OpenMed/multicare-articles huggingface dataset:
Multimodal imaging of angioid streaks
Authors: Sugandha Goel, Isha Gupta, Samarth Mishra, Barun Garg, Kumar Saurabh, Rupak Roy
Journal: GMS Ophthalmol Cases (2020)
Keywords: angioid streaks, comet lesions, multicolor imaging
MeSH terms: Case Reports

Angioid streaks (AS) are irregular crack-like dehiscences in Bruch's membrane that are often associated with atrophic degeneration of the overlying retinal pigment epithelium. We herein report multimodal imaging of AS. Multicolor imaging highlighted AS in dark orange color. AS were better visualized in infrared reflectance as compared to green reflectance and blue reflectance. Peau d'orange appearance was seen as alternating dark and bright patches on color fundus photography with corresponding hyporeflective and hyperreflective patches on infrared reflectance. Comet lesions showed increased signal on infrared reflectance and hyperautofluorescence. Multicolor imaging is a non-invasive imaging modality which helps in clearly delineating these lesions.
A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier
Authors: Ihsan Ates, Mustafa Kaplan, Selim Demirci, Emin Altiparmak
Journal: Euroasian J Hepatogastroenterol (2016)
Keywords: hepatitis b e antigen, hepatitis b surface antigen, hepatitis b virus
MeSH terms: Case Reports

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed.
How to cite this article:
Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.
A Case Report of Dramatically Increased Thyroglobulin after Lymph Node Biopsy in Thyroid Carcinoma after Total Thyroidectomy and Radioiodine
Authors: Mandana Moosavi, Stuart Kreisman
Journal: Case Rep Endocrinol (2016)

Thyroglobulin (Tg) is an important modality for monitoring patients with thyroid cancers, especially after thyroidectomy followed by radioiodine (RAI). It is also used as a marker for burden of thyroid tissue whether malignant or benign. Although there have been several reports of rising serum Tg transiently after thyroid biopsy in intact glands and following palpation or trauma, there are no reports in the literature of elevation in Tg after biopsy of suspicious lesions in thyroidectomized patients. In this paper we report a fascinating case of a considerable and initially worrying, although ultimately transient, rise in Tg in a patient 2 years after total thyroidectomy and RAI ablation after fine needle aspiration (FNA) of a suspicious thyroid bed nodule that was proven positive.
Post-treatment periapical periodontitis X-ray versus CBCT - a case report
Authors: P Perlea, C Nistor, I Suciu
Journal: J Med Life (2016)
Keywords: cbct, post treatment periodontitis, radiograph
MeSH terms: Cone-Beam Computed Tomography / methods, Periapical Periodontitis / diagnostic imaging, Case Reports, Comparative Study, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Root Canal Therapy, X-Rays

Post treatment periapical periodontitis is usually caused by residual microbes, due to poorly treated root canals and microleakage. Our clinical case proved that orthograde, single-visit endodontic re-treatment is the first choice for the clinician. Cone Beam Computed Tomography (CBCT) images detect the presence and the real extension of the periapical periodontitis and the outcome of the endodontic treatment, in terms of healing the bone defect. Compared with the limited 2-D data obtained by using the radiograph, the CBCT shows a 3-D image of the tooth, the root canal, and the surrounding tissue.
Giant cell reparative granuloma of the hallux following enchondroma
Authors: Khaled Kamoun, Tarak Sellami, Zied Jlailia, Layla Abid, Mourad Jenzri, Mouna Bouaziz, Omar Zouar
Journal: Pan Afr Med J (2015)
Keywords: tumor, benign, bone, foot
MeSH terms: Bone Neoplasms / diagnosis, Chondroma / diagnosis, Granuloma, Giant Cell / diagnosis, Hallux / pathology, Case Reports, Adolescent, Biopsy, Bone Neoplasms / pathology, Chondroma / pathology, Granuloma, Giant Cell / pathology, Humans, Male

Giant cell reparative granuloma (GCRG) is a rare, benign intra osseous lytic lesion occurring especially in gnathis bone but also seen in feet and hands. It has similar clinical and radiological presentations than giant cell tumor, chondroblastoma, aneurysmal bone cyst, and hyperparathyroidism brown tumors but with specific histological findings We report a case of a GCRG of hallux phalanx in 18 years old patient appearing many years after enchondroma curettage and grafting. Radiographs showed a multiloculated osteolytic lesions involving whole phalanx with cortical thinning and without fluid-fluid levels in CT view. Expected to be an enchondroma recurrence, second biopsy confirmed diagnosis of GCRG with specific histological findings. Although if aetiopathogeny remains unknown, GCRG is reported to be a local non neoplasic reaction to an intraosseous hemorrhage. Our exceptional case claims that this tumor can appear in reaction to cellular disturbance primary or secondary.
Atypical Presentation of Right Ventricular Cardiac Hamartoma in a Young Man
Authors: Ramez Barsoom, Lamees I El Nihum, Qasim Al Abri, Areeba Ali, Susan L Haley, Mohammed A Chamsi-Pasha, Moritz C Wyler von Ballmoos, Thomas E MacGillivray, Michael J Reardon
Journal: Methodist Debakey Cardiovasc J (2022)
Keywords: cardiac hamartoma, cardiac tumor, echocardiography, mass, right ventricle, ventriculotomy
MeSH terms: Hamartoma / diagnosis, Hamartoma / diagnostic imaging, Heart Neoplasms / complications, Heart Neoplasms / diagnostic imaging, Heart Neoplasms / surgery, Heart Septal Defects, Ventricular, Ventricular Septum / diagnostic imaging, Ventricular Septum / pathology, Ventricular Septum / surgery, Case Reports, Adult, Heart Ventricles / diagnostic imaging, Heart Ventricles / pathology, Heart Ventricles / surgery, Humans, Male

Cardiac tumors in adults are exceedingly rare and usually benign. We describe a 29-year-old man with a previous diagnosis of interventricular septal hypertrophy who presented with increasing severity of dyspnea and fatigue. Work-up revealed a 4.9 × 3.7 cm mass at the base of the interventricular septum. Biopsy revealed a benign cardiac hamartoma atypically located in the right ventricle, and the mass was resected via right ventriculotomy.
Case Report: Primary Leiomyosarcoma of the breast with unusual metastasis to the femur
Authors: Evgeniya Sokolovskaya, Zheng Liu, Kelly Weintraub, Arpad Szallasi, Yasmeen Shariff
Journal: F1000Res (2014)

With less than 40 cases reported, primary leiomyosarcoma is an extremely rare form of breast cancer (less than 0.0006% of cases) with unpredictable biological behavior that usually presents as a slow growing, mobile mass in middle age women. Most cases are low-grade and are cured by complete excision with wide margins. After surgical resection, late local recurrence and distant hematogenous metastasis to lungs and liver is, however, well-documented. To the best of our knowledge, bone metastasis has never been reported. Here we present a case of primary leiomyosarcoma of the breast metastatic to the femur.
Cortical Tremor (CT) with coincident orthostatic movements
Authors: Pichet Termsarasab, Steven J Frucht
Journal: J Clin Mov Disord (2015)
Keywords: cortical tremor, levetiracetam, orthostatic tremor
MeSH terms: Case Reports

Cortical tremor (CT) is a form of cortical reflex myoclonus that can mimic essential tremor (ET). Clinical features that are helpful in distinguishing CT from ET are the irregular and jerky appearance of the movements. We report two patients with CT with coexisting orthostatic movements, either orthostatic tremor (OT) or myoclonus, who experienced functional improvement in both cortical myoclonus and orthostatic movements when treated with levetiracetam.
Unusual presentation of rare case of papillary adenofibroma of cervix in a young woman
Authors: H Mahesha Navada, B Poornima Ramachandra Bhat, Gayatri Ramani, R Rohan Chandra Gatty, C S Jayaprakash
Journal: Case Rep Oncol Med (2012)
MeSH terms: Case Reports

Adenofibroma is an extremely rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. These tumors tend to occur in postmenopausal and elderly women. We report the case of a large polypoidal mass per vagina occupying the whole pelvis in a young woman. Preoperative biopsy showed benign epithelial and mullerian mesenchymal components suggestive of mullerian adenofibroma. Total hysterectomy with bilateral salpingectomy was done. The diagnosis of papillary adenofibroma of cervix was made. The total surgery assured complete excision and permitted adequate sampling to exclude malignancy.
An incidentaloma: primitive neuroectodermal tumor of the thymus
Authors: Suzanne M Smith, Abigail Berniker, Stephen B Iorfido
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

After presenting for a routine screening exam, and 57-year-old man was diagnosed with an incidentaloma-a primitive neuroectodermal tumor (PNET) of the thymus. A member of the Ewing sarcoma family of tumors, a PNET is typically regarded as a malignancy of childhood and adolescence, usually occurring in the central nervous system. In the case at hand, our patient had an extremely unusual presentation, given his age and tumor location. Initial presentation is the only predictor for long-term survival. Current treatment recommendations advocate complete surgical resection whenever possible, radiation therapy, and adjuvant versus neoadjuvant chemotherapy.
Hypercalcemia and Osteolytic Lesions as Presenting Symptoms of Acute Lymphoblastic Leukemia in Children: Case Report and Literature Review
Authors: Min Chen, Jiaqi Ni, Xiaoxi Lu
Journal: Front Pediatr (2022)
Keywords: acute lymphoblastic leukemia, calcitonin, children, hypercalcemia, pamidronate
MeSH terms: Case Reports

Acute lymphoblastic leukemia (ALL) presenting with hypercalcemia and osteolytic lesions is rare and unusual in childhood. We report a case of a 13-year-old boy with ALL who presented with intermittent fever, nausea, vomiting, and increasing lower limb pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Physical examination revealed multiple inguinal lymph nodes. Laboratory tests demonstrated severe hypercalcemia (Ca > 3.49 mmol/L), decreased parathyroid hormone (PTH), and vitamin D level. Despite a normal complete blood count and the absence of circulating blasts, bone marrow biopsy revealed B-precursor ALL. Hypercalcemia was initially treated with intravenous isotonic sodium chloride and furosemide but the serum calcium level was not normalized. It was successfully managed with calcitonin and pamidronate afterward. Later, the child responded well to chemotherapy and continued with consolidation treatment. The clinical condition was stable, and the bone marrow revealed complete remission. This case indicated that hypercalcemia alone or combined with osteolytic lesions can be the only presenting symptom of ALL in children. Diagnostic errors may occur especially when combined with the absence of circulating blasts in the peripheral blood smear. Bone marrow aspiration should be considered to confirm the diagnosis.
Acetaminophen Use: An Unusual Cause of Drug-Induced Pulmonary Eosinophilia
Authors: Mathieu D Saint-Pierre, Onofre Moran-Mendoza
Journal: Can Respir J (2016)
MeSH terms: Acetaminophen / adverse effects, Analgesics, Non-Narcotic / adverse effects, Pulmonary Eosinophilia / chemically induced, Case Reports, Aged, Female, Humans, Pulmonary Eosinophilia / diagnostic imaging, Radiography, Thoracic, Tomography, X-Ray Computed, Analgesics, Non-Narcotic, Acetaminophen

Pulmonary eosinophilia (PE) can be found in very diverse pathological processes. Several medications have also been associated with this entity. Acetaminophen is a medication commonly used in multiple different drug formulations, many of which are available without a prescription. It has however been associated with pulmonary eosinophilia (eosinophilic pneumonia) in a few cases in Japan. We describe the case of a 68-year-old Caucasian female who presented with new persistent dry cough and dyspnea on exertion after she started using up to 4 grams of acetaminophen on a daily basis. Chest imaging revealed peripheral lower lung zone ground glass and reticular opacities, and increased eosinophils were present on bronchoalveolar lavage (BAL). The patient's symptoms markedly improved upon acetaminophen cessation, and significantly decreased eosinophils were seen on repeat BAL. To our knowledge, this is the first case of likely acetaminophen-induced pulmonary eosinophilia reported outside Japan.
Human Botfly: A Case Report and Overview of Differential Diagnosis
Authors: Mina Shenouda, Garrett Enten, Thanh Nguyen, Devanand Mangar, Enrico Camporesi
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: dermatobia hominis, furuncular lesion, human botfly

Dermatobia hominis, commonly known as the human botfly, is native to Tropical America. As such, cutaneous infestation by its developing larvae, or myiasis, is quite common in this region. The distinct dermatological presentation of D hominis myiasis allows for its early recognition and noninvasive treatment by locals. However, it can prove quite perplexing for those unfamiliar with the lesion's unique appearance. Common erroneous diagnoses include the following: folliculitis, benign dermatocyst, and embedded foreign body with localized infection. We present a patient who acquired D hominis while she was in Belize. In this report, we discuss the presentation, differential diagnosis, diagnostic tests, and therapeutic approaches of human botfly lesion to raise the awareness about human botfly.
Adaptation of problem-solving therapy for primary care to prevent late-life depression in Goa, India: the 'DIL' intervention
Authors: Amit Dias, Fredric Azariah, Miriam Sequeira, Revathi Krishna, Jennifer Q Morse, Alex Cohen, Pim Cuijpers, Stewart Anderson, Vikram Patel, Charles F Reynolds 3rd
Journal: Glob Health Action (2019)
Keywords: indicated depression prevention, late-life depression, lay health counselors, low- and middle-income countries, problem-solving therapy
MeSH terms: Counseling, Depression / prevention & control, Peer Group, Primary Health Care, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Aged, Depression / physiopathology, Feasibility Studies, Female, Focus Groups, Humans, Hypertension, India, Interviews as Topic, Male, Mental Health, Middle Aged, Prevalence, Qualitative Research, Self Report

Background:
Depression in late life is a major, yet unrecognized public health problem in low- and middle-income countries (LMICs). The dearth of specialist resources, together with the limited ability of current depression treatments to avert years lived with disability, underscores the need for preventive interventions that can be delivered by lay health workers in primary care settings. We describe the development of an intervention for the indicated prevention of depression in older adults at risk due to subsyndromal symptoms, attending rural and urban public primary care clinics in Goa, India.
Objectives:
(1) to describe a mixed-methods approach (qualitative and quantitative)to the development of 'DIL,' an intervention for preventing the onset of major depression in older adults living with subsyndromal symptoms in Goa, India; (2) to describe resulting components of the 'DIL' intervention; and (3) to present data on the feasibility, acceptability, and benefit of DIL to participants.
Methods:
We followed a mixed-methods design, including in-depth interviews, focus group discussions, a theory of change workshop to develop a logic model, and an open-case series.
Results:
The mixed-method approach led to the development and adaptation of the DIL (Depression in Later Life) intervention for the indicated prevention of depression in older adults. The intervention was delivered by lay health counselors (LHCs). 'DIL' is a hybrid model of simple behavioral strategies grounded in Problem-solving Therapy for Primary Care, improved self-management of common, co-occurring medical disorders such as diabetes mellitus, and pragmatic assistance in navigating to needed social services. The use of 'DIL' in an open-case series with 19 participants led to a moderate reduction in symptoms of depression and anxiety on the General Health Questionnaire. A pictorial flipchart was developed to assist in delivering the intervention to participants with low levels of literacy. High rates of participant retention and satisfaction were achieved.
Conclusion:
The DIL intervention was adapted to the local context for delivery by lay health counselors and was found to be acceptable and feasible among the elderly participants in the study.
Case report: Double L611S/V617L JAK2 mutation in a patient with polycythemia vera originally diagnosed with essential thrombocythemia
Authors: Xiao-Qing Li, Jia-Jun Liu, Cheng-Cheng Liu
Journal: Front Oncol (2022)
Keywords: csf1r mutation, jak2 l611s/v617l mutation, essential thrombocythemia, myeloproliferative neoplasm, phenotype transformation, polycythemia vera
MeSH terms: Case Reports

Double JAK2 mutations have rarely been described in myeloproliferative neoplasms (MPNs) and are demonstrated to be associated with the polycythemia vera (PV) phenotype. Here, we first report a case of a PV patient with a de novo double L611S/V617L in cis mutation of JAK2. A 40-year-old woman was admitted to the hospital with massive splenomegaly, multiple splenic infarcts, and abdominal pain. She had a 4-year history of erythrocytosis with an antecedent 10-year history of thrombocytosis before coming to our hospital. She was diagnosed with JAK2 L611S/V617L double-mutant PV after a detailed medical examination in 2017. According to the literature, IFNα therapy can induce clinical, hematological, histopathological, and occasionally molecular remission in individuals with MPNs. Our report demonstrates that combination therapy with ruxolitinib and IFNα can lead to a substantial reduction in JAK2 L611S/V617L double-mutant allele burden.
Isolated cryptococcosis of a lumbar vertebra in an immunocompetent patient: A case report and literature review
Authors: Zhongxiong Jia, Min Tang, Xiaojun Zhang, Xiaojuan Xin, Wei Jiang, Jie Hao
Journal: Front Surg (2023)
Keywords: cryptococcus, case report, lumbar vertebral cryptococcosis, spinal infection, surgery
MeSH terms: Case Reports

Background:

Cryptococcus, a kind of fungus, can be found in soil, decayed wood, and avian excreta. Immunocompromised patients are prone to infection caused by Cryptococcus, and the lungs and central nervous system are the main target organs. Cryptococcosis rarely occurs in the lumbar vertebra or in immunocompetent patients.
Case presentation:
A 40-year-old adult male with isolated lumbar vertebra cryptococcosis at the L4 vertebra underwent successful lesion removal surgery performed via the posterior approach and postoperative administration of an antifungal agent. At the 12-month follow-up, the patient's pain was relieved, and his motor function had improved. Isolated Cryptococcus vertebrae infection is a rare infectious disease.
Conclusions:
A needle biopsy can confirm the diagnosis of Cryptococcus infection. When patients present with unbearable symptoms of nerve compression, posterior depuration combined with postoperative antifungal agents is a good option.
Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series
Authors: Chao-Yin Kuo, Yuan-Yung Lin, Hsin-Chien Chen, Cheng-Ping Shih, Chih-Hung Wang
Journal: Biomed Res Int (2017)
MeSH terms: Adenoidectomy / methods, Adenoids / diagnostic imaging, Adenoids / surgery, Endoscopy / methods, Video-Assisted Surgery / methods, Case Reports, Adolescent, Adult, Child, Female, Humans, Male, Young Adult

Objectives. The primary objective for this study is to evaluate the advantages, disadvantages, surgical applicability, and outcome of the pulsed electron avalanche knife (PEAK) PlasmaBlade in transoral adenoidectomy under direct visualization using video nasoendoscopy. Patients and Methods. In this series, six cases of adenoid hypertrophy showing varying clinical presentations in relation to its clinical course were surgically treated using a PEAK PlasmaBlade. Before and after surgery, all patients underwent nasal endoscopy to define the grading of hypertrophic adenoids and postoperative outcome. Pure tone audiometry and tympanometry tests were carried out to investigate the change in middle and inner ear functions. Results. The mean follow-up period was 23.8 months. Postoperatively, symptoms of otitis media with effusion were all relieved with closure of the air-bone gap (6/6). Other relevant ear complaints like tinnitus were resolved (1/1) and aural fullness disappeared in 87.5% of ears (7/8). Nasal obstruction (2/2) and postnasal drip (2/2) were improved after surgery. Conclusions. Based on this preliminary report of a case series in a limited sample size, we suggest that using the transoral PEAK PlasmaBlade for adenoidectomy guided by video nasoendoscopy is a safe and feasible surgical technique, allowing remarkable outcomes by providing precise tissue removal, effective hemostasis, and painless postoperative recovery.
Metastatic Renal Cell Carcinoma with Level IV Thrombus: Contemporary Management with Complete Response to Neoadjuvant Targeted Therapy
Authors: Abhishek Bhat, Bruno Nahar, Vivek Venkatramani, Indraneel Banerjee, Oleksandr N Kryvenko, Dipen J Parekh
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Renal cell carcinoma, particularly the most common clear cell type, is one of the most aggressive of urological cancers with significant risk of metastatic spread. It also has a propensity for venotropism with a proportion of tumors developing thrombi up to the right atrium. The response with newly adopted targeted therapy has been considered to be in the evolutionary stage with no clear role with respect to debulking or reducing the size of the inferior vena cava (IVC) thrombus. We describe a case of a right-sided metastatic RCC with Level IV thrombus initially managed with Pazopanib followed by Nivolumab and Adalimumab followed by cytoreductive nephrectomy and IVC thrombectomy in the post-targeted therapy setting with complete curative response.
An Undiagnosed Ventricular Septal Rupture Presenting as New Onset Heart Failure: A Rare Complication of an Anterior Myocardial Infarction
Authors: Ryan T Nguyen, Priyanka Satish, Marvin D Atkins Jr, Sachin S Goel
Journal: Methodist Debakey Cardiovasc J (2022)
Keywords: myocardial infarction, ventricular septal rupture
MeSH terms: Anterior Wall Myocardial Infarction / complications, Anterior Wall Myocardial Infarction / diagnostic imaging, Heart Failure / diagnostic imaging, Heart Failure / etiology, Heart Failure / therapy, Myocardial Infarction / complications, Myocardial Infarction / diagnostic imaging, Ventricular Septal Rupture / diagnostic imaging, Ventricular Septal Rupture / etiology, Ventricular Septal Rupture / surgery, Case Reports, Humans

Ventricular septal ruptures (VSR) are a rare but fatal complication of acute myocardial infarctions. We present a patient complaining of new onset heart failure symptoms that were found to be secondary to a new ventricular septal rupture from a recently undiagnosed anterior myocardial infarction. The patient underwent successful VSR patch repair with eventual recovery. This case highlights the importance of early diagnosis of VSR and reviews management options and appropriate timing for intervention.