OpenMed/multicare-articles huggingface dataset:
Intradermal melanocytic nevus of the external auditory canal
Authors: Renato V Alves, Fabiano H Brandão, José E P Aquino, Maria R M S Carvalho, Suzana M Giancoli, Eduado A P Younes
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Ear Canal / pathology, Nevus, Intradermal / pathology, Skin Neoplasms / pathology, Case Reports, Aged, Biopsy, Diagnosis, Differential, Female, Humans

Intradermal nevi are common benign pigmented skin tumors. Their occurrence within the external auditory canal is uncommon. The clinical and pathologic features of an intradermal nevus arising within the external auditory canal are presented, and the literature reviewed.
Leydig Cell Tumor in a Patient with 46,XX Disorder of Sex Development (DSD), Ovotesticular: A Case Report and a Review of the Literature
Authors: Steffen Gretser, Maria-Noemi Welte, Frederik Roos, Jens Köllermann
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Disorder of sex development (DSD) is a rare condition with atypical development of chromosomal, gonadal, or anatomical sex. It is classified in different subgroups based on the patient's karyotype, gonadal dysgenesis, and the appearance of the internal and external genitalia. Within the subgroups, the risk for developing neoplasms varies a lot. Here, we report the case of a 41-year-old patient with disorder of sex development, showing a 46,XX karyotype with an ovotestis and the simultaneous manifestation of a Leydig cell tumor in the ovotestis. The patient initially presented with infertility, and a suspicious lesion of the left testicle was noted on MRI-Scan. Upon resection, a Leydig cell tumor and an ovotestis were diagnosed. Nongerm call tumors are rare in patients with DSD. We report a nongerm cell tumor in a patient with 46,XX DSD, ovotesticular. This shows that although 46,XX DSD, ovotesticular is known to have a low potential for germ cell neoplasia, nongerm cell tumors can develop and should be into account for the management of those patients.
Hospital-Acquired COVID-19: Case Discussions of Two Patients Treated at a Level I Trauma Center
Authors: Ryan M Desrochers, Jonathan D Gates, Daniel Ricaurte, Jane J Keating
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

The community spread of COVID-19 is well known and has been rigorously studied since the onset of the pandemic; however, little is known about the risk of transmission to hospitalized patients. Many practices have been adopted by healthcare facilities to protect patients and staff by attempting to mitigate internal spread of the disease; however, these practices are highly variable among institutions, and it is difficult to identify which interventions are both practical and impactful. Our institution, for example, adopted the most rigorous infection control methods in an effort to keep patients and staff as safe as possible throughout the pandemic. This case report details the hospital courses of two trauma patients, both of whom tested negative for the COVID-19 virus multiple times prior to producing positive tests late in their hospital courses. The two patients share many common features including history of psychiatric illness, significant injuries, ICU stays, one-to-one observers, multiple consulting services, and a prolonged hospital course prior to discharge to a rehabilitation facility. Analysis of these hospital courses can help provide a better understanding of potential risk factors for acquisition of a nosocomial COVID-19 infection and insight into which measures may be most effective in preventing future occurrences. This is important to consider not only for COVID-19 but also for future novel infectious diseases.
Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager
Authors: Kamil Buczkowski, Irena Ożóg-Zabolska, Jacek Gulczyński, Ewa Iżycka-Świeszewska
Journal: Autops Case Rep (2022)
Keywords: autopsy, diabetes mellitus, gastroenterology, hepatitis, pediatrics
MeSH terms: Case Reports

Hypoxic hepatitis is a rare complication of type 1 diabetes with unknown prevalence in Pediatrics. We present a case report of an 11-year-old boy admitted to the ER in the spring of 2020 (the beginning of the COVID19 pandemic in Poland) due to nausea, abdominal pain, and weight loss. A diagnosis of type 1 diabetes accompanied by severe ketoacidosis (pH 6.9, blood glucose 632mg/dl, ketone bodies in urine - 150mg/dl) was made. The hyperglycemia, ketoacidosis, and water-electrolyte disturbances were treated in the Pediatric Intensive Care Unit. On day 4, the boy developed fulminant septic shock with high aminotransferases (AST 9026 U/l, ALT 3559 U/l). CT scan revealed hepatic enlargement and steatosis. Acute viral hepatitis was suspected. The levels of anti-CMV IgM and IgG antibodies were slightly elevated. At autopsy, the liver was enlarged, with petechial bleedings on the surface. The liver parenchyma was congested, with signs of steatosis. Microscopically, there was extensive centrilobular necrosis, acute passive sinusoidal congestion, and steatosis of hepatocytes. There were no signs of CMV infection. Based on the entire clinicopathological picture, the patient was diagnosed with hypoxic hepatitis, complicated by septic shock and multiple organ failure.
Residual fistula of fourth branchial arch anomalies and recurrent left-side cervical abscess: clinical case and review of the literature
Authors: Bassel Hallak, Salim Bouayed, Crispin Leishman, Kishore Sandu
Journal: Case Rep Otolaryngol (2014)

Congenital fourth branchial arch anomalies are uncommon entities. Most of these anomalies are diagnosed in childhood. The majority of cases occur on the left side. The clinical presentation of these anomalies varies with age. A respiratory distress is the usual clinical presentation in neonates, cervical cutaneous fistulas in late childhood or acute suppurative thyroiditis. Multiples diagnostic options have been described with different modalities of treatment. The majority of cases of fourth branchial arch anomalies are described only in case reports. We report a clinical case of recurrent cervical abscess in a young woman due to a residual fistula of fourth branchial arch.
Adult Ileocolic Intussusception from the Appendix
Authors: Natalie Green, William Krantz, Allison Tadros
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Intussusception is more commonly considered in the pediatric patient with abdominal pain, but can occur in adults as well. Adult patients are more likely to have an underlying intra-abdominal pathology leading to the condition. We present an adult patient presenting with abdominal pain with ileocecal intussusception diagnosed on imaging and confirmed surgically. In this case, appendiceal pathology served as the lead point for the intussusception.
Presence of Probst Bundles Indicate White Matter Remodeling in a Dog With Corpus Callosum Hypoplasia and Dysplasia
Authors: Adriano Wang-Leandro, Matthias Dennler, Katrin M Beckmann
Journal: Front Vet Sci (2018)
Keywords: dti, adipsia, axonal bundles, canine, epilepsy, hypernatremia, seizures
MeSH terms: Case Reports

Corpus callosum abnormalities (CCA) rarely occur in dogs and are related to hypo/adypsic hypernatremia and seizures. Hypoplasia and dysplasia of the corpus callosum (CC) with concomitant lobar holoprosencephaly is the most common variant. It is currently uncertain using conventional MRI if canine CCA reflects the failure of commissural fibers to develop or the failure of the commissural fibers to cross hemispheres. Diffusion tensor imaging was performed in a 4-year-old Staffordshire mix breed dog with CCA and an age-matched healthy Beagle. In comparison to the control dog, CC tractography of the affected dog depicted only axonal tracts corresponding to the temporal CC fibers. The cingulum bundles appeared supernumerary with unorganized architecture, extending into the ipsilateral cerebral cortex, and therefore strongly suggested homology to Probst bundles reported in humans with CCA. The presence of Probst bundles in canine CCA could represent compensatory neuroplasticity-mediated networking and may contribute the fair prognosis reported in affected dogs.
Gender-based difference in early mortality among patients with ST-segment elevation myocardial infarction: insights from Kermanshah STEMI Registry
Authors: Soraya Siabani, Patricia M Davidson, Maryam Babakhani, Nahid Salehi, Yousef Rahmani, Farid Najafi, Hossein Karim, Ali Soroush, Behrooz Hamzeh, Mojtaba Amiri, Hossein Siabani
Journal: J Cardiovasc Thorac Res (2020)
Keywords: cohort, mortality, myocardial infarction, registry, sex

Introduction: This study aimed to evaluate the in-hospital mortality of patients with ST-segment elevation myocardial infarction (STEMI), according to gender and other likely risk factors. Methods: This study reports on data relating to 1,484 consecutive patients with STEMI registered from June 2016 to May 2018 in the Western Iran STEMI Registry. Data were collected using a standardized case report developed by the European Observational Registry Program (EORP). The relationship between in-hospital mortality and potential predicting variables was assessed multivariable logistic regression. Differences between groups in mortality rates were compared using chi-square tests and independent t-tests. Results: Out of the 1484 patients, 311(21%) were female. Women were different from men in terms of age (65.8 vs. 59), prevalence of hypertension (HTN) (63.7% vs. 35.4%), diabetes mellitus (DM) (37.7% vs. 16.2%), hypercholesterolemia (36.7% vs. 18.5%) and the history of previous congestive heart failure (CHF) (6.6% vs. 3.0%). Smoking was more prevalent among men (55.9% vs. 13.2%). Although the in-hospital mortality rate was higher in women (11.6% vs. 5.5%), after adjusting for other risk factors, female sex was not an independent predictor for in-hospital mortality. Multivariable analysis identified that age and higher Killip class (≥II) were significantly associated with in-hospital mortality rate. Conclusion: In-hospital mortality after STEMI in women was higher than men. However, the role of sex as an independent predictor of mortality disappeared in regression analysis. The gender based difference in in-hospital mortality after STEMI may be related to the poorer cardiovascular disease (CVD) risk factor profile of the women.
Eosinophilic panniculitis and insect bite-like eruption in a patient with chronic lymphocytic leukaemia: a spectrum of the same entity
Authors: R Rodríguez-Lojo, M Almagro, F Piñeyro, L Pérez-Varela, B Fernández-Jorge, J Del Pozo, F Sacristán, E Fonseca
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Background. Eosinophilic dermatosis of hematologic disorders is a reactive process that may cause a variety of clinical manifestations. Methods. We report a patient who had outbreaks of skin lesions since the onset of chronic lymphocytic leukaemia. Results. The cutaneous eruptions began as eosinophilic panniculitis and after changed to insect bite-like lesions. Conclusion. We think that eosinophilic panniculitis and insect bite-like lesions may be part of the spectrum of the same entity in patients with hematologic disorders.
Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up
Authors: Ines Kallel, Eya Moussaoui, Fadwa Chtioui, Nabiha Douki
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

According to the American Association of Endodontists, "a 'true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually." Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.
Leiomyoma of the Round Ligament of the Uterus Mimicking Inguinal Hernia
Authors: Ioulia Maria Christodoulou, Argiris Angelopoulos, Petros Siaperas, Argyrios Ioannidis, Andreas Skarpas, Antreas Tellos, Georgios Velimezis, Ioannis Karanikas
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Masses of the round ligament of the uterus are uncommon. Leiomyomas are the most common of them, followed by mesothelial cysts and in some cases endometriosis. The exact incidence is not known, but most cases are frequently encountered during the fertility age. Leiomyomas are benign tumors, which can present as hernias, lymph nodes, or other inguinal masses. Surgical excision is the appropriate treatment. We are presenting a case of a 47-year-old female patient who was admitted to the hospital with a left inguinal mass. Our patient underwent surgery, and a leiomyoma of the round ligament was found.
Video event data recording of a taxi driver used for diagnosis of epilepsy
Authors: Kotaro Sakurai, Junko Yamamoto, Tsugiko Kurita, Youji Takeda, Ichiro Kusumi
Journal: Epilepsy Behav Case Rep (2014)
Keywords: driving, epilepsy, video event data recorder
MeSH terms: Case Reports

A video event data recorder (VEDR) in a motor vehicle records images before and after a traffic accident. This report describes a taxi driver whose seizures were recorded by VEDR, which was extremely useful for the diagnosis of epilepsy. The patient was a 63-year-old right-handed Japanese male taxi driver. He collided with a streetlight. Two years prior to this incident, he raced an engine for a long time while parked. The VEDR enabled confirmation that the accidents depended on an epileptic seizure and he was diagnosed with symptomatic localization-related epilepsy. The VEDR is useful not only for traffic accident evidence; it might also contribute to a driver's health care and road safety.
Thoracic curlicue: A case of ureteral herniation
Authors: Sudhir Sukumar, P Ginil Kumar, Appu Thomas
Journal: Indian J Urol (2010)
Keywords: ureter, diaphragm, hernia
MeSH terms: Case Reports

Isolated herniation of ureter into thoracic cavity due to a defect in the diaphragm is a very rare entity. We present clinical details and radiographic images of an incidentally detected herniation of right ureter into the thorax in an elderly lady with no previous history of trauma or urinary tract symptoms. This acquired but asymptomatic condition is confirmed by radiologic imaging that reveals the classical loop configuration which is described as the curlicue sign. Further evaluation had revealed mild renal failure but with no definite evidence of obstruction. In view of age and asymptomatic status, patient was offered non-surgical management.
Hepatic rupture from haematomas in patients with pre-eclampsia/eclampsia: a case series
Authors: Takura Innocent Kanonge, Felix Chamunyonga, Nellia Zakazaka, Claitos Chidakwa, Mugove Gerald Madziyire
Journal: Pan Afr Med J (2018)
Keywords: hellp syndrome, hepatic haematoma, pre-eclampsia
MeSH terms: Eclampsia / physiopathology, Hematoma / etiology, Liver Diseases / etiology, Pre-Eclampsia / physiopathology, Case Reports, Abruptio Placentae / physiopathology, Adult, Cesarean Section, Female, Humans, Pregnancy, Pregnancy Outcome, Stillbirth

Hepatic rupture from haematomas is a rare complication of severe preeclampsia/eclampsia especially when complicated with the haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome. It is associated with poor maternal and foetal outcomes as demonstrated by three cases we describe. The first case had eclampsia at 31 weeks gestation with features of abruptio placentae and at caesarean section we found haemoperitoneum of 1.5 litres, a 10cm liver rupture and a still birth. She subsequently died in ICU within 24 hours of surgery; the second case had eclampsia at 35 weeks and ended up as a table death during emergency caesarean section. She had 4 litres of haemoperitoneum, hepatic rupture, placental abruption and a stillbirth; the third case had pre-eclampsia at 33 weeks with markedly elevated liver enzymes. She had one litre haemoperitoneum, right lobe hepatic rupture and a stillbirth. She recovered after conservative management. Severe pre-eclampsia/eclampsia associated hepatic rupture calls for rapid and aggressive intervention with prompt multidisciplinary management to avert adverse outcomes.
Small cell neuroendocrine carcinoma of the urinary tract successfully managed with neoadjuvant chemotherapy
Authors: Mustapha Ahsaini, Omar Riyach, Mohammed Fadl Tazi, Mohammed Jamal El Fassi, My Hassan Farih, Hind Elfatmi, Afaf Amarti
Journal: Case Rep Urol (2013)

Introduction. Small cell neuroendocrine carcinomas of the urinary tract is an extremely rare entity and very few cases have been reported in the literature. Small cell neuroendocrine carcinoma of the urinary tract (SCC-UT) is the association between bladder and urinary upper tract-small cell carcinoma (UUT-SCC). It characterized by an aggressive clinical course. The prognosis is poor due to local or distant metastases, and usually the muscle of the bladder is invaded. Case Presentation. We report a rare case of a 54-year-old Arab male native of moroccan; he is a smoker and was referred to our institution for intermittent hematuria. Following a diagnosis of small cell neuroendocrine carcinomas of the ureter and the bladder, thoracoabdominal-pelvic CT was done, and the staging of the tumor was done in the bladder (T2N0M0) and (T1N0M0) in the ureter. Neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin was realized, and nephroureterectomy associated to a cystoprostatectomy was carried out. After 24 months of followup, no local or distant metastasis was detected. Conclusion. The purpose of this review is to present a rare case of pure small cell neuroendocrine carcinoma of the urinary tract and review the literature about the place of neoadjuvant chemotherapy in this rare tumors.
A Pregnancy Case of Primary Mediastinal Large B Cell Lymphoma with Superior Vena Cava Syndrome
Authors: Lauren Brownhalls, Ann Gillett, Yasmin Whately, Keisuke Tanaka
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Primary mediastinal large B cell lymphoma (PMLBCL) is a subtype of non-Hodgkin's lymphoma which presents rarely in pregnancy. It is an aggressive tumour that is associated with symptoms of superior vena cava (SVC) compression and airway compromise such as dyspnoea, facial and arm swelling, cough, or chest pain. Timely diagnosis is imperative to optimising patient outcomes and reducing both maternal and fetal morbidity and mortality. We report a case of a 33-year-old woman diagnosed with PMLBCL who presented at 33-week gestation with SVC obstruction to 1 mm in diameter. After multidisciplinary team discussion regarding maternal and fetal implications of management options, we proceeded to a caesarean section and initiated chemotherapy postdelivery. Lower segment caesarean section was uncomplicated, and she underwent a cycle of R-CHOEP followed by 5 cycles of DA-EPOCH. Eighteen months since the completion of the chemotherapy, the disease remained in remission.
Successful management of dexmedetomidine for postoperative intensive care sedation in a patient with anti-NMDA receptor encephalitis: a case report and animal experiment
Authors: Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
Journal: Springerplus (2016)
Keywords: dexmedetomidine, encephalitis, nmda receptor

Background:
Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis.
Findings:
(1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis. Administration of MK-801 produced well-characterized schizophrenia-like behaviors, i.e. hyperlocomotion and stereotyped sniffing. Ketamine, an NMDA receptor-dependent anesthetic, exaggerated both behaviors, even at sub-anesthetic doses. On the other hand, dexmedetomidine did not show any exacerbation, suggesting that dexmedetomidine has no clinically relevant interaction with the NMDA-R in vivo. (2) CASE REPORT: our patient, a 27-year-old female, was diagnosed with anti-NMDA-R encephalitis secondary to ovarian teratoma. She underwent laparoscopic ovariectomy under general anesthesia using thiopental, sevoflurane, and remifentanil, which were well tolerated. After transfer to the intensive care unit, she became increasingly agitated despite repeated boluses of intravenous fentanyl. Infusion of dexmedetomidine (0.5-1.0 μg/kg/h) was started, and an adequate level of sedation was achieved uneventfully. After discontinuation of dexmedetomidine, recovery from sedation was smooth and quick without any deterioration of neurological or psychological symptoms.
Conclusions:
Our experimental findings and the presented case suggest that dexmedetomidine may be safely used in patients with anti-NMDA-R encephalitis. Further clinical evaluation is warranted to validate this finding.
Primary pleomorphic rhabdomyosarcoma of the adrenal gland in an adult: A case report
Authors: Chao-Jun Wang, Jun Li, Jie Qin
Journal: Oncol Lett (2014)
Keywords: adrenal, adult, rhabdomyosarcoma

A 61-year-old female was referred to The First Affiliated Hospital, College of Medicine, Zhejiang University (Hangzhou, China) due to a right adrenal tumor. A pre-operative transcutaneous fine-needle aspiration biopsy and right adrenalectomy were performed, and pathological analysis resulted in the diagnosis of pleomorphic rhabdomyosarcoma (RMS). Primary pleomorphic RMS of the adrenal gland in an adult is a rare condition. To the best of our knowledge, this is the first case of pleomorphic RMS of the adrenal gland in an adult diagnosed by light microscopy and immunohistochemical stains.