OpenMed/multicare-articles huggingface dataset:
Delayed Diagnosis of Colonic Adenocarcinoma in a 30-Year-Old Postpartum Woman Misdiagnosed with HELLP Syndrome
Authors: Alexander J Maqueira, Ahmad O Rifai, Courtney Albury, William A Kantrales, David Rydell, Henry Breland
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Colon cancer is a rare diagnosis in 30-year-old women, which may be further complicated by their concurrent gravid status. Several physiological changes that occur during an intrauterine pregnancy (IUP) can mask symptoms of early colon cancer. Our patient was a 30-year-old, Gravida 2, Para 0 woman with an uncomplicated pregnancy until the 35th week of gestation when she developed preeclampsia and symptoms suggestive of early hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. Following induction of labor and the subsequent, uncomplicated vaginal delivery, the patient developed symptoms of nausea, vomiting, and constipation with abdominal pain and bloating. Abdominal computed tomography (CT) revealed a large mass in the right colon along with the involvement of periaortic lymph nodes and the presence of liver metastases. Hepatic metastases were possibly responsible for the patient's elevated liver enzyme levels, which were initially considered to have been caused by HELLP syndrome because the patient also had preeclampsia. The rarity of colon cancer in young, pregnant patients with no family history, such as in this case, results in poor prognosis owing to nonspecific symptoms of the developing malignancy being attributed to pregnancy, which further delays diagnosis and subsequent therapy. Of 29 cases of colon cancer in pregnant patients recorded till date, this is the first report of a stage 4 adenocarcinoma of the colon with hepatic metastasis, elevated liver enzyme levels, and increased blood pressure with associated preeclampsia, which was diagnosed in the postpartum period. It may be important to consider broader differential diagnoses in expectant patients presenting with unusual and persistent symptoms.
Lenvatininb as Treatment for Naïve Patients with Aggressive Thyroid Cancer Bone Metastases and Bad Performance Status
Authors: Sonia Garcia-Rodriguez, Guillermo Martinez Pinillos, Manuel Chaves-Conde
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Lenvatinib is an oral multityrosine kinase inhibitor (TKI) with proven effectiveness in the treatment of radioactive iodine- (RAI-) refractory and/or unresectable differentiated thyroid carcinoma (DTC). The present study reports the case of a 41-year-old male who underwent hemithyroidectomy in June 2015 due to a thyroid nodule with fine-needle aspiration follicular neoplasm cytology and no evidence of malignancy in the histopathological exam. Three years later, acute disabling clinical symptoms emerged, mainly high skeletal pain conditioned with an important performance status decrease. PET/CT scan displayed several metastatic bone lesions in this context, located in the vertebral bodies, sternum, ribs, iliac crest, right acetabulum, and both necks of the femur. Histological study and immunohistochemistry confirmed DTC metastases, as they were strongly positive for thyroglobulin and TTF-1. At this point, the patient was unfit for conventional management that would have included completion of surgery and RAI treatment as first options. Thus, it was decided to start systemic treatment with TKI, Lenvatinib. Within the first week of treatment, the patient was almost asymptomatic and his performance status moved from 3 to 0. This allowed the patient to undergo resection of the thyroid gland remnant plus RAI treatment. Unfortunately, RAI refractory illness was confirmed so Lenvatinib treatment should be continued in this case until the evidence of no further clinical benefit. Despite drug adverse events, the patient continues with treatment one year later, remaining asymptomatic and with normal functional capacity.
Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate
Authors: Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Journal: Case Rep Urol (2016)

Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates.
Shah's Indian penile prosthesis placement after phallic reconstruction with radial forearm flap
Authors: Sujata K Patwardhan, Rupin Shah, Vijay Kulkarni, Radheshyam R Varma
Journal: Indian J Urol (2008)
Keywords: neo-phallus, radial forearm flap, rigid penile prosthesis
MeSH terms: Case Reports

We report a successful implantation of Indian penile prosthesis after total phallic reconstruction. The differential stiffness of the Shah penile prosthesis is felt to have less potential for erosion, the most common complication of rigid prosthetic stiffening devices when used in a neo-phallus. This prosthesis is an alternative to the inflatable prosthesis in patients who choose a rigid prosthesis due to economical constraints.
Conversion therapy from unresectable stage IIIC non-small-cell lung cancer to radical surgery via anti-PD-1 immunotherapy combined with chemotherapy and anti-angiogenesis: A case report and literature review
Authors: Guohua Jia, Shuimei Zhou, Tangpeng Xu, Yabing Huang, Xiangpan Li
Journal: Front Oncol (2022)
Keywords: conversion therapy, immunotherapy, locally advanced, squamous cell carcinoma, unresectable lung cancer

The prognosis of patients with stage IIIC non-small-cell lung cancer (NSCLC) is poor due to the loss of surgical treatment opportunities. Improving the prognosis of these patients with IIIC NSCLC urgently needs to be addressed. Here, we report a stage IIIC (T4N3M0 IIIC (AJCC 8th)) NSCLC patient treated with 2 cycles of anti-PD-1 immunotherapy combined with chemotherapy and anti-angiogenesis therapy; after two cycles of treatment, the patient achieved a partial response and obtained the opportunity for surgical treatment. After the operation, the patient achieved a pathological complete response and successfully transformed from unresectable stage IIIC lung cancer to radical surgery (ypT0N0M0). Our study is expected to provide new ideas for treating patients with unresectable stage IIIC NSCLC in the future.
Puzzling painful nodules on back: a case report
Authors: Meghana Pendam, Bhushan Madke, Samyak Ganjre, Meenakshi Chandak, Adarsh Lata Singh
Journal: Pan Afr Med J (2022)
Keywords: piloleiomyoma, arrector pili muscle, calcium channel blocker, case report, painful skin tumour
MeSH terms: Leiomyoma / diagnosis, Skin Neoplasms / diagnosis, Skin Neoplasms / pathology, Case Reports, Amlodipine, Calcium Channel Blockers, Humans, Pain, Calcium Channel Blockers, Amlodipine

Cutaneous leiomyomas are known to arise from three locations viz, arrector pili muscle, dartos muscle in the scrotal sac, and smooth muscle layer of blood vessels. Cutaneous piloleiomyoma (arising from arrector pili) is an uncommon benign skin tumor presenting clinically as a single or numerous painful nodules. They can either appear diffuse or zosteriform/segmental in rare cases. We report an unusual case of multiple tender papulonodular lesions on the right infrascapular region. Histology from one of the nodules showed a dermal tumor consisting of interlacing fascicles of spindle cells, consistent with the diagnosis of piloleiomyoma. We prescribed our patient with oral calcium channel blocker, amlodipine, to provide symptomatic relief from pain and which can be considered used it to treat similar cases.
Devastating Complications of Metal Strut Migration Following Pectus Excavatum Repair
Authors: Mila Stajevic, Milorad Bijelovic, Jovan Kosutic, Radoje Simic
Journal: European J Pediatr Surg Rep (2019)
Keywords: complications, pectus excavatum, strut migration, the ravitch procedure
MeSH terms: Case Reports

The modified Ravitch technique with metal struts and the Nuss operation have been the dominant operative techniques for treatment of pectus excavatum in the previous decades. We present devastating postoperative complications of a 16-year-old boy after the modified Ravitch procedure for a severe deformity utilizing two metal bars. Four months following surgery, one strut was removed after the displacement noted on a regular postoperative examination. Ten days after the strut removal, the patient complained of lower limb pain but the sensations were attributed to physical inactivity. Two months later, after pain intensification, the boy was diagnosed with bilateral arterial and venous lower limb thromboses and subsequently, the migration of the remaining metal strut intracardially with the free end in the left ventricular cavity embedded in massive thrombi. An urgent cardiac procedure was performed and the bar removed. Postoperatively, the boy made a full cardiac recovery but with severe neurological complications and subsequent death. Migration of metal struts is a rare complication and, except in our case, had been dealt with successfully. This case should emphasize more attention to the postoperative follow-up management of such patients.
Sarcoidosis and Monoclonal Gammopathy of Undetermined Significance (MGUS): A True Association or Just a Coincidence?
Authors: Mohamed Hassanein, Lilit Karapetyan, Afshan Khan, Supratik Rayamajhi
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Sarcoidosis is a systemic inflammatory disease characterized by the presence of noncaseating granulomas in different organs. Sarcoidosis associated with monoclonal gammopathy of undetermined significance (MGUS) is a rare finding with only 10 cases reported to date. We describe a 79-year-old male patient who presented with dry mouth for 4 months. Lip biopsy done prior to admission showed nonnecrotizing epithelioid cell granulomas. On admission, laboratory analysis was significant for elevated calcium, decreased parathyroid hormone, increased erythrocyte sedimentation rate, undetectable parathyroid hormone-related peptide (PTHrp), mildly decreased 25-hydroxyvitamin D, elevated 1,25-dihydroxyvitamin D, elevated angiotensin converting enzyme, and positive Bence Jones protein in the urine. Serum protein electrophoresis showed an elevated gamma globulin level at 38% and an IgG monoclonal gammopathy with an M-spike of 1.47. Bone marrow biopsy was consistent with MGUS. The patient showed significant improvement with steroids and was discharged with close follow-up from nephrology and oncology. Salivary gland involvement in patients with sarcoidosis is a rare finding. Our case is a valuable addition to the small number of cases described in the literature supporting an association between plasma cell disorders and sarcoidosis. Larger prospective studies are needed to determine if a true association between the two diseases exists.
Case report: Successful multimodal assessment and management of chemothorax
Authors: Teodora Panza, Rosatea Quercia, Francesca Signore, Giulia De Iaco, Debora Brascia, Doroty Sampietro, Anna Rita Gasbarro, Maria Dell'Aera, Vito Lorusso, Giuseppe Marulli, Angela De Palma
Journal: Front Surg (2022)
Keywords: port-a-cath, chemotherapy, chemothorax, dislocation, multidisciplinary management, pleural effusion, thoracoscopy, video-assisted thoracic surgery
MeSH terms: Case Reports

Dislocation or wrong placement of central venous catheters into the pleural cavity is rare, but if undiagnosed, may cause major, sometimes life-threatening, complications (pneumothorax, hemothorax, infection, and migration) and accidental pleural effusion due to intravenous injection of fluids containing drugs (i.e. chemotherapy, antibiotics, parenteral nutrition, other). We report a rare case of pleural effusion consisting of chemotherapy (chemothorax) directly injected into the pleural cavity due to the wrong placement of a central venous catheter (Porth-A-Cath) in a woman with breast cancer. A multidisciplinary management consisting of antidote administration, followed by removal of the venous device and washing of the pleural cavity through video-assisted thoracic surgery (VATS), avoided any major complication related to the adverse event.
Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction
Authors: Lindsey Kalvin, Rayan Yousefzai, Bijoy K Khandheria, Timothy E Paterick, Khawaja Afzal Ammar
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Postmyocardial infarction ventricular septal defect is an increasingly rare mechanical complication of acute myocardial infarction. We present a case of acute myocardial infarction from right coronary artery occlusion that developed hypotension and systolic murmur 12 hours after successful percutaneous coronary intervention. Although preoperative imaging suggested a large ventricular septal defect and a pseudoaneurysm, intraoperative findings concluded a serpiginous dissection of the ventricular septum. The imaging technicalities are discussed.
Failure to eradicate Isospora belli diarrhoea despite immune reconstitution in adults with HIV--a case series
Authors: Tom H Boyles, John Black, Graeme Meintjes, Marc Mendelson
Journal: PLoS One (2012)
MeSH terms: Diarrhea / immunology, Diarrhea / prevention & control, Disease Eradication, HIV Infections / complications, HIV Infections / immunology, Isosporiasis / immunology, Isosporiasis / prevention & control, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Adult, Diarrhea / complications, Diarrhea / parasitology, Fatal Outcome, Female, HIV Infections / parasitology, Humans, Isospora, Isosporiasis / complications, Isosporiasis / parasitology, Male

Isospora belli causes diarrhoea in patients with AIDS. Most respond to targeted therapy and recommendations are that secondary prophylaxis can be stopped following immune reconstitution with ART. We report eight cases of chronic isosporiasis that persisted despite standard antimicrobial therapy, secondary prophylaxis, and good immunological and virological response to ART. Median CD4 nadir was 175.5 cells/mm(3) and median highest CD4 while symptomatic was 373 cells/mm(3). Overall 34% of stool samples and 63% of duodenal biopsy specimens were positive for oocytes. Four patients died, two remain symptomatic and two recovered. Possible explanations for persistence of symptoms include host factors such as antigen specific immune deficiency or generalised reduction in gut immunity. Parasite factors may include accumulating resistance to co-trimoxazole. Research is required to determine the optimum dose and duration of co-trimoxazole therapy and whether dual therapy may be necessary. Mortality was high and pending more data we recommend extended treatment with high-dose co-trimoxazole in similar cases.
HER2 Negative Mammary Paget's Disease or In Situ Melanoma? A Case Report and Review of the Literature
Authors: Luana-Andreea Boșoteanu, Mariana Așchie, Cristian Ionuţ Orǎșanu, Mădălina Boșoteanu
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Mammary Paget's disease (MPD) is a rare histological condition, accounting for 1-4% of female breast cancers, which may appear either independently (1.4-13% of the cases), or in association with an in situ or invasive ductal carcinoma (approximately 90% of the cases). The purpose of this article is to highlight the histopathological challenges related to the microscopical polymorphism of this disease and the utmost importance of immunohistochemistry in the thorough process of Paget's disease differential diagnosis. Moreover, the primary objective of this review of literature was to corroborate the existing data concerning the potential peculiar immunohistochemical profile that mammary Paget's disease might express. We report the case of a 44-year-old female patient, histopathologically diagnosed with HER2-negative MPD accompanying an invasive mammary carcinoma. The histopathological and immunohistochemical approach is derived from the exigency of excluding the possibility of synchronous tumors-a mammary invasive carcinoma, accompanied by another component with MPD phenotypic mimicry. The unexpected negative HER2 reaction is conducted to a primary focus on excluding a malignant melanoma in situ. The absence of MelanA and S100 immunoexpression and lack of pigmentation and clinical aspects infirmed it. Bowen's disease was invalidated by its rare presentation in the breast cutaneous tissue and the absence of individual risk factors suggestive of an existing immunosuppressive status. In the case of similar morphoimmunohistochemical aspects, significant expression of Ki-67 signals MPD, an immunoreactivity that helped distinguish the cellular population from Toker cells. The great similarity of MPD with other benign and malignant cutaneous tumors might determine delay or misdiagnosis. Thus, the utmost importance of immunohistochemistry is reflected in its prognostic significance and geared towards extending the therapeutic arsenal.
Grinspan's Syndrome: A Rare Case with Malignant Transformation
Authors: Numan Kökten, Lokman Uzun, Ayşe Serap Karadağ, Tülay Zenginkinet, M Tayyar Kalcıoğlu
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Aim:
Oral lichen planus (OLP) is one of the common chronic inflammatory, noninfectious, and precancerous oral mucosal diseases that affect the stratified squamous epithelium in adults. Grinspan et al. reported an association of OLP with diabetes mellitus and vascular hypertension and called that Grinspan's syndrome in 1966. We aim to present a case of Grinspan's syndrome with malignant transformation.
Case presentation:
A 60-year-old man who presented with a ten-year history of OLP diagnosed clinically and histologically was referred to our otolaryngology department with a painless swallowing in the left buccal mucosa for 3 months. Clinical examination revealed several plaques, striated white lesions in the buccal mucosa bilaterally, and an exophytic tumor in the left buccal mucosa. Histopathological examination showed lichen planus bilaterally and oral squamous cell carcinoma in the left buccal mucosa. The tumor had been developed on the preexisting areas of lichen planus which had been histologically proven before. The tumor was removed completely, and the tissue defect on the buccal mucosa was repaired with a split-thickness skin graft.
Conclusion:
Patients with OLP should be followed up periodically in a long term at close intervals for early diagnosis of malignant transformation.
Secondary Syphilis with Eosinophilia Complicated by Severe Jarisch-Herxheimer Reaction
Authors: Anthony Elias, Kirsty Wark, Dana Slape, David Cook, Kenneth Lee, Genevieve Mckew
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

It has long been acknowledged that syphilis is a disease with a diverse range of presentations. We herein describe a case of a young man who presented with fever, rash, and eosinophilia following the commencement of allopurinol, only to be diagnosed with secondary syphilis on histopathology. His treatment was complicated by a severe exacerbation of his cutaneous eruption following the commencement of penicillin, likely secondary to a Jarisch-Herxheimer reaction, an entity often overlooked by clinicians managing syphilis.
Bilateral primary psoas abscesses due to methicillin-resistant Staphylococcus aureus in a neutropenic patient: a case report
Authors: Faris G Bakri, Azmy M Hadidy, Fadi Hadidi, Nosaiba Ryalat, Lina Saket, Nour Shurbasi, Jamal Melhem
Journal: J Med Case Rep (2016)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Antineoplastic Agents / adverse effects, Breast Neoplasms / drug therapy, Methicillin-Resistant Staphylococcus aureus / isolation & purification, Neutropenia / chemically induced, Psoas Abscess / microbiology, Staphylococcal Infections / complications, Case Reports, Breast Neoplasms / complications, Breast Neoplasms / immunology, Drainage / methods, Female, Humans, Middle Aged, Neutropenia / immunology, Psoas Abscess / drug therapy, Staphylococcal Infections / drug therapy, Staphylococcal Infections / microbiology, Treatment Outcome, Anti-Bacterial Agents, Antineoplastic Agents

Background:
Pyogenic abscess of psoas muscles is a rare condition. Psoas abscess due to methicillin-resistant Staphylococcus aureus is an emerging and rare infection and so far the related data are scarce.
Case presentation:
We report the rare case of primary and bilateral large psoas abscesses due to methicillin-resistant Staphylococcus aureus in a 54-year-old Arab Jordanian woman with breast cancer who had neutropenia after starting chemotherapy. She was diagnosed 50 days after onset of symptoms. However, despite this delay in diagnosis and the large size of the abscesses, she had a full recovery. She was treated with antibiotics and percutaneous drainage and was doing very well at a follow up of 18 months.
Conclusions:
Psoas abscess due to methicillin-resistant Staphylococcus aureus might have insidious presentation with extensive disease especially in immunocompromised patients. However, it can be managed effectively with percutaneous catheter drainage and appropriate antibiotic therapy.
Antenatally diagnosed wilms' tumour
Authors: Y K Sarin, S K Rahul, S Sinha, N Khurana, S Ramji
Journal: J Neonatal Surg (2014)
Keywords: antenatal detection, hydrops foetalis, wilms’ tumour
MeSH terms: Case Reports

Wilms' tumour (WT) is seldom seen in a neonate and prenatal diagnosis is rare. We present a case of antenatally diagnosed left sided WT with features of hydrops foetalis in a girl baby. Emergency LSCS was done at 34 weeks of gestation for foetal distress. Patient required mechanical ventilation for birth asphyxia and congestive cardiac failure. After stabilization, gross total resection of the tumour was done on day 4 of life. Histopathology HPE confirmed classical WT (stage I). Unfortunately, the patient died on the second postoperative day despite all supportive measures.
Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
Authors: Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen. On further inquiry specific to trauma, the child disclosed that his older brother had punched him in his abdomen the night before. The child's parents were separated due to intimate partner violence, and this older sibling recently had been very stressed. The sibling was referred for mental health evaluation and counseling, and the case reported to the county children and youth investigative services system. A low threshold for considering trauma and child abuse in the pediatric population is recommended when significant intra-abdominal injury is diagnosed.