OpenMed/multicare-articles huggingface dataset:
Cloacal Malformation with Associated Urethral Atresia
Authors: Tamador Al-Shamaileh, Laura Tiusaba, Shimon Eric Jacobs, Teresa Lynn Russell, Elizaveta Bokova, Hans G Pohl, Briony K Varda, Christina Ho, Christina Feng, Andrea Badillo, Marc A Levitt
Journal: European J Pediatr Surg Rep (2023)
Keywords: cloaca, rectal patch, urethra atresia
MeSH terms: Case Reports

Introduction Cloacal malformations comprise a heterogeneous group of anomalies that are considered the most complex anorectal malformations (ARMs) in females. Precise evaluation to identify the unique anatomy prior to reconstruction with collaboration between colorectal surgeons, urologists, and gynecologists is vital. Here, we present a rare anatomical variation in a patient with a cloacal malformation which affected operative and postoperative management. Case description A 6-year-old female with cloaca who underwent colostomy, vaginostomy, and vesicostomy as a newborn presented for reconstruction. Her VACTERL workup was negative except for an atretic right kidney. Her ARM index included the cloaca, a normal spine, and sacrum with a lateral sacral ratio of 0.7, predicting good potential for bowel continence. Cystoscopy through the vesicostomy showed a small bladder with normal ureteral orifices, and a closed bladder neck, with no identifiable urethra. A cloacagram showed an atretic common channel, a single small vagina, and a rectum below the pubococcygeal line. The patient underwent a posterior sagittal anorectovaginourethroplasty, vaginal patch using rectum, rectoplasty, and perineal body reconstruction. The urethra was not amenable to reconstruction, so the vesicostomy was preserved and a future Mitrofanoff was planned. Conclusion Urethral atresia is a rare and challenging finding in cloaca patients, and a vesicostomy is needed to drain urine in the newborn period. Preoperative examination under anesthesia, cystoscopy, vaginoscopy, and cloacagram are crucial to identify the precise anatomy and to plan accordingly.
When It Doesn't Fit: Congenital Anomalies of the Choledochus
Authors: Helena Reusens, Mark Davenport
Journal: European J Pediatr Surg Rep (2020)
Keywords: choledochal cyst, congenital choledochal malformation, epidermoid cyst, hepaticojejunostomy
MeSH terms: Case Reports

Introduction Congenital choledochal malformations (CCMs) are characterized by intra- and/or extrahepatic bile duct dilatation. Five basic types (1-5) are recognized in Todani's classification and its modifications, of which types 1 and 4 typically have an associated anomalous pancreatobiliary junction and common channel (CC). We describe two cases with previously undescribed features. Case Report 1 Antenatal detection of a cyst at porta hepatis was made in an otherwise normal girl of Iranian parentage. She was confirmed to be a CCM (20 mm diameter), postnatally, with no evidence of obstruction. Surgical exploration was performed at 12 weeks. She had an isolated cystic dilatation of the right-hepatic duct only. The left-hepatic duct and common bile duct (CBD) were normal without a CC. Histology of the resected specimen showed stratified squamous epithelium. Case Report 2 A preterm (31 weeks of gestation) boy of Nigerian parentage was presented. His mother was HIV + ve and he was treated with nucleoside reverse transcriptase inhibitors following birth. He had persistent cholestatic jaundice and a dilated (10 mm) bile duct from birth. Although the jaundice resolved, the dilatation persisted and increased, coming to surgery aged 2.5 years. This showed cystic dilatation confined to the common hepatic duct, and otherwise normal distal common bile duct and no CC. Result Both underwent resection with the Roux-en-Y hepaticojejunostomy reconstruction to the transected right-hepatic duct alone in case 1, leaving the preserved left duct and CBD in continuity, and to the transected common hepatic duct in case 2. Conclusions Neither choledochal anomaly fitted into the usual choledochal classification and case 1 appears unique in the literature.
Fatal Infection Caused by Chromobacterium violaceum: A Case Report from a Tertiary Care Hospital in Bangladesh
Authors: Sadia Sharmin, Aflatun Akter Jahan, S M Mostofa Kamal, Protim Sarker
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Chromobacterium violaceum is a Gram-negative bacterium, found in tropical and subtropical regions. C. violaceum infection rarely occurs, but once occurs, it is associated with significant mortality due to severe systemic infection. Since the first human case from Malaysia in 1927, >150 cases of C. violaceum infection have been reported worldwide. We have described here a fatal case of C. violaceum infection in a tertiary care hospital in Dhaka, Bangladesh. To the best of our knowledge, this is the first case of C. violaceum infection in Bangladesh.
Case Report: Anomalous Experience in a Dissociative Identity and Borderline Personality Disorder
Authors: Hugo André de Lima Martins, Valdenilson Ribeiro Ribas, Ketlin Helenise Dos Santos Ribas, Luciano da Fonseca Lins, Alessandra Ghinato Mainieri
Journal: Front Psychiatry (2022)
Keywords: anomalous experience, borderline, case report, dissociation, mediumship, personality
MeSH terms: Case Reports

Introduction:
Dissociative identity disorder, formerly called multiple personality disorder, is a rupture of identity characterized by the presence of two or more distinct personality states, described in some cultures as an experience of possession.
Objective:
The case of a 30-year-old woman with dissociative identity disorder and borderline personality disorder associated with a previous history of anomalous experience was reported.
Case report:
A 30-year-old woman who fulfilled the DSM-5 criteria for dissociative identity disorder and borderline personality disorder reported the presence of unusual sensory experiences (clairvoyance, premonitory dreams, clairaudience) since she was 5 years old. The patient told that for 12 months she presented episodes in which a "second self" took charge of her actions: she would then speak with a male voice, become aggressive, and require several people to contain her desire for destruction. After 3 months of religious follow-up, and accepting her unusual experiences and trance possessions as normal and natural, she had significant improvement.
Conclusion:
When approaching DID and BPD patients, it is necessary to observe the anomalous phenomena (in the light of) closer to their cultural and religious contexts, to promote better results in the treatment of their disorders, which has not been explored in the treatment guide.
Biatrial myxoma floating like a butterfly: A case report and review of the literature
Authors: Yanhui Li, Xiaodong Li, Xiaocong Wang, Liping Chen
Journal: Medicine (Baltimore) (2018)
MeSH terms: Heart Neoplasms / pathology, Myxoma / pathology, Case Reports, Review, Female, Heart Atria, Humans, Middle Aged

Rationale:
Myxoma is the most common type of primary benign cardiac tumor in adults. The left atrium is the most frequent site of origin followed by the right atrium. Biatrial myxoma is extremely rare.
Patient concerns:
We present a case of a 60-year-old woman with biatrial myxoma, who presented with palpitations for one month.
Diagnoses:
Echocardiography revealed an irregular homogeneous mass in the left atrium and in the right atrium, and were connected via the fossa ovalis suspiciously. Computed tomography angiography revealed a hypo-intense mass in both atria.
Interventions:
The tumors were successfully removed by surgical excision and histological analysis confirmed the diagnosis.
Outcomes:
The patient was discharged one week after surgery, and did not experience recurrence during the two years follow-up period.
Lessons:
Biatrial myxoma is rare. Surgical resection is the mainstay of treatment and there is no recurrence reported. The clinical data and the features on echocardiogram of biatrial myxoma are reviewed, providing important clinical information for the pre-operative diagnosis and intraoperative removal of biatrial myxoma.
Interpretation of PET/CT findings in patients with advanced lung cancer who have undergone pleurodesis
Authors: Marcus Paulo Fernandes Amarante, Riad Naim Younes, Letícia Rigo, Marcelo Rocha de Sousa Cruz
Journal: Ecancermedicalscience (2014)
Keywords: pet/ct, lung cancer, pleurodesis
MeSH terms: Case Reports

A consensus has not yet been reached for the ideal moment to carry out pleurodesis in patients with malignant pleural effusion among the majority of centres, especially those which don't specialise in oncologic treatment. The PET (positron emission tomography)/CT (computed tomography) used in the staging of patients with non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) has caused controversy when used in the evaluation of therapeutical response and in detection of recurrence in patients with pleurodesis. For not distinguishing between inflammatory and neoplasic processes while using PET or CT, suspicion of pleural involvement can result in the indication for invasive diagnostic procedures or inadequate exchange of therapy. In such cases, the hypothesis of the inflammatory process must be included in the differential diagnoses for positive findings with the PET/CT in patients with NSCLC who have undergone pleurodesis, independently of time since the procedure. The reports of two patients with NSCLC have been presented in order to illustrate situations in which pleurodesis has been performed at the moment of diagnosis, outside of a cancer centre.
Mediastinal Tracheostoma for Treatment of Tracheostenosis after Tracheostomy in a Patient with Mucopolysaccharidosis-Induced Tracheomalacia
Authors: Yasuhiro Chikaishi, Kenichi Kobayashi, Shuichi Shinohara, Akihiro Taira, Yusuke Nabe, Shinji Shinohara, Taiji Kuwata, Masaru Takenaka, Soichi Oka, Ayako Hirai, Kazue Yoneda, Koji Kuroda, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Background:
Treatment of tracheostenosis after tracheostomy in pediatric patients is often difficult. Mucopolysaccharidosis is a lysosomal storage disease that may induce obstruction of the airways.
Case presentation:
A 16-year-old male patient underwent long-term follow-up after postnatal diagnosis of type II mucopolysaccharidosis. At 11 years of age, tracheostomy was performed for mucopolysaccharidosis-induced laryngeal stenosis. One week prior to presentation, he was admitted to another hospital on an emergency basis for major dyspnea. He was diagnosed with tracheostenosis caused by granulation. The patient was then referred to our institution. The peripheral view of his airway was difficult because of mucopolysaccharidosis-induced tracheomalacia. For airway management, a mediastinal tracheostoma was created with extracorporeal membrane oxygenation. To maintain the blood flow, the skin incision for the mediastinal tracheal hole was sharply cut without an electrotome. The postoperative course was uneventful, and the patient was weaned from the ventilator on postoperative day 19. He was discharged 1.5 months postoperatively. Although he was referred to another institution because of respiratory failure caused by his primary disease 6 months postoperatively, his airway management remained successful for 1.5 years postoperatively.
Conclusion:
Mediastinal tracheostomy was useful for treatment of tracheostenosis caused by granulation tissue formation after a tracheostomy.
Concomitant Extramedullary Plasmacytoma in the Oropharynx and Hypopharyngeal Squamous Cell Carcinoma
Authors: Hiroki Sato, Shoko Yoshimasu, Isaku Okamoto, Akira Shimizu, Yasuaki Katsube, Hideki Tanaka, Kiyoaki Tsukahara
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

We report a rare case of hypopharyngeal squamous cell carcinoma occurring synchronously with extramedullary plasmacytoma (EPM) of the oropharynx in which radiotherapy was used as the curative treatment. A 73-year-old man presented with a sore throat that had persisted for 6 months. Examination revealed a superficial, smooth tumorous lesion at the base of his tongue with a red hue in the oropharynx. In addition, a protruding tumor was observed on the mucosal surface in the right piriform recess of the hypopharynx, and computed tomography revealed thickening of the pharyngeal wall at the right tongue base and in the right piriform recess of the hypopharynx. Because no definitive diagnosis could be reached for the lesion at the base of the tongue, the entire tongue-base tumor was resected by transoral surgery under endoscopy. Proliferation of plasma cells in the tumor was detected, and a bone marrow puncture test ruled out multiple myeloma leading to a definitive diagnosis of Stage I (cT1N0M0) squamous cell carcinoma in the right piriform recess of the hypopharynx and primary extramedullary plasmacytoma in the oropharynx. Radiotherapy was selected for curative treatment with a complete response for both cancers. No recurrences have been observed as of 12 months postoperatively.
Endovascular Repair for Giant Right Subclavian Artery Aneurysm With Gore Viabahn and Pull-Through Procedure: A Case Report
Authors: Binshan Zha, Zhiyong Chen, Huan Ou-Yang
Journal: Front Surg (2022)
Keywords: aneurysm, case report, endovascular repair, stent graft, subclavian artery
MeSH terms: Case Reports

Background:
Giant true subclavian artery aneurysms (SAAs) (>5 cm) are rare. Technical and anatomical considerations complicate the endovascular treatment of SAAs and pose some challenges. Here, we present a giant right SAA that was successfully excluded using stent grafts with the pull-through technique after two interventional steps and discuss the pull-through technique details as well as the lessons to be learned from this case.
Methods:
A 50-year-old man presented at our department complaining of dyspnea and hoarseness. Computed tomography angiography (CTA) showed a giant right SAA with partial intraluminal thrombus and severe angulated aneurysm necks originating from the proximal right subclavian artery, approximately 70 × 71 mm in size.
Outcomes:
An 8 × 100-mm Gore Viabahn was selected to exclude the SAA. A decision was made to stabilize the wire tension using the pull-through technique. Final angiography showed that the SAA was essentially excluded, and slight endoleak was observed. At 6 months, imaging showed that the aneurysm was not obviously shrinking, there was still an endoleak and stent graft dislodgement was observed. Angiography confirmed a type Ia endoleak, which was managed by the placement of a 10 × 50-mm Gore Viabahn, again with the assistance of the pull-through technique. At the 25-month follow-up, CTA showed that the SAA was satisfactorily excluded, with no endoleak, and the SAA was reduced in size.
Conclusions:
Endovascular treatment of SAAs is a safe, reliable and minimally invasive approach. The pull-through technique may improve wire tension and device stabilization. Additionally, size selection and positioning should be reappraised under a severely angulated aneurysm neck.
Imaging findings of gastric calcifying fibrous tumour
Authors: Sae Miyashita, Yasuji Ryu, Harumi Takata, Yoshihide Asaumi, Mitsuaki Sakatoku, Takuya Seike, Toshiyuki Okamura, Katsuhisa Inamura, Hiroshi Kawai, Noriko Okuno, Shintaro Terahata
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Calcifying fibrous tumours (CFTs) are rare benign lesions that usually affect the soft tissues, the mesentery and the peritoneum. Gastric CFT is particularly rare. Here, we report a CFT found incidentally in a 31-year-old male. The mass was well circumscribed and showed partial calcification on the CT scan, with dark signal intensity seen on T2 weighted MRI. To the best of our knowledge, there is very limited published information concerning imaging findings of CFTs. We discuss the CT scan and MRI findings of this patient, which can be considered typical for gastric CFT, and present a review of the limited literature available.
Ecthyma gangrenosum without bacteremia in a previously healthy man: a case report
Authors: Serap Gençer, Serdar Ozer, Aylin Ege Gül, Mustafa Doğan, Oznur Ak
Journal: J Med Case Rep (2008)

Introduction:
Ecthyma gangrenosum is known as a characteristic lesion of Pseudomonas aeruginosa sepsis and is usually seen in immunocompromised patients.
Case presentation:
A previously healthy 63-year-old man was admitted with sloughy necrotic ulcerations of the skin over his sternum. He was afebrile and in good condition. A skin biopsy revealed ecthyma gangrenosum. Blood cultures remained sterile, but a culture of biopsy material grew Pseudomonas aeruginosa.
Conclusion:
Ecthyma gangrenosum may develop even in the absence of bacteremia and even in immunocompetent patients. It should be considered as a possible diagnosis even when a previously healthy patient has negative blood cultures.
Focal segmental glomerulosclerosis associated with mitochondrial disease
Authors: Kenneth Lim, David Steele, Andrew Fenves, Ravi Thadhani, Eliot Heher, Amel Karaa
Journal: Clin Nephrol Case Stud (2017)
Keywords: deafness, focal segmental glomerulosclerosis (fsgs), hearing loss, kidney transplantation, mitochondrial disease, whole exome sequencing
MeSH terms: Case Reports

Primary mitochondrial diseases (MD) are complex, heterogeneous inherited diseases caused by mutations in either the mitochondrial or nuclear DNA. Glomerular diseases in MD have been reported with tRNA mutation m.3243A>G causing a syndrome of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). We describe here a case of focal segmental glomerulosclerosis (FSGS) associated with a new tRNA mutation site. A 34-year-old man with a history of living related kidney transplantation, diabetes, hearing loss, and developmental delay presented to the outpatient clinic with complaints of new behavioral difficulties, worsening symptoms, and brain involvement on imaging. Physical examination was remarkable for difficulty hearing, a pattern of dysarthric speech, and cerebellar gait. Laboratory investigations including lactate levels were unremarkable. Based on this set of clinical circumstances, concern for an underlying genetic abnormality was raised. Multiple metabolic tests were unremarkable. Whole exome sequencing revealed a mitochondrial MT-TW tRNA change at position m.5538G>A. Genotype-phenotype correlations are consistent with this tRNA mutation as a cause of his symptoms. To the best of our knowledge, this is the first case describing FSGS-associated MD caused by an m.5538 G>A mutation. Consideration of an underlying MD should be made in patients presenting with deafness, neurologic changes, diabetes, and renal failure.
Gastric Mucormycosis: An Infection of Fungal Invasion into the Gastric Mucosa in Immunocompromised Patients
Authors: Haider A Naqvi, Muhammad Nadeem Yousaf, Fizah S Chaudhary, Lawrence Mills
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Primary gastric mucormycosis is a rare but potentially lethal fungal infection due to the invasion of Mucorales into the gastric mucosa. It may result in high mortality due to increased risk of complications in immunocompromised patients. Common predisposing risk factors to develop gastric mucormycosis are prolonged uncontrolled diabetes mellitus with or without diabetic ketoacidosis (DKA), solid organ or stem cell transplantation, underlying hematologic malignancy, and major trauma. Abdominal pain, hematemesis, and melena are common presenting symptoms. The diagnosis of gastric mucormycosis can be overlooked due to the rarity of the disease. A high index of suspicion is required for early diagnosis and management of the disease, particularly in immunocompromised patients. Radiological imaging findings are nonspecific to establish the diagnosis, and gastric biopsy is essential for histological confirmation of mucormycosis. Prompt treatment with antifungal therapy is the mainstay of treatment with surgical resection reserved in cases of extensive disease burden or clinical deterioration. We presented a case of acute gastric mucormycosis involving the body of stomach in a patient with poorly controlled diabetes and chronic renal disease, admitted with acute onset of abdominal pain. Complete resolution of lesion was noted with 16 weeks of medical treatment with intravenous amphotericin B and posaconazole.
Treatment with penicillin G and hydrocortisone reduces ALS-associated symptoms: a case series of three patients
Authors: Bert Tuk, Harmen Jousma, Pieter J Gaillard
Journal: F1000Res (2017)
Keywords: amyotrophic lateral sclerosis, gaba, dysarthria, dysphagia, hydrocortisone, neuromuscular disease, penicillin g, respiratory depression

Three male Caucasian patients with ALS were admitted to the hospital due to progressive dysphagia and dysarthria. During two 21-day courses of penicillin G and hydrocortisone, these patients' dysphagia and dysarthria resolved. The patient's other ALS-associated symptoms also improved, including respiratory function, coordination, walking, and muscle strength. This is the first report of a treatment with a protocol for treating dysphagia, dysarthria, respiratory depression and other ALS-related symptoms. Furthermore, the observations are consistent with the recent hypothesis that the successful treatment of ALS symptoms with this treatment course in six patients with syphilitic ALS was not directly due to the treatment of syphilis; but that the administered penicillin G and/or hydrocortisone treated these patients' ALS symptoms due the off-target pharmacological activity of penicillin G and/or hydrocortisone. This report therefore underscores the need to evaluate the efficacy of this treatment course in a clinical trial.
Case report: Case report and literature review: Treatment of sweat gland carcinoma
Authors: Yuhong Dai, Jin Feng, Xiao Zhou
Journal: Front Oncol (2023)
Keywords: chemotherapy, immunotherapy, radiotherapy, surgery, sweat gland carcinoma
MeSH terms: Case Reports

Background:
Sweat gland carcinoma (SGC) is a rare neoplasm originating from sweat glands. Surgical resection is the first choice for SGC treatment, and there is no consensus on other treatments for advanced SGC.
Methods and result:
In this case report, we present a case of a female patient with advanced SGC who received surgery; radiotherapy; multiple lines of chemotherapy, which include docetaxel, nedaplatin, albumin-bound paclitaxel, and pemetrexed; and immunotherapy (camrelizumab). The survival time of this patient is 35 months. MRI tumor monitoring indicated that these treatments slowed the progression of the disease. The effectiveness of chemotherapy, radiotherapy, and immunotherapy should be tested for more patients with SGC in the future.
Conclusion:
Although the patient's tumor was uncontrolled eventually, multiple treatments delayed tumor growth over a period of time, providing ideas for others when choosing regimens.