OpenMed/multicare-articles huggingface dataset:
A case of recurrent leg necrotic ulcers secondary to silicone migration in a transgender patient: radiographic, ultrasound and MRI findings
Authors: Eugen Lungu, Ariane Thibault-Lemyre, J Manuel Dominguez, Dominique Trudel, Nathalie J Bureau
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Injection of massive quantities of liquid silicone into body parts for cosmetic purposes is a popular practice among the transgender population. Although a myriad of short-term complications associated with this procedure have been described, few reports of chronic and persistent ailments exist. We present the case of a male-to-female transgender with recurrent necrotic leg ulcers associated with migration of the silicone material injected in the buttocks 25 years ago. We review the imaging findings as well as the clinical and pathological aspects of this presentation, with an emphasis on the necessity of a high degree of suspicion for silicone-associated complications in a transgender patient presenting with leg wounds. We highlight the importance of the characteristic sonographic snowstorm artefact generated by free silicone material in soft tissues in the diagnosis of this entity.
Elastofibroma dorsi: case report and review of the literature
Authors: Basma Karrakchou, Youssef Yaikoubi, Mohamed Said Chairi, Abdelouahed Jalil
Journal: Pan Afr Med J (2017)
Keywords: elastofibroma dorsi, benign tumor, pathology, scapula, surgery
MeSH terms: Fibroma / diagnosis, Magnetic Resonance Imaging, Soft Tissue Neoplasms / diagnosis, Case Reports, Review, Diagnosis, Differential, Female, Fibroma / pathology, Fibroma / surgery, Humans, Middle Aged, Prognosis, Scapula, Soft Tissue Neoplasms / pathology, Soft Tissue Neoplasms / surgery

Elastofibroma dorsi (ED) is an uncommon benign soft tissue tumor with an uncertain pathogenesis. It mostly occurs in the infrascapular region of elderly people with a female predominance. Typically bilateral, ED can also be unilateral. While many patients remain asymptomatic, ED can be responsible of a periscapular arch source of ache. The diagnosis of ED is set on magnetic resonance imaging, and the pathological study ensures the diagnosis after surgical excision and establishes the differential diagnosis with malignant neoplasic process. The prognosis is excellent with extremely rare recurrence cases. Herein we report a case of a 54-years-old woman with a bilateral painful ED. The diagnosis was based on clinical and MRI findings that revealed bilateral tumors. Surgery was decided due to the symptomatic nature of the tumors. Pathological study confirmed the diagnosis. The post operative course was uncomplicated. We update through a review of the literature aspects of the diagnostic and therapeutic care of Elastofibroma dorsi.
Femtosecond laser machining for characterization of local mechanical properties of biomaterials: a case study on wood
Authors: Severin Jakob, Manuel J Pfeifenberger, Anton Hohenwarter, Reinhard Pippan
Journal: Sci Technol Adv Mater (2017)
Keywords: 10 engineering and structural materials, 103 composites, 305 plasma / laser processing, ultrashort pulse laser, beam damage, cell wall rupture, cellular material, femtosecond laser, fibre debonding, micromechanics, sample preparation, spruce, wood

The standard preparation technique for micro-sized samples is focused ion beam milling, most frequently using Ga+ ions. The main drawbacks are the required processing time and the possibility and risks of ion implantation. In contrast, ultrashort pulsed laser ablation can process any type of material with ideally negligible damage to the surrounding volume and provides 4 to 6 orders of magnitude higher ablation rates than the ion beam technique. In this work, a femtosecond laser was used to prepare wood samples from spruce for mechanical testing at the micrometre level. After optimization of the different laser parameters, tensile and compressive specimens were produced from microtomed radial-tangential and longitudinal-tangential sections. Additionally, laser-processed samples were exposed to an electron beam prior to testing to study possible beam damage. The specimens originating from these different preparation conditions were mechanically tested. Advantages and limitations of the femtosecond laser preparation technique and the deformation and fracture behaviour of the samples are discussed. The results prove that femtosecond laser processing is a fast and precise preparation technique, which enables the fabrication of pristine biological samples with dimensions at the microscale.
Prefibrotic Myelofibrosis Presenting with Multiple Cerebral Embolic Infarcts and the Rare MPL W515S Mutation
Authors: Stephen E Langabeer, Lisa Lee Tokar, Laura Kearney, Cathal O'Brien, Kowshika Thavarajah, Aisling Barrett, John McManus, Hilary O'Leary
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Acquired, activating mutations of MPL W515 are recognised driver mutations of the myeloproliferative neoplasms (MPN), namely, essential thrombocythemia and primary myelofibrosis. The most common mutation at this codon is W515L with several other mutations also described at a lower frequency. Of these less common mutations, MPL W515S has only been reported sporadically with limited information on clinicopathological associations. We describe the case of an elderly man with persistent thrombocytosis presenting with an ischemic cerebral event. Bone marrow biopsy showed evidence of prefibrotic myelofibrosis with targeted sequencing demonstrating the presence of the rare MPL W515S mutation. Thrombolytic and cytoreductive therapies resulted in a favorable outcome and follow-up. This case provides additional, necessary, and phenotypic data for the rare MPN-associated MPL W515S mutation.
A Unique Case of Low-Grade Mucinous Neoplasm in Stump Appendectomy
Authors: Mohannad Al-Tarakji, Syed Muhammad Ali, Amjad Ali Shah, Mahir Abdulla Petkar, Salman Mirza, Rajvir Singh, Ahmad Zarour
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Background:
We describe a case of a young male with a history of appendectomy one year ago, who developed symptoms of stump appendicitis, and after removing this stump, histopathology showed low grade neoplasm. Summary. Stump appendicitis is an uncommon complication after appendectomy and may lead to serious complications. Management of low-grade appendiceal mucinous neoplasm (LAMN) is controversial, and we discuss the importance of the case.
Conclusion:
The case of young male post stump appendectomy with histopathology showing LAMN in the stump of the appendix, which to our knowledge, is the first in the medical literature and, discuss the stump appendicitis and incomplete appendectomy concerning malignancy, mucinous neoplasm, and adenocarcinoma.
A Chinese Child Presented with Early T Cell Precursor Lymphoblastic Lymphoma
Authors: Xiangyang Pu, Shengyong Deng, Nange Yin, Lin Song, Xiangling He, Jianwen Xiao
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

T cell lymphoblastic lymphoma (T-LBL) is regarded as the leukemic phase of T cell acute lymphoblastic leukemia (T-ALL). The early T cell precursors ALL/LBL (ETP-LBL/ALL) are derived from thymic cells at the ETP differentiation stage and recognized as a high-risk subgroup of T-ALL/LBL. Most of these cases presented with ALL at the disease onset, but the ETP-LBL phase is uncommon. Here, we report a patient who presented with ETP-LBL at the disease onset. In this case, ALL developed even despite receiving chemotherapy, but the patient achieved a complete remission with intensive chemotherapy.
Impact of Powered Knee-Ankle Prosthesis on Low Back Muscle Mechanics in Transfemoral Amputees: A Case Series
Authors: Chandrasekaran Jayaraman, Shenan Hoppe-Ludwig, Susan Deems-Dluhy, Matt McGuire, Chaithanya Mummidisetty, Rachel Siegal, Aileen Naef, Brian E Lawson, Michael Goldfarb, Keith E Gordon, Arun Jayaraman
Journal: Front Neurosci (2018)
Keywords: amputees, gait, low back pain, microprocessor knee, musculoskeletal injuries, powered knee-ankle prosthesis, variability
MeSH terms: Case Reports

Regular use of prostheses is critical for individuals with lower limb amputations to achieve everyday mobility, maintain physical and physiological health, and achieve a better quality of life. Use of prostheses is influenced by numerous factors, with prosthetic design playing a critical role in facilitating mobility for an amputee. Thus, prostheses design can either promote biomechanically efficient or inefficient gait behavior. In addition to increased energy expenditure, inefficient gait behavior can expose prosthetic user to an increased risk of secondary musculoskeletal injuries and may eventually lead to rejection of the prosthesis. Consequently, researchers have utilized the technological advancements in various fields to improve prosthetic devices and customize them for user specific needs. One evolving technology is powered prosthetic components. Presently, an active area in lower limb prosthetic research is the design of novel controllers and components in order to enable the users of such powered devices to be able to reproduce gait biomechanics that are similar in behavior to a healthy limb. In this case series, we studied the impact of using a powered knee-ankle prostheses (PKA) on two transfemoral amputees who currently use advanced microprocessor controlled knee prostheses (MPK). We utilized outcomes pertaining to kinematics, kinetics, metabolics, and functional activities of daily living to compare the efficacy between the MPK and PKA devices. Our results suggests that the PKA allows the participants to walk with gait kinematics similar to normal gait patterns observed in a healthy limb. Additionally, it was observed that use of the PKA reduced the level of asymmetry in terms of mechanical loading and muscle activation, specifically in the low back spinae regions and lower extremity muscles. Further, the PKA allowed the participants to achieve a greater range of cadence than their predicate MPK, thus allowing them to safely ambulate in variable environments and dynamically control speed changes. Based on the results of this case series, it appears that there is considerable potential for powered prosthetic components to provide safe and efficient gait for individuals with above the knee amputation.
COVID-19 Infection-Related Thyrotoxic Hypokalemic Periodic Paralysis
Authors: Fadlila Fitriani, Vina Yanti Susanti, Mohammad Robikhul Ikhsan
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

SARS-CoV-2 infection induces the dysfunction of many organs including the thyroid gland through the role of ACE2 receptors as well as the consequences of the cytokine storm. Thyroid diseases such as subacute thyroidism, Graves' disease, thyrotoxicosis, and Hashimoto's thyroiditis have been documented in patients with SARS-CoV-2 infection. However, there are limited reports about the consequences of SARS-CoV-2 infection-related thyroid complications. We describe a case of man who was admitted to the emergency department due to repeated lower limb weakness since diagnosed with COVID-19. He had refractory hypokalemia and was treated with potassium replacement therapy for 2 months. However, the complaints continued. The patient has no history of thyroid disease, yet the laboratory result showed hyperthyroidism. Accordingly, he received oral thiamazole. As the laboratory parameters of the thyroid hormones improved, potassium levels returned to normal and the limb weakness stopped. This unusual thyroid complication should be considered in SARS-CoV-2 infection. The prompt diagnosis and appropriate therapy can reduce the burden of the disease.
Secret Sarcoma: A Cardiac Mass Disguised as Influenza
Authors: Christopher DeZorzi, Katherine I Harris
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

This case presentation discusses an extremely rare diagnosis presenting with common symptoms, attributed to influenza, which were not investigated further when clear cardiac symptoms developed. The patient initially presented with symptoms consistent with influenza, but when orthopnea and dyspnea on exertion developed, these cardiac symptoms continued to be attributed to a postviral syndrome and were not further evaluated. Premature closure bias contributed to a delay in diagnosing a rare cardiac condition. The diagnostic momentum, or the continuing of a diagnostic label, occurred across multiple providers and settings. This case demonstrates the risk of premature closure and diagnostic momentum and reminds clinicians to reframe the differential diagnosis as more information on history or physical exam becomes available.
Clinical Features of Painful Ophthalmoplegia with a High-Intensity Ring Appearance around the Optic Nerve on MRI: A Case Series
Authors: Yasunobu Nosaki, Ken Ohyama, Maki Watanabe, Takamasa Yokoi, Katsushige Iwai
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Objective:
Painful ophthalmoplegia includes nonspecific magnetic resonance imaging (MRI) manifestations and various clinical features including orbital pain and cranial nerve palsies. Treatment for painful ophthalmoplegia remains controversial. The aim of this report was to describe detailed clinical features, MRI findings, treatments, and prognosis of patients with painful ophthalmoplegia. Patients and Methods. We retrospectively investigated four cases of patients with painful ophthalmoplegia diagnosed using the International Classification of Headache Disorders, 3rd edition.
Results:
All patients experienced unilateral orbital pain and oculomotor nerve palsy with diplopia but no vision loss. One of the four patients was diagnosed with Tolosa-Hunt syndrome based on the appearance of a granulomatous inflammation of the cavernous sinus on MRI. No specific lesions were detected on brain MRI for the other three patients; therefore, their headaches were attributed to ischaemic ocular motor nerve palsy. In all patients, a high-intensity ring appearance around the ipsilateral optic nerve was observed on MRI. Steroid therapy was administered to these patients, and good prognoses were anticipated.
Conclusion:
These results indicate that prednisolone is a useful treatment for painful ophthalmoplegia that displays ipsilateral hyperintense ring lesions around the optic nerve on MRI, regardless of the presence of granulomatous inflammation of the cavernous sinus.
Ventricular Tachycardia Originating from Moderator Band: New Perspective on Catheter Ablation
Authors: Jin-Yi Li, Jing-Bo Jiang, Yan He, Jian-Chun Luo, Guo-Qiang Zhong
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

A 59-year-old woman was referred to the institution with burdens of idiopathic ventricular tachycardia (IVT). Electroanatomic mapping revealed a complex fractionated, high frequency potential with long duration preceding the QRS onset of the IVT. The real end point of ablation was the disappearance of the conduction block of Purkinje potential during the sinus rhythm besides the disappearance of the inducible tachycardia. Location of distal catheter was at the moderator band (MB) by transthoracic echocardiography (TTE). Only irrigated radiofrequency current was delivered at both insertions of the MB which can completely eliminate the IVT.
A pediatric genetic disorder diagnosed in adulthood
Authors: Joseph A Church
Journal: PLoS Med (2006)
MeSH terms: Genetic Diseases, Inborn / diagnosis, Proteins / genetics, Pseudogenes / genetics, Case Reports, Adult, Diagnosis, Differential, Dietary Fats / metabolism, Female, Genetic Diseases, Inborn / genetics, Heterozygote, Humans, Malabsorption Syndromes / diagnosis, Malabsorption Syndromes / genetics, Malabsorption Syndromes / metabolism, Mutation, Neutropenia / diagnosis, Neutropenia / genetics, Respiratory Tract Infections / diagnosis, Respiratory Tract Infections / genetics, Time Factors, Dietary Fats, Proteins, SBDS protein, human

Church's case report is a reminder that "pediatric" genetic diseases are not limited to children.
Solitary Metastasis in the Mediastinal Lymph Node After Radical Nephrectomy for Clear Cell Renal Cell Carcinoma: A Case Report and Literature Review
Authors: Hang Lin, Heng Zhang, Yuanda Cheng, Chunfang Zhang
Journal: Front Oncol (2020)
Keywords: clear cell renal cell carcinoma, posterior mediastinal lymph node, renal cell carcinoma, solitary metastasis, surgical resection
MeSH terms: Case Reports

Background:
Renal cell carcinoma can metastasize to virtually any anatomical site throughout the body, especially the lung, bone, lymph nodes, liver, and brain. However, it is extremely rare for renal cell carcinoma to metastasize solely to the mediastinal lymph node more than 15 years after radical nephrectomy.
Case presentation:
The case we present here is that of a 50-year-old Chinese male with an isolated posterior mediastinal lymph node metastasis of clear cell renal cell carcinoma 16 years after radical nephrectomy. However, based on imaging examination, the mass was clinically misdiagnosed as Castleman's disease before operation. Following surgical excision of the mass, it was finally judged to be a metastasis from clear cell renal cell carcinoma according to the patient's medical history and immunohistochemical findings. Currently, there is no clinical or radiological finding the recurrence of metastasis after 10 months of follow-up.
Conclusion:
We report a case of solitary metastasis in the posterior mediastinal lymph node 16 years after radical nephrectomy for clear cell renal cell carcinoma. Given the long disease-free interval between primary renal cell carcinoma to isolated mediastinal lymph node metastasis, it is important to conduct a lifelong regular follow-up, including thoracic computed tomography. In addition, surgical resection remains the best method of treatment for mediastinal lymph node metastases from clear cell renal cell carcinoma if the metastatic lesion is limited.
Cutaneous melioidosis and necrotizing fasciitis caused by Burkholderia pseudomallei
Authors: Yi-Shi Wang, Chin-Ho Wong, Asok Kurup
Journal: Emerg Infect Dis (2003)
MeSH terms: Anti-Infective Agents / therapeutic use, Burkholderia pseudomallei / isolation & purification, Fasciitis, Necrotizing / microbiology, Melioidosis / drug therapy, Skin Diseases / drug therapy, Case Reports, Burkholderia pseudomallei / pathogenicity, Fasciitis, Necrotizing / complications, Fasciitis, Necrotizing / drug therapy, Humans, Male, Melioidosis / complications, Melioidosis / physiopathology, Middle Aged, Skin Diseases / complications, Skin Diseases / microbiology, Anti-Infective Agents

In areas where melioidosis is endemic, stress on the healthcare system is substantial. Because clinical manifestations are protean, the illness is difficult to diagnose, and cutaneous Burkholderia pseudomallei infections can progress to necrotizing fasciitis. While it is and uncommon complication of cutaneous melioidosis, necrotizing fasciitis is potentially fatal and requires aggressive management, including early diagnosis, appropriate antibiotics selection and operative débridement.
High-grade soft tissue sarcoma arising in a desmoid tumor: case report and review of the literature
Authors: François Bertucci, Marjorie Faure, Maria-Rosa Ghigna, Bruno Chetaille, Jérôme Guiramand, Laurence Moureau-Zabotto, Anthony Sarran, Delphine Perrot
Journal: Clin Sarcoma Res (2015)
Keywords: breast cancer, desmoid tumor, soft tissue sarcoma
MeSH terms: Case Reports

Desmoid tumors are rare benign monoclonal fibroblastic tumors. Their aggressiveness is local with no potential for metastasis or dedifferentiation. Here we report on a 61-year-old patient who presented a locally advanced breast desmoid tumor diagnosed 20 years after post-operative radiotherapy for breast carcinoma. After 2 years of medical treatment, a high-grade undifferentiated pleomorphic soft tissue sarcoma arose within the desmoid tumor. Despite extensive surgery removing both tumors, the patient showed locoregional relapse by the sarcoma, followed by multimetastatic progression, then death 25 months after the surgery. The arising of a soft tissue sarcoma in a desmoid tumor is an exceptional event since our case is the fourth one reported so far in literature. It reinforces the need for timely and accurate diagnosis when a new mass develops in the region of a preexisting desmoid tumor, and more generally when a desmoid tumor modifies its clinical or radiological aspect.
A Case of Sheehan Syndrome Six Years Postpartum Presented With Adrenal Crisis and Complicated by Hypothyroidism and Massive Pericardial Effusion
Authors: Priya Mishra, Himanshu Jindal, Efa Khan, Sandeep S Palawat
Journal: Cureus (2023)
Keywords: adenohypophyseal hyposecretion, empty sella syndrome, hypopituitarism, pituitary apoplexy, postpartum hypopituitarism, sheehan syndrome
MeSH terms: Case Reports

Sheehan syndrome is often a sequela of massive postpartum hemorrhage in resource-poor healthcare settings where blood loss during delivery is often neglected. The diagnosis of this rare but fatal disease is often delayed because the symptoms are vague and the pituitary dysfunction is insidious in nature. We report the case of a 35-year-old multiparous female with anhedonia and raised serum transaminases. She presented with constitutional symptoms. Her last vaginal delivery, six years back, was the last obstetric event that yielded a stillbirth child. She had had amenorrhea since then. Upon further evaluation, she was found to have a massive pericardial effusion, hypopituitarism, and a partially empty sella. This case report highlights the uncharacteristic symptoms that a patient presents with which ultimately lead to delayed diagnosis. Early diagnosis can go miles in improving the quality of life of the patient besides saving the patient from an adrenal crisis.
Central Sleep Apnea in Patients due to Severe Aortic Stenosis
Authors: Christian Prinz, Thomas Bitter, Olaf Oldenburg, Lothar Faber, Dieter Horstkotte, Cornelia Piper
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

History. We report about the course of central sleep apnea (CSA) in 3 patients (70.3 +/- 15.2 years) with severe aortic stenosis (AS) (AVA </= 1.0 cm(2), NYHA 2.7 +/- 1.4). Investigations. Every patient received echocardiography, left/right-heart catheterization, and cardiorespiratory polygraphy before and 6 months after surgical aortic valve replacement (without right-heart catheterization during follow up). Course. Preoperatively all patients demonstrated reduced systolic left ventricular function (EF <55%). They had elevated pulmoraryarterialy pressures and severe CSA. After valve replacement left ventricular function and exercise capacity improved, as well as the severity of CSA. Conclusion. Patients with severe AS can develop CSA, which seems to improve after surgery. Patients with severe AS should be screened for CSA, because CSA might be an additional risk factor and hint that myocardial adaptation is exhausting.