OpenMed/multicare-articles huggingface dataset:
Late Recurrence of Ovarian Cancer after 18 Years of Disease-Free Survival: A Case Report and Review of the Literature
Authors: Yoko Suzuki, Satoko Eguchi, Takahide Arimoto
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

We present a case of recurrent ovarian cancer at the age of 75, gravida 1 para 0, with 18 years of disease-free survival. Chemotherapy brought a 10-month partial response status; to further improve the overall survival, the patient was evaluated using the AGO score (DESKTOP III trial, 2020), which was originally intended for cases immediately after the diagnosis of recurrence; the score has indicated a significant outcome; the patient went through a hepatosplenic metastatic site resection; and complete resection was achieved. Subsequently, the PARP inhibitor was introduced, which has led to 14 months of disease-free survival. Fifteen cases of late recurrence of epithelial ovarian cancer have been reported and are summarized at the end of this paper.
Case Report: Transcatheter closure of a giant post-traumatic femoral arteriovenous fistula using ventricular septal occluder
Authors: Zewei Chen, Yiyuan Huang, Chenxi Ye, Jiale Liu, Yuxin Liu, Yirui Tang, Zhenfei Fang
Journal: Front Surg (2024)
Keywords: arteriovenous fistula (avf), traumatic arteriovenous fistula, vascular injury, vascular interventional therapy, ventricular septal occluder
MeSH terms: Case Reports

Giant femoral arteriovenous fistulas are comparatively uncommon, typically treated through covered stents, coil embolization, and open surgical repair. Nevertheless, these options may not be appropriate for all patients. Herein, we describe a case of traumatic femoral arteriovenous fistulas that led to drastic dilatation of the femoral arteriovenous system and considerable heart failure symptoms due to prolonged lack of treatment. Given the intricate anatomical location of the fistula and the patient's severe cardiac dysfunction, surgical repair is often unfeasible. Consequently, we adopted an innovative approach in this case, utilizing a ventricular septal occluder device for fistula closure. This constitutes the first report of an arteriovenous fistula transcatheter closure with a septal occluder.
Adverse Cardiovascular Events Associated With Kopi Jantan
Authors: Mohd Khairi Othman, Zurkurnai Yusof, Nur Imani Mohd Rossli, Mohd Hafizazham Mohd Fauzi, W Yus Haniff W Isa
Journal: Cureus (2024)
Keywords: acute coronary syndrome, atrial flutter with rapid ventricular response, energy drink, myocardial infarction, myocardial infarction with non-obstructive coronary arteries (minoca)
MeSH terms: Case Reports

Energy drinks (EDs) are widely accessible worldwide. In Malaysia, it is common for EDs to be premixed with sexual stimulants. ED consumption has been shown to have an association with cardiac arrest, myocardial infarction, spontaneous coronary artery dissection, and coronary vasospasm. In addition to this, EDs are associated with arrhythmias, which significantly prolong the QTc interval. Myocardial infarction with no obstructive coronary artery disease (MINOCA) is defined as a patient presenting with myocardial infarction with no obstructive coronary artery disease or ≤50% stenosis. It is a challenging and complex pathophysiology compared to obstructive coronary artery disease. MINOCA is more frequently associated with younger patients and women. Here, we report two cases related to a Malaysian local energy drink Kopi Jantan, which presented with atrial flutter and MINOCA.
Endoscopic retrieval of 195 incidentally found ingested magnets in a pediatric patient: The limitations of radiography
Authors: Wissam Jamal Al Tamr, Kareem Omran, Mohammad Aldisi, Hilal Matta, Mohamed Nada
Journal: Clin Case Rep (2023)
Keywords: gastroenterology and hepatology, general surgery, oncology, pediatrics and adolescent medicine
MeSH terms: Case Reports

Ingestion of magnetic foreign bodies in children can present elusively on radiographs, requiring detailed history for accurate intervention guidance. Clustering and the weight of multiple magnets may indicate falsely distal positions in the GI tract.
Case report: Solitary mass of the sciatic nerve confirmed as a primary extranodal manifestation of diffuse large B-cell lymphoma in a geriatric patient
Authors: Hannes Becker, Antonio Vogelsberg, Daniel Feucht, Arne Estler, Deniz Tafrali, Jens Schittenhelm, Jakob Milla, Sylvia Kurz, Falko Fend, Marcos Tatagiba, Martin U Schuhmann, Helene Hurth
Journal: Front Oncol (2024)
Keywords: b-cell lymphoma, extranodal manifestation, peripheral nerves, peripheral non nerve sheath tumor, sciatic nerve
MeSH terms: Case Reports

Background:
Neoplastic lesions affecting peripheral nerves are rare in the general population and, most often, are benign peripheral nerve sheath tumors. However, a minority of lesions represent high-grade malignancies associated with a poor prognosis, such as malignant peripheral nerve sheath tumors (MPNSTs). Very rarely, these tumors represent peripheral non-nerve sheath tumors (PNNSTs), such as hematological neoplasms that impair nerve function. These can be hard to distinguish from MPNSTs and other lesions arising from the nerve itself. In the present case report, we describe a rare case of direct infiltration of nerves by tumor cells of a hematological neoplasm.
Methods:
We report the case of a 90-year-old woman with acute onset of right-sided foot palsy, sensory loss, and pain, caused by an extensive solitary mass of the sciatic nerve in the thigh. We present and discuss the clinical presentation, multimodal diagnostic procedures, and treatment.
Results:
MRI of the right thigh and the caudal pelvis revealed a contrast-enhancing lesion infiltrating the sciatic nerve. Additionally performed staging imaging was non-revealing. After multidisciplinary discussion in the neuro-oncology tumor board, a MPNST was suspected and the patient underwent radical tumor resection. However, final histopathology revealed a diffuse large B-cell lymphoma (DLBCL). The patient received adjuvant palliative local radiotherapy which led to acceptable symptom control.
Conclusion:
Rare PNNSTs, including extranodal manifestations of DLBCL can have similar clinical and radiological diagnostical features as PNSTs. Comprehensive diagnostic workup of contrast-enhancing lesions affecting peripheral nerves including MRI and metabolic imaging are recommended. Discussion in interdisciplinary tumor boards facilitates finding individual treatment approaches.
Personalized medicine for locally advanced rectal cancer: five years of complete clinical response after neoadjuvant radiochemotherapy-a case report with a literature review
Authors: Dennis Obonyo, Verena Uslar, Dirk Weyhe, Navid Tabriz
Journal: Front Surg (2024)
Keywords: case report, complete clinical response (ccr), neoadjuvant radiochemotherapy (nrct), non-operative management (nom), personalized medicine, rectal cancer, watch-and-wait (w&w) strategy
MeSH terms: Case Reports

We present a case report of a 73-year-old male patient with a complete clinical response following neoadjuvant radiochemotherapy of mid-rectal adenocarcinoma. The patient was initially diagnosed with stage IIIB microsatellite stable mid-rectal adenocarcinoma in February 2017. During restaging in June 2017, which included rectoscopy, endosonography, computed tomography and magnetic resonance imaging, a complete clinical response was observed. After appropriate consultation, a watch-and-wait strategy was chosen. During stringent follow-up every 3 months for the first 3 years and thereafter every 6 months, no recurrence or regrowth was observed. After the fifth year of complete clinical response, we recommended an annual follow-up. As of November 2023, the patient has no signs of recurrence or late toxicity after radiochemotherapy. The omission of resection in patients with locally advanced rectal cancer and the establishment of a watch-and-wait strategy are currently under discussion as possible treatment courses in patients with complete clinical response. Long-term data on watch-and-wait strategies for patients with a complete clinical response in locally advanced rectal cancer are rare. A clear national and international accepted standardization of follow-up programs for patients managed by a watch-and-wait strategy in the long-term is missing. Here, we report the case of a patient who had undergone a follow-up program for more than five years and discuss the current literature. Our case report and literature review highlights that a watch-and-wait strategy does not seem to increase the risk of systemic disease or compromise survival outcomes in selected locally advanced rectal cancer patients. Thus, our case contributes to the growing body of knowledge on personalized and precision medicine for rectal cancer.
External Cervical Resorption Detected by Cone Beam Computed Tomography on an Immature, Unerupted Maxillary Second Premolar
Authors: Karen Berrigan, Bradly Gettleman, Sabita Rao, Janet Jordan, Mark Stieg, Lawrence Johns
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Root resorption is a commonly recognized risk of orthodontic treatment and can range from minimal changes at the apex to aggressive and extensive erosion of tooth structure. The following report is aimed at presenting a rare case of idiopathic aggressive preeruptive root resorption in a maxillary second premolar of a young child prior to orthodontic force. During phase I orthodontic treatment, the maxillary premolar required surgical exposure with a bracket and chain to assist in its eruption. Before the exposure, a cone beam computed tomography (CBCT) was captured to aid in localizing the premolar and its relationship to vital structures. In addition to identifying relevant anatomy, the image also revealed an incidental finding of extensive external cervical root resorption. The risks, benefits, prognosis, and alternatives of continuing with surgical exposure of the affected premolar were presented to the guardian. The informed and consented decision was made to continue with the exposure and subsequent orthodontic treatment to align the tooth in the arch. Upon eruption to the occlusal plane, the tooth was amenable to endodontic pulp vitality testing, Endo Ice, and a follow-up CBCT. It was determined that there was advanced aggressive progression of the resorptive process. The Patel Classification 3Cd/Class 4 Heithersay ECR diagnosis and a poor prognosis ultimately resulted in the extraction of the tooth. Management of this case highlights a number of important clinical features including the rarity of advanced preeruptive idiopathic external cervical root resorption, a multidisciplinary approach (orthodontic, endodontic, and surgical) to diagnose and manage the ECR, and the importance of prescribing and acquisition of appropriate imaging to aid in the early diagnosis of the entity. This case report will add to the body of knowledge of a rare incidence of advanced ECR on a young patient with a nontraumatized, unerupted maxillary second premolar.
Successful treatment of nivolumab and ipilimumab triggered type 1 diabetes by using sodium-glucose transporter 2 inhibitor: a case report and systematic review
Authors: Makoto Fujiwara, Masaru Shimizu, Tatsuya Okano, Yuko Maejima, Kenju Shimomura
Journal: Front Public Health (2023)
Keywords: sglt2 inhibitor, diabetes, insulin, ipilimumab, nivolumab
MeSH terms: Diabetes Mellitus, Type 1 / chemically induced, Diabetes Mellitus, Type 1 / complications, Diabetes Mellitus, Type 1 / drug therapy, Diabetic Ketoacidosis / chemically induced, Diabetic Ketoacidosis / drug therapy, Lung Neoplasms / drug therapy, Sodium-Glucose Transporter 2 Inhibitors / adverse effects, Systematic Review, Case Reports, Aged, Humans, Insulin / adverse effects, Ipilimumab / therapeutic use, Male, Nivolumab / therapeutic use, Nivolumab, Sodium-Glucose Transporter 2 Inhibitors, Ipilimumab, Insulin

Objective:
Checkpoint inhibitors (CPIs) can trigger complications related to the autoimmune process such as CPI-triggered diabetes mellitus. The typical treatment for CPI-triggered diabetes is insulin, but a detailed therapeutic method has not yet been established. To prevent severe symptoms and mortality of diabetic ketoacidosis in advanced-stage cancer patients, the establishment of effective treatment of CPI-triggered diabetes, other than insulin therapy, is required.
Methods:
We present a case of a 76-year-old man with CPI-triggered diabetes who was treated with nivolumab and ipilimumab for lung cancer. We also conducted a systematic review of 48 case reports of type 1 diabetes associated with nivolumab and ipilimumab therapy before June 2023.
Results:
The patient's hyperglycemia was not sufficiently controlled by insulin therapy, and after the remission of ketoacidosis, the addition of a sodium-glucose transporter (SGLT) 2 inhibitor, dapagliflozin, improved glycemic control. Most of the reported nivolumab/ipilimumab-induced type 1 diabetes was treatable with insulin, but very few cases required additional oral anti-diabetic agents to obtain good glucose control.
Conclusion:
Although SGLT2 inhibitors have been reported to have adverse effects on ketoacidosis, recent studies indicate that the occurrence of ketoacidosis is relatively rare. Considering the pathological mechanism of CPI-triggered diabetes, SGLT2 inhibitors could be an effective choice if they are administered while carefully monitoring the patient's ketoacidosis.
Navigation-Assisted One-Stage Total Knee Arthroplasty With Extra-Articular Corrective Osteotomy for Knee Osteoarthritis With Femoral and Tibial Extra-Articular Deformity: A Case Report
Authors: Mitsuhiko Kubo, Sho Hirobe, Tsutomu Maeda, Kosuke Kumagai, Yasutaka Amano, Yuki Nosaka, Takahide Hasegawa, Shinji Imai
Journal: Case Rep Orthop (2024)
MeSH terms: Case Reports

Background: Knee osteoarthritis (OA) with extra-articular deformity (EAD) is a rare condition for which achieving accurate alignment with total knee arthroplasty (TKA) is difficult. Extra-articular corrective osteotomy may be necessary for severe deformities. Case Presentation: A 76-year-old man underwent TKA for knee OA with EAD due to malunion after fractures of the femur and tibia. The femoral varus and the tibial valgus/recurvatum deformities were mild and corrected by intra-articular osteotomy using navigation (i.e., navigation-assisted standard TKA). However, the femoral antecurvatum deformity was severe, and we performed extra-articular corrective osteotomy simultaneously with TKA. Navigation was used not only for TKA but also for extra-articular corrective osteotomies. The osteotomy site was fixed with a cemented stem and metaphyseal sleeve. The postoperative hip-knee-ankle angle was 1° varus, the femoral implant was implanted at 0.5° varus/0.5° flexion, and the tibial implant was implanted at 0.5° varus/0° posterior slope. Two years after surgery, improvements were obtained in the range of motion from 15°-95° to 0°-110°, the Knee Society Score from 39 to 92 points, and the functional score from 35 to 100 points. Conclusions: One-stage TKA with extra-articular corrective osteotomy achieved good clinical results due to accurate alignment using navigation and firm fixation of the osteotomy site using cemented-stem and metaphyseal sleeve without any fixation devices.
Factors associated with terminated pregnancies in Sri Lanka: A case study of the Sri Lankan Demographic and health survey (DHS) 2016
Authors: Kaludura Anupama Seuwandi Thabrew, Ranawaka Arachchige Chathuri Saranga Ranawaka, Senaratne Ranamukhaarachchi
Journal: PLoS One (2024)
MeSH terms: Contraceptive Agents, Women's Health, Educational Status, Family Characteristics, Female, Humans, Pregnancy, Sri Lanka / epidemiology, Contraceptive Agents

Pregnancy termination is considered to have adverse effects on women's health and to have created financial, economic, and social problems in their lives. This study aimed to identify factors associated with pregnancy termination in Sri Lanka. The study used 2016 Sri Lanka Demographic and Health Survey (DHS) data of 16,323 ever-married women aged 15-49, who were clustered in selected enumerated areas. A binary logistic random intercept multilevel model was fitted to find the association between pregnancy termination and the predictor variables in this study. The overall pregnancy termination rate among Sri Lankan women was 16.14%. Increasing age of women was found to be associated with increasing odds of pregnancy termination. Women who were overweight or obese had higher odds of pregnancy termination, with 14% and 36%, respectively, compared to women with a normal weight. With increasing parity, the likelihood of pregnancy termination decreased. Women who used contraceptives had a 24% higher likelihood of pregnancy termination than those who refrained from using them. Cohabiting women had a 57% higher chance of pregnancy termination. Working women had 15% higher odds than unemployed women. Women who experienced domestic violence had a 14% higher odds of pregnancy termination than those who did not. Women from the Northern, Eastern, and North Central provinces had a lower likelihood of pregnancy termination compared to those from the Western province. Women in the urban sector were more likely to terminate their pregnancy than those in the estate sector. Further, women residing in households where indoor smoking was permitted had a 13% greater chance of ending their pregnancy compared to non-smoking households. The study highlights the importance of restructuring education related to health and well-being, family planning, and work-life balancing for both women and their partners, and developing and implementing or strengthening policies and laws related to mitigating pregnancy termination including domestic violence for women.
Tracheal agenesis: the importance of teamwork in an uncommon pathology, challenging diagnosis, and high mortality-a case report
Authors: Belén Fernández Monteagudo, Salvador Piris Borregas, Lidia Niño Díaz, Tania Carbayo Jiménez, Rocío Morante Valverde, Jesús Vicente Redondo Sedano, Maria Teresa Moral Pumarega
Journal: Front Pediatr (2024)
Keywords: polyhydramnios, respiratory distress, single umbilical artery, tracheal agenesis, tracheoesophageal fistula
MeSH terms: Case Reports

Introduction:
We present the case of a patient with an unexpected postnatal diagnosis of tracheal agenesis, a severe and rare pathology with fewer than 200 cases documented in the literature, typically diagnosed postmortem. In our instance, early diagnosis was achieved through collaborative efforts and teamwork among various professionals. We provide illustrative images and videos to assist colleagues in identifying this congenital anomaly.
Case presentation:
The patient is a term newborn with prenatal indicators of polyhydramnios and a single umbilical artery. Upon birth, the infant exhibited severe respiratory distress, and orotracheal intubation via direct laryngoscopy was unfeasible. Consequently, an urgent fibrobronchoscopy, conducted by pediatric surgeons, led to the diagnosis of tracheal agenesis with tracheoesophageal fistula and the placement of a directed endotracheal tube. This intervention facilitated temporary ventilation until parental consensus on management was achieved. Following a multidisciplinary consultation, the decision was made to proceed with extracorporeal membrane oxygenation. Unfortunately, the patient experienced a prolonged refractory cardiorespiratory arrest and died after 7 h of life in his mother's arms.
Conclusion:
Teamwork in neonatology is indispensable when addressing emergent pathologies. In our experience, multidisciplinary management, including anesthesiologists and pediatric surgeons, should be contemplated in complex scenarios.
Deadly Aspiration Pneumonia Secondary to Superior Mesenteric Artery Syndrome
Authors: Rhea Akel, Iskandar Daou, Dany Jamal, Elham Hobeika, Rany Aoun, Georges Nawfal
Journal: Case Rep Gastrointest Med (2024)
MeSH terms: Case Reports

Superior mesenteric artery syndrome (SMAS) is a rare and unusual disease, suspected clinically and confirmed radiologically. It represents a duodenal obstruction secondary to the impingement of the third portion of the duodenum between the abdominal aorta (AA) and the superior mesenteric artery (SMA) due to decreased intraabdominal fat. High morbidity and mortality rates are linked to missed or late diagnosis that can lead to complications, such as gastric perforation and gastric hemorrhage. We present the case of a 33-year-old man who was not previously known to have a SMAS, who presented to the emergency department with signs of septic shock, complaining of fever and respiratory symptoms for several days. Investigations showed aspiration pneumonia secondary to an upper gastrointestinal obstruction with signs of SMAS on a computed tomography (CT) scanner. Acute and rapid deterioration led to cardiac arrest and death. Through this article, we highlight the importance of early and correct diagnosis of SMAS which can sometimes be challenging, since no number is strictly diagnostic and radiological images must be interpreted in light of the clinical history and physical examination.
Case report: Efficacy of icotinib treatment in lung adenocarcinoma with esophageal squamous cell carcinoma: a rare case of double primary malignant tumors
Authors: Min Deng, Xiaoqing Li, Honghao Mu, Man Wei, Lan Sun
Journal: Front Med (Lausanne) (2024)
Keywords: double primary malignant tumors, esophageal squamous cell carcinoma, icotinib, lung adenocarcinoma, tyrosine kinase inhibitor
MeSH terms: Case Reports

Background:
Lung adenocarcinoma with esophageal squamous cell carcinoma is rare and the prognosis is poor, therefore there is an urgent need to improve this situation. The objective of this study was to explore the effect of first-generation tyrosine kinase inhibitors (TKIs) in the patient of the double primary malignant tumors.
Case report:
We report a case of lung adenocarcinoma with esophageal squamous cell carcinoma treated by icotininb after five-year follow-up. A 71-year-old Chinese woman complaining of swallowing obstruction, heartburn, regurgitation of gastric acid for more than 2 months. An esophageal lesion was found by chest CT scans in T7 vertebral level. The diagnosis by gastroscopic biopsy was squamous cell carcinoma (SCC) with EGFR over-expression. Simultaneously, chest CT showed a 2 cm x 1 cm solitary lesion in the right superior pulmonary. The histological diagnosis by percutaneous lung Biopsy was "adenocarcinoma." Epidermal growth factor receptor (EGFR) gene mutation status was evaluated by Sanger sequencing, and an exon 21 point mutation (L858R) was identified. When the double primary malignant tumors were diagnosed, the patient refused operation and received a tyrosine kinase inhibitor (TKI), icotinib, at the dose of 125 mg, three times per day. All serum tumor biomarkers such as CEA and cancer antigen 125 (CA125) were in the normal range during the treatment period. After five-year follow-up, the patient has no evidence of recurrence or metastasis. The lung cancer was stable, meanwhile the esophageal lesion was almost cured.
Conclusion:
Icotininb is an effective treatment in the patients of the double primary malignant tumors of lung adenocarcinoma with EGFR gene mutation and esophageal squamous cell carcinoma with EGFR over-expression.