Pub Date : 2024-09-22eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae118
Ghassan Bayat, Farah Haneyah, Laura Merjaneh, Sultaneh Haddad, Aboud Thaljah, Jack Zambakjian, Mike Ghabally
Endoscopic retrograde cholangiopancreatography is a complex procedure with a significant risk of severe consequences. We herein report a 56-year-old Middle Eastern female who was diagnosed with acute ascending cholangitis. Endoscopic retrograde cholangiopancreatography was performed with gallstone absorption and stent implanting. However, the patient developed significant pneumothorax; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema of the abdomen, chest, right arm and shoulder, face and right orbital area. Radiological studies demonstrated no evidence of perforation on bowel obstruction. The patient was treated successfully with good results and post-operative follow-up was unremarkable. In conclusion, air leakage following endoscopic retrograde cholangiopancreatography without evidence of perforation is extremely rare. While pneumothorax development usually requires thoracostomy; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema are usually treated conservatively.
{"title":"Right pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema as rare complications after ERCP: a case report.","authors":"Ghassan Bayat, Farah Haneyah, Laura Merjaneh, Sultaneh Haddad, Aboud Thaljah, Jack Zambakjian, Mike Ghabally","doi":"10.1093/omcr/omae118","DOIUrl":"10.1093/omcr/omae118","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography is a complex procedure with a significant risk of severe consequences. We herein report a 56-year-old Middle Eastern female who was diagnosed with acute ascending cholangitis. Endoscopic retrograde cholangiopancreatography was performed with gallstone absorption and stent implanting. However, the patient developed significant pneumothorax; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema of the abdomen, chest, right arm and shoulder, face and right orbital area. Radiological studies demonstrated no evidence of perforation on bowel obstruction. The patient was treated successfully with good results and post-operative follow-up was unremarkable. In conclusion, air leakage following endoscopic retrograde cholangiopancreatography without evidence of perforation is extremely rare. While pneumothorax development usually requires thoracostomy; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema are usually treated conservatively.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae118"},"PeriodicalIF":0.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-22eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae111
Antonio Mancini, Paola Concolino, Edoardo Vergani, Alessandro Oliva, Giuseppe Macis, Emanuela Traini, Esther Diana Rossi
MEN1 is a rare syndrome caused by mutations in the MEN1 gene. We describe a clinical case of MEN1 syndrome associated with a recently discovered pathogenic mutation of MEN1 gene. A 32-year-old man with a history of osteopenia, nephrolithiasis, hypercalcemia and hypophosphatemia, impaired fasting glucose, and asthenia was admitted to our outpatient unit. Primary hyperparathyroidism, sustained by three hyperplastic parathyroid glands, was diagnosed. Prolactin- and GH-secreting adenomas were ruled out. After undergoing subtotal parathyroidectomy, the patient was diagnosed with non-functioning pituitary adenoma, three pancreatic lesions, and Cushing syndrome sustained by left adrenal adenoma. The patient underwent left adrenal surgery; somatostatin analogue lanreotide was started for the pancreatic lesions; the pituitary adenoma, being small and non-secreting, was not treated. A genetic test was performed to confirm the diagnosis of MEN1 syndrome, finding an association with a recently discovered mutation: the (NM_130799.2):c.758delC (p.Ser253Cysfs*28) in exon 4.
{"title":"Phenotypic presentation of <i>MEN1</i> c.758delC (p.Ser253Cys<i>fs</i> <sup>*</sup>28) pathogenic variant: a case report.","authors":"Antonio Mancini, Paola Concolino, Edoardo Vergani, Alessandro Oliva, Giuseppe Macis, Emanuela Traini, Esther Diana Rossi","doi":"10.1093/omcr/omae111","DOIUrl":"10.1093/omcr/omae111","url":null,"abstract":"<p><p>MEN1 is a rare syndrome caused by mutations in the MEN1 gene. We describe a clinical case of MEN1 syndrome associated with a recently discovered pathogenic mutation of MEN1 gene. A 32-year-old man with a history of osteopenia, nephrolithiasis, hypercalcemia and hypophosphatemia, impaired fasting glucose, and asthenia was admitted to our outpatient unit. Primary hyperparathyroidism, sustained by three hyperplastic parathyroid glands, was diagnosed. Prolactin- and GH-secreting adenomas were ruled out. After undergoing subtotal parathyroidectomy, the patient was diagnosed with non-functioning pituitary adenoma, three pancreatic lesions, and Cushing syndrome sustained by left adrenal adenoma. The patient underwent left adrenal surgery; somatostatin analogue lanreotide was started for the pancreatic lesions; the pituitary adenoma, being small and non-secreting, was not treated. A genetic test was performed to confirm the diagnosis of MEN1 syndrome, finding an association with a recently discovered mutation: the (NM_130799.2):c.758delC (p.Ser253Cysfs<sup>*</sup>28) in exon 4.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae111"},"PeriodicalIF":0.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An 83-year-old woman presented with disturbance of consciousness and hand tremor. She had taken lithium carbonate 300 mg/day for bipolar disorder and magnesium oxide 660 mg/day for constipation. Blood tests revealed lithium poisoning, hypermagnesemia and acute kidney injury. Computed tomography showed colonic obstruction caused by cancer of the descending colon. In the outpatient section, her blood pressure decreased to 89/54 mmHg, and her heart rate dropped to 40 bpm. We considered that the obstructive ileus induced intravascular dehydration, which led to toxic serum concentrations of lithium and magnesium, triggering the emergence of severe arrythmia induced by sinus dysfunction. The patient was treated with fluid resuscitation and hemodialysis, followed by endoscopic stent replacement for the descending colon cancer obstruction. These treatments improved her general condition and alleviated the lithium poisoning, hypermagnesemia and colonic obstruction. Such a case is considered extremely rare.
{"title":"A case of acute lithium poisoning and hypermagnesemia involving advanced colon cancer-induced colonic obstruction.","authors":"Hideo Takayama, Takuya Komura, Taro Kawane, Toshiki Matsuo, Makiko Kimura, Masashi Nishikawa, Kiyoki Kitagawa, Wataru Omi, Kenichi Sakajiri, Ichiro Onishi, Satoru Sakagami, Taro Yamashita, Takashi Kagaya","doi":"10.1093/omcr/omae107","DOIUrl":"https://doi.org/10.1093/omcr/omae107","url":null,"abstract":"<p><p>An 83-year-old woman presented with disturbance of consciousness and hand tremor. She had taken lithium carbonate 300 mg/day for bipolar disorder and magnesium oxide 660 mg/day for constipation. Blood tests revealed lithium poisoning, hypermagnesemia and acute kidney injury. Computed tomography showed colonic obstruction caused by cancer of the descending colon. In the outpatient section, her blood pressure decreased to 89/54 mmHg, and her heart rate dropped to 40 bpm. We considered that the obstructive ileus induced intravascular dehydration, which led to toxic serum concentrations of lithium and magnesium, triggering the emergence of severe arrythmia induced by sinus dysfunction. The patient was treated with fluid resuscitation and hemodialysis, followed by endoscopic stent replacement for the descending colon cancer obstruction. These treatments improved her general condition and alleviated the lithium poisoning, hypermagnesemia and colonic obstruction. Such a case is considered extremely rare.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae107"},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae109
Harvey Stevenson, Daniele Ramsay, Waseem Jerjes
Recognising emergent acute pathology in the context of established chronic conditions can be challenging and is often overlooked due to cognitive biases in the physician's decision making. In the context of Parkinson's disease (PD), there is a large overlap between the non-motor symptoms of PD, common gastrointestinal symptoms amongst the elderly population, and symptoms associated with acute, severe GI pathology, which can result in diagnostic overshadowing. Here, a 68-year-old man with a background of PD reported nausea, constipation, and abdominal discomfort during routine frailty review by his general practitioner (GP). The patient reported these were common symptoms which usually resolved with laxatives. Aware of the potentially sinister nature of this presentation, the GP arranged transfer to the emergency department where CT subsequently revealed a closed-loop small bowel obstruction. This case highlights how frailty medicine is particularly susceptible to cognitive biases, which are commonly cited sources of medical errors.
{"title":"Unmasking bowel obstruction in a Parkinson's patient: the influence of cognitive bias in frailty medicine.","authors":"Harvey Stevenson, Daniele Ramsay, Waseem Jerjes","doi":"10.1093/omcr/omae109","DOIUrl":"https://doi.org/10.1093/omcr/omae109","url":null,"abstract":"<p><p>Recognising emergent acute pathology in the context of established chronic conditions can be challenging and is often overlooked due to cognitive biases in the physician's decision making. In the context of Parkinson's disease (PD), there is a large overlap between the non-motor symptoms of PD, common gastrointestinal symptoms amongst the elderly population, and symptoms associated with acute, severe GI pathology, which can result in diagnostic overshadowing. Here, a 68-year-old man with a background of PD reported nausea, constipation, and abdominal discomfort during routine frailty review by his general practitioner (GP). The patient reported these were common symptoms which usually resolved with laxatives. Aware of the potentially sinister nature of this presentation, the GP arranged transfer to the emergency department where CT subsequently revealed a closed-loop small bowel obstruction. This case highlights how frailty medicine is particularly susceptible to cognitive biases, which are commonly cited sources of medical errors.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae109"},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silver hair in a neonate is an uncommon occurrence. The aetiology of this condition is varied and is associated with immunodeficiency disorders such as Griscelli syndrome and Chédiak-Higashi syndrome. A preterm neonate with Griscelli syndrome type 2 might present with just silver colour staining of hair including the lanugo hair with no other complications. In those with associated systemic abnormalities such as congenital pulmonary airway malformation, further evaluation for conditions such as Menke-Kinke hair syndrome is required. In this case series, we describe two unique cases of silver hair syndrome in preterm neonates with their clinical description, course in the hospital, role of hair mount and genetic testing for further identification and diagnosis of this disorder.
{"title":"Silver hair in a neonate: a tale of 2 fatal cases.","authors":"Lakshmi Satish Kumar, Prashanth Ranya Raghavendra, Sruthi Nair, Muthu Vijaya Nathan D, Umair Ahmed Bargir, Anitha Haribalakrishna, Sunanda Arun Mahajan","doi":"10.1093/omcr/omae106","DOIUrl":"https://doi.org/10.1093/omcr/omae106","url":null,"abstract":"<p><p>Silver hair in a neonate is an uncommon occurrence. The aetiology of this condition is varied and is associated with immunodeficiency disorders such as Griscelli syndrome and Chédiak-Higashi syndrome. A preterm neonate with Griscelli syndrome type 2 might present with just silver colour staining of hair including the lanugo hair with no other complications. In those with associated systemic abnormalities such as congenital pulmonary airway malformation, further evaluation for conditions such as Menke-Kinke hair syndrome is required. In this case series, we describe two unique cases of silver hair syndrome in preterm neonates with their clinical description, course in the hospital, role of hair mount and genetic testing for further identification and diagnosis of this disorder.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae106"},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae136
[This corrects the article DOI: 10.1093/omcr/omae018.].
[此处更正了文章 DOI:10.1093/omcr/omae018]。
{"title":"Correction to: Cardiogenic shock without hypotension in acute severe primary mitral regurgitation: a case report.","authors":"","doi":"10.1093/omcr/omae136","DOIUrl":"https://doi.org/10.1093/omcr/omae136","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/omcr/omae018.].</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae136"},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae108
Hiroaki Ikawa, Masashi Koto
{"title":"An unusual case of oral mucosal melanoma successfully treated by carbon-ion radiotherapy.","authors":"Hiroaki Ikawa, Masashi Koto","doi":"10.1093/omcr/omae108","DOIUrl":"https://doi.org/10.1093/omcr/omae108","url":null,"abstract":"","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae108"},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae103
Alexander Paul Henning Maclennan, Emily Sitner-Medvedovsky, Daryelle Varon, Abhinav Parikh, Ankur Shah, Manoj Chhabra
Supraventricular tachycardia (SVT) is a narrow QRS complex tachyarrhythmia with a heart rate above 220 beats per minute in infants and children. Ventricular tachycardia can be due to electrolyte abnormalities, cardiomyopathies, congenital heart disease, myocarditis or drug toxicity. Incidence has been estimated to be 1 in 250 to 1 in 1000 with spontaneous resolution in infants by one year of life. We present a full-term neonate who started experiencing a tachyarrhythmia on day zero of life until she reverted to sinus rhythm on day nine of life. The rhythm was most likely a ventricular tachyarrhythmia rather than supraventricular tachycardia due to its unresponsiveness to adenosine, wide QRS complexes, and lack of association with hemodynamic instability. This is a unique case presentation of a ventricular tachyarrhythmia for its diagnostic and therapeutic challenges, it's idiopathic nature and lack of association with any cardiac compromise, congenital heart disease or electrolyte imbalance.
{"title":"Ventricular Tachyarrhythmia in a Newborn Baby.","authors":"Alexander Paul Henning Maclennan, Emily Sitner-Medvedovsky, Daryelle Varon, Abhinav Parikh, Ankur Shah, Manoj Chhabra","doi":"10.1093/omcr/omae103","DOIUrl":"10.1093/omcr/omae103","url":null,"abstract":"<p><p>Supraventricular tachycardia (SVT) is a narrow QRS complex tachyarrhythmia with a heart rate above 220 beats per minute in infants and children. Ventricular tachycardia can be due to electrolyte abnormalities, cardiomyopathies, congenital heart disease, myocarditis or drug toxicity. Incidence has been estimated to be 1 in 250 to 1 in 1000 with spontaneous resolution in infants by one year of life. We present a full-term neonate who started experiencing a tachyarrhythmia on day zero of life until she reverted to sinus rhythm on day nine of life. The rhythm was most likely a ventricular tachyarrhythmia rather than supraventricular tachycardia due to its unresponsiveness to adenosine, wide QRS complexes, and lack of association with hemodynamic instability. This is a unique case presentation of a ventricular tachyarrhythmia for its diagnostic and therapeutic challenges, it's idiopathic nature and lack of association with any cardiac compromise, congenital heart disease or electrolyte imbalance.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae103"},"PeriodicalIF":0.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07eCollection Date: 2024-09-01DOI: 10.1093/omcr/omae104
Samuel Essoun, Nii A Adu-Aryee, Henry E Obaka, Bernard Seshie, Dzifa Dey, Simon Naporo
Introduction: Pancreatic lesions have varied morphology and presentation making their diagnosis challenging. The lesions may be asymptomatic incidentalomas on abdominal imaging for other conditions, symptomatic producing specific hormone effects or causing local effects.
Case: We report a 35-year-old woman with recurrent abdominal pain confirmed gastroesophageal reflux disease. Initial CT imaging reported findings of a pancreatic pseudocysts. A careful review of the imaging showed cystic dilatation of the main pancreatic duct mimicking a main pancreatic duct intra-ductal papillary mucinous neoplasm. At surgery, a small nodule palpated in the pancreatic head with sacculation in the body and tail. A histopathological review showed a pancreatic neuroendocrine tumour blocking the main pancreatic duct at the neck causing downstream dilatation and sacculation. This case highlights the difficulty of diagnosing small asymptomatic pancreatic tumours especially with limited range of imaging modalities while increasing awareness of these conditions to improve our ability to manage them effectively.
{"title":"An unusual case of incidental pancreatic neuroendocrine tumor presenting with main pancreatic duct cystic dilatation.","authors":"Samuel Essoun, Nii A Adu-Aryee, Henry E Obaka, Bernard Seshie, Dzifa Dey, Simon Naporo","doi":"10.1093/omcr/omae104","DOIUrl":"10.1093/omcr/omae104","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic lesions have varied morphology and presentation making their diagnosis challenging. The lesions may be asymptomatic incidentalomas on abdominal imaging for other conditions, symptomatic producing specific hormone effects or causing local effects.</p><p><strong>Case: </strong>We report a 35-year-old woman with recurrent abdominal pain confirmed gastroesophageal reflux disease. Initial CT imaging reported findings of a pancreatic pseudocysts. A careful review of the imaging showed cystic dilatation of the main pancreatic duct mimicking a main pancreatic duct intra-ductal papillary mucinous neoplasm. At surgery, a small nodule palpated in the pancreatic head with sacculation in the body and tail. A histopathological review showed a pancreatic neuroendocrine tumour blocking the main pancreatic duct at the neck causing downstream dilatation and sacculation. This case highlights the difficulty of diagnosing small asymptomatic pancreatic tumours especially with limited range of imaging modalities while increasing awareness of these conditions to improve our ability to manage them effectively.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae104"},"PeriodicalIF":0.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We conducted clinical and histological evaluations on two male patients who presented with corneal keloid. One patient had a history of corneal trauma due to contact with boiling sunflower oil, while the other had undergone pterygium removal. Upon slit lamp examination, the corneal lesions were identified as single, well-circumscribed, pearly white nodules with a smooth surface. We successfully removed these nodules using a combination of superficial keratectomy and the application of mitomycin C. Light microscopy analysis of the excised nodules revealed hyperplastic epithelium, disrupted Bowman's layer, and irregularly arranged abundant collagen fibers within the stroma. Notably, there was no recurrence of the lesions in either case within six months following the surgical excision. Secondary corneal keloids should be considered as a potential diagnosis in patients with elevated corneal nodules, especially when there is a history of ocular surface trauma or surgery.
{"title":"Secondary corneal keloid: a report of two cases.","authors":"Ali Sharifi, Touraj-Reza Mirshekari, Milad Azh, Hamid Sadeghi, Zahra Akbari, Amin Zand","doi":"10.1093/omcr/omae105","DOIUrl":"10.1093/omcr/omae105","url":null,"abstract":"<p><p>We conducted clinical and histological evaluations on two male patients who presented with corneal keloid. One patient had a history of corneal trauma due to contact with boiling sunflower oil, while the other had undergone pterygium removal. Upon slit lamp examination, the corneal lesions were identified as single, well-circumscribed, pearly white nodules with a smooth surface. We successfully removed these nodules using a combination of superficial keratectomy and the application of mitomycin C. Light microscopy analysis of the excised nodules revealed hyperplastic epithelium, disrupted Bowman's layer, and irregularly arranged abundant collagen fibers within the stroma. Notably, there was no recurrence of the lesions in either case within six months following the surgical excision. Secondary corneal keloids should be considered as a potential diagnosis in patients with elevated corneal nodules, especially when there is a history of ocular surface trauma or surgery.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae105"},"PeriodicalIF":0.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}