Benign schwannoma in paranasal sinuses: a clinico-pathological study of five cases, emphasising diagnostic difficulties

2007 ◽  
Vol 122 (6) ◽  
pp. 598-602 ◽  
Author(s):  
H Y Sheikh ◽  
R P Chakravarthy ◽  
N J Slevin ◽  
A J Sykes ◽  
S S Banerjee
Keyword(s):  
Malignant Disease ◽  
Correct Diagnosis ◽  
Rare Condition ◽  
Benign Schwannoma ◽  
Local Bone ◽  
Appropriate Treatment ◽  
Pathological Review ◽  
Diagnostic Difficulties ◽  
Clinical Awareness

AbstractObjectives:To highlight the difficulty in making a correct diagnosis of benign schwannoma in the paranasal region, to raise awareness of this rare condition, and to suggest the most appropriate treatment.Method:Retrieval of cases retrospectively from archives of the histopathology department of a major UK cancer centre with central review of all cases.Results:Five cases were identified since 1990 and clinical and pathological features are summarised. Median follow up of patients was 8.1 years. Radiological appearances of local bone invasion and histological features of tumour unencapsulation and hypercellularity could give the mistaken impression of malignant disease and lead to unnecessary over-treatment.Conclusion:Central pathological review and clinical awareness is required. Although local recurrence can occur, the prognosis is excellent. The treatment of choice is local excision. Radiotherapy can be considered, but in most cases it would incur unnecessary morbidity.

scholarly journals Pantaloon Hernia in a Female: A Rare Finding

2021 ◽  
Vol 3 (2) ◽  
pp. 1-2
Author(s):  
Onyeyirichi Otuu ◽  
Uche Emmanuel Eni ◽  
Callistus Ugochukwu Ndunaka ◽  
Nwanneka Louisa Kwentoh
Keyword(s):  
Inguinal Hernia ◽  
Correct Diagnosis ◽  
Posterior Wall ◽  
Uneventful Recovery ◽  
Indirect Inguinal Hernia ◽  
Left Groin ◽  
Epigastric Artery ◽  
Appropriate Treatment ◽  
Groin Swelling

The incidence of inguinal hernia in females is less compared to the males. Pantaloon hernia in females is even rarer and may be first diagnosed during surgery. We report a rare case of pantaloon hernia in a 60 year old female patient. She presented with reducible left groin swelling of 3 years duration and a clinical diagnosis of an indirect inguinal hernia made. A direct sac and an indirect sac were discovered at operation on both sides of the inferior epigastric artery. The posterior wall was repaired by Lichtenstein method. Patient made an uneventful recovery and there was no recurrence after 12 months of follow up. Though pantaloon hernia is rare in females, proper dissection, and identification of structure in the inguinal canal is necessary to make the correct diagnosis and to offer the appropriate treatment.

scholarly journals Perinephric urinoma following spontaneous renal rupture in the third trimester of pregnancy: a case report and brief review of the literature

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ya Chen ◽  
Yun Fang Yan ◽  
Ying Zhang ◽  
Xianming Carroll ◽  
Hui Rong Li ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urine Analysis ◽  
Rare Condition ◽  
Percutaneous Nephrostomy ◽  
Third Trimester ◽  
The Third ◽  
Appropriate Treatment ◽  
Perinephric Space ◽  
Renal Rupture

Abstract Background Spontaneous formation of urinoma is a rare condition, especially for pregnant women. We report a patient in the third trimester of pregnancy with a spontaneous renal rupture who then develops a urinoma from urine leaking into the perinephric space. Case presentation A 23-year-old primagravida was diagnosed with a spontaneous renal rupture and acute left loin pain accompanied by hematuria when she was 35 weeks pregnant. A sub-capsular perinephric cyst then developed to a size of 319 × 175 × 253 mm, and because of discomfort to the patient, we performed Cesarean section. After a healthy male newborn was delivered, fluid was suctioned from a large perirenal cyst that had an estimated size of 300 × 200 × 300 mm. A percutaneous nephrostomy tube was left in the cyst until CT showed no remaining fluid. In the six-month follow-up, the patient showed no perirenal extravasation according to an ultrasound scan, and the urine analysis and renal function tests were normal. Conclusion Close follow-up should be recommended for the patient who has renal rupture after conservative therapy, especially for pregnant woman. CT or MRI should be considered in addition to utilizing ultrasound in the management of pregnant women who present with urinomas. Percutaneous nephrostomy is suggested as an appropriate treatment for large urinomas.

Clear cell chondrosarcoma of proximal femur: a rare entity with diagnostic dilemma

2020 ◽  
Vol 13 (10) ◽  
pp. e236389
Author(s):  
Manish Pruthi ◽  
Jagandeep Singh Virk ◽  
Anila Sharma ◽  
Vivek Mahawar
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Correct Diagnosis ◽  
Malignant Neoplasm ◽  
Diagnostic Dilemma ◽  
Clear Cell Chondrosarcoma ◽  
High Local Recurrence Rate ◽  
Appropriate Treatment ◽  
Slow Growing

Clear cell chondrosarcoma is an extremely rare malignant neoplasm. The rarity and slow-growing nature of this tumour often lead to prolonged symptoms and also initial misdiagnosis with benign lesions such as chondroblastoma. It can also be confused with avascular necrosis of the femoral head when the lesion is located in the femoral head, as was in the case we report. The patient was kept on observation and conservative treatment for almost 9 years before the correct diagnosis and appropriate treatment. Wide local resection with negative margins forms the mainstay of treatment since intralesional procedures predispose to high local recurrence rate. A prolonged follow-up is recommended since late local recurrences and metastases are common.

scholarly journals Acute Pisiform Dislocation in Association with Terrible Triad Injury of the Elbow

2019 ◽  
Author(s):  
Pedro Martins Branco ◽  
João Sousa ◽  
Carlos Maia Dias ◽  
Manuel Oliveira ◽  
António Júlio Silva ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Kirschner Wire ◽  
Ground Level ◽  
Collateral Ligaments ◽  
Terrible Triad ◽  
Range Of Movement ◽  
Rare Injury ◽  
Radial Head Arthroplasty ◽  
Appropriate Treatment

Dislocation of the pisiform is a rare injury, with only few cases reported in the literature. This condition, in association with terrible triad injury of the elbow, is an even more rare occurrence. We report a case of a 51-years-old right-handed female patient who suffered from a dislocation of the left pisiform in association with terrible triad injury of the elbow, after a ground level fall. It was performed a reinsertion of the coronoid process and radial collateral ligaments with anchors, radial head arthroplasty, and closed reduction and internal fixation of the pisiform with Kirschner wire. At the end of follow-up, the patient had satisfactory range of movement of the wrist and elbow, and no residual pain. This rare injury to the wrist is demanding in diagnostics and treatment. However, with a correct diagnosis and appropriate treatment, an excellent clinical outcome can be achieved.

Artery of Percheron Infarction: A Characteristic Pattern of Ischemia and Variable Clinical Presentation: a literature review

2020 ◽  
Vol 16 ◽  
Author(s):  
Osama Kheiralla ◽  
Salem Alghamdi ◽  
Rowa Aljondi ◽  
Abdulrahman Tajaldeen ◽  
Adel Othman Bakheet
Keyword(s):  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Small Diameter ◽  
Characteristic Pattern ◽  
Arterial Trunk ◽  
Appropriate Treatment ◽  
Clinical Presentations ◽  
Artery Of Percheron ◽  
Diagnostic Difficulties ◽  
Thalamic Infarct

: The Artery of Percheron (AOP) is an uncommon anatomic variant that provides arterial supply to the paramedian region of the thalami and bilaterally to the rostral part of the midbrain; it is a solitary arterial trunk that branches from a proximal segment of the posterior cerebral artery (PCA). Although AOP infarction results in a characteristic pattern of ischemia—namely bilateral paramedian thalamic infarct with or without midbrain involvement— it may cause diagnostic difficulties due to the variety of its clinical presentations and wide differentials, as well as its small diameter and the difficulty of obtaining visualization through diagnostic imaging. Early neuroimaging of AOP infarction and correct diagnosis are mandatory for early initiation of the appropriate treatment and better patient outcomes. In this study, we discuss imaging the patterns of AOP infarction, as well as its differentials and clinical presentation.

scholarly journals Supernumerary Ovary: A Case Report

2017 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
D. Kavitha Yogini ◽  
Devi Balasubramaniam ◽  
Malathi Ezhil ◽  
Kodeeswari Periyasamy ◽  
Chinnusamy Palanivelu
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Correct Diagnosis ◽  
Rare Condition ◽  
Malignant Potential ◽  
Clinical Implications ◽  
Incidental Diagnosis ◽  
The Third ◽  
Serous Cystadenocarcinoma

Supernumerary Ovary is a rare incidental diagnosis, which is on the rise due to modern imaging modalities and advent of laparoscopy in Gynecology. It has various clinical implications. It can present like Endometrioma, Fibroma or as papillary serous cystadenocarcinoma. Removal of this additional ovary tends to stay in dilemma, because its follicles can be used in the treatment of infertility and it has malignant potential. Hence, correct diagnosis and prompt decision making is necessary based on the patient age and parity. As in our case, a nulligravida presented with torsion of the ovarian cyst. During Laparoscopic procedure, we noticed that this pathology was from the third ovary as in this case Supernumerary ovary. The removal of the ovary was not done as this patient was undergoing treatment for infertility. Weighing the benefits over risks, patient was counselled for proper follow-up and removal of this Supernumerary ovary following completion of family. All gynecologists should be aware of this rare condition due to its clinical implications and its appropriate management. Keywords: Supernumerary Ovary, Ovarian Torsion, Malignant potential, Fertility, Incidental diagnosis

scholarly journals Aggressive Angiomyxoma in Pregnancy: A Rare Condition, a Common Misdiagnosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
J. Sampaio ◽  
I. Sarmento-Gonçalves ◽  
D. Ramada ◽  
T. Amaro ◽  
P. Tiago-Silva
Keyword(s):  
Early Recognition ◽  
Correct Diagnosis ◽  
Progesterone Receptors ◽  
Rare Condition ◽  
Unknown Origin ◽  
Surgical Excision ◽  
Aggressive Angiomyxoma ◽  
Mesenchymal Neoplasm ◽  
The Impact

Introduction. Aggressive angiomyxoma is a rare mesenchymal neoplasm. Although benign in the majority of the cases, these neoplasms usually present a locally infiltrative nature and high rates of recurrence. Due to its rarity, misdiagnosis is a common problem.Case Presentation. We present one case of aggressive angiomyxoma in a 25-year-old pregnant woman. The patient presented with a large vaginal mass that was interpreted as a vaginal cyst. We performed surgical resection of the neoplasm and the correct diagnosis was only achieved after histological examination. With this case, we highlight the importance of considering this diagnosis in patients with genital and perineal masses of unknown origin and the impact of a correct preoperative diagnosis in patient’s management and follow-up.Conclusion. Although aggressive angiomyxoma is rare, it should be considered in differential diagnosis of pelviperineal masses in young women. Its positivity to estrogen and progesterone receptors can justify enlargement and recurrence during pregnancy, although few cases are reported. Early recognition demands high index of suspicion for both gynaecologists and pathologists. Wide surgical excision with tumor free margins is the basis of curative treatment. Adjuvant therapy may be necessary for residual or recurrent tumors. Long-term follow-up is recommended.

scholarly journals Tuberculosis of breast: a rare case report

2017 ◽  
Vol 4 (12) ◽  
pp. 4099
Author(s):  
Shubhi Bhatnagar ◽  
Shahaji Chavan ◽  
Mayank Chakraborty ◽  
Rahul Banik ◽  
Sree Ganesh Balasubramanian ◽  
...  
Keyword(s):  
Elderly Women ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Antituberculous Therapy ◽  
Breast Tuberculosis ◽  
Multiparous Women ◽  
Rare Case Report ◽  
Diagnostic Difficulties ◽  
One Year

Tuberculosis of the breast is an extremely rare extra pulmonary presentation of tuberculosis accounting for less than 1% of all diseases of the breast. It usually affects young lactating multiparous women, although it may also be reported in prepubescent males, or in elderly women. This rare condition can pose diagnostic difficulties and can mimic carcinoma breast or abscess. We report a case of a 42-year-old female patient with breast tuberculosis. We have reviewed this case in terms of clinical presentation, investigations, surgical treatment and antituberculous therapy and have shortly described our experience. Ultrasonography of breast, mammography and magnetic resonance imaging of breast supported the diagnosis of tuberculosis of breast. Wide local excision of the breast lump was done, and the excised specimen was sent for histopathological examination which confirmed the diagnosis of tuberculosis of breast. Antituberculous therapy was started post operatively. Post-operative period was uneventful. No active breast or pulmonary disease was present one year after surgery in chest computerized tomography scan. Possibility of this condition should be kept in mind in cases of breast carcinoma or abscess. Diagnosis is made by assessing a combination of clinical, radiological and pathological features. Treatment is mainly antituberculous therapy. Surgery is rarely required. A regular follow up is recommended to rule out recurrence of tuberculosis.

Autoimmune Pancreatitis – Diagnosis, Management and Longterm Follow-up

2014 ◽  
Vol 23 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Suvadip Chatterjee ◽  
Kofi W. Oppong ◽  
John S. Scott ◽  
Dave E. Jones ◽  
Richard M. Charnley ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Rare Condition ◽  
Team Approach ◽  
Diagnostic Challenge ◽  
Multisystem Disorder ◽  
North East ◽  
The North ◽  
Work Up ◽  
Igg4 Level

Background & Aims: Autoimmune pancreatitis (AIP) is a fibroinflammatory condition affecting the pancreas and could present as a multisystem disorder. Diagnosis and management can pose a diagnostic challenge in certain groups of patients. We report our experience of managing this condition in a tertiary pancreaticobiliary centre in the North East of England.Methods: Patients were identified from a prospectively maintained database of patients diagnosed with AIP between 2005 and 2013. Diagnosis of definite/probable AIP was based on the revised HISORt criteria. When indicated, patients were treated with steroids and relapses were treated with azathioprine. All patients have been followed up to date.Results: Twenty-two patients were diagnosed with AIP during this period. All patients had pancreatic protocol CT performed while some patients had either MR or EUS as part of the work up. Fourteen out of 22 (64%) had an elevated IgG4 level (mean: 10.9 g/L; range 3.4 - 31 g/L). Four (18%) patients underwent surgery. Extrapancreatic involvement was seen in 15 (68%) patients, with biliary involvement being the commonest. Nineteen (86%) were treated with steroids and five (23%) required further immunosuppression for treatment of relapses. The mean follow up period was 36.94 months (range 7 - 94).Conclusion: Autoimmune pancreatitis is being increasingly recognized in the British population. Extrapancreatic involvement, particularly extrahepatic biliary involvement seems to be a frequent feature.Diagnosis should be based on accepted criteria as this significantly reduces the chances of overlooking malignancy. Awareness of this relatively rare condition and a multi-disciplinary team approach will help us to diagnose and treat this condition more efiectively thereby reducing unnecessary interventions.

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