OpenMed/multicare-articles huggingface dataset:
Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman
Authors: Anuradha Jayasuriya, Dimuthu Muthukuda, Preethi Dissanayake, Shyama Subasinghe
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Background:
Gestational trophoblastic disease (GTD) which includes hydatidiform mole, invasive mole, placental site trophoblastic tumor, and choriocarcinoma is a rare cause of hyperthyroidism due to excess production of placental human chorionic gonadotrophin hormone (hCG) by tumor cells. Molecular mimicry between hCG and thyroid stimulating hormone (TSH) leads to continuous stimulation of TSH receptor by extremely high levels of hCG seen in these tumors. Consequently, biochemical and clinical hyperthyroidism ensues and it is potentially complicated by thyrotoxic crisis which is fatal unless urgent therapeutic steps are undertaken. Case Description. We present a 49-year-old perimenopausal woman who presented with recurrent thyroid storm and high output cardiac failure. The initial workup revealed suppressed TSH, high-free thyroxine (FT4), and free triiodothyronine (FT3) levels with increased vascularity of the normal-sized thyroid on ultrasonography. She was managed with parenteral beta blockers, steroids, and high-dose carbimazole. Her lower abdominal tenderness led to further investigations which revealed tremendously elevated beta-hCG and a snow storm appearance on transabdominal ultrasound suggestive of GTD. She underwent curative surgery and was diagnosed with complete hydatidiform mole postoperatively by histology.
Conclusion:
Recurrent thyroid crisis in gestational trophoblastic disease is an exceedingly rare presentation and that is highly fatal. This case highlights the importance of early detection and treatment of the etiology of thyrotoxicosis to eliminate mortality.
Undifferentiated pleomorphic sarcoma in the anterior mediastinum with a rapidly progressive course: A case report
Authors: Masamichi Sato, Sumito Inoue, Tsuyoshi Arao, Akira Igarashi, Keiko Yamauchi, Kento Sato, Hiroshi Nakano, Masafumi Watanabe
Journal: EXCLI J (2020)
Keywords: computed tomography-guided biopsy, mediastinal tumor, undifferentiated pleomorphic sarcoma
MeSH terms: Case Reports

A 77-year-old woman with heart failure was admitted to our hospital. Computed tomography (CT) of the chest revealed an anterior mediastinal tumor. CT-guided biopsy revealed a malignant nonepithelial tumor of unknown origin. She was not treated with chemotherapy or radiotherapy because of her poor clinical condition. She died 33 days after admission. Following autopsy, we confirmed that the mediastinal tumor had infiltrated the large blood vessels. After final histological examination, undifferentiated pleomorphic sarcoma was diagnosed. Primary mediastinal sarcomas are very rare; clinicians should be aware of their possibility because some cases may progress rapidly as evidenced in this case.
Cervical mature teratoma 17 years after initial treatment of testicular teratocarcinoma: report of a late relapse
Authors: Ramesh Omranipour, Mina Alavion
Journal: World J Surg Oncol (2007)
MeSH terms: Head and Neck Neoplasms / secondary, Head and Neck Neoplasms / surgery, Teratocarcinoma / secondary, Testicular Neoplasms / pathology, Case Reports, Adult, Biopsy, Needle, Chemotherapy, Adjuvant, Follow-Up Studies, Head and Neck Neoplasms / pathology, Humans, Immunohistochemistry, Male, Neoplasm Staging, Orchiectomy / methods, Risk Assessment, Teratocarcinoma / pathology, Teratocarcinoma / therapy, Testicular Neoplasms / therapy, Time Factors, Tomography, X-Ray Computed

Background:
Late relapses of testicular germ cell tumor are uncommon. We report a case of cervical mature teratoma appeared 17 years after treatment of testicular teratocarcinoma.
Case presentation:
A 20-year-old patient underwent left sided orchiectomy followed by systemic therapy and retroperitoneal residual mass resection in 1989. He remained in complete remission for 200 months. In 2005 a huge left supraclavicular neck mass with extension to anterior mediastinum appeared. Radical surgical resection of the mass was performed and pathologic examination revealed mature teratoma.
Conclusion:
This is one of the longest long-term reported intervals of a mature teratoma after treatment of a testicular nonseminoma germ cell tumor. This case emphasizes the necessity for follow up of testicular cancer throughout the patient's life.
A child with x-linked agammaglobulinemia and enthesitis-related arthritis
Authors: Sukesh Sukumaran, Katherine Marzan, Bracha Shaham, Joseph A Church
Journal: Int J Rheumatol (2011)
MeSH terms: Case Reports

X-linked agammaglobulinemia (XLA) is a primary immune deficiency characterized by recurrent bacterial infections and profoundly depressed serum immunoglobulin levels and circulating mature B cells. We describe a 12-year-old boy with XLA and enthesitis-related arthritis (ERA). To date, there has been a paucity of reports of noninfectious inflammatory arthritis in children with XLA. This case illustrates that functional B cells and/or immunoglobulin are not required for ERA pathogenesis. In addition, this case suggests a possible link between immune deficiency, immune dysregulation, and rheumatic illness.
A rare 47 XXY/46 XX mosaicism with clinical features of Klinefelter syndrome
Authors: Noor Shafina Mohd Nor, Muhammad Yazid Jalaludin
Journal: Int J Pediatr Endocrinol (2016)
Keywords: 47xxy/46xx mosaicism, klinefelter syndrome, radioulnar synostosis
MeSH terms: Case Reports

Background:
47 XXY/46 XX mosaicism with characteristics suggesting Klinefelter syndrome is very rare and at present, only seven cases have been reported in the literature.
Case presentation:
We report an Indian boy diagnosed as variant of Klinefelter syndrome with 47 XXY/46 XX mosaicism at age 12 years. He was noted to have right cryptorchidism and chordae at birth, but did not have surgery for these until age 3 years. During surgery, the right gonad was atrophic and removed. Histology revealed atrophic ovarian tissue. Pelvic ultrasound showed no Mullerian structures. There was however no clinical follow up and he was raised as a boy. At 12 years old he was re-evaluated because of parental concern about his 'female' body habitus. He was slightly overweight, had eunuchoid body habitus with mild gynaecomastia. The right scrotal sac was empty and a 2mls testis was present in the left scrotum. Penile length was 5.2 cm and width 2.0 cm. There was absent pubic or axillary hair. Pronation and supination of his upper limbs were reduced and x-ray of both elbow joints revealed bilateral radioulnar synostosis. The baseline laboratory data were LH < 0.1 mIU/ml, FSH 1.4 mIU/ml, testosterone 0.6 nmol/L with raised estradiol, 96 pmol/L. HCG stimulation test showed poor Leydig cell response. The karyotype based on 76 cells was 47 XXY[9]/46 XX[67] with SRY positive. Laparoscopic examination revealed no Mullerian structures.
Conclusion:
Insisting on an adequate number of cells (at least 50) to be examined during karyotyping is important so as not to miss diagnosing mosaicism.
Hyperchloremic Metabolic Acidosis due to Cholestyramine: A Case Report and Literature Review
Authors: Fareed B Kamar, Rory F McQuillan
Journal: Case Rep Nephrol (2015)

Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap metabolic acidosis, a complication featured in this report of an adult male with concomitant acute kidney injury. This case emphasizes the caution that must be taken in prescribing cholestyramine to patients who may also be volume depleted, in renal failure, or taking spironolactone.
A large parosteal ossifying lipoma of lower limb encircling the femur
Authors: Atif Ali Hashmi, Babar Malik, Muhammad Muzzammil Edhi, Naveen Faridi, Muhammad Ashraful
Journal: Int Arch Med (2014)
MeSH terms: Case Reports

Introduction:
Lipoma is a benign soft tissue neoplasm that may contain mesenchymal elements, as a result of metaplastic process. Ossification in benign and malignant soft tissue tumors can also manifest due to metaplastic process.
Case presentation:
A 45 year old woman presented with a large thigh mass. The mass was developed one and a half year ago which insidiously increased in size and was associated with movement restriction. Radiological findings revealed soft tissue neoplasm on antero-medial aspect of thigh encircling the femur and displacing adjacent muscles. Fine trabeculations were seen in neoplasm suggestive of ossification. Excision of the mass was performed and histopathology revealed adipocytes with mature bony trabeculae possessing prominent osteoblastic rimming suggestive of ossifying lipoma.
Conclusion:
It is important to recognize this variant of lipoma as it is associated with a better clinical outcome in contrast to most of the deep seated soft tissue neoplasms. Secondly it should also be differentiated from myositis ossificans and heterologous differentiation in other soft tissue neoplasms. We suggest an algorithmic approach to the diagnosis of ossifying soft tissue neoplasms histopathologically. Mature bony trabeculae with prominent osteoblastic rimming in a soft tissue lesion are due to a metaplastic process and should not be confused with osteosarcoma.
Giant congenital melanocytic naevus with proliferative nodules mimicking congenital malignant melanoma: a case report and review of the literature of congenital melanoma
Authors: Massimiliano Scalvenzi, Franco Palmisano, Sara Cacciapuoti, Fiorella Migliaro, Maria Siano, Stefania Staibano, Luigi Tornillo, Claudia Costa
Journal: Case Rep Dermatol Med (2013)

Congenital malignant melanoma (CMM) is a rare condition that is defined as malignant melanoma recognized at birth. CMM may develop in utero in one of three ways: (1) transmission by metastasis through the placenta from a mother with melanoma; (2) primary melanoma arising within a giant congenital melanocytic naevus (GCMN); (3) primary de novo cutaneous CMM arising in utero. CMM can be confused clinically and histologically with benign proliferative melanocytic lesions such as giant congenital nevi. We describe the case of a patient presenting a GCMN with proliferative nodules, clinically and dermoscopically resembling a CMM, demonstrating the importance of caution in making a diagnosis of MM and highlighting the possibility that benign lesions as GCMN can mimic a malignant melanoma in this age group.
Case report: p.Glu134del SOD1 mutation in two apparently unrelated ALS patients with mirrored phenotype
Authors: Giulia Gianferrari, Ilaria Martinelli, Cecilia Simonini, Elisabetta Zucchi, Nicola Fini, Serena Carra, Cristina Moglia, Jessica Mandrioli
Journal: Front Neurol (2023)
Keywords: als, case report, genotype-phenotype correlation, motor neuron diseases, pglu134del sod1
MeSH terms: Case Reports

With upcoming personalized approaches based on genetics, it is important to report new mutations in amyotrophic lateral sclerosis (ALS) genes in order to understand their pathogenicity and possible patient responses to specific therapies. SOD1 mutations are the second most frequent genetic cause of ALS in European populations. Here, we describe two seemingly unrelated Italian patients with ALS carrying the same SOD1 heterozygous c.400_402 deletion (p.Glu134del). Both patients had spinal onset in their lower limbs, progressive muscular weakness with respiratory involvement, and sparing bulbar function. In addition to the clinical picture, we discuss the possible pathogenic role of this unfamiliar SOD1 mutation.
Delirium Induced by Quetiapine and the Potential Role of Norquetiapine
Authors: Filipe Almeida, Elisabete Albuquerque, Ilda Murta
Journal: Front Neurosci (2019)
Keywords: adverse effects, anticholinergic, antipsychotics, delirium, quetiapine

Quetiapine in an atypical antipsychotic drug that is frequently used for delirium and behavioral and psychological symptoms in dementia. However, its potential anticholinergic effects, mediated primarily through its metabolite norquetiapine, could present as counterproductive adverse effects in these situations. There is little data published discussing this potential negative impact on quetiapine's safety and tolerability, especially in the elderly. Here, we present what is, to our knowledge, the first published case report of delirium apparently induced by low-dose quetiapine, in a 95-year-old patient with no prior history of mental illness, and the potential role of its metabolite norquetiapine.
Combined venlafaxine and olanzapine prescription in women with psychotic major depression: a case series
Authors: Lucio Ghio, Werner Natta, Paola Rossi, Laura Peruzzo, Elisa Zanelli, Simona Gotelli, Filippo Gabrielli
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Patients with psychotic major depression suffer prolonged duration and greater severity of illness, including an increased likelihood of recurrent episodes and resistance to conventional pharmacotherapies. They do not respond to placebo and respond poorly to antidepressant or antipsychotic monotherapy. On the other hand, as has been demonstrated, they do respond well to antidepressant and antipsychotic combination therapies. Different combinations of drugs were studied, but little is known up to now with regard to the combination of venlafaxine and olanzapine. The following paper presents three separate case studies of female patients suffering from psychotic unipolar major depression, all of whom were admitted to a psychiatric ward and successfully treated with a combination of venlafaxine and olanzapine.
A Case of Serratia marcescens Endocarditis in a Nonintravenous Drug-Using Male Patient and Review of Literature
Authors: Achilleas Nikolakopoulos, Nikolaos Koutsogiannis, Panagiota Xaplanteri, Charalambos Gogos, Fevronia Kolonitsiou, Alexandra Lekkou
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Introduction:

Serratia marcescens is a rare cause of infective endocarditis and has almost exclusively been associated with intravenous drug use and hospital-acquired infections. Here, we present a case of infective endocarditis caused by Serratia marcescens in an otherwise healthy, nonintravenous drug-using male patient.
Case report:
A 41-year-old man presented with hypertension and hemoptysis. Blood cultures were obtained that showed bacteremia by Serratia marcescens. An echocardiogram was carried out that revealed severe mitral regurgitation accompanying ruptured mitral chordae tendineae. The patient received the appropriate antibiotic treatment, without further surgical intervention.
Discussion:
Hospital-acquired infections by Serratia species are a common problem in medical practice and have been attributed to specialized interventional procedures. Taking into consideration the patient's immunocompetence and lack of intravenous drug use, it is possible that bacteremia could be attributed to a medical procedure. Moreover, in contrast to most cases described in the literature, no surgery was performed.
Pediatric Pancreatic Tuberculosis: A Case Report and Review of the Literature
Authors: Yajun Zhang, Yuhong Tao
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Pancreatic tuberculosis (TB) is an uncommon form of extrapulmonary TB and represents a diagnostic challenge for physicians. Pancreatic TB presents with nonspecific signs and symptoms and may mimic malignancy. However, pancreatic TB rarely occurs in children. Here, we present a case of a 5-year-old girl with pancreatic TB and markedly elevated serum cancer antigen- (CA-) 125 levels, thus raising the suspicion of malignancy, but positivity for Mycobacterium tuberculosis DNA was noted. The patient recovered after being administered standard antitubercular therapy for one year. This case suggests that clinicians should have a heightened suspicion of pancreatic TB when faced with pancreatic lesions despite the fact that increased CA-125 may indicate malignancy. Laparoscopy combined with peritoneal biopsy and polymerase chain reaction (PCR) may provide a new method to confirm the diagnosis.
Solitary Langerhans cell histiocytosis in an adult: case report and literature review
Authors: Cíntia Ferreira Gonçalves, Marília Oliveira Morais, Rita de Cássia Gonçalves Alencar, Aline Carvalho Batista, Elismauro Francisco Mendonça
Journal: BMC Res Notes (2016)
MeSH terms: Histiocytosis, Langerhans-Cell / pathology, Case Reports, Review, Adult, Follow-Up Studies, Histiocytosis, Langerhans-Cell / diagnostic imaging, Humans, Immunohistochemistry, Male, Middle Aged, Mouth / diagnostic imaging, Radiography, Staining and Labeling

Background:
Langerhans cell histiocytosis (LCH) is a disease that often affects children, but can also occur in adults and smokers. Oral manifestations are unusual and are characterized by bone pain, tooth mobility, necrotic ulcers and local edema. The aim of this paper is to describe a clinical case of LCH in an oral cavity that mimicked oral squamous cell carcinoma.
Case presentation:
A male, 63 years old, complaining about a "wound in the mouth" for 6 months, without any pain or spontaneous bleeding. His medical history was free of disease. The patient was a smoker for 33 years. Intraoral examination revealed a destructive ulcerative lesion around the upper left first and second molars that resembled an oral squamous cell carcinoma. Biopsy of the ulcerative lesion was performed and the microscopic features showed an inflammatory infiltrate rich in plasma cells. Based on this microscopical finding, the final diagnosis was periodontal disease associated with a proliferative non-neoplastic lesion. The patient was referred to a specialized dental surgeon and underwent periodontal therapy including surgical procedures. After that, according to follow-up with the patient, there were no signs of disease remission. The lesion increased in size, although the patient did not complain of any symptoms. A second biopsy was performed and the microscopic features again showed a rich inflammatory infiltrate with mononuclear cells and histiocytic cells, characterized by pale histiocytes with lobed nuclei, resembling a bean. A varying number of eosinophils also were observed, without any evidence of atypical cells present in this infiltrate. An immunohistochemical staining panel was done to determine the nature of this inflammatory infiltrate by using antibodies S-100, CD1a, CD-68 and CD45RO that were positive. These immunohistochemical findings were fundamental for the final diagnosis of LCH. The treatment included surgical extraction of all superior teeth, radiation and systemic corticoid therapies. After 8 years of treatment, the patient is free of disease.
Conclusion:
Although LCH is an unusual lesion in an oral cavity, it can be present. Biopsy and a histological exam are essential to establish the diagnosis. Immunohistochemicals were fundamental to exclude malignant lesion and to confirm the diagnosis of LCH.
Management of crown root fracture by interdisciplinary approach
Authors: K Radhakrishnan Nair, Anoop N Das, Manoj C Kuriakose, Nandakumar Krishnankutty
Journal: Case Rep Dent (2013)

Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance, and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patients confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fiber-reinforced post for retention after periodontal tissue management.
Recrudescence of Plasmodium malariae after Quinine
Authors: Irfanali R Kugasia, Farhana K Polara, Hussein Assallum
Journal: Case Rep Med (2014)

Plasmodium malariae causes uncommon benign malaria found in the malaria endemic regions mostly of Sub-Saharan Africa. As Plasmodium malariae does not have a continued liver stage in humans the only way to have reinfection without reexposure is through recrudescence. However, reports of its recrudescence after antimalarials are rare with only a handful of case reports in the literature. Research in this field to date has not been able to establish definitively an emergence of resistance in Plasmodium malariae to commonly used antimalarials. In the presented case, patient had a recrudescence of P. malariae after full treatment with quinine and clindamycin. This recrudescence was treated with full course of chloroquine with clearance of parasite from blood immediately after treatment and at two months' follow up. The recrudescence in this case cannot be explained by mechanisms explained in prior articles. We propose that the indolence of some of the Plasmodium malariae trophozoites in the blood can shield them from the effect of the toxic effects of antimalarials and enable them to produce recrudescence later. However, when recrudescence happens, this should not be considered a case of development of resistance and a course of chloroquine should be considered.
Absent Ductus Venosus Associated with Partial Liver Defect
Authors: Kenji Horie, Hironori Takahashi, Daisuke Matsubara, Koichi Kataoka, Rieko Furukawa, Yosuke Baba, Akihide Ohkuchi, Shigeki Matsubara
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Absent ductus venosus (ADV) is a rare vascular anomaly. We describe a fetus/neonate with ADV with a partial liver defect. A 41-year-old woman was referred to our institute because of fetal cardiomegaly detected by routine prenatal ultrasound, which revealed absence of ductus venosus with an umbilical vein directly draining into the right atrium, consistent with extrahepatic drainage type of ADV. She vaginally gave birth to a 3,096-gram male infant at 38 weeks of gestation. Detailed ultrasound examination revealed a defect of the hepatic rectangular leaf at half a month postnatally. He showed normal development at 1.5 years of age with the liver abnormality and a Morgagni hernia. Liver morphological abnormality should also be considered as a complication of ADV.