OpenMed/multicare-articles huggingface dataset:
Case Report: Successful Control of Pulmonary Metastatic Pheochromocytoma With Iodine-125 Seed Implantation
Authors: Hongbing Shi, Chao Wang, Weiguang Qiang, Bai Sun, Hao Wang, Ye Yuan, Wenwei Hu
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: 125i seed implantation, brachytherapy, interventional therapy, metastasis, pheochromocytoma
MeSH terms: Adrenal Gland Neoplasms / radiotherapy, Brachytherapy / methods, Iodine Radioisotopes / therapeutic use, Lung Neoplasms / radiotherapy, Pheochromocytoma / radiotherapy, Case Reports, Adrenal Gland Neoplasms / pathology, Female, Humans, Lung Neoplasms / secondary, Middle Aged, Pheochromocytoma / pathology, Prognosis, Iodine Radioisotopes, Iodine-125

Pheochromocytoma with lung metastases is rare in clinics, and the prognosis of metastatic pheochromocytoma is generally poor. In this case, a 57-year-old woman who presented with hypertension and palpitations was diagnosed with left adrenal pheochromocytoma with lung metastasis in 2010. The patient received left adrenalectomy for pheochromocytoma 10 years ago, but pulmonary lesions had significant progression 7 years ago. The patient was treated with iodine-125 (125I) seed implantation for pulmonary lesions. All of the 5 pulmonary lesions achieved partial response 6 months later, further shrank 1 year later, and were successfully controlled for 7 years. This case indicated that 125I seed implantation could be an alternative local therapy for metastatic pheochromocytoma in the lung.
Sleep Disturbance and Severe Hydrocephalus in a Normally Behaving Wistar Rat With Traumatic Brain Injury
Authors: Jenni Kyyriäinen, Pedro Andrade, Elina Hämäläinen, Asla Pitkänen
Journal: Neurotrauma Rep (2023)
Keywords: brain injury, case study, electroencephalography, hydrocephalus, lateral fluid-percussion injury, sleep

We report on a case study of a Wistar rat that was investigated in detail because it exhibited no N3 sleep in electroencephalography (EEG) after lateral fluid-percussion injury (FPI)-induced traumatic brain injury (TBI). The rat (#112) belonged to a cohort of 28 adult Wistar rats exposed to lateral FPI. Rats were monitored by continuous video EEG for 30 days to follow-up on the evolution of sleep disturbances. The beam walking test was used to measure post-TBI functional recovery. Severity of the cortical lesion area, total brain volume, and cortical volume were measured from histological brain sections. Rat #112 had a normal body and skull appearance. Its baseline body weight did not differ from that of the rest of the cohort. At baseline, rat #112 crossed the beam in 6.3 sec (score range for the rest of the cohort, 4.7-44.3) and showed no evident slipping of the paws, scoring a 5.3 (score range for the rest of cohort, 4.3-6.0). On day 30 post-TBI, however, rat #112 was the only rat with a score of 0 on the beam. Histological analysis at 30 days post-TBI revealed a small 0.6-mm2 post-TBI lesion in the somatosensory cortex (lesion size range for the rest of the cohort, 1.2-10.9). The brain volume of rat #112 was 2-fold larger than the mean volume of the rest of the cohort (1592 vs. 758 mm3), the ventricles were remarkably enlarged, and the layered cerebral cortex was very thin. Analysis of the sleep EEG revealed that rat #112 had rapid eye movement sleep and wakefulness, but no N3 sleep, during the 72-h EEG epoch analyzed. This case report demonstrates that brain abnormalities presumably unrelated to the impact-induced cortical lesion, such as presumed pre-existing hydrocephalus, may worsen TBI-induced behavioral and electrographical outcome measures and complicate the assessment of the cause of the abnormalities.
Erlotinib in a patient with vaginal carcinoma and pulmonary metastasis: A case report
Authors: Qing Ma, Yao-Yao Ren, Xia Liu, Ting Gong, Dian-Sheng Zhong
Journal: Oncol Lett (2014)
Keywords: erlotinib, pulmonary metastasis, vaginal carcinoma

Erlotinib is an epidermal growth factor receptor tyrosine kinase inhibitor. It is widely used in the treatment of advanced non-small cell lung cancer and pancreatic cancer. However, there are currently no reports of the efficacy of erlotinib in patients with metastatic vaginal carcinoma. A 48-year-old female with vaginal carcinoma was diagnosed with lung metastasis four years following surgery. The patient received three cycles of chemotherapy but could not tolerate further treatment due to the side effects. Next, erlotinib was administered, prompting a partial response and disease stabilization for 9 months prior to disease progression. While the main treatments for vaginal carcinoma with distant metastasis are chemotherapy and radiotherapy, this case supplies preliminary evidence that erlotinib may have activity in these patients. Further studies are required to determine the potential of this therapy.
Rapid Development of Bleeding Esophageal Varices after Placement of Continuous Flow Left Ventricular Assist Device
Authors: Kaushal Majmudar, Michael Northcutt, Robert Gordon, Claus J Fimmel
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

We describe a patient with compensated cirrhosis and portal hypertension who underwent continuous flow LVAD implantation. Shortly after LVAD implantation, the patient developed new onset bleeding esophageal varices and ultimately had a fatal outcome. Our experience suggests that even well-compensated cirrhotic patients with significant portal hypertension are at risk of variceal bleeding after LVAD placement.
Electroencephalogram-Based Brain-Computer Interface and Lower-Limb Prosthesis Control: A Case Study
Authors: Douglas P Murphy, Ou Bai, Ashraf S Gorgey, John Fox, William T Lovegreen, Brian W Burkhardt, Roozbeh Atri, Juan S Marquez, Qi Li, Ding-Yu Fei
Journal: Front Neurol (2017)
Keywords: brain–computer interfaces, control, electroencephalography, lower limb, prosthesis, rhythm modulation

Objective:
The purpose of this study was to establish the feasibility of manipulating a prosthetic knee directly by using a brain-computer interface (BCI) system in a transfemoral amputee. Although the other forms of control could be more reliable and quick (e.g., electromyography control), the electroencephalography (EEG)-based BCI may provide amputees an alternative way to control a prosthesis directly from brain.
Methods:
A transfemoral amputee subject was trained to activate a knee-unlocking switch through motor imagery of the movement of his lower extremity. Surface scalp electrodes transmitted brain wave data to a software program that was keyed to activate the switch when the event-related desynchronization in EEG reached a certain threshold. After achieving more than 90% reliability for switch activation by EEG rhythm-feedback training, the subject then progressed to activating the knee-unlocking switch on a prosthesis that turned on a motor and unlocked a prosthetic knee. The project took place in the prosthetic department of a Veterans Administration medical center. The subject walked back and forth in the parallel bars and unlocked the knee for swing phase and for sitting down. The success of knee unlocking through this system was measured. Additionally, the subject filled out a questionnaire on his experiences.
Results:
The success of unlocking the prosthetic knee mechanism ranged from 50 to 100% in eight test segments.
Conclusion:
The performance of the subject supports the feasibility for BCI control of a lower extremity prosthesis using surface scalp EEG electrodes. Investigating direct brain control in different types of patients is important to promote real-world BCI applications.
Intraosseous schwannoma of the femur in a patient with monoclonal gammopathy of undetermined significance
Authors: Timothy McAleese, Kevin Clesham, Darren Moloney, Andrew Hughes, Nazia Faheem, Khalid Merghani
Journal: Int J Surg Case Rep (2020)
Keywords: case report, femoral schwannoma, intraosseous schannoma, monocloncal gamopathy of underdetermined significance (mgus), neurilemmoma, primary bone tumour
MeSH terms: Case Reports

Introduction:
Schwannomas are slow-growing, benign tumours normally originating from the schwann cells of the nerve sheath. Intraosseous schwannomas account for 0.175% of primary bone tumours and are extremely rare, especially outside the axial skeleton. Monoclonal gammopathy has been associated with soft tissue schwannomas but never with the intraosseous variety.
Presentation of case:
A 55-year-old woman with a background of monoclonal gammopathy of undetermined significance (MGUS) presented with a 2-year history of right thigh pain. CT scan showed a well defined, lytic lesion with a thin peripheral rim of sclerosis in the midshaft of the femur. MRI displayed a hyperintense, well marginated and homogenous lesion. Definitive diagnosis was made based on the classical histopathological appearance of schwannoma. We managed our patient with local curettage and prophylactic cephalomedullary nailing based on her high mirel score.
Discussion:
Intraosseous schwannomas are poorly understood but most commonly reported in middle-aged women. Radiologically, their differential diagnosis includes malignant bone tumours, solitary bone cysts, aneurysmal bone cysts and giant cell tumours. As a result, they are usually diagnosed incidentally on histology. Although malignant transformation is possible in soft tissue schwannomas, all intraosseous schwannomas reported to date have been benign.
Conclusion:
This case demonstrates the importance of suspecting intraosseous schwannoma as a differential diagnosis for lytic bone lesions to avoid the overtreatment of patients. We also highlight monoclonal gammopathy of undetermined significance as a potential risk factor for a poorly understood disease and make recommendations about the appropriate management of these lesions.
A case of recurrent metastatic ameloblastoma and hypercalcaemia successfully treated with carboplatin and paclitaxel: long survival and prolonged stable disease
Authors: Af Ghiam, A Al Zahrani, R Feld
Journal: Ecancermedicalscience (2013)
Keywords: carboplatin, metastatic ameloblastoma, paclitaxel, survival
MeSH terms: Case Reports

We describe a case of recurrent metastatic malignant ameloblastoma to the lungs with hypercalcaemia in a 47-year-old man. The first lung metastasis was resected nine years after the initial primary, and the tumour recurred with extensive pulmonary metastases 21 years after the primary tumour was resected. This case presented with malignancy-associated hypercalcaemia, likely due to paraneoplastic syndrome, which is exceedingly unusual in association with malignant ameloblastoma. He was successfully treated with carboplatin/paclitaxel and showed the longest survival and stable disease, from the diagnosis of recurrent metastasis, recorded as a case report. This regimen is reasonably well tolerated and can be repeated safely.
The "giant dog ear" sign of left atrial appendage aneurysm-revisited on 3 T cardiac MRI (free-breathing, non-contrast)
Authors: Alpa Bharati, Suleman Merhcant, Chinmay Nagesh, Ashank Bansal
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Left atrial appendage aneurysm (LAAA) is a rare congenital anomaly, usually identified incidentally on a chest radiograph performed for another indication. Our case is that of an 11-month-old male infant who was incidentally diagnosed as having a giant LAAA while being clinically evaluated for pneumonia. The lesion was accurately diagnosed on preoperative, non-contrast, free-breathing cardiac MRI (CMR). LAAA has a peculiar appearance, resembling a "giant dog ear"-a sign first described on cardiac angiography and holding true on CMR as well. Fast free-breathing sequences on CMR, especially on 3 T, provide high-resolution images and eliminate the need for other pre-operative imaging that are either invasive, involve radiation exposure, require general anaesthesia or a combination of these.
Esophageal Rhabdoid-Like Tumor: A Rare Disease With Aggressive Clinical Behavior
Authors: Andrea Lovece, Daniele Bernardi, Barbara Bruni, Emanuele Asti, Claudio Clemente, Luigi Bonavina
Journal: Front Surg (2020)
Keywords: dysphagia, esophagus, minimally invasive esophagectomy, rhabdoid tumor, undifferentiated cancer
MeSH terms: Case Reports

Background: Malignant rhabdoid tumor is a kidney childhood tumor with aggressive clinical behavior and a wide spectrum of histologic, immunophenotypic, and cytogenetic findings. Extra-renal rhabdoid tumors have been reported in the brain, breast, liver, pancreas, bladder, vulva, prostate, and colon. To date, only nine cases of esophageal rhabdoid tumors have been described, all in patients over 50-year old. We add to the current literature the case of an esophageal, poorly differentiated rhabdoid tumor occurring in a young man. Case Report: A 24-year-old man was referred for progressive dysphagia, retrosternal pain, nausea, and food regurgitation. Esophagogastroduodenoscopy showed an obstructing neoplastic lesion of the distal esophagus associated with Barrett's esophagus. Biopsies revealed undifferentiated esophageal cancer with epithelial morphology and immunohistochemistry positive for CK pan, CK 7 e CK 8-18. Minimally invasive esophagectomy and extended lymphadenectomy was performed. Histopathology showed a poorly differentiated tumor, with morphologic characteristics of rhabdoid tumor, central necrosis and transmural infiltration of the esophageal wall. Definitive immunohistochemistry was positive for vimentin, CD34, synaptophysin, and INI1. Conclusion: Esophageal rhabdoid tumor is extremely rare and highly aggressive, with only few patients alive at 1 year follow-up, according to our review. Immunohistochemistry characterization is critical for diagnosis. Minimally invasive esophagectomy is an appealing and possibly less morbid option compared to open surgery. However, further research is needed to investigate the potential role of targeted immunotherapy.
Left sided PAPVC with intact IAS-Surgically managed with vertical vein anastomosis to LA appendage: A rare case report
Authors: Ganesh Kumar K Ammannaya, Prashant Mishra, Jayant V Khandekar
Journal: Int J Surg Case Rep (2019)
Keywords: atrial septal defect (asd), case report, left atrial appendage, partial anomalous pulmonary venous connection (papvc), vertical vein

Introduction:
Partial anomalous pulmonary venous connection (PAPVC) is a rare entity. Only 10% of these are left sided. An intact atrial septum is further uncommon.
Presentation of case:
We present a case of left sided PAPVC with no atrial septal defect (ASD), who presented with effort intolerance and an unremarkable physical examination. Computed tomography pulmonary angiography (CTPA) confirmed the primary diagnosis as suggested by an initial 2-D echocardiography, and aided in better understanding of the anatomy.
Conclusion:
Patient underwent successful surgery through a simple & reproducible technique of anastomosis of vertical vein to left atrial appendage. Patient recovered uneventfully and was discharged on day 10.
Gestational and congenital syphilis: gaps to be elucidated
Authors: Déborah Esteves Carvalho, João Victor Andrade Pimentel, Luise Oliveira Ribeiro da Silva, Letícia Maria Cardoso Lima Rodrigues, Leonardo Santana Andrade, Carlos Ramon Costa Santana, Marcelo Antônio Silva Menezes, Eloyse Emanuelle Nunes Silva, Gabryelle Eduarda Gama Dos Santos, Sayron Natanael Lopes Pereira Santos, Breno Gustavo do Nascimento Gomes, Letícia Almeida Meira, Helga Machado de Farias Santos, Izailza Matos Dantas Lopes
Journal: Rev Soc Bras Med Trop (2023)
MeSH terms: Syphilis / diagnosis, Syphilis, Congenital / diagnosis, Case Reports, Adult, Brazil, Child, Female, Humans, Pregnancy, Syphilis Serodiagnosis, Young Adult

Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.
Case report: Severe acute hepatitis in a 22-month-old Chinese boy with Omicron sub-variant BA.2.38
Authors: Xinying Chen, Junbin Hong, Yuxia Li, Caixia An, Jianwen Guo, Jinghua Yang
Journal: Front Public Health (2022)
Keywords: omicron variant, sars-cov-2, case report, pediatrics, severe acute hepatitis
MeSH terms: COVID-19, Hepatitis / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Asian People, Child, East Asian People, Humans, Infant, Male, SARS-CoV-2

The etiology of severe acute hepatitis (SAH) in children is various. We describe the first Chinese case of severe acute hepatitis in a 22-month-old boy with the mild illness of Omicron sub-variant BA.2.38. With the application of Compound Glycyrrhizin Injection (CGI), the patient gradually recovered from acute liver injury (ALI). This case highlights the possibility of severe ALI in children with the non-critical illness of SARS-CoV-2. The management of SAH associated with the pandemic presents challenges for clinicians, and follow-up is in need. The method of differential diagnosis using limited laboratory results is of great value to the clinicians.
Clinical Challenges in the Management of Leishmania/HIV Coinfection in a Nonendemic Area: A Case Report
Authors: K Grabmeier-Pfistershammer, W Poeppl, P M Brunner, K Rappersberger, A Rieger
Journal: Case Rep Infect Dis (2012)

We report on a 37-year-old male HIV-positive patient with generalized cutaneous leishmaniasis undiagnosed for several years. Upon presentation, visceral leishmaniasis was diagnosed in addition to cutaneous manifestation of the disease. Over a period of three years, several different treatment regimens including liposomal amphotericin B, liposomal amphotericin B with miltefosine, liposomal amphotericin B with interferon, and pentamidine combined fluconazole and allopurinol were applied until Leishmania PCR from blood turned negative. This case supports the necessity of multidrug combinational and sequential therapy over a very prolonged period of time in severely immunosuppressed patients infected with Leishmania and highlights the tremendous individual but also economic burden of this disease.
Lung Adenocarcinoma Harboring EGFR Kinase Domain Duplication ( EGFR-KDD) Confers Sensitivity to Osimertinib and Nivolumab: A Case Report
Authors: Jie Li, Junrong Yan, Ran Cao, Guanjun Du, Guofang Zhao
Journal: Front Oncol (2020)
Keywords: egfr-kdd, nivolumab, osimertinib, lung adenocarcinoma, targeted next-generation sequencing
MeSH terms: Case Reports

Background:
Kinase domain duplication of EGFR (EGFR-KDD) is a rare oncogenic driver alteration and serves as a potential therapeutic target. Its effect on EGFR-tyrosine kinase inhibitors (TKIs), especially the third-generation drug Osimertinib, and immune checkpoint inhibitors (ICIs) remains inconclusive.
Case presentation:
A 45-year old male with lung adenocarcinoma progressed with liver metastasis after receiving pemetrexed and cisplatin as adjuvant chemotherapy. Targeted next-generation sequencing (NGS) identified an EGFR-KDD in the resected left upper lung. Icotinib was used in the following treatment and the liver metastasis was found to shrink but the progression-free survival (PFS) only lasted for 4 months with the appearance of right hepatic metastasis. Meantime, the same EGFR-KDD was identified in the left hepatic re-biopsy. Afterward, the patient benefited from the third-line therapy of Osimertinib with a PFS as long as 21 months. Then he progressed with enlarged mediastinal lymph nodes, and targeted NGS consistently identified EGFR-KDD, as well as a new RELN p.G1774E mutation. Given the continually increasing tumor mutation burden (TMB, 3.4 mutation/Mb) and PD-L1 expression-based tumor proportion score (TPS, 1%), Nivolumab was used as the fourth-line salvage therapy, which lead to considerable efficacy, with decreased blood carcinoembryonic antigen (CEA), regressed mediastinal lymph nodes, and reduced liver metastases.
Conclusions:
Our case provided direct evidence to support the role of Osimertinib in the treatment of EGFR-KDD, as well as added valuable insights into application of immune-based therapeutics in the specific subgroups bearing EGFR alteration(s).
Bilateral papillitis and unilateral focal chorioretinitis as the presenting features of syphilis
Authors: Christy Elizabeth Benson, Mohamed Kamel Soliman, Alexander Knezevic, Daisy Ding Xu, Quan Dong Nguyen, Diana V Do
Journal: J Ophthalmic Inflamm Infect (2015)
Keywords: chorioretinitis, panuveitis, papillitis, retinitis, syphilis, uveitis

Background:
Syphilis is a multisystem bacterial infection caused by Treponema pallidum. The incidence of infection in the United States has risen by more than 75% since the year 2000, when it was at a low of 2.1 per 100,000 people. Ocular involvement may occur in any stage of infection and may present in a variety of ways, with posterior uveitis being the most common manifestation. We report a case of ocular syphilis infection with an unusual presentation of bilateral non-granulomatous panuveitis with papillitis and unilateral focal chorioretinitis.
Findings:
This is a retrospective case report with literature review. A 39-year-old Caucasian female presented with a 2-week history of bilateral ocular flashes and left eye pain. Dilated fundus examination revealed mild optic disc edema in both eyes, the right eye more than the left. In the left eye, there was an area of retinal elevation and whitening involving the peripheral retina. Fluorescein angiography, B-scan ultrasonography, and ocular coherence tomography were performed, and laboratory tests were ordered based on the clinical presentation. After rapid plasma reagin (RPR) and fluorescent treponemal antibody absorption (FTA-Abs) were positive, syphilitic uveitis was confirmed, and the patient was admitted for a 14-day course of high-dose intravenous penicillin G.
Conclusions:
The first signs and symptoms of syphilis may be ocular, which can lead to a diagnostic challenge. A high index of suspicion is the key for early diagnosis of ocular syphilis. Prompt treatment with intravenous penicillin G is highly effective in resolving the infection.
Incidental Lymphoma Discovered During Surveillance for Low-Grade Upper Tract Urothelial Carcinoma Treated Ureteroscopically: A Case Report Series
Authors: Scott G Hubosky, Kelly A Healy, Amar J Raval, Costas D Lallas, Joanne Filicko-O'Hara, Demetrius H Bagley
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Two cases of incidentally found follicular lymphoma during surveillance for ureteroscopically treated upper tract urothelial carcinoma with cross-sectional imaging are described. Multiple independent primary malignancies should be considered in this population.