OpenMed/multicare-articles huggingface dataset:
Case Report: Rare occurrence of Pseudomonas aeruginosa osteomyelitis of the right clavicle in a patient with IgA nephropathy
Authors: Aishwarya Damodaran, Anusha Rohit, Georgi Abraham, Sanjeev Nair, Anand Yuvaraj
Journal: F1000Res (2014)

We describe the case of a 47 year old patient with proven primary IgA nephropathy who presented with osteomyelitis of the medial end of the right clavicle. The patient was not on immunosuppressive medications. He underwent aspiration curettage and CT scan of the clavicle which yielded pus that grew Pseudomonas aeruginosa. Following treatment with appropriate antibiotic therapy the patient presented a complete recovery of the lesion with no loss of renal function. This case highlights the importance of positive cultures in the choice of the appropriate therapy in an extremely rare case of an immunocompetent patient with osteomyelitis of the clavicle.
Large Enterolith Complicating a Meckel Diverticulum Causing Obstructive Ileus in an Adolescent Male Patient
Authors: Constantinos Nastos, Dimitrios Giannoulopoulos, Ioannis Georgopoulos, Christos Salakos, Dionysios Dellaportas, Ioannis Papaconstantinou, Theodosios Theodosopoulos, Georgios Polymeneas
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

We present a unique case of a 16-year-old male patient who was eventually diagnosed with a large enterolith arising from a Meckel's diverticulum. The enterolith had caused intermittent intestinal symptoms for three years before resulting in small bowel obstruction requiring surgical intervention. Meckel's enterolith ileus is very rare with only few cases described in the literature. To our knowledge, this is only the second case of Meckel's enterolith which had caused intermittent symptoms over a period of time, before resulting in ileus, and the first case where the intermittent symptoms lasted several years before bowel obstruction. The patient had been evaluated with colonoscopy, computerized tomography (CT), and magnetic resonance imaging enterography (MRIE); a calcified pelvic mass had been found, but no further diagnosis other than calcification was established. The patient presented at our emergency department, with symptoms of obstructive ileus and underwent exploratory laparotomy, where a large enterolith arising from a Meckel's diverticulum (MD) was identified, causing the obstruction. A successful partial enterectomy, enterolith removal, and primary end-to-end anastomosis took place; the patient was permanently relieved from his long-standing symptoms. Consequently, complications of Meckel's diverticulum and enterolithiasis have to be included in the differential diagnosis of abdominal complaints.
Herniation of the broad ligament… And the other side?
Authors: J Zemour, X Coueffe, H Fagot
Journal: Int J Surg Case Rep (2019)
Keywords: broad ligament, case report, internal hernia, small bowel obstruction

Introduction:
Broad ligament herniation is a very uncommon cause of small bowel obstruction. Surgery permits reduction of the hernia and closure of the defect to prevent recurrence.
Presentation of case:
We report a rare case of a 35 year old woman admitted in our hospital for recurrence of a small-bowel obstruction, secondary to internal hernia. The patient underwent intestinal resection in 2018 for herniated left broad ligament of the uterus strangulated. This time, the computed tomography revealed a double junctional syndrome with ileal dilation localized in right side of uterus. Emergency surgery confirmed internal hernia with passage of ileal loops through the right broad ligament. After reduction of the hernia, closure of the defect was performed to prevent recurrence. For the first time, a check of other classic abdominal hernias was carried out.
Discussion:
Internal hernias are responsible for less than 5% of mechanical bowel obstruction. Broad ligament hernias represent only 4-7% of these hernias. The diagnosis is often delayed, because of its rarity and lack of surgical history. Surgery confirms the diagnosis, treats the occlusion and prevents recurrence. The presence of several internal hernias has never been studied and no recommendation has been made on this topic.
Conclusion:
This case demonstrate the importance of a systematic exploration of other internal abdominal hernias during the surgery, especially a contralateral broad ligament hernia.
Wooden Penetrating Pelvic Trauma Passing the Foramen Ischiadicum
Authors: Benedikt Ruben Abel, Heinz-Lothar Meyer, Roman Müller, Katharina Henze, Marcel Dudda, Max Daniel Kauther
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We describe the case of a 45-year-old woman who suffered an impalement injury of the pelvis with penetration of the sciatic foramen by a wooden foreign body. Following a single operation, the injury healed without complications or infection. We have taken this as an opportunity to describe the case and our standard procedure in more detail.
Nodular Calcification in Saphenous Vein Graft Successfully Treated by Percutaneous Coronary Intervention
Authors: Ko Yamamoto, Masahiro Natsuaki, Takeshi Serikawa, Masanori Okabe, Yusuke Yamamoto
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Nodular calcification is sometimes detected in the native coronary artery. However, it is very rare to find in a saphenous vein graft (SVG). We herein report a rare case of stable angina pectoris (AP) due to nodular calcification. A 75-year-old man who had previously undergone coronary artery bypass grafting was admitted to our hospital due to stable AP. On angiography, significant stenosis was detected in the proximal SVG. Based on the findings of coronary angiography and optical coherence tomography, a red thrombus was suspected at the culprit lesion. However, nodular calcification was also suspected, as there were calcifications around the lesion. As intravascular ultrasound showed the protruding calcification, which we judged to be a nodular calcification, the calcified SVG lesion was successfully treated by percutaneous coronary intervention without any complications. Nodular calcification should be considered as a potential cause of AP, even when located in a SVG.
Clinical and MRI manifestations of nitrous oxide induced vitamin B12 deficiency: A case report
Authors: Anahid Safari, Farhad Emadi, Elham Jamali, Afshin Borhani-Haghighi
Journal: Iran J Neurol (2013)
Keywords: ataxia, general anesthesia, nitrous oxide, spinal cord, vitamin b12 deficiency
MeSH terms: Case Reports

A 50 year-old man was referred with history of acute ataxia and lower extremity paresthesia 10 days after general anesthesia with nitrous oxide. Cervical MRI showed long hypersignal lesion in posterior segment of the cord. Blood analysis revealed vitamin B12 deficiency. Nitrous oxide-induced myelopathy should be considered in patients who develop acute neurological manifestation after general anesthesia. It is recommended for physicians to think about symptoms and signs of B12 deficiency when evaluating patients in postoperative visits.
Acral Eruptive Syringoma: An Unusual Presentation with Misdiagnosis
Authors: Fatemeh Mohaghegh, Akramsadat Amiri, Farahnaz Fatemi Naeini, Parvin Rajabi, Maryam Soltan
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Eruptive syringoma is a rare variant of syringoma presenting with skin-colored or slightly pigmented papules mostly before or during puberty. In this report, we presented a rare case of eruptive syringoma in a 30-year-old woman. She exhibited multiple skin lesions in dorsal areas of her both hands, developed from the age of 15.
X-linked dominant chondrodysplasia punctata with severe phenotype in a female fetus: A case report
Authors: Yan Liu, Li Wang, Bin Xu, Yike Yang, Dan Shan, Qingqing Wu
Journal: Medicine (Baltimore) (2019)
MeSH terms: Chondrodysplasia Punctata / diagnosis, Case Reports, Chondrodysplasia Punctata / genetics, Female, Humans, Phenotype, Pregnancy, Ultrasonography, Prenatal

Rationale:
X-linked dominant chondrodysplasia punctata type 2 (CDPX2) is a condition involving facial, skin, and skeletal dysplasia as a result of a mutation in emopamil binding protein (EBP). It usually presents with mild symptoms in female patients but is fatal in male patients.
Patient concerns:
A fetus was diagnosed with asymmetrical short limbs and a narrow and small thorax by prenatal ultrasound examination at 24+5 weeks gestation. The pregnancy was terminated at 27 weeks of gestation; gross examination, postnatal X-ray and, whole exome analysis were performed to clarify the diagnosis.
Diagnosis:
A provisional diagnosis of fatal skeletal dysplasia was given and the definite diagnosis of CDPX2 was based on postnatal X-ray and genetic testing of the aborted fetus.
Intervention:
The pregnancy was terminated at 27 weeks' gestation after a fetal ultrasound indicated a severe abnormal phenotype.
Outcomes:
Whole exome analysis of aborted tissue confirmed EBP mutation in this case. Unlike most case reports, this female patient presented a severe phenotype that was considered to be related to X-chromosome inactivation.
Lessons:
Chondrodysplasia punctata (CDP) should be considered if prenatal ultrasound shows high punctuate echoes at the metaphysis of long bones and asymmetrical short lower limbs. Postnatal X-ray and measurement of sterol levels in the amniotic fluid may aid in the diagnosis of CDP, but the condition can be confirmed with genetic testing of a blood sample or aborted tissue after delivery.
Inverted takotsubo cardiomyopathy induced by dobutamine stress echocardiography with atypical presentation
Authors: Christian Cadeddu, Silvio Nocco, Fabio Cadeddu, Martino Deidda, Pierpaolo Bassareo, Alessandra Serra, Mario Piga, Giuseppe Mercuro
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

A 48-year-old woman was scheduled by our lab to perform a standard dobutamine/atropine stress echocardiogram. During the test, the patient referred to a slight chest discomfort and developed a progressive left ventricle akinesia of all midbasal LV segments, thus mimicking a midbasal ballooning. ECG persisted without significant abnormalities and with no raise of Troponin I. Coronary angiography showed normal coronary arteries and ventriculography a severe EF reduction and apical hypercontractility. Echocardiography showed a progressive improvement with a complete recovery 48 hours later. This is a rare case of inverted takotsubo syndrome induced by dobutamine stress echocardiography that occurred with atypical presentation.
Natural History of Invasive Papillary Breast Carcinoma Followed for 10 Years: A Case Report and Literature Review
Authors: Yong Joon Suh, Hyukjai Shin, Tae Jung Kwon
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Diachronic research on untreated breast cancer completely depends on past medical records when no more recent, advanced methods are available. Herein, we report a case of invasive papillary breast carcinoma followed for 10 years in a 59-year-old woman who refused any treatment. The diagnosis was based on core needle biopsies. At the patient's first visit in July 2006, the tumor measured 10.4 × 7.2 × 3.5 cm. It was staged as IIIB (T4bN1). In May 2016, the tumor was staged as IIIC (T4bN3a). In the past 10 years, the tumor has increased to 12.1 × 9.0 × 4.2 cm. However, a whole-body bone scan and 18F-FDG PET/CT showed no evidence of distant metastasis. Immunohistochemistry results, corresponding to biopsies taken at subsequent examinations, have remained unaltered since 2006. The tumor was estrogen/progesterone receptor-positive and C-erbB2 expression was not detected. The Ki-67 labeling index was around 10%.
ORAL HAIRY POLYP IN A TEENAGER: CASE REPORT AND LITERATURE REVIEW
Authors: Vinícius Gonçalves de Souza, Damilys Joelly Souza Santos, Thalía Rissa Silva, Mathias Rezende Macedo, Tatiana Santos Araújo, Aparecida de Lourdes Carvalho, Ludimila Paula Vaz Cardoso, Carla Silva Siqueira Miranda
Journal: Rev Paul Pediatr (2020)
MeSH terms: Mouth / pathology, Polyps / diagnosis, Polyps / surgery, Tongue / pathology, Case Reports, Review, Adult, Aftercare, Biopsy, Child, Choristoma / diagnosis, Dermoid Cyst / diagnosis, Diagnosis, Differential, Humans, Infant, Infant, Newborn, Male, Middle Aged, Polyps / congenital, Polyps / pathology, Teratoma / diagnosis, Treatment Outcome

Objective:
To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease.
Case description:
A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP.
Comments:
Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.
Monitoring of central venous pressure and stroke volume variation in a case with a ruptured brain arteriovenous malformation and Fontan circulation
Authors: Toshiyuki Nakanishi, Kazuyoshi Ishida, Kiyotaka Shiramoto, Mishiya Matsumoto
Journal: JA Clin Rep (2017)
Keywords: central venous pressure, fluid resuscitation, fontan circulation, hypoplastic left heart syndrome, stroke volume variation

Background:
Patients with complex congenital heart disease increasingly undergo noncardiac surgeries because of advancements in surgical techniques and medical management. In Fontan circulation, maintaining an adequate transpulmonary gradient is essential for preserving both pulmonary blood flow and cardiac output. However, intraoperative circulatory monitoring of Fontan patients has not been established.
Case presentation:
A 17-year-old girl required an emergency craniotomy for ruptured arteriovenous malformation. She had a surgical history of bidirectional Glenn operation and Fontan palliation for her congenital hypoplastic left heart syndrome and double outlet right ventricle. We performed general anesthesia with continuous monitoring of central venous pressure (CVP) and stroke volume variation (SVV). Transesophageal echocardiography was not conducted because of difficulty in manipulating the probe due to the patient's position and surgical setting. After incision of the dura, approximately 1700 ml of rapid blood loss from the arteriovenous malformation was observed in 30 min. In this period, CVP decreased from 15 to 5 mmHg or less. In contrast, there was only a slight rise in SVV from 5 to 8%. We rapidly administered fluid and then transfused blood, and CVP gradually recovered to 10-15 mmHg. During the surgery, circulatory collapse was not observed. The patient was transferred to the intensive care unit under sedation and controlled ventilation.
Conclusions:
CVP decreased sharply, whereas SVV rose only slightly during acute bleeding in the present case. CVP monitoring may have been useful for the management of an acute bleeding case with a Fontan circulation but SVV may not have been reliable. As more patients with a Fontan circulation undergo noncardiac surgeries, appropriate circulatory monitoring in these patients should be further investigated.
A Case Presentation: Decidualized Endometrioma Mimicking Ovarian Cancer during Pregnancy
Authors: Aybike Tazegül, Ozlem Seçilmiş Kerimoğlu, Feyza Nur Incesu, Nasuh Utku Doğan, Setenay Arzu Yılmaz, Cetin Celik
Journal: Case Rep Obstet Gynecol (2013)

During pregnancy, masses that are larger than 5 cm and appearing in the Doppler ultrasonography as having increased blood flow, echoes of heterogeneous density, and containing solid components are suspicious for malignancy; however, differential diagnosis of decidualized endometriomas should also be considered. The patient was an 8 weeks pregnant primigravida. The ultrasonographic evaluation showed a cystic mass of size 65 × 57 mm in the left ovary that was well circumscribed, heterogeneous, with highly dense internal echo, and containing a solid component of size 8 × 14 mm. In the 12th week, the ultrasonographic examination revealed an increase in the size of the mass and increased arterial blood flow in the mass. The patient underwent surgery. It was observed that both ovaries were adherent in the Douglas pouch and that the left ovary contained an endometrioma of size 8cm. While the capsule was being peeled, lesions of soft density, with irregular surfaces, and with adhesion in the Douglas pouch were observed. The results of the frozen section revealed decidualized endometrioma and decidual structures. Even in pregnant women when adnexal masses are encountered and the ultrasonography, Doppler, MRI, and CA 125 level analysis still do not favor endometriosis, decidualized endometrioma should be considered in the differential diagnosis.
The combined effect of cranial-nerve non-invasive neuromodulation with high-intensity physiotherapy on gait and balance in a patient with cerebellar degeneration: a case report
Authors: Andisheh Bastani, L Eduardo Cofré Lizama, Maryam Zoghi, Grant Blashki, Stephen Davis, Andrew H Kaye, Fary Khan, Mary P Galea
Journal: Cerebellum Ataxias (2018)
Keywords: neuroplasticity, portable neuromodulation stimulator, stroke, tongue stimulator
MeSH terms: Case Reports

Background:
Cranial-nerve non-invasive neuromodulation (CN-NINM) using the portable neuromodulation stimulator (PoNS™) device has been proposed as a novel adjuvant intervention to improve efficacy of gait and balance. This device modulates input and output signals during motor tasks which prompts neuroplastic changes. In this study, we investigated the efficacy of physiotherapy using the PoNS™ in a case with cerebellar degeneration.
Case presentation:
The PoNS™ was used during a high-intensity physiotherapy programme delivered over 2 weeks (2 × 1.5 h sessions daily). Clinical and instrumented gait and balance tests were applied pre- and post-intervention.
Results:
The patient improved in all tests without any adverse effects.
Conclusion:
This study showed the efficacy and feasibility of combined high-intensity physiotherapy and CN-NINM for gait and balance rehabilitation. Further studies should explore CN-NINM effects in larger and more diverse samples of neurological patients.
Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia
Authors: Stephen E Langabeer, Rehman Faryal, Michael O'Dwyer, Sorcha Ní Loingsigh
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

The introduction of tyrosine kinase inhibitors (TKI) has revolutionised the management of patients with chronic myeloid leukemia (CML) over the last twenty years, but despite significant improvements in survival, patients exhibit long-term side effects that impact on quality of life. A major advance in CML management has been the ability to discontinue TKI therapy achieving a treatment-free remission (TFR), yet this option is only available to eligible patients who present with low-risk disease and who subsequently attain deep and sustained molecular responses. A case is described of a patient with CML who self-initiated stopping of TKI therapy when in a less than optimal molecular remission. Despite this action, the patient continues to experience a TFR with prospective close molecular monitoring performed. It is emphasized that this approach may lead to ineffective treatment discontinuation, molecular relapse, and increased patient anxiety. As TFR for patients with CML moves from clinical trials into routine clinical practice, emphasis is placed on adherence to (evolving) guidelines critical to ensure optimal counselling, selection, monitoring, and continued management of patients whether TFR is successful or not.
Osteoblastoma of the os capitatum
Authors: Cağrı Kaptan, Halil Atmaca
Journal: Case Rep Orthop (2014)

An osteoblastoma is a primary benign bone tumor, which is rarely seen in hand bones. Osteoblastoma is generally seen in spine, pelvis, and long bones. However, there are a few case reports of osteoblastoma in wrist and hand bones. To our knowledge, up to now, only one male patient with osteoblastoma in capitate bone was reported. We report the first female case of osteoblastoma of capitate bone and discuss diagnosis and treatment.
Successful Imatinib Treatment for Systemic Mastocytosis Associated With Myelodysplastic/Myeloproliferative Neoplasm: Report of a Case and Literature Review
Authors: Enrico Barozzi, Cristina Bucelli, Federica Irene Grifoni, Umberto Gianelli, Alessandra Iurlo, Daniele Cattaneo
Journal: Front Oncol (2022)
Keywords: mds/mpn, sm-ahn, imatinib, myeloid neoplasms, systemic mastocytosis
MeSH terms: Case Reports

Systemic mastocytosis (SM) is a heterogeneous disease characterized by the expansion of mast cells in one or more tissues, frequently characterized by the presence of KITD816V mutation. The updated World Health Organization (WHO) classification of myeloid neoplasms recognizes SM with an associated hematological neoplasm (SM-AHN) as a new subtype among the others, which is depicted by the coexistence of SM with another hematological clonal disease. Prognosis is very different among SM patients, while its treatment, although highly personalized, is still challenging. Here we report a case of KITD816V-unmutated SM associated with MDS/MPN successfully treated with imatinib.