OpenMed/multicare-articles huggingface dataset:
Desmoplastic infantile ganglioglioma: Report of a case and review of the literature
Authors: Bita Geramizadeh, Ahmad Kamgarpour, Ali Moradi
Journal: J Pediatr Neurosci (2010)
Keywords: desmoplastic infantile ganglioglioma, histopathology, immunohistochemistry
MeSH terms: Case Reports

Desmoplastic infantile ganglioglioma (DIG) is a rare supratentorial brain tumor occurring mostly before the age of 2 years. It has a good prognosis and total excision of the tumor is curative, necessitating no further treatment. An accurate pathologic diagnosis is crucial. Until now, <60 cases of this tumor type have been reported. Herein, we report a 3-month-old boy with intractable seizure who was found to have DIG after surgery.
Case Report: Initial Evidence of Safety and Efficacy of High Definition-Transcranial Direct Current Stimulation in a Patient With Neuropathic Pain and Implanted Spinal Cord Stimulator
Authors: Choi Deblieck, Steven Smeijers, Bart Morlion, Abhishek Datta, Chris Thomas, Tom Theys
Journal: Front Pain Res (Lausanne) (2021)
Keywords: complex regional pain syndrome, high definition transcranial direct current stimulation, modeling, neuropathic pain, non-invasive electrical stimulation
MeSH terms: Case Reports

Neuropathic pain (NP), often treatment-refractory, is one of the most debilitating conditions contributing to suffering and disability worldwide. Recently, non-invasive neuromodulation techniques, particularly repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have emerged as potential therapeutic alternatives due to their ability to alter cortical excitability of neural circuits. However, the magnetic field induced in rTMS may be unsafe for patients with an implanted electrode in the head or neck area while tDCS poses no theoretical risk of injury to these patients. High definition (HD)-tDCS is a novel, more focal technique of tDCS and may be safer to the patient compared to the more diffuse stimulation of conventional tDCS. To our knowledge, no study has ever demonstrated the safety and/or feasibility of HD-tDCS in patients with spinal cord stimulation (SCS) devices using computational modeling of induced electrical fields. Furthermore, this study highlights the potential use of (HD-)tDCS as predictive tool for a positive response in chronic epidural motor cortex stimulation (MCS), especially in patients with an implanted device not suitable for rTMS. In a 54-year-old woman with an implanted spinal cord stimulation (SCS) system for another pain syndrome, HD-tDCS was initiated for refractory post-surgical inferior alveolar nerve neuropathy. She was submitted to 7 days of anodal HD-tDCS over the left motor cortex at 1.5 mA for 30 min. A notable decrease in pain perception was observed, lasting for approximately 5-6 h (Numeric Rating Score decreased from 8 to 4.34). No adverse events were reported. The stimulation parameters and clinical efficacy of the SCS system remained unchanged. Additionally, computational analysis indicated no meaningful alteration of current flow when considering a model with a SCS implant with respect to a model without implant. Regarding the positive therapeutic effect of HD-tDCS, the patient was selected for an epidural MCS trial and subsequent implantation, which showed short-term pain relief of 50-75%. Although one case does not demonstrate efficacy, tolerability, or safety to the novel intervention, it paves the way for better diagnosis and treatment for patients who are otherwise excluded from other non-invasive neuromodulation techniques, such as rTMS. A positive tDCS effect could be a potential biomarker for positive epidural MCS response in patients with an implanted stimulation device non-compatible with rTMS.
Successful treatment of severe arterial hypotension and anuria in a preterm infant with renal tubular dysgenesis- a case report
Authors: Katharina Ruf, Johannes Wirbelauer, Antje Beissert, Eric Frieauff
Journal: Matern Health Neonatol Perinatol (2018)
Keywords: anuria, arterial hypotension, dry lung syndrome, neonatal renal failure, oligohydramnios sequence, potter sequence, preterm, renal tubular dysgenesis, respiratory distress, vasopressin
MeSH terms: Case Reports

Background:
Oligohydramnios sequence can be caused by renal tubular dysgenesis (RTD), a rare condition resulting in pulmonary and renal morbidity. Besides typical features of Potter-sequence, the infants present with severe arterial hypotension and anuria as main symptoms. Establishing an adequate arterial blood pressure and sufficient renal perfusion is crucial for the survival of these infants.
Case presentation:
We describe a male preterm infant of 34 + 0 weeks of gestation. Prenatally oligohydramnios of unknown cause was detected. After uneventful delivery and good adaptation the infant developed respiratory distress due to a spontaneous right-sided pneumothorax and required thoracocentesis and placement of a chest tube; he showed no major respiratory concerns thereafter and needed only minimal ventilatory support. Echocardiography revealed no abnormalities, especially no pulmonary hypertension. However, he suffered from severe arterial hypotension and anuria refractory to catecholamine therapy (dobutamine, epinephrine and noradrenaline). After 36 h of life, vasopressin therapy was initiated resulting in an almost immediate stabilization of arterial blood pressure and subsequent onset of diuresis. Therapy with vasopressin was necessary for three weeks to maintain adequate arterial blood pressure levels and diuresis. Sepsis and adrenal insufficiency were ruled out as inflammation markers, microbiological tests and cortisol level were normal. At two weeks of age, our patient developed electrolyte disturbances which were successfully treated with fludrocortisone. He did not need renal replacement therapy. Genetic analyses revealed a novel compound hyterozygous mutation of RTD. Now 17 months of age, the patient is in clinically stable condition with treatment of fludrocortisone and sodium bicarbonate. He suffers from stage 2 chronic kidney disease; blood pressure, motor and cognitive development are normal.
Conclusions:
RTD is a rare cause of oligohydramnios sequence. Next to pulmonary hypoplasia, severe arterial hypotension is responsible for poor survival. We present the only second surviving infant with RTD, who did not require renal replacement therapy during the neonatal period. It can be speculated whether the use of vasopressin prevents renal replacement therapy as vasopressin increases urinary output by improving renal blood flow.
Orofacial Pain with Cardiac Origin of Coronary Artery Disease: A Case Report and Literature Review
Authors: Eunhye Choi, Yeon-Hee Lee, Hee-Kyung Park
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

When diagnosing orofacial pain, clinicians should also consider non-odontogenic origin and systemic diseases as possible etiological factors, along with odontogenic origin. This case report aimed to provide information for early detection of orofacial pain of cardiac origin by dentists, when pain due to coronary artery disease is the only presenting symptom. A 60-year-old male patient with unexplained isolated bilateral jaw pain that had persisted for the past 5 years was referred to a dentist by an anesthesiologist who suspected temporomandibular joint disorder. In oral examination, no specific pathological changes were observed in the oral cavity, including teeth, surrounding alveolar bone, and buccal mucosa. Magnetic resonance imaging and conventional radiography showed no pathological destruction or abnormalities of bone and soft tissue in the temporomandibular joint region. However, pain was precipitated by ordinary daily activities, and the pain alleviating factor was rest. Eventually, the patient was referred to a cardiologist for further evaluation since his pain was induced by physical activity. Coronary artery disease (CAD) was diagnosed using coronary computed tomography angiography, and the pain was considered to be angina pectoris. Percutaneous coronary intervention was successfully done for the patient, after which his orofacial symptoms disappeared. To conclude, isolated craniofacial pain of cardiac origin may lead to patients seeking dental care or visiting orofacial pain clinics. In these settings, dentists and orofacial pain specialists may contribute to the diagnosis of CAD and refer patients for cardiac evaluation and appropriate management.
Surgical Removal of an Extrauterine Device Migrating to Appendix
Authors: Gulsum Uysal, Hakan Nazik, Nefise Tanridan Okçu, Sevtap Seyfettinoglu, Halil Kazgan
Journal: Case Rep Med (2016)

Intrauterine devices (IUDs) remain highly effective reversible family planning methods in developing countries. We aimed to report one of the complications of extrauterine and intrauterine devices. A 44-year-old woman was admitted to our hospital with mislocated intrauterine device and abnormal uterine bleeding. Extrauterine IUD device was proven by ultrasound and X-ray. She had normal blood test count with a negative pregnancy test. There are several cases of complications with intrauterine devices, but this is the first case report about an extrauterine IUD embedded by inflame enlarged appendix presenting with abnormal uterine bleeding. Although intrauterine devices are a common safe method for contraception, there is no risk-free insertion even with advanced ultrasounds. A regular self-examination should be taught to the patients and ultrasonography should be performed in the follow-up of the patients especially for inserted devices during lactation period. Extrauterine IUDs can be successfully removed by laparotomy.
Isolated Inferior Rectus Muscle Entrapment following Endoscopic Sinus Surgery
Authors: Scott Shapiro, Jamie L Schaefer, Sumeet Gupta, John Nguyen, Brian Kellermeyer
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Orbital complications are known risks of endoscopic sinus surgery (ESS). The lamina papyracea and medial rectus muscle are the most commonly injured structures during ESS. Inferior rectus injury is more rare, with only one reported case of isolated inferior rectus injury in the literature. Guidelines for managing ESS-induced inferior rectus injury do not exist, and delayed intervention and management of adjacent sinuses may affect long-term outcomes such as persistent diplopia and disfigurement. In this report, we present a case of a 67-year-old man with diplopia due to isolated left inferior rectus muscle entrapment and injury from violation of the orbital floor during previous ESS. We postulate that an incomplete maxillary antrostomy contributed to scar band formation and entrapment of the inferior rectus muscle after the orbital floor was violated, and advocate early intervention with a wide, complete maxillary antrostomy if the orbital floor is injured during ESS.
Case report and literature analysis: Autoimmune cerebellar ataxia associated with homer-3 antibodies
Authors: Qisi Wu, Beibei Gong, Anan Jiang, Xinyue Qin
Journal: Front Neurol (2022)
Keywords: homer-3 antibody, autoimmune cerebellar ataxia, brain mri enhanced abnormalities, relapse, rituximab
MeSH terms: Case Reports

Objective:
We present a case of autoimmune cerebellar ataxia (ACA) associated with Homer protein homolog 3 (Homer-3) antibodies. Then, a review of the literature was conducted to summarize its clinical spectrum to improve clinicians' understanding of this rare entity.
Case presentation:
A 25-year-old man suffered from the subacute onset of cerebellar ataxia and psychiatric symptoms with abnormalities in the cerebellum on initial brain MRI and Homer-3 antibodies titers of 1:100 in the serum. His neurological symptoms did not improve after intravenous methylprednisolone but significantly improved following plasma exchange with a modified Rankin Scale (mRS) score of 1. However, 5 months later, he experienced relapse during oral prednisone tapering with enhanced cerebellar lesions and obvious cerebellar atrophy on repeated MRI. Various immunomodulatory approaches, including corticosteroids and plasma exchange, were utilized with no improvement. Then rituximab was given for the first time to treat Homer-3 autoimmunity with partial improvement of symptoms. However, the patient remained profoundly disabled with an mRS score of 4.
Conclusion:
ACA associated with Homer-3 antibodies may have a suboptimal response to corticosteroid therapy. More intense immunotherapy such as rituximab may contribute to the improvement of cerebellar syndrome. Relapsing courses and presentation of cerebellar atrophy may suggest a poor prognosis in this entity.
A case of Talaromyces marneffei infection that required differentiation from Pneumocystis pneumonia
Authors: Mieko Tokano, Norihito Tarumoto, Kazuo Imai, Jun Sakai, Masahiro Kodana, Erika Naito, Yoshitaka Uchida, Makoto Nagata, Shigefumi Maesaki
Journal: IDCases (2022)
Keywords: acquired immunodeficiency syndrome (aids), human immunodeficiency virus (hiv), japan, pneumocystis pneumonia, talaromyces marneffei, voriconazole
MeSH terms: Case Reports

We report a case of Talaromyces marneffei fungemia in a patient with HIV infection with a history of travelling to southern China. At first, Pneumocystis pneumonia was considered in this case because chest CT images showed typical ground-glass opacity and elevated β-D-glucan levels. However, PCR testing of sputum for Pneumocystis jirovecii was negative and a filamentous fungus was isolated from blood cultures. The cultured fungus was subsequently identified as T. marneffei, and the patient was considered to have pneumonia caused by this organism. However, skin disease and lymphadenopathy, which are common in T. marneffei infections, were not observed during the disease course. This patient was successfully treated with voriconazole and consequently the chest CT shadow disappeared. In the present case, T. marneffei infection required differentiation from pneumonia with Pneumocystis jirovecii infection.
Mucinous Signet-Cell Adenocarcinoma of the Ileum: A Diagnostic Challenge-Case Report and Review of the Literature
Authors: Tiago Martins, Jalaluddin Umar, Kevin Groudan, Hariharan S Bharadwaj, David Desilets
Journal: Case Rep Gastrointest Med (2022)
MeSH terms: Case Reports

Malignancies of the small intestine are rare. Signet-ring cell carcinoma (SRCC) is one of the rarest forms of adenocarcinoma that can arise in the small intestines. We present a case of a patient who originally presented with abdominal pain and radiographic findings suggestive of ileal congestion. The ileal biopsy specimens were nonspecific, and the patient began a trial of corticosteroid treatment for suspected Crohn's disease. A repeat colonoscopy yielded biopsies that were positive for malignancy. The patient then underwent an exploratory laparotomy which led to the diagnosis of SRCC. Given their similar presentations and the extreme rarity of this unusual malignancy, it can be difficult to differentiate between new-onset Crohn's disease and SRCC. A review of the literature was conducted to provide us with an improved understanding of previously documented cases of SRCC.
Combined resection of a tumor and the inferior vena cava: report of two cases
Authors: Masatoshi Jibiki, Yoshinori Inoue, Toshifumi Kudo, Takahiro Toyofuku, Kazutaka Saito, Kazunori Kihara, Atsushi Kudo, Daisuke Ban, Shigeki Arii
Journal: Surg Today (2014)
MeSH terms: Blood Vessel Prosthesis Implantation, Carcinoma, Renal Cell / surgery, Kidney Neoplasms / surgery, Liver Neoplasms / surgery, Neoplastic Cells, Circulating, Thrombectomy, Vena Cava, Inferior / surgery, Case Reports, Adult, Aged, Aorta, Abdominal, Carcinoma, Renal Cell / pathology, Constriction, Female, Hepatectomy, Humans, Kidney Neoplasms / pathology, Liver Neoplasms / pathology, Liver Neoplasms / secondary, Neoplasm Invasiveness, Nephrectomy

Tumor resection and caval tumor thrombectomy, with or without cavotomy and inferior vena cava (IVC) replacement are sometimes performed in patients with renal cell carcinoma (RCC) extending into the IVC or liver tumors invading the IVC. Two such cases were treated. Case 1: a 68-year-old female was transferred with a diagnosis of right RCC with tumor thrombus extending into the IVC. A plication was performed to prevent extension into the right atrium before the nephrectomy and cavotomy with removal of the tumor thrombus was accomplished, because the IVC was almost completely obstructed and the hemodynamics were stable during cross-clamping of the IVC. Case 2: a 37-year-old female was transferred with a diagnosis of a giant metastatic liver tumor. A trisegmentectomy with resection of the invaded IVC and IVC replacement was performed while the abdominal aorta was cross-clamped to maintain the hemodynamics. Therefore, abdominal aortic cross-clamping was convenient to maintain the hemodynamics when the IVC replacement was performed during IVC cross-clamping.
The Intraoperative Use of a Portable Cone-Beam Computed Tomography System for the Diagnosis of Intraperitoneal Bladder Perforation
Authors: Ankur Choksi, Benjamin Press, Cayce Nawaf, Shannon Longyear, Marc Ferrante, Thomas V Martin
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Background:
Intraoperative imaging for endourologic procedures is generally limited to single-plane fluoroscopic X-ray. The O-arm™ is a mobile cone-bean CT scanner that may have applications in urologic surgeries. Case Presentation. We present a case of an 85-year-old male with radiation cystitis and recurrent gross hematuria who was identified to have a bladder perforation on cystoscopy during emergent clot evacuation. Single-view fluoroscopic evaluation was inconclusive as to whether an intraperitoneal bladder perforation occurred. A portable cone-beam CT scan was used to acquire a 3-D CT cystogram, which demonstrated intraperitoneal contrast extravasation, confirming the diagnosis of an intraperitoneal bladder perforation.
Conclusion:
We report the first use of a portable cone-beam CT scanner to perform an intraoperative CT cystogram to diagnose an intraperitoneal bladder perforation and guide surgical management.
Tracheal ring fracture and early tracheomalacia following percutaneous dilatational tracheostomy
Authors: Eu Chin Ho, Atul Kapila, William Colquhoun-Flannery
Journal: BMC Ear Nose Throat Disord (2005)

Background:
Percutaneous dilatational tracheostomy (PDT) is increasingly popular within intensive care units for patients who need prolonged ventilatory support. Significant complications are rare.
Case presentation:
Our patient suffered tracheal ring fracture and early tracheomalacia following this procedure. These complications are demonstrated in our accompanying video.
Conclusion:
Contrary to common beliefs, tracheal rings are commonly fractured during the PDT procedure. The consequent granulation can lead to tracheal stenosis and tracheomalacia.
Glanzmann's Thrombastenia: The Role of Tranexamic Acid in Oral Surgery
Authors: Rocco Franco, Michele Miranda, Laura Di Renzo, Antonino De Lorenzo, Alberta Barlattani, Patrizio Bollero
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Glanzmann's thrombastenia (GT) is the most frequent inherited condition. GT is a genetic autosomal recessive disease caused by the alteration of the genes ITGA2B and ITGB3, located on the chromosome 17. The incidence of GT is calculated in 1 on 1000000. The patients, during their life, show episodes of mucocutaneous bleeding, epistaxis, and gingival bleeding. Some subjects required continuous bleeding transfusion. The aim of this case report is to demonstrate that oral assumption of tranexamic acid is a gold standard to prevent excessive bleeding. The patient GM of 36 years old with GT type 1 needs dental extractions of the teeth 4.7 and 4.8 at the "Tor Vergata" University Hospital in Rome. The specialist suggests that 3 days before surgery, the patient must take 6 vials every day of tranexamic acid that is used in obstetrics and gynecology. The teeth were extracted and applied suture. The patient is observed and is recommended mouth rinse with tranexamic acid. No bleeding complications were observed.
Hemostasis After Brachial Artery Access With the MynxGrip Device: A Case Report
Authors: Arturo Giordano, Stefano Messina, Gennaro Maresca, Giuseppe Biondi-Zoccai
Journal: Clin Med Insights Cardiol (2018)
Keywords: arteriotomy closure device, brachial artery, case report
MeSH terms: Case Reports

Purpose:
Brachial access is occasionally used for endovascular procedures when other more established or safer ones (eg, femoral or radial) are contraindicated. Although manual compression is the standard of care after brachial arteriotomy, suboptimal compression may lead to bleeding or thrombosis. Arteriotomy closure devices have thus been proposed as an alternative means to achieve hemostasis after brachial arteriotomy. Yet, there is a paucity of evidence and a limited spectrum of devices suitable for brachial arteriotomy closure. We present the use of the MynxGrip closure device after brachial arteriotomy.
Case:
A 70-year-old gentleman underwent brachial arteriotomy followed by iliac artery stenting with a 7F compatible device. Hemostasis was then achieved with the MynxGrip device, uneventfully.
Conclusions:
This clinical vignette highlights the feasibility and safety of brachial use of the MynxGrip device in experienced hands, suggesting that it can represent a useful adjunct to the armamentarium of the endovascular specialist.
Rapid Response to the Combination of Lenvatinib and Sintilimab in a Pancreatic Acinar Cell Carcinoma Patient With Elevated Alpha-Fetoprotein: A Case Report
Authors: Lanqun Qin, Jie Shen, Yueling Yang, Zhengyun Zou
Journal: Front Oncol (2021)
Keywords: alpha-fetoprotein, case report, lenvatinib, pancreatic acinar cell carcinoma, sintilimab
MeSH terms: Case Reports

A 48-year old woman was diagnosed with metastatic pancreatic acinar cell carcinoma (PACC) and with a marked elevation in alpha-fetoprotein (AFP), this being a recognized but uncommon feature of PACC. As she refused chemotherapy, the combined therapy of lenvatinib and sintilimab (lenvatinib 8 mg, orally, qd; and sintilimab 100 mg, intravenous glucose tolerance test, q21d) was given, which conferred significant tumor shrinkage and long progression-free survival (>21 months). This study is the first report and description of a PACC demonstrating favorable response to the combination therapy of an antiangiogenic agent and immunotherapy.
Case Report: Hyper IgE, but Not the Usual Suspects-Kimura Disease in an Adolescent Female
Authors: Prasanna Venkatesh Ramachandran, C Mary Healy, Elton M Lambert, Deyanara Guerra, Choladda V Curry, Tiphanie P Vogel
Journal: Front Pediatr (2021)
Keywords: ige, igg4-related disease, kimura disease, t helper 2, angiolymphoid hyperplasia with eosinophilia, lymphocytic hypereosinophilic syndrome
MeSH terms: Case Reports

Elevated immunoglobulin E (IgE) levels can be associated with infectious, allergic and inflammatory disorders, and rarely as a manifestation of an inborn error of immunity. Here we report the case of an adolescent female who presented with a gradually enlarging neck mass, lymphadenopathy, eosinophilia and highly elevated IgE levels. Laboratory and histopathologic evaluation revealed an unlikely diagnosis of Kimura Disease. We discuss the differential diagnosis of a neck mass with prominent eosinophils on histology, and review support for T-helper type 2 (Th2) cell activation and hyper-IgE in Kimura Disease.