door" (RD) phenomenon. He was hospitalized in an acute psychiatric clinic three times in 1 year. After each hospitalization, he was discharged with incompletely reduced psychotic symptoms, persistent negative symptoms, low functioning, lack of insight, and adherence. He had an insufficient response to maximally tolerated doses of antipsychotic monotherapy with haloperidol and risperidone. Moreover, his treatment was complicated due to the low accessibility of long-acting injectable atypical antipsychotics (LAI) in the country and his refusal of the only available atypical LAI paliperidone palmitate and refusal to take clozapine. Due to limited alternatives, the decision to administer combinations of antipsychotics was made. Since his diagnosis, he received several combinations of antipsychotics, i.e., haloperidol + quetiapine, risperidone + quetiapine, haloperidol + olanzapine, risperidone + olanzapine, but without sufficient clinical effectiveness. Although combinations of antipsychotics reduced his positive symptoms to some degree, persistent negative symptoms and extrapyramidal side effects were observed. After initiating cariprazine, which was combined with olanzapine, improvement in the patient's positive symptoms, negative symptoms, and overall functioning was detected. The combination of medications mentioned above facilitated the therapeutic alliance, thus providing control over the symptoms and preventing psychiatric hospitalizations.
Insulinoma Mimicking Psychiatric Illness: A Covert Endocrine Tumor
Authors: Sidra Aslam, Ahmed I Siddiqi, Waqas Shafiq, Umal Azmat, Hira Irfan, Wania Rafaey, Sidra Masood
Journal: Cureus (2023)
Keywords: hyperinsulinemia, hypoglycemia, insulinoma, neuroendocrine tumor, pancreas
MeSH terms: Case Reports

Insulinomas are rare neuroendocrine tumors with an annual incidence of four cases per million people in the general population. They have varied presentations making their diagnosis a challenging task necessitating a thorough patient assessment to ascertain early detection of this clinical entity by treating physicians. Insulinomas are characterized by the presence of Whipple's triad comprising of hypoglycemic symptoms, biochemical demonstration of hypoglycemia, and improvement of those symptoms after glucose administration. Biochemical detection of insulinoma by supervised 72-hour fasting test with plasma glucose, insulin, C-peptide, and proinsulin level measurements remains the gold standard of diagnosis. In this report, we present an interesting case of delayed diagnosis of pancreatic insulinoma. He was treated for more than six years as a psychiatric illness before receiving the correct diagnosis and treatment. Herein, a middle-aged man with a history of recurrent episodes of altered talk and confusion that resolved after eating something sweet. Biochemical investigations were suggestive of endogenous hyperinsulinemia. Pancreatic insulinoma was localized by a computed tomography scan. The patient underwent surgical resection of the tumor with complete resolution of his symptoms.
Intractable Fasting Hypoglycemia as a Manifestation of Hepatocellular Carcinoma
Authors: Justin J Forde, Ofor Ewelukwa, Tony Brar, Roniel Cabrera
Journal: Case Reports Hepatol (2017)
MeSH terms: Case Reports

Non-islet cell tumor hypoglycemia (NICTH) is a rare and serious paraneoplastic complication of both malignant and benign tumors to consider when evaluating fasting hypoglycemia, especially in the setting of liver diseases. We present a case of NICTH in a 54-year-old male with hepatocellular carcinoma (HCC) who presented with symptomatic intractable hypoglycemia (IH) after bowel preparation and fasting for screening upper endoscopy and colonoscopy.
Portomesenteric Reconstruction during Whipple Procedure Using Autologous Left Renal Vein Patch Graft in a Patient with a Gastric Cancer Recurrence
Authors: Lidija Ljubicic, Igor Petrovic, Andrea Crkvenac Gregorek, Hrvoje Silovski
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

The case of vascular reconstruction of the superior mesenteric and portal vein confluence using a left renal vein (LRV) graft has been researched in this paper. The patient was a 66-year-old female who presented with features of biliary obstruction. A contrast-enhanced computed tomography scan revealed bile duct dilatation and a common bile duct tumor mass. Four years ago, she underwent stomach resection with subsequent Billroth II gastrojejunostomy due to gastric cancer. After surgical resection, on histopathological and immunohistochemistry examination, a recurrence of previously resected poorly cohesive gastric cancer was found.
Chemo-immunotherapy for metastatic non-squamous NSCLC in a patient with HIV infection: A case report
Authors: Alessandro Inno, Emanuela Lattuada, Giovanni Foti, Stefania Gori
Journal: Front Oncol (2023)
Keywords: hiv, nsclc, anti-pd1, carboplatin, chemotherapy, immunotherapy, pembrolizumab, pemetrexed
MeSH terms: Case Reports

Activity and safety data of chemo-immunotherapy for patients with metastatic NSCLC and known HIV infection are still limited, since HIV-positive patients were generally excluded from clinical trials. Here we report the case of a metastatic NSCLC patient with HIV infection and undetectable viral load treated with first-line chemo-immunotherapy (pembrolizumab, carboplatin and pemetrexed), achieving a meaningful and durable objective response, with no treatment-related adverse events and no HIV-related complications. This report suggests that NSCLC patients with virologically controlled HIV infection can be safely treated with chemo-immunotherapy and should not be excluded from this treatment based on their viral infection only.
Erythrodermic atopic dermatitis with late onset--case presentation
Authors: Cristina Lancrajan, Roxana Bumbacea, Calin Giurcaneanu
Journal: J Med Life (2010)
MeSH terms: Dermatitis, Atopic / drug therapy, Dermatitis, Exfoliative / drug therapy, Case Reports, Adult, Dermatitis, Atopic / pathology, Dermatitis, Exfoliative / pathology, Female, Humans

Atopic dermatitis is a chronic inflammatory disease, usually associated with a personal or family history of atopic diseases such as AD, allergic rhinitis or asthma that most commonly arise in childhood and present with elevated IgE serum in up to 85% of patients. The severity of AD is based on the extent of affected areas, itch intensity and appearance of skin lesions. Here, we present the case of a 21-year-old female patient with generalized erythematous eczematous skin lesions, flexural lichenifications accompanied by intense pruritus, painful fissures and erosions resulting from scratching. She also presented erythematous plaques with thin scales on the scalp. The patient had no personal or familial history of AD, allergic rhinitis or asthma and the onset of cutaneous symptoms presented severe exacerbation in the last 2 months of the last 3 years. The main laboratory findings were- high serum eosinofilia (2400/microL) and very high total IgE serum (11449 UI/L). The flare remission was induced with systemic treatment (corticotherapy, oral H1 antihistamines, and antibiotherapy) and topical therapy (UVB 311 nm, topical glucocorticoids and hydration). It is very important to recognize AD as a cause of erythroderma, especially in a patient with a late onset of the disease, in order to treat it promptly and to prevent ulterior recurrences, by educating the patient to have an adequate life style and to treat the recurrences at the very first symptoms.
Spontaneous Isolated Visceral Artery Dissection in a Middle Aged Male
Authors: Eric Melnychuk, Robert Strony
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Epigastric pain is a common complaint made by patients being evaluated in the emergency department. Spontaneous isolated visceral artery dissection is a rare cause with no reported prevalence. We present a case of a 37-year-old male evaluated in the emergency department for epigastric pain and subsequently diagnosed with a spontaneous isolated celiac artery dissection with involvement of the hepatic and splenic arteries. Recent case series suggest this disease may be managed medically in most cases. Surgical intervention may be considered for significant bleeding or signs of intestinal ischemia.
Solitary pancreatic metastasis of gastric cancer with synchronous pancreatic ductal carcinoma: A case report
Authors: Yuichiro Yokoyama, Hiroki Sakata, Toshimasa Uekusa, Yusuke Tajima, Masahiro Ishimaru
Journal: Int J Surg Case Rep (2020)
Keywords: gastric cancer, pancreatic cancer, pancreatic metastasis
MeSH terms: Case Reports

Background:
There have been a few reports on solitary pancreatic metastases of gastric cancer. We present a case of solitary pancreatic metastasis of gastric cancer with synchronous primary pancreatic ductal carcinoma.
Presentation of case:
An 86-year-old man who had undergone total gastrectomy two and half years prior presented with a poorly enhanced tumor in the pancreatic body. We diagnosed pancreatic ductal carcinoma and performed distal pancreatosplenectomy. Histopathologically, the tumor comprised poorly differentiated adenocarcinoma cells mixed with moderately differentiated tubular adenocarcinoma cells that were compatible with metastasis of gastric cancer. There was also invasive ductal carcinoma of the pancreas. The postoperative course was uneventful. Six months after surgery, computed tomography revealed peritoneal dissemination, and he died of recurrence 10 months after surgery.
Conclusion:
Pancreatic metastasis of gastric cancer with synchronous primary pancreatic cancer can occur and should be considered in the differential diagnosis.
Urethrogluteal fistula developing secondary to the use of clean intermittent self-catheterization: first case report in the literature
Authors: Aliseydi Bozkurt, Mehmet Karabakan, Mehmet Soyturk, Erkan Hirik, Barış Nuhoglu
Journal: Case Rep Urol (2014)

Clean intermittent self-catheterization is the standard method for bladder evacuation in these patients today. The patient was diagnosed with urethrogluteal fistula and gluteal-perineal abscess by radiological evaluation. Gluteal drainage decreased after cystostomy. In our paper, a case of urethrogluteal fistula and pelvic urinoma that developed as a result of the use of clean intermittent self-catheterization (CISC), which is rarely found in the literature, is presented.
Development of Liver Cancers as an Unexpected Consequence of Anabolic Androgenic Steroid Use
Authors: Sameeha Khalid, Gieric Laput, Kamal Khorfan, Marina Roytman
Journal: Cureus (2023)
Keywords: cholangiocarcinoma, drug-induced liver injury (dili), hepatocellular carcinima, hepatotoxicity, testosterone hormone
MeSH terms: Case Reports

Although the relationship between androgens and hepatocellular tumor development has been noted since 1975, cases involving hepatocellular carcinoma (HCC) or cholangiocarcinoma development in patients on chronic androgen therapy or anabolic androgenic steroid (AAS) use are few, and far between. We present three cases of patients who developed hepatic and bile duct malignancies in the setting of AAS use and testosterone supplementation, arising from a single tertiary referral center. Additionally, we review the literature for the mechanisms behind the possible androgen-mediated malignant transformation of these liver and bile duct tumors.
Painful Hip Leading to the Diagnosis of MEN 2B Syndrome
Authors: Mehtab Ahmad, Imran Rizvi, Amit Jain, Noorin Zaidi
Journal: Case Rep Endocrinol (2012)

Context. MEN 2B syndrome is characterized by the presence of medullary thyroid cancer, pheochromocytoma, mucosal neuromas, marfanoid features, and skeletal abnormalities like kyphoscoliosis, joint laxity, pes cavus, and slipped capital femoral epiphysis (SCFE) in a minority; we present the case of a young female who was brought to medical attention due to painful hip because of SCFE. Case Report. A 16-year-old female presented to orthopedics out-patient department (OPD) with complaints of pain around the left hip and walking with a limp for the last two months. MRI of hip confirmed the presence of SCFE of the left hip. General examination detected thyroid swelling which was found to be a medullary thyroid cancer and imaging of abdomen confirmed the presence of bilateral pheochromocytoma, also present were neuromas of tongue and lips. Thus, a diagnosis of MEN 2B syndrome was made. Conclusion. SCFE can sometimes be the presenting feature of MEN 2B syndrome. Physicians should keep this in mind as it can lead to early diagnosis of a potentially lethal illness.