OpenMed/multicare-articles huggingface dataset:
Successful reconstruction using three flaps combination after wide excision due to basosquamous carcinoma: A case report
Authors: Sedra Sheikh Debs, Maher Badawi, Ghina Majd Hussain, Yazan Soliman Khadour, M Noor Khouja, Aladdin Etr
Journal: Int J Surg Case Rep (2024)
Keywords: basosquamous carcinoma, case report, mcgregor flap, nasolabial laterally based cheek flap, v-y glabellar flap
MeSH terms: Case Reports

Introduction:
Basosquamous carcinoma (BSC) is an uncommon and malignant subtype of non-melanoma skin cancer. It has features that are halfway between basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Case presentation:
An 87-year-old female presented with a lesion on her left cheek, nasal ala, medial canthal area, and eyelids. After investigations, which included biopsies and a computed tomography scan (CT), surgery was decided upon to completely remove the mass. A 5 × 4 cm defect after the surgery was reconstructed by mobilizing three flaps, including the McGregor flap, VY glabellar flap, and nasolabial laterally based cheek flap. The excisional biopsy detected malignancy at the lateral border of the upper lid, which led to the patient undergoing surgery to remove the tumor formation. After the second surgery, the histopathology confirmed no malignancy. The patient had functionally and aesthetically pleasing results, preserved eyelid movement and visual field. No surgical complications or recurrences occurred within the first year after the surgery.
Discussion:
BSC is a neoplasm without well-defined histologic characteristics or standardized treatment procedures compared to other non-melanoma skin cancers. However, several studies recommend using wide excision. In our case, Reconstructing the area was challenging due to important anatomical structures and finding tissue that matches the desired appearance, while preserving functional and aesthetic results.
Conclusion:
In this case report, we highlight the value of reconstructing face defects after wide excision due to BSC using three flaps.
Case report: Fatal ischemic stroke induced by unruptured traumatic intracranial vertebral artery dissection
Authors: Shuheng Wen, Kana Unuma, Motoki Inaji, Yohsuke Makino, Shutaro Nagano, Kazuki Harada, Nobutaka Arai, Koichi Uemura
Journal: Front Neurol (2023)
Keywords: forensic autopsy, intracranial vertebral artery dissection, ischemic stroke, shower embolism, traumatic intracranial artery dissection
MeSH terms: Case Reports

Intracranial vertebral artery dissection (IVAD) is rare and potentially fatal due to the risk of secondary subarachnoid hemorrhage once ruptured. Unruptured traumatic IVAD is even rarer and can result in ischemic stroke, yet mostly benign when timely diagnosed. Herein, we present an uncommon case of a patient who underwent a fatal ischemic stroke induced by unruptured traumatic IVAD. The patient was symptomatic soon after being physically assaulted but left untreated until acute deterioration for multiple brain infarctions occurred, secondary to IVAD-induced cerebellar stroke. Fifteen days later, he died, regardless of an urgently performed thrombectomy. Multiple serial histologic examinations revealed an unruptured dissection of the intracranial vertebral artery with a slit-like tear of the intimal and medial layers, considered to be the culprit lesion. The 15-day prolonged onset of stroke was rare in traumatic IVADs. Furthermore, the slit-like tear of the intimal layer in our case may support the initial intimal laceration hypothesis for VAD pathogenesis. Since limited pathohistological information is available regarding ischemic IVAD, we believe this rare case will be beneficial in understanding the pathophysiology of ischemic IVAD.
The Successful Resolution of a Large Splenic Abscess With Six Years of Follow-Up and Without Recurrence
Authors: Afnan D Almasaud, Ihab F Sulaiman
Journal: Cureus (2024)
Keywords: interventional radiology guided drainage, multilocular abscess, radiology interventional, spleen abscess, ultrasound-guided drianage, virtual follow-up
MeSH terms: Case Reports

Splenic abscess is an uncommon medical condition that presents many diagnostic difficulties. Although rare, this clinical disease can be potentially life-threatening, with a fatality rate exceeding 70% in immunocompromised patients. Clinical manifestations of splenic abscess include fever, tenderness in the upper left region of the abdomen, and leukocytosis with left shift. Performing abdominal ultrasonography (USG) and CT in patients presenting with clinical manifestations enables a prompt and accurate diagnosis. The treatment for splenic abscess includes medical therapy, imaging-guided drainage, and splenectomy. We discuss the case of a 60-year-old female patient who presented to our emergency department with a large splenic abscess; she was managed with an ultrasound-guided drainage catheter, which led to the successful resolution of the condition. She did not experience any recurrence during six years of follow-up. This case report aims to highlight the role of interventional radiology in managing splenic abscesses.
Case report: Microwave ablation is a safe and effective method for primary hyperparathyroidism in pregnancy
Authors: Yunbo Luo, Qi Lv, Zhou Xu, Jiang Fang, Hongyu Pu, Yanchun Gao, Shuangqiang Qian, Fei Chen, Xiaobo Zhao, Lingmi Hou
Journal: Front Med (Lausanne) (2024)
Keywords: hypercalcemia, microwave ablation, parathyroid adenoma, pregnancy, primary hyperparathyroidism
MeSH terms: Case Reports

Primary hyperparathyroidism (PHPT) is a rare disease in pregnancy and endangers the health of both pregnant women and fetuses. However, the treatments are very limited for PHPT and most of them are unsatisfactory because of the peculiar state in pregnancy. The only curable method is parathyroidectomy which can be safely performed in the second trimester of pregnancy. In this case, we reported a pregnant woman with primary parathyroid adenoma presenting hypercalcemia and severe vomit at the end of first trimester. Finally, she got cured by microwave ablation at the end of first trimester and gave birth to a healthy baby boy.
Sellar hemangiopericytoma masquerading as pituitary adenoma: an overlooked intriguing case study unveiling a rare surgical conundrum
Authors: Kaveh Ebrahimzadeh, Mohammad Mirahmadi Eraghi, Mohammad Ansari, Adam A Dmytriw
Journal: Front Surg (2024)
Keywords: endoscopic trans-sphenoidal surgery, hemangiopericytoma, pituitary adenoma, sellar hemangiopericytoma, sellar tumor
MeSH terms: Case Reports

Hemangiopericytoma (HPC) constitutes less than 1% of all primary central nervous system tumors. It is a vascular neoplasm with potential malignancy that, in rare instances, manifests as a primary lesion within the brain. Typically, it originates from the meninges. Here, we describe an exceptionally uncommon sellar region solitary fibrous tumor/hemangiopericytoma (SFT/HPC) that mimicked a nonfunctional pituitary adenoma.
Case presentation:
A 54-year-old male was referred to our hospital due to progressive blurred vision in the left eye over the past year. A homogeneous iso-dense extra-axial intrasellar round mass with extension into the suprasellar region, mainly on the left side, along with bony erosion and osteolysis around the sellar region, was observed on a brain computed tomography (CT) scan. Brain magnetic resonance imaging (MRI) revealed a well-defined 251,713 mm mass with iso-signal on T1-weighted images and hypersignal on T2-weighted images, originating from the pituitary gland within the sella turcica. The mass avidly enhanced following Gadolinium injection and adhered to both carotid arteries without vascular compression or invasion. It extended to the suprasellar cistern and compressed the optic chiasm. The diagnosis was nonfunctional pituitary macroadenoma, leading to the decision for Endoscopic Trans-Sphenoidal Surgery (ETSS). A non-sustainable, soft, grayish mass was grossly and totally resected during the operation. Subsequently, there was a significant improvement in visual acuity during the early postoperative period. Histopathologic examination confirmed hemangiopericytoma (WHO grade II).
Conclusion:
Due to its malignant nature, hemangiopericytoma should be included in the differential diagnosis of a sellar mass, both from a clinical and morphological perspective.
The call for an "educational footprint" in conceptualizing mental health and psychosocial support: the case of Norwegian kindergarten teachers
Authors: Ingrid R Christensen
Journal: Front Psychol (2024)
Keywords: conceptualization, kindergarten, mental health and psychosocial support, qualitative study, qualitative study mental health and psychosocial support, teachers

This article presents an in-depth qualitative case study asking, "How do Norwegian kindergarten teachers conceptualize and negotiate the field of psychosocial support?" This article thoroughly explores how Norwegian kindergarten teachers perceive of the field Mental health and psychosocial support (MHPSS). Recognizing the global imperative to advance mental health and psychosocial support for children, the study highlights the crucial need for interprofessional grounded concepts and logics in developing MHPSS interventions. The study employs a grounded theory approach to actively develop concepts in the MHPSS field in Norway. The six selected Norwegian expert teachers can make up a so-called "unique case", representing a high-income country with a robust welfare system and child-centered pedagogy. Yet, they reveal challenges in embracing the concept of psychosocial support: The analysis shows that the teachers seem to neglect and even reject the concept of psychosocial support, while also expressing inferiority and lack of agency towards other professions. However, the teachers also express the desire for more knowledge, and with proudness they energetically engage in fostering children's agency and functioning by their everyday descriptions of «meeting with the child». The study calls for the kindergarten teachers' increased efforts to actively participate in MHPSS interventions, advocating for the further development of an «educational footprint» that can empower interprofessional work.
Microcephaly type 22 and autism spectrum disorder: A case report and review of literature
Authors: Jiqiang Ma, Yu'e Liu, Kaijun Zhao
Journal: Dialogues Clin Neurosci (2024)
Keywords: autism spectrum disorder, cryptogenic vascular dissection, stent neurodevelopmental disorder
MeSH terms: Autism Spectrum Disorder / complications, Autism Spectrum Disorder / diagnosis, Case Reports, Review, Child, Humans, Male, Microcephaly / complications, Microcephaly / diagnosis

Introduction:
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with a multifaceted etiology. This case report explores the ischemic cryptogenic vascular dissection as a potential underlying cause of ASD.
Methods:
A 9-year-old child presented with symptoms of ASD, including social interaction difficulties, repetitive behaviors, and cognitive challenges. Despite conventional ASD treatments, significant improvement was only observed after addressing an underlying ischemic cryptogenic vascular dissection identified through DCE-CT.
Results:
Following a reconstructive treatment approach to the vascular dissection, the patient showed marked improvement in cognitive functions, social abilities, and a reduction in ASD-related symptoms whether during the perioperative period or during approximately 5-month follow-up.
Conclusion:
This case suggests that ischemic cryptogenic vascular dissection may contribute to the symptoms of ASD. Identifying and treating underlying vascular anomalies may offer a new avenue for mitigating ASD symptoms, emphasizing the need for comprehensive diagnostic estimations in ASD management.
EBV Positive Diffuse Large B Cell Lymphoma with Negative Pan-B Cell Markers, Case Report, and Literature Review
Authors: Janna Shold, Lea Jukic, Daniel Farrell, Wei Cui, Da Zhang
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Most B cell lymphomas are positive for one or more B cell markers including CD19, CD20, CD79a, or PAX5. However, rare cases of mature B cell lymphoma not expressing any B cell markers have been characterized and recognized as distinct diagnostic entities by current classification guidelines, including plasmablastic lymphoma, primary effusion lymphoma, and ALK-positive large B cell lymphoma. We present a case of pan-B cell marker negative, EBV positive diffuse large B cell lymphoma that is positive for OCT2, BOB1, and clonal immunoglobulin gene rearrangement that does not meet diagnostic criteria for any B cell lymphoma by current 4th and 5th Ed beta version WHO Hematolymphoid Tumors classification. In challenging cases like the one presented, utilizing OCT2 and BOB1 immunohistochemical stains can assist in determining B cell lineage. The WHO tumor classification system should consider adding OCT2 and BOB1 as alternative B cell lineage markers into their corresponding categories.
A Case Report Emphasizing an Early Approach in a Patient With Diffuse Axonal Injury
Authors: Mansee S Dangare, Akshaya Saklecha, Pallavi Harjpal
Journal: Cureus (2024)
Keywords: diffuse axonal injury, early approach, neurophysiotherapy, quality of life, rehabilitation, traumatic brain injury
MeSH terms: Case Reports

Diffuse axonal injury (DAI) is a severe and frequently life-altering form of traumatic brain injury that is brought on by forces of rapid acceleration as well as deceleration impacting the brain. DAI primarily stems from mechanical forces that lead to the widespread disruption of axons throughout the brain. Unlike focal injuries that affect a specific brain region, DAI manifests as multifocal axonal damage, often impairing vital neural connections. This injury occurs due to shear and tensile forces during traumatic events, such as car accidents, falls, and sports-related incidents. This current case report includes a 19-year-old male who had a fall from his bike and was hospitalised with brain trauma. A Magnetic resonance imaging (MRI) scan was done, which revealed a case of DAI, and a computed tomography (CT) scan of the brain revealed the extra-calvarial soft tissue swelling in the left parietal region. Small haemorrhagic contusions involved the right ganglio-capsular region. Several integrative techniques, including joint approximation, proprioceptive neuromuscular facilitation (PNF) rhythmic initiation, D1 flexion-extension, and patient education, were used to manage the patient. The patient's development was evaluated using outcome measures, such as the functional independence measure (FIM) and the Glasgow coma scale (GCS). Thus, we conclude that completing physiotherapy exercises consistently helps patients achieve their highest level of functional independence and also enhances their quality of life.
Case report: Germline POT1 mutation in a patient with GIST and lung adenocarcinoma
Authors: Stefania Martino, Simona De Summa, Brunella Pilato, Maria Digennaro, Letizia Laera, Stefania Tommasi, Margherita Patruno
Journal: Front Oncol (2024)
Keywords: gist, pot1, case report, lung adenocarcinoma, tumor predisposition syndrome
MeSH terms: Case Reports

The gene protection of telomere 1 (POT1) is involved in telomere maintenance and stability and plays a crucial role in the preservation of genomic stability. POT1 is considered a high-penetrance melanoma susceptibility gene; however, the number of cancer types associated with the pathogenic germline variants of POT1 is gradually increasing, including chronic lymphocytic leukemia (CLL), angiosarcomas, and gliomas, even though many associations are still elusive. Here, we reported a case of a 60-year-old man who showed early-onset multiple neoplasms, including multiple melanomas, gastrointestinal stromal tumor (GIST), and lung adenocarcinoma. Next-generation sequencing (NGS) analyses revealed a germline heterozygous pathogenic variant in the POT1 gene. Notably, GIST and lung adenocarcinoma were not previously reported in association with the POT1 germline variant. Lung cancer susceptibility syndrome is very rare and the actual knowledge is limited to a few genes although major genetic factors are unidentified. Recently, genome-wide association studies (GWAS) have pointed out an association between POT1 variants and lung cancer. This case report highlights the clinical relevance of POT1 alterations, particularly their potential involvement in lung cancer. It also suggests that POT1 testing may be warranted in patients with familial cancer syndrome, particularly those with a history of melanoma and other solid tumors.
Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China
Authors: Qi Wang, Huali Cao, Xuetong Zhang, Huifeng Wu, Zhuangli Tang
Journal: Front Immunol (2024)
Keywords: apalutamide, long incubation period, prognosis, severe dermatologic adverse events, withdrawal
MeSH terms: Drug Eruptions / diagnosis, Drug Eruptions / etiology, Stevens-Johnson Syndrome / diagnosis, Stevens-Johnson Syndrome / etiology, Thiohydantoins, Case Reports, Research Support, Non-U.S. Gov't, Humans, Male, Prognosis, Skin, apalutamide, Thiohydantoins

Introduction:
Apalutamide is a novel agent for castration-resistant prostate cancer while skin rashes are the most common untoward reactions. Up to now, most of the reported dermatologic adverse events (dAEs) allocated to mild and moderate with a fair prognosis. Herein, we report a case series of severe dAEs in China caused by apalutamide.
Case presentation:
The four patients all developed severe and lethal drug eruptions including Stevens-Johnson syndrome and toxic epidermal necrolysis with a mean incubation period of 40 days. On the basis of the medical condition, all the patients were suggested to withdraw apalutamide and three of them recovered. Of note, attempts of rechallenges of apalutamide may be fatal.
Discussion:
The incidence of dAEs in previously conducted clinical trials exceeded 20%, with maculopapular rashes being the most common feature. However, the incidence and severity varied in different geographic regions and ethnicities. Inadequate attention was paid to severe cutaneous adverse reactions. Long latency may easily lead to the misdiagnosis of dAEs, and immediate withdrawal of apalutamide is the cornerstone of therapies.
Conclusion:
Special and adequate attention should be paid to apalutamide-attributed severe cutaneous adverse effects. Besides, the prognosis of severe drug eruptions may be disappointing, and in-time withdrawal is vital.
Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review
Authors: Leah Chan, Nicholas Pereira
Journal: Cureus (2024)
Keywords: acute vision loss, dyschromatopsia, multiple sclerosis and other demyelinating disorders, neuro-ophthalmology, optic nerve enhancement, painful vision loss, pediatric optic neuritis, pediatric
MeSH terms: Case Reports

Optic neuritis represents a rare clinical entity leading to vision loss within the pediatric population. While not an urgent or life-threatening condition, optic neuritis may serve as a manifestation of various systemic diseases. When pediatric patients present with complaints of vision loss, it is imperative to consider optic neuritis as a potential differential diagnosis. This prompts further investigation to exclude systemic diseases capable of causing substantial morbidity. This article details a case report involving optic neuritis in a 15-year-old Hispanic female, outlining the investigation and management approach. Additionally, a review of the literature identifies six recent case reports documenting pediatric optic neuritis within the last year.
Case report and literature review: cardiac hematic cyst
Authors: Roberto Baltodano-Arellano, Eduardo Alvarez-Tiburcio, Lucia Barriales-Revilla, David Bellido-Yarlequé, Angela Cachicatari, Kelly Cupe-Chacalcaje, Alan La Torre-Zuñiga, Kevin Velarde-Acosta
Journal: Front Cardiovasc Med (2024)
Keywords: cardiac hematic cyst, computed tomography angiography, echocardiography, multimodality imaging, right atrium
MeSH terms: Case Reports

A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm2, implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), confirmed the dimensions of the mass, which presented homogeneous content, calcified areas, and a 12-mm pedicle implanted near the ostium of the coronary sinus. Additionally, contrast uptake and infiltration of adjacent structures were ruled out. In the surgical field, an encapsulated mass with blood content was found, which pathology reported as a hematic endocardial cyst (HEC). These are rare cardiac masses, constituting 1.5% of all primary cardiac tumors. It is usually an incidental finding, and its clinical presentation will depend on its dimensions and the intracardiac hemodynamic impact. A highlighting feature is its anechogenic content on ultrasound, however, multimodality imaging allows for making diagnostic assumptions, discerning between primary cardiac tumors, and provides morphological and hemodynamic information useful for therapeutic decision making. The age of the patient, the large size of the HEC, and its location in the interatrial septum make up a completely atypical presentation of this rare disease, which motivated this report.
An Unusual Case of Vasospastic Angina Resulting in Multiple Episodes of Cardiac Arrest
Authors: Francisco d'Orey, Joao Nuno Patricio, Maria Inês Ribeiro, Hugo Côrte-Real
Journal: Cureus (2024)
Keywords: coronary vessel anomaly, in hospital cardiac arrest, prinzmetal’s angina, vasospastic angina, vasospastic disorders
MeSH terms: Case Reports

Coronary vasospasm is a well-recognized cause of angina (also known as Prinzmetal angina) and a common cause of admissions to the emergency department and coronary intensive care units. It is however an uncommon cause of cardiac arrest. We describe a patient with multiple episodes of chest pain followed by cardiac arrest in pulseless electrical activity (PEA) due to coronary vasospasm. Telemetry and electrocardiography showed ST-segment elevation followed by PEA. Each event was short-lived and resolved after a maximum of six minutes of advanced life support measures. The patient was started on treatment with a dihydropyridine calcium channel blocker (CCB) and nitroglycerin patch with no further episodes recorded to date.
Achieving Successful Pregnancy in a Patient With Ovarian Endometriosis Through Assisted Reproductive Technology (ART) Intervention: A Case Report
Authors: Prerana Dagwar, Akash More, Namrata Choudhary, Jarul Shrivastava, Princee Tyagi
Journal: Cureus (2024)
Keywords: art, estradiol, fertility treatment, infertility, ovarian endometrioma
MeSH terms: Case Reports

Endometriosis stands out as the predominant issue among gynecological disorders. Approximately 50% of women experiencing infertility have been observed to be affected by endometriosis. Growing evidence indicates that endometriomas, in isolation, might adversely affect ovarian physiology. Medications such as ethinyl estradiol and levonorgestrel have been found to contribute to the amelioration of ovarian cysts in women of reproductive age. Presently, there are limited alternatives available for addressing the infertility associated with endometriosis. The primary effective approaches for treatment still revolve around surgery and assisted reproductive technology for endometriosis-related infertility. This case study centers on the utilization of ethinyl estradiol and levonorgestrel in patients with ovarian endometrioma, leading to an enhancement in the likelihood of achieving a successful clinical pregnancy.