Symptomatic pulmonary sclerosing hemangioma: a rare case of a solitary pulmonary nodule in a woman of advanced age

Background Pulmonary sclerosing hemangioma (PSH) is a rare tumor that usually develops in middle-aged Asian women. PSH has four histological types (hemorrhagic, sclerotic, solid, and papillary) and often grows slowly in a lower lobe of the lung. Preoperative misdiagnosis frequently occurs because of the absence of specific clinical manifestations and imaging findings. Few reports have described PSH in women of advanced age. Case presentation: A 75-year-old woman presented to our hospital in China with a 5-day history of productive cough and intermittent hemoptysis. Computed tomography indicated bronchiectasis and a large mass in the left inferior lobe of the lung. Treatment of the bronchiectasis provided no symptom relief. The hemoptysis resolved following left lower pulmonary lobectomy, and PSH was pathologically diagnosed following surgery. At the time of this writing (after 6 months of follow-up), the tumor had not recurred, no metastases had been detected, and close follow-up was ongoing. Conclusions Both bronchiectasis and PSH can cause hemoptysis. This case demonstrates that PSH should be included as a differential diagnosis of hemoptysis in women of advanced age. For patients with chronic hemoptysis, the diagnosis of PSH should be considered if the therapeutic effect of bronchiectasis is poor.

Download Full-text

A Solitary Giant Neurofibroma of Inguinal Region—A Case Report

10.21203/rs.3.rs-39194/v1 ◽

2020 ◽

Author(s):

Haiying Zhou ◽

Hui Lu

Keyword(s):

Tumor Resection ◽

Clinical Manifestations ◽

Inguinal Region ◽

Case Presentation ◽

Neurogenic Tumors ◽

Long Time ◽

Giant Neurofibroma ◽

History Of ◽

Recurrence Tendency

Abstract Background:Neurofibroma is a rare nerve sheath tumorofneuroectodermal origin, especially the huge and isolated neurofibroma located in the inguinal region. To our knowledge, no such case has previously been reported.Case presentation:We report a case of 34-year-old male patient with a 4-year history of progressive enlargement of the medial root mass in his left thigh with sitting and standing disorders along with pain. The tumor was completely removed by operation, and pathological diagnosisshowed neurofibroma. There was no obvious neurologic defect after surgery, and no recurrence tendency was found in the follow-up of 2years.Conclusions:For a large solitary mass with slow growth and no malignant clinical manifestations for a long time, clinicians can not rule out the hypothetical diagnosis of neurofibroma, even though its growth site is very rare, such as this case of a huge tumor located in the groin. For neurogenic tumors, early operation should be performed, and the prognosis of patients after tumor resection isexcellent.

Download Full-text

Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

African Journal of Urology ◽

10.1186/s12301-019-0006-1 ◽

2019 ◽

Vol 25 (1) ◽

Author(s):

Danielle Whiting ◽

Ian Rudd ◽

Amit Goel ◽

Seshadri Sriprasad ◽

Sanjeev Madaan

Keyword(s):

Case Reports ◽

Case Presentation ◽

Open Adrenalectomy ◽

Large Size ◽

History Of ◽

Loin Pain ◽

Benign Tumours ◽

Spontaneous Haemorrhage ◽

Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

Download Full-text

The spontaneous resolution of a vortex vein varix: case report

BMC Ophthalmology ◽

10.1186/s12886-021-01861-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara L Weidmayer ◽

Hakan Demirci

Keyword(s):

Case Report ◽

Natural History ◽

Extended Period ◽

Spontaneous Resolution ◽

Case Presentation ◽

Clinical Resolution ◽

History Of ◽

Vortex Vein ◽

Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

Download Full-text

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i3.5897 ◽

2021 ◽

Author(s):

Zahra Tavoli ◽

Ali Montazeri

Keyword(s):

Renal Agenesis ◽

Primary Diagnosis ◽

Case Presentation ◽

Uterus Didelphys ◽

Future Fertility ◽

History Of ◽

Ohvira Syndrome ◽

Obstructed Hemivagina ◽

Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

Download Full-text

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽

10.1177/27325016211053640 ◽

2021 ◽

pp. 273250162110536

Author(s):

Joshua Harrison ◽

Samantha Marley ◽

Shawhin Shahriari ◽

Christian Bowers ◽

Anil Shetty

Keyword(s):

Frontal Sinus ◽

Surgical Excision ◽

Extramedullary Plasmacytoma ◽

High Rate ◽

Solitary Plasmacytoma ◽

Case Presentation ◽

Long Term Follow Up ◽

History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

Download Full-text

Chronic Obstructive Lung Disease in young: Alpha 1 anti trypsin deficiency

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v3i2.14067 ◽

2015 ◽

Vol 3 (2) ◽

pp. 65-67

Author(s):

S.S. Dhakal ◽

K.K. Agrawaal ◽

N.K. Bhatta

Keyword(s):

Bronchial Asthma ◽

Clinical Manifestations ◽

Lower Lobe ◽

Chronic Obstructive Lung Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Severe Deficiency ◽

History Of ◽

Pulmonary Arterial ◽

Alpha 1 Antitrypsin

Alpha-1 antitrypsin (AAT) deficiency is a clinically under recognized inherited disorder. The main clinical manifestations relate to three separate organs: the lung, the liver, and the skin. In the lung, severe deficiency of AAT predisposes to chronic obstructive pulmonary disease. We present a case of 34 years male with a history of recurrent chest infections in past and treated in the line of bronchial asthma but not relieved. He was admitted on 22nd May 2011 at BPKIHS. He presented with type 2 respiratory failure and had features of severe pulmonary arterial hypertension and left lower lobe pneumonia. The patient got improved with the treatment and is doing well on follow up. The diagnosis should be strongly suspected in patients with history suggestive of bronchial asthma and with obstructive features.Journal of Advances in Internal Medicine 2014;3(2):65-67

Download Full-text

Identification of NR0B1 Gene Mutation and Analysis of Bone Damages and Drug Treatment Effect in a Big Family With X-linked Adrenal Hypoplasia Congenita: a Case Report

10.21203/rs.3.rs-373516/v1 ◽

2021 ◽

Author(s):

XIAOHUI TAO ◽

LI LIU ◽

XIAOYUN LIN ◽

TIAN XU ◽

HUA YUE ◽

...

Keyword(s):

Mass Density ◽

Hypogonadotropic Hypogonadism ◽

Clinical Manifestations ◽

Osteonecrosis Of The Jaw ◽

Bone Mass Density ◽

Insertion Mutation ◽

Case Presentation ◽

Skeletal Complications ◽

Adrenal Hypoplasia

Abstract Background: X-linked congenital adrenocortical hypoplasia (XL-AHC) is a rare disorder, which is characterized by primary adrenal insufficiency and hypogonadotropic hypogonadism. However, the skeletal complications caused by the disease were rarely reported, not to mention the treatment.Case presentation: The patient from a big family with XL-AHC was identified carrying a homozygous insertion mutation（p.Thr193GlyfsX13）in DAX-1 gene. The diagnosis of secondary osteoporosis was made after imaging, laboratory and bone mass density examinations. However, he showed a suboptimal response to bisphosphonates during 2 years of follow-up, even suffered from atypical femoral fracture (AFF). Now it had been replaced by menatetrenone, bone healing was satisfactory. Conclusions: We harbored the idea that clinicians should not only focus on typical clinical manifestations of XL-AHC, but also pay attention to the skeletal complications in clinical practice. Conventional anti-osteoporosis drugs may cause side effects such as AFF and osteonecrosis of the jaw (ONJ), which was rare in general osteoporosis patients. In other words, anabolic agent may be a better choice.

Download Full-text

Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

10.21203/rs.3.rs-1064619/v1 ◽

2021 ◽

Author(s):

Tao Sun ◽

Wentao Wang ◽

Longshuang He ◽

Yu Su ◽

Ning Li ◽

...

Keyword(s):

Nervous System ◽

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Treatment Strategies ◽

Glossopharyngeal Neuralgia ◽

Case Presentation ◽

Involuntary Contraction ◽

History Of ◽

Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

Download Full-text

Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

Scottish Medical Journal ◽

10.1177/0036933019853170 ◽

2019 ◽

Vol 64 (3) ◽

pp. 116-118

Author(s):

Özant Helvacı ◽

Seyma Yıldız ◽

Berfu Korucu ◽

Ulver Derici ◽

Turgay Arinsoy

Keyword(s):

Nephrotic Syndrome ◽

Coeliac Disease ◽

Post Partum ◽

Lower Extremity Weakness ◽

Case Presentation ◽

Multisystem Involvement ◽

Life Threatening ◽

History Of ◽

Rare Occasion

Background Coeliac crisis is a life-threatening presentation of coeliac disease. Severe diarrhoea, weight loss, electrolyte imbalances and malnutrition are prominent features. Although mainly a disease of childhood, it can on the rare occasion be diagnosed in adults. Case presentation A 25-year-old female with severe generalised oedema, lower extremity weakness, hypokalemia and profound hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. Three months previously she had given birth to a healthy child following an uneventful pregnancy. She did not have proteinuria. She had a history of diarrhoea with gluten-containing food since childhood but lacked a formal diagnosis of coeliac disease. A duodenal biopsy confirmed the suspected diagnosis. Coeliac crisis was diagnosed with life-threatening multisystem involvement. Introduction of a gluten-free diet abolished all disease symptoms and ameliorated laboratory parameters at six months’ follow-up. Conclusion Coeliac crisis is a rare, yet dangerous presentation of coeliac disease in adults. As this case suggests, it can present with generalised oedema and hypoalbuminemia mimicking nephrotic syndrome. Rapid diagnosis is the key to successful treatment.

Download Full-text

A case of hypokalemia-induced bidirectional ventricular tachycardia

Journal of International Medical Research ◽

10.1177/0300060520971440 ◽

2020 ◽

Vol 48 (11) ◽

pp. 030006052097144

Author(s):

Yanan Xie ◽

Jingzhe Han ◽

Jinming Liu ◽

Jie Hao ◽

Xiuguang Zu ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Potassium Level ◽

Serum Potassium Level ◽

Electrical Storm ◽

Case Presentation ◽

Cardioverter Defibrillator ◽

Long Term Follow Up ◽

History Of

Background Bidirectional ventricular tachycardia (BVT) is a rare, but serious, arrhythmia. Hypokalemia is commonly found in clinical practice, but hypokalemia-induced BVT has rarely been reported. Case presentation A 74-year-old male patient with the symptoms of chest distress and palpitations was admitted owing to frequent discharge of his implantable cardioverter defibrillator (ICD) for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of his ICD with a total of approximately 17 discharges in 4 days. He had no history of digitalis use. The serum potassium level after admission was 3.1 mmol/L and an electrocardiogram was consistent with BVT. The diagnosis was ventricular tachycardia, electrical storm, and hypokalemia. His ventricular tachycardia was completely relieved after correction of hypokalemia. Conclusions After correction of hypokalemia in this patient, the episode of BVT was terminated and no recurrence of BVT was observed during long-term follow-up. Our findings suggest the diagnosis of hypokalemia-induced BVT.

Download Full-text