OpenMed/multicare-articles huggingface dataset:
Patient-Derived Organoid Facilitating Personalized Medicine in Gastrointestinal Stromal Tumor With Liver Metastasis: A Case Report
Authors: Ying Cao, Xi Zhang, Qianyun Chen, Xi Rao, Enming Qiu, Gang Wu, Yu Lin, Ziqi Zeng, Bin Zheng, Zhou Li, Zhai Cai, Huaiming Wang, Shuai Han
Journal: Front Oncol (2022)
Keywords: kit exon 11 mutations, gastrointestinal stromal tumor, pv560e, patient-derived organoid, personalized medicine
MeSH terms: Case Reports

The gastrointestinal stromal tumors (GIST) are a rare gastrointestinal tract malignancy. The two primary mutation sites are found in KIT and platelet-derived growth factor receptor-α (PDGFR-α) genes. The current study reports on a point mutation within the exon 11 of KIT, named KIT p.V560E. Patient-derived organoids (PDOs) are potential 3D in vitro models of tissues that can be used to identify sensitivity toward specific targets in patients with tumors and allow for personalized medicine when drugs specific for newly identified genetic locus mutations are not yet available. This study describes a 68-year-old patient who complained of diffused abdominal pain and intermittent melena lasting more than 10 days. He has no other gastrointestinal abnormalities, prior abdominal surgery, or related family history. Surgery was conducted first to remove the lesions and ascertain the disease through histology and immunohistochemical stains of the mass. Immunohistochemistry revealed that the tumor was positive for CD117 and Dog-1. Based on the above findings, he was diagnosed with GISTs. Gene detection analysis and organoid culture were then performed to verify clinical decisions. KIT p.V560E and the reduced number of RB1 copies were identified as two obvious mutations, so the patient was administrated first-line treatment of imatinib 400 mg/d. However, progressive disease prompted us to switch to sunitinib, and his condition gradually improved. Meanwhile, organoid culture showed sensitivity to sunitinib and tolerance to imatinib with half-maximal inhibitory concentration (IC50) values of 0.89 and >20, respectively. In summary, to the best of our knowledge, this is the first time that the established organoid culture indicated that the GISTs organoid could identify the sensitivity to target therapies and facilitate individual-based treatment.
A case of recurrent obscure gastrointestinal bleeding: Heyde's syndrome - case report and review
Authors: Rajarajeshwari Ramachandran, Hakim Uqdah, Niraj Jani
Journal: J Community Hosp Intern Med Perspect (2018)
Keywords: heyde’s syndrome, angiodysplasias, aortic stenosis, gastrointestinal bleeding, trans-valvular aortic valve replacement
MeSH terms: Case Reports

Gastrointestinal bleeding from angiodysplasias in patients with aortic stenosis is termed as 'Heyde's syndrome'. We report a case of Heyde's syndrome successfully treated with trans-catheter aortic valve replacement.
Treatment of acute tacrolimus toxicity with phenytoin in solid organ transplant recipients
Authors: Arin S Jantz, Samir J Patel, Wadi N Suki, Richard J Knight, Arvind Bhimaraj, A Osama Gaber
Journal: Case Rep Transplant (2013)

The pharmacokinetics of tacrolimus are influenced by many factors, including genetic variability, acute infections, liver dysfunction, and interacting medications, which can result in elevated concentrations. The most appropriate management of acute tacrolimus toxicity has not been defined though case reports exist describing the therapeutic use of enzyme inducers to increase tacrolimus metabolism and decrease concentrations. We are reporting on the utilization of phenytoin to assist in decreasing tacrolimus concentrations in a case series of four solid organ transplant recipients with acute, symptomatic tacrolimus toxicity presenting with elevated serum creatinine, potassium, and tacrolimus trough concentrations greater than 30 ng/mL. All four patients had the potential causative agents stopped or temporarily held and were given 300 to 400 mg/day of phenytoin for two to three days. Within three days of beginning phenytoin, all four patients had a decrease in tacrolimus concentration to less than 15 ng/mL, a return to or near baseline creatinine concentration, and lack of phenytoin-related side effects. Therefore, phenytoin appears to be a safe and potentially beneficial treatment option in patients with symptomatic tacrolimus toxicity.
Pancoast's Syndrome due to Fungal Abscess in the Apex of Lung in an Immunocompetent Individual: A Case Report and Review of the Literature
Authors: Anirban Das, Sabyasachi Choudhury, Sumitra Basuthakur, Sibes Kumar Das, Angshuman Mukhopadhyay
Journal: Case Rep Pulmonol (2014)

Malignant tumours in the apices of the lungs, especially bronchogenic carcinoma (Pancoast tumours), are the most common cause of Pancoast' syndrome which presents with shoulder or arm pain radiating along the medial aspect of forearm and weakness of small muscles of hand with wasting of hypothenar eminence due to neoplastic involvement of C8 and T1 and T2 nerve roots of brachial plexus. There are a number of benign conditions which may lead to Pancoast's syndrome; fungal abscess located in the apex of lung is one of them. Oral or intravenous antifungals are the treatment of choice in this case and complete recovery is usual, whereas, surgical resection followed by chemoradiotherapy is the treatment of choice in case of Pancoast's syndrome due to lung cancers. Hence, tissue diagnosis is mandatory. Here, we report a case of apical fungal abscess causing Pancoast's syndrome in an immunocompetent individual of 35 years of age to raise the awareness among the clinicians regarding this rare clinical entity.
Fluconazole for Hypercortisolism in Cushing's Disease: A Case Report and Literature Review
Authors: Yiming Zhao, Weiwei Liang, Feng Cai, Qun Wu, Yongjian Wang
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: cushing’s disease, cushing’s syndrome, fluconazole, hypercortisolism, medical treatment
MeSH terms: Antifungal Agents / therapeutic use, Cushing Syndrome / drug therapy, Cushing Syndrome / etiology, Fluconazole / therapeutic use, Pituitary ACTH Hypersecretion / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Brain / diagnostic imaging, Cryptococcosis / diagnostic imaging, Cryptococcosis / drug therapy, Cryptococcus neoformans, Cushing Syndrome / diagnostic imaging, Female, Humans, Lung / diagnostic imaging, Lung Diseases, Fungal / drug therapy, Magnetic Resonance Imaging, Middle Aged, Neurosurgical Procedures, Pituitary ACTH Hypersecretion / diagnostic imaging, Pituitary ACTH Hypersecretion / surgery, Tomography, X-Ray Computed, Treatment Outcome, Antifungal Agents, Fluconazole

Background:
Cushing's disease is associated with an increased risk of pulmonary fungal infection, which could be a relative contraindication for pituitary adenoma excision surgery.
Case:
We report a case of a patient with Cushing's disease and pulmonary Cryptococcus neoformans. A 48-year-old woman was admitted to our hospital because of moon face and edema. Laboratory and radiological findings suggested a diagnosis of Cushing's disease and pulmonary cryptococcus infection. Fluconazole 400 mg per day was administered intravenously and continued orally for 3 months. Both cryptococcus infection and hypercortisolism relieved and transsphenoidal resection was performed.
Conclusion:
Cushing's disease can be effectively treated with fluconazole to normalize cortisol concentration prior to pituitary surgery. Fluconazole is an alternative treatment especially in Cushing's disease patients with cryptococcal pneumonia.
Multiple Impacts of Urban Built and Natural Environment on Lung Cancer Incidence: A Case Study in Bengbu
Authors: Kangkang Gu, Yuwei Li, Xianjie Jia, Chengrong Liu
Journal: J Healthc Eng (2023)
MeSH terms: Environment, Lung Neoplasms / epidemiology, Research Support, Non-U.S. Gov't, Aged, China / epidemiology, Cities / epidemiology, Humans

Tumours are the main disease affecting the health of the Chinese population, and lung cancer is the malignancy with the highest incidence. Hence, the need to study and analyse the population of lung cancer incidence in order to effectively control and prevent it. In this research, we discuss the demographic characteristics of lung cancer incidence population of 2014 to 2020 from the perspective of multiple urban environmental factors, taking Bengbu city in the Huaihe River Basin of China as the research area, analyse the correlation between environmental indicators and lung cancer incidence population through the Spearman's rank correlation assessment model, and analyse the interaction between the influence factors of a geographic detector to analyse the influence of urban environmental factors. The results showed the followings: (1) The distribution characteristics of lung cancer incidence population were mainly geriatric population and spatially mainly fell in the old urban area of the study area, and the population distribution had clustered characteristics. (2) Through Spearman's rank correlation analysis, the land use, road traffic, spatial form, service facilities, and the open space of green space of the urban-built environment as well as the natural environment are all correlated with the incidence of lung cancer. (3) Factor detection and interaction analysis revealed a greater effect of spring and winter on lung cancer prevalence. In addition, the road intersection density and the distance to industrial are the most important potential influencing factors, and the interaction of any two factors will increase the risk of lung cancer.
Minimal Change Nephrotic Syndrome with Acute Kidney Injury after the Administration of Pfizer-BioNTech COVID-19 Vaccine
Authors: Erdinc Gulumsek, Dilan Damla Ozturk, Huseyin Ali Ozturk, Tayyibe Saler, Kivilcim Eren Erdogan, Ahmed Muhammad Bashir, Hilmi Erdem Sumbul
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Nephrotic syndrome progresses with various metabolic disturbances, such as proteinuria over 3.5 grams in 24 hours, hypoalbuminemia, and hypercoagulability. Patients usually complain about diffuse edema throughout the body, which is secondary to hypoalbuminemia. It has many primary and secondary causes. Patients may require a renal biopsy to confirm the diagnosis. Besides, many secondary causes of nephrotic syndrome should be examined and excluded. Although many vaccines were developed due to the COVID-19, many side effects are still reported because of the Pfizer-BioNTech COVID-19 vaccine (COVID-19 mRNA and BNT162b2), which is widely used in Turkey. This study examines a case of nephrotic syndrome with acute renal injury after Pfizer-BioNTech vaccine.
Deep head and neck infection causing pathological fracture of the mandibular condyle
Authors: Mette Werner Linderup, Sidse Bregendahl, Malene Helleberg, Sten Schytte, Arunas Pikelis, Sven Erik Nørholt
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

We report an unusual case of a 46-year-old male with a severe deep head and neck infection after extraction of two mandibular molars that led to a potentially life-threatening condition and caused pathological fracture of the mandibular condyle. This is the first published spontaneous pathological fracture of the mandibular condyle caused by an infection spread from a lower molar tooth. Based on CT scan we discuss the pathways of infection of odontogenic origin and the reflections of treatment. This case report illustrates an unusual presentation of a spontaneous pathological condylar fracture caused by a severe life-threatening infection after tooth extraction. It details the examination and management of the patient and reflections about the treatment.
Leser-Trélat syndrome in patients affected by six multiple metachronous primitive cancers
Authors: Giovanni Ponti, Gabriele Luppi, Lorena Losi, Alberto Giannetti, Stefania Seidenari
Journal: J Hematol Oncol (2010)
MeSH terms: Adenocarcinoma / diagnosis, Intestinal Neoplasms / diagnosis, Neoplasms, Second Primary / diagnosis, Neoplastic Syndromes, Hereditary / diagnosis, Stomach Neoplasms / diagnosis, Case Reports, Adenocarcinoma / complications, Aged, 80 and over, Humans, Intestinal Neoplasms / complications, Keratosis, Seborrheic / complications, Keratosis, Seborrheic / diagnosis, Male, Neoplasms, Second Primary / complications, Stomach Neoplasms / complications

Leser-Trélat syndrome is characterized by the eruptive appearance of multiple seborrheic keratoses in association with underlying malignant disease. Usually, the sign of Leser-Trélat is associated with adenocarcinoma, most frequently of the colon, breast, or stomach, but also of the lung, kidney, liver, and pancreas. Herein, we present a case that we believe is the first report of the sign of Leser-Trélat in association with occult gastric adenocarcinoma and the anamnestic oncologic history of five other multiple primitive cancers. Epidermal growth factor receptor (EGFR) immunohistochemical expression analysis of multiple seborrheic keratoses revealed an intense membranous staining in the basal keratinocytes and in all the upper epidermal layers. Patients with the sign of Leser-Trélat should undergo a diagnostic screening programme for malignant disease along with patients with known Leser-Trélat syndrome who present with a recent acute and florid eruption of their seborrheic keratoses. We propose the importance of combining the molecular features of multiple seborrheic keratoses with EGFR immunohistochemistry analyses to determine the likelihood of Leser-Trélat syndrome and the consequent high risk of underlying multiple visceral malignancies.
A Case of Glycogenic Hepatopathy as a Complication of Poorly Controlled Type 1 Diabetes Mellitus
Authors: Samhitha Munugoti, Vamsee Reddy, Gaurav Patel, Maneesh Gaddam, Triveni Abburi
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

A 23-year-old African American male with a medical history significant for poorly controlled type 1 diabetes mellitus (T1DM) presented with abdominal pain and vomiting. His laboratory workup was consistent with diabetic ketoacidosis (DKA). An acute elevation of liver enzymes was noted as the DKA resolved, with the alanine transferase and aspartate transferase levels elevated to more than 50 times the normal limit within the next 24 hours. Because abnormal liver function tests are found frequently in patients with type 1 diabetes mellitus, it is important to have a broad differential diagnosis. Furthermore, a low threshold of suspicion is required to identify a relatively underdiagnosed etiology like glycogenic hepatopathy (GH). This case report describes how patterns and trends of liver function tests provide important clues to the diagnosis of GH; how imaging modalities like ultrasonography, computerized tomography (CT) scan, and magnetic resonance imaging (MRI) scan could be used to differentiate GH from nonalcoholic fatty liver disease (NAFLD); and how the diagnosis of GH can be made without the need for invasive liver biopsy. The knowledge about GH should prevent its delayed diagnosis and improve the outcomes by appropriately managing uncontrolled type 1 DM.
Metastatic Primary Gastric Squamous Cell Carcinoma: An Uncommon Presentation of a Rare Malignancy
Authors: Michael Beattie, Ramy Mansour, Derek Thigpin, Carolyn Haus
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Primary gastric squamous cell carcinoma is a very rare disease. A 53-year-old male with history of hypertension, alcoholism, and nicotine abuse presented to the hospital after a syncopal episode. He complained of bloating abdominal pain, early satiety, and poor appetite. A CT of his abdomen and pelvis revealed a gastric mass with diffuse hepatic metastasis. A gastric mass was seen on upper endoscopy and biopsies revealed gastric squamous cell carcinoma. There was no involvement of the esophagus. This case should add to the limited literature and serve as a reminder that while this is a rare malignancy, it must be considered when evaluating a gastric mass.
Placement of Unilateral Cortical Bone Trajectory Screws in Previously Instrumented Pedicle without Removal of Existing Hardware for Adjacent Segment Disease
Authors: Rojeh Melikian, Sofia Yeremian
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Adjacent segment disease (ASD) in the lumbar spine is a possible consequence in segments adjacent to a fusion. As the number of lumbar fusions in the United States increases, the rates of ASD will continue to climb. There are several treatment options for ASD with open decompression and extension of the fusion being common. However, need for exposure and removal of existing instrumentation can lead to increased operative times resulting in increasing blood loss and infection risk. The purpose of this paper is to describe a case report for unilateral cortical trajectory screw instrumentation, allowing for posterior instrumentation without having to remove the existing pedicle screws in the setting of ASD. Our technique can be done with standard c-arm fluoroscopy without the need for navigation.
Endotracheal metastasis of hepatocellular carcinoma: a case report
Authors: Giacomo Ghinassi, Pasquale Imitazione, Alfonso Pecoraro, Luciano B G Montella, Paola Martucci, Raffaella Giacobbe, Campione Severo, Domenico Aronne
Journal: Multidiscip Respir Med (2019)
MeSH terms: Case Reports

We describe the case of a 75 years old patient with a history of hepatocellular carcinoma, with acute respiratory failure due to tracheal obstruction by metastasis, successfully treated with airway disobstruction with rigid bronchoscope.
Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma
Authors: Sreelakshmi N Nair, Raghavendra Kini, Prasanna Kumar Rao, Gowri P Bhandarkar, Roopashri Rajesh Kashyap, Roopashri Rajesh Kashyp, Manjunath Rai, Neel Naik, Athul Santhosh
Journal: Case Rep Dent (2016)
MeSH terms: Case Reports

Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma.
Revascularization of Chronic Total Occlusion of the Infrarenal Aorta in a Patient with Triple Vessel Disease: Report of a Case Treated by Endovascular Approach
Authors: Mahek Shah, Soumya Patnaik, Rahul Sinha, Issac Opoku-Asare, Khalid Chaudhry, Sean Janzer
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Surgical management of advance aortoiliac occlusive disease is time-tested and a widely practiced strategy, particularly when there is significant coronary artery disease associated with aortoiliac occlusive disease. The technological advances in the field of percutaneous techniques have facilitated the use of nonsurgical endovascular alternatives for peripheral arterial disease in patients with significant comorbidities at high surgical risk, as illustrated in our case report. We report a case of chronic total occlusion of the aorta that was treated percutaneously with endovascular stenting. We also discuss the specific technique used in this procedure.
Erector Spinae Plane Block for Different Laparoscopic Abdominal Surgeries: Case Series
Authors: Serkan Tulgar, Onur Selvi, Mahmut Sertan Kapakli
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

The ultrasound guided erector spinae plane (ESP) block is a recent block described for various surgeries for postoperative analgesia. ESP block has effect on both visceral and somatic pain; therefore, its use in laparoscopic cholecystectomy and other abdominal surgeries can be advantageous. We describe successful ESP block application in three different cases for postoperative pain. Two patient were operated on using endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy and one patient was operated on using laparoscopic cholecystectomy together with the inguinal hernia operation.
Case Report: Orbital Myositis and Myasthenia Gravis as Symptoms of Immune Reconstitution Inflammatory Syndrome in a Patient With Human Immunodeficiency Virus Infection
Authors: Yanli Wang, Ning Zhao, Jun Yang, Ying Wen
Journal: Front Immunol (2020)
Keywords: acquired immune deficiency syndrome, antiretroviral therapy, autoimmune diseases, myasthenia gravis, orbital myositis
MeSH terms: HIV Infections / complications, HIV Infections / drug therapy, HIV Infections / immunology, HIV Infections / pathology, HIV-1 / immunology, Immune Reconstitution Inflammatory Syndrome / complications, Immune Reconstitution Inflammatory Syndrome / drug therapy, Immune Reconstitution Inflammatory Syndrome / immunology, Immune Reconstitution Inflammatory Syndrome / pathology, Prednisolone / administration & dosage, Pyridostigmine Bromide / administration & dosage, Tacrolimus / administration & dosage, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Male, Myasthenia Gravis / complications, Myasthenia Gravis / drug therapy, Myasthenia Gravis / immunology, Myasthenia Gravis / pathology, Orbital Myositis / complications, Orbital Myositis / drug therapy, Orbital Myositis / immunology, Orbital Myositis / pathology, Prednisolone, Pyridostigmine Bromide, Tacrolimus

We present a case of a 37-year-old man with HIV infection who had been on antiretroviral therapy for one year. He was admitted to our hospital with red and swollen eyes, acute onset progressive exophthalmos, and intermittent diplopia endured for 7 days. His symptoms, exam, and imaging led to a diagnosis of immune reconstitution inflammatory syndrome associated orbital myositis. His symptoms improved considerably after glucocorticoid therapy. Following a reduction in the oral prednisone dose, he re-presented with left ptosis, which rapidly progressed to bilateral ptosis. Diagnostic testing led to the diagnosis of immune mediated myasthenia gravis. Treatment with pyridostigmine bromide, prednisone, and tacrolimus was initiated. One month later, the patient's symptoms improved significantly. There was a probable association between his symptoms and autoimmune immune reconstitution inflammatory syndrome. This report highlights the importance of recognizing autoimmune disorders in human immunodeficiency virus-infected patients undergoing antiretroviral therapy. Orbital myositis and myasthenia gravis in human immunodeficiency virus-infected patients correlate closely with immunity status following a marked increase in CD4+ T cell counts.