OpenMed/multicare-articles huggingface dataset:
Central retinal vein occlusion in a patient with breast carcinoma
Authors: V G Madanagopalan, V Paneer Selvam, N V Sarath Sivan, N V Govindaraju
Journal: GMS Ophthalmol Cases (2019)
Keywords: breast carcinoma, central retinal vein occlusion, microcytic hypochromic anemia
MeSH terms: Case Reports

Purpose: Systemic malignancies may have ocular manifestations in the form of metastatic tumors, carcinoma associated retinopathy or central retinal vein occlusion (CRVO). Although CRVO has been mentioned in association with renal, lung, prostatic and ovarian malignancies, the association of CRVO with breast carcinoma is unreported. We report a patient with one such rare association. Methods: We describe a patient with breast carcinoma who was diagnosed to have CRVO. The history, ocular examination, retinal optical coherence tomography scan, ocular ultrasound scan, hematological profile, mammogram details and aspiration cytology description of the malignant breast lesion are reported in this article. Results: The retina showed extensive hemorrhages and dilated retinal veins. Complete hematologic evaluation revealed the presence of microcytic hypochromic anemia and increased hematocrit. These changes are possibly related to the malignant disease and might contribute to the pathogenesis of CRVO. Coclusion: This case report demonstrates the rare association between breast malignancy and CRVO.
Intestinal Perforation due to Neutropenic Enterocolitis in a Patient Treated with Bevacizumab for Ovarian Cancer
Authors: Akinori Sasaki, Kenichi Harano, Takahiro Kogawa, Nobuaki Matsubara, Yoichi Naito, Ako Hosono, Hirofumi Mukai, Takayuki Yoshino, Toru Mukohara
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Intestinal perforation is a rare adverse event of antineoplastic therapy. However, once it occurs, it is potentially fatal. This report describes a case of intestinal perforation caused by bevacizumab in a patient with ovarian cancer who concurrently developed neutropenic enterocolitis. A 66-year-old woman diagnosed with metastatic ovarian cancer received combination chemotherapy with carboplatin, gemcitabine, and bevacizumab. On day 14, she developed grade 4 pancytopenia and febrile neutropenia, which resulted in neutropenic enterocolitis and intestinal perforation. Emergency surgery was performed, and an intestinal perforation found in the ascending colon was closed. Postoperatively, she developed an intra-abdominal abscess requiring peritoneal drainage. She was discharged from the hospital on recovery.
Management of a severely submerged primary molar: a case report
Authors: Iman Parisay, Fatemeh Kebriaei, Bentolhoda Varkesh, Milad Soruri, Roya Ghafourifard
Journal: Case Rep Dent (2013)

Ankylosis is a condition frequently associated with primary molars, wherein the ankylosed primary teeth remain in a fixed position, while the adjacent teeth continue to erupt, moving occlusally. In this case report, a five-year-old boy, who had a retained and submerged left lower second primary molar, was presented. Luxation of ankylosed primary molar was considered as a treatment approach. After four months, the tooth erupted to the occlusal level, and there was evidence of further development of a permanent successor in radiographic evaluation. After one year, tooth mobility, bone formation, and development of a permanent successor were in good condition.
Unusual B-Lymphoid Blastic Crisis as Initial Presentation of Chronic Myeloid Leukemia Imposes Diagnostic Challenges
Authors: Nouran Momen, Bora Baysal, Sheila Jani Sait, Joseph Tario, You-Wen Qian
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder, characterized by reciprocal translocation t(9,22) (q34; q11), leading to increased myeloid proliferation. Most cases are diagnosed in the chronic phase (CP). However, a minority of cases can be present in the blastic phase (BP). In most patients with CML-BP, the blasts have a myeloid phenotype, however, in 20-30% of cases, the blasts have a lymphoid phenotype, mostly a B-cell phenotype. It is challenging to differentiate CML B-lymphoblastic phase (CML-BLP) from Ph + primary B-acute lymphoblastic leukemia (B-ALL) especially when the CML-BLP is the initial presentation of the disease, which is uncommon. We report here an unusual case of CML-BLP as an initial presentation of the disease without typical CML morphological findings. This case demonstrates diagnostic challenges and emphasizes the importance of an integrated approach using morphology, multiparametric flow cytometry, cytogenetic studies, and molecular studies to render an accurate diagnosis.
Eosinophilic gastrointestinal disorder in coeliac disease: a case report and review
Authors: Dennis N F Lim, Annelise Wilkins, Laura Elizabeth Horton, Ishfaq Ahmad, Catherine Lo Polito, Chris Phillips
Journal: Case Rep Gastrointest Med (2012)

Eosinophilic gastrointestinal disorder is a rare disorder characterised by eosinophilic infiltration of the gastrointestinal tract. There are various gastrointestinal manifestations with eosinophilic ascites being the most unusual and rare presentation. Diagnosis requires high index of suspicion and exclusion of various disorders associated with peripheral eosinophilia. There are no previous case reports to suggest an association between eosinophilic gastrointestinal disorder and coeliac disease in adults. We report a case of eosinophilic ascites and gastroenteritis in a 30-year-old woman with a known history of coeliac disease who responded dramatically to a course of steroids.
Case report: Surgical repair for left main coronary artery to right atrium fistula with endocarditis
Authors: Weimin Zhang, Abdunabi Maimaitiaili, Yan Xing, Fei Yan, Qiang Huo
Journal: Front Cardiovasc Med (2023)
Keywords: computed tomography, coronary artery fistula, echocardiography, heart failure, surgery
MeSH terms: Case Reports

Coronary artery fistula (CAF) is a rare coronary anomaly defined as a communication between coronary artery and other heart chambers or vascular structures. In this case report, a 32-year-old woman with a giant left main coronary artery to the right atrium fistula with endocarditis was presented. CAF was diagnosed by transthoracic echocardiography and subsequently confirmed by cardiac computerized tomographic and coronary angiography. The patient received antibiotic treatment for infective endocarditis for 6 weeks preoperatively. The fistula was successfully treated with surgical repair. The patient is well now after 18 months of follow-up.
Tumor invasion to the spinal region after primary surgery: A case report
Authors: Zahra Davoudi, Arezoo Chouhdari, Guive Sharifi, Nader Akbari Dilmaghani
Journal: Caspian J Intern Med (2021)
Keywords: cushing syndrome, pituitary carcinoma, tumor invasion
MeSH terms: Case Reports

Background:
It is believed that pituitary carcinoma is a rare disorder and arise from the transformation of benign invasive macroadenomas, and the process of this transformation takes place slowly.
Case presentation:
A 51-year-old man presented with the clinical features of Cushing syndrome and walking impairment who was diagnosed with metastatic corticotroph pituitary carcinoma to the spine region, 6 years after the initial resection of a primary invasive pituitary adenoma. He made a visit to neurosurgery and endocrinology clinic with the chief complaint of weight gain, facial and extremities swelling, paresthesia, weakness, motion and speaking impairments, and HTN which all appeared through the last 1 year; hormonal laboratory tests showed urine free cortisol (UFC) 197.8 and 367. 30 ug/24hrs (36-137), cortisol 8 am after 1 mg overnight dexamethasone test 375 ng/mL (50-250) and ACTH 59 pg/mL. MRI study revealed a mass in the brainstem with the compression effect on spinal region, pituitary imagine does not differ from the last MRI. He underwent a neurosurgery for spinal mass resection, which was successful and the total mass was resected. After surgery, the patient's condition became better.
Conclusion:
Pituitary carcinoma is a rare entity impossible to recognize as a primary tumor because its diagnosis by definition requires the presence of metastasis. Clinical awareness of the rare possibility for aggressive adenomas will progress, to metastasize is essential to appropriately monitor patients for possible early detection and treatment of pituitary carcinoma.
Efficacy of new intermittent abdominal pressure ventilator for post-ischemic cervical myelopathy ventilatory insufficiency
Authors: Paolo I Banfi, Eleonora Volpato, John R Bach
Journal: Multidiscip Respir Med (2019)
Keywords: intermittent abdominal pressure ventilator (iapv), non-invasive ventilation (niv), quality of life (qol), tracheostomy mechanical ventilation (tmv)
MeSH terms: Case Reports

Non-invasive ventilation (NIV) is the treatment of choice for patients symptomatic for respiratory muscle dysfunction. It can normalize gas exchange and provide up to continuous non-invasive ventilator support (CNVS) as an alternative to intubation and tracheotomy. It is usually provided via non-invasive facial interfaces or mouthpieces, but these can be uncomfortable and uncosmetic. The intermittent abdominal pressure ventilator (IAPV) has been used for diurnal ventilatory support since 1938 but has been off the market since about 1990. Now, however, with greater emphasis on non-invasive management, a new IAPV is available. A patient with chronic ventilatory insufficiency post-ischemic cervical myelopathy, dependent on sleep NVS since 2003, developed symptomatic daytime hypercapnia for which he also used diurnal NVS via nasal pillows. However, he preferred not having to use facial interfaces. When not using diurnal NVS he was becoming dyspnoeic. Diurnal use of an IAPV was introduced. Arterial blood gas analysis using the IAPV decreased his blood pH from 7.45 to 7.42, PaCO2 from 58 to 37 mmHg, and improved PaO2 from 62 to 92 mmHg. At discharge, the patient used the IAPV 8 h/day with improved mood and quality of life. Consequently, he returned to work as a painter.
Congenital Unilateral Agenesis of the Parotid Gland: A Case Report and Review of the Literature
Authors: Afshin Teymoortash, Stephan Hoch
Journal: Case Rep Dent (2016)

Congenital unilateral agenesis of the parotid gland is a rare condition with only few cases reported in the literature. A review of 21 cases in the available literature is presented in this article. We report on a further case of a 34-year-old woman with agenesis of the left parotid gland and lipoma of the right cheek. Clinicopathological characteristics of described cases in the literature were discussed.
Intracranial Inflammatory Myofibroblastic Tumor: A Review of 49 cases
Authors: Deepika Phogat, S G S Datta, Mukul Bajpai, Swayam Tara, Sunil Kumar Ganti
Journal: Autops Case Rep (2021)
Keywords: granuloma, plasma cell, magnetic resonanceimaging, meningeal neoplasms, meningioma, seizures
MeSH terms: Case Reports

Inflammatory Myofibroblastic Tumor (IMT) is a rare pathologic entity that was first described in 1973. This lesion is most commonly found in the lungs, but other organs' involvement has also been reported. Intracranial location of Inflammatory Myofibroblastic Tumor is rare, and the first case was reported in 1980. An intriguing fact about the intracranial IMT is its resemblance with meningioma on clinical presentation and neuroimaging. We came across a case of intracranial Inflammatory Myofibroblastic Tumor (IIMT) in a 27-year-old male who presented with recurrent episodes of seizures and was diagnosed as meningioma on neuroimaging. The lesion did not subside with medical management and kept on progressing in size. The patient had to undergo surgery, and diagnosis of Inflammatory Myofibroblastic Tumor was ascertained on histopathology. This 'surprise' diagnosis prompted us to review the literature on all cases of IIMTs reported to date to better understand the entity and its implications. In this review article, we present our observations regarding various studied parameters, including patient profile, clinical presentation, site of involvement, focality of the lesion, special associations, and lines of management of the 49 published cases of IIMTs.
Regional Injection of CAR-T Cells for the Treatment of Refractory and Recurrent Diffuse Large B Cell Lymphoma: A Case Report
Authors: Yan-Hui Wei, Yu-Zhuo He, Xiao-Yan Lin, Fu-Xian Ren, Hong-Bin Zhu, Ying Cheng, Zhen Nan, Zheng-Biao Liu, Jing-Ya Yu, Xue-Jun Guo
Journal: Front Cell Dev Biol (2020)
Keywords: case report, chimeric antigen receptor t cells, diffuse large b cell lymphoma, refractory recurrence, regional injection

Background:
Lymphoma is a common hematological malignancy with many subtypes and considerable heterogeneity. Traditional treatments include chemotherapy, radiotherapy, and surgery. Patients with relapsed, refractory or advanced stage lymphoma have a dismal prognosis. In recent years, chimeric antigen receptors (CARs) have been recognized as powerful tools that redirect antigen-specific T cells independent of human lymphocyte antigen (HLA) restriction and specifically kill tumor cells. Satisfactory results with CAR-based treatments have been achieved in relapsed/refractory B cell leukemia/lymphoma. Our center explored the strategy of subcutaneous injections combined with intravenous drip to overcome certain issues.
Case presentation:
A patient with stage IV refractory and relapsed diffuse large B cell lymphoma was treated with regional and intravenous CAR-T cells. During the observation period, the temperature of the skin at the abdominal wall mass was slightly elevated, and tolerable pain in the injection area was reported. Imaging showed regional liquefactive necrosis. After the sequential administration of ibrutinib and venetoclax, the abdominal wall mass significantly decreased in size.
Conclusion:
The regional injection of CAR-T cells might be safe and feasible for the treatment of regional lesions in patients with refractory and relapsed advanced lymphoma.
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Presenting as Chronic Diarrhea; An Unusual Presentation of a Common Lymphoproliferative Disorder
Authors: Smitha Narayana Gowda, Hafez Mohammad Abdullah, Rakshya Sharma, Mohamed A Abdallah
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disorder in the United States. It has a variable presentation with most patients having asymptomatic lymphocytosis. Many other patients present with lymphadenopathy or enlargement of other organs of the reticuloendothelial system. However, CLL can present with extramedullary involvement. Most commonly, this is in the form of skin or central nervous system involvement, though rarely it can present with gastrointestinal involvement. Here, we present the case of a 70-year-old Caucasian male who presented with chronic diarrhea for over 4 months. After failing conservative treatment, a colonoscopy was performed which showed diffuse mucosal nodularities with a biopsy revealing CLL. The patient was treated successfully with chemotherapy and his diarrhea improved. This is a differential to keep in mind in patients with chronic diarrhea, once the more common causes have been ruled out.
Case Report: Metastatic breast cancer to the gallbladder
Authors: Giulia Missori, Francesco Serra, Giorgia Prestigiacomo, Andrea Aurelio Ricciardolo, Lucio Brugioni, Roberta Gelmini
Journal: F1000Res (2020)
Keywords: breast cancer, cholecystitis, emergency surgery
MeSH terms: Breast Neoplasms / pathology, Cholecystitis, Acute / etiology, Cholecystitis, Acute / surgery, Gallbladder Neoplasms / secondary, Gallbladder Neoplasms / surgery, Case Reports, Review, Aged, 80 and over, Breast Neoplasms / therapy, Female, Humans

Cholecystitis is one of the leading causes of emergency surgical interventions; the occurrence of metastases to the gallbladder is rare and has only been reported in the literature exceptionally. Metastatic breast cancer to the gallbladder is even less frequent; in fact, breast cancer usually metastasizes to bone, lung, lymph nodes, liver and brain. We report the case of an 83-year-old female patient with a previous history of breast surgery with axillary dissection in 1997, followed by adjuvant chemotherapy due to invasive ductal carcinoma of the left breast. The patient was admitted at the emergency department for sepsis and an episode of acute kidney failure, anuria and fever. Right-upper quadrant abdominal pain triggered by food intake and abdominal tenderness was also present, placing the diagnostic suspicion of biliary sepsis due to acute cholecystitis. The histological examination of the surgical specimen highlighted the presence of metastasis from an infiltrating ductal breast carcinoma with positive hormone receptors. We also report here the results of a review of the literature looking at articles describing cases of gallbladder metastasis from breast cancer.
Inflammatory Arthritis Induced by Pembrolizumab in a Patient With Head and Neck Squamous Cell Carcinoma
Authors: Nikolaos Spathas, Panagiota Economopoulou, Myrto Cheila, Ioannis Kotsantis, Antonis Fanouriakis, Dimitra Kassara, Amanda Psyrri
Journal: Front Oncol (2018)
Keywords: head and neck cancer, immune checkpoint inhibitors, immune-related adverse events, inflammatory arthritis, pembrolizumab
MeSH terms: Case Reports

Introduction: T cell checkpoint inhibitors targeting Programmed cell Death protein-1 (PD-1) have emerged as novel immunotherapy agents showing remarkable efficacy in head and neck squamous cell carcinoma (HNSCC). Despite important clinical benefits, they are associated with side effects that occur as a consequence of general immunological stimulation due to loss of T cell inhibition. Herein, we report the unusual case of inflammatory arthritis induced by anti-PD-1 agent pembrolizumab. Case report: A 55-years old male was treated with pembrolizumab at a dose of 200 mg every 3 weeks for a metastatic hypopharyngeal carcinoma. Following two cycles of immunotherapy, and while complete response of lung metastases was achieved, the patient presented with stiffness, swelling and pain of the right knee. Clinical examination and synovial fluid analysis revealed a seronegative inflammatory arthritis. Pembrolizumab therapy was interrupted and low-dose prednisone was administered with remarkable clinical improvement. Pembrolizumab was reintroduced, but after the fifth cycle, the patient developed inflammatory polyarthritis involving both knees and interphalangeal joints of both hands resulting in severe clinical deterioration. At that time, treatment with pembrolizumab was permanently discontinued. High-dose prednisone and methotrexate treatment led to remission of clinical symptoms. Conclusion: Pembrolizumab-induced inflammatory arthritis is an unusual rheumatic immune-related adverse event that physicians are likely to encounter as ICI use expands. Multidisciplinary management and rheumatology consultation are necessary to provide immediate treatment and avoid permanent joint damage.
Conization Using an Electrosurgical Knife for Cervical Intraepithelial Neoplasia and Microinvasive Carcinoma
Authors: Libing Xiang, Jiajia Li, Wentao Yang, Xiaoli Xu, Xiaohua Wu, Huaying Wang, Ziting Li, Huijuan Yang
Journal: PLoS One (2015)
MeSH terms: Conization / methods, Electrosurgery / methods, Uterine Cervical Dysplasia / pathology, Uterine Cervical Dysplasia / surgery, Research Support, Non-U.S. Gov't, Adult, Aged, Biopsy, Colposcopy, Conization / adverse effects, Female, Humans, Middle Aged, Neoplasm Invasiveness, Postoperative Complications / etiology, Uterus / pathology, Uterus / surgery, Young Adult

Objective:
The aim of the present study was to evaluate the incidences of margin involvement, disease relapse, and complications in patients who had undergone conization using an electrosurgical knife (EKC) for cervical intraepithelial neoplasia (CIN) or microinvasive carcinomas (micro-CAs).
Materials and methods:
A retrospective case series analysis was performed with a total of 1359 patients who underwent EKC in Fudan University Shanghai Cancer Center between June 2004 and July 2010.
Results:
The median age of the patients was 39 years old (range: 19-72). Conization revealed the presence of CIN in 1113 (81.9%) patients, micro-CA in 72 (5.3%) patients and invasive carcinomas in 44 (3.2%) patients. The remaining 130 (9.6%) patients were free of diseases in the cone specimens. Positive surgical margins, or endocervical curettages (ECCs) were found in 90 (7.6%) patients with CINs or micro-CAs. Three factors were associated with positive margins and ECCs and included age (>50 years; odds ratio (OR), 3.0, P<0.01), postmenopausal status (OR, 3.1, P<0.01) and microinvasive disease (OR, 2.7, P<0.01). One thousand and eighty-nine (92.0%) patients were followed-up regularly for a median follow-up duration of 46 months (range: 24-106 months). Disease relapse was documented in 50 (4.6%) patients. Eighty-two (6.0%) cases experienced surgical complications that needed to be addressed, including early or late hemorrhages, infections, cervical stenosis, etc.
Conclusions:
Our patients demonstrated that EKC was an alternative technique for diagnosis and treatment of CIN or micro-CAs with relatively low rate of recurrence and acceptable rate of complications. A randomized clinical trial is warranted to compare EKC, CKC and LEEP in the management of CIN or micro-CA.
Double-Lung Transplantation in a Patient with Pulmonary Type B Niemann-Pick Disease: A Valid Treatment Option
Authors: Víctor Manuel Cuesta Mora, Joy Selene Chávez Osorio, David Fernández Iturbe, Sandra Mena Tello, Yedra Gómez Guzmán, Laura Moreno Sánchez, José Javier Román Gómez, José Manuel Martínez Cifrián
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Niemann-Pick disease is a rare autosomal recessive disease characterized by an abnormal intracellular lipid accumulation. Type B is later in onset and a less severe form of the disease, so affected people may survive in adulthood. Storage of sphingomyelin in pulmonary macrophages can lead to interstitial lung disease. There are very few published cases of lung transplantation in patients with Niemann-Pick disease, all of them described in the last 2 years. We present here one case of a 57-year-old man successfully treated with a double-lung transplant.
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids, with Cranial and Caudal Extension
Authors: Mahmood Mubasher, Aseel Sukik, Ahmed Hassan El Beltagi, Ali Rahil
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

A 23-year-old lady presented with vertigo and imbalance in walking, blurring of vision, diplopia, and headache, in addition to numbness in the lower limbs over a period of six days. On examination patient had nystagmus, ataxia, positive Romberg test, and hyperreflexia. MRI examination of the brain and spinal cord showed evidence of faint bright signal intensity foci in T2/FLAIR involving bilateral cerebral hemispheres, subcortical deep white matter, bilateral thalami, posterior pons and left brachium pontis, and basal ganglia, with small nodular enhancement that aligned along curvilinear structures; those lesions also were apparent along the spinal cord at multiple levels. The clinical and radiological features suggested CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) syndrome. Symptoms improved dramatically with high dose oral corticosteroids. Our report addresses the radiological and clinical pattern of a case of CLIPPERS rhombencephalitis, with added superior and inferior extension to involve the brain and spinal cord, which is to emphasize the importance of raising the awareness of this disease and the combined role of radiologist and physicians for the diagnosis of this potentially treatable entity, responsive to glucocorticosteroid immunosuppression.