OpenMed/multicare-articles huggingface dataset:
A rare cause of scrotal swelling: transitional cell carcinoma of the bladder presenting as a testicular metastasis
Authors: W Mahmalji, S Jain, M Stower
Journal: Adv Urol (2011)
MeSH terms: Case Reports

A 72-year-old Caucasian male who presented with haematuria in July of 2000 was found to have a large left-sided bladder tumour. He underwent a transurethral resection of the tumour and surveillance program. In October 2008 he underwent a transurethral resection of the prostate (TURP). Histology of the prostatic chippings showed poorly differentiated TCC with prostatic invasion. A CT of his chest abdomen and pelvis revealed no lymph node involvement or metastatic spread. He therefore underwent a cystoprostato-urethrectomy with ileal conduit formation, in December 2008. In May 2010 the decision was made to perform a left inguinal orchidectomy as he presented with a craggy mass of his left testis, and there were clinical concerns that this was a tumour. Histology revealed that the left testis had been wholly replaced by a tumour. Taking into account his previous urological history, the features of this tumour are consistent with metastatic TCC, which is very rare.
Meningitis retention syndrome
Authors: Abhishek Krishna, Pavan Devulapally, Ibrahim Ghobrial
Journal: J Community Hosp Intern Med Perspect (2012)
Keywords: elsberg syndrome, acyclovir, aseptic meningitis, atonic bladder, herpes simplex 2 virus infection, polyradiculitis, radiculomyelitis
MeSH terms: Case Reports

A 50-year-old Caucasian woman presented with signs and symptoms of meningitis preceded by a 3 day history of flu-like symptoms and progressive difficulty with urination. Cerebrospinal Fluid (CSF) analysis was consistent with aseptic meningitis. She was found to have a significant urinary retention secondary to atonic bladder. MRI of the brain and spine were normal and CSF-PCR (polymerase chain reaction) was positive for HSV-2. Urinary retention in the context of meningitis and CSF pleocytosis is known as Meningitis Retention Syndrome (MRS). MRS is a rare but important complication of meningitis most commonly associated with HSV-2. Involvement of central pathways may have a role in the pathogenesis of MRS but this is poorly documented. MRS is different from Elsberg syndrome wherein patients display features of lumbosacral polyradiculitis or radiculomyelitis. Early treatment with antiviral therapy was associated with a favorable outcome in our patient.
Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch
Authors: Hiromichi Ishii, Takuma Kobayashi, Michihiro Kudou, Masumi Nishimura, Atsushi Toma, Kenji Nakamura, Takeshi Mazaki, Tsuyoshi Itoh
Journal: World J Surg Oncol (2012)
MeSH terms: Bile Duct Neoplasms / surgery, Bile Ducts, Intrahepatic / surgery, Carcinoma, Hepatocellular / surgery, Cholangiocarcinoma / surgery, Hepatectomy / methods, Liver Neoplasms / surgery, Thrombosis / surgery, Case Reports, Bile Duct Neoplasms / pathology, Bile Ducts, Intrahepatic / pathology, Carcinoma, Hepatocellular / pathology, Cholangiocarcinoma / pathology, Humans, Liver Neoplasms / pathology, Male, Middle Aged, Portal Vein / pathology, Portal Vein / surgery, Prognosis, Thrombosis / pathology

Background:
Hepatic resection is the only effective treatment for combined hepatocellular carcinoma and cholangiocarcinoma.
Case presentation:
A 52-year-old man was preoperatively diagnosed with hepatocellular carcinoma in segment 2 with tumor thrombus in the segment 2 portal branch. Anatomical liver segmentectomy 2, including separation of the hepatic arteries, portal veins, and bile duct, enabled us to remove the tumor and portal thrombus completely. Modified selective hepatic vascular exclusion, which combines extrahepatic control of the left and middle hepatic veins with occlusion of left hemihepatic inflow, was used to reduce blood loss. A pathological examination revealed combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in the segment 2 portal branch. No postoperative liver failure occurred, and remnant liver function was adequate.
Conclusion:
The separation method of the hepatic arteries, portal veins, and bile duct is safe and feasible for a liver cancer patient with portal vein tumor thrombus. Modified selective hepatic vascular exclusion was useful to control bleeding during liver transection. Anatomical liver segmentectomy 2 using these procedures should be considered for a patient with a liver tumor located at segment 2 arising from a damaged liver.
Point-of-Care Ultrasound for the Diagnosis of Colon Cancer
Authors: Weihao Chen, Readon Teh, Absar Qurishi
Journal: POCUS J (2022)
Keywords: pseudokidney, cancer, colorectal
MeSH terms: Case Reports

We present a case of a 64-year-old gentleman for whom point of care ultrasound (POCUS) expedited the diagnosis and subsequent early treatment of colon adenocarcinoma. He was referred by his primary provider to our clinic for abdominal bloating. He had no other abdominal symptoms such as abdominal pain, change in bowel habits or rectal bleeding. He had no constitutional symptoms such as weight loss. The patient's abdominal examination was also unremarkable. However, POCUS identified a 6 cm long hypoechoic circumscribed colon wall thickening around the hyperechoic pattern of bowel lumen (Pseudokidney sign)1 in the right upper quadrant, which suggested the presence of an ascending colon carcinoma. In view of this prompt bedside diagnosis, we organised a colonoscopy, staging computerised tomographic scan and colorectal surgery consultation the next day. After the locally advanced colorectal carcinoma was confirmed, the patient had curative surgery within 3 weeks of his presentation to the clinic.
Protein biomarkers in serum as a conservation tool to assess reproduction: a case study on brown bears ( Ursus arctos)
Authors: Abbey E Wilson, Sarah A Michaud, Angela M Jackson, Gordon Stenhouse, Cameron J R McClelland, Nicholas C Coops, David M Janz
Journal: Conserv Physiol (2021)
Keywords: conservation, physiology, population monitoring, proteomics, reproduction, wildlife management

Monitoring the reproductive characteristics of a species can complement existing conservation strategies by understanding the mechanisms underlying demography. However, methodology to determine important aspects of female reproductive biology is often absent in monitoring programs for large mammals. Protein biomarkers may be a useful tool to detect physiological changes that are indicative of reproductive state. This study aimed to identify protein biomarkers of reproductive status in serum collected from free-ranging female brown bears (Ursus arctos) in Alberta, Canada, from 2001 to 2018. We hypothesized that the expression of proteins related to reproduction in addition to energetics and stress can be used to answer specific management-focused questions: (i) identify when a female is pregnant, (ii) detect if a female is lactating, (iii) determine age of sexual maturity (i.e. primiparity) and (iv) assess female fertility (i.e. reproduction rate). Furthermore, we investigated if silver spoon effects (favourable early life conditions provide fitness benefits through adulthood) could be determined using protein expression. A target panel of 19 proteins with established relationships to physiological function was measured by peptide-based analysis using liquid chromatography and multiple reaction monitoring mass spectrometry and their differential expression was evaluated using a Wilcoxon signed-rank test. We found biomarkers of pregnancy (apolipoprotein B-100 and afamin), lactation (apolipoprotein B-100 and alpha-2-macroglobulin) and sexual maturity (corticosteroid-binding globulin), but there were no statistically significant relationships with protein expression and fertility. The expression of proteins related to reproduction (afamin) and energetics (vitamin-D binding protein) was associated with the nutritional quality of the individual's present habitat rather than their early life habitat. This study highlights potential biomarkers of reproductive status and provides additional methods for monitoring physiological function in wildlife to inform conservation.
Case report: Traumatic ventricular aneurysm combining tricuspid valve avulsion in a child: Diagnostic findings and treatment protocols
Authors: Dengshen Zhang, Shan Wei, Wenhong Tao, Yuanfeng Liao, Ruihan Xiao, Daxing Liu
Journal: Front Cardiovasc Med (2022)
Keywords: acquired left ventricular aneurysm, aneurysmoplasty, blunt cardiac injury, cardiac surgery, traumatic tricuspid regurgitation
MeSH terms: Case Reports

This case report is an extremely rare case of a traumatic left ventricular aneurysm in a 3-year-old child who also had tricuspid valve avulsion due to blunt trauma. The diagnostic findings and treatment protocols are discussed to provide a clinical reference.
Surgical Management of a Giant Desmoid Fibromatosis of Abdominal Wall With Vessels Invasion in a Young Man: A Case Report and Review of the Literature
Authors: Jiming Zhao, Fajuan Cheng, Zhigang Yao, Bin Zheng, Zhihong Niu, Wei He
Journal: Front Surg (2022)
Keywords: abdominal, desmoid fibromatosis, surgery, therapy, β-catenin

Background:
Desmoid fibromatosis (DF) is a rare clonal proliferation of fibroblasts and myofibroblasts. It develops in the connective tissues and does not metastasize but may infiltrate adjacent structures. Because of the rarity of these tumors and the unpredictable natural history of the disease, well-defined and precise guidelines of the optimal treatment for DF have not been formulated.
Case presentation:
Here, we present a giant abdominal DF that invaded the right spermatic cord and iliac vessels. The lesion was excised with external iliac artery dissection; however, the vein was sacrificed. The abdominal wall defect was then repaired with a polypropylene mesh. The lesional cells are positive for β-catenin.
Conclusions:
In the past decades, there has been a change in the treatment of DF. The "wait and see" policy has been considered initially in most cases. Surgical intervention remains a valid option for symptomatic lesions. The optimal regimes of the tumor should not take the risk of making the patient more symptomatic than the lesion itself.
De novo Migraine with Aura in the Third Trimester of Pregnancy: A Case Report and Literature review
Authors: Elena Paškevičiūtė, Diana Bužinskienė, Kristina Ryliškienė
Journal: Acta Med Litu (2021)
Keywords: acute headache, migraine management, migraine with aura, pregnancy, secondary headache disorder
MeSH terms: Case Reports

Background:
Among all headache disorders, migraine has the highest prevalence during gestation. The majority of migraineurs experience improvement during pregnancy, but a few may experience migraine for the first time. This poses a diagnostic challenge in the differential diagnosis between primary and life-threatening secondary headache disorders. Because pregnancy itself is an independent risk factor for secondary headache disorders, it is mandatory to exclude these conditions in order to diagnose migraine. There is a large body of literature about pre-existing migraine course during pregnancy and its link with adverse pregnancy outcomes, but there are no studies examining these aspects among women with new-onset migraine during pregnancy.
Case report:
A 31-year-old female at 33 weeks of gestation (gravida 2, para 2) was referred to the neurologist eds disturbances, which were followed by pressing severe headache, rated as 8 out of 10 on a numeric rating scale and accompanied by dizziness. The headache lasted for one day, and dizziness continued to the following day. The patient was investigated for a secondary headache disorder, but laboratory and neuroimaging results were unremarkable. A migraine with aura was diagnosed. The patient was advised to keep a consistent sleep schedule, maintain regular low physical activity, eat regularly and take magnesium supplementation. The patient was informed about a safe treatment approach in case of an acute attack. At 40 weeks of gestation the patient delivered female newborn, weighing 3750g, with Apgar scores of 8 and 9 (due to a nuchal cord). The postpartum period was uneventful. During the subsequent 4 years, the patient did not experience any recurrent migraine attacks and had no pregnancies.
Conclusion:
In order to diagnose a migraine during pregnancy, exclusion of secondary headache disorders is mandatory. Pregnant migraineur should be regularly monitored for adverse birth outcomes. It is essential to educate patients, provide information about the safe treatment of migraine attacks, and explain nonpharmacological prevention and supplementation benefits.
Retained Surgical Drains in Orthopedics: Two Case Reports and a Review of the Literature
Authors: John S Cox, Darin Friess
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Though a relatively rare event, retained surgical drains are preventable and can lead to significant consequences. Two case reports from our institution are discussed as examples for the challenging management of this problem as well as an overview of techniques for the prevention and removal of retained drains based on the current literature.
Acute pulmonary embolism as a complication in a young male patient with a left popliteal venous aneurysm
Authors: Emmanuel Contreras-Jiménez, Jose I Martínez-Quesada, Montserrat W Miranda-Ramirez, Javier E Anaya-Ayala, Luis H Arzola-Flores, Santiago Mier Y Terán-Ellis, Cesar Cuen-Ojeda, Carlos A Hinojosa
Journal: J Vasc Bras (2023)
Keywords: aneurysm, popliteal vein, pulmonary embolism
MeSH terms: Case Reports

Venous aneurysms are rare and have a prevalence of 0.1 to 0.2% in the reported series. Typically, patients do not present any symptoms, but are prone to develop deep venous thrombosis (DVT) and the most feared complication, pulmonary embolism (PE). We present the case of a previously healthy 36-year-old man who presented at the emergency department with tachycardia, dyspnea, and pleuritic pain. A thoracic computed tomography angiography (CTA) confirmed the diagnosis of acute pulmonary embolism. He was treated with systemic thrombolysis and anticoagulation. In the further workup of the cause of the embolism, computed tomography revealed a fusiform dilation of the left popliteal vein measuring 3 by 3 centimeters (cm) with an incomplete filling defect because of thrombus presence. The patient underwent open surgical repair. At one month follow-up, he was asymptomatic, and an ultrasound revealed complete patency of the popliteal vein without dilatation or thrombus.
Case report: Bilateral globus pallidus lesions and delayed progressive leukoencephalopathy in COVID-19: Effects of hypoxia alone or combination of hypoxia and inflammation?
Authors: Ahmad A Ballout, Michael Kolesnik, Yuna Choi, Marc S Ayoub, Asaff Harel, Souhel Najjar
Journal: Front Neurol (2023)
Keywords: covid-19, sars-cov-2, globus pallidus, hypoxia, leukoencephalopathy
MeSH terms: Case Reports

Background:
The globus pallidus is a highly mitochondria-rich metabolic structure that is particularly sensitive to metabolic disturbances and hypoxia. Symmetric lesions of globus pallidus and delayed diffuse leukoencephalopathy were documented in toxic-metabolic disorders, hypoxia, a neurodegenerative disorder, and mitochondrial encephalopathies. Similar changes are also reported in individuals with active COVID-19 infections with associated hypoxia or critical illness.
Case information:
We describe a patient with post-COVID-19 infection who presented with rapid cognitive and neurological decline associated with similar neuroimaging structural changes but without toxic-metabolic changes or hypoxia. Despite multiple non-inflammatory cerebrospinal fluid studies, mechanisms involving post-COVID-19 inflammation and immune dysregulation are suspected, given the unexplained continued decline in the neurological status, lack of concurrent hypoxia or antecedent respiratory difficulties, and after a reasonable exclusion of alternative etiologies. Hypermetabolism of both anteromedial temporal structures and diffuse hypometabolism predominantly in the frontal region on PET scan provided indirect support for possible inflammatory mechanisms after reasonable exclusion of alternative etiologies, such as direct CNS infection, among others. The patient's neurological impairment improved substantially after treatment with pulse steroids, plasmapheresis, and rituximab.
Conclusion:
To the best of our knowledge, this is the first report of post-COVID-19 with bilateral symmetric contrast-enhancing necrotic lesions of globus pallidus with delayed diffuse supratentorial leukoencephalopathy with microhemorrhages without concurrent hypoxia or reported preceding symptoms suggestive of hypoxia. We suspect that these inflammatory mechanisms might be triggered by prior COVID-19 exposure/infection. Furthermore, the role of the cross-talk between inflammation and clinically mild or silent hypoxia linked to prior COVID-19 infection cannot be excluded. Awareness of these post-COVID-19 neurological sequelae and their potential pathophysiology among those with no known antecedent significant hypoxia are important for early recognition and treatment.
Aggressive fibromatosis of the oral cavity in a 5 year old boy: a rare case report
Authors: Keerthi Krishnankutty Nair, Kanad Chaudhuri, Ashok Lingappa, Ranjani Shetty, Pramod Gujjar Vittobarao
Journal: Pan Afr Med J (2017)
Keywords: aggressive fibromatosis, desmoid tumor, extra-abdominal fibromatosis, infantile fibromatosis, soft tissue tumor
MeSH terms: Fibromatosis, Aggressive / diagnosis, Mouth Neoplasms / diagnosis, Case Reports, Child, Preschool, Fibromatosis, Aggressive / pathology, Humans, Male, Mouth Neoplasms / pathology

Fibrous tissue proliferations express a wide spectrum of histologic and morphologic variation in both infants and adults. This ranges from hypertrophic scar formation at one end to malignant fibrosarcoma at the other end of the spectrum. Aggressive fibromatosis is an intermediate tumor which is in proximity to fibrosarcomas. These are locally invasive and often recur after excision, but do not metastasize. Histologically, they are characterized by proliferating fibroblasts with little mitotic activity. Aggressive fibromatosis in the head and neck region is not common, and very sporadically occurs in the oral cavity or jaw bones. Here we report a rare case of aggressive fibromatosis occurring in a 5 year old boy.
A Case of Cardiac Tamponade in a Patient with Metastatic Renal Cell Carcinoma on Pazopanib Treatment
Authors: Vinu Sarathy, Sriniivas Belagutty Jayappa, Thianesh Waran, Radheshyam Naik
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Asymptomatic minimal pericardial effusion may be frequently found in patients with hypothyroidism. Cardiac tamponade secondary to hypothyroidism is rarely referenced in medical literature. Hypothyroidism as an adverse effect of pazopanib (tyrosine kinase inhibitor) treatment leading to cardiac tamponade is an even rarer occurrence. Here, we report an unusual case of a 71-year-old male, with a case of renal cell carcinoma on pazopanib treatment presenting with shortness of breath who was found to have hypothyroidism with a large pericardial effusion leading to cardiac tamponade. The patient did not have any prior reports of thyroid-stimulating hormone (TSH) or thyroid hormone levels at presentation. No such case of cardiac tamponade due to hypothyroidism as an adverse effect of pazopanib tablet treatment has been reported to our knowledge.
Spinal Intradural, Extramedullary Ependymoma with Astrocytoma Component: A Case Report and Review of the Literature
Authors: Gene M Weinstein, Knarik Arkun, James Kryzanski, Michael Lanfranchi, Gaurav K Gupta, Harprit Bedi
Journal: Case Rep Pathol (2016)

Ependymomas are common spinal lesions, with the vast majority arising in an intramedullary location. Several cases have been described in the literature of ependymomas in an intradural, extramedullary location. The authors present a case of a 56-year-old female who presented with several weeks of lower back pain and weakness. MRI revealed an intradural, extramedullary enhancing mass at L1-L2. The mass was successfully resected surgically. Pathologic evaluation revealed a low grade glioma with components of both ependymoma and pilocytic astrocytoma with MUTYH G382D mutation. Extramedullary ependymomas are very rare tumors. To the authors' knowledge, this is the first case of ependymoma/astrocytoma collision tumors described in an extramedullary location.
Management of chyle leak in right side neck dissection: a rare case and review of literature (a case report)
Authors: Rahul Deshmukh, Purva Kulkarni, Umesh Bhutekar, Atul Kala, Shivam Richhariya, Hitesh Tawari
Journal: Pan Afr Med J (2021)
Keywords: chyle leak, case report, head and neck surgery, lymphatic, thoracic duct
MeSH terms: Chyle, Case Reports, Review, Humans, Middle Aged, Neck, Neck Dissection / adverse effects, Postoperative Complications / surgery, Surgical Flaps, Thoracic Duct

Chyle leak is a well-recognized iatrogenic thoracic duct injury but a rare and serious complication of head and neck surgery affecting 1-2.5% of head and neck surgery dissections. It is potentially a life-threatening condition and management may be problematic and prolonged. Here we presented a rare case report of right sided chyle leak with its surgical management and review of literature. A 56-year-old patient with a complain of non-healing ulcer in the right buccal vestibule in the last 1-2 months reported to the outpatient department (OPD). After complete preoperative profile and counseling patient's consent was taken and wide local excision of lesion was done with bite composite resection with right hemimandibulectomy and maxillary alveolectomy till pterygoid plates, with right side selective neck dissection, level I-III followed by reconstruction with right side pectoralis major myofascial flap. Then the patient was on 5 days octreotide therapy. Regular post-operative follow-up was taken and no leak was noted further. In case of a chyle leak early diagnosis and aggressive treatment is essential to avoid local and systemic complications that prolong hospitalization.