OpenMed/multicare-articles huggingface dataset:
A Rare Case of Small-Cell Neuroendocrine Cancer of the Cervix: An Unexpected Diagnosis
Authors: Deepthy Balakrishnan, Saunri Hansadah, Pooja Sahu
Journal: Cureus (2023)
Keywords: cervical cancer, immunohistochemistry, international federation of gynecology and obstetrics (figo), postmenopausal bleeding, small cell neuroendocrine cervical cancer (scncc)
MeSH terms: Case Reports

Cervical cancer is a significant healthcare problem worldwide, especially in developing countries. It is the second most common cause of cancer-related deaths in women. Small-cell neuroendocrine cancer of the cervix (SCNCC) accounts for about 1-3% of all cervical cancers. In this report, we present a case of a patient with SCNCC, whose disease had metastasized to the lungs even without an obvious growth in the cervix. A 54-year-old multiparous woman presented with post-menopausal bleeding for 10 days; she had a history of a similar episode in the past. Examination revealed an erythematous posterior cervix and upper vagina without any obvious growth. Histopathology showed SCNCC on the biopsy specimen. Following further investigations, the stage assigned was IVB, and she was started on chemotherapy. SCNCC is an extremely rare but highly aggressive type of cervical cancer and it requires a multidisciplinary therapeutic approach for an optimal standard of care.
First Report of CD4 Lymphopenia and Defective Neutrophil Functions in a Patient with Amebiasis Associated with CMV Reactivation and Severe Bacterial and Fungal Infections
Authors: Etienne Ghrenassia, Amélie Guihot, Yuan Dong, Pauline Robinet, Thierry Fontaine, Karine Lacombe, Thomas Lescot, Marie-Caroline Meyohas, Carole Elbim
Journal: Front Microbiol (2017)
Keywords: cd4 t cells, amebiasis, aspergillosis, cytomegalovirus, neutrophils
MeSH terms: Case Reports

We report the case of a patient with acute necrotizing colitis due to invasive amebiasis associated with CD4 lymphopenia and impaired neutrophil responses. The course of the disease was characterized by CMV reactivation and severe and recurrent bacterial and fungal infections, which might be related to the decreased CD4 T cell count and the impaired functional capacities of neutrophils, respectively. The clinical outcome was positive with normalization of both CD4 cell count and neutrophil functions.
OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy
Authors: Carl S Wilkins, Jorge S Andrade Romo, Toco Y P Chui, Richard B Rosen, Stephanie Llop
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Introduction. We present a case of serpiginous choroidopathy (SC) with novel OCTA and en face OCT reflectance findings which help identify subclinical disease progression. Case Presentation. En face OCT reflectance images demonstrated outer retinal tubules (ORT) at the serpiginous lesion margins of affected and unaffected retina on multimodal imaging. OCTA findings demonstrate variable dropout of choriocapillaris in "normal" retina beyond lesion borders which was not visible on standard imaging and which demonstrated a clear transition zone beyond the ORT. Discussion. This is the first report of choriocapillaris atrophy identified on OCTA not identified on traditional multimodal imaging in serpiginous choroidopathy. Damage to vasculature only visible with OCTA may help characterize the distribution of inflammation, aiding in monitoring of suppression not illustrated by traditional imaging and which may threaten the central macula. ORT in SC suggest death and reorganization of outer segments from dysfunction of the choriocapillaris and RPE, as well as serve to demarcate the area of chronic or old inflammation, supporting the hypothesis that the choriocapillaris is the primary site of inflammation in SC. Based on these findings, we recommend OCTA on all patients with serpiginous choroidopathy to monitor underlying state of inflammation and help determine immunosuppressive threshold.
Endodontic treatment and esthetic management of a geminated central incisor bearing a talon cusp
Authors: Elif Tarım Ertaş, Meral Yırcalı Atıcı, Hakan Arslan, Bilal Yaşa, Hüseyin Ertaş
Journal: Case Rep Dent (2014)

Gemination with talon cusps is an uncommon morphologic dental anomaly, characterized by the formation of clinically wide tooth that can cause significant aesthetic and clinical problems including esthetic impairment, pain, caries susceptibility, and tooth crowding. These morphological dental anomalies have specific treatment needs due to the abnormal morphology and need virtuous radiologic diagnosis. Multidisciplinary approach can supply success of the treatment plan that can provide esthetic and occlusal requirements. In this case report, the multidisciplinary approach for the treatment of geminated tooth with talon cusp is presented with the clinical and radiographic findings.
An innovative alternative for spherophakia
Authors: Madhivanan Nivean, Devi Pratheeba Nivean, Rithula Raja
Journal: GMS Ophthalmol Cases (2021)
Keywords: cm t-flex iol, aphakic iol, glued iol, spherophakia
MeSH terms: Case Reports

Objective: The aim of this case report is to report a new aphakic intraocular lens (IOL) that can be used for spherophakia. Methods: This is a single case report wherein the authors elaborate the technique of inserting the new IOL design in patients with spherophakia. Results: This new IOL design is very stable and is very promising in our follow-up of 6 months. Conclusion: The CM T-flex IOL can be a simple and alternate option for correcting aphakia.
An Unusual Cause of Necrotising Fasciitis in a Young Male with Juvenile Dermatomyositis
Authors: Adelaide Ankomaa Asante, Josephine Nsaful, Dzifa Dey
Journal: Case Rep Rheumatol (2022)
MeSH terms: Case Reports

Juvenile dermatomyositis (JDM) is a rare condition worldwide, affecting children younger than 16 years. It is characterized by weakness in the proximal skeletal muscles and a pathognomonic skin rash. Patients with JDM develop complications that are usually a consequence of vasculopathy affecting multiple organ systems. Occult gastrointestinal (GI) perforation is an uncommon complication and is associated with an increased risk of mortality due to a delay in diagnosis. We report on a 14-year-old male with JDM with an aggressive course over two years and severe clinical manifestations. The patient developed necrotizing fasciitis, an unusual rapidly progressing lethal infection of the fascia resulting from bowel contents seeping from multiple intestinal perforations. This case, less commonly seen in males, highlights the occurrence of multiple phenomena-JDM complicated by skin and gastrointestinal vasculopathy with resultant development of multiple GI perforations and consequently life-threatening necrotizing fasciitis of the leg. Physicians need a high index of suspecting GI perforation in JDM patients as the delayed recognition of this complication can result in significant morbidity and/or mortality since the typical symptoms of perforation may be absent.
Fibroepithelial polyp of the external auditory canal: a case report and a literature review
Authors: Nobuaki Tanaka, Takeshi Matsunobu, Akihiro Shiotani
Journal: Case Rep Otolaryngol (2013)

This paper reports the first case of fibroepithelial polyp arising independently of the external auditory canal. A 16-year-old female patient presented to our clinic for aural fullness of the left side. Physical examination revealed a papillomatous tumor at the posterior wall of the inlet of the left external auditory canal. After biopsy, which yielded a diagnosis of benign papilloma, the patient underwent tumor excision. Final diagnosis was fibroepithelial polyp. One week after resection, aural fullness had resolved. Fibroepithelial polyp is a benign lesion and occurs mainly in the skin, ureteropelvic system, and genitals. In the head and neck area, there are reports on fibroepithelial polyp of the tongue, piriform fossa, inferior nasal turbinate, and tonsil, in addition to the skin, but none on independent fibroepithelial polyp of the external auditory canal. Excision of fibroepithelial polyp of the external auditory canal is advisable, especially in the presence of any symptoms, and should be preceded by confirmation of nonmalignancy by biopsy, if possible.
Neuropsychiatric Disorder Associated with Group G Streptococcus Infection
Authors: Rie Okumura, Sawako Yamazaki, Tsukasa Ohashi, Shinichi Magara, Jun Tohyama, Hiroshi Sakuma, Masaharu Hayashi, Akihiko Saitoh
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Immune-mediated central nervous system manifestations of group A β-hemolytic Streptococcus (GABHS) infection include Sydenham's chorea, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS)-which includes tic and obsessive compulsive disorders-and a variety of neurobehavioral disorders. We report a case of Streptococcus dysgalactiae subspecies equisimilis (group G Streptococcus) (GGS) infection associated with involuntary movements, complex tics, and emotional lability in an 11-year-old Japanese girl. Serum IgM and IgG antibodies to lysoganglioside were positive, and she responded rapidly to intravenous immunoglobulin treatment. Neuropsychiatric disorder associated with GGS infection was ultimately diagnosed. The present findings suggest that neuropsychiatric disorders can result from GGS infection and that the pathogenic mechanism is similar to that of GABHS infection. Future large-scale studies should examine the relation between GGS infection and onset of neuropsychiatric disorder.
Bladder diverticulitis: a case report
Authors: Michael Silberman, Rebecca Jeanmonod
Journal: Case Rep Emerg Med (2011)
MeSH terms: Case Reports

Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.
Case report: Complete response of a bladder cancer patient with multiple hepatic and pelvic metastases treated by nab-paclitaxel combined with sintilimab
Authors: Zhu-Lei Tao, Wei Wu, Lin-Chun Liang, Jin-Feng Pan, Jian-Zhou Cao, Xiao-Long Jia, Li Fang, Qi Ma
Journal: Front Oncol (2022)
Keywords: pd-1, case report, metastatic bladder cancer, nab-paclitaxel, sintilimab
MeSH terms: Case Reports

This article described a patient with metastatic bladder cancer (mBC) who was successfully treated with nab-paclitaxel plus sintilimab. Localized muscle-invasive bladder cancer (MIBC) was discovered in a 56-year-old man who received radical cystectomy and platinum-based adjuvant chemotherapy. Eleven months after cystectomy, this patient developed numerous hepatic and pelvic metastases and progressed to mBC. The patient was given an anti-PD-1 antibody (sintilimab 200mg, q3w) in combination with Nab-paclitaxel (100mg, qw) for mBC. Complete remission (CR) was achieved after nine cycles of therapy, and the patient had no severe side effects during the treatment. The disease remained in CR after 41 months of follow-up. This case suggests that nab-paclitaxel combined with sintilimab is a safe and effective option in treatment of mBC.
Subvesical bile duct and the importance of the critical view of safety: Report of a case
Authors: Constantine P Spanos, Marianna P Spanos
Journal: Int J Surg Case Rep (2019)
Keywords: case report, cholecystectomy, laparoscopic, subvesical duct

Introduction:
This is a case report in which a subvesical duct was identified intra-operatively during laparoscopic cholecystectomy.
Presentation of case:
A 49-year-old man underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis. During the procedure, the cystic duct and cystic artery were dissected. After ligation and division of these structures, a subvesical bile duct draining directly into the gallbladder was noted. In the present case, the subvesical duct was ligated and divided. The patient had an uneventful recovery.
Discussion:
Subvesical bile ducts, also known as ducts of Luschka, represent anatomic variations of the biliary tree in which one or more bile ducts traverse in close contact with the gallbladder fossa. Inadvertent and undetected injury of these ducts are a frequent cause of cholecystectomy-associated bile leaks.
Conclusion:
Application of the critical view of safety principle may assist in intra-operative detection of aberrant biliary anatomy, thus preventing iatrogenic injury.
Renal Angiomyolipoma Mimicking a Well-Differentiated Retroperitoneal Liposarcoma
Authors: Honoka Fuse, Masaya Ito, Kosuke Takemura, Shuzo Ikuta, Toru Motoi, Tomotake Okuma, Madoka Kataoka, Fumitaka Koga
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

A 37-year-old Burmese woman presented with an incidentally found retroperitoneal fat-containing tumor. The tumor was 9 cm in the longest diameter, surrounding the right kidney, and composed of homogenous adipose tissue with thickened septum-like structures and spotty nonadipose structures, which were enhanced on contrast-enhanced computed tomography and magnetic resonance imaging. The tumor did not show either a beak sign or synchronous angiomyolipoma-like lesion in the kidneys. The tumor had irregular septa, thin blood vessels, and spotty small soft-tissue nodules. The tumor did not contain any heterogeneously enhanced solid lesions suspicious for dedifferentiated liposarcomas. Based on these imaging findings, a clinical diagnosis of a well-differentiated liposarcoma was made. Under the consensus of a multidisciplinary cancer board, she was recommended to undergo core-needle biopsy to confirm the clinical diagnosis. However, she declined to undergo biopsy for financial reasons. She underwent kidney-sparing retroperitoneal tumor resection. Histopathologically, the tumor was an angiomyolipoma with positive immunostaining for HMB45 and Melan A. The present case suggests the importance of core-needle biopsy prior to surgical intervention for retroperitoneal fat-containing tumors.
The Unusual Late-Onset Graves' Disease following Hashimoto's Related Hypothyroidism: A Case Report and Literature Review
Authors: Aseel Sukik, Sara Mohamed, Mhd-Baraa Habib, Sundus Sardar, Bashar Tanous, Raad Tahtouh, Mouhand F H Mohamed
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Background. The shift of Graves' disease (GD) to Hashimoto's disease- (HD-) related hypothyroidism is well established. However, the opposite is rare. This is likely to the loss of critical thyroid mass available for stimulation by thyroid hormone receptor stimulating antibody, making this shift unusual. Herein, we report a young lady with a late shift from HD into GD and present a scoping literature review. Case presentation. We report a twenty-five-year-old lady with a sixteen-year-history of Hashimoto's-related hypothyroidism stable on levothyroxine. While following in the clinic, she started developing thyrotoxic symptoms in the form of anxiety, weight loss, and palpitation. Physical examination was remarkable for mild exophthalmos. The thyroid function test confirmed hyperthyroidism. Levothyroxine-induced hyperthyroidism was initially suspected; however, the symptoms did not improve despite reducing and stopping levothyroxine. Subsequent workup confirmed the diagnosis of GD. Discussion and Conclusion. This case highlights a unique association that has significant diagnostic and management implications. This shift should be considered when hyperthyroidism persists despite reducing or stopping levothyroxine. The diagnosis is made utilizing antibody titers and radioiodine update scan. While the management depends on the disease's stage and the treating physician preference, antithyroid agents can be used initially. Following up these patients is essential as the shift can be transient.
Diffuse pulmonary calcification in allergic bronchopulmonary aspergillosis
Authors: Johnny F Jaber, Lauran Zeineddine, Divya C Patel, Diana Gomez-Manjarres
Journal: Respir Med Case Rep (2022)
Keywords: abpa, allergy, aspergillosis, asthma, radiology
MeSH terms: Case Reports

Allergic bronchopulmonary aspergillosis (ABPA) is a condition that most often occurs in patients with asthma or cystic fibrosis. The diagnosis is usually confirmed by the combination of clinical, radiographic, and immunologic criteria as there is not individual test to establish the diagnosis. We describe the case of a 64-year-old male with a prior medical history of moderate persistent asthma who presented with worsening cough and was found to have IgE positive for Aspergillus fumigatus with findings of diffuse bilateral pulmonary calcifications on HRCT.
A case report for a diagnostic dilemma of a giant intra-abdominal cyst with an uncertain origin
Authors: Nern Hoong Kao
Journal: Int J Surg Case Rep (2020)
Keywords: giant cyst, intra-abdominal cyst
MeSH terms: Case Reports

Introduction:
Giant intra-abdominal cystic lesions are seldom encountered and can post a diagnostic challenge pre-operatively. These often present as increasing abdominal size and from its mass effect.
Presentation of case:
Here, we present a case of a 58 year-old gentleman with worsening bloating and abdominal distension. A contrasted CT scan of the abdomen revealed a giant intra-abdominal cyst with no definite organ of origin. He underwent a laparotomy and excision of the giant cyst which was not found to be attached to any organ or mesentery. This resulted in resolution of his symptoms and a drastic improvement in his appetite.
Discussion:
It is often difficult to identify the origin of giant intra-abdominal cysts as pre-operative imaging may show it abutting multiple organs due to its size. Common intra-abdominal cysts include mesenteric, ovarian or peritoneal cysts. A precipitating history such as pancreatitis or surgical implants can suggest pseudocysts. Surgical excision alone is curative but can be difficult due to the size. Controlled intra-operative aspiration can aid in visualization and dissection.
Conclusion:
Giant intra-abdominal cystic lesions cause significant discomfort due to its mass effect. Pre-operative investigations may not identify its cause. Surgical excision is recommended to diagnostic and therapeutic purposes.
Case Report: Rubella Virus-Induced Cutaneous Granulomas in Two Pediatric Patients With DNA Double Strand Breakage Repair Disorders - Outcome After Hematopoietic Stem Cell Transplantation
Authors: Ulrich Baumann, Johannes H Schulte, Jonathan P Groß, Rita Beier, Marius Ludwig, Volker Wahn, Jörg Hofmann, Britta Maecker-Kolhoff, Martin Sauer, Petra Kaiser-Labusch, Negin Karimian, Ulrike Blume-Peytavi, Franziska Ghoreschi, Hagen Ott, Ludmila Perelygina, Christian Klemann, Oliver Blankenstein, Horst von Bernuth, Renate Krüger
Journal: Front Immunol (2022)
Keywords: artemis deficiency, ataxia telangiectasia, granuloma formation, inborn errors of immunity, primary immunodeficiency, rubella virus vaccine strain, stem cell transplantation
MeSH terms: Ataxia Telangiectasia / genetics, DNA Repair-Deficiency Disorders / complications, Hematopoietic Stem Cell Transplantation / adverse effects, Immunologic Deficiency Syndromes / genetics, Case Reports, Child, Granuloma / genetics, Humans, Infant, Newborn, Rubella virus / genetics

We report two patients with DNA repair disorders (Artemis deficiency, Ataxia telangiectasia) with destructive skin granulomas, presumably triggered by live-attenuated rubella vaccinations. Both patients showed reduced naïve T cells. Rapid resolution of skin lesions was observed following hematopoietic stem cell transplantation. However, the patient with AT died due to complications of severe hepatic veno-occlusive disease 6 month after HSCT. Dried blood spots obtained after birth were available from this patient and showed absent T-cell receptor excision circles (TRECs). Therefore, newborn screening may help to prevent patients with moderate T-cell deficiency from receiving live-attenuated rubella vaccine potentially causing granulomas.
A Nonfunctioning Pituitary Macroadenoma Presenting as Cyclical Vomiting and Severe Hyponatremia in a Young Female
Authors: Dinuka S Warapitiya, Dimuthu Muthukuda, W A H P Sanjeewa, Kushalee Poornima Jayawickreme, Shyama Subasinghe
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Introduction:
Recurrent vomiting is a commonly overlooked debilitating symptom which causes significant impact on the quality of life. There are several causes for vomiting, ranging from commonly known causes to rare causes. Nonfunctioning pituitary macroadenomas generally present with visual disturbances, headache, and symptoms due to anterior pituitary hormone deficiencies. This case report is about an atypical presentation of a nonfunctioning pituitary macroadenoma in which the patient presented with cyclical vomiting with severe hyponatremia. Case Report. A 23-year-old girl presented with four to five episodes of vomiting per day for two days duration. She had a history of similar episodes of vomiting since 2016, with each episode generally lasting for 4-5 days and occurring in every four to six months. All episodes exhibited similar symptomatology and she was free of symptoms in-between. Generalized body weakness, postural dizziness, reduced appetite, and secondary amenorrhea were other symptoms she has had since 2016. Examination findings showed a low body mass index (BMI) (16 kg/m2) with normal system examination. Investigations showed severe hyponatremia (110 mmol/L) with hypokalemia (3.2 mmol/L) and hypochloremia (74 mmol/L). Her urinary excretion of potassium, sodium, and serum osmolality was low. Urine osmolality was mildly elevated compared to serum osmolality. Blood urea was normal. Severe hyponatremia with minimal hyponatremic symptoms was suggestive of chronic hyponatremia, which was accentuated by ongoing vomiting and possible reduced intake of salt. Further investigations showed evidence of secondary hypoadrenalism, central hypothyroidism, hypogonadotropic hypogonadism, and mild hyperprolactinemia. Magnetic resonance imaging (MRI) revealed a pituitary macroadenoma with mass effect on the optic chiasma. Hydrocortisone and levothyroxine were started, and she underwent transsphenoidal resection of the pituitary tumor. She recovered from cyclical vomiting.
Conclusion:
There can be multiple overlapping aetiologies for every observed symptom, sign, and abnormal investigation finding. Therefore, aetiological diagnosis is challenging, especially in the presence of an atypical clinical presentation. Cyclical vomiting and severe hyponatremia are atypical presentations of nonfunctioning pituitary macroadenomas.