OpenMed/multicare-articles huggingface dataset:
Dabrafenib and trametinib activity in a patient with BRAF V600E mutated and microsatellite instability high (MSI-H) metastatic endometrial cancer
Authors: Michele Moschetta, Gabriel Mak, Joana Hauser, Catriona Davies, Mario Uccello, Hendrik-Tobias Arkenau
Journal: Exp Hematol Oncol (2017)
Keywords: braf v600e mutation, dabrafenib, endometrial cancer, microsatellite instability, trametinib
MeSH terms: Case Reports

Background:
Targeting BRAF V600E mutation has been proven effective in the treatment of several types of cancer. In endometrial adenocarcinoma, the BRAF V600E mutation has been rarely reported. Whether targeting BRAF oncogene may represent a plausible therapeutic strategy for the rare patients with BRAF-mutated endometrial cancer remains to be ascertained in prospective studies.
Case presentation:
We report herein the case of a heavily pre-treated patient with recurrent microsatellite instability high (MSI-H) BRAF V600E mutated endometrial adenocarcinoma, which was successfully treated with the V600E targeting agent dabrafenib. After developing resistance to this agent, the MEK targeting agent trametinib was added to dabrafenib achieving again a therapeutic response.
Conclusions:
This case shows that dabrafenib both as monotherapy and when combined with trametinib may exert significant therapeutic activity in heavily pretreated BRAF V600E mutated endometrial adenocarcinoma, and highlight potential benefits of personalized treatment in this disease.
Accelerated theta-burst transcranial magnetic stimulation of the bilateral dorsolateral prefrontal cortex in a patient with post-traumatic stress disorder and major depressive disorder: Case report
Authors: Chun-Hung Chang, Chieh-Yu Liu, Shaw-Ji Chen, Hsin-Chi Tsai
Journal: Front Psychiatry (2023)
Keywords: depression, dorsolateral prefrontal cortex, post-traumatic stress disorder, theta-burst stimulation, transcranial magnetic stimulation
MeSH terms: Case Reports

Background:
Theta-burst transcranial magnetic stimulation has demonstrated promising effectiveness as treatment for post-traumatic stress disorder (PTSD) and depression. However, the effect of accelerated theta-burst stimulation (TBS) in comorbid with PTSD and depression remains unknown.
Case presentation:
We report a case of a 25-year-old woman with PTSD and depression whose symptoms markedly improved after continuous TBS of the right dorsolateral prefrontal cortex (DLPFC) and intermittent TBS (iTBS) over the left DLPFC, and then with 20 min break before the 2nd iTBS session.
Conclusions:
Accelerated TBS over the bilateral DLPFC may improve severe PTSD and depression. Accelerated TBS may have more improvement of depression symptoms than PTSD symptoms. Further trials are warranted to investigate the effect and safety for patients with complicated PTSD and depression.
Left ventricular apical thrombus after systemic thrombolysis with recombinant tissue plasminogen activator in a patient with acute ischemic stroke
Authors: Florian Doepp, Wasiem Sanad, Stephan J Schreiber, Gert Baumann, Adrian C Borges
Journal: Cardiovasc Ultrasound (2005)
MeSH terms: Heparin / administration & dosage, Thrombolytic Therapy / adverse effects, Thrombosis / chemically induced, Thrombosis / prevention & control, Tissue Plasminogen Activator / adverse effects, Ventricular Dysfunction, Left / chemically induced, Ventricular Dysfunction, Left / prevention & control, Acute Disease, Brain Ischemia / complications, Brain Ischemia / diagnostic imaging, Brain Ischemia / drug therapy, Fibrinolytic Agents / adverse effects, Humans, Male, Middle Aged, Stroke / diagnostic imaging, Stroke / drug therapy, Stroke / etiology, Tissue Plasminogen Activator / therapeutic use, Treatment Outcome, Ultrasonography, Fibrinolytic Agents, Heparin, Tissue Plasminogen Activator

Background:
Thrombolysis with recombinant tissue plasminogen activator (rtPA) is an established treatment in acute stroke. To prevent rethrombosis after rtPA therapy, secondary anticoagulation with heparin is commonly performed. However, the recommended time-point and extent of heparin treatment vary and are not well investigated.
Case presentation:
We report a 61-year-old man who developed an acute global aphasia and right-sided hemiparesis. Cranial CT was normal and systemic thrombolytic therapy with tPA was started 120 minutes after symptom onset. Low-dose subcutaneous heparin treatment was initiated 24 hours later. Transthoracic echocardiography (TTE) 12 hours after admission showed slightly reduced left ventricular ejection fraction (LVEF) but was otherwise normal. 48 hours later the patient suddenly deteriorated with clinical signs of dyspnea and tachycardia. TTE revelead a large left ventricular apical thrombus as well as a reduction of LVEF to 20 %. Serial further TTE investigations demonstrated a complete resolution of the thrombus and normalisation of LVEF within two days.
Conclusion:
Our case demonstrates an intracardiac thrombus formation following rtPA treatment of acute stroke, probably caused by secondary hypercoagulability. Rethrombosis or new thrombus formation might be an underestimated complication of rtPA therapy and potentially explain cases of secondary stroke progression.
What is the best algorithm for investigation of acute lower gastrointestinal haemorrhage?
Authors: Ainkaran Santhirasekaram, Sherif Latif, Easha Arooj, Kamran Rostami, Sauid Ishaq
Journal: Gastroenterol Hepatol Bed Bench (2017)
Keywords: ct angiogram, catheter angiography, colonoscopy, lower gastrointestinal (gi) bleed
MeSH terms: Case Reports

An 81-year-old male presented with multiple episode of severe PR bleeding over 2 days. CTA done prior to catheter angiography that enabled successful intervention. This case emphasises the importance of CTA prior to catheter angiography in acute LGIB.
Solid pseudopapillary neoplasm of the pancreas showing marked distal atrophy: A case report
Authors: Masanori Tsujie, Tomoko Wakasa, Shigeto Mizuno, Hajime Ishikawa, Hironobu Manabe, Taichi Koyama, Kotaro Kitani, Shumpei Satoi, Keisuke Inoue, Shuichi Fukuda, Toshihiko Kawasaki, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue
Journal: Int J Surg Case Rep (2019)
Keywords: case report, central pancreatectomy, exocrine dysfunction, parenchymal atrophy, solid pseudopapillary neoplasm

Introduction:
Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm, affecting primarily young females. Because SPNs are of low-malignancy, they rarely obstruct the main pancreatic duct (MPD) and cause atrophy of the distal pancreas even if their tumor sizes are large.
Presentation of case:
A 35-year-old female was referred to our hospital due to pancreatic tumor. Imaging findings showed the presence of well-defined round tumor in the body of the pancreas with 25-mm in diameter. The pancreas parenchyma distal to the tumor was markedly atrophic, and MPD dilatation was not observed. The lesion was diagnosed as SPN by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and central pancreatectomy was performed. Intraoperative frozen section of the distal atrophic pancreas showed no evidence of acinar cells, indicating exocrine dysfunction. Therefore, we closed distal pancreas stump instead of reconstruction. In the distal atrophic parenchyma, scattered foci of islets of Langerhans and the vestige of dilated MPD were observed. She has shown neither endocrine nor exocrine insufficiency after surgery.
Discussion:
SPNs are usually found without atrophic change of distal pancreas. To the best of our knowledge, this is the first report of SPN in which exocrine dysfunction of atrophic pancreas was demonstrated pathologically and central pancreatectomy without anastomosis of distal pancreas was chosen for the surgical treatment.
Conclusion:
We reported a very rare case of SPN with marked distal parenchymal atrophy. We successfully performed central pancreatectomy without reconstruction.
Case report: Corneal endothelial degeneration and optic atrophy in dentatorubral-pallidoluysian atrophy quantified by specular micrography and optical coherence tomography
Authors: Shunya Takizawa, Hiroto Mitamura, Yuko Ohnuki, Kenji Kawai, Yoichi Ohnuki, Eiichiro Nagata, Wakoh Takahashi
Journal: Front Neurol (2022)
Keywords: cag repeat, corneal endothelial degeneration, dentatorubral-pallidoluysian atrophy, optical coherence tomography, specular micrography
MeSH terms: Case Reports

Introduction:
Dentatorubral-pallidoluysian atrophy (DRPLA) is an autosomal dominant neurodegenerative disease with various neurological manifestations. Corneal endothelial degeneration and optic atrophy have been reported separately; however, there are no reports of corneal endothelial degeneration with optic atrophy.
Cases:
Herein, we present four related patients with DRPLA: two patients (69-year-old woman and 80-year-old man) who exhibited both corneal endothelial degeneration and optic atrophy and another two (49- and 51-year-old women, respectively) who exhibited only corneal endothelial degeneration. We quantified the reduction in corneal endothelial cell density (ECD) and hexagonality using specular microscopy and thinning of the circumpapillary retinal nerve fiber layer (RNFL) using optical coherence tomography (OCT).
Conclusion:
This is the first report of DRPLA accompanied by corneal endothelial degeneration and/or optic atrophy, which were both quantified based on the corneal ECD and the circumpapillary RNFL thickness using specular micrography and OCT, respectively. The pathophysiological mechanism is unclear; however, the involvement of the nuclear receptor TLX interacting with atrophin-1 may be implicated in ophthalmic manifestations of DRPLA. Therefore, we recommend performing specular micrography and/or OCT when patients with DRPLA experience visual disturbances.
Safe administration of etoposide phosphate after hypersensitivity reaction to intravenous etoposide
Authors: J Siderov, P Prasad, R De Boer, J Desai
Journal: Br J Cancer (2002)
MeSH terms: Antineoplastic Agents / therapeutic use, Drug Hypersensitivity / prevention & control, Etoposide / adverse effects, Etoposide / therapeutic use, Organophosphorus Compounds / therapeutic use, Case Reports, Adult, Etoposide / analogs & derivatives, Humans, Infusions, Intravenous, Male, Antineoplastic Agents, Organophosphorus Compounds, etoposide phosphate, Etoposide

Etoposide is commonly used in a variety of malignancies. A well known but rare toxicity are hypersensitivity reactions, usually manifested by chest discomfort, dyspnoea, bronchospasm and hypotension. We report the details of a patient who developed hypersensitivity reactions to intravenous etoposide, but subsequently tolerated the administration of intravenous etoposide phosphate with no sequelae.
Case report: Neonatal diabetes mellitus caused by KCNJ11 mutation presenting with intracranial hemorrhage
Authors: Bo Wu, Wei Xu
Journal: Front Neurol (2023)
Keywords: kcnj11, encephalomalacia, epilepsy, intracranial hemorrhage, neonatal diabetes mellitus
MeSH terms: Case Reports

Neonatal diabetes mellitus (NDM) is a rare type of monogenic diabetes. At present, most published studies have focused on the types of gene mutations associated with NDM and the therapeutic effect of sulfonylureas (SUs) on the disease; few studies on NDM-associated intracranial hemorrhage (ICH) exist. In addition, p.V59M mutations generally lead to intermediate DEND (iDEND: intermediate developmental delay and neonatal diabetes) syndrome without epilepsy. Here, we present a case of a 1-month-old male infant who was diagnosed with NDM caused by a KCNJ11 missense mutation (p.V59M), presenting with cerebral injury. In the early stage of the disease, continuous insulin dose adjustment did not achieve an ideal level of blood glucose. Although blood glucose was subsequently controlled by oral SUs, which were administered after the genetic test result, the patient still displayed epilepsy and developmental delay. In this case report, we present our experience in the treatment of the infant, switching from insulin to oral SUs and we thought that SUs have limited effects on improving the prognosis of neurodevelopmental disturbances in NDM with foci of encephalomalacia. In addition, there may be a relationship between KCNJ11 missense mutations and cerebral injury, and further research must be carried out to confirm these points.
Case Report: Complete Response of Primary Massive Hepatocellular Carcinoma to Anti-Programmed Death Ligand-1 Antibody Following Progression on Anti-Programmed Death-1 Antibody
Authors: Gang Liu, Wenxuan Zhou, Xiaoli Li, Lijie Guo, Tingting He, Juan Zhao, Liansheng Gong
Journal: Front Immunol (2021)
Keywords: hcc, pd-1, pd-l1, atezolizumab, immunotherapy, pembrolizumab
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / therapeutic use, B7-H1 Antigen / antagonists & inhibitors, Carcinoma, Hepatocellular / drug therapy, Liver Neoplasms / drug therapy, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Case Reports, Research Support, Non-U.S. Gov't, Angiogenesis Inhibitors / administration & dosage, Antibodies, Monoclonal, Humanized / administration & dosage, Bevacizumab / administration & dosage, Carcinoma, Hepatocellular / diagnostic imaging, Carcinoma, Hepatocellular / immunology, Drug Substitution, Female, Hepatitis B, Chronic / complications, Humans, Immune Checkpoint Inhibitors / administration & dosage, Liver Cirrhosis / etiology, Liver Neoplasms / diagnostic imaging, Liver Neoplasms / immunology, Middle Aged, Phenylurea Compounds / administration & dosage, Portal Vein, Quinolines / administration & dosage, Salvage Therapy, Tomography, X-Ray Computed, Venous Thrombosis / etiology, Angiogenesis Inhibitors, Antibodies, Monoclonal, Humanized, B7-H1 Antigen, CD274 protein, human, Immune Checkpoint Inhibitors, PDCD1 protein, human, Phenylurea Compounds, Programmed Cell Death 1 Receptor, Quinolines, Bevacizumab, atezolizumab, pembrolizumab, lenvatinib

Hepatocellular carcinoma (HCC) is an aggressive liver tumor that occurs due to chronic liver disease, and it has a high mortality rate and limited treatment options. Immune checkpoint inhibitors have been successfully introduced and used in cancer therapy, among which inhibitors of programmed death ligand-1 (PD-L1) and its receptor programmed death-1 (PD-1) are commonly administered for HCC as combination therapy, including combined anti-angiogenic and immunotherapy combination therapy. We report a case of a primary massive HCC patient with portal hepatic vein tumor thrombus who had a good response to atezolizumab in combination with bevacizumab, following progression of disease on combined immunotherapy with pembrolizumab and lenvatinib. This case demonstrates for the first time that an HCC patient who is resistant to anti-PD-1 antibody immunotherapy can benefit from anti-PD-L1 antibody immunotherapy, providing a potentially promising strategy for the treatment of HCC.
Congenital hairy polyp of posterior tonsillar pillar
Authors: Bilal Mirza, Shahid Iqbal, Nabila Talat, Muhammad Saleem
Journal: J Neonatal Surg (2014)
Keywords: congenial hairy poly, neonate, posterior tonsillar pillar
MeSH terms: Case Reports

Congenital hairy polyps are exceedingly rare congenital anomalies. We report a case of congenital hairy polyp arising from posterior tonsillar pillar which was excised with bipolar cautry.
Necrotizing Ulcerative Gingivitis, a Rare Manifestation as a Sequel of Drug-Induced Gingival Overgrowth: A Case Report
Authors: Marah Damdoum, Sudhir Rama Varma, Mohamed A Jaber, Manjusha Nambiar
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Purpose:
The purpose of this case report is to present a rare case of amlodipine-induced gingival overgrowth with a secondary formation of necrotizing ulcerative gingivitis involving the upper and lower arches of a 68-year-old female patient with a chief complaint of "swollen gums and pain on mastication which has been recurring for the past 5 years."
Materials and methods:
The treatment plan of this case was divided according to quadrants of the mouth. Each week, one quadrant was surgically excised, and the remaining quadrants were observed for any changes. The gingival overgrowths were excised using a 15 blade, and debris/plaque was removed with Gracey curettes.
Results:
Although full-mouth exodontia was performed, the patient unfortunately suffered with recurrences in GO. These results are suggestive of idiopathic causes of GO.
Conclusion:
Careful examination, physician referrals, and biopsy to rule out any specific anomalies and to assist in proper diagnosis are followed by sequential management of the case results in productive outcomes.
A Neonatal Case of Glial Choristoma of the Tongue Causing Airway Obstruction
Authors: Hajime Machi, Hiroki Karata, Yusuke Yamane, Junya Fukuoka, Yasutomo Funakoshi, Hiroyuki Moriuchi
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Glial choristoma is considered to be a type of brain heterotopia consisting of ectopic central nervous tissue. We herein report a neonate with glial choristoma of the tongue who developed respiratory distress due to airway obstruction. A male neonate presented with respiratory distress due to a soft mass on the midline region of the dorsal tongue base at birth. He was intubated using a flexible fiberoptic nasopharyngoscope. MRI showed a well-circumscribed mass measuring 25 × 23 × 27 mm in size in the same region. A histologic examination confirmed a pathological diagnosis of glial choristoma. He underwent tracheotomy at 22 days of age, and a subtotal resection of the tumor was performed at five months of age. The clinical behavior of oral glial choristoma varies depending on the age at onset as well as the location and size of the mass. The small size of the organ and the narrow operating field hamper the surgical approach in neonates. The optimal therapeutic strategy for neonatal cases of glial choristoma should thus be determined based on the condition of each individual patient.
Interference of COVID-19 Vaccination With PET/CT Leads to Unnecessary Additional Imaging in a Patient With Metastatic Cutaneous Melanoma-Case Report
Authors: Rafał Czepczyński, Jolanta Szczurek, Jacek Mackiewicz, Marek Ruchała
Journal: Front Oncol (2021)
Keywords: covid-19, pet/ct, malignant melanoma, metastases, vaccination
MeSH terms: Case Reports

The COVID-19 pandemic has widely influenced oncological imaging mainly by presenting unexpected pulmonary and mediastinal lesions. The ongoing global program of vaccination has led to incidental diagnosis of axillary lymphadenopathy. We present a case of increased accumulation of 18F-FDG in an axillary lymph node in a PET/CT scan performed in a 43-year-old female patient with metastatic melanoma. The scan was performed 4 days after the AZD1222 vaccination. The occurrence of lymphadenopathy was verified with another PET/CT scan scheduled one month later. This case report presents a possible misinterpretation of PET/CT images caused by the recent COVID-19 vaccination. To avoid distress of the patient and unnecessary oncological diagnostics to verify the findings, we recommend avoiding scheduling PET/CT shortly after vaccination.
Successful treatment with laparoscopy-assisted surgery for ileal perforation due to an ingested foreign body: A report of two cases
Authors: Soichi Ito, Yuma Tsuchitani, Souhei Hashimoto, Takuji Uemura, Kazunori Katsura, Takayuki Abe, Koichiro Sato, Hirotaka Kato
Journal: Int J Surg Case Rep (2019)
Keywords: case report, foreign body, laparoscopy-assisted surgery, small bowel perforation

Introduction:
Presently, the advantage of laparoscopic surgery is widely recognized and it is gaining popularity not only in elective abdominal surgeries but also in various kinds of emergent abdominal surgeries. This report describes two patients diagnosed with ileal perforation due to an ingested foreign body (FB)-a rare abdominal emergency-who were treated laparoscopically.
Presentation of case:
Both patients were brought in by an ambulance to our hospital, with complaints of increasing lower abdominal pain. Computed tomography scan revealed a small bowel perforation due to an ingested FB in both patients, and laparoscopy-assisted partial ileal resection was immediately performed. Their postoperative recoveries were uneventful.
Discussion:
Both patients with this rare abdominal emergency were successfully treated with laparoscopic surgery. Its feasible diagnostic and therapeutic abilities and decreased invasiveness contributed to their uneventful and fast recoveries. Extracorporeal handling of the affected small bowel via mini-laparotomy was useful in this setting as it was safe, fast, and cost-effective.
Conclusion:
Laparoscopic surgery is effective, even for this rare abdominal emergency. Moreover, laparoscopy-assisted surgery accompanying mini-laparotomy is a rational treatment approach, especially for this condition.
Ventricular Tachycardia from a Central Line Fracture Fragment Embolus: A Rare Complication of a Commonly Used Procedure-A Case Report and Review of the Relevant Literature
Authors: Saptarshi Biswas, Patrick McNerney
Journal: Case Rep Crit Care (2015)

A 22-year-old male admitted with multiple gunshot wounds (GSW) had central line placed initially for hemodynamic monitoring and later for long term antibiotics and total parenteral nutrition (TPN). On postoperative day 4 he presented with bouts of nonsustained ventricular tachycardia; the cause was unknown initially and later attributed to a catheter fragment accidentally severed and lodged in the right heart. Percutaneous retrieval technique was used to successfully extract the catheter fragment and complete recovery was achieved.
Adenoid cystic carcinoma of cervix: two cases report and review of the literature
Authors: Khadija Benhayoune, Hinde El Fatemi, Abdelaziz Bannani, Abdelilah Melhouf, Toufik Harmouch
Journal: Pan Afr Med J (2015)
Keywords: adenoid cystic carcinoma, bleeding, cervix, cribriform pattern
MeSH terms: Carcinoma, Adenoid Cystic / pathology, Uterine Cervical Neoplasms / pathology, Case Reports, Review, Aged, 80 and over, Biopsy, Carcinoma, Adenoid Cystic / diagnosis, Female, Humans, Uterine Cervical Neoplasms / diagnosis

Adenoid cystic carcinoma of the cervix is a rare and aggressive tumor with fatal outcome. In this paper we report two cases of primary adenoid cystic carcinoma and a review of literature. A 80 years old woman, admitted to our hospital with postmenopausal bleeding and hydrorrhea. Gynealogical examination showed a cervical stenotic with the presence of a tumor processus. Biopsy of cervical growth was done. 80-year-old woman presented with vaginal bleeding with pelvic pain. Physical examination revealed a friable mass in the cervix. Incisional biopsy was performed. In the both cases the diagnosis of adenoid cystic carcinoma of the cercix was confirmed. Adenoid cystic carcinoma of the cervix is clinically and radiologically similar to other tumors of the cervix but the diagnosis can only be made by histological examination.