OpenMed/multicare-articles huggingface dataset:
Case Report: Ocular Manifestations and Treatments of Ciliary Body Involvement by Lymphoma
Authors: Yu Di, Junjie Ye, Ruoan Han, Mengda Li, Bilei Zhang
Journal: Front Oncol (2021)
Keywords: ciliary body, diagnostic vitrectomy, lymphoma, treatment, uveitis
MeSH terms: Case Reports

Purpose:
To describe the ocular clinical features, histopathological findings, and treatment outcomes of lymphomas involving the ciliary body.
Methods:
We demonstrate three cases of ciliary body involvement by lymphoma from 2013 to 2019 in Peking Union Medical College Hospital (PUMCH). All patients underwent examinations including best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscope, ultrasound biomicroscopy (UBM), and diagnostic vitrectomy. In addition, cytopathology, immunohistochemistry, gene rearrangement, cytometric immunophenotypic, or in-situ hybridization were used for determining the pathological type of lymphoma.
Results:
The patients were a 25-year-old man, a 52-year-old woman, and a 54-year-old man. Two patients had unilateral involvement, and one patient had bilateral involvement. All patients presented with anterior uveitis and elevated intraocular pressure. Ciliary body masses or infiltration were found in 3 patients. Two patients had diffuse large B-cell lymphoma and one patient had natural killer/T-cell lymphoma. All patients received 0.4 mg methotrexate intravitreal injections, and the ciliary body lesions regressed completely.
Conclusion:
Lymphomatous involvement of the ciliary body usually presents as an atypical anterior chamber reaction. Vitreous biopsy should be considered in these patients for diagnosis. Methotrexate intravitreal injection combine with chemotherapy or radiotherapy, might extend the survival time and preserve visual acuity for patients with ciliary body involvement by lymphoma.
Spinal cord stimulation for complex regional pain syndrome type 1 with dystonia: a case report and discussion of the literature
Authors: Caroline Voet, Bernard le Polain de Waroux, Patrice Forget, Ronald Deumens, Etienne Masquelier
Journal: F1000Res (2014)

Background:
Complex Regional Pain Syndrome type 1 (CRPS-1) is a debilitating chronic pain disorder, the physiopathology of which can lead to dystonia associated with changes in the autonomic, central and peripheral nervous system. An interdisciplinary approach (pharmacological, interventional and psychological therapies in conjunction with a rehabilitation pathway) is central to progress towards pain reduction and restoration of function.
Aim:
This case report aims to stimulate reflection and development of mechanism-based therapeutic strategies concerning CRPS associated with dystonia.
Case description:
A 31 year old female CRPS-1 patient presented with dystonia of the right foot following ligamentoplasty for chronic ankle instability. She did not have a satisfactory response to the usual therapies. Multiple anesthetic blocks (popliteal, epidural and intrathecal) were not associated with significant anesthesia and analgesia. Mobilization of the foot by a physiotherapist was not possible. A multidisciplinary approach with psychological support, physiotherapy and spinal cord stimulation (SCS) brought pain relief, rehabilitation and improvement in the quality of life.
Conclusion:
The present case report demonstrates the occurrence of multilevel (peripheral and central) pathological modifications in the nervous system of a CRPS-1 patient with dystonia. This conclusion is based on the patient's pain being resistant to anesthetic blocks at different levels and the favourable, at least initially, response to SCS. The importance of the bio-psycho-social model is also suggested, permitting behavioural change.
From an Incidental Finding to an Emergent Treatment: A Case Report of a Hepatic Adenomatosis and Large Ruptured Hepatic Adenoma
Authors: Maria Mironova, Mohammed K Mahdi, Jyoti Bhatia, Rosemarie C Nielson, Cataldo Doria
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Introduction. Hepatic adenoma is an uncommon benign liver tumor presenting as solitary lesions or even rarely as hepatic adenomatosis. Large lesions carry a risk of rupture, hemorrhage, and malignant transformation. This case report aims to increase awareness about risk factors for hepatic adenomas, considering the increasing prevalence of obesity and the widespread use of oral contraceptive pills. Case Presentation. A 20-year-old obese female who was taking oral contraceptive pills for seven years presented to the emergency department with vomiting and abdominal pain caused by gastroenteritis. On imaging, multiple hepatic adenomas, including two lesions 6 and 9 cm in diameter, were incidentally found. During the hospitalization, the patient suddenly developed acute anemia and rupture of the largest lesion, which was promptly treated with arterial embolization. Discussion. Obesity and exposure to hormones are well-known risk factors for hepatic adenomas. The incidence of hepatic adenomas is steadily increasing because of the prevalence of obesity, especially among females. Lifestyle interventions for weight loss and discontinuation of oral contraceptive pills are considered a conservative treatment of hepatic adenomas. Large lesions possess the risk of malignant transformation and rupture and require surgical excision.
Unexpected Lung and Brain Metastases 9 Years After Thyroid Lobectomy for Follicular Adenoma: A Case Report
Authors: Yoo Jin Lee, Dong Wook Kim, Gi Won Shin, Young Jin Heo, Jin Young Park, Jin Wook Baek, Hye Jung Choo, Young Jun Cho, Ha Kyoung Park, Tae Kwun Ha, Do Hun Kim, Soo Jin Jung, Ji Sun Park, Sung Ho Moon, Ki Jung Ahn
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: follicular adenoma, metastasis, papillary thyroid carcinoma, thyroid, ultrasonography
MeSH terms: Case Reports

Background: Benign thyroid follicular tumors without histological evidence of carcinoma can metastasize. However, the pathogenesis of metastasis remains unclear. Here, the new proposed terminology, "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" should be considered. We present a case of an encapsulated type of follicular variant of papillary thyroid carcinoma (FVPTC) that exhibited distant lung and brain metastases and was initially diagnosed as follicular adenoma. Case Report: In December 2006, a 64-year-old woman underwent ultrasonography-guided fine-needle aspiration of the right thyroid nodule at our hospital because of a palpable right neck mass. Right lobectomy was performed, and a follicular adenoma was diagnosed. In October 2015, she visited our hospital owing to dry cough and mild dyspnea and underwent computed tomography-guided transthoracic core needle biopsy for the lung nodule owing to probably multiple lung metastasis on chest X-ray and computed tomography. Based on retrospective analysis of the primary thyroid tumor and lung nodule specimen, an encapsulated follicular variant of papillary thyroid carcinoma with lung metastasis was confirmed. Conclusion: We report a case of an encapsulated follicular variant of papillary thyroid carcinoma with unexpected metastasis to the lung 9 years after thyroid surgery in a patient who was initially diagnosed as follicular adenoma. A careful close follow-up with re-examination of the histopathology specimen may be needed in patients who were diagnosed with benign thyroid follicular tumors.
Evaluation of teriparatide for treatment of osteoporosis in four patients with cystic fibrosis: a case series
Authors: Oranan Siwamogsatham, Kelly Stephens, Vin Tangpricha
Journal: Case Rep Endocrinol (2014)

Introduction. Bone disease is a common complication of cystic fibrosis (CF). To date, there have been no reports on the effectiveness of teriparatide, recombinant human parathyroid hormone, to treat CF-related bone disease. Case Presentation. We report on four patients with CF-related bone disease who were treated with teriparatide. Three patients completed two years of therapy with teriparatide, and all had significant improvements in their bone mineral density (BMD). One patient was unable to tolerate teriparatide and discontinued treatment 1 week into therapy. Conclusion. Teriparatide may be a potential treatment option for CF-related bone disease. This report highlights the need for further investigation into the use of teripartide in the CF population.
Intracerebral schwannoma in a 16-year-old girl: a case report and review of the literature
Authors: R Srinivas, D Krupashankar, V Shasi
Journal: Case Rep Neurol Med (2013)

Intracerebral schwannomas are rare tumors of the CNS. We report a rare case of intracerebral schwannoma, presenting as a cystic and solid frontoparietal mass, arising in a 16-year-old girl. The patient presented seizures and headache. Neuroradiologic findings showed a left frontoparietal lesion with cystic and tissular components. The tumor was removed through a left frontoparietal craniotomy. Histological features confirmed the diagnosis of intracerebral schwannoma. Intracerebral schwannomas, unrelated to cranial nerves, are rare. The Schwann cells are not indigenous to brain substance, and hence histogenesis of these tumours has attracted a lot of speculation, but because most reported cases have involved young patients, a developmental origin has been suggested. The theories and literature related to this case are reviewed.
Bilateral Recurrent Laryngeal Nerve Palsy following Total Thyroidectomy in Triple A Syndrome, an Unexpected but Critical Complication
Authors: Mathieu Chamberland, Marc-Antoine Poulin, Danielle Beaudoin
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Introduction:
Triple "A" syndrome (TAS) is a rare autosomal recessive disorder that presents in childhood with achalasia cardia, alacrima, ACTH-resistant adrenal insufficiency, with sensorimotor and autonomic polyneuropathy developing later in the course of the disease. Case Presentation. An adult white male affected by this syndrome underwent an uneventful total thyroidectomy for malignancy and suffered delayed bilateral recurrent laryngeal nerve palsy in the early postoperative hours. The palsy spontaneously resolved after a five-week course.
Conclusion:
Given the rarity of this severe condition and the absence of surgical or medical causes identifiable, there is possibility that it is the neurological involvement caused by TAS that predisposed the patient to this adverse outcome, precipitated by standard manipulations during surgery.
Case report: Withdrawal of angiotensin-converting enzyme inhibitors in children with advanced chronic kidney disease and rapidly declining kidney function
Authors: Tomáš Seeman, Jiří Dušek
Journal: Front Pediatr (2023)
Keywords: blood pressure (bp), case report, chronic kidney disease, estimated glomerular filtration rate (egfr), proteinuria
MeSH terms: Case Reports

Background:
It is not known whether withdrawal of angiotensin-converting enzyme inhibitors (ACEIs) in children with advanced chronic kidney disease (CKD) is beneficial similar to adults. We report a case series of children with advanced CKD whose ACEIs were stopped.
Methods:
In the last 5 years, we stopped ACEIs in seven consecutive children on ACEI therapy with rapidly declining CKD stage 4-5. The median age was 12.5 years (range 6.8-17.6); the median estimated glomerular filtration rate (eGFR) at stopping ACEIs was 12.5 ml/min/1.73 m2 (range 8.8-19.9).
Results:
Six to twelve months after stopping ACEIs, the eGFR increased in five children (71%). The median absolute increase of eGFR was 5.0 ml/min/1.73 m2 (range -2.3 to +20.0) and relative increase of eGFR was 30% (range -34 to +99). The median follow-up after stopping ACEIs was 2.7 (range 0.5-5.0) years, either until the start of dialysis (n = 5) or until the last follow-up without dialysis (n = 2).
Conclusions:
This case series showed that withdrawal of ACEIs in children with CKD stage 4-5 and rapidly declining kidney function may lead to an increase in eGFR.
Traditional Chinese Medicine Enema Therapy in a Patient With a Confirmed Negative SARS-CoV-2 Test in the Respiratory Tract but Positive in the Intestinal Tract: A Case Report
Authors: Yuzhu Dai, Zhiyou Zhao, Huajun Zhou, Dedong Huang, Jianjun Luo, Cunhai Zhang, Qingyong Chen, Xingcan Chen, Yuan Yao, Xiaoxiao Jiang, Jun Cheng
Journal: Front Public Health (2021)
Keywords: sars-cov-2 infection, discharge standard, fecal-oral transmission, nucleic acid test of sars-cov-2, traditional chinese medicine enema therapy
MeSH terms: COVID-19, SARS-CoV-2, Case Reports, Research Support, Non-U.S. Gov't, Adult, Enema, Humans, Intestines, Male, Medicine, Chinese Traditional, Respiratory System

We report the case of a 43-year-old man who was infected with SARS-CoV-2 in February 2020 and actively cooperated with treatment in the hospital. During the course of treatment, we found that the respiratory SARS-CoV-2 nucleic acid became negative, but remained positive in the intestinal tract. As a result, we adjusted the treatment plan to include traditional Chinese medicine enema treatment. The patient had negative intestinal SARS-CoV-2 nucleic acid test within 4 days, and the subsequent repeated review of intestinal SARS-CoV-2 nucleic acid was negative, and the virus was undetectable. It is suggested that traditional Chinese medicine enema treatment may be helpful to remove the SARS-CoV-2 in the intestines of patients with COVID-19 infection, and may support the treatment of patients with respiratory SARS-CoV-2 nucleic acid negative and positive in the intestinal tract.
Atrioventricular Block: A Heralding Sign of Cardiac Allograft Rejection
Authors: S Shafaghi, F Naghashzadeh, B Sharif Kashani, N Behzadnia, Z H Ahmadi
Journal: Int J Organ Transplant Med (2020)
Keywords: arrhythmia, heart transplant, rejection, second degree av block
MeSH terms: Case Reports

Heart transplantation is the treatment of choice for those with end-stage heart failure. However, despite improvements in immunosuppressive treatment, patients are at significant risk of allograft rejection, especially early after transplantation. Any changes in patient's heart condition including reduced left ventricular ejection fraction, arrhythmia and any types of blocks need attention. Herein we report on a 29-year-old man who underwent heart transplantation 5 years before due to dilated cardiomyopathy. He was on immunosuppressive therapy and was good until one week before his admission, when he felt palpitation. Electrocardiography during palpitation showed a second-degree AV-block with heart rate of 60 beats/min. Echocardiography showed good left ventricular systolic function with no regional wall motion abnormality. The patient referred for coronary angiography and endomyocardial biopsy. The angiography was normal. The biopsy showed rejection compatible with ISHLT grade 2R. After treating the patient with 1.5 g methylprednisolone, the symptoms relieved and the block resolved. Bradycardia and second-degree AV-block late after heart transplantation could be a sign of cardiac allograft rejection and need more evaluation, especially endomyocardial biopsy.
Langerhans cell histiocytosis of the clavicle in a 13-year-old boy
Authors: Shital N Parikh, Vishal R Desai, Anita Gupta, Christopher G Anton
Journal: Case Rep Orthop (2014)

Langerhans Cell Histiocytosis (LCH) is a rare neoplasm characterized by abnormal proliferation of histiocytic cells. In this case report, we describe a unique case of a 13-year-old boy who presented to the clinic with an insidious onset of mid-clavicular pain. The provisional radiologic diagnosis of Langerhans Cell Histiocytosis of the clavicle was confirmed by an incisional biopsy of the left mid-clavicle lesion. The patient's lesion was treated by curettage, bone grafting, and internal fixation, due to the presence of pathologic fracture. At the 2-year followup, the patient was asymptomatic, and the lesion showed complete resolution without recurrence. The case report highlights the characteristic features of Langerhans Cell Histiocytosis in an unusual location, the knowledge of which would help avoid delayed or missed diagnosis in the future.
Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
Authors: Michiaki Nagai, Keigo Dote, Masaya Kato, Shota Sasaki, Noboru Oda, Carola Y Förster
Journal: Front Neurosci (2022)
Keywords: hfpef, sglt2i, intrarenal venous flow pattern, laterality, renal congestion, vagus nerve stimulation
MeSH terms: Case Reports

Renal congestion in heart failure (HF) is a predictor of the prognosis of cardiovascular disease. The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and vagus nerve stimulation (VNS) on renal congestion has not been reported in HF. A 77-year-old man with HF with preserved ejection fraction (HFpEF) was referred to our hospital because of poor response to loop diuretics. Echocardiography showed severe tricuspid regurgitation with dilation of the right atrium. Three months after adding SGLT2i, body weight was lost without worsening of renal function. Left and right doppler-derived intrarenal venous flow (IRVF) has been changed from a monophasic to a discontinuous pattern with a systolic interruption. One month later, he discontinued SGLT2i administration at his own discretion. In order to stabilizing autonomic balance, transcutaneous VNS (tVNS) was performed via left ear tragus. One hour after transcutaneous tVNS, ipsilateral IRVF has been dramatically improved from a fusional biphasic to a discontinuous pattern with a systolic interruption. SGLT2i and tVNS may be associated with renal decongestion in HFpEF.
Metastatic mesenteric dedifferentiated leiomyosarcoma: a case report and a review of literature
Authors: Mercy Varghese, Oyvind Bruland, Anne Marit Wiedswang, Ingvild Lobmaier, Bård Røsok, Robert S Benjamin, Kirsten Sundby Hall
Journal: Clin Sarcoma Res (2016)
Keywords: abdominal, chemotherapy, histological-subtype, leiomyosarcoma, mesenteric, metastases, multimodal
MeSH terms: Case Reports

Background:
Abdominal leiomyosarcoma arising from the mesentery is a rare malignancy. It is an aggressive entity with an overall 5 year survival rate between 20 and 30 %. Surgical resection is the cornerstone of primary treatment and may be curative for localized disease. However, patients often develop intra-abdominal relapse and/or metastatic disease. If surgical resection is not feasible, palliative chemotherapy is the treatment of choice. However, there are no clear guidelines regarding chemotherapy; neither in the adjuvant nor advanced setting.
Case presentation:
We present a 40 year-old woman, with a mesenteric leiomyosarcoma, who underwent radical tumor resection and did not receive adjuvant oncological therapy. Three months postoperatively, she developed metastatic disease to the lungs and liver. After multidisciplinary assessment she received an unconventional histological-subtype-tailored chemotherapy comprising 3-4 regimens. Initially, there was a decrease both in number and size of metastases. Ultimately, an almost complete radiological response was seen. Subsequent surgical resection and radiofrequency ablation of residual metastatic foci in the liver and lung brought her into complete clinical remission. She is presently tumor free, 36 months following diagnosis of metastatic disease.
Conclusions:
To our knowledge, this is the first report of a patient with metastatic mesenteric leiomyosarcoma who is in complete clinical and radiological long-term remission following very aggressive multimodal treatment; including intense poly-drug chemotherapy and without any demonstrable long-term side effects. Given the rarity of mesenteric leiomyosarcoma and lack of guidelines regarding oncological therapy, we suggest that multimodal therapy including aggressive chemotherapy, guided by a multidisciplinary team, is essential to achieve an optimal outcome.
Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson's Disease, and Torticollis: Surgical Management
Authors: Sarah Merrill, Maziyar A Kalani, Naresh P Patel, Mark K Lyons, Matthew T Neal
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Case Report. Spine surgery in patients with Parkinson's disease (PD) involves increased risk. We describe a case of cervical myelopathy in a patient with PD, multiple fractures involving the atlas and axis vertebrae, and spasmodic torticollis. The patient was successfully treated with an upper cervical decompression and occipital-cervical (OC) fusion surgery. Strategies for torticollis reduction and successful surgical outcome are discussed. Risks and benefits must be carefully weighed when considering occipital cervical fusion in PD patients. Conclusion. Intraoperative manual reduction of laterocollis is possible after general endotracheal anesthesia, and continuous neuromonitoring is established. Use of optimizing strategies such as perioperative botulinum injections and intraoperative O-arm navigation should be considered.
Pain management in pediatric age group
Authors: R Namrata, Pv Ramamani, G Saroja
Journal: Indian J Palliat Care (2009)
Keywords: cancer pain, oral morphine, pediatric
MeSH terms: Case Reports

The management of pain in palliative care of children is somewhat different from that in adults. The use of opioids in pediatric palliative care presents some unique challenges. Confident and rational use of opioids, illustrated by WHO Guidelines is essential for adequate management of pain in children with life limiting conditions.
Screening for the causes of refractory hypoxemia in critically ill patients: A case report
Authors: Wanglin Liu, Xin Ding, Huaiwu He, Yun Long, Na Cui
Journal: Front Med (Lausanne) (2022)
Keywords: causes, echocardiography, electrical impedance tomography, hypoxeima, lung ultrasound
MeSH terms: Case Reports

Hypoxemia was a very common symptom in critical patients and should be treated immediately before resulting in permanent organ failure. Rapid diagnosis of the etiology of hypoxemia could be achieved by combining the use of various bedside and radiation-free techniques such as lung ultrasound, electrical impedance tomography and echocardiography. By presenting a case of serious acute refractory hypoxemia, we proposed an efficient protocol for diagnosing and treating hypoxemia in a safe and fast way.
Gastric and colonic erosion caused by laparoscopic gastric band: a case report
Authors: Luis E Gonzalez, Rajendra P Kedar
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Laparoscopic adjustable gastric banding is commonly used to treat obesity. It rarely results in complications, one of which is gastrointestinal erosion. Simultaneous erosion of the stomach and colon is a rare finding that has been documented in only a few case reports. We present a 62-year-old female with abdominal pain, nausea, and hematochezia. She was found to have simultaneous gastric and colonic erosion identified on CT scan. Imaging findings were confirmed and device was removed during surgery.
Failure of asnis iii 5.0 mm cannulated screw: a case report
Authors: A Chen, C Willis-Owen, K Akhtar, S Kamineni
Journal: Cases J (2010)

We describe a case of an ASNIS III 5.0 mm partially threaded cannulated screw unthreading itself as it was being inserted during fracture fixation of a humerus. The majority of complications associated with cannulated screws involve breaking of the screw, as opposed to unthreading. We believe that the self tapping design of the screw, in combination with the cannulated design, creates a potential area of weakness when used on hard bone.