OpenMed/multicare-articles huggingface dataset:
Desmoplastic Fibroblastoma Invading the Humerus
Authors: Tomoya Matsunobu, Akira Maekawa, Suguru Fukushima, Mao Jotatsu, Kosuke Makihara, Masanori Hisaoka, Yukihide Iwamoto
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Desmoplastic fibroblastoma (DFB) is an uncommon, benign, soft tissue tumor. The tumor most often presents as a slowly growing, painless soft tissue mass and is usually small. There have been only a few reports of patients with DFB who presented with bone invasion. Herein, we report the case of a 66-year-old woman with DFB with bone invasion in her left axilla. A lump under the left axilla was detected and was associated with pain and limited range of motion (ROM) of the shoulder. Computed tomography showed a soft tissue mass with invasion of the adjacent left humerus. Magnetic resonance imaging revealed a lesion with low signal intensity on T1- and T2-weighted images, and weak internal enhancement on postcontrast T1-weighted images with fat suppression. Histologic evaluation of a preoperative needle biopsy revealed DFB with FOSL1 expression. The tumor was marginally excised. Postoperative outpatient follow-up demonstrated a significant improvement in pain and ROM of the shoulder and no recurrence after 1 year. Even though DFB with bone invasion can cause pronounced clinical symptoms with pain and limited ROM, we conclude that simple excision is an adequate treatment.
Severe Multiple Sclerosis Relapse After COVID-19 Vaccination: A Case Report
Authors: Giorgia T Maniscalco, Valentino Manzo, Maria E Di Battista, Simona Salvatore, Ornella Moreggia, Cristina Scavone, Annalisa Capuano
Journal: Front Neurol (2021)
Keywords: covid-19 vaccine, acute relapse, case report, cladribine, multiple sclerosis
MeSH terms: Case Reports

We describe a case of acute relapse in a woman with Multiple Sclerosis (MS) shortly after the mRNA COVID-19 vaccination. The patient received a diagnosis of MS in November 2016 at the MS Centre of the A. Cardarelli Hospital (South of Italy). Since that moment, her clinical conditions and pharmacological therapies have been managed at this MS centre where, according to national recommendations, in April 2021, the patient received the BNT162b2 vaccine. Almost 48 h after receiving the vaccine, the patient developed paraesthesia and weakness in her left arm and limbs. The neurological examination revealed walking difficulties while the MRI showed three new voluminous enhancing lesions. After having received methylprednisolone iv for 5 days, the patient's neurological symptoms fully recovered. Along with the implementation of COVID-19 vaccination programmes among vulnerable population, further studies are needed in order to improve our knowledge on the benefit/risk ratio of COVID-19 vaccines.
Case report: Hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma: a rare case and review of the literature
Authors: Shuai Yan, Zhiqiang Yue, Peng Zhang, Liuxia Yuan, Huixuan Wang, Fei Yin, Linglin Ju, Lin Chen, Weihua Cai, Yi Ni, Jinzhu Wu
Journal: Front Med (Lausanne) (2023)
Keywords: case report, follicular dendritic cell, hepatic, inflammatory pseudotumor, sarcoma
MeSH terms: Case Reports

Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a rare subtype of follicular dendritic cell sarcoma (FDCS) that primarily occurs in the liver and spleen. The etiology of IPT-like FDCS is unknown, and it has nonspecific clinical manifestations, imaging performance and laboratory test results. Recently, a patient with IPT-like FDCS was admitted to our hospital because of abdominal distension and anemia. Over the past 3 years, the patient has been followed up after a liver mass was found in a physical examination. The lesion gradually enlarged and caused compression symptoms. In November 2022, a tumor with a diameter of approximately 20 cm was found in the right posterior lobe of the liver after abdominal enhanced Magnetic resonance imaging (MRI) in our hospital. Liver tumor biopsy before the operation revealed a large number of hyperplastic plasma cells and a small number of spindle cells, and the spindle cells were atypical. After a complete examination, the patient underwent liver resection. Pathology after surgery confirmed liver IPT-like FDCS.
Treatment of proximal patellar tendon rupture with custom-made anchor-like plate and suture: cases report and literature review
Authors: Hongfei Qi, Zhong Li, Teng Ma, Cheng Ren, Yibo Xu, Qiang Huang, Kun Zhang, Ming Li
Journal: Front Surg (2023)
Keywords: bone plates, case report, patellar tendon, rupture repair, surgery
MeSH terms: Case Reports

We reported 2 cases of patellar tendon rupture at the lower pole of the patella. For patellar tendon rupture, simple suture fixation has been proved to be inadequate in strength. Our center uses custom-made anchor-like plate and suture to treat proximal patellar fracture. The fixation strength is reliable, no additional bone tunnel is required, and the fixation of the lower patellar fracture can be achieved at the same time. After the operation, the patient starts functional exercise of the knee joint at an early stage, The function of the knee joint of the patient recovered well after 1 year, without other complications.
A Rare Case of a Bladder Neck Abscess Masquerading as a Benign Mass
Authors: Victor A Abdullatif, Jacob Novack, Philip J Shalhoub, Todd G Campbell, Joel E Abbott
Journal: Case Rep Urol (2022)
MeSH terms: Case Reports

Introduction:
Bladder neck abscesses are rare urologic pathologies with very few cases published in modern literature. This report explores a case of a bladder neck mass incidentally found on computed tomography (CT) imaging in a patient with an iliopsoas abscess. Case Presentation. We present a case of a 60-year-old woman who was recently treated for sepsis secondary to an iliopsoas abscess in July of 2022. A CT scan revealed an indeterminate structure in the posterior inferior left paramedian bladder wall. During a cystoscopy with transurethral resection of the mass, an abscess was uncovered and evacuated. A postoperative Foley catheter was left in place, and the patient recovered without any complications.
Conclusion:
At the time of publication, the patient feels well and denies pain or lower urinary tract symptoms. Although bladder abscesses are exceptionally rare, incidental findings during cystoscopy may warrant further investigation in patients with comorbid abscesses.
Toxic epidermal necrolysis induced by sintilimab in a patient with advanced non-small cell lung cancer and comorbid pulmonary tuberculosis: A case report
Authors: Gang Li, Sheng Gong, Ning Wang, Xiaojun Yao
Journal: Front Immunol (2022)
Keywords: immune-related adverse events (ir-aes), neoadjuvant therapy, non-small cell lung cancer, pulmonary tuberculosis, toxic epidermal necrolysis
MeSH terms: Carcinoma, Non-Small-Cell Lung / complications, Carcinoma, Non-Small-Cell Lung / drug therapy, Carcinoma, Non-Small-Cell Lung / pathology, Lung Neoplasms / complications, Lung Neoplasms / drug therapy, Lung Neoplasms / pathology, Skin Diseases / chemically induced, Stevens-Johnson Syndrome / diagnosis, Stevens-Johnson Syndrome / etiology, Tuberculosis, Pulmonary / complications, Tuberculosis, Pulmonary / diagnosis, Tuberculosis, Pulmonary / drug therapy, Case Reports, Antibodies, Monoclonal, Humanized, Humans, Antibodies, Monoclonal, Humanized, sintilimab

Immune checkpoint inhibitors (ICIs) have had a revolutionary effect on the treatment of patients with advanced non-small cell lung cancer (NSCLC), especially squamous cell lung cancer. However, ICIs may cause associated immune-related adverse events (ir-AEs). No case of sintilimab-induced toxic epidermal necrolysis (TEN) has been reported. In this report, we discussed a patient with advanced NSCLC and comorbid pulmonary tuberculosis who underwent immunotherapy and chemotherapy as neoadjuvant therapy and anti-tuberculosis therapy concurrently. Partial response (PR) of the tumor was achieved after three cycles of neoadjuvant therapy without cutaneous toxicities. Video-assisted thoracoscopic surgery (VATS) left lower lobectomy was performed successfully. Sintilimab and chemotherapy were administered as adjuvant therapy, after which the patient suffered severe TEN that rapidly progressed to cover >50% of the skin. TEN was associated with extensive rashes of the trunk and pruritus. With history of sintilimab use, clinical symptoms, and physical examination, TEN was diagnosed. Intravenous methylprednisolone and oral prednisone were administered until the patient totally recovered from the cutaneous toxicities caused by sintilimab. Monitoring of such rare but severe cutaneous toxicities is essential in patients who are treated with sintilimab.
Tracheostomy and mechanical ventilation weaning in children affected by respiratory virus according to a weaning protocol in a pediatric intensive care unit in Argentina: an observational restrospective trial
Authors: Gustavo Caprotta, Patricia Gonzalez Crotti, Judith Frydman
Journal: Ital J Pediatr (2011)
MeSH terms: Influenza, Human / therapy, Intensive Care Units, Pediatric, Respiratory Insufficiency / therapy, Tracheostomy / methods, Ventilator Weaning / methods, Case Reports, Argentina, DNA, Viral / analysis, Female, Humans, Infant, Influenza A Virus, H1N1 Subtype / genetics, Influenza, Human / complications, Influenza, Human / virology, Male, Positive-Pressure Respiration / methods, Respiratory Insufficiency / etiology, Retrospective Studies, DNA, Viral

We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were successful, the patients failed all extubations. Therefore a tracheostomy was performed and the weaning plan was begun. The strategy for weaning was the decrease of ventilation support combining pressure control ventilation (PCV) with increasing periods of continuous positive airway pressure + pressure support ventilation (CPAP + PSV) and then CPAP + PSV with increasing intervals of T-piece. They presented acute respiratory distress syndrome on admission with high requirements of mechanical ventilation (MV). Intervening factors in the capabilities and loads of the respiratory system were considered and optimized. The average MV time was 69 days and weaning time 31 days.We report satisfactory results within the context of a directed weaning protocol.
An unusual presentation of cutaneous histoplasmosis as a recurrent solitary and spontaneously healing lesion in an immunocompetent patient
Authors: Jessica L Muldoon, Timothy R Wysozan, Yulianna Toubin, Ryan F Relich, Thomas E Davis, Chen Zhang, Ahmed K Alomari
Journal: Access Microbiol (2020)
Keywords: histoplasma, dermatopathology, fungal infections
MeSH terms: Case Reports

Infection with Histoplasma capsulatum typically manifests as a self-limiting pulmonary disease in immunocompetent patients. Systemic symptoms such as cutaneous lesions are associated with immunodeficient states. Our patient was an immunocompetent 68-year-old male who presented with a plaque on his left infraorbital area that was concerning for malignancy. Histological examination of the lesion revealed granulomatous inflammation and small yeast forms suggestive of H. capsulatum. The lesion resolved spontaneously and recurred 1 year later. On recurrence, histological examination again revealed yeast forms consistent with H. capsulatum. Serum and urine testing for H. capsulatum antigen were negative. Next-generation sequencing detected H. capsulatum, which supported the diagnosis of a cutaneous infection. The patient was prescribed and started treatment with itraconazole for 1 year after recurrence of the lesion, and he has not reported further disease recurrence to date. This case is unique because of the presentation of a primary cutaneous recurrent H. capsulatum lesion, and it demonstrated the utility of laboratory testing in its diagnosis.
Piezosurgery-Assisted Surgical Treatment in Impacted Canine Transmigration
Authors: Matheus Francisco Barros Rodrigues, Layla Louise de Amorim Rocha, Rodrigo da Franca Acioly, Cristofe Coelho Lopes da Rocha, Daniel do Carmo Carvalho
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Delayed eruption of a canine tooth may represent a possible impaction. If this is the case, a slight elevation in the palatal or vestibular mucosa is often observed. Cases of transmigration, where the unerupted tooth crosses the midline, are less frequent. This article reports on the piezosurgery-assisted surgical treatment of a transmigrated canine in the mentonian region. Treatment for this condition varies depending on the clinical characteristics, symptoms, and location of the dental element. The surgical treatment established for this case was satisfactory, and full recovery of the patient was achieved without complications such as an intense postoperative inflammatory response.
CT appearance of a patent impar umbilical artery in an adult woman and related anomalies: a case report and review of the literature
Authors: Bernhard Glodny, Benjamin Henninger, Karin Hofmann, Thomas Trieb, Johannes Petersen, Peter Rehder
Journal: Cases J (2009)

Background:
We report on a case of an impar umbilical artery (IUA) in an 18-year-old woman.
Case presentation:
The aorta branched off at level L2 into a ventral IUA and a dorsal aorta. The strong IUA produced the inferior mesenteric artery (IMA), the renal artery of a left-sided duplex kidney, and the right-sided ovarian artery before it turned to the right to merge into the right common iliac artery. From the aorta arose the lumbar arteries, the median sacral artery, lateral sacral arteries, and iliolumbar arteries before it turned to the left. Both vessels were connected by an artery 0.8 cm in diameter running infraperitoneal, from the left side of which the uterine artery arose for a left paramedian uterus didelphys.
Conclusion:
This anatomical situation is presented for the first time using an arterial contrast enhanced CT and is discussed within the context of previously known cases.
C20209T prothrombin gene mutation associated deep venous thrombosis in a hemodialysis patient
Authors: Samer Bani-Hani, Omar Siddiqui, Anami Patel, Arif Showkat
Journal: Clin Nephrol Case Stud (2014)
Keywords: c20209t prothrombin gene mutation, deep vein thrombosis, end-stage renal disease
MeSH terms: Case Reports

Venous thromboembolism (VTE) represents the formation of a blood clot in one of the deep veins of human body. The significant morbidity and mortality rates associated with VTE have spurred increasing investigations seeking to identify causative factors for this complex condition. While the most frequent causes of an inherited hypercoagulable state are the Factor V Leiden mutation and the prothrombin gene mutation, polymerase chain reaction (PCR) analysis has helped to identify other rare causes of inherited VTE. We report a case of a recurrent deep venous thrombosis in an end-stage renal disease patient. All laboratory tests for hypercoagulable states were normal. However, PCR analysis detected a rare polymorphism of prothrombin gene mutation at position C20209T, instead of G20210A. The patient was treated successfully with a high dose of warfarin to maintain adequate anti-coagulation during the 2-year follow-up.
Eltrombopag Improves Refractory Thrombocytopenia in a Patient with Systemic Lupus Erythematosus
Authors: Natsuki Shima, Keiichi Sumida, Masahiro Kawada, Akinari Sekine, Masayuki Yamanouchi, Rikako Hiramatsu, Noriko Hayami, Eiko Hasegawa, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Kenmei Takaichi, Kenichi Ohashi, Takeshi Fujii, Yoshifumi Ubara
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

A 42-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital for evaluation of severe thrombocytopenia. She was treated with steroids, intravenous cyclophosphamide, intravenous immunoglobulin, and plasma exchange, but her thrombocytopenia did not improve. Renal biopsy showed class IV-S(C) + V lupus nephritis, according to the classification of the International Society of Nephrology/Renal Pathology Society. The PA-IgG and serum thrombopoietin (TPO) levels were elevated. Her thrombocytopenia responded to off-label administration of eltrombopag, which was discontinued after 42 months. At 18 months after stopping eltrombopag, the platelet count was 19.3 × 104/μL. Eltrombopag may be a therapeutic option for SLE patients with severe thrombocytopenia refractory to conventional therapy.
Follicular lymphoma presenting as scalp mass deformity: Case Report and Review of the literature
Authors: Divine Nwafor, Walid Radwan, Brandon Lucke-Wold, William Underwood, Kymberly Gyure, Robert Marsh
Journal: Biomed Res Clin Pract (2018)
Keywords: chemo-immunotherapy, follicular lymphoma, radiotherapy, scalp mass

Lymphoma presenting as a scalp mass is a rare but serious medical condition mandating aggressive treatment and neurosurgical intervention. We report a case of 53-year-old male who presented with a large right sided frontal scalp mass and a smaller mass located on the left frontal scalp. After discussion with the patient, it was decided to resect the larger mass for definitive diagnosis. After subtotal resection of the mass, biopsy revealed WHO grade 1 follicular lymphoma (FL), diffuse pattern stage IV. The patient was subsequently treated with 4 grays (Gy) of palliative radiotherapy over 2 fractions to the right frontal scalp and systemic chemo-immunotherapy (6 cycles) followed by rituximab maintenance. Lumbar puncture to obtain cerebrospinal fluid was done a month after therapy began and the results were negative for spread of malignant cells. Approximately 3 months after initiation of therapy, PET/CT showed no evidence of active malignancy and MRI revealed a complete internal resolution of the enlarged right frontal scalp mass. We use this case to provide a detailed discussion regarding disease pathophysiology, early diagnosis, and management.
Acute pulmonary embolism in a child following SARS-CoV-2 infection: a case report
Authors: Amal El Ouarradi, Nabila Chekhlabi, Mahassine Elharras, Ilham Bensahi, Sara Oualim, Fatimazahr Merzouk, Salma Abdeladim, Mohammed Sabry, Nouzha Dini
Journal: Pan Afr Med J (2021)
Keywords: covid-19 children, pulmonary embolism, sars-cov-2 antibody, case report, thromboembolism
MeSH terms: COVID-19 / complications, Pulmonary Embolism / virology, Thrombosis / virology, Case Reports, Acute Disease, Adolescent, Anticoagulants / administration & dosage, Female, Heart Diseases / drug therapy, Heart Diseases / etiology, Humans, Pulmonary Embolism / drug therapy, Thrombosis / drug therapy, Anticoagulants

In children, coronavirus disease 2019 infection is rarely symptomatic. Severe forms with respiratory distress are rare, thromboembolic complications are exceptional. We report a rare case of a 14 years old girl with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was admitted to the hospital for bilateral pulmonary embolism with intracardiac thrombus. The girl progressed well on anticoagulation.
Phenotyping variants of tumefactive demyelinating lesions according to clinical and radiological features-A case series
Authors: Thérèse Boyle, Suran L Fernando, James Drummond, Ariadna Fontes, John Parratt
Journal: Front Neurol (2023)
Keywords: extended disability status scale, case report, case series, giant demyelinating lesions, tumefactive demyelinating lesion (tdl)
MeSH terms: Case Reports

Background:
Tumefactive demyelinating lesions (TDLs) are defined as lesions >2 cm on MRI of the brain. They are identified in a range of demyelinating diseases including massive demyelination due to Marburg's acute MS, Schilder's Disease, Balo's concentric sclerosis, and Tumefactive MS. Apart from the rare demyelinating variants which are often diagnosed histologically, there are no detailed data to phenotype TDLs.
Methods:
We describe the clinical and radiological features of four similar patients with very large TDLs (>4 cm), that are not consistent with the rare demyelinating variants and may represent a distinct phenotype.
Results:
All patients presented with hemiplegia and apraxia. The mean age at onset was 37 years with an equal sex distribution. All patients were diagnosed with Tumefactive demyelination based on MRI and CSF analysis, precluding the need for brain biopsy. All responded to potent immunotherapy (including high dose corticosteroids, plasma exchange, rituximab, and/or cyclophosphamide). The mean lag from diagnosis to treatment was 1 day. The median EDSS at presentation was six and recovery to a median EDSS of two occurred over 6 months.
Conclusion:
We propose that Tumefactive lesions larger than 4 cm are termed "Giant demyelinating lesions" (GDLs) not only on the basis of size, but a rapid and fulminant demyelinating presentation leading to acute, severe neurological disability that is, nonetheless, responsive to immunotherapy. Further clinical studies are required to ratify this proposed phenotype, establish the immunological profile and best treatment for such patients.
Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome
Authors: Jason Deforest Jones, Rishi Pawa
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.
Vulvar Langerhans cell histiocytosis: a case report
Authors: Nadia Khoummane, Cyriane Guimeya, Dominique Lipombi, François Gielen
Journal: Pan Afr Med J (2014)
Keywords: histiocytosis x, langerhans cell histiocytosis
MeSH terms: Histiocytosis, Langerhans-Cell / pathology, Vulvar Diseases / pathology, Case Reports, Female, Granuloma / etiology, Granuloma / pathology, Humans, Middle Aged, Skin Ulcer / etiology, Skin Ulcer / pathology

Langerhans cell histiocytoses (LCH) are a rare group of disorders that comprise a large spectrum of diseases initially known as histiocytosis X. In this case report, we relate a case of LCH affecting the vulva of a 47-year-old female. The patient presented since 3 years with a vulvar lesion characterized by non-healing ulcers and a perineal granuloma on which she underwent surgery. Professionals should keep in mind not to treat straightforwardly lesions of the genital tract as simple sexually transmitted diseases. Chronic, atypical genital lesions seen in women need to be worked up and dealt with accordingly.