Recurrence-free management of type 2 variant of giant cell tumour of extensor tendon sheath of thumb

A 30-year-old woman presented with swelling in her right thumb of 3-month duration which was slow-growing in nature without a history of trauma. On examination, firm non-tender swelling with ill-defined border over the dorsomedial aspect of the first metacarpal was noted. The swelling was mobile only in the vertical plane with restricted adduction and abduction. Plain X-ray revealed mild erosion of the first metacarpal head. Diagnostic ultrasound confirmed the lesion to arise from the extensor tendon sheath of diffuse type without any bony involvement. A wide local excision biopsy of the swelling was planned. Intraoperatively, a 3×2 cm greyish-white mass, bony hard in consistency with lobulated surface was found arising from the tendon sheath of the extensor tendon of the thumb; it was completely excised with a wide margin. Histopathological examination revealed polyhedral cells admixed with osteoclastic type giant cells. Biopsy from the first metatarsal was normal. The patient is on follow-up for the last 5 years with no evidence of recurrence.

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Extra-synovial Pigmented Villonodular Synovitis of the knee joint, Case Repor

International Journal of Case Reports ◽

10.28933/ijcr-2020-12-0106 ◽

2021 ◽

pp. 192

Author(s):

Keyword(s):

Histopathological Examination ◽

Giant Cells ◽

Pigmented Villonodular Synovitis ◽

Villonodular Synovitis ◽

Biopsy Result ◽

Posterior Aspect ◽

Case Presentation ◽

History Of ◽

Full Flexion ◽

Pigmented Villonodular

Background: PVNS is a rare, benign & aggressive disorder arising from either synovial joints or tendon sheaths; it may erode articular structures and bones. We present a case with unique features of PVNS being extra-synovial and by this report we open a gate for more researches in this field. Case Presentation: This case report concerns a 35-year-old female with a history of right knee pain for 6-month duration proceeded by gradual swelling over posterior aspect of the knee, she denies any history of trauma, clinical examination was unremarkable but apart from tenderness over the infrapatellar region with full flexion. MRI shows a heterogenous signal extra-articular and extra-synovial lesion in posterior aspect of the knee suggesting Pigmented Villonodular Synovitis, FNA revealed a hemosiderin-laden macrophages and multinucleated giant cells, Tru-cut biopsy result was suggesting PVNS as synovial cells were seen admixed with hemosiderin-laden macrophages with fibroblastic elements. Through posterior approach; the lesion was surgically excised and histopathological examination confirmed the diagnosis, the lesion was recurrent after 1-year and MRI revealed the same features, the lesion was excised by arthroscopic intervention. Conclusion: We concluded that PVNS cannot be excluded when extra-synovial lesion is assessed, and further researches on this topic will expand our understanding of the etiological and pathological aspects of this tumor.

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A Rare Case of Lateral Canthal Gouty Tophus Presenting as an Eyelid Mass

Case Reports in Ophthalmological Medicine ◽

10.1155/2016/9786810 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Austin S. Nakatsuka ◽

Timothy F. McDevitt ◽

Pamela S. Tauchi-Nishi

Keyword(s):

Clinical Examination ◽

Rare Case ◽

Histopathological Examination ◽

Giant Cells ◽

Crystalline Material ◽

Multinucleated Giant Cells ◽

Lateral Canthus ◽

History Of ◽

Gouty Tophus

A 41-year-old man with a history of gout presented with an enlarging eyelid growth. Clinical examination revealed a mildly indurated nodule at the lateral canthus. Following resection, histopathological examination revealed needle-shaped, crystalline material surrounded by multinucleated giant cells, findings consistent with gouty tophus. This represents just the sixth case of gouty tophus of the eyelid reported in the literature.

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Tuberculoma of the Conus Medullaris: Case Report

Neurosurgery ◽

10.1097/00006123-200203000-00043 ◽

2002 ◽

Vol 50 (3) ◽

pp. 651-653 ◽

Cited By ~ 1

Author(s):

Kudret Türeyen

Keyword(s):

Histopathological Examination ◽

Inflammatory Cells ◽

Mass Effect ◽

Giant Cells ◽

Conus Medullaris ◽

Antituberculosis Therapy ◽

Patient Reported ◽

History Of ◽

Leg Weakness ◽

Muscle Groups

Abstract OBJECTIVE AND IMPORTANCE: Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. This article describes an affected patient who presented with left leg paresis. CLINICAL PRESENTATION: A 46-year-old man presented with a 7-day history of left leg weakness. The patient's medical history included infection with pulmonary tuberculosis 15 years previously, at which time he had been treated with antituberculosis therapy. The neurological examination performed at admission revealed left leg paresis with Grade 2/5 power in all muscle groups. The patient reported no urinary or bowel problems. INTERVENTION: Surgery was performed with the patient in the prone position. The procedure involved laminectomies at T11, T12, and L1, followed by a midline myelotomy. The mass was excised completely. Histopathological examination revealed a granulomatous lesion that contained Langhans' giant cells, inflammatory cells, and evidence of caseating necrosis. The patient was prescribed a 6-month course of antituberculosis therapy with pyrazinamide, isoniazid, and rifampin. CONCLUSION: The outcome was favorable. Recently, a number of authors have reported success with medical management of intraspinal tuberculoma. Intraspinal tuberculoma produces a mass effect that can jeopardize spinal cord function. The optimal treatment is a combination of microsurgical resection and antituberculosis chemotherapy.

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Leukoplakia or LPR: The Misdiagnosis of Laryngeal Tuberculosis

Ear Nose & Throat Journal ◽

10.1177/0145561319891264 ◽

2019 ◽

pp. 014556131989126

Author(s):

Zheng cai Lou ◽

Xiuguo Li

Keyword(s):

Pulmonary Tuberculosis ◽

Histopathological Examination ◽

Laryngopharyngeal Reflux ◽

Case Series ◽

Giant Cells ◽

Epithelioid Cell ◽

Normal Lung ◽

Acute Epiglottitis ◽

Type Giant ◽

Laryngeal Tuberculosis

Objective:The objective is to reduce the rates of misdiagnosis and inappropriate treatment of laryngeal tuberculosis (LTB).Study Design:Retrospective case series.Materials and Methods:Medical records of 3 histopathology-confirmed cases at a tertiary medical center from 2000 to 2018.Results:Seventeen patients with LTB included in this study. Of the 17 patients, 16 patients were male and 1 was female; 11 patients had a history of smoking. Odynophagia was the chief complaint in 6 cases, and 11 patients complained of hoarseness. The appearance of the affected larynx was ranged from diffuse swelling (n = 7, 41.2%), mucosa white lesion (n = 5,29.4%), and granulomatous tumors (n = 2, 11.76%), and these features presented together (n = 2, 11.76%). Seventeen patients with LTB were misdiagnosed as acute epiglottitis in 4 (23.5%) patients, acute laryngitis in 1 (5.9%) patient, leukoplakia in 5 (29.4%) patients, laryngopharyngeal reflux (LPR) in 6 (35.3%) patients, and laryngocarcinoma in 1 (5.9%) patient. Chest computed tomography reported old pulmonary tuberculosis in 2 (11.7%) patients, active pulmonary tuberculosis in 7 (41.2%) patients, and normal lung status in 8 (47.1%) patients. Histopathological examination reported Mycobacterium tuberculosis infection by revealing epithelioid cell granulomas with Langhans-type giant cells in 14 (82.4%) patients and epithelioid cell granulomas with caseous necrosis and Langhans-type giant cells in 3 (17.6%) patients.Conclusions:Laryngeal tuberculosis was easily misdiagnosed as acute epiglottitis or leukoplakia because of diffuse swelling of the epiglottis or white lesions over the true vocal cord, especially patients with increasing LTB were misdiagnosed as LPR with the enhancement of LPR awareness among otolaryngologist. Clinicians should be aware of the possibility of LTB for chronic intractable laryngitis with failure treatment of proton pump inhibitor and recurrent acute epiglottitis with foreign body injury.

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MUSCULAR TUBERCULOSIS: RARE PRESENTATION OF A COMMON ENTITY

10.36106/ijar/1500739 ◽

2021 ◽

pp. 20-21

Author(s):

Vertika Gupta ◽

Rashmi Gautam ◽

Bhuvan Adhlakha ◽

Sarita Devdhar ◽

Arun Chaudhary

Keyword(s):

Histopathological Examination ◽

Giant Cells ◽

Excision Biopsy ◽

Epithelioid Cells ◽

Rare Presentation ◽

Triceps Muscle ◽

Antituberculosis Therapy ◽

Foamy Macrophages ◽

Global Health Problem

Tuberculosis is a global health problem mainly affecting people in developing countries although muscular involvement is rarely seen. Authors hereby, describe a case of tuberculosis of triceps muscle in a 35-year-old immunocompetent female who presented with swelling in right upper arm. Radiological examination ruled out involvement of underlying bones. Excision biopsy was performed and on histopathological examination cyst wall showed presence of foamy macrophages in sheets, inammatory cells and few scattered epithelioid cells but no well-formed granulomas or giant cells were seen. ZN stain for acid fast bacilli was positive. Based on the above ndings a diagnosis of tuberculosis of triceps muscle was made. The patient responded well to antituberculosis therapy and is currently on follow up.

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Giant cell tumor of tendon sheath in the wrist that damaged the extensor indicis proprius tendon: a case report and literature review

BMC Cancer ◽

10.1186/s12885-019-6293-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Qingfang Zhao ◽

Hui Lu

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Histopathological Examination ◽

Surgical Excision ◽

Tendon Sheath ◽

Cell Tumor ◽

Case Presentation ◽

Extensor Indicis Proprius ◽

History Of

Abstract Background Giant cell tumor of the tendon sheath (GCTTS) is a benign soft tissue (synovial membrane) tumor that rarely involves the hands or wrists. And Tendon impairment caused by GCTTS is extremely rare. Case presentation Here, we reported a case of a 60-year-old female with a 10-year history of gradually increasing mass in her left dorsal wrist. The EIP tendon was partially impaired by the mass.The patient was treated with surgical excision of the mass and reconstruction of the EIP tendon. The histopathological examination suggested the presence of GCTTS. After surgery, the patient had adequate functional recovery and no tumor recurrence after 2 years’ follow-up. Conclusion GCTTS in hands and wrists rarely damages the tendon. Early diagnosis and proactive interventions may likely contribute to good prognostic outcomes.

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Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽

10.1024/0301-1526/a000101 ◽

2011 ◽

Vol 40 (3) ◽

pp. 251-255 ◽

Cited By ~ 4

Author(s):

Gruber-Szydlo ◽

Poreba ◽

Belowska-Bien ◽

Derkacz ◽

Badowski ◽

...

Keyword(s):

Case Report ◽

Magnetic Resonance Angiography ◽

Popliteal Artery ◽

Doppler Ultrasonography ◽

Histopathological Examination ◽

Previous History ◽

Plain Radiography ◽

Artery Thrombosis ◽

History Of ◽

The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v0i0.151 ◽

2019 ◽

pp. 33

Author(s):

K Thuraikumar ◽

V Naveen ◽

Mustaqim A ◽

Arieff AA ◽

K Shri ◽

...

Keyword(s):

Back Pain ◽

Soft Tissue ◽

Histopathological Examination ◽

Posterior Instrumentation ◽

Spinal Tuberculosis ◽

Previous History ◽

Skin Lesions ◽

Titanium Implants ◽

Paravertebral Abscess ◽

History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

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Scopolamine fatal outcome in an inmate after buscopan® smoking

International Journal of Legal Medicine ◽

10.1007/s00414-021-02583-2 ◽

2021 ◽

Author(s):

Sabina Strano-Rossi ◽

Serena Mestria ◽

Giorgio Bolino ◽

Matteo Polacco ◽

Simone Grassi ◽

...

Keyword(s):

Computed Tomography ◽

Drug Abuse ◽

Muscarinic Receptors ◽

Histopathological Examination ◽

Fatal Outcome ◽

Post Mortem ◽

Butyl Bromide ◽

Cannabis Abuse ◽

Toxic Concentration ◽

History Of

AbstractScopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.

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Giant Fibrovascular Polyp as an Unusual Cause of Globus Pharyngeus

Ear Nose & Throat Journal ◽

10.1177/01455613211003989 ◽

2021 ◽

pp. 014556132110039

Author(s):

Jelena Sotirović ◽

Ljubomir Pavićević ◽

Stanko Petrović ◽

Saša Ristić ◽

Aleksandar Perić

Keyword(s):

Differential Diagnosis ◽

Asymptomatic Patient ◽

Histopathological Examination ◽

Complete Resection ◽

Airway Compromise ◽

Endoscopic Removal ◽

Globus Sensation ◽

Fibrovascular Polyp ◽

History Of ◽

Fatal Complications

Differential diagnosis of globus sensation in an otherwise asymptomatic patient should include hypopharyngeal fibrovascular polyp to avoid potentially fatal complications like airway compromise following regurgitation. We present a case of a 74-year-old man with a 13-cm long hypopharyngeal fibrovascular polyp with 9 months history of globus sensation. A narrow stalk of the giant polyp allowed endoscopic removal and complete resection with the CO2 laser. Histopathological examination was conclusive for the fibrovascular polyp.

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