OpenMed/multicare-articles huggingface dataset:
The Ankle Fleck Sign Indicating Fibular Avulsion of the Superior Peroneal Retinaculum
Authors: Kris Mertens, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2022)
Keywords: computed tomography, conventional radiography, magnetic resonance imaging, peroneal retinaculum avulsion, ultrasound
MeSH terms: Case Reports

Teaching point: A linear flake of bone at the posterolateral aspect of the distal fibula indicates avulsion of the superior peroneal retinaculum and warrants further investigation by dynamic ultrasound.
Prosthetic Valve Candida Endocarditis: A Case Report with 18F-FDG-PET/CT as Part of the Diagnostic Workup
Authors: Soile Pauliina Salomäki, Antti Saraste, Päivi Jalava-Karvinen, Laura Pirilä, Ulla Hohenthal
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Diagnosis of Candida spp. infective endocarditis (IE) is challenging, and diagnostic delays are common. We describe two patients with Candida spp. prosthetic valve endocarditis (PVE) and 18fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) as a part of diagnostic workup. We also refer to 5 other cases we found from the published literature. These cases highlight that 18F-FDG-PET/CT can improve diagnostic accuracy in prosthetic valve Candida endocarditis.
Simultaneous Bilateral Avulsion of Tibial Anterior Tubercle in Adolescent: Two Case Reports and Narrative Review of the Literature
Authors: Dario Giunchi, Jorge Gonzalez, Marco Odorizzi, Mario Sagaon Mendoza, Vincenzo De Rosa
Journal: Case Rep Orthop (2023)
MeSH terms: Case Reports

Fractures of the anterior tibial tuberosity are uncommon, ranging from 0.4% to 2.7% of all epiphyseal lesions reported. Bilateral sequential fractures are even rarer, with less than twenty-eight cases described to date and, as such, there is very little consensus data on their treatment as a whole. We report the first two documented cases of bilateral tibial tuberosity avulsions of the anterior tubercle in Switzerland, treated by open reduction and internal fixation. Both cases were 14-year-old healthy males with no previous medical history, who both suffered extra-articular fractures after falling from a height. The first case was treated in 2012 with a four-year long clinical follow-up and full recovery. The second, treated in 2019, was clinically followed for one year with a complete recovery and has returned to sporting activity at a pre-injury level. Due to the rarity of the condition, a lack of consensus on the optimal therapy, we believe the documentation of these two cases treated by the same team may be of clinical relevance.
Giant Hypopharyngeal Fibrovascular Polyp: A Case Report and Review of the Relevant Literature
Authors: Suheyl Haytoglu, Birgul Tuhanioglu, Abdurrahman Bozkurttan, Osman Kursat Arikan
Journal: Case Rep Otolaryngol (2015)

Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the hypopharynx. In this paper, we report a case of fibrovascular polyp of a 52-year-old female, who presented with progressive dysphagia and weight loss and regurgitating a mass from her mouth. By the endoscopic examination, a polyp covered by normal mucosa with a wide stalk was detected at the hypopharynx. The pedicle of the mass was identified under general anesthesia and the 13 × 3 × 2 cm mass was completely resected perorally. Histopathological examination of the tumor showed oedematous subepithelial fibrous stroma, surrounded by squamous epithelium and containing many congested vascular structures. No recurrence was detected over one year of follow-up. This case highlights the need for clinicians to be aware of this rare entity and to develop the best approach to patient management.
Unusual Maxillary First Molars with C-Shaped Morphology on the Same Patient: Variation in Root Canal Anatomy
Authors: Naji Kharouf, Youssef Haïkel, Davide Mancino
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

A maxillary first molar should be considered a four-canal tooth until proved otherwise; however, a clinician should also be aware of the possibility of the presence of C-shaped root canal configuration with or without possibility of splitting into two or three canals. The two clinical cases reported in this paper describe the endodontic treatment of two maxillary first molars, on the same patient, with uncommon anatomy: the first case is about a maxillary first molar with only one C-shaped root and one oval canal with a large buccolingual diameter, a C1 type according to Fan's classification; the second case, about the contralateral maxillary first molar, is probably the first case documented of a maxillary first molar with a C-shaped root canal and C-shaped root with complete fusion of the three roots, having a C3 configuration.
Benign Histiocyte-Rich Pseudotumor Developing Postchemotherapy and Mimicking Residual Disease
Authors: Amrit P Singh, Glenn P Murray, Soumya Pandey
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Histiocyte-rich pseudotumors (HRPT) developing postchemoradiation therapy are a florid response to treatment and reparative change. Although these are benign processes, clinically and radiologically, these may mimic recurrent/relapsed disease. We describe a case of an adult male with history of diffuse large B-cell lymphoma (DLBCL), status postchemoradiation therapy, who developed HRPT at the site of original involvement, mimicking relapse of disease on positron emission tomography/computed tomography (PET/CT) imaging. This is one of the few reported cases of posttreatment HRPT. This entity is important to point out the limitations of PET/CT imaging in patients with lymphomas and metastatic disease and stresses the importance of an excisional biopsy for determining relapse and the need for further treatment.
Avoidable Compartment Syndrome! High Index of Suspicion for a Newly Presenting Haemophiliac: A Case Series
Authors: A Niblock, K Donnelly, F Sayers, P Winter, G Benson
Journal: Case Rep Emerg Med (2016)

Bleeding disorders can present at any age and vary in their severity. Haemophilia, which is characterised by its x-linked recessive inheritance, can present with a spontaneous mutation and therefore no family history will be evident. Three cases of trauma induced thigh haematomas as an initial presenting feature for people with haemophilia are discussed. The cases highlight the importance of a coagulation screen if the patients bleeding phenotype does not match the injury sustained. An isolated prolonged APTT with no offending anticoagulant cause should always be investigated to look for underlying haemophilia. Interestingly the cases demonstrate the limitations of a coagulation screen. Factor VIII being an acute phase reactant can result in the fact that the initial coagulation screen may be temporarily normal. Therefore, if there is a high index of suspicion for a bleeding disorder, consider repeating the coagulation screen and seeking haematology opinion. Early diagnosis and appropriate specific factor replacement for an injured haemophiliac prevent haematomas expanding thus avoiding potential complications like compartment syndrome or unnecessary surgical input.
Case Report: Kearns Sayre Syndrome Complicated With Postpartum Cardiac Failure
Authors: Caixia Han, Zongyang Jia, Guangcai Zhao, Wenhui Chen, Yue Hu, Haiying Liu
Journal: Front Med (Lausanne) (2022)
Keywords: kearns sayre syndrome, cardiac failure, case report, mitochondrial, postpartum, pregnancy
MeSH terms: Case Reports

Kearns Sayre Syndrome (KSS) is a rare mitochondrial disease characterized by a primary dysfunction of the mitochondrial respiratory chain. Cardiac involvement is a poor prognostic factor of KSS. Pregnancy and delivery in a KSS patient with cardiac involvement is uncommon, and strategies for the supervision and management of this group remain unclear. Herein, we report and discuss pregnancy and delivery complicated with acute cardiopulmonary failure in a woman with KSS.
A typical bilateral Toxoplasma retinochoroiditis in a bone marrow transplant patient with negative serum titers
Authors: Albert Hazan, Rakesh M Patel, David Levinson, Umar Mian, David C Gritz
Journal: J Ophthalmic Inflamm Infect (2013)

Background:
Toxoplasma retinochoroiditis can have an atypical presentation and be difficult to diagnose in immunocompromised patients. Accurate diagnosis and appropriate treatment is important since the disease can be aggressive in these patients. This paper is a case report with literature review, emphasizing on the diagnosis and treatment of Toxoplasma retinochoroiditis.
Findings:
A 27-year-old male with chronic myelogenous leukemia with history of bone marrow transplantation presented with floaters in his right eye. Fundus exam showed bilateral, multifocal retinochoroiditis with subsequent development of a mild vitritis. Serum cytomegalovirus and toxoplasmosis antibody titers and syphilis screen were negative. Aqueous polymerase chain reaction (PCR) analysis revealed the presence of Toxoplasma gondii DNA OU. Clindamycin (1.0 mg/0.1 mL) was injected bilateral intravitreal OU twice at 4 days apart with subsequent resolution of retinochoroiditis.
Conclusions:
When evaluating retinochoroiditis in an immunocompromised patient, one must keep a high index of suspicion for atypical presentations of well-known disease entities. Aqueous and vitreous samples for PCR can be useful in obtaining an accurate diagnosis and therefore provide appropriate management for the patient. Intravitreal clindamycin is an option for treatment in these patients.
Unilateral triplicate ureter with ipsilateral ureterocele a case report
Authors: Mohammad Al-Zubi, Anas Al Faqieh, Oroub Altamimi, Soha Albeitawi
Journal: Int J Surg Case Rep (2020)
Keywords: congenital abnormality, smith classification, triplicate ureter, ureterocele
MeSH terms: Case Reports

Introduction:
Triplicate ureter is a rare congenital anomaly of the upper urinary tract.
Presentation of case:
In this case we present a triplicate ureter with ipsilateral ureterocele in a 9 years old boy. After literature review we found out this presentation very rare.
Discussion:
Ureteral triplication classified by Smith into 4 subtypes, and usually associated with other congenital abnormality, most common one is contralateral ureteric duplication. Usually this anomaly is asymptomatic. We present a type 3 ureteral triplication.
Conclusion:
Although triplicate ureter is a rare congenital anomaly, we must keep it in our differential diagnosis of unexplained urinary symptoms.
Combined Pre- and Postnatal Minimally Invasive Approach to a Complex Symptomatic Congenital Pulmonary Airway Malformation
Authors: Francesco Macchini, Stefano Mazzoleni, Giacomo Cavallaro, Nicola Persico, Irene Borzani, Ernesto Leva
Journal: European J Pediatr Surg Rep (2023)
Keywords: case report, congenital pulmonary airway malformation, neonate, thoraco-amniotic shunt, thoracoscopic lobectomy
MeSH terms: Case Reports

Congenital pulmonary airway malformation (CPAM) is a rare congenital lung lesion that usually remains asymptomatic during the fetal and neonatal period. However, it can occasionally cause prenatal cardiocirculatory failure and fetal hydrops, requiring a thoraco-amniotic shunt (TAS) placement. In other cases, it can also cause symptoms at birth (such as respiratory distress) and may require urgent surgical intervention. Thoracoscopic lobectomy for neonates is rarely reported. Here, we report a case of right macrocystic CPAM causing fetal hydrops at 27 weeks of gestation. The fetus was treated with a TAS placement that successfully resolved the hydrops. At 39 weeks of gestation, a male neonate was born (weight 2,850 g). The TAS spontaneously displaced during delivery, causing an open pneumothorax (PNX), initially treated with a drainage. His condition gradually worsened, requiring ventilatory support. Computed tomography (CT) scan showed different giant cysts in the context of the right lower lobe, left mediastinal shift, and compression of the rest of the lung. An urgent surgical management was required. A thoracoscopic right lower lobectomy was performed at 10 days of life (weight 2,840 g). The postoperative course was uneventful; the child remained totally asymptomatic and showed a good recovery. To the best of our knowledge, this is the first reported case of open iatrogenic PNX following TAS positioning and the second of neonatal thoracoscopic lobectomy in a newborn weighting less than 3 kg. The purpose of this report is to indicate that minimally invasive surgery is feasible, safe, and effective for the resection of CPAM, even in small newborns.
Idiopathic partial central diabetes insipidus
Authors: Larissa Fabre, Viviane Calice da Silva
Journal: Einstein (Sao Paulo) (2023)
MeSH terms: Diabetes Insipidus / complications, Diabetes Insipidus / therapy, Diabetes Insipidus, Neurogenic / diagnosis, Diabetes Mellitus, Case Reports, Humans

Diabetes insipidus is a rare disorder characterized by the inability to concentrate urine, which results in hypotonic urine and increased urinary volume. It may occur because of antidiuretic hormone deficiency or resistance to its action in the renal tubules. When there is a deficiency in the synthesis of antidiuretic hormones, diabetes insipidus is called central; when there is resistance to its action in the renal tubules, it is said to be nephrogenic. We report a case of idiopathic partial central diabetes insipidus and highlight the management and treatment of the disease.
A novel 8-bp duplication in ADAT3 causes mild intellectual disability
Authors: Ahmad Reza Salehi Chaleshtori, Noriko Miyake, Mohammad Ahmadvand, Oranous Bashti, Naomichi Matsumoto, Mehrdad Noruzinia
Journal: Hum Genome Var (2018)
MeSH terms: Case Reports

Inosine is a base located at wobble position 34 of the tRNA anticodon stem-loop, enabling the recognition of more than one codon in the translation process. A heterodimer consists of ADAT3 and ADAT2 and is involved in the adenosine-to-inosine conversion in tRNA. Here, we report the second novel ADAT3 mutation in a patient with microcephaly, intellectual disability, and hyperactivity. These findings constitute a second mutation and expand the clinical spectrum of extremely rare ADAT3 mutations.
Challenges and lessons from a primary care intervention in a Brazilian municipality
Authors: Mônica V Andrade, Kenya Noronha, Clareci S Cardoso, Claudia D L Oliveira, Júlia A Calazans, Michelle N Souza
Journal: Rev Saude Publica (2019)
MeSH terms: Community Health Services / standards, Diabetes Mellitus / epidemiology, Diabetes Mellitus / prevention & control, Hypertension / epidemiology, Hypertension / prevention & control, Primary Health Care / standards, Observational Study, Adolescent, Adult, Aged, Brazil / epidemiology, Child, Preschool, Chronic Disease, Community Health Workers, Cross-Sectional Studies, Family Characteristics, Female, Health Services Accessibility / statistics & numerical data, Humans, Infant, Male, Middle Aged, National Health Programs, Pregnancy, Reference Values, Risk Assessment, Risk Factors, Time Factors, Young Adult

Objective:
To address the implementation of the Lab for Innovation in Chronic Conditions in Santo Antonio do Monte, indicating the main challenges and lessons of a new chronic condition model.
Methods:
This is an observational study based on two sources of data: 1) two cross-sectional household surveys, 2013 (2012 as reference year) and 2015 (2014 as reference year), representative for the entire population and four target groups (pregnant women; children under two years old; individuals with hypertension and diabetes); medical records of individuals who self-reported having hypertension or diabetes in the household survey of 2013. A descriptive statistics analysis was performed.
Results:
The main findings showed that the public health system is the main provider of health services, mainly primary care, in Santo Antonio do Monte. Besides, the implementation of Lab for Innovation in Chronic Conditions showed the importance of building a Primary Health Care network in small municipalities.
Conclusions:
Community health agents and health managers played a fundamental role in the Primary Health Care network. The case study of Santo Antonio do Monte poses some challenges and lessons that clarify future interventions on building a Primary Health Care network that is essential to provide an adequate and longitudinal care to chronic conditions.
Gallbladder cancer during pregnancy treated with surgery and adjuvant gemcitabine: A case report and review of the literature
Authors: A Diciolla, M Gianoni, M Fleury, P Szturz, N Demartines, S Peters, R Duran, D Desseauve, Monnat A Panchaud, F Fasquelle, A Digklia
Journal: Front Oncol (2022)
Keywords: biliary tract cancer, chemotherapy, gallbladder cancer, gemcitabin, pregnancy
MeSH terms: Case Reports

Background:
Gallbladder cancer (GBC) represents the most common biliary tract cancer. Prognosis remains poor with 5-year overall survival rates less than 5% in advanced stages. GBCs are diagnosed more frequently in women, supposedly due to endocrine factors.
Case:
A 35-year-old woman, diagnosed with a non-metastatic GBC in the 22nd week of gestation, underwent a complete surgical resection 5 weeks later. Adjuvant gemcitabine was administered without complications, temporarily discontinued in the 32nd week to allow childbirth. The patient was disease-free for more than 3 years with ongoing remission at the last visit in July 2022. During the follow-up period, the child had no developmental, cognitive, or other health issues.
Conclusion:
Malignant tumors occur in about 0.1% of pregnant women, many are treated with chemotherapy. In oncology, the need to deliver optimal treatment in these patients represents a major concern. Both surgery and adjuvant chemotherapy of locally advanced GBC can be performed safely, with certain considerations, in the second trimester of pregnancy.
Concomitant primary angiosarcoma and invasive carcinoma of the breast: a case report
Authors: Mouna Zghal, Meriam Triki, Fatma Khanfir, Marwa Bouhamed, Imen Mallouli, Doulira Louati, Tahya Boudawara, Ines Saguem
Journal: Pan Afr Med J (2022)
Keywords: breast, case report, collision tumor, invasive carcinoma, primary angiosarcoma
MeSH terms: Breast Neoplasms / pathology, Carcinoma, Hemangiosarcoma / diagnosis, Hemangiosarcoma / pathology, Hemangiosarcoma / surgery, Case Reports, Breast / pathology, Female, Humans, Mastectomy, Middle Aged

Collision tumor is a rare entity composed of two different tumors that occur in close to one another and maintain distinct borders. Only few cases have been reported in the breast. We report the first case of concomitant and adjacent primary angiosarcoma (PBAS) and invasive carcinoma of the breast (IBC), in a 45-year-old patient which presented with a lump in her right breast. Biopsy revealed PBAS. She underwent mastectomy. Gross examination showed a hemorrhagic and spongy tumor in contact with a second small grayish-white mass. Histologically, the hemorrhagic tumor was consistent with a high grade (HG) PBAS; the second mass was consistent with an IBC with no images of histological admixture. The diagnosis of a collision tumor composed of HG PBAS and IBC was established. During follow-up, the patient developed ovarian angiosarcomatous metastasis. The diagnosis of breast collision tumor is very uncommon and hence is challenging for pathologist. Careful gross and microscopic examinations help in establishing the appropriate diagnosis.
Case Report: Pseudoxanthoma elasticum
Authors: Catarina Lucas, João Aranha, Isabel da Rocha, Domingos Sousa
Journal: F1000Res (2020)
Keywords: abcc6 gene, pseudoxanthoma elasticum, hypertension, retina angioid streaks
MeSH terms: Pseudoxanthoma Elasticum / diagnosis, Pseudoxanthoma Elasticum / genetics, Case Reports, Biopsy, Cardiovascular System / pathology, Child, Female, Humans, Retina / pathology, Skin / pathology, Ultrasonography

Pseudoxanthoma elasticum (PXE) is a rare inherited disorder, characterised by a progressive mineralization and fragmentation of elastic fibres of the skin, retina and cardiovascular system. At an initial stage, the skin usually exhibits distinctive lesions and subsequently extra-dermal manifestations. The diagnosis is based on clinical manifestations, histological analysis of the lesions and genetic analysis. This is a case report of a 12-year-old child complaining of painless, mildly itchy yellow papules in the cervical region with 1 year of evolution. PXE is currently an incurable disease and has a favourable prognosis when cardiovascular and retinal complications are prevented and monitored.
Prostate tuberculosis complicated by huge prostatic abscess: A rare case report from Nepal
Authors: Suman Baral, Raj Kumar Chhetri, Milan Gyawali, Neeraj Thapa, Ranjit Mahato, Rupesh Sharma, Prahar Dahal
Journal: Int J Surg Case Rep (2020)
Keywords: prostatic abscess, prostatic tuberculosis, trans-urethral loop drainage
MeSH terms: Case Reports

Introduction:
Prostatic tuberculosis is one of the rarest findings in clinical practice and associated prostatic abscess is even scarce, described in literatures. We present a rare case of prostatic tuberculosis complicated by huge prostatic abscess.
Presentation of a case:
A 68-year-old male with no any comorbidity presented with history of increased frequency of micturition along with poor flow, urgency and nocturia for 17 days. He was under medical treatment for benign enlargement of prostate for 2 years. Per rectal examination revealed a boggy cystic swelling anteriorly with enlarged prostate with mild tenderness. Ultrasonography abdomen and pelvis showed massive enlargement of prostate with central avascular necrotic area with moving internal echoes. Contrast enhanced computed tomography (CECT) showed 230 g of prostate with central liquefaction of approximately 101 mm3. Transurethral loop drainage along with resection of prostate was done. Histopathology revealed granulomatous prostatitis highly suggestive of prostatic tuberculosis. Prostatic abscess culture was negative. Patient is currently under category 1 anti-tubercular therapy.
Discussion:
Prostatic tuberculosis is a rare clinical finding which is commonly seen in patients with disseminated tuberculosis with immunocompromised status. Prostatic abscess in setting of granulomatous tuberculosis of prostate is even rarer. Transrectal ultrasonography is the investigation of choice for diagnosis of abscess if available. Treatment includes drainage of abscess preferably transurethral, and antitubercular therapy.
Conclusion:
Trans-urethral loop drainage is a safe treatment modality for patients presenting with prostatic abscess followed by anti-tubercular therapy if histopathology findings are suggestive of granulomatous lesions.
Removal of Separated Endodontic K-File with the Aid of Hypodermic Needle and Cyanoacrylate
Authors: Luciana Maria Arcanjo Frota, Bernardo Almeida Aguiar, Maria Gerusa Brito Aragão, Bruno Carvalho de Vasconcelos
Journal: Case Rep Dent (2016)

A wide range of accidents might happen during the treatment of the root canal system, where the instrument separation is one of the most unpleasant occurrences. Several techniques have been developed to facilitate the removal of the fragments; however, they generally require specific devices that not always are available to the clinician. The aim of this case report is to present a simple alternative technique to remove from the root canals manual instruments fractured during the treatment. The case has its outline based on a 31-year-old patient who sought the clinic to have her maxillary first left premolar rehabilitated. The clinic and radiographic examinations revealed the need of endodontic retreatment and the presence of a fragment of a K-file instrument localized at the apical third of the palatine canal. The retreatment was initiated by the removal of the obturation materials followed by several unsuccessful attempts to take out the fractured instrument. Hence, it was chosen to perform the fragment removal using a hypodermic needle and cyanoacrylate adhesive. The fragment easily came out, which reinforces the technique adopted as a safe, simple, and low cost mean to solve the problem of fractured instruments using only items already present in the endodontic arsenal.