OpenMed/multicare-articles huggingface dataset:
Melanoma Marjolin's ulcer in the hand: A case report
Authors: Rafaela Pais Serras, David Carvalho Rasteiro, Maria Manuel Mendes, Maria Manuel Mouzinho
Journal: Int J Surg Case Rep (2019)
Keywords: burn scar, case report, chronic wound, marjolin’s ulcer, melanoma, skin cancer

Introduction:
Burn scars have the potential to malignant transformation, creating an identity named Marjolin's ulcer. This term refers to any scar in a traumatized skin that degenerates into a skin cancer. The majority of them are derived from burns that were not grafted, appearing several years later. The most frequent type is squamous cell carcinoma with few cases of melanoma described in the literature. This last one accounts for a poor prognosis.
Case presentation:
Female, 74 years old, presents to our department with a malignant melanoma arising from a thermal burn scar in the right thenar eminence 14 years after the initial injury. The lesion was excised and the defect covered by a full thickness skin graft. At 6 months post-operatively there are no signs of locoregional recurrence or systemic dissemination.
Discussion:
Malignant melanoma arising from a burn scar is extremely rare and the pathogenesis is unknown. Many theories try to explain this low incidence and the factors that contribute to degenerative changes of melanocytes in the affected skin.
Conclusion:
Health professionals must consider this pathology when evaluating a burn scar or a chronic wound, performing a biopsy when suspicion is high. An early diagnosis, a prompt surgical intervention and a greater vigilance are the keys to success and survival.
Minimally Invasive Surgery for Pediatric Adrenal Masses-Report on Four Cases
Authors: Ahmed ElHaddad, Christoph Castellani, Erich Sorantin, Martin Benesch, Eva Kampelmühler, Georg Singer, Holger Till
Journal: European J Pediatr Surg Rep (2019)
Keywords: adrenal, laparoscopy, oncology, tumor
MeSH terms: Case Reports

The dignity of adrenal masses in children varies from benign lesions like adenoma and ganglioneuroma to malignant tumors like adrenocortical carcinoma and neuroblastoma. Any surgical approach, especially minimally invasive surgery (MIS), requires careful risk stratification based on oncological and technical criteria. Herein, we present four patients who underwent MIS for adrenal masses. Laboratory testing differentiated between simple cysts and adenoma, but could not identify a child with adrenocortical tumor preoperatively. Analysis of image-defined risk factors excluded vascular encasement in all cases. All patients underwent laparoscopic adrenalectomy without complications. Histopathology revealed simple cyst, ganglioneuroblastoma, adenoma, and potentially malignant adrenocortical tumor in one patient/case each. All specimen showed clear margins and no recurrence was noted at a mean follow-up of 18 months.
Timing Embryo Preservation for a Patient with High-Risk Newly Diagnosed Acute Myeloid Leukemia
Authors: Rebecca Ye, Benjamin Tomlinson, Marcos de Lima, Ehsan Malek
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Great strides have been made in the treatment of acute myeloid leukemia (AML) resulting in increased number of survivors over all age groups, but especially in patients of reproductive age. Given the gonadotoxicity of high-dose induction chemotherapy and subsequent allogeneic stem cell transplant, it is paramount that fertility preservation options are discussed and explored at the time of diagnosis as fertility preservation has been associated with greater quality of life in survivors. Starting the conversation early is especially important for female patients given the time needed for all currently available fertility preservation techniques. Furthermore, due to a lack of current guidelines for the optimal timing of treatment, patients often encounter difficulties trying to balance life-saving treatment and fertility preservation. We present a case of female patient of reproductive age diagnosed with AML who opted for ovarian stimulation, oocyte retrieval, and subsequent IVF following a cycle of induction chemotherapy with satisfactory results for both embryo generation and disease treatment.
Measures to Contain the Transmission of Hepatitis C in a Chronic Kidney Care Hospital Unit in the Triângulo Mineiro in Brazil: A Case Study
Authors: Geisa Perez Medina Gomide, Lívia Helena de Morais Pereira, Fernanda Carolina Camargo, Lara Maximiano Rodrigues, Regiane da Silva Souza, Isadora Vieira de Melo, Thayná Andreza Ribeiro Pereira, Cristina da Cunha Hueb Barata de Oliveira
Journal: Int J Public Health (2023)
Keywords: epidemiology, hemodialysis units, hepatitis c, hospital, patient care team, public health services
MeSH terms: Hepacivirus, Hepatitis C / epidemiology, Hepatitis C / prevention & control, Brazil / epidemiology, Hemodialysis Units, Hospital, Humans, Kidney, Prevalence, Renal Dialysis / adverse effects

Objectives: Hepatitis C virus elimination is complex. The objective was to analyze measures to eliminate virus transmission in a hemodialysis unit. Methods: Case study composed of multiple units of analysis. The scenario is the hemodialysis unit of a Brazilian public hospital. Population composed of health service records. Descriptive analyzes were performed and the beginning of the event was considered as the moment of increased incidence of HCV. The intentional and purposeful collection of information for understanding the event and implementing interventions. Results: The subunits of analysis were related to: clinical-epidemiological profile, active search, transmission routes, management protocol and results achieved. In August 2019, out of 45 patients, six were reactive for anti-HCV. All received treatment. Patients had exposure to contaminated medical equipment, objects or hands of professionals. Preventive measures were adopted and routine techniques were corrected. Situational Analysis Committee guided the management of the event. No new cases were detected. Conclusions: Strategies for the microelimination of the C virus in a dialysis environment are demonstrated and it shows the multidisciplinary efforts in conducting the event.
Connectivity-based parcellation of the thalamus explains specific cognitive and behavioural symptoms in patients with bilateral thalamic infarct
Authors: Laura Serra, Mara Cercignani, Giovanni A Carlesimo, Lucia Fadda, Nadia Tini, Giovanni Giulietti, Carlo Caltagirone, Marco Bozzali
Journal: PLoS One (2013)
MeSH terms: Behavioral Symptoms / physiopathology, Cerebral Infarction / physiopathology, Cognition, Magnetic Resonance Imaging, Nerve Net / physiopathology, Thalamic Diseases / physiopathology, Thalamus / pathology, Thalamus / physiopathology, Case Reports, Adult, Brain Mapping, Cerebral Infarction / pathology, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Thalamic Diseases / pathology

A novel approach based on diffusion tractography was used here to characterise the cortico-thalamic connectivity in two patients, both presenting with an isolated bilateral infarct in the thalamus, but exhibiting partially different cognitive and behavioural profiles. Both patients (G.P. and R.F.) had a pervasive deficit in episodic memory, but only one of them (R.F.) suffered also from a dysexecutive syndrome. Both patients had an MRI scan at 3T, including a T1-weighted volume. Their lesions were manually segmented. T1-volumes were normalised to standard space, and the same transformations were applied to the lesion masks. Nineteen healthy controls underwent a diffusion-tensor imaging (DTI) scan. Their DTI data were normalised to standard space and averaged. An atlas of Brodmann areas was used to parcellate the prefrontal cortex. Probabilistic tractography was used to assess the probability of connection between each voxel of the thalamus and a set of prefrontal areas. The resulting map of corticothalamic connections was superimposed onto the patients' lesion masks, to assess whether the location of the thalamic lesions in R.F. (but not in G. P.) implied connections with prefrontal areas involved in dysexecutive syndromes. In G.P., the lesion fell within areas of the thalamus poorly connected with prefrontal areas, showing only a modest probability of connection with the anterior cingulate cortex (ACC). Conversely, R.F.'s lesion fell within thalamic areas extensively connected with the ACC bilaterally, with the right dorsolateral prefrontal cortex, and with the left supplementary motor area. Despite a similar, bilateral involvement of the thalamus, the use of connectivity-based segmentation clarified that R.F.'s lesions only were located within nuclei highly connected with the prefrontal cortical areas, thus explaining the patient's frontal syndrome. This study confirms that DTI tractography is a useful tool to examine in vivo the effect of focal lesions on interconnectivity brain patterns.
Repetitive complete molar pregnancy in a 54-year-old patient in a time distance of eighteen years from the first incident: case report and mini review
Authors: Polychronis Oikonomidis, Basileios Pergialiotis, Elina Pitsouni, Stavros Natsis, Antonios Lagkadas, Konstantinos Giannakopoulos
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report a case of complete hydatidiform mole in a 54-year-old patient referred to Gynecology department of General Hospital of Athens "Laiko", with history of previous molar pregnancy at the age of thirty-six. Our purpose was to indicate the advanced maternal age beside the long recurrence distance of the disease, which was eighteen years after the first molar pregnancy. Our diagnostic approach was through measurement of serum beta-human chorionic gonadotropin (β-HCG) and pelvic ultrasound evaluation, and the chosen therapeutic approach was abdominal hysterectomy and bilateral salpingoophorectomy.
Iodine-123-meta-iodobenzylguanidine Myocardial Scintigraphy in Isolated Autonomic Failure: Potential Red Flag for Future Multiple System Atrophy
Authors: Francesca Baschieri, Giovanna Calandra-Buonaura, Annagrazia Cecere, Giorgio Barletta, Manuela Contin, Piero Parchi, Pietro Cortelli
Journal: Front Neurol (2017)
Keywords: iodine-123-meta-iodobenzylguanidine myocardial scintigraphy, parkinson’s disease, autonomic failure, multiple system atrophy, orthostatic hypotension
MeSH terms: Case Reports

Pure autonomic failure is challenging as it can be the presenting feature of a central nervous system syncleinopathy such as Parkinson's disease (PD) or multiple system atrophy (MSA). Because the prognosis of MSA and PD is so different, predictive features for a possible conversion can be extremely valuable. In this paper, we report three cases (two with autopsy-proven diagnosis) that had isolated AF for many years before converting to MSA or PD. Of all the tests that were performed during the premotor stage, Iodine-123-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy was predictive of the conversion to MSA. We suggest that MIBG myocardial scintigraphy, when performed in patients with isolated AF, may be a valuable predictor of conversion to MSA. On the contrary, the role of such test in parkinsonian patients irrespective of the presence of AF is still to be clarified.
Myelodysplastic Syndrome with Transfusion Dependence Treated with Venetoclax
Authors: Waqas Jehangir, Alexander Karabachev, Taimoor Jahangir, Elvira Umyarova
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Myelodysplastic syndromes are characterized by ineffective hematopoiesis in one or more lineages of the bone marrow. They are a group of heterogeneous clonal stem cell malignancies with a high risk to progress to acute myeloid leukemia. Currently, there are no curative FDA-approved medications for myelodysplastic syndromes. Hematopoietic cell transplantation is potentially the only curative option; however, treatment is often unavailable due to age and comorbidities. Hypomethylating agents, azacitidine and decitabine, and the immunomodulatory agent, lenalidomide, are the only FDA approved medications for the treatment of MDS, all of which are noncurative. Venetoclax, an inhibitor of the antiapoptotic protein BCL-2 used to treat chronic lymphocytic leukemia, is currently being evaluated in clinical trials as a monotherapy in high-risk myelodysplastic syndromes/acute myeloid leukemia. We present a patient with transfusion-dependent myelodysplastic syndromes refractory to the current standard of care treatment not a candidate for hematopoietic cell transplantation who responded well to monotherapy treatment with venetoclax and has since remained transfusion-independent.
Ibrutinib Plus R-ICE Induces Remission in Blastoid Variant Mantle Cell Lymphoma with CNS Relapse
Authors: Timothy S Oh, Madelyn Burkart, Amir Behdad, Hatice Savas, Reem Karmali
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Mantle cell lymphoma (MCL) is an aggressive, difficult to treat subtype of lymphoma, resulting in relapses and poor outcomes. Novel agents such as Bruton tyrosine kinase (BTK) inhibitors have been studied in the treatment of relapsed/refractory (R/R) MCL. BTK inhibitor ibrutinib, in particular, has demonstrated improvement in survival outcomes of R/R MCL. Despite these advancements, many cases of MCL, including the more aggressive blastoid and pleomorphic variants, will undergo disease progression leading to poor survival outcomes. Blastoid variant MCL is associated with an increased risk of central nervous system (CNS) involvement, causing high mortality rates. In this case report, we discuss a patient with a diagnosis of blastoid MCL with CNS relapse who achieved a complete response (CR) after receiving standard rituximab plus ifosfamide-carboplatin-etoposide (R-ICE) salvage chemotherapy with the addition of ibrutinib. The patient subsequently underwent autologous stem cell transplantation (autoSCT) and maintained CR with ibrutinib maintenance.
A case of Meigs syndrome mimicking metastatic breast carcinoma
Authors: Sophocles Lanitis, Sivahamy Sivakumar, Kasim Behranwala, Emmanouil Zacharakis, Ragheed Al Mufti, Dimitri J Hadjiminas
Journal: World J Surg Oncol (2009)
MeSH terms: Breast Neoplasms / diagnosis, Carcinoma, Ductal, Breast / diagnosis, Fibroma / diagnosis, Meigs Syndrome / diagnosis, Ovarian Neoplasms / diagnosis, Case Reports, Antineoplastic Agents / therapeutic use, Breast Neoplasms / blood, CA-125 Antigen / blood, Carcinoma, Ductal, Breast / blood, Diagnosis, Differential, Female, Fibroma / drug therapy, Gynecologic Surgical Procedures, Humans, Letrozole, Mastectomy, Meigs Syndrome / blood, Meigs Syndrome / therapy, Middle Aged, Nitriles / therapeutic use, Ovarian Neoplasms / drug therapy, Pleural Effusion / diagnosis, Pleural Effusion / drug therapy, Triazoles / therapeutic use, Antineoplastic Agents, CA-125 Antigen, Nitriles, Triazoles, Letrozole

Background:
Adnexal masses are not uncommon in patients with breast cancer. Breast cancer and ovarian malignancies are known to be associated. In patients with breast cancer and co-existing pleural effusions, ascites and adnexal masses, the probability of disseminated disease is high. Nevertheless, benign ovarian masses can mimic this clinical picture when they are associated with Meigs' syndrome making the work-up and management of these patients challenging. To our knowledge, there are no similar reports in the literature and therefore we present this case to highlight this entity.
Case presentation:
A 56-year old woman presented with a 4 cm, grade 2, invasive ductal carcinoma of her left breast. Pre-treatment staging investigations showed a 13.5 cm mass in her left ovary, a small amount of ascites and a large right pleural effusion. Serum tumour markers showed a raised CA125 supporting the malignant nature of the ovarian mass. The cytology from the pleural effusion was indeterminate but thoracoscopic biopsy failed to show malignancy. The patient was strongly against mastectomy and she was commenced on neo-adjuvant Letrozole 2.5 mg daily with a view to perform breast conserving surgery. After a good response to the hormone manipulation, the patient had breast conserving surgery, axillary sampling and laparoscopic excision of the ovarian mass which was eventually found to be a benign ovarian fibroma.
Conclusion:
Despite the high probability of disseminated malignancy when an ovarian mass associated with ascites if found in a patient with a breast cancer and pleural effusion, clinicians should be aware about rare benign syndromes, like Meigs', which may mimic a similar picture and mislead the diagnosis and management plan.
Development of Hepatocellular Carcinoma in a Patient with Chronic Hepatitis C 21 Years after Achieving a Sustained Virological Response to Interferon Therapy
Authors: Tasuku Hara, Tomoya Ohara, Masashi Taniguchi, Toshiaki Sakai, Kohei Oka, Naoto Iwai, Toshifumi Tsuji, Takashi Okuda, Toshiyuki Komaki, Junichi Sakagami, Keizo Kagawa
Journal: Case Reports Hepatol (2020)
MeSH terms: Case Reports

A 77-year-old man with chronic hepatitis C (CH-C) infection, who achieved a sustained virological response (SVR) to interferon (IFN) therapy, was followed up regularly. Before IFN therapy, he did not have metabolic diseases, and the histological diagnosis of his chronic hepatitis was stage-3 fibrosis. After achieving SVR, the fibrosis-4 (FIB-4) index level dropped once but gradually increased. 21 years after SVR, hepatocellular carcinoma (HCC) was diagnosed by dynamic computed tomography. The HCC was 12 mm in diameter. The HCC was treated with radiofrequency ablation. CH-C patients with advanced fibrosis require long-term follow-up, even after achieving SVR.
An Interesting Case of a 57-Year-Old Male with an Upper Gastrointestinal Bleeding and Obstructive Uropathy with Bilateral Hydronephrosis Diagnosed with Systemic Mucormycosis
Authors: Dora E Izaguirre-Anariba, Felicia Chee, Zeyar Thet, Jesus Lanza
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Mucormycosis is a rare and invasive fungal disease with high mortality rate caused by members of the order Mucorales. Mucorales species are vasotrophic organisms that may cause angioinvasive disease in immunosuppressed hosts. Risk factors include diabetic ketoacidosis, chronic kidney disease, organ or bone marrow transplantation, neutropenia, burns, malignancies, and steroid therapy. There are six different clinical presentations of mucormycosis, which includes rhino-orbital cerebral, pulmonary, gastrointestinal, cutaneous, disseminated, and miscellaneous infection. Here, we report a case of a 57-year-old male with stage-IV sarcoidosis on long-term steroids presenting with upper gastrointestinal bleeding and obstructive uropathy who was diagnosed with systemic mucormycosis. Biopsy obtained by endoscopy revealed necrotic debris with acute leukocytic exudate and numerous variably sized, 90-degree angulated fungal hyphae favoring mucormycosis-causing species. Imaging studies showed hydronephrosis, and cystoscopy findings were consistent with fungal infection of the bladder. Isavuconazonium sulfate was used as systemic salvage therapy along with continuous bladder irrigation with amphotericin-B for localized bladder infection after a trial with first-line systemic treatment with intravenous liposomal amphotericin-B failed. A repeat endoscopy showed inflammatory changes with a pathology report in which mucormycosis was no longer appreciated. The patient was discharged home to complete 6 months of antifungal therapy with monthly follow-ups. The patient has been asymptomatic after 12-month completion of therapy.
Case report: An adult intussusception caused by ascending colon cancer
Authors: Guowei Zhao, Wenjun Meng, Lian Bai, Qigang Li
Journal: Front Surg (2022)
Keywords: adult intussusception, case report, colon cancer, colonoscopy, computed tomography
MeSH terms: Case Reports

Adults with bowel intussusception caused by malignant tumors are fairly uncommon. We presented a case of a 64-year-old woman whose intussusception was secondary to ascending colon cancer. A color Doppler ultrasonography of the abdomen revealed a low echo mass in the right middle abdomen. Physical examination and digital rectal examination were both unremarkable. Computed tomography (CT) revealed a concentric circle change in the colon, as well as the mesenterium and arteries. Electronic colonoscopy discovered the colonic giant proliferative lesions and stenosis. Adenocarcinoma with moderate differentiation was discovered after a biopsy. Then laparotomy showed intussusception and the tumor was located in the ascending colon. The postoperative pathological test revealed moderately differentiated adenocarcinoma in the right colon invaded the whole layer. After hospitalization, the patient was discharged without any complications. This case highlights that rational use of CT, endoscopy, and timely surgery combines an effective strategy for the treatment of adult intussusception.
Spontaneous intracerebral haemorrhage in a child
Authors: Amit Agrawal, Vikram Jeet Singh Dhingra
Journal: APSP J Case Rep (2012)
Keywords: intracerebral haematoma, spontaneous intracerebral haemorrhage
MeSH terms: Case Reports

Spontaneous intracerebral haemorrhage (SICH) is a rare occurrence in children, with different aetiological factors, clinical characteristics and prognosis. A 14 year male child had sudden onset of headache associated with multiple vomiting. Magnetic resonance imaging showed deep seated intracerebral haematoma. Haematoma was evacuated successfully and child recovered without deficits. A high index of suspicion is necessary for the diagnosis of spontaneous intracerebral haemorrhage in children.
PAX2 Mutation-Related Renal Hypodysplasia: Review of the Literature and Three Case Reports
Authors: Yu-Ming Chang, Chih-Chia Chen, Ni-Chung Lee, Junne-Ming Sung, Yen-Yin Chou, Yuan-Yow Chiou
Journal: Front Pediatr (2022)
Keywords: pax2, chronic kidney disease (ckd), congenital anomalies of kidney and urinary tract (cakut), renal coloboma syndrome, renal hypodysplasia
MeSH terms: Case Reports

Paired box 2 (PAX2)-related disorder is an autosomal dominant genetic disorder associated with kidney and eye abnormalities and can result in end stage renal disease (ESRD). Despite reported low prevalence of PAX2 mutations, the prevalence of PAX2 related disorders may have been underestimated in past studies. With improved genetic sequencing techniques, more genetic abnormalities are being detected than ever before. Here, we report three patients from two families with PAX2 mutations identified within 1 year. Two patients were adults with chronic kidney disease and were followed for decades without correct diagnoses, including one with ESRD who had even undergone kidney transplant. The third patient was a neonate in whom PAX2-related disorder manifested as oligohydramnios, coloboma, and renal failure that progressed to ESRD within 1 year after birth. The phenotypes of PAX2 gene mutation were shown to be highly variable, even within the same family. Early detection promoted genetic counseling and guided clinical management. The appropriate time point for genetic study is an important issue. Clinicians must be more alert for PAX2 mutation when facing patients with congenital kidney and urinary tract anomalies, chronic kidney disease of unknown etiology, involvement of multiple systems, and/or a family history of renal disease.