OpenMed/multicare-articles huggingface dataset:
An Unusual Case of Gullo's Syndrome Concomitant with Serious Endometriosis Disease in a Postmenopausal Woman
Authors: Abdelhakim Ainahi, Abdellaziz Ziane, Lahcen Wakrim, Naima Elmdaghri, Abdelhamid Barakat
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Gullo's syndrome is a singular physiological phenomenon defined by an abnormal increase in serum pancreatic enzyme levels that may occur in healthy subjects in the absence of pancreatic disorders. During routine health examination in a 54-year-old postmenopausal woman with severe endometriosis, elevated values of serum amylase and lipase were fortuitously observed (198 and 1461 U/L, resp.). Over five years of regular pancreas surveillance, all clinical, biological, and imaging investigations were normal. However, the pancreatic enzyme levels have shown considerable fluctuations including some episodic transient normalization. The description of this benign pancreatic hyperenzymemia case incidentally associated with endometriosis disease is a very rare clinical situation. More in-depth documentation of this phenomenon may help clinicians to avoid unnecessary diagnostic management approaches and reassure the concerned patients that this affection would not be so worrying.
A Patient with Milky Urine: Nonparasitic Chyluria and Silver Nitrate Sclerotherapy
Authors: M Sivashankar, A C N Nandasena
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Chyluria has become a rare clinical presentation in Sri Lanka, which may have a direct correlation with the low prevalence of lymphatic filariasis following the use of diethylcarbamazine and albendazole mass drug administration (MDA) for five rounds between 2002 and 2006. Here we report a 50-year-old male who presented with milky urine and progressive weight loss, diagnosed as having nonparasitic chyluria. The patient was initially managed with a trail of diethylcarbamazine (DEC) 6 mg/kg/day for 21 days and a low-fat diet with an unsatisfactory response. Subsequent management with endoscopic instillation of 0.5% silver nitrate brought in him a quick response, which was maintained for a year. Endoscopic sclerotherapy is considered a safer, effective and a minimally invasive treatment option for symptomatic patients.
Late Pancreatic Fistula After Pancreaticoduodenectomy: A Case Report and Review of the Literature
Authors: Numa P Perez Jr, David G Forcione, Cristina R Ferrone
Journal: Case Rep Pancreat Cancer (2016)
Keywords: ampullary adenocarcinoma, pancreatic fistula, pancreaticojejunostomy stricture
MeSH terms: Case Reports

Background: More than 100 years after its conception, the pancreaticoduodenectomy (PD) remains a challenging procedure with significant morbidity, often due to a postoperative pancreatic fistula (POPF). Factors related to patient physiology, tumor anatomy/pathology, and surgeon/surgical technique have been studied, yielding results at times conflicting and difficult to reproduce. We present a case of a late POPF along with a brief review of the current literature. Case Presentation: The patient is a 55-year-old female with a 20 pack-year smoking history and no history of alcohol abuse, who presented for evaluation of new nausea. Her laboratory tests and computed tomography (CT) imaging were suggestive of biliary obstruction. She was found to have an invasive ampullary adenocarcinoma and subsequently underwent a classic PD. She developed a POPF, managed through a closed suction drain placed intraoperatively. Her course was complicated by the development of an intra-abdominal abscess, managed percutaneously through CT-guided placement of two drains, subsequently removed without issues. She recovered uneventfully until 8 months after the operation, when she presented with abdominal pain and pancreatitis. She was found to have an intra-abdominal collection, again managed percutaneously via CT-guided drainage. This time, the amylase and lipase levels of the drainage fluid were 21,860 and 86,650 U/L, respectively, and cultures were sterile. Upon workup of her pancreatic fistula, a severe stricture at the pancreaticojejunostomy (PJ) was identified. She underwent endoscopic placement of a Hobbs stent by the GI service. Conclusion: Although commonly diagnosed in the days to weeks after a PD, we present a case of a POPF that manifested 8 months after the initial operation in association with a PJ stricture. This case highlights the importance of considering the diagnosis even months after the operation in a patient who presents with symptoms of pancreatitis and/or imaging findings consistent with an intra-abdominal collection.
Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management
Authors: Keiko Mekaru, Sugiko Oishi, Kozue Akamine, Chiaki Heshiki, Yoichi Aoki
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16-22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment.
Induced Myopia Secondary to Blunt Trauma
Authors: Mohammad Reza Sedaghat, Hamed Momeni-Moghaddam, Shehzad A Naroo, Mohammad Etezad-Razavi, Majid Moshirfar
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

A 28-year-old young man presented with sudden and severe visual loss in the left eye, starting three days ago following blunt head trauma from a closed fist. Vision was not improved to better than 0.4 in the left eye. Slit lamp examinations revealed asymmetric anterior chamber depth (ACD) with shallow ACD in the left eye. The key learning in this report is the use of anterior segment optical coherence tomography (AS-OCT) to better document the anterior segment changes following the blunt trauma. AS-OCT was used to visualize the forward displacement of the iris-crystalline lens diaphragm secondary to ciliary body anterior rotation and ciliochoroidal effusion. There was a temporary myopic shift about 7.00 D which resolved after 15 days.
Nivolumab plus ipilimumab induced endocrinopathy and acute interstitial nephritis in metastatic sarcomatoid renal-cell carcinoma: A case report and review of literature
Authors: Christopher Hino, Kevin Nishino, Bryan Pham, Won Jin Jeon, Michael Nguyen, Huynh Cao
Journal: Front Immunol (2022)
Keywords: sarcomatoid renal cell carcinoma (srcc), acute interstitial nephritis (ain), adrenal insufficiency, hypothyroidism, diabetes mellitus, immune related adverse events, ipilimumab (pubchem sid
MeSH terms: Carcinoma, Renal Cell, Kidney Neoplasms, Nephritis, Interstitial / chemically induced, Nephritis, Interstitial / diagnosis, Case Reports, Review, Antineoplastic Combined Chemotherapy Protocols / adverse effects, Humans, Ipilimumab / adverse effects, Male, Middle Aged, Nivolumab / therapeutic use, Ipilimumab, Nivolumab, Acute Tubulointerstitial Nephritis

The prognosis of sarcomatoid renal cell carcinoma has changed dramatically with the emergence of immune checkpoint inhibitors. Notably the use of nivolumab and ipilimumab combination therapy has demonstrated promising durable therapeutic response for patients with treatment-naïve sarcomatoid renal-cell carcinoma. We present a case of 45-year-old man with a history of metastatic sarcomatoid renal cell carcinoma treated with nivolumab plus ipilimumab who developed type 1 diabetes mellitus, adrenal insufficiency, thyroiditis/hypothyroidism, and acute interstitial nephritis as a result of immunotherapy.
Challenges of Surgical Treatment of Atypical Giant Choledochal Cyst with the Absence of Gallbladder in Adult Patient
Authors: Ismar Rasic, Nermin Mahmutovic, Samir Custovic, Nedim Hasic, Ali Gavrankapetanovic, Edin Beciragic, Sanela Brzika
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Choledochal cysts (CCs) are rare congenital anomalies in the form of cystic dilatation of any part of the biliary tree, and they rarely reach the size over 10 cm. We present a case of a 51-year-old female with a one-year history of abdominal pain and palpable mass in the epigastrium and right upper abdomen. Diagnosis of giant CC was made using magnetic resonance cholangiopancreatography. Intraoperatively, a large CC without gallbladder (no previous cholecystectomy was performed) was found under the liver pushing the surrounding structures, extending into the intrapancreatic portion of bile ducts and leading to the destruction of the backside of the pancreas head. Complete excision of CC and biliopancreatic reconstruction was achieved by Roux-en-Y pancreaticojejunostomy and hepaticojejunostomy. This case report describes an extremely rare association between an atypical giant choledochal cyst and gallbladder agenesis.
Case report: A rare case of neutropenia caused by pembrolizumab in squamous lung cancer and literature review
Authors: Qiaoyun Tan, Lichao Liu, Yu Huang, Xiaorong Dong, Lingjuan Chen
Journal: Front Oncol (2022)
Keywords: adverse effect, infection, lung cancer, neutropenia, pembrolizumab
MeSH terms: Case Reports

Background:
Immune checkpoint inhibitors, including anti-PD-1 therapies, have prolonged overall survival in patients with a variety of cancers, and immunotherapy is sometimes associated with immune-related adverse events (irAEs); however, hematological toxicity, especially neutropenia, is rare.
Case presentation:
A 78-year-old man with squamous lung cancer, with brain metastasis, was treated with pembrolizumab and albumin-bound paclitaxel as first-line treatment for one cycle and changed to pembrolizumab plus anlotinib at the second cycle. After two therapy cycles, grade 4 neutropenia developed, which mainly contributed to irAEs. The patient was started on granulocyte colony-stimulating factor (G-CSF) but did not improve; he was then treated with corticosteroids, and neutrophil counts gradually returned to normal levels. However, the patient eventually died because of neurological problems.
Conclusion:
Grade 4 neutropenia associated with ICI, although rare, is often severe and presents with infectious complications; it needs to be diagnosed early, and clinicians should ensure prompt and proper management to such patients.
Acupuncture treatment for bortezomib-induced peripheral neuropathy: a case report
Authors: Ting Bao, Ruixin Zhang, Ashraf Badros, Lixing Lao
Journal: Pain Res Treat (2011)
MeSH terms: Case Reports

Peripheral neuropathy is a common and severe dose-limiting side effect of the chemotherapy agent, bortezomib, in multiple myeloma patients. Treatment with narcotics, antidepressants, and anticonvulsants has limited response and potential significant side effects. Acupuncture has been reported to be effective in treating diabetic neuropathy and chemo-induced peripheral neuropathy. There has not been report on the effect of acupuncture in treating bortezomib-induced peripheral neuropathy specifically. Here, we report a successful case of using acupuncture to relieve bortezomib-induced peripheral neuropathy symptoms.
Metastatic Recurrence of Typical Pulmonary Carcinoid Accompanied by Carcinoid Syndrome, Successfully Treated with Octreotide LAR
Authors: Asako Yanagisawa, Satoshi Hirano, Shinichiro Shimizu, Takuma Hiroishi, Kohei Shikano, Noriko Hayama, Tetsuo Fujita, Hiroyuki Amano, Makoto Nakamura, Sukeyuki Nakamura, Hiroshi Tabeta
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

We present a case of metastatic recurrence of carcinoid tumor accompanied by carcinoid syndrome in a 68-year-old Japanese man, 12 years after resection of typical pulmonary carcinoid. Histopathologic examination from percutaneous liver biopsy revealed metastatic typical carcinoid. Clinical symptoms gradually improved after administration of octreotide LAR. Two years after starting treatment, the disease remains well controlled. This case report illustrates the possibility of antiproliferative effects of octreotide LAR on typical pulmonary carcinoid.
Complaint of Testicular Discomfort in Patient with Esophageal Adenocarcinoma
Authors: Kevin Krughoff, Alan Schned, Bing Ren, Vernon M Pais Jr
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

We report a case of esophageal cancer with solitary metastasis to the testicle in a 71-year-old man. The tumor was picked up on physical exam following new onset complaints of pain and swelling. While most testicular masses in older men are due to lymphoma, this case highlights the need to consider metastatic disease as a source of new symptoms in patients with a recent cancer diagnosis.
Primary squamous cell carcinoma of the urinary bladder presenting as an inguinal mass
Authors: Zahra Qaiyumi, Pankaj Nepal, Christopher Iannuzzi, Joshua Sapire
Journal: SA J Radiol (2021)
Keywords: ct, pet-ct, imaging, squamous cell carcinoma, urinary bladder hernia
MeSH terms: Case Reports

This report involves a rare case of a 74-year-old man who presented with a progressively increasing swelling in the right groin, which represented a squamous cell bladder carcinoma herniating into the right inguinal canal. The manuscript discusses the role of multimodality imaging in bladder carcinoma presenting as an inguinoscrotal hernia. The patient subsequently underwent treatment with a chemotherapy regimen consisting of 5-fluorouracil and mitomycin, which was extrapolated from squamous cell carcinoma of the anal canal, and responded well.
Therapy-Induced Growth and Sexual Maturation in a Developmentally Infantile Adult Patient with a PROP1 Mutation
Authors: Ludmila Brunerova, Ivana Cermakova, Bozena Kalvachova, Jana Skrenkova, Renata Poncova, Petr Sedlak
Journal: Front Endocrinol (Lausanne) (2017)
Keywords: prop1 mutation, growth, growth hormone therapy, hormonal substitution therapy, sexual maturation
MeSH terms: Case Reports

Background:
Hypopituitarism as a result of PROP1 (prophet of PIT1) mutation represents the most common genetic cause of combined deficiency of pituitary hormones and due to growth retardation it is typically diagnosed in childhood.
Case description:
We present a unique case report of a prepubertal woman with growth retardation in whom combined pituitary hormone deficiency [central hypopituitarism, hypogonadism, and growth hormone (GH) deficiency] caused by homozygous mutation c.150delA in the PROP1 gene was diagnosed late in young adulthood due to unfavorable life circumstances. Through cautiously combined GH therapy and sex hormone therapy, she has achieved better than expected height (exceeding predictions based on family height) and sexual maturation, including regular menstrual cycles.
Conclusion:
Early diagnosis of panhypopituitarism due to PROP1 mutation is essential for successful treatment; however, our case report shows that carefully titrated GH treatment and sex hormone substitution, although initiated in adulthood, enable restoration of physiological growth and sexual development in a hormonally infantile adult woman with a PROP1 mutation.
Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma
Authors: Camila V Ventura, Audina M Berrocal, Jennifer Thomson, Fiona J Ehlies, Azeema Latiff, Timothy G Murray
Journal: Int J Retina Vitreous (2017)
Keywords: intra-arterial chemotherapy, retinoblastoma, rhegmatogenous detachment
MeSH terms: Case Reports

Background:
Retinoblastoma is considered the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Management of retinoblastoma has evolved over the past two decades and intra-ophthalmic artery chemotherapy has emerged as a new modality of globe-conserving treatment with excellent results. This treatment achieves effective tumor reduction by delivering localized chemotherapy, decreases enucleation rate, and minimizes systemic and local side effects.
Case presentation:
We report the case of an 8-year-old girl with a late presentation of an advanced unilateral retinoblastoma associated to diffuse exudative retinal detachment in the right eye, classified as group E by the International Classification of Retinoblastoma. The initial therapeutic proposal for the patient was five sessions of intra-ophthalmic artery chemotherapy (IAC) associated to large spot diode laser therapy. After undergoing four sessions of IAC, the fundus exam revealed a giant retinal tear associated to a total retinal detachment in the affected eye. The IAC treatment was concluded and enucleation was considered the best treatment option at that moment, since IAC was unable to control the tumor's activity and the patient's eye presented with a complex rhegmatogenous retinal detachment (RRD). However, family left for a second opinion and never returned.
Conclusions:
The usage of IAC for retinoblastoma management may lead to important local complications. Despite rare, RRD secondary to IAC may occur. We postulate that the giant tear observed in this case was caused by the rapid tumor necrosis using this route of treatment.
Inguinal bladder hernia: A case report and literature review
Authors: Adel Elkbuli, Raed Ismail Narvel, Mark McKenney, Dessy Boneva
Journal: Int J Surg Case Rep (2019)
Keywords: bladder hernia, inguinal hernia, urinary bladder, urinary leakage

Introduction:
Cases of inguinal bladder hernia are rare, with bladder involvement seen in 1-4% of inguinal hernias. The majority of cases are diagnosed intraoperatively, with only 7% of bladder hernias identified prior to surgery. Diagnosis may be challenging as patients are often asymptomatic or have nonspecific symptoms. Surgical repair is currently the standard treatment, and careful surgical planning is necessary to avoid complications including bladder injury.
Presentation of case:
A 58-year-old man presented to our Emergency Department with 2-day history of progressively worsening left lower quadrant pain, groin bulge, and dysuria. Physical exam revealed an irreducible left inguinal hernia associated with urinary urgency on attempted reduction. Plain CT was ordered and demonstrated inguinal hernia with bladder protrusion into the left scrotum. The patient underwent open surgical reduction and hernia repair and made a quick postoperative recovery without complications.
Discussion:
Inguinal bladder hernia most often presents in older, obese males and clinicians should have a high index of suspicion when assessing patients with inguinal hernia. Preoperative diagnosis based on history, physical, and radiologic imaging allow for careful surgical planning and prevention of severe complications including bladder injury and leakage.
Conclusion:
We present a case report of inguinal bladder hernia in a middle-aged man that presented as left lower quadrant pain, groin pain, and dysuria. Diagnosis was confirmed preoperatively with radiographic imaging. The hernia was surgically reduced and the defect repaired without complications.
A Case Report of Acute Necrotizing Pancreatitis after COVID-19 Infection
Authors: Amir Mohammad Salehi, Hossain Salehi, Maryam Hasanzarrini, Ensiyeh Jenabi, Aida Alizamir
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Coronavirus 2019 (COVID-19), which is associated with many systemic inflammatory reactions and high morbidity and mortality rates, became a serious public health problem and led to a rapid epidemic. Fever, dry cough, and shortness of breath are the most common symptoms of COVID-19. In addition to respiratory symptoms, gastrointestinal manifestations of COVID-19 are increasingly known to progress more rapidly than other symptoms and can occur in cases of mild infection or even after remission of the viral infection. Acute pancreatitis (AP) caused by COVID-19 is one of the rare gastrointestinal symptoms which is an acute inflammatory disease of the pancreas that is associated with high complications. Here, we report acute COVID-19-induced pancreatitis in a 38-year-old man who died.
Periodontal Management of Cyclosporin A-Induced Gingival Overgrowth: A Nonsurgical Approach
Authors: Rayhana Malek, Bouchra El Houari, Jamila Kissa
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Gingival overgrowth is a major and frequent unwanted effect accompanying the chronic usage of antihypertensive, anticonvulsant, and immunosuppressant drugs. The expression and the severity of this tissue-specific condition are influenced by a variety of factors, mainly drug and periodontal variables. Such increased volume of gingiva may compromise normal oral functions, aesthetics in addition to the patients' ability to practice optimal oral hygiene. The management of gingival overgrowth includes nonsurgical approach, surgical approach, or both of them for severe cases of gingival overgrowth as well as drug withdrawal. This case report illustrates a successful nonsurgical management of a 21-year-old patient with cyclosporin A-induced gingival overgrowth who experienced a total regression of the gingival enlargement without any surgical procedure or drug substitution. And it highlights therefore the key role of supportive periodontal therapy in maintaining good and stable outcomes over 2 years of follow-up.
ANCA vasculitis presenting with acute interstitial nephritis without glomerular involvement
Authors: Callie Plafkin, Weixiong Zhong, Tripti Singh
Journal: Clin Nephrol Case Stud (2019)
Keywords: anca-associated vasculitis, mpo-anca, interstitial nephritis
MeSH terms: Case Reports

ANCA-associated vasculitis (AAV) with renal involvement typically causes pauci-immune glomerulonephritis. We present a case of acute interstitial nephritis (AIN) as the sole renal lesion without glomerulonephritis with myeloperoxidase (MPO) AAV. A 45-year-old female with history of Crohn's disease, gastroesophageal reflux disease (GERD) with Barrett's esophagus, pulmonary embolism, and polyarthralgias was evaluated in nephrology clinic in 2018. AIN without glomerulonephritis was first diagnosed in 2011 on renal biopsy. p-ANCA was positive with MPO titer of > 100 U/mL. Serum creatinine improved from 2.1 to 0.9 mg/dL with prednisone and azathioprine. Repeat biopsy in 2013 for worsening renal function showed AIN without glomerular involvement. Serum creatinine improved from 1.9 to 1.2 mg/dL with prednisone and cyclosporine. Crohn's disease was diagnosed in 2014. AIN was attributed to Crohn's, and cyclosporine was stopped in 2016. Adalimumab was started in 2016, without improvement in renal function or urine sediment. Attempt was made to switch proton pump inhibitor (PPI) to H2-blocker, but the latter was not tolerated. Repeat biopsy in 2/2018 showed AIN with severe fibrosis and tubular atrophy and glomerulosclerosis but no active glomerular disease. MPO titers remained high at 132 U/mL. Mycophenolic acid and prednisone were started without response, followed by rituximab for AAV-associated AIN. Serum creatinine worsened to 6.0 mg/dL in 9/2018, with plan to start peritoneal dialysis. AAV may present with isolated AIN without glomerular involvement. The rarity of this presentation may contribute to delay in appropriate management. Alternative explanations for AIN, such as Crohn's disease or PPI use should be considered with caution in the setting of high-titer ANCA positivity.