OpenMed/multicare-articles huggingface dataset:
Rare Presentation of Postpericardiotomy Syndrome After Left Atrial Myxoma Removal
Authors: Jessy Feng, Nina Shyama Appareddy, Yaman Gibran, Aryana Garza, Jacqueline Luevano, Gustavo Garcia
Journal: J Investig Med High Impact Case Rep (2023)
Keywords: anticoagulation, myxoma, pericardial effusion, postpericardiotomy syndrome
MeSH terms: Cardiac Surgical Procedures, Heart Neoplasms / complications, Heart Neoplasms / diagnosis, Heart Neoplasms / surgery, Myxoma / complications, Myxoma / diagnosis, Myxoma / surgery, Case Reports, Aged, Female, Humans, Postoperative Complications / diagnosis, Postoperative Complications / etiology, Postpericardiotomy Syndrome / complications, Postpericardiotomy Syndrome / etiology

Postpericardiotomy syndrome (PPS) is a known complication of cardiac valve surgery, but it has not been commonly reported as a postoperative complication of cardiac myxoma removal. A 78-year-old female with hypertension and atrial fibrillation presenting with angina was found to have a large left atrial myxoma (7.5 cm × 4.4 cm). The myxoma was resected; however, 1-week postoperation hemoglobin and blood pressure decreased with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Limited transthoracic echocardiogram (TTE) showed moderate pericardial effusion, confirming the diagnosis of PPS. This case highlights the importance of monitoring patients postremoval of myxoma for symptoms of PPS.
Central hyperthyroidism due to an ectopic TSH-secreting pituitary tumor: a case report and literature review
Authors: Chonggui Zhu, Tong Liu, Haonan Yu, Lina Chang, Xiaona Zhang, Jia Yao, Geng Zhang, Qiusong Chen, Qing He, Ming Liu
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: 68 ga-dotatate pet/ct, tsh-secreting tumor, diagnosis, ectopic pituitary tumor, octreotide suppression test
MeSH terms: Adenoma / pathology, Hyperthyroidism / etiology, Pituitary Neoplasms / pathology, Thyroid Neoplasms / complications, Case Reports, Review, Female, Gallium Radioisotopes, Humans, Middle Aged, Octreotide / therapeutic use, Positron Emission Tomography Computed Tomography, Thyroid Hormones, Thyrotropin, Gallium Radioisotopes, Octreotide, Thyroid Hormones, Thyrotropin

Ectopic thyroid-stimulating hormone (TSH)-secreting tumors are extremely rare, with only 15 reported cases in the literature. Herein, we described a 60-year-old female patient with thyrotoxicosis and elevated or unsuppressed levels of TSH. Family history and laboratory and genetic tests did not support a diagnosis of resistance to thyroid hormone (RTH). Given the unsuppressed TSH, TSH-secreting tumor was suspected, and magnetic resonance imaging (MRI) of the pituitary gland was performed. Surprisingly, the MRI scans revealed a nodule in the nasopharynx rather than a pituitary tumor in the sella region. Further evaluation using Gallium-68 DOTATATE positron emission tomography/computed tomography (68Ga-DOTATATE PET/CT) demonstrated increased DOTATATE uptake in the nasopharyngeal nodule. Additionally, an octreotide suppression test (OST) revealed an obvious reduction in TSH levels, further supporting the suspicion of the nasopharyngeal mass as the cause of inappropriate TSH secretion. To prepare for surgery, the patient received preoperative administration of octreotide, resulting in the normalization of TSH and thyroid hormone levels. The patient subsequently underwent successful surgical removal of the nasopharyngeal mass. Following the procedure, the patient experienced complete resolution of hyperthyroidism symptoms, with TSH declined and thyroid hormone levels returned to normal. Histochemistry analysis of the tumor revealed positive staining for TSH, growth hormone (GH), prolactin (PRL), luteinizing hormone (LH), and somatostatin receptor 2 (SSTR2). We discussed differential diagnosis of hyperthyroidism due to inappropriate TSH secretion, with a particular emphasis on the importance of 68Ga-DOTATATE PET/CT in combination with OST for identifying ectopic pituitary tumors.
Insulin autoimmunity associated with vitiligo: a rare case presentation
Authors: Presoon Kuruvilla, Angel John, Ashith Murali
Journal: Endocrinol Diabetes Metab Case Rep (2024)

Summary:
Insulin autoantibody syndrome (IAS) or Hirata's disease is a rare condition characterized by recurrent fasting hypoglycaemic and postprandial hyperglycaemic episodes. Insulin autoantibodies are diagnostic for the condition. Hirata's disease has been seen to be associated with other autoimmune conditions. Vitiligo is a common depigmentation disorder whose exact cause is unknown but thought to have an autoimmune aetiology. Although autoimmunity plays a role in the pathogenesis of both the diseases, association between the two has not been reported till date. In our case, a 72-year-old Indian woman with vitiligo for the past 30 years presented with recurrent episodes of fasting hypoglycaemia. She was found to have very high levels of fasting insulin, C-peptide, and insulin antibody and was diagnosed with IAS. Thus, we conclude that the clinical spectrum of Hirata's disease has to be taken as more heterogenous than previously assumed.
Learning points:
Insulin autoantibody syndrome (IAS) or Hirata's disease is a rare condition characterized by recurrent fasting hypoglycaemic and postprandial hyperglycaemic episodes in which insulin plays a major role. Insulin autoantibodies are diagnostic for IAS. The endocrine insulin and its autoantibodies play a major role in the pathogenesis of the disease. Vitiligo is a common depigmentation disorder whose exact cause is unknown but thought to have an autoimmune aetiology. IAS and vitiligo are two diseases with autoimmune aetiology which has been seen to be associated with each other (the first case to be reported). The clinical spectrum of Hirata's disease has to be taken as more heterogenous than previously assumed. On dealing with autoimmune diseases, we should also keep in mind about other diseases with autoimmune pathogenesis.
Case Report: Left bundle branch pacing in an amyloid light-chain cardiac amyloidosis patient with atrioventricular block
Authors: Jiaqi Yu, Fanyi Kong, Peng Gao, Taibo Chen, Yongtai Liu, Zhongwei Cheng, Hua Deng, Jinzhi Lai, Lihua Zhang, Jingbo Fan, Jiaqi Wang, Xiaohan Qin, Keyue Sun, Jian Li, Quan Fang, Deyan Yang, Kang'an Cheng
Journal: Front Cardiovasc Med (2024)
Keywords: atrioventricular block, cardiac amyloidosis, case report, conduction system disease, left bundle branch pacing
MeSH terms: Case Reports

Introduction:
Amyloid light-chain cardiac amyloidosis is a progressive infiltrative disease characterized by the deposition of amyloid fibrils in the cardiac tissue, which can cause serious atrioventricular block requiring pacemaker implantation. Left bundle branch pacing has emerged as an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle. However, left bundle branch pacing in patients with amyloid light-chain cardiac amyloidosis has not been studied in detail. Therefore, in this study, we present a case of left bundle branch pacing in a patient with amyloid light-chain cardiac amyloidosis.
Case summary:
A 66-year-old male patient with amyloid light-chain cardiac amyloidosis presented with syncope for 1 month. Holter monitoring revealed intermittent third-degree atrioventricular block. Left bundle branch pacing was performed successfully. During the 1-year follow-up, it was observed that the left bundle branch capture threshold remained stable without any pacemaker-related complications or left ventricle systolic dysfunction, and there was no recurrence of syncope.
Conclusion:
Left bundle branch pacing appears to be a safe and feasible option for patients with amyloid light-chain cardiac amyloidosis experiencing atrioventricular block.
Recurrent Serous Borderline Tumor After Fertility-Sparing Surgery Following Twin Pregnancy and Resumption of Menstruation
Authors: Noriko Morita, Hiroshi Matsushita, Hiromitsu Yabushita, Akihiko Wakatsuki
Journal: Cureus (2024)
Keywords: borderline ovarian tumor, estrogen, fertility-sparing surgery, hormone replacement therapy, recurrence, surgical menopause
MeSH terms: Case Reports

Gynecologic malignancies sometimes affect women before menopause. Aggressive treatments, such as surgery, chemotherapy, and/or radiotherapy, often lead to premature menopause. Hormone replacement therapy (HRT), typically used for managing menopause-associated health issues, may be limited by tumor sensitivity to estrogen. Here, we present a case of a 37-year-old woman seeking fertility, who was diagnosed with a serous borderline ovarian tumor (BOT). Fertility-preserving surgery and in-vitro fertilization resulted in a twin pregnancy. During a postpartum amenorrheic period, there was no recurrence. However, she experienced a rapid recurrence of the disease following the resumption of menstruation and underwent radical surgery. This rapid recurrence after menstruation resumed suggests potential estrogen sensitivity. Close postoperative monitoring has been ongoing without HRT.
Striatal Lacunar Infarction in a Late Preterm Infant Born to a Mother with Active Peripartum SARS-CoV-2 Infection
Authors: Christoph Hochmayr, Marlene Hammerl, Ira Winkler, Gisela Schweigmann, Ursula Kiechl-Kohlendorfer, Elke Griesmaier, Anna Posod
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Background:
The current literature suggests that neonatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections generally have a mild course. Data on how in utero exposure to maternal infection affects neonatal health outcomes are limited, but there is evidence that neurological damage to the fetus and thromboembolic events may occur. Case Presentation. We describe the case of a late preterm infant, who presented with striatal lacunar infarction in the neonatal period, born to a mother with active peripartum SARS-CoV-2 infection. Diagnostic workup did not identify risk factors apart from the maternal SARS-CoV-2 infection. Repeated reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 using oropharyngeal swab specimens of the patient were negative. IgG, but not IgM antibodies against spike protein S1 receptor-binding domain (S1RBD) epitope were detectable in umbilical cord blood and neonatal serum collected at 48 hours of life. Anti-SARS-CoV-2 total antibody titers against nucleocapsid protein in umbilical cord blood were negative.
Conclusions:
Bearing in mind a possible association of in utero exposure to SARS-CoV-2 and neonatal thromboembolic events, neonatologists should be aware of these complications even in well-appearing preterm infants.
Case report: Rupture of an ileus tube in a patient with recurrent rectal cancer
Authors: Jun Ma, Ye Jiang, Chaoping Zhou, Datian Wang, Chunxia Zhao, Yaming Zhang
Journal: Front Oncol (2023)
Keywords: complication, ileus tube, intestinal obstruction, rectal cancer, recurrence or metastasis
MeSH terms: Case Reports

The insertion of an ileus tube is an important treatment for intestinal obstruction. According to previous reports, jejunal intussusception has been reported as a complication associated with ileus tube placement. However, rupture of the weighted tip of an ileus tube has not been reported before. Herein, we report a 55-year-old Chinese woman who underwent radical proctectomy (DIXON) for rectal cancer and developed pelvic recurrence and lung metastasis 65 months after surgery, accompanied by symptoms of acute intestinal obstruction. An ileus tube was inserted before the operation (extensive total hysterectomy, bilateral adnexal resection, rectal Hartman operation, partial enterectomy, and intestinal adhesion lysis). Rupture of the ileus tube occurred after the operation and was treated with paraffin oil and enteral nutrition, and the metal beads and spring were eliminated through the colostomy. During the follow-up, the patient received targeted therapy plus immunotherapy, which was successful: the quality of life of the patient was excellent, and no obvious abnormal symptoms were found. Endoscopy-assisted ileus tube insertion should be performed under intravenous anesthesia, and a knot should be tied at the tip of the ileus tube before insertion so that the ileus tube can be inserted easily by grasping the thread with biopsy forceps(the "thread-knotting" method). With the above methods, the procedure of ileus tube insertion could be improved to reduce the incidence of tube-related rupture.
Intraoperative Diagnosis of Gallbladder Volvulus
Authors: Hassan Mohamed Ali, Eyad Rabih Abdul Wahab, Amjad Damaj, Bassam Moussawi, Walid Audi, Mohammad Haidar, Youssef Badra
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Background:
A gallbladder torsion typically presents as an acute abdomen presentation with nonspecific clinical signs. When not detected by a clinician preoperatively, it can lead to the delay of emergency surgery and possible misdiagnosis for other, more common causes of an acute abdomen. Case Presentation. We report the case of acute gallbladder volvulus in an 80-year-old woman complaining of constant pain in the right upper quadrant of the abdomen.
Conclusions:
The patient was successfully treated with cholecystectomy. The case highlights the high index of suspicion required to diagnose the condition preoperatively in this population of patients to reduce complications such as biliary peritonitis and death.
Secondary adrenocortical insufficiency after treatment with retifanlimab: a case report
Authors: Wenjing Zhang, Li Xiao, Guangxin Zhou, Huijuan Zhu, Yongmin Bi, Junjie Du, Da Zhang
Journal: Front Immunol (2024)
Keywords: adrenocortical insufficiency, hyponatremia, immune-related endocrine event, immunotherapy, retifanlimab
MeSH terms: Adrenal Insufficiency / chemically induced, Adrenal Insufficiency / diagnosis, Adrenal Insufficiency / etiology, Case Reports, Addison Disease / chemically induced, Addison Disease / diagnosis, Addison Disease / drug therapy, Addison Disease / etiology, Aged, Female, Humans, Hydrocortisone / therapeutic use, Immune Checkpoint Inhibitors / adverse effects, Immune Checkpoint Inhibitors / therapeutic use, Immune Checkpoint Inhibitors, Hydrocortisone

With advancements in medical oncology, immune checkpoint inhibitors (ICIs) have become the first-line treatment for many malignancies. ICIs play a significant role in improving cancer prognosis, but a series of immune-related adverse events (irAEs), including immune-related endocrine events (irEEs), caused by ICIs have also aroused concerns. Rapid clinical identification of irAEs caused by ICIs is particularly important. We describe a case of secondary adrenocortical insufficiency (AI) after PD-1 treatment in a postoperative patient with endometrial cancer. A 73-year-old female patient developed anorexia, nausea, vomiting, malaise, electrolyte disturbances, ineffective symptomatic treatment, and decreased serum adrenocorticotropin and cortisol levels six months after retifanlimab treatment. The vomiting resolved, and the electrolyte levels were corrected after 3 days of treatment with glucocorticoids (hydrocortisone, intravenous, 200 mg/day). When patients present with gastrointestinal symptoms, such as poor appetite and nausea, not only symptomatic treatment but also a search for the etiology behind the symptoms is needed, especially in immunotherapy patients who should undergo a thorough evaluation of the endocrine system and be alert for adrenocortical insufficiency.
Unveiling the Unexpected: Co-occurrence of Acute Pancreatitis and Riedel's Lobe
Authors: Andreea I Ghiță, Matei Olteanu, Alex E Debelka, Oana M Cîlțea, Mihai R Pahomeanu
Journal: Cureus (2024)
Keywords: acute pancreatitis, ct, incidental, liver, riedel's lobe
MeSH terms: Case Reports

Riedel's lobe is a rare anatomical variant of the liver, more often being diagnosed incidentally, with the patient being investigated for other underlying pathology. As regards acute pancreatitis, this represents one of the most treated diseases worldwide in gastroenterology with a variable severity and outcome. Here, we report a case of a non-palpable Riedel's lobe in a 47-year-old man, smoker, and chronic alcohol consumer, who presented to the hospital with epigastric pain radiating in the right hypochondrium, accompanied by nausea. Based on his clinical examination, laboratory, and imaging findings, he was admitted in the gastroenterology department with the diagnosis of alcohol-related acute pancreatitis. The computed tomography scan emphasized the presence of Riedel's lobe, causing an increased anterior diameter of the liver. Riedel's lobe is, in most cases, an unforeseen radiologic disclosure, which can remain clinically latent, or it can raise confusion regarding the differential diagnosis.
Ventricular restoration in adults with huge congenital left ventricular aneurysm: report of two cases
Authors: Charles Mve Mvondo, Hermann Nestor Tsague Kengni, Laurence Carole Ngo Yon, Amalia Ariane Owona Ngandebe, Etienne Sene, Marcelin Ngowe Ngowe
Journal: Pan Afr Med J (2024)
Keywords: cameroon, congenital aneurysm, case report, ventricular restoration
MeSH terms: Chest Pain / etiology, Heart Aneurysm / congenital, Heart Aneurysm / diagnosis, Heart Aneurysm / diagnostic imaging, Heart Aneurysm / surgery, Heart Ventricles / diagnostic imaging, Magnetic Resonance Imaging, Case Reports, Adult, Africa South of the Sahara, Black People, Dyspnea / etiology, Echocardiography, Doppler, Female, Humans, Male, Young Adult

Congenital ventricular aneurysms (CVA) are rare cardiac anomalies that have been predominantly described in the Black population. They are characterized by an akinetic ventricular protrusion that is commonly located at the basal and apical segments. Although the diagnosis is often incidental and the majority of patients are asymptomatic, life-threatening events such as persistent ventricular arrhythmias, CVA rupture, and heart failure are not uncommon. However, no standardized therapy is currently available and good outcomes have been reported with both conservative and surgical management. We report the cases of two young Black African patients with huge symptomatic CVA lesions who underwent successful surgical repair with a ventricular restoration technique. Both cases were consulted for chest pain and dyspnea. Chest X-ray and transthoracic Doppler echocardiography suggested the diagnosis. Thoracic angioscanner and thoracic magnetic resonance imaging confirmed the diagnosis. Both patients underwent successful surgery. This case report aims to revisit the diagnostic and therapeutic approach to this rare pathology, in our professional environment.
Inflammatory myofibroblastic tumor in the liver: a case report
Authors: Yinying Meng, Jinlan Xie, Yan Liang, Mulan Wu, Yi Lu, Qian Lu
Journal: Front Oncol (2024)
Keywords: case report, hepatectomy, hepatic inflammatory myofibroblastic tumor, histology, imaging
MeSH terms: Case Reports

Background:
Hepatic inflammatory myofibroblastic tumor (IMT) is an infrequent tumor with potential malignancy. However, it lacks specific clinical symptoms and usual imaging features.
Case presentation:
A 34-year-old woman had a six-month history of fever and on-and-off pain in the upper right part of her abdomen that lasted for two weeks. Imaging tests revealed a liver mass initially thought to be liver malignancy, but subsequent histopathological examination after liver removal confirmed the diagnosis as hepatocellular inflammatory myofibroblastic tumor (HIMT).
Conclusion:
Hepatic inflammatory myofibroblastic tumor (IMT) is an uncommon growth with vague clinical symptoms and lab results. Surgical removal remains the primary treatment method, resulting in favorable prognostic outcomes.
18F-FDG PET CT in cardiac device infections - A Case series
Authors: Awiral Saxena, Manjit Sarma, Bhagirath Bhad, Ramkesh Ratheesan, Padma Subramanyam, P Shanmuga Sundaram
Journal: Asia Ocean J Nucl Med Biol (2024)
Keywords: 18f-fdg pet ct, cied infection, coronary stent infection, infection imaging  a b s t r a c t, prosthetic valve infection
MeSH terms: Case Reports

With the increasing number of interventional cardiology procedures, the number of cardiac device infections (including pacemakers, prosthetic valves, coronary and aortic stents) have also increased. These infections can cause significant morbidity and can even lead to mortality if not managed promptly. If suspected clinically the first-line imaging modality is Trans-Thoracic Echocardiography, while Transesophageal Echocardiography is also used in selected cases. The confirmation of a cardiac device infection is mostly done with the help of blood or pus culture. Even though Echocardiography is a very efficient technique for the evaluation of the heart, it cannot differentiate infection from thrombus or fibrosis. With the increasing availability of Positron Emission Tomography CT (PET CT) machines worldwide, the use of 18F-FDG PET CT for infection imaging has gained traction, especially for cardiac device infection. Most of the recent studies show a good diagnostic accuracy of 18F-FDG PET CT with many of the recent diagnostic and management guidelines now acknowledging its role, especially in equivocal cases. We present six such cases where 18F-FDG PET CT provided valuable information either for diagnosis, confirming the presence of infection, delineating extent, therapy response or sometimes even helping appropriate treatment decision making in patients with suspected cardiac device infection.
Case report: Ibogaine reduced severe neuropathic pain associated with a case of brachial plexus nerve root avulsion
Authors: Jonathan E Dickinson, Jose Adalberto Dominguez Inzunza, Liliana Perez-Villa, Trevor G Millar, Abhiram P Pushparaj
Journal: Front Pain Res (Lausanne) (2023)
Keywords: brachial plexus nerve root avulsion, ibogaine, neuropathic pain, noribogaine, pain management, vehicular trauma
MeSH terms: Case Reports

Brachial plexus nerve root avulsion results from complete separation of the nerve root from the spinal cord and is one of the most challenging types of neuropathic pain, coinciding with motor, sensory and autonomic deficits. The severe pain and typical impossibility of root reattachment often leads to requests for amputation. Ibogaine is an indole alkaloid producing psychoactive effects through reported actions upon multiple neurotransmitter systems, including NMDA, κ- and µ-opioid receptors and σ2 receptor sites, along with stimulation of neurotrophic factors GDNF and BDNF. In this case report we describe a 53-year-old male with two decades of severe intractable pain due to brachial plexus nerve root avulsion from vehicular trauma who was successfully treated with both high dose inpatient and low dose outpatient administrations of ibogaine. Though promising for future study, the adverse effects of high dose ibogaine administrations may limit tolerability of this saturation protocol to the most refractory cases.
Dermal Granuloma Annulare After SARS-CoV-2 Vaccination: A Rare Complication
Authors: Muhammad Tahir, Belin F Bodies, Sara Shalin, Thuy Phung, Thomas C Myers, Robert Israel, Adriano Piris, Kurt Knowles
Journal: Cureus (2024)
Keywords: annular granuloma annulare, covid-19 vaccine, diffuse granuloma annulare, granuloma annulare, interstitial granuloma annulare, post covid-19 vaccination
MeSH terms: Case Reports

Granuloma annulare (GA) is an inflammatory granulomatous skin disease of unknown etiology that is self-limiting in nature. However, it is hypothesized that trauma, medications, malignancy, viral infections, different vaccines, and hypersensitivity reactions can trigger the formation of GA. Only three cases of post-SARS-CoV-2 vaccination-related GA have been reported so far. Here, we report the fourth documented case of post-SARS-CoV-2 vaccination-related generalized GA.