scholarly journals Self-Induced Traumatic Macroglossia: Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Abdullah A. Alarfaj ◽  
Ali R. AlHayek ◽  
Rashid Alghanim ◽  
Nasser A. Al-Jazan

Traumatic macroglossia is an extremely rare condition characterized by a sudden edematous swelling of the tongue due to trauma. We report a rare case of traumatic macroglossia in a 37-year-old male with known trisomy 21 and epilepsy who presented to the emergency room with a huge protruded tongue due to aggressive behavior and a history of multiple tongue tractions, leading to sudden severe tongue swelling without any respiratory distress symptoms. The examination was unremarkable; fixable nasolaryngoscopy relieved bilateral vocal cord movement, and there was no laryngeal edema. The patient was managed immediately by endotracheal intubation to secure the airway, and corticosteroids were used to diminish and stop the tongue swelling. We describe the clinical management for such patients, highlighting the different causes of traumatic macroglossia. A few cases have been reported in the literature, but this is the first case to report self-induced traumatic macroglossia in a seizure-free patient managed successfully by endotracheal intubation, corticosteroids, a bite block, and warm wet dressing.

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Nonso Osakwe ◽  
Diane Johnson ◽  
Natalie Klein ◽  
Dalia Abdel Azim

Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.


2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Masanori Kudoh ◽  
Ken Omura ◽  
Arata Satsukawa ◽  
Koshi Matsumoto ◽  
Takahide Taguchi ◽  
...  

Symmetric lipomatosis is definitively characterized by symmetric, tumorous lipomatous proliferation of adipose tissue that often develops in the head and neck, shoulders, and upper trunk. However, in the oral region, symmetric lipomatosis of the tongue (SLT) is an extremely rare condition related to generalized lipidosis that is often caused by chronic alcoholism. It is characterized by multiple symmetric lipomatous nodules and diffuse bilateral swelling located within the tongue. We report an extremely rare case of SLT arising in an 80-year-old man with a long history of alcoholic liver cirrhosis. He exhibited multiple soft nodular protrusions on the bilateral margin of the tongue presenting as macroglossia for years. Although MR imaging showed multiple fatty masses on both sides of the tongue, there was no elevated tumor mass on the bilateral margin. The patient underwent bilateral partial glossectomy under general anesthesia. Histopathologically, the resected tumor exhibited diffuse infiltration with mature adipose tissue lacking a fibrous capsule. Due to the lipidosis and the unusual presentation of multiple lesions, the lesion was ultimately diagnosed as SLT. At present, after surgery, the patient wears a full-denture and is in excellent condition, with no sign of recurrence, improved QOL, and recovery of masticatory, articulatory, and speech intelligibility functions.


Author(s):  
Suzan Saylisoy ◽  
Goknur Yorulmaz

Background: The ectopic posterior pituitary (EPP) is a rare condition characterized by the ectopic location of the posterior pituitary lobe associated with varying degrees of stalk anomalies. The arachnoid cysts (AC) are benign lesions of the arachnoid, which account for 1% of all intracranial space-occupying lesions. Sellar/suprasellar ACs account for approximately 1% of all ACs. This is the first case of coexistence EPP with sellar/suprasellar AC. Case Report: A 67-year-old woman presented with 6 months history of fatigue. Her medical history was positive for irregular menstruation. Her endocrine examinations indicated low free thyroxine level with low TSH level, low oestradiol with low gonadotrophin level, slightly elevated prolactin level. Her Insulin-like growth factor-1 was below the normal levels. Dynamic contrast hypophysis MRI revealed a sellar cystic lesion with a dimension of 18 × 14 × 14 mm, extending from the suprasellar cistern, traversing the diaphragma sellae and reaching the level of the floor of the 3rd ventricle, consistent with sellar/suprasellar AC. There was no wall enhancement. The optic chiasm was compressed. The precontrast T1-weighted magnetic resonance images did not demonstrate the characteristic bright spot of posterior pituitary within the sella, which was higher in position, in the region of the median eminence. The pituitary stalk was not present. Conclusion: Although speculative, we have a hypothesis to explain how the EPP and sellar/- suprasellar AC coexist in this patient. Due to the absence of stalk, CSF may enter the sella tursica from the central aperture of the diaphragma sellae through which normally the stalk passes.


2005 ◽  
Vol 119 (3) ◽  
pp. 233-234 ◽  
Author(s):  
Claudine Elizabeth Pang ◽  
Tee Sin Lee ◽  
Kenny Peter Pang ◽  
Yoke Teen Pang

We present the first case of a thoracic ranula which originated from the left submandibular area extending into the subcutaneous tissue planes of the anterior chest wall. The patient had a history of surgery for a previous benign left salivary gland cyst, and presented with an enlarging mass in the anterior chest wall. This was a recurrence of a ranula, with an extension into the anterior thoracic wall. The thoracic ranula was excised, together with ipsilateral sublingual and submandibular glands, via a transcervical approach. No recurrence was detected over a 3-year post-operative follow up.


2018 ◽  
Vol 5 (2) ◽  
pp. 1-6 ◽  
Author(s):  
Hiroshi Kanno ◽  
Seiki Osano ◽  
Masamichi Shinonaga

Central nervous system hemangioblastomas are generally restricted to the cerebellum, spinal cord, and brainstem. Supratentorial hemangioblastomas are uncommon, and optic nerve hemangioblastomas are extremely rare, with fewer than 25 reports including this case. In this report, we present the case of a 36-year-old woman with von Hippel-Lindau (VHL) disease who presented with progressive diminution of vison in the left eye due to a retrobulbar optic nerve hemangioblastoma. The patient had a history of cerebellar /spinal hemangioblastomas and pancreatic cysts, and her father and brother were patients with VHL disease. Gadolinium enhanced MRI showed intraorbital retrobulbar enhanced mass on the left optic nerve. The optic nerve hemangioblastoma was treated with fractionated stereotactic radiosurgery using Novalis. Eighteen months after the stereotactic radiosurgery, the tumor volume decreased although the patient lost vision. This report presents an extremely rare case of optic nerve hemangioblastoma, which is the first case treated with stereotactic radiosurgery.


2018 ◽  
Vol 3 (2) ◽  

We report a case of Purulent pericarditis and pneumopericardium by Streptococcus angiosus in 35-year-old man detained in prison, history of ischemic cerebrovascular event due to cocaine, with no recent surgical or traumatic history who had subacute clinical course of chest pain and signs of systemic inflammatory response. He was empirically treated with vancomycin and cefepime with subsequent pericardiotomy and drainage. The patient has a poor clinical evolution after the procedure, presents septic shock and dies. This is a rare case, a serious infection, the second reported in world, however in comparison to the first case the clinical course was different.


2021 ◽  
Author(s):  
Leila Pourali ◽  
Hamidreza Ghorbani ◽  
Atiyeh Vatanchi ◽  
Sedigheh Ayati ◽  
Ghazal Ghasemi ◽  
...  

Uterine prolapse and bladder exstrophy (BE) during pregnancy is a rare condition. The aim of this study was to present a rare case of pregnancy complicated by both bladder exstrophy and uterine prolapse. A 39-year-old pregnant woman (gravida 2, para 1) presented to the maternity department at 39 weeks of gestation with labor pain. Physical examination showed regular uterine contractions; the cervix was completely out of the vaginal opening with dilatation of 3 cm and effacement of 30%. She had a history of multiple surgeries for correction of bladder exstrophy and also suffered from uterine prolapse. In active labor, abnormal fetal heart rate tracing happened, so an emergent cesarean section was planned, and a healthy neonate with the normal Apgar score was born. At regular follow-up until four months after delivery, there was no sign or symptom of uterine proplase. Multidisciplinary management of patients with BE and uterine prolapse may result in optimal perinatal outcomes. Uterine prolapse may disappear after delivery, even in the complicated case of bladder exstrophy.


2019 ◽  
Vol 160 (38) ◽  
pp. 1510-1513
Author(s):  
Călin Molnar ◽  
Tibor Sárközi ◽  
Cedric Kwizera ◽  
Marian Botoncea ◽  
Opriș Zeno ◽  
...  

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.


2005 ◽  
Vol 2 (1) ◽  
pp. 81-84
Author(s):  
Kiyoyuki Yanaka ◽  
Muneyoshi Yasuda ◽  
Kentoaro Furusho ◽  
Hiroyuki Asakawa ◽  
Yuji Matsumaru ◽  
...  

Spontaneous intracerebral hematomas usually produce the sudden onset of devastating neurological symptoms. We describe a case showing slowly progressive clinical symptoms followed by a sudden deterioration caused by two different types of intracerebral hematomas coexisting in the adjacent area. A 72-year-old female with a 2-year history of Alzheimer’s disease and a 3-month history of occasional headache and vomiting was admitted after she experienced the sudden onset of right hemiparesis and a speech disturbance. Neuroradiological examinations demonstrated two different types of intracerebral hematomas coexisting in the left temporal lobe. The patient underwent a left frontotemporal craniotomy. A solid hematoma was found immediately below the cortex and a large hematoma cavity, which contained degraded bloody fluid, was found below the solid hematoma. Histological study demonstrated an arteriovenous malformation (AVM). The AVM may have been responsible for the pathogenesis of these two different types of intracerebral hematomas. Initially, a silent intracerebral hemorrhage from the AVM and liquefaction of the hematoma probably formed the cavity and repeated small subclinical hemorrhages into the cavity during a prolonged period of time may have caused the growth of the inner hematoma. The sudden rupture of the AVM most likely caused the outer solid hematoma, resulting in the abrupt onset of hemiparesis and speech disturbance. This is the first case to demonstrate two different types of intracerebral hematomas coexisting in the adjacent area. A possible mechanism for this rare condition is discussed. Nepal Journal of Neuroscience, Volume 2, Number 1, 2005


2011 ◽  
Vol 3 (4) ◽  
pp. 213-217
Author(s):  
Cassia Gisele Terrassani Silveira ◽  
Admir Agic ◽  
Markus Kleemann ◽  
Hartmut Merz ◽  
Daniela Hornung

Introduction Extrapelvic endometriosis is a rare condition typically associated with variable symptomatology and complex diagnosis. Case report: Here, we report a rare case of phrenic endometriosis manifested insidiously in a woman of reproductive age after a prolonged history of endometriosis with several surgical interventions, including laparoscopic bowel resection a few months ago. The patient presented with menstrual-related, cyclical, right upper abdominal pain. Results Accurate surgical inspection during the laparoscopic procedure enabled the identification and full resection of a deep infiltrating endometriotic lesion growing from the peritoneum into the phrenic tissue, which was suspected by symptomatology. No pulmonary complications were detected before or after surgery except for a small right-sided pneumothorax, which did not require drainage and disappeared spontaneously after five days. Conclusions The rare case reported here emphasizes the importance of a very exact conversation with the patient before surgery, a systematic and accurate surgical exploration for the diagnosis, and the successful laparoscopic treatment of a symptomatic phrenic disease in a woman with a longstanding history of endometriosis.


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