OpenMed/multicare-articles huggingface dataset:
Persistent left superior vena cava and partial anomalous pulmonary venous return in an old asymptomatic female patient
Authors: Tayfun Sahin, Teoman Kilic, Umut Celikyurt, Ulas Bildirici, Dilek Ural
Journal: Cardiol Res Pract (2009)
MeSH terms: Case Reports

Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography. The diagnosis can be made when injection of contrast in left antecubital vein results in enhancement of the dilated coronary sinus before right atrium. MRI, CT-scan and catheterisation can be used to confirm the diagnosis.
Case report: Therapeutic potential of T-VEC in combination with MEK inhibitors in melanoma patients with NRAS mutation
Authors: Sonja C S Simon, Verena Müller, Jochen S Utikal
Journal: Front Oncol (2023)
Keywords: mek inhibitor, nras mutation, t-vec, case series, melanoma
MeSH terms: Case Reports

Mutations in the NRAS gene are common alterations in malignant melanoma. However, there are no specific treatment options approved for NRAS-mutated melanoma patients besides immune checkpoint inhibition. Since preclinical data suggests a synergistic effect of a MEK inhibitor (MEKi) and the oncolytic virus talimogene laherparepvec (T-VEC), we have treated three melanoma patients with this combination. All of the three patients had been suffering from recurring cutaneous and subcutaneous in-transit metastases. Upon treatment one patient (case 1) presented full regression of locoregional metastases and remained progression-free until date, for almost three years. The second patient (case 2) showed a partial regression of painful gluteal satellite metastases but died from brain metastases. The third patient (case 3) showed a durable response of locoregional metastases for seven months. The combination treatment was well tolerated with common adverse events known for each single agent. This report is the first case series presenting a clinical benefit of the combined T-VEC and MEKi treatment. We suggest the combination of T-VEC and MEKi as an off-label treatment option for patients with NRAS mutations, especially with recurrent in-transit or satellite metastases.
Solitary tibial osteolytic lesion
Authors: Emilios E Pakos, Dimitrios N Gartzonikas, Pericles G Tsekeris, Theodore A Xenakis
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We report an unusual case of solitary osteolytic tibial metastasis from a primary endometrial cancer in a 62-year-old woman. The primary cancer was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with postoperative external beam radiotherapy, while the tibial metastasis was treated with an above knee amputation. The rarity of the case lies on the fact that metastases distally to the elbow and knee are uncommon and endometrial cancer rarely gives distal bone metastases and particularly solitary to the extremities.
Multiple bone and joint diseases in a nigerian sickle cell anaemia: a case report
Authors: John A Olaniyi, Adekunle E Alagbe, Toluwalase A Olutoogun, Oluwasogo E Busari
Journal: Mediterr J Hematol Infect Dis (2012)
MeSH terms: Case Reports

This case highlights the fact that bone involvement is the commonest clinical manifestation of Sickle Cell Disease (SCD) both in the acute settings such as painful vaso-occlusive crisis (VOC) and as a source of chronic, progressive debility such as avascular necrosis (AVN), chronic osteomyelitis and fixed flexion deformity of joints.Protracted multiple bone involvement i.e. bilateral femoral and left humeral chronic osteomyelitis, Left elbow, Left knee and right humeral septic arthritis together with avascular necrosis of both femoral and right humeral heads, coupled with urinary tract infection (UTI) and decubitus ulcer in a young adult SCD patient is an unusual occurrence. This morbidities resulted into an uninterrupted 29 weeks of hospitalization for the patient who had previously enjoyed fairly good health.Various micro-organisms were sequentially cultured at various times and sites; these include E coli and Klebsiella in urine and klebsiella spp in the aspirates of the affected knee joint, elbow joint and femoral osteomyelitis. A screen for HIV 1 and 2 were non-reactive.Multidisciplinary approach was applied to the patient who was finally discharged home on a wheelchair. This case reflects not only the high susceptibility of SCD patients to infection, but also the morbidity and the attendant complications. It also highlights the need to forestall VOC which often predisposes to osteomyelitis. There is a need to have a highly organized, well-equipped and highly subsidized Sickle Cell and rehabilitation center in Nigeria in order to improve the medical care for SCD patients.
Human Papillomavirus-Associated Lymphoepithelioma-Like Carcinoma of the Anal Canal: A Case Report and Literature Review
Authors: Weiwei Weng, Weiqi Sheng, Lei Wang
Journal: Front Med (Lausanne) (2021)
Keywords: anal canal, case report, human papillomavirus, immune microenvironment, lymphoepithelioma-like carcinoma
MeSH terms: Case Reports

Lymphoepithelioma-like carcinoma is a rare type of tumor that is histologically identical to lymphoepithelial carcinoma of the nasopharynx. Lymphoepithelioma-like carcinomas (LELCs) are closely associated with viral infections. Human papillomavirus (HPV)-associated LELCs have been reported in a variety of anatomic sites. We reported an extremely rare case of a 25-year-old woman with LELC derived from the anal canal, which is the second case reported at this site. The tumor was diffusely positive for p16 staining, and was correlated with high-risk HPV-16; Epstein-Barr virus-encoded small RNA was negative; PD-L1 positivity and abundant CD8+ T cell infiltration were observed, indicating a "hot" immune microenvironment. In reporting this case, we highlight the potential for misdiagnosis and suggested an association of HPV infection with LELC in the anal canal.
Ballistic Trauma of Limbs
Authors: Léopold Lamah, Damany Keita, Ibrahima Marie Camara, Mohamed Lamine Bah, Sidimé Sory, Mamadou Moustapha Diallo
Journal: Open Orthop J (2017)
Keywords: ballistics, case special, donka members, traumatism, traumatology
MeSH terms: Case Reports

The objective of our study was to report the management and follow-up of a particular case of ballistic trauma and to do the literature review.
Observation:
A 35-year-old patient, a trader who was the victim of a firearm accident under not very clear circumstances. He was admitted to the emergency department after 3 hours. Clinically, the patient had significant bleeding in the arm and was in a state of clouding of consciousness. We could notice on the right arm, a posterior large transfixing wound of 1 cm and a 6 cm one on the antero-internal side. The limb was cold with a small and thready pulse. Sensitivity was decreased in the radial nerve area. The radiograph showed bone comminution from the middle 1/3 to the superior 1/3 of the humeral diaphysis. The treatment was orthopedic (after debridement) by scapula-brachio-ante-brachiopalmar plaster splint with thoracic strap. The wound healed in 46 days and the patient resumed his activities after 11 months and 2 weeks.
Conclusion:
The authors presented the value of using the scapulo-brachio-palmar plaster splints with thoracic strap in some severe upper limb trauma in the absence of the external fixator.
Impact of a Ketogenic Diet on Sporadic Inclusion Body Myositis: A Case Study
Authors: Matthew C L Phillips, Deborah K J Murtagh, Fouzia Ziad, Samuel E Johnston, Ben G Moon
Journal: Front Neurol (2020)
Keywords: degeneration, inclusion body myositis, inflammation, ketogenic diet, muscle
MeSH terms: Case Reports

Sporadic inclusion body myositis (IBM) is a chronic inflammatory and degenerative muscle disease with limited treatment options; no therapy can alter its natural course. Ketogenic diets are theoretically capable of suppressing inflammation, enhancing cell bioenergetics, alleviating mitochondria dysfunction, and stimulating autophagy, which may be beneficial in IBM. We report the case of a 52-year-old woman with worsening IBM who pursued a modified ketogenic diet for 1 year. Adverse effects were mild and resolved 3 weeks into the diet. Prior to starting her ketogenic diet, despite the use of a walking stick at all times, she was experiencing one to two falls per week as well as swallowing difficulties, musculoskeletal pain, and depression. Moreover, magnetic resonance imaging (MRI) of the bilateral thighs during the year prior to the diet indicated worsening muscle inflammation and a 14% decrease in thigh muscle volume, which corresponded to a 4% decrease in the ratio of thigh muscle to thigh total volume. After 1 year on her ketogenic diet, our patient regained independent walking, and her swallowing difficulties, pain, and depression resolved. She maintained her strength, improved in every test of function, enhanced her quality of life, and lowered her blood creatine kinase. MRI of the bilateral thighs during the year of the diet indicated stabilized muscle inflammation and a 2.9% decrease in thigh muscle volume, which in the context of diet-induced fat loss corresponded to a sustained 1% increase in the ratio of thigh muscle to thigh total volume. This case is unique in that a ketogenic diet was utilized as the primary treatment strategy for a patient with confirmed IBM, culminating in substantial clinical improvement, stabilized muscle inflammation, and a slowed rate of muscle atrophy. Our patient has remained on her ketogenic diet for over 2 years now and continues to enjoy a full and independent life.
RapidArc for centrally recurrent cervical cancer in the vaginal cuff following primary surgical therapy: a case report
Authors: I Lalya, A Maghous, E Marnouche, N Zaghba, K Andaloussi, M Elmarjany, K Hadadi, H Sifat, H Mansouri
Journal: World J Surg Oncol (2016)
MeSH terms: Adenocarcinoma / surgery, Chemoradiotherapy, Hysterectomy / adverse effects, Neoplasm Recurrence, Local / therapy, Postoperative Complications, Uterine Cervical Neoplasms / surgery, Vaginal Neoplasms / therapy, Case Reports, Research Support, Non-U.S. Gov't, Adenocarcinoma / pathology, Aged, Female, Humans, Incidence, Neoplasm Recurrence, Local / epidemiology, Neoplasm Recurrence, Local / etiology, Neoplasm Staging, Prognosis, Radiotherapy Dosage, Salvage Therapy, Uterine Cervical Neoplasms / pathology, Vaginal Neoplasms / epidemiology, Vaginal Neoplasms / etiology

Background:
Pelvic recurrences of cervical cancer after primary surgical treatment can be potentially cured with radical hysterectomy or chemoradiation therapy. Combined radio-chemotherapy is believed to improve results compared to other option. Currently, RapidArc radiotherapy is considered an excellent technological advance that shows great potential for producing highly conformal doses to treatment volumes.
Case presentation:
We present a case of a 67-year-old woman with history of early cervical cancer initially treated by radical laparoscopic hysterectomy. More than 5 years later, the patient presented with a central pelvic vaginal cuff recurrence that is histologically confirmed. Salvage radiotherapy using RapidArc with concurrent cisplatin-based chemotherapy was indicated. A high dose of 70 Gy was delivered to the gross recurrent disease with simultaneous integrated boost (SIB) to the subclinical disease and good sparing of organs at risk especially the rectum and sigmoid.
Conclusions:
This case clearly demonstrates a large benefit for salvage RapidArc radiotherapy to central pelvic recurrences of gynecological cancers with an excellent rate of local control and less rate of toxicity.
Cardiac venous malformation concurrent with multiple hepatic venous malformations: A case report
Authors: Shijie Zhang, Zhenqiang Xu, Chengwei Zou, Gang Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac, cardiac metastases, cardiac venous malformation, hepatic venous malformation, tricuspid regurgitation
MeSH terms: Case Reports

A 50-year-old woman who had previously undergone right radical mastectomy presented with chest tightness and shortness of breath after physical activities. A cardiac mass and multiple hepatic lesions were successively detected. We first performed hepatic puncture biopsy. Histopathologic examination confirmed that the multiple hepatic lesions were venous malformations. Based on the imaging findings and previous reports in the literature, we boldly speculated that the cardiac mass was also a venous malformation. The cardiac venous malformation was successfully resected, and the postoperative pathology confirmed our suspicion.
Hook Plate Technique for Bony Mallet Thumb
Authors: Fumihiro Mukasa, Yoshimasa Tomita, Hideyuki Hirasawa, Kazuo Kaneko
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Bony mallet is a common sport injury, but bony mallet thumb is rarely encountered. We performed open reduction and fixation of bony mallet thumb using a hook plate procedure on a 27-year-old man under general anesthesia. The patient began working one day after surgery. Six months postoperatively, the patient had excellent dexterity according to Crawford's evaluation criteria and no difficulties at work or playing softball. Tension band fixation, compression pins, and the extension block technique are commonly used to manage bony mallet. Despite the anatomical reduction, rigid fixation, and early resumption of motion skills offered by the hook plate technique, to our knowledge, no previous reports of its application to bony mallet thumb were found. In this case, the hook plate technique was chosen and made an early return to work possible and brought about a successful result.
Case of hypercalcemia secondary to hypervitaminosis a in a 6-year-old boy with autism
Authors: Arpita Kalla Vyas, Neil H White
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Vitamin A intoxication secondary to over-the-counter nutritional supplements and from its use in acne treatment has been described. However, there have been very few case reports of chronic hypervitaminosis A leading to hypercalcemia in the pediatric population. This paper describes a boy with hypercalcemia secondary to chronic vitamin A intoxication in the context of vitamin A usage for therapy of autism. In addition to discontinuation of vitamin A, hyperhydration, and furosemide, the hypercalcemia in this patient required the use of prednisone and pamidronate to normalize the calcium.
Case Report: Human Recombinant Growth Hormone Therapy in a DSH Cat Presented With Dwarfism
Authors: Martina Načeradská, Kateřina Návojová Horáčková, Michaela Fridrichová
Journal: Front Vet Sci (2021)
Keywords: igf-i, cat, dwarfism, human growth hormone, hyposomatotropism
MeSH terms: Case Reports

A 6-month-old kitten, male, domestic shorthair cat was presented with dwarfism, ocular and nasal discharge, and Ascaris infestation. Congenital hyposomatotropism was diagnosed on the basis of serum level of insulin-like growth factor-1 (IGF-I). The cat was treated with human recombinant growth hormone for 9 weeks. After that, his liver enzymes became elevated, and the therapy was discontinued. His IGF-I levels were normal at the end of the therapy. Normal IGF-I was present 3 months after discontinuation of therapy with human recombinant growth hormone and even half a year after the discontinuation. All other comorbidities were addressed with the therapy. The cat is now the size of normal cats, living with the first author.
Exacerbation of Mania due to Metronidazole in a Bipolar Disorder Patient
Authors: Majed AlShakori, Savera I Arain, Shabeer A Thorakkattil, Syed Abdulkader
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Bipolar disorder is a mental health disorder where the patient experiences extreme shifts in mood marked by depression, mania, or hypomania. It affects their overall daily life activities and sleep patterns. This case report is of a 74-year-old female patient with bipolar disorder who experienced a manic episode after initiation of antibiotics to treat gallbladder perforation with abscess formation. The patient's past medical history included Parkinson's disease, diabetes mellitus, bipolar disorder, and acalculous cholecystitis. The patient required hospitalization for a cholecystostomy tube insertion for drainage. During hospitalization, the patient was started on empiric treatment with broad-spectrum antibiotics, including piperacillin/tazobactam and metronidazole. The patient remained stable during the inpatient stay and was discharged home one week later. She was prescribed cefuroxime and metronidazole to complete a 2-week duration of antibiotics. However, upon discharge, she developed manic symptoms, including lack of need to sleep, excessive talking, and severe agitation. Upon assessment, the psychiatric team decided to hold metronidazole as it has an adverse effect of mania as evidenced in drug information resources. The patient started to show immediate recovery from the symptoms with complete resolution of manic symptoms on the 3rd day following the discontinuation of metronidazole. This case emphasizes the increased need for vigilance in bipolar patients upon prescribing metronidazole. Also, further research is needed to predict the time to onset of manic symptoms and improvement in patient symptoms upon drug discontinuation.
Solitary fibrous tumor of the spermatic cord: A case report and literature review
Authors: Shanbiao Hu, Lu Yi, Luoyan Yang, Yinhuai Wang
Journal: Exp Ther Med (2015)
Keywords: mesenchymal tumor, solitary fibrous tumor, spermatic cord

A 31-year-old male patient with a six-year history of left inguinoscrotal swelling was admitted to the Second Xiangya Hospital (Changsha, China). The mass was not found to be associated with intraperitoneal pressure. Ultrasonography and computed tomography examinations demonstrated several solid, botryoidal masses involving the spermatic cord, with limited capacity of mobility. The demarcation between the masses and the left testicle was clear; thus, the masses were removed by a left spermatic cord tumor resection via a left inguinal approach, under epidural anesthesia. Positive staining of the tumor markers, CD34+, CD99+ and Bcl-2+, was confirmed by pathological examination following surgery, and a solitary fibrous tumor of the spermatic cord was diagnosed. No recurrence and metastasis were observed in the patient during the subsequent 25-month follow-up period.
Palliative Surgical Management of a Metastatic Lesion of the Tibia with Extension into the Popliteal Fossa Using Polytetrafluoroethylene Felt and Bone Cement
Authors: Kyriakos Papavasiliou, Konstantinos Asteriadis, Sousana Panagiotidou, Eleftherios Tsiridis
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

The treatment of metastatic bony lesions with the involvement of adjacent neurovascular structures presents a surgical challenge. We present-to the best of our knowledge-the first case of a patient suffering from a metastatic lytic lesion at the proximal tibia who underwent palliative treatment with the use of a polytetrafluoroethylene (PTFE) felt as a liner in order to preserve the adjacent vasculature and nerves. An 82-year-old female patient was diagnosed with multiple lytic bone metastases from renal cell carcinoma. One of these metastatic lesions was located at the proximal metaphysis of the left tibia. The lesion destructed the proximal metaphyseal part and the posterior cortex, and it was extending into the popliteal fossa. As a result, the patient was unable to bear weight. The patient was not fit to undergo radical operative treatment. As a means of palliative therapy, she underwent intralesional curettage and instillation of Poly-Methyl-Methacrylate (PMMA) bone cement using an alternative novel surgical technique with the use of a PTFE felt as a liner in order to protect the adjacent vasculature and nerves. This technique has proven to be successful in preventing cement leak into the popliteal cavity and efficient in allowing the patient to bear weight and walk independently until she demised 14 months later. The use of a PTFE felt as a liner, when treating lytic lesions, in order to protect the adjacent vasculature and nerves from PMMA leakage, is a helpful novel surgical option in cases when a radical treatment cannot be implemented.
Hemorrhagic cerebral infarction in carbon monoxide poisoning: a case report
Authors: Mostafa El Khashab, Farideh Nejat
Journal: Cases J (2009)

Introduction:
Almost every known central neurological syndrome has been reported as a complication of carbon monoxide poisoning. Hemorrhagic infarct has rarely been considered as an early manifestation of carbon monoxide poisoning. A case of cerebral hemorrhagic infarction is presented. Typical findings, neuropathology and the role of vascular injury are described.
Case presentation:
The symptoms and clinical course of acute poisoning with carbon monoxide in a 7-year-old boy are described. To evaluate the possible causes, a brain computed tomography (CT) was performed that showed thick clot in the left medial temporal and parasellar area, left sylvian fissure (acute intravascular thrombus) accompanied by left diffuse frontotemporal hypodensity and midline shift. Four-vessel digital subtraction angiography two weeks after intoxication was not indicative of any vascular lesion.
Conclusion:
Hemorrhagic infarction is a rare presentation of carbon monoxide poisoning. When found in a child, in addition to conservative treatment to reduce the neurocognitive squeal, other probable causes should be ruled out.
Invasive pulmonary aspergillosis in a haematopoietic stem cell transplant recipient with sickle cell disease: a successful treatment
Authors: Katia Paciaroni, Gioia De Angelis, Cristiano Gallucci, Cecilia Alfieri, Michela Ribersani, Andrea Roveda, Antonella Isgrò, Marco Marziali, Ivan Pietro Aloi, Alessandro Inserra, Javid Gaziev, Pietro Sodani, Guido Lucarelli
Journal: Mediterr J Hematol Infect Dis (2015)
MeSH terms: Case Reports

Sickle Cell Anaemia (SCA) is the most common inherited blood disorder and is associated with severe morbidity and decreased survival. Allogeneic Haematopoietic Stem Cell Transplantation (HSCT) is the only curative approach. Nevertheless the decision to perform a bone marrow transplant includes the risk of major complications and transplant-related mortality. Infections represent the leading cause of death in SCA patients undergoing HSCT. Invasive Pulmonary Aspergillosis (IPA) is a devastating opportunistic infection and remains a significant cause of morbidity and mortality in HSCT recipients. Data regarding IPA in the setting of SCA are lacking. In the present report, we describe a patient with SCA, who developed IPA after allogeneic bone marrow transplant. The fungal infection was treated by systemic antifungal therapy in addition to surgery, despite mild chronic graft versus host disease (GVHD) and continuing immunosuppressive therapy. This case shows that IPA occurring in bone marrow recipients with SCA can be successfully treated.