OpenMed/multicare-articles huggingface dataset:
Intraocular Lymphoma or Infection? Subretinal Aspirate Confirms the Diagnosis
Authors: A Saad, S O Salceanu, K Oswal, A Aboushrkh, D Hamada
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

Purpose:
To demonstrate the importance of subretinal biopsy to reach a diagnosis when vitreous biopsy is negative or inconclusive.
Methods:
A 54-year-old Caucasian gentleman presented with bilateral anterior uveitis at JCUH. He initially responded to topical steroids and dilating agents. Subsequently he developed bilateral panuveitis and cataract with poor response to treatment. Detailed workup had been done to rule out infectious etiology. A suspicion of lymphoma was considered and vitreous biopsy sample was taken from one eye, which was inconclusive. Then, to help with definitive diagnosis vitreous sample, subretinal aspirate and retinal biopsy were taken.
Results:
Subretinal aspirate revealed Aspergillus niger. Treatment was initiated accordingly.
Conclusions:
Subretinal aspirate and retinal biopsy can help with diagnosis of unusual clinical panuveitis like presentation.
Cytomegalovirus Cholangiopathy in an Immunocompetent Patient: A Case Report and Literature Review
Authors: Ervin Alibegovic, Admir Kurtcehajic, Boris Ilic, Ahmed Hujdurovic, Edinka Smajic, Amar Habibovic, Darja Perkunic
Journal: Case Reports Hepatol (2021)
MeSH terms: Case Reports

A 37-year-old man presented with jaundice, upper right quadrant pain, and intermittent fever with chills. Laboratory assessment showed biliary stasis, with total bilirubin of 203 µmol/L (2-20), conjugated bilirubin of 105 µmol/L, and alkaline phosphatase of 556 U/L (30-120). Markers for hepatitis A-E viruses were negative. Serology assessment for rubeola, herpes simplex virus, Epstein-Barr virus, and Toxoplasma gondii showed negative IgM antibodies. HIV serology status was negative. For cytomegalovirus, both types of antibodies (IgM and IgG) were positive, with an IgM level >300 U/mL. pp65 antigen was also detected as well as CMV DNA. Diagnostic imaging of the abdomen except the dilated common bile duct showed a normal appearance of the gallbladder, liver, pancreas, spleen, and both kidneys. To our knowledge, cytomegalovirus cholangiopathy in the absence of any other underlying disease has not been reported. Therefore, the presence of cholangiopathy in our patient is interesting from an imaging, laboratory, and clinical point of view.
Hemangioblastoma in the lung: metastatic or primary lesions?
Authors: Li Lu, Peter A Drew, Anthony T Yachnis
Journal: Case Rep Pathol (2014)

Hemangioblastoma primarily occurs in the CNS, most commonly in the posterior fossa. Extracranial locations are less common, and metastatic tumor involving the lung is exceedingly rare with only three cases previously reported. Two were autopsy studies in patients who died of complications of the CNS hemangioblastomas in 1943 and 1981, and the third was mentioned in a case report addendum providing follow-up information on hepatic hemangioblastoma in 1991. We report a case of a 48-year-old man who presented with multiple lung nodules treated by surgical excision. Pathological study revealed features classic for hemangioblastoma. The patient had a remote history of hemangioblastomas having been excised from the posterior fossa 7 and 20 years previously. This report details a fourth case of metastatic pulmonary hemangioblastoma. It is the first report on surgically resected hemangioblastomas from the lung of a living patient with histological and immunohistochemical characterization.
A Case of Congenital Brainstem Oligodendroglioma: Pathology Findings and Review of the Literature
Authors: Stefan Kostadinov, Suzanne de la Monte
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Congenital and perinatal primary brain neoplasms are extremely rare. Brainstem neoplasms in the perinatal and neonatal period are typically of high-grade nature and have poor prognoses with survival rates of less than 2 years from diagnosis. Herein, we report an unusual case of congenital anaplastic oligodendroglioma that arose in the pons and was detected as diffuse pontine glioma on in utero imaging studies during prenatal evaluation at 26 weeks' gestation. A male infant was delivered at 36.4 weeks of gestation via Cesarean section who developed progressive dyspnea shortly after birth. Magnetic resonance imaging (MRI) studies of his head showed the expansile, poorly demarcated mass in the pons with minimal heterogeneous enhancement and severe communicating hydrocephalus. Despite aggressive management, including dexamethasone treatment, the infant expired on the third day of postnatal life. On postmortem examination cut sections through the brainstem and cerebellum disclosed the neoplasm that infiltrated the entire pons, extended into the midbrain, medulla, cerebellar peduncles, and caudal diencephalon. Histological sections demonstrated an anaplastic oligodendroglioma infiltrating the pons, 4th ventricle, midbrain, medulla, cerebellar white matter, posterior thalamus, and occipital white matter. The pathological features of the lesion distinguish it from previous reports in which spontaneous regression of pontine gliomas occurred and argue in favor of establishing a tissue diagnosis to plan for aggressive versus conservative management.
Spinal Cord Infarction with Aortic Dissection
Authors: Atsuyuki Kawabata, Masaki Tomori, Yoshiyasu Arai
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Spinal cord infarction is an uncommon but devastating disorder caused by various conditions. Aortic dissection is a possible etiological factor and is usually associated with severe chest or back pain. We encountered two cases of spinal cord infarction associated with aortic dissection that presented without typical severe pain, and each case resulted in a different clinical course. Aortic dissection should be considered a cause of spinal cord infarction even if there is little or no pain. The different outcomes in our two patients reflected a difference in their initial functional scores.
Longitudinal course of eating disorders after transsexual treatment: a report of two cases
Authors: Maiko Hiraide, Saki Harashima, Ryo Yoneda, Makoto Otani, Mami Kayano, Kazuhiro Yoshiuchi
Journal: Biopsychosoc Med (2017)
Keywords: eating disorders, gender confirmation surgery, gender dysphoria, gender reassignment surgery
MeSH terms: Case Reports

Background:
Several reports have been published on patients with gender dysphoria and eating disorders. However, there have been few reports on the longitudinal course of eating disorders after gender reassignment surgery (GRS)/gender confirmation surgery (GCS).
Case presentation:
We report two Japanese cases of transsexual persons with eating disorders who underwent GRS/GCS, one male-to-female (MtF) and one female-to-male (FtM). Case 1 was a 35-year MtF person who had a 14-year-course of bulimia nervosa that developed after GRS. Case 2 was a 35-year FtM person with anorexia nervosa who underwent GCS 9 years before.
Conclusions:
We found that the treatment of our transsexual patients influenced the course of their eating disorders for a long period, which could be attributable partly to the cultural situation in Japan, an East Asian country. It is possible that many gender identity problems and identity problems in general persist even after surgery and treatment; therefore, continual clinical support should be provided for patients with gender dysphoria and eating disorders even after hormonal therapy or GRS/GCS.
Laparoscopic extraction of gastric self-expandable metallic stent after migration in ileum: A case report
Authors: F-X Terryn, E Dereeper, S Lo Bue
Journal: Int J Surg Case Rep (2018)
Keywords: case report, gastric banding, laparoscopy, self-expandable metallic stent (sems), sleeve gastrectomy, stent migration

Revisional surgery in bariatric patients can sometimes lead to life-threatening complications that need a fast diagnosis and treatment as well as a multidisciplinary approach. If left undiagnosed or untreated, this may lead to sepsis, multiple organ failure, and death. In this case report, we describe the management of a gastric perforation which occurred after conversion of a gastric banding to a sleeve gastrectomy.
Excellent Response to Plasma Exchange in Three Patients With Enterovirus-71 Neurological Disease
Authors: Elba Pascual-Goñi, Maria Josa, Cristian Launes, Luis Querol, Marga Del Cuerpo, M Alba Bosch, Iolanda Jordan, Eulàlia Turón-Viñas
Journal: Front Neurol (2019)
Keywords: ev71, brainstem encephalitis with cardiorespiratory failure, encephalomyelitis, enterovirus, immunotherapy, plasma exchange
MeSH terms: Case Reports

The clinical spectrum of Enterovirus-71-associated neurological disease includes acute flaccid paralysis, encephalomyelitis, or brainstem encephalitis with autonomic dysfunction. As no specific antiviral treatments are available, intravenous human immunoglobulin is used in early stages of the illness, decreasing serum proinflammatory cytokines, and improving clinical outcomes. Plasma exchange aims to eliminate pathogenic autoantibodies and proinflammatory cytokines, and is used in diverse immune-mediated neurologic conditions. However, its effect in Enterovirus-71 infections is unknown. We report three cases of severe Enterovirus-71 neurological disease treated with plasma exchange during an outbreak in Catalonia (Spain) in 2016. We observed a striking improvement in all three patients within 48 h of starting plasma exchange. Patients received four to six sessions every other day. Good outcomes were confirmed at the 1-year follow-up visit. Our observations suggest that plasma exchange is an effective complementary therapy for severe Enterovirus-71 neurological disease.
Cytological Features of a Variant NUT Midline Carcinoma of the Lung Harboring the NSD3-NUT Fusion Gene: A Case Report and Literature Review
Authors: Shiho Kuroda, Shioto Suzuki, Akira Kurita, Mari Muraki, Yoichiro Aoshima, Fumihiko Tanioka, Haruhiko Sugimura
Journal: Case Rep Pathol (2015)

Background. Nuclear protein in testis (NUT) midline carcinoma (NMC) is a very rare and aggressive malignancy. In more than two-thirds of these NMC cases, a fusion between NUT and BRD4 or BRD3 has been documented; other variants are rare. The cytology of NMC itself has been sparsely documented and that of variant NMC has never been reported. Case Presentation. A 36-year-old woman was admitted because of a rapidly progressing lung tumor with metastases to the breast and bone. We recently reported this patient as the first case of a variant NMC of the lung harboring an NSD3-NUT fusion, based on immunohistochemical and genetic analyses. Cytological material was available for the present review. A highly cellular smear contained a predominantly noncohesive pattern of monomorphic cells with diameters 2-2.5 times greater than those of small lymphocytes, with a round-to-oval nucleus, slightly irregular nuclear contours, variably prominent nucleoli, scant cytoplasm, and identifiable mitotic figures. Foci of stratification and overt pearl formation, including a dyskeratocyte, were occasionally observed. The necrotic background contained naked nuclei, karyorrhectic debris, apoptotic cells, and macrophages phagocytizing karyorrhectic debris; nuclear crushing was noted. Conclusion. The cytological features of a variant NMC of the lung are described for the first time.
An Alarming Mimicry of Intra-Abdominal Infections: Acute Appendiceal Diverticulitis
Authors: Youseung Kim, Varun Kesar, Douglas Grider, Maithili V Chitnavis
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

A 65-year-old woman presented with three days of colicky abdominal pain. Abdominal imaging illustrated small bowel enteritis, ascites in both paracolic gutters, and incidental hepatic steatosis. Although ascites fluid demonstrated high neutrophil count consistent with peritonitis and the patient received adequate antibiotics, she clinically deteriorated. Subsequent exploratory laparotomy revealed necrotic appendix and multiple intra-abdominal abscesses. Histopathology showed acute suppurative appendicitis with multiple other intact small diverticula, indicating likely perforation of inflamed appendiceal diverticula with subsequent abscess formation and abdominal peritonitis. This case highlights the importance of ascites fluid analysis and continued clinical correlation, especially in cases of rare entities with atypical presentations.
Measuring Female Gaming: Gamer Profile, Predictors, Prevalence, and Characteristics From Psychological and Gender Perspectives
Authors: Olatz Lopez-Fernandez, A Jess Williams, Daria J Kuss
Journal: Front Psychol (2019)
Keywords: female gamer, female gender, gaming disorder, internet addiction, internet gaming disorder, psychological assessment, psychometrics, psychopathology

Research investigating female gaming is relatively scarce, and past research has demonstrated that men are more likely to be problematic gamers. Few studies have focused on female gamers in community samples, and those that have been published have mainly collected qualitative data in Europe. There is case study evidence suggesting clinicians are increasingly treating problem female gamers. The aim of this study is threefold: (i) to establish an international female gamer profile, (ii) to determine predictors associated with perceived internet gaming disorder (IGD), and (iii) to identify those who are potentially at risk of developing gaming addiction and its characteristics by applying a quantitative approach. A cross-sectional online survey was applied through international gaming forums recruiting 625 female gamers, assessing sociodemographics, gaming devices used and play genres, and a set of questionnaires on gaming [e.g., problem online gaming (e.g., the nine-item short-form scale to assess IGD: IGDS9-SF), female stereotypes (e.g., sex role stereotyping scale), and psychological symptoms (e.g., Symptom CheckList-27-plus)]. Female gamers from all continents reported the use of all videogames, especially popular online games using computers and consoles. The proportion of gamers with potential IGD was one per cent. Regression analyses identified several risk factors for increased scores on the IGDS9-SF, namely having achievement and social motivations, embodied presence and identification with the avatar, hostility and social phobia together with negative body image, playing Multiplayer Online Battle Arena games, Massively Multiplayer Online Role-Playing Games, and First-Person-Shooter games. Findings contribute to filling the gap in knowledge on female gaming, to aid in the applicability of problematic gaming measurements in female gamers, especially those who are at risk of problematic gaming. The purpose of this study is to enhance the validity of the current measures to diagnose problem gaming appropriately in both genders.
Usefulness of laparoscopy in the management of incidentally discovered retroperitoneal liposarcoma mimicking inguinal hernia: A case report and literature review
Authors: Takashi Matsumoto, Kosuke Mima, Asuka Ono, Nobutomo Miyanari, Atsushi Morito, Shinsei Yumoto, Keisuke Kosumi, Mitsuhiro Inoue, Takao Mizumto, Tatsuo Kubota, Hideo Baba
Journal: Int J Surg Case Rep (2020)
Keywords: retroperitoneum, sarcoma, transabdominal preperitoneal repair
MeSH terms: Case Reports

Introduction:
Liposarcomas comprise around 10%-16% of soft tissue sarcomas. The two major sites of liposarcoma are the extremities and retroperitoneum. However, retroperitoneal liposarcomas mimicking inguinal hernia are rare. We present a case of retroperitoneal liposarcoma mimicking inguinal hernia, which was diagnosed after laparoscopic surgery and underwent curative resection.
Presentation of case:
A 46-year-old man was admitted to our hospital with a right inguinal pain and swelling that had been recognized for 3 years. We diagnosed the inguinal swelling as a right inguinal hernia and planned laparoscopic surgery for inguinal hernia repair. A hernia sac, however, was not found and swollen retroperitoneal fatty tissue near the right internal inguinal ring was observed by laparoscopy. We aborted the surgical procedure and performed computed tomography and magnetic resonance imaging, which revealed an extraperitoneal and lipomatous tumor extending through the inguinal canal to the scrotum. Wide local excision of the tumor, along with right orchidectomy, was performed under laparotomy. Histopathological diagnosis showed well-differentiated liposarcoma of the retroperitoneum and confirmed tumor-free margins. No evidence of recurrence or metastasis was seen in the 9 months after curative resection.
Discussion and conclusion:
Laparoscopic surgery for inguinal hernia enables to observation of the inguinal region and management of rare cases, such as retroperitoneal liposarcoma.
Rare fetal monster in Holstein crossbred cow
Authors: A Sharma, P Kumar, M Singh, N K Vasishta, R Jaswal
Journal: Open Vet J (2013)
Keywords: cow, fetus, holstein friesian, monster, twins
MeSH terms: Case Reports

This report describes a rare case of conjoined female twin monster (Monocephalus Thoracopagus Tetrabrachius Tetrapus Dicaudatus) in a Holstein Friesian pluriparous crossbred cow.
Mature cystic extragonadal teratoma in Douglas' pouch: Case report and literature review
Authors: Yun Yang, Mengru Zhao, Mengyue Chen, Huimin Tang, Zhenyue Qin, Junling Liu, Huihui Wang, Mingyue Bao, Jiming Chen, Bairong Xia
Journal: Front Med (Lausanne) (2023)
Keywords: douglas’ pouch, case report, literature review, mature cystic teratoma, old women
MeSH terms: Case Reports

Teratomas often occur in the gonads, while Extragonadal mature cystic teratomas are reported occasionally, with the most common site being the omentum. Teratoma in the Douglas sac is extremely rare. we report a rare case of mature cystic Teratoma in the Douglas sac in a 71-year-old woman who underwent laparoscopic surgery. A cyst with a diameter of approximately 6 cm from Douglas was found during surgery, and the mass was separated from both ovaries. Microscopically, the cyst was a mature cystic teratoma that did not originate from the ovary.
Esthetic Reconstruction of Diastema with Adhesive Tooth-Colored Restorations and Hyaluronic Acid Fillers
Authors: Supawadee Naorungroj
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Objective. This report presents a comprehensive esthetic treatment with adhesive tooth-colored restorations in a combination with hyaluronic acid (HA) fillers of diastema in an orthodontic patient with relapse. Case Report. A 36-year-old female patient consulted about 1.5-2 mm midline diastema after an orthodontic relapse of replacing missing central incisors with lateral incisors and dark-colored gingival tissue as a result of a metal post and core with porcelain fused to a metal (PFM) crown at the left lateral incisor. Restorative treatments included replacing the PFM with all-ceramic material and placing a ceramic veneer on the right lateral incisor. To close the space, crown forms of both lateral incisors were altered. A direct resin composite was then used to reform right and left canines to a more ideal lateral incisor shape. An HA fillers injection was used to fill the remaining open gingival embrasure. Eighteen months after treatment, the interdental papilla remained stable and the patient was satisfied with the result. Conclusion. Esthetic reconstruction of diastema and open gingival embrasure in this case can be accomplished without orthodontic retreatment. Tooth-colored restorations and HA filler injection appear as a promising modality to address this patient's esthetic concern.
Long-term neuropsychological outcomes in children with febrile infection-related epilepsy syndrome (FIRES) treated with anakinra
Authors: Anima Shrestha, E Lynne Wood, Gretchen Berrios-Siervo, Coral M Stredny, Katrina Boyer, Clemente Vega, Srishti Nangia, Eyal Muscal, Krista Eschbach
Journal: Front Neurol (2023)
Keywords: fires, norse, anakinra, cognitive outcomes, febrile infection-related epilepsy syndrome, neuropsychological outcomes, new-onset refractory status epilepticus

Background:
Febrile-infection related epilepsy syndrome (FIRES) is a rare epilepsy syndrome in which a previously healthy individual develops refractory status epilepticus in the setting of a preceding febrile illness. There are limited data regarding detailed long-term outcomes. This study aims to describe the long-term neuropsychological outcomes in a series of pediatric patients with FIRES.
Methods:
This is a retrospective multi-center case series of pediatric patients with a diagnosis of FIRES treated acutely with anakinra who had neuropsychological testing at least 12 months after status epilepticus onset. Each patient underwent comprehensive neuropsychological evaluation as part of routine clinical care. Additional data collection included the acute seizure presentation, medication exposures, and outcomes.
Results:
There were six patients identified with a median age of 11.08 years (IQR: 8.19-11.23) at status epilepticus onset. Anakinra initiation was a median of 11 days (IQR: 9.25-13.50) after hospital admission. All patients had ongoing seizures and none of the patients returned to baseline cognitive function with a median follow-up of 40 months (IQR 35-51). Of the five patients with serial full-scale IQ testing, three demonstrated a decline in scores over time. Testing results revealed a diffuse pattern of deficits across domains and all patients required special education and/or accommodations for academic learning.
Conclusions:
Despite treatment with anakinra, neuropsychological outcomes in this series of pediatric patients with FIRES demonstrated ongoing diffuse neurocognitive impairment. Future research will need to explore the predictors of long-term neurocognitive outcomes in patients with FIRES and to evaluate if acute treatment interventions improve these outcomes.
Eales' Disease: When the Rare Sounds Frequent
Authors: Beatriz Oliveira Lopes, Margarida Sena Brízido, Ana Isabel Reis, Margarida Maria Miranda, Susana Morais Pina
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Eales' disease is a peripheral occlusive retinal phlebitis, with an unclear pathogenesis. The classic association with hypersensitivity to Mycobacterium tuberculosis protein infers that immunologic disturbance may be involved. Here, we described three cases of Eales' disease. All patients are Caucasian men aged 27-58 years and presented with vitreous hemorrhage and/or peripheral venous vasculitis. Tuberculin skin sensitive test (Mantoux screening test) and interferon-gamma release assay (IGRA) were positive in all patients. Therapeutic approach included antituberculosis therapy and systemic steroids, associated or not to immunosuppressive therapy, and retinal scatter photocoagulation in all cases. Antivascular endothelial grow factor (VEGF) intravitreal injections were also required in two cases. Since various retinal diseases can resemble this presentation, Eales' disease is considered a diagnosis of exclusion. Early diagnosis and appropriate therapeutic approach are both essential to accomplish disease control and reduce ophthalmologic complications.