Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11128
Durgesh Kumar, D. Kumar, Rajesh Kumar Yadav
A 13-year-old girl presented with fever, nausea and projectile vomiting and altered sensorium. On physical examination, the meningeal signs were presented without focal neurological deficits and Grade Ⅱ papilledema was presented on fundus examination. The patient was found to be positive for Japanese encephalitis virus in cerebrospinal fluid. Focal neurological deficit in the form of right hemiparesis was noticed at day 6 of hospitalisation. Multiple lesions with minimal enhancement with perilesional edema were observed in cerebral cortex in contrast with enhanced magnetic resonance imaging of the brain, givingrise to starry sky appearance. No tests for neurotuberculosis were found positive. Serum IgG enzyme-linked immunosorbent assay test was negative for Cysticercosis, but magnetic resonance spectroscopy was suggestive of cysticercal meningitis. During treatment, she had intermittent episodes of nausea and vomiting with waxing and waning sensorium. Subsequently, it was planned to start Albendazole after steroids coverage and anticonvulsants but the patient did not improve and succumbed to her illness.
{"title":"Starry Sky on MRI Brain: Unusually Observed in a Pediatric Case of Japanese Encephalitis","authors":"Durgesh Kumar, D. Kumar, Rajesh Kumar Yadav","doi":"10.18502/crcp.v7i3.11128","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11128","url":null,"abstract":"A 13-year-old girl presented with fever, nausea and projectile vomiting and altered sensorium. On physical examination, the meningeal signs were presented without focal neurological deficits and Grade Ⅱ papilledema was presented on fundus examination. The patient was found to be positive for Japanese encephalitis virus in cerebrospinal fluid. Focal neurological deficit in the form of right hemiparesis was noticed at day 6 of hospitalisation. Multiple lesions with minimal enhancement with perilesional edema were observed in cerebral cortex in contrast with enhanced magnetic resonance imaging of the brain, givingrise to starry sky appearance. No tests for neurotuberculosis were found positive. Serum IgG enzyme-linked immunosorbent assay test was negative for Cysticercosis, but magnetic resonance spectroscopy was suggestive of cysticercal meningitis. During treatment, she had intermittent episodes of nausea and vomiting with waxing and waning sensorium. Subsequently, it was planned to start Albendazole after steroids coverage and anticonvulsants but the patient did not improve and succumbed to her illness.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44327312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11121
A. Fathi, M. Rashidbeygi, Maryamalsadat Mousavi, Zahra Azizan, S. Sadrehosseini, Azin Tabari, Mehdi Zeinalizadeh
Cavernous sinus hemangiomas (CSHs) are rare, benign, slow-growing neoplasms within the cavernous sinus. Laterally located to these lesions, the cranial nerves and carotid artery are subject to injury during removal of hemangiomas through a transcranial route. Therefore, forsurgi- cal management of cavernous sinus hemangiomas a medial corridor granted through an endoscop- ic endonasal approach may be less traumatic to the neurovascular bundle. Case-1 describes a 23-year old male who presented with intermittent blurred vision and very mild ptosis on the right side for two yearsbefore admission. Fundoscopic exam, visual acuity and perimetry tests were normal. With intense enhancement after contrastadministration, both brain MRI and CT scan demonstrated an extra-axial mass in the right cavernous sinus. Case-2 presents a 59-year-old male, a known case of renal oncocytoma who underwent nephrec- tomy a year before, with chief complain ofmoderate intermittent headaches. Imaging study of the brain by MRI revealed a sellar mass. Near-total resection for case-1 and gross total resection for case-2 were performed through the an extended endoscopic endonasal approach. We report two cases of near-total and gross total resection of CSHs via an extend- ed endoscopic endonasal approach substantiatingadvances in minimal access neurosurgery to the treatment of such grim lesions of an intricate vicinity of the skull base. At the same time, we focus to review extensively the growing yet heterogenous literature of the past twenty years on the broached topic. The evolution of extended endoscopic endonasal approach over the past two decades changes the dynamism of the surgical practices steeped in tradition and provides a safer alternate route for preserving cranial nerves of this anatomic region.
{"title":"Endoscopic Endonasal Approach to Cavernous Sinus Hemangioma: A Report of Two Cases and Review of the Literature","authors":"A. Fathi, M. Rashidbeygi, Maryamalsadat Mousavi, Zahra Azizan, S. Sadrehosseini, Azin Tabari, Mehdi Zeinalizadeh","doi":"10.18502/crcp.v7i3.11121","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11121","url":null,"abstract":"Cavernous sinus hemangiomas (CSHs) are rare, benign, slow-growing neoplasms within the cavernous sinus. Laterally located to these lesions, the cranial nerves and carotid artery are subject to injury during removal of hemangiomas through a transcranial route. Therefore, forsurgi- cal management of cavernous sinus hemangiomas a medial corridor granted through an endoscop- ic endonasal approach may be less traumatic to the neurovascular bundle. \u0000Case-1 describes a 23-year old male who presented with intermittent blurred vision and very mild ptosis on the right side for two yearsbefore admission. Fundoscopic exam, visual acuity and perimetry tests were normal. With intense enhancement after contrastadministration, both brain MRI and CT scan demonstrated an extra-axial mass in the right cavernous sinus. \u0000Case-2 presents a 59-year-old male, a known case of renal oncocytoma who underwent nephrec- tomy a year before, with chief complain ofmoderate intermittent headaches. Imaging study of the brain by MRI revealed a sellar mass. \u0000Near-total resection for case-1 and gross total resection for case-2 were performed through the an extended endoscopic endonasal approach. \u0000We report two cases of near-total and gross total resection of CSHs via an extend- ed endoscopic endonasal approach substantiatingadvances in minimal access neurosurgery to the treatment of such grim lesions of an intricate vicinity of the skull base. At the same time, we focus to review extensively the growing yet heterogenous literature of the past twenty \u0000years on the broached topic. The evolution of extended endoscopic endonasal approach over the past two decades changes the dynamism of the surgical practices steeped in tradition and provides a safer alternate route for preserving cranial nerves of this anatomic region.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46112912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11119
Nasir Hematian, S. Torabi, S. Hantoushzadeh, Maasoumeh Saleh, Mahboubeh Saleh
CCTGA, also known as levo- or L-loop transposition (L-TGA), double discordance, or ventricular inversion, is a rare cardiovascular anomaly with inversion of the ventricles and great arteries. In this anomaly, the right atrium communicates with the morpho- logic left ventricle, which gives rise to the pulmonary artery, while the left atrium communicates with the morphologic right ventricle, which gives rise to the aorta. Thus, atrioventricular and ventriculoarterial discordance (double discordance) exist, and although the blood flows in the normal direction, it passes through the wrong ventricular chambers. It is a unique conotruncal anomaly, inwhich the four-chamber view is abnormal. It may be associated with other heart disorders. In most fetuses, TGA remains undiagnosed before birth. The diagnosis of TGA can be made by care- fully and appropriately evaluating the anatomic locationsof cardiac chambers and the connections between the atria, ventricles, and great arteries with high-resolution ultrasound. Patients with isolated CTGA generally present later in life with signs and symptoms related to either arrhythmias or heart failure. TGA is rarely associated with chromosomal abnormality and amniocentesis is usually not undertaken. We report a case of CTGA detected at 18 week’s gestation on screening ultrasound.
{"title":"Prenatal Diagnosis of Congenitally Corrected Transposition of the Great Arteries (CCTGA): A Case Report","authors":"Nasir Hematian, S. Torabi, S. Hantoushzadeh, Maasoumeh Saleh, Mahboubeh Saleh","doi":"10.18502/crcp.v7i3.11119","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11119","url":null,"abstract":"CCTGA, also known as levo- or L-loop transposition (L-TGA), double discordance, or ventricular inversion, is a rare cardiovascular anomaly with inversion of the ventricles and great arteries. In this anomaly, the right atrium communicates with the morpho- logic left ventricle, which gives rise to the pulmonary artery, while the left atrium communicates with the morphologic right ventricle, which gives rise to the aorta. Thus, atrioventricular and ventriculoarterial discordance (double discordance) exist, and although the blood flows in the normal direction, it passes through the wrong ventricular chambers. It is a unique conotruncal anomaly, inwhich the four-chamber view is abnormal. It may be associated with other heart disorders. In most fetuses, TGA remains undiagnosed before birth. The diagnosis of TGA can be made by care- fully and appropriately evaluating the anatomic locationsof cardiac chambers and the connections between the atria, ventricles, and great arteries with high-resolution ultrasound. Patients with isolated CTGA generally present later in life with signs and symptoms related to either arrhythmias or heart failure. TGA is rarely associated with chromosomal abnormality and amniocentesis is usually not undertaken. We report a case of CTGA detected at 18 week’s gestation on screening ultrasound.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45056949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11120
Hana Magrooni, N. Javadian, Ghasem Farahmand, Sakineh Ranji-Burachaloo
The presented case is an 81- year-old woman who had experienced episodes of facial twitching without loss of consciousness and flu like symptoms for a few weeks prior to her admission. examinations were unremarkable except for left 3rd nerve and right 6th nerve palsy, right peripheral facial palsy and right -side hemiparesis. FH was positive for sarcoidosis. neuroimaging were in favor of PCNSL. Sarcoidosis and malignancy maybe etiologically related in at least 25% of cases. Coexis- tence of sarcoidosis and lymphoma have been reported previously. Our patient had two daughters with sarcoidosis and her chest CT scan showed multiple lymph nodes inmedias- tinum. Unfortunately, due to the location and the technical restriction, biopsy of mediasti- nal lymph nodes was not performedfor our patient and we could not differentiate whether it was reactive, paraneoplastic or granulomatous. We present this case as concurrence of lymphoma and sarcoidosis in a family, which could guide a new concern for the patient with granulomatous infiltrative disease for early diagnosis and familial screening.
{"title":"Sarcoidosis in Close Family Members and Susceptibility to High Grade B-Cell Lymphoma: A Case Report Study","authors":"Hana Magrooni, N. Javadian, Ghasem Farahmand, Sakineh Ranji-Burachaloo","doi":"10.18502/crcp.v7i3.11120","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11120","url":null,"abstract":"The presented case is an 81- year-old woman who had experienced episodes of facial twitching without loss of consciousness and flu like symptoms for a few weeks prior to her admission. examinations were unremarkable except for left 3rd nerve and right 6th nerve palsy, right peripheral facial palsy and right -side hemiparesis. FH was positive for sarcoidosis. neuroimaging were in favor of PCNSL. \u0000Sarcoidosis and malignancy maybe etiologically related in at least 25% of cases. Coexis- tence of sarcoidosis and lymphoma have been reported previously. Our patient had two daughters with sarcoidosis and her chest CT scan showed multiple lymph nodes inmedias- tinum. Unfortunately, due to the location and the technical restriction, biopsy of mediasti- nal lymph nodes was not performedfor our patient and we could not differentiate whether it was reactive, paraneoplastic or granulomatous. We present this case as concurrence of lymphoma and sarcoidosis in a family, which could guide a new concern for the patient with granulomatous infiltrative disease for early diagnosis and familial screening.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49013572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11118
Narjes Mohammadzadeh, S. Hashemi
In this case report, a man presenting with a rare symptom of appendix cancer is dis- cussed. Hematuria, which was the key diagnostic feature in this patient, has never been re- ported as a presenting feature of appendix cancer which may explain why this patient has been experiencing this symptom for months and yet have not get the proper di- agnosis. As we discussed in the case report, although appendiceal cancer is a potentially life-threatening issue, it is frequently missed in patients. Therefore, we believe report- ing this key symptom in this journal would help physicians to make a more accurate diagnosis in this matter.
{"title":"Appendicovesical Fistula, as the First Presentation of Mucinous Adenocarcinoma of Appendix: A Case Report","authors":"Narjes Mohammadzadeh, S. Hashemi","doi":"10.18502/crcp.v7i3.11118","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11118","url":null,"abstract":"In this case report, a man presenting with a rare symptom of appendix cancer is dis- cussed. \u0000Hematuria, which was the key diagnostic feature in this patient, has never been re- ported as a presenting feature of appendix cancer which may explain why this patient has been experiencing this symptom for months and yet have not get the proper di- agnosis. \u0000As we discussed in the case report, although appendiceal cancer is a potentially life-threatening issue, it is frequently missed in patients. Therefore, we believe report- ing this key symptom in this journal would help physicians to make a more accurate diagnosis in this matter.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44423808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11125
Pourya Farhangi, M. Hajmiri, N. Shirzad, M. Hemmatabadi
Hereditary hemochromatosis (HH) is a rare genetic disorder, causing systemic iron overload. High amounts of iron in the bloodstream gradually oversaturate the trans- ferrin which can cause sedimentation of iron in the pancreas, liver, heart, pituitaryand joints, though it can establish multiorgan involvements. We present a case of TFR2 (type 3) HH who had minor α-thalassemia and uncontrolled diabetes mellitus, and discuss the clinical presentation and patient management. A 33-year-old man with type 3 HH and alpha-thalassemia trait, presented with uncon- trolled diabetes mellitus, skin hyperpigmentation and hypogonadism. The patient had high blood glucose ,despite the administration of 80 units of Glargineand 80 units of Aspart insulins per day, but after changing them into human insulins, his diabetes mellitus was surprisingly controlled with only 32 units of NPH and 18 units of Regular insulins. Furthermore, he was treated with testosterone (due to hypogonadism) and Deferasirox (due to iron overload).
{"title":"Hereditary Hemochromatosis and Alpha-Thalassemia Presenting with Diabetes Mellitus: A Rare Case Report","authors":"Pourya Farhangi, M. Hajmiri, N. Shirzad, M. Hemmatabadi","doi":"10.18502/crcp.v7i3.11125","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11125","url":null,"abstract":"Hereditary hemochromatosis (HH) is a rare genetic disorder, causing systemic iron overload. High amounts of iron in the bloodstream gradually oversaturate the trans- ferrin which can cause sedimentation of iron in the pancreas, liver, heart, pituitaryand joints, though it can establish multiorgan involvements. \u0000We present a case of TFR2 (type 3) HH who had minor α-thalassemia and uncontrolled diabetes mellitus, and discuss the clinical presentation and patient management. \u0000A 33-year-old man with type 3 HH and alpha-thalassemia trait, presented with uncon- trolled diabetes mellitus, skin hyperpigmentation and hypogonadism. The patient had high blood glucose ,despite the administration of 80 units of Glargineand 80 units of Aspart insulins per day, but after changing them into human insulins, his diabetes mellitus was surprisingly controlled with only 32 units of NPH and 18 units of Regular insulins. Furthermore, he was treated with testosterone (due to hypogonadism) and Deferasirox (due to iron overload).","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44755469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11127
S. Deme, Bhaskar Kakarla, R. Thakur, Purushotham Ramireddygari, Nageswara Rao Modugu
Tuberculosis, a preventable and curable disease caused by Mycobacterium tuberculosis, is the leading infectious cause of mortality worldwide. Organs commonly affected are lungs and extrapulmonary organs like lymph nodes, meninges, bones, genitourinary and gastrointestinal tract. Ileocaecal tuberculosis is the commonest form of the gastrointestinal tract. Disseminated infection can involve almost all organs in the body but isolated pancreatic tuberculosis is rarely reported in the literature. Hereby,we report a case of a young female presenting with abdominal pain and further evaluation with imaging revealed pancreatic mass raising suspicion of malignancy. Endoscopic ultrasound (EUS) guided FNAC of pancreatic mass surprisingly revealed necrotizing granulomatous lesions favoring tuberculosis. This was further supported by the complete resolution of the mass with Antituberculous Therapy (ATT). What is important: All pancreatic masses are not malignant. Infectious causes like tuberculosis should be considered in the differential diagnosis which is curable by medication. With a high index of suspicion and adequate workup, unnecessary invasive procedures can be avoided.
{"title":"Pancreatic Tuberculosis Mimicking a Mass: A Case Report","authors":"S. Deme, Bhaskar Kakarla, R. Thakur, Purushotham Ramireddygari, Nageswara Rao Modugu","doi":"10.18502/crcp.v7i3.11127","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11127","url":null,"abstract":"Tuberculosis, a preventable and curable disease caused by Mycobacterium tuberculosis, is the leading infectious cause of mortality worldwide. Organs commonly affected are lungs and extrapulmonary organs like lymph nodes, meninges, bones, genitourinary and gastrointestinal tract. Ileocaecal tuberculosis is the commonest form of the gastrointestinal tract. Disseminated infection can involve almost all organs in the body but isolated pancreatic tuberculosis is rarely reported in the literature. Hereby,we report a case of a young female presenting with abdominal pain and further evaluation with imaging revealed pancreatic mass raising suspicion of malignancy. Endoscopic ultrasound (EUS) guided FNAC of pancreatic mass surprisingly revealed necrotizing granulomatous lesions favoring tuberculosis. This was further supported by the complete resolution of the mass with Antituberculous Therapy (ATT). What is important: All pancreatic masses are not malignant. Infectious causes like tuberculosis should be considered in the differential diagnosis which is curable by medication. With a high index of suspicion and adequate workup, unnecessary invasive procedures can be avoided. \u0000 \u0000 ","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47143376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11126
Y. Tan, Vivek Vijayan, K. K. Sia
Spontaneous pneumomediastinum has been reported in association with COVID-19. Pneumomediastinum could remainelusive until computed tomogra- phy is performed. Hence, we need to be vigilant even though it generally has a benign clinical course. We presented four confirmed COVID-19 cases with typical ground glass opacity on chest radiograph. All four had the computedtomography that re- vealed pneumomediastinum, pneumothorax and subcutaneous emphysema. Only one patient had pneumomediastinum after intubation. Pneumomediastinum is a devastating finding which should be picked up as early as possible and must be excluded in COVID patients whom deteriorate quickly, as adequate time may pass before any viable intervention can be done to expedite the patients’ recovery.
{"title":"Case Series of Pneumomediastinum and Subcutaneous Emphysema in COVID-19 Patients","authors":"Y. Tan, Vivek Vijayan, K. K. Sia","doi":"10.18502/crcp.v7i3.11126","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11126","url":null,"abstract":"Spontaneous pneumomediastinum has been reported in association with COVID-19. Pneumomediastinum could remainelusive until computed tomogra- phy is performed. Hence, we need to be vigilant even though it generally has a benign clinical course. \u0000We presented four confirmed COVID-19 cases with typical ground glass opacity on chest radiograph. All four had the computedtomography that re- vealed pneumomediastinum, pneumothorax and subcutaneous emphysema. Only one patient had pneumomediastinum after intubation. \u0000Pneumomediastinum is a devastating finding which should be picked up as early as possible and must be excluded in COVID patients whom deteriorate quickly, as adequate time may pass before any viable intervention can be done to expedite the patients’ recovery.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48583646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.18502/crcp.v7i3.11117
E. Nazar, Zohre Shabanzade, Amir Ahmadi
Synovial sarcoma is a malignant mesenchymal neoplasm which com- monly arises in the extremities of adults, in close associationwith joint capsules. Only a few cases of synovial sarcoma occurring in the abdominal wall have been reported. We report an extremely rare case of monophasic synovial sarcoma of abdominal wall in a 58-year-old woman who had presented with painless left ante- rior abdominal wall mass. The patient underwent excisional surgery. Histological and immunohistochemistry examinations revealed monophasic synovial sarcoma. Base on the diagnosis, the patientreceived chemoradiation.Primary synovial sarcoma is rarely found in the anterior abdominal wall. But, it should be included in the differential diagnosis.
{"title":"Abdominal Wall Synovial Sarcoma, a Rare Presentation","authors":"E. Nazar, Zohre Shabanzade, Amir Ahmadi","doi":"10.18502/crcp.v7i3.11117","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11117","url":null,"abstract":"Synovial sarcoma is a malignant mesenchymal neoplasm which com- monly arises in the extremities of adults, in close associationwith joint capsules. Only a few cases of synovial sarcoma occurring in the abdominal wall have been reported. We report an extremely rare case of monophasic synovial sarcoma of abdominal wall in a 58-year-old woman who had presented with painless left ante- rior abdominal wall mass. The patient underwent excisional surgery. Histological and immunohistochemistry examinations revealed monophasic synovial sarcoma. Base on the diagnosis, the patientreceived chemoradiation.Primary synovial sarcoma is rarely found in the anterior abdominal wall. But, it should be included in the differential diagnosis.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47475497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.18502/crcp.v7i2.10823
R. Erfanian, F. Heidari, Saeed Sohrabpour, S. Shakiba
A 35- year- old woman presented with massive enlargement of the tongue. She had suffered this problem since a week ago when her tongue became enlarged with a sudden onset and eventually did not fit her mouth. Chronic tongue enlargement since childhood is noted. Patient had history of mental problems, namely cerebral palsy, and as she is not able to walk, she uses a wheelchair. Furthermore, due to severe scoliosis, right lung was atelectatic. Soon after initial assessments, she was carried to surgery room and as she could not lie down to supine position, was intubated in sitting position with a rigid laryngoscope. During the whole process, patient was sedated. Afterwards, tracheostomy was performed. After 5 days, no improvement in the size of tongue was observed. Diagnosis was revised in a medical commission and despite inflammatory pathology, the bulging tongue was resected. After recovery, patient could bear oral feeding and was dismissed with good general health. After a week, the devised airway created by tracheostomy was removed without any complication. During one-year follow up, no sequelae were observed.
{"title":"Massive Enlargement of The Tongue: A Report of Unusual Case","authors":"R. Erfanian, F. Heidari, Saeed Sohrabpour, S. Shakiba","doi":"10.18502/crcp.v7i2.10823","DOIUrl":"https://doi.org/10.18502/crcp.v7i2.10823","url":null,"abstract":"A 35- year- old woman presented with massive enlargement of the tongue. She had suffered this problem since a week ago when her tongue became enlarged with a sudden onset and eventually did not fit her mouth. Chronic tongue enlargement since childhood is noted. Patient had history of mental problems, namely cerebral palsy, and as she is not able to walk, she uses a wheelchair. Furthermore, due to severe scoliosis, right lung was atelectatic. \u0000Soon after initial assessments, she was carried to surgery room and as she could not lie down to supine position, was intubated in sitting position with a rigid laryngoscope. During the whole process, patient was sedated. Afterwards, tracheostomy was performed. \u0000After 5 days, no improvement in the size of tongue was observed. Diagnosis was revised in a medical commission and despite inflammatory pathology, the bulging tongue was resected. \u0000After recovery, patient could bear oral feeding and was dismissed with good general health. After a week, the devised airway created by tracheostomy was removed without any complication. During one-year follow up, no sequelae were observed.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42331391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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