scholarly journals A Unique Presentation of Metastatic Gallbladder Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yuqian Tian ◽  
Carrie Luu ◽  
Danielle H. Carpenter ◽  
Grace Montenegro
Keyword(s):  
Gallbladder Carcinoma ◽  
Cytoreductive Surgery ◽  
Clinical Presentation ◽  
Early Stage ◽  
Interesting Case ◽  
Ovarian Cysts ◽  
Final Pathology ◽  
Poor Outcome ◽  
Intraperitoneal Therapy ◽  
Appendiceal Carcinoma

Gallbladder carcinoma can be challenging to diagnose and treat and usually leads to poor outcome, due to its aggressive nature and the nonspecific clinical presentation at early stage. We describe an interesting case of a 60-year-old female who presented with stage 3 appendiceal carcinoma after appendectomy was performed outside hospital. Further imaging workup demonstrated enlarged ovarian cysts and porcelain gallbladder. Upon exploration, she was found to have carcinomatosis and we proceeded with cytoreductive surgery (CRS) and hyperthermic intraperitoneal therapy (HIPEC). Final pathology demonstrated carcinoma from gallbladder primary.

scholarly journals Neuropathic Pain in Children with Sickle Cell Disease: The Hidden Side of the Vaso-Occlusive Crisis

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 84
Author(s):  
Jeanne Sigalla ◽  
Nathalie Duparc Alegria ◽  
Enora Le Roux ◽  
Artemis Toumazi ◽  
Anne-Françoise Thiollier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neuropathic Pain ◽  
Sickle Cell Disease ◽  
Sex Ratio ◽  
Prospective Study ◽  
Sickle Cell ◽  
Clinical Presentation ◽  
Early Stage ◽  
Cell Disease ◽  
A Prospective Study

The majority of hospitalizations of patients with sickle cell disease (SCD) are related to painful vaso-occlusive crises (VOCs). Although the pain of VOC is classically nociceptive, neuropathic pain (NP) has also been demonstrated in SCD patients. The aim of our study is to specify the prevalence of NP during VOCs in SCD children using a dedicated scale and to measure its characteristics. We performed a prospective study that included SCD children hospitalized for an acute VOC. The presence of NP was sought with the DN4 scale on the second and fourth days of hospitalization. A total of 54 SCD children were included in the study. Overall, 41% of the patients (n = 22) experienced neuropathic pain during the VOC, mostly at an early stage (Day 2). The median age, the sex ratio, the location of the pain, and the morphine consumption were similar for patients with and without NP. Our study shows that neuropathic pain is very common during VOCs in SCD children. The absence of identified risk factors should prompt us to be vigilant regardless of the patient’s age, sex, and clinical presentation.

scholarly journals Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

2021 ◽  
Vol 10 (5) ◽  
pp. 1058
Author(s):  
Grégoire Rocher ◽  
Thomas Gaillard ◽  
Catherine Uzan ◽  
Pierre Collinet ◽  
Pierre-Adrien Bolze ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Cohort Analysis ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Retrospective Cohort Analysis

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

scholarly journals Clinical presentation and management of malignant germ cell ovarian tumours in BPKMCH

2016 ◽  
Author(s):  
Jitendra Pariyar ◽  
Binuma Shrestha
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Germ Cell ◽  
Clinical Presentation ◽  
Early Stage ◽  
Germ Cell Tumour ◽  
Cystic Teratoma ◽  
Germ Cell Tumours ◽  
Early Stage Disease ◽  
Cancer Hospital ◽  
Disseminated Disease

Background: Germ cell malignancies account for about 5% of all ovarian cancers. These tumours grow rapidly and often produce symptoms quicker than the slow growing epithelial tumour. Commonly seen in the first two decades of life germ cell malignancies are highly chemosensitive and are potentially curable with surgery and chemotherapy. This study is the first of its kind regarding the epidemiology, management and outcome of patients with malignant germ cell tumour in Nepal. Objective: To analyze the clinical presentation and management outcomes of malignant germ cell tumours managed in B.P. Koirala Memorial Cancer Hospital, Nepal. Methodology: Descriptive study conducted in B.P. Koirala Memorial Cancer Hospital, Nepal. Case records of malignant germ cell tumours attending the hospital from January 1999 to December 2009 were analyzed regarding their illness history, clinical examination, investigations, treatment, follow-up and outcomes measured. Observations: Total 65 cases of malignant germ cell tumours with age range from 2 to 58 years (mean 21.7 years) were received. 42% cases were Tibeto-Burmese; 30% were Indo-Aryans. There were 15 cases (23%) of dysgeminoma, 21 endodermal sinus tumor (32%), 16 Immature Cystic Teratoma (24.5%), 9 (14%) Mixed Germ Cell, 2 unclassified GCT (3.5%) and 2 malignant transformation in teratoma (3.5%). 33 (49.5%) patients had early stage disease, 37 (57%) underwent fertility preserving surgery. 4 cases (9%) due to disseminated disease, underwent neoadjuvant chemotherapy followed by debulking surgery. 51 cases (78.5%) received adjuvant chemotherapy (BEP or EP regimen). The overall survival was 70%. Conclusion: Early stage germ cell malignancies can be safely managed by fertility preserving surgery followed by, chemotherapy if indicated. For advanced diseases, neoadjuvant chemotherapy followed by surgery can be undertaken with curable intent.

scholarly journals Clinical and histopathological pattern of colorectal malignancies, the experience in a tertiary hospital in south-western region, Saudi Arabia

2018 ◽  
Vol 5 (11) ◽  
pp. 4684
Author(s):  
Majed Saleh M. Aldayhum ◽  
Anas Abdullah R. Alshehri ◽  
Dlaim H. AlQahtani ◽  
Eman Yahia Alfussaily ◽  
Suha Abdulrahman S. Althibait ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Clinical Presentation ◽  
Early Stage ◽  
Tertiary Hospital ◽  
Central Hospital ◽  
Early Stage Disease ◽  
Common Cancer ◽  
Stage Disease ◽  
Common Grade ◽  
The Mean

Background: Colorectal cancer is the third most common cancer all over the world and the second leading cause of the cancer death in both sexes. CRC is the second most common cancer in Kingdom Saudi Arabia. However, this aspect was not recently studied.Methods: This is a retrospectively cohort based study. We collected and analyzed the records of the patients with CRC diagnosed at Aseer Central Hospital, Abha, Saudi Arabia from January 2008 to June 2016. A pre-specified data sheet was used to collect information regarding socio-demographics, age, Altitude, site of tumor, clinical presentation, outcome and prognosis as well as histopathological pattern of cancer and the stages of disease. Descriptive statistics was performed using SPSS.Results: A total of 291 cases of CRC were registered in the Aseer Central Hospital. 171 cases 58.87% were males while 120 cases 41.2% were females. The mean age of patients (SD) at the time of diagnosis was 59.38 years. At the time of diagnosis, 219 patients 84.6% presented with early stage disease and 40 15.4% had distant metastasis advanced stage. The most frequent CRC located in sigmoid 26.5%, rectal 23.7%and 14% in ascending. The moderately differentiate adenocarcinoma grade of tumor is being the most common grade among all variants 75.6%.Conclusions: In this study, we have nearly similar results found in previously published study by Alshehri et al. Males considered most affected, most of the patients were more than 50 years, 84.6% of the patients came with early stage disease. Left side colon were the most common site of CRC.

scholarly journals Hypertensive Emergency and Type 2 Myocardial Infarction Resulting From Pheochromocytoma and Concurrent Capnocytophaga Canimorsus Infection

2014 ◽  
Vol 8 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Graham J Fent ◽  
Hazlyna Kamaruddin ◽  
Pankaj Garg ◽  
Ahmed Iqbal ◽  
Nicholas F Kelland ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Presentation ◽  
Plaque Rupture ◽  
Interesting Case ◽  
Hypertensive Emergency ◽  
Cardiac Biomarkers ◽  
Dog Bite ◽  
Capnocytophaga Canimorsus ◽  
Review Current

A diagnosis of myocardial infarction is made using a combination of clinical presentation, electrocardiogram and cardiac biomarkers. However, myocardial infarction can be caused by factors other than coronary artery plaque rupture and thrombosis. We describe an interesting case presenting with hypertensive emergency and type 2 myocardial infarction resulting from Pheochromocytoma associated with Capnocytophaga canimorsus infection from a dog bite. We also review current literature on the management of hypertensive emergency and Pheochromocytoma.

Trends and outcomes of ruptured ovarian cysts

2021 ◽  
pp. postgradmedj-2020-138833
Author(s):  
Wei How Lim ◽  
Nikki Woods ◽  
Vincent P Lamaro
Keyword(s):  
Emergency Department ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Ovarian Cysts ◽  
Free Fluid ◽  
Vaginal Intercourse ◽  
Imaging Diagnosis ◽  
Retrospective Audit ◽  
Common Clinical Presentation ◽  
Health Institutions

BackgroundRuptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.MethodsA retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent’s Hospital, Sydney.ResultsDuring the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).ConclusionRuptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.

scholarly journals Development of an esophageal stricture following paradichlorobenzene mothball ingestion

2020 ◽  
Vol 8 ◽  
pp. 2050313X2097421
Author(s):  
Marisa Laughrey ◽  
Molly Kidder ◽  
Desiree Rivera ◽  
Michael Wilsey ◽  
Sara Karjoo
Keyword(s):  
Foreign Body ◽  
Esophageal Stricture ◽  
Clinical Presentation ◽  
Interesting Case ◽  
Solid Food ◽  
Short Exposure

A 2-year-old patient presented with a paradichlorobenzene mothball ingestion. The foreign body was removed with a straight Miller blade and a curved Allis clamp. Two weeks following the removal of the mothball, the patient developed solid food dysphagia due to an esophageal stricture. This complication after a short exposure to mothballs is unreported in the literature to date, making this a unique and interesting case. In addition, a comparison of the clinical presentation and treatment of naphthalene and paradichlorobenzene mothballs was reviewed in this article.

scholarly journals Anorectal Cancer with Bone Marrow and Leptomeningeal Metastases

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Ahmed Zeeneldin ◽  
Nasser Al-Dhaibani ◽  
Yasser M. Saleh ◽  
Amal Mostafa Ismail ◽  
Zuhair Alzibair ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Early Stage ◽  
Cranial Nerves ◽  
Specific Treatment ◽  
Leptomeningeal Carcinomatosis ◽  
Interesting Case ◽  
Treatment Recommendation ◽  
Early Stage Disease ◽  
Signet Ring ◽  
Anorectal Cancer

This is an interesting case of anorectal signet ring carcinoma with first presentation of an early stage disease, showing the aggressive disease and the undetectable behavior of this type of histology which can mislead diagnosis. Brain/CNS metastasis from colorectal cancer (CRC) is rare occurring in 3% of cases, and leptomeningeal carcinomatosis (LMC) is extremely rare in CRC (<0.02%). Symptoms and signs of LMC are pleomorphic and may be localized to three compartments: cerebral hemispheres, cranial nerves, and spinal cords and roots. Treatment of metastatic rectal cancer has been improving over the last few years with a lot of changes toward longer survival and improvement in quality of life and to change the disease into a chronic condition. However, in our case, the overall survival from the onset of LMC was 3 weeks only. Revising the evidence in the treatment of signet ring histology of rectal cancer, there is no specific treatment recommendation that is for this histology and for such very aggressive behavior which could be considered as a separate entity to the classic adenocarcinoma histology.

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