OpenMed/multicare-articles huggingface dataset:
Combined Approach of Cryoablation and Stent-In-Stent Technique for Removal of an Embedded Esophageal Stent
Authors: Madhuri Chandnani, Jonah Cohen, Tyler M Berzin
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Self-expanding removable stents are used for the treatment of esophageal strictures. Partially covered metal stents become embedded in the esophageal wall due to mucosal tissue reaction providing good anchorage. This can also lead to extreme difficulty in the removal of such stents. Several different individual techniques have been used in literature for removal of these esophageal stents. Ours is the first case using a combination of cryoablation and stent-in-stent technique for removal of an extremely difficult case of embedded esophageal stent.
Amiodarone Induced Thyrotoxicosis and Treatment Complications in a Man With Cyanotic Congenital Heart Disease: A Case Report
Authors: Marvin Wei Jie Chua, Shao Feng Mok
Journal: Front Cardiovasc Med (2020)
Keywords: amiodarone induced thyrotoxicosis, complications, cyanotic congenital heart disease, thyrotoxicosis, treatment
MeSH terms: Case Reports

Background and Case: Amiodarone induced thyrotoxicosis (AIT) is a potentially life-threatening condition that exists in two main subtypes - AIT Type 1 (AIT1) and AIT Type 2 (AIT2). AIT1 is a form of iodine-induced hyperthyroidism with increased thyroid hormone synthesis, while AIT2 is a form of destructive thyroiditis with increased release of pre-formed thyroid hormone. This case report describes a patient with cyanotic congenital heart disease, who developed AIT with severe biochemical thyrotoxicosis. Due to complications to corticosteroids and thionamides, second-line treatment with cholestyramine and lithium was given which eventually restored euthyroidism, averting the need for thyroidectomy and its associated risks. Due to the presence of both typical and unusual features, the final diagnosis of AIT2 could only be retrospectively elucidated after a prolonged clinical course. Conclusion: Corticosteroids are well-recognized to be the first-line treatment for AIT2. This case illustrates a rare phenomenon: successful treatment of AIT2 with lithium and cholestyramine. In patients who develop complications from first-line therapy, prompt treatment with alternative agents may successfully avert thyroidectomy and its associated risks.
Case Report: Mitral Valve Involvement and First-Degree Atrial-Ventricular Block in Two Patients With Multisystem Inflammatory Syndrome in Children
Authors: Paola Di Filippo, Massimiliano Raso, Marta Cacciatore, Roberta Patacchiola, Giulia Renda, Nadia Rossi, Francesco Chiarelli
Journal: Front Pediatr (2021)
Keywords: covid-19, mis-c multisystem inflammatory syndrome in children, sars–cov−2, child, heart involvement
MeSH terms: Case Reports

COVID-19 seems to be less frequent and severe in children compared to adults. Despite the very few symptoms usually found in children, great attention was recorded when in April 2020 a hyperinflammatory process in children with fever and multiorgan involvement after a paucisymptomatic COVID infection was reported. The United States Centers for Disease Control and the World Health Organization recognized and defined this syndrome as "Multisystem Inflammatory Syndrome in Children (MIS-C)." We describe two cases of MIS-C presenting with fever, cutaneous rash, and a mild cardiac involvement expressed with a transient mitral valve involvement and a first-degree atrioventricular block. Acute treatment was managed with intravenous immunoglobulin, oral aspirin, and intravenous corticosteroids reaching consequent good outcome. Clinical characteristics, treatment management, follow-up, and long-term evolution of children with MIS-C are still poorly defined. Further research is needed to better understand the pathogenesis of this newly described condition, to validate a high-level recommended therapy and a specific therapy tapering timings.
Do Primitive Neuroectodermal Tumors of the Kidney Have a Predilection for Inferior Vena Cava Involvement? A Case Series and Review of the Literature
Authors: Sovan Hota, Sidhartha Kalra, Lalgudi Narayanan Dorairajan, Ramanitharan Manikandan, Sreerag Kodakkattil Sreenivasan
Journal: J Kidney Cancer VHL (2020)
Keywords: ivc thrombus, pnet, immunohistochemistry, multimodality treatment, renal pnet, renal pelvis pnet
MeSH terms: Case Reports

The primitive neuroectodermal tumor (PNET) of the kidney is an extremely rare neoplasm, the diagnosis of which mainly depends upon histopathology, immunohistochemistry (IHC), and cytogenetics. A handful of cases reported in the literature mention about aggressive features of this neoplasm. The purpose of our study was to review our experience in not only the diagnosis and management of the patients with renal PNET but also to highlight its propensity to involve inferior vena cava (IVC) and also present a rare occurrence of Ewing's sarcoma (ES)/PNET of the renal pelvis. The clinical, operative, and histopathology records of four patients of renal PNET treated between January 2017 and December 2019 were reviewed and data analyzed concerning the available literature. Out of the four patients treated, two had level III and IV IVC thrombus, and one had dense desmoplastic adhesions with the IVC wall. One of the cases had a rare presentation of ES/PNET of the renal pelvis. All patients were managed surgically, while only one patient received adjuvant chemotherapy and following up with remission for the last 2 years and 4 months. On IHC, cluster of differentiation-99 (CD-99) was positive in all patients, and three were positive for Friend leukemia integration-1. PNET of the kidney is primarily an immunohistopathological diagnosis. This neoplasm has an increased propensity for the local invasion of surrounding structures. A multimodality approach with surgery, chemotherapy, and radiotherapy could offer better outcomes, although the prognosis of these tumors remains poor.
Using a New Landmark of the Most External Point in the Embolization of Distal Anterior Choroidal Aneurysms: A Report of Two Cases
Authors: Nai Zhang, Wen-Qiang Xin, Shu-Yuan Yue, Yue Zhong, Wei Wei, Xin-Yu Yang, Zi-Jun Wang, Fu-Shun Xiao
Journal: Front Neurol (2020)
Keywords: case report, distal anterior choroidal aneurysms, embolization, most external point, plexal point

There are landmarks on the course of the anterior choroidal artery (AChoA), such as the original point (OP) and the plexal point (PP), as documented in previous articles. In these previous articles, the AChoA was the terminal branch of the internal carotid artery (ICA), which had two segments throughout its course. The first cisternal segment began from the origin and ended at the point where the artery reached the choroidal fissure (the PP). The second segment consisted of one or more branches, which passed through the choroidal fissure and entered the choroid plexus. However, we found another angiographic landmark, named the most external point (MEP), along the course of the AChoA in the anteroposterior (AP) view. There was a sharp turn at the outermost limit of the course of the AChoA, and then the AChoA progressed inward and upward. We defined the outermost limit as the MEP of the AChoA. This study describes two rare cases of distal AChoA aneurysms associated with arteriovenous malformation (AVM) and Moyamoya disease that developed intraventricular hemorrhage, and we used the parent artery occlusion (PAO) technique to embolize the distal AChoA lesions at the MEP. The patients recovered well without any neurological complications.
Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings
Authors: Pawwan Kumar Kagitha, Srinivas Namineni, Abhinaya Reddy Tupalli, Santhosh Kumar Challa
Journal: Int J Clin Pediatr Dent (2016)
Keywords: agenesis, central incisor, concordance, hypodontia, siblings
MeSH terms: Case Reports

Concordance is an identical expression of phenotype in two related individuals. Concordance expression of hypodontia is an uncommon condition where associated individuals are affected with exactly similar kind and number of missing teeth. There is very limited documentation of this condition either in twins or in siblings, and literature shows paucity of data with regard to this anomaly. To the best of our knowledge, there is only one such case reported in the literature, which has actually showed similar missing lower central incisors in siblings. This report presents a case of two girl siblings aged 11 and 13 years with congenital bilateral missing of permanent mandibular central incisors, which is an absolute concordant condition. Apart from discussing etiology, clinical implications and management, this article highlights the significance of concordant and discordant condition of hypodontia and expression of this condition in twins and siblings. How to cite this article: Kagitha PK, Namineni S, Tupalli AR, Challa SK. Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings. Int J Clin Pediatr Dent 2016;9(1):74-77.
Absence of Rejection in a Facial Allograft Recipient with a Positive Flow Crossmatch 24 Months after Induction with Rabbit Anti-Thymocyte Globulin and Anti-CD20 Monoclonal Antibody
Authors: Bruce E Gelb, J Rodrigo Diaz-Siso, Natalie M Plana, Adam Jacoby, William J Rifkin, Kimberly S Khouri, Daniel J Ceradini, Eduardo D Rodriguez
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Background:
Donor-specific antibodies (DSA) to human leukocyte antigen increase the risk of accelerated rejection and allograft damage and reduce the likelihood of successful transplantation. Patients with full-thickness facial burns may benefit from facial allotransplantation. However, they are at a high risk of developing DSA due to standard features of their acute care.
Case presentation:
A 41-year-old male with severe disfigurement from facial burns consented to facial allotransplantation in 2014; panel reactive antibody score was 0%. In August of 2015, a suitable donor was found. Complement-dependent cytotoxicity crossmatch was negative; flow cytometry crossmatch was positive to donor B cells. An induction immunosuppression strategy consisting of rabbit antithymocyte globulin, rituximab, tacrolimus, mycophenolate mofetil (MMF), and methylprednisolone taper was designed. Total face, scalp, eyelid, ears, and skeletal subunit allotransplantation was performed without operative, immunological, or infectious complications. Maintenance immunosuppression consists of tacrolimus, MMF, and prednisone. As of posttransplant month 24, the patient has not developed acute rejection or metabolic or infectious complications.
Conclusions:
To our knowledge, this is the first report of targeted B cell agents used for induction immunosuppression in skin-containing vascularized composite tissue allotransplantation. A cautious approach is warranted, but early results are promising for reconstructive transplant candidates given the exceptionally high rate of acute rejection episodes, particularly in the first year, in this patient population.
Case report: Patient specific combination of surgery and immunotherapy in advanced squamous cell carcinoma of the head and neck - a case series and review of literature
Authors: Manuel Olmos, Rainer Lutz, Tjark-Ole Büntemeyer, Jacek Glajzer, Christopher-Philipp Nobis, Jutta Ries, Tobias Möst, Markus Eckstein, Markus Hecht, Antoniu-Oreste Gostian, Michael Erdmann, Yannick Foerster, Marco Kesting, Manuel Weber
Journal: Front Immunol (2022)
Keywords: cscc, hnscc, oscc, anti-pd 1, checkpoint inhibition, immunotherapy, neoadjuvant, salvage surgery
MeSH terms: Carcinoma, Squamous Cell / pathology, Carcinoma, Squamous Cell / surgery, Head and Neck Neoplasms / surgery, Skin Neoplasms, Review, Case Reports, Humans, Immunotherapy, Neoplasm Recurrence, Local / pathology, Squamous Cell Carcinoma of Head and Neck / therapy

Background:
Prognosis of patients with recurrent or metastatic head and neck cancer is generally poor. Adjuvant immunotherapy (IT) featuring immune checkpoint inhibition (ICI) is standard of care in advanced stage head and neck squamous cell carcinoma (HNSCC) and cutaneous squamous cell carcinoma (CSCC). ICI response rates in CSCC are described as higher than in HNSCC. IT is constantly shifting into earlier disease stages which confronts the surgeon with immunotherapeutically pre-treated patients. It is therefore becoming increasingly difficult to assess which patients with symptomatic tumor disease and a lack of curative surgical option might benefit from salvage surgery.
Case presentations:
The following 6 cases describe therapeutic decision-making regarding ICI and (salvage) surgery in patients with advanced stage HNSCC or CSCC. Cases A and B focus on neoadjuvant ICI followed by salvage surgery. In Cases C and D salvage surgery was performed after short-term stabilization with partial response to ICI. The last two cases (Cases E and F) address the surgical approach after failure of ICI. All cases are discussed in the context of the current study landscape and with focus on individual decision-making. For better understanding, a timetable of the clinical course is given for each case.
Conclusions:
ICI is rapidly expanding its frontiers into the neoadjuvant setting, frequently confronting the surgeon with heavily pretreated patients. Salvage surgery is a viable therapeutic concept despite the rise of systemic treatment options. Decision-making on surgical intervention in case of a salvage surgery remains an individual choice. For neoadjuvant ICI monitoring regarding pathological tumor response or tumor necrosis rate, we suggest correlation between the initial biopsy and the definite tumor resectate in order to increase its significance as a surrogate marker. Scheduling of neoadjuvant ICI should be further investigated, as recent studies indicate better outcomes with shorter time frames.
Pseudomyxoma Peritonei Originating from Transverse Colon Mucinous Adenocarcinoma: A Case Report and Literature Review
Authors: Yingbo Gong, Xin Wang, Zhi Zhu
Journal: Gastroenterol Res Pract (2020)

Background:
Pseudomyxoma peritonei (PMP) is a rare neoplasm involving the peritoneum. Most PMPs are low-grade appendicular mucinous neoplasms (LAMNs). There have been no reports of PMP originating from a transverse colonic mucinous adenocarcinoma and causing metastatic mucinous adenocarcinoma. Case Presentation. We report a 46-year-old woman who presented with a right abdominal mass of more than 4-month duration. Transverse colonic mucinous adenocarcinoma, PMP, and ovarian metastatic mucinous adenocarcinoma were diagnosed. The patient's diet was normal, and she had no abdominal pain or bloating. The abdomen mass increased in the month before treatment. After chemotherapy, the transverse colon mass and ovarian giant cyst were resected and about 2000 mL of gelatinous tumor tissue was removed. Postoperative histology confirmed PMP from the transverse colonic mucinous adenocarcinoma, ovarian metastatic mucinous adenocarcinoma, and mesocolon metastatic cancer. Multiple lung metastases appeared 8 months after surgery. The patient died 29 months after surgery because of an inability to eat and poor nutrition. A systematic literature review of the management and outcome of all known similar cases is also presented.
Conclusions:
This is the first report of PMP originating from a transverse colonic mucinous adenocarcinoma. It was diagnosed during resective surgery, involved ovarian metastasis, and survival was short. We did an extensive literature review in order to describe the clinical characteristics, histopathological findings, genetic profile, and potential treatments of PMP caused by nonappendiceal mucinous adenocarcinoma.
Rhino-orbito-cerebral mucormycosis (ROCM) with internal carotid artery stenosis in a diabetic patient with caries tooth and oroantral fistula
Authors: Kataveeranahally Shekar Manjunath, Santosh Shivaswamy, Jayashree Dattatraya Kulkarni, Raghavendra Kenkare Venkatachalaiah
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Mucormycosis is a rare, potentially fatal and opportunistic infection caused by fungi belonging to the order Mucorales. Rhinocerebral, gastrointestinal, pulmonary, cutaneous and disseminated are the different forms of mucormycosis. Rhinocerebral mucormycosis is the most common type and presents as a highly destructive infection in immunocompromised hosts, especially in patients with poorly controlled diabetes. The infection originates in the nasal mucosa owing to fungal inoculation and then spreads to the paranasal sinuses, orbits, orbital apex, cavernous sinuses and brain. Our patient was a 36-year-old female with poorly controlled diabetes who presented with orbital symptoms and signs, with very subtle involvement of the sinuses. She had stenosis of the entire left internal carotid artery, with multiple small infarcts in the left frontal and parietal lobes. She incidentally had tooth caries tooth with a periapical cyst and an oroantral fistula. Ours was a histopathologically proven case of rhino-orbito-cerebral mucormycosis.
Suspected COVID-19 mRNA Vaccine-Induced Postural Orthostatic Tachycardia Syndrome
Authors: Nicole Maharaj, Steven Swarath, Rajeev Seecheran, Valmiki Seecheran, Avidesh Panday, Naveen Seecheran
Journal: Cureus (2023)
Keywords: autonomic dysfunction, coronavirus disease 2019, covid-19, dysautonomia, mrna vaccine, pfizer-biontech, pfizer-biontech covid-19 vaccine, postural orthostatic tachycardia syndrome, postural orthostatic tachycardia syndrome (pots)
MeSH terms: Case Reports

We present a case of a 15-year-old South Asian male who developed suspected postural orthostatic tachycardia syndrome (POTS) two weeks after receiving the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine booster, which was successfully managed with low-dose fludrocortisone and ivabradine. Clinicians should be aware of the Pfizer-BioNTech COVID-19 vaccine being implicated with the onset of POTS.
Extramedullary hematopoiesis: an unusual finding in subdural hematomas
Authors: Rong Li, Vishnu V B Reddy, Cheryl Ann Palmer
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

We present a case of a 59-year-old man who was found to have clusters of hyperchromatic, small, round nucleated cells within a subdural hematoma removed after a skull fracture. Immunohistochemistry study confirmed that the cells were hematopoietic components predominantly composed of normoblasts. In this paper, we describe the clinical and pathological findings. A brief review of published information on extramedullary hematopoiesis in subdural hematoma and the mechanisms of pathogenesis are also discussed. While extramedullary hematopoiesis is seen anecdotally by neuropathologists in chronic subdural hematomas, only a few cases are documented in the literature. Furthermore, extramedullary hematopoiesis in subdural hematoma can pose a diagnostic challenge for general pathologists who encounter subdural hematoma evacuations seldom in their surgical pathology practices.
Acute Device-Related Thrombus after Watchman Device Implant
Authors: Muhammad Ajmal, Vijendra Swarup
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Atrial fibrillation is characterized by irregularly irregular heart rhythm with an increased morbidity and mortality. It is associated with an increased risk of thromboembolism due to formation of blood clot in the left atrium. Most of these blood clots are formed in the left atrial appendage. The risk of blood clot formation is reduced with the use of anticoagulants. The patients who cannot take anticoagulants due to an increased bleeding risk can undergo percutaneous left atrial appendage (LAA) closure. A Watchman device is used for this purpose. LAA closure with the Watchman device is associated with some adverse effects, and one of them is device-related thrombus. Currently, there are no specific guidelines for the management of device-related thrombus. We present a case of Watchman device-related thrombus which developed 16 hours after the device placement. We will also discuss various options for the management of acute thrombosis.
Kaposi Varicelliform Eruption in a Patient with Pemphigus Vulgaris: A Case Report and Review of the Literature
Authors: Bibisha Baaniya, Sudha Agrawal
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Haemorrhagic crusted lesions over pre-existing pemphigus vulgaris erosions should arouse suspicion of Kaposi varicelliform eruption (KVE). Immediate treatment with antivirals helps to prevent mortality and morbidities. Here, we report a case of a 67-year-old male who developed haemorrhagic crusted lesions on pre-existing pemphigus lesions during his hospital stay and obtained almost 90% resolution of cutaneous lesions of Pemphigus vulgaris as well as Kaposi varicelliform eruption within 2 weeks of acyclovir treatment along with the continuation of systemic steroids. We also highlight the review of the literature of other reported cases with its management.
Case Report: Potocki-Lupski Syndrome in Five Siblings
Authors: Alina Grama, Claudia Sîrbe, Diana Miclea, Simona Sorana Cǎinap, Delia Huniadi, Bogdan Bulata, Tudor Lucian Pop
Journal: Front Pediatr (2021)
Keywords: 17p112 duplication, potocki-lupski syndrome, children, cognitive delay, craniofacial dysmorphism, hypotonia
MeSH terms: Case Reports

Potocki-Lupski syndrome (PTLS) is a rare developmental disorder resulting from the partial duplication of the short arm of chromosome 17. Affected children may have hypotonia, facial dysmorphism, or neurological abnormalities. PTLS is also frequently associated with failure to thrive due to swallowing difficulties or growth hormone deficiency. We report the first Romanian family (a mother and her five children) diagnosed with PTLS (17p11.2 microduplication). Fortunately, they present a less severe form of the disease. The neurological manifestations (speech delay, mild intellectual disability) are associated with craniofacial dysmorphism (microcephaly, micrognathia, triangular face, broad forehead, long chin, prominent ears, dolichocephaly, down slanting palpebral fissures). The diagnostic was established using a multiplex ligation-dependent probe amplification technique (MLPA) test, which detected the duplication of three regions of the 17p11.2 chromosome (RAI1, DRC3-6, LLGL1-4RA). Children with PTLS have specific phenotypes (craniofacial dysmorphism or neurological manifestations), which must draw the pediatrician's attention to a possible genetic condition. However, every child with this disease is unique and may have a different clinical presentation. A multi-disciplinary team is needed for the management of these patients. The parent's counseling and genetic advice are essential for a family with children with PTLS.