OpenMed/multicare-articles huggingface dataset:
Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period
Authors: Koji Nakamura, Kensuke Nakanishi, Satoshi Kubota, Ryoko Takahashi, Mari Tomiie, Akihiro Moriyama
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Venous thrombophlebitis is an uncommon cause of fever and lower abdominal pain during the early postpartum period. It mostly occurs in the right ovarian vein, and computed tomography (CT) is useful for diagnosis. We present a case of thrombophlebitis of the renal capsular vein. A 27-year-old postpartum woman presented with right lower abdominal pain and fever unresponsive to antibiotics. Contrast CT showed a ring-enhancing mass in the right retroperitoneum, which was distinct from the right ovarian vein. Exploratory laparoscopy revealed a retroperitoneal hematoma and normal appendix. Reconstruction of CT images revealed that the mass was connected to the right renal capsular vein. Anticoagulation therapy improved the patient's symptoms. Postpartum thrombophlebitis can occur at locations other than the ovarian vein, such as the renal capsular vein. If a retroperitoneal mass is discovered during puerperium, a thorough investigation of the mass's continuity with surrounding vessels is essential to avoid unnecessary surgery.
The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report
Authors: Jürgen C Becker, Roland Houben, Claudia S Vetter, Eva B Bröcker
Journal: BMC Cancer (2006)
MeSH terms: Carcinoma, Squamous Cell / chemically induced, Immunosuppressive Agents / adverse effects, Lichen Planus, Oral / drug therapy, Tacrolimus / adverse effects, Tongue Neoplasms / chemically induced, Case Reports, Administration, Topical, Calcineurin Inhibitors, Cell Transformation, Neoplastic / pathology, Enzyme Activation, Female, Guanine Nucleotide Exchange Factors / metabolism, Humans, Immunosuppressive Agents / pharmacology, Lichen Planus, Oral / pathology, Middle Aged, Mitogen-Activated Protein Kinase 3 / metabolism, Tacrolimus / pharmacology, Ubiquitin-Protein Ligases, Calcineurin Inhibitors, Guanine Nucleotide Exchange Factors, Immunosuppressive Agents, HERC1 protein, human, Ubiquitin-Protein Ligases, Mitogen-Activated Protein Kinase 3, Tacrolimus

Background:
Since tacrolimus ointment was approved by the U.S. Food and Drug Administration (FDA) as a promising treatment for atopic dermatitis, it has been approved in more than 30 additional countries, including numerous European Union member nations. Moreover, in the current clinical routine the use of this drug is no longer restricted to the approved indication, but has been extended to a wide variety of inflammatory skin diseases including some with the potential of malignant transformation. So far, the side-effects reported from the topical use of tacrolimus have been relatively minor (e.g. burning, pruritus, erythema). Recently, however, the FDA reviewed the safety of topical tacrolimus, which resulted in a warning that the use of calcineurin inhibitors may be associated with an increased risk of cancer.
Case presentation:
Oral lichen planus (OLP) was diagnosed in a 56-year-old women in February 1999. After several ineffective local and systemic therapeutic measures an off-label treatment of this recalcitrant condition using Tacrolimus 0.1% ointment was initiated in May 2002. After a few weeks of treatment most of the lesions ameliorated, with the exception of the plaques on the sides of the tongue. Nevertheless, the patient became free of symptoms which, however, reoccurred once tacrolimus was weaned, as a consequence treatment was maintained. In April 2005, the plaques on the left side of the tongue appeared increasingly compact and a biopsy specimen confirmed the suspected diagnosis of an oral squamous cell carcinoma.
Conclusion:
The suspected causal relationship between topical use of tacrolimus and the development of a squamous cell carcinoma prompted us to test the notion that the carcinogenicity of tacrolimus may go beyond mere immune suppression. To this end, tacrolimus has been shown to have an impact on cancer signalling pathways such as the MAPK and the p53 pathway. In the given case, we were able to demonstrate that these pathways had also been altered subsequent to tacrolimus therapy.
Tetryl exposure: forgotten hazards of antique munitions
Authors: Walla A Alfaraj, Brian McMillan, Alan M Ducatman, Charles L Werntz 3rd
Journal: Ann Occup Environ Med (2016)
Keywords: munitions, occupational safety, tetryl, west virginia
MeSH terms: Case Reports

Background:
Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection.
Case presentation:
Symptoms and findings from 22 workers who were exposed to tetryl are summarized.
Conclusions:
This study highlights the health hazards from exposure to tetryl. Occupational health professionals need to maintain vigilance to protect workers from the risks of handling older munitions.
Pagetoid spread of urothelial carcinoma controlled without resection
Authors: Shutaro Yamamoto, Tatsuya Shimomura, Kanako Kasai, Taisuke Yamazaki, Yuki Enei, Yusuke Koike, Toshihiro Ito, Tohru Harada, Nozomu Furuta, Takahiro Kimura
Journal: IJU Case Rep (2022)
Keywords: chemotherapy, extramammary paget's disease, urinary bladder neoplasms, vulva, vulvectomy
MeSH terms: Case Reports

Introduction:
Extramammary Paget's disease is an eczematous skin condition that affects the vulva and perineum. Extramammary Paget's disease secondary to urothelial carcinoma is a rare condition that is typically treated with invasive surgical resection of the lesion.
Case presentation:
An 80-year-old woman with a 7-year history of urothelial carcinoma presented with erythema of the labia majora. Immunostaining of skin biopsy specimens suggested extramammary Paget's disease secondary to urothelial carcinoma. The patient did not consent to resection of the lesion. Nine cycles of first-line platinum-based chemotherapy for metastatic urothelial carcinoma were administered. As tumor cells remained after systemic chemotherapy, pembrolizumab will be administered to the patient for treating residual extramammary Paget's disease.
Conclusion:
Platinum-based chemotherapy can control extramammary Paget's disease secondary to urothelial carcinoma.
Pelvic Lymph Node Lymphangiomyomatosis Found During Surgery for Gynecological Fallopian Tube Cancer: A Case Report and Literature Review
Authors: Shan Xiao, Yijia Chen, Qianjue Tang, Lianwei Xu, Li Zhao, Zhenzhen Wang, Erkai Yu
Journal: Front Med (Lausanne) (2022)
Keywords: case report, fallopian tube carcinoma, gynecological surgery, lymphangiomyomatosis, pelvic lymph nodes
MeSH terms: Case Reports

Background:
Lymphangioleiomyomatosis (LAM) is a rare low-grade metastatic tumor with an unknown origin that spreads through lymphatic vessels. It is characterized by the proliferation of smooth muscle-like or epithelioid tumor cells in the lung and axial lymphatic system. Extrapulmonary LAM is a localized disease with a low incidence rate, and the location of the related lesions is atypical. It is difficult to diagnose. The LAM of pelvic lymph nodes is hidden. It is usually found through gynecological oncology surgery.
Case presentation:
We report a 57-year-old postmenopausal woman with a pelvic mass and vaginal bleeding as the main symptoms. The patient had no history of pulmonary LAM, tuberous sclerosis complex (TSC), or renal angiomyolipoma and had not used exogenous hormones. We performed a total hysterectomy, bilateral adnexectomy, greater omentum resection, and pelvic lymphadenectomy under laparoscopy. The postoperative pathology confirmed high-grade serous carcinoma of the left fallopian tube, and four lymph nodes were found in the pelvic lymph nodes, suggesting lymphangiomyomatosis. Immunohistochemical results also showed that these cells could express markers of smooth muscle cells and melanoma cells. The patient was treated with chemotherapy after the operation. Chest CT did not suggest lung LAM during the postoperative follow-up, and there was no tumor recurrence.
Conclusion:
The diagnosis of this disease is challenging. At the same time, due to insufficient clinical samples, it is still unknown whether there is a potential relationship between pelvic and peritoneal lymph node LAM found in the surgical staging of gynecological tumors and lung LAM and/or TSC. There is no evidence that pelvic and peritoneal lymph node LAM will increase the risk of pulmonary LAM. Therefore, additional clinical data are required to analyze and summarize the relationship between pelvic and peritoneal lymph node LAM, pulmonary LAM, and the source of LAM. We present a case of pelvic lymph node LAM and propose a hypothesis that the pathogenesis of endometriosis can be used for reference in the study of this disease.
Post-infectious glomerulonephritis presenting as acute renal failure in a patient with Lyme disease
Authors: Davide Rolla, Novella Conti, Francesca Ansaldo, Laura Panaro, Tiziano Lusenti
Journal: J Renal Inj Prev (2013)
Keywords: acute renal failure, glomerulonephritis, lyme disease
MeSH terms: Case Reports

Introduction:
We report a case of a patient with acute renal failure in Lyme disease-associated focal proliferative mesangial nephropathy. Lyme disease is a vector-borne disease caused by Borrelia burgdorferi, transmitted by the bite of an infected ixodes tick. Post-infectious glomerulonephritis (GN)secondary to Borrelia burgdorferi infection in man could be fatal, as it is in canine Lyme borreliosis.
Case:
A 61-year old man with chronic ethanolic hepatitis was admitted to a provincial hospital, complaining of nausea, diarrhoea and loss of his sense of taste. A few days prior hospitalization, he had been bitten by a tick. He developed erythema gyratum repens in the right leg, thorax and face. Kidney function was altered despite normal urine flow: creatinine 5.04 mg/dl and BUN 126 mg/dl. Urinalysis showed light proteinuria and microscopic hematuria. IgG and IgM antibodies to Borrelia burgdorferi were detected by ELISA and Western blot confirmed the diagnosis. Renal biopsy showed mild mesangial proliferation and mesangial and paramesangial deposits on AFOG stain. A diagnosis of acute renal failure in Lyme disease-associated focal proliferative IgA nephropathy was made. Intravenous antibiotic medication was started (ceftriaxone 1 gram daily i.v.). The patient was later discharged, serum creatinine had decreased to 3.5 mg/dl with a BUN of 58 mg/dl, and a slight improvement was observed on follow-up.
Conclusion:
Borrelia burgdorferi is a possible cause of post-infectious GN in humans as it is in dogs. Difficulties in identifying Borrelia burgdorferi may also be one of the reasons for the paucity of reports on the association of this infection with glomerulonephritis in humans. Currently, various types of histological renal lesions have been reported.
Unusual occurrence of rare lipid-rich carcinoma and conventional invasive ductal carcinoma in the one breast: case report
Authors: Katarina Machalekova, Karol Kajo, Marian Bencat
Journal: Case Rep Pathol (2012)

A 56-year-old woman noticed a palpable mass in her left breast during self-examination. Patient was admitted to our hospital and malignant bifocal tumour was diagnosed by ultrasonography, digital mammography, magnetic resonance, and core-cut biopsy. The patient underwent planned conservative surgery (biquadrantectomy) with a sentinel node examination, but after results of the frozen section with positive resection margins and positive sentinel lymph nodes subsequent mastectomy with axillary lymph node dissection were realized. Histology in the resection specimen revealed two isolated and distinct tumours. One of the lesions represented conventional invasive ductal carcinoma of histological grade 3, and the second tumour was evaluated as invasive lipid-rich carcinoma, containing tumour cells with clear and foamy cytoplasm. Lipids in neoplastic cells were detected by Oil Red O staining and ultrastructural examination. Immunohistochemical analysis of both carcinomas was almost identical with negative steroid receptors, positive staining of HER-2, and p53 and with high proliferation activity (Ki-67). Mastectomy specimen contained residual foci of invasive ductal carcinoma and dissected axillary lymph nodes were free of metastasis. Patient underwent first cycles of chemotherapy with paclitaxel and Herceptin together with local radiotherapy and two month after surgery is without any evidence of the disease.
Multiple myeloma presenting as a cervical intraforaminal tumor: A case report and review of literature
Authors: Dragan Jankovic, Darius Kalasauskas, Naureen Keric, Malte Ottenhausen, Florian Ringel
Journal: Front Surg (2023)
Keywords: case report, multiple myeloma, outcome, spine, surgery
MeSH terms: Case Reports

Multiple myeloma (MM) is a hematological malignancy with characteristic clonal plasma cell proliferation and production of monoclonal immunoglobulins. Although it can often metastasize to the bony spine, completely extravertebral and extra-/intradural manifestations are exceedingly rare. In this case report, we describe a 51-year-old male patient with cervical extradural and intraforaminal MM who was surgically treated in our department. Clinical findings and radiological images were retrieved from medical records and an imaging system. This unusual localization of MM and similar cases in the literature are reviewed in detail. The patient underwent tumor resection via a ventral approach, and postoperative MRI demonstrated a sufficient decompression of neural structures. No new neurological deficits were observed at subsequent follow-ups. Although 7 cases of extramedullary extradural manifestations of multiple myeloma have been described in the literature so far, this is the first case of intraforaminal extramedullary multiple myeloma located in the cervical spine and treated by surgery.
Valuing and Sustaining (or Not) the Ability of Volunteer Community Health Workers to Deliver Integrated Community Case Management in Northern Ghana: A Qualitative Study
Authors: Karen Daniels, David Sanders, Emmanuelle Daviaud, Tanya Doherty
Journal: PLoS One (2015)
MeSH terms: Community Health Services / organization & administration, Community Health Workers / organization & administration, Research Support, Non-U.S. Gov't, Attitude of Health Personnel, Case Management, Community Health Services / economics, Ghana, Health Services Accessibility, Qualitative Research, Volunteers

Background:
Within the integrated community case management of childhood illnesses (iCCM) programme, the traditional health promotion and prevention role of community health workers (CHWs) has been expanded to treatment. Understanding both the impact and the implementation experience of this expanded role are important. In evaluating UNICEF's implementation of iCCM, this qualitative case study explores the implementation experience in Ghana.
Methods and findings:
Data were collected through a rapid appraisal using focus groups and individual interviews during a field visit in May 2013 to Accra and the Northern Region of Ghana. We sought to understand the experience of iCCM from the perspective of locally based UNICEF staff, their partners, researchers, Ghana health services management staff, CHWs and their supervisors, nurses in health facilities and mothers receiving the service. Our analysis of the findings showed that there is an appreciation both by mothers and by facility level staff for the contribution of CHWs. Appreciation was expressed for the localisation of the treatment of childhood illness, thus saving mothers from the effort and expense of having to seek treatment outside of the village. Despite an overall expression of value for the expanded role of CHWs, we also found that there were problems in supporting and sustaining their efforts. The data showed concern around CHWs being unpaid, poorly supervised, regularly out of stock, lacking in essential equipment and remaining outside the formal health system.
Conclusions:
Expanding the roles of CHWs is important and can be valuable, but contextual and health system factors threaten the sustainability of iCCM in Ghana. In this and other implementation sites, policymakers and key donors need to take into account historical lessons from the CHW literature, while exploring innovative and sustainable mechanisms to secure the programme as part of a government owned and government led strategy.
A Case Report on an Atypical Presentation of the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) in a War Veteran with Bipolar Disorder and PTSD
Authors: Miguela Marie Señga, Gemmalynn Sarapuddin, Edmundo Saniel
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Background:
Lithium is still the first-line agent for bipolar disorder. Despite common knowledge on monitoring lithium levels to prevent toxicity, it still occurs at varying degrees. Here we present a rare sequela of lithium toxicity, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT). Case Presentation. A 56-year-old male war veteran who is fully functional despite being on chronic lithium therapy for Posttraumatic Stress Disorder (PTSD) and bipolar disorder presented at the emergency room with altered mental status and seizures associated with elevated lithium levels and renal insufficiency. Antiepileptic drugs were given for seizure control, and intermittent hemodialysis was done to clear the lithium. Despite clearance of the offending agent, the patient remained to have a generalized slowing on repeated EEG with only eye opening and nonpurposeful limb movements regained even after more than 2 months of lithium cessation.
Conclusion:
SILENT has been coined after reports of persistent neurologic deficits were seen in patients who experienced lithium toxicity more than 2 months after cessation of lithium. Chronic lithium therapy predisposes to gradual accumulation of lithium in the brain. Demyelination is the typically reported feature of SILENT. It can also leave the patient in a persistent encephalopathic state. Chronic lithium toxicity from failure of monitoring puts patients on lithium therapy at risk.
Case report: Primary mediastinal Ewing's sarcoma presenting with chest tightness
Authors: Manman Cui, Duchang Zhai, Yan Liu, Xiuzhi Zhou, Tingting Wang, Lihuan Wang, Wu Cai, Guohua Fan, Shenghong Ju
Journal: Front Oncol (2023)
Keywords: ewing’s sarcoma, chest, extraskeletal, mediastinum, oncology, primary
MeSH terms: Case Reports

Ewing's sarcoma is a part of a rare group of malignant neoplasms, whose pathological morphological features are small round cells. Extraskeletal Ewing's sarcoma is a more uncommon primary tumor. Herein, we report the case of a 66-year-old man who complained of chest tightness. Subsequent chest CT scans revealed an irregular and uneven density mass on the right side of the anterior mediastinum with invasion of the superior vena cava, pericardium and right lung. The patient's clinical symptoms were improved after performing excision of the mediastinal lesions under cardiopulmonary bypass. Based on histological and immunohistochemical findings, the tumor was diagnosed as extraskeletal Ewing's sarcoma.
Immune Thrombocytopenia in a Very Elderly Patient With Covid-19
Authors: Fehmi Hindilerden, Ipek Yonal-Hindilerden, Senoglu Sevtap, Kadriye Kart-Yasar
Journal: Front Med (Lausanne) (2020)
Keywords: covid-19, corticosteroids, immune thrombocytopenia, intravenous immunoglobulin, very old age
MeSH terms: Case Reports

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a decreased number of platelets and mucocutaneous bleeding. Many viruses have been identified as triggers of the autoimmune process, including human immunodeficiency virus (HIV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus, rubella, and measles. Association with the new severe acute respiratory syndrome coronavirus, SARS-CoV-2 infection (Covid-19 infection) has been rarely reported. Here, we report the oldest case of ITP patient triggered by the novel coronavirus infection. He showed inadequate response to IVIG but responded to corticosteroids with no severe adverse events. Further studies are warranted to determine the optimal therapeutic strategies for ITP with the Covid-19 infection.
Case report: Filariasis presenting as an intra-abdominal cyst
Authors: Abhay K Kapoor, Sunil Kumar Puri, Ankur Arora, Lalendra Upreti, Amrender S Puri
Journal: Indian J Radiol Imaging (2011)
Keywords: abdominal cyst, filaria, lymphadenovarix
MeSH terms: Case Reports

Filariasis is an endemic infection seen in the tropical and subtropical regions of the world, presenting with lymphatic dysfunction in the form of lymphocele, hydrocele, chyluria, or groin lymphadenovarix. We report a rare presentation of filariasis as an intra-abdominal cystic mass.
Case report: Ruxolitinib plus dexamethasone as first-line therapy in haemophagocytic lymphohistiocytosis
Authors: Lin Zhao, Hui Yang, Wei-Ying Qu, Ying-Jia Lu, Zhou Feng
Journal: Front Oncol (2023)
Keywords: dexamethasone, first-line, haemophagocytic lymphohistiocytosis, ruxolitinib, therapy
MeSH terms: Case Reports

Haemophagocytic lymphohistiocytosis (HLH) is a cytokine-driven inflammatory syndrome caused by uncontrolled hypersecretion of inflammatory cytokines. Conventional first-line treatment for HLH included HLH-94 and HLH-2004 regimens. However, quite a few patients do not respond to treatment or cannot tolerate intensive chemotherapy. We reported two cases of HLH, one caused by natural killer (NK)/T-cell lymphoma and another associated with missense variants in the perforin 1 gene. They both received the ruxolitinib plus dexamethasone protocol and had a rapid response to treatment without obvious adverse effects. Our report indicates that treatment with ruxolitinib plus dexamethasone might be a potential option for HLH, and clinical trials warrant further investigation. In addition, the detection of HLH-related genes is necessary for the identification of late-onset familial HLH in certain settings.
A Rare Case of Gastric Metastasis in Ewing's Sarcoma of the Femur
Authors: Krishna Amulya Koti, Selvamani Backianathan, Patricia Sebastian, Leni G Matthew, Mithun Raam, Dipti Masih
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

The stomach is a very unusual site of metastasis. Published reports on metastatic lesion in the stomach is generally limited to single case reports and case series. Gastric metastasis in an Ewing's sarcoma is extremely rare and has been reported in English literature but once to our knowledge. We present a case report of Ewing's sarcoma of the right proximal femur metastasizing to the stomach. A young female treated for Ewing's sarcoma of the femur in 2012 presented with gastric metastasis after four years of disease-free interval. She was treated with irinotecan-based chemotherapy followed by total gastrectomy with esophagojejunal anastomosis and radiation therapy. At one-year follow-up, she was disease free.