OpenMed/multicare-articles huggingface dataset:
Case report: Regression of in-transit metastases of cutaneous squamous cell carcinoma with combination pembrolizumab and topical diphencyprone
Authors: Dina Poplausky, Jade N Young, Brandon R Block, Yeriel Estrada, Giselle K Singer, Vicky Wong, Patricia Cabral, Yamato Suemitsu, Randie H Kim, Philip Friedlander, Nicholas Gulati
Journal: Front Oncol (2024)
Keywords: dpcp), cutaneous metastases, diphencyprone (dcp, immune check inhibitor (ici), metastatic squamous cell carcinoma, open-label clinical study, phase 1 cancer trials
MeSH terms: Case Reports

While typically low-risk, cutaneous squamous cell carcinoma (cSCC) can infrequently progress to metastatic disease with in-transit lesions, localized to the dermis or subcutaneous tissue between the primary tumor and draining regional lymph nodes. These lesions are associated with poor prognostic values, including decreased survival rates and increased risk of recurrence. We present the case of a 75-year-old male with cSCC and in-transit metastases on his scalp treated with the immune checkpoint inhibitor (ICI) pembrolizumab in conjunction with diphencyprone (DPCP), a topical hapten that induces a delayed-type hypersensitivity reaction in the skin. The patient was enrolled in a clinical trial (NCT05481658) that involved the twice-weekly application of DPCP 0.04% ointment to four of the in-transit metastases on his frontal scalp, concurrent with pembrolizumab 300 mg administered every three weeks. Following effective sensitization and a twelve-week treatment course, complete clearance of all lesions, DPCP-treated and non-DPCP treated, was achieved, with no adverse events. The immunologic profiles of the post-treatment biopsies were analyzed by TaqMan Low Density Array quantitative real-time polymerase chain reaction to measure immune marker gene expression. Relative to the non-DPCP-treated lesion, the DPCP-treated lesion demonstrated increased pro-inflammatory genetic markers and T-cell activation. This case represents the first reported instance of in-transit metastases of cSCC successfully treated with DPCP and an ICI. It highlights the potential safety and efficacy of DPCP with systemic immunotherapy for the management of in-transit metastases of cSCC in patients for whom surgery and radiation may be contraindicated.
An individual-supported program to enhance placement in a sheltered work environment of autistic individuals mostly with intellectual disability: a prospective observational case series in an Italian community service
Authors: Roberta Maggio, Laura Turriziani, Caterina Campestre, Marcella Di Cara, Emanuela Tripodi, Caterina Impallomeni, Angelo Quartarone, Claudio Passantino, Francesca Cucinotta
Journal: Front Psychiatry (2023)
Keywords: adolescents, adult, autism spectrum disorder, employment, intellectual disability, transitional age, vocational/labor participation

Introduction:
Autism spectrum disorder is a lifelong neurodevelopmental disorder. The profile of functioning in autistic people is very heterogeneous, and it is necessary to take into account individual characteristics to better support integration in the workplace. However, unemployment rates are higher for autistic people than for other types of disabilities. We present a prospective case series to explore the feasibility and efficacy of an individual-supported program to enhance placement in a sheltered work environment delivered by an Italian community day care center.
Methods:
Autistic subjects, aged from 12 to 31 years, participated in an individual-supported program regarding employment in sheltered art workshops, integrated into the regular activity of a semi-residential center three times a week for 1 year. Their feasibility retention rate and time worked per session were registered; moreover, working methods efficacy and self-organization improvement were tracked by the Likert-based rating system. Secondary outcome measures span functional levels, challenge behaviors, and sensory problems.
Results:
All the individuals presented a good adaptation to the environment, with a significant increase in time worked per session. After 1 year, the intervention allowed an increase in tasks completed in an assigned complex job and an improvement in self-organization within the work schedule in a group of subjects consisting mainly of severe-to-moderate levels of autism severity (86.6%). Finally, we observed a significant increase in independent functioning areas of the TEACCH transitional assessment profile. Challenge behaviors and sensory problems were also recorded.
Conclusion:
This case series supports the idea that individual-supported programs for placement in sheltered job environments delivered by community day care centers could be feasible and effective for ASD with higher levels of severity and co-occurring intellectual disability. Further targeted studies based on community models and accessible methods need to be planned to define the effectiveness of the intervention and promote improved practice at the community level with a better social impact.
Pathological complete response to neoadjuvant therapy with serplulimab and chemotherapy in stage IIIB small cell lung cancer: a case report and literature review
Authors: Ting Mei, Ting Wang, Chuanfen Lei, Dan Jiang, Qinghua Zhou
Journal: Front Immunol (2024)
Keywords: case report, immunotherapy, neoadjuvant therapy, pathological complete response, serplulimab, small cell lung cancer
MeSH terms: Carcinoma, Non-Small-Cell Lung / drug therapy, Drug-Related Side Effects and Adverse Reactions, Lung Neoplasms / drug therapy, Small Cell Lung Carcinoma / drug therapy, Review, Case Reports, Research Support, Non-U.S. Gov't, Comment, Antibodies, Monoclonal, Humans, Immune Checkpoint Inhibitors, Neoadjuvant Therapy, Pathologic Complete Response, Antibodies, Monoclonal, Immune Checkpoint Inhibitors

Chemotherapy combined with immunotherapy has significantly improved survival in patients with extensive-stage small cell lung cancer (ES-SCLC), and neoadjuvant immunotherapy combined with chemotherapy has emerged as the standard treatment for those with resectable non-small cell lung cancer (NSCLC). However, the potential benefits of surgery following neoadjuvant immunotherapy combined with chemotherapy in locally advanced SCLC remain unclear. Herein, we report a patient diagnosed with stage IIIB SCLC, who was administered five cycles of neoadjuvant serplulimab combined with chemotherapy followed by surgery, and subsequently achieved a pathologic complete response (pCR). Within a follow-up duration of six months, the patient displayed neither recurrence nor metastasis and experienced no treatment-related adverse reactions of any grade. Based on this case, for locally advanced SCLC, neoadjuvant serplulimab combined with chemotherapy followed by surgery may present an effective, safe, and potentially curative treatment strategy. Nonetheless, further prospective studies are needed to verify our findings.
Case report: positive pitfalls of PSMA PET/CT: diagnostic challenges in degenerative bone lesions including MODIC type 1
Authors: Hicham Moukaddam, Ghida El Saheb, Nadine Omran, Nour El Ghawi, Alain Abi Ghanem, Mohamad Haidar
Journal: Front Nucl Med (2024)
Keywords: modic type 1, pet/ct, psma, bone lesion, case report, prostate cancer
MeSH terms: Case Reports

Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is an imaging technique that has demonstrated high sensitivity and specificity in detecting prostate cancer and its metastasis, especially in the bones. This case describes a 60-year-old man who presented for increased prostate-specific antigen (PSA) level and underwent [68Ga]gallium-PSMA-11 PET/CT imaging for better disease assessment. 68Ga-PSMA-11 PET/CT revealed numerous radiotracer-positive lesions in both prostate lobes with associated sclerotic lesions on L4 and L5, but only L5 showed increased radiotracer avidity raising the possibility of metastasis. Magnetic Resonance Imaging (MRI) raises the possibility of aggressive MODIC type 1 lesion vs. infectious/inflammatory process. A biopsy of the radiotracer avid area was performed and showed no evidence of metastasis. The final diagnosis was aggressive MODIC type 1, in keeping with the false positive result of 68Ga-PSMA-11 PET/CT. This example demonstrates the possible limitations of 68Ga-PSMA-11 PET/CT, particularly in detecting bone metastases, and emphasizes the need for cautious interpretation and additional study to improve its diagnostic accuracy. Understanding and resolving these limitations is critical for increasing the accuracy of PSMA PET/CT in prostate cancer management.
Reactionary Bone Changes in Long-Standing Pyogenic Granuloma: A Case Report
Authors: Rosalyn Lalremtluangi, Suwarna Dangore-Khasbage
Journal: Cureus (2024)
Keywords: exophytic, osteogenesis, pyogenic granuloma, trabeculae, vascular
MeSH terms: Case Reports

Pyogenic granuloma is a reactive lesion that is commonly seen in the skin and oral cavity. Though it is an unfortunate misnomer, being neither pyogenic nor a true granuloma, the name has been used for years. In the oral cavity, it presents as a growth mostly situated on the gingiva, but may also occur on the tongue, buccal and labial mucosa, and palate, and may even be seen in relation to dental implants. The lesion is usually bright or purple red in color, soft in consistency, relatively painless, and appears highly vascularized. Local etiologic factors are usually poor oral hygiene or chronic irritation. Histopathologically it is an inflammatory hyperplasia of the connective tissue with exuberant vascularity. Sometimes, this lesion may present with unusual histopathological patterns, which could lead to difficulty in diagnosis. Long-standing pyogenic granuloma may show histologic changes such as localized osteogenesis in the matrix of the lesion which could potentially lead to complications in the area of the lesion. This article reports a rare case with rare histopathological features in an 18-year-old female presenting with long-standing soft tissue gingival growth.
Case Report: Case report: Rapidly progressing tooth wear dominated by intrinsic and extrinsic erosion
Authors: Shivaughn Marchan, Estévan Ollivierra, Alexa Diaz, Rochard Santo
Journal: F1000Res (2024)
Keywords: tooth wear, diet, erosion, gastroesophageal reflux disease
MeSH terms: Gastroesophageal Reflux / complications, Tooth Erosion / complications, Tooth Erosion / diagnosis, Tooth Wear / complications, Case Reports, Diet, Disease Progression, Humans, Male, Middle Aged

Tooth wear is multi-factorial presenting as a combination of abrasion, attrition, and erosion. This case report represents a case of combined tooth wear in a 46-year-old Indo-Trinidadian male, with a predominant erosive component with both the clinical signs and features of intrinsic and extrinsic erosion. This patient case is unique since the wear predominated by dental erosion has occurred rapidly evidenced by the physical clinical appearance of a lack of compensation and the upper left premolars and molars relatively unaffected by the overall effects of tooth wear. This lack of compensation, where opposing teeth have not supra-erupted to maintain inter-arch stability, and the maintenance of occlusal vertical dimension on the left due to the non-worn posterior maxillary teeth, provides the benefit of simplifying subsequent restorative management. The medical and diet history corroborates the diagnoses of intrinsic and extrinsic erosion respectively. Complications noted with rapid tooth wear, such as dentine sensitivity and pulpal necrosis are known sequelae of tooth wear however the patient presented in this case report shows a concomitant high caries experience and poor oral hygiene. Cases such as the one presented here require not only comprehensive dental management, utilizing a restorative approach but also medical referral for confirmation of a diagnosis and management of gastroesophageal reflux disease. Inherent to the management of this patient should be a multidisciplinary medical and dental approach, with confirmation and management of the cause of the intrinsic erosion as well as restorative dental management, together with dietary counseling to mitigate the effect of intrinsic and extrinsic sources of acid on dental hard tissue. A key lesson learned from this case is the importance of history and targeted questioning when trying to determine the cause of tooth wear dominated by intrinsic and extrinsic erosion.
Recurrent Subglottic Stenosis in a 16-Month-Old Male in the Setting of Influenza A, Intubation, and Honey Consumption
Authors: Allison T Jakiel, Krisdaniel Berreta, Hanna S Sahhar, Sami Rishmawi
Journal: Cureus (2024)
Keywords: honey consumption, pediatric influenza a, pediatric intensive care unit (picu), post intubation tracheal stenosis, post-intubation complications, recurrent tracheal stenosis, subglottic stenosis
MeSH terms: Case Reports

Recurrent episodes of subglottic stenosis are rare in the literature, and the etiologic causes are misunderstood but can be congenital, idiopathic, or iatrogenic in nature. Complications of intubation can result in subsequent inflammation and reactive processes. This case involves a 16-month-old male who suffered from a recurrent episode of subglottic stenosis in the setting of croup, influenza, and honey consumption. He had presented to the emergency department in respiratory distress after ingesting a home remedy of onion juice and honey. He had been discharged one day prior from the pediatric intensive care unit after four days of intubation and a seven-day hospital course with evidence of croup on imaging. He was readmitted, and subglottic edema and narrowing were confirmed via endoscopy, which prompted antibiotic treatment and close monitoring. After three days of monitoring and re-evaluation by bronchoscopy, the patient's condition began to improve, and no intubation was necessary. It is unclear what the cause of recurrent subglottic stenosis is due to the patient's clinical picture being clouded by a potential allergic reaction to honey versus an inflammatory reactive process post-intubation from the previous admission days prior. This case emphasizes the need for further research on the prevalence and etiology of recurrent subglottic stenosis and a deeper understanding of how to optimize diagnosis and treatment.
Hearing impairment in systemic sclerosis patients-what do we really know?
Authors: Michał Sieśkiewicz, Damian Rębacz, Andrzej Sieśkiewicz
Journal: Front Med (Lausanne) (2024)
Keywords: auditory neuropathy, capillaroscopy, cochlear diseases, cochlear impairment, hearing loss, systemic sclerosis
MeSH terms: Systematic Review

Background:
Systemic sclerosis (SSc) is a disease of a very heterogeneous clinical picture and immunological profile with progression rate that varies between individuals. Although hearing deterioration is not a complaint that comes to the fore in SSc patients, as it is not life-threatening compared to many other more severe symptoms of this disease, it can significantly impair the quality of life. Medical literature concerning this problem is rather scarce.
Materials and methods:
In this article we systematically reviewed the medical publications concerning hearing impairment in patients with systemic sclerosis to evaluate current understanding of this complex problem. Following PRISMA guidelines a total of 19 papers were found and analysed including 11 original studies and 8 case reports.
Results:
Although it seems that hearing impairment in SSc patients is relatively more common than in the general population, based on the analysis of available literature, no firm conclusions regarding its frequency and pathomechanism can be drawn yet. Microangiopathy leading to damage to the sensory cells of the inner ear is suspected to be the main mechanism of hearing loss, although damage to the higher levels of the auditory pathway appears to be underestimated due to incomplete audiological diagnosis.
Conclusion:
Undoubtedly, the reason for the difficulty in such an evaluation are the complex and still not fully elucidated pathomechanism of SSc, the individually variable dynamics of the disease and the unique heterogeneity of symptoms. Nevertheless, further studies in larger and appropriately selected groups of patients, focused more on the dynamics of microangiopathy and not solely on clinical symptoms could provide answers to many key questions in this regard.
Mitigating nipple areolar complex (NAC) ischemia following mastopexy augmentation using nitroglycerin application and methylprednisolone: a case report
Authors: Thor S Stead, Matteo Laspro, Giovanni Ramirez-Arroyo, Latha Ganti, Amitabha Mitra
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: mastopexy, body contouring, breast augmentation, emergency department, ischemia, nipple necrosis
MeSH terms: Case Reports

A patient who underwent bilateral wise-pattern mastopexy augmentation with threatened nipple-areolar complex necrosis was successfully managed medically with IV methylprednisolone and topical nitroglycerin ointment as immediate consultation with the operating surgeon was not possible.
Mucinous intestinal adenocarcinoma arising from mature cystic teratoma of the ovary treated with FOLFOX-6 - a case report
Authors: Enrique Bedoya-Ismodes, Karem Portugal, Sandy Carmona-Lozano, Mirna Dominguez-Gonzales, Jaime Torres, Nestor Juarez-Herrera
Journal: Ecancermedicalscience (2024)
Keywords: folfox 6, colorectal origin, malignant transformation, mature cystic teratoma, mucinous intestinal adenocarcinoma
MeSH terms: Case Reports

The malignant transformation of mature cystic teratomas during pregnancy is a rare occurrence in medical literature. In this case report, we present a remarkable instance of mucinous intestinal adenocarcinoma arising from a mature ovarian cystic teratoma diagnosed during pregnancy. This is among the few reports detailing the effective use of the FOLFOX 6 chemotherapy regimen for treating this type of intestinal cancer. Furthermore, we emphasize the immunohistochemical results that confirm the colorectal histological origin.
The Importance of Primary Care Physicians in the Diagnosis and Exclusion of Rare Syndromes: A Case Study of Ruling Out PHACE Syndrome
Authors: Hannah Lynch, Ezra Dweck, Jehanzeb Nadeem
Journal: Cureus (2024)
Keywords: follow-up in primary care, infantile hemangioma, interdisciplinary team, phace syndrome, primary care physicians, pediatric
MeSH terms: Case Reports

PHACE (posterior fossa malformations, hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects, and eye abnormalities) syndrome is an extremely uncommon condition that requires a team of physicians to properly diagnose, treat, and follow. Patients are at risk of posterior fossa malformations, hemangiomas, and arterial, cardiac, eye, and sternal cleft abnormalities. These syndrome hallmarks can cause severe functional and developmental issues or, in the worst case, death. The pediatrician's role is even more essential for pediatric patients who present with rare and intricate syndromes. Primary care physicians are the first line of defense for patients. They recognize alarm signs, coordinate patient care, and promote participation. This case report aims to describe the process by which a multisystemic and potentially lethal syndrome was excluded and illustrates the significance of a primary care physician for the diagnosis and management of such conditions.
Case report: Cannabinoid therapy for discoid lupus erythematosus in a dog
Authors: Maria Eduarda Schmitz da Silva, Bruna Christianetti, Erik Amazonas, Marcy Lancia Pereira
Journal: Front Vet Sci (2024)
Keywords: cbd, thc, autoimmune disease, cannabinoid therapy, cannabis, discoid lupus erythematosus
MeSH terms: Case Reports

Discoid lupus erythematosus (DLE) is a common autoimmune skin disease in dogs. Conventional treatments, such as corticosteroids, can be effective but often have side effects. This case report presents a successful use of cannabinoid therapy (CT) in a dog with DLE resistant to conventional treatment. A 2-year-old mixed-breed dog with a history of DLE presented with worsening lesions despite treatment with corticosteroids and other medications. Liver enzymes levels were elevated, indicating corticosteroid-induced side effects. CT with a CBD-rich full spectrum Cannabis oil was initiated. The dosage was gradually adjusted until the minimum effective dose was found. Within a few weeks of starting CT, the dog showed significant improvement in skin lesions and in liver enzymes levels. After 1 year, the dog remains clinically stable on a low dose of full-spectrum CBD-rich oil. No evidence of DLE recurrence was observed. This case suggests that CT may be a viable alternative or complementary therapy for DLE in dogs, particularly for those experiencing adverse effects from conventional treatments. Further research is warranted to confirm the efficacy and safety of CT for DLE management in dogs.
Diode laser surgery for the treatment of denture-induced fibrous hyperplasia: a case report
Authors: Er-Raji Samir, Rokhssi Hasnae, Ennibi Oumkeltoum
Journal: Pan Afr Med J (2024)
Keywords: hyperplasia, case report, diode laser, surgery
MeSH terms: Hyperplasia / surgery, Lasers, Semiconductor / therapeutic use, Case Reports, Denture, Complete, Female, Fibrosis, Humans, Laser Therapy / adverse effects, Laser Therapy / methods, Middle Aged, Mouth Mucosa / pathology

Denture-induced fibrous hyperplasia (DIFH) is a persistent lesion caused by low-intensity chronic injury of the tissue in contact with an ill-fitting, over-extended denture. This fibrous connective tissue lesion commonly occurs in oral mucosa in patients showing important alveolar ridge atrophy. Surgical excision is the treatment of choice for DIFH. This article describes a successful laser surgery to remove a DIFH on a lower alveolar ridge of a patient wearing an ill-fitting completely removable denture. The use of a diode laser may result in less surgical time, less bleeding during surgery, more vestibular depth, better re-epithelialization of the wound, and no need for suturing.
Giant cell-rich osteosarcoma of the lumbar spine - A rare entity
Authors: Tushar Kalekar, Ojasvi Sharma, Sayali Paidlewar, Ankita Pandey, Eshan C Durgi
Journal: SA J Radiol (2024)
Keywords: giant cell, lumbar spine, lumbo-sacral, osteosarcoma, spinal tumour
MeSH terms: Case Reports

Giant cell-rich osteosarcoma (GCRO) is a rare variant of osteosarcoma. A significant diagnostic hurdle is presented by the lesion's uncommon appearance on histopathology. This report presents a case of a 59-year-old female patient diagnosed with GCRO.
Contribution:
While it is extremely difficult to distinguish GCRO from malignant giant cell tumour, it is important to do so because of the difference in prognosis and management. Distinctive anatomy of the lumbar spine increases the risks associated with surgical excision.