OpenMed/multicare-articles huggingface dataset:
A Case Report of Aggressive Chronic Rhinosinusitis with Nasal Polyps Mimicking Sinonasal Malignancy
Authors: S Velegrakis, N Chatzakis, E Prokopakis, M Papadakis, E Panagiotaki, M Doulaptsi, A Karatzanis
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Introduction:
Cases of extensive nasal polyps rarely occur and may mimic more aggressive lesions of the nose and paranasal sinuses. A case of extensive nasal polyposis with unusually aggressive behavior and its management is presented.
Presentation of case:
A 27-year-old male patient visited the emergency department of a tertiary center, complaining of recurrent episodes of epistaxis. The patient presented with a large polypoid lesion protruding from the right nostril and producing asymmetry of the face. Diagnostic imaging illustrated a lesion of the right maxillary sinus producing excessive bone remodeling and extension into neighboring structures in every direction. Fine limits were noted, however, with no invasive characteristics. Biopsy under local anesthesia was performed, showing findings consistent with nonspecific inflammation. Open surgery through a lateral rhinotomy under general anesthesia was performed, and the mass was readily mobilized and removed. No macroscopic invasion of neighboring structures was noted. Permanent histology confirmed the diagnosis of nasal polyposis. Postoperative follow-up has shown no evidence of recurrence after 12 months.
Conclusion:
Nasal polyps do not typically expand in an aggressive manner, producing bone resorption or extending into neighboring structures. However, nasal polyposis should be included in the differential diagnosis of nasal tumors with such behavior.
Bilateral Ureteral-Iliac Artery Fistula in a Patient with Chronic Indwelling Ureteral Stents: A Case Report and Review
Authors: Arash Rafiei, Timothy A Weber, Michael Kongnyuy, Raul Ordorica
Journal: Case Rep Urol (2015)

Ureteral-arterial fistula (UAF) is an exceedingly rare but life-threatening condition warranting emergent intervention. Prompt recognition and management of UAF in suspect patients presenting with gross hematuria are required for a successful outcome. We report a rare subset of UAF involving the bilateral common iliac arteries. The patient underwent successful endovascular stent-grafting to correct the arterial defect and delayed open repair of the ureteral strictures. Timely management has benefited from the collaboration of the involved medical teams, which included emergency medicine, urology, and interventional radiology.
Double Lung Transplantation for Idiopathic Pulmonary Fibrosis in a Patient with a History of Liver Transplantation and Prolonged Journey for Disease-Specific Antifibrotic Therapy
Authors: Sebastian Majewski, Maria Królikowska, Ulrich Costabel, Wojciech J Piotrowski, Marek Ochman
Journal: Case Rep Pulmonol (2022)
MeSH terms: Case Reports

Idiopathic pulmonary fibrosis (IPF) is characterized by uncontrolled progressive lung fibrosis with a median survival of 3 to 5 years. Although currently available pharmacotherapy cannot cure the disease, antifibrotics including pirfenidone and nintedanib were shown to slow disease progression and improve survival in IPF. Nevertheless, there is a knowledge gap on the safety of antifibrotics in patients after liver transplantation receiving concomitant immunosuppressive therapy. This case report of a 68-year-old male patient with IPF illustrates how a complex medical history has led to diagnostic and therapeutic challenges considerably affecting clinical decisions and impacting the patient's journey. The increasing severity of lung function impairment due to the progressive natural history of IPF ultimately led to severe respiratory failure. Double lung transplantation (LTx) was performed as the only therapeutic option in end-stage disease with the potential to improve quality of life and survival. To the best of our knowledge, this is the first case report describing the feasibility and safety of antifibrotic therapy with pirfenidone for IPF in a 68-year-old patient with a history of liver transplantation receiving concomitant immunosuppressive therapy with tacrolimus who underwent successful double lung transplantation when alternative medical interventions had been exhausted.
Hepatic cavernous hemangioma developed in non-small cell lung cancer patients after receiving Camrelizumab treatment: two case reports
Authors: Yonglong Jin, Jinpeng Xu, Dunmin Zhuang, Lina Dong, Yang Sun, Lin Zhao, Wenjing Xiao
Journal: Front Oncol (2023)
Keywords: camrelizumab, pd-1 inhibitors, case reports, cavernous hemangioma, non-small cell lung cancer
MeSH terms: Case Reports

Purpose:
To report two cases of hepatic cavernous hemangioma, a rare complication, in patients with locally advanced and advanced non-squamous non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors. Additionally, to share clinical experiences related to the management of this condition.
Methods:
Two patients with locally advanced and advanced non-squamous non-small cell lung cancer (NSCLC) were enrolled in our hospital. Following the NCCN guidelines and expert consensus, both patients received standard treatment with Camrelizumab (PD-1 inhibitor). Subsequent abdominal CT scans revealed hepatic focal lesions that did not exhibit typical characteristics of metastatic tumors. Therefore, further systematic investigation was conducted to study the hepatic focal lesions.
Results:
(1) Ultrasound-guided percutaneous biopsy confirmed the diagnosis of hepatic cavernous hemangioma. A multidisciplinary consultation concluded that it was an adverse drug reaction to Camrelizumab. (2) Ten-gene testing for both patients did not reveal any driver gene mutations associated with lung cancer. Apart from the occurrence of hepatic cavernous hemangioma, there were no signs of disease progression or worsening. (3) Both patients had resolution of hepatic cavernous hemangioma after switching to alternative PD-1 inhibitors or discontinuing PD-1 inhibitor treatment. One patient experienced hemorrhage related to the hepatic hemangioma, which was managed with hemostasis and symptomatic treatment, resulting in improvement. (4) Clinical outcomes: The first patient achieved a progression-free survival (PFS) of 33 months in first-line treatment and had not reached the PFS endpoint in second-line treatment, with an overall survival exceeding 56 months. The second patient had not reached the PFS endpoint in first-line treatment, with an overall survival exceeding 31 months.
Conclusion:
Hepatic cavernous hemangioma is a rare and serious adverse reaction associated with PD-1 inhibitors. Camrelizumab may interact with the PD-1 molecule in a different manner compared to other PD-1 inhibitors, affecting the regulation of the VEGFR/ULBP2 signaling pathway. In future studies, next-generation sequencing may provide detailed molecular pathology information, which could help explain individual differences and provide a basis for the prevention or intervention of hepatic cavernous hemangioma.
Intramedullary spinal cord metastasis from laryngeal carcinoma: case report and review of literature
Authors: Mohamed Sahli, Bouchaib Hemmaoui, Fouad Benariba
Journal: Pan Afr Med J (2017)
Keywords: larynx, intramedullary spinal cord metastasis, squamous cell carcinoma
MeSH terms: Carcinoma, Squamous Cell / pathology, Laryngeal Neoplasms / pathology, Spinal Cord Neoplasms / pathology, Case Reports, Review, Aged, Biopsy, Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / surgery, Humans, Laryngeal Neoplasms / diagnosis, Laryngeal Neoplasms / surgery, Male, Spinal Cord Neoplasms / diagnosis, Spinal Cord Neoplasms / secondary

Laryngeal cancer metastases are relatively rare and mainly affect the lung. The medullary localization remains exceptional. We report the case of a patient followed for operated laryngeal cancer and whose oncologic control revealed a medullary localization. A patient followed for squamous cell carcinoma of the larynx, treated in 2010 by a partial surgery whose endoscopic control at 5 years revealed the presence of right arytenoid edema without suspicious lesions, multiple biopsies were made and which returned negative. A month later, the patient presented a rebel cervical spine pain and a feeling of heaviness of the upper limbs, for which a radiological assessment was done finally objectifying a right hypopharyngeal process and a suspicious right internal jugular lymphadenopathy (biopsy confirmed the squamous type), as well as an intramedullary metastasis. This case is an illustration of an exceptional evolution of this type of cancer and a are metastatic localization difficult to highlight, which leads us to ask the question on the need of simultaneous and systematic radiological and endoscopic control treatment for operated laryngeal cancer.
Fatal hemorrhage from peripheral varicose vein rupture
Authors: Guendalina Gentile, Stefano Tambuzzi, Michele Boracchi, Alessandro Del Gobbo, Paolo Bailo, Riccardo Zoia
Journal: Autops Case Rep (2021)
Keywords: autopsy, hemorrhage, varicose veins
MeSH terms: Case Reports

Varix of the lower extremities is a common entity that eventually presents fatal outcome. Fatal massive bleeding due to rupture of a peripheral varicose vein is rare. The estimated incidence of these cases is 1/1000 autopsies. The case we present is unique among 26,054 autopsies performed in Milan from 1993 to 2020. It describes the investigations carried out in the suspicion of a non-natural event in an elderly woman. She was found dead at home with a large volume of blood near her feet that drained from the right leg. Pathological examination disclosed that the hemorrhage occurred by the rupture of a venous varix of the lower limb. Cases of fatal hemorrhage from peripheral variceal rupture are insidious and require proper characterization. The bloodstain pattern analysis, careful autopsy dissection by layers to demonstrate the rupture, and histologic examination of the lesion are the essential elements to find out the actual cause of death.
Inflammatory myofibroblastic tumor: a rare tumor of the lung
Authors: Özlem S İçmeli, Levent A Alpay, Baran Gündoğuş, Hatice Türker, Ayçim Şen
Journal: Eur Clin Respir J (2014)
Keywords: cancer, inflammatory tumor, lung, myobibroblastic tumor, rare lung tumor
MeSH terms: Case Reports

Inflammatory myofibroblastic tumor (IMT) is a rare lesion, representing 0.04-1.2% of all lung tumors. Brunn first described it in 1939, but its etiology remains uncertain. A 16-year-old patient was admitted to our hospital for further examination following abnormal radiological findings. The physical examination showed no abnormality, and routine hematological and biochemical parameters were within normal range. Chest radiograph revealed homogenous opacity of the right upper lobe with regular margins. Thoracic CT showed a nodular lesion, 30×26 mm in dimensions, with lobular contours in the right hilar. Bronchoscopic examination showed a vascular endobronchial lesion in the anterior right upper lobe, with bleeding when palpated. She underwent right thoracotomy for diagnostic and therapeutic purposes since bronchoscopic biopsy failed because of bleeding. With a pathological diagnosis of IMT, the present report discusses her case accompanied by relevant literature as it is a very rare type of lung tumor. IMT is a rare benign tumor. The diagnosis is difficult to make before surgery since its clinical and radiological features are variable and nonspecific. Although it is a benign lesion, it should be completely resected and patients should be closely monitored following the resection in order to avoid local invasion and recurrence.
A 23-year-old female with a mixed germ cell tumor of the pituitary infundibulum: the challenge of differentiating neoplasm from lymphocytic infundibuloneurohypophysitis-a case report and literature review
Authors: Sann Yu Mon, Hussain Mahmud, Munira Abbasi, Geoff Murdoch, Juan C Fernandez-Miranda, Paul A Gardner, Sue M Challinor
Journal: Case Rep Endocrinol (2014)

The pathologic spectrum of diseases that infiltrate the pituitary infundibulum includes a broad variety of clinical entities. There are significant differences in the prevalence of these etiologies depending on the age of presentation. Lymphocytic infundibuloneurohypophysitis (LINH) predominates over other causes of infundibular disease in adults over age 21. Differentiating LINH from other causes of infundibular disease can be difficult because the various etiologies often have similar clinical presentations and radiologic imaging characteristics. We report the first case in an adult of a mixed germ cell tumor comprised of germinoma and embryonal cell carcinoma infiltrating the pituitary infundibulum. In our case, a 23-year-old female was initially misdiagnosed as having LINH. She presented with panhypopituitarism and diabetes insipidus, which is the most common initial presentation in both entities. The two diagnoses are difficult to distinguish based on MRI imaging, CSF findings, and histopathological examination. Our case demonstrates the need for close follow-up of patients with isolated lesions of the pituitary infundibulum and reinforces the need for biopsy of an infundibular lesion when progression of disease is demonstrated. In our case, biopsy with comprehensive immunohistochemical staining was the sole means of making a definitive diagnosis.
Choice modelling with Gaussian processes in the social sciences: A case study of neighbourhood choice in Stockholm
Authors: Richard P Mann, Viktoria Spaiser, Lina Hedman, David J T Sumpter
Journal: PLoS One (2018)
MeSH terms: Choice Behavior, Residence Characteristics / statistics & numerical data, Research Support, Non-U.S. Gov't, Adult, Aged, Child, Female, Housing / economics, Housing / statistics & numerical data, Humans, Logistic Models, Male, Models, Psychological, Models, Statistical, Normal Distribution, Schools / economics, Schools / statistics & numerical data, Social Sciences, Socioeconomic Factors, Statistics, Nonparametric, Sweden

We present a non-parametric extension of the conditional logit model, using Gaussian process priors. The conditional logit model is used in quantitative social science for inferring interaction effects between personal features and choice characteristics from observations of individual multinomial decisions, such as where to live, which car to buy or which school to choose. The classic, parametric model presupposes a latent utility function that is a linear combination of choice characteristics and their interactions with personal features. This imposes strong and unrealistic constraints on the form of individuals' preferences. Extensions using non-linear basis functions derived from the original features can ameliorate this problem but at the cost of high model complexity and increased reliance on the user in model specification. In this paper we develop a non-parametric conditional logit model based on Gaussian process logit models. We demonstrate its application on housing choice data from over 50,000 moving households from the Stockholm area over a two year period to reveal complex homophilic patterns in income, ethnicity and parental status.
A Novel Mutation c.841C>T in COPA Syndrome of an 11-Year-Old Boy: A Case Report and Short Literature Review
Authors: Jingxia Zeng, Jing Hao, Wei Zhou, Zhaoqun Zhou, Hongjun Miao
Journal: Front Pediatr (2021)
Keywords: copa syndrome, auto-immunity, children, gene mutation, lung disease
MeSH terms: Case Reports

COPA syndrome is a rare autosomal dominant disorder with auto-immune and auto-inflammatory abnormalities. This disease is caused by mutations of COPα, a protein that functions in the retrograde transport from the Golgi to the ER. Here we report the first COPA case of an 11-year-old boy with c.841C>T, p.R281W mutation. The arginine at position 281 was located in a highly evolutionary-conserved region. Immunosuppressive drugs and corticosteroids might not improve the long-term outcome of COPA patients. For patients with pulmonary disease, polyarthritis and/or kidney disorder, and suspected of COPA, genetic analysis should be conducted promptly for early diagnosis.
Destructive Upper Airway Disease from Eosinophilic Granulomatosis with Polyangiitis (EGPA): The Very First Case
Authors: Biplab Saha, Aditi Saha, Fernanda Cordeiro-Rudnisky, Boris Shkolnik, Scott Beegle
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem vasculitic disorder that predominantly affects medium- and small-sized blood vessels. EGPA belongs to a group of vasculitides known as anti-neutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV). Upper airway involvement is seen in all ANCA-associated vasculitides, but destructive upper airway disease has never been reported in patients with EGPA. We report the first case of erosive chondritis and saddle nose deformity in a 50-year-old patient suffering from EGPA.
Abscopal effect leading to complete disappearance of extensive meningiomatosis after gamma knife radiosurgery: Case report
Authors: Salman Aldakhil, David Mathieu
Journal: Front Surg (2022)
Keywords: abscopal effect, case report, gamma knife, meningioma, stereotactic radiosurgery
MeSH terms: Case Reports

Background and importance:
The abscopal effect is partial or complete tumor response in a separate site that was not the target of prior local treatment. There have been only 50 well-documented cases from 1960 to 2014. Our case is the first one of presumed low-grade meningioma demonstrating a possible response via the abscopal effect after single-fraction stereotactic radiosurgery.
Clinical presentation:
A case of a 70-years-old female with extensive intracranial meningiomatosis who had complete disappearance of all tumors after gamma knife radiosurgery targeting the right petroclival part of the tumor. She had complete resolution of her symptoms, which included hearing loss, headache, ataxia and dysphagia.
Conclusion:
The abscopal effect is an extremely rare phenomenon after local radiation therapy of a remote tumor. Our case demonstrates that this can occur in remote meningiomas after single fraction GKRS of a different tumor.
Sudden peroneal nerve palsy in an osteoarthritic knee: a case report
Authors: Vijay Kumar, Mayur Nayak, Tahir Ansari, Rajesh Malhotra
Journal: SICOT J (2017)

Peroneal nerve injuries have been reported in association with various causes around the knee such as traumatic varus injury, traumatic dislocation, upper tibial osteotomy, knee arthroscopy and total knee arthroplasty. Two instances of varus arthritic knee associated with a peroneal nerve palsy have been reported so far. One presented with gradual onset peroneal nerve palsy that recovered with time and the other with sudden onset peroneal nerve palsy that did not recover. We describe the case of a 63-year-old man who presented with a symptomatic varus arthritic knee and sudden onset peroneal nerve palsy with synovial cysts over the lateral aspect of the knee. We performed a total knee arthroplasty with decompression of the synovial cyst in the same patient. Three months following the surgery the patient was walking pain free with a completely recovered nerve palsy.
Imperforate hymen and leaking hematosalpinx mimicking acute appendicitis: A report of a rare case and a review of literature
Authors: Foster Amponsah-Manu, Paddy Ssentongo, Temitope Arkorful, Richard Ofosu-Akromah, Anna E Ssentongo, Seth Hansen-Garshong, John S Oh
Journal: Int J Surg Case Rep (2019)
Keywords: acute appendicitis, case report, hematocolpometra, imperforate hymen

Introduction:
Cases of imperforate hymen with leaking hematosalpinx into the peritoneum are rare. We present a case of imperforate hymen mimicking acute appendicitis creating diagnostic challenges with a near miss diagnosis.
Case:
A 12-year-old premenarchal female presented with severe pain that migrated from the epigastrium to the right lower quadrant. Physical examination revealed an ill-defined non-tender mass in the right lower quadrant on deep palpation, without signs of peritonitis. We made a diagnosis of an appendiceal mass and the patient underwent an appendectomy. We found approximately 200 mL of dark blood in the peritoneum and an inflamed appendix. After the appendectomy we noticed an engorged right fallopian tube leaking into the peritoneum and a bulky pelvic mass in the lower segment of the uterus. Perineal examination revealed a slightly bulging imperforate hymen. Hymenectomy was performed and 500 mL of viscous old blood was drained. On follow-up, the hymen was still open.
Discussion:
Imperforate hymen commonly presents with cyclic abdominal pain and enlarging mass in premenarchal females, it is rare to present with hemoperitoneum and mimicking acute appendicitis.
Conclusion:
Although rare, imperforate hymen with retrograde menstruation that causes dilatation of the vagina and uterus (i.e., hematocolpometra) is an important consideration in the differential diagnosis of abdominal pain in premenarchal females with abdominal pain. It is easily diagnosed by physical examination. However, if patient or parents refuse genital exam evaluation, imaging studies can greatly help with diagnosis. Ultrasound will show an echogenic fluid accumulation in the vagina that can extend to uterus.
Recurrent Solid Pseudopapillary Neoplasm of Pancreas: Case Report and Review of Literature
Authors: Piyush K Sharma, Sanjana Mehrotra, Ana L Gleisner, Richard D Schulick, Martin D McCarter
Journal: J Pancreat Cancer (2018)
Keywords: recurrence, solid pseudopapillary neoplasm of pancreas, surgical pathology

Background: Solid pseudopapillary neoplasm of pancreas is a rare tumor with a low potential for metastasis and recurrence. Long-term outcomes after surgical resection are excellent and recurrences after an R0 resection are extremely rare. Case Presentation: We present an unusual case of a 42-year-old man who had a recurrence of his solid pseudopapillary tumor 4 years after undergoing a distal pancreatectomy and splenectomy and then again a year after his reresection. Conclusions: The lack of histological features deemed to be suggestive of a malignant variant and the aggressive clinical course seen in this case is remarkable. It underscores the fact that despite the low incidence, recurrences of solid pseudopapillary neoplasms of the pancreas do occur and it can be very difficult to predict malignant potential based on radiological or histopathological features.
Perivascular epitheloid cell tumor (PEComa) mimicking retroperitoneal liposarcoma
Authors: Moritz Wildgruber, Karen Becker, Marcus Feith, Jochen Gaa
Journal: World J Surg Oncol (2014)
MeSH terms: Biomarkers, Tumor / metabolism, Liposarcoma / diagnosis, Perivascular Epithelioid Cell Neoplasms / diagnosis, Retroperitoneal Neoplasms / diagnosis, Case Reports, Aged, Humans, Immunoenzyme Techniques, Liposarcoma / metabolism, Magnetic Resonance Imaging, Male, Perivascular Epithelioid Cell Neoplasms / metabolism, Prognosis, Retroperitoneal Neoplasms / metabolism, Tomography, X-Ray Computed, Biomarkers, Tumor, Retroperitoneal liposarcoma

PEComas are a collection of generally rare tumors, defined by the World Health Organization as 'mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epitheloid cells'. We describe the case of retroperitoneal PEComa with a liposarcoma-like appearance on cross-sectional imaging, but distinctive immunohistochemistry revealing the correct diagnosis.
A Rare Case of Extrinsic Stenosis of Dural Sinus
Authors: Axel Boyer, Louis Deprez
Journal: J Belg Soc Radiol (2022)
Keywords: dural sinus stenosis, increased intracranial pressure
MeSH terms: Case Reports

Teaching Point: Dural sinus stenosis are a rare cause of increased intracranial pressure and can be treated in some cases by stenting.