Grisel syndrome: a delayed presentation in an asymptomatic patient

2007 ◽  
Vol 121 (8) ◽  
pp. 800-802 ◽  
Author(s):  
J Doshi ◽  
S Anari ◽  
I Zammit-Maempel ◽  
V Paleri
Keyword(s):  
Skull Base ◽  
Asymptomatic Patient ◽  
Neck Region ◽  
Rare Condition ◽  
Delayed Presentation ◽  
Computed Tomography Scan ◽  
Head And Neck Region ◽  
Grisel Syndrome ◽  
Tomography Scan

AbstractGrisel syndrome is a rare condition characterised by atlanto-axial subluxation following an inflammatory process in the head and neck region. It occurs more commonly in children and usually presents with cervical pain and torticollis, in addition to symptoms of the primary infection. We present the case of an asymptomatic 78-year-old man who was incidentally found to have atlanto-axial subluxation on a routine follow-up computed tomography scan, three months following successful treatment of a skull base infection. This case emphasises the importance of appropriate follow-up imaging for patients with skull base infections, even if they respond clinically to medical treatment.

scholarly journals A Case of Primary Systemic Amyloidosis Involving the Sinonasal Tract

2020 ◽  
pp. 014556132092271
Author(s):  
Toshinori Onishi ◽  
Makoto Yasuda ◽  
Atsuhide Koida ◽  
Taka-aki Inui ◽  
Shota Okamoto ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Neck Region ◽  
Rare Condition ◽  
Systemic Amyloidosis ◽  
Sinonasal Tract ◽  
Sinus Surgery ◽  
Blurred Vision ◽  
Head And Neck Region ◽  
Amyloid Deposits

We present a case of primary systemic amyloidosis diagnosed by endoscopic sinus surgery. A 75-year-old woman had blurred vision in her left eye; computed tomography and magnetic resonance imaging showed shadows of the bilateral paranasal sinuses. Endoscopic sinus surgery was performed, and amyloidosis was diagnosed by histopathology. She had previously been diagnosed with amyloidosis of the stomach, and therefore, she was diagnosed with primary systemic amyloidosis. A systemic workup for additional amyloid deposits revealed no evidence of other diseases. The patient remained under follow-up without further treatment, as no further amyloid deposition or progression of the lesions was seen. Amyloidosis is a rare condition characterized by the deposition of abnormal protein filaments in the extracellular tissue. Generally, systemic amyloidosis does not involve the head and neck region, and the presence of amyloid in the nasal and paranasal sinus mucosa is more likely to be indicative of a localized process. However, in our patient, the lesions were located in both the sinonasal tract and the stomach, indicating systemic amyloidosis. To our knowledge, there have been no previous reports of systemic amyloidosis involving the sinonasal tract, and therefore, we consider this case to be extremely rare.

Primary carcinoid tumour of nasal septum

2008 ◽  
Vol 123 (7) ◽  
pp. 789-792 ◽  
Author(s):  
T Galm ◽  
N Turner
Keyword(s):  
Nasal Septum ◽  
World Literature ◽  
Carcinoid Syndrome ◽  
Carcinoid Tumour ◽  
Primary Tumour ◽  
Neck Region ◽  
Head And Neck Region ◽  
Carcinoid Tumours ◽  
History Of

AbstractObjective:We present the first reported case of primary carcinoid tumour of the nasal septum.Method:Case report of our experience of a carcinoid tumour of the nasal septum. We discuss our clinical, radiological and pathological findings.Result:An 83-year-old woman presented with a history of left-sided nasal blockage. Clinical examination showed a unilateral, left-sided nasal polyp. Further imaging and histological analysis confirmed this to be a carcinoid tumour. Carcinoid tumours outside the gastrointestinal tract are rare. There have been reports of carcinoid tumours in the head and neck region, but no published cases occurring in the nasal septum. Our management involved wide surgical resection with regular follow up to monitor for recurrence and for the development of carcinoid syndrome. Four years from initial presentation, the patient remained free of the primary tumour and had displayed no signs or symptoms suggestive of carcinoid syndrome.Conclusion:To the authors' best knowledge, and after searching the world literature, the presented case represents the first report of primary carcinoid tumour of the nasal septum. Despite its rarity, this tumour should be considered as part of the differential diagnosis, as timely recognition and intervention are critical for successful treatment.

Positional Hand Pallor and Isolated Epitrochlear Lymphadenitis Secondary to Bartonella henselae Infection.

2021 ◽  
Vol 20 (4) ◽  
pp. 914-917
Author(s):  
Siti Nuradliah Jamil ◽  
Ilham Ameera Ismail ◽  
Siti Fatimah Badlishah Sham ◽  
Norliana Dalila Mohamad Ali
Keyword(s):  
Lymph Node ◽  
Communicable Disease ◽  
Bartonella Henselae ◽  
Medical Science ◽  
Neck Region ◽  
Rare Condition ◽  
Cat Scratch Disease ◽  
Serological Evidence ◽  
External Compression ◽  
Head And Neck Region

Cat scratch disease is a communicable disease caused by the Bartonella henselae bacteria. Regional lymphadenopathy is the hallmark of cat scratch disease and about 75% of lymphadenopathy cases are localized in the head and neck region. An epitrochlear lymphadenopathy is a rare condition at any age and often misdiagnosed as it is not normally palpable. External compression of an enlarged epitrochlear lymph node compromising vascularity was not mentioned in any literature before. We present a case of a 13-year-old girl with right positional ipsilateral hand pallor and epitrochlear lymphadenitis with serological evidence of Bartonella henselae infection. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.914-917

scholarly journals Chondroid syringoma of the upper lip: a rare entity

2020 ◽  
Vol 6 (10) ◽  
pp. 1900
Author(s):  
Ashiya Goel ◽  
Aman . ◽  
Vinny Raheja ◽  
Manisha Kumari
Keyword(s):  
Differential Diagnosis ◽  
Normal Tissue ◽  
Neck Region ◽  
Rare Entity ◽  
Upper Lip ◽  
Head And Neck Region ◽  
Chondroid Syringoma ◽  
The Face ◽  
Slow Growing

<p class="abstract"><span lang="EN-US">Chondroid syringomas are uncommon cutaneous neoplasms of sweat gland origin which are slow-growing, nontender, subcutaneous or intracutaneous in location and often occurring in the head and neck region. Chondroid syringoma should be considered in the differential diagnosis of any subcutaneous nodule over the face. The clinician may miss the diagnosis of this lesion and if it is suspected, tumour should be excised with a margin of normal tissue and regular follow up should be done.</span></p>

Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report

2017 ◽  
Vol 10 (6) ◽  
pp. 567-571
Author(s):  
Toshinori Kurashige ◽  
Seiichi Suzuki
Keyword(s):  
Case Report ◽  
Hallux Valgus ◽  
Rare Condition ◽  
Valgus Deformity ◽  
Delayed Union ◽  
Flexor Hallucis Longus ◽  
Computed Tomography Scan ◽  
Hallux Valgus Deformity ◽  
Severe Hallux Valgus ◽  
Tomography Scan

Coalition of the hallux sesamoids is an extremely rare condition. To our knowledge, only 1 case report has been published. We report a case of severe hallux valgus deformities with coalitions of the hallux sesamoids. The coalitions themselves were asymptomatic; however, this severe hallux valgus deformity needed to be surgically treated. The hallux sesamoids in both feet appeared to be fused and heart shaped on anteroposterior radiographs and dumbbell shaped on axial radiographs. It is known that postoperative incomplete reduction of the medial sesamoids can be a risk factor for the recurrence of hallux valgus. The computed tomography scan demonstrated a groove in the bottom of the center of the heart-shaped sesamoid. The flexor hallucis longus tendon was located in the groove. Therefore, a modified Lapidus procedure was performed considering the medial half of the heart-shaped sesamoid as the medial sesamoid. Although delayed union occurred, successful correction of the deformity was achieved. Levels of Evidence: Level IV

Adaptive Dosing of Nivolumab + Ipilimumab Immunotherapy Based Upon Early, Interim Radiographic Assessment in Advanced Melanoma (The ADAPT-IT Study)

2021 ◽  
Author(s):  
Michael A. Postow ◽  
Debra A. Goldman ◽  
Alexander N. Shoushtari ◽  
Allison Betof Warner ◽  
Margaret K. Callahan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Progression Free Survival ◽  
Advanced Melanoma ◽  
Computed Tomography Scan ◽  
Free Survival ◽  
Immunotherapy Trial ◽  
Grade 3 ◽  
Almost All ◽  
Tomography Scan

PURPOSE Nivolumab + ipilimumab (nivo + ipi) is highly efficacious but has high toxicity. Standard treatment in advanced melanoma is four doses of nivo + ipi followed by nivo alone. Whether four doses of nivo + ipi are needed is unclear. METHODS The Adaptively Dosed ImmunoTherapy Trial (ADAPT-IT) study ( NCT03122522 ) is a multicenter, single-arm phase II clinical trial. Patients received two doses of nivo (1 mg/kg) + ipi (3 mg/kg) followed by a computed tomography scan at week 6. Patients without new lesions or index lesion tumor growth of > 4% had protocol-defined early favorable antitumor effect (FATE) and ceased nivo + ipi, transitioning to nivo monotherapy. Patients without FATE at week 6 received the standard third and fourth doses of nivo + ipi followed by nivo monotherapy. The primary end point was response rate by RECIST 1.1 at week 12. Secondary end points included additional efficacy assessments and safety. RESULTS Sixty patients were enrolled; 41 patients (68%) had FATE at week 6 and met criteria for stopping nivo + ipi. Best overall response rates by RECIST at week 12 or any time afterward were 48% (95% CI, 35 to 62) and 58% (95% CI, 45 to 71), respectively. With a median follow-up of 25 months, the estimated 18-month progression-free survival and overall survival are 52% and 80%, respectively. Fifty seven percent of patients had grade 3-5 treatment-related toxicity. CONCLUSION The efficacy and toxicity of standard four dose nivo + ipi induction therapy in melanoma is likely driven by the first two doses. An interim computed tomography scan after two doses guided cessation of combination dosing and identified almost all responders. Longer follow-up and further study are needed to fully understand the implications of a shortened induction course of nivo + ipi.

scholarly journals Voluminous Intrapericardial Lipoma Mimicking Pericardial Effusion

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Fabíola Prado de Morais ◽  
Noah Romero Nakajima ◽  
Olívia Félix Marconi Andalécio ◽  
Pedro de Santana Prudente ◽  
Guilherme Emílio Ferreira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pericardial Effusion ◽  
Signs And Symptoms ◽  
Tumor Location ◽  
Pathological Examination ◽  
Computed Tomography Scan ◽  
Radiologic Imaging ◽  
Heart Tumors ◽  
Tomography Scan

Lipomas are rare primary heart tumors and may involve the endocardium, myocardium, or pericardium. Signs and symptoms depend on the tumor location and size. The intrapericardial lipoma we report has massive dimensions and mimics a pericardial effusion. A 38-year-old male complained of dyspnea and precordial pain. On physical examination, heart sounds were diminished. The patient had received extensive medication for a clinically suspected pericardial effusion due to heart failure. A voluminous mass resembling fat within the pericardial sac was revealed by transesophageal echocardiography and a computed tomography scan. The tumor was removed successfully by a subxiphoid surgical approach. The diagnosis of a 635 gram intrapericardial lipoma was confirmed by pathological examination. After surgery, the patient recovered well and was completely asymptomatic at a follow-up at 90 days. No medications were being taken since. The diagnosis of a pericardial effusion should be secured by imaging exams to avoid unnecessary medications. Cardiac lipomas can be readily recognized by their typical features on radiologic imaging. The surgical pathology examination confirms the diagnosis and rules out malignancy criteria.

scholarly journals Endoscopic endonasal removal of a large fibrous dysplasia of the paranasal sinuses and skull base

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Ali A AlMomen ◽  
Fadel M Molani ◽  
Moath A AlFaleh ◽  
Ahmed K AlMohisin
Keyword(s):  
Skull Base ◽  
Fibrous Dysplasia ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Facial Pain ◽  
Rare Condition ◽  
Endoscopic Endonasal ◽  
Image Guided ◽  
Long Duration

Abstract Fibrous dysplasia is a rare condition. We present a case of a 34-years-old man presented with left-sided facial pain, headache and nasal obstruction for a long duration. CT scan of the sinuses showed a mass occupying the left ethmoidal region abutting the orbit and skull base obstructing the left frontal sinus. The patient was treated successfully by image-guided endoscopic endonasal removal of the tumor with no recurrence after 3 years of follow-up. This report aims to show the usefulness of endoscopic endonasal removal of a large fibrous dysplasia of paranasal sinuses and skull base.

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