Solitary neurofibroma of the larynx: a diagnostic challenge

Solitary neurofibromas of the larynx are extremely rare, with a total of 15 cases described in the literature. Nonetheless, acquaintance with this diagnosis is important, as misdiagnoses can have negative consequences. Presenting symptoms are non-specific and depend on tumour size and location. As well-defined submucosal masses with a broad differential diagnosis, they remain a clinical and radiological challenge. While some characteristics might favour a benign nature and subtle signs might help narrow the differential diagnosis, imaging alone is not sufficient for differentiation and definitive diagnosis requires a biopsy. Complete surgical resection and long-term follow-up is indicated. We share our experience on a case of a solitary laryngeal neurofibroma in a middle-aged woman, presenting with a large well-defined paraglottic lesion.

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Melanoacanthoma on the nipple of a middle-aged woman: A diagnostic challenge

JAAD Case Reports ◽

10.1016/j.jdcr.2021.01.026 ◽

2021 ◽

Vol 9 ◽

pp. 93-96

Author(s):

Maria Fernanda Hunziker ◽

Gianine Rigoni Guaraldo ◽

Nilceo Schwery Michalany ◽

Alexandre Michalany ◽

Antonio Carlos Herrmann de Andrade ◽

...

Keyword(s):

Middle Aged ◽

Diagnostic Challenge ◽

Aged Woman ◽

Middle Aged Woman

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Postural orthostatic tachycardia syndrome (POTS) occurring during treatment for breast cancer

BMJ Case Reports ◽

10.1136/bcr-2021-242472 ◽

2021 ◽

Vol 14 (8) ◽

pp. e242472

Author(s):

Deshveer Babra ◽

Suhyun Youn ◽

Senan Devendra

Keyword(s):

Breast Cancer ◽

Heart Rate ◽

Differential Diagnosis ◽

Beta Blocker ◽

Orthostatic Intolerance ◽

Postural Orthostatic Tachycardia Syndrome ◽

Common Condition ◽

Aged Woman ◽

Middle Aged Woman ◽

New Onset

Postural orthostatic tachycardia syndrome (POTS) is a common condition of orthostatic intolerance in response to changes in position. We report a case of a middle-aged woman presenting with a new onset of POTS likely due to chemotherapy for treatment of breast cancer. She was started on a trial of a beta blocker, which was effective in controlling her symptoms and heart rate. The objective of this report was to encourage clinicians to consider POTS as a differential diagnosis, while managing patients with symptoms of orthostatic intolerance.

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Radiation-induced sarcoma presenting as a gluteal abscess: a diagnostic and therapeutic challenge

BMJ Case Reports ◽

10.1136/bcr-2020-236601 ◽

2020 ◽

Vol 13 (12) ◽

pp. e236601

Author(s):

Sudharshan Mahalingam ◽

Sudharsanan Sundaramurthi ◽

Balamourougan Krishnaraj ◽

Sarath Chandra Sistla

Keyword(s):

Radiation Treatment ◽

Diagnostic Challenge ◽

Incision And Drainage ◽

Aggressive Management ◽

Aged Woman ◽

Increased Risk ◽

Middle Aged Woman ◽

Treatment Complication ◽

Radiation Induced ◽

Gluteal Abscess

Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.

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Rectal Metastases of Breast Carcinoma: A Case Report

Archives of Iranian Medicine ◽

10.34172/aim.2021.19 ◽

2021 ◽

Vol 24 (2) ◽

pp. 125-128

Author(s):

Emilia Virginia Lima Curvelo Fontes ◽

Nataliê Almeida Silva ◽

Lister Arruda Modesto dos Santos ◽

Vitorino Modesto dos Santos

Keyword(s):

Breast Cancer ◽

Breast Cancers ◽

Management Options ◽

Invasive Lobular Cancer ◽

Lobular Cancer ◽

Aged Woman ◽

Long Term Follow Up ◽

Middle Aged Woman ◽

Diagnostic Hypothesis ◽

Poor Outcomes

The scarcely reported hematogenous rectal metastases from breast cancer are rare and the diagnosis is challenging. They may be recognized before, concomitantly with, or after the diagnosis of the primary site of breast cancer. Invasive lobular cancer is the histological type more frequently described, and most of the affected patients have a late diagnosis. Tardive recognition is associated with poor outcomes, despite the management options. Endoscopic and imaging evaluations, mainly magnetic resonance studies, are useful, but the anatomopathological findings are mandatory to confirm the diagnostic hypothesis. We describe a middle-aged woman with advanced rectal metastases of unsuspected breast cancer found during the evaluation of manifestations due to intestinal implants. One must highlight long-term follow-up of breast cancers even if seeming in remission. The aim of this report is to enhance the suspicion index of primary health care workers.

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A hoarse voice: atypical mycobacterial infection of the larynx

The Journal of Laryngology & Otology ◽

10.1258/0022215011909369 ◽

2001 ◽

Vol 115 (11) ◽

pp. 920-922 ◽

Cited By ~ 5

Author(s):

J. A. McEwan ◽

A. H. Mohsen ◽

M. L. Schmid ◽

M. W. McKendrick

Keyword(s):

Differential Diagnosis ◽

Pulmonary Disease ◽

Pulmonary Infection ◽

Mycobacterial Infection ◽

Middle Aged ◽

Aged Woman ◽

Atypical Mycobacterial Infection ◽

Middle Aged Woman ◽

Hoarse Voice ◽

Mycobacterium Malmoense

Myobacterium malmoense is a non-tuberculous mycobacterium that most commonly causes pulmonary infection, particularly in patients with underlying pulmonary disease or immunodeficiency. We describe a case of Mycobacterium malmoense infection of the larynx in a previously well middle-aged woman, which has previously not been reported. The case highlights the importance of considering atypical mycobacterial infection in the differential diagnosis of laryngeal lesions.

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Onychomatricoma with Onychomycosis: A Case Report and Review of the Literature

Skin Appendage Disorders ◽

10.1159/000516662 ◽

2021 ◽

pp. 1-5

Author(s):

Thomas Novoa Gomes Jaeger ◽

Clarissa Canella ◽

Andreia Pizarro Leverone ◽

Robertha Carvalho Nakamura

Keyword(s):

Differential Diagnosis ◽

Benign Neoplasm ◽

Conservative Surgery ◽

Review Of The Literature ◽

Fungal Treatment ◽

Tissue Microenvironment ◽

Important Differential Diagnosis ◽

Aged Woman ◽

Middle Aged Woman ◽

Oral Terbinafine

Onychomatricoma is a primary benign neoplasm of the nail matrix. Currently, a limited number of cases have been reported, so it is still considered a rare neoplasia. However, it is debatable if this condition is underdiagnosed and underreported. Onychomycosis is an important differential diagnosis of onychomatricoma, and sometimes, both these conditions may even coexist in the same nail. As the tumor grows, tissue microenvironment is more vulnerable to dermatophytes. Probably, the altered keratin appears to be susceptible to fungal invasion. Careful clinical assessment and dermoscopic evaluation help nailing the diagnosis. Usually, total nail avulsion is the preferred therapeutic approach when they coexist. Herein, we present a case of a middle-aged woman with onychomycosis and onychomatricoma affecting a single fingernail. The proposed therapy was oral terbinafine for 6 months followed by a conservative surgery. There were dramatic changes in dermoscopic features after fungal treatment, which, to our knowledge, have not been previously reported.

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Erdheim-Chester Disease with a Posterior Fossa Tumour Mimicking Neurosarcoidosis: A Case Report.

10.21203/rs.3.rs-246426/v1 ◽

2021 ◽

Author(s):

Laura Parrado-Sánchez ◽

Verónica Alzate-Carvajal ◽

Luis Alberto Escobar Florez ◽

Ana María Granados-Sánchez ◽

Javier Lobato-Polo

Keyword(s):

Middle Aged ◽

Diagnostic Challenge ◽

Male Population ◽

Fibrotic Tissue ◽

Erdheim Chester Disease ◽

Aged Woman ◽

Middle Aged Woman ◽

Mass Lesions ◽

Erdheim Chester ◽

Chester Disease

Abstract Erdheim-Chester disease (ECD) is a rare non-Langerhans'cell histiocytosisdescribed in 1930 by Jakob Erdheim and William Chester, it can present as a multisystemic entity that forms xanthogranulomas which are foamy histiocytes surrounded by fibrotic tissue. Lesions are commonly located in long bones, central nervous system (CNS), cardiovascular system, lungs, kidneys and skin. The CNS is involved in approximately 50% of cases and can compromise both extra or intra-axial structures and therefore can mimic schwannomas or meningiomas, amongst other mass lesions [2, 9]. Clinical presentation will differ from patient to patient thus diagnosis depends greatly in imaging, immunohistochemistry and genetic findings within the pathology analysis [4]. The pathogenesis of this disease remains unknown. It is most commonly found in the middle-aged male population [1, 8]. Here, we present a case of a middle-aged woman with an extra-axial lesion that was initially considered to be neurosarcoidosis proving the diagnostic challenge this entity implies.

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