OpenMed/multicare-articles huggingface dataset:
Mature ovarian teratoma with carcinoid tumor in a 28-year-old patient
Authors: Stamatios Petousis, Ioannis Kalogiannidis, Chrysoula Margioula-Siarkou, Alexandros Traianos, Dimosthenis Miliaras, Apostolos Kamparoudis, Apostolos Mamopoulos, David Rousso
Journal: Case Rep Obstet Gynecol (2013)

Introduction. Coexistence of carcinoid tumor inside a mature cystic teratoma is an extremely rare phenomenon, especially in young women. We present the case of a 28-year-old woman diagnosed with a right ovarian carcinoid and treated uneventfully with conservative surgical approach. Case Report. A 28-year-old woman, gravid 0, parity 0, presented to our department for her annual gynecological examination and Pap smear test. During her examination, a mobile cystic mass was detected in the right lower abdomen. Ultrasound indicated a right ovarian mass 10.5 × 6.3 cm, confirmed by CT scan. Further investigation revealed AFP levels (1539 ng/mL). The ovarian mass was excised by laparoscopy, leaving intact the remaining right ovary. Frozen sections showed a mature cystic teratoma. However, paraffin sections revealed the presence of a small carcinoid within the teratoma's gastric-type mucosa. The patient was set to a close followup. Nine months postoperatively, ultrasound pelvis imaging and CT scan of the abdomen as well as serum tumor markers have shown no evidence of recurrence disease. Conclusion. Despite the weak evidence, fertility spare surgical approach for women wanting to preserve their genital tract might be a reasonable option.
Tuberous sclerosis associated with polycystic kidney disease: effects of rapamycin after renal transplantation
Authors: C Rosado, P García-Cosmes, P Fraile, F Vázquez-Sánchez
Journal: Case Rep Transplant (2013)

Tuberous sclerosis is rarely associated with autosomal dominant polycystic kidney disease in the so-called tuberous sclerosis complex. This association leads to an increased frequency of end-stage renal disease. We present a patient suffering from both syndromes, who received a renal graft and anticalcineurinic drugs as immunosuppressive agents. Progressive titration of the drug was necessary in order to attain the effective doses due to the enzymatic induction caused by concomitant treatment with antiepileptic drugs. These high doses resulted in nephrotoxicity. Immunosuppressor treatment was switched to rapamycin, whereby an improvement in renal function and other signs of tuberous sclerosis and polycystic kidney disease was observed. This case report highlights both the efficacy and safety of rapamycin as an immunosuppressor treatment and its capacity for controlling other symptoms of these genetic-related disorders.
Effective Analgesia with Bilateral Erector Spinae Plane Catheters for a Patient with Traumatic Rib and Spine Fractures
Authors: L Klesius, K Schroeder
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

Pain management in trauma patients with acute rib and spine fractures presents a challenge for the anesthesiologist and achieving adequate analgesia is important in preventing pulmonary complications. Unfortunately, neuraxial techniques are often challenging or contraindicated due to spine fractures or coagulopathy. Erector spinae plane (ESP) blocks provide an alternative regional anesthetic technique to manage pain. We describe a case of bilateral ESP catheters placed intraoperatively after spinal instrumentation in a patient with bilateral rib and spine fractures sustained in a tractor rollover crash. Prior to surgery, the patient had inadequate pain control and poor respiratory function despite multimodal analgesia. With the addition of bilateral ESP catheters, the patient's pain control improved and he was weaned from respiratory support. ESP blocks have been shown to provide effective analgesia in patients with rib fractures; however, the utilization of these blocks has not been described in patients with spine fractures undergoing spinal instrumentation. Thus, ESP blocks provide a simple alternative to providing surgical and trauma analgesia when neuraxial techniques are contraindicated. The success of bilateral ESP catheters in our patient indicates a further area for application of ESP blocks in patients undergoing spine surgery with acute traumatic spine fractures.
Intestinal Hemangiomatosis: Case Report of an Uncommon Cause of Rectal Bleeding
Authors: Rita Pina-Prata, Carina A Ruano, Vera B Carvalho, Ana Nunes, Eugénia Soares
Journal: J Belg Soc Radiol (2023)
Keywords: gastroenterology, hemangioma, intestinal, pediatrics, radiology
MeSH terms: Case Reports

A four-month-old girl presented with recurrent low gastrointestinal hemorrhage. Abdominal ultrasound showed diffuse parietal thickening and hyperemia of the colon. Computed tomography (CT) demonstrated diffuse thickening of the colon but also intense arterial globular mural enhancement with diffuse filling in the portal phase. Colonoscopy revealed multiple pseudopolipoid lesions along the colon which were histologically diagnosed as hemangiomas. The infant was diagnosed with gastrointestinal hemangiomatosis and was treated with propranolol resulting in complete resolution of symptoms.
Teaching point:
Although rare, the possibility of intestinal hemangiomatosis should be considered in the setting of rectal bleeding in an infant.
Left ventricular pseudoaneurysmectomy in patient without hemodynamic instability: A case report
Authors: Zviad Bakhutashvili, Lia Janelidze, Kakhaber Beria, Nana Bakashvili, Nika Kuridze
Journal: Clin Case Rep (2023)
Keywords: dor technique, aneurysmectomy, left ventricular aneurysm
MeSH terms: Case Reports

We present a case of a 66-year-old male with a history of two previous diagnoses of myocardial infarction, followed by drug-eluting stent implantation. During the check-up, he complained of dyspnea, fatigue, and dizziness. Echocardiography revealed a massive left ventricular pseudoaneurysm (LVP). According to the patient's clinical manifestations and radiologic data, urgent surgical intervention was performed. Postoperatively, several complications appeared, which were managed successfully. The patient was discharged in stable condition. This is an interesting case of massive LVP without hemodynamic instability.
Small bowel exteriorisation after uterine perforation from manual vacuum aspiration for abortion in a young cameroonian: a case report
Authors: Efuetnkeng Bechem, Djokam Leopold, Takang William Ako
Journal: Pan Afr Med J (2016)
Keywords: manual vacuum aspiration, abortion, small bowel, uterine perforation
MeSH terms: Abortion, Incomplete / therapy, Intestine, Small / pathology, Uterine Perforation / etiology, Vacuum Curettage / adverse effects, Case Reports, Cameroon, Female, Humans, Pregnancy, Pregnancy Trimester, First, Vacuum Curettage / methods, Young Adult

Manual vacuum aspiration is an effective and safer surgical method of uterine evacuation for an abortion. Nonetheless, it can present some life-threatening complications like uterine perforations. In a uterine perforation the suction cannula is thought to be usually involved in the perforation and the resulting intraabdominal organ damage. We presented a case of a young muilti-parous Cameroonian woman who was underwent a manual vacuum aspiration for a first trimester incomplete abortion, and which was complicated by a fundal uterine perforation with exteriorisation of small bowels through the vagina.
Invasive carcinoma in accessory axillary breast tissue: A case report
Authors: Ruqayya Naheed Khan, Muhammad Asad Parvaiz, Amina Iqbal Khan, Asif Loya
Journal: Int J Surg Case Rep (2019)
Keywords: accessory breast tissue, breast carcinoma, ectopic breast tissue

Introduction:
Accessory or ectopic breast tissue is an aberration of normal breast development. It is known to be a rare entity present anywhere along the embryologic mammary streak or milk line but more common in axilla.
Presentation of case:
We report a case of 36 year old female with accessory breast carcinoma who presented with a progressive lump in her left axilla for 1 year. On examination a 2 cm solitary mass was palpable in axilla. Ultrasound confirmed a 19 mm mass with no other lesion in breast and axilla. Core biopsy showed invasive ductal carcinoma. She was discussed in multidisciplinary board meeting and was offered upfront surgery with excision of accessory breast tissue and sentinel lymph node biopsy. Axillary lymph node dissection was omitted following ACOSG Z0011 criteria. She was offered adjuvant chemotherapy and radiation post operatively along with endocrine treatment as she was hormone receptor positive.
Discussion:
Accessory breast development is hormone dependent just like normal breast. Breast cancer in accessory breast tissue is very rare. The incidence is around 6%. Most common pathology is invasive ductal carcinoma (50-75%). The most common location is axilla (60-70%) although it can present in other less common locations like infra-mammary region (5-10%) and rarely in thighs, perineum, groin, and vulva.
Conclusion:
Since accessory axillary breast tissue is out of the image of screening breast examination, it is necessary for the oncologists to be aware of this entity and associated pathologies. Their preventive excision in high risk women can also be considered.
A Third Surgically Managed Ectopic Pregnancy after Two Salpingectomies Involving the Opposite Tube
Authors: Naoyuki Iwahashi, Yoko Deguchi, Yuko Horiuchi, Kazuhiko Ino, Kenichi Furukawa
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Recurrent ectopic pregnancy in a remnant fallopian tube after ipsilateral salpingectomy is clinically rare. We report the extremely rare case of a third recurrent ectopic pregnancy after two previous salpingectomy procedures involving the opposite tube. A 26-year-old woman, gravida 3 para 0, experienced three ectopic pregnancies brought about by natural conception, all of which were treated surgically (right partial salpingectomy, right remnant tube resection, and left total salpingectomy). During the two salpingectomy procedures involving the right tube, the patency of the intact left tube was intraoperatively confirmed with indigo carmine. The most appropriate surgical intervention should be discussed when managing recurrent ectopic pregnancies. It might be necessary to perform total salpingectomy to reduce the risk of future recurrence on the remaining tube.
Microabrasion: an effective method for improvement of esthetics in dentistry
Authors: Biji Balan, Chengappa Madanda Uthaiah, Sreejesh Narayanan, Priyadarshini Mookalamada Monnappa
Journal: Case Rep Dent (2013)

Enamel microabrasion can eliminate enamel irregularities and discoloration defects, thus improving the appearance of teeth. This paper presents the latest treatment protocol of enamel microabrasion to remove stains on the enamel surface. It has been verified that teeth submitted to microabrasion acquire a yellowish colour because of the thinness of the remaining enamel, revealing the colour of dentinal tissue to a greater degree. Enamel microabrasion is a technique that can be used to correct discoloured enamel. Enamel microabrasion was developed in the mid-1980s as a method of eliminating enamel discolouration defects and improving the appearance of teeth. Several years after the method was developed, much has been learned about this technique, long-term results of treatment, and microscopic changes to the enamel surface that have distinguishable clinical implications. In addition, certain patients can benefit from enamel microabrasion to yield attractive cosmetic results. The aim of this study was to report the clinical case of a male patient of 25 years with moderate fluorosis, whose smile was re-established by the use of an enamel microabrasion technique, with 18% hydrochloric acid and pumice slurry shown to be a safe and efficient method for removing fluorosis stains.
Oral candidiasis in Chikungunya viral fever: a case report
Authors: Jairaj C Kumar, Y Vivek, Pk Sudhindra, Bd Dhananjaya, Amith T Kumar, Kumar Guru, Arunachalam Kumar, Monappa B Hegde
Journal: Cases J (2010)

A 32 year old Indian male patient presented with chief complaints of a high fever, erythema on ear, severe polyarthritic joint pains & swelling, non pitting pedal oedema, facial puffiness and itching for past four days. He had no significant past medical and drug history and was serologically confirmed to have Chikungunya. Oral cavity inspection revealed whitish non erythematous pseudo membranous plaques on the hard palate, buccal surface of cheek and the floor of the mouth which was later microbiologically confirmed as Candidiasis. He tested negative for HIV and had leucopenia with severe CD4 T-lymphocytopenia. This is the first report of an opportunistic infection with CD4 T-lymphocytopaenia in Chikungunya fever.
Human adenovirus associated with severe cold agglutinin syndrome: a rare complication in Pediatrics
Authors: Julia Loureiro Sion, Angelica Lucía Hidalgo Flores, Regina Aparecida Cardoso, Marlene Pereira Garanito
Journal: Rev Paul Pediatr (2023)
MeSH terms: Adenoviruses, Human, Anemia / etiology, Case Reports, Adult, Blood Transfusion, Child, Female, Humans, Young Adult, cold agglutinins

Objective:
The objectives of this study were to describe the first pediatric case of cold agglutinin syndrome (CAS) triggered by human adenovirus and review the literature.
Case description:
This case report involves a previously healthy, 2½-year-old female child with human adenovirus isolated in a nasal swab. At 72 h after admission, the patient progressed to a severe episode of anemia (hemoglobin level: 2.6 g/dL). The laboratory findings were consistent with CAS. The patient received blood transfusion, vitamin supplementation, adequate hydration, and thermal protection. At her last follow-up, 1 year after her initial presentation, she remains clinically well without signs of hemolysis.
Comments:
While severe CAS is extremely uncommon in the pediatric emergency department, human adenovirus infection is a common illness in pediatrics. Recently, the adenovirus has been associated with new complications (acute hepatitis and fulminant liver failure). Pediatric physicians and hematologists should be aware of unusual evolution, signs, and symptoms of this infection that warrant more urgent medical attention. In this case, the hematologic complication suspicion was the key to early diagnosis and adequate management.
Atresia of the ascending colon: a rarity
Authors: Haroon Mansoor, Naila Kanwal, Mahmood Shaukat
Journal: APSP J Case Rep (2010)
Keywords: atresia of ascending colon, early ileostomy reversal, neonatal intestinal obstruction
MeSH terms: Case Reports

Atresia of the colon is among the rare types of all gastrointestinal atresias. Ascending colon is the rarest site of all the colonic atresias. The authors report a case of a 4-day-old male baby who presented with the features of distal intestinal obstruction. At laparotomy type I atresia of the ascending colon, just distal to cecum, was found. Primary ceco-colic anastomosis along with a covering ileostomy was performed. Ileostomy was reversed 3 weeks later.
Gas Expansion Three Days after Pars Plana Vitrectomy with Sulfur Hexafluoride 20% Tamponade following Carbon Monoxide Toxicity and Oxygen Therapy
Authors: Mojtaba Abrishami, Mehrdad Motamed Shariati, Ali Bolouki, Ghodsieh Zamani
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

Purpose:
To report an unusual case of gas expansion following oxygen therapy in a patient with sulfur hexafluoride (SF6) 20% tamponade after pars plana vitrectomy. Case Report. A 40-year-old man came to the clinic with severe ocular pain and redness and also vision decrease in his left eye three days after uncomplicated 23-gauge pars plana vitrectomy, internal limiting membrane peeling combined with phacoemulsification, and using 20% SF6 injection as a tamponade agent due to significant cataract and a full-thickness macular hole. In ophthalmic examinations of his left eye, high intraocular pressure (approximately 70 mmHg), a flat anterior chamber, and a gas-filled vitreous cavity were found. The patient had been hospitalized the day before due to carbon monoxide poisoning and had undergone oxygen therapy with a pure 100% mask for three hours.
Conclusion:
It seems that oxygen therapy or carbon monoxide poisoning increases the volume of gas in the patient's vitreous cavity and the nonexpansile percentage of SF6 expands.
Uterine Rupture at 21 Weeks in Twin Pregnancy with TTTS and Previous C-Section
Authors: Gieta Bhikha-Kori, Marieke Sueters, Johanna M Middeldorp
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Uterine rupture is a health problem in every country. The diagnosis is not always obvious and fetal and maternal morbidity and mortality can be high.
Clinical Resolution of Osmotic Demyelination Syndrome following Overcorrection of Severe Hyponatremia
Authors: Ruhin Yuridullah, Vinod Kumar, Sushant Nanavati, Monisha Singhal, Chandra Chandran
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Osmotic Demyelination Syndrome (ODS) occurs after rapid overcorrection of severe chronic hyponatremia usually in those with a predisposition such as chronic alcoholism, malnutrition, or liver disease. Rarely, do patients make a full recovery. We report a case of ODS secondary to overcorrection of severe hyponatremia with pathognomonic clinical and radiologic signs making a complete neurological recovery. A detailed course of events, review of literature, and optimal and aggressive management strategies are discussed. There is some controversy in the literature regarding the prognosis of these patients. Our aim here is to show that, with aggressive therapy and long-term care, recovery is possible in these patients.
Myoglobin clearance by super high-flux hemofiltration in a case of severe rhabdomyolysis: a case report
Authors: Toshio Naka, Daryl Jones, Ian Baldwin, Nigel Fealy, Samantha Bates, Hermann Goehl, Stanislao Morgera, Hans H Neumayer, Rinaldo Bellomo
Journal: Crit Care (2005)
MeSH terms: Acute Kidney Injury / complications, Hemofiltration / methods, Myoglobin / blood, Myoglobinuria / therapy, Rhabdomyolysis / therapy, Serotonin Syndrome / complications, Case Reports, Comparative Study, Female, Glasgow Coma Scale, Hemofiltration / instrumentation, Hospitals, Teaching, Humans, Intensive Care Units, Middle Aged, Oliguria / complications, Serotonin Syndrome / diagnosis, Serotonin Syndrome / therapy, Time Factors, Myoglobin

Objective:
To test the ability of a novel super high-flux (SHF) membrane with a larger pore size to clear myoglobin from serum.
Setting:
The intensive care unit of a university teaching hospital.
Subject:
A patient with serotonin syndrome complicated by severe rhabodomyolysis and oliguric acute renal failure.
Method:
Initially continuous veno-venous hemofiltration was performed at 2 l/hour ultrafiltration (UF) with a standard polysulphone 1.4 m2 membrane (cutoff point, 20 kDa), followed by continuous veno-venous hemofiltration with a SHF membrane (cutoff point, 100 kDa) at 2 l/hour UF, then at 3 l/hour UF and then at 4 l/hour UF, in an attempt to clear myoglobin.
Results:
The myoglobin concentration in the ultrafiltrate at 2 l/hour exchange was at least five times greater with the SHF membrane than with the conventional membrane (>100,000 microg/l versus 23,003 microg/l). The sieving coefficients with the SHF membrane at 3 l/hour UF and 4 l/hour UF were 72.2% and 68.8%, respectively. The amount of myoglobin removed with the conventional membrane was 1.1 g/day compared with 4.4-5.1 g/day for the SHF membrane. The SHF membrane achieved a clearance of up to 56.4 l/day, and achieved a reduction in serum myoglobin concentration from >100,000 microg/l to 16,542 microg/l in 48 hours.
Conclusions:
SHF hemofiltration achieved a much greater clearance of myoglobin than conventional hemofiltration, and it may provide a potential modality for the treatment of myoglobinuric acute renal failure.
Kawasaki Disease Complicated by Late-Onset Fatal Cerebral Infarction: A Case Report and Literature Review
Authors: Lin Wang, Hongyu Duan, Kaiyu Zhou, Yimin Hua, Xiaoliang Liu, Chuan Wang
Journal: Front Pediatr (2021)
Keywords: cerebral infarction, coronary artery aneurysms, kawasaki disease, late-onset, thrombosis
MeSH terms: Case Reports

Background: Cerebral infarction is a rare neurological complication of Kawasaki disease (KD) and occurs in the acute or subacute stage. There have been no reported cases of late-onset fatal cerebral infarction presenting over 1 year after the onset of KD. Case Presentation: A 5-month-old male patient with KD received timely intravenous immunoglobulin therapy; however, extensive coronary artery aneurysms (CAA) and coronary artery thrombosis (CAT) developed 1 month later. Anticoagulation and thrombolytic agents were suggested, but the child's parents refused. Fifteen months after KD onset, an attack of syncope left him with left hemiplegia; brain computerized tomography (CT) scans revealed cerebral infarction of the right basal ganglion without hemorrhage. Magnetic resonance angiography (MRA) revealed severe stenosis of the right middle cerebral artery, and a series of tests were performed to exclude other causes of cerebral infarction. Considering the cerebral infarction and CAT, combination therapy with urokinase and low-molecular-weight heparin (LMWH) was initiated within 24 h of syncope onset, together with oral aspirin and clopidogrel. Five days later, his clinical symptoms partially regressed and he was discharged. Unfortunately, 5 days after discharge, his clinical condition suddenly deteriorated. Repeat brain CT showed hemorrhagic stroke involving the entire left cerebral area, in addition to the previous cerebral infarction in the right basal ganglion, with obvious secondary cerebral swelling and edema, which might have been caused by previous thrombolysis. Severe cerebral hernias developed quickly. Regrettably, the patient's parents abandoned treatment because of economic factors and unfavorable prognosis, and he died soon after. Conclusions: Cerebral infarction and cerebral artery stenosis can develop late, even 1 year after the onset of KD. Pediatricians should be aware of the possibility of cerebrovascular involvement in addition to cardiac complications during long-term follow-up of KD patients. Prompt anticoagulation therapy and regular neuroimaging evaluation are essential for the management of patients with KD with giant CAA and/or CAT.