OpenMed/multicare-articles huggingface dataset:
Cap-Assisted Endoscopic Mucosal Resection of an Incidental Rectal Traumatic Neuroma
Authors: Elias Estifan, Varun Patel, Matthew Grossman
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

A traumatic neuroma is a well-known complication after acute trauma to a peripheral nerve; the nerve tries to re-establish continuity by an orderly growth of axons from the peripheral to distal stump through the proliferation of Schwann cells. However, this process is not always perfect, and aberrant repair gives rise to a neuroma. We present a 50-year-old female who underwent an initial colonoscopy for change in bowel habits and was found to have a 7 mm submucosal lesion in the proximal rectum. Endoscopic ultrasound was done which showed a hypoechoic lesion in the submucosal plane without muscularis propria invasion. The patient underwent successful cap-assisted endoscopic mucosal resection of the lesion without complication. Pathology of the specimen revealed a traumatic rectal neuroma with immunostaining positive for S100. However, this patient did not have any known risk factors such as previous surgery including polypectomy or hemorrhoidectomy or any previous rectal manipulation. Interestingly, this is the second case of traumatic rectal neuroma reported in the English-language literature.
Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-Linking with Riboflavin and UVA Irradiation
Authors: George D Kymionis, Michael A Grentzelos, Alexandra E Karavitaki, George A Kounis, Georgios A Kontadakis, Sonia Yoo, Ioannis G Pallikaris
Journal: J Ophthalmol (2010)
MeSH terms: Case Reports

Purpose. To present a case of a keratoconic patient who underwent epithelial removal with transepithelial phototherapeutic keratectomy (t-PTK) using a 213-nm solid-state laser system followed by corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) irradiation. Methods. Case report. Results. A twenty-four-year-old male with keratoconus underwent CXL treatment after epithelial removal with t-PTK using a solid-state laser system. No intra- or early postoperative complications were found. One month postoperatively, uncorrected visual acuity (UCVA) improved from 20/63 to 20/32 while best spectacle- corrected visual acuity (BSCVA) improved from 20/40 to 20/25. Corneal topography revealed a significant improvement which remained stable during the six-month followup period. Conclusions. Epithelial removal with t-PTK before CXL could improve patient's visual outcome.
Tubulocystic Renal Cell Carcinoma of the Native Kidney in a Renal Transplant Recipient: A Rare Case Report
Authors: Brianna Ruch, Ashley J Limkemann, Paulo Garcia, Cameron Benedict, Gaurav Gupta, Marlon Levy, Amit Sharma
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Tubulocystic renal cell carcinoma (TCC) is a rare and newly recognized variant of renal cell carcinoma, which may mimic benign cystic disease of the kidney. To our knowledge, we present the first reported case of a patient who, despite standard preoperative workup, developed TCC of his native kidney soon after receiving kidney transplantation. He was appropriately treated with native nephrectomy and has had no signs of reoccurrence 7 years postoperatively. Given the significant risk of malignancy in renal transplant patients, this case emphasizes the need for close monitoring of native cystic disease before and after transplantation, with low threshold to proceed with surgical intervention.
Sebaceous Lymphadenoma of Parotid: Imaging, Cytological, and Histological Findings in Detail
Authors: Golsa Shekarkhar, Hossein Soleimanpour, Seyed Hamed Jafari, Fatemeh Zamani
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Sebaceous lymphadenomas are rare and account for less than 1% of primary salivary gland tumors. These rare tumors are mostly found in men older than 50 years. The clinicopathological features of these tumors are poorly understood and no definite causative factor has been reported for them till now. They are not often diagnosed prior to surgery, which could be due to their rarity and lack of enough preop radiological and cytological findings. Few case reports have been published in literature about their pathogenesis and accompanying malignant lesions. The cytological and imaging findings have been dealt with in some articles. Here we describe the histologic, cytologic, and radiologic findings of sebaceous lymphadenomas of parotid gland, all together, and discuss their differential diagnoses in various diagnostic methods.
Synchronous Supraglottic and Esophageal Squamous Cell Carcinomas Treated with a Monoisocentric Hybrid Intensity-Modulated Radiation Technique
Authors: Christian L Barney, Pedro Zamora, Ashlee Ewing, Matthew Old, Arnab Chakravarti, Aashish Bhatt
Journal: Front Oncol (2018)
Keywords: esophageal cancer, head and neck cancer, intensity-modulated radiation, monoisocenter, squamous cell carcinoma, supraglottic cancer, synchronous tumors
MeSH terms: Case Reports

Risk factors for squamous cell carcinomas (SCCs) of the head and neck (HN) and esophagus are similar. As such, synchronous primary tumors in these areas are not entirely uncommon. Definitive chemoradiation (CRT) is standard care for locally advanced HNSCC and is a preferred option for inoperable esophageal SCC. Simultaneous treatment of both primaries with CRT can present technical challenges. We report a case of synchronous supraglottic and esophageal SCC primary tumors, highlighting treatment with a monoisocentric hybrid radiation technique and normal tissue toxicity considerations.
A case report of a thymic neuroblastoma associated with syndrome of inappropriate secretion of antidiuretic hormone: Ten-year follow-up results after surgical treatment
Authors: Yukitoshi Satoh
Journal: Int J Surg Case Rep (2019)
Keywords: neuroblastoma, surgery, survival, thymus

Introduction:
Thymic neuroblastoma with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in adults is an extremely rare and malignant neoplasm. Although the tumor is known to grow rapidly and have a poor prognosis, its etiology is still uncertain. In 2009, we described a case of thymic neuroblastoma with SIADH. We report here the clinical course over the last 10 years.
Presentation of case:
A 70-year-old Japanese male with a history of thymic neuroblastoma with SIADH was regularly followed up on an out-patient basis after complete surgical resection for more than 10 years. He remains free of the disease and asymptomatic.
Discussion and conclusion:
Complete surgical removal is considered as one of the treatment options for this tumor if clearly separated from the surrounding tissue with no invasion.
Case Report: Management of an Elderly Patient With Metastatic Radioiodine-Resistant Differentiated Thyroid Cancer in a Rural Community, Remote From Specialist Oncology Services
Authors: Rachael Wybrew, Michael Loynd, Maria Wybrew, Leslie Samuel
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: case report, lenvatinib, metastatic thyroid cancer, radioiodine-resistant, remote management
MeSH terms: Adenocarcinoma, Follicular / drug therapy, Bone Neoplasms / drug therapy, Iodine Radioisotopes / administration & dosage, Phenylurea Compounds / therapeutic use, Quinolines / therapeutic use, Radiation Tolerance / drug effects, Thyroid Neoplasms / drug therapy, Case Reports, Adenocarcinoma, Follicular / secondary, Aged, Antineoplastic Agents / therapeutic use, Bone Neoplasms / secondary, Disease Management, Female, Humans, Prognosis, Remote Consultation, Thyroid Neoplasms / pathology, Antineoplastic Agents, Iodine Radioisotopes, Phenylurea Compounds, Quinolines, lenvatinib

This case report describes an elderly patient with radioiodine-resistant differentiated thyroid cancer and additional multiple metastases living in a rural setting, remote from the specialist oncology service. This case is of interest because effective systemic therapies for treatment-resistant cancers, such as lenvatinib, are now available but can potentially cause significant toxicities that require extensive medical management. Here, we discuss how patient care was provided collaboratively by the local community teams integrated with remote specialist oncology services. A 77-year-old patient presented with symptoms of cauda equina secondary to a large metastatic sacral deposit. The deposit was biopsied, and histology revealed a diagnosis of differentiated follicular thyroid cancer that was treated with external beam radiotherapy and thyroidectomy, followed by radioiodine. However, the disease was found to be resistant to radioiodine therapy, and the patient subsequently developed back pain due to new bone metastases. After further palliative external beam radiotherapy, the patient was started on systemic treatment with lenvatinib. Treatment has continued for more than 2.5 years with a slow but steady improvement in symptoms and quality of life. Monitoring and assessment of lenvatinib therapy and management of associated toxicities was coordinated remotely from a specialist cancer center over 200 miles away, using the skills of the local medical and nursing teams. This case report demonstrates how a cooperative effort using local teams and video-conferencing links to a specialist cancer center can be applied to safely treat a patient with a medication that may result in significant potential toxicities that require attentive and dynamic management.
A rapid and accurate new bedside test to assess maximal liver function: a case report
Authors: Sascha A Müller, Ignazio Tarantino, Marcello Corazza, Frank Pianka, Jürgen Fornaro, Ulrich Beutner, Cornelia Lüthi, Bruno M Schmied
Journal: Patient Saf Surg (2013)
Keywords: limax, liver function, liver function measurement, liver resection, liver volumetry
MeSH terms: Case Reports

Background:
In liver surgery, appropriate preoperative evaluation and preparation of the patient is of cardinal importance. The up-to-date, preoperative prediction of residual liver function has thus far been limited. As post-hepatectomy liver failure is a major cause of mortality, a new and simple bedside test (LiMAx) has been developed to predict postoperative liver function in conjunction with preoperative volumetric analysis of the liver.
Case presentation:
A 45-year-old patient presented with a cecal carcinoma and a large synchronous liver metastasis for major liver surgery. Liver function was determined by the LiMAx-test for the enzymatic capacity of cytochrome P450 1A2, which is ubiquitously and solely active in the liver. A solution of 2 mg/kg body weight (13)C-labeled methacetin was injected as a bolus into an intravenous catheter and, thereafter, was metabolized into acetaminophen and (13)CO2 and pulmonarily exhaled. The analysis of the (13)CO2/(12)CO2 ratio was performed using online breath sampling over a period of maximally 60 minutes. Based on this test, a value of more than 315 μg/kg/h represents normal liver function. A laparoscopic right hemihepatectomy was planned during virtual resection with a residual liver volume of 48% and a preoperative anticipated residual LiMAx of 301 μg/kg/h. After successful resection, the initial postoperative LiMAx value was 316 μg/kg/h, indicating good liver function and a correct prediction of the outcome.
Conclusion:
In the presented patient, residual liver function could be accurately predicted preoperatively using a combination of the new LiMax test with CT-volumetry. This test might significantly improve preoperative evaluation and postoperative outcomes in liver surgery.
Self-Injury with Carbamazepine Intoxication in an Elementary School-Aged Child
Authors: Andrew Shieh, Natalie Schellpfeffer
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Carbamazepine is a common anticonvulsant medication used to treat seizure disorders and is generally considered a safe medication. We describe the case of a 9-year-old female who presented with acute altered mental status and respiratory failure requiring mechanical ventilation. She was found to be intoxicated with carbamazepine through a urine drug test which was confirmed by bloodwork. After her medical condition improved, the patient admitted to self-injury through ingestion to cope with the death of a family member. She received a complete psychiatric assessment and was eventually discharged without permanent neurologic sequelae. To our knowledge, this is the first case of intentional self-injury with carbamazepine intoxication in an elementary school-aged child. When intoxication is suspected in children presenting with altered mental status, all medications available at home should be investigated. Preadolescent children may engage in nonfatal self-injury behavior, and diagnosis requires a high index of suspicion.
Neisseria meningitidis as a Cause of Septic Arthritis: An Unusual Case of Periprosthetic Joint Infection
Authors: A Mc Carthy, J M Broderick, A P Molloy
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

One of the most feared complications after arthroplasty is infection due to its significant impact on patient morbidity. Infection may transfer to the joint at the time of surgery or be seeded, haematologically, to the prosthetic joint from another infection source. In this case, a 72-year-old female presented with symptoms of septic arthritis seven years after her original arthroplasty surgery. At presentation, she denied trauma and any comorbidity which would predispose her to infection. Culturing of samples taken revealed the patient was infected with Neisseria meningitidis, and the patient underwent a DAIR procedure. She continued postoperative long-term antimicrobial therapy with resolution of her infection. Follow-up at one year showed complete resolution of the patient's illness with a return to premorbid baseline. To our knowledge, this is the third reported case of septic arthritis caused by Neisseria meningitidis in a prosthetic joint in the literature.
Abnormal Origin of the Left Coronary Artery: When the Bloodstream Finds its Way
Authors: Amin Mahsouli, Cristina Anca Dragean
Journal: J Belg Soc Radiol (2023)
Keywords: alcapa syndrome, lca steal phenomenon, coronary anomaly, myocardial infarction
MeSH terms: Case Reports

Teaching Point: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA syndrome) is a rare congenital anomaly characterized by a steal phenomenon; it must be recognized, as a prompt treatment may prevent life-threatening complications such as myocardial infarction, mitral dysfunction, and malignant dysrhythmias in adults.
Inadvertent Entrapment of a Central Venous Catheter by a Purse-String Suture during Cardiopulmonary Bypass: A Case Report
Authors: Abdorasoul Anvaripour, Forouzan Yazdanian, Mohammad-Zia Totonchi, Houshang Shahryari
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

A 65-year-old female patient with severe mitral valve stenosis plus coronary artery disease was scheduled for mitral valve replacement and 2-vessel coronary artery bypass graft (CABG) surgeries simultaneously. After a successful procedure, resistance was met on a CVC withdrawal. During postoperative fluoroscopy, fixation of the catheter at the heart was confirmed which necessitated reopening the chest, cutting the suture, and removing the catheter. When a catheter became hard to withdraw after open heart surgery, we should never withdraw it forcefully and blindly. Although rare, one should consider inadvertent entrapment of CVC by a suture as the possible cause.
Acquired Sleep-Related Hypermotor Epilepsy with Disrupted White Matter Tracts Assessed by Multishell Diffusion Magnetic Resonance Imaging
Authors: Zahari N Tchopev, Ping-Hong Yeh, Greg W Morgan, Eric Meyer, Johanna M Wolf, John M Ollinger, Gerard P Riedy, Lisa C Young
Journal: Front Neurol (2018)
Keywords: eeg, magnetic resonance imaging, posttraumatic epilepsy, sleep-related hypermotor epilepsy, tractography, traumatic brain injury
MeSH terms: Case Reports

Sleep-related hypermotor epilepsy (SHE) (previously frontal lobe epilepsy) is a rare seizure disorder commonly misdiagnosed or unrecognized, causing negative patient sequelae. While usually reported in familial studies, it is more commonly acquired. Diagnosis is a challenge due to its low incidence in comparison with the more common sleep disorders or psychogenic etiologies in the differential diagnosis. Diagnosis is scaled on degree of certainty based on described or clinically documented semiology, with video EEG as a helpful, but not necessary, adjunct. Current treatment is similar to other focal epilepsies. We studied a 36-year-old active duty male soldier who presented with 2 years of predominantly sleep related, abrupt, short, and anamnestic hyperkinetic movements with unstructured vocalizations. Prior workup included non-contributory video electroencephalograph (EEG) and polysomnography as well as normal brain magnetic resonance imaging (MRI). Treatments for presumed psychiatric and parasomnia disturbances were not effective in establishing diagnosis or relief. Evaluation at our tertiary, multidisciplinary care institution recorded events consistent with the diagnosis of clinical SHE. He was enrolled in an advanced multishell diffusion-weighted imaging MRI research study to evaluate white matter tracts, given his history of mild, repetitive, non-penetrating traumatic brain injury, not otherwise requiring hospitalization. Multishell diffusion MRI tractography found changes not previously described in the right frontal lobe white matter tracts. These changes were consistent with neurological localization and serve as a potential nidus for this patient's seizure disorder. Misdiagnosis of SHE can result in detrimental biopsychosocial sequelae of untreated epilepsy, unnecessary or harmful intervention, or the stigmata of a behavioral disorder. Further investigation into diagnosis and etiology of acquired SHE is needed. Assessment for white matter abnormalities can potentially provide information into pathogenesis of epilepsy disorders.
Gas-producing renal infection presenting as pneumaturia: a case report
Authors: Youssef S Tanagho, Jonathan M Mobley, Brian M Benway, Alana C Desai
Journal: Case Rep Med (2013)

We present a case of persistent pneumaturia of one-year duration in a fifty-five-year-old male with a history of spinal cord injury. The evaluation demonstrated gas throughout the collecting system attributable to a urinary tract infection with a gas-forming organism, Klebsiella pneumoniae.
Case report: The remarkable response of pembrolizumab combined with RC48 in the third-line treatment of metastatic urothelial carcinoma
Authors: Zhenying Xu, Jiaman Ma, Ting Chen, Yu Yang
Journal: Front Immunol (2022)
Keywords: rc48-adc, antibody-drug conjugates, human epidermal growth factor receptor 2 (her2),trastuzumab (herceptin), pembrolizumab, urothelial carcinoma
MeSH terms: Carcinoma, Transitional Cell / drug therapy, Renal Insufficiency, Urinary Bladder Neoplasms / drug therapy, Case Reports, Aged, Humans, Male, Positron Emission Tomography Computed Tomography, pembrolizumab

Background:
Systemic chemotherapy has been the mainstay treatment for locally advanced or metastatic urothelial carcinoma (UC). In the past few years, novel immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) have improved the treatment of advanced UC.
Case presentation:
Here, we report systemic therapy of a 68-year-old male diagnosed with HER2 positive (immunohistochemistry 3+), programmed cell death ligand 1(PD-L1) negative metastatic UC, and renal insufficiency. He had encountered numerous metastases and failed first-line platinum-based chemotherapy and second-line treatment with pembrolizumab and trastuzumab. During third-line treatment with RC48 (a HER2 targeting ADC) combined with pembrolizumab, he achieved a rapid partial response (PR) in the first evaluation and subsequent complete response (CR) on PET/CT and long-term progression-free survival (>12 months) at the last follow-up on 25 August 2022. There are no grade 3 or 4 adverse events or aggravations of renal insufficiency during the third-line therapy.
Discussion:
RC48 combined with pembrolizumab demonstrated outstanding efficacy and safety in this HER2-positive metastatic UC patient. ADC combined with ICI is a promising anti-tumor strategy that deserves further exploration in advanced UC.
Parents' planning, children's agency and heritage language education: Re-storying the language experiences of three Chinese immigrant families in Australia
Authors: Chunxuan Shen, Wenying Jiang
Journal: Front Psychol (2023)
Keywords: chinese immigrant families, child agency, family language policy, heritage language, parent agency

This study delves into the heritage language experiences of Australian-born Chinese immigrant children under the framework of family language policy. Storytelling as a narrative inquiry method is used to reveal the lived experiences of the protagonists in relation to heritage language and culture. The three family stories involved for case studies reveal different levels of parent agency in Chinese immigrant families regarding their children's home language use and heritage language education. It is noted that the level of child agency corresponds with the level of their parent agency. Where parents strongly advocate and practice heritage language maintenance, stronger agency is observed in their children to continue the use and learning of their heritage language. In addition, maintaining harmony while parents are implementing family language policies and providing children with formal instruction in heritage language are conducive to heritage language development, particularly in terms of its literacy.