OpenMed/multicare-articles huggingface dataset:
Magnetic resonance imaging findings of pulmonary sclerosing pneumocytoma: a case report and literature review
Authors: Yang Li, Li Yang, Xiaolong Gu, Yaning Wang, Huiyan Deng, Hui Feng, Ning Zhang, Mingbo Wang, Qi Wang, Gaofeng Shi
Journal: Front Oncol (2023)
Keywords: case report, computed tomography, magnetic resonance imaging, pulmonary, pulmonary sclerosing pneumocytoma
MeSH terms: Case Reports

Background:
Pulmonary sclerosing pneumocytoma (PSP) is a rare lung tumor that is mostly isolated and commonly reported among middle-aged East Asian women. Recently, Immunohistochemistry (IHC) analysis has suggested that PSP is of primitive epithelial origin, most likely derived from type II alveolar air cells. Patients with PSP are generally asymptomatic and usually detected for other unrelated reasons during routine imaging. Several studies have already investigated the computed tomography (CT) features of PSP and their correlation with pathology. Magnetic resonance imaging (MRI) is a radiation-free imaging technique with important diagnostic value for specific pulmonary nodules. However, very few case reports or studies focus on the MRI findings of PSP.
Case report:
We reported a case of an asymptomatic 56-year-old female with a solitary, well-defined soft-tissue mass in the lower lobe of the left lung. The mass showed iso-to-high signal intensity (SI) than muscle on T1-weighted image (T1WI) and T2-weighted image (T2WI) and a much higher SI on fat-suppressed T2WI, diffusion-weighted image, and apparent diffusion coefficient image. Contrast-enhanced fat-suppressed T1WI revealed noticeable inhomogeneous progressive enhancement throughout the mass. The mass revealed early enhancement without a significant peak, followed by a plateau pattern on dynamic contrast-enhanced MRI images. The patient underwent left basal segmentectomy via thoracoscopic surgery. Histopathology and IHC results of the surgical specimen confirmed that it was a PSP. We concluded that the MRI findings of PSP might adequately reflect the different components within the tumor and aid clinicians in preoperative diagnosis and assessment. To the best of our knowledge, this is the most comprehensive case report on the MRI findings of PSP.
Conclusion:
The MRI findings of PSP correspond to its histopathological features. Here, we present a case of PSP with the most comprehensive MRI findings, emphasizing the importance of multiple-sequence MRI in diagnosing PSP.
Advancements in veterinary medicine: the use of Flowgy for nasal airflow simulation and surgical predictions in big felids (a case study in lions)
Authors: Manuel Burgos, Alejandro Pérez-Ramos, Baptiste Mulot, Daniel Sanz-Prieto, Francisco Esteban, Markus Bastir
Journal: Front Vet Sci (2024)
Keywords: panthera leo, airflow, virtual surgery, wild mammals, zoology

Flowgy is a semi-automated tool designed to simulate airflow across the nasal passage and detect airflow alterations in humans. In this study, we tested the use and accuracy of Flowgy in non-human vertebrates, using large felids as the study group. Understanding the dynamics of nasal airflow in large felids such as lions (Panthera leo) is crucial for their health and conservation. Therefore, we simulated airflow during inspiration through the nasal passage in three lions (Panthera leo), two of which were siblings (specimens ZPB_PL_002 and ZPB_PL_003), without breathing obstructions. However, one of the specimens (ZPB_PL_001) exhibited a slight obstruction in the nasal vestibule, which precluded the specimen from breathing efficiently. Computed tomography (CT) scans of each specimen were obtained to create detailed three-dimensional models of the nasal passage. These models were then imported into Flowgy to simulate the airflow dynamics. Virtual surgery was performed on ZPB_PL_001 to remove the obstruction and re-simulate the airflow. In parallel, we simulated the respiration of the two sibling specimens and performed an obstructive operation followed by an operation to remove the obstruction at the same level and under the same conditions as the original specimen (ZPB_PL_001). Thus, we obtained a pattern of precision for the operation by having two comparable replicas with the obstructed and operated specimens. The simulations revealed consistent airflow patterns in the healthy specimens, demonstrating the accuracy of Flowgy. The originally obstructed specimen and two artificially obstructed specimens showed a significant reduction in airflow through the right nostril, which was restored after virtual surgery. Postoperative simulation indicated an improvement of >100% in respiratory function. Additionally, the temperature and humidity profiles within the nostrils showed marked improvements after surgery. These findings underscore the potential of Flowgy in simulating nasal airflow and predicting the outcomes of surgical interventions in large felids. This could aid in the early detection of respiratory diseases and inform clinical decision-making, contributing to improved veterinary care and conservation efforts. However, further research is needed to validate these findings in other species and explore the potential of integrating Flowgy with other diagnostic and treatment tools in veterinary medicine.
Incarceration of a part of the gastric wall into the abdominal cavity in a patient with hiatal hernia and complete dislocation of the stomach (upside-down stomach)
Authors: Suguru Chiyonaga, Yuki Ohya, Mitsuhiro Inoue, Dan Matsuda, Akira Yoneda, Jun Tomiguchi, Yukari Hinokuma, Shintaro Hayashida, Masayoshi Iizaka, Yukihiro Inomata
Journal: DEN Open (2024)
Keywords: cameron's ulcer, fundoplication, hernia incarceration, hiatal hernia, upside‐down stomach
MeSH terms: Case Reports

An upside-down stomach is a rare type of hiatal hernia. An 83-year-old woman presented to the emergency room with abdominal pain and vomiting. Computed tomography revealed an upside-down stomach and the incarceration of a part of the gastric body into the abdominal cavity. Upper gastrointestinal endoscopy revealed a circular ulcer caused by gastric ischemia. Although she was discharged after 1 week of conservative therapy, she was readmitted to the hospital 1 day after discharge because of a recurrence of hiatal hernia incarceration. She underwent laparoscopic surgery 4 days after readmission and recovered successfully.
A Rare Case When Acromegaly Meets Cushing Syndrome
Authors: Jacob Gabbay, Samantha Steinmetz-Wood, Natalia Chamorro-Pareja, Kaitlyn Barrett
Journal: JCEM Case Rep (2023)
Keywords: igf monitoring, acromegaly, adrenal cushing syndrome
MeSH terms: Case Reports

Acromegaly is very uncommon, as is non-iatrogenic Cushing syndrome; we discuss a patient who was found to have both a pituitary adenoma causing acromegaly and a cortisol-producing adrenal adenoma causing Cushing syndrome within 1 year. She was a healthy, 44-year-old woman who presented with visual changes and was found to have bitemporal hemianopsia and a 3.3-cm pituitary mass along with central hypogonadism, central hypothyroidism, and suppressed adrenocorticotropin and discrepant cortisol. After transsphenoidal resection she had declining, but persistently elevated, insulin-like growth factor 1 (IGF-1), raising concern for persistent acromegaly. She also was experiencing several cushingoid symptoms and was found to have elevated salivary and urinary cortisol. An abdominal computed tomography scan showed a 3.1-cm adrenal adenoma, and she subsequently underwent adrenalectomy. Following adrenalectomy, her cortisol levels normalized, and her IGF-1, growth hormone, and oral glucose tolerance test showed substantial improvement consistent with previous reports linking hypercortisolism and elevated IGF-1 levels. Combinations of pituitary and adrenal disease are seen in a handful of genetic syndromes; however, her clinical presentation and genetics do not fit with known syndromes. This case describes two rare endocrine tumors in one patient and associated limitations of routine laboratory testing.
Two case reports: EML4-ALK rearrangement large cell neuroendocrine carcinoma and literature review
Authors: Qin Chen, Jingjing Zhang, Xuan Wang, Wenkang Zong, Leina Sun, Jianwen Qin, Yan Yin
Journal: Front Oncol (2023)
Keywords: alk-tki inhibitor, eml4-alk rearrangement, alectinib, immunohistochemistry, large cell neuroendocrine carcinoma
MeSH terms: Case Reports

Anaplastic lymphoma kinase gene (ALK) rearrangement is present in only approximately 5% of non-small cell lung cancers (NSCLCs) and is scarce in LCNEC patients. The conventional first-line treatment options are chemotherapy combined with immunotherapy or chemotherapy followed by palliative radiotherapy. In this report, we present two cases of metastatic LCNEC with EML4-ALK fusion that were treated with ALK-TKI inhibitors and demonstrated a rapid therapeutic response. Both patients were nonsmoking women who declined cytotoxic chemotherapy, underwent Next-Generation Sequencing (NGS), and confirmed EML4-ALK fusion. They were treated with alectinib as first-line therapy, and the tumors showed significant shrinkage after two months, achieving a PR (defined as a more than 30% decrease in the sum of maximal dimensions). The PFS was 22 months and 32 months, respectively, until the last follow-up. A systematic review of all previously reported cases of LCNEC with ALK mutations identified only 21 cases. These cases were characterized by being female (71.4%), nonsmoking (85.7%), diagnosed at a relatively young age (median age 51.1), and stage IV (89.5%), with an overall response rate (ORR) of 90.5%. PFS and OS were significantly longer than those treated with conventional chemotherapy/immunotherapy. Based on the clinical characteristics and the effective therapeutic outcomes with ALK inhibitors in LCNEC patients with ALK fusion, we recommend routine ALK IHC (economical, affordable, and convenient, but with higher false positives) as a screening method in advanced LCNEC patients, particularly nonsmoking females or those who are not candidates for or unwilling to undergo cytotoxic chemotherapy. Further molecular profiling is necessary to confirm these potential beneficiaries. We suggest TKI inhibitors as the first-line treatment for metastatic LCNEC with ALK fusion. Additional studies on larger cohorts are required to assess the prevalence of ALK gene fusions and their sensitivity to various ALK inhibitors.
High-grade serous carcinoma of unknown primary origin associated with STIC clinically presented as isolated inguinal lymphadenopathy: a case report
Authors: Paola Giancontieri, Camilla Turetta, Giacomo Barchiesi, Angelina Pernazza, Gemma Pignataro, Giuliano D'Onghia, Daniele Santini, Federica Tomao
Journal: Front Oncol (2024)
Keywords: hgsoc, stic, lymphadenopathy, metastasis, ovarian, cancer, p53
MeSH terms: Case Reports

Serous tubal intraepithelial carcinoma (STIC) is a precancerous lesion of high-grade serous ovarian carcinoma (HGSOC). Usually, it arises from the fimbrial end of the tube, and it is associated with metastatic potential. On average, the time to progress from STIC to HGSOC is 6.5 years. Therefore, whenever a STIC lesion is found, surgical staging and prophylactic salpingectomy are recommended in order to prevent ovarian cancer. We report a rare case of a 45-year-old female patient who clinically presented an isolated right inguinal lymphadenopathy. The remaining clinical examination was normal. Therefore, an excisional biopsy of the lymph node was performed. Pathological analysis revealed a high-grade serous carcinoma, most likely of gynecological origin. Due to histological evidence, a computed tomography (CT) scan was carried out. There was no CT evidence of ovarian disease, pelvic involvement, intra-abdominal lymphadenopathies, metastatic disease, or ascites. All tumor markers were negative. The patient underwent laparoscopic hysterectomy and bilateral salpingo-oophorectomy followed by surgical staging. Surprisingly, pathological examination showed a STIC lesion in the fimbria of the left fallopian tube. We aim to report the potential capability of STIC to spread particularly through lymphatic pathways rather than peritoneal dissemination.
Cardiac tamponade associated with primary myelofibrosis: a case report
Authors: Wishnu Aditya Widodo, Teuku Muhammad Haykal Putra, Maria Elfiana, Eka Widya Khorinal
Journal: Eur Heart J Case Rep (2023)
Keywords: cardiac tamponade, case report, constrictive pericarditis, extramedullary haematopoiesis, pericardial disease, primary myelofibrosis
MeSH terms: Case Reports

Background:
Cardiac tamponade is a life-threatening condition that occurs when an abnormal amount of fluid accumulates in the pericardial sac and impedes the cardiac filling process. Although extremely rare, haematological diseases have the potential to trigger an extramedullary haematopoiesis (EMH) process within the pericardium, resulting in a substantial build-up of pericardial effusion.
Case summary:
We present the case of a 29-year-old male previously diagnosed with primary myelofibrosis (PMF), who presented to the emergency unit with cardiac tamponade. An emergent pericardiocentesis procedure was performed, successfully evacuating 850 mL of haemorrhagic fluid. Over the course of 3 days, a total of 1.5 L of haemorrhagic effusion were drained from the pericardial space. Analysis of the pericardial fluid revealed evidence of haematopoietic activity, suggesting a potential association with the EMH process occurring within the pericardium. Following a 7-day hospitalization, the patient was discharged in stable condition but later experienced the development of constrictive pericarditis.
Discussion:
Haemorrhagic pericardial effusion is a rare occurrence. The majority of cases stems from complications of medical procedures (iatrogenic), malignancies, or side effects of antiplatelet/anticoagulant medications. In patients with PMF, the impaired haematopoietic ability caused by the fibrotic process in the bone marrow compels the body to produce blood components elsewhere, a phenomenon known as EMH. On very rare occasions, EMH can develop in the pericardial space, potentially leading to life-threatening cardiac tamponade. Our patient was successfully managed through pericardial fluid evacuation and drainage but later developed constrictive pericarditis.
Granuloma after the Injection of Poly-D,L-Lactic Acid (PDLLA) Treated with Triamcinolone
Authors: Kateryn Michelle Perez Willis, Rosario Ramirez Galvez
Journal: Case Rep Dermatol Med (2024)
MeSH terms: Case Reports

Biostimulators are the latest trends in cosmetic procedures, substances such as PDLLA are used to induce collagen synthesis by a subclinical inflammatory reaction. We are describing a granuloma-like reaction case presentation 4 months after the application of PDLLA and its complete resolution with injections of triamcinolone. A 45-year-old female with any past medical history of allergies or immune diseases was injected with PDLLA on the mandibular border and cheek area to correct skin laxity. Four months after the application, the patient reported facial edema and granuloma-like reactions according to clinical examination on all the application areas. The ultrasound reports showed the presence of multiple nodules in the injection areas; therefore, we decided to apply triamcinolone to the granulomatous reaction areas 2 times a month and Prednisone 20 mg daily for 3 days followed by 10 mg for 2 days. After 4 applications, the adverse reaction was completely solved. Biostimulators are biocompatible and resorbable substances; however, nodules and/or granulomas have been reported as rare adverse events. Intralesional and oral steroids can allow us to treat this kind of adverse events.
A Case of a Mirror Image Artifact in the Forearm
Authors: Miloud Dewilde, Peter Brys
Journal: J Belg Soc Radiol (2024)
Keywords: ultrasound imaging, artifacts, mirror image artifact, misinterpretation, reverberation artifact
MeSH terms: Case Reports

Teaching point: To emphasize the importance of recognizing mirror image artifacts in musculoskeletal ultrasound to avoid misdiagnosis, unnecessary interventions, and additional diagnostic procedures that can lead to patient anxiety, increased healthcare costs, and potential harm.
Massive extrapancreatic solid pseudopapillary neoplasm misdiagnosed as hepatic tumor: a case report and literature review
Authors: Jixu Guo, Qingjuan Zhao, Liting Qin, Shengjie Xie, Shiliu Lu, Baibei Li, Meilin He, Linhong Xie, Shuiping Yu
Journal: Front Oncol (2024)
Keywords: case report, local invasion, misdiagnosis, retroperitoneum, solid pseudopapillary neoplasms
MeSH terms: Case Reports

Background:
Solid pseudopapillary neoplasms (SPNs) of the pancreas are uncommon, low-malignancy neoplasms. Moreover, the occurrence of extrapancreatic SPNs is rarely encountered.
Case summary:
A 45-year-old female presented with a right upper abdominal mass and abdominal pain for 3 and 1 months as chief complaints, respectively. Initially, the patient was misdiagnosed with hepatocellular carcinoma based on her symptoms and results of physical and imaging examinations. Following multidisciplinary discussion and ruling out surgical contraindications, a decision was taken to proceed with surgical intervention. Interestingly, the tumor was found to originate from the retroperitoneum and had invaded the right half of the liver and the right wall of the inferior vena cava. The operation was uneventful, and the pathological findings confirmed the tumor as an extrapancreatic SPN. The patient remained asymptomatic after 15 months of follow-up.
Conclusion:
Surgical treatment remains the preferred option for extrapancreatic SPN. The preoperative misdiagnosis also highlights the importance of accurate diagnosis and the development of appropriate treatment strategies for liver masses.
Ureter mixed neuroendocrine-non-neuroendocrine neoplasm: a case report and literature review
Authors: Bing Zhou, Xing Gan, Xiaohua Li, Lizi Peng, Hua Hao
Journal: Front Oncol (2024)
Keywords: minen, diagnosis, immunohistochemistry, mixed neuroendocrine-non-neuroendocrine neoplasm, ureter
MeSH terms: Case Reports

Cases of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) of the urinary system are rare, and reports of primary MiNENs in the ureter are lacking. Herein, we present the case of a 71-year-old man who presented with painless gross hematuria and weight loss. Contrast-enhanced abdominal computed tomography (CT) revealed a tumor, comprising small cell neuroendocrine carcinoma (SCNEC) and adenocarcinomatous components, attached to the ureter. The SCNEC components were strongly positive for synaptophysin, CD56 and INSM1 and adenocarcinomatous components were strongly positive for CDX2 and cytokeratin 20, respectively. Four weeks post-surgery, the patient received four cycles of cisplatin-based chemotherapy; the 7-month follow-up CT confirmed that he was healthy without disease recurrence. The occurrence of MiNEN in the ureter with SCNEC and adenocarcinomatous components is extremely rare, wherein histopathological and immunohistochemical features aid in the diagnosis MiNEN. With its aggressive nature, MiNEN can only be effectively treated by early diagnosis and radical surgery.
A single scalp nodule as the first presentation of acute lymphoblastic leukemia (KMT2A::MLLT3) in a healthy-appearing infant: a case report
Authors: Francesco Pellegrino, Paola Coppo, Elena Barisone, Nicoletta Bertorello, Manuela Spadea, Franca Fagioli
Journal: Front Pediatr (2023)
Keywords: all, acute lymphoblastic leukemia, leukemia, leukemia cutis, scalp nodule
MeSH terms: Case Reports

Background:
Infant leukemia is a rare form of acute leukemia diagnosed prior to the age of 1 and is characterized by an extremely poor prognosis due to its dismal response to current therapeutic approaches. It comprises about 4% of all childhood cases of acute lymphoblastic leukemia (ALL). Isolated initial cutaneous involvement in ALL is uncommon, and even more so in infant ALL.
Case presentation:
Here, we present the case of a 2-month-old healthy-appearing infant, initially presenting with a single scalp nodule and subsequently diagnosed with an infant ALL. The leukemia was characterized by the most immature B-lineage immunophenotype [pro-B ALL/B-I, according to the European Group for the Immunological Characterization of Leukaemias (EGIL) classification] and chromosomal translocation t(9;11)(p22;q23), resulting in fusion gene KMTLA2::MLLT3, which is considered a negative prognostic factor. The patient underwent hematopoietic stem cell transplantation and is still in remission.
Conclusions:
This case is peculiar because of the rare occurrence of isolated initial cutaneous involvement in ALL. Despite the healthy appearance of the patient, every suspicious symptom suggestive of malignancies should be further investigated to anticipate the diagnosis and start treatment early.
Gastric-type endocervical adenocarcinoma: a case report and literature review
Authors: Xiao Wen, Li Yu, Xiangyu Liu, Xinjia He, Yuanyuan Zhao, Guoliang Li
Journal: Front Oncol (2024)
Keywords: case report, endocervical adenocarcinoma, gastric-type, human papillomavirus, treatment
MeSH terms: Case Reports

Gastric-type endocervical adenocarcinoma (G-EAC) represents a rare variant of cervical mucinous adenocarcinoma that is typically unrelated to human papillomavirus (HPV) infection. G-EAC exhibits highly atypical clinical presentations and characteristics, and aggressive biological behavior often leads to challenges in timely diagnosis. Here, we present a case study involving a 74-year-old Chinese woman who experienced urinary incontinence for one month. Biopsy pathology confirmed the diagnosis of G-EAC, revealing stage IVa by imaging examinations. The patient subsequently underwent three cycles of chemotherapy, followed by adjuvant radiotherapy and surgical excision of residual tumor foci. This comprehensive treatment approach yielded a favorable survival outcome. For patients with advanced G-EAC, a multimodal therapeutic approach holds promise and warrants further exploration.
Acute Respiratory Distress Syndrome in a Patient With Systemic Sclerosis: A Case of a Life-Threatening Complication
Authors: Rawan Almutairi, Dalal Alkhudair
Journal: Cureus (2024)
Keywords: acute respiratory distress syndrome, aspiration pneumonia, diffuse cutaneous systemic sclerosis, diffuse systemic sclerosis, esophageal dilatation, intensive care unit, systemic scleroderma, systemic sclerosis
MeSH terms: Case Reports

Numerous pulmonary conditions, such as aspiration pneumonia and acute respiratory distress syndrome (ARDS), may result from aspiration of gastric or oropharyngeal contents passing into the lower respiratory tract. ARDS is a type of diffuse lung injury that is distinguished by the abrupt onset of extensive pulmonary inflammation accompanied by the failure of multiple organ systems. Systemic sclerosis is an uncommon connective tissue disorder that presents with skin thickening, the etiology of which remains unknown. Esophageal luminal dilatation is observed in the distal third of the esophagus in most cases of systemic sclerosis. This dilatation is primarily attributed to the greater abundance of smooth muscle fibers in this area. Here, we present the case of a 70-year-old female patient who was diagnosed clinically with diffuse systemic sclerosis and fulfilled the 2013 European League Against Rheumatism/American College of Rheumatology classification criteria. She had esophageal dilatation, with an esophageal luminal diameter measured at the upper, middle, and lower thoracic esophagus of 2.5 cm, 2.5 cm, and 3.5 cm, respectively. The patient was admitted to the intensive care unit (ICU) due to ARDS from aspiration pneumonia. Our patient's complicated condition at the time of ICU admission with ARDS secondary to aspiration pneumonia was primarily due to esophageal dilatation and reflux. Aggressive anti-reflux pharmacotherapy and bed elevation may be beneficial in preventing pulmonary injury caused by aspiration. Esophageal complications are common in such patients and can have a substantial impact on the prognosis and quality of life. Regular medical attention is necessary to identify and manage any potential issues.