OpenMed/multicare-articles huggingface dataset:
Myxoid Epithelial Leiomyoma of the Vulva: A Case Report and Literature Review
Authors: Ting Zhao, Xishi Liu, Yuan Lu
Journal: Case Rep Obstet Gynecol (2015)

Leiomyoma of vulva is rare, and usually misdiagnosed clinically as Bartholin cyst. It usually presents spindle-shaped tumor cells, but some rare cases consisted mainly of atypical epithelioid tumor cells. We report here a case of 30-year-old woman consulting with a vulvar mass of 7 cm in the Bartholin glands area. The lesion was surgically excised with its capsule completely. Pathological examination and immunochemistry showed characteristic of epithelioid leiomyoma with myxoid stroma with both estrogen receptor (ER) and progesterone receptor (PR) staining negative, which was really rare as only 2 cases of vulvar leiomyoma with both ER and PR were reported before.
Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male
Authors: Kenneth C Pang, Thomas P Nguyen, Rita Upreti
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: adolescent, gender dysphoria, hair growth, minoxidil, transgender
MeSH terms: Antihypertensive Agents / therapeutic use, Hair / growth & development, Hair Diseases / drug therapy, Minoxidil / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Face, Hair / drug effects, Hair Diseases / pathology, Humans, Male, Prognosis, Antihypertensive Agents, Minoxidil

Increasing numbers of trans and gender diverse young people are presenting to health services seeking gender-affirming medical care. While testosterone therapy in transgender males is generally effective in inducing masculinization, some adolescents encounter barriers to accessing such treatment or may not wish to experience all the changes that usually accompany testosterone. Here, we describe the case of a 17 year old trans male who presented with gender dysphoria but was initially unable to start testosterone therapy. Due to a desire for facial hair, he was therefore treated with topical minoxidil, an easily accessible, over-the-counter medication that has been used to treat androgenic alopecia for several decades. In this case, minoxidil was applied regularly to the lower face and, after three months of treatment, he developed obvious pigmented facial hair that was sufficient to help him avoid being misgendered. The only reported side effect was excessive skin dryness. Unexpectedly, despite no direct application to other areas, there was also an increase in pigmented body hair, suggestive of systemic absorption and effect. Given its long-standing use and safety record in the management of alopecia, minoxidil might thus represent a useful treatment option for trans males who desire an increase in facial hair.
High-Grade B-Cell Neoplasm with Surface Light Chain Restriction and Tdt Coexpression Evolved in a MYC-Rearranged Diffuse Large B-Cell Lymphoma: A Dilemma in Classification
Authors: Dina Sameh Soliman, Ahmad Al-Sabbagh, Feryal Ibrahim, Ruba Y Taha, Zafar Nawaz, Sarah Elkourashy, Abdulrazzaq Haider, Susanna Akiki, Mohamed Yassin
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

According to World Health Organization (WHO) classification (2008), B-cell neoplasms are classified into precursor B-cell or a mature B-cell phenotype and this classification was also kept in the latest WHO revision (2016). We are reporting a male patient in his fifties, with tonsillar swelling diagnosed as diffuse large B-cell lymphoma (DLBCL), germinal center. He received 6 cycles of RCHOP and showed complete metabolic response. Two months later, he presented with severe CNS symptoms. Flow cytometry on bone marrow (BM) showed infiltration by CD10-positive Kappa-restricted B-cells with loss of CD20 and CD19, and downregulation of CD79b. Moreover, the malignant population showed Tdt expression. BM Cytogenetics revealed t(8;14)(q24;q32) within a complex karyotype. Retrospectively, MYC and Tdt immunostains performed on original diagnostic tissue and came negative for Tdt and positive for MYC. It has been rarely reported that mature B-cell neoplasms present with features of immaturity; however the significance of Tdt acquisition during disease course was not addressed before. What is unique in this case is that the emerging disease has acquired an immaturity marker while retaining some features of the original mature clone. No definitive WHO category would adopt high-grade neoplasms that exhibit significant overlapping features between mature and immature phenotypes.
Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall
Authors: Jayan George, Michael Peirson, Samuel Birks, Paul Skinner
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

We describe the case of a 37-year-old gentleman with Crohn's disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.
Extramedullary Manifestations of Chronic Myelomonocytic Leukemia: Do We Treat like an Acute Myeloid Leukemia?
Authors: Prasun Pudasainee, Bimatshu Pyakuryal, Yogesh Subedi, Jenisha Upadhyay, Subarna Adhikari
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Chronic myelomonocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Extramedullary leukemic involvement is rarely a presenting feature of CMML. As there are no clear guidelines in regard to the treatment of patients with extramedullary manifestations, its management is challenging. In this report, we discuss the management of our patient who presented with submandibular lymphadenopathy and gingivitis and was diagnosed with CMML.
Vomiting-induced short gastric artery apoplexy
Authors: Trishna R Shimpi, Sumer Shikhare, Darren Yl Chan, Wilfred Cg Peh, Ashish Chawla
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Abdominal apoplexy due to short gastric artery rupture following vomiting is an exceedingly rare condition. It results from non-traumatic and non-iatrogenic causes. This entity has variable clinical presentation and patients usually present with non-specific abdominal pain. Imaging plays a vital role in early diagnosis, as immediate exploratory laparotomy is the treatment of choice for successful outcome and helps to reduce mortality rate. We report the case of a 27-year-old male patient who presented to the emergency department with acute-onset abdominal pain after multiple episodes of vomiting following binge alcohol drinking. Contrast-enhanced CT revealed intraperitoneal haemorrhage secondary to vessel rupture, probably from a short gastric artery. Intraoperatively, the short gastric artery was identified as the bleeding source and ligated. The patient had an uneventful postoperative course.
Rhabdomyolysis and dengue Fever: a case report and literature review
Authors: Tanya Sargeant, Tricia Harris, Rohan Wilks, Sydney Barned, Karen Galloway-Blake, Trevor Ferguson
Journal: Case Rep Med (2013)

The medical literature contains only a few reports of rhabdomyolysis occurring in patients with dengue fever. We report the case of a 25-year-old Jamaican man who was admitted to a private hospital four days after the onset of an acute febrile illness with fever, myalgia, and generalized weakness. Dengue fever was confirmed with a positive test for the dengue antigen, nonstructural protein 1. He remained well and was discharged on day 6 of his illness. On day 8, he started to pass red urine and was subsequently admitted to the University Hospital of the West Indies. On admission he was found to have myoglobinuria and an elevated creatine phosphokinase (CPK) of 325,600 U/L, leading to a diagnosis of rhabdomyolysis. Dengue IgM was positive. He was treated with aggressive hydration and had close monitoring of his urine output, creatinine, and CPK levels. His hospital course was uneventful without the development of acute renal failure and he was discharged after 14 days in hospital, with a CPK level of 2463 U/L. This case highlights that severe rhabdomyolysis may occur in patients with dengue fever and that early and aggressive treatment may prevent severe complications such as acute renal failure and death.
Case Report: A Rare Abdominopelvic Arteriovenous Malformation: Originating From Splenic Artery and Draining Into Portal Vein
Authors: Xin Li, Jiehua Li, Mo Wang, Junwei Wang, Lunchang Wang, Hao He, Ming Li, Quanming Li, Chang Shu
Journal: Front Cardiovasc Med (2022)
Keywords: abdominopelvic arteriovenous malformation, portal vein, splenic artery, surgical resection, vascular malformation
MeSH terms: Case Reports

Background:
Abdominopelvic arteriovenous malformation is an uncommon congenital vascular lesion, for which the diagnosis and treatment are usually difficult. Though embolization and sclerotherapy are the primary treatment strategies, traditional surgical resection remains a valuable option.
Case presentation:
Herein, we present a 32-year-old female diagnosed with a massive abdominopelvic arteriovenous malformation that originates from the splenic artery and drains into the portal vein. The vascular lesion was evaluated with multiple imaging modalities and then surgically resected successfully. The patient was discharged post-operatively on day 6 and free of symptoms during the 12-month follow-up.
Conclusion:
To our knowledge, the presented abdominopelvic arteriovenous malformation is the first to be reported in the literature, with such a rare condition originating from the splenic artery and draining into the portal vein.
Psychosis following a stroke to the cerebellum and midbrain: a case report
Authors: Michael Bielawski, Helen Bondurant
Journal: Cerebellum Ataxias (2015)
Keywords: cerebellar cognitive affective syndrome, cerebellar stroke, cerebellum, post-stroke psychosis, psychosis
MeSH terms: Case Reports

Background:
There is growing evidence that the cerebellum serves an important role in controlling affect and cognition, and its pathology has been implicated in several psychiatric disorders. Furthermore, the brainstem's role in cognition and affect has been historically overlooked. Neuroimaging studies and an increasing number of case reports indicate cognitive deficits and hallucinatory phenomena after isolated brainstem lesions.
Case presentation:
We report a 56-year-old man who developed persistent persecutory delusions, hallucinations, cognitive impairment and flattened affect following an extensive bilateral cerebellar stroke with involvement of the midbrain.
Conclusions:
This is one of the few reported cases of unremitting psychosis secondary to cerebellar and mesencephalic vascular infarction. We suggest, based on the distribution of the patient's lesions, that his corresponding symptoms are a result of a disruption to cerebrocerebellar pathways. This article briefly reviews recent pathophysiological explanations behind the psychosis associated with brainstem and cerebellar lesions, the treatment, as well as the relation of these structures to each other.
A Rare Presentation of AKI: Gastric Infiltration of the Bladder Wall
Authors: Sandipani Sandilya, Ladan Golestaneh
Journal: Case Rep Nephrol (2011)
MeSH terms: Case Reports

We describe the case of a man who presented with back pain and acute kidney injury and was found to have bilateral ureteral obstruction, which initially corrected with ureteral stents. Imaging studies showed thickening of the bladder. Shortly thereafter, he developed obstructive jaundice, pancreatitis, recurrence of renal failure, and was diagnosed with advanced gastric cancer after a laparotomy revealed peritoneal carcinomatosis. The patient deteriorated rapidly after diagnosis. While peritoneal carcinomatosis, ureteral metastases, and extrinsic ureteral compression have been recognized in gastric cancer, obstructive renal failure due to tumor infiltration of the bladder wall is seldom described. We present this case as an unusual cause of acute renal failure and presentation of gastric cancer.
Case report: Alpelisib-induced Stevens-Johnson syndrome
Authors: Christine Jane Kurian, Akshay Desai, William Rafferty, Ahmed Kamel Abou Hussein
Journal: Front Oncol (2022)
Keywords: stevens johnson syndrome, stevens johnson syndrome (sjs), alpelisib, breast cancer, metastatic breast cancer
MeSH terms: Case Reports

Background:
Alpelisib is a recently approved treatment for hormone receptor-positive, HER2-negative, PIK3CA-mutated advanced breast cancer. It has been associated with alopecia and rash, but there are no documented cases of Stevens-Johnson Syndrome (SJS) associated with this drug. Here, we detail the first case of SJS associated with alpelisib.
Case description:
Our patient is a 60-year-old woman with a past medical history of metastatic hormone receptor-positive (ER+ 80% and PR+ 1%), HER2-negative metastatic breast cancer who presented with acute odynophagia, fevers, and diffuse body rash after receiving her first doses of alpelisib and fulvestrant in the preceding days. She presented to the emergency department after developing a whole-body rash and severe ulceration of her buccal mucosa. She was started on methylprednisolone with remarkable improvement in symptoms.
Conclusion:
This case report details the only report of SJS following alpelisib treatment. Immediate cessation of drugs and initiation of steroids are the cornerstone of treatment. Patients who experience such side effects will have to be monitored closely for long-term sequelae associated with SJS, including cutaneous, ocular, and oral sequelae, all of which can profoundly affect the quality of life for cancer patients.
Case Report: Giant Biatrial Myxoma Mimicking Malignant Cardiac Tumor in a Patient With a Hepatic Angiomatous Mass
Authors: Chengming Fan, Hao Zhang, Huanwei Zhuang, Zenan Jiang, Haoyu Tan, Chukwuemeka Daniel Iroegbu, Long Song, Liming Liu
Journal: Front Cardiovasc Med (2021)
Keywords: cox-maze iv procedure, atrial fibrillation, giant biatrial myxoma, malignant, surgery
MeSH terms: Case Reports

Cardiac myxomas, primarily originating from the left atrium, are the most prevalent types of benign cardiac tumors; however, biatrial myxomas are extremely rare. Herein, we present a rare case of a 55-year old male with exertional dyspnea and intermittent chest discomfort due to a giant biatrial mass with concomitant atrial fibrillation and hepatic hemangioma. The giant tumor with its peduncle at the interatrial septum involved both atria; however, bulging through the tricuspid valve to the right ventricle during systole. Hence, excision of the giant cardiac tumor (which grossly composed of three parts: stiff, fleshy, and soft) and Cox-Maze IV procedure was performed with the resected specimen measuring 100 × 80 × 40 mm. The patient who was in a stable condition was discharged home on the 12th post-operative day. Thus, given the excellent post-operative results achieved, surgical treatment in large multi-cavitary benign cardiac tumors is feasible and should be considered a potentially curative therapy.
Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough
Authors: Albert Jang, Kallie N Kram, Scott N Berger, Mahmoud R Gaballa, Lee B Lu, David R Dunaway, Courtney N Miller-Chism
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Spinal cord compression (SCC) is a rare initial presentation and complication of acute lymphoblastic leukemia (ALL) with nearly all reported cases occurring in the pediatric population. We report a 38-year-old previously healthy man who presented with acute on chronic lower back pain, gait instability, urinary retention, and severe thrombocytopenia. Radiologic examination revealed two soft tissue masses of the thoracic spine associated with compression fractures causing spinal canal narrowing and cord compression. Bone marrow biopsy confirmed the diagnosis of ALL. Immediate initiation of high-dose corticosteroids and systemic chemotherapy resolved the patient's symptoms without radiation therapy or surgical intervention. After two courses of chemotherapy, the patient achieved complete remission in the bone marrow. Rapid administration of chemotherapy alone in this case resulted in a complete resolution of SCC. Given the rarity of this complication in adults, no standardized treatment has been established. The success of this case recommends chemotherapy as the initial management of SCC in chemotherapy-naïve ALL.
Broadening the Spectrum of Adulthood X-Linked Adrenoleukodystrophy: A Report of Two Atypical Cases
Authors: Matteo Foschi, Veria Vacchiano, Patrizia Avoni, Alex Incensi, Stella Battaglia, Vincenzo Donadio, Elena Panzeri, Maria Teresa Bassi, Rocco Liguori, Giovanni Rizzo
Journal: Front Neurol (2019)
Keywords: abcd1, mri, adrenoleukodystrophy, adrenomyelopathy, brain development defects, skin biopsy, small fiber neuropathy, very long chain fatty acids
MeSH terms: Case Reports

X-linked adrenoleukodystrophy (x-ALD) is a rare genetic disorder caused by a mutation in the ABCD1 gene, which encodes for a peroxisomal very long chain fatty acid transporter. Clinically, x-ALD can present a wide spectrum of different phenotypes: asymptomatic carriers, Addison only, cerebral x-ALD, and myelopathy with/without evidence of peripheral axonopathy (Adrenomyeloneuropathy). We report on two cases of adult x-ALD, with atypical phenotypes: (Case 1) A 37-years-old male with a 2-years-long history of spastic paraparesis, urinary urgency, and subclinical adrenocortical insufficiency. As an atypical finding, the MRI showed multiple congenital brain development defects. (Case 2) A 63-years-old male with a previous diagnosis of Addison disease, with a 6-years-long history of spastic paraparesis. Two years later, he complained of severe and disabling burning pain in his feet. A nerve conduction study was normal, but a skin biopsy revealed autonomic and somatic small fiber neuropathy. In both cases, genetic testing disclosed hemizygous mutation in ABCD1 associated with x-ALD: c.1394-2A > G and p.(Thr254Met), respectively. While case 1 supports the key role of peroxisome functions in brain development, case 2 points to a possible selective and clinically relevant peripheral small fiber degeneration in x-ALD myelopathy.
A case report of left lower lobe segmentectomy for pulmonary metastasis from retroperitoneal liposarcoma
Authors: Kazuhiro Yoshida, Masakazu Yoshida, Minoru Haisa, Takuro Yukawa, Yasumasa Monobe, Yoshio Naomoto, Takuya Fukazawa, Tomoki Yamatsuji
Journal: Int J Surg Case Rep (2019)
Keywords: limited resection, pulmonary metastasis, retroperitoneal liposarcoma

Background:
The principle treatment for retroperitoneal liposarcoma is surgical resection, however there are many cases of recurrence. In addition to local recurrence, retroperitoneal liposarcoma, particularly dedifferentiated liposarcoma is known to occasionally cause lung metastases.
Case report:
A 72-year-old woman with a diagnosis of retroperitoneal liposarcoma and probable right upper lobe early pulmonary adenocarcinoma underwent sequential local tumor resection and right upper lobectomy. Twenty months after liposarcoma resection, a computed tomography (CT) scan of the chest revealed a nodule located in the left lower lobe. A CT-guided biopsy was performed and she was subsequently diagnosed with pulmonary metastasis from retroperitoneal liposarcoma. The nodule enlarged chronologically, however a left lower lobectomy could not be performed because respiratory function after the right upper lobectomy was not sufficient. Therefore, in order to preserve the left superior segment (S6), the basal segments (S8+S9+S10) were resected. Seven months after the surgery, she is living a self-reliant life without recurrence of liposarcoma.
Conclusion:
Here we have reported a case of pulmonary metastasis from retroperitoneal liposarcoma following limited surgery. In cases where respiratory function is limited, lower lobe segmentectomy can be an effective treatment. For the treatment of a single pulmonary metastasis from retroperitoneal liposarcoma, metastasectomy was considered to be effective as long as no local recurrence was seen after initial primary tumor resection.
Successful Orthograde Treatment of Teeth with External Inflammatory Root Resorption and Perforation Using a Tricalcium Silicate-Based Material
Authors: Mariana Díaz, Hugo Plascencia, Fabián Esaú Hernández-Guerrero, Flávio R F Alves, Karina Martínez-Carrillo, Gerardo Gascón
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

One possible consequence of dentoalveolar trauma is the development of external inflammatory root resorption (EIRR), which represents an anatomic and microbiologic challenge for clinicians. This case report describes different strategies implemented for successful endodontic management of teeth with multiple EIRR lesions, highlighting the orthograde root canal filling using a tricalcium silicate-based material (Biodentine, Septodont, Saint-Maur-des-Fossés, France). A 17-year-old female patient presented with severe pain in the anterior maxillary teeth and a history of trauma. Two- and three-dimensional radiographic exams confirmed EIRR in three teeth, with a total of 11 EIRR lesions, three exhibiting communication with the root canal. Therefore, chemo-mechanical preparation complemented by ultrasonic activation of irrigants and some changes of intra-canal dressing with calcium hydroxide were performed to reduce the microbiologic load of the affected teeth as much as possible. Then, the canals were entirely filled with Biodentine to interrupt the root resorption process and strengthen the remaining root structure. A 60-month follow-up showed the disappearance of bone rarefactions and the complete repair of the 11 EIRR lesions. The favorable long-term response indicates the feasibility of using tricalcium silicate-based putty as part of orthograde endodontic treatment of teeth with EIRR and root perforations.
Basic fibroblast growth factor for treatment of onychomadesis with delayed regrowth of the nail
Authors: Tomito Oji, Masaki Yazawa, Kazuo Kishi
Journal: Case Rep Dermatol Med (2013)

Onychomadesis usually arises from an inflammation of the paronychium or as a result of blisters and hemorrhaging under a nail that has been struck or compressed. No documented interactions between basic fibroblast growth factor (bFGF) and onychomadesis have hitherto been reported. This case report describes a 25-year-old woman with onychomadesis following infection of the ingrown nail of her left thumb. After ten months of observation with no treatment showed no regrowth of her left thumbnail, the external use of bFGF and antibiotic ointment was started. One month later, nail regrowth was observed up to the halfway point of the nail bed, and after treatment for three months, the regrown nail reached the top of the nail bed. Both thumbnails now looked identical. This case suggests that external use of bFGF can promote nail regrowth in cases of onychomadesis with delayed regrowth of the nail.