Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, characterized by ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. A 64-year-old man, ex-smoker, with previous history of multiple myeloma and tetralogy of Fallot non surgically corrected. Admitted to the Pulmonology Department for worsening dyspnea in the last week.
Issue 10 (Oct)
Leiomyomas, or fibroids, are a common, benign tumor of the smooth muscle of the uterus, with a cumulative incidence of 70% in white women and 80% in black women by age 50. Suppurative leiomyoma, also referred to as pyomyoma, is a rare disorder of infarction with subsequent infection of a leiomyoma, which must be distinguished from other degenerative changes.
Current medical practice separates Cardiovascular Implantable Electronic Devices (CIED) into two categories, conditional and nonconditional. Many physicians have been taught that patients with nonconditional CIEDs should never have MRI scans due to negative effects that the magnetic field could have on the device.
Signet Ring Cell Carcinoma (SRCC) also known as mucocellular carcinoma, it is a cancer cell with a lot of mucus. Primary lung SRCC is an extremely rare type of lung cancer malignancy. At present, there is no standard treatment scheme for primary pulmonary SRCC at home and abroad. We describe the clinical symptoms of a unique primary lung SRCC and the evaluation of its efficacy after targeted drug therapy.
We report the case of a 34-year-old woman with a history of dermatomyositis in its typical form. She was treated by corticosteroids and methotrexate with no further relapses. She also had universalis calcinosis. 24 years later, the patient suffered from breast abscesses. Mammograms showed irregular, bizarre and coarse calcifications involving bilateral breasts. She received antibiotics for the infection.
A 61-year-old female with no significant past medical history presented with painless progressive left lower extremity weakness and foot drop resulting in altered gait over the course of two years prior to seeking care. Examination revealed a hypertrophied left lower extremity, steppage gait, and 1 out of 5 strength with left ankle dorsiflexion. Initial x-ray of the affected ankle was unremarkable.
Gastric Lymphoma is a rare condition, accounting for only 2% of all lymphomas . Intramedullary Spinal Cord lesions resulting from Metastases (ISCM) are also extremely uncommon, primarily arising from malignancies in the lung and breast. Only 2% of patients are reported to have contracted secondary spinal cord metastases from a primary lymphoma
Linitis plastica is a rare desmoplastic phenomenon typically seen secondary to metastatic gastric cancer. First identified in 1779 and often referred to as â€œleather bottle stomachâ€, this finding is most often seen in female patients of Asian descent and suggests a poor prognosis.
False occult hepatitis B virus infection with negative HBsAg while positive HBeAg & overt DNA levels: Case report and literature review
Occult Hepatitis B Infection (OBI) is characterized by the detection of Hepatitis B Virus (HBV) DNA in serum (usually HBV DNA <200 IU/ml) or liver but negativity for hepatitis B surface antigen. The diagnosis of OBI is based on the sensitivity of assays used in the detection of HBV DNA and HBsAg. HBsAg assays with inadequate sensitivity or inability to detect HBV S variants.
This retrospective study aimed to evaluate the diagnostic value of preoperative18F-Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in detecting groin Lymph Node (LN) metastases in newly diagnosed vulvar cancer patients. In the period 01.01.2014 to 31.12.2018, we retrospectively collected data by reviewing the medical record of 237 patients with diagnosed vulvar cancer referred to Aarhus University Hospital.
We present 2 patients with invasive ductal carcinoma of the breast who had metastases to the endometrium. Both patients presented similarly with abnormal uterine bleeding. Gynecologic metastases are very infrequently seen amongst breast cancer patients, and even less frequently in patients with invasive ductal carcinoma by comparison to invasive lobular carcinoma.
Metatypical basal cell carcinoma is a rare skin cancer. Compared to basal cell carcinoma, this tumor type is more aggressive and has higher incidence of metastasis. We present the case of a 45-year-old female with metatypical basal cell carcinoma of the scalp with invasion of the central nervous system.
This article is about the implementation of a web-based e-medical patient portal to facilitate the interaction between the hospital, the medical practitioners and the patients. The aim of this study is to develop a guideline that can be used to implement a web-based e-medical portal. An E-medical portal is an information system that provides to individuals the access to their personal health records and many other services related to healthcare.
Corticospinal tract decussation alteration: A single case of a healthy woman presenting with left fronto-parietal intraparenchimal haemorrhage showing homolateral symptoms and signs
Alterations in crossing CST pathways are rare findings which may cause diagnostic confusion and in some cases pose a real challenge. Some of these patients have a known genetic or congenital syndrome which correlates with CST crossing pattern alterations, but in many others the diagnosis is less intuitive due to the absence of conditions related.
With the continuous spread of COVID-19 pandemic and no effective drugs for its treatment, getting vaccinated is the only effective method to defend against the COVID-19. However, few adverse events related to the vaccination of COVID-19 vaccine have been reported. Here, we report a case of cutaneous plasmacytosis after COVID-19 vaccination.
Two cases of intracranial infection after percutaneous microballoon compression of trigeminal neuralgia
Trigeminal neuralgia is a common cranial nerve disease. Percutaneous Microballoon Compression (PBC) has a definite therapeutic effect, and postoperative intracranial infection is rarely reported. A total of 1051 patients with trigeminal neuralgia conducted PBC surgery in our hospital from October 2014 to December 2021, and 2 cases reported intracranial infection, which were cured and discharged after active and effective treatment.
Benign fibroepithelial polyp of ureter masquerading as upper tract urothelial carcinoma: A management conundrum
Upper tract Urothelial Cell Carcinomas (UTUCs) account for only 5â€“7% of urothelial carcinomas. Of these only 25% are located in the ureter. The imaging characteristics of these tumors can mimic certain benign entities like fibroepithelial polyps. The gold standard treatment for invasive upper tract urothelial carcinomas, regardless of the tumorâ€™s location in the UUT, is Radical Nephroureterectomy (RNU) with excision of a bladder cuff.
Syringoma is a benign adnexal neoplasm originating from the intraepidermal eccrine duct. Eruptive Syringoma (ES) is a rare variant that is characterized by skin-colored to reddish-brown and shiny papules. Here we report three cases of ES, one of them initially misdiagnosed as Darier disease. Dermoscopy showed light brown pigment networks and dotted or linear vessels.
Recurrent stroke associated with brain metastasis due to a cardioembolism secondary to left atrial Sarcoma: Case presentation and review of the literature
Primary cardiac tumours are rare; 75% of primaries are benign mesenchymal, mostly myxomas. Primary sarcomas are the second most frequent type. Only a few hundred primary cardiac sarcomas have been reported, most diagnosed by autopsy. Sarcomas of the intima are polypoid mesenchymal masses anchored to a vessel or the cardiac wall.
Automated CT Perfusion (CTP) has become an essential decision-making tool for treatment decision in the extended-time window of acute ischemic stroke. But its interpretation can be challenging. Making a correct diagnosis requires a good clinical examination, in conjunction with neuroimaging. We present a case of an 85-year-old patient who presented a seizure in the emergency room, followed by a left hemiplegia, language impairment and left gaze deviation.
Mixed Connective Tissue Disease (MCTD) is a complex clinical entity, which includes features of Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Systemic Sclerosis (SSc) and Polymyositis/Dermatomyositis (PM/DM), along with the presence of a distinctive antibody, anti-U1-Ribonucleoprotein (RNP). Autoimmune hepatitis is a chronic inflammatory disease of the liver.
A 34-year young lady with a right-sided euthyroid nodule of 3 x 5 cm size for one year visited our clinic for surgery. FNAC was reported as colloid goiter. The right hemi- thyroidectomy surgery was planned. Intraoperatively while dissecting the right thyroid lobe, we could not find the right recurrent laryngeal nerve in its normal course, but we found a cord white-like structure running transversely & entering the larynx at the level of the cricothyroid muscle.
Lymphoepithelioma-like hepatocellular carcinoma, case report of a rare indolent subtype of hepatic cancer
Lymphoepithelioma - Like Carcinomas (LELC) of the liver are tumors of poorly differentiated epithelial cells with prominent lymphoid cell infiltration of the stroma. Unlike common primary liver cancers, LELC is a rare subtype of primary liver cancer with notably better prognosis. Unfortunately, available data and understanding of this unique cancer type is limited.
Cerebral Palsy (CP) is an umbrella term used to describe a permanent disability resulting from non-progressive damage to the brain, specifically the corticospinal tract, of a developing fetus or infant. CP is believed to be caused by a malformation of the brain during its development and is a common pediatric disorder with about two to three cases occurring out of every thousand births.
Helcococcus is a resident bacteria in human and animal skin. It is a rare opportunistic pathogen in humans. Helcococcus kunzii, which causes mainly skin infection, was first discovered by Collins in 1993 . At present, there are few case reports of infection caused by Helcococcus kunzii. Here, we report a case of Helcococcus kunzii infection admitted to our department, to increase the understanding of its diagnosis and treatment in the clinic.
Prognostic value of hematological along with biochemical, and inflammatory parameters in COVID-19 infection
Coronavirus 2019 (COVID-19), first detected in patients in Wuhan, China, and soon became an international emergency concern. Since, blood tests can play a pivotal role in the early diagnosis and management the present study aimed to investigate any possible association between hematological and biochemical markers and the prognosis in these patients.
The annular pancreas is a rare congenital anomaly with retained ventral pancreas encircling the duodenum. It can be either complete or incomplete. The annular pancreas may manifest clinically in the neonate, but in the elderly it can mimic a wide range of clinical entities as a duodenal obstruction, rarely as a biliary tract obstruction making the diagnosis difficult.
A 42â€yearâ€old man with ESKD who has been on intermittent hemodialysis for 7 years, presented with extremely painful inguinal ulcer and abdominal mass. The lesion was developed 2 weeks after repairing aneurysmal cubital AVF. At first, it was a small and painful red nodule but then its size increased and a large ulcer was developed.
Pulmonary nodules are a frequent finding on chest CT. Many are Perifissural Pulmonary Nodules (PFN), which are shown to be benign on follow-up in lung cancer screening and routine care subjects and represent intrapulmonary lymph nodes. Since a growing number of patients that undergo CT have an oncology history, it is increasingly important to have knowledge on whether metastases can mimic PFN and whether these lesions should be treated with more suspicion in oncology patients.
Incidence of surgery after gamma knife radiosurgery for parasagittal and parafalcine meningiomas is higher than meningiomas in other locations: A 10-year institutional analysis and review of the literature
Parasagittal and Parafalcine Meningiomas (PSPF) have a higher rate of recurrence, increased risk of postoperative morbidities, and less favorable outcomes after stereotactic radiosurgery compared to other ocations. Herein, we try to find factors associated with treatment failure after radiosurgery in patients with PSPF meningiomas. We retrospectively reviewed records of 104 patients with 130 Gamma KnifeÂ® Radiosurgery (GKRS) treatments for individual meningiomas at a single institution.
Moyamoya disease is a chronic cerebral vascular disease of undetermined origin, characterized by stenosis and progressive occlusion of the distal portion of the internal carotid arteries and the proximal portion of the middle and anterior cerebral arteries with resulting, abnormal vascular network development at the base of the skull, realizing a smoke volute appearance or moyamoya.
Silver Russell syndrome is a congenital growth disorder with features of craniofacial dysmorphia and asymmetrical limbs. This case highlights failure to thrive (height and weight are less than -2SD), hemi-hypertrophy of the left side of the body and dysmorphic facial profile in a 13 year old boy. The parents have been counselled regarding etiology of the disease and the child is being treated with growth hormone therapy.
One of the known causes of GI bleeding is angiodysplasia, which usually causes bleeding over 70 years old patients. 30-40% of small bowel Angiodysplasia (AD) shows Gastrointestinal (GI) bleeding which occurs chronically and repeatedly. A 25-year-old patient in 27+6 weeks of pregnancy administered to our hospital with os bleeding.
Could machine learning approach improve diagnosis accuracy for malignancy in imaging examinations? A mini-review
The early diagnosis of malignancy by ultrasound, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) is still limited. Therefore, the diagnostic efficacy could be improved from Machine Learning (ML), which mainly based on deep learning and convolutional neural networks. In this work, we reviewed ML-based imaging examinations ultrasound, CT and MRI could evaluate early diagnosis value of small size tumor.
A 60-year-old female with no previous medical history presented with progressive left sided weakness. Examination demonstrated a large, fungating chest wall mass with mucopurulent drainage and necrotic odor. The patient stated this lesion was worsening for multiple years and was associated with a 90-pound weight loss; however, she was hesitant to seek medical care until the onset of weakness.
A 59-year-old female presented with pain, warmth, erythema, and swelling over the medial aspect of her left knee that began after medial unicompartmental arthroplasty. Exam fulfilled the Budapest criteria for diagnosis of Complex Regional Pain Syndrome (CRPS) type 2. Topical compound cream and physical therapy were prescribed, and symptoms were improved at follow up visit.
Clinical manifestations of diseases caused by Y.pseudotuberculosis and Y.enterocolitica (Yersinioses)
Yersinioses are typical representatives of zoonotic infectious diseases. Yersinioses are wide spread without clearly delimited endemic territories. Yersinias (except Y.pestis) have neither specific hosts nor specific vectors, they can survive and reproduce in an abiotic environment â€“ soil, rotting plant remains, etc. (which allows some authors to attribute them to sapronoses).
Point-of-care ultrasound is an effective tool for pediatric emergency physicians in addition to the physical examination for respiratory failure and suspected pleural effusion. We present a series of three unusual cases where point-of-care ultrasound was crucial as first diagnostic tool to identify pleural effusion and to allow further therapeutic choices.
A 93-year-old diabetic patient was prescribed sitafloxacin (100 mg, bid, po) for 8 days to treat a pulmonary infection. Prior to the treatment with sitafloxacin, his blood sugar was well controlled, but during treatment, his blood sugar showed abnormal biphasic dysregulation, with a downward trend in the early stages of treatment (d1-3) and an upward trend in the late stages of treatment.
Intrabronchial haemorrhage â€“ the bronchoscopistâ€™s nightmare: A case of major haemoptysis due to pulmonary Dieulafoyâ€™s disease
Massive haemoptysis is a term used to describe a large amount of expectorated blood or rapid rate of bleeding (>100 ml blood in 24 h) and is associated with a serious risk of death. However, there is no clear consensus on its definition. In the present we report the case of a 39-year-old male, investigated for haemoptysis, quickly turning bad during diagnostic flexible bronchoscopy due to a rare condition.
The majority of intradural spinal tumors are extramedullary accounting for 40% of all spinal tumors with meningiomas and nerve sheath tumors being the most frequent. To determine the diagnostic accuracy of MRI in the detection of intradural extramedullary spinal tumors taking histopathology as gold standard.
A 72-year-old male with a history of atherosclerosis and radiation therapy for laryngeal cancer presented with complaints of decreased vision. The exam of the right eye was notable for neovascularization of the iris and significant vaso-occlusive disease of the retina, with non-perfusion of the peripheral retina.
Cirrhosis of the liver is characterized by a profound disarrangement of the parenchyma and intrahepatic circulation, which leads to portal hypertension. Several vascular changes occur in the course of hepatic cirrhosis leading eventually to renal vascular changes with consequent renal function affection. Renal hemodynamic changes with intense intrarenal vasoconstriction begin early in the course of liver disease before changes in the level of serum urea and serum creatinine.
Mastitis tuberculosis is a very unusual form of extrapulmonary tuberculosis, even in endemic countries. The clinical and imaging features are not specific to this condition, which must be distinguished from other mammary pathologies, especially breast cancer, in order to avoid investigations and treatments that are sometimes mutilating.
Thrombocytopenia is commonly experienced with Temozolomide (TMZ) during treatment for Glioblastoma (GBM). With the increasing prevalence of obesity and associated Non-Alcoholic Steatohepatitis (NASH) worldwide, chronic thrombocytopenia is becoming increasingly common, and necessitates modifications in the standard of care treatment regimen for GBM.
Axillary artery aneurysm as rare cause of concurrent cerebellar infarct and acute limb ischemia: A case report
Axillary artery aneurysms are well documented and have potentially severe or life-threatening complications. While pseudoaneurysms of the axillary artery can be caused by trauma or iatrogenic complications, true aneurysms are often due to repeated blunt trauma to the axillary artery over time, leading to weakening of the artery wall.