OpenMed/multicare-articles huggingface dataset:
Surgical Treatment of Single Pontomedullary Junction Metastasis from Lung Cancer
Authors: Paolo Missori, Simone Peschillo, Angela Ambrosone, Antonio Currà, Sergio Paolini
Journal: Case Rep Oncol Med (2022)
MeSH terms: Case Reports

Background:
When lung cancer develops a solitary metastasis at the pontomedullary junction, due to surgical risk, the current oncologic treatment is radiosurgery and chemotherapy. Case Description. We describe a patient with a single intrinsic metastasis at the pons and medulla. Removal was successful, without complication.
Conclusion:
Surgery can provide excellent results, and in selected patients, it should be considered a first-line treatment in experienced hands.
Detection and characterization of a coxsackievirus B2 strain associated with acute meningoencephalitis, Brazil, 2018
Authors: Ivanildo Pedro de Sousa Jr, Raiana Scerni Machado, Fernanda Marcicano Burlandy, Edson Elias da Silva
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Meningoencephalitis / diagnosis, Case Reports, Adolescent, Brazil, Humans, Phylogeny

Although different etiological agents can cause acute meningoencephalitis, this syndrome is usually associated with viruses. Among these, enteroviruses play a significant role. Here, we describe a fatal case of meningoencephalitis in a previously healthy teenager. Real-time RT-PCR and cell culture assays were performed with serum and cerebrospinal fluid (CSF) from a clinically diagnosed meningoencephalitis case that occurred in Rio de Janeiro State, Brazil. Coxsackievirus B2 (CVB2) was identified. Phylogenetic analysis revealed that the identified CVB2 was genetically related to strains known to cause neurological diseases. This case highlights the importance of continuous laboratory surveillance of central nervous system infections.
ECT in an Adolescent With Schizophrenia and Seizures: Case Report
Authors: Anna Gralewicz, Łukasz Świȩcicki, Anna Z Antosik-Wójcińska, Magdalena Konopko, Iwona Kurkowska-Jastrzȩbska, Halina Sienkiewicz-Jarosz, Łukasz Szostakiewicz, Barbara Remberk
Journal: Front Psychiatry (2021)
Keywords: ect, adolescent, case report, early onset schizophrenia (eos), seizure
MeSH terms: Case Reports

Electroconvulsive therapy (ECT) has been recognized as an effective treatment option in catatonia, and for prolonged or severe affective episodes and schizophrenia. Response rates vary from 40 to 80% in adolescents. The procedure is safe if the required precautions are undertaken. Nonetheless, ECT remains a serious clinical challenge in patients with comorbid seizures. We present a case study of a 17-year-old female student suffering from schizophrenia who was scheduled for ECT due to prior treatment inefficacy. Seizures had occurred a few days before the first ECT session. Nevertheless, the patient received the ECT course, combined with clozapine at 125 mg/day, after neurological diagnosis and treatment modification because the illness became life-threatening. The patient's clinical outcome was satisfactory without any seriously adverse events and further improvements were observed in the mental state following long-term psychosocial treatment at our inpatient unit. A few months later, epilepsy was however diagnosed with probably coexistence of partial seizures and seizure-like events without EEG correlate. Administering ECT in patients with seizure comorbidity was also investigated based on previous research. Data on this is, however, extremely scarce and to the best of our knowledge, the safety and efficacy of using ECT in adolescents with schizophrenia and seizures has yet not to any great extent been discussed in the literature.
An unusual clinical presentation resembling superior vena cava syndrome post heart surgery
Authors: Angel López-Candales, David Kaczorowski, Ronald Pellegrini
Journal: Cardiovasc Ultrasound (2005)
MeSH terms: Cardiac Surgical Procedures / adverse effects, Echocardiography, Transesophageal, Pulmonary Embolism / surgery, Superior Vena Cava Syndrome / diagnostic imaging, Superior Vena Cava Syndrome / surgery, Case Reports, Aged, Diagnosis, Differential, Female, Heart Neoplasms / diagnostic imaging, Heart Neoplasms / surgery, Humans, Myxoma / diagnostic imaging, Myxoma / surgery, Pulmonary Embolism / diagnostic imaging, Pulmonary Embolism / etiology, Rare Diseases / diagnostic imaging, Tricuspid Valve / diagnostic imaging, Tricuspid Valve / surgery, Vena Cava, Superior

Background:
An unusual sequence of post operative events heralded by hemodynamic deterioration followed by dyspnea and rapidly progressive dilatation of superficial neck and facial veins, resembling a superior vena cava syndrome, two days post surgical resection of filamentous aortic valve masses, closure of a patent foramen ovale, and performance of a modified Maze procedure for atrial fibrillation in a patient that presented with transient neurologic findings is presented.
Case presentation:
Although both clinical findings and hemodynamic derangements completely resolved following tricuspid valve repair aimed to correct the new onset severe tricuspid regurgitation noted post operatively; a clear mechanism was not readily obvious and diagnostic testing data somewhat conflictive. We present a careful retrospective examination of all clinical data and review possible clinical entities that could have been implicated in this particular case and recognize that transesophageal echocardiographic findings were most useful in identifying the best course of action.
Conclusion:
After reviewing all clinical data and despite the inconclusive nature of test results; the retrospective examination of transesophageal echocardiographic findings proved to be most useful in identifying the best course of action. We postulate that in our case, resolution of the suspected pulmonary embolism with anticoagulation and reestablishment of a normal right ventricular geometry with tricuspid valve repair worked in unison in restoring normal hemodynamics and resolving both dyspnea and venous dilatation.
Iatrogenic displacement of a foreign body into the periapical tissues
Authors: Hugo Plascencia, Alvaro Cruz, Rodrigo Solís, Mariana Díaz, Josué Vázquez
Journal: Case Rep Dent (2014)

The presence of a foreign body in the periapical tissues can cause endodontic failure by triggering an inflammatory response and a subsequent foreign body reaction. This inflammatory response, which can occur to varying degrees, appears radiographically as a radiolucency that can remain asymptomatic for many years. A foreign object can reach the apical region by accident or iatrogenic procedures during dental procedures. The aim of the present case report is to describe the endodontic surgical treatment of an iatrogenic displacement of a foreign body (a metal fragment) into the periapical tissues and to describe its clinical and radiographic follow-up over a period of 52 months.
Second degree AV block and severely impaired contractility in cardiac myxedema: a case report
Authors: Apostolos Chatzitomaris, Michael Scheeler, Michael Gotzmann, Roland Köditz, Janice Schildroth, Kathy Miriam Knyhala, Volkmar Nicolas, Christoph Heyer, Andreas Mügge, Harald H Klein, Johannes W Dietrich
Journal: Thyroid Res (2015)
Keywords: cardiac myxedema, hypothyroid graves’ disease, peri-myocarditis, thyrocardiac axis
MeSH terms: Case Reports

The heart is a major target organ for thyroid hormone action. Severe overt hypothyroidism can result in diastolic hypertension, lowered cardiac output, impaired left ventricular contractility and diastolic relaxation, pericardial effusion and bradycardia. However, the function of the atrial pacemaker is usually normal and the degree by which the heart rate slows down is often modest. Here we report the case of a 20 year old male Caucasian with severe overt hypothyroidism. He presented with syncopation due to second degree atrioventricular block type Mobitz 2 and heart failure with reduced ejection fraction (38 %). Laboratory testing revealed a severe overt hypothyroidism with markedly elevated TSH (>100 mIU/L) and reduced fT3 and fT4 levels. The condition was caused by hypothyroid Graves' disease (Graves' disease with Hashimoto component). Although magnetic resonance imaging of the heart demonstrated decreased cardiac contractility and pericardial effusion, suggesting peri-myocarditis, plasma levels for BNP and troponin I were low. A possible infectious cause was unlikely, since testing for cardiotropic viruses was negative. The patient was treated with intravenous levothyroxine and after peripheral euthyroidism had been achieved, left ventricular ejection fraction returned to normal and pericardial effusion dissolved. Additionally, bradycardiac episodes abated, although intermittent second degree AV block was still occasionally present during the night. In conclusion, overt hypothyroidism may be associated by cardiac myxedema affecting both electrophysiology and contractility, observations that underscore the necessity of thyroid testing in different phenotypes of heart failure.
Pseudo-Meigs' Syndrome in a Patient With Uterine Fibroids With Massive Pleural Effusion After Starting Gonadotropin-Releasing Hormone Agonist Therapy: A Case Report
Authors: Hidesato Odaka, Ruriko Asahi, Kengo Shimada, Takuo Tokairin, Yukiyo Kumazawa
Journal: Cureus (2023)
Keywords: gonadotropin-releasing hormone agonist, leuprorelin acetate, massive pleural effusion, pseudo-meigs’ syndrome, uterine fibroids
MeSH terms: Case Reports

Pseudo-Meigs' syndrome is caused by uterine fibroids, which is often treated using gonadotropin-releasing hormone (GnRH) agonists. Here we report a case of pseudo-Meigs' syndrome that developed with massive pleural effusion after the initiation of GnRH agonist therapy for uterine fibroids. A 48-year-old woman presented with dyspnea. Her medical history included uterine fibroids and GnRH agonist therapy. Contrast-enhanced computed tomography revealed a massive pleural effusion, uterine fibroids, and ascites. A total laparoscopic hysterectomy was performed. The pathologic findings were consistent with those of uterine fibroids. The pleural effusion and ascites resolved completely. The patient was diagnosed with pseudo-Meigs' syndrome due to uterine fibroids.
Physical Incompatibility between Vancomycin and Viscoelastic Mimicking Acute Endophthalmitis: The First Report
Authors: Biljana Kuzmanović Elabjer, Dean Šarić, Mladen Bušić, Mirjana Bjeloš, Andrej Pleše
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

This is the first documentation of vancomycin precipitation with viscoelastic in the anterior chamber of the eye. A 34-year-old white male underwent uneventful penetrating keratoplasty. Intracameral instillation of 1 mg/0.1 mL of vancomycin followed no attempts of meticulous viscoelastic irrigation. Six hours later thick white material in the anterior chamber was sedimented. The following criteria excluded the diagnosis of endophthalmitis and TASS: clear and transparent anterior chamber and vitreous body, the absence of ciliary injection and corneal oedema, and unremarkable laboratory tests' results. This iatrogenic complication mimicking endophthalmitis does not require any specific management and should be acknowledged in guidelines for prevention and treatment of endophthalmitis. The objective of this paper is to alert colleagues to this iatrogenic complication of vancomycin mimicking endophthalmitis. Whether this condition should be labelled as positive or negative demands further investigation. As vancomycin is a time-dependent antibiotic, it is possible that this precipitate could serve as a slowly releasing drug depot and viscoelastic as a vehicle for precipitation. This being the case, investigation is needed to analyse its potential to precipitate with another dispersive and cohesive viscoelasticity.
Fine needle aspiration of lung lesion: Lateral and transpectoral approach
Authors: K Smith
Journal: Biomed Imaging Interv J (2012)
Keywords: ct, fine needle aspiration (fna), biopsy, lung lesion, pneumothorax
MeSH terms: Case Reports

A 69 year-old man presented with an incidental finding on radiograph of a lesion in the left upper lobe. CT indicated it was likely to be a neoplasm and CT-guided FNA was requested. The lesion was located medial to the scapula so a creative approach was utilised to gain access to the lesion. This study discusses the approach used and why it reduced patient risk compared to a more conventional procedure. The sample was positive for neoplasm and there were no complications arising from the procedure.
Sonographic diagnosis of arterioportal fistula
Authors: Canan Alkim, Huseyin Alkim, Gonul Gurkaynak, Gulay Temucin
Journal: HPB Surg (2010)
MeSH terms: Case Reports

Aim:
We aimed to identify and describe characteristic and diagnostic ultrasonographic features of arterioportal fistula cases.
Patients:
In this case series we describe 3 patients with arterioportal fistula. By depending on shared sonographic features of these patients we describe a "sonographic pattern" for the sonographic diagnosis of arterioportal fistula.
Conclusion:
In summary; both of the artery and vein related with fistula were wider than normal and seen as adjacent anechoic circles, there was an aneurysmatic dilation on vein which has turbulent flow within it, the communication between the artery and aneurysm can be seen sonographically, both of the vessels have arterial flow, filling of the vein was retrograde and other branches of the artery and vein unrelated with aneurysm were all normal in dimension.
Pulse Dye Laser Therapy Successful for Elastosis Perforans Serpiginosa
Authors: Giulia Rinaldi, Alisha Chacko, Samira Batul Syed
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Background:
We describe a case of elastosis perforans serpiginosa and its successful management with PDL laser.
Case presentation:
A 15-year-old male presented with a history of itchy, raised, red and unsightly lesions on the back of his neck. He was diagnosed with Elastosis Perforans Serpiginosa on tissue biopsy and underwent pulse dye laser therapy over four years with excellent results.
Conclusions:
Our results show that pulse dye laser therapy is a safe and effective treatment for elastosis perforans serpiginosa.
Urothelial Carcinoma in a 22-Year-Old Female with Angelman Syndrome
Authors: Jessica Pugh, R Keith Huffaker
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

A 22-year-old nulligravid white female with Angelman syndrome was noted to have a 4-month history of premenstrual nausea, vomiting, and abdominal pain. She had an echogenic focus in her bladder noted on ultrasound. She was diagnosed with low grade urothelial carcinoma after cystoscopic evaluation with biopsy and was sent to urology for further treatment. Urothelial carcinoma is rare in individuals younger than age 40. Patients may present with gross hematuria. There is often a delay in diagnosis in younger individuals with different genetic mutations noted upon diagnosis.
Parapharyngeal meningioma extending through foramen ovale: a case report
Authors: Jin Mao, Kai Wei, Siyu Yang, Ling Hu, Chao Wang
Journal: Front Oncol (2023)
Keywords: extracranial meningioma, foramen ovale, magnetic resonance imaging, parapharyngeal space, preoperative diagnosis
MeSH terms: Case Reports

Background:
Meningioma is a common non-glial tumor of the brain. Extracranial meningiomas in the parapharyngeal space are especially rare. Herein we report a case of extracranial meningioma in the parapharyngeal space and give a comprehensive description of its complete clinical course and radiological findings, which may provide helpful information in the diagnosis and treatment of extracranial meningiomas in the parapharyngeal space.
Case presentation:
A 61-year-old man presented a slowly increased mass under the left ear without pain and numbness over one year. Ultrasound examination detected a hypoechoic uneven mass behind the left parotid gland with a clear boundary, and color Doppler flow imaging revealed blood flow signals within the mass. Unenhanced computed tomography (CT) of the craniofacial region revealed a homogenous soft tissue mass in the parapharyngeal space without calcification. Magnetic resonance imaging (MRI) showed that a homogenous soft tissue mass was hyperintense on T2-weighted image, hypointense on T1-weighted image, and obviously enhanced after contrast enhancement in the parapharyngeal space. Coronal MRI showed that the lesion originated from basicranial dura extending into parapharyngeal space through the left foramen ovale at the skull base. Finally, histopathological and immunohistochemical analyses confirmed the final diagnosis of extracranial meningiomas in the parapharyngeal space.
Conclusion:
Extracranial meningiomas of the parapharyngeal space are rare and often pose a diagnostic challenge. Preoperative imaging examinations, especially CT and MRI, can aid in the accurate preoperative diagnosis, especially when intracranial extensions and dural tail signs are observed.
2, 8 Dihydroxyadenine urolithiasis: A case report and review of literature
Authors: P Sreejith, K L Narasimhan, V Sakhuja
Journal: Indian J Nephrol (2009)
Keywords: 2, 8 dihydroxyadenine, adenine phosphoribosyl transferase deficiency, urolithiasis
MeSH terms: Case Reports

Adenine phosphoribosyl transferase deficiency is a rare metabolic abnormality presenting with 2,8 dihydroxyadenine urolithiasis. The stones are characteristically radiolucent and therefore need to be differentiated from uric acid stones which are also radiolucent and have identical chemical reactivity. No cases of 2, 8- dihydroxyadenine urolithiasis have been reported from India. We report a 3 year old child with 2, 8- dihydroxyadenine urolithiasis and acute renal failure.
Successful thrombolysis following enoxaparin therapy in two pediatric patients with congenital heart disease presenting with intracardiac and cerebral thrombosis
Authors: Gesa Wiegand, Vanya Icheva, Martin Schöning, Michael Hofbeck
Journal: Thromb J (2014)
Keywords: children, enoxaparin, low-molecular-weight heparin, thrombosis
MeSH terms: Case Reports

Enoxaparin displays fibrinolytic activity through stimulation of endothelial release of tissue plasminogen activator. Moreover, enoxaparin increases the release of tissue factor pathway inhibitor, which inhibits coagulation activity. However, there are only few reports regarding the use of enoxaparin for the treatment of children with thrombosis complicating congenital heart disease. We report the clinical findings from two patients, one child with an A. cerebri media infarction and another with a left ventricular thrombus. In both cases successful thrombolysis was obtained by intravenous administration of enoxaparin. The first patient was a 12-year-old girl with an atrioventricular septal defect, who underwent biventricular repair at the age of 8 months. She presented with right-sided middle cerebral artery infarction. Thrombolysis was contraindicated, because she was beyond the therapeutic window recommended by accepted guidelines. Enoxaparin 2.5 mg/kg/d was administered as a continuous intravenous infusion (CII). The MRI 10 days later revealed a reopened middle cerebral artery and she experienced complete remission of the neurological signs. The second patient was a 16-year-old boy who had tetralogy of Fallot corrected in late infancy. He presented with severe heart failure and a mural thrombus in the left ventricular apex. Enoxaparin was administered and resulted in complete disappearance of the thrombus within a week. According to our experience, CII of enoxaparin was safe and well tolerated without secondary bleeding and resulted in complete dissolution of the thrombi without secondary embolization. Therefore, CII of enoxaparin may be a possible alternative for the treatment of thrombotic complications in children with contraindications against conventional thrombolytic therapy.
Case Report: Sarcoidosis in the lymph nodes of a breast cancer patient
Authors: Perwasha Kerio, Zain Abid, Masooma Abid, Desaar Zehra, Ghulam Haider
Journal: F1000Res (2019)
Keywords: breast cancer, mediastinal lymph adenopathy, positron emission tomography, sarcoidosis
MeSH terms: Breast Neoplasms / complications, Breast Neoplasms / therapy, Sarcoidosis / complications, Case Reports, Adult, Biopsy, Female, Humans, Lymph Nodes, Neoplasm Recurrence, Local

Background: Sarcoidosis is an inflammatory disease that affects multiple organs in the body, especially the lungs and lymph nodes. The coexistence of sarcoidosis and breast cancer has been reported, but the coexistence of both diseases in the same patient often leads to misdiagnosis. Case: We report a case of a 36-year-old woman who presented with concerns of a lump in her left breast along with pain and discharge from the nipple. On examination a 3-cm hard and tender mass was noted in the upper medial quadrant of the left breast with no palpable axillary lymph nodes. The patient was diagnosed with an infiltrating ductal cell carcinoma of the left breast with T2N0M1 Stage IV disease, due to positive mediastinal lymphadenopathy on positron emission tomography scan. The biopsy of mediastinal lymph nodes allowed us to diagnose sarcoidosis and correctly stage her disease as T2N0M0 Stage IIA breast cancer. The patient underwent lumpectomy followed by adjuvant chemo radiotherapy and hormonal therapy - corticosteroids given for sarcoidosis up to 1 year. The patient is doing well 18 months later without recurrence of disease. Conclusion: The simultaneous occurrence of both diseases in the same patient is the risk for misdiagnosis and mismanagement, therefore it is of utmost importance to correctly stage the disease with appropriate investigations and histologic confirmation prior to initiate the treatment for breast cancer.
Complex young lives: a collective qualitative case study analysis of young fatherhood and breastfeeding
Authors: Jennifer Ayton, Emily Hansen
Journal: Int Breastfeed J (2016)
Keywords: breastfeeding, socioeconomic disadvantage, young fatherhood

Background:
Of all births in Australia, 10 % are to young fathers aged less than 24 years. How young fathers experience any breastfeeding and how this is shaped by their social context is poorly understood. Our aim is to increase understanding of the lived experience of young fathers (aged less than 24 years) and to explore the way they speak about breastfeeding in the context of their lives and parenting.
Methods:
This collective case study analysis uses qualitative data from interviews and focus groups with young fathers (aged less than 24 years) and community support staff. The research was undertaken in Tasmania, Australia, March to December 2013.
Results:
Young fathers in our study had complex social and emotional circumstances that meant breastfeeding was not a high priority despite them valuing the health benefits of breastfeeding for their babies. If supported by peers and their community they appear to have a more positive parenting experience.
Conclusion:
Breastfeeding although understood by the young fathers in our study as healthy and desirable is not a priority in their lives. Learning to be a parent and support their partners to breastfeed may be more effectively gained through mentoring and father-to-father localized community based support services.