OpenMed/multicare-articles huggingface dataset:
Response to Dabrafenib and Trametinib of a Patient with Metaplastic Breast Carcinoma Harboring a BRAF V600E Mutation
Authors: Takuji Seo, Emi Noguchi, Masayuki Yoshida, Taisuke Mori, Maki Tanioka, Kazuki Sudo, Akihiko Shimomura, Kan Yonemori, Yasuhiro Fujiwara, Kenji Tamura
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Background:
Metaplastic breast carcinomas are rare and carry poor prognoses. They are also more aggressive than other breast cancers and are known for their resistance to chemotherapy. Prolonged treatment with dabrafenib and trametinib is a therapy for malignant melanoma that improves the progression-free survival and overall survival. Such molecular-targeted therapies are also being developed for cancers with BRAF mutation, a driver of malignant melanoma. Case Presentation. A 57-year-old woman with metaplastic breast cancer and chemotherapy-refractory massive pleural effusion. After contained anthracycline regimen failure, her breast cancer progressed to an advanced stage. We ordered next-generation sequencing- (NGS-) based tumor molecular profiling from core needle biopsy of the breast. The NGS report indicated the presence of a BRAF V600E mutation. After initiation of dabrafenib and trametinib, her symptom and the pleural effusion were decreased. The first assessment of CT scans showed a decreased pleural effusion and shrunken subcutaneous lesions. Approximately 2 weeks later, a new lesion appeared. She died from 12 weeks after initiation of dabrafenib and trametinib treatment.
Conclusion:
To the best of our knowledge, this is the first report of BRAF mutation breast cancer treated with dabrafenib and trametinib and it heralds the possibility of targeted therapy for rare breast cancers.
A Rare Case of Autoimmune Demyelinating Polyneuropathy and Hydrocephalus Secondary to Pembrolizumab
Authors: Aakriti Arora, Amar Shere, Kunal Patel, Nuwan Gunawardhana, Ericka LiFuentes
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: aidp, immune system, pembrolizumab, squamous cell carcinoma
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, Antineoplastic Agents, Immunological / adverse effects, Hydrocephalus / chemically induced, Polyneuropathies / chemically induced, Case Reports, Aged, Carcinoma, Squamous Cell / drug therapy, Humans, Hydrocephalus / diagnostic imaging, Magnetic Resonance Imaging, Male, Polyneuropathies / diagnostic imaging, Skin Neoplasms / drug therapy, T-Lymphocytes, Regulatory / drug effects, Tomography, X-Ray Computed, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, pembrolizumab

Pembrolizumab is a humanized monoclonal antibody that targets the programmed cell death 1 protein (PD-1) receptor and blocks the inhibitory checkpoint interaction between PD-1 and its ligands. This interaction leads to the upregulation of effector T-cells and downregulating regulatory T-cell production. Although this mechanism is essential for the management of cancer, it may lead to decreased self-tolerance with an autoimmune reaction toward healthy functioning tissue. One of the less commonly reported and less understood immune-related adverse events includes neuromuscular complications. We present a rare case of autoimmune demyelinating polyneuropathy and hydrocephalus secondary to pembrolizumab use for cutaneous squamous cell carcinoma of the cheek.
Incidental Cone Beam CT Finding of Juvenile Pleomorphic Adenoma
Authors: Noura Alsufyani
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Pleomorphic adenoma is a benign mixed tumor composed of epithelial and myoepithelial cells, less commonly occurring in minor salivary glands or in children. A case of juvenile pleomorphic adenoma missed clinically and incidentally found in cone beam CT images is described. Clinical, radiographic, and histologic images are presented.
Post-operative Hamman's sign: a case report
Authors: John Michael DiBianco, Archana Nair, Richard Williams
Journal: Springerplus (2015)
Keywords: hamman’s sign, pneumothorax, precordial sounds

Introduction:
We provide this brief case report on Hamman's sign, as a reminder that both pneumomediastinum and pneumothorax can cause sounds that may disclose the abnormal presence of air in these respective locations.
Background:
Attributed originally to the observations and report of Louis Hamman in 1937, abnormal sounds may emanate from air in the otherwise quiet mediastinum or pleural space.
Case presentation:
Our patient, a 36 year old white male, reported the occurrence of an abnormal "rhythmic clicking" sound emanating from his upper body when lying on his left side, 3 weeks following nasal septal surgery. The patient's clear report of particularly loud sounds, beginning post-operatively, was corroborated by the patient's wife. A CT scan of the chest which confirmed the presence of air in the left pleural space.
Conclusions:
The presence of a sound, loud enough to be heard at a distance from the patient (corroborated by another individual) is unusual. The value of patient history is underscored by the finding of a pneumothorax, suggesting Hamman's sign.
A case report of sepsis and death caused by Parvimonas micra, a rare anaerobe
Authors: Yuhang Jiang, Weichao Qin, Jian Li, Yuan Gao, Yan Zeng
Journal: Front Public Health (2022)
Keywords: parvimonas micra, blood culture, bloodstream infection, diabetes mellitus, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, molecular diagnostic technique, next-generation sequencing, septicemia
MeSH terms: Firmicutes, Sepsis / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Parvimonas micra

Parvimonas micra is a type of Gram-positive anaerobic cocci widely distributed in the oral cavity, gastrointestinal tract, respiratory tract, and female reproductive system mucosa. It is a conditional pathogen that can cause infections in the human oral cavity, wounds, and other areas as well as sepsis. In this case report, the patient's immune system was compromised by various underlying diseases and a pulmonary infection, which led to the entry of P. micra infection into the bloodstream. P. micra is a slow-growing organism (When a bloodstream infection occurs, flagging an anaerobic bottle of blood culture as positive will usually take >48 h), which makes it hard to secure timely blood culture results. Our patient's poor physical condition eventually led to sepsis, and she died after 5 days in the hospital.
Malignant Course of Anomalous Left Coronary Artery Causing Sudden Cardiac Arrest: A Case Report and Review of the Literature
Authors: Mahesh Anantha Narayanan, Christopher DeZorzi, Abhilash Akinapelli, Toufik Mahfood Haddad, Aiman Smer, Janani Baskaran, William P Biddle
Journal: Case Rep Cardiol (2015)

Sudden cardiac arrest has been reported to occur in patients with congenital anomalous coronary artery disease. About 80% of the anomalies are benign and incidental findings at the time of catheterization. We present a case of sudden cardiac arrest caused by anomalous left anterior descending artery. 61-year-old African American female was brought to the emergency department after sudden cardiac arrest. Initial EKG showed sinus rhythm with RBBB and LAFB with nonspecific ST-T wave changes. Coronary angiogram revealed no atherosclerotic disease. The left coronary artery was found to originate from the right coronary cusp. Cardiac CAT scan revealed similar findings with interarterial and intramural course. Patient received one-vessel arterial bypass graft to her anomalous coronary vessel along with a defibrillator for secondary prevention. Sudden cardiac arrest secondary to congenital anomalous coronary artery disease is characterized by insufficient coronary flow by the anomalous left coronary artery to meet elevated left ventricular (LV) myocardial demand. High risk defects include those involved with the proximal coronary artery or coursing of the anomalous artery between the aorta and pulmonary trunk. Per guidelines, our patient received one vessel bypass graft to her anomalous vessel. It is important for clinicians to recognize such presentations of anomalous coronary artery.
The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography
Authors: William E Haley, El-Sayed H Ibrahim, Mingliang Qu, Joseph G Cernigliaro, David S Goldfarb, Cynthia H McCollough
Journal: Case Rep Radiol (2015)

Dual-energy computed tomography (DECT) has recently been suggested as the imaging modality of choice for kidney stones due to its ability to provide information on stone composition. Standard postprocessing of the dual-energy images accurately identifies uric acid stones, but not other types. Cystine stones can be identified from DECT images when analyzed with advanced postprocessing. This case report describes clinical implications of accurate diagnosis of cystine stones using DECT.
Acute myocardial infarction in young adults with antiphospholipid syndrome: report of two cases and literature review
Authors: Leila Abid, Faten Frikha, Zouhir Bahloul, Samir Kammoun
Journal: Pan Afr Med J (2011)
Keywords: antiphospholipid syndrome, acute myocardial infarction, coronarography
MeSH terms: Angioplasty, Balloon, Coronary / methods, Antiphospholipid Syndrome / complications, Myocardial Infarction / etiology, Case Reports, Review, Adult, Antibodies, Anticardiolipin / immunology, Anticoagulants / administration & dosage, Anticoagulants / therapeutic use, Antiphospholipid Syndrome / immunology, Emergencies, Female, Follow-Up Studies, Humans, Male, Myocardial Infarction / therapy, Stents, Antibodies, Anticardiolipin, Anticoagulants

Acute myocardial infarction (AMI) is rarely associated with antiphospholipid syndrome. The treatment of these patients is a clinical challenge. We report the observations of 2 young adults (1 woman and 1 man), admitted in our acute care unit for acute myocardial infarction (AMI). A coagulopathy work-up concludes the existence of antiphospholipid syndrome (APS) in the 2 cases. APS syndrome was considered primary in 2 cases. All patients presented an intense inflammatory syndrome (high level of CRP). Anticardiolipine was present in the 2 cases. However, anti B2 glycoprotein I antibodies were detected in only one case. Emergency percutaneous transluminal coronary angioplasty (PTCA) with direct stenting had been performed successfully only in the first case, and the follow-up was uncomplicated. Thereafter, long-term oral anticoagulant appeared to be effective. The last patient was admitted because of peripheral acute ischemia of legs. Standard electrocardiogram showed signs of previous silent anteroseptal wall myocardial infarction confirmed by echocardiography. The latter revealed an apical thrombus and a very low left ventricular ejection fraction. Amputation of the right leg was necessary because of consultation occurred too late. However, he died four weeks later. Primary antiphospholipid syndrome should be considered as a cause of acute myocardial infarction in young adults, and PTCA with anticoagulant treatment is effective for initial treatment of this complication.
Blood parasite load by qPCR as therapeutic monitoring in visceral leishmaniasis patients in Brazil: a case series study
Authors: Samuel Ricarte de Aquino, Lucyo Flávio Bezerra Diniz, Sávio Luiz Pereira Nunes, Roberta Lane de Oliveira Silva, Gisele Veneroni Gouveia, João José Simoni Gouveia, Kamila Gaudêncio da Silva Sales, Filipe Dantas-Torres, Rodrigo Feliciano do Carmo
Journal: Rev Soc Bras Med Trop (2023)
MeSH terms: Leishmania / genetics, Leishmaniasis, Visceral / diagnosis, Leishmaniasis, Visceral / drug therapy, Leishmaniasis, Visceral / parasitology, Brazil, DNA, Kinetoplast / genetics, Humans, Parasite Load, DNA, Kinetoplast

Background:
This study aimed to describe the kinetics of Leishmania parasite load determined using kinetoplast DNA (kDNA)-based quantitative polymerase chain reaction (qPCR) in visceral leishmaniasis (VL) patients.
Methods:
Parasite load in blood was assessed by qPCR at five time points, up to 12 months post-diagnosis. Sixteen patients were followed up.
Results:
A significant reduction in the parasite load was observed after treatment (P < 0.0001). One patient had an increased parasite load 3 months post-treatment and relapsed clinically at month six.
Conclusions:
We have described the use of kDNA-based qPCR in the post-treatment follow-up of VL cases.
A Case of GATA3 Positive Pleomorphic Liposarcoma, Epithelioid Variant: A Diagnostic Pitfall
Authors: Makoto Abe, Nobuo Hoshi, Sayuri Hoshi, Kaoru Hirabayashi, Kazutaka Kikuta, Toru Hirozane, Rumi Nakagawa, Tsukasa Mizuno, Hiroshi Nakamura, Koichi Inoue, Takehiko Yamaguchi
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Pleomorphic liposarcoma is a rare malignant adipocytic tumor showing undifferentiated pleomorphic sarcoma morphology with various degrees of epithelioid features. It is sometimes difficult to distinguish from carcinoma metastasis. Immunohistochemical panel is very important for differential diagnosis; however, there is a risk that unexpected staining could lead to misinterpretation. We report a pleomorphic liposarcoma, epithelioid variant, in an 88-year-old man, with tricky-positive staining for GATA3. Histological examination revealed a tumor with epithelioid morphology. The tumor consists of solid sheets of epithelioid tumor cells with focal aggregates of pleomorphic lipoblasts. Immunohistochemically, the adipocytic tumor cell areas were positive for S100 protein, and the epithelioid tumor cells showed CAM 5.2 positivity. GATA3 was diffusely positive. The combination of CAM 5.2 and GATA3 staining suggested the possibility of metastatic cancer, but systemic clinical examinations did not detect any presence of a primary tumor, including urinary bladder, breasts, and salivary glands. The pathological diagnosis of pleomorphic liposarcoma, epithelioid variant, was made because of the presence of malignant lipoblasts. Our report may contribute for differential diagnosis of pleomorphic liposarcoma, epithelioid variant, with unexpected positive immunoreaction for GATA3.
Supraventricular tachycardia and urticaria complicating leuprolide-induced ovarian suppression in a young woman with breast cancer: a case report
Authors: Sharan Prakash Sharma, Franco Muggia
Journal: Ecancermedicalscience (2013)
Keywords: breast cancer, gelatin, leuprolide, supraventricular tachycardia, urticaria
MeSH terms: Case Reports

Gonadotropin-releasing hormone (GnRH) agonists are used for gonadal suppression in the treatment of breast and prostate cancers. In older men, their use has occasionally been associated with cardiovascular side effects such as supraventricular tachyarrhythmias (SVTs). Several reports document their occurrence in men receiving leuprolide for prostate cancer. We now report this complication with concomitant occurrence of migratory trunk and extremity urticaria in a young woman receiving this treatment after diagnosis of a T1cN0 premenopausal breast cancer. Changing from leuprolide to another GnRH agonist, goserelin, no additional problems with SVT or accompanying urticaria were encountered during the nearly two years of treatment and three subsequent years of follow-up.
Costal chondrosarcoma mimicking a breast cancer: Case report and review of literature
Authors: Nesrine Tounsi, Ines Zemni, Nawel Abdelwahed, Ichraf Jbir, Lamia Charfi, Radhi Ben Nasser, Riadhe Chargui, Khaled Rahel
Journal: Int J Surg Case Rep (2019)
Keywords: case report, chondrosarcoma, reconstructive surgery, rib

Introduction:
Chondrosarcoma (CS) was the third most common primary bone malignancy. Frequently chondrosarcoma was occurring in long bones or in the pelvis. Their localization in the rib is rare.
Case presentation:
A 45-year-old male presented to our institution with a lump in the left breast. A physical exam revealed a large, fixed 10 cm mass occupied the entire right breast. Clinical presentation had supposed initially as a sarcoma of the breast. Preoperative unenhanced CT imaging showed well-defined round heterogeneous soft tissue density with hypo dense areas. A core-needle biopsy was taken, which was suggestive of chondrosarcoma grade II. The whole tumor was excised en-bloc along with 4th, 5th and 6th ribs. Reconstruction of the defect was undertaken with polypropylene plate and ipsilateral pedicle latissimus dorsi muscle flap was placed on the alloplastic mesh. The patient had an uneventful postoperative course and was discharged on the 10th postoperative day. No adjuvant treatment was administrated.
Conclusion:
En-bloc resection with appropriate margins and thanks to the evolution of reconstructive surgical techniques used to ensure preservation of respiratory mechanics. All this procedure represents the cornerstone and the only curative option.
Reconstruction of an anterior chest wall defect in a child using a latissimus dorsi muscle-thoraco-lumbar fascia composite flap - A case report
Authors: Mohammad M Al-Qattan, Waseem M Hajjar
Journal: Int J Surg Case Rep (2020)
Keywords: chest wall, children, latissimus dorsi muscle-thoraco-lumbar fascia composite flap, reconstruction
MeSH terms: Case Reports

Introduction:
Reconstruction of chest wall defects in children poses a challenge because the use of hard implants will impair chest wall growth. In this report, we demonstrate the reconstruction of a chest wall defect in a pediatric patient with an innovative technique using the latissimus dorsi muscle-thoraco-lumbar fascia composite flap.
Case report:
A 5-year old boy presented to the clinic with a congenital anterior right chest wall defect. Reconstruction was done using this composite flap. Drill holes were made in the sternum and remaining ribs at the edges of the chest wall defect. The muscle-fascia composite flap was then sutured over the defect using polypropylene sutures anchored to these drill holes. There were no post-operative complications. At final follow-up 11 years later, the chest wall depression was still present but to a lesser degree when compared to the pre-operative depression. There was no bulging of the lung through the defect.
Discussion:
The composite flap technique was compared to other options of chest wall reconstruction in children.
Conclusions:
Congenital anterior chest wall defects that are not associated with breathing problems may be reconstructed in early childhood with a pedicled latissimus dorsi muscle-thoraco-lumbar fascia composite flap. The flap is rigid enough to prevent bulging of the lung though the defect and hence, it provides an adequate reconstruction. However, the remaining chest wall depression and further chest wall rigidity requires a second operation after puberty.
Hypercalcemia-leukocytosis syndrome in a patient with cavitating squamous cell carcinoma of the lung
Authors: Olga Burzyantseva, Sanath Dharmasena, Suriya Jayawardena, Vijay A Rupanagudi, Padmanabhan Krishnan
Journal: Cases J (2009)

Introduction:
Lung cancer is the leading cause of death among the cancers seen in the United States. Hypercalcemia and leukocytosis are two common paraneoplastic syndromes associated with lung cancer. Unfortunately patients presenting with Hypercalcemia- leukocytosis syndrome has a worse prognosis than patients presenting with lung cancer alone.
Case presentation:
We present a 67 yr old Caucasian male with a history of active smoking presenting as pneumonia being diagnosed as cavitating squamous cell carcinoma of the lung with hypercalcemia-leukocytosis syndrome
Conclusion:
There should be a high degree of suspicion to diagnose lung cancer in patients presenting with symptoms of paraneoplastic syndrome.
A Recurrent Platinum Refractory Ovarian Cancer Patient With a Partial Response After RRx-001 Resensitization to Platinum Doublet
Authors: Hope Cottrill, Stephanie Cason, Scott Caroen, Bryan Oronsky, Elvis Donaldson
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: rrx-001, epithelial ovarian cancer, platinum doublet

This case report describes the clinical course of a heavily pretreated patient enrolled on the Phase II QUADRUPLE THREAT clinical trial (NCT02489903) with recurrent metastatic epithelial ovarian cancer that was previously treated with a platinum doublet and that benefited from another reintroduction of a platinum doublet after a brief priming period with RRx-001. Platinum-taxane combination is the initial treatment of choice in ovarian cancer and the "go-to regimen" for patients with recurrent, platinum-sensitive disease. However, platinum resistance is an inevitable and uniformly fatal development. One of the "Holy Grails" in ovarian cancer, besides early detection, is to reverse this resistance and retreat with a platinum doublet regimen. Because of the correlation between therapeutic resistance and poor clinical outcomes, this case, which potentially demonstrates a new avenue of anticancer development in epithelial ovarian cancer provided it is repeatable with other ovarian patients, was felt to merit a report.
Metastatic Clear Cell Renal Cell Carcinoma to Pancreas and Distant Organs 24 Years After Radical Nephrectomy: A Case Report and Literature Review
Authors: Huawei Cao, Zejia Sun, Jiyue Wu, Changzhen Hao, Wei Wang
Journal: Front Surg (2022)
Keywords: clear cell renal cell carcinoma, combinatorial treatment, metastasectomy, pancreatic metastasis, systemic therapy
MeSH terms: Case Reports

Background:
Clear cell renal cell carcinoma (CCRCC) is a common urological neoplasm, and even though surgical resection is effective for localized CCRCC, the prognosis of metastatic CCRCC is poor. Currently, there is a paucity of recognized effective therapeutic protocols for metastatic CCRCC.
Case presentation:
A 76-year-old Asian man underwent radical left nephrectomy for CCRCC 26 years ago; this patient visited our hospital with abdominal pain due to multiple abdominal metastases 24 years after the nephrectomy. After metastasectomy, he underwent targeted therapy combined with a programmed death receptor-1 (PD-1) inhibitor, and the current imaging results indicate remarkable tumor remission.
Conclusions:
Metachronous pancreatic metastasis from CCRCC after nephrectomy is rare, but clinicians and patients should not ignore this possibility. The combination of targeted therapy and immunotherapy can result in satisfactory outcomes in cases where metastatic CCRCC continues to progress despite metastasectomy and targeted therapy. The combination of local and systemic therapy can be an effective therapeutic protocol for metastatic CCRCC, but there is no consensus on suitable therapeutics.
Pancreatic kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon: A rare entity
Authors: Denny Mathew, Nasreen Mahomed
Journal: SA J Radiol (2019)
Keywords: paediatric radiology, paediatric surgery, paediatrics, pancreas vascular tumours, radiology
MeSH terms: Case Reports

Primary pancreatic tumours are a rare and unusual entity in children. In this article, we present the case of an 8-month-old girl who presented with obstructive jaundice. The differential diagnosis based on imaging studies was that of a pancreatic vascular neoplasm; however, with the laboratory evidence of Kasabach-Merritt phenomenon (KMP), this prompted the diagnosis of pancreatic kaposiform hemangioendothelioma. A core biopsy of the pancreatic mass was taken at laparotomy and confirmed this diagnosis. The pancreas is an exceedingly rare site of occurrence for this tumour, with only nine cases being published to date. The clinical, biochemical, imaging and pathological findings are discussed to highlight a rare and potentially life-threatening vascular tumour.