OpenMed/multicare-articles huggingface dataset:
Prolonged Response to Pembrolizumab in Spindle Cell Squamous Cell Carcinoma Metastatic to the Central Nervous System
Authors: Yuxin Liu, Bailey Fitzgerald, Edward Perry, Ashutosh Pathak, Herta H Chao
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: brain metastases, metastatic cutaneous squamous cell carcinoma, pembrolizumab, spindle cell
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Carcinoma, Squamous Cell / drug therapy, Central Nervous System Neoplasms / secondary, Head and Neck Neoplasms / drug therapy, Head and Neck Neoplasms / pathology, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Skin Neoplasms / drug therapy, Case Reports, Aged, Carcinoma, Squamous Cell / pathology, Central Nervous System Neoplasms / diagnostic imaging, Humans, Magnetic Resonance Imaging, Male, Neoplasm Staging, Skin Neoplasms / pathology, Antibodies, Monoclonal, Humanized, Programmed Cell Death 1 Receptor, pembrolizumab

Background:
Cutaneous squamous cell carcinoma is a common type of skin cancer, with aggressive metastatic or locally advanced disease representing an uncommon minority of presentations. Emerging data have supported the Food and Drug Administration approval of the anti-PD1 human monoclonal antibody cemiplimab in select patients with advanced disease. However, there is limited data regarding durability of effect and generalizability of anti-PD1 effectiveness across therapies. Additionally, information regarding applicability of these regimens to the rare spindle cell variant and to central nervous system metastases for cutaneous squamous cell carcinoma is unfortunately limited.
Case presentation:
A 72-year-old gentleman presented with facial neurological deficits and a dermal nodule and was diagnosed with spindle cell squamous cell carcinoma with perineural invasion. His course was notable for early intracranial metastasis with progressive neurological deficits despite recurrent radiation therapy with intermittent response. When progressive left-sided weakness prompted imaging evaluation that was concerning for disease recurrence after exhaustion of radiation therapy options, the patient was started on systemic therapy with the anti-PD-1 monoclonal antibody treatment prior to the approval of cemiplimab. Pembrolizumab was chosen due to the fact that the patient was ineligible for clinical trials and for its every 21-day dosing. With this treatment, he has achieved a durable clinical response, resulting in near resolution of neurological deficits and more than a year of progression-free survival to date, despite aggressive intracranial disease.
Conclusions:
This case suggests that anti-PD-1 therapy with pembrolizumab may represent an effective and well-tolerated treatment for patients with metastatic spindle cell squamous cell carcinoma including patients with metastatic disease to the central nervous system.
Propofol-remifentanil combination for management of electroconvulsive therapy in a patient with neuroleptic malignant syndrome
Authors: Modabber Arasteh, Shoaleh Shami, Karim Nasseri
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Electroconvulsive therapy can be effective in severe or treatment resistant neuroleptic malignant syndrome patients. Anesthesia and use of muscle relaxant agents for electroconvulsive therapy in such patients may encounter anesthesiologists with specific challenges. This case report describes successful management of anesthesia in 28-year-old male patient undergoing eight electroconvulsive therapy sessions for treatment of neuroleptic malignant syndrome.
Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: case report and literature review
Authors: Jeannine Bachmann, Jorg Kleeff, Frank Bergmann, Shailesh V Shrikhande, Wolfgang Hartschuh, Markus W Büchler, Helmut Friess
Journal: World J Surg Oncol (2005)

Background:
Merkel cell carcinomas are rare neoplasm of neuroendocrine origin, usually observed in elderly people in areas with abundant sunlight, and predominantly located on the head and neck, extremities, and trunk. In many patients, a local recurrence after resection of the primary tumour and even distant metastases can be found.
Case presentation:
We report an unusual occurrence of pancreatic metastases from a previously diagnosed Merkel cell carcinoma with the discovery of a concomitant insulinoma. An 82-year old lady suffered from recurrent attacks of hypoglycemia and presented with an abdominal mass, 2 years prior she had an excision done on her eyebrow that was reported as Merkel cell carcinoma. An extended distal pancreatectomy and splenectomy along with resection of the left flexure of the colon for her abdominal mass was carried out. Final histopathology of the mass was a poorly differentiated endocrine carcinoma in the pancreatic tail, in the peripancreatic tissue and in the surrounding soft tissue consistent with metastatic Merkel cell carcinoma in addition to an insulinoma of the pancreatic body.
Conclusion:
This is the first documented case of a metastatic Merkel cell carcinoma and a concomitant insulinoma, suggesting either a mere coincidence or an unknown neuroendocrine tumor syndrome.
Calcified Right Atrial Thrombus With Near-Systemic Pulmonary Pressures in a Morbidly Obese Patient: A Clinical Conundrum
Authors: Carlson Sama, Muchi Ditah Chobufo, Li Pang, Joyce Foryoung, James Mills
Journal: Cureus (2023)
Keywords: calcified right atrial thrombus, intracardiac mass, outcome, pulmonary embolism, therapeutic anticoagulation
MeSH terms: Case Reports

Intracardiac masses are not uncommon, but a calcified right atrial thrombus (CRAT) is an exceedingly rare entity and often poses a diagnostic and therapeutic dilemma. We discuss the case of an incidentally noted CcRAT in a 40-year-old man presenting with progressive dyspnea. We further review the literature on the subject, highlighting the need for an individual patient-centred care plan.
A case with life-threatening uterine bleeding due to postmenopausal uterine arteriovenous malformation
Authors: Emi Sato, Kentaro Nakayama, Kohei Nakamura, Masako Ishikawa, Hiroshi Katagiri, Satoru Kyo
Journal: BMC Womens Health (2015)
MeSH terms: Arteriovenous Malformations / complications, Hysterectomy, Iliac Artery / abnormalities, Uterine Artery / abnormalities, Uterine Artery Embolization, Uterine Hemorrhage / etiology, Case Reports, Angiography, Arteriovenous Malformations / diagnosis, Arteriovenous Malformations / surgery, Female, Humans, Iliac Artery / diagnostic imaging, Magnetic Resonance Imaging, Middle Aged, Postmenopause, Rupture, Spontaneous, Tomography, X-Ray Computed, Treatment Failure, Uterine Artery / diagnostic imaging, Uterine Hemorrhage / diagnosis, Uterine Hemorrhage / surgery

Background:
Uterine arteriovenous malformation is a rare but life-threatening condition that accounts for 1-2% of massive vaginal bleeding. Uterine arteriovenous malformations are less common after menopause. The condition can be diagnosed using Doppler ultrasound, magnetic resonance imaging, computed tomography, and pelvic angiography.
Case presentation:
We report a postmenopausal patient with a uterine arteriovenous malformation who underwent emergency hysterectomy for sudden onset of life-threatening uterine bleeding following an initially successful but ultimately failed uterine artery embolization. Interestingly, it was not difficult to ligate and cut the dilated vessels and we were able to safely perform the hysterectomy with little bleeding in the operative field. The hysterectomy was successful, with most of the intraoperative vaginal blood loss due to the ruptured arteriovenous malformation. One year after surgery, the patient has had no vaginal bleeding.
Conclusion:
We consider hysterectomy to be a comparatively safe and effective therapeutic option for postmenopausal women who suffered from uterine arteriovenous malformations with life-threatening uterine bleeding.
Left minimally invasive esophagectomy in a patient with synchronous esophageal and lung cancers: Case report
Authors: Baihua Zhang, Junliang Ma, Xinjian Yan, Xu Li, Qin Xiao, Wenxiang Wang, Yong Zhou
Journal: Medicine (Baltimore) (2018)
MeSH terms: Esophageal Neoplasms / surgery, Esophagectomy / methods, Lung Neoplasms / surgery, Minimally Invasive Surgical Procedures / methods, Case Reports, Aged, Esophageal Neoplasms / complications, Esophageal Neoplasms / diagnostic imaging, Humans, Laparoscopy / methods, Lung Neoplasms / complications, Lung Neoplasms / diagnostic imaging, Male, Mediastinoscopy / methods

Rationale:
Minimally invasive esophagectomy (MIE) have been increasingly used and are regarded as suitable alternatives to open esophagectomy. However, few previous reports described minimally invasive esophagectomy using a left-sided approach.
Patient concerns and diagnoses:
A 71-year-old man was admitted to our hospital because of progressive dysphagia. Synchronous double primary thoracic esophageal and left lung cancers were considered before the operation.
Interventions and outcomes:
A lobectomy and MIE, via a left video-assisted thoracoscopic approach, was performed. Preparation of a gastric conduit and an intra-abdominal lymphadenectomy were completed by laparoscopy and a cervical anastomosis was made. In addition, a cervical mediastinoscopy was performed to dissect the lymph nodes along the bilateral recurrent laryngeal nerves. No postoperative complications were observed. The patient achieved a favorable short-term outcome.
Lessons:
This is the first report of a patient with synchronous esophageal and left lung cancers treated with minimally invasive resection via left thoracoscopy, laparoscopy, and cervical mediastinoscopy. Our results showed that the left MIE approach in combination with cervical mediastinoscopy is potentially most appropriate for some esophageal cancer patients, when the right MIE approach is not applicable in certain conditions.
Chondroid Lipoma Mimicking Malignancy
Authors: Kris Mertens, Annelies Van Beeck, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2022)
Keywords: chondroid lipoma, computed tomography, conventional radiography, magnetic resonance imaging
MeSH terms: Case Reports

Teaching Point: A chondroid lipoma is a rare benign adipocytic neoplasm, containing a chondromyxoid matrix, that may mimic a myxoid liposarcoma and myxoid chondrosarcoma.
Patient Satisfaction with Resin Infiltration Treatment for Masking Noncavitated White Spot Lesions on Anterior Maxillary Teeth: Two Case Reports
Authors: Rana A Alamoudi, Asmaa A Yaseen, Amjad S Alharthi, Sara M Bagher
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Aim:
We assessed patient satisfaction with resin infiltration treatment outcomes for masking postorthodontic treatment noncavitated white spot lesions on anterior maxillary teeth.
Background:
White spot lesions (WSLs) are opaque white areas of demineralization. The lesion may remineralize over time, but the opaque color usually remains, retaining the undesirable tooth color. Case Description: Resin infiltration (RI) was administered to two patients with a total of 10 anterior maxillary teeth diagnosed with noncavitated WSLs. Immediately after treatment, patients were asked about their comfort during the RI treatment and their level of satisfaction with treatment outcomes. Two weeks post-treatment, the two patients were asked again about their level of treatment outcome satisfaction and if they thought they needed a second treatment. Both reported that they were comfortable during the treatment and were extremely satisfied with the achieved treatment outcomes immediately and two weeks after the treatment and did not feel that they would need to seek further treatment to reach the desired outcome.
Conclusion:
Resin infiltration is a comfortable, conservative treatment option providing satisfactory outcomes in masking noncavitated WSLs on anterior maxillary teeth after orthodontic treatment. Clinical Significance. Resin infiltration is a conservative treatment option to mask noncavitated WSLs after orthodontic treatment.
Addison's Disease and Possible Cannabis Withdrawal Syndrome Presenting as an Eating Disorder in a Thirty-Year-Old Female
Authors: Kimberly Lazare
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms. This case elucidates the importance of ruling out other biologic and psychologic causes of clinical presentations before an eating disorder diagnosis can be made.
Characteristics and Risk Factors for Spontaneous Closure of Idiopathic Full-Thickness Macular Hole
Authors: Xida Liang, Wu Liu
Journal: J Ophthalmol (2019)
MeSH terms: Review

Idiopathic full-thickness macular hole is a severe visual impairment disease. Pars plana vitrectomy remains the primary treatment option for idiopathic full-thickness macular holes, and over 90% idiopathic full-thickness macular holes are closed by vitrectomy surgery. However, the full-thickness macular hole may close spontaneously, with a good visual acuity progress. Since recent studies are small-sample studies and case reports, the characteristics for spontaneous closure of idiopathic full-thickness macular holes are not fully understood. Here, we review the articles in PubMed database from 1999 to 2018 and discuss the characteristic and the risk factors, especially OCT structure features, for spontaneous closure of idiopathic full-thickness macular holes.
A case of severe acute necrotizing pancreatitis in a 38-year-old woman postpartum due to a parathyroid adenoma
Authors: Holger Rupprecht, Julia Reinfelder, Alp Turkoglu
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2017)
Keywords: hyperparathyroidism, pancreatitis, parathyroid adenoma, pregnancy
MeSH terms: Case Reports

Lethal necrotizing pancreatitis postpartum due to primary hyperparathyroidism caused by a parathyroid adenoma can be considered as a rarity. Due to the unspecific clinical signs and uncommonness this disorder may be overseen very easily. The reported case illustrates the very importance of early diagnosis of this endocrine disorder in pregnancy in order to avoid a lethal course.
A Comprehensive Study on Epidemiology Case Studies Using Computational Analysis
Authors: Xinjiang Lin, Shouping Chen, Amatul Bushra Akhi
Journal: Comput Intell Neurosci (2022)
MeSH terms: Hand Injuries / epidemiology, Occupational Injuries, Review, Adult, Child, Preschool, China / epidemiology, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Retrospective Studies, Young Adult

Health-related issues and occurrences with regard to a particular population are the subject of an epidemiology study. This paper presents the results of a retrospective epidemiological investigation on 15922 hospitalized hand trauma patients from Central China between 2011 and 2020. Gender, age, onset season, injury mechanism, injury environment, injury location, and clinical characteristics are among the characteristics of the data gathered. The study is using computational analysis to draw inferences from the case studies collected in the databases of the hospitals. The types and characteristics of occupational injuries at home and outdoor are compared and analyzed. The purpose of the study is to present the findings from recent case studies for future reference and to recommend useful roles for the industrial sector in the care of patients with hand trauma in order to lower occupational harm. The injuries of preschool children are also analyzed. The incidence rate of hand injuries in infants has been increasing year by year which is directly related to the inefficient growth of children in rural areas. The data are collected from hospitals, then the data analytical tools are applied to draw conclusions. The suggested model is intelligently learned through the application of computational techniques, which are also used to suggest treatments to trauma victims. According to this study, males are more likely than females to sustain hand trauma; occupational injuries are more common than living injuries; males between the ages of 20 and 50 are at an increased risk of suffering an occupational injury. This study showed that the proportion of hand trauma in preschool children was higher (12.27%), and the 2-3-year-old group was the main injury target of preschool children (45.70%). The accidental injuries of newborns and young children can be reduced by government assistance, social support, and tighter monitoring.
Resolution of Periodic Breathing in a Child with Idiopathic Pulmonary Arterial Hypertension
Authors: Saadoun Bin-Hasan, Abdullah Khayat, Tilman Humpl, Janette T Reyes, Suhail Al-Saleh
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Central sleep apnea (CSA) and periodic breathing are unusual findings described in pediatric patients with congestive heart failure. However, CSA has not been reported in children with pulmonary hypertension. We hereby report on a 10-year-old girl with idiopathic pulmonary arterial hypertension who had frequent central events in a periodic breathing fashion seen in her polysomnography, which was normalized following medical treatment leading to improvement of the pulmonary pressures.
An Unusual Case of Abdominal Leiomyoma Presenting as a Free Lying Intraperitoneal Mass in an Elderly Gentleman
Authors: Amrit Nasta, Kunal Nandy, Yogesh Bansod
Journal: Case Rep Surg (2016)

Introduction. Leiomyomas are common benign tumours of female reproductive tract and are rarely seen in extrauterine location. Case Report. We report an interesting case of a free lying abdominal leiomyoma presenting as a painless abdominal lump in an elderly gentleman. Discussion. Primary abdominal leiomyomas are uncommon and require surgical removal if symptomatic.
Opening Wedge Osteotomy for Valgus Deformity of the Little Finger after Proximal Phalangeal Fracture in Children: Two Case Reports
Authors: Souichi Ohta, Ryosuke Ikeguchi, Hiroki Oda, Hirofumi Yurie, Hisataka Takeuchi, Shuichi Matsuda
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

In the treatment of posttraumatic valgus deformity of the pediatric little finger, it is usually difficult to achieve accurate correction of angular and rotational deformity using closing wedge osteotomy. We report two cases of valgus deformity of the little finger (both 11-year-old female patients) successfully treated using opening wedge osteotomy followed by intramedullary semirigid fixation with a single Kirschner wire. A wire tip inserted from the retrocondylar fossa of the proximal phalangeal head was advanced along the radial side of the intramedullary cortex after gradual opening of the osteotomy site. If needed, further fine adjustment of the rotational alignment can be performed even after K-wire insertion. Postoperatively, the gap between the little and ring fingers in the fully extended and adducted position and the finger overlapping in the fully flexed position were completely resolved. The flexibility of the pediatric bone and sagittal clearance between the wire and the inner wall of the proximal phalangeal medullary cavity allow fine adjustment of the rotational alignment even after wire insertion.
Solitary fibrous tumour of the mesentery: a case report
Authors: Stephanie Vella, Christine Cannataci, Kelvin Cortis
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

We present the case of a male with an asymptomatic abdominal mass, where imaging-guided biopsy confirmed the lesion as a solitary fibrous tumour arising from the mesentery. This is a notably rare location for solitary fibrous tumours with only a few reported cases in the literature.
Medial and Lateral Meniscus Posterior Root Tears with an Intact Anterior Cruciate Ligament
Authors: Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Yoshinori Matsumoto, Motoki Takahashi, Toshifumi Ozaki
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Background:
Medial meniscus (MM) posterior root tear (PRT) is often caused by meniscal degeneration, whereas lateral meniscus (LM) PRT is mainly caused by trauma, especially trauma associated with anterior cruciate ligament (ACL) injuries. Although there are a few reports on PRTs of both menisci with an ACL injury, to our knowledge, there is no report on those with an intact ACL. Thus, the purpose of this study was to describe a rare case of both meniscal PRTs with an intact ACL. Case Presentation. A 67-year-old woman complained of right knee pain during weeding in a deep knee flexion position. At presentation, three days after the injury, physical examination revealed signs of meniscal injury without ACL rupture. Magnetic resonance imaging showed PRTs of both menisci and damaged cartilage, especially on the medial femoral condyle and lateral tibial plateau. MM was sutured using the FasT-Fix dependent modified Mason-Allen suture technique, and LM by a single simple stitch using the Knee Scorpion suture passer. Referring to previous cadaveric studies, transtibial pullout repair using a single tibial tunnel for MM fixation was performed. The stability of the repaired menisci was checked by probing during second-look arthroscopy at one year after the primary surgery, and no meniscal signs and symptoms were present at the last follow-up one year after the surgery.
Conclusions:
This rare case showed PRTs of both menisci with an intact ACL. We speculated that, in this case, both roots tore because of the degenerative menisci. A good clinical outcome was achieved after single-transtibial pullout repair. This technique may be an effective surgical approach for PRTs of both menisci.
T1 Vertebra Pedicular Osteoid Osteoma: Minimally Invasive Surgical Resection Aided by New Integrated Navigation to 3D Imaging Device
Authors: M Prod'homme, G Cavalié, G Kerschbaumer, S Valmary-Degano, M Boudissa, J Tonetti
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We hereby describe a minimally invasive resection of a T1 pedicular osteoid osteoma next to the vertebral canal. The patient had an 18-month report of painful radiculopathy. We performed the surgery under 3D imaging guidance using navigation with an all-in-one device. Full procedure irradiation was 1.17 mSv for a 181-picture acquisition. Complete operative time incision to closure was 58 minutes. Despite sparing the vertebral stability without any fixation, the tumor resection was well-margined, thanks to the focused guidance. After surgery, the patient had complete relief of his symptoms at the 6-month follow-up. 3D imaging system coupled to navigation made the procedure safe without consuming time. The single Surgivisio® device allows comfortable 3D minimally invasive spine navigation surgery with the ergonomics of a C-arm.