OpenMed/multicare-articles huggingface dataset:
Case report: Cardiac arrest during carotid body tumor resection indicating carotid sinus hypersensitivity
Authors: Hong Yong Duan, Qiang Guan, Yu Jie Guo, Ning Liang
Journal: Front Cardiovasc Med (2022)
Keywords: carotid body tumors, carotid sinus hypersensitivity, intraoperative cardiac arrest, surgical complications, tumor resection
MeSH terms: Case Reports

Background:
Carotid body tumor surgery is associated with various complications. However, intraoperative cardiac arrest is very rare and no more than 10 cases have been reported.
Case description:
A 58-year-old woman diagnosed with bilateral carotid body tumors underwent right carotid body tumor surgery. Sudden cardiac arrest occurred during the resection and was attributed to carotid sinus hypersensitivity. The patient recovered after prompt treatment and the tumor was removed completely with no complications.
Conclusion:
Cardiac arrest attributed to carotid sinus hypersensitivity during carotid body tumor resection is very rare. Proper treatments can reverse intraoperative cardiac arrest. If carotid sinus hypersensitivity is detected preoperatively, prophylactic temporary pacemaker implantation may be appropriate.
Delayed identification and diagnosis of Huntington's disease due to psychiatric symptoms
Authors: Alina Mihaela Pascu, Petru Ifteni, Andreea Teodorescu, Victoria Burtea, Christoph U Correll
Journal: Int J Ment Health Syst (2015)

Huntington's disease (HD) is a progressive neurodegenerative illness that affects 2-9/100.000 of the general population. The usual onset is at around age 35-40 years, but there were cases with onset above 55 years. The disease manifests clinically with many neurological and psychiatric symptoms, leading in advanced phases to dementia, but cognitive symptoms are frequently present much earlier in the disease course. HD is caused by an expanded polyglutamine stretch in the N-terminal part of a 350 kDa protein called huntingtin (HTT). This stretch is encoded by a trinucleotide CAG repetition in exon 1 of HTT. An expansion of greater than 36 repeats results in HD. The number of repeats is inversely correlated with the age of onset of motor symptoms, and disease onset during childhood or adolescence is associated with more than 60 CAG repeats. Mood disturbances may be one of the earliest symptoms of HD and may precede the onset of the motor pheno-type for almost 10 years. Neuropsychiatric symptoms may delay the appropriate diagnosis of HD and have major implications for disease management, prognosis and quality of life for patients and families. This case study is about a 58 years old female patient with late identification of Huntington's disease after two admissions to psychiatric inpatient units, for the treatment of behavioral disturbances.
Acute profound sensorineural hearing loss as the initial manifestation of Hairy Cell Leukemia, Case Report and literature review
Authors: Abdulaziz AlEnazi, Riyadh Alhedaithy, Abdulrhman Alfayez, Yazeed Alghonaim
Journal: Int J Surg Case Rep (2019)
Keywords: case report, hairy cell leukemia, hematologic diseases, sudden hearing loss

Introduction:
Hematologic diseases are rarely present with sudden hearing loss as an initial symptom. Although the precise cause of sudden sensorineural hearing loss has not been identified, several pathophysiological mechanisms have been proposed. However, a variety of hematologic diseases are among the causes of sudden onset deafness. This article represents the first reported case of Hairy cell leukemia (HCL) which presented with acute unilateral profound sensorineural hearing loss as an inital mainfestation.
Presentation of case:
A 41-year-old man presented with unilateral sudden hearing loss for one day's duration was found to have HCL during a worked up for his hearing loss. The disease worsened, and there was no improvement in his hearing.
Discussion:
Sudden sensorineural hearing loss can rarely be seen as a paraneoplastic occurrence.Very few cases have been reported in the literature. It has been reported as a presenting symptom of leukemia in numerous clinical and histopathological reports concerning the hearing loss in hematologic diseases. Our case is an example of such a rare incidence.
Conclusion:
The purpose of this study is to draw physicians' attention to the possible association between acute sensorineural hearing loss to HCL, and to highlights permanent deafness as a complication secondary to HCL. Furthermore, it is important to increase awareness on early diagnosis and treatment that may improve treatment outcomes.
Hypohidrotic Ectodermal Dysplasia: Prosthetic and Endodontic Management
Authors: Deshraj Jain, Sandhya Jain, Alok Kumar, Tripty Rahangdale
Journal: Int J Clin Pediatr Dent (2010)
Keywords: ectodermal dysplasia, anodontia, complete dentures, overdentures
MeSH terms: Case Reports

Individuals affected by ectodermal dysplasia syndromes have abnormalities of the glands, tooth buds, hair follicles, and nail development. Oral finding in ectodermal dysplasia patient are significant and can include multiple abnormalities of the dentition such as anodontia, hy-podontia or malformed and widely spaced peg like teeth, loss of occlusal vertical dimension, protuberant lips and lack of normal alveolar ridge development. This clinical report describes a combined surgical, pedodontic, and prosthodontic approach for the treatment of a patient with hypohidrotic ectodermal dysplasia.
Case Report: Recurrent meningioma with multiple metastases
Authors: Juyue Zhou, Zhonghai Du
Journal: Front Oncol (2023)
Keywords: aggressiveness, case report, extracranial metastasis, meningioma, recurrence
MeSH terms: Case Reports

Post-surgery recurrence of meningiomas with multiple extracranial metastases is rare. Currently, information on extracranial metastases is limited, and no clear predictors and standardized treatment protocols can be applied clinically. Herein, we report a case of meningioma that recurred after two surgeries and had multiple distant metastases. Computed tomography revealed multiple enlarged lymph nodes in the para-aortic arch, left lower lung region, retroperitoneum, and abdominopelvic region, as well as soft tissue mass-like lesions under the liver capsule in the right lobe of the liver. Magnetic resonance imaging showed space-occupying lesions under the cranial plate of the left parietal lobe. Tissue biopsy confirmed the diagnosis of recurrent meningioma with extracranial metastases. Immune checkpoint inhibitors and anti-angiogenic drugs were administered. After two treatment cycles, the patient's clinical symptoms were significantly relieved, and the imaging assessment confirmed a stable disease. Although it did not meet our expectations, this combination therapy still demonstrated a possible benefit in improving meningioma patients' survival and quality of life. In this report, along with the case, we also review the relevant literature on the subject and discuss the associated risk factors and treatment options.
Immune Checkpoint Inhibitor Induced Diabetes Mellitus Treated with Insulin and Metformin: Evolution of Diabetes Management in the Era of Immunotherapy
Authors: Taha Alrifai, Faisal Shaukat Ali, Sameer Saleem, Diana Carolina Miranda Ruiz, Dana Rifai, Sundas Younas, Faisal Qureshi
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICPIs) are a breakthrough therapy in oncology and have been approved by the Food and Drug Administration for the treatment of several malignancies. ICPIs have been reported to cause immune-mediated damage of islet cells leading to ICPI-induced type 1 diabetes mellitus (T1DM). These reports described patients presenting with severe diabetic ketoacidosis (DKA). We present a case of a 69-year-old Caucasian male with type 2 diabetes suffering from non-small cell lung cancer and undergoing treatment with pembrolizumab, an anti-programmed cell death protein-1 antibody, who presented to our emergency department with complaints of nausea, vomiting, polyuria, and polydipsia. He was found to have high anion gap metabolic acidosis with ketosis and elevated blood glucose levels consistent with DKA. Lab workup was consistent with T1DM. Despite being on a tailored insulin regimen, his blood glucose remained elevated, necessitating the addition of metformin to his regimen which effectively controlled his blood glucose.
Conversion of a surgical elbow arthrodesis to total elbow arthroplasty
Authors: Dominik Rog, Lee M Zuckerman, Barth Riedel
Journal: Case Rep Orthop (2015)

Arthrodesis of the elbow joint addresses pain due to intra-articular pathology, but with significant functional limitations. Loss of motion at the elbow is not completely compensated by the wrist and shoulder joints and elbow fusion is thus purely a salvage procedure. Advances in joint arthroplasty have allowed surgeons to address the functional limitations of arthrodesis, but despite these advances the elbow is still one of the joint replacements with higher complication rate. Conversion of a joint fusion to arthroplasty has been reported for the hip, knee, shoulder, and ankle. The takedown of a surgically fused elbow was reported in German literature in 2013. We present the first such case report in the English literature with a 49-year-old male whose status is elbow fusion performed for trauma 31 years prior.
Utilization of Iodinated SpaceOAR Vue™ During Robotic Prostate Stereotactic Body Radiation Therapy (SBRT) to Identify the Rectal-Prostate Interface and Spare the Rectum: A Case Report
Authors: Dylan Conroy, Kelly Becht, Matthew Forsthoefel, Abigail N Pepin, Siyuan Lei, Abdul Rashid, Brian Timothy Collins, Jonathan W Lischalk, Simeng Suy, Nima Aghdam, Ryan Andrew Hankins, Sean P Collins
Journal: Front Oncol (2021)
Keywords: spaceoar vue, magnetic resonance imaging, prostate cancer, stereotactic body radiation therapy, urethrogram
MeSH terms: Case Reports

We describe the utilization of SpaceOAR Vue™, a new iodinated rectal spacer, during Robotic Stereotactic Body Radiation Therapy (SBRT) for a Prostate Cancer Patient with a contraindication to Magnetic Resonance Imaging. A 69-year-old Caucasian male presented with unfavorable intermediate risk prostate cancer and elected to undergo SBRT. His medical history was significant for atrial fibrillation on Rivaroxaban with a pacemaker. He was felt to be at increased risk of radiation proctitis following SBRT due to the inability to accurately contour the anterior rectal wall at the prostate apex without a treatment planning MRI and an increased risk of late rectal bleeding due to prescribed anticoagulants. In this case report, we discuss the technical aspects of appropriate placement and treatment planning for utilizing SpaceOAR Vue™ with Robotic SBRT.
Structural scoliosis secondary to thoracic osteoid osteoma: a case report of delayed diagnosis
Authors: Mohamed Zairi, Mohamed Nabil Nessib
Journal: Spine Deform (2023)
Keywords: adolescent, delayed diagnosis, osteoid steoma, scoliosis
MeSH terms: Osteoma, Osteoid / complications, Osteoma, Osteoid / diagnostic imaging, Osteoma, Osteoid / surgery, Scoliosis / diagnostic imaging, Scoliosis / etiology, Scoliosis / surgery, Spinal Neoplasms / complications, Spinal Neoplasms / diagnostic imaging, Spinal Neoplasms / surgery, Case Reports, Adolescent, Back Pain / etiology, Delayed Diagnosis, Humans, Male

Purpose:
The aim of this case report is to show that late diagnosis of vertebral osteoid osteoma gives rise to structural scoliosis which sometimes requires long-term management.
Methods:
We report a case of an osteoid osteoma in the thoracic spine associated with structural scoliosis. We describe a 14-year-old boy who complained chronic nightly left back pain and scoliosis. Spine's X-ray was reported thoraco-lumber scoliosis without bone lesion.
Results:
MRI as well as technetium-99 m total body bone scan and a computed tomography scan revealed a bony lesion in the upper left joint of T11 vertebra consistent with the diagnosis of OO. Anatomopathological study of the resection piece confirmed the diagnosis of OO. Surgical excision of the tumor resolved pains, but scoliosis needed an orthopedic treatment for 1 year.
Conclusion:
Through this case, it has been demonstrated that late diagnosed vertebral OO can be the cause of structural scoliosis. Clinical and radiological results indicate that OO resection is an effective and safe method of treatment.
Levels of evidence:
IV.
Combined superior mesenteric artery syndrome and nutcraker syndrome presenting as acute pancreatitis: a case report
Authors: Bárbara Neto Castro, Ana Rita Ferreira, Susana Graça, Manuel Oliveira
Journal: J Vasc Bras (2023)
Keywords: acute pancreatitis, nutcracker syndrome, rare diseases, superior mesenteric artery syndrome
MeSH terms: Case Reports

Superior mesenteric artery syndrome designates compression of the third part of the duodenum between the superior mesenteric artery and the aorta. This condition has a low incidence, being more common in thin young women. Nutcracker syndrome is compression of the left renal vein between the superior mesenteric artery and the aorta. Both entities are rare, and their coexistence has been reported in a few cases. Conservative treatment targeting weight gain is sufficient in most cases. An association between the superior mesenteric artery syndrome and acute pancreatitis has rarely been reported. We intend to describe the case of an 18-year-old girl who was admitted to the emergency room with epigastric pain and emesis. Our investigation revealed acute acalculous pancreatitis. During work-up, we discovered superior mesenteric artery syndrome and a compressed left renal vein. The patient is on conservative treatment, and her symptoms have improved.
Acoustic Neuroma Mimicking Orofacial Pain: A Unique Case Report
Authors: Praveenkumar Ramdurg, Naveen Srinivas, Vijaylaxmi Mendigeri, Surekha R Puranik
Journal: Case Rep Otolaryngol (2016)

Acoustic neuroma (AN), also called vestibular schwannoma, is a tumor composed of Schwann cells that most frequently involve the vestibular division of the VII cranial nerve. The most common symptoms include orofacial pain, facial paralysis, trigeminal neuralgia, tinnitus, hearing loss, and imbalance that result from compression of cranial nerves V-IX. Symptoms of acoustic neuromas can mimic and present as temporomandibular disorder. Therefore, a thorough medical and dental history, radiographic evaluation, and properly conducted diagnostic testing are essential in differentiating odontogenic pain from pain that is nonodontogenic in nature. This article reports a rare case of a young pregnant female patient diagnosed with an acoustic neuroma located in the cerebellopontine angle that was originally treated for musculoskeletal temporomandibular joint disorder.
Leiomyoma of Kidney
Authors: Vishnu Karayil R, Mini Bhaskarashenoy, Geetha Sukumaran
Journal: J Kidney Cancer VHL (2023)
Keywords: kidney, renal leiomyomas, tumors, wedge resection
MeSH terms: Case Reports

Renal leiomyomas are rare benign mesenchymal tumors of kidney that affect adults of second to sixth decade. They can present as small asymptomatic multifocal lesions that are identified only in autopsy, or as large solitary lesions that cause pain and abdominal distention. Histomorphologically it appears exactly like its counterpart in other soft tissues. Differentiating renal leiomyoma from the lipid-poor angiomyolipoma is difficult by morphology, hence immunohistochemical studies are recommended. The case described is that of a female patient aged 74 years with a small solitary lesion in right kidney, who presented with history of pain and abdominal distention. She underwent wedge resection, histopathologically and immunohistochemically diagnosed as renal leiomyoma.
Changes in Frequency and Activation Status of Major CD4+ T-Cell Subsets after Initiation of Immunosuppressive Therapy in a Patient with New Diagnosis Childhood-Onset Systemic Lupus Erythematosus
Authors: Saimun Singla, Scott E Wenderfer, Eyal Muscal, Anna Carmela P Sagcal-Gironella, Jordan S Orange, George Makedonas
Journal: Front Pediatr (2017)
Keywords: pd-1, t effector cells, t regulatory cells, t-cell exhaustion, childhood-onset systemic lupus erythematosus
MeSH terms: Case Reports

Background:
Several studies suggest that defects of regulatory T-cells (Tregs) and impaired cellular immunity are secondary to an imbalance between auto-aggressive T-cells and Tregs in lupus patients. Discrepancies in Tregs and effector T-cells (Teff) in active lupus patients are shown to be restored in patients upon receiving immunosuppressive therapy. Therefore, our main aim was to observe frequencies of these CD4+ T-cell subsets and Tregs/Teff ratio in a new diagnosis of childhood-onset systemic lupus erythematous (cSLE) before and after initiation of therapy. In addition, we monitored T-cell exhaustion status by examining responses to super-antigen staphylococcal enterotoxin B (SEB) and PD-1 expression in this patient.
Methods:
Phenotyping of CD4+ T-cell subsets was carried out under basal conditions and after SEB stimulation using flow cytometry in one inactive (I-cSLE) and one active cSLE (A-cSLE) patient, as well as a healthy control (HC). The A-cSLE patient was a new diagnosis. Variables were measured at three consecutive time points in the active patient, reflecting various stages of disease activity. Activation status of CD4+ T-cells in the A-cSLE patient was compared to that of the I-cSLE patient and HC. Disease activity was measured by calculating the systemic lupus erythematous disease activity index.
Results:
We found that the A-cSLE patient was not Tregs deficient. The patient had increased frequency of Tregs, and the Tregs/Teff ratio increased when the disease activity became less severe. CD4+ T-cells in the I-cSLE patient and in the A-cSLE patient with milder disease activity had heightened responsiveness to SEB, whereas T-cells were relatively hypo-responsive to SEB in the A-cSLE patient when disease activity was higher. The active patient exhibited higher frequencies of PD-1+ expressing Tregs, Teff, and Tnaïve/mem cells under basal conditions compared to the HC and I-cSLE patient.
Conclusion:
In the A-cSLE patient, changes in Tregs/Teff ratio correlated better with clinical improvement compared to Tregs frequencies alone and might reflect the restoration of immune homeostasis with therapy. SEB hypo-responsiveness in the A-cSLE patient when disease activity was higher paralleled with findings of greater frequencies of PD-1+ expressing Tregs, Teff, and Tnaïve/mem cells, suggests a possible global exhaustion status of CD4+ T-cells in this patient.
A Case Report of Steroid-Resistant Cryptogenic Organizing Pneumonia Managed with Intravenous Immunoglobulins
Authors: Christian Akem Dimala, Urvi Patel, Benjamin Lloyd, Anthony Donato, William B Kimmel, Robert Hallowell, Caitlyn Moss
Journal: Case Rep Pulmonol (2021)
MeSH terms: Case Reports

Fewer than ten reported cases of cryptogenic organizing pneumonia (COP) have been managed with intravenous immunoglobulins (IVIg). We report a case of a 72-year-old man who presented with a worsening cough and diffuse opacities on chest radiograph. Following no improvement with antibiotics and negative complementary investigations for infectious, malignant, and autoimmune etiologies, COP was confirmed on lung biopsy. Due to continued clinical deterioration despite high-dose steroids and new severe steroid-induced hallucinations, the patient was placed on intravenous immunoglobulins (IVIg) and mycophenolate mofetil and made a satisfactory recovery. IVIg should be considered as an important steroid-sparing alternative in patients with COP.
Complex composite odontoma with characteristic histology
Authors: Sujatha Govindrajan, J Muruganandhan, Shaik Shamsudeen, Nalin Kumar, M Ramasamy, Srinivasa Prasad
Journal: Case Rep Dent (2013)

Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. These clinically asymptomatic tumors are classified into complex and compound odontomas. They are usually discovered in radiographs and rarely cause bony expansion or infection. This paper discusses a case report of a complex odontoma exhibiting all the structural features and defects of enamel, dentine, and cementum in succession, with an overview on its etiology.
Invasive pulmonary aspergillosis with brain dissemination in an immunocompetent host
Authors: Senthil Kumar, Valliappan Muthu, Yogender Singh Bansal, Nikhil Mehta, Vanshika Arora
Journal: Autops Case Rep (2021)
Keywords: autopsy, invasive pulmonary aspergillosis, microscopy, neuroaspergillosis
MeSH terms: Case Reports

Invasive aspergillosis is an uncommon infection, which is mainly seen among immunocompromised patients. In recent years, cases of aspergillosis involving immunocompetent hosts are increasingly being reported. Herein, we report the case of a 27-year-old man with fever, productive cough, shortness of breath, and left hemiparesis. He had suffered trauma to his head 25 days prior. Imaging of the chest showed bilateral cavitary lesions in the lungs, and neuroimaging revealed a space-occupying lesion in the right frontoparietal cerebrum. He was suspected of having an abscess or metastasis. He died on day 3 of hospitalization, and an autopsy was performed. The autopsy revealed the cause of death to be invasive pulmonary aspergillosis, with brain dissemination. Invasive aspergillosis is uncommon in apparently immunocompetent individuals, and we discuss the autopsy findings in detail.
Primary syphilis without chancre - A case report of rare syphilitic balanitis of Follmann
Authors: Xu-Qi Ren, Qun-Ling Nie, An-Qi Liu
Journal: Front Med (Lausanne) (2022)
Keywords: primary, primary syphilis without chancre, rare, syphilis, syphilitic balanitis
MeSH terms: Case Reports

Introduction:
Syphilitic balanitis of Follmann (SBF) is a rare condition of primary syphilis which is characterized by any kind of balanitis with or without chancre on the penis combined with the presence of swollen inguinal lymph nodes confirmed by the finding of Treponema pallidum in the lesions or by the positive serological syphilitic testing. Timely identification of the SBF is very important in properly treating the disease stopping the spread of syphilis.
Case presentation:
A 42year-old heterosexual male patient came to our clinic and complained of a painless, hard erythema nodule with a whitish scale in his coronal sulcus of the penis for about a week. The dermatologic examination revealed an infiltrative, hard erythematous lesion surrounding the coronal sulcus of the patient's penis, with mild erosion and a small amount of exudation. There was a whitish pseudomembrane-like covering on the surface of the erythematous lesion in the coronal sulcus, which is mimicked as candidal balanitis. The result of the fungus microscopic examination was negative, while the laboratory findings showed positive results in serologic syphilitic testing. The patient was diagnosed with primary syphilis and intramuscularly treated with a dose of benzylpenicillin of 2.4 million units. The patient's skin lesions disappeared completely 60 days after penicillin treatment.
Conclusion:
To our knowledge, this is the first SBF case reported in China. Syphilitic balanitis of Follmann may have variable clinical appearances. We emphasize that when balanitis with risky sexual activities or with sexually transmitted diseases, the diagnosis of SBF should be kept in mind.