OpenMed/multicare-articles huggingface dataset:
A Rare Lesion in the Anterior Region of the Third Ventricle: Rosette-Forming Glioneuronal Tumor
Authors: Leopoldina Pereira, Djamel Kitumba, Mário Gil Fontoura, David A João, Lino Mascarenhas, Mário Resende
Journal: Cureus (2024)
Keywords: cerebral salt-wasting syndrome, endoscopy, rosette-forming glioneuronal tumor, seizures, third ventricle
MeSH terms: Case Reports

Rosette-forming glioneuronal tumor (RGNT) is a rare and indolent mixed glioneuronal tumor involving primarily the fourth ventricular region and occurring predominantly in young adults. We present a case of a 44-year-old woman presented with progressive headaches, vomiting, and a sudden decreasing level of consciousness. The magnetic resonance imaging showed a regular lesion within the anterior portion of the third ventricle and the patient underwent an endoscopic approach to remove the tumor that was exclusively within the anterior portion of the third ventricle. Histopathology showed an RGNT that was totally removed. We also report some unusual complications that are described in the literature and are related to ventricular endoscopy such as seizures and hydroelectrolyte disorders. With two years of follow-up, the patient had no complaints and no tumor progression was observed.
Dexmedetomidine Used to Maintain Spontaneous Ventilation in a Patient With Anterior Mediastinal Mass and Superior Vena Cava Syndrome
Authors: Daniel J Olix, Dominic S Carollo, Kelly G Ural
Journal: Ochsner J (2023)
Keywords: dexmedetomidine, mediastinal disease, superior vena cava syndrome
MeSH terms: Case Reports

Background: Anterior mediastinal masses (AMMs), which can be benign or malignant, are a common cause of superior vena cava (SVC) syndrome. Because of their location, AMMs can cause significant airway compromise during the perioperative period, so anesthetic management of a patient with SVC syndrome can present significant challenges. Case Report: A patient presented with SVC syndrome secondary to a large AMM. After careful consideration and discussion with the patient about the risks and benefits of various approaches, the decision was made to provide sedation using dexmedetomidine as the sole agent during image-guided biopsy. Conclusion: Patients who present with AMMs require careful anesthetic planning. Dexmedetomidine can be effective in achieving the primary objective of maintaining spontaneous respiration.
Reversible cerebral vasoconstriction syndrome following intracranial hypotension in a postpartum patient: a case report and literature review
Authors: Shuhua Li, Yi Yang, Jiacai Zuo, Ningli Du, Guoxian Kou
Journal: Front Neurol (2023)
Keywords: rcvs, case report, cerebral vasospasm, intracranial hypotension, postpartum
MeSH terms: Case Reports

Introduction:
Reversible cerebral vasoconstriction syndrome (RCVS) is a potentially life-threatening neurological disorder, rarely linked to intracranial hypotension. The presentation showed a patient with intracranial hypotension after peridural anesthesia who experienced RCVS during the early postpartum period, suggesting a potential involvement of intracranial hypotension in RCVS occurrence.
Case report:
A young female of 29 years of age initially developed an orthostatic headache after undergoing a painless delivery with lumbar epidural anesthesia. Intracranial hypotension was considered the underlying cause. Her headache was partially resolved after intravenous fluid therapy and strict bed rest. After 2 days, the patient had a new onset thunderclap headache with generalized seizures, cortical blindness, and elevated blood pressure. An MRI scan revealed high signal intensity within the temporal, parietal, and occipital lobes, left caudate nucleus, and right cerebellum on T2-FLAIR imaging with vasogenic edema. MR angiography indicated multifocal, segmental, diffuse narrowing affecting the cerebral arteries that are large and medium. An RCVS2 score was six, and the patient was diagnosed with RCVS. She was managed conservatively, quickly improving her symptoms. After 10 days, a follow-up MRI indicated a significant reduction in the abnormal signal, and a substantial resolution of the constriction of the cerebral artery constriction was confirmed by MR angiography.
Conclusion:
Intracranial hypotension could potentially lead to RCVS in postpartum patients, and it may be triggered by cerebral vasospasm secondary to intracranial hypotension.
First report of human infection with Leptospira interrogans serovar Bratislava in the Eastern Black Sea region of Turkey
Authors: Ersin Kuloglu, Kubilay Issever
Journal: Rev Inst Med Trop Sao Paulo (2023)
MeSH terms: Leptospira interrogans, Leptospirosis / diagnosis, Case Reports, Adult, Black Sea, Humans, Serogroup, Turkey

Leptospirosis is one of the most common zoonotic bacterial infections worldwide. It is an infection that usually affects people with low socioeconomic status, with morbidity and mortality risk. The clinical course of the disease may range from mild, featuring nonspecific clinical signs and symptoms, to severe, resulting in death. The respective studies conducted in Turkey indicate that leptospirosis seropositivity in animals and humans is higher in coastal and rural areas. Turkey's Eastern Black Sea Region has a humid climate with heavy rainfalls and a large population of mice and other rodents. However, a Leptospira interrogans serovar Bratislava case is yet to be reported in this region. This article reports the case of a 38-year-old patient who presented fever and acute renal failure and was diagnosed with Leptospira interrogans serovar Bratislava after hospitalization.
Hepatic Tuberculosis Manifested as Hepatic Abscess: A Report of a Unique Case
Authors: Nilesh Jagdale, Vutukuru Kalyan Kumar Reddy, Mohith Prakash Kondapalli, Saimounika Adapa, Diksha Sabharwal
Journal: Cureus (2024)
Keywords: abdominal cect, biopsy, extrapulmonary manifestation, hepatic tuberculosis (hepatic tb), tuberculosis (tb)
MeSH terms: Case Reports

Millions of people around the world suffer from tuberculosis (TB), a long-term contagious illness. TB can invade almost all human body systems, with the respiratory system being the most impacted. Hepatic TB is a form of TB infection that affects the liver. It is considered an extrapulmonary manifestation of TB, which is a rare manifestation. Early identification of hepatic TB allows for prompt treatment, while leaving it untreated can result in fatality. Our patient is a 46-year-old female who presented with fever, weight loss, loss of appetite, and abdominal pain. An abdominal contrast-enhanced computed tomography (abdominal CECT) scan shows a well-defined, peripherally enhancing hypodense lesion in the liver, which helps with diagnosis. The biopsy demonstrates granulomatous inflammation accompanied by caseating necrosis. The objective of our study is to provide a detailed description of this unique condition through a case presentation.
Case report: Novel insights into hemorrhagic destruction of the brain, subependymal calcification, and cataracts disease
Authors: Tameemi Abdallah Moady, Marwan Odeh, Ayalla Fedida, Zvi Segal, Maayan Gruber, Moshe Goldfeld, Limor Kalfon, Tzipora C Falik-Zaccai
Journal: Front Pediatr (2023)
Keywords: hdbscc, jam3/jam-c, auditory neuropathy, brain calcification, brain hemorrhages, congenital cataracts
MeSH terms: Case Reports

Introduction:
Pathogenic variants of the junctional adhesion molecule 3 (JAM3/JAM-C; OMIM#606871) is the cause of the rare recessive disorder called hemorrhagic destruction of the brain, subependymal calcification, and cataracts (HDBSCC, OMIM#613730) disease. A similar phenotype is universal, including congenital cataracts and brain hemorrhages with high mortality rate in the first few weeks of life and with a poor neurologic outcome in survivors. We aim to describe and enlighten novel phenotype and genotype of a new patient and review the literature regarding all reported patients worldwide.
Case report:
We report the case of a prenatal and postnatal phenotype of a new patient with a novel pathogenic loss-of-function variant in JAM3, who presented prenatally with cataracts and brain anomalies and postnatally with brain hemorrhages, failure to thrive (FTT), progressive microcephaly, recurrent posterior capsule opacities, and auditory neuropathy.
Discussion:
This study enlightens novel possible functions of JAM3 in the normal development of the brain, the ocular lenses, the auditory system, and possibly the gastrointestinal tract. This study is the first to report of cataracts evident in as early as 23 weeks of gestation and a rare phenomenon of recurrent posterior capsule opacities despite performing recurrent posterior capsulectomy and anterior vitrectomy. We suggest that auditory neuropathy, which is reported here for the first time, is part of the phenotype of HDBSCC, probably due to an endothelial microvasculature disruption of the peripheral eighth nerve or possibly due to impaired nerve conduction from the synapse to the brainstem.
Conclusions:
Prenatal cataracts, brain anomalies, FTT, and auditory neuropathy are part of the phenotype of the HDBSCC disease. We suggest including JAM3 in the gene list known to cause congenital cataracts, brain hemorrhages, and hearing loss. Further studies should address the auditory neuropathy and FTT phenomena in knockout mice models. We further suggest performing comprehensive ophthalmic, audiologic, and gastroenterologic evaluations for living patients worldwide to further confirm these novel phenomena in this rare entity.
Continuous response despite reduced dose of trametinib as single agent in an adolescent with a relapsed disseminated pediatric low-grade glioma KIAA1549-BRAF fusion positive: a case report and review of the literature
Authors: Serafin Castellano-Damaso, Felisa Vazquez-Gomez, Jose Luis Moreno-Carrasco, Begoña Arce, Pedro Borrego, Alvaro Lassaletta
Journal: Front Oncol (2024)
Keywords: braf fusion, mek inhibitor, children, low-grade gliomas, response, trametinib
MeSH terms: Case Reports

Dissemination in pediatric low-grade glioma may occur in about 4%-10% of patients according to retrospective cohort studies. Due to its low incidence, there is no consensus on treatment for these patients. According to the constitutional activation of the MAPK/ERK pathway in these tumors, MEK inhibitors such as trametinib have been used successfully in the relapsed setting. Skin toxicity is frequent in patients receiving trametinib, normally mild to moderate, but sometimes severe, needing to discontinue the drug, limiting the efficacy in the tumor. There is not much information in the literature regarding whether reducing the dose of trametinib is able to maintain efficacy while, at the same time, decreasing toxicity. Here, we present an adolescent, with severe skin toxicity, whose trametinib dose was reduced by 50% and efficacy on the tumor continued while skin toxicity significantly decreased.
Diagnostic journey and multimodal management of a rare urogenital rhabdomyosarcoma with rectovaginal fistula in an adolescent: a case report
Authors: Shailendra Katwal, Aastha Ghimire, Kriti Shrestha, Suban Amatya
Journal: Ann Med Surg (Lond) (2023)
Keywords: case report, multidisciplinary treatment, paediatric tumour, rhabdomyosarcoma, urogenital
MeSH terms: Case Reports

Introduction and importance:
Rhabdomyosarcoma is a malignant tumour that originates from immature muscle cells and belongs to the category of soft-tissue sarcomas. It is predominantly diagnosed in children under the age of 6. This condition can manifest within the genitourinary tract and may exhibit non-specific symptoms such as changes in bowel habits and fever. Early detection and a comprehensive, multidisciplinary approach are essential to achieving more favourable outcomes. This report highlights an uncommon case of urogenital rhabdomyosarcoma in a 15-year-old girl, in addition to the presence of a rectovaginal fistula.
Case presentation:
A 15-year-old girl with presented with fever, altered bowel habits, and a lump in her lower abdomen, abdominal discomfort, and incomplete bowel evacuation. She also had faecal discharge from the vagina. Diagnostic imaging and biopsy confirmed urogenital rhabdomyosarcoma with a rectovaginal fistula. The patient is currently undergoing induction chemotherapy and is scheduled for radiation therapy and surgery.
Clinical discussion:
Rhabdomyosarcoma is a rare paediatric oncologic concern due to its aggressive nature and potential metastasis. The presentation varies based on age, tumour location, and metastasis presence. This patient presented with altered bowel habits, a pelvic mass and unusual feculent discharge, suggesting a rectovaginal fistula. Diagnostic imaging confirmed the diagnosis, and induction chemotherapy led to a positive response and reduced tumour size.
Conclusion:
Urogenital rhabdomyosarcoma is an aggressive malignancy with non-specific symptoms, making early diagnosis challenging. An accurate diagnosis requires high suspicion, imaging, and a biopsy. Multidisciplinary management, including surgery, chemotherapy, and radiation therapy, improves outcomes and improves paediatric patients' prognosis and quality of life.
Case report: Complete restoration of the HPA axis function in Cushing's disease with drug treatment
Authors: Joanne Thanh-Tâm Nguyen, Amandine Ferrière, Antoine Tabarin
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: aip mutation, cushing’s disease, cabergoline, pituitary macroadenoma, prolactinoma, remission
MeSH terms: Pituitary ACTH Hypersecretion / complications, Pituitary ACTH Hypersecretion / drug therapy, Pituitary Neoplasms / complications, Pituitary Neoplasms / drug therapy, Case Reports, Adrenocorticotropic Hormone, Adult, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Prolactin, Young Adult, Hydrocortisone, Prolactin, Adrenocorticotropic Hormone

This report describes a rare case of a 20-year-old man with an ACTH- and prolactin-secreting invasive pituitary macroadenoma causing hyperprolactinemia and Cushing's disease. He was later found to have an AIP mutation. Treatment with cabergoline (1.5 mg weekly) normalized prolactin concentrations and induced a major shrinkage of the adenoma. Not only was urinary free cortisol normalized for more than 14 years, but also the treatment induced normal hypothalamo-pituitary-adrenal (HPA) axis function as illustrated by the reappearance of a normal cortisol/ACTH circadian rhythm, cortisol suppression to dexamethasone, and disappearance of the excessive and aberrant responses to CRH and desmopressin, respectively. This case is the first description of complete restoration of the physiological characteristics of the HPA axis by a medication during the treatment of Cushing's disease. Although exceptional, it illustrates that drugs targeting the pituitary adenoma can bring true complete remission of Cushing's disease.
Application of autologous platelet-rich gel formed by calcium gluconate combined with hormone therapy for endometrial repair after hysteroscopic transcervical resection of adhesion surgery and successful pregnancy: case report and literature review
Authors: Yunying Li, Yingxue Han, Xiaojuan Su, Junjuan Cao, Junxia Liu, Wenjuan Zhang
Journal: Front Med (Lausanne) (2024)
Keywords: autologous platelet-rich gel, calcium gluconate, case report, endometrial repair, intrauterine adhesion, pregnancy
MeSH terms: Case Reports

Introduction:
Intrauterine adhesion (IUA), a common gynecological disease, is mainly caused by traumatic or infectious factors that lead to basal endometrial layer physiological repair disorders. IUA is mostly treated via hysteroscopic transcervical resection of adhesion and although it can restore uterine cavity shape, its endometrial repair effectiveness is limited. The figures showed that after surgery, patients with IUA have a high recurrence rate. Therefore, quick endometrial damage repair is key to successful treatment.
Case presentation:
A 34-year-old patient visited our hospital after experiencing amenorrhea for 4 months following an induced abortion and had a fertility requirement. Based on the American Fertility Society intrauterine scores, the patient was diagnosed with moderate IUA. She underwent transcervical resection of adhesion, followed by autologous platelet-rich gel intrauterine perfusion and periodic estrogen-progesterone treatment for three menstrual cycles. No complications developed during treatment and the patient's endometrium was significantly repaired, with successful pregnancy being achieved.
Conclusion:
Autologous platelet-rich gel promoted endometrial repair and acted as a mechanical barrier to prevent intrauterine adhesion. This approach May offer new insights into IUA treatment.
Unmasking Coincident Hodgkin Lymphoma and Giant Cell Tumor: Insights from [18F] FDG PET/CT
Authors: Akram Al-Ibraheem, Serin Moghrabi, Ahmed Saad Abdlkadir, Mohamad Haidar, Omar Jaber
Journal: Asia Ocean J Nucl Med Biol (2024)
Keywords: giant cell tumor, hodgkin lymphoma, pet/ct, synchronous giant cell tumor
MeSH terms: Case Reports

Tenosynovial giant cell tumors represent a group of typically non-malignant tumors found within the joints and soft tissues. The occurrence of tenosynovial giant cell tumor alongside hematologic malignancies is an infrequent finding. Herein, we report a patient who presented with coinciding Hodgkin Lymphoma (HL) and tenosynovial giant cell tumor before chemotherapy initiation. The case was discovered during initial assessment using [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) imaging for HL staging. An unrelated hypermetabolic mass within the left knee joint led to the discovery of this unusual case, which led to a CT-guided biopsy and tenosynovial giant cell tumor discovery. This was clearly demonstrated in interim and end-of-therapy PET/CT studies when all lymphomatous lesions had resolved but the tenosynovial giant cell tumor remained. This case serves as a reminder of the intricate nature of oncological pathology and emphasizes the need for thorough and vigilant diagnostic evaluation for optimal management plan.
Heartbeats in Distress: Unveiling Cardiac Sarcoidosis Through Palpitations
Authors: Temitope A Tobun, Ndausung Udongwo, Joshua Stephens, Joseph Heaton, Farah Bashir, Theodora Esomonye, Mohammed Alkubeysi, Jalal Ghali
Journal: Cureus (2024)
Keywords: cardiac sarcoidosis, cardiovascular magnetic resonance imaging, palpitations, positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose, sarcoidosis
MeSH terms: Case Reports

Cardiac sarcoidosis (CS), a rare complication of systemic sarcoidosis, can have subtle or no symptoms. It is characterized by granuloma formation in the myocardium, which can occur in isolation or alongside systemic sarcoidosis. Clinical manifestations include conduction system disorders (e.g., atrioventricular block and ventricular tachyarrhythmia), heart failure, and sudden cardiac death. Timely evaluation and screening for CS are crucial, especially in systemic sarcoidosis patients with limited symptoms. We present the case of a 50-year-old African-American male diagnosed with cardiac sarcoidosis following a recent diagnosis of pulmonary sarcoidosis after experiencing tachycardia for two years, as confirmed by imaging studies.
Thyroid ultrasound pattern in primary hypothyroidism is similar to Graves' disease: a report of three cases
Authors: Andrey Valerievich Ushakov
Journal: J Med Life (2024)
Keywords: doppler, ft3, ft4, gd, graves’ disease, psv, psv-sta, sta, tgab, tpoab, tsh, tshr-ab, total t4, autonomic nervous system, free thyroxine, free triiodothyronine, hyperthyroidism, hypothyroidism, peak systolic velocity, superior thyroid arteries, thyroglobulin, thyroid peroxidase, thyroid ultrasound, thyroid-stimulating hormone, total thyroxine
MeSH terms: Graves Disease / complications, Graves Disease / diagnostic imaging, Hypothyroidism / complications, Hypothyroidism / diagnostic imaging, Thyroid Gland / diagnostic imaging, Ultrasonography / methods, Case Reports, Adult, Female, Humans, Male, Middle Aged

Ultrasound can identify important characteristics in primary hypothyroidism and diffuse hyperthyroidism (Graves' disease). Therefore, sonologists are actively investigating ultrasound criteria to differentiate between these two conditions. Nevertheless, practice shows the absence of such ultrasonic landmarks. For the first time in the literature, three cases of primary hypothyroidism have demonstrated an ultrasound pattern identical to that of Graves' disease. This pattern includes the presence of goiter, marked total hypoechogenicity of the parenchyma, significantly or moderately increased blood flow intensity ('thyroid inferno'), and elevated peak systolic velocity of the superior thyroid arteries. These signs are less common in hypothyroidism compared to hyperthyroidism. Diagnostic data suggest that the pathogeneses of primary hypothyroidism and Graves' disease share the same mechanisms, leading to similar thyroid ultrasound patterns. One of these shared mechanisms is presumably thyroid overstimulation by the autonomic nervous system, which is adequate to the body's hormonal requirements in hypothyroidism but excessive in hyperthyroidism.
Novel surgical approach to nasal dorsum midline dermoid sinus cyst
Authors: Aynur Aliyeva
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: nasal dermoid sinus cyst, novel technique, septal cartilage
MeSH terms: Case Reports

The correct reconstructive technique following dermoid cyst removal is critical for treatment and aesthetics. This article will discuss the management of nasal dermoid sinus cysts. A mixture of "Turkish-delight" crushed cartilage with Fibrin-based tissue adhesives and non-crushed septal cartilage was used for the primary reconstruction of the nasal dorsum.
Primary abdominal cocoon syndrome manifesting with Chilaiditi syndrome and intestinal obstruction: A case report
Authors: Ali Tajaddini, Mohammadmehdi Fallahi, Hoda Haghshenas, Soheila-Sadat Nourmohammadi, Leila Ghahramani, Reza Shahriarirad
Journal: Clin Case Rep (2023)
Keywords: chilaiditi syndrome, abdominal cocoon syndrome, encapsulating peritoneal sclerosis, intestinal obstruction, peritoneal sclerosis
MeSH terms: Case Reports

Key clinical message:
Abdominal cocoon syndrome and Chilaiditi syndrome are rare etiologies of bowel obstruction which have to be considered in patients with obstructive symptoms. Patients can profit from surgical management rather than non-surgical approach.
Abstract:
Encapsulating peritoneal sclerosis or abdominal cocoon syndrome (ACS) is an uncommon cause of intestinal obstructions associated with encapsulation of the small bowel by a fibro collagenous sac. Clinical presentations of ACS are unspecific and most patients are diagnosed intraoperatively. Moreover, Chilaiditi syndrome is another rare cause of bowel obstruction defined by interposition of colon and liver. There is no reported relation between these two conditions and surgical intervention is the suggested approach for severe bowel obstruction following them individually. We present a case with both conditions and describe our approach. A 47-year-old male presented with complaints of colic abdominal pain and distention, nausea and several attacks of bilious and nonbilious vomiting, anorexia, and constipation in the last 10 days before his admission. Laboratory data were normal and abdominal X-ray showed large dilation at the distal part of the bowel without air fluid level. The patient underwent explorative laparotomy and a mass-like lesion containing necrotic bowel and a whitish spleen accompanied by a complete anterior-rotated liver was found. The encapsulated bowel and the spleen were resected followed by the complete resolution of symptoms in the patient. The intestinal obstruction caused by ACS is mostly approached by surgery to prevent the fatal sequela of this condition.