OpenMed/multicare-articles huggingface dataset:
A Rare Metastatic Site of Invasive Lobular Breast Carcinoma: A Case Report
Authors: Sara Husain, Mohamed Isa, Raed Almarzooq
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Here, we report a case of a 42-year-old female patient with left lobular breast cancer-gastric metastasis (initially misdiagnosed five years ago as an invasive ductal carcinoma) presenting with dyspepsia, weight loss, and persistent vomiting lasting for four weeks. Upper GI endoscopy revealed evidence of linitis plastica, and histological and immunocytochemical analyses of the biopsy confirmed gastric metastasis secondary to invasive lobular breast carcinoma.
Real-World Use of Albutrepenonacog Alfa, A Recombinant Coagulation Factor IX Albumin Fusion Protein, for Personalized Prophylaxis in Japanese Individuals With Hemophilia B: A Case Series
Authors: Azusa Nagao, Masato Bingo, Tomoko Yamaguchi, Katsuyuki Fukutake
Journal: Cureus (2023)
Keywords: albutrepenonacog alfa, factor xi, hemophilia b, personalized usage, prophylaxis, real-world clinical practice
MeSH terms: Case Reports

Currently, the mainstay of disease management for hemophilia B, a hemorrhagic disease caused by a congenital deficiency or molecular abnormalities of blood coagulation factor IX (FIX), is prophylaxis using FIX concentrate. On-demand injections of FIX concentrate may also be required, even during prophylaxis, when a patient with hemophilia B is bleeding. Albutrepenonacog alfa (rFIX-FP) is a human albumin fusion gene recombinant FIX, which is administered once every seven, 14, or 21 days, depending on patient preferences and symptoms. Studies have demonstrated its efficacy and safety in a range of patients; however, to date, reports of real-world experiences of the use of rFIX-FP in Japan are limited. We present a case series of three Japanese individuals with moderately severe (FIX activity 1 to <2%) or severe (FIX activity <1%) hemophilia B who benefited from prophylaxis using rFIX-FP in our clinical practice setting. We highlighted the good effectiveness of rFIX-FP in a patient with moderately severe hemophilia B who required prophylaxis due to joint bleeding, which was causing deterioration of his left ankle joint, as well as in a patient with severe hemophilia B and atherothrombotic cerebral infarction, whose trough level had to be ≥5% for concomitant use of an antiplatelet drug, and in a patient with severe hemophilia B who was working in nursing care, which involved heavy labor and night shifts, and who had previously been treated with on-demand FIX concentrate. In all three cases, rFIX-FP improved disease symptoms, and the patients were able to maintain steady states of therapy due to the treatment characteristics of rFIX-FP, which stabilizes FIX at high trough levels.
Successful Management of Jejunal Perforation in Burkitt's Lymphoma: A Case Report
Authors: David A Finch, Malcolm S Wilson, Sarah T O'Dwyer
Journal: Case Rep Surg (2012)

Burkitt's lymphoma (BL) is rare, rapidly growing, and highly aggressive. Urgent commencement of chemotherapy is vital to prevent complications and promote a favourable prognosis. Any factor causing a delay in the initiation of chemotherapy will affect prognosis significantly. Intestinal perforation is a well-known complication with devastating consequences. It inevitably leads to a delay in the initiation of chemotherapy. There are few reports in the literature that discuss this complication. Furthermore, there are no reports of patients that have survived intestinal perforation occurring prior to the commencement of chemotherapy. We present a case of a 55-year-old male who survived perforation of advanced sporadic BL of the jejunum occurring prior to the commencement of chemotherapy. Critical aspects of the patients care are discussed.
Persistent Left Superior Vena Cava (PLSVC) with a Connection to the Azygos System: Case Report and Clinical Implications
Authors: Alastair E Moody, Catriona E Moody, Bryce D Beutler, Micaela M Koci
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

Persistent left superior vena cava (PLSVC) is a rare anatomic variant that has a significant effect on the structure of the heart and venous system with clinical implications that are far-reaching. The presence of this variant is relevant to central venous catheter insertion, cardioverter-defibrillator placement, coronary artery bypass grafting, and numerous other medical procedures. In this report, we describe a rare case of PLSVC with a connection to the azygos system; notably, the vast majority of PLSVCs connect to the coronary sinus. We also discuss the anatomic and anesthetic considerations for individuals with this uncommon variant.
Ruptured Renal Angiomyolipoma
Authors: Sébastien Azzi, Patrice Jissendi, Fadi Tannouri
Journal: J Belg Soc Radiol (2022)
Keywords: acute abdomen, angiomyolipoma, renal tumour, retroperitoneal haemorrhage
MeSH terms: Case Reports

Teaching Point: This case highlights the importance of extending the medical analysis to other areas with lumbar computed tomography, especially to the kidneys and the retroperitoneum.
Recent advances in managing and understanding pyoderma gangrenosum
Authors: Josh Fletcher, Raed Alhusayen, Afsaneh Alavi
Journal: F1000Res (2019)
Keywords: pyoderma gangrenosum
MeSH terms: Pyoderma Gangrenosum, Review, Cytokines, Humans, Cytokines

Pyoderma Gangrenosum (PG) is a rare neutrophilic dermatosis with multiple different clinical presentations and associated comorbidities. PG has historically been a challenging disorder to diagnose, leading to the development of new diagnostic criteria rather than the traditional approach of a diagnosis of exclusion. The pathophysiology is thought to involve both innate and adaptive immune system dysregulation, neutrophilic abnormalities, environmental, and genetic factors. As of today, no gold standard therapy exists for the treatment of PG, and the literature is restricted to mainly case reports, case series, and 2 small randomized clinical trials. Topical, systemic, and biologic therapy, as well as adequate analgesia and proper wound care all play a role in the management of PG. Recent studies have identified additional cytokines and signalling cascades thought to be involved in the pathogenesis of PG, ultimately leading to the development of new targeted therapies. This review will focus on recent advances in the pathophysiology, clinical presentation and associated comorbidities, diagnosis, and management of PG.
Primary percutaneous coronary intervention for acute myocardial infarction in a young female with idiopathic thrombocytopenic purpura: a case report and review
Authors: Ahmet Yildiz, Ugur Coskun, Ozlem Esen Batukan, Kudret Keskin
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

A 23-year-old female with the diagnosis of idiopathic thrombocytopenic purpura (ITP) was admitted to our hospital with severe chest pain. The electrocardiogram (ECG) revealed acute anterior myocardial infarction. She underwent an immediate cardiac catheterization. An occluded left anterior descending (LAD) was detected by coronary angiography. Reperfusion was performed successfully by angioplasty and stenting with optimal distal flow without any complications. In this report we discussed the management strategies of acute myocardial infarction (AMI) in a patient with ITP.
Breast implant-associated squamous cell carcinoma in a male patient: A case report and review of the medical literature
Authors: Zihuan Xia, Bing Han, Lei Wang, Guansen Ning, Zongke Guo, Jue Zhang, Bing Yu, Ming Chen, Wanxing Zhang, Ke Wang, Xiaojun Ma
Journal: Front Surg (2023)
Keywords: poland's syndrome, breast implant, case report, male breast cancer, squamous cell carcinoma
MeSH terms: Case Reports

Background:
Primary squamous cell carcinoma (SCC) of the breast is a rare tumor type. The diagnosis of this tumor type is more frequently made only after microscopy evaluation. Breast implant-associated SCC is rarer with medical literature review indicating only 18 cases reported in female individuals.
Case presentation:
We reported an unusual case that a man found a 3-cm sized mass on his left breast at first, who had a implant surgery 18 years previously to reconstruct the deformed left breast, as related to the Poland's syndrome. More than 1 year after the mass was detected, the size of the mass gradually increased to 20 cm with swelling and severe pain, and the patient was admitted to our hospital. The patient underwent surgical excision of the tumor, followed by removal of the implant, complete capsulectomy, and sentinel lymph node biopsy. The microscopy evaluation demonstrated the tumor as moderately and poorly differentiated invasive SCC. Follow-up at 12 months after showed multiple metastases, including the skin of the chest, axillary lymph nodes and pleura.
Conclusion:
Breast implant-associated SCC can occur in male patients. Therefore, it should be considered when the clinical manifestation or histopathological appearance is not typical of other breast neoplasms. Malignant transformation of normal epithelial cells takes about 18 years, after which rapid evolution follows leading to fast growth of the tumor.
Transient anisocoria after corneal collagen cross-linking
Authors: George D Kymionis, Michael A Grentzelos, Nela Stojanovic, Theodore A Paraskevopoulos, Efstathios T Detorakis
Journal: Case Rep Ophthalmol Med (2014)

Purpose. To report a case with transient anisocoria after corneal collagen cross-linking (CXL). Methods. Case report. Results. A 24-year-old male underwent corneal collagen cross-linking (CXL) in his right eye for keratoconus. At the end of the procedure, the pupil of the treated eye was irregular and dilated, while the pupil of the fellow eye was round, regular, and reactive (anisocoria). The following day, pupils were round, regular, and reactive in both eyes. Conclusion. Anisocoria may be a transient and innocuous complication after CXL. A possible cause for this complication might be the anesthetic drops used before and during the surgical procedure or/and the ultraviolet A irradiation during the treatment.
Treatment of auricular relapsing polychondritis in a Saudi child using only non-steroidal anti-inflammatory drugs: a case report
Authors: Ashwaq Ahmed AlE'ed
Journal: Pan Afr Med J (2020)
Keywords: nsaid, polychondritis, saudi arabia, auricular, autoimmune disease, case report
MeSH terms: Anti-Inflammatory Agents, Non-Steroidal / administration & dosage, Ear Cartilage / pathology, Polychondritis, Relapsing / drug therapy, Case Reports, Child, Preschool, Humans, Male, Polychondritis, Relapsing / pathology, Saudi Arabia, Treatment Outcome, Anti-Inflammatory Agents, Non-Steroidal

Relapsing polychondritis (RP) is an autoimmune disease that can involve multiple sites within the human body. It is characterized by recurrent bouts of painful cartilage inflammation, and it can cause severe complications if it affects the vital organs. This report describes the case of a five-year-old child with limited auricular RP. The patient's history was obtained from his family, and a physical examination was performed at a pediatric rheumatology clinic. The patient was successfully treated using only a non-steroidal anti-inflammatory drug, and he completely recovered. This treatment and recovery have not been reported in the literature. Therefore, these results are worthy of mention in order to avoid the use of immunosuppressant medications with localized involvement.
Lingual Leiomyomatous Hamartoma in an Adult Male
Authors: Amanda Phoon Nguyen, Norman Firth, Sophie Mougos, Omar Kujan
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

An otherwise healthy 20-year-old male presented with an exophytic, polypoid, yellowish lesion involving the dorsal surface of his tongue, which he reported being present since birth and unchanged. This was removed by surgical excision and diagnosed as a leiomyomatous hamartoma. Histological examination revealed a combination of fibrovascular connective tissue, conspicuous smooth-muscle bundles, adipose tissue, minor salivary gland tissue, blood vessels, lymphoid tissue, peripheral nerves, and normal skeletal muscle. This case is exceptional due to the patient's age, as until now, lingual leiomyomatous hamartomas have been reported almost exclusively in a paediatric population. To our knowledge, this is the eldest age at which a LLH has been reported in the literature. This underscores the need for clinicians to consider this rarely reported entity when considering the radiographic and clinical differential diagnoses for these lesions, both in the paediatric and adult populations. We also present a review of the literature regarding lingual leiomyomatous hamartomas.
A Case of Apparent Upper-Body Freezing in Parkinsonism while Using a Wheelchair
Authors: Samuel T Nemanich, Marie E McNeely, Gammon M Earhart, Scott A Norris, Kevin J Black
Journal: Front Neurol (2017)
Keywords: parkinson’s disease, akinesia, freezing, hypokinesia, upper-limb freezing
MeSH terms: Case Reports

Freezing of gait (FOG) is a common, disabling gait disturbance in Parkinson's disease (PD) and other Parkinsonian syndromes. Freezing also occurs during non-gait movements involving the upper limbs. The mechanisms underlying freezing are complex, likely involving motor, cognitive, and sensory systems that contribute to the episodes. Here, we reported a 60-year-old female with a 24-year history of parkinsonism who experienced significant FOG when ambulatory. Disease progression resulted in her permanent use of a powered wheelchair. While using the power chair, the patient experiences apparent paroxysmal freezing in the hand and arm used to steer and propel the chair. These episodes, some lasting up to several minutes, occur only in circumstances (e.g., entering and leaving an elevator) that are similar to environments known to elicit and exacerbate FOG. Episodes are transient and can be volitionally interrupted by the patient but sometimes require external assistance. Therapeutic intervention for this type of potential freezing has yet to be determined. This case may provide insight into the complex nature of freezing behavior and suggests a need for new approaches to treating non-traditional freezing behavior.
"Mass casualty management (Rana Plaza Tragedy) in secondary military hospital-anesthesiologist experience: case study"
Authors: Hasan Murshed, Rokshana Sultana
Journal: Disaster Mil Med (2015)
Keywords: anaesthesiologist, mass casualty, principal issues

Major challenges in the management of mass casualty have been identified as lack of human resources, lack of material resources, lack of communication and co-ordination. Our hospital has limited resources of manpower and disposable items. The Departments of Anaesthesiology and Intensive Care have been seriously disrupted by the influx of 155 severely injured patients following the collapse of a nine storey building. Such a large, instantaneous influx of injured citizens would overwhelm even the most well resourced health care system. A multidisciplinary team approach was planned to manage the casualties. Senior anaesthesiologists took responsibility for the organisation of different staff members into medical triage team, an immediate care team, an urgent care team, a non-urgent care team and a clerical team. Different teams have accomplished casualty management by addressing four principal issues (the assessment of available resources; ensuring critical but limited care; stocking up on medicine and equipment for the patient surge; and tough rationing of decisions). Assessments of available resources were done by emphasising three #8216;S's - staff (human resources), stuff (material resources) and structure. Additional human resources (anaesthesiologists, orthopaedic surgeons etc.) and material resources (#8216;H' type oxygen cylinders, intravenous fluid etc.) were reinforced from nearby hospitals. Additional influxes of critical patients were supported in the postoperative ward and recovery rooms without any monitoring devices. A surgical dressing room without any basic monitoring device was used as an operating room. To do the greatest good for the greatest number of patients, we restricted ourselves to providing "essential rather than limitless critical care". "Stocking up on medicine and equipment resources" on assessment of the constraints in managing the patient surge, was the next essential step in the management of the casualty load. Patients with life-limiting illnesses were excluded from receiving scarce critical care resources. Thus "Tough rationing of decision" was also an important element. Although the patients that were managed were not large in number, a consideration of the setup with a limited workforce and modern equipment and management experience of a mass casualty addressing the four principal issues in our department, might also help other departments in managing such events.
Combination of dabrafenib and radiotherapy: could skin toxicity be affected by different irradiation techniques?
Authors: Daniela Alterio, Giulia Marvaso, Annamaria Ferrari, Ombretta Alessandro, Emilia Cocorocchio, Pier Francesco Ferrucci, Roberto Orecchia, Barbara Alicja Jereczek-Fossa
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

The prognosis of patients with metastatic melanoma is changing owing to the introduction of selective BRAF inhibitors combined with MEK inhibitors. Management of these patients continues to be a challenge, especially when systemic therapy has to be combined with concomitant radiotherapy, particularly owing to skin toxicity. Here we report a case of a patient who underwent concomitant treatment for two vertebral sites using two different radiotherapy techniques. An unexpected acute skin toxicity was reported at one of the treated sites. This finding might be owing to the different absorbed dose to the subcutaneous tissues linked with the technique of irradiation.
Bordetella petrii clinical isolate
Authors: Norman K Fry, John Duncan, Henry Malnick, Marina Warner, Andrew J Smith, Margaret S Jackson, Ashraf Ayoub
Journal: Emerg Infect Dis (2005)
MeSH terms: Bordetella / classification, Bordetella Infections / microbiology, Osteomyelitis / microbiology, Case Reports, Aged, Amoxicillin-Potassium Clavulanate Combination / therapeutic use, Anti-Bacterial Agents / therapeutic use, Bordetella / drug effects, Bordetella / genetics, Bordetella Infections / drug therapy, Drug Resistance, Multiple, Bacterial, Humans, Male, Osteomyelitis / drug therapy, Anti-Bacterial Agents, Amoxicillin-Potassium Clavulanate Combination

We describe the first clinical isolate of Bordetella petrii from a patient with mandibular osteomyelitis. The only previously documented isolation of B. petrii occurred after the initial culture of a single strain from an environmental source.
Salmonella typhimurium Endocarditis and Myocarditis in a Cat
Authors: Andrea Vercelli, Enrico Lo Cicero, Luca Pazzini
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

An 8-month-old neutered male outdoor cat was brought to our surgical center for a sudden onset of diarrhea, pyrexia, and lethargy. Physical examination revealed a loud left parasternal systolic murmur with no thrill. An echocardiogram showed a large hyperechoic vegetation (about 9 mm thick) on the aortic valve leaflets. The results of Doppler ultrasound examination were compatible with severe aortic stenosis. A singular urine culture test performed by cystocentesis samples enabled the isolation of more than 105 CFU/ml in a pure culture of Salmonella typhimurium. Enlarged mesenteric lymph nodes and moderate dilatation of small bowel loops were found on abdominal ultrasound examination. The patient was treated with marbofloxacin (2 mg/kg IM every 24 hours), cefazoline (20 mg/kg SC every 12 hours), metronidazole (10 mg/Kg IV every 12 hours), clopidogrel (18.75 mg PO every 24 hours), atenolol (0.5 mg/kg OS every 12 hours), and fluid therapy (ringer acetate 2.5 ml/kg/h), but after three days in hospital the patient died from presumed septic shock. A urine culture revealed that Salmonella typhimurium was sensitive to third generation cephalosporins but not to fluoroquinolones. Necropsy, histologic examinations, culture of the aortic valve, and PCR analysis of the aortic valve leaflets were eventually performed and Salmonella typhimurium endocarditis with myocardial phlegmon was confirmed. Endocarditis is a rare disease in cats and poorly described in the veterinary literature. To the best of the authors' knowledge, this is the first report of Salmonella typhimurium endocarditis and myocarditis in a cat.
Pulmonary Disease Secondary to Reflux Mimicking Interstitial Pneumonia in Systemic Sclerosis: Case Report and Literature Review
Authors: Ricardo Azêdo de Luca Montes, Nathalia Mazolli Veiga, Pedro Gemal Lanzieri, Luis Otávio Cardoso Mocarzel
Journal: Case Rep Rheumatol (2016)

Systemic sclerosis is a complex disease due to the variety of clinical presentations, often superimposed on other conditions, related or not to the connective tissue. We report a 43-year-old Brazilian woman with limited systemic sclerosis and pulmonary symptoms secondary to gastroesophageal reflux disease, with a clinical presentation similar to a diffuse interstitial lung disease. Because of the frequency of interstitial lung injury due to systemic sclerosis, this was an important differential diagnosis, which could be excluded after optimized treatment of reflux disease, with clinical and radiological improvement. Clinical management of patients with collagen diseases requires clinician skills to identify the natural history and understand its nuances. This is a common situation in clinical practice, but with a few discussions in international literature.
Contiguous Multilevel Thoracic Ossification of Ligamentum Flavum in a Young Adult Spine
Authors: Tsuyoshi Yamada, Ichiro Torigoe, Kenichiro Sakai, Atsushi Okawa, Yoshiyasu Arai
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

The ossification of the ligamentum flavum (OLF) was characterized by the replacement of the ligamentum flavum by ectopic new bone formation. Although OLF is well known as one of the causes of thoracic myelopathy through the compression of the spinal cord from the posterolateral side, contiguous multilevel OLF is quite a rare cause of myelopathy. Severe ossifications were reported that only present in individuals aged over 25 years. External triggers of OLF might likely be increased as a consequence of biomechanical stress to the effect of posttraumatic ossification. The authors described one rare case of an enormous contiguous multilevel OLF in a 20-year-old female's thoracic spine after mild back trauma, to the extent that it was misdiagnosed as an old epidural hematoma initially. This female with obesity presented with a 6-month history of progressively worsening dorsal cord disorders. Resection or floating of the enormous OLF could be successfully achieved using O-arm-based navigation, and sensory loss, numbness, and gait disturbance were improved after operation.
Primary borderline mucinous tumors of the testis: a case report and literature review
Authors: Satoshi Funada, Toru Yoshida, Masaaki Ito, Fumihiko Kono, Takehiko Segawa
Journal: Case Rep Oncol Med (2015)

Ovarian-type epithelial tumors of the testes and paratestes are very rare. Mucinous subtypes of such tumors are extremely rare; only 25 cases have been reported to date. Ovarian-type epithelial tumors are histologically classified into cystadenomas, borderline tumors, and carcinomas. We herein report a case involving a 60-year-old man with a primary borderline mucinous tumor of the testis. He underwent orchiectomy and has developed no recurrence for 4 years. This is the 26th report of a mucinous tumor of the testis in the literature. We also herein review the literature and discuss the etiology, prognosis, and treatment of mucinous tumors of the testes.