OpenMed/multicare-articles huggingface dataset:
SIADH Induced by Pharyngeal Squamous Cell Carcinoma: Case Report and Literature Review
Authors: Hafiz Muhammad Sharjeel Arshad, Aleida Rodriguez, Faten Suhail
Journal: Case Rep Nephrol (2016)

Background. The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is considered to be the most common cause of euvolemic hyponatremia. The most common malignancy associated with SIADH is small cell lung cancer. We present a rare case of a patient with SIADH secondary to well differentiated squamous cell carcinoma of the naso-oropharynx. Case. A 46-year-old Caucasian woman presented to emergency department with four-week history of progressive dysphagia. On examination, she was found to have a pharyngeal mass. CT scan and MRI of neck confirmed a mass highly suspicious of carcinoma. Patient's serum sodium level decreased to 118 mEq/L and other labs including serum and urine osmolality confirmed SIADH. She was started on fluid restriction and oral sodium tablets which gradually improved her serum sodium levels. Biopsy confirmed diagnosis of squamous cell carcinoma of pharynx. Conclusion. SIADH can be caused by squamous cell carcinoma. Appropriate management includes fluid restriction.
Extramedullary plasmacytoma of the larynx: a case report of subglottic localization
Authors: Jaqueline Ramírez-Anguiano, Hugo Lara-Sánchez, Deborah Martínez-Baños, Braulio Martínez-Benítez
Journal: Case Rep Otolaryngol (2012)

Extramedullary plasmacytoma (EMP) is a rare neoplasm of plasma cells, described in soft tissue outside the bone marrow. EMP of the larynx represents 0.04 to 0.45% of malignant tumors of the larynx. A male of 57 years old presented with hoarseness, dyspnea, and biphasic stridor of 2 months. The indirect laryngoscopy (IL) revealed severe edema of the posterior commissure and a polypoid mass in the right posterior lateral subglottic wall. A biopsy of the subglottic mass was performed by a direct laryngoscopy (DL). The histopathologic diagnosis was EMP CD138+, therefore radiotherapy was given at 54 Gy in 30 sessions. The patient had an adequate postoperative clinical course and a new biopsy was performed having tumor-free margins. All laryngeal lesions should be biopsied prior to treatment to determine an accurate diagnosis to guide a proper management of the condition. Radiation therapy to the EMP is considered the treatment of choice, having local control rates of 80% to 100%. The subglottis is the least accessible area of view and the least frequent location of a laryngeal mass, nevertheless the otolaryngologist should always do a complete and systematic exam of the larynx when a tumor is suspected, to detect diagnoses such as a subglottic plasmacytoma.
Case report: Post-COVID new-onset neurocognitive decline with bilateral mesial-temporal hypometabolism in two previously healthy sisters
Authors: Fabrizio Cocciolillo, Daniela Pia Rosaria Chieffo, Alessandro Giordano, Valentina Arcangeli, Ilaria Lazzareschi, Rosa Morello, Giuseppe Zampino, Piero Valentini, Danilo Buonsenso
Journal: Front Pediatr (2023)
Keywords: covid-19, sars-cov-2, children, long covid, post-covid condition
MeSH terms: Case Reports

Background:
Long coronavirus disease (COVID) is increasingly recognized in adults and children; however, it is still poorly characterized from a clinical and diagnostic perspective, particularly in the younger populations.
Case presentation:
We described the story of two sisters-with high social and academic performance before their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-who reported severe neurocognitive problems, initially classified as psychologic pandemic distress and eventually found to have significant brain hypometabolism.
Conclusions:
We provided a detailed clinical presentation of neurocognitive symptoms in two sisters with long COVID associated with brain hypometabolism documented in both sisters. We believe that the evidence of objective findings in these children further supports the hypothesis that organic events cause persisting symptoms in a cohort of children after SARS-CoV-2 infection. Such findings highlight the importance of discovering diagnostics and therapeutics.
Necrotizing Fasciitis: A Life-threatening Complication of Intraoperative Electromyography
Authors: Alireza Shoakazemi, Marc Moisi, R Shane Tubbs, Mary Wingerson, Olaide Ajayi, Michael E Zwillman, Jourdan Gottlieb, David Hanscom
Journal: Cureus (2016)
Keywords: emg, intraoperative neurophysiological monitoring, necrotizing fasciitis, needle electrode infection, soft tissue infection, spine surgery
MeSH terms: Case Reports

Intraoperative neurophysiological monitoring is a commonly used practice during spine surgery. Complications of electromyography (EMG) needle electrode placement are very uncommon. We present a patient who was infected with necrotizing fasciitis in her left thigh due to an EMG needle electrode during a two-stage complex spine procedure. This case demonstrates that providers should continue to meticulously adhere to protocol when inserting and removing EMG needles, but also be cognizant during postoperative observation of the possibility of infection caused by EMG needles.
The Impact of COVID-19 on Criminal Investigations and Proceedings in Sweden - A Snapshot of Practitioners' Realities
Authors: Moa Lidén
Journal: Forensic Sci Int Synerg (2020)
Keywords: covid-19, crime, sweden

Since well-functioning criminal investigations and proceedings are crucial parts of a society governed by the rule of law, it is essential to understand whether and how they are impacted by the current COVID-19 pandemic. The Swedish context provides an interesting case study and comparison to developments in other countries which have introduced more far-reaching interventions such as lockdowns. In this study, Swedish practitioners (N =10), including police officers, forensic pathologists, prosecutors, defense counsels and judges, participated in an online survey in which they gave their views on the pandemic's impact on their work situations. The overall results show that the major impact was on their work methods, with transitions to using more online methods and increased remote working, while the smallest impact was noted in relation to work character, including crime and evidence types which have remained relatively constant. Forensic pathologists reported the largest impact on work quality, although there was large individual variation in their responses. On a general level, the practitioners perceived that the measures undertaken at their work places were relatively sufficient and also perceived of the risk of contracting or spreading the virus as relatively low but also this was associated with large individual variation. Given the small sample of practitioners and that practitioners' responses relate to an early stage of what is presumed to be a prolonged pandemic, replication as well as caution in interpreting the results are needed.
An Unusual Localization of Lunate in a Transcaphoid Volar Lunate Dislocation: Current Concepts
Authors: Grigorios Kastanis, George Velivasakis, Anna Pantouvaki, Manolis Spyrantis
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Perilunate dislocation and fracture dislocations are rare injuries corresponding to 10% of all carpal injuries. They usually come with high-energy trauma, with associated injuries representing 61%. Volar lunate dislocation or fracture-dislocation accounts for 3% of perilunate injuries. We present a case of a 42-year-old polytrauma male, transmitted to our department 48 hours after a car accident with a trans-scaphoid volar lunate dislocation. During operation, the lunate was displaced volarly to the ulnar side of the wrist, forward to the styloid process of the distal ulna, while the scaphoid fracture appeared at the waist with comminution, and the proximal pole of the scaphoid protruded under the dorsal capsule. Carpal injuries are often missed out in polytrauma patients, and these injuries are underestimated because of the severity of the other visceral or extremity lesions. Untreated or improperly treated, those injuries lead to serious morbidity and loss of function. Therefore, good functional prognosis with decreased percentage of complications can be achieved following early recognition and early open surgical ligamentous complex repair.
A rare case of congenital rhabdomyosarcoma with review of the literature
Authors: Gautam Bir Singh, Rubeena Arora, Deepak Kumar, Manjula Jain, Vandana Puri
Journal: Case Rep Otolaryngol (2013)

We present a rare case of rhabdomyosarcoma of lip in a neonate with multiple lesions within the head and necksub site hitherto unreported in the medical literature. This case report also reviews the scant medical literature on neonatal rhabdomyosarcoma.
The Youngest Case of Metachronous Bilateral Acinic Cell Carcinoma of the Parotid Gland: A Case Report and Literature Review
Authors: Raid Alhayaza, M Anas Dababo, Suresh Velagapudi
Journal: Case Rep Otolaryngol (2022)
MeSH terms: Case Reports

Introduction:
Acinic cell carcinoma (ACC) is a low-grade malignant salivary neoplasm that represents 17% of all salivary gland malignancies. It has a tendency to affect young individuals, especially females. ACC mainly originates in the parotid gland and has a potential for recurrence and metastases. Rarely, ACC can affect both parotid glands in a single individual. A bilateral ACC of the parotid gland could either present as a synchronous or a metachronous tumor. Case Report. Our patient is a 19-year-old female known case of ACC of the right parotid gland. The tumor was resected in December 2017. After 3 years, she presented with a left parotid pain and swelling, which raised the suspicion of a contralateral metachronous tumor of the left parotid gland. In September 30, 2020 we proceeded with ultrasound-guided fine needle aspiration of the left intraparotid lesion, and the results turned out to be consistent with ACC. Here, we report a case of a 19-year-old female presenting with metachronous bilateral ACC of the parotid gland with an interval of 3 years, which is the 6th of its kind in the literature and the youngest amongst them.
Conclusion:
Despite the rareness of metachronous occurrence of bilateral ACC of the parotid gland, it is still encountered in the medical practice. Here, we are highlighting the importance of follow-up with a periodic clinical and radiological examinations, bearing in mind the contralateral nonaffected parotid gland.
SARS-CoV-2 Infection and Active, Multiorgan, Severe cGVHD After HSCT for Adolescent ALL: More Luck Than Understanding? A Case Report
Authors: Natalia Zubarovskaya, Irene Hofer-Popow, Marco Idzko, Oskar A Haas, Anita Lawitschka
Journal: Front Pediatr (2022)
Keywords: covid-19, sars-cov-2, chronic graft vs host disease, immunodeficiency, stem cell transplantation
MeSH terms: Case Reports

Graft-vs. -host disease (GvHD) is a serious and complex immunological complication of haematopoietic stem cell transplantation (HSCT) and is associated with prolonged immunodeficiency and non-relapse mortality. Standard treatment of chronic GvHD comprises steroids in combination with other immunosuppressive agents. Extracorporeal photopheresis (ECP), with its immunomodulatory mechanism, is applied as part of steroid-sparing regimens for chronic GvHD. Immunocompromised, chronically ill patients are at particular risk of severe disease courses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. T-cell immunity in SARS-CoV-2 infection is well-described but the role of the humoral immune responses is not fully understood. This case report describes a moderate course of SARS-CoV-2 infection in a patient <9 months after HSCT who was suffering from active, severe, chronic GvHD treated with prednisone and ECP. Following HSCT from a matched unrelated donor to cure acute lymphoblastic leukaemia, the 25-year-old male patient experienced multiple infectious complications associated with cytopenia, B-cell dyshomeostasis and autoantibody production followed by development of severe chronic GvHD thereafter at day +212. The steroid-sparing treatment plan consisted of supportive care, topical treatment, prednisone and ECP. He was diagnosed with SARS-CoV-2 infection at day +252, experiencing loss of smell and taste as well as a cough. The patient's oxygen saturation was between 94 and 97% on room air, and computed tomography images showed evolution of typical of SARS-CoV-2 infiltrates. In addition to cytopenia and immune dyshomeostasis, laboratory tests confirmed macrophage activating syndrome, transaminitis and Epstein-Barr virus viraemia. At that time, anti-SARS-CoV-2 monoclonal antibodies were not available in Austria and remdesivir seemed contraindicated. Surprisingly, despite severe lymphopenia the patient developed SARS-CoV-2-specific antibodies within 15 days, which was followed by clearance of SARS-CoV-2 and EBV with resolution of symptoms. Thereafter, parameters of immune dysregulation such as lymphopenia and B-cell dyshomeostasis, the latter characterised by elevated CD21low B cells and autoantibody expression, normalised. Moreover, we observed complete response of active chronic GvHD to treatment.
Tuberculous peritonitis in a cerebral palsy patient: A challenge in diagnosis and management
Authors: Vorapatu Tangsirapat, Vichack Chakrapan Na Ayudhya, Panutchaya Kongon, Kobkool Chakrapan Na Ayudhya, Paiboon Sookpotarom, Paisarn Vejchapipat
Journal: Int J Surg Case Rep (2019)
Keywords: case report, cerebral palsy, peritonitis, tuberculous

Introduction:
Diagnosis of tuberculous peritonitis (TBP) in a normal person, although possible, is often difficult to make because of its non-specific symptoms and signs. However, establishing a diagnosis of TBP in a patient with cerebral palsy (CP) does not seem to be possible due to impaired mental development accompanied by communication problems.
Presentation of case:
A 19-year-old spastic man diagnosed with CP presented with fever and a nonverbal complaint of abdominal pain. The conditions were hard to evaluate due to his mental status. Abdominal radiography showed dilatation of both small and large bowels, and a subsequent computed tomography (CT) scan did not provide any additional information. With respect to a common suspected cause, a diagnosis of perforated appendicitis was established. However, at the theatre, there was only bowel dilatation with multiple small nodules at the serosa of small and large bowels. Postoperatively, polymerase chain reaction and culture revealed Mycobacterium tuberculosis, thereby leading to a diagnosis of TBP.
Discussion:
Due to spasticity caused by CP, on examination, the patient presented with board-like rigidity, from which a diagnosis of a surgical condition was established. The misdiagnosis of an acute abdomen situation had let the patient to undergo an unnecessary exploration. To our knowledge, there has not been a report of TBP in a CP patient.
Conclusion:
The diagnosis of TBP had been complicated by the presence of CP in the reported case. The underlying CP not only preclude the diagnosis of TBP, but also produced symptoms that mimicked a condition requiring surgery.
The Sigmoidal Pregnancy: A Rare Entity Complicated by an Inappropriate Medical Intervention
Authors: Antoine Naem, Baraa Ahmad, Bashar Al-Kurdy
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

The abdominal ectopic pregnancy is very rare and accounts for less than 1% of all ectopic gestations. Due to the lack of clinical suspicion, many obstetricians confuse it with other diseases and manage it inappropriately. Here, we are reporting the case of a 41-year-old woman that was referred to our hospital because of severe vaginal bleeding caused by multiple uterine perforations during the dilatation and curettage. Her medical history was significant for constipation and a misdiagnosis of incomplete abortion. Upon the surgical exploration, a big amount of blood clots was taken out, and a fetus with his placenta inserted into the sigmoid colon were observed. The uterus and the sigmoid colon were resected. Ultimately, the patient recovered uneventfully. To the best of our knowledge, this is the third case of pure sigmoidal pregnancy and the first one to reach an advanced gestational age.
Left side gallbladder with agenesis of right anterior sector and absence of right hepatic duct. A case report
Authors: Filippo Banchini, Ekerette Francis Ekpo, Luigi Conti, Patrizio Capelli
Journal: Int J Surg Case Rep (2019)
Keywords: agenesis, anomaly, biliary, gallbladder, left gallbladder, liver

Introduction:
Left sided gallbladder is a rare congenital abnormality more often discovered as incidental finding during laparoscopic cholecystectomy requiring surgical challenge to prevent complication. We present a case of a true left sided gallbladder treated with laparoscopic cholecystectomy.
Case:
A 90 y/o woman with acute abdominal pain was hospitalised and underwent a laparoscopic cholecystectomy. A preoperative CT scan didn't show the variation. Intraoperative finding revealed a true left sided gallbladder that was carefully dissected at the Calot's triangle with identification of the cystic duct and artery. After a complete separation of the gallbladder from the liver, the cystic duct and the artery were safely clipped and transected. CT scan reconstruction reveal agenesis of the right superior sector with simultaneous absence of the right biliary duct.
Discussion:
True left sided gallbladder is defined as one attached in the left of the ligamentum teres and falciform ligament. This abnormality predispose to a numerous anatomical variation. Unfortunately its finding is more often incidentally during intervention and recognition of such variation could be difficult that can be of high risk for surgical injury.
Conclusion:
Left sided gallbladder presents a significant challenge to the surgeon and makes it even more difficult to avoid postoperative complications. Therefore, a careful dissection of Calot's triangle and the complete mobilisation of the gallbladder should be done before clipping the cystic duct and artery. However, if a preoperative finding suggests a left sided gallbladder, then an in-depth preoperative anatomical study is advocated.
Oral Local Anesthesia Successfully Ameliorated Neuropathic Pain in an Upper Limb Suggesting Pain Alleviation through Neural Plasticity within the Central Nervous System: A Case Report
Authors: Jun Hozumi, Masahiko Sumitani, Arito Yozu, Toshiya Tomioka, Hiroshi Sekiyama, Satoru Miyauchi, Yoshitsugu Yamada
Journal: Anesthesiol Res Pract (2011)
MeSH terms: Case Reports

Neural blockades are considered an alternative to pharmacotherapy for neuropathic pain although these blockades elicit limited effects. We encountered a patient with postbrachial plexus avulsion injury pain, which was refractory to conventional treatments but disappeared temporarily with the administration of the local anesthetic lidocaine around the left mandibular molar tooth during dental treatments. This analgesic effect on neuropathic pain by oral local anesthesia was reproducible. Under conditions of neuropathic pain, cerebral somatotopic reorganization in the sensorimotor cortices of the brain has been observed. Either expansion or shrinkage of the somatotopic representation of a deafferentated body part correlates with the degree of neuropathic pain. In our case, administration of an oral local anesthetic shrank the somatotopic representation of the mouth, which is next to the upper limb representation and thereby expanded the upper limb representation in a normal manner. Consequently, oral local anesthesia improved the pain in the upper limb. This case suggests that pain alleviation through neural plasticity within the brain is related to neural blockade.
Acceleration of puberty during growth hormone therapy in a child with septo-optic dysplasia
Authors: Gönül Catlı, Ayça Altıncık, Ahmet Anık, Korcan Demir, Handan Güleryüz, Ayhan Abacı, Ece Böber
Journal: J Clin Res Pediatr Endocrinol (2014)
MeSH terms: Human Growth Hormone / therapeutic use, Hypothyroidism / chemically induced, Puberty, Precocious / chemically induced, Septo-Optic Dysplasia / drug therapy, Case Reports, Child, Female, Humans, Recombinant Proteins / therapeutic use, Septo-Optic Dysplasia / complications, Sexual Maturation, Thyroxine, Recombinant Proteins, Human Growth Hormone, Thyroxine

Septo-optic dysplasia (SOD) is a heterogeneous disorder of the central nervous system characterized by various endocrinological and neurological findings. It is a complex disease caused by a combination of genetic and environmental factors. Herein, we report the case of a 5.5-year-old girl who presented with short stature and strabismus. Ophthalmological examination revealed bilateral optic nerve hypoplasia. Ectopic posterior pituitary and bilateral optic hypoplasia were detected on brain magnetic resonance imaging. The presence of bilateral optic nerve hypoplasia and hypopituitarism led to the diagnosis of SOD. An abated growth hormone (GH) response was found in the GH stimulation test and GH replacement therapy was initiated. At the end of the first year of clinical follow-up, secondary hypothyroidism was detected and L-thyroxine was added to the treatment. At the age of 8.25 years, thelarche was noted and 6 months later, the patient presented with menarche. At this time, the bone age was 12 years and the basal luteinizing hormone level was 7 mIU/mL. These findings indicated acceleration in the process of pubertal development. We report this case (i) to emphasize the need to investigate hypopituitarism in cases with bilateral optic nerve hypoplasia and (ii) to draw attention to the fact that during the follow-up of SOD cases receiving GH therapy, inappropriate acceleration of growth velocity and rapid improvement in bone age may be predictive of central precocious puberty development.
Herpes Simplex Viral Encephalitis Masquerading as a Classic Left MCA Stroke
Authors: Peter A Abdelmalik, Timothy Ambrose, Rodney Bell
Journal: Case Rep Neurol Med (2015)

Objective. Stroke is a clinical diagnosis, with a history and physical examination significant for acute onset focal neurological symptoms and signs, often occurring in patients with known vascular risk factors and is frequently confirmed radiographically. Case Report. A 79-year-old right-handed woman, with a past medical history of hypertension, hyperlipidemia, and prior transient ischemic attack (TIA), presented with acute onset global aphasia and right hemiparesis, in the absence of fever or prodrome. This was initially diagnosed as a proximal left middle cerebral artery (MCA) stroke. However, CT perfusion failed to show evidence of reduced blood volume, and CT angiogram did not show evidence of a proximal vessel occlusion. Furthermore, MRI brain did not demonstrate any areas of restricted diffusion. EEG demonstrated left temporal periodic lateralized epileptiform discharges (PLEDs). The patient was empirically loaded with a bolus valproic acid and started on acyclovir, both intravenously. CSF examination demonstrated a pleocytosis and PCR confirmed the diagnosis of herpes simplex viral encephalitis (HSVE). Conclusions. HSVE classically presents in a nonspecific fashion with fever, headache, and altered mental status. However, acute focal neurological signs, mimicking stroke, are possible. A high degree of suspicion is required to institute appropriate therapy and decrease morbidity and mortality associated with HSVE.