OpenMed/multicare-articles huggingface dataset:
Not All Monstrous Cells Indicate Glioblastoma: A Neuropathological Case Report of Pleomorphic Xanthoastrocytoma Misdiagnoses As Giant Cell Glioblastoma
Authors: George S Stoyanov, Lilyana Petkova, Bogomil Iliev, Radoslav Georgiev, Yavor Enchev
Journal: Cureus (2023)
Keywords: glial neoplasms, glioblastoma, neurooncology, neuropathology, pleomorphic xanthoastrocytoma
MeSH terms: Case Reports

Pleomorphic xanthoastrocytoma (PXA) is a rare central nervous system malignant neoplasm with a relatively favorable prognosis. As PXA histologically presents with large, multinucleated neoplastic cells, its principal differential diagnosis is giant cell glioblastoma (GCGBM). While there is a significant overlap between the two histologically and the neuropathological diagnosis can be challenging, as well as having some overlap neuroradiologically, the patient prognosis differs significantly, with PXA having a more favorable one. Herein we present a case report of a male patient in his thirties diagnosed with GCGBM and presenting again six years later with thickening of the wall of the porencephalic cyst suggestive of disease recurrence. Histopathology revealed neoplastic spindle, small lymphocyte-like, large epithelioid-like, some with foamy cytoplasm, and scattered large multinucleated cells with bizarre nuclei. For the most part, the tumor had a distinct border to the surrounding brain parenchyma, except for a single zone of invasion. As per the depicted morphology, with a lack of pathognomic features of GCGBM, the diagnosis of PXA was defined, and the oncologic committee reevaluated the patient with treatment reinitiation. Based on the close morphological profile of these neoplasias, it is likely that in the case of limited material, multiple PXA cases are diagnosed as GCGBM, resulting in misdiagnosed long survivors.
Clinical presentation of a patient with localized acquired cutis laxa of abdomen: a case report
Authors: Tugomir Gverić, Marko Barić, Vedrana Bulat, Mirna Situm, Jana Pusić, Dubravko Huljev, Boris Zdilar, Snjezana Gverić-Ahmetasević, Davor Tomas
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Background. Cutis laxa (CL) is a rare disorder of elastic tissue characterized by loose, sagging skin with reduced elasticity, and resilience without resulting scarring. CL may be inherited as a dominant, recessive, or X-linked recessive disease, or acquired. The heritable forms of CL predominantly begin at birth, but it may be delayed until puberty or age of 30 years with extracutaneous manifestations including pulmonary emphysema, umbilical and inguinal hernias, and gastrointestinal and vesicourinary tract diverticuli. An acquired form of the disease occurs in adults with no evidence of internal organ involvement. Objective. The aim of this case report was to present our patient suffering from CL, and to evaluate clinical presentation, diagnostic and therapeutic difficulties in this rare condition. Case Report. A 30-year-old female patient was admitted to our Hospital due to localized loose and sagging skin of abdomen, induced by prior cesarean section 6 years ago. CL has been diagnosed based on the clinical picture and pathohistological appearance. Conclusion. Reconstructive surgery provides a dramatic cosmetic improvement with significant psychosocial benefit. Repeated surgical procedures may be required to correct the lax skin, which worsens with age.
Extensive deep vein thrombosis treatment using fondaparinux and edoxaban: a case report
Authors: Kazuhiro Shimizu, Takeshi Sasaki, Takanobu Tomaru, Hirofumi Noike
Journal: Thromb J (2016)
Keywords: deep vein thrombosis, edoxaban, factor xa inhibitor, fondaparinux, venous thromoboembolism
MeSH terms: Case Reports

Background:
Factor Xa inhibitor is a key drug in the coagulation cascade. Parenteral anticoagulation using low molecular weight heparin or fondaparinux is the recommended form of treatment for most patients presenting with venous thrombosis. Following the acute phase, edoxaban is recommended. We present a case of extensive deep vein thrombosis treated using fondaparinux and edoxaban.
Case presentation:
A 63-year-old man with redness, pain, and swelling of the left leg lasting for more than 1 month was referred to our hospital. Ultrasonography revealed a thrombus in the left femoral vein. Computed tomographic angiography revealed clots in the distal right pulmonary artery. Thus, the anticoagulant treatment was initiated with subcutaneous injections of fondaparinux (7.5 mg) for 5 consecutive days, followed by once daily oral administration of edoxaban (60 mg). After 3 months of treatment, a regression of thrombotic clots was shown. Three months later, the remaining clots disappeared, leaving only mural thrombi; no bleeding complications were observed during the treatment period.
Conclusion:
The anticoagulant treatment with subcutaneous fondaparinux and subsequently with oral edoxaban was effective for treating extensive deep vein thrombosis.
Dengue Myocarditis: A Case Report and Major Review
Authors: Roberto Cristodulo, Gracia Luoma-Overstreet, Fernando Leite, Manuel Vaca, Michelle Navia, Gustavo Durán, Fernando Molina, Bozorg Zonneveld, Sergio Víctor Perrone, Alejandro Barbagelata, Edgardo Kaplinsky
Journal: Glob Heart (2023)
Keywords: acute myocarditis, dengue, expanded dengue syndrome
MeSH terms: Dengue / complications, Dengue / diagnosis, Heart Diseases, Heart Failure, Myocarditis / diagnosis, Myocarditis / etiology, Severe Dengue / complications, Severe Dengue / diagnosis, Case Reports, Review, Adult, Female, Humans, Male

Dengue is a viral disease transmitted by the bite of a female arthropod, prevalent primarily in tropical and subtropical regions. Its manifestations include asymptomatic infections, dengue fever, and a severe form called hemorrhagic dengue or dengue shock syndrome. Atypical manifestations can also occur, called expanded dengue syndrome. We describe the case of a 43-year-old man with an unusual presentation of dengue, demonstrating a workup suggestive of myocardial and pericardial damage. Symptoms and markers indicative of cardiac compromise improved after five days on anti-inflammatory treatment. Dengue myocarditis is considered an uncommon complication of dengue, although its reported incidence is likely an underestimation. In general, most cases of dengue myocarditis are self-limited, with only a minority at risk of progressing to heart failure. In order to improve recognition and prevent progression, healthcare providers should maintain a high degree of suspicion regarding potential cardiac complications in patients with dengue.
First report on severe septic shock associated with human Parvovirus B19 infection after cardiac surgery
Authors: Chunlin Xiang, Xiaoxiao Wu, Youkang Wei, Tianlong Li, Xuemei Tang, Yi Wang, Xiaoqin Zhang, Xiaobo Huang, Yiping Wang
Journal: Front Cell Infect Microbiol (2023)
Keywords: cardiac surgery, human parvovirus b19, infection, metagenomic next generation sequencing, septic shock
MeSH terms: Cardiac Surgical Procedures, Erythema Infectiosum / complications, Parvovirus B19, Human / genetics, Shock, Septic / complications, Shock, Septic / etiology, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Viral, Female, Humans, Middle Aged, Antibodies, Viral

Background:
Human Parvovirus B19 (PB19) is a single-stranded DNA virus. Septic shock from viremia is rare with PB19; however, this infection can progress to life-threatening conditions. We report the first case of severe septic shock associated with a PB19 infection after cardiac surgery.
Case presentation:
A 50-year-old Chinese woman received elective double metal valve replacement, including the aortic valve and the mitral valve, under cardiopulmonary bypass (CPB) and suffered severe septic shock on postoperative day (PD) 30. Through the detection of PB19-specific nucleic acids in blister fluid and serum samples via metagenomic next-generation sequencing (mNGS), positive serum PB19 IgM and no other proven infection, acute PB19 infection was confirmed. After five days of combined treatment, no further fever or abdominal discomfort was noted, and the patient's circulation gradually became stable without vasoactive medications.
Conclusion:
PB19 may be an unrecognized cause of septic shock, rash, fever of unknown origin or multiple systemic signs and symptoms, especially in immunosuppressed and immunocompetent critically ill patients. Investigations for viral aetiology are needed.
Possible clinical failure of artemether-lumefantrine in an italian traveler with uncomplicated falciparum malaria
Authors: Ernestina C Repetto, Antonio Traverso, Claudio G Giacomazzi
Journal: Mediterr J Hematol Infect Dis (2011)
MeSH terms: Case Reports

Artemisinin-combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in endemic areas with multidrug resistant Plasmodium falciparum. We report a case of possible artemether-lumefantrine clinical failure in an Italian traveler with uncomplicated P. falciparum malaria imported from Democratic Republic of Congo.
Laparoscopic Surgery for Seminal Vesicle Cysts and Ureterocele with Urination Disorder: A Case Report of Zinner Syndrome
Authors: Takeshi Maehana, Fumimasa Fukuta, Ko Kobayashi, Megumi Hirobe, Toshiaki Tanaka, Naoya Masumori
Journal: J Endourol Case Rep (2018)
Keywords: zinner syndrome, laparoscopic surgery, seminal vesicle cyst, ureterocele
MeSH terms: Case Reports

Background: Zinner syndrome is defined as seminal vesicle cysts with ipsilateral renal agenesis and an ectopic ureter. Symptomatic cases are very rare. In this article, we present a laparoscopic approach for a case of Zinner syndrome. Case Presentation: The patient was a 21-year-old male with difficult urination. A right seminal vesicle cyst and right kidney agenesis associated with ureterocele were found on examination and he was diagnosed with Zinner syndrome. First, we performed transperineal puncture of the ureterocele because it closed the bladder neck during voiding. Although voiding symptoms temporarily improved, the ureterocele recurred soon and the urination disorder was reexacerbated. Next, we selected laparoscopic removal of the ureterocele and the seminal vesicle cyst. The procedure was performed with transperitoneal access using four trocars. Perioperative and postoperative complications were not observed, and micturition was satisfactory after surgery. Conclusion: Treatment for difficult urination because of Zinner syndrome is mostly selected puncture of the ureterocele or seminal vesicle cyst. However, some patients experience recurrence. The laparoscopic approach is minimally invasive and provides a satisfactory surgical field. Therefore, it should be considered the method of treatment for symptomatic Zinner syndrome.
Equine Facilitated Therapy for Complex Trauma (EFT-CT)
Authors: Tiffany M Naste, Maggi Price, Jane Karol, Lia Martin, Kathryn Murphy, Jennifer Miguel, Joseph Spinazzola
Journal: J Child Adolesc Trauma (2018)
Keywords: animal assisted therapy, child traumatic stress, complex trauma, equine therapy, trauma, treatment

Emerging research suggests that Equine Facilitated Psychotherapy (EFP) may be beneficial for traumatized youth. In addition, complex trauma (i.e., multiple and/or prolonged developmentally adverse traumatic events which are typically interpersonal in nature) treatment research is still growing and there is a need for the development and examination of novel treatments for youth with complex trauma histories. The current article describes a promising EFP model for this population called Equine Facilitated Therapy for Complex Trauma (EFT-CT). EFT-CT embeds EFP practices within Attachment, Regulation and Competency (ARC), an extant evidence-based complex trauma treatment framework for children and adolescents. The authors provide three case studies using both observational data provided by clinicians, as well as longitudinal measures of psychosocial functioning, to illustrate the potential promise of EFT-CT. The article concludes with a discussion about implications for EFP treatment and research.
Arterial microcalcifications in the breast mimicking malignancy
Authors: Katrin Janzen, Jan Janzen
Journal: Case Rep Radiol (2012)
MeSH terms: Case Reports

Microcalcifications in the breast are highly suggestive of malignancy; they can occur in many pathological conditions. A 36-years-old nondiabetic woman came to the gynaecologist with a suspect palpable mass in the upper outer quadrant of the right breast. Histopathological examination confirmed a calcification of a small artery (diameter: 0.45 mm). Arterial calcifications can mimic a malignant lesion in the breast.
Case report: Paralysis after epidural analgesia due to a hemorrhage of pure epidural venous hemangioma
Authors: Jiahui Li, Pengyun Xie, Xiaolei Liu, Daheng Li, Jing Tang
Journal: Front Neurol (2023)
Keywords: epidural analgesia, extradural venous angiomas, myofascial pain syndrome, pain, paralysis
MeSH terms: Case Reports

Purpose:
To report a case of sudden paralysis after epidural analgesia to raise awareness of the condition and the importance of early identification and appropriate treatment of extradural venous angiomas.
Clinical features:
A 28-year-old man with myofascial pain syndrome experienced paraplegia after receiving an epidural block for pain relief, which was later discovered to be caused by hemorrhage from extradural venous angiomas. Decompression surgery was performed immediately and successfully. A follow-up examination was performed 5 months after surgery. The patient reported improvement in urinary retention. The muscle strength in both his lower extremities had recovered to 4 out of 5 but still exhibited considerable residual spasticity.
Conclusions:
Before administering epidural analgesia to relieve undetermined pain, it is prudent to carefully weigh potential benefits against potential risks to patient health to minimize the likelihood of complications.
Bilateral retinal toxicity as a result of poisoning with pure iodine
Authors: Bahadir Camgoz Esra, Sakir Goker Yasin
Journal: Rom J Ophthalmol (2021)
Keywords: fundus autofluorescence, iodine toxicity, optical coherence tomography, toxic retinopathy
MeSH terms: Iodine / poisoning, Retinal Diseases / chemically induced, Retinal Pigment Epithelium / pathology, Visual Acuity, Case Reports, Adult, Fluorescein Angiography / methods, Fundus Oculi, Humans, Male, Retinal Diseases / diagnosis, Retinal Pigment Epithelium / drug effects, Tomography, Optical Coherence / methods, Iodine

Iodine is an essential mineral that is necessary for the synthesis of thyroid hormones, which can cause many diseases in the body. The application of adding potassium iodate to table salts started in Turkey in 1998. High doses of iodate cause retinal toxicity, leading to significant vision loss. A 42-year-old paranoid schizophrenic patient who attempted suicide with pure iodine was admitted with bilateral vision loss. Widespread retinal pigment epithelium (RPE), ellipsoid zone (EZ) and interdigitation zone (IZ) damage were present in the optical coherence tomography (OCT) assessment. Fundus autofluorescence (FAF) findings, which included hypoautofluorescence areas that supported this condition, were also found. In conclusion, iodate in high doses is toxic on RPE, EZ and IZ. This situation could be irreversible depending on the dose.
Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
Authors: László Rudas, Péter Hankovszky, András Lovas, Éva Zöllei, Zsolt Molnár
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Dynamic preload assessment tests, especially pulse pressure variation (PPV) and stroke volume variation (SVV), are increasingly acknowledged in mechanically ventilated patients as being predictors of fluid responsiveness. However, the limitations of this method are often neglected or overlooked. One of the prerequisites for PPV and SVV evaluation, in addition to intermittent positive pressure ventilation, is a "regular heart rhythm," which may be an ambiguous term. We present a case where, despite a regular (paced) rhythm, atrioventricular dissociation was present and resulted in marked PPV elevation, which subsequently disappeared once sinus rhythm returned. Our case indicates that PPV and SVV should be interpreted with caution when atrioventricular dissociation is present.
Case Report: A Novel Lateral Approach to the C7, C8, and T1 Intervertebral Foramina for Resection of Malignant Peripheral Nerve Sheath Neoplasia, Followed by Adjunctive Radiotherapy, in Three Dogs
Authors: Oliver Marsh, Naomi Shimizu, Sarah L Mason, Ane Uriarte
Journal: Front Vet Sci (2022)
Keywords: brachial plexus, dog, peripheral nerve sheath tumor, radiotherapy, surgery
MeSH terms: Case Reports

This case report describes the diagnosis, management and outcome of three dogs with peripheral nerve sheath tumors (PNSTs) involving the brachial plexus, C7 (case 1), C8 (case 2), and C8 and T1 (case 3) spinal nerves and nerve roots with intrathoracic invasion. Surgical resection required thoracic limb amputation and removal of the first rib, facilitating a novel lateral approach to the spinal nerves and foramina in all cases. This was followed by hemilaminectomy and rhizotomy in cases 1 and 2. Adjunctive radiotherapy was then performed in all dogs. All three dogs regained a good quality of life in the short-term following surgery. Two were euthanased after 3 and 10 months, following detection of a pulmonary mass in one case and multiple thoracic and abdominal masses in the other. The third dog was alive and well at the time of writing (7 months post-surgery). This surgical approach facilitated good access and allowed gross neoplastic tissue to be resected. The ease of surgical access was dependent, to a degree, on the size of the patient. This surgical approach can be considered in cases of PNSTs involving the caudal cervical or cranial thoracic spinal nerves and nerve roots. Adjunctive radiotherapy should be considered as part of a multi-modal approach to these challenging tumors due to the difficulty of achieving clean margins, particularly proximally, even with optimal surgical access.
May-thurner syndrome: a case report and review of the literature
Authors: Shivani Kalu, Payal Shah, Aparna Natarajan, Nwabundo Nwankwo, Usman Mustafa, Nasir Hussain
Journal: Case Rep Vasc Med (2013)

May-Thurner syndrome (MTS) has been recognized as a clinical entity for almost six decades. The true incidence rate of MTS is unknown and perhaps ranges from 22 to 32% according to the autopsy studies in the early twentieth century. However, MTS related deep venous thrombosis (DVT) accounts for only 2%-3% of all lower limb DVTS. In MTS, the left common iliac vein is compressed against the fifth lumbar vertebrae by the right common iliac artery, as it crosses in front of the vein. Chronic pulsation of the artery is thought to cause elastin, collagen deposition, and intimal fibrosis leading to formation of venous spur and venous thrombosis. MTS can present as acute or chronic DVT leading to pulmonary embolism (PE), chronic leg pain, chronic ulcers, or skin pigmentation changes. In this case report we have described an interesting case of a 28-year-old Caucasian female who presented for evaluation of shortness of breath (SOB) associated with cough for one week. SOB was found to be secondary to massive bilateral pulmonary embolism resulting from extensive MTS related DVT of the left lower extremity. Patient underwent pharmacomechanical treatment with local thrombolysis, thrombectomy, and venoplasty along with stent placement that extended to inferior vena caval junction. Subsequently patient was discharged on coumadin. MTS should be considered in differentials when faced with a case of unilateral DVT particularly in younger age group.
Excessive unilateral proliferation of spermatogonia in a patient with non-obstructive azoospermia - adverse effect of clomiphene citrate pre-treatment?
Authors: Daniela Fietz, Adrian Pilatz, Thorsten Diemer, Florian Wagenlehner, Martin Bergmann, Hans-Christian Schuppe
Journal: Basic Clin Androl (2020)
Keywords: azoospermia, blood-testis barrier, clomiphene citrate, male infertility, sertoli cell function, spermatogonia
MeSH terms: Case Reports

Background:
Clomiphene citrate has been proposed as pre-treatment for infertile men with non-obstructive, testicular azoospermia (NOA) before surgery for testicular sperm extraction (TESE), especially when serum testosterone is low.
Case presentation:
Here, we report on a 33-year old azoospermic patient with a previous history of repeated "fresh" TESE and clomiphene citrate therapy (50 mg/day over 6 months) before undergoing microscopically assisted, bilateral testicular biopsy. Comprehensive histological and immunohistochemical work-up revealed a heterogeneous spermatogenic arrest at the level of spermatogonia or primary spermatocytes, with focally preserved spermatogenesis up to elongated spermatids in the right testis. In the left testis, the majority of tubules (> 70%) showed no tubular lumen or regular seminiferous epithelium but a great number of spermatogonia-like cells. These cells proved to be normally differentiated spermatogonia (positive for melanoma associated antigen 4 (MAGEA4), negative for placental alkaline phosphatase (PlAP)) with increased proliferative activity (positive for proliferating cell nuclear antigen (PCNA)) and a slightly higher rate of apoptotic cells. When compared to a tissue control with normal spermatogenesis, expression of sex hormone receptors androgen receptor (AR), estrogen receptor (ER) alpha, and G-protein coupled estrogen receptor 1 (GPER1) was not altered in patient samples. Sertoli cells appeared to be mature (positive for vimentin, negative for cytokeratin 18), whereas the expression of zona occludens protein 1 (ZO-1), claudin 11, and connexin 43 was absent or dislocated in the tubules with abundance of spermatogonia.
Conclusion:
This result suggests that formation of the blood-testis barrier is disturbed in affected tubules. To our knowledge this is the first observation of excessive, non-malignant proliferation of spermatogonia in a NOA patient. Although underlying molecular mechanisms remain to be elucidated, we hypothesize that the unusual pathology was triggered by the high-dose clomiphene citrate treatment preceding testicular biopsy.
Radiofrequency-Targeted Vertebral Augmentation: Case Report of a Patient with 7 Osteoporotic Vertebral Fractures in a Variant of Osteogenesis Imperfecta
Authors: Leonard Westermann, Peer Eysel, Marvin Simons, Kourosh Zarghooni
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Introduction:
Radiofrequency-targeted vertebral augmentation (RF-TVA) is a recognized treatment for painful compression fractures. RF-TVA in a patient with multiple compression fractures due to type I osteogenesis imperfecta (OI) has not been previously reported.
Case presentation:
A 54-year-old patient with type I OI is presented with a segmental thoracic hyperkyphosis and 7 recent vertebral compression fractures. Because of persistent severe thoracolumbar back pain despite conservative therapy, RF-TVA was indicated. Nocturnal back pain was almost completely relieved at all postoperative time points evaluated. However, overall pain relief dropped only slightly from 7 to 5 on the numerical rating scale (NRS) at the 6-week follow-up, and there was only a small decrease in the Oswestry Disability Index (ODI) from 72% to 63%. An MRI at the 3-month follow-up revealed hyperintensity at levels T11 and T12, indicating slight recollapsing. At the 6-month follow-up, the ODI improved to 55%, although overall pain had worsened to 6 on the NRS. Pain at rest remained at a very low level.
Conclusion:
Despite the remaining lumbago, RF-TVA may be a good option for patients with OI who have multiple fractures. However, fractures at multiple levels and segmental thoracic hyperkyphosis may increase the risk for recollapsing and ongoing pain.