OpenMed/multicare-articles huggingface dataset:
An Extremely Rare and Demanding Diagnosis of Primary Renal Synovial Sarcoma: A Case Report
Authors: Thiago Guimarães, Miguel Cristovão, Nuno Gião, Hugo Pinheiro, Luís Campos Pinheiro
Journal: Cureus (2023)
Keywords: primary renal synovial sarcoma, renal vein tumor thrombus, spindle cell, synovial sarcoma, syt-ssx fusion gene
MeSH terms: Case Reports

Primary renal synovial sarcoma (PRSS) is an extremely rare malignancy. The diagnosis of PRSS is unforeseen due to the absence of clinical and radiological typical aspects. Here, we present a case of a 69-year-old male with complaints of hematuria and left lumbar pain. Abdominal-pelvic computed tomography scan with contrast injection showed a solid mass of 8cm diameter in the left kidney and renal vein tumor thrombus. The patient was further subjected to robotic-assisted left radical nephrectomy and renal vein thrombectomy. We concomitantly performed left adrenalectomy and paraaortic lymphadenectomy. Immunohistochemical and genetic analysis revealed PRSS. This entity is characterized by abnormal chromosomal translocation t(X;18)(p11.2; q11.2) and consequently the characteristic SYT-SSX fusion gene. Due to the disease's rarity and severity, diagnosis and management of PRSS rely upon a demanding and multidisciplinary approach.
Infected hydrocele of the canal of nuck
Authors: Parkash Mandhan, Zaid Raouf, Khalid Bhatti
Journal: Case Rep Urol (2013)

Hydrocele of the canal of Nuck in children is rare. It may present as incarcerated inguinal hernia and necessitates emergency exploration. Risk of infection in hydrocele of the canal of nuck is very rare. We present a case report of a 5-year-old girl who presented with a left tender inguinolabial region swelling with fever, tachycardia, and mild dehydration. The clinical features were suggestive of strangulated left inguinal hernia and further imaging and surgical exploration revealed it to be an infected hydrocele of the canal of Nuck. High ligation and hydrocelectomy were performed. Hydrocele of the canal of Nuck in a female child presenting with an inguinal swelling should be considered in differential diagnosis.
A Rare Case of Multiple Myeloma Presenting as Evan's Syndrome
Authors: Anthony Karapetians, Tushar Bajaj, Amanda Valdes, Arash Heidari
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: evans syndrome, anemia, multiple myeloma, thrombocytopenia
MeSH terms: Anemia, Hemolytic, Autoimmune / diagnosis, Bone Marrow / pathology, Multiple Myeloma / diagnosis, Thrombocytopenia / diagnosis, Case Reports, Adult, Anemia, Hemolytic, Autoimmune / complications, Anemia, Hemolytic, Autoimmune / drug therapy, Antineoplastic Agents / therapeutic use, Bortezomib / therapeutic use, Female, Humans, Multiple Myeloma / complications, Multiple Myeloma / drug therapy, Steroids / therapeutic use, Thrombocytopenia / complications, Thrombocytopenia / drug therapy, Antineoplastic Agents, Steroids, Bortezomib, Evans Syndrome

Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan's syndrome (ES). Evan's syndrome is autoimmune hemolytic anaemia with autoimmune thrombocytopenia. A 44-year-old female was referred from her primary physician to the hospital as laboratory testing revealed haemoglobin of 5 gm/dL. The patient reported a two-month history of fatigue and a sixty-pound weight loss. Laboratory results demonstrated autoimmune hemolytic anaemia, C3 positivity, elevated immunoglobulin (Ig)G, elevated lactate dehydrogenase (LDH), low haptoglobin, elevated reticulocyte count, elevated RDW-CV (red blood cell distribution width-corpuscular volume), positive direct Coombs test, thrombocytopenia, and proteinuria, all of which led to an underlying ES. The patient was started on intravenous steroids followed by oral steroids. A flow cytometry, serum protein electrophoresis, and cytogenetics were obtained. A bone marrow biopsy revealed multiple myeloma and she was started on Bortezomib treatment. We present the fifth reported case of Evan's syndrome and multiple myeloma.
Incidental detection of operational tolerance in a deceased donor kidney transplant recipient lost to follow-up for more than 10 years: A case report and literature review
Authors: Sasmit Roy, Monzurul Hasan Chowdhury, Debargha Basuli, Sreedhar Adapa, Kenneth Bodziak
Journal: Clin Nephrol Case Stud (2023)
Keywords: graft survival, immunosuppression medications, kidney transplantation, operational tolerance
MeSH terms: Case Reports

Graft tolerance is a clinical state of absence of an immune response in the recipient toward a donor allograft without any exogenous immunosuppression. Although more prevalent in liver transplantation recipients, it has rarely been reported in renal transplant recipients. We present a 62-year-old deceased donor kidney transplant recipient who exhibited operational tolerance as they stopped immunosuppressant medications for more than 10 years and yet demonstrated stable graft function. Although various hypotheses, such as deletion, anergy, immunoregulation, and clonal exhaustion, have been experimentally validated, clinical "operational tolerance" of a renal allograft on a prolonged basis has been infrequently reported in the medical literature. This review intends to highlight possible etiologies and make clinicians aware of this possible rare condition to which more research is needed.
Treating Primary Arthroprosthesis Infection Caused by Mycobacterium abscessus subsp. a bscessus
Authors: Valerio Pace, Pierluigi Antinolfi, Emanuele Borroni, Daniela Maria Cirillo, Elio Cenci, Claudio Piersimoni, Angela Cardaccia, Marco Nofri, Chiara Papalini, Rosario Petruccelli, Fabrizio Marzano, Maria Bruna Pasticci
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Prosthetic joint infections (PJI) caused by nontuberculous mycobacteria are very rare, and results of treatment can be unpredictable. A 72-year-old female underwent hip replacement after an accidental fall in a local hospital in Santo Domingo. The postoperative period was uneventful except for a traumatic wound near the surgical scar. PJI caused by Mycobacterium abscessus subsp. abscessus was diagnosed 6 months later. A two-stage reimplantation was performed after a 3-month period of aetiology-directed therapy, including amikacin, imipenem, and clarithromycin. M. abscessus isolate was reported to be resistant to clarithromycin when incubation was protracted for 14 days and to harbour the gene erm(41). The patient manifested major side effects to tigecycline. At reimplant, microbiologic investigations resulted negative. Overall, medical treatment was continued for a 7-month period. When discontinued and at 6-month follow-up, the patient was clinically well, inflammatory markers were normal, and the radiography showed well-positioned prosthesis. Mycobacterium abscessus subsp. abscessus is a very rare cause of PJI, yet it must be included in the differential diagnosis, especially when routine bacteria cultures are reported being negative. Further investigations are needed to determine any correlations between clinical results and in vitro susceptibility tests, as well as the clinical implications of M. abscessus subsp. abscessus harbouring the functional gene erm(41). Moreover, investigations are needed for determine optimal timings of surgery and lengths of medical therapy to improve patient outcome.
Robot-Assisted Thoracoscopic Resection of a Posterior Mediastinal Mullerian Cyst
Authors: Calvin Chao, Vijay Vanguri, Karl Uy
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

First described in 2005, the Mullerian derived cyst in the mediastinum is a rare finding with few subsequent reports. We report a case of Mullerian cyst occurring in the mediastinum of a 49-year-old female that was resected by robot-assisted thoracoscopic surgery. To our knowledge, this is the first report of robot-assisted resection of Hattori's cyst. Histopathologic analysis revealed ciliated Mullerian-type tubal epithelium positive for paired box gene 8 (PAX8), estrogen receptor (ER), and progesterone receptor (PR), confirming Mullerian differentiation. We also review the clinical presentation, pathology, and differential diagnosis of such cysts.
Acute kidney injury in a patient with nontuberculous mycobacterial infections: a case report
Authors: Zachary Z Brener, Igor Zhuravenko, Michael Bergman
Journal: Cases J (2009)

Nontuberculous mycobacterial infections are an increasingly recognized cause of chronic lung disease in both immunocompromised and immunocompetent patients. Pre-existing lung disease, alcohol abuse, diabetes mellitus, malignancy, and smoking have been identified as important risk factors in nontuberculous mycobacterial infections, with only few cases of Nontuberculous mycobacterial infection in renal failure patients, mostly on peritoneal dialysis. However, acute kidney injury associated with atypical mycobacterial infection is a very rare clinical event. To our knowledge, the present patient is the first case of acute kidney injury in a patient with documented nontuberculous mycobacterial infection. Our case is also a first report of Mycobacteria avium complex and Mycobacteria gordonae isolated simultaneously from individual patient with nontuberculous mycobacterial disease.
An Illustration of Interpersonal Psychotherapy for Perinatal Depression
Authors: Huey Jing Renee Tan
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

This is a case of a 38-year-old married woman presenting with major depressive disorder one month after the birth of her third child. The depressive episode began in the context of interpersonal difficulties with her husband. In addition, she was also battling an internal conflict of continuing to pursue her career dream as an obstetrician and fulfilling her responsibility as a wife and a mother. Interpersonal psychotherapy (IPT) was selected as the treatment choice as an evidence-based peripartum treatment that could specifically address the two presenting problem areas, i.e., marital interpersonal dispute and role transition. This paper provides an illustration of IPT sessions conducted with verbatim selections of the sessions.
Tuberculous cold abscess of sternoclavicular joint: a case report
Authors: Ismail Burud, Mohammad Arshad Ikram, Mahadevan Deva Tata, Junalina Jaafar
Journal: Pan Afr Med J (2020)
Keywords: swelling of sternoclavicular joint, cold abscess, extrapulmonary tuberculosis, tuberculosis
MeSH terms: Antitubercular Agents / administration & dosage, Sternoclavicular Joint / microbiology, Tuberculosis, Osteoarticular / diagnosis, Case Reports, Abscess / microbiology, Adult, Debridement / methods, Humans, Male, Mycobacterium tuberculosis / isolation & purification, Tuberculosis, Osteoarticular / therapy, Antitubercular Agents

Bone and joint tuberculosis is a serious medical problem; tuberculosis of sternoclavicular joint is rare. We present a case of a healthy 37-year old man with sternoclavicular joint tuberculosis. The subject presented with a three weeks history of left sternoclavicular joint painless swelling without fever or weight loss. He had no previous history of pulmonary tuberculosis. Laboratory testing revealed erythrocyte sedimentation rate of 70 mm/hour, C-reactive protein of 30 mg/liter and a normal leucocyte count. Biopsy of the lesion showed caseous necrosis and pus culture revealed Mycobacterium tuberculosis. He was treated with joint debridement and anti-tuberculous medications. Tuberculosis resolved completely but post-infection patients had residual joint arthritis. Tuberculosis may infect unusual joints such as the sternoclavicular joint.
Sodium oligomannate combined with rivastigmine may improve cerebral blood flow and cognitive impairment following CAR-T cell therapy: A case report
Authors: Yan-Li Wang, Yuan Zhang, Jun Xu
Journal: Front Oncol (2022)
Keywords: car-t, cerebral blood flow, cognitive impairment, rivastigmine, sodium oligomannate
MeSH terms: Case Reports

Chimeric antigen receptor-T (CAR-T) cell therapy is a breakthrough for B-cell hematological malignancies but is commonly associated with cytokine release syndrome and neurotoxicity and is occasionally complicated by neurological symptoms, such as cognitive disturbances. Currently, no effective treatments for CAR-T therapy-related cognitive impairment are available. Here, we present a 22-year-old patient with cognitive impairment who was treated with CAR-T cells as a salvage therapy for Burkitt lymphoma. One month after CAR-T cell infusion, he experienced memory loss that mainly manifested as forgetting recent-onset events. Two months of rehabilitation and hyperbaric oxygen therapy failed to provide clinical improvement. Subsequently, the patient improved with oral oxiracetam for 5 months. However, after 10 months of withdrawal, he showed significantly worse memory decline. Then, he began to take sodium oligomannate (22 February 2021). Follow-up testing at 6 and 12 months revealed maintenance of memory gains with sodium oligomannate alone or in combination with rivastigmine. Our case shows that CAR-T therapy may compromise cognitive function and that sodium oligomannate may have partial efficacy in restoring cognitive performance and activities of daily living. This may provide insights for further applications of sodium oligomannate for neurological symptoms, especially cognitive deficits following CAR-T cell therapy.
Cervical Interspinous Ligament Sprain in a 6-Year-Old Boy
Authors: Thomas Saliba, Hanna Salame, Denis Tack
Journal: J Belg Soc Radiol (2022)
Keywords: cervical spine injury, ligament injury, paediatric cervical spine, soft tissue injury, spine trauma
MeSH terms: Case Reports

Paediatric cervical spine trauma, though rare, is difficult to detect as the injuries are often soft-tissue injuries and thus not visible using conventional radiography. A 6-and-a-half-year-old child presented with neck pain following a fall. A thorough radiological workup over several days demonstrated soft-tissue injuries, undetected by initial cervical X-rays, requiring MRI to definitively prove. The patient recovered with conservative treatment. Teaching Point: Paediatric cervical spine injuries often present with soft tissue injuries, which can missed on X-rays and require further imaging to detect.
A ruptured aneurysm in the vasa corona at the craniocervical junction with dysgenesis of the posterior inferior cerebellar artery
Authors: Katsuhiro Mizutani, Takenori Akiyama, Dai Kamamoto, Hideaki Nagashima, Kazunari Yoshida
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

This paper reports the case of a ruptured aneurysm in the vasa corona at the craniocervical junction with dysgenesis of the posterior inferior cerebellar artery (PICA). Dysgenesis of the proximal PICA in the present case caused the development of a pial anastomosis in the vasa corona, resulting in the formation of an aneurysm because of increased haemodynamic stress at the vasa corona. The aneurysm was successfully treated with transarterial coil embolization. The clinical entity in the present case is extremely rare and it is important to consider an aberrant vascular anomaly as the cause of an isolated spinal aneurysm.
Prolonged menstruation and increased menstrual blood with generalized δ electroencephalogram power: A case report
Authors: Fenghua Peng, Lianping Zhang
Journal: Exp Ther Med (2014)
Keywords: electroencephalogram, estradiol, prolonged menstruation, δ frequency

Estradiol changes associated with the menstrual cycle have a great impact on brain activation. δ frequency mainly appears during normal sleep status or brain injury diseases, including encephalitis and mental confusion. The current case report presents a 51-year-old female with prolonged menstruation and increased menstrual blood volume whose electroencephalogram (EEG) recording demonstrated a rare generalized 3 Hz δ frequency band in the waking status. The patient had been suffering from heart palpitations and dizziness for 6 months and was receiving treatment in the Department of Neurology (Second Xiangya Hospital). The individual had been experiencing prolonged menstruation and increased menstrual blood volume for 6 years. Gynecologial examination revealed secondary anemia and hysteromyoma. Hemoglobin levels were decreased to 69 g/l. Physical and neurological examinations, and computed tomography results appeared normal. The EEG recording indicated a generalized 3 Hz δ frequency band with 30-80 μV power and a long-range δ frequency band when the patient was hyperventilating. The prolonged menstruation and increased menstrual blood volume may have induced the generalized δ frequency without brain injury. To the best of our knowledge, this is the first formal case report of prolonged menstruation and increased menstrual blood volume with the abnormality of δ EEG power.
Draft genome sequence of Venturia carpophila, the causal agent of peach scab
Authors: Chunxian Chen, Clive H Bock, Bruce W Wood
Journal: Stand Genomic Sci (2017)
Keywords: cladosporium carpophilum, fungal pathogen, fusicladosporium carpophilum, prunus persica, venturiacae
MeSH terms: Case Reports

Venturia carpophila causes peach scab, a disease that renders peach (Prunus persica) fruit unmarketable. We report a high-quality draft genome sequence (36.9 Mb) of V. carpophila from an isolate collected from a peach tree in central Georgia in the United States. The genome annotation is described and a phylogenetic analysis of the pathogen is presented. The genome sequence will be a useful resource for various studies on the pathogen, including the biology and ecology, taxonomy and phylogeny, host interaction and coevolution, isolation and characterization of genes of interest, and development of molecular markers for genotyping and mapping.
Systemic mastocytosis: a rare cause of osteoporosis
Authors: Vishnu Vardhan Garla, Kanooz Ul Qadir Chaudhary, Abid Yaqub
Journal: Pan Afr Med J (2019)
Keywords: osteoporosis, bisphosphonate, secondary osteoporosis, systemic mastocytosis, tryptase, urticaria
MeSH terms: Alkaline Phosphatase / metabolism, Mastocytosis, Systemic / diagnosis, Osteoporosis / etiology, Case Reports, Absorptiometry, Photon / methods, Bone Density, Diphosphonates / administration & dosage, Female, Humans, Mastocytosis, Systemic / complications, Middle Aged, Osteoporosis / diagnosis, Osteoporosis / drug therapy, Diphosphonates, Alkaline Phosphatase

A 61-year old female patient who was referred to the endocrine clinic for evaluation of an elevated alkaline phosphatase. She was originally referred to gastroenterology (GI), however no GI causes of elevated alkaline phosphatase was found. Upon fractionation, it was noted that she had elevation in bone specific alkaline phosphatase. Past history was significant for hypertension, atrial fibrillation and menopause 6 years ago. She was also noted to have multiple drug allergies manifesting as urticaria and flushing. Review of the past records revealed a persistently elevated alkaline phosphatase over the last two years. She had no history of falls or fractures. Computed tomography (CT) abdomen done to rule out biliary pathology, revealed osteosclerotic and osteolytic lesion in the pelvis concerning neoplastic disease. Bone marrow biopsy however, was negative for cancer but consistent with systemic mastocytosis (SM). Dual Energy X-ray absorbimetery (DEXA) scan revealed osteoporosis Serum tryptase levels were elevated; further genetic analysis showed a positive CKIT D816 mutation. She was started on bisphosphonates (initially alendronate and then ibandronate). Upon follow up at two years she had not experienced any fractures and her bone mineral density also had improved significantly.
Two cases of focal status epilepticus in pregnancy
Authors: Andrew Christiana, Micaela Della Torre, Anna Serafini
Journal: Epilepsy Behav Rep (2021)
Keywords: continuous eeg, epilepsy, fetal heart tracing, focal status epilepticus, pregnancy
MeSH terms: Case Reports

The management of women with epilepsy (WWE) presents many challenges for physicians. The primary goal during pregnancy is to achieve the best possible control of seizures with the least adverse effects associated with exposure to antiseizure medications (ASMs). Even though the guidelines for managing pregnant WWE are expanding, no definitive guidelines exist for the treatment of status epilepticus (SE). Additionally, much of our data comes from the effect of generalized tonic clonic seizures on the fetus. There is very little data on the effect of focal seizures and even less on focal SE. Here we present two cases of pregnant WWE who presented in focal SE, who underwent simultaneous video-EEG monitoring and fetal heart tracing (FHT). During each focal seizure the FHT demonstrated a normal baseline heart rate with moderate variability. In the second case due to continuous seizures more aggressive treatment had to be started. This led to maternal relative autonomic instability as well as absent variability on FHT. These findings raise many questions on the management of focal SE during pregnancy including if the effect of treatment is worse than the seizures, and how do we balance our goals for both mother and fetus?
Surgical Repair of a Quadricuspid Aortic Valve With Severe Regurgitation Utilizing "Tricuspidization" and Annular Banding: A Case and Technique Details Report
Authors: Yang Yu, Ruixuan Huang, Zheng Ding, Enyi Shi, Tianxiang Gu
Journal: Front Cardiovasc Med (2022)
Keywords: aortic valve repair (av repair), aortic valve replacement (avr), heart failiure, quadricuspid aortic valve (qav), root banding
MeSH terms: Case Reports

The quadricuspid aortic valve (QAV) is a rare congenital disease with a prevalence of 0. 013-0.043% of cardiac cases. Most patients with QAV are treated with aortic valve replacement. A Type B QAV with dilated ascending aorta of 47.9 mm; combined with severe regurgitation is reported here. In this case, considering the patient's cusps are flexible and reservable, the aortic root was reconstructed utilizing tricuspidization and annular banding technique, and dilated ascending aorta was replaced at the same time.
Christ Siemens Touraine syndrome: a case report
Authors: Luiz Gutenberg Tm Coelho Jr, Arnaldo F Caldas Jr, Evelyne P Soriano, Veronica Ms Rodrigues, Roseane S Costa
Journal: Cases J (2009)

Background:
The ectodermal dysplasias are a large and complex group of diseases.
Case presentation:
This article presents a case in a 37 years old female patient, referred to the dental clinic for impairment patients maintained by the University of Pernambuco. She presented typical characteristics of Christ Siemens Touraine syndrome such as alterations of the inferior members, a great number of diffuse pigmentations, poor oral hygiene, periodontal disease, oligodontia, enamel hypoplasia, including alteration in the form and size of the teeth.
Conclusion:
The optimal treatment for these patients should require the multidisciplinary collaborative efforts of health professionals.