OpenMed/multicare-articles huggingface dataset:
Case report: IgG4-related intracranial lesions mimicking multiple sclerosis in a 14-year-old girl
Authors: Pingying Qing, Chenyang Lu, Bing Yan, Chang Liu, David A Fox, Yi Zhao, Yi Liu, Chunyu Tan
Journal: Front Neurol (2022)
Keywords: igg4-related disease, brain parenchyma, lymphadenopathy, magnetic resonance imaging, multiple sclerosis
MeSH terms: Case Reports

Objectives:
IgG4-related disease (IgG4-RD) is distinguished by the infiltration of IgG4-positive plasma cells in a variety of tissues and organs. Even so, central nervous system lesions associated with IgG4-RD are scarce. We present a case of IgG4-related brain parenchymal lesions that mimics multiple sclerosis in a young girl.
Methods:
The patient was followed by our neurology and rheumatology teams. Clinical information was recorded, and the brain was screened using magnetic resonance imaging (MRI). During follow-up, we examined serum IgE, IgG and IgG4 and lymph node biopsy.
Results:
Here, we presented details of a 14-year-old Chinese girl suffering from diplopia, left eyelid ptosis, right facial numbness, and right lower limb weakness admitted to our institute. Brain MRI revealed multiple sclerosis-like lesions in the brain parenchyma and spinal cord. During the follow-up, she developed lymphadenopathy. Elevation of serum, IgG, IgG4 and IgE and lymph node biopsy favors a diagnosis of IgG4-RD. The patient had a good response to glucocorticoids and mycophenolate mofetil. The literature review summarized eight previously reported IgG4-RD involving brain parenchyma.
Discussion:
Our case expands the known age spectrum of IgG4-RD. The intracranial IgG4-RD is rare and could mimic multiple sclerosis. Careful examination and dynamic review of disease history are crucial in the differential diagnosis.
Spontaneous Retroperitoneal Bleeding as a Complication of Unusual Renal Paraganglioma
Authors: Tawfeeq I Sangey, Hamim Abdul Rusheke, Ansaar I Sangey, Nimishkumar Chaya, Advera Ngaiza
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Spontaneous retroperitoneal bleeding is a rare occurrence that might have catastrophic implications. We present a 58-year-old male with a 4-day history of progressively worsening left-sided flank pain due to retroperitoneal hemorrhage from a nonfunctional renal paraganglioma. Abdominal contrast CT scan was helpful in locating the tumor, estimating tumor size and extent of bleeding, visualizing the interaction between the tumor and the surroundings, and ruling out any potential metastasis; however, it lacked specificity in identifying the origin of the mass, needing histologic investigation for a conclusive diagnosis. MRI was not available at our center. We report a rare case of spontaneous retroperitoneal bleeding as a complication of an unusual nonfunctional renal paraganglioma, which was initially misdiagnosed as renal cell carcinoma but later confirmed by postoperative histopathology.
Management of Choroidal Neovascularization Associated with Optic Disc Melanocytoma with Intravitreal Aflibercept: A Case Report and Review of the Literature
Authors: Hany S Hamza, Magdy Moussa, Abdelrahman M Elhusseiny
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Purpose:
To report a rare case of melanocytoma associated choroidal neovascularization (CNV) treated with intravitreal aflibercept.
Methods:
We reviewed the literature for the previous reports and different methods of treatment.
Results:
Optic disc melanocytoma has been considered as a benign melanocytic tumor that rarely affects vision. There is evidence in the literature of association between choroidal neovascular membrane and disc melanocytoma.
Conclusions:
In conclusion, our article provides a review of literature of such a rare association in which the ophthalmologists must be aware of its occurrence and possible ways of management.
Benign Cementoblastoma Associated with an Impacted Third Molar inside Maxillary Sinus
Authors: Rafael Correia Cavalcante, Maria Fernanda Pivetta Petinati, Edimar Rafael de Oliveira, Isabela Polesi Bergamaschi, Nelson Luis Barbosa Rebelatto, Leandro Klüppel, Rafaela Scariot, Delson João da Costa
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Cementoblastoma is a rare and benign odontogenic mesenchymal tumor, often characterized by the formation of cementum-like tissue produced by neoplastic cementoblasts attached to or around the roots of a tooth.
Case report:
22-year-old male patient was referred to the Federal University of Paraná after occasional finding on a routine panoramic radiograph. Clinical examination suggested no alterations. Medical and family history presented no alterations as well. Computed tomographic (CT) showed the presence of a radiopaque area associated with the roots of the impacted third molar measuring 15 mm × 10 mm inside the left maxillary sinus. The treatment plan suggested was to surgically remove it under general anesthesia. An intraoral approach was conducted, using the Newmann incision from the superior left first molar to the retromolar area with anterior and posterior relaxant incisions. Using a Caldwell-Luc access next to the maxillary tuberosity region, the maxillary sinus was exposed and the calcified mass attached to the roots of the tooth was reached. Pathological mass removed was sent for histopathological investigation. Examination revealed dense, mineralized, cementum-like material and vascular soft tissue areas that consisted of cementoblasts. One-year follow-up shows no recurrence and absence of symptoms.
Oral lesion as unusual first manifestation of multiple myeloma: case reports and review of the literature
Authors: A Romano, M S Marescalco, Chiara Liardo, L Villari, C Vetro, C Conticello, F Di Raimondo, S Ferlito
Journal: Case Rep Hematol (2014)

Extramedullary plasmacytoma (EMP) and solitary bone plasmacytoma (SBP) represent a disease continuum through a multistage process of cell differentiation, survival, proliferation, and dissemination, strictly related to multiple myeloma (MM), the second most common hematological malignancy. Herein, we report two cases of recurrent oral plasmacytoma progressed to MM, in which the first clinical sign of a more widespread disease was limited to the mouth. Based on our experience, we recommend a strict workup for the differential diagnosis between EMP, SBP, and MM for patients with oral plasmacytoma, including radiological exam of the skeleton, magnetic resonance imaging (MRI) of the bone, and positive emission tomography (FDG-PET). MRI and possibly PET can all be used to more sensitively detect EM plasmacytoma sites.
Glycopyrrolate in toxic exposure to ammonia gas
Authors: A Bhalla, S Mahi, N Sharma, S Singh
Journal: J Emerg Trauma Shock (2011)
Keywords: ammonia, anti-cholinergic, glycopyrrolate, hoarseness of voice, inhalational injury, toxic gas, toxic gas inhalation, vocal cord injury
MeSH terms: Case Reports

Ammonia (NH(3)) is a highly water-soluble, colorless, irritant gas with a unique pungent odor. Liquid ammonia stored under high pressure is still widely used for refrigeration in cold stores used for storing grains. Severe toxicity may occur following accidental exposure. We report an interesting case of accidental exposure to ammonia treated with glycopyrrolate along with other supportive measures.
Spontaneous posterior rectus sheath hernia: A case report and literature review
Authors: Fatima Alshayeb, Layth Al-Karaja, Ahmadullah Musleh Abu Yousef, Jalal Ahmad Taqatqa, Rafiq M A Salhabb, Mohammad Eid Al Mohtasib
Journal: Int J Surg Case Rep (2023)
Keywords: abdominal wall, case report, hernia, rectus sheath, rectus sheath hernia
MeSH terms: Case Reports

Introduction:
Hernias of the posterior rectus sheath are very rare abdominal wall hernias with only around 15 reported cases to date.
Clinical presentation:
This case report examines a 27-year-old female who is presented with epigastric abdominal pain and vomiting. An Abdomen CT scan was done and showed signs of SBO and herniation of the small bowel at the posterior rectus sheath. The patient underwent exploratory laparotomy that showed right-sided posterior rectus sheath obstructed hernia, which was repaired with primary closure. Postoperatively, the patient was doing well and was discharged on postoperative day 3 in good general condition.
Conclusion:
The patient had no complaints during her follow-up at one month. Due to its rarity and potential complications, it is also important to report this case to enhance the evidence base for posterior rectus sheath hernia and to familiarise this uncommon condition to radiologists, clinicians, and surgeons.
Endoscopic inguinal lymphadenectomy in penile cancer: case report and literature review
Authors: Juan Carlos Pérez Astigueta, Milagros Abad-Licham, Eloy Silva, Edgar Yan, Hugo Álvarez, Folker Agreda, Mariela Pow-Sang
Journal: Ecancermedicalscience (2015)
Keywords: endoscopy, inguinal lymphadenectomy, penile cancer
MeSH terms: Case Reports

Objectives:
The objective was to submit our first experience in endoscopic inguinal lymphadenectomy (EIL), evaluate the feasibility of the procedure and carry out a review of the literature.
Material and methods:
A 41-year-old patient was diagnosed with penile cancer with squamous cell carcinoma pT2G1 pathology, with no palpable inguinal lymph nodes. A bilateral inguinal lymphadenectomy was performed with preservation of the saphenous vein, conventional left and endoscopic right procedures. The perioperative data is presented and that obtained is discussed in the literature.
Results:
The total time was 270 minutes, 180 for endoscopic and 90 for conventional procedures. Blood loss was minimal in both cases. Fifteen lymph nodes were dissected on the endoscopic side, and 17 in the conventional side, the latter with more pain and devitalised skin flap.
Conclusions:
EIL for penile cancer is feasible and there is less morbidity with an early recovery. The literature is not conclusive on the indication of EIL.
Case report: Cerebellar swelling and hydrocephalus in familial hemophagocytic lymphohistiocytosis
Authors: Taro Yoshida, Kunihiko Moriya, Keisuke Oikawa, Shoko Miura, Yoshiko Asakura, Sachiko Tanifuji, Shuji Kusano, Mikiya Endo, Manami Akasaka
Journal: Front Pediatr (2022)
Keywords: cerebellar swelling, familial hemophagocytic lymphohistiocytosis, hydrocephalus, inborn errors of immunity, newborn screening (ns)
MeSH terms: Case Reports

Familial hemophagocytic lymphohistiocytosis (FHL) is a severe inborn error of immunity caused by a genetic defect that impairs the function of cytotoxic T and NK cells. There are only a few reported cases of FHL with diffuse swelling of the cerebellum and obstructive hydrocephalus. We report a case of FHL3 with neurological symptoms associated with cerebellar swelling and obstructive hydrocephalus. A male patient was hospitalized several times due to fever and decreased feeding, hepatosplenomegaly, and cytopenia since the first month of life. At 7 months of age, disturbance of consciousness was seen. Brain magnetic resonance imaging revealed signal intensity in the bilateral cerebellar hemispheres, diffusely increased periventricular white matter, and ventriculomegaly. Although he was treated with methylprednisolone pulse therapy, he was unresponsive to the treatment. He was then transferred to a local hospital after tracheotomy but died. Targeted clinical sequencing revealed a homozygous splice-site mutation in UNC13D. Pediatric hemophagocytic lymphohistiocytosis (HLH) includes some cases of central nervous symptom (CNS)-isolated HLH or CNS HLH preceding systemic lesions, which often do not initially meet the diagnostic criteria for FHL. Patients with FHL initiated by cerebellar symptoms may present with an atypical clinical course for HLH, leading to delayed diagnosis and poor outcomes. Despite the usefulness of a combination of a high percentage of lymphocytes in the peripheral leukocytes, a low lactate dehydrogenase level, and a high sIL-2R/ferritin ratio for identifying FHL, the diagnosis may be missed due to the absence of these results. Presymptomatic diagnosis of FHL by screening of newborns and subsequent early treatment of patients with a predicted poor prognosis may contribute to better outcomes.
Persistent Notochord in a Fetus with COL2A1 Mutation
Authors: Elisabeth Codsi, Brian C Brost, Arij Faksh, Amber K Volk, Kristi S Borowski
Journal: Case Rep Obstet Gynecol (2015)

Multiple anomalies including micromelia, poor mineralization of the vertebrae, and a persistent notochord were identified on second trimester ultrasound in a fetus with a COL2A1 mutation. To our knowledge, this represents the first case of a persistent notochord associated with a COL2A1 mutation in humans. In this case report, we describe ultrasound and postmortem findings and review the pathogenesis associated with a persistent notochord.
Cardiovocal Syndrome (Ortner's Syndrome) Associated with Chronic Thromboembolic Pulmonary Hypertension and Giant Pulmonary Artery Aneurysm: Case Report and Review of the Literature
Authors: Jaakko Heikkinen, Katrin Milger, Enrique Alejandre-Lafont, Christian Woitzik, Detlef Litzlbauer, Julia-Franziska Vogt, Jens Peter Klußmann, Ardeschir Ghofrani, Gabriele A Krombach, Henning Tiede
Journal: Case Rep Med (2012)

Cardiovocal syndrome or Ortner's syndrome is hoarseness due to left recurrent laryngeal nerve palsy caused by mechanical affection of the nerve from enlarged cardiovascular structures. Chronic thromboembolic pulmonary hypertension is extremely rarely found to cause this syndrome. We describe a case of a 56-year-old patient with sudden onset of hoarseness. The patient had known long standing severe pulmonary hypertension. Fiberoptic laryngoscopy showed left vocal cord palsy. Computed tomography of the neck and chest revealed extensive enlargement of the pulmonary arteries and excluded a malignant tumor. The diagnosis of cardiovocal syndrome was retained. It is important for the radiologist to be aware of this possible etiology causing left recurrent laryngeal nerve palsy and to understand its mechanism.
Sclerosing mesenteritis as a cause of abdominal mass and discomfort in an elderly patient: a case report and literature review
Authors: Farzana Nawaz Ali, Sidra Ishaque, Bushra Jamil, Nasir-Ud-Din, Muhammad Idris
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Sclerosing mesenteritis is a rare benign process that involves inflammation, fat necrosis, and fibrosis of the mesentery. The disease poses great diagnostic challenge due to its nonspecific clinical and diagnostic findings. We report the case of a 75-year-old man who presented with vague abdominal discomfort associated with an intra-abdominal mass. With suspicion of a bowel carcinoid tumor on computed tomography scans, the patient underwent diagnostic laparoscopy. A diagnosis of sclerosing mesenteritis was made on histological examination. The patient's symptoms responded to a combination of immunosuppressive drugs, with no interval change in the size of the mass on radiological examination after fifteen months.
Diabetic Muscle Infarction Masquerading as Necrotizing Fasciitis
Authors: Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection. These findings in the acute setting concerned necrotizing fasciitis. After careful discussion following a multidisciplinary approach, a decision was made to perform a fasciotomy with tissue debridement. The patient was treated with IV antibiotics and discharged with a vacuum assisted wound drain. The surgical pathology revealed evidence of muscle edema with necrosis. Seven weeks later the patient presented with similar complaints on the other thigh (right thigh). MRI of the thighs revealed worsening edema with features suggestive of myositis and possible muscle infarction. A CT guided biopsy of the right quadriceps muscle revealed fibrotic interstitial connective tissue and no evidence of necrosis. This favored a diagnosis of diabetic muscle infarction. The disease was managed with pain control, strict diabetes management, and aggressive dialysis.
The double-pedicled dorsal-metacarpal-artery (dpDMCA) flap of the hand: a novel DMCA-derived flap
Authors: Till Wagner, Oliver Kloeters, Dietmar Ulrich
Journal: Eur J Plast Surg (2018)
Keywords: dorsal-metacarpal-artery (dmca) flap, double pedicle, soft tissue defect

The dorsal-metacarpal-artery (DMCA) flap in its standard or extended version is considered as the working horse to cover dorsal soft tissue finger defects with exposed extensor tendon or bone. We hereby present a clinical case of an 80-year-old male patient who is right-handed and sustained a soft tissue defect of the proximal dorsal aspect of his left 5th finger and the postoperative outcome employing a modified transposition flap. The double-pedicled DMCA flap (dpDMCA flap) of the hand poses in adequate clinical scenarios a comparably fast and safe solution to cover dorsal finger defects extending just distal to the PIP joint. To the best of our knowledge, this is the first report of a DMCA-based flap with a double pedicle to cover soft tissue defects at the dorsum of the hand.
Level of evidence:
Level V, therapeutic study.
Thrombotic microangiopathy associated with lenvatinib therapy
Authors: Macarena Contreras Angulo, Belén García Izquierdo, Laura Armengod Grao, Nuria Palacios García
Journal: Endocr Oncol (2023)
Keywords: lenvatinib, thrombotic microangiopathy, thyroid cancer
MeSH terms: Case Reports

Summary:
Systemic thrombotic microangiopathy (TMA) is a serious condition whose early treatment is essential to reduce morbidity and mortality. TMA with only renal involvement has been associated with tyrosine kinase inhibitors, including lenvatinib, a drug used for certain advanced neoplasms. To date, TMA with systemic involvement associated with this drug has not been described. We present the case of a patient with progressive metastatic thyroid cancer who developed this complication after starting treatment with lenvatinib. We describe the signs and symptoms that led to the diagnosis and the treatment required for her recovery.
Learning points:
Thrombotic microangiopathy (TMA) is a group of disorders characterized by thrombosis in capillaries and arterioles due to an endothelial injury. Both, localized and systemic forms have been described.TMA with systemic involvement is characterized by hemolytic anemia, low platelets, and organ damage.Vascular endothelial growth factor signaling inhibitors have been associated with TMA, either restricted to the kidney or with systemic involvement.Lenvatinib has been rarely associated with TMA. Although only forms with isolated or predominantly renal involvement had been described so far, a predominantly systemic form can occur.Lenvatinib-induced systemic TMA must be distinguished from primary forms by measuring ADAMTS-13. Treatment includes discontinuation of the drug and supportive measures.When anemia and thrombocytopenia coexist in a patient receiving treatment with lenvatinib, a peripheral blood smear to exclude TMA is recommended.
Renal fungal ball-two case reports and review of literature
Authors: Devimeenal Jegannathan, Kanagasabai Ramanathan
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Fungal ball or fungal bezoar is the saprophytic colonization of a pre-formed cavity by a conglomerate of fungal mycelia without invasion of the adjacent tissue. Fungal bezoar is seen commonly in immunocompromised individuals. We describe the cross-sectional imaging characteristics of two cases of renal fungal ball, a rare clinical entity. The first case is that of a 36-year-old female with diabetes who presented with a single fungal ball that caused ballooning of the renal pelvis by coelomycetes, a rare species of fungi. The second case is that of a 45-year-old immunosuppressed male with diabetes who presented with multiple Candida albicans fungal balls and emphysematous pyelonephritis. Awareness about the various imaging findings of this rare clinical entity and a high index of suspicion in high-risk individuals will help in overcoming the challenges in early diagnosis and, thereby, institution of proper treatment.
Prosthetic rehabilitation of a pediatric patient with an ocular defect
Authors: Triveni Mohan Nalawade, Rachappa M Mallikarjuna, Bina M Anand, Mayur Anand Kk Shashibhusan, Vv Subba Reddy
Journal: Int J Clin Pediatr Dent (2013)
Keywords: anophthalmos, custom-made ocular prosthesis, ocular defect
MeSH terms: Case Reports

The eye is a vital organ for vision and an important component of facial expression. Loss of an eye has a crippling effect physically and psychologically. Especially, in case of a child where it affects the parent too and the approach toward these special children needs to be very special indeed. The construction of an ocular prosthesis for a child is the same as for an adult. A growing child will require periodic enlargement of the prosthesis in order to accompany the expansion of the anophthalmic cavity and it is the only way to esthetically rebuild the anophthalmic socket. Although implant eye prosthesis has superior outcome, due to economic factors it may not be advisable in all patients. Therefore, an acrylic custom-made ocular prosthesis replacement as soon as possible is a good alternative to promote physical and psychological healing for the patient and to improve social acceptance. A case of a custom fabricated ocular acrylic prosthesis using the advantages of digital photography is presented here, which had acceptable fit, retention and improved esthetics with a certain degree of motility in coordination with the contralateral normal eye. How to cite this article: Nalawade TM, Mallikarjuna RM, Anand BM, Anand M, Shashibhusan KK, Subba Reddy VV. Prosthetic Rehabilitation of a Pediatric Patient with an Ocular Defect. Int J Clin Pediatr Dent 2013;6(1):62-65.
Clear cell papillary renal cell carcinoma in the bilateral native kidneys after 2 years of renal transplantation: report of a case and review of the literature
Authors: Zhanyong Bing, John E Tomaszewski
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

Renal transplantation increases the probability of malignant tumors by about 2-4-fold overall with a much higher rate for renal epithelial malignancy. Renal tumors in renal transplant recipients are commonly conventional clear cell or papillary renal cell carcinoma. Clear cell papillary renal cell carcinoma is a recently described unique renal epithelial neoplasm with scant eosinophilic or moderate amount of clear cytoplasm and pyknotic small nuclei oriented commonly toward the apical surfaces. No such tumor has been reported in renal transplant recipients. In this paper, we describe a clear cell papillary renal cell carcinoma involving bilateral native kidneys in a patient who had received a renal transplant 2 years earlier. Clear cell papillary renal cell carcinoma commonly presents with low pathologic stage and lower Fuhrman grade and is clinically indolent. Additional cases are needed to evaluate the clinical behavior of this type of tumor in renal transplant recipients.