OpenMed/multicare-articles huggingface dataset:
An Atypical Clinical Manifestation of a Hump-Nosed Pit Viper Envenomation
Authors: N D B Ehelepola, C N Karunathilaka, G L H S Liyanage, W A C B Wickramaarachchi, J R P U Samarathunga, Wasantha P Dissanayake
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Envenomations by hump-nosed pit vipers (HNVs) are frequent in Sri Lanka and in South India. Until recently, HNV was considered a moderately venomous snake. Here, we report a case of a previously healthy female developing all the known serious complications, plus some previously unreported complications following a HNV envenomation. She had muscarinic symptoms like profuse sweating and salivation within a couple of minutes and a seizure several minutes after envenomation. Her acute kidney injury (AKI) was swift onset and progressed to end-stage renal failure at three months. She had mild parotid swelling, crepitations in her lungs, and edema of the bitten leg. She had evidence of microangiopathic hemolytic anemia and hemolytic uremic syndrome as well. She developed local tissue necrosis, a non-ST-elevation myocardial infarction (non-STEMI), and anterior ischemic optic neuropathy (AION) following the envenomation. We believe the best explanation for her swift onset complication is intravascular injection of venom. We believe ischemia due to thrombotic microangiopathy has contributed to local tissue necrosis. Those ischemia and kidney failure have contributed to non-STEMI and AION. We illustrate the issue of the sluggish progress made by medicine in understanding the complications of envenomation by using HNV as an example.
Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report
Authors: Boban Gjakov, Darja Kopač, Mateja Vukmanič Pohar, Miha Lučovnik
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been shown in epidemiological studies to be associated with an increased risk of stillbirth. Several histopathologic features of placental SARS-CoV-2 infection have been proposed as potential causes of fetal death. We present a case of an otherwise healthy G3P1 women with mild symptoms of SARS-CoV-2 infection at 23 6/7 weeks of gestation. At 25 2/7 weeks, she presented with signs and symptoms of preterm labor and decreased fetal movements. Fetal death was diagnosed at admission. Placental pathology showed pronounced placental mixed intervillositis. Inflammatory infiltrate caused extreme narrowing of intervillous space leading to placental malfunction and fetal death. Placental tissue SARS-CoV-2 infection was confirmed by positive immunohistochemistry staining of syncytiotrophoblasts with spike protein antibody. The case presented suggests that SARS-CoV-2 associated inflammatory placental changes pose an elevated risk for the fetus.
Endovascular Treatment of Thoracic Aortic Aneurysm Causing Life-Threatening Hemoptysis: Two Case Reports
Authors: Şükrü Oğuz, Süleyman Bekirçavuşoğlu, Zerrin Pulathan
Journal: Case Rep Vasc Med (2018)
MeSH terms: Case Reports

Purpose:
To describe two patients presenting life-threatening hemoptysis with saccular thoracic aortic aneurysm penetrating lung parenchyma and its endovascular treatment.
Case report:
We present two cases of 73- and 74-year-old men with massive hemoptysis secondary to saccular thoracic aortic aneurysm ruptured lung parenchyma who were successfully treated with endovascular approach with 3rd month's imaging follow-up.
Conclusion:
Thoracic aortic aneurysm is one of the rarest causes of hemoptysis and thoracic endovascular aortic repair (TEVAR) and can be used for an effective and problem-solving treatment approach.
Hepatic Epithelioid Hemangioendothelioma Presenting as an Enlarging Vascular Lesion within the Spleen
Authors: Juliet A Emamaullee, Klaudia Nowak, Marla Beach, Julinor Bacani, A M James Shapiro
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm with variable malignant potential that most often presents within the liver. Many patients present with bilobar or extrahepatic disease, and the current treatment paradigm involves liver transplantation, with favorable long term results. Up to 25% of patients are diagnosed incidentally following imaging for other indications, and confirmation of diagnosis requires histologic analysis, as there are no classical imaging features to distinguish hepatic EHE (HEHE) from other solid hepatic lesions. Here we describe a case of microscopic HEHE that was diagnosed following splenectomy for an enlarging vascular tumor within the spleen. Due to the unexpected diagnosis of EHE within the spleen and coexisting but stable appearing liver hemangiomata, a left hepatic lobectomy was performed. Explant histology revealed benign hemangiomata and diffuse, microscopic HEHE. The patient ultimately underwent liver transplantation. HEHE can be a challenging diagnosis, and this case emphasizes that any enlarging vascular lesion, even within the spleen, should prompt a high index of suspicion for HEHE in the setting of known hemangiomata.
Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
Authors: Hilde Fiskvik, Anne F Jacobsen, Nina Iversen, Carola E Henriksson, Eva-Marie Jacobsen
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Pregnancy is associated with an increased risk of venous thromboembolism (VTE). Previous VTE and severe thrombophilia are important risk factors. Our case was a 36-year-old woman, gravida 6, para 0, with antithrombin (AT) deficiency caused by a homozygous mutation in the heparin-binding site (HBS). Her history included seven prior VTEs, three early and two late pregnancy losses. She was prophylactically treated with both human plasma-derived AT concentrate (hpATC) and low molecular weight heparin (LMWH), resulting in a successful 6th pregnancy and a healthy live born baby. There is limited evidence and guidance on the management of AT deficiency in pregnancy. Dosing and monitoring of anticoagulants, alone or together with hpATC, must be based on individual risk assessment. The severity of clinical manifestations varies with the type of AT deficiency. Characterization of the AT mutation may aid in the decision-making process and optimize pregnancy outcomes.
Aneurysm of Upper Limb Arteries in Children: Report of Five Cases
Authors: Ildar Nurmeev, Dmitry Osipov, Bruce Okoye
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Arterial aneurysm in children is rare.
Aim:
To present the description of case series of successful surgical treatment of upper limb aneurysms in children. The case series included 2 boys and 3 girls, with median age 3.3 years. One of them was a newborn with a true brachial artery aneurysm. Aneurysms were in the brachial (n = 3) and radial (n = 2) arteries. Two patients had idiopathic aneurysms. Two cases were associated with connective tissue dysplasia syndrome. One patient had a history of trauma. In 4 of 5 cases, there was a true aneurysm and in one a pseudoaneurysm. Diagnosis was carried out in all cases by using ultrasound, with arteriography in one case. All 5 children were operated on. Resection of the aneurysm and restoration of arterial patency was performed in 4 of 5 cases (ligation of the radial artery near the aneurysm in 1 case, aneurysm resection with end-to-end anastomosis in 1 case, resection with PTFE graft implantation in 1 case, and resection with implantation of an autovenous graft in 2 cases. Complications. Dysfunction and thrombosis of the PTFE graft required reoperation using an autovenous graft.
Conclusion:
Despite the rarity of the disease, timely and adequate surgical treatment of aneurysms of the arteries of the upper extremities in children is possible successfully in a specialized hospital.
Pseudarthrosis of the Calcaneus: Advantages of Regenerative Medicine in the Management of a Rare Entity, A Case Report and Review of Literature
Authors: Bouaziz Wajdi, Mohamed Ali Rebai, Walid Baya, Nabil Krid, Wassim Zribi, Hassib Keskes
Journal: Open Orthop J (2018)
Keywords: bone marrow concentrate, calcaneus, malunion, nonunion, pseudarthrosis, regenerative
MeSH terms: Case Reports

Background:
The follow-up of calcaneal fractures has shown that they are difficult to manage and lead to multiple complications such as malunion and subtalar osteoarthritis. Pseudarthrosis of the calcaneus is an extremely rare complication, which was described in the literature through case reports.In the existing literature, only seven studies, including thirteen patients have reported the nonunion. However, to the best of our knowledge, no study elucidates the role of new techniques of regenerative medicine such as Bone Marrow Concentrates (BMC) or Platelet Rich Plasma (PRP) in the management.
Methods:
We report a case of a patient with a pseudarthrosis after a calcaneal fracture treated with BMC injection in the non-union site, without the need for surgical approach.
Results:
Four months after treatment, the patient was ambulant without support and was completely pain-free. Moreover, after one year the radiological follow up by CT scan showed a satisfactory filling of the non union.
Conclusion:
In one case, we try to highlight the advantage of our therapeutic alternatives, which are having a good union while avoiding the complications of surgical approaches and without sacrificing the subtalar joint when it is possible.
Malignant transformation of hepatocellular adenoma: report of a case
Authors: Mohamed Mouhoub, Achraf Miry, Anass Haloui, Nassira Karich, Imane Kamaoui, Mehdi Soufi, Amal Bennani
Journal: Pan Afr Med J (2020)
Keywords: hepatocellular adenoma, hepatocellular carcinoma, malignant transformation
MeSH terms: Adenoma, Liver Cell / pathology, Carcinoma, Hepatocellular / pathology, Liver Neoplasms / pathology, Case Reports, Adenoma, Liver Cell / diagnosis, Carcinoma, Hepatocellular / diagnosis, Cell Transformation, Neoplastic, Female, Humans, Liver Neoplasms / diagnosis, Middle Aged

Hepatocellular adenomas are benign liver tumours that occur mainly but not exclusively in young women taking contraceptives. Their malignant transformation into hepatocellular carcinoma is a rare complication that has been rarely reported in women taking contraceptives. The purpose of our work is to remind the epidemiological and diagnostic features of malignant transformation of hepatic adenomas by reporting the case of a hepatocellular carcinoma developed from a hepatocellular adenoma diagnosed within the Pathology Department of the Mohammed VI university hospital of Oujda.
Mandibular non-Hodgkin's lymphoma: two observations of a challenging disease
Authors: Yassine Oueslati, Raouaa Belkacem Chebil, Iyadh Abidi, Badreddine Sriha, Habib Khochtali, Lamia Oualha, Nabiha Douki
Journal: Pan Afr Med J (2020)
Keywords: burkitt lymphoma, non-hodgkin’s lymphoma, biopsy, chemo-immunotherapy, diagnosis, diffuse large b-cell lymphoma, mouth
MeSH terms: Burkitt Lymphoma / diagnosis, Lymphoma, Large B-Cell, Diffuse / diagnosis, Mandibular Neoplasms / diagnosis, Case Reports, Adolescent, Aged, Biopsy, Burkitt Lymphoma / pathology, Burkitt Lymphoma / therapy, Female, Humans, Lymphoma, Large B-Cell, Diffuse / pathology, Lymphoma, Large B-Cell, Diffuse / therapy, Male, Mandibular Neoplasms / pathology, Mandibular Neoplasms / therapy

Lymphomas are a heterogeneous group of malignant tumours of the haematopoietic system characterized by an aberrant proliferation of mature lymphoid cells or their precursors and mainly represented by non-Hodgkin´s lymphomas (NHL). The aim of this paper was to report two cases of NHLs with mandibular locations by detailing their different clinical, radiological, and histopathological aspects, as well as the approach followed to diagnose these diseases and to provide patients with the appropriate therapeutic management. The first case is about a 72-year-old female patient who was diagnosed with a large B-cell lymphoma while the second one concerns a 16-year-old male patient who was diagnosed with a Burkitt's lymphoma. These observations represent the two highly aggressive known NHLs according to the WHO classification. The mandibular locations of these diseases are rare and represent only 0.6% of all the reported cases. It is important to note that only a deep and good quality tumour biopsy can provide a diagnosis of certainty. The reference treatment is medical consisting in the introduction of chemo-immunotherapy. As oral surgeons, we have an important role in the early diagnosis of these malignancies and in the patient's referral to specialized care in order to get the appropriate treatment.
Case report: Indolent drug-related pneumonitis with alectinib therapy in the treatment of non-small cell lung cancer
Authors: Xianmeng Chen, Daqing Xia, Xuqin Jiang, Lejie Cao, Jay H Ryu, Xiaowen Hu
Journal: Front Pharmacol (2022)
Keywords: alectinib, anaplastic lymphoma kinase, drug-related pneumonitis, interstitial lung disease, lung cancer
MeSH terms: Case Reports

Molecular targeting therapy is becoming the standard of care for some patients with anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma. Drug-related pneumonitis (DRP) has been identified as an infrequent but potentially severe adverse effect. Herein, we report a 50-year-old woman with ALK-rearranged advanced lung adenocarcinoma who developed interstitial lung disease associated with alectinib therapy. At 102-day of treatment, chest CT revealed scattered ground glass opacities (GGOs) involving both lungs. Since she was asymptomatic and alectinib provided a beneficial tumor treatment response, alectinib therapy was continued. However, 2 months later, she presented with progressive dyspnea and diffuse GGOs on chest computed tomography. There was no evidence for infection or other etiologies for her lung complication. Alectinib was discontinued and steroid therapy was initiated which was followed by improvement in respiratory symptoms and chest CT findings; DRP was diagnosed. Although rare, alectinib therapy can cause DRP of indolent onset.
Off-label magnetic resonance imaging of an InterStim II sacral nerve stimulator device
Authors: Andrew Fry, Nikhil Kotnis, Russel Edward, Peter J Wright
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

The InterStim II (Medtronic, Inc., Minneapolis, MN) sacral nerve stimulator has been approved for MRI scanning of the head only. All other body areas are contraindicated by the manufacturer. This report presents the successful MRI examination of the left hand in a patient with an InterStim II device. Following an assessment of the risks and benefits of proceeding with the scan it was shown that there were minimal additional risks, which could be easily managed with appropriate patient positioning, coil selection and other established techniques. Informed consent was obtained and the scan completed without incident. Following the scan the patient reported full functioning of the device. MRI of the hand is feasible in patients with InterStim II implants using transmit/receive coils with appropriate risk controls in place. Further study of the safety of MRI of other body regions in InterStim II patients is appropriate.
Melanoma Mimicking Malignant Peripheral Nerve Sheath Tumor with Spread to the Cerebellopontine Angle: Utility of Next-Generation Sequencing in Diagnosis
Authors: Katie Fox Hanson, Paul Birinyi, Ronald Walker, Constantine Raptis, Rebecca Chernock, Jeroen Coppens, Katherine E Schwetye
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Cutaneous spindle cell malignancy is associated with a broad differential diagnosis, particularly in the absence of a known primary melanocytic lesion. We present an unusually challenging patient who presented with clinical symptoms involving cranial nerves VII and VIII and a parotid-region mass, which was S100-positive while lacking in melanocytic pigment and markers. Over a year after resection of the parotid mass, both a cutaneous primary lentigo maligna melanoma and a metastatic CP angle melanoma were diagnosed in the same patient, prompting reconsideration of the diagnosis in the original parotid-region mass. Next-generation sequencing of a panel of cancer-associated genes demonstrated 19 identical, clinically significant mutations as well as a high tumor mutation burden in both the parotid-region and CP angle tumors, indicating a metastatic relationship between the two and a melanocytic identity of the parotid-region tumor.
Cannabis-Related Diffuse Alveolar Hemorrhage in a 16-Year-Old Patient: A Case Report
Authors: Laura Bucchino, Alice Monzani, Sara Fracon, Giulia Genoni, Tiziana Cena, Simonetta Bellone
Journal: Front Pediatr (2019)
Keywords: acute respiratory failure, anesthesia, cannabis, diffuse alveolar hemorrhage, pediatrics, sevoflurane
MeSH terms: Case Reports

Diffuse alveolar hemorrhage (DAH) is a clinical condition characterized by the rapid onset of dyspnea, hemoptysis and acute respiratory failure (ARF). It is commonly caused by autoimmune systemic vasculitis, pulmonary infections, drugs and tumors. Here, we report a case of DAH caused by frequent cannabis smoking. A 16-year old boy presented with hemoptysis, dyspnea and ARF soon after laparoscopic surgery for varicocele in general anesthesia. The suspected diagnosis of DAH emerged from the initial chest radiography, and it was then confirmed by CT scan findings and the bronchoalveolar lavage. His general conditions completely recovered after only 24 h of oxygen supplementation and after intravenous corticosteroid and antibiotic therapy. This is the first pediatric case of DAH related to smoking marijuana, even though the inhalational anesthetic agent sevoflurane might have also been involved in this pathogenesis. Other possible causes of DAH have been considered. Negative-pressure pulmonary edema could be ruled out because no clinical evidence of upper airway obstruction was observed during general anesthesia and throughout the surgery. In addition, a possible causative role of cannabis additives/contaminants could not be excluded. Given the high prevalence of cannabis smoking in young people and that DAH can be a complication in cannabis smokers, a careful history and high index of suspicion are recommended as part of the pre-operative assessment before these patients are proceeded to receive general anesthesia.
Idiopathic Orbital Inflammation Treated With Rituximab Monotherapy
Authors: Amani Bawazeer, Wejdan Rahali, Alhanouf Alsharif, Malak Alshehri, Lama Maksood, Ahad Babkier, Walaa Hommadi, Basant Othman, Mohammed A Omair, Waleed A Hafiz
Journal: Cureus (2023)
Keywords: idiopathic orbital inflammation, occular diseases, ophthalmology, rheumatology, rituximab therapy
MeSH terms: Case Reports

Idiopathic orbital inflammation is a benign condition that affects the orbit and the extra-orbital structures. It presents as ocular pain, peri-orbital swelling, proptosis, and restricted ocular movements. This condition is diagnosed based on clinical features that are then confirmed by radiological and histopathological findings. Corticosteroids are the initial therapy of choice. Disease-modifying antirheumatic drugs are added in steroid non-responsive patients. Rituximab is now becoming increasingly used as a third-line therapy for this disease. We report a case of idiopathic orbital inflammation treated with rituximab monotherapy without the use of corticosteroids or disease-modifying antirheumatic drugs.
Large Parotid Gland Lipoblastoma in a Teenager
Authors: Danny Jandali, Ashley Heilingoetter, Ritu Ghai, Jill Jeffe, Samer Al-Khudari
Journal: Front Pediatr (2018)
Keywords: facial nerve, head and neck mass, lipoblastoma, parotid gland, parotid gland tumor
MeSH terms: Case Reports

Background:
Lipoblastomas are rare benign neoplasms that arise from fetal white fat cells. They are typically found in children under the age of 3 and have been reported in the mediastinum, extremities, and infrequently in the head and neck. We present a rare case of a lipoblastoma arising from the parotid gland and the first known report of a parotid lipoblastoma in a teenager.
Case presentation:
A 15-year-old male presented with a painless, slowly enlarging parotid mass and left facial swelling. A fine needle aspiration was non-diagnostic and initial MRI showed a 3.8 cm × 5.0 cm × 4.0 cm fatty lesion involving the superficial and deep lobes of the left parotid gland and masticator space with widening of the stylo-mandibular tunnel and thinning of the adjacent mandibular condyle. The patient was taken to the operating room, and the mass was excised under general anesthesia via a transcervical parotid approach with facial nerve monitoring. The most superficial aspect of the parotid bed was spared and with upper and lower divisions of the facial nerve preserved. The tumor, which primarily involved the deep lobe of the parotid, was entirely excised. Final pathology revealed a 5.2 cm lipoblastoma. The patient did well post-operatively with full function of the facial nerve and 20 months of follow up without evidence of recurrence.
Conclusion:
This is the first reported case of a lipoblastoma of the parotid gland in a teenager. Although a rare tumor, it should be considered in the differential diagnosis of a parotid mass in this population.
Palliative splenic irradiation for symptomatic splenomegaly in non-Hodgkin lymphoma
Authors: Liliana Castro Oliveira, Carlos Fardilha, Manuel Louro, Carlos Pinheiro, Abílio Sousa, Herlander Marques, Paulo Costa
Journal: Ecancermedicalscience (2018)
Keywords: lymphoma, palliative, radiotherapy, splenomegaly
MeSH terms: Case Reports

Introduction and aims:
Splenic marginal zone lymphoma, an uncommon subtype of non-Hodgkin lymphoma (NHL), is usually present with symptomatic splenomegaly. Although splenectomy has long been considered the first-line therapy in symptomatic or cytopenic patients, it can lead to significant morbidity and mortality. Splenic irradiation is an option for patients who have a poor response to systemic therapy and/or are not surgical candidates. In this paper, we present a case report of a patient who received splenic radiotherapy for symptomatic splenomegaly.
Methods:
An 85-year-old Caucasian man with a 4 year history of low-grade NHL presented with progressive pancytopenia, significant weight loss and symptomatic splenomegaly (abdominal discomfort, sense of fullness and limitation of mobility due to spleen size). The patient refused splenectomy and, in December 2017, was referred to palliative splenic radiotherapy. He was initially treated with five fractions of one Grey (Gy) in order to evaluate clinical and haematology response. After that, 1.5 Gy daily, 5 days a week for 3 weeks. 3D conformal radiotherapy, multiple fields and mixed energy (6 and 15 Mv) were used.
Results:
Radiotherapy allowed significant splenic reduction to almost half the size, resolving abdominal discomfort and improving quality of life. There was no decline of haemoglobin, leukocytes and platelet counts; in fact, there was a marginal increase.
Conclusion:
Palliative splenic irradiation was well tolerated confirming that it is a safe treatment option for palliation of symptomatic splenomegaly. Thereby, splenic irradiation should be strongly considered in the management of symptomatic splenomegaly, for selected patients who are refractory to or unsuitable for other options or when the patient refuses other treatments.