OpenMed/multicare-articles huggingface dataset:
Case series: Five pediatric germ cell/sex cord stroma tumors
Authors: James G Glasser, James M Nottingham, Michael E Haney, Elizabeth A Manci
Journal: Ann Med Surg (Lond) (2018)

•This report consists of five pediatric tumors of ovarian cell lineage.•These unusual, interesting tumors challenge both surgeon and oncologist.•Some appear malignant, seemingly require chemotherapy, but behave with benignity. Some are easily resected; others demand the utmost skill.•Complexity perplexes; elucidation is by selection - ignoring some things, attending to others.•Case studies illustrate - for good or ill - the process whereby clinical conundrums are resolved.
Cardiac sarcoidosis or giant cell myocarditis? On treatment improvement of fulminant myocarditis as demonstrated by cardiovascular magnetic resonance imaging
Authors: Hari Bogabathina, Peter Olson, Vikas K Rathi, Robert W W Biederman
Journal: Case Rep Cardiol (2012)
MeSH terms: Case Reports

Giant cell myocarditis, but not cardiac sarcoidosis, is known to cause fulminant myocarditis resulting in severe heart failure. However, giant cell myocarditis and cardiac sarcoidosis are pathologically similar, and attempts at pathological differentiation between the two remain difficult. We are presenting a case of fulminant myocarditis that has pathological features suggestive of cardiac sarcoidosis, but clinically mimicking giant cell myocarditis. This patient was treated with cyclosporine and prednisone and recovered well. This case we believe challenges our current understanding of these intertwined conditions. By obtaining a sense of severity of cardiac involvement via delayed hyperenhancement of cardiac magnetic resonance imaging, we were more inclined to treat this patient as giant cell myocarditis with cyclosporine. This resulted in excellent improvement of patient's cardiac function as shown by delayed hyperenhancement images, early perfusion images, and SSFP videos.
Pruritic Crusted Scabies in an Immunocompetent Infant
Authors: Alexander K C Leung, Kin Fon Leong, Joseph M Lam
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Crusted scabies (also known as Norwegian scabies) is a highly contagious variant of scabies characterized by profuse proliferation of mites in the skin and widespread, crusted, hyperkeratotic papules, plaques, and nodules. Typically, pruritus is minimal or absent. The condition usually occurs in immunocompromised individuals. Occurrence in healthy infants has rarely been reported. We report an 11-month-old healthy Malay boy who presented with crusted scabies.
Rare incidence of primary adrenocortical carcinosarcoma: A case report and literature review
Authors: Yong-Bao Wei, Yun-Liang Gao, Hong-Tao Wu, Shi-Feng Ou-Yang, Tao Xu, Dong-Fang Mao, Jin-Rui Yang
Journal: Oncol Lett (2015)
Keywords: adrenocortical carcinoma, adrenocortical carcinosarcoma, pathology

Adrenocortical carcinoma (ACC) is a rare, but highly aggressive type of tumor with an incidence of one to two per million annually. Adrenocortical carcinosarcoma is an exceptional variant of ACC, which is characterized by the presence of histological regions of carcinoma and sarcoma. To date, to the best of our knowledge, there have only been 12 reported cases of adrenocortical carcinosarcoma. In the present study, a case of primary, non-functional adrenocortical carcinosarcoma is described, as well as a review of the literature to raise awareness of this particularly rare type of malignant neoplasm that is associated with a worse diagnosis and prognosis than adrenocortical carcinoma. In the present study, the patient underwent a laparoscopic left adrenalectomy and the tumor was dissected without complication from the left kidney. Microscopic observations showed the tumor comprised of epithelial and spindle cell components. The patient did not exhibit signs of tumor recurrence at the one-month follow-up. The potential diagnosis of adrenocortical carcinosarcoma must be considered when diagnosing adrenal malignancies in adults. In addition, comphrensive imunohistochemical staining may be required to identify possible sarcomatous patterns. To the best of our knowledge, the present case is the first to report an incidence of adrenocortical carcinosarcoma in China. Details of the patient are presented and the pathology of adrenocortical carcinosarcoma is discussed.
Osteomyelitis of the Jaw in COVID-19 Patients: A Rare Condition With a High Risk for Severe Complications
Authors: Ana Kvolik Pavić, Vedran Zubčić
Journal: Front Surg (2022)
Keywords: covid-19, concomitant infection, healthy, jaw, odontogenic, osteomyelitis, surgical complication
MeSH terms: Case Reports

Osteomyelitis of the jaw is an uncommon infection that arises from the flora of the oral cavity or sinuses and affects immunocompromised and polymorbid patients. Treatment includes surgical debridement and long regiments of broad-spectrum antibiotics. We present three cases of complicated jaw osteomyelitis presented with concurrent COVID-19 infection, including only two reported cases of odontogenic COVID-related osteomyelitis. The two mandibular cases were patients in their 30s with no comorbidities. The first case was an asymptomatic COVID-19-positive patient who developed an odontogenic infection after tooth extraction that was complicated by the second bout of abscess formation and localized osteomyelitis. The second case was a COVID-19-positive patient with an odontogenic infection that presented as airway compromise due to trismus and neck edema, which required an emergency tracheotomy. He developed osteomyelitis of the mandibular ramus that was reconstructed with a titanium plate. The third case was a polymorbid post-COVID-19 patient who developed a protracted infection of the maxillary sinus that resulted in the loss of an eye, destruction of the maxilla, palate, and parts of nasal cavum, and oronasal incontinence. The defect was reconstructed with a microvascular anterolateral thigh flap. We hypothesize that COVID-19-related immune dysfunction and microvascular changes contributed to osteomyelitis in our patients.
Uncovering ecosystem service bundles through social preferences
Authors: Berta Martín-López, Irene Iniesta-Arandia, Marina García-Llorente, Ignacio Palomo, Izaskun Casado-Arzuaga, David García Del Amo, Erik Gómez-Baggethun, Elisa Oteros-Rozas, Igone Palacios-Agundez, Bárbara Willaarts, José A González, Fernando Santos-Martín, Miren Onaindia, Cesar López-Santiago, Carlos Montes
Journal: PLoS One (2012)
MeSH terms: Ecosystem, Social Behavior, Research Support, Non-U.S. Gov't, Conservation of Natural Resources, Humans, Probability, Spain, Surveys and Questionnaires

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.
Double seronegative myasthenia gravis with antiphospholipid syndrome: a case report
Authors: Diana Dan, Pierre-Alexandre Bart, Jan Novy, Thierry Kuntzer, Carole Clair
Journal: J Med Case Rep (2014)

Introduction:
Myasthenia gravis is an autoimmune disease characterized by fluctuating muscle weakness. It is often associated with other autoimmune disorders, such as thyroid disease, rheumatoid arthritis, systemic lupus erythematosus, and antiphospholipid syndrome. Many aspects of autoimmune diseases are not completely understood, particularly when they occur in association, which suggests a common pathogenetic mechanism.
Case presentation:
We report a case of a 42-year-old Caucasian woman with antiphospholipid syndrome, in whom myasthenia gravis developed years later. She tested negative for both antibodies against the acetylcholine receptor and against muscle-specific receptor tyrosine-kinase, but had typical decremental responses at the repetitive nerve stimulation testing, so that a generalized myasthenia gravis was diagnosed. Her thromboplastin time and activated partial thromboplastin time were high, anticardiolipin and anti-β2 glycoprotein-I antibodies were slightly elevated, as a manifestation of the antiphospholipid syndrome. She had a good clinical response when treated with a combination of pyridostigmine, prednisone and azathioprine.
Conclusions:
Many patients with myasthenia gravis test positive for a large variety of auto-antibodies, testifying of an immune dysregulation, and some display mild T-cell lymphopenia associated with hypergammaglobulinemia and B-cell hyper-reactivity. Both of these mechanisms could explain the occurrence of another autoimmune condition, such as antiphospholipid syndrome, but further studies are necessary to shed light on this matter.Clinicians should be aware that patients with an autoimmune diagnosis such as antiphospholipid syndrome who develop signs and neurological symptoms suggestive of myasthenia gravis are at risk and should prompt an emergent evaluation by a specialist.
Lymphoma Spectrum of Image Findings in One Patient
Authors: Kuan-Yu Lin, Wilson Tiu Lao, Wing P Chan
Journal: J Belg Soc Radiol (2023)
Keywords: hodgkin’s lymphoma, cancer, lymphoma, metastasis, neoplasm
MeSH terms: Case Reports

Lymphoma is a malignancy arising from lymphocytes or lymphoblasts. It affects the lymphoid system and may be expressed in a variety of ways and behave in different fashions. Depending on the organ involved, aggressiveness, and primary or secondary disease, the expression of lymphoma shows polymorphism and sometimes makes it difficult to diagnose from imaging. This article will describe the image findings of lymphoma in different organ systems of one patient.
Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function
Authors: Silvia Ciancia, Silvia Cesari, Barbara Predieri, Sergio Bernasconi, Lorenzo Iughetti
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

In case of primary hypothyroidism, reactive pituitary hyperplasia can manifest as pituitary (pseudo) macroadenoma. We report the case of a 12-year-old boy who was evaluated for impaired growth velocity and increased body weight. Because of low insulin-like growth factor 1 levels and poor response to the growth hormone stimulation test, brain magnetic resonance imaging was performed and a pituitary macroadenoma was found. Treatment with levothyroxine was started, and thyroid function was evaluated approximately every 40 days to titrate the dosage. After few months of therapy, the size of the macroadenoma decreased and growth hormone secretion normalized. The pituitary returned to normal size in approximately 5 years. The boy went through puberty spontaneously and reached a normal adult height. In a patient affected by primary hypothyroidism, reactive pituitary hyperplasia can cause growth hormone deficiency; however, growth hormone secretion usually normalizes after starting levothyroxine treatment. Pituitary macroadenoma can be difficult to distinguish from severe pituitary hyperplasia; however, pituitary macroadenomas are rare in childhood, and our clinical case underlines how the hormonal evaluation is essential to achieve a correct diagnosis and prevent unnecessary surgery in a context of pituitary mass.
Surgical Outcomes of Cerebellopontine angle Tumors in 50 Cases
Authors: Faramarz Memari, Fatemeh Hassannia, Seyed Hamid Reza Abtahi
Journal: Iran J Otorhinolaryngol (2015)
Keywords: acoustic neuroma, cerebellopontine angle tumors, retrosigmoid approach, translabyrinthine approach

Introduction:
To report our experience with a large series of surgical procedures for removal of cerebellopontine angle (CPA) tumors using different approaches.
Materials and methods:
This was a retrospective analysis of 50 patients (mean age, 49 years) with CPA tumors (predominantly acoustic neuroma) who underwent surgical removal using appropriate techniques (principally a translabyrinthine approach) during a 4-year period.
Results:
One death occurred during this study. There were nine cases (18%) of cerebrospinal fluid leak, and five patients (10%) were diagnosed as having bacterial meningitis. Complete gross tumor removal was not achieved in four patients (8%). Facial nerve function as measured by the House Brackmann system was recorded in all patients 1 year following surgery: 32% had a score of 1 or 2; 26% had a score of 3 or 4; and 8% had a score of 5 or 6. Other complications included four cases of wound infection.
Conclusion:
The translabyrinthine approach was predominantly used in our series of CPA tumors, and complication rates were comparable with other large case series.
An Exceedingly Rare Case of Liraglutide-Induced Liver Injury
Authors: Swetha Parvataneni, Rajarajeshwari Ramachandran, Eric Then, Tyler Grantham, Vinaya Gaduputi
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the treatment of type 2 diabetes mellitus. We are reporting the second case of liraglutide-induced liver injury, with complete resolution of liver injury after discontinuation of the drug.
Duplicated gall bladder with gall bladder polyp presenting with cholecystitis: Case report with literature review
Authors: Sardar Hassan Arif, Ihsan Salih Hussein, Ayad Ahmad Mohammed
Journal: Int J Surg Case Rep (2019)
Keywords: cholecystectomy, cholecystitis, duplicated gall bladder, gall bladder polyp

Introduction:
Gall bladder anomalies may be in the form of abnormalities in the shape, position, or number. It could be true duplication being completely separated or Y-shaped being united with single cystic duct.
Presentation of case:
A 38-year-old lady presented with frequent attacks of right hypochondrial pain for the last 4 months. Ultrasound of the abdomen showed distended gall bladder with 1.3 cm gall bladder polyp at the region of the fundus. Decision done for laparoscopic cholecystectomy. During surgery a duplicated gall bladder found with single cystic duct. Successful surgery done and the gall bladder sent for the histopathological examination which showed a benign gall bladder polyp. There were no post-operative complications and the patient discharged on the third days.
Discussion:
Duplicated gall bladder may be diagnosed with ultrasound or magnetic resonance cholangiopancreatography (MRCP) which is the investigation of choice however most cases diagnosed intraoperatively. It may be associated with other biliary anomalies. In some occasions a single gall bladder may be removed during the first operation and the second may be missed which require another surgery. In asymptomatic individuals with duplicated gall bladder no specific treatment is required and role of surgery is controversial.
Conclusion:
duplicated gall bladder is a rare finding which may be completely asymptomatic. In symptomatic patients specially if associated with gall stones, surgery is required and the surgeon must be aware of any associated biliary anomalies.
Brucella Shunt Infection as a Rare Presentation of Neurobrucellosis
Authors: Fatemeh Mehrabian, Zahra Abdi Layaee, Zahra Ahmadinejad
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, and abdominal pain. Laboratory studies, including cerebrospinal fluid (CSF) and blood tests, revealed a VP shunt infection with Brucella spp. We treated the patient with rifampicin, trimethoprim-sulfamethoxazole (cotrimoxazole), and ceftriaxone. Also, the shunt was temporarily replaced with an extraventricular drain until the CSF culture was sterile and a new permanent VP shunt could be inserted. We report this case to underline the diagnostic possibility of brucellosis in every case of protracted fever of unknown origin (FUO), irrespective of accompanying signs and symptoms.
Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
Authors: Shoko Merrit Yamada, Katsuya Gorai, Koichi Gonda
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Introduction:
In cranioplasty, pinwheel-shaped titanium mini plates are frequently used to cover bone defects produced by burr holes, and it is common to insert screws through only a few of the holes in cranial flap fixation.
Presentation of case:
A 69-year-old man who had undergone clipping surgery for subarachnoid hemorrhage 16 years previously visited our clinic because a titanium plate had penetrated his scalp one month after he was hit on the head by a wall cabinet. Imaging studies revealed that part of the titanium plate had bent outwards and penetrated the skin. The plate was surgically removed, a relief skin incision was made 6 cm posterior to the skin defect to suture the defected portion without causing tension, and a skin graft was applied to the relief skin incision portion. Two months after the maneuver, the skin graft had been successfully incorporated without infection.
Discussion:
Even after the subcutaneous and the cutaneous tissue have completely covered the pinwheel-shaped titanium mini plate, an edge without screw fixation can be easily bent by a hard blow to the overlying scalp. We recommend fixation of pinwheel-shaped titanium plates used in cranioplasty through all screw holes to protect against the plate being bent.
Congenital hypothyroidism with neurological and respiratory alterations: a case detected using a variable diagnostic threshold for TSH
Authors: Jesús Barreiro, Jóse Ramón Alonso-Fernández, Lidia Castro-Feijoo, Cristóbal Colón, Paloma Cabanas, Claudia Heredia, Luis Antonio Castaño, Carmen Gómez-Lado, M Luz Couce, Manuel Pombo
Journal: J Clin Res Pediatr Endocrinol (2011)
MeSH terms: Congenital Hypothyroidism / diagnosis, Thyrotropin / blood, Case Reports, Bronchial Hyperreactivity / etiology, Congenital Hypothyroidism / complications, Humans, Infant, Newborn, Male, Neonatal Screening / methods, Thyrotropin

We report a case of congenital hypothyroidism (CH) with neurological and respiratory alterations due to a heterozygotic c.374-1G > A mutation of TITF1/NKX2-1. The hypothyroidism was detected using a neonatal screening protocol in which the thyroid stimulating hormone (TSH) threshold is re-set each day on the basis of within-day variability and between-day variation. In this case, the threshold on the day of the initial analysis was 8.2 mIU/L, and the measured TSH level in heel-prick blood was 8.3 mIU/L.
Importance of Extraintestinal Manifestations in Early Diagnosis of Gardner Syndrome
Authors: Bruno Besteiro, Filipa Gomes, Cláudia Costa, Raquel Portugal, Isabel Garrido, Jorge Almeida
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Gardner's syndrome is an autosomal dominant disease caused by a mutation in the APC gene with 20-30% of cases presenting de novo. This entity is a variant of familial adenomatous polyposis, with a prevalence of 3/100,000 habitants. It may present as early as 2 months of age with a variety of both colonic and extracolonic symptoms. We report a case of a 21-year-old man, without any known family history, presenting with microcytic hypochromic anemia and constitutional symptoms for two months. Ultimately, after the etiological study, Gardner syndrome diagnosis was established as an index primary familiar case. Gardner syndrome is a clinical challenge which requires a prompt suspicion in order to reach its diagnosis. Given the malignant evolution of adenomas in 100% of untreated patients, early identification of extraintestinal manifestations (identifiable prior to colonic symptoms) is of the essence. A consequent endoscopic study to confirm gastrointestinal involvement is essential for a more favorable prognosis.
Case report--ancient schwannoma of the scrotum
Authors: Peter T Chan, Sankalp Tripathi, Su E Low, Lee Q Robinson
Journal: BMC Urol (2007)
MeSH terms: Genital Neoplasms, Male / diagnosis, Genital Neoplasms, Male / therapy, Neurilemmoma / diagnosis, Neurilemmoma / therapy, Case Reports, Review, Adult, Humans, Male, Scrotum

Background:
Scrotal schwannoma is a rare neoplasm and poses a diagnostic challenge to urologists. This article describes a rare case of ancient scrotal schwannoma and reviews the current modality of investigation and treatment of this tumour.
Case report:
A 28 year old man presented with a 3-month history of an asymptomatic scrotal swelling. Ultrasonography and computer topography revealed an intra-scrotal and extra-testicular mass without local invasion. Surgical excision was undertaken and histology was an ancient schwannoma of the scrotum.
Conclusion:
Schwannoma is a benign encapsulating neoplasm with an overall low incidence, occurring mostly in the head and neck region and seldom in the scrotum. Histology shows two distinctive patterns, Antoni type A and B areas. Variations of schwannoma such as cellular, ancient, glandular and epithelioid are observed based on the appearances. Ancient schwannoma exhibits pleomorphism without mitosis as the result of cellular degeneration, which can lead to an erroneous diagnosis of malignancy. Imaging modalities are non-specific for schwannomas, but can define tumour size, site and extension. The mainstay treatment is complete excision, although local recurrence may occur in large and incompletely excised lesions. Malignant change is exceedingly rare.
Delayed presentation of renocolic fistula at 4 months after blunt abdominal trauma
Authors: Sang Don Lee, Tae Nam Kim, Hong Koo Ha
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Causes of previously reported reno-colic fistulas included primary renal and colonic pathologic states involving infectious, malignant or other inflammatory processes. However, reno-colic fistula after renal injury is extremely uncommon. We report an unusual delayed presentation of reno-colic fistula that occurred at 4 months later after blunt abdominal trauma.