Giant pedunculated liver mass: primary hepatocellular carcinoma masquerading as hepatic haemangioma

2021 ◽  
Vol 14 (9) ◽  
pp. e242625
Author(s):  
Olivia Cohen ◽  
Muhammad Aleem ◽  
Steven Wolberink ◽  
Miklos Attila Perenyei
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Case Reports ◽  
Surgical Excision ◽  
Sporadic Case ◽  
Primary Hepatocellular Carcinoma ◽  
Free Fluid ◽  
Liver Mass ◽  
History Of ◽  
Hepatic Haemangioma

A woman in her mid-60s was referred to surgeons with a 2-week history of worsening right-sided abdominal pain. CT demonstrated a large encapsulated, pedunculated hepatic lesion with active intracapsular bleeding and free fluid but nil further lesions. Findings suggested giant hepatic haemangioma; surgical excision took place the following day. Histopathology however confirmed malignancy. Pedunculated hepatocellular carcinoma (HCC) is rare but characteristically large and encapsulated. Sporadic case reports indicate that diagnosis is typically challenging and delayed with liver metastases at presentation. This case describes a patient with no clear risk factors for HCC found to have a well-defined, encapsulated and pedunculated mass but no detected metastasis or other lesions on initial CT. In this instance, subsequent MRI did identify further lesions in the liver. Such cases are limited in the literature: much remains to be learnt regarding presentation, differential diagnoses, investigation and management.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

Irresectable tumours of the temporal bone

1987 ◽  
Vol 101 (5) ◽  
pp. 432-442 ◽  
Author(s):  
R. E. Quiney ◽  
L. M. Flood
Keyword(s):  
Temporal Bone ◽  
Case Reports ◽  
Sporadic Case ◽  
Petrous Apex ◽  
Surgical Approaches ◽  
Total Removal ◽  
Inaccessible Area ◽  
History Of ◽  
Petrous Temporal Bone

AbstractSporadic case reports and the few published series of expanding lesions of the deep petrous temporal bone propose a variety of surgical approaches to ensure excision. All such surgery represents a compromise between exposure adequate for total removal and avoidance of further neurological deficit. Unfortunately pathology in the petrous apex evolves relatively silently and diagnosis is delayed. In many cases total excision is impossible. We present a series of patients presenting with advanced tumours of the deep petrous temporal bone in order to illustrate the spectrum of disease encountered, the limited role of surgery and the natural history of irresectable pathology in this remote and inaccessible area.

Abstract WP190: Clinical Features of Sarcoid Patients With Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Ahmed Z Obeidat ◽  
Heidi Sucharew ◽  
Charles J Moomaw ◽  
Dawn O Kleindorfer ◽  
Brett M Kissela ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Current Knowledge ◽  
Case Reports ◽  
Brain Mri ◽  
Sporadic Case ◽  
Prior History ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Stroke Event ◽  
History Of

Background: Current knowledge on ischemic stroke in sarcoid patients stems from sporadic case reports. The mechanism is thought to be related to granulomatous involvement of brain vasculature. However, clinical, demographic, and radiographic features of sarcoid patients with ischemic stroke are lacking. If sarcoid patients are at higher risk for ischemic stroke event, we hypothesized that the risk factors for ischemic stroke and stroke subtype distribution would differ between sarcoid and non-sarcoid ischemic stroke patients. Methods: Cases of ischemic stroke were identified for the years 2005 and 2010 from the population-based Greater Cincinnati/Northern Kentucky Stroke Study (population 1.3 million). Ischemic stroke cases were physician study confirmed and patients with a history of sarcoid were identified through medical chart review. Clinical variables were compared between stroke patients with history of sarcoid and those with no prior sarcoid history. Results: A total of 4258 cases of ischemic stroke were identified; of them, only 18 had prior diagnosis of sarcoid (0.04%). Brain MRI showed diffusion restriction in 14 out of 15 (93%) MRIs performed in sarcoid patients. The table presents risk factor and subtype data on sarcoid patients compared with non-sarcoid patients. Conclusions: We identified only a few cases of prior sarcoid history in our two-year ascertainment of ischemic stroke patients in our population. In comparison with stroke patients with no prior history of sarcoid, the sarcoid patients tended to be of younger age at presentation, female, have a history of diabetes and hyperlipidemia, and more likely of African descent, perhaps related to the diagnosis of sarcoid itself. We were unable to detect differences in stroke subtype distributions between sarcoid and non-sarcoid ischemic stroke patients.

scholarly journals Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kyle J. Fortinsky ◽  
Ali Alali ◽  
Khursheed Jeejeebhoy ◽  
Sandra Fischer ◽  
Morris Sherman ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Crohn’S Disease ◽  
Liver Disease ◽  
Crohn's Disease ◽  
Case Reports ◽  
Future Research ◽  
Azathioprine Therapy ◽  
Additional Risk ◽  
Early Imaging ◽  
History Of

Hepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn’s disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmune and viral workup was unremarkable. Unfortunately, the patient developed widespread metastatic disease and passed away 5 months after his initial diagnosis. The mechanism of hepatocellular carcinoma in patients’ with Crohn’s disease is poorly understood and may include both autoimmunity and treatment-related complications. Previous case reports suggest the possibility of a concerning association between azathioprine therapy and the development of hepatocellular carcinoma in patients with Crohn’s disease. Clinicians may consider early imaging in patients with Crohn’s disease presenting with concerning symptomatology or abnormal liver enzymes, especially in those being treated with azathioprine alone or in combination with infliximab. Future research may help to uncover additional risk factors for this exceedingly rare diagnosis in this patient population.

Risk factors of hospital mortality after initial hepatic resection among patients with primary hepatocellular carcinoma.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 352-352
Author(s):  
Hong-Gui Qin ◽  
Jian-Hong Zhong ◽  
Yan-Yan Wang ◽  
Shi-Dong Lu ◽  
Bang-De Xiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Portal Hypertension ◽  
Major Hepatectomy ◽  
Postoperative Mortality ◽  
Primary Hepatocellular Carcinoma ◽  
Model Parameters ◽  
Tumor Number ◽  
Independent Risk Factors

352 Background: Hepatectomy is widely used to treat patients with hepatocellular carcinoma (HCC), even those with intermediate and advanced disease. Despite its well-demonstrated clinical efficacy in many patients, postoperative mortality is an inevitable problem. This study aims to investigate the risk factors of mortality after hepatectomy. Methods: A consecutive sample of 1518 patients with HCC who underwent initial hepatectomy from January 1, 2004 to October 31, 2013 were retrospective analyzed. Multivariate analysis to identify independent risk factors of postoperative mortality was carried out using the Cox proportional hazards model. Parameters for multivariate analyses included age, gender, tumor size, tumor number, preoperative serum albumin, alanine aminotransferase, total bilirubin, α-fetoprotein, prothrombin time, tumor capsule, macrovascular invasion, portal hypertension, diabetes mellitus, ascites, major hepatectomy, surgical time, blood loss, blood transfusion, and clamping portal hepatis time. Results: A total of 18 (1.19%) and 45 (2.96%) patients died within 30 and 90 days after hepatectomy, respectively. Multivariate analysis revealed that tumor number ( ≥ 4), macrovascular invasion, and major hepatectomy were independent risk factors of 30 and 90 days mortality, while portal hypertension was also an independent risk factor of 90 days mortality. Conclusions: Among HCC patients with tumor number equal or more than four, macrovascular invasion, portal hypertension, or underwent major hepatectomy, intensive postoperative care management are in particular.

scholarly journals Risk factors for early postoperative recurrence in single and small hepatitis B virus-associated primary hepatocellular carcinoma

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096126
Author(s):  
Hongmei Jin ◽  
Hui Wang ◽  
Guanghao Li ◽  
Qingshun Hou ◽  
Wei Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Postoperative Recurrence ◽  
Primary Hepatocellular Carcinoma ◽  
B Virus ◽  
Drinking History ◽  
Class C ◽  
Recurrence Group

Objective To investigate the risk factors of early postoperative recurrence in patients with single and small (≤3 cm) hepatitis B virus-associated primary hepatocellular carcinoma (HBV-HCC). Methods This retrospective study analyzed patients with single and small HBV-HCC. All patients were followed up for 1 year after surgery. Results Among 182 patients, 54 patients had early recurrence within 1 year. The recurrence group had higher proportions of men, drinking history, Child–Turcotte–Pugh (CTP) class C, patients who underwent transarterial chemoembolization (TACE), and serum alpha-fetoprotein (AFP) >10 ng/mL as well as higher gamma-glutamyl transpeptidase (GGT) levels and lower total protein (TP) and CD8+ T lymphocyte levels than the no recurrence group. Cox multivariate regression analysis demonstrated that drinking history (HR, 1.312; 95% CI, 1.042–1.652), CTP class C (HR, 1.236; 95% CI, 1.037–1.473), TACE treatment (HR, 1.241; 95% CI, 1.026–1.501), GGT (HR, 1.138; 95% CI, 1.042–1.243), TP (HR, 0.729; 95% CI, 0.555–0.957), and AFP (HR, 2.519; 95% CI, 1.343–4.726) were independently associated with early postoperative recurrence. Conclusion Drinking history, CTP class C, TACE, serum AFP, GGT, and TP levels were independently associated with early postoperative recurrence in patients with single and small HBV-HCC.

Evaluate Survival Rate of Hepatocellular Carcinoma in Yazd from 1390 to 1394

2021 ◽  
Vol 15 (8) ◽  
pp. 2339-2345
Author(s):  
Shokoh Taghipour ◽  
Marzieh Ghane Ezabadi ◽  
Vahid Rakhshandeh
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Survival Rate ◽  
Liver Cancer ◽  
Significant Relationship ◽  
Cox Regression ◽  
Disease Risk ◽  
Cross Sectional ◽  
Common Cancer ◽  
History Of

Objectives: Liver cancer is one of the five most common cancer and the second leading cause of cancer death in men worldwide and the seventh most common cancer and the sixth leading cause of death in women from cancers. Liver cancer was the tenth most common cancer in Yazd in 1388 to 19% in women and 26% of males that has been more prevalent than in other provincial capitals. Methods: This cross-sectional descriptive study is a census of patients with hepatocellular carcinoma who referred to Yazd hospital pathology centers. All samples that have complete data from 1390 to 1394 were enrolled in the study. Information including age, sex, method of treatment and numbers of patients collected and then analyzed using statistical software spss 16 is placed. The aim of this study was to determine the survival rate of liver cancer patients according to age, sex, treatment, race and disease risk factors. Results: Of the 48 patients, 47.9% were female and 52.1% male during the five years . the average of age in this study was 62.81years. of the patients studied was 62.81 years .93.8% of patients were Iranian race. In this study, median survival was 7.43 months. The diabetes melitus with a prevalence of 18.8% was most common among the risk factors. alcohol consumption and the prevalence of hepatitis C has the lowest prevalence that was 1.9%. 83% of patients in this study were treated but other don’t come satisfaction for any treatment. Conclusion: In this study, like other studies, the incidence of liver cancer in men was higher than women. Most were Iranian people and the relationship between race and survival was no significant relationship between age, type of treatment, such as surgery, radiotherapy or chemotherapy with survival rate was not significant. But after Cox regression between age, family history of liver cancer, diabetes and treatment with survival in patients with hepatocellular carcinoma, there was a significant relationship. Keywords: HCC, Yazd, Survival

scholarly journals An Ovarian Pregnancy in a Patient with a History of Bilateral Salpingectomies: A Rare Case

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Sadia Khandaker ◽  
Pranav Chitkara ◽  
Eric Cochran ◽  
Jed Cutler
Keyword(s):  
Abdominal Pain ◽  
Emergency Room ◽  
Rare Case ◽  
Adnexal Mass ◽  
Case Reports ◽  
Free Fluid ◽  
Ovarian Pregnancy ◽  
History Of ◽  
Multiple Case ◽  
Ectopic Pregnancies

Background. 1 in 200 ectopic pregnancies are true ovarian pregnancies that fulfill the Spiegelberg criteria. Despite being rare, multiple case reports and series have been reported. Few cases have been published in which the event was preceded by salpingectomy.Case. The patient is a 32-year-old female who presented to the emergency room with abdominal pain. She was found to be pregnant, despite a history of two previous ectopic pregnancies treated with salpingectomies. Sonography confirmed a left adnexal mass and free fluid. Surgery revealed a ruptured ovarian pregnancy which was also confirmed by pathology.Conclusion. This is a case of an ovarian pregnancy in a patient with two previous salpingectomies. It underscores the importance of searching for an ectopic pregnancy in patients with abdominal pain after fertility impairing surgery.

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