OpenMed/multicare-articles huggingface dataset:
Congenital cholesteatoma localized to the mastoid cavity and presenting as a mastoid abscess
Authors: Salim M Sloma Tabook, Hazem M Abdel Tawab, Naveen Kumar Gopal
Journal: Case Rep Otolaryngol (2015)

Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report. A 21-year-old male patient presented to our department with severe right mastoid pain and postauricular fluctuant swelling for 23 days. There was no preceding history of ear complaints and examination showed a normal right ear drum. Emergency exploration of the mastoid process was done on the same day and revealed localized cholesteatoma limited only to the mastoid cavity. Conclusion. Despite a rarity, the mastoid process should be always put in mind as a site of origin for congenital cholesteatoma.
Anti-CD20 Treatment of Autoimmune Hemolytic Anemia Refractory to Corticosteroids and Azathioprine: A Pediatric Case Report and Mini Review
Authors: Alexandros Makis, Zoi Kanta, Dimitrios Kalogeropoulos, Nikoloaos Chaliasos
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Autoimmune hemolytic anemia (AIHA) is a relatively uncommon hematological entity in children and sometimes is characterized by a severe course requiring more than one line course therapy. Treatment decisions depend on the severity and chronicity of the anemia and the characteristics of the autoantibodies. Immunosuppression with corticosteroids is the first-line treatment, especially in warm-reactive AIHA. Refractory cases are treated with immunosuppressive drugs, cytotoxic agents, androgens, or splenectomy, with various side effects and questionable efficacy. Another second-line option is rituximab, an anti-CD20 monoclonal antibody, which has been used as an off-label agent with encouraging results from small limited studies or case reports. Herein, we add our experience on the safety and clinical efficacy of rituximab by presenting the case of a boy with warm-type AIHA resistant to corticosteroids and azathioprine, successfully treated with rituximab. We also offer a review of the relevant literature.
Orbitocranial Penetrating Injury With Multiple Vessel Invasion in an Infant: A Case Report and Literature Review
Authors: Yun Wu, Tiange Chen, Meng Yuan, Juma Magogo Mzimbiri, Ziyuan Liu, Yilei Chen, Xiangying Luo, Fenghua Chen, Jinfang Liu
Journal: Front Neurol (2020)
Keywords: case report, imaging, individualized strategy, infant, multiple vessel invasion, orbitocranial penetrating injury
MeSH terms: Case Reports

Orbitocranial penetrating injury (OPI) with multiple vascular invasions is a rare occurrence. To our knowledge, experience with its clinical treatment is rather limited, especially for infants. This case report describes an infant who fell from a 0.5 m high bed and landed on a toy with a keen-edged plastic rod. The fractured end of the rod was noted at the medial aspect of the left eyelid, and she was experiencing impaired consciousness. Computed tomography showed that the foreign body penetrated the cavernous sinus with internal carotid artery involvement, and compressed the transverse sinus through the cerebellum. Emergency surgery was performed with temporal occlusion of the left common carotid artery. The rod was removed from the orbital side, and bleeding from cavernous sinus region was effectively controlled under direct inspection via a sub-temporal approach. The patient was successfully treated and recovered consciousness after 17 days. This is the first report of successful management of OPI combined with multiple vascular injury in an infant. Herein, we highlight the anatomical imaging features of the injuries and also the individualized strategy concerning vascular invasion.
Leiomyosarcoma of the Renal Vein Mimicking a Primitive Renal Cell Carcinoma: Case Report of an Unusual Presentation
Authors: Amal Fekkar, Hafsa Elouazzani, Ahmed Jahid, Kaoutar Znati, Fouad Zouaidia, Zakia Bernoussi
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Primary leiomyosarcomas (LMS) of vascular origin are rare tumors, and more than half of the cases arise in the inferior vena cava (IVC). Primary LMS of the renal vein are extremely rare tumors with only a few cases reported in the literature. Their diagnosis is made only by pathological features. Histologically, they are made of atypical spindle-shaped cells arranged in long intersecting fascicles. Tumor cells stain positive for myogenic markers in immunohistochemistry. Standard treatment consists of radical nephrectomy followed by chemotherapy and/or radiotherapy. Because of insufficient histological data and follow-up, the prognosis factors are not well identified. Overall prognosis of renal vein LMS is poor. We report here an exceptional case of a huge LMS of the right renal vein mimicking a primitive renal cell carcinoma, occurring in a 56-year-old male patient.
Laboratory-acquired brucellosis
Authors: Stephanie Noviello, Richard Gallo, Molly Kelly, Ronald J Limberger, Karen DeAngelis, Louise Cain, Barbara Wallace, Nellie Dumas
Journal: Emerg Infect Dis (2004)
MeSH terms: Brucellosis / epidemiology, Laboratory Infection / transmission, Case Reports, Aged, Antibodies, Bacterial / blood, Brucella melitensis / isolation & purification, Brucellosis / blood, Brucellosis / immunology, Female, Humans, Laboratory Infection / diagnosis, Middle Aged, Antibodies, Bacterial

We report two laboratory-acquired Brucella melitensis infections that were shown to be epidemiologically related. Blood culture isolates were initially misidentified because of variable Gram stain results, which led to misdiagnoses and subsequent laboratory exposures. Notifying laboratory personnel who unknowingly processed cultures from brucellosis patients is an important preventive measure.
Surgical management of Miescher's cheilitis: a case report
Authors: Juan Cámara-Pérez, José Carlo Zapata-Negreiros, Pedro Enrique Alonso, Fernando Leiva-Cepas
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2021)
Keywords: melkersson-rosenthal syndrome, miescher’s cheilitis, cheiloplasty
MeSH terms: Case Reports

Miescher's cheilitis, also known as cheilitis granulomatosa, is an infrequent disease characterized by chronic recurrent swelling of one lip or both lips. It is considered as one of the three main symptoms of the triad of the Melkersson-Rosenthal syndrome, although in many cases it may develop monosymptomatically. The initial management is based on the administration of corticoids, followed in many cases by the use of other systemic treatments. Nevertheless, because recurrence is quite frequent, surgery remains in many cases as the only definitive treatment. In this report we present the case of a Caucasian woman with Miescher's cheilitis who was successfully surgically managed.
Association of Brucella meningoencephalitis with cerebrospinal fluid shunt in a child: a case report
Authors: Babak Abdinia, Mohammad Barzegar, Majid Malaki, Haleh Behbod, Shahram Oskoui
Journal: Iran J Child Neurol (2013)
Keywords: brucella, meningoencephalitis, shunt
MeSH terms: Case Reports

Brucellosis is an endemic zoonosis in Iran. It is a systemic infection that can involve any organs or systems of the body and have variable presentations. Ventriculoperitoneal (VP) shunt infections due to brucellosis have been rarely reported in the literatures. This is the history of a four years old boy who developed Brucella meningoencephalitis at the age of 42 months, whilst he had a VP shunt in situ for hydrocephalus treatment. Also, he presented brucellosis as acute abdomen. This patient was treated with trimethoprim-sulfamethoxazole, gentamicin and rifampicin. The shunt was extracted and all clinical and laboratory test abnormalities subsided through this management. We propose that in a patient with Brucella meningoencephalitis, the cerebrospinal fluid shunt system can be extracted and treatment with appropriate combination of antibiotics could be successful. Moreover, it shows that brucellosis should be considered in the differential diagnosis for acute abdomen and ascites in endemic regions.
Case Report: Immune checkpoint inhibitor-induced multiorgan vasculitis successfully treated with rituximab
Authors: Sehrish Qureshi, Naszrin Arani, Vishnu Parvathareddy, Amanda Tchakarov, Maen Abdelrahim, Maria Suarez-Almazor, Jianjun Zhang, Don Lynn Gibbons, John Heymach, Mehmet Altan, Ala Abudayyeh
Journal: Front Nephrol (2023)
Keywords: acute renal failure, autoimmune induction, immune check inhibitor, rituximab, vasculitis
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer. ICIs have a unique side effect profile, generally caused by inflammatory tissue damage, with clinical features similar to autoimmune conditions. Acute kidney injury from ICIs has been well studied; incidence ranges from 1% to 5%, with higher incidence when combination ICI therapies are used. Although the overall reported incidence of ICI-associated glomerulonephritis is less than 1%, vasculitis is the most commonly reported ICI-related glomerulonephritis. Other biopsy findings include thrombotic microangiopathy, focal segmental glomerulosclerosis, minimal change disease, and IgA nephropathy with secondary amyloidosis. We report a case in which a woman previously treated with the PD-L1 inhibitor durvalumab for locally advanced non-small cell lung cancer with pre-existing antineutrophil cytoplasmic (anti-PR3) antibody who later developed multi-organ vasculitis after ICI exposure, which was successfully treated with rituximab, with continued cancer remission for 3 years.
The Youngest Reported and Successfully Treated Patient with a Dermoid Cyst of the Parotid Gland: A Rare Pediatric Case
Authors: Marcel Fabian Glaas, Jörg Schipper, Nelofar Kajasi, Angelika Albrecht
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Dermoid cysts (DCs) are rare benign, epithelial-lined lesions. Up to 7% of them are found in the head and neck region and 80% of those predominantly occur in the orbit, in the nose, and in the floor of the mouth. The average age of presentation is around the age of six. Dermoid cysts located in the parotid gland have only been published in 19 cases so far. Interestingly, the mean age of occurrence in the parotid gland was much higher (31 years). We report on a four-year-old girl being the youngest patient who had ever been diagnosed with this disease.
Malaria in a 2-Month-Old HIV-Exposed Nigerian Infant: Challenges of Care
Authors: Olusola Adetunji Oyedeji
Journal: J Int Assoc Provid AIDS Care (2019)
Keywords: hiv, exposure, infancy, malaria
MeSH terms: HIV Infections / diagnosis, HIV Infections / parasitology, Malaria / diagnosis, Case Reports, Coinfection / parasitology, Coinfection / virology, Fever / parasitology, Fever / virology, Humans, Infant, Malaria / virology, Male, Nigeria, Risk Factors, Tertiary Care Centers

Background:
Reports on malaria and HIV coinfections in exposed infants from tropical countries are scarce.
Results:
The case of a 2-month-old HIV-exposed Nigerian infant who presented with intermittent fever at a Nigerian tertiary hospital is reported. The rarity of the case and the challenges associated with making the diagnosis informed our decision to report the case.
Conclusion:
Diagnosing malaria in HIV-exposed infants in early infancy requires a high index of suspicion, good knowledge of the clinical presentation, and appropriate microbiological investigations for sepsis and malaria. Further studies need to be conducted on the association between malaria and HIV exposure.
A case report of racemose pattern of intracranial tuberculoma with brain stem and hypophyseal involvement developing paradoxically during treatment
Authors: Denver Steven Pinto, Thara Joseph, Arun George, Ravi V Hoisala
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Tuberculosis involving the central nervous system, a source of considerable morbidity and mortality, forms 5-10% of the disease burden associated with tuberculosis. Central nervous system tuberculosis may present as meningitis, tuberculoma, abscesses, cerebritis or miliary tuberculosis. The most common site of tuberculoma has been reported to be at the grey-white matter junction and the periventricular region. They may even be found in the epidural, subdural and subarachnoid spaces, and the brain stem, with the rarer sites of involvement being the cavernous sinus, sella turcica, hypophysis, hypothalamus, sphenoid sinus and the mastoid air cells. Although tuberculosis is very common in developing countries, with the increasing prevalence of immunosuppression owing to human immunodeficiency virus and patients surviving chemotherapy or organ transplantation, the incidence of tubercular infections has been rising in developed countries. The authors report a case of intracranial tuberculosis in a human immunodeficiency virus-negative patient, who underwent incomplete treatment for tubercular peritonitis and presented with unilateral ptosis. Tuberculous involvement was noted in a racemose pattern in the subarachnoid space, cavernous sinuses, suprasellar cistern and parasellar region. To the best of our knowledge, the term racemose pattern of tuberculoma has not been described before, while about 10 cases of tuberculoma involving the cavernous sinuses have been reported in the literature. Furthermore, the racemose pattern of tuberculosis in the subarachnoid space, as well as involvement of the cavernous sinus, hypothalamus, pituitary and the cisterns, developed paradoxically after initiation of antitubercular chemotherapy.
A Novel 3q29 Deletion in Association With Developmental Delay and Heart Malformation-Case Report With Literature Review
Authors: Adela Chirita Emandi, Andreea Iulia Dobrescu, Gabriela Doros, Capucine Hyon, Diana Miclea, Calin Popoiu, Maria Puiu, Smaranda Arghirescu
Journal: Front Pediatr (2019)
Keywords: 3q29, behavior, cardiac malformation, cytogenetics, intellectual disability
MeSH terms: Case Reports

3q29 deletion syndrome is a rare disorder, causing a complex phenotype. Clinical features are variable and relatively non-specific. Our report aims to present an atypical, de novo deletion in chromosome band 3q29 in a preschool boy, first child of healthy non-consanguineous parents, presenting a particular phenotype (microcephaly, "full moon" face, flattened facial profile, large ears, auricular polyp, and dental dystrophies), motor and cognitive delay, characteristics of autism spectrum disorder and aggressive behavior. He also presented intrauterine growth restriction (birth weight 2,400 g) and a ventricular septal defect. SNP Array revealed a 962 kb copy number loss, on the chromosome 3q29 band (195519857-196482211), consistent with 3q29 microdeletion syndrome. FISH analysis using a RP11-252K11 probe confirmed the deletion in the proband, which was not present in the parents. Although the patient's deletion is relatively small, it partly overlaps the canonical 3q29 deletion (defined between TFRC and DLG1 gene) and extends upstream, associating a different facial phenotype compared to the classic 3q29 deletion, nonetheless showing a similar psychiatric disorder. This deletion is different from the canonical region, as it does not include the PAK2 and DLG1 genes, considered as candidates for causing intellectual disability. Thus, narrowing the genotype-phenotype correlation for the 3q29 band, FBX045 is suggested as a candidate gene for the neuropsychiatric phenotype.
Bilateral Chondroepitrochlearis Muscle: Case Report, Phylogenetic Analysis, and Clinical Significance
Authors: Sujeewa P W Palagama, Raymond A Tedman, Matthew J Barton, Mark R Forwood
Journal: Anat Res Int (2016)

Anomalous muscular variants of pectoralis major have been reported on several occasions in the medical literature. Among them, chondroepitrochlearis is one of the rarest. Therefore, this study aims to provide a comprehensive description of its anatomy and subsequent clinical significance, along with its phylogenetic importance in pectoral muscle evolution with regard to primate posture. The authors suggest a more appropriate name to better reflect its proximal attachment to the costochondral junction and distal attachment to the epicondyle of humerus, as "chondroepicondylaris"; in addition, we suggest a new theory of phylogenetic significance to explain the twisting of pectoralis major tendon in primates that may have occurred with their adoption to bipedalism and arboreal lifestyle. Finally, the clinical significance of this aberrant muscle is elaborated as a cause of potential neurovascular entrapment and as a possible hurdle during axillary surgeries (i.e., mastectomy).
Primary breast angiosarcoma: A case report
Authors: Yu He, Liyuan Qian, Lang Chen, Yang Liu, Yanguang Wen, Peiguo Cao
Journal: Front Surg (2023)
Keywords: dsa (digital subtraction angiography), breast angiosarcoma, case report, chemotherapy, radiotherapy, surgery
MeSH terms: Case Reports

Background:
Primary breast angiosarcoma (PBA) is a rare sarcoma, accounting for only 0.04% of all breast malignancies, with a difficult diagnosis and a poor prognosis. Mastectomy is the standard treatment, and the role of adjuvant treatment (chemotherapy and/or radiotherapy following surgery) remains uncertain with very few studies.
Case presentation:
We report the case of a 17-year-old female patient who presented with a right breast lump that had rapidly increased in size and was hemorrhaging. She was diagnosed with breast angiosarcoma by needle biopsy and pathological evaluation. However, the mass showed a quick tendency to bleed during biopsies. After that, we performed angiography and tumor vascular embolization. The patient underwent a mastectomy followed by adjuvant chemotherapy.
Conclusion:
Tumor vascular embolization reduced the surgical risk of PBA with hemorrhage complications. Postoperative therapeutic roles still need further exploration and verification.
Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report Unveiling Several Clinical and Histopathological Challenges
Authors: Tarek Aridi, Mohamad Fawwaz, Ahmad Kassab, Marwan Bahmad, Faisal Houcheimi, Mohamad Mshiek, Fouad Boulos, Ali Kanj, Ghassan Ramadan, Hisham F Bahmad, Najla Fakhruddin
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor. Surgical CAse REports (SCARE) guidelines were followed for reporting our case. The rarity of LELC of the breast warrants the establishment and implementation of well-defined guidelines and criteria for diagnosis and management.
Thoracic duct lymphangioma and chylous ascites in a 24-year-old female
Authors: Larissa Moreira Galvão Bello, Vitorino Modesto Dos Santos, Márcia Mayumi Marques Suzuki, Naiara Regina Siqueira, Fernanda Gonçalves Reis
Journal: Autops Case Rep (2021)
Keywords: chylous ascites, lymphangioma, octreotide, thoracic duct, treatment
MeSH terms: Case Reports

Lymphangiomas are rare and correspond to 0.7% to 4.0% of mediastinal tumors, and isolated mediastinal location occurs in 1% of cases. They are benign tumors that originate from a congenital malformation of the lymphatic vessels and are diagnosed more frequently in children less than 2 years of age. Chylous ascites is a clinical manifestation of thoracic duct lymphangioma and is composed of lymph accumulation caused by dilation of this lymphatic channel. It appears milky in the peritoneal cavity, containing triglyceride levels higher than 200 mg/dl. We report the case of a young patient with chylous ascites and lymphangioma of the thoracic duct, who was conservatively treated with octreotide and a low-fat diet with medium-chain triglycerides.
Bone metastasis from malignant phyllodes breast tumor: report of two cases
Authors: Mohamed Reda El Ochi, Mehdi Toreis, Mohamed Benchekroun, Zineb Benkerroum, Mohamed Allaoui, Mohamed Ichou, Basma El Khannoussi, Abderrahman Albouzidi, Mohamed Oukabli
Journal: BMC Clin Pathol (2016)
Keywords: bone, breast, metastatic, phyllodes, tumor
MeSH terms: Case Reports

Background:
Phyllodes tumors are rare fibroepithelial tumors accounting for less than 1 % of all breast neoplasms. They are malignant in 20 % of cases. Only a few cases of malignant phyllodes tumors metastatic to bone have been reported.
Case presentation:
Case 1: A 40 year-old white woman presented with three-week history of pain and functional impairment of the left lower limb. Her clinical past was remarkable for previous left mastectomy and radiotherapy for malignant phyllodes tumor performed one year ago. Computed tomography revealed a moth-eaten appearance of the left femoral head. The patient underwent computed guided femoral head biopsy. Pathological findings were consistent with metastatic malignant phyllodes tumor. The patient received ifosfamide and adriamycin chemotherapy. She is doing well without any evidence of progression on her imaging follow- up after 8 months. Case 2: A 48 year-old white woman, with history of bilateral mastectomy and radiotherapy for malignant phyllodes tumor performed one and two year ago, presented with four-week left lower quadrant abdominal pain. Computed tomography and magnetic resonance imaging revealed a solid aggressive osteolytic mass of the left iliac bone with extensive soft tissue invasion. Biopsy of the tumor was performed and showed a sarcomatous proliferation consistent with metastatic malignant phyllodes tumor. The patient received the same chemotherapy regimen as in the first case but without any response on her imaging follow up after 6 months.
Conclusion:
Malignant phyllodes tumor is a rare and aggressive fibroepithelial neoplasm. An accurate diagnosis of metastases should be based on clinicopathological correlation allowing exclusion of differential diagnoses. The goal of successful managing this tumor is early detection and complete resection prior to dissemination.
Sagittal sinus thrombosis due to L-asparaginase
Authors: Nisar A Wani, Tasleem Kosar, Nazir A Pala, Umar A Qureshi
Journal: J Pediatr Neurosci (2010)
Keywords: cerebral sinovenous thrombosis, l-asparaginase, leukemia, venous infarct
MeSH terms: Case Reports

Cerebral Sinovenous Thrombosis (CSVT) is a serious complication of L-asparaginase chemotherapy for leukemia in children. Clinical features of headache, altered consciousness, focal neurological deficit, and seizures developing during or immediately after treatment with L-asparaginase should alert the treating physician to the possibility of CSVT. Immediate imaging of the brain should be done using CT and MRI and the veins should be visualized noninvasively by CT and MR venography. We report two children on induction therapy for acute leukemia who presented with seizures, headache, and altered consciousness. Venous infarcts with and without hemorrhage were seen on CT in one patient and the empty delta sign was seen after contrast injection; however, the early changes were missed by CT. MRI detected dural sinus thrombosis relatively earlier in another patient, while the CT findings were equivocal; in this patient, contrast-enhanced MRI showed the empty delta sign and MR venography confirmed absent flow in the superior sagittal sinus, which was diagnostic of sinus thrombosis. Rapid anticoagulation was started with heparin and maintained with warfarin. The child with a unilateral small nonhemorrhagic infarct made a complete recovery while the other, with bilateral hemorrhagic infarcts, did not survive. We stress the importance of early diagnosis of CSVT using CT and MRI in children with leukemia being treated with L-asparaginase; this will permit timely treatment.