OpenMed/multicare-articles huggingface dataset:
Feasibility, tolerability, and first experience of intracystic treatment with peginterferon alfa-2a in patients with cystic craniopharyngioma
Authors: Cora Hedrich, Priya Patel, Lukas Haider, Tracey Taylor, Elaine Lau, Roxanne Hook, Christian Dorfer, Karl Roessler, Natalia Stepien, Maria Aliotti Lippolis, Hannah Schned, Clara Koeller, Lisa Mayr, Amedeo A Azizi, Andreas Peyrl, Bienvenido Ros Lopez, Alvaro Lassaletta, Julie Bennett, Johannes Gojo, Ute Bartels
Journal: Front Oncol (2024)
Keywords: craniopharyngioma, intracystic treatment, pediatric neurooncology, pediatric neurosurgery, peginterferon alfa-2a

Background:
Children with craniopharyngiomas (CPs) typically suffer from a life-long chronic disease. The younger the child, the more vulnerable the maturing brain is to invasive therapies such as surgery or radiotherapy. Therefore, treatment modalities facilitating avoidance or delay of invasive therapies are beneficial for these patients. In the last decade, intracystic injection of interferon alfa-2a or alfa-2b evolved as a treatment of choice based on efficacy and minor toxicity. However, the drug is no longer available internationally. After an extensive pharmacological review, peginterferon alfa-2a was identified as the agent with closest similarity.
Methods:
A retrospective case series is described, including five patients treated with intracystic peginterferon alfa-2a for cystic CP according to an innovative care protocol. After initial CP cyst aspiration, peginterferon alfa-2a was injected once per week via an Ommaya reservoir for 6 weeks followed by response assessment with MRI.
Results:
Patients' age ranged from 4 to 54 years (four patients <12 years, one adult patient). Intracystic therapy with peginterferon alfa-2a was tolerated well by all five individuals without any major toxicities and resulted in cyst shrinkage in all of the five patients. The importance of a permeability study prior to commencing intracystic therapy became apparent in one patient who suffered from cyst leakage.
Conclusions:
Intracystic treatment with peginterferon alfa-2a was found to be a tolerable and efficacious treatment modality in patients with cystic CP. This experience warrants further research with a larger number of patients with measurement of long-term efficacy and safety outcomes.
Case report: When infection lurks behind malignancy: a unique case of primary bone lymphoma mimicking infectious process in the spine
Authors: Ayoub Jaafari, Ornella Rizzo, Sohaïb Mansour, Anas Chbabou, Anne-Laure Trepant, Rachid Attou, Celine Mathey
Journal: Front Nucl Med (2024)
Keywords: 18fdg-pet/ct, mri, diffuse large b-cell lymphoma, primary bone lymphoma, spondylodiscitis
MeSH terms: Case Reports

Primary bone lymphoma of the spine (PBL) is a rare entity that may be misdiagnosed due to its atypical location and clinical and imaging features mimicking certain pathologies as infectious processes, which complicates and delays diagnosis. Our case reports a patient in her sixties who had been suffering from chronic low back pain for a year, and had gradually started to develop cruralgia. She underwent a blood sample, magnetic resonance imaging (MRI), and positron emission tomography (18F-FDG-PET/CT) which revealed inflammatory syndrome, and an image of spondylodiscitis of the lumbar spine associated with a morphological and metabolical widespread invasion posteriorly suggesting epiduritis. No other lesions were found on the rest of the body. Neurosurgical management was performed and a biopsy was made. Histological results showed aggressive and diffuse large B-cell lymphoma, suggesting a diagnosis of PBL. This case highlights the first case of spondylodiscitis mimicking PBL in the lumbar spine, the intricacies of the diagnostic work-up, and the complexity of discriminating with an infectious process in the spine, as both have a similar, non-specific clinical presentation, while morphological and metabolic findings can be alike.
Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
Authors: Jiali Cheng, Jin Huang, Wenyue Cao, Liang Huang, Xia Mao, Liting Chen, Jianfeng Zhou, Na Wang
Journal: Front Immunol (2023)
Keywords: b-all, car-t cell therapy, cmv disease, cmv pneumonia, case report
MeSH terms: Cytomegalovirus Infections / etiology, Cytomegalovirus Infections / therapy, Pneumonia / etiology, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Adult, Cell- and Tissue-Based Therapy, Cytomegalovirus, Follow-Up Studies, Humans, Male, Young Adult, Receptors, Chimeric Antigen

Introduction:
The rapidly developed CAR-T cell therapy has a unique profile of side effects, which perhaps has not been totally realized and understood, especially the late-phase toxicity. CMV is prevalent world-wide and establishes a life-long latency infection. It can lead to life-threatening complications in immunocompromised host, and little is known about CMV disease in patients after CAR-T cell therapy. Here, we report a patient who developed possible CMV-pneumonia three months after anti-CD19 and anti-CD22 CAR-T cell therapy for relapsed B-ALL, contributing to the understanding of severe side-effects mediated by virus infection or reactivation in patients receiving CAR-T cell infusion.
Case presentation:
A 21-year old male patient with relapsed B-ALL received anti-CD19/22 CAR-T cell therapy, and achieved complete remission 2 weeks after the infusion. However, three months later, the patient was hospitalized again with a 10-day history of fever and cough and a 3-day history of palpitations and chest tightness. He was diagnosed with possible CMV pneumonia. Under treatment with antiviral medicine (ganciclovir/penciclovir), intravenous gamma globulin and methylprednisolone and the use of BiPAP ventilator, his symptoms improved, but after removing penciclovir his symptoms went out of control, and the patient died of respiratory failure 22 days after admission.
Conclusion:
CMV infection/reactivation can occur in patients long after receiving anti-CD19/22 CAR-T cell therapy, and induce fatal pneumonia, which reminds us of the late side effects associated with immunosuppression after CAR-T cell infusion.
Silent Echoes: A Case Report of Wernicke Encephalopathy's Unheard Voice
Authors: Stefan Gafoor, Raheem Robertson
Journal: Cureus (2024)
Keywords: alcohol use, non-alcoholic wernicke's encephalopathy, thiamine defecincy, wernicke-korsakoff syndrome, wernicke’s
MeSH terms: Case Reports

Wernicke encephalopathy (WE) is an acute neuropsychiatric emergency that is caused by a deficiency in vitamin B1 (thiamine). This condition is most commonly seen in patients with alcohol use disorder; however, patients with other disorders of severe malnourishment are also at increased risk. In severe cases, this disease may be followed by Korsakoff's psychosis and even death. We present a case of a 64-year-old African American female with a history of alcohol use disorder who presented to the emergency department on account of an acute confusional state. Neurological examination revealed right beating nystagmus on the left gaze and a wide-based gait. Initial laboratory work-up was unrevealing; however, magnetic resonance imaging (MRI) of the brain demonstrated an abnormal T2 fluid-attenuated inversion recovery (FLAIR) signal involving the bilateral mammillary bodies and surrounding lateral ventricles that extended into the periaqueductal parenchyma. The patient was admitted to the neurology unit, and high-dose intravenous thiamine was commenced. During hospitalization, the patient's confusion improved and they were subsequently discharged with oral thiamine. The spectrum of severity of WE is wide, ranging from fatal disease and can lead to permanent brain damage or even Korsakoff syndrome, characterized by severe memory loss and confabulation. The diagnosis is mainly clinical and based on the presence of symptoms in the classic triad of mental status change, oculomotor abnormality, and ataxia. This triad is only present in about 10% of cases, making the diagnosis very challenging. Laboratory testing can assist in making the diagnosis, but it is not always reliable or available. In situations of clinical uncertainty, imaging may also be used to support diagnosis or rule out other differentials. The mainstay of treatment is with high-dose parenteral thiamine.
Paediatric cerebellar glioblastoma - long-term survival following surgery and adjuvant chemoradiotherapy: A case report and literature review
Authors: Matthew I Sanders, Daniel Gatt, Victoria Lee, Stephen B Wharton, Veejay Bagga
Journal: Brain Spine (2024)
Keywords: chemoradiotherapy, paediatric cerebellar glioblastoma, progression-free survival, surgery
MeSH terms: Case Reports

Introduction:
Paediatric cerebellar glioblastoma is an exceptionally rare clinical entity, with very few cases described in the literature. In the majority of reported cases, prognosis is extremely poor, despite surgical and oncological management. The paucity of data results in lack of consensus as to the optimal management of these patients, with the objective of prolonging survival.
Research question:
Do patient or tumour characteristics suggest more favourable rates of progression-free survival in paediatric cerebellar glioblastoma?
Material and methods:
Tumour histopathology plus retrospective molecular analysis of archived samples, as well treatment strategy and patient characteristics of a six-year-old child with cerebellar glioblastoma and prolonged progression-free survival were assessed. Characteristics in the published literature that inferred prolonged survival were identified and compared.
Results:
Paediatric cerebellar glioblastoma is extremely rare, with only a handful of cases reported over several decades, during which time diagnostic and therapeutic techniques have evolved markedly. Consequently, the scarcity of data with sufficient granularity means that limited conclusions can be drawn. Specific clinical and histopathological factors (i.e. female sex, young age, EGFR negativity and surgical resection plus adjuvant chemoradiotherapy) may indicate a more favourable progression-free survival.
Discussion and conclusion:
Rates of progression-free survival in this rare condition are generally poor, however, several patient and tumour characteristics may infer more favourable prognosis. As increasingly refined means of diagnosis and characterisation are developed, particularly as a result of advances in molecular analyses, more adjuvant treatment options are likely to come on stream in future.
Crohn's disease: An enigmatic variant with gastritis and ileal obstruction
Authors: Samuel Amo-Tachie, Fredrick Kojo Ocansey, Abena Durowaa Yeboah
Journal: Clin Case Rep (2023)
Keywords: crohn's disease, constipation, gastritis, intestinal obstruction
MeSH terms: Case Reports

There are multiple atypical manifestations of Crohn's disease, which sometimes delay diagnosis or even more often result in complete misdiagnosis, especially in poorly equipped facilities. This is the case of an elderly woman with Crohn's disease who presented with gastritis and bowel obstruction. She had hitherto been wrongly managed for peptic ulcer disease and functional constipation based mainly on her symptoms. Her diagnosis was made only after years of failed symptomatic management. This case aims to highlight the uncommon and easily misdiagnosed gastroduodenal presentation of Crohn's disease, as well as clinical clues to correctly diagnosing the condition.
Transient Perivascular Inflammation of the Carotid Artery as a Poorly Recognized Cause of Neck Pain
Authors: Sophie Greutert, Tatiana Schlomer, Marc Righini
Journal: TH Open (2024)
Keywords: fay syndrome, tipic syndrome, carotidynia, neck pain, temporary perivascular infiltration
MeSH terms: Case Reports

Transient perivascular inflammation of the carotid artery (TIPIC) syndrome, historically named idiopathic carotidynia or Fay syndrome, is a rare condition characterized by inflammation and pain in the carotid artery. The diagnosis requires a specific clinical-radiological presentation. We describe a 37-year-old female who presented with headaches and left neck pain and was diagnosed with TIPIC syndrome with temporary perivascular infiltration.
Surgical Periodontal Management of Peripheral Ossifying Fibroma: A Series of Three Cases
Authors: Karo Parsegian, Roger M Arce, Nikola Angelov
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Peripheral ossifying fibroma (POF) is a benign swelling of the gingival connective tissue commonly associated with dental biofilm and biofilm-retentive dental appliances. In the present case report, we described three cases of POF with different clinical presentations and treatment approaches. The treatment consisted of the removal of supra- and subgingival calculus, followed by a flap surgery with excision of the entire lesion ensuring the inclusion of the periosteal bed. The first patient developed POF during her pregnancy that remained clinically noticeable postpartum. The second case represented a rare case of POF appearing on the palatal aspect of the anterior maxilla of an African American male. The third case represented POF that developed on the mandible, and contrary to the first two cases, it was excised using a diode laser and not a scalpel blade. All patients showed uneventful healing during follow-up appointments; however, poor patient compliance did not allow for evaluation of long-term healing responses and possible recurrence of the lesion. Within the limitations of this clinical report, it is evident that the periodontal surgical approach was effective in managing POF with stable short-term clinical outcomes.
Case Report: Imaging features of a new type double inferior vena cava malformation and review
Authors: Yu-Lin Wu, Guo-Kai Yang, Qian Chen, Yi Tang, Jian-Hui Zhang, Shao-Jie Wu, Sen-Lin Cai, Yan-Feng Zhou, Yao-Bin Zhu, Jie-Wei Luo, Zhu-Ting Fang
Journal: Front Cardiovasc Med (2023)
Keywords: computed tomography venography, congenital abnormalities, double inferior vena cava, inferior vena cava filter, venous thromboembolism
MeSH terms: Case Reports

Background:
Double inferior vena cava (DIVC) is a rare vascular malformation. With advances in radiological techniques and diagnosis, more and more types of DIVC were identified and diagnosed. Recognition of the variety of DIVC seen on imaging is essential for subsequent venous interventions.
Case presentation:
A 77-year-old man presented with low back pain with left lower limb pain for 1 month. Scattered petechiae above the skin surface on the left lower leg, especially on the extensor surface, with flaking and mild tingling of the skin, were noted 3 weeks ago. Ultrasound revealed deep vein thrombosis (DVT) in the left lower limb. Computed tomography pulmonary angiography (CTPA) suggested no significant thrombus in the pulmonary artery. Computed tomography venography (CTV) of bilateral lower limbs showed that iliac vein compression syndrome with formation of deep and superficial venous traffic branches in bilateral lower limbs, predominantly on the left side. CTV of the inferior vena cava (IVC) suggested that the left common iliac vein crossed the common iliac artery bifurcation from dorsal to ventral and continued to travel cranially as a ventral vessel, and connected with the ventral IVC anterior to the right common iliac artery. The right common iliac vein extended cephalad as a dorsal vessel, which was narrowed at the level of 4th lumbar vertebra by compression of the hyperplastic bone and the osteophyte. The patient was discharged after right and left common iliac vein angiography and balloon dilation of bilateral common iliac vein.
Conclusion:
The formation of both ventrally and dorsally aligned DIVC is rarer. It should be clarified the effects of DIVC on DVT formation, and the importance of imaging for preoperative planning.
Case report: Synchronous tumors of the female reproductive tract in systemic lupus erythematosus: report of two cases and review of the literature
Authors: Ling Wang, Qin Zhang, Nan Shi, Jiaxi Wang, Shuang Song, Huadi Yang, Xingbei Chen
Journal: Front Oncol (2024)
Keywords: case report, cervical cancer, female reproductive tract tumors, synchronous tumors, systemic lupus erythematosus, vaginal cancer, vulvar cancer
MeSH terms: Case Reports

Background:
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple systems. Patients with SLE are prone to a variety of malignancies, especially neoplasms of the female reproductive tract. Synchronous tumors, considered to involve multiple sites, are rare in the female reproductive tract. There are hardly any reports of SLE with synchronous reproductive tract tumors.
Case presentation:
We report the occurrence of two to three reproductive tract tumors in two women with SLE. A 52-year-old woman was diagnosed with vulvar cancer and cervical cancer. Another woman, aged 67, was diagnosed with concurrent vulvar cancer, vaginal cancer, and cervical cancer and also presented with a suspected lung cancer.
Conclusion:
The presence of synchronous tumors of the reproductive tract in patients with SLE is uncommon and can be easily disregarded. It is crucial to highlight that SLE patients with multiple primary malignancies exhibit notable late-stage presentation at the time of diagnosis, inadequate disease-free survival, poor overall survival, rapid progression rates, and mortality. Consequently, greater awareness must be raised regarding synchronous reproductive tract tumors in patients with SLE. Regular comprehensive cancer screening and management should be implemented for individuals diagnosed with SLE.
Juvenile dermatomyositis complications: navigating gastrointestinal perforations and treatment challenges, a case report
Authors: Chen Xiangyuan, Zeng Xiaoling, Sun Guangchao, Zeng Huasong, Liu Dexin
Journal: Front Pediatr (2024)
Keywords: janus kinase inhibitors, juvenile dermatomyositis, anti-nuclear matrix protein 2, case report, gastrointestinal perforation
MeSH terms: Case Reports

Juvenile dermatomyositis (JDM) is a rare autoimmune disorder with multi-system involvement, often presenting with a heliotrope rash, Gottron's papules, and proximal muscle weakness. JDM patients with anti-nuclear matrix protein 2 (anti-NXP2) positivity tend to have more severe manifestations, including a higher risk of gastrointestinal (GI) complications such as dysphagia, intestinal motility changes, edema, malabsorption, ulcers, and perforations. These complications are associated with poor outcomes and high mortality rates, particularly in patients with anti-NXP2 positivity. A case is presented of a 12-year-old girl with JDM who developed multiple GI perforations after being treated with high-dose methylprednisolone. Despite multiple surgical attempts, the patient experienced continued leakage and new perforations. The treatment approach was shifted to include jejunostomy, plasma exchanges, fresh frozen plasma support, and tofacitinib, leading to gradual improvement in muscle strength and reduction in inflammation. GI involvement in JDM is a significant concern due to its association with poor prognosis and high mortality. The use of high-dose glucocorticoids must be carefully considered in JDM patients with GI involvement, as they may contribute to the development of perforations and complicate treatment. A combination of plasma exchange, fresh frozen plasma support, low-dose glucocorticoids, and Janus kinase inhibitors may offer a safer treatment strategy for managing refractory JDM with GI complications. The case highlights the importance of a multidisciplinary approach to treatment and the need for further research to determine the necessity of high-dose glucocorticoid therapy following GI involvement in JDM.
Occipital Lobe Cavernoma Presenting With Headaches and Visual Hallucinations: A Case Report
Authors: Mohammed A Abdulaal, Fatema M Ali, Zainab H Rabea, Alaa M Husain, Zainab A Naser, Sajeda K Mohamed, Zainab A Abdulla, Ahlam Alharbi
Journal: Cureus (2024)
Keywords: cavernoma, computed tomography, headache, magnetic resonance imaging, occipital lobe, visual hallucination
MeSH terms: Case Reports

Cavernomas, also known as cavernous angiomas or cavernous malformations, are rare vascular lesions characterized by abnormal clusters of dilated capillaries without intervening brain tissue. While often asymptomatic, they can manifest with neurological symptoms such as headaches, seizures, and focal deficits. We present a case of a 45-year-old male who presented with persistent headaches and visual hallucinations. Thorough clinical assessment revealed intermittent throbbing headaches localized to the left occipital region, accompanied by brief episodes of vivid visual hallucinations. Extensive work-up, including laboratory tests and neuroimaging, identified a subependymal cavernoma in the left occipital lobe. A surgical excision was performed, resulting in sustained relief from headaches and the absence of visual hallucinations during follow-up examinations. This case contributes to the understanding of cavernomas by detailing the clinical presentation, diagnostic process, and successful surgical intervention for a subependymal cavernoma in the left occipital lobe. The resolution of symptoms postoperatively underscores the importance of individualized treatment approaches, considering factors such as lesion location, patient age, and associated risks. The case highlights the evolving knowledge in cavernoma management and emphasizes the need for tailored therapeutic decisions in addressing neurovascular disorders.
Endovascular treatment of a mycotic aneurysm in an immunocompromised child with acute leukemia-case report and review of the literature
Authors: Sabine Daphne Diepenbruck, Andre Jakob, Nikolaus Alexander Haas, Guido Mandilaras
Journal: Front Pediatr (2023)
Keywords: bacteremia, covered stent implantation, endovascular treatment, leukemia, thoracic mycotic aneurysm
MeSH terms: Case Reports

Mycotic aneurysms are dilatations of an artery, a rare but severe complication arising from infectious obliteration of the vessel wall. Thoracic aneurysms often present with unspecific symptoms and multiple diagnostic and therapeutic challenges. In an advanced state, they have an increased risk of perforation and a high mortality rate. The surgical therapeutic approach has a high perioperative complication rate. In this study, we report a case of a thoracic mycotic aortic aneurysm in an immunocompromised pediatric patient caused by Klebsiella pneumoniae bacteremia. A combination of prompt antibacterial treatment and minimally invasive stent implantation showed a good outcome, avoiding possible severe surgical problems.
Retrospective Analysis of a Seborrheic Keratosis-Like Melanoma on the Head
Authors: Jesús Iván Martínez-Ortega, Arely Ramirez Cibrian
Journal: Cureus (2024)
Keywords: clinical case, dermoscopy, diagnostic challenges, melanoma, seborrheic keratosis
MeSH terms: Case Reports

We present a clinical case of a 50-year-old female initially suspected of seborrheic keratosis but later diagnosed with melanoma through biopsy. This case highlights the challenges in distinguishing between these two conditions and emphasizes the importance of accurate diagnosis. Overdiagnosis of malignancy in seborrheic keratosis cases and the accurate identification of melanoma through dermoscopy are discussed. Further research is needed to explore potential mechanistic connections between seborrheic keratosis and melanoma.