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tumor in the left lobe of the liver, increased tumor size, 51-mm tumor in hepatic segment 4, 40-mm tumor in hepatic segments 3 and 4, hemorrhagic cyst, small nodules with enhancement defects in hepatic segments 6, 7, and 8, high FDG uptake at the verge of the S3 + 4 tumor
Leiomyosarcoma
A 62-year-old male patient had a history of partial gastric resection for a gastrointestinal stromal tumor (GIST) two years prior. Six months post-surgery, a solitary tumor appeared in the left lobe of the liver. Initial treatment with imatinib was started based on the characteristics of the original lesion. After two ...
2,347
Decline in ability to lift lower limbs, difficulty climbing stairs, loss of strength in ankles, dysesthesia on soles of feet, progressive weakness in lower extremities, edema, ejection systolic murmur, hyperpigmentation, slow pitting edema in lower limbs, right-sided inguinal lymphadenopathy, diffuse muscle w...
POEMS syndrome
The patient is a 76-year-old male who experienced a decline in his ability to lift both lower limbs more than 30 cm and climb stairs starting four months ago. Three months ago, he noticed a loss of strength in his ankles and dysesthesia on the soles of his feet. While the sensory abnormalities remained unchanged, the w...
3,549
Pain, swelling, tenderness to palpation, mild swelling on the dorsal hand extending to the forearm, mild leukopenia, anemia.
Reactive Arthritis
A 37-year-old female with a medical history including congestive heart failure, asthma, gastroesophageal reflux disease (GERD), and morbid obesity with a history of bariatric surgery presented with sudden onset pain and swelling in the right hand. The symptoms began in the morning and worsened throughout the day, promp...
3,047
enterocoelic mass
Follicular Dendritic Cell Sarcoma
A 47-year-old male patient presented with an enterocoelic mass discovered during an annual physical examination. Upon admission to our hospital, the patient did not exhibit any gastrointestinal symptoms. The patient's medical history includes extensive outdoor work, irregular meal schedules, and a history of smoking an...
4,399
fluctuating fever, muscle pain, arthritis in both ankle joints, high temperature, anemia
Adult-onset Still disease
A 52-year-old Malay male presented with a history of fluctuating fever, with temperatures ranging from 36°C to 40°C for over 10 months. He experienced muscle pain and arthritis in both ankle joints without any skin rashes. There were no respiratory symptoms such as cough or hemoptysis, and no constitutional symptoms. H...
2,362
Protrusion of the left eye, fever
Rosaï-Dorfman disease
A previously healthy two-year-old male was brought to a pediatric ophthalmologist due to sudden protrusion of the left eye accompanied by fever. During the examination, the child demonstrated the ability to follow and fixate with both eyes. Notable findings included significant protrusion of the left eye, with no detec...
4,992
High-grade fever, multiple joint pain, joint swelling, painful nodular skin lesions, tender and swollen MCPs, PIPs, wrists, elbows, knees, MTPs, enthesitis around knees, tenosynovitis of wrist extensors, thickened ulnar nerves, proteinuria, hematuria.
Leprosy
A 27-year-old male from Nepal presented to the emergency department with a five-day history of high-grade fever and multiple joint pain and swelling. This was preceded by a four-week history of progressive painful nodular skin lesions over the face, scalp, both ears, all four limbs, and upper chest. The fever was not a...
3,987
Swelling in the right palatal region, difficulties in pronunciation, difficulties in chewing, painless progressively enlarging mass in the right preauricular area, swelling of the right parotid gland, mass with central ulceration on the right hard palate.
MALT lymphoma
A 61-year-old woman presented with a 1-year history of swelling in the right palatal region, along with difficulties in pronunciation and chewing. Additionally, she had a painless, progressively enlarging mass in the right preauricular area. Physical examination revealed swelling of the right parotid gland and a 2 × 2....
4,649
fever, chills, productive cough with dark phlegm, rhinorrhea, headaches, abdominal pain, shortness of breath, diminished breath sounds, rales, worsening shortness of breath
Acute lung injury
A 27-year-old Hispanic female college student with no significant past medical history came to the emergency room experiencing fever, chills, productive cough with dark phlegm, rhinorrhea, headaches, abdominal pain, and shortness of breath for 2 days. Vital signs showed a fever of 103 °F, heart rate of 75 beats per min...
4,387
Persistent globus sensation in the right pharynx, enlarged right tonsil
Follicular dendritic cell sarcoma
In March 2011, a 59-year-old male visited the Department of Otolaryngology at The First Affiliated Hospital, College of Medicine, Zhejiang University (Hangzhou, China) due to a persistent globus sensation in the right pharynx for six weeks. The patient did not report fever, difficulty swallowing, painful swallowing, br...
2,541
Substernal chest discomfort, pain radiating to jaw, constant severe stabbing pain, pain worsening over time, pain intensified by physical exertion, fever, myalgia, lethargy.
Takotsubo Cardiomyopathy
A 45-year-old male with no prior medical history experienced substernal chest discomfort during dinner. The pain, which radiated to his jaw, lasted around 2 hours and was described as a constant, severe stabbing pain that worsened over time. Physical exertion made the pain more intense, but it was not pleuritic. The pa...
3,148
Difficulty swallowing, weight loss
inflammatory myofibroblastic tumor
A 29-year-old male presented with progressively worsening difficulty swallowing and weight loss. He reported no history of cancer or tuberculosis. Endoscopy revealed a tight stricture in the esophagus with intact mucosa, and the endoscope could not pass through the stricture. Multiple biopsies showed inflammatory chang...
2,805
No symptoms.
Benign schwannoma
A 78-year-old man was referred to our hospital after a mass was incidentally found in the right hepatic duct by CT. He had undergone open cholecystectomy for gallstones 13 years previously, and prostate cancer surgery 15 years previously. There was no evidence of jaundice or abdominal symptoms. An abdominal examination...
5,179
Back pain, hand pain, morning stiffness, tenderness in sacroiliac joints.
Ankylosing Spondylitis
A 52-year-old female presented to the outpatient department of a rural community hospital with a primary complaint of new-onset back and hand pain lasting for six weeks. She reported that the pain began six weeks prior, particularly noticeable upon waking in the morning. The pain worsened with initial movement after pe...
1,942
Shortness of breath, difficulty breathing when lying flat, sudden nighttime breathing difficulties, systolic ejection murmur, bilateral basilar crackles, diffuse wheezing, bilateral pitting edema in the lower extremities, elevated jugular venous pressure.
Qualitative or quantitative defects of beta-myosin heavy chain (MYH7)
A 37-year-old male with a medical history of type 2 diabetes, depression, anxiety, and asthma presented with a two-week history of worsening shortness of breath. He also experienced difficulty breathing when lying flat and sudden nighttime breathing difficulties. He reported no recent infections. On examination, his ox...
4,318
Metastasis to the liver, Metastasis to lymph nodes, Tumor growth, Taste disorder, Watery diarrhea, Anorexia, General fatigue, Bronchial asthma attack, Mildly increased peripheral absolute eosinophil count, Elevated absolute eosinophil count, Increased serum immunoglobulin E (IgE) levels, Dyspnea on exertion,...
Eosinophilic Granulomatosis with Polyangiitis
A 65-year-old Japanese man had previously undergone total left kidney resection and descending colectomy for kidney large cell neuroendocrine carcinoma (G3 grade, 52.1% Ki67-positive stained cells, PD-L1 TPS 70%). Three months post-surgery, metastasis to the liver and lymph nodes around the abdominal aorta was observed...
2,860
skin lesions, loose stools, oozing, erosion, eczematous changes
Acrodermatitis Enteropathica
An 8-month-old male presented to the dermatologic outpatient clinic on 6 May 2008 with skin lesions located in the inguinal area and on the knees, which had been present since he was 7 months old. His body weight was 8.4 kg (25-50 percentile) and his height was 69.2 cm (10-25 percentile). There were no signs of growth ...
5,067
Vomiting, diarrhea, full-body joint pain, muscle pain, bilateral temporomandibular joint stiffness, bilateral temporomandibular joint tenderness, severe persistent headache, fever, nausea, malar rash, erythematous nodular rash on arms, bilateral knee effusions, weakness, edema in lower extremities, anuria...
Systemic Lupus Erythematosus
A 36-year-old African-American woman arrived at the ER with a 3-day history of vomiting, diarrhea, full-body joint pain, muscle pain, and bilateral temporomandibular joint stiffness and tenderness, along with a severe persistent headache. She had visited urgent care a week earlier with fever, nausea, and diarrhea. Her ...
2,621
Mild weakness in left leg, motor weakness in right face and arm, difficulty speaking
Multiple Sclerosis
A 27-year-old woman, with no prior medical history, received the first dose of BNT162b2 vaccine on June 16, 2021, followed by the second dose 21 days later. One week after the second dose, she experienced mild weakness in her left leg, which resolved on its own within 10 days. Shortly after, she developed motor weaknes...
5,102
Pain, thickening of the right frontal bone, swelling in the right frontal area, sensation of pressure in the right eye, feeling unable to open the right eye
Meningioma
A sixty-three year old woman presented with increasing pain and thickening of the right frontal bone of the skull. Physical examination showed a swelling in the right frontal area measuring approximately 12 cm in diameter. The swelling was not attached to the overlying skin, nor was it mobile or tender. The patient did...
2,417
pneumococcal sepsis, streptococcal sepsis, multiorgan failure, autoimmune hepatitis, hypothyroidism, neuropathic pain, depression, poor perfusion, hypotension, metabolic acidosis, hypokalaemia
Takotsubo cardiomyopathy
A 43-year-old woman presented for a surgical termination of pregnancy at 9 weeks’ gestation. Her medical history included pneumococcal and streptococcal sepsis in 2009 with multiorgan failure, leading to a below-knee amputation. She had previously tolerated general anaesthetics for multiple skin grafts and a splenectom...
4,589
Itching, erythematous-brownish maculopapular lesions
Sarcoidosis
A 53-year-old male with a history of penicillin allergy, lichen ruber planus, and Hashimoto’s disease presented with itching and erythematous-brownish maculopapular lesions on the back, which had been present for four months. The skin lesions were located in the right and left periscapular regions and at the dorsal-lum...
4,844
Abdominal pain, labial swelling, large ecchymosis, upper respiratory infection symptoms, joint discomfort, peripheral edema, palpable purpuric rash, hypertension, exudative plaque on tonsil, significant edema, diffuse abdominal tenderness, faint raised papular rash, leukocytosis, microscopic hematuria.
Henoch-Schönlein purpura
A previously healthy 7-year-old Caucasian girl was admitted with abdominal pain, labial swelling, and a large ecchymosis extending from the left subcostal area to the left lower quadrant. Two weeks prior, she experienced symptoms of an upper respiratory infection followed by joint discomfort, peripheral edema, and a pa...
221
painless bruise on right thigh
Acquired hemophilia A
A 60-year-old Sri Lankan woman with a history of hypothyroidism, diabetes mellitus, hypertension, hyperlipidaemia, and bronchial asthma was admitted to a general medical ward. She presented with a recent, large, spontaneous, painless bruise on her right thigh. Her medication regimen included low-dose aspirin at 75mg da...
2,847
painless swelling, progressively enlarging swelling, excessive tearing, firm diffuse mass, mild medial ectropion, conjunctival scarring, medial fornix obliteration, punctal stenosis
Solitary fibrous tumor
A 60-year-old female reported experiencing a painless, progressively enlarging swelling in the left lower eyelid over the past 7 years, accompanied by excessive tearing. She had similar swellings in the same location in 2006 and 2013, which were surgically removed but recurred after 1–2 years. No records of the previou...
4,895
thrombocytopenia, liver dysfunction, esophageal varices, ascites, pancytopenia, splenomegaly, bleeding tendency
B-cell chronic lymphocytic leukemia
A 66-year-old female presented with severe thrombocytopenia. She had a history of liver dysfunction due to HCV diagnosed 16 years ago, with a liver biopsy showing chronic hepatitis classified as stage A2, F2 (Inuyama classification). She had lost follow-up and reappeared with esophageal varices and ascites in March 201...
2,364
Enlarging lump on the right hard palate, asymptomatic at rest, painless when compressed, painless during eating, lump covered with darker violet mucous membrane, smooth surface lump.
Benign schwannoma
A 17-year-old Caucasian female was brought to a maxillofacial surgeon in January 2024 due to an enlarging lump on the right hard palate, present for about one year. The lump is asymptomatic at rest and does not cause pain when compressed or during eating. The patient has no other diseases, does not take medication, and...
2,469
Shortness of breath, coughing up blood, weight loss, decreased appetite, tachycardia, tachypnea, bilateral temporal muscle wasting, oral ulcers, bilateral lung rales, purpuric rash, normocytic anemia, microscopic hematuria, proteinuria.
Granulomatosis with Polyangiitis
A 47-year-old male arrived at the emergency department with complaints of shortness of breath during physical activity, coughing up blood for two weeks, and a 20-pound weight loss over the past three months, along with a decreased appetite. His medical history was clear, and he reported no family history of cancers or ...
2,743
bilateral lower limb swelling, burning sensation in distal extremities, blackish discoloration of fingers, complete loss of sensation in discolored areas, severe tenderness in viable areas proximal to discolored areas, non-palpable right radial artery, weak left ulnar artery pulsation, hyperpigmented painless pa...
Antiphospholipid syndrome
A 29-year-old female from a remote hilly area of Uttarakhand, with no known comorbidities or addictions, presented with bilateral lower limb swelling for two weeks. The swelling began insidiously and gradually progressed from the feet to the ankles, legs, and eventually involved both hands. Initially painless, the swel...
1,526
Increasing radicular pain in the lower right extremity, difficulty walking, symmetrical depressed reflexes in the lower limbs, reduced extension of the right knee, tenderness in the posterolateral areas of the right buttock and thigh.
Myeloid sarcoma
A 5-year-old girl received chemotherapy, which included 2 cycles of induction with daunorubicin, cytarabine, and etoposide, followed by 2 cycles of consolidation with high-dose cytarabine 3 gr/m2 per dose ×6 in each cycle. Intrathecal therapy was also administered. Post-treatment assessments showed remission by morphol...
1,108
Sharp pain in the upper central abdomen, general discomfort, tiredness, joint pain, feeling full quickly, lack of appetite, weight loss of 30 pounds.
Sarcoidosis
A 47-year-old white woman presented with sharp pain in the upper central abdomen, accompanied by flu-like symptoms including general discomfort, tiredness, and joint pain. These symptoms had been fluctuating for 1-2 months but had significantly worsened in the week prior to presentation. She also reported feeling full ...
629
Itchy lesions, erythematous plaques, edematous plaques, blushing plaques, tense serous bullae, swelling of the lips, swelling of the eyelids
Wells syndrome
A 44-year-old woman with no significant past medical history presented with a 24-year history of recurrent itchy lesions on her limbs and face. These skin lesions persisted for more than 24 hours and resolved without leaving scars. No specific triggers were identified. The patient had been treated multiple times with s...
1,851
Double vision, weakness on the left side, headache, recurrent oral ulcers, occasional joint pain, impaired lateral gaze of the left eye.
Behçet disease
A 9-year-old boy was transferred to our department in March 2007 with double vision and weakness on the left side following a minor head injury. He had no prior history of neurological issues and was previously healthy. The injury occurred while he was playing and was pushed by another boy, causing him to fall backward...
1,892
chest pain, shortness of breath, nausea, vomiting
Bronchogenic Cyst
A 19-year-old Caucasian female with no prior medical history presented with chest pain located substernally, radiating to her back. The pain worsened when lying flat and with deep inspiration, but improved when sitting upright. She also experienced shortness of breath, nausea, and vomiting. Her social history included ...
4,601
Sclera hematomas, thrombocytopenia, non-oliguric acute renal failure, hyperbilirubinemia, progressive anemia, presence of schistocytes, elevated lactate dehydrogenase levels, nephrotic proteinuria.
Atypical hemolytic uremic syndrome with complement gene abnormality
A 21-year-old woman was admitted to the internal medicine department due to the appearance of sclera hematomas and thrombocytopenia within 24 hours after receiving a second dose of an mRNA vaccine against SARS-CoV-2 (Comirnaty). Her medical history includes idiopathic epilepsy, previously treated with carbamazepine, an...
1,411
General weakness, pale conjunctiva, microcytic anemia
Rare cardiac tumor
A 42-year-old female experienced general weakness over a period of 3 months. She has a history of being a hepatitis B carrier and has previously undergone surgeries for benign breast nodules and a parotid gland tumor. Recently, she was diagnosed with uterine myoma. Upon admission, her vital signs were as follows: tempe...
4,178
No specific symptoms.
Benign schwannoma
A 54-year-old woman was transferred to our hospital for further evaluation and management of a subepithelial tumor located in the duodenum. Physical examination did not reveal any specific symptoms or signs. The patient had no history of upper gastrointestinal bleeding, nor any past medical or surgical interventions. V...
2,676
reddish macules, numbness, tingling, oedema
Leprosy
A 50-year-old male presented with a history of chronic reddish macules throughout his body. The first lesion, which was asymptomatic, appeared on his back four years prior in 2014. He was referred to a dermatologist two years after the initial lesion when similar lesions developed on his legs. Biopsies of the lesions t...
2,048
tonic-clonic seizures, ST elevation, apical hypokinesia
Takotsubo Syndrome
A 61-year-old African American woman with a history of epilepsy, bipolar disorder, and hypertension was admitted due to recurrent tonic-clonic seizures related to medication noncompliance. She reported no chest pain, shortness of breath, or palpitations. There was no family history of premature coronary artery disease ...
2,055
Agitation, fever, severe headache, incontinence, violent behavior, aggressive behavior, uncooperative behavior, metabolic acidosis, positive Kernig's sign.
Behçet disease
A 44-year-old male with no prior health issues was brought to the emergency department by ambulance due to sudden agitation and fever. The patient had no history of psychiatric conditions or stressors. His family reported that he had been experiencing a severe headache and fever for three days, and two hours before arr...
2,926
Progressive psychosyndrome, numbness in both hands, difficulty speaking, drowsiness, fatigue, aggression, sustained gaze-evoked and vertical nystagmus, reduced sensation at the periumbilical level, spinal ataxia, absence of abdominal skin reflex, slower thought processes, reduced motivation, memory deficien...
Multiple Sclerosis
A 34-year-old female with no prior health issues was admitted in February 2012 due to recent development of progressive psychosyndrome, numbness in both hands, and difficulty speaking. Her medical history included a previous hospital admission for acute psychiatric symptoms such as drowsiness, fatigue, and aggression, ...
3,741
Yellow papules, yellowish plaques, yellowish macula on the inner aspect of the lower lip, arterial systemic hypertension, dyslipidemia.
Pseudoxanthoma Elasticum
A 55-year-old woman visited the Dermatologic Service seeking treatment for her condition. She reported that her symptoms began at age 16, with progressive, coalescent yellow papules initially appearing in the axillae and later spreading to flexural sites such as the elbows, neck, and groin. She mentioned that a general...
976
Slurred speech, difficulty pronouncing certain consonants and closed vowels, trouble closing eyes, bilateral facial droop, fatigue, loss of taste, reduced appetite, mild dysarthria, bilateral facial palsy, lymphopenia
Guillain-Barré syndrome
On 1 May 2020, a 50-year-old Hispanic male with no prior health issues presented with a 2-day history of slurred speech, difficulty pronouncing certain consonants and closed vowels, trouble closing his eyes, and bilateral facial droop. He did not report numbness, extremity weakness, difficulty swallowing, or blurry vis...
4,930
abdominal pain, watery diarrhea, lack of appetite, vomiting after meals, fever, unintentional weight loss
Crohn disease
A 14-year-old male presented with abdominal pain, watery diarrhea, lack of appetite, and a history of vomiting after meals for 2 months. Four months prior, he was admitted to another hospital where he was treated with antacids for a pyloric ulcer and underwent balloon dilation for pyloric stenosis. Four months later, h...
3,634
Difficulty breathing, labored breathing, confusion, mild crackles in both lung fields, sinus tachycardia.
Myasthenia Gravis
A 22-year-old woman arrived at the emergency department with difficulty breathing for three days. She reported no cough, sputum production, chest pain, or other respiratory symptoms. She also denied weakness in her upper and lower extremities, blurred vision, or difficulty swallowing. Her medical history included treat...
5,277
dizziness, headache, neck pain, visual disturbance, diarrhea, intermittent hematochezia, iron deficiency anemia
Takayasu arteritis
A 38-year-old female presented with a 14-day history of dizziness, headache, and neck pain. She had a previous episode of visual disturbance and was diagnosed with optic neuritis 4 years earlier, which resolved spontaneously after 3 months. Five months later, she experienced diarrhea, intermittent hematochezia, and iro...
4,734
Difficulty speaking, weakness on the right side of his body, drooping right side of his face, mild upper respiratory symptoms, fever, muscle pain, painful swallowing, abdominal pain, diarrhea.
Multisystem inflammatory syndrome in children and adults
A 17-year-old male arrived at the emergency department experiencing eight hours of difficulty speaking, weakness on the right side of his body, and a drooping right side of his face. His National Institutes of Health Stroke Scale (NIHSS) score was 9, indicating moderate impairment. A non-contrast head CT scan showed an...
2,535
Recurrent sinusitis, recurrent otitis media, absence of tonsils, purulent postnasal drip, palpable lymph nodes, fluid collection and cloudiness of the eardrum, significantly decreased levels of CD19+ B cells.
X-linked agammaglobulinemia
A 15-month-old Korean boy was referred for evaluation due to recurrent sinusitis and otitis media. He was born weighing 2,700 g at 40 weeks of gestation via normal vaginal delivery and was healthy until 6 months of age. Since then, he experienced recurrent sinusitis and otitis media that did not respond to high-dose or...
3,676
Right upper quadrant pain, epigastric pain, back pain, tenderness in the right upper quadrant, tenderness in the epigastric region, shortness of breath, hypotension.
Takotsubo Cardiomyopathy
A 41-year-old woman with a history of hypertension managed with nifedipine experienced sudden right upper quadrant and epigastric pain that extended to her back. Upon arrival, her vital signs were: heart rate 140/min, blood pressure 142/90 mm Hg, respiratory rate 16/min, and temperature 36.8 °C. Physical examination re...
796
low-density heterogeneous mass in the liver, right rib fracture, mildly elevated C-reactive protein (CRP)
Inflammatory myofibroblastic tumor
A woman in her early 70s with a history of lung cryptococcosis follow-up and a previous traffic accident was found to have an unenhanced, low-density, heterogeneous, and increasing mass in the peripheral right lobe of the liver on abdominal dynamic computed tomography (CT). Additionally, a right rib fracture from the e...
3,671
right retroperitoneal mass, slight elevation in noradrenaline
Benign schwannoma
A 73-year-old male was referred for further examination of a right retroperitoneal mass in the renal hilum. Physical examination revealed no notable findings. Abdominal CT and MRI identified a well-defined mass in the right hilum of the kidney. Laboratory tests showed a slight elevation in noradrenaline at 809 ng/dl. T...
3,532
sharp left upper quadrant pain, fever, loss of appetite, severe discomfort due to abdominal pain, tenderness in the left upper quadrant, severe anemia
Gastrointestinal Stromal Tumor
A 35-year-old woman with a history of genital herpes on valacyclovir presented to the emergency department due to sharp 10/10 left upper quadrant pain, fever, and loss of appetite. On presentation, she had a temperature of 101 °F and a heart rate of 108. The physical exam revealed an ill-appearing woman with severe dis...
3,867
painless scrotal mass, scrotal swelling, non-tender fixed mass
Dermatofibrosarcoma protuberans
A 9-year-old male presented to the Urology Department with a history of a painless scrotal mass that started small and gradually increased in size over three years. His early childhood was uneventful until the onset of the scrotal swelling. Physical examination showed a non-tender, fixed mass on the left side of the sc...
2,140
No symptoms.
Neurofibroma
A 70-year-old woman visited the gastroenterology clinic for routine colon cancer screening. She reported no symptoms such as abdominal pain, nausea, vomiting, heartburn, irregular bowel habits, or blood in the stool. A colonoscopy performed 10 years ago at another facility was reportedly normal. Her medical history inc...
1,689
Right leg weakness, unable to walk, 0/5 strength in right ankle flexion, 0/5 strength in right ankle extension, 0/5 strength in right ankle eversion, 0/5 strength in right ankle inversion, increased muscle tone.
Meningioma
A 34-year-old female was transferred from a peripheral hospital 10 days after an elective lower uterine section caesarean section for a breech presentation, during which she received an epidural anaesthetic. She visited her general practitioner with a 2-day history of worsening right leg weakness. Subsequently, she was...
1,267
swelling in the lower left back tooth region, diffuse swelling on the left lower third of the face, vestibular obliteration in the area of the mandibular left second premolar, first molar, and second molar, buccolingual expansion
Benign schwannoma
A 19-year-old male patient presented with swelling in the lower left back tooth region for 7 months. Initially, the swelling was small, about the size of a peanut, and gradually increased in size. There was no history of pain, paresthesia, fever, or pus discharge. On facial examination, a diffuse swelling was observed ...
1,290
Epigastric pain
Benign schwannoma
A 77-year-old female with a history of cholelithiasis experienced epigastric pain for six months. CT imaging showed a homogeneous round mass, 5 cm in size, located on the posterior wall of the stomach. An upper gastrointestinal endoscopy identified a submucosal mass between the antrum and body of the stomach along the ...
2,360
End-stage renal disease, profound hearing loss, progressive myopia, poor vision, corneal opacities, anterior lenticonus, mild cataract, yellowish lesions in the retina.
Alport syndrome
A 63-year-old Caucasian male was referred to the retina service for evaluation of fundus abnormalities identified by a general ophthalmologist. The patient had a history of end-stage renal disease from a young age and had undergone two renal transplantations. He also experienced profound hearing loss. Additionally, he ...
4,614
Tingling sensations in hands and feet, low-grade fever, sore throat, weakness in both sides of face, weakness in lower limbs, bilateral facial palsy, decreased light touch sensation in lower limbs, decreased proprioception in lower limbs, muscle weakness in upper extremities, muscle weakness in lower extremiti...
Guillain-Barré syndrome
A 38-year-old man with no prior medical or travel history was admitted to our hospital following a 5-day history of progressively worsening and symmetric tingling sensations in his hands and feet. Fourteen days prior to admission, he received the first dose of the Sputnik V COVID-19 vaccine, after which he experienced ...
636
Fatigue, cough, shortness of breath, chest tightness, inability to lie flat at night, excessive sweating, general malaise, mild edema in the lower extremities.
Pheochromocytoma-paraganglioma
A 35-year-old male was admitted in May 2019 with complaints of fatigue and cough for 15 days, and shortness of breath for 5 days. He had experienced a cold 15 days prior, followed by general malaise and fatigue, which improved with self-medication. Five days ago, he developed shortness of breath without an obvious caus...
2,240
Involuntary jerking of the left shoulder and arm, muscle wasting in the supraspinatus, infraspinatus, subscapularis, triceps, biceps, deltoid, and brachioradialis muscles, weakness in the proximal muscles of the left upper limb, weakness in the distal muscles of the right lower limb, bilateral leg spasticity,...
Multiple sclerosis
A 31-year-old male soldier reported experiencing brief involuntary jerking of the left shoulder and arm for the past 2 months, which continued during sleep. One year prior, he had developed subacute weakness in his right lower limb and had been using a cane for walking support. He did not report any neck pain, limb or ...
3,137
left leg pain, low back pain, generalized weakness, right-sided blurred vision, abnormal gait in the left leg, right lateral strabismus, worsening low back pain, pain on ambulation, bilateral lower extremity weakness, bilateral lower extremity numbness, decreased pinprick sensation, dysesthesias, weakness w...
Inflammatory myofibroblastic tumor
A 45-year-old obese Hispanic female, who previously underwent cholecystectomy, initially presented with left leg pain, low back pain, generalized weakness, and right-sided blurred vision. Physical examination revealed an abnormal gait in the left leg and right lateral strabismus. Laboratory results showed mildly elevat...
3,251
Palpitations, ventricular premature beats, ventricular fibrillation, elevated serum levels of soluble interleukin-2 receptor, elevated high-sensitivity cardiac troponin-T, first-degree atrioventricular block, mild hypokinesis in the basal posteroinferior wall of the left ventricle.
Sarcoidosis
A 68-year-old man with no prior medical history reported experiencing palpitations due to frequent ventricular premature beats (5767/day) and was prescribed mexiletine (300 mg/day). Two months later, he suffered an out-of-hospital cardiac arrest caused by ventricular fibrillation and was successfully resuscitated by by...
4,817
slowly enlarging mass on the scalp, asymptomatic mass, firm swelling, slightly fixed swelling, non-tender swelling, non-fluctuant swelling, no discharge, no punctum
Meningioma
A 40-year-old woman presented with a slowly enlarging, asymptomatic mass on the scalp in the right parieto-occipital region. She reported no history of trauma, fractures, headaches, or convulsions. There was no weight loss or loss of appetite, and her menstrual cycles were regular. The mass had been increasing in size ...
3,332
Recurrent vomiting, headaches, infantile spasms, seizures, asymmetric facial expressions.
Meningioma
A 17-year-old female presented with recurrent vomiting and headaches over several months. She was born at term without perinatal complications but experienced infantile spasms at 3 months old, necessitating ongoing antiepileptic medication. She exhibited typical skin lesions, including shagreen patches on her back and ...
1,219
exertional shortness of breath, easy fatigue, non-radiating central chest pain, palpitations
Sarcoidosis
A 49-year-old male bus driver presented with a five-month history of exertional shortness of breath that developed gradually, accompanied by easy fatigue and non-radiating central chest pain with palpitations. The shortness of breath varied in intensity but never fully resolved. He did not have a chronic cough. On exam...
2,256
difficulty breathing, persistent pain on the left side of his back
Plasmablastic Lymphoma
A 52-year-old male presented to the Department of Respiratory Medicine with difficulty breathing and persistent pain on the left side of his back, which intensified with activity and eased with rest. The patient had a history of left testis removal due to swelling. Physical examination revealed no weight loss, fever, o...
3,440
Right limb bradykinesia, motor fluctuations, short OFF motor periods, significant dyskinesia during the ON period, right palpebral ptosis, vertical diplopia, generalized dyskinesias, vertical down-gaze limitation of the left eye, hypomimic facies, mild bilateral bradykinesia, rigidity (more pronounced on the ...
Myasthenia Gravis
A 60-year-old male patient, initially noted right limb bradykinesia in 2008 and was subsequently diagnosed with Parkinson’s disease. He currently experiences motor fluctuations with short OFF motor periods and significant dyskinesia during the ON period for most of the day (Hoehn & Yahr stage III). His treatment regime...
2,678
fever, dizziness, recurrent vomiting, neck rigidity, positive Kernig’s sign, positive Brudzinski’s sign, febrile, tachycardic, tachypneic
X-linked agammaglobulinemia
An 8-year-old Chinese boy presented with fever, dizziness, and recurrent vomiting for 3 days. He had been treated for bacterial meningitis at another tertiary hospital with cefatriaxone, vancomycin, intravenous immunoglobulin (IVIG), and mannitol for 2 days. His medical history includes an episode of acute bacterial me...
3,926
Pigmentation on the right side of the trunk, knee joint pains, oral ulcers, gingivitis
Lichen planus pigmentosus
A 30-year-old female visited the dermatology clinic with pigmentation on the right side of her trunk for one year, following a C-section at 28 weeks. The pigmentation began on the breast and extended to the chest and abdomen, sparing the axillae and face. She experienced knee joint pains and oral ulcers before the pigm...
4,405
abdominal pain, jaundice, scleral icterus
Autoimmune Pancreatitis
A ten-year-old previously healthy female presented with several months of abdominal pain and 4 days of worsening jaundice and scleral icterus. Initial laboratory results showed elevated transaminases: alanine transaminase at 230 units/L, aspartate transaminase at 133 units/L, conjugated bilirubinemia with a total bilir...
4,211
Asymptomatic
Lynch syndrome
A 61-year-old woman underwent surgery for asymptomatic grade 2 endometrial endometrioid carcinoma, which was incidentally found during routine health checks. The surgical procedures included a total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph node dissection. The tumor invaded less than half of t...
736
bi-temporal headaches, temporo-mandibular pain, severe acute back pain, T12 compression fracture, acute low-back pain, new compression fractures of L1 and L3, gastrointestinal intolerance, hair loss, hyper-pigmented reddish skin nodules
Sarcoidosis
A 74-year-old White woman was admitted to our internal medicine service in June 2016. Her medical history included hypertension, dyslipidaemia, obesity, an ischaemic stroke affecting the pons, and chronic hepatitis C with stable liver enzyme levels. The patient experienced sudden onset of intermittent, worsening bi-tem...
2,734
Dizziness, tingling sensation below both ankles and elbows
Guillain-Barré Syndrome
A 49-year-old male arrived at the emergency department of a university hospital, a tertiary referral center, experiencing dizziness and a tingling sensation below both ankles and elbows. These symptoms appeared ten days after receiving his first COVID-19 vaccination (AstraZeneca vaccine, ChAdOx1-S, 0.5 mL, Andong, Kore...
4,154
Fever, non-secretive conjunctivitis, neck lymphadenitis, generalized fixed rash, hepatosplenomegaly, gallbladder hydrops, neutrophil leucocytosis, hyponatremia, hypoalbuminemia, elevated C-reactive protein, elevated erythrocyte sedimentation rate, elevated D-dimer, elevated liver enzymes, anemia, thromboc...
Kawasaki disease
A 3-year-old boy presented with a fever lasting for 6 days, non-secretive conjunctivitis, neck lymphadenitis, and a generalized, fixed rash that was more pronounced in the perineal region. Physical examination revealed hepatosplenomegaly and gallbladder hydrops. Laboratory findings included neutrophil leucocytosis, hyp...
939
balance loss, recurrent falls, memory loss, mild confusion, visual changes, impaired depth perception, loss of peripheral vision, unsteady gait, cognitive impairment, wide-base ataxic gait
Wernicke Encephalopathy
A 64-year-old female with a medical history including generalized anxiety disorder, major depression, post-traumatic stress disorder, hypertension, gastroesophageal reflux disease, neurogenic bladder, and alcohol use disorder presented with symptoms of balance loss, recurrent falls, memory loss, mild confusion, and vis...
533
Cough, shortness of breath
Peripheral primitive neuroectodermal tumor
A 70-year-old man presented with a worsening cough and shortness of breath. A chest radiograph identified a mass in the left lung. Further imaging with computed tomography showed a well-defined 6 cm tumor in the left upper lung, without evidence of thoracic wall invasion. Systemic magnetic resonance imaging and bone sc...
1,876
Epigastric abdominal pain, jaundice, scleral icterus, jaundice.
Myeloid Sarcoma
A 70-year-old man presented with one week of epigastric abdominal pain and jaundice. Physical examination revealed a slightly distended, nontender abdomen with scleral icterus and jaundice. Laboratory results at admission showed total bilirubin at 12.1 mg/dL (0.1–1.2 mg/dL), direct bilirubin at 7.8 mg/dL (0.1–0.2 mg/dL...
4,123
Severe myalgia in both lower limbs, significant functional loss.
Granulomatosis with Polyangiitis
A 64-year-old male patient presented with stage IVB poorly differentiated non-small cell lung cancer (NSCLC) of the right upper lobe, characterized by several bone lesions (cT4N2M1c). His medical history includes a cerebrovascular accident and ischemic heart disease with a subacute myocardial infarction in 2003. He has...
4,731
Decreased vision, scotoma, myodesopsia, fever, fatigue, joint pain, muscle pain
Cat-scratch disease
A 20-year-old woman with no prior medical history was admitted in November 2018 to the ophthalmology department at Farhat Hached University Hospital in Sousse, Tunisia, due to a 5-day history of decreased vision, scotoma, and myodesopsia in her left eye. She did not experience any eye pain, redness, or discharge. Two w...
1,314
blurry vision, photopsias
Acute Macular Neuroretinopathy
Patient C, a 40-year-old woman, reported experiencing blurry vision and photopsias in her right eye. She was not on any medication, had no recent flu-like symptoms, and had never tested positive for COVID-19. She received her second dose of the COVID-19 vaccine (Spikevax; Moderna) 1.5 months before these symptoms appea...
2,984
Bilateral mechanical pain, inflammatory pain in the pelvic region, inflammatory pain in the lumbar region, significant fatigue, unresolved lumbar pain.
Sarcoidosis
A 54-year-old female with no prior medical history presented with bilateral mechanical and inflammatory pain in the pelvic and lumbar regions, persisting for the past two years. Initial treatment with non-steroidal anti-inflammatory drugs resulted in minor improvement, but symptoms persisted. The patient experienced si...
958
Diffuse mild-intensity abdominal pain, multiple vomiting episodes, mild dehydration, minimal tenderness upon abdominal palpation, nausea, dizziness, persistent vertigo-like sensations, progressive vision impairment, blurred vision, photophobia, nystagmus, right upper limb dysmetria.
Wernicke encephalopathy
A 38-year-old male with a history of type III intestinal failure due to chronic intestinal pseudo-obstruction related to gastrointestinal dysmotility, cardiac and intestinal arrhythmia syndrome, dependence on parenteral nutrition, sinus dysfunction, and a pacemaker. The patient has chronic intestinal insufficiency due ...
5,073
High-grade fever, headache, generalized maculopapular rash, bilateral conjunctival congestion, cervical lymphadenopathy.
Multisystem inflammatory syndrome in children and adults
A 21-year-old male with no prior medical conditions presented with a high-grade fever and headache lasting nine days. He had a recent history of COVID-19 infection about a month prior, which was managed with home isolation. On examination, he was conscious, oriented, and hemodynamically stable, except for a heart rate ...
4,462
Left-sided lateral neck pain, minor localized swelling, anosmia, ageusia, prominent tenderness over the left common carotid artery, subtle swelling, mildly elevated C-reactive protein.
sarcoidosis
A 31-year-old male presented to the emergency department with a 6-week history of left-sided lateral neck pain and minor localized swelling. He reported no throat aches, dyspnea, fever, weight loss, or other systemic symptoms. Three weeks after the onset of neck pain, he experienced a mild case of COVID-19, characteriz...
601
Progressively worsening gait difficulty, inability to move right leg at initiation of walking, right arm stiffness while writing or eating with utensils.
Paroxysmal Kinesigenic Dyskinesia
A 14-year-old right-handed male presented to the rehabilitation department with a 1-year history of progressively worsening gait difficulty. He had no prior history of neurological or psychological conditions. The episodes were characterized by an inability to move his right leg at the initiation of walking, which reso...
1,106
Dry cough, difficulty breathing, hoarseness, facial swelling, weight loss, pallor, facial puffiness, dilated veins over the neck and chest, anterior neck mass, right supraclavicular lymph node enlargement, bilateral coarse breath sounds, occasional wheezing, absent air entry in specific lung areas.
Precursor T-cell acute lymphoblastic leukemia
A 19-year-old male arrived at the emergency department with a primary complaint of a dry cough and difficulty breathing for one month. The cough began suddenly, worsened when lying on his back, and improved when sitting up. The breathing difficulty also worsened when standing. He reported hoarseness for 15 days and fac...
1,382
Right-sided facial hemihypertrophy, swelling in the preauricular area, bright red mass, rapid growth of the mass, mobile mass, soft mass, trismus.
Infantile capillary hemangioma
A 6-month-old male infant exhibited right-sided facial hemihypertrophy in the preauricular area. He was brought to Shahid Sadoughi Hospital of Yazd, Iran, for assessment and management of a swelling that initially appeared as a bright red mass with rapid growth. The swelling began at 4 months of age and grew quickly. T...
7
nausea, epigastric pain, weight loss, early satiety, weakness, intermittent fever, night sweats, pallor, cachexia, hematemesis
Inflammatory myofibroblastic tumor
An 18-year-old male presented with a two-year history of nausea, epigastric pain, weight loss, early satiety, weakness, intermittent fever, and night sweats. Physical examination revealed pallor and cachexia, with a body mass index (BMI) of 18 kg/m2. Abdominal examination identified a palpable mass in the epigastric re...
4,669
Headache, dizziness, progressive sensorineural hearing loss on the left side
Solitary fibrous tumor
A 66-year-old male presented to the neurology outpatient department with a 5-year history of headache and dizziness, and 1 month ago he experienced progressive sensorineural hearing loss on the left side. Vestibular testing yielded positive results. Computed tomography (CT) of the head showed a 3.0 × 2.7 cm well-define...
3,903
Paroxysmal cough, whistling sound during sleep, shortness of breath, whistling sound in the right lung during inhalation.
Rosaï-Dorfman disease
The patient is an 18-year-old male who began experiencing a paroxysmal cough, a whistling sound during sleep, and shortness of breath starting in May 2021. Enhanced chest computed tomography (CT) performed on June 1, 2021, revealed neoplasms located on the trachea and at the opening of the right main bronchus. Pulmonar...
391
Multiple discharging sinuses, mild erythema, minimal serosanguinous discharge.
Coccidioidomycosis
A 62-year-old male visited the dermatology clinic with multiple discharging sinuses located on the neck and right axillary region, persisting for 2 months. The patient reported a gradual increase in the lesion size with minimal discharge. He denied any history of trauma, fever, weight loss, or tuberculosis. The patient...
93
Intermittent spiking fever, chills, polyarthritis, myalgia, increased uptake in joints, inflammation in various regions, anemia, elevated white blood cell count, elevated platelet count, elevated CRP level, elevated ferritin level, elevated erythrocyte sedimentation rate.
Thymoma type A
A 37-year-old male, height 1.64 m and weight 70 kg, presented with intermittent spiking fever and chills for 2 months. He had no prior systemic disease, animal contact, unexplained wounds, or drug abuse, and no irritative symptoms of the airways, intestine, or brain. Polyarthritis developed in all proximal interphalang...
5,245
soft tissue swellings, slight redness, mild tenderness
Sarcoidosis
A female in her 40s came to the clinic with several soft tissue swellings in both upper extremities, which had been present for four months. These swellings were located on the forearms and both elbows, affecting the extensor sides of her fingers and thumb. The condition had been gradually worsening, with slight rednes...
2,061
abnormal shadow on chest x-ray, ill-defined nodule in the left upper lung field, additional nodules in the lungs, accumulation of fluorodeoxyglucose in the left lung nodule, elevated levels of soluble interleukin 2 receptor (sIL-2R), elevated anti-Epstein–Barr nuclear antigen IgG, mixed stenosis in the bronchus, ...
MALT lymphoma
A 79-year-old Japanese female presented with an abnormal shadow on chest x-ray during an annual checkup. She had no history of smoking, and her family history was unremarkable. The patient had a medical history of hypertension, hyperlipidemia, and ocular sarcoidosis. The chest x-ray revealed an ill-defined nodule, appr...
5,191
palpitations, dizziness, arrhythmia
Inflammatory myofibroblastic tumor
A 62-year-old woman presented with palpitations and dizziness over the past five months, with episodes lasting from 10 seconds to an hour and resolving on their own. She had previously been treated for rapid atrial fibrillation and hypertension at a local hospital, but her symptoms continued. Upon admission to our hosp...
4,730
Pain in the right iliac fossa, tender mass in the right iliac fossa
MALT lymphoma
A 35-year-old woman reported experiencing pain in the right iliac fossa for one month, which suddenly intensified. Physical examination revealed a tender mass in the right iliac fossa. Imaging studies, including ultrasound and CT scan of the abdomen, identified an ileocolic intussusception with a homogenous enhancing m...
1,912
Loss of consciousness, inability to sit for more than a few seconds, Broca's aphasia, right hemiparesis, generalized hyperreflexia, extensor plantar response on the right side.
Takayasu arteritis
A 24-year-old housewife experienced recurrent episodes of loss of consciousness over a 1-month period. These episodes occurred with changes in posture, particularly when sitting upright or standing, and she was unable to sit for more than a few seconds. There was no history of seizures. The patient had a history of str...
5,078
slow-growing mass, protruding, soft, non-tender
Unicentric Castleman disease
A 42-year-old Korean woman presented with a slow-growing mass on her left temporal region over the past year. The mass measured approximately 2.0×1.5 cm, was protruding, soft, and non-tender. She reported no systemic symptoms such as headache, weight loss, fatigue, or fever. Contrast-enhanced computed tomography (CT) o...
625
Fatigue
Familial hypocalciuric hypercalcemia
A 73-year-old male was admitted on September 21, 2015, presenting with recurrent fatigue over the past year. His medical history includes type 2 diabetes diagnosed 18 years ago and chronic kidney disease diagnosed 4 years ago. He has been taking compound α-keto acid (2520 mg three times daily, containing approximately ...
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