OpenMed/multicare-articles huggingface dataset:
Muscular Tuberculosis: A New Case and a Review of the Literature
Authors: Yanping Zeng, Yin Liu, Yanchun Xie, Jingjing Liang, Jiabing Kuang, Zuneng Lu, Yu Zhou
Journal: Front Neurol (2019)
Keywords: biopsy, muscle, muscular tuberculosis, pathology, tuberculosis
MeSH terms: Case Reports

Objective: To investigate the clinical manifestations, underlying diseases, pathological features, and therapeutic responses in patients with muscular tuberculosis (MT), which is rare and often misdiagnosed in clinical practice. Methods: This study describes a rare MT case that was recently diagnosed in our department. Additionally, 18 other MT cases retrieved from the PubMed database from 2,000 to date are included in this study. The clinical manifestations, areas of residence, underlying diseases, laboratory test results, pathology results, and outcomes of the patients were recorded and analyzed. Results: The MT patients in this study included 13 males and six females with an average age of 34.58 years old. Eight patients were from Asia, and six patients were from Africa, accounting for the majority of patients, at 73.68%. Underlying diseases included flu-like illness in one patient; chronic kidney disease (CKD) in one patient; Sjögren's syndrome in one patient; systemic lupus erythematosus (SLE), lupus nephropathy, and deep vein thrombosis in one patient; and Alzheimer's disease (AD) and Paget's disease in one patient. Two patients had a previous history of tuberculosis, and two patients had contact with suspected tuberculosis patients. All patients presented chronic occult onset, with an average of 3 (1.75, 5) months. Six cases had local masses, and 13 cases had swelling as the main clinical manifestations. Twelve patients (63.2%) presented manifestations at single sites, and seven patients presented manifestations at multiple sites, including the thigh, calf, arm, chest wall, dorsal, psoas, gluteal, and forehead muscles. Of the 19 total patients, 13 (68.4%) reported pain, and only 8 (42.1%) patients presented tuberculosis symptoms. All patients received laboratory results associated with Mycobacterium tuberculosis infection. Fourteen (73.7%) of the 19 patients underwent skeletal muscle biopsy, where granulomatous inflammation was observed. Eighteen patients were treated with anti-tuberculosis therapies. Sixteen patients improved or recovered after anti-tuberculosis treatment, and unfortunately, two patients died. Conclusion: As a kind of systemic disease, MT is mainly characterized by painful or painless muscle masses and swelling at a single site or at multiple sites. Patients with a history of tuberculosis and immune system disease are susceptible to MT. A diagnosis is mainly made on the basis of the results of pathological biopsy and bacteriological culture. Early diagnosis and timely standardized anti-tuberculosis treatment can improve the prognosis.
Single coronary artery with anomalous rising of the right coronary artery: a rare coronary anomaly diagnosed by 256-multidetector computed tomography
Authors: Gitsios Gitsioudis, Evangelos Giannitsis, Waldemar Hosch, Hans U Kauczor, Hugo A Katus, Grigorios Korosoglou
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Herein we report the diagnostic potential of cardiac computed tomography (cCT) to delineate the origin and course of an anomalous right coronary artery (RCA) originating from the midpart of the left anterior descended artery (LAD) in an adult with no other form of congenital heart disease. The patient was referred to our institution due to exertional dyspnea and suspected coronary artery disease. The patient underwent X-ray coronary angiography, and no high grade lesions were observed in the left coronary vessels. In the course of the mid-left-anterior-descending artery (LAD), an anomalous side branch coursing away from the left circumflex coronary artery (LCX) was observed, while a right coronary ostium could not be depicted. cCT confirmed the absence of a right coronary ostium, and the vessel originating from the mid LAD was identified as an anomalous RCA, which coursed anterior of the aorta and the pulmonary trunk.
Total lower lip reconstruction by bilateral Fujimori technique-A case report
Authors: Hannah Trøstrup, Jette B Løvenwald, Jørgen Hesselfeldt
Journal: Int J Surg Case Rep (2019)
Keywords: cancer, fujimori flap, lower lip, squamous cell

Squamous cell carcinomas are the most common type of lower lip cancer. In cases where the tumour involves less than on third of the lower lip, direct suture maintains the physical appearance of a normal mouth with few adverse effects. Squamous cell carcinomas involving more than half or even most of the lower lip are not common. We report a successful case of complete lower lip reconstruction after recurrent squamous cell carcinoma involving most of the lower lip by use of bilateral Fujimori technique.
Case:
We present a case of full-thickness squamous cell cancer located to the vermillion border initially, but progressing rapidly in two months during radiotherapy to a state in which most of the lower lip, including the angles of the mouth, were affected.
Discussion:
Surgical management ensuring a functional and aesthetic acceptable outcome is a challenge in patients with large tumours including all of the lower lip. Several methods for reconstruction of the entire lower lip are discussed.
Conclusion:
Bilateral Fujimori one-stage flaps can be used in cases of squamous cell carcinomas involving most of the lower lip, including the commissures of the mouth. A limitation of the method is an eventual lack of local tissue when preparing the flap.
Another Case of Multilevel Cervical Disconnection Syndrome Presenting as Neonatal Encephalopathy
Authors: Kaylan M Brady, Jonathan A Blau, Spencer J Serras, Jeremy T Neuman, Richard Sidlow
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Multilevel cervical disconnection syndrome (MCDS) is a rare malformation of the cervical spine previously documented in two toddlers. We present a case of a newborn first thought to have hypoxic-ischemic encephalopathy who was subsequently diagnosed with MCDS. The possibility of in utero presentation of the syndrome in this patient and the categorization of this syndrome in the spectrum of basilar skull/upper cervical malformation syndromes is discussed.
Multicentric Adenocarcinomas in a Long-Segment of Barrett's Esophagus
Authors: Stefan Hartl, Joerg-Ruediger Siewert, Joerg Theisen
Journal: Clin Med Oncol (2008)
MeSH terms: Case Reports

This report describes a complicated course of a 58-year-old patient with multicentric Barrett's carcinoma within a long-segment of Barrett metaplasia. After abdominal-thoracic resection of the cancer, with incomplete removal of the long-segment metaplastic lesion, invasive carcinoma was diagnosed in the remnant Barrett's segment. Endoscopic mucosal resection was done, but Barrett's mucosa was left in situ again. Recurrent tumor growth was diagnosed only few months later. Finally, transthoracic complete resection on the remnant Barrett's segment was performed. Thus, our case demonstrates impressively the appearance of multicentric adenocarcinomas in Barrett's esophagus and underlines the necessity of resection of the complete Barrett mucosa.
Accessory Mental Foramen in a Patient with Mandibular Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) Lesion: A Case Report
Authors: Sahand Samieirad, Elahe Tohidi
Journal: World J Plast Surg (2020)
Keywords: accessory mental foramen, bisphosphonate, jaw, mandible, osteonecrosis, paresthesia
MeSH terms: Case Reports

The mental nerve is a sensory nerve which traverses through mental foramen to innervate the lower lip, chin skin and the mandibular labial gingiva. Interestingly, it's variant such as the accessory mental foramen (AMF) was described as an unusual finding in the recent literature. Hereby, we reported a patient who was operated to treat the mandibular bisphosphonate-related osteonecrosis of the jaw (BRONJ) lesion. Intraoperatively, an accessory mental foramen was detected posterior to the main foramen and nerve, on the right side of the mandible. This case report highlighted the necessity for proper radiological and clinical evaluation of mental foramina in order to avoid nerve injury and postoperative paresthesia. The review of the literature and the clinical findings were also discussed in this article.
Fulminant Myocarditis Managed by Extracorporeal Life Support (Impella® CP): A Rare Case
Authors: Henrik Fox, Martin Farr, Dieter Horstkotte, Christian Flottmann
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Background:
Treating myocarditis can be difficult, as clear criteria for diagnosis and management are lacking for heterogeneous clinical presentations.
Case description:
We report a case of a 49-year-old female who presented with cardiogenic shock and subsequent cardiac arrest. Extracorporeal life support was instituted, and after eight days with Impella CP the patient recovered and at six months presented with normal cardiac function.
Conclusion:
Fulminant myocarditis remains a challenging disease in daily clinical practice, not only for diagnosis, but also for treatment. With this report we emphasize that myocardial failure due to fulminant myocarditis may be reversible if treated with extracorporeal life support, which thus plays an important and life-saving role.
A pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) (NET and undifferentiated carcinoma of the pancreas with osteoclast-like giant cells) with metastatic neuroendocrine component to the liver
Authors: Guofeng Gao, Amir Qorbani, Chihong Heidi Zhou
Journal: Autops Case Rep (2020)
Keywords: carcinomas, ductal carcinoma of the pancreas, neuroendocrine tumors, pancreatic neoplasms
MeSH terms: Case Reports

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCOGCs) is an extremely rare morphologically and clinically distinct variant of pancreatic ductal adenocarcinoma (PDAC), exhibiting a characteristic component of reactive osteoclast-like giant cells admixed with neoplastic mononuclear cells. Sommers and Meissner first described it in 1954 as an "unusual carcinoma of the pancreas". Later it acquired many different names. In 2010, the WHO classified these tumors as a variant of PDAC under the heading of "undifferentiated carcinoma with osteoclast-like giant cells". Here we describe the first case of pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) composed of UCOGC and pancreatic neuroendocrine tumor (NET), which occurred in a 78-year-old man with biliary colic and pancreatitis. The mass did not respond to the chemotherapy, and he soon developed liver metastasis from the NET component, and unfortunately, the patient passed away 10 months later. Since UCOGC is extremely rare, and its association with NET has not been reported yet, our case expands the knowledge regarding its unusual presentation and poor prognosis.
Management of an Extrusive Luxation Concomitant with Subluxation: A Case Report with Ten-Year Follow-Up
Authors: Saeedeh Mokhtari, Sepideh Hosseini, Maryam Khosrozadeh
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Traumatic dental injuries (TDIs) are a public health concern with high prevalence and incidence rates. Proper intervention can significantly reduce the subsequent complications of these events. This case report describes the clinical interventions to manage a patient with traumatized maxillary incisor with severe extrusive luxation. The procedure was aimed at preserving pulp vitality and providing periodontal maintenance to the highest possible degree. Owing to timely and accurate treatments, ten years of success have been achieved in this patient, as discussed in this case report.
A rare presentation of primary leiomyosarcoma of ovary in a young woman
Authors: J Vijaya Kumar, Anil Khurana, Paramjeet Kaur, Ashok K Chuahan, Sunita Singh
Journal: Ecancermedicalscience (2015)
Keywords: chemotherapy, leiomyosarcoma, ovary, radiation therapy, soft tissue sarcoma, surgery
MeSH terms: Case Reports

Primary ovarian leiomyosarcoma is a very rare tumour which is most commonly seen in postmenopausal women. A case is described here involving a 30-year-old female who presented with pain in the abdomen. The patient underwent laparotomy with peritoneal lavage, bilateral salpingo-oophorectomy, and total abdominal hysterectomy. Microscopic and immunohistochemical findings established the diagnosis of primary ovarian leiomyosarcoma. Similar to sarcoma of other tissues, an adjuvant chemotherapy regimen consisting of vincristine, epirubicin, and cyclophosphamide was given for this present case. Six months after treatment completion, the patient is on regular follow-up and disease-free on clinical and radiological examination.
Intraoperative antepulsion of a posterior lumbar interbody fusion cage: three case reports
Authors: Davut Ceylan, Can Yaldiz, Kiyasettin Asil, Tibet Kaçira, Necati Tatarli, Aytaç Can
Journal: Pan Afr Med J (2015)
Keywords: posterior lumbar interbody fusion cage, antepulsion, interbody cage dislocation, migration of fusion cage
MeSH terms: Foreign-Body Migration / diagnosis, Intraoperative Complications / diagnosis, Spinal Fusion / instrumentation, Case Reports, Female, Humans, Lumbar Vertebrae, Middle Aged, Pseudarthrosis / prevention & control, Spinal Fusion / methods

Spinal fusion surgery techniques develop together with technologic advancements. New complications are seen as the result of new techniques and these may be very severe due to spinal cord and vascular structures in the lumbar region. The posterior lumbar interbody fusion cage (PLIFC) was shown to enhance spinal fusion and to prevent pseudoarthrosis due to its basic dynamic characteristics. PLIFC migrations are usually observed during the postoperative period, just after the mobilization of the patient and usually toward spinal canal. Migration to the retroperitoneal region is a extremely rare condition in the literature. In this article we discussed three cases of PLIFC antepulsion into the retroperitoneal region during the intraoperative period.
Huge trichobezoar presenting as abdominal mass and weight loss: Case report
Authors: Ayad Ahmad Mohammed, Sardar Hassan Arif
Journal: Int J Surg Case Rep (2019)
Keywords: bezoar, trichobezoar, trichophagia, trichotillomania

Introduction:
Trichobezoar is a condition in which hair is accumulated in the stomach forming a ball like mass. Human hair is resistant to digestion and peristalsis therefore over time it accumulates in the gastric folds. Trichophagia and trichotillomania is a psychiatric disorder in which the affected person has the tendency to pull her or his own hair and ingest it. The condition is almost exclusively seen in females.
Case presentation:
A 48-year-old lady presented for the last 6 months with epigastric pain, early satiety and weight loss. There are episodic attacks of vomiting. Abdominal examination showed a large, 30 cm × 15 cm, firm, oval shaped mass occupying the left hypochondrial region and extending below the umbilicus. The mass was mobile from side to side but not from up and down it has smooth surface. The mass was non pulsatile. The CT scan of the abdomen was taken and it showed a large oval mass with interspersed gas. Endoscopy showed a huge ball of hair occupying the whole gastric cavity and extending to the upper part of the duodenum. During laparotomy a huge hair mass extracted from the stomach.
Conclusion:
Trichobezoar is an extremely rare condition that may be encountered during the surgical practice, high index of suspicion is needed to diagnose the condition and endoscopy is still the gold standard method for investigation and diagnosis. The main treatment modality if the open surgery. All patients need psychiatric consultation and long term follow up.
Case Report: Urgent endovascular treatment of subclavian artery injury after blunt trauma
Authors: Taka-Aki Nakada, Koji Idoguchi, Hiroshi Fukuma, Hidefumi Ono, Shota Nakao, Tetsuya Matsuoka
Journal: F1000Res (2014)
Keywords: endovascular treatment, blunt trauma, open clavicle fracture, subclavian artery injury

Subclavian arterial injury is rare and potentially life-threatening, particularly when it leads to arterial occlusion, causing limb ischemia, retrograde thromboembolization and cerebral infarction within hours after injury. Here we report a blunt trauma case with subclavian arterial injury, upper extremity ischemia, and the need for urgent treatment to salvage the limb and prevent cerebral infarction. A 41-year-old man had a left, open, mid-shaft clavicle fracture and left subclavian artery injury accompanied by a weak pulse in the left radial artery, decreased blood pressure of the left arm compared to the right, and left hand numbness. Urgent debridement and irrigation of the open clavicle fracture was followed by angiography for the subclavian artery injury. The left distal subclavian artery had a segmental dissection with a thrombus. Urgent endovascular treatment using a self-expanding nitinol stent successfully restored the blood flow and blood pressure to the left upper extremity. Endovascular treatment is a viable option for cases of subclavian artery injury where there is a risk of extremity ischemia and cerebral infarction.
Synchronized extracorporeal shockwave lithotripsy may still affect the heart: a case report of perioperative ST-segment elevation myocardial infarction
Authors: Yi Hong Li, Chao Yu Hsu, Chih Tsung Liu, Yi Sheng Lin, Yen Chuan Ou, Min Che Tung
Journal: Front Med (Lausanne) (2023)
Keywords: stemi (myocardial infarction), case report, complication, shockwave lithotripsy, urolithiasis (urinary stones)
MeSH terms: Case Reports

Extracorporeal shockwave lithotripsy (ESWL) is widely used as a primary treatment for urolithiasis and is performed as an elective outpatient surgical procedure because of its ease of use. However, patients undergoing this treatment rarely develop cardiac complications. In this article, we present the case of a 45-year-old male patient who presented with ST-elevation myocardial infarction during ESWL. Moreover, atypical symptoms and electrocardiogram patterns were recognized by the nursing staff. Early primary evaluation and intervention resulted in favorable outcomes along with patent coronary artery flow following stent placement for stenosis, and no complications were noted.
Concurrent Myotonic Dystrophy and Inflammatory Myopathy in a Patient with HIV/AIDS
Authors: Akash Gupta, Anita Huttner, Marwan M Azar
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Neuromuscular complications are common in patients with HIV/AIDS at any stage of the disease process. Myopathies can be secondary to antiretroviral therapy, HIV myositis itself, or other etiologies. Here, we present the case of a middle-aged male with HIV who presented with myalgias and was diagnosed with myotonic dystrophy and HIV-associated polymyositis after extensive workup including clinical history and physical exam, laboratory markers, electromyogram, and muscle biopsy. This case illustrates the importance of a comprehensive workup for myopathy in HIV/AIDS and the possibility of multiple concurrent conditions.
Is Asphyxiating Thoracic Dystrophy (Jeune's Syndrome) Deadly and Should We Insist on Treating It? Reconstructive Surgery "On Demand"
Authors: Rosen Stanchev Drebov, Atanas Katsarov, Emiliyan Gagov, Nia Atanasova, Zlatin Penev, Alexander Iliev
Journal: Surg J (N Y) (2017)
Keywords: jeune's syndrome, asphyxiating thoracic dystrophy, mandible locking plate, thoracic insufficiency syndrome
MeSH terms: Case Reports

Our aim is to present the treatment of one of the skeletal manifestations of Jeune's syndrome (JS), the hypoplastic chest, which can result in thoracic insufficiency syndrome and present "on-demand" stage surgical technique using mandible locking plate system for the fixation of ribs. The diagnosis "Jeune's syndrome" was presented clinically in a 3-month-old girl from a family in which the first child died of JS at the age of 18 months. After close follow-up for several months and preoperative planning, we decided to make reconstructive chest operation with atypical use of a double-angled mandible locking plate for fixation. The plate was shaped as a "crown" to ensure the three dimension stability, from the dorsal part of the most curved ribs (paravertebrally) to the sternum after the resection of this area. Operation was done at the period of worsened breathing. For nearly 1 year, the rib cage preserved its stability and the child was in good condition. During the next 3 months, the upper part of the deformation started to grow inward fast. Second operation was "on demand," and the implants used were mandible locking plates curved anterolaterally to effectuate extension of the rib cage and the sternum. In both the reconstructive operations, we spared the rectus and pectoral muscles and achieved good enlargement of the thoracic volume. The postoperative period is smooth and the child is active, without complications. We believe that in the future, the treatment should be "on demand" according to the course of the illness and the results of the follow-up examinations and adequate to the progress of chest wall deformity.
Dedifferentiated Leiomyosarcoma of the Auricle with Heterologous Osteosarcoma Component: Case Report and Literature Review
Authors: Andrea Dekanić, Nives Jonjić, Anita Savić Vuković
Journal: Case Rep Otolaryngol (2022)
MeSH terms: Case Reports

Leiomyosarcomas are rare malignant tumors of smooth muscles. Head and neck involvement by this disease is very rare, and cutaneous leiomoysarcomas of the ear are even rarer. This is way clinically they are usually mistaken for either squamous or basal cell carcinomas, as was the case in an 85-year-old male patient presented in this report. However, the final diagnosis was even more interesting considering that it was a dedifferentiated leiomyosarcoma of the auricle with a heterologous component of osteosarcoma. The auricular cutaneous malignancies have a much higher rate of recurrence than the corresponding malignancy in other regions of the head and neck, even when resected with negative surgical margins, and dedifferentiated leiomyosarcoma is clinically even more aggressive. Thus, the treatment of choice is a total auriculectomy and great attention should be paid to appropriate margins.
Cutaneous Vasculitis and Digital Ischaemia Caused by Heterozygous Gain-of-Function Mutation in C3
Authors: Ebun Omoyinmi, Iman Mohamoud, Kimberly Gilmour, Paul A Brogan, Despina Eleftheriou
Journal: Front Immunol (2018)
Keywords: autoinflammation, complement component (c3, c4), cutaneous vasculitis, digital ischaemia, gain-of-function (gof), next-generating sequencing, targeted gene capture
MeSH terms: Complement C3 / genetics, Gain of Function Mutation / genetics, Ischemia / genetics, Skin Diseases / genetics, Vasculitis / genetics, Case Reports, Research Support, Non-U.S. Gov't, Child, Complement C4 / genetics, Female, Heterozygote, Humans, Male, Complement C3, Complement C4

It is now increasingly recognized that some monogenic autoinflammatory diseases and immunodeficiencies cause vasculitis, although genetic causes of vasculitis are extremely rare. We describe a child of non-consanguineous parents who presented with cutaneous vasculitis, digital ischaemia and hypocomplementaemia. A heterozygous p.R1042G gain-of-function mutation (GOF) in the complement component C3 gene was identified as the cause, resulting in secondary C3 consumption and complete absence of alternative complement pathway activity, decreased classical complement activity, and low levels of serum C3 with normal C4 levels. The same heterozygous mutation and immunological defects were also identified in another symptomatic sibling and his father. C3 deficiency due GOF C3 mutations is thus now added to the growing list of monogenic causes of vasculitis and should always be considered in vasculitis patients found to have persistently low levels of C3 with normal C4.