OpenMed/multicare-articles huggingface dataset:
Primary pulmonary hyalinizing clear cell carcinoma with fusions of both EWSR1::CREM and IRF2::NTRK3: report of a case with an aggressive behavior
Authors: You-Li Wu, Feng Wu, Mian-Fu Cao, Yang Lan, Ming-Shan Du, Song-Tao Yu, Yan Wang, Xiao-Chu Yan, Xiu-Wu Bian, Guang-Jie Duan
Journal: Front Oncol (2023)
Keywords: ewsr1
MeSH terms: Case Reports

Primary pulmonary hyalinizing clear cell carcinoma (HCCC) is a rare salivary gland-type tumor newly recognized in recent years, with approximately 21 cases reported to date in the English literature, which constitutes a challenge in pathology diagnosis, particularly in small biopsy specimens. Here, we present a case of pulmonary HCCC diagnosed by computed tomography-guided percutaneous lung biopsy in a 70-year-old man's right lower lung. Although the morphology and immunophenotype of the tumor suggested the diagnosis of mucoepidermoid carcinoma, fluorescence in situ hybridization failed to reveal the rearrangement of MAML2 gene, which is characteristic of mucoepidermoid carcinoma. Instead, further molecular genetic testing showed that the tumor harbored a rare EWSR1::CREM fusion combined with a previously unreported IRF2::NTRK3 fusion. Pulmonary HCCC is commonly regarded as a low-grade malignant tumor with an indolent course, but this case has a different biological behavior, presenting extensive dissemination and metastases at the time of diagnosis, which expands our understanding of the prognosis of this tumor. The patient has had five cycles of combination chemotherapy and has been alive with the tumor for eight months.
The Effect of Exercise Intervention on Disability and Kinesiophobia in a Retired Athlete With Old Patella Fracture: A Case Report
Authors: Yuqin Su, Li Huang, Haowei Liu, Shifan Chen, Li Peng
Journal: Front Psychol (2021)
Keywords: disability, exercise intervention, kinesiophobia, patella fracture, retired athlete
MeSH terms: Case Reports

Objectives: To evaluate the effect of exercise intervention on disability, pain, and kinesiophobia in a retired athlete with old patella fracture. Methods: A 34-year-old retired football player with old patella fracture conducted the exercise intervention for 12 weeks, 1 h each time, three times a week. the retired football player completed the Lysholm Knee Score (LKS), Visual Analog Scale (VAS), and the Tampa Scale for Kinesiophobia (TSK) were measured at pre-intervention, mid-intervention, and post-intervention. Results: Based on the functional training perspective, the retired athlete was subjected to two stages of exercise intervention for a total of 12 weeks. The patient's LKS score increased from 76 to 95, and the pain level of various physical states was relieved. When walking, the VAS score was reduced from 3 to 1, and when running, the VAS score was reduced from 5 to 2. Jumping VAS score for actions was reduced from 6 to 3, and the VAS score for of daily life activities was reduced from 3 points to 2. The patient's TSK score from 50 to 37. Conclusion: A 12-week exercise intervention could improve knee joint function, relieve pain and relieve kinesiophobia.
Choroidal metastasis from follicular cell thyroid carcinoma masquerading as circumscribed choroidal haemangioma
Authors: V P Papastefanou, A K Arora, J L Hungerford, V M L Cohen
Journal: Case Rep Oncol Med (2014)

Choroidal metastases from follicular thyroid carcinoma are uncommon and usually present as an amelanotic lesion against a background of known systemic disease. We present the case of a 56-year-old woman with a thyroid metastatic focus with unusual clinical presentation, systemic involvement, and early response to systemic treatment. A review of the literature accompanies this case presentation.
An unusual complication in osteonecrosis of femoral head: a case report
Authors: Singaravadivelu Vaidyanathan, Yuvaraja Murugan, Kingsly Paulraj
Journal: Case Rep Orthop (2013)

We report a case of fracture of femoral head occurring in the setting of underlying osteonecrosis following a low-energy trauma in a middle-aged male. Patient also has underlying pelvic pathology from a previous trauma. The possible mechanism of injury is discussed. Extensive literature search reveals that this is the first report of a fracture in an osteonecrotic femoral head.
Familial adenomatous polyposis-rendering a diagnosis based on recognition of an unusual primary thyroid neoplasm
Authors: David F Schaeffer, Eric M Yoshida, David A Owen, Kenneth W Berean
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

It has been well established in the literature that the cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) has been observed with higher frequency in familial adenomatous polyposis (FAP) patients. In the usual setting, patients with FAP are identified based on their germline mutations and the diagnosis of thyroid neoplasm is made after the FAP diagnosis. We herein report a case in which the recognition of a CMVPTC led to the initial diagnosis of FAP. The histological and clinical features of CMVPTC are reviewed with emphasis on its relationship to FAP.
Postmenopausal Hyperandrogenism due to Ovarian Hyperthecosis
Authors: Laryssa Santos Metzker, Luyanne Azevedo Cabral Ferreira, Julia Caroliny Nogueira Borges, Mariana Furieri Guzzo, Rodrigo Neves Ferreira, Lucas Luciano Rocha Silva, Rodrigo Monico Cavedo, Antonio Chambô Filho
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Ovarian hyperthecosis or ovarian stromal hyperplasia is a non-neoplastic functional disorder resulting from the presence of luteinized thecal cells within a hyperplastic ovarian stroma. The condition is more common in postmenopausal women than in those of reproductive age and leads to substantial clinical and laboratory alterations, principally androgenetic alopecia, progressive hirsutism, and elevated testosterone levels. Investigation should include clinical evaluation, laboratory tests, and imaging tests to differentiate between the principal diagnostic hypotheses. The gold standard for diagnosis is histopathology of the ovarian tissue. The present case report describes a woman being followed up as an outpatient at the Santa Casa de Misericórdia Hospital in Vitória, Brazil. The objective in publishing this case report is to add to available data on ovarian hyperthecosis, thus contributing towards improving timely diagnosis and treatment. Early diagnosis and treatment would ensure better quality of life for patients with this condition and better physical and mental health. Moreover, these data should be useful both for the medical community and for future research into this disease.
Ethical diversity and the role of conscience in clinical medicine
Authors: Stephen J Genuis, Chris Lipp
Journal: Int J Family Med (2013)
MeSH terms: Review

In a climate of plurality about the concept of what is "good," one of the most daunting challenges facing contemporary medicine is the provision of medical care within the mosaic of ethical diversity. Juxtaposed with escalating scientific knowledge and clinical prowess has been the concomitant erosion of unity of thought in medical ethics. With innumerable technologies now available in the armamentarium of healthcare, combined with escalating realities of financial constraints, cultural differences, moral divergence, and ideological divides among stakeholders, medical professionals and their patients are increasingly faced with ethical quandaries when making medical decisions. Amidst the plurality of values, ethical collision arises when the values of individual health professionals are dissonant with the expressed requests of patients, the common practice amongst colleagues, or the directives from regulatory and political authorities. In addition, concern is increasing among some medical practitioners due to mounting attempts by certain groups to curtail freedom of independent conscience-by preventing medical professionals from doing what to them is apparently good, or by compelling practitioners to do what they, in conscience, deem to be evil. This paper and the case study presented will explore issues related to freedom of conscience and consider practical approaches to ethical collision in clinical medicine.
Evaluation of anti-infective-related Clostridium difficile-associated colitis using the Japanese Adverse Drug Event Report database
Authors: Satoshi Nakao, Shiori Hasegawa, Kazuyo Shimada, Ririka Mukai, Mizuki Tanaka, Kiyoka Matsumoto, Hiroaki Uranishi, Mayuko Masuta, Hiroaki Ikesue, Tohru Hashida, Kazuhiro Iguchi, Mitsuhiro Nakamura
Journal: Int J Med Sci (2020)
Keywords: clostridium difficile-associated colitis, jader, adverse event, anti-infective
MeSH terms: Anti-Infective Agents / adverse effects, Clostridioides difficile, Databases, Pharmaceutical, Enterocolitis, Pseudomembranous / chemically induced, Aged, Cephalosporins / adverse effects, Enterocolitis, Pseudomembranous / epidemiology, Fluoroquinolones / adverse effects, Humans, Japan / epidemiology, Macrolides / adverse effects, Odds Ratio, Anti-Infective Agents, Cephalosporins, Fluoroquinolones, Macrolides

Clostridium difficile-associated colitis (CDAC) may cause gastrointestinal illness, ranging in severity from mild diarrhea to fulminant colitis and even mortality. The purpose of this study was to evaluate anti-infective-related CDAC profiles using the Japanese Adverse Drug Event Report (JADER) database. Methods: We selected case reports of adverse events of CDAC as specified in the Medical Dictionary for Regulatory Activities. The association between the number of administered anti-infectives and aging was evaluated using reporting odds ratio (ROR) and adjusted for covariates using multiple-logistic regression. We also evaluated anti-infective-related CDAC-onset profiles using Weibull shape parameter. Results: The JADER database contained 534 688 reports from April 2004 to June 2018. There were 1222 anti-infective related CDAC events. The top five anti-infectives were as follows: third-generation cephalosporins (Anatomical Therapeutic Chemical (ATC) code: J01DD, 313 cases), fluoroquinolones (ATC code: J01MA, 201 cases), macrolides (ATC code: J01FA, 146 cases), carbapenems (ATC code: J01DH, 143 cases), and penicillins with extended spectrum (ATC code: J01CA, 103 cases). The adjusted RORs (95% confidence interval) in individuals using 1, 2, and ≥ 3 anti-infectives were 8.88 (7.05-11.18), 9.77 (6.89-13.86), and 18.39 (11.85-28.54), respectively. Moreover, 47.2% of CDACs occurred within 7 days of anti-infective therapy initiation. The adjusted ROR of interaction terms of ≥ 70 years × 1 drug was 21.81 (14.56-32.68). Conclusion: Our results suggest that the number of administered anti-infectives and patient age are associated with CDAC. These data may be particularly beneficial to prescribers and would contribute to improving the management of CDAC.
Spontaneous Rupture of Pancreatic Pseudocyst: Report of Two Cases
Authors: Ricardo Rocha, Rui Marinho, António Gomes, Marta Sousa, Nuno Pignatelli, Carla Carneiro, Vitor Nunes
Journal: Case Rep Surg (2016)

Introduction. Pancreatic pseudocysts are a common complication of acute pancreatitis. Pancreatic pseudocyst's natural history ranges between its spontaneous regression and the settlement of serious complications if untreated, such as splenic complications, hemorrhage, infection, biliary complications, portal hypertension, and rupture. The rupture of a pancreatic pseudocyst to the peritoneal cavity is a dangerous complication leading to severe peritonitis and septic conditions. It requires emergent surgical exploration that is often of great technical difficulty and with important morbidity and mortality. Case Study. We present two cases of spontaneous rupture of pancreatic pseudocysts, managed differently according to the local and systemic conditions. Conclusion. The best surgical choice is the internal drainage of the cyst to the GI tract; however, in some conditions, the external drainage is the only choice available.
African tick bite fever in returning Swedish travellers. Report of two cases and aspects of diagnostics
Authors: Kenneth Nilsson, Katarina Wallménius, Pernilla Rundlöf-Nygren, Susanne Strömdahl, Carl Påhlson
Journal: Infect Ecol Epidemiol (2017)
Keywords: atbf, pcr, isolation, rickettsioses, serology
MeSH terms: Case Reports

Introduction: African tick-bite fever, caused by Rickettsia africae, is endemic in rural areas of sub-Saharan Africa and a possible cause of fever in returning Swedish travellers. Two patients are presented, and the advantages and disadvantages of different diagnostic methods are discussed. Patients and methods: Two middle-aged men fell ill with fever after returning home from South Africa. Both had single eschars and one also presented with a lymph node swelling. Samples were taken for serology, general bacterial culture from the wound (Patient 1) using a swab and additionally for Patient 2 PCR of a skin biopsy from the eschar. Results and discussion: Both patients seroconverted one month after onset. Real-time PCR of the biopsy was positive, where sequencing of the gltA gene was 99-100% consistent with R. africae. A drop of fluid from the biopsy contained a sufficient number of bacteria to also allow for isolation of rickettsiae in Vero cell culture. Direct molecular detection by PCR from a swab used for bacteria culture from the eschar from Patient 1 also yielded a positive result. In conclusion, the findings highlight the usefulness of swabs for early non-invasive diagnosis of African tick-bite fever in febrile travellers.
Case Report: The Added Value of Liquid Biopsy in Advanced Colorectal Cancer From Clinical Case Experiences
Authors: Paola Ulivi, Alessandro Passardi, Giorgia Marisi, Elisa Chiadini, Chiara Molinari, Matteo Canale, Luigi Pasini, Fabio Ferroni, Giovanni Luca Frassineti, Giulia Bartolini, Manlio Monti
Journal: Front Pharmacol (2021)
Keywords: ctdna, ras, case report, metastatic colorectal cancer, mutations
MeSH terms: Case Reports

Liquid biopsy represents a valid strategy for tumor molecular characterization. It gives the opportunity to bypass tumor heterogeneity, to monitor tumor characteristics during the course of treatment, and to perform the analysis even when tumor tissue is not available or inadequate. In the clinical practice of metastatic colorectal cancer, tumor molecular characterization is crucial for patient management, as RAS and BRAF status could influence the treatment choice. Although for this type of cancer tumor tissue is usually available at diagnosis, liquid biopsy could give complementary information and could permit monitoring of the mutation status during the course of treatment. At present, there are no clinical indications for its use in clinical practice. However, we report four clinical cases for which liquid biopsy analysis gave integrative information with respect to tumor tissue characterization, which permits us to understand the unresponsiveness of patients to treatment, with potential implications in patient's management.
The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report
Authors: Luís Mata-Ribeiro, Diogo Casal, João Amaral Ferreira, Daniel Sá Costa, João Lacerda
Journal: Int J Surg Case Rep (2019)
Keywords: calcaneum, case report, fibula, free flap, osteomyelitis

Introduction:
Calcaneal osteomyelitis poses a tough challenge for any reconstructive surgeon. The eradication of the infection and the reconstruction of the defect are the main goals of treatment.
Presentation of case:
We present the case of a 53-year-old male with chronic calcaneal osteomyelitis. The patient was submitted to several bone and soft tissue debridements and twice the application of gentamicin/sulfate implants at the wound bed with no success. He was then submitted to a partial calcanectomy followed by obliteration of the bone defect (4.5 × 2 × 1.5 cm) with a free vascularized fibula-flexor hallucis longus osteomuscular flap (bone dimension:4.5 × 1.5 × 1.2 cm; muscle size: 4 × 1.5 × 0.5 cm). The flap remained viable, and the post-operative period was uneventful. Bone incorporation was evident nine months after the surgery with no signs of recurrent infection or avascular necrosis. Final follow up, at one year, showed an excellent functional result. The patient was able to ambulate without assistance and referred occasional minimal foot pain. Donor site morbidity was minimal.
Conclusion:
The authors believe that this osteomuscular flap may be a valuable option to reconstruct calcaneal defects after chronic osteomyelitis.
Trichoepithelioma Arising in an Ovarian Mature Cystic Teratoma
Authors: Takashi Suzuki, Satoru Nakayama, Haruka Muto, Shinichi Shimizu, Yoshiro Otsuki, Hiroshi Adachi, Takeshi Murakoshi
Journal: Case Rep Obstet Gynecol (2016)
MeSH terms: Case Reports

Here, we report an extremely rare case of trichoepithelioma (TE)-a benign epithelial tumor originating from the outer root sheath of a hair follicle-arising in an ovarian mature cystic teratoma (MCT) with fluorodeoxyglucose-positron emission tomography (FDG-PET) findings. A 48-year-old Japanese woman presented to our hospital for her annual follow-up of adenomyosis. Ultrasonography and magnetic resonance imaging revealed a left ovarian tumor with irregular-shaped septum, which was suspicious of malignancy. However, tumor marker levels were within normal range. On FDG-PET, the maximum standardized uptake value (SUVmax) of the tumor was 2.9. Laparotomy with left salpingooophorectomy was performed. Pathologic examination revealed the probability of TE, rather than basal cell carcinoma (BCC), arising in an ovarian MCT. After five years of follow-up, the patient had no sign of recurrence. The FDG-PET SUVmax was low in TE, as with other benign tumor. However, future investigation is needed to evaluate the findings of FDG-PET imaging in TE cases.
Case Report: Intervention of radiotherapy improves the prognosis of rectal squamous cell carcinoma with high PD-L1 expression and enable patients to obtain NED status
Authors: Fuyin Qu, Linlin Xiao, Yuting Xiao, Chao Gao, Xuan Wang, Yi Wang, Yuanhang Gao, Fengpeng Wu, Ming Liu
Journal: Front Immunol (2023)
Keywords: pd-l1, chemotherapy, immunotherapy, radiotherapy, rectal squamous cell carcinoma
MeSH terms: Carcinoma, Squamous Cell / drug therapy, Rectal Neoplasms / radiotherapy, Case Reports, Research Support, Non-U.S. Gov't, B7-H1 Antigen / metabolism, Humans, Prognosis, B7-H1 Antigen

Background:
Rectal squamous cell carcinoma (RSCC) is a rare malignancy of the rectal tumor. Due to its extremely low incidence, there is still a lack of high-level treatment evidence and clinical consensus on this disease.
Case report:
In this article, we report a treatment process of RSCC with high PD-L1 expression. Firstly, this patient received 2 cycles of Pembrolizumab immunotherapy, but the efficacy was less sanguine. Subsequently, 4 cycles of mFOLFOX6 chemotherapy were synchronously performed on the basis of the initial regimen. Although partial remission was achieved in the lymph nodes thereafter, the changes in the primary lesions were still not significant. After that, the patient received radiotherapy, and followed by 6 cycles of PC (Albumin-binding Paclitaxel and Nedaplatin) regimen chemotherapy combined with Pembrolizumab. Eventually, the patient achieved no evidence of disease (NED) status, and no signs of recurrence or metastasis were found after 12 months of follow-up.
Conclusion:
This is the first report of a RSCC patient with high PD-L1 expression achieving a complete response. Looking back over the whole treatment process of this patient, we found that the participation of radiotherapy was the inflection point of prominent efficacy, which may provide a new idea for the selection of comprehensive treatment strategies for patients with RSCC.
Effectiveness of REAC neuro postural and neuro psycho physical optimization in improving peripheral vasospasm dysfunction: a case report
Authors: Fabio Bechelli
Journal: Front Med Technol (2023)
Keywords: anxiety, case report, depression, neuromodulation, neurostimulation, peripheral vasospasm, radio electric asymmetric conveyer, stress
MeSH terms: Case Reports

This case report discusses an elderly male patient (86 years old), suffering from limb pain related to ulcers in the lower limbs resulting from peripheral arterial disease (PAD). Clinically evaluated with the aid of infrared thermal imaging before, during and after treatment, he was submitted to treatment with neuromodulation protocols with REAC Technology, Neuro Postural Optimization (NPO) and Neuropsychophysical Optimization (NPPO) in association with traditional treatments for PAD. It was followed clinically with the aid of infrared thermal imaging of the lower limbs before, during and after treatment. He had a clinical result with a significant reduction in pain and infrared thermal images with complete revascularization of both feet. Evidencing that the treatment of dysfunctional adaptive responses by managing psychological factors often associated with anxiety, depression and stress performed by the REAC NPO and NPPO protocols can be a useful intervention to improve symptoms of patients with lower limb pain and circulatory disturbances.
Legionellosis and lung abscesses: contribution of legionella quantitative real-time PCR to an adapted followup
Authors: G Descours, C Tellini, C Flamens, F Philit, M Celard, J Etienne, G Lina, S Jarraud
Journal: Case Rep Infect Dis (2013)

We report a case of severe Legionnaires' disease (LD) complicated by a lung abscess in an immunocompetent patient who required ECMO therapy and thoracic surgery. The results of repeated Legionella quantitative real-time PCR performed on both sera and respiratory samples correlated with the LD severity and the poor clinical outcome. Moreover, the PCR allowed for the detection of Legionella DNA in the lung abscess specimen, which was negative when cultured for Legionella. This case report provides a logical basis for further investigations to examine whether the Legionella quantitative PCR could improve the assessment of LD severity and constitute a prognostic marker.
Case Report: Congenital diaphragmatic hernia associated with esophageal atresia and tracheoesophageal fistula
Authors: Feihong Zhang, Yang Wu, Li Zhang, Bin Xia
Journal: Front Surg (2023)
Keywords: congenital abnormalities, deformities, diaphragm defect, premature infants, surgery
MeSH terms: Case Reports

The coexistence of congenital diaphragmatic hernia and esophageal atresia with or without tracheoesophageal fistula is extremely rare; only 36 cases have been reported. We report a case of a preterm male newborn infant with left congenital diaphragmatic hernia, esophageal atresia, and tracheoesophageal fistula and review 27 related cases.
Hemangioma of the Atherosclerotic Changed Aortic Valve
Authors: A van Broekhoven, P A J Krijnen, H W M Niessen, A B A Vonk
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

The incidence of heart valve hemangioma is very low and is mostly observed in the mitral and tricuspid valve. In 2006, two cases of aortic valve hemangioma were reported for the first time, including one with calcifying aortic valve stenosis. We now present a case of aortic valve hemangioma in a patient suffering from aortic valve insufficiency combined with atherosclerotic thickening.