OpenMed/multicare-articles huggingface dataset:
Retroodontoid Pseudotumor Related to Development of Myelopathy Secondary to Atlantoaxial Instability on Os Odontoideum
Authors: M Hamard, S P Martin, S Boudabbous
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Retroodontoid pseudotumor (ROP) is a nonneoplasic lesion of unknown etiology, commonly associated with inflammatory conditions, and the term of pannus is usually used. Less frequently, ROP formation can develop with other noninflammatory entities, with atlantoaxial instability as most accepted pathophysiological mechanism for posttraumatic or degenerative ROP. As it can clinically and radiologically mimic a malignant tumor, it is paramount for the radiologist to know this entity. Magnetic resonance imaging is the modality of choice to reveal the possible severe complication of ROP in the form of a compressive myelopathy of the upper cervical cord. The purpose of the surgical treatment is the regression or complete disappearance of ROP, with posterior decompression by laminectomy and posterior C1-C2 or occipitocervical fixation. We present the case of an elderly patient with retroodontoid soft tissue mass secondary to a chronic atlantoaxial instability on os odontoideum, an extremely rare cause of ROP. The patient developed a posttraumatic cervical myelopathy related to the decompensation of this C1-C2 instability responsible for the formation of a compressive ROP. We will overview the retroodontoid pseudotumor and its differential diagnosis.
Efficiency of fluorescent cholangiography during laparoscopic cholecystectomy for subvesical bile ducts: A case report
Authors: Hirotaka Kitamura, Toshikatsu Tsuji, Daisuke Yamamoto, Tohru Takahashi, Shinichi Kadoya, Masaru Kurokawa, Hiroyuki Bando
Journal: Int J Surg Case Rep (2019)
Keywords: aberrant bile duct, bile duct injury, duct of luschka, fluorescence imaging, hepaticocholecystic duct

Introduction:
The subvesical bile ducts are located in the peri-hepatic connective tissue of the gallbladder fossa. Injury of the subvesical bile ducts provokes the severe complication of bile leak. Until now, fluorescent cholangiography has been employed during hepatobiliary surgery. Herein, we report the detection of subvesical bile ducts by fluorescent cholangiography during laparoscopic cholecystectomy.
Presentation of case:
A 63-year-old female was admitted to our department for surgery for symptomatic cholelithiasis. The subvesical bile ducts were not observed on drip-infusion cholangiography with computed tomography. Immediately following induction of anesthesia, 2.5 mg of indocyanine green was intravenously injected. Fluorescent cholangiography demonstrated two thin aberrant bile ducts during dissection of Calot's triangle. We considered them to be subvesical bile ducts. We ligated them with clips, divided them, and then performed laparoscopic cholecystectomy using a standard procedure. The patient had a good post-operative recovery without bile leakage. Postoperative laboratory test results were all within normal limits. Computed tomography revealed no dilatation of the intrahepatic bile duct after laparoscopic cholecystectomy. The patient was discharged on postoperative day 4.
Discussion:
Injury to the subvesical bile ducts is one of the most common causes of bile leakage associated with cholecystectomy. Fluorescent cholangiography enabled real-time identification of the thin subvesical bile ducts, which were undetectable by drip-infusion cholangiography with computed tomography.
Conclusion:
Fluorescent cholangiography during laparoscopic cholecystectomy may be useful for preventing postoperative bile leakage.
Right upper quadrant pain and raised alkaline phosphatase is not always a hepatobiliary problem
Authors: G Cheyne, F Runau, D M Lloyd
Journal: Ann R Coll Surg Engl (2014)
MeSH terms: Abdominal Pain / etiology, Abscess / diagnosis, Alkaline Phosphatase / metabolism, Bile Duct Diseases / diagnosis, Spinal Diseases / diagnosis, Case Reports, Cholangiopancreatography, Magnetic Resonance, Diagnosis, Differential, Empyema / diagnosis, Empyema / etiology, Humans, Liver Function Tests, Male, Middle Aged, Alkaline Phosphatase

Right upper quadrant pain is a common presenting complaint to the general and hepatobiliary surgical team. Differential diagnoses include gallstones, cholecystitis, liver and pancreatic pathology. A 64-year-old man presented to our general surgical unit with right upper quadrant pain and deranged liver function tests. He underwent ultrasonography several times as well as magnetic resonance cholangiopancreatography (MRCP) in pursuit of hepatobiliary pathology. However, it was the identification of an empyema on MRCP that led to computed tomography of the thorax and the eventual discovery of the cause of the pain: a paraspinal abscess causing T10/T11 discitis. Right upper quadrant pain and deranged liver function tests justify hepatobiliary investigation. Nevertheless, after several negative tests, the differential diagnoses should be broadened and referred pain considered.
IgG4-Related Disease, the Malignancy Mimicker: Case Series from Bahrain
Authors: Majeed Haider, Fatima Haji, Osama Alalwan, Eman Aljufairi, Tejal S Shah
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

IgG4-related disease is an evolving immune-mediated condition. The hallmark of this condition is IgG4(+) plasma cells infiltration of the affected organs accompanied by a variable degree of fibrosis and occasionally elevated serum IgG4 level. It links many conditions that were once recognized as isolated unrelated idiopathic single organ disorders (e.g., autoimmune pancreatitis, Mikulicz syndrome, and retroperitoneal fibrosis) under one umbrella. It usually presents clinically as tumor-like swelling of the involved organs that can be misdiagnosed as neoplasia. In this case series, we present four cases that were considered as neoplasia but turned out to be IgG4-related disease, we demonstrate the protean manifestations of this condition and variable organs involvement, and we share our experience in using rituximab as the steroid sparing immunosuppressant agent to control this disease.
Acantholytic variant of squamous cell carcinoma of breast: a rare case report
Authors: Ht Kamra, Pa Gadgil, Sa Chaware, Ua Kanade
Journal: Ecancermedicalscience (2011)
Keywords: pseudoglandular, acantholytic, breast, squamous cell carcinoma
MeSH terms: Case Reports

Primary squamous cell carcinoma of the breast is a very rare and aggressive malignancy, and very few have been reported in the literature. Here we report a case of an acantholytic variant of a squamous cell carcinoma of the breast in a 60-year-old woman who presented with a lump in the right breast. Histogenesis is controversial as to whether a pure form of squamous cell carcinoma exists or if these malignancies represent an extreme squamous metaplasia within an adenocarcinoma. Prognosis and management is uncertain due to its rarity and controversy over its definition.
Octreotide Infusion for the Treatment of Congenital Chylothorax
Authors: Sumayyah Ahmed Nezar Kobeisy, Abdulaziz Alkhotani, Mohammed M Barzanji
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Congenital chylothorax is an uncommon cause of pleural effusion in the pediatric age group, and it should be kept in consideration when evaluating a neonate with pleural effusion, as it is the commonest cause of pleural effusion in this age group (Tutor, 2014). No commonly accepted guidelines have been published so far regarding the management of congenital chylothorax in the neonate, but trials of octreotide have appeared to be promising (Bellini et al., 2018). We present a neonate with congenital chylothorax successfully treated with octreotide infusion.
Spontaneous Gastric Necrosis: A Rare Presentation of Invasive Mucormycosis in an Immunocompetent Adult
Authors: Tariq Hameed, Sudhir Kumar Jain, Faiz Manzar Ansari, Adiba Nizam, Amrita Dua
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Spontaneous gastric perforations are usually seen in patients with untreated peptic ulcer disease. Mucormycosis, an uncommon, opportunistic, life-threatening fungal infection, rarely causes gastric perforation in immunocompetent adults. Here, we present a case of young female who was admitted to hospital for acute pain abdomen and distension with 5 days history of fever. She was operated and was found to have multiple perforations in the stomach with transmural necrosis. Despite adequate surgical excision and intravenous amphotericin B, patient succumbed to sequelae of infection.
Polyarteritis Nodosa Following mRNA-1273 COVID-19 Vaccination: Case Study and Review of Immunological Mechanisms
Authors: Bahadar S Srichawla
Journal: Cureus (2023)
Keywords: coronavirus disease 2019, covid 19, moderna covid-19 vaccine, moderna mrna adverse effects, mrna-1273 vaccine, pfizer-biontech covid-19 vaccine, pfizer-biontech covid-19 vaccine related adverse events, polyarteritis nodosa, sars-cov-2, severe acute respiratory syndrome coronavirus 2
MeSH terms: Case Reports

Numerous post-vaccine complications have been reported secondary to the COVID-19 vaccine. Many of these complications are believed to be due to a hyperactive immune system. A 59-year-old woman developed diffuse abdominal pain two days after receiving the mRNA-1273 COVID-19 vaccine (Moderna). A computerized tomography (CT) angiogram of the abdomen and pelvis revealed the presence of numerous vascular irregularities in the celiac axis, bilateral renal arteries, and inferior mesenteric artery consistent with polyarteritis nodosa (PAN), a medium-vessel vasculitis. The patient was managed with intravenous methylprednisolone 500 mg daily for three days and was then placed on oral methotrexate (MTX) 12.5 mg daily for immunosuppressive maintenance treatment. Until now, a limited number of cases of polyarteritis nodosa secondary to the COVID-19 vaccine have been reported. Major mechanisms of post-vaccine autoimmunity are molecular mimicry and autoantibody production. Although rare adverse events from COVID-19 vaccination are possible, there remains an immense benefit to vaccination in preventing COVID-19-related morbidity and mortality.
Extramedullary hematopoiesis within cystic renal cell carcinoma with oncocytic and chromophobe cell types: A case report
Authors: Betul Celik, Tangul Bulut, Murat Sedele, Cem Sezer, Volkan Karakus
Journal: Oncol Lett (2014)
Keywords: chromophobe, extramedullary hematopoiesis, oncocyte, renal cell carcinoma

Extramedullary hematopoiesis (EMH) is a phenomenon in which hematopoietic cells are found in sites other than the bone marrow. It is usually observed in the liver and spleen but may occasionally be found within solid tumors. The current case report presents a 69-year-old female patient who presented with a renal cyst. Histopathological examination following surgical removal of the cyst revealed a lining of oncocytic- and chromophobe-type cells with capsular invasion and a mass forming EMH with evident bone trabeculae within the cyst wall. Circulating hematopoietic stem cells in the blood and their colonization within tissues is discussed in the present case report, emphasizing certain types of renal cell carcinoma.
Recurrent Extradural Myxopapillary Ependymoma With Oligometastatic Spread
Authors: Kristen A Batich, Richard F Riedel, John P Kirkpatrick, Betty C Tong, William C Eward, Char Loo Tan, Patricia D Pittman, Roger E McLendon, Katherine B Peters
Journal: Front Oncol (2019)
Keywords: extradural, glial fibrillary acidic protein, myxopapillary ependymoma, oligometastases, post-sacral
MeSH terms: Case Reports

Myxopapillary ependymomas are a slow-growing, grade I type glial tumor in the lumbosacral region. More rarely, they can present as extradural, subcutaneous sacrococcygeal, or perisacral masses, and it is under these circumstances that they are more likely to spread. Here, we report the presentation of a sacrococcygeal mass in patient that was initially resected confirming extradural myxopapillary ependymoma. At initial resection, multiple small pulmonary nodules were detected. This mass recurred 2 years later at the resection site with an interval increase in the previously imaged pulmonary nodules. Resection of both the post-sacral mass and largest lung metastasis confirmed recurrent myxopapillary ependymoma with oligometastatic spread. Because these tumors are rare, with extradural presentation being even more infrequent, to this date there are no definitive therapeutic guidelines for initial treatment and continued surveillance. For myxopapillary ependymoma, current standard of care is first-line maximal surgical resection with or without postoperative radiotherapy depending on the extent of disease and extent of resection. However, there remains insufficient evidence on the role of radiotherapy to oligometastatic foci in providing any further survival benefit or extending time to recurrence. Thus, prospective studies assessing the role of upfront treatment of oligometastases with local resection and adjuvant radiotherapy are needed for improved understanding of extradural myxopapillary ependymoma.
Metabolic syndrome features presenting in early childhood in Alström syndrome: a case report
Authors: Özgür Pirgon, Mehmet Emre Atabek, Ilhan Asya Tanju
Journal: J Clin Res Pediatr Endocrinol (2009)
Keywords: alström syndrome, child, metabolic syndrome
MeSH terms: Alstrom Syndrome / complications, Metabolic Syndrome / etiology, Case Reports, Alstrom Syndrome / genetics, Child, Humans, Male, Metabolic Syndrome / genetics, Metabolic Syndrome / physiopathology

Alström syndrome is a rare autosomal recessive disorder characterized by retinal degeneration, sensorineural hearing loss, early-onset obesity, and non-insulin-dependent diabetes mellitus. Affected individuals have normal birth weight, but growth deceleration starts at about 8-10 years of age. In patients with the disorder linked to chromosome 2, the increase in body mass index is very high in childhood and continues high thereafter. In this paper, we report a patient who had the proposed diagnostic criteria for Alström syndrome associated with metabolic syndrome starting at age 7, a relatively early age.
A Rare Case of Stroke Secondary to Iron Deficiency Anemia in a Young Female Patient
Authors: Kavitha Gopalratnam, Kevin Andrew Woodson, Jigarkumar Rangunwala, Kanaga Sena, Manisha Gupta
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Ischemic strokes occur when there is a sudden obstruction of an artery supplying blood flow to an area of the brain, leading to a focal neurological deficit. Strokes can be thrombotic or embolic in etiology and are associated with underlying conditions such as hypertension and atherosclerosis. Possible etiologies of strokes include cardioembolic disease, hematologic disorders, connective tissue disorders, and substance abuse or can be cryptogenic. Most stroke cases are seen in patients over 65 years of age. However, about one-fourth of strokes occur in young adults. Iron deficiency anemia (IDA) has been described as a known cause for strokes in children, but very few case reports describe this association in adults. We describe a 20-year-old female who presented with sudden onset left side weakness. Magnetic Resonance Imaging (MRI) of the brain demonstrated ischemic infarctions. Patient was also found to be severely anemic. Patient had a thorough work-up including Magnetic Resonance Angiography (MRA) of the brain, echocardiogram, and an extensive screen for thrombophilia disorders. This, however, did not demonstrate a clear etiology. As it has been suggested that IDA is a potential cause for stroke, it is possible the stroke in this young patient was attributable to severe IDA.
Inferior Pole Sleeve Fracture of the Patella in an Adolescent: A Case Report
Authors: Koshiro Shimasaki, Masafumi Uesugi, Takahiro Kobayashi, Haruka Tanaka, Harumitsu Ichimura
Journal: Cureus (2023)
Keywords: avulsion fracture, patella fracture, pediatric sleeve fracture, pediatrics, pull-out
MeSH terms: Case Reports

An 11-year-old boy was admitted to our hospital due to severe pain in his right knee when he landed after jumping over a vaulting box. A plain X-ray image and computed tomography scan showed an avulsion fracture of the lower pole of the patella and patella alta. Furthermore, magnetic resonance imaging (MRI) revealed an articular cartilage lesion and rupture between the inferior pole of the patella and the patella tendon. We diagnosed a sleeve fracture of the patella and performed surgical treatment. Open reduction and internal fixation were performed by the pull-out technique using transosseous no. 2 MaxBraid™​​​​​​ ​(Zimmer Biomet, Tokyo, Japan) sutures. While postoperative weight-bearing was permitted, the knee joint was immobilized in a brace for four weeks. Three months of postoperative assessment revealed excellent functional outcomes.
Laparoscopic exploration in pediatric surgery emergencies
Authors: Isabela Drăghici, Liviu Drăghici, Maria Popescu, Mircea Liţescu
Journal: J Med Life (2010)
MeSH terms: Emergencies, Laparoscopy / methods, Pediatrics, Case Reports, Child, Child, Preschool, Humans, Minimally Invasive Surgical Procedures

The laparoscopic approach of pediatric surgery emergencies represents a specific preoccupation in hospitals everywhere in the world. Nowadays, when confronted with this pathology, pediatric surgeons are able to apply certain well-defined therapeutic protocols, depending on the technical equipment at their disposal and their laparoscopic expertise and training. We hereby present some of the surgical pediatric emergencies that have been subjected to minimally invasive celioscopic techniques, in the Department of Pediatric Surgery "Maria Sklodowska Curie" Hospital, from August 1999 to July 2007. Out of 83 exploratory laparoscopies, 12 were performed for emergency pathology, other than acute appendicitis (in its various forms, including peritonitis) or acute cholecystitis. However, during the above-mentioned period, the number of therapeutic laparoscopies for emergencies has grown significantly (239 from a total of 663 laparoscopies), reflecting to a large extent the activity of a clinic with an emergency surgery profile. The authors conclude that exploratory laparoscopies in pediatric surgery emergencies are suited for surgical teams with a solid experience in celioscopy and a certain professional maturity, necessary to correctly appreciate the surgical and anesthetic risks involved by each individual case. It is not recommended that inexperienced laparoscopic surgeons embark on the "adventure" of this minimally invasive approach for this type of pathology. Only when the training and learning process is fully and correctly completed, specialists are offered the advantage of continuing a celioscopic exploration by performing a minimally invasive therapeutic procedure, even for a pediatric emergency case.
Functional and aesthetic reconstruction of a dorsal digital skin defect with a sensory neurotized DMCA III flap
Authors: Martin Aman, Arne Boecker, Ulrich Kneser, Leila Harhaus
Journal: Case Reports Plast Surg Hand Surg (2021)
Keywords: dmca flap, dorsal finger defect, nerve, neurorrhaphy, reconstruction
MeSH terms: Case Reports

The dorsal metacarpal artery (DMCA) flap is an elegant way to reconstruct tissue defects. We present a 25-year-old female patient with a dorsal injury on the fourth digit, which was reconstructed with a third webspace DMCA flap which was neurorrhaphied with a branch of the ulnar nerve, to regain sensation.
Unilateral upper limb chorea associated with hyperthyroidism: A case report and literature review
Authors: Wei Chen, Bin Wu, Hongna An, Kaiying Zheng, Daming Zhai, Jiahua Zang, Xiaobing Wu
Journal: Front Neurol (2022)
Keywords: graves' disease, chorea, hyperthyroidism, initial presentation, involuntary movement
MeSH terms: Case Reports

Chorea, a hyperkinetic syndrome, is generally reported in patients with Huntington's disease (HD), hyperglycemia, and other diseases but occasionally occurs in patients with Grave's disease. Here, we report a 44-year-old woman presenting with a 1-year history of involuntary movements with a known history of primary hyperthyroidism. Physical examination revealed the continuous, rapid, irregular, and spontaneous choreic movement of her right arm. Laboratory investigations demonstrated increased triiodothyronine (T3) and free thyroxine (FT4) and suppressed thyroid-stimulating hormone (TSH) levels. An electroencephalogram and brain magnetic resonance imaging were normal. After antithyroid treatment, the patient achieved complete remission. Our case indicated that hemichorea might initially manifest hyperthyroidism. Therefore, thyroid function tests should be routinely performed in patients with chorea.
Dog bite- fracture of the mandible in a 9 month old infant: a case report
Authors: Twm Walker, Pc Modayil, L Cascarini, Jc Collyer
Journal: Cases J (2009)

Background:
We present the case of a fractured mandible due to a dog bite in a 9 month old female. Dog bites in this age group are rare as are fractured mandibles. There are only two reported cases of fractured mandibles due to dog bites in the literature. This is the youngest. The other reported cases were in a 1 year old and also in a 4 year old.
Case presentation:
A 9 month old female was brought by her parents to the Emergency Department after sustaining a dog bit to the face. This was assessed by the emergency physicians and deemed to be superficial. The patients wounds were irrigated, and she was given oral antibiotics. She was transferred to our department were she was assessed under anaesthetic. A fracture of her mandible was discovered and treated with open reduction and internal fixation.
Conclusion:
The case presentation highlights the important of proper assessment of facial lacerations for not only neurovascular status and the parotid duct, but also the hard tissues. The case also highlights the difficulty of treating children and infants with fractures of the mandible and the importance of follow-up to monitor growth.
Epileptic Seizure Provoked by Bone Metastasis of Chronic Lymphoid Leukemia and Merkel Cell Carcinoma
Authors: András Folyovich, Angéla Majoros, Tamás Jarecsny, Gitta Pánczél, Zsuzsanna Pápai, Gábor Rudas, Lajos Kozák, Gábor Barna, Katalin A Béres-Molnár, Károly Vadasdi, Gabriella Liszkay, Eszter Horváth, Gergely Toldi
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Merkel cell carcinoma (MCC) is a rare primary neuroendocrine cutaneous tumor, rarely metastasizing to the brain. Chronic lymphoid leukemia (CLL) is a disease predisposing to MCC. According to previous reports, headache and focal neurological deficits suggest disease progression to the brain. We present a patient with MCC whose seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. Case Presentation. A 62-year-old female patient had a history of CLL. A lesion with the appearance of an atheroma was removed from the right upper arm. Histology confirmed the diagnosis of MCC. She was admitted to the neurology department with her first GM seizure. The cranial MRI/MRA showed bone metastases in the right parietal and both frontal areas, compressing the brain. Flow cytometry of CSF did not reveal metastasis of MCC.
Conclusions:
The case history of the patient was unique even among the rare cases of MCC with neurological involvement. The seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. In addition to patient history, clinical presentation and radiological findings enabled a suspected diagnosis of skull metastasis of MCC compressing the brain, causing symptomatic epileptic seizures.