OpenMed/multicare-articles huggingface dataset:
A rare case of recurrent eccrine poroma underlying gluteal abscess
Authors: Abdulkarim Hasan, Khalid Nafie, Khaled Monazea, Alsayed Othman, Abdoh Salem, Amal Ismail
Journal: Int J Surg Case Rep (2020)
Keywords: eccrine poroma, gluteal abscess, gluteal region, simple excision
MeSH terms: Case Reports

Introduction:
Eccrine poroma is a benign adnexal neoplasm originating from epidermal sweat ducts mainly affecting the palmoplantar skin, buttock as a location of origin of poroma has rarely been reported, it is the first reported case of recurrent poroma in this site.
Presentation of case:
We report an unusual case of eccrine poroma in the gluteal region of a 62 years old female associated with gluteal abscess, surgically excised with histologically clear margins, then recurred after one and half year with a given history of mild trauma.
Discussion:
Given the uncommonness of these neoplasms, there stays a general lack of data on pathogenesis, atypical presentation, atypical sites, recurrence and risk of malignant transformation into porocarcinoma.
Conclusion:
Gluteal skin is an unusual location for a benign poroma. Early recognition and appropriate treatment at the initial presentation by complete resection with histopathology confirmation and follow-up are crucial to ruling out other diagnoses, such as lesions of malignant transformation.
Rectal dieulafoy lesions: a rare etiology of chronic lower gastrointestinal bleeding
Authors: Ugur Dogan, Ismail Gomceli, Umit Koc, Mani Habibi, Nurullah Bulbuller
Journal: Case Rep Med (2014)

Dieulafoy lesion is rarely seen, yet it can be life-threatening. This lesion makes up to 1-2% of gastrointestinal bleedings and must definitely be considered in gastrointestinal bleedings whose source cannot be identified. In this case study, the 75-year-old woman was suffering from active, fresh, and massive rectal bleeding. Colonoscopy was applied in order to find out the source of bleeding. In the typical endoscopic appearance of the lesion a single round mucosal defect in the rectum and arterial bleeding were observed. To procure hemostasis, epinephrine was injected into the lesion and the bleeding vein was sutured.
LMNB1-Related Adult-Onset Autosomal Dominant Leukodystrophy Presenting as Movement Disorder: A Case Report and Review of the Literature
Authors: Yanyan Zhang, Jie Li, Rong Bai, Jianping Wang, Tao Peng, Lijie Chen, Jingtao Wang, Yanru Liu, Tian Tian, Hong Lu
Journal: Front Neurosci (2019)
Keywords: lmnb1 gene, adult-onset autosomal dominant leukodystrophy, movement disorder, neurodegenerative disease, tremor

Adult-onset autosomal dominant leukodystrophy (ADLD) is a lately described rare form of leukodystrophy with only one family report from China. As the only disease associated with increased lamina B1 encoded by LMNB1, ADLDs have different clinical presentations, ranging from autonomic to pyramidal tract and cerebellar ataxia. Here, we report a case of ADLD that presented with positional tremor as the initial symptom. T2-weighted brain MRI showed brain atrophy and diffuse high signal intensity of the cerebral white matter and the brain stem. The precise diagnosis was made by identification of the mutated gene. To the best of our knowledge, this is perhaps the first case report of ADLD presenting as tremor in China.
Case Report: Immune Dysregulation Due to Toxoplasma gondii Reactivation After Allogeneic Hematopoietic Cell Transplant
Authors: Robert B Lindell, Michael S Wolf, Alicia M Alcamo, Michael A Silverman, Daniel E Dulek, William R Otto, Timothy S Olson, Carrie L Kitko, Paisit Paueksakon, Kathleen Chiotos
Journal: Front Pediatr (2021)
Keywords: hematopoietic cell transplant, hyperferritinemia, immune dysregulation, multiple organ dysfunction syndrome, toxoplasmosis
MeSH terms: Case Reports

Disseminated toxoplasmosis is an uncommon but highly lethal cause of hyperferritinemic sepsis after hematopoietic cell transplantation (HCT). We report two cases of disseminated toxoplasmosis from two centers in critically ill adolescents after HCT: a 19-year-old who developed fever and altered mental status on day +19 after HCT and a 20-year-old who developed fever and diarrhea on day +52 after HCT. Both patients developed hyperferritinemia with multiple organ dysfunction syndrome and profound immune dysregulation, which progressed to death despite maximal medical therapies. Because disseminated toxoplasmosis is both treatable and challenging to diagnose, it is imperative that intensivists maintain a high index of suspicion for Toxoplasma gondii infection when managing immunocompromised children, particularly in those with known positive T. gondii serologies.
Successful pregnancy in a chronically hemodialyzed patient with end-stage renal failure
Authors: G Orlowska-Kowalik, T Malecka-Massalska, A Ksiazek
Journal: Indian J Nephrol (2009)
Keywords: end-stage renal failure, hemodialysis, hypertension, pregnancy
MeSH terms: Case Reports

A 36 year-old female with chronic kidney failure due to hypertension and who was being treated with hemodialysis for eight months, was admitted to the hospital on the suspicion of being pregnant. Gynecological examination and ultrasound scan confirmed the pregnancy. Gestation was diagnosed in the 29(th) week after the patient felt fetal movements. Intensification of the dialysis treatment was started immediately after the diagnosis was made.
Neurosarcoidosis presenting as longitudinally extensive myelitis: Diagnostic assessment, differential diagnosis, and therapeutic approach
Authors: Alessandra Cicia, Viviana Nociti, Assunta Bianco, Chiara De Fino, Vincenzo Carlomagno, Massimiliano Mirabella, Matteo Lucchini
Journal: Transl Neurosci (2022)
Keywords: longitudinally extensive transverse myelitis, neurosarcoidosis, sarcoidosis, treatment, trident sign
MeSH terms: Case Reports

Neurosarcoidosis is an uncommon and multiform clinical entity. Its presentation as an isolated longitudinal extensive transverse myelitis (LETM) is rare and challenging to identify. We report a case of LETM in a 60-year-old patient with no significant systemic symptoms nor relevant medical history. The peculiar spinal magnetic resonance imaging finding characterized by a posterior and central canal subpial contrast enhancement, the so-called "trident sign," together with chest computed tomography scan and lymph node biopsy led to the diagnosis of sarcoidosis. We also discuss the main differential diagnoses of LETM and therapeutic options for sarcoidosis-related myelitis.
Acute pancreatitis after major spine surgery: a case report and literature review
Authors: Daniela Ghisi, Alessandro Ricci, Sandra Giannone, Tiziana Greggi, Stefano Bonarelli
Journal: Scoliosis Spinal Disord (2018)
Keywords: amylase, lipase, pancreatitis, postoperative complications, prone position, scoliosis
MeSH terms: Case Reports

Background:
Acute pancreatitis has been described as potential complication of both abdominal and non-abdominal surgeries. The pathogenetic mechanism underlying acute pancreatitis in spine surgery may include intraoperative hemodynamic instability causing prolonged splanchnic hypoperfusion, as well as mechanical compression of the pancreas due to scoliosis correction, with a higher risk in cases of more extended fusions, especially in young adults with lower body mass index (BMI).
Case presentation:
We report here a case of postoperative acute pancreatitis with benign evolution in a young female patient after the first and second surgery of a two-stage correction of right thoracic idiopathic scoliosis.In December 2017, the patient underwent first-stage T4-L3 posterior arthrodesis with T7-T12 osteotomies and temporary magnetic bar. Intraoperative blood loss required massive transfusion. In the immediate postoperative period, the patient started reporting nausea/vomiting, abdominal pain at pressure, moderate meteorism, abdominal distension, hypoactive bowel sounds, and fever. Laboratory tests indicated a progressive increase in aspartate aminotransferase, alanine aminotransferase, serum amylase, lipase, phospho-creatine kinase, and reactive C-protein. A CT scan showed free abundant abdominal fluid in the hepatic, renal, pancreatic, and pelvic regions. After the diagnosis, a hypolipidic diet was initiated, and good hydration per os was maintained. After gastroenterologic consultation, somatostatin, rifaximin, and ursodehoxycholic acid were initiated and maintained for 8 days. In the following days, laboratory tests showed a slow but consistent decrease in liver and pancreatic enzymes until normalization. In January 2018, the patient underwent second-stage surgery with removal of magnetic bar, definitive posterior fusion, and instrumentation T4-L3. Laboratory tests showed a second, even more significant, increase in the amylase and lipase level and a moderate increase in the reactive C-protein. Therapy was maintained until complete normalization of amylase and lipase levels.
Conclusions:
Early recognition of symptoms plays a key role in preventing severe morbidity after scoliosis surgery. When symptoms suggest abdominal complication, pancreatic and liver enzymes are to be evaluated for posing prompt diagnosis. Gastroenterologic consultation and eventual imaging are further steps in differential diagnosis and treatment of this rare complication.
Brain Herniation into Giant Arachnoid Granulation: An Unusual Case
Authors: Joana Ruivo Rodrigues, Gonçalo Roque Santos
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Arachnoid granulations are structures filled with cerebrospinal fluid (CSF) that extend into the venous sinuses through openings in the dura mater and allow the drainage of CSF from subarachnoid space into venous system. Usually they are asymptomatic but can be symptomatic when large enough to cause sinus occlusion. We report a rare case of a brain herniation into a giant arachnoid granulation in an asymptomatic elderly male patient, which was discovered incidentally.
A Case of an Atraumatic Posterior Perirenal Lumbar Hernia
Authors: Kristin N Slater, Moustapha Doulaye, Uzoamaka Obodo, Ann George, Adnan Mohammadbhoy
Journal: Cureus (2023)
Keywords: atraumatic hernia, lumbar hernia, perirenal, perirenal hernia, primary hernia, primary lumbar hernia
MeSH terms: Case Reports

Retroperitoneal lumbar hernias are a rare entity. Atraumatic posterior perirenal hernias are an exceptionally rare form of retroperitoneal lumbar hernias. Because of their infrequency, there are no standardized methods of surgical care for the treatment of atraumatic (primary spontaneous) posterior perirenal hernias. This report documents the finding and management of an atraumatic posterior perirenal lumbar hernia in a 69-year-old female.
Struma ovarii with contralateral ovarian teratoma: A case report
Authors: Xinjie Ren, Zhaoyou Guo, Jiao Bai
Journal: Front Surg (2022)
Keywords: papillary thyroid cancer, struma ovarii, teratoma, thyroid carcinoma, tumor ovarii
MeSH terms: Case Reports

Struma ovarii (SO) is a rare form of ovarian teratoma in which the thyroid tissue constitutes over 50% of the tumor. SO comprise 1% of all ovarian tumors. We report the case of a 61-year-old woman who was admitted to the hospital because of frequent urination and dysuria. Abdominal magnetic resonance imaging revealed a mass measuring approximately 16 cm in diameter in the right adnexal area. After transabdominal bilateral adnexectomy, pathological examination revealed a teratoma of the ovary on the right and goiter of the ovary with focal thyroid cancer on the left side. Subsequent total thyroidectomy was performed, and no cancer was found on pathological examination. The patient was treated with thyroxine for a long time after the operation, and there was no recurrence 3 years after diagnosis.
Acute contained ruptured aortic aneurysm presenting as left vocal fold immobility
Authors: Sharon H Gnagi, Brittany E Howard, Joseph M Hoxworth, David G Lott
Journal: Case Rep Otolaryngol (2015)

Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner's syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.
Successful Use of a Multidisciplinary Approach to Treat a Perforated Duodenal Malignant Lymphoma in an Elderly Patient
Authors: Tomoko Takagishi, Yuta Niimi, Goshi Matsuki, Shinta Nagano, Junsuke Hinami, Masaaki Kajiwara, Kiyoshi Kaneko, Yoshihiro Kubota, Osamu Nakai
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Treatment of duodenal malignant lymphoma is difficult due to life-threatening complications such as intestinal obstruction, perforation, and pancreatitis. Thus, multidisciplinary procedures are required alongside surgical intervention. Contrast abdominal CT images of a 75-year-old female suffering from vomiting revealed thickening of the duodenal wall (from the second to third segment). Gastrojejunostomy and biopsy identified the tumor as diffuse large B-cell lymphoma. A diagnosis of stage II duodenal lymphoma was made. The lymphoma continued to grow, resulting in jaundice and intestinal perforation, which was first treated with two cycles of rituximab and antibiotics. Thereafter, less intensive chemotherapy (two cycles each of R-mini-CHP, CHP, and R-CHOP) was administered, which led to significant improvement upon assessment by PET-CT. Residual lymphoma was treated with consolidation radiotherapy (50 Gy in 25 fractions) over 5 weeks after chemotherapy. The patient attained a complete response and has been disease-free for more than 4 years. Thus, duodenal perforated lymphoma can be treated successfully using a multidisciplinary approach that combines surgery, immunochemotherapy, and radiation therapy.
Opsismodysplasia: Phosphate Wasting Osteodystrophy Responds to Bisphosphonate Therapy
Authors: Ansab Khwaja, Shawn E Parnell, Kathryn Ness, Viviana Bompadre, Klane K White
Journal: Front Pediatr (2015)
Keywords: bisphosphonates, genu varum, metabolic bone disease, opsismodysplasia, scoliosis, skeletal dysplasias

We present two siblings affected with opsismodysplasia (OPS), a rare skeletal dysplasia caused by mutations in the inositol polyphosphate phosphatase-like 1 gene. The skeletal findings include short stature with postnatal onset micromelia, marked platyspondyly, squared metacarpals, delayed skeletal ossification, metaphyseal cupping, and postnatal micromelia. Respiratory compromise, delayed ambulation, and progressive lower extremity deformities are described. The severity of findings is variable. Renal phosphate wasting is associated with severe bone demineralization and a more severe phenotype. This report represents the first described cases of opsismodysplasia treated with intravenous bisphosphonate (pamidronate). Surgical management for lower extremity deformities associated with OPS is also reviewed.
Level of evidence:
IV Case series.
Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury
Authors: Conor D Marron, Damian McKay, Ruth Johnston, Eamon McAteer, W J Ivan Stirling
Journal: BMC Emerg Med (2005)

Background:
Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We highlight the steps to diagnosis of these injuries, and methods of managing these injuries. It is important for clinicians to be aware of the potential for this injury in patients with seemingly innocuous trauma from sports injuries, who have significant ankle pain and swelling.
Case presentation:
A young, professional sportsman presented with a swollen, painful ankle after an innocuous hyper-plantar flexion injury whilst playing football, which was initially diagnosed as a ligamentous injury after no bony injury was revealed on X-Ray. He returned 2 days later with a large ulcer at the lateral malleolus and further investigation by duplex ultrasound and transfemoral arteriogram revealed a Pseudo-Aneurysm of the Anterior Tibial Artery. This was initially managed with percutaneous injection of thrombin, and later open surgery to ligate the feeding vessel. The patient recovered fully and was able to return to recreational sport.
Conclusion:
Vascular injuries remain a rare cause of ankle pain and swelling following sports injuries, however it is important to consider these injuries when no definite musculo-skeletal cause is found. Ultrasound duplex and Transfemoral arteriogram are appropriate, sensitive modalities for investigation, and may allow novel treatment to be directed percutaneously. Early diagnosis and intervention are essential for the successful outcome in these patients.
Uterine Tumors Resembling Ovarian Sex Cord Tumors: Case Report of Rare Pathological and Clinical Entity
Authors: Rotem Sadeh, Yakir Segev, Meirav Schmidt, Jacob Schendler, Tamar Baruch, Ofer Lavie
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Uterine tumors resembling ovarian sex cord tumors (UTROSCT) are rare uterine neoplasms. These tumors are usually benign, displaying a nodular or polypoid growth pattern; common occurrence is observed at the 4th to 6th decade of life. This entity is divided according to clinical behavior and pathological typical findings including different immunohistochemical staining. Traditionally type I tumors show a predominant endometrial stromal pattern with less than 50% ovarian sex cord component. This type has been shown to behave more aggressively with a decreased disease free survival period. Type II tumors, the classical UTROSCT, are less invasive but have the tendency to recur. We report a case of a 57-year-old patient presenting with postmenopausal bleeding. Hysteroscopic polypectomy showed the diagnosis of UTROSCT. This case presents a less morbid minimally invasive treatment plan and exemplifies that in patients where low malignant potential exists and their will is taken into consideration such management is both crucial and correct.
Pernicious Anemia and Vitiligo in an HIV Patient: An Unfamiliar Case Presentation
Authors: Katongo Mutengo, Francis Mupeta, Owen Ngalamika
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Pernicious anemia (PA) is a rarely considered cause of anemia in HIV-infected population and is seldom on the list of differential diagnoses. However, PA can have serious consequences if misdiagnosed or left untreated. We present the case of a 38-year-old HIV-positive man who was diagnosed with PA, which was preceded by a one-year history of vitiligo. Our case is a reminder for clinicians to have a high index of suspicion for an autoimmune process as a potential cause of anemia in HIV-infected individuals.
Stress Fracture of the Hamate Hook in a Water Polo Player
Authors: Hana Ueda, Shunpei Hama, Masataka Yasuda, Kenta Minato, Masahiro Miyashita, Kishik Shin
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Hamate hook fractures are usually caused by direct trauma while using a tennis racket or a baseball bat. We report stress fracture of the hamate hook in a water polo player without any specific trauma. We consider that the stress fracture occurred via indirect mechanisms through the flexor tendons. Strong ulnar deviation of the wrist during ball release and strong grip on a ball with outstretched fingers, which are unique to water polo, were the likely causes of the stress fracture of the hamate hook.
Musical Neglect Training for Chronic Persistent Unilateral Visual Neglect Post-stroke
Authors: Kyurim Kang, Michael H Thaut
Journal: Front Neurol (2019)
Keywords: musical neglect training (mnt), neurologic music therapy (nmt), spatial perception and attention, stroke, unilateral visual neglect
MeSH terms: Case Reports

Unilateral visual neglect from right hemispheric stroke is a condition that reduces a person's ability to attend to and process stimuli in their left visual field, resulting in neglect and inattention to the left side of their environment. This perceptual processing deficit can negatively affect individuals' daily living which in turn reduces functional independence. Musical Neglect Training (MNT) has been developed based on previous research evidence to improve left visual field processing. Two individuals with persistent chronic unilateral visual neglect participated in this study. Participants underwent six individual MNT sessions. Active MNT was used involving exercises on musical equipment (tone bars) to complete musical patterns emphasizing attentional focus toward the neglect visual field. Two standardized assessments (Albert's and Line Bisection Test) were used. The assessments were administered immediately before and after each of the 6 MNT sessions to assess the within-session effect of MNT. Follow-up testing was done 1 week after their 6th session to examine the longer-lasting effects of MNT. Paired t-test and Wilcoxon signed rank test were used to examine results. Both participants showed significant improvement pre vs. posttest on the Albert's Test but not on the Line Bisection Test. The current study presents the positive potential of MNT for patients with chronic persistent visual neglect. In particular, effects were shown for exploratory visuomotor neglect (Albert's test), but not for egocentric perceptive neglect (Line Bisection Test), and substantiated for within-session effects only. The predictable auditory stimulus patterns associated with object sequences (tone bars) to provide feedback, direct spatial attention and orientation, and initiate intention for movement into the neglect field may offer specific advantages to reduce persistent perceptual attention deficits.
Colorectal Cancer Metastasis to the Thymus Gland: Rare Presentation of Colorectal Cancer as Anterior Mediastinal Mass
Authors: H Charles Peters, Xiuli Liu, Atif Iqbal, Lisa A Cunningham, Sanda A Tan
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Despite improved screening modalities, 15-25% of newly diagnosed colorectal cancers are metastatic at the time of diagnosis. The vast majority of these cases present as hepatic metastasis; however, 22% present with concomitant extrahepatic disease. The thymus gland is an uncommon site of metastasis for any primary malignancy, particularly, colorectal cancer given its vascular and lymphatic drainage. This case report details our experience with a rare case of colorectal cancer metastasis to the thymus gland presenting as a symptomatic mediastinal mass.