SAGE Open Medical Case Reports最新文献

Uterine leiomyoma, also referred to as fibroid or myoma, is a prevalent benign tumor that can present with a range of clinical manifestations. The symptoms, which vary based on the tumor's location, size, and number, include pain, constipation, urinary disturbances, and abnormal menstrual bleeding. Certain types of uterine leiomyomas, such as pedunculated subserosal myomas or large degenerating cystic myomas, may closely mimic ovarian tumors, leading to significant diagnostic and management challenges. In this report, we present the case of a 47-year-old woman who experienced severe dyspnea and abdominal distension. Comprehensive radiological evaluation revealed a massive lesion, with both solid and cystic components, occupying the entire abdominopelvic cavity. Histological analysis confirmed the diagnosis of cellular leiomyoma. This case underscores the importance of considering degenerative cystic myoma in the differential diagnosis of large, cystic intra-abdominal tumors of unknown origin, to avoid misdiagnosis and ensure appropriate management.

Edentulous patients with history of cleft palate and severe maxillary atrophy are challenging patients to rehabilitate through an oral approach. The difficulty of rehabilitating these patients lies in the unusual anatomy they present and the alteration of the vascular supply of local tissues caused by the previous performed surgeries, along with other causes. This report describes the successful dental rehabilitation with zygomatic implants of a patient with complete bilateral cleft palate who was edentulous and had severe maxillary atrophy.

Dias-Logan syndrome, also known as intellectual developmental disorder with persistence of fetal hemoglobin (HbF), or BCL11A-related intellectual developmental disorder, is an extremely rare neurogenetic disorder characterized by intellectual disability (ID), delayed psychomotor development, variable dysmorphic features, and asymptomatic persistence of fetal hemoglobin. The prevalence and incidence of this condition are currently unknown. We report an 8-year-old Han Chinese male patient with Dias-Logan syndrome who carries a de novo heterozygous pathogenic variant, c.1078dupC (p.Leu360Profs*212), in the BCL11A gene, leading to ID and γ-globin suppression, identified through trio-based whole exome sequencing (trio-WES). All his blood parameters were normal except for an elevated HbF level, which was 19.9% of total hemoglobin. Given the negative family history for ID, epilepsy, and alcohol consumption, de novo inheritance was presumed. Consequently, trio-WES analysis (parents and child) was conducted as it can identify potential new causal variants in the offspring. So far, a comprehensive understanding of the phenotypic spectrum of Dias-Logan syndrome and the impact of genotypic variation on disease severity is still lacking. Therefore, our case report enriches the existing literature on the clinical spectrum and genotype-phenotype correlations of BCL11A-related syndrome and provides some helpful information for diagnosis, management, and genetic counseling.

In India, it is not uncommon for individuals to attempt suicide by ingesting pesticides. Though several publications have reported cases, there are no specific guidelines for managing indoxacarb poisoning. There is no established antidote for indoxacarb poisoning; however, early recognition and treatment of methemoglobinaemia, the primary manifestation, is essential. Early intervention is crucial for a positive outcome. Methemoglobinaemia can be successfully treated with methylene blue, which serves as the first line of management. This case report describes a 24-year-old man presenting with methemoglobinaemia following the ingestion of indoxacarb combined with novaluron and was successfully treated with early administration of methylene blue, leading to rapid recovery despite a methaemoglobin level as high as 75%.

Hidradenitis suppurativa is a chronic inflammatory disease of the skin with a suppurative-cicatricial outcome affecting the infundibular component of the pilo-sebaceous unit. The lesions are typically localized in the intertriginous and apocrine gland-rich areas. Hidradenitis suppurativa mainly affects patients at a young age and is very often refractory to conventional medical treatment. During pregnancy, the management of hidradenitis suppurativa becomes demanding due to the need of safety therapies. Certolizumab pegol is a pegylated monoclonal TNF-α inhibitor that lacks the fragment crystallizable region preventing active placental transfer and could be used in pregnancy and lactation if clinically needed and is label for chronic plaque psoriasis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease. Herein, we describe a case of a 32-year-old pregnant woman with Hurley stage III hidradenitis suppurativa successfully treated with certolizumab pegol.

Papulonodular mucinosis is a rare dermatological condition characterized by mucin deposition in the dermis, leading to the formation of papules and nodules that can occur with, or antedate, autoimmune connective tissue diseases. This case report presents a 67-year-old female with a chronic history of cutaneous mucinosis, which posed significant diagnostic challenges. Despite various treatments and extensive diagnostic workup, her condition evolved, highlighting the difficulties in diagnosing papulonodular mucinosis, especially in the absence of systemic lupus erythematosus and antinuclear antibody positivity. The unusual presentation and diagnostic complexity underscore the need for awareness and thorough investigation in similar cases.

Paraspinal hematomas are common complications following spine surgery. In general, these hematomas are asymptomatic and resolve without issue. Unfortunately, there is a paucity of literature that describes the recurrence of these hematomas in a chronic setting. This case report describes a patient with a chronic recurrent calcified paraspinal hematoma that first developed over 4 years and then reoccurred 11 years later at the same site. The case features a 53-year-old female presented with severe lumbar back pain and right lower extremity radiculopathy in which she underwent a lumbar decompression posterior spinal fusion from L3 to L5 in 2008. Postoperatively, she developed a lumbar paraspinal hematoma which was treated with aspiration followed by conservative management. Four years later, the patient had a large paraspinal mass removed from a similar location in an outside medical facility. The procedure required the assistance of plastic surgery for flap closure and a pathologic review of the mass revealed a calcified hematoma. Ten years later, the patient sought treatment from her index surgeon for a recurrence of the lumbar mass with new onset radicular symptoms. Magnetic resonance imaging of the lumbar spine confirmed the presence of a large paraspinal mass. The patient proceeded with the removal of hardware, revision of laminectomy, revision of posterior instrumentation from L2 to L5, and removal of the lumbar mass. The pathology report classified the mass as a chronic calcified hematoma. The patient remains symptom-free for 1 year following the revision procedure. This case demonstrates an extremely rare presentation, ill-described in the existing literature, of a recurrent symptomatic calcified lumbar paraspinal hematoma requiring repeat operative intervention.

Cutaneous pseudolymphoma refers to a group of skin conditions that simulate lymphoma either clinically and/or histologically. Cutaneous pseudolymphoma is a benign disorder that can often be misdiagnosed and has a wide range of treatment modalities. Currently, there is no gold standard of treatment, and the literature would benefit from more reports on successful and unsuccessful treatments of cutaneous pseudolymphoma. In this case, we present a 24-year-old female with cutaneous pseudolymphoma successfully treated with intralesional triamcinolone acetonide after misdiagnosis and several failures with other treatments.

Ponatinib, a tyrosine kinase inhibitor used for chronic myeloid leukemia and acute lymphoblastic leukemia, can cause rare cutaneous side effects. In this case, a 63-year-old woman developed a pityriasis rubra pilaris-like eruption 1 month after starting the drug. The skin reaction improved with dose reduction and recurred more mildly at a lower dose. Symptomatic relief was achieved with topical tretinoin, triamcinolone, and emollients. This case underscores the importance of managing dose-dependent skin reactions while maintaining cancer therapy.

This case report emphasizes the complexities involved in dental implant placement within the anterior esthetic zone, focusing on the integration of advanced surgical techniques and meticulous prosthetic design for optimal esthetic and functional results. A 28-year-old male presented with the absence of the upper left central incisor, which had been extracted 5 years prior due to fracture. Clinical and radiographic assessments indicated normal alveolar bone levels; however, the esthetic demands required a specialized approach. The surgical procedure included a papilla preservation flap, immediate implant placement, and bone grafting to prevent peri-implant resorption and achieve an optimal emergence profile. An Osstem implant and resorbable Xenograft were utilized to address the thin labial bone. Over 4 months, successful osseointegration occurred, followed by the placement of a permanent crown. This case illustrates that dental implant restoration in the anterior esthetic zone can effectively address functional and esthetic challenges, leading to high patient satisfaction with the final restoration's natural appearance.