Medicine
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Case Reports
Sarcomatoid hepatocellular carcinoma with subdiaphragmatic metastasis misdiagnosed as liver abscess: A case report.
Sarcomatoid hepatocellular carcinoma (SHC) is a rare subtype of hepatocellular carcinoma. Its imaging findings often resemble those of liver abscess, making preoperative diagnosis particularly challenging. To date, there have been no documented cases of SHC with subdiaphragmatic metastases. In this report, we present a case of SHC with subdiaphragmatic metastasis that was initially misdiagnosed as hepatic abscess. In addition, we conducted a retrospective analysis of the clinical and imaging findings to improve the clinical understanding of this disease. ⋯ To the best of our knowledge, cases of SHC with subdiaphragmatic metastases are rare, and the preoperative diagnosis presents a significant challenge in clinical practice. More comprehensive case analyses of SHC are needed to enhance the accuracy of clinical and imaging diagnoses.
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Current literature describes only 2 cases combining miniscrew-assisted rapid palatal expansion (MARPE) with lingual appliances. These cases require 2 impressions, 1 before and 1 after palatal expansion, to ensure accurate lingual appliance placement, potentially increasing treatment time and cost. This case report aimed to demonstrate a modified workflow of combining MARPE and lingual appliances in managing an adult patient with anteroposterior and transversal discrepancies, requiring only a single digital impression for both fabrication and positioning. ⋯ The combination of MARPE and lingual appliances offers a viable treatment alternative that prioritizes both esthetics and effective skeletal expansion for nonsurgical and esthetic management of adult class III malocclusion with maxillary constriction. The modified workflow, employing a single digital impression, may offer several advantages, including reduced treatment duration and associated costs, prolonged postexpansion retention, and minimized aesthetic impact of midline diastema.
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Case Reports
Resolution of acute motor axonal neuropathy in a patient after treatment with efgartigimod: A case report.
Guillain-Barré syndrome (GBS) is an acute autoimmune neuropathy characterized by progressive muscle weakness, often caused by immunoglobulin G (IgG) autoantibodies. There are several subtypes of GBS, of which acute motor axonal neuropathy (AMAN) is one of the most severe subtypes associated with axonal damage. It is well known that the current clinical standard of treatment is intravenous immunoglobulin (IVIg) and plasma exchange (PLEX), but some patients often show limited response or experience persistent disability. Efgartigimod, an Fc fragment of human IgG antibody, provides a way to target and reduce pathogenic IgG antibodies as a natural ligand Fc receptor (FcRn). The purpose of this study was to observe the therapeutic effect of efgartigimod on axonal GBS, which is expected to be a potential therapeutic method for GBS and AMAN. ⋯ Efgartigimod at a dose of 10 mg/kg weekly for 4 weeks demonstrated promising results in this case of AMAN. While further research is warranted, our findings suggest that efgartigimod may represent a valuable addition to the therapeutic armamentarium for AMAN and potentially other autoimmune neurological conditions. Well-designed clinical trials are crucial to confirm these findings and establish optimal treatment protocols for efgartigimod in AMAN.
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Case Reports
Metastatic dedifferentiated liposarcoma of the mediastinum with osteosarcomatous differentiation: A case report.
Liposarcoma is a malignant tumor of adipocytic differentiation that rarely arises within the mediastinum. Most of the existing data available comes from scattered case reports and a few small series. ⋯ This paper presents a case of dedifferentiated liposarcoma with osteosarcomatous differentiation in a rare location: the mediastinum. Correct diagnosis is of importance for appropriate choice of therapy. Clinicians should be aware of the presence of a dedifferentiated liposarcoma within a mass on the mediastinum and enhancing treatment and management strategies for affected patients.
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Orthognathic surgery cases are inherently challenging to treat with lingual appliances due to the complexities of orthodontic management and difficulties in achieving intermaxillary fixation during surgery. This challenge is further amplified in cases involving asymmetric space closure, such as those with a missing molar on one side and a premolar on the other, a scenario not yet documented in the literature. This case report presents the orthodontic-orthognathic management of an adult patient requiring space closure of asymmetric missing lower teeth. ⋯ The combination of mini-screws and lingual appliances may offer effective anchorage management in both presurgical and postsurgical orthodontic stages for optimal orthodontic-orthognathic treatment outcomes. This approach allows for precise tooth movement and control during space closure in the presence of challenging asymmetric missing tooth patterns.