OpenMed/multicare-articles huggingface dataset:
Paraneoplastic proteinuria in papillary renal cell carcinoma; a case report
Authors: Fatemeh Yaghoubi, Maliheh Yarmohammadi, Mohammad Vasei
Journal: J Renal Inj Prev (2016)
Keywords: nephrotic syndrome, paraneoplastic glomerulopathy, renal cell carcinoma
MeSH terms: Case Reports

We report a 55-year-old man presented with anemia and weakness, history of flank pain, hematuria and nephrotic syndrome. Spiral abdominopelvic computerized tomography (CT) scan showed multiloculated cystic mass (120 ×100 ×80 mm) in lower portion of left kidney with internal enhancing solid components and coarse peripheral calcifications. Radical nephrectomy of left kidney was done and biopsy confirmed renal cell carcinoma (RCC), papillary type, sarcomatoid foci, Fuhrman grade III. We assumed that, presence of nephrotic syndrome and paraneoplastic glomerulopathy leaded to heavy proteinuria in this case. Secondary, paraneoplastic glomerulopathy such as immunoglobulin A nephropathy and focal segmental glomerulosclerosis as a paraneoplastic syndrome of RCC have been reported previously. RCC can present with a wide range of signs and symptoms. Atypical presentations of papillary RCC such as proteinuria should be considered for patients presenting with nephrotic syndrome.
Sinonasal Melanoma: A Case Report and Literature Review
Authors: I S S Alves, L G S Berriel, R T Alves, M B Pinto, C F P Oliveira, A C Cazzotto, W V Moura
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Purpose. Sinonasal malignant mucosal melanoma is a rare, aggressive tumour. Nasal obstruction and epistaxis are the most commonly reported symptoms, although symptomatology may develop late and be nonspecific, which tends to delay diagnosis, resulting in a poorer prognosis. Case Report. This report describes a 64-year-old male patient with nasal obstruction and epistaxis. Computed tomography of the facial sinuses revealed a large lesion in the right nasal cavity, with infiltration into the left cavity, ethmoidal cells, and erosion of the cribriform plate. Initial incisional biopsy revealed an undifferentiated carcinoma of the right maxillary sinus, staged as T4aN0M0. Induction chemotherapy was initiated with cisplatin and etoposide. Response to treatment was complete. The patient was then submitted to radiotherapy with concomitant cisplatin. Immunochemical analysis revealed positivity for vimentin, S100, and HMB-45 (human melanoma black 45), a result compatible with a diagnosis of malignant melanoma. Discussion. Due to the rarity of the tumour and the patient's complete response to chemotherapy and since no blackened lesion had been found at the previous exam, treatment was continued as planned. The patient remains healthy, with no metastasis or recurrence. He is currently being monitored by the clinical oncology team.
Ventricular Septal Rupture After Blunt Chest Trauma in an Infant: A Case Report and Mini-Review
Authors: Xu Zhu, Xiaojuan Ji, Chun Wu, Harvey Ho, Kunfeng Jiang, Yanqin Wang, Ke Bai
Journal: Front Pediatr (2020)
Keywords: blunt chest trauma, echocardiography, infant, therapy, ventricular septal rupture
MeSH terms: Case Reports

Ventricular septal rupture (VSR) due to blunt chest trauma (BCT) is rare in infants. Traumatic VSR should be considered in infants with acute congestive cardiac failure following blunt trauma to the chest. Echocardiography is the method of choice for diagnosis and guiding the management of VSR. In this case report, we present a case of VSR caused by BCT in a 1-year and 9-month-old infant, who was diagnosed by emergency bedside echocardiography. We also provide a mini-review of literatures on BCT-induced VSR in children.
A Case of a Paracardial Osteophyte Causing Atrial Compression
Authors: Stergios Tzikas, Konstantinos Triantafyllou, Christodoulos Papadopoulos, Vassilios Vassilikos
Journal: Case Rep Med (2016)
MeSH terms: Case Reports

Osteophytes are pointed or beaked osseous outgrowths at the margins of articular surfaces that are often associated with degenerative changes of articular cartilage. They are the most common aspect of osteoarthritis and they infrequently cause symptoms by compression of the adjacent anatomic structures, such as nerves, vessels, bronchi, and esophagus. We present here a rare case of a patient with a left atrial deformation by a large osteophyte.
Isolated Renal Calyceal Urothelial Carcinoma Effectively Treated With PD-1 Inhibitor Alone: A Case Report And Literature Review
Authors: Shihao Li, Yi Zhu, Zhijian Xu, Jianjun Liu, Hongwei Liu
Journal: Front Oncol (2022)
Keywords: immunotherapy, isolated kidney, programmed cell death protein-1 inhibitor, tislelizumab, urothelial carcinoma
MeSH terms: Case Reports

The discovery of immune checkpoint inhibitors (ICIs) represents a significant step forward in the battle against malignant tumors. In a number of advanced malignancies, ICIs, such as antibodies to programmed cell death protein-1 inhibitor (PD-1) and its ligand, programmed death-ligand 1 (PD-L1), have shown good therapeutic benefits. A 71-year-old male patient was diagnosed with solitary renal calyceal urothelial cancer. The space-occupying lesion in the upper calyx of the left kidney dramatically decreased after 13 treatments with a PD-1 inhibitor (tislelizumab) alone, and the tumor reached partial remission. This case suggests that a PD-1 inhibitor (tislelizumab) alone may be an effective treatment strategy for solitary renal calyceal urothelial carcinoma.
Massive Uterine Leiomyoma in a Patient with Friedreich's Ataxia: Is There a Possible Association?
Authors: Evangelos P Misiakos, Elli Siama, Dimitrios Schizas, Constantinos Petropoulos, Nikos Zavras, Nikos Economopoulos, Alexandros Charalabopoulos, Anastasios Macheras
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

A possible association between Friedreich's ataxia (FA) and neoplastic development has been recognized. FA patients have low frataxin levels and insufficient response to oxidative stress. In these patients fibroblasts are characterized by a high rate of mutations. Herein, a case of a 39-year-old woman with FA tetraplegia, who was admitted in our department with intestinal obstruction due to a huge uterine tumor, is described. An abdominal CT revealed a huge intra-abdominal mass originating from the right cornu of the uterus. Tumor excision and adhesionlysis were performed. The histological examination of the tumor revealed a leiomyoma. FA patients seem to present with a variety of neoplasms uncommon for their young age. This is the first report of a leiomyoma originating from the genital system in a female patient with FA tetraplegia. Therefore it is important to identify neoplasms at an early stage in patients with FA and start immediate therapy.
A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis
Authors: Anusha Battineni, Naresh Mullaguri, Shail Thanki, Anand Chockalingam, Raghav Govindarajan
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Introduction:
Patients with myasthenia crisis can develop Takotsubo stress cardiomyopathy (SC) due to emotional or physical stress and high level of circulating catecholamines. We report a patient who developed recurrent Takotsubo cardiomyopathy during myasthenia crisis. Coexisting autoimmune disorders known to precipitate stress cardiomyopathy like Grave's disease need to be evaluated.
Case report:
A 69-year-old female with seropositive myasthenia gravis (MG), Grave's disease, and coronary artery disease on monthly infusion of intravenous immunoglobulin (IVIG), prednisone, pyridostigmine, and methimazole presented with shortness of breath and chest pain. Electrocardiogram (ECG) showed ST elevation in anterolateral leads with troponemia. Coronary angiogram was unremarkable for occlusive coronary disease with left ventriculogram showing reduced wall motion with apical and mid left ventricle (LV) hypokinesis suggestive of Takotsubo stress cardiomyopathy. Her symptoms were attributed to MG crisis. Her symptoms, ECG, and echocardiographic findings resolved after five cycles of plasma exchange (PLEX). She had another similar episode one year later during myasthenia crisis with subsequent resolution in 10 days after PLEX.
Conclusion:
Takotsubo cardiomyopathy can be one of the manifestations of myasthenia crisis with or without coexisting Grave's disease. These patients might benefit from meticulous fluid status and cardiac monitoring while administering rescue treatments like IVIG and PLEX.
Avulsion of Permanent Mandibular Incisors: A Report of Two Cases with Pertinent Literature
Authors: Ibadat Preet Kaur, Jitendra Sharan, Pallawi Sinha, Ashok Kumar, Anand Marya
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Introduction. This study reports two rare cases of avulsion of permanent mandibular incisors with their sequelae after being reimplanted by two contrary methods. The relevant literature regarding the avulsion of permanent mandibular incisors is also being discussed. Case Presentation. In Case I, a 9-year-old girl reported an avulsion of the permanent mandibular left lateral incisor that was immediately reimplanted within 20 minutes after injury, whereas in Case II, all four permanent mandibular incisors were avulsed and reimplanted after a prolonged extraoral dry time of 36 hours in an 18-year-old female. Both cases missed their scheduled follow-up visits and were reported after 3.5 years and 7 months, respectively, with severe root and alveolar bone resorption that was confirmed by clinical examination and Intra oral periapical radiograph (IOPA) radiographs. Discussion. Avulsion of permanent mandibular incisors is rare. The similar unfavorable outcome of contrary cases at a variable duration of time after missed follow-up illustrates the role of the appropriate treatment protocol and regular follow-up visits for the long-term success of reimplanted teeth.
Case Report: Mitral valve obstruction by metastatic malignant phyllodes tumor
Authors: Chamtouri Ikram, Amdouni Nesrine, Kaddoussi Rania, Ahlem Bellalah, Kortas Chokri, Achour Asma, Joober Sameh, Maatouk Faouzi
Journal: F1000Res (2022)
Keywords: breast cancer, acute heart failure, cardiac metastasis, mitral stenosis
MeSH terms: Breast Neoplasms / complications, Heart Neoplasms / complications, Heart Neoplasms / pathology, Heart Neoplasms / surgery, Lung Neoplasms, Phyllodes Tumor / complications, Phyllodes Tumor / pathology, Phyllodes Tumor / surgery, Case Reports, Adult, Female, Humans, Mitral Valve / surgery, Neoplasm Recurrence, Local

Cardiac metastases are rare. Herein, we report a case of a 37-year-old female patient with a history of borderline breast phyllodes tumor (PT) treated by surgery, admitted to our department for concomitant cardiac and pulmonary metastases of malignant PT. Cardiac metastasis occurred through direct extension from pulmonary metastasis to the left atrium via the right inferior pulmonary vein, causing severe mitral valve obstruction. Although the total surgical removal of metastases, the patient had a huge relapse of the mediastinal metastasis resulting in her death.
Posterior common femoral branch pseudoaneurysm: an unusual arterial complication following femoral venous access
Authors: James Davies, James Metcalfe, Robert Ward
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 70-year-old male presented with groin pain and swelling 11 days following a pulmonary vein isolation procedure via an unguided femoral venous puncture for atrial fibrillation. On the fourth visit, his haemoglobin level had dropped from 14.2 gl-1 to 10.7g l-1. Repeat duplex imaging revealed a large haematoma with deep flow. A CT angiogram revealed a pseudoaneurysm of a right common femoral branch artery. A subsequent angiogram revealed active bleeding, and the feeding artery was coiled. Pseudoaneurysms are recognized complications of vascular intervention, but more commonly occur anteriorly in major vessels. This elusive presentation reminds us of several important points. First, with the increasing use of interventional techniques across all medical specialties, the use of image guidance to aid vessel access is paramount for safety; not all specialties currently practise this routinely. Furthermore, we should consider arterial injury in all patients, including those who have had venous puncture. Injuries may not necessarily occur at the anterior vessel wall, and may well be deeper. Finally, there should be a low threshold for alternative imaging if symptoms are out of context with clinical findings.
Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis
Authors: Houssam Khodor Abtar, Mostapha Mneimneh, Mazen M Hammoud, Ahmed Zaaroura, Yasmina S Papas
Journal: Case Rep Surg (2016)

Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula), bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.
Case Report: Neuroleptic malignant syndrome in a HIV-positive patient
Authors: Sibi Joseph, Jerry George, Mongezi Tau, Lourdes de Fatima Ibanez-Valdes, Thozama Dubula, Humberto Foyaca-Sibat
Journal: F1000Res (2020)
Keywords: hiv, neuroleptic malignant syndrome, elevated creatine kinase, neuroleptic side effects, permanent focal simple motor seizure
MeSH terms: Case Reports

We report a 29-year-old, HIV-positive woman being treated with antipsychotic medication for psychosis (Clopixol 200mg intramuscularly monthly, Risperidone 2mg orally daily Haloperidol 2.5mg twice a day), who presented with neuroleptic malignant syndrome. She was also receiving lorazepam and sodium valproate. The patient was referred to our department as she had developed involuntary upper limb movements and simple permanent focal seizure on the lower part of the left hemiface. Clinically the patient had altered consciousness, autonomic dysfunction, and rigidity. Her blood tests showed elevated creatine kinase (1467U/L) but no leucocytosis. We did a thorough workup for other causes of such a presentation. A comprehensive history was taken from the family to exclude other medications used. Her cerebrospinal fluid results were average. Blood tests did not show evidence of infection or other abnormalities. Computed tomography brain was normal. The patient died a few days after the beginning of the attack, which we have also observed in other HIV-female patients. As far as we know, it is the first report about this comorbidity reported in the medical literature.
Safe and effective implantation and use of vagal nerve stimulation in new-onset refractory status epilepticus in early pregnancy: a case report
Authors: Malaika Jindal, Laura Delaj, Joel Winston, Rishu Goel, Sadia Bhatti, Milena Angelova-Chee, Richard Selway, Laura Mantoan Ritter
Journal: Front Neurol (2023)
Keywords: norse, vns, outcomes, pregnancy, status epilepticus
MeSH terms: Case Reports

Introduction:
The management of new-onset refractory status epilepticus (NORSE) in pregnancy may be complicated by anti-seizure medication (ASM) polytherapy-associated teratogenicity. We aim to demonstrate the safety and efficacy of vagal nerve stimulation (VNS) in a pregnant patient presenting with NORSE.
Case description:
A 30-year old female, at 5-weeks' gestation presented with drug-refractory myoclonic status epilepticus, responsive only to high levels of anesthetic agents. The severity of seizures did not allow extubation, and the patient remained ventilated and sedated. VNS was implanted 26 days after seizure onset. The immediate post-operative output was 0.25 mA, which was rapidly titrated up to 0.5 mA the next morning, and to 0.75 mA that afternoon. This was further increased to 1.0 mA on 3rd day post-operation, and to 1.25 mA 7 days post-op. Myoclonic jerks diminished significantly 7 days post-op, allowing extubation. Twenty days after VNS implantation, no myoclonic jerks were observed. There was also a notable neurological improvement including increased alertness and mobility, and ability to obey commands. Drug overdose was subsequently found to be the most likely etiology of her NORSE. An early pregnancy assessment 17 days after VNS implantation showed a normally sited pregnancy, normal fetal heart activity and crown-rump length. The patient remained seizure free, gained functional independence and delivered a premature but otherwise healthy baby at 33 weeks' gestation.
Conclusion:
NORSE is challenging to manage, further compounded in pregnancy due to the teratogenicity of ASMs and ASM polytherapy. This is the first case-study to report the safe implantation and use of VNS during the first trimester of pregnancy for the management of NORSE.
Intraoral Laser Welding (ILW) in Implant Prosthetic Dentistry: Case Report
Authors: Carlo Fornaini, Elisabetta Merigo, Igor Cernavin, Gonzalo Lòpez de Castro, Paolo Vescovi
Journal: Case Rep Dent (2012)

The aim of this clinical study was to describe the possibility of using the Nd:YAG laser device utilized in the dental offices to weld metals intraorally. The authors, before applying this technique "in vivo" on human subjects, tested the "in vitro" metal welding efficacy of dental Nd:YAG device firstly by interferometry, SEM, and EDS and subsequently by thermal camera and thermocouples in order to record temperature changes during the welding process on bovine jaws. Four implants were inserted in the edentulous maxillary arch of a 67 years old male patient. Immediately after that, a bar previously made by the dental technician was intraorally welded to the abutments by Nd:YAG laser (Fidelis Plus III, Fotona, Slovenia) with these parameters: 9.90 mJ, 1 Hz, 15 msec, 0.6 mm spot. Then the prosthesis was connected to the bar with four OT Caps. This clinical study, even if preliminary, suggests that laser welding technique may be intraorally used without side effects.
A Case of Osteomyelitis after Calcaneal Fracture Treated by Antibiotic-Containing Calcium Phosphate Cements
Authors: Yoohak Kim, Fumiaki Inori, Kiyotaka Yamanaka, Shouichi Murakami, Eri Narita, Kazumasa Yamamura, Hiroyuki Yasuda, Makoto Fukuda, Sadahiko Konishi, Yukihide Minoda
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Calcaneal osteomyelitis (CO) is considered to be difficult to cure when it turned into a chronic phase. We report one case of calcaneal osteomyelitis which arises after the operation of calcaneal fracture. Remission was obtained by performing curettage of the infected cancellous bone of the calcaneal body and filling antibiotic-containing calcium phosphate cements (CPC) within its bone defect. This one-stage surgery is useful to treat calcaneal osteomyelitis.
Dysphagia revealing diffuse idiopathic skeletal hyperostosis: report of two cases and literature review
Authors: Monia Ghammam, Jihene Houas, Mouna Bellakhdher, Mohamed Abdelkefi
Journal: Pan Afr Med J (2019)
Keywords: musculoskeletal disorder, calcification, dysphagia, ligaments
MeSH terms: Anti-Inflammatory Agents / therapeutic use, Deglutition Disorders / etiology, Hyperostosis, Diffuse Idiopathic Skeletal / diagnosis, Case Reports, Review, Aged, 80 and over, Disease Progression, Humans, Hyperostosis, Diffuse Idiopathic Skeletal / complications, Hyperostosis, Diffuse Idiopathic Skeletal / therapy, Male, Middle Aged, Anti-Inflammatory Agents

Diffuse Idiopathic Skeletal Hyperostosis (DISH) also known as Forestier's disease, is a musculoskeletal disorder characterized by the calcification of ligaments essentially the vertebral longitudinal anterior ligament. Men are generally affected. It is often asymptomatic. The most common extra-spinal clinical manifestation of this disease presents as dysphagia followed by respiratory disturbances such as dyspnea and sleep apnea. In this paper we discuss two cases where the patients have experienced progressive dysphagia. Radiological findings were compatible with DISH. The management was based on diet modification and anti-inflammatory medication.
Atypical presentation of adenosquamous carcinoma: A case report
Authors: Annie Genois, Catherine Maari, Danielle Bouffard
Journal: SAGE Open Med Case Rep (2018)
Keywords: adenosquamous carcinoma, aggressive, squamous cell
MeSH terms: Case Reports

Cutaneous adenosquamous carcinoma is a rare malignant neoplasm that is more aggressive than conventional squamous cell carcinoma. The typical clinical presentation is an indurated papule or plaque on the head and neck of elderly patients. The authors report the case of a 52-year-old man with a right scrotal and inguinal tumour measuring 10 cm × 15 cm that had progressed over the past 2 years. The histological examination was compatible with adenosquamous carcinoma. Metastatic inguinal and pelvic lymph nodes were identified. This case demonstrates an atypical presentation of a rare tumour. Adenosquamous carcinoma is more aggressive than conventional squamous cell carcinoma, and prompt diagnosis is important.
Solitary sarcoid granuloma of the iris mimicking tuberculosis: a case report
Authors: Robert Rejdak, Pavel Pogorelov, Christian Y Mardin, Małgorzata Szkaradek, Anselm G M Juenemann
Journal: J Ophthalmol (2014)
MeSH terms: Review

Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management of an "iris tumor with iridocyclitis" in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function. Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.