OpenMed/multicare-articles huggingface dataset:
Giant symptomatic serous cystadenoma mimicking carcinoma: A case report and literature review
Authors: Lauren Pointer, Luke D Rothermel, Carolina Strosberg, Daniel Anaya, Pamela Hodul
Journal: Int J Surg Case Rep (2019)
Keywords: pancreatic cyst, serous cystadenocarcinoma, serous cystadenoma

Introduction:
Advanced imaging has led to an increase in the incidental diagnosis of pancreatic cysts. Serous cystadenomas (SCAs) account for nearly 30% of cases. These are typically considered benign lesions but up to 16% of cases are resected for aggressive behavior and symptoms.
Presentation of case:
A 64 year old female presented with a large incidental cyst in the pancreatic body. Pre-operative imaging conferred a diagnosis of SCA. After 2 years the cyst grew resulting in abdominal pain. Enlargement was associated with splenic vein occlusion and varices of the short gastric vessels. This change in behavior was concerning for malignant transformation. The cyst was resected by distal pancreatectomy and splenectomy. The patient recovered with minimal morbidity. Final pathology revealed a 15.5 × 10.3 × 8.5 cm SCA with negative margins.
Discussion:
In this case a patient presents with aggressive radiographic features and new symptoms suggesting malignant transformation of a previously diagnosed SCA on imaging. Although malignant variants can be diagnosed by findings of metastatic deposits at the time of surgery or as recurrence years later, histologic findings cannot discriminate benign from malignant potential. Preoperative imaging is challenging with erroneous characterization in nearly 60% of cases.
Conclusion:
Based on the low risk of malignancy, selective surgical resection for SCA appears warranted. Accepted indications for surgery include development of symptoms or concern for correct diagnosis in a medically fit individual. Routine resection for cysts >4 cm has been suggested however, prospective studies are needed to determine benefit over risk rationale.
Use of Erbium Laser in the Treatment of a Patient with Acute Purulent Periostitis and a Resistant Form of Primary Immune Thrombocytopenia
Authors: Elena Larionova, Svetlana Tarasenko, Elena Morozova, Ekaterina Diachkova
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

In our article, we described a clinical case of a patient with an acute periostitis of the maxilla with a comorbidity (primary immune thrombocytopenia, resistant form) who was treated using laser technology allowing us to provide good results: an intensive regeneration process and a decreased risk of developing infection complications and unpleasant signs for the patient, such as postoperative edema and intraoperative and postoperative pain syndrome.
Mesenteric Castleman's disease mimicking neuroendocrine tumour
Authors: Ricky H Bhogal, Andrew Wotherspoon, Aamir K Khan
Journal: Int J Surg Case Rep (2019)
Keywords: castleman’s disease, lymphadenopathy, neuroendocrine tumour, small bowel resection

Introduction:
Castleman's disease is a rare entity and is a benign hyperplastic enlargement of lymph nodes. It can occur anywhere within the body but only approximately 50 cases of mesenteric Castleman's disease have been reported within the literature.
Case presentation:
We report a female patient who was thought to have developed a neuroendocrine tumour within the small bowel and a large nodal mass within the mesentery based on nuclear scintigraphy imaging. Following surgical resection the nodal mass found confirmed to be Castleman's disease.
Discussion:
Although rare complete resection of mesenteric Castleman's disease offer excellent long term outcome although the diagnosis may only be made after surgery.
Conclusion:
The diagnosis of mesenteric Castleman's disease is often made post-operatively but complete surgical resection offers excellent long-term survival.
Bilateral Ureteral Obstruction Caused by Stone Formation After Laparoscopic Appendectomy in Children
Authors: Ya-Fu Cheng, Yao-Jen Hsu, Tai-Wai Chi, Yu-Wei Fu
Journal: J Endourol Case Rep (2018)
Keywords: appendectomy, pediatrics, ureteral obstruction, ureteral stone
MeSH terms: Case Reports

In children, urologic complications are rare after laparoscopic appendectomy (LA). In this article, we report the case of a 9-year-old boy with bilateral hydronephrosis caused by ureteral calculi 10 days after he had undergone LA. The patient's urinary output normalized and renal function recovered after stone extraction and bilateral ureteral stent insertion.
Case Report: Next generation sequencing identifies a NAB2-STAT6 fusion in Glioblastoma
Authors: Phedias Diamandis, Ruben Ferrer-Luna, Raymond Y Huang, Rebecca D Folkerth, Azra H Ligon, Patrick Y Wen, Rameen Beroukhim, Keith L Ligon, Shakti H Ramkissoon
Journal: Diagn Pathol (2016)
MeSH terms: Biomarkers, Tumor / genetics, Brain Neoplasms / genetics, Gene Fusion, Glioblastoma / genetics, High-Throughput Nucleotide Sequencing, Parietal Lobe / chemistry, Parietal Lobe / pathology, Parietal Lobe / surgery, Repressor Proteins / genetics, STAT6 Transcription Factor / genetics, Case Reports, Adult, Brain Neoplasms / chemistry, Brain Neoplasms / pathology, Brain Neoplasms / surgery, Comparative Genomic Hybridization, Genetic Predisposition to Disease, Glioblastoma / chemistry, Glioblastoma / pathology, Glioblastoma / surgery, Humans, Immunohistochemistry, Magnetic Resonance Imaging, Male, Phenotype, Predictive Value of Tests, Biomarkers, Tumor, NAB2 protein, human, Repressor Proteins, STAT6 Transcription Factor, STAT6 protein, human

Background:
Molecular profiling has uncovered genetic subtypes of glioblastoma (GBM), including tumors with IDH1 mutations that confer increase survival and improved response to standard-of-care therapies. By mapping the genetic landscape of brain tumors in routine clinical practice, we enable rapid identification of targetable genetic alterations.
Case presentation:
A 29-year-old male presented with new onset seizures prompting neuroimaging studies, which revealed an enhancing 5 cm intra-axial lesion involving the right parietal lobe. He underwent a subtotal resection and pathologic examination revealed glioblastoma with mitoses, microvascular proliferation and necrosis. Immunohistochemical (IHC) analysis showed diffuse expression of GFAP, OLIG2 and SOX2 consistent with a tumor of glial lineage. Tumor cells were positive for IDH1(R132H) and negative for ATRX. Clinical targeted-exome sequencing (DFBWCC Oncopanel) identified multiple functional variants including IDH1 (p.R132H), TP53 (p.Y126_splice), ATRX (p.R1302fs*), HNF1A (p.R263H) and NF1 (p.H2592del) variants and a NAB2-STAT6 gene fusion event involving NAB2 exon 3 and STAT6 exon 18. Array comparative genomic hybridization (aCGH) further revealed a focal amplification of NAB2 and STAT6. IHC analysis demonstrated strong heterogenous STAT6 nuclear localization (in 20 % of tumor cells).
Conclusions:
While NAB2:STAT6 fusions are common in solitary fibrous tumors (SFT), we report this event for the first time in a newly diagnosed, secondary-type GBM or any other non-SFT. Our study further highlights the value of comprehensive genomic analyses in identifying patient-specific targetable mutations and rearrangements.
Crouzon's Syndrome: A Case Report
Authors: G Ravi Kumar, M Jyothsna, Syed Basheer Ahmed, K Sree Lakshmi
Journal: Int J Clin Pediatr Dent (2013)
Keywords: craniosynostosis, exophthalmos, hypertelorism, midfacial hypoplasia
MeSH terms: Case Reports

Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37.
Gastric resection with intrathoracic anastomosis in a hiatal hernia - A case report
Authors: Radek Vrba, Dušan Klos, Daniela Kürfurstová, Petr Špička
Journal: Int J Surg Case Rep (2023)
Keywords: gastric necrosis, mixed hiatal hernia, total gastrectomy
MeSH terms: Case Reports

•Severe complication of hiatal hernia with gastric and esophageal necrosis•Acute total gastrectomy with esophagojejunoanastomosis via right-sided thoracotomy•Simultaneous resection of multiple jejunal diverticula present
Case Report: Nerve Root Entrapment Due to Epidural Fibrosis in a Patient With Failed Back Surgery Syndrome: Value of 2-18F-Fluorodeoxyglucose Simultaneous Positron Emission Tomography-Magnetic Resonance Imaging
Authors: Yueh-Hsun Tsai, Guo-Shu Huang, Chi-Tun Tang, Wei-Chou Chang, Yi-Chih Hsu
Journal: Front Med (Lausanne) (2022)
Keywords: case report, epidural fibrosis, failed back surgery syndrome, magnetic resonance imaging, positron emission tomography
MeSH terms: Case Reports

Failed back surgery syndrome (FBSS) is a highly prevalent condition in patients after spine surgery. Although magnetic resonance imaging (MRI) is the gold standard for the diagnosis of epidural fibrosis, it is sometimes difficult to determine if epidural fibrosis contributes to radiculopathy. Herein, we share our experience in locating radiculopathy lesions using simultaneous positron emission tomography (PET)/MRI. 2-[18F]-FDG (18F-fluorodeoxyglucose) simultaneous PET/MRI maps of body glucose metabolism detected using PET can be used to correlate anatomical details provided by MRI to offer a very clear picture of neural inflammation due to extensive epidural fibrosis. More applications of 2-[18F]-FDG simultaneous PET/MRI in low back pain and other musculoskeletal diseases should be further investigated in the future.
A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite
Authors: Domenico Aiello, Riccardo Nucera, Stefania Costa, Michele Mario Figliuzzi, Sergio Paduano
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Monolateral and bilateral crossbites are amongst the most frequent forms of malocclusion in the world population. The lack of early correction of this type of malocclusion leads to the partial or total ossification of the sutures which then require surgical treatment in adult patients. In recent years, devices on minipalatal screws have noticeably increased the time window in which it is possible to correct these types of alterations. In this case report, we show how it is possible to correct a third-class skeletal malocclusion associated with a posterior bilateral crossbite in a young woman using a rapid expander on miniscrews and fixed orthodontic device to finalise the process. The procedure for the insertion of the palatal screws was aided by the use of a digitally printed surgical guide, and the appliance was applied in the same sitting thanks to the use of a digital flow software and a systematic easy driver. The CBCT scans show how the orthopaedic expansion of the upper maxilla was obtained without any important alterations that damaged the permanent teeth. This case report wishes to demonstrate how easy and predictable it can be to resolve cases of this type with optimal aesthetic and functional results even when body growth has ended.
Traumatic Obturator Hip Dislocation with Marginal Femoral Head Fracture in a 15-Year-Old Adolescent: A High-Energy Trauma-A Case Report and a Review of the Literature
Authors: Yoann Durand, Clémence Bruyère, Marco Saglini, Aurélien Michel-Traverso
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report the case of a 15-year-old boy brought to the emergency department after a bike accident, complaining of an isolated left hip pain. The X-rays showed an obturator hip dislocation treated by closed reduction under general anaesthesia, followed by 6 weeks of discharge. The follow-up MRI performed 6 weeks after the trauma showed an avascular femoral head necrosis, for which we performed multiple retrograde femoral head drilling, completed by the injection of autologue stem cells from the iliaq crest. One year later, the patient has no hip pain, no joint limitation, and can practice BMX at a high level again. The purpose of this report is to make the physicians aware of this rare problem that may be damaging for hip function, especially in young people.
Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications
Authors: Kagmeni Giles, Domngang Christelle, Bilong Yannick, Otto Herrmann Fricke, Peter Wiedemann
Journal: Pan Afr Med J (2016)
Keywords: pediatric cataract, intraocular lenses, local anesthesia, postoperative complications
MeSH terms: Cataract / pathology, Cataract Extraction / methods, Lens Implantation, Intraocular / methods, Visual Acuity, Adolescent, Anesthesia, Local / methods, Cataract Extraction / adverse effects, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Intraoperative Complications / epidemiology, Male, Postoperative Complications / epidemiology, Retrospective Studies, Treatment Outcome

The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.
Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient
Authors: Ismail Ibrahim Ismail, Fathi Massoud, K J Alexander, Jasem Youssef Al-Hashel
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Background:
Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11-15% of thalassemic patients in intermediate and severe cases causing a paraspinal compressive mass. We present a rare case of spinal EMH with thoracic cord compression in a 22-year-old female with beta thalassemia who presented with paraparesis and we provide a review of literature.
Case report:
A 22-year-old female patient with a known history of beta thalassemia presented with subacute onset of weakness and numbness of both lower limbs with a sensory level at T6. Magnetic resonance imaging (MRI) of the dorsal spine showed cord compression secondary to paraspinal EMH from T2 to T9 with most prominent compression over T5. She was managed with blood transfusion and low-dose radiotherapy.
Conclusion:
Although rare, EMH should be suspected in thalassemic patients presenting with paraplegia. Treatment with blood transfusions is usually effective. Other options include radiotherapy, surgery, hydroxyurea or a combination of these modalities.
From Postural Orthostatic Tachycardia Syndrome to Radiologically Isolated Syndrome
Authors: Richa Tripathi, Evanthia Bernitsas
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Background:
Autonomic dysfunction is common in Multiple Sclerosis (MS) patients. Most spinal cord lesions entail some degree of autonomic nervous system dysfunction. MS patients may develop autonomic dysfunction later in their disease course.
Methods:
We report a patient with no prior history of MS presenting with orthostatic symptoms and diagnosed initially with postural orthostatic tachycardia syndrome (POTS). Four months later, she was diagnosed with radiologically isolated syndrome (RIS). The diagnosis was supported by imaging and CSF analysis.
Conclusion:
Our case sheds light on the need to consider autonomic dysfunction as an initial presentation of demyelinating pathology. Larger trials are needed to outline the possible association between POTS and RIS.
Angiogenic factors and renal disease in pregnancy
Authors: Julie S Rhee, Brett C Young, Sarosh Rana
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

Background. Preeclampsia is difficult to diagnose in patients with underlying renal disease and proteinuria. Prior studies show that there is an angiogenic factor imbalance with elevated levels of antiangiogenic proteins soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) and reduced levels of the proangiogenic protein, placental growth factor (PlGF) in women with preeclampsia. These angiogenic biomarkers may be useful in distinguishing preeclampsia from other conditions of pregnancy, which may present with overlapping clinical characteristics. Cases. Case 1: A multiparous woman at 18 weeks gestation with nephrotic syndrome presented with hypertensive emergency and worsening renal insufficiency. She underwent induction of labor for severe preeclampsia. Her sFlt1 and sEng levels were at the 97 percentile while her PlGF level was undetectable (less than the 1st percentile). Case 2: A nulliparous woman with lupus nephritis at 22 weeks gestation presented with fetal demise and heart failure. Three weeks previously, the patient had developed thrombocytopenia and hypertensive urgency. She underwent dilation and evacuation. Her angiogenic profile was consistent with severe preeclampsia. Conclusion. Angiogenic factors may provide evidence to support a diagnosis of preeclampsia in patients with preexisting renal disease and proteinuria, conditions in which the classical definition of hypertension and proteinuria cannot be used.
Tamoxifen-associated vasculitis in a breast cancer patient
Authors: Myrna Candelaria, Rafael Hurtado-Monroy, Pablo Vargas-Viveros, Silvia Carrillo-Muñnoz, Alfonso Duenas-Gonzalez
Journal: World J Surg Oncol (2007)
MeSH terms: Antineoplastic Agents, Hormonal / adverse effects, Breast Neoplasms / drug therapy, Cholestasis / chemically induced, Selective Estrogen Receptor Modulators / adverse effects, Skin Diseases, Vascular / chemically induced, Tamoxifen / adverse effects, Vasculitis / chemically induced, Case Reports, Female, Humans, Middle Aged, Antineoplastic Agents, Hormonal, Selective Estrogen Receptor Modulators, Tamoxifen

Background:
Estrogen plays a critical role in breast cancer. Thereafter, endocrine therapy is a standard of care in patients with breast carcinoma, expressing ER or PR.
Case presentation:
Herein we report the case of a 53-year old patient, who developed cholestasis and vasculitis during the treatment with tamoxifen. This toxicity was reversable after the removal of the drug. Thereafter she continued adjuvant treatment for breast carcinoma with anastrazole. Since tamoxifen has been widely indicated for patients with breast carcinoma, we did a literature review, looking for other cases with this type of toxicity.
Conclusion:
This case is the third with vasculitis informed in the literature, but the first one that additionally developed cholestasis and arthritis. Although it is rare, we discuss the indication of this drug in the actual era, where aromatase inhibitors offer a better security profile.
Incidentally Identified Pulmonary AVM: An Unusual Cause for Stroke in a Young Patient
Authors: Vinod Kalapurackal Mathai, Dale Sebire, Scarlett Bowen
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Pulmonary arteriovenous malformation is an uncommon though important potential source for embolic right-to-left extracardiac shunt as a cause for both silent and clinically evident stroke. We present this case to highlight this pathology as a cause for stroke, the importance of treating this malformation, even if incidentally identified, and finally the role of echocardiography in screening for extracardiac shunt and indicating those patients that may benefit from further investigations looking for extracardiac shunt.
Cetuximab-Associated Crescentic Diffuse Proliferative Glomerulonephritis
Authors: Sukesh Manthri, Sindhura Bandaru, Anthony Chang, Tamer Hudali
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

Cetuximab-induced nephrotoxicity is very rare, occurring in less than 1% of colorectal cancer patients and not defined in other populations. We report a rare case of crescentic diffuse proliferative glomerulonephritis (GN) that developed in close temporal association with cetuximab treatment. A 65-year-old female recently completed chemotherapy with cetuximab treatment for moderately differentiated oral squamous cell carcinoma. She was admitted with acute renal failure and nephrotic-range proteinuria. Laboratory data showed serum creatinine of 6.6 mg/dl and urinalysis showed proteinuria, moderate hemoglobinuria, hyaline casts (41/LPF), WBC (28/HPF), and RBC (81/HPF). Serologic studies were negative for ANA, anti-GBM, ANCA, hepatitis B, and hepatitis C. Serum C3 and C4 level were normal. Renal biopsy showed crescentic diffuse proliferative GN with focal features of thrombotic microangiopathy. Patient was started on cyclophosphamide and steroids. Her renal function did not improve on day 8 and she was started on hemodialysis. Previous reports suggest that EGFR-targeting medications can possibly trigger or exacerbate an IgA-mediated glomerular process leading to renal failure. This case suggests that cetuximab therapy may have triggered or exacerbated a severe glomerular injury with an unfavorable outcome. Treating physicians should maintain a high degree of caution and monitor renal function in patients on EGFR inhibitors.