: Case reports provide scientific knowledge and opportunities for new clinical research. However, it is estimated that less than 5% of cases presented by Japanese generalists at academic conferences are published due to various barriers such as the complex process of writing articles, conducting literature searches, the significant time required, the reluctance to write in English, and the challenge of selecting appropriate journals for publication. Therefore, the purpose of this opinion paper is to provide clinicians with practical tips for writing case reports that promote diagnostic excellence. In recent years, clinical practitioners have been striving for diagnostic excellence and optimal methods to accurately and comprehensively understand the patient’s condition. To write a case report, it is essential to be mindful of the elements of diagnostic excellence and consider the quality of the diagnostic reasoning process. We (the authors) are seven academic generalists who are members of the Japanese Society of Hospital General Medicine (JSHGM) – Junior Doctors Association, with a median of 7 years after graduation and extensive experience publishing case reports in international peer-reviewed journals. We conducted a narrative review and discussed ways to write case reports to promote diagnostic excellence, leveraging our unique perspectives as academic generalists. Our review did not identify any reports addressing the critical points in writing case reports that embody diagnostic excellence. Therefore, this report proposes a methodology that describes the process involved in writing diagnostic excellence-promoting case reports and provides an overview of the lessons learned. Based on our review and discussion, we explain the essential points for promoting diagnostic excellence through case reports categorized into seven components of clinical reasoning. These strategies are useful in daily clinical practice and instrumental in promoting diagnostic excellence through case reports.
{"title":"Writing Case Reports Can Improve Seven Components in Clinical Reasoning","authors":"Toshinori Nishizawa, Kosuke Ishizuka, Yuki Otsuka, Toshiyuki Nakanishi, Akira Kawashima, Taiju Miyagami, S. Yamashita","doi":"10.2147/imcrj.s449310","DOIUrl":"https://doi.org/10.2147/imcrj.s449310","url":null,"abstract":": Case reports provide scientific knowledge and opportunities for new clinical research. However, it is estimated that less than 5% of cases presented by Japanese generalists at academic conferences are published due to various barriers such as the complex process of writing articles, conducting literature searches, the significant time required, the reluctance to write in English, and the challenge of selecting appropriate journals for publication. Therefore, the purpose of this opinion paper is to provide clinicians with practical tips for writing case reports that promote diagnostic excellence. In recent years, clinical practitioners have been striving for diagnostic excellence and optimal methods to accurately and comprehensively understand the patient’s condition. To write a case report, it is essential to be mindful of the elements of diagnostic excellence and consider the quality of the diagnostic reasoning process. We (the authors) are seven academic generalists who are members of the Japanese Society of Hospital General Medicine (JSHGM) – Junior Doctors Association, with a median of 7 years after graduation and extensive experience publishing case reports in international peer-reviewed journals. We conducted a narrative review and discussed ways to write case reports to promote diagnostic excellence, leveraging our unique perspectives as academic generalists. Our review did not identify any reports addressing the critical points in writing case reports that embody diagnostic excellence. Therefore, this report proposes a methodology that describes the process involved in writing diagnostic excellence-promoting case reports and provides an overview of the lessons learned. Based on our review and discussion, we explain the essential points for promoting diagnostic excellence through case reports categorized into seven components of clinical reasoning. These strategies are useful in daily clinical practice and instrumental in promoting diagnostic excellence through case reports.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268126","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}
Khabab Abbasher Hussien Mohamed Ahmed, A. Siddig, AlHussien Abbashar, Mohammed Abbasher, Abubaker Alsedig Abbasher, A. Hussien, Gaffar Alemam A Manhal
{"title":"Lower Motor Neuron Facial Palsy Following COVID-19 Infection and COVID-19 AZD1222 Vaxzervria (AstraZeneca) Vaccine Administration: Two Case Reports","authors":"Khabab Abbasher Hussien Mohamed Ahmed, A. Siddig, AlHussien Abbashar, Mohammed Abbasher, Abubaker Alsedig Abbasher, A. Hussien, Gaffar Alemam A Manhal","doi":"10.2147/imcrj.s453158","DOIUrl":"https://doi.org/10.2147/imcrj.s453158","url":null,"abstract":"","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"32 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269009","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}
A. Asseri, Ahmad Alzoani, Mohammed Almahdi, Hussein Almahdi, Nouf Almushayt, Noha Alyazidi, Basmah M Al Mufarrih
{"title":"Whole-Exome Sequencing Identifies DYNC2H1 Mutations as a Cause of Jeune Asphyxiating Thoracic Dystrophy Without Extra‐Skeletal Organ Involvement","authors":"A. Asseri, Ahmad Alzoani, Mohammed Almahdi, Hussein Almahdi, Nouf Almushayt, Noha Alyazidi, Basmah M Al Mufarrih","doi":"10.2147/imcrj.s447466","DOIUrl":"https://doi.org/10.2147/imcrj.s447466","url":null,"abstract":"","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271293","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}
: We report a case of pneumonia caused by coinfection with Chlamydia psittaci and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB.1 variant, confirmed using metagenomic next-generation sequencing (mNGS) and quantitative polymerase chain reaction (qPCR). C. psittaci and SARS-CoV-2 were detected in bronchoalveolar lavage fluid using mNGS. Additionally, mNGS detected C. psittaci in blood and nasopharyngeal specimens and was more sensitive than qPCR. The patient recovered after treatment with moxifloxacin. This report highlights the use of coinfections of C. psittaci and SARS-CoV-2, as mNGS has already been recognized to be a diagnostic tool for identifying coinfections.
{"title":"Pneumonia Caused by Chlamydia psittaci and SARS-CoV-2 Coinfection Diagnosed Using Metagenomic Next-Generation Sequencing: A Case Report","authors":"Anbing Zhang, Jinguang Liang, Xiaoli Lao, Xiuqiong Xia, Jianping Liang","doi":"10.2147/imcrj.s458131","DOIUrl":"https://doi.org/10.2147/imcrj.s458131","url":null,"abstract":": We report a case of pneumonia caused by coinfection with Chlamydia psittaci and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB.1 variant, confirmed using metagenomic next-generation sequencing (mNGS) and quantitative polymerase chain reaction (qPCR). C. psittaci and SARS-CoV-2 were detected in bronchoalveolar lavage fluid using mNGS. Additionally, mNGS detected C. psittaci in blood and nasopharyngeal specimens and was more sensitive than qPCR. The patient recovered after treatment with moxifloxacin. This report highlights the use of coinfections of C. psittaci and SARS-CoV-2, as mNGS has already been recognized to be a diagnostic tool for identifying coinfections.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"104 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283245","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}
Introduction Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction with various etiological factors, including herpes simplex virus type 1 (HSV-1) infection, known as herpes-associated erythema multiforme (HAEM). Oral health-related quality of life (OHRQoL) is a multidimensional concept of biopsychosocial aspects related to oral health. OHRQol contains information for patient-centered treatment plan development. The OHRQoL measurement instrument widely used by clinicians is the oral health impact profile-14 (OHIP-14). This case report aimed to evaluate OHRQoL in HAEM patient, which only manifests on the lips and oral cavity. Case A 25-year-old male patient came to the Department of Oral Medicine with the chief complaint of painful canker sores on the lips. Extra-oral examination revealed serosanguineous crusts on the lips that were painful and easily bleed. Intra-oral examination showed diffused and painful irregular erythematous lesions on the upper and lower labial mucosa. The anti-HSV1 IgG test was positive. The patient was diagnosed with HAEM. Case Management Pharmacological therapy included triamcinolone acetonide 0.1% in orabase, acyclovir tablets, multivitamins, and 0.9% NaCl. Non-pharmacological therapy included advice on maintaining good oral hygiene, avoiding spicy and sour foods, and breaking the bad habit of licking the lips. Conclusion The patient’s physical, psychological, and social conditions showed improvement and returned to normal after 7 days of treatment. In conclusion, oral health is an important factor that can improve the quality of life of HAEM patient.
{"title":"Evaluation of Oral Health-Related Quality of Life in Patient with Herpes-Associated Erythema Multiforme: A Unique Case Report","authors":"Fitrah Bakti, T. Dewi","doi":"10.2147/IMCRJ.S456301","DOIUrl":"https://doi.org/10.2147/IMCRJ.S456301","url":null,"abstract":"Introduction Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction with various etiological factors, including herpes simplex virus type 1 (HSV-1) infection, known as herpes-associated erythema multiforme (HAEM). Oral health-related quality of life (OHRQoL) is a multidimensional concept of biopsychosocial aspects related to oral health. OHRQol contains information for patient-centered treatment plan development. The OHRQoL measurement instrument widely used by clinicians is the oral health impact profile-14 (OHIP-14). This case report aimed to evaluate OHRQoL in HAEM patient, which only manifests on the lips and oral cavity. Case A 25-year-old male patient came to the Department of Oral Medicine with the chief complaint of painful canker sores on the lips. Extra-oral examination revealed serosanguineous crusts on the lips that were painful and easily bleed. Intra-oral examination showed diffused and painful irregular erythematous lesions on the upper and lower labial mucosa. The anti-HSV1 IgG test was positive. The patient was diagnosed with HAEM. Case Management Pharmacological therapy included triamcinolone acetonide 0.1% in orabase, acyclovir tablets, multivitamins, and 0.9% NaCl. Non-pharmacological therapy included advice on maintaining good oral hygiene, avoiding spicy and sour foods, and breaking the bad habit of licking the lips. Conclusion The patient’s physical, psychological, and social conditions showed improvement and returned to normal after 7 days of treatment. In conclusion, oral health is an important factor that can improve the quality of life of HAEM patient.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"132 4","pages":"253 - 259"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140404800","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}
Abstract This case report presents a rare occurrence of herpes zoster (HZ) outbreak in a 50-year-old male following botulinum toxin (BTX) type A injections. The patient developed burning swollen lesions on the left forehead four days after receiving BTX injections. Physical examination revealed papules and erosions in a dermatomal distribution. He was diagnosed with HZ and promptly treated with oral acyclovir. The lesions resolved within two weeks without complications. Previous literature reports a few similar HZ outbreaks following aesthetic treatments with BTX injections. The exact mechanism triggering varicella reactivation in these cases remains unclear. Prompt diagnosis and treatment of HZ are crucial in order to minimize outbreak duration and reduce complications. Physicians should maintain awareness of HZ as a potential complication following BTX injections.
{"title":"A Case Report of Herpes Zoster After Botulinum Toxin Injections","authors":"Shadi Zari","doi":"10.2147/imcrj.s457239","DOIUrl":"https://doi.org/10.2147/imcrj.s457239","url":null,"abstract":"Abstract This case report presents a rare occurrence of herpes zoster (HZ) outbreak in a 50-year-old male following botulinum toxin (BTX) type A injections. The patient developed burning swollen lesions on the left forehead four days after receiving BTX injections. Physical examination revealed papules and erosions in a dermatomal distribution. He was diagnosed with HZ and promptly treated with oral acyclovir. The lesions resolved within two weeks without complications. Previous literature reports a few similar HZ outbreaks following aesthetic treatments with BTX injections. The exact mechanism triggering varicella reactivation in these cases remains unclear. Prompt diagnosis and treatment of HZ are crucial in order to minimize outbreak duration and reduce complications. Physicians should maintain awareness of HZ as a potential complication following BTX injections.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"17 9","pages":"261 - 263"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407721","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}
Gebrehiwot Legese, Y. Tesfaye, Eleni Ayele, Desalew Ayalew, Aron Abebaw, T. Gurji, A. Tadesse
Background: Dermatomyositis is an inflammatory myopathies causing proximal muscle weakness accompanied by muscular inflammation and skin rash. Dermatomyositis patients have a higher incidence of malignancy as compared to the general population. Case Report: A 52-year-old known female patient with a toxic multi-nodular goiter presented with insidious onset of itchy erythematous rash on her neck and bilateral hands and progressive muscle weakness of 4 months’ duration. Associated with this, she had photosensitivity, and periorbital edema of 2 months’ duration. On physical examination, she had an anterior neck mass, proximal muscle weakness, periorbital edema, and violaceous skin rash on her bilateral arms, shoulders and neck. Thyroid function tests were normal, creatinine kinase was elevated, and muscle biopsy revealed inflammatory myositis. Ultrasound of the anterior neck mass and analysis of fine needle aspiration suggested thyroid cancer. Conclusion: A high index of clinical suspicion is usually required for early diagnosis of dermatomyositis in resource-limited settings in order to prevent adverse outcomes and identify associated malignancies.
{"title":"Diagnosis of Thyroid Neoplasm-Associated Dermatomyositis in Ethiopian Woman","authors":"Gebrehiwot Legese, Y. Tesfaye, Eleni Ayele, Desalew Ayalew, Aron Abebaw, T. Gurji, A. Tadesse","doi":"10.2147/imcrj.s448187","DOIUrl":"https://doi.org/10.2147/imcrj.s448187","url":null,"abstract":"Background: Dermatomyositis is an inflammatory myopathies causing proximal muscle weakness accompanied by muscular inflammation and skin rash. Dermatomyositis patients have a higher incidence of malignancy as compared to the general population. Case Report: A 52-year-old known female patient with a toxic multi-nodular goiter presented with insidious onset of itchy erythematous rash on her neck and bilateral hands and progressive muscle weakness of 4 months’ duration. Associated with this, she had photosensitivity, and periorbital edema of 2 months’ duration. On physical examination, she had an anterior neck mass, proximal muscle weakness, periorbital edema, and violaceous skin rash on her bilateral arms, shoulders and neck. Thyroid function tests were normal, creatinine kinase was elevated, and muscle biopsy revealed inflammatory myositis. Ultrasound of the anterior neck mass and analysis of fine needle aspiration suggested thyroid cancer. Conclusion: A high index of clinical suspicion is usually required for early diagnosis of dermatomyositis in resource-limited settings in order to prevent adverse outcomes and identify associated malignancies.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"132 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274758","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}
Jun Cheng, Jinjin Pan, Dongmei Zhao, Xuejiao Ma, Qiulin Sun, Jiabin Li
Abstract The global prevalence of hepatitis C virus (HCV) infection is approximately 3%, with a post-infection chronicity rate of up to 50%–85%. HCV reactivation can occur when anti-HCV positive individuals receive antineoplastic therapy. In this study, we report a case of an anti-HCV positive patient with negative HCV RNA after 12 weeks of direct antiviral therapy. Two months later, sorafenib was used to treat hepatocellular carcinoma, and HCV reactivation occurred after 8 months of the treatment. HCV RNA was negative after 12 weeks of antiviral treatment with Sofosbuvir-velpatasvir. We also discussed the mechanism of HCV reactivation caused by sorafenib and the antiviral treatment regimen after HCV reactivation with the relevant literature.
{"title":"HCV Reactivation in a Patient with Hepatocellular Carcinoma Due to Sorafenib: A Case Report","authors":"Jun Cheng, Jinjin Pan, Dongmei Zhao, Xuejiao Ma, Qiulin Sun, Jiabin Li","doi":"10.2147/IMCRJ.S444521","DOIUrl":"https://doi.org/10.2147/IMCRJ.S444521","url":null,"abstract":"Abstract The global prevalence of hepatitis C virus (HCV) infection is approximately 3%, with a post-infection chronicity rate of up to 50%–85%. HCV reactivation can occur when anti-HCV positive individuals receive antineoplastic therapy. In this study, we report a case of an anti-HCV positive patient with negative HCV RNA after 12 weeks of direct antiviral therapy. Two months later, sorafenib was used to treat hepatocellular carcinoma, and HCV reactivation occurred after 8 months of the treatment. HCV RNA was negative after 12 weeks of antiviral treatment with Sofosbuvir-velpatasvir. We also discussed the mechanism of HCV reactivation caused by sorafenib and the antiviral treatment regimen after HCV reactivation with the relevant literature.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"8 5","pages":"121 - 124"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139811924","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}
Chien-Ching Lee, Hao-Yu Chuang, C. Chang, Hung-Lin Lin, Cheng-Hsin Cheng
Background and Importance This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications. Clinical Presentation Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps. Conclusion Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.
背景和重要性 这篇视频文章报道了一例罕见的右侧 L5/S1 腔根部裂孔瘤病例，介绍了该病的自然病程、影像学检查结果、治疗方案、手术过程，并强调了一些可能出现的手术并发症。临床表现 磁共振成像（MRI）显示右侧 L5/S1 水平有一个硬膜内、髓外、强化良好的肿块。手术过程包括右侧最小L5/S1椎板切除术/后方椎板切除术，以打开右侧L5根部。为防止脊柱不稳，手术保留了面关节。打开右侧L5/S1孔后，肿瘤沿着根部被找到。术中进行了肌电图（IOM）检查，以发现患者是否有神经损伤。打开硬脑膜后，在 IOM 监测下小心地将肿瘤与正常的根神经分离。用微型钳将肿块逐块切除。结论 组织病理学检查确诊为分裂瘤。患者术后恢复顺利，右腿疼痛和麻木症状轻微。
{"title":"Minimally Invasive Resection of a Foraminal Lumbar Root Schwannoma","authors":"Chien-Ching Lee, Hao-Yu Chuang, C. Chang, Hung-Lin Lin, Cheng-Hsin Cheng","doi":"10.2147/IMCRJ.S445098","DOIUrl":"https://doi.org/10.2147/IMCRJ.S445098","url":null,"abstract":"Background and Importance This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications. Clinical Presentation Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps. Conclusion Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"45 3","pages":"125 - 129"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139821005","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}
Chien-Ching Lee, Hao-Yu Chuang, C. Chang, Hung-Lin Lin, Cheng-Hsin Cheng
Background and Importance This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications. Clinical Presentation Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps. Conclusion Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.
背景和重要性 这篇视频文章报道了一例罕见的右侧 L5/S1 腔根部裂孔瘤病例，介绍了该病的自然病程、影像学检查结果、治疗方案、手术过程，并强调了一些可能出现的手术并发症。临床表现 磁共振成像（MRI）显示右侧 L5/S1 水平有一个硬膜内、髓外、强化良好的肿块。手术过程包括右侧最小L5/S1椎板切除术/后方椎板切除术，以打开右侧L5根部。为防止脊柱不稳，手术保留了面关节。打开右侧L5/S1孔后，肿瘤沿着根部被找到。术中进行了肌电图（IOM）检查，以发现患者是否有神经损伤。打开硬脑膜后，在 IOM 监测下小心地将肿瘤与正常的根神经分离。用微型钳将肿块逐块切除。结论 组织病理学检查确诊为分裂瘤。患者术后恢复顺利，右腿疼痛和麻木症状轻微。
{"title":"Minimally Invasive Resection of a Foraminal Lumbar Root Schwannoma","authors":"Chien-Ching Lee, Hao-Yu Chuang, C. Chang, Hung-Lin Lin, Cheng-Hsin Cheng","doi":"10.2147/IMCRJ.S445098","DOIUrl":"https://doi.org/10.2147/IMCRJ.S445098","url":null,"abstract":"Background and Importance This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications. Clinical Presentation Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps. Conclusion Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.","PeriodicalId":508214,"journal":{"name":"International Medical Case Reports Journal","volume":"44 2","pages":"125 - 129"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880887","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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