Case Reports in Medicine最新文献

Systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS) are chronic, multisystem disorders. When the two coexist, the manifestations become more complex and diverse, and early diagnosis and treatment are a key to improving the patient prognosis. However, to date, only scarce reports have been published, especially overlap syndrome. We review the diagnosis and treatment process of a case of acute renal injury and encephalopathy syndrome secondary to SLE with overlapping SS to gain a comprehensive understanding of the disease with review of the current literature.

Hodgkin's lymphoma (HL) is uncommon, and its etiology has been attributed to infectious sources such as Epstein-Barr virus (EBV). Though pathogenesis is not completely understood, studies have revealed that specific viral proteins from EBV conduct the process of HL development. In this report, we will discuss the case of a patient who developed EBV-associated classic HL 15 years after an episode of infectious mononucleosis.

Ewing sarcoma is a small round cell tumor of uncertain differentiation, primarily originating in bone in children and adolescents. Ewing sarcoma of the kidney is a rare occurrence and follows an aggressive course with early metastasis. Herein, we present a case of a 16-year-old male presenting with abdominal pain and lump. He underwent nephrectomy and histopathological diagnosis of small round cell tumor with differential diagnosis of Ewing sarcoma was made which was further confirmed by immunohistochemistry. Thus, Ewing sarcoma must also be taken into consideration while dealing with tumors of the kidney in young age group.

Introduction: Hypopharyngeal rupture caused by indirect neck trauma is a rare but potentially life-threatening injury. Delayed diagnosis can lead to severe complications, highlighting the importance of clinical suspicion and appropriate imaging. Case Presentation: A 64-year-old male patient sustained indirect neck trauma following a car accident. He was initially transferred to the hospital with mild symptoms and was discharged. However, a few hours later, he returned to the emergency department with neck pain, odynophagia, and dysphagia. CT imaging revealed evidence of hypopharyngeal rupture accompanied by retropharyngeal emphysema. The patient was managed conservatively with Nil Per Os (NPO), intravenous antibiotics, and the placement of a nasogastric (NG) tube. He achieved full recovery without complications. Conclusion: This case emphasizes the importance of thoroughly evaluating the relationship between clinical complaints and the mechanism of injury in patients with indirect neck trauma. High clinical suspicion, detailed history-taking, and appropriate imaging modalities are crucial for early diagnosis and effective management.

Phosphatase and tensin homolog (PTEN), a tumor suppressor gene, is also associated with neurological phenotypes, including macrocephaly, Cowden syndrome, and autism spectrum disorder. We present a 34-year-old Chinese male who complained of recurrent seizures within one year. His occipital frontal circumference was 62.8 cm. Whole-exon sequencing revealed that he carried a heterozygous missense mutation of NM_000314.4:c.4375C > T (p.Met35Val) in PTEN gene. Therefore, heterozygous mutations of c.103A > G in PTEN may increase the risk of macrocephaly with epilepsy.

Small-cell lung carcinoma (SCLC) associated with cystic airspaces is rare. We describe the case of a 68-year-old man who was referred to our hospital because of a cystic lesion detected on chest radiography. Initial computed tomography revealed a small nodule abutting the cystic airspace due to paraseptal emphysema in the right lower lobe. Histopathological examination of lymphadenopathy indicated SCLC. Postchemotherapy, recurrence appeared as a thick-walled cystic airspace with an exophytic nodule along the cyst wall, mimicking pneumonia. Additional chemotherapy, but not antibiotic therapy, led to a reduction in the wall thickness and nodules. This case emphasizes unresponsiveness to antibiotic therapy, especially in patients with risk factors, highlighting the diagnostic pitfall that may delay timely cancer treatment.

Hairy cell leukemia (HCL) is among a group of mature lymphoid B-cell disorders characterized by the identification of hairy cells and a unique genetic profile. Detection of CD103 expression on flow cytometry is the key in enumerating the immunologic score for diagnosing HCL. For a disease that is more prevalent in Caucasians and less common in African populations, we report an unusual case of CD103-negative classical HCL in a 43-year-old African male, who presented with refractory anemia, thrombocytopenia, and splenomegaly. In patients with refractory anemia, it is crucial to consider investigating HCL, as this may influence therapeutic decisions and, consequently, overall patient outcomes.

Hodgkin lymphoma (HL) is a type of lymphoma, characterized by the presence of abnormal Reed-Sternberg cells. It typically affects lymph nodes, generally in the upper body (such as neck, chest, and armpits). It can also involve the spleen, liver, and bone marrow. In the literature, there are sporadic cases of atypical localization of HL. The aim of this article is to report a peculiar case of HL in a 55-year-old male presenting with primary epitrochlear lymphadenopathy as the only localization of disease, also performing a literature review on this atypical presentation. We also summarized the possible underlying malignant pathologies that arise from the soft tissues of the upper limb adjacent to the elbow.

Background: Inguinal hernia is one of the most common causes of surgeries around the world; however, the herniation of the urinary bladder as a recurrence in this region is rare. It can have urinary symptoms with pain and protrusion in the inguinoscrotal region. Case Presentation: We report the case of a 65-year-old Iranian male patient who presented with obstructive urinary symptoms and a reducible protrusion in the right inguinoscrotal region. The patient underwent a successful repairment operation in a laparoscopic manner without any intra- or postoperative complications. Also, here, we review the risk factors, symptoms, and paraclinics that should be noted regarding the inguinal hernia with visceral organ protrusion. Conclusion: Clinicians must be aware of different symptoms of herniated organs in the inguinal region to avoid unwanted complications.

Female fertility decline with age presents a challenge to successful IVF outcomes. The rising trend of delayed family planning due to societal changes has led to increased demand for reproductive assistance among older women. Despite clinical and scientific advances in Assisted Reproductive Technology, age remains a barrier to successful outcomes mainly due to declining oocyte quality and quantity, leading to decreased fecundity rates and increased miscarriage risks. This report highlights an exceptional case of a women aged 46 achieving live birth through IVF using her own oocytes. Notably, awareness among women about the profound effect of age on fertility remains insufficient. Educating women about these age-related reproductive challenges is crucial. Oocyte cryopreservation emerges as a potential strategy, while egg donation stands as a pragmatic alternative. However, the probability of live birth among women at the extremes of reproductive age using their own oocytes is low, at 0.3%. It is important to approach this case report with caution to avoid unrealistic expectations among women aged 45 or older seeking IVF services.