OpenMed/multicare-articles huggingface dataset:
A Rare Case of Small Intestinal Cancer With Uterine Metastasis After Surgery for Ovarian Metastasis, Diagnosed Using Immunostaining
Authors: Sachiko Nagao, Motoki Matsuura, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito
Journal: Case Rep Oncol Med (2024)
Keywords: cancer of the ileum, diagnostic techniques, metastasis, surgery, uterus
MeSH terms: Case Reports

Uterine metastases from extragenital sites are rare. We present a case of a woman who had undergone surgery for small intestinal cancer and subsequently developed metastases in her left ovary and uterus. A nulliparous woman in her 50s underwent laparoscopic partial small bowel resection with lymph node dissection for small intestinal cancer. Five months later, computed tomography (CT) revealed a left ovarian tumor and ascites. She underwent bilateral adnexectomy and adjuvant chemotherapy, and the ovarian tumor was diagnosed as a small intestinal cancer metastasis. Two years after the small intestinal cancer surgery, a positron emission tomography (PET)-CT scan revealed a uterine accumulation. Cervical cytology was negative for intraepithelial lesion or malignancy. Endometrial histology showed an adenocarcinoma of the uterus. The patient underwent total abdominal hysterectomy followed by adjuvant chemotherapy. Histopathology and immunohistochemistry of the uterine tumor revealed that it was a metastasis of small intestinal cancer (Cytokeratin 7 [CK7] [-], Cytokeratin 20 [CK20] [+], Special AT-Rich Sequence-Binding Protein 2 [SATB2] [+], Paired Box Gene 2 [PAX2] [-], and estrogen receptor [ER] [-]). In patients with cancer, histopathology and immunohistochemistry are important for distinguishing between primary and metastatic tumors and for guiding the choice of treatment.
Case report: Refractory Evans syndrome in two patients with spondyloenchondrodysplasia with immune dysregulation treated successfully with JAK1/JAK2 inhibition
Authors: Yael Gernez, Mansi Narula, Alma-Martina Cepika, Juanita Valdes Camacho, Elisabeth G Hoyte, Kirsten Mouradian, Bertil Glader, Deepika Singh, Bindu Sathi, Latha Rao, Ana L Tolin, Kenneth I Weinberg, David B Lewis, Rosa Bacchetta, Katja G Weinacht
Journal: Front Immunol (2024)
Keywords: acp5, jak inhibitor, autoimmunity, interferonopathy, myeloma, spondyloenchondrodysplasia, tartrate-resistant acid phosphatase
MeSH terms: Anemia, Hemolytic, Autoimmune, Autoimmune Diseases, Immunoglobulin G, Immunologic Deficiency Syndromes, Janus Kinase 2, Osteochondrodysplasias, Thrombocytopenia, Review, Case Reports, Humans, Janus Kinase 1, Tartrate-Resistant Acid Phosphatase / genetics, Tartrate-Resistant Acid Phosphatase, Immunoglobulin G, JAK1 protein, human, Janus Kinase 1, JAK2 protein, human, Janus Kinase 2, Combined Immunodeficiency with Autoimmunity and Spondylometaphyseal Dysplasia, Evans Syndrome, Spondyloenchondrodysplasia

Biallelic mutations in the ACP5 gene cause spondyloenchondrodysplasia with immune dysregulation (SPENCDI). SPENCDI is characterized by the phenotypic triad of skeletal dysplasia, innate and adaptive immune dysfunction, and variable neurologic findings ranging from asymptomatic brain calcifications to severe developmental delay with spasticity. Immune dysregulation in SPENCDI is often refractory to standard immunosuppressive treatments. Here, we present the cases of two patients with SPENCDI and recalcitrant autoimmune cytopenias who demonstrated a favorable clinical response to targeted JAK inhibition over a period of more than 3 years. One of the patients exhibited steadily rising IgG levels and a bone marrow biopsy revealed smoldering multiple myeloma. A review of the literature uncovered that approximately half of the SPENCDI patients reported to date exhibited increased IgG levels. Screening for multiple myeloma in SPENCDI patients with rising IgG levels should therefore be considered.
The Rare Large Common Peroneal Nerve's Schwannoma-A Case Report and Literature Review
Authors: Rudiansyah Harahap, Nurmaliannysa Dwinandia Harahap
Journal: Case Rep Oncol Med (2024)
Keywords: common peroneal nerve, neurological deficit, schwannoma
MeSH terms: Case Reports

Schwannoma in the popliteal fossa is still rare, often diagnosed late because it grows slowly and has no symptoms. It is often misdiagnosed with connective tissue tumors or with neurological disorders originating in the spine or disorders of the peroneal nerve. Schwannoma within the common peroneal nerve is still rare in the popliteal fossa, with most tumor sizes around 2 cm in diameter due to their smaller size of nerve but can cause neurologic disturbance, especially when it is large. And over a long time, it can cause serious complaints like neurological deficits and make surgery difficult by leaving greater sequelae. There is no data yet showing the incidence of schwannoma in the common peroneal nerve. In this case, a 36-year-old woman, for 5 years, feels soreness in the popliteal fossa and pain in the right instep, suspected that a nerve was pinched, due to an abnormality in the spine. As time went on, there was a lump in the fold of the right knee, suspected to be a Baker's cyst. As time went by, the complaint was burning pain in the right instep to the lateral ankle and distal right lower leg, disturbing sleep. Tinel's sign was positive. The right instep has hypoesthesia and a slight drop in the foot. On radiological examination of the right knee, a circumferential mass appeared, measuring 5 cm × 4 cm. The diagnosis is suspicious for a common peroneal nerve tumor. The encapsulated operation to remove the tumor was carried out with a size measuring 5 cm × 4.5 cm × 4 cm. The histopathological examination showed schwannoma. After surgery, the pain disappeared, hypoesthesia and a slight drop in the foot underwent physiotherapy, and stimulation with the result gradually improved. A thorough early examination includes correct and systematic anamnesis, physical examination, and neurological evaluation such as paraesthesia, hypoesthesia, and Tinel's sign; also, additional examinations, such as radiographic, ultrasound, and MRI, are needed for early detection of schwannoma so that delays in diagnosis and surgery can be avoided to prevent neurological deficits.
Hypersensitivity to man-made electromagnetic fields (EHS) correlates with immune responsivity to oxidative stress: a case report
Authors: Thawatchai Thoradit, Marthe Chabi, Blanche Aguida, Soria Baouz, Verene Stierle, Marootpong Pooam, Stephane Tousaints, Casimir D Akpovi, Margaret Ahmad
Journal: Commun Integr Biol (2024)
Keywords: antioxidant therapy, ehs, emf - lf, electromagnetic field sensitivity, electromagnetic fields, oxidative stress, reactive oxygen species, wifi

There is increasing evidence that exposure to weak electromagnetic fields (EMFs) generated by modern telecommunications or household appliances has physiological consequences, including reports of electromagnetic field hypersensitivity (EHS) leading to adverse health effects. Although symptoms can be serious, no underlying mechanism for EHS is known and there is no general cure or effective therapy. Here, we present the case study of a self-reported EHS patient whose symptoms include severe headaches, generalized fatigue, cardiac arrhythmia, attention and memory deficit, and generalized systemic pain within minutes of exposure to telecommunications (Wifi, cellular phones), high tension lines and electronic devices. Tests for cerebral, cardiovascular, and other physiological anomalies proved negative, as did serological tests for inflammation, allergies, infections, auto-immune conditions, and hormonal imbalance. However, further investigation revealed deficits in cellular anti-oxidants and increased radical scavenging enzymes, indicative of systemic oxidative stress. Significantly, there was a large increase in circulating antibodies for oxidized Low-Density Lipoprotein (LDLox), byproducts of oxidative stress accumulating in membranes of vascular cells. Because a known primary effect of EMF exposure is to increase the concentration of cellular oxidants, we propose that pathology in this patient may be causally related to a resulting increase in LDLox synthesis. This in turn could trigger an exaggerated auto-immune response consistent with EHS symptoms. This case report thereby provides a testable mechanistic framework for EHS pathology with therapeutic implications for this debilitating and poorly understood condition.
Case report: Severe respiratory failure caused by licorice
Authors: Hiroaki Taniguchi, Takero Terayama, Nobuaki Kiriu, Hiroshi Kato, Soichiro Seno, Yasumasa Sekine, Yoshihiro Tanaka, Tetsuro Kiyozumi
Journal: Front Pharmacol (2023)
Keywords: apparent mineralocorticoid excess, diaphragm, herbal medicine, hypercapnia, licorice, pseudoaldosteronism
MeSH terms: Case Reports

Licorice, one of the most commonly used herbs, can cause hypokalemia, metabolic alkalosis, and apparent mineralocorticoid excess, also known as pseudoaldosteronism. Herein, we present a case of diaphragmatic dysfunction caused by licorice administration. An 80-year-old woman who had been taking dietary supplements and following a restricted diet for approximately 6 months was brought to the emergency department with impaired consciousness. Chronic respiratory acidosis was observed, and hypertension and hypokalemia became more prominent during hospitalization. History revealed that she was taking herbal medicines containing licorice. Based on the results of hormone tests, the patient was diagnosed with pseudoaldosteronism. Chest radiography and pulmonary function tests confirmed the clinical diagnosis of diaphragmatic dysfunction. The metabolic alkalosis resulting from licorice administration may have contributed to the impairment of the respiratory muscles. This case suggests that caution should be exercised when using licorice in patients with preexisting health or medical issues such as advanced age, malnutrition, and electrolyte imbalance.
Pilot report: objective quantification of trabecular meshwork pigmentation using densitometry and the NIDEK GS-1 gonioscope in glaucoma patients
Authors: Daniel Laroche, Aaron Brown, Jose Sinon, Alexander Martin, Chester Ng, Sohail Sakkari
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: nidek gs-1, biomarkers, densitometry, pigment dispersion glaucoma, pigmentary glaucoma, trabecular meshwork pigmentation

In this case series, we present a methodology for a proof of principle for the development of a unique biomarker for pigmentary glaucoma to detect progression before nerve fiber layer loss. Out of the five patients in this case series, one was excluded because of an outlier due to pseudoexfoliation syndrome with excessively dense pigmentation of the trabecular meshwork. The remaining patients displayed a decreased visual field loss with increased superior to inferior trabecular meshwork ratios. This methodology, though limited due to small sample size, shows that in a limited number of patients, visual field loss is positively correlated with increased superior to inferior trabecular meshwork ratios. The next steps would be to look at patients without glaucoma and patients with pigmentary glaucoma, along with complete inter-eye comparisons for patients with unilateral exfoliation syndrome to act as controls. To our knowledge, this is a novel methodology, and if the pattern holds, it can act as proof of principle for the development of a novel early biomarker for pigmentary glaucoma to improve early intervention and delay vision loss.
Atypical Adult-Onset Still's Disease Presenting With Seizures and Myocarditis Complicated by Macrophage Activation Syndrome
Authors: Anh N Le, Nino Gudushauri, Irene J Tan, Rekha Bhat, Rasha Khan
Journal: Cureus (2024)
Keywords: adult-onset still’s disease (aosd), hemophagocytic lymphohistiocytosis (hlh), hyperferritinemia, macrophage activation syndrome (mas), myocarditis, organomegaly, recurrent seizure, right ventricle failure, seizure
MeSH terms: Case Reports

Adult-onset Still's disease (AOSD) is a rare multi-systemic inflammatory disorder characterized by high spiking fevers, nonpruritic, salmon-colored rash, and severe polyarthralgia. Laboratory features typically include elevation in white blood cells, liver enzymes, and ferritin. Central nervous system and cardiac involvements, particularly myocarditis, are rare. Macrophage activation syndrome (MAS) is a well-described complication of AOSD, leading to a high mortality rate. Herein, we describe a case of AOSD complicated by MAS in a 32-year-old male presenting with atypical clinical manifestations, including recurrent seizures, scaly, pruritic, and hyperpigmented rash, and right heart failure due to lymphocytic myocarditis. The patient exhibited a delayed onset of fever, leukocytosis, and transaminitis that initially deterred eligibility for Yamaguchi criteria for AOSD. Bone marrow and lymph node biopsies did not show malignancy, infection, or hemophagocytosis. However, soluble interleukin-2 receptor alpha or soluble CD-25 was elevated. The patient experienced significant improvement on combination therapy of anakinra, methotrexate, and stress-dose steroids. HScore was later indicative of a high probability for MAS. Outpatient management involved prednisone, cyclosporine, and canakinumab for MAS. Seizure and myocarditis are possible presenting features of atypical AOSD. Early recognition of non-criteria AOSD and MAS and prompt initiation of therapy may prevent mortality.
Case Report: Exacerbation after fat grafting in patients with active localized scleroderma
Authors: Shunxin Han, Juzi Liu, Feng Lu, Junrong Cai
Journal: Front Surg (2024)
Keywords: active stage, autologous fat grafting, localized scleroderma, morphea, pigmentary
MeSH terms: Case Reports

Background:
The application of autologous fat transplantation in facial lesions of patients with localized scleroderma (LoS) has been reported in recent years.
Objective:
The authors report a case of worsening of active localized scleroderma after autologous fat transplantation.
Methods:
A man presented with neck and facial skin atrophy and pigmentation with a history of LoS. Appearing 1.5 years ago, the lesion had progressively grown in size and shape. Consent was obtained after the patient was informed of the possible surgical risks during the active phase of the disease. He underwent autologous fat grafting into the right cheek with about 30 ml Coleman fat graft.
Results:
Skin dyspigmentation and atrophy progressively deteriorated 1 month into therapy, with slightly increased erythema and enlargement of the lesion. Six months after the therapy, the localized scleroderma-related score worsened.
Limitations:
There are different factors, such as that systemic medications could affect the treatment of localized scleroderma by autologous fat transplantation. Meanwhile, considering the limitation of the 6-month follow-up period, obtaining long-term follow-up data is necessary to evaluate sustained outcomes and potential complications.
Conclusion:
More clinical research is needed to determine the time interval between disease inactivity and the application of any surgical procedures to avoid reactivation.
Case report: A novel case of paraneoplastic voltage gated calcium channel antibodies secondary to appendiceal adenocarcinoma
Authors: Ghanshyam Patel, Ahmet Sakiri, Abby Brown, Arfa Pasha, Vibhav Bansal
Journal: Front Neurol (2024)
Keywords: vgcc, vgcc – voltage-gated calcium channels, appendiceal adenocarcinoma, carcinoma induced antibodies, paraneoplastic syndrome
MeSH terms: Case Reports

Voltage gated calcium channels (VGCCs) play a critical role in neural transmission. Antibodies that target these ion channels can disrupt cellular signal transmission resulting in various clinical presentations. VGCC antibodies are most commonly associated with paraneoplastic syndromes such as Lambert-Eatons myasthenic syndrome. Here, we report a 47-year-old female with Stage IV appendiceal adenocarcinoma status post appendectomy and right hemicolectomy, who presented with progressive memory impairment, aphasia, ataxia, weakness, and headache. Neurologic exam was notable for right-sided parietal drift, decreased right arm swing, and ataxia of the bilateral upper extremities, more prominent on the right side. MRI of the brain with and without contrast was unremarkable. Cerebrospinal fluid (CSF) was notable for an elevated myelin basic protein (4.9 ng/mL, normal reference 0.0-3.7 ng/mL) with normal cell count, flow cytometry, and cytology. An extensive serum autoimmune neurology antibody evaluation revealed elevated VGCC autoantibodies (observed value: 96.1 pmol/L, normal range 0.0-30.0 pmol/L). A diagnosis of paraneoplastic voltage gated calcium channel antibodies secondary to appendiceal adenocarcinoma was made. The patient was treated with five exchanges with plasmapheresis over 10 days with significant clinical improvement in her symptoms. Upon literature review, this would be the first reported case of VGCC antibodies associated with appendiceal adenocarcinoma.
Physiotherapy Rehabilitation Towards Foot Drop in a Paediatric Case of Iatrogenic Sciatic Nerve Palsy: A Case Report
Authors: Akshaya Saklecha, Pallavi Harjpal, Ragini Dadgal
Journal: Cureus (2024)
Keywords: case report, foot drop, paediatric injection palsy, physiotherapy rehabilitation, sciatic nerve injury
MeSH terms: Case Reports

In this report, we are presenting a case of injection nerve palsy in a three-year-old child whose parents visited with the complaint of weakness of the left lower limb, inability to walk, and difficulty in performing lower limb movements after taking diphtheria-tetanus-pertussis (DPT) vaccination in the gluteal region by intramuscular route. The child exhibited a foot drop on his left leg and a high step gait when examined. Nerve conduction velocity was performed, which revealed pure motor axonal mononeuropathy involving the left sciatic nerve. She was diagnosed with a left sciatic nerve injury from a foot drop and was referred to physiotherapy. With the proper exercise protocol, physiotherapy rehabilitation began. We report that after rehabilitation, she showed improvement in the strength of the lower limb and gait pattern. As a result, physiotherapy is critical in improving a patient's gait pattern, ensuring early and rapid recovery, and treating the condition's clinical manifestations. This case study concludes that physiotherapy rehabilitation for injection palsy in a three-year-old female child with foot drop led to improved lower-limb strength, which assisted the patient in ambulation and prevented other deformities.
Treatment of congenital middle ear cholesteatoma in children using endoscopic and microscopic ear surgeries: a case series
Authors: Po Xue, Zhaoyan Wang, Yongchuan Chai, Mingjue Si, Lingxiang Hu
Journal: Front Pediatr (2024)
Keywords: cholesteatoma, congenital, endoscopy, middle ear, pediatric

Introduction:
Surgical removal is widely employed in children with congenital middle ear cholesteatoma (CMEC). Here, we report the surgical outcomes of CMEC removal via endoscopic ear surgery (EES) and microscopic ear surgery (MES) in children.
Methods:
Children with CMEC who underwent preoperative medical history inquiry, hearing test, endoscopic evaluation, and radiology imaging before receiving EES or MES were included. Postoperative audiological outcomes and recurrence rates were collected.
Results:
Seventeen children (20 ears) with stage II-IV CMEC were included. Of those, 11 ears (55.0%) underwent EES, and 9 ears (45.0%) underwent MES. The follow-up time was 35 ± 13.5 months. One child in the EES group with stage III CMEC had a recurrence during the follow-up period. In the EES group, the average minimum diameter of the external auditory canal on the affected side was 5.8 mm (4.3-8.0 mm). No linear association was found between age and the minimum diameter of the external auditory canal.
Discussion:
EES is a promising treatment option for children with early-stage CMEC because of its low recurrence rate and minimally invasive nature. The minimum diameter of the external auditory canal on the affected side should be meticulously examined when performing EES in children.
Lichen planus of the esophagus: a case report
Authors: Elvira Guarner, Fatimetu Mohamed, David Busquets, Begoña Fuertes Negro, Rosa Ortiz, Berta Oliveras, Carlos Huertas, Carme López
Journal: Front Med (Lausanne) (2023)
Keywords: deglution disorders, esophageal squamous cell carcinoma, esophageal squamous dysplasia, lichen planus, lichen planus oral
MeSH terms: Case Reports

Esophageal lichen planus (ELP) is an inflammatory disorder that affects the skin, cutaneous appendages and mucous membranes. The esophageal involvement is rare. We present the case of a 70-year-old woman with years of dysphagia and a history of erosive lichen planus involving the vulva, vagina, gingiva, and skin, who was eventually diagnosed with esophageal lichen planus. The patient's condition was refractory and progressed to the development of intraepithelial squamous neoplasia. We reviewed the literature on this condition.
Imaging spectrum of horseshoe lung: A series of four cases
Authors: Vikas Yadav, Rama Anand, Pooja Abbey, Samrin Haq
Journal: SA J Radiol (2024)
Keywords: congenital lung anomaly, horseshoe lung, lung hypoplasia, pseudo-horseshoe lung, scimitar syndrome
MeSH terms: Case Reports

Horseshoe lung (HL) is a rare congenital anomaly represented by the fusion of both lungs, posterior to the heart, and is typically associated with various bronchopulmonary and cardiovascular malformations. Multi-detector contrast enhanced CT is the imaging modality of choice to demonstrate the pathology and associated malformations. There has been inconsistency in the nomenclature used for such cases in literature. To resolve ambiguity, the authors emphasise that only two terms: HL and pseudo-HL be used on imaging to describe variants of this congenital malformation.
Contribution:
A description of the imaging features in four cases of HL, with their associated malformations and a review of the nomenclature.