OpenMed/multicare-articles huggingface dataset:
Neuroimaging Features of Optic Nerve Hemangioblastoma Identified by Conventional and Advanced Magnetic Resonance Techniques: A Case Report and Literature Review
Authors: Meihan Duan, Lie Yang, Jun Kang, Renzhi Wang, Hui You, Ming Feng
Journal: Front Oncol (2021)
Keywords: angiography, apparent diffusion coefficient (adc), diffusion-weighted imaging (dwi), edema, magnetic resonance imaging (mri), neuroimaging, optic nerve hemangioblastoma
MeSH terms: Case Reports

Optic nerve hemangioblastoma is a very rare benign tumor with only 39 reported cases by now. It appears to be hyperintense on T2-weighted images with a significant enhancement on contrast scans, which are similar to glioma and meningioma. Due to the lack of specificity in MRI manifestations, optic nerve hemangioblastoma is often misdiagnosed. To provide new insights into differential diagnosis of optic nerve hemangioblastoma, we report for the first time an optic nerve hemangioblastoma case employing advanced magnetic resonance techniques including diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) maps, and magnetic resonance angiography (MRA). In addition, we have collected all reported optic nerve hemangioblastoma cases and reviewed their neuroimaging findings by MRI and angiography. Our results show that solid-type tumor is the dominant form of optic nerve hemangioblastoma and extensive edema is widely observed. These findings are surprisingly contrary to manifestations of cerebellar hemangioblastoma. Besides the structural features, quantitative indexes including ADC and relative cerebral blood volume (rCBV) ratio, which are significantly elevated in cerebellar hemangioblastoma, may also shed a light on the preoperative diagnosis of hemangioblastoma of optic nerve. Finally, we discuss the critical neuroimaging features in the differential diagnosis between optic nerve hemangioblastoma from optic pathway glioma and optic nerve sheath meningioma.
Inflammatory choroidal neovascular membrane after healed tuberculous choroidal granuloma
Authors: Sikander A K Lodhi, Khadija Saifuddin, Santhosh Devulapally
Journal: GMS Ophthalmol Cases (2017)
Keywords: cnvm, bevacizumab, choroidal granuloma, exudative retinal detachment, tuberculosis
MeSH terms: Case Reports

Objective: To present a case of choroidal granuloma masquerading as intraocular tumor that healed on anti-tuberculous treatment but led to the development of inflammatory choroidal neovascular membrane (CNVM). Method: A 42-year-old female patient with past history of hysterectomy presented with diminution of vision in the right eye. Fundus examination in the right eye showed a yellowish white choroidal mass with associated bullous retinal detachment superotemporal to fovea. Left eye fundus was normal. Fundus flourescein angiography showed early and late hyperflourescence with late pooling in serous detachments. Complete systemic evaluation did not yield a clue to diagnosis. Positron emission tomography scan (PET scan) showed enlarged lymph nodes in cervical, mediastinal and peritoneal regions. Lymph node biopsy showed caseating granulomas. Results: The granuloma subsided and a scar formed 5 months after starting anti-tuberculous treatment with improvement in vision. Six months later, the vision deteriorated again with the development of a choroidal neovascular membrane (CNVM) at the margin of the scar. The CNVM resolved and all the signs of activity subsided after giving intravitreal antivascular endothelial growth factor (anti-VEGF) injections. Conclusions: Making a diagnosis of tuberculous granuloma in a case of choroidal mass lesion is a challenge. PET scan helps in identifying metabolically active lymph nodes appropriate for biopsy. Healed scars of tuberculous choroid lesions should be followed closely to detect the development of CNVM.
Case Report: Regulatory T Cell-Independent Induction of Remission in a Patient With Collagenous Colitis
Authors: Hajime Honjo, Tomohiro Watanabe, Mizuki Tomooka, Takuya Matsubara, Masashi Kono, Ikue Sekai, Akane Hara, Masayuki Kurimoto, Keisuke Yoshikawa, Yasuhiro Masuta, Yasuo Otsuka, Ryutaro Takada, Tomoe Yoshikawa, Ken Kamata, Kosuke Minaga, Shigenaga Matsui, Masatomo Kimura, Masatoshi Kudo
Journal: Front Med (Lausanne) (2021)
Keywords: cd8+ t cells, foxp3, collagenous colitis, immunohistochemistry, regulatory t cells
MeSH terms: Case Reports

Collagenous colitis (CC), a prototypical microscopic colitis, is a chronic inflammatory disorder of the colon. The diagnosis of CC depends on the pathological examination. The colonic mucosa of patients with CC is characterized by the presence of a substantially thickened collagen band (>10μm) under the surface epithelium. In addition, intraepithelial and lamina propria lymphocytes are markedly increased in patients with CC. However, the roles played by the lymphocytes accumulating in the colonic mucosa of patients with CC are poorly defined. Recent studies indicate that T cells infiltrating the colonic mucosa of patients with CC are mainly represented by CD4+ T cells, CD8+ T cells, and forkhead box P3 (FOXP3)+ regulatory T cells (Tregs). Given that activation of CD4+/CD8+ T cells and FOXP3+ Tregs usually mediates pro-inflammatory and anti-inflammatory responses, respectively, alterations in the colonic numbers of these adaptive T cells might be related to the resolution of colitis in patients with CC. We determined alterations in the composition of colonic T cells by extensive immunohistochemical (IHC) analyses in a case of CC successfully treated with budesonide and metronidazole. Colonic lamina propria immune cells mainly comprised CD3+ T cells, CD4+ T cells, CD8+ T cells, CD68+ macrophages, and FOXP3+ Tregs, but not CD20+ B cells or myeloperoxidase (MPO)+ granulocytes in the active phase. During remission, the numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD68+ macrophages did not change significantly in the colonic lamina propria, whereas FOXP3+ Tregs were markedly decreased, suggesting that induction of remission was achieved in a Treg-independent manner. Thus, our study indicates that accumulation of FOXP3+ Tregs in the colonic mucosa of patients with CC might be a counter-regulatory mechanism reflecting persistent inflammation and that induction of remission might be achieved without activation of Tregs.
Case Report: Levetiracetam causing acute liver failure complicating post-operative management in a neurosurgical patient
Authors: Sharanya Jayashankar, Sunil Munakomi, Vignesh Sayeerajan, Prakash Kafle, Pramod Chaudhary, Jagdishchandra Thingujam, Deepak Poudel, Iype Cherian
Journal: F1000Res (2019)
Keywords: levetiracetam, anti-epileptics, hepatotoxicity
MeSH terms: Anticonvulsants / adverse effects, Levetiracetam / adverse effects, Liver Failure, Acute / chemically induced, Case Reports, Humans, Male, Middle Aged, Neurosurgical Procedures, Seizures / prevention & control, Anticonvulsants, Levetiracetam

Background: Herein we report a rare case of acute liver failure due to levetiracetam, which has been considered to have an excellent safety profile with minimal hepatic side effects. Case presentation: A 55-year-old male patient presenting with sudden onset dizziness, slurring of speech and headache was operated for posterior fossa cerebellar hematoma. His post-surgical period was complicated by development of icterus with elevation of liver enzymes. After ruling out common inciting factors, it was decided to stop levetiracetam which was given prophylactically for preventing seizures owing to presence of external ventricular drain. From the next day patient had dramatic improvement in liver functions and sensorium. Conclusions: We would like to highlight this side effect that is potentially life threatening, though rare, of levetiracetam, which is very commonly used in today's practice and fast superseding all other time-tested antiepileptics.
Added Value of Dual-Energy CT in COVID-19 Pneumopathy
Authors: Louis Deprez, Yves-Gauthier Boulanger, Julien Guiot
Journal: J Belg Soc Radiol (2021)
Keywords: covid-19, chest, dual-energy scanner, infectious diseases, pneumonia, pulmonary embolism, viral
MeSH terms: Case Reports

Teaching point: The use of dual-energy instead of conventional single-energy computed tomography pulmonary angiogram can provide additional value concerning the diagnosis of COVID-19 and its complications, especially in the detection of small pulmonary embolism.
When the Uterus Competes for Perfusion: Management of a Pregnant Patient with Bypass Graft Occlusion
Authors: Sarah McGriff, Paige Percer, Iberia Sosa, Hector Mendez-Figueroa, Joseph L Mills, Manisha Gandhi
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts.
Case:
A woman presented with increasing left lower extremity pain at 18 weeks of gestation with a complex history of PAD and a previous bifurcated aorta-left femoral, -right iliac bypass. CT angiogram demonstrated known occluded bypass graft. A multidisciplinary team of providers developed guidelines for potential surgical intervention based upon clinical symptoms.
Conclusion:
Pelvic PAD can worsen in pregnancy in the setting of the enlarging uterus, which can potentially deplete perfusion of existing collateral vessels. Symptomatic approach to worsening disease provided an effective management strategy in this case.
A novel variant of COL6A3 c.6817-2(IVS27)A>G causing Bethlem myopathy: A case report
Authors: Maohua Li, Jiandi Huang, Min Liu, Chunmei Duan, Hong Guo, Xiaoyan Chen, Yue Wang
Journal: Front Neurol (2023)
Keywords: bethlem myopathy, col6-rd, col6a3, muscle mri, muscular dystrophy
MeSH terms: Case Reports

Bethlem myopathy (BM) is a disease that is caused by mutations in the collagen VI genes. It is a mildly progressive disease characterized by proximal muscle weakness and contracture of the fingers, the wrist, the elbow, and the ankle. BM is an autosomal dominant inheritance that is mainly caused by dominant COL6A1, COL6A2, or COL6A3 mutations. However, a few cases of collagen VI mutations with bilateral facial weakness and Beevor's sign have also been reported. This study presents a 50-year-old female patient with symptoms of facial weakness beginning in childhood and with the slow progression of the disease with age. At the age of 30 years, the patient presented with asymmetrical proximal muscle weakness, and the neurological examination revealed bilateral facial weakness and a positive Beevor's sign. Phosphocreatine kinase was slightly elevated with electromyography showing myopathic changes and magnetic resonance imaging (MRI) of the lower limb muscles showing the muscle MRI associated with collagen VI (COL6)-related myopathy (COL6-RM). The whole-genome sequencing technology identified the heterozygous mutation c.6817-2(IVS27)A>G in the COL6A3 gene, which was in itself a novel mutation. The present study reports yet another case of BM, which is caused by the recessive COL6A3 intron variation, widening the clinical spectrum and genetic heterogeneity of BM.
Systemic Therapy for Microsatellite Instability Small Bowel Adenocarcinoma With Mesenteric Vascular Embolism as Initial Symptom: A Case Report
Authors: Zhongyi Dong, Xiang Xia, Zizhen Zhang
Journal: Front Med (Lausanne) (2021)
Keywords: case reports, immune checkpoint inhibitor, intestinal cancers, mesenteric vascular occlusion, palliative care
MeSH terms: Case Reports

Background: Small bowel adenocarcinoma are relatively rare tumors of the digestive system. Due to the lack of specific screening methods, patients are often diagnosed at an advanced stage. At present, there is no specific surgical guidance and chemotherapy regimen for small bowel adenocarcinoma. Here, we report a rare small bowel adenocarcinoma case with mesenteric vascular embolization and microsatellite instability, in which palliative surgery combined with chemotherapy and anti-Programmed cell death protein 1(PD-1) therapy resulted in complete remission. Case Presentation: The patient was a 55-year-old man who was admitted for suspected small bowel adenocarcinoma combined with incomplete ileus, mesenteric vascular occlusion and distant metastasis. We performed palliative surgery to remove adenocarcinoma as well as relieve obstruction. Then according to the pathological and immunohistochemical results (Stage IV and microsatellite instability), we used XELOX regimen combined with anti-PD-1 therapy. In last 2 years follow up, this patient achieved complete remission. Conclusions: The possibility of small intestinal tumor should be considered in patients with mesenteric vascular obstruction. PD-1 blockade is an effective therapy for small bowel adenocarcinoma with microsatellite instability.
Orbital cellulits following cataract surgery under peribulbar anaesthesia
Authors: Chandoshi Mukherjee, Arijit Mitra, Bushra Mushtaq
Journal: GMS Ophthalmol Cases (2015)
Keywords: complication, orbital cellulitis, peribulbar anaesthesia
MeSH terms: Case Reports

Introduction:
Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection.
Case description:
An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr anaesthesia, with soreness, swelling and reduced visual acuity (6/18) in the operated eye. On initial presentation periorbital swelling was noted, the eye was minimally tender, intraocular pressure was raised at 28 mHg and fundoscopy was limited due to a hazy cornea. The patient was discharged on topical medication with a diagnosis of allergic reaction to postoperative drops. The following day, the patient re-presented with worsening orbital swelling involving the left cheek. Ocular findings remained unchanged. CT scan revealed left orbit soft tissue swelling and a locule of air medial to the medial rectus. There were no signs of sinus infection or periosteal inflammation. A diagnosis of left orbital and facial cellulitis was made and the patient was treated with intravenous antibiotics.
Discussion:
Our patient did not have any predisposing risk factors, therefore most likely cause of cellulitis is surgical trauma during administration of the peribulbar block. This case illustrates the need for adequate skin preparation before the administration of peribulbar anaesthesia and minimal tissue trauma during the procedure.
"Bailout" Endovascular Treatment of Acute Aortic Occlusion
Authors: Konstantinos Tigkiropoulos, Kyriakos Stavridis, Ioannis Lazaridis, Nikolaos Saratzis
Journal: Case Rep Vasc Med (2018)
MeSH terms: Case Reports

A 37-year-old man who had a recent history of acute myocardial infarction (AMI) 3 months ago presented to the emergency department with acute ischemia of lower limbs. A CT aortography was performed, where left ventricle thrombi and acute thromboembolic occlusion of aortoiliac bifurcation were depicted. He was urgently transferred to the operation theatre, where Fogarty embolectomy was initially unsuccessful. He was managed by primary deployment of balloon expandable (BE) covered stents in the aortic bifurcation followed by thrombectomy of the left ventricle (LV) under extracorporeal circulation by cardiothoracic surgeons 2 days after initial operation. He was discharged in good general condition after 20 days under warfarin and aspirin therapy.
Diabetic cheiroarthropathy: a case report and review of the literature
Authors: Rabia Cherqaoui, Sheldon McKenzie, Gail Nunlee-Bland
Journal: Case Rep Endocrinol (2013)

Diabetes mellitus is associated with a wide variety of rheumatologic manifestations which can significantly affect a patient's quality of life. One of these manifestations includes diabetic cheiroarthropathy (DCA) which affects the hands. We review a case of a 28-year-old female patient with type 1 diabetes mellitus who was diagnosed with DCA after complaining of limited movements of all joints in her hands and tightening of the skin. We examine how the diagnosis was made, the treatment administered, and the successful clinical outcome. Clinicians should be able to identify and treat this affliction. The diagnosis is mainly clinical. It is imperative to remember that the presence of DCA carries with it a significant relationship with microvascular disease.
Chikungunya Fever in Traveler from Angola to Japan, 2016
Authors: Saho Takaya, Satoshi Kutsuna, Eri Nakayama, Satoshi Taniguchi, Shigeru Tajima, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Yasuyuki Kato, Shuzo Kanagawa, Norio Ohmagari
Journal: Emerg Infect Dis (2017)
Keywords: africa, angola, arboviruses, chikungunya fever, viruses, yellow fever
MeSH terms: Chikungunya Fever / diagnosis, Chikungunya virus / genetics, Phylogeny, Viral Envelope Proteins / genetics, Case Reports, Letter, Angola, Chikungunya Fever / transmission, Chikungunya Fever / virology, Chikungunya virus / classification, Chikungunya virus / isolation & purification, Female, Gene Expression, Humans, Japan, Travel, Young Adult, Viral Envelope Proteins

Simultaneous circulation of multiple arboviruses presents diagnostic challenges. In May 2016, chikungunya fever was diagnosed in a traveler from Angola to Japan. Travel history, incubation period, and phylogenetic analysis indicated probable infection acquisition in Angola, where a yellow fever outbreak is ongoing. Thus, local transmission of chikungunya virus probably also occurs in Angola.
Fungating Breast Wound: A Rare Manifestation of Primary Breast Leiomyosarcoma
Authors: Catarina Osório, Egon F Rodrigues, Mariana Santos, Teresa Santos, Mário Nora
Journal: Cureus (2023)
Keywords: best supportive care, breast cancer, breast leiomyosarcoma, fungating breast wound, metastatic
MeSH terms: Case Reports

Leiomyosarcomas are the least frequent primary breast sarcomas, making it an extraordinarily rare malignancy. The clinical manifestation of this entity as a fungating breast wound is, on its own, highly unusual in developed nations, mainly due to the improvement of worldwide screening programs and easier access to health care. Management of this breast wound remains challenging, and an accurate histopathological diagnosis is essential for a proper treatment plan. Thus, we present this rare case of metastatic breast leiomyosarcoma to contribute to the scarce literature regarding this disease.
Complicated Infective Endocarditis Limited to a Chiari Network
Authors: Olufolahan Carrena, Oluchukwu Oluoha, Amr Wahba, Derek Eshun, Maria Endsley, Henry Okafor
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Introduction:
The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain.
Case summary:
A 61-year-old man was admitted with a 2-month history of hemoptysis, pleuritic chest pain, and right upper extremity numbness and weakness. He was found to have multifocal bilateral pulmonary opacities and an abscess collection in the brain. Blood cultures grew Streptococcus intermedius and transthoracic echocardiogram (TTE) was normal. Subsequent transesophageal echocardiogram (TEE) revealed an 8.3 × 4.6 mm vegetation arising from the Chiari network, close to the right atrial appendage, without involvement of the tricuspid valve or any of the other valves. There were no atrial or ventricular septal defects. He was treated with appropriate antibiotics with improvement of symptoms. Repeat imaging showed improvement of the lung opacities, but not the brain abscess, warranting transfer to another hospital for neurosurgical intervention.
Conclusion:
The diagnosis and management of isolated Chiari network endocarditis require a high index of clinical suspicion. A multidisciplinary approach incorporating both medical and surgical approaches where necessary is essential for optimal outcome.
False Negativity of Tc-99m Labeled Sodium Phytate Bone Marrow Imaging Under the Effect of G-CSF Prescription in Aplastic Anemia: A Case Report
Authors: Akanganyira Kasenene, Aju Baidya, Chang-Yin Wang, Hai-Bo Xu
Journal: Asia Ocean J Nucl Med Biol (2019)
Keywords: aplastic anemia, bone marrow imaging, g-csf, spect
MeSH terms: Case Reports

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine which controls the differentiation and growth of hematopoietic cells in the bone marrow. We report a severe aplastic anemia (SAA) patient with false-negative 99mTc sodium phytate bone marrow imaging findings under concurrent G-CSF therapy. The first bone marrow imaging showed a normal bone marrow activity. However, the bone marrow biopsy pathology report revealed a lack of hematopoietic cells. Furthermore, the complete blood count indicated severe pancytopenia resulting in the diagnosis of aplastic anemia (AA). A second marrow scan implemented after the stoppage of G-CSF showed an abnormal bone marrow activity, which matched the pathology reports. Accordingly, the concurrent administration of G-CSF was considered as the cause of false-negative bone marrow imaging findings obtained in the first scan. Consequently, it should be kept in mind that a 99mTc sodium phytate bone marrow scintigraphy during the concurrent administration of G-CSF may lead to the achievement of false negative results because it induces changes in bone marrow mimicking a normal marrow scan in patients with AA.
Rare MLL-ELL fusion transcripts in childhood acute myeloid leukemia-association with young age and myeloid sarcomas?
Authors: Ioannis Panagopoulos, Ludmila Gorunova, Gitte Kerndrup, Signe Spetalen, Anne Tierens, Liv T N Osnes, Kristin Andersen, Lil-Sofie Ording Müller, Marit Hellebostad, Bernward Zeller, Sverre Heim
Journal: Exp Hematol Oncol (2016)
Keywords: acute myeloid leukemia, chromosomal translocation, ell, fusion gene, mll, myeloid sarcoma, rna-sequencing, t(11, 19)(q23, p13)
MeSH terms: Case Reports

Background:
The chromosomal translocation t(11;19)(q23;p13) with a breakpoint within subband 19p13.1 is found mainly in acute myeloid leukemia (AML) and results in the MLL-ELL fusion gene. Variations in the structure of MLL-ELL seem to influence the leukemogenic potency of the fusion in vivo and may lie behind differences in clinical features. The number of cases reported so far is very limited and the addition of more information about MLL-ELL variants is essential if the possible clinical significance of rare fusions is to be determined.
Case presentation:
Cytogenetic and molecular genetic analyses were done on the bone marrow cells of a 20-month-old boy with an unusual form of myelomonocytic AML with multiple myeloid sarcomas infiltrating bone and soft tissues. The G-banding analysis together with FISH yielded the karyotype 47,XY, +6,t(8;19;11)(q24;p13;q23). FISH analysis also demonstrated that MLL was split. RNA-sequencing showed that the translocation had generated an MLL-ELL chimera in which exon 9 of MLL (nt 4241 in sequence with accession number NM_005933.3) was fused to exon 6 of ELL (nt 817 in sequence with accession number NM_006532.3). RT-PCR together with Sanger sequencing verified the presence of the above-mentioned fusion transcript.
Conclusions:
Based on our findings and information on a few previously reported patients, we speculate that young age, myelomonoblastic AML, and the presence of extramedullary disease may be typical of children with rare MLL-ELL fusion transcripts.