OpenMed/multicare-articles huggingface dataset:
Case Report: Primary Extraskeletal Osteosarcoma in the Lung and Pulmonary Artery
Authors: Duchang Zhai, Wu Cai, Guohua Fan, Junlin Yang, Chenchen Liu
Journal: Front Oncol (2021)
Keywords: chest imaging, extraskeletal, lung, oncology, osteosarcoma, primary, pulmonary artery
MeSH terms: Case Reports

Extraskeletal osteosarcoma is an uncommon and high-grade soft tissue malignancy. The incidence is even lower when the lung and pulmonary artery are the primary site. The purpose of this report is to present the radiological features of this neoplasm in a 52-year-old man. In our case, contrast-enhanced CT and 3D-CT reconstruction clearly showed the primary lesion and its invasion into surrounding tissues. Although wide local excision of the primary tumor is the treatment of choice, local recurrence and metastasis rates remain high, and this progression can be clearly shown on CT and SPECT/CT examinations.
Surgical Management of Falcotentorial Junction Tumors: A Case Series Report
Authors: Peixi Liu, Xiaowen Wang, Yingjun Liu, Jiajun Cai, Zixiao Yang, Kai Quan, Wei Zhu, Jianping Song
Journal: Front Oncol (2022)
Keywords: falcotentorial, hemangiopericytoma, hybrid operation, meningioma, surgery

Objective:
The surgical strategy for falcotentorial junction tumors remains complex. Different approaches are selected according to the location and growth pattern of the tumor and the operator's experience. This report reviews our single-institution experience in the surgical management of falcotentorial junction tumors.
Methods:
We retrospectively reviewed the clinical and imaging data, surgical strategy, and follow-up outcomes of 49 patients treated from 2007 to 2020.
Result:
All 49 patients (12 male, 37 female, mean age: 56.3 ± 11.3 years) underwent safe tumor resection. The most common complaints were headache (43%), dizziness (39%), and unstable gait (16%). Thirty percent of the tumors showed calcification, and the computed tomography scans revealed hydrocephalus in 36% of the patients. On magnetic resonance imaging, 43% of the tumors were unilateral. According to the Asari classification, the tumors were divided into inferior (16%), superior (29%), anterior (22%), and posterior (33%) types. The occipital interhemispheric approach (88%) and supracerebellar-infratentorial approach (10%) were primarily used to reach the tumors. The pathology examination results revealed that 85.7% of the tumors were meningioma and 14.3% were hemangiopericytoma. Of the 49 patients, 15 achieved a Simpson grade I resection, and 29 achieved a Simpson grade II resection. The follow-up rate was 77.6% (38/45); 94.7% of patients (36/38) achieved a favorable outcome, and 9 experienced tumor recurrences.
Conclusion:
Surgical approach selection depends on the growth characteristics of the tumor and the degree of venous or sinus involvement. The occipital interhemispheric approach is the most commonly used and safest approach for falcotentorial junction tumors with multiple brain pressure control assistance techniques.
Isolated splenic tuberculosis detected only on FDG-PET
Authors: Anuradha Rao, Govindarajan Mallarajapatna, Sharanabasappa Godehal, Swarna Shivakumar
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Tuberculosis (TB) is a well-known problem in developing countries but has shown resurgence in non-endemic populations in recent years. This may be due to increased migration, and is more commonly seen in populations with lowered immunity due to various causes. Isolated splenic TB is extremely rare, especially in immunocompetent patients. In this case report we have described an immunocompetent female, presenting to the physician with fever, without any chest symptoms or weight loss. All microbiological investigations for pyrexia of unknown origin were done, which did not reveal the cause. Imaging modalities including chest radiographs and ultrasound did not reveal any significant abnormalities. Finally, fluorodeoxyglucose (FDG)-positron emission tomography (PET) showed FDG-avid multiple focal nodular lesions (not seen on contrast and non-contrast CT). MRI including diffusion-weighted imaging did not reveal the splenic nodules. PET-directed CT-guided biopsy of the splenic lesions was performed, with histopathology findings suggestive of TB. Atypical clinical and imaging presentations are not uncommon in TB. History of exposure to TB may not be present. Nevertheless, TB should be kept in mind as a differential diagnosis in patients with fever, and extensive search of the source is important. Splenic TB reported in literature to date has been detected by morphological imaging modalities such as ultrasound or contrast CT. Ours is possibly the first case reported in the English literature where FDG-PET has detected the lesions that other imaging modalities failed to show, thus illustrating the role of molecular imaging in the evaluation of pyrexia of unknown origin to localize the site of affection.
Isolated anti-Ro/SSA thrombocytopenia: a rare feature of neonatal lupus
Authors: Imene Dahmane Ayadi, Emira Ben Hamida, Mohamed Riadh Boukhris, Ahlem Bezzine, Sihem Chaouachi, Zahra Marrakchi
Journal: Pan Afr Med J (2015)
Keywords: neonatal lupus erythematosus, anti-ro/ssa, thrombocytopenia
MeSH terms: Antibodies, Antinuclear / immunology, Lupus Erythematosus, Systemic / congenital, Thrombocytopenia / etiology, Thrombocytopenia / immunology, Case Reports, Antibodies, Antinuclear / blood, Humans, Infant, Newborn, Lupus Erythematosus, Systemic / complications, Male, Antibodies, Antinuclear, SS-A antibodies, Neonatal Systemic lupus erythematosus

We report a rare case of isolated thrombocytopenia related to anti-Ro/SSA antibodies. The mother was followed for unlabeled familial thrombocytopenia. The mother had positive anti-Ro/SSA antibodies. She was asymptomatic without skin lesions or other criteria neither of systemic lupus erythematosus nor other connective tissue disease. Pregnancy was uneventful. The postnatal examination was normal. On the first day of life, blood cells count showed thrombocytopenia at 40 x 10(9)/L. Within the second day of life, platelet level dropped to 20 x 10(9)/L. The management of thrombocytopenia included platelet transfusion and human immunoglobulin infusion. On the fifth day of life, there has been a drop in platelet count to 10 x 10(9)/L requiring renewed platelet transfusion and human immunoglobulin infusion. On the 10(th) of life platelets rate was stable around 60 x 10(9)/L. The infant had no evidence of cardiac, dermatologic or hepatobilary involvement initially or throughout follow up.
An Unusual Benign Cause of an Alarming Finding on Chest-X ray: A Case Report of Widened Mediastinum due to Rare Congenital Abnormality (Azygos Vein Continuation of Inferior Vena Cava)
Authors: Michael Hanna, Ghada Elshimy, Medhat Ismail, Mourad Ismail
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Acute widened mediastinum is an alarming finding. It has many possible differential diagnoses; aortic dissection (AD) is considered one that carries catastrophic outcomes. AD is relatively uncommon; it requires early and accurate diagnosis and treatment for better patient survival. However, acute mediastinal widening also can be present in more benign conditions. We report a case of a 50-year-old African American female with postoperative shortness of breath; initial imaging studies revealed an acute widened mediastinum, but on further management with diuresis and follow-up imaging, she was diagnosed with azygous vein continuation of the Inferior vena cava (IVC). This is considered as a rare benign cause of wide mediastinum. Clinicians must be aware of the presence of such a benign cause when dealing with acute wide mediastinum.
Disseminated Aspergillosis due to Aspergillus niger in Immunocompetent Patient: A Case Report
Authors: Ulku Ergene, Zeynep Akcali, Demircan Ozbalci, Nalan Nese, Sebnem Senol
Journal: Case Rep Infect Dis (2013)

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Many cases of pulmonary, cutaneous, cerebral, and paranasal sinus aspergillosis in immunocompetent patient were defined in literature but disseminated aspergillosis is very rare. Here we present an immunocompetent case with extrapulmonary disseminated aspergillosis due to Aspergillus niger, totally recovered after effective antifungal treatment with voriconazole.
Tuberous sclerosis, deep vein thrombosis and lack of C and S proteins: A case report
Authors: Seyed Seifollah Beladi-Mousavi, Abbasali Zeraati, Farzaneh Sharifipour, Masih Naghibi, Farnaz Kalani, Sara Moussavinik, Marzieh Beladi-Mousavi
Journal: J Renal Inj Prev (2012)
Keywords: adult polycystic kidney disease, protein c, protein s, tuberous sclerosis
MeSH terms: Case Reports

Introduction:
Tuberous sclerosis, an autosomal dominant disorder, is characterized by hamartomas in different organs of body. Kidney involvement is quite common in this disorder and sometimes it is accompanied by adult polycystic kidney disease.
Case:
A 46-year-old woman who was being treated for adult polycystic kidney disease and systemic hypertension was admitted to this hospital because of acute lower limb edema. Color Doppler sonography study showed deep vein thrombosis of lower limbs and also left iliac vein. Despite the initiation of hourly heparin infusion, the patient involved by pulmonary emboli on the 2(nd)day of admission. Lab tests revealed protein C and S deficiency. The patient had already experienced episodes of pneumothorax too. Cutaneous lesions due to sebaceous adenoma were seen on her cheeks, nose and neck. She had also periungual fibroma suggestive of tuberous sclerosis.
Conclusion:
Although, according to our patient with both tuberous sclerosis and protein C and S deficiency, a significant relation between these two diseases, cannot confirmed, however, evaluation of other patients who have tuberous sclerosis can help to confirm or rule out this relation.
Multiples of multiple: Case series of mirror aneurysms and review of literature
Authors: Niranjana Rajagopal, Yasuhiro Yamada, Arun Balaji, Tsukasa Kawase, Yoko Kato
Journal: Int J Surg Case Rep (2019)
Keywords: embryology, multiple intracranial mirror aneurysms, treatment options

Introduction:
Mirror aneurysms are a rare subtype of multiple aneurysms, located in identical or adjacent arterial segment bilaterally. We report a case series of 3 such patients amongst whom one of them had 3 sets of mirror aneurysms and the other patient had 2 sets of mirror aneurysm on the same arterial segment which has not been reported till date.
Methods:
A retrospective analysis of 3 patients with incidentally detected multiple mirror aneurysms, who were treated with microsurgical clipping and coiling, was conducted. A systematic search was performed using the PUBMED database and relevant articles were reviewed with particular attention to incidence, associated conditions, risk factors and management strategies. Written informed consent was obtained from all of the patients for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request. This research work has been reported in line with the PROCESS criteria (Agha et al., 2018).
Results:
All the 3 patients were females with incidentally detected multiple mirror aneurysms. All the 3 patients were known Hypertensives. All the aneurysms were successfully clipped by a multistage, bilateral craniotomy except the one in the cavernous ICA, for which an endovascular procedure is planned. All of them had an uneventful postoperative course with the CT angiogram showing obliteration of all the clipped aneurysms except the one in the cavernous ICA.
Conclusions:
Multiple mirror aneurysms represent a rare occurrence of a diverse pathology. Both these described types of cases have not been reported so far in the literature. The treatment strategy for mirror aneurysms should be determined individually based on the location, size, and morphology of the aneurysms, as well as, on the clinical manifestations of each patient.
Secondary amyloidosis associated with heroin use and recurrent infections - A case report
Authors: Deepthi Mani
Journal: Ann Med Surg (Lond) (2018)
Keywords: heroin use, renal amyloidosis, secondary amyloidosis
MeSH terms: Case Reports

A 49-year-old lady with history of polysubstance use disorder, recurrent cutaneous abscesses, spinal diskitis and septic thrombophlebitis presented to the emergency room with complaints of intermittent fevers, worsening right hip pain and bilateral lower extremity edema. A month before the presentation, she had left another hospital against medical advice after being diagnosed with Methicillin-resistant Staphylococcus aureus bacteremia and right hip septic arthritis. Post discharge, she was off antibiotics, but continued heroin and methamphetamine use. On admission, she had right hip chronic osteomyelitis and was also in acute renal failure with evidence of nephrotic range proteinuria. Her renal biopsy subsequently revealed acute tubular necrosis and secondary (AA) amyloidosis with the classic apple green birefringence and positive immunohistochemical stain for serum amyloid A protein. Secondary amyloidosis, where there is deposition of fibrils composed of fragments of the acute phase reactant - serum amyloid A protein, often complicates chronic diseases with ongoing or recurring inflammation like spondyloarthropathies, inflammatory bowel disease and heredofamilial periodic fever syndromes. Epidemiological studies now indicate that chronic inflammation as noted in illicit drug users, especially heroin users is on the rise as the etiology for AA amyloidosis in some parts of the developed world. The most common organ system involved in AA amyloidosis is the kidney. Given the opioid epidemic, clinicians are more likely to encounter similar cases of secondary amyloidosis.
Denosumab as the Treatment of Recalcitrant Tuberculous Pleural Effusion-Associated Hypercalcemia
Authors: Afdhal Afiq Abd Jalil, Sharifah Faradila Wan Muhamad Hatta, Aimi Fadilah Mohamad, Mohammed Fauzi Abdul Rani
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Denosumab is a human monoclonal antibody that binds to RANKL (receptor activator of nuclear factor-kappa B ligand). It has mainly been used in the treatment of osteoporosis for a variety of causes especially in situations refractory to bisphosphonates or when kidney function is impaired. It is also used in cases of malignancy-associated hypercalcemia. There are many causes of hypercalcemia, but only rarely it is associated with granulomatous diseases such as tuberculous pleural effusion. We report a case of hypercalcemia from tuberculous pleural effusion that was initially admitted with left medium abundance pleural effusion and a serum corrected calcium level of 3.48 mmol/L. The calcium level was successfully normalized within 72 hours of subcutaneous denosumab administration after other interventions have failed.
Transient oculomotor palsy after influenza vaccination: short report
Authors: Diogo Fraxino de Almeida, Adilson Teixeira Teodoro, Rafael de Figueiredo Radaeli
Journal: ISRN Neurol (2011)
MeSH terms: Case Reports

Several neurological complications have been described after influenza vaccination. Oculomotor palsy has not been yet related with influenza vaccine. We report a 79-year-old man who developed an acute transient right oculomotor palsy two days after a routine influenza vaccination, for which no other cause was identified. There was no evidence of diabetes, glucose intolerance, high blood pressure, hipercholesterolemia, smoking, obesity, systemic vasculitis, or other risk factor for ischemic neuropathy. The cerebrospinal fluid was normal as well as the MRI and MRA scans. The differential diagnosis and the possible relationship between the vaccine and the oculomotor palsy are discussed.
Case Report: Lenalidomide as a Second-Line Treatment for Bortezomib-Ineffective Nephrotic Syndrome Caused by LCDD: 2 Case Reports and a Literature Review
Authors: Xin Zhang, Xiao-Juan Yu, Su-Xia Wang, Fu-de Zhou, Ming-Hui Zhao
Journal: Front Med (Lausanne) (2021)
Keywords: case report, lenalidomide, light-chain deposition disease, monoclonal gammopathies of renal significance, nephrotic syndrome (ns)
MeSH terms: Case Reports

Background: Light-chain deposition disease (LCDD) is a rare systemic disorder characterized by the deposition of monoclonal light chains in organs. The kidney is a prominent target of light-chain deposition, with a median time to end-stage renal disease (ESRD) of 2.7 years and 5-year ESRD-free survival of 37%. The therapeutic management of LCDD remains ill-defined. In addition to bortezomib-based therapy as first-line therapy, the effect of lenalidomide on LCDD is rarely reported. Case Presentation: This study describes two male LCDD patients in their 60s with nephrotic syndrome and moderately impaired renal function. One patient had monoclonal IgGλ with underlying MGRS, and another had monoclonal IgGκ with underlying monoclonal gammopathy that developed into symptomatic MM during follow-up. The hallmarks of this disease were consistent with previous reports. Both patients initially received BCD therapy, but no hematological response was observed. Consequently, the nephrotic syndrome was refractory. Sequential Rd therapy was initiated, and partial hematological response and nephrotic remission were observed in the IgGλ patient but absent in the IgGκ patient. Conclusion: Limited reports have demonstrated the effect of lenalidomide in LCDD. We report the outcome of lenalidomide in two cases of bortezomib-resistant LCDD. This treatment might be a beneficial supplement for those unresponsive or intolerant to bortezomib in LCDD, but the effect should be prospectively investigated.
Extended negative pressure wound therapy-assisted dermatotraction for the closure of large open fasciotomy wounds in necrotizing fasciitis patients
Authors: Jun Yong Lee, Hyunwook Jung, Ho Kwon, Sung-No Jung
Journal: World J Emerg Surg (2014)
Keywords: dermatotraction, fasciotomy, fournier’s gangrene, necrotizing fasciitis, negative pressure wound therapy

Background:
Necrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction.
Methods:
A retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure.
Results:
After the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm(2) to 29.37 cm(2); p = 0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier's gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on average and showed satisfactory results without wound recurrence.
Conclusions:
Extended NPWT-assisted dermatotraction advances scarred, stiff fasciotomy wound margins synergistically in NF and allows direct closure of the wound without complications. This method can be another good treatment option for the NF patient with large open wounds whose general condition is unsuitable for extensive reconstructive surgery.
Nonsyndromic intellectual disability with novel heterozygous SCN2A mutation and epilepsy
Authors: Takayuki Yokoi, Yumi Enomoto, Yoshinori Tsurusaki, Takuya Naruto, Kenji Kurosawa
Journal: Hum Genome Var (2018)
MeSH terms: Case Reports

SCN2A mutations are primarily associated with a variety of epilepsy syndromes. Recently, SCN2A has been reported as a gene responsible for nonsyndromic intellectual disability or autism spectrum disorders. Here, we present a case of a 12-year-old girl with nonsyndromic intellectual disability who exhibited a heterozygous de novo missense mutation in SCN2A. She developed seizures during the course of illness. This case suggests that the phenotype of patients with heterozygous SCN2A mutations can be variable.
Recurrent herpes zoster duplex symmetricus in HIV infection
Authors: T S Rajashekar, Gurcharan Singh, V Shivakumar, Rajendra Okade
Journal: Indian J Dermatol (2008)
Keywords: contralateral side recurrent zoster, same dermatome

A HIV infected patient with recurrent herpes zoster has been presented. Recurrence of herpes zoster contralaterally on the same dermatome and concomitant occurrence of three viral infections, viz. HIV, HPV and VZV in the same patient were the unusual and interesting observations in the present case report.
Life-Saving Emergency Adrenalectomy in a Pheochromocytoma Crisis with Cardiogenic Shock
Authors: Thalia Bekelaar, Gervais Nougon, Marc Peters, Frederic De Roeck, Steven Haine, Dirk Ysebaert, Maarten Spinhoven, Philippe G Jorens, Rudi De Paep, Frederik Lahaye
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Cardiogenic shock during a pheochromocytoma crisis is a life-threatening disorder. This case report illustrates a 49-year-old male with profound cardiogenic shock, extreme hemodynamic instability (systolic blood pressure ranging from 45 up to 290 mmHg in a cyclic pattern), and progressive multiple organ failure in the presence of a unilateral adrenal mass. Emergency adrenalectomy led to rapid hemodynamic stabilization. Histological investigation confirmed the diagnosis of pheochromocytoma. This case indicates that emergency adrenalectomy, although usually not considered first choice, is a valid option in cardiogenic shock and extremely fluctuating hemodynamics due to a pheochromcytoma-induced catecholamine storm.