Focal multiphasic demyelination- a diagnostic dilemma - Rare presentation of relapse of disseminated encephalomyelitis or multiple sclerosis

2017 ◽  
Vol 381 ◽  
pp. 537
Author(s):  
T. Hasan ◽  
M. Imran ◽  
D. Kanwar
Keyword(s):  
Multiple Sclerosis ◽  
Rare Presentation ◽  
Diagnostic Dilemma

Acute proptosis secondary to bilateral pansinus mucopyocele with orbital compartment syndrome: a rare presentation, its management and outcome

2021 ◽  
Vol 14 (7) ◽  
pp. e241972
Author(s):  
Khushboo Chauhan ◽  
Tanya Sharma ◽  
Bhavana Sharma ◽  
Samendra Karkhur
Keyword(s):  
Compartment Syndrome ◽  
Nasal Polyposis ◽  
Signs And Symptoms ◽  
Sinus Surgery ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Guided Exploration ◽  
Rapid Relief ◽  
Maxillary Sinuses

A 37-year-old Indian female presented with forward protrusion of left eye for one week, associated with progressive diminution of vision. The patient had undergone sinus surgery for nasal polyposis a year ago. On examination, there was severe proptosis and limitation of extraocular movements in all gazes. CT-scan revealed a heterogeneous expansile mass, arising from left fronto-ethmoidal sinus, infiltrating left orbit. MRI showed T2-hyperintense, peripherally enhancing areas in bilateral nasal cavity (right >left), bilateral ethmoidal sinuses and frontal, sphenoidal and maxillary sinuses. Otorhinolaryngology consultation was sought and in view of vision threatening proptosis — with likely orbital compartment syndrome — emergent endoscopic guided exploration and orbital decompression was undertaken. Rapid relief of signs and symptoms was achieved, with normal vision, extraocular movements and resolution of proptosis. Cytology and microbiology ruled out infectious or malignant aetiology and helped in resolving a diagnostic dilemma. Histopathology confirmed the diagnosis of mucopyocele and follow-up period was uneventful.

scholarly journals Primary umbilical endometriosis – A rare presentation of cutaneous endometriosis

2021 ◽  
Vol 6 (3) ◽  
pp. 226-230
Author(s):  
Girija C ◽  
Muhammed Aslam K K
Keyword(s):  
Rare Condition ◽  
Surgical Excision ◽  
Rare Presentation ◽  
Surgical Biopsy ◽  
Diagnostic Dilemma ◽  
Child Bearing ◽  
Surgical Speciality ◽  
Cutaneous Endometriosis ◽  
Clinical Differential Diagnosis ◽  
Umbilical Endometriosis

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

scholarly journals A rare presentation of undiagnosed multiple sclerosis after the COVID-19 vaccine

2021 ◽  
Vol 11 (6) ◽  
pp. 772-775
Author(s):  
Ariana R. Tagliaferri ◽  
George Horani ◽  
Katherine Stephens ◽  
Patrick Michael
Keyword(s):  
Multiple Sclerosis ◽  
Rare Presentation

Rare presentation of isolated hydatid disease of the breast

2021 ◽  
Vol 14 (7) ◽  
pp. e243052
Author(s):  
Ronal Kori ◽  
Sudhir Kumar Jain ◽  
Rehan Nabi Khan
Keyword(s):  
Hydatid Cyst ◽  
Echinococcus Granulosus ◽  
Hydatid Disease ◽  
Similar Case ◽  
Rare Condition ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Endemic Areas ◽  
Accidental Host ◽  
Cattle And Sheep

Isolated hydatid disease of the breast is a rare condition, possessing a diagnostic dilemma for the clinicians. Hydatid disease is common in endemic areas affecting most commonly the liver and lungs. Other organs rarely involved are the kidney, bone and brain. It is caused by the parasite Echinococcus granulosus, widely spread by cattle and sheep. Humans are the accidental host for this organism. We present a similar case of isolated hydatid cyst of the breast, which was diagnosed preoperatively and managed successfully.

Primary synovial sarcoma of the lung: a rare presentation, diagnostic dilemma and review of literature

2020 ◽  
Vol 13 (11) ◽  
pp. e237678
Author(s):  
Laxman Pandey ◽  
Deepa Joseph ◽  
Rajesh Pasricha ◽  
Manoj Kumar Gupta
Keyword(s):  
Synovial Sarcoma ◽  
Left Lung ◽  
Treatment Protocol ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Rare Tumour ◽  
Improved Outcomes ◽  
Long Term Follow Up ◽  
Lung Metastasectomy ◽  
Malignant Lung Tumours

Primary synovial sarcoma of the lung (PSSL) is a rare tumour with only 0.5% incidence among other primary malignant lung tumours. Published medical literature regarding the natural history treatment protocol and clinical outcomes of PSSL remains limited. Here, we present a case of a 39-year-old man with primary synovial sarcoma with long-term follow-up, which was initially viewed as a metastasis from another unknown site. After evaluating histopathologically from the specimen post left lung metastasectomy and ruling out any other site for neoplastic changes, the diagnosis of PSSL was confirmed. Furthermore, this article reviews the literature and discusses various aspects of PSSL, including clinical presentation, radiological imaging and pathological characteristics, diagnostic dilemma, management and prognosis. This paper serves to provide an update and aims to enhance the understanding of PSSL. Timely diagnosis and treatment are imperative to achieve improved outcomes.

A cute verbal dyspraxia, a rare presentation in multiple sclerosis: a case report with MRI localization

2003 ◽  
Vol 9 (6) ◽  
pp. 630-632 ◽  
Author(s):  
Stephen L Jaffe ◽  
Michael F Glabus ◽  
Roger E Kelley ◽  
Alireza Minagar
Keyword(s):  
Multiple Sclerosis ◽  
White Matter Lesion ◽  
Inferior Frontal Gyrus ◽  
Speech Disorders ◽  
Rare Presentation ◽  
Qualitative And Quantitative ◽  
Relapsing Remitting ◽  
Brodmann Areas ◽  
Magnetic Resonance Imaging Mri

C ortical speech disorders rarely occur in multiple sclerosis (MS). We report a patient with relapsing-remitting MS, who presented with acute verbal dyspraxia. Magnetic resonance imaging (MRI) demonstrated an acute T2/Flair hyperintense, primarily white matter lesion underlying the middle third of the inferior frontal gyrus. The verbal dyspraxia cleared beginning 48 hours after the initiation of iv dexamethasone. Follow-up MRI demonstrated qualitative and quantitative diminution of the hyperintensity. This is the first report of a clinically definite MS patient with acute verbal dyspraxia. Moreover, there was a suggestive localization of verbal praxis to Brodmann areas 44/45.

The diagnostic dilemma of multiple sclerosis presenting with isolated cognitive and behavioral disorders

2017 ◽  
Vol 23 (11) ◽  
pp. 1561-1563 ◽  
Author(s):  
Maria Pia Amato
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Behavioral Disorders ◽  
White Matter Lesions ◽  
Accurate Diagnosis ◽  
Diagnostic Workup ◽  
Behavioral Symptoms ◽  
Diagnostic Dilemma ◽  
Early Stages

Cognitive and behavioral symptoms are common in multiple sclerosis (MS), even from the early stages of the disease, but they are considered to be rarely the inaugural and predominant manifestation of the disease, thus jeopardizing early and accurate diagnosis. This clinical commentary highlights a number of peculiar characteristics that should be taken into consideration in case of primary cognitive/neuropsychiatric dysfunction and white matter lesions of unclear origin, in order to prompt appropriate diagnostic workup.

scholarly journals Soft Tissue Tumor Leg - A Rare Presentation of Cutaneous Rhinosporidiosis

2020 ◽  
pp. 1-2
Author(s):  
R. Chithra ◽  
B Sai Dhandapani ◽  
R King Gandhi ◽  
R. Chithra
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Soft Tissue Mass ◽  
Radiological Findings ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Tissue Mass ◽  
Tissue Tumor ◽  
Typical History ◽  
Polypoidal Growth

Rhinosporidiosis presents commonly as polypoidal growth in nose, but presentation in other sites including skin, genitourinary tract is documented. Cutaneous presentation is rare, which may present as pedunculated swelling or cutaneous ulceration, but presenting as soft tissue tumor is extremely rare. The multifaceted presentation of the disease causes diagnostic dilemma to an unsuspecting physician. Clinical and radiological findings may mislead, but usually typical history helps, and typical histology clinches the diagnosis. We are presenting a case of disseminated cutaneous rhinosporidiosis presented as soft tissue mass lesion in the leg causing diagnostic difficulty due to the rare presentation.

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