OpenMed/multicare-articles huggingface dataset:
Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
Authors: Cheng Han Wu, Eugene Wei Ren Yang, Kelvin Kah Ho Lor
Journal: Biomedicine (Taipei) (2021)
Keywords: anterior cervical spine surgery, recurrent laryngeal nerve palsy, revision surgery
MeSH terms: Case Reports

Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that acute RLNP can rarely occur contralateral to the side of surgical approach in the setting of revision surgery. Surgeons performing revision ACDF can consider approaching from the same side as the index surgery or a posterior approach to reduce the risk of developing bilateral RLNP.
Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast
Authors: Tae Hwan Park, Sang Won Seo, June Kyu Kim, Choong Hyun Chang
Journal: World J Surg Oncol (2011)
MeSH terms: Breast Neoplasms / surgery, Mammaplasty / methods, Skin Neoplasms / surgery, Case Reports, Adult, Breast / injuries, Breast / pathology, Breast Neoplasms / pathology, Dermatofibrosarcoma / pathology, Dermatofibrosarcoma / surgery, Female, Humans, Skin Neoplasms / pathology, Time Factors

Dermatofibrosarcoma protuberans is an uncommon locally aggressive malignant neoplasm that most frequently appears in the trunk, followed by the extremities, head, and neck. But occurrence in the breast is extremely rare. We present a case of a 28-year-old woman, who had a history of trauma 5 years previously and excision 1 year before presentation at our clinic. We performed wide excision, together with microscopic and immunohistochemical analysis. No postoperative oncologic treatment was used and she remains disease-free 1 year after the surgery without any tumor recurrence. Here, we report a case of dermatofibrosarcoma protuberans in the female breast and present a detailed discussion of the diagnosis and treatment with reference to available literatures.
Undifferentiated Pleomorphic Sarcoma of Pancreas: A Case Report and Review of the Literature for the Last Updates
Authors: Behnam Sanei, Amirhosein Kefayat, Melika Samadi, Parvin Goli, Mohammad Hossein Sanei, Fatemeh Ghahremani, Alireza Amouheidari
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

The most prevalent type of soft tissue sarcoma is undifferentiated pleomorphic sarcoma (UPS) or previously known as malignant fibrous histiocytoma. It accounts over 20% of all soft tissue sarcomas and occurs most frequently in the extremities, trunk, and retroperitoneum. However, it has been rarely observed in the digestive system. Pancreas sarcoma represents less than 1% of all pancreatic tumors, and primary UPS of the pancreas is even rarer. It exhibits high recurrence and poor prognosis. In this case, a 72-year-old woman with a UPS tumor which was located in the pancreas head and neck without adhesion to the retroperitoneum will be discussed.
A paraduodenal hernia revealed by bowel obstruction: case report and literature review
Authors: Mustapha Ben Moussa, Ismail Nouhi, Taib Lachguar, Mohamed El Absi, El Hassan El Faricha El Alami, Mohamed El Ouanani, El Mahjoub Echarrab, Mohamed El Amraoui, Mohamed Rachid Chkof
Journal: Pan Afr Med J (2018)
Keywords: internal hernia, intestinal obstruction, left paraduodenal hernia
MeSH terms: Duodenal Diseases / complications, Hernia, Abdominal / complications, Intestinal Obstruction / etiology, Case Reports, Review, Acute Disease, Duodenal Diseases / diagnosis, Duodenal Diseases / pathology, Hernia, Abdominal / diagnosis, Hernia, Abdominal / pathology, Humans, Intestine, Small / pathology, Male, Middle Aged

Internal hernias are defined as the protrusion of abdominal viscera through an aperture in the intraperitoneal recesses, they are considered as a rare cause of intestinal obstruction. The paraduodenal hernias are the most common type of congenital hernia especially the left-sided ones. We report a case of a 46 year-old man presenting a left paraduodenal hernia with acute small bowel obstruction, which was firstly (preoperatively) assigned to a tumoral cause.
Emmonsia helica Infection in HIV-Infected Man, California, USA
Authors: Martin Rofael, Ilan S Schwartz, Lynne Sigler, Li K Kong, Nicholas Nelson
Journal: Emerg Infect Dis (2018)
Keywords: aids, california, hiv, emmonsiosis, endemic dimorphic fungi, mycosis, opportunistic infection, viruses
MeSH terms: Chrysosporium, HIV Infections / complications, Mycoses / complications, Case Reports, Letter, Adult, Antifungal Agents / therapeutic use, CD4 Lymphocyte Count, California / epidemiology, Fatal Outcome, Humans, Male, Mycoses / drug therapy, Viral Load, Antifungal Agents

Emmonsia-like fungi have rarely been reported from North America. We report a fatal case of E. helica infection in a man with advanced HIV infection from California, USA, who had progressive respiratory failure and a brain abscess.
Extracorporeal cardiac shock wave therapy ameliorates clinical symptoms and improves regional myocardial blood flow in a patient with severe coronary artery disease and refractory angina
Authors: Christian Prinz, Oliver Lindner, Thomas Bitter, Detlef Hering, Wolfgang Burchert, Dieter Horstkotte, Lothar Faber
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Different therapeutic options are being used for chronic coronary artery disease (CAD). We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The patient received cardiac shock wave therapy (CSWT) over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium.
Concurrent germline and somatic pathogenic BAP1 variants in a patient with metastatic bladder cancer
Authors: Megan E Tesch, Justin A Pater, Gillian Vandekerkhove, Gang Wang, Kristin Binnington, Alan I So, Alexander W Wyatt, Bernhard J Eigl
Journal: NPJ Genom Med (2020)
MeSH terms: Case Reports

Germline pathogenic variants in the BRCA1-associated protein-1 (BAP1) gene cause the BAP1 tumor predisposition syndrome (TPDS). BAP1 TPDS is associated with an increased risk of uveal and cutaneous melanoma, mesothelioma, renal cell carcinoma, and several other cancer subtypes. Here, we report a germline nonsense BAP1 variant (c.850G>T, p.Glu284Ter) in a patient with bladder cancer and a strong family history of malignancy. Concurrently, we identified a somatic frameshift BAP1 variant, and as expected, immunostaining validated the loss of BAP1 protein in patient-derived tumor specimens. Together, these data provide strong evidence of pathogenicity in this case. With the addition of bladder cancer to the tumor types reported with germline BAP1 mutations, our understanding of the BAP1 TPDS continues to evolve, and may affect future screening and surveillance guidelines.
Case report: Application of morphology in the diagnosis of siderosis in a patient with tuberculosis infection
Authors: Yuli Zhou, Ying Wang, Wenbing Liu, Haibin Wang, Daqiang He, Juan Jin, Qiaoyun Li, Junying Li, Qiong Chen, Senlin Ruan, Shenghai Wu, Jiyu Tang
Journal: Front Oncol (2023)
Keywords: case report, morphology, siderosis, tuberculosis, welder
MeSH terms: Case Reports

A 49-year-old male who had been working in welding for more than 30 years was admitted to the hospital for a medical checkup that revealed a lung shadow without specific symptoms such as coughing and sputum. Imaging studies showed diffuse ground-glass changes in both lungs, wall cavities with wall nodules, multiple peripheral nodules, and some nodules with calcification. The patient has been engaged in welding work for more than 30 years and exposed to iron dust. Lung tissue biopsy, routine morphological and pathological fluid basis examination of alveolar lavage fluid, can be considered as pulmonary iron particles, which can be regarded as iron dust lung. Acid-fast bacilli were detected in both fibrobronchoscopic brush extract and alveolar lavage fluid acid-fast staining. As the pathological examination revealed granulomatous inflammation showed caseation necrosis, the patient was judged to have concomitant pulmonary TB. After the diagnosis was made, the patient was no longer exposed to dust and was treated with appropriate anti- tuberculosis (TB) therapy. Lung lesions caused by welding have been reported, but the simultaneous finding of siderosis with pulmonary TB is specific to the case presented here. By describing the imaging features, combining different staining methods of alveolar lavage fluid and pathological examination of lung tissue, we showed various morphological manifestations of this case, aiming at improving the morphological diagnosis level of laboratory physicians and enabling patients to be diagnosed and treated early.
Adhesive-Enhanced Sternal Closure: Feasibility and Safety of Late Sternal Reentry
Authors: Aaron J Spooner, Holly E M Mewhort, Lisa M DiFrancesco, Paul W M Fedak
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

This clinical case report describes sternal reentry performed years after adhesive-enhanced sternal closure using Kryptonite bone cement. This report provides novel data on the late effects of this innovation. We observed that sternal reentry is feasible and safe. The adhesive did not weaken from biodegradation over a period of several years. There was no evidence of adherence to adjacent soft tissues or other nonbony deep mediastinal structures. Surgeons who receive patients who require redoing cardiac surgery after adhesive-enhanced closure with Kryptonite can be reassured that sternal reentry is safe and feasible.
Vogt-Koyanagi-Harada Syndrome in a Ugandan: Diagnostic and Therapeutic Challenges
Authors: Felix Bongomin, Francis S Onen, Mark Kaddumukasa
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Background:
Vogt-Koyanagi-Harada (VKH) syndrome is a multisystemic autoimmune disease of uncertain pathogenesis. Infectious aetiology has been proposed which is suggested to lead to the loss of melanocytes in the skin, inner ear, meninges, and uvea in those who are genetically predisposed. Information regarding VKH syndrome is scanty among the African population.
Case presentation:
We report a 28-year-old HIV-uninfected Ugandan woman who had previously been well and presented with chronic bilateral panuveitis; symmetrical vitiligo patches on the head, trunk, and upper limbs; tinnitus; and poliosis of the scalp hair, eyelashes, and eyebrows. A flu-like syndrome preceded this. Several weeks of prednisolone and azathioprine therapy resulted in remarkable improvement of the ocular and inner ear symptoms.
Conclusion:
A high index of suspicion is required in diagnosing VKH syndrome, even in sub-Saharan Africa where the disease is reported to be rare. Initiation of prompt and appropriate treatment prevents blindness and other complications.
Rare Head and Neck Benign Mesenchymoma in Close Proximity to Submandibular Gland in a Pediatric Patient: Case Report and Review of the Literature
Authors: Priyanka Jain, Shraddha Mukerji
Journal: Case Rep Otolaryngol (2015)

Pediatric head and neck masses are commonly congenital in origin or of infectious etiology. We present a rare case of benign mesenchymoma in close proximity to the submandibular gland in an otherwise asymptomatic child. Computerized tomography (CT) scan of the head and neck area revealed a benign lesion, which was later determined to be a benign mesenchymoma on histopathology. The child did well after surgery without any reported recurrence. We discuss the salient features of a benign mesenchymoma in a child and also discuss relevant imaging and management.
Isolated duodenal Crohn's disease: a case report and a review of the surgical management
Authors: Faruk Karateke, Ebru Menekşe, Koray Das, Sefa Ozyazici, Pelin Demirtürk
Journal: Case Rep Surg (2013)

Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn's diseases, and reviewed the surgical options in the literature.
Lateral Lumbar Interbody Fusion for Ossification of the Yellow Ligament in the Lumbar Spine: First Reported Case
Authors: Kengo Fujii, Tetsuya Abe, Toru Funayama, Hiroshi Noguchi, Keita Nakayama, Kousei Miura, Katsuya Nagashima, Hiroshi Kumagai, Masashi Yamazaki
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

When ossification of the yellow ligament (OYL) occurs in the lumbar spine and extends to the lateral wall of the spinal canal, facetectomy is required to remove all of the ossified lesion and achieve decompression. Subsequent posterior fixation with interbody fusion will then be necessary to prevent postoperative progression of the ossification and intervertebral instability. The technique of lateral lumbar interbody fusion (LLIF) has recently been introduced. Using this procedure, surgeons can avoid excess blood loss from the extradural venous plexus and detachment of the ossified lesion and the ventral dura mater is avoidable. We present a 55-year-old male patient with OYL at L3/4 and anterior spondylolisthesis of L4 vertebra, with concomitant ossification of the posterior longitudinal ligament, who presented with a severe gait disturbance. He underwent a 2-stage operation without complications: LLIF for L3/4 and L4/5 was performed at the initial surgery, and posterior decompression fixation using pedicle screws from L3 to L5 was performed at the second surgery. His postoperative progress was favorable, and his interbody fusion was deemed successful. Here, we present the first reported case of LLIF for OYL of the lumbar spine. This procedure can be a good option for OYL of the lumbar spine.
Intraoperative real-time fluorescence angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report
Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C Ambe, Konstantinos Zarras
Journal: Patient Saf Surg (2018)
Keywords: icg fluorescence angiography, incarcerated obturator hernia, intestinal blood flow, laparoscopy
MeSH terms: Case Reports

Background:
Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative fluorescence angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction.
Case presentation:
The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented. An incarcerated segment of the small bowel was reduced during emergency laparoscopy. Intraoperative ICG fluorescence angiography revealed ischaemic changes in the normal appearing bowel, so that the involved segment was resected. The postoperative course was uneventful and the patient was discharged home safely on postoperative day seven.
Conclusion:
Intraoperative ICG fluorescence angiography provides an objective method of judging bowel perfusion and therefore represents a useful tool for assessing intestinal perfusion in patients with incarcerated hernia.
Undifferentiated round cell sarcoma of the broad ligament
Authors: Rebeca Diaz-Murillo, Carlos Iglesias-Sanchez, Ignacio Zapardiel
Journal: Ecancermedicalscience (2013)
Keywords: broad ligament tumour, round cells tumour, sarcoma, undifferentiated sarcoma
MeSH terms: Case Reports

Sarcomas of the broad ligament are very uncommon. To our knowledge, there are no cases published of undifferentiated round cell sarcoma of the broad ligament. Round cell sarcomas are a rare and very aggressive variant, which due to their sensitivity to chemotherapy, have an acceptable prognosis. We report the case of a 27-year-old woman who presented with a pelvic mass with a 7-cm diameter placed on the right broad ligament. After surgery, she was diagnosed with undifferentiated round cell sarcoma of the broad ligament. The patient received adjuvant chemotherapy and radiotherapy, and after 12 years of follow-up, she still remains asymptomatic. Proper differential diagnoses as well as an appropriate adjuvant therapy after surgical treatment seem to be essential to obtain good oncological outcomes in this rare entity.
Rapid Change in Mental Status in a Patient with Hypereosinophilia
Authors: Hanyin Wang, John K Erban
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

We present the case of a 48-year-old female with acute onset altered mental status, who was found to have eosinophilia, elevated troponin, and embolic strokes. Extensive testing for autoimmune, infectious, and coronary artery etiologies was unremarkable. After a cardiac MRI revealed focal myocardial hyperenhancement, the patient underwent an endomyocardial biopsy with findings consistent with eosinophilic myocarditis. The patient was diagnosed of idiopathic hypereosinophilic syndrome and started on prednisone and apixaban. Our case highlights the importance of considering hypereosinophilic syndrome when eosinophilia is associated with multisystem impairments, as tissue biopsy is usually required to diagnose this rare condition.
Deep vein thrombosis after insertion of a central venous catheter: a case report
Authors: Ihdinal Mukti, Artaria Tjempakasari
Journal: Pan Afr Med J (2022)
Keywords: deep vein thrombosis, case report, double lumen catheter, hemodialysis
MeSH terms: Catheterization, Central Venous / adverse effects, Catheterization, Central Venous / methods, Central Venous Catheters / adverse effects, Venous Thrombosis / diagnosis, Venous Thrombosis / drug therapy, Venous Thrombosis / etiology, Case Reports, Humans, Male, Pain, Warfarin, Warfarin

A male patient aged 50 years, presented with a swelling in the right leg which had occurred five days before hospital admission. This was associated with pain in the swollen leg. The patient had a history of femoral double lumen catheter (DLC) insertion for hemodialysis. On physical examination, Wong Baker's scale was 3, Wells' score was 3, and the patient had edematous, red, and warm right lower extremity. Laboratory results showed anemia (Hb 11.4 g/dl), leukocytosis (27.99 x 103/ul), increased blood urea nitrogen (BUN) (60 mg/dl), increased serum creatinine (9.93 mg/dl), hyperkalemia (6 mmol/l), urine leukocytes +3; 15-20/hpf. Lower extremity ultrasound revealed diffuse deep vein thrombosis (DVT). After the diagnosis of DVT, the patient was treated with fondaparinux injection and warfarin as an anticoagulant for six days. Our results show that treatment was effective in reducing swelling and pain in the right leg, that disappeared after a three months´ treatment.
Double Interphalangeal Joint Dislocation of the Finger in Adolescent Athletes: A Review of Two Cases and the Relevant Literature
Authors: Angelo V Vasiliadis, Alexandros Maris, Maria Tsatlidou, Edward D R Bray, Dimitrios Metaxiotis
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Double interphalangeal joint dislocation of the same finger is a rare condition. We report two cases of adolescent athletes with distal and proximal interphalangeal joint dislocation. The diagnosis was confirmed with plain radiograph, while anatomical reduction was easily obtained with gentle longitudinal traction. A simple immobilization of the injured finger was applied by buddy taping for two weeks. Early mobilization as tolerated was recommended, and they have made a full return to their previous status of activities within 5 months. We also provide a review of the literature detailing demographic characteristics, cause and mechanism of injury with associated injuries, treatment options, and functional outcomes in this population.
A Novel Heterozygous Intronic Mutation in the FBN1 Gene Contributes to FBN1 RNA Missplicing Events in the Marfan Syndrome
Authors: Mario Torrado, Emilia Maneiro, Juan Pablo Trujillo-Quintero, Arturo Evangelista, Alexander T Mikhailov, Lorenzo Monserrat
Journal: Biomed Res Int (2018)
MeSH terms: Fibrillin-1 / genetics, Introns / genetics, Marfan Syndrome / genetics, Mutation, Case Reports, Adult, Aorta / pathology, Dilatation, Pathologic, Heterozygote, Humans, Male, Microfilament Proteins, FBN1 protein, human, Fibrillin-1, Microfilament Proteins

Marfan syndrome (MFS) is an autosomal dominantly inherited connective tissue disorder, mostly caused by mutations in the fibrillin-1 (FBN1) gene. We, by using targeted next-generation sequence analysis, identified a novel intronic FBN1 mutation (the c.2678-15C>A variant) in a MFS patient with aortic dilatation. The computational predictions showed that the heterozygous c.2678-15C>A intronic variant might influence the splicing process by differentially affecting canonical versus cryptic splice site utilization within intron 22 of the FBN1 gene. RT-PCR and Western blot analyses, using FBN1 minigenes transfected into HeLa and COS-7 cells, revealed that the c.2678-15C>A variant disrupts normal splicing of intron 22 leading to aberrant 13-nt intron 22 inclusion, frameshift, and premature termination codon. Collectively, the results strongly suggest that the c.2678-15C>A variant could lead to haploinsufficiency of the FBN1 functional protein and structural connective tissue fragility in MFS complicated by aorta dilation, a finding that further expands on the genetic basis of aortic pathology.