OpenMed/multicare-articles huggingface dataset:
Intracranial Subarachnoid Haemorrhage Caused by Cervical Spinal Dural Arteriovenous Fistulas: Case Report
Authors: Junjie Zhao, Yagmur Esemen, Neil Rane, Ramesh Nair
Journal: Front Neurol (2021)
Keywords: indocyanine green angiography, interventional neuroradiology, neurosurgery, spinal dural arteriovenous fistula, subarachnoid haemorrhage
MeSH terms: Case Reports

Cervical spinal vascular abnormalities commonly present with progressive myelopathy as a result of venous congestion. They are not very prone to bleed and tend to be underdiagnosed due to their subtle clinical presentation. We came across a rare case of intracranial subarachnoid haemorrhage caused by cervical spinal dural fistula in the Imperial College Healthcare NHS Trust Hospitals/UK in June 2020. We diagnosed the patient under strict evidence base medicine guidance, which otherwise would have been missed. We discussed the case in several multidisciplinary team (MDT) meetings, and patient was treated under the joint care of the neurology and neurosurgical teams. Patient made a full recovery and discharged home with no neurological defects or complications. Here, we reported this case with all the evidence we gathered from our MDT discussion. We hope our experience would help improve the diagnosis and management protocol for future patients with a similar condition.
Psychomotor Agitation Non-responsive to Treatment: A Case Report of Phenibut Withdrawal Syndrome
Authors: Cecilia Maria Esposito, Gian Mario Mandolini, Giuseppe Delvecchio, Alessio Fiorentini, Paolo Brambilla
Journal: Front Psychiatry (2021)
Keywords: phenibut, psychiatric aspects, psychomotor agitation, psychopharmacology, withdrawal
MeSH terms: Case Reports

Background and Objectives: Phenibut (4-amino-3-phenyl-butyric acid), acting as a GABA-B receptor agonist, has a beneficial effect on anxiety. Although its medical use is not approved in western countries, it can be easily obtained worldwide via the Internet, so it spread as a substance of abuse. In recent years, some case reports have, therefore, highlighted episodes of acute toxicity or withdrawal, but it is still a largely unknown phenomenon. Methods: In this case report, a 50-year-old woman was admitted to the emergency room with psychomotor agitation, psychotic symptoms, and insomnia, and was non-responsive to treatment. She was hospitalized at the psychiatry ward for 25 days and gave her consent for the publication of the present case report. Results: The suspicion of phenibut withdrawal allowed to establish the appropriate management, leading to the restitutio ad integrum of the psychopathological case. Conclusions: In the face of an incoercible psychomotor agitation case, the knowledge of the so-called novel psychoactive substances allows for more appropriate clinical management of intoxication and withdrawal syndromes. This is a scientifically significant report as it provides therapeutic and outcome data concerning a syndrome that is still quite unfamiliar.
Bilateral Congenital Retinal Macrovessel: A Case Report
Authors: Dalal Ismaeel, Soner Keskin, Foued Dallali
Journal: Cureus (2023)
Keywords: congenital anomaly, congenital retinal macrovessel, foveal avascular zone, optical coherence tomography angiography, retina
MeSH terms: Case Reports

Congenital retinal macrovessel (CRM) is a congenital anomaly where an aberrant vessel supplies both the macula on either side of the horizontal raphe. It is usually an incidental finding but may be associated with other retinal findings that may impact vision. We present an unusual case of bilateral congenital retinal macrovessel in a 40-year-old patient. The patient presented to the ophthalmology clinic for diabetic retinopathy screening and had no visual complaints. The patient underwent a complete ophthalmological examination including fundus imaging, fundus fluorescein angiography, and optical coherence tomography (OCT) imaging. Dilated fundus examination showed bilateral hypertensive retinopathy with optic disc collateral vessels and congenital retinal macrovessels. The multimodal imaging techniques that were used to confirm the finding indicated that the vessel is arterial.
Fetal Gallstones in a Newborn after Maternal COVID-19 Infection
Authors: Gurleen Kaur Kahlon, Anna Zylak, Patrick Leblanc, Noah Kondamudi
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Fetal gallstones are rare incidental findings on ultrasound during pregnancy. We describe a newborn girl with gallstones that was born to a mother who had COVID-19 infection during her last trimester. The baby remained asymptomatic, and the stones resolved spontaneously without any treatment or complications within six weeks of birth. Several conditions predispose to fetal gallstones, and it is unclear if the recent maternal COVID-19 infection had any role in the occurrence of these abnormalities or was merely coincidental. This is the first case describing an association of fetal gallstones with a COVID-19 infection in pregnancy.
Zollinger Ellison Syndrome in a Patient with Multiple Endocrine Neoplasia Type 1: A Classic Presentation
Authors: Ishani Shah, Neil Vyas, Kambiz S Kadkhodayan
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Zollinger Ellison Syndrome (ZES) is characterized by a wide spectrum of conditions including severe gastroesophageal reflux disease, peptic ulcer disease, watery diarrhea, and weight loss. We present a case of a 60-year-old woman being evaluated for severe dyspepsia, vomiting, and chronic diarrhea, who was diagnosed to have ZES associated with a pancreatic neuroendocrine tumor, in the setting of multiple endocrine neoplasia (MEN) type 1. Although cases of ZES have been reported previously, we believe that our case is a classic presentation of ZES diagnosed on the basis of typical radiologic, endoscopic, and endosonographic features.
Right-Sided Urinary Extravasation Caused by a Ureteral Stone and Associated With Peritonitis in an Older Woman
Authors: Yumi Naito, Soshi Takagi, Keita Inoue, Chiaki Sano, Ryuichi Ohta
Journal: Cureus (2023)
Keywords: abdominal pain, general medicine, gerota fascia, peritonitis, urinary extravasation
MeSH terms: Case Reports

Right upper quadrant pain can originate from the liver, cholecystic duct, gallbladder, pancreas, or surrounding organs. Peritonitis in the right upper quadrant of the abdomen can be caused by lesions in these organs as well as the adjacent organs, such as the kidney and colon. The kidneys are surrounded by Gerota's fascia and fat; therefore, mild local inflammation may not cause peritonitis. Herein, we report the case of a 72-year-old woman with right-sided abdominal pain who was diagnosed with urinary extravasation due to a ureteral stone. Urinary extravasations can present with peritonitis. For effective diagnosis, prompt physical examination and abdominal ultrasound are essential, with the extent of extravasation being key to effective management. Therefore, general physicians should consider urinary extravasation, which is typically caused by kidney and urinary stones, in patients with right upper quadrant pain.
Delayed Healing of Tooth Extraction Sockets with Ramucirumab Use
Authors: Yosuke Iijima, Miki Yamada, Shunsuke Hino, Motohiko Sano, Takahiro Kaneko, Norio Horie
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Objective:
An angiogenesis inhibitor can cause medication-related osteonecrosis of the jaw (MRONJ). To our knowledge, there has been no report that an angiogenesis inhibitor causes delayed healing of tooth extraction socket. Here, we describe a case of delayed healing of tooth extraction sockets associated with an angiogenesis inhibitor, ramucirumab, which showed characteristics similar to MRONJ.
Materials and methods:
A 76-year-old male patient, who was diagnosed with gastric cancer with liver metastasis, received tooth extraction twice during continuous chemotherapy comprising paclitaxel and ramucirumab.
Results:
The first extraction was performed 30 days after ramucirumab discontinuation without complication. The second extraction was conducted without ramucirumab discontinuation. Although tooth socket healing was finally achieved, it took about 150 days. Discussion. This case was considered to be delayed healing of dry sockets rather than MRONJ due to ramucirumab. Dentists and oral surgeons need to be aware that angiogenesis inhibitors can cause not only MRONJ but also dry sockets after tooth extraction.
Nanoparticle albumin-bound-Paclitaxel in the treatment of metastatic urethral adenocarcinoma: the significance of molecular profiling and targeted therapy
Authors: Yasmin M Abaza, Carlos Alemany
Journal: Case Rep Urol (2014)

Primary urethral cancer is rare and accounts for only 0.003% of all malignancies arising from the female genitourinary tract. Due to the rarity of this disease, no consensus exists regarding the optimal therapeutic approach. Nanoparticle albumin-bound-paclitaxel has been shown to be effective in the treatment of a number of malignancies including metastatic breast, pancreatic, and bladder cancer. We present a 67-year-old woman with advanced metastatic urethral adenocarcinoma resistant to two lines of chemotherapy (ifosfamide/paclitaxel/cisplatin and irinotecan/5-fluorouracil/leucovorin) that showed a dramatic response to nanoparticle albumin-bound-paclitaxel. This is the first case report to document the use and efficacy of nanoparticle albumin-bound-paclitaxel in the treatment of unresectable metastatic urethral cancer.
Acupuncture treatment of a patient with persistent allergic rhinitis complicated by rhinosinusitis and asthma
Authors: Ae-Ran Kim, Jun-Yong Choi, Jong-In Kim, So-Young Jung, Sun-Mi Choi
Journal: Evid Based Complement Alternat Med (2011)
MeSH terms: Case Reports

A pathophysiologic relationship between allergic rhinitis and rhinosinusitis and asthma has long been suggested. However, few clinical studies of acupuncture have been conducted on these comorbid conditions. A 48-year-old male suffering from persistent allergic rhinitis with comorbid chronic rhinosinusitis and asthma since the age of 18 years was studied. He complained of nasal obstruction, sneezing, cough, rhinorrhea and moderate dyspnea. He occasionally visited local ear-nose-throat clinics for his nasal symptoms, but gained only periodic symptom relief. The patient was treated with acupuncture, infrared radiation to the face and electro-acupuncture. Needles were inserted at bilateral LI20, GV23, LI4 and EX-1 sites with De-qi. Electro-acupuncture was performed simultaneously at both LI20 sites and additional traditional Korean acupuncture treatments were performed. Each session lasted for 10 min and the sessions were carried out twice a week for 5 weeks. The patient's Mini-Rhinoconjunctivitis Quality-of-Life Questionnaire score decreased from 38, at the beginning of treatment, to 23, 3 weeks after the last treatment. The Total Nasal Symptom Score was reduced from six (baseline) to five, 3 weeks after the last treatment. There was significant clinical improvement in the forced expiratory volume in 1 s-from 3.01 to 3.50 l-with discontinuation of the inhaled corticosteroid, and no asthma-related complaints were reported. Further clinical studies investigating the effectiveness of acupuncture for the patients suffering from allergic rhinitis and/or rhinosinusitis with comorbid asthma are needed.
Cannabis arteritis
Authors: Naoual El Omri, Rachid Eljaoudi, Fadwa Mekouar, Mohammed Jira, Youssef Sekkach, Taoufik Amezyane, Driss Ghafir
Journal: Pan Afr Med J (2017)
Keywords: cannabis, arteritis, digital necrosis
MeSH terms: Amputation, Surgical / methods, Arteritis / etiology, Hyperbaric Oxygenation / methods, Marijuana Abuse / complications, Case Reports, Adult, Arteritis / diagnosis, Arteritis / therapy, Female, Humans, Necrosis, Risk Factors

Cannabis is the most consumed psychoactive substance by young people. Chronic use of cannabis can lead to cannabis arteritis, which is a very rare peripheral vascular disease similar to Buerger's disease. It is affecting young adults, especially men, consuming cannabis. A 27-year old woman, with no particular past medical history except for long-term use of cannabis and tobacco developed a digital necrosis in the left hand. She denied using other illicit drugs. Doppler ultrasound examination of the upper limbs was unremarkable. Toxicological analysis revealed the presence of cannabis in both biological fluid and hair strand. Despite medical treatment, cessation of the cannabis and tobacco consumption and hyperbaric oxygen therapy, an amputation of necrotic parts was then required. This case shows the prolonged use of cannabis could be a risk factor for young adult arteritis. Faced with a rapidly progressive arteritis occurring in young adult, the physician should consider the history of use of cannabis. Hair analysis can be useful for confirmation of the chronic consumption of drugs.
Foreign Body in Paranasal Sinus: A Late Clinical Presentation
Authors: Francisco Monteiro, Pedro Oliveira, Artur Condé
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

The occurrence of foreign bodies in paranasal sinuses is extremely rare. The symptoms are vague and usually discovered after extra/intracranial complications. They may, therefore, go unnoticed if there isn't a strong clinical suspicion. We present a clinical case of a 64-year-old woman with a paranasal sinus microsurgery history more than 30 years ago, who presented with headache and purulent rhinorrhea. A glass tubular structure was discovered in the ethmoid complex. She underwent functional endoscopic sinus surgery. Since glass is an inert material that doesn't cause foreign body reaction, the patient may not present any symptom or sign. However, if there is obstruction in the drainage of the ostiomeatal complex, it can manifest itself as rhinosinusitis, which we believe happened in our case. To the best of our knowledge, this is probably the first reported case of a glass removed from the ethmoidal sinuses, diagnosed with more than 30 years of evolution.
Pleomorphic adenoma of the soft palate: major tumor in a minor gland
Authors: Mounir Hmidi, Hicham Aatifi, Ali Boukhari, Mohammed Zalagh, Abdelhamid Messary
Journal: Pan Afr Med J (2015)
Keywords: pleomorphic adenoma, salivary gland, soft palate
MeSH terms: Adenoma, Pleomorphic / pathology, Palate, Soft / pathology, Salivary Gland Neoplasms / pathology, Salivary Glands, Minor / pathology, Case Reports, Adenoma, Pleomorphic / diagnosis, Female, Humans, Middle Aged, Salivary Gland Neoplasms / diagnosis, Tomography, X-Ray Computed, Salivary Gland Adenoma, Pleomorphic

Salivary gland tumors are a relatively rare and morphologically diverse group of lesions. Pleomorphic adenoma is a benign tumor of the salivary gland that consists of a combination of epithelial and mesenchymal elements. The tumor most commonly arises from the parotid (60-70%) or submandibular glands. It develops less frequently in a minor salivary gland, presenting as an intraoral mass depend on the soft palate. We describe a case of benign pleomorphic adenoma of soft palate in a 45 year old female with computed tomography and histopathological findings. This patient presented in ENT department with history of gradually increasing mass lesion in the palatal region over a period of few months.
Total regression of brain metastases in non-small cell lung cancer patients harboring EGFR mutations treated with gefitinib without radiotherapy: two case reports
Authors: Masashi Chonan, Norio Narita, Teiji Tominaga
Journal: BMC Res Notes (2016)
MeSH terms: Brain Neoplasms / drug therapy, Brain Neoplasms / secondary, Carcinoma, Non-Small-Cell Lung / genetics, Carcinoma, Non-Small-Cell Lung / pathology, ErbB Receptors / genetics, Lung Neoplasms / genetics, Lung Neoplasms / pathology, Quinazolines / therapeutic use, Case Reports, Aged, Carcinoma, Non-Small-Cell Lung / diagnostic imaging, Fatal Outcome, Female, Gefitinib, Humans, Lung Neoplasms / diagnostic imaging, Magnetic Resonance Imaging, Middle Aged, Mutation / genetics, Radiography, Thoracic, Remission Induction, Quinazolines, ErbB Receptors, Gefitinib

Background:
Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor. Clinical trials have reported its effectiveness in the treatment of brain metastases from non-small cell lung cancer by overcoming the blood-brain barrier. Gefitinib is generally regarded as a relatively safe agent, and several reports have described its efficacy in patients with epidermal growth factor receptor mutation-positive non-small cell lung cancer and a poor performance status.
Case presentation:
We herein described two patients with brain metastasis from non-small cell lung cancer who achieved the total regression of metastasis with the administration of gefitinib. A 70-year-old Japanese woman was referred to our hospital with a severe cough. Brain magnetic resonance imaging revealed a metastatic lesion in the left temporal lobe. The tumor was positive for an epidermal growth factor receptor L858R mutation in exon 21 using the peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp method. She was treated with 250 mg gefitinib per day, and, 1 month later, the primary lesion and brain metastasis had totally resolved. A 58-year-old Japanese woman was referred to our hospital with nausea and headache. Brain magnetic resonance imaging revealed a metastatic lesion in the left cerebellar hemisphere and meningeal dissemination. The tumor was positive for the epidermal growth factor receptor L858R mutation in exon 21. She was treated with 250 mg gefitinib per day, and, 3 weeks later, the primary lesion, brain metastasis, and meningeal dissemination had completely resolved.
Conclusion:
We successfully treated two lung cancer patients with brain metastasis using gefitinib. Gefitinib therapy may be a suitable treatment for brain metastasis in lung cancer with an epidermal growth factor receptor mutation, particularly in elderly patients with a poor performance status.
Penile and Scrotal Strangulation due to Metal Rings: Case Reports and a Review of the Literature
Authors: Neel H Patel, Ariel Schulman, Jonathan Bloom, Nikil Uppaluri, Michael Iorga, Suraj Parikh, John Phillips, Muhammad Choudhury
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Penile and scrotal entrapment from a metal ring placed at the base of the penis is a rare, but important clinical dilemma encountered in urology. Emergent presentation to the urologist, after ring placement far longer than safely practiced, risks ischemic and permanent injury to penile, scrotal, and intrascrotal structures. Treating urologists should be aware of the prevalence of metal ring use, their potential complications, and the surgical approach to their safe removal. We present two patients who were identified at our institution with strangulating injuries of retained penile rings. The first patient was a healthy, 43-year-old male with a metal ring retained for 24 hours that was safely removed with industrial bolt cutters. The second patient, a 74-year-old male, died as a result of sepsis from injuries secondary to penoscrotal ischemia after >48 hour ring retention despite prompt removal at emergent presentation. Although rare, sexual practices may include the use of penoscrotal rings. When retained, ischemic injury and edema may lead to strangulation. Emergent removal may require industrial equipment that is not within the confines of normal operating room tools. Tissue injury may be severe and sepsis life-threatening, even after ring removal.
Case Report: Focal leptomeningeal disease, atypical cancer of unknown primary site
Authors: Miguel A Vences, Mary M Araujo-Chumacero, Diego Urrunaga-Pastor, Leila Barreto, Liliana Rodríguez-Kadota, Elliot Barreto-Acevedo, César Saavedra-Rocha, Elder V Quispe-Huamaní
Journal: F1000Res (2022)
Keywords: brain metastasis, dementia, leptomeningeal neoplasms, nervous system neoplasms, pet-ct scan
MeSH terms: Lung Neoplasms / diagnosis, Meningeal Neoplasms / diagnostic imaging, Neoplasms, Unknown Primary / diagnosis, Case Reports, Aged, Female, Fluorodeoxyglucose F18, Humans, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18

Background: Leptomeningeal metastasis is an infrequent form of cancer expression, and it has a poor prognosis due to its torpid evolution and its challenging diagnosis. Case report: We report the case of a 68-year-old woman with rapidly progressing cognitive decline and focal epilepsy. Brain magnetic resonance imaging showed extensive gyriform hypersignal in the right precentral sulcus region, without mass effect, tenuous contrast uptake, and hydrocephalus with transependymal edema. The body tomographic study was negative for solid cancer and the 18F-FDG PET-CT revealed a severe hypermetabolism in the right lung upper lobe. These findings were suggestive of lung cancer with leptomeningeal metastasis. We performed a brain biopsy, finding atypical cells in the leptomeningeal region with positive immunohistochemical staining for CK7 and negative for CK20 corresponding to lung adenocarcinoma. The patient was evaluated in the oncology service and scheduled for radiotherapy and chemotherapy. Conclusions: Focal leptomeningeal disease is an entity that should be considered as a differential diagnosis in all cases of focal leptomeningitis. Timely diagnosis and adequate cancer management can increase patient survival.
Posttraumatic parotid fistula treated with transdermal scopolamine: a case report
Authors: Giulio Pagliuca, Salvatore Martellucci, Chiara Rosato, Camilla Gallipoli, Andrea Gallo
Journal: Case Rep Surg (2012)

A parotid fistula is a rare and extremely unpleasant condition. In this paper, we present the case of a 53-year-old woman with a diagnosis of posttraumatic fistula of the parotid gland. After exclusion of other therapeutic alternatives, it was decided to use transdermal scopolamine patches at sustained release (Scopoderm TTS). This technique consists in the application every three days of a patch with 1.5 mg of scopolamine in the area of the mastoid apophysis; the patch releases a dose of 0.5 mg of the active substance over each 24-hour period. The patient underwent periodic clinical followup over a period of three years, achieving satisfactory results with no significant adverse effects.
Clinical, magnetic resonance imaging, and histological description of a choroid plexus papilloma with disseminated intraventricular and spinal cerebrospinal fluid drop metastases in a young adult dog: a case report
Authors: Guillaume Marc Albertini, Alexandra Malbon, Anne Staudacher, Fabio Stabile
Journal: Front Vet Sci (2023)
Keywords: csf, choroid plexus papilloma, choroid plexus tumor, dogs, drop metastases
MeSH terms: Case Reports

A 2-year-old male entire Cane Corso was presented for investigations into a 1-week history of ambulatory paraparesis and pelvic limb ataxia gradually deteriorating. Magnetic resonance imaging (MRI) revealed intraventricular space-occupying lesions affecting the fourth ventricle and lateral apertures and intradural-extramedullary space-occupying lesions at the level of C7 vertebra, L4-L5, and L7-S1 intervertebral disk spaces. Due to poor quality of life, the patient was euthanized. A post-mortem examination revealed partially encapsulated, multifocally infiltrative, and moderately cellular neoplastic masses. The histological description was similar for all masses. The cells appeared cuboidal with round central nuclei and a moderate amount of eosinophilic cytoplasm and were arranged almost exclusively in single-layered papilliform patterns supported by a fibrovascular stroma. Mitoses were rarely observed (1/2.37 mm2). The primary neoplasm was morphologically most consistent with a choroid plexus papilloma despite drop metastases. This is the first report of a histologically confirmed primary ventricular choroid plexus papilloma causing disseminated MRI-apparent intraventricular and spinal drop metastases.