OpenMed/multicare-articles huggingface dataset:
Imaging Findings in Dogs and Cats With Presumptive Sclerosing Encapsulating Peritonitis
Authors: Bérengère C H Gremillet, Charles Porsmoguer, Géraldine Bolen, Frédéric Billen, Stéphanie Noël, Flore Brutinel, Valeria Busoni
Journal: Front Vet Sci (2022)
Keywords: canine, computed tomography, diagnostic imaging, feline, radiograph (x-ray), sclerosing encapsulating peritonitis, ultrasound

This retrospective case series describes imaging findings in seven dogs and two cats with a presumptive diagnosis of sclerosing encapsulating peritonitis (SEP) between 2014 and 2021. Peritoneal effusion was present in all animal patients. Sonographically, echogenic fluid with or without echogenic intraperitoneal septations, gathered or corrugated bowel loops, and abdominal lymphadenomegaly were suggesting an inflammatory process and the presence of adhesions. Gathering of the bowel with abdominal distension and/or signs of intestinal obstruction were major findings on radiographs. Abdominal fat stranding was an additional finding in animals undergoing a CT examination. Previous surgery, pregnancy, and the presence of a perforating foreign body were potential predisposing causes in 4/9 animals. Peritonitis was septic in 4/9 animals. As SEP is a rare condition but life threatening, this detailed description of imaging findings in a short case series can be useful for a presumptive diagnosis and surgical planning.
Solitary mastocytoma of the vulva
Authors: Shasi Velusamy, Jayasree Karuthedath Areeppurath Mana, Chalissery Francis Mathew
Journal: Case Rep Pathol (2014)

Solitary mastocytoma of the skin is a rare tumor. Its occurrence in the vulva is extremely rare with only few case reports in the literature. We report a solitary mastocytoma of the vulva in a 10-year-old girl. Her systemic examination was unremarkable. The clinical and histopathological features were consistent with the diagnosis of solitary mastocytoma of the vulva. The follow-up after surgical excision was uneventful. The purpose of this communication is (i) to report a case of solitary mastocytoma occurring in an unusual site, the vulva and to show that (ii) in this case age at presentation is 10 years with infancy as common age of presentation of solitary mastocytoma, and to show that (iii) in appropriate setting this should be included in the differential diagnosis of vulval swelling.
Relapse of typhoid fever following delayed response to meropenem: A case report and review of previously published cases indicating limited clinical efficacy of meropenem for the treatment of typhoid fever
Authors: Christian G Blumentrath, Gernot Müller, Dieter Teichmann, Jens Tiesmeier, Jasmina Petridou
Journal: Ger Med Sci (2019)
Keywords: persistence, resistance, salmonella, tolerance, treatment failure
MeSH terms: Anti-Bacterial Agents / therapeutic use, Meropenem / therapeutic use, Salmonella typhi / drug effects, Typhoid Fever / drug therapy, Case Reports, Review, Adolescent, Drug Resistance, Multiple, Bacterial, Humans, Male, Recurrence, Treatment Outcome, Anti-Bacterial Agents, Meropenem

In times of emerging multi-drug resistance among Gram-negative bacteria (including Salmonella enterica, Serovar Typhi), we observed relapse of typhoid fever following delayed response to treatment with meropenem, suggestive for limited clinical efficacy of the drug. Three previously published cases supported our suspicion. Within this context, we discuss the case details with a focus on potential explanations for insufficient clinical response to meropenem (e.g. limited intracellular penetration, phenomena of tolerance and persistence). Meropenem is a last-resort antimicrobial agent for the treatment of multi-drug resistant Gram-negative infections. Reliable clinical data evaluating the efficacy of meropenem for the treatment of typhoid fever are urgently needed. Future clinical studies evaluating typhoid fever outcome should also investigate the impact of (i) intracellular penetration of antibiotics, and (ii) tolerance and persistence on outcome.
Polypoid Cystitis and Bilateral Hydronephrosis Mimicking Urothelial Carcinoma
Authors: Jia-Lun Kwok, Molly Eng
Journal: J Endourol Case Rep (2019)
Keywords: infection, obstruction, polypoid cystitis, ureteritis
MeSH terms: Case Reports

Background: Polypoid cystitis is infrequently seen in noncatheterized patients, occasionally posing challenging treatment options. We present a rare case of polypoid cystitis with bilateral upper tract obstruction mimicking a bladder tumor, needing staged endoscopic management. Case Presentation: A 45-year-old Asian man with a bladder tumor presented with lower urinary tract symptoms. Subsequent transurethral resection of bladder tumor histology revealed polypoid cystitis. This had caused intramural edema and obstruction of the distal ureters that were managed with initial local resection, ureteral dilatation with a period of ureteral stenting, and oral steroids. Subsequent intravenous urogram and diuretic renogram showed resolution of obstruction and resolution of hydronephrosis. He also had mixed lower urinary tract symptoms and hematuria managed with combination of solifenacin, finasteride, and tamsulosin. Conclusion: Polypoid cystitis with ureteral obstruction needs to be considered in differentials of a bladder tumor, and management may include a combination of endoscopic resection, ureteral stenting, and in resistant cases oral steroids can be considered to aid resolution of inflammation in the absence of infection.
Propionibacterium acnes Osteomyelitis after Intraosseous Cannulation in a Child
Authors: Keegan A Cole, Samik Banerjee, John A Dipreta
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Propionibacterium acnes osteomyelitis secondary to intraosseous (IO) cannulation is not well documented in literature. We report here an extremely rare incident of P. acnes tibial osteomyelitis at the IO access site, in a 4-year-old child, who presented 3 months after an episode of fluid resuscitation for streptococcal toxic shock syndrome necessitating irrigation and debridement and prolonged antibiotic therapy. We advocate for heightened awareness of osteomyelitis in patients with continued pain after IO cannulation. Low-grade persistent symptoms may be caused by less virulent organisms and may dictate need for early magnetic resonance imaging studies for diagnosis and treatment planning.
Tegmen tympani defect and brain herniation secondary to mastoid surgery: case presentation
Authors: Oguz Kadir Egilmez, Fatih Mehmet Hanege, M Tayyar Kalcioglu, Tuncay Kaner, Numan Kokten
Journal: Case Rep Otolaryngol (2014)

Brain herniation into the middle ear is very rarely seen. In addition to reasons like congenital factors, trauma, and infection, tegmen defect may develop as a result of iatrogenic events secondary to chronic otitis media surgery with or without cholesteatoma. Since it may cause life-threatening complications, patients must be evaluated and monitored for tegmen defect. In this paper, diagnosis and treatment of a brain herniation case due to iatrogenic tegmen defect were described along with relevant literature.
Inguinal Bladder and Ureter Hernia Permagna: Definition of a Rare Clinical Entity and Case Report
Authors: Michela De Angelis, Guido Mantovani, Francesco Di Lecce, Luigi Boccia
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
Inguinoscrotal herniation of the bladder is a rare clinical entity, with a frequency between 0.5% and 4% of all inguinal hernias. The bladder can partially or entirely herniate into the inguinal canal; when the whole bladder and ureters migrate into the scrotum, it may cause urinary disorders.
Case presentation:
A 62-year-old male patient presented with urinary disorders and right-sided inguinoscrotal hernia. Under clinical suspicion of bladder involvement in the inguinal canal, abdominal and pelvic computed tomography (CT) scan with endovenous contrast was performed, revealing a right inguinoscrotal hernia, containing the whole urinary bladder and the right pelvic ureter. Without violating the urinary bladder wall integrity, the content of the hernial sac was reduced into the abdominal cavity. Hernioplasty was performed by means of Lichtenstein's method.
Conclusions:
Ureteral involvement should be suspected when a clinical inguinal hernia is diagnosed concurrently with unexplained hydronephrosis, renal failure, or urinary tract infection, as in the case described. When suspected, the preoperative diagnosis, particularly with CT scan, is essential to avoid complications and to reduce risk of bladder and ureter injuries during hernia repair.
Case Report: Atypical Solitary Brain Metastasis: The Role of MR Spectroscopy In Differential Diagnosis
Authors: Dusko Kozic, Nebojsa Lasica, Danica Grujicic, Savo Raicevic, Natasa Prvulovic Bunovic, Igor Nosek, Jasmina Boban
Journal: Front Oncol (2022)
Keywords: brain metastasis, case report, magnetic resonance spectroscopy, neuroendocrine tumor, nonenhancing
MeSH terms: Case Reports

Background:
Metastatic brain tumors are typically located at the cerebral hemispheres or the cerebellum and most frequently originate from primary breast or lung tumors. Metastatic lesions are usually associated with blood-brain barrier disruption, solid or ring-like contrast enhancement, and perilesional vasogenic edema on brain imaging. Even in cases where metastases are predominantly cystic, enhancement of the minor solid component can be detected. In contrast, non-enhancing secondary brain tumors were only reported in a patient after antiangiogenic treatment with bevacizumab.
Case report:
We report a case of a 54-year-old male who presented with left-sided weakness and multiple seizures. Brain magnetic resonance imaging revealed a T2-weighted heterogeneous solid tumor in the right frontoparietal parasagittal region, with no apparent enhancement on T1-weighted post-contrast images and no evident perilesional edema. Further MRS analysis revealed markedly increased choline and lipid peaks. The patient underwent craniotomy for tumor removal. Histopathology revealed findings consistent with metastatic non-microcellular neuroendocrine lung cancer. positron emission tomography/computed tomography (PET/CT) revealed a stellate lesion within the right upper lung lobe, compatible with primary lung cancer.
Conclusion:
Non-enhancing brain metastatic tumors are rarely reported in the literature, usually following antiangiogenic treatment. Here, we report the first ever case of a non-enhancing metastatic brain tumor with no prior history of antiangiogenic treatment, with particular emphasis on the importance of MRS analysis in atypical brain lesions.
Cognitive diagnosis and algorithmic cultural analysis of fourth-grade Yi students' mathematical skills in China: A case study of several primary schools in Puge county, Liangshan prefecture
Authors: Hong Zhang, Shuang Ye, Lingke Shi
Journal: Front Psychol (2023)
Keywords: chinese yi ethnic group, dina model, algorithmic culture, cognitive diagnosis, mathematical ability

The Liangshan Yi Autonomous Prefecture is the largest area in China inhabited by the Yi people, and the original Yi characteristics and culture are well maintained. The Yi also have a high degree of ethnic and cultural intermingling with Tibetans, Han and other ethnic groups. The level of mathematical abilities directly determines the quality of mathematical learning of Yi students. Primary four is the stage of "concrete operations," and is a critical point in the development of mathematical symbolic awareness. In this study, the geographical location of the school and the financial income of the township in which the school is located were used as the basis for sampling, and the DINA model was used to diagnose the mathematical ability of fourth grade students in three rural Yi primary schools in Puge County. The study found that there was individual variability in the mathematical abilities of fourth grade Yi students, with 21 different types of cognitive error patterns identified, the main ones being five. In addition, the state of knowledge of fourth grade Yi students in arithmetic revealed that their overall level of mathematical ability was low, showing a lag, with none of the knowledge attributes of arithmetic being fully mastered. Cultural differences between the Chinese and Yi languages contribute to the difficulties that Yi students have in learning mathematical operations, including differences in understanding the place value system, zero, decimal expressions, and differences in the perception of multiplication and division. The above research can inform the implementation of targeted remediation for teaching and learning.
Luteinized ovarian thecoma in a postmenopausal women presenting with virilization
Authors: Athula Kaluarachchi, Jeevan P Marasinghe, Thuwan M Batcha, Preethika Agunawela
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

We report a case of luteinizing thecoma in a 58-year-old postmenopausal woman who presented with progressive androgenic features and hypertension of one year duration. She did not notice a significant change in her body weight or appetite. Her total serum testosterone level was 4.5 ng/mL. Ultrasound scan revealed a normal-sized uterus and a right-sided solid ovarian mass of 5 cm x 5 cm. Left ovary was normal. She had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and an omentectomy performed. Histological examination confirmed the diagnosis of luteinized thecoma. This case illustrates the necessity to consider the rare possibility of luteinized ovarian thecoma as a cause for virilization in a menopausal woman.
Does the Intensity of IGG4 Immunostaining Have a Correlation with the Clinical Presentation of Riedel's Thyroiditis?
Authors: C A Simões, M R Tavares, N M M Andrade, T M Uehara, R A Dedivitis, C R Cernea
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Riedel's thyroiditis (RT) represents one type of IgG4-related thyroid disease (IgG4RTD) and the diagnosis involves quantitative immunohistochemistry showing dense lymphoplasmacellular inflammatory infiltrate consisting of IgG4-positive plasma cells with storiform fibrosis and obliterative phlebitis. We report a case of RT with progressive enlargement of the anterior neck, severe dysphagia, odynophagia, and dyspnea. The patient underwent surgical decompression of the airway, protection tracheotomy, and gastrostomy for nutritional intake 6 months after first symptoms. Complete resolution occurred after surgical treatment combined with prednisolone. Immunostaining revealed IgG4-positive plasma cells 12/HPF (high-power field) and the IgG4/IgG ratio 25%, values that were disproportionate to the intensity of the patient's symptoms. As to this case and the few cases described and analyzed in the literature, our impression is that there is no relation between the intensity of symptoms in RT with the total number of IgG4-positive plasma cells and the IgG4/IgG ratio, but more studies are needed.
Successful treatment of metastatic pheochromocytoma in the spine with cement augmentation
Authors: Siyi Cai, Xiangyi Kong, Chengrui Yan, Yong Liu, Xi Zhou, Guixing Qiu
Journal: Medicine (Baltimore) (2017)
MeSH terms: Lumbar Vertebrae / surgery, Pheochromocytoma / surgery, Spinal Neoplasms / surgery, Case Reports, Adrenal Gland Neoplasms / pathology, Adult, Bone Cements, Female, Humans, Lumbar Vertebrae / pathology, Male, Middle Aged, Minimally Invasive Surgical Procedures, Pheochromocytoma / secondary, Spinal Neoplasms / secondary, Bone Cements

Metastatic pheochromocytoma in the spine is rare, and there is no standard curative management. Treatment via open surgery is often risky in the perioperative period, while osteoplasty by cement augmentation is a less invasive option.We describe 2 patients with recurrence of pheochromocytoma involving the spine and the pelvis who were successfully treated with osteoplasty by cement augmentation. A 31-year-old female underwent cement augmentation for a pelvic lesion 6 months after the resection and screw fixation of an L3 lesion. A 58-year-old male underwent cement augmentation to directly destroy the functional tumor, with a surgical decompression 6 months later. Both patients showed appropriate destruction of the tumor, adequate pain relief, and the decreased release of catecholamine from metastatic lesions.Osteoplasty by cement augmentation may be a treatment option for patients with metastatic pheochromocytoma who cannot undergo appropriate surgery or decline surgery. This represents a safe approach to sustainably relieve pain and stabilize vertebral bodies with metastatic malignant pheochromocytoma.
Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin
Authors: Rashi Sandooja, John M Moorman, Monisha Priyadarshini Kumar, Karla Detoya
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Overdose of long-acting insulin can cause unpredictable hypoglycemia for prolonged periods of time. The initial treatment of hypoglycemia includes oral carbohydrate intake as able and/or parenteral dextrose infusion. Refractory hypoglycemia following these interventions presents a clinical challenge in the absence of clear guidelines for management. Octreotide has sometimes been used, but its use is generally limited to sulfonylurea overdose. In this case report, we present a case of refractory hypoglycemia following an overdose of 900 units of long-acting insulin glargine that failed to respond to usual modes of therapy mentioned above. Stress-dose corticosteroids were then initiated, followed by subsequent improvement in IV dextrose and glucagon requirements and blood glucose levels. Hence, corticosteroids may serve as an adjunctive therapy in managing hypoglycemia and can be considered earlier in the course of treatment in patients with refractory hypoglycemia to prevent volume overload, especially when large volumes of dextrose infusions are required.
Fever as the Sole Presentation of Giant Cell Arteritis: A Near Miss
Authors: Pooja Poudel, Thein Swe, Michael Wiilliams, Eduardo Bonilla
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: fever of unknown origin, giant cell arteritis
MeSH terms: Fever of Unknown Origin / etiology, Giant Cell Arteritis / diagnosis, Giant Cell Arteritis / physiopathology, Temporal Arteries / pathology, Case Reports, Aged, 80 and over, Diagnosis, Differential, Humans, Male, Near Miss, Healthcare

Giant cell arteritis (GCA) presenting solely as fever is very rare. Usually, it manifests with typical features such as visual problems, headache, jaw claudication, or it can be associated with polymyalgia rheumatica. We present a case of a patient with GCA who presented only with prolonged fever. The cause of fever could not be initially identified in spite of a comprehensive workup. The patient was started on steroids for presumed GCA resulting in the resolution of fever. It is of paramount importance to consider GCA in the differential diagnosis of fever of unknown origin. Early diagnosis with effective treatment is crucial since the mortality rate remains high for untreated cases.
Cushing's Syndrome in a Patient With Rathke's Cleft Cyst and ACTH Cell Hyperplasia Detected by 11C-Methionine PET Imaging-A Case Presentation
Authors: Karol Piotr Sagan, Elzbieta Andrysiak-Mamos, Leszek Sagan, Przemysław Nowacki, Bogdan Małkowski, Anhelli Syrenicz
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: rathke's cleft cyst, case report, cushing syndrome, methionine-pet, pituitary hyperplasia
MeSH terms: Adrenocorticotropic Hormone / metabolism, Carbon Radioisotopes / analysis, Central Nervous System Cysts / diagnosis, Cushing Syndrome / diagnosis, Hyperplasia / diagnosis, Pituitary Diseases / diagnosis, Positron-Emission Tomography / methods, Case Reports, Research Support, Non-U.S. Gov't, Adult, Central Nervous System Cysts / complications, Central Nervous System Cysts / diagnostic imaging, Central Nervous System Cysts / metabolism, Cushing Syndrome / complications, Cushing Syndrome / diagnostic imaging, Cushing Syndrome / metabolism, Female, Humans, Hyperplasia / complications, Hyperplasia / diagnostic imaging, Methionine / metabolism, Pituitary Diseases / complications, Pituitary Diseases / diagnostic imaging, Pituitary Diseases / metabolism, Carbon Radioisotopes, Adrenocorticotropic Hormone, Methionine

Background: Adrenocorticotropic Hormone (ACTH)-dependent Cushing's Syndrome (CS) is most often caused by a pituitary adenoma. Although rarely, it can also result from pituitary corticotroph cell hyperplasia (CH). Reports on concomitant pituitary lesions including ACTH-producing adenomas and Rathke's cleft cysts (RCCs) have been published. Positron emission tomography (PET), using 11C-labelled-methionine (MET) as a tracer and co-registered with magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of pituitary collision lesions, however, its role is still under investigation. In this work we present the case of a patient in whom CS was caused by non-adenomatous CH within the wall of an RCC. Case Summary: In 2015 a patient with signs and symptoms of CS was referred to our Department. Biochemical studies repeatedly showed elevated midnight serum cortisol and ACTH levels. Magnetic resonance imaging of the sellar region revealed an RCC and MET-PET/MR showed heterogeneous labelled-methionine metabolism in the vicinity of the cyst's wall. Transsphenoidal surgery resulted in rapid, complete and lasting relief of symptoms. Histopathological examination demonstrated an RCC and CH. Conclusions: Concomitance of pituitary focal lesions is a rare phenomenon. Methionine-labelled PET/MR may be useful in the diagnosis of collision sellar lesions, including CH. Corticotroph cell hyperplasia can present as mild and fluctuating hypercortisolaemia.
Intrathyroidal Thymic Tissue in an Adolescent with Graves' Disease: Case Report and Review of Current Literature
Authors: Liane Eng, Lisa Underland, Leslie Lam
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Intrathyroidal thymic tissue (ITT) is a benign entity found in children and young adolescents that often mimics a concerning thyroid nodule with microcalcifications on ultrasound. It is challenging for the clinician to distinguish between these two entities, which may lead to unnecessary invasive procedures. We report an adolescent female patient with Graves' disease who underwent total thyroidectomy for a thyroid nodule concerning for malignancy for which the surgical pathology ultimately revealed ITT. As ITT is rarely found beyond childhood, the concurrent Graves' disease may have led to persistence of thymic tissue in this patient. Several sonographic features can help in differentiating ITT from a concerning thyroid nodule. Once identified, ITT should be followed by serial imaging with anticipation of decreasing size or complete resolution over time.
Successful pancreatoduodenectomy of de novo duodenal malignancy after orthotopic liver transplantation: A case report
Authors: Linhua Ji, Danhua Xu, Chunchao Zhu, Jia Xu, Hui Cao, Gang Zhao
Journal: Front Surg (2023)
Keywords: case report, de novo malignancy, duodenal carcinoma, liver transplantation, pancreatoduodenectomy
MeSH terms: Case Reports

Introduction:
Liver transplantation is a risk factor for premalignant and malignant changes of the duodenum. De novo duodenal malignancy is seldom reported after liver transplantation.
Case report:
The present study reports a case of an asymptomatic 67-year-old male patient who underwent liver transplantation more than 10 years ago and subsequently developed duodenal malignancy. Endoscopic biopsy of the de novo duodenal malignancy indicated duodenal carcinoma and pancreatoduodenectomy (PD) was performed. The patient was successfully discharged 12 days after the surgery. A metastatic lesion occurred at the right seventh rib 14 months after the pancreatoduodenectomy. Postoperative pathological examination indicated hepatocellular carcinoma metastasis.
Conclusions:
To the best of our knowledge, this case type has not been previously reported. The present study sheds light on the development, the treatment, the prognosis, and the management of a new type of de novo duodenal malignancy.