OpenMed/multicare-articles huggingface dataset:
Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by Vertebrobasilar Compression: A Report of Four Cases
Authors: Yoshimasa Mori, Yasuhiro Matsushita, Kazuyuki Koyama, Atsuo Masago
Journal: Cureus (2024)
Keywords: basilar artery, stereotactic radiosurgery, trigeminal nerve, trigeminal neuralgia, vertebral artery
MeSH terms: Case Reports

Background:
Microvascular decompression (MVD) of the trigeminal nerve is an effective procedure for treating patients with trigeminal neuralgia (TGN). However, vertebrobasilar decompression involves technical difficulties and demonstrates a higher risk of minor trigeminal hypesthesia/hypalgesia, transient diplopia, and hearing loss. Stereotactic radiosurgery (SRS) has been an effective alternative treatment for TGN. Few studies reported the treatment results of SRS for TGN caused by vertebrobasilar compression. This report presents the treatment results of SRS using gamma knife (GK) in four TGN cases.
Materials and methods:
GK-SRS was performed for TGN due to vertebrobasilar compression in four patients, including two males and two females, aged 67-90 years. The maximum dose of 80 Gy was delivered at the retrogasserian portion (RGP) of the ipsilateral trigeminal nerve root.
Results:
All four cases with TGN achieved relief in four to 10 months after GK-SRS. However, TGN recurred 41 months after GK-SRS in one of the four cases. A second GK-SRS at the root entry zone (REZ) at a maximum dose of 70 Gy relieved pain again 10 days later. TGN in another case among the four partially recurred in three years but did not deteriorate until the patient died from old age 62 months after GK-SRS. The other three cases, including the one with repeat GK-SRS, were alive with complete TGN remission at the end of follow-up of 20-52 months. GK-SRS-related adverse effects were not observed in any case.
Conclusions:
GK-SRS was a safe and effective treatment in all four TGN cases due to vertebral artery (VA)-basilar artery (BA) compression, although a second treatment session was added again for pain recurrence in one of the four cases.
An Unusual Cause of Longstanding Diarrhea
Authors: Isairis Peralta, Elizabeth Hubbard, Laurentia Nodit
Journal: Cureus (2024)
Keywords: chronic diarrhea, colchicine poisoning, colchicine toxicity, ring mitoses, weight loss
MeSH terms: Case Reports

Colchicine is an alkaloid drug used in multiple medical conditions. It has a narrow therapeutic index, and gastrointestinal symptoms can occur at the beginning or after long-term therapy. Unintentional toxicity is common and has a high mortality rate when missed. Histopathologic recognition is challenging, and timely identification is conducted to improve patients' outcomes. We describe the case of a 77-year-old female who presented to the emergency room for dehydration, longstanding diarrhea, and weight loss. Upper and lower endoscopies showed erythematous mucosa without bleeding in the gastric antrum and an unremarkable duodenum and colon. Duodenal biopsies demonstrated partial villous atrophy with elongated glands and numerous arrested ring mitoses, consistent with colchicine toxicity.
Case report: Staged tension-reducing excision of giant acquired vulvar lymphangioma secondary to cervical cancer surgery
Authors: Ling-Juan Hu, Hao-Ming Fang, Huan-Mei Lin, Xu Kang, Ying Lin, Jing Xiao
Journal: Front Oncol (2024)
Keywords: case report, cervical cancer, staged excision, surgery, vulvar lymphangioma
MeSH terms: Case Reports

Introduction:
Acquired vulvar lymphangioma (AVL), a rare disease caused by the dilation of superficial lymphatic vessels secondary to deep lymphatic vessel injury, is characterized by a wide range of morphological diversity and massive exudate. This morphological heterogeneity has often led to misdiagnosis or non-diagnosis. The management of AVL presents a therapeutic challenge due to the absence of a standardized treatment protocol.
Case presentation:
A 53-year-old female patient, previously received surgical treatments for stage IIb cervical squamous cell carcinoma, presented with vulvar enlargement and copious amount of yellow exudate seven years post-treatment. Clinically, the patient exhibited chronic vulvar swelling, with easily-exudated nodules. The vulvar biopsy revealed lymphatic vessel dilation with lymphocyte infiltration, consistent with AVL. Due to the extensive lesions and severe exudate, staged excisions of bilateral vulvar lesions were performed at one-month intervals. Follow-up examinations of this patient for one-year post-surgery showed no evidence of recurrence.
Conclusion:
In this instance, AVL manifest secondary to cervical cancer surgery, as a result of damage to the deep lymphatic vessels of the vulva, with characteristic symptoms of copious amounts of exudate and vulvar lesions with diverse morphologies, which provides a cautionary note for physicians. Besides, the staged resection strategy in this case may offer insights into surgical treatment protocol for extensive AVL.
Expectant treatment for angular pregnancy after assisted reproduction technology: a safe and patient-friendly treatment strategy
Authors: Peiwen Yang, Lin Shen, Jihui Ai, Yiqing Zhao
Journal: Front Med (Lausanne) (2023)
Keywords: angular pregnancy, assisted reproductive technology, expectant treatment, live birth, term birth

Introduction:
Currently, the treatment strategies for angular pregnancy in the first trimester after assisted reproduction technology (ART) are unclear. Improper treatment will cause unnecessary losses to patients, especially infertile patients, after ART. The purpose of this study was to clarify the pregnancy outcomes of expectant treatment for angular pregnancy post-ART and to provide a basis for the formulation of clinical treatment strategies.
Method:
This retrospective case series study was performed at the Reproductive Medicine Center of a university hospital. Maternal data and pregnancy outcomes were collected and analyzed for all patients diagnosed with angular pregnancies after ART between January 2016 and August 2021. The outcomes included live birth, term birth, premature birth, early pregnancy loss, fetal death, placental abruption, uterine rupture, maternal death, and hysterectomy.
Results:
A total of 78 patients were analyzed in this study, of whom 54 (69.2%) had live births, 44 (56.4%) had term births, 21 (26.9%) had an early pregnancy loss, 1 (1.3%) had mid-trimester missed abortion, 1 (1.3%) underwent mid-trimester labor induction due to fetal malformation, and 1 (1.3%) underwent uterine rupture. There were no cases of maternal death, placental abruption, or hysterectomies.
Discussion:
Angular pregnancy after ART is not as dangerous as that described in previous studies; most cases could be treated expectantly under close-interval follow-up and obtain live birth.
"Complete Venous Shutdown:" A Rare Case of Combined Superior Vena Cava (SVC) and Inferior Vena Cava (IVC) Occlusion
Authors: M Kasim Malik, Wajahat Humayun, Amir Darki
Journal: Case Rep Vasc Med (2023)
MeSH terms: Case Reports

Independently, superior vena cava (SVC) occlusion and inferior vena cava (IVC) occlusion are usually seen in the setting of SVC syndrome and iliocaval venous obstruction (ICVO), respectively. Concomitant occlusion of the SVC and IVC is rare and most commonly seen in the setting of malignancy or other hypercoagulable states. Venous hypertension can lead to the formation of "downhill" varices in the esophagus and can be a rare source of gastrointestinal bleeding. We present a rare case of combined SVC and IVC occlusion and its management.
Edema of the Scrotum and Penile Shaft: An Uncommon Initial Presentation of Acquired Angioedema With Low C1-Inhibitor
Authors: Meghan V Matheny, Timothy Craig, Joseph Y Clark
Journal: Case Rep Urol (2024)
Keywords: acquired angioedema, acquired angioedema with low c1-inhibitor, angioedema, penile angioedema, scrotum angioedema
MeSH terms: Case Reports

Acquired angioedema with low C1-inhibitor (AAE-C1-INH) is a rare disorder characterized by an acquired deficiency in the C1 esterase inhibitor (C1-INH). This case report describes a 79-year-old patient presenting to the emergency department for painless swelling of his scrotum, penile shaft, and left lower and upper extremities with lab values consistent with acquired angioedema without identifiable lymphoreticular or rheumatic disorder on history, exam, or total body PET scan. Proper diagnosis of AAE-C1-INH is essential to prevent life-threatening airway compromise, ensure proper therapy, and exclude lymphoreticular disorders as the etiology of AAE-C1-INH.
IgG4-related disease with massive pericardial effusion diagnosed clinically using FDG-PETCT: a case report
Authors: Qiaofeng Wei, Huili Qi, Hongmei Wei, Xiuhua Wang, Hongju Zhang
Journal: Front Immunol (2023)
Keywords: fdg-petct, igg4-related disease, pericardial effusion, prognosis, treatment
MeSH terms: Immunoglobulin G4-Related Disease / diagnostic imaging, Pericardial Effusion / diagnostic imaging, Case Reports, Aged, 80 and over, Female, Fluorodeoxyglucose F18, Humans, Immunoglobulin G, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18, Immunoglobulin G

Background:
IgG4-related disease (IgG4-RD) is a systemic inflammatory disease which involves various organs such as the pancreas, lacrimal gland, salivary gland, retroperitoneum, and so on. These organs can be affected concomitantly. 18-Fluorodeoxyglucose positron emission tomography computed tomography (FDG-PETCT) is a systemic examination which can identify active inflammation and detect multiple organ involvement simultaneously. Pericardial involvement is rare in IgG4-RD, early detection and treatment can greatly improve the prognosis of patients.
Case summary:
We reported a 82-year-old female patient referred to our department complaining of chest tightness and abdominal fullness for 8 months and massive pericardial effusion for 2 months. A large amount of pericardial effusion was found during the hospitalization of Gastroenterology. Then she was transferred to cardiology. Although infectious, tuberculous, and neoplastic pericardial effusions were excluded, there was still no diagnosis. The patients were examined by FDG-PETCT which considered IgG4-RD. After coming to our department, the results of the patient's laboratory tests showed that immunoglobulin subgroup IgG4 was 14.0 g/L. Then we performed a biopsy of the right submandibular gland. Pathological morphology and immunohistochemistry suggested IgG4-RD. Combined with level of IgG4, clinical, pathological and immunohistochemical results, we determined the final diagnosis of IgG4 related diseases. Then we gave glucocorticoid and immunosuppressant treatment. At the end, pericardial effusion was completely absorbed. As prednisone acetate was gradually reduced, no recurrence of the disease has been observed.
Conclusion:
Pericardial effusion can be the initial presentation in IgG4-RD. For patients with massive pericardial effusion of unknown cause, early detection of IgG4 is recommended, and PETCT may be helpful for obtaining the diagnosis.
The imaging dynamic changes in the malignant transformation of an epidermoid cyst: a case report and literature review
Authors: Tian Yang, Jibo Hu, Lele Li, Houyun Xu, Caijuan Zhang, Zhilan Huang, Jun Yang, Huiqing Zhang
Journal: Front Neurol (2024)
Keywords: epidermoid cysts, follow-up, malignant transformation, pre-pontine cistern, squamous cell carcinoma
MeSH terms: Case Reports

Malignant transformation of epidermoid cysts is a rare complication. Most of the previously reported cases have involved postoperative malignant transformations. We present a case of malignant transformation of a nonpostoperative epidermoid tumor into squamous cell carcinoma (SCC) that occurred in a 61-year-old Chinese woman. The patient's initial cranial MRI scan showed an epidermoid cyst with marginal enhancement in the pre-pontine cistern, and the lesion gradually enlarged after 10 months. A craniotomy was performed using to remove part of the tumor via the right retrosigmoid approach, and postoperative pathology confirmed that the transformation of the epidermoid cyst was malignant. Our case study suggests that the possibility of malignant transformation of epidermoid cyst should not be ignored on the basis of enhanced imaging features, regardless of whether they are nodular, annular, or patchy, as is the case for inflammation. Strict follow-up is required for early detection of malignant transformation to prompt correspondingly early clinical treatment.
EBV-Positive Pleomorphic Variant Transformation of CD5-Negative Mantle Cell Lymphoma: A Rare Case Report and Literature Review
Authors: Amy Song, Julie Y Li, Samuel G Cockey, Richard Shao, Hailing Zhang
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Mantle cell lymphoma (MCL) is a mature B-cell lymphoma associated with cyclin D family rearrangements and typically expresses CD5 and cyclin D1. Epstein-Barr virus- (EBV-) positive MCL is rare, and the role of EBV infection and its transformation in MCL remains unclear. We present a case of CD5-negative classic MCL that progressed to an EBV + pleomorphic MCL six years after the initial diagnosis. Molecular studies confirmed the same clonal origin. To the best of our knowledge, the EBV-positive transformation of CD5-negative MCL into a pleomorphic variant has rarely been reported, and its recognition is important for the diagnosis and the management of patients with MCL.
Case Report: A rare treatable metabolic syndrome (Brown-Vialetto-Van Laere syndrome) masquerading as chronic inflammatory demyelinating polyneuropathy from Saudi Arabia
Authors: Amal Y Kentab, Yara Alsalloum, Mai Labani, Abrar Hudairi, Muddathir H Hamad, Dima Z Jamjoom, Ali H Alwadei, Reem M Alhammad, Fahad A Bashiri
Journal: Front Pediatr (2024)
Keywords: brown-vialetto-van laere syndrome, mri, chronic inflammatory demyelinating polyneuropathy, pontobulbar palsy, riboflavin transporter deficiency
MeSH terms: Case Reports

Background:
Brown-Vialetto-Van Laere (BVVL) syndrome is an extremely rare autosomal recessive progressive motoneuron disease that is caused by a defect in the riboflavin transporter genes SLC52A2 and SLC52A3. BVVL syndrome has a variable age of presentation, and it is characterized by progressive auditory neuropathy, bulbar palsy, stridor, muscle weakness, and respiratory compromise secondary to diaphragmatic and vocal cord paralysis. BVVL syndrome has a poor prognosis in the absence of treatment, including morbidity with quadriparesis and sensorineural hearing loss, with mortality in the younger age group. Early administration of riboflavin is associated with prolonged survival, low morbidity, and reversal of some clinical manifestations.
Case presentation:
We describe an 18-month-old male infant with progressive pontobulbar palsy, loss of developmental milestones, and a clinical picture suggestive of chronic inflammatory demyelinating neuropathy. A nerve conduction study revealed axonal neuropathy, while molecular analysis revealed a homozygous mutation in one of the riboflavin transporter genes, SLC52A3, confirming BVVL syndrome. The patient needed long-term respiratory support and a gastrostomy tube to support feeding. With high-dose riboflavin supplementation, he experienced moderate recovery of motor function.
Conclusion:
This report highlights the importance of considering BVVL syndrome in any patient who presents with the clinical phenotype of pontobulbar palsy and peripheral axonal neuropathy, as early riboflavin treatment may improve or halt disease progression, thus reducing the associated mortality and morbidity.
A Rare Tick Tale: A Novel Case of the Australian Paralysis Tick Causing Multiple Cranial Neuropathies
Authors: Sujan A Surendran, Philomena McNamara, Jonathan N Hyer, Charles S Su
Journal: Case Rep Ophthalmol Med (2024)
Keywords: australian paralysis tick, ixodes holocyclus, cranial neuropathies, orbital apex syndrome, tick bite
MeSH terms: Case Reports

The Australian paralysis tick (Ixodes holocyclus) is found along the east coast of Australia. Tick bites may result in paralysis ranging from muscular weakness to ascending paralysis requiring respiratory support. Ocular complications and facial nerve involvement are rare. We present a rare occurrence of tick-bite-associated visual loss, proptosis, and multiple cranial neuropathies not previously reported in the literature. The tick was removed, and the patient's symptoms improved following treatment with steroids and oral doxycycline. The vision and sensory changes are not explained by the Ixodes toxin; thus, we hypothesize this is related to orbital apex inflammation.
Subacute infective endocarditis due to Lodderomyces elongisporus: a case report and review of the literature
Authors: Ye Qiu, Yongying Shi, Ying Mai, Zhile Wu, Jing Guan, Juanni Huang, Danhong Su, Feng Ye, Zhengtu Li
Journal: Front Public Health (2023)
Keywords: lodderomyces elongisporus, central nervous system infection, fungemia, infective endocarditis, invasive fungal disease
MeSH terms: Endocarditis / diagnosis, Endocarditis / drug therapy, Endocarditis / microbiology, Saccharomycetales / genetics, Review, Case Reports, Research Support, Non-U.S. Gov't, Antifungal Agents / therapeutic use, Female, Humans, Middle Aged, Antifungal Agents, Lodderomyces elongisporus

Lodderomyces elongisporus, a rare emerging pathogen, can cause fungemia often related to immunosuppression or intravenous devices. Herein, we report the case of a 58-year-old woman with subacute infective endocarditis due to Lodderomyces elongisporus identified by blood fungal culture and whole-genome sequencing, who was treated with antifungals, mitral replacement and endocardial vegetation removal surgery.
Unnecessary orchiectomy due to atypical sarcoidosis manifesting as a unilateral scrotal mass: a case report and literature review
Authors: Valeria Skopelidou, Pavel Hurník, Vladimir Židlík, Lubomír Tulinský, Jiří Lenz, Tomáš Balner, Dušan Žiak, Patricie Delongová, Rudolf Karas, Miroslava Škripková, Matěj Jendřejek
Journal: Front Immunol (2023)
Keywords: case report, extrapulmonary sarcoidosis, genitourinary sarcoidosis, orchiectomy, sarcoidosis, testicular sarcoidosis
MeSH terms: Sarcoidosis / diagnosis, Sarcoidosis / pathology, Sarcoidosis / surgery, Testicular Neoplasms / diagnosis, Review, Case Reports, Research Support, Non-U.S. Gov't, Adult, Biopsy, Humans, Male, Orchiectomy

Sarcoidosis is a disease characterised primarily by lung tissue involvement. Extrapulmonary involvement, particularly in the genitourinary tract, is extremely rare, particularly when it comes to primary disease detection in this location. The gold standard in establishing a definitive diagnosis of sarcoidosis is a combination of the clinical picture, the results of imaging methods, and histopathological examination from the biopsy taken (thus ruling out other causes of granulomatous inflammation). However, it is common for the biopsy to be infeasible or for the patient to refuse such an examination, resulting in the neglect of this critical verification. We introduce the case of a young 29-year-old man of Czech nationality who had been complaining for some time about non-specific pain above the pubic bone and in the lower abdomen, which was combined with a painless enlargement of the right half of the scrotum. Due to suspected malignancy, it was, after considering clinical, imaging, and laboratory findings, decided to perform a radical orchiectomy as a treatment option. The histological examination revealed that it was not cancer, but rather a rare genitourinary form of extrapulmonary sarcoidosis. In this case, radical resection had been, therefore, unnecessary. We also present a review of the literature on published extrapulmonary, genitourinary, and testicular sarcoidosis cases. All the above demonstrates the importance of considering a possible atypical sarcoidosis manifestation and histological confirmation before pursuing radical solutions.
Bilateral Virchow nodes: an unusual finding of pulmonary small-cell neuroendocrine carcinoma metastasis
Authors: Matthew J Zdilla, Alexander R Gross, Tara Hajarat, Jeffrey A Vos
Journal: Autops Case Rep (2023)
Keywords: anatomy, carcinoma, lymph nodes, neoplasm metastasis, neoplasms
MeSH terms: Case Reports

An enlarged left-sided supraclavicular node is a signal node for cancer metastasis. In such a case, the enlarged lymph node is often referred to as a Virchow node. The left-sided nature of the node is due to the drainage of the thoracic duct. So, the enlargement of a Virchow node is typically associated with malignancies, including gastrointestinal, pulmonary, and genitourinary carcinomas, in addition to lymphomas. This report documents a particularly unusual finding: bilateral Virchow nodes, representing metastasis of small-cell neuroendocrine carcinoma.
Case Report: I feel like a mother to other babies: experiences and perspectives on bereavement and breastmilk donation from Vietnam
Authors: Hoang Thi Tran, Tuan Thanh Nguyen, Oanh Thi Xuan Nguyen, Roger Mathisen, Tanya M Cassidy
Journal: Front Glob Womens Health (2023)
Keywords: anthropology, bereavement, breastfeeding, child health and nutrition, human milk, human milk banking, neonatal mortality, vulnerable babies
MeSH terms: Case Reports

There is a growing recognition globally that care regarding lactation following a perinatal death needs to potentially offer the opportunity for maternal donation. This article discusses this experience and perspectives from a human milk bank (HMB) in Vietnam. This is a descriptive exploratory case study that has a long tradition in both the social and health sciences. Triangulated data collection involved a review of video data, interview data with the donor, and data review for the Da Nang HMB, a Center for Excellence in Breastfeeding. We found that although it is common for mothers in Vietnam to donate breastmilk to HMBs, it is less common for this to occur following perinatal loss. We offer a descriptive case study of the maternal loss of twins and a subsequent choice to donate for approximately 1 month to the Da Nang HMB, the first HMB in Vietnam. We discuss four reasons derived from this case regarding donation following perinatal loss. (1) A strong motivation to donate breastmilk when aware of the service, (2) donating breastmilk helped her deal with grief, (3) family members supported her through this tough time and supported her decision, and (4) health staff supported her decision. While human milk sharing (e.g., wet nursing) has been practiced in Vietnam, breastmilk donation from bereaved mothers has neither been discussed nor well-researched. Because maternal grief is complex and individual, deciding to donate breastmilk is a personal decision that needs to be supported, without creating guilt for those who do not wish to donate.
A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult
Authors: Awad Al Harbi, Jameelah Saeedi, Enas Almowalad, Razan Alahmari, Hana A Alzuabi, Leenah Almanea, AlAnoud AlAbdulhadi
Journal: Cureus (2024)
Keywords: high icp, immunocompetent, meningitis, varicella-zoster virus, vzv, vzv meningitis
MeSH terms: Case Reports

Varicella-zoster virus (VZV) is an alphaherpesvirus causing varicella (chickenpox) and herpes zoster. While varicella typically presents with a vesicular rash, latent VZV may reactivate within the sensory ganglia causing shingles, characterized by painful vesicular rash, which may lead to neurologic complications such as aseptic meningitis. This case explores an atypical presentation in an immunocompetent young man with VZV meningitis lacking the characteristic skin rash but featuring elevated intracranial pressure. A literature review revealed rare instances of VZV-related neurologic disease without typical skin manifestations, suggesting the virus's potential to affect the central nervous system directly. Treatment with intravenous acyclovir is recommended, with ganciclovir as an alternative treatment option. This case emphasizes the importance of considering VZV meningitis in the differential diagnosis of patients presenting with viral meningitis symptoms, with or without dermatomal rash or immunocompromised conditions.