OpenMed/multicare-articles huggingface dataset:
A Case of a Gastrointestinal Stromal Tumor Diagnosed at the Postpartum Period
Authors: Sefa Kurt, Aras Emre Canda, Emre Karadeniz, Tugba Yavuzsen, Ozgul Sagol, Funda Obuz, Mehmet Serefettin Canda
Journal: Case Rep Obstet Gynecol (2016)

Introduction. We discuss a rare gastrointestinal stromal tumor (GIST) case detected at the 10th postpartum week and we want to pay attention to the challenges and improvements in the diagnosis, surgery, chemotherapy, and follow-up of this rare tumor accompanied with the review of the current literature. Case Presentation. A 32-year-old multiparous woman presented with abdominal swelling 10 weeks after her second vaginal birth. Abdominal examination revealed a mass starting from the pelvic level and extending to the right upper quadrant. Radiological examinations showed a solid, multiloculated, and hypervascular mass starting from the pelvis and extending to the transverse colon. En bloc mass with a 20 cm jejunal segment resection and a left pelvic side wall peritonectomy with omentectomy was performed. The pathologic examination revealed a high-risk GIST which originated from the jejunum and disseminated to the peritoneum. The patient has been given imatinib 400 mg/day since then. She did not reveal any progression during the 15-month follow-up postoperatively. Conclusion. GIST tumors are rare and there is not sufficient information in the literature regarding its management. In this patient having high risk GIST and GIST sarcomatosis we successfully treated the patient by surgery and adjuvant imatinib chemotherapy.
Solitary plasmacytoma of thoracic vertebra in a woman with Lynch syndrome: A case report
Authors: E F Röpke, F Theissig, G Ulrich, K Bäker, C Bochwitz, A Grundig, C Paasch
Journal: Int J Surg Case Rep (2019)
Keywords: case report, dna mismatch repair, lynch syndrome, solitary plasmacytoma, spinal tumor

Introduction:
One of the major disabling health conditions among elderly is back pain due to degenerative diseases. Less than 1% of spine disorders are caused by malignancies. Among the rare primary vertebral neoplasms the multiple myeloma and the plasmacytoma account for 26% of these cases.
Presentation of case:
We are reporting a case of 64 year-old woman, who suffered from progressive upper back pain and intermittent neurological symptoms including lower limb weakness and voiding disorder under axial loading. Her medical history includes a Lynch syndrome (LS). Computed tomography (CT) and magnetic resonance imaging (MRI) detected a single malignant osteolytic process of the spine involving T5. Urgent surgery with laminectomy intralesional tumor removal and posterior stabilization (Th4-Th6) due to unstable pathologic fracture with spinal cord compression was conducted after interdisciplinary decision. Histopathological examination of the tumor revealed a solitary plasmacytoma.
Discussion:
To our knowledge this is the first case report of a solitary plasmacytoma of the bone (SPB) that arise in a patient who suffers from LS. Similar DNA mismatch repair malfunction is existent in LS and SPB. Hence, a hereditary correlation might be imaginable.
Conclusion:
When detecting a lytic spinal tumor in a patient who suffers from LS a SPB should be taken under consideration.
Hemolytic anemia following intravenous immunoglobulins in children with PIMS-TS: Two case reports
Authors: E Sedlin, S Lau, H von Bernuth, T Kallinich, B Mayer
Journal: Front Pediatr (2023)
Keywords: ivig (intravenous immunoglobulin) administration, mis-c, pims-ts, sars-cov-2, blood group, hemolytic anemia
MeSH terms: Case Reports

This is the first case report on two children presenting with immediate and severe hemolytic anemia following the administration of high-dose intravenous immunoglobulins (IVIGs) in the context of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Hemolytic anemia was described as a significant decrease in hemoglobin and an increase in lactate dehydrogenase after the second administration of high-dose IVIGs was performed. Both patients were found to have AB blood group. One of our patients showed massive pallor, weakness, and inability to walk in association with hemolysis. However, in both cases, the anemia was self-limiting and transfusion of red blood cells was not required: both patients recovered without persistent impact. Nonetheless, we aim to draw attention to this widely unknown adverse effect of IVIG, especially in the context of PIMS-TS. We suggest determining the patient's blood group prior to high-dose IVIG infusion and replacing the second IVIG through high-dose steroids or anticytokine therapy. Using IVIGs containing lower titers of specifically anti-A or anti-B antibodies to avoid isoagglutinin-caused hemolytic anemia is desirable; however, the information is not routinely available.
Real-Time Observations of Food and Fluid Timing During a 120 km Ultramarathon
Authors: Floris C Wardenaar, Daan Hoogervorst, Joline J Versteegen, Nancy van der Burg, Karin J Lambrechtse, Coen C W G Bongers
Journal: Front Nutr (2018)
Keywords: fluid balance, recommendations, running, sports nutrition, supplements, sweat rate

The aim of the present case study was to use real-time observations to investigate ultramarathon runners' timing of food and fluid intake per 15 km and per hour, and total bodyweight loss due to dehydration. The study included 5 male ultramarathon runners observed during a 120 km race. The research team members followed on a bicycle and continuously observed their dietary intake using action cameras. Hourly carbohydrate intake ranged between 22.1 and 62.6 g/h, and fluid intake varied between 260 and 603 mL/h. These numbers remained relatively stable over the course of the ultra-endurance marathon. Runners consumed food and fluid on average 3-6 times per 15 km. Runners achieved a higher total carbohydrate consumption in the second half of the race (p = 0.043), but no higher fluid intake (p = 0.08). Energy gels contributed the most to the total average carbohydrate intake (40.2 ± 25.7%). Post-race weight was 3.6 ± 2.3% (range 0.3-5.7%) lower than pre-race weight, revealing a non-significant (p = 0.08) but practical relevant difference. In conclusion, runners were able to maintain a constant timing of food and fluid intake during competition but adjusted their food choices in the second half of the race. The large variation in fluid and carbohydrate intake indicate that recommendations need to be individualized to further optimize personal intakes.
Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter
Authors: Eric Kamenetsky, Rahul Reddy, Mark C Kendall, Antoun Nader, Jessica J Weeks
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient.
Optical Coherence Tomography Angiography of Retinal Arterial Macroaneurysm before and after Treatment
Authors: Victoria S Chang, Stephen G Schwartz, Harry W Flynn Jr
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

A case of retinal arterial macroaneurysm (RAM) is presented with multimodal imaging, including commercially available optical coherence tomography angiography (OCT-A). Following treatment with intravitreal bevacizumab, reduction of flow signal through the RAM is documented. OCT-A provides useful information for the diagnosis and management of at least some patients with RAM, without the need for traditional fluorescein angiography.
Long-term course of early onset developmental and epileptic encephalopathy associated with 2q24.3 microduplication
Authors: Takuya Masuda, Hitoshi Osaka, Naomi Tsuchida, Satoko Miyatake, Kou Nishimura, Toshiki Takenouchi, Takao Takahashi, Naomichi Matsumoto, Takanori Yamagata
Journal: Epilepsy Behav Rep (2022)
Keywords: 2q243 microduplication, clb, clobazam, cnvs, copy number variations, czp, clonazepam, copy number variations, dee, developmental and epileptic encephalopathy, developmental and epileptic encephalopathy, eiees, early infantile epileptic encephalopathies, pb, phenobarbital, pht, phenytoin, scn, voltage-gated sodium channels, vpa, valproic acid, voltage-gated sodium channel, wes, whole exome sequencing, zns, zonisamide
MeSH terms: Case Reports

Copy number variations (CNVs) have been related to developmental and epileptic encephalopathy (DEE). The 2q24.3 region includes a cluster of genes for voltage-gated sodium channels (SCN) and CNVs in this region cause DEE. However, the long-term course of DEE with a 2q24.3 duplication has not been described. A 20-year-old female developed epileptic encephalopathy in early infancy that was resistant to various antiseizure medications. Her seizures disappeared after starting vitamin B6 therapy. Therefore, her epilepsy was considered pyridoxine-dependent epilepsy. At 16 years old, whole exome sequencing revealed a 2q24.3 microduplication including SCN1A, SCN2A, SCN3A, SCN7A, and SCN9A. Quantitative PCR detected an increased copy number of 1.3 Mb on 2q24.3 involving these genes, but no gene mutation accounting for pyridoxine-dependent epilepsy. Considering that with this duplication she was reported to be seizure-free after infancy, she was able to be off antiseizure medications including vitamin B6. Our case involvingdrug-resistant epilepsy in early infancy had no recurrent seizures during long-term follow up. Detecting CNVs using whole exome sequencing data was useful to identify a 2q24.3 duplication unassociated with pyridoxine-dependent epilepsy, leading to cessation of unnecessary medications.
All Inside Intraepiphyseal ACL Reconstruction Using Flexible Curved Instrumentation and Intraoperative Fluoroscopy in a Skeletally Immature Patient
Authors: Richard N Puzzitiello, Avinesh Agarwalla, Grant Garcia, Enrico M Forlenza, Brian Forsythe
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Case:
A 13-year-old skeletally immature female presenting with an anterior cruciate ligament (ACL) rupture after a noncontact injury was treated with an intraepiphyseal ACL reconstruction. Flexible instrumentation was utilized to drill a femoral tunnel with an anatomic starting point, with a trajectory that curved inferolaterally away from the physis. At three years postoperatively, she had returned to her preinjury functioning and did not display any lower limb length growth abnormalities.
Conclusions:
The novel application of curved guides and flexible instruments, with intraoperative fluoroscopy, facilitated growth plate avoidance and a successful outcome of ACL reconstruction in a skeletally immature patient.
Case report: specific phobia of vaginal penetration in a pregnant patient
Authors: Wenqi Geng, Jinya Cao, Li Jin, Jing Wei
Journal: Front Psychiatry (2023)
Keywords: muscle relaxation, phobic disorders, prenatal care, psychopharmacology, referral and consultation
MeSH terms: Case Reports

Specific phobia is frequently unrecognized or untreated unless it causes significant impairment. In this report, we documented a rare case of a pregnant patient who had a specific fear related to vaginal penetration. Due to abnormal fetal cardiac development in the second trimester, the patient was admitted for termination of pregnancy. The patient's persistent request for surgical termination via cesarean delivery prompted the obstetrician to seek psychiatric consultation for tokophobia, a labor- and childbirth-related phobia. The consulting psychiatrist discovered that the patient had developed a significant fear of vaginal penetration during adolescence. Throughout the extended period of this specific phobia, the patient established a range of avoidance strategies. Had it not been for the unforeseen need for abortion, her phobia may not have been identified. Psychoeducation on specific phobias, exposure therapy, muscle relaxation techniques, and the administration of anxiolytics were implemented. The pregnancy was terminated through a vaginal labor induction procedure 2 days later. Collaboration across disciplines is necessary to support a thorough assessment of obstetric patients who express hesitancy toward vaginal delivery.
Acute Aneurismal Bilateral Subdural Haematoma without Subarachnoid Haemorrhage: A Case Report and Review of the Literature
Authors: Ossama Mansour, Tamer Hassen, Sameh Fathy
Journal: Case Rep Neurol Med (2014)

Spontaneous pure acute bilateral subdural haematoma (ASDH) without intraparenchymal or subarachnoid haemorrhage caused by a ruptured cerebral aneurysm is extremely rare. It can follow rupture of different aneurysms specially located in anterior incisural space; the most frequently encountered location is the PcoA aneurysms as demonstrated in the present case. We present a case report of a PcoA aneurysm presenting as pure bilateral ASDH. A high level of suspicion for bleeding of arterial origin should be maintained in all cases of acute subdural haematoma without history of trauma. The neurological status on admission dictates the appropriate timing and methodology of the neuroradiological investigations.
Expanded Dengue Syndrome Presenting as Intracranial Hemorrhage, Fever, and Rhabdomyolysis: A Case Report
Authors: Shubhajeet Roy, Shikhar S Gupta, Shashank Prajapati, Syed N Muzaffar, Avinash Agrawal
Journal: Cureus (2023)
Keywords: dengue, intracranial hemorrhages, myoglobinuria, rhabdomyolysis, severe dengue
MeSH terms: Case Reports

Rare clinical manifestations of dengue are included under the expanded dengue syndrome (EDS), with intracranial hemorrhage (ICH) being one of them. We discuss an uncommon presentation of dengue with basal ganglia hemorrhage, hyperthermia, and rhabdomyolysis in a 53-year-old hypertensive female who presented with sudden onset syncope, left-sided weakness, and altered sensorium for days, with high-grade fever and vomiting. The Glasgow coma scale (GCS) score was 5, and the patient was intubated. Noncontrast computerized tomography (NCCT) of the brain revealed right basal ganglia bleeding with intraventricular hemorrhage. Electrocardiography (ECG) revealed sinus tachycardia. The patient had spikes of high-grade fever, rhabdomyolysis, stage III acute kidney disease, and coagulopathy. Dengue IgM antibodies were positive. Treatment was started, and the patient was in the intensive care unit (ICU) for six months, following which she was discharged. Given this, one can speculate on the importance of viral diseases presenting with ICH as these are rare and are diagnosed quite late, which can also prove to be fatal.
Case report: MELAS and T3271C mitochondrial mutation in an adult woman
Authors: Dong-Hua Chen, Wei Li, Hai-Shan Jiang, Chao Yuan
Journal: Front Neurol (2023)
Keywords: melas, t3271c mutation, case report, glucocorticoid therapy, peripheral nerve dysfunction
MeSH terms: Case Reports

Introduction:
Patients with mitochondrial disorders always show neurological deficits. However, the diversity of clinical manifestations, genetic heterogeneity and threshold effect caused by maternal heredity make its diagnosis very challenging.
Case presentation:
A 30-year-old female presented to our neurology department with a recurrence of symmetrical weakness proximally in the lower extremities. Seven years ago, the patient had a sudden onset of persistent weakness in bilateral proximal lower extremities, along with elevated creatinine kinase (CK) and CK-MB. Given the diagnosis of Guillain-Barre syndrome, she was treated with high-dose glucocorticoid (GC) therapy at the local hospital and recovered. After admission to our hospital, laboratory analysis revealed elevated CK and alpha-hydroxybutyrate dehydrogenase in serum. Electrocardiography showed sinus tachycardia and left high ventricular voltage. Electromyography (EMG) and evoked potential (EP) suggested peripheral neurogenic damage of the upper and lower extremities with myogenic wear. Chronic inflammatory demyelinating polyneuropathy (CIDP) was initially considered, but neurological symptoms were not significantly improved with glucocorticoid shock therapy. An elevated level of lactate was found. The short-tau inversion recovery (STIR) axial magnetic resonance image (MRI) revealed mild hyperintensities, indicating muscle edema. Meanwhile, muscle biopsies suggested pathological changes in mitochondrial disorders (MIDs) and neuronal damage. Further mitochondrial genome analysis revealed a heteroplasmic m3271 T>C mutation in the mitochondrial tRNA-Leu gene (UUR). Collectively, the patient was finally diagnosed with mitochondrial disorder and apparently improved after the corresponding treatment to regulate energy metabolism.
Conclusions:
To our knowledge, it's the first report about MELAS with 3271 mutation that have only shown peripheral nerve motion impairment. Proximal weakness is also common in CIDP. In the context of this patient's experience, mitochondrial genome analysis provides an auxiliary criterion for differential diagnosis between MIDs and CIDP. In the meantime, we discussed the clinical effect of GCs on MIDs.
An Uncommon Location for a Urinary Tract Stone: Urethral Stone
Authors: Anas Da'meh, Amin Da'meh
Journal: J Belg Soc Radiol (2022)
Keywords: urolithiasis, ascending urethrogram, computed tomography, flank pain, hydronephrosis, urethral stricture
MeSH terms: Case Reports

Teaching point: Attention to the urethra is essential when looking for urinary tract stones or etiology for hematuria.
Case Report: 18F-PSMA-1007 PET/CT Avid Solitary Penile Metastasis of Castration-Resistant Prostate Cancer With a PSA of 0.072 ng/ml
Authors: Yongliang Li, Yanmei Li, Siying Dong, Jian Chen, Pengfei Yang, Juan Li
Journal: Front Oncol (2022)
Keywords: 18f-psma-1007 pet/ct, psa, castration resistance, penile metastasis, prostate cancer
MeSH terms: Case Reports

Penile metastasis of prostate cancer is rare, with a poor prognosis, and only a limited number of relevant cases have been reported so far. With the application of 18F-PSMA-1007 PET/CT, the biochemical recurrence of prostate cancer can be detected at an early stage for providing important evidence, facilitating clinical decision-making. Here, we have reported a case of solitary penile metastatic recurrence in the context of mild PSA progression (PSA: 0.072 ng/ml). This case highlights the preferable sensitivity of 18F-PSMA-1007 PET/CT imaging in prostate cancer.
Collagenous colitis and spondylarthropathy
Authors: Kaouther Ben Abdelghani, Hana Sahli, Leila Souabni, Selma Chekili, Salwa Belhadj, Selma Kassab, Ahmed Laatar, Leith Zakraoui
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Collagenous colitis is a recent cause of chronic diarrhea. Cooccurrence with spondylarthropathy is rare. We describe two cases: one man and one woman of 33 and 20 years old were suffering from spondylarthropathy. They then developed collagenous colitis, 4 and 14 years after the onset of spondylarthropathy. The diagnosis was based on histological features. A sicca syndrome and vitiligo were observed with the female case. The presence of colitis leads to therapeutic problems. This association suggests a systemic kind of rheumatic disease of collagenous colitis.
Case Report: Bilateral symmetrical primary kaposiform hemangioendothelioma of the femur
Authors: Tong Qiu, Yuru Lan, Jiangyuan Zhou, Kaiying Yang, Xue Gong, Zixin Zhang, Siyuan Chen, Yi Ji
Journal: Front Pediatr (2022)
Keywords: kasabach–merritt phenomenon, bone, case report, kaposiform hemangioendothelioma, pediatric
MeSH terms: Case Reports

Kaposiform hemangioendothelioma (KHE) is a rare borderline vascular tumor that usually presents as a mass of skin or deep soft tissue. We report a unique case of an 8-year-old KHE patient with bilateral symmetrical sites involving both femurs. The laboratory, radiographic, and pathological findings of the patient were minutely described. During the 6-month follow-up, the symptoms of pain and dysfunction of this patient were relieved. This study aimed to arouse clinicians' concern about the symmetrical sites of KHE patients.
A novel approach for treatment of an unusual presentation of radicular cysts using autologous periosteum and platelet-rich fibrin in combination with demineralized freeze-dried bone allograft
Authors: Veena A Patil, Manthan H Desai, Veerendra S Patil, Hanisha Reddy Kaveti, Kiran Kumar Ganji, Prasanna M Danappanavar
Journal: Case Rep Dent (2013)

Radicular cysts are the most common cystic lesions affecting the jaws. They are most commonly found at the apices of the involved teeth. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. The following case report presents the successful treatment of radicular cysts using autologous periosteum and platelet-rich fibrin with demineralized freeze-dried bone allograft.
Spindle Cell Melanoma Presenting as an Ulcer in a Black Diabetic
Authors: D A Gaskin, D Brathwaite, N Depeiza, P S Gaskin, J Ward
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Background. Melanoma in blacks is uncommon and exceedingly rare in association with a diabetic ulcer. We present a case of a spindle cell melanoma masquerading as a diabetic ulcer. Case Report. A 57-year-old overweight woman presented to The Maria Holder Diabetes Centre for the Caribbean with a nonhealing ulcer of the right heel after being treated by various primary care physicians over the preceding year. Her general and systematic examinations were unremarkable. There was a 1 × 1.5 cm ulcer with a necrotic base which bled easily on contact with no evidence of peripheral neuropathy nor arterial insufficiency. Microscopic examination of a biopsy of the lesion showed fascicles of spindle cells with plump nuclei and intracytoplasmic yellow-brown pigment. Immunohistochemistry confirmed a diagnosis of melanoma. Discussion. There should be a high index of suspicion of malignancy with nonhealing diabetic ulcer especially when coupled with short disease duration. This case highlights the importance of a biopsy and histological evaluation in ulcers presenting in recently diagnosed diabetics with no evidence of peripheral neuropathy or vascular disease. Melanoma should be considered in spindle cell lesions especially with pigment and residual nevus cells.
Epidural Gas Accumulation in Connection with Canine Degenerative Lumbosacral Disease
Authors: Ditte Skytte, Hugo Schmökel
Journal: Front Vet Sci (2017)
Keywords: canine, disc protrusion, epidural gas accumulation, lumbosacral degeneration, pneumorrhachis
MeSH terms: Case Reports

Three dogs were presented with lumbosacral hyperesthesia. Computerized tomography scans were performed in all the cases, and magnetic resonance imaging was also performed in cases 1 and 3. There was intervertebral disc (IVD) protrusion causing nerve root compression and epidural gas accumulation in all the three cases. The gas-filled cystic structures in cases 1 and 3 were within the spinal canal; in case 2, the gas was within the disc protrusion. The IVD vacuum phenomenon is relatively common in dogs, but the formation of an epidural gas accumulation in cases of a lumbar disc protrusion is rare. The clinical significance of these epidural gas accumulations is unknown. Two of the dogs were treated surgically, improved after surgery, and showed no signs of pain in the follow-up examinations.