OpenMed/multicare-articles huggingface dataset:
Case Report: A rare synchronous multiple gastric carcinoma achieved progression-free disease through NGS-guided serial treatment
Authors: Xinyi Shao, Jin Yin, Di Wang, Erjiong Huang, Yini Zhang, Jiani C Yin, Chen Huang, Hao Wu, Xiaoli Wu
Journal: Front Oncol (2023)
Keywords: anti-her2 treatment, circulating tumor dna (ctdna), immunotherapy, next-generation sequencing (ngs), synchronous multiple gastric carcinoma (smgc)
MeSH terms: Case Reports

Synchronous multiple gastric carcinoma (SMGC) is a rare condition characterized by the simultaneous occurrence of two or more primary malignant tumors in the stomach, each with its own distinct pathological morphology. SMGC differs from gastric metastases, which originate from primary gastric or non-gastric tumors. At present, the incidence of SMGC is low in China, with no established guidelines for standard treatment. Here, we report a rare case of advanced SMGC that achieved long-lasting clinical benefits through a treatment strategy informed by next-generation sequencing (NGS). Dynamically monitoring of the tumor and/or circulating cell-free DNA guided the patient's treatment sequentially. The patient received anti-HER2 therapy, followed by immunotherapy, pembrolizumab in combination with trastuzumab and chemotherapy, and ultimately underwent successful total gastrectomy. This case highlights a novel approach of utilizing liquid biopsy-based NGS to gain insights into disease progression and molecular response to NGS-guided treatment in SMGC patients.
Acute Joint Blockage due to Abrasion-Related Dislocation of a Silastic Radial Head Prosthesis: A Histological Examination after 14 Years of Durability
Authors: Heinz-Lothar Meyer, Christina Polan, Anke Bernstein, Benedikt Abel, Manuel Burggraf, Marcel Dudda, Max Daniel Kauther
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

The implantation of a radial head prosthesis can take place as a therapeutic option after radial head fracture. There are various implants for this purpose. Many studies and case reports about silastic radial head prosthesis implantation describe foreign body reactions with accompanying synovitis and poor functional results. A few studies have investigated the reason for the material failure and the accompanying synovitis. The case report presented shows an unusually long durability of an in situ 14-year silastic radial head prosthesis. 14 years after implantation, a previously full-time working and healthy patient presented himself with a dislocation of the silastic radial head prosthesis and atraumatic joint blockage of the right elbow triggered by a negligible movement. The prosthesis was removed surgically. We found a macroscopic foreign body reaction intraoperatively. In a histopathological examination, with hematoxylin and eosin staining (HE) in 40x and 100x magnification, we have seen an aseptic inflammatory response to foreign bodies with activated epithelial cells and multinucleated giant cells with intracytoplasmic foreign material. Due to these problems, the silastic radial head prosthesis is no longer used today. However, there are still patients with the implanted silastic radial head prosthesis, which should therefore be checked regularly. A metal prosthesis also does not seem to be an optimal alternative due to cartilage wear and loss of ROM. The choice of prosthesis material should be selected carefully and patient-specific in radial head prosthetics according of the results presented.
Osteosarcoma of the mandible masquerading as a dental abscess: report of a case
Authors: Sukumaran Anil, Anitha P Krishnan, R Rajendran
Journal: Case Rep Dent (2012)

An aggressive and fatal case of osteosarcoma of the mandible in a 19-year-old female is reported. Six weeks after the clinical appearance of the swelling, the patient died. This paper is unique in that the age of occurrence and the biologic behavior of the tumor were not consistent with the reported literature. The case report is followed by a brief review of osteosarcoma of the jaw with a note on its clinical presentation, diverse radiologic appearance, varied histopathologic picture, and prognosis.
Multifocal Recurrent Osteomyelitis and Hemophagocytic Lymphohistiocytosis in a Boy with Partial Dominant IFN-γR1 Deficiency: Case Report and Review of the Literature
Authors: Aidé Tamara Staines-Boone, Caroline Deswarte, Edna Venegas Montoya, Luz María Sánchez-Sánchez, Jorge Alberto García Campos, Teodoro Muñiz-Ronquillo, Jacinta Bustamante, Francisco J Espinosa-Rosales, Saul Oswaldo Lugo Reyes
Journal: Front Pediatr (2017)
Keywords: mendelian susceptibility to mycobacterial disease, bacille calmette–guérin vaccine, hemophagocytic lymphohistiocytosis, human recombinant interferon gamma, interferon gamma receptor 1 deficiency, macrophage activation syndrome, multiorgan dysfunction, osteomyelitis
MeSH terms: Case Reports

Mutations in the genes coding for cytokines, receptors, second messengers, and transcription factors of interferon gamma (IFN-γ) immunity cause Mendelian susceptibility to mycobacterial disease (MSMD). We report the case of a 7-year-old male patient with partial dominant (PD) IFN-γ receptor 1 deficiency who had suffered from multifocal osteomyelitis attributable to bacille Calmette-Guérin vaccination since the age of 18 months. He developed hemophagocytic lymphohistiocytosis (HLH), a hyper-inflammatory complication, and died with multiorgan dysfunction, despite having been diagnosed and treated relatively early. Patients with PD IFN-γR1 deficiency usually have good prognosis and might respond to human recombinant subcutaneous IFN-γ. Several monogenic congenital defects have been linked to HLH, a catastrophic "cytokine storm" that is usually ascribed to lymphocyte dysfunction and thought to be triggered by interferon gamma. This is the sixth patient with both MSMD and HLH of whom we are aware. The fact that patients with macrophages that cannot respond to IFN-γ still develop HLH, bring these assumptions into question.
Post-Transplant Ureteric Stricture Managed By Extra-Anatomical Stenting With Modification on the Originally Described Stent Location: A Case Report
Authors: Omar Buksh, Ahmed Khogeer, Abdullah O Bawazir, Adel Alammari, Islam Junaid
Journal: Cureus (2023)
Keywords: extra anatomical stent, kidney transplant ureteral stricture, ureteral stents, ureteral stricture management, ureteric stricture
MeSH terms: Case Reports

Ureteric strictures are a relatively uncommon complication following renal transplant, which may be managed endoscopically or surgically by repairing the stricture. Extra-anatomical bypass is a useful procedure in complex cases that bypasses the ureter by creating a subcutaneous route, although it is uncommonly used given its rare indication. We report a case of renal transplant ureteric stricture, in which we utilized a modified extra-anatomical stenting technique with a Detour® stent to avoid the fibrotic planes surrounding the lateral aspect of the kidney graft.
Case Report: Low-Dose Decitabine Plus Anti-PD-1 Inhibitor Camrelizumab for Previously Treated Advanced Metastatic Non-Small Cell Lung Cancer
Authors: Xin Yan, Yongtian Zhao, Yang Liu, Qingming Yang, Liang Dong, Zhiqiang Wu, Jing Nie, Deyun Chen, Miaomiao Bai, Dongdong Ti, Kaichao Feng, Weidong Han
Journal: Front Oncol (2020)
Keywords: decitabine, epigenetics, immunotherapy, programmed cell death protein 1, treatment
MeSH terms: Case Reports

Background: Although the programmed death 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors have markedly changed the strategies of cancer treatment, most patients with advanced non-small cell lung cancer (NSCLC) do not respond to PD-1/PD-L1 monotherapy. Epigenetic drugs have been hypothesized to possess the potential to sensitize PD-1/PD-L1 inhibitors. Case Presentation: Three patients with advanced metastatic NSCLC failed to respond to first-line systemic therapy and had a low tumor mutation burden, low tumor neoantigen burden, low microsatellite instability, and HLA loss of heterozygosity according to their target lesion biopsies, all of which were considered unfavorable factors for PD-1/PD-L1 blockage. However, all three patients responded to low-dose decitabine, an epigenetic drug, in combination with camrelizumab (anti-PD-1 antibody), with only controllable adverse events, indicating that low-dose decitabine can sensitize PD-1/PD-L1 inhibitors. Summary: We report a novel therapy with low-dose decitabine plus camrelizumab for advanced NSCLC on the basis of successful treatment of three patients, emphasizing the potential of epigenetic drugs to regulate PD-1/PD-L1 inhibitors in advanced NSCLC.
Pneumococcal tricuspid valve endocarditis in a young african american: a case for inclusion of african americans in pneumococcal vaccine criteria
Authors: Oghenerukevwe Odiete, Olagoke Akinwande, John J Murray, Joseph Akamah
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Following the development of penicillin, complications from streptococcus pneumonia such as endocarditis have become rare. However, certain independent risk factors such as cigarette smoking and being of African-American (AA) decent have been associated with a higher incidence of invasive pneumococcal disease, but only cigarette smoking has been targeted by current recommendations from the Advisory Committee on Immunological Practices (ACIPs). We report a case of a young AA smoker, who developed an isolated tricuspid valve pneumococcal endocarditis. This case will illustrate the high susceptibility for invasive pneumococcus sequelae in AA, thereby raising the argument for the consideration of AA in the Pneumococcal Conjugate Vaccine (PCV) criteria, regardless of smoking history.
Novel Pathogenic Variant in TGFBR2 Confirmed by Molecular Modeling Is a Rare Cause of Loeys-Dietz Syndrome
Authors: Michael T Zimmermann, Raul A Urrutia, Patrick R Blackburn, Margot A Cousin, Nicole J Boczek, Eric W Klee, Colleen Macmurdo, Paldeep S Atwal
Journal: Case Rep Genet (2017)
MeSH terms: Case Reports

Loeys-Dietz syndrome (LDS) is a connective tissue disorder characterized by vascular findings of aneurysm and/or dissection of cerebral, thoracic, or abdominal arteries and skeletal findings. We report a case of a novel pathogenic variant in TGFBR2 and phenotype consistent with classic LDS. The proband was a 10-year-old presenting to the genetics clinic with an enlarged aortic root (Z-scores 5-6), pectus excavatum, and congenital contractures of the right 2nd and 3rd digit. Molecular testing of TGFBR2 was sent to a commercial laboratory and demonstrated a novel, likely pathogenic, variant in exon 4, c.1061T>C, p.(L354P). Molecular modeling reveals alteration of local protein structure as a result of this pathogenic variant. This pathogenic variant has not been previously reported in LDS and thus expands the pathogenic variant spectrum of this condition.
Anorectal malformation combined with Hirschsprung's disease: a case report
Authors: Jiansen Fan, Mingkun Liu, Yu Lin, Yuanbin He, Yifan Fang
Journal: Front Pediatr (2023)
Keywords: hirschsprung's disease, anorectal malformation, barium enema examination, enterocolitis, severe constipation
MeSH terms: Case Reports

Anorectal malformation (ARM) and Hirschsprungs disease (HSCR) are frequently associated with other congenital malformations, but rarely with one another. We describe the case of a child with intermediate anorectal malformation who underwent ARM correction. This child experienced recurrent postoperative symptoms, including intestinal obstruction, nutrition intolerance, and weight loss. The child was diagnosed with Hirschsprung's disease by colon barium contrast and pathological findings from a rectal biopsy, and subsequently underwent pull -through procedure after conservative treatment failed. After six months of postoperative follow-up, the patient still experiences occasional episodes of enteritis, but the symptoms are substantially less severe than they were before surgery, and the patient's weight is slowly increasing. We described a case of a child who had ARM combined with HSCR. Although the association between ARM and HSCR is uncommon, severe constipation or enteritis following complete correction of ARM in the absence of anal stricture should prompt consideration for HSCR. Before the second stage of ARM surgery, pay close attention to the barium enema examination, as an abnormal shape may indicate the presence of HSCR.
Ameloblastic Fibroma of the Mandible Reconstructed with Autogenous Parietal Bone: Report of a Case and Literature Review
Authors: Conor Carroll, Mishaal Gill, Eleanor Bowden, John Ed O'Connell, Rajeev Shukla, Chris Sweet
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Ameloblastic fibroma (AF) is a rare, slow-growing benign neoplasm, comprised of tissues of odontogenic origin. It constitutes 2% of odontogenic tumours, occurring at any age, but has a predilection to present in the first two decades of life. AF principally affects the posterior mandible. It is characterized by epithelial islands and cords immersed in ectomesenchyme that mimics the dental papilla and enamel organ but without actual hard tissue formation. Herein, we describe the case of a 6-year-old Caucasian male who presented to the Oral and Maxillofacial Department at Alder Hey Children's Hospital, Liverpool, UK, with a painless expansile mass in the left mandible which was diagnosed as a benign ameloblastic fibroma and subsequently enucleated and reconstructed with a parietal calvarial bone graft. A brief literature review and the issues surrounding diagnosis are discussed.
Giant cystic lymphangioma of the small bowel mesentery: case report
Authors: Khalid Khattala, Mohamed Rami, Aziz Elmadi, Abdelhalim Mahmoudi, Youssef Bouabdallah
Journal: Pan Afr Med J (2011)
Keywords: giant cystic lymphangioma, morocco, abdominopelvic mass, imaging, surgery
MeSH terms: Intestine, Small / pathology, Lymphangioma, Cystic / diagnosis, Mesentery / pathology, Peritoneal Neoplasms / diagnosis, Case Reports, Child, Diagnosis, Differential, Female, Humans, Intestine, Small / surgery, Lymphangioma, Cystic / surgery, Mesentery / surgery, Peritoneal Neoplasms / surgery

Cystic lymphangioma is an uncommon mesenteric tumor which is usually reported in children. We describe a case of a 12-years old girl who was admitted in our hospital with abdominal distension and pain. Physical examination showed an abdomino-pelvic mass. Preoperative studies including abdominal ultrasonography and computed tomography failed to determine the cause of the pain. Laparotomy found a giant cystic tumor of the small bowel mesentery. Histological studies confirm the diagnosis of cystic lymphangioma. Based on this case, a review of the literature is suggested.
AIN to PIN transfer for PIN palsy following distal biceps tendon repair: a case report
Authors: Jillian A Fairley, Parham Daneshvar
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: nerve transfer, pin palsy, anterior interosseous nerve, distal biceps tendon, posterior interosseous nerve
MeSH terms: Case Reports

Posterior interosseous nerve injury after distal biceps repair significantly impairs hand function. For treatment, we describe an anterior interosseous nerve to posterior interosseous nerve transfer. Our technique is useful when the injury is too distal for median nerve transfer or when the zone of injury is too long for nerve graft reconstruction.
Schizophrenia spectrum disorders in a Nigerian family: 4 case reports
Authors: Joyce O Omoaregba, Bawo O James, George O Eze
Journal: Cases J (2009)

Introduction:
The risk of developing schizophrenia is higher among persons with an affected sibling compared to the general population. Beliefs about aetiology influence presentation, management and treatment outcomes. There are no reports on multiple occurrences of this disorder in a family in this part of the world. In this case series we also highlight how cultural beliefs hamper and shape management.
Case presentation:
We report a case series of schizophrenia spectrum disorders affecting four women in a Nigerian family of Ibo tribal origin who responded marginally to pharmacological interventions and required insight oriented psychotherapy and family therapy in resolving psychosocial problems.
Conclusion:
While western taught disease models might explain these presentations, it is not usually accepted by lay persons from developing cultures. Limitations in contemporary treatment approaches necessitate the development of culturally relevant psychotherapeutic interventions.
Angioneurotic edema associated with haloperidol
Authors: Samrina Kahlon, Cathy Lee, Roger Chirurgi, Getaw Worku Hassen
Journal: Case Rep Emerg Med (2012)

Background. Angioneurotic edema is a life-threatening medical emergency that requires urgent diagnosis and treatment. Haloperidol is in the butyrophenone class of antipsychotic medications. Acute anaphylaxis to Haloperidol is very rare and no cases have been reported in literature. Objective. To report the association of life-threatening angioneurotic edema with intramuscular Haloperidol. Case Report. We present a case of an adult with no known allergies in whom angioneurotic edema with tongue swelling and protrusion developed after the administration of a single IM dose of Haloperidol. Conclusion. We propose angioneurotic edema in a rare side effect of Haloperidol. The onset of the symptoms is abrupt, but it may take 12-36 hours to resolve completely. Therefore patient should be monitored for 12-36 hrs.
Pulmonary arteriovenous malformations presenting as difficult-to-control asthma: a case report
Authors: Marta Navratil, Vinko Vidjak, Filip Rubić, Damir Erceg, Mirjana Turkalj
Journal: J Med Case Rep (2013)

Introduction:
Although pulmonary arteriovenous malformations are relatively rare disorders, they are an important part of the differential diagnosis of common pulmonary problems, such as hypoxemia, dyspnea on exertion and pulmonary nodules.
Case presentation:
An 11-year-old Croatian boy of Mediterranean origin with a history of asthma since childhood was admitted to our hospital for evaluation of difficult-to-control asthma during the previous six months. A chest X-ray showed a homogeneous soft tissue mass in the lingual area. Computed tomography angiography of the thorax showed two pulmonary arteriovenous malformations, one on each side of the lungs. Diagnosis of hereditary hemorrhagic telangiectasia was made clinically by Curaçao criteria. Genetic analysis revealed a mutation in the endoglin gene. The patient was treated with embolotherapy with good clinical outcome.
Conclusion:
We present a case of pulmonary arteriovenous malformations masquerading as refractory asthma.
Acute Unilateral Audiovestibulopathy due to Embolic Labyrinthine Infarction
Authors: Zhong Liqun, Kee-Hong Park, Hyo-Jung Kim, Sun-Uk Lee, Jeong-Yoon Choi, Ji-Soo Kim
Journal: Front Neurol (2018)
Keywords: embolism, hearing loss, infarction, inner ear, vertigo

Introduction:
Labyrinthine infarction is a cause of acute audiovestibulopathy, but can be diagnosed only in association with other infarctions involving the brainstem or cerebellar areas supplied by the anterior inferior cerebellar artery (AICA) since current imaging techniques cannot visualize an infarction confined to the labyrinth. This case series aimed to establish embolic labyrinthine infarction as a mechanism of isolated acute audiovestibulopathy.
Methods:
We analyzed clinical features, imaging findings, and mechanisms of embolism in 10 patients (8 men, age range: 38-76) who had developed acute audiovestibulopathy in association with an obvious source of embolism and concurrent acute embolic infarctions in the non-anterior inferior cerebellar artery territories. The presence of audiovestibulopathy was defined when bedside or laboratory evaluation documented unilateral vestibular (head-impulse tests or caloric tests) or auditory loss (audiometry).
Results:
Six patients showed combined audiovestibulopathy while three had isolated vestibulopathy. One patient presented isolated hearing loss. Audiovestibular findings were the only abnormalities observed in nine patients. In all patients, MRIs documented single or multiple infarctions in the cerebellum (n = 5) or cerebral hemispheres (n = 5). Especially three patients showed single or scattered foci of tiny acute infarctions only in the cerebral hemispheres. Cardiac sources of embolism were found in eight, and artery-to-artery embolism was presumed in two patients.
Conclusion:
Selective embolism to the labyrinth may be considered in patients with acute unilateral audiovestibulopathy and concurrent acute infarctions in the non-AICA territories.
Postinfectious Onset of Myasthenia Gravis in a COVID-19 Patient
Authors: Meret Huber, Sophia Rogozinski, Wolfram Puppe, Carsten Framme, Günter Höglinger, Karsten Hufendiek, Florian Wegner
Journal: Front Neurol (2020)
Keywords: covid-19, sars-cov-2, anosmia/ageusia, diplopia, neurological manifestation, postinfectious myasthenia gravis
MeSH terms: Case Reports

Objective: We report the case of a young woman with postinfectious onset of myasthenia gravis after COVID-19 with mild respiratory symptoms and anosmia/ageusia 1 month before admission to our neurological department. Methods: Patient data were derived from medical records of Hannover Medical School, Germany. Written informed consent was obtained from the patient. Results: The 21-year-old female patient presented with subacute, vertically shifted double vision evoked by right sided partial oculomotor paresis and ptosis. About 4 weeks earlier she had suffered from mild respiratory symptoms, aching limbs and head without fever, accompanied by anosmia/ageusia. During the persistence of the latter symptoms for around 10 days the patient had already noticed "tired eyes" and fluctuating double vision. Clinical assessment including a positive test with edrophonium chloride and increased acetylcholine receptor antibodies related the ocular manifestation etiologically to myasthenia gravis. Antibodies (IgA/IgG) against SARS-CoV-2 using three different serological tests (Abbott, DiaSorin, Euroimmun) were detected in serum suggesting this specific coronavirus as previously infectious agent in our patient. The myasthenic syndrome was treated successfully with intravenous immunoglobulins and oral pyridostigmine. Conclusion: This is the first case presentation of postinfectious myasthenia gravis as neurological complication in a COVID-19 patient.
Case Report: First Case of Consolidation Immunotherapy After Definitive Chemoradiotherapy in Mediastinal Lymph Node Metastatic Sarcomatoid Carcinoma
Authors: Yu Wang, Lin Yang, Jianyang Wang, Lin Gui, Wei Li, Zhiqiang Liu, Xiangyu Ma, Yin Yang, Luhua Wang, Nan Bi
Journal: Front Oncol (2022)
Keywords: pd-l1 inhibitors, case report, chemoradiotherapy, immunotherapy, sarcomatoid carcinoma
MeSH terms: Case Reports

Sarcomatoid carcinoma (SC) is a rare lung cancer subtype with poor prognosis and lack of effective treatment regimens. Studies concerning SC indicated common programmed death ligand-1 (PD-L1) overexpression and higher tumor mutational burden, leading to potential benefits from immunotherapy. The present case is the first report employing PD-L1 inhibitor durvalumab following definitive concurrent chemoradiotherapy (cCRT) in a patient with mediastinal lymph node metastatic SC, which was considered as a high probability of pulmonary origin but unclear primary lesion. After the 19-month follow-up, there was neither local recurrence nor distant metastasis. The patient was in a good condition, with the thoracic lesion controlled at Partial response-Response Evaluation Criteria in Solid Tumors (PR-RECIST). Except for grade 2 esophagitis, none of the other adverse events was observed. Our first attempt to adopt the consolidation immunotherapy after cCRT in unresectable locally advanced mediastinal SC exhibited improved local control, manageable safety, and potential survival benefits, representing a novel and promising therapeutic option for SC and encouraging further research exploration of this regimen in the future.