OpenMed/multicare-articles huggingface dataset:
Histological and radiological analyses of a maxillary sinus lift with extensive drilling of the schneider membrane using xenogeneic bone
Authors: Marcelo M Romano, Júlia A Smanio, Lorraine B Ferreira, Victor E Arana-Chavez, Mário S Soares
Journal: Case Rep Dent (2014)

The objective of this study is to report a clinical case of maxillary sinus with lyophilized, xenogeneic graft, in which, despite a large perforation of the sinus membrane, the surgery was not aborted and the results of histological examinations indicate bone neoformation in the surgical area. Results. This case showed that the biomaterials evaluated in this study and the procedure used to place them proved to be biocompatible and presented high osteogenic potential, leading to a successful surgery and osseointegration implant. Conclusion. Positioning Schneider's membrane and filling it with the graft biomaterial helped to achieve the desired osteoconduction and proliferation of bone cells even though the patient had a large perforation of the sinus membrane.
Antiphospholipid Syndrome: Multiple Manifestations in a Single Patient-A High Suspicion Is Still Needed
Authors: Uroosa Ibrahim, Shiksha Kedia, Gwenalyn Garcia, Jean Paul Atallah
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Antiphospholipid Syndrome (APS) is an autoimmune disorder with clinical and laboratory features of vascular thrombosis, pregnancy loss, and persistent antiphospholipid antibodies (aPLs). The pathophysiology is thought to involve the activation of endothelial cells, monocytes, platelets, and complement by aPLs. Disease can range from asymptomatic to rapidly fatal catastrophic APS. We present a case of a 34-year-old male referred for pancytopenia and splenomegaly. On examination, he had decreased sensation and 4/5 power in the left upper extremity. A lacy, purplish rash was noted on the trunk and upper extremity. MRI of brain showed acute/subacute lacunar infarctions. Laboratory studies revealed an elevated lactate dehydrogenase level, bilirubin and ferritin, decreased haptoglobin, and positive Coombs test. Antinuclear antibody test was negative and antiphospholipid antibody panel revealed positivity for anti-cardiolipin IgG and IgM, antiphosphatidylserine IgG, and anti-β2-glycoprotein IgG. The patient was diagnosed with primary APS. Pancytopenia is relatively rare in primary APS and is more often seen in secondary APS. Our patient demonstrated involvement of multiple organ systems as well as livedo reticularis and autoimmune-related findings such as Raynaud phenomenon and Coombs positive hemolytic anemia. We discuss the various clinical and laboratory findings in patients with APS that aid in diagnosis, as well as important management considerations.
Actinomycotic Osteomyelitis of Maxilla Presenting as Oroantral Fistula: A Rare Case Report
Authors: Ashalata Gannepalli, Bhargavi Krishna Ayinampudi, Pacha Venkat Baghirath, G Venkateshwara Reddy
Journal: Case Rep Dent (2015)

Actinomycosis is a chronic granulomatous infection caused by Actinomyces species which may involve only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is relatively rare when compared to mandible. These are normal commensals and become pathogens when they gain entry into tissue layers and bone where they establish and maintain an anaerobic environment with extensive sclerosis and fibrosis. This infection spreads contiguously, frequently ignoring tissue planes and surrounding tissues or organ. The portal of entry may be pulpal, periodontal infection, and so forth which may lead to involvement of adjacent structures as pharynx, larynx, tonsils, and paranasal sinuses and has the propensity to damage extensively. Diagnosis is often delayed and is usually based on histopathology as they are cultured in fewer cases. The chronic clinical course without regional lymphadenopathy may be essential in diagnosis. The management of actinomycotic osteomyelitis is surgical debridement of necrotic tissue combined with antibiotics for 3-6 months. The primary actinomycosis arising within the maxilla with contiguous involvement of paranasal sinus with formation of oroantral fistula is rare. Hence, we present a 50-year-old female patient with chronic sclerosing osteomyelitis of maxilla which presented as oroantral fistula with suppurative and sclerotic features.
Anuria Secondary to Bilateral Obstructing Ureteral Stones in the Absence of Renal Colic
Authors: Carolyn A Salter, Christopher Lang, Hernan O Altamar
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Background:
Obstructing ureteral stones are a rare cause of anuria, which is typically from prerenal or renal etiologies. Classically, obstructive stones cause moderate to severe renal colic. Urolithiasis is rarely considered during evaluation of painless anuria.
Case presentation:
We present an unusual case of a 73-year-old Caucasian female who presented with anuria and was found to have large bilateral obstructing ureteral stones in the absence of renal colic.
Conclusion:
Given that patients with obstructive anuria can be asymptomatic, urolithiasis should be considered in all patients presenting with anuria.
Severe Esophageal Stricture Post Accidental Corrosive Substance Ingestion: A Case Report of Balloon Endoscopic Dilation
Authors: Leen Jamel Doya, Maria Naamah, Hanin Ahmed Mansour, Ali Ibrahim, Ammar Omran
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Corrosive substance ingestion is a very serious home accident, mostly common in developing countries. It frequently causes esophageal burns in the acute stage and esophageal stricture, stenosis, and even cancer in the chronic stage. Severe cases of caustic esophagitis may require esophageal replacement. We describe a case of balloon endoscopy dilation in a two-year-old girl with a severe stricture of the esophagus resulting from accidental ingestion of a corrosive substance (strong alkaline liquid) which helped the patient preserve the esophagus and prevent esophageal replacement. We describe the clinical complication and development during the treatment.
Multiple myeloma with concurrent immune thrombocytopenic purpura
Authors: Humaira Sarfraz, Kartik Anand, Shujuan Liu, Shilpan Shah
Journal: Ecancermedicalscience (2020)
Keywords: itp, auto immune disorder, immunoglobulin, multiple myeloma, thrombocytopenia
MeSH terms: Case Reports

Multiple myeloma (MM) is the second most common haematological malignancy in the USA. MM has been linked to various autoimmune disorders in many studies; one systemic review even suggested an increased risk of MM among patients with autoimmune disorders. MM is associated with many haematological, rheumatologic and neurological conditions. A few case reports suggest that MM can be associated with immune thrombocytopenic purpura (ITP), although this is rare. We present a case of MM with concurrent ITP which was refractory of steroids and intravenous immunoglobulin but had a response with anti-neoplastic therapy for MM. We also review all the cases of ITP with MM described in the literature. If conventional treatment for ITP associated with MM fails to improve platelet count, anti-neoplastic therapy for MM should be considered.
A case of Sjögren's syndrome with worsening of pleural effusion due to steroid discontinuation
Authors: Osamu Usami
Journal: Respir Med Case Rep (2021)
Keywords: anti-ss-a antibody, pleural effusion, sjögren's syndrome, steroids
MeSH terms: Case Reports

The etiology of Sjögren's syndrome (SS) remains unclear and is associated with many other autoimmune diseases. In particular, symptoms of SS are not apparent when steroids are already being administered for other autoimmune diseases. This report documents a case of autoimmune hepatitis with SS, which was diagnosed on the basis of the worsening of unilateral pleural effusion after the discontinuation of steroids as well as the manifestation of symptoms, such as dry mouth. Adrenal insufficiency due to the discontinuation of steroids was assumed to be the cause of the worsening, rather than infection stress, because no indicators of infectious diseases were observed. The diagnosis of SS was confirmed via lip biopsy examination and anti-SS antibody positivity. Re-administration of steroids rather than antibiotics drastically reduced the pleural effusion and improved the dry mouth symptom. SS with pleural effusion in a case of autoimmune disease was reported to show both unilateral and bilateral pleural effusion predominantly containing lymphocytes. SS with pleural effusion may be more common than expected and should be differentiated from traditional SS. Moreover, biopsy examination should be considered if necessary because the condition might remain latent when steroids are administered.
Complete ileal transection: A rare complication of adhesive bowel disease-A case report
Authors: Qurrat Al Ain Atif
Journal: Int J Surg Case Rep (2019)
Keywords: acute small bowel obstruction, adhesive bowel disease, ileal transection, postoperative adhesions

Introduction:
Adhesive bowel disease is a sequel of abdominal surgeries and has come forth as the leading cause of small bowel obstruction (SBO). It may also lead to chronic abdomino-pelvic pain and infertility in women. Adhesions form as a result of peritoneal irritation, giving rise to an inflammatory process. The treatment of choice for adhesive small bowel obstruction remains controversial, and relies on the surgeon's judgment.
Case presentation:
Being described is an unusual case of a young girl who developed complete ileal transection secondary to postoperative adhesive band formation.
Conclusions:
Adhesive small bowel disease (ASBD) and small bowel obstruction are a major cause of patient distress and financial and clinical practice burden. It is usually a diagnosis of exclusion and leads to delayed treatment and morbidity. Many preventive techniques and materials are being tested to prevent adhesion formation. A lot more needs to be done to prevent, in the first place, the formation of adhesions or treat this condition to reduce such morbid outcomes as strangulation or transection of gut.
Case report: Wallerian degeneration: The innate-immune response to adult-onset Still's disease peripheral nerve injury
Authors: Hao Cheng, He Lv, Yan Wang, Gui-Qiang Wang
Journal: Front Neurol (2022)
Keywords: wallerian degeneration, adult-onset still's disease, delayed aggravation, innate-immune response, sensory ganglionopathy, sensory neuropathy
MeSH terms: Case Reports

Peripheral nerve injury is one of the rare complications of adult-onset Still's disease (AOSD). We report a 20-year-old woman diagnosed with AOSD combined with severe sensory neuropathy. She presented with a sore throat, joint pain, rash, and lymphadenopathy. After receiving glucocorticoid therapy, her fever, rash, and inflammatory markers improved. Unexpectedly, 3 weeks after the onset, she experienced sudden paresthesia in her extremities, decreased muscle strength, and diminished tendon reflexes. The electrophysiological examination and peripheral nerve biopsy confirmed immune-mediated severe sensory neuropathy. For the first time, we report typical Wallerian degeneration in AOSD patients with sensory neuropathy by nerve biopsy. Compared with other common symptoms, the delayed aggravation of neurological symptoms may be an important characteristic of sensory neuropathy secondary to AOSD. We emphasize that intensive attention to neurological symptoms after general symptoms control, administration of adequate and appropriate prolonged immunosuppressive therapy, and long-term follow-up are essential for these patients.
Severe Recurrent Fever Episodes With Clinical Diagnosis of Hemophagocytic Lymphohistiocytosis, Incomplete Kawasaki Disease and Systemic-Onset Juvenile Idiopathic Arthritis: A Case Report and Literature Review
Authors: Hongkun Jiang, Zhiliang Yang
Journal: Front Pediatr (2020)
Keywords: pfapa, hemophagocytic lymphohistiocytosis, incomplete kawasaki disease, recurrent fever, systemic-onset juvenile idiopathic arthritis
MeSH terms: Case Reports

The pathogeneses of recurrent fever are quite complicated when excluding repeated infections. Recurrent fever is a common symptom for autoinflammatory diseases, relapse of Systemic-onset juvenile idiopathic arthritis (SoJIA) and recurrent Kawasaki disease (KD). There are no specific diagnostic laboratory tests for the diseases. Some studies showed that KD was the precursor of hemophagocytic lymphohistiocytosis (HLH). Macrophage activation syndrome (MAS) is another form of HLH in SoJIA. Cytokine disturbances are considered to be involved in the pathogenesis of the diseases. We describe a Chinese female toddler that developed three separate fever episodes with eventual diagnose of SoJIA within about 10 months. The first episode was diagnosed as IKD, immunoglobulin nonresponsive KD, and HLH. The second and third episodes were diagnosed as IKD and SoJIA, respectively. The fever was hard to be relieved by antipyretics, and the peak axillary temperature was above 40°C. For every fever episode, infections were excluded. For the first episode, trends over time of hemoglobin, platelets, fibrinogen, and triglycerides indicated HLH, which was finally diagnosed and treated according to the HLH-2004 protocol. For the second episode 6 months later, after excluding an HLH relapse and infections, IKD was finally diagnosed. Oral aspirin was administered, and the HLH treatment was ceased. The third episode occurred 3 months later, and SoJIA was finally diagnosed. For each episode, except for relative tests, we only tested for cytokines interleukin-1β, interleukin-6, and interferon-γ, due to limited laboratory test availability. These cytokines were elevated during remission and rose much higher in the fever phases. The case showed the difficulty to differentiating the recurrent fever in clinical practice. Surveillance of routine laboratory parameters over time might reveal a trend that indicates possible disease, even when parameter values do not meet diagnostic criteria. Changes in cytokine profiles are promising markers for differentiating recurrent fever diseases in future. An unknown immunological defect for the case may contribute to the recurrent immunological insults, and we are following up the recurrence of fever episode.
Giant leiomyoma of the retzius space: a case report
Authors: Franco Pepe, Pietro Pepe, Filippo Rapisarda, Marta Fauzia, Maria Giunta
Journal: Case Rep Obstet Gynecol (2013)

Extrauterine leiomyoma is a very rare clinical condition; we report a case of leiomyoma of the Retzius space in a 49-year-old women who suffered for two years from bladder voiding symptoms characterized by dysuria, feeling of incomplete emptying, and pelvic pain. Clinical evaluation and abdominal and transvaginal ultrasound suggested the presence of a voluminous (about 10 cm in diameter) fibromyoma of the anterior uterus surface. The urodynamic evaluation demonstrated the presence of bladder outlet obstruction (voiding pressure greater than 20 cm H2O and maximum flow rate less than 12 mL/s) with a postvoiding urine residual equal to 80 mL; moreover, the presence of cystocele and urethral stricture was ruled out performing clinical evaluation, cystography, and cystourethroscopy. The patient underwent laparotomy to remove the uterine fibromyoma. Intraoperatively, a voluminous soft mass arising from the Retzius space was found; it was firmly adhered to the uterus with obliteration of vesicouterine pouch owing to severe adhesion to the anterior surface of uterus. The tumour was isolated, enucleated from the prevesical space, and removed; moreover, the patient became asymptomatic after surgery. In conclusion, leiomyoma of the Retzius space is a very rare benign tumour that should be considered in the presence of severe bladder voiding symptoms.
Tibia Adamantinoma Resection and Reconstruction with a Custom-Made Total Tibia Endoprosthesis: A Case Report with 8-Year Follow-Up
Authors: Gilber Kask, Toni-Karri Pakarinen, Jyrki Parkkinen, Hannu Kuokkanen, Jyrki Nieminen, Minna K Laitinen
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

This case study describes a total tibia resection and reconstruction with a custom-made endoprosthetic replacement (EPR) and a long-term, 8-year follow-up. The patient underwent a total tibia adamantinoma resection in 2009. Reconstruction was performed with a custom-made total tibia EPR, where both the knee joint and ankle joint were reconstructed. Two muscle flaps, latissimus dorsi free flap and a pedicled medial gastrocnemius flap, were used for soft tissue reconstruction. The patient returned to normal life as a kindergarten teacher, without complications for eight years. This case demonstrated the importance of successful multidisciplinary teamwork in close collaboration with industry. In our best knowledge, no over 2 years of follow-up of total tibia replacement reports have been published.
An Unusual Case of Deep Vein Thrombosis and Concurrent Necrotizing Fasciitis Following a Fall
Authors: Muhammad U Rohail, Ayub Khan, Jane Maloof
Journal: Cureus (2023)
Keywords: cellulitis, deep vein thrombosis (dvt), dvt diagnosis, fall injury, methicillin-sensitive staphylococcus aureus, necrotizing fasciitis (nf), necrotizing soft tissue infection, nf
MeSH terms: Case Reports

A 74-year-old male patient presented to the emergency department following a fall with signs and symptoms consistent with right lower extremity (RLE) deep vein thrombosis (DVT) and non-specific skin changes. Further imaging confirmed the initial diagnosis of DVT, and the patient was appropriately treated. However, his condition continued to deteriorate with worsening overlying skin changes, which prompted a computed tomography (CT) scan of his right femur without intravenous (IV) contrast. This revealed fluid tracking along the lateral compartment muscles, which raised suspicion of an abscess. Suspicion for necrotizing fasciitis (NF) was raised with a subsequent CT of the right femur with IV contrast that demonstrated a considerable increase in rim-enhancing fluid collections intramuscularly and extending into both the anterior and posterior compartments, likely correlating with increasing intermuscular abscesses. On imaging, no subcutaneous emphysema or gas accumulation was found, which is a common finding in NF. However, necrotic-appearing muscle was found on surgical debridement and wound cultures confirmed the diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) NF. The patient was then treated with appropriate IV antibiotics and was discharged to long-term inpatient wound care. Similar presentations of DVT and NF made a prompt diagnosis of NF difficult, and it highlights the need for further imaging to rule out NF when a patient has a confirmed diagnosis of DVT.
Surgical repair of a pseudocoarctation with cervical aortic arch complicated by multiple aneurysms of the aorta: a case report
Authors: Said Makani, Julia Mitchell, Olivier Metton, Sylvie Di Filippo, Roland Henaine, Jean Ninet
Journal: Pan Afr Med J (2017)
Keywords: pseudocoarctation, aneurysm, arch surgery, cervical aortic arch
MeSH terms: Aorta, Thoracic / surgery, Aortic Aneurysm, Thoracic / surgery, Aortic Coarctation / surgery, Case Reports, Aorta, Thoracic / pathology, Aortic Aneurysm, Thoracic / pathology, Aortic Coarctation / pathology, Child, Humans, Male, Sternotomy / methods, Subclavian Artery, Treatment Outcome

Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and deformity of the aortic arch and is known to be associated with aneurysmal formation. Several studies unite to say it leads to a surgical sanction as soon as symptomatic or associated with aneurysms of the aortic arch. Our patient is a 12 years old boy, followed since birth for a little tight pseudocoarctation with a cervical aortic arch and transverse aortic arch hypoplasia. Close clinical and paraclinical monitoring including angioscans, showed the gradual enlargement of the superior mediastinum, in relation with the appearance of three aneurysms of the aortic arch. The intervention, performed by sternotomy, has consisted of the resection of the aneurysmal area and the interposition of a Dacron tube to repair the aortic arch and the reimplantation of the left subclavian artery into the left carotid artery. The postoperative course was uneventful. Management of pseudocoarctation associated with cervical aortic arch and aneurysms remains surgical. Close monitoring of patients with pseudocorctation, seems to be essential to avoid fatal complications such as aneurysmal rupture.
Laryngeal schwannoma: case report and literature review
Authors: Y Ramakrishnan, W J Issing
Journal: ISRN Otolaryngol (2011)
MeSH terms: Case Reports

Neurogenic tumours of the larynx, particularly schwannomas are rare. We report a case report of a schwannoma in a 30-year-old woman which was excised endoscopically. The aim of this paper is to highlight this rare condition and management options to the otolaryngological community.
Sciatic nerve schwannoma complicated by nerve bundle membrane effusion: Two case reports and a literature review
Authors: Lian He, Yan-Ji Zhang, Shi-Li He, Jia-Ren Zhang, Jun Wu, Gao-Feng Zhang, Da-Li Wang
Journal: Front Oncol (2022)
Keywords: mri, case report, nerve bundle membranes effusion, schwannoma, sciatic nerve
MeSH terms: Case Reports

Schwannoma is a benign tumor that originates from Schwann cells in the peripheral nerve tunica or bundle of nerves and grows along the longitudinal axis of the nerve. Schwannoma can occur in multiple anatomic locations but rarely in the sciatic nerve. To our knowledge, there are no previous reports in the literature related to schwannoma combined with effusion of the nerve bundle membranes. Here, we report two cases of sciatic nerve schwannoma combined with nerve bundle membrane effusion, and the relationship between them is uncertain. We have boldly speculated about this uncertain relationship by combining the two patients' imaging manifestations to help determine the mechanism of schwannoma or effusion generation as well as a clinical treatment.
Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site
Authors: Amen Dhaoui, Haifa Nfoussi, Nidhameddine Kchir, Slim Haouet
Journal: Pan Afr Med J (2012)
Keywords: ectopic breast tissue, fibroadenoma, lactating adenoma, pathology, vulva
MeSH terms: Adenoma / pathology, Breast Neoplasms / pathology, Choristoma / pathology, Fibroadenoma / pathology, Lactation, Vulvar Neoplasms / pathology, Case Reports, Adult, Female, Humans, Puerperal Disorders / diagnosis, Puerperal Disorders / etiology

Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.
A rare case of adductor longus muscle rupture
Authors: R J L L van de Kimmenade, C J A van Bergen, P J E van Deurzen, R A W Verhagen
Journal: Case Rep Orthop (2015)

An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture.