OpenMed/multicare-articles huggingface dataset:
Giant Cell Tumor of Soft Tissue-A Rare Cause of Mass in the Liver: A Case Report
Authors: Piaopiao Chen, Qiang Hu, Jinfeng Wu
Journal: Front Surg (2022)
Keywords: case report, giant cell tumor of soft tissue, hemorrhage, primary liver tumor, rupture
MeSH terms: Case Reports

Primary giant cell tumors of soft tissues (GCT-STs) are extremely rare soft tissue tumors located both in superficial and in deep soft tissues. Clinically, GCT-ST manifests as a slow-growing, well-defined, painless mass. We report a case of an 88-year-old female patient with upper abdominal distension, fever, and anemia. Laparoscopic exploration revealed a tumor located in the left lobe of the liver with localized rupture and hemorrhage. Postoperative pathology revealed that the tumor was composed of monocytes and osteoclast-like multinucleated giant cells, accompanied by extensive hemorrhage, necrosis, and cytologic atypia. Because mitotic cells are difficult to be detected in pathological diagnosis, combined with immunohistochemistry, the tumor was diagnosed as a giant cell tumor of soft tissue. This case report highlights the primary choice of histology and immunohistochemistry for the correct diagnosis of GCT-ST because preoperative radiological diagnosis is nonspecific and prone to mistakes.
IgA vasculitis with nephritis in cirrhotic Wilson disease: Is there an association?
Authors: Ratna Acharya, Xu Zeng, William L Clapp, Kiran Upadhyay
Journal: Clin Nephrol Case Stud (2020)
Keywords: iga vasculitis, wilson disease, child, nephritis
MeSH terms: Case Reports

Introduction:
IgA vasculitis (IgA-V) predominantly involves skin, gastrointestinal (GI) tract, joints, and kidneys. Wilson disease (WD) is a hepatolenticular degenerative disease caused by ATP7B gene mutation.
Case report:
Here we describe an unusual association of IgA-V with nephritis (IgA-VN) in an 11-year-old child with WD. He presented with palpable purpura without arthritis and GI involvement. Renal function was normal. Urinalysis showed microscopic hematuria and tubular proteinuria. Evaluation showed transaminitis, hypoalbuminemia, IgA hyperglobulinemia, and coagulation abnormalities. Serum ceruloplasmin and copper were low and 24-hour urine copper was extremely elevated. Liver biopsy showed stage IV cirrhosis with increased quantitative liver copper content. Skin and renal biopsy showed IgA-positive leukocytoclastic vasculitis and mesangial hyperplasia with IgA deposition, respectively. Quantitative renal copper content was normal. Homozygous pathogenic variant c.3207C>A (p.His1069Gln) of ATP7B was detected. There were no Kayser-Fleischer rings in the eyes, and neuropsychiatric examination was normal. Treatment with zinc and trientine led to normalization of hepatic function and serum IgA level with resolution of the rash and maintenance of renal function.
Conclusion:
Defective hepatic processing and/or clearance of IgA/IgA immune complexes probably led to the IgA-mediated skin and renal injury. Further such reports will help augment our understanding on the pathophysiology of IgA-VN in WD.
Long Term Rigid Retained Foreign Object After Breast Augmentation: A Case Report and Literature Review
Authors: Coral Franco, Anner Moskovitz, Iuliana Weinstein, Samuel Kwartin, Yoram Wolf
Journal: Front Surg (2021)
Keywords: breast augmentation, case report, patient safely, retained foreign object, syringe coverage
MeSH terms: Case Reports

Introduction: Retained foreign object (RFO) is a rare iatrogenic complication. This article presents an unprecedented case of a plastic RFO post-augmentation mammoplasty. Case Presentation: We present the case of a 32-year-old woman, 8 years after breast augmentation surgery, with a 4 year history of a palpable migrating mass in the superior lateral quadrant of her right breast with fluctuating levels of pain. Imaging studies included mammography tests, sonographic examinations, a Magnetic Resonance Imaging scan, and a Computed Tomography scan, all of which did not identify any pathological findings. Exploratory surgery discovered a syringe-tip cover in the implant pocket. Conclusion: Persistent complaints and symptoms accompanied by non-specific imaging studies warrant escalation of diagnostic methods, in line with a high awareness for the possibility of an RFO. As pocket lavage is a common practice in various surgeries, this report can serve as a valuable reminder for surgical teams to account for syringe covers and other disposable items at the end of all operations.
Adverse Effects of Ramadan Fasting in a Girl with Salt-Losing Congenital Adrenal Hyperplasia
Authors: Valeria Calcaterra, Francesco Bassanese, Andrea Martina Clemente, Rossella Amariti, Corrado Regalbuto, Anna Sala, Gian Vincenzo Zuccotti
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Objective:
Congenital adrenal hyperplasia (CAH) is the most common cause of adrenal insufficiency in pediatrics. Chronic glucocorticoid replacement is the mainstay of treatment in the classic forms of CAH, and mineralocorticoid replacement therapy is mandatory in the salt-wasting form. Fasting is a mild stressor, which can expose to dehydration, hypotension, hypoglycemia, and acute adrenal crisis in patients with adrenal insufficiency.
Case:
We report the case of an adolescent affected by the classic form with salt-losing CAH, who observed Ramadan for 30 days, without individualized therapeutic management plan. After Ramadan, a dramatic increase of ACTH level (1081 pg/ml, n.v. 6-57), reduced cortisolemia, tendency to hypotension, and weight loss were recorded. She experienced insomnia, intense thirst, asthenia, and headache. The symptoms disappeared restarting the previous therapy schedule and increasing the total hydrocortisone daily dose with progressive restoring of hormonal control.
Conclusion:
Our case confirms that patients with CAH are vulnerable, especially during fasting in Ramadan, with a higher risk of acute adrenal crisis. CAH patients should reform and individualize their treatment plan and be submitted to careful monitoring.
Congenital nasal pyriform aperture stenosis
Authors: José V Tagliarini, Victor Nakajima, Emanuel C Castilho
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Nasal Obstruction / etiology, Nose / abnormalities, Case Reports, Choanal Atresia / diagnosis, Constriction, Pathologic / congenital, Constriction, Pathologic / diagnostic imaging, Constriction, Pathologic / surgery, Diagnosis, Differential, Humans, Infant, Newborn, Male, Nasal Obstruction / diagnostic imaging, Nasal Obstruction / surgery, Nose / diagnostic imaging, Nose / surgery, Tomography, X-Ray Computed

The congenital stenosis of pyriform aperture is an unusual cause of neonatal nasal obstruction. It is due to bony overgrowth of the nasal lateral process of the maxilla. Initially this narrowest part of nasal airway was considered an isolated deformity; subsequently the congenital Stenosis of pyriform aperture was thought to represent a microform of holoprosencephaly. In this report a male neonate had respiratory distress, cyclic cyanosis and apnea after delivery. The patient underwent surgical correction of pyriform stenosis by sublabial access. In the follow up, the patient had good evolution. The report of this deformity shows an important cause of neonatal nasal obstruction and its differential diagnosis with bilateral choanal atresia. Congenital stenosis of nasal pyriform aperture can be surgically corrected when necessary.
Essential Thrombocythemia Complicated by Occlusive Thrombosis of the Abdominal Aorta
Authors: Jamie Geringer, Joshua Fenderson, Michael Osswald
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Introduction:
Essential thrombocythemia (ET) is a myeloproliferative neoplasm of excessive platelet production complicated by thrombohemorrhagic events. Thrombosis typically occurs in small to medium vessels; thrombosis of large vessels is rare.
Case presentation:
A 75-year-old woman with ET complicated by bilateral retinal vein occlusion was evaluated for fatigue, early satiety, and unintentional weight loss. Her hypertension was well controlled, and her chronic lower extremity claudication from peripheral artery disease was stable. She reported adherence to aspirin 81 mg and hydroxyurea 1000 mg daily, and her platelets (375 × 109/L) were at goal. Bone marrow biopsy was consistent with ET without progression to myelofibrosis or leukemia. CT abdomen demonstrated complete occlusion of the infrarenal aorta, extending into the common iliac arteries, with reconstitution of flow distally via collaterals. The addition of clopidogrel, for platelet inhibition, and cilostazol, for claudication, caused symptom improvement without further thrombosis or bleeding.
Discussion:
There are few published reports of ET complicated by aortic thrombosis. To our knowledge, this is the first report of aortic thrombosis occurring in an ET patient with normal platelet count on antiplatelet and cytoreductive therapies. There is limited evidence to guide treatment, but medical management with triple antiplatelet therapy may be effective in selected patients.
Anesthesia management for cesarean section 10 years after heart transplantation: a case report
Authors: Xiaofei Qi, Xiaolei Wang, Xiaolei Huang, Chenhong Wang, Yin Gu, Yuantao Li
Journal: Springerplus (2016)
Keywords: anesthesia, cardiac transplantation, cesarean section, pregnancy

Introduction:
Pregnancy after organ transplantation is becoming increasingly common. However, reports of the anesthesia for such patients are rare. Heart transplant recipients are always accompanied with pathophysiological changes and present anesthesiologists with challenge.
Case description:
We reported a case of anesthesia management of gravida undergoing cesarean section 10 years after cardiac transplantation. We used two points spinal and epidural anesthesia, combined with phenylephrine throughout the surgery. The course was absolutely successful and both mother and baby got good results.
Discussion and evaluation:
Physiology of heart transplant recipients and key points of anesthesia management were discussed.
Conclusions:
Spinal anesthesia can be performed in heart transplant recipients, however, we have to think twice before anesthesia for this kind of patients.
The Case of Reactive Arthritis Secondary to Echinococcus Infestation
Authors: Bülent Alım, Sinan Çetinel, M Alperen Servi, Fahrettin Bostancı, Mehmet Ozan Bingöl
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Reactive arthritis is an inflammatory joint disease that develops after an infection and it usually occurs following a gastrointestinal or genitourinary system infection and it belongs to the family of arthritis called "spondyloarthritis." We wanted to represent a rare case of reactive arthritis secondary to Echinococcus infestation. Cyst hydatid disease is common in endemic regions like Turkey. Internal organ involvements, especially liver and lung, are most frequent involvements. Primary bone involvement is rare complication of Echinococcus infestation. In our case, the patient with Echinococcus infection developed right knee arthritis and sacroiliitis. Other reactive and oligoarthritis causes were excluded and diagnosis of reactive arthritis secondary to cyst hydatid infestation was done with the present findings. Cold pack and TENS treatment were applied as symptomatic treatment to the right knee of the patient. Acemetacin was given as medical treatment. On the 5th day of treatment, right knee and ankle arthritis were clinically regressed. In regions where the disease is seen as endemic, such as Turkey, patients with musculoskeletal symptoms should consider the possibility of musculoskeletal involvement due to the hydatid cyst.
The management of a patient with a cervical disc herniation: a case report
Authors: Sherry Tsao, Peter Pidcoe
Journal: Clin Med Case Rep (2008)
Keywords: cervical spine, disc herniation, radiculopathy, traction
MeSH terms: Case Reports

Purpose:
To present the management of a patient with a cervical disc herniation and illustrate the efficacy of cervical traction as a main form of treatment for cervical disc herniation in conjunction with a home exercise program.
Background:
A 71-year-old white female diagnosed with cervical disc herniation at the levels of C5-6 and C6-7 presented to physical therapy with neck pain radiating into the left upper extremity down to the 5th digit of the left hand.
Treatment:
The patient reported to outpatient physical therapy for cervical disc herniation and radiculopathy. After initial evaluation she received intermittent cervical traction and was given a home exercise program consisting of cervical lateral flexion stretch, unilateral wall stretch for pectoralis muscles and to continue with her over the door cervical traction.
Conclusion:
Cervical traction and a good home exercise program have been shown to reduce cervical disc herniation and its subsequent symptoms.
Treatment of low-grade bulbar transitional cell carcinoma with urethral instillation of mitomycin C
Authors: Emmanuel J Melonakos, Richard A Santucci
Journal: Adv Urol (2008)
MeSH terms: Case Reports

A 63-year old man was referred to us after three rapid recurrences of low-grade urethral papillary transitional cell carcinoma of the bulbar urethra, after repeated primary excision. Cystoscopy confirmed 3-4 low-grade urethral transitional cell carcinomas, which were subsequently fulgurated. After urethral healing, a solution of Mitomycin C (40 mg/80 cc) was instilled into the urethra for fifteen minutes and held in place with a penile clamp. Urethral instillations were repeated weekly for six weeks. The patient is currently disease-free more than one year and three months posttreatment. This case highlights the successful treatment of urethral carcinoma with topical chemotherapy, which is usually reserved for the bladder, using a slight modification of standard technique.
Potential of essential fatty acid deficiency with extremely low fat diet in lipoprotein lipase deficiency during pregnancy: A case report
Authors: Elaine C Tsai, Judy A Brown, Megan Y Veldee, Gregory J Anderson, Alan Chait, John D Brunzell
Journal: BMC Pregnancy Childbirth (2004)

BACKGROUND: Pregnancy in patients with lipoprotein lipase deficiency is associated with high risk of maternal pancreatitis and fetal death. A very low fat diet (< 10% of calories) is the primary treatment modality for the prevention of acute pancreatitis, a rare but potentially serious complication of severe hypertriglyceridemia. Since pregnancy can exacerbate hypertriglyceridemia in the genetic absence of lipoprotein lipase, a further reduction of dietary fat intake to < 1-2% of total caloric intake may be required during the pregnancy, along with the administration of a fibrate. It is uncertain if essential fatty acid deficiency will develop in the mother and fetus with this extremely low fat diet, or whether fibrates will cross the placenta and concentrate in the fetus. CASE PRESENTATION: A 23 year-old gravida 1 woman with primary lipoprotein lipase deficiency was seen at 7 weeks of gestation in the Lipid Clinic for management of severe hypertriglyceridemia that had worsened with pregnancy. While on her habitual fat intake of 10% of total calories, her pregnancy resulted in an exacerbation of the hypertriglyceridemia, which prompted further restriction of fat intake to < 2% of total calories, as well as administration of gemfibrozil at a lower than average dose. The level of gemfibrozil, as the active metabolite, in the venous and arterial fetal cord blood was within the expected therapeutic range for adults. The clinical signs and a biomarker of essential fatty acid deficiency, namely the ratio of 20:3 [n-9] to 20:4 [n-6] fatty acids, were closely monitored throughout her pregnancy. Despite her extremely low fat diet, the levels of essential fatty acids measured in the mother and in the fetal blood immediately postpartum were normal. Normal essential fatty acid levels may have been achieved by the topical application of sunflower oil. CONCLUSIONS: An extremely low fat diet in combination with topical sunflower oil and gemfibrozil administration was safely implemented in pregnancy associated with the severe hypertriglyceridemia of lipoprotein lipase deficiency.
Laparoscopic evaluation and management of isolated gastric rupture in a boy after blunt abdominal injury
Authors: Anastasiadis Kleanthis, Vasilis Mouravas, Vasilis Lampropoulos, Evgenia Babatseva, Ioannis Spyridakis
Journal: Pan Afr Med J (2017)
Keywords: gastric rupture, abdominal trauma, children, laparoscopic surgery, minimally invasive surgery, trauma
MeSH terms: Abdominal Injuries / surgery, Laparoscopy / methods, Stomach Rupture / surgery, Wounds, Nonpenetrating / surgery, Case Reports, Abdomen, Acute / etiology, Abdomen, Acute / surgery, Abdominal Injuries / diagnosis, Bicycling / injuries, Child, Humans, Male, Stomach Rupture / diagnosis, Tomography, X-Ray Computed / methods, Wounds, Nonpenetrating / diagnosis

Blunt abdominal injury in children can be a significant diagnostic and therapeutic challenge. The extent and localization of organ damage cannot be always thoroughly investigated noninvasively and in spite of modern imaging techniques and a laparotomy may be necessary for diagnosis, even though it carries a significant morbidity. We present a rare case of isolated gastric rupture after blunt abdominal injury in a 12 year old boy that sustained a bicycle accident. He was hemodynamically stable, had signs of acute abdomen and axial tomography was inconclusive as of the site of visceral perforation. Definitive diagnosis and treatment were carried out laparoscopically with excellent results. Laparoscopic surgery in cases of blunt abdominal injury with gastric rupture can serve both as a diagnostic and therapeutic modality with the additional advantage of being less traumatic. The accumulation of relevant experience is mandatory in order to establish this modality in the diagnostic and therapeutic protocols.
Very late stent thrombosis 42 months after implantation of sirolimus-eluting stent and discontinuation of antiplatelet therapy
Authors: Dirk Sibbing, Karl-Ludwig Laugwitz, Lorenz Bott-Flügel, Jürgen Pache
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Although safety profiles of sirolimus-eluting stents do not seem to differ in short-to-medium term from those of bare-metal stents, late stent thrombosis after deployment of drug-eluting stents has emerged as a potential safety concern in the era of high-pressure stent implantation. Here, we describe the case of a patient with acute myocardial infarction due to stent thrombosis of a sirolimus-eluting stent 42 months after stent deployment and 5 weeks after discontinuation of aspirin treatment. To the best of our knowledge, this is one of the most delayed cases of sirolimus-eluting stent thrombosis described so far. The case emphasizes the potential risk that late stent thrombosis can unpredictably occur at any time point after drug-eluting stent deployment.
Pulmonary Artery Sling Presenting as Pneumonia and Inhalation of a Foreign Body
Authors: Shujuan Luo, Huaping Rao
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Pulmonary artery sling is a rare cause of respiratory distress created by compression of the lower trachea and right mainstem bronchus due to an aberrant origin of the left pulmonary artery. The condition is frequently associated with recurrent respiratory infections and other congenital malformations including tracheal rings. We present the case of an infant presenting with pulmonary distress and a history of recurrent respiratory infection. The infant underwent surgery to remove a foreign object; however, the symptoms did not resolve. Bronchoscopy revealed bronchus stenosis, and subsequent echocardiogram and CT scans revealed the presence of a pulmonary artery sling. We prescribed infection prophylaxis with the immunomodulator OM-85 to mitigate the risk of further infections prior to surgery. PAS and bronchus stenosis were corrected successfully by surgical intervention leading to resolution of symptoms of respiratory distress and a reduction in the incidence of respiratory infection.
Rare causes of anisocoria: Ipratropium bromide and Angel's trumpet
Authors: Arzu Ekici, Busra Caglar, Ozlem Kara, Arzu Oto, Nevin Kilic
Journal: North Clin Istanb (2021)
Keywords: angel’s trumpet, anisocoria, ipratropium bromide
MeSH terms: Case Reports

It is considered a neurological emergency when a patient presents with anisocoria. It is important that the anisocoria whether or not accompanied by the neurological findings. Other reasons of anisocoria should be considered when the absence of neurological or ophthalmological signs such as change of mental status, hemiparesis, ophthalmoplegia, ptosis. Herein we report two cases of temporary anisocoria due to inhaler ipratropium bromide and Angel's trumpet.
Symptomatic Massive Splenomegaly in Persistent Polyclonal B-cell Lymphocytosis Requiring Splenectomy
Authors: Shanel B Bhagwandin, Elliot S Weisenberg, Howard Ozer, Ajay V Maker
Journal: Open J Clin Med Case Rep (2015)

Introduction:
Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare lymphoproliferative hematological disease characterized by binucleated lymphocytes, CD 19+ CD 5-lymphocytosis, and elevated levels of serum immunoglobulin M (IgM). It can rarely be associated with splenomegaly, though the disease usually remains indolent.
Case presentation:
We present a case of PPBL in a young man with massive splenomegaly that mimicked isolated splenic lymphoma requiring splenectomy for persistent pain, symptoms, and diagnosis.
Discussion:
Determining the etiology of splenomegaly in these patients is often confounding due to a lack of a tissue diagnosis and the limited morphological and immuno-histochemical features of PPBL, therefore, the presentation remains highly concerning for lymphoma.
Conclusion:
The presentation, surgical treatment, tissue and peripheral blood molecular analysis, and flow cytometry integral to managing these patients and to prevent an assumptive and misleading diagnosis are reviewed.
Case of Secondary Tics Associated With Olanzapine in an Adult
Authors: Eric W Mills, Lindsay S Shaffer, Fernando S Goes, Akira Sawa, Frederick C Nucifora Jr
Journal: Front Psychiatry (2017)
Keywords: atypical antipsychotic, neuroleptic, olanzapine, schizophrenia, tics
MeSH terms: Case Reports

Atypical antipsychotic medications, such as risperidone, aripiprazole, and olanzapine, have utility in treating motor tics, particularly in Tourette syndrome. In rare cases, atypical antipsychotic medications have been associated with adult-onset motor tics. Such adverse drug reactions have been documented in response to quetiapine, aripiprazole, and amisulpride. Here, we report, to our knowledge, the first case of adult-onset motor tics related to olanzapine administration.
Primary renal Ewing's sarcoma in a young male treated completely by surgical excision without chemotherapeutic agents: Case report
Authors: Khalid M Abdalla, Nour A Tashtush, Abdelwahab J Aleshawi, Ghassan Talahmeh, Khaled Z Alawneh
Journal: Int J Surg Case Rep (2019)
Keywords: cd99, ewing, nephrectomy, round cell tumor

Introduction:
Primary renal Ewing's sarcoma is a rare tumor with dismal prognosis. The main treatment modality of treatment is surgical excision with adjuvant or neoadjuvant chemotherapy.
Case presentation:
We present a case of primary renal EWS in 27-year-old male. He presented to our center complaining of three days history of severe left flank pain associated with nausea and vomiting. Computerized tomography (CT) revealed a 10 × 7 × 6.5 cm left lower pole renal mass. Left radical nephrectomy was performed and revealed a tumor with uniform round to oval nuclei cells. The cells stained strongly positive for CD 99. The diagnosis was established as primary renal Ewing's sarcoma. The patient refused the chemotherapy. Fortunately, he was free of the disease on regular clinical and radiological follow-up, the last follow up was 30 months post-nephrectomy.
Conclusion:
This case highlights the importance of proper surgical treatment and its role in the managing this type of malignancy especially in localized disease at presentation.