OpenMed/multicare-articles huggingface dataset:
Delayed Intraventricular Hemorrhage following a Ventriculoperitoneal Shunt Placement: Exploring the Surgical Anatomy of a Rare Complication
Authors: Ioannis N Mavridis, Athanassios Mitropoulos, Constantinos Mantas, Aikaterini Karagianni, Konstantinos Vlachos
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Ventriculoperitoneal shunt (VPS) placement is one of the commoner neurosurgical procedures worldwide. The purpose of this article is to report a case of delayed intraventricular hemorrhage (IVH) following a VPS and to review the literature regarding anatomic factors that could potentially explain this rare complication. A 78-year-old man with normal pressure hydrocephalus, who underwent an uneventful right VPS placement, suffered from a catastrophic isolated IVH five days later. The reported cases of delayed intracerebral hemorrhage (ICH) following VPS are rare and those with IVH are even rarer. Potential factors of surgical anatomy that could cause delayed ICH/IVH following a VPS procedure include erosion of vasculature by catheter cannulation, multiple attempts at perforation, puncture of the choroid plexus, improper placement of the tubing within the brain parenchyma, VPS system revision, venous infarction, vascular malformations, head trauma, and brain tumors. Other causes include generalized convulsion, VPS system malfunction, increased intracranial or blood pressure, sudden intracranial hypotension, and bleeding disorders. According to the current literature, our case is the first reported delayed isolated IVH after a VPS placement so far. Neurosurgeons should be aware of the delayed ICH/IVH as a rare, potentially fatal complication of VPS, as well as of its risk factors.
The simultaneous occurrence of multiple myeloma and JAK2 positive myeloproliferative neoplasms - Report on two cases
Authors: S Badelita, C Dobrea, A Colita, M Dogaru, M Dragomir, C Jardan, D Coriu
Journal: J Med Life (2015)
Keywords: jak2, essential thrombocythemia, multiple myeloma, primary myelofibrosis
MeSH terms: Janus Kinase 2 / genetics, Multiple Myeloma / enzymology, Multiple Myeloma / genetics, Myeloproliferative Disorders / enzymology, Myeloproliferative Disorders / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Biopsy, Bone Marrow / pathology, Cryoglobulins / metabolism, Female, Humans, Multiple Myeloma / pathology, Myeloproliferative Disorders / pathology, Cryoglobulins, JAK2 protein, human, Janus Kinase 2

Multiple myeloma and JAK2 positive chronic myeloproliferative neoplasms are hematologic malignancies with a completely different cellular origin. Two cases of simultaneous occurrence of multiple myeloma, one with primary myelofibrosis and another one with essential thrombocythemia are reported in this article. In such cases, an accurate diagnosis requires a molecular testing, including gene sequencing and differential diagnosis of pancytosis associated with splenic amyloidosis. In general, in such cases, of two coexisting malignant hematologic diseases, the treatment of the most aggressive one is recommended. For our two cases, it was decided to start a Velcade based therapy. The main concern was the medullar toxicity, especially when a multiple myeloma was associated with a primary myelofibrosis.
Case report: Endoscopic closure with double stenting and autologous fascia lata graft of large tracheo-esophageal fistula
Authors: Francesco Mattioli, Edoardo Serafini, Alessandro Andreani, Gaia Cappiello, Daniele Marchioni, Massimo Pinelli, Roberto Tonelli, Enrico Clini, Alessandro Marchioni
Journal: Front Surg (2023)
Keywords: bronchoscope, fascia lata autograft, stent, tracheoesophageal fistula (tef), tracheoscopy
MeSH terms: Case Reports

Introduction:
Radiotherapy and esophageal stenting are usually employed to manage esophageal localization of distant cancer. However, they are also related to the occurrence of an increased risk of tracheoesophageal fistula. Tracheoesophageal fistula management in these patients involves dealing with poor general conditions and short-term prognosis. This paper presents the first case in literature of bronchoscopic fistula closure through an autologous fascia lata graft placement between two stents.
Case report and aim:
A 67-years-old male patient was diagnosed with pulmonary squamous cell carcinoma in the inferior lobe of the left lung with mediastinal lymph node metastasis. After a multidisciplinary discussion, bronchoscopic repair of tracheoesophageal fistula with autologous fascia lata was decided without the removal of the esophageal stent due to the high risk on the esophagus possibly related to such a procedure. Oral feeding was progressively introduced without the development of aspiration symptoms. Videofluoroscopy and esophagogastroduodenoscopy were performed at 7 months showing no signs of tracheoesophageal fistula patency.
Conclusion:
This technique might represent a low risks viable option for patients unsuitable for open surgical approaches.
Epidermal growth factor receptor inhibitor therapy for recurrent respiratory papillomatosis
Authors: Matthew M Moldan, Bruce C Bostrom, Robert J Tibesar, Timothy A Lander, James D Sidman
Journal: F1000Res (2013)

The epidermal growth factor pathway has been implicated in various tumors, including human papillomavirus (HPV) lesions such as recurrent respiratory papillomatosis (RRP). Due to the presence of epidermal growth factor receptors in RRP, epidermal growth factor receptor (EGFR) inhibitors have been utilized as adjuvant therapy. This case series examines the response to EGFR inhibitors in RRP. Four patients with life-threatening RRP were treated with EGFR inhibitors. Operative frequency and anatomical Derkay scores were calculated prior to, and following EGFR inhibitor treatment via retrospective chart review. The anatomical Derkay score decreased for all four patients after initiation of EGFR inhibitor therapy. In one patient, the operative frequency increased after switching to an intravenous inhibitor after loss of control with an oral inhibitor. In the other patients there was a greater than 20% decrease in operative frequency in one and a more than doubling in the time between procedures in two. This study suggests that EGFR inhibitors are a potential adjuvant therapy in RRP and deserve further study in a larger number of patients.
Case Report: Hypercholesterolemia "Lean Mass Hyper-Responder" Phenotype Presents in the Context of a Low Saturated Fat Carbohydrate-Restricted Diet
Authors: Nicholas G Norwitz, Adrian Soto-Mota, David Feldman, Stefanos Parpos, Matthew Budoff
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: hdl cholesterol, ldl cholesterol, carbohydrate restriction, coronary computed tomography angiography (ccta), ketogenic diet, lean mass hyper-responder, triglycerides
MeSH terms: Hypercholesterolemia / etiology, Hyperlipidemias, Case Reports, Carbohydrates, Cholesterol, LDL, Diet, Carbohydrate-Restricted, Humans, Male, Phenotype, Triglycerides, Carbohydrates, Cholesterol, LDL, Triglycerides

Emerging evidence suggests that "leanness" and good metabolic health markers may predict larger increases in LDL cholesterol (LDL-C) in response to carbohydrate restriction. Specifically, a recent cohort study demonstrated an inverse association between BMI and LDL-C change among individuals on carbohydrate-restricted diets and identified a subgroup of "Lean Mass Hyper-Responders" (LMHR) who exhibit exceptional increases in LDL-C, in the context of low triglycerides and high HDL-C. We present the case of one subject, LM, who adopted a ketogenic diet for management of ulcerative colitis. He subsequently experienced an increase in LDL-C from 95 to 545 mg/dl, at peak, in association with HDL-C >100 mg/dl and triglycerides ~40 mg/dl, typical of the emergent LMHR phenotype. Assessments of LM's dietary intake, lipid panels, and BMI are consistent with prior data and suggest that the LMHR phenomenon is not dependent on saturated fat intake but inversely associates with BMI changes. Finally, computed tomography angiography conducted on LM after over 2 years of hypercholesterolemia revealed no evidence of calcified or non-calcified plaque.
Nodal Langerhans cell neoplasm: detailing the diagnostic quandaries
Authors: Zachariah Chowdhury, Juhi Varshney, Anil Singh, Satvik Khaddar
Journal: Autops Case Rep (2021)
Keywords: langerhans cell, histiocytosis, lymphoma, pleura, sarcoma
MeSH terms: Case Reports

Langerhans cells, found in the supra-basal region of the mucous membranes in the epidermis of the skin, in lymph nodes and thymus, function as antigen-presenting cells within the histiocyte system. Tumors derived from Langerhans cells (LC) can be divided according to the degree of cytological atypia and clinical behavior into Langerhans cell histiocytosis (LCH) and Langerhans cell sarcoma (LCS). LCS is rare, and the nodal presentation is even rarer with challenging histological characteristics. LCS has a dismal overcome despite intensive chemotherapy. Herein, we report a case of a 29-year-old male who presented with generalized lymphadenopathy initially considered as a lymphoma. An outright definitive diagnosis could not be attained in the initial histomorphological and immunohistochemical evaluation, fraught with differential diagnoses. The key to decoding the precise neoplasm was a combination of the cytopathologic features, review of the histomorphology, and extensive immunohistochemical assessment in conjunction with the clinical and positron emission tomography (PET) scan findings. The best diagnosis proffered was a Langerhans cell histiocytosis progressing to Langerhans cell sarcoma. This case highlights the grey zone areas in LC neoplasms, the diagnostic conundrums encountered, the indispensable role of meticulous pathological analysis, and the importance of ancillary studies in hammering out the final diagnosis.
Malignant schwannoma of the upper mediastinum originating from the vagus nerve
Authors: Fumihiro Shoji, Riichiroh Maruyama, Tatsuro Okamoto, Hiroshi Wataya, Kenichi Nishiyama, Yukito Ichinose
Journal: World J Surg Oncol (2005)

Background:
Malignant schwannoma of the upper mediastinum originating from the vagus nerve is extremely rare.
Case presentation:
A 46-year-old female was admitted for a left cervical mass which was associated with both hoarseness and Horner's syndrome. Chest computed tomography showed a mass extending from the left upper mediastinum to the left supraclavicular area. A fine needle aspiration cytological examination suggested primary lung cancer stage IIIB large cell carcinoma. After administering induction chemo-radiotherapy, a complete surgical resection was performed. The tumor was found to involve both the left vagus nerve and the left sympathetic nerve. Histological examination of the resected specimen revealed the tumor to be malignant schwannoma.
Conclusion:
Despite incorrect preoperative diagnosis, the multimodality treatment administered in this case, including induction chemo-radiotherapy and surgery, proved to be effective.
Case Report: Precision COVID-19 Immunization Strategy to Overcome Individual Fragility: A Case of Generalized Lipodystrophy Type 4
Authors: Salvatore Zaffina, Eva Piano Mortari, Reparata Rosa Di Prinzio, Marco Cappa, Antonio Novelli, Emanuele Agolini, Massimiliano Raponi, Bruno Dallapiccola, Franco Locatelli, Carlo Federico Perno, Rita Carsetti
Journal: Front Immunol (2022)
Keywords: cavin1, sars-cov-2 vaccine, case report, congenital generalized lipodystrophy type 4, memory b cells
MeSH terms: Adenovirus Vaccines, COVID-19, Lipodystrophy, Congenital Generalized, Case Reports, Research Support, Non-U.S. Gov't, BNT162 Vaccine, COVID-19 Vaccines / adverse effects, Humans, Liposomes, Middle Aged, Nanoparticles, SARS-CoV-2, Vaccination, Adenovirus Vaccines, COVID-19 Vaccines, Lipid Nanoparticles, Liposomes, BNT162 Vaccine

A 48-year-old patient affected with congenital generalized lipodystrophy type 4 failed to respond to two doses of the BNT162b2 vaccine, consisting of lipid nanoparticle encapsulated mRNA. As the disease is caused by biallelic variants of CAVIN1, a molecule indispensable for lipid endocytosis and regulation, we complemented the vaccination cycle with a single dose of the Ad26.COV2 vaccine. Adenovirus-based vaccine entry is mediated by the interaction with adenovirus receptors and transport occurs in clathrin-coated pits. Ten days after Ad26.COV2 administration, S- and RBD-specific antibodies and high-affinity memory B cells increased significantly to values close to those observed in Health Care Worker controls.
Cerebral edema associated with ventricular reservoirs in two patients: a case report
Authors: Marshall C Cress, Angela N Spurgeon, Douglas C Miller, N Scott Litofsky
Journal: Case Rep Neurol Med (2012)
MeSH terms: Case Reports

Placement of ventricular reservoirs is a common practice to treat various tumors of the central nervous system (CNS). Ventricular catheter-reservoir-associated edema has been noted in the literature, but a thorough review of this literature identified no articles that examine this particular complication in neurooncology patients, specifically. We report two cases of ventricular catheter-reservoir-associated edema in patients receiving treatment for CNS metastasis.
A case of invasive aspergillosis in CGD patient successfully treated with Amphotericin B and INF-gamma
Authors: Setareh Mamishi, Kamiar Zomorodian, Farshid Saadat, Mohsen Gerami-Shoar, Bita Tarazooie, Seyad Ahmad Siadati
Journal: Ann Clin Microbiol Antimicrob (2005)
MeSH terms: Amphotericin B / administration & dosage, Aspergillosis / drug therapy, Granulomatous Disease, Chronic / complications, Interferon-gamma / administration & dosage, Case Reports, Child, Preschool, Drug Therapy, Combination, Granulomatous Disease, Chronic / immunology, Humans, Male, Amphotericin B, Interferon-gamma

Background:
Chronic granulomatous disease (CGD) is a rare disorder of phagocytes in which absence of superoxide and hydrogen peroxide production in phagocytes predisposes patients to bacterial and fungal infections. The most common fungal infections in these patients are caused by Aspergillus species.
Case presentation:
Here, we describe Aspergillus osteomyelitis of the ribs and hepatic abscess in a 5-year-old boy. The patient was successfully treated with Amphotericin B and INF-gamma.
Conclusion:
With respect to the high frequency of aspergillosis in the CGD patient, immune deficiency should be investigated in patients with invasive aspergillosis. Moreover, using antifungal drugs as prophylaxis can improve the quality of life in these patients.
A Case Series: Continuous Kidney Replacement Therapy in Neonates With Low Body Weight
Authors: Chen-Yu Wu, Yung-Chieh Lin, Chih-Chia Chen
Journal: Front Pediatr (2021)
Keywords: acute kidney injury, continuous kidney replacement therapy (ckrt), dialysis, low body weight, neonate
MeSH terms: Case Reports

Emerging data indicate that acute kidney injury (AKI) may contribute to a worse prognosis in the infant population. Kidney replacement therapy (KRT) can be used to treat patients with AKI; however, this technique is challenging in patients in the neonatal intensive care units (NICUs) due to the low body weights and blood volumes in this population. Peritoneal dialysis (PD) is a potential modality since it is technically less challenging. However, PD has been associated with several disadvantages, including poor fluid status control, catheter-associated leakage, and peritonitis. Unfortunately, these complications can cause the temporary cessation of PD. Continuous kidney replacement therapy (CKRT) may represent a suitable alternative for PD. CKRT may be technically feasible in infants; however, little is known about the application of CKRT in neonates with low body weights. In this report, we discuss three cases of CKRT who were treated in the NICU at a tertiary medical center in southern Taiwan. We selected an adequate catheter diameter and achieved vascular access via an internal jugular vein or umbilical vein. The prescription of an appropriate dose of heparin was then used to prolong the circuit life of the CKRT. The maintenance of circuit durability in neonates with low body weight remains problematic. We hope that our experience can assist with the future clinical management of CKRT in neonates with low body weight.
A Rare Case of Systemic Sarcoidosis in a Middle-Aged Female with a Solitary Thyroid Nodule
Authors: Ayrton Bangolo, John Bukasa Kakamba, Ali Atoot, Mohammad Jurri, Ashraf Mahmoud, Arthur Oliver Lo, Kunchang Song, Syed Sirajuddin, Adam Atoot
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Sarcoidosis is a multisystem inflammatory disease characterized by the presence of noncaseating granulomas. Sarcoidosis can affect any organ of the body, the lung being the most affected. Sarcoidosis rarely affects the thyroid gland, and only a few cases of thyroid-related sarcoidosis have been reported in the literature. Herein, we report a case of systemic sarcoidosis with multiple organ involvement in a patient with a solitary left thyroid nodule and benign Fine Needle Aspiration (FNA) findings. The patient was eventually diagnosed with thyroid sarcoidosis using a core needle biopsy of the thyroid nodule. With this case report, we highlight the limitations of the FNA. This case report has the objective to encourage clinicians to include thyroid sarcoidosis in the differential diagnosis of thyroid nodules in patients with systemic sarcoidosis even with unremarkable FNA findings.
Recurrent chest pain, as a presenting sign of ovarian endometrioma
Authors: Mehmet Yildirim, Ozgur Oztekin, Deniz Oztekin
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Chest pain is a rare sign of thoracal endometriosis associated with endometrioma of the tubo-ovarian endometrioma. We report the case periodic episodes of chest pain concurrent with menstruation in a 35-year-old female, in which ovarian endometrioma was diagnosed and left-sided oophorectomy was performed. After surgery, patient underwent medical treatment which included a Gn-RH agonist and a combined oral contraceptive. In the follow-up period, there was no evidence of chest pain.
Multiple Urethral Hemangiomas Associated with Urethral Stricture: An Uncommon Aetiology for Urethral Bleeding
Authors: Raquel Varea-Malo, Félix Campos-Juanatey, José Antonio Portillo Martín, Luisana Castillo Carvajal
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Urethral haemangiomas are rare benign vascular tumours. They usually cause painless urethral bleeding and haematospermia. Urethroscopy is the preferred diagnostic tool, while complementary radiologic studies could describe the extension of the tumour. Treatment should be tailored to each case, considering size, location, and number of lesions. We present a case of a male patient diagnosed with urethral haemangiomas following painless spontaneous urethral bleeding associated with voiding symptoms.
Stenotrophomonas maltophilia Meningitis in a Term Healthy Neonate: A Case Report and Literature Review
Authors: Judy Ibrahim, Nadia Hamwi, Hala Rabei, Mohamed Abdelghafar, Zahraa Al-Dulaimi, Hossam Al Tatari
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Stenotrophomonas maltophilia is an environmental bacterium of growing concern due to its multidrug resistance and pathogenic potential. It is considered an opportunistic pathogen of nosocomial origin most of the time, targeting a specific patients' population. We describe a case of a previously healthy full-term neonate who was found to have S. maltophilia meningitis and was successfully treated with a combination of Trimethoprim-Sulfamethoxazole and Ciprofloxacin.
Colonic perforation in a child with Crohn's disease: successful medical treatment rescues from colectomy
Authors: Marco Gasparetto, Benedetta Giorgi, Wolfgang Kleon, Faise Al Bunni, Graziella Guariso
Journal: Case Rep Gastrointest Med (2012)

Background. The challenging treatment of penetrating paediatric Crohn's disease (CD) involves pharmacological and surgical approaches. Despite a proved efficacy of anti-TNF agents for treatment of complex fistula, a large number of patients cannot achieve a complete healing and relapse during the followup. Aim. We report a paediatric case with CD and colonic perforation who was successfully treated with medical therapy only, including anti-TNFα. Case Presentation. During a colonoscopy performed on a 9-year-old girl with CD, a perforation occurred in correspondence of a fistula at the colonic splenic flexure. The formation of a collection was then detected (US, enteric-CT), as well as a fistula connecting the colon to the collection. The girl was kept fasting and treated with total parenteral nutrition and antibiotic therapy. Treatment with Infliximab was also started, and after the third dose a US control showed disappearance of the collection and healing of the enteric fistula. Parenteral nutrition was progressively substituted with enteral feeding, and no surgical treatments were needed. Discussion. In pubertal children with penetrating CD, the option of an efficacious medical treatment to avoid a major surgical approach on the bowel is to be aimed for growth improvement. This approach requires a strictly monitored long-term followup.
Maintenance treatment with chemotherapy and immunotherapy in non-small cell lung cancer: a case report
Authors: Anabella Llanos, Mariana Savignano, Gabriela Cinat
Journal: Front Oncol (2012)
Keywords: chemotherapy, concurrent review, immunotherapy, lung cancer, vaccines
MeSH terms: Case Reports

A 53-years-old woman was diagnosed with lung adenocarcinoma state IV (synchronous pleural involvement) in April 2009. First-line systemic treatment included six cycles of Carboplatin, Paclitaxel, and Bevacizumab. Partial response was achieved. Maintenance therapy with Bevacizumab and Pemetrexed was given from September 2009 to February 2010. No response changes were observed. Immunotherapy was initiated, and then Pemetrexed was given with the same disease status. Both treatments were well tolerated. Immunotherapy toxicity included reaction at the site of injection grade 2. At present, the patient is still on this treatment. Given the poor prognosis of patients with advanced lung cancer, the combination of both treatments during the stable phase of the disease may improve progression-free survival.
Outside the Thorax: Doege-Potter Syndrome Presenting as a Retroperitoneal Abdominal Mass
Authors: Daniel M Berrebi, Oksana Symczyk, Taylor Cater, Ayodele Adelanwa, Patrick Bacaj, Alan A Thomay, Adnan Haider
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Objective:
We present a case of refractory hypoglycemia, weight loss, and retroperitoneal solitary fibrous tumor. Case report. A 68-year-old female presented with symptomatic hypoglycemia, weight loss, and abdominal mass identified on CT scan of the abdomen. Blood work during symptomatic hypoglycemia was consistent with an IGF-2-producing tumor. The abdominal mass pathology was consistent with solitary fibrous tumor surrounding the adrenal gland, and resection resulted in complete resolution of hypoglycemia. Discussion. Understanding the biochemical mechanisms behind glucose regulation is necessary to diagnose and adequately treat Doege-Potter syndrome, a paraneoplastic syndrome observed in patients with solitary fibrous tumors. Solitary fibrous tumors can be characterized by specific histologic and immunohistochemical studies.
Conclusion:
This report describes the clinical workup of a patient presenting with hypoglycemia and a retroperitoneal tumor. This case is unique because of its presentation with severe, refractory hypoglycemia and the tumor's location in the retroperitoneum, given the majority of solitary fibrous tumors are found in the lungs originating from the pleura.