Lipofibromatous Hamartoma of the Median and Ulnar Nerves at the Ipsilateral Wrist

2016 ◽  
Vol 21 (01) ◽  
pp. 116-120 ◽  
Author(s):  
Sho Kohyama ◽  
Toshikazu Tanaka ◽  
Eriko Okano ◽  
Takaji Yanai ◽  
Naoyuki Ochiai
Keyword(s):  
Physical Examination ◽  
Median Nerve ◽  
Peripheral Nerves ◽  
Rare Condition ◽  
First Dorsal Interosseous ◽  
Imaging Studies ◽  
Left Hand ◽  
Lipofibromatous Hamartoma ◽  
History Of ◽  
History Of Pain

Lipofibromatous hamartoma (LFH) is a rare condition of the peripheral nerves that typically affects the median nerve. To the best of our knowledge, this is the first report of LFH of both, the median and ulnar nerves, at the wrist of a 63-year-old female patient. The patient presented to our hospital with a 40-year history of pain, numbness, and dysesthesia affecting all fingers of her left hand. Atrophy of the thenar muscles and the first dorsal interosseous was observed upon physical examination. Imaging studies and a surgery revealed that the patient's median and ulnar nerves were significantly enlarged, confirming the LFH diagnosis. The patient's dysesthesia and numbness improved after Carpal tunnel and Guyon canal release, and her pinch ability improved after opponensplasty. LFH has been known to be solitary, typically affecting median nerve, but it must be noted that the tumor may affect multiple nerves like in our case.

scholarly journals Carpal Tunnel Syndrome Associated with Klippel-Trénaunay Syndrome: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 161-164
Author(s):  
Joan Arenas-Prat ◽  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerves ◽  
Distribution Area ◽  
Left Hand ◽  
Nerve Involvement ◽  
Tunnel Syndrome ◽  
Operative Findings ◽  
Klippel Trenaunay Syndrome

Background and Importance: Klippel-Trénaunay syndrome is a rare congenital condition that rarely affects peripheral nerves. Median nerve involvement at the carpal tunnel level has only been reported on four occasions of this syndrome in the medical literature. Case Presentation: A 61-year-old Caucasian female patient with Klippel-Trénaunay syndrome presented with a 10-month history of paraesthesia and numbness affecting the median nerve distribution area of her left hand. The clinical and neurophysiological examination confirmed a moderately severe carpal tunnel syndrome that required surgical decompression. Conclusion: Pre-operative findings demonstrated diffuse vascular infiltration and engorgement of the median nerve. Flexor tendons had a normal appearance. The patient had a satisfactory post-operative period with full resolution of her symptoms 4 weeks after the procedure. Although peripheral nerves are rarely affected in patients with Klippel-Trénaunay syndrome, neurological symptoms could indicate nerve involvement and magnetic resonance imaging (MRI) examination should be considered to further assess the extension of the lesion.

scholarly journals Transvaginal uterine evisceration during labor in a Bengal queen

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691987230
Author(s):  
Mila Freire ◽  
Mouhamadou Diaw
Keyword(s):  
Physical Examination ◽  
Surgical Intervention ◽  
Patient Survival ◽  
Uterine Prolapse ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Rapid Identification ◽  
Urethral Catheterization ◽  
Case Summary ◽  
History Of

Case summary A 2.5-year-old Bengal queen was admitted with a 12-h history of a mass protruding from the vulva during labor. At that time, three healthy kittens had already been delivered. Physical examination identified the mass as a portion of the uterus that was eviscerated without eversion of the mucosa. Exploratory laparotomy revealed a vaginal vault rupture with a large portion of the uterus herniated through the tear and eviscerated through the vulva. Ovariohysterectomy was performed, and a dead fetus was removed with the uterus. Reconstruction of the vaginal rupture required careful dissection and urethral catheterization. The queen recovered without complications. Relevance and novel information Uterine evisceration through a vaginal tear is a very rare condition that sometimes is erroneously referred to as ‘prolapse’. Uterine prolapse and uterine evisceration may have similar presenting signs; however, proper identification and surgical correction is key when the uterus is eviscerated. This case highlights the importance of differentiating these two conditions and of rapid identification and surgical intervention for successful patient survival.

scholarly journals Case Report on Chiari Syndrome

2021 ◽  
pp. 406-411
Author(s):  
Asawari Meshram ◽  
Vaishali Tembhare ◽  
Seema Singh ◽  
Ranjana Sharma ◽  
Ruchira Ankar ◽  
...  
Keyword(s):  
Physical Examination ◽  
Chiari Malformation ◽  
Rare Condition ◽  
Health Care Team ◽  
Left Hand ◽  
Professional Management ◽  
Comprehensive Health ◽  
Chiari Syndrome ◽  
Arterial Pulses ◽  
Pedal Edema

Chiari Malformation is a rare condition. A condition known as Chiari malformation occurs when brain tissue spreads into the spinal canal. When a portion of your skull is excessively small or malformed, it presses on your brain and forces it downward. Chiari malformation is a rare occurrence, although the increased use of imaging testing has resulted in more diagnosis. Case Presentation: A 18-year-old boy was admitted to the hospital with the following symptoms: Tingling sensation, numbness over left hand since 2 to 3 months. Neck bend toward right side, pain in left hand since 6 month. Difficulty during eating by hand since 2 to 3 month. On physical examination, indicated a bright attentive person with pale conjunctiva and no symptoms of icterus. He had a tachycardia, bilateral pitting pedal edema and a swollen abdomen with shifting dullness, all of which pointed to as cites. He had a history of intermittent abdominal pain. On admission he complaint of new onset of dyspnea on exertion, fatigue and abdominal swelling. The rest of all physical examination was normal, with no skin changes and an intact arterial pulses in all four extremities. Conclusion: The primary focus of this case study is on professional management and outstanding nursing care, which may provide the holistic care that Chiari Syndrome necessitates while also effectively managing the challenging case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and satisfaction.

scholarly journals Hyperphosphatemic tumoral calcinosis: a rare differential of periarticular swelling

2020 ◽  
Vol 8 (5) ◽  
pp. 1874
Author(s):  
Sunil Nanjareddy ◽  
Rajashree Paidipatti ◽  
Vishwanath Muttagaduru Shivalingappa ◽  
Nuthan Jagadeesh
Keyword(s):  
Soft Tissue ◽  
Rare Condition ◽  
The Body ◽  
Tumoral Calcinosis ◽  
Greater Trochanter ◽  
X Ray ◽  
Osseous Involvement ◽  
History Of ◽  
Calcium Deposits ◽  
History Of Pain

Tumour calcinosis is a rare clinical and histopathological syndrome characterised by deposition of calcium deposits in different periarticular soft tissue regions of the body. It mainly manifest in childhood/ adolescence as a painless, firm to hard tumour like mass around the joints. Most common regions involved: Shoulder, elbow and hip. An 18 year old male patient presented to the opd with a history of pain and swelling over his left hip since 2 months. On examination, there was a diffuse tender swelling over the left greater trochanter, skin over the swelling was normal with no discharge, no dilated/ engorged veins. Range of motion of left hip was normal, no limb length discrepancies. X-ray: Showed a well define calcified mass over the greater trochanter with no osseous involvement. MRI revealed an encapsulated hypointense mass present posterior to the greater trochanter, mostly in the muscular plane. Lab findings revealed mild hyperphosphetemia. An aspirate from the swelling showed casseousmaterial. En mass removal was done and sent for biopsy. Biopsy showed features suggestive of tumoral calcinosis. Tumoral calcinosis is a distinct clinico-radiopathological entity characterised by soft tissue periarticular calcinosis which mimics a true neoplasm, associated with elevated levels of serum phosphate. It is an extremely rare condition which is seen in the adolescence and requires more studies regarding the surgical and medical management of the same.

scholarly journals Idiopathic Hypertrophic Pachymeningitis: A Case Report from Bangladesh

2018 ◽  
Vol 3 (2) ◽  
pp. 110-112
Author(s):  
Meera Momtaz Sabeka ◽  
Md Nazrul Islam
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Optic Atrophy ◽  
Severe Headache ◽  
Imaging Studies ◽  
Hypertrophic Pachymeningitis ◽  
History Of ◽  
Diagnostic Clue ◽  
Work Up ◽  
Rule Out

A 52 years old lady presented with sudden severe headache with the history of similar intense headache twenty years back which ended up with left sided blindness. Her physical examination was unremarkable except optic atrophy of the left eye. Investigation included biochemical work up, imaging studies and CSF study. The MRI of brain with contrast gave the key diagnostic clue with characteristic findings of hypertrophic pachymeningitis. Other investigations helped to rule out possible etiologies and the diagnosis idiopathic hypertrophic pachymeningitis was finally made. The patient has been treated with steroid and enjoyed improvement in her yearlong symptoms.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 110-112

PSEUDOHYPOPARATHYROIDISM

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 790-797
Author(s):  
M. G. PETERMAN ◽  
J. L. GARVEY
Keyword(s):  
Physical Examination ◽  
Mental Disease ◽  
Rare Condition ◽  
Palpebral Fissure ◽  
Pituitary Extract ◽  
History Of ◽  
Convulsive Disorders ◽  
Hoarse Voice ◽  
The Right ◽  
Hospital Clinic

THIS case is presented because the circumstances provided an unusual opportunity to review and study a rare condition. The child concerned had been diagnosed as having a case of hypothyroidism and epilepsy and the parents had been advised to place her in an institution. The child was referred to the authors in a further effort to obtain relief or advice. CASE HISTORY A 12 yr. old girl was examined because of "incessant talking in a silly, immature fashion; excessive greed for food and salt; lethargy, fatigue, over-affection and clumsiness, awkwardness, inability to skate or ride a bicycle." A year before admission she began to scream in her sleep once or twice every night. Six months later she began to scream during the day. The attacks of screaming occurred suddenly without warning. She abruptly stopped what she was doing, stared ahead and screamed in a loud, hoarse voice for several seconds. Immediately afterward, she was embarrassed and tried to withdraw from the scene. Treatment elsewhere with adequate doses of phenobarbital, tridione, benzedrine, thyroid and pituitary extract had been ineffective. Report of a previous examination at a university clinic was "moderately plump girl with a round face and lethargic appearance. There was narrowing of the right palpebral fissure and mild ataxia of the lower extremities. The physical examination was otherwise unimportant. The IQ was 80." Examination later at a hospital-clinic was reported as "revealing obesity and cretinism in spite of a basal metabolic rate of minus 6 and minus 7." Mother and father are intelligent and the 4 siblings are normal and well-adjusted. There is no history of convulsive disorders or mental disease.

Segmental thoracic lipomatosis of nerve with nerve territory overgrowth

2014 ◽  
Vol 120 (5) ◽  
pp. 1118-1124 ◽  
Author(s):  
Mark A. Mahan ◽  
Kimberly K. Amrami ◽  
B. Matthew Howe ◽  
Robert J. Spinner
Keyword(s):  
Peripheral Nerves ◽  
Fatty Infiltration ◽  
Rare Condition ◽  
Spinal Nerves ◽  
Fibrolipomatous Hamartoma ◽  
Scoliotic Deformity ◽  
Lipomatosis Of Nerve ◽  
Thoracic Spinal ◽  
History Of ◽  
Hands And Feet

Lipomatosis of nerve (LN), or fibrolipomatous hamartoma, is a rare condition of fibrofatty enlargement of the peripheral nerves. It is associated with bony and soft tissue overgrowth in approximately one-third to two-thirds of cases. It most commonly affects the median nerve at the carpal tunnel or digital nerves in the hands and feet. The authors describe a patient with previously diagnosed hemihypertrophy of the trunk who had a history of large thoracic lipomas resected during infancy, a thoracic hump due to adipose proliferation within the thoracic paraspinal musculature, and scoliotic deformity. She had fatty infiltration in the thoracic spinal nerves on MRI, identical to findings pathognomonic of LN at better-known sites. Enlargement of the transverse processes at those levels and thickened ribs were also found. This case appears to be directly analogous to other instances of LN with overgrowth, except that this case involved axial nerves rather than the typical appendicular nerves.

scholarly journals Nontraumatic Myositis Ossificans of Hip: A Case Presentation

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Yunus Oc ◽  
Muhammed Sefa Ozcan ◽  
Hasan Basri Sezer ◽  
Bekir Eray Kilinc ◽  
Osman Tugrul Eren
Keyword(s):  
Myositis Ossificans ◽  
External Rotation ◽  
Rare Condition ◽  
Surgical Excision ◽  
Case Presentation ◽  
History Of ◽  
History Of Pain ◽  
Well Differentiated ◽  
Restriction Of Range ◽  
Mature Bone

In most of the cases trauma is the leading etiology and the nontraumatic myositis ossificans (MO) is a very rare condition. We present an MO case without any trauma occurring. A 36-year-old female patient with a history of pain and restriction of range of motion of the left hip was admitted. Hip motions were restricted with 10–60° of flexion, 10° of internal rotation, 20° of external rotation, 10° of abduction, and 10° of adduction. There was no history of trauma and familial involvement. The biopsy of the lesion revealed mature bone tissue confirming our diagnosis of MO. The mass was removed surgically and postoperatively the patient was treated with a single dose radiotherapy with 800 gyc. MO is a benign and well differentiated bone formation or in other words heterotopic ossification of the muscle tissue. It has a prevalence of less than 1/1 million. Trauma is the most frequent etiological factor seen in almost 60–75% of the cases. Nontraumatic MO is very rare in the literature. Our patient had no history of trauma or familial involvement. Combination of the surgical excision with radiotherapy in the treatment of the MO of the hip may give satisfactory results.

scholarly journals Epehólyag-agenesia. Epekövességet utánzó ritka rendellenesség egy felnőtt nőben

2019 ◽  
Vol 160 (38) ◽  
pp. 1510-1513
Author(s):  
Călin Molnar ◽  
Tibor Sárközi ◽  
Cedric Kwizera ◽  
Marian Botoncea ◽  
Opriș Zeno ◽  
...  
Keyword(s):  
Rare Case ◽  
Medical Literature ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Final Diagnosis ◽  
Biliary Colic ◽  
Caucasian Woman ◽  
Imaging Studies ◽  
History Of ◽  
Gallbladder Agenesis

Abstract: Gallbladder agenesis is a rare congenital malformation due to an embryological defect of the biliary system. In most cases it is asymptomatic, but it can also mimic biliary colic. We report the case of a 72-year-old Caucasian woman with a medical history of cardiovascular disease and hypercholesterolemia, under cholesterol-lowering and hypotensive treatment, who presented symptoms suggesting biliary colic. She underwent laparoscopic surgery that confirmed the final diagnosis. We present our approach in this rare case as well as a brief review of medical literature. The surgeon should decide intraoperatively whether to continue and search for a possible ectopic gallbladder or investigate further with imaging studies. Gallbladder agenesis is a rare condition that the surgeon must be aware of. In the cases of inconclusive or indirect signs of cholelithiasis, the best approach is complementary imaging investigations such as magnetic resonance cholangiopancreatography in order to avoid surgery. Orv Hetil. 2019; 160(38): 1510–1513.

Median Nerve Compression Secondary to a High Insertion of Pronator Teres

2010 ◽  
Vol 2 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Robert A. Mcculloch ◽  
Simon B. M. Maclean ◽  
Jag Dhaliwal ◽  
Adrian W. Simons
Keyword(s):  
Median Nerve ◽  
Nerve Compression ◽  
Surgical Removal ◽  
X Rays ◽  
Upper Arm ◽  
Median Nerve Compression ◽  
Pronator Teres ◽  
History Of ◽  
History Of Pain ◽  
Supracondylar Process

We present a case of a 46-year-old male presenting with a 10 year history of pain and paraesthesia in the median nerve distribution together with a palpable lump in the upper arm. X-rays confirmed a supracondylar process of the humerus. Intra-operatively it was found that there was an aberrant insertion of one of the heads of pronater teres from the process. After surgical removal of the process and release of the head of pronator teres his symptoms improved.

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