OpenMed/multicare-articles huggingface dataset:
A Prosthetic and Surgical Approach for Full-Arch Rehabilitation in Atrophic Maxilla Previously Affected by Peri-Implantitis
Authors: Angélica Letícia Reis Pavanelli, Erica Dorigatti de Avila, Luiz Antônio Borelli Barros-Filho, Francisco de Assis Mollo Junior, Joni Augusto Cirelli, Luiz Antônio Borelli Barros, Rafael Scaf de Molon
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Rehabilitation of atrophic maxilla with dental implants is still a challenge in clinical practice especially in cases of alveolar bone resorption due to peri-implantitis and pneumatization of the maxillary sinuses. Several surgical approaches have been employed to reconstruct the lost tissues allowing the proper tridimensional position of the implants. In this context, the aim of this case report is to describe a surgical and prosthetic approach to fully rehabilitate the atrophic maxilla with dental implants. The patient presented with unsatisfactory functional and esthetical implant-supported prosthesis with some of the implants already lost by peri-implantitis. The remaining three implants were also affected by peri-implantitis. Reversal prosthetic planning was performed, and a provisional prosthesis was fabricated and anchored in two short implants. Sinus floor augmentation procedure and onlay bone graft were then accomplished. After a healing period of 8 months, digital-guided surgery approach was performed to place the implants. Finally, a definitive prosthesis was installed. One-year follow-up has revealed stabilization of the bone tissue level, successful osseointegration, and a pleasant esthetic and functional result. A proper diagnosis and careful planning play an important role to enhance precision and to achieve patient esthetic and functional outcomes.
Variations in burn perfusion over time as measured by portable ICG fluorescence: A case series
Authors: Sharmila Dissanaike, Senan Abdul-Hamed, John A Griswold
Journal: Burns Trauma (2014)
Keywords: burn depth assessment, spy, indocyanine green
MeSH terms: Case Reports

The early determination of healing potential in indeterminate thickness burns may be difficult to establish by visual inspection alone, even for experienced burn practitioners. This case series explores the use of indocyanine green (ICG) fluorescence using portable bedside assessment as a potential tool for early determination of burn depth. Three subjects with indeterminate thickness burns had daily perfusion assessment using ICG fluorescence assessment using the SPY machine (SPY®, Lifecell Corp., NJ, USA) in addition to standard burn care. The fluorescence was quantified as a percentage of the perfusion of intact skin, and areas of hypo- and hyper-perfusion were indicated. The study was concluded when the burn surgeon, blinded to the ICG results, made a clinical determination of the need for skin grafting or discharge. The perfusion in areas of differing depth of burn were compared over the entire study period to determine both the magnitude of difference, and the point in the time course of healing when these changes became evident. Significant differences in perfusion were noted between burned areas of varying depth. These differences were evident as early as the first post-burn day, and persisted till the completion of the study. ICG fluorescence represents a potential adjunct in burn assessment in this first longitudinal study of its use; however much more systematic research will be required to judge the feasibility of clinical implementation.
Fatal Disseminated Kaposi's Sarcoma due to Immune Reconstitution Inflammatory Syndrome following HAART Initiation
Authors: Fatuma Catherine Atieno Odongo
Journal: Case Rep Infect Dis (2013)

This is a case report of disseminated Kaposi's sarcoma in the context of immune reconstitution inflammatory syndrome in an HIV-infected patient on HAART regimen for 2 months. The patient rapidly progressed to death in 5 days after worsening pulmonary infiltrates and multiple organ failure.
A colonic splenic flexure tumour presenting as an empyema thoracis: a case report
Authors: K Murphy, M Chaudry, Hp Redmond
Journal: J Med Case Rep (2009)

Introduction:
The case report describes the rare presentation of a 79-year-old patient with a locally perforated splenic flexure tumour of the colon presenting with an apparent empyema thoracis in the absence of abdominal signs or symptoms.
Case presentation:
Initial presentation was with a non-productive cough, anorexia and general malaise. An admission chest X-ray and subsequent computed tomographic image of the thorax showed a loculated pleural effusion consistent with an empyema. The computed tomography also showed a thickened splenic flexure. Thoracotomy was performed and a defect in the diaphragm was revealed after the abscess had been evacuated. A laparotomy was carried out at which point a tumour of the splenic flexure of the colon was found to be invading the spleen and locally perforated with subsequent collection in communication with the thorax. The tumour and spleen were resected and a transverse end colostomy was fashioned.
Conclusion:
One must consider the diagnosis of pathology inferior to the diaphragm when an apparent empyema thoracis is encountered even in the absence of clinical signs or symptoms.
Diagnosis of an occult gastric adenocarcinoma by oral manifestations (acanthosis nigricans): A case report
Authors: Pegah Mosannen Mozafari, Roham Salek, Ava Taghizadeh, Mohammad Javad Yazdanpanah, Hooman Mosannen Mozaffari, Elham Esmaeili
Journal: Caspian J Intern Med (2021)
Keywords: myxosarcoma, transthoracic echocardiogram (tte)
MeSH terms: Case Reports

Background:
Acanthosis nigricans (AN) is a condition with an important characteristics of symmetrical areas of thickened skin with grayish brown hyperpigmentation. The mucosa may show a papillomatous surface, with or without hyperpigmentation. Lips and sites at risk of trauma may be affected and palmoplantar keratosis might also be present. In some rare cases, acanthosis nigricans presents as a sign of internal neoplasia, mostly a gastrointestinal cancer, and is called malignant acanthosis nigricans (MAN).
Case presentation:
In this study, a 55-year-old female Iranian patient with malignant acanthosis nigricans (MAN) is reported. She was seeking esthetic treatment for her oral and perioral regions. The peculiarity of this case is simultaneous skin manifestation consistent with MAN, "tripe palms" (TP) and Leser-Trélat (LT) sign and mucosal changes in the oral cavity such as papillomatosis and roughened surfaces of the lips, hard palate and buccal mucosa. These changes harbored gastric adenocarcinoma stage T3 N3, but the patient was asymptomatic except for pruritis.
Conclusion:
There is an urgent need to suspect a correlation between oral and skin changes and the possibility of an internal neoplasia, therefore it is of utmost importance to refer these patients for early diagnosis of the underlying disease. This would improve the prognosis and lessen the consequences to a great extent.
Infliximab for idiopathic deep cutaneous vasculitis refractory to cyclophosphamide
Authors: Marcelo Derbli Schafranski, Giuliano Doretto Campanari
Journal: Int J Vasc Med (2010)
MeSH terms: Case Reports

Cutaneous vasculitis can be classified as primary or idiopathic; or secondary, when it presents as a manifestation of connective tissue diseases, infections, drug reactions or malignancies. Although most of the idiopathic cases are self-limited and responsive to supportive measures and nonsteroidal anti-inflammatory drugs, potent immunosuppressants are sometimes required for the management of the refractory situations. Here we describe a case of a 32-year-old Caucasian female patient with history of idiopathic cutaneous deep vasculitis unresponsive to methotrexate, dapsone, and cyclophosphamide who was effectively treated with infliximab.
Case Report: Viral Pneumonia Could Prompt the Advancement of Immune-Mediated Liver Disease
Authors: Qian Li, Jun Wang, Xueshi Zhou, Hongzhou Lu, Mengji Lu, Lihua Huang
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars-cov-2, autoimmune hepatitis, influenza a, liver cirrhosis
MeSH terms: Case Reports

Background: The impact of the influenza A (H1N1) and SARS-CoV-2 virus on the development of autoimmune hepatitis has not been described previously. Methods: In this case series, we evaluated the dynamic changes in liver function of three patients with autoimmune hepatitis who presented with viral infection (two with the H1N1 and one with the SARS-CoV-2 virus) during the recent COVID-19 outbreak. Result: Patient 1 was a 68-year-old woman with a history of hepatitis of unknown origin before being infected with the H1N1 virus. Autoimmune hepatitis with an exacerbation of liver injury was diagnosed during the infection. Patient 2 was a 48-year-old woman with pre-existing autoimmune hepatitis. Despite being on immunosuppressant therapy (using glucocorticoids), liver injury recurred with elevated total bilirubin and gamma-glutamyl transferase levels post H1N1 infection. Patient 3 was a 61-year-old woman with probable autoimmune hepatitis. Liver injury recurred with a flare in alanine transaminase/aspartate transaminase levels post SARS-CoV-2 infection, in spite of the patient being on liver protection therapy (using ursodeoxycholic acid). Conclusion: The case series raises the possibility that COVID-19 or influenza induced pneumonia triggers the progression of autoimmune hepatitis.
Adenomatoid odontogenic tumour associated with dentigerous cyst--unusual case report
Authors: Cassiano Francisco Weege Nonaka, Lélia Batista de Souza, Lêda Bezerra Quinderé
Journal: Braz J Otorhinolaryngol (2007)
MeSH terms: Dentigerous Cyst / pathology, Maxillary Neoplasms / pathology, Odontogenic Tumors / pathology, Case Reports, Adolescent, Biopsy, Dentigerous Cyst / surgery, Female, Humans, Maxillary Neoplasms / surgery, Odontogenic Tumors / surgery, Radiography, Panoramic

The adenomatoid odontogenic tumor is a relatively uncommon lesion which mainly affects females in their second decade of life, exhibiting predilection for the anterior region of the maxilla. The lesion is usually associated with the crown of an enclosed tooth, most commonly the maxillary canine. In this paper we present a case of adenomatoid odontogenic tumor associated with a dentigerous cyst affecting the left maxillary region in a 13-year-old female. The authors also discuss clinical, radiographic, histopathologic and therapeutic features of the case.
Candida krusei Empyema Thoracis: A Community-Acquired Infection Requiring a High Index of Suspicion
Authors: Hazim Bukamur, Waseem Ahmed, Yazan Numan, Ibrahim Shahoub, Fuad Zeid
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is Candida spp. This article presents a 74-year-old female with Candida krusei pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia. She was initially suspected to have community-acquired pneumonia and was started on azithromycin and ceftriaxone. Worsening respiratory function led to the diagnosis of hydropneumothorax. Pleural fluid and an independent sample of pus and pleural tissue grew Candida krusei, giving the diagnosis of fungal empyema. With further respiratory deterioration, the patient was intubated and switched to piperacillin/tazobactam and micafungin. Decortication with extensive pleural peel and removal of foul-smelling pus and food particles within the chest was performed. This further lead to confirmation of esophageal perforation, and she was started on voriconazole and meropenem. After developing septic shock, the patient was managed with phenylephrine and vasopressin. Finally, after improving she was weaned off pressors and extubated, followed by an esophagogastroduodenoscopy (EDG) with pneumatic balloon dilation and WallFlex stent placement. This patient's case demonstrated an example of empyema thoracis, which required a high index of suspicion since the presentation was with a community-acquired infection. Candida empyema thoracis may be a complication of operation, gastroesophageal fistula, and spontaneous esophageal rupture. On the other hand, the course of this patient's hospital stay progressed from esophageal perforation to Candida krusei pneumonia, empyema, and pneumothorax. Thus, community-acquired fungal empyema should be considered in patients with respiratory symptoms and suspected esophageal perforation; nevertheless, after a diagnosis of fungal empyema, esophageal perforation should also be ruled out in addition to other causes like pneumonia, subphrenic abscess, and hematogenous spread. Improved communication between clinicians and microbiologists can lead to early diagnosis and a reduction in the morbidity and mortality of this condition.
Combined Bile Duct and Pancreatic Duct Injuries during Distal Gastrectomy for Obstructing Peptic Ulcer Disease
Authors: Narendra Pandit, Kunal Bikram Deo
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

A combination of bile and pancreatic duct injuries is very rare. Anomalous ductal anatomy, distorting duodenal fibrosis, and pancreatic atrophy predispose to this untoward complication during performance of distal gastrectomy for benign peptic stricture. The technical challenges posed by this complication and experience gained by managing it are shared.
Case Report: Tumor Microenvironment Characteristics in a Patient With HER2 Mutant Lung Squamous Cell Carcinoma Harboring High PD-L1 Expression Who Presented Hyperprogressive Disease
Authors: Lixia Xia, Yinghui Yu, Fen Lan, Junrong Yan, Jinfan Li, Wen Li, Yang Xia
Journal: Front Oncol (2021)
Keywords: her2, pd-1 inhibitor, hyperprogressive disease, macrophage, non-small cell lung cancer
MeSH terms: Case Reports

Background:
High PD-L1 expression in non-small cell lung cancer (NSCLC) is evident to predict elevated immunotherapy efficacy, to which NSCLC with onco-driver gene mutations is probed with poor responsiveness. Thus, it is of great interest to investigate how effective immune monotherapy is in the presence of concurrent high PD-L1 expression and driving gene mutation.
Patients and methods:
We present a case of squamous lung cancer with high PD-L1 expression and HER2 exon 20 insertion (20Ins) who presented hyperprogressive disease (HPD) after being treated with PD-1 inhibitor.
Results:
A 71-year-old female was diagnosed with advanced squamous lung cancer with 98% tumor proportion score of PD-1 and 20ins. She benefited from first-line docetaxel cisplatin followed by 2 months second-line afatinib. Third-line pembrolizumab monotherapy was then given. Unfortunately, she rapidly progressed with dramatically enlarged primary site as well as mediastinal lymph nodes and pleural effusion only 2 weeks later, presenting severe dyspnea and dysphagia. Re-biopsy was conducted, and we found that compared with the baseline, CD8+ T cells were largely recruited only in tumor stroma but not in tumor parenchyma. Tumor-associated macrophages were notably increased in both tumor stroma and parenchyma. Concomitantly, CD56dim NK cells in tumor parenchyma were decreased.
Conclusions:
Application of immune monotherapy in patients with positive driver genes demands extreme caution, even harboring high PD-L1 expression. Abnormality of tumor microenvironment might be critically involved in immune checkpoint inhibitor-induced HPD. Further study in greater depth is required.
Synchronous Hodgkin lymphoma and gastric adenocarcinoma: A rare case report and literature review
Authors: Hongying Wu, Liyan Wei, Lumei Hao, Xuemei Li, Lei Wang, Chenglu Yuan
Journal: Medicine (Baltimore) (2018)
MeSH terms: Adenocarcinoma / diagnosis, Adenocarcinoma / therapy, Hodgkin Disease / diagnosis, Hodgkin Disease / therapy, Neoplasms, Multiple Primary / diagnosis, Neoplasms, Multiple Primary / therapy, Stomach Neoplasms / diagnosis, Stomach Neoplasms / therapy, Case Reports, Review, Humans, Male, Middle Aged

Hodgkin lymphoma (HL) is a lymphoproliferative disease arising in the lymphoid tissue, which is characterized by Reed-Sternberg cells. Adenocarcinoma is the most frequent pathological type of stomach cancer. Improved survival in HL patients leads to the development of secondary malignancies. However, synchronous occurrence of these 2 malignancies is extremely rare. Here, we present a 45-year-old male complaining of a lymph node mass in the neck, without any abdominal symptoms, diagnosed as HL and gastric adenocarcinoma with hepatitis B carrier status. We treated the patient with 8 courses of pirarubicin bleomycin, vincristine, and dacarbazine (modified ABVD), and 4 courses of capecitabine therapy concurrently along with oral entecavir, as the patient survived longer than 20 months.The prognosis of multiple primary malignancies is poor because therapy is difficult, without a standard treatment. The frequency of multiple primary malignancies is increasing in recent years, and second malignancies in patients with cancer should be taken into consideration.
Adult granulosa cell tumour of the ovary incidentally discovered during caesarean section in a pregnant patient after IVF: a rare case and a review of the literature
Authors: Kong Chi Pham, Phuong Thi Minh Ta, Nhat Minh Huynh
Journal: Ecancermedicalscience (2023)
Keywords: foetal outcome, granulosa cell tumour, in vitro fertilisation, maternal outcome, pregnancy
MeSH terms: Case Reports

Adult granulosa cell tumours (AGCTs) of the ovary are very rare during pregnancy. To date, only five cases of ovarian AGCT in pregnancy have been reported in the literature and the patients all conceived spontaneously. We report a case of AGCT of the ovary that was incidentally discovered during a caesarean section in a patient undergoing In vitro fertilisation (IVF). To the authors' knowledge, this is the first case of AGCT incidentally discovered during caesarean section in a pregnant patient after IVF. A 44-year-old primigravida with 39 weeks gestation was admitted to our hospital due to premature rupture of membranes in May 2019. She was treated by in vitro fertilisation due to being an elderly mother and she was pregnant after the first cycle. She was indicated for caesarean section due to conceiving following in vitro fertilisation and being an elderly mother. She gave birth to a 3,000 g baby boy and his Apgar scores were 8/1'-9/5'. When examining the adnexa, the left ovary had a tumour with a size of 7 × 4 × 4 cm. Left oophorectomy was performed and specimen sent to for histopathology. The histopathological diagnosis was an AGCT of the ovary. A month later, the patient received chemotherapy with Carboplatin and Paclitaxel for four cycles. After 32 months of follow-up, no recurrence was detected. In conclusion, AGCTs of the ovary are very rare during pregnancy. Pre-operative diagnosis is difficult. Conservative surgery should be considered in women who wish to have children. Patients should receive adequate counselling and long-term follow-up to ensure the highest survival rates and early detection of recurrence.
Extracranial Meningioma in the Scalp with Concurrent Steatocystoma
Authors: Jiankun Tong, Sergei A Aksenov, Mitchell I Chorost, William H Rodgers
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

This report documents a rare case of an extracranial meningioma on the posterior scalp without apparent dural connection. Additionally, a sebaceous steatocystoma of the anterior scalp presented alongside the meningioma. A steatocystoma localized to the scalp is also remarkably rare. To our knowledge, this is the first report documenting both an extracranial meningioma and a steatocystoma presenting concurrently on the scalp. A male patient in his thirties presented with a mass lesion on the scalp. A CT scan revealed one posterior scalp mass with no intracranial abnormalities. Post excision histologic examination confirmed an extracranial meningioma (meningothelial variant, WHO Grade I). A second anterior scalp mass, not revealed by CT scan, was discovered during surgery. It was excised and diagnosed as a steatocystoma. Meningiomas predominantly occur intracranially but, in some instances, may present as a standalone extracranial tumor without intracranial abnormalities. Because extracranial meningioma is uncommon, it may be overlooked during clinical diagnosis of scalp masses. We recommend that this neoplasm be routinely considered in the differential diagnosis of extracranial tumors. The discovery of another rare tumor-a steatocystoma located in immediate proximity on the scalp-is further remarkable. We briefly review relevant case reports and etiologies and consider a potential relationship between the two neoplasms. However, it remains more likely that the concurrence of these tumors in our patient was simply coincidental.
Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C
Authors: Inês Coutinho, Diana Silva, Mafalda Mota, Maria Lisboa, Fernando Trancoso Vaz, Isabel Prieto
Journal: GMS Ophthalmol Cases (2017)
Keywords: glaucoma, hypotony maculopathy, scleral flap, trabeculectomy
MeSH terms: Case Reports

Aim: To present a challenging case of hypotony after trabeculectomy and its treatment. Case description: A 22-year-old woman with juvenile glaucoma underwent a conventional trabeculectomy with mitomycin C on the right eye (OD). In the immediate postoperative period, we observed a hyperfiltration bleb with hypotony refractory to conservative measures leading to hypotony maculopathy. A surgical revision with scleral flap resuture and conjunctival graft was performed with a satisfactory result and resolution of hypotony maculopathy. After two years, the patient complained of low visual acuity (VA) of the OD. During examination, we observed a fine and avascular bleb with Seidel and visualization of the underlying uveal tissue, an intraocular pressure (IOP) of 5 mmHg, and chorioretinal folds. A new revision of the trabeculectomy was performed. During the procedure, it was not possible to identify the scleral flap, so the fistula was closed with a patch of collagenous membrane derived from bovine pericardium (Tutopatch® graft). A good clinical evolution occurred. After 2 months, IOP was 15 mmHg without Seidel or changes in the fundus and VA was 20/20. After 8 months of follow-up, the IOP remains stable without further complaints. Conclusion: This case illustrates the difficulties faced in the management of a common complication of trabeculectomy and highlights some of the options available for its treatment. There are few reports of scleral melting after trabeculectomy. However, trauma and scleral necrosis associated with mitomycin are listed as the main causes. The use of a scleral patch derived from bovine pericardium allows effective suturing and closure of the aqueous leak.