OpenMed/multicare-articles huggingface dataset:
Unruptured anterior Inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: Case report and literature review
Authors: Denghui Lu, Haoda Ping, Chen Wei, Wei Fang, Yunze Zhang, Yingxi Wu, Yafei Xue, Bao Wang, Yan Qu, Tianzhi Zhao
Journal: Front Surg (2023)
Keywords: aneurysm, anterior inferior cerebellar artery, case report, radiotherapy, vestibular schwannoma
MeSH terms: Case Reports

Background:
The clinical features and therapeutic measures of vestibular schwannoma (VS) radiation-related aneurysm (RRA) have not been well described. We reported the first VS RRA case admitted for acute anterior inferior cerebella artery (AICA) ischemic symptoms. Literature was reviewed to present the research fruits about VS RRAs, and some therapeutic advices were given.
Materials and methods:
A 54-year-old woman who had undergone GKS 10 years previously for a right VS was admitted to our hospital in 2018 because of sudden onset of severe vertigo and vomiting, accompanied with unsteady gait. During tumor resection, a dissecting aneurysm arose from the main trunk of AICA was encountered accidently within the tumor. The aneurysm was successfully treated with direct clip ligation, sparing the parent vessel. Data about this case were combined with those of other 11 radiation-related AICA aneurysm cases retrieved from the current literature. The following parameters were evaluated: Age, Sex, Diagnostic method, Location of aneurysm, Age of radiotherapy (Years)/Latency, Rupture, x-ray dosage, Type of radiotherapy, History of surgical resection of VS, Aneurysm Type, Morphology, Number, Treatment, Operative complications, Sequela, Outcome. VS RRAs mainly occurred in women (75%) with a median age of 62.5 years and were mainly located on AICA. Ruptured aneurysms accounted for 75.0% of the total cases. This paper reported the first VS case admitted with acute AICA ischemic symptoms. Cases with sacciform-like, irregular and fusiform-shaped aneurysms accounted for 50.0%, 25.0% and 25.0% of the total, respectively. After surgical treatment, 75.0% patients recovered, except for 3 patients who developed new ischemic consequence.
Conclusion:
Patients should be informed of the risk of RRAs after receiving radiotherapy for VS. In these patients, RRAs should be suspected when subarachnoid hemorrhage or AICA ischemic symptoms occurred. Active intervention should be conducted considering the high instability and bleeding rate of VS RRAs.
Latent Autoimmune Diabetes in an Adult Male Presenting With Diabetic Ketoacidosis (DKA)
Authors: Syed K Imam, Fatima M Hassan, Hossam Mohamed
Journal: Cureus (2023)
Keywords: diabetic ketoacidosis, glutamic acid decarboxylase antibodies, latent autoimmune diabetes in adults, type 1 diabetes, type 2 diabetes
MeSH terms: Case Reports

Latent autoimmune diabetes in adults (LADA) is a common but not well-studied entity and its features overlap between type 1 and type 2 diabetes mellitus (T1D, T2D). Although autoimmunity is a well-known factor associated with this diabetes subtype, environmental factors including excessive weight, physical inactivity, and smoking may also be associated with it. It is commonly misdiagnosed as T2D and generally treated by oral anti-diabetes medications that cause a delay in commencing insulin therapy. There are few cases mentioned in the literature of LADA presenting first time as diabetic ketoacidosis (DKA). Here, we report a case of latent autoimmune diabetes in an adult male who presented with DKA.
Sequential Use of Second-Generation Tyrosine Kinase Inhibitor Treatment and Intensive Chemotherapy Induced Long-Term Complete Molecular Response in Imatinib-Resistant CML Patient Presenting as a Myeloid Blast Crisis
Authors: Masaaki Tsuji, Tatsuki Uchiyama, Chisaki Mizumoto, Tomoharu Takeoka, Kenjiro Tomo, Tatsuharu Ohno
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Myeloid blast crisis of chronic myeloid leukemia (CML-MBC) is rarely seen at presentation and has a poor prognosis. There is no standard therapy for CML-MBC. It is often difficult to distinguish CML-MBC from acute myeloid leukemia expressing the Philadelphia chromosome (Ph+ AML). We present a case in which CML-MBC was seen at the initial presentation in a 75-year-old male. He was treated with conventional AML-directed chemotherapy followed by imatinib mesylate monotherapy, which failed to induce response. However, he achieved long-term complete molecular response after combination therapy involving dasatinib, a second-generation tyrosine kinase inhibitor, and conventional chemotherapy.
Treatment of Severe Hypercapnic Respiratory Failure Caused by SARS-CoV-2 Lung Injury with ECCO2R Using the Hemolung Respiratory Assist System
Authors: Ramiro Saavedra-Romero, Francisco Paz, John M Litell, Julia Weinkauf, Carina C Benson, Lisa Tindell, Kari Williams
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Acute respiratory distress syndrome (ARDS) due to COVID-19 leads to a high rate of mortality in the intensive care unit (ICU). A lung-protective mechanical ventilation strategy using low tidal volumes is a cornerstone to management, but uncontrolled hypercapnia is a life-threatening consequence among severe cases. A mechanism to prevent progressive hypercapnia may offset hemodynamic instability among patients who develop hypercapnia. We present the case of a woman in her mid-60's with severe acute hypercapnic respiratory failure secondary to COVID-19 pneumonia who was successfully treated with early implementation of lung-protective ventilation facilitated by extracorporeal carbon dioxide removal (ECCO2R). This patient's multiple comorbid conditions included obesity, hypertension, type 2 diabetes mellitus, and hypercholesterolemia. On her fifth day of admission at the referring hospital, her worsening hypoxemia prompted endotracheal intubation during which she developed pneumothorax. She was transferred to our institution for advanced care where upon arrival, she had profound hypercapnia and respiratory acidosis. She met the criteria for treatment with an investigational ECCO2R device (Hemolung Respiratory Assist System) available through FDA Emergency Use Authorization. ECCO2R is similar to extracorporeal membrane oxygenation (ECMO) but operates at much lower blood flows (350-550 mL/min) through a smaller 15.5 French central venous catheter. Standard heparinization was provided intravenously to achieve appropriate levels of anticoagulation during ECCO2R therapy. Unlike ECMO, ECCO2R does not provide clinically meaningful oxygenation but is simpler to implement and manage. The use of ECCO2R successfully corrected and controlled the patient's hypercapnia and acidosis and enabled meaningful reductions in ventilator tidal volumes, respiratory rates, and mean airway pressures. The patient was weaned from ECCO2R after 17 days and from mechanical ventilation 10 days later. With low tidal volume ventilation facilitated by expeditious implementation of ECCO2R, the patient survived to discharge despite her many risk factors for a poor outcome and an extended duration of invasive mechanical ventilation.
Acute Heart Failure Exacerbation with Cardiogenic Shock and Elevated Systemic Vascular Resistance Treated with a Combination of Nicardipine and Dobutamine Therapy
Authors: Lydia E Issac, Setri Fugar, Naser Yamani, Burhan Mohamedali
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Acute heart failure is a common reason for hospital admission and is usually caused by decreased cardiac output either as a result of an intrinsic cardiac issue or as a result of severe hypertension with elevated afterload. We present a patient with a history of HFrEF who presented with acute heart failure, found to have hypotension requiring Dobutamine support and an elevated systemic vascular resistance requiring Nicardipine drip, with subsequent recovery of cardiac function.
Secondary syphilis with pleural effusion: case report and literature review
Authors: Abdel-Naser Elzouki, Mustafa Al-Kawaaz, Zaid Tafesh
Journal: Case Rep Infect Dis (2012)

Here we present a case of a 38-year-old Indian man with a history of extramarital relationships who presented with pleurisy, skin rash, and radiological findings of pleural effusion. After thorough investigation of the etiology of his acute illness, he was found to be positive for syphilis. Review of literature revealed a small number of case reports of pleural effusion as a manifestation of secondary syphilis. The review of criteria proposed in the literature was utilized to diagnose this patient as a case of pulmonary syphilis.
Pigtail saves a twisted redo: successful management of chylopericardium after midline valve surgery
Authors: Aayush Goyal, Rohit Shahapurkar, Balaji Aironi, Ninad Kotkar, Ankur Goel
Journal: J Cardiovasc Thorac Res (2018)
Keywords: chylomediastinum,, chylopericardium, complication valve replacement
MeSH terms: Case Reports

Pericardial effusion after midline cardiac surgery may be transudative or exudative. The exudative infective or haemorrhagic variety requires early surgical intervention. However there are rare cases of collections like chylomediastinum which should be ruled out. Their low incidence prompts to establish protocol for evaluating postoperative pericardial collections, which includes echocardiography and biochemical analysis of aspirate. The same is important from the perspective of management as chylopericardium may be successfully managed without surgical intervention by aspiration, pig tail insertion, dietary and medical management, which we demonstrate through our rare case which occurred after midline double valve replacement.
A Rare Case of Supinator Intramuscular Myxoma with Encasement of the Posterior Interosseous Nerve
Authors: Chiao Yee Lim, Suryasmi Duski, Ping Ching Chye
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Intramuscular myxomas are rare, benign mesenchymal tumors. Tumor location in the forearm is very rare among all the intramuscular myxomas. To the best of our knowledge, there were two cases of supinator intramuscular myxoma reported in the literature, and we intend to report the third case of supinator myxoma with encasement of the posterior interosseous nerve (PIN). A 67-year-old lady presented with history of left proximal forearm swelling for the past 5 years. Magnetic resonance imaging showed a lobulated multiseptated lesion seen within left supinator muscle, which was hyperintense on T2-weighted images (T2WI) and hypointense on T1-weighted images (T1WI), with peripheral enhancement post contrast. The tissue diagnosis of myxoma was confirmed via an open biopsy. She underwent en bloc resection of the tumor. The PIN was encased by the tumor; it was preserved and carefully released from the tumor. The nerve sheath served as an excision margin. In conclusion, we present a rare case of an intramuscular myxoma in the supinator muscle. In view of the location, extra attention should be paid during excision surgery to locate the PIN and to avoid damaging the surrounding structures.
Rare Leiomyoma of the Tunica Dartos: A Case Report with Clinical Relevance for Malignant Transformation and HLRCC
Authors: Robert C Bell, Evan T Austin, Stacy J Arnold, Frank C Lin, Jonathan R Walker, Brandon T Larsen
Journal: Case Rep Pathol (2016)

Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up. Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion. Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up.
Unilateral lymphangiomatous polyp of the palatine tonsil in a very young child: a clinicopathologic case report
Authors: Edward Park, Seth M Pransky, Denise M Malicki, Paul Hong
Journal: Case Rep Pediatr (2011)
MeSH terms: Case Reports

Childhood lymphangiomatous polyp of the palatine tonsil is a very unusual lesion found in the head and neck. Tonsillectomy has been reported to be the curative procedure of choice for this lesion. We report a case of a very young child with unilateral lymphangiomatous polyp of the palatine tonsil.
Giant vesical lithiasis, complication of enterocystoplasty: case report
Authors: Robert Nang, Hadiya Hinchi, Taoulouth Lafia, Mohamed Rami, Rachid Belkacem
Journal: Pan Afr Med J (2018)
Keywords: enterocystoplasty, giant lithiasis, one port trocar
MeSH terms: Lithiasis / etiology, Urinary Bladder Calculi / diagnosis, Urologic Surgical Procedures / adverse effects, Case Reports, Anastomosis, Surgical / methods, Female, Humans, Intestinal Mucosa / metabolism, Intestines / surgery, Lithiasis / pathology, Urinary Bladder / pathology, Urinary Bladder / surgery, Urinary Bladder Calculi / etiology, Urologic Surgical Procedures / methods, Young Adult

Frequent and recurrent pathology, bladder stone is a constant complication in enterocystoplasty enlargement. The occurrence of this lithiasis is due to some factors such as urinary tract infections, mucus secretion by the intestine segment moved, poor urinary emptying and foreign bodies (sutures, staples) intra-vesical. Clinical signs are not specific. However the formation of giant lithiases remains exceptional. Some cases have been documented in the literature. The occurrence of this affection must be prevented by dietary measures and regular follow up. New therapies for the control of mucus in the bladder tank have been emerged. Open surgical remains the most common. Today, One port trocar endoscopy enables to handle and extracted lithiases of every size.
Reconstruction for labial adhesion in postmenopausal woman using vulvoperineal flap
Authors: Marika Takimoto, Tomoya Sato, Shigeru Ichioka
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: labial adhesion, labial fusion, perineal pain, postmenopausal woman, vulvoperineal flap
MeSH terms: Case Reports

We report the case of an 86-year-old postmenopausal woman with severe labial adhesion. The adhesion overlying the vestibule was manually separated and the skin defect was covered with bilateral vulvoperineal flaps. Reconstruction using the vulvoperineal flap enabled to prevent recurrence by covering with normal skin tissue.
Unicystic ameloblastoma of the mandible--an unusual case report and review of literature
Authors: Rakesh S Ramesh, Suraj Manjunath, Tanveer H Ustad, Saira Pais, K Shivakumar
Journal: Head Neck Oncol (2010)
MeSH terms: Ameloblastoma / pathology, Mandibular Neoplasms / pathology, Case Reports, Adult, Ameloblastoma / diagnosis, Ameloblastoma / diagnostic imaging, Female, Humans, Mandibular Neoplasms / diagnosis, Mandibular Neoplasms / diagnostic imaging, Radiography

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm, and only odontoma outnumbers it in reported frequency of occurrence. Its incidence, combined with its clinical behavior, makes ameloblastoma the most significant odontogenic neoplasm. Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. It accounts for 5-15% of all intraosseous ameloblastomas. We report a case of unicystic ameloblastoma in a 30-year-old female, and review the literature.
Treatment of Maxillary Second Premolar with 4 Roots
Authors: Z Allahem, S AlYami
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Aim. To report a case of maxillary second premolar with four roots and four separate foramina and the use of CBCT to help identify the root canal system configuration. Summary. A 45-year-old female patient with a no significant medical history was referred for treatment tooth #15. The tooth was diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. After taking periapical radiographs and expected uncommon morphology, CBCT was taken to help confirm canals configuration and aid in the treatment of the case. Root canals treatment was carried without complication under dental operating microscope using a rotary system and continuous wave obturation.
Intravitreal Dexamethasone Implant in Autoimmune Retinopathy
Authors: Fernando Longhi Bordin, Carolina da Silva Mengue, Manuel Augusto Pereira Vilela
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Purpose:
To describe the results of an intravitreal dexamethasone implant in managing autoimmune retinopathy (AIR).
Methods:
Two patients affected by AIR underwent intravitreal dexamethasone implantation and were followed by ocular coherence tomography, visual fields, and electroretinography.
Results:
The patients showed an interruption of the functional losses and remained stable with semestral injections.
Conclusion:
AIR is a complex condition with no standard treatment. The use of dexamethasone could be a valid option.
Cutaneous sporotrichoid leishmaniasis: An atypical case caused by Leishmania major
Authors: Adila Bassaid, Yassine Merad, Mohand Ouali Ait Si Ali, Assya Djeridane, Fatma Bachi, Haiet Adjmi-Hamoudi
Journal: IDCases (2022)
Keywords: cutaneous leishmaniasis, leishmania major, rare leishmaniasis, sporotrichoid leishmaniasis, vectorborne disease
MeSH terms: Case Reports

A 32 year-old male was referred in our institution for painless erythematous papules on the back of the right hand, treated by various local therapies with no noticeable benefits. On examination multiples inconspicuous nodules were identified 10 days after the onset of the primary lesion. Mycological examination was done to rule out sporotrichosis, then cutaneous leishmaniasis was retained by finding amastigotes forms, and Leishmania major agent was confirmed after culture on NNN medium followed by isoenzyme electrophoresis. Sporortrichoid leishmaniasis is a rare condition and usually due to extension of local leishmaniasis into the subcutaneous tissue via direct extension, bloodstream or lymphatics. The patient responded favorably to Meglumine antimoniate treatment. To our knowledge, sporotrichoid cutaneous leishmaniasis after an erythematous-papular onset has never been reported in Algeria, this clinical entity should be considered for an earlier diagnosis and specific therapy.
Idiopathic pyometra and tubo-ovarian abscess in a postmenopausal patient treated conservatively
Authors: Maria Ntioudi, Katerina Vasiliadou, Parthena Charalampidou-Keremidou
Journal: Ger Med Sci (2022)
Keywords: postmenopausal, pyometra, tubo-ovarian abscess
MeSH terms: Abdominal Abscess / diagnosis, Abdominal Abscess / drug therapy, Oophoritis / drug therapy, Pyometra / complications, Pyometra / drug therapy, Salpingitis / drug therapy, Case Reports, Abscess / drug therapy, Abscess / therapy, Aged, Anti-Bacterial Agents / therapeutic use, Female, Humans, Postmenopause, Anti-Bacterial Agents

Background:
Pyometra is a rare gynecological condition and is characterized by pus accumulation in the uterine cavity. It occurs more frequently in postmenopausal women than tubo-ovarian abscesses, which constitute a more common gynecological complication among premenopausal women.
Objective:
A 72-year-old woman was admitted to our emergency department with lower abdominal pain, diarrhea and fever for the last three days. The laboratory results were indicative to sepsis. The clinical examination revealed sensitivity by palpation of the lower abdomen without any signs of acute abdomen. The gynecological assessment showed pus outflow through the cervix and a pus culture was done. The ultrasound examination found an enlarged uterus, full of hypoechoic fluid, unclear borders between endometrium-myometrium, a mixed echogenicity adnexal mass and no free fluid in the pouch of Douglas. A computed tomography (CT) of the abdomen showed the presence of pyometra and a tubo-ovarian abscess of the right adnexa.
Method:
The patient was treated with intravenous antibiotic therapy. When the patient was hemodynamically stable and afebrile, she underwent ultrasound-guided dilatation and curettage of the cervical canal and the endometrium in order to exclude an underlying malignancy, under general anesthesia.
Results:
The patient responded promptly to the intravenous antibiotic therapy which was adapted to the pus culture result. The laboratory results withdrew to normal values and the patient was discharged after fifteen days of hospitalization in an afebrile and hemodynamically stable condition.
Conclusion:
Pyometra and tubo-ovarian abscess in postmenopausal women could be a lethal complication of pelvic inflammatory disease. The key in treatment is the dilatation of the cervix and drainage of the pyometra. The administration of intravenous antibiotics and drainage through the cervix could be a suitable method of treatment for pyometra in older patients or those with poor performance status if only the histological examination is negative for malignancy.
An all-arthroscopic light bulb technique to treat osteonecrosis of the femoral head through outside-in fashion without distraction: A case report
Authors: Hua-Zhang Xiong, Yu-Hong Deng, Ying Jin, An-Hong Wang, Song Hong
Journal: Front Surg (2022)
Keywords: arthroscopy, case report, distraction, femoral head, osteonecrosis, treatment
MeSH terms: Case Reports

The technique of distraction has been widely used in hip arthroscopy for opening joint spaces. However, an all-arthroscopic light bulb technique through outside-in fashion without distraction has not been reported for the treatment of osteonecrosis of the femoral head (ONFH). A 29-year-old man was admitted to our department with hip pain and limited range of motion (ROM) in both hips over 4 months. X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) showed a mixed appearance, including sclerosis and cysts on the anterosuperior site of the bilateral femoral heads. The patient had an 11-year history of liquor intake. In addition, no other pathologies were found before the operation. After diagnosing bilateral ONFH (stage II) according to the Ficat classification, the patient underwent an all-arthroscopic light bulb technique through outside-in fashion without distraction because of failing conservative treatment. At the 2-year postoperative follow-up, the patient had neither pain nor limitation of ROM. The postoperative x-ray, CT, and MRI revealed a well-healed area of the previous bone grafting in the bilateral femoral heads. An all-arthroscopic light bulb technique through outside-in fashion without distraction can be a feasible method for the treatment of early-stage ONFH. This case reminds us that distraction- and perforation-related complications may be avoided in patients with ONFH without the concomitant pathologies of the central compartment.