scholarly journals Retroperitoneal Lymphangioma in an Adult: A Case Report of a Rare Clinical Entity

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mayank Tripathi ◽  
Sanjeev Parshad ◽  
Rajender Kumar Karwasra ◽  
Ashish Gupta ◽  
Saket Srivastva ◽  
...  
Keyword(s):  
Abdominal Distension ◽  
Final Diagnosis ◽  
Definitive Diagnosis ◽  
Rare Entity ◽  
Imaging Studies ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Case Presentation ◽  
Cystic Lymphangiomas ◽  
Retroperitoneal Lymphangioma

Background. Retroperitoneal lymphangioma is a rare, benign mesodermal tumor arising from the retroperitoneal lymphatics which usually presents in infancy and it is worthy to report a case when it has presented in an adult. After a thorough literature search in English we concluded that less than 200 cases of adult retroperitoneal lymphangioma have been reported so far. Apart from being a rare entity it also presents as a diagnostic dilemma and final diagnosis is often made on surgical exploration.Case Presentation. We report a case of retroperitoneal lymphangioma in a 55-year-old male who presented with abdominal distension and dull aching abdominal pain.Conclusion. Retroperitoneal lymphangiomas are rare tumors of infancy but may also present in adults where they are a diagnostic challenge. Differentiating cystic lymphangiomas from other cystic growths by imaging studies alone are often inconclusive and surgery is frequently required for definitive diagnosis and to ameliorate the symptoms.

scholarly journals Benign Intracranial Hypertension: A Diagnostic Dilemma

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Gary Y. Shaw ◽  
Stephanie K. Million
Keyword(s):  
Intracranial Hypertension ◽  
Signs And Symptoms ◽  
Pseudotumor Cerebri ◽  
Empty Sella ◽  
Definitive Diagnosis ◽  
Benign Intracranial Hypertension ◽  
Imaging Studies ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Empty Sella Syndrome

Benign intracranial hypertension (BIH) (also known as pseudotumor cerebri and empty sella syndrome) remains a diagnostic challenge to most physicians. The modified Dandy criteria consist of, the classic findings of headache, pulsatile tinnitus, papilledema, and elevated cerebrospinal fluid (CSF) pressure, however, these are rarely collectively present in any one patient. Furthermore, these findings can wax and wane over time. Due to the nature of this disease, both signs and symptoms may be intermittent, making definitive diagnosis difficult. Newer imaging studies, particularly the magnetic resonance venogram (MRV) along with a constellation of correlative findings and associated diseases have given new impetus in the diagnosis, treatment, and pathophysiology of this disease. This has led the authors to offer modifications to the classic Dandy criteria. This report presents three representative cases of BIH highlighting many of the newer advances in both diagnosis and treatment of this perplexing disorder.

scholarly journals A Case of Ectopic Odontogenic Ghost Cell Tumor: Histogenetic Features of a New Entity

2021 ◽  
Author(s):  
Yuri Noda ◽  
Chisato Ohe ◽  
Mitsuaki Ishida ◽  
Kimiaki Okano ◽  
Kaori Sando ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Cell Tumor ◽  
Clinicopathological Features ◽  
Rare Entity ◽  
Ghost Cell ◽  
Case Presentation ◽  
Floor Of The Mouth ◽  
Odontogenic Origin ◽  
Odontogenic Neoplasm

Abstract Background: Odontogenic tumors arising from extra-alveolar sites are extremerly rare. Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic neoplasm characterized by CTNNB1 mutation, ghost cell appearance, and dentinoid-like calcification. We present a case of an ectopic DGCT arising from a calcifying odontogenic cyst in the floor of the mouth. Case presentation: A 72-year-old man presented with a painless sublingual swelling. Imaging revealed a multi-lobulated, solid-cyst mass on the floor of the mouth. Cytology showed folded epithelial clusters composed of basaloid cells, keratinized material, and dentinoid matrix. Histology also revealed a multi-cystic, cribriform to solid nest. Immunohistochemically, CK19, CK5/6, bcl-2, and p63 were diffuse positive. CTNTTB1 mutation was detected, leading to the final diagnosis of an ectopic DGCT. There was no recurrence during a 6-month follow-up. Conclusion: This is the first report to comprehensively describe the clinicopathological features of an ectopic DGCT of odontogenic origin, developing similarly to that of a true odontogenic DGCT. Accurate diagnosis of this rare entity is necessary to avoid overtreatment.

scholarly journals Intramural Duodenal Hematoma In 2-year Old Child

2018 ◽  
Vol 9 (3) ◽  
pp. 18
Author(s):  
Dayanand Hota ◽  
Kamal Nain Rattan ◽  
Ahmad Khursheed ◽  
Manish Swami ◽  
Harish Bhardwaj
Keyword(s):  
Duodenal Obstruction ◽  
Intramural Hematoma ◽  
Abdominal Distension ◽  
Rare Entity ◽  
Diagnostic Dilemma ◽  
X Ray ◽  
Duodenal Hematoma ◽  
High Degree ◽  
High Intestinal Obstruction ◽  
Head Of Pancreas

Background: Intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction. It is often a diagnostic dilemma and a high degree of suspicion is required to make an early and accurate diagnosis in children. Case Report: A 2-year-old child presented with bilious vomiting and abdominal distension. X-ray abdomen showed high intestinal obstruction. Ultrasound and CT scan abdomen gave suspicion of pancreatic pseudo-cyst near head of pancreas. At surgery, an intramural hematoma of the duodenum was found and drained. Conclusion: Intramural duodenal hematoma is a rare entity especially in children and should be considered in differential diagnosis of acquired duodenal obstruction.

scholarly journals Inflammation and obstruction of the small intestine due to phytobezoar

2021 ◽  
Author(s):  
Van Trung Hoang ◽  
The Huan Hoang ◽  
Ngoc Trinh Thi Pham ◽  
Vichit Chansomphou ◽  
Duc Thanh Hoang
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Rare Entity ◽  
Imaging Studies ◽  
Case Presentation ◽  
Characteristic Imaging

Abstract Background: Bezoar bowel obstruction is a rare entity and remains difficult to detect on imaging studies. Recognition of its characteristic imaging pattern will be useful for diagnosis and management in the setting of intestinal obstruction.Case presentation: We report a 68-year-old female patient who was admitted to the hospital with signs of intestinal obstruction including abdominal pain, nausea, vomiting, and abdominal distention. She was diagnosed with phytobezoar small bowel obstruction on computed tomography (CT) imaging. The patient underwent surgery to confirm the diagnosis and subsequently recovered well.Conclusions: Bezoar is indicated by the sign of floating fat-density debris sign on CT images. It needs to be differentiated from small-bowel feces sign in intestinal obstruction.

scholarly journals Obturator hernia of Richter type: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e238252
Author(s):  
Cathal Hayes ◽  
Karl Schmidt ◽  
Yuwaraja Neduchelyn ◽  
Ivan Ivanovski
Keyword(s):  
Small Bowel ◽  
Primary Repair ◽  
Abdominal Distension ◽  
Suture Technique ◽  
Obturator Hernia ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Hernia Sac ◽  
Left Groin ◽  
Obturator Internus

An 85-year-old malnourished woman presented with symptoms of small bowel obstruction of uncertain aetiology. She had presented numerous times over the previous 2 years with symptoms of left groin and thigh pain, vomiting and abdominal distension. A CT of her abdomen and pelvis ultimately revealed a left-sided pelvic hernia, between the obturator internus and pectineal muscles. This was consistent with an obturator hernia. Diagnostic laparoscopy confirmed an obturator hernia of Richter type, incarcerated within the left obturator canal. Reduction revealed a hernia sac containing viable small bowel. A primary repair was performed using a double-layer suture technique to both close and plug the hernia defect. The patient rapidly recovered following hernia repair, with resolution of all previous long-standing symptoms. This case exemplifies the typical presentation of an obturator hernia and the diagnostic challenge it poses to clinicians.

scholarly journals Chondromyxoid Fibroma-Like Osteosarcoma in a 13 Years Old Girl: A Report of a New Case

2021 ◽  
Vol 14 ◽  
pp. 2632010X2110575
Author(s):  
Sabrine Derqaoui ◽  
Oussama Marbouh ◽  
Tarik Madhi ◽  
Lamalmi Najat ◽  
Lamia Rouas
Keyword(s):  
Poor Prognosis ◽  
Rare Variants ◽  
Fatal Outcome ◽  
Low Grade ◽  
Rare Entity ◽  
Chondromyxoid Fibroma ◽  
Imaging Studies ◽  
Case Presentation ◽  
Clinical Behavior ◽  
Aggressive Clinical Behavior

Osteosarcoma (OS) is the most common primary non hematopoietic malignant tumor of bone with a strict histologic definition: the presence of unequivocal osteoid produced by neoplastic cells. Rare variants displaying low-grade histological features have been described; among which chondromyxoid fibroma-like (CMF-OS) is the rarest. However, despite its bland morphology; CMF-like OS has an aggressive clinical behavior and a poor prognosis. To the best of our knowledge, only 3 cases of CMF-OS have been previously reported in children. Because of its atypicality and scarcity; misdiagnosis is more likely to occur. Herein we describe a new case of CMF-OS in a 13 years old girl with fatal outcome. Diagnosis was based on focal malignant bone formation and correlation with imaging studies. The aim of the present case presentation is to raise awareness of this rare entity and to highlight the challenging diagnosis

scholarly journals A case report: ruptured primary ovarian abscess in pregnancy

2021 ◽  
Vol 10 (9) ◽  
pp. 3627
Author(s):  
Dinesh D. Pratapwar ◽  
Namdev M. Bhure ◽  
Sarika P. Zunjare
Keyword(s):  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Definitive Diagnosis ◽  
Rare Entity ◽  
Diagnostic Dilemma ◽  
Minimally Invasive Surgical Procedure ◽  
Delay In Diagnosis ◽  
Minimally Invasive Surgical ◽  
Ovarian Abscess ◽  
In Pregnancy

Primary ovarian abscess during pregnancy is a very rare entity.  The clinical presentation is very vague and hence can be a diagnostic dilemma. Diagnostic laparoscopy gives a definitive diagnosis and an opportunity to treat the entity in same settings. Herein we discussed a case of a ruptured primary ovarian abscess in pregnancy which was successfully managed by laparoscopy. Ovarian abscess is different from tubo-ovarian abscess. A delay in diagnosis may be associated with risk of maternal death and can be detrimental to the fetus also. Surgical drainage of ovarian abscess and conservative and minimally invasive surgical procedure under antibiotics are recommended during pregnancy.

scholarly journals SPIGELIAN HERNIA : A DIAGNOSTIC DILEMMA

2020 ◽  
pp. 1-3
Author(s):  
Shailendra Rai ◽  
Basanti Mazumdar ◽  
Arvind Pratap
Keyword(s):  
Case Series ◽  
Abdominal Wall Hernia ◽  
Great Difficulty ◽  
Spigelian Hernia ◽  
Clinical Aspects ◽  
Rare Entity ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Diagnostic Difficulties ◽  
Enhanced Computed Tomography

PURPOSE- Spigelian Hernia[SH] constitutes 0.12% to 2% of total abdominal wall hernia. The diagnosis of SH poses great difficulty because of non-specific presentation, and non obvious finding on examination. Also, Surgeons are less experienced with this entity and have low index of suspicion further contributing to underdiagnosis. Thus, whether SH is a rare entity or an underdiagnosed condition is debatable. The aim is share our experience and discuss different clinical aspects and outcomes of SH with a literature review regarding diagnostic difficulties. PATIENTS AND METHODS- This is a case series of 18 patients diagnosed with 20 SH, were operated in a single surgical unit of Sir Sunderlal Hospital from January 2016 to July 2019. Historical patient’s records including demographic profiles, clinical presentation, and management were analysed. RESULTS- Total 18 patients were admitted with women preponderance. The mean age of presentation was 39.23years. The most common presentation is pain followed by swelling. Most patients don’t have any clinical finding. Defect is identified only in 3 patients. Ultrasound, Contrast-Enhanced Computed Tomography and Magnetic Resonance Imaging were used to diagnose the hernia. All the patients were managed operatively with pre-peritoneal fat as the most frequent content. CONCLUSION- SH is a diagnostic challenge with rather simple management. A high index of clinical suspicion is the key to diagnosis. SH seems more of an under-diagnosed rather than a rare entity. Also the author suggests to scan whole length of spigelian aponeurosis whenever there is a suspicion or the failure to reach an otherwise diagnosis.

Triquetral Osteoid Osteoma: A Diagnostic Dilemma

2020 ◽  
Author(s):  
Mahmoud Farzan ◽  
Amirreza Farhoud ◽  
Mohammad Zarei ◽  
Furqan Mohammed Yaseen Khan ◽  
Mohammed Javad Dehghani-Firoozabadi
Keyword(s):  
Osteoid Osteoma ◽  
Carpal Bones ◽  
X Rays ◽  
Advanced Imaging ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Case Presentation ◽  
Nocturnal Pain ◽  
History Of ◽  
Low Threshold

Background: Osteoid osteoma (OO) is a benign osteoblastic neoplasm, mostly occurring in long bones of lower extremity. Its manifestation in unusual locations can be a diagnostic challenge and distressing for patients. OO in carpal bones is uncommon; its occurrence in triquetrum is even more so. Case Presentation: This study reports on a nineteen-year-old female with history of wrist pain for 4 years. She had sustained trauma to the same wrist before commencing of pain. Patient's pain was unresponsive to conservative treatments. Her routine x-rays were mostly interpreted as normal and obtaining further imaging helped us in diagnosis of OO of triquetrum. Surgical resection of the nidus was performed. Conclusions: Manifestation of OO in small carpal bones may not be typical; identifying the lesion or nidus could be challenging. Whatever unusual the location or presentation of such lesions may be, obtaining advanced imaging can be of significant help; therefore, we suggest clinicians to have low threshold in ordering advanced imaging specifically in patients suffering from chronic pain. Also, persistent history of nocturnal pain is a sign which is worth attention.

Giant secretory multifocal adrenal myelolipoma: a diagnostic dilemma

2021 ◽  
Vol 14 (1) ◽  
pp. e239441
Author(s):  
Brijesh Kumar Singh ◽  
Prasanna Ramana Arumugaswamy ◽  
Sunil Chumber ◽  
Yashwant Singh Rathore
Keyword(s):  
Erectile Dysfunction ◽  
Postoperative Period ◽  
Adrenal Mass ◽  
Final Diagnosis ◽  
Rare Entity ◽  
Imaging Findings ◽  
Diagnostic Dilemma ◽  
Adrenal Myelolipoma ◽  
Left Flank ◽  
Noradrenaline Levels

A 38-yearr-old man presented with erectile dysfunction and infertility. On examination, he was hypertensive and detected to have a left flank mass. Blood investigations were unremarkable except raised serum noradrenaline levels. Imaging revealed multiple well-defined fat-containing hypodense lesions in left suprarenal area with largest one measuring 14×16 cm, suggestive of left adrenal myelolipoma. Diagnostic dilemma was posed due to discordance between clinical, biochemical and imaging findings. Left adrenal mass resection was planned keeping the possibility of pheochromocytoma. However, histopathology revealed it to be adrenal myelolipoma. Hypertension was resolved in the postoperative period and serum noradrenaline levels were normalised. Final diagnosis of a secretary adrenal myelolipoma was made, which is an extremely rare entity

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