OpenMed/multicare-articles huggingface dataset:
Ectopic thyroid in the hepatoduodenal ligament: a case report and literature review
Authors: Lei Zhang, Xijun Cui, Baolei Wang, Xiulan Du, Guoqi Hou, Xiaoqian Yu
Journal: Front Oncol (2024)
Keywords: case report, ectopic thyroid, extra thyroid gland, hepatoduodenal ligament, vagal thyroid
MeSH terms: Case Reports

Ectopic thyroid arises from abnormal development of thyroid primordial tissues as it migrates to the lower interstitium during the embryonic period, which can occur at various locations during the descent process. However, ectopic thyroid in the subdiaphragmatic area is extremely rare. In this case, we report a case of ectopic thyroid located in the hepatoduodenal ligament. The 60-year-old female patient was admitted to hospital with gallbladder stones and cholecystitis. Preoperative imaging showed a mass in the hepatoduodenal ligament. As the patient declined a needle biopsy of the mass, the nature of the mass remained unclear prior to surgery. The patient subsequently underwent laparoscopic cholecystectomy and exploratory resection of the mass. The histopathology of the resected mass showed the characteristics of ectopic thyroid, and immunohistochemical staining revealed positive expression of thyroid transcription factor-1 and thyroglobulin. The diagnosis of ectopic thyroid was established. Upon confirming the diagnosis, comprehensive neck examination revealed the presence of a normally functioning thyroid gland. Throughout the four-year follow-up period, the patient's thyroid ultrasonography and thyroid function tests indicated no abnormalities. Ectopic thyroid in the hepatoduodenal ligament and surrounding areas is an extremely rare clinical abnormality, achieving a clear diagnosis before initiating treatment offers diagnostic and treatment insights and clues for clinicians when differentiating masses within this region.
Leveraging Color M-Mode to Diagnose Aorto-Atrial Fistula as a Complication of Infective Endocarditis
Authors: Kramer J Wahlberg, Matthew A Kluge, William E Hopkins
Journal: Case Rep Cardiol (2024)
MeSH terms: Case Reports

Aorto-atrial fistula is a rare and life-threatening complication of infective endocarditis, classically diagnosed by visualizing a connection between the aorta and atrium with associated continuous flow. A patient presented with bioprosthetic and native valve enterococcal endocarditis with multiple complications, including an aorto-atrial fistula that was diagnosed by color M-mode on transesophageal echocardiography. We review the features of aorto-atrial fistula and utilize this case to demonstrate how M-mode can be leveraged to provide improved temporal resolution in the setting of diagnostic uncertainty.
Treatment Response to Acute Total Ophthalmoplegia in Primary Pituitary Lymphoma: A Case Report and Review of the Literature
Authors: Saygı Uygur, Derya Karataş, Gözde Arslan, Ahmet Dağtekin, Emel Avcı
Journal: Cureus (2024)
Keywords: chemotherapy, ophthalmoplegia, primary pituitary lymphoma, sellar-parasellar lesion, surgical resection
MeSH terms: Case Reports

Primary pituitary lymphoma (PPL) is an extremely rare localized lymphoma without systemic involvement. The most common clinical presentations of PPL are hypopituitarism, headaches, and ophthalmoplegia. Diagnosing PPL without a biopsy is almost impossible. There is no study that has specifically investigated and reviewed treatment responses to the ophthalmological symptoms of PPL patients. Herein, we present a 66-year-old female patient who had acute-onset total ophthalmoplegia and headache as admission symptoms, which was diagnosed as PPL after subtotal resection. In the present study, we discussed the response of ophthalmological symptoms to treatment with a review of the literature. Only 18 reported cases had postoperative ophthalmological examination, and in 94.4% of these cases, ophthalmoplegia resolves after surgery and chemotherapy. The complete resection rate of the PPL in the literature was found to be as low as 12.3% in this region because of the hard and adhesive nature of the tumor. Our review unveiled that complete recovery of ophthalmoplegia can be achieved even in the late phase of the symptoms. In the present case, ophthalmoplegia resolved completely following subtotal resection and rituximab, high-dose methotrexate, and cytarabine treatment.
Symptoms similar to Kleine-Levin syndrome in a patient with basilar artery occlusion: a case report and literature review
Authors: Linghua Kong, Chunyan Li
Journal: Front Neurol (2024)
Keywords: kleine–levin syndrome, hypersomnia, pathogenesis, thrombectomy, vascular disease
MeSH terms: Case Reports

Introduction:
Kleine-Levin syndrome (KLS) is a rare disorder characterized by recurrent periodic hypersomnia, cognitive disturbances, hyperphagia, and hypersexuality. Although many factors have been associated with its occurrence, little is known about treatment. Herein, we present a case of symptoms similar to KLS thought to be related to vascular occlusion disease.
Case description:
An 81-year-old woman was admitted to the hospital due to recurring episodes of disturbance of consciousness, cognitive disorder, and hyperphagia for 18 years. She was diagnosed with KLS and basilar artery occlusion. Endovascular and antithrombotic therapy was initiated, and her symptoms fully resolved within 2 weeks of treatment initiation.
Conclusion:
KLS has diverse clinical presentations and demonstrates variable therapeutic responses. Vascular disease or blood flow disorder may be one possible factor for this disease. This case underscores the need for further research into the etiology and pathogenesis of KLS to promote evidence-based approaches for its diagnosis and treatment.
Case report: Drug-eluting bead transcatheter arterial chemoembolization in liver metastasis and retroperitoneal lymph node metastases of renal cell carcinoma: effective local therapy with the first report
Authors: Zhenkang Qiu, Junjie Ji, Shuo Zhang, Song Wang
Journal: Front Oncol (2024)
Keywords: deb-tace, case report, livermetastasis, renal cell carcinoma, retroperitoneal lymph node metastases
MeSH terms: Case Reports

The liver is the fourth most common site of metastasis in renal cell carcinoma (RCC), which is usually treated with systemic therapies and local treatments. However, local treatments are challenging in RCC patients with liver metastasis who failed in first-line systemic therapy. Here, we report a case of a patient with both liver-dominant RCC metastasis and recurrence in the operative site who had failed in first-line targeted therapy plus immunotherapy, received drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE), and achieved a complete response.
Case Report: Hybrid approach as a Rescue Treatment in a patient with vascular Ehlers-Danlos Syndrome
Authors: Suehyun Park, Deokbi Hwang, Woo-Sung Yun, Hyung-Kee Kim, Seung Huh
Journal: Front Surg (2023)
Keywords: arteriovenous fistula, endovascular procedure complication, iliac aneurysm, vascular ehlers-danlos syndrome (veds), vascular ehlers-danlos syndrome [type iv], vascular closure devices
MeSH terms: Case Reports

Vascular Ehlers-Danlos Syndrome (vEDS) is a rare connective tissue disorder associated with COL3A1 gene mutation encoding type III collagen. Given the possible fatal prognosis if not treated timely, it is important to suspect and diagnose as soon as possible. Despite advances in endovascular technique, access point complications remain a serious challenge in patients with vEDS. Here, we describe a 30-year-old male patient who was diagnosed with vEDS after consecutive events of bilateral iliac vessels at an interval of 3 months: (1) spontaneous dissecting aneurysm of right iliac artery and (2) arteriovenous fistula between left internal iliac artery (IIA) and left common iliac vein. This patient was treated with iliac stent-grafts and overlapping femoral interposition graft (Dacron) in the 1st operation and access artery repair with surgical dissection after coil embolization of IIA and stent-graft insertion into left common to external iliac arteries in the 2nd operation. The patient has been treated with beta-blockers and anticoagulants for the management of vEDS and postoperative deep vein thrombosis, respectively. The stent-grafts in both iliac arteries and the access sites have been well-tolerated without any adverse effects for 14 months following the 2nd operation. In conclusion, given the vascular fragility and the potential for future events, additional vascular manipulation should be avoided unless it is in a life-threatening condition. In particular, meticulous hybrid interventions can be effective treatments.
A young lady presenting with acute limb ischemia secondary to systemic lupus erythematosus, antiphospholipid syndrome and infective endocarditis
Authors: Alia Ali Muhammad, Javeria Shah
Journal: Pak J Med Sci (2024)
Keywords: acute limb ischemia (ali), antiphospholipid syndrome (apls), infective endocarditis (ie), systemic lupus erythematosus (sle)
MeSH terms: Case Reports

We report a case of a 35 years old lady presenting with acute upper limb ischemia secondary to systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS) and infective endocarditis (IE). It is rare for SLE/APLS to present with acute limb ischemia (ALI) as the initial manifestation. The patient presented with high grade fever along with pain and numbness in her right upper limb. On examination her right upper limb was cold to touch and the peripheral pulses were not palpable. There was also an audible pansystolic murmur in the mitral area. CT Angiography confirmed a complete occlusion of the right axillary artery while echocardiogram revealed severe mitral regurgitation with large vegetations on the mitral valve leaflets, suggesting infective endocarditis. After the patient's clinical deterioration and considering the severity of the ischemic condition, additional investigations were conducted, which ultimately led to the diagnosis of SLE with APLS. Management included antibiotic therapy for IE and high dose of IV steroids and anticoagulants for SLE/APLS, to which she responded well. This case emphasizes the significance of conducting a comprehensive evaluation of all possible causes of acute limb ischemia, while considering the patient's medical history and physical examination findings.
A rare case of mucormycosis in a diabetic patient: diagnostic challenges and clinical management of mucormycosis hand infection
Authors: Hatan Mortada, Razan Albrahim, Saad Alrobaiea, Moinuddin Ahmad, Elfayad Hamad A Abdelraheem, Muath Hakami
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: immunosuppression, mucormycosis, cutaneous, diabetes mellitus, fungal infection, hand, zygomycosis
MeSH terms: Case Reports

Mucormycosis hand infection in poorly controlled diabetic presented as rapidly progressive swelling, redness, pain, and necrosis unresponsive to antibiotics. Prompt diagnosis and aggressive surgery, antifungals, and diabetes management were critical, highlighting the need for early recognition and treatment of mucormycosis in diabetics.
Case Report: A case of third-degree atrioventricular block associated with primary cardiac lymphoma
Authors: Jianping Liu, Yong Zheng, Weishan Zhang, Juan Xia, Yongheng Zhang, Long Tang
Journal: Front Cardiovasc Med (2024)
Keywords: atrioventricular block, cardiac lymphoma, case report, diagnosis, diffuse large b-cell lymphoma, treatment
MeSH terms: Case Reports

Background:
Primary cardiac lymphoma is an extremely rare malignant lymphoma, with clinical manifestations related to its location. We reported the diagnosis and treatment of primary cardiac lymphoma in a patient presented with atrioventricular block.
Case presentation:
A 64 year-old man was admitted to our hospital because of symptoms of a tired heart and shortness of breath. The initial electrocardiogram revealed a third-degree atrioventricular block. Computed tomography scan showed an irregularly shaped right heart, irregular clusters, and relatively weakly enhanced areas in the right auricle, atrium, and ventricle. The local boundary between the lesion, pericardium, and left atrium was unclear, and the ventricular septum was irregular and thickened. Multiple irregular gray neoplasms with less smooth surfaces were observed, with a maximum diameter of approximately 7 cm. Pathological findings confirmed a non-germinal center B cell subtype of diffuse large B-cell lymphoma. After surgical resection of the tumor and implantation of a permanent pacemaker, the symptoms of the patient were significantly improved, allowing subsequent chemotherapy.
Conclusion:
Surgical resection and placement of a permanent pacemaker were effective treatments for a patient with primary cardiac lymphoma presented with atrioventricular block.
Case report: Successful radical surgery following complete pathological remission of advanced HCC with Tislelizumab/Lenvatinib plus TACE
Authors: Yong Xie, Tianshi Lyu, Yinghua Zou, Jian Wang
Journal: Front Oncol (2024)
Keywords: case report, hepatocellular carcinoma, lenvatinib, surgery, tislelizumab, transarterial chemoembolization
MeSH terms: Case Reports

The combination therapy of Tislelizumab plus Lenvatinib has recently emerged as the new standard of care for unresectable hepatocellular carcinoma (HCC). This treatment has demonstrated a significant reduction in tumor burden, raising the possibility of conversion therapy. However, the full safety and efficacy of this combination in real-world settings are not yet fully understood. We recently reported the case of a 36-year-old man with initially unresectable massive HCC, for whom radical surgery (RS) was contraindicated. After receiving Tislelizumab/Lenvatinib plus transarterial chemoembolization (TACE), the patient achieved complete pathological remission and subsequently underwent RS. The patient did not experience postoperative severe complications, and there was no recurrence during the follow-up period. Tislelizumab/Lenvatinib plus TACE therapy may lead to a complete pathological response in advanced HCC. Nevertheless, the safety of prolonged treatment needs to be assessed.
Bleeding From a Ruptured, Extraluminally Growing Gastric Gastrointestinal Stromal Tumor Treated by Transcatheter Arterial Embolization: A Case Report
Authors: Hiroshi Okano, Atsuhiro Nakatsuka, Masaomi Ogura, Katsumi Mukai, Akira Nishimura, Kana Asakawa, Youichirou Baba, Tetsuya Murata, Seiichi Hirota
Journal: Cureus (2024)
Keywords: embolization, gastrointestinal stromal tumor, intra-abdominal bleeding, the platelet-derived growth factor receptor alpha (pdgfra) mutation, transcatheter arterial angiography
MeSH terms: Case Reports

A 49-year-old man with abdominal pain was referred to our hospital. Abdominal computed tomography showed an extraluminal tumor near the gastric anterior wall and intra-abdominal fluid collection. A ruptured intra-abdominal tumor was suspected, and emergency abdominal angiography was performed. Hemorrhage into the abdominal cavity was seen, and transcatheter arterial embolization (TAE) was performed, which stopped the bleeding. The tumor was surgically resected, and a diagnosis of an extraluminally growing gastric gastrointestinal stromal tumor was made. TAE should be considered for rare cases of extraluminally growing tumors with intra-abdominal hemorrhage.
Endovascular comprehensive treatment of post-traumatic superior mesenteric arteriovenous fistula: case report and literature review
Authors: Hongxin Wang, Kai Zheng, Qiangqiang Nie, Bo Yang, Xueqiang Fan, Peng Liu, Zhidong Ye
Journal: Front Cardiovasc Med (2024)
Keywords: case report, coil embolization, covered stent, endovascular treatment (evt), superior mesenteric arteriovenous fistula (smavf)
MeSH terms: Case Reports

Background:
Superior mesenteric arteriovenous fistula is a rare and difficult complication after abdominal trauma. Utilizing comprehensive endovascular treatment represents an effective approach to managing this condition.
Case presentation:
We report a case involving a 53-year-old female with a history of trauma who presented with complaints of abdominal pain, malaise, and melena. A computed tomographic scan revealed the presence of a superior mesenteric arteriovenous fistula. The fistula was occluded using four Interlock detachable coils, and a covered stent was positioned over the arteriovenous fistula in the superior mesenteric artery. Following endovascular treatment, the patient's abdominal pain and melena symptoms disappeared.
Conclusion:
Utilizing covered stents and Interlock detachable coils for endovascular treatment of a superior mesenteric arteriovenous fistula proves to be both feasible and highly effective.
Case Report: Radiopharmaceutical extravasation, radiation paranoia, and chilling effect
Authors: Jason Mace, Jackson W Kiser
Journal: Front Nucl Med (2024)
Keywords: snmmi, diagnostic imaging, medical event reporting, radiation paranoia, radiopharmaceutical extravasation
MeSH terms: Case Reports

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) has publicly commented that they do not support the reporting of large extravasations to patients or regulatory bodies. The comment cites recently published articles suggesting that extravasations are infrequent and not severe. The comment stresses the importance of ensuring patients are not apprehensive or resistant to nuclear medicine procedures because of "radiation paranoia" and a "chilling effect" that can result from misinformation. Radiation paranoia and chilling effect are not defined, and there are no references to specific misinformation. Our experiences and this case suggest the comment may be incongruent with real-world clinical experiences. Our severe case, at a center with a long-standing focus on reducing radiopharmaceutical extravasation, suggests these events can still happen, can be significant, and should be shared with our patients. Our experiences also suggest that being transparent with patients builds trust. We are concerned that a reluctance to recognize the true frequency of extravasations and their severity may create distrust in the relationship between the nuclear medicine community and patients.
Case report: Approaches to treatment-refractory and super-refractory glutamic acid decarboxylase antibody-spectrum disorders
Authors: Ravi Rajmohan, Shivali Baveja, Dai Nguyen, Eshita Shah, Michael Sy, Sanaz Attaripour, David Swope
Journal: Front Immunol (2024)
Keywords: gad-65, deep brain stimulation, rituximab, stem cells, stiff person syndrome
MeSH terms: Autoimmune Diseases of the Nervous System, Glutamate Decarboxylase, Case Reports, Antibodies, Humans, Immunomodulation, Glutamate Decarboxylase, Antibodies

Background:
Glutamic acid decarboxylase antibody-spectrum disorders (GAD-SDs) include a group of autoimmune neurological diseases associated with neuronal excitability, most noticeably stiff person syndrome. Immune modulators are the mainstay of treatment, but a significant number of patients remain refractory.
Methods:
We present our single-center experience of eight cases of GAD-SD, two of which were refractory to immune modulatory treatments.
Results:
Of the two cases that were refractory to immunomodulation, one showed significant improvement with bilateral globus pallidus interna deep brain stimulation (GPi DBS) placement, and the other showed significant improvement with autologous hematopoietic stem cell transplant (aHSCT).
Discussion:
To our knowledge, this is the first instance of GPi DBS placement being noted to improve GAD-SD movements.
Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report
Authors: Vera Radici, Cinzia Giagulli, Eugenia Accorsi Buttini, Mirko Farina, Nicola Polverelli, Duilio Brugnoni, Marco Chiarini, Anna Galvagni, Camillo Almici, Emilio Ferrari, Andrea Bianchetti, Stefania Masneri, Alessandro Leoni, Federica Re, Simona Bernardi, Michele Malagola, Alessandro Re, Arnaldo Caruso, Domenico Russo
Journal: Front Transplant (2023)
Keywords: car-t cell, covid-19, infection, lymphoma, mantle cell lymphoma (mcl)
MeSH terms: Case Reports

Background:
The COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.
Case presentation:
We present the successful treatment of a 44-year-old male patient with refractory mantle cell lymphoma treated with chimeric antigen receptor T (CAR-T) cell therapy, despite concurrent COVID-19 infection. The patient developed grade II cytokine release syndrome, requiring admission to the intensive care unit. The CAR-T cells expanded effectively, and the patient achieved complete metabolic remission. During the treatment course, the patient experienced complications including COVID-19-associated pulmonary aspergillosis and a co-infection with Stenotrophomonas maltophilia and the SARS-CoV-2 omicron variant. Prompt antifungal and antibacterial therapy, along with appropriate COVID-19 treatment, led to the resolution of these infections. Dexamethasone was also administered to reduce inflammation and aid hematologic recovery. Despite the presence of multiple infections, the patient achieved complete remission of lymphoma, highlighting the effectiveness of CAR-T cell therapy in this high-risk patient.
Conclusion:
Despite the challenges posed by concurrent infections, the decision to proceed with CAR-T cell therapy in this patient proved to be successful, resulting in complete remission of lymphoma. Early initiation of supportive therapies and the use of dexamethasone contributed to the resolution of complications. This case underscores the importance of individualized decision-making and the potential benefits of CAR-T cell therapy in similar high-risk patients.
Case report: Organ donation after euthanasia for psychiatric suffering: some of the practical and ethical lessons Martijn taught us
Authors: Nathalie van Dijk, Wim de Jongh, Paulan Stärcke, David Shaw, Jan Bollen, Walther van Mook
Journal: Front Psychiatry (2024)
Keywords: assisted suicide and euthanasia, case report, euthanasia, organ donation, psychiatric suffering
MeSH terms: Case Reports

Euthanasia in psychiatric patients presents unique challenges, especially when combined with organ donation. In this article, the hurdles psychiatric patients might encounter after expressing their wish for organ donation after euthanasia, are discussed and illustrated by the case of Martijn, a 45-year-old psychiatric patient who altruistically donated his organs after euthanasia. Hospital and physician-related factors, including caution in determination of mental capacity, consideration of conflicting interests, and healthcare staff stress are discussed as impediments to organ donation after euthanasia (ODE) in psychiatric patients. The primary objective of this article is to raise awareness among psychiatrists regarding the fact that although the combination of euthanasia and organ donation is an uncommonly performed procedure, it is frequently requested by psychiatric patients. In conclusion, the article advocates for a nuanced approach, respecting patients' altruistic wishes while at the same time addressing challenges associated with ODE in psychiatric suffering. Where possible, and within the current medical, ethical and legal boundaries, the importance of facilitating organ donation without unnecessarily prolonging the suffering of competent psychiatric patients seeking euthanasia is emphasized. The topic calls, for example, for further qualitative research to understand the stakeholders' perspectives to determine the perceived possibilities on the one hand and boundaries on the other.