OpenMed/multicare-articles huggingface dataset:
Case report: A case of primary cardiac malignant mesothelioma
Authors: Ao Wang, Baohui Liu, Shengjun Dong, Yujiu Wang
Journal: Front Oncol (2024)
Keywords: case report, mesothelioma, primary cardiac malignant tumors, radiation therapy, surgical treatment
MeSH terms: Case Reports

Primary cardiac malignant tumors are extremely rare, making up about 10% of all primary cardiac tumors. Most of these tumors are primary sarcomas, with primary mesothelioma being even less common. This report details a 53-year-old male patient diagnosed with primary cardiac malignant mesothelioma. The patient had symptoms of chest pain and difficulty breathing. A CT scan showed an enlarged heart, fluid around the heart, and irregular thickening of the pericardium. Diagnosis was confirmed through a surgical biopsy, which showed the presence of malignant mesothelioma. After the procedure, the patient received appropriate cardiac support. Although stable at discharge, the patient unfortunately died three months later due to severe wheezing. There may be a potential link between exposure to radioactive iodine treatment and this outcome. This case highlights the diagnostic and treatment challenges of primary cardiac malignant tumors and reminds physicians to consider this rare disease when evaluating patients with similar symptoms.
Case Report: Idiopathic pleuroparenchymal fibroelastosis
Authors: Selsabil Daboussi, Ben Hmida Lenda, Samira Mhamedi, Boubaker Nouha, Chiraz Aichaouia, Aida Ayadi, Zied Moatemri
Journal: F1000Res (2023)
Keywords: elastofibrosis, idiopathic, interstitial lung disease, lung function, pleural thickening, pleuropulmonary elastosis
MeSH terms: Tomography, X-Ray Computed, Case Reports, Aged, Humans, Lung / diagnostic imaging, Lung / pathology, Male, Pleura / diagnostic imaging, Pleura / pathology

Background: Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a very rare and a slowly conspicuous progressing chronic lung disease, which usually involves the upper lobes of the lung. This unusual disease, first recognized as a rare idiopathic interstitial pneumonia in 2013, is characterized by dense fibrosis of the visceral pleura and the subjacent lung parenchyma accompanied by elastosis predominating in the subpleural alveolar walls. In the interest of improving our understanding of this uncommon disease, we report a case of IPPFE established by pathology results. Case report: A 73-year-old male patient, smoker, with a medical history of chronic obstructive pulmonary disease, presented since January 2022 with a gradual worsening of dyspnea on exertion and productive cough with weight loss. The chest X-ray detected a thoracic distention. The chest high resolution computed tomography revealed biapical subpleural parenchymatous condensations with tractive bronchiectasis and pleural retraction in the right upper lobe and diffuse bilateral cento-lobular emphysema. A scan-guided trans-parietal lung biopsy showed lung parenchyma tattooed with anthracosic deposits, largely remodeled by fibrous tissue, intermingled with numerous wavy and refractive dyselastotic structures in polarized light. The orcein staining confirmed the presence of excess elastosic fibers within these lesions. All etiological investigations were negative. His lung function studies revealed a reversible obstructive ventilatory disorder. Following a multidisciplinary discussion, the diagnosis of IPPFE was confirmed on the basis of the distribution in the upper lungs on chest computed tomography combined with pathology pattern. Conclusions: This case emphasizes the atypical misleading radiological presentation of IPPFE and the key role of pathological results in establishing the diagnosis. Hence, further studies are needed to improve our understanding of this uncommon disease and to establish clear-cut guidelines for IPPFE diagnosis and management.
Multiple systemic infections caused by Rhodococcus equi: a case report
Authors: Ning Li, Changsheng Wu, Pengju Cao, Dongjie Chen, Falin Chen, Xiuqing Shen
Journal: Access Microbiol (2024)
Keywords: rhodococcus equi, multiple abscesses, non-human immunodeficiency virus, susceptibility
MeSH terms: Case Reports

Background:

Rhodococcus equi is one of the most important causes of zoonotic infections from grazing animals. It poses a particular risk to immunocompromised individuals, including those who are undergoing long-term immunosuppressive therapy.
Case presentation:
We report a case of Rhodococcus equi infection in a 65-year-old man with a medical history of diabetes, hypertension, and Adult Still's Disease, currently taking long-term hormone therapy. The non-human immunodeficiency virus (HIV)-infected patient had blood, lung tissue, and sputum samples infected with Rhodococcus equi. His condition initially failed to improve despite multiple therapies, including vancomycin and meropenem. Although his symptoms improved after shifting his antibiotics to cover for the causative agent, he did not completely recover upon hospital discharge.
Conclusions:
In recent years, the number of Rhodococcus equi cases has increased. This report describes a lethal case of Rhodococcus equi infection in a patient without HIV.
Primary hepatic malignant triton tumor mimicking hepatocellular carcinoma by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging: a case report and literature review
Authors: Bo Zhou, Canyang Zhan, Yang Tian, Zhenzhen Gao, Sheng Yan
Journal: Front Med (Lausanne) (2024)
Keywords: case report, complete surgical removal, hepatic malignant triton tumor, hepatocellular carcinoma, prognosis
MeSH terms: Case Reports

Background:
Malignant Triton tumor (MTT) is a relatively rare subtype of malignant peripheral nerve sheath tumor (MPNST) characterized by rhabdomyosarcoma differentiation. There are no distinct features of MTT, and it is easy to misdiagnose preoperatively.
Case presentation:
Here, we describe a rare case of primary hepatic MTT in a 56-year-old male who presented with nonspecific abdominal pain for 1 day. Magnetic resonance imaging and abdominal computed tomography revealed an extremely large mass located in the right liver with intratumoral hemorrhage, arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging and the possibility of intrahepatic metastasis. Tumor marker levels revealed only an elevated level of alpha-fetoprotein (AFP: 5304.0 ng/mL). Then, he received transcatheter arterial chemoembolization combined with lenvatinib and pembrolizumab, and he was diagnosed with hepatocellular carcinoma. After 3 months of neoadjuvant therapy, we resected the hepatic cancer and adherent diaphragmatic pleura. MTT was confirmed by postoperative pathology and immunohistochemistry.
Conclusion:
Despite the preoperative diagnosis of hepatocellular carcinoma with a rising serum AFP level, typical CT and MRI findings, histopathology assessment showing MPNST with rhabdomyosarcoma differentiation confirms the diagnosis of primary hepatic MTT.
Case Report: Two different acromelic dysplasia phenotypes in a Chinese family caused by a missense mutation in FBN1 and a literature review
Authors: Fengyan Tian, Xiao Dong, Ruyue Yuan, Xiaohan Hou, Jing Qing, Yani Li
Journal: Front Pediatr (2024)
Keywords: fbn1, acromelic dysplasia, acromicric dysplasia, geleophysic dysplasia, recombinant human growth hormone
MeSH terms: Case Reports

Background:
Acromelic dysplasia caused by FBN1 mutation includes acromicric dysplasia (AD), geleophysic dysplasia 2 (GD2), and Weill-Marchesani syndrome 2 (WMS2). All three diseases share severe short stature and brachydactyly. Besides phenotypic similarity, there is a molecular genetic overlap among them, as identical FBN1 gene mutations have been identified in patients with AD, GD2, and WMS2. However, no family with different acromelic dysplasia phenotypes due to the same variant has been described in English reports.
Case report:
The proband presented with typical facial features, severe short stature, short limbs, stubby hands and feet and radiological abnormalities. Her elder sister and mother had similar physical features. In addition, her elder sister was found to have aortic valve stenosis by echocardiography. Mutation analysis demonstrated a heterozygous missense mutation, c.5179C>T (p.Arg1727Trp) in exon 42 of the FBN1. The proband and her mother were diagnosed with AD, and her elder sister with GD2. The proband was treated with recombinant human growth hormone (rhGH) and had a body length gain of 0.72 SDS in half a year.
Conclusion:
These findings expand the phenotypic spectrum of FBN1 gene mutations and highlight that identical FBN1 genotypes can result in different phenotypes of acromelic dysplasia in a family. The efficacy of rhGH therapy in patients with acromelic dysplasia is controversial. More follow-up is needed on the long-term efficacy of rhGH therapy.
The efficacy of stereotactic radiotherapy followed by bevacizumab and temozolomide in the treatment of recurrent glioblastoma: a case report
Authors: Wangyan Zhong, Jiwei Mao, Dongping Wu, Jianghua Peng, Wanli Ye
Journal: Front Pharmacol (2024)
Keywords: bevacizumab, combination therapy, recurrent glioblastoma, stereotactic radiotherapy, temozolomide
MeSH terms: Case Reports

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor among adults. Despite advancements in multimodality therapy for GBM, the overall prognosis remains poor, with an extremely high risk of recurrence. Currently, there is no established consensus on the optimal treatment option for recurrent GBM, which may include reoperation, reirradiation, chemotherapy, or a combination of the above. Bevacizumab is considered a first-line treatment option for recurrent GBM, as is temozolomide. However, in recurrent GBM, it is necessary to balance the risks and benefits of reirradiation in combination with bevacizumab and temozolomide. Herein, we report the case of a patient with recurrent GBM after standard treatment who benefited from stereotactic radiotherapy followed by bevacizumab and temozolomide maintenance therapy. Following 16 months of concurrent chemoradiotherapy (CCRT), the patient was diagnosed with recurrent GBM by a 3-T contrast-enhanced magnetic resonance imaging (MRI). The addition of localized radiotherapy to the ongoing treatment regimen of bevacizumab, in combination with temozolomide therapy, prolonged the patient's disease-free survival to over 2 years, achieving a significant long-term outcome, with no notable adverse effects observed. This clinical case may provide a promising new option for patients with recurrent GBM.
A Rare Cause of Intellectual Disability
Authors: Íris Oliveira, Andreia Fernandes, Mafalda Pereira, Márcia Rodrigues, Noémia Silva, Carla Mendonça
Journal: Cureus (2024)
Keywords: delayed psychomotor development, dyrk1a, language impairment, microcephaly, mrd7
MeSH terms: Case Reports

A seven-year-old female was followed in a developmental clinic from the age of nine months due to delayed psychomotor development. The first physical examination showed a newborn with irritability and a large anterior fontanelle. A transfontanellar ultrasound was performed, revealing mild enlargement of the lateral and third ventricles. Head circumference remained below the third percentile until the age of five months, then rose to the third percentile. Developmental milestones were globally delayed, with expressive language being more severely affected and axial hypotonia with appendicular hypertonia on neurological examination. Subsequent medical observation revealed deep-set eyes, mildly up-slanted palpebral fissures, a high nasal bridge with a broad nasal tip, a thin upper lip, widely spaced teeth, retrognathia, and a slight pectus excavatum. Genetic investigation revealed the diagnosis, with whole-exome sequencing consistent with the genetic diagnosis of autosomal dominant mental retardation type 7 (MRD7). All patients diagnosed with MRD7 have a development delay detected at a young age and, typically, a mild to severe intellectual disability later in life. All individuals present language impairment, especially in verbal expression. Motor development is typically affected by gait disturbances and generalized hypertonia, which are noted early in life. Microcephaly is a prominent feature of this syndrome, present in over 90% of the cases. The most common findings in MRD7 (microcephaly and intellectual disability) have a broad differential diagnosis. Some disorders have multiple findings in common with MRD7, such as Angelman syndrome (AS), MECP2 disorders, or Mowat-Wilson syndrome (MWS). MRD7 is a rare genetic syndrome characterized by developmental delay/intellectual disability, microcephaly, autism spectrum disorder, behavior problems, typical facial features, and seizures. Early intervention is more likely to be effective and potentially change a child's developmental path. Small gains early in life could represent a significant difference in the children's future autonomy.
Case report: A rare case of anti-PD-1 sintilimab-induced agranulocytosis/severe neutropenia in non-small cell lung cancer and literature review
Authors: Yanzhu Qin, Shuaiji Lu, Jingwen Chen, Jing Peng, Jijun Yang
Journal: Front Oncol (2024)
Keywords: pd-1-immune related adverse effects, agranulocytosis, immune checkpoint inhibitors, neutropenia, non-small cell lung cancer, sintilimab
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) demonstrate unique advantages in the treatment of lung cancer and are widely used in the era of immunotherapy. However, ICIs can cause adverse reactions. Hematological toxicities induced by immunotherapy are relatively rare. Agranulocytosis, a rare hematologic adverse event associated with immune checkpoint inhibitors, has received limited attention in terms of treatment and patient demographics. Herein, we report the case of a 68-year-old male with non-small cell lung cancer(NSCLC) who received two cycles of programmed cell death-1 (PD-1) antibody sintilimab immunotherapy combined with albumin-bound paclitaxel and carboplatin chemotherapy and one cycle of sintilimab monotherapy. He was diagnosed with grade 4 neutropenia and sepsis (with symptoms of fever and chills) after the first two cycles of treatment. Teicoplanin was promptly initiated as antimicrobial therapy. The patient presented with sudden high fever and developed agranulocytosis on the day of the third cycle of treatment initiation, characterized by an absolute neutrophil count of 0.0×109/L. The patient was treated with granulocyte colony-stimulating factor but did not show improvement. He was then treated with corticosteroids, and absolute neutrophil counts gradually returned to normal levels. To the best of our knowledge, this is the first reported case of sintilimab-induced agranulocytosis in a patient with NSCLC. Sintilimab-induced severe neutropenia or agranulocytosis is a rare side effect that should be distinguished from chemotherapy-induced neutropenia and treated promptly with appropriate therapies; otherwise, the condition may worsen.
A case of varicella due to primary varicella zoster virus infection followed by respiratory disease on the background of an immunocompromised condition
Authors: Hizuru Tomita, Yoshimasa Nobeyama, Miya Morishima, Akihiko Asahina
Journal: Clin Case Rep (2024)
Keywords: cytomegalovirus activation, immunocompromised condition, systemic lupus erythematosus, varicella, varicella zoster virus infection
MeSH terms: Case Reports

We encountered an immunocompromised patient with severe respiratory disease immediately after the onset of varicella. Varicella zoster virus infection may be associated with more severe immunosuppressive condition.
Acute Cardiac Manifestations of SARS-CoV-2 Infection: Spotting the Clot
Authors: Robert N Kerley, Amal John, Sajjad Matiullah, Mark Rogan
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

A middle-aged gentleman presented with a one-week history of progressive dyspnoea on minimal exertion, persistent haemoptysis, and right calf swelling. His only past medical history of note was a recently positive SARS-CoV-2 nasopharyngeal swab performed as part of a workplace outbreak screening. A CT pulmonary angiogram (CTPA) showed bilateral pulmonary thrombi, extensive consolidation, and a left ventricular (LV) thrombus. A transthoracic echocardiogram (TTE) showed a dilated LV with severely impaired systolic function and LV thrombus. The patient was anticoagulated with warfarin, commenced on IV diuretics and COVID-19 protocol. Cardiac magnetic resonance (CMR) imaging showed a severely dilated nonischaemic cardiomyopathy with a heavy thrombus burden and a fibrosis pattern in keeping with myocarditis. We present a case of COVID-19-related myocardial dysfunction with high thrombotic burden and a discussion of its management.
Magnetic resonance imaging findings of intravascular leiomyomatosis of the uterus: a case report
Authors: Bin Guo, Shuhui Zhao, Juan Li, Xiaoyan Wang
Journal: Front Med (Lausanne) (2024)
Keywords: mri, benign metastasizing leiomyoma, intravascular leiomyomatosis, misdiagnosis, uterine leiomyoma, variant types of leiomyoma
MeSH terms: Case Reports

Background:
Intravascular leiomyomatosis (IVL) is often a non-malignant condition that grows inside the blood vessels and does not invade surrounding tissues. However, its presence within the blood vessels can lead to obstructions. The majority of IVL cases manifest symptoms related to blockage.
Case presentation:
We present a case of a 50-year-old female patient who was referred to our institution due to the presence of a common non-cancerous tumor in the uterus, known as a benign uterine leiomyoma. The tumor was identified during an ultrasound examination during a routine physical examination. Postoperative pathology established the existence of intrapelvic IVL.
Conclusion:
Intrapelvic IVL often not present with complications when it is confined to the pelvic cavity. Furthermore, the imaging features of intrapelvic IVL resemble those of typical benign uterine leiomyomas. This can often result in the clinical misdiagnosis of the tumor as a typical benign uterine leiomyoma.
Body-piercing associated appendicitis in the pregnant patient incidentally discovered during Caesarian section
Authors: Jennifer Schadt, Andrew Hungerford, Molly Houser, Nia Zalamea
Journal: J Surg Case Rep (2024)
Keywords: appendicitis, foreign body appendicitis, pregnancy
MeSH terms: Case Reports

Appendicitis is the most common general surgery condition encountered in pregnant patients. Its presentation and diagnosis can be confounded by physiological changes of pregnancy causing atypical symptoms and overlap between pregnancy symptoms and appendicitis. Diagnosis of appendicitis in pregnancy is important, as pregnant persons have a much higher rate of complication from appendicitis. In this case report, we describe a patient with a history of right lower quadrant pain thought to be related to round ligament pain. Her previously undiagnosed appendicitis was discovered during routine inspection during caesarian section. The patient's final pathology revealed a metallic foreign body, one of the rarest causes of appendicitis.
Case Report: Giant cholesterol granuloma in the anterior mediastinum
Authors: Milica Ludoski, Igor Zivkovic, Petar Milacic, Novica Boricic, Slobodan Micovic, Milovan Bojic, Zoran Tabakovic
Journal: Front Cardiovasc Med (2024)
Keywords: cabg, cholesterol granuloma, mediastinum, open heart surgery, tumor
MeSH terms: Case Reports

Cholesterol granuloma is a rare entity, which can develop in many regions of the body, accounting at most 1% of all mediastinal tumors. Etiology of this granuloma is still not clearly understood. The gold standard choice of treatment for cholesterol granuloma is total surgical resection. Symptomatic mediastinum granuloma can be easily diagnosed, but if mass effect is not evident then diagnosis of this tumor is really challenging. We present a rare case of huge cholesterol granuloma in the anterior mediastinum of the patient who underwent on elective coronary artery graft bypass surgery.
Self-care for maternal and reproductive health in conflict settings: qualitative case study in Nuba Mountains, Sudan
Authors: Sali Hafez, Stella Sadia Samson, Lydia Tanner, Naomi Pendle
Journal: Front Glob Womens Health (2024)
Keywords: sudan, communal care, conflict, humanitarian, maternal health, self-care, sexual and reproductive health

Introduction:
Self-care is a critical component of Reproductive, Maternal, and Neonatal Health (RMNH), offering women the knowledge, skills, and autonomy needed for well-being throughout the reproductive cycle. This paper explores the significance of self-care in conflict-affected regions, where access to formal healthcare is limited. Such areas place pregnant women at higher risk due to increased incidents of adverse events during pregnancy and childbirth. Self-care interventions have the potential to enhance access to quality healthcare services.
Methods:
Employing a qualitative approach, this study explores RMNH self-care practices among pregnant and post-natal women in the Nuba Mountains. The methods included in-depth semi-structured interviews with 24 participants, comprising pregnant women, recent mothers, and healthcare providers. Purposive sampling was used to capture the experiences of mothers, and thematic analysis identified key patterns and themes in self-care practices. The perspectives of healthcare professionals were included to understand the context of RMNH care in conflict settings.
Results:
The study revealed the crucial role of community cohesion in providing emotional and practical support in pregnancy, childbirth, and in the post-natal period. Limited healthcare infrastructure and ongoing conflict-related challenges provided important drivers for self-care practices. A spectrum of self-care interventions ranged from personal hygiene practices to community-supported childbirth and postnatal care. Significant reliance on elder women's wisdom and traditional midwifery was observed, particularly in the absence of formal healthcare facilities. Some women moved to live with family close to the hospital in the weeks before their due dates in order to mitigate the risks of early deliveries, complications, or general insecurity in their home areas.
Discussion:
The findings present a compelling narrative of communal self-care, challenging the conventional notion of self-care as solely individualistic. In this setting, the community's role is fundamental, with knowledge sharing and mutual support forming the bedrock of maternal health practices. Elder women, embodying repositories of perceived traditional wisdom, emerge as central figures, guiding pregnant and postpartum women through shared experiences and practices. This collective approach is not merely a cultural characteristic but a necessity born out of the region's limited healthcare infrastructure and ongoing conflict. The study underscores the need to recognize and integrate these communal self-care strategies into broader health interventions.