OpenMed/multicare-articles huggingface dataset:
Pseudomelanoma: occult intraocular foreign body mimicking choroidal melanoma
Authors: Aslıhan Yılmaz Çebi, Bilge Batu Oto, Oğuzhan Kılıçarslan, Ahmet Murat Sarıcı
Journal: GMS Ophthalmol Cases (2023)
Keywords: choroid hemorrhage, choroid neoplasms, choroidal neovascularization, eye injuries, foreign bodies
MeSH terms: Case Reports

Purpose:
To report an occult intraocular foreign body mimicking choroidal melanoma.
Methods:
Medical records and imagings of the patient were retrospectively reviewed.
Case description:
A 76-year-old male was referred to our ocular oncology clinic with a suspicious hyperpigmented retinal lesion in the left eye. Biomicroscopy showed aphakia and peripheral iridectomy in the left eye. Fundoscopy revealed a pigmented, slightly elevated lesion on the macula of the left eye surrounded by diffuse atrophy. B-scan ultrasonography showed a preretinal hyperechoic lesion with posterior shadowing. There was no choroidal mass in B-scan or optical coherence tomography (OCT) imaging. On further questioning, it was disclosed that the patient had been hit by an iron fragment in the left eye forty years ago.
Conclusion:
Choroidal melanoma is a vision- and life-threatening intraocular malignant tumour. Various neoplastic, degenerative, and inflammatory conditions can simulate choroidal melanoma. A previous history of penetrating ocular trauma should lead the surgeon to re-evaluate a diagnosis of melanoma.
Case report: Implantation metastasis following stereotactic biopsy of pineal parenchymal tumor of intermediate differentiation in an adult patient: An exceptionally rare complication
Authors: Steven Tandean, Andre Marolop Pangihutan Siahaan, Michael Lumintang Loe, Rr Suzy Indharty, Julijamnasi, Mega Sari Sitorus, Iskandar Japardi, Julius July
Journal: Front Neurol (2022)
Keywords: complication, implantation, metastase, pineal parenchymal tumor of intermediate differentiation, stereotactic biopsy
MeSH terms: Case Reports

Implantation metastasis following stereotactic biopsy in the brain had been reported as a rare complication. A 36-years-old female patient was treated with ventriculoperitoneal (VP) shunt and stereotactic biopsy of a pineal parenchymal tumor of intermediate differentiation (PPTID) with hydrocephalus. The patient underwent five cycles of radiotherapy on the pineal area. Seven years after the procedure, the patient developed left hemiparesis with the brain MRI findings showing an enhanced mass along the biopsy tract. Craniotomy tumor removal was carried out and the pathological assessment was consistent with those of the PPTID. Radiation on metastase area and craniospinal was subsequently performed. The patient was disease-free during the 2-year follow-up assessments. The potential occurrence of implantation metastasis following the stereotactic biopsy of PPTID should be considered in the treatment plan and follow-up assessments and evaluations. Expanding the radiation area to cover the entire biopsy tract may be favorable to lower the risk of implantation metastasis.
A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion
Authors: Mehmet Obut, Uğur Değer
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Introduction:
Most cases of ovarian torsion occur in the reproductive age and many are related to ovarian and paraovarian masses. If it occurs without any subtle anatomic etiology or ovarian and paraovarian masses, recurrence of ovarian torsion is more likely. Recurrent left ovarian torsion is much less common than recurrent right ovarian torsion. The authors describe a rare case with their new ovarian fixation technique.
Case and method:
A 21-year-old female patient with polycystic ovarian syndrome had a 7th recurrence of left ovarian torsion. Although ovarian fixation was performed in addition to detorsion at the 5th and the 6th laparoscopic surgeries, it had failed. Due to recurrence ovarian torsion after ovarian fixation, the authors performed a different technique:folding the utero-ovarian ligament which folded on itself. The distal part of the utero-ovarian ligament with the ovary was both fixed to the proximal part of the round ligament which was adjacent to the uterus.
Conclusion:
Although a wide range of oophoropexy methods have been described in the literature, the best method remains a matter for debate. This technique can be performed even when the ovarian tissue is necrotic. Because of this, we think that this technique is useful and effective technique.
Case report: Remission of chronic low back pain and oral dysesthesia comorbid with attention deficit/hyperactivity disorder by treatment with atomoxetine and pramipexole
Authors: Satoshi Kasahara, Yuichi Kato, Miwako Takahashi, Ko Matsudaira, Naoko Sato, Shin-Ichi Niwa, Toshimitsu Momose, Kanji Uchida
Journal: Front Pain Res (Lausanne) (2023)
Keywords: conners' adult adhd rating scale, spect, adult adhd, atomoxetine, chronic overlapping pain conditions, low back pain, oral dysesthesia, pramipexole
MeSH terms: Case Reports

Introduction:
Oral dysesthesia is a disease characterized by pain and/or abnormal sensations in the oral region, without any organic abnormality. Its symptoms include pain, and it is considered to be a disorder associated with idiopathic oral-facial pain. It is also known that idiopathic oral-facial pain tends to coexist with chronic musculoskeletal pain, including low back pain, even before its onset. Such coexisting idiopathic pain conditions are also called chronic overlapping pain conditions (COPCs). In general, COPCs are often refractory to treatment. Recently, it has been reported that attention deficit hyperactivity disorder (ADHD) is associated with many COPCs, such as pain in the facial and lower back regions and so on. However, there are no reports of (1) ADHD as a comorbidity with oral dysesthesia (OD) or (2) of the therapeutic effects of ADHD medications or dopamine agonists on low back pain and OD or an (3) evaluation of cerebral blood flow over time after treatment with these medications for OD and low back pain.
Case presentation:
In this study, we report the case of an 80-year-old man with OD and chronic low back pain that persisted for more than 25 years. His OD and chronic back pain were refractory to standard treatment, prevented him from continuing work, and tended to be exacerbated by conflicts in his relationship with his son. In recent years, ADHD has often been found to be comorbid with chronic pain, and ADHD medications have been reported to improve chronic pain as well. The patient was confirmed to have undiagnosed ADHD and was treated with the ADHD medication atomoxetine and dopamine agonist pramipexole, which dramatically improved his OD, chronic back pain, and cognitive function. Furthermore, along the course of treatment, there was improvement in cerebral blood flow in his prefrontal cortex, which was thought to reflect improved function in the region. Consequently, he was able to resume work and improve his family relationships.
Conclusion:
Therefore, in the cases of ODs and COPCs, screening for ADHD and, if ADHD is diagnosed, ADHD medications or dopamine agonists may be considered.
Indigenous Sundanese Leadership: Eco-Systemic Lessons on Zero Emissions: A conversation with Indigenous leaders in Ciptagelar, West Java
Authors: Ida Widianingsih, Janet Judy McIntyre, Ugi Sugriana Rakasiwi, Gustaff Harriman Iskandar, Rudolf Wirawan
Journal: Syst Pract Action Res (2023)
Keywords: indigenous knowledge systems, re-generation, systemic balance with nature, west java

'Ecology of mind' (Bateson, 1972) is a key concept applied to this project engaged in by a social anthropologist, a policy researcher, and a Sundanese Chief. Together we explore how the agendas for COP 26 could be attained and to what extent the Nobel economist Elinor Ostrom's (2018) eight principles are relevant for managing the commons and key learnings that can be shared more broadly.The paper details the Sundanese forest community's organisational systems to support living in ways that re-generate and sustain the forest and the way that the community has connected with Universitas Padjadjaran and an NGO called the Common Room Networks (common room.id), in order to support and extend their learning with nature program within and beyond Indonesia. Decolonising and learning from Indigenous leadership can be fostered through forming communities of practice between universities and indigenous leaders. The paper discusses how the Ciptagelar community demonstrates low carbon living and how they have organised agriculture in terms of a seasonal calendar. It makes the case that sharing their agricultural methods and community lifestyle to lower emissions could help to inspire others to follow their re-generative approach to governance and their organisational strategies. The paper demonstrates the relevance of Ostrom's principles which are considered in relation to the case study. On the basis of a series of conversations held via zoom and email we make a case for learning from the leadership rooted in the Sundanese culture and demonstrated in West Java First Nations. It can be read as a twin paper with the paper on the Venda forest, titled 'Eco-centric living: a way forward towards zero carbon'.
Skin-Limited Graft-versus-Host Disease after Pancreatic Transplantation
Authors: Muneeb Ilyas, Elika Hoss, David J DiCaudo, Hasan Khamash, Mark R Pittelkow, Amit Sharma
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Introduction:
The phenomenon of graft-versus-host disease, a solid organ transplant recipient, is a rare development with a very poor prognosis.
Case presentation:
A 40-year-old woman with type 1 diabetes developed cutaneous graft-versus-host disease following second pancreas transplantation.
Conclusion:
The development of a nonspecific rash in the early posttransplant period following a pancreas transplant warrants suspicion for graft-versus-host disease.
Does landscape fragmentation influence sex ratio of dioecious plants? A case study of Pistacia chinensis in the Thousand-Island Lake region of China
Authors: Lin Yu, Jianbo Lu
Journal: PLoS One (2011)
MeSH terms: Pistacia / physiology, Sex Ratio, Research Support, Non-U.S. Gov't, China, Nitrogen / analysis, Ovule, Pollen, Soil / chemistry, Soil, Nitrogen

The Thousand-Island Lake region in Zhejiang Province, China is a highly fragmented landscape with a clear point-in-time of fragmentation as a result of flooding to form the reservoir. Islands in the artificial lake were surveyed to examine how population sex ratio of a dioecious plant specie Pistacia chinensis B. was affected by landscape fragmentation. A natural population on the mainland near the lake was also surveyed for comparison. Population size, sex ratio and diameter at breast height (DBH) of individuals were measured over 2 years. More than 1,500 individuals, distributed in 31 populations, were studied. Soil nitrogen in the different populations was measured to identify the relationship between sex ratio and micro-environmental conditions. In accordance with the results of many other reports on biased sex ratio in relation to environmental gradient, we found that poor soil nitrogen areas fostered male-biased populations. In addition, the degree of sex ratio bias increased with decreasing population size and population connectivity. The biased sex ratios were only found in younger individuals (less than 50 years old) in small populations, while a stable 1∶1 sex ratio was found in the large population on the mainland. We concluded that the effects of landscape fragmentation on the dioecious population sex ratio were mainly achieved in relation to changing soil nitrogen conditions in patches and pollen limitation within and among populations. Large populations could maintain a more suitable environment in terms of nutrient conditions and pollen flow, subsequently maintaining a stable sex ratio in dioecious plant populations. Both micro-environmental factors and spatial structure should be considered in fragmented landscape for the conservation of dioecious plant species.
Surgically Treated Nonunion following Ischial Tuberosity Avulsion Fracture of a 14-Year-Old Athlete
Authors: Yuta Nakamatsu, Tomoaki Fukui, Keisuke Oe, Shinya Hayashi, Tomoyuki Matsumoto, Takehiko Matsushita, Ryosuke Kuroda, Takahiro Niikura
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

A 14-year-old girl experienced acute left buttock pain during a sprint. At the local hospital, she was diagnosed with an avulsion fracture of the left ischial tuberosity. She was kept for observation for about 10 months; however, the buttock pain persisted, and the bone fragments did not unite. She was referred to our hospital approximately 11 months after the injury. Plain radiography revealed an increased transposition of the bone fragment, from 12 mm immediately after the injury to 23 mm. Twelve months after the injury, she underwent osteosynthesis using two cannulated cancellous screws and three suture anchors. Following postoperative rehabilitation, the power in her left hamstring recovered, and she was able to run at full speed and returned to athletics 9 months after the surgery. The operative indications for avulsion fractures of the ischial tuberosity are unclear. Careful follow-up is required as the rate of nonunion after conservative treatment tends to be high. This needs to be identified in order to provide timely treatment that allows for early return to sport. Although she had significant chronic pain and muscle weakness, the surgery successfully treated the fracture, and her muscle power recovered, leading to her return to sports.
Eradication of Lomentospora prolificans Osteomyelitis of the Wrist with Combination Antifungal Therapy, Voriconazole Bone Cement, and Surgical Debridement
Authors: Jeremy Lee, Mark Wilson, Nikki Casey
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Lomentospora prolificans is an emerging pathogen that is difficult to treat due to its intrinsic resistance to currently available antifungal agents. Current evidence demonstrates synergy between Azoles and Terbinafine against L. prolificans infections, while adjunct use of antifungal agent-loaded bone cement has also shown favourable outcomes. We report a case of an immunosuppressed adult with rheumatoid arthritis who developed L. prolificans osteomyelitis in his right wrist following trauma and subsequent exposure to commercially available fertiliser. The infection was successfully eradicated via a combination of aggressive, staged surgical source control, antifungal therapy using voriconazole and Terbinafine, and insertion of voriconazole-loaded bone cement into the wrist and carpus. The utility of this approach supports the synergistic effects of voriconazole and Terbinafine and, more broadly, the clinical benefits of antifungal-loaded bone cement, as demonstrated in previous case reports and in vitro studies. As such, combination antifungal therapy and voriconazole-loaded bone cement should be considered the therapy of choice in cases of osteomyelitis where L. prolificans is proven to be the causative organism.
Spinal-Pelvic Dissociation in Pregnancy: Surgical Fixation of Culture-Negative Extrapulmonary Tuberculosis
Authors: Ali Taha, Jessica Rogers, Timothy Bishop, Darren F Lui, Madhusree Ghosh, Paul Gillespie
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

A 33-year-old gravid female from Pakistan presented to the Emergency Department with persistent, intractable low back pain and neuropathic left L5 leg pain, associated with a left foot drop. There was a notable history of weight loss for 1 year. Investigations revealed a large collection in the right posterior paraspinal muscles tracking from a large bony defect in the right half of her sacrum extending into the pelvis. The collection was suggestive of an abscess and underwent US-guided aspiration. Culture, PCR examination, and bone biopsy were culture-negative for tuberculosis (TB). Samples taken from the placenta showed two small granulomata in the chorionic villi only. A multidisciplinary approach commenced with initiation of empirical TB treatment and attempted normal vaginal delivery. An urgent caesarean section for the delivery of the baby was required for failure to proceed. Spinal-pelvic stabilization in two stages was performed for the unstable fracture pattern, followed by pharmacotherapy and physiotherapy rehabilitation. At 12-month follow-up, the patient showed resolving TB and eradication of the paraspinal abscess. There was bony union and stability of the spinal-pelvic reconstruction. Back pain and sciatica can be common in pregnancy. However, this case highlights a rare occurrence of culture-negative extrapulmonary TB leading to an unstable spinal-pelvic fracture requiring a multidisciplinary approach for careful obstetric and orthopaedic treatment with empirical treatment by the infectious disease team and microbiology.
Central Hyperthyroidism due to Thyroid-Stimulating Hormone-Secreting Pituitary Microadenoma in an Adolescent Boy: Case Report and Review of the Literature
Authors: Le Hoang Bao, Nguyen Minh Duc, Phan Cong Chien, Thieu-Thi Tra My, Tran Viet Thang, Tran Quang Nam
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Thyroid-stimulating hormone- (TSH-) secreting pituitary adenoma (TSH-oma) is a rare cause of secondary hyperthyroidism and can be misdiagnosed as primary hyperthyroidism. We report a case of a 15-year-old male patient who was one of two monozygotic twins and exhibited hyperthyroidism syndrome. The laboratory results showed secondary hyperthyroidism, with increased levels of free T3 (FT3) and free T4 (FT4) and no TSH inhibition. Magnetic resonance imaging (MRI) and histopathological examination of the pituitary gland confirmed pituitary microadenoma. The patient was treated with methimazole, propranolol, and somatostatin analogs to restore euthyroidism before undergoing an endoscopic transsphenoidal resection of the pituitary tumor. After surgery, the hyperthyroidism symptoms improved, thyroid hormones normalized, and MRI of the pituitary gland showed the complete removal of the tumor with no recurrence after 2 years of follow-up.
Rapid and significant reduction in size of pituitary adenoma in children treated with fractionated stereotactic radiation therapy: a case report
Authors: Putipun Puataweepong, Mantana Dhanachai
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Radiation treatment in the management of pituitary adenoma in children is still a controversy due to the great concern of late radiation effect. Stereotactic radiation therapy is the modern radiation technique that is more widely applicable in pituitary adenoma because of the ability to give highly conformal radiation to the target organ and to reduce the radiation dose to normal tissue. A 15-year-old boy presented with postradiation therapy recurrence pituitary macroadenoma. His vision was useful only on the left eye. MRI revealed the recurrent macroadenoma with severe invasion of optic apparatus. Since no any other treatment option was to be given to this patient, we decided to reirradiate the patient with conventional fractionated stereotactic radiation. At 3 months of followup, MRI showed that the tumor had an early and significant reduction in size without any sign of toxicity.
Polymerase Gamma Mitochondrial DNA Depletion Syndrome Initially Presenting as Disproportionate Respiratory Distress in a Moderately Premature Neonate: A Case Report
Authors: Andrew D Franklin, Bimal P Chaudhari, Daniel C Koboldt, Kerri Z Machut
Journal: Front Genet (2021)
Keywords: case report, mitochondria dna depletion, polymerase gamma, pulmonary hypertension, whole exome sequencing
MeSH terms: Case Reports

A 32-week premature infant presented with respiratory failure, later progressing to pulmonary hypertension (PH), liver failure, lactic acidosis, and encephalopathy. Using exome sequencing, this patient was diagnosed with a rare Polymerase Gamma (POLG)-related mitochondrial DNA (mtDNA) depletion syndrome. This case demonstrates that expanding the differential to uncommon diagnoses is important for complex infants, even in premature neonates whose condition may be explained partially by their gestational age (GA). It also shows that patients with complex neonatal diseases with significant family history may benefit from exome sequencing for diagnosis.
Congenital lumbar vertebrae agenesis in a lamb
Authors: Mohammad Farajli Abbasi, Bahador Shojaei, Omid Azari
Journal: Vet Res Forum (2017)
Keywords: congenital anomaly lamb, lumbar vertebrae agenesis
MeSH terms: Case Reports

Congenital agenesis of lumbar vertebrae was diagnosed in a day-old female lamb based on radiology and clinical examinations. There was no neurological deficit in hindlimb and forelimb associated with standing disability. Radiography of the abdominal region revealed absence of lumbar vertebrae. Necropsy confirmed clinical and radiographic results. No other anomaly or agenesis was seen macroscopically in the abdominal and thoracic regions as well as vertebral column. Partial absence of vertebral column has been reported in human and different animal species, as an independent occurrence or associated with other organs anomalies. The latter has been designated as caudal regression syndrome. Vertebral agenesis may arise from irregularity in the differentiation of somites to the sclerotome or sclerotome to the vertebral primordium. Most of the previously reported cases of agenesis were related to the lumbosacral region, lonely or along with other visceral absences. This case was the first report of congenital agenesis of lumbar vertebrae in a lamb.
An Unusual Cervical Mass in the Hyoid Bone: Intermediate-Grade Chondrosarcoma
Authors: Ozge Caglar, O Karatag, A Avci, Sefa Dereköy
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

We describe a case of a 31-year-old woman with a chondrosarcoma of the hyoid bone. The patient presented with a mass in the left submandibular region. Fine-needle aspiration cytology suggested chondroma, but further imaging investigation with CT revealed an exophytic tumor originating from the body of the hyoid bone. Histopathology of the surgical specimen confirmed the diagnosis of a intermediate-grade chondrosarcoma. Chondrosarcomas account for 11% of all bone cancers. Primary sites of the head and the neck include the nasal cavity, the skull base, the maxilla, the mandible. Chondrosarcomas of the hyoid bone are very rare, with only 23 cases previously reported in the literature.
Undiagnosed impacted knife blade from a penetrative orbital injury: A case report
Authors: Mohamed El Sayed, Reem Hassan Saad, Ahmed Fereir
Journal: Int J Surg Case Rep (2018)
Keywords: case report, facial trauma, foreign body, maxillofacial, orbital injury, stab wounds

Introduction:
Impacted foreign bodies in the complex maxillofacial region is uncommon and their safe removal is a challenge.
Case presentation:
The authors report an unusual case of a 41 year old male patient who suffered from violence-related orbital trauma with a knife. The presence of this foreign body was not diagnosed for a period of 20 months. After proper clinical and radiologic examination it was localized and extracted in the theater in a safe controlled manner. Although the tip of the blade was left in situ, the patient had a rapid uneventful recovery and follow up.
Discussion:
The path of penetration of the foreign body in presented case didn't follow the predicted patterns of orbital injury described in literature. A dilemma exists as to how aggressive such injuries should be managed. Thus the surgical approach implemented for retrieving the current foreign body was highlighted.
Conclusion:
Radiographs are a crucial element for early diagnosis and proper management of foreign body injuries. Rapid postoperative recovery can be achieved with simple safe surgical retrieval maneuvers.