OpenMed/multicare-articles huggingface dataset:
Giant gastric lipoma mimicking well-differentiated liposarcoma
Authors: Mohamed Moncef Hamdane, Ehsen Ben Brahim, Mériam Belhaj Salah, Nooman Haouas, Ahmed Bouhafa, Achraf Chedly-Debbiche
Journal: Pan Afr Med J (2012)
Keywords: stomach, cytogenetics, lipoma, liposarcoma, pathology
MeSH terms: Lipoma / diagnosis, Liposarcoma / diagnosis, Stomach Neoplasms / diagnosis, Case Reports, Cyclin-Dependent Kinase 4 / genetics, Diagnosis, Differential, Gene Amplification, Humans, In Situ Hybridization, Fluorescence, Lipoma / genetics, Lipoma / pathology, Liposarcoma / pathology, Male, Middle Aged, Proto-Oncogene Proteins c-mdm2 / genetics, Stomach Neoplasms / genetics, Stomach Neoplasms / pathology, MDM2 protein, human, Proto-Oncogene Proteins c-mdm2, CDK4 protein, human, Cyclin-Dependent Kinase 4

Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, antral tumor. CT scan reveals an antral mass with fat attenuation. The patient underwent a total gastrectomy. Macroscopic examination identified in the antral wall a 9-cm, well-circumscribed, nodular lesion, with a yellow, greasy cut surface. On histological examination, the tumor was composed of a mature adipocytes proliferation, showing significant variation in cell size, associated to some lipoblasts. Nuclei were sometimes large, slightly irregular, but without hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed no MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization. The diagnosis of lipoma was made. Twelve months following surgery, the patient is doing well.
Pulmonary schistosomiasis mimicking IgG4-related lung disease
Authors: Timothy Baird, Caroline L Cooper, Richard Wong, Naomi Runnegar, Gregory Keir
Journal: Respirol Case Rep (2017)
Keywords: igg4‐related disease, lung, schistosomiasis
MeSH terms: Case Reports

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterized by tumefactive lesions in various organ systems, including the lungs. Clinical and radiological manifestations of IgG4-RD are relatively non-specific, and we report a case highlighting the importance of histopathological confirmation in cases of suspected IgG4-related lung disease. A 44-year-old male with significantly elevated serum IgG4 levels, patchy consolidation on thoracic CT imaging, and cough was referred with suspected IgG4-related lung disease. However, surgical lung biopsy revealed an unexpected diagnosis of pulmonary schistosomiasis, and following treatment with praziquantel, cough resolved and IgG4 levels significantly declined. This case highlights the potentially diverse array of conditions that may mimic IgG4-related lung disease and the importance of comprehensive evaluation including histopathological confirmation where possible.
A Case Report of Two Kala-Azar Cases in China Diagnosed by Metagenomic Next-Generation Sequencing
Authors: Hongguang Gao, Jing Wang, Shu Zhang, Tian Li
Journal: Front Microbiol (2022)
Keywords: leishmania, diagnosis, fever, kala-azar, mngs

Background:
Leishmaniasis being a local disease, as kala-azar this particular form is a visceral form. It is transmitted by sandflies, and is a parasitic disease involving the reticuloendothelial system of mononuclear macrophages. Due to its poor prognosis and high fatality rate, the fatality rate of patients without effective treatment can exceed 95%. Thereby, early diagnosis and treatment can significantly improve its prognosis. The metagenomic next-generation sequencing (mNGS) has the advantage of being able to find pathogens that cannot be detected by traditional methods. More importantly, it can conduct nucleic acid detection of pathogens covering a wide range in a short time. For infectious diseases like kala-azar, which is clinically complicated and difficult, mNGS detection provides a basis for accurate etiological diagnosis.
Case report:
We report 2 cases of kala-azar in West China Hospital, Chengdu, China. The first case is a 47-year-old male patient who had recurrent fever for 4 months, accompanied by reduction of red blood cell, white blood cell, and blood platelet. He was detected by mNGS and clinically diagnosed as kala-azar (Leishmania detection), finally died of multiple organ failure. The second patient was a 15-year-old male who had fever for more than 10 days. He was detected by mNGS and clinically diagnosed as kala-azar (Leishmania detection). He recovered and discharged quickly after treatment with sodium stibogluconate.
Conclusion:
Efforts should be made to improve early etiological diagnosis in order to improve patient prognosis. mNGS detection is beneficial to the diagnosis and treatment of infectious diseases with unknown causes in the early stage of emergency treatment.
Cushing's syndrome with no clinical stigmata - a variant of glucocorticoid resistance syndrome
Authors: Ved V Gossain, Mohammad El-Rifai, Preethi Krishnan, Bhavini Bhavsar
Journal: Clin Diabetes Endocrinol (2018)
Keywords: cortisol resistance, cortisol resistance syndrome, cushing’s syndrome
MeSH terms: Case Reports

Background:
Cortisol resistance syndrome is a very rare condition characterized by high cortisol levels, but without any clinical features of Cushing's syndrome. Our objective is to present such a case.
Case presentation:
A 41 year old female presented with mild hirsutism and elevated urinary cortisol levels. Plasma cortisol levels were elevated and were not suppressed by conventional doses of dexamethasone on multiple occasions, but decreased following administration of higher doses of dexamethasone. Adrenocorticotropic hormone (ACTH) levels were inappropriately elevated. Despite significantly elevated cortisol levels, she did not develop any clinical signs or symptoms of Cushing's syndrome. Pituitary and adrenal imaging did not reveal any abnormalities. Genetic testing for human glucocorticoid receptor did not reveal any mutations.
Conclusions:
Although we were not able to identify any new mutations, we believe that our patient has a variant of cortisol resistance syndrome. This syndrome should be considered in the differential diagnosis of patients who present with high levels of cortisol but have no clinical features of Cushing's syndrome.
Case Report: Intramedullary Intervertebral Disk Extrusion in a Cat: Clinical, Computed Tomographic, High-Field Magnetic Resonance Imaging, and Outcome Findings
Authors: Maud Debreuque, Isabelle Valin, Daniela Prata, Pauline De Fornel, Jean-Laurent Thibaud
Journal: Front Vet Sci (2020)
Keywords: ct, cauda equina, case report, cat, high-field mri, intramedullary, non-compressive, peracute disk extrusion
MeSH terms: Case Reports

Background: Intramedullary disk extrusions has rarely been described in veterinary medicine, more especially in cats, with only two cases are reported in the veterinary literature. Diagnosis may be difficult, even though clinical presentation and imaging studies, such as MRI or CT, can present specific features. Treatment and prognosis are not clearly described. Case presentation: A 10-year-old domestic shorthair female cat was evaluated for a 12 h-history of peracute-onset of paraparesis with flaccid tail and urinary and fecal incontinence. The patellar reflexes were normal, the pelvic flexor reflexes were decreased (more markedly on the right limb) and the perianal reflex was absent. The tail was flaccid, without nociception. Abdominal palpation revealed a small urinary bladder, easily expressed. Manipulation of the lumbar vertebral column elicited marked pain. Neurological examination was consistent with a L7-caudal segments lesion. A lumbosacral MRI and CT evaluations were performed and revealed a focal intramedullary hemorrhagic lesion, with an associated vertical linear tract communicating with the L5-L6 intervertebral disk space, and a suspected intramedullary focus of mineralization. These imaging findings were highly suggestive of an L5-L6 intramedullary disk extrusion. A dorsal L5-L6 laminectomy confirmed the presence of intramedullary degenerative nucleus pulposus fragments, which were surgically removed. Rapid and progressive neurological improvement was observed post-surgery. At the 1-year follow-up, right plantigrade stance and mild paraparesis were still noticed, but jumps and voluntary tail movements were observed. Occasional urinary and fecal incontinence episodes remained. Conclusions: This is the first feline case report of an intramedullary disk herniation with long-term follow-up available. Clinical description, CT and High-Field MRI findings, surgical procedure and histological results are reported, and help describing the characteristics of this rare non-compressive category of peracute intervertebral disk extrusion. Surgical management may be considered in feline cases of intramedullary disk herniation and may be associated with a good outcome.
Clinical Status and Outcome of Isolated Right Ventricular Hypoplasia: A Systematic Review and Pooled Analysis of Case Reports
Authors: Keiichi Hirono, Hideki Origasa, Kaori Tsuboi, Shinya Takarada, Masato Oguri, Mako Okabe, Nariaki Miyao, Hideyuki Nakaoka, Keijiro Ibuki, Sayaka Ozawa, Fukiko Ichida
Journal: Front Pediatr (2022)
Keywords: cyanosis, heart failure, patent foramen ovale, right ventricular hypoplasia, tricuspid valve
MeSH terms: Systematic Review

Background:
Isolated right ventricular hypoplasia (IRVH), not associated with severe pulmonary or tricuspid valve malformation, is a rare congenital myocardial disease. This study aims to evaluate the clinical status and outcome of IRVH.
Methods:
A systematic search of keywords on IRVH was conducted. Studies were searched from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) published between January 1950 and August 2021.
Results:
Thirty studies met the inclusion criteria. All of these studies were case reports and included 54 patients (25 males and 29 females). The median age of the patients was 2.5 years old (0-15.3 years). Of the 54 patients, 13 (24.1%) reported a family history of cardiomyopathy. Moreover, 50 (92.6%), 19 (35.2%), and 17 (31.5%) patients were diagnosed with cyanosis, finger clubbing, and dyspnea, respectively. Furthermore, 53 (98.2%) patients had a patent foramen ovale or an atrial septal defect (ASD). Z-score of the tricuspid valve diameter on echocardiogram was -2.16 ± 1.53, concomitant with small right ventricular end-diastolic volume. In addition, 29 (53.7%), 21 (38.9%), 7 (13.0%), and 2 (3.7%) patients underwent surgery, ASD closure, Glenn operation, and one and a half ventricular repair, respectively. Among them, nine (20.4%) patients expired, and the multivariable logistic regression analysis showed that infancy, heart failure, and higher right ventricular end-diastolic pressure were risk factors for death.
Conclusions:
IRVH was diagnosed early in children with cyanosis and was associated with high mortality. This systematic review and pooled analysis provided evidence to assess the of IRVH degree in order to evaluate the clinical status and outcome of IRVH.
Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
Authors: Nino Chiron Morsink, Nienke Johanna Maria Klaassen, Björn Petrus Meij, Jolle Kirpensteijn, Guillaume Cornelis Maria Grinwis, Irene Afra Schaafsma, Jan Willem Hesselink, Johannes Frank Wilhelmus Nijsen, Sebastiaan Alexander van Nimwegen
Journal: Front Vet Sci (2021)
Keywords: brachytherapy, canine, dog, holmium, intratumoral treatment, pituitary, radionuclide, translational model
MeSH terms: Case Reports

Introduction: In this case study, a client-owned dog with a large pituitary tumor was experimentally treated by intratumoral injection of radioactive holmium-166 microspheres (166HoMS), named 166Ho microbrachytherapy. To our knowledge, this is the first intracranial intratumoral treatment through needle injection of radioactive microspheres. Materials and Methods: A 10-year-old Jack Russell Terrier was referred to the Clinic for Companion Animal Health (Faculty of Veterinary Medicine, Utrecht University, The Netherlands) with behavioral changes, restlessness, stiff gait, and compulsive circling. MRI and CT showed a pituitary tumor with basisphenoid bone invasion and marked mass effect. The tumor measured 8.8 cm3 with a pituitary height-to-brain area (P/B) ratio of 1.86 cm-1 [pituitary height (cm) ×10/brain area (cm2)]. To reduce tumor volume and neurological signs, 166HoMS were administered in the tumor center by transsphenoidal CT-guided needle injections. Results: Two manual CT-guided injections were performed containing 0.6 ml of 166HoMS suspension in total. A total of 1097 MBq was delivered, resulting in a calculated average tumor dose of 1866 Gy. At 138 days after treatment, the tumor volume measured 5.3 cm3 with a P/B ratio of 1.41 cm-1, revealing a total tumor volume reduction of 40%. Debulking surgery was performed five months after 166HoMS treatment due to recurrent neurological signs. The patient was euthanized two weeks later at request of the owners. Histopathological analysis indicated a pituitary adenoma at time of treatment, with more malignant characteristics during debulking surgery. Conclusion: The 40% tumor volume reduction without evident severe periprocedural side effects demonstrated the feasibility of intracranial intratumoral 166HoMS treatment in this single dog.
Susac syndrome: about two cases
Authors: Fatoumata Ba, El Hadji Makhtar Ba, Modou Mbacké Guèye, Marième Soda Diop Sène, Massar Diagne
Journal: Pan Afr Med J (2019)
Keywords: senegal, susac syndrome, cochleo-vestibular neuropathy, encephalopathy, neurophysiology
MeSH terms: Brain / blood supply, Susac Syndrome / diagnosis, Case Reports, Adult, Ear, Inner / blood supply, Female, Humans, Male, Middle Aged, Retinal Vessels / pathology, Senegal, Susac Syndrome / physiopathology

Susac syndrome is an autoimmune endothelopathy that affects precapillary arterioles of the brain, retina and inner ear. We report for the first time observations of two patients with Susac syndrome in Senegal.
Preaxial Polydactyly in an Elderly Woman
Authors: Barkha Chhabra, Richy Charls, John J Faillace
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

A 70-year-old woman born and raised in India presented with Wassel type IV preaxial polydactyly of the right thumb and difficulty performing daily activities. She elected for surgical reconstruction after postponing the procedure for many years due to cultural norms. Her postoperative course was unremarkable. At her 3-month follow-up, she was diagnosed with carpal tunnel syndrome and underwent open carpal tunnel release. Preaxial polydactyly repair is unusual in patients older than 25 years. Though the duplication is considered lucky in South Asia, indications for this case were arthritic pain, cosmesis, and function. This case report details a unique indication for polydactyly reconstruction, arthritic pain, which may benefit hand surgeons when discussing the literature on adult polydactyly with their patients.
Giant fibroepithelial stromal polyp of the vulva: largest case reported
Authors: Obianuju Sandra Madueke-Laveaux, Radhika Gogoi, Gary Stoner
Journal: Ann Surg Innov Res (2013)
MeSH terms: Case Reports

Background:
Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made.
Case:
We present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date.
Conclusion:
Fibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis.
Intercostal Artery Laceration: Rare Complication of Thoracentesis and Role of Ultrasound in Early Detection
Authors: Wissam Mansour, Ghassan Samaha, Sandy El Bitar, Ziad Esper, Rabih Maroun
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization.
Case report: Atypical spindle cell/pleomorphic lipomatous tumor masquerading as a myxoid liposarcoma or intramuscular myxoma
Authors: Jiro Ichikawa, Tomonori Kawasaki, Hiroki Imada, Satoshi Kanno, Naofumi Taniguchi, Tomoyuki Ashizawa, Hirotaka Haro
Journal: Front Oncol (2022)
Keywords: atypical spindle cell/pleomorphic lipomatous tumor, differential diagnosis, fluorescence in situ hybridization, histopathology, immunohistochemistry, magnetic resonance imaging
MeSH terms: Case Reports

Atypical spindle cell/pleomorphic lipomatous tumors (ASPLTs) were recently categorized as benign lipomatous tumors. However, accurate and complete preoperative diagnosis of ASPLTs may be difficult. Furthermore, diagnosis based on magnetic resonance imaging (MRI) findings is uncertain because of the varying ratios of the fat component within the tumor. Here, we report a case of ASPLT masquerading as a myxoid tumor. Although MRI findings were consistent with a myxoid liposarcoma, needle biopsy findings suggested a myxoma, and we performed marginal resection. Histopathological findings revealed infiltrating spindle cells with atypia. In addition, immunohistochemistry (IHC) showed positive staining for CD34 and heterogeneous retinoblastoma deficiency, and fluorescence in situ hybridization (FISH) showed no amplification of mouse double minute 2 homolog and no rearrangement of FUS or EWSR1. When MRI and histopathological findings suggest a myxoid tumor, IHC and FISH should be considered and performed for a precise and accurate diagnosis.
SARS-CoV-2-Induced Multisystem Inflammatory Syndrome in a Young Adult: Case Report
Authors: Haldun Bulut, Alexandra H E Herbers, Ilse M G Hageman, Paetrick M Netten, Hendrik J M de Jonge, Robert Joustra, Frank L van de Veerdonk, Cornelis P C de Jager
Journal: SN Compr Clin Med (2021)
Keywords: covid-19, glucocorticoids, heart failure, immunoglobulins, multisystem inflammatory syndrome

We describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement within five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS); MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2. MIS shares similar clinical features compatible with several overlapping lifethreatening hyperinflammatory syndromes, such as incomplete Kawasaki Disease (KD) and toxic shock syndrome (TSS) associated to a cytokine storm suggestive of a macrophage activation syndrome (MAS) without fulfilling the criteria for hemophagocytic lymphohistiocytosis (HLH), that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality. In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.
Repigmentation of Tenacious Vitiligo on Apremilast
Authors: Sara B Huff, Lorie D Gottwald
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Vitiligo is a common pigment disorder characterized by acquired loss of function or absence of melanocytes, leading to distinct areas of depigmentation. Physical exam reveals sharply demarcated, depigmented macules or patches on otherwise normal skin. Vitiligo can present at any age, in any skin color. There is no specific serologic marker for diagnosis, but patients often have other autoimmune problems. Treatment options are limited and are difficult given the fact that the pathogenesis of the disease is not well elucidated. We present the case of a 52-year-old woman with vitiligo for over 2 decades. The patient's medical history reveals a lack of response to many different approaches. This case highlights the ability of apremilast, an FDA-approved drug for the treatment of psoriasis and psoriatic arthritis, to achieve repigmentation in a case a vitiligo that has been extremely recalcitrant.
A Retroperitoneal Isolated Enteric Duplication Cyst Mimicking a Teratoma: A Case Report and Literature Review
Authors: Daichi Momosaka, Yasuhiro Ushijima, Akihiro Nishie, Yoshiki Asayama, Kousei Ishigami, Yukihisa Takayama, Daisuke Okamoto, Nobuhiro Fujita, Tetsuo Ikeda, Keiichiro Uchida, Masaaki Sugimoto, Kenichi Kohashi, Hiroshi Honda
Journal: Case Rep Radiol (2016)
MeSH terms: Case Reports

Enteric duplication cysts lacking anatomic association with the gastrointestinal tract are called isolated enteric duplication cysts (IEDCs). We present an atypical case of a retroperitoneal IEDC with a tortuous tubular complex shape that enfolded the surrounding retroperitoneal fat and mimicked a retroperitoneal teratoma. Multiplanar reconstruction images should be used to evaluate such a lesion correctly. A tortuous tubular complex shape could be a key finding to differentiate from other retroperitoneal cysts.
Epidermoid cyst of clitoris mimicking clitoromegaly
Authors: Satish Kumar Aggarwal, Vivek Manchanda, Nitin Pant
Journal: J Indian Assoc Pediatr Surg (2010)
Keywords: clitoral cysts, clitoromegaly, epidermoid cysts
MeSH terms: Case Reports

Clitoromegaly in pediatric and adolescent age group is usually indicative of a disorder of sexual differentiation. We report a girl child presenting with clitoral enlargement due to an epidermoid cyst. The cyst was excised with complete cosmetic recovery.