OpenMed/multicare-articles huggingface dataset:
Pulmonary thromboembolism after operation for bilateral open distal radius fractures: a case report
Authors: Yuka Igeta, Kiyohito Naito, Yoichi Sugiyama, Kazuo Kaneko, Osamu Obayashi
Journal: BMC Res Notes (2014)
MeSH terms: Bed Rest / adverse effects, Fractures, Open / surgery, Multiple Trauma / surgery, Postoperative Complications / etiology, Pulmonary Embolism / etiology, Radius Fractures / surgery, Case Reports, Accidental Falls, Aged, 80 and over, Anticoagulants / therapeutic use, Bed Rest / psychology, Bone Plates, Combined Modality Therapy, Debridement, Depression / complications, Dyspnea / etiology, Female, Fracture Fixation, Internal, Heparin / therapeutic use, Humans, Oxygen Inhalation Therapy, Patient Readmission, Postoperative Complications / drug therapy, Postoperative Complications / therapy, Pulmonary Embolism / drug therapy, Pulmonary Embolism / therapy, Warfarin / therapeutic use, Anticoagulants, Warfarin, Heparin

Background:
Pulmonary thromboembolism after upper extremity operation is rare. We report a patient with thromboembolism after debridement open reduction and internal fixation for bilateral open distal radius fractures.
Case presentation:
The Japanese patient was an 80-year-old previously healthy female who was able to walk on her own. She fell down and was taken to our hospital. She was diagnosed with bilateral open distal radius fractures and we performed debridement open reduction and internal fixation on the same day. Although she could not walk and was depressed, she was discharged on the ninth postoperative day. However, on the eleventh postoperative day, she returned to our emergency department with complaints of dyspnea and cold sweat. Her serum D-dimer level was 19.0 μg/dl, troponin T was positive, and urgent contrast computed tomography scan of her thorax revealed thrombosis in the bilateral main pulmonary artery. She was diagnosed with pulmonary thromboembolism and admitted to our hospital again. On the second admission, although she had breathing problems, she did not require a respirator. Oxygen was supplied as well as anticoagulants. On the seventh day after being diagnosed with embolism, thrombosis in the bilateral main pulmonary arteries had disappeared.
Conclusion:
The patient did not have any "strong" risk factors as reported in the Japanese Orthopedic Association Clinical Practice Guideline on the Prevention of Venous Thromboembolism in Patients Undergoing Orthopedic Treatments. In general, upper extremity operation carries a low risk for pulmonary thromboembolism. For patients with decreased activity of daily living and depression, we should consider postponing discharge and performing rehabilitation until activity of daily living is improved.
Analysis of thyroid involvement in children and adult Langerhans cell histiocytosis: An underestimated endocrine manifestation
Authors: Yuanmeng Li, Long Chang, Xiaofeng Chai, He Liu, Hongbo Yang, Yu Xia, Li Huo, Hui Zhang, Naishi Li, Xiaolan Lian
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: 18-f-fluorodeoxyglucose positron emission tomography/computed tomography, langerhans cell histiocytosis, diabetes insipidus, fine needle aspiration biopsy, pathological diagnosis, thyroid involvement, thyroid ultrasonography
MeSH terms: Diabetes Insipidus, Histiocytosis, Langerhans-Cell / complications, Histiocytosis, Langerhans-Cell / diagnosis, Histiocytosis, Langerhans-Cell / epidemiology, Hypothyroidism / complications, Thyroid Neoplasms / drug therapy, Research Support, Non-U.S. Gov't, Adult, Child, Humans, Retrospective Studies

Background:
Langerhans cell histiocytosis (LCH) is a rare disease caused by the clonal expansion of CD1a+/CD207+ LCH cells. The thyroid involvement in LCH has mostly been described in case reports.
Methods:
We retrospectively evaluated the clinical characteristics, diagnosis, and treatment of 27 children and adult patients with thyroid LCH in our center between 2010 and 2021.
Results:
The incidence of thyroid LCH was 14.00% (7/50) in children and 10.10% (20/198) in adults, respectively. Among patients with thyroid involvement, 81.5% presented with diabetes insipidus (DI) as the first symptom, and 51.9% complained of neck swelling or mass. Children and adults with thyroid LCH had higher frequencies of the hypothalamic-pituitary axis (HPA) (children: 100% vs. 62.8%, P=0.05; adult: 95% vs. 42.1%, P<0.001), the lung (children: 85.7% vs. 25.6%, P=0.004; adult: 70% vs. 50.6%, P=0.099), and a lower frequency of bone (children: 14.3% vs. 55.8%, P=0.049; adult: 45% vs. 73.6%, P=0.008) involvement than patients without thyroid involvement. Patients with thyroid LCH had a higher frequency of primary hypothyroidism and a lower frequency of euthyroidism than patients without it. The two major types of ultrasound imaging were diffuse (55%) and nodular type (45%). The standardized uptake value of thyroid on 18-F-fluorodeoxyglucose positron emission tomography/computed tomography was 5.3-12.8. The diagnoses were confirmed using thyroid aspiration (54.5%) or surgery (45.5%). In addition, thyroid LCH combined with papillary thyroid carcinoma was not rare (2/27).
Conclusion:
Thyroid involvement in LCH is not rare. Furthermore, identifying thyroid involvement can facilitate the pathological diagnosis of LCH. Therefore, the possibility of thyroid LCH should be fully investigated in patients with DI, primary hypothyroidism, abnormal thyroid ultrasound results, and multi-system disease. In addition, thyroid aspiration can confirm suspected thyroid LCH. Finally, special attention should be paid to evaluating HPA and pulmonary involvement in thyroid LCH.
Repair of Postoperative Abdominal Hernia in a Child with Congenital Omphalocele Using Porcine Dermal Matrix
Authors: V Lambropoulos, E Mylona, V Mouravas, C Tsakalidis, I Spyridakis, G Mitsiakos, P Karagianni
Journal: Case Rep Med (2016)

Introduction. Incisional hernias are a common complication appearing after abdominal wall defects reconstruction, with omphalocele and gastroschisis being the most common etiologies in children. Abdominal closure of these defects represents a real challenge for pediatric surgeons with many surgical techniques and various prosthetic materials being used for this purpose. Case Report. We present a case of repair of a postoperative ventral hernia occurring after congenital omphalocele reconstruction in a three-and-a-half-year-old child using an acellular, sterile, porcine dermal mesh. Conclusion. Non-cross-linked acellular porcine dermal matrix is an appropriate mesh used for the reconstruction of abdominal wall defects and their postoperative complications like large ventral hernias with success and preventing their recurrence.
Periosteal osteoblastoma of the pelvis: a rare case
Authors: Swaroop Patel, Atul Agrawal, Rajesh Maheshwari, Vijendra D Chauhan
Journal: Iran J Med Sci (2015)
Keywords: osteoblastoma, osteochondroma, periosteal, pubic bone
MeSH terms: Case Reports

Among the rare bone tumors, the osteoblastoma is a fascinating tumor. The rarity, the predisposition to occur in any bone and the diagnostic dilemma makes this infrequent tumor interesting. It is sporadically reported in the literature and what is rarer is its occurrence in the pelvis. The unusual location and inconclusive radiographic findings with diffused diagnostic evidences delays the management of benign osteoblastoma. We encountered a patient with benign osteoblastoma of the pubic ramus of right side. An excisional biopsy was performed. Peroperatively, the tumor appeared as oval, reddish brown, bony hard mass lying just over the cortex of the right pubic ramus and not breaching the cortex. Histopathological study revealed an osteoid rich lesion. Its presence in pubis must not be ignored and periosteal osteoblastoma should be considered as a differential diagnosis.
Tuberculosis (TB) of the Porta Hepatis Presenting with Obstructive Jaundice Mimicking a Malignant Biliary Tumor: A Case Report and Review of the Literature
Authors: Rashid Al Umairi, Ahmed Al Abri, Atheel Kamona
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Localized hepatobiliary tuberculosis (TB) is a rare disorder which can present with an obstructive jaundice mimicking other noninfectious causes such as cholangiocarcinoma. Here, we report a case of porta hepatis tuberculosis in 19-year-old female who presented with an obstructive jaundice, and her computed tomography (CT) of the abdomen revealed a hepatic hilar mass with radiological features mimicking a malignant biliary tumor. We also review the literature related to this disorder.
Pulmonary Vein Thrombosis Associated with Metastatic Follicular Thyroid Carcinoma: A Case Report and Review
Authors: Maria Mavromati, Annick Gerber, Gregor John
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Pulmonary vein thrombosis (PVT) mainly occurs following lung transplantation but cases associated with thoracic malignancy have also been described. We describe here the first case of PVT in an asymptomatic patient with metastatic follicular thyroid carcinoma.
Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy
Authors: Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Background:
Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy.
Case presentation:
A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems. The patient, however, developed airway obstruction one hour after extubation and was reintubated following commencement of mechanical ventilation for one day. At the age of 70 years, the patient received an emergency tracheostomy due to bilateral vocal cord paralysis and then was diagnosed with spinal and bulbar muscular atrophy (SBMA). Although no muscle weakness of either upper or lower extremities was observed, rocuronium showed hypersensitivity during total laryngectomy under general anesthesia.
Conclusions:
Vocal cord paralysis combined with postoperative laryngeal edema, the cause of which was presumed to be SBMA, likely caused airway obstruction after RALP. As neuromuscular symptoms progress gradually in patients with SBMA, muscle relaxants should be used carefully, even if patients with SBMA present no immobility of their extremities.
Case Report: Behçet's disease accompanied with vitiligo
Authors: Ragıp Ertaş, Kemal Özyurt, Atıl Avcı, Sule Ketenci Ertas, Mustafa Atasoy
Journal: F1000Res (2017)
Keywords: arthritis, autoimmunity, autoinflammatory, behçet’s disease, depigmentation, erythema nodosum, thrombophlebitis, vitiligo

Recently, a few case reports and clinical studies have been published that explore the association of Behçet's Disease (BD) and vitiligo, with conflicting results. Genetic and immunological properties of BD and presence of autoantibodies support autoimmunity, but clinical features suggest autoinflammatory diseases. BD is thought to be a cornerstone between autoimmune and autoinflammatory diseases. On the other hand, vitiligo has been accepted as an autoimmune disease with associations of other autoimmune disorders and there is a possible role of autoimmunity in pathogenesis of the disease. Significant advances have been made understanding the pathogenesis and genetics of BD. However, it is worth presenting rare clinical variants for improving the clinical understanding of BD. Herein, we are presenting a case with diagnosis of both Behçet's disease and vitiligo in same patient, which is a rare occurrence. Discussion and demonstrating the association of these two diseases may give rise to understanding similar and different aspects of autoimmunity and autoinflammatory pathogenesis of both diseases.
Surgical Management of Pilocytic Astrocytoma of the Optic Nerve: A Case Report and Review of the Literature
Authors: Ifeoluwa Apanisile, Tamás Karosi
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Optic nerve astrocytomas (ONAs) are frequent types of optic nerve gliomas (ONGs), which can affect the visual pathway. An 18-year-old male patient was admitted to our department with right-sided intraorbital/retrobulbar swelling, which progressively grew over several months. Clinical examination showed right-sided diplopia, mydriasis, low visual acuity (0.4), exophthalmus (3 cm), epiphora, and severe retrobulbar pain. There was a family history of high-grade (IV) astrocytomas in which two of the family members died due to the disease. Preoperative MRI scan revealed a soft tissue mass around the retrobulbar area of the right eye with intact orbital bony walls. Surgery was performed whereby it was dissected freely from the muscles and was separated from the optic nerve and the globe. Histopathologic analysis confirmed a benign astrocytoma. The follow-up examination revealed no recurrent or residual tumor. A systemic review of the literature indicates that early diagnosis and experienced multidisciplinary management are required in case of unilateral, resectable forms of ONAs with no distant metastasis, in order to provide a long-time survival of patients. Surgical intervention of unilateral ONAs is a relatively safe procedure, allowing complete or partial tumor removal with minimal morbidity and low recurrence rate.
Case report: Rapid development of amyloid A amyloidosis in temporal arteritis with SAA1.3 allele; An unusual case of intestinal amyloidosis secondary to temporal arteritis
Authors: Shuhei Yoshida, Haruki Matsumoto, Jumpei Temmoku, Norshalena Shakespear, Yuichiro Kiko, Kentaro Kikuchi, Yuya Sumichika, Kenji Saito, Yuya Fujita, Naoki Matsuoka, Tomoyuki Asano, Shuzo Sato, Eiji Suzuki, Hiroshi Watanabe, Hiromasa Ohira, Kiyoshi Migita
Journal: Front Immunol (2023)
Keywords: saa1 polymorphism, amyloid a amyloidosis, large-vessel vasculitis, serum amyloid a, temporal arthritis, tocilizumab
MeSH terms: Amyloidosis / etiology, Amyloidosis / genetics, Giant Cell Arteritis / complications, Giant Cell Arteritis / diagnosis, Giant Cell Arteritis / drug therapy, Case Reports, Aged, 80 and over, Alleles, Diarrhea, Humans, Inflammation / complications, Male, Serum Amyloid A Protein, SAA1 protein, human, Serum Amyloid A Protein, AA amyloidosis

Temporal arteritis (TA) is a large-vessel vasculitis mostly seen in older patients. Amyloid A (AA) amyloidosis secondary to a chronic inflammation induces multiple organ dysfunctions, including a dysfunction of the gastrointestinal tract. Herein, we present a case of TA complicated by AA amyloidosis that was resistant to oral and intravenous steroids. An 80-year-old man with a history of new-onset headache, jaw claudication, and distended temporal arteries was referred to our department. On admission, the patient presented with tenderness and a subcutaneous temporal nodule in both temple arteries. Ultrasonography of the nodule revealed an anechoic perivascular halo surrounding the right temporal artery. Following the diagnosis of TA, high-dose prednisolone therapy was initiated. However, the patient presented with recurrent abdominal pain and refractory diarrhea. Due to the unclear origin of refractory diarrhea, an extensive workup, including biopsy of the duodenal mucosa, was performed. Endoscopy revealed chronic inflammation in the duodenum. Immunohistochemical analysis of duodenal mucosal biopsy samples revealed AA amyloid deposition resulting in the diagnosis of AA amyloidosis. After tocilizumab (TCZ) administration, refractory diarrhea reduced; however, the patient died of intestinal perforation 1 month after the start of TCZ administration. Gastrointestinal involvement was the main clinical manifestation of AA amyloidosis in the present case. This case highlights the importance of bowel biopsy screening for amyloid deposition in patients with unexplained gastrointestinal tract symptoms, even in a recent onset of large-vessel vasculitis. In the present case, the carriage of the SAA1.3 allele likely contributed to the rare association of AA amyloidosis with TA.
Concurrent intracranial and spinal subdural hematoma in a teenage athlete: a case report of this rare entity
Authors: Daniel S Treister, Sara E Kingston, Gabriel Zada, Manu Singh, Jesse G A Jones, Jena N Mills, Alexander Lerner, Orest B Boyko, Meng Law, Anandh Rajamohan, Mark S Shiroishi
Journal: Case Rep Radiol (2014)

A 15-year-old male high school football player presented with episodes of headache and complete body stiffness, especially in the arms, lower back, and thighs, immediately following a football game. This was accompanied by severe nausea and vomiting for several days. Viral meningitis was suspected by the primary clinician, and treatment with corticosteroids was initiated. Over the next several weeks, there was gradual symptom improvement and the patient returned to his baseline clinical status. The patient experienced a severe recurrence of the previous myriad of symptoms following a subsequent football game, without an obvious isolated traumatic episode. In addition, he experienced a new left sided headache, fatigue, and difficulty ambulating. He was admitted and an extensive workup was performed. CT and MRI of the head revealed concurrent intracranial and spinal subdural hematomas (SDH). Clinical workup did not reveal any evidence of coagulopathy or predisposing vascular lesions. Spinal SDH is an uncommon condition whose concurrence with intracranial SDH is an even greater clinical rarity. We suggest that our case represents an acute on chronic intracranial SDH with rebleeding, membrane rupture, and symptomatic redistribution of hematoma to the spinal subdural space.
Ultrasonographic guidance and characterization of cryoanalgesic lesions in treating a case of refractory sural neuroma
Authors: Ellen E Rhame, Alexander F Debonet, Thomas T Simopoulos
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

The recurrent pain of a neuroma following surgical excision and burial of nerve endings can be clinically challenging to manage. Cryoanalgesia in conjunction with ultrasound guidance was used successfully to manage this type of pain. Furthermore, ultrasound provided visualization of the cryolesions, as well as the relationships of the ice ball to the surrounding tissue. Following the completion of the freeze cycle, the tissue can be monitored for return to its usual morphology during the thaw period.
Hunter Syndrome Diagnosed by Otorhinolaryngologist
Authors: Ayako Hashimoto, Tadayuki Kumagai, Hiroyuki Mineta
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Hunter syndrome is a lysosomal disease characterized by deficiency of the lysosomal enzyme iduronate-2-sulfatase (I2S). It has an estimated incidence of approximately 1 in 1,62,000 live male births. We report a case of Hunter syndrome diagnosed by an otorhinolaryngologist. To our knowledge, this is the first study diagnosed by an otorhinolaryngologist despite the fact that otorhinolaryngological symptoms manifest at a young age in this disease. The patient was a 4-year-old boy. He underwent adenotonsillectomy. Intubation was difficult, and he had some symptoms which are reasonable as a mucopolysaccharidosis. The otorhinolaryngologist should play an integral role in the multidisciplinary approach to the diagnosis and management of many children with MPS (mucopolysaccharidoses) disorders.
Thoraco-abdominal ectopia cordis in southwest Cameroon
Authors: John B Chishugi, Trixy J Franke
Journal: Pan Afr Med J (2014)
Keywords: cantrell's pentalogy, ectopia cordis, congenital defect
MeSH terms: Ectopia Cordis / pathology, Case Reports, Cameroon, Fatal Outcome, Female, Humans, Infant, Newborn, Male, Patient Transfer, Pregnancy

Ectopia cordis is a rare congenital defect where the heart is completely displaced outside the chest wall. Cantrell's pentalogy is an embryologic anomaly with five classic midline deficiencies often associated with ectopia cordis. Here we present a case of thoraco-abdominal ectopia cordis, brief literature review, and possible implications for changes in antenatal care.
External Ophthalmomyiasis Caused by a Rare Infesting Larva, Sarcophaga argyrostoma
Authors: Shmuel Graffi, Avi Peretz, Amos Wilamowski, Heather Schnur, Fouad Akad, Modi Naftali
Journal: Case Rep Ophthalmol Med (2013)

Purpose. External ophthalmomyiasis (EO) is caused by infesting larvae belonging to various species of flies. Most documented cases result from sheep (Oestrus ovis) and Russian (Rhinoestrus purpureus) botfly larvae, but we recently discovered a rare case of EO caused by flesh fly (Sarcophaga argyrostoma) larvae. Here, we report the case of a patient with EO who had been hospitalized and sedated for 1 week because of unrelated pneumonia. Methods. Case report. Results. A total of 32 larvae were removed from the adnexae of both eyes. Larvae identification was confirmed through DNA analysis. Treatment with topical tobramycin resulted in complete resolution of EO. Conclusion. EO can be caused by S. argyrostoma, and the elderly and debilitated may require extra ocular protection against flies during sedation.
Identification of an APC Variant in a Patient with Clinical Attenuated Familial Adenomatous Polyposis
Authors: Andrew T Schlussel, Susan S Donlon, Faye A Eggerding, Ronald A Gagliano
Journal: Case Rep Med (2014)

Introduction. The objective of this case report is to discuss an unclassified germline variant of the adenomatous polyposis coli (APC) gene identified in an older patient with attenuated familial adenomatous polyposis syndrome (AFAP). Methods. We present a case report of a 66-year-old man diagnosed with AFAP. Colonoscopy found multiple polyps and invasive adenocarcinoma arising in the transverse colon. Samples were tested for mutations in the APC gene. Results. DNA sequencing of germline DNA identified a cytosine (C) to thymine (T) transition at nucleotide 1240, heterozygous. The C to T transition at codon 414 is predicted to convert an arginine residue to a cysteine that is possibly pathogenic. Analysis of the patient's colon tumor DNA indicated that the tumor had lost the mutant variant allele and retained only the normal allele, suggesting that the variant may not be significant. Conclusions. The p.R414C variant has been described previously as a germline mutation of probable pathogenicity. This substitution should be considered an unclassified variant and possibly not pathogenic. These findings support the need for further genetic testing of tissue, as well as for developing a mechanism for testing all variants, as this could significantly impact the lives of patients and their family members.
A Rare Presentation of a Bi-Maxillary Brown Tumour due to Secondary Hyperparathyroidism
Authors: Cheboh Cho-Fon, Zilefac Brian Ngokwe, Obolo Nwaga Ines
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Brown tumours are localized bone lesions, seen in patients with high parathyroid hormone levels. This can be due to primary hyperparathyroidism, which occurs more often in neoplasms of the parathyroid gland or due to secondary hyperparathyroidism more often seen as a result of renal impairment. Facial involvement is rare, with most reports focusing on long and axial bones. However, the mandibular bone is often the only bone affected. Here, we report a rare case of a bi-maxillary attainment of brown tumour in a patient with secondary hyperparathyroidism due to chronic kidney disease.