OpenMed/multicare-articles huggingface dataset:
Case Report: Upper limb dysfunction may be caused by chest wall mass excision: An enlightenment from a special case
Authors: Ping-Shang Wu, Ling Yuan, Dan Xiong, Yan-Hong Gao, Luan Xiang
Journal: Front Oncol (2022)
Keywords: axilla, case report, lymph node, schwannoma, surgery trap, surgical excision
MeSH terms: Case Reports

Of all the thoracic surgical procedures, chest wall surgery is probably the lowest-risk type. In fact, it is not so. Clinical work also often has the trap of chest wall surgery. An operation to remove a mass in the axilla may result in upper limb disability on the affected side. Here, we report the case of a 47-year-old female patient with a left chest wall adjacent axillary mass, which was considered an abnormal structural lymph node on color ultrasound examination and chest CT. Otherwise, she felt no discomfort. The left upper limb moved freely without being affected by the mass. A routine resection of the tumor was performed after the preoperative examination was completed. After the operation, the incision recovered well. However, the day after the surgery, she developed numbness and pain in her left little finger and ring finger, pain that often kept her from sleeping. The mass was confirmed to be a schwannoma with cystic degeneration by pathology slicing after the operation. By this time, doctors were alerted to the fact that the removal of the chest wall mass had nearly disabled the left upper limb of the patient, which was a great warning to the thoracic surgeon. In this case report, we hope that all surgeons will be cautious and careful and will not trust the imaging diagnosis too much. It is also hoped that the patient understands that some procedures may lead to unexpected complications.
Metastatic Papillary Thyroid Carcinoma with Multifocal Synchronous Transformation to Anaplastic Thyroid Carcinoma
Authors: Mark Benedict, Jose Costa
Journal: Case Rep Pathol (2016)

Papillary thyroid carcinoma is a common malignancy to affect the thyroid and is typified by a nonaggressive nature and low rates of mortality. In contrast, anaplastic thyroid carcinoma is the most aggressive thyroid malignancy with a mortality rate of nearly 90% and survival typically of only six months after the diagnosis is made. The transformation of papillary thyroid carcinoma to anaplastic thyroid carcinoma is well documented in the literature but is uncommon and in most instances is reported as a case report or small series only. Transformation of papillary thyroid carcinoma to anaplastic thyroid carcinoma usually takes place in the thyroid itself or in the adjacent lymph nodes. Only on rare occasions does a transformation occur in a papillary thyroid carcinoma metastasis outside of these locations. In the present case report and subsequent discussion we highlight an unusual case of PTC with transformation to anaplastic thyroid carcinoma, which is shown to involve numerous locations to include near total lung parenchyma obliteration. We also discuss the differential diagnostic challenges when faced with a thyroid malignancy that is negative for thyroglobulin.
Topical Nitric Acid Burns: Initial Assessment and Management
Authors: Asmaa Laanaya, Mehdi Ami Ali, Amal Miqdadi, Mostapha Noussair, Mourad Nafaa, Lahcen Belyamani
Journal: Case Rep Dermatol Med (2023)
MeSH terms: Case Reports

Nitric acid (NA) is corrosive. On contact with the skin, liquid splashes with nitric acid and may produce severe burns. These burns usually take on a characteristic yellowish hue. We report the case of a 54-year-old man presenting a nitric acid burn with a pathognomonic skin lesion and perfect healing. NA is a chemical that is important in industry, and it is a very strong acid that is used for engraving, metal refining, electroplating, and fertilizer manufacturing. Skin contact with NA leads to severe burns. The pathophysiology depends on the type of concentration, the strength, quality, and duration of contact, and the penetration power of the acids concerned. The early and abundant irrigation with water or sterile isotonic saline solution, the use of panthenol-containing creams and covering with silver sulphadiazine dressing, carefully monitoring wounds, keeping wounds clean and moist, and preventing and managing secondary infection allow the healing.
Sudden Cardiac Death: The Most Feared but Potentially Preventable Presentation of Wolff-Parkinson-White Syndrome
Authors: Ana Rita Pereira, Alexandra Briosa, Rita Miranda, Sofia Sequeira Almeida, Luís Brandão, Hélder Pereira
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Background. Wolff-Parkinson-White syndrome is an uncommon cardiac disorder characterized by the presence of one or more accessory pathways that predispose patients to frequent episodes of arrhythmias. The prognosis is usually good, but there is a lifetime risk of malignant arrhythmias and sudden cardiac death. Case Summary. A 25-year-old male presented a witnessed out-of-hospital cardiac arrest with ventricular fibrillation rhythm. Due to rapid initiation of prehospital advanced life support, return of spontaneous circulation was observed. During the transport to the hospital, an irregular wide complex tachycardia suggestive of preexcited atrial fibrillation with haemodynamic instability was also observed and a synchronized shock was applied. Baseline 12-lead electrocardiogram was compatible with sinus rhythm and ventricular preexcitation pattern. After clinical stabilization, an electrophysiological study was performed confirming the presence of a left anterolateral accessory pathway with a short antegrade effective refractory period. Successful radiofrequency catheter ablation was achieved. Discussion. The reported clinical case recalls fundamental features of the Wolff-Parkinson-White syndrome and outlines the increasing evidence and importance of the invasive risk stratification and even catheter ablation in asymptomatic patients who suffer from this uncommon disease that may have a dramatic and fatal initial clinical manifestation.
COVID-19-induced multisystem inflammatory syndrome in a child with Wilson disease: a case report
Authors: Tawhida Yassin Abdel-Ghaffar, Haidy Mohammed Zakaria, Eman Mohamed Elsayed, Sondos Magdy, Suzan El Naghi, Suhaib Alsayed Mohammed Naeem, Mahmoud Yosry Hasan, Rabab Qasim Khallaf
Journal: Egypt Liver J (2022)
Keywords: covid-19, mis-c, multiorgan failure, wilson’s disease
MeSH terms: Case Reports

Background:
Infection with coronavirus disease 2019 (COVID-19) can progress to the multisystem inflammatory syndrome in children (MIS-C). Patients with liver cirrhosis are at increased risk of complications.
Case presentation:
We report on a 13-year-old Wilson's disease patient who was referred for liver transplantation because of rapid deterioration in his hepatic condition. After admission, he developed fever, respiratory distress, coronary arteries dilatation on echocardiography, laboratory evidence of inflammation, and positive severe acute respiratory syndrome coronavirus (SARS-CoV-2) PCR. SARS-CoV-2-induced MIS-C was diagnosed. Inspite of aggressive management of MIS-C, progressive deterioration of the respiratory, liver, kidney, and cardiac functions occurred and he passed away.
Conclusion:
MIS-C is a serious possible complication leading to multiorgan failure and higher death rate especially in cirrhotic children. So, early diagnosis and management with higher level of care by a multidisciplinary team are warranted.
Coronary Artery Fistula Diagnosed by Echocardiography during NSTEMI: Case Report and Review of Literature
Authors: Angelo Acitelli, Sabrina Bencivenga, Maria B Giannico, Chiara Lanzillo, Luciano Maresca, Renata Petroni, Maria Penco, Leonardo Calò, Silvio Romano
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Coronary artery fistulas are rare abnormal connections between a coronary artery and a cardiac chamber or a major vessel. Often, they are asymptomatic and the diagnosis is accidental. The case we present is the incidental finding of a fistula displayed with echocardiography during acute coronary syndrome (ACS). A 73-year-old man presented in the emergency room for non-ST-elevation ACS. Echocardiogram showed in a parasternal short axis view an abnormal diastolic flow inside the ventricular inferior wall. Angiography and CT confirmed the diagnosis of coronary fistula from the right coronary into the left ventricular cavity. A literature analysis with discussion about coronary fistulas classification and management was also performed.
Relapsing De Novo Membranous Nephropathy
Authors: Ala Ali, Huda Al-Taee, Thaer J Kadhim
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Allograft membranous glomerulopathy can be a recurrent or de novo disease. Both instead have different underlying immune pathophysiology and disease pattern. While the introduction of ANTI-PLAR2 and THS7A brought new insights into the management of Immune/primary MN, the treatment of de novo MN is not clear. Relapsing de novo MN in a kidney transplant was rarely reported. Here, we present a case of relapsing de novo MN without evidence of rejection and a gratifying response to rituximab.
Multiple Myeloma of the Central Nervous System: 13 Cases and Review of the Literature
Authors: Gergely Varga, Gábor Mikala, László Gopcsa, Zoltán Csukly, Sarolta Kollai, György Balázs, Tímár Botond, Nikolett Wohner, Laura Horváth, Gergely Szombath, Péter Farkas, Tamás Masszi
Journal: J Oncol (2018)
MeSH terms: Review

Central nervous system involvement is a rare complication of multiple myeloma with extremely poor prognosis as it usually fails to respond to therapy. We present 13 cases diagnosed at two centers in Budapest and review the current literature. The majority of our cases presented with high-risk features initially; two had plasma cell leukemia. Repeated genetic tests showed clonal evolution in 3 cases. Treatments varied according to the era, and efficacy was poor as generally reported in the literature. Only one patient is currently alive, with 3-month follow-up, and the patient responded to daratumumab-based treatment. Recent case reports show promising effectivity of pomalidomide and marizomib.
Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review
Authors: Vijay Gayam, Amrendra Kumar Mandal, Pavani Garlapati, Mazin Khalid, Arshpal Gill, Khalid Mowyad
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Recurrent acute pancreatitis secondary to hypertriglyceridemia (HTG) with levels below 1000 mg/dL has been rarely reported in the literature. HTG is the third most common cause of acute pancreatitis and has been established in the literature as a risk factor when levels are greater than 1000 mg/dL. A 43-year-old patient presented to the hospital with severe epigastric abdominal pain. Initial laboratory investigations were significant for a lipase level of 4143 U/L and a triglyceride level of 600 mg/dL. Computed tomography (CT) of the abdomen showed diffuse enlargement of the pancreas consistent with pancreatitis. A diagnosis of severe acute pancreatitis secondary to high triglycerides was made based on the revised Atlanta classification 2012. The patient was initially managed with intravenous boluses of normal saline followed by continuous insulin infusion. Diabetic Ketoacidosis (DKA) was ruled out due to a past medical history of diabetes. Her clinical course was complicated by acute respiratory distress syndrome requiring intubation and mechanical ventilation. During the course, she improved symptomatically and was extubated. She was started on nasogastric feeding initially and subsequently switched to oral diet as tolerated. After initial management of HTG with insulin infusion, oral gemfibrozil was started for long-term treatment of HTG. Emerging literature implicates HTG as an independent indicator of poor prognosis in acute pancreatitis (AP). Despite the paucity of data, the risk of developing AP must be considered even at triglyceride levels lower than 1000 mg/dL.
Nontyphi Salmonella Empyema with Bronchopleural Fistula in a Patient with Human Immunodeficiency Virus
Authors: Douglas Bretzing, Tasnim Lat, Andrew Shakespeare, Mary Lee, Salim Surani, Shekhar Ghamande
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Patients with human immunodeficiency virus (HIV) have an increased risk of inoculation with nontyphoid Salmonella compared to the general population. While nontyphoid Salmonella commonly manifests as gastroenteritis, Salmonella bacteremia can be seen in patients with HIV. We present a case of disseminated Salmonellosis in a patient with HIV complicated by bronchopleural fistula and secondary empyema. Case Presentation. A 40-year-old African American male with HIV noncompliant with HAART therapy presented with complaints of generalized weakness, weight loss, cough, night sweats, and nonbloody, watery diarrhea of four weeks' duration. A computed tomography (CT) scan demonstrated a bilobed large, thick-walled cavitary lesion in the right upper lobe communicating with the pleural space to form a bronchopleural fistula. Thoracentesis yielded growth of nontyphi Salmonella species consistent with empyema; he was treated with intravenous Ceftriaxone and underwent placement of chest tube for drainage of empyema with instillation of alteplase/dornase twice daily for three days. Repeat CT chest showed a hydropneumothorax. The patient subsequently underwent video-assisted thoracoscopy with decortication. The patient continued to improve and follow-up CT chest demonstrated improved loculated right pneumothorax with resolution of the right bronchopleural fistula and resolution of the cavitary lesions. Discussion. We describe one of the few cases of development of bronchopulmonary fistula and the formation of empyema in the setting of disseminated Salmonella. Empyema complicated by bronchopulmonary fistula likely led to failure of intrapleural fibrinolytic therapy and the patient ultimately required decortication in addition to antibiotics. While Salmonella bacteremia can be seen in immunocompromised patients, extraintestinal manifestations of Salmonella infection such as empyema and bronchopleural fistulas are uncommon. Bronchopleural fistulas most commonly occur as a postoperative complication of pulmonary resection. Conclusions. This case highlights the unusual pulmonary manifestations that can occur due to disseminated Salmonella in an immunocompromised patient as well as complex management decisions related to these complications.
An oblique muscle hematoma as a rare cause of severe abdominal pain: a case report
Authors: Masanori Shimodaira, Tomohiro Kitano, Minoru Kibata, Kumiko Shirahata
Journal: BMC Res Notes (2013)
MeSH terms: Abdominal Pain / etiology, Hematoma / diagnosis, Muscle, Skeletal / pathology, Case Reports, Abdominal Pain / diagnostic imaging, Adult, Hematoma / complications, Humans, Male, Tomography, X-Ray Computed, Ultrasonography

Background:
Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They are more common in elderly individuals, particularly in those under anticoagulant therapy. Most abdominal wall hematomas occur in the rectus sheath, and hematomas within the oblique muscle are very rare and are poorly described in the literature. Here we report the case of an oblique muscle hematoma in a middle-aged patient who was not under anticoagulant therapy.
Case presentation:
A 42-year-old Japanese man presented with a painful, enlarging, lateral abdominal wall mass, which appeared after playing baseball. Abdominal computed tomography and ultrasonography showed a large soft tissue mass located in the patient's left internal oblique muscle. A diagnosis of a lateral oblique muscle hematoma was made and the patient was treated conservatively.
Conclusion:
Physicians should consider an oblique muscle hematoma during the initial differential diagnosis of pain in the lateral abdominal wall even in the absence of anticoagulant therapy or trauma.
Ligament Reconstruction for Recurrent Anterior Dislocation of the Radial Head
Authors: Taku Hatta, Kiyotsugu Shinagawa, Kou Hayashi, Kazushige Hasegawa, Yoshinori Miyasaka, Nobuyuki Yamamoto, Eiji Itoi
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Isolated recurrent dislocation of the radial head (RH) is very rare, and there have been few reports describing the surgical treatment of this injury. We herein report the case of a 13-year-old girl who underwent ligament reconstruction surgery for isolated recurrent RH dislocation. Her symptoms included pain and apprehension at the elbow with the forearm in supination. A radiologic examination revealed anterior dislocation of the RH with the forearm in supination but complete reduction with the forearm in neutral to pronated positions. Surgical treatment to reconstruct the annular ligament and facilitate the radial collateral ligament was performed using an autograft with internal brace augmentation. At a 12-month follow-up examination, the patient had asymptomatic stability with recovery to sports activities. This case report describes a novel technique for the treatment of a rare pathological condition of the elbow.
Five-Year Recall after Treatment of External Cervical Resorption
Authors: Fahd A Aljarbou
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The management of external cervical resorption can be challenging. This study described a two-step procedure for the treatment of external cervical resorption. It involved nonsurgical root canal treatment and a dental amalgam core buildup, followed by a surgical approach to restore the root structure using resin-modified glass ionomer (Geristore®). The patient was recalled for a period of five years, and the overall outcome was successful.
Greenberg Skeletal Dysplasia: first reported case in the Democratic Republic of Congo
Authors: Toni Kasole Lubala, Nina Lubala, Arthur Ndundula Munkana, Adonis Muganza Nyenga, Augustin Mulangu Mutombo
Journal: Pan Afr Med J (2013)
Keywords: greenberg, hydrops, postaxial polydactyly, skeletal dysplasia
MeSH terms: Face / abnormalities, Hydrops Fetalis / etiology, Limb Deformities, Congenital / diagnosis, Osteochondrodysplasias / diagnosis, Case Reports, Adult, Democratic Republic of the Congo / epidemiology, Fatal Outcome, Female, Humans, Infant, Newborn, Osteochondrodysplasias / epidemiology, Pregnancy, HEM dysplasia

We describe the first Congolese case of Greenberg Skeletal Dysplasia. Were noted at birth a congenital hydrops, a chondrodystrophy, a severe hypoplastic face as well as an ulnar (postaxial) hexadactyly on all four limbs.
Successful embolisation of intrahepatic portosystemic venous shunt using AMPLATZER Vascular Plug II
Authors: Akiko Tomiyama, Sota Oguro, Mayumi Kato, Hiromi Watanabe, Hiroya Yamazaki, Tatsuya Suzuki, Shinichi Tominaga
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

An intrahepatic portosystemic venous shunt is a relatively rare abnormality that can cause encephalopathy owing to hyperammonaemia. Two patients with encephalopathy owing to intrahepatic portosystemic venous shunts were treated with transcatheter emboli sation using the AMPLATZER Vascular Plug II. Both patients achieved complete obliteration, which was confirmed on dynamic CT. Their symptoms that had been related to portalsystemic encephalopathy subsequently improved after the intervention. No short-term complications were observed in either patient. We recommend that the AMPLATZER Vascular Plug II be used for embolis ation owing to its superior safety and utility when compared with metallic coils or other liquid embolic materials.
Serous retinal detachment after trabeculectomy in angle recession glaucoma
Authors: Avik Kumar Roy, Debananda Padhy
Journal: GMS Ophthalmol Cases (2015)
Keywords: angle recession, complication of trabeculectomy, serous retinal detachment
MeSH terms: Case Reports

An 18-year-old male with 360 degree angle recession after blunt trauma in his right eye developed uncontrolled intraocular pressure (IOP) despite four antiglaucoma medications (AGM) with advancing disc damage. He underwent trabeculectomy with intraoperative mitomycin-c (MMC) application. There was an intraoperative vitreous prolapse which was managed accordingly. On post-surgery day 1, he had shallow choroidal detachment superiorly with non-recordable IOP. This was deteriorated 1 week postoperatively as choroidal detachment proceeded to serous retinal detachment. He was started with systemic steroid in addition to topical route. The serous effusions subsided within 2 weeks time. At the last follow up at 3 months, he was enjoying good visual acuity, deep anterior chamber, diffuse bleb, an IOP in low teens off any AGM and attached retina. This case highlights the rare occurrence of serous retinal detachment after surgical management of angle recession glaucoma.
Connections Between Febrile Infection-Related Epilepsy Syndrome and Autoimmune Encephalitis. A Case Report of a Child With New Anti-neuronal Antibodies
Authors: Martina Basso, Matteo Gastaldi, Valeria Leonardi, Giana Izzo, Sara Olivotto, Stefania Ferrario, Pierangelo Veggiotti, Diego Franciotta, Stefania M Bova
Journal: Front Pediatr (2022)
Keywords: fires (febrile infection-related epilepsy), anti-neuronal antibodies, autoimmune encephalitis (ae), case report, claustrum abnormalities, plasma exchange (plasmapheresis)
MeSH terms: Case Reports

Acute encephalitis and febrile infection-related epilepsy syndrome (FIRES) are debilitating neurological disorders. It is increasingly accepted that FIRES should be considered an autoinflammation-mediated epileptic encephalopathy, but the debate about its etiopathogenesis is still very much open. Despite showing a considerable overlap with encephalitis, it continues to be regarded as a distinct entity. We describe the case of a previously healthy 5-year-old child who, following a fever, developed acute encephalopathy, status epilepticus, neurological, neuropsychological, and psychiatric manifestations, and claustrum involvement on MRI. At symptom onset, his clinical and instrumental data met the diagnostic criteria for both FIRES and acute encephalitis. He received benzodiazepines, levetiracetam, phenytoin, phenobarbital, thiopental, and first-line immunotherapy for acute inflammatory encephalopathy (intravenous methylprednisolone and immunoglobulins), without substantial improvement. Following the detection of anti-neuronal antibodies through immunohistochemistry performed on rat brain slices, he received therapeutic plasma exchange (TPE). His neurological and behavioral conditions improved drastically and his antibody titer fell sharply from the first to the last course of PE. Claustrum abnormalities on MRI disappeared. The patient's long-term outcome is favorable. At 13 months after discharge, he experienced a focal seizure and carbamazepine was started, achieving seizure control. At 10 years of age, he is still on carbamazepine, with well-controlled seizures, focal EEG abnormalities, and an otherwise normal neurological and cognitive profile and normal MRI. This case strengthens the view that FIRES might constitute the initial clinical presentation of a CNS inflammatory disease that could have, among multiple distinct etiologies, an autoimmune cause. Immunological and specific second- or third-level investigations including immunohistochemistry should be included in the diagnostic work up of patients with FIRES-like phenotypes. PE could be effective in this subset of patients, protecting them from long-term neurological sequelae.