OpenMed/multicare-articles huggingface dataset:
Inverted papilloma in the sphenoethmoidal recess
Authors: Eduardo Macoto Kosugi, Rodrigo de Paula Santos, Fernando Freitas Ganança, Rodrigo de Paiva Tangerina, Vinícius Magalhães Suguri, Wellington Yugo Yamaoka, Luis Carlos Gregório
Journal: Braz J Otorhinolaryngol (2008)
MeSH terms: Papilloma, Inverted / diagnosis, Paranasal Sinus Neoplasms / diagnosis, Sphenoid Sinus / pathology, Sphenoid Sinus / surgery, Case Reports, Adult, Endoscopy, Humans, Male, Papilloma, Inverted / pathology, Papilloma, Inverted / surgery, Paranasal Sinus Neoplasms / pathology, Paranasal Sinus Neoplasms / surgery, Tomography, X-Ray Computed

Inverted papilloma is a nasal benign tumor that usually arises from the lateral nasal wall, especially from the middle meatus. It has high local invasive likelihood, high recurrence rates and malignancy potential. Sphenoethmoidal recess involvement is rare and is usually due to sphenoid sinus primary disease. In the literature, no case of isolated sphenoethmoidal recess inverted papilloma has been reported yet. The present report describes an exceptional location of inverted papilloma, arising from the sphenoethmoid recess, without involving the sphenoid sinus.
Liver lipoma: a case report
Authors: Guglielmo Manenti, Eliseo Picchi, Antonella Castrignanò, Massimo Muto, Marco Nezzo, Roberto Floris
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Liver lipoma is a rare benign mesenchymal tumour without malignant degeneration. Lesions may be asymptomatic, nevertheless they may sometimes cause abdominal pain depending upon the size. Usually liver lipomas are an incidental finding during radiological examinations performed for other reasons, and there is no evidence of familiar genetic cluster or predisposing factors but it seems to have a strong association with impaired lipidic profile. In this report, we describe the case of a 72 year old female with a giant liver lipoma observed during an ultrasound examination. The clinical examination was completed with CT and MRI scans. Features of the lesion such as negative attenuation values on multiphasic CT examination and MRI signal drop-out on T 2 spectral presaturation with inversion recovery sequences, with no enhancement after administration of contrast medium, are suggestive for this kind of benign neoplasm. The purpose of this report is provide an anthological case of liver lipoma, helping to define the diagnostic features with imaging techniques.
Case Report: ALK rearranged locally advanced lung adenocarcinoma showing inconsistent radiographic findings and pathological responses during neoadjuvant alectinib therapy
Authors: Peijun Cao, Qingchun Zhao, Yongwen Li, Ruifeng Shi, Guangsheng Zhu, Zihe Zhang, Hongbing Zhang, Minghui Liu, Sen Wei, Hongyu Liu, Jun Chen
Journal: Front Pharmacol (2023)
Keywords: eml4-alk fusion gene, alectinib, neoadjuvant therapy, pseudoresistance, pulmonary adenocarcinoma
MeSH terms: Case Reports

Alectinib has been approved as first-line treatment for anaplastic lymphoma kinase (ALK)-positive non-small cell lung carcinoma. Oncologists are also exploring the possibility of applying alectinib in the perioperative period. Here, we present a patient with locally advanced lung adenocarcinoma associated with EML4-ALK fusion mutation, who received neoadjuvant chemotherapy and alectinib treatment, and then underwent thoracoscopic left lower lung lobectomy. The patient initially received eight chemotherapy cycles and achieved partial remission. After eight cycles of chemotherapy, the lymph nodes in the hilar region again enlarged. The patient was then switched to 4 months of alectinib therapy, but no significant lesion changes were detected on imaging during this period. This raised the question of whether the patient developed alectinib resistance. The pathological findings of the postoperative lung lobe specimens indicated extensive necrosis in the tumor area with no residual tumor cells and massive chronic inflammatory cell infiltration around the tumor area, confirming inconsistency between the imaging findings and pathological results. Multi-point tumor specimen sampling was postoperatively performed. Tumor immune-related gene expression was detected in the sample with the help of the PanCancer IO360™ panel based on the nCounter platform. This is a rare case of a patient who was treated with neoadjuvant alectinib and had paradoxical radiographic findings and pathological responses. The possibility that intratumoral immune heterogeneity was responsible for this phenomenon has been discussed. Based on the findings, it is argued that the pathological response should be an important basis for assessing the effectiveness of neoadjuvant alectinib therapy.
Loeys-Dietz Syndrome Complicated by Right Coronary Artery Pseudoaneurysm
Authors: Yasir Jawaid, Obadah Aqtash, Kanaan Mansoor, Aman N Ajmeri, Frank Fofie, Ahmed Amro, Larry Dial
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Loeys-Dietz syndrome is a rare autosomal dominant connective tissue disorder notable for rapidly progressive vascular aneurysmal disease and craniofacial defects. Patients are at an increased risk for aneurysm rupture and dissection at younger ages compared to other aneurysmal syndromes. Early surgical intervention is important for prevention of ruptures and/or dissection. The coronary arterial tree is mostly involved as a result of postoperative complications of an aortic root repair. This fact has been sparsely reported. We report a unique case of LDS2 presenting with chest pain that was later diagnosed as a pseudoaneurysm as a result of a right coronary artery graft dehiscence.
Gelsemium elegans Poisoning: A Case with 8 Months of Follow-up and Review of the Literature
Authors: Zhou Zhou, Lei Wu, Yuhua Zhong, Xiaobo Fang, Yanmei Liu, Hongbing Chen, Weixi Zhang
Journal: Front Neurol (2017)
Keywords: gelsemium elegans, coma, depressive disorder, poisoning, suicide
MeSH terms: Case Reports

Background:

Gelsemium elegans (G. elegans) is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail.
Case presentation:
A 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis. After mechanical ventilation for hours, the patient recovered from coma with sequelae of impaired short-term memory, disorientation, and childish behaviors. Brain magnetic resonance imaging (MRI) showed bilateral hippocampus and basal ganglia damage due to hypoxia. During 8 months of follow-up, both her symptoms and brain MRI scan improved significantly.
Conclusion:

G. elegans is highly toxic. Although patients may die within 30 min due to its strong respiratory depressive effect, they can survive with timely respiratory support and enjoy gradual improvement without delayed postanoxic encephalopathy.
A New Three-Way Translocation t(4;11;7)(q21;q23;q22) in a Mixed-Phenotype Acute Leukemia
Authors: Hirotaka Takasaki, Takayoshi Tachibana, Masatsugu Tanaka, Atsuo Maruta, Yoshiaki Ishigatsubo, Heiwa Kanamori
Journal: Case Rep Hematol (2011)
MeSH terms: Case Reports

A 68-year-old man was admitted to our hospital in September 2008 because of a left-sided chest pain. Bone marrow examination showed that 85.5% of leukemic cells were positive for myeloperoxidase (MPO) and were negative for esterase stain. Flow cytometric analysis (FCM) revealed the expression of CD19, CD79a, CD13, CD33, CD34, and HLA-DR on the blasts. Cytogenetic analysis of bone marrow cells using the G-banding technique demonstrated 47, XY, +X, t(4;11;7)(q21;q23;q22) in five of the 20 analyzed cells. The patient was diagnosed as having mixed biphenotypic acute leukemia according to the European Group for Immunologic Classification of Leukemia criteria. Mixed-phenotype acute leukemia is a rare, difficult to diagnose entity. Whether patients with mixed-phenotype acute leukemia should be treated with regimens designed for acute myeloid leukemia, acute lymphoblastic leukemia, or both remains unclear.
Personalised mapping of tumour development in synchronous colorectal cancer patients
Authors: Valentina Thomas, Maura B Cotter, Miriam Tosetto, Yi Ling Khaw, Robert Geraghty, Desmond C Winter, Elizabeth J Ryan, Kieran Sheahan, Simon J Furney
Journal: NPJ Genom Med (2020)
Keywords: cancer genomics, colorectal cancer, genome informatics
MeSH terms: Case Reports

Synchronous colorectal cancers (syCRCs) are two or more primary tumours identified simultaneously in a patient. Previous studies report high inter-tumour heterogeneity between syCRCs, suggesting independent origin and different treatment response, making their management particularly challenging, with no specific guidelines currently in place. Here, we performed in-depth bioinformatic analyses of genomic and transcriptomic data of a total of eleven syCRCs and one metachronous CRC collected from three patients. We found mixed microsatellite status between and within patients. Overlap of mutations between synchronous tumours was consistently low (<0.5%) and heterogeneity of driver events across syCRCs was high in all patients. Microbial analysis revealed the presence of Fusobacterium nucleatum species in patients with MSI tumours, while quantification of tumour immune infiltration showed varying immune responses between syCRCs. Our results suggest high heterogeneity of syCRCs within patients but find clinically actionable biomarkers that help predict responses to currently available targeted therapies. Our study highlights the importance of personalised genome and transcriptome sequencing of all synchronous lesions to aid therapy decision and improve management of syCRC patients.
Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases
Authors: Ichiro Tonogai, Daisuke Hamada, Yuhei Yamasaki, Keizo Wada, Tomoya Takasago, Takahiko Tsutsui, Tomohiro Goto, Koichi Sairyo
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina ceramic total talar prosthesis. Immobilization of the ankle in a short-leg cast for 3 weeks was followed by early rehabilitation. One year and 6 months after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatments of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis.
Pre-B acute lymphoblastic leukemia with t(1;19) in an adult initially presenting as hematuria and bilateral renal enlargement: a case report and literature review
Authors: Jian Wu, Xiao-Ling Pi, Zhi-Bin Ye
Journal: Clin Nephrol Case Stud (2017)
Keywords: all, acute renal failure, initial presentation, t(1, 19)
MeSH terms: Case Reports

Although pre-B acute lymphoblastic leukemia (ALL) is the most common type of renal leukemic infiltration; the renal infiltration with leukemia cells as the initial manifestation of leukemia is very rare. Translocation (1;19)(q23;p13) is one of the most common chromosomal abnormalities in patients with ALL and is observed in 5 - 6% of children with pre-B ALL. However, the incidence of t(1;19) in adults is lower, not exceeding 3%, and the prognosis of adult patients is usually poor. Herein, we report a 52-year-old female patient with pre-B ALL who initially presented as bilateral renal enlargement. The cytogenetic analysis revealed chromosomal abnormalities including t(1;19). The patient underwent three consecutive courses of chemotherapy with VDLP (vincristine, daunorubicin, L-asp, and prednisolone) and gained a short complete remission. Her kidneys recovered to normal size, and renal function returned to normal level. However, after complete remission for only 3 months, the patient exhibited resistance to consolidation chemotherapy and indicated evidence of marrow relapse. Although we increased the drug dosage and attempted to use a different protocol, she died of severe anemia and hemorrhage almost 10 months after she was first admitted. In conclusion, pre-B cell ALL is the most common type of leukemia to present with renal infiltration as the presenting sign. Because of the poor outcome of ALL, some new therapeutic approaches may improve the patients' conditions.
Delayed diagnosis of PRES and eclampsia in a concealed pregnancy
Authors: Zeynep Ozcan Dag, Yavuz Simsek, Yakup Turkel, Ozlem Banu Tulmac, Yuksel Isik
Journal: Pan Afr Med J (2014)
Keywords: concealed pregnancy, eclampsia, posterior reversible encephalopathy syndrome, pre-eclampsia
MeSH terms: Eclampsia / diagnosis, Posterior Leukoencephalopathy Syndrome / diagnosis, Premature Birth / etiology, Case Reports, Adult, Delayed Diagnosis, Female, Humans, Posterior Leukoencephalopathy Syndrome / etiology, Pregnancy, Risk Factors

Pre-eclampsia and eclampsia are well-known risk factors of posterior reversible encephalopathy syndrome. Early recognition and proper treatment result in complete reversibility of this disease. Concealed pregnancy obstacles a safe prenatal care and a safe planned delivery, because of latency in the diagnosis. We present a case of unrecognized posterior reversible encephalopathy syndrome, eclampsia and premature delivery due to concealed pregnancy.
Triple Valvulopathy and Jaccoud's Arthropathy: A Case Report and Literature Review
Authors: Ali Naderi Mahabadi, Bassam Alhaddad, Stanley Ballou
Journal: Case Rep Rheumatol (2016)

Cardiac involvement is fairly common in patients with systemic lupus erythematosus (SLE). It may involve all layers of the heart and coronary arteries as well as the heart valves. We report an extremely rare presentation of valvulitis and valvular dysfunction associated with systemic lupus erythematosus. This is the first case of lupus valvulitis which required three mechanical prosthetic valve replacements with disease recurrence leading to a fatal outcome. This is, in our point of view, the consequence of aggressive natural history of the disease and perhaps late diagnosis and treatment of underlying SLE which was unsuccessful.
Case Report:Pregnancy and birth in a mild phenotype of Alström syndrome
Authors: Luca Marozio, Francesca Dassie, Gianluca Bertschy, Emilie M Canuto, Gabriella Milan, Stefano Cosma, Pietro Maffei, Chiara Benedetto
Journal: Front Genet (2022)
Keywords: alström syndrome, ciliopathies, delivery, hyperandrogenism, obesity, preeclampsia, pregnancy
MeSH terms: Case Reports

Background: Alström syndrome (AS) is an ultrarare multisystemic progressive disease caused by autosomal recessive variations of the ALMS1 gene (2p13). AS is characterized by double sensory impairment, cardiomyopathy, childhood obesity, extreme insulin resistance, early nonalcoholic fatty liver disease, renal dysfunction, respiratory disease, endocrine and urologic disorders. In female AS patients, hyperandrogenism has been described but fertility issues and conception have not been investigated so far. Case: This case report describes the spontaneous conception, pregnancy, and birth in a 27-year-old woman with AS, characterized by a mild phenotype with late onset of visual impairment, residual perception of light, and hypertension. Before pregnancy, menses were regular with increased levels of dihydrotestosterone and androstanediol glucuronide in the follicular phase, and the ovaries and endometrium were normal during vaginal ultrasound. A thorough clinical follow-up of the maternal and fetal conditions was carried out. A weight gain of 10 kg during pregnancy was recorded, and serial blood and urine tests were all within the normal range, except for mild anemia. The course of pregnancy was uneventful up to 34 weeks of gestation when preeclampsia developed with an abnormally high level of blood pressure and edema in the lower limbs. At 35 weeks + 3 days of gestation, an urgent cesarean section was performed, and a healthy male weighing 1,950 g was born. Histological examination of the placenta showed partial signs of flow obstruction, limited abruption areas, congested fetal vessels and villi, and a small single infarcted area. Conclusion: The present case demonstrates for the first time that conceiving is possible for patients with ALMS. Particular attention should be given to the management of AS systemic comorbidities through the course of pregnancy.
Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report
Authors: Mouhsine Lamtri Laarif, Raphael Schils, Fréderic Lifrange, Christophe Valkenborgh, Pauline Pitti, Pauline Brouwers, Elettra Bianchi, Cécile Meex, Marie-Pierre Hayette
Journal: Access Microbiol (2023)
Keywords: actinomyces israelii, fusobacterium nucleatum, actinomycosis, brain abscesses, periodontitis
MeSH terms: Case Reports

Introduction:
Brain abscess is the most common focal infectious neurological injury. Until the nineteenth century this condition was fatal, however the development of neuroimaging for early diagnosis, neurosurgery and antibiotic therapy in the twentieth century has led to new therapeutic strategies decreasing mortality from 50 % in the 1970s to less than 10 % nowadays. In this context we report a case of brain abscess with a dental origin.
Case report:
A immunocompetent man without any addiction presented to the emergency department with dysarthria and frontal headache at home. The clinical examination was normal. Further investigations revealed a polymicrobial brain abscess as a consequence of an ear, nose or throat (ENT) infection with locoregional extension with a dental starting point involving Actinomyces israelii and Fusobacterium nucleatum . In spite of a rapid diagnosis and a neurosurgical management associated with an optimal treatment by a dual therapy made of ceftriaxone and metronidazole the patient unfortunately died.
Conclusion:
This case report shows that despite a low incidence and a good prognosis following the diagnosis, brain abscesses can lead to patient's death. Thereby, when the patient's condition and urgency allow, a thorough dental examination of patients with neurological signs following the recommendations would improve the diagnosis made by the clinician. The use of microbiological documentation, the respect of pre-analytical conditions, the interaction between the laboratory and the clinicians are indispensable for an optimal management of these pathologies.
Rapidly evolving giant dermatofibroma
Authors: K J Lang, S Lidder, M Hofer, C Graham, A Taylor
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Dermatofibroma, also known as "fibrous histiocytoma", is a benign dermal or subcutaneous poorly circumscribed proliferation of spindle-shaped fibroblasts and macrophages in the dermis. Although it is commonly present as a brownish nodule the legs of females, it may also arise on the upper extremities, trunk, and rarely on the head. The exact pathogenesis is unclear. However, it is widely believed that the originating insult to the dermis is a folliculitis, an arthropod bite, or an unspecified initial inflammatory condition. Giant dermatofibromas of greater than 5 cm in diameter are rare, with only 22 cases reported in the literature. We present a case of a rapidly evolving pedunculated mass in the groin of a male patient. Histological examination confirmed this to be a giant dermatofibroma. Though this specimen cannot is not confirmed as such, the cellular subtype is sometimes present as a larger lesion with anecdotal reports of local recurrence and distant metastases. The clinical and radiological features which were somewhat suspicious of malignancy are considered in the context of the definitive pathological diagnosis of a benign lesion.
Traditional serrated adenoma with superficially serrated adenoma: A case treated with endoscopic submucosal dissection with detailed endoscopic observation and pathological study
Authors: Momoka Sato, Tomoji Kato, Yu Tezen, Takeshi Hayashi, Toru Matsui, Katsuya Kobayashi, Kenichiro Sekigawa, Ryosuke Tajiri, Hiroshi Mitsui
Journal: DEN Open (2023)
Keywords: kras, rspo, endoscopic submucosal dissection, superficially serrated adenoma, traditional serrated adenoma
MeSH terms: Case Reports

A new subtype of serrated lesions, superficially serrated adenoma (SuSA), has been proposed as a lesion that histopathologically exhibits the morphological features of both conventional adenomas and serrated lesions and is difficult to classify as either one. SuSA has been elucidated to be a precursor lesion of KRAS-type traditional serrated adenoma. It has also been reported that SuSA may have malignant potential. We report a case treated with endoscopic submucosal dissection and detailed observation. Endoscopy revealed a raised lesion with a two-tier raised appearance in the sigmoid colon: a tall pinecone-like reddish structure and flattened whitish elevation on white light imaging. Magnifying narrow-band imaging revealed conspicuous blood vessels in the pinecone-like structure and slightly dilated reticular vessels in the flattened area. Crystal violet staining showed that the pinecone-like structure had a type IVH pit pattern and the flattened area had a stellate to slightly elongated type IIIH pit pattern diagnosed based on Kudo's classification and other pit pattern classification systems. Ki67-positive cells were distributed in the basal and middle layers of the gland in the flattened elevated area. Genetic analysis results were positive for KRAS mutation and negative for BRAF mutation. Histopathological examination revealed a traditional serrated adenoma in the pinecone-like structure and SuSA in the adjacent flattened elevated area.
Retroperitoneal abscess: a rare localization of tubercular infection
Authors: Sami Karoui, Norsaf Bibani, Afef Ouaz, Meriem Serghini, Faouzi Chebbi, Kais Nouira, Ines Chelly, Jalel Boubaker, Zoubeir Ben Safta, Emna Menif, Moncef Zitouna, Azza Filali
Journal: Gastroenterol Res Pract (2010)
MeSH terms: Case Reports

Incidence of tuberculosis infection has considerably increased during the past 20 years due to the HIV pandemic and continues to be one of the most prevalent and deadly infections worldwide. Extrapulmonary tuberculosis lacks specific clinical manifestation and can mimic many diseases. It can invade neighbouring tissue and form a big cyst with manifesting clinical symptoms. We describe a rare case of 31-year-old immunocompetent man affected by a retroperitoneal abscess secondary to tubercular infection. Exploratory laparotomy and histopathological examinations of tissue were required for achieving diagnosis of tuberculosis. No pulmonary or spinal involvement was identified. The patient was successfully treated with standard four-drug antitubercular therapy.