OpenMed/multicare-articles huggingface dataset:
Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients
Authors: Lin Zhao, Tao Song
Journal: Front Neurol (2021)
Keywords: high cervical spinal cord stimulation, maxillary nerve, peripheral nerve stimulation, short-term stimulation, trigeminal postherpetic neuralgia
MeSH terms: Case Reports

Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) affecting the V2 and V3 divisions. We also sought to use a novel PNS approach to the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division. Method: Two elderly patients successfully treated with different neuromodulation methods for TPHN are presented in this case series. Results: The first case referred to an 83-year-old Chinese female patient with V2 and V3 TPHN who experienced a significant pain relief using a combination of short-term high cervical SCS at the C1-C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old Chinese male patient with V1 and V2 TPHN that obtained an excellent pain relief after having received short-term PNS on the supraorbital nerve (SON), the supratrochlear nerve (STN), and the maxillary nerve. Both reported improvements in their quality of life and ability to perform daily tasks during a 3-month follow-up period. Conclusions: Short-term high cervical SCS at the C1-C2 spinal segments may be a feasible method to treat recent-onset V3 TPHN in elderly patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel PNS approach to the maxillary nerve not previously reported for TPHN therapy.
Primary Pleuropulmonary Synovial Sarcoma: A Case
Authors: Fatima Zahra Mrabet, Hafsa El Ouazzani, Leila El Akkari, Sanaa Hammi, Jamal Eddine Bourkadi, Fouad Zouaidia
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Primary pleuropulmonary synovial sarcoma is extremely rare. The diagnosis can only be made after having eliminated an extrapleuropulmonary localization in the past and at the time of diagnosis. Our presentation is about a 40-year-old woman having a cough and dyspnea since three weeks ago; imaging had showed a left pleurisy with pleuropulmonary process. Histological study of the biopsy confirmed the diagnosis of pleuropulmonary synovial sarcoma. PET-SCAN had not identified any extrathoracic localization. This tumor is known for its aggressive nature and high risk of metastasis. Its primitive character is retained following a diagnostic procedure of exclusion. Surgical treatment remains the best therapeutic tool when it is technically feasible; otherwise the prognosis is often unfortunate. In this paper, we report a case of primary pleuropulmonary synovial sarcoma. Through this case, we present a rare disease that is often difficult to diagnose.
Sarcomatoid variant of urothelial carcinoma in the renal pelvis with brain metastasis: a case report
Authors: Hamid Nasrollahi, Faisal Ahmed, Ali Eslahi, Mehrdad Golmoradi Pilehroud, Akbar Safaei, Mohammad Reza Askarpour, AbdolAzim Khorshidi, Soorena Khorshidi
Journal: Pan Afr Med J (2022)
Keywords: brain metastasis, case report, chemotherapy, sarcomatoid variant, urothelial carcinoma
MeSH terms: Brain Neoplasms / pathology, Brain Neoplasms / secondary, Brain Neoplasms / therapy, Carcinoma, Transitional Cell / diagnosis, Carcinoma, Transitional Cell / pathology, Carcinoma, Transitional Cell / therapy, Sarcoma / pathology, Soft Tissue Neoplasms / pathology, Urinary Bladder Neoplasms / pathology, Case Reports, Aged, Female, Humans, Kidney Pelvis / pathology, Nephroureterectomy

Sarcomatoid urothelial carcinoma (UC) of the renal pelvis is rare. It is a high-grade malignant tumor that contains both epithelial and mesenchymal elements. Brain metastases from renal pelvis UC are infrequent and represented in few cases. We report a 68-year-old female with a right renal mass diagnosed as a UC with a sarcomatoid variant. The patient underwent a right radical nephroureterectomy and received chemotherapy. She developed brain metastasis in the left temporal area two months later. Therefore, metastasectomy and palliative brain radiotherapy were performed for her. Sadly, her general condition worsened, and she passed away after one month. Brain metastasis in patients with UC is rare and poorly understood. Therefore, we describe the clinico pathological characteristics, including the clinical follow-up of our case with a focus on the treatment and outcome.
Fatal Sarcocystis falcatula Infection in Three Penguins
Authors: Shannon G M Kirejczyk, Rachel E Burns, Michael W Hyatt, Michael J Yabsley, Julia M Ter Beest, Zoltan S Gyimesi, Robert J Ossiboff, Amelia Waltman, Tracie A Seimon, Rita McManamon
Journal: Front Vet Sci (2019)
Keywords: eudyptes chrysocome, sarcocystis falcatula, spheniscus demersus, apicomplexa, penguin, protozoal pneumonia
MeSH terms: Case Reports

Sarcocystis falcatula is a well-known cause of fatal pneumonia in some birds, particularly Old World psittacines. Here we describe fatal sarcosystosis due to S. falcatula in 3 penguins (Family Spheniscidae) under managed care, including one African penguin (Spheniscus demersus), and two Southern rockhopper penguins (Eudyptes chrysocome). Randomly distributed foci of necrosis, inflammatory cell infiltrates, edema, and variable numbers of round to elongated protozoal schizonts were observed in sections of lung. Protozoal organisms exhibited strong immunoreactivity for Sarcocystis sp. antigen by immunohistochemistry. Apicomplexan and Sarcocystis genus-specific PCR assays and sequence analysis confirmed S. falcatula as the etiologic agent. These cases of fatal pneumonia attributed to S. falcatula expand the list of aberrant intermediate avian hosts, with particular implications for penguins.
Thymoma: A case report and update
Authors: N Mathiselvan, E M Irusen, C F N Koegelenberg
Journal: Afr J Thorac Crit Care Med (2019)
Keywords: thymoma, mediastinal mass
MeSH terms: Case Reports

Thymomas are slow growing, evolve with metastasis and commonly present as ipsilateral pleural involvement along with the primary tumour of the mediastinum. Early-stage recognition and treatment with surgical resection and postoperative chemoradiotherapy may offer a better 10-year survival rate.
Subacute intestinal obstruction by enterolith: a case study
Authors: V S Kappikeri, Akshay Mahesh Kriplani
Journal: Springerplus (2016)
Keywords: enterolith, ileo-ileal anastomoses, subacute intestinal obstruction

Introduction:
Enteroliths are an uncommon entity in humans and form a rare cause of subacute intestinal obstruction. They occur proximal to stricture or in a diverticulum or a blind loop due to stasis.
Case description:
40 years male presenting with intermittent right lower abdominal pain since 1 year. Barium meal follow-through and CT abdomen diagnosed as a case of subacute intestinal obstruction with an enterolith in the distal ileal segment. On exploratory laparotomy multiple ileal strictures with mesenteric adhesions were noted. An enterolith was delivered from one of the segments between two strictures followed by segmental resection of the pathological ileal segment with ileo-ileal anastomoses. Histopathology of the ileal segment showed inflammatory infiltrates.
Discussion and evaluation:
It was a case of a primary enterolith formed due to stasis between ileal strictures causing subacute intestinal obstruction.
Conclusion:
An enterolith should also be considered while evaluating a case of intestinal obstruction as one of the rare differentials.
Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid
Authors: Gen Owada, Hideo Nishizawa, Yuki Matoyama, Eri Watanabe, Keigo Mitsuda, Naoki Kaneko, Yasuhiro Kimura, Taikan Nanao, Junichi Fujimoto
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

5-Aminolevulinic acid (5-ALA) is used for the photodynamic diagnosis of malignant tumors and has been effectively utilized to improve the complete resection rate and reduce the risk of tumor recurrence. However, intraoperative hypotension is a common adverse effect of oral 5-ALA, and it occasionally progresses to severe prolonged hypotension requiring high-dose catecholamine administration. We report a case of intraoperative hypotension due to oral 5-ALA in which arginine vasopressin (AVP) administration was effective for increasing the blood pressure. A 77-year-old man scheduled for a craniotomy for glioma was administered 5-ALA orally before surgery. After the induction of anesthesia, his blood pressure decreased substantially. Although we administered various vasopressor agents, hypotension was prolonged. However, after starting a continuous administration of AVP, the systolic blood pressure increased, and the hemodynamic parameters remained stable during the remainder of the operation. 5-ALA administration may lower blood pressure by inducing nitric oxide production, and AVP inhibits inducible nitric oxide synthase messenger RNA expression and interleukin-1β-stimulated nitric oxide production. In light of these mechanisms, AVP may be a reasonable treatment agent for hypotension induced by 5-ALA.
Rehabilitation, Using Guided Cerebral Plasticity, of a Brachial Plexus Injury Treated with Intercostal and Phrenic Nerve Transfers
Authors: Lars B Dahlin, Gert Andersson, Clas Backman, Hampus Svensson, Anders Björkman
Journal: Front Neurol (2017)
Keywords: brachial plexus injury, cerebral plasticity, electromyography, guided plasticity, intercostal nerve, nerve transfer, phrenic nerve, rehabilitation
MeSH terms: Case Reports

Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5-C7 and a non-rupture of C8-T1, was operated 3 weeks after the injury with nerve transfers: (a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve. A second operation-free contralateral gracilis muscle transfer directly innervated by the phrenic nerve-was done after 2 years due to insufficient recovery of the biceps muscle function. One year later, electromyography showed activation of the biceps muscle essentially with coughing through the intercostal nerves, and of the transferred gracilis muscle by deep breathing through the phrenic nerve. Voluntary flexion of the elbow elicited clear activity in the biceps/gracilis muscles with decreasing activity in intercostal muscles distal to the transferred intercostal nerves (i.e., corresponding to eighth intercostal), indicating cerebral plasticity, where neural control of elbow flexion is gradually separated from control of breathing. To restore voluntary elbow function after nerve transfers, the rehabilitation of patients operated with intercostal nerve transfers should concentrate on transferring coughing function, while patients with phrenic nerve transfers should focus on transferring deep breathing function.
Case report: Transapical transcatheter double valve-in-valve replacement of degenerated aortic and mitral bioprosthetic valves with limited radiopaque landmarks
Authors: Jiawei Zhou, Yuehuan Li, Haibo Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: j-valve, tvi-transcatheter valve implantation, double valve-in-valve replacement, structural valve deterioration, transapical
MeSH terms: Case Reports

A 67-year-old male patient who had undergone double valve replacement 11 years before presented with severe dyspnea to our department. The bioprosthetic aortic and mitral valves have failed. Because of the high risk of redo surgery. We perform a simultaneous transapical transcatheter valve-in-valve replacement of degenerated aortic and mitral bioprosthetic valves with limited radiopaque landmarks using the second-generation self-expanding J-valve. The post-operative course was stable and the patient was discharged on post-operative day eight.
Importance of the Right Protocol in Using a Diode Laser (980 nm) for Small Oral Vascular Malformation Treatment
Authors: Marcia M Vidor, Luciane Hiramatsu Azevedo, Patrícia Moreira de Freitas
Journal: Cureus (2023)
Keywords: clinical case report, diode laser, diode laser therapy, oral health, vascular lesions, venous disease
MeSH terms: Case Reports

Small vascular anomalies are commonly present on the lips and other areas of the oral mucosa. These lesions are also known as venous lake lesions, and they can be treated in many ways with surgical and non-surgical methods. Laser is an arising technique for this type of procedure and its use has been growing in dental practices in the last years. The technique that uses the diode laser delivers the energy in a non-contact treatment, leading to the coagulation of the lesion in a minimally invasive manner, and for this reason, there is less chance of developing scar formation. In this report, a 56-year-old female patient had a vascular lesion on her lower lip measuring about 3.0 mm in diameter. The patient reported having it for more than 10 years. A first approach using a high-power diode laser had already been done but with no success. At this time, the diode laser was used under local anesthesia, with a flexible quartz fiber held 2 to 3 mm from the lesion, using the continuous wave mode set, 1.0 W of power for 10 seconds, with an interval of 30 seconds to prevent heat damage to the adjacent tissue. The laser was applied until the lesion appeared white and with evidence of shrinkage. In this case, two rounds of irradiation were done. After a 30-day follow-up, the lesion was repaired with no signs of scars on the lip. The diode laser is an effective technique for treating this type of lesion, with many advantages, such as providing coagulation, excellent healing, no postoperative complication, and no need for suturing. Besides all, it is also a low-cost procedure, small lesions usually require only one appointment, and this treatment is also better accepted by the patients.
Primary papillary carcinoma of the thyroglossal duct in a 14-year-old female: case report and review of the literature
Authors: Amel El Korbi, Jihène Houas, Rachida Bouatay, Khaled Harrathi, Jamel Koubaa
Journal: Pan Afr Med J (2019)
Keywords: thyroglossal cyst, papillary carcinoma, surgery
MeSH terms: Thyroglossal Cyst / pathology, Thyroid Cancer, Papillary / therapy, Thyroid Neoplasms / therapy, Case Reports, Review, Adolescent, Female, Humans, Iodine Radioisotopes / administration & dosage, Thyroid Cancer, Papillary / diagnosis, Thyroid Cancer, Papillary / pathology, Thyroid Neoplasms / diagnosis, Thyroid Neoplasms / pathology, Thyroidectomy / methods, Thyroxine / administration & dosage, Iodine Radioisotopes, Thyroxine

Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons.
An Italian Case of Disseminated Histoplasmosis Associated with HIV
Authors: Chiara Papalini, Barbara Belfiori, Giovanni Martino, Rita Papili, Lucia Pitzurra, Stefano Ascani, Maria Bruna Pasticci
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries.
Severe irritability in a critically ill preterm infant: a case of delirium at the neonatal intensive care unit
Authors: Lucas Hirano Arruda Moraes, Vanessa Lisbethe Bezerra Maropo, Ivete Zoboli, Mário Cícero Falcão, Werther Brunow de Carvalho
Journal: Dement Neuropsychol (2023)
Keywords: analgesia, delirium, infant, newborn, neonatal abstinence syndrome, quetiapine fumarate
MeSH terms: Case Reports

Delirium is a common disorder in intensive care units, being associated with greater morbidity and mortality. However, in neonatal intensive care units, delirium is rarely diagnosed, due to the low familiarity of the neonatologist with the subject and the difficulties in the applicability of diagnostic questionnaires. This case report aimed to assess the presence of this disorder in this group of patients and identify the difficulties encountered in the diagnosis and treatment. We report the case of a premature newborn with necrotizing enterocolitis during hospitalization and underwent three surgical approaches. The newborn exhibited intense irritability, having received high doses of fentanyl, dexmedetomidine, clonidine, ketamine, phenytoin, and methadone, without the control of the symptoms. A diagnosis of delirium was then made and treatment with quetiapine was started, with a complete reversal of the symptoms. This is the first case reported in Brazil and the first describing the withdrawal of the quetiapine.
Pediatric Granular Cell Tumor of the Breast: A Case Report and Review of the Literature
Authors: Nathan P Heinzerling, Shannon M Koehler, Sara Szabo, Amy J Wagner
Journal: Case Rep Surg (2015)

Objective. Granular cell tumors arise from neurogenic mesenchymal stem cells and can occur anywhere throughout the body. They rarely present as breast masses and should be included in the differential diagnosis of pediatric breast neoplasms. We report a rare presentation of a pediatric breast granular cell tumor and a review of the literature. Participant. A 15-year-old female presented with an enlarging breast mass. She underwent ultrasound imaging and excisional biopsy, which revealed a granular cell tumor. Granular cell tumors of the breast are difficult to diagnose using ultrasound and mammography due to numerous similarities to other breast masses. Histopathologic staining best differentiates breast granular cell tumors from other breast masses with their positive staining for S100, CD68, and neurospecific enolase. Conclusion. Although rare, granular cell tumors of the breast should be considered as a possible diagnosis for pediatric breast masses to allow for proper management and follow-up for these patients. Although rare, these tumors do have malignant potential necessitating a correct and timely diagnosis.
Malignant Phyllodes Tumor of the Breast with Metastasis to the Pancreas: A Case Report and Review of Literature
Authors: R A Amir, Rola S Rabah, S S Sheikh
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Phyllodes tumor (PT) is a rare tumor of the breast accounting for approximately 1% of all breast neoplasms. In 1838, J. Muller coined the term "cystosarcoma phyllodes" based on the leaf-like projections of the tumor extending into the cystic spaces and sarcomatous stromal growth. However, seeing as up to 70% of phyllodes tumors are benign, "cystosarcoma" was removed, and the tumor is now recognized simply as phyllodes tumor. It is mainly seen in females between the ages of 35 and 55. Although most phyllodes tumors are benign, malignant cases do uncommonly occur, 22% of which have distant metastasis typically to the lungs and bones. Rarely, this tumor metastasizes to other locations. Herein, we report a case of malignant phyllodes tumor with metastasis to the pancreas. According to our knowledge, only 3 case reports of pancreatic metastasis from malignant phyllodes tumor have been reported in literature thus far. We aim to increase awareness among physicians of this rare metastasic potential of the uncommonly encountered malignant phyllodes tumor.
Long-Term Follow-Up of Refractory Large Macular Hole with Autologous Neurosensory Retinal Free Flap Transplantation
Authors: Po-Yen Lee, Yo-Chen Chang, Pei-Kang Liu, Tzu-En Kao, Horng-Jiun Wu, Kuo-Jen Chen, Kwou-Yeung Wu, Kai-Chun Cheng, Wen-Chuan Wu
Journal: J Ophthalmol (2022)

Purpose:
To evaluate the long-term anatomic and functional outcomes of autologous neurosensory retinal free flap transplantation (ART) for patients with refractory large macular hole (MH).
Design:
Retrospective interventional case series.
Methods:
We reviewed 9 patients who underwent ART for their refractory large MH. In this extended follow-up study, postoperative assessment including spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) were recorded at 12, 15, 18, 21, and 24 months after surgery.
Results:
The macular hole of all patients appeared successfully closed during the whole follow-up period. The mean logMAR BCVA improved from 1.61 ± 0.44 (preoperative) to 0.72 ± 0.30 (12 months after surgery) (p < 0.001). Thereafter, the mean BCVA remained stable at each follow-up. At the mean 16.0 ± 0.8 months postoperatively, inner retinal cystic changes were observed in 4 eyes (44.4%), but these did not significantly affect vision.
Conclusion:
ART is a good alternative technique for closing large refractory macular holes. Although inner retinal cystic changes were observed in 4 eyes (44.4%), this phenomenon did not significantly affect visual acuity. It provides long-term good anatomical and functional results, especially in cases where insufficient ILM or lens capsule are left.