OpenMed/multicare-articles huggingface dataset:
Occult Congenital Ureteropelvic Junction Obstruction in Two Adults Presenting with Collecting System Rupture After Blunt Renal Trauma: A Case Report Series
Authors: Haley E Hoffner, Lawrence M Dagrosa, Eric P Raffin, Vernon M Pais Jr
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

We report two adult cases of congenital ureteropelvic junction obstruction detected incidentally in the setting of blunt abdominal trauma. CT images are provided to describe the presentation, while review of the literature and management of renal trauma are discussed.
Idiopathic Gingival Fibromatosis
Authors: Prathibha Anand Nayak, Ullal Anand Nayak, Vishal Khandelwal, Nupur Ninave
Journal: Int J Clin Pediatr Dent (2011)
Keywords: gingival hyperplasia, idiopathic gingival fibromatosis
MeSH terms: Case Reports

Idiopathic gingival fibromatosis is a rare heriditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements. This case report gives an overview of gingival fibromatosis in a 11-year-old female patient who presented with generalized gingival enlargement. Based on the history and clinical examination, the diagnosis was made and the enlarged tissue was surgically removed. The patient was being regularly monitored clinically for improvement in her periodontal condition as well as for any recurrence of gingival overgrowth.
Rhabdoid meningioma with a history of Budd-Chiari syndrome: a case report and review of the literature
Authors: Ying Zeng, Jing Zhang, Wei Jian, Yong Zhang, Ying Yang, Rongqing Li, Qiaofen Fu
Journal: Front Oncol (2023)
Keywords: budd-chiari syndrome, central nervous system tumour, liver cirrhosis, meningioma, rhabdoid meningioma
MeSH terms: Case Reports

Background:
Rhabdoid meningioma and Budd-Chiari syndrome are both extremely rare, and there is no report describing the two diseases occurring in the same patient thus far. Herein, we showed an unusual case of rhabdoid meningioma with a history of Budd-Chiari syndrome.
Case presentation:
The man was found to have abnormal liver function during physical examination in 2016 at 36 and was not paid attention to it. In 2019, he went to Beijing YouAn Hospital Affiliated to Capital Medical University for the decompensation of cirrhosis and was diagnosed with Budd-Chiari syndrome, subsequent angiography of the inferior vena cava combined with balloon dilatation were performed, the anticoagulation and hepatoprotective therapy were performed for a long time. When he turned 40 who had magnetic resonance imaging (MRI) that showed a left frontotemporal lobe space-occupying lesion, and postoperative pathological examination confirmed rhabdoid meningioma. He underwent surgery and postoperative adjuvant radiotherapy, but then he developed severe psychiatric symptoms and eventually succumbed to a lung infection two months after treatment.
Conclusions:
Budd-Chiari syndrome and Rhabdoid meningiomas are both extremely rare diseases. To the best of our knowledge, there is no report that the two rare diseases occurred in the same patient, and this is the first case. However, whether there is any link between the two diseases is unclear, more researches are needed to confirm it in the future.
Pulmonary artery aneurysm as a cause of massive hemoptysis: diagnosis and management
Authors: Peter Corr
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

Massive hemoptysis is a life-threatening medical emergency. Prompt radiological diagnosis and management are essential. I present a case of an inflammatory pulmonary aneurysm (Rasmussen aneurysm) from active pulmonary tuberculosis. This is an uncommon cause for massive hemoptysis which was successfully treated by endovascular coiling.
An Elderly Gentleman with Acute Lupus Pneumonitis as the Initial Manifestation of Systemic Lupus Erythematosus
Authors: Gina Ferrero, Kate Chernow, Marissa Karpoff, Pamela Traisak, David Feinstein, Hala Eid
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Systemic lupus erythematosus is a systemic autoimmune disease, with presentations that vary within a population and across the lifespan of an individual. The disease afflicts childbearing women more than men and uncommonly presents in the geriatric population. Lupus pneumonitis is rare, with a reported incidence of 1-4%. Herein, we discuss the case report of an elderly gentleman with biopsy-proven acute lupus pneumonitis (ALP) as an initial presentation of lupus. After starting high-dose steroids, the patient initially improved, though unfortunately endured a non-ST elevation myocardial infarction and recurrent gastrointestinal bleeding. Despite multiple interventions and a prolonged hospital course, his gastrointestinal bleeding persisted. He elected to go on home hospice and ultimately passed away due to ongoing gastrointestinal bleeding. As with our patient, elderly patients can pose a diagnostic dilemma with regard to late-onset lupus; multiple comorbidities and growing evidence that late-onset lupus may manifest with distinct clinical patterns from younger cohorts complicate diagnosis in these patients. It is critical to maintain a broad differential, which includes unusual rheumatic manifestations when management of common comorbidities fails to alleviate symptoms for an elderly patient. Failure to do so may result in delayed diagnosis of rheumatic disease and increased side effects related to treatment. Additionally, this case serves as a reminder that due to the complexity of rheumatic disease and the additional challenge of older patients with baseline comorbidities, sometimes palliative care options may be appropriate.
A Case of Spontaneously Improving Secondary Hemophagocytic Lymphohistiocytosis in an Adult Associated with T-Cell Histiocyte-Rich Large B-Cell Lymphoma
Authors: Cyrus Askin, Ashley Burris, Clifton Layman, Brian Haney, Jordan Hall
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Secondary hemophagocytic lymphohistiocytosis (HLH) in adults is a rare, often fatal syndrome characterized by widespread immune dysregulation. It is seen as a complication of infections, autoimmune diseases, and malignancies. Among the malignancy-related causes, aggressive T-cell or NK-cell neoplasms are most notable, while B-cell lymphomas are less commonly implicated. We present the case of a 32-year-old male transferred to our facility with concern for HLH. During the first week of his hospitalization, his diagnosis was confirmed and the patient demonstrated spontaneous improvement in his symptoms prompting us to delay therapy while searching for a primary cause. In the second week, the patient deteriorated, leading us to initiate steroid monotherapy in the absence of a cause for his HLH. Meanwhile, pathology results from an excisional lymph node biopsy confirmed a diagnosis of T-cell/histiocyte-rich large B-cell lymphoma (TCHRLBCL). Subsequently, we initiated therapy with dose-adjusted R-EPOCH. The patient achieved a complete remission of both HLH and TCHRLBCL as well as a complete return to his prior functional status. In our review of the literature, this represents only the second documented case of HLH associated with TCHRLBCL and the only documented case of an adult experiencing significant spontaneous recovery in this context.
Congenital fistulisation of Meckel's diverticulum in omphalocele sac: case report
Authors: Mohammed Tazi Charki, Hicham Abdellaoui, Saad Andaloussi, Mohammed Amine Oukhouya, Abdelhalim Mahmoudi, Aziz El Madi, Khalid Khattala, Youssef Bouabdallah
Journal: Pan Afr Med J (2019)
Keywords: meckel’s diverticulum, exomphalos, fistulisation
MeSH terms: Hernia, Umbilical / diagnosis, Intestinal Fistula / congenital, Meckel Diverticulum / diagnosis, Case Reports, Hernia, Umbilical / pathology, Humans, Infant, Newborn, Intestinal Fistula / pathology, Male, Meckel Diverticulum / pathology

Fistulisation of Meckel's diverticulum in the top of an omphalocele sac is very rare. To our Knowledge, three cases were reported in the literature. We presente in this report a new case of this uncommon presentation.
A Case of Biliary Pancreatitis Which Subsided after Endoscopic Sphincterotomy during Pregnancy
Authors: Gulbanu Erkan, Ibrahim Dogan, Seren Ozenirler, Candan Tuncer
Journal: ISRN Gastroenterol (2011)
MeSH terms: Case Reports

A 24-year-old pregnant patient was referred to us because of pain and tenderness in the right upper quadrant. Her liver enzymes and bilirubin levels were elevated; an abdominal ultrasound examination revealed gallstones within the gallbladder. Diagnosis of biliary pancreatitis was established based on elevated amylase levels. Oral intake was withheld; intravenous antibiotic therapy and total parenteral nutrition were administered. An endoscopic sphincterotomy without the use of fluoroscopy was performed. Abdominal pain and elevated serum amylase levels subsided after this procedure. In our case, biliary pancreatitis, which developed during pregnancy, responded well to the endoscopic sphincterotomy, and this procedure obviated the need for surgical intervention and prevented the recurrence of pancreatitis.
Case Report: Single Dose Anti-PD1 in a Patient With Metastatic Melanoma and Cardiac Allograft
Authors: Amy E Goodman, Lilit Karapetyan, Melissa Pugliano-Mauro, Joshua E Levenson, Jason J Luke
Journal: Front Immunol (2021)
Keywords: biomarkers, case report, genomics, immune-related adverse events, immunotherapy, transplant
MeSH terms: Allografts, Antibodies, Monoclonal, Humanized / therapeutic use, Antineoplastic Agents, Immunological / therapeutic use, Heart, Melanoma / drug therapy, Melanoma / secondary, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Case Reports, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Aged, Antibodies, Monoclonal, Humanized / administration & dosage, Antineoplastic Agents, Immunological / administration & dosage, Humans, Immune Checkpoint Inhibitors / therapeutic use, Immunotherapy, Male, Melanoma / diagnostic imaging, Tomography, X-Ray Computed, Transplant Recipients, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, Immune Checkpoint Inhibitors, Programmed Cell Death 1 Receptor, pembrolizumab

Background:
Immune-checkpoint inhibition has improved outcomes in metastatic melanoma. However, limited data describes the safety and efficacy of this treatment in the setting of cardiac allograft. Emerging translational and clinical evidence suggests that the majority of the benefit from these therapies is driven by the initial dose(s), and that attenuated dosing schedules may be as effective as continuous treatment.
Case presentation:
We present a case vignette of a cardiac transplant recipient with metastatic melanoma who experienced six months of clinical benefit after one dose of pembrolizumab and did not suffer allograft rejection.
Conclusion:
This case adds to the current available literature on the administration of checkpoint inhibitors in patients with cardiac allografts. Further, it explores potential markers of immunotherapy response and supports the potential of shorter or individualized immune-checkpoint blockade dosing strategies.
Persistent Necrotizing Mediastinitis after Dental Extraction
Authors: Eugênia Leal de Figueiredo, Carolina Chaves Gama Aires, Bruno José Carvalho Macêdo Neres, Bruna Luna de Araújo, José Alcides Almeida de Arruda, Ricardo José de Holanda Vasconcellos
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Mediastinitis is a rare, progressive, and destructive infectious process due to cervical or odontogenic infections, which, if not diagnosed early, may lead to several complications, including airway involvement and even an imminent risk of death. Herein, we report an unusual case of a 37-year-old male with a bilateral submandibular hard swelling after the left third molar extraction. After surgical intervention with submandibular drainage and antibiotic therapy, the infection persisted without explanation, since the patient was not hypertensive, did not have diabetes mellitus or sexually transmitted infections such as HIV or syphilis, and did not smoke or drink alcoholic beverages. A thoracic surgeon then intervened, treating the mediastinitis surgically by drainage, thus obtaining a significant improvement of the patient's health. Mediastinitis is a serious condition. Clinicians and maxillofacial surgeons should be alert to make an immediate diagnosis and select the appropriate treatment in order to prevent worsening of the patient's clinical condition.
Late lower extremity free flap vascular compromise and salvage in a Pediatric patient diagnosed with monophasic synovial sarcoma
Authors: Shervin Zoghi, Kelsey Millar, Steven Thorpe, Christopher O Bayne
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: flap salvage, flap failure, pediatric orthopedic surgery, sarcoma, vascular compromise
MeSH terms: Case Reports

Free tissue flap transfer can be utilized for reconstruction following tumor resection. While flap failure occurs primarily within 72 h post-operation, late failure after day 7 is rare. We present the case of a 14-year-old with a late lower extremity free flap vascular compromise, along with the successful flap salvage.
Posterior Reversible Encephalopathy Syndrome Caused by Fioricet (Butalbital-Acetaminophen-Caffeine)
Authors: Naomi Cret, Madalina Halalau, Shahab Rezvani, Alexandra Halalau
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

A common side effect of Fioricet (butalbital-acetaminophen-caffeine) is high blood pressure caused by the caffeine content. We report a case of a 54-year-old female who developed the worst headache of her life after taking 2 tablets of butalbital-acetaminophen-caffeine every six hours for three days before presenting to the emergency department, where her blood pressure was 178/87 mmHg. A brain MRI showed edema in the subcortical white matter of the right occipital lobe, right parietal lobe, and left occipital lobe. Posterior reversible encephalopathy syndrome (PRES) was diagnosed. The patient returned within the week with severe headaches, visual hallucinations, and a blood pressure of 150/80 mmHg. Repeat brain MRI showed slight improvement of edema. Her brain imaging studies completely normalized at 10 months after diagnosis. Although the patient received appropriate treatment, she was unable to make full recovery. Due to her inability to work and the constant pain, the patient continues to struggle with depression.
Fibrodysplasia ossificans progressiva: A rare disease with spinal deformity and severe hip dysfunction
Authors: Dong Sun, Peng Liu, Zhaolin Wang, Jianhu Mu, Jian Cao
Journal: Front Pediatr (2022)
Keywords: fascial release, fibrodysplasia ossificans progressive, heterotopic ossification, hip dysfunction, iliopsoas muscle
MeSH terms: Case Reports

Introduction:
Progressive fibrous dysplasia ossification (FOP) is a rare genetic disease characterized by congenital bone malformations and soft tissue masses that progress to heterotopic ossification. Congenital great toe deformity and progressive heterotopic ossifications with an anatomical and temporal pattern are the two classical clinical characteristics of FOP. We present a unique case of FOP characterized by mandibular angle fascial contracture and back and iliopsoas muscle ossification managed via surgery in a 13 year old girl.
Case presentation:
A 13 year old girl with a history of right cervical fascial release surgery and back heterotopic osteotomy presented to our clinic due to recurrence of heterotopic ossification, scoliosis, and progressive joint stiffness. Computed tomography (CT) or magnetic resonance imaging (MRI) examination confirmed heterotopic ossification of the left back and left iliopsoas muscle and spinal scoliosis. Two years after the surgery, the patient presented with recurrence of back heterotopic ossification and rapidly advancing ossification of the left iliopsoas muscle. Six months after surgery, the patient had no disability, pain and clinical recurrence, and the joint function recovered.
Conclusions:
In patients with multiple-site heterotopic ossification caused by FOP, oral function and hip stiffness improve with detailed facial release surgery and rehabilitation treatment. However, dorsal fascia ossification and spinal scoliosis can recur shortly after resection.
Bronchiolitis Obliterans Organizing Pneumonia as an Initial Presentation of Systemic Lupus Erythematosus: A Rare Case Report and Literature Review
Authors: Hung-Ping Wang, Chun-Ming Chen, Yih-Yuan Chen, Wei Chen
Journal: Case Rep Med (2016)

The etiology of bronchiolitis obliterans organizing pneumonia (BOOP) remains controversial. While it has been reportedly associated with several connective tissue disorders, there are only rare reports of BOOP associated with systemic lupus erythematosus (SLE). Herein, we report a 56-year-old female patient who presented with dyspnea on exertion, cough, fever, and joint pain of her left wrist and fingers as initial symptoms. Laboratory tests revealed positivity for anti-nuclear antibody, anti-Ro, and anti-double strand DNA antibody. In this case, the patient with SLE had respiratory illness as the initial symptom due to BOOP in the absence of clear etiology. The diagnosis of BOOP was confirmed by thoracic surgery biopsy. Her respiratory symptoms and radiologic findings significantly improved following prednisolone treatment.
Arteria lusoria dissection with mediastinal hematoma as a complication of a transradial coronary catheterization: Case report and literature review
Authors: Raffaele Serra, Tiberio Rocca, Luca Traina, Noemi Licastro, Nicola Ielapi, Vincenzo Gasbarro
Journal: Int J Surg Case Rep (2020)
Keywords: aberrant right subclavian artery, arteria lusoria, dissection, endovascular, mediastinal hematoma, transradial coronary catheterization
MeSH terms: Case Reports

Introduction:
Aberrant right subclavian artery (ARSA), or arteria lusoria is the most common embrologic anomaly of the aortic arch. It is generally asymptomatic and incidentally diagnosed during a radiological exam or procedure.
Presentation of case:
Here, we report a case of ARSA incidentally diagnosed and injured (dissection with mediastinal hematoma) during a right transradial coronary angiography in a 83 years old female patient. The patient underwent prompt hybrid procedure with the isolation of the right humeral artery from where we positioned a GORE® VIABAHN® 9 × 100 mm endoprosthesis. The procedure was successful with optimal results at early and long term follow up.
Discussion:
Sometimes, a dissection of the ARSA may occur, especially for excessive manipulation during endovascular procedures, and when such complication happens it should be promptly treated as it can be life-threatening.
Conclusion:
If transradial catheterization during coronary angiography becomes particularly difficult, requires longer time, or the guide wire enters in the descending aorta, particularly attention should be paid, as dreadful complications such as dissection or lesion may happen and prompt treatment is required.
Conjoined twins in a triplet pregnancy: a case report
Authors: Lynn J Shepherd, Graeme N Smith
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

Background. Conjoined twins are a rare complication of monozygotic twinning and are associated with high perinatal mortality. Case. Here we present a case of conjoined twins in a triplet pregnancy diagnosed at 13 of weeks gestation. With the aid of 3D ultrasound and MRI images, the parents were counseled regarding the management options, including continuation of pregnancy, termination of pregnancy, or selective fetocide. They chose selective fetocide of the conjoined twins and went on to deliver the remaining triplet at term. Conclusion. This case represents to our knowledge the only MRI images of conjoined twins in a triplet pregnancy and demonstrates how 3D imaging can be used to better counsel patients about management options.
A Rare Case of Splenic Pneumocystis jirovecii in a HIV-Positive Patient
Authors: Hafsa Abbas, Harish Patel, Ahmed Baiomi, Masooma Niazi, Trupti Vakde, Sridhar Chilimuri
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Introduction:
Human immunodeficiency virus (HIV) positive individuals with the CD4 count less than 200 cells/mm3 are at risk for opportunistic infections. Pneumocystis jirovecii, a fungal pathogen, is a common cause of opportunistic infections with predominantly pulmonary involvement. Disseminated P. jiroveciii infection presenting with hepatosplenic lesion is extremely rare. Case Summary. A 31-year-old male with HIV with and acquired immunodeficiency syndrome (AIDS) presented with diarrhea for 3 weeks. He had splenomegaly and inguinal lymphadenopathy on physical examination. Laboratory parameters revealed anemia and hypoalbuminemia, while stool studies for infectious etiology and fecal leucocyte were negative. Computed tomography (CT) of the chest and abdomen depicted consolidation of the lungs and a large splenic mass. He underwent fiberoptic bronchoscopy with transbronchial biopsy which was consistent with P. jirovecii pneumonia. He also had a ultrasound-guided core biopsy of the splenic mass which revealed necrotizing granulomas with Pneumocystis jirovecii infection on Grocott-Gomori's methenamine silver (GMS) stain and was initiated on treatment for P. jirovecii with sulfamethoxazole with trimethoprim.
Conclusion:
Malignancy and atypical infection are key differentials in patients presenting with hepatosplenic lesions. HIV positive patients are at increased risk of AIDS-related lymphoma. Tissue diagnosis is often required for further evaluation. Disseminated P. jirovecii presenting with splenic mass and liver lesion is extremely rare.
Case report: Thromboembolic heartworm induced lower limb necrosis in a dog
Authors: Piyanan Taweethavonsawat, Kasem Rattanapinyopituk, Kittipong Tachampa, Srireepong Kiertkrittikhoon, Wanarit Jitsamai, Wuthichai Klomkleaw, Nan Choisunirachon, Kiatpichet Komin
Journal: Front Vet Sci (2022)
Keywords: aberrant, dog, heartworm, ischemia, parasitic thrombosis
MeSH terms: Case Reports

A 9-year-old spayed female boxer suffered from lameness in both hindlimbs with a perforated paw wound. Additionally, a linear, worm-like creature was penetrating out from the wound. On examination, the dog was emaciated and infected with heartworms, detected through a fresh blood smear, echocardiography, and transabdominal ultrasonography. Adult heartworms were detected at the right atrium (RA), right ventricle (RV), and pulmonary artery (PA), including the distal abdominal aorta, external iliac, and femoral arteries. During the surgery, adults heartworms were removed from both the heart (n = 8) and the femoral arteries (n = 5). Unfortunately, not all heartworms could be removed from these locations due to the extent of the heartworm infection. The opened, ischemic wounds in the distal limbs progressively expanded and the dog subsequently died, possibly due to caval syndrome complications and septicemia. The necropsy showed no evidence of an atrial septal defect, and a total of 25 adult heartworms were collected from the perforated paw, heart, pulmonary, and femoral arteries. All worms collected during the necropsy process were molecularly confirmed to be Dirofilaria immitis.