OpenMed/multicare-articles huggingface dataset:
Perioperative Management of Metastatic Paraganglioma-Pheochromocytoma of the Humerus with the Aid of Regional Anesthesia
Authors: Iyabo O Muse, Kumar Vivek, Noah A Bloomgarden, Amit Singla, David S Geller
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

A 38-year-old female with a past history of pheochromocytoma and subsequent malignant paraganglioma presented with right arm pain after a fall. Imaging demonstrated a malunited humeral shaft associated with a large cortical destructive lesion and extraosseous extension. Here, we report the use of a multidisciplinary team approach including an endocrinologist, anesthesiologist, and orthopedic surgeon in the perioperative management of a patient with metastatic paraganglioma undergoing a surgical resection of the humerus, internal fixation, reconstruction, and placement of endoprosthesis. The challenges of perioperative anesthetic management and the use of regional anesthesia, especially peripheral nerve block for perioperative pain management, are highlighted.
Pneumothorax complicating isolated clavicle fracture
Authors: Redouane Hani, Badr Ennaciri, Idriss Jeddi, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
Journal: Pan Afr Med J (2015)
Keywords: clavicle, chest drain, fracture, pneumothorax
MeSH terms: Clavicle / injuries, Fractures, Bone / complications, Pneumothorax / etiology, Thoracostomy / methods, Case Reports, Adult, Chest Tubes, Fractures, Bone / surgery, Humans, Male, Pneumothorax / therapy

Isolated clavicle fractures are among the commonest of traumatic fractures in the emergency department. Complications of isolated clavicle fractures are rare. Pneumothorax has been described as a complication of a fractured clavicle only rarely in English literature. In all the reported cases, the pneumothorax was treated by a thoracostomy and the clavicle fracture was treated conservatively. In our case, the pneumothorax required a chest drain insertion and the clavicle fracture was treated surgically with good result.
Infected abdominal aortic aneurysm graft complicated by lumbar discitis
Authors: Hamzeh B Sumrein, Sally D Parry, Ravi V Ayer, Andrew P Leonard
Journal: BJR Case Rep (2018)
MeSH terms: Case Reports

We present the case of a 68-year-old male, who underwent open abdominal aortic graft in August 2016 owing to a ruptured large infrarenal abdominal aneurysm. He subsequently presented 6 months later with back pain, general weakness, reduced mobility and cachexia. He underwent CT, MRI and fluorodeoxyglucose (PDG)-PET spinal imaging, all modalities showing signs of aortic graft infection complicated by L4/5 discitis. The patient was treated conservatively with intravenous antibiotics and spinal brace support, as his general condition did not allow for surgery. Although he showed initial clinical improvement allowing plans for supported discharge, his improvement was not sustained and he died 4 months after admission.
BK Polyomavirus-Induced Nephropathy in Native Kidney
Authors: Ripudaman S Munjal, Jaskaran Munjal, Pulkit Gandhi, Nikhil Gupta
Journal: Cureus (2023)
Keywords: acute kidney injury, bk nephropathy, bk polyomavirus, chronic kidney disease, dialysis, immunosuppressed, nephropathy
MeSH terms: Case Reports

BK polyomavirus has been well-studied as an opportunistic infection in immunocompromised kidney transplant patients. In the majority of the population, BK polyomavirus establishes a lifelong infection in renal tubular and uroepithelial cells; however, in an immunocompromised state, the virus can reactivate and can lead to BK polyomavirus-associated nephropathy (BKN). In this case, the patient was a 46-year-old male with a past medical history of HIV, compliant with antiretroviral therapy (ART), and B-cell lymphoma treated with chemotherapy. The patient presented with worsening kidney function of unknown etiology. This prompted further assessment with a kidney biopsy. Kidney biopsy findings were consistent with BKN. In the literature, BKN has been studied in renal transplant patients; however, it rarely involves native kidneys.
Three Case Reports of Rhupus Syndrome: An Overlap Syndrome of Rheumatoid Arthritis and Systemic Lupus Erythematosus
Authors: Gul Devrimsel, Munevver Serdaroglu Beyazal
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

We present the clinical and serological characteristics of three patients with rhupus. The 3 patients with rhupus presented ACR criteria for SLE as well as for RA, ANA positive with a titer of 1/100 in all patients, and positive anti-DNA in 2 of the 3 patients, with the predominance of symmetrical polyarthritis. We found anti-CCP positivity and rheumatoid factor positivity and high titers in all patients, positive anti- anti-SSA in one patient, and positive anti- anti-Sm in one patient. Renal and liver function tests were normal in all patients. The 3 patients achieved clinical remission with DMARD treatment.
Large Rhinolith Mimicking Atypical Odontogenic Pain: Case Report and Brief Review of the Literature
Authors: Zahra Vasegh, Mitra Ghazizadeh Ahsaie
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Rhinoliths are rare calcified entities in the nasal fossa, frequently originating around a nidus near the midway point in the inferior meatus, where the passage is the narrowest. They can be clinically asymptomatic and undetected for years. In this study, we present a rare case of large rhinolith mimicking atypical odontogenic pain in a 40-year-old Caucasian female in the left nasal cavity. The lesion was detected in the CBCT and removed uneventfully.
Pituitary metastases from papillary carcinoma of thyroid: a case report and literature review
Authors: Viral Chikani, Duncan Lambie, Anthony Russell
Journal: Endocrinol Diabetes Metab Case Rep (2013)

Metastases to the pituitary gland are an uncommon complication of thyroid cancer. They resemble pituitary neoplasms posing a diagnostic challenge. We present a case of an aggressive non-radioiodine avid papillary thyroid cancer with recurrent pituitary metastases and a review of the literature. A 70-year-old woman with a history of papillary thyroid cancer and bony metastases presented with symptoms of hypoadrenalism and peripheral vision loss. Magnetic resonance imaging showed a large pituitary mass impinging on the optic chiasm. She underwent transsphenoidal resection followed by (131)I ablation. Post-therapy scintigraphy showed no iodine uptake in the sellar region or bony metastases. Histology of the pituitary mass confirmed metastatic papillary thyroid cancer. Fifteen months later, she had a recurrence of pituitary metastases affecting her vision. This was resected and followed with external beam radiotherapy. Over 2 years, the pituitary metastases increased in size and required two further operations. Radioactive iodine was not considered due to poor response in the past. Progressively, she developed a left-sided III and IV cranial nerve palsy and permanent bitemporal hemianopia. There was a rapid decline in the patient's health with further imaging revealing new lung and bony metastases, and she eventually died 8 months later. To our knowledge, this is the first case of pituitary metastases from a radioiodine-resistant papillary thyroid cancer. Radioiodine-resistant metastatic thyroid cancer may exhibit rapid aggressive growth and remain poorly responsive to the currently available treatment.
Learning points:
Differentiated thyroid cancer (DTC) has an excellent prognosis with <5% of the cases presenting with distant metastases, usually to lung and bone.Metastasis to the pituitary is a rare complication of DTC.The diagnosis of pituitary insufficiency secondary to pituitary metastases from DTC may be delayed due to the non-specific systemic symptoms of underlying malignancy and TSH suppression therapy for thyroid cancer.The imaging characteristics of metastases to the pituitary may be similar to non-functioning pituitary adenoma.Radioiodine refractory metastatic thyroid cancer has significantly lower survival rates compared with radioactive iodine-avid metastases due to limited therapeutic options.
Electrocardiographic Changes After Suicidal Digoxin Intoxication in a Healthy Woman
Authors: Natalia Lorenzo Muñoz, Amparo Benedicto Buendía, Fernando Alfonso Manterola
Journal: Open Cardiovasc Med J (2017)
Keywords: (ct) scan, digoxin, electrocardiogram (ecg), multiple arrhythmias, myocardial necrosis
MeSH terms: Case Reports

Background:
Suicidal digoxin intoxication is a rare clinical entity. Clinical suspicious remains of paramount importance as adequate interpretation of the electrocardiographic changes enable to readily initiate treatment.
Method:
We describe a case of suicidal attempt after massive digoxin intake that was satisfactory managed with conservative management strategy that involved a close clinical surveillance of the evolving electrocardiographic changes and digoxin serum levels.
Cervical necrotizing fasciitis and acute mediastinitis of odontogenic origin: A case series
Authors: Paolo Cariati, Fernando Monsalve-Iglesias, Almudena Cabello-Serrano, Alfredo Valencia-Laseca, Blas Garcia-Medina
Journal: J Clin Exp Dent (2017)
MeSH terms: Case Reports

Necrotising fasciitis (NF) is an uncommon infection. Early signs and symptoms include fever, severe pain and swelling, and redness at the wound site. Moreover, fulminant evolution and high mortality rate are typical of this pathology. In the present report we describes three cases of cervical necrotizing fasciitis complicated by acute mediastinitis. All patients were apparently immunocompetent adults. The main aim of the present report is to show the serious consequences that a dental infection might trigger. Furthermore, we highlight the importance of a multidisciplinary approach in these cases. The constant interaction between different medical specialties is essential for ensuring a proper management of each case. Key words:Cervical necrotizing fasciitis, acute mediastinitis, odontogenic origin , multidisciplinary approach.
A Remarkable Case of Acute Motor-Sensory Axonal Polyneuropathy (AMSAN) Variant of Guillain Barré Syndrome, in a Diabetic Patient Infected With COVID-19: A Case Report and Review of the Literature
Authors: Sajjad Ali, Alvina Karam, Aarish Lalani, Sadia Jawed, Musfirah Moin, Zain Douba, Murtaza Ali
Journal: Front Neurol (2022)
Keywords: covid-19, guillain-barré syndrome, coronavirus, neuroelectrophysiological characteristics, neuroinfection
MeSH terms: Case Reports

Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease- 2019 (COVID-19), has been a global epidemic in our healthcare system. SARS-CoV-2 primarily affects the respiratory system, but neurological involvement has also been reported, including Guillain-Barré syndrome (GBS) development.
Case presentation:
A 58-year-old male with known co-morbid hypertension and type 2 diabetes mellitus presented to the emergency room with complaints of worsening shortness of breath, dry cough, and fever for the past 10 days. On day 20 of hospitalization, he developed neurological symptoms after being tested positive for COVID-19. A neuroelectrophysiology study was conducted to evaluate neurological symptoms and suggested that the patient suffers from acute motor-sensory axonal polyneuropathy (AMSAN). CSF analysis showed elevated protein levels that confirmed the diagnosis of GBS. He was subsequently treated with oral prednisolone and IVIG, which improved neurological symptoms.
Conclusion:
Ever since the emergence of COVID-19, GBS has surfaced as to its potentially dangerous outcome. Healthcare professionals should be mindful of GBS and should rule it out in anyone having sensory symptoms or weakness during or after a COVID-19 infection. Its early detection and treatment can result in improved clinical outcomes.
A Case of an Epithelioid Hemangioendothelioma Arising from the Innominate Vein Mimicking Cervical Metastatic Lymphadenopathy
Authors: Jason B Brill, Isaac E Schwartz, Lindsey M Prescher, Theodore C Pratt
Journal: Case Rep Surg (2016)

Background. Epithelioid hemangioendothelioma (EHE) is a rare tumor usually presenting in soft tissue. EHE is a vascular malignancy of intermediate clinical behavior, with a histologic appearance of endothelial cells growing in nests or cords. Although EHE often originates from a vessel, it is relatively rare for a primary vascular EHE to originate from a large vein or artery. Occurrence in the mediastinum is exceptionally rare. There are no known associations with other malignancies. Case Presentation. We present a case of mediastinal invasive EHE in a 39-year-old female with concurrent papillary thyroid cancer. She initially presented with a thyroid mass found by her primary care provider, with preoperative imaging concerning for extension into the superior mediastinum. Operative exploration revealed a mediastinal mass distinct from her thyroid carcinoma with invasion into the great vessels, requiring off-pump interposition graft bypass for en bloc resection. Final pathology confirmed pT3N1b multifocal papillary thyroid carcinoma with a separate grade 1 pT1b EHE. Review of the literature describes the demographics, updated pathologic outcomes, histologic findings, and reported incidence of EHE. Conclusions. This is the first reported case of thyroid malignancy with separate and concurrent EHE. Surgeons should remain aware of this entity given its variable behavior. Although initially described as an indolent neoplasm, tumors with poor prognostic factors have been shown to be locally aggressive.
A primary Rosai-Dorfman-Destombes disease of the scalp: case report and literature review
Authors: Wenxiong Song, Feiyu Ding, Yong Xiao, Xinhua Hu, Kun Yang, Liangyuan Geng, Yuanjie Zou
Journal: Front Neurol (2023)
Keywords: rosai-dorfman-destombes disease, benign histiocytic proliferative, cutaneous, scalp, surgery
MeSH terms: Case Reports

Background:
Rosai-Dorfman-Destombes disease (RDD) was first described in 1965 as a benign histiocytic proliferative disorder of unknown cause. Cases of RDD limited to cutaneous tissue have been reported over the past few decades, but single cutaneous RDD of the scalp is rare.
Case presentation:
We report a 31-year-old male with a lump on the parietal scalp without extranodal lesion lasting 1 month with gradual enlargement. The surgical incision ruptured with purulent after the first resection. Then the patient was treated with plastic surgery after disinfection and antibiotic treatment. Finally, he recovered well and discharged after 20 days.
Conclusions:
RDD of the scalp is rare. Surgical incision can cure the lesion but it may become infected because of increased lymphocytic infiltration. Early diagnosis and differential diagnosis of RDD are necessary. For treatment, individualized therapy is critical to patient prognosis.
Spinal Epidural Lipoma on the Ventral Dura Side and Intervertebral Foramen Causing Lumbar Radiculopathy
Authors: Hiroshi Noguchi, Masao Koda, Tetsuya Abe, Toru Funayama, Hiroshi Takahashi, Kousei Miura, Kentaro Mataki, Mamoru Kono, Fumihiko Eto, Yosuke Shibao, Masashi Yamazaki
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

A 56-year-old obese man with a body mass index of 30.9 kg/m2 presented with left sciatica and intermittent claudication. Computed tomography scans showed a posterior vertebral scalloping change in L3, L4, and L5. Meanwhile, magnetic resonance imaging revealed epidural mass posterior to the L3, L4, and L5 vertebral bodies. The solitary mass was isosignal to subcutaneous fat and asymmetrically compressed to the left side of the dural sac and L4 nerve root, as observed on axial T1- and T2-weighted images. To the best of our knowledge, there have been few reports of a solitary epidural lipoma causing lumbar radiculopathy. The patient underwent transforaminal lumbar interbody fusion at L4-L5, and his symptoms then resolved. Thus, we recommend decompression and fixation as appropriate management for lumbar radiculopathy caused by epidural lipoma located on the ventral side of the dura and intervertebral foramen.
Factitiously Elevated Total Triiodothyronine in a Euthyroid Patient with Multiple Myeloma
Authors: Kaushik Mandal, Damilola Ashorobi, Alice Lee, Huijuan Liao, Salini C Kumar, David S Rosenthal
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Sporadic reports of factitious elevations of thyroid hormones related to laboratory interference from autoantibodies and multiple myeloma paraproteins have appeared in the literature. Such clinically confusing laboratory results can lead to erroneous diagnoses and inappropriate treatments. We report an additional case of a patient with multiple myeloma and an IgG paraproteinemia who had such a spurious elevation of total T3 complicating her levothyroxine management of hypothyroidism. In addition, we alert clinicians that differences in performance characteristics between various manufacturers' test platforms may also cause spurious reports.
Hemiballism-hemichorea induced by ketotic hyperglycemia: case report with PET study and review of the literature
Authors: Yuyan Tan, Xiaoyu Xin, Qin Xiao, Shengdi Chen, Li Cao, Huidong Tang
Journal: Transl Neurodegener (2014)
Keywords: hemiballism-hemichorea, ketotic hyperglycemia, primary diabetes mellitus
MeSH terms: Case Reports

Hemiballism-hemichorea (HB-HC) is commonly used to describe the basal ganglion dysfunction in non-ketotic hyperglycemic elderly patients. Here we report two elderly female patients with acute onset of involuntary movements induced by hyperglycemia with positive urine ketones. We described the computed tomography and magnetic resonance imaging findings in these two patients, which is similar to that of non-ketotic hyperglycemic HB-HC patients. FDG-PET was performed and the glucose metabolism in the corresponding lesion in these two patients was contradictory with each other. We tried to clarify the underlying mechanisms of HB-HC and explain the contradictory neuroradiological findings in FDG-PET as being performed at different clinical stages.
A case report of systemic embolic events associated with atrial fibrillation
Authors: Hidehiko Nakano, Hiroshi Yamagami, Hisashi Ofuchi
Journal: Acute Med Surg (2016)
Keywords: atrial fibrillation, circulation, coagulopathy
MeSH terms: Case Reports

Case:
An 82-year-old woman who had atrial fibrillation was found unconscious and was brought to the emergency department by ambulance. Her Glasgow Coma Scale score was 3, and an electrocardiogram showed ST segment elevation in V3 and V4. Cardiac ultrasonography showed left ventricular asynergy in the anterior wall, septum, and apex. Although dissection of the aorta was suspected, contrast computed tomography showed multiple arterial thromboses, including bilateral common carotid arteries and poor contrast in the left ventricle. Diffusion-weighted images of magnetic resonance imaging showed a diffuse high-intensity area in both cerebral cortices.
Outcome:
The diagnosis was multiple arterial thromboembolisms associated with atrial fibrillation. There was no available treatment because of massive multiple lesions and the patient died within 24 h of presentation.
Conclusion:
Extracranial systemic embolic events other than cerebral embolism could be critical complications associated with atrial fibrillation.
Iris Ring Melanoma Presenting as Scleral Pigmentation
Authors: Matej Zupan, Alenka Lavrič, Jože Pižem, Katrina Novak Andrejčič
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

To report a patient with a very rare variant of iris melanoma that grows in the shape of a ring (ring melanoma). A 65-year-old patient was examined because of a pigmented lesion on the sclera. After a complete ophthalmic and ultrasound examination, a ring melanoma was diagnosed. Enucleation of the affected eye was performed, and histology report confirmed iris ring melanoma. This type of malignancy represents an exceedingly rare variant of uveal melanoma, and because of atypical clinical picture, it can be easily overlooked or misdiagnosed, which often delays adequate treatment. Gonioscopy, transillumination, and ultrasound help us to recognize and diagnose ring melanoma. Suspicion should be raised with a clinical picture that shows unilateral pigmentary glaucoma. The objective of this presentation is to describe and outline the challenging diagnosis and management of this rare disease entity.
Ipilimumab administration for advanced melanoma in patients with pre-existing Hepatitis B or C infection: a multicenter, retrospective case series
Authors: Sowmya Ravi, Kristen Spencer, Mary Ruisi, Nageatte Ibrahim, Jason J Luke, John A Thompson, Keisuke Shirai, David Lawson, Heddy Bartell, Ragini Kudchadkar, Ngoc Thi Gunter, Janice M Mehnert, Evan J Lipson
Journal: J Immunother Cancer (2014)
Keywords: hepatitis b, hepatitis c, ipilimumab, melanoma

Ipilimumab is a fully human, monoclonal antibody directed against Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) that has demonstrated a survival benefit and durable disease control in patients with advanced melanoma. Ipilimumab is associated with potentially serious immune-related adverse events, including autoimmune hepatitis. Because clinical trials of ipilimumab excluded patients with pre-existing hepatitis B or C infection, there is a paucity of data on the safety of ipilimumab administration to that patient population. Here, we report the largest case series to date of patients with hepatitis B or C who received ipilimumab for advanced melanoma. Two of the nine patients described in this case series experienced fluctuations in their liver function tests (LFTs) and were subsequently treated with corticosteroids. Although this is a small series, the rate of hepatotoxicity appears similar to what has been seen in the general population treated with ipilimumab, and the ability to administer ipilimumab did not appear to be affected by concomitant hepatitis B or C infection. The use of ipilimumab in patients with metastatic melanoma who have pre-existing hepatitis can be considered among other therapeutic options.
Minimally Invasive Subtemporal Intradural Approach for Penetrating Orbitocranial Injury by Wooden Foreign Body Into the Lateral Wall of the Cavernous Sinus
Authors: Elad Avraham, Alexander Smolikov, Rozalia Smolyakov, Amit Azriel, Yuval Sufaro, Tehila Kaisman-Elbaz, Gregory Zlatin, Israel Melamed
Journal: Front Surg (2020)
Keywords: cavernous sinus, minimally invasive, orbitocranial injury, penetrating injury, subtemporal approach, wooden foreign body
MeSH terms: Case Reports

Non-missile transorbital penetrating head injuries are relatively rare, though potentially fatal injuries. Trajectory for intracranial entrance is typically via the orbital roof, the superior orbital fissure (SOF), or the optic canal. Non-metallic intracranial penetrating injuries are even scarcer and may pose unusual diagnostic and surgical challenges. Here we present and discuss a unique case of a penetrating injury by a wooden foreign body (FB) which entered and expanded the inter-dural space of the lateral cavernous sinus (CS) sinus wall without intracavernous or intradural involvement. The patient was a 71 year-old male who fell face-down and sustained a penetrating transorbital injury by a dry twig fragment, which passed through the SOF and into the interdural space of lateral wall of the ipsilateral CS. The patient was fully conscious (GCS15) at presentation but had severe ocular injury (complete ophthalmoplegia and blindness of the injured eye). The wooden FB was successfully removed via a minimally invasive subtemporal intradural approach with no apparent immediate or long-term complications. We emphasize the unusual diagnostic and surgical challenges related to this kind of rare injuries as reflected by the decision-making considerations taken in the presented case.