OpenMed/multicare-articles huggingface dataset:
Metastatic gastric tube cancer detected in a resected mandibular bone with osteoradionecrosis
Authors: Joe Iwanaga, Osamu Iwamoto, Keita Todoroki, Ryuchiro Tanoue, Akihiro Koba, Jingo Kusukawa
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Osteoradionecrosis (ORN) of the jaw is an intractable complication of radiotherapy for head and neck cancer. However, osteolytic lesions are often hard to distinguish from malignancies. We report a rare case of metastatic cancer in a resected mandibular bone after segmental resection for ORN of the jaw. A 63-year-old male with a history of subtotal oesophageal resection for oesophageal cancer and reconstruction of the oesophagus with a gastric tube subsequently developed ORN of the jaw. Conservative treatment was unsuccessful and pathological fracture of the necrotic mandible occurred. The patient underwent segmental resection of the mandible and adenocarcinoma was detected in the resected mandibular bone. Immunohistochemical staining for cytokeratin 7 and 20 revealed that the adenocarcinoma had metastasized from the reconstructed gastric tube. This case highlights the fact that cancers of the gastric tube may metastasize to radiation-induced necrotic bone tissue in the mandible.
Complete Response after Treatment with Neoadjuvant Chemoradiation with Prolonged Chemotherapy for Locally Advanced, Unresectable Adenocarcinoma of the Pancreas
Authors: Tiffany A Pompa, William F Morano, Chetan Jeurkar, Hui Li, Suganthi Soundararajan, Jaganmohan Poli, Wilbur B Bowne, Michael Styler
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC), the National Comprehensive Cancer Network (NCCN) suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss. An MRI demonstrated a mass in the pancreatic body measuring 6.2 × 3.2 cm; biopsy revealed proven ductal adenocarcinoma. Due to splenic vein/artery and contiguous celiac artery encasement, she was deemed surgically unresectable. She was started on FOLFIRINOX therapy (three cycles), intensity modulated radiation to a dose of 54 Gy in 30 fractions concurrent with capecitabine, followed by FOLFIRI, and finally XELIRI. After 8 cycles of ongoing XELIRI completed in March 2015, restaging showed a remarkable decrease in tumor size, along with PET-CT revealing no FDG-avid uptake. She was reevaluated by surgery and taken for definitive resection. Histopathological evaluation demonstrated a complete R0 resection and no residual tumor. Based on this patient and literature review, this strategy demonstrates potential efficacy of neoadjuvant chemoradiation with prolonged chemotherapy, followed by surgery, which may improve outcomes in patients deemed previously unresectable.
Vascular surgery of aortic thrombosis in a dog using Fogarty maneuver - technical feasibility
Authors: Maartje Schwede, Olaf Richter, Michaele Alef, Tobias Theuß, Shenja Loderstedt
Journal: Clin Case Rep (2017)
Keywords: aortic thromboembolism, canid, cardiovascular disorders, vascular surgery
MeSH terms: Case Reports

Aortic thromboembolism is a rare and life-threatening disease in dogs. This report aims to describe the successful surgical treatment by use of a Fogarty Thrombectomy Catheter in an 8-year-old patient. The postsurgical intensive care therapy to prevent ischemia-reperfusion syndrome is specified, despite poor outcome in our case (owner elected euthanasia).
A striking response of plasmablastic lymphoma of the oral cavity to bortezomib: a case report
Authors: Makoto Hirosawa, Hiroaki Morimoto, Ryo Shibuya, Shohei Shimajiri, Junichi Tsukada
Journal: Biomark Res (2015)
Keywords: bortezomib, oral cavity, plasmablastic lymphoma
MeSH terms: Case Reports

Background:
Plasmablastic lymphoma (PBL) is a rare and aggressive subtype of non-Hodgkin diffuse large B-cell lymphoma originally with a predilection to the oral cavity of patients infected with HIV. However, PBL of extraoral sites possesses clinicopathological characteristics distinct from oral PBL. Recently, therapeutic approaches using a proteasome inhibitor bortezomib to PBL of extraoral sites have been reported. We present a PBL patient with a bulky tumor of the oral cavity, who dramatically responded to bortezomib.
Case presentation:
The patient was a 58 year-old Japanese male, who presented with a rapidly progressive history of a swelling on his left cheek and restricted mouth opening. He did not have a history or evidence of immunosuppression including HIV infection. A computed tomography demonstrated a bulky tumor in the oral cavity without enlarged lymph nodes. The tumor showed the proliferation of large lymphoid cells with centroblastic morphology, which were positive for CD138, CD38, CD56 and MUM-1, and negative for CD20, CD79a, BCL-6 and HHV8. The Ki-67 proliferation index was almost 100 %. Neither osteolytic lesions nor M-protein was observed. One week after the initiation of bortezomib, a marked regression of the oral tumor was obtained.
Conclusions:
Thus, our case demonstrated the effectiveness of bortezomib on PBL of the oral cavity as well as the extraoral sites.
Dural Arteriovenous Fistula Presenting As Pulsatile Tinnitus
Authors: Maxime Van Sumere, Luc Defreyne, Vincent VandeVyver
Journal: J Belg Soc Radiol (2021)
Keywords: dural arteriovenous fistula, embolization, interventional, pulsatile, radiology, tinnitus
MeSH terms: Case Reports

Teaching point: We report magnetic resonance imaging characteristics of a dural arteriovenous fistula (dAVF), a possible cause of pulsatile tinnitus.
Preoperative assessment and treatment of appendiceal mucocele complicated by acute torsion: a case report
Authors: Christoffer Stark, Mikko Jousi, Berndt Enholm
Journal: BMC Res Notes (2014)
MeSH terms: Appendectomy / methods, Appendix / pathology, Cecal Diseases / surgery, Laparoscopy / methods, Magnetic Resonance Imaging, Mucocele / surgery, Preoperative Care / methods, Torsion Abnormality / surgery, Case Reports, Abdomen, Acute / etiology, Adult, Appendix / diagnostic imaging, Appendix / surgery, Cecal Diseases / diagnosis, Cecal Diseases / diagnostic imaging, Emergencies, Female, Humans, Mucocele / complications, Mucocele / diagnosis, Mucocele / diagnostic imaging, Necrosis, Torsion Abnormality / diagnostic imaging, Torsion Abnormality / etiology, Ultrasonography

Background:
Mucus-producing tumours of the appendix or mucoceles can, if left untreated, lead to dissemination of its contents into the peritoneal cavity causing substantial morbidity to the patient. Symptoms for complicated mucoceles can mimic those of acute appendicitis and the final diagnosis is most likely made intraoperatively. We here present a case that is, to our knowledge, one of only ten described in the literature and the first to characterize torsion of an appendiceal mucocele with abdominal magnetic resonance imaging.
Case presentation:
The patient, a 34-year-old Caucasian female presented at the emergency department with acute abdominal pain in the right lower quadrant. Initial diagnostic work-up including ultrasonography and abdominal magnetic resonance imaging showed a large tubular mass at the base of the appendix with indirect signs of torsion. A laparoscopic appendectomy was performed the following day where the finding was confirmed. The patient went on to have an uneventful recovery and was discharged from the hospital on the first postoperative day.
Conclusions:
Magnetic resonance imaging is a useful tool in identifying unknown lesions of the appendix and should be considered the primary imaging modality in especially younger patients requiring diagnostic imaging. In this case the preoperative imaging findings aided in choosing the correct timing and treatment option for the patient.
Granulomatous Lymphocytic Interstitial Lung Disease (GLILD) in Common Variable Immunodeficiency (CVID)
Authors: Nico Hustings, Adriana Dubbeldam, Birgit Weynand
Journal: J Belg Soc Radiol (2022)
Keywords: ct, cvid, glild, pathology, pulmonary, radiology
MeSH terms: Case Reports

Teaching Point: Granulomatous lymphocytic interstitial lung disease is a non-infectious complication of common variable immunodeficiency. Computed tomography (CT) has an important diagnostic value by demonstrating pulmonary nodules, ground glass opacities, bronchiectasis, subpleural reticulations, lymphadenopathy and splenomegaly.
Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient
Authors: Debopriya Chatterjee, Aishwarya Chatterjee, Manoj Agarwal, Meetu Mathur, Setu Mathur, R Mallikarjun, Subrata Banerjee
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India.
Thrombosis of the Azygos Anterior Cerebral Artery
Authors: Camila Soares Moreira de Sousa, Carla Lorena Vasques Mendes de Miranda, Marcelo Coelho Avelino, Breno Braga Bastos, Rafael Soares Moreira de Sousa, Carla Valéria Vasques Mendes de Miranda
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

The azygos anterior cerebral artery is a rare variant, characterized by the absence of the anterior communicating artery and the union of two proximal segments of the anterior cerebral artery, forming a single trunk and ascending through the interhemispheric fissure. The incidence in the population varies from 0.3 to 2%. The presence of occlusion for this vessel causes bifrontal infarcts, with potentially devastating functional consequences, hence the importance of recognizing this anatomical variation in imaging exams.
Grade IV blunt splenic injury--the role of proximal angioembolization. A case report and review of literature
Authors: I Gheju, M D Venter, M Beuran, L Gulie, I Racoveanu, P Carstea, I Iftimie Nastase, D P Venter
Journal: J Med Life (2013)
Keywords: angio-embolization, non-operative management, severe splenic laceration
MeSH terms: Splenic Rupture / surgery, Wounds, Nonpenetrating / surgery, Case Reports, Review, Adult, Humans, Male, Splenic Rupture / diagnostic imaging, Tomography, X-Ray Computed, Treatment Outcome, Wounds, Nonpenetrating / diagnostic imaging

The authors present a case of grade IV traumatic spleen rupture (AAST-OIS) and an Injury Severity Score of 21 and a Revised Trauma Score RTS=7.841, which was managed without surgery, but with proximal splenic angioembolization (SAE), with a positive outcome. Indications, types and side-effects of SAE are also discussed with regard to blunt spleen trauma and the benefits of SAE as non-operative treatment approach. It is the first case of a grade IV splenic laceration non-operatively managed to be published in Romania.
Volvulus of the Sigmoid Colon during Pregnancy: A Case Report
Authors: Enzo Fabrício Ribeiro Nascimento, Michelle Chechter, Fábio Piovezan Fonte, Nara Puls, Juliana Santos Valenciano, Cláudio Luciano Penna Fernandes Filho, Ronaldo Nonose, Crhistiny Emmanuelle Gabriel Bonassa, Carlos Augusto Real Martinez
Journal: Case Rep Obstet Gynecol (2012)
MeSH terms: Case Reports

Colonic obstruction due to sigmoid colon volvulus during pregnancy is a rare but complication with significant maternal and fetal mortality. We describe a case of sigmoid volvulus in a patient with 33 weeks of gestation that developed complete necrosis of the left colon. Case. 27-year-old woman was admitted with 3 days of abdominal distention, vomit, and the stoppage of the passage of gases and feces. She was admitted with poor clinical conditions with septic shock, acute respiratory distress syndrome, and signs of diffuse peritonitis. Abdominal radiography showed severe dilation of the colon with horseshoe signal suggesting a sigmoid volvulus, pneumoperitoneum and we could not we could not identify fetal heartbeats. With a diagnosis of complicate sigmoid volvulus she was underwent to the laparotomy where we found necrosis of all descending colon due to double twist volvulus of the sigmoid. We performed a colectomy with a confection of a proximal colostomy, and closing of the rectal stump. Due to an uncontrollable uterine bleeding during cesarean due, it was required a hysterectomy. The patient had an uneventful postoperative course thereafter and was discharged on a regular diet on the 15th postoperative day.
Case Report: Morphologic and Functional Characteristics of Intestinal Mucosa in a Child With Short Bowel Syndrome After Treatment With Teduglutide: Evidence in Favor of GLP-2 Analog Safety
Authors: Enrico Costantino Falco, Antonella Lezo, Pierluigi Calvo, Caterina Rigazio, Anna Opramolla, Ludovica Verdun, Giovanna Cenacchi, Marianna Pellegrini, Marco Spada, Gabriella Canavese
Journal: Front Nutr (2022)
Keywords: proliferation, safety, short bowel syndrome, teduglutide, treatment
MeSH terms: Case Reports

Teduglutide is a glucagon-like peptide-2 (GLP-2) analog employed in patients with short bowel syndrome (SBS) to reduce the need of parenteral nutrition in these patients, by virtue of its effects on enteric function. The experimental studies reported that the stimulating action of GLP-2 on epithelial turnover implies the potential development of dysplastic and neoplastic lesion. However, the clinical trials could not detect preneoplastic lesions on histologic material, and in a recent pilot study the occurrence of polyps was similar before and after treatment and included only low-grade dysplastic lesions. Another clue in GLP-2 function in stimulating mucosal restore is its enhancement through cooperation with epidermal growth factor (EGF). In this study, we analyzed gastroscopy and colonoscopy samplings from a child successfully weaned off parenteral nutrition with teduglutide. Villous and crypt structure was regular both in duodenal and in colonic samplings; in properly oriented villi, villus/crypt ratio was regular. The absorptive epithelium demonstrated a regular morphology. No atypia was detected in enterocytes, along epithelial structures. At the ultrastructural analysis, only a few enterocytes with vacuolized cytoplasm were observed. An S-phase marker Ki67 stained nuclei in the transitional amplifying zone, while nuclei stained by the cell cycle regulatory proteins p21 and p27 were placed in the differentiated epithelium of the duodenal villi and colonic crypts, as in the control cases. The counts of enterocytes immunostained with the same antisera, evaluated with image analysis software, were in the range of control cases. The ratio of the number of epidermal growth factor receptor (EGFR) signals/the number of centromere probe of chromosome 7 (CEP7) signals was less than 2. The findings available from this single patient are consistent with good preservation of functional capability of intestinal epithelium after treatment with GLP-2, given the histologic and ultrastructural features of enterocytes. In addition, the findings from cell cycle regulatory proteins immunolocalization and quantitative analysis show that cell renewal machinery in our case is comparable to control cases. The gene of the receptor EGFR is regularly expressed in enteric epithelium of our case. Morphologic and functional data from our patient improve evidence in favor of the safety of GLP-2 employ in SBS.
Lysosomal Acid Lipase Deficiency: Report of Five Cases across the Age Spectrum
Authors: Marco Antonio Curiati, Sandra Obikawa Kyosen, Vanessa Gonçalves Pereira, Francy Reis da Silva Patrício, Ana Maria Martins
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Lysosomal acid lipase (LAL) deficiency is an autosomal recessive lysosomal storage disorder caused by mutations in the LIPA gene that leads to premature organ damage and mortality. We present retrospective data from medical records of 5 Brazilian patients, showing the broad clinical spectrum of the disease.
Severe fatigue due to valproate-induced hypothyroidism in a case of bipolar disorder
Authors: Tadashi Kanamori, Masahiro Suzuki, Yoshiyuki Kaneko, Kouju Yamada, Hideyuki Kubo, Makoto Uchiyama
Journal: Ann Gen Psychiatry (2020)
Keywords: bipolar disorder, hypothyroidism, symptomatic, valproate
MeSH terms: Case Reports

Background:
Valproate-induced hypothyroidism is a rare condition and has been considered asymptomatic. Here, we report a case of bipolar I disorder who developed symptomatic valproate-induced hypothyroidism.
Case presentation:
A 44-year-old woman with bipolar I disorder complained of severe fatigue after starting valproate. She showed a hormonal pattern of central hypothyroidism. Thyroid autoantibodies were negative, and no pituitary abnormality was seen on magnetic resonance imaging. After stopping valproate, her severe fatigue rapidly improved with normalizing thyroid function.
Conclusions:
Our case suggests that valproate-induced hypothyroidism should be considered when patients complain of excessive fatigue under treatment with valproate.
Case report: Canine distemper virus infection as a cause of central nervous system disease in a Eurasian lynx ( Lynx lynx)
Authors: Mara Sophie Lombardo, Monica Mirolo, Florian Brandes, Albert D M E Osterhaus, Karolin Schütte, Martin Ludlow, Michael Barkhoff, Wolfgang Baumgärtner, Christina Puff
Journal: Front Vet Sci (2023)
Keywords: computer tomography, encephalitis, endangered species, viral infection, wildlife
MeSH terms: Case Reports

The Eurasian lynx (Lynx lynx) represents an endangered species with only small populations remaining in Central Europe. Knowledge about the threat posed by potential infectious agents to these animals is crucial for informing ongoing protection measures. Canine distemper virus (CDV) is known to have a wide host range with infection reported in many mammalian species including several lynx species (Lynx pardinus, Lynx canadensis, Lynx rufus), but is an extremely rare finding in the Eurasian lynx. The present report describes a case of a Eurasian lynx showing central nervous signs, including apathy and ataxia. A CT scan revealed multiple hypodense areas in different localizations within the brain as well as enlarged liquid filled areas, leading to the suspicion of a degenerative process. Due to clinical deterioration, the animal was euthanized and submitted for macroscopical and histological investigations. Histological investigations revealed multifocal demyelinations in the cerebellum, brain stem and cervical spinal cord as well as a multifocal, perivascular, lymphohistiocytic meningoencephalitis. A CDV infection was confirmed by immunohistochemistry and RT-PCR analyses. This CDV infection of a Eurasian lynx resembles a classical chronic manifestation of distemper in dogs and highlights the threat posed by canine distemper to this species.
Malignant infantile osteopetrosis in a 3-year-old Yemeni child: a case report
Authors: Saeed Thabet, Mohammed Almajeedi, Maged Mohammed, Faisal Ahmed
Journal: Pan Afr Med J (2022)
Keywords: infantile malignant osteopetrosis, case report, hepatosplenomegaly
MeSH terms: Osteopetrosis / complications, Osteopetrosis / diagnosis, Case Reports, Atrophy, Bone Density, Cell Differentiation, Child, Child, Preschool, Female, Humans, Infant, Newborn, Osteoclasts

Infantile malignant osteopetrosis (IMOP) is a rare bone resorptive disorder with an autosomal recessive inheritance pattern. It is characterized by increased bone density due to osteoclastic failure in differentiation or function. The clinical manifestations of IMOP start at birth or infancy with varied rings according to the type and degree of osteopetrosis. We presented a 3-year-old female patient referred to us due to chronic anaemia six months ago. The physical examination revealed hepatosplenomegaly, axial hypotonia, and visual impairment. Blood investigation revealed pancytopenia and hypocalcemia. Radiologic studies revealed a generalized increase in bone density, abnormal metaphyseal remodelling, and rain atrophy. The bone marrow aspiration (BMA) shows dry tap and hypocellularity of all cell lines. IMOP was diagnosed depending on clinical, radiologic, and BMA results. In conclusion, IMOP is relatively uncommon. Accurate diagnosis should be made through clinical, BMA, and radiologic investigations, especially in a resource-limited setting, as performed in our case.
Renal Vein Injury During Percutaneous Nephrolithotomy Procedure
Authors: Sarwar Noori Mahmood, Hewa Mahmood Toffeq
Journal: J Endourol Case Rep (2016)
Keywords: percutaneous nephrostolithotomy, renal vein injury
MeSH terms: Case Reports

Background: Percutaneous nephrostolithotomy is an important approach for removing kidney stones. Puncturing and dilatation are two mandatory steps in percutaneous nephrolithotomy (PCNL). Uncommonly, during dilatation, the dilators can cause direct injury to the main renal vein or to their tributaries. Case Presentation: A 75-year-old female underwent PCNL for partial staghorn stone in the left kidney. During puncturing and dilatation, renal vein tributary was injured, and the nephroscope entered the renal vein and inferior vena cava, which was clearly recognized. Injection of contrast material through the nephroscope confirms the false pathway to the great veins (renal vein and inferior vena cava). Bleeding was controlled intraoperatively by applying Amplatz sheath over the abnormal tract, the procedure was continued and stones were removed. At the end of the procedure, a Foley catheter was used as a nephrostomy tube and its balloon was inflated inside the renal pelvis and pulled back with light pressure to the lower calix, which was the site of injury to the renal vein tributaries, then the nephrostomy tube was closed; by this we effectively controlled the bleeding. The patient remained hemodynamically stable; antegrade pyelography was done on the second postoperative day, there was distally patent ureter with no extravasation, neither contrast leak to renal vein, and was discharged home at third postoperative day. After 2 weeks, the nephrostomy tube was gradually removed in the operative room, without bleeding, on the next day, Double-J stent was removed. Conclusion: Direct injury and false tract to the renal vein tributaries during PCNL can result in massive hemorrhage, and can be treated conservatively in hemodynamically stable patients, using a nephrostomy catheter as a tamponade.
Management of locally advanced renal cell carcinoma with invasion of the duodenum
Authors: Andrew T Schlussel, Aaron B Fowler, Herbert K Chinn, Linda L Wong
Journal: Case Rep Surg (2013)

Renal cell carcinoma (RCC) is rare but aggressive, with greater than 20% of patients presenting with stage III or IV, disease. Surgical resection of the primary tumor regardless of stage is the treatment of choice, and en bloc resection of involved organs provides the only potential chance for cure. This case report describes a patient with metastatic right-sided RCC with invasion of the inferior vena cava and duodenum managed by en block resection and pancreaticoduodenectomy. This report will review the workup and treatment of locally advanced RCC, as well as the role of cytoreductive nephrectomy in the setting of metastatic disease.