OpenMed/multicare-articles huggingface dataset:
Reversible rituximab-induced rectal Kaposi's sarcoma misdiagnosed as ulcerative colitis in a patient with HIV-negative follicular lymphoma
Authors: Emilien Billon, Anne-Marie Stoppa, Lena Mescam, Massimo Bocci, Audrey Monneur, Delphine Perrot, François Bertucci
Journal: Clin Sarcoma Res (2018)
Keywords: follicular lymphoma, immune suppression, kaposi sarcoma, rituximab

Background:
Kaposi's sarcoma is a low-grade mesenchymal angioproliferative tumor, most commonly observed in immunocompromised individuals, such as HIV-infected patients. Iatrogenic Kaposi's sarcoma occurs in patients undergoing immunosuppressive therapies. Rituximab is a chimeric monoclonal antibody targeted against the pan B cell marker CD20. Because of its immunosuppressive effects through reduction of mature B-cells, it may exacerbate Kaposi's sarcoma in HIV-positive patients. Rituximab-related Kaposi's sarcomas have been previously reported in only two HIV-negative patients and were treated surgically.
Case presentation:
Here, we report on a Kaposi's sarcoma that developed under rituximab treatment in a HIV-negative 55-year-old patient treated for follicular lymphoma. The lesion developed during the maintenance rituximab therapy at the rectal level with an aspect of apparent ulcerative colitis, without any cutaneous lesion. The premature stop of rituximab led to the complete regression of Kaposi's sarcoma, without any additional specific treatment.
Conclusions:
To our knowledge, this is the third case of Kaposi's sarcoma diagnosed under rituximab in a HIV-negative patient, the first one at the rectal level and the first one that completely regresses after stop of rituximab. This case raises awareness of iatrogenic Kaposi's sarcoma in HIV-negative patients treated with rituximab, and further highlights the importance of immunosuppression in the pathophysiology of disease.
Primary squamous cell carcinoma of the breast: A case report and review of the literature
Authors: Yaping Wu, Zhiying Chen, Wei Li, Fengguang Wang, Yongchun Zhang
Journal: Front Oncol (2023)
Keywords: breast metaplastic carcinoma, breast squamous cell carcinoma (bsqcc), case report, recurrence, treatment
MeSH terms: Case Reports

Primary squamous cell carcinoma (PSCC) of the breast, as a rare metaplastic breast cancer, currently has limited clinical data on its biological behavior, treatment and prognosis. At present, the optimal treatment of this tumor is still controversial. We reported a case of a 56-year-old woman with a mass on the right breast. She underwent a modified radical mastectomy and lymph node biopsy, which revealed that the tumor was a metaplastic squamous cell carcinoma with axillary lymph node metastasis, followed by traditional adjuvant chemotherapy and radiotherapy. The patient re-examined by PET/CT after two years in May 2017 and found a recurrence in the right chest wall, so resection of the recurring lesion was resected, then she was given postoperative adjuvant radiotherapy and chemotherapy. In August 2019, the patient re-examined by PET/CT, and there were pulmonary and mediastinal lymph node metastases. After 4 cycles of albumin paclitaxel plus cisplatin chemotherapy combined with nivolumab immunotherapy, the patient achieved complete response (CR), and then switched to nivolumab immune maintenance therapy. So far, no obvious metastasis has been seen. We believe that surgical treatment is necessary for PSCC of the breast;paclitaxel and cisplatin chemotherapy regimens and adjuvant radiotherapy are effective, but it may be resistant to radiotherapy; and immunotherapy may prolong the survival of patients with PSCC of the breast.
A Case of Rituximab-Induced Necrotizing Fasciitis and a Review of the Literature
Authors: Abdullateef Abdulkareem, Ryan S D'Souza, Oluwaseun Shogbesan, Anthony Donato
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Necrotizing fasciitis is a fulminant soft tissue infection characterized by rapid progression and high mortality. Rituximab is a generally well-tolerated immunosuppresive medication used for B-cell malignancies and some rheumatological disorders. We report a case of a 69-year-old male with chronic lymphocytic leukemia who suffered necrotizing fasciitis of his left lower extremity secondary to Clostridium septicum 7 weeks after treatment with rituximab. Despite immediate intravenous antimicrobial therapy and emergent fasciotomy with extensive debridement, his hospital course was complicated by septic shock and he required an above-the-knee amputation. Physicians need to be aware of the possibility of necrotizing fasciitis in patients presenting with skin infections after rituximab therapy.
Calcifying fibrous tumor
Authors: Hanan Elsarraj, Ameer Hamza
Journal: Autops Case Rep (2022)
Keywords: gastrointestinal stromal tumors, intestinal polyps, neoplasms, fibrous tissue
MeSH terms: Case Reports

Calcifying fibrous tumor is a rare benign mesenchymal neoplasm. The etiology and pathogenesis of this tumor are uncertain. It has wide anatomical distribution. The tumor is most commonly found in the soft tissues of the extremities in younger individuals. However, in middle-aged patients, it tends to affect the visceral locations more commonly. In visceral location, it can mimic aggressive lesions clinically. The purpose of this report is to describe a case of calcifying fibrous tumor in a 71-year-old female with a history of breast carcinoma who was found to have an incidental small bowel mass on her follow-up. Clinically and radiologically, the mass was suspicious for either metastatic disease or gastrointestinal stromal tumor. The patient underwent open small bowel resection, and a 6.5 cm segment of the small bowel was sent to pathology. Grossly, a 2.0 cm tan-pink smooth round submucosal polyploid mass protruding into the lumen, mimicking a gastrointestinal stromal tumor, was identified. The tumor was hard and serially sectioned to reveal a white, calcified cut surface. Microscopically, the tumor appeared hypocellular and composed of scant spindle cells embedded in a dense, hyalinized and calcified collagenous stroma. Immunohistochemical stains for pan-cytokeratin, DOG1, desmin, S100, CD34, and MUC4 were negative, and a diagnosis of the calcifying fibrous tumor was rendered. This case provides a rare gross specimen image of calcifying fibrous tumor and highlights the importance of knowledge of rare entities in providing an accurate diagnosis for entities that can mimic other lesions.
Intertrochanteric fracture non-unions with implant failure of the gamma nail
Authors: Mouhcine Sbiyaa, Adil El Alaoui, Mohammed Admi, Kamal Lahrach, Amine Marzouki, Fawzi Boutayeb
Journal: Pan Afr Med J (2016)
Keywords: complication, fracture non union, intertrochanteric fracture
MeSH terms: Fracture Fixation, Internal / methods, Fractures, Ununited / surgery, Hip Fractures / surgery, Case Reports, Aged, Bone Nails, Bone Plates, Bone Transplantation / methods, Female, Humans, Treatment Failure

Failure of internal fixation of intertrochanteric fracture is associated with delayed union or malunion resulting in persistent pain and diminished function. We report a rare case of implant failure of the gamma nail with intertrochanteric fracture non union treated by DCS plate screw and bone graft.
Acute thoracolumbar pain due to cholecystitis: a case study
Authors: Chris T Carter
Journal: Chiropr Man Therap (2015)

Background:
This article describes and discusses the case of an adult female with cholecystitis characterized on initial presentation as acute thoracolumbar pain.
Case presentation:
A 34-year-old female presented for care with a complaint of acute right sided lower thoracic and upper lumbar pain with associated significant hyperalgesia and muscular hypertonicity. The patient was examined, referred, and later diagnosed by use of ultrasound imaging.
Conclusion:
Despite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. A clinical neurological discussion of cholecystitis visceral pain and referred viscerosomatic phenomena is included.
Evolving 50-50% bilingual pedagogy in Alberta: what does the research say?
Authors: Rahat Naqvi, Elaine Schmidt, Marlene Krickhan
Journal: Front Psychol (2014)
Keywords: spanish, bilingual learning, bilingual pedagogy, cross-linguistic transfer

This paper outlines the provincial frameworks that define the Spanish bilingual program in Alberta, Canada, provides an historical overview of its pedagogic constraints and evolution, and proposes a framework for bilingual pedagogy. The framework is conceptualized from the research evidence of three local case studies, and is based on the centrality of cross-linguistic transfer, in relation to linguistic interdependence and bilingual learning.
Hip transposition procedure due to osteosarcoma metastasis of the ilium in a patient with preexisting rotationplasty leads to satisfactory functional result: A case report
Authors: Jan Puetzler, Niklas Deventer, Georg Gosheger, Thomas Goesling, Winfried Winkelmann, Tymoteusz Budny
Journal: Int J Surg Case Rep (2020)
Keywords: bone tumor, hip transposition procedure, osteosarcoma, reconstruction, rotationplasty
MeSH terms: Case Reports

Introduction:
The hip transposition is a limb salvage procedure for periacetabular malignancies. Here we present the case of a patient that already had a preexisting ipsilateral rotationplasty.
Presentation of case:
A 16 year old male patient with an Osteosarcoma of the left distal femur was treated with wide surgical resection of the tumor and rotationplasty (Salzer/Winkelmann type A1). Despite adjuvant chemotherapy (EURAMOS protocol) he was diagnosed with metachronous metastases in the lung and in the left ilium affecting the acetabulum. As a limb salvage procedure the patient received an internal hemipelvectomy Enneking PI-II and an attachment of the femoral head with a Trevira tube to the sacrum using suture anchors. After six weeks a prosthesis was fitted and gradually full weight bearing was allowed. The patient achieved a good functional result as he was able to walk freely for three more years before he passed away.
Discussion:
The hip transposition procedure does not require the implantation of a large tumor prosthesis and thus avoids the problem of an increased risk of infection. Even with preexisting ipsilateral rotationplasty a good functional outcome that allowed the patient full weight bearing could be achieved.
Conclusion:
If there are already existing deformities, such as rotationplasty on the same leg, the hip transposition procedure can be considered for periacetabular malignancies, as it can achieve satisfactory results.
Intraperitoneal doxorubicin achieves access to mesenteric lymph nodes, case series of two patients
Authors: Paul H Sugarbaker, O Anthony Stuart
Journal: Int J Surg Case Rep (2019)
Keywords: case series, doxorubicin, hyperthermic intraperitoneal chemotherapy (hipec), intestinal adhesions, intraperitoneal chemotherapy, mesenteric lymph nodes, peritoneal metastases, pharmacokinetic studies, preperitoneal lymphatic network

Background:
Intraperitoneal chemotherapy has been used extensively to treat cancers that metastasize to the peritoneal surfaces. In the operating room the intraperitoneal chemotherapy is administered with moderate heat. The chemotherapy is used after surgery when there is minimal residual disease. Alternatively, intraperitoneal chemotherapy can be used long-term in an attempt to prevent the progression of disease in patients at high risk for peritoneal metastases to occur during follow-up.
Methods:
Hyperthermic intraperitoneal chemotherapy (HIPEC) with doxorubicin was used to treat peritoneal metastases in two patients. These two patients required generous sampling of mesenteric lymph nodes because involvement of these lymph nodes was suspected on preoperative radiologic studies by computed tomography (CT). The lymph nodes, peritoneal fluid and plasma along with tumor tissue in one patient were subjected to a determination of doxorubicin chemotherapy concentrations by high pressure liquid chromatography (HPLC).
Results:
The ratio of doxorubicin present in peritoneal fluid as compared to plasma was 80 in patient 1 and 50 in patient 2. There was an increased doxorubicin concentration within lymph nodes as compared to plasma. The accumulation of doxorubicin in lymph nodal tissue was 40 times that of plasma in patient 1 and 30 times that in patient 2. In patient 2, the concentration of doxorubicin in lymph nodes was very similar to the concentration of chemotherapy within tumor nodules.
Conclusion:
Doxorubicin chemotherapy was not only present in peritoneal surface tissue but also a surprisingly high level was present in mesenteric lymph nodes in patients treated by HIPEC. This observation may have implications for interpreting clinical future studies performed with HIPEC. To our knowledge, this is the first time this pharmacologic information regarding intraperitoneal chemotherapy access to mesenteric lymph nodes has been reported.
The Resilience of Social Service Providers and Families of Children With Autism or Development Delays During the COVID-19 Pandemic-A Community Case Study in Hong Kong
Authors: Paul Waiching Wong, Yanyin Lam, Janet Siuping Lau, Hungkit Fok
Journal: Front Psychiatry (2021)
Keywords: covid-19 pandemic, hong kong, children with autism or development delays, service needs, social service providers

Background: Hong Kong is one of the earliest cities to have hampered by the COVID-19. When preventive public health measures are enforced, specific groups, who have already been facing inequality before the outbreak, are likely to become more overlooked and vulnerable. Aim: This community case study aims to describe the additional needs of families of children with autism spectrum disorder and other developmental issues, as well as unexpected difficulties and challenges social service professionals encountered when delivering service and their solutions toward these challenges. Methods: A focus group with 10 professionals providing the Caregiver Skills Training Program was conducted. Results: Poor families of vulnerable children were found to be challenged, more than average, in finding daily necessities during the initial stage of the outbreak. Most vulnerable children displayed additional problematic behaviors and emotional problems during the quarantine. The social service professionals addressed the family needs by providing tangible resources and offering online training, workshops, and programs to meet their needs. Several important lessons were learned. First, technology know-how on conducting online training, workshop, and program could be a challenge to some social service professionals and the parents. Second, the professionals reported that they made huge efforts to produce guidelines in protecting services users' privacy, to equip themselves with necessary skills in executing privacy-protection measures, and to keep exploring for safer alternatives. Third, providing tele-services in online mode represented a different interaction pattern between social service professionals and service users, especially in the recruitment processes and group dynamics. Conclusion: In comparison with other cities, Hong Kong has responded to the COVID-19 efficiently and effectively based on the citizen's strict adherence to behavioral advice and the innovative altruistic efforts from the multi-sectors in the community.
Case report: Remedial surgical treatment of aorto-duodenal fistula with infected aneurysm after endovascular aortic repair
Authors: Wen-Dong Li, Guang-Yan Wu, Bin Song, Jie Zhao, Xiao-Qiang Li, Min Zhou
Journal: Front Cardiovasc Med (2022)
Keywords: aortic abdominal aneurysm, aorto-duodenal fistula, endovascular aortic repair complications, infected aneurysm, ruptured iliac artery aneurysm
MeSH terms: Case Reports

Aorto-duodenal fistula (ADF) is a rare cause of upper gastrointestinal bleeding, but it is associated with high mortality. It usually occurs in patients with prior aortic surgery or who have undergone aortic graft placement. Abdominal aortic aneurysm (AAA) might be a cause of primary ADF, which could develop into sudden shock. Because ADF is difficult to diagnose, surgery to correct it has a poor outcome. We here report the successful treatment of an ADF complicated with infected AAA after endovascular repair of a ruptured aneurysm of the iliac artery.
Case Report: Diffuse Polymicrogyria Associated With a Novel ADGRG1 Variant
Authors: Fábio Carneiro, Júlia Duarte, Francisco Laranjeira, Sofia Barbosa-Gouveia, María-Luz Couce, Maria José Fonseca
Journal: Front Pediatr (2021)
Keywords: adgrg1, gpr56, bilateral frontoparietal polymicrogyria, bilateral generalized polymicrogyria, case report, polymicrogyria
MeSH terms: Case Reports

Pathogenic variants of the ADGRG1 gene are associated with bilateral frontoparietal polymicrogyria, defined radiologically by polymicrogyria with an anterior-posterior gradient, pontine and cerebellar hypoplasia and patchy white matter abnormalities. We report a novel homozygous ADGRG1 variant with atypical features. The patient presented at 8 months of age with motor delay, esotropia, hypotonia with hyporeflexia and subsequently developed refractory epilepsy. At the last assessment, aged 12 years, head control, sitting and language were not acquired. Magnetic resonance imaging revealed diffuse polymicrogyria with relative sparing of the anterior temporal lobes, without an anterior-posterior gradient, diffuse hypomyelination and pontine and cerebellar hypoplasia. A panel targeting brain morphogenesis defects yielded an unreported homozygous ADGRG1 nonsense variant (dbSNP rs746634404), present in the heterozygous state in both parents. We report a novel ADGRG1 variant associated with diffuse polymicrogyria without an identifiable anterior-posterior gradient, diffuse hypomyelination and a severe motor and cognitive phenotype. Our case highlights the phenotypic diversity of ADGRG1 pathogenic variants and the clinico-anatomical overlap between recognized polymicrogyria syndromes.
Thanatophoric Dysplasia: A Report of 2 Cases with Antenatal Misdiagnosis
Authors: Lamidi Audu, Amina Gambo, Tokan Silas Baduku, Bilkisu Farouk, Anisa Yahaya, Kefas Jacob
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Thanatophoric dysplasia (TD) is a rare but uniformly lethal inherited disorder of the skeletal system resulting from defects in the fibroblast growth factor receptor-3 gene on the short arm of chromosome ##4. It is characterised by pronounced shortening of the tubular bones resulting in significant short stature, macrocephaly, a funnel-shaped chest, protuberant abdomen, redundant skin in the limbs, and typical facies among others. The two clinical types of TD are differentiated by typical cranial and tubular bone configurations. Antenatal diagnosis is usually made in the last trimester and corroborated at birth. We present 2 cases of TD seen at Barau Dikko Teaching Hospital (BDTH) between January and August 2021 to highlight the potential difficulty with antenatal diagnosis, its diagnostic features, and associated early postnatal fatality. The antenatal diagnosis was missed in both cases in spite of repeated 2nd and 3rd-trimester sonographic examinations. Both babies presented with remarkable micromelic short stature with the telephone-handle appearance of the femoral bones characteristic of type 1 TD, developed progressive respiratory distress at birth, and died within 36 hours of life despite respiratory support with Bubble CPAP. These cases are discussed along with a review of existing relevant literature.
Hodgkin lymphoma in a thymic cyst: report of a case with multiple secondary neoplasms
Authors: Saeeda Almarzooqi, Sue Hammond, Samir B Kahwash
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The presentation of Hodgkin Lymphoma in a thymic cyst is rare. We describe a case in a 9 year-old boy, with a long follow-up course, complicated by two secondary neoplasms and a post bone marrow transplant lymphoproliferative disorder. We also review the literature on such presentations and second malignant neoplasms in childhood.
Orogenital Transmission of Neisseria meningitidis Causing Acute Urethritis in Men Who Have Sex with Men
Authors: Arnaud Jannic, Hedi Mammeri, Lise Larcher, Vincent Descamps, William Tosini, Bao Phung, Yazdan Yazdanpanah, Fabrice Bouscarat
Journal: Emerg Infect Dis (2019)
Keywords: neisseria meningitidis, st11, bacteria, clonal complex, men who have sex with men, monogamous couple, orogenital transmission, sequence type 11, sexually transmitted infections, urethritis, whole-genome sequencing
MeSH terms: Anti-Bacterial Agents / administration & dosage, Communicable Diseases, Emerging / transmission, Meningococcal Infections / transmission, Neisseria meningitidis / genetics, Sexually Transmitted Diseases / transmission, Urethritis / microbiology, Case Reports, Acute Disease, Azithromycin / administration & dosage, Ceftriaxone / administration & dosage, Communicable Diseases, Emerging / drug therapy, Communicable Diseases, Emerging / microbiology, Humans, Injections, Intramuscular, Male, Meningococcal Infections / drug therapy, Meningococcal Infections / microbiology, Neisseria meningitidis / isolation & purification, Sexual and Gender Minorities, Sexually Transmitted Diseases / drug therapy, Sexually Transmitted Diseases / microbiology, Treatment Outcome, Urethritis / drug therapy, Whole Genome Sequencing, Young Adult, Anti-Bacterial Agents, Ceftriaxone, Azithromycin

Neisseria meningitidis sequence type 11 is an emerging cause of urethritis. We demonstrate by using whole-genome sequencing orogenital transmission of a N. meningitidis sequence type 11 isolate causing urethritis in a monogamous couple of men who have sex with men. These results suggest dissemination of this clonal complex among low-risk patients.
Psychiatry Meets Cardiology: A Case Report on the Need for Mental Health Assessment in the Evaluation of Cardiovascular Symptoms
Authors: Kofi Tekyi Asamoah, Richard Dei-Asamoa
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Cardiovascular symptoms like chest pain and palpitations are among the commonest reasons for outpatient hospital visits. Physician preoccupation with ruling out sinister cardiological diagnoses often results in a failure to recognise mental health-related disorders, which account for over 40% of such cases, especially among young women. These disorders can independently cause cardiovascular symptoms or worsen preexisting cardiovascular disease, worsening morbidity. The pathophysiology of mental stress-induced myocardial ischaemia involves increased levels of neurotransmitters, as opposed to anatomical obstruction seen in conventional coronary artery disease. This results in a battery of tests (including invasive assessments) which yield normal results, deepening the patient's psychological stress. There is therefore an increased expenditure on healthcare with little assurance of wellness. Detection of these conditions is poorer in developing countries due to limited capacity in appreciating mental health disorders, though over 70% of mental health disorders occur in these countries. Two young ladies with no comorbidities who presented with chest pain and palpitations are reported in this paper. Laboratory investigations and specific cardiology-based tests were normal, but a thorough family and social history revealed underlying mental stresses, corroborated by a mental state examination. A diagnosis of panic disorder was made and once managed, symptoms abated and quality of life improved. We seek to emphasise that mental health disorders are an important cause of cardiovascular symptoms among young adults and must be actively sought by physicians to reduce the associated morbidity, as conventional tests for ischaemia are not useful in their diagnosis. Mental state examination should be done routinely in all clinical assessments to identify patients with subtle signs and improve their clinical outcomes. There must be commitment to build capacity among nonpsychiatrists to reduce the treatment gap.