OpenMed/multicare-articles huggingface dataset:
Surgical Management of Unusual Biangular Mandibular Fractures
Authors: Stefan Cocis, Umberto Autorino, Fabio Roccia, Chiara Corio
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy's technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.
Superficial Temporal Artery Pseudoaneurysm: A Case Report
Authors: Syed Muneeb Younus, Muhammad Imran, Rabia Qazi
Journal: Front Surg (2015)
Keywords: craniotomy, meningioma, pseudoaneurysm, superficial temporal artery
MeSH terms: Case Reports

Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up.
Myasthenia Gravis Induced by Ipilimumab in a Patient With Metastatic Melanoma
Authors: Vera Montes, Sandra Sousa, Fernando Pita, Rui Guerreiro, Cátia Carmona
Journal: Front Neurol (2018)
Keywords: immunity, ipilimumab, myasthenia, safety, side effects
MeSH terms: Case Reports

In daily clinical practice, there is a growing number of patients receiving new biological agents used in the treatment of malignancies. Ipilimumab is a fully humanized monoclonal antibody approved for patients with melanoma. It acts as an immune checkpoint inhibitor, binding and blocking cytotoxic T-lymphocyte antigen-4 in order to increase the antitumor immune response. There are several reports of autoimmune responses after its use. A 74-year-old man developed a mild rash and pruritus a few hours after the second infusion of ipilimumab and 24 h after the third dose of ipilimumab, he presented with shortness of breath, proximal limb muscle weakness, and diplopia. Repetitive nerve stimulation was consistent with a postsynaptic neuromuscular junction disorder. He began therapy with corticosteroids and pyridostigmine and ipilimumab was discontinued. Following ipilimumab suspension, the patient started to improve gradually. Here, we describe a rare case of myasthenia gravis presumably related with ipilimumab's therapy. A better knowledge of these agents is necessary, in order to identify characteristics or biomarkers that may be associated with the development of potentially serious autoimmune responses.
Congenital epicardial coronary artery to bilateral internal mammary artery fistulae
Authors: Arjun Kumar Ghosh, Sze Mun Mak, Yousif Ahmad, Iqbal Malik, Petros Nihoyannopoulos, Deepa Gopalan
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 39-year-old male ex-smoker gave a history of exertional chest pain ever since he suffered a respiratory tract infection. Clinical examination, electrocardiogram and echocardiography were normal and he was referred for a cardiac CT scan to assess coronary artery calcification and patency. The scan demonstrated incidental fistulae between the right internal mammary artery and the right coronary artery, and the left internal mammary artery and the left anterior descending artery.
Primary Mesenteric Undifferentiated Pleomorphic Sarcoma Masquerading as a Colon Carcinoma: A Case Report and Review of the Literature
Authors: Robert Diaz-Beveridge, Marcos Melian, Carlos Zac, Edwin Navarro, Dilara Akhoundova, Melitina Chrivella, Jorge Aparicio
Journal: Case Rep Oncol Med (2015)

Undifferentiated pleomorphic sarcoma (UPS) is the most common sarcoma that appears in older patients, usually in the extremities and the retroperitoneum. Other locations are rare. By definition, in UPS, although the malignant cells tend to appear fibroblastic or myofibroblastic, they should not show differentiation towards a more specific line of differentiation. In this sense, we report the case of an 80-year-old patient with an initial clinical diagnosis of a locally advanced colonic neoplasm that was later confirmed as a primary mesenteric UPS. Primary mesenteric UPS are extremely rare with less than 20 cases reported. We also review the pathologic and radiologic diagnostic criteria and the natural history of these tumours.
Infected Facial Tissue Fillers Caused by Dental Infection
Authors: Antoine Berberi, Bouchra Hjeij, Georges Aad, Georges Aoun
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Injectable dermal fillers are widely used for facial rejuvenation; they help reshape the facial contours by treating volume loss due to aging changes. Facial fillers may become infected following a dental infection. In this report, we present a case of a 44-year-old female patient who presented with a swelling in her upper right buccal region following dental treatment of her second maxillary right premolar. After a thorough history, clinical, and radiological examinations, the diagnosis of infected dermal filler was made. The lesion was treated by association of two antibiotics (ciprofloxacin IM and clindamycin tablets 300 mg), and a complete healing was observed two months after the end of the dental treatments.
Case Report: Vemurafenib Treatment in Brain Metastases of BRAFS365L -Mutant Lung Papillary Cancer by Genetic Sequencing of Cerebrospinal Fluid Circulating Tumor DNA Detection
Authors: Jianing Jiang, Jinqi Gao, Gang Wang, Jinyan Lv, Wenting Chen, Jing Ben, Ruoyu Wang
Journal: Front Oncol (2021)
Keywords: bm of nsclc, brafs365l mutation, brafv600e mutation, csf ctdna, vemurafenib
MeSH terms: Case Reports

BRAF mutations, primarily sensitizing mutations, such as BRAFV600E , have been proven to response to the BRAF inhibitor, Dabrafenib combined with trametinib therapy, but there have been no data demonstrating that it has activity against NSCLC-related brain metastases (BM). How patients harboring BRAFS365L mutation (a rare mutation following BRAFV600E -inhibitor treatment) in NSCLC is unknown. Vemurafenib, another BRAF inhibitor, can reverse the resistance that develops with the BRAFS365L mutation following dabrafenib combined with trametentinib treatment in melanoma, but none has been reported in NSCLC. Lung papillary cancer, as a rare typing, occupies about 4% of NSCLC. Hence, we reported the first case of a patient with BM of lung papillary carcinoma harboring a BRAFV600E mutation who benefited from dabrafenib combined with trametinib, and following the development of the BRAFS365L mutation, vemurafenib remained an effective therapeutic option. Moreover, we found that the next-generation sequencing (NGS) of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) may potentially provide more accurate information about intracranial lesions than ctDNA in the blood serum, which will be a better detection method.
Rigid Posterior Lumbopelvic Fixation without Formal Debridement for Pyogenic Vertebral Diskitis and Osteomyelitis Involving the Lumbosacral Junction: Technical Report
Authors: Marcus D Mazur, Vijay M Ravindra, Andrew T Dailey, Sara McEvoy, Meic H Schmidt
Journal: Front Surg (2015)
Keywords: s2-alar-iliac screw, diskitis, lumbosacral, osteomyelitis, pelvic fixation, posterior, pyogenic
MeSH terms: Case Reports

Background:
Pelvic fixation with S2-alar-iliac (S2AI) screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis.
Purpose:
To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO) at the lumbosacral junction.
Study design:
Technical report.
Methods:
We describe the management of PVDO at the lumbosacral junction in which the infection invaded the endplates, disk space, vertebrae, prevertebral soft tissues, and epidural space. Pedicle involvement precluded screw fixation at L5. Surgical management consisted of a single-stage posterior operation with rigid lumbopelvic fixation augmented with S2-alar-iliac screws and without formal debridement of the infected area, followed by long-term antibiotic treatment.
Results:
At 2-year follow-up, successful fusion and eradication of the infection were achieved.
Conclusion:
PVDO at the lumbosacral junction may be treated successfully using rigid posterior-only fixation without formal debridement combined with antibiotic therapy.
Case Report: Osimertinib Followed by Osimertinib Plus Bevacizumab, Personalized Treatment Strategy for a Lung Cancer Patient With a Novel EGFR Exon 20 Insertion D770_N771insGT and Multiple Brain Metastases
Authors: Xiaoyu Zhi, Jiancheng Luo, Weiwei Li, Jinliang Wang, Yuying Wang, Yi Cai, Xiang Yan
Journal: Front Oncol (2021)
Keywords: bevacizumab, brain metastasis, exon 20 insertion mutation, non-small cell lung cancer, osimertinib
MeSH terms: Case Reports

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) are the standard of care for non-small cell lung cancer (NSCLC) patients with EGFR exon 19 deletion and L858R mutations. However, no EGFR TKI has been approved for NSCLC patients harboring insertion mutations in EGFR exon 20 (EGFRex20ins), a subgroup of uncommon EGFR mutations resistant to first-generation EGFR TKIs. This unmet clinical challenge is further complicated by disease progression due to brain metastases (BMs), which limits the use of EGFR TKIs with low intracranial activity. Osimertinib, a third-generation EGFR TKI with high CNS activity, has demonstrated superior efficacy as a first-line treatment for EGFR-mutant NSCLC with or without BM. The VEGF pathway is a key mediator of cancer metastasis and resistance to EGFR TKIs. Accumulating evidence has demonstrated that the addition of anti-VEGF agents to EGFR TKIs provides an alternative treatment option for the clinical management of EGFR-mutant NSCLC. We herein report an NSCLC case with a novel EGFRex20ins mutation D770_N771insGT and multiple brain metastases who briefly responded to first-line osimertinib treatment and subsequently achieved prolonged disease control with osimertinib plus bevacizumab as second-line treatment. Our case suggests that osimertinib in combination with bevacizumab may be an effective option for NSCLC patients with specific EGFRex20ins mutations and brain metastases.
Oral Tradition as Context for Learning Music From 4E Cognition Compared With Literacy Cultures. Case Studies of Flamenco Guitar Apprenticeship
Authors: Amalia Casas-Mas, Juan Ignacio Pozo, Ignacio Montero
Journal: Front Psychol (2022)
Keywords: discourse about practice, embodiment, flamenco culture of learning, instrumental learning, musical practice, oral learning

The awareness of the last 20 years about embodied cognition is directing multidisciplinary attention to the musical domain and impacting psychological research approaches from the 4E (embodied, embedded, enactive, and extended) cognition. Based on previous research regarding musical teaching and learning conceptions of 30 young guitar apprentices of advanced level in three learning cultures: Western classical, jazz, and flamenco of oral tradition, two participants of flamenco with polarised profiles of learning (reproductive and transformative) were selected as instrumental cases for a prospective ex post facto design. Discourse and practice of the two flamenco guitarists were analysed in-depth to describe bodily issues and verbal discourse on the learning practice in their natural contexts. Qualitative analysis is performed on the posture, gestures, verbal discourse, and musical practice of the participants through the System for the Analysis of Music Teaching and Learning Practices (SAPIL). The results are organised attending: (a) the Embodied mind through differential postures and gestures of flamenco participants that showed a fusion among verbal, body language, and musical discourse with respect to the musical literacy cultures; (b) the Embedded mind and a detailed description of circumstances and relationships of the two flamenco participants, and how music is embedded in their way of life, family and social context, and therefore transcends musical activity itself; (c) the Enactive mind, regarding the active processes that make differences between the reproductive and the transformative flamenco apprentices, then tentative relationship are observed in the discourse of each apprentice and the way in which they practice; finally, (d) the Extended mind through the bodily, technical and symbolic tools they use during learning. Flamenco culture of oral tradition made use of listening, and temporary external representations instead of notational, but also the body played a central role in a holistic rhythm processing through multimodality, such as singing, playing, and dancing. Conclusions point out the embodied mind as a result of the culture of learning reflected through the body and the gesture in instrumental learning.
Matrix Stone Occupying an Entire Renal Collecting System: A Case Report and Video of Diagnostic Ureterorenoscopy
Authors: Jonathan Cobley, Yih Chyn Phan, Wasim Mahmalji
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Renal matrix stones are a rare phenomenon and they present a diagnostic challenge due to their atypical radiological appearances in comparison to more commonly encountered renal tract calculi. We describe a case of known stone former presenting with loin pain and recurrent urinary tract infections who was diagnosed with a matrix stone. The video of the diagnostic flexiureterorenoscopy demonstrating the matrix stone occupying almost the entire right renal collecting system is also presented.
Duodenectomy with jejunal advancement and reimplantation of the ampulla of Vater for recurrent right colon cancer: A case report
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: local recurrence, pancreaticoduodenectomy, reoperative, surgery, whipple procedure

Background:
Local or regional recurrence of colon or rectal cancer frequently occurs if there is a positive margin of resection or spillage of cancer cells during the operation.
Methods:
The clinical course of a patient with right colon cancer recurrent within the resection site and on the anterior aspect of the duodenum was reviewed.
Results:
Resection of recurrent right colon cancer was accomplished by subtotal duodenectomy. Reconstruction was with jejunal advancement and reimplantation of the ampulla of Vater. No postoperative complications occurred and palliation was excellent.
Conclusions:
Prevention of recurrent right colon cancer is an import consideration for primary resection. However, if this duodenum is involved by recurrence, techniques for resection exist.
Safe Administration of Ipilimumab, Pembrolizumab, and Nivolumab in a Patient with Metastatic Melanoma, Psoriasis, and a Previous Guillain-Barré Syndrome
Authors: Alessio Cortellini, Alessandro Parisi, Maria Concetta Fargnoli, Katia Cannita, Azzurra Irelli, Giampiero Porzio, Claudio Martinazzo, Corrado Ficorella
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Background:
Patients with autoimmune diseases were not evaluated in clinical trials with immune checkpoint inhibitors (ICIs), since a history of immune disorders, such as Guillain-Barré syndrome (GBS) and psoriasis, is one of the major risk factors for the development of immune-related adverse events (irAEs). This risk cannot be defined; therefore, physicians are called to manage these patients in clinical practice.
Case report:
We report the case of a 62-year-old male patient affected by metastatic melanoma, with a history of GBS and psoriasis, and treated with sequential ipilimumab, pembrolizumab, and nivolumab, without significant toxicities.
Conclusion:
This case report supports that although a history of immune disorders is one of the major risk factors for development of irAEs, in some patients, it could be possible to safely administer sequential treatments with ICIs. A proper decision should be made, considering therapeutic options, disease-related risks, and those related to a recurrence of preexisting autoimmune disorders.
Iatrogenic Complications of Compulsory Treatment in a Patient Presenting with an Emotionally Unstable Personality Disorder and Self-Harm
Authors: Charlotte Burrin, Natasha Faye Daniels, Rudolf N Cardinal, Catherine Hayhurst, David Christmas, Jorge Zimbron
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Attempted suicide and deliberate self-harm are common and challenging presentations in the emergency department. A proportion of these patients refuse interventions and this presents the clinical, legal, and ethical dilemma as to whether treatment should be provided against their will. Multiple factors influence this decision. It is difficult to foresee the multitude and magnitude of complications that can arise once it has been decided to treat individuals who do not consent. This case illustrates a particularly complex chain of events that occurred after treating someone against their will who presented with self-harm and suicidal ideation. These consequences are contrasted with those of not intervening when similar situations arose with the same patient.
Solitary hepatic lymphangioma: a one-case report
Authors: Qu Liu, Cheng-Jun Sui, Bao-Shan Li, Ang Gao, Jian-Yue Lu, Jia-Mei Yang
Journal: Springerplus (2014)
Keywords: hepatic lymphangioma, solitary cyst, surgical treatment

Hepatic lymphangiomas, malformations of the liver lymphatic system, are extremely rare conditions in adults. A 41-year-old man presented with right upper abdominal pain for 6 months was introduced in this report. Ultrasound (US) and computed tomography (CT) scan demonstrated a giant cystictumor with a pedunculatedextrahepatic growth pattern. Due to diagnostic uncertainty, a partial hepatectomy was performed and pathological results confirmed the diagnosis of solitary hepatic lymphangioma. In this article, we reviewed the clinical and pathology features, preoperative diagnostic challenges, and treatments of hepaticlymphangiomas.
Small cell neuroendocrine carcinoma expressing alpha fetoprotein in the endometrium
Authors: Weiwei Hou, Bin Zhou, Gang Hou, Yu Pang, Jing Sang, Ning Li
Journal: Open Life Sci (2021)
Keywords: alpha-fetoprotein, endometrium, immunohistochemistry, small cell neuroendocrine carcinoma, vaginal bleeding
MeSH terms: Case Reports

Rare small cell neuroendocrine carcinoma (SCNEC) cases showed alpha fetoprotein (AFP) expression in the endometrium. In this study, we reported a case of uterine SCNEC expressing AFP. In addition, a literature review was performed to investigate the potential mechanism and the clinicopathological features of SCNEC to provide clinical guidance. A 65-year-old female was referred to our hospital due to vaginal bleeding for 1 month in November 2020. The clinical features were summarized. After total hysterectomy and removal of bilateral appendages, the histological examination and immunohistochemistry examination were performed. Histological findings showed that the cancer cells were arranged in a nest-like pattern distributed in a lamellar manner. The smooth muscles of the uterus were invaded by cancer cells. Cancer cells were relatively consistent in size. Small glandular duct-like and rosettes-like structures were distinguished, together with necrotic tissues. The deep staining showed that the amount of cytoplasm was lower in the nucleus. Partial cancer cells had small nucleolus with an irregular profile. There were some mitotic figures. Immunohistochemistry examination indicated that there was a diffuse expression of CK, Syn, CgA, CD56, CK8/18, P16, AFP, HepPar-1, Glypican-3, and Ki67 (90%). In this case, we reported a SCNEC patient expressing AFP, Glypican-3, and HepPar-1.
Clusters of Healthcare-Associated Legionnaires' Disease in Two Hospitals of Central Greece
Authors: Maria A Kyritsi, Varvara A Mouchtouri, Anna Katsiafliaka, Foteini Kolokythopoulou, Elias Plakokefalos, Vasileios Nakoulas, George Rachiotis, Christos Hadjichristodoulou
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Healthcare-associated Legionnaires' disease often leads to fatal respiratory tract infection among hospitalized patients. In this report, three cases of Legionnaires' disease among patients in two different hospitals (Hospital A and Hospital B) were investigated. After conducting an epidemiologic and environmental investigation, the water distribution systems (WDSs) were identified as the possible source of infection, as Legionella pneumophila serogroup 1 (Lp1) was isolated from both clinical and environmental samples. Patients received aerosol therapy with nebulizers during their hospitalization. Based on the results of the investigation, the hospitals' infection control committees reviewed their policies for Legionnaires' disease prevention and implemented control measures focusing on using sterile fluids for aerosol treatments.
COVID-19-associated familial acute disseminated encephalomyelitis (ADEM): A case report
Authors: Sivaram Neppala, Dinesh Kumar Sundarakumar, Joseph W Caravella, Himaja Dutt Chigurupati, Prateek Patibandla
Journal: IDCases (2021)
MeSH terms: Case Reports

Background:
Several neurological complications are being reported in hospitalized patients with severe COVID-19 infection. This is presumed due to direct spread of infection or due to immunological response. Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory and demyelinating disorder of the central nervous system that is often preceded by infection or vaccination. Very few cases of ADEM have been reported in the literature that are associated with COVID-19 infection.
Case report:
Here we demonstrate familial cases of ADEM in a hospitalized father and son, who presented to the emergency department with fever and shortness of breath, later diagnosed with COVID-19, and subsequently requiring mechanical ventilation. Both patients developed neurological symptoms with upper motor neuron involvement at approximately day 30 of admission. MRI of the brain demonstrated bilateral multifocal periventricular white matter FLAIR signal hyperintensities consistent with ADEM. The patients were treated with medium dose IV methylprednisolone with variable outcomes. The 49-year-old son developed severe residual neurological deficits with encephalomalacic changes on MRI which required extensive rehabilitation; meanwhile, the 68-year-old father predominantly had pulmonary sequelae including fibrosis and the development of a pneumatocele, but he had a better neurological outcome.
Conclusion:
To our knowledge, this is the first reported case report of ADEM involving father and son in severe COVID-19 infection. Final neurological outcomes in these patients appeared to be in line with the severity of COVID-19 infection. More research is needed to better understand the management of ADEM in patients with severe COVID-19 infection.