Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure

A 75-year-old man presented to the emergency department with 1-day history of right lower limb pain and 3-month history of vague abdominal pain. In the emergency department a thrombus was discovered in the right popliteal artery. CT scan of the abdomen and pelvis revealed high-density material in the pelvis, multiple hypodensities on the liver, ascites with omental nodularity, and high-density material along the stomach wall. He underwent thrombectomy and was started on anticoagulation therapy. The core needle biopsy revealed primary omental mesothelioma. There was no history of any known asbestos exposure. He also had to undergo therapeutic paracentesis twice due to abdominal distension. Mesothelioma treatment of carboplatin and pemetrexed was started, and the patient is currently receiving this chemotherapy treatment regimen.

Download Full-text

Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature

Journal of International Medical Research ◽

10.1177/03000605211019641 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110196

Author(s):

Xiaotong Peng ◽

Zhi Duan ◽

Hongling Yin ◽

Furong Dai ◽

Huining Liu

Keyword(s):

Adverse Events ◽

Soft Tissues ◽

Malignant Tumors ◽

Cystic Teratoma ◽

Abdominal Distension ◽

Epithelioid Angiosarcoma ◽

History Of ◽

New Ideas ◽

The Right ◽

Clinical Awareness

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.

Download Full-text

Resection of a colonic mass following trauma: a diagnostic dilemma

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa226 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Paul Burchard ◽

Alan A Thomay

Keyword(s):

Ct Scan ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Symptomatic Improvement ◽

Diagnostic Dilemma ◽

Vehicle Accident ◽

Abdomen Ct ◽

History Of ◽

Mitotic Figures ◽

The Right

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.

Download Full-text

A Complex Renal Cyst: It Is Time to Call the Oncologist?

International Journal of Nephrology ◽

10.4061/2011/893985 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Antonio Granata ◽

Antonio Basile ◽

Giuseppe Alessandro Bruno ◽

Alberto Saita ◽

Mario Falsaperla ◽

...

Keyword(s):

Hydatid Cyst ◽

Hydatid Disease ◽

Rare Case ◽

Renal Cyst ◽

Renal Involvement ◽

Case Presentation ◽

Magnetic Resonance Scan ◽

History Of ◽

The Right ◽

Vague Abdominal Pain

Introduction. Hydatid disease is a cyclozoonotic parasitic infestation caused by the cestodeEchinococcus granulosus. The cysts mainly arise in the liver (50 to 70%) or lung (20 to 30%), but any other organ can be involved, in abdominal and pelvic locations, as well as in other less common sites, which may make both diagnosis and treatment more complex. Isolated renal involvement is extremely rare.Case Presentation. We report a rare case of isolated renal hydatid disease in a 71-year-old man with a history of vague abdominal pain, anemia, fever, and microhematuria. Ultrasonographic examination revealed a complex cyst in the right kidney, including multiple smaller cysts with internal echoes. A magnetic resonance scan of the abdomen confirmed the findings, and hydatid cyst disease was diagnosed. Right nephrectomy was performed, and microscopic examination confirmed the diagnosis of hydatid cyst. Albendazole, 10 mg/kg per day, was given for 4 weeks (2 weeks preoperatively and 2 weeks postoperatively).Conclusion. Isolated primary hydatidosis of the kidney should always be considered in the differential diagnosis of any cystic renal mass, even in the absence of accompanying involvement of liver or other visceral organs.

Download Full-text

A 26-Year-Old Male with Mesothelioma Due to Asbestos Exposure

Case Reports in Medicine ◽

10.1155/2011/951732 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

P. Zarogoulidis ◽

M. Orfanidis ◽

T. C. Constadinidis ◽

E. Eleutheriadou ◽

T. Kontakiotis ◽

...

Keyword(s):

Young Adults ◽

Lymph Node ◽

Survival Rate ◽

Poor Prognosis ◽

Asbestos Exposure ◽

Older Men ◽

Chemotherapy Treatment ◽

Supraclavicular Lymph Node ◽

Occupationally Exposed ◽

The Right

Mesothelioma is a malignancy with poor prognosis, with an average 5-year survival rate being less than 9%. This type of cancer is almost exclusively caused by exposure to asbestos. A long exposure can cause mesothelioma and so can short ones, as each exposure is cumulative. We report a case of a 26-year-old male who was exposed to asbestos during his primary school years from the age of 6 to 12. Although the tumor mainly affects older men who in their youth were occupationally exposed to asbestos, malignant mesothelioma can also occur in young adults. A medical history was carefully taken and asbestos exposure was immediately mentioned by the patient. We conducted biopsy on the right supraclavicular lymph node. The patient was not a candidate for surgery, and chemotherapy treatment was initiated. While patient's chemotherapy is still ongoing, no other similar cases of students or teachers have been traced up to date from his school. The school building was demolished in January 2009.

Download Full-text

Incarcerated inguinal hernia? No, acute pancreatitis

Open Medicine ◽

10.2478/s11536-011-0092-3 ◽

2011 ◽

Vol 6 (6) ◽

pp. 770-772 ◽

Cited By ~ 2

Author(s):

Jose Ramia-Angel ◽

Eloy Sancho ◽

Rafael Lozoya ◽

Andrej Gasz ◽

Jose Santos

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Acute Pancreatitis ◽

Incarcerated Hernia ◽

Intravenous Antibiotic ◽

Incarcerated Inguinal Hernia ◽

Testicular Pain ◽

Inguinal Area ◽

History Of ◽

The Right

AbstractA 62-year-old man presented to the Emergency Department with a 2-day history of right testicular pain. The initial diagnosis was orchiepididymitis (later found to be mistaken), and intravenous antibiotic treatment was started. Twenty-four hours later, the patient had mild pain in the right inguinal area and right infra-abdominal area. We performed an inguinal ultrasound that showed an incarcerated mass of mixed echogenicity in the right inguinal area. Surgery was performed because we thought the patient had an inguinal incarcerated hernia. Two days after the surgical procedure, the patient began to have fever and erythema and pain in the back. Abdominal computed tomography (CT) showed an acute pancreatitis with a peripancreatic collection from the pancreas to right inguinal area. We have reviewed similar cases in the literature and note that, infrequently, an inguinal mass can be the first sign of mostly asymptomatic acute pancreatitis.

Download Full-text

Malignant Peritoneal Mesothelioma: Clinicopathological Characteristics of Two Cases

Case Reports in Surgery ◽

10.1155/2014/748469 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Mustafa Cem Algın ◽

Faik Yaylak ◽

Zülfü Bayhan ◽

Figen Aslan ◽

Nilüfer Araz Bayhan

Keyword(s):

Abdominal Pain ◽

Asbestos Exposure ◽

Final Diagnosis ◽

Clinicopathological Characteristics ◽

Clinical Findings ◽

Peritoneal Mesothelioma ◽

Abdominal Masses ◽

History Of ◽

The Right ◽

Specific Symptoms

Introduction. Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30–45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report two cases of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed.Case Presentation. The cases were two men (one aged 54 years old and the other 40 years old). Prolonged abdominal pain and swelling were the primary presentation symptoms and findings. The mesotheliomas were developed in the right upper quadrant of abdomen in both of the cases. Both cases were treated with surgical resection. Final diagnosis were possible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported.Conclusion. Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas.

Download Full-text

1271 High-Density EEG Correlates During Confusional Arousals in a Child With a Long-Lasting History Of Sleepwalking

SLEEP ◽

10.1093/sleep/zsaa056.1265 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A483-A483

Author(s):

A Castelnovo ◽

N Amato ◽

S Riccardi ◽

M Pereno ◽

S Miano ◽

...

Keyword(s):

Prefrontal Cortex ◽

Case Report ◽

Sleep Stage ◽

Single Case ◽

Case Reports ◽

Nrem Sleep ◽

High Density ◽

Source Power ◽

History Of ◽

The Right

Abstract Introduction Sleepwalking belongs to a family of disorders (Disorders of Arousal - DOA) that are thought to derive from incomplete arousals out of Non Rapid Eye Movement (NREM) sleep. At yet, our knowledge about the specific neural dynamics occurring during clinical episodes is limited and relies on one SPECT case study, four stereo-EEG case reports/series and one single high-density electro-encephalography (hdEEG) case report. We herein describe a single case captured by hdEEG. Report of Case We collected two consecutive sleep recordings (using a 256-channel hdEEG coupled with standard video-polysomnography) of a non-medicated, otherwise healthy, 13-year-old male, with a history of recurrent daily sleepwalking episodes. We visually identified 17 behavioral events during sleep stage 3 and divided them into two groups: clear clinical episodes (n = 7) and simple movements associated with burst of delta waves (n = 10). Source power topography in the delta range (1-4 Hz) was computed using LORETA. Source images during selected episodes were compared to 30 second-windows of baseline stage 3 sleep. Comparisons were performed using statistical non-parametric mapping with supra-threshold cluster tests. Events were associated with an increase of delta power over the right frontopolar prefrontal cortex (rPFC) / Broadman area 10 (BA10) at their onset. This finding was clearly observable even when considering only clear-cut events, followed by the involvement of the right dorsolateral and medial prefrontal cortex / BA9 and of the left superior temporal gyrus/ BA 22. Conclusion We were able to replicate a recently published case report by our group, where we highlighted the putative role of rPFC and PFC and prefronto-temporal circuit in DOA episodes. Intriguingly, we observed a lateralization of this effect, with a prominent right frontal involvement. Novel research has shown a physiological asymmetry in the generation of large slow waves between the two hemispheres. An increased right-left unbalance might prime behavioral episodes in DOA patients.

Download Full-text

Meningococcal Pneumonia in a Young Healthy Male

Case Reports in Infectious Diseases ◽

10.1155/2018/2179097 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Abdullah M. Al Alawi

Keyword(s):

Emergency Department ◽

Lower Lobe ◽

Community Acquired Pneumonia ◽

Cell Counts ◽

History Of ◽

Chest X Ray ◽

White Blood Cell Counts ◽

The Right ◽

Local Guideline

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Laboratory analysis showed raised white blood cell counts and elevated inflammation markers. Chest X-ray showed right lower lobe consolidation. Intravenous(IV) ceftriaxone and doxycycline were started for the management of community-acquired pneumonia as per the local guideline. Later, on admission, blood culture was positive for Neisseria meningitidis (N. meningitidis). Ceftriaxone was continued for 4 days, and the patient was discharged while being on oral amoxicillin (1 gm TDS) for another 3 days. He remained well during the outpatient follow-up.

Download Full-text

Surgical management of ileocecocolic intussusception in a Korean native calf: a case report

Veterinární Medicína ◽

10.17221/7185-vetmed ◽

2013 ◽

Vol 58 (No. 12) ◽

pp. 645-649 ◽

Cited By ~ 1

Author(s):

DB Lee ◽

SM Shin ◽

KC Lee ◽

HB Lee ◽

MS Kim ◽

...

Keyword(s):

General Condition ◽

Abdominal Distension ◽

Good Survival ◽

Poor General Condition ◽

Surgical Operation ◽

Severe Diarrhoea ◽

National University ◽

History Of ◽

Uncommon Case ◽

The Right

A two-month-old male 40 kg Korean native calf was referred to the Chonbuk Animal Medical Centre, College of Veterinary Medicine, Chonbuk National University because of prolonged diarrhoea, depression, and anorexia lasting three weeks. On physical examination, abdominal distension presented in the right flank and a percussion sound was audible. A round-shaped lesion was observed in the area of the large intestine on computed tomography and ultrasonography, and a diagnosis of intestinal intussusception was made. A surgical operation was decided upon immediately to correct the intussusception. An infarct lesion was found during surgery, and the lesion was observed on the intussuscepted intestines including the cecum, ileum, and colon. The area of intussusception was excised, and an anastomosis was performed. Despite intensive and supportive care, the patient died one day after the surgery due to poor general condition. An ileocecocolic intussusception is an uncommon case compared within other intestinal intussusceptions. Most affected calves have a history of severe diarrhoea and the prognosis is guarded due to poor general condition. Good survival can be expected if patients are diagnosed quickly.

Download Full-text

Tension hydrothorax in a patient with SARS-CoV-2 pneumonitis and pleural Mycobacterium tuberculosis

BMJ Case Reports ◽

10.1136/bcr-2021-243760 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243760

Author(s):

Mohsin F Butt ◽

Maggie Symonds ◽

Ruhaid Khurram

Keyword(s):

Emergency Department ◽

Mycobacterium Tuberculosis ◽

Pleural Effusion ◽

Respiratory Distress ◽

Chest Radiograph ◽

Left Lung ◽

Pleural Effusions ◽

Mediastinal Shift ◽

History Of ◽

The Right

Unilateral pleural effusions are uncommonly reported in patients with SARS-CoV-2 pneumonitis. Herein, we report a case of a 42-year-old woman who presented to hospital with worsening dyspnoea on a background of a 2-week history of typical SARS-CoV-2 symptoms. On admission to the emergency department, the patient was severely hypoxic and hypotensive. A chest radiograph demonstrated a large left-sided pleural effusion with associated contralateral mediastinal shift (tension hydrothorax) and typical SARS-CoV-2 changes within the right lung. She was treated with thoracocentesis in which 2 L of serosanguinous, lymphocyte-rich fluid was drained from the left lung pleura. Following incubation, the pleural aspirate sample tested positive for Mycobacterium tuberculosis. This case demonstrates the need to exclude non-SARS-CoV-2-related causes of pleural effusions, particularly when patients present in an atypical manner, that is, with tension hydrothorax. Given the non-specific symptomatology of SARS-CoV-2 pneumonitis, this case illustrates the importance of excluding other causes of respiratory distress.

Download Full-text