OpenMed/multicare-articles huggingface dataset:
Delivery of Euthyroid Baby following Hyperthyroidism in Twin Gestation with Coexisting Complete Hydatidiform Mole
Authors: Rishi Raj, Edilfavia Mae Uy, Matthew Hager, Kamyar Asadipooya
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Context:
Gestational trophoblastic disease (GTD) is a rare complication of pregnancy, ranging from molar pregnancy to choriocarcinoma. Twin pregnancies with GTD and coexisting normal fetus are extremely rare with an estimated incidence of 1 case per 22,000-100,000 pregnancies. Molecular mimicry between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH) leads to gestational trophoblastic hyperthyroidism (GTH) which is further associated with increased maternal and fetal complications. This is the first reported case in literature describing the delivery of a baby with biochemical euthyroid status following a twin pregnancy with hydatidiform mole (HM) associated with gestational trophoblastic hyperthyroidism (GTH).
Case description:
A 24-year-old G4 P3 Caucasian female with twin gestation was admitted to hospital for gestation trophoblastic hyperthyroidism. She was later diagnosed to have twin pregnancy with complete mole and coexisting normal fetus complicated by gestational trophoblastic hyperthyroidism (GTH). Despite the risk associated with the continuation of molar pregnancy, per patient request, pregnancy was continued till viability of the fetus. The patient underwent cesarean section due to worsening preeclampsia and delivered a euthyroid baby at the 24th week of gestation.
Conclusions:
Twin pregnancy with gestational trophoblastic disease and coexisting normal fetus is associated with high risk of hyperthyroidism, and careful monitoring of the thyroid function test along with dose titration of thionamides is of utmost importance throughout the gestation. If normal thyroid hormone levels are maintained during the pregnancy, euthyroidism could be successfully achieved in the baby.
Case Report: A Pediatric Case of Lipoprotein Glomerulopathy in China and Literature Review
Authors: Yue Song, Changqiang Yang, Lan Liu, Hua Wang
Journal: Front Pediatr (2021)
Keywords: chinese, anemia, lipoprotein glomerulopathy, nephrotic syndrome, pediatric
MeSH terms: Review

Background: Lipoprotein glomerulopathy is a rare kidney disease characterized by lipoprotein thrombi in the glomerulus. Here, we report a case of lipoprotein glomerulopathy in a Chinese pediatric patient. Furthermore, we summarized the clinical features and genetic characteristics of lipoprotein glomerulopathy in China. Case Presentation: An 11-year-old Chinese girl presented with nephrotic syndrome with anemia (98 g/L). After excluding secondary causes, primary nephrotic syndrome was considered. Treatment with prednisone (60 mg/day) did not improve her condition. Renal biopsy showed marked dilation of the capillary lumen with lipoprotein thrombi and positive oil red O staining. Genetic testing revealed the genetic variant c.127C > T (p.R43C), known as the Kyoto mutation of the APOE gene. These findings are consistent with the diagnosis of lipoprotein glomerulopathy. Prednisone was gradually tapered and captopril was initiated. A 2-year follow-up revealed elevated urine protein and serum creatinine levels. We also reviewed 17 pediatric and 156 adult cases of lipoprotein glomerulopathy reported in China from the year of creation to 2021. The most common clinical features were edema, hematuria, hypertriglyceridemia, and increased serum apoE levels. Extra-renal manifestations included anemia, splenomegaly, and cardiac lipoprotein deposition. Conclusion: APOE Kyoto is the most common mutation in patients with lipoprotein glomerulopathy. In China, homozygosity for E3 (E3/3) is the most common isoform.
Teaching NeuroImages: Absence of bilateral internal carotid arteries with multiple aneurysms
Authors: Yang Gao, Jianhua Yuan, Jian-Zhi Wang
Journal: Clin Case Rep (2023)
MeSH terms: Case Reports

Absence of bilateral internal carotid arteries is a rare congenital vascular dysplasia. We reported the case and present some typical and exquisite neuroimges for teaching.
A Case of Crossed Left Renal Ectopia Identified during Colostomy Reversal
Authors: Rachel NeMoyer, Sumana Narayanan, Nell Maloney-Patel
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Unilateral crossed renal ectopia without fusion is an uncommon anatomic anomaly, which often goes undiagnosed. We report a case of this renal variant discovered incidentally during colostomy reversal after Hartmann's procedure for diverticular stricture.
Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter
Authors: Yutaro Hayashi, Takashi Kawahara, Yusuke Hattori, Kota Shimokihara, Sohgo Tsutsumi, Daiji Takamoto, Taku Mochizuki, Jun-Ichi Teranishi, Yasushi Yumura, Yasuhide Miyoshi, Masako Otani, Hiroji Uemura
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Introduction:
Xanthogranulomatous pyelonephritis (XGP) is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare.
Case presentation:
A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT) revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed.
Conclusion:
We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter.
Case Report: A case report of Moyamoya disease in a 36 year old African American woman
Authors: Rohit Kumar Gudepu, Mohtashim A Qureshi, Ihtesham A Qureshi, Lakshman Rao
Journal: F1000Res (2014)

Moyamoya is a rare idiopathic progressive vaso-occlusive disease characterized by irreversible condition of main blood vessels to the brain as they enter into the skull. We present a case of 36 year old African American female presenting to the Out Patient Clinic with headache which were on and off for 4-6 months and did not relieve on routine medical therapy. It was associated with weakness on right side for last few days. The patient was investigated with CT Angiogram, diagnosed as Moyamoya disease and operated. She has been followed up for the last 5 years and the patient has not complained of any headaches or focal neurological symptoms.
A Case of Severe Tricuspid Regurgitation Related to Traumatic Papillary Muscle Rupture
Authors: Ruchika Meel, Bongane Ngutshane, Ricardo Gonçalves, Shungu Mogaladi
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

A 25-year-old male presented after a motor vehicle accident with tricuspid valve (TV) regurgitation, due to a flail TV secondary to papillary muscle rupture. We highlight the importance of three-dimensional echocardiographic imaging of the tricuspid valve and its utility in aiding a successful surgical repair.
Left ventricular myxoma: case report
Authors: Mohamed Rida Ajaja, Amine Cheikh, Noëllie Akpabie, Wafa Elmire, Amale Tazi Mezalek, Amine El Hassani, Mahdi Ait Houssa
Journal: Pan Afr Med J (2020)
Keywords: left ventricular myxoma, cardiopulmonary bypass, echocardiography, resection
MeSH terms: Heart Neoplasms / diagnostic imaging, Heart Ventricles / diagnostic imaging, Myxoma / diagnostic imaging, Case Reports, Aged, Echocardiography, Heart Neoplasms / surgery, Heart Ventricles / surgery, Humans, Male, Myxoma / surgery

Left ventricular (LV) myxomas are rare. We present a case of a LV myxoma arising from the interventricular septum in a 70-year-old asymptomatique man. General examination of the patient did not reveal any abnormality. Transthoracic echocardiography revealed a round pedunculated mass (size, 20mm x 13mm) at the interventricular septum with a broad pedicle. The mass was successfully removed and was pathologically confirmed to be a myxoma.
TB Meningitis and TB Peritonitis: Abdominal Pseudocyst and VP-Shunt Link
Authors: Manzoor Ahmed, Essameldin Ali ElGamal, Anwar Ahmad, Muhammad Badar Zaman
Journal: Case Rep Radiol (2019)
MeSH terms: Case Reports

TB meningitis (TBM) carries high morbidity and mortality and is a relatively common extrapulmonary TB in the third world countries. TBM as thick exudative disease manifests on MRI and CT as nodular basal leptomeningitis, hydrocephalus, basal infarcts, and tuberculomas. Hydrocephalus is treated with ventriculoperitoneal shunting (VPS). Shunt malfunction and revision are common. We report a case of multidrug-resistant TBM with spinal involvement and dissemination of the disease via VPS causing TB peritonitis (TBP). TBP presented as a large abdominal pseudocyst around the catheter tip with shunt malfunction. There was no evidence for any other site of extra-CNS disease. TBP per se is relatively less common. This is the first case reporting VPS as a means of TB spread.
Analysis of Cases with Cerebrospinal Fluid Characteristics Similar to Tuberculous Meningitis
Authors: Duanhua Cao, Tingting Wang, Yali Wang, Jingzhe Han
Journal: Biomed Res Int (2022)
MeSH terms: Brain Diseases, Encephalitis, Meningeal Carcinomatosis / complications, Sarcoidosis, Tuberculosis, Meningeal / diagnosis, Case Reports, Cerebrospinal Fluid, Humans, Retrospective Studies

Purpose:
The diagnosis of tuberculous meningitis (TBM) is difficult and relies on the patient's clinical presentation and initial cerebrospinal fluid testing. Treatment outcomes for some patients with early consideration of TBM meningitis are often poor. Patients and Methods. In this study, we retrospectively analyzed 24 non-TBM patients whose early changes of cerebrospinal fluid were similar to those of TBM through the second-generation cerebrospinal fluid sequencing technology.
Results:
All patients included in this study had an acute onset, including 5 patients with a history of upper respiratory tract infection, 9 patients with fever, 6 patients with headache, 5 patients with psychiatric symptoms, 6 patients with cognitive impairment, 9 patients with signs of meningeal irritation, and 6 patients with seizures. Sixteen patients presented with altered content and level of consciousness during their admission. The leukocyte counts (median, 124.0 × 106/L) and total protein concentrations (median, 1300 mg/L) were higher than normal reference values in all patients, whereas glucose (median, 1.345 mmol/L) and chloride concentration values (average, 111.7 ± 5.2 mmol/L) were lower than normal reference values. The patients included 2 cases of Liszt's meningitis, 2 cases of Brucella infection in the CNS, 4 cases of Varicella zoster virus encephalitis, 2 cases of human herpes simplex virus type 1, 2 cases of lupus encephalopathy, 2 cases of anti-NMDAR receptor encephalitis, 2 cases of meningeal carcinomatosis, 5 cases of cryptococcal meningitis, 2 cases of CNS sarcoidosis, and a case of invasive Rhizopus oryzae infection. All patients were tested for NGS in cerebrospinal fluid. Eight patients were diagnosed with anti-NMDAR encephalitis, meningeal carcinomatosis, lupus encephalopathy, and CNS sarcoidosis. Nine patients experienced death; 15 patients had a good prognosis and left no significant sequelae.
Conclusion:
The analysis of patients with TBM-like cerebrospinal fluid changes will help improve the diagnostic accuracy of the disease and reduce misdiagnosis and underdiagnosis.
Vertebral Artery Caught in the Fracture Gap after Traumatic C2/3 Spondylolisthesis
Authors: Ralf Henkelmann, Christoph Josten, Stefan Glasmacher, Christoph-Eckhard Heyde, Ulrich Josef Albert Spiegl
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Background context:
Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap.
Purpose:
Presentation of a case with follow-up until end of treatment.
Study design:
Case report.
Methods:
A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment. Radiological diagnostics revealed a traumatic C2/3 spondylolisthesis. A computer tomography (CT) angiographic scan showed a dislocation of the right vertebral artery into the fracture gap without injury to the artery. Open reduction and osteosynthesis were considered of too high risk. Therefore, we conducted fracture treatment with closed reduction and halo fixation. After removal of the halo fixator, the patient was given a soft cervical collar and was advised to rest for additional 6 weeks before beginning gradual activity.
Results:
Conventional follow-up revealed osseous consolidation and a CT angiographic scan showed consistent blood flow to the artery.
Conclusion:
Halo fixation was a safe and effective therapy strategy in the case of vertebral artery entrapment after traumatic C2 spondylolisthesis.
Cryptococcal Meningitis Presenting as New-Onset Seizures in an Immunocompetent Patient
Authors: Andrea Akyeampong, Nadia Solomon, Nicholas A Boire, Aam A Baqui
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: cryptococcosis, diagnostic delay, infectious disease, pathology, seizure
MeSH terms: Meningitis, Cryptococcal / complications, Seizures / microbiology, Case Reports, Adult, Brain / diagnostic imaging, Brain / microbiology, Brain / surgery, Cryptococcus, Delayed Diagnosis, Humans, Immunocompetence, Magnetic Resonance Imaging, Male, Meningitis, Cryptococcal / diagnosis, Meningitis, Cryptococcal / diagnostic imaging, Meningitis, Cryptococcal / surgery, Neuroimaging, Seizures / diagnostic imaging, Seizures / etiology, Tomography, X-Ray Computed

This report describes a 30-year-old immunocompetent male with new-onset seizures, later found on imaging to have 2 enhancing lesions in the brain. The patient underwent a left parietal craniectomy with resection of one of the masses, which demonstrated focal areas of necrosis and many small cystic structures positive for periodic acid-Schiff and Gomori's methenamine silver special stain. Numerous laboratory examinations, including HIV test, rapid plasma reagin, toxoplasma immunoglobulin G and immunoglobulin M, Lyme, cytomegalovirus, tuberculosis, cysticercosis, and Echinococcus serology, were all negative. Despite negative cerebrospinal fluid (CSF) culture and several negative CSF antigen tests, continued investigation, and follow-up, CSF antigen testing ultimately revealed Cryptococcus as the causative agent. In light of the mysterious and unusual presentation, the authors discuss potential infectious differential diagnoses in patients with atypical clinical presentation, laboratory tests, and surgical pathology.
Case report of bilateral testicular infarction due to severe bilateral epididymo-orchitis: A catastrophic complication causing castration
Authors: William Ong Lay Keat, Sivaneswaran Lechmiannandan, Devindran Manoharan, Say Bob Lee, Premnath Nagalingam
Journal: Int J Surg Case Rep (2020)
Keywords: bilateral, castration, epididymo-orchitis, ischemia, orchidectomy, testicular infarction
MeSH terms: Case Reports

Introduction:
Testicular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature. We report an even rarer case of bilateral epididymo-orchitis complicated with testicular infarction, resulting in bilateral orchidectomy.
Presentation of case:
49 year old gentleman presented with fever, persistent, unresolving pain and scrotal swelling of two weeks duration. Despite close clinical monitoring, timely ultrasounds of the testis and antibiotics there was an inexorable progression to bilateral testicular ischemia.
Discussion:
This is only the second reported case of this nature in published literature. Epididymo-orchitis usually responds well to appropriate antibiotic therapy, although progression to testicular infarction is possible.
Conclusion:
Clinical presentation of persistent scrotal pain and oedema in cases of epididymo-orchitis should raise strong suspicion of testicular ischemia or infarction. Despite all efforts, progression to bilateral testicular infarction resulting in castration is a possible catastrophic outcome.
A patient with superior mesenteric artery lymph node metastasis after laparoscopic gastrectomy for gastric cancer with Adachi type VI vascular anomaly: A case report
Authors: Kenjiro Hirai, Taro Aoyama, Wataru Hirata, Hiroshi Okabe, Akira Mitsuyoshi
Journal: Int J Surg Case Rep (2020)
Keywords: adachi type vi, laparoscopic gastrectomy, superior mesenteric artery lymph node metastasis
MeSH terms: Case Reports

Introduction:
Due to recent advances in surgical procedures and instruments, laparoscopic gastrectomy for gastric cancer has been widely performed, and previous studies reported laparoscopic surgery for gastric cancer with Adachi type VI vascular anomaly. In Adachi type VI patients, the common hepatic artery (CHA) originates from the superior mesenteric artery (SMA); therefore, the route of lymph flow differs from the normal route, and the supra- and infrapyloric lymph nodes (LN) may reach SMA LN. However, metastasis has not yet been reported. A case of SMA LN metastasis 3 years after laparoscopic distal gastrectomy for gastric cancer with Adachi type VI CHA anomaly, which was diagnosed using preoperative computed tomography (CT), was described herein.
Presentation of case:
The patient was a 77-year-old male. Laparoscopic distal gastrectomy and D2 + 14v LN dissection for gastric cancer with Adachi type VI vascular anomaly were performed. Three years after surgery, periodic CT revealed swelling of regional and mediastinal SMA LN, leading to a diagnosis of recurrent gastric cancer. A histopathological examination of the resected specimen showed metastases to the greater curvature right group and infrapyloric LN.
Discussion:
Metastasis to LN No. 6 may have reached SMA LN via the gastroduodenal artery and CHA, but not the celiac artery.
Conclusion:
If preoperative diagnostic imaging suggests metastasis to the greater curvature right group and pyloric regions in gastric cancer patients with Adachi type VI vascular anomaly, LN dissection along CHA originating from SMA and the hepatomesenteric trunk needs to be considered.
Polyarticular Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of the Literature
Authors: Annelise Miller, Fahad Abduljabbar, Peter Jarzem
Journal: Case Rep Orthop (2015)

Septic arthritis is a clinical emergency requiring prompt diagnosis and treatment to avoid significant morbidity and mortality. Polyarticular septic arthritis (PASA) accounts for 15% of all infectious arthritides and rarely occurs in immunocompetent adults. Staphylococcus aureus is the most commonly isolated organism, with infection primarily affecting knees, shoulders, elbows, and hips. The morbidity associated with PASA is very high, and mortality in treated cases of PASA may be as high as 50% of cases. We report a case of PASA with associated epidural abscess in a healthy adult male, who presented with complaints of arthralgia and limited range of motion of his left shoulder, wrist, and ankle. He also presented with low back pain and motor weakness associated with an epidural abscess spanning L2-S1, with multilevel vertebral osteomyelitis. Surgical washout of the affected joints as well as decompressive laminectomies was performed, and he received a standard course of intravenous antibiotics. Staphylococcus aureus was isolated from joint aspirations and from blood cultures. The patient had a full neurological and functional recovery postoperatively with no sequelae. To the best of our knowledge this is the only case report of Staphylococcus aureus PASA with concomitant epidural abscess in an immunocompetent adult.
Case Report: Life-threatening hypercalcemia associated with MMR-deficient endometrial carcinoma secreting parathyroid hormone
Authors: Huazhen Liu, Dan Gao, Yongfa Huang, Ji Li, Mengyun Zhao, Zhaohui Lu, Ya Hu, Tao Wang, Yingqiang Zhang, Wenze Wang, Dongyan Cao
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: mmr-deficient, ectopic, endometrial carcinoma, hypercalcemia, parathyroid hormone
MeSH terms: Endometrial Neoplasms / complications, Endometrial Neoplasms / genetics, Goiter, Nodular, Hypercalcemia / complications, Hypercalcemia / pathology, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Middle Aged, Parathyroid Hormone / metabolism, Parathyroid Hormone-Related Protein, Parathyroid Hormone, Parathyroid Hormone-Related Protein

Ectopic secretion of parathyroid hormone (PTH) is a rare cause of hypercalcemia in malignancy patients. A 56-year-old woman with life-threatening hypercalcemia was caused by poorly-differentiated endometrial carcinoma secreting PTH with concomitant nodular goiter mimic parathyroid tumors. The elevated level of PTH and calcium decreased immediately after cytoreductive surgery (CRS). The pathology confirmed mismatch repair (MMR)-deficient endometrial carcinoma with PTH expression. The patient received four-course chemotherapy and one-course immunotherapy after CRS. The disease progression led to multiple organ failure and death about five months after CRS. To our knowledge, this is the first case of hypercalcemia caused by MMR-deficient endometrial carcinoma with ectopic PTH secreting and the first report of malignancy associated hypercalcemia complicated with nodular goiter.
A rare case of intracranial solitary fibrous tumor that is still alive after multiple surgical resections: a case report and review of the literature
Authors: YiMeng Gao, Yan Xu, RuiZhi Xie, YouBi Shen, DaoJin Xue, Zheng Zhen, JingJing Lu, Tao Huang, ZiZhuang Peng
Journal: Front Neurol (2023)
Keywords: follow-up, gross total resection, hemangioepithelial cell tumors, intracranial solitary fibrous tumor, multimodal treatment
MeSH terms: Case Reports

A Solitary Fibrous Tumor (SFT) is a rare, aggressive, and metastasis- and recurrence- prone mesenchymal tumor. In this case report and review, we describe a rare instance of intracranial SFT, discovered for the first time. It was discovered in 2008 and following total surgical removal, the pathology was categorized as hemangiopericytoma cell tumor (HPC) at the time by WHO tumor criteria. An imaging review 8 months after surgery revealed a tumor recurrence: combined radiation and gamma-knife therapy was continued throughout this time. The tumor did not metastasis until June 2018 when it presented in the pancreas with ruptured bleeding and a postoperative pathology was suggestive of SFT. Fortunately, the patient is still alive nearly 3 years after the 2020 surgery, after staged surgical resection and combined multimedia therapy, with no imaging or clinical evidence of a recurrent intracranial primary lesions. To our knowledge, there is no previous record of using a combined treatment modality for Intracranial Solitary Fibrous Tumor (ISFT). Combined with an account of the patient's experience, we empirically describe a combined approach with a preference for gross-total resection (GTR), supplemented by multimodal assistance with stereotactic (radiotherapy), gamma knife (GK), molecular targeting, and immunization for patients admitted acutely, with accurate preoperative identification and aggressive management after intraoperative case response to maximize treatment of recurrent ISFT and improve prognosis. We recommend multimodal management for SFT with prolonged-term recurrence and metastases, both for the control benefits of GTR, RT, or GK for local recurrence and for the positive prognosis of targeted and immune metastases.