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Acute Disseminated Encephalomyelitis after Rabies Vaccine: About Two Cases 狂犬病疫苗后急性播散性脑脊髓炎:关于两个病例
Pub Date : 2024-06-07 DOI: 10.36347/sjmcr.2024.v12i06.018
K. Elmazi, N. Rada, G. Draiss, M. Bouskraoui, K. Elfakiri
The current study outlines two cases of Acute Disseminated Encephalomyelitis (ADEM) occurring in two children who received a rabies vaccine. The patients, aged 10 and 8 respectively, developed anarchic neurological symptoms after vaccination, confirming the diagnosis of ADEM through brain MRI. In the first case, bilateral abnormalities were observed in several regions, while in the second case, bilateral abnormalities of the occipital and parietal subcortical white matter were detected. Treatment included intravenous corticosteroid therapy and plasma exchange. Although slight clinical improvement was observed, neurological symptoms persisted.
本研究概述了两例急性播散性脑脊髓炎(ADEM)病例,这两例病例发生在两名接种过狂犬病疫苗的儿童身上。患者年龄分别为 10 岁和 8 岁,接种疫苗后出现神经系统症状,通过脑磁共振成像确诊为急性播散性脑脊髓炎。第一个病例的多个区域出现双侧异常,第二个病例的枕叶和顶叶皮层下白质出现双侧异常。治疗包括静脉注射皮质类固醇和血浆置换。虽然临床症状略有改善,但神经症状依然存在。
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引用次数: 0
A Rare Case of a Large Mucinous Cystadenoma of the Tail of the Pancreas 胰腺尾部巨大粘液性囊腺瘤的罕见病例
Pub Date : 2024-06-07 DOI: 10.36347/sjmcr.2024.v12i06.017
H. Amal, G. Nizigiyimana, M. Abdillahi, E. Niyonkuru
Mucinous cystadenomas are part of the cystic tumours of the pancreas. They are benign tumours whose malignant potential recommends surgical resection. They are often discovered incidentally, in 75% of cases. These tumours have radiological characteristics that suggest the diagnosis. There are known radiological criteria predictive of malignancy, including a tumour diameter ≥ 3cm. Furthermore, the diagnosis of certainty is provided by anatomopathological examination. Practitioners must bear in mind the existence of these tumours, their malignant potential, and the possibility of a benign nature despite the presence of radiological criteria predictive of malignancy. Treatment consists of surgical resection without cystic rupture in order to prevent the risk of recurrence.
粘液性囊腺瘤是胰腺囊性肿瘤的一部分。它们属于良性肿瘤,其恶变可能性建议进行手术切除。它们通常是偶然发现的,占 75% 的病例。这些肿瘤具有提示诊断的放射学特征。有一些已知的放射学标准可预测恶性肿瘤,包括肿瘤直径≥ 3 厘米。此外,解剖病理学检查也能提供确定的诊断。医生必须牢记这些肿瘤的存在、其恶性可能性,以及尽管存在预测恶性的放射学标准,但仍有可能是良性的。治疗方法包括手术切除,但不能造成囊肿破裂,以防止复发风险。
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引用次数: 0
Cystic Teratoma of the Pancreas: Case Report 胰腺囊性畸胎瘤:病例报告
Pub Date : 2024-06-06 DOI: 10.36347/sjmcr.2024.v12i06.015
Dr Zineb Oudrhiri, Dr. Hajar Dardar, Professor Othmane Alaoui, Professor Mahmoudi Abdelhalim, Professor Khalid Khattala, Professor Youssef Bouabdallah
Dermoid cysts of the pancreas, also known as cystic teratomas, are uncommon germ cell neoplasms that are typically benign and well-differentiated. Their rarity and lack of specific preoperative diagnostic tests make them challenging to diagnose before surgery. We describe the case of an 8-year-old girl who complained of abdominal pain and was found to have a cystic mass in the head of her pancreas on CT scan. The final diagnosis was confirmed as a dermoid cyst of the pancreas. Although these cysts are usually benign, complete surgical removal is often necessary.
胰腺皮样囊肿又称囊性畸胎瘤,是一种不常见的生殖细胞肿瘤,通常为良性且分化良好。由于其罕见性和术前缺乏特异性诊断检测,因此术前诊断具有挑战性。我们描述了一个 8 岁女孩的病例,她主诉腹痛,CT 扫描发现她的胰腺头部有囊性肿块。最终确诊为胰腺皮样囊肿。虽然这些囊肿通常是良性的,但通常需要进行彻底的手术切除。
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引用次数: 0
Synchronous Rectal Adenocarcinoma and Urothelial Carcinoma of the Bladder: Fortuitous Association or Oncogenetic Predisposition? 直肠腺癌和膀胱尿路上皮癌的同步性:偶然关联还是肿瘤遗传倾向?
Pub Date : 2024-06-06 DOI: 10.36347/sjmcr.2024.v12i06.016
Hamadoun Traoré, Saâd Mohammed Amine, C. Elm’hadi, R. Tanz, Hassan Errihani
Synchronous primary cancers involving the rectum and the bladder are quite rare and poorly reported in the literature. We report the case of a 58-year-old non-smoking patient who presented with proctalgia with diarrhea and rectal bleeding, as well as pollakiuria and hematuria. Pelvic magnetic resonance imaging showed the presence of two tissue masses involving the rectum and the bladder, in addition to a bone lesion in the pelvis. The biopsy of the three sites (rectum, bladder and bone) was in favor of a rectal adenocarcinoma and urothelial carcinoma of the bladder, with absence of signs of malignancy for bone involvement. The PET-Scan did not show any distant lesion. The patient was treated with a trans-urethral resection of the bladder, and concomitant radio-chemotherapy for the rectum. We are going to do a review of the literature concerning this association.
涉及直肠和膀胱的同步原发性癌症相当罕见,文献报道也很少。我们报告了一例 58 岁非吸烟患者的病例,该患者出现直肠痛、腹泻、直肠出血以及花粉尿和血尿。盆腔磁共振成像显示,除了盆腔骨质病变外,还有涉及直肠和膀胱的两个组织肿块。三个部位(直肠、膀胱和骨骼)的活检结果均为直肠腺癌和膀胱尿路上皮癌,骨骼未发现恶性病变迹象。PET 扫描未显示任何远处病灶。患者接受了经尿道膀胱切除术,同时对直肠进行了放射化疗。我们将对有关这一关联的文献进行综述。
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引用次数: 0
Amantadine Enhances Recovery from Delayed Neuropsychiatric Effects Caused by Carbon Monoxide Poisoning: A Case Report 金刚烷胺可促进一氧化碳中毒所致迟发性神经精神影响的恢复:病例报告
Pub Date : 2024-06-04 DOI: 10.36347/sjmcr.2024.v12i06.011
S. T. Eddine, A. Oumoussa, I. Adali, F. Manoudi
Carbon monoxide (CO) poisoning causes severe brain damage, including delayed neuropsychiatric sequelae (DNS), which occur after a lucid interval following recovery from the insult of acute CO poisoning. Delayed neuropsychiatric syndrome (DNS) is a well-known complication following carbon monoxide (CO) poisoning and develops in up to 50 % of adult survivors. The syndrome is probably immunologically mediated. We describe a 19-year-old female who developed DNS, including slowness, Parkinsonism; irritability and cognitive impairment. All symptoms, including cognitive impairment, were dramatically improved by amantadine monotherapy. The present case illustrates the possibility of amantadine treatment for cognitive impairment and parkinsonism induced by CO poisoning.
一氧化碳(CO)中毒会造成严重的脑损伤,包括迟发性神经精神后遗症(DNS),这种后遗症是在急性一氧化碳(CO)中毒恢复后的一段清醒期后出现的。迟发性神经精神综合征(DNS)是众所周知的一氧化碳(CO)中毒后并发症,高达 50% 的成年幸存者会出现这种症状。该综合征可能是由免疫介导的。我们描述了一名出现 DNS 的 19 岁女性,她的症状包括行动迟缓、帕金森症、易怒和认知障碍。金刚烷胺单药治疗后,包括认知障碍在内的所有症状均得到显著改善。本病例说明了金刚烷胺治疗一氧化碳中毒引起的认知障碍和帕金森氏症的可能性。
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引用次数: 0
Exploring the Complexities of an Intricate Connection: Psychosis in Focal Epilepsy: Case Report 探索错综复杂的联系:局灶性癫痫患者的精神病:病例报告
Pub Date : 2024-06-04 DOI: 10.36347/sjmcr.2024.v12i06.012
S. T. Eddine
Background: Epilepsy is still a real mental health problem; although most epilepsies are curable, their psychopathological consequences are often significant and complex to manage. In this framework, the association of epilepsy with psychotic disorders has long been known. Case Report: To discuss the links between epilepsy and psychosis, we report the observation of a 42-year-old man, treated for complex focal epilepsy, admitted to a psychiatric department for attempting suicide by phlebotomy in a postictal psychosis under the commands of auditory hallucinations and a severe state of psychomotor agitation. Discussion: Psychotic symptoms in epilepsy can be part of intercritical, post-critical or alternative psychoses. In our patient's case, the psychotic symptoms were post-critical. Delusional themes are often mystical, fueled by auditory and unusual visual hallucinations. Negative disorders are rare. Conclusion: Epileptic psychoses have not been identified as nosographic entities in the psychiatric classification systems (DSM-V and ICD-10), which poses a problem in recognizing these disorders. Therefore, a collaboration between psychiatrists and neurologists is necessary to understand this complex comorbidity better, avoid diagnostic errors, and optimize management.
背景:癫痫仍然是一个现实的精神健康问题;尽管大多数癫痫是可以治愈的,但其精神病理后果往往非常严重,而且处理起来非常复杂。在此框架下,癫痫与精神障碍的关联早已众所周知。病例报告:为了讨论癫痫与精神病之间的联系,我们报告了对一名 42 岁男子的观察结果,这名男子因复杂性局灶性癫痫接受治疗,在幻听和严重精神运动性躁动的指挥下,在发作后精神病中试图通过抽血自杀而被送入精神科。讨论:癫痫患者的精神症状可能是危重间期、危重后或替代性精神病的一部分。在我们的病例中,精神症状属于临界后精神病。妄想的主题通常是神秘的,由听觉和不寻常的视觉幻觉引起。阴性失调症很少见。结论癫痫性精神病在精神病分类系统(DSM-V 和 ICD-10)中尚未被确定为分类实体,这给识别这些疾病带来了问题。因此,精神科医生和神经科医生有必要开展合作,以便更好地了解这种复杂的合并症,避免诊断错误,优化治疗。
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引用次数: 0
Leiomyosarcoma of the Left Femur: A Case Report and Review of the Literature 左股骨骨髓肉瘤:病例报告与文献综述
Pub Date : 2024-06-04 DOI: 10.36347/sjmcr.2024.v12i06.009
Hind Ameur, Motsatsa M. Gedeon, S. Barkich, N. Oumghare, M. Darfaoui, A. Alomrani, M. Khouchani
Soft tissue sarcomas of the limbs are rare tumors with a poor prognosis. Their diagnosis is difficult and its histological confirmation. Surgery represents the main therapeutic weapon while radiotherapy allows better local control. Chemotherapy is reserved for high-grade tumors with high metastatic potential. Our work is based on a study of a rare case of metastatic leimyosarcoma of the thigh in a 49-year-old patient.
四肢软组织肉瘤是一种罕见的肿瘤,预后较差。其诊断和组织学确认都很困难。手术是主要的治疗手段,而放疗则能更好地控制局部肿瘤。化疗适用于转移可能性大的高级别肿瘤。我们的研究基于对一例罕见的大腿转移性亮肌肉瘤(49 岁)患者的研究。
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引用次数: 0
Pregnancy and Acromegaly: About 2 Cases 妊娠与肢端肥大症约 2 个病例
Pub Date : 2024-06-04 DOI: 10.36347/sjmcr.2024.v12i06.014
Oussama Jaddi, Z. A. S. Ali, Sana Rafi, G. E. Mghari, N. Ansari
Introduction: Pregnancies in women with acromegaly are rare. Literature reports indicate the absence of fetal malformations, rarely symptomatic increases in adenoma volume, and a possible risk of gestational diabetes and pregnancy-induced hypertension in women not adequately controlled by medication before pregnancy. Variations in somatotrope function have been rarely studied. Observations: Our two patients had previously undergone surgery for somatotrope adenomas and were treated with somatostatin analogs before pregnancy, with treatment discontinued upon pregnancy diagnosis. All pregnancies were normal without gestational diabetes, pregnancy-induced hypertension, or pituitary tumor syndrome. No newborns had congenital malformations. Conclusion: Pregnancy does not appear to worsen acromegaly in young patients well-controlled with somatostatin analogs before pregnancy.
简介肢端肥大症妇女怀孕的情况非常罕见。文献报道显示,肢端肥大症患者不会导致胎儿畸形,腺瘤体积增大很少出现症状,如果孕前未充分用药,则可能有妊娠糖尿病和妊娠高血压的风险。有关体细胞功能变化的研究很少。观察结果:我们的两名患者曾接受过体细胞腺瘤手术,怀孕前接受过体细胞生长激素类似物治疗,确诊怀孕后停止了治疗。所有妊娠均正常,无妊娠糖尿病、妊娠诱发高血压或垂体瘤综合征。没有新生儿出现先天性畸形。结论对于孕前使用体生长抑素类似物治疗效果良好的年轻患者,怀孕似乎不会导致肢端肥大症恶化。
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引用次数: 0
Unusual Location of Intermuscular Lipoma in the thenar eminence: Case Report and Review of the Literature 位于耳后突的肌间脂肪瘤位置不寻常:病例报告和文献综述
Pub Date : 2024-06-04 DOI: 10.36347/sjmcr.2024.v12i06.013
A. Bouya, R. Salah, K. E. Mokhtari, Badr Chalouah, A. Bennis, O. Zaddoug, M. Benchakroun, S. Bouabid
Introduction: Lipomas are the most common benign mesenchymal tumors, typically located in subcutaneous tissue. They can also occur intramuscularly (1-5%) or intermuscularly (0.3-1.9%). Hand lipomas are rare. Case Report: A 53-year-old woman presented with a 2-year history of a painless, enlarging mass in her left hand's thenar region, impairing hand function and grip strength. Physical examination revealed a 5cm, well-defined, painless mass fixed to the deep plan. MRI indicated a benign lipoma. Surgical removal was performed under locoregional anesthesia, and histological analysis confirmed the lipoma diagnosis. Postoperative rehabilitation led to full recovery with no recurrence after 16 months. Discussion: Lipomas, though usually found in subcutaneous tissues of the neck, torso, and limbs, can also develop within muscles, with hand occurrences being particularly rare. Diagnosis is typically confirmed by ultrasound or MRI, which distinguishes lipomas from malignant tumors. Histologically, lipomas consist of mature adipocytes and are often encapsulated. Surgical removal is advised if symptomatic, with recurrence being rare. Conclusion: Hand lipomas, especially intramuscular, are uncommon and can significantly impair function. Accurate diagnosis and careful surgical excision are crucial for effective treatment and preventing recurrence.
简介脂肪瘤是最常见的良性间质肿瘤,通常位于皮下组织。脂肪瘤也可发生在肌肉内(1-5%)或肌肉间(0.3-1.9%)。手部脂肪瘤很少见。病例报告:一名 53 岁的妇女就诊 2 年,左手腕部出现无痛性肿块,且肿块不断增大,影响了手部功能和握力。体格检查发现一个 5 厘米、轮廓清晰、固定在深部的无痛性肿块。核磁共振成像显示为良性脂肪瘤。在局部麻醉下进行了手术切除,组织学分析证实了脂肪瘤的诊断。术后康复完全恢复,16 个月后未再复发。讨论脂肪瘤虽然通常发生在颈部、躯干和四肢的皮下组织,但也可能发生在肌肉内,手部脂肪瘤尤其罕见。通常通过超声波或核磁共振成像来确诊,从而将脂肪瘤与恶性肿瘤区分开来。从组织学角度看,脂肪瘤由成熟的脂肪细胞组成,通常呈包裹状。如果有症状,建议进行手术切除,复发的情况很少见。结论手部脂肪瘤(尤其是肌肉内脂肪瘤)并不常见,但会严重影响功能。准确的诊断和仔细的手术切除是有效治疗和防止复发的关键。
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引用次数: 0
Lymphoblastic Lymphoma: Epidemio-Clinical, Therapeutic and Prognostic Aspects 淋巴母细胞淋巴瘤:流行病学-临床、治疗和预后方面
Pub Date : 2024-05-21 DOI: 10.36347/sjmcr.2024.v12i05.068
N. Elhamdi, M. E. Baz, J. El Houdzi
Lymphoblastic lymphoma (LL) is a multifactorial, frequent and highly progressive but curable cancer, and one of the haemopathies frequently managed at the Mohammed VI University Hospital, Marrakech. Seventeen patients with lymphoblastic lymphoma (LL) were included in this study. The annual hospital incidence of LL in Marrakech was 1.8 cases/year. The 6-10 age group was in the majority (n=11; 70%). The sex ratio was 3.25 in favor of boys, and 82% had RAMED, which corresponds to a low socioeconomic level. Dyspnea was found in 10 patients (60%). Stage 3 was in the majority (n=7; 70%). Diagnosis was made by cytology in 94% of patients, histology in 23% and immunohistochemistry in 82%. Four patients died of chemotherapy toxicity after blood product rupture, and 3 of disease progression on chemotherapy. The 10 patients in remission survived event-free for an average of 21 months.
淋巴母细胞淋巴瘤(LL)是一种多因素、多发、高度进展性但可治愈的癌症,也是马拉喀什穆罕默德六世大学医院经常治疗的血液病之一。本研究共纳入了 17 名淋巴细胞淋巴瘤(LL)患者。马拉喀什淋巴瘤的年住院发病率为 1.8 例/年。6-10岁年龄组占多数(11人;70%)。性别比为 3.25,男孩居多,82% 的患者患有 RAMED,这与较低的社会经济水平相对应。10名患者(60%)出现呼吸困难。大多数患者(7 人;70%)处于第 3 期。94%的患者通过细胞学诊断,23%通过组织学诊断,82%通过免疫组化诊断。4 名患者死于血制品破裂后的化疗毒性,3 名患者死于化疗后的疾病进展。10名病情缓解的患者平均存活了21个月。
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引用次数: 0
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Scholars Journal of Medical Case Reports
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