scholarly journals Metastatic Cutaneous Melanoma of the Gallbladder

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Dhruvan Patel ◽  
Shazia Sohrawardy ◽  
Yub Raj Sedhai ◽  
Soney Basnyat ◽  
Anisha Daxini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Wedge Resection ◽  
The Body ◽  
Aggressive Disease ◽  
Laparoscopic Excision ◽  
The Face ◽  
History Of

Metastatic melanoma is an aggressive disease that can spread to many organs of the body. In rare cases, it can spread to the gallbladder causing secondary lesions, yet presenting with little to no symptoms. Therefore, most cases of metastatic melanoma lesions to the gallbladder go undiagnosed. Here, we present the case of a 41-year-old male with a four-month history of melanoma of the face, with a postresection status, who presented with right upper quadrant abdominal pain. Doppler ultrasound and computed tomography confirmed the presence of a mass on the gallbladder. Laparoscopic excision along with liver wedge resection was performed. Pathology staining revealed the presence of a malignant metastatic melanoma lesion of the gallbladder.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

Vancomycin-Induced Red Man Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 572-580
Author(s):  
Maurice Levy ◽  
Gideon Koren ◽  
Lee Dupuis ◽  
Stanley E. Read
Keyword(s):  
Signs And Symptoms ◽  
The Body ◽  
Control Group ◽  
Severe Hypotension ◽  
The Face ◽  
Red Man Syndrome ◽  
History Of ◽  
Serum Vancomycin ◽  
Mild Temperature ◽  
Cold Extremities

A total of 11 cases of red man syndrome collected among 650 children who had received vancomycin in our hospital between 1986 and 1988 (estimated prevalence 1.6%) were retrospectively analyzed. These 11 children were compared with 11 age-matched children who received vancomycin in whom red man syndrome did not develop. Of the patients with red man syndrome, 73%, and of the patients with no reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus epidermidis-positive cultures, or because of history of penicillin allergy. No difference was observed in the dose per kilogram given to both groups (12.9 ± 3.5 mg/kg per dose in those with red man syndrome vs 12.3 ± 6.9 mg/kg per dose in control childrens. The duration (mean ± standard deviation) of vancomycin infusion was 45.9 ± 16.7 minutes (range 10 to 90 minutes) in patients with red man syndrome and 54.5 ± 7.6 minutes (range 45 to 65 minutes) in the control group (P = .07). In the 5 children with red man syndrome rechallenged with vancomycin, slower infusion rates prevented or reduced the syndrome, which emphasized the fact that the rate of administration is the important determinant of red man syndrome in susceptible cases. Clinically, the syndrome developed at the end of the infusion in most patients, but appeared as early as 15 minutes after initiation of the infusion. It was mostly manifested as a flushed, erythematous rash on the face, neck, and around the ears. Less frequently, the rash was distributed all over the body. Pruritus was usually localized to the upper trunk but was also generalized (2 of 11 children). Associated signs and symptoms were hypotension, watery puffy eyes, tachycardia, respiratory distress, dizziness, agitation, and mild temperature increase. A premature infant with the red man syndrome had skin rash associated with poor perfusion, cold extremities, increased need for oxygen, and severe hypotension. The rash disappeared within 20 minutes (range 5 minutes to 7 hours) after vancomycin infusion was stopped. There was no association between serum vancomycin concentrations and red man syndrome; in both groups of patients therapeutic as well as subtherapeutic concentrations were observed, suggesting that this is an idiosyncratic and not a concentration-dependent phenomenon.

Comparison of Primary and Metastatic Malignant Melanoma of the Esophagus: Clinicopathologic Review of 10 Cases

2008 ◽  
Vol 132 (10) ◽  
pp. 1623-1629 ◽  
Author(s):  
Amy A. Sanchez ◽  
Tsung-Teh Wu ◽  
Victor G. Prieto ◽  
Asif Rashid ◽  
Stanley R. Hamilton ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Cell Morphology ◽  
Growth Phase ◽  
Cutaneous Melanoma ◽  
Radial Growth ◽  
Spindle Cell ◽  
Previous History ◽  
Depth Of Invasion ◽  
History Of

Abstract Context.—Primary esophageal melanoma (PEM) is a rare disease and is difficult to distinguish from other esophageal malignancies and from metastatic melanoma. Objective.—To develop diagnostic criteria for PEM, we compared the clinicopathologic features of 5 PEMs and 5 metastatic melanomas to esophagus. Design.—Ten cases of esophageal melanoma, including 4 surgically resected specimens, 2 autopsy cases, and 4 cases reported on mucosal biopsies, were reviewed. The histologic parameters used in this study were well-characterized features for cutaneous melanoma, including junctional component (in situ melanoma), radial growth phase, modified Breslow thickness, depth of invasion, lymphovascular invasion, satellitosis, predominant type of cytology, and regional lymph node metastasis. Clinical and follow-up information was obtained by reviewing patients' medical records. Results.—Previous history of cutaneous melanoma was present in all 5 cases of metastatic esophageal melanoma but was not present in the 5 patients with PEMs. In situ melanoma and/or radial growth phase were identified in all 5 PEMs but were not present in any of the metastatic cases. Among the 4 resected and 2 autopsy cases, melanocytosis and mixed epithelioid and spindle cell morphology was present in 2 (50%) of 4 PEMs but was not present in 2 (40%) of the metastatic melanomas. Melanin pigment was detectable in all cases. Patients with PEM had better survival than those who had metastatic melanoma to esophagus (P = .03). Conclusions.—The presence of in situ melanoma, radial growth phase, melanocytosis, and mixed epithelioid and spindle cell morphology, in the context of no history of melanoma, distinguishes PEM from metastatic melanoma.

scholarly journals Abdominal Pain and Vomiting in a Patient with Over-anticoagulation -- a Rare Case of Spontaneous Intramural Hematoma of the Jejunum

2020 ◽  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Vitamin K Antagonists ◽  
Intramural Hematoma ◽  
Rare Condition ◽  
The Body ◽  
Diagnostic Process ◽  
Tomography Scan

Anticoagulants, including vitamin K antagonists, are widely used for therapeutic and prophylactic purposes. Bleeding is the most important complication of anticoagulant therapy due to over-anticoagulation. Over-anticoagulation may present in unusual ways, such as spontaneous intramural hematoma of the small bowel. The classical clinical picture consists of abdominal pain, small bowel obstruction (that can present as vomiting) and hemorrhagic symptoms that can be related to the bowel or other parts of the body. Radiological examinations are essential for the diagnosis. Ultrasound can be helpful in the diagnostic process, but computed tomography is the procedure of choice. Conservative treatment is usually successful, including procedures that stop the over-anticoagulant consequences. A surgical approach is reserved for complications such as necrosis or perforation of the bowel. The diagnosis is definitively confirmed by the spontaneous resolution of the pathological findings on a follow-up computed tomography scan. We present a case of a 72-year-old woman who was diagnosed with this rare condition affecting the jejunum in the emergency department in our hospital.

scholarly journals Editorial

2005 ◽  
Vol 22 (2) ◽  
pp. i-iv
Author(s):  
Katherine Bullock
Keyword(s):  
Arab World ◽  
Medical Center ◽  
Knowledge Society ◽  
The Body ◽  
Modern World ◽  
Ibn Sina ◽  
Muslim Countries ◽  
The Face ◽  
History Of ◽  
Independent Thought

As Mehmet Mahfuz Söylemez documents in his “The Jundishapur School:Its History, Structure, and Functions,” Southwest Asia has long been a sitefor a cross-fertilization of ideas that have led to productive societies.Although Jundishapur’s excellence as a medical center predates the comingof Islam, it nevertheless played a key role in transmitting knowledge toMuslim physicians as well as contributing to Baghdad’s development as anup-and-coming center of excellence. In an open and welcoming climate,the scholars and physicians of Jundishapur and Baghdad fostered a learningenvironment that allowed Muslim civilizations to flourish.Today’s Muslims often look back to such “golden ages” with wistfulness,admiration, and frustration. Given the constant defeats and subjugationfaced by Muslim countries since western colonization, this wistfulness is notsurprising. In order to bolster their identity to defend themselves against thiscontinuing subjugation, Muslims often offer this glorious past to anIslamophobic world: “We are not barbarians! See what Muslim civilizationwas capable of!” And in the face of Eurocentric curricula that largely denyany role to a non-European civilization in the history of ideas since Plato,such reminders are crucial.But as Dieter Weiss’ “Paths toward an Arab Knowledge Society” inadvertentlyhighlights, such wistfulness is underscored by an ignorance of justwhat it takes to produce a golden age. For a society to flourish, it must createthe conditions that enable its inhabitants to engage in knowledge creation:the freedom to think, debate, and discuss. While he focuses only onthe Arab world, one would have to be blind to reality not to realize that thesame deplorable situation can be found in most Muslim countries today.Imagine what kind of Muslim cultural and political society must haveexisted for Ibn Sina, who produced great medical and philosophical workswhile denying the resurrection of the body. Compare that with the assassinations,death threats, and the like facing contemporary writers who engagein independent thought about Islam and the modern world. Think of the roleof caliph Ma’mun’s bayt al-hikmah (House of Wisdom), where Christians,Muslims, and scholars who followed other religions worked side-by-side to ...

scholarly journals Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract managed conservatively with corticosteroids

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Tyler McKechnie ◽  
Haroon Yousuf ◽  
Stephen Somerton
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
T Cell ◽  
Complete Resolution ◽  
Lymphoproliferative Disorder ◽  
Duodenal Biopsy ◽  
High Dose ◽  
History Of

An 82-year-old female presented with a 4-week history of abdominal pain, weight loss, diarrhea, and nausea. A complete infectious workup was negative. Her computed tomography (CT) scan showed no pathologic changes and her esophagogastroduodenoscopy (EGD) showed erosive damage in the duodenum. Her duodenal biopsy showed inflammation with a marked increase in intra-epithelial lymphocytes and her immunohistochemistry was consistent with indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. She was started on high dose steroids three months after the onset of her symptoms. She gradually improved with complete resolution of erosive changes on her repeat EGD.

Recurrent primary vulvovaginal malignant melanoma arising in melanoma in situ – the natural history of lesions followed for 23 years

2004 ◽  
Vol 14 (4) ◽  
pp. 628-632
Author(s):  
N. J. Kingston ◽  
R. W. Jones ◽  
J. Baranyai
Keyword(s):  
Malignant Melanoma ◽  
Natural History ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Mucosal Melanoma ◽  
Histologic Examination ◽  
Melanoma In Situ ◽  
Pigmented Lesions ◽  
History Of

Multifocal melanoma and melanoma in situ of the vulva and vagina are uncommon lesions, and our understanding of their natural history is limited. Vulvovaginal melanoma appears to be biologically different from cutaneous melanoma and has more in common with mucosal melanoma. A 60-year-old woman presented in 1977 with a pigmented vulvar lesion. Histologic examination revealed melanoma in situ associated with focal invasive melanoma. She re-presented with recurrent primary melanomas arising in melanoma in situ in 1990 and 1998 and died of widespread metastatic melanoma in 2000. Melanoma in situ of the vulva and vagina is rare and appears to have a relatively slow but definite progression to invasive melanoma. All suspicious pigmented lesions in this region should be biopsied, and if multifocal in situ melanoma is identified, vulvo(vagin)ectomy should be considered.

Therapeutic management of blood transfusion reaction in a crossbred cow

2016 ◽  
Author(s):  
N. Chand ◽  
P. S. Dhaliwal ◽  
S. K. Uppal
Keyword(s):  
Blood Transfusion ◽  
Tick Infestation ◽  
The Body ◽  
Transfusion Reaction ◽  
Pale Mucous Membrane ◽  
Blood Smear Examination ◽  
The Face ◽  
History Of ◽  
Veterinary Hospital ◽  
Crossbred Cow

A crossbred cow aged 6 year was presented to Teaching Veterinary Hospital of the Institute with the history of fever, tick infestation, anemia and decreased milk yield since last 10 days. Clinical examination revealed fever, pale mucous membrane and nil rumen motility. Hematological examination findings were anemia, leucopenia, relative neutrophilia and lymphopenia and decreased platelets. Blood smear examination revealed Anaplasma Marginale infection. Animal was treated with blood transfusion, oxytetracyclin, oral hematinic and multivitamin. After half an hour of start of transfusion, cow showed transfusion reaction in the form of urticarial eruptions all over the body, edema of eyelids, lips and over the face, frothy discharge from mouth with muscle tremor and shivering. Transfusion reaction was successfully managed with Adrenalin, Dexona, Avil along with normal saline.

scholarly journals A Case of Gastric Metastatic Melanoma 15 Years after the Initial Diagnosis of Cutaneous Melanoma

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Sohail Farshad ◽  
Scott Keeney ◽  
Alexandra Halalau ◽  
Gehad Ghaith
Keyword(s):  
Gastrointestinal Tract ◽  
Metastatic Melanoma ◽  
Chest Wall ◽  
Cutaneous Melanoma ◽  
Delayed Diagnosis ◽  
Gastric Cardia ◽  
Rare Occurrence ◽  
Endoscopic Appearance ◽  
Common Cancer ◽  
History Of

Melanoma is the most common cancer to metastasize to the gastrointestinal tract; however, metastasis to the stomach is a rare occurrence. We present the case of a patient with a history of melanoma of the chest wall 15 years prior to presentation who initially presented to the hospital with sepsis but was later found to have metastatic melanoma in the gastric cardia. This case illustrates the rare occurrence of metastatic melanoma to the stomach which occurred 15 years after the initial skin diagnosis of melanoma was made, its endoscopic appearance, and how the nonspecific symptoms frequently lead to a delayed diagnosis or one that is not made at all until after autopsy. For these reasons, endoscopy should be promptly performed if there is a suspicion of gastrointestinal metastatic melanoma.

Combined Hookwire and Methylene Blue Localization of Pulmonary Nodules

2018 ◽  
Vol 13 (3) ◽  
pp. 184-189 ◽  
Author(s):  
John Joseph Brady ◽  
Christie Hirsch Reilly ◽  
Robert Guay ◽  
Uday Dasika
Keyword(s):  
Computed Tomography ◽  
Methylene Blue ◽  
Thoracic Surgery ◽  
Wedge Resection ◽  
Pulmonary Nodules ◽  
Tactile Sensation ◽  
Wire Localization ◽  
Pathologic Diagnosis ◽  
History Of ◽  
The Mean

Objective Because of decreased tactile sensation with thoracoscopic approaches to biopsy, localization preoperatively and intraoperatively is important for successful biopsy. Our study evaluated the technique of combined computed tomography-guided hookwire and methylene blue localization. Methods Seventy-five patients from November 2007 to August 2013 who underwent combined Hawkins hookwire and methylene blue localization of 76 total pulmonary nodules before video-assisted thoracic surgery-guided wedge resection were retrospectively reviewed. Multiple patient, nodule, and procedural characteristics were analyzed for correlation with successful wire localization and wire dislodgement. Successful wire localization was defined as absence of lesions requiring re-resection, wire dislodgement necessitating re-resection, or conversion to thoracotomy for localization. Results Seventy-four patients were included in the study (75 pulmonary nodules - 1 patient had 2 lesions localized) and mean ± SD patient age was 65.8 ± 12.1 years and 50% were male. The mean ± SD largest nodule diameter was 14.6 ± 7.4 mm and 29.3% of these were subcentimeter pulmonary nodules. Increased age and history of malignancy were associated with malignant diagnoses ( P = 0.037 and 0.009, respectively) Successful wire localization was present in 86.4% of patients. Lesions with lower mean distance to the pleura correlated with successful localization ( P = 0.002). Wire dislodgement was present in 9.3% (7 patients) with 4 (5.3%) of these necessitating need for re-resection to establish pathologic diagnosis. Albeit wire dislodgement, 57.4% (4/7) still had successful thoracoscopic localization. Conclusions This study demonstrates that utilization of Hawkins hookwire in combination with methylene blue injection is an effective method to successfully localize pulmonary nodules for thoracoscopic wedge resection and should prompt further investigation for its utilization.

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