OpenMed/multicare-articles huggingface dataset:
Proximal Tibial Epiphysis Fracture in a 13-Year-Old Male Athlete
Authors: Ioannis M Stavrakakis, Pavlos E Katsoulis, Maria S Katsafarou
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-old male athlete with a posteriorly displaced Salter-Harris type II fracture of the proximal epiphysis of the left tibia who was treated conservatively with closed reduction and cast immobilization.
Combined anterior sclera staphylectomy and vitrectomy with anterior sclera staphyloma and vitreous hemorrhage occurring 38 years after cataract surgery
Authors: Qinxiang Zheng, Ronghan Wu, Wensheng Li
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Introduction. To report a case of anterior sclera staphyloma and vitreous hemorrhage occurring over 38 years after bilateral cataract surgery. Methods. A 58-year-old man presented with anterior sclera staphyloma and vitreous hemorrhage in the right eye, after bilateral cataract surgery, over 38 years ago. We performed combined anterior sclera staphylectomy and vitrectomy of right eye for anterior sclera staphyloma and vitreous hemorrhage. Results. Forty-eight months after the combined surgery, best-corrected visual acuity was 0.3 (+10.00/-4.50 × 60) with eutopic stitches of the corneoscleral junction on the superior nasal quadrant and a stable ocular surface. Conclusions. This is the first reported case of anterior sclera staphyloma with vitreous hemorrhage successfully managed by combined surgery.
Metagenomic next-generation sequencing assists in the diagnosis of Cryptococcus pneumonia: Case series and literature review
Authors: Huifen Wang, Su Yan, Ying Liu, Yaoguang Li, Guangying Cui, Xiaoxu Ma
Journal: Front Public Health (2022)
Keywords: cryptococcus neoformans, cryptococcus pneumonia, diagnosis, metagenomic next-generation sequencing (mngs), pathological biopsy
MeSH terms: Cryptococcosis / diagnosis, Cryptococcus, Pneumonia, Review, Case Reports, Research Support, Non-U.S. Gov't, High-Throughput Nucleotide Sequencing / methods, Humans, Metagenomics / methods

Background:
Pulmonary cryptococcosis (PC) was once thought to occur only in patients with immune deficiencies, such as tested positive for the Human Immunodeficiency Virus (HIV). However, in recent years, it has been discovered that more than half of the patients with PC in our nation are individuals with normal immune function. As more and more PC cases are recorded, our diagnosis and treatment approaches, as well as our understanding of PC, are gradually improving. In reality, most PC patients still have a high incidence of misdiagnosis on their initial visit. It is primarily linked to the diverse clinical manifestations, atypical imaging findings, and inaccurate diagnostic approaches.
Methods:
The research was conducted from 2019 to 2020. We performed traditional microbiological testing and mNGS on sample from patients with fever of Pulmonary nodules or lung infections. Furthermore, we collected patients' baseline information, clinical features, laboratory and imaging examination results, diagnosis, treatment and outcome. In the end, we confirmed three cases of PC using biopsy and mNGS.
Conclusion:
Our data demonstrates that mNGS can be utilized as an auxiliary method for PC diagnosis. Early mNGS aids in the identification of pathogens, enabling early diagnosis and treatment, as well as a reduction in the rate of misdiagnosis and illness progression.
A giant quiet esophageal polyp: A case report
Authors: Hossein Sadidi, Ghazale Ahmadi, Ali Mehri, Marzie Nouri Dalouee
Journal: Clin Case Rep (2023)
Keywords: esophagus, fibrovascular, polyp
MeSH terms: Case Reports

Fibrovascular polyps of the esophagus are rare, benign, intraluminal submucosal tumors. In this report, we present a case of esophageal polyp in a young woman and discuss its diagnostic and surgical aspects.
A Rare Localized Pituitary Stalk Germinoma Presenting in the Third Decade
Authors: Alex González Bóssolo, Michelle Mangual Garcia, Kyrmarie Davila, Ricardo Brau, Javier Sanchez Ortiz, Jose Hernan Martinez
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

We report the case of a 34-year-old male Hispanic patient who presented with an 8-month history of polyuria and decreased libido. An evaluation revealed hypopituitarism, central diabetes insipidus, and a pituitary stalk lesion. No evidence of a neoplasm or an inflammatory/infiltrative disease was found. We treated the patient conservatively with steroid therapy. However, as a result of disease progression, transsphenoidal surgery was performed to obtain tissue for a pathological analysis. Histopathology revealed an intrasellar germinoma, confirmed by immunochemistry. Due to localized disease, radiotherapy was initiated and clinical improvement was noted. This case emphasizes the importance of histopathological analysis; for many physicians, the presentation of a pituitary stalk lesion in a young male adult creates a clinical conundrum. Although the most common etiologies are an inflammatory or secondary neoplasm, the possible presence of an intrasellar neoplasm should not be ruled out. In many cases, imaging characteristics and tumor markers may aid in the diagnosis without the need of an aggressive diagnostic approach. However, in this case, histopathological analysis was the only way to make a correct diagnosis and provide adequate treatment for the patient.
TFE3-expressing primary perivascular epithelioid cell tumor of the Lymph node mimicking nodal relapse of rectal cancer: A case report
Authors: Jongmin Park, An Na Seo
Journal: Int J Surg Case Rep (2019)
Keywords: lymph node, perivascular epithelioid cell tumour, rectal cancer, relapse, transcription factor e3

Introduction:
Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm.
Presentation of case:
We treated a 50-year-old woman who underwent neoadjuvant chemoradiotherapy followed by low anterior resection and adjuvant chemotherapy for ystage IIIB rectal adenocarcinoma. The patient was diagnosed with metastatic rectal adenocarcinoma in the right lower lobe of the lung after 14 months of follow-up. Later, after 3 years of follow-up, a mass in the gastrosplenic area was revealed by computed tomography, which was considered indicative of metachronous mass relapse. The patient underwent partial omentectomy, and an enlarged mass measuring 2.2 × 1.3 cm was found. Microscopic findings revealed an alveolar-like collection of epithelioid cells surrounded by a thin-wall vascular channel within a lymph node (LN). These epithelioid cells were positive for HMB45 and TFE3 but negative for Melan-A, CK, and S100. The patient was finally diagnosed with TFE3-expressing primary PEComa of LN.
Discussion:
We report a rare case of TFE3-expressing primary LN PEComa that mimicked nodal recurrence of rectal cancer. Thus, imaging results in patients affected by neoplasm present a clinical diagnostic dilemma, as the presence of newly onset PEComa of LN may lead to the erroneous diagnosis of tumor recurrence or progression.
Conclusion:
Suspicious isolated recurrences of rectal cancer in unusual locations may require surgical excision to confirm definitive diagnosis.
Intraosseous Schwannoma of the Calcaneus: A Rare Tumor of the Bone
Authors: Bahtiyar Haberal, Duygu Turkbey Simsek, Ekin Kaya Simsek
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Schwannomas (also called neurilemmomas) are slow-growing nerve sheath tumors derived from Schwann cells. However, intraosseous schwannoma is a rare entity with an incidence of only 0.2% in overall primary bone tumors. The purpose of this case report is to present a case of an intraosseous schwannoma of the calcaneus. A 35-year-old woman was admitted to our outpatients' clinics with a complaint of long-time right heel pain (for approximately eight months). After a suspicious cystic lesion was observed on the patient's plain radiograph examination, a magnetic resonance imaging (MRI) was performed. The MRI showed a 22 × 20 mm intraosseous cystic lesion at the posterior part of the calcaneus. Extended curettage and iliac bone grafting were performed. In the presence of postoperative histopathologic and immunohistochemical examination, histopathologic diagnosis of the patient was reported as intraosseous schwannoma. After 4 weeks of nonweight-bearing, she completely recovered with no pain. In conclusion, intraosseous schwannoma of the calcaneus must be kept in mind for patients who have chronic heel pain.
Successful use of eculizumab to treat atypical hemolytic uremic syndrome in patients with inflammatory bowel disease
Authors: Ramy M Hanna, Noah Merin, Richard M Burwick, Lama Abdelnour, Umut Selamet, Beshoy Yanny, Patrick Bui, Mary Fouad, Ira Kurtz
Journal: Thromb J (2019)
Keywords: atypical hemolytic uremic syndrome, complement, complement blockade, crohn’s colitis/crohn’s disease, inflammatory bowel disease, thrombotic microangiopathy, ulcerative colitis
MeSH terms: Case Reports

Background:
Atypical hemolytic uremic syndrome is a rare group of disorders that have in common underlying complement amplifying conditions. These conditions can accelerate complement activation that results in a positive feedback cycle. The known triggers for complement activation can be diverse and include, infection, autoimmune disease, and malignancy. Recent reports suggest that certain autoimmune and rheumatological triggers of complement activation may result in atypical hemolytic uremic syndrome that does not resolve despite treating the underlying disorder. Specifically, patients with systemic lupus erythematosus and microangiopathic hemolysis may not respond to treatment of their underlying rheumatological trigger but responded to complement blockade.
Case presentations:
We report two patients with inflammatory bowel disease complicated by development of atypical hemolytic uremic syndrome. In both cases, patients were on treatment for inflammatory bowel disease, that was not well controlled/flaring at the time. The first patient is a male who developed Crohn's disease and microangiopathic hemolysis at age 5 and was treated with eculizumab successfully. Discontinuation of the medication led to multiple relapses, and the patient currently is being treated with eculizumab and has normal hematological and stable renal parameters. The second patient is a 49-year-old female with Ulcerative Colitis treated with 6-Mercaptopurine. She developed acute kidney injury and microangiopathic hemolysis. Prompt diagnosis and treatment with eculizumab resulted in the recovery of kidney injury along with a complete hematological response.
Conclusions:
These two cases are the fifth and sixth patients to be published in the literature with atypical hemolytic uremic syndrome and inflammatory bowel disease treated with complement blockade. This confirms that C5 complement blockade is effective in treating complement mediated thrombotic microangiopathy/atypical hemolytic uremic syndrome when it is triggered in patients with inflammatory bowel disease.
Unilateral maxillary canine agenesis: a case report and literature review
Authors: Nagihan Koç, L Berna Cağırankaya, Nursel Akkaya
Journal: Case Rep Dent (2014)

Congenital absence of maxillary permanent canines is an extremely rare condition, which may appear as part of a syndrome or as a nonsyndromic form. Nonsyndromic canine agenesis combined with other types of tooth agenesis has occasionally been described in the literature but isolated cases are rarely observed. This report presents an isolated case of maxillary permanent canine agenesis in a healthy 18-year-old female patient and a literature review on the prevalence, etiology, and differential diagnosis of the condition.
Bipolar Disorder as Comorbidity with Sjögren's Syndrome: What Can We Do?
Authors: Selima Chebli, Yosra Zgueb, Uta Ouali, Sana Taleb, Fethi Nacef
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Neuropsychiatric manifestations in Sjögren's syndrome are common and can occur not only during its course, but also at the onset of the disease. Depression and anxiety were the most frequently described symptoms. However, the association with bipolar disorder seems to be rare and not well documented. This case report presents a patient with bipolar disorder as comorbidity with Sjögren's syndrome, suggesting that bipolar disorder could be associated with this autoimmune disease, which could lead to delaying diagnosis and treatment. A better analysis of the clinical background should be done by psychiatrists so to help early diagnosis and adapting prescription. Corticosteroids indicated in Sjögren's syndrome should be prescribed with caution in bipolar disorder.
Polyarticular Septic Arthritis Caused by Haemophilus influenzae Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature
Authors: Raheel Ahmed Ali, Sheldon L Kaplan, Scott B Rosenfeld
Journal: Case Rep Orthop (2015)

Background. The standard use of vaccinations against pathogens has resulted in a decreased incidence of musculoskeletal infections caused by these previously common bacterial pathogens. Consequently, the incidence of infections caused by atypical bacteria is rising. This report presents a case of septic arthritis caused by non-type b H. influenzae in a pediatric patient. Methods. We report a case of an infant with polyarticular septic arthritis caused by H. influenzae serotype f. A literature review was conducted with the inclusion criteria of case reports and studies published between 2004 and 2013 addressing musculoskeletal H. influenzae infections. Results. An 8-month-old female presented with pain and swelling in her right ankle and left elbow. The patient was diagnosed with septic arthritis and underwent incision and drainage. Wound and blood cultures were positive for Haemophilus influenzae serotype f. In addition to treatment with IV antibiotics, the patient underwent immunocompetency studies, which were normal. Subsequent follow-up revealed eradication of the infection. Conclusions. Haemophilus influenzae non-type b may cause serious invasive infections such as sepsis or septic arthritis in children with or without predisposing factors such as immunodeficiency or asplenia. Optimal treatment includes surgical management, culture driven IV antibiotics, and an immunologic workup.
Osseous Metaplasia in Castleman's Disease: A Case Report
Authors: Maral Mokhtari, Perikala Vijayananda Kumar
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Background. Castleman's disease is a benign lymphoproliferative disorder. The disease may be localized or multicentric. Three histologic variants are recognized: hyaline vascular, plasma cell, and mixed types. Case. A 20-year-old man presented with large left axillary mass. The histologic examination of the resected mass showed follicular pattern with large nodules of mantle cells arranged concentrically around atrophic and vascularized germinal centers. There was also some benign-appearing bone trabeculae interspersed with lymphoid tissue. The diagnosis of Castleman's disease, hyaline-vascular type with osseous metaplasia, was made.
Disseminated and late metastatic disease from nasal pit leiomyosarcoma after radical surgical resection. Case report of a singular presentation of a rare disease
Authors: Enrico Pinotti, Marta Sandini, Simone Famularo, Marta Jaconi, Fabrizio Romano, Luca Nespoli, Luca Gianotti
Journal: Clin Sarcoma Res (2017)
Keywords: follow up, leiomyosarcoma, metastasis, nasal pit, pancreas
MeSH terms: Case Reports

Background:
Leiomyosarcoma of the head and neck is a rare cancer with high local aggressiveness. Radical surgery and adjuvant treatment offer the best chance for cure, nonetheless 5-years recurrence rate remains high. Despite international guidelines are available for soft tissue sarcomas, no recommendations are specifically endorsed for leiomyosarcoma of the head and neck, due to the rarity of its presentation and consequently scarcity of data on long-term outcome.
Case presentation:
A 50-year old woman, operated 10 years before for leiomyosarcoma of the nasal pit and with negative 5-years follow-up, was admitted to our ward for impairment of the hepatic function. Total-body CT scan detected multiple localizations at lungs, kidneys, pancreas, bones, muscles, lymph nodes and thyroid. The pathologic report after lung biopsy confirmed the diagnosis of metastasis from leiomyosarcoma and the patients was scheduled for first line chemo-radiotherapy.
Conclusions:
Despite adequate primary treatment, distant and disseminated metastatic disease may be not excluded in leiomyosarcoma of the head and neck.
Gastric emphysema a spectrum of pneumatosis intestinalis: a case report and literature review
Authors: Guillermo López-Medina, Roxana Castillo Díaz de León, Alberto Carlos Heredia-Salazar, Daniel Ramón Hernández-Salcedo
Journal: Case Rep Gastrointest Med (2014)

The finding of gas within the gastric wall is not a disease by itself, rather than a sign of an underlying condition which could be systemic or gastric. We present the case of a woman identified with gastric emphysema secondary to the administration of high doses of steroids, with the purpose of differentiating emphysematous gastritis versus gastric emphysema due to the divergent prognostic implications. Gastric emphysema entails a more benign course, opposed to emphysematous gastritis which often presents as an acute abdomen and carries a worse prognosis. Owing to the lack of established diagnostic criteria, computed tomography is the assessment method of choice. Currently no guidelines are available for the management of this entity, since the evidence is limited to a few case series and a considerable number of single case reports.
Early Onset Immune-Related Adverse Event to Identify Pseudo-Progression in a Patient With Ovarian Cancer Treated With Nivolumab: A Case Report and Review of the Literature
Authors: Hui Li, Xin Zhou, Ding Zhang, Guoqiang Wang, Xiaochun Cheng, Caihong Xu, Bin Yao, Linrong Pang, Jun Chen
Journal: Front Med (Lausanne) (2020)
Keywords: biomarker, immunotherapy, nivolumab, ovarian cancer, pseudo-progression
MeSH terms: Case Reports

Background: Immune checkpoint inhibitors (ICIs) have shown clinical benefit in many advanced tumors, however, pseudo-progression is a noted phenomenon of ICIs characterized by radiologic enlargement of the tumor burden, followed by regression. How to differentiate pseudo-progression from progression remains a critical clinical issue. Recent studies have demonstrated the association between immune-related adverse events (irAEs) and efficacy of ICIs. Here we demonstrated an ovarian cancer patient treated with nivolumab in whom the early-onset irAE was identified to differentiate pseudo-progression from progression. Case presentation: Here we present the case of a 47-years-old woman with histopathologically confirmed diagnosis of metastatic ovarian cystadenocarcinoma. Immunohistochemical examination showed 10% of tumor cells to express the programmed cell death receptor ligand 1 (PD-L1) and a 381-gene panel sequencing in a College of American Pathologists (CAP) certificated lab revealed a moderate mutational tumor burden with 5.7 Mutants/Mb. The patient received nivolumab 100 mg every 2 weeks as a fourth line treatment. Within the first 2 months, the tumor volume increased by 23.6%. However, the patient experienced an elevation of Alanine aminotransferase (ALT) and Aspartate aminotransmerase (AST), which was diagnosed as the immune-related hepatitis. Thus, the treatment continued and afterwards, the patient reached a partial response (PR) to nivolumab and the progression-free survival was 9 months. Conclusion: To our knowledge, this is the first case describing early-onset immune-related adverse events to identify pseudo-progression in a patient with ovarian cancer treated with nivolumab, and PD-L1 expression level may be a predictive biomarker in the immunotherapy of ovarian cancer.
An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report
Authors: Won Ro Park, Jae Hoon Jang
Journal: Int J Surg Case Rep (2019)
Keywords: locking plate, locking screw removal, stripped locking screw

Introduction:
Removal of stripped or jammed locking screws involves several difficulties. Especially when two or more screws are involved, their removal is a more challenging and time-consuming process because the various reported techniques have certain limitations.
Case presentation:
Herein, we report a case in which five stripped screws were removed using a novel technique.
Discussion:
Many techniques to remove damaged locking head screw were introduced, however in case with multiple screws were involved, they are limited to use. In the case, screw extractor, although it is not a medical device, is helpful in terms of time and cost.
Conclusion:
In case with the failure of removal of multiple locking screws, our technique using non-medical screw extractor can be a good option.
Case Report: Multimodal Imaging of Toxic Retinopathies Related to Human Immunodeficiency Virus Antiretroviral Therapies: Maculopathy vs. Peripheral Retinopathy. Report of Two Cases and Review of the Literature
Authors: Arthur Hammer, François-Xavier Borruat
Journal: Front Neurol (2021)
Keywords: hiv, case report, didanosine, retinopathy, ritonavir
MeSH terms: Case Reports

Purpose: We report two patients with toxic retinopathy from either ritonavir or didanosine and reviewed the literature on the topics. We provide an overview of the retinal toxicity of these two antiretroviral drugs in human immunodeficiency virus-positive patients. Methods: First, we performed a retrospective study of the medical charts of two patients examined by us, one with ritonavir maculopathy and one with didanosine peripheral retinopathy. Secondly, we searched the world literature for similar cases through PubMed and Google Scholar, using the terms "HIV," "AIDS," "ritonavir," "didanosine," "maculopathy," "retinopathy," "visual loss," and "toxicity" to retrieve the appropriate literature on the subject. Results: Patient 1: A 49-year-old woman complained of progressive central visual loss over the past 12 months. History disclosed ongoing ritonavir therapy for the past 11 years. Ritonavir maculopathy was diagnosed, and visual loss increased relentlessly despite cessation of treatment. Patient 2: A 55-year-old man complained of slowly progressive peripheral visual field constriction for the past 5 years. History disclosed didanosine therapy for 13 years, however, stopped 4 years before the onset of visual symptoms. No alteration of therapy was offered to patient 2 as didanosine therapy was interrupted 9 years previously. Since 2011, 11 cases of ritonavir maculopathy have been reported in the literature. Relentless worsening of vision was reported in 3/7 patients despite cessation of ritonavir therapy. Didonasine peripheral retinopathy was first described in 1992, and a total of 24 patients have been reported since. Relentlessly progressive peripheral retinopathy was diagnosed despite the previous cessation of therapy in 14 patients. Conclusion: Ritonavir causes a slowly progressive atrophic maculopathy, and didanosine toxicity results in a relentlessly progressing peripheral atrophic retinopathy. The relentless progression of both toxic retinopathies reflects permanent alterations of the retinal metabolism by these medications. Both ritonavir and didanosine toxic retinopathies are rare events, but their clinical presentation is highly specific.