Management of a catecholamine-secreting tympanicum glomus tumour: case report

2008 ◽  
Vol 122 (12) ◽  
pp. 1377-1380 ◽  
Author(s):  
H Kouzaki ◽  
J Fukui ◽  
T Shimizu
Keyword(s):  
Case Report ◽  
Osteolytic Lesion ◽  
Hypertensive Crisis ◽  
Potassium Titanyl Phosphate ◽  
Glomus Tumour ◽  
Vanillylmandelic Acid ◽  
Tissue Mass ◽  
Feeding Vessels ◽  
Angiographic Examination ◽  
Potassium Titanyl Phosphate Laser

AbstractObjective:To report the safe management and treatment of a catecholamine-secreting tympanicum glomus tumour.Case report:A 73-year-old women presented with a catecholamine-producing glomus tympanicum tumour, complaining of hearing impairment and left ear pain. Physical examination revealed a red, pulsating swelling in the left tympanic membrane. Computed tomography demonstrated a soft tissue mass filling the entire middle-ear cavity and a partial osteolytic lesion in the internal carotid artery. Angiographic examination revealed a densely contrasting tumour with feeding vessels from the ascending pharyngeal artery. Concentrations of serum noradrenalin and urine vanillylmandelic acid (VMA) were high. The tumour was completely resected using a potassium titanyl phosphate laser, the feeding vessels having been embolised the previous day. Concentrations of serum noradrenalin and urine VMA normalised following the operation.Conclusion:Pre-operative embolisation is useful in the treatment of catecholamine-secreting tympanicum glomus tumours, not only for preventing a hypertensive crisis but also for reducing bleeding. The potassium titanyl phosphate laser is useful for complete resection of the tumour.

scholarly journals Robotic excision of interaortocaval paraganglioma: a case report with the literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Anoop Handa ◽  
Sharat Chandra Dash ◽  
Nimit Solanki ◽  
Gagandeep Singh
Keyword(s):  
Case Report ◽  
Treatment Approach ◽  
Hypertensive Crisis ◽  
Secondary Hypertension ◽  
Resonance Imaging ◽  
Robot Assisted ◽  
Case Presentation ◽  
Feeding Vessels ◽  
Grade 3 ◽  
Extra Adrenal Paraganglioma

Abstract Background Paragangliomas are rare neuroendocrine tumors of extra adrenal origin. The symptomatic paragangliomas require multimodal treatment approach. Case Presentation We report a case of 34-year-old female who presented with complains of headache and blurring of vision. Examination revealed Hypertensive crisis with grade 3 retinopathy. The patient was diagnosed as a case of extra-adrenal paraganglioma during evaluation for secondary hypertension. Magnetic Resonance Imaging of the abdomen revealed 23*28*28 mm mass lesion in the inter-aortocaval region at the level of L3–L4. The patient was started on medical management for hypertension and was managed safely with robot-assisted surgery, owing to enhanced visualization of feeding vessels and avoidance of excessive manipulation of tumor. Conclusions Our case report emphasizes on the robot assisted surgical technique for the removal of tumor in a vulnerable anatomical position and presents a review of the literature.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

Healing Of A Large Osteolytic Mandibular Lesion – A Case Report

2018 ◽  
Author(s):  
Ingrid Różyło-Kalinowskav ◽  
Karolina Sidor
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Surgical Approach ◽  
Orthodontic Treatment ◽  
Incidental Finding ◽  
Osteolytic Lesion ◽  
Panoramic Radiograph ◽  
Endodontic Treatment ◽  
Osteolytic Lesions

The purpose of this article was to present a case report of 11–year old female patient with a large osteolytic mandibular lesion which healed after endodontic treatment. The patient was referred for radio diagnostics due to an incidental finding of a large osteolytic lesion of the area of the left lower first and second premolars in the panoramic radiograph taken before orthodontic treatment. CBCT was performed and the patient asked to have teeth 33-35 treated by endodontics before surgery. The patient missed the surgical appointment and when she reappeared several months later, the lesion showed signs of healing thus surgery were aborted. The presented case testifies to the observation that even large osteolytic lesions can heal after endodontic treatment without surgical approach.

Primary renal synovial sarcoma presenting with a retroperitoneal bleed

2021 ◽  
Vol 14 (3) ◽  
pp. e237099
Author(s):  
Daanesh Huned ◽  
Juinn Huar Kam ◽  
Lui Shiong Lee ◽  
Raj Vikesh Tiwari
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Synovial Sarcoma ◽  
Soft Tissue Mass ◽  
Renal Angiomyolipoma ◽  
Right Hepatectomy ◽  
Tissue Mass ◽  
Biopsy Confirmation ◽  
Synovial Sarcomas ◽  
Neo Adjuvant Chemotherapy

Synovial sarcomas are most commonly localised in extremities, especially in the lower thigh and knee areas. Comprising less than 1% of all malignancies, retroperitoneal synovial sarcoma is very rare with primary synovial sarcoma of the kidney being even more infrequent and difficult to diagnose. We describe a case report of a renal synovial sarcoma in a young adult who was initially managed as a case of Wunderlich’s syndrome secondary to what was believed to be a ruptured renal angiomyolipoma. After biopsy confirmation, the patient was eventually managed with neo-adjuvant chemotherapy followed by a right radical nephrectomy and right hepatectomy. Despite its rarity, synovial sarcoma should be considered as differential diagnosis of a bleeding retroperitoneal soft tissue mass detected in young adults.

scholarly journals Hyperthermia in a pediatric patient with neuroblastoma during anesthesia: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chuan Wang ◽  
Wenqiong Xin ◽  
Yi Ji
Keyword(s):  
Tumor Resection ◽  
Neuron Specific Enolase ◽  
Tracheal Extubation ◽  
Posterior Mediastinum ◽  
Gas Analysis ◽  
Vanillylmandelic Acid ◽  
Management Options ◽  
Paravertebral Space ◽  
Tissue Mass ◽  
The Right

Abstract Background Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options. Case presentation The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma. Conclusions Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.

scholarly journals Successful extracorporeal membrane oxygenation resuscitation of patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 746-751
Author(s):  
Tao Wang ◽  
Qiancheng Xu ◽  
Xiaogan Jiang
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Tumour Size ◽  
Acute Onset ◽  
Left Ventricular ◽  
Vanillylmandelic Acid ◽  
Membrane Oxygenation ◽  
First Case ◽  
Va Ecmo

Abstract A 29-year-old woman presented to the emergency department with the acute onset of palpitations, shortness of breath, and haemoptysis. She reported having an abortion (56 days of pregnancy) 1 week before admission because of hyperthyroidism diagnosis during pregnancy. The first diagnoses considered were cardiomyopathy associated with hyperthyroidism, acute left ventricular failure, and hyperthyroidism crisis. The young woman’s cardiocirculatory system collapsed within several hours. Hence, venoarterial extracorporeal membrane oxygenation (VA ECMO) was performed for this patient. Over the next 3 days after ECMO was established, repeat transthoracic echocardiography showed gradual improvements in biventricular function, and later the patient recovered almost completely. The patient’s blood pressure increased to 230/130 mm Hg when the ECMO catheter was removed, and then the diagnosis of phaeochromocytoma was suspected. Computed tomography showed a left suprarenal tumour. The tumour size was 5.8 cm × 5.7 cm with central necrosis. The vanillylmandelic acid concentration was 63.15 mg/24 h. Post-operation, pathology confirmed phaeochromocytoma. To our knowledge, this is the first case report of a patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism which was successfully resuscitated by VA ECMO.

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