OpenMed/multicare-articles huggingface dataset:
Successful cardiopulmonary resuscitation of cardiac arrest induced by massive pulmonary embolism under general anesthesia: a case report
Authors: Zhen Li, Ning Cai
Journal: Front Cardiovasc Med (2023)
Keywords: computed tomography pulmonary angiography, electrocardiography, general anesthesia, pulmonary embolism, thrombolysis
MeSH terms: Case Reports

Background:
While pulmonary embolism (PE) is a common occurrence, a large life-threatening PE is not. Herein, we discuss the case of a patient with a life-threatening PE that occurred under general anesthesia.
Case presentation:
We present the case of a 59-year-old male patient who was at bed rest for several days due to trauma, which resulted in femoral and rib fractures and a lung contusion. The patient was scheduled for femoral fracture reduction and internal fixation under general anesthesia. After disinfection and surgical towel laying, there was a sudden occurrence of severe PE and cardiac arrest; the patient was successfully resuscitated. Computed tomography pulmonary angiography (CTPA) was performed to confirm the diagnosis, and the patient's condition improved after thrombolytic therapy. Unfortunately, the patient's family eventually discontinued treatment.
Discussion:
Massive PE frequently occurs suddenly, may endanger a patient's life at any point in time, and cannot be diagnosed quickly on the basis of clinical manifestations. Although the vital signs fluctuate greatly and there is insufficient time to conduct more tests, some factors such as special disease history, electrocardiography, end-tidal carbon dioxide, and blood gas analysis may help us determine the preliminary diagnosis; however, the final diagnosis is made using CTPA. Current treatment options include thrombectomy, thrombolysis, and early anticoagulation, of which thrombolysis and early anticoagulation are the most feasible.
Conclusion:
Massive PE is a life-threatening disease that requires early diagnosis and timely treatment to save patients' lives.
A case of recurrent mesocolon myxoid liposarcoma and review of the literature
Authors: Amar M Eltweri, Gianpiero Gravante, Sarah Louise Read-Jones, Sonpreet Rai, David J Bowrey, Ian Gordon Haynes
Journal: Case Rep Oncol Med (2013)

Background. Liposarcoma is the second most common soft tissue sarcoma affecting predominantly the retroperitoneal space and extremities. Mesenteric liposarcoma is uncommon and occurs in the small bowel mesentery. In this paper we report the case of a recurrent mesocolon myxoid liposarcoma manifesting 6 years from the initial right hemicolectomy for the primary tumour. Case Report. A 41-year-old female presented with a 4-day history of signs and symptoms indicative of small bowel obstruction, subsequently confirmed on plain abdominal X-ray. In 2006 she underwent a right hemicolectomy for a myxoid liposarcoma of the mesentery. The patient was initially managed conservatively; however she showed no signs of improvement and was taken to theatre for an exploratory laparotomy and division of adhesional bands. During this procedure an incidental finding of a dark purple, smooth pelvic mass was identified with similar macroscopic appearance to that of splenic tissue. Histological examination revealed a recurrent mesocolon myxoid liposarcoma. Conclusion. Mesocolon myxoid liposarcoma is a rare soft tissue neoplastic pathology and carries a high risk of recurrence. Therefore, a symptomatic patient with a previous history of primary liposarcoma excision should be treated with a high index of suspicion and a longer period of followup should be considered.
Spontaneous rupture of the long head of the biceps tendon in a woman with hypothyroidism: a case report
Authors: K Pantazis, N D Roupas, Andreas Panagopoulos, S Theodoraki, A Tsintoni, V Kyriazopoulou
Journal: J Med Case Rep (2016)
MeSH terms: Hypothyroidism / complications, Hypothyroidism / physiopathology, Shoulder Joint / physiopathology, Shoulder Pain / etiology, Tendons / physiopathology, Thyrotropin / blood, Thyroxine / therapeutic use, Case Reports, Anti-Inflammatory Agents, Non-Steroidal / therapeutic use, Female, Humans, Hypothyroidism / blood, Immobilization, Middle Aged, Range of Motion, Articular, Rotator Cuff / physiopathology, Rupture, Spontaneous / complications, Rupture, Spontaneous / etiology, Shoulder Pain / drug therapy, Thyroid Function Tests / methods, Treatment Outcome, Anti-Inflammatory Agents, Non-Steroidal, Thyrotropin, Thyroxine

Background:
Tendinitis can be a presenting complaint in hypothyroidism, with symptomatic relief being obtained by appropriate management of the primary thyroid deficiency. To the best of our knowledge no other cases of spontaneous rupture of the long head of the biceps tendon during uncontrolled hypothyroidism have yet been reported.
Case presentation:
This case report describes an unusual case of spontaneous rupture of the long head of the biceps tendon in a 48-year-old white woman with severe hypothyroidism. She described experiencing a sudden sharp pain and an audible pop in her right shoulder while using her personal computer. On physical examination she was positive for Yergason's sign and a subsequent magnetic resonance imaging scan showed complete rupture of the long head of her biceps tendon. Laboratory tests revealed significantly elevated thyrotropin levels (>100 μIU/ml) and very low levels of both triiodothyronine (0.17 ng/ml) and free thyroxine (0.18 ng/dl). She was switched to a different thyroxin regimen with a progressive dosage increment. She declined surgical re-anchorage of the tendon but despite the discreet Popeye sign, her overall strength and shoulder function were satisfactory. After 2 months, she was found to be clinically euthyroid, having normal thyroid function tests (thyrotropin 2.95 μIU/mL, free thyroxine 1.07 ng/dl). At her last follow-up visit, 1 year post-injury, she reported nearly normal shoulder function in her daily activities and had a constant shoulder score of 93 points.
Conclusions:
The role of thyroid hormones in the synthesis and degeneration of collagen and in the proliferation and apoptosis of human tenocytes is discussed, providing a possible mechanism whereby hypothyroidism may lead to tendon tears. This report may have a greater impact among different subspecialties as it presupposes a high degree of awareness from internists, endocrinologists and orthopedic surgeons.
Solitary fibrous tumor of central nervous system masquerading as meninigioma: Report of a rare case
Authors: Sant Prakash Kataria, Namita Bhutani, Sanjay Kumar, Gajender Singh, Rajeev Sen, Ishwar Singh
Journal: Int J Surg Case Rep (2019)
Keywords: central nervous system, hemangiopericytoma, intracranial, solitary fibrous tumor

Introduction:
Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin that occurs most often in the visceral pleura. It rarely occurs in the central nervous system (CNS). If they occur intracranially, they are extra-axially located and develop from the meninges.
Case report:
Herein, we present a case of SFT in a 45 years old female. MR imaging showed isointense to hypointense signal intensity, and marked enhancement. Microscopically, the tumors showed characteristic "patternless-pattern" architecture. Elongated tumor cells formed fascicles alternating with hypocellular densely collagenous stroma. Immunohistochemistry for STAT6, CD34, BCL2 and CD99 favours the definitive diagnosis of SFT.
Conclusion:
In general, complete surgical resection may offer the best chance of a favourable clinical outcome. Their biological features remain largely unknown. Hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data.
Case Report: Metagenomics Next-Generation Sequencing for Diagnosing Cerebral Infarction and Infection Caused by Hematogenous Disseminated Mucormycosis in a Patient With Acute Lymphoblastic Leukemia
Authors: Bingbing Wen, Lisheng Cai, Yun Cai, Xin Du
Journal: Front Med (Lausanne) (2021)
Keywords: rhizomucor miehei, cerebral infarction, cerebral infection, hematogenous disseminated, leukemia, metagenomics next-generation sequencing, mucormycosis

Disseminated mucormycosis, a serious complication, is associated with high mortality in patients with acute leukemia after chemotherapy. Blood cultures are always negative because of recurrent empirical antifungal treatments. The identification of pathogens is important for diagnosis and therapy. In this case report, we diagnosed culture-negative disseminated mucormycosis with Rhizomucor miehei infection leading to cerebral infarction in a patient with leukemia using metagenomics next-generation sequencing (mNGS) form peripheral blood, cerebral spinal fluid, and bronchoalveolar lavage fluid. mNGS technology can be applied to precisely diagnose culture-negative disseminated mucormycosis.
Genetic polymorphisms in human SULT1A1 and UGT1A1 genes associate with breast tumor characteristics: a case-series study
Authors: Ekaterina G Shatalova, Susan E Walther, Olga O Favorova, Timothy R Rebbeck, Rebecca L Blanchard
Journal: Breast Cancer Res (2005)
MeSH terms: Arylsulfotransferase / genetics, Breast Neoplasms / genetics, Glucuronosyltransferase / genetics, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Arylsulfotransferase / metabolism, Case-Control Studies, Estrogens / metabolism, Ethnicity, Female, Genetic Predisposition to Disease, Genotype, Glucuronosyltransferase / metabolism, Humans, Middle Aged, Odds Ratio, Phenotype, Polymorphism, Genetic, Prognosis, Receptors, Estrogen, Estrogens, Receptors, Estrogen, UGT1A1 enzyme, Glucuronosyltransferase, Arylsulfotransferase, SULT1A1 protein, human

Introduction:
Estrogens are important in breast cancer development. SULT1A1 and UGT1A1 catalyze estrogen metabolism and are polymorphic. The SULT1A1*2 protein exhibits low activity, and a TA repeat within the UGT1A1 promoter alters the level of expression of the protein. We hypothesized that the SULT1A1*2 allozyme has decreased capacity to sulfate estrogens, that the SULT1A1*2 allele conferred increased capacity of cells to proliferate in response to estrogens, and that individuals with the variant SULT1A1 and UGT1A1 genotypes exhibited different breast tumor characteristics.
Methods:
The capacity for SULT1A1*2 to sulfate 17beta-estradiol and the capacity for cells expressing SULT1A1*1 or SULT1A1*2 to proliferate in response to 17beta-estradiol was evaluated. A case-series study was performed in a total of 210 women with incident breast cancer, including 177 Caucasians, 25 African-Americans and eight women of other ethnic background. The SULT1A1 and UGT1A1 genotypes were determined and a logistic regression model was used to analyze genotype-phenotype associations.
Results:
We determined that the SULT1A1*1/*1 high-activity genotype was associated with tumor size <or=2 cm (odds ratio = 2.63, 95% confidence interval = 1.25-5.56, P = 0.02). Individuals with low-activity UGT1A1 genotypes (UGT1A1*28/*28 or UGT1A1*28/*34) were more likely to have an age at diagnosis >or=60 years (odds ratio = 3.70, 95% confidence interval = 1.33-10.00, P = 0.01). Individuals with both SULT1A1 and UGT1A1 high-activity genotypes had low tumor grade (odds ratio = 2.56, 95% confidence interval = 1.04-6.25, P = 0.05). Upon stratification by estrogen receptor status, significant associations were observed predominantly in estrogen receptor-negative tumors.
Conclusion:
The data suggest that genetic variation in SULT1A1 and UGT1A1 may influence breast cancer characteristics and might be important for breast cancer prognosis.
Treatment of Esophageal Perforation with Primary Closure and Reinforcement Using TachoSil
Authors: Abolghasem Daneshvar Kakhki, Seyed Reza Saghebi, Farahnaz Sadegh Bigee
Journal: Tanaffos (2017)
Keywords: closure, esophageal perforation, treatment
MeSH terms: Case Reports

Two patients with iatrogenic esophageal perforation following rigid esophagoscopy for foreign body removal were successfully treated with primary repair and reinforcement using a collagen patch coated with human fibrinogen and thrombin (TachoSil, Nycomed, Austria, Vienna). The clinical implication of this report is that TachoSil can be used to bolster the repair site of esophageal perforation.
Recurrent lung adenocarcinoma benefits from microwave ablation following multidisciplinary treatments: A case with long-term survival
Authors: Guanyu Jiang, Chenghu Song, Yongrui Xu, Shengfei Wang, Huixing Li, Rongguo Lu, Xiaokun Wang, Ruo Chen, Wenjun Mao, Mingfeng Zheng
Journal: Front Surg (2023)
Keywords: immune reaction, lung cancer, microwave ablation, multidisciplinary treatment, target therapy
MeSH terms: Case Reports

Lung cancer has become the leading cause of cancer death all over the world. Nowadays, there is a consensus that the treatment of non-small cell lung cancer (NSCLC) prefers a combination of multidisciplinary comprehensive treatment and individualized treatment, which can significantly improve the prognosis of patients. Here, we report a female patient with recurrence-prone NSCLC. She had a decade-long disease course, during which the lesion recurred twice and finally cured with Multi-Disciplinary Treatment (MDT). An elderly female patient was admitted to the hospital after diagnosis of lung cancer, and treated with surgery and postoperative adjuvant chemotherapy. Five years later, suspicious lesions were found by computed tomography (CT) reexamination, and then confirmed tumor recurrence by puncture biopsy. Based on the genetic test results, gefitinib was used for subsequent targeted therapy, and the lesion gradually shrunk to disappear. However, the lesion appeared again two years later, after consultation the microwave ablation was adopted and the curative effect was excellent. At last, regular reexamination showed no abnormality, the patient has survived so far. The case proves the great benefit of multidisciplinary comprehensive treatment, especially microwave ablation for patient with recurrence-prone NSCLC. And the effect of systemic anti-tumor immune response induced by microwave ablation on lung cancer also needs to be further explored.
Clear Cell Carcinoma Arising in an Abdominal Wall Cesarean Section Scar: A Case Report With Description of Pathological and Molecular Features
Authors: Cristina Colarossi, Maria Carolina Picardo, Lorenzo Colarossi, Enrica Deiana, Costanza D'Agata, Corrado Fichera, Eleonora Aiello, Giorgio Giannone, Lorenzo Memeo
Journal: Front Surg (2021)
Keywords: pik3ca, abdominal wall, c-section, clear cell carcinoma, endometriosis
MeSH terms: Case Reports

Clear cell carcinoma is a clinically and biologically distinct type of carcinoma predominantly encountered in the ovary and endometrium. In the ovary, it is frequently associated with endometriosis, which is a well-known risk factor. Endometriosis has often been described in the abdominal wall of women who had a cesarean section; however, malignant transformation is a very rare event, occurring in <1% of cases. The authors report a case involving a 52-year-old woman with an abdominal wall nodule at a cesarean section scar. Radiology revealed a mass, measuring 8 cm in size, in the abdominal wall suggestive of a soft tissue tumor. After resection, histology revealed the presence of clear, eosinophilic, and hobnail cells, which, together with immunohistochemical and molecular findings, enabled the diagnosis of clear cell carcinoma of the abdominal wall. The present report describes the clinical, radiological, pathological, and molecular features of an unusual abdominal lesion that represents a rare but challenging diagnosis.
Adolescent with severe granulomatosis with polyangiitis: a case report
Authors: Hajar Arfaoui, Hamza Elkihal, Hasna Jabri, Wiam Elkhattabi, Hicham Afif
Journal: Pan Afr Med J (2021)
Keywords: granulomatosis with polyangiitis, wegener’s granulomatosis, antineutrophil cytoplasmic antibody -associated vasculitis, case report, pediatric gpa
MeSH terms: Antibodies, Antineutrophil Cytoplasmic / immunology, Glucocorticoids / administration & dosage, Granulomatosis with Polyangiitis / diagnosis, Immunosuppressive Agents / administration & dosage, Case Reports, Adolescent, Biopsy, Female, Granulomatosis with Polyangiitis / drug therapy, Granulomatosis with Polyangiitis / physiopathology, Humans, Severity of Illness Index, Treatment Outcome, Antibodies, Antineutrophil Cytoplasmic, Glucocorticoids, Immunosuppressive Agents

Granulomatosis with polyangiitis (GPA) is a rare vasculitis among adolescents. Its pulmonary manifestations may mimic tuberculosis. We report the case of a 16-years-old female patient with multiple excavated lung nodules revealed by a chronic cough, hemoptysis, epistaxis and weight loss. The diagnosis of GPA was achieved due to systemic pulmonary, ENT and renal involvement, the positivity of anti-neutrophil cytoplasmic antibody directed against proteinase 3 (C-ANCA) and bronchial and nasal biopsies showing granulomatous inflammation with a dense perivascular infiltrate destroying the vessel wall. Bolus of glucocorticoids and immunosuppressants reversed her symptoms. Although GPA is a rare disease in teenagers, it should be considered as one of the differential diagnosis in adolescents presenting with excavated pulmonary nodules.
On a Rare Cutaneous Metastasis from a Sacrococcygeal Chordoma
Authors: Alessandro D'Amuri, Matteo Brunelli, Federica Floccari, Francesco De Caro, Giuliana Crisman, Francesca Sanguedolce, Marcello Filotico
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Chordomas are rare malignant tumors of notochordal origin and are rare locally aggressive ones with a metastatic potential. The skin rarely is seen as metastatic site. We describe a case of an adult woman with cutaneous metastasis of a primary sacral chordoma excised ten years before, which appeared as a painless cutaneous mass located in the dorsal region. Once removed, the surgical specimen was formalin fixed and in paraffin embedded. Sections were stained with haematoxylin-eosin, and histochemical and immunohistochemical investigations were performed. Histologically, the neoplasia was characterized by cords or single tumor cells with an abundant myxoid stroma, conspicuous pale vacuolated cytoplasm (the classic "physaliphorous cells"), and mild nuclear atypia. Mitotic activity was scanty. At immunohistochemistry, the tumor cells were diffusely positive for S-100 protein, pan-keratins, EMA, and vimentin. A diagnosis of cutaneous metastasis of chordoma was performed. This case illustrates a diagnostic challenge because of the unusual presentation of an already rare tumor.
A Case of Monoclonal Lymphoplasmacytosis of the Bone Marrow with IgM-Positive Russell Bodies
Authors: Hidekazu Kayano, Tsuneyuki Shimada, Naoki Wakimoto, Yuichi Nakamura, Masami Bessho, Hiroshi Yamaguchi, Atsushi Sasaki, Michio Shimizu
Journal: Bone Marrow Res (2011)
MeSH terms: Case Reports

A 71-year-old Japanese male patient infected with HCV was diagnosed with thrombocytopenia. Histological examination of the bone marrow aspirate showed numerous lymphoid aggregates with Russell bodies. Immunohistochemistry and flow cytometric analysis demonstrated clonal expansion of CD5+ CD23+ B cells. Russell bodies were positive for IgM and lambda immunoglobulin light chain. The patient also underwent gastric biopsy, which revealed Helicobacter pylori (HP) infection. Subsequent eradication of the bacteria resulted in improvement of his thrombocytopenia. The clinical course remained uneventful at 15-month follow-up, consistent with monoclonal B-cell lymphocytosis. The observed clonal expansion with plasmacytic differentiation may have occurred under the influence of HCV with HP infection.
Anti-glycine receptor antibody-positive progressive encephalomyelitis with rigidity and myoclonus initially presenting with one-sided stiff face: A case report
Authors: Ken-Ichi Irie, Takahisa Tateishi, Taiga Moritaka, Naonori Sakurada, Shinsuke Kikuchi, Takayuki Taniwaki
Journal: Front Neurol (2022)
Keywords: perm, anti-glyr antibody, hyperekplexia, myoclonus, rigidity, stiff-person syndrome
MeSH terms: Case Reports

Background:
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a subtype of stiff-person syndrome, a rare cerebrospinal disease that causes brainstem symptoms, myoclonus, muscle rigidity, and hyperekplexia.
Case presentation:
A 71-year-old man experienced left-sided stiff face, and was subsequently admitted to our hospital because of the appearance of left-dominant lower limb myoclonus. Muscle rigidity followed 3 days later. Magnetic resonance imaging revealed no abnormality. An electrophysiological examination showed a toughness of the antagonistic muscle following evocation of the Achilles tendon reflex, and a tonic phenomenon affecting the left facial muscles during the blink reflex. The patient's serum was positive for anti-glycine receptor (anti-GlyR) antibody, suggesting PERM. The patient was administered steroids, immunoglobulin therapy, and immunosuppressive drugs. He gradually improved after these therapies and became able to walk using a walker.
Conclusions:
We conclude that this was a rare case of anti-GlyR antibody-positive PERM with unilateral brainstem symptoms, myoclonus, and muscle rigidity.
Conservative Approach of a Dentigerous Cyst
Authors: Farah Chouchene, Wassim Ben Ameur, Habib Hamdi, Maissa Bouenba, Fatma Masmoudi, Ahlem Baaziz, Fethi Maatouk, Hichem Ghedira
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Dentigerous cysts (DC) are the most common odontogenic cystic lesions of inflammatory origin occurring in children. These lesions can be treated by enucleation with or without related impacted teeth or marsupialization/decompression. The latter procedures have been used successfully for many years, but decompression is increasingly recommended in children because of its good outcomes and the preservation of the developing tooth. This conservative surgical technic allows simultaneously the normal eruption of the involved permanent teeth and the ossification of the bony defect. The present report describes an 8-year-old female patient with an inflammatory DC associated with an endodontically treated primary molar accidentally discovered on panoramic radiograph. Decompression of the cyst was performed, by means of a removable space maintainer acting as an acrylic obturator after removal of teeth 83 and 84. Ten months after the decompression procedure, a complete resolution and regression of the cystic lesion with full spontaneous eruption of the premolar were observed.