What is the onset mechanism of internal hernia after vertebral body fracture? A case of internal hernia secondary to traumatic vertebral fracture

A 67-year-old man who had been pinned between a basket crane and a tree complained of severe pain in his lower back and a decreased appetite. Laparotomy after decompressing the gastrointestinal tract revealed incarceration of an ileal loop within a fractured third lumbar vertebra. The damaged bowel was resected, and an end-to-end anastomosis was performed. Once the patient’s condition had stabilised, posterior lumbar fixation was performed. There were no abdominal complications or lower limb neurological deficits during the follow-up period. Enhanced CT and MRI had been helpful in making the diagnoses. Histopathological examination revealed the aetiology of the traumatic incarceration: the intestine had been pinched as the disc space closed, and the body attempted to return to its original state by exerting countertraction.

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Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) of pancreas: a rare entity—worth to note

BMJ Case Reports ◽

10.1136/bcr-2020-234855 ◽

2020 ◽

Vol 13 (4) ◽

pp. e234855 ◽

Cited By ~ 1

Author(s):

Bharti Varshney ◽

Jyotsna Naresh Bharti ◽

Vaibhav Kumar Varshney ◽

Taruna Yadav

Keyword(s):

Histopathological Examination ◽

Neuroendocrine Tumour ◽

Pancreatic Head ◽

Ductal Adenocarcinoma ◽

Neuroendocrine Neoplasms ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Rare Malignancy

Mixed adenocarcinoma with neuroendocrine tumour of pancreas has been reported infrequently and consists of both epithelial and neuroendocrine component. We encountered an 81-year-old male patient who presented with clinical features of painful progressive jaundice for 1 month. Contrast-enhanced CT abdomen reported a mass in the pancreatic head with dilated common bile duct and pancreatic duct. He underwent pancreatoduodenectomy and histopathological examination revealed two different tumours: ductal adenocarcinoma admixed with neuroendocrine tumour of pancreas. He received adjuvant chemotherapy, and at the end of 1-year follow-up, he has no recurrence. Here, we reported this rare malignancy of pancreas for which pancreatoduodenectomy was done and diagnosed on histopathology with immunohistochemistry.

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Osteoid osteomas and osteoblastomas of the spine

Neurosurgical FOCUS ◽

10.3171/foc.2003.15.5.5 ◽

2003 ◽

Vol 15 (5) ◽

pp. 1-7 ◽

Cited By ~ 35

Author(s):

Mehmet Zileli ◽

Sedat Çagli ◽

Gülçin Basdemir ◽

Yusuf Ersahin

Keyword(s):

Osteoid Osteoma ◽

Cervical Vertebra ◽

Complete Removal ◽

The Body ◽

Neurological Deficits ◽

Common Symptom ◽

Primary Bone Tumors ◽

Female Patients ◽

Primary Bone

Object Osteoid osteomas and osteoblastomas are rare primary bone tumors that usually do not arise in the spine. In this report the authors analyze 16 cases of osteoid osteoma or osteoblastoma of the spine that were surgically treated over a 27-year period. Methods A retrospective study was conducted in which the following data were found: five patients had osteoid osteomas (two male and three female patients) and 11 had osteoblastomas (seven male and four female patients). The site of the tumor was the cervical spine in four, thoracic in six, and lumbar spine in six. In 14 patients, the tumor involved the posterior vertebral elements, with lumbar and thoracic levels being the most common. Only two patients had tumors in the body of a cervical vertebra. The mean age of the patients was 20 years for osteoid osteoma and 19 years for osteoblastoma. The most common symptom was local pain in the area of the tumor. Among 11 patients with osteoblastoma, six (two with paraparesis, four with monoparesis) had neurological deficits caused by extradural compression. None of the patients with osteoid osteoma had neurological deficits. The diameters of osteoblastomas were 3 to 8 cm (mean 4 cm), and those of osteoid osteomas were 1.5 to 2 cm (mean 1.7 cm). Although the peritumoral bone was normal in patients with osteoblastoma, a sclerotic rim was observed in all patients with osteoid osteoma. All patients were treated with resection; tumor excision was complete in 15 cases. Follow-up periods ranged from 2 months to 13 years (mean 36 months). Complete pain relief was achieved in 15 patients; the other patient described mild pain with activity. There was no tumor recurrence except one regrowth in a patient with osteoblastoma who then received radiation therapy. There were two complications: one surgery was performed at the wrong level, and there was one instrument failure that required revision. Conclusions With the help of modern imaging modalities that aid in diagnosis and surgical planning, a complete removal and cure may be achieved for most of these rare tumors.

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Symptomatic pseudarthrosis in ochronotic spine: case report

Journal of Neurosurgery Spine ◽

10.3171/2016.5.spine15671 ◽

2017 ◽

Vol 26 (2) ◽

pp. 220-228 ◽

Cited By ~ 3

Author(s):

Abolfazl Rahimizadeh ◽

Housain Soufiani ◽

Valliolah Hassani ◽

Ava Rahimizadeh

Keyword(s):

Neurological Status ◽

Single Stage ◽

Neurological Deficits ◽

Disc Space ◽

Posterior Surgery ◽

Dural Sac ◽

Alternative Approach ◽

Progressive Paraparesis ◽

Anterior Posterior

In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine. However, its occurrence in ochronotic spine has not been reported previously. Evaluation of progressive paraparesis in a 68-year-old man with ochronosis revealed pseudarthrosis at the T11–12 level. Circumferential dural sac decompression, debridement of the disc space, interbody fusion, and screw-rod fixation were all done via a posterior-only approach. Postoperatively the patient exhibited a marked recovery in terms of pain and neurological status. At the 3-month follow-up, he was able to walk independently. Ochronosis should be included in the etiology of pseudarthrosis. With aggravation of back pain and the appearance of neurological deficits in an already stable patient with any ankylosing disease, pseudarthrosis should be suspected. Furthermore, single-stage, 360°, posterior-only surgery may obviate the need for single-stage or staged anterior-posterior surgical intervention in patients with pseudarthrosis of the thoracic and lumbar spine.

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An aggressive fibromatosis in the palm of a female child: A rare case

Indian Journal of Case Reports ◽

10.32677/ijcr.v7i11.3121 ◽

2021 ◽

pp. 482-484

Author(s):

Arun Ranjan Napit ◽

Shraddha Panchal ◽

Dhaval Panchal

Keyword(s):

Rare Case ◽

Benign Tumor ◽

Histopathological Examination ◽

Aggressive Fibromatosis ◽

Female Child ◽

The Body ◽

Common Site ◽

Mesenchymal Origin ◽

High Degree

Aggressive fibromatosis is the locally aggressive benign tumor of mesenchymal origin. It can be found in any part of the body. However, abdomen is the most common site of this lesion. It has a predilection to females between 15 and 60 years. We report the case of a 16-month-old female child with an aggressive fibromatosis in her right palm. The location and age of presentation make this a rare case. She was diagnosed by histopathological examination and the mass was excised. The patient was advised for follow-up examination due to the high degree of recurrence of this tumor.

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Pheochromocytoma in von Hippel-Lindau disease

Archive of oncology ◽

10.2298/aoo0304269p ◽

2003 ◽

Vol 11 (4) ◽

pp. 269-272

Author(s):

Milan Petakov ◽

Marina Djurovic ◽

Dragana Miljic ◽

Sandra Obradovic ◽

Mirjana Doknic ◽

...

Keyword(s):

Histopathological Examination ◽

Left Kidney ◽

The Body ◽

Single Strand Conformational Polymorphism ◽

Von Hippel Lindau ◽

Adrenal Pheochromocytoma ◽

Von Hippel Lindau Disease ◽

Pre Treatment ◽

The Right

A 70-year old female was admitted to the hospital because of hypertension increased sweating and weight loss. The hypertension was sustained. Five months before admission CT scan of the abdomen had revealed a well-defined right adrenal mass together with left kidney tumor. A magnetic resonance imaging of the abdomen confirmed the presence of the right adrenal and left kidney masses, but also showed another tumor in the pancreas between the body and the tail. Urinary 24-hour noradrenaline was grossly elevated and confirmed the diagnosis of pheochromocytoma. 131I-metaiodobenzylgvanidine (MIBG) scintiscan showed increased MIBG uptake in the right adrenal gland. After pre-treatment with phenoxybenzamine 30 mg daily, the patient was operated, and the right adrenalectomy was done. Histopathological examination revealed encapsulated adrenal pheochromocytoma without infiltrative characteristics and lymph node metastasis. After the operation hypertension was controlled easily with amlodipine. The patient was discharged for recovery. Ulteriorly, SSCP (single strand conformational polymorphism) method detected a point mutation in the third exon of the VHL (von Hippel-Linday) gene. It was decided to follow up the patient with the von Hippel-Lindau disease, while waiting for the results of the sequence analysis to confirm that the found mutation is not associated with renal cancer.

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‘Bone within bone appearance’ in a pathological fracture

BMJ Case Reports ◽

10.1136/bcr-2020-238567 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238567

Author(s):

Sathish Muthu ◽

Eswar Ramakrishnan ◽

Girinivasan Chellamuthu

Keyword(s):

Histopathological Examination ◽

Subtrochanteric Fracture ◽

Fracture Site ◽

The Body ◽

Diagnostic Dilemma ◽

History Of ◽

Similar Appearance ◽

The Right

A 60-year-old man presented to our hospital with complaints of pain and deformity on his right thigh for the past 2 days following a history of accidental slip and fall. Radiological investigations suggested a pathological type 2 Seinsheimer subtrochanteric fracture of the right femur with a ‘bone within bone’ appearance, which posed a diagnostic dilemma as this radiological appearance is seen in a spectrum of conditions. Radiographic skeletal survey failed to identify a similar appearance elsewhere in the body. Laboratory investigations pointed in favour of bone mineral disease, and histopathological examination of the bone narrowed it down to Paget’s disease. The fracture was fixed with a contralateral distal femur locking compression plate. The fracture site failed to show signs of union until 6 months postsurgery and hence the patient was advised for grafting procedure. The patient deferred surgery and remains without major complications until 18 months of follow-up.

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Frontal sinus cholesteatoma: a masquerading diagnosis

BMJ Case Reports ◽

10.1136/bcr-2019-231495 ◽

2019 ◽

Vol 12 (11) ◽

pp. e231495

Author(s):

Regi Kurien ◽

Leah Thomas ◽

Lalee Varghese ◽

Bijesh Ravindran Nair

Keyword(s):

Paranasal Sinus ◽

Frontal Sinus ◽

Histopathological Examination ◽

Malignant Lesion ◽

Rare Condition ◽

Neurological Deficits ◽

Radiological Findings ◽

Bony Erosion ◽

Rule Out

Cholesteatoma of the paranasal sinus is a very rare condition. As in the tympanomastoid region where cholesteatomas are a common entity, the paranasal sinus cholesteatomas also tend to erode the surrounding bony structures. Because of the extensive bony erosion, this condition often masquerades as a chronic granulomatous or a malignant lesion. Clinical presentation can be quite varied like facial deformities, visual and neurological deficits. Radiological findings are also non-specific making a preoperative diagnosis challenging. Histopathological examination is the only confirmatory investigation. We present a patient with frontal cholesteatoma who presented with forehead swelling of 1 month duration. Since the diagnosis could be obtained only intraoperatively, the patient required multiple surgeries. Frontal sinus cholesteatomas often require a combined endoscopic and external approach to ensure complete disease clearance. Periodic follow-up is essential to rule out recurrence.

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Analysis of surgical outcome and review of literature of schwannomas arising from the extremities

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193384 ◽

2019 ◽

Vol 7 (8) ◽

pp. 2995

Author(s):

Chandrashekhar Wahegaonkar ◽

Bhushan Patil ◽

Alok Sharma ◽

Bharat Bhushan Dogra

Keyword(s):

Histopathological Examination ◽

Operative Management ◽

Nerve Graft ◽

The Body ◽

Review Of Literature ◽

Complete Excision ◽

Nerve Sheath ◽

Patient Consent ◽

The Mean

Background: Schwannoma is a benign peripheral nerve sheath tumour derived from Schwann cells. Also known as Neurilemoma, it can affect any nerve in the body. They usually present as a painless swelling or paresthesia over the sensory distribution of the affected nerve. Although it is classically described that schwannomas are well encapsulated and can be completely enucleated during excision, many of them have fascicular involvement and could not be completely shelled out. The aim of this work is to present our experience in operative management of schwannomas located in extremities.Methods: Authors conducted a retrospective review for 18 adult patients with schwannoma, from June 2012 to June 2018. There were 10 men and 8 women, ranging from 20 to 68 years of age, with a mean age of 46 years old. All patients had excision done for the tumour and histopathological examination confirmed schwannoma. All patients were preoperatively evaluated both clinically and radiologically. FNAC was also done to confirm the origin of the swelling.Results: The mean follow up period has been 2 years. Complete excision with preservation of nerve was done in all cases except for one case in which nerve graft was used.Conclusions: Use of preoperative MRI, magnification and good surgical technique will help to enucleate the tumour completely without any collateral damage or recurrence. The possibility and option of nerve graft should be discussed with patients prior to schwannoma excision, so that nerve grafting could be directly proceeded with patient consent in case there is fascicular involvement of tumour found intraoperatively.

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Traumatic Atlantoaxial Dislocation with Type II Odontoid Fractures: A Case Report

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.25 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Aldhi Tri Budhi ◽

Nasrullah ◽

Andi Asadul Islam ◽

Djoko Widodo ◽

Willy Adhimarta ◽

...

Keyword(s):

Ct Scanning ◽

Odontoid Fracture ◽

Atlantoaxial Dislocation ◽

The Body ◽

Neurological Deficits ◽

Type Ii ◽

Body Type ◽

Case Presentation ◽

Internal Stabilization

BACKGROUND፡ Odontoid fracture frequently ensues after a cervical trauma, and most commonly at the junction between the dens and the body (type II odontoid fracture).CASE PRESENTATION: This report is focused on a 24-years-old male patient with right-sided hemiparesis, resulting from traumatic atlantoaxial dislocation with type II odontoid fracture. Cervical CT-scanning showed a spondylolisthesis of the C1-C2 complex with type II odontoid fracture, and the injury was treated using posterior reduction and internal stabilization. Therefore, hemiparesis was reduced, and during the follow-up period, our patients were disease-free.CONCLUSION: Early diagnosis and the appropriate management of atlantoaxial trauma is a possible approach towards preventing severe neurological deficits.

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Laryngeal amyloidosis: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202793 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1357

Author(s):

Jameel N. Alswaiheb ◽

Mohammed A. Motiwala ◽

Abdulmalik Alkhodair ◽

Abdulrahman Aljadoa ◽

Ghada Alhindi ◽

...

Keyword(s):

Histopathological Examination ◽

Surgical Excision ◽

Lateral View ◽

The Body ◽

Systemic Amyloidosis ◽

Laryngeal Amyloidosis ◽

Laryngeal Tumors ◽

Long Term Follow Up

Amyloidosis is a rare, benign, slowly progressive disease characterized by extracellular accumulation of amyloid in different tissues of the body. It accounts for 0.2-1.2% of benign laryngeal tumors and usually presents as an isolated localized laryngeal amyloidosis, but can also be part of systemic amyloidosis. A 26 years old female with history of gradually developing, persistent hoarseness, and progressive dyspnea since 1 year, worsened over the past three days. Outpatient Department based endoscopy showed bilateral mobile, thickened vocal cords with subglottic edematous thickness. Computed tomography scan showed symmetrical thickening of bilateral vocal cord, causing glottic narrowing about 70% on the AP view and about 50% on the lateral view and no cartilage invasion or lymphadenopathy. Microlaryngoscopy and biopsy of the specimen were performed and histopathology confirmed the diagnosis of amyloidosis with Congo red stain. Patient was managed by surgical excision of the mass and long term follow-up. To rule out systemic amyloidosis patient is referred to rheumatology clinic and hematology clinic for further evaluation and management. Histopathological examination of the involved tissue confirms the diagnosis, and long term follow up is mandatory in the management of amyloidosis.

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