OpenMed/multicare-articles huggingface dataset:
Unusual differential diagnosis of upper abdominal pain
Authors: Monika Lanthaler, Thomas Grissmann, Lukas Schwentner, Hermann Nehoda
Journal: Diagn Ther Endosc (2009)
MeSH terms: Case Reports

We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.
Transient serotonin syndrome by concurrent use of electroconvulsive therapy and selective serotonin reuptake inhibitor: a case report and review of the literature
Authors: Nagahisa Okamoto, Kota Sakamoto, Maki Yamada
Journal: Case Rep Psychiatry (2012)

The serotonin syndrome, which is characterized by psychiatric, autonomic nervous and neurological symptoms, is considered to be caused by excessive stimulation of the 5-HT1A and 5-HT2 receptors in the gray matter and spinal cord of the central nervous system, after the start of dosing or increase of the dose of a serotoninergic drug. There have been hardly any reports of induction of serotonin syndrome by electroconvulsive therapy (ECT) in combination with antidepressant. We present the case of a female patient with major depressive disorder (MDD) who developed transient serotonin syndrome soon after the first session of ECT in combination with paroxetine. Paroxetine was discontinued, and her psychiatric, autonomic nervous and neurological symptoms were gradually relieved and disappeared within 2 days. We performed the second ECT session 5 days after the initial session and performed 12 sessions of ECT without any changes in the procedure of ECT and anesthesia, but no symptoms of SS were observed. Finally, her MDD remitted. ECT might cause transiently increased blood-brain barrier (BBB) permeability and enhance the transmissivity of the antidepressant in BBB. Therefore, it is necessary to pay attention to rare side effect of serotonin syndrome by ECT in combination with antidepressant.
Petersen's Space Internal Hernia after Laparoscopic One Anastomosis (Mini) Gastric Bypass
Authors: Mohammad Kermansaravi, Mohammad Kazazi, Abdolreza Pazouki
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
One anastomosis gastric bypass (OAGB) is now considered as an appropriate alternative for Roux-en-Y gastric bypass (RYGB) with some advantages such as absence of risk for internal hernia (IH). But, is really the risk of IH equal zero after OAGB? Case Summary. A 37-year-old male was admitted due to severe abdominal crampy pain, nausea, vomiting, and obstipation. He had chronic and intermittent abdominal pain from 2 years after OAGB. With high suspicion of complete obstruction, the exploratory laparoscopy was performed. Intraoperative findings showed incarcerated bowel hernia from Petersen's defect. The incarcerated bowel was reduced, and the defect was repaired. The patient was discharged 2 days after operation.
Conclusion:
The incidence of IH after OAGB is rare but not zero. In any suspicious signs and symptoms for IH, the early exploratory laparoscopy is mandatory to diagnose and treat.
A Rare Cause of Neck Lump in an Infant
Authors: David J McCreary, Salmah Lashhab
Journal: POCUS J (2022)
Keywords: pocus, ewing sarcoma, neck lump, neck mass, paediatric pocus
MeSH terms: Case Reports

A 5 month old girl presented to the Paediatric Emergency Department with a rapidly growing neck mass over 24 hours. She was systemically well and otherwise asymptomatic. On examination she had a mobile, soft and non-tender 5 cm x 5 cm neck mass. Blood tests were unremarkable with normal inflammatory markers. Point of Care Ultrasound (POCUS) was done which showed a solid left sided neck mass with increased vascularity but no evidence of collection or abscess. Given the atypical presentation and rapid growth the patient was commenced on empirical antibiotics and was discussed with both tertiary ENT and Oncology teams. An MRI was performed which was indeterminate. Biopsy of the neck mass was positive for Ewing Sarcoma. This is a rare case of Ewing Sarcoma in an infant. POCUS can be used to rule out common pathology and abnormal lymph nodes, aiding in ongoing investigation and management in neck lumps.
Anterior portion of the cingulate gyrus: A novel location for transient global amnesia?
Authors: Renata Barbosa Menezes, Edla Renata Cunha Cavalcante, Fernanda Martins Maia, Norberto Anizio Frota
Journal: Dement Neuropsychol (2014)
Keywords: cyrus cinguli, transient global amnesia
MeSH terms: Case Reports

Transient global amnesia (TGA) is characterized by abrupt transient loss of anterograde memory, lasting up to 24 hours, and no other focal neurological signs. We report the case of a right-handed 71-year-old female patient who presented temporal-spatial disorientation 5 minutes after ingestion of 1000 ml of iodinated contrast. The patient had mild temporal-spatial disorientation, with significant deficit in anterograde memory. After 12 hours under observation, the patient progressed to gradual improvement and was discharged. A reevaluation after 15 days showed normal cortical functions, score on mini-mental state exam of 30, and unaffected working and recall memory. MRI performed 48 hours after the event showed hypersignal in the diffusion sequence in the anterior portion of the cingulate gyrus, with hypointense signal in MAP/ADC, confirming a finding consistent with TGA. No previous reports in the literature have described the location affected in this patient, rendering it a novel site consistent with this diagnosis.
A case of B-cell acute lymphoblastic leukemia in a child with Down syndrome bearing a t(2;12)(p12;p13) involving ETV6 and biallelic IGH@ rearrangements
Authors: Carlos A Tirado, David Shabsovich, Yeun Kim, Peter Traum, Sheeja Pullarkat, Michael Kallen, Nagesh Rao
Journal: Biomark Res (2015)
Keywords: b-all, cytogenetics, etv6, fish
MeSH terms: Case Reports

Background:
Rearrangements involving ETV6 (12p13) are among the most common structural abnormalities in pediatric B-cell acute lymphoblastic leukemia (B-ALL) and involve numerous partner genes. Additionally, the t(8;14)(q11.2;q32), which can result in the placement of CEBPD (8q11.2) near the regulatory regions of IGH@ (14q32) and consequent overexpression of CEPBD, occurs at a higher frequency in individuals with Down syndrome-associated ALL (DS-ALL) compared to both the general and pediatric population. The coexistence of cytogenetically detectable ETV6 abnormalities and t(8;14)(q11.2;q32) is a rare occurrence in B-ALL and has only been reported in a single case in the literature.
Findings:
Herein, we present a case of B-ALL in a 9-year old male with Down syndrome in which conventional cytogenetic analysis revealed two reciprocal translocations: a t(8;14)(q11.2;q32) and a t(2;12)(p12;p13). Interphase and metaphase fluorescence in situ hybridization (FISH) analysis using break apart probes confirmed the involvement of IGH@ and ETV6 in these translocations, respectively. Additionally, interphase FISH revealed a clonal subpopulation bearing biallelic IGH@ rearrangements not observed by conventional cytogenetic analysis.
Conclusions:
To the best of our knowledge, this is the first reported case of B-ALL bearing an ETV6 translocation with a partner gene on the short arm of chromosome 2 confirmed by FISH. Additionally, it is the second reported case of t(8;14)(q11.2;q32)-ALL bearing a concomitant, cytogenetically detectable abnormality involving ETV6. This case provides insight into a novel translocation involving ETV6 as well as potentially unique and understudied mechanisms of clonal evolution in pediatric B-ALL.
Management of Intraocular Pressure Elevation After CO2 Laser-Assisted Sclerectomy Surgery in Patients With Primary Open-Angle Glaucoma
Authors: Min Chen, Yuxiang Gu, Yumei Yang, Qi Zhang, Xin Liu, Kaijun Wang
Journal: Front Med (Lausanne) (2021)
Keywords: co2 laser, nd

Purpose: To report the safety and efficiency of carbon dioxide (CO2) laser-assisted sclerectomy surgery (CLASS) in Chinese patients with primary open-angle glaucoma (POAG) and the management of unexpected postoperative intraocular pressure (IOP) elevation. Methods: This was a prospective case series study. A total of 23 eyes from 23 patients with POAG who underwent CLASS were involved and followed-up for 12 months. The primary outcomes included the changes in best corrected visual acuity (BCVA), IOP, and medications before and after CLASS. The secondary outcomes were success rate and postoperative laser interventions. Results: The mean age of the patient was 42.6 ± 16.0 years. There was no significant change in BCVA and visual field at baseline and 12 months after CLASS. The number of medications was significantly reduced after CLASS. The IOP was also significantly decreased and remained well controlled during the follow-up period, except for a transient elevation at 1 month postoperatively, due to the occurrence of peripheral anterior synechiae (PAS). Generally, 17 patients (73.9%) were treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser synechiolysis to remove iris obstruction in the filtration site and seven patients (30.4%) underwent Nd:YAG laser goniopuncture to deal with scleral reservoir reduction. Only one patient (4.3%) received surgical repositioning due to iris incarceration. The complete success rate and total success rate at 12 months were 69.6 and 95.7%, respectively. Conclusion: CLASS was a safe and effective approach for Chinese patients with POAG. Peripheral anterior synechiae (PAS), iris incarceration, and scleral reservoir reduction were common causes of unexpected postoperative IOP elevation. Individualized Nd:YAG laser intervention helps to improve the long-term outcomes after CLASS.
Primary coronary embolism as an unusual manifestation of nonbacterial thrombotic endocarditis in a patient with gastric cancer
Authors: Giovanni Ferlan, Annalisa Fiorella, Claudio De Pasquale, Francesco Tunzi
Journal: Cardiol Res Pract (2010)
MeSH terms: Case Reports

Nonbacterial thrombotic endocarditis (NBTE) is a rare clinical condition characterized by the presence of sterile vegetations on valvular leaflets Gross and Friedberg (1936). The most frequent cause of NBTE is antiphospholipid syndrome Hughson and et al. (1993); malignancy, through an intrinsic condition of hypercoagulability, is the second most common cause Thomas (2001). Systemic thromboembolic complications are frequently associated with this condition, but coronary embolism is not common. We report the case of a patient with NBTE secondary to gastric adenocarcinoma with clinical symptoms of coronary and systemic emboli.
Endodontic management of mandibular second molar fused to a supernumerary tooth, using spiral computed tomography as a diagnostic aid: a case report
Authors: Kavitarani Rudagi, B M Rudagi, Sandeep Metgud, Rahul Wagle
Journal: Case Rep Dent (2012)

Fusion is a developmental anomaly characterized by the union of two adjacent teeth. In this paper we report a rare case of fusion involving permanent mandibular second molar with supernumerary tooth. The rarity with which this entity appears, along with its complex characteristics, often makes it difficult to treat. The use of high-end diagnostic imaging modalities such as spiral computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. In the present case, we have used spiral computed tomography (SCT) for better understanding the complicated root canal morphology of the fused tooth and successful management of this rare case.
Genoa syndrome and central diabetes insipidus: a case report
Authors: Bülent Hacıhamdioğlu, Zeynep Şıklar, Şenay Savaş Erdeve, Merih Berberoğlu, Gülhiz Deda, Serap Teber Tıraş, Suat Fitöz, Gönül Öcal
Journal: J Clin Res Pediatr Endocrinol (2010)
Keywords: genoa syndrome, central diabetes insipidus, cleft lip/palate, craniosynostosis, holoprosencephaly
MeSH terms: Abnormalities, Multiple / pathology, Craniosynostoses / pathology, Diabetes Insipidus, Neurogenic / pathology, Holoprosencephaly / pathology, Case Reports, Cleft Lip / pathology, Cleft Palate / pathology, Humans, Infant, Male, Nose / abnormalities, Syndrome, Genoa syndrome

Genoa syndrome was first described by Camera et al in 1993 in two patients with semilobar holoprosencephaly (HPE), craniosynostosis and abnormal small hands with cone-shaped epiphyses and hypoplastic terminal phalanges of fingers (OMIM: 601370). In 2001, Lapunzina et al reported a case of craniosynostosis and HPE associated with several other malformations and suggested that these findings could be attributed to a severe form of Genoa syndrome or to a newly recognized syndrome. Endocrinopathies in association with HPE are frequently reported in the literature. Diabetes insipidus, hypothyroidism, hypocortisolism, and growth hormone deficiency are frequently associated with HPE. We here report a case of semilobar HPE, craniosynostosis and cleft lip/palate, possibly a case of Genoa syndrome, associated with central diabetes insipidus.
Biomechanics for Orthodontic Intrusion of Severely Extruded Maxillary Molars for Functional Prosthetic Rehabilitation
Authors: Ivan Pedro Taffarel, Thiago Martins Meira, Lara Karolina Guimarães, Oscar Mario Antelo, Orlando Motohiro Tanaka
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The objective of this clinical case is thus to present a Class II, division 1, subdivision malocclusion with a severely extruded maxillary left hemiarch, which, due to the loss of mandibular teeth, makes prosthetic rehabilitation of the edentulous spaces impossible. A significant intrusion was performed with mini-implants followed by miniplates associated with fixed appliance and elastomeric chains. The results of this process showed that the biological responses of the teeth and the surrounding bony structure to the intrusion were demonstrated to be normal and acceptable. A clinically significant intrusion of the left maxillary molars, along with the recovery of the interocclusal space and the prosthetic rehabilitation, was obtained with a fixed orthodontic appliance that was associated to the biomechanics with TADs. It also allowed the obtaining of Class I canine relationship, demonstrated periodontal health and favored the prosthetic rehabilitation with good occlusion, aesthetics, and satisfactory function.
Neuromuscular Complications of Targeted Anticancer Agents: Can Tyrosine Kinase Inhibitors Induce Myasthenia Gravis? Getting Answers From a Case Report up to a Systematic Review
Authors: Dimitrios C Ziogas, Dimitrios Mandellos, Charalampos Theocharopoulos, Panagiotis-Petros Lialios, Spyros Bouros, Paolo A Ascierto, Helen Gogas
Journal: Front Oncol (2021)
Keywords: tkis (tyrosine kinase inhibitors), case report, metastatic cancer, myasthenia (myasthenia gravis—mg), review—systematic, targeted therapies
MeSH terms: Case Reports

More than 40 tyrosine kinase inhibitors (TKIs) have received hematological or oncological indications over the past 20 years, following the approval of imatinib, and many others are currently being tested in clinical and preclinical level. Beyond their common toxicities, no certain agent from this large class of molecularly targeted therapies was strongly associated with "off-target" impairment of neuromuscular transmission, and although myasthenia gravis (MG) is a well-characterized autoimmune disorder, only few sporadic events proven by serologically detected causative autoantibodies and/or by positive electrophysiological tests are reported in the literature. Herein, we present the first case of anti-MUSK (+) MG in a woman with metastatic BRAF-mutant melanoma after long-term treatment with dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor). Triggered by this report, a systematic literature review was conducted, summarizing all other cancer cases that developed MG, after exposure to any type of targeted agent and regardless of the underlying malignancy. All available data on the clinical diagnosis, the potential of administered TKIs to induce a seropositive myasthenic syndrome, the immune and non-immune-mediated pathogenesis of postsynaptic damage, and the challenging management of this neuromuscular toxicity were collected and discussed. In the presented case, MG was confirmed by both autoantibodies and nerve-conduction tests, while its reactivation after TKIs rechallenge supports a more than coincidental association. The following review identified 12 cancer cases with TKI-related MG in six case reports and one case series. In most of them, the myasthenia diagnosis was challenging, since the clinical symptomatology of fatigable weakness was not corroborating with consistent laboratory and electrophysiological findings. In fact, anti-AchR titers were positive in five and anti-MuSK only in the abovementioned individual. The symptomatology corresponded to TKI discontinuation and standard treatment with pyridostigmine and prednisolone; intravenous immunoglobulin was added only in three, and two required mechanical ventilation. In an era where TKIs will be prescribed more frequently for various malignancies, even in combinations with immune-checkpoint inhibitors, this report synthesizes their risk for neuromuscular complications and increases the clinicians' awareness in order to extend the on-treatment and overall survival of TKI-treated cancer patients.
Pole to pole intraocular transit of tarantula hairs-an intriguing cause of red eye
Authors: Hiten G Sheth, Patricio Pacheco, Ahmed Sallam, Sue Lightman
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

This intriguing case report provides novel images and a description of the anterior and rarer posterior segment findings seen in ocular inflammation associated with tarantula spider hair exposure. We present an interventional case report of a 9-year-old boy who presented with a red, sore eye. Slit lamp examination revealed right eye injection, multiple small hairs at differing levels of the cornea with associated opacities and inflammation within the anterior and posterior segments of the eye. Only after detailed and repeated questioning did the aetiology become apparent. Conservative management in the form of topical steroid and antibiotics was commenced and he did well with no obvious sequelae in the medium term. Healthcare personnel (and indeed pet shop owners, arachnid enthusiasts and even parents) should be aware of the potential ocular complications of tarantula hair exposure and clinicians should perhaps specifically ask about pet-keeping when presented with an unusual red eye.
Neutralizing monoclonal antibodies against SARS-CoV-2 for COVID-19 pneumonia in a rituximab treated patient with systemic sclerosis-A case report and literature review
Authors: Melek Yalcin Mutlu, Jule Taubmann, Jochen Wacker, Koray Tascilar, Filippo Fagni, Maximilian Gerner, Daniel Klett, Georg Schett, Bernhard Manger, David Simon
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, casirivimab/imdevimab, immune mediated inflammatory disease, neutralizing mabs, rituximab, systemic sclerosis
MeSH terms: Case Reports

Patients with immune-mediated diseases (IMID) such as systemic sclerosis (SSc), who are treated with B cell depleting treatments, are at risk for developing severe COVID-19 due to inadequate humoral immune response. During B cell depletion, therapeutic substitution of neutralizing monoclonal antibodies against the SARS-CoV-2 spike protein (mAbs) might be helpful to prevent severe COVID-19. It has been shown, that in non-IMID patients mABs reduce SARS-CoV-2 viral load and lower the risk of COVID-19 associated hospitalization or death. However, there are limited data on the effect of mAbs in IMID patients after exposure, especially in patients treated with B cell depleting agents. Herein, we report a case of a rituximab treated SSc patient who developed COVID-19 and was successfully treated with a combination of mAbs (casirivimab/imdevimab). With this case we show that IMID patients may benefit from post-exposure administration of mAbs. In our case treatment with neutralizing autoantibodies was safe and a possible contributor in protecting the patient from mechanical ventilation and eventually death. We frame this case within the current evidence from the literature and provide a perspective on the future potential role of mAbs for treating IMID patients suffering from COVID-19.
Lymphoma presenting as cancer of the glans penis: a case report
Authors: Konstantinos Stamatiou, Nikolaos Pierris
Journal: Case Rep Pathol (2012)

Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple enlarged inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder. Biopsy showed diffuse, large B-cell lymphoma. The patient was treated with systemic chemotherapy with full remission of the disease. We review the literature relevant to penile lymphoma and discuss this uncommon condition.
PFOh No: Spontaneous Globe Rupture During Injection of Perfluoro- n-Octane (PFO) During Retinal Detachment Repair
Authors: Jon David Hammer, Syed Gibran Khurshid
Journal: Front Med (Lausanne) (2020)
Keywords: pfo, globe rupture, perfluoro-n-octane, retina, retinal detachment (rd)
MeSH terms: Case Reports

The authors describe a case of spontaneous globe rupture during instillation of perfluoro-n-octane (PFO) during retinal surgery. A 71-year-old male with a macular-involving rhegmatogenous retinal detachment underwent pars plana vitrectomy. During instillation of PFO manually on a single-bore cannula by the assisting resident, spontaneous globe rupture occurred superotemporally in an area with no visible underlying structural abnormalities. Factors that led to this complication include the use of single-bore cannula, error in judgment of resistance during PFO injection, and inexperience. This is the first report of this complication without an identifiable structural abnormality predisposing patient to perforation.