BMJ Case Reports最新文献

A female patient with previous vitrectomy for epiretinal membrane in the left eye underwent bilateral selective laser trabeculoplasty (SLT) for pigmentary glaucoma and subsequently developed cystoid macular oedema (CMO) in the vitrectomised eye. This resolved fully with treatment with topical steroids and non-steroidal anti-inflammatory drug (NSAID) drops. This complication has been very rarely reported in the literature, and a subsequent internal audit found a very low rate of CMO temporally related to SLT of 0.07%. We suggest close follow-up and 'red flag' follow-up instructions to patients with previous vitrectomy or epiretinal membrane to watch for this complication, and clinicians may consider covering higher risk patients with an NSAID post-laser.

Achondroplasia is a genetic condition resulting from specific disruptions in the formation of endochondral bone. Telecanthus, exotropia, angle anomalies and cone-rod dystrophy have been observed as associated ophthalmic features in patients with achondroplasia. Here, we present a case of achondroplasia associated with unique ocular features including telecanthus, esotropia and bilateral microphthalmos. Fundus evaluation revealed a distinctive combination of optic disc anomalies, namely, optic disc coloboma, morning glory disc and optic disc pit maculopathy, along with retroorbital cysts. This represents the first reported case of such a combination of ocular anomalies in achondroplasia.

Background: Angular pregnancy is a rare event and is a commonly missed diagnosis in the antepartum period. Data regarding the optimal mode of delivery and management of the placenta are limited.

Case description: A patient in her 30s, gravida 3, para 1 presented at 37 weeks with severe range blood pressure and was admitted for induction of labour due to preeclampsia. Her labour course and delivery of the neonate were uncomplicated. Despite attempts at manual extraction and suction dilation and curettage, the placenta was unable to be removed. Ultrasound revealed the placenta in the right cornua, suspicious for angular pregnancy. She was taken to the operating room for exploratory laparotomy and hysterotomy for extraction of the placenta. She had an uncomplicated postpartum course and was discharged home on postpartum day 4.

Conclusion: In patients with suspected angular pregnancy, exploratory laparotomy and hysterotomy may be required for placental removal.

Rectal cancer metastasising to the penis is an exceptionally rare clinical entity, with less than 80 reported cases. Metastasis to the penis is typically identified in conjunction with widespread metastatic disease and as such is usually associated with a very poor prognosis. We report a case of a man who presented with a metastatic deposit in his penis 15 years after the initial diagnosis of rectal cancer. The patient was initially managed with radical penectomy and perineal urethrostomy formation. This was followed by FOLFIRI chemotherapy regimen when further nodules were identified in his lungs on postoperative imaging. At 20months' follow-up, the patient remains alive and disease-free.

A previously healthy female infant was brought to the paediatrics outpatient department by her mother reporting increased irritability and swelling behind her left shoulder, accompanied by restricted movement in her left arm. The irritability had been present for the past 5 months, with swelling also noticed at that time, gradually increasing in size. On examination, a large, firm, immobile mass was detected on the left scapular region. The mass was tender to touch, without any hardening or induration of the overlying skin. The child was afebrile, and her vital signs were stable. Subsequent imaging revealed hyperostosis in the left scapula, along with swelling of the surrounding soft tissue. After ruling out conditions such as chronic osteomyelitis, Ewing's sarcoma, rhabdomyosarcoma, trauma or child abuse, chronic recurrent multifocal osteomyelitis and hypervitaminosis A, the findings pointed to Caffey disease. Although infantile cortical hyperostosis, or Caffey disease, is rare, it should be considered in the differential diagnosis of a bony swelling in a young child.

Scrotal calcinosis is an infrequent benign pathological condition characterised by the presence of multiple calcified nodules on the skin of the scrotum. Despite the formulation of several theories, the precise pathogenesis of this condition remains a subject of controversy within the scientific community. The predominant concern associated with scrotal calcinosis is of an aesthetic nature, and histological examination serves as the definitive method for confirmation of the diagnosis. The manifestation of scrotal nodules and cysts is an uncommon occurrence, and in cases where these manifestations are asymptomatic, the diagnostic timeframe may extend over several years, potentially spanning decades. Surgical excision of the calcified lesions is the established treatment modality, serving both diagnostic and therapeutic objectives.