OpenMed/multicare-articles huggingface dataset:
Neutrophilic Dermatosis of the Dorsal Hands: Report of a Case and Review of the Literature
Authors: Narciss Mobini, Kaviyon Sadrolashrafi, Susun Michaels
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Neutrophilic dermatosis of the dorsal hands is an underrecognized entity, which is a distributional variant of Sweet's syndrome. It is often clinically misdiagnosed as an infectious process in overwhelming majority of the cases and the treatment is therefore delayed. Also, its association with underlying systemic and neoplastic disorders makes the need for an accurate diagnosis more crucial. We present a 45-year-old Caucasian woman who was initially diagnosed as having a hand infection with unsuccessful courses of antibiotic therapy. A later biopsy revealed a diffuse dermal infiltrate of neutrophils with leukocytoclasis, vasculopathic changes, and marked papillary dermal edema. Patient responded rapidly to oral prednisone treatment. By sharing a new case and comprehensive review of available published literature, we intend to raise awareness of this underreported entity and emphasize the role of timely biopsy of the lesions that will not only lead to an accurate diagnosis, but also avoid unnecessary antibiotic treatments, potentially aggressive management strategies such as surgical debridement or amputation, and referrals to wound care centers. More importantly, it will prompt a search to exclude any possible association, particularly hematopoietic malignancies.
Leiomyosarcoma of the inferior vena cava as etiology of chronic abdominal pains - a case report
Authors: Raíssa Campos D'Amico, Tamara Marques Ziliotto, Rayssa Marquesa Ávila, Stela Kremmer Bezerra Paes, José Sampaio, Giovanna Golin Guarinello, Jéssica Prado da Silva
Journal: J Vasc Bras (2022)
Keywords: leiomyosarcoma, retroperitoneal neoplasms, vena cava, inferior
MeSH terms: Case Reports

Inferior vena cava leiomyosarcomas are rare tumors that account for less than 0.7% of all retroperitoneal leiomyosarcomas. They are more common in women and cause nonspecific chronic abdominal pain. In this report, we present the case of a 53-year-old female patient complaining of chronic nonspecific periumbilical abdominal pain with initial onset 8 months previously who was diagnosed with inferior vena cava leiomyosarcoma by computed tomography angiography. The patient was treated with complete resection of the tumor and reconstruction of the inferior vena cava with interposition of a Dacron prosthetic graft. The treatment considered the gold standard consists of complete surgical excision, because these tumors are resistant to chemotherapy and radiotherapy. The prognosis of these patients is closely related to early diagnosis. Therefore, it is very important that vascular and general surgeons know that this disease is a possible differential diagnosis of chronic abdominal pains.
Case Report: Subtotal Lymphoid and Total Marrow Irradiation as Bridge Therapy to CD19-Directed CAR T Cells in a Chemorefractory DLBCL With Leukemic Involvement
Authors: Simonetta Saldi, Vincenzo Maria Perriello, Lorenza Falini, Loredana Ruggeri, Christian Fulcheri, Sara Ciardelli, Alessandra Innocente, Stelvio Ballanti, Nicodemo Baffa, Leonardo Flenghi, Antonio Pierini, Cynthia Aristei, Brunangelo Falini
Journal: Front Immunol (2022)
Keywords: car (chimeric antigen receptor) t cells, bridge therapy, diffuse large b-cell lymphoma, gene therapy, radiotherapy
MeSH terms: Bone Marrow, Lymphoma, Large B-Cell, Diffuse / radiotherapy, Case Reports, Antigens, CD19, Humans, Neoplasm Recurrence, Local, Positron Emission Tomography Computed Tomography, T-Lymphocytes, Antigens, CD19

CAR T cell therapy has transformed the salvage approach for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Maintaining disease control before CAR T cell infusion during product manufacturing (so-called bridging therapy) is an important step to optimizing outcome. Among possible bridging therapies, radiation therapy (RT) represents a valuable option, particularly when the disease is limited. Here, we report for the first time on a patient with chemorefractory-transformed DLBCL showing nodal, extranodal, and massive bone marrow (BM) lymphoma infiltration associated with leukemic involvement, a successful bridge therapy to CD19-directed CAR T cell therapy by subtotal lymphoid/total marrow irradiation plus thiothepa followed by reinfusion of CD34+ autologous hematopoietic stem cells. Such a novel bridging regimen allowed a significant reduction of nodal and BM tumor volume while improving blood cell count before CAR T cell infusion. The PET-CT scan and BM evaluation performed at 1, 3, and 6 months after treatment showed complete remission of the disease. A relapse occurred at almost 1 year in lymph nodes because of CD19 antigen escape while the BM remained free of disease. This extended radiotherapy approach may be an effective bridging therapy for chemorefractory DLBCL patients eligible for CAR T cells who present with a high tumor burden, including massive BM involvement associated with leukemic involvement. This preliminary evidence is worth confirming in additional patients.
Early Recurrence of Ovarian Cancer during Pregnancy after Primary Staging Surgery in the First Trimester
Authors: Munetoshi Akazawa, Kazunori Hashimoto
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Cancer during pregnancy is rare. However, even during pregnancy, there is the possibility of recurrence for the patients. We present the case of recurrence of ovarian cancer during pregnancy regardless of primary staging surgery performed in the first trimester of the same pregnancy. The patient was a 29-year-old woman who underwent fertility-sparing surgery at 15 weeks of pregnancy for ovarian cancer (mucinous adenocarcinoma, FIGO stage IC). Omitting adjuvant chemotherapy during pregnancy, we continued the prenatal checkups in the outpatient. At 31 weeks of gestation, massive ascites emerged and oliguria/anuria developed acutely. We performed emergent cesarean section, diagnosing acute kidney injury during pregnancy. On surgical finding, there were a number of 1 cm sized nodules in the small bowel wall and peritoneum. The infant was appropriate for gestational age without any abnormalities. Oliguria continued due to rapid accumulation of ascites in the early postpartum period. After two cycles of chemotherapy, ascites decreased gradually and the markers gradually decreased. However, after six courses of chemotherapy, she suddenly complained of nausea and anorexia. CT imaging showed cancerous ileus and ascites fluids. The patient chose palliative care. Even in the case of nonadvanced cancer, it has the potential to be an extremely aggressive malignancy under the irregular hormonal environment of pregnancy.
Myoma Expulsion after Uterine Artery Embolization
Authors: Vivian Fernanda do Amaral, Fernanda Yumi Yochiy, Mário Luiz Furlanetto Jr, Spencer Luiz Marques Payão
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Introduction:
Uterine leiomyomas are the most common benign pelvic tumors in women over 35 years and can be symptomatic or asymptomatic. Among the main treatment strategies, there are hormone therapy, hysterectomy, myomectomy, and uterine artery embolization (UAE), a recent and promising treatment for patients who wish to avoid hysterectomy. Ideal candidates for UAE are women with symptomatic uterine leiomyomas that present no desire for pregnancy, premenopausal and heavy menstrual bleeding, or dysmenorrhea caused by intramural fibroids. Case Presentation. A 36-year-old female diagnosed with leiomyomas and an extensive history of failed previous treatments who, in order to preserve her uterus, underwent UAE and had tumor expulsion 15 days after the procedure. The patient remained eight months in amenorrhea and, currently, presents normal hormone levels and irregular periods.
Conclusion:
UAE presents itself as a minimally invasive procedure and as an efficient alternative for those patients who wish to preserve their uteri and also improve their symptoms and quality of life.
A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
Authors: Medina G Saffie, Anjali Shroff
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

In this article, we present a case of pyoderma gangrenosum (PG), misdiagnosed initially as a necrotizing infection that significantly worsened due to repeated surgical debridement and aggressive wound care therapy, almost resulting in limb amputation despite antibiotic therapy. The PG lesions improved after pancytopenia were further investigated, and the diagnosis and treatment of an underlying hematologic malignancy was initiated. The diagnosis and management of PG is challenging given the paucity of robust clinical evidence, lack of standard diagnostic criteria, and absence of clinical practice guidelines. It is imperative that clinicians recognize PG as a clinical diagnosis that must be considered in any patient with enlarging, sterile, necrotic lesions that are unresponsive to prolonged and appropriate antibiotics. Early recognition can prevent devastating sequelae such as deep tissue and bone infections associated with a chronic open wound, severe cosmetic morbidity, and potential limb amputation.
Nonchylous idiopathic pleural effusion in the newborn
Authors: Geeta Gathwala, Jagjit Singh, K N Rattan, Kapil Bhalla
Journal: Indian J Crit Care Med (2011)
Keywords: idiopathic neonatal pleural effusion, nonchylous, respiratory distress
MeSH terms: Case Reports

Congenital isolated pleural effusion is a rare cause of respiratory distress in neonates. It is usually chylous. Herein, we report a rare case of nonchylous congenital idiopathic pleural effusion.
Usefulness of molecular biology performed with formaldehyde-fixed paraffin embedded tissue for the diagnosis of combined pulmonary invasive mucormycosis and aspergillosis in an immunocompromised patient
Authors: Véronique Hofman, Abdelmajid Dhouibi, Catherine Butori, Bernard Padovani, Martine Gari-Toussaint, Dea Garcia-Hermoso, Michèle Baumann, Nicolas Vénissac, Gieri Cathomas, Paul Hofman
Journal: Diagn Pathol (2010)
MeSH terms: Fixatives, Formaldehyde, Immunocompromised Host, Immunosuppressive Agents / adverse effects, Invasive Pulmonary Aspergillosis / diagnosis, Mucormycosis / diagnosis, Paraffin Embedding, Polymerase Chain Reaction, Tissue Fixation / methods, Case Reports, Aged, Aspergillus fumigatus / genetics, Aspergillus fumigatus / isolation & purification, Bronchoalveolar Lavage Fluid / microbiology, Fatal Outcome, Humans, Invasive Pulmonary Aspergillosis / immunology, Invasive Pulmonary Aspergillosis / microbiology, Invasive Pulmonary Aspergillosis / pathology, Kidney Transplantation / adverse effects, Lung / microbiology, Lung / pathology, Male, Mucormycosis / immunology, Mucormycosis / microbiology, Mucormycosis / pathology, Necrosis, Pneumonia / diagnosis, Pneumonia / immunology, Pneumonia / microbiology, Predictive Value of Tests, Rhizopus / genetics, Rhizopus / isolation & purification, Staining and Labeling, Tomography, X-Ray Computed, Fixatives, Immunosuppressive Agents, Formaldehyde

Immunocompromised patients who develop invasive filamentous mycotic infections can be efficiently treated if rapid identification of the causative fungus is obtained. We report a case of fatal necrotic pneumonia caused by combined pulmonary invasive mucormycosis and aspergillosis in a 66 year-old renal transplant recipient. Aspergillus was first identified during the course of the disease by cytological examination and culture (A. fumigatus) of bronchoalveolar fluid. Hyphae of Mucorales (Rhizopus microsporus) were subsequently identified by culture of a tissue specimen taken from the left inferior pulmonary lobe, which was surgically resected two days before the patient died. Histological analysis of the lung parenchyma showed the association of two different filamentous mycoses for which the morphological features were evocative of aspergillosis and mucormycosis. However, the definitive identification of the associative infection was made by polymerase chain reaction (PCR) performed on deparaffinized tissue sections using specific primers for aspergillosis and mucormycosis. This case demonstrates that discrepancies between histological, cytological and mycological analyses can occur in cases of combined mycotic infection. In this regard, it shows that PCR on selected paraffin blocks is a very powerful method for making or confirming the association of different filamentous mycoses and that this method should be made available to pathology laboratories.
Hypertensive encephalopathy and cerebral infarction
Authors: Bengt Edvardsson
Journal: Springerplus (2014)
Keywords: cerebral infarction, hypertensive encephalopathy, ischemia, magnetic resonance imaging, posterior reversible encephalopathy syndrome

Introduction:
Hypertensive encephalopathy is one cause of posterior reversible encephalopathy syndrome. Hypertensive encephalopathy and cerebral infarction have only been reported in a few individual case reports.
Case description:
A 51-year-old woman presented with hypertensive encephalopathy. T2-weighted images from magnetic resonance imaging showed hyperintense lesions in both occipital and parietal lobes. Diffusion-weighted imaging showed that this represented cytotoxic oedema and perfusion magnetic resonance imaging revealed reduced blood volume and flow. The magnetic resonance imaging was repeated 5 months later and subtotal regression of theT2-hyperintensity had occurred. However, small bilateral infarcts were seen on T1-weighted images. Perfusion magnetic resonance imaging presented reduced blood volume and flow on the right side.
Discussion and evaluation:
The patient in this report had posterior reversible encephalopathy syndrome caused by hypertensive encephalopathy. Magnetic resonance imaging of the brain showed bilateral cytotoxic oedema that partially resolved and resulted in small infarcts. The imaging findings are compatible with posterior reversible encephalopathy syndrome with subtotal resolution and infarct evolution.
Conclusion:
The case report suggests that the presence of hypertensive encephalopathy and posterior reversible encephalopathy syndrome should alert clinicians and lead to prompt treatment in order to prevent cerebral damage.
Primary adenoid cystic carcinoma of the tracheobronchial tree: report of two cases
Authors: Ahmed Ben Saad, Rania Kadoussi, Manel Njima, Saousen Cheikh Mhamed, Nesrine Fahem, Nouha Ben Abdeljelil, Samah Joobeur, Naceur Rouatbi
Journal: Pan Afr Med J (2019)
Keywords: adenoid cystic carcinoma, bronchogenic carcinoma, lung cancer, salivary gland cancer
MeSH terms: Bronchial Neoplasms / diagnosis, Carcinoma, Adenoid Cystic / diagnosis, Tracheal Neoplasms / diagnosis, Case Reports, Bronchial Neoplasms / pathology, Bronchial Neoplasms / therapy, Carcinoma, Adenoid Cystic / pathology, Carcinoma, Adenoid Cystic / therapy, Female, Humans, Male, Middle Aged, Pneumonectomy, Tracheal Neoplasms / pathology, Tracheal Neoplasms / therapy

Adenoid cystic carcinoma (ACC) is a rare malignant epithelial tumor that predominantly originates in the salivary glands. Primary ACC of the tracheobronchial tree is extremely rare. We report two new cases of central airways primary ACC: a 58 year-old male with an ACC of the left main bronchus who underwent a pneumonectomy with node dissection, and a 52 year-old female with proximal tracheal ACC presenting as asthma treated by surgical resection and a postoperative radiotherapy. Primary ACC of the tracheobronchial tree is often misdiagnosed given the non-specific clinical presentation. An early diagnosis is essential to ensure good outcomes. An interdisciplinary treatment is required based especially on surgery and radiotherapy.
Case Report: Spontaneous Remission of an Infraorbital Follicular B-Cell Lymphoma: Case Report and Review of the Literature
Authors: Maxime Peeters, Joris Geusens, Fréderic Van der Cruyssen, Lucienne Michaux, Laurence de Leval, Thomas Tousseyn, Peter Vandenberghe, Constantinus Politis
Journal: Pathol Oncol Res (2021)
Keywords: case reports, cheek, follicular lymphoma, head and neck neoplasms, spontaneous remission
MeSH terms: Lymphoma, B-Cell / pathology, Lymphoma, B-Cell / surgery, Lymphoma, Follicular / pathology, Lymphoma, Follicular / surgery, Case Reports, Review, Humans, Male, Middle Aged, Prognosis, Remission, Spontaneous

Non-Hodgkin lymphomas comprise a heterogeneous group of malignancies, with a wide scope of clinical, radiological and histological presentations. In this paper, a case is presented of a 59-year-old white male with an infraorbital follicular B-cell lymphoma, which appeared as a painless mass in the left cheek. The lymphoma achieved spontaneous remission five and a half months after his diagnostic incision biopsy. The literature is reviewed, focusing on this rare site of presentation and spontaneous remission. In literature, only four cases have been reported with a follicular B-cell lymphoma of the cheek or infraorbital region, and only 26 cases of spontaneous remission of an extracranial non-Hodgkin lymphoma in the head and neck region have been described. To the authors' best knowledge, this is the first time spontaneous remission of an infraorbital follicular lymphoma could be observed. The nature of the processes inducing spontaneous remission remains obscure. It is important to recognize this phenomenon as this might prevent unnecessary treatment.
Resistance to Pembrolizumab and Axitinib in Renal Cell Carcinoma: Clinical and Genomic Evaluation
Authors: Panagiotis J Vlachostergios
Journal: J Kidney Cancer VHL (2020)
Keywords: angiogenesis, immunotherapy, molecular biomarker, mutation, renal cell carcinoma
MeSH terms: Case Reports

Clear cell renal cell carcinoma (ccRCC) represents the most common subtype of renal cell carcinoma (RCC). In spite of recent advances in the treatment armamentarium and outcomes with the combined use of immune checkpoint and angiogenesis inhibitors, prediction of responses and selection of patients remain a challenge. This is a case of ccRCC with recurrence to the liver 1 year following right radical nephrectomy, who rapidly progressed on frontline therapy with axitinib/pembrolizumab. The clinical course and targeted tumor sequencing findings are discussed. In addition to established clinical prognostication in RCC, several surrogate markers of efficacy or/and resistance have been proposed for immunotherapy or/and anti-angiogenic therapy. Since the majority of patients will still progress after these combinations, it is becoming increasingly important to develop robust predictive biomarkers to guide patient selection and sequencing of targeted therapies.
Acute Neurological Presentation in Children With SARS-CoV-2 Infection
Authors: Antonella Riva, Gianluca Piccolo, Federica Balletti, Maria Binelli, Noemi Brolatti, Alberto Verrotti, Elisabetta Amadori, Alberto Spalice, Thea Giacomini, Maria Margherita Mancardi, Paola Iannetti, Maria Stella Vari, Emanuela Piccotti, Pasquale Striano, Giacomo Brisca
Journal: Front Pediatr (2022)
Keywords: covid-19, sars-cov-2, acute, children, neurological symptoms

Background:
In the pediatric population, the knowledge of the acute presentation of SARS-CoV-2 infection is mainly limited to small series and case reports, particularly when dealing with neurological symptoms. We describe a large cohort of children with acute SARS-CoV-2 infection, focusing on the neurological manifestations and investigating correlations between disease severity and population demographics.
Methods:
Patients aged 0-18 years with a positive molecular swab were recruited between April 2020 and March 2021 from a tertiary Italian pediatric centre. Clinical data, imaging, and laboratory test results were retrieved from our local dataset and statistically analyzed.
Results:
A total of 237 patients with a median age of 3.2 years were eligible; thirty-two (13.5%) presented with neurological symptoms, including headache (65.6%), altered awareness (18.8%), ageusia/anosmia (12.5%), seizures (6.3%), and vertigo (6.3%), combined in 7 (21.9%) cases. Respiratory (59.5%) and gastrointestinal (25.3%) symptoms were the most common among the 205 (86.5%) patients without neurological involvement. Neurological symptoms did not significantly influence the severity of the triage access codes. Moreover, pre-existing medical conditions were not higher in the group with neurological manifestations. Overall, fifty-nine patients (25%, 14/59 with neurological symptoms) required treatment, being antibiotics, systemic steroids, and heparin those most prescribed.
Conclusion:
Our study supports the overall benign course of the SARS-CoV-2 infection in children. Neurological manifestations, except for headache, remain a rare presenting symptom, and disease severity seems unrelated to pre-existing medical conditions.
A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel's Thyroiditis
Authors: Jennifer Walsh, Tomas P Griffin, Carmel B Ryan, James Fitzgibbon, Patrick Sheahan, Matthew S Murphy
Journal: Case Rep Endocrinol (2015)

A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a "woody" hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel's thyroiditis (RT). Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel's thyroiditis). A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes.
Biodentine™ Partial Pulpotomy of a Young Permanent Molar with Signs and Symptoms Indicative of Irreversible Pulpitis and Periapical Lesion: A Case Report of a Five-Year Follow-Up
Authors: W Chinadet, T Sutharaphan, P Chompu-Inwai
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.