OpenMed/multicare-articles huggingface dataset:
A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent
Authors: Kleanthi Mylopotamitaki, Dionisios Klonaris, Georgios Kazamias, Christos Simandirakis, Irene Vourliotaki, Efthimios Karakostas
Journal: Case Rep Otolaryngol (2023)
MeSH terms: Case Reports

Background:
Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation. A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck. Physical examination revealed a well-circumscribed, moderately hard, tender mass of the anterior neck midline anteroinferior to the hyoid bone. Imaging findings suggested TDC as the most likely diagnosis. The patient had a Sistrunk procedure under general anesthesia. Histopathological findings diagnosed a BRAFV600E-positive papillary thyroid carcinoma (PTC) in a TDC. A thyroid gland and neck ultrasound revealed a highly suspicious finding for malignancy right level VI lymph node, which was not confirmed by fine needle aspiration cytology (FNAC). Under general anesthesia, total thyroidectomy and central compartment lymph node neck dissection were performed. Histopathological findings revealed a thyroid parenchymal locus of PTC, as well as three lymph nodes infiltrated by PTC. The patient received adjuvant radioactive iodine ablation (RAI) therapy and is closely followed.
Conclusion:
TDC carcinomas in conjunction with thyroid carcinomas in young patients are rare. Preoperative diagnosis can be challenging, as the vast majority of neck masses in young patients are benign in nature, and most malignant tumors lack specific clinical features. The diagnostic accuracy of FNAC is considered unsatisfactory due to its frequently cystic nature. Definitive diagnosis is based on histopathological findings. Clinicians should maintain a high level of suspicion for coexisting thyroid malignancies. Although surgical extirpation of the malignancy is considered standard of care, the treatment of TDC cancer should always be individualized by a multidisciplinary team.
Schistosomiasis Involving the Central Nervous System: Case Report of a Rare Complication
Authors: Rahaf F Alanazi, Maryam Al Karawi, Abdulrahman Almalki, Fahd Sufiani, Sarmad Al Karawi
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Introduction:
Schistosomiasis is a parasitic infection caused by schistosome invasion of blood circulation. Neuroschistosomiasis is a severe cerebral complication that accounts for less than 2.3% of reported cases. Patients present with progressive encephalitis, seizures, or both. Management includes antiparasitic medications, steroids, and surgical intervention. Case Presentation. We report a case of a 44-year-old female who presented to the ER with a history of transient loss of consciousness (LOC) and seizure. Radiological investigations revealed a right frontal brain lesion. Histopathological results confirmed the diagnosis of schistosomiasis.
Conclusion:
Schistosomiasis is a parasitic infection commonly diagnosed in patients who live in tropical areas. Early diagnosis with radiological and histopathological evaluation is required to identify patients at risk of developing severe neurological complications.
Friendly Kisses Can Be Deadly: Capnocytophaga canimorsus Bacteremia in an Asplenic Patient Exposed to Canine Saliva
Authors: Christina Rubio, Jared Miller, Tomasz Zrodlowski, Susanti Ie
Journal: Case Rep Crit Care (2023)
MeSH terms: Case Reports

The differential diagnosis for febrile asplenic patients must always include opportunistic infections. Capnocytophaga canimorsus is one such infection. In this report, we discuss the case of a 73-year-old woman with a medical history significant for splenectomy for splenic sarcoma with prophylactic vaccination for pneumococcus who presented with rigors, emesis, and abdominal pain. Initial vital signs were 39.6°C (103.3°F), 166/70 mmHg, 92 bpm, and 95% SpO2 on room air. A physical examination revealed mild epigastric tenderness. Initial labs and imaging were unremarkable. Eight hours after the presentation, she became hypotensive. Repeat labs revealed leukopenia with 51% bands, hemoglobin 11.0 g/dL down from 13.9 g/dL, platelets 74 K/μL trending down to 15 K/μL, PT 23.5 sec., aPTT 60.3 sec., D-dimer greater than 20 μg/mL, fibrinogen 190 mg/dL, LDH 1515 IU/L, haptoglobin less than 20 mg/dL, and creatinine 1.84 mg/dL. A peripheral smear showed schistocytes. Blood cultures identified gram-negative rods and Capnocytophaga canimorsus. After further questioning, she recalled her dog licking an abrasion on her left index finger. Four days after the presentation, she developed a purpuric rash on her bilateral hands and feet with areas of Nikolsky's negative bullae along the dorsum of her left foot. She also developed acute renal failure requiring renal replacement therapy and hemodialysis. Capnocytophaga canimorsus is an encapsulated facultative anaerobic gram-negative bacillus. Infection can result in bacteremia and sepsis and carries a high mortality rate, even with treatment. Those with hyposplenism/asplenia are particularly susceptible to infection and can deteriorate quickly, as seen in this case. Although this infection is rare, our case highlights how all asplenic patients must be assessed and treated for encapsulated bacterial infections when presenting with an acute febrile illness, regardless of initial laboratory analysis.
Participatory design research for the development of real-time simulation models in healthcare
Authors: Alison Harper, Navonil Mustafee
Journal: Health Syst (Basingstoke) (2023)
Keywords: design science research, participatory modelling and simulation, real-time simulation

The implementation challenges for modelling and simulation in health and social care are well-known and understood. Yet increasing availability of data and a better understanding of the value of Operational Research (OR) applications are strengthening opportunities to support healthcare delivery. Participative approaches in healthcare modelling have shown value through stakeholder engagement and commitment towards co-creation of models and knowledge but are limited in focus on model design and development. For simulation modelling, a participative design research methodology can support development for sustained use, emphasising model usefulness and usability using iterative cycles of development and evaluation. Within a structured methodology, measures of success are built into the design process, focusing on factors which contribute to success, with implicit goals of implementation and improvement. We illustrate this through a participative case study which demonstrates development of the component parts of a real-time simulation model aimed at reducing emergency department crowding.
Use of Handheld Bedside Ultrasound to Confirm Successful Reduction of an Anterior Shoulder Dislocation
Authors: Robin Lahr, Frank Wheeler, James Espinosa, Alan Lucerna, Henry Schuitema
Journal: Cureus (2024)
Keywords: anterior shoulder dislocation, bedside ultrasound, handheld ultrasound, handheld ultrasound in shoulder dislocations, shoulder dislocation
MeSH terms: Case Reports

We present the case of a 30-year-old male with anterior shoulder dislocation in which a bedside handheld ultrasound was used after sedation and a reduction procedure to confirm successful reduction. X-ray imaging as well as bedside ultrasound was performed before and after the reduction. The bedside handheld ultrasound demonstrated findings comparable to the X-ray results. X-ray imaging is used as a standard not only in the diagnosis of a dislocated shoulder but also to ensure successful reduction and to assess for any procedure-related fractures. An advantage of immediate bedside ultrasound is that immediate recognition by ultrasound of an unsuccessful reduction can allow the reduction process to continue while the patient is sedated, thus avoiding additional independent sedation procedures. The utilization of bedside ultrasonography in this manner may allow more expeditious and safer care for patients with shoulder dislocations.
Primary Peritoneal Serous Cancer: A Case Report of a Tumor in the Rectovaginal Septum
Authors: Analy Herrera-Torres, Carlos Guadalupe Parra-Torres, Gabriela C Alamilla García, María Del Rocío Thompson Bonilla, Oscar Manuel García Córdova, Alfredo Padilla Martínez, Rodolfo Iván Lara Ruíz, Esther Ramírez Moreno
Journal: Case Rep Oncol Med (2024)
MeSH terms: Case Reports

Peritoneal cancer is the invasion by malignant cells of serous membrane that lines the abdominal cavity, the viscera, and the coelom of the amniotes. Histologically, it is indistinguishable from ovarian counterpart, although in the former, it commonly involves the ovary only superficially, or it may totally lack an ovarian component, but with extensive involvement of the peritoneum, calcified perihepatic peritoneal nodules, or involvement of the omentum, in most cases. The current study describes the case of a 54-year-old female patient referring a history of colitis and dairy intolerance. A transvaginal ultrasound and a computed tomography (CT) scan revealed a tumor measuring 70 × 61 × 63 mm. CA-125 serum levels were 880 U/ml. Laparotomy surgery was indicated, and tumor was found at the level of the rectovaginal septum without evidence of metastasis. Tumor dissection and protective colostomy with loop sigmoid colon were performed. A pathological study gave a diagnosis of a high-grade peritoneal serous carcinoma with a micropapillary pattern. The present study describes the case of papillary serous peritoneal cancer presented as a single tumor mass without extensive involvement of the peritoneum. Additionally, the need for routine tests for its diagnosis and documenting hormonal alterations as the cause of its origin are suggested.
Case Report: Carcinoid heart disease with severe tricuspid regurgitation and concomitant patent foramen ovale causing severe hypoxia
Authors: Michael Cronin, Brendan McAdam
Journal: Front Cardiovasc Med (2024)
Keywords: carcinoid heart disease, echocardiography, patent foramen ovale, transcatheter, tricuspid regurgitation
MeSH terms: Case Reports

This case report demonstrates a unique case of managing complex concomitant structural cardiac issues using transcatheter techniques in a frail patient. The primary regurgitant lesion in this case caused significant right to left shunting with severely debilitating hypoxaemia for the patient, requiring high volumes of ambulatory oxygen to compensate. We would like to highlight the role of multi-modality cardiac imaging demonstrated in this case, as well as the limited surgical data and poor outcomes in advanced disease with higher peri-operative complications. Finally, it should be noted that percutaneous correction of structural lesions may provide palliative relief but carries an uncertain risk of recurrence.
Unveiling the Enigma: A Rare Case of a Massive Gartner's Cyst Inducing Acute Urinary Retention
Authors: Aishwarya Gupta, Neema Acharya, Sandhya Pajai, Preeti Mishra, Jalormy S Joshi
Journal: Cureus (2024)
Keywords: acute urinary retention, gartner's cyst, mullerian cysts, vaginal cysts, wolffian remnants
MeSH terms: Case Reports

Vaginal cysts can occur due to embryonic remnants, misplaced tissue, or an abnormality in the urinary system. They are a common occurrence and usually indicate non-cancerous conditions. A case is presented here of a 35-year-old female para three living three who reported to the emergency room with complaints of acute retention of urine with something coming out of her vagina over the last two years. She was managed operatively by vaginal cystectomy, which led to the resolution of the symptoms.
Case Report: Vertical muscle-sparing latissimus dorsi flap in the reconstruction of chronic radiation-induced chest wall ulcers after breast cancer surgery: a case series
Authors: Sung Joon Han, Junghee Kim, Sunje Kim, Yooseok Ha
Journal: Front Surg (2024)
Keywords: breast cancer, chronic ulcers, flap surgery, latissimus dorsi flap, radiation therapy, reconstruction
MeSH terms: Case Reports

Introduction:
Radiation therapy, a standard postoperative treatment for breast cancer, can lead to chronic ulcers owing to compromised tissue healing. Accordingly, flap surgery using healthy tissues is essential for aesthetic and functional recovery. Although various flap techniques exist, each has its own drawbacks. This study introduces the vertical muscle-sparing latissimus dorsi flap as a superior alternative due to its comparative operative efficiency and tissue preservation.
Case report:
Two female patients aged 60 and 59 years with histories of breast cancer in their left breast treated with radiotherapy presented with chronic ulcers. The first patient had a 4 × 5 cm defect infiltrating the pleural space, while the second had a 15 × 9 cm defect after thoracic surgery for a bronchopleural fistula. In both cases, debridement was followed by reconstruction using a vertical muscle-sparing latissimus dorsi flap, thereby avoiding the need to change the patient's position and repeated draping during surgery. Both patients showed good postoperative recovery without significant complications.
Results:
The vertical muscle-sparing latissimus dorsi flap resulted in better adhesions and functional outcomes due to shorter surgical duration.
Conclusion:
The vertical muscle-sparing latissimus dorsi flap is an effective and efficient method for reconstructing radiation-induced chest wall ulcers in patients with breast cancer. Its application in the presented cases highlights its potential as a preferred option in similar clinical scenarios.
Carcinosarcoma of the ovary: a case report and literature review
Authors: Jian Zheng, Cui Tang, Ping Liu, Hua Hao
Journal: Front Oncol (2023)
Keywords: carcinosarcoma, case report, clinicopathology, differential diagnosis, ovary, treatment
MeSH terms: Case Reports

Objective:
Carcinosarcoma of the ovary is a rare pathological type of ovarian cancer that is highly aggressive and occurs most frequently in the female reproductive tract at the site of the uterus. Herein, we explore the clinicopathological features, diagnosis, differential diagnosis, and treatment options for carcinosarcoma of the ovary.
Methods:
We analyzed the clinical data of a case of carcinosarcoma, observed its histological morphology and immunohistochemical characteristics, detected the homologous recombination repair deficiency gene mutation, and reviewed the relevant literature.
Results:
A 76-year-old menopausal woman visited our hospital because of abdominal distension, difficulty in urination, and constipation. Ultrasonography demonstrated abnormalities in the uterus and pelvic cavity, suggesting that the patient should undergo surgery. Immunohistochemical findings of carcinosarcoma of the right ovary were as follows: CK fraction (+), vimentin fraction (+), CK5/6 foci (+), p16 (+), p53 in approximately 70% (+), WT-1 foci (+), ER foci (+), PR part (+), Her-2 (1+), CK7 fraction (+), CK20 foci (+), CD99 fraction (+), CD10 fraction (+), CD56 foci (+), c-kit foci (+), SMA part (+), desmin foci (+), PD-L1 (-), SALL4 (-), OCT3/4 (-), p63 (-), p40 (-), D2-40 (-), inhibin (-), PLAP (-), CD30 (-), and Ki67 hotspot in approximately 80% (+). The patient underwent tumor cytoreduction and adjuvant chemotherapy. Currently, she is being followed up for 16 months and has a good general condition.
Conclusion:
The diagnosis of carcinosarcoma relies on histopathological examination and differentiation of carcinosarcoma from immature teratoma. The current therapeutic regimen for carcinosarcoma is still based on tumor cytoreduction and platinum-containing chemotherapy; research on targeted therapy is still in progress.
A Rare Coexistence of Smoldering Multiple Myeloma and JAK2-Positive Myeloproliferative Neoplasm: A Case of Dual Synchronous Hematological Malignancy
Authors: Adnane Hammani, Othman Doghmi, Mohammed Allaoui, Mounir Ababou, El Mehdi Mahtat, Hicham El Maaroufi, Kamal Doghmi
Journal: Cureus (2024)
Keywords: essential thrombocythemia, jak2 mutation, monoclonal gammopathy, myeloproliferative neoplasm, smoldering multiple myeloma, synchronous dual hematological malignancy
MeSH terms: Case Reports

This article explores the rare case of an 82-year-old man diagnosed concurrently with essential thrombocythemia and smoldering multiple myeloma (SMM). The limited existing literature on individuals harboring both myeloproliferative neoplasm (MPN) and monoclonal gammopathy (MG) is of significant interest due to the distinct origins of these malignancies. The etiology of MG in MPN patients remains elusive, leading to speculation about a potential relationship or interplay between the two conditions. This unique case prompts a deeper exploration of the mechanisms underlying the coexistence of JAK2-positive MPN and SMM. It underscores the importance of tailored therapeutic strategies that carefully consider the inherent risks and potential adverse outcomes associated with these specific malignancies, thereby warranting further clinical research.
Use of Preoperative 3D Virtual Planning and 3D-Printed Patient-Specific Guides to Facilitate a Single-Stage Cranial Closing Wedge Ostectomy and Tibial Plateau Leveling Osteotomy Procedure to Address Proximal Tibial Deformity, an Excessive Tibial Plateau Angle, and Cranial Cruciate Ligament Insufficiency in a Dog
Authors: Christina C De Armond, Daniel D Lewis, Sarah Townsend
Journal: Case Rep Vet Med (2023)
MeSH terms: Case Reports

A 9-month-old mixed-breed dog was presented for bilateral proximal tibial deformity resulting in an excessive tibial plateau angle and cranial cruciate ligament insufficiency. Initial surgical management of the right pelvic limb was done by performing a cranial closing wedge ostectomy. Inadequate leveling of the plateau resulted in a postliminal meniscal tear which was addressed during a revision tibial plateau leveling osteotomy. The left pelvic limb was managed in a single-session surgery using three-dimensional (3D) virtual surgical planning and custom 3D-printed surgical guides to perform a combined cranial closing wedge ostectomy and tibial plateau leveling osteotomy. Postoperative 3D analysis of the left tibia revealed the accuracy of the surgical result within 2° of the virtual surgical plan. The dog developed a transient grade II/IV left medial patellar luxation following surgery but ultimately attained a full functional recovery and was actively engaged in competitive agility work 46 months following surgery on the left pelvic limb.
Incidental Discovery of Hepatocellular Carcinoma on 18F-PSMA PET CT Performed for Prostate Cancer Reassessment
Authors: Lauren Hekman, Eva Napierkowski, Natalie C Hartman, Jeffrey L Ellis, Robert H Wagner, Davide Bova, Maria M Picken, Robert C Flanigan
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Prostate-specific membrane antigen positron emission tomography (PSMA PET) has been approved by the Food and Drug Administration (FDA) to identify prostate cancer in the setting of biochemical recurrence but can also identify other malignancies. 18F-PSMA PET has not been studied as a potential tool for hepatocellular carcinoma (HCC). We describe the case of a 76-year-old male with a rising prostate-specific antigen (PSA) after definitive prostate cancer treatment and no prior liver pathology who was incidentally found to have HCC on 18F-PSMA PET.
Extrapleural air secondary to idiopathic pulmonary fibrosis-related pneumomediastinum
Authors: Yuichi Nagata, Takayasu Watanabe, Yuki Tanabe, Motoyasu Kato, Takehito Shukuya, Kuniaki Seyama, Kazuhisa Takahashi
Journal: Respirol Case Rep (2024)
Keywords: coronal reconstruction, extrapleural air, pneumomediastinum, pneumothorax, pulmonary fibrosis
MeSH terms: Case Reports

Extrapleural air is a rare condition that may concurrently develop with pneumomediastinum and pneumothorax, especially in older patients with fragile connective tissues. Physicians should consider extrapleural air to prevent inadvertent harm. Coronal reconstruction computed tomography images help appreciate extrapleural air and recognize the track of extrapulmonary air.
A Chinese patient with POLR3A-related leukodystrophy: a case report and literature review
Authors: Lei Sun, Weihong Lin, Hongmei Meng, Wuqiong Zhang, Shuai Hou
Journal: Front Neurol (2023)
Keywords: 4h syndrome, polr3a, demyelinating diseases, diagnosis, hypomyelinating leukodystrophy-7
MeSH terms: Case Reports

Background:
Leukodystrophies are hereditary white matter diseases characterized by genetic polymorphisms and considerable phenotypic variability. They can be classified into myelin and non-myelin malformations. These diseases are rare, affecting 1 out of 250,000-500,000 individuals and can manifest at any age. A subtype of leukodystrophy, associated with missense mutations in the RNA polymerase subunit III (POLR3A) gene, is inherited in an autosomal recessive manner.
Case report:
We report and analyse a case of a 34-year-old female who presented with ataxia. Magnetic Resonance Imaging (MRI) of the brain revealed demyelinating lesions in the white matter. Genetic testing identified the c.4044C > G and c.1186-2A > G variants in the POLR3A gene. The patient was diagnosed with hypomyelinating leukodystrophy type 7 and received neurotrophic and symptomatic supportive therapy. However, after 1 month of follow-up, there was no improvement in her symptoms.
Conclusion:

POLR3A-induced leukodystrophy is relatively rare and not well understood, making it challenging to diagnose and easy to overlook. The prognosis for this disease is generally poor, significantly impacting the quality of life of affected individuals. Currently, no cure is available for this condition, and treatment is limited to managing symptoms. Further research into new treatment methods for POLR3A-induced leukodystrophy is imperative to improve the quality of life and potentially extend the life expectancy of patients.
An adult with cystathionine beta-synthase deficiency, camptodactyly-arthropathy-coxa vara-pericarditis syndrome, and deafness: A case report
Authors: Karina Carvalho Donis, Marco Antônio Baptista Kalil, Fabiano Poswar, Fernando Kok, Charles Lubianca Kohem, Soraia Poloni, Taciane Borsatto, Filippo Pinto E Vairo, Franciele Cabral Pinheiro, Ida Vanessa Doederlein Schwartz
Journal: Genet Mol Biol (2024)

Massive sequencing platforms allow the identification of complex clinical phenotypes involving more than one autosomal recessive disorder. In this study, we report on an adult patient, born to a related couple (third degree cousins), referred for genetic evaluation due to ectopia lentis, deafness and previous diagnosis of juvenile idiopathic arthritis. He was biochemically diagnosed as having Classic Homocystinuria (HCU); Sanger sequencing of the CBS gene showed the genotype NM_000071.2(CBS):c.[833T>C];[833T>C], compatible with the diagnosis of pyridoxine-responsive HCU. As he also had symptoms not usually associated with HCU, exome sequencing was performed. In addition to the variants found in the Sanger sequencing, the following variants were identified: NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A]; and the NM_005807.6(PRG4):c.[3756dup]:[3756dup], confirming the diagnosis of autosomal recessive nonsyndromic deafness and Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome (CACP), respectively. Genomic analysis allowed the refinement of the diagnosis of a complex case and improvement of the patient's treatment.