OpenMed/multicare-articles huggingface dataset:
Diagnosis and treatment of ectopic thyroid carcinoma: A case report and literature review
Authors: Guiming Fu, Fengli Guo, Wei Zhang, Xianhui Ruan, Xiangqian Zheng, Zhaohui Wang, Ming Gao
Journal: Front Oncol (2022)
Keywords: diagnosis, ectopic thyroid, thyroid cancer, thyroid tumor, treatment
MeSH terms: Case Reports

Introduction:
Ectopic thyroid cancer (ETC) is primary thyroid cancer occurring in ectopic thyroid tissue, and its incidence rate is approximately 0.3%-0.5% of thyroid cancer. Only approximately 132 cases of ETC have been diagnosed and treated worldwide in the past 110 years, with most of them being adults. Of note, patients with ETC are prone to misdiagnosis and mistreatment.
Case report:
This was a 13-year-old adolescent female who reported having a sensation of swallowing obstruction when eating blocky foods. Color Doppler Ultrasound (CDU) found a 2.3 cm ×1.7 cm × 2.1 cm hypoechoic nodule slightly to the right of the deep surface of the tongue base, with a honeycomb shape. Meanwhile, a mixed echogenic nodule of approximately 2.0 cm × 1.9 cm × 2.3 cm was seen deep in the mouth floor, and a very low echogenic region of 1.4 cm × 1.1 cm × 1.8 cm was observed in the nodule. We then performed a fine needle aspiration biopsy (FNAB) of the thyroid nodules guided by CDU, and the results showed papillary thyroid carcinoma (PTC). Then, a local extended resection of the thyroid carcinoma was performed. Bilateral cervical IA and adjacent subhyoid lymph node dissection was performed through a small anterior cervical incision. The patient recovered well, and was discharged on the fifth day after surgery. The patient only took levothyroxine tablets for replacement therapy after surgery. The patient was followed up for 36 months, and the thyroid function remained in the normal range. Reexamination by CDU showed no tumor recurrence, lymph node enlargement, or obvious change in the tongue base ectopic thyroid.
Conclusions:
ETC is an extremely rare type of thyroid cancer, which is easy to be misdiagnosed. Preoperative use of CDU, nuclide scanning, computed tomography (CT)/Magnetic resonance imaging (MRI), and FNAB can significantly reduce the misdiagnosis rate of this disease. Surgery is currently the main treatment for ETC. Complete resection still has a high cure rate. For patients with advanced ETC who cannot be completely resected, external radiotherapy and targeted therapy can be tried, but the prognosis needs to be verified with more cases in the future.
Dental Management of a Patient with Nager Acrofacial Dysostosis
Authors: R Bozatlıoğlu, A P Münevveroğlu
Journal: Case Rep Dent (2015)

Nager syndrome is a rare syndrome resulting from developmental abnormalities of the first and second branchial arches. Nager syndrome is rare and mostly sporadic. The main clinical features consist of craniofacial, limb, and musculoskeletal morphogenesis. These findings included malar hypoplasia, maxillomandibular hypoplasia, micrognathia, downslanting palpebral fissures, cleft palate, ear anomalies, hypoplastic thumb, short forearm, proximal radioulnar synostosis, atrial septal defect, lower limb deformities, and flat nasal bridge. The prevalence is unknown; about 100 cases of Nager syndrome have been published up to now. Patients with Nager syndrome are found worldwide among all racial and ethnic groups. Trismus and glossoptosis resulting in oropharyngeal airway narrowing cause life-threatening respiratory distress for patients with Nager syndrome. In this case report, dental rehabilitation of a 10-year-old child with Nager syndrome is presented.
Case Report: ANXA2 Associated Life-Threatening Coagulopathy With Hyperfibrinolysis in a Patient With Non-APL Acute Myeloid Leukemia
Authors: Leo Ruhnke, Friedrich Stölzel, Lisa Wagenführ, Heidi Altmann, Uwe Platzbecker, Sylvia Herold, Andreas Rump, Evelin Schröck, Martin Bornhäuser, Johannes Schetelig, Malte von Bonin
Journal: Front Oncol (2021)
Keywords: anxa2, pdpn, wes, acute myeloid leukemia, acute promyelocytic leukemia, coagulopathy, disseminated intravascular coagulation, hyperfibrinolysis
MeSH terms: Case Reports

Patients with acute promyelocytic leukemia (APL) often present with potentially life-threatening hemorrhagic diathesis. The underlying pathomechanisms of APL-associated coagulopathy are complex. However, two pathways considered to be APL-specific had been identified: 1) annexin A2 (ANXA2)-associated hyperfibrinolysis and 2) podoplanin (PDPN)-mediated platelet activation and aggregation. In contrast, since disseminated intravascular coagulation (DIC) is far less frequent in patients with non-APL acute myeloid leukemia (AML), the pathophysiology of AML-associated hemorrhagic disorders is not well understood. Furthermore, the potential threat of coagulopathy in non-APL AML patients may be underestimated. Herein, we report a patient with non-APL AML presenting with severe coagulopathy with hyperfibrinolysis. Since his clinical course resembled a prototypical APL-associated hemorrhagic disorder, we hypothesized pathophysiological similarities. Performing multiparametric flow cytometry (MFC) and immunofluorescence imaging (IF) studies, we found the patient's bone-marrow mononuclear cells (BM-MNC) to express ANXA2 - a biomarker previously thought to be APL-specific. In addition, whole-exome sequencing (WES) on sorted BM-MNC (leukemia-associated immunophenotype (LAIP)1: ANXAlo, LAIP2: ANXAhi) demonstrated high intra-tumor heterogeneity. Since ANXA2 regulation is not well understood, further research to determine the coagulopathy-initiating events in AML and APL is indicated. Moreover, ANXA2 and PDPN MFC assessment as a tool to determine the risk of life-threatening DIC in AML and APL patients should be evaluated.
Aortic valve papillary fibroelastoma associated with acute cerebral infarction: a case report
Authors: Nobuhiro Takeuchi, Masanori Takada, Koichi Fujita, Yoshiharu Nishibori, Takao Maruyama, Kazuyoshi Naba
Journal: Case Rep Cardiol (2013)

An 80-year-old woman with a history of congestive heart failure, atrial fibrillation, and hypertension was transferred to our institution with hematemesis. Her drug regimen included 2 mg warfarin potassium/day to prevent thromboembolic events. Transthoracic echocardiography (TTE) performed at 78 years of age revealed a mass attached to the noncoronary cusp and a cardiac tumor was suspected. The patient declined surgery and was meticulously followed up with periodic TTE. Upper gastroendoscopy revealed a gastric ulcer with an exposed blood vessel; anticoagulant therapy was ceased. On day 15 of admission, acute cerebral infarction occurred. Heparin sodium and warfarin potassium were administered rapidly, and her symptoms improved. TTE revealed no alteration of the mobile, string-like mass attached to the noncoronary cusp. Cardiac tumor was considered the cause of cerebral infarction, and the patient consented to surgical therapy. Pathological examination of the resected tumor suggested papillary fibroelastoma (PFE). Although no guidelines exist for PFE management, a mobile, cardiac tumor necessitates surgical resection to prevent thromboembolic events, even when small in size.
Secondary severe thrombocytosis in a patient who underwent splenectomy due to hereditary spherocytosis and its treatment using hydroxyurea
Authors: Hakan Sarbay, Sinan Akbayram
Journal: Pan Afr Med J (2019)
Keywords: hydroxyurea, splenectomy, thrombocytosis
MeSH terms: Hydroxyurea / administration & dosage, Spherocytosis, Hereditary / surgery, Splenectomy / methods, Thrombocytosis / etiology, Case Reports, Adolescent, Humans, Male, Platelet Count, Severity of Illness Index, Thrombocytosis / drug therapy, Hydroxyurea

Thrombocytosis is a frequently seen condition during childhood. While it usually develops secondarily due to reasons such as infection or anemia, it may rarely develop due to clonal causes. Thrombocytosis becomes a life-threatening condition by causing severe complications such as hemorrhage and thrombosis development. Treatment is not recommended in patients who are asymptomatic and with a platelet count below 1,500,000/mm3, however, treatment is required in cases who are symptomatic and with a platelet count above 1,500,000/mm3 in conditions such as primary thrombocytosis. This article present the outcomes of a patient who was treated using low-dose hydroxyurea when he developed severe thrombocytosis after splenectomy.
Rapid Bone Healing after Intentional Replantation of a Molar with Apical Actinomycosis
Authors: Saeed Asgary, Leyla Roghanizadeh
Journal: Iran Endod J (2018)
Keywords: actinomycosis, cem cement, calcium-enriched mixture, endodontic, periapical periodontitis, tooth replantation
MeSH terms: Case Reports

Actinomycosis is a rare lesion of the jaws and may present as periapical pathosis; therefore, it is essential to be correctly diagnosed and managed. This case presentation describes management of a tooth with a symptomatic apical periodontitis caused by Actinomyces species supplemented with medicine prescription. A woman was referred for endodontic management of tooth #19. The tooth had a history of previous nonsurgical endodontic retreatment. Clinically, the tooth was very sensitive to percussion. Radiographic evaluation showed a large periapical lesion. Intentional replantation (IR) was planned. The tooth was atraumatically extracted. Without any curettage, through the blood flow coming out of the socket, a small yellowish granule was detected and sent for examination. After root-end preparations, the cavities were filled with calcium-enriched mixture cement and the tooth was carefully replanted. Histopathological assessment proved actinomycosis sulfur granule. According to infectious disease specialist recommendation, low-dose and long-term penicillin V was prescribed. Interestingly, at 2-month follow-up, remarkable bone healing was observed. In the cases of apical actinomycosis, IR in combination with antibiotic therapy, even without the curettage of the lesion, may be successfully employed.
Melanotic Schwannomas Are Rarely Seen Pigmented Tumors with Unpredictable Prognosis and Challenging Diagnosis
Authors: Elif Keskin, Sumeyye Ekmekci, Ozgur Oztekin, Gulden Diniz
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Melanotic Schwannoma (MS) is rarely seen and potentially malignant neoplasm that is categorized as a variant of Schwannoma. MS most frequently involves intracranial structures followed by posterior nerve roots in the spinal canal. Approximately 50% of the cases with MS have psammomatous calcifications and this type of MS is related to Carney complex with autosomal dominant inheritance. Most cases of MS are benign, though 10% of them are malignant with metastatic potential. MS mimics melanoma and the differential diagnosis should be made excluding other melanin producing neoplasms especially melanoma. Case 1. A 42-year-old hypertensive male presented for checkup. He had a well-defined extraspinal oval lesion measuring 3.5 × 2.5 cm near right adrenal. Case 2. A 22-year-old female presented with neurofibromatosis-2, bilateral acoustic schwannomas and café au lait lesions on sacrococcygeal region. She had an intradural extramedullary lesion measuring 6.1 × 2.0 cm at L1-2 level. MS is a rare neoplasm composed of Schwann cells and melanin pigment. These tumors are usually benign but they may become aggressive. The biologic behavior of MS is difficult to predict; the patients have to be followed up for a longer period due to its malignant potential.
Newly acquired fear of falling leads to altered eye movement patterns and reduced stepping safety: a case study
Authors: William R Young, Mark A Hollands
Journal: PLoS One (2012)
MeSH terms: Eye Movements / physiology, Fear / physiology, Fear / psychology, Walking / physiology, Walking / psychology, Case Reports, Accidental Falls, Aged, 80 and over, Female, Humans

This opportune case study describes visual and stepping behaviours of an 87 year old female (P8), both prior to, and following two falls. Before falling, when asked to walk along a path containing two stepping guides positioned before and after an obstacle, P8 generally visually fixated the first stepping guide until after foot contact inside it. However, after falling P8 consistently looked away from the stepping guide before completing the step into it in order to fixate the upcoming obstacle in her path. The timing of gaze redirection away from the target (in relation to foot contact inside it) correlated with absolute stepping error. No differences in eyesight, cognitive function, or balance were found between pre- and post-fall recordings. However, P8 did report large increases in fall-related anxiety and reduced balance confidence, supporting previously suggested links between anxiety/increased fear or falling and maladaptive visual/stepping behaviours. The results represent a novel insight into how psychological and related behavioural factors can change in older adults following a fall, and provide a possible partial rationalisation for why recent fallers are more likely to fall again in the following 12 months. These findings highlight novel possibilities for falls prevention and rehabilitation.
Malignant peripheral nerve sheath tumour-A case report
Authors: Senthilkumar A C, S Sridharan, B Mahendra, V Chander
Journal: Int J Surg Case Rep (2019)
Keywords: case, mpnst, malignant, nerve, peripheral, pre-sacral, report, sheath, tumour

Introduction:
Malignant peripheral nerve sheath tumors (MPNST) are rare, aggressive sarcomatous tumors that arise from peripheral nerve sheaths and show schwann cell differentiation (Thangadurai, 2017) [1]. They commonly arise among patients with neurofibromatosis I and following radiation therapy (Farid et al., 2014). High resolution PET scans confirm the diagnosis and the definitive treatment is surgical excision. Post operative radiotherapy plays an important role in disease free survival rates. Chemotherapy is offered to people who have a systemic disease.
Presentation of case:
This case report is on a 47 year old lady, a known case of Von Recklinghausen, who complained of a vague mass in the pelvis with recent history of pain to her right thigh. Pelvic examination revealed a vague mass on the right side of her pelvis. She was planned for excision of the mass. Intraoperative findings were consistent with the clinical and radiological findings. She is currently on regular follow-up and disease free.
Discussion:
MPNSTs are rare tumours that arise in patients with neurofibromatosis I. Mutations at the genetic level is responsible for the development of MPNST. Early presentation, radiological confirmation, aggressive margin free surgery followed by chemoradiation helps in near complete cure of the disease.
Conclusion:
MPNST are difficult to manage because of their aggressive nature and the limitations in early diagnosis and management. In patients with Von Recklinghausens disease, malignancy must be suspected when a patient presents with the complaints as mentioned in this case report.
Mood disorder due to a general medical condition with manic features
Authors: J P Oliveira, S L Morais, D Araújo, C G Carlotti, B O Colli, J A S Crippa, J E Cecílio Hallak
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

This case report describes a patient with manic and psychotic symptoms who had a history of neurocysticercosis and presented with an episode of hypertensive hydrocephalus in 2003. Despite her history, she was initially treated for primary psychiatric disease.
Response to sunitinib of a gastrointestinal stromal tumor with a rare exon 12 PDGFRA mutation
Authors: Andrew S Brohl, Elizabeth G Demicco, Karen Mourtzikos, Robert G Maki
Journal: Clin Sarcoma Res (2015)
Keywords: gist, imatinib, pdgfra, sunitinib
MeSH terms: Case Reports

Background:
Gastrointestinal stromal tumors (GISTs) are commonly driven by activating mutations in either KIT or PDGFRA. Importantly, different mutations within these two genes can lead to very different levels of sensitivity or resistance to kinase inhibitor therapy. Due to rarity, sensitivity or resistance of exon 12 PDGFRA mutant GIST to kinase inhibitor therapy is not well defined.
Case summary:
We report the case of a patient with a PDGFRA exon 12 mutated GIST. The patient experienced a very good response to imatinib in the neoadjuvant setting, but then relapsed while still on adjuvant imatinib. In this patient, we report a dramatic response to second line treatment with sunitinib, with complete resolution of two liver lesions at the time of first restaging.
Conclusions:
This is the first report detailing a response to treatment with sunitinib of a gastrointestinal stromal tumor with an uncommon exon 12 PDGFRA mutation. Based on the observed efficacy, GIST patients with this rare molecular subtype should be considered for sunitinib therapy.
Case report: Myocardial noncompaction causing massive cerebral infarction in 1 patient with eyelid edema as an early manifestation and literature review
Authors: Pingping Ge, Yafei Zhu
Journal: Front Pediatr (2023)
Keywords: children, clinical manifestations, massive cerebral infarction, noncompaction of ventricular myocardium (nvm), prognosis
MeSH terms: Case Reports

Objective:
To summarize and analyze the early clinical manifestations, risk factors, treatment and prognosis of myocardial noncompaction in children, and to provide scientific basis for early and effective intervention.
Methods:
Combined with a case of myocardial noncompaction with massive cerebral infarction in a child, the related research reports of myocardial noncompaction in children were analyzed retrospectively.
Results:
Myocardial noncompaction in children is cardiomyopathy caused by abnormal myocardial compaction during embryonic development. Feeding intolerance, dyspnea, chest tightness, fatigue, eyelid edema and other non-specific manifestations may occur in the early stage. It is easy to miss the diagnosis and misdiagnosis in clinical diagnosis and treatment, leading to intractable heart failure, nausea and arrhythmia, thromboembolism and even sudden death and other serious complications. Early diagnosis, symptomatic treatment, control of complications and regular follow-up can prevent the occurrence of serious complications and reduce mortality.
Conclusion:
There is no specific clinical manifestation in the early stage of myocardial noncompaction in children. If it is not detected early and treated symptomatically, the prognosis is poor and the mortality is high. Therefore, clinicians should fully improve the understanding of the early clinical manifestations of this disease, give early diagnosis and early intervention to children, reduce the occurrence of serious complications and improve the survival rate.
Tuberculous Thoracic Aortic Pseudoaneurysm Associated With Spinal Tuberculosis: A Case Report and Literature Review
Authors: Yurou Chen, Bo Sheng, Jia Li, Furong Lv
Journal: Front Med (Lausanne) (2022)
Keywords: case report, endovascular repair, endovascular stent-graft, spinal tuberculosis, thoracic aortic pseudoaneurysm
MeSH terms: Case Reports

Background:
Thoracic aortic pseudoaneurysm associated with spinal tuberculosis is a rare but fatal condition. The risk of pseudoaneurysm rupture is extremely high and this disease needs greater awareness. The present study reported a case of thoracic aortic pseudoaneurysm caused by paravertebral cold abscess with spinal tuberculosis.
Case presentation:
A 35-year-old woman with back pain was diagnosed with thoracic aortic pseudoaneurysm with spinal tuberculosis, and endovascular aneurysm repair (EVAR) was performed. The patient's symptoms disappeared after EVAR, following which she was discharged.
Conclusions:
The case highlighted that in cases where non-enhanced computed tomography (CT) revealed that the aortic vessel was surrounded by a paravertebral abscess, magnetic resonance imaging (MRI) should be performed to confirm whether the presence of a pseudoaneurysm. Upon diagnosis of pseudoaneurysm, surgery should be performed immediately. In recent times, EVAR has emerged as a promising alternative to open surgery.
Bilateral pneumothorax: The cause of hypoxia during endoscopic retrograde cholangiopancreatography
Authors: Saeed Madani, Rohallah Taghavi, Mohammad Saiidi, Jamshid Vafaeimanesh
Journal: Caspian J Intern Med (2021)
Keywords: ercp, hypoxemia, pneumothorax
MeSH terms: Case Reports

Background:
Endoscopic retrograde cholangiopancreatography (ERCP) is recognized as a significant diagnostic and therapeutic procedure for the administration of different pancreatic and biliary problems. This procedure runs a considerable risk of complications despite its substantial safety. The rate of significant inconveniences is reported to range from 5.4% to 23.0% and the general mortality from 0.1 to 1%. Post-ERCP pneumothorax is an uncommon complication that is usually underestimated.
Case presentation:
In the present study, we report a 65-year-old woman who develops hypoxemia during the ERCP. Based on the obtained results, it was revealed that this patient had perforation-related bilateral pneumothorax and hypoxemia.
Conclusion:
Based on the obtained results, it was revealed that this patient had perforation-related bilateral pneumothorax and hypoxemia.
Inadvertent steroid injection into the crystalline lens
Authors: Md Shahid Alam, Vikas Khetan
Journal: GMS Ophthalmol Cases (2017)
Keywords: intralenticular, steroid, triamcinolone
MeSH terms: Case Reports

Intravitreal triamcinolone is administered for a wide number of vitreoretinal conditions. Several complications including cataract formation, raised intraocular pressure, and endophthalmitis have been reported following intravitreal injections. We report a rare case wherein triamcinolone was inadvertently injected directly into the crystalline lens. A 41-year-old male presented to us with a history of intravitreal injection of triamcinolone in the left eye 2 weeks earlier. Slit lamp examination revealed a needle tract in the crystalline lens with steroid granules dispersed throughout the lens core. Such a complication is extremely rare with only three cases reported previously.