OpenMed/multicare-articles huggingface dataset:
C-arm cone-beam computed tomography-guided minimally invasive open excision of an osteoid osteoma undetectable on fluoroscopy: A case report
Authors: Takashi Higuchi, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Kensaku Abe, Yuta Taniguchi, Yoshihiro Araki, Hiroyuki Tsuchiya
Journal: Int J Surg Case Rep (2019)
Keywords: a robotic c-arm cone-beam computed tomography, case report, minimally invasive surgery, osteoid osteoma

Introduction:
The small size of a nidus and the extensive sclerosis around it often make it difficult to identify tumors from the surrounding normal bone by fluoroscopy, and a large amount of bone resection might be required to secure complete removal during osteoid osteoma surgery. In this report, we present the first case of radiographically invisible osteoid osteoma that was successfully resected under a robotic C-arm cone-beam computed tomography (CBCT) imaging system.
Presentation of case:
A 14-year-old boy presented with persistent pain around the left knee joint was diagnosed with osteoid osteoma of the left distal femur. Since the tumor was not detectable by intraoperative fluoroscopy, a CBCT system was used for guidance during an open tumor resection. For a less invasive surgery, we repurposed the dilator and retractor of the microendoscopic discectomy (MED) system and resected the tumor using the wider trephine tips for bone biopsy. At the final follow-up one year later, the function of the afflicted limb was normal with no complaint of any symptoms. Plain radiograph at the final follow-up showed new bone formation completely filling the bone defect, without local recurrence.
Discussion:
CBCT allowed for clear intraoperative visualization of the osteoid osteoma, thereby promising a secure resection and less invasive osteoid osteoma treatment. Furthermore, the repurposed use of the dilator and retractor of the MED system as well as the wider trephine tips for bone biopsy made the procedure less invasive.
Conclusion:
CBCT-guided minimally invasive open excision surgery could be a useful option for the management of radiographically invisible osteoid osteoma.
Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment
Authors: Eleni Thodou, Maria Befani, George Triantafyllidis, Theodosia Choreftaki, George Kanellis, Nikolaos Giannakoulas
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Extranodal Hodgkin lymphoma involving the breast is infrequent. Most cases reported in the literature were diagnosed by histology after lumpectomy. We present a Hodgkin lymphoma mimicking inflammatory breast carcinoma in a 57-year-old woman. The diagnosis was performed by fine-needle aspiration (FNA) of the breast lesion and the axillary lymph nodes with rapid on-site evaluation followed by immunocytochemistry, and it was confirmed by histology. The patient after first-line chemotherapy developed relapse/refractory disease. Salvage chemotherapy regimens were applied with poor results and severe toxicity. Total remission was achieved with monotherapy of brentuximab vedotin, a novel anti-CD30-targeted antibody drug conjugate. This is a unique case of breast HL with misleading clinical presentation initially diagnosed by cytology. FNA as a minimally invasive diagnostic tool was crucial in avoiding unnecessary breast surgery and further delay of chemotherapy. It is also the first report highlighting the importance of this novel immunotherapy in the management of refractory Hodgkin lymphoma with breast involvement.
Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: a case report
Authors: Sita Thakur, Ajay Sood, Chanderdeep Sharma
Journal: Case Rep Obstet Gynecol (2012)

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.
Pectoralis Plane Block for Pacemaker Insertion: A Successful Primary Anesthetic
Authors: Ana C Mavarez, Caroline I Ripat, Maria R Suarez
Journal: Front Surg (2019)
Keywords: analgesia, pacemaker, pectoralis block, regional anesthesia, ultrasound-guided
MeSH terms: Case Reports

Effective anesthesia, analgesia, and hemodynamic stability is important to maintain during pacemaker implantation surgery, especially in the elderly population and patients with compromised cardiac function. As a strategy to avoid the need for intravenous (IV) anesthetics, peripheral nerve block techniques may be used in these specific cases. We report a case of successful pacemaker implantation surgery in a patient with severe Aortic Stenosis (AS) and Sick Sinus Syndrome (SSS) using unilateral pectoralis plane block for surgical anesthesia. Since general anesthesia was considered risky, monitored anesthesia care utilizing peripheral nerve block was planned. A single shot left side pectoralis plane block (PECS II) was done under ultrasound guidance injecting a total of 20 mL of 0.5% Ropivacaine with 1% Lidocaine. No sedation was needed. The patient tolerated the procedure with no significant hemodynamic changes. Patient did not require opioids post-operative and was discharged home in stable condition the next day. This case highlights that PECS block can also provide effective surgical anesthesia for relatively long procedures avoiding the risk of complications associated with IV anesthesia in high risk cardiovascular patients. Additionally, these blocks can provide an opioid sparing option for post-operative management in pacemaker implantation surgeries.
Case study: patient-derived clear cell adenocarcinoma xenograft model longitudinally predicts treatment response
Authors: Roberto Vargas, Priyanka Gopal, Gwendolyn B Kuzmishin, Robert DeBernardo, Shlomo A Koyfman, Babal K Jha, Omar Y Mian, Jacob Scott, Drew J Adams, Craig D Peacock, Mohamed E Abazeed
Journal: NPJ Precis Oncol (2018)
MeSH terms: Case Reports

There has been little progress in the use of patient-derived xenografts (PDX) to guide individual therapeutic strategies. In part, this can be attributed to the operational challenges of effecting successful engraftment and testing multiple candidate drugs in a clinically workable timeframe. It also remains unclear whether the ancestral tumor will evolve along similar evolutionary trajectories in its human and rodent hosts in response to similar selective pressures (i.e., drugs). Herein, we combine a metastatic clear cell adenocarcinoma PDX with a timely 3 mouse x 1 drug experimental design, followed by a co-clinical trial to longitudinally guide a patient's care. Using this approach, we accurately predict response to first- and second-line therapies in so far as tumor response in mice correlated with the patient's clinical response to first-line therapy (gemcitabine/nivolumab), development of resistance and response to second-line therapy (paclitaxel/neratinib) before these events were observed in the patient. Treatment resistance to first-line therapy in the PDX is coincident with biologically relevant changes in gene and gene set expression, including upregulation of phase I/II drug metabolism (CYP2C18, UGT2A, and ATP2A1) and DNA interstrand cross-link repair (i.e., XPA, FANCE, FANCG, and FANCL) genes. A total of 5.3% of our engrafted PDX collection is established within 2 weeks of implantation, suggesting our experimental designs can be broadened to other cancers. These findings could have significant implications for PDX-based avatars of aggressive human cancers.
Urothelial bladder carcinoma in childhood: a case report
Authors: Aref Zribi, Sonia Ben Nasr, Issam Msakni, Sarra Karrit, Faten Gargouri, Sana Fendri, Mehdi Balti, Abderrazek Haddaoui
Journal: Pan Afr Med J (2020)
Keywords: pediatric, bladder, carcinoma, prognosis, surgery, urothelial
MeSH terms: Carcinoma, Transitional Cell / diagnosis, Hematuria / etiology, Urinary Bladder Neoplasms / diagnosis, Case Reports, Adolescent, Carcinoma, Transitional Cell / pathology, Carcinoma, Transitional Cell / surgery, Follow-Up Studies, Humans, Male, Treatment Outcome, Urinary Bladder Neoplasms / pathology, Urinary Bladder Neoplasms / surgery

We report an exceptional case of transitional cell carcinoma of the bladder in a 14-years old boy without personal nor family history who consulted for a total hematuria. Work-up showed a bladder lesion sized 5cm with histology of urothelial cancer. Treatment consisted of a transurethral surgery with carcinologic complete resection. Patient is alive, free of disease with a follow-up of 36 months.
Case report: Laparoscopic gastrojejunostomy for duodenal atresia with situs inversus and preduodenal portal vein: a report of two cases
Authors: Yoichi Nakagawa, Wataru Sumida, Satoshi Makita, Hiroo Uchida, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Kazuki Yokota, Hizuru Amano, Akihiro Yasui, Aitaro Takimoto, Daiki Kato, Takuya Maeda, Yousuke Gohda
Journal: Front Pediatr (2023)
Keywords: duodenal atresia, gastrojejunostomy, laparoscopy, preduodenal portal vein, situs inversus
MeSH terms: Case Reports

Congenital duodenal atresia with situs inversus is occasionally accompanied by a preduodenal portal vein (PDPV), which is incidentally diagnosed during surgery. Duodenoduodenostomy is the most common and effective treatment. However, some patients require other anastomoses. Here, we present two cases of laparoscopic gastrojejunostomy for congenital duodenal atresia with situs inversus and PDPV and describe the reason for selecting gastrojejunostomy. The optimal surgical strategy is patient specific and should be determined based on the patient's general and physical condition.
Unusual occurrence of orbital hemangiopericytoma in the zygomatic bone of an adolescent: a case report
Authors: Bahram Eshraghi, Hadi Ghadimi, Zohreh Nozarian
Journal: Eye Vis (Lond) (2018)
Keywords: hemangiopericytoma, orbital neoplasm, solitary fibrous tumor, zygomatic bone
MeSH terms: Case Reports

Background:
Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor. They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.
Case presentation:
A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm, regular mass in the region. Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall (zygomatic bone), expanding the bone and protruding anteriorly and medially. MRI showed the mass to be heterogenous and strongly enhancing with contrast medium. Inferior transconjunctival orbitotomy was performed and the mass was removed. The histopathologic examination and immunohistochemistry staining results (positive for CD34, CD31 and smooth muscle actin, but negative for CD99, S100, B-cell lymphoma 2 (bcl-2) and desmin) confirmed the diagnosis of hemangiopericytoma. The postoperative course was uneventful, with no evidence of recurrence after 5 years follow up.
Conclusions:
This case represents the second hemangiopericytoma reported in the zygomatic bone. Although extremely rare, hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.
Case report: a genomics-guided reclassification of a blood culture isolate misassigned by MALDI-TOF as Yersinia pestis
Authors: Eby M Sim, Bryant Koh, Jimmy Ng, Trang Nguyen, Qinning Wang, Andrew N Ginn, Mitchell Brown, David Pham, Vitali Sintchenko
Journal: Access Microbiol (2022)
Keywords: yersinia, genome sequencing, laboratory biosafety, laboratory identification
MeSH terms: Case Reports

In this report, we describe a case where Gram-negative rods were isolated from a blood culture which subsequently presented a discordant Yersinia species result by MALDI-TOF. Rapid sequencing provided high-resolution identification of the isolate as Yersinia pseudotuberculosis , which was subsequently confirmed by biochemical tests.
Disseminated Mycobacterium Tuberculosis and IgA Nephropathy
Authors: Gordon Audley, Bianca Davidson, Erika Jones, Brendon Price, Brian Rayner, Nicola Wearne, Zibya Barday
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Mycobacterium tuberculosis (MTB) is an under-recognised cause of genitourinary disease. IgA nephropathy (IgAN), a leading cause of glomerulonephritis worldwide, has been described as a rare consequence of disseminated MTB infection. In this case report, we present the first case of MTB associated IgAN in Africa. Finding IgAN on kidney biopsy in an MTB endemic area should prompt a thorough investigation for MTB to increase the chance of remission of IgAN and prevent inappropriate use of immunosuppression.
Aggressive tumors and difficult choices in acromegaly
Authors: Carmen A Carrasco, Mônica Gadelha, Marcos Manavela, Oscar D Bruno
Journal: Pituitary (2014)
MeSH terms: Acromegaly / pathology, Adenoma / pathology, Growth Hormone-Secreting Pituitary Adenoma / pathology, Case Reports, Review, Acromegaly / drug therapy, Adenoma / drug therapy, Human Growth Hormone / metabolism, Humans, Male, Neoplasm Invasiveness, Retrospective Studies, Somatostatin / analogs & derivatives, Somatostatin / economics, Somatostatin / therapeutic use, Human Growth Hormone, Somatostatin

Purpose:
The current article looks at some of the factors associated with pituitary adenomas displaying unusually aggressive biological and clinical behaviour in patients with acromegaly.
Methods:
This was a retrospective, narrative review of previously published evidence chosen at the authors' discretion and presented from the perspective of a Latin American case study.
Findings and conclusions:
Although most pituitary tumors in acromegalic patients are benign and non-aggressive many can behave more aggressively, compromising local surrounding structures. These lesions tend to respond poorly to somatostatin analogs, have a higher risk of recurrence after surgery and, thus, a worse prognosis. Patients with more aggressive tumors constitute a particular challenge, as they often require several therapeutic approaches and may be difficult to manage, especially when options are restricted due to limited resources.
Hemorrhagic Shock after Neonatal Circumcision: Severe Congenital Factor XIII Deficiency
Authors: Erin L Cohen, Samantha E Millikan, Perry C Morocco, Jill L O de Jong
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

A Caucasian male infant born full term via normal spontaneous vaginal delivery was given vitamin K after birth, circumcised on day of life (DOL) 1, and discharged from the nursery on DOL 2. At the time of circumcision, oozing from the surgical site was noted and initially resolved with silver nitrate. Over the next two days, he presented to local emergency rooms multiple times for recurrent bleeding, eventually developing hemorrhagic shock resulting in admission to the neonatal intensive care unit. After extensive work up, he was ultimately diagnosed with severe congenital factor XIII deficiency. Congenital factor XIII deficiency is a rare bleeding disorder characterized by normal prothrombin time (PT) and activated partial thromboplastin time (aPTT) coagulation labs on routine screening, and has a high risk of complications, such as spontaneous intracranial hemorrhage. Although uncommon, when caring for a child with bleeding, physicians must have a high index of suspicion to make this diagnosis in order to initiate proper treatment and start prophylaxis given the risk of morbidity and mortality in untreated patients.
Umbilical Cord Hematoma: A Case Report and Review of the Literature
Authors: Gennaro Scutiero, Giulia Bernardi, Piergiorgio Iannone, Luigi Nappi, Danila Morano, Pantaleo Greco
Journal: Obstet Gynecol Int (2018)
MeSH terms: Review

Objectives:
To deepen the knowledge in obstetrics on a very rare pregnancy complication: umbilical cord hematoma.
Methods:
A review of the case reports described in the last ten years in the literature was conducted in order to evaluate epidemiology, predisposing factors, potential outcomes, prenatal diagnosis, and clinical management.
Results:
Spontaneous umbilical cord hematoma is a rare complication of pregnancy which represents a serious cause of fetal morbidity and mortality. There are many risk factors such as morphologic anomalies, infections, vessel wall abnormalities, iatrogenic causes, and traction or torsion of the cord, but the exact etiology is still unknown.
Conclusions:
Due to the rarity of this condition, every new case of umbilical cord hematoma should be reported in order to improve the knowledge of predisposing factors, prenatal diagnosis, and clinical management.
Caring for children with neurodevelopmental disability: Experiences from caretakers and health workers in rural eastern Uganda
Authors: Gertrude Namazzi, Claudia Hanson, Christine Nalwadda, Moses Tetui, Margaret Nampijja, Peter Waiswa, James K Tumwine, Helena Hildenwall
Journal: PLoS One (2020)
MeSH terms: Caregivers, Child Care, Disabled Persons, Health Personnel, Neurodevelopmental Disorders / therapy, Rural Population, Research Support, Non-U.S. Gov't, Child, Communication, Follow-Up Studies, Humans, Perception, Social Support, Uganda

Background:
Long term outcomes of children with neurodevelopmental disability are influenced by the condition itself, available health services and caretakers' coping ability to nurture the children which may be related to their beliefs and experiences. Most children with neurodevelopmental disabilities live in resource constrained settings. To inform design of contextually appropriate interventions, this study explored health workers' and caretakers' experiences in caring for infants with neurodevelopmental disability in rural eastern Uganda.
Methods:
A qualitative case study was carried out in December 2017 and involved in-depth interviews with 14 caretakers of infants with severe neurodevelopmental disability, and five health workers in Iganga/Mayuge Demographic Surveillance Site in eastern Uganda. The interviews with caretakers were conducted in Lusoga, the local language, and in English for the health workers, using a pre-determined open-ended interview guide. Data were analyzed using latent content analysis.
Results:
Caretakers described the experience of caring for children with neurodevelopmental disability as impoverishing and 'imprisoning' due to high care costs, inability to return to income generating activities and nursing challenges. The latter resulted from failure in body control and several aspects of nutrition and maintaining vital functions, coupled with limited support from the community and the health system. Many caretakers expressed beliefs in supernatural causes of neurodevelopmental disability though they reported about complications during and shortly after the birth of the affected child. Care-seeking was often challenging and impeded by costs and the feeling of lack of improvement. The health care system was also found to be incapable of adequately addressing the needs of such children due to lack of commodities, and human resource limitations.
Conclusion:
The caretakers expressed a feeling of emotional stress due to being left alone with a high nursing burden. Improvement in the health services including a holistic approach to care, improved community awareness and parental support could contribute to nursing of children with NDD.
The efficacy of exposure and response prevention for geriatric obsessive compulsive disorder: a clinical case illustration
Authors: Mairwen K Jones, Bethany M Wootton, Lisa D Vaccaro
Journal: Case Rep Psychiatry (2012)

Obsessive compulsive disorder (OCD) is one of the most frequently occurring psychiatric conditions in older adults. While exposure and response prevention (ERP) is considered the most effective psychological treatment for children and adults with OCD, research investigating its effectiveness for older adults is scarce. This clinical case study investigates the effectiveness of ERP in an 80-year-old man with a 65-year history of OCD. The client received 14 individual, 50-minute ERP treatment sessions. Clinician-based Y-BOCS scores reduced by 65% from 20 (moderate) at pretreatment to 7 (subclinical) at 7-month posttreatment followup. OCI-R total scores reduced by 45% from 38 at baseline to 21 at 7-month follow-up. Despite his long history of the disorder, ERP was effective and well tolerated. The application of ERP for older adults with OCD, including age-specific modifications that may be required for this treatment approach, is discussed.
Varicella-Zoster-Mediated Radiculitis Reactivation following Cervical Spine Surgery: Case Report and Review of the Literature
Authors: Doniel Drazin, George Hanna, Faris Shweikeh, Sunil Jeswani, Leah Lovely, Richard Sokolov, John C Liu
Journal: Case Rep Infect Dis (2013)

Varicella-zoster virus and herpes simplex virus types 1 and 2 are neurotropic viruses that can be reactivated after a surgical or stressful intervention. Although such cases are uncommon, consequences can be debilitating, and variable treatment responses merit consideration. We describe a 41-year-old male with a history of varicella-mediated skin eruptions, who presented with continuing right arm pain, burning, and numbness in a C6 dermatomal distribution following a C5-6 anterior cervical discectomy and fusion and epidural steroid injections. The operative course was uncomplicated and he was discharged home on postoperative day 1. Approximately ten days after surgery, the patient presented to the emergency department complaining of severe pain in his right upper extremity and a vesicular rash from his elbow to his second digit. He was started on Acyclovir and discharged home. On outpatient follow-up, his rash had resolved though his pain continued. The patient was started on a neuromodulating agent for chronic pain. This case adds to the limited literature regarding this rare complication, brings attention to the symptoms for proper diagnosis and treatment, and emphasizes the importance of prompt antiviral therapy. We suggest adding a neuromodulating agent to prevent long-term sequelae and resolve acute symptoms.
Saddle Pulmonary Embolus Caught in Transit across a Patent Foramen Ovale
Authors: Aram Barbaryan, Stefania Bailuc, Travis Abicht, Sergey Barsamyan, Yonatan Gizaw, Aibek E Mirrakhimov
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Impending paradoxical embolism (IPE) also described in the literature as thrombus straddling a patent foramen ovale (PFO) or paradoxical embolus in transit is a rare condition when thrombus (originating mostly in deep veins of lower extremities) embolized to the heart gets caught in PFO or in atrial septal defect without systemic embolization. We present a case of a 39-year-old female on oral contraceptive pills who presented to the emergency department with chief complaint of dyspnea and chest pain. She was found to have saddle pulmonary embolus (PE) extending through PFO to left atrium and into the left ventricle. Patient underwent emergent open pulmonary embolectomy, removal of right and left atrial thrombi, and closure of patent foramen ovale. She tolerated the surgery well and was discharged home on chronic anticoagulation therapy.