OpenMed/multicare-articles huggingface dataset:
Clinical Controversy Surrounding the Differential Diagnosis of Branchiogenic Carcinoma
Authors: Alexander Karatzanis, Kleanthi Mylopotamitaki, Eleni Lagoudaki, Emmanuel Prokopakis, Sofia Agelaki
Journal: Case Rep Otolaryngol (2022)
MeSH terms: Case Reports

Clinical evaluation, differential diagnosis, and management of a neck mass constitute commonly encountered problems for the head and neck surgeon. An asymptomatic neck mass in adults may be the only clinical sign of head and neck cancer. A 50-year-old female patient presented with a painless, slowly enlarging, left lateral neck lump. Ultrasonography described a possible lymph node with cystic degeneration, and fine needle aspiration biopsy only detected atypical cells of squamous epithelium. An open biopsy under general anesthesia was performed. Histopathological findings suggested the diagnosis of lymph node infiltration by squamous cell carcinoma of an unknown primary site, but differential diagnosis also included branchiogenic carcinoma arising in a branchial cleft cyst. A diagnostic algorithm for metastatic squamous cell carcinoma of an unknown primary site was followed, including positron emission tomography with computed tomography. The patient underwent panendoscopy and bilateral tonsillectomy, and an ipsilateral p16 positive tonsillar squamous cell carcinoma was detected. Further appropriate management followed. The existence of true branchiogenic carcinoma is controversial. When such a diagnosis is contemplated, every effort should be made to detect a possible primary site. Branchiogenic carcinoma, if exists at all, remains a diagnosis of exclusion.
Multilayered Connective Tissue Grafting Technique to Improve Aesthetics after Failed GBR: A Clinical Case Report of 16 Months Follow-Up
Authors: Gabriele Villa, Gionata Bellucci, Simone Magnolo, Farah Asa'ad
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Objective:
This case report describes soft-tissue management after a failed GBR procedure to enhance the soft-tissue quality, quantity, and aesthetic outcomes. Case Presentation. A 38-year-old patient visited the Dental Clinic of the Ospedale Maggiore Policlinico, University of Milan, Milan, Italy, for a chief complaint of unsatisfactory aesthetics of the anterior maxillary area. Dental history disclosed failed preimplant vertical bone augmentation with GBR procedure in the area of the left maxillary central incisor resulting in a severe gingival recession of adjacent teeth and compromised soft-tissue quantity and quality and severe ridge atrophy (class III). Multilayered connective tissue grafting technique, in a two-step mucogingival surgery, was used to cover the gingival recessions, reach even gingival margin, and reconstruct the defect. Frenectomy was done after the second mucogingival surgery to relieve the muscle attachment. A definitive cantilever bridge was placed to restore the left and right maxillary central incisors, and a satisfactory aesthetic outcome was reached.
Conclusions:
Multilayered connective tissue grafting technique might be successful in correcting soft-tissue quantity and quality in class III ridge defects.
A customized anthropomorphic 3D-printed phantom to reproducibility assessment in computed tomography: an oncological case study
Authors: Carlo Cavaliere, Dario Baldi, Valentina Brancato, Marco Aiello, Marco Salvatore
Journal: Front Oncol (2023)
Keywords: 3d printing, computed tomography, lung tumor, phantom, polylactic acid

Introduction:
Studies on computed tomography (CT) reproducibility at different acquisition parameters have to take into account radiation dose administered and related ethical issues. 3D-printed phantoms provide the possibility to investigate these features deeply and to foster CT research, also taking advantage by outperforming new generation scanners. The aim of this study is to propose a new anthropomorphic 3D-printed phantom for chest lesions, tailored on a real patient CT scan, to investigate the variability of volume and Hounsfield Unit (HU) measurements at different CT acquisition parameters.
Methods:
The chest CT of a 75-year-old patient with a paramediastinal lung lesion was segmented based on an eight-compartment approach related to HU ranges (air lung, lung interstitium, fat, muscle, vascular, skin, bone, and lesion). From each mask produced, the 3D.stl model was exported and linked to a different printing infill value, based on a preliminary test and HU ratios derived from the patient scan. Fused deposition modeling (FDM) technology printing was chosen with filament materials in polylactic acid (PLA). Phantom was acquired at 50 mAs and three different tube voltages of 80, 100, and 120 kVp on two different scanners, namely, Siemens Somatom Force (Siemens Healthineers, Erlangen, Germany; same setting of real patient for 80 kVp acquisition) and GE 750 HD CT (GE Healthcare, Chicago, IL). The same segmentation workflow was then applied on each phantom acquisition after coregistration pipeline, and Dice Similarity Coefficient (DSC) and HU averages were extracted and compared for each compartment.
Results:
DSC comparison among real patient versus phantom scans at different kVp, and on both CT scanners, demonstrated a good overlap of different compartments and lesion vascularization with a higher similarity for lung and lesion masks for each setting (about 0.9 and 0.8, respectively). Although mean HU was not comparable with real data, due to the PLA material, the proportion of intensity values for each compartment remains respected.
Discussion:
The proposed approach demonstrated the reliability of 3D-printed technology for personalized approaches in CT research, opening to the application of the same workflow to other oncological fields.
Management of an Extremely Low Birth Weight Infant with Bilateral Renal Obstruction Caused by Candida albicans Fungus Balls
Authors: Fabian Brüning, Axel Hegele, Günter Klaus, Rolf F Maier, Rainer Hofmann
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

We report an extremely low birth weight infant with anuria caused by bilateral Candida albicans fungus balls it was treated with a combination of antifungal therapy, irrigation and pyelotomy. This lead to a recovery of renal function, after a follow-up of 77 month no more Candida was cultured from urine.
Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique
Authors: Chukwunonso Chime, Charbel Ishak, Kishore Kumar, Muhammad Kamal, Srinivasan Krishna, Paul Kelly, Sridhar Chilimuri
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma.
Rare presentation of unilateral weakness, involuntary movements and ataxia with subcortical t2 hypointensity in a diabetic patient: a case report
Authors: Venkatraman Indiran, Prabakaran Maduraimuthu
Journal: Case Rep Radiol (2012)

Subcortical T2 hypointensity on MRI is not a common finding. We present a case of subcortical T2 hypointensity in a diabetic patient, who was referred with weakness of left lower limb and involuntary movements and ataxia of the left upper limb. Lab reports confirmed the diagnosis of nonketotic hyperglycemia. It is rather important to identify subcortical T2 hypointensity which has only been recently found to be associated with nonketotic hyperglycemia. Early identification and prompt correction of blood sugar would help in alleviating the neurological symptoms.
Traumatic Submacular Hemorrhage with Macular Hole Repaired by Pneumatic Displacement and Intravitreal t-PA Injection
Authors: Amy A Mehta, Jay Berdia, Lilly H Wagner, Irene Choi, Brandon B Johnson
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

This paper presents a case demonstrating repair of traumatic macular hole and submacular hemorrhage with intravitreal gas tamponade and t-PA in an office setting.
Abdominal Wall Clear Cell Carcinoma: Case Report of a Rare Event with Potential Diagnostic Difficulties
Authors: Maria Del Mar Rivera Rolon, Dyron Allen, Gwyn Richardson, Cecilia Clement
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Clear cell carcinoma (CCC) is a well-known aggressive histological type of carcinoma, predominantly seen in ovary and endometrium. However, CCC arising in abdominal wall is a very rare event. We report a case of a 48-year-old woman with an abdominal wall mass at her cesarean section (c-section) scar, which increased in size and became painful in the last months. Radiology revealed a 7 cm mass in the right inferior rectus muscle sheath, suggestive of endometriosis. An irregular, firm mass was resected, densely adherent to the rectus muscle and pubic bone. Frozen section revealed a multicystic lesion with minimal cytologic atypia, and a benign cystic neoplasm was favored. However, permanent sections showed marked nuclear atypia, hobnail morphology, and areas of infiltrative growth within fibrous stroma. No benign endometrial glands were found, although fibrosis and hemorrhage were present. Napsin-A, racemase, and PAX-8 were positive, consistent with CCC, likely arising within a c-section endometriosis focus. Although CCC usually presents with moderate to marked nuclear atypia, it can be mild and, especially in cases with a predominant cystic pattern, create diagnostic difficulties. An endometriosis-associated malignancy should be considered in the differential with any enlarging nodule or increasing pain within an abdominal wall scar.
Small cell carcinoma of the renal pelvis: a case report and review of the literature
Authors: Sachin Patil, R C M Kaza, A K Kakkar, Ronald S Chamberlain
Journal: ISRN Urol (2011)
MeSH terms: Case Reports

Extrapulmonary small cell carcinoma occurs in nearly all organs except the central nervous system and the liver. We are presenting a case of renal small cell carcinoma (SCC) with two unique characters. A 75-year-old patient was evaluated for back pain with no other complaints. Magnetic Resonance (MR) imaging of the abdomen revealed homogeneous tumor in the left renal pelvis extending beyond the kidney. Metastatic workup was negative. A left nephroureterectomy was performed. Histopathology and immunohistochemistry revealed a small cell carcinoma of the renal pelvis. The patient declined adjuvant therapy and died 2 months after surgery due to unrelated causes. After comprehensive worldwide literature search, we found 13 cases of SCC of the renal pelvis, including the current case. The mean age was 61.6 years (37-83), with a M : F ratio of 1 : 1.8. The average duration of symptoms was 71.4 days (21-168). Gross hematuria was the most common symptom (69.2%) followed by pain (61.5%). Adjuvant chemotherapy was provided to 4 patients (30.7%), and neoadjuvant to 1 patient. The median survival of patients who did and did not receive chemotherapy was 5.5 months (3-8) and 6 months (2-31), respectively, P < .50. In conclusion, renal SCC (both parenchymal and pelvic SCC) is a rapidly fatal disease with a median survival of ≤8 months.
Pancreatic intraductal papillary mucinous neoplasm with concomitant heterotopic pancreatic cystic neoplasia of the stomach: a case report and review of the literature
Authors: Dimitrios Tsapralis, Alexandros Charalabopoulos, Eva Karamitopoulou, Dimitrios Schizas, Konstantinos Charalabopoulos, Theodoros Liakakos, Anastasios Macheras
Journal: Diagn Pathol (2010)
MeSH terms: Carcinoma, Pancreatic Ductal / surgery, Carcinoma, Papillary / surgery, Choristoma, Neoplasms, Cystic, Mucinous, and Serous / surgery, Pancreas, Pancreatic Neoplasms / surgery, Stomach Diseases / diagnosis, Case Reports, Review, Biopsy, Carcinoma, Pancreatic Ductal / pathology, Carcinoma, Papillary / pathology, Cholangiopancreatography, Magnetic Resonance, Gastrectomy, Humans, Incidental Findings, Male, Middle Aged, Neoplasms, Cystic, Mucinous, and Serous / pathology, Pancreatectomy, Pancreatic Neoplasms / pathology, Splenectomy, Stomach Diseases / pathology, Stomach Diseases / surgery, Treatment Outcome

A 60-year-old Caucasian male underwent a total pancreatectomy for a mixed type pancreatic intraductal papillary mucinous neoplasm (IPMN) arising in the main and secondary pancreatic ducts. During surgery, a subserosal polypoid mass was noted at the greater curvature of the gastric antrum and was enucleated. This mass was proven to be heterotopic pancreatic tissue with cystic neoplasia of the IPMN histologic subtype. Through an extensive search of the literature, we found that this is the first case ever reported with simultaneous existence of IPMN changes, in the main and secondary ducts of the orthotopic pancreas and in the heterotopic pancreatic tissue of the gastric wall.
Central serous chorioretinopathy with angioid streaks: a rare combination
Authors: Ambreen Sarmad, Fadi Alfaqawi, Monali Chakrabarti, Samer Elsherbiny
Journal: GMS Ophthalmol Cases (2018)
Keywords: cnv, angioid streaks, central serous chorioretinopathy, choroidal neo-vascularizartion, photodynamic therapy
MeSH terms: Case Reports

Purpose: This rare case shows the presence of both angioid streaks (AS) and central serous chorioretinopathy (CSC) in the same eye. Methods: A 41-year-old Caucasian male who also has a positive family history of AS was diagnosed with angioid streaks. He was followed for few years, later developed CSC in his good eye. Results: Fundus fluorescein led to the diagnosis of CSC and indocyanine green angiography ruled out the possibility of idiopathic polypoidal choroidal vasculopathy (IPCV). The CSC followed a chronic course of non-resolution and finally half fluence photodynamic therapy was performed. Unfortunately, there was still some deterioration of vision with poor response. Conclusion: There is no known correlation between the two disorders and their presence in one eye has not been reported to our knowledge.
Agomelatine augmentation of escitalopram therapy in treatment-resistant obsessive-compulsive disorder: a case report
Authors: Domenico De Berardis, Nicola Serroni, Stefano Marini, Giovanni Martinotti, Francesca Ferri, Gaetano Callista, Raffaella La Rovere, Francesco Saverio Moschetta, Massimo Di Giannantonio
Journal: Case Rep Psychiatry (2012)

Obsessive-compulsive disorder (OCD) is a chronic condition characterized by obsessions or compulsions that cause distress or interfere with functioning. Selective serotonin reuptake inhibitors are the first-line strategy in the treatment of OCD, but approximately 40% to 60% of patients with OCD fail to respond to them. Several augmentation strategies have been proposed, including the use of atypical antipsychotics and antidepressant combinations. In the present paper we describe the case of a young female patient suffering from severe treatment-resistant OCD who remitted as a result of agomelatine augmentation of escitalopram therapy.
Case report: A pediatric case of MPO-ANCA-associated granulomatosis with polyangiitis superimposed on post-streptococcal acute glomerulonephritis
Authors: Qianhuining Kuang, Xu He, Lili Jia, Zhiqiang Zhang, Chunhong Gui, Chunlin Gao, Zhengkun Xia
Journal: Front Pediatr (2023)
Keywords: anca-associated vasculitides, mpo-anca, granulomatosis with polyangiitis, immunosuppressive therapy, post-streptococcal acute glomerulonephritis
MeSH terms: Case Reports

An eight-year-old girl was admitted with vomiting, gross hematuria, and progressive renal dysfunction. A renal biopsy revealed endocapillary proliferative glomerulopathy and crescent formation. Immunofluorescence staining revealed diffuse granular deposits of IgG and C3. Post-streptococcal acute glomerulonephritis (PSAGN) was suspected, based on the elevated anti-streptolysin O levels, decreased serum C3 concentrations, and histologic findings. The myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) test was positive, and the young patient gradually developed palisaded neutrophilic and granulomatous dermatitis (PNGD), orbital and paranasal sinus granulomatous neoplasms, along with intermittent nose, head, and orbital pain. Finally, she was diagnosed with the rare MPO-ANCA-associated granulomatosis with polyangiitis (GPA) superimposed on PSAGN. The patient was treated with aggressive renal replacement therapy, methylprednisolone pulse therapy, and intravenous pulse cyclophosphamide; her renal function normalized, and her pain symptoms improved.
Anterior mediastinal mass in a young marijuana smoker: a rare case of small-cell lung cancer
Authors: Jiten P Kothadia, Saurabh Chhabra, Alan Marcus, Michael May, Biren Saraiya, Salma K Jabbour
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

The use of cannabis is embedded within many societies, mostly used by the young and widely perceived to be safe. Increasing concern regarding the potential for cannabis to cause mental health effects has dominated cannabis research, and the potential adverse respiratory effects have received relatively little attention. We report a rare case of 22-year-old man who presented with bilateral neck lymphadenopathy, fatigue, and sore throat without significant medical or family history. The patient had smoked one marijuana joint three times a week for three years but no cigarettes. Chest CT demonstrated a large anterior mediastinal mass compressing the superior vena cava and mediastinal lymphadenopathy. A final diagnosis of small-cell lung cancer was reached. Although rare, a small-cell lung cancer in this patient should alert the physician that cannabis smoking may be a risk factor for lung cancer.
Recurrent Painful Ophthalmoplegic Neuropathy and Oculomotor Nerve Schwannoma: A Pediatric Case Report with Long-Term MRI Follow-Up and Literature Review
Authors: Maria Giuseppina Petruzzelli, Mariella Margari, Flora Furente, Maria Carmela Costanza, Anna Rosi Legrottaglie, Franca Dicuonzo, Lucia Margari
Journal: Pain Res Manag (2019)
MeSH terms: Cranial Nerve Neoplasms / diagnostic imaging, Neurilemmoma / diagnostic imaging, Oculomotor Nerve Diseases / diagnostic imaging, Ophthalmoplegic Migraine / etiology, Case Reports, Review, Adolescent, Cranial Nerve Neoplasms / complications, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Neurilemmoma / complications, Oculomotor Nerve Diseases / complications

Background:
Recurrent painful ophthalmoplegic neuropathy (RPON), previously known as ophthalmoplegic migraine (OM), is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. The age of presentation is most often during childhood or adolescence. MRI has a central role in the assessment of the RPON, especially to distinguish orbital, parasellar, or posterior fossa lesions that mimic symptoms of RPON. Actually, oculomotor nerve tumors may be masquerade as RPON so that MRI follow-ups are required to detect the possibility of tumor etiology.
Case presentation:
We report a 16-year-old boy with a 7-year follow-up and multiple brain MRI data, previously diagnosed as OM. The last brain MRI, performed during an acute phase of oculomotor paresis with ipsilateral headache, showed a nodular lesion described as schwannoma of III cranial nerve. Then, we reviewed the literature on OM and RPON in pediatric age with a focus on brain MRI findings.
Conclusions:
This review highlights the important role of serial brain MRIs in the long-term follow-up of RPON, especially in the cases with childhood onset, in order to not delay the diagnosis of a possible oculomotor nerve schwannoma.
Primary Hepatic Burkitt Lymphoma in a Kidney Transplant Recipient
Authors: Sophia Lionaki, Eystratios Tsakonas, Athina Androulaki, George Liapis, Panagiotis Panayiotidis, George Zavos, John N Boletis
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function. Four years after KTx she presented with fatigue, hepatomegaly, and impaired liver function and the workup revealed multiple, variable-sized, low density nodules in the liver, due to diffuse monotonous infiltration of highly malignant non-Hodgkin lymphoma of B-cells, which turned out to be a Burkitt lymphoma. Bone marrow biopsy and spinal fluid exam were free of lymphoma cells. At time of lymphoma diagnosis she was shown to be positive for Epstein-Barr virus polymerase chain reaction. She received aggressive chemotherapy but died due to sepsis, as a result of toxicity of therapy.
Genotype-phenotype correlation of deletions and duplications of 4p: case reports and literature review
Authors: Xuan Zhang, Hongjuan Lu, Hanran Yang, Yichen Ji, Huixin Liu, Wenjian Liu, Jiayi Li, Zhixian Yang, Wei Sun
Journal: Front Genet (2023)
Keywords: 4p trisomy, chromosome 4p, partial duplication 4p, terminal 4p deletion, wolf-hirschhorn syndrome
MeSH terms: Case Reports

Structural rearrangements of chromosome 4p gives rise to a group of rare genomic disorders that mainly result in two different clinical entities: Wolf-Hirschhorn syndrome (WHS) and partial 4p trisomy. The severity of the phenotype depends on the size of the deletion or locus duplication. Here, we present two unrelated individuals with a copy number variation of chromosome 4p. Inverted duplication deletions (inv dup-del) in 4p are particularly rare. Case 1 describes a 15-year-old girl with a 1.055 Mb deletion of terminal 4p, distal to the recognized critical region of WHS, and a large duplication of 9.6 Mb in size from 4p16.3 to p16.1. She had postnatal development delay, intellectual disability (especially pronounced in speech), seizure/electroencephalogram anomalies, and facial dysmorphic features. This unusual chromosomal imbalance resulted in the WHS phenotype rather than the 4p trisomy syndrome phenotype. Case 2 describes a 21-month-old boy with a 1.386 Mb terminal 4p deletion who presented with slight developmental delay, borderline intellectual disability, and seizures. Combined with previous reported cases of 4 pter del-dup or pure 4p terminal deletions, our observations suggest that terminal chromosome 4p deletion is more pathogenic than the concomitant partial 4p duplication, and some regions of the 4p terminal may have regulatory effects on the remaining region of 4p. About nine cases have been reported thus far to date, and our study delineates further genotype-phenotype correlations about terminal 4p duplication-deletions for predicting disease prognosis and patient counseling.
Case report of granular acute lymphoblastic leukemia and review of the literature
Authors: Sangyang Jia, James Jae, Cyrus C Hsia
Journal: Clin Case Rep (2018)
Keywords: acute lymphoblastic leukemia, cytoplasmic granules
MeSH terms: Case Reports

Granular acute lymphoblastic leukemia (ALL) is a rare variant of the disease that is associated with a lower remission rate to standard induction chemotherapy. Flow immunophenotyping, cytogenetics, and molecular diagnostics should be utilized to confirm the diagnosis of ALL versus acute myeloid leukemia (AML) in order to provide appropriate management.