OpenMed/multicare-articles huggingface dataset:
Physiologic Midtreatment Tooth Movement as a Correction Strategy for Iatrogenic Root Exposure
Authors: Adith Venugopal, Paolo Manzano, M Srirengalakshmi, Anand Marya, Nikhilesh R Vaid, S Jay Bowman
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

In the case report showcased, we describe orthodontic treatment of a female patient with an excessive gingival display on smiling and severe dental crowding, with maxillary canines positioned excessively buccal (ectopic) to and in near transposition to the lateral incisors. The treatment involved extractions and initial use of unmitigated forces leading to excessive gingival thinning and buccal root positioning of the ectopic canines. Eventually, the root position was corrected and periodontal equilibrium was attained. On finishing the treatment, all objectives were achieved with a good esthetic outcome as well as excellent dental and occlusal relationships.
Case Report: Wide-to-Narrow QRS Tachycardia in a 3-Month-Old Infant
Authors: Liang Zhao, Song Yan, Tao Wang, Yimin Hua, Kaiyu Zhou
Journal: Front Cardiovasc Med (2021)
Keywords: coumel law, electrophysiological, infant, tachycardia, transesophageal
MeSH terms: Case Reports

Introduction: It is rare to find that wide QRS tachycardia automatically changes to narrow QRS tachycardia, and it is more difficult to clarify the mechanism. Case Report: A 3-month-old infant with recurrent paroxysmal supraventricular tachycardia underwent transesophageal cardiac electrophysiological examination. The wide QRS tachycardia was induced by atrial RS2 stimulation, and it soon changed to narrow QRS tachycardia automatically. By the accurate measurement of esophageal lead, it was found that the electrocardiogram changes completely conform to Coumel law. The mechanism of wide and narrow QRS tachycardia was orthodromic atrioventricular reentrant tachycardia with or without ipsilateral functional bundle branch block, and the accessory pathway was defined as the left free wall-concealed accessory pathway. Conclusion: Transesophageal cardiac electrophysiological examination can reveal some special electrophysiological phenomena, and its non-invasive nature is especially suitable for infants.
The enigma of vasculitis
Authors: Daniela Ghetie, Alla Rudinskaya, Raymond Raut
Journal: Int J Rheumatol (2010)
MeSH terms: Case Reports

We describe the case of an 86-year-old man presenting with clinical symptoms suggestive of Temporal Arteritis. The evolution of the case prompted extensive work-up, including temporal artery and kidney biopsy. Based on the clinical and pathological findings, a diagnosis of ANCA-negative granulomatous necrotizing vasculitis involving the small-, medium-, and large-size vessels was made. The patient was treated with prednisone and cyclophosphamide, which was later switched to rituximab. The patient remained asymptomatic under this regimen and stabilization of his kidney function was achieved.
Foreign Body Ingestion Followed by Appendiceal Perforation
Authors: Sarah Qassim, Ali Lairy, Sami Asfar
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Background:
Foreign body ingestion is very common among specific groups, especially children. However, appendicitis and perforated appendix caused by a foreign body is rare. Case summary. A 40-year-old female presented with abdominal pain in the right lower quadrant of 10 days duration after accidentally ingesting a drilling bit during a dental procedure. She had right iliac fossa tenderness on physical examination. X-ray showed a pointed long metal object in the right lower quadrant. A contrast-enhanced computed tomography scan of the abdomen revealed a pointed metal object in the pelvis with inconclusive location. Diagnostic laparoscopy showed an inflamed appendix with the tip of the metal object perforating it. Appendectomy was performed. Histopathology showed an inflamed appendix.
Conclusion:
Foreign bodies that cause appendicitis are rare. However, they may become lodged at any site of the gastrointestinal tract and cause inflammation or perforation. This is a bizarre case of foreign body-induced appendicitis with perforation.
IgLON5-Associated Encephalitis With Atypical Brain Magnetic Resonance Imaging and Cerebrospinal Fluid Changes
Authors: Massimiliano Montagna, Rizvana Amir, Ilse De Volder, Martin Lammens, Jef Huyskens, Barbara Willekens
Journal: Front Neurol (2018)
Keywords: iglon5, akathisia, autoimmune encephalitis, brain inflammation, dyskinesia, rapidly evolving dementia
MeSH terms: Case Reports

IgLON5-associated encephalitis is a syndrome with different clinical presentations consisting of sleep dysfunction, bulbar dysfunction, chorea, and progressive supranuclear palsy-like symptoms whereas dysautonomy and cognitive decline usually appear in later stages of the disease. We report a case of a patient with IgLON5-associated encephalitis presenting with rapidly progressive cognitive decline and atypical inflammatory lesions on brain magnetic resonance imaging, oligoclonal bands on cerebrospinal fluid, anti-IgLON5 antibodies exclusively of the IgG1 class, and a fierce inflammatory reaction on brain biopsy, who responded favorably to immunotherapy.
Squamous Cell Carcinoma in a Calyceal Diverticulum Detected by Percutaneous Nephroscopic Biopsy
Authors: Taku Mitome, Tadashi Tabei, Yukio Tsuura, Kazuki Kobayashi
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

A 73-year-old woman was referred to our department with a complaint of asymptomatic gross hematuria. Dynamic computed tomography revealed a complicated (Bosniak type IIF) cyst in the upper pole of her right kidney, which was diagnosed as a calyceal diverticulum. The diagnosis was confirmed by ureteroscopy. The diverticulum was filled with a soft protein matrix that was difficult to completely remove from the inner surface of the calyceal diverticulum. Endoscopy combined with intrarenal surgery (ECIRS) was performed to completely remove the matrix. Percutaneous nephroscopy further revealed papillary lesions on the surface of the diverticulum, confirmed as squamous cell carcinoma on pathological assessment. A laparoscopic right radical nephroureterectomy was performed, with curative intent. Pathological assessment confirmed a high-grade squamous cell carcinoma with renal parenchymal invasion (pT3). Although carcinomas in a calyceal diverticulum are highly uncommon, when present, these tend to be high-grade neoplasms that deeply invade the parenchymal wall. As the effective management of these lesions is difficult, early-stage diagnosis is required for curative treatment. We report the case of squamous cell carcinoma in a calyceal diverticulum that was difficult to diagnose on preoperative computed tomography, urinal cytology examination, and ureteroscopy but was found during ECIRS.
Metastatic Breast Cancer Coexisting With HER-2 Amplification and EGFR Exon 19 Deletion Benefits From EGFR-TKI Therapy: A Case Report
Authors: Wei Jing, Jie-Tao Ma, Cheng-Bo Han
Journal: Front Oncol (2020)
Keywords: egfr mutation, her-2 amplification, breast cancer, lung metastasis, molecular targeted therapy
MeSH terms: Case Reports

Background: Patients with different molecular subtypes of breast cancers have different recurrence risks and prognoses. Clinical support and evidence to guide management are absent for patients with breast cancer coexisting with HER-2 amplification and EGFR mutations. Case presentation: We report a case of breast cancer coexisting with HER-2 amplification and EGFR exon 19 deletion (E19 del). The patient presented with solitary pulmonary nodule and enlargement of hilar and mediastinal lymph nodes 2 years after radical mastectomy. Biopsy of the subcarinal lymph node showed suspected adenocarcinoma. The specimen was too small for further immunohistochemistry, but an EGFR E19 del was discovered. Due to the primary diagnosis of EGFR-mutant lung adenocarcinoma, EGFR-TKI gefitinib was administered and resulted in 1 year of stable disease until the patient developed progression in the right pulmonary nodule with new metastatic cervical lymph nodes. According to histopathological findings of re-biopsy of the pulmonary nodule and left cervical and subcarinal lymph nodes, the patient was diagnosed with breast cancer with lung metastasis and multiple lymph node metastases. The patient received multiple anti-HER-2-targeted therapies (trastuzumab for 9.7 months, lapatinib for 9 months, and pyrotinib for 4+ months) and survived for more than 36 months after lung metastasis. Conclusions: This case suggested that breast cancer coexisting with HER-2 amplification and EGFR E19 del may be driven by both HER-2 and EGFR signaling pathways, and patients can benefit from EGFR-TKI and anti-HER-2 therapy.
Indications and Limitations of Sirolimus in the Treatment of Vascular Anomalies-Insights From a Retrospective Case Series
Authors: Anna Karastaneva, Paolo Gasparella, Sebastian Tschauner, Roman Crazzolara, Gabriele Kropshofer, Manfred Modl, Andreas Pfleger, Ante Burmas, Mirjam Pocivalnik, Raphael Ulreich, Werner Zenz, Wolfgang Schwinger, Besiana P Beqo, Christian Urban, Emir Q Haxhija, Herwig Lackner, Martin Benesch
Journal: Front Pediatr (2022)
Keywords: covid-19, kasabach–merritt phenomenon, central conducting lymphatic anomaly (ccla), epithelioid hemangioendothelioma (ehe), sirolimus, vascular anomalies, vincristine

Background:
Despite recent developments, the role of sirolimus in the heterogeneous spectrum of vascular anomalies is yet to be defined, in terms of indication, dosage, and therapy duration, recognizing both its potential and limitations.
Methods:
We retrospectively analyzed 16 children with vascular anomalies treated with sirolimus in two pediatric centers between 2014 and 2020 [male: n = 7, the median age at diagnosis: 4.6 months (range, 0-281.4)]. In addition, repetitive volumetric analyses of the vascular anomalies were performed when possible (11 cases).
Results:
Ten patients were diagnosed with vascular malformations and 6 with vascular tumors. The mean therapy duration was 27.2 months (range, 3.5-65). The mean sirolimus level was 8.52 ng/ml (range, 5.38-12.88). All patients except one with central conducting lymphatic anomaly responded to sirolimus, with the most noticeable volume reduction in the first 4-6 months. Additional administration of vincristine was needed in five patients with kaposiform hemangioendothelioma and yielded a response, even in cases, refractory to sirolimus monotherapy. As a single agent, sirolimus led to impressive improvement in a patient with another vascular tumor-advanced epithelioid hemangioendothelioma. Complicated vascular malformations required long-term sirolimus therapy. Side effects of sirolimus included mucositis and laboratory abnormalities. No major infectious episodes were recorded. An infant with COVID-19, diagnosed while on sirolimus therapy, presented with a mild course.
Conclusion:
In the current series, we reported limitations of sirolimus as monotherapy, addressing the need to redefine its indications, and explore combination regimens and multimodal treatment strategies. Tools for objective evaluation of response trends over time could serve as a basis for the establishment of future therapeutic algorithms.
Malaria parasite carriage before and two years after the implementation of seasonal malaria chemoprevention: a case study of the Saraya health district, southern Senegal
Authors: Isaac Akhenaton Manga, Mamadou Sarifou Ba, Fassiatou Tairou, Amadou Seck, Ekoue Kouevidjin, Doudou Sow, Khadime Sylla, Magatte Ndiaye, Fatou Ba Fall, Alioune Babara Gueye, Ibrahima Diallo, Médoune Ndiop, Mady Ba, Roger Clément Tine, Omar Gaye, Babacar Faye, Jean Louis Abdourahim Ndiaye
Journal: Wellcome Open Res (2022)
Keywords: plasmodium, senegal, carriage, malaria, seasonal malaria chemoprevention

Background : Seasonal malaria chemoprevention (SMC) has been adopted and implemented in the southern regions of Senegal in children aged between three and 120 months since 2013. Scaling up this strategy requires its evaluation to assess the impact. This study was carried out to determine the dynamics of Plasmodium falciparum carriage before and after two years of SMC implementation. Methods : Four household surveys were conducted in villages in the health district of Saraya, which is a SMC implementation area in Senegal. These villages were selected using probability proportional to size sampling. Each selected village was divided into segments containing at least 50 children. In each segment, a household questionnaire was administered to the parents or legal representatives of children aged three to 120 months. Blood smears were collected to determine P. falciparum prevalence by microscopy one month before the first round of SMC, one month after the last round of the first SMC campaign and two years after the start of the implementation. Results : A total of 2008 children were included with a mean average age of 4.81 (+/-2.73) years. Of the study population, 50.33% were more than five years old and 50.3% were male. In 2013, mosquito net ownership was 99.4 % before the SMC campaign and 97.4% after. In 2015, it was 36.6% before and 45.8% after the campaign. In 2013, the prevalence of plasmodium carriage was 11.8% before and 6.1% after the SMC campaign. In 2015, the prevalence was 4.9% before the administration of SMC and this increased up to 15.3% after. Malaria prevalence was high among children over five years old and in boys. Conclusions : The decrease in Plasmodium falciparum parasite prevalence, which subsequently increased after two years of SMC implementation in this study, suggests adding an extra cycle of the SMC or adjusting the administration period.
Signaling pathway screening platforms are an efficient approach to identify therapeutic targets in cancers that lack known driver mutations: a case report for a cancer of unknown primary origin
Authors: Pedro Torres-Ayuso, Sudhakar Sahoo, Garry Ashton, Elvira An, Nicole Simms, Melanie Galvin, Hui Sun Leong, Kristopher K Frese, Kathryn Simpson, Natalie Cook, Andrew Hughes, Crispin J Miller, Richard Marais, Caroline Dive, Matthew G Krebs, John Brognard
Journal: NPJ Genom Med (2018)
MeSH terms: Case Reports

Precision medicine aims to tailor cancer therapies to target specific tumor-promoting aberrations. For tumors that lack actionable drivers, which occurs frequently in the clinic, extensive molecular characterization and pre-clinical drug efficacy studies will be required. A cell line maintained at low passage and a patient- derived xenograft model (PDX) were generated using a fresh biopsy from a patient with a poorly-differentiated neuroendocrine tumor of unknown primary origin. Next-generation sequencing, high throughput signaling network analysis, and drug efficacy trials were then conducted to identify actionable targets for therapeutic intervention. No actionable mutations were identified after whole exome sequencing of the patient's DNA. However, whole genome sequencing revealed amplification of the 3q and 5p chromosomal arms, that include the PIK3CA and RICTOR genes, respectively. We then conducted pathway analysis, which revealed activation of the AKT pathway. Based on this analysis, efficacy of PIK3CA and AKT inhibitors were evaluated in the tumor biopsy-derived cell culture and PDX, and response to the AKT inhibitor AZD5363 was observed both in vitro and in vivo indicating the patient would benefit from targeted therapies directed against the serine/threonine kinase AKT. In conclusion, our study demonstrates that high throughput signaling pathway analysis will significantly aid in identifying actionable alterations in rare tumors and guide patient stratification into early-phase clinical trials.
Clinical Challenges with Talimogene Laherparepvec: Cured Lymph Nodes Masquerading as Active Melanoma
Authors: Umang Swami, Brian Swick, Yousef Zakharia, Mohammed Milhem
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Talimogene laherparepvec is a novel, genetically engineered, oncolytic herpes virus approved for local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery. It is administered as an intralesional injection. However, if the lesion continues to persist, it presents with a clinical challenge as when to stop treatment. Herein, we present two cases from our institution wherein the disease appeared to be persistent radiologically; however, on pathological excision, there was no evidence of disease and patients continue to be in durable remission after stopping treatment.
Case report: Intracranial and spinal subarachnoid hemorrhage in a dog with Angiostrongylosis
Authors: Koen M Santifort, Marjolein den Toom, Laurent Garosi, Ines Carrera
Journal: Front Vet Sci (2023)
Keywords: angiostrongylus vasorum, t1-hyperintense, canine (dog), hyperesthesia, subarachnoid hemorrhage
MeSH terms: Case Reports

A 1-year-old male intact Staffordshire terrier, born and raised in the Netherlands, was presented with a 3-week history of progressive lethargy and spinal, predominantly cervical, hyperesthesia. Other than hyperthermia and cervical hyperesthesia, general and neurological examination did not reveal any abnormalities. Comprehensive hematological and biochemical tests were considered normal. Magnetic resonance imaging of the craniocervical region revealed heterogeneity of the subarachnoid space, characterized by pre-contrast T1W hyperintensity, corresponding to a T2* signal void. Extending from the caudal cranial fossa to the level of the third thoracic vertebra, there were uneven patchy extra-parenchymal lesions that caused mild spinal cord compression, most marked at the level of C2. At this level, the spinal cord showed an ill-defined hyperintense T2W intramedullary lesion. Mild intracranial and spinal meningeal contrast enhancement was evident on post-contrast T1W images. Subarachnoid hemorrhage was suspected, and further diagnostic tests including Baermann coprology resulted in a diagnosis of hemorrhagic diathesis caused by an Angiostrongylus vasorum infection. The dog rapidly responded to treatment with corticosteroids, analgesic medication, and antiparasitic treatment. Follow-up over 6 months yielded complete clinical remission and repeatedly negative Baermann tests. This case report details clinical and magnetic resonance imaging findings in a dog with subarachnoid hemorrhage associated with an Angiostrongylus vasorum infection.
Hypocalcemia Revealing an Enteropathy-Associated T-cell Lymphoma
Authors: Maria Belen Alonso Ortiz, Noel Lorenzo Villalba, Emilio Almaraz Marroquin, Melek Kechida, Manuel Mendez-Bailon, Imanol Pulido Gonzalez
Journal: Caspian J Intern Med (2019)
Keywords: celiac disease, enteropathy-associated t-cell lymphoma, hypocalcemia, hypomagnesemia
MeSH terms: Case Reports

Background:
Enteropathy-associated T-cell lymphoma (EATL) is a rare and aggressive type of extranodal T-cell lymphoma (TCL) arising in the gastrointestinal (GI) tract and represents 5-8% of all T-cell non-Hodgkin lymphomas (NHL) and 10-25% of primary intestinal lymphomas.
Case presentation:
We reported a 78-year-old woman presenting with severe hypocalcemia. Investigations confirmed vitamin D and iron deficiency as well as hypoalbuminemia. Celiac disease was suspected and confirmed, but despite intravenous calcium and magnesium supplementation and a gluten-free diet, normal electrolyte levels were never reached. Intestinal perforation was the clue to the diagnosis of enteropathy-associated T-cell lymphoma (EATL).
Conclusion:
Hypocalcemia can result from multiple conditions. In patients not responding to adequate supplementation, further investigations should be performed to diagnose the underlying condition.
IgG4-Related Sclerosing Disease Causing Spinal Cord Compression: The First Reported Case in Literature
Authors: Nooraldin Merza, Ahmed Taha, John Lung, Anthony W Benderman, Stephen E Wright
Journal: Case Reports Immunol (2019)
MeSH terms: Case Reports

Immunoglobulin G4-related disease (IgG4-RD) is known for forming soft tissue mass lesions that may have compressive effects. It is an extremely rare disease that most frequently affects the pancreas causing autoimmune pancreatitis. It can also affect the gallbladder, salivary glands, and lacrimal glands causing respective organ-specific complications. In our report, we describe an IgG4-RD case that affected the spinal cord. A 60-year-old female presented with cervical spinal cord compression caused by IgG4-RD leading to several neurological deficits. Pathological examination of the excisional biopsy of the mass revealed dense lymphoplasmacytic cells infiltration and stromal fibrosis with IgG4 and plasma cells. The patient showed a dramatic response to the administration of systemic steroids with almost resolution of her neurological symptoms. This case highlights the first case in literature for IgG4-RD of the extradural tissue causing spinal compression. Hereby, we also demonstrate the dramatic response of IgG4-RD to the administration of systemic steroids as the patient had no recurrence after 5 years of close follow-up, the longest reported period of follow-up reported in the literature to date.
A typical bilateral atrial myxoma: a case report
Authors: Zhenghua Xiao, Wei Meng, Da Zhu, Eryong Zhang
Journal: Case Rep Cardiol (2012)

Myxoma is a rare type of tumor which have an incidence of 0.0017% among the general population. Cardiac myxomas which arise from two different heart chambers is even extremely rare; we herein report a unique case of male patient with bilateral myxoma.
Pure squamous cell carcinoma of the pancreas: a rare and challenging diagnosis (case report)
Authors: Fatima Belabbes, Mohamed Bouziane, Wafaa Kaikani, Abderrahmane Al Bouzidi, Youssef Bennani
Journal: Pan Afr Med J (2023)
Keywords: squamous cell carcinoma, case report, endoscopic ultrasonography, pancreas
MeSH terms: Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / therapy, Pancreatic Neoplasms / diagnosis, Pancreatic Neoplasms / therapy, Case Reports, Biopsy, Endoscopy, Gastrointestinal, Humans, Male, Middle Aged, Pancreas / pathology

Squamous cell carcinoma (SCC) of the pancreas is a rare exocrine ductal tumour with unknown pathophysiology and poor treatment options. We present a case of SCC in a 59-year-old male patient who presented with epigastric pain, vomiting, anorexia, asthenia, and weight loss. Abdomino-pelvic CT revealed a pancreatic mass with adenopathy satellites. Surgical biopsies were negative, and a trans-duodenal gastric endoscopy showed suspicious lymphadenopathies and a hypoechoic lesion invading the portal vein. An anapathological study confirmed SCC at the site of intense necrotic and inflammatory changes. The patient received radio-chemotherapy, but ultimately developed peritoneal carcinoma.