OpenMed/multicare-articles huggingface dataset:
Concomitant of Pulmonary Hydatid Cyst and Aspergilloma: A Rare Coinfection
Authors: Zahra Zareshahrabadi, Bahador Sarkari, Nadereh Shamsolvaezin, Bizhan Ziaian, Alireza Tootoonchi, Reza Shahriarirad, Kamiar Zomorodian
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

The coexistence of cystic echinococcosis (CE) and aspergilloma is rather uncommon. Aspergillus species, saprophytic fungi, can colonize pulmonary cavities that are caused by tuberculosis, sarcoidosis, and CE. Infection by Aspergillus is often occurring in immunosuppressed patients. However, coinfection of aspergilloma with pulmonary hydatid cyst is very unusual, especially in an immunocompetent patient with unruptured cyst. Herein, we report a case of lung hydatid cyst coinfected with Aspergillus in a 42-year-old Iranian man from Southern Iran. Chest X-ray and computed tomography (CT) scan showed a circumscribed cystic lesion in the superior and inferior segment of the lower lobes of right and left lungs that suggests hydatid cyst. Radical surgery (lobectomy) was performed for the patient. Histopathological evaluation reconfirmed the classical laminated layer of hydatid cyst. Moreover, the ectocyst layer of the right lung showed the presence of numerous cluster septate hyphae with acute-angled branching, as seen in the morphology of Aspergillus species. DNA was extracted from the cyst, and the ITS1-5.8s-ITS2 region of the fungal agent was amplified. Sequencing and analysis of seminested PCR product revealed that the isolate has the most similarity with Aspergillus niger. Further attention is recommended to control fungal pathogens during pulmonary hydatidosis. The coexistence of aspergilloma should always be kept in mind for the better management of CE.
Case Report: Spontaneous lung intercostal hernia series and literature review
Authors: Sara Ugolini, Moslem Abdelghafar, Eduart Vokkri, Annabel J Sharkey, Eustace Fontaine, Luca Voltolini, Antonino Morabito, Dario Ugolini, Felice Granato
Journal: Front Surg (2023)
Keywords: 12 spontaneous, cough, fracture, hernia, lung, pleura, rupture, spontaneous
MeSH terms: Case Reports

Spontaneous lung intercostal hernia (SLIH) is a rare condition potentially carrying severe morbidity. About 120 cases have been described so far, with an apparently increasing number of reports in recent years. The main presenting findings are chest pain and bulging, with ecchymosis in the affected area, hemoptysis, respiratory distress, and signs of infection or incarceration being described as well. The gold standard treatment has not been established, and conservative management has been advocated as first-line treatment for asymptomatic patients. Here, we report a case series of five patients, and surgical repair was deemed necessary for four of them either at first evaluation or after failure of conservative management. One patient remains under surveillance and conservative management. We believe that SLIH surgical repair should be considered as first-line treatment for fit patients, due to the uncertainty of its mid- and long-term impact and described pejorative trend/defect enlargement. A proposed algorithm for SLIH management is also presented.
Atrioventricular Nodal Re-entry Tachycardia in Identical Twins: A Case Report and Literature Review
Authors: Walid Barake, Jane Caldwell, Adrian Baranchuk
Journal: Indian Pacing Electrophysiol J (2013)
Keywords: avnrt, paroxysmal supraventricular tachycardia, twins

This report details the case of 17 year old identical twins who both presented with paroxysmal supraventricular tachycardia (PSVT). Electrophysiological studies revealed atrioventricular nodal reentry tachycardia (AVNRT) in both twins. Successful but technically challenging slow pathway ablation was performed in both twins. This is the first reported case of confirmed AVNRT in identical twins which adds strong evidence to heritability of the dual AV node physiology and AVNRT. A review of the current literature regarding PSVT in monozygotic twins is provided.
Isolated Splenic Metastases from Renal Cell Carcinoma 11 Years after Surgery
Authors: Davi Dos Santos Romao, Natally Horvat, Marianne Castro Gonçalves, Emerson Shigueaki Abe, Rodrigo Blanco Dumarco, Publio Cesar Cavalcante Viana, Marcel Cerqueira Cesar Machado
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Splenic metastases are rare and usually occur in cases of disseminated disease. We report a case of a patient who had isolated splenic metastases with a previous history of left nephrectomy due to a renal cell carcinoma 11 years before. The aim of this report is to describe the case and review the literature of isolated splenic metastases due to renal carcinoma. This case emphasizes the importance of considering splenic metastatic disease even after many years of diagnosis of renal cell carcinoma.
Clear cell carcinoma of the endometrium causing paraneoplastic retinopathy: case report and review of the literature
Authors: Paulina Cybulska, Eduardo V Navajas, Filiberto Altomare, Marcus Q Bernardini
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

We reviewed the literature for cases in which gynecologic malignancies caused paraneoplastic retinopathy and ultimately led to blindness. Twenty-eight cases were derived from the literature, and one unique case is described from our institution. Of these 28 cases, 14 patients were diagnosed with endometrial cancer, 7 with ovarian cancer, 5 with cervical cancer, 1 fallopian tube cancer and 1 with concomitant endometrial and ovarian cancers. The average age of patients at the time of diagnosis was 64 years (range, 35-89 years). Typically, ocular manifestations antedate symptoms of the underlying carcinoma by 3-12 months. Information regarding the interval from visual symptoms to time of death is limited, but ranges from several months to several years. Our report is the first to document a clear cell carcinoma of the endometrium causing paraneoplastic retinopathy and is the first to review all gynecologic malignancies associated with visual paraneoplastic syndromes.
Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis
Authors: Matthew Chak Hin Szeto, Metin Devrim Yalçın, Abdul Khan, Andrzej Piotrowicz
Journal: Case Reports Immunol (2016)

Tocilizumab is an interleukin-6 receptor inhibitor licensed for moderate to severe rheumatoid arthritis (RA). We report a case of Tocilizumab monotherapy for severe active RA in a patient with coexisting ulcerative colitis (UC). The patient was intolerant to multiple disease-modifying drugs, so Tocilizumab monotherapy was commenced. We found clinical improvement in both RA and UC. There was no major adverse event after 2 years. Manufacturer advised caution in using Tocilizumab in patient with gastrointestinal ulceration due to an increased risk of bowel perforation. However, alternative treatments such as glucocorticoid and nonsteroidal anti-inflammatory drugs may carry a higher bowel perforation risk. The presence of gastrointestinal ulceration therefore should not constitute an absolute contraindication for Tocilizumab therapy. Future studies of registry data will inform clinician of the Tocilizumab-related risk of gastrointestinal toxicity in "real-life" settings. Contrary to previous case report, we found Tocilizumab therapy to have a positive effect on UC. Laboratory studies supported a role for interleukin-6 in the pathophysiology of UC. Further clinical trial to evaluate the therapeutic role of Tocilizumab in UC would be warranted.
Head and neck cancer with dermatomyositis: a report of two clinical cases
Authors: Kohichi Yamauchi, Yasunao Kogashiwa, Hiroshi Nagafuji, Naoyuki Kohno
Journal: Int J Otolaryngol (2010)
MeSH terms: Case Reports

Dermatomyositis is well known to be associated with several types of malignancy and patients with dermatomyositis have higher rates of mortality from cancer. Although rare in Japan, head and neck cancer, especially nasopharyngeal cancer, is the predominant type of cancer associated with dermatomyositis in several areas in Asia, including Hong Kong and Singapore. Here we report two cases of head and neck cancer with dermatomyositis as well as a literature review. Both cases were treated with chemotherapy and radiotherapy. Although the patients were immunosuppressed due to dermatomyositis treatment, no grade 3 or 4 adverse events occurred.
The management of acute lower gastrointestinal bleeding using a Sengstaken-Blakemore tube
Authors: Michael G Fadel, Piers R Boshier, Ann-Marie Howell, Mohamad Iskandarani, Paris Tekkis, Christos Kontovounisios
Journal: Int J Surg Case Rep (2020)
Keywords: balloon tamponade, case report, lower gastrointestinal bleeding, sengstaken-blakemore tube
MeSH terms: Case Reports

Introduction:
Acute lower gastrointestinal haemorrhage can potentially be life-threatening. We present a case of a massive rectal bleed which was managed successfully with a balloon tamponade device designed for upper gastrointestinal haemorrhage.
Presentation of case:
A 75-year-old gentleman, with a history of human immunodeficiency virus and cirrhosis with portal hypertension, presented with bright red rectal bleeding. Investigations showed a low haemoglobin level (74 g/L) and deranged clotting. Oesophago-gastro-duodenoscopy demonstrated no fresh or altered blood. Flexible sigmoidoscopy revealed active bleeding from a varix within the anterior rectal wall 4 cm from the anal verge. Efforts to stop the bleeding, including endoscopic clips, adrenaline injection and rectal packing, were unsuccessful and the patient became haemodynamically unstable. A Sengstaken-Blakemore tube was inserted per rectum and the gastric balloon was inflated to tamponade the lower rectum. The oesophageal balloon was then inflated to hold the gastric balloon firmly in place. A computed tomography angiogram demonstrated no evidence of haemorrhage with balloon tamponade. After 36 h, the balloon was removed with no further episodes of bleeding.
Discussion:
The application of a balloon tamponade device should be considered in the management algorithm for acute lower gastrointestinal bleed. Advantages include its rapid insertion, immediate results and ability to measure further bleeding after the catheter has been placed.
Conclusion:
Sengstaken-Blakemore tube per rectum may effectively control massive low rectal bleeding when alternative methods have been unsuccessful.
Os Cuboideum Secundarium: A Rare Accessory Ossicle in the Foot
Authors: Arne Vermeulen, Nirav Gupta, Seema Döring
Journal: J Belg Soc Radiol (2023)
Keywords: accessory ossicle, ankle distortion, bone marrow edema, fracture, os cuboideum secundarium
MeSH terms: Case Reports

Teaching Point: Knowledge of the accessory ossicles in the foot and the possible disorders of these ossicles are important to prevent misdiagnosis and mistreatment.
Classic congenital adrenal hyperplasia: A delayed presentation
Authors: Saima Aziz Siddiqui, Nargis Soomro, Ashraf Ganatra
Journal: Pak J Med Sci (2013)
Keywords: ambiguous genitalia, clitoromegaly, clitoroplasty, congenital adrenal hyperplasia, virilization
MeSH terms: Case Reports

Congenital adrenal hyperplasia (CAH) is a rare congenital disorder, which in cases of female genotype may result in virilization. Specific enzyme deficiencies in adrenocorticoid hormones biosynthetic pathway lead to excess androgen production causing virilization. Classic type presents early in infant life as salt losing or simple virilizing type, whereas non classic form presents late at puberty or in adult life. Depending on the type of classic CAH, type of adrenocorticoid deficiency, extent of virilization & genotype, surgical corrective procedures, glucocorticoid & mineralocorticoid replacement therapy are the mainstay of management. We present here a case of classic congenital adrenal hyperplasia of simple virilizing type, which presented later in childhood.
Management of Small Bowel Perforation by a Bizarre Foreign Body in a 55-Year-Old Woman
Authors: Francesca D'Auria, Vincenzo Consalvo, Antonio Canero, Maria Russo, Carmela Rescigno, Domenico Lombardi
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Ingestion of foreign bodies including dentures, fishbone, screw, and/or surgical devices can be a cause of morbidity, and it rarely could be fatal.
Presentation of case:
We present the first hitherto reported case of mussel shell ingestion, which caused acute abdominal pain in a 55-year-old woman. The shell pierced ileal loops, and it was found in the abdominal cavity.
Discussion:
The accidental or voluntary ingestion of a foreign body is an uncommon event compared to the other causes of bowel perforation. It is fundamental to immediately remove the intestinal fluid, repair the tear, and prevent sepsis, because each delay in diagnosis can lead to a worst outcome.
Conclusion:
In case of bowel perforation, it important for surgeons, who are dealing with these acute care patients, to be aware of different designs and constructions of possible foreign bodies, in order to be prepared to deal with different possible scenarios and be able to manage them properly.
A Case of Anesthetic Management of Arnold-Chiari Malformation I: A Contest to Anesthesiologists
Authors: Vidur Mago, Vivek Chakole, Roshan Nisal, Roshan Umate
Journal: Cureus (2023)
Keywords: chiari, difficult laryngoscopy, hindbrain, malformation, scoliosis, video laryngoscopy
MeSH terms: Case Reports

Arnold-Chiari malformation is a very uncommon array of deformities in the posterior part of the cranium and hindbrain caused due to abnormal extension of the posterior brain into the spinal canal. Chiari malformation is further divided into subtypes 1, 2, and 3. The latter two are more common in pediatric forms and present at birth. The severity of symptoms depends upon the extent of herniation of the hindbrain due to herniation of the cerebellum through the foramen of the cranium. Also, there have been instances of absence of cerebellum. Multiple associated disorders like hydrocephalus due to increased intracranial pressure, then encephalocele, syrinx, or spinal deformity in the form of scoliosis have been presented in many cases. All these factors thus become a challenge to anesthesiologists for such patients. Hence evidence-based knowledge along with multidisciplinary, well-planned approach is required for its management.
Infantile myofibroma eroding into the frontal bone: a case report and review of its histopathologic differential diagnosis
Authors: Aatish Thennavan, Venkadasalapathi Narayanaswamy, Thanvir Mohammed Niazi, Lakshmi Rao, Raghu Radhakrishnan
Journal: Case Rep Pediatr (2012)

Infantile myofibroma is a rare and benign tumour of children presenting in the head and neck region. Rendering a final diagnosis of infantile myofibroma can be challenging in the light of nonspecific clinical, radiological findings and its histopathological similarities with a number of neoplasms especially spindle cell tumours. In this paper we discuss a case of infantile myofibroma in a 2-month-old infant, enumerating the various differential entities that have to be eliminated in reaching its specific diagnosis and highlighting the importance of immunopositivity to vimentin and smooth muscle actin (SMA) in establishing its myofibroblastic differentiation.
Small bowel hemangioma diagnosed with laparoscopy: Report of two pediatric cases
Authors: A E Jones, B H Ainsworth, A Desai, T T Tsang
Journal: J Minim Access Surg (2007)
Keywords: hemangioma, laparoscopy, pediatric, small bowel
MeSH terms: Case Reports

Hemangiomas of the small bowel are rare tumors that often present with gastrointestinal bleeding. Diagnosis can be difficult and exploratory laparotomy has often proved to be the only method with which to determine the presence and location of these tumors. We report two cases of small bowel hemangioma in children aged 10 and 7 years, in which the diagnosis was made by laparoscopy. Laparoscopy identifies the affected segment of bowel and allows delivery to a minimally extended umbilical port site. The avoidance of an open laparotomy helps to reduce post-operative analgesic requirement and achieves an early return of bowel function.
Acute Traumatic Patellar Tendon Rupture at the Tibial Tuberosity Attachment without Avulsion Fracture
Authors: Shuichi Miyamoto, Makoto Otsuka, Fumio Hasue, Takayuki Fujiyoshi, Koushirou Kamiya, Hitoshi Kiuchi, Ken Ohara, Atsushi Yunde, Yasunori Toki, Tadashi Tanaka, Junichi Nakamura, Seiji Ohtori
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Patellar tendon rupture in children is especially rare. The fact that the area of traumatic rupture has wide variations makes surgical treatment difficult. We present an 11-year-old boy with acute traumatic patellar tendon rupture at the tibial tuberosity attachment without avulsion fracture. Primary end-to-end repair and reinforcement using 1.5 mm stainless steel wires as a surgical strategy were undertaken. Early range of motion began with a functional knee brace and the reinforced stainless wire was removed 3 months after surgery. Knee function at the final follow-up was satisfactory. We suggest that this strategy may provide a useful option for surgical treatment.
Identification of Hollow Viscus Injury with FAST Examination in Kurdistan, Iraq
Authors: Ruj Al-Sindy, Heleen Alaqrawy, Mahmood Sh Hafdullah, Christine Butts
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury. We present a case of an unidentified man that presented to a hospital in the Kurdistan region of northern Iraq, a region of low resources, surrounded by war. The FAST exam proved to be the key to identifying this patient's injuries.
Chromobacterium violaceum Septicaemia and Urinary Tract Infection: Case Reports from a Tertiary Care Hospital in South India
Authors: Vishnu Kaniyarakkal, Shabana Orvankundil, Saradadevi Karunakaran Lalitha, Raji Thazhethekandi, Jahana Thottathil
Journal: Case Rep Infect Dis (2016)

Chromobacterium violaceum is a gram negative oxidase positive bacillus that causes human infections infrequently. It is a normal inhabitant of soil and stagnant water of the tropical and subtropical areas. In humans, it can cause infections ranging from life threatening sepsis with metastatic abscesses to skin infections and urinary tract infections. The organism is notoriously resistant to most cephalosporins and Ampicillin. Fluoroquinolones and aminoglycosides show good in vitro susceptibility. High mortality rates associated with these infections necessitate prompt diagnosis and appropriate antimicrobial therapy. Here we present three cases of Chromobacterium violaceum infection from Government Medical College Kozhikode, Kerala.
Solitary large hepatic metastasis in an elderly patient with anaplastic thyroid carcinoma: a case report
Authors: Alexandra Adamidou, Panagiotis Kotsaftis, Maria Vlachou, Afroditi Haritanti, Ioannis Xanthakis, Anestis Zantidis, George Ntaios
Journal: Cases J (2009)

Background:
We present the case of a patient who presented with anaplastic thyroid carcinoma with a solitary large liver metastasis. Hepatic metastases are extremely rare in anaplastic thyroid carcinoma.
Case presentation:
We report the case of a 78-year old Greek man who presented with voice hoarseness, dyspnoea and a large mass on the anterior surface of the cervical region (neck), as well as constitutional symptoms such as anorexia, weight loss and malaise. On physical examination, the thyroid was hard and tender on palpation and a liver mass was palpable. Routine biochemistry yielded normal results except increased C-reactive protein, alkaline phosphatase and gamma-glutaryl transferase. Other biochemical tests including tumor markers, thyroid hormones, antithyroid antibodies, hepatitis B and hepatitis C antibodies were negative. Imaging methods revealed enlargement of the left thyroid lobe extending to the anterior mediastinum and compressing the trachea, metastatic bilateral pulmonary lesions and a large, nodular, contrast-enhanced mass-occupying lesion in the right hepatic lobe. The findings of fine-needle aspiration biopsy of the thyroid were consistent with anaplastic carcinoma. Liver biopsy showed infiltrations by poorly differentiated anaplastic cells, few of which were slightly positive for thyroglobulin. These findings were suggestive of a hepatic metastasis originating from anaplastic thyroid carcinoma. During his hospitalization, the patient suffered progressive obstruction of the trachea due to rapid increase of the thyroid gland mass. The tumor was considered unresectable due to its advanced stage, as well as the presence of extrathyroid metastatic lesions. The patient was irradiated on cervical region (neck) and upper mediastinum with a daily dose of 300 cGy for 10 days which resulted in mild improvement of obstructive phenomena. However, his clinical condition deteriorated rapidly and he died within a few days.
Conclusion:
Solitary, large hepatic metastasis may constitute a rare complication in anaplastic thyroid carcinoma.
Vitiligo-like lesions induced by cyclin-dependent kinase 4/6 inhibitor Palbociclib: a case report and literature review
Authors: Shan Gao, Guanjing Wei, Yanrong Hao
Journal: Pathol Oncol Res (2023)
Keywords: cdk4/6 inhibitors, palbociclib, adverse events, breast cancer, vitiligo-like lesions
MeSH terms: Breast Neoplasms / pathology, Vitiligo / chemically induced, Vitiligo / drug therapy, Review, Case Reports, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Cyclin-Dependent Kinase 4 / metabolism, Cyclin-Dependent Kinase 4 / therapeutic use, Female, Humans, Protein Kinase Inhibitors / adverse effects, Receptor, ErbB-2 / metabolism, palbociclib, Cyclin-Dependent Kinase 4, Protein Kinase Inhibitors, Receptor, ErbB-2

Endocrine therapy has played an essential role in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer. With the continuous development of endocrine targeting drugs, especially the emergence of selective cyclin-dependent kinase (CDK4/6) inhibitors, the overall survival time in patients with HR+HER2- advanced breast cancer has been greatly improved. Their adverse reactions also need more attention in response to the climbing number of CDK4/6 inhibitors. The common side effects of CDK4/6 inhibitors were hematological toxicity, diarrhea, and liver function damage. Skin toxicity related to CDK4/6 inhibitors was rare. We describe herein our preliminary observation of one HR+HER2- advanced metastatic breast cancer patient diagnosed with vitiligo-like lesions after 10 months of taking Palbociclib. Hoping to share our experience to increase the clinician awareness of this unusual adverse and contribute to the information in the literature.