OpenMed/multicare-articles huggingface dataset:
Sjögren's Syndrome Complicated by Myeloid/Natural Killer Cell Precursor Acute Leukemia: Case Report and Review of the Literature
Authors: Hao Feng, Jianlin Qiao, Ningning Ding, Wei Chen, Kunming Qi, Xiuying Pan, Jiang Cao, Kailin Xu
Journal: Case Rep Hematol (2016)

We report a case of Sjögren's syndrome (SS) complicated by myeloid/natural killer (NK) cell precursor acute leukemia (M/NKPAL). A 75-year-old woman with a previous SS history for 2 years was routinely treated. Peripheral blood progenitor cells were increased, and subsequent bone marrow cell morphology examination showed the presence of acute myeloid leukemia type M4. However, flow cytometry analysis revealed that CD7/CD56/CD33/CD34/HLA-DR/cCD3 were all positive and myeloperoxidase- (MPO-) specific staining, other T cells, NK cells, and myeloid markers were all negative. Clonal T-cell receptor (TCR)β/TCRγ/TCRδ gene rearrangements and Epstein-Barr virus (EBV) were negative. The diagnosis of M/NKPAL was therefore confirmed. Unfortunately, this patient did not receive chemotherapy and later died of acute left heart failure and respiratory failure. SS complication with M/NKPAL is relatively rare. Combined with the relevant literatures, our study offers new insights into the clinical characteristics, pathological features, possible pathogenesis, and differential diagnosis of this rare disease.
Nevus-like appearance of primary malignant melanoma of the esophagus
Authors: Min-Jung Kang, Sun Young Yi
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

The primary malignant melanoma of the esophagus (PMME) is a rare malignant disease, accounting for only 0.1-0.2% of all esophageal neoplasms, and the majority of the patients are diagnosed at advanced stages with poor prognosis. We present here a case of 56-year-old woman with epigastric pain and her endoscopic finding revealed several flat and black pigmented mucosal lesions within the distal portion of the esophagus which looked like flat nevus. The histopathology and immunohistochemical profile of the tissue specimens were diagnostic of malignant melanoma.
Case report: Large follicular thyroid carcinoma with multiple cervical lymph node metastases
Authors: Fei Ye, Liyan Liao, Wanlin Tan, Yi Gong, Xiaodu Li, Chengcheng Niu
Journal: Front Surg (2022)
Keywords: pet/ct, tert promoter mutation, cervical lymph node metastases, follicular thyroid carcinoma (ftc), thyroid ultrasonography, vascular invasion
MeSH terms: Case Reports

Introduction:
Follicular thyroid carcinoma (FTC) rarely metastasizes to regional lymph nodes, as they mainly metastasize through hematogenous route; in particular, a large FTC with only lateral lymph node metastasis and without distant metastasis has rarely been reported.
Case report:
We present a 66-year-old male patient with a progressively growing thyroid for more than 20 years, causing tracheal compression and narrowing. Neck ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging and positron emission tomography-computed tomography (PET/CT) were carried out to obtain images of the thyroid and surrounding tissues. Total thyroidectomy and cervical lateral and central lymph node dissection were undertaken, and histopathological, and immunohistochemical evaluations and molecular pathology confirmed the diagnosis of FTC with multiple cervical lymph node metastases.
Conclusion:
We have reported a rare case of large FTC with diffuse nodal involvement but no distant metastases. We present the thyroid ultrasound, neck CT, MR and whole body PET/CT.
Collecting Duct Carcinoma of the Native Kidney in a Renal Transplant Recipient
Authors: Ian Zheng, Mahmoud Alameddine, Yaohong Tan, Zhobin Moghadamyeghaneh, Joshua S Jue, Ali Yusufali, Ahmed Farag, Gaetano Ciancio
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Collecting duct carcinoma (CDC) is a rare and aggressive form of renal cell carcinoma (RCC) arising from the epithelium of Bellini's duct. It presents earlier in life and has a poorer prognosis than the clear-cell type. Historically, immunosuppressed renal transplant patients are more likely to develop malignancies than the general population. We report a case of CDC of the native kidney in a 59-year-old man who initially underwent kidney transplantation five years before the time of presentation. To our knowledge, CDC in the setting of renal transplant and long-term immunosuppression has not been previously described.
Cardiogenic shock following administration of propofol and fentanyl in a healthy woman: a case report
Authors: Alfredo Renilla González, Iñigo Lozano Martinez-Luengas, Eva M Benito Martín, Sandra Secades González, Irene Alvarez Pichel, Paloma Alvarez Martinez, Elena Santamarta Liébana, Beatriz Díaz Molina
Journal: J Med Case Rep (2011)

Introduction:
Cardiogenic shock is very uncommon in healthy people. The differential diagnosis for patients with acute heart failure in previously healthy hearts includes acute myocardial infarction and myocarditis. However, many drugs can also depress myocardial function. Propofol and fentanyl are frequently used during different medical procedures. The cardiovascular depressive effect of both drugs has been well established, but the development of cardiogenic shock is very rare when these agents are used.
Case presentation:
After a minor surgical intervention, a 32-year-old Caucasian woman with no significant medical history went into sudden hemodynamic deterioration due to acute heart failure. An urgent echocardiogram showed severe biventricular dysfunction and an estimated left ventricular ejection fraction of 20%. Extracorporeal life support and mechanical ventilation were required. Five days later her ventricular function had fully recovered, which allowed the progressive withdrawal of medical treatment. Prior to her hospital discharge, cardiac MRI showed neither edema nor pathological deposits on the delayed contrast enhancement sequences. At her six-month follow-up examination, the patient was asymptomatic and did not require treatment.
Conclusion:
Although there are many causes of cardiogenic shock, the presence of abrupt hemodynamic deterioration and the absence of a clear cause could be related to the use of propofol and fentanyl.
Aggressive angiomyxoma of the vulva: a précis for primary care providers
Authors: R Elkattah, O Sarkodie, H Otteno, A Fletcher
Journal: Case Rep Obstet Gynecol (2013)

Vulvar aggressive angiomyxoma (AA) is a rare mesenchymal tumor of the vulva. Due to its slow-growing nature, it is often overlooked and misdiagnosed by primary care providers (PCPs). We describe a case report of vulvar AA in a 38-year-old woman who underwent complete surgical excision of the neoplasm with no evidence of recurrence on a 5-year followup. A literature review follows to provide PCPs with the clinical, radiologic, and pathologic features that this tumor displays.
Identification and Mapping of a 2,009-bp DNA Deletion in SERPING1 of a Hereditary Angioedema Patient
Authors: Wai-Yu Wong, Helen Wong, Elaine Au, Eric Chan
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

We report a heterozygous, 2,009 base pairs (bps) genomic DNA deletion within the SERPING1 gene that has not previously been reported in a case of type I hereditary angioedema (HAE). The patient is a 28-year-old Han Chinese female living in Hong Kong who has suffered from recurrent angioedema since adolescence, with increasing attack frequency as she entered adulthood; in the past, episodes occurred annually, but now occur every two to three months. The affected areas are not itchy and include common sites such as the left and right forearms, but without throat involvement. The patient also experiences epigastric pain. The patient's mother suffers from similar symptoms. A mutation in the serine protease inhibitor, clade G, member 1 (SERPING1) gene is associated with HAE. Patients with HAE type I commonly carry either a small deletion within SERPING1 or a truncated transcript. We performed a multiplex ligation-dependent probe amplification (MLPA) assay on our indexed patient. Our result suggests a 2,009 bps deletion spanning across exons 5 and 6 within SERPING1. Although earlier literature has described other large DNA deletions encasing exons 5 and 6 in SERPING1, these DNA rearrangements were larger in size between 4 and 6 kbps, and the breakpoint locations were generally not determined due to technical constraints (Pappalardo et al., 2000; Duponchel et al., 2001; Roche et al., 2005; Loules et al., 2018; and Göβwein et al., 2008). Our report describes mapping of this 2,009 bps in SERPING1. Using a combination of molecular techniques, we were able to confirm and locate this large heterozygous genomic DNA deletion that includes both exons 5 and 6 of SERPING1.
Conservative Management of Placenta Percreta: Three Cases and a Review of the Literature regarding Conservative Management of Placenta Accreta Spectrum (PAS) Disorders
Authors: M Patabendige, J M P Sanjeewa, A M A K G Amarasekara, R P Herath
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Background:
The incidence of placenta accreta spectrum (PAS) disorders has risen over the last decades, and there has been a gradual shift towards expectant management. Conservative management of PAS is known to reduce major obstetric haemorrhage and salvage hysterectomy. There is a lack of consensus on the follow-up of patients undergoing conservative approaches. Here, we describe the follow-up of three patients with placenta percreta who were conservatively managed and review the literature for the conservative management of PAS. Case Presentation. We have successfully managed three cases of placenta percreta expectantly using combined methods involving symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass.
Conclusions:
Use of a combined approach with symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass with colour Doppler may guide the surveillance of these conservatively managed cases. However, at least one magnetic resonance imaging three months postoperatively may predict a further risk of delayed haemorrhage.
Laparoscopic repair of combined right diaphragm and liver injuries with a sharp object: a case report
Authors: M Kasım Arık, Sükrü Tas, Faruk Ozkul, Hasan Sahin, Ozan Karatağ, Muammer Karaayvaz
Journal: Case Rep Surg (2013)

Introduction. Diaphragm injuries develop following penetrating or blunt traumas. The purpose of the case report is to present a 28 year old male patient with stable hemodynamic findings treated with laparoscopic approach following a liver injury combined with a right diaphragm injury caused by a sharp penetrating object. Case. 4 cm long transverse laceration was observed near the middle axillary line in the 6th right intercostal space in the examination performed on a 28 year old male patient who applied to the emergency service due to sharp penetrating object injury. Respiratory sounds were decreased in the right side and the examination revealed sensitivity in the abdomen. Elevation in the right diaphragm and hemopneumothorax was monitored in chest X-ray and computerized tomography. Closed subaqueous thorax drain was placed and the patient was taken to the surgery with a right diaphragm injury prediagnosis. Laparoscopic exploration was performed to the patient with stable hemodynamic findings by entering through 10 mm port above the abdomen. 6 cm long injury at the right side of diaphragm and approximately 2 cm deep at the deepest point and 5 cm long linear laceration was observed in the 7th segment of the liver. The diaphragm was repaired laparoscopically with sutures that do not melt on their own. Tampon was applied to the laceration in the liver and bleeding control was performed with suture. Patient was discharged on the 3rd day because he had no problems during postoperative follow-ups. Result. No noticed right side diaphragm rupture and possible concomitant visceral organ injuries following a penetrant injury that can cause significant mortality and morbidity should be definitely kept in mind. The detection of right side diaphragm and liver injury is vital with high mortality in case of delayed diagnosis, and direct radiography and computerized tomography are helpful in the diagnosis. Surgical treatment with laparoscopic approach is a method that leads to less hospitalization duration and less pain in cases that are hemodynamically stable.
Multisystemic Side Effects of an Indispensable Old Drug: A Case Report of Chronic Lithium Use (A Patient with Multiple Side Effects of Lithium)
Authors: Levent Demirtas, Emin Murat Akbas, Husnu Degirmenci, Ali Gurel, Eren Duzgun
Journal: Case Rep Med (2015)

Presented here is a case of long-term lithium use, with multiple emerging lithium-associated side effects. An 82-year-old woman was brought into the emergency department because of loss of consciousness. According to the physical examination and laboratory analyses, patient was diagnosed with lithium-associated hypercalcemia, hyperparathyroidism, nephrogenic diabetes insipidus (NDI), symptomatic sinus bradycardia, and thyroid dysfunction. In the literature, there is a limited number of case reports with lithium induced multiple clinical conditions. Multiple clinical manifestations due to the side effects of chronic lithium use might be seen. Health care professionals should keep in mind that lithium-related side effects might trigger or exacerbate each other. To avoid toxicity, close follow-up and clinical supervision are important for the early diagnosis and treatment of these side effects, due to the narrow therapeutic index and obscure clinical signs and symptoms of toxicity.
Placenta Accreta following Hysteroscopic Lysis of Adhesions Caused by Asherman's Syndrome: A Case Report and Literature Review
Authors: Yuko Sonan, Shigeru Aoki, Kimiko Enomoto, Kazuo Seki, Etsuko Miyagi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Asherman's syndrome is defined as partial or complete obstruction of the uterine cavity primarily caused by intrauterine procedures and infections. Hysteroscopic adhesiolysis is commonly used to treat Asherman's syndrome. Although the frequency of placenta accreta is known to increase with pregnancy after hysteroscopic adhesiolysis, precise data remain unknown. We report a case of placenta accreta following hysteroscopic lysis of adhesions caused by Asherman's syndrome and IVF treatment and review the literature on placenta accreta following hysteroscopic adhesiolysis. It is necessary to consider placenta accreta as a complication of pregnancies after hysteroscopic adhesiolysis for Asherman's syndrome, particularly in those conceived using IVF.
Inflatable penile prosthesis placement after prior transcorporal artificial urinary sphincter placement: A case report
Authors: Leah Ashton, Brad Erickson, Amy Pearlman
Journal: Urol Case Rep (2022)
Keywords: aus, artificial urinary sphincter, artificial urinary sphincter, case report, ipp, inflatable penile prosthesis, inflatable penile prosthesis, prostatectomy complications, rte, rear tip extenders, sui, stress urinary incontinence, transcorporal aus
MeSH terms: Case Reports

Stress urinary incontinence and erectile dysfunction often coexist in men surgically treated for prostate cancer. Despite many men having both an artificial urinary sphincter and inflatable penile prosthesis to treat these conditions, there is limited information in the literature to guide surgeons when it comes to placing both devices. We recommend obtaining direct exposure of proximal crura to allow for complete dilation of corporal spaces for proper prosthetic placement. Further dissection via penoscrotal incision or perineal counter-incision can be utilized. Surgeons should consider dorsal lithotomy position at time of IPP placement to allow for perineal exposure.
Development of nephrotic syndrome after administration of sorafenib in a case of metastatic renal cell carcinoma
Authors: Yumiko Okuno, Haruki Kume, Chihiro Hosoda, Yukio Homma
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Nephrotic syndrome, after administration of tyrosine kinase inhibitors, is uncommon and not well known. A 62-year-old male, who had experienced a left nephrectomy due to a traffic accident 38 years ago, underwent a partial nephrectomy for right renal cell carcinoma (RCC). Histologically, the tumor was a clear cell RCC. Two years later abdominal CT revealed para-aortic lymph node metastasis. During these two years, serum creatinine had increased from 2.0 mg/dL to 2.9 mg/dL along with the appearance of proteinuria. After only a week of sorafenib, 400 mg/day, fever developed and sorafenib was stopped. Although normotensive, his serum creatinine increased to 3.83 mg/dL and serum albumin decreased from 1.8 g/L to 1.0 g/L. Proteinuria also worsened to 27.5 g/day. He became edematous, and ascites and cardiac effusions also appeared. He was diagnosed with nephrotic syndrome. A retrospective review of the histology of the partial nephrectomy revealed no change in the glomeruli.
Bilateral intracavernous carotid artery aneurysms presenting as diplopia in a young patient
Authors: Nikolaos Kopsachilis, Maria Pefkianaki, Gianluca Carifi, Ioannis Lialias
Journal: Case Rep Med (2013)

Introduction. Bilateral intracavernous carotid artery aneurysms (ICAAs) are extremely rare and difficult to treat. Case Report. A 26-year-old female presented in our clinic with acute diplopia due to oculomotor nerve palsy on the left side. Magnetic resonance imaging of the brain showed two heterogeneously enhanced masses indicating bilateral ICAA. An endovascular coil embolization was performed on the left side successfully, resulting in resolution of her symptoms. Conclusion. Thorough systemic evaluation in young patients with diplopia can reveal life-threatening underlying pathology and prevent major complications.
Case Report: Magnetic Resonance Imaging Features of Scrotal Angiomyofibroblastoma (AMF) With Pathologic Correlation
Authors: Jing Zeng, Lingtao Zhang, Changzheng Shi, Liangping Luo
Journal: Front Surg (2022)
Keywords: aggressive angiomyxoma, angiomyofibroblastoma (amf), angiomyofibroblastoma-like tumor, case report, magnetic resonance imaging
MeSH terms: Case Reports

Angiomyofibroblastoma (AMF) is a rare benign myofibroblastic tumor that mainly occurs in the genital tract of middle-aged female patients. However, it can also arise in the scrotum, spermatic cord, and bladder. We described, herein, a case of a 42-year-old patient who was admitted to our hospital with a left scrotal mass. Imaging examinations showed that the mass had abundant vessels and displayed obvious progressive intensification on enhanced MRI. The following histopathological and immunohistochemical studies led to the diagnosis of AMF. Here, we describe the magnetic resonance imaging findings of a case of scrotal AMF. We hope that the information can help radiologists to identify AMF.
A case of persistent foot pain in a neurofibromatosis type I patient
Authors: Vasilis Stavrinides, Salim Nasra
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Introduction. This is the case of a young male patient who presented to his family physician with atypical left foot pain, which was extremely resistant to analgesia and caused significant disability. Despite extensive investigations, the cause of his pain was not identified until 18 months after his initial symptoms, when the official diagnosis of malignant peripheral nerve sheath tumour (MPNST) was made. Detailed review of the patient's past history established the diagnosis of type I neurofibromatosis (NF-1), previously undetected. Discussion. NF-1 is an autosomal dominant genetic disorder caused by loss of function mutations of the NF1 gene in chromosome 17. Patients with this condition are at increased risk for developing MPNSTs which, however, are treatable only in early stages. Conclusion. Although monitoring NF-1 patients for the development of MPNSTs is common practice, the index of clinical suspicion in patients without an established NF-1 diagnosis is low. Any atypical pain in young adults should raise the possibility of this malignancy, and this case illustrates the fact that MPNSTs can be the first manifestation of NF-1 in patients previously undiagnosed with the disease.
Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
Authors: Tali Teitelbaum, Isaac Shochat, Golda Grinblat, Mohamad Taha, Itzhak Braverman
Journal: Case Rep Otolaryngol (2023)
MeSH terms: Case Reports

Background:
Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by "pushing" during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks' gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane.
Conclusion:
Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea.
Case Report: Syndrome of Remitting Seronegative Symmetrical Synovitis with Pitting Edema-A Rare but Treatable Condition in Palliative Medicine
Authors: L Merkle Moore, Jennifer M Brouner, Nelly Grigorian, R J Leach, Steven J Baumrucker
Journal: Palliat Med Rep (2022)
Keywords: rs3pe, bone pain, corticosteroids, palliative medicine, paraneoplastic, synovitis
MeSH terms: Case Reports

The syndrome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare diagnosis that is often missed due to lack of both definitive diagnostic criteria and awareness of the disease. This case report describes a patient with chronic lymphocytic leukemia whose diagnosis of RS3PE was possibly delayed due to concomitant treatment-related arthralgias. The pathophysiology, presentation, and treatment of RS3PE are discussed. Greater awareness of malignancy-related RS3PE is crucial from a palliative care perspective as typical opioid pain management will prove ineffective and delay appropriate treatment.
Pericardial Mesothelioma in a Dog: The Feasibility of Ultrasonography in Monitoring Tumor Progression
Authors: Rina Nabeta, Yuki Nakagawa, Shiori Chiba, Hou Xiantao, Tatsuya Usui, Kazuhiko Suzuki, Tetsuya Furuya, Ryuji Fukushima, Tsuyoshi Uchide
Journal: Front Vet Sci (2019)
Keywords: dog, early detection, pericardial mesothelioma, pleural dissemination, ultrasonography
MeSH terms: Case Reports

A 6-year-old neutered male Yorkshire Terrier presented with recurrent pericardial effusion. Although clinical examinations including computed tomography were inconclusive, an exploratory thoracotomy revealed multiple small nodules and plaques on the inner surface of the pericardial sac (Day 1). A subtotal pericardiectomy was performed to prevent cardiac tamponade due to the increasing pericardial effusion, and the resected section of the pericardium was histopathologically diagnosed with mesothelioma. After surgery, chemotherapy with intrathoracic carboplatin was commenced. During the course of the treatment, a detailed follow-up ultrasonographic scan was performed to detect early lesions disseminated on the pleura, originating from the primary pericardial mesothelioma. On Day 101, the minute pleural nodules, which were disseminated lesions as predicted, were successfully imaged by ultrasonography. As the clinical stage advanced, the nodules were observed to gradually increase in size and number, implying tumor progression. These observations highlight the feasibility of ultrasonography in detecting minute disseminated lesions at an early stage, monitoring tumor progression, and thereby, predicting the prognosis of canine pericardial mesothelioma.