OpenMed/multicare-articles huggingface dataset:
Long-Term Survival and Improved Quality of Life following Multiple Repeat Gamma Knife Radiosurgeries for Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature
Authors: Erik W Larson, Halloran E Peterson, Robert K Fairbanks, Wayne T Lamoreaux, Alexander R Mackay, Jason A Call, John J Demakas, Barton S Cooke, Christopher M Lee
Journal: Case Rep Oncol Med (2013)

The management of glioblastoma multiforme (GBM) is in most cases complex and must be specifically tailored to the needs of the patient with the goals of extended survival and improved quality of life. Despite advancements in therapy, treatment outcomes remain almost universally poor. Salvage treatment options for the recurrence of the disease is an area of intense study. The following case highlights the utility of Gamma Knife Radiosurgery (GKRS) as a salvage treatment. In this clinical situation, three sequential GKRS treatments led to prolonged survival (beyond four years after diagnosis) and improved quality of life in a patient who was unable to receive further chemotherapy regimens and was unwilling to undergo further aggressive resection. To date, there have been few reports of three or more sequential GKRS treatment sessions utilized as salvage therapy for recurrent GBM in patients who can no longer tolerate chemotherapy. This report provides evidence that aggressive local treatment with GKRS at the time of recurrence may be appropriate, depending on a patient's individual clinical situation, and can lead to prolonged survival and improved quality of life.
Multilocular Cystic Renal Cell Carcinoma or Cystic Nephroma?
Authors: Adolfo González-Serrano, Roberto Cortez-Betancourt, Alejandro Alías-Melgar, Pedro Jair Botello-Gómez, Emilio Ramírez-Garduño, Eric Iván Trujillo-Vázquez, Yosimart Torres-Santos, José Antonio Mata-Martínez, Fernando Carreño-de la Rosa
Journal: Case Rep Urol (2016)
MeSH terms: Case Reports

The incidence of Multilocular cystic renal cell carcinoma (MCRCC) in literature is very low and confounding MCRCC with cystic nephroma (CN) is even more unusual. The aim of this report is to present a case of MCRCC and emphasize the importance of the preoperative radiologic evaluation and immunohistochemical staining confirmation to obtain an accurate diagnosis. A 73-year-old woman presented with a history of 4-month right flank pain. CT showed a Bosniak type III renal mass. After laparoscopic partial nephrectomy the initial report was cystic nephroma. Immunohistochemical staining was performed being positive for Epithelial Membrane Antigen thus changing the diagnosis to MCRCC. Multilocular cystic renal cell carcinoma cannot reliably be distinguished from cystic nephroma neither by physical examination nor by radiologic evaluation; immunohistochemical staining assay is useful to differentiate between these conditions allowing an accurate diagnosis and proper follow-up.
Malignant Priapism as a Result of Metastatic Thyroid Cancer: A Hard Reality
Authors: Ethan Vargo, Bryson Cook, Jason Lane, Eric Speakman, Neel Parekh
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Metastasis to the penis is an extremely rare entity. Malignant priapism is defined as a persistent, nonsexual erection that is refractory to pharmacologic treatment, corporal aspiration, and surgical shunts. Furthermore, it is typically a hallmark of an advanced cancer that has metastasized, most commonly from regional organs like the prostate or bladder. We report an unusual case of malignant priapism in the setting of metastatic follicular thyroid carcinoma. To date, this is the second reported case of penile metastasis due to thyroid carcinoma and the first incidence of priapism secondary to follicular thyroid carcinoma metastasis.
Response to hydralazine-valproate in a patient with mycosis fungoides
Authors: Alfonso Dueñas-Gonzalez, Maria Teresa Vega, Déborah Martinez-Baños, Linda García-Hidalgo, Pedro Sobrevilla
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Histone deacetylase (HDAC) inhibitors have shown significant activity in the treatment of cutaneous T-cell lymphomas (CTCL). The epigenetic alterations of CTCL not only are limited to altered histone acetylation but also include aberrant DNA gene methylation hence, the combination of an HDAC inhibitor with a DNA demethylating agent is a promising therapy to be tested. Here we report a mycosis fungoides patient having a dramatic response to hydralazine and valproate, two repositioned drugs as HDAC and DNA methylation inhibitors, respectively.
Diagnostic and Management Challenges of Caesarean Scar Ectopic Pregnancy in a Lower Middle Income Country
Authors: Kwaku Asah-Opoku, Nana Essuman Oduro, Alim Swarray-Deen, Kareem Mumuni, Isaac Osei Koranteng, Rita Catherine Senker, Marcus Rijken, Kobinah Nkyekyer
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Caesarean scar ectopic pregnancy is defined as the implantation of the blastocyst in a previous Caesarean scar. It is a rare type of ectopic pregnancy. The incidence is however rising due to the increasing rates of Caesarean sections as well as in-vitro fertilization embryo-transfer. It can be diagnosed early by ultrasound. This remains a challenge in lower middle income countries where the availability of high resolution ultrasound and the skill for such sonography may be lacking. Misdiagnosis or a delay in diagnosis often leads to poor treatment outcomes. We present a case of a gravida 3 para 2 + 0 who had laparotomy for a caesarean scar pregnancy and highlight the challenges associated with diagnosis and management of this rare ectopic pregnancy in a lower middle income country.
Gallbladder schistosomiasis: rare but possible, a case report and review of the literature
Authors: Mohamed Hedfi, Mehdi Debaibi, Senda Ben Iahouel, Adnen Chouchen
Journal: Pan Afr Med J (2019)
Keywords: gallbladder, schistosomiasis, treatment
MeSH terms: Cholecystectomy, Laparoscopic / methods, Gallbladder Diseases / diagnosis, Schistosomiasis / diagnosis, Case Reports, Review, Cholelithiasis / diagnosis, Cholelithiasis / surgery, Female, Gallbladder Diseases / parasitology, Gallbladder Diseases / surgery, Humans, Middle Aged, Schistosomiasis / surgery, Tunisia

After Malaria, schistosomiasis remains the most important tropical disease in large parts of the world. It affects mainly the colon and the urinary tract. The hepatic involvement is significantly frequent, particularly by the mansoni species. Still one of the extremely rare locations is the gallbladder. Our case is about a 51 year old woman from Tunisia, which is no longer considered an endemic country, with no particular medical history, underwent surgery for symptomatic cholelithiasis. She had a laparoscopic cholecystectomy. Post operative period was uneventful. Histology of the gallbladder showed fibrosis in the mucosa and schistosomal ova in the wall. As a conclusion we can see that due to the lack of specific clinical and radiological signs, the diagnosis of gallbladder schistosomiasis is established only after the histological examination.
Staphylococcus hominis Infective Endocarditis Presenting with Embolic Splenic and Renal Infarcts and Spinal Discitis
Authors: David Vasconcellos, Bruce Weng, Patrick Wu, Gary Thompson, Made Sutjita
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Staphylococcus hominis (S. hominis) is a Gram-positive, coagulase-negative bacteria that occurs as a normal commensal organism on the skin and may rarely cause native valve endocarditis (NVE). We present a 62-year-old male with type 2 diabetes mellitus, coronary artery disease, and hypertension presenting with fever and abdominal pain. CT (computerized tomography) of the abdomen revealed splenic and renal infarcts; further imaging with MRI (magnetic resonance imaging) revealed enhancements consistent with discitis in T5-6 and L1-2. Three sets of blood cultures were positive for S. hominis sensitive to methicillin on antimicrobial susceptibility tests, and echocardiogram showed posterior mitral valve vegetation. The patient was initially treated with 10 weeks of nafcillin IV (intravenous) 2 g q4 hours. He had recurrent bouts of S. hominis bacteremia that was treated with IV vancomycin. His clinical course was complicated by new-onset atrial fibrillation with rapid ventricular response and congestive heart failure. Once bacteremia was cleared, his infective endocarditis was successfully definitively treated with mitral valve replacement and tricuspid repair.
Case report: Rare persistent complete donor chimerism and GVHD following micro-transplantation from HLA haplotype homozygous donors
Authors: Lingling Liu, Qingya Cui, Mengyun Li, Zheng Li, Sifan Chen, Yunju Ma, Jun He, Depei Wu, Xiaowen Tang
Journal: Front Immunol (2022)
Keywords: hla haplotype homozygous donor, acute myeloid leukemia, complete donor chimerism, graft-versus-host disease (gvhd), micro-transplantation
MeSH terms: Graft vs Host Disease / drug therapy, Graft vs Host Disease / genetics, Leukemia, Myeloid, Acute / drug therapy, Case Reports, Chimerism, HLA Antigens, Haplotypes, Humans, Male, Tacrolimus, Unrelated Donors, HLA Antigens, Tacrolimus

HLA-mismatched hematopoietic stem cell micro-transplantation (MST) is an effective treatment for older patients (≥60 years) with acute myeloid leukemia. Donor selection for MST is broad, ranging from HLA fully mismatched unrelated donors to HLA partially matched related donors. However, the influence of HLA haplotype homozygous donors such donors on MST has not been studied. Such donors has been reported to be associated with a higher risk of graft-versus-host disease (GVHD) in transfusion and cord blood transplantation (CBT). Additionally, sustained complete donor chimerism is rare in MST and usually accompanied by severe acute GVHD and death. Herein, we report the first case of MST using an HLA haplotype homozygous donor. The patient developed persistent complete donor chimerism (donor cells>95%) for 7 months and prolonged isolated thrombocytopenia (PT) for 3 months, after receiving MST from his HLA homozygous son. Grade I acute GVHD presented on day 12 post-MST and it was controlled by timely immunosuppressive treatment. Then he maintained complete molecular remission, complete donor chimerism and mild GVHD for 5 months. However, moderate overlapping GVHD with skin, oral, eyes, and intestinal involvement developed after he self-discontinued Tacrolimus treatment. Fortunately, the GVHD was controlled after intensive anti-rejection therapy and Tacrolimus is now being continued for prophylaxis. This case underscores that HLA haplotype homozygous donors might not be a good choice for MST and GVHD prophylactic should be administrated if such donors have to be selected.
Intramural duodenal hematoma secondary to pancreatitis: case report and review of the literature
Authors: João Henrique Botto de Oliveira, Raiza Samenica Esper, Rodrigo Campos Ocariz, Flora Specian Sartori, Lucas Marcelo Dias Freire, Elinton Adami Chaim, Francisco Callejas-Neto, Everton Cazzo
Journal: Sao Paulo Med J (2018)
MeSH terms: Duodenal Diseases / etiology, Duodenal Diseases / therapy, Embolization, Therapeutic, Hematoma / etiology, Pancreatitis / complications, Case Reports, Review, Acute Disease, Chronic Disease, Duodenal Diseases / diagnostic imaging, Endoscopy, Digestive System, Gastrointestinal Hemorrhage, Hematoma / therapy, Humans, Male, Middle Aged, Pancreatitis / diagnostic imaging, Tomography, X-Ray Computed

Context:
Spontaneous intramural duodenal hematoma is uncommon and is usually associated with coagulopathy, anticoagulant therapy and endoscopic procedures. The aim here was to describe a case of intramural duodenal hematoma caused by chronic exacerbation of pancreatitis.
Case report:
A 46-year-old male with chronic alcoholic pancreatitis was admitted to hospital due to abdominal pain, melena and low hemoglobin. An intramural duodenal hematoma with active bleeding was detected and selective angioembolization was warranted. The patient evolved with a perforated duodenum and underwent laparotomy with exclusion of the pylorus and Roux-en-Y gastrojejunostomy. He was discharged nine days later.
Conclusion:
Intramural duodenal hematoma is a rare complication of pancreatitis. Selective embolization is the preferred treatment for hemorrhagic complications of pancreatitis. However, the risk of visceral ischemia and perforation should be considered.
Endovascular treatment of an asymptomatic hepatic artery aneurism: case report
Authors: João Lucas O'Connell, Lucas Antônio Oliveira Faria, Marcela Gomes de Souza, Gabriel Alves Meneses, Alice Mirane Malta Carrijo
Journal: J Vasc Bras (2021)
Keywords: endovascular treatment, hepatic aneurysm, visceral aneurysm
MeSH terms: Case Reports

We report a case of an asymptomatic, 77-year-old, male patient with arterial hypertension and no other comorbidities or risk factors for coronary disease. During a routine abdominal ultrasound examination, he was diagnosed with a hepatic vascular mass with an approximate diameter of 5 cm. Abdominal computed angiotomography was requested, showing an aneurysm of the hepatic artery, with maximum diameter of up to 5.2 cm, longest longitudinal axis of 7.2 cm, and a maximum true lumen caliber of 3.0 cm. We opted for endovascular aneurysm repair with implantation of three sequential Lifestream covered vascular stents (7x58mm, 8x58mm, and 8x37mm), successfully diverting the flow through the stents and excluding the aneurysm. The patient remains asymptomatic and free from clinical complications 2 years after the procedure. Control examinations with arterial duplex ultrasound 6 and 12 months after the procedure showed good flow through the stents with no leakage into the aneurysmal sac.
A case of psychosis in disulfiram treatment for alcoholism
Authors: Raquel Calvão de Melo, Rui Lopes, José Carlos Alves
Journal: Case Rep Psychiatry (2014)

Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine- β -hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account.
Narrowing the FOXF1 distant enhancer region on 16q24.1 critical for ACDMPV
Authors: Przemyslaw Szafranski, Carmen Herrera, Lori A Proe, Brittany Coffman, Debra L Kearney, Edwina Popek, Paweł Stankiewicz
Journal: Clin Epigenetics (2016)
Keywords: copy-number variants, genomic imprinting, transcriptional enhancer
MeSH terms: Chromosomes, Human, Pair 16 / genetics, Enhancer Elements, Genetic, Forkhead Transcription Factors / genetics, Persistent Fetal Circulation Syndrome / genetics, RNA, Long Noncoding / genetics, Sequence Deletion, Case Reports, Research Support, N.I.H., Extramural, Binding Sites, Comparative Genomic Hybridization, CpG Islands, Estrogen Receptor alpha / genetics, Female, Forkhead Transcription Factors / chemistry, GATA3 Transcription Factor / genetics, Genomic Imprinting, Humans, Infant, Newborn, Male, Sequence Analysis, DNA / methods, YY1 Transcription Factor / genetics, ESR1 protein, human, Estrogen Receptor alpha, FOXF1 protein, human, Forkhead Transcription Factors, GATA3 Transcription Factor, GATA3 protein, human, RNA, Long Noncoding, YY1 Transcription Factor, YY1 protein, human

Background:
Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is a rare lethal lung developmental disorder caused by heterozygous point mutations or genomic deletions involving FOXF1 or its 60-kb tissue-specific enhancer region mapping 270 kb upstream of FOXF1 and involving fetal lung-expressed long non-coding RNA genes and CpG-enriched sites. Recently, we have proposed that the FOXF1 locus at 16q24.1 may be a subject of genomic imprinting.
Findings:
Using custom-designed aCGH and Sanger sequencing, we have identified a novel de novo 104 kb genomic deletion upstream of FOXF1 in a patient with histopathologically verified full phenotype of ACDMPV. This deletion allowed us to further narrow the FOXF1 enhancer region and identify its critical 15-kb core interval, essential for lung development. This interval harbors binding sites for lung-expressed transcription factors, including GATA3, ESR1, and YY1, and is flanked by the lncRNA genes and CpG islands. Bisulfite sequencing of one of these CpG islands on the non-deleted allele showed that it is predominantly methylated on the maternal chromosome 16.
Conclusions:
Substantial narrowing and bisulfite sequencing of the FOXF1 enhancer region on 16q24.1 provided new insights into its regulatory function and genomic imprinting.
A Case of Allergic Bronchopulmonary Aspergillosis (ABPA) in a Patient with a History of Cocaine Use and Tuberculosis
Authors: Noura Ayoubi, Samuel Jalali, Nikesh Kapadia
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Aspergillosis refers to a spectrum of disorders that can occur due to colonization with the Aspergillus fungus. Allergic bronchopulmonary aspergillosis (ABPA) is an airway hypersensitivity reaction to the fungus that is almost exclusively seen in patients with cystic fibrosis or asthma. Here, we present a case of ABPA in a patient with a history of chronic cocaine use and tuberculosis and no history of asthma or cystic fibrosis. The patient had presented with progressively worsening dyspnea for three months as well as a 20-pound weight loss. Diagnosis was made with an elevated IgE against Aspergillus and chest CT findings, which included bronchiectasis and tree-in-bud nodular opacities. The patient was treated with IV methylprednisolone followed by a 4-day course of oral prednisone, with significant improvement. It is our hope to make healthcare providers aware of the potential presence of ABPA in chronic cocaine users and patients with tuberculosis, both of which are not traditionally associated with this condition.
A Case of Trapezium Avascular Necrosis Treated Conservatively
Authors: Evangelos Petsatodis, Konstantinos Ditsios, Panagiotis Konstantinou, Iosafat Pinto, Lazaros Kostretzis, Ioannis Theodoroudis, Mayia Pilavaki
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Introduction:
Avascular necrosis (AVN) of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively.
Case presentation:
A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium.
Conclusion:
AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.
Spontaneous Pneumomediastinum and Diffuse Subcutaneous Emphysema after Methamphetamine Inhalation
Authors: Michael Agustin, Gabriel David, Ji Yeong Kang, Ornusa Teerasukjinda
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Methamphetamines are commonly abused drugs for their stimulant and euphoric effects. Inhaled and intravenous use may cause damage to the respiratory system. Spontaneous pneumomediastinum is a condition where changes in intrathoracic pressure leads to alveolar rupture and dissection of air along the tracheobronchial tree. Massive subcutaneous emphysema may result from pneumomediastinum which may compromise the central airway. In this case report, we present an unusual case of spontaneous pneumomediastinum and severe subcutaneous emphysema following inhalation of methamphetamine. This case emphasizes the rising concern on the acute respiratory complications of methamphetamine use.
Cardiac Lymphoma Diagnosed by Multi-Modality Imaging: A Case Report
Authors: Dayan Yang, Tangna Wu, Lini Gao, Lili Liu, Fujin Liu, Xiangxiang Jing
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac lymphoma, cardiac tumor, diagnosed, multi-modality medical imaging, myocardial contrast echocardiography, ultrasound
MeSH terms: Case Reports

A 79-year-old female patient who presented with a cardiac mass detected by conventional echocardiography was ultimately diagnosed with a malignant tumor by myocardial contrast echocardiography. A positron emission tomography/computed tomography examination showed tumors in the right atrium consistent with the findings of the contrast-enhanced ultrasound. Finally, the patient was confirmed by pathology to have cardiac lymphoma. Because no lesions were found elsewhere in the body, primary cardiac lymphoma was diagnosed by combining multi-modal imaging examination and pathological examination. Although conventional echocardiography may identify a cardiac mass, it is difficult to identify whether they are malignant or not. Myocardial contrast echocardiography helps to identify the location, shape, and size of the mass, its relationship with the surrounding tissue, and evaluate its blood supply. Thus, this imaging modality is of great value for identifying the likely etiology of a cardiac mass. Multi-modal imaging is complementary to echocardiography for determining the location of cardiac masses, invasion of surround structures, extra cardiac spread, and determination of whether a mass is likely benign or malignant. Multi-modality imaging provides an important basis for clinical treatment and decision-making.
Iliac vein compression syndrome in an active and healthy young female
Authors: Sonia Cerquozzi, Graham F Pineo, Jason K Wong, Karen A Valentine
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Iliac vein compression syndrome is a condition involving external compression of the left common iliac vein by the right iliac artery, which was first described in the 1850s. It predominates in females typically between the third and fourth decade of life and has been associated with thrombophilias. Importantly, the syndrome is amenable to endovascular treatment. Here, we describe a case of a young athletic female with an incidental finding of a left iliac vein thrombosis while taking oral contraceptives, who was identified as having iliac vein compression syndrome on follow-up MR venography with positive testing for Factor V Leiden mutation.