OpenMed/multicare-articles huggingface dataset:
Sledge Hammer Impalement: a case report of challenges of managing a patient with a heavy pendant
Authors: M I Ajaero, C P Echieh, C Onyema, S Nduagu
Journal: Int J Surg Case Rep (2020)
Keywords: case report, impalement injury, zone 1
MeSH terms: Case Reports

Introduction:
Impalement injuries are well defined. Transfixion injuries involve impalement and are defined in terms of fixation usually to a large object.
Case report:
We report a spectacular case of sledge hammer impalement in the neck where the patient was transfixed, albeit to a small object, requiring movement of the patient and the transfixing object as a single unit.
Discussion:
The patient was fixed to the head of the sledge hammer because he was unable to move with the heavy pendant.
Conclusion:
We argue that transfixion injuries should be defined in terms of weight of the object in relation to the patient's weight and the ability of the patient to move (with) the impaling object.
A Rare Case of Penile Metastases as a Harbinger of Primary Pulmonary Adenosquamous Carcinoma
Authors: Partha Hota, Tejas N Patel, Xiaofeng Zhao, Carrie Schneider, Omar Agosto
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Although lung cancer has a high propensity for distant metastatic disease, penile metastases from primary lung neoplasms are considered particularly rare. A 71-year-old male presented to our hospital with a rapidly enlarging hard palpable penile mass. MR imaging demonstrated two penile masses centered in the left and right corpus cavernosa. Subsequent CT imaging revealed a spiculated pulmonary mass in the right upper lobe with PET/CT, MRI, and surgical exploration, demonstrating evidence of metastases to the left adrenal gland, right subscapularis muscle, brain, and small bowel. Tissue sampling of lesions in the small bowel, right subscapularis muscle, and penis demonstrated histopathology consistent with an adenosquamous carcinoma which in combination with the appearance of the right upper lobe mass on PET/CT imaging suggested the patient's lung cancer as the primary lesion. Prior to our case, pulmonary adenosquamous carcinoma metastasizing to the penis has only been reported once in the literature. Herein, we report a rare case of penile metastases as the presenting sign of metastatic pulmonary adenosquamous carcinoma characterized with PET/CT and MR imaging.
Dental transposition of canine and lateral incisor and impacted central incisor treatment: a case report
Authors: Tarcisio Jacinto Gebert, Vinícius Canavarros Palma, Alvaro Henrique Borges, Luiz Evaristo Ricci Volpato
Journal: Dental Press J Orthod (2014)
Keywords: corrective orthodontics, ectopic tooth eruption, impacted tooth
MeSH terms: Cuspid / pathology, Incisor / pathology, Maxilla / pathology, Tooth Eruption, Ectopic / therapy, Tooth, Impacted / therapy, Case Reports, Child, Female, Humans, Orthodontic Appliance Design, Orthodontic Brackets, Orthodontic Wires, Patient Care Planning, Space Maintenance, Orthodontic / instrumentation, Surgical Flaps / surgery, Tooth Eruption, Ectopic / surgery, Tooth Movement Techniques / instrumentation, Tooth Movement Techniques / methods, Tooth, Impacted / surgery

Introduction:
Dental transposition and impaction are disorders related to ectopic eruption or failure in tooth eruption, which can affect child physical, mental and social development and may be difficult to be clinically solved.
Methods:
We describe a case of transposition between the upper left canine and lateral incisor associated with impaction of the central incisor on the same side, in a 12-year-old patient. Conservative treatment involving surgical-orthodontic correction of transposed teeth and traction of the central incisor was conducted.
Conclusions:
The option of correcting transposition and orthodontic traction by means of the segmented arch technique with devices such as cantilever and TMA rectangular wire loops, although a complex alternative, was proved to be esthetically and functionally effective.
Recurrent multifocal diabetic myonecrosis: a cause of severe extremity pain in a diabetic patient
Authors: M J Welck, P Vetpillai, V Balaji, R Jennings, W D Goodier
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Diabetes Mellitus, Type 1 / complications, Diabetic Nephropathies / complications, Kidney Failure, Chronic / complications, Muscle, Skeletal / pathology, Musculoskeletal Pain / etiology, Case Reports, Adult, Extremities, Female, Humans, Magnetic Resonance Imaging, Necrosis / complications, Recurrence, Thigh

We detail the unusual occurrence of successive episodes of diabetic myonecrosis in both lower and upper limbs in a young woman with diabetic end organ dysfunction. We highlight the importance of recognising this as a differential diagnosis for acute limb pain in diabetic patients and advocate conservative measures for successful treatment and return to function.
Unveiling the genomic landscape of possible metastatic malignant transformation of teratoma secondary to cisplatin-chemotherapy: a Tempus gene analysis-based case report literature review
Authors: Christian M Farag, Elena K Johnston, Ryan M Antar, Shaher G Issa, Qasim Gadiwalla, Zoon Tariq, Sun A Kim, Michael J Whalen
Journal: Front Oncol (2023)
Keywords: tempus, adenocarcinoma, chemotherapy resistance, cisplatin (cas number
MeSH terms: Case Reports

In this case report, we describe a patient who developed metastatic liver cancer of unknown primary origin one year following the surgical removal of a retroperitoneal adenocarcinoma. The retroperitoneal adenocarcinoma is considered a malignant transformation of teratoma (MTT), given the patient's distant history of testicular tumor excised 25 years prior and treated with chemotherapy. Despite no primary tumor being identified, the leading primary hypothesis is that the liver metastasis stemmed from the resected retroperitoneal adenocarcinoma from one year prior. We theorize that the patient's cisplatin-based chemotherapy 25 years ago may have triggered the MTT, as documented in the existing literature. Using TEMPUS gene testing on both the retroperitoneal adenocarcinoma and the recently discovered liver metastasis, we identified several genes with variants of unknown significance (VUS) that could potentially be linked to cisplatin chemotherapy resistance. While we cannot conclude that this patient definitively underwent MTT, it remains the most plausible explanation. Future research should investigate both the validity of the genes we have uncovered with respect to cisplatin resistance, as well as other genes associated with cisplatin resistance to further understand the pathogenesis of cisplatin resistance for better prediction of treatment response. As the world of medicine shifts towards individualized therapies and precision medicine, reporting and analyzing genetic mutations derived from tumors remains imperative. Our case report aims to contribute to the growing database of defined mutations and underscores the immense potential of genetic analysis in directing personalized treatment options.
Late-onset benefit in progressive advanced hepatocellular carcinoma with continued sorafenib therapy: a case report
Authors: Yusuke Okuwaki, Takahide Nakazawa, Hisashi Hidaka, Akitaka Shibuya, Wasaburo Koizumi
Journal: J Med Case Rep (2012)

Introduction:
In the past, no effective systemic therapy has existed for patients with advanced hepatocellular carcinoma. Sorafenib, an oral multikinase inhibitor, has recently been shown to improve overall survival in patients with advanced hepatocellular carcinoma in two randomized, double-blinded, placebo-controlled trials. This drug has been approved as the first-line therapy for advanced hepatocellular carcinoma patients. We report an intriguing case of advanced hepatocellular carcinoma in which the patient achieved late- onset partial response by prolonged administration of sorafenib in spite of progressive disease.
Case presentation:
A 54-year-old Japanese man was treated with sorafenib for multiple lung metastases after surgical resection for advanced hepatocellular carcinoma accompanied by vascular invasion of the left branch of the portal vein. Although the effective diagnosis was progressive disease, almost all sites began to reduce or disappear eight months after the diagnosis of progressive disease. A dramatic reduction in alpha-fetoprotein and des-gamma-carboxy prothrombin levels was observed. The patient finally achieved partial response and his status remains unchanged.
Conclusions:
If tolerated, prolonged sorafenib treatment may be beneficial.
Abdominal Visceral Injury, a Devastating Consequence of Abdominal Liposuction: A Case Report and Literature Review
Authors: Mohamed H Khalaf, Mohammed Sameer, Mohammad B Khan, Aryan Ahmed
Journal: Cureus (2023)
Keywords: acute care surgery, bowel perforation, liposuction, liposuction complications, visceral injury
MeSH terms: Case Reports

Abdominal liposuction is a commonly performed cosmetic procedure. However, as with any procedure, it can be associated with complications. One of the life-threatening complications of this procedure is visceral injury and bowel perforation. This complication is very rare, nevertheless general, and acute care surgeons must be aware of its possibility, its management, and its possible sequelae. We report a case of a 37-year-old female who underwent abdominal liposuction which was complicated by bowel perforation and was transferred to our facility for further care. She underwent an exploratory laparotomy in which multiple perforations were repaired. The patient then underwent multiple surgeries including stoma creation and had a long postoperative course. A literature review reveals the devastating sequelae of reported similar visceral and bowel injuries. The patient eventually did well and her stoma was reversed. This patient population will require close intensive care unit observation and a low threshold of suspicion for missed injuries during initial exploration. Further down the line, they will need psychosocial support and the mental health implications of this outcome must be cared for. The long-term aesthetic outcome is yet to be addressed.
Delayed chylopericardium after radical surgery for esophageal cancer: a case report
Authors: Pengjie Yang, Rui Han, Benben Zhu, Yu Wu, Bater Han
Journal: Front Oncol (2023)
Keywords: a case report, chylopericardium, esophageal cancer, radical surgery, thoracic
MeSH terms: Case Reports

Background:
Postoperative chylpericardium is a rare clinical disease that often manifests as chest tightness, shortness of breathdyspnea, and other symptoms of pericardial tamponade. The etiological spectrum of chylopericardium is complex, but the disease is mainly idiopathic. Chylopericardium caused by thoracic surgery is rarely reported, both at home and abroad.
Case summary:
We report a case of a 65-year-old male patient who developed chylopericardium after thoracoabdominal combined incision and partial esophagogastric anastomosis plus lymph node dissection for 1 month. After pericardiocentesis and drainage, low-fat enteral nutrition, and parenteral nutrition, the patient was cured. Based on this case, this article reviews the literature on the diagnosis and treatment of chylopericardium after thoracic surgery.
Conclusion:
In conclusion, thoracic surgery (excluding cardiac surgery) can cause delayed chylopericardium. This condition is rarely reported in China, and only a few cases have been reported abroad. Thus, the diagnosis is likely to be missed or misdiagnosed. Early diagnosis and treatment are important to reduce patient discomfort as much as possible.
Case report: recognizing pneumatosis intestinalis: a case of bowel ischemia presenting as renal colic
Authors: Peter D Corr
Journal: Case Rep Radiol (2012)
MeSH terms: Case Reports

The clinical diagnosis of bowel ischemia is often difficult and the diagnosis can easily be missed unless there is a high index of clinical and radiological suspicion. Bowel ischemia and or infarction must be considered in the differential diagnosis in the older patient with pre-existing coronary artery or generalized vascular disease, cardiac failure, or arrhythmias especially atrial fibrillation and hypertension. An elderly patient with caecal infarction is presented who was initially diagnosed and treated for renal colic.
Phlebosclerotic Colitis - An Enigma Among Ischemic Colitis
Authors: Rishi Philip Mathew, Safwat Girgis, Malcolm Wells, Gavin Low
Journal: J Clin Imaging Sci (2019)
Keywords: idiopathic mesenteric phlebosclerosis, ischemic colitis, mesenteric vein calcification, phlebosclerotic colitis
MeSH terms: Case Reports

Phlebosclerotic Colitis is a rare, potentially life-threatening condition of unclear etio-pathogenesis seen almost exclusively in Asians and people of Asian descent. The condition predominantly affects the right hemicolon and imaging plays a crucial role in its diagnosis. Here we report the only second documented case of phlebosclerotic colitis in North America in a 60-year-old Canadian resident of Vietnamese descent with a history of consuming herbal medication (sanshishi) in soup for 2-3 decades.
Multiple ocular manifestations in a case of cat scratch disease without systemic signs
Authors: Kanako Annoura, Ichiya Sano, Shinji Makino, Hidetoshi Kawashima
Journal: GMS Ophthalmol Cases (2020)
Keywords: anterior uveitis, cat scratch disease, serous macular detachment
MeSH terms: Case Reports

A 43-year-old woman presented with impaired vision and redness in her left eye of 2 weeks duration. She had a pet cat that scratched her forehead 3 weeks before she presented to us. She had no systemic signs such as lymphadenopathy, fever, or fatigue. The respective right and left corrected visual acuities were 20/16 and 20/2000. The anterior chamber of the left eye exhibited inflammation; a fundus examination of that eye revealed optic disc swelling and a serous macular detachment with hard stellate exudates. Based on the recent cat scratch and the ocular findings, cat scratch disease (CSD) was suspected. The results of serologic testing showed elevated titres of IgM and IgG antibodies to Bartonella henselae. Administration of doxycycline and a steroid was initiated. This report describes the occurrence of multiple ocular manifestations of CSD in both the posterior and the anterior segment.
Case report: Atlantoaxial instability and subluxation in a dog with Ehlers-Danlos syndrome
Authors: Simon Choi, Louise Sullivan, Sam Long
Journal: Front Vet Sci (2023)
Keywords: ehlers–danlos, atlantoaxial instability, collagenopathy, congenital, connective tissue, surgery
MeSH terms: Case Reports

Ehlers-Danlos syndrome is a rare, heritable connective tissue disorder characterized by soft, hyperextensible skin, joint hypermobility, and tissue fragility, the severity of which can range from mild to severe. A 9-month-old male entire miniature Dachshund was presented following peracute tetraparesis. Neurological examination was suggestive of intracranial vestibular disease or high cervical myelopathy. MRI revealed atlantoaxial instability and subluxation, resulting in marked spinal cord compression at C1-C2, which was surgically stabilized. On discharge from the hospital, skin fragility was noted as the result of skin tearing during tape removal. A piece of full-thickness antebrachial skin was submitted for histopathology which showed changes consistent with Ehlers-Danlos syndrome. This case report describes the first case of atlantoaxial instability and subluxation in a dog as the result of a confirmed underlying collagenopathy.
Impressive reduction of brain metastasis radionecrosis after cabozantinib therapy in metastatic renal carcinoma: A case report and review of the literature
Authors: Jacopo Lolli, Francesca Tessari, Franco Berti, Marco Fusella, Davide Fiorentin, Davide Bimbatti, Umberto Basso, Fabio Busato
Journal: Front Oncol (2023)
Keywords: cabozantinib, immunotherapy, radionecrosis (rn), radiosurgery, stereotacic radiation
MeSH terms: Case Reports

Introduction:
Radionecrosis is a consequence of SRS (stereotactic radiosurgery) for brain metastases in 34% of cases, and if symptomatic (8%-16%), it requires therapy with corticosteroids and bevacizumab and, less frequently, surgery. Oncological indications are increasing and appropriate stereotactic adapted LINACs (linear accelerators) are becoming more widely available worldwide. Efforts are being made to treat brain radionecrosis in order to relieve symptoms and spare the use of active therapies.
Case presentation:
Herein, we describe a 65-year-old female patient presenting with brain radionecrosis 6 months after stereotactic radiotherapy for two brain metastatic lesions. Being symptomatic with headache and slow cognitive-motor function, the patient received corticosteroids. Because of later lung progression, the patient took cabozantinib. An impressive reduction of the two brain radionecrosis areas was seen at the brain MRI 2 months after the initiation of the angiogenic drug.
Discussion:
The high incidence of radionecrosis (2/2 treated lesions) can be interpreted by the combination of SRS and previous ipilimumab that is associated with increased risk of radionecrosis. The molecular mechanisms of brain radionecrosis, and its exact duration in time, are poorly understood. We hypothesize that the antiangiogenic effect of cabozantinib may have had a strong effect in reducing brain radionecrosis areas.
Conclusion:
In this clinical case, cabozantinib is associated with a fast and significant volume reduction of brain radionecrosis appearing after SRS and concomitant immunotherapy. This drug seems to show, like bevacizumab, clinical implications not only for its efficacy in systemic disease control but also in reducing brain radionecrosis. More research is needed to evaluate all molecular mechanisms of brain radionecrosis and their interaction with systemic therapies like third-generation TKIs.
Treatment of Ethylene Glycol Poisoning with Oral Ethyl Alcohol
Authors: B Achappa, D Madi, T Kanchan, N K Kishanlal
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Ethylene glycol poisoning is not uncommon in India. The ill effects are primarily caused by its toxic metabolites: glycolic acid and oxalic acid. A 70-year-old female presented to our hospital with ataxia after ingestion of ethylene glycol. The reported case describes the management of ethylene glycol poisoning using oral ethyl alcohol as an alternative to the recommended intravenous ethyl alcohol and fomepizole that are not available for use in India. The need for high degree of clinical suspicion, targeted investigations, and early instigation of treatment is of prime importance in cases of ethylene glycol poisoning as it can lead to long-term complications or even death.
Angioleiomyoma of the Auricle: An Unusual Tumor on a Rare Location
Authors: Jean Kanitakis
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Cutaneous angioleiomyomas (ALMs) (also known as vascular leiomyomas or angiomyomas) are unusual benign tumors of the skin deriving from the muscle layer of dermal blood vessels. They usually manifest as tender subcutaneous nodules, mostly encountered on the legs of adult women in their fifth or sixth life decade. ALMs rarely develop on the head/neck area, and even more rarely (<3% of all cases) on the auricle. Head/neck (including ear) ALMs differ from their more usual leg counterparts in that they are usually painless and do not show a female predominance. The diagnosis is clinically difficult, and most cases are diagnosed by histopathologic examination. A new case of an auricular ALM in a 40-year-old Caucasian man is reported herein, and a brief literature review on this unusual tumor is presented.
Recurrent Macroprolactinoma with Malignant Conversion to Carcinoma with Spinal Metastasis
Authors: Madeline Mori, Amanda Frugoli, Udesh Shah, Brad Barrows, Tricia Westhoff, David Westra
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

In contrast to pituitary adenomas, pituitary carcinomas represent a rare malignant neoplasm with a remarkable high mortality. Pituitary carcinomas can arise from any pituitary tumor cell line and are determined to be carcinomas when there is distant metastasis or central nervous system dissemination. In this case vignette, we describe a rare case of malignant prolactinoma with intraspinal metastasis, and we also provide a review of relevant literature and treatment.
Parotid gland, an exceptional localization of sebaceous carcinoma: case report
Authors: Mouna Khmou, Karima Laadam, Nadia Cherradi
Journal: BMC Clin Pathol (2016)
Keywords: carcinoma, gland, parotid, rare, sebaceous
MeSH terms: Case Reports

Background:
Sebaceous carcinoma (SC) is a rare malignancy, occurring predominantly in eyelids. Till date, only 25 cases of sebaceous carcinoma (SC) of the parotid gland have been reported in world literature.
Case presentation:
A 33 year-old male presented with left sided laterocervical mass. Clinical examination showed enlargement of the left parotid gland, with cervical lymphadenopathy. No skin lesions were found. A resection of the gland was performed. Pathological findings were consistent with primary sebaceous carcinoma of the parotid gland.
Conclusion:
Sebaceous carcinoma of the parotid gland is extremely uncommon. Clinical and radiological features are not specific. The aim of this report, is to describe histopathological, and immunohistochemical findings of this rare entity, and discuss differential diagnosis.
Switch to mania after ayahuasca consumption in a man with bipolar disorder: a case report
Authors: Alejandro G Szmulewicz, Marina P Valerio, Jose M Smith
Journal: Int J Bipolar Disord (2015)
Keywords: ayahuasca, bipolar disorder, dsm 5, mao inhibitors, switch to mania

Background:
There is an increasing use of ayahuasca for recreational purposes. Furthermore, there is a growing evidence for the antidepressant properties of its components. However, there are no reports on the effects of this substance in the psychiatric setting. Harmaline, one of the main components of ayahuasca, is a selective and reversible MAO-A inhibitor and a serotonin reuptake inhibitor.
Case report:
We present the case of a man with bipolar disorder who had a manic episode after an ayahuasca consumption ritual. This patient had had at least one hypomanic episode in the past and is currently depressed. We discuss the diagnostic repercussion of this manic episode.
Conclusion:
There is lack of specificity in the diagnosis of substance-induced mental disorder. The knowledge of the pharmacodynamic properties of ayahuasca consumption allows a more physiopathological approach to the diagnosis of the patient.