OpenMed/multicare-articles huggingface dataset:
Bicornuate Bicollis Uterus with Obstruction of the Lower Uterine Segment and Cervical Prolapse Complicating Pregnancy
Authors: Kristen Stearns, Antoun Al Khabbaz
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Congenital Mullerian duct anomalies are conditions involving the female genital tract. Cases of complex Mullerian duct anomalies with involvement of the renal system are rare. Occasionally, these cases can be associated with obstetrical complications. Cervical prolapse infrequently complicates pregnancy, and an association between uterine malformations and cervical prolapse has not been cited in the literature. We describe the case of a primigravid patient at 38 weeks of gestation noted to have cervical prolapse during evaluation for preeclampsia and labor induction. Obstetrical ultrasound at presentation to the labor and delivery suite revealed a high suspicion for a bicornuate uterus. The patient was delivered by cesarean section due to obstruction of the lower uterine segment of the gravid uterus. Further evaluation post-partum revealed a bicornuate bicolis uterus and renal agenesis. Pregnancies in patients with bicornuate bicollis uterus can be complicated by obstruction of the gravid uterus, resulting in cervical prolapse and necessitating cesarean section.
Rhinolithiasis as cause of oronasal fistula
Authors: Gabriel Cesar Dib, Rodrigo P Tangerina, Carlos E C Abreu, Rodrigo de Paula Santos, Luiz Carlos Gregório
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Foreign Bodies / complications, Lithiasis / complications, Nasal Obstruction / etiology, Nose Diseases / etiology, Oral Fistula / etiology, Respiratory Tract Fistula / etiology, Case Reports, Adult, Female, Foreign Bodies / surgery, Humans, Lithiasis / surgery, Nasal Obstruction / surgery

Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review.
Camouflage of Severe Skeletal Class II Gummy Smile Patient Treated Nonsurgically with Mini Implants
Authors: Irfan Qamruddin, Fazal Shahid, Mohammad Khursheed Alam, Wafa Zehra Jamal
Journal: Case Rep Dent (2014)

Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by general practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.
CASE REPORT Total Management of a Severe Case of Systemic Keloids Associated With High Blood Pressure (Hypertension): Clinical Symptoms of Keloids May Be Aggravated by Hypertension
Authors: Rei Ogawa, Juri Arima, Shimpei Ono, Hiko Hyakusoku
Journal: Eplasty (2013)

Introduction:
Many cases of severe keloid are associated with high blood pressure (hypertension). An analysis of 100 consecutive patients with keloid in our department in 2011 revealed that patients with multiple (>3) or large keloids (>10 cm(2)) were significantly more likely to have hypertension than patients with mild keloids (<2 or <10 cm(2)). In the present paper, a case of severe keloids associated with hypertension is described. How such patients should be treated is discussed.
Methods:
This 63-year-old woman had hypertension together with severe keloids that covered her right elbow, wrist joints, and thumb and made it difficult for her to use her right hand. The contractures were released by using surgery and postoperative radiation therapy. The internal medicine clinic started her on a Ca-channel blocker (amlodipine besilate) and an angiotensin II blocker (candesartan cilexetil).
Results:
The contractures were completely released by a distally based radial artery flap and postoperative 4 MeV electron beam irradiation (15 Gy/3 fractions for 3 days). The angiotensin-converting enzyme inhibitor and the Ca-channel blocker improved the objective symptoms of the remaining keloids.
Conclusions:
If patients with severe keloids present, the possibility of hypertension should be considered: the patient may have hypertension already or may be affected in the future. Hypertension may be a risk factor of keloid deterioration. Antihypertensive treatment may reduce symptoms of patients with severe keloids. At present, surgery and postoperative radiotherapy appear to be the only solution to the functional problems experienced by patients with severe keloids.
Ascending colon cancer accompanied by tumor thrombosis in the superior mesenteric vein: A case report
Authors: Yoshiaki Fujii, Kenji Kobayashi, Sho Kimura, Shuhei Uehara, Shuji Takiguchi
Journal: Int J Surg Case Rep (2020)
Keywords: case report, colorectal cancer, superior mesenteric vein, tumor thrombosis
MeSH terms: Case Reports

Introduction:
Venous tumor thrombosis occasionally accompanies renal cancer, liver cancer, and pancreatic cancer. Colorectal cancer is seldom accompanied by venous tumor thrombosis in the portal vein or the superior or inferior mesenteric veins (SMV, IMV), and little is known about its features. We report a case of ascending colon cancer with tumor thrombosis in the SMV treated with right hemicolectomy and combined resection of the SMV.
Presentation of case:
An 82-year-old man with chief complaints of loss of appetite was admitted to our hospital. He was diagnosed with ascending colon cancer accompanied with tumor thrombosis extending to the SMV. He underwent right hemicolectomy and combined resection of the tumor thrombosis and the SMV. Intestinal blood flow was evaluated by intraoperative indocyanine green (ICG) fluorography. He continued to recover well from surgery. No adjuvant chemotherapy was employed because of the patient's advanced age and his own will. He was transferred to another hospital on postoperative day 39. Six months after surgery, abdominal CT showed multiple liver metastases. He died 8 months after surgery.
Discussion and conclusions:
Radical resection of the primary tumor and surgical thrombectomy should be considered for the treatment of colorectal cancer without distant metastasis accompanied by tumor thrombosis. However, venous tumor thrombosis is representative of an aggressive cancer and that may be a strong risk factor for the development of liver metastasis. Adjuvant systematic chemotherapy in addition to complete surgical resection may be one of the treatment strategies.
Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report
Authors: Alpaslan Ozgun, Tolga Tuncel, Levent Emirzeoglu, Serkan Celik, Oguz Bilgi, Abdullah Haholu, Muammer Urhan, Bulent Karagoz
Journal: Oncol Lett (2015)
Keywords: malignant melanoma, papillary thyroid carcinoma

Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-α therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously.
Intraoperative Frozen Section Analysis of the Pancreas: A Case Report and Review of the Literature
Authors: Jillian W Bonaroti, Stephen Doane, Peter A McCue, Jordan M Winter
Journal: Case Rep Pancreat Cancer (2016)
Keywords: adenocarcinoma, cystadenoma, intraoperative frozen section, pancreas
MeSH terms: Case Reports

Background: Intraoperative frozen section analysis is frequently used to obtain a histological diagnosis at the time of resection and to assess resection margins. Although many surgeons perceive a clinical benefit, particularly with respect to the transected resection margins, the limitations and pitfalls of frozen section analysis have not been well documented. Case: Here, we report a case of serous cystadenoma with background pancreatitis masquerading on frozen section as an invasive pancreatic ductal adenocarcinoma. This interpretation was a surprise in light of preoperative imaging that was highly suggestive of a benign cystic tumor, but nevertheless prompted intraoperative consideration of a more radical operation to ensure a complete resection was achieved. Conclusions: Frozen section analysis is an imperfect test, and misdiagnoses can potentially impact patient outcomes adversely. Intraoperative decisions must carefully integrate the preliminary pathological interpretation with the overall clinical context. Further studies are warranted to more fully characterize the accuracy, utility, and cost-effectiveness of intraoperative frozen section analysis for pancreatic surgery.
An Unusual Tumor of the Ear: Pilomatricoma in a Middle-Aged Woman
Authors: Akira Inagaki, Yoriko Yamashita, Yusuke Mori, Erika Takeuchi, Kyosuke Asaoka, Shingo Murakami
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Pilomatricoma is a benign tumor arising from hair follicle matrix cells, presenting as an asymptomatic, firm, slow growing, mobile, superficial skin nodule typically in children. This lesion with an atypical clinical presentation is frequently misdiagnosed as other skin lesions and even as malignant entities regardless of detailed cytological, imaging examinations; the site of occurrence is one of the keys to accurate diagnosis. Here, we present a case of pilomatrixoma involving the ear, the cymba conchae of the auricle, which is an extremely rare site for the lesion in a 52-year-old woman. The present case suggests that this benign tumor needs to be included in the differential diagnosis in patients who present with an atypical auricular lesion.
Median nerve repair with autologous sciatic nerve graft: a case report
Authors: Brian T Ragel, Gregory C Park, Sid Brevard
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity injuries. Bilateral above-the-knee amputations (AKAs) and exploration of the medial shrapnel wound were undertaken. A 7 cm traumatic defect in the median nerve was repaired with interpositional sciatic nerve graft harvested from the AKA. Conclusion. Recovery of motor function after nerve grafting is dependent on motor axons reinnervating target muscles, making proximal nerve injuries problematic. We identify a potential nerve harvest site in patients with lower extremity amputations in need of long segment nerve repairs.
Testicular Rupture or Testicular Fracture? A Case Report and Literature Review
Authors: Firas Addas, Sylvia Yan, Marios Hadjipavlou, Michael Gonsalves, Samer Sabbagh
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Testicular trauma is relatively uncommon. However, severe injuries can result in many complications and should be carefully diagnosed and managed. We present a case of testicular fracture diagnosis made by ultrasonography. The surgical exploration revealed the fracture as well as complete rupture of the tunica albuginea. Testicular rupture is the disruption of the tunica albuginea, while testicular fracture is a "break" in the testicular parenchyma. Management could be conservative in mild fracture cases without rupture while suspected or confirmed fracture should be treated by surgical exploration.
Disseminated Mucormycosis with Positive Aspergillus Galactomannan
Authors: Despoina Kitmiridou, Su N Aung, Dimitrios Farmakiotis
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

We describe a case of disseminated mucormycosis (Apophysomyces elegans) diagnosed on autopsy, in a man who had been working in construction with undiagnosed neutropenia from hairy-cell leukemia, which is rarely associated with invasive mold infections. Galactomannan values in both blood and bronchoalveolar lavage were strongly positive. There is an unmet need for accurate noninvasive fungal diagnostic tests. Detailed history, including occupational exposures, can be more informative than laboratory workup.
Nephrotic Syndrome Induced by Lenvatinib Treatment for Hepatocellular Carcinoma
Authors: Thaninee Prasoppokakorn, Kessarin Thanapirom, Sombat Treeprasertsuk
Journal: Case Reports Hepatol (2022)
MeSH terms: Case Reports

Lenvatinib, an oral small-molecule multiple tyrosine kinase inhibitor (TKI), has been approved for first-line therapy for unresectable hepatocellular carcinoma (HCC). Proteinuria is one of the most common adverse events associated with lenvatinib treatment. We reported a 67-year-old Thai female was diagnosed with NASH cirrhosis and HCC BCLC B with TACE refractoriness. She received 8 mg of lenvatinib for 2 weeks and began to experience worsening hypertension, bilateral pleural effusion, pedal edema, hypoalbuminemia, hypercholesterolemia, and proteinuria. After exclusion of all possible causes, lenvatinib-induced nephrotic syndrome (NS) was diagnosed. One week after discontinuing the drug, her symptoms gradually improved. To date, there have been only a handful of reported cases of lenvatinib-induced nephrotoxicity. We report herein the case of lenvatinib-induced NS in a cirrhotic patient with HCC with resolution of symptoms in a short period after drug discontinuation. In addition, we reviewed all reported cases of lenvatinib-induced nephrotoxicity.
Patient-focussed outcomes in acromegaly
Authors: Mirtha Guitelman, Alin Abreu, Ana Laura Espinosa-de-los-Monteros, Moisés Mercado
Journal: Pituitary (2014)
MeSH terms: Acromegaly / therapy, Quality of Life, Case Reports, Acromegaly / epidemiology, Acromegaly / psychology, Acromegaly / surgery, Adult, Arthralgia / epidemiology, Comorbidity, Fatal Outcome, Humans, Male, Patient-Centered Care, Sleep Apnea Syndromes / epidemiology, Surveys and Questionnaires

Background:
Health-related quality of life (QoL) is severely impaired in acromegaly due to the physical and psychological consequences of the disease. Pharmacological and surgical treatments, when available, can improve QoL and life expectancy.
Case description:
A 34-year-old male with uncontrolled acromegaly due to a large and invasive macroadenoma, which could not be resected by transsphenoidal surgery. Over 9 years, he had limited access to pharmacological interventions and persisted with clinically and biochemically active disease, with severe co-morbidities and a poor QoL, which eventually lead to a premature sudden death.
Conclusion:
This case highlights the impact that active acromegaly has when treatment resources are limited. We review the factors contributing to poor QoL in this disease, with special reference to the Latin American scenario.
Prolonged refractory status epilepticus following acute traumatic brain injury: a case report of excellent neurological recovery
Authors: Adam D Peets, Luc R Berthiaume, Sean M Bagshaw, Paolo Federico, Christopher J Doig, David A Zygun
Journal: Crit Care (2005)
MeSH terms: Brain Injuries / complications, Brain Injuries / rehabilitation, Status Epilepticus / etiology, Case Reports, Adult, Anticonvulsants / therapeutic use, Brain Injuries / diagnosis, Cervical Vertebrae / injuries, Electroencephalography, Female, Humans, Neck Injuries / complications, Occipital Bone / injuries, Recovery of Function, Skull Fractures / complications, Spinal Fractures / complications, Status Epilepticus / drug therapy, Treatment Outcome, Anticonvulsants

Introduction:
Refractory status epilepticus (RSE) secondary to traumatic brain injury (TBI) may be under-recognized and is associated with significant morbidity and mortality.
Methods:
This case report describes a 20 year old previously healthy woman who suffered a severe TBI as a result of a motor vehicle collision and subsequently developed RSE. Pharmacological coma, physiological support and continuous electroencephalography (cEEG) were undertaken.
Results:
Following 25 days of pharmacological coma, electrographic and clinical seizures subsided and the patient has made an excellent cognitive recovery.
Conclusion:
With early identification, aggressive physiological support, appropriate monitoring, including cEEG, and an adequate length of treatment, young trauma patients with no previous seizure history and limited structural damage to the brain can have excellent neurological recovery from prolonged RSE.
A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
Authors: Naoki Kawakami, Ho Namkoong, Takanori Ohata, Shinji Sakaguchi, Fumitake Saito, Hideki Yuki
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Introduction:
The prognosis of mycoplasma pneumonia in adults is generally favorable, but a few patients show progression to acute respiratory distress syndrome (ARDS). We have described the management of a patient who showed progression of mycoplasma pneumonia to ARDS.
Presentation of case:
A 26-year-old male patient with no significant past medical or social history presented with a 5-day history of fever. Following this, he was diagnosed with bacterial pneumonia and treated with tazobactam/piperacillin; however, he showed little clinical improvement with this treatment approach. We diagnosed the patient with mycoplasma pneumonia with an antigen test and treated him with azithromycin and prednisolone. Despite the appropriate antimicrobial therapy, his symptoms worsened and therefore we changed his oxygen therapy from a reservoir mask to nasal high-flow oxygen in addition to minocycline. Consequently, with this treatment, he recovered from severe mycoplasma pneumonia.
Discussion:
In patients with severe pneumonia who experience respiratory failure, it has been reported that nasal high-flow oxygen therapy is not inferior to noninvasive positive pressure ventilation therapy regarding intubation rate. In this case, induction of nasal high-flow oxygen therapy led to avoidance of ventilator management. This is a valuable case report highlighting the optimal outcome of nasal high-flow oxygen therapy in a fulminant case of acute respiratory distress syndrome.
Conclusion:
In patients who present with severe mycoplasma pneumonia with respiratory failure, nasal high-flow oxygen therapy can help reduce the needs for ventilator management including intubation.
Case Report: A False Negative Case of Anti-Yo Paraneoplastic Myelopathy
Authors: Christopher M Bartley, Neelroop N Parikshak, Thomas T Ngo, Jessa A Alexander, Kelsey C Zorn, Bonny A Alvarenga, Min K Kang, Massimo Pedriali, Samuel J Pleasure, Michael R Wilson
Journal: Front Neurol (2021)
Keywords: cdr2l, anti-yo antibodies, breast cancer, myelopathy, paraneoplastic neurologic disease, phage display
MeSH terms: Case Reports

The development of autoimmune antibody panels has improved the diagnosis of paraneoplastic neurological disorders (PNDs) of the brain and spinal cord. Here, we present a case of a woman with a history of breast cancer who presented with a subacute sensory ataxia that progressed over 18 months. Her examination and diagnostic studies were consistent with a myelopathy. Metabolic, infectious, and autoimmune testing were non-diagnostic. However, she responded to empirical immunosuppression, prompting further workup for an autoimmune etiology. An unbiased autoantibody screen utilizing phage display immunoprecipitation sequencing (PhIP-Seq) identified antibodies to the anti-Yo antigens cerebellar degeneration related protein 2 like (CDR2L) and CDR2, which were subsequently validated by immunoblot and cell-based overexpression assays. Furthermore, CDR2L protein expression was restricted to HER2 expressing tumor cells in the patient's breast tissue. Recent evidence suggests that CDR2L is likely the primary antigen in anti-Yo paraneoplastic cerebellar degeneration, but anti-Yo myelopathy is poorly characterized. By immunostaining, we detected neuronal CDR2L protein expression in the murine and human spinal cord. This case demonstrates the diagnostic utility of unbiased assays in patients with suspected PNDs, supports prior observations that anti-Yo PND can be associated with isolated myelopathy, and implicates CDR2L as a potential antigen in the spinal cord.
What Do Transgender Patients Teach Us About Idiopathic Intracranial Hypertension?
Authors: Catherine Hornby, Susan P Mollan, James Mitchell, Keira Annie Markey, Andreas Yangou, Ben L C Wright, Michael W O'Reilly, Alexandra J Sinclair
Journal: Neuroophthalmology (2017)
Keywords: androgens, gender reassignment, idiopathic intracranial hypertension, papilloedema testosterone
MeSH terms: Case Reports

Idiopathic intracranial hypertension (IIH), a condition of raised intracranial pressure, is characterised by headaches and visual disturbances. Its pathogenesis is currently unknown; however, dysregulation of androgens may be implicated. Here, the authors present a case of a 22-year-old patient undergoing female-to-male (FTM) gender reassignment who developed IIH shortly after commencing testosterone therapy. This interesting case presents the possibility of androgens having a pathogenic role in IIH.