OpenMed/multicare-articles huggingface dataset:
Case Report: Single-port laparoscopic total gastrectomy for gastric cancer in patient with situs inversus totalis
Authors: In Young Lee, Danbi Lee, Chang Min Lee
Journal: Front Oncol (2023)
Keywords: gastric cancer, laparoscopic, single-port, situs inversus totalis, total gastrectomy
MeSH terms: Case Reports

Situs inversus totalis (SIT) is a rare anatomical condition, where all the viscera appear in its reverse position. Although minimally invasive surgery has evolved to achieve totally laparoscopic gastrectomy for gastric cancer patients with SIT, it is difficult to perform lymphadenectomy in such a transposed anatomical condition. Recently, we performed a single-port laparoscopic total gastrectomy (SPTG) for gastric cancer in a patient with SIT. No postoperative complications or dietary problems were observed. Based on this experience, we are to design a safe strategy to perform D2 lymphadenectomy during SPTG in patients with SIT.
Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned
Authors: Michael G Hillegass, Samuel F Luebbert, Maureen F McClenahan
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

We report a case in which a 34-year-old female with refractory intracranial hypotension headaches due to a spontaneous dural tear was ultimately treated with CT-guided transforaminal epidural placement of a synthetic absorbable sealant (DuraSeal®). The procedure successfully resolved her headaches; however she subsequently developed thoracic neuralgia presumably due to mass effect of the sealant material on the lower thoracic spinal cord and nerve roots. This case report describes the potential for significant spinal cord and nerve root compression as well as the development of chronic neuralgia with the placement of epidural hydrogel and fibrin glue sealants. Careful consideration should be taken into the needle gauge, needle position, injectate volumes, and injection velocity when delivering the sealant to the epidural space. Use of an 18-gauge Tuohy needle with a slow but steady injection pressure, constant patient feedback, and a conservative injectate volume (less than 2 ml per level) may best optimize sealant delivery to minimize the risk of spinal cord compression and neurologic injury.
Some Mushrooms are Hard to Digest: Gastrostomy Tube Exchange
Authors: Nishant Gupta, Pradeep Goyal, Itisha Bansal, Kusum Hooda, Yogesh Kumar, Gregory Bearden
Journal: Pol J Radiol (2017)
Keywords: endoscopy, gastrointestinal, enteral nutrition, gastrostomy
MeSH terms: Case Reports

Background:
Percutaneous endoscopic gastrostomy (PEG) is an effective and safe mode of enteral nutrition for patients needing chronic enteric nutritional support. Exchanging PEG tubes may result in complications due to inexperience as well as due to lack of protocol.
Case report:
We encountered a 73 year-old female with unnoticed, accidently detached portion of the internal bumper of a PEG tube in the gastric lumen after a challenging gastrostomy tube exchange.
Conclusions:
This case report discusses the complications associated with gastrostomy tube exchange and proposes a planned protocol for successful gastrostomy tube exchange.
Periprosthetic Fracture of Greater Trochanter in Total Hip Replacement Stemming from Pin Site Placement in Navigation-Assisted Surgery
Authors: Ava Brozovich, David R Lionberger
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Surgeons are looking to use computer computer-assisted surgery (CAS) in total hip arthroplasty (THA) in order to quantify leg length measurement, angular cup placement, and enhance stability to provide enhanced accuracy in implant placement. As a result, CAS in THA is gaining popularity. This technology employs the use of pins and provides the surgeon with real-time feedback on positioning intraoperatively. Previous total knee arthroplasty (TKA) literature has reported pin-associated complications such as infections, neuropraxia, and suture abscess. To our knowledge, there have been reports of tibial stress fracture after CAS TKA, but this is the first report of a pin causing fracture of the greater trochanter leading to dislocation in THA. Further studies may be warranted to optimize pin placement for trackers to prevent fractures of the greater trochanter.
Pituitary Metastatic Composite Tumors: A Case Report with Next-Generation Sequencing and Review of the Literature
Authors: Matthew Helton, Muhammad Abu-Rmaileh, Kevin Thomas, Murat Gokden, Alissa Kanaan, Analiz Rodriguez
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Background:
While pituitary tumors are well understood, little research has been done on metastasis from primary tumors into pituitary adenomas, also known as composite tumors. Because only 34 cases of composite tumors have been reported to date, we hope to better characterize these tumors by reviewing cases reported in the literature and reviewed our own documented case, which includes next-generation sequencing. Case Presentation. A 74-year-old man presented to the emergency department with left vision loss for 3 months. He had a history of colon cancer treated with colectomy and clear cell renal carcinoma treated with left nephrectomy. A preoperative MRI demonstrated growth of a peripherally enhancing, centrally necrotic mass with sellar expansion measuring 5.7 × 3.1 × 3.0 cm. Given these findings, an endoscopic endonasal transsphenoidal resection was performed. Histological assessment revealed a composite tumor: one neoplasm was a nonfunctioning pituitary adenoma, and another neoplasm was a clear cell carcinoma. Next-generation sequencing demonstrated that the tumors shared mutations in VHL and Notch2. The patient died 2 months later from systemic metastatic cancer.
Conclusion:
From our literature review, most metastatic lesions in these composite tumors originated from neoplasms of the lung and kidney. Approximately 63% patients presented with ophthalmoplegia as the initial symptom while 23% displayed hormonal abnormalities. Postoperative mortality had a median of 3.5 months. In our patient, the presence of VHL and Notch2 mutations in both tumors highlights the possibility of using next-generation sequencing to help identify therapeutic targets even in complex composite neoplasms.
Surgical Management of Radicular Cyst With the Application of a Natural Platelet Concentrate: A Case Report
Authors: Lokhasudhan Govindaraju, Delphine P Antony, Pradeep S
Journal: Cureus (2023)
Keywords: mineral trioxide aggregate, plasma rich fibrin, platelet rich fibrin, pulp necrosis, radicular cyst, retrograde filling
MeSH terms: Case Reports

Traumatic dental injuries usually involve the dentoalveolar region, and they readily affect the teeth and their surrounding soft and hard tissues. The common sequelae of traumatic dental injuries lead to pulpal necrosis and apical periodontitis along with cystic changes. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary incisors and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] used for postoperative healing. A 38-year-old male patient presented to the department with pain and mild swelling in the upper front tooth region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the right maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery and retrograde filling with mineral trioxide aggregate (MTA), and PRF was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled for follow-ups after 12 weeks, 24 weeks, and 36 weeks; he was found to be asymptomatic, and significant periapical healing was observed in the radiograph with almost adequate bone formation.
Primary CNS Burkitt Lymphoma: A Case Report of a 55-Year-Old Cerebral Palsy Patient
Authors: Kathryn Bower, Nilay Shah
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

With primary central nervous system lymphoma (PCNSL) being a rare disease, the subtype of Burkitt lymphoma (BL) presenting as a sole CNS lesion is an even more exceptional diagnosis. A case of coexistent primary CNS Burkitt lymphoma (PCNSBL) with cerebral palsy (CP) is presented. A 55-year-old Caucasian male presented with increasing bilateral lower extremity weakness above his baseline in addition to signs of increased intracranial pressure. Four abnormal enhancing masses were detected on MRI with biopsy results consistent with Burkitt lymphoma. Complete staging workup was completed with no evidence of extra-CNS disease noted on PET/CT, bone marrow biopsy, or cerebral spinal fluid analysis. The patient was treated with intravenous as well as intrathecal chemotherapy and found to be in a complete remission at six months. Recurrence in the CNS was observed four months later with treatment consisting of whole brain radiation as well as intrathecal chemotherapy. Thirty months after diagnosis, the patient remains disease-free. To our knowledge, this is the first case of PCNSBL in the setting of CP. A review of literature regarding treatment options in this controversial setting is provided.
Calcaneus Metastasis from Follicular Thyroid Carcinoma 12 Years after Total Thyroidectomy
Authors: Mohammad Jawad H Rahal, Karam M Karam, Selim M Nasser, Jihad A Daher, Hicham G Abdel Nour, Alexandre H Nehme, Ramzi C Moucharafieh
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report the case of a sixty-eight-year-old female patient who presented for left ankle pain; X-rays and MRI showed a benign calcaneal cyst, found to be delayed distant metastasis from primary papillary thyroid carcinoma. Patient required surgical excision of the cyst. Results of histological examination showed metastatic papillary thyroid carcinoma. The patient underwent total thyroidectomy 12 years prior to presentation, with the same pathology. Postoperatively, she was treated with radioactive iodine. At 10-year follow-up post calcaneal mass excision, she was found to have a right proximal tibial mass and found to be recurrent with the same pathology. This case reports a rare condition that will be taken into consideration in bone metastasis with thyroid cancer.
Can Surgery Be Avoided? Exclusive Antibiotic Treatment for Pelvic Actinomycosis
Authors: M P Ruiz, E M Williams, C M Markey, A M Johnson, P B Morales-Ramirez
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Pelvic actinomycosis is an uncommon, slowly progressing granulomatous infection that has been associated with the presence of intrauterine devices. Due to its unspecific clinical and radiologic findings, it can mimic pelvic or intra-abdominal malignancy leading to mutilating surgery of high morbidity. Rarely, diagnosis is made preoperatively and in most cases surgical intervention is necessary. The patient in our case is a 42-year-old female with an IUD for 15 years diagnosed with pelvic actinomycosis. Patient was uniquely diagnosed preoperatively through paracentesis and treated conservatively with prolonged antibiotic therapy and without any type of surgical intervention. Follow-up at 1 year showed almost complete radiologic resolution of the inflammatory mass, nutritional recovery, and absence of symptoms. Pelvic actinomycosis can be successfully diagnosed and treated medically without surgical interventions.
A Rare Case of Cyclical Hemothorax: Thoracic Endometriosis Syndrome
Authors: Muhammad Shabbir Rawala, Muhammad Farhan Khaliq, Muhammad Asif Iqbal, S Tahira Shah Naqvi, Kinaan Farhan, Andrew Myers, Kristen Helmick
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Endometriosis is a common condition in which endometrial cells and stroma are deposited in extrauterine sites. Its prevalence has been estimated to be 10% of reproductive age females. It is commonly found in the pelvis; however, it may be found in the abdomen, thorax, brain, or skin. Thoracic involvement is a relatively rare presentation of this common disease. Thoracic endometriosis commonly presents as pneumothorax in 73% of patients. A rarer presentation of thoracic endometriosis is hemothorax (<14%) or hemoptysis (7%). Thoracic endometriosis is an uncommon cause of a pleural effusion. We present a case of 28-year-old African American female with no other medical conditions. She presented to the hospital with worsening right-sided pleuritic chest pain, dyspnea, and menorrhagia. She had been complaining of pleuritic chest pain for 5 years, the onset of which corresponds to the start of her menstrual cycle and is relieved with cessation of menses. Initial laboratory studies revealed a severe microcytic anemia with normal coagulation profile. Chest X-ray showed small right pleural effusion and suspicious for airspace disease. A computed tomography (CT) of chest was ordered for further clarification and identified large right pleural effusion. CT-guided thoracentesis removed 500 ml of serosanguinous fluid consisting of blood elements. There can be multiple sites involved with endometriosis and can present with wide range of symptoms that occur periodically with menses in young woman. The history and pleural fluid findings of this case are suggestive of Thoracic Endometriosis Syndrome. The diagnosis of this is often missed or delayed by clinicians, which can result in recurrent hospitalization and other complications. As internists we should be suspicious of atypical presentations of endometriosis and treat them early before complications develop. This case also highlights the importance of suspecting atypical etiologies for pleural effusion.
Myasthenia Gravis With Reversible Pyramidal Tract Damage and Pseudo Internuclear Ophthalmoplegia. A Case Report and Literature Review
Authors: Yinghong Weng, Yan Min, Zhenghe Sheng, Jia Li, Dehong Huang
Journal: Front Neurol (2019)
Keywords: myasthenia gravis, prognosis, pseudo internuclear ophthalmoplegia, pyramidal tract damage, signs and symptoms
MeSH terms: Case Reports

Myasthenia gravis (MG) is a rare and treatable antibody-mediated autoimmune disease. Pseudo internuclear ophthalmoplegia (-INO) or pyramidal tract damage is rarely observed in MG, and there were no known cases of MG with both pseudo-INO and pyramidal tract damage. Here, we report a case of a 61-year-old female suffering from MG accompanied by pseudo-INO and pyramidal tract damage with a rapid progressive course. Her blood and cerebrospinal fluid (CSF) tests were normal, except for the presence of the anti-acetylcholine receptor antibody. CT and contrast enhancement of the chest showed a thymic involution. MRI and contrast enhancement images of the brain and whole spine were normal. Both the clinical response to the administration of neostigmine and the repetitive nerve stimulation test were positive. The motor evoked potentials at lower limb recordings were normal. According to her signs, symptoms, decrementing response on repetitive stimulation test, elevated anti-acetylcholine receptor antibody and positive response to neostigmine, the patient was diagnosed as having MG. After treatment with pyridostigmine, intravenous immunoglobulin, prednisone acetate tablets and methotrexate, all her symptoms disappeared, including pseudo-INO and pyramidal tract damage. To our best knowledge, this is the first report of a case of MG with both pseudo-INO and pyramidal tract damage. Based on our case and a review of the literature, we propose that pyramidal tract damage and pseudo-INO can be two signs of MG, and that MG can cause damage to other systems besides neuromuscular junctions.
A novel insertion ins(18;5)(q21.1;q31.2q35.1) in acute myeloid leukemia associated with microdeletions at 5q31.2, 5q35.1q35.2 and 18q12.3q21.1 detected by oligobased array comparative genomic hybridization
Authors: Eigil Kjeldsen
Journal: Mol Cytogenet (2014)
Keywords: acute myeloid leukemia, chromosomal insertion, cryptic chromosomal aberration, microdeletion, add(18q), del(5q), ins(18, 5), oacgh analysis
MeSH terms: Case Reports

Background:
Nonrandom clonal chromosomal aberrations can be detected in approximately 55% of adult patients with acute myeloid leukemia (AML). Recurrent cytogenetic abnormalities play an important role in diagnosis, classification and prognosis of AML. However, several chromosomal abnormalities have not been completely determined or characterized, primarily because of their low incidence and limited amount of data.
Results:
We characterized an AML patient with a novel apparently balanced insertion ins(18;5)(q21;q31.2q35.1) that was cryptic by G-banding. The rearrangement was further examined by molecular cytogenetic methods and oligobased high-resolution array CGH (oaCGH) analysis. We show that an approximately 31.8 Mb large segment from chromosome 5 bands q31.2 to q35.1 has been inserted, by a direct mechanism, into chromosome 18 between bands q12.3 and q21.1. The insertion was unbalanced with concurrent submicroscopic deletions at 5q31.2 (approximately 0.37 Mb in size), 5q35.1q35.2 (approximately 1.98 Mb in size), and 18q12.3q21.1 (approximately 2.07 Mb in size). The microdeletions affect genes on 5q and 18q that have been associated with hematological malignancy and other cancers. A novel juxtaposition of the genes NPM1 and HAUS1 at 5q35.1 and 18q21.1, respectively, was detected by FISH analysis. Searching the literature and the Mitelman database revealed no previously reported ins(18;5) cases. Interestingly, however, two AML patients with translocation t(5;18)(q35;q21) encompassing the 5q35 and 18q21 breakpoint regions as detected in our present ins(18;5) patient have been reported.
Conclusions:
It is well-known that cytogenetic abnormalities on the long arm of chromosome 5 affect hematopoiesis. However, the precise mechanism of their involvement in myeloid transformation is elusive. Our present data shed new light onto the frequent abnormalities on 5q as well as to the less frequent abnormalities observed on 18q in myeloid malignancies. In addition, we show that oaCGH analysis is a useful adjunct to revealing submicroscopic aberrations in regions of clinical importance. Reporting rare and nonrandom chromosomal abnormalities contribute to the identification of the whole spectrum of cytogenetic abnormalities in AML and their prognostic significance.
Reverse Total Shoulder Arthroplasty as Treatment for Rotator Cuff-Tear Arthropathy and Shoulder Dislocations in an Elderly Male with Parkinson's Disease
Authors: John G Skedros, James S Smith, Tanner D Langston, Micheal G Adondakis
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We report the case of a 70-year-old male with Parkinson's disease (PD) and recurrent traumatic left shoulder dislocations. This case is rare because (1) he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy) of the same shoulder and (2) his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA). His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy. Initial surgical treatment included an open capsular-labral reconstruction; RTSA was not an ideal option because of the presumed risk of failure from PD-related dyskinesias. However, the capsular-labral reconstruction failed after he lost balance and stumbled but did not fall. A RTSA was then done which restored the patient's shoulder stability and greatly improved his pain. At final follow-up two years later, he reported pain relief and improved function. This was partially attributed to the fact that he had moved to an assisted living center. He also began using an electric wheelchair one year after the RTSA. We report this case because of the unusual set of conditions and circumstances, namely, the implantation of a RTSA in a patient with PD and shoulder instability.
Tenosynovitis with rice body formation in a non-tuberculosis patient: a case report
Authors: Hiroyuki Nagasawa, Kyoji Okada, Seietsu Senma, Shuichi Chida, Yoichi Shimada
Journal: Ups J Med Sci (2009)
MeSH terms: Fibrin / metabolism, Tenosynovitis / diagnosis, Case Reports, Aged, Humans, Magnetic Resonance Imaging, Male, Tenosynovitis / metabolism, Tenosynovitis / pathology, Tuberculosis, Fibrin

In this report, we present a 68-year-old man with rice body formation in the flexor tendon sheath of the fingers without any inflammatory diseases such as tuberculosis or rheumatoid arthritis. The patient visited our institute in March 2004 with a one-month history of swelling and pain of the right distal forearm. Laboratory data were within normal limits, and the rheumatoid factor was negative. He had no history of tuberculosis, and the tuberculin reaction was weakly positive. Magnetic resonance (MR) images showed a mass measuring 6 cm x 4 cm around the flexor tendons of the forearm. Many rice bodies had been erupted from a small hole of the fibrous wall of the mass at the time of incisional biopsy performed in June 2004. Histological diagnosis was synovitis with fibrous loose bodies. In July 2004, spontaneous ruptures of the right fourth and fifth flexor tendons occurred. Open repair was performed in August 2004. The patient regained good function of the operated fingers with no evidence of recurrence at the latest follow-up in March 2009.
Apatinib with EGFR-TKIs in advanced wild gene-type NSCLC: A case report
Authors: Yuan-Peng Wu, Ji-Jin Wu, Shu-Mei Tian, Tao Jin, Chan Li, Ke Xie
Journal: Medicine (Baltimore) (2019)
MeSH terms: Carcinoma, Non-Small-Cell Lung / drug therapy, Carcinoma, Non-Small-Cell Lung / genetics, ErbB Receptors / antagonists & inhibitors, Erlotinib Hydrochloride / therapeutic use, Pyridines / therapeutic use, Case Reports, Aged, Carcinoma, Non-Small-Cell Lung / pathology, Erlotinib Hydrochloride / administration & dosage, Female, Humans, Karnofsky Performance Status, Protein Kinase Inhibitors / administration & dosage, Protein Kinase Inhibitors / therapeutic use, Pyridines / administration & dosage, Treatment Outcome, Protein Kinase Inhibitors, Pyridines, apatinib, Erlotinib Hydrochloride, EGFR protein, human, ErbB Receptors

Rationale:
For advanced non-small-cell lung cancer (NSCLC), targeted therapy and chemoradiotherapy are recommended as the first-line treatment. For patients with a performance status (PS) score over 2 and without gene mutation, however, only supportive treatment is provided and survival time is extremely short. We believe that more can be done to improve the patient's survival time and their quality of life.
Patient concerns and diagnoses:
A 65-year-old female came to our hospital due to "cough and pain and lack of movement in the left leg". The diagnosis was advanced wild gene-type lung adenocarcinoma and PS score over 2.
Interventions and outcomes:
She was treated in our clinic with apatinib and erlotinib and has had no progression of the disease for 15.4 months. Except for the presence of hand-foot syndrome and diarrhea, no other serious adverse reactions were seen.
Lessons:
For patients in poor physical condition and unacceptable of chemo-radiotherapy, apatinib combined with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is a safe and effective therapeutic method for advanced wild gene-type NCSCL.