OpenMed/multicare-articles huggingface dataset:
Nonepiphyseal giant cell tumor of the rib: a case report
Authors: Hippocrates Moschouris, Athanasios Marinis, Evanthia Bouma, Evangelos Karagiannis, Michalis Kiltenis, Marina Papadaki
Journal: Case Rep Oncol Med (2012)

A case of a 32-year-old female patient with a giant cell tumor originating in the middle part of the left 10th rib is presented. On X-rays and CT, the tumor caused a well-defined osteolysis with nonsclerotic borders. On MRI, it exhibited intermediate signal intensity on T1 sequences and central high signal and peripheral intermediate signal on T2 sequences. On contrast-enhanced MR images both central and peripheral-periosteal enhancement was noted. Thanks to its small size (2 × 1.3 cm), the lesion was easily resected en bloc with a part of the affected rib. The patient is free of recurrence for 3 years after the operation.
Monochorionic Triplet Gestation after Single Blastocyst Transfer Using Donor Oocytes: Case Report and Review
Authors: G Ferri, M Musto, G Colombo, V M Savasi
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

We report a case of a 43-year-old patient with a monochorionic triamniotic triplet pregnancy after IVF with donor oocytes. After failed IVF attempts, the patient chose to undergo treatment with donor oocytes. Her 22-year-old oocyte donor underwent standard controlled ovarian hyperstimulation. The retrieved oocytes were fertilized in vitro, and one embryo was transferred at the blastocyst stage. At 6 weeks and 5 days of gestation, an ultrasound revealed monochorionic triamniotic (MCTA) triplets. The risk of monozygotic twinning in women undergoing in vitro fertilization (IVF) is reported to be higher than that in natural conception, although the causes of the phenomenon have not yet been clarified. Efforts still must be made in order to prevent monozygotic multiple pregnancies, associated with much greater chances of obstetric and perinatal morbidity and mortality.
A Successful Living Donor Liver Transplantation Using Hepatic Iron Deposition Graft Suspected by Magnetic Resonance Imaging
Authors: Nobuhiko Kurata, Masato Shizuku, Kanta Jobara, Yoji Ishizu, Masatoshi Ishigami, Yasuhiro Ogura
Journal: Case Rep Transplant (2023)
MeSH terms: Case Reports

Recently, magnetic resonance imaging (MRI) has been developed as a widely available and noninvasive method for detecting and evaluating hepatic iron overload. This case report presents a successful living donor liver transplantation (LDLT) in which the donor was suspected to have hepatic iron deposition by MRI evaluation. A preoperative donor liver biopsy and genetic examination were performed to exclude hereditary hemochromatosis and other chronic liver diseases. A liver biopsy showed an almost normal liver specimen with a slight deposition of iron in 2-3% of hepatocytes, and a genetic examination of hereditary hemochromatosis revealed no typical mutations in HFE, TFR2, HJV, HAMP, or SLC40A1. Despite the traumatic hemothorax complication caused by the liver biopsy, the liver transplant eligibility was confirmed. Two months after the hemothorax complication, an LDLT donor operation was performed. The donor was discharged from the hospital on postoperative day (POD) #17 with favorable liver function. The recipient's posttransplant clinical course was generally favorable except for acute cellular rejection and biliary complications, and the recipient was discharged from the hospital on POD #87 with excellent graft function. A one-year follow-up liver biopsy of the recipient demonstrated almost normal liver with iron deposition in less than 1% of the hepatocytes, and no iron deposition was identified in the liver graft by MRI examination. Liver biopsy and genetic examination are effective methods to evaluate the eligibility of liver transplant donors with suspected hepatic iron deposition. The living donor with slight hepatic iron deposition, if hereditary hemochromatosis was ruled out, can donate partial liver safely.
Pleomorphic giant cell carcinoma of the pancreas with hepatic metastases--initially presenting as a benign serous cystadenoma: a case report and review of the literature
Authors: Petrou Athanasios, Papalambros Alexandros, Brennan Nicholas, Karles Dimitrios, Bramis Kostantinos, Manzelli Antonio, Papalambros Efstathios
Journal: HPB Surg (2010)
MeSH terms: Carcinoma, Giant Cell / diagnosis, Carcinoma, Giant Cell / secondary, Cystadenoma, Serous / diagnosis, Liver Neoplasms / diagnosis, Liver Neoplasms / secondary, Pancreatic Neoplasms / diagnosis, Case Reports, Review, Adult, Diagnosis, Differential, Humans, Male, Pancreatic Neoplasms / pathology

Introduction:
Pleomorphic giant cell pancreatic cancer is a very rare and aggressive pancreatic neoplasm. A case of pleomorphic giant cell pancreatic cancer presenting as a cystic lesion and in association with a serous cystadenoma presents a unique case which has not been described before.
Case presentation:
A 44-year-old alcoholic man presented with abdominal pain, vomiting, and weight loss. Initially, imaging suspected a pancreatic pseudocyst measuring 4.2 cm. Endoscopic ultrasound- (EUS-) guided fine-needle aspiration revealed a serous cystadenoma. With conservative intervention only (fluid resuscitation, analgesia, and antiemetics) the patient improved and was discharged under close observation. Follow-up scan at four months revealed minimal change. Three months later, he was admitted acutely. Repeat scans demonstrated mild cyst enlargement with new liver lesions. Laparoscopic biopsy revealed pleomorphic giant cell carcinoma with the organ of origin the pancreas.
Conclusion:
This unusual case highlights the challenges in managing pancreatic cystic lesions and emphasizes the importance of considering less common forms of pancreatic cystic masses when the findings are atypical for the presentation. Surgical excision in these cases over conservative steps may be the most appropriate management.
Recognizing Late Onset Frontotemporal Dementia with the DAPHNE scale: A case report
Authors: Leonardo Tafarello Martins, Ivan Abdalla Teixeira, Jerson Laks, Valeska Marinho
Journal: Dement Neuropsychol (2018)
Keywords: daphne, bipolar disorder, frontotemporal dementia, late onset, scale
MeSH terms: Case Reports

Frontotemporal dementias are classically described as early onset dementias with personality and behavioral changes, however, late onset forms can also be found. Considering the paucity of information about late onset behavioral variant frontotemporal dementia and its challenging diagnosis, we present a case report of an 85-year-old woman with behavioral changes and slow progression to dementia who was first diagnosed as having bipolar disorder and then Alzheimer's disease. The Daphne scale provided a structured means to improve clinical diagnosis, also supported by characteristic features on MRI and SPECT, while CSF biomarkers ruled out atypical Alzheimer's disease.
Cotard's Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature
Authors: Jeff Huarcaya-Victoria, Mario Ledesma-Gastañadui, Maria Huete-Cordova
Journal: Case Rep Psychiatry (2016)

Jules Cotard described, in 1880, the case of a patient characterized by delusions of negation, immortality, and guilt as well as melancholic anxiety among other clinical features. Later this constellation of symptoms was given the eponym Cotard's syndrome, going through a series of theoretical vicissitudes, considering itself currently as just the presence of nihilistic delusions. The presentation of the complete clinical features described by Cotard is a rare occurrence, especially in the context of schizophrenia. Here we present the case of a 50-year-old male patient with schizophrenia who developed Cotard's syndrome. The patient was treated with aripiprazole, showing improvement after two weeks of treatment. A review of the literature is performed about this case.
Surgical management for an infected urachal cyst in an adult: Case report and literature review
Authors: Adel Elkbuli, Kyle Kinslow, John D Ehrhardt Jr, Shaikh Hai, Mark McKenney, Dessy Boneva
Journal: Int J Surg Case Rep (2019)
Keywords: cysto-urachal malignancy, two-stage approach, urachal cyst infection, urachal remnants

Introduction:
Incomplete urachal obliteration during fetal development gives rise to distinct malformations of the median umbilical ligament. Most anomalies are asymptomatic and resolve during early infancy, but some go unrecognized until adulthood. These rare cases can present with acute abdominal symptomatology secondary to infected urachal remnants.
Presentation of case:
A 20-year-old man presented with periumbilical pain. Physical exam showed a warm, erythematous infra-umbilical mass that was tender to palpation. CT revealed an infected urachal cyst. The patient underwent urachal abscess incision and drainage with cyst excision. The patient returned home on postoperative day two. Two-week outpatient follow-up confirmed an uncomplicated recovery.
Discussion:
Surgical excision of urachal anomalies in adults is curative and preventive against recurrent infection and malignancy, but preoperative management is currently unstandardized. Current literature recommends a two-stage approach characterized by preoperative antibiotics and cyst incision and drainage followed later by complete surgical excision. Our patient underwent a single therapeutic approach with preoperative antibiotics and definitive operative excision. Our patient had a comparable outcome with no complications and a short hospitalization.
Conclusion:
Preoperative antibiotics with excision of urachal remnants was effective in our case. Staged approaches are appropriate in complicated cases as a means to reduce post-operative infection rates and hospital stays. Urachal remnant excision is recommended in adults to prevent future malignancy.
Kimura's Disease
Authors: Cláudia Savassi Guimaraes, Natalie Moulton-Levy, Allen Sapadin, Claudia Vidal
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Kimuras disease is a chronic inflammatory disorder of unknown etiology. It is rare in the West, but endemic in Asia. It typically presents as solitary or multiple subcutaneous nodules, that slowly increase in size. The lesions are variably painful and pruritic. It often accompanied by regional lymphadenopathy, raised serum eosinophil counts, and markedly elevated serum immunoglobulin E levels. Histologically, the lesions are characterized by reactive lymphoid follicles with eosinophilic infiltration and an increased amount of postcapillary venules. The optimal treatment for KD remains controversial. Although the condition seldom resolves spontaneously, malignant transformation has not been reported to date, and the prognosis is good. We describe a male patient with a 4-year pruritic progressive "bump" in front of his left ear. On physical examination, the patient had 2 discrete lesions on the left side of his face near his ear. Postauricularly, there was a 3 x 5 cm erythematous to violaceous, indurated nodule. Preauricularly, there was a similar, but smaller cyst-like nodule. Punch biopsy showed a superficial and deep nodular and interstitial infiltrate, reactive lymphoid follicles with a dense infiltration of eosinophils and areas of eosinophilic follicle lysis. The patient received intralesional triamcinolone acetonide injections 10 mg/cc behind left ear with a good improvement.
Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
Authors: Muddasir Ashraf, Arshad Jahangir, M Fuad Jan, Lakshmi Muthukumar, Gary Neitzel, A Jamil Tajik
Journal: Front Cardiovasc Med (2022)
Keywords: apical hypertrophic cardiomyopathy, case report, left ventricular apex, metastatic melanoma, tumor
MeSH terms: Case Reports

Background:
Cardiac tumors are usually metastatic. Melanoma is the tumor with the highest rate of cardiac metastasis. Clinicians need to be aware of the metastatic involvement of the left ventricular apex as a differential diagnosis of apical hypertrophic cardiomyopathy.
Case summary:
A 74-year-old woman presented for evaluation of fatigue. The initial electrocardiogram and echocardiogram showed features of apical hypertrophic cardiomyopathy. The patient reported a lesion on her right forearm that had been present for many years, leading to its biopsy, which showed melanoma. Further evaluation with a chest-computed tomography (CT) scan showed left lung nodules and nodular thickening of the left ventricular apex. Positron emission tomography showed an increased uptake of fluorodeoxyglucose in the left lung nodule and left ventricular apex, suggestive of metastatic spread of the melanoma. A CT-guided biopsy of the left lung nodule revealed melanoma. The patient was treated with ipilimumab initially, followed by paclitaxel with poor response to treatment, and later passed under hospice care.
Conclusion:
Metastatic tumors involving the left ventricular apex should be considered in the differential diagnosis of apical hypertrophic cardiomyopathy, especially in patients with a history of melanoma, and advanced cardiac imaging, including cardiac magnetic resonance imaging, CT, and/or positron emission tomography (PET) may help with narrowing down the differential diagnosis.
Lymphoepithelial Cyst of Parotid in an Immunocompetent Patient with Chronic Otitis Media
Authors: Meera Niranjan Khadilkar, Vishnu Prasad, Vijendra Shenoy Santhoor, M P Kamath, Haneesh Domah
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Lymphoepithelial cysts of parotid are known to occur in HIV patients. In the present report, lymphoepithelial cyst of parotid was diagnosed in a middle aged immunocompetent patient, along with chronic otitis media. The source of infection and treatment options are summarized.
Functional recovery in chronic stage of spinal cord injury by neurorestorative approach: a case report
Authors: Alok Sharma, Hemangi Sane, Dipti Khopkar, Nandini Gokulchandran, V C Jacob, Joji Joseph, Prerna Badhe
Journal: Case Rep Surg (2014)

Spinal cord injury (SCI) at an early age can be debilitating for the child's growth. Current treatments show a level of stagnancy, after which the recovery is minimal. Cellular therapy is an emerging area of research and has been found to possess many benefits in the previous studies. Transplantation of autologous bone marrow mononuclear cells (BMMNCs) has demonstrated therapeutic potential for many neurological conditions, including spinal cord injury. Here we report a case of 6-year-old girl with traumatic SCI at the level of C7-D1 4 years back, who underwent 2 doses of cell transplantation with autologous BMMNCs with an interval of 6 months along with standard rehabilitation. The patient did not have any major or minor side effects. The patient showed clinical improvements throughout the 6 months after transplantation, which was assessed using Functional Independence Measure (before: 82, after: 101 out of 126). There were patchy areas of sensory gain in bilateral feet recorded, with improvements in the bladder sensation and control. Improved gait was seen as a result of better strength in abdominals and back extensors. The fact that there was functional improvement in the chronic plateau phase indicates the potential of cell therapy in chronic SCI. Further clinical studies are warranted.
Unrecognized Orbital Images Cause Diagnostic Confusion: Silicone Oil and Implanted Silicone Encircling Bands
Authors: Tsuyoshi Nojima, Takafumi Obara, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito
Journal: Case Rep Emerg Med (2021)
MeSH terms: Case Reports

Introduction:
Most physicians are not familiar with postoperative changes to the orbit, so radiologists and clinicians may sometimes find it challenging to conduct a proper radiological assessment of the globe of the eye and orbital abnormalities. We present a patient with head trauma who had surgery for retinal detachment with implantation of silicone encircling bands. This case report may help clinicians recognize imaging characteristics after ophthalmic surgery to prevent misdiagnosis and unnecessary workup. Case Report. An 18-year-old man with severe head trauma was admitted to our hospital. Initial computed tomography (CT) revealed a high attenuation of intraocular silicone that could be mistaken for a hemorrhage. Ophthalmological examination and detailed ophthalmic history confirmed silicone oil in his eye for treatment of retinal detachment. Knowledge of the anatomical changes and radiological appearance of postsurgical findings following retinal detachment, including the surgical materials of silicone oil or bands, can prevent unnecessary alarm.
Conclusion:
Implanted ophthalmic devices, for example, silicone oil, appear similar to hemorrhages on CT and magnetic resonance imaging and cause diagnostic confusion. When in doubt, it is useful to assess the clinical presentation and obtain an accurate medical history.
Spontaneous rupture of continent cutaneous urinary diversion after 25 years
Authors: Seyed Yousef Hosseini, Mehdi Dehghani, Amin Afsharimoghaddam, Zahra Sepehri, Mahdi Afshari
Journal: J Renal Inj Prev (2016)
Keywords: cutaneous pouch, radical cystoprostatectomy, spontaneous rupture, urinary diversion
MeSH terms: Case Reports

Spontaneous rupture of a continent cutaneous urinary diversion is uncommon and diagnosis of this situation requires a high degree of suspicion. In this paper we present a 66-year-old man with continent cutaneous pouch after radical cystoprostatectomy that presented with spontaneous perforation 25 years after surgery. Spontaneous pouch perforation in our case after 25 years emphasizes the need for long follow-up in patients with continent diversion.
Case Report: Ectopic Adrenocortical Carcinoma in the Ovary
Authors: Wen-Hsuan Tsai, Tze-Chien Chen, Shuen-Han Dai, Yi-Hong Zeng
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: adrenocortical carcinoma, ectopic, immunohistochemistry, metastasis, ovary
MeSH terms: Adrenal Cortex Neoplasms / diagnostic imaging, Adrenal Cortex Neoplasms / drug therapy, Adrenal Cortex Neoplasms / pathology, Adrenal Cortex Neoplasms / surgery, Adrenocortical Carcinoma / diagnostic imaging, Adrenocortical Carcinoma / drug therapy, Adrenocortical Carcinoma / pathology, Adrenocortical Carcinoma / surgery, Ovarian Neoplasms / diagnostic imaging, Ovarian Neoplasms / drug therapy, Ovarian Neoplasms / pathology, Ovarian Neoplasms / surgery, Case Reports, Antineoplastic Agents / therapeutic use, Bevacizumab / therapeutic use, Cisplatin / therapeutic use, Cytoreduction Surgical Procedures, Etoposide / therapeutic use, Female, Humans, Liver Neoplasms / diagnostic imaging, Liver Neoplasms / secondary, Lung Neoplasms / diagnostic imaging, Lung Neoplasms / secondary, Middle Aged, Ovary / diagnostic imaging, Ovary / surgery, Antineoplastic Agents, Bevacizumab, Etoposide, Cisplatin

Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.7-2.0 cases/million habitants/year. ACCs are rare and usually endocrinologically functional. We present the case of a 59-year-old woman who experienced abdominal fullness for 6 months and increased abdominal circumference. A large pelvic tumor was observed. She underwent cytoreductive surgery and the pathological test results revealed local tumor necrosis and prominent lympho-vascular invasion. Neuroendocrine carcinoma was the first impression, but positivity for synaptophysin, alpha-inhibin, transcription factor enhancer 3 (TFE-3), calretinin (focal), and CD56 (focal) and high Ki-67-labeling proliferating index (>80%) confirmed the diagnosis of ectopic ACC. Ectopic primary aldosteronism could not be excluded. However, we did not perform saline infusion test or captopril test due to poor performance status. When pathological test reports reveal neuroendocrine features not typically found in the organ being examined, IHC staining should be performed to rule out ectopic ACC. Whether the ectopic ACC is functional or not requires complete survey.
Doxycycline Sclerotherapy of a Cervical Cystic Hygroma: A Caribbean Institution Experience
Authors: Nicholas Figaro, Robbie Rampersad, Solaiman Juman
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Cervical cystic lymphangiomas are rare benign tumors that pose a formidable challenge to surgeons confronted with managing this uncommon entity. Due to the intimacy with which these cystic lesions blend with critical cervical structures, a considerable number of patients who undergo surgical management are often plagued with recurrence and morbidity. As a result, doxycycline sclerotherapy has become an attractive, safe, and effective alternative as a primary treatment modality in a select group of pediatric patients. This case report presents an 18-month-old patient with a large cervical cystic hygroma that was effectively treated with exclusive doxycycline sclerotherapy.
Various neuromodulation methods including Deep Brain Stimulation of the medial forebrain bundle combined with psychopharmacotherapy of treatment-resistant depression-Case report
Authors: Joanna Rymaszewska, Tomasz Wieczorek, Karolina Fila-Witecka, Katarzyna Smarzewska, Artur Weiser, Patryk Piotrowski, Paweł Tabakow
Journal: Front Psychiatry (2023)
Keywords: deep brain stimulation, transcranial magnetic stimulation, electroconvulsive therapy, neurostimulation, treatment-resistant depression
MeSH terms: Case Reports

Background:
Treatment-resistant depression remains one of the main concerns of modern psychiatry. Novel methods such as Transcranial Magnetic Stimulation (including deep and theta burst protocols, iTBS) and Deep Brain Stimulation (DBS) can be considered as alternative treatment options.
Case presentation:
Twenty-nine-year-old Caucasian female, single, higher-educated was treated with major depressive disorder initially with standard pharmaco- and psychotherapy. Due to diagnosed treatment resistance additional therapeutic approaches were introduced sequentially: Electroconvulsive therapy (efficient only 4 months) and Transcranial Magnetic Stimulation (intermittent Theta Burst Stimulation, iTBS improved just insomnia). Finally the patient was enrolled to the Deep Brain Stimulation (DBS) study with the medial forebrain bundle target. After 20 months of active DBS a reduction of over 80% of depressive symptom severity was observed (Montgomery-Asberg and Hamilton Depression Rating Scales), together with an 87% reduction of anxiety symptoms intensity (Hamilton Anxiety Rating Scale) and a 90% increase in social and occupational functioning. Subjective assessment of the patient performed with questionnaires and visual analog scales showed less pronounced improvement in terms of depressive and anxiety symptoms, and high reduction of anhedonia. Some mild, transient side effects of neurostimulation were eliminated with an adjustment in stimulation parameters.
Conclusions:
The presented clinical case confirms the possibility of achieving remission after the use of MFB DBS in treatment-resistant depression, but postponed for many months. Nevertheless, personalization of every combined therapy with DBS is necessary with exploration of individual factors as past traumas and personality traits. More reports on long-term observations in DBS treatment in TRD trials (especially focused on MFB target) are needed.