OpenMed/multicare-articles huggingface dataset:
Riedel's thyroiditis masquerading as anaplastic thyroid carcinoma: a case report
Authors: Navneel Shahi, Mohammed F Abdelhamid, Mudit Jindall, Reda W Awad
Journal: J Med Case Rep (2010)

Introduction:
Riedel's thyroiditis is a rare thyroid disease characterized by dense fibrous tissues that replace the thyroid gland and invade the adjacent structures that can mimic thyroid malignancy. We discuss the presentation, investigation and management of this very rare condition.
Case presentation:
We present a case of a 59-year-old African-Caribbean man who presented with a rapidly growing hard neck mass, a hoarse voice, dysphagia and breathing difficulty that clinically suggested thyroid malignancy. Biopsy, however, revealed dense fibrous tissues suggestive of Riedel's thyroiditis. This was successfully treated with very high dose steroids, with no relapse in the symptoms.
Conclusion:
It is important for clinicians to be aware of this diagnosis when managing patients with thyroid disease, because Riedel's thyroiditis can mimic malignancy. In addition, our case demonstrates that this condition should be treated with very high dose steroids to prevent relapse.
PD-1 Inhibitors Plus Capecitabine as Maintenance Therapy for Advanced Intrahepatic Cholangiocarcinoma: A Case Report and Review of Literature
Authors: Zhihong Wang, Tianmei Zeng, Yong Li, Ding Zhang, Zhengang Yuan, Mengli Huang, Yuan Yang, Weiping Zhou
Journal: Front Immunol (2021)
Keywords: biomarker (bm), capecitabine, immunotherapy, intrahepatic cholangiocarcinoma (icca), maintenance therapy
MeSH terms: Antibodies, Monoclonal, Humanized / administration & dosage, Bile Duct Neoplasms / drug therapy, Capecitabine / administration & dosage, Cholangiocarcinoma / drug therapy, Immune Checkpoint Inhibitors / administration & dosage, Maintenance Chemotherapy / methods, Case Reports, Research Support, Non-U.S. Gov't, Review, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Humans, Male, Middle Aged, Antibodies, Monoclonal, Humanized, Immune Checkpoint Inhibitors, Capecitabine, sintilimab

Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with a poor prognosis. Recently, an immunotherapy strategy represented by programmed cell death 1 (PD-1) inhibitors has been applied to the systemic treatment of advanced iCCA. However, immunotherapy combined with chemotherapy as first-line maintenance therapy was rarely reported. Our report presented an advanced iCCA patient who had a dramatic response to the PD-1 inhibitor sintilimab combined with gemcitabine plus cisplatin as the first-line therapy and sintilimab combined with capecitabine as maintenance therapy, yielding an ongoing progression-free survival of 16 months.
Acute Pancreatitis Complicated by Stress Cardiomyopathy With Persistent Apical Akinesis: A Case Report and Literature Review
Authors: Temidayo Abe, Melvin Simien, Hayes Dolphurs
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: pancreatitis, stress cardiomyopathy, takotsubo
MeSH terms: Pancreatitis / complications, Takotsubo Cardiomyopathy / diagnosis, Case Reports, Review, Coronary Angiography, Echocardiography, Electrocardiography, Female, Humans, Middle Aged, Systole, Takotsubo Cardiomyopathy / etiology, Ventricular Function, Left

Takotsubo cardiomyopathy or stress cardiomyopathy is a transient reversible cardiomyopathy characterized by regional wall motion abnormalities that usually extend beyond a single epicardial vascular distribution. It is often precipitated by acute physical or emotional stressors. In this article, we present the case of a postmenopausal woman who was admitted for management of acute pancreatitis. On the second day of admission, she developed shortness of breath and electrocardiographic abnormalities. A transthoracic echocardiogram revealed left ventricular systolic dysfunction and apical akinesis, and coronary angiography revealed normal coronary arteries. She was diagnosed with takotsubo cardiomyopathy triggered by acute pancreatitis and started on guideline-directed heart failure medications. A follow-up echocardiogram 4 months later revealed persistent systolic dysfunction and apical akinesis.
Case Report: Specific ABL-Inhibitor Imatinib Is an Effective Targeted Agent as the First Line Therapy to Treat B-Cell Acute Lymphoblastic Leukemia With a Cryptic NUP214:: ABL1 Gene Fusion
Authors: Egle Stukaite-Ruibiene, Rimvydas Norvilas, Vaidas Dirse, Sigita Stankeviciene, Goda Elizabeta Vaitkeviciene
Journal: Pathol Oncol Res (2022)
Keywords: bcr-abl1-like, acute lymphoblastic leukemia, case report, imatinib, targeted therapy, tyrosine kinase inhibitors
MeSH terms: Antineoplastic Agents / therapeutic use, Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics, Case Reports, Adolescent, Benzamides, Gene Fusion, Humans, Imatinib Mesylate / therapeutic use, Nuclear Pore Complex Proteins / genetics, Oncogene Proteins, Fusion / genetics, Oncogene Proteins, Fusion / metabolism, Piperazines / pharmacology, Protein Kinase Inhibitors / pharmacology, Protein Kinase Inhibitors / therapeutic use, Protein Kinases / genetics, Protein Kinases / metabolism, Pyrimidines / therapeutic use, Antineoplastic Agents, Benzamides, NUP214 protein, human, Nuclear Pore Complex Proteins, Oncogene Proteins, Fusion, Piperazines, Protein Kinase Inhibitors, Pyrimidines, Imatinib Mesylate, Protein Kinases

Acute lymphoblastic leukemia (ALL) with recurrent genetic lesions, affecting a series of kinase genes, is associated with unfavorable prognosis, however, it could benefit from treatment with tyrosine kinase inhibitors (TKI). NUP214::ABL1 fusion is detected in 6% of T-cell acute lymphoblastic leukemia (T-ALL), and is very rare in B-ALL. We present a case of adolescent with B-ALL and a cryptic NUP214::ABL1 fusion which was initially missed during diagnostic screening and was detected by additional RNA sequencing. Treatment with specific ABL-inhibitor Imatinib was added later in therapy with a good effect. Initial treatment according to conventional chemotherapy was complicated by severe side effects. At the end of Consolidation, the patient was stratified to a high risk group with allogeneic hematopoietic stem cell transplantation because of insufficient response to therapy. At that time, targeted RNA sequencing detected NUP214::ABL1 gene fusion which was previously missed due to a small microduplication in the 9q34 chromosome region. Gene variant analysis revealed no TKI-resistant ABL1 mutations; therefore, treatment with Imatinib was added to target the NUP214::ABL1 fusion protein. A negative minimal residual disease was achieved, and treatment was downgraded to intermediate risk protocol. Combining routine genetic assays with next-generation sequencing methods could prevent from missing atypical gene alterations. Identification of rare targetable genetic subtypes is of importance in order to introduce targeted therapy as early as possible that may improve survival and reduce toxicity. Treatment with ABL1 inhibitor imatinib mesylate revealed as a highly effective targeted therapy against the leukemia driving protein kinase.
Successful and Less Successful Psychotherapies Compared: Three Therapists and Their Six Contrasting Cases
Authors: Andrzej Werbart, Amanda Annevall, Johan Hillblom
Journal: Front Psychol (2019)
Keywords: negative processes, non-improvement, outcome and process research, patient and therapist perspective, psychoanalytic psychotherapy, qualitative research methods, therapeutic relationship, unsuccessful treatments

Despite the general effectiveness of bona fide psychotherapies, the number of patients who deteriorate or fail to improve is still problematic. Furthermore, there is an increased awareness in the field that the therapists' individual skills make a significant contribution to the variance in outcome. While some therapists are generally more successful than others, most therapists have experienced both therapeutic success and failure in different cases. The aim of this case-series study was to deepen our understanding of what matters for the therapists' success in some cases, whereas other patients do not improve. How do the patients and their therapists make sense of and reflect on their therapy experiences in most successful and unsuccessful cases? Are there any distinctive features experienced by the participants at the outset of treatment? To explore these issues, we applied a mixed-method design. Trying to keep the therapist factor constant, we selected contrasting cases from the caseloads of three therapists, following the criterion of reliable and clinically significant symptom reduction or non-improvement at termination. Transcripts of 12 patient interviews and 12 therapist interviews (at baseline and at termination) were analyzed, applying inductive thematic analysis and the multiple-case comparison method. The comparisons within the three therapists' caseloads revealed that in the successful cases the patient and the therapist shared a common understanding of the presenting problems and the goals of therapy and experienced the therapeutic relationship as both supportive and challenging. Furthermore, the therapists adjusted their way of working to their patients' needs. In non-improved cases, the participants presented diverging views of the therapeutic process and outcome. The therapists described difficulties in the therapeutic collaboration but not how they dealt with obstacles. They tended to disregard their own role in the interactions and to explain difficulties as being caused by the nature of their patients' problems. This could indicate that the therapists had difficulty in reflecting on their own contributions, accepting feedback from their patients, and adjusting their work accordingly. These within-therapist differences indicate that taking a "third position" is most needed and seems to be most difficult, when early signs of a lack of therapeutic progress appear.
Case Report: Abdominal Lymph Node Metastases of Parathyroid Carcinoma: Diagnostic Workup, Molecular Diagnosis, and Clinical Management
Authors: Christina Lenschow, Carmina Teresa Fuss, Stefan Kircher, Andreas Buck, Ralph Kickuth, Joachim Reibetanz, Armin Wiegering, Albrecht Stenzinger, Daniel Hübschmann, Christoph Thomas Germer, Martin Fassnacht, Stefan Fröhling, Nicolas Schlegel, Matthias Kroiss
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: [18f]fdg-pet-ct, abdominal lymph node metastases, immune check inhibitor, molecular diagnostics, parathyroid carcinoma, pembrolizumab, repeated surgery
MeSH terms: Liver Neoplasms / secondary, Lymphatic Metastasis, Parathyroid Hormone / metabolism, Parathyroid Neoplasms / metabolism, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal, Humanized / pharmacology, Calcium / metabolism, Cinacalcet / pharmacology, Disease Progression, Female, Fluorodeoxyglucose F18, Humans, Immune System, Immunotherapy, Middle Aged, Molecular Biology, Neoplasm Metastasis, Neoplasm Recurrence, Local / pathology, Parathyroid Neoplasms / pathology, Positron Emission Tomography Computed Tomography, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Antibodies, Monoclonal, Humanized, Parathyroid Hormone, Fluorodeoxyglucose F18, pembrolizumab, Calcium, Cinacalcet

Parathyroid carcinoma (PC) is an orphan malignancy accounting for only ~1% of all cases with primary hyperparathyroidism. The localization of recurrent PC is of critical importance and can be exceedingly difficult to diagnose and sometimes futile when common sites of recurrence in the neck and chest cannot be confirmed. Here, we present the diagnostic workup, molecular analysis and multimodal therapy of a 46-year old woman with the extraordinary manifestation of abdominal lymph node metastases 12 years after primary diagnosis of PC. The patient was referred to our endocrine tumor center in 2016 with the aim to localize the tumor causative of symptomatic biochemical recurrence. In view of the extensive previous workup we decided to perform [18F]FDG-PET-CT. A pathological lymph node in the liver hilus showed slightly increased FDG-uptake and hence was suspected as site of recurrence. Selective venous sampling confirmed increased parathyroid hormone concentration in liver veins. Abdominal lymph node metastasis was resected and histopathological examination confirmed PC. Within four months, the patient experienced biochemical recurrence and based on high tumor mutational burden detected in the surgical specimen by whole exome sequencing the patient received immunotherapy with pembrolizumab that led to a biochemical response. Subsequent to disease progression repeated abdominal lymph node resection was performed in 10/2018, 01/2019 and in 01/2020. Up to now (12/2020) the patient is biochemically free of disease. In conclusion, a multimodal diagnostic approach and therapy in an interdisciplinary setting is needed for patients with rare endocrine tumors. Molecular analyses may inform additional treatment options including checkpoint inhibitors such as pembrolizumab.
Inflammatory Pseudotumor Formation at a Port Site after Robotic Partial Nephrectomy for Renal Cell Carcinoma
Authors: Mitsuo Ofude, Ryunosuke Nakagawa, Satoko Urata, Tohru Miyagi, Takao Nakashima, Hiroshi Minato
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Inflammatory pseudotumors (IPTs) are benign masses arising from nonspecific inflammatory conditions including surgical invasion. We herein report the rare case of an IPT mimicking port-site metastasis in a 69-year-old patient who underwent retroperitoneal robotic partial nephrectomy for stage T1a renal cell carcinoma. Radiological examination performed six months after the surgery revealed the presence of a mass underneath the abdominal wall which coincided with a port site. The tumor was resected by laparoscopic transperitoneal approach, and histological examination led to the diagnosis of an IPT that consists of xanthogranulomatous inflammation. We also discuss the etiology of IPT formation and features distinguishing IPTs from port-site metastasis.
Transperineal abdominoperineal resection for anorectal melanoma: A case report
Authors: Hiroki Hashida, Masato Kondo, Daisuke Yamashita, Shigeo Hara, Ryosuke Mizuno, Motoko Mizumoto, Hiroyuki Kobayashi, Satoshi Kaihara
Journal: Int J Surg Case Rep (2019)
Keywords: anorectal melanoma, metastasis, transanal total mesorectal excision, transperineal abdominoperineal resection

Introduction:
Anorectal melanoma is a rare type of cancer characterized by frequent metastasis. We report our experience with a case of anorectal melanoma resected via transperineal abdominoperineal resection and total mesorectal excision.
Presentation of case:
A 77-year-old woman visited our hospital with the complaint of melena. Colonoscopic examination revealed a black type 1 tumor measuring 5 mm in size on the dentate line of the anal canal circumference. Tumor biopsy revealed malignant melanoma, and positron emission tomography-computed tomography showed tracer accumulation within the mass but not at other sites. We performed a two-stage abdominoperineal resection surgery with lymphadenectomy via transperineal abdominoperineal resection, and pathological diagnosis indicated submucosal tumor depth. The patient was diagnosed with T2 N0 M0 stage I malignant melanoma and was followed on an outpatient basis. A 24-month follow-up computed tomography revealed multiple liver metastases.
Discussion:
Anorectal melanoma is associated with a very poor prognosis because of its association with early lymph node metastasis and distant metastasis. The tumor may spread beyond the main lesion and involve the surrounding mucosa and draining lymph nodes. Transperineal abdominoperineal resection is a minimally invasive procedure that can be used to achieve curative tumor resection with lymphadenectomy.
Conclusion:
Transperineal abdominoperineal resection appears to be a feasible approach for the treatment of anorectal melanoma.
Oguchi's disease with Mizuo-Nakamura phenomenon in a seven-year-old boy
Authors: Pukhraj Rishi, Ekta Rishi, Sharanya Abraham
Journal: GMS Ophthalmol Cases (2018)
MeSH terms: Case Reports

A seven-year-old boy presented with difficulty in night vision of five years duration. Vision was 20/20 OU. Fundus examination revealed a golden sheen over the posterior pole in both eyes which disappeared after 45 minutes of dark adaptation, suggestive of Mizuo-Nakamura phenomenon. Clinical findings were suggestive of Oguchi's disease. ERG was confirmatory.
Plasma cell free next-generation sequencing detects an unusual pneumonia pathogen in an immunocompetent adolescent with acute respiratory distress syndrome
Authors: Katherine M Rodriguez, Nanda Ramchandar, Nicole G Coufal
Journal: Front Pediatr (2022)
Keywords: acute respiratory distress syndrome, legionella, pediatric critical care, plasma microbial cell-free dna next generation sequencing, pneumonia
MeSH terms: Case Reports

This case details a rapid diagnosis of legionella pneumonia causing severe acute respiratory distress syndrome (ARDS) in an otherwise healthy adolescent through plasma microbial cell-free DNA next generation sequencing (mcfDNA-NGS). Diagnosis by mcfDNA-NGS of this unexpected pathogen led to narrowing of antimicrobials and the addition of glucocorticoids as adjunctive therapy for ARDS.
Excision of Mucocele Using Diode Laser in Lower Lip
Authors: Subramaniam Ramkumar, Lakshmi Ramkumar, Narasimhan Malathi, Ramalingam Suganya
Journal: Case Rep Dent (2016)
MeSH terms: Case Reports

Mucoceles are nonneoplastic cystic lesions of major and minor salivary glands which result from the accumulation of mucus. These lesions are most commonly seen in children. Though usually these lesions can be treated by local surgical excision, in our case, to avoid intraoperative surgical complications like bleeding and edema and to enable better healing, excision was done using a diode laser in the wavelength of 940 nm.
Coagulation disorders during treatment with cefazolin and rifampicin: rare but dangerous
Authors: Ines Kouki, Clémence Montagner, Wladimir Mauhin, Jonathan London, Thierry Lazard, Sylvie Grimbert, Valérie Zeller, Olivier Lidove
Journal: J Bone Jt Infect (2021)
MeSH terms: Case Reports

We describe a 79-year-old man with spondylodiscitis and unknown pathogen, treated with cefazolin and rifampicin. He developed a massive digestive hemorrhage. Prothrombin time was prolonged with severe vitamin-K-dependent clotting-factor deficiency. Severe bleeding can occur during cefazolin and rifampicin use. This deficiency should be assessed before prescribing cefazolin-rifampicin and prothrombin time monitored.
Successful Treatment of Severe Type B Lactic Acidosis in a Patient with HIV/AIDS-Associated High-Grade NHL
Authors: Marco Mejia, Ariel Perez, Harold Watson, Daniel Sanchez, Jorge Parellada, Mario Madruga, S J Carlan
Journal: Case Reports Immunol (2018)
MeSH terms: Case Reports

Type B lactic acidosis is a rare metabolic complication sometimes associated with hematologic malignancies. When present, this type of lactic acidosis is most commonly seen in patients with high-grade lymphomas or leukemias and is usually indicative of a dismal prognosis. We report a case of a 27-year man with acquired immunodeficiency syndrome (AIDS) that presented with bilateral lower extremity swelling, an abdominal mass, and weight loss. His lab values showed elevated anion gap with lactic acidosis and computed tomography (CT) of the abdomen showed a large soft-tissue mass arising from the left hepatic lobe. Biopsy of the abdominal mass demonstrated a high-grade diffuse large B-cell lymphoma. The patient's lactic acidosis resolved after starting chemotherapy, and a complete response was evident on PET-CT after a third cycle of rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOC-RR). Care-givers should be aware of the implications of lactic acidosis associated with malignancy and the need for prompt diagnosis and treatment.
Giant Paratubal Cyst Mimicking Mesenteric Cyst
Authors: Ebrahim Almahmeed, Abdulaziz Alshaibani, Hamad Alhamad, Abdulmenem Abualsel
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Paratubal cysts are adnexal masses located in the broad ligament; whenever the size of the cyst is >20 cm, it is considered a giant cyst and can present with complications including ovarian torsion and perforation. Diagnosis can be made clinically with the help of radiological investigations, although the gold standard diagnostic tool is diagnostic laparoscopy. Managing this condition relies mainly on surgical intervention (open or laparoscopic). Giant paratubal cysts carry challenges in their surgical excision as they carry a higher risk of spillage. We present a case of giant paratubal cyst in a 26-year-old Bahraini female who presented with abdominal distension and pain for 3 years.
Simultaneous Association of Variations in the Origin and Diameter of the Left Vertebral Artery in a Patient with a C1 Lateral Mass Tumor
Authors: Seyed Reza Mousavi, Majid Reza Farrokhi, Shayan Yousufzai, Maryam Naseh, Fatemeh Karimi
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

The anomalous origin of a hypoplastic Left Vertebral Artery (LVA) from the aortic arch is a rare anatomic variant. This study discusses the case of a patient with a C1 lateral mass tumor that surrounded a dominant Right Vertebral Artery (RVA) according to preoperative computed tomography angiography, with a hypoplastic LVA originating from the aortic arch. Surgery was performed, and the patient recovered uneventfully. To date, no study has reported the simultaneous association of two variations (origin and diameter) in the LVA. A deep understanding of abnormalities in the diameter and origin of LVA is a must for neurosurgeons as well as for thoracic and vascular surgeons to conduct surgical procedures.
Compound Odontoma Associated with Dentigerous Cyst Incidentally Detected in an Adult Patient: Tomography and Histological Features
Authors: Mattia Manfredini, Susanna Ferrario, Luca Creminelli, Elisabetta Kuhn, Pier Paolo Poli
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Odontoma is the most common benign odontogenic tumor of epithelial and mesenchymal origin. The standard treatment involves a conservative approach. While this procedure is generally well accepted and tolerated, some difficulties may arise in case of odontomas associated with cystic lesions. In general, the expansive nature of cystic lesions requires their surgical excision, different from isolated nonsymptomatic odontomas that can be monitored radiographically. However, to the best of our knowledge, there is scarce evidence currently available reporting on the presence of odontoma-associated cystic lesions in the oral cavity. Therefore, the present case report is aimed at describing the diagnostic clinical, radiological, and histological features together with the surgical management of a dentigerous cyst associated with a compound odontoma. Following surgical removal of the lesion, no recurrence was observed after 12 months of follow-up.