OpenMed/multicare-articles huggingface dataset:
Advanced composite of large cell neuroendocrine carcinoma and squamous cell carcinoma: a case report of uterine cervical cancer in a virgin woman
Authors: Ryusuke Murakami, Iemasa Kou, Kenjiro Date, Hirofumi Nakayama
Journal: Case Rep Obstet Gynecol (2013)

Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is very rare and aggressive. The prognosis is very poor despite multimodal treatment. We report a virgin woman with FIGO stage 4b LCNEC of uterine cervix coexisting with squamous cell carcinoma. An early thirties virgin woman presented with 2-month history of abdominal pain. A chest X-ray showed multiple lung metastatic tumors. A vaginal smear showed malignant cells, and a biopsy specimen had features of LCNEC. The tumor showed trabecular patterns. Tumor cells possessed a moderate amount of cytoplasm, prominent nucleoli, and large nuclei. The tumor cells are stained positive for synaptophysin, chromogranin A, and neuron specific enolase (NSE). The invasive tumor cells in connection with cervical squamous epithelium were focally positive for 34bE12. We made a diagnosis of composite LCNEC and nonkeratinizing squamous cell carcinoma. High-risk HPV test was negative with hybridized captured method 2.
Focal Cortical Dysplasia with hippocampal sclerosis
Authors: Devendra Jadav, Vaibhav Gupta, Sudeep Khera, Vikas Meshram
Journal: Autops Case Rep (2023)
Keywords: cortical dysplasia- focal epilepsy syndrome histopathology, forensic pathology, autopsy, immunohistochemistry
MeSH terms: Case Reports

Focal Cortical Dysplasia (FCD) is a group of focal developmental malformations of the cerebral cortex cytoarchitecture. FCD usually manifests as medically intractable epilepsy, especially in young children. Live patients are diagnosed by radiological examination such as magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography (FDG PET), magnetoencephalography (MEG), diffusion-tensor imaging (DTI), and intracranial electroencephalogram (EEG). While some cases can be missed by radiological examination, they are usually diagnosed on the histopathological examination of the surgically removed specimens of medically intractable epilepsy patients. We report a case of a young girl with cerebral palsy, mental retardation, and seizure disorder who died in her sleep. The deceased was diagnosed with FCD type III with hippocampal sclerosis on histopathological examination at autopsy. H & E stain and NeuN immunohistochemistry neuronal cell marker were used to demonstrate the findings of FCD.
Case Report: Hyponatremia Secondary to Desmopressin Administration Prior to Percutaneous Kidney Biopsy: A Case-Based Review
Authors: Alexandra Vornicu, Bogdan Obrişcă, Bogdan Cotruta, Adriana Octaviana Dulămea, Nicu Caceaune, Gener Ismail
Journal: Front Med (Lausanne) (2021)
Keywords: case report, cerebral edema, desmopressin, gastrointestinal bleeding, hyponatremia, kidney biopsy
MeSH terms: Case Reports

Bleeding remains the most clinically relevant complication of kidney biopsy and several prophylactic approaches were proposed, including desmopressin administration. We present the case of a 60-year-old man with a history of liver transplantation, admitted for the evaluation of a renal dysfunction. As part of our department protocol, desmopressin 60 μg was administered orally, 2 h before the percutaneous kidney biopsy. The patient developed acute, severe, symptomatic hyponatremia (i.e., headache and recurrent vomiting), followed by a life-threatening upper gastrointestinal bleeding due to a Mallory-Weiss syndrome. Although it is often used as bleeding prophylaxis prior to kidney biopsy, data regarding the efficacy and safety of desmopressin in this setting are inconsistent. Accordingly, we performed a thorough literature review of the use of desmopressin as bleeding prophylaxis prior to kidney biopsy, focusing on the incidence of hyponatremia. The reported incidence of hyponatremia (<130 mmol/l) was 7-11%, probably because serum sodium was monitored in few studies. Nevertheless, hyponatremia was rarely symptomatic but, in some cases, like the one presented here, its complications could be severe. Pre-biopsy low serum sodium and estimated glomerular filtration rate as well as high spot urine sodium and non-restricted fluid intake were reported to be associated with hyponatremia incidence. However, the current evidence cannot clearly establish which patients benefit the most from desmopressin use with respect to bleeding complications. We propose that when desmopressin is used for bleeding prophylaxis prior to kidney biopsy, measurements of serum sodium levels, before and every 6 h after, should complement ultrasound and hemoglobin as part of the patient post-procedural monitoring. Also, water intake should be restricted in the day of biopsy. However, this proposed approach should be adequately evaluated in a clinical trial.
Endoscopic removal of a bullet from the parapharyngeal space just anterior-lateral to the first vertebral body: case report
Authors: Wardeh Alhusban, Qais Aljfout, Yousef Alsardia, Nabeela Tawalbeh, Mohammad Aboroman, Amer Abu-Ain
Journal: Pan Afr Med J (2022)
Keywords: bullet injury, case report, fluoroscopy, navigation, trans-nasal endoscopic removal
MeSH terms: Firearms, Foreign Bodies / diagnostic imaging, Foreign Bodies / surgery, Wounds, Gunshot / diagnostic imaging, Wounds, Gunshot / surgery, Case Reports, Adult, Humans, Male, Parapharyngeal Space, Vertebral Body

In all head and neck bullet injuries, treatment has to be individualized, as there is no universal protocol for all cases. Five important steps of management should be taken: securing airways, hemorrhage control, recognizing other injuries, foreign body removal when necessary, and repair of facial wounds. In this report, the case of a 28-year-old male patient will be presented and discussed. The patient was referred from a surgery clinic to an ear, nose and throat (ENT) outpatient clinic complaining of right neck pain, throat pain, and foreign body sensation in the throat for 2 months following a firearm injury to his face. The entry wound was observed on the left alar cartilage of his nose, which was almost healed and had left a scar. A sinus computed tomography scan showed a bullet in the right parapharyngeal space about 3 mm in front of the first vertebral body. The bullet was successfully removed using a trans-nasal endoscopic approach with the support of an image-guided navigational system and frequent fluoroscopy. These 2 methods help to replace the old traditional open approaches.
Diphenhydramine induced acute dystonia: a case report
Authors: Danielle Abou Khater, Rafi Daou, Ali Al Dailaty, Mariana Helou
Journal: Pan Afr Med J (2022)
Keywords: dystonia, abnormal movements, case report, diphenhydramine
MeSH terms: Dystonia / chemically induced, Dystonia / diagnosis, Hypersensitivity, Case Reports, Diphenhydramine / adverse effects, Female, Humans, Diphenhydramine

Acute dystonia has notably been a challenge in the emergency unit. Drug-induced dystonia is reported in a limited number of cases in the literature. Rarely, diphenhydramine was found to be the culprit. We report the case of a 25-year-old female patient who developed an acute dystonic reaction following the administration of 25 mg of intravenous diphenhydramine as a treatment for an allergic reaction. The patient was given 5 mg diazepam, admitted for monitoring, and discharged home. Diphenhydramine-induced acute dystonia is a user drug-induced threatening reaction that warrants further investigation on the metabolism of these drugs and the contributing phenotypes to this adverse reaction.
Progressive Pseudorheumatoid Dysplasia or JIA?
Authors: Geetha Wickrematilake
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Progressive pseudorheumatoid dysplasia (PPD) or spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare arthropathy of childhood involving the axial skeleton as well as small peripheral joints. A 10-year-old boy was referred by a general practitioner with pain and deformity in the fingers of hands and limping gait. There was no joint synovitis although the finger joints were bulky on examination with mild flexion deformity. Patient had exaggerated kyphosis and lumbar lordosis with pigeon chest and restricted hip joint movements. Anteroposterior X-rays of the hip joints revealed widened and flattened epiphyses of the femoral heads with narrow and irregular joint spaces. Hand X-rays revealed periarticular osteopenia, significant narrowing of the joint spaces of proximal interphalangeal, and distal interphalangeal joints, together with osseous enlargement of the basis of metacarpal bones and phalanges. Spinal X-rays revealed generalized platyspondyly and anterior beaking of vertebral bodies. There was a clear mega os trigonum in his feet images. All blood investigations were normal with no evidence of inflammation and thyroid hormone levels were normal. The diagnosis of PPD was favored by imaging studies and normal inflammatory markers and the patient was treated with physiotherapy, family counseling, and anti-inflammatory medications.
Transient Left-Sided Paralysis following Robotic-Assisted Laparoscopic Uteropexy
Authors: Jasmina Kurdija, Jan G Jakobsson
Journal: Case Rep Anesthesiol (2015)

We describe a case report of a 47-year-old ASA 2 female patient who exhibits severe headache and hemineurology during awakening following robotic pelvic prolapse surgery. The symptoms resolved spontaneously during the first postoperative day. We could not find any explicit root cause. Robotic surgery associated adverse events are discussed.
A Case Report of Overcoming an Obstructive, Pedunculated Cervical Fibroid at the Time of Uterine Evacuation
Authors: Jayesh Tigdi, Cynthia Chan
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Fibroids, which can impact pregnancies at later gestations, such as obstructing delivery, may also affect the pregnancy termination process.
Case:
We present the case of a 28-year-old G1 at 18 weeks who consented for a genetic pregnancy termination via dilation and evacuation. During the typical preparatory procedure with laminaria, it was noted that a 5-6cm cervical fibroid prolapsed into the vagina obstructing access to the uterine cavity. Through osmotic dilation followed by cervical Foley catheter ripening, a planned myomectomy was possible with minimal blood loss prior to uterine evacuation.
Conclusion:
Through appropriate counselling, planning, and effective cervical dilatation, a planned myomectomy for prolapsing fibroids at the time of termination of pregnancy is possible. This can prevent unnecessary hysterotomy and avoid need for subsequent cesarean section.
Qualitative evaluation of rapid implementation of remote blood pressure self-monitoring in pregnancy during Covid-19
Authors: Charlotte Paterson, Elaine Jack, Brian McKinstry, Sonia Whyte, Fiona C Denison, Helen Cheyne
Journal: PLoS One (2023)
MeSH terms: COVID-19 / epidemiology, Research Support, Non-U.S. Gov't, Blood Pressure, Female, Humans, Pandemics, Pregnancy, SARS-CoV-2, State Medicine

In March 2020, the World Health Organisation named the severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2), which causes corona virus disease 2019 (COVID -19), as a pandemic. Pregnant women were considered at increased risk of developing severe COVID-19 after viral infection. In response maternity services reduced face-to-face consultations with high-risk pregnant women by supplying blood pressure monitors for supported self-monitoring. This paper explores the experiences of patients and clinicians of the rapid roll-out of supported self-monitoring programme in Scotland during the first and second wave of the COVID-19 pandemic. We conducted semi-structured telephone interviews with high-risk women and healthcare professionals who were using supported self-monitoring of blood pressure (BP) In four case studies during the COVID-19 pandemic. 20 women, 15 midwives and 4 obstetricians took part in the interviews. Interviews with healthcare professionals showed that while implementation occurred at pace and at scale across the National Health Service (NHS) in Scotland, implementation differed locally, resulting in mixed experiences. Study Participants observed several barriers and facilitators to implementation. Women value the simplicity of use and convenience of the digital communications platforms while health professionals were more interested in their impact on reducing workload for both women and health professionals largely found self-monitoring acceptable, with only a few exceptions. These results show that rapid change can occur in the NHS at a national level when there is a shared motivation. While self-monitoring is acceptable to most women, decisions regarding self-monitoring should be made jointly and on an individual basis.
Pancreatic hamartoma: a case report and literature review
Authors: Daisuke Matsushita, Hiroshi Kurahara, Yuko Mataki, Kosei Maemura, Michiyo Higashi, Satoshi Iino, Masahiko Sakoda, Hiroyuki Shinchi, Shinichi Ueno, Shoji Natsugoe
Journal: BMC Gastroenterol (2016)
MeSH terms: Hamartoma / pathology, Pancreatic Diseases / pathology, Rare Diseases / pathology, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, Diagnosis, Differential, Hamartoma / diagnostic imaging, Hamartoma / surgery, Humans, Male, Pancreas / diagnostic imaging, Pancreas / pathology, Pancreas / surgery, Pancreatic Diseases / diagnostic imaging, Pancreatic Diseases / surgery, Rare Diseases / diagnostic imaging, Rare Diseases / surgery, Tomography, X-Ray Computed

Background:
Pancreatic hamartoma is an extremely rare benign disease of the pancreas. Only 30 cases have been reported to date.
Case presentation:
A 68-year-old man presented with an asymptomatic solid and multi-cystic lesion in the uncus of the pancreas, incidentally detected on abdominal enhanced computed tomography. The tumor was found to be a well-demarcated solid and multi-cystic lesion without any enhancement, measuring 4 cm in diameter. After 28 months of follow-up, the tumor enlarged. At 31 months after initial diagnosis, the patient underwent surgical resection because it was difficult to clinically determine whether the tumor was malignant or not. Macroscopically, the solid tumor consisted of yellow adipose tissue with a smooth thin capsule confined to the pancreatic uncus. The inner structure of the tumor consisted of multiple cysts with a white nodule between the cysts. Histologically, the solid part and the multi-cystic portion consisted of mature adipose tissue and colonization of dilated pancreatic ducts with mild fibrosis, respectively. Immunohistochemical findings revealed cytokeratin 7 and 19 positive staining in the epithelial cells of the ducts. Adipose tissue showed positive staining for S-100 protein and there were only a few MIB-1 positive cells. The tumor was then diagnosed as a pancreatic hamartoma.
Conclusion:
Beside on the above findings, we suggest that the term "well-demarcated solid and cystic lesion with chronological morphological changes" could be a clinical keyword to describe pancreatic hamartomas.
Mediastinal Germ Cell Tumor-associated Histiocytic Proliferations Treated With Thalidomide Plus Chemotherapy Followed by Alemtuzumab-containing Reduced Intensity Allogeneic Peripheral Blood Stem Cell Transplantation: A Case Report
Authors: Li-Hua Fang, Li-Sun Shih, Pei-Ing Lee, Wei-Ting Chen, Rong-Long Chen
Journal: Medicine (Baltimore) (2016)
MeSH terms: Antineoplastic Agents / therapeutic use, Histiocytic Sarcoma / drug therapy, Mediastinal Neoplasms / complications, Neoplasms, Germ Cell and Embryonal / complications, Peripheral Blood Stem Cell Transplantation, Case Reports, Alemtuzumab, Antibodies, Monoclonal, Humanized / therapeutic use, Fatal Outcome, Histiocytic Sarcoma / etiology, Humans, Immunosuppressive Agents / therapeutic use, Male, Mediastinal Neoplasms / drug therapy, Neoplasms, Germ Cell and Embryonal / drug therapy, Thalidomide / therapeutic use, Transplantation, Homologous, Young Adult, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunosuppressive Agents, Alemtuzumab, Thalidomide

Mediastinal nonseminomatous germ cell tumor (MNSGCT)-associated histiocytic proliferations are rare and rapidly fatal disorders. Standard treatment modalities have yet to be established.We report a case of MNSGCT-associated hemophagocytic syndrome that evolved into malignant histiocytosis/disseminated histiocytic sarcoma (MH/HS), which was initially treated with intravenous immunoglobulin, corticosteroids, and cyclosporine. Then, thalidomide plus cyclophosphamide, adriamycin, oncovin, prednisolone chemotherapy followed by alemtuzumab-containing reduced-intensity allogeneic peripheral blood stem cell transplantation (PBSCT) was used as salvage therapy.The severe constitutional symptoms and pancytopenia resolved shortly after thalidomide with cyclophosphamide, adriamycin, oncovin, prednisolone. After PBSCT, the patient developed steroid-dependent skin graft-versus-host disease, but maintained a functional life for 1.5 years. Rapid resolution of chronic graft-versus-host disease preceded the fulminant recurrence of hemophagocytic syndrome and MH/HS.Thalidomide plus chemotherapy followed by alemtuzumab-containing reduced intensity allogeneic PBSCT is effective in allaying MNSGCT-associated histiocytic disorders, but does not prevent eventual relapse. However, further posttransplant immune modulation should be developed to completely eradicate the residual MH/HS cells.
Interstitial Lung Disease and Psoriasis in a Child With Aicardi-Goutières Syndrome
Authors: Shaoling Zheng, Pui Y Lee, Jun Wang, Shihao Wang, Qidang Huang, Yukai Huang, Yuqi Liu, Qing Zhou, Tianwang Li
Journal: Front Immunol (2020)
Keywords: aicardi-goutières syndrome, ifih1/mda5, interstitial lung disease, psoriasis, pulmonary hypertension
MeSH terms: Autoimmune Diseases of the Nervous System / complications, Lung Diseases, Interstitial / etiology, Nervous System Malformations / complications, Psoriasis / etiology, Case Reports, Adolescent, Adrenal Cortex Hormones / therapeutic use, Autoimmune Diseases of the Nervous System / diagnosis, Autoimmune Diseases of the Nervous System / drug therapy, Autoimmune Diseases of the Nervous System / genetics, Gain of Function Mutation, Genetic Predisposition to Disease, Humans, Immunosuppressive Agents / therapeutic use, Interferon-Induced Helicase, IFIH1 / genetics, Janus Kinase Inhibitors / therapeutic use, Lung Diseases, Interstitial / diagnosis, Lung Diseases, Interstitial / drug therapy, Male, Nervous System Malformations / diagnosis, Nervous System Malformations / drug therapy, Nervous System Malformations / genetics, Psoriasis / diagnosis, Psoriasis / drug therapy, Treatment Outcome, Adrenal Cortex Hormones, Immunosuppressive Agents, Janus Kinase Inhibitors, IFIH1 protein, human, Interferon-Induced Helicase, IFIH1, Aicardi-Goutieres syndrome

Aicardi-Goutières syndrome (AGS) is characterized by progressive neurologic decline, cerebral calcification, and variable manifestations of autoimmunity. Seven subtypes of AGS have been defined and aberrant activation of the type I interferon system is a common theme among these conditions. We describe a 13-year-old boy who presented with an unusual constellation of psoriasis, interstitial lung disease (ILD), and pulmonary hypertension in addition to cerebral calcifications and glomerulonephritis. He was found to have late-onset AGS due to a gain-of-function mutation in IFIH1 and over-activation of the type I interferon pathway was confirmed by RNA sequencing. The majority of his clinical manifestations, including ILD, psoriasis and renal disease improved markedly after treatment with the combination of corticosteroids, cyclophosphamide, and the Janus-kinase inhibitor tofacitinib. This case extends the clinical spectrum of AGS and suggests the need for lung disease screening in patients with AGS.
Early Disseminated Lyme Disease with Carditis Complicated by Posttreatment Lyme Disease Syndrome
Authors: Cheryl Novak, Andrew Harrison, John Aucott
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi. When untreated, infection may spread to the heart, nervous system, and joints. Cardiac involvement usually manifests as abnormalities of the conduction system and bradycardia. Treatment of Lyme disease is generally effective, with a subset of patients experiencing persistent, sometimes long-term symptoms called posttreatment Lyme disease syndrome.
Secreting retroperitoneal latero-aortic paraganglioma revealed by acute abdominal pain: a case report
Authors: Idriss Ziani, Ahmed Ibrahimi, Omar Bellouki, Fouad Zouidia, Hachem El Sayegh, Lounis Benslimane, Yassine Nouini
Journal: Pan Afr Med J (2023)
Keywords: paraganglioma, abdominal pain, case report, lateral aortic, retroperitoneal
MeSH terms: Abdomen, Acute, Paraganglioma / complications, Paraganglioma / diagnosis, Paraganglioma / surgery, Retroperitoneal Neoplasms / complications, Retroperitoneal Neoplasms / diagnosis, Retroperitoneal Neoplasms / surgery, Case Reports, Abdominal Pain / etiology, Adult, Humans, Male, Retroperitoneal Space

We report the case of a retroperitoneal paraganglioma in a 35-year-old man discovered by abdominal pain. The abdomino-pelvic computed tomography (CT) showed a retro-peritoneal latero-aortic mass compatible with a paraganglioma, confirmed by the 24-hour urinary metanephrines and normetanephrines test. After an adequate pharmacological preparation, we decide to perform a laparoscopic resection of the paraganglioma. The surgery went without any complication. Blood pressure and urinary catecholamines were normal after the surgery. Our observation presents the particularity of the mode of discovery which is atypical, as well as the particularity of the therapeutic management, which is the laparoscopic resection of the mass.
Case Report: Using basic liver function tests as a guide to suspected Wilson's disease
Authors: Sudeep Adhikari, Prashant Kumar Shah, Yuba Raj Sharma
Journal: F1000Res (2021)
Keywords: nepal, wilson's disease, basic liver function tests, liver disease
MeSH terms: Hepatolenticular Degeneration / diagnosis, Hepatolenticular Degeneration / therapy, Case Reports, Adult, Bilirubin, Copper, Female, Humans, Liver Function Tests, Copper, Bilirubin

We present a case of a 36-year-old female patient who presented with subacute liver disease with a history of alcohol abuse. On basic liver function tests (LFT), she had aspartate transaminase / alanine transaminase > 2.2 and alkaline phosphatase / total bilirubin < 4. This pattern in acute liver failure patients signifies Wilson's disease. Its presence in our patient with subacute liver disease also prompted us to suspect Wilson's disease and we extended the liver disease screen to include slit lamp eye examination for Kayser-Fleischer rings, serum ceruloplasmin and 24-hour urinary copper level, which led to the diagnosis. She improved clinically and biochemically with zinc acetate therapy. As screening for rare diseases is not always possible in low-income countries, this case demonstrates the usefulness of the basic LFT as a guide for suspecting Wilson's disease in patients with liver disease.