OpenMed/multicare-articles huggingface dataset:
Fibrous dysplasia - differential diagnosis of cystic lesions in the proximal femur:a case report
Authors: Stefan Endres, Axel Wilke
Journal: Cases J (2009)

Background:
We are reporting about the case of a 22-year old woman, who made a first visit as an outpatient with pain that arose in acute form in the area of the left groin. The patient history did not indicate a preceding trauma, or an inflammatory or malignant disease.
Case presentation:
Conventional X-ray showed the image of a cystic lesion in the area of the neck of the thigh [collum femoris] with pathological fracture in the area of the calcar. The MRT produced the diagnosis of an aneurismal bone cyst, in which the presence of juvenile bone cyst or a giant cell tumor could be taken into consideration by differential diagnosis.Owing to the pathological fracture, repair by operation of the lesion was carried out by means of spongioplastic surgery and internal fixation (DHS).
Conclusion:
Histology produced characteristic findings fitting the condition of fibrous dysplasia, which was not included among the primary causes in the considerations offered by differential diagnosis.Therefore, this case is a good example of the fact that fibrous dysplasia must be taken into account when using differential diagnosis as one of the cystic lesions.
Autotransplantation and Orthodontic Treatment after Maxillary Central Incisor Region Trauma: A 13-Year Follow-Up Case Report Study
Authors: Farzad Piroozmand, Hossein Hessari, Mohsen Shirazi, Pegah Khazaei
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

The anterior maxilla is the most prone region to the trauma during childhood, and tooth loss sometimes happens due to trauma. Replacing the missing teeth has always been one of the dentists' challenges in children and adolescents, since their dentofacial growth is not complete. Autotransplantation of mandibular premolars with two-thirds or three-quarters of root formation provides the best prognosis for the tooth survival. This case report describes the management of a 10-year-old boy suffering a severe dental injury who received the autotransplantation of the premolars from mandible to restore the space caused by trauma in maxillary central incisor region and a 13-year follow-up of the autotransplantation.
A Case of Multivessel Coronary Artery Disease and Anomalous Origin of the Right Coronary Artery With a Malignant Course Presenting With Non-exertional Chest Discomfort and Brugada Phenocopy
Authors: Maan Kathryn L Gozun, Isaac Mizrahi, Mohammed Ali, Dipanjan Banerjee, Peter Tsai
Journal: Cureus (2023)
Keywords: caa
MeSH terms: Case Reports

Coronary artery anomalies (CAAs) are an uncommon cause of chest pain in the younger population. Misdiagnosis can be detrimental and lead to sudden cardiac deaths. We present a 62-year-old male with a past medical history significant for chest pain history with a workup in 2001 presumed to be non-cardiac in origin from bronchial asthma. He presented from a Micronesian Island for the evaluation of non-exertional chest discomfort. Further workup showed a Brugada type I pattern on ECG and ST wave depressions on anterolateral and inferior leads with associated AVR elevation on exercise stress testing. Further ischemic workup with coronary angiography revealed right dominant circulation with three-vessel coronary artery disease (CAD), including mid-left anterior descending (LAD) artery chronic total occlusion (CTO) with the right to left collaterals, left circumflex, and right coronary artery (RCA) with the accompanied anomalous origin of RCA. The patient underwent surgical correction of the anomalous RCA and coronary artery bypass grafting for the multi-vessel CAD. CAAs are usually found incidentally during ischemic workups similar to this case. Patients with CAAs can be managed conservatively with caution regarding physical activity. However, high-risk patients will warrant surgical treatment to avoid sudden cardiac death. The diagnosis of CAAs can be challenging and prone to misdiagnosis and maltreatment. It may be beneficial to pursue this in younger patients with ischemia-like symptoms. Further studies should be performed to identify the true incidence and guide medical practitioners regarding the risks, costs, and benefits of diagnosing and surgically treating CAAs in the general population.
A cyst in the mist: bronchogenic mediastinal cysts
Authors: Sowmya Prasanna Kumar Menon, Lianne Wachira, Lakshmi Srinivasan
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

Malformations of the bronchopulmonary foregut can lead to the formation of bronchogenic mediastinal cysts (BMC). BMC are rare congenital malformations usually found in the middle or posterior mediastinum. Only one-third of patients with BMC are symptomatic. We report a case of BMC in a 48-year-old female who was referred to the cardiothoracic surgeons due to an incidental finding of an anterior mediastinal mass on investigation for intermittent chest pain. The mass was treated surgically with a partial median sternotomy and mass excision. The patient's symptomology and mass histology were atypical for BMC. At follow-up, the patient reported no residual symptoms. This case demonstrates the significance of considering BMC, especially the anterior subtype, as a differential diagnosis in the findings of patients with intermittent chest pain and computerized tomography findings of a mediastinal mass.
Negative Myoclonus Secondary to Thalamic Infarction: Case Report
Authors: Talita Aparecida Conte, Leo Coutinho, Hélio A Ghizoni Teive
Journal: Tremor Other Hyperkinet Mov (N Y) (2021)
Keywords: hyperkinesias, movement disorders, myoclonus, stroke, thalamus
MeSH terms: Movement Disorders, Myoclonus / complications, Myoclonus / drug therapy, Stroke / complications, Stroke / diagnostic imaging, Case Reports, Aged, Arm, Cerebral Infarction / complications, Cerebral Infarction / diagnostic imaging, Humans, Male

Background:
Movement disorders are an infrequent presentation to stroke, and in this context, negative myoclonus is not among the most common movement disorders, hence we present a case of negative myoclonus secondary to thalamic stroke.
Case:
A 75 year old male presented with left central facial palsy and negative myoclonus on his left upper limb. He was submitted to a diagnostic workup, with evidence of a right thalamic stroke. He was started on Phenobarbital 50 mg and the movement disorder resolved.
Conclusion:
Given the relevance of cerebrovascular disease as a cause of morbidity and mortality, it is important to the clinician to be aware of the less typical presentations such as the observed in our case, in order to provide adequate care to the patient.
Mast cell leukemia associated with undefined morphology and chronic basophilic leukemia
Authors: Cavit Cehreli, Inci Alacacioglu, Ozden Piskin, Halil Ates, Ruksan Cehreli, Gizem Calibasi, Erdinc Yuksel, Sermin Ozkal, Guner H Ozsan
Journal: BMC Hematol (2014)
Keywords: basophilia, dysplasia, interleukin-6, mast cell leukemia, mastocytosis
MeSH terms: Case Reports

Background:
Mast cell leukemia (MCL) is rare type of neoplasia with an incidence of 1% in a large series of 342 adult patients with systemic mastocytosis (SM). Chronic basophilic leukemia (CBL) is an extremely rare type of leukemia with appearance of 7 cases in the literature.
Case presentation:
A 73 year-old female patient who presented with weaknes, had a prolonged duration of hematologic remission after treatment of her CBL by hydroxyurea (HU). Evolution of SM occurring as a second neoplasia concurrently with relapse of de novo CBL was demonstrated by mast cells (MCs) infiltration in the bone marrow (BM) biopsy and smear and increase in tryptase level. Transformation to MCL with simultaneous occurrance of accelerated phase of CBL were documented by the appearance of MCs in both BM and peripheral blood (PB) smears, antigen expressions detected by flow cytometry and spesific stains. Sequence analysis of c-kit gene revealed c-kit exon 11 K550N mutation. Undefined associations of MCL with different mast cell morphology, increase in IL-6 level and accelerated phase of de novo CBL was described.
Conclusion:
Elevations in CRP and IL-6 levels occurring with increases in basophil counts to high levels revealed that febrile episodes with abdominal pain seen in our patient were induced by increase in IL-6 levels released from neoplastic basophils. Neoplastic basophils with diffuse and coarse basophilic granules possibly mimic neutrophils with toxic granules and cause wrong characterization of neoplastic basophils as neutrophils by the automated blood cell counters and misleaded physicians.
CEUS Retrograde Cystography Is Helpful in Percutaneous Drainage of Complex Posttransplant Lymphocele
Authors: Stefano Di Domenico, Valentina Patti, Federico Fazio, Elisabetta Moggia, Iris Fontana, Umberto Valente
Journal: Case Rep Urol (2012)
MeSH terms: Case Reports

After monolateral dual kidney transplantation, a 69 years old male patient developed symptomatic lymphocele with mild hydroureteronephrosis, impaired renal function, and right inferior limb oedema. A percutaneous ultrasound-guided drainage of the fluid collection was planned, but the complex mutual relations between the collection and the renal hilus did not allow to identify a suitable route for a safe drainage insertion during conventional ultrasound examination. A retrograde cystography using echographic contrast agent was, therefore, performed, and it clarified the position of both ureters and the renal vessels, permitting an harmless ultrasound-guided percutaneous lymphocele drainage. In conclusion contrast-enhanced ultrasound retrograde cystography may be helpful in percutaneous drainage of complex posttransplant lymphocele.
Transformation of a cutaneous follicle center lymphoma to a diffuse large B-cell lymphoma-an unusual presentation
Authors: J Dias Coelho, F Diamantino, I Costa, P Farinha, P Gameiro, M Sebastião, J Baptista
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Primary cutaneous follicle center lymphoma (PCFCL) is characterized by a proliferation of follicle center cells in the skin. A definitive diagnosis is frequently delayed because of difficulties in interpretation of the histopathologic findings. It has an excellent prognosis with a 5-year survival over 95% and its risk of transformation has not been established. We describe a case report of man with a gastric diffuse large B-cell lymphoma (DLBCL) referred to our clinic because of nodules in the back that had gradually developed over a period of 10 years. A biopsy performed 3 years before was interpreted as reactive follicular hyperplasia. A new skin biopsy revealed a diffuse large B-cell lymphoma and immunoglobulin heavy chain gene rearrangements from the initial skin biopsy (PCBCL) and the DLBCL gastric biopsy were studied by polymerase chain reaction and an identical clonal rearrangement was detected which was highly suggestive of a transformation lymphoma.
Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma
Authors: Kei Nagai, Hiroaki Tachi, Kohei Inoue, Atsushi Ueda
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Malignant pleural mesothelioma is rarely associated with nephrotic syndrome. Cryoglobulinemia is found in various pathological statuses, such as hepatitis C virus infection but rarely in malignant neoplasms. We recently encountered a patient with malignant mesothelioma coincident with nephrotic syndrome and cryoglobulinemia in the course of chemotherapy. A 60-year-old man employed as a building painter was diagnosed with malignant mesothelioma by lung biopsy two years earlier and was started on chemotherapy. Nivolumab seemed effective in controlling mesothelioma, but skin immune-related adverse events occurred during the course of treatment. After discontinuation of nivolumab and administration of gemcitabine as an alternative therapy, the patient was referred to a nephrologist because of the subsequent development of edema, renal injury, and proteinuria. Following the investigation, he was diagnosed with nephrotic syndrome and cryoglobulinemia with C4-dominant cold activation. However, a percutaneous renal biopsy could not be performed due to persistent severe cough induced by pleural involvement. The patient died a little over three years after the pathological diagnosis of pleural mesothelioma. Our case had three key features nephrotic syndrome was possibly associated with malignant mesothelioma; cryoglobulinemia occurred in malignant mesothelioma; and concomitant nephrotic syndrome and cryoglobulinemia occurred after chemotherapy. Unfortunately, our rare case lacks a basis in renal pathology or evidence of links between the pathogenesis of malignant mesothelioma, cryoglobulinemia, and nephrotic syndrome. This case does not provide a causal mechanism, but may be worth adding to the case list as one of the rare renal involvement in a patient with malignant mesothelioma.
Case Report: Ovarian pregnancy, a rare but lethal condition: An analysis of 112 cases
Authors: Mengyuan Shao, Xinyi Wang, Xin Zhou
Journal: Front Surg (2023)
Keywords: laparoscopy surgery, ovarian ectopic pregnancy, reproductive outcomes, risk factors, ultrasonic classification
MeSH terms: Case Reports

Study objective:
To explore how to improve the treatment, and prognosis of ovarian pregnancy (OP).
Patients:
A total of 111 OP patients, one of the patients suffered from OP twice.
Results:
In this study, 112 OP cases confirmed by postoperative pathology were retrospectively analyzed. Common risk factors for OP were previous abdominal surgery (39.29%) and intrauterine device use (18.75%). We modified the ultrasonic classification into four types: gestational sac type, hematoma type I, hematoma type II, and intraperitoneal hemorrhage type. Among these four types, the proportion of patients who underwent emergency surgery as initial treatment after admission was 68.75%, 10.00%, 92.00%, and 81.36%, respectively. The treatment for hematoma type I patients was often delayed. The rate of OP rupture was 86.61%. All methotrexate therapy for OP patients failed. All these 112 cases underwent surgery treatment finally. The surgical procedures were pregnancy ectomy and ovarian reconstruction by laparoscopy or laparotomy. No significant differences were observed in the operation time or intraoperative blood loss between laparoscopy and laparotomy. Laparoscopy showed less influence on patients regarding length of hospital stay and postoperative fever than laparotomy. Further, 49 patients who desired fertility were followed up over 3 years. Among them, 24 (48.98%) experienced spontaneous intrauterine pregnancy.
Conclusion:
Among the four modified ultrasonic classifications, hematoma type I was associated with more delays in surgical time. Laparoscopic surgery was a better choice for OP treatment. The reproductive prognosis of OP patients was promising.
Fluorescent tetracycline bone labeling as an intraoperative tool to debride necrotic bone during septic hip revision: a preliminary case series
Authors: Ernesto Muñoz-Mahamud, Jenaro Ángel Fernández-Valencia, Andreu Combalia, Laura Morata, Álex Soriano
Journal: J Bone Jt Infect (2021)

A plausible cause of persistent infection after septic hip revision may be the presence of nonviable osteomyelitic bone. Since surgical excision of these necrotic fragments is often challenging, the use of fluorescent tetracycline bone labeling (FTBL) as an intraoperative tool may pose an additional assessment aid to provide a visual index of surgical debridement. Methods: We present a single-center study performed in a university hospital from January 2018 to June 2020, in which all consecutive cases of chronic hip periprosthetic joint infection (PJI) undergoing revision using FTBL were retrospectively reviewed. In all cases, the patient was under treatment with tetracyclines at the moment of the revision surgery. During the surgery, all bone failing to fluoresce was considered nonviable and thus removed and sent for both culture and histology. Results: We include three cases in which the FTBL technique was used. In all cases, the histopathological examinations of the nonfluorescent removed bone were consistent with chronic osteomyelitis. Conclusion: The intraoperative use of FTBL successfully aided the surgeon to detect the presence of nonviable bone in all the presented cases of chronic prosthetic hip infection.
Reformed child and adolescent mental health services in a devolved healthcare system: a mixed-methods case study of an implementation site
Authors: Emily Banwell, Neil Humphrey, Pamela Qualter
Journal: Front Health Serv (2023)
Keywords: child and adolescent mental health, implementation science, mental health services, programme evaluation, reformed health services

Background:
Efforts are being made to reform and reconceptualise children and young people's (CYP) mental health services. This is in response to a rapid increase in mental health difficulties in this population, and the shortcomings of current service provision. The present study seeks to comprehensively evaluate the local implementation of the THRIVE Framework for System Change in Greater Manchester, UK (GM i-THRIVE) from 2018 to 2021. The framework was designed to change the way mental health is perceived, and subsequently how support is allocated. The current study focusses on the implementation of the framework's principles into CYP mental health support in the region.
Methods:
The study comprised three methodological components, beginning with examination of the GM i-THRIVE implementation plan and self-assessment questionnaire measure using the Quality Implementation Tool. This was to provide a wider backdrop of implementation method adequacy to the rest of the study's findings. Subsequently, evaluation measures completed by professionals across Greater Manchester were examined to establish implementation progress, before corroborating key items from this measure with thematically analysed interview data from six CYP (13-22 years) who recently received mental health support in the region. Levels of agreement between staff and CYP were examined.
Results:
GM i-THRIVE's implementation plan and self-assessment measure were respectively deemed a strong guiding foundation, and a suitable way of evaluating implementation progress. Every principle within the self-assessment measure demonstrated closer alignment with the THRIVE Framework as time progressed. Two themes were developed from the qualitative interview data, each overarching four subthemes: (1) Qualities of the service: information and decision sharing; communication and continuity; needs-based support; compassion and trust, and (2) The mental health journey: beginnings; endings; waiting; satisfaction with support. A good level of agreement between CYP testimony and staff progress reports was found.
Conclusions:
Findings suggested that the experiences of the CYP in the sample, who were interviewed in the spring to summer period of 2022, were overwhelmingly positive. The rich insights into mental health support offered by the young participants lead us to recommend continued qualitative research with service-users as GM i-THRIVE's embedding period continues, with focus on representing a wide range of experiences in future research samples. Methodological limitations were explored, including the extent to which true cross-references could be made between professional and CYP accounts.
Large retroperitoneal cystic lymphangioma mimicking mesenteric cyst: a case report
Authors: Deepak Rajput, Kandhala Srikanth, Amit Gupta, Arvind Kumar, Sanketh Edem, Lena Elizabath David, Krishna Sai Bhukya
Journal: Pan Afr Med J (2022)
Keywords: retroperitoneal cyst, case report, cystic lymphangioma, primary retroperitoneal mass
MeSH terms: Lymphangioma, Cystic, Mesenteric Cyst, Retroperitoneal Neoplasms, Case Reports, Adult, Child, Humans, Mesentery, Abdominal cystic lymphangioma

Cystic lymphangioma is a benign tumour that occurs secondary to obstruction of lymphatic channels. Its appearance in the paediatric age group is quite common, but adulthood presentation is infrequent. Common locations are head and neck areas, whereas intra-abdominal occurrence is rare. To date, a few retroperitoneal cystic lymphangioma cases have been reported. A pre-operative clinical detection is always confusing, and most often, the diagnosis rests over the intraoperative findings and histopathological examination. The cyst's complete surgical resection remains the treatment of choice in patients with bulky, rapidly growing lesions or symptoms. Herein, we report a large retroperitoneal cystic lymphangioma that mimicked the mesenteric cyst clinically.
Case Report: Sudden Fatal Hemorrhage in Ulcerative Fungal Laryngotracheitis-A Pediatric Case Report
Authors: Andrea Porzionato, Elena Stocco, Aron Emmi, Veronica Macchi, Raffaele De Caro
Journal: Front Pediatr (2022)
Keywords: aspergillus laryngotracheitis, acute lymphoblastic leukemia, hemoptysis, inferior thyroid artery, invasive aspergillosis, laryngotracheal ulcers
MeSH terms: Case Reports

In this report, we describe an autopsy case of a child affected by acute lymphoblastic leukemia and opportunistic pulmonary aspergillosis. The patient died because of a full-thickness tracheal wall ulceration with right inferior thyroid artery lesion and sudden hemorrhage, likely ascribable to undiagnosed invasive Aspergillus laryngotracheitis. Aspergillus infection, particularly in immunocompromised patients, should be considered an urgent risk factor to manage as it may lead to sudden fatal events in absence of evident critical symptoms.
Etanercept in the treatment of recalcitrant enteropathic arthritis: a case report
Authors: Mohd Shahrir Mohamed Said, Sazliyana Shaharir, Sakthiswary Rajalingham, Sheikh Anwar Abdullah, Aizan Bin Hassanudin, Ngiu Chai Soon, Mohd Shahdan Shahid
Journal: J Med Case Rep (2012)

Introduction:
Enteropathic arthritis is one of the recognized extraintestinal manifestations of inflammatory bowel disease and affects up to 25% of patients. The treatment options for refractory disease were rather limited and ineffective until the arrival of biologic therapy in the last few years. The use of etanercept was unique for this disease.
Case presentation:
In this case report, a 58-year-old Malay woman with a 17-year history of ulcerative colitis had persistent left knee effusion and synovitis for seven years, despite remission of the primary disease. She had had multiple courses of systemic and intra-articular steroid that caused significant systemic side effects such as impaired fasting glucose, hypertension, cataract, and weight gain. She also had a total left knee replacement for secondary osteoarthritis. But the left knee synovitis and effusion recurred a month after the total knee replacement, and she was subjected to a total synovectomy the following year. In view of failure of remission despite multiple immunosuppressants (100 mg of azathioprine daily, 1 g of sulfasalazine twice a day, 10 mg of prednisolone daily, and 10 mg of methotrexate weekly), 25 mg of subcutaneous etanercept twice weekly was started. After 5 weeks of treatment, complete resolution of left knee effusion and normalization of the inflammatory markers were shown. This continued up to 12 months of follow-up while our patient was on etanercept and 10 mg of methotrexate weekly. No relapse or serious side effects were noted.
Conclusions:
This case demonstrates the efficacy of etanercept in recalcitrant enteropathic arthritis with no relapse of the underlying colitis while on treatment. The usage of this tumor necrosis factor inhibitor was unique in this case of rheumatology and gastroenterology.