OpenMed/multicare-articles huggingface dataset:
Dyspnea as the First Manifestation of Silent Renal Cell Carcinoma
Authors: Atieh Khorsand-Rahimzadeh, Fatemeh Khatami, Salma Sefidbakht, Hiva Saffar, Seyed Mohammad Tavangar
Journal: Iran J Pathol (2019)
Keywords: clear cell renal cell carcinoma, dyspnea, neoplasm metastasis, pleura
MeSH terms: Case Reports

Renal cell carcinoma (RCC) accounts for only 3% of adult malignancies, and the lung is the most common site of metastasis of this tumor, which may be accompanied by pleural metastasis. However, solitary pleural involvement is very rare and its presentation with dyspnea as the first manifestation of RCC is extremely rare. We describe a 39-year-old male with episodes of dyspnea dating back 6 months prior to hospital admission. During paraclinical investigations, chest computed tomography (CT) demonstrated pleural effusion and multiple pulmonary nodules, raising the question of primary mesothelioma or metastasis from distant focus. Histopathology and immuno- histochemical examinations of pleural biopsy provided evidence of metastatic RCC of the clear cell type. Therefore, an abdominal contrast computed tomography (CT) was performed, revealing a 3 cm right renal mass, which was then removed by partial nephrectomy. Physicians and pathologists should be aware of unusual presentations of RCC with no symptoms attributable to the kidneys, including dyspnea as in our case.
Contrast-enhanced ultrasound of pancreatic melanoma: A case report and literature review
Authors: Zhiqiang Yuan, Hualin Yan, Wenwu Ling, Yan Luo
Journal: Front Oncol (2022)
Keywords: case report, contrast-enhanced ultrasound, enhancement, pancreatic carcinoma, pancreatic ductal adenocarcinoma, pancreatic melanoma
MeSH terms: Case Reports

Melanoma is a malignant tumor that originates from melanocytes, most of which are of cutaneous origin. Most melanomas identified in the pancreas are metastatic, and primary pancreatic melanoma is extremely rare and has rarely been discussed. The correct preoperative diagnosis of pancreatic metastatic melanoma, especially primary melanoma, is challenging. Herein, we report a 43-year-old man who presented to our hospital due to unexplained left abdominal distension and pain. Abdominal ultrasound examination demonstrated multiple space-occupying lesions of the pancreas, and hypoechoic masses partially filled the splenic vein behind the pancreatic body. In the contrast-enhanced ultrasound (CEUS), all of these lesions showed iso-enhancement to slight hypo-enhancement in the arterial phase and hypo-enhancement in the venous phase. Masses in the splenic vein also showed hypo-enhancement. Imaging features suggested that the pancreatic lesions were malignant tumors. The tumor markers carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 19-9 were within normal limits. Based on clinical symptoms, imaging findings and incidence of pancreatic tumors, the patient's clinical diagnosis was pancreatic carcinoma. Surgery was performed for the patient, while postoperative pathology confirmed malignant melanoma of the pancreas. Therefore, it is significant to identify the clinical and imaging manifestations of pancreatic melanoma in order to better manage the disease. Herein, we reported this case and reviewed the literature from 2000 to 2021 on the clinical and imaging features of 26 patients with pancreatic melanoma. It may improve clinicians' awareness of the clinical and imaging performance of pancreatic melanoma, resulting in improved diagnosis, differential diagnosis, treatment, and outcomes.
Procedures Used in Managing SARS-CoV-2 Infected Dental Personnel or Patients: A Case Study From a Thai Dental Hospital
Authors: Pisha Pittayapat, Ruchanee Ampornaramveth, Chongpean Jirachoksopon, Kanchana Suvarnbriksha, Siripun Kattapong, Theerabhorn Pethprasert, Kajorn Kungsadalpipob, Soranun Chantarangsu, Panida Thanyasrisung, Natthavoot Koottathape, Suphot Tamsailom, Pairoj Linsuwanont, Kasekarn Kasevayuth, Rangsima Sakoolnamarka, Thanaphum Osathanon, Pornchai Jansisyanont
Journal: Front Oral Health (2021)
Keywords: covid-19, sars-cov-2, dental practice, infection, procedure
MeSH terms: Review

SARS-CoV-2 can transmit undetected from asymptomatic and pre-symptomatic patients in dental clinics. Triaging dental patients using temperature and questionnaire screening cannot completely exclude asymptomatic SARS-CoV-2 infected individuals. Hence, asymptomatic SARS-CoV-2 infected individuals might visit dental hospitals/clinics seeking dental treatment without knowing that they are infected and might infect others, especially in a pandemic area. Ideally, a nasopharyngeal swab for real-time polymerase chain reaction or rapid antigen screening for dental personnel and patients prior to their appointment should be done. However, the implementation of this approach is impractical in some situations. Here, we describe the procedures for dental hospitals/clinics in case of an asymptomatic SARS-CoV-2 infected individual involved in dental service/treatment and later after testing positive for SARS-CoV-2. Potential closely contacted individuals were traced and classified according to their exposure risk. The recommended course of action is to identify individuals based on their risk and take the risk-appropriate action. We also discuss the implementation of these procedures in a dental setting during the COVID-19 pandemic in our school as a case study.
Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
Authors: Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after the initial injury demonstrated an acute infarct in the right middle cerebral artery (MCA) territory. Thus, despite initial negative imaging, neurological deficits must be aggressively pursued in order to prevent stroke in BCVI cases.
Anaphylactic response to topical fluorescein 2% eye drops: a case report
Authors: Humma Shahid, John F Salmon
Journal: J Med Case Rep (2010)

Introduction:
The intravenous use of fluorescein 10% during retinal angiography can cause severe systemic reactions including, on rare occasions, anaphylaxis. Fluorescein 2% eye drops are used extensively for clinical examination and diagnosis, but to the best of our knowledge, they have only been reported as being responsible for a systemic anaphylactic response on two previous occasions.
Case presentation:
We report the case of a 51-year-old woman who developed an anaphylactic reaction when she was administered fluorescein sodium 2% eye drops after cataract surgery. This was the second time she had been exposed to fluorescein. She had brittle asthma and a history of anaphylaxis following exposure to a variety of drug and food allergens. She was successfully resuscitated and recovered completely over a period of two days.
Conclusions:
Fluorescein 2% drops are universally used in general practice, ophthalmology, optometry, and casualty departments. Our case report reveals the potential for this benign eye drop to cause a life-threatening systemic reaction and emphasises the importance of considering this consequence when administering topical fluorescein 2% to a patient with a history of anaphylaxis to other allergens.
Pancreatic Tuberculosis with Vascular Involvement and Peritoneal Dissemination in a Young Man
Authors: Meng Zhu, Ning Zhang, Wei Tao, Zhitao Wang, Shuixiang He
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Pancreatic tuberculosis (TB) is an extremely rare form of extrapulmonary tuberculosis even in endemic areas that masquerades as a mass or inflammation because of lack of typical clinical manifestations and radiologic features and therefore usually misdiagnosed as a pancreatic malignancy or pancreatitis. Here we present a 23-year-old young man with pancreatic tuberculosis mimicking pancreatic head carcinoma A man who suffered from upper abdominal pain and nausea for half a month was admitted to our hospital. Narrow band imaging (NBI) and gastroscopic imaging, together with endoscopic ultrasonography (EUS), revealed a duodenal bulb mucous prominences lesion. Computed tomography (CT) and magnetic resonance imaging (MRI) both suggested a pancreatic mass which resembled a pancreatic head tumor that had a higher risk of malignancy. The patient therefore accepted an exploratory laparotomy and pancreatoduodenectomy, Whipple operation. Biopsies of pancreas, duodenum, lymph nodes, omentum, and adipose tissues were all performed, revealing tuberculosis infection in pancreas, hepatic portal vein infiltration, and peritoneal dissemination. The patient was treated successfully after operation and recovered with standard anti-TB drugs for 6 months. Timely reporting of this rare case can help physicians improve their ability to identify several specific illnesses and diseases that share confusing signs or symptoms clinically and radiographically.
Severe Murine Typhus Presenting with Acalculous Cholecystitis: A Case Report and Literature Review
Authors: Nikolaos Spernovasilis, Constantinos Tsioutis, Maria Zafeiri, Georgios Hamilos, Achilleas Gikas
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

A 54-year-old otherwise healthy male, who was being evaluated for prolonged fever, developed clinical and ultrasonographic signs compatible with acute acalculous cholecystitis. Diagnosis of murine typhus was confirmed by serology and the patient was treated with doxycycline. He improved rapidly and all clinical and laboratory abnormalities returned to normal. The present case dictates that knowledge of the local epidemiology and keeping a high index of clinical suspicion can help recognize uncommon manifestations of murine typhus, in order to treat appropriately and avoid unnecessary investigations and interventions.
Case report: Persistent Müllerian duct syndrome and enlarged prostatic utricle in a male dog
Authors: Peter J Welsh, Kaylyn McDaniel, Elizabeth W Goldsmith, Joshua D Ramsay, Alan Conley, Tina Jo Owen, Yoko M Ambrosini, Michela Ciccarelli
Journal: Front Vet Sci (2023)
Keywords: disorder of sex development, hematuria, prostatic utricle, urometra, uterus masculinus
MeSH terms: Case Reports

A 1-year-old male intact Miniature Schnauzer mix was presented for chronic intermittent hematuria. Abdominal ultrasonography revealed a large, fluid-filled cystic structure extending cranially and dorsally to the prostate. Computed tomography scan images revealed that the fluid-filled cavity resembled a uterus, with both horns entering the scrotum through the inguinal canal adjacent to the testes. On cytogenetic analysis, the dog was found to have a homozygote mutation on AMHRII consistent with persistent Müllerian duct syndrome (PMDS). A gonadohysterectomy was performed, and surgical and histologic findings confirmed the presence of a uterus, oviducts, vagina, and testes in this dog. Additionally, an intraoperative fluoroscopy exam revealed a communication between the uterus and the bladder via an enlarged utricle, explaining the hematuria and urine in the reproductive tract (urometra). To our knowledge, this is the first clinical report of a phenotypically intact male dog with PMDS and urometra due to an enlarged prostatic utricle. This case illustrates a combination of a disorder of sex and urogenital sinus development.
Management of 'double eyelid ectropion' using 5% hypertonic saline in an Indian newborn
Authors: Priti Bhoutekar, Dilip Kumre, Bhushan Uplanchiwar
Journal: GMS Ophthalmol Cases (2020)
Keywords: 5% hypertonic saline, indian newborn, congenital ectropion, conservative management, double congenital ectropion
MeSH terms: Case Reports

Objective: This report describes a clinically rare case of congenital ectropion involving both upper lids in a one-day-old Indian newborn. We emphasize the importance of non-invasive conservative management with 5% hypertonic saline. Method: Observational case report Result: A term newborn presented to us on day 1 with bilateral upper lid ectropion or 'double congenital ectropion' noted since birth following an uneventful vaginal delivery. Examination revealed severe chemosis and prolapse of upper palpebral conjunctiva bilaterally. The repeated attempts to manually revert the eyelids in position failed. Otherwise, the eyes were normal. We started to treat the baby with topical hypertonic saline (5% sodium chloride), topical antibiotic, and topical lubricant frequently. Eye pads soaked in 5% hypertonic saline were also used. Following five days of treatment, the chemosis and ectropion resolved completely without recurrence. Conclusion: We advocate non-invasive conservative management with 5% hypertonic saline soaked pads over the eyes along with topical antibiotic and lubricants. It should be the first line of treatment in all cases of congenital ectropion, before jumping to any aggressive invasive treatment like tarsorrhaphy, skin grafting etc., or unnecessary referral.
The Association of Renal Agenesis and Ipsilateral Seminal Vesicle Cyst: Zinner Syndrome Case Report
Authors: Mishal AlArifi, Magdi Al-Gahwary, Mohamed Gomha
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Introduction:
Zinner syndrome is a rare congenital malformation characterized by the association of an ipsilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. This case is one of the first to be reported in the Kingdom of Saudi Arabia.
Case presentation:
A 20-year-old Saudi male patient presented complaining of chronic left groin pain radiating to the left testis and the medial aspect of the left thigh for the last 6 years. Patient is also complaining of painful ejaculation with no history of lower urinary tract symptoms, hematuria, or trauma. Physical examination was unremarkable. Ultrasound (US) report from the referring hospital mentioned that there is a left pelvic mass. Computed tomography (CT) and magnetic resonance imaging (MRI) showed diffuse distension of left seminal vesicle (9 X 7 cm) cyst with ipsilateral left renal agenesis which corresponds to Zinner syndrome. Left seminal vesicle cyst excision through a low midline incision was done. The patient was asymptomatic during his follow-up in our clinic with disappearance of the pain.
Conclusion:
The combination of a good clinical history and radiological assays aided in making the diagnosis. Surgical intervention is the mainstay in the management plan in symptomatic patients.
Candida glabrata: A Unique Cause of Necrotizing Urethritis
Authors: Christine Ibilibor, James T Cammack
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Necrotizing urethritis is a rare malady with only one other case reported in the literature found to be due to an infectious cause. We report a case of necrotizing urethritis caused by Candida glabrata and review all relevant literature to date. The patient is a 56-year-old man with a past medical history significant for poorly controlled insulin-dependent type 2 diabetes mellitus and incomplete bladder emptying who presented to the University Medical Center with perineal pain, fever, and urinary retention. Cross-sectional imaging showed emphysematous changes in the bulb of the corpus spongiosum. After admission, his fever and leukocytosis persisted, and his physical exam worsened with intravenous antibiotics alone. Subsequently, the patient underwent cystourethroscopy with incision and debridement of the corpus spongiosum. Postoperatively, he improved clinically and his spongiosum wound and urine grew Candida glabrata. To our knowledge, we report the first case of necrotizing urethritis caused by Candida glabrata.
Life-threatening hemoperitoneum secondary to rupture of a uterine leiomyoma: A case report and review of the literature
Authors: Adel Elkbuli, Saamia Shaikh, Mark McKenney, Dessy Boneva
Journal: Int J Surg Case Rep (2019)
Keywords: fibroids, hemoperitoneum, massive transfusion protocol, uterine leiomyoma

Introduction:
While uterine leiomyomas are the most common pelvic tumors in females, resultant hemoperitoneum is an extremely rare and acute complication which requires emergent intervention and resuscitation. To date, less than one-hundred cases have been reported in the literature.
Presentation of case:
We report a case of massive hemoperitoneum due to spontaneous rupture of a 20 cm pedunculated leiomyoma in a 74-year-old female who presented as a trauma alert. Rapidly declining hemodynamic status with an ultrasound consistent with extensive hemoperitoneum led to activation of the massive transfusion protocol and an emergent laparotomy. In the operating theater the laparotomy revealed 4 L of blood. She underwent a myomectomy and subsequently, an angiogram and embolization of a bleeding uterine artery. In all, she required transfusion of 26 units of blood. Post operatively she was discharged home on hospital day 13.
Discussion:
Near fatal hemoperitoneum secondary to a uterine leiomyoma may be due to traumatic or spontaneous rupture of an overlying vein or artery. Leiomyomas greater than 10 cm in size have an increased risk of rupturing. A significant amount of blood can accumulate in the peritoneum resulting in hypovolemic shock.
Conclusion:
Acute complications of uterine leiomyomas requiring surgical intervention are exceptionally rare. Candidates for the massive transfusion protocol must be appropriately and timely identified. Additionally, because surgery is a potential treatment for hemorrhage control in leiomyoma-related hemoperitoneum, surgeons should be aware of such complications.
Metastatic Spreading of Community Acquired Staphylococcus aureus Bacteraemia
Authors: Giovanna Fabio, Maria Carrabba, Luca Mellace, Cinzia Hu, Diego Spagnoli, Maria Domenica Cappellini
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

A 29-year-old woman presented to the Fondazione IRCCS "Cà Granda" Ospedale Maggiore, a tertiary care university hospital in Milan (Italy), with skin lesions, fever, myalgia, joint pain and swelling, and a one-week history of low back pain. The diagnosis was Staphylococcus aureus (S. aureus) bacteraemia spreading to skin, bones, and joints and a lumbosacral epidural abscess L5-S2. Neither initial focus nor predisposing conditions were apparent. The antibiotic therapy was prolonged for six-weeks with the resolution of fever, skin lesions, articular inflammation, and the epidural abscess. Community-acquired S. aureus infections can affect patients without traditional healthcare-associated risk factors, and community acquisition is a risk-factor for the development of complications. Raised awareness of S. aureus bacteraemia, also in patients without healthcare-associated risk factors, is important in the diagnosis, management, and control of this infection, because failure to recognise patients with serious infection and lack of understanding of empirical antimicrobial selection are associated with a high mortality rate in otherwise healthy people.
Limbal Squamous Cell Carcinoma in a Black Baldy Cow: Case Report and Surgical Treatment
Authors: Alexandra T J Ng, Richard J McMullen Jr, Gillian C Shaw, Thomas Passler, Jenna Stockler
Journal: Case Rep Vet Med (2023)
MeSH terms: Case Reports

Objective:
To document a case of limbal squamous cell carcinoma (SCC) in an adult Black Baldy cow treated with photodynamic therapy (PDT) as an adjunctive therapy following surgical excision. Animals Studied. One privately owned 8-year-old female, entire, Black Baldy cow. Procedures. A complete ophthalmic examination was performed on an adult Black Baldy cow for assessment of a mass affecting the left eye. Following a routine partial incision superficial lamellar keratectomy and conjunctivectomy under local analgesia using a Peterson retrobulbar block, photodynamic therapy was performed as an adjunctive treatment to lower the chance for recurrence and improve the prognosis for the globe.
Results:
Histopathologic analysis of the limbal mass was reported to be consistent with a squamous cell carcinoma, removed with clean margins. The patient was comfortable and visual with no signs of tumor recurrence 11 months after surgery.
Conclusion:
Superficial lamellar keratectomy and conjunctivectomy with adjunctive photodynamic therapy is an effective treatment for limbal squamous cell carcinoma and may be performed as an alternative to enucleation, exenteration, euthanasia, or slaughtering in cattle.
Durable Response to Immunotherapy With Antiangiogenic Drug in Large-Cell Lung Carcinoma With Multiple Fulminant Postoperative Metastases: A Case Report
Authors: Zhilin Luo, Hong Zhang, Yajie Xiao, Rui Wang, Liping Zhang, Chenglu Huang, Yu Cao, Chao Sun, Yongtian Zhao, Hanqing Lin, Dongfang Wu, Tianhu Wang
Journal: Front Oncol (2021)
Keywords: antiangiogenic drugs, immunotherapy, large-cell lung carcinoma, loss of heterozygosity at hla, multiple postoperative metastases
MeSH terms: Case Reports

Immunotherapy alone or chemo-immunotherapy has recently been recommended for treating advanced lung carcinoma in patients without driver mutations. However, the efficacy of immunotherapy and molecular mechanism in large-cell lung cancer (LCLC) remains unclear. Here, we reported a rare case of multiple fulminant postoperative body and mouth metastases in LCLC treating with combination immunotherapy. Initially, the patient was diagnosed as early stage LCLC and underwent a radical resection of the right lower lobe. Just one month later, multiple fulminant body and mouth lesions appeared in the right upper arm, right elbow, right waist, and tongue root. Meanwhile, serum neuron specific enolase (NSE) concentration dramatically increased from 12.12 to 30.14 ng/ml. Immumohistochemistry findings demonstrated moderate PD-L1 expressions with tumor proportion score (TPS), while next-generation sequencing indicated moderate tumor mutational burden (TMB) levels and gene mutations in PBRM1 L1230P and TP53 L194R of both foci. Besides, loss of heterozygosity (LOH) at human leukocyte antigen (HLA) class I (HLA-A*02:03, HLA-B*55:02 and HLA-C*12:03) were detected in the right upper arm metastasis, which may facilitate malignant postoperative metastases in this case. Notably, this patient received combination therapy with anti-PD-1 antibody sintilimab plus anlotinib, and achieved a partial response for at least 12 months. Using an integrated computational method, the mutant peptide TEIPENDIPL derived from PBRM1 L1230P was predicted to be a specific neoantigen and could still be presented by HLA-B*40:01. This case suggests that immunotherapy plus antiangiogenic drug may provide an alternative therapeutic option for advanced LCLC patients without common gene mutations.
Association of isochromosome (7)(q10) in Shwachman-Diamond syndrome with the severity of cytopenia
Authors: Yuko Shimosato, Reo Tanoshima, Shin-Ichi Tsujimoto, Masanobu Takeuchi, Koji Sasaki, Ryosuke Kajiwara, Hiroaki Goto, Junichi Nagai, Masakatsu D Yanagimachi, Shuichi Ito, Shumpei Yokota
Journal: Clin Case Rep (2017)
Keywords: shwachman–diamond syndrome, cytopenia, i(7q)
MeSH terms: Case Reports

We report two male siblings with SDS. They have the same compound heterozygous mutations. Only one of the siblings acquired cytogenetic abnormality of i(7q) 2 years after diagnosis, became transfusion-dependent, and underwent allogeneic hematopoietic stem cell transplantation. These cases indicate that i(7q) is associated with significant cytopenia in SDS patients.