OpenMed/multicare-articles huggingface dataset:
Accessory nipple reconstruction following a central quadrantectomy: a case report
Authors: Stefano Magno, Daniela Terribile, Gianluca Franceschini, Cristina Fabbri, Federica Chiesa, Alba Di Leone, Riccardo Masetti
Journal: Cases J (2009)

Introduction:
nipple dichotomy (or intra-areolar polythelia) is a rare congenital malformation in which one or more supernumerary nipples are located within the same areola.A case of a woman undergoing a central quadrantectomy with a contralateral supernumerary nipple used for reconstruction is reported. No other report in the Literature, according to our search, has focused on reconstructive use of an accessory nipple after breast conserving surgery.
Case presentation:
the patient is a 73 year-old Caucasian woman, who two years earlier underwent a lower-outer left Quadrantectomy plus axillary sampling and radiation therapy for a 2,2 cm lobular carcinoma with no lymph node involvement.A routine follow-up assessment showed an important fibrotic change on the operated breast, just across the infra-mammary fold; at a breast Magnetic Resonance Imaging, a 1,5 cm area in retroareolar position, suspicious for local recurrence, was evident.An open biopsy was therefore performed, under local anaesthesia, including the nipple-areolar complex to realize a central Quadrantectomy with a Grisotti procedure; a congenital dichotomic nipple in the contralateral breast was then used to repair the defect through a "nipple-sharing" technique. The final histological examination reported a fibrotic mastopathy without atypias.
Conclusion:
in this case, the "nipple-sharing" technique has allowed in the same time the correction of a rare congenital defect and provided the surgeon with a supernumerary nipple to be used in the immediate reconstruction after breast conserving surgery.
Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy
Authors: Robert Dorrell, Katelyn Madigan, Swati Pawa, Rishi Pawa
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is a technique used to access the biliary tree in patients with surgically altered anatomy. Additionally, development of EUS-HG fistula permits intraductal therapy, thereby preventing patients from requiring surgery or percutaneous transhepatic biliary drainage (PTBD), thus decreasing morbidity. This clinical vignette describes an 83-year-old man with a history of gangrenous cholecystitis requiring cholecystectomy, partial gastrectomy, and Roux-en-Y gastrojejunostomy who presented to an outside hospital with abdominal pain and fever and found to have cholangitis and choledocholithiasis. He underwent two endoscopic retrograde cholangiopancreatography (ERCP) procedures at an outside hospital which were unsuccessful due to an inaccessible major papilla in the setting of the patient's surgically altered anatomy. On arrival to Wake Forest, the patient underwent EUS-HG with successful biliary drainage and resolution of cholangitis. He returned for ERCP three months later with balloon sphincteroplasty, cholangioscopy, and electrohydraulic lithotripsy (EHL) performed through the existing metal stent (hepaticogastrostomy), resulting in stone fragmentation and antegrade removal with balloon sweeps. Repeat cholangioscopy post-EHL and balloon sweeps showed complete duct clearance with no residual stones. The hepaticogastrostomy stent was subsequently removed, and the patient recovered without any complications.
Jerky Movement with Ceftazidime: A Case of Ceftazidime-Induced Neurotoxicity with a Review of the Literature
Authors: Mohammed Al-Sadawi, Romy Rodriguez Ortega, Natalie Sun, Madina Abdurahimova, Samy I McFarlane
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Neurotoxicity manifested as confusion and seizures has been recognized as a side effect of multiple cephalosporins including ceftazidime. Renal impairment and inappropriate dosing are the most common contributors to the development of neurological abnormalities in patients receiving these antibiotics. The presence of baseline neurological abnormalities likely contributes to the frequency of these adverse events. Here, we present a case of a 78-year-old man that developed altered mental status and myoclonic movement after initiation of ceftazidime in the setting of mild renal dysfunction. Resolution of clinical picture was evident after 48 hours of discontinuation of the antibiotic without additional interventions.
Pitfalls in the embolisation of a thyrocervical trunk bleeding: a case report
Authors: Luca Perrucci, Monica Graziano, Zairo Ferrante, Elisabetta Salviato, Aldo Carnevale, Roberto Galeotti
Journal: Patient Saf Surg (2020)
Keywords: embolisation, emergency radiology, haemorrhage, head/neck, trauma
MeSH terms: Case Reports

Introduction:
An intrathoracic bleeding from the thyrocervical branch is not common in blunt trauma, but an interventional radiologist should be aware of the risks in order to prevent complications.
Case presentation:
A 30-year-old male presented with a right pneumo-haemothorax due to active bleeding revealed at contrast-enhanced CT, as a consequence of a fall occurred in the previous week. The patient was treated with endovascular embolisation in an angiographic room with coils placement, since the right thyrocervical artery was found to be supplying the pneumo-haemothorax. A radiculo-medullary branch rose from the thyrocervical trunk, impeding the proximal embolization with microparticles and needing selective isolation of the bleeding artery with the catheter to avoid spinal cord injuries. The treatment had a successful result and the following CT control showed signs of recovering, without any complication.
Conclusion:
Our paper presents a rare contingency, warning the operator to bear in mind the presence of arteries feeding the spinal cord. This crucial detail precludes the use of microparticles embolisation to prevent neurologic sequelae, whereas the use of endovascular coils for embolization should be mandatory. Moreover, this case reminds that the post-traumatic bleeding deriving from a cervical trauma may also occur later.
Wound Complication and Neuropraxia of the Posterior Cutaneous Nerve of the Arm after Primary Repair of a Latissimus Dorsi and Teres Major Tear
Authors: Matthew G Alben, Neil Gambhir, Michael A Boin, Kirk A Campbell, Mandeep S Virk
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

We present a case of a surgically treated latissimus dorsi (LD) and teres major (TM) tear with a one-year outcome. The postoperative course was complicated by wound dehiscence requiring operative intervention and neuropraxia of the posterior cutaneous nerve of the arm. The report highlights previously unreported surgical risks associated with repair of LD/TM tendons.
Charlin'S Syndrome Following a Routine Septorhinoplasty
Authors: Ali Kavyani, Ali Manafi
Journal: World J Plast Surg (2018)
Keywords: charlin’s syndrome, complication, septorhinoplasty
MeSH terms: Case Reports

There are some rare but probable devastating complications following any rhinoplasty. Charlin's syndrome is a typical one. It is completely related to the external nasal nerve. In this report, we are presenting a 21-year-old female with signs and symptoms of Charlin's syndrome, persisting for 4 years after a routine septorhinoplasty operation. Surgery was uneventful and the patient underwent bony septal resection and caudal septal relocation. Osteotomy was internal low to low and external transverse bilaterally. Overall, a routine septorhinoplasty was executed. Everything went well postoperatively, until 4 months after surgery, when some irritating symptoms developed and gradually intensified.
Behavioral activation therapy for depression and anxiety in cancer patients: a case series study
Authors: Takatoshi Hirayama, Yuko Ogawa, Yuko Yanai, Shin-Ichi Suzuki, Ken Shimizu
Journal: Biopsychosoc Med (2019)
Keywords: adjustment disorders, anxiety, behavioral activation therapy, cancer, depression, psychotherapy
MeSH terms: Case Reports

Background:
Behavioral activation therapy (BAT) directly addresses activities that individuals value most highly, and may be easily applicable to cancer patients. However, there is no established evidence of the use of BAT in this population. In this study, we examined the possibility of a BAT program for depression and anxiety in cancer patients.
Case presentation:
We retrospectively reviewed the medical records of cancer patients with each of the following characteristics: 1) were outpatients or inpatients visiting the psycho-oncology division of the National Cancer Center Hospital in Japan; 2) met criteria for Major Depressive Disorder or Adjustment Disorders; and 3) participated in a BAT program. The primary outcome was the program completion percentage. Secondary outcomes were self-reported depression severity (Patient Health Questionnaire-9 (PHQ-9) score), anxiety disorder status (Generalized Anxiety Disorder-7 (GAD-7) score), and clinical improvement (Clinical Global Impression-Improvement (CGI-I) score) after the program. We analyzed both depression and anxiety by the matched paired t-test. Ten patients participated in the program, and nine completed it. One dropped out due to cognitive impairment secondary to brain metastasis. Both the PHQ-9 scores (pre: 14.4 (SD, 6.1); post: 5.1 (SD, 5.8)) and the GAD-7 scores (pre: 11.9 (SD, 4.9); post: 4.7 (SD, 5.5)) significantly improved after the program (PHQ-9: P = 0.0014; GAD-7: P = 0.0004). CGI-I scores ranged from 1 to 3, and all subjects except the patient who dropped out improved clinically. Among the ten patients, three distinctive cases could be observed as follows. Case 1; a 45-year-old housewife with breast cancer who did not agree to take antidepressants because of concerns about the side effects achieved remission without antidepressants and began to live an active life. Case 4; a 66-year-old housewife was so shocked after endometrial cancer diagnosis that she was absent-minded and her compliance with the assigned homework was poor, therefore, her depression did not improve much. Case 9; a 62-year-old man with laryngeal cancer who had recurrent anxiety. Increased business activity, on which he put great value, gradually allowed him to be able to live his life actively without concerns.
Conclusions:
This study suggests that BAT would be effective for the depression and anxiety of cancer patients.
A rare combination of Dermoid cyst and Cystadenoma: Are collision tumors in the ovary a real entity?
Authors: Tushar Kalonia, Neha Kumari, Akanksha Malik, Arvind Kumar, Anupama Bahadur, Sanjeev Kishore
Journal: Autops Case Rep (2021)
Keywords: cystadenoma, mucinous, ovary, teratoma
MeSH terms: Case Reports

Collision tumors have been reported in various organs like the gastrointestinal tract, lung, skin, adrenals, central nervous system, lymph nodes, uterus, but are rarely seen in the ovary. Collision tumors are two histologically distinct neoplasms in the same organ without any intermixture between them. Here we present a case of a collision tumor of the ovary represented by a mucinous cystadenoma and teratoma. It is imperative for a surgical pathologist to correctly diagnose the collision tumor components and differentiate them from mixed tumors as it will dictate the appropriate treatment based on the individual biological aggressiveness of each component.
Multidisciplinary approach for the treatment of horizontal root-fractured maxillary anterior teeth
Authors: Berkan Celikten, Ceren Feriha Uzuntas, Reza Safaralizadeh, Gulbike Demirel, Semra Sevimay
Journal: Case Rep Dent (2014)

Dental trauma can lead to a wide range of injuries of which crown and root fractures are examples. Crown-root fractures often need complex treatment planning. This case report describes the use of MTA in the multidisciplinary management of a patient with a horizontally fractured central incisor and luxation in a different central incisor. A 42-year-old female patient presented within 1 h of receiving direct trauma to her maxillary area. Clinical examination revealed that the right and left maxillary central incisors presented mobility and sensitivity to percussion and palpation but no sensitivity to thermal stimulations. Occlusal displacement with extrusion in the left maxillary central incisor and luxation in the right maxillary central incisor was observed. Radiographic examination revealed horizontal root fracture at the apical third of the left maxillary central incisor. Root fracture in the right maxillary incisor was not observed. Endodontic and aesthetic restorative treatments were completed. MTA showed a good long-term outcome when used in root-fractured and luxated teeth. In addition, composite resin restoration provided satisfactory aesthetic results even after 15 months.
Metastatic insulinoma in a patient with type 2 diabetes mellitus: case report and review of the literature
Authors: Noormuhammad Oosman Abbasakoor, Marie Louise Healy, Donal O'Shea, Donal Maguire, Cian Muldoon, Kieran Sheahan, Dermot O'Toole
Journal: Int J Endocrinol (2011)
MeSH terms: Case Reports

Pancreatic neuroendocrine tumors (NETs) are extremely rare, and although insulinomas are the commonest, less than 10% of insulinomas are malignant. Most patients with insulinomas present with neuroglycopenic symptoms and weight gain attributable to insulin excess. Here, we report a case where a 67-year-old lady with a background history of type 2 diabetes mellitus and breakthrough hyperinsulinism who presented with coma. The biochemical profile revealed features typical of insulinoma, and CT and endosonography confirmed a pancreatic tumor with large volume right-sided liver metastases (biopsy confirming a neuroendocrine tumor). The patient underwent successful one-step RO surgical resection, distal pancreatectomy, splenectomy, and right hepatectomy, and 9 months postoperatively, she remains free of recurrent disease. She remains a diabetic.
Carcinoid Syndrome-Induced Ventricular Tachycardia
Authors: Austin B Rupp, Abdulmohsin Ahmadjee, Jack H Morshedzadeh, Ravi Ranjan
Journal: Case Rep Cardiol (2016)

Introduction. Carcinoid tumors are rare neuroendocrine malignancies that secrete multiple bioactive substances. These bioactive substances are responsible for the carcinoid syndrome characterized by diarrhea, flushing, syncope, and right-sided valvular heart disease. Previous case reports have described carcinoid syndrome associated with coronary vasospasm and the well-characterized carcinoid heart disease. Case. Our patient is a 73-year-old female with complex past medical history most notable for metastatic carcinoid tumors diagnosed in 2013-05. She initially presented in 2014-09 with syncope and dizziness associated with sinus pause on an event monitor. She received a pacemaker given normal left ventricular function and was discharged. However, she was readmitted with similar symptoms corresponding to multiple episodes of ventricular tachycardia. She was started on high-dose beta blockade and has had no recurrence of arrhythmia over a follow-up period of 12 months. Conclusion. We hypothesize that the patient's ventricular tachycardia was mediated by the multiple bioactive substances secreted by her carcinoid tumors. Her carcinoid tumor biomarkers were elevated and other explanations for arrhythmia were investigated and ruled out. To our knowledge, this is the first case of ventricular tachycardia mediated by carcinoid syndrome and suppressed by beta-blocker. Further investigation into this relationship is needed.
Severe hemobilia from hepatic artery pseudoaneurysm
Authors: Fabio Sansonna, Stefano Boati, Raffella Sguinzi, Carmelo Migliorisi, Francesco Pugliese, Raffaele Pugliese
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

Background. Hemobilia is a rare, jeopardizing complication of laparoscopic cholecystectomy coming upon usually within 4 weeks after surgery. The first-line management is angiographic coil embolization of hepatic arteries, which is successful in the majority of bleedings: in a minority of cases, a second embolization or even laparotomy is needed. Case Presentation. We describe the case history of a patient in which laparoscopic cholecystectomy was complicated 3 weeks later by massive hemobilia. The cause of haemorrhage was a pseudoaneurysm of a right hepatic artery branching off the superior mesenteric artery; this complication was successfully managed by one-stage angiographic embolization with full recovery of the patient.
Superior vena cava syndrome caused by a swollen absorbable haemostat after repair of ischaemic mitral regurgitation
Authors: Koki Eto, Mitsuaki Matsumoto, Yoji Kubo, Reiko Kemmochi
Journal: J Cardiothorac Surg (2014)
MeSH terms: Cellulose, Oxidized / adverse effects, Heart Valve Prosthesis Implantation / methods, Hematoma / complications, Mitral Valve Insufficiency / surgery, Myocardial Ischemia / surgery, Postoperative Hemorrhage / prevention & control, Superior Vena Cava Syndrome / etiology, Case Reports, Aged, 80 and over, Cellulose, Oxidized / therapeutic use, Coronary Artery Bypass / methods, Diagnosis, Differential, Echocardiography, Female, Hematoma / diagnosis, Humans, Mitral Valve Insufficiency / complications, Myocardial Ischemia / complications, Postoperative Hemorrhage / complications, Superior Vena Cava Syndrome / diagnosis, Tomography, X-Ray Computed, Cellulose, Oxidized, Surgicel

Surgicel, an absorbable haemostat, is widely used in cardiovascular surgery. An 81-year-old woman, who was diagnosed with ischaemic mitral regurgitation, underwent mitral valve plasty and coronary artery bypass grafting. On postoperative day two, her superior vena cava (SVC) pressure gradually rose to 38 mmHg and she developed low output syndrome. Emergent surgery revealed that the cause of SVC syndrome was external compression from a haematoma at the posterior surface of the SVC, which formed around the Surgicel.
First Video Case Report of Chronic Retrograde Jejunojejunal Intussusception after Subtotal Gastrectomy with Braun's Anastomosis
Authors: Savaş Bayrak, Hasan Bektaş, Necdet Derici, Ekrem Çakar, Şükrü Çolak
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Intussusception, which is seen rarely in adults, is defined as the pulling or invagination of a part of the intestine into another segment of the intestine. In this case report we present chronic retrograde jejunojejunal intussusception following gastric surgery with Braun's anastomosis in adult with video presentation. A 66-year-old woman, who had undergone gastric surgery 39 years ago and cholecystectomy 20 years ago, was admitted to our clinic with the complaints about weight loss, abdominal pain, nausea, and vomiting. Upper gastrointestinal endoscopy (UGISE) was applied, and patient was treated with surgery. This case report indicates that intussusception should be considered in the presence of clinical complaints following gastric surgery, as well as importance of endoscopy in diagnosis.
Cavitating leukoencephalopathy with multiple mitochondrial dysfunction syndrome and NFU1 mutations
Authors: Federica Invernizzi, Anna Ardissone, Eleonora Lamantea, Barbara Garavaglia, Massimo Zeviani, Laura Farina, Daniele Ghezzi, Isabella Moroni
Journal: Front Genet (2014)
Keywords: mmds1, nfu1, brain mri, leukoencephalopathy, mitochondrial disorders, multiple mitochondrial dysfunction syndrome
MeSH terms: Case Reports

Multiple Mitochondrial Dysfunction Syndrome (MMDS) comprises a group of severe autosomal recessive diseases with onset in early infancy and characterized by a systemic disorder of energy metabolism, resulting in weakness, respiratory failure, lack of neurological development, lactic acidosis, and early death. Biochemical findings include defects of complexes I, II, and III of the mitochondrial respiratory chain and severe deficiency of Pyruvate dehydrogenase complex (PDHc). Three genes have been associated with MMDS since now: NFU1, BOLA3, and IBA57. We describe an Italian male patient presenting with severe psychomotor regression after an infectious episode, lactic acidosis, hyperglycinemia, reduction of respiratory chain complex II associated with a marked deficiency of PDHc activity. He carried two heterozygous mutations in NFU1, one novel (p.Cys210Phe) and one previously reported (p.Gly189Arg) missense change affecting highly conserved residues. A severe leukoencephalopathy with cavitations in deep white matter was disclosed at brain MRI, suggesting a peculiar neuroradiological phenotype associated with defect in this gene.
Large bilateral adrenal metastases in non-small cell lung cancer
Authors: Charisios Karanikiotis, Apostolos Anto Tentes, Sotirios Markakidis, Konstantinos Vafiadis
Journal: World J Surg Oncol (2004)

Background:
The adrenal gland is one of the common sites of metastasis from primary lung cancer. Adrenal metastases are usually unilateral however bilateral adrenal metastases are seen in 10% of all lung cancer patients; of these 2-3% occurs at the initial presentation of non-small cell lung cancer. Secondary tumors can disrupt the structure and function of the adrenal. This can lead to adrenal hemorrhage, which constitutes a life threatening hazard for the patient.
Case presentation:
A 59-year-old male presented with persisting abdominal pain. His initial work-up revealed significant anemia, an invasive process in the right upper lobe of the lung and large masses of heterogeneous texture, with hemorrhagic and necrotic elements in both adrenal glands. A biopsy confirmed it to be a large-cell carcinoma of the lungs. The patient developed severe leukocytosis akin to the paraneoplastic syndrome and died suddenly five days after the administration of chemotherapy.
Conclusion:
Intratumoral hemorrhage is a rare but life threatening complication of adrenal metastases and should be treated as soon as it has been diagnosed. If adrenalectomy is not feasible, combination chemotherapy should be applied as in metastatic disease. For choosing the appropriate chemotherapeutic regimen it is important to accurately achieve the diagnosis.
Intravenous immunoglobulin treatment stabilizing a patient with Anti-PL7 antisynthetase syndrome with interstitial lung disease and eosinophilic inflammation
Authors: Soran Peshbahar, Charlotte Hyldgaard, Elisabeth Bendstrup
Journal: Respir Med Case Rep (2022)
Keywords: anti-pl7, antisynthetase syndrome (as), eosinophilic inflammation, interstitial lung disease (ild), intravenous immunoglobulin (ivig)
MeSH terms: Case Reports

Antisynthetase syndrome (AS) is a rare autoimmune disease characterized by autoantibodies against aminoacyl-transfer RNA synthetase and clinical features which can include interstitial lung disease (ILD). Current available evidence of treatment is based on expert opinions and case reports. Here, we present a patient with an initial diagnosis of eosinophilic pneumonia, who was later diagnosed with anti-PL7 antisynthetase syndrome with ILD and eosinophilic inflammation. The patient was non-responsive to classic immunosuppressants but responded remarkably well to intravenous immunoglobulin.