OpenMed/multicare-articles huggingface dataset:
HER-2-positive primary neuroendocrine neoplasms of the breast with signet ring feature: A case report and review of literature
Authors: Yunjin Li, Yi Cao, Xiaoying Wu, Ruijie Liu, Kuansong Wang
Journal: Front Oncol (2022)
Keywords: her-2 positive, breast cancer, neuroendocrine neoplasm, review, signet ring feature
MeSH terms: Review

Background:
Primary neuroendocrine neoplasm of the breast (BNEN) is an uncommon breast neoplasm, and in most cases, it presents as hormone receptors positive and HER-2 negative. Moreover, in neuroendocrine neoplasms (NENs), the signet ring feature is a rare morphological subtype, and only a few cases have been reported. Here, we report the case of a primary breast neuroendocrine neoplasm with an unusual signet ring cell appearance in this paper. The documentation of this case, combined with a review of the literature, may add to existing knowledge about the outcome and management of this rare tumor.
Methods:
In the present review, we describe a unique case of HER-2-positive primary BNEN with a signet ring feature that has not been reported in English. Additionally, we performed a literature search of the PubMed and Web of Science databases and calculated statistics for clinical data and follow-up.
Results:
Our literature search, excluding non-English literature, identified 15 articles with data from 24 cases, including ours. The mean age was 51.25 years (range, 30-79 years), and there were 13 male patients (54%) and 11 female patients (46%). Of the 24 cases, some cases (11/24) were associated with lymph node metastases, a few cases (6/24) had distant metastasis, and the vast majority of cases (23/24) occurred in the digestive system. Primary hepatic signet ring cell neuroendocrine tumor showed slow progression and good prognosis. Lymph node involvement was identified in one of eight (12.5%) documented cases, and one of eight (12.5%) reported cases presented with distant metastatic disease. However, the prognosis of neuroendocrine tumors with signet ring cells in the pancreas and stomach was poor. Lymph node involvement was identified in 9 of 15 (60%) documented cases, and 5 of 15 (33.3%) reported cases presented with distant metastatic disease.
Conclusion:
NENs with a signet ring feature is uncommon, and this is the first case report of its occurrence in the breast. Current knowledge is limited to anecdotal experience based on case reports and small case series. We provide a literature review to summarize knowledge about this rare entity.
Dentofacial Deformity Caused by Bulky Osteochondroma: Report of an Unusual Case and the Importance of Cone Beam Computed Tomography
Authors: Weeraya Tantanapornkul, Kittipong Dhanuthai, Phonkit Sinpitaksakul, Chumpot Itthichaisri, Paksinee Kamolratanakul, Vacharee Changsirivatanathamrong
Journal: Open Dent J (2017)
Keywords: condyle, conebeam ct, dentofacial deformity, osteochondroma, tomography
MeSH terms: Case Reports

Introduction:
Osteochondroma of mandibular condyle is a rare benign tumor.
Case report:
This case report described clinical, radiographic features, differential diagnosis, histopathologic correlation and treatment of condylar osteochondroma.
Conclusion:
Conebeam computed tomography (CBCT) is an alternative modality to CT or MRI that should be performed in all cases of suspected osteochondroma of the mandibular condyle.
Abernethy malformation: beware in cases of unexplained hepatic encephalopathy in adults-case report and review of the relevant literature
Authors: Romeu Duarte Mesquita, Marta Sousa, Filipa Vilaverde, Rosa Cardoso
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

The Abernethy malformation consists of a congenital extrahepatic portosystemic shunt and is believed to be extremely rare in humans. The potential implications of abnormal portovenous shunting and decreased hepatic portal flow are numerous and potentially serious. Although congenital extrahepatic portosystemic shunts are increasingly suspected and diagnosed in specialized centres, much of their clinical presentation and natural history is not fully understood. Symptoms of portosystemic shunt are mainly caused by increased levels of ammonia, which lead to signs of encephalopathy. Therapeutic options depend on the type of shunt and its clinical course, so the classification of the congenital portosystemic shunt is a key finding in these patients.
Benign Duodenal Stricture Treated with Surgical Correction and Dietary Therapy in a Golden Retriever
Authors: John C Rowe, Alice A Huang, Jin Heo, Nolie K Parnell, Adam J Rudinsky
Journal: Case Rep Vet Med (2020)
MeSH terms: Case Reports

A benign duodenal stricture is a well-documented condition of humans that has not been characterized in dogs. In this case report, the clinical, radiographic, ultrasonographic, endoscopic, surgical, and histopathologic findings of a single benign duodenal stricture in a Golden Retriever are reported. Definitive diagnosis was made possible with the utilization of esophagogastroduodenoscopy (EGD). Surgical correction of the stricture, paired with dietary therapy that utilized a highly digestible diet, resolved the clinical signs in the case reported. Several inciting causes were identified as possible drivers of stricture formation, including nonsteroidal anti-inflammatory drug (NSAID) administration, mucosal ulceration, traumatic injury, or inflammatory intestinal disease. A benign duodenal stricture should be considered an infrequent cause of intermittent, chronic gastrointestinal signs that may have a favorable outcome via surgical correction and dietary management.
Stewart-Treves syndrome: a case report
Authors: Anis Benmansour, Saad Laanaz, Abdeslam Bougtab
Journal: Pan Afr Med J (2014)
Keywords: stewart–treves, angiosarcoma, syndrome
MeSH terms: Breast Neoplasms / surgery, Hemangiosarcoma / diagnosis, Lymphangiosarcoma / diagnosis, Mastectomy / adverse effects, Case Reports, Aged, Female, Hemangiosarcoma / pathology, Hemangiosarcoma / therapy, Humans, Lymphangiosarcoma / pathology, Lymphangiosarcoma / therapy, Stewart Treves syndrome

The Stewart-Treves syndrome was first described in 1948, it's an angiosarcoma developed on a longstanding lymphadenomatous limb, more often after radical mastectomy. Diagnosis is made on skin biopsy and the prognosis is poor when radical surgery can't be performed. We report the case on a Stewart-Treves syndrome in a sixty-six years old woman who underwent radical mastectomy for breast carcinoma ten years earlier. Surgery was not feasible at the time of diagnosis, and we lost touch of the patient even if chemotherapy was decided. Radical surgery is the best treatment to date for this rare disease. Conservative surgery with adjuvant radiotherapy is also possible. Systemic chemotherapy is reserved for locally advanced unresectable and metastatic forms. We advocate long term follow-up for every post mastectomy lymphedema to diagnosis this fatal disease when curable.
Comprehensive Review and Case Study on the Management of Buried Penis Syndrome and Related Panniculectomy
Authors: Hadley Burns, J Stephen Gunn, Saeed Chowdhry, Thomas Lee, Steven Schulz, Bradon J Wilhelmi
Journal: Eplasty (2018)
Keywords: buried penis, panniculectomy, penis externalization, penoplasty, reconstruction

Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue. Thoughtful planning and coordination between plastic surgery and urology were paramount to externalize the penis for an excellent functional and cosmetic result. Conclusions: Management of a buried, hidden penis is complex and difficult. Patients are often obese and have poor hygiene due to the inability to cleanse areas that are entrapped by excessive fat. Following removal of the overhanging panniculus, satisfactory reconstruction of a hidden penis is possible when proper care is taken to adhere the base of the penis to the pubis. Split-thickness skin grafts are often necessary but depend on the viability of the penile skin and whether it is restricting penile length. Complications with wound dehiscence and infection are not uncommon; however, patients generally recover well, are satisfied with results, and are reported to have fully regained urinary and sexual functions following surgical correction of the buried penis.
Exploring the Feasibility and Effects of a Ketogenic Diet in Patients With CNS Malignancies: A Retrospective Case Series
Authors: Cristina M Panhans, Gillian Gresham, L J Amaral, Jethro Hu
Journal: Front Neurosci (2020)
Keywords: atkins, warburg effect, astrocytoma, glioblastoma, glioma, ketogenic diet, ketosis, metabolic therapy

Background: Recently, the ketogenic diet has been proposed as an adjunct treatment for a range of medical conditions including weight loss, diabetes, cancer, and neurodegenerative diseases. Because malignant CNS tumors are highly dependent on glucose, the use of a ketogenic diet as an adjunct therapy is currently being explored. This case series summarizes our experience implementing a ketogenic diet for patients with CNS malignancies. Methods: Patients diagnosed with CNS malignancies following a ketogenic diet were identified between 2015 and 2017. Malignancies included confirmed diagnoses of glioblastoma (GBM), astrocytoma, or oligodendroglioma. With guidance from a registered dietitian, ketone levels, glucose levels, and weight were regularly collected for several patients along with patient-reported symptoms and adverse effects. Interested patients were asked to follow a 3:1 ketogenic diet for 120 days. The ketogenic diet is a high-fat, moderate protein, and very low carbohydrate diet, where patients limited carbohydrate intake to ≤20 g per day. Brain imaging was reviewed. A series of descriptive analyses were conducted. Results: The ketogenic diet was initiated in 12 patients of which 8 patients contributed data on their blood glucose and ketone levels. The majority of patients were male (n = 10) with a median age of 45 (range 32-62). Diagnoses included GBM (n = 6), grade 2/3 astrocytomas (n = 5) and one patient with a grade 2 spinal cord astrocytoma. Ten of the 12 patients were receiving concurrent treatment; two received supportive care only. The majority of patients with evaluable data (n = 8) maintained ketone levels above 0.5 mM for the duration of 120-day period. Ketone levels generally increased from baseline while glucose levels and BMI decreased. Overall, patients reported improved symptoms over the course of the diet. Imaging also suggested improved disease control and reduction in vasogenic edema. Conclusion: Taking advantage of a tumor's metabolic inflexibility can have a positive impact on patients, particularly those with CNS malignancies. More structured and statistically planned clinical trials are needed to determine the margin of impact of a ketogenic diet.
Anesthetic consideration for airway management of patients undergoing endoscopic fibrin glue treatment of tracheobronchial rupture: a case series of three patients
Authors: Vincenzo Pota, Pasquale Sansone, Alfonso Fiorelli, Maria Beatrice Passavanti, Mauro D'Amora, Paola Vosa, Elena Bignami, Maria Caterina Pace, Caterina Aurilio
Journal: Perioper Med (Lond) (2018)
Keywords: airway management, case report, tracheobronchial ruptures

Tracheobronchial ruptures are very severe and life-threatening injuries. The origin of such airway damage is trauma or an iatrogenic event. Last year, we operated on three different cases of tracheal ruptures using endobronchial suture with three different airway management. We exposed the description of three different techniques to manage the airway during an endoscopic suture of tracheobronchial rupture with fibrin glue (laryngeal mask, orotracheal tube positioned distally the lesion, one lung ventilation with a small size single tube). Using this kind of technique, we have obtained a protective ventilation on tracheal rupture, a rapid healing, and fast recovery of spontaneous breathing.
Closure of a giant saphenous vein graft aneurysm with embolization coil
Authors: Ashwani Kumar, Dixon Santana, Leigh Ann Jenkins
Journal: Cardiol Res Pract (2009)
MeSH terms: Case Reports

Aneurysms of saphenous vein grafts (SVGs) to coronary arteries are rare, usually asymptomatic and found incidentally. We report a case of an 84-year-old female who was found to have 8.1 x 8.4 cm aneurysm of an SVG to obtuse marginal (OM) artery. The aneurysm was prior to the distal anastamosis but no flow into the OM artery was noted. Cook Tornado Embolization Coils were used successfully to occlude the SVG proximal to the aneurysm. No complications occurred. The use of embolization coils is an effective and safe method for aneurysm occlusion when the anatomy is suitable and especially when patient is high risk for repeat surgical intervention.
Targeted Therapy Followed by Salvage Surgery and Adjuvant Therapy: A Promising Therapy for Lung Cancer With Malignant Pleural Effusion From a Case Report
Authors: Han-Yu Deng, Deyan Li, Ying Ren, Ke Wang, Xiaojun Tang
Journal: Front Surg (2021)
Keywords: adjuvant therapy, lung cancer, malignant pleural effusion, salvage surgery, targeted therapy
MeSH terms: Case Reports

Introduction: Malignant pleural effusion was encountered in about 8-15% of lung cancer patients at initial cancer diagnosis. The optimal therapeutic strategies for lung cancer with malignant pleural effusion (MPE) remain unclear. Case Description: In this study, we reported a case of lung cancer with MPE, which was successfully managed with a multidisciplinary therapeutic strategy. The patient initially received gefitinib for 4 months with excellent response and he underwent salvage thoracoscopic lobectomy and systematic lymphadenectomy. Pathological complete response was confirmed for the patient and he discontinued gefitinib but received 4 cycles of adjuvant chemotherapy instead. The patient is still alive without disease progression for 62 months after surgery. Conclusions: Combining targeted therapy, salvage surgery, and adjuvant therapy may be a promising treatment strategy for lung cancer with MPE harboring oncogene-targeted mutations.
Debromoaplysiatoxin as the Causative Agent of Dermatitis in a Dog after Exposure to Freshwater in California
Authors: Birgit Puschner, Adrienne C Bautista, Chris Wong
Journal: Front Vet Sci (2017)
Keywords: lyngbya sp, cyanobacteria, cyanotoxins, debromoaplysiatoxin, dog, skin irritation, toxicosis
MeSH terms: Case Reports

Contamination of recreational waters with cyanobacterial toxins continues to increase and presents a risk to animals and humans. Although cases of acute hepato- and neurotoxicoses in dogs following cyanotoxin exposure exist, no reports of skin-related reactions in dogs exist. A 5-year-old female spayed 34 kg Bracco Italiano was initially presented for rapid onset of severe pruritus and urticaria. Marked excoriation and erythema were noted over the chest and neck, while urticaria was noted in the inguinal regions and ventral abdomen. Initial basic dermatology work-up excluded parasitic, fungal, and bacterial organisms. Due to the severity and progression of urticaria, the dog received IV dexamethasone and IM diphenhydramine. Improvement of the urticaria and the dog's clinical status was noted over the next 45 min. Assessment of the dog's environment revealed access to a lake on the property with visible algal bloom. Water from the lake was submitted for toxicology testing and revealed the presence of debromoaplysiatoxin. Access to the lake was discontinued and follow-up evaluation over the next few weeks revealed a complete resolution of the skin irritation. To the authors' knowledge, this is the first case report of debromoaplysiatoxin exposure in a dog after swimming in cyanobacteria-contaminated water. Veterinarians should recognize the potential harm that contaminated waters may cause in terms of dermal, hepatic, and neurological conditions. In addition, more prudent oversight of contaminated recreational waters is recommended for animals and humans to prevent adverse events and intoxications.
Alteration of ACTH and Cortisol Levels After Estradiol Valerate Treatment in a Male Subject With Gender Dysphoria: A Case Report
Authors: Takatoshi Anno, Fumiko Kawasaki, Ryo Shigemoto, Shintaro Irie, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: acth, cortisol, estradiol levels, estrogen replacement therapy, male-to-female transsexual subjects
MeSH terms: Case Reports

Background: The number of subjects with gender dysphoria has been increasing. In general, male-to-female transsexual subjects are treated with estradiol valerate therapy. In this report, we showed the time course of ACTH and cortisol levels after estradiol valerate injection in a male subject with gender dysphoria. It seemed that alteration of estradiol levels influenced ACTH and cortisol levels via some pathway. Case presentation: A 31-year-old man with estradiol valerate therapy for gender dysphoria was referred due to an elevation of serum cortisol levels. She started hormone therapy at 26 years old. Her laboratory analyses showed an elevation of plasma ACTH and cortisol levels. There were no remarkable changes in the adrenal gland and pituitary gland. Her estradiol levels were elevated 7 days after estradiol valerate injection, but they were not detected 18 days after such treatment. Interestingly, plasma ACTH and serum cortisol levels were moderately decreased 7 days after estradiol valerate injection, but both were markedly elevated 18 days after such treatment. Conclusions: We should bear in mind the possibility of elevation in plasma ACTH and serum cortisol levels when we start estradiol valerate injection in subjects with gender dysphoria. In addition, we may need to check ACTH and cortisol levels when we use estrogen replacement therapy for a long period of time in subjects with gender dysphoria.
Closed reduction of bilateral posterior shoulder dislocation with medium impression defect of the humeral head: a case report and review of its treatment
Authors: Soorena Rezazadeh, Amir Reza Vosoughi
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Bilateral dislocation of the shoulder is a rare injury. The main causes are electrical shock, extreme trauma, and epilepsy. A 25-year-old athletic-body man had sustained bilateral shoulder pain and restricted external rotation following electrical shock for five days. Although articular surface damage was about 50% in the right side and 30% in the left, it could be managed successfully by close reduction without pinning. During one-year follow-up, no recurrent dislocation or limitation of motion was seen. Closed management of medium size defect of the humeral head after posterior dislocation can be performed in cooperative and especially muscular patients.
Lyme Carditis Buried Beneath ST-Segment Elevations
Authors: Basia Michalski, Adrian Umpierrez De Reguero
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Lyme disease is caused by the spirochete Borrelia burgdorferi and is carried to human hosts by infected ticks. There are nearly 30,000 cases of Lyme disease reported to the CDC each year, with 3-4% of those cases reporting Lyme carditis. The most common manifestation of Lyme carditis is partial heart block following bacterial-induced inflammation of the conducting nodes. Here we report a 45-year-old gentleman that presented to the hospital with intense nonradiating chest pressure and tightness. Lab studies were remarkable for elevated troponins. EKG demonstrated normal sinus rhythm with mild ST elevations. Three weeks prior to hospital presentation, patient had gone hunting near Madison. One week prior to admission, he noticed an erythematous lesion on his right shoulder. Because of his constellation of history, arthralgias, and carditis, he was started on ceftriaxone to treat probable Lyme disease. This case illustrates the importance of thorough history taking and extensive physical examination when assessing a case of possible acute myocardial infarction. Because Lyme carditis is reversible, recognition of this syndrome in young patients, whether in the form of AV block, myocarditis, or acute myocardial ischemia, is critical to the initiation of appropriate antibiotics in order to prevent permanent heart block, or even death.
The recognition of oral manifestations of haematological disease saves lives: a case report
Authors: Fabienne Aurora, Anita Arasaretnam, Andrew Hobkirk
Journal: Bull Natl Res Cent (2022)
Keywords: covid-19, diagnosis, leukaemia, oral manifestations, oral surgery
MeSH terms: Case Reports

Background:
Acute Leukaemias are haematological disorders characterised by the proliferation of immature white blood cells in the bone marrow and/or peripheral blood. Oral manifestations of leukaemia are common and may be the first sign of the disease. The clinical presentation of these Acute Leukaemias may include neutropenic sepsis, hyperviscocity and coagulopathy which confer a potential morbidity and mortality. Clinicians must be able to recognise this pattern of presentation.
Case report:
We report a 34-year-old female who was referred to the Oral and Maxillofacial Surgery department with acute dental pain and pericoronitis. She subsequently had a simple dental extraction but re-presented with a bleeding socket that did not respond to local treatment. Investigation of this led to a diagnosis of Acute Promyelocytic Leukemia (APL). She was admitted under the care of the haematology team for urgent, life-saving, treatment.
Conclusions:
Early diagnosis and treatment of the Acute Leukaemias can be life saving. The oral manifestations of disease are common and may be the first sign. Clinicians must be able to recognise this pattern of presentation and arrange urgent investigation and specialist management.
Clinical/cpd relevance:
This case report discusses leukaemia and highlights the important role General Dental Practitioners can play in early diagnosis. We frame a safe approach to managing these patients in a typical case. Whilst this disease subtype is rare, the learning points can be universally applied.
Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents
Authors: Iliyana H Pacheva, Ivan S Ivanov, Krastina Stefanova, Elena Chepisheva, Lyubov Chochkova, Dafina Grozeva, Angelina Stoyanova, Stojan Milenkov, Penka Stefanova, Anna Petrova
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009-2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0.9%) had CNS involvement presenting as Posterior Reversible Encephalopathy Syndrome (PRES), which may be a result of CNS vasculitis or arterial hypertension. It was an 8-year-old girl with atypical HSP which started with abdominal pain requiring surgery. On the third day after the operation a transient macular rash and arterial hypertension appeared, followed by visual disturbances, hemiconvulsive epileptic seizures, postictal hemiparesis, and confusion. Head CT showed occipital hypodense lesions and MRT-T2 hyperintense lesion in the left occipital lobe. The patient experienced a second similar episode after 2 weeks when palpable purpura had also appeared. Neurological symptoms and MRI resolved completely. HSP can be an etiological factor for PRES in childhood. Although PRES is a rare complication of HSP, clinicians must be aware of it and avoid diagnostic and therapeutic delays.