OpenMed/multicare-articles huggingface dataset:
Solitary extramedullary plasmacytoma in the lung misdiagnosed as lung cancer: A case report and literature review
Authors: Jingjing Wang, Xiaoyun Yang, Xiaomei Liu, Tao He, Bin Liu, Lei Yang, Fei Yuan, Jing Li
Journal: Front Oncol (2022)
Keywords: ct scan, extramedullary plasmacytoma, pathology, primary pulmonary plasmacytoma, prognosis
MeSH terms: Review

Background:
Extramedullary plasmacytoma (EMP) is an extremely rare kind of soft tissue plasma cell neoplasm without bone marrow involvement or other systemic characteristics of multiple myeloma. Primary pulmonary plasmacytoma (PPP), with no specific clinical manifestations, is an exceedingly rare type of EMP. Because of its complexity, PPP is often difficult to diagnose. Computed tomography-guided percutaneous core needle biopsy (CT-guided PCNB) has been shown to have high sensitivity, specificity and accuracy for characterization of pulmonary lesion, particularly if malignancy is suspected. Here we presented a rare case of PPP diagnosed with CT-guided PCNB.
Case presentation:
A 78-year-old female smoker who visited our outpatient clinic for a mass in the left lower lobe of the lung. Pathological based on CT-guided PCNB yielded a PPP with no lymph node or other distant metastasis.
Conclusions:
Extramedullary plasmacytoma should be considered in the differential diagnosis of a pulmonary mass.
Endoscopic management of bilateral frontal mucopyoceles: A Case Report and Literature review
Authors: Zainab Alhassan, Fadel Molani, Ali Almomen
Journal: Int J Surg Case Rep (2020)
Keywords: bilateral, endoscopic, fess, frontal sinus, image guided, mucocele
MeSH terms: Case Reports

Objective:
To demonstrate the effectiveness of the endonasal endoscopic approach in managing a large bilateral frontal mucopyocele causing a mass effect on the brain.
Case presentation:
A 17 year old chronic sinusitis patient, presented with bilateral nasal obstruction and increasing left sided headache; was found to have a very large bilateral frontal mucopyoceles with extensive intracranial extradural brain involvement on CT scan and MRI of the sinuses and brain which was drained and evacuated completely using the endonasal endoscopic image guided approach with no complications.
Conclusion:
The endonasal endoscopic image guided approach is the approach of choice in managing large frontal mucopyocele with brain extension. It is a safe, accurate, reliable approach with no complications.
Case Report: Challenging Otologic Surgery in Patients With 22q11.2 Deletion Syndrome
Authors: Emmy Verheij, Laura M Markodimitraki, Robert J Stokroos, Hans G X M Thomeer
Journal: Front Surg (2020)
Keywords: 22q112 deletion syndrome, mastoidectomy, ossicular chain, otitis media, otologic surgical procedures
MeSH terms: Case Reports

Patients with 22q11.2 deletion syndrome frequently have conductive hearing loss and/or chronic otitis media. Otologic surgery is often opted for. We present two patients undergoing otologic surgery. This case report outlines the typical otologic surgical challenges in patients with 22q11.2 deletion syndrome. Case one is a 52 year old male patient with chronic otitis media who underwent a mastoidectomy. The pre-operative CT scan showed a fused lateral semicircular canal and vestibule. Peroperatively, the lateral semicircular canal could not be used as a landmark to identify the facial nerve. Case two is a 10 year old female patient with conductive hearing loss. A middle ear inspection was performed where a bony epitympanic fixation of the malleus was encountered. In addition, the manubrium of the malleus was atrophic and also fixated. The bony fixation was removed, as was the manubrium of the malleus. Otologists should be aware of these typical anatomical variations in patients with 22q11.2 deletion syndrome. We recommend to use CT scanning of the middle and inner ear when preparing for otologic surgery in 22q11.2 deletion syndrome.
Sudden death due to the atrioventricular node contusion: Three cases report
Authors: Wenhe Li, Lin Zhang, Yue Liang, Fang Tong, Yiwu Zhou
Journal: Medicine (Baltimore) (2017)
MeSH terms: Atrioventricular Node / injuries, Contusions / complications, Death, Sudden, Cardiac / etiology, Case Reports, Adolescent, Adult, Humans, Male, Young Adult

Introduction:
Atrioventricular node (AVN) contusion usually results in cardiogenic shock and arrhythmia and is a rare but fatal condition. The condition is difficult to diagnose and easily overlooked because it develops rapidly and is asymptomatic. We here report 3 cases that demonstrate blunt chest impact and hemorrhages of the posterior atrioventricular junction, eventually result in death.
Clinical findings:
Autopsy and histological examination were performed on all cases. External inspection revealed bruises in the hearts and fractures in the sternum and ribs. However, histological examinations were conclusive and showed cardiac contusion on the surface of the posterior atrioventricular junction of the individuals, and the death was due to the AVN contusion. The position of the AVN on the heart surface is determined by detailed examinations via an autopsy and microscopic, both of which are critical in the certification of cause of death.
Conclusion:
The report is intended to raise our understanding and make forensic pathologists aware of the surface of the posterior atrioventricular junction.
Two Monogenetic Disorders, Activated PI3-Kinase-δ Syndrome 2 and Smith-Magenis Syndrome, in One Patient: Case Report and a Literature Review of Neurodevelopmental Impact in Primary Immunodeficiencies Associated With Disturbed PI3K Signaling
Authors: Nidia Moreno-Corona, Loïc Chentout, Lucie Poggi, Romane Thouenon, Cecile Masson, Melanie Parisot, Lou Le Mouel, Capucine Picard, Isabelle André, Marina Cavazzana, Laurence Perrin, Anne Durandy, Saba Azarnoush, Sven Kracker
Journal: Front Pediatr (2021)
Keywords: apds2, pi3k signaling, pik3r1, neurodevelopmental impact, primary immunodeficiency
MeSH terms: Case Reports

Activated PI3-kinase-δ syndrome 2 (APDS2) is caused by autosomal dominant mutations in the PIK3R1 gene encoding the p85α, p55α, and p50α regulatory subunits. Most diagnosed APDS2 patients carry mutations affecting either the splice donor or splice acceptor sites of exon 11 of the PIK3R1 gene responsible for an alternative splice product and a shortened protein. The clinical presentation of APDS2 patients is highly variable, ranging from mild to profound combined immunodeficiency features as massive lymphoproliferation, increased susceptibility to bacterial and viral infections, bronchiectasis, autoimmune manifestations, and occurrence of cancer. Non-immunological features such as growth retardation and neurodevelopmental delay have been reported for APDS2 patients. Here, we describe a patient suffering from an APDS2 associated with a Smith-Magenis syndrome (SMS), a complex genetic disorder affecting, among others, neurological manifestations and review the literature describing neurodevelopmental impacts in APDS2 and other PIDs/monogenetic disorders associated with dysregulated PI3K signaling.
Case Report: Long-Term Survival of a Dog With Chronic Lymphocytic Leukemia Treated With Chlorambucil, Prednisolone, and Imatinib
Authors: Ga-Won Lee, Min-Hee Kang, Jin-Ha Jeon, Doo-Won Song, Woong-Bin Ro, Heyong-Seok Kim, Hee-Myung Park
Journal: Front Vet Sci (2022)
Keywords: chlorambucil, chronic lymphocytic leukemia, dog, flow cytometry, imatinib, lymphocytosis
MeSH terms: Case Reports

A 7-year-old castrated male Poodle dog presented with chronic progressive lymphocytosis. Hematologic and peripheral blood smear findings included remarkable lymphocytosis with well-differentiated small lymphocytes. Cytology of bone marrow aspirate showed hypercellular integrity with infiltration of small mature lymphocytes, accounting for 45% of all nucleated cells. Flow cytometry of blood and marrow samples revealed neoplastic lymphocytes predominantly expressing the CD21 molecule. B-cell chronic lymphocytic leukemia (CLL) was diagnosed on an immunophenotypic analysis. Administrations of prednisolone and chlorambucil were initiated and the response was unremarkable. Therefore, additional treatment with imatinib was provided, which resolved the hematologic abnormalities associated with CLL. Flow cytometry after ~1 year of treatment showed normalization of the count of lymphocytes positive for CD21 and resolved hematologic lymphocytosis. The dog was followed-up for 2 years, and there were no severe adverse effects. This case indicates that imatinib may be a good option as an adjunctive therapy with prednisolone and chlorambucil treatment for CLL in dogs without treatment response.
Mediastinal, retroperitoneal, and subcutaneous emphysema due to sigmoid colon penetration: A case report and literature review
Authors: Tomohiro Muronoi, Akihiko Kidani, Eiji Hira, Kayo Takeda, Shunsuke Kuramoto, Kazuyuki Oka, Yoshihide Shimojo, Hiroaki Watanabe
Journal: Int J Surg Case Rep (2019)
Keywords: colonic perforation, diverticulitis, mediastinal emphysema, pneumomediastinum, retroperitoneal emphysema, subcutaneous emphysema

Introduction:
Mediastinal and subcutaneous emphysema usually result from spontaneous rupture of the alveolar wall. We present an extremely rare case of massive mediastinal, retroperitoneal, and subcutaneous emphysema due to the penetration of the colon into the mesentery.
Presentation of case:
A 57-year-old man presented to our institution with a history of chest pain. The patient's medical history included malignant rheumatoid arthritis during the use of steroids and an immunosuppressive agent. The patient had no signs of peritoneal irritation or abdominal pain. A chest radiography revealed subcutaneous emphysema of the neck, mediastinal emphysema, as well as subdiaphragmatic free air. Computed tomography showed extensive retroperitoneal, mediastinal, and mesenteric emphysema of the sigmoid colon without pneumothorax. Diagnostic laparoscopy was performed and revealed perforation into the sigmoid mesentery. Segmental resection of the sigmoid colon and end-colostomy were performed. The diverticulum was communicating with the outside of the mesentery via the mesentery. The mediastinal emphysema disappeared a few days after the surgery.
Discussion:
Colonic perforation generally results in free perforation. Colonic gas may spread via various anatomical pathways when perforation of the colon occurs in the retroperitoneum; thus, diverse atypical clinical symptoms may be present. Signs of peritoneal irritation can be hidden in cases of retroperitoneal colonic perforation. The atypical manifestation of a retroperitoneal colonic perforation can cause difficulties in making a diagnosis.
Conclusions:
Massive mediastinal and retroperitoneum emphysema are rare signs of colonic perforation. Emergency laparotomy should be considered in colonic penetration of the diverticulitis where the emphysema expands to the mediastinum extensively.
Anatomic variant of the inferior lateral cutaneous branch of the radial nerve during the posterior approach to the humerus: a case report
Authors: Li Sun, Brian K Park, Salil Gupta, John T Capo, Richard S Yoon, Frank A Liporace
Journal: Patient Saf Surg (2015)
Keywords: anatomic variant, humerus fracture, lateral cutaneous branch, radial nerve
MeSH terms: Case Reports

Iatrogenic injury during the posterior approach to the humerus during operative fixation is not an uncommon occurrence. A comprehensive understanding of the normal anatomy and its variants is of paramount importance in order to avoid such injury. Typically, the inferior lateral cutaneous branch of the radial nerve originates towards the distal end of the humerus at the inferior portion of the spiral groove. Here, we report an important variant of this nerve, which originated significantly more proximal than expected, further emphasizing the importance of identification, dissection and protection of the radial nerve and its major branches.
A Rare Case of a Translocation-Associated Perivascular Epithelioid Cell Neoplasm (PEComa)
Authors: Kimberly Pereira, Arati A Inamdar, Aditi Zaveri, Jonathan E Teitelbaum, Wendy Shertz, Kenneth Belitsis
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

A perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm composed of perivascular epithelioid cells with distinctive histologic, immunohistochemical, and genetic features. PEComas arising from various anatomical sites have been reported, but gastrointestinal PEComas are extremely rare entities. Here, we discuss the clinical and pathological features of a gastrointestinal PEComa with a transcription factor E3 (TFE3) translocation in a 17-year old adolescent male with a clinical presentation of abdominal pain and gastrointestinal bleeding. Our case report provides insight into this rare entity as well as discusses the pathophysiological aspects of TFE3-SFPQ-associated GI PEComas and their management.
Evaluation of coronavirus-2019-related arterial thrombosis in noncontrast spectral computed tomography with electron density imaging
Authors: Junji Mochizuki, Takeshi Nakaura, Hiroaki Matsumi, Yoshiki Hata
Journal: Radiol Case Rep (2022)
Keywords: covid-19, computed tomography, contrast media, electrons, thrombosis
MeSH terms: Case Reports

Thrombosis can be associated with coronavirus disease 2019 infection. Computed tomography is essential for the diagnosis of pneumonia in these patients and conventionally contrast agents are required for the assessment of thrombus. In this study, we report a patient with coronavirus disease 2019 who was diagnosed with thrombosis using spectral noncontrast computed tomography with electron density imaging. The patient was a 76-year-old man who presented with a 2-day history of lower-leg pain. Tachycardia and atrial fibrillation were identified, with elevated D-dimer, N-terminal pro-B-type natriuretic peptide, creatine kinase, and C-reactive protein levels. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2 was positive. Conventional computed tomography showed pulmonary changes consistent with coronavirus disease 2019 and no changes in the aorta, but spectral computed tomography with electron density imaging of noncontrast computed tomography showed a thrombus in the right external iliac artery. Spectral computed tomography with electron density imaging provides more data compared with conventional computed tomography and has the potential to depict thrombus without the use of contrast media.
Herpes Zoster Infection Presenting as Aseptic Meningitis and Dermatomal Rash in Immunocompetent Adult
Authors: Suyash Dawadi, Sudesh Lamsal, Bhupendra Shah
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Herpes zoster is a localized, painful, and vesicular rash involving one or adjacent dermatomes caused by varicella-zoster virus reactivation. Herpes zoster presenting as aseptic meningitis is prevalent among elderly population and people with immunocompromised status. However, it is a rare phenomenon in the young immunocompetent adult; hence, we are reporting a case of a herpes zoster infection presenting as aseptic meningitis and dermatological manifestation in a 19-year-old immunocompetent male.
Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen
Authors: Tahsin Colak, Tolga Olmez, Ozgur Turkmenoglu, Ahmet Dag
Journal: Case Rep Surg (2013)

Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT). The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB) complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass.
Case Report: Coil Occlusion of Two Congenital Coronary Cameral Fistulas Connecting Right and Left Circumflex Arteries to the Right Ventricle: An Innovative Stent-Assisted Technique
Authors: Igor V Buzaev, Vladimir V Plechev, Gulchachak Khalikova, Kristina Khabirova, Irina Evgenievna Nikolaeva, Eustaquio Maria Onorato
Journal: Front Cardiovasc Med (2022)
Keywords: coil occlusion, congenital heart disease, coronary angiography, coronary cameral fistulas, coronary fistulas
MeSH terms: Case Reports

Background:
Coronary cameral fistulas (CCFs) are rare congenital malformations consisting of abnormal vascular connections between coronary arteries and cardiac chambers, often incidentally found during cardiac catheterizations.
Case summary:
A 66-year-old female asymptomatic patient, without cardiovascular risk factors and a history of varicose veins lower extremities and coronavirus disease 2019 (COVID-19) pneumonia in December 2020, was diagnosed by coronary angiography with two large coronary cameral fistulas connecting the distal right coronary artery (RCA) and the distal left circumflex artery (LCx) to the right ventricle (RV). Additional imaging modalities such as two-dimensional transthoracic/transesophageal echocardiography and three-dimensional multidetector CT angiography were required to confirm the fistula's pathway (location, number, and size), which was difficult to delineate using selective coronary angiography alone. After heart team discussion, with the aim to reduce the risk of embolization, an innovative stent-assisted coil occlusion antegrade technique was used with optimal immediate results.
Discussion:
Even though our otherwise asymptomatic patient was not the best suitable candidate for an interventional procedure (large vessels, multiple fistulas without distal narrowing, distal portion of the fistula not accessible with the closure device), the innovative stent-assisted fistula coil occlusion technique to stabilize the first coil and deploy safely the additional ones resulted to be key for successful and complete obliteration of the abnormal congenital vascular connections.
Term Infant with Cerebral Venous Sinus Thrombosis
Authors: Sanket Jani, Ralph Ariss, Pradeep Velumula, Deniz Altinok, Sanjay Chawla
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Hypernatremic dehydration in neonates is a common condition in an exclusively breastfed infant but often underdiagnosed. Any newborn who has lost more than 10% of birthweight should be carefully evaluated and monitored for clinical features of dehydration. Efforts such as frequent follow-up for weight check, and formula supplementation, if needed, should be provided to a neonate at risk of developing complications of dehydration. Adequate lactation consultation, both inpatient and outpatient, should also be provided, especially to the primigravida mother. Here, we present a case of a neonate with severe hypernatremic dehydration caused by inadequate lactation in a primigravida mother, which resulted in cerebral venous sinus thrombosis leading to significant intracerebral hemorrhage. The infant suffered permanent neurologic damage and was sent home on technological devices (tracheostomy and gastrostomy tubes). Further, we provide a brief review of hypernatremic dehydration and sinus venous thrombosis in neonates.
Phytobezoar: A Brief Report with Surgical and Radiological Correlation
Authors: Sameer A Hirji, Faith C Robertson, Grace F Chao, Bharti Khurana, Jonathan D Gates
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Gastrointestinal bezoars, collections of incompletely digested material within the alimentary tract, can present as a diagnostic challenge and should be considered in the differential diagnosis and management of small bowel obstruction, ischemic bowel, or bowel perforation. We present a case of a 37-year-old man with a distant history of laparotomy for superior mesenteric artery thrombosis requiring partial small bowel resection of the jejunum who presented with worsening abdominal pain, nausea, vomiting, and hematemesis. An abdominal computed tomography revealed dilated loops of small bowel with a transition point at the ileum, distal to his prior bowel anastomosis. He was managed initially nonoperatively, but persistent vomiting and worsening distention necessitated urgent exploratory laparotomy. During the procedure, a 4 cm by 3 cm phytobezoar was discovered at the midjejunum. The patient had an unremarkable postoperative course with no further symptoms at 1-year follow-up. Timely diagnosis and treatment of bezoar is essential to minimize patient complications.
Isolated Pulmonary Embolism following Shoulder Arthroscopy
Authors: Nicole H Goldhaber, Christopher S Lee
Journal: Case Rep Orthop (2014)

Pulmonary embolism (PE) following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT) angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.
Sudden Cardiac Arrest in a Patient With COVID-19 as a Result of Severe Hyperkalemia After Administration of Succinylcholine Chloride for Reintubation. A Case Report
Authors: Mateusz Putowski, Tomasz Drygalski, Andrzej Morajda, Jarosław Woroń, Tomasz Sanak, Jerzy Wordliczek
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, hyperkalemia, rocuronium, succinylcholine, sudden cardiac arrest
MeSH terms: Case Reports

Background:
We present a case study of a man with coronavirus disease 2019 (COVID-19) who developed cardiac arrest as a result of hyperkalemia following administration of chlororsuccinylcholine during endotracheal intubation.
Case summary:
A patient with a severe course of COVID-19, hospitalized in the Intensive Care Unit, underwent reintubation on day 16. The applied scheme was rapid sequence induction and intubation with administration of chlororsuccinylcholine. Immediately after intubation, there was a sudden cardiac arrest due to hyperkalemia (cK + 10.2 meq/L). Treatment was initiated as per guidelines, which resulted in a return to spontaneous circulation after 6 min.
Conclusion:
Chlorsucynylcholine may cause life-threatening hyperkalemia. We recommend using rocuronium as a neuromuscular blocking agent in critically ill COVID-19 patients due to its more optimal safety profile.