OpenMed/multicare-articles huggingface dataset:
Mucinous cystadenocarcinoma of breast in a 69-year-old woman with positive hormone receptors, the first case reported
Authors: Ghodsieh Kamrani, Novin Nikbakhsh, Akarm Hosseini, Hossein Ghorbani, Niloufar Arefisigaroudi, Ali Davarian
Journal: Caspian J Intern Med (2021)
Keywords: breast cancer, estrogen receptor, mucinous cystadenocarcinoma, progesterone receptor
MeSH terms: Case Reports

Background:
Mucinous cystadenocarcinoma is a relatively uncommon histological subtype of breast cancer that is a cystic form of papillary mucinous carcinoma. It is regularly negative for estrogen and progesterone receptors and it is most often diagnosed in older than 55-60 years old. The incidence of breast mucinous cystadenocarcinoma is about 1-6% of primary breast cancers. Here, we present a case of breast mucinous cystadenocarcinoma of left breast in a 69-year-old female which is positive for estrogen and progesterone receptors.
Case presentation:
In this article, we describe a case of a-69-year-old female with a painful mass in her left breast. Based on intraoperative pathology consult, neoplastic tissue mostly floating in mucinous lakes with invasion to surrounding stroma was seen. Immunohistochemistry profile showed positive estrogen and progesterone receptors and negative for HER2.
Conclusion:
Mucinous cystadenocarcinoma of breast is typically triple negative for hormone receptors. But ER and PR positive variant of this tumor is rare, giving the chance of a better prognosis for the patient with hormonal therapy.
Management and clinical outcome of penetrating keratoplasty for long-term corneal changes in sympathetic ophthalmia
Authors: Saraswathi Ramamurthi, Ebube E Obi, Gordon N Dutton, Kanna Ramaesh
Journal: J Ophthalmol (2011)
MeSH terms: Case Reports

Purpose. To report the visual outcome of penetrating keratoplasty performed on the sympathizing eye in three cases of sympathetic ophthalmitis. Methods. Interventional case series of three patients, diagnosed with sympathetic ophthalmitis, with corneal changes in the form of band keratopathy and decompensation underwent penetrating keratoplasty to the sympathizing eye. They had each sustained penetrating trauma as a child and had undergone previous cataract surgery and superficial keratectomy. Two patients had undergone lamellar keratoplasty prior to this procedure. One patient had undergone trabeculectomy for glaucoma, and she was on antiglaucoma medication. The preoperative visual acuity was 1/60 in the affected eye of each patient. Penetrating keratoplasty was performed in the sympathizing eye and the donor graft size was 7.50 mm, and the host graft size was 7.25 mm. Our patients were immunosuppressed prior to the procedure to help prevent graft rejection. Result. At one year follow-up, a BCVA of 6/36 or better was achieved in all three patients. Postoperative examination of the fundus showed peripheral chorioretinal atrophy with pigmentary changes at the macula, accounting for the limited vision. The grafts remain clear to date, and there has been no recurrence of uveitis or rejection. Conclusion. Penetrating keratoplasty can be considered as a surgical option to restore useful vision in a stable sympathizing eye in sympathetic ophthalmitis, and this depends on the extent of the pathology. However, these cases require treatment with immunosuppressives to prevent graft rejection and to prolong graft survival.
An Unusual Association between Unilateral Intracranial Vessels Occlusion with Iron Deficiency Anaemia and Alpha-Thalassemia Trait: A Case Report
Authors: Yeong Yeh Lee, Shalini Bhaskar
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report a 33-year-old Malay woman presented with acute left dense hemiparesis and an NIHSS score of 11/15. Computed tomography (CT) scan brain showed a massive right middle cerebral artery (MCA) territory infarct. The right internal carotid artery (ICA) and right proximal MCA were shown occluded from digital substraction angiography (DSA). Carotid dissection, carotid canal anomaly, and intercavernous communication were systematically ruled out. She had no risk factors for atherosclerosis. The connective tissue screening and thrombophilic markers were negative. However, she was anaemic on admission and subsequent investigations revealed that she had alpha-thalassemia and iron deficiency anaemia. The right ICA remained occluded from a repeat CT cerebral angiogram after one year, but otherwise she was neurologically stable. This case illustrates an unusual association between intracranial vessel occlusion with iron deficiency anaemia and alpha-thalassemia trait.
Case report: Myocarditis following COVID-19 protein subunit vaccination
Authors: Yi-Ming Dong, Xia Liu, Chen-Teng Yang, Qian Qi, Wei-Bo Shi, Ying-Min Li, Min Zuo, Song-Jun Wang, Hai-Tao Bi, Ru-Fei Ma, Guo-Zhong Zhang, Bin Cong
Journal: Front Cardiovasc Med (2022)
Keywords: covid-19, adverse event, autopsy, myocarditis, protein subunit vaccine
MeSH terms: Case Reports

We report findings in a 34-year-old female patient who presented with fulminant myocarditis 8 days after receiving the first dose of the ZF2001 RBD-subunit vaccine against coronavirus disease 2019 (COVID-19). Autopsy showed severe interstitial myocarditis, including multiple patchy infiltrations of lymphocytes and monocytes in the myocardium of the left and right ventricular walls associated with myocyte degeneration and necrosis. This report highlights the details of clinical presentations and autopsy findings of myocarditis after ZF2001 (RBD-subunit vaccine) vaccination. The correlation between vaccination and death due to myocarditis is discussed.
Uniportal Video-Assisted Thoracoscopic Resection and Lobectomy for Infants With Pulmonary Sequestration: Case Series and Initial Experience
Authors: Jin-Xi Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong, Hua Cao
Journal: Front Pediatr (2021)
Keywords: infant, lobectomy, pulmonary sequestration, uniportal, video-assisted thoracoscopic surgery

Background: The present study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic surgery (U-VATS) for infants with pulmonary sequestration (PS). Methods: From January 2019 to July 2020, 19 infants with PS were admitted to a provincial hospital in the Fujian Province of China. A 1.5-cm utility port was created in the fifth intercostal space at the anterior axillary line. A rigid 30° 5-mm optic thoracoscope was used for vision, and two or three instruments were utilized through the port. Surgical options include standard lobectomy, wedge resection, and resection of the extralobar sequestration. Only one intercostal space was entered, and a chest tube was inserted through the same skin incision if necessary. Results: The procedure was successful in all patients with an average operation duration of 58.3 ± 31.5 min. The length of post-operative hospital stay was 5.4 ± 1.5 days, and no post-operative deaths or serious complications were observed. The mean post-operative drainage volume was 164.6 ± 45.9 mL, and the mean post-operative thoracic tube indwelling duration was 5.5 ± 1.0 days. No intraoperative conversion, surgical mortality, or major complications were identified among the patients. Conclusion: Our preliminary experience presented a series of U-VATS lobectomy, wedge resection, and resection of the PS for infants with satisfactory perioperative results.
Half-dose alteplase for sub-massive pulmonary embolism directed by emergency department point-of-care ultrasound
Authors: Richard Amini, Ashish R Panchal, David Bahner, Srikar Adhikari
Journal: West J Emerg Med (2015)
MeSH terms: Emergency Service, Hospital, Fibrinolytic Agents / administration & dosage, Point-of-Care Systems, Pulmonary Embolism / drug therapy, Tissue Plasminogen Activator / administration & dosage, Ultrasonography, Interventional, Case Reports, Fibrinolytic Agents / therapeutic use, Humans, Male, Pulmonary Embolism / diagnostic imaging, Tissue Plasminogen Activator / therapeutic use, Fibrinolytic Agents, Tissue Plasminogen Activator

This report describes a patient with sub-massive pulmonary embolism (PE) who was successfully treated with half-dose thrombolytics guided by the use of point-of-care (POC) ultrasound. In this case, POC ultrasound was the only possible imaging since computed tomography was contraindicated. POC ultrasound demonstrated a deep vein thrombosis and evidence of cardiac strain. In situations or locations where definitive imaging is unobtainable, POC ultrasound can help diagnose submassive PE and direct the use of half-dose tissue plasminogen activator.
Anterior Segment Findings in Vitamin A Deficiency: A Case Series
Authors: Pierangela Rubino, Paolo Mora, Nicola Ungaro, Stefano A Gandolfi, Jelka G Orsoni
Journal: Case Rep Ophthalmol Med (2015)

Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed.
Noise annoyance through railway traffic - a case study
Authors: Paulo Henrique Trombetta Zannin, Fernando Bunn
Journal: J Environ Health Sci Eng (2014)

This paper describes an assessment of noise caused by railway traffic in a large Latin American city. Measurements were taken of noise levels generated by trains passing through residential neighborhoods with and without blowing their horns. Noise maps were also calculated showing noise pollution generated by the train traffic. In addition - annoyance of the residents - affected by railway noise, was evaluated based on interviews. The measurements indicated that the noise levels generated by the passage of the train with its horn blowing are extremely high, clearly exceeding the daytime limits of equivalent sound pressure level - Leq = 55 dB(A) - established by the municipal laws No 10.625 of the city of Curitiba. The Leq = 45 dB (A) which is the limit for the night period also are exceeded during the passage of trains. The residents reported feeling affected by the noise generated by passing trains, which causes irritability, headaches, poor concentration and insomnia, and 88% of them claimed that nocturnal noise pollution is the most distressing. This study showed that the vast majority of residents surveyed, (69%) believe that the noise of the train can devalue their property.
Solitary Fibrous Tumor Arising in the Buccal Space
Authors: Tatsuo Okui, Soichiro Ibaragi, Hotaka Kawai, Akira Sasaki
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

A 39-year-old Japanese woman presented to the Department of Oral and Maxillofacial Surgery, Okayama University Hospital, with the complaint of a slowly growing buccal mass. The mass was well defined, had rounded margins, and was free from skin and muscles. A color Doppler echographic examination indicated high flow velocity of the blood surrounding the mass. Contrast-enhanced images on CT and contrast-enhanced T1-weighted images on MRI displayed a homogeneous enhanced mass with a well-defined margin. A fine-needle aspiration biopsy and histological examination were performed. On immunohistochemistry, spindle cells were strongly positive for CD34, STAT6, and vimentin and negative for EMA, S100, and α-SMA. The tumor was removed with extracapsular dissection. The tumor was composed of bland spindle cells proliferating in a patternless arrangement with a collagenous background. Most of the tumor mass consisted of hypocellular areas including ectatic blood vessels. A prominent branching vascular pattern was observed. Immunohistochemistry demonstrated that the tumor cells were positive for CD34, STAT6, vimentin, and Bcl-2, and negative for α-SMA, S100, and EMA. Three mitotic cells were observed per 10 high-power fields, and the Ki-67 index was 5.7%. The morphological and immunohistochemical features were consistent with a diagnosis of solitary fibrous tumor.
Craniofacial Brown Tumor in Patients with Secondary Hyperparathyroidism to Chronic Renal Failure: Report of Two Cases in Cipto Mangunkusumo Hospital
Authors: Diani Kartini, Maria K Siswiandari, Gunawan Wibisana, Erwin D Yulian, Ahmad Kurnia, Sonar S Panigoro, Azdi Z Albar, Muchlis Ramli
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Brown tumor is a bone lesion that arises in the setting of excess osteoclast activity in hyperparathyroidism. It consists of fibrous tissue, woven bone, and supporting vasculature, while contains no matrix. The characteristic of brown-colored lesion is a result of hemosiderin deposition into the osteolytic cysts. Two cases of young women aged 26 and 29 years old, respectively, are known with a history of end-stage renal disease (ESRD). Dialysis is performed two times/week over the last 7 years. Our patients presented with an intraoral mass of the hard palate since 12 months ago and decreased body height of 10 cm. The lesion causes difficulties in swallowing and talking. Laboratory workup showed elevated parathormone or PTH (3.391 pg/mL and >5.000 pg/mL). Neck ultrasound showed enlargement of the parathyroid glands. Supporting examination to diagnose brown tumor are neck ultrasound, CT of the neck, and parathyroid sestamibi scan. We performed parathyroidectomy. Pathology revealed hyperplasia of the parathyroid. The tumor regressed significantly within 2 weeks following the surgery, and we still observe tumor regression as well as reduction in PTH level. As clinicians, we should be alert to other possible causes of bony lesions. Clinical examination, laboratory finding, and imaging present important information to diagnose brown tumor.
Case report: Pylorus-preserving pancreatoduodenectomy for focal congenital hyperinsulinism in a 5-month-old baby
Authors: Gionata Spagnoletti, Zoe Larghi Laureiro, Alberto Maria Fratti, Arianna Maiorana, Maria Carmen Garganese, Milena Pizzoferro, Carlo Dionisi-Vici, Marco Spada
Journal: Front Surg (2023)
Keywords: congenital hyperinsulinemic hypolglycemia (chi), hypoglycaemia, insulin dysregulation, pediatric surgery, pylorus-preserving pancreaticoduodenectomy (pppd)
MeSH terms: Case Reports

Background:
In focal congenital hyperinsulinism (CHI), surgery is the gold standard of treatment, even for lesions localized in the head of the pancreas. We report the video of the pylorus-preserving pancreatoduodenectomy performed in a five-month-old child with focal CHI.
Operative technique:
Baby was placed in the supine position with both arms outstretched to the up. After transverse supraumbilical incision and mobilization of ascending and transverse colon, exploration and multiple biopsies of the tail and the body of the pancreas ruled out multifocality. Pylorus-preserving pancreatoduodenectomy was performed according to the following steps: extended Kocher maneuver, followed by retrograde cholecystectomy and common bile duct isolation; division of the gastroduodenal artery and of the gastrocolic ligament; division of the duodenum, Treitz ligament and jejunum; transection of the pancreatic body. The reconstructive time was with: pancreato-jejunostomy; hepaticojejunostomy; pilorus-preserving antecolic duodeno-jejunostomy. The anastomoses were accomplished with synthetic absorbable monofilament sutures; two drains were placed close to the biliary and pancreatic anastomoses and to the intestinal anastomosis, respectively. Total operative time was 6 h, with no blood loss and/or intra-operative complications, immediate normalization of blood glucose levels and discharge from surgical ward 19 days after surgery.
Conclusions:
Surgical treatment of medical unresponsive focal forms of CHI is feasible in very small children: it is mandatory to refer the baby to a high-volume centre for a multidisciplinary management involving hepato-bilio-pancreatic surgeons and experts in metabolic disease.
Long-Lasting Symptomatic Cerebral Hyperperfusion Syndrome following Superficial Temporal Artery-Middle Cerebral Artery Bypass in a Patient with Stenosis of Middle Cerebral Artery
Authors: Shinji Shimato, Toshihisa Nishizawa, Takashi Yamanouchi, Takashi Mamiya, Kojiro Ishikawa, Kyozo Kato
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Cerebral hyperperfusion syndrome (CHPS) is a complication that can occur after cerebral revascularization surgeries such as superficial temporal artery- (STA-) middle cerebral artery (MCA) anastomosis, and it can lead to neurological deteriorations. CHPS is usually temporary and disappears within two weeks. The authors present a case in which speech disturbance due to CHPS lasted unexpectedly long and three months was taken for full recovery. A 40-year-old woman, with a history of medication of quetiapine, dopamine 2 receptor antagonist as an antipsychotics for depression, underwent STA-MCA anastomosis for symptomatic left MCA stenosis. On the second day after surgery, the patient exhibited mild speech disturbance which deteriorated into complete motor aphasia and persisted for one month. SPECT showed the increase of cerebral blood flow (CBF) in left cerebrum, verifying the diagnosis of CHPS. Although CBF increase disappeared one month after surgery, speech disturbance continued for additionally two months with a slow improvement. This case represents a rare clinical course of CHPS. The presumable mechanisms of the prolongation of CHPS are discussed, and the medication of quetiapine might be one possible cause by its effect on cerebral vessels as dopamine 2 receptor antagonist, posing the caution against antipsychotics in cerebrovascular surgeries.
Late Treatment and Recurrence of Kawasaki Disease in a Moroccan Infant
Authors: R Elqadiry, O Louachama, N Rada, G Draiss, M Bouskraoui
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Introduction:
While the diagnosis of typical form of Kawasaki disease (KD) is obvious, this multifaceted disease continues to surprise us. We report the case of a recurrent Kawasaki disease in an infant.
Case:
At the age of 13 months, the infant was diagnosed with complete Kawasaki disease; he presented with prolonged fever, bilateral conjunctivitis, enanthem, exanthema, edema of the lower limb, peeling, and biological inflammatory syndrome. He was treated with intravenous immunoglobulin (IVIG) associated with a high dose of aspirin and then an antiplatelet dose with a good clinical-biological evolution. The echocardiography was normal. Seven months later, the patient was again admitted, in a similar picture: a prolonged fever evolving for 7 days, bilateral conjunctivitis, enanthem, cervical adenopathy of 1.5 cm/1 cm, scarlatiniform erythema, pruriginous of the trunk and limb, and peeling of the toes, with indurated edema of the hands and feet. The rest of the examination was normal except the irritability. The diagnosis of recurrent KD was made according the five criteria of the American Heart Association. The echocardiography was normal again. The infant received IVIG with good outcome.
Conclusion:
Despite its rarity, the possibility of recurrence of KD should be known by clinicians, so as not to delay the specific management of vasculitis whose stakes in terms of prevention of coronary artery lesions are well known. Our case confirms the possibility of this recurrence.
Intraoperative anaphylaxis due to gelofusine in a patient undergoing intramedullary nailing of the femur: a case report
Authors: Ioannis Polyzois, Andrina Lampard, Paras Mohanlal, Evgenios Tsiridis, Nikolaos Manidakis, Eleftherios Tsiridis
Journal: Cases J (2009)

Background:
Although uncommon, anaphylaxis due to a colloid plasma expander can occur peri-operatively
Case presentation:
We present a case of an intra-operative cardiac arrest in a 72 year old Caucasian male patient who underwent prophylactic intramedullary nailing for a proximal femoral metastasis from prostate cancer. The patient was resuscitated successfully and the procedure was completed uneventfully. Elevated serum tryptase levels confirmed the diagnosis of an anaphylactic reaction and positive allergy skin prick testing identified gelofusine as the causative agent.
Conclusion:
A high index of suspicion, prompt diagnosis and rapid institution of treatment are essential for a safe outcome following such reactions. To our knowledge, this is the first published report of such a severe reaction to gelofusine infusion that occurs during an orthopaedic procedure.
Intraparenchymal papillary meningioma of brainstem: case report and literature review
Authors: Xiao-Bing Jiang, Chao Ke, Zhi-An Han, Shao-Hua Lin, Yong-Gao Mou, Rong-Zhen Luo, Shao-Xiong Wu, Zhong-Ping Chen
Journal: World J Surg Oncol (2012)
MeSH terms: Brain Stem Neoplasms / pathology, Meningeal Neoplasms / pathology, Meningioma / pathology, Case Reports, Adult, Brain Stem Neoplasms / radiotherapy, Brain Stem Neoplasms / surgery, Combined Modality Therapy, Humans, Magnetic Resonance Imaging, Male, Meningeal Neoplasms / radiotherapy, Meningeal Neoplasms / surgery, Meningioma / radiotherapy, Meningioma / surgery, Treatment Outcome, Young Adult

Both intraparenchymal papillary meningioma and papillary meningioma with cyst formation of brainstem have never been reported. The authors present an extremely rare case of patient with intraparenchymal papillary meningioma of brainstem. A 23-year-old Chinese male presented with a 4-month history of progressive left upper limb and facial nerve palsy. Magnetic resonance imaging revealed a cystic-solid, heterogeneously enhancing mass in pons and right cerebral peduncle with no dural attachment. The tumor was totally removed via subtemporal approach. During surgery, the lesion was found to be completely intraparenchymal. Histological and immunohistochemical examinations were compatible with the diagnosis of papillary meningioma. The lesion recurred nine months after primary surgery, a second surgery followed by radiotherapy was performed. Till to now (nearly 2 years after the treatment), the patient is tumor free survival. Intraparenchymal meningioma of brainstem with cystic formation is very rare, however, it should be considered as a differential diagnosis of a brainstem neoplasm. The present case strongly recommended that postoperative radiotherapy was essential for the patients with papillary meningiomas.
Necrotizing Epididymo-Orchitis: A Rare Manifestation of COVID-19
Authors: Ali Tavoosian, Sana Ahmadi, Seyed Mohammad Kazem Aghamir
Journal: Case Rep Urol (2022)
MeSH terms: Case Reports

Epididymo-orchitis is an infection of the epididymis and testis, one of the most common urogenital infections. It can be seen at any age. It is caused by sexually transmitted microorganisms and nonsexual transmitted pathogens. Viruses such as mumps and cytomegalovirus can also cause epididymo-orchitis. During the COVID-19 pandemic, in case of abnormal clinical manifestations of COVID infection and inadequate therapeutic response to the routine therapies, this disease with unusual manifestations should be considered. The case introduced in this paper is a 55-year-old man referred to a urology clinic with typical clinical presentations of epididymo-orchitis. Diagnosis by color Doppler examination and ultrasound also confirmed epididymo-orchitis. The patient underwent appropriate and routine treatment for epididymo-orchitis. Because of the lack of adequate clinical response and the continuation of fever and the development of scrotal lesions and the results of the control ultrasound, which suggested rupture of the tunica albuginea capsule, he underwent surgical exploration and subsequent orchiectomy. Due to the unconventional conditions and the usual culture and pathology, COVID-19 PCR was also performed on the tissues. The PCR showed tissue infection with COVID-19. The patient's clinical condition improved with an orchiectomy, the fever stopped, and he was discharged in a good general condition. It should be noted that before referral to the urology clinic and during hospitalization, evaluation, and treatment, the patient had no evidence in favor of respiratory tract infection with the coronavirus.