Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review

Parathyroid adenomas are most commonly diagnosed when symptoms consistent with primary hyperparathyroidism arise. However, certain parathyroid glands may enlarge without such symptoms. Described here is a case in which a patient presented with acute signs of unilateral cervical point tenderness, dysphagia, and odynophagia. Calcium and parathyroid hormone levels tested within normal range. Imaging revealed an enlarged right-sided mass, with compression of the trachea-esophageal groove and potentially the right recurrent laryngeal nerve. Surgical excision was performed, and final pathology revealed an infarcted parathyroid adenoma. Clinical symptoms promptly resolved thereafter. Current NIH criteria for parathyroidectomy include various symptoms of hyperparathyroidism but do not include the above findings. Nonsecreting parathyroid adenomas rarely cause laryngeal symptoms, as this has only been documented once before.

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Late-onset malignant glaucoma

Latin American Journal of Ophthalmology ◽

10.25259/lajo_19_2019 ◽

2020 ◽

Vol 3 ◽

pp. 1

Author(s):

Ramiro José Daud ◽

Horacio Freile ◽

Mauricio Freile ◽

Soledad Mariano

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Acute Pain ◽

Late Onset ◽

Slit Lamp ◽

Normal Range ◽

Slit Lamp Examination ◽

Complete Occlusion ◽

Malignant Glaucoma ◽

The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

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Intrascrotal lipoblastoma in adulthood

BMJ Case Reports ◽

10.1136/bcr-2019-231320 ◽

2019 ◽

Vol 12 (12) ◽

pp. e231320

Author(s):

Mário José Pereira-Lourenço ◽

Duarte Vieira-Brito ◽

João Pedro Peralta ◽

Noémia Castelo-Branco

Keyword(s):

Case Report ◽

Magnetic Resonance ◽

S100 Protein ◽

Surgical Excision ◽

Large Mass ◽

Histological Diagnosis ◽

Physical Exam ◽

Nodular Lesion ◽

Inferior Portion ◽

The Right

This case report describes the case of a 37-year-old man that noticed an intrascrotal right mass with 1 month of evolution. During physical exam presented with a large mass at the inferior portion of the right testicle, clearly separated from the testicle, with a tender consistency and mobile. An ultrasound was performed that showed a solid and subcutaneous nodular lesion, extra testicular, heterogeneous, measuring 7.2 cm. Pelvic magnetic resonance imageMRI showed a lesion compatible with a lipoma. The patient was subjected to surgical excision of the lesion by scrotal access, having histology revealed a lipoblastoma (LB) of the scrotum. Histological diagnosis was obtained by microscopic characteristics (well-circumscribed fatty neoplasm) and immunohistochemistry (stains for CD34, S100 protein and PLAG1 were positive; stains for MDM2 and CDK4 were negative). LB is extremely rare after adolescence in any location, being this first described case of intrascrotal LB described in adulthood.

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A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00057-7 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Victoria Blackabey ◽

Olivia Kenyon ◽

Rishi Talwar

Keyword(s):

Hearing Loss ◽

Case Report ◽

Clinical Symptoms ◽

Symptomatic Relief ◽

Clinical History ◽

Histological Diagnosis ◽

Unusual Presentation ◽

Sinus Surgery ◽

Cancer Management ◽

The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

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An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2017-0077 ◽

2017 ◽

Vol 30 (9) ◽

Author(s):

Brent D. Bauman ◽

Maria Evasovich ◽

Amanda Louiselle ◽

Eugene Zheng ◽

Kevin Goodwin ◽

...

Keyword(s):

Case Report ◽

Parathyroid Adenoma ◽

Pediatric Patient ◽

Pediatric Population ◽

Preoperative Imaging ◽

Management Algorithm ◽

Postoperative Mri ◽

Complex Patients ◽

Multiple Imaging ◽

Parathyroid Adenomas

AbstractBackground:Hyperparathyroidism (HPT) is a rare disease in the pediatric population, and optimal management may be unclear if it is due to an occult parathyroid adenoma. We present a case report of a pediatric patient with an occult, ectopic, supernumerary, parathyroid adenoma.Case presentation:A 13-year-old female who initially presented with anxiety was diagnosed with HPT. Preoperative imaging and bilateral neck exploration with four-gland biopsy were negative for any parathyroid adenoma. Postoperative MRI identified a thymic mass. She subsequently underwent video-assisted thoracoscopic thymectomy with resection of an intrathymic parathyroid adenoma.Conclusions:The diagnosis of pediatric HPT is increasing. Supernumerary or occult parathyroid adenomas are rare and add complexity to presurgical planning and management. Our case represents the rare occurrence of a pediatric ectopic supernumerary occult parathyroid adenoma treated with a two-stage approach utilizing multiple imaging studies. We provide a review of the pathology and propose an algorithmic approach to manage these complex patients.

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Primary hyperfibrinolysis as the presenting sign of prostate cancer: A case report

Vojnosanitetski pregled ◽

10.2298/vsp150525076k ◽

2016 ◽

Vol 73 (9) ◽

pp. 877-880 ◽

Cited By ~ 2

Author(s):

Andrijana Kulic ◽

Zorica Cvetkovic ◽

Vesna Libek

Keyword(s):

Prostate Cancer ◽

Case Report ◽

Fibrinogen Level ◽

Laboratory Diagnosis ◽

Cancer Case ◽

Normal Range ◽

Normal Ranges ◽

Assay Result ◽

The Right ◽

D Dimer

Introduction. A bleeding syndrome in the setting of primary hyperfibrinolysis in a prostate cancer patient is only 0.40? 1.65% of cases. The laboratory diagnosis of primary hyperfibrinolysis is based on the increase of biomarkers like D-dimer, fibrinogen split products, plasminogen, and euglobulin lysis test. These tests are not specific for primary hyperfibrinolysis. We reported a rare case of hemorrhagic syndrome caused by primary hyperfibrinolysis as the first clinical symptom of metastatic prostate cancer. Case report. A 64-year-old male was admitted to our hospital with large hematomas in the right pectoral and axillary areas (20 x 7 cm), right hemiabdomen (30 x 30 cm) and the left lumbal area, (25 x 5 cm). The patient had no subjective symptoms nor used any medication. Initial coagulation testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were within the normal range, while fibrinogen level was extremely low (1.068 g/L) (normal range 2.0?5.0) and the D-dimer assay result was high 1.122 mg/L (normal range < 0.23). The results obtained by rotation thrombelastometry pointed to primary fibrinolysis. Further clinical and laboratory examination indicated progressive malignant prostate disease. First line treatment for the patient was a combined administration of tranexamic acid (3 x 500 mg iv) and transfusion of ten units of cryoprecipitate (400 mL). Next day, fibrinolytic function measurements by rotation thrombelastometry were within the normal ranges. Fibrinogen level was normalized within two days (2.4 g/L). There were no newly developed hematomas. Conclusion. This case report shows primary hyperfibrinolysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagnosis and treatment.

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Huge true aneurysm of the facial artery treated with internal trapping and surgical excision: a case report

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa375 ◽

2020 ◽

Vol 2020 (9) ◽

Author(s):

Kiyoko Nakagawa ◽

Takuji Yasuda ◽

Natsuko Kobayashi ◽

Kazuhiko Urabe

Keyword(s):

Case Report ◽

Case Reports ◽

Surgical Excision ◽

Facial Artery ◽

True Aneurysm ◽

The Right

Abstract A report of true aneurysms is extremely rare. There are only five previous case reports of true aneurysm of the facial artery. In the previously reported cases, there was no case that underwent trapping and surgical excision. In this case report, we describe the procedure of internal trapping before the surgical excision of a huge true aneurysm of the right facial artery for a 79-year-old woman. There was no recurrence of the aneurysm during a 6-month follow-up period.

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Nontraumatic Parapharyngeal Haematoma: A Rare Lesion

Case Reports in Otolaryngology ◽

10.1155/2018/7340937 ◽

2018 ◽

Vol 2018 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Pedro Carneiro de Sousa ◽

Inês Gambôa ◽

Delfim Duarte ◽

Nuno Trigueiros-Cunha

Keyword(s):

Case Report ◽

Parathyroid Hormone ◽

Conservative Treatment ◽

Parathyroid Adenoma ◽

Parapharyngeal Space ◽

Neck Swelling ◽

Parathyroid Adenomas ◽

Rare Lesion ◽

Symptoms And Signs ◽

Emergent Surgery

Nontraumatic haematoma of parapharyngeal space is very rare and may cause dysphagia and dyspnea. The authors present a case report of a 74-year-old woman with sudden nontraumatic neck swelling without dyspnea and with left pharyngeal bulging and endolaryngeal displacement. Parathyroid hormone elevation and imaging exams confirmed bleeding from a parathyroid adenoma. Symptoms and signs resolved after one week of conservative treatment. There are few cases of parapharyngeal haematomas caused by parathyroid adenomas. Most patients can be managed without emergent surgery, but close airway monitoring is fundamental.

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Vallecular cyst in an infant with stridor: a case report

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v6i1.20578 ◽

2018 ◽

Vol 6 (1) ◽

pp. 58-62

Author(s):

Nabin Lageju ◽

Rajendra Prasad Sharma Guragain

Keyword(s):

Case Report ◽

Ct Scan ◽

Cystic Lesion ◽

Failure To Thrive ◽

Surgical Excision ◽

Infants And Children ◽

Solid Component ◽

Feeding Difficulties ◽

The Right ◽

In Infants And Children

Background and Objectives: Vallecular cysts are rare and generally asymptomatic. In infants and children they present with stridor, feeding difficulties, failure to thrive. Treatment is surgical excision with cautery or laser.Presentation of Case: We discuss the clinical, radiological presentation of a 7 months old child with vallecular cyst which was surgically treated with deroofing and marsupialisation with elecrocautery. There was no recurrence even up 2 years of follow-up.Discussion: Flexible nasopharyngolaryngoscopic examination was done which showed present of swelling in the left vallecula pushing the epiglottis posteriorly and to the right with narrowed normal endolarynx. Radiological investigations with CT scan showed cystic lesion noted in left side of neck with no septation and solid component. The lesion was extending to ipsilateral vallecula and paraglottic region with narrowing of endolarynx.Conclusion: Vallecular cyst is rare cause of noisy breathing in infants and children. In adults it is usually asymptomatic. Treatment of choice is marsupialization with electrocautery or laser.

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A maxillary ameloblastic fibrosarcoma tumor: a rare case report from Syria

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa255 ◽

2020 ◽

Vol 2020 (8) ◽

Author(s):

Amjad Soltany ◽

Ghazal Asaad ◽

Rami Daher ◽

Mouhannad Dayoub ◽

Ali Khalil ◽

...

Keyword(s):

Case Report ◽

Soft Tissue ◽

Rare Case ◽

Soft Tissue Sarcomas ◽

Surgical Excision ◽

Low Grade ◽

Rare Case Report ◽

Ameloblastic Fibrosarcoma ◽

The Right

Abstract Ameloblastic fibrosarcoma (AFS) is a rare, aggressive malignant odontogenic tumor. AFS is seen most frequently in second and third decades of life. We are reporting a case of a low grade AFS in a 21-year-old male complaining of a painless swelling in the right side of the maxilla. The patient was treated with surgical excision followed by radiotherapy, which is considered the most effective approach for most of soft tissue sarcomas. AFS has a high-reported recurrence rate (up to 37%); therefore, long-term surveillance for recurrence is crucial.

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