OpenMed/multicare-articles huggingface dataset:
Primary central nervous system post-transplant lymphoproliferative disorder after allogeneic stem cell transplantation: a case report
Authors: Margaret Tugend, Jordan Dattero, Tsiporah Shore, Vladislav Korobeynikov, Raymond F Sekula Jr
Journal: Front Oncol (2024)
Keywords: matrix regimen, case report, cerebellopontine angle, diffuse large b-cell lymphoma, double umbilical cord allogeneic transplant, polyploid, post-transplant lymphoproliferative disorder, primary central nervous system lymphoma
MeSH terms: Case Reports

Purpose:
Primary central nervous system, diffuse large B-cell lymphoma, post-transplant lymphoproliferative disorder in the cerebellopontine angle after an allogeneic stem cell transplantation has never been reported in the literature. Typically, diffuse large B-cell lymphoma is non-polyploid. We report the first case of a patient with polyploid post-transplant lymphoproliferative disorder in the cerebellopontine angle who presented with back pain.
Case presentation:
A 45-year-old man with a history of nodular sclerosing classic Hodgkin lymphoma stage IIB treated with systemic chemotherapy, external radiation and autologous stem cell transplant and double umbilical cord allogeneic transplant presented with several weeks of back pain. He was found to have a small right cerebellopontine angle mass thought to be consistent with a meningioma. Patient presented again two weeks later with acute onset of severe headache, right sided ptosis, right facial numbness, weakness and possible seizure event. Repeat MRI scans showed an interval and significant increase of the right cerebellopontine angle lesion. Biopsy of the cerebellopontine angle lesion was planned with suspicion of lymphoma. Intraoperative pathology consultation findings were not consistent with an acoustic neuroma, meningioma, or epidermoid cyst. Lymphoma could not be definitively identified by intra-operative frozen section. However, it was suspected, and a portion of fresh specimen was submitted for flow cytometry analysis. A near total resection of the tumor and decompression of the brainstem was achieved. Final pathologic analysis was positive for post-transplant lymphoproliferative disorder, monomorphic type, diffuse large B-cell lymphoma, non-germinal center B-cell type, EBV+, post-transplant (allogeneic stem cell) setting (post-transplant lymphoproliferative disorder (PTLD), monomorphic type, diffuse large B-cell lymphoma, non-germinal center B-cell type (non-GCB), EBV-positive under pre-2022 WHO terminology). The patient began a high-dose methotrexate-based regimen (the MATRIX regimen).
Conclusions:
Our case illustrates an unusual presentation of post-transplant lymphoproliferative disorder in the cerebellopontine angle in a patient with a remote history of allogeneic stem cell transplantation. It demonstrates the importance of keeping primary central nervous system post-transplant lymphoproliferative disorder on the differential for patients who present with back pain or headache that have a history of allogeneic stem cell transplant.
Case report: Enfortumab vedotin induced refractory DKA and multi organ failure - a rare fatal adverse event
Authors: Astha Koolwal Kapoor, Carleton S Ellis, Deepali Pandey, Derek B Allison, Zin W Myint
Journal: Front Oncol (2024)
Keywords: crrt, diabetes ketoacidosis, enfortumab vedotin, insulin, liver failure, maculopapular rash
MeSH terms: Case Reports

There are very few therapeutic options to treat patients with locally advanced or metastatic Urothelial Cancer (UC). Enfortumab vedotin (EV) was recently approved by the FDA and has become a new therapeutic option for patients previously managed with conventional treatments. Despite its efficacy, EV carries the potential for infrequent yet severe adverse effects. In this report, we present a case of a patient undergoing EV treatment for urothelial carcinoma who developed refractory diabetic ketoacidosis (DKA) unresponsive to escalating insulin doses and necessitating continuous renal replacement therapy. While DKA was resolved, the patient eventually succumbed to progressive maculopapular skin rash, liver failure, and respiratory failure. Additionally, the study delves into a review of cases of EV-induced refractory DKA in the literature, shedding light on the similarities in patient profiles, timelines of adverse effects and the treatment strategies employed to manage the ensuing complications.
Subarachnoid Hemorrhage Caused by Supratentorial Cerebral Cavernous Malformation: A Case Report
Authors: Fatima Al Sada, Muhammad Mohsin Khan, Javeed Iqbal, Kazim Mohammed, Ali Ayyad
Journal: Cureus (2024)
Keywords: case report, cavernoma, cavernous hemangioma, ischemic stroke, non-aneurysmal subarachnoid hemorrhage
MeSH terms: Case Reports

Cavernous malformations (CMs) are acquired vascular abnormalities of the central nervous system that are typically asymptomatic. Clinically symptomatic lesions may present with seizures, intracerebral hemorrhage, or focal neurological deficits. Very rarely, CMs have been described as the cause of subarachnoid hemorrhage. We report a case of a previously healthy 58-year-old man who presented with acute onset of severe headache associated with vomiting. Head computed tomography (CT) scan showed subarachnoid hemorrhage with intraventricular extension. Subsequent CT angiography (CTA) and digital subtraction angiography (DSA) studies showed no evidence of vascular abnormalities. The patient was initially managed conservatively but later required neurosurgical and radiological interventions due to a complicated hospital course and worsening clinical condition. During surgery, an incidental mass was found in the temporal lobe, and subsequent histopathological examination confirmed the diagnosis of cavernoma, which was likely the underlying cause of the subarachnoid hemorrhage. This report highlights the importance of considering CMs in the differential diagnoses of subarachnoid hemorrhage, especially in the absence of informative results from CTA and DSA studies. Timely detection and management of CMs may positively impact the clinical outcome, leading to reduced morbidity and mortality rates.
Parodontgel® on Wound Healing and Patient-Reported Outcome Measures (PROMs) after Tunneled Coronally Advanced Flap (TCAF)
Authors: Leonardo Mancini, Vincenzo Mancini
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

The adjunctive use of healing gels following periodontal plastic surgery is not common in clinical practice, and no definitive benefits have yet been demonstrated. Case Presentation. A 33-year-old male patient with a central lower incisor class RT1 recession sought treatment due to sensitivity and dissatisfaction with the appearance of his smile. The patient had no history of periodontal disease; however, he was under orthodontic treatment contributing to the gingival recession and irregular gum contours. Treatment. The patient underwent two sequential surgical procedures. Initially, an apically repositioned flap (APF) was performed to correct the frenulum reducing flap tension and improving the gum line aesthetics. Subsequently, after 8 weeks, a tunneled coronally advanced flap (TCAF) was executed to further refine the gum contours and achieve root coverage. Postoperative Healing Protocol. To enhance the healing process and alleviate postoperative discomfort, a healing gel containing hyaluronic acid as the active molecule was applied to the surgical sites. The gel was expected to reduce pain perception and minimize the need for painkiller intake during the critical first week of recovery. The patient was asked to fill a pain chart for the initial 7 days, recording pain levels on a visual analogue scale (VAS 0-10) and the number of paracetamol tablets taken as painkillers. Results. After both the APF and TCAF surgeries, the patient reported pain levels with a mean VAS score of 4.33 and 4.25, respectively. The painkiller intake during the first week was noted to be 3 tablets for the APF and 2 tablets for the TCAF. Notably, the application of the healing gel with hyaluronic acid did not cause any adverse reactions, indicating its potential safety and efficacy in this context. Conclusion. The application of a healing gel containing hyaluronic acid after periodontal plastic surgery showed promising results in reducing postoperative pain and the need for painkillers during the initial week of recovery. However, further investigations through randomized clinical trials are required to establish the potential benefits and broader applicability of such healing gel applications in the context of periodontal plastic surgery.
Anti-NMDAR encephalitis in a child with long impaired consciousness and persistent antibodies: a case report and mini review
Authors: Wenhao Zhang, Wenjia Cao, Wenhan Tao, Yufei Wang, Chenchen Tangzhu, Qinru Shen, Xulai Shi
Journal: Front Immunol (2024)
Keywords: anti-nmdar antibody, anti-nmdar encephalitis, autoimmune encephalitis, case report, prognosis
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / immunology, Autoantibodies / blood, Autoantibodies / immunology, Case Reports, Review, Child, Consciousness Disorders / etiology, Consciousness Disorders / immunology, Female, Humans, Receptors, N-Methyl-D-Aspartate / immunology, Autoantibodies, Receptors, N-Methyl-D-Aspartate

We described a challenging case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in a young girl. Despite enduring months of reduced consciousness with ongoing antibody presence, she ultimately exhibited remarkable improvement within a 5-year follow-up period. Additionally, we conducted a concise review of relevant literature on anti-NMDAR encephalitis, with a specific focus on anti-NMDAR antibodies. Our findings enhance the clinical comprehension of anti-NMDAR encephalitis and offer valuable insights to clinicians for its management.
Cold-Induced Urticaria in a Paediatric Patient: A Case Report and Literature Review
Authors: Madalena Von Hafe, Afonso Caires, Leonor Carneiro-Leão, Diana Bordalo
Journal: Cureus (2024)
Keywords: anaphylaxis, cold-urticaria, paediatric allergy, physical urticaria, temptest
MeSH terms: Case Reports

Acquired cold-induced urticaria is a rare form of physical urticaria, especially in children. The variety of clinical presentations and the low estimated prevalence contribute to its underdiagnosis. Given the associated risk of anaphylaxis, it is crucial to alert clinicians to the different forms of presentation, diagnosis, and treatment. Starting with a case report of acquired cold-induced urticaria in a previously healthy nine-year-old boy, the authors then review the literature about acquired cold-induced urticaria and discuss the diagnostic exams and disease management.
Double Trouble: A Case of Gallstone Ileus as a Result of Multiple Obstructive Gallstones
Authors: Malsha Kularatna, Fransiska Falconer
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Gallstone ileus is a rare condition. It accounts for approximately 1% of small bowel obstruction and is more prevalent in the elderly population. It is usually present in relatively comorbid patients posing further operative challenges. The following report investigates the management of two large gallstones resulting in two different points of obstruction. Is double trouble doubly hard to manage?
Case report: Cerebrospinal fluid neutrophilic pleocytosis upon intrathecal triamcinolone injection
Authors: Thanos Tsaktanis, Jenny Stritzelberger, Vi Tuong Daniel To, Martin Uhl, Stefan Schwab, Dieter Heuss, Veit Rothhammer
Journal: Front Neurol (2024)
Keywords: chemical meningitis, inflammatory csf syndrome, intrathecal injection of triamcinolone, side effect, spasticity, triamcinolone
MeSH terms: Case Reports

Intrathecal corticosteroids, initially employed in the 1950s, faced declining use due to complications like arachnoiditis and aseptic meningitis. Triamcinolone, which is nowadays used as intrathecally applied glucocorticoid formulation, has been shown to beneficially influence spasticity without demonstrable influence on disease activity or progression. We here present the case of a patient with recurrent episodes of aseptic cerebrospinal fluid (CSF) neutrophilic pleocytosis over a year following intrathecal triamcinolone treatment. CSF analyses revealed a post-injection CSF cytokine profile resembling cytokine release reaction rather than drug hypersensitivity. This case thus highlights a potential side effect of intrathecal triamcinolone injection with yet unclear clinical relevance, underscores the need for further assessment of clinical benefits of intrathecal triamcinolone, and emphasizes potential short and long-term side effects associated with extended intrathecal triamcinolone use.
Case report: Radiography and computed tomography of tension pneumoperitoneum caused by gastric perforation in a dog
Authors: Myounghun Kim, Jeongyun Jeong, Changhyeon Cho, Kidong Eom, Jaehwan Kim
Journal: Front Vet Sci (2024)
Keywords: computed tomography, dog, gastric perforation, radiography, tension pneumoperitoneum
MeSH terms: Case Reports

Tension pneumoperitoneum is characterized by excessive accumulation of gas in the peritoneal cavity, which leads to cardiorespiratory distress. We present the case of a 4-year-old female Labrador retriever who presented with a severe abdominal distension and panting. Radiography revealed a large volume of free gas in the peritoneal cavity with decreased serosal detail. After emergency needle decompression, ultrasound-guided aspiration of the peritoneal effusion helped confirm septic peritonitis. Computed tomography revealed a gastric mass measuring approximately 3.7 × 5.0 × 5.5 cm, which was suspected to have caused the gastric perforation. A large volume of free gas was present in the peritoneal cavity, causing compression and centralization of the abdominal organs. A low-attenuating cleft suggestive of perforation site near the gastric mass was also observed. Exploratory laparotomy confirmed gastric perforation of approximately 2.2 cm adjacent to the gastric mass. The patient was finally diagnosed with tension pneumoperitoneum caused by gastric perforation. The mass was resected with a 1-2-cm surgical margin, and imprinting cytology indicated gastric carcinoma. The patient was aggressively treated with fluid, analgesic, antithrombotic, and antibacterial therapy. However, the patient's condition continued to deteriorate, and euthanasia was performed at the owner's request. Our report is the first to describe the multimodal imaging features of a dog with tension pneumoperitoneum secondary to gastric perforation caused by gastric neoplasm.
Multi-level barriers to early detection of breast cancer among rural midlife women in Tanzania: A qualitative case study
Authors: Tumaini Nyamhanga, Rosemary W Eustace, Janeth Philip Makoye, Katunzi Mutalemwa
Journal: PLoS One (2024)
MeSH terms: Breast Neoplasms / diagnosis, Breast Neoplasms / epidemiology, Breast, Early Detection of Cancer, Female, Humans, Male, Qualitative Research, Tanzania / epidemiology

Background:
Breast cancer is the second most common cause of cancer mortality among women in Tanzania and thus, early detection and treatment methods are central to improving breast cancer outcomes. However, in low- and middle-income countries in Sub-Saharan Africa, the survival rates remains low due to late presentation. Hence, a significant number of deaths could be prevented if barriers and facilitators to early detection are known.
Purpose:
This qualitative case descriptive study explored the possible barriers to awareness and early breast cancer diagnostic services among midlife women in rural Tanzania.
Methods:
Ten key informant interviews with health systems managers and community health workers and eight focus group discussions with women aged 40-65 years and their spouses were conducted to elicit the study data conducted from July to August 2021.
Results:
The data revealed nine themes describing the barriers to early detection methods across five Socio-Ecological levels of influence, namely: 1) limited knowledge and 2) witchcraft beliefs (individual level); 3) limited male support (interpersonal level); 4) age and gender factors and 5) procrastination (community level) 6) limited availability of services 7) emphasis of curative over preventive care (institutional level); 8) poverty/inability to pay and 9) limitations of health insurance (societal/policy level).
Conclusions:
The study findings suggest a need to further the design, implementation and evaluation of evidence-based community breast health awareness and education interventions to promote early detection of breast cancer in Tanzania. Specifically, the study highlights the need to address multiple level determinants of influence in breast cancer control as part of the country's Community Health Strategy.
Lorlatinib in the treatment of a rare pulmonary mucoepidermoid carcinoma with EML4-ALK fusion: a case report and literature review
Authors: Zijun Xu, Xiaofeng Cong, Ziling Liu
Journal: Front Oncol (2024)
Keywords: eml4-alk fusion, anaplastic lymphoma kinase-tyrosine kinase inhibitor, first line treatment, lorlatinib, pulmonary mucoepidermoid carcinoma (pmec)
MeSH terms: Case Reports

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare tumor with limited clinical data available due to its low incidence. So far, there are no universal treatment guidelines for this malignant tumor. We present here the case of a 59-year-old female never smoker who was initially referred to our hospital with cough and hemoptysis and was eventually diagnosed with PMEC. Based on further genetic testing, echinoderm microtubule-associated protein-like4-anaplastic lymphoma kinase (EML4-ALK) fusion variants E20:A20 (V2) was found. The patient was treated with lorlatinib as the first-line treatment. This case is the first to describe the effectiveness of lorlatinib in treating an advanced high-grade PMEC with EML4-ALK fusion V2 mutation patient.
A Case of Myxedema Coma and Adrenal Insufficiency Post Pembrolizumab
Authors: Andrew El Alam, Mohamad Fleifel, Dana El Masri, Bertha Maria Nassani, Jessica Abou Chaaya, Mahamadou Minkailou, Mariana Barbat, Arnaud Monier
Journal: Case Rep Endocrinol (2024)
MeSH terms: Case Reports

Background:
Despite their important clinical benefits, immune checkpoint inhibitors (ICIs) are associated with a spectrum of side effects known as immune-related adverse events (irAEs). These can be of various organ system backgrounds, including dermatologic, pulmonary, gastrointestinal, and endocrine. Polyglandular endocrinopathies (PLEs) post-ICIs therapy has been reported in the literature; however, to our knowledge, only a few have been documented with pembrolizumab. Case Report. We present a case of a female patient who developed myxedema coma (MC) and adrenal insufficiency (AI) after 4 months of stopping pembrolizumab, a programed-cell death-1 inhibitor. The patient was clinically symptomatic and was subsequently treated with levothyroxine and hydrocortisone. Discussion. It is very important to be vigilant and alert in detecting MC and AI to avoid any mortality. Pembrolizumab's effect on inducing antitumor responses leads to a wide variety of multiorgan alterations. Its role in raising the risk of all-grade endocrine disorders has been previously highlighted along with thyroidal dysfunctions. Our patient's presentation falls within the literature-based median time for hypothyroidism and AI with respect to the period from the initiation of pembrolizumab. The patient's predisposition to hypothyroidism and the likelihood of intertwined manifestations of AI and hypothyroidism should always be considered in the setting of critical illness.
Conclusion:
It is of high significance to explore the mechanism of action of ICIs and their side effects. PLEs can house some endocrinologic emergencies that are life threatening.
Surgical management of abdominal wall sheath and rectus abdominis muscle endometriosis: a case report and literature review
Authors: Olga Triantafyllidou, Nikoletta Mili, Theodoros Kalampokas, Nikolaos Vlahos, Emmanouil Kalampokas
Journal: Front Surg (2024)
Keywords: abdominal wall, cesarean section, endometriosis, parietal repair, scar endometriosis
MeSH terms: Case Reports

Introduction:
Endometriosis, defined as the presence of endometrial glands and stroma outside the uterine cavity, mainly affects the pelvic viscera and peritoneum. Endometriosis can also occur at sites of surgical incisions on the abdominal wall, mainly in women with a history of cesarean section (CS). The incidence of abdominal wall endometriosis after CS reaches 1%. Clinical suspicion, along with imaging, plays a crucial role in diagnosis. The preferred treatment involves extensive surgical excision with clear margins, ensuring a definitive diagnosis through histopathology examination.
Case presentation:
This case report is of a 44-year-old woman with a history of two CS procedures who developed pain and pigmentation at the incisional site one year after the last CS. Thirteen years after the surgical excision of an abdominal wall endometriosis (AWE) mass, followed by hormone therapy, she presented in our hospital with worsening pain for further management. Pelvic MRI findings were consistent with AWE. During surgery, the abdominal wall endometriosis foci were removed, and the defect in the aponeurosis was repaired using a dual-sided mesh in a tension-free procedure.
Conclusion:
Although AWE is a rare condition, we foresee an increase in cases because of the ever-increasing CS rates and the important association between AWE and CS. Healthcare practitioners should remain vigilant for this condition in women of reproductive age who exhibit cyclic pain, a palpable mass in the abdomen, and a background of previous uterine surgeries.
Central Retinal Vein Occlusion with Three-Retinal Quadrant Involvement: Another Focus on Optic Disc Head Vascular Anatomy Variations
Authors: Narges Hassanpoor, Vahid Abdolrahimi, Mohamad Reza Niyousha
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

A 50-year-old male patient with sudden visual acuity loss in his right eye came to our clinic. Visual acuity at presentation was 1/10 in right eye and 10/10 in left. The patient was otherwise healthy Caucasian man without any history of previous systemic or ophthalmic disease. There was not any history of amblyopia and refractive error. Anterior segment findings were unremarkable. Three quadrants of retina were fully involved with central retinal vein occlusion (CRVO) features including retinal hemorrhages, retinal edema obscuring retinal details, and cotton wool spots while sparing inferior temporal quadrant. Inferior temporal quadrant sparing in this patient is due to a specific retinal vascular anatomical variation. In conclusion, in unusual presentations of retinal vascular branch obstructions, considering retinal vascular anatomy variations would help us to explain the clinical presentation more precisely in some cases.