scholarly journals Canine Ependymoma: Diagnostic Criteria and Common Pitfalls

2019 ◽  
Vol 56 (6) ◽  
pp. 860-867 ◽  
Author(s):  
Andrew D. Miller ◽  
Jennifer W. Koehler ◽  
Taryn A. Donovan ◽  
Jennifer E. Stewart ◽  
Brian F. Porter ◽  
...  
Keyword(s):  
Lateral Ventricle ◽  
Single Case ◽  
Case Reports ◽  
Third Ventricle ◽  
Ciliated Cells ◽  
Histologic Feature ◽  
Neoplastic Cells ◽  
Papillary Meningioma ◽  
Cns Neoplasms ◽  
Retrospective Database

Reports of canine ependymoma are generally restricted to single case reports with tumor incidence estimated at 2% to 3% of primary central nervous system (CNS) tumors. While most commonly reported in the lateral ventricle, tumors can occur anywhere in the ventricular system and in extraventricular locations. Rosettes and pseudorosettes are a common histologic feature; however, these features can be mimicked by other CNS neoplasms. Thirty-seven potential ependymoma cases were identified in a retrospective database search of 8 institutions, and a histologic review of all cases was conducted. Of 37 cases, 22 candidate cases were further subjected to a consensus histologic and immunohistochemical review, and only 5 of 37 (13.5%) were conclusively identified as ependymoma. The neuroanatomic locations were the lateral ventricle (3/5), third ventricle (1/5), and mesencephalic aqueduct (1/5). Subtypes were papillary (4/5) and tanycytic (1/5). Histologic features included rosettes (5/5), pseudorosettes (5/5), ependymal canals (2/5), tanycytic differentiation (1/5), blepharoplasts (1/5), ciliated cells (1/5), and high nuclear to cytoplasmic ratio (5/5). Immunolabeling for GFAP (4/4) and CKAE1/3 (3/4) was found in pseudorosettes, rosettes, and scattered individual neoplastic cells. Diffuse but variably intense cytoplasmic S100 immunolabeling was detected in 3 of 4 cases. Olig2 intranuclear immunolabeling was observed in less than 1% of the neoplastic cells (3/3). Tumors that had pseudorosettes and mimicked ependymoma included oligodendroglioma, choroid plexus tumor, pituitary corticotroph adenoma, papillary meningioma, and suprasellar germ cell tumor. These findings indicate that canine ependymoma is an extremely rare neoplasm with histomorphologic features that overlap with other primary CNS neoplasms.

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

2021 ◽  
Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang
Keyword(s):  
Literature Review ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Subtotal Resection ◽  
Study Cohort ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

Micronodular Thymoma With Lymphoid Stroma: A Trio of Cases, With Diverse-associated Histological Features

2021 ◽  
pp. 106689692110011
Author(s):  
Neha Bakshi ◽  
Shashi Dhawan ◽  
Seema Rao ◽  
Kishan Singh Rawat
Keyword(s):  
Mediastinal Mass ◽  
Single Case ◽  
Case Reports ◽  
Good Prognosis ◽  
Anterior Mediastinal Mass ◽  
Histological Features ◽  
Lymphoid Stroma ◽  
Thymic Cysts ◽  
Robotic Thymectomy ◽  
Conventional Type

Introduction. Micronodular thymoma with lymphoid stroma (MNTLS) is a rare thymoma subtype characterized by distinctive histological appearance, unique clinical profile, and indolent course with good prognosis. In addition to its distinctive morphology, MNTLS may be associated with diverse histological features, such as thymic cysts and conventional thymoma, complicating the diagnostic picture further. Materials and methods. We report herein an account of 3 elderly patients (male—02; female—01), who presented with anterior mediastinal mass, and underwent robotic thymectomy. Microscopic examination revealed MNTLS in all 3 cases. In addition, 2 cases showed associated histological features in the form of a multilocular thymic cyst and conventional (type B2) thymoma, respectively. All 3 patients are doing well without recurrence or metastasis at 34, 28, and 19 months postsurgery. Conclusions. Awareness of this rare thymoma subtype is vital among pathologists to avoid misdiagnosis and ensure appropriate patient management. To date, only a few cases of this rare thymoma subtype have been reported in the literature, mostly as single case reports.

scholarly journals Schwannoma of the abdominal wall: updated literature review

2021 ◽  
Author(s):  
Tommaso Panici Tonucci ◽  
Andrea Sironi ◽  
Eleonora Pisa ◽  
Benedetta Di Venosa ◽  
Luigi Bonavina
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Abdominal Wall ◽  
Single Case ◽  
Case Reports ◽  
Rectus Abdominis ◽  
Malignant Neoplasms ◽  
Palpable Mass ◽  
Surgical Specimen ◽  
Benign Schwannoma

Summary Background Schwannoma is a benign tumor arising from Schwann cells of the peripheral nerves. It is often asymptomatic and can develop in the retroperitoneum, mediastinum, head and neck region, and upper and lower extremities. Schwannoma of the abdominal wall is extremely rare, but differential diagnosis with malignant neoplasms is important to reduce the risk of undertreatment. Methods A narrative review of abdominal wall schwannoma was performed using PubMed, EMBASE, and Web of Science database and the search terms “schwannoma”, “neurinoma”, “neurilemmoma”, “soft tissue tumors”, “neurogenic tumor”, “rectus abdominis mass”, “abdominal wall”. In addition, the hospital charts were reviewed to report the personal experience. Results Only 9 single case-reports of benign schwannoma of the abdominal wall were found in the English medical literature over the past decade. None of the patients received preoperative biopsy and all were resected with clear margins. In addition to the literature review, we report the case of a 58-year-old man referred for a palpable mass in the left upper abdominal quadrant. Ultrasonography and magnetic resonance imaging revealed a solid and well-encapsulated mass inside the left rectus abdominis muscle. A core biopsy of the lesion provided the diagnosis of cellular schwannoma and this was confirmed by histopathologic examination of the surgical specimen. Conclusions Benign schwannoma of the abdominal wall is extremely rare. Percutaneous core needle biopsy is important for the differential diagnosis with more common and biologically more aggressive malignancies, such as desmoid tumors and sarcomas, and may be relevant for planning the most appropriate management.

Insidious Onset Compartment Syndrome of the Forearm in a Teenager: A Case Report and Review of the Literature

2021 ◽  
Vol 26 (03) ◽  
pp. 481-484
Author(s):  
Hidetoshi Iwata ◽  
Hideki Okamoto ◽  
Yohei Kawaguchi ◽  
Kojiro Endo ◽  
Yuji Joyo ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Single Case ◽  
Case Reports ◽  
Upper Extremities ◽  
Review Of The Literature ◽  
Right Hand ◽  
Insidious Onset ◽  
Forearm Compartment Syndrome ◽  
Cash Register ◽  
Proximal Forearm

Compartment syndrome affecting the upper extremities is a relatively underreported event compared with compartment syndrome affecting the lower extremities. Moreover, insidious onset forearm compartment syndrome has been rarely reported and is usually limited to single case reports. We report a compartment syndrome of the forearm in a teenager. She hit her right proximal forearm lightly on the cash register, but there was no pain. However, the next day, she had difficulty in moving her right hand. Although she underwent electrotherapy, her right forearm gradually became swollen, and she felt numbness in the ring and little fingers of her right hand. Six day after the onset, she came to our hospital and underwent fasciotomy. There was no aftereffect, and very good functional recovery was obtained. All clinicians need to keep the case of forearm compartment syndrome in a young individual with a diffuse course, such as in this case in mind.

scholarly journals An Introduction to Pharmacotherapy for Inborn Errors of Metabolism

2018 ◽  
Vol 23 (6) ◽  
pp. 432-446
Author(s):  
Aaron A. Harthan
Keyword(s):  
Adverse Effects ◽  
Inborn Errors Of Metabolism ◽  
Single Case ◽  
Case Reports ◽  
Review Article ◽  
Metabolic Process ◽  
Inborn Errors ◽  
Herbal Products ◽  
Disease States ◽  
Treatment Plans

Inborn errors of metabolism comprise a wide array of diseases and complications in the pediatric patient. The rarity of these disorders limits the ability to conduct and review robust literature regarding the disease states, mechanisms of dysfunction, treatments, and outcomes. Often, treatment plans will be based on the pathophysiology associated with the disorder and theoretical agents that may be involved in the metabolic process. Medication therapies usually consist of natural or herbal products. Established efficacious pediatric doses for these products are difficult to find in tertiary resources, and adverse effects are routinely limited to single case reports. This review article attempts to summarize some of the more common inborn errors of metabolism in a manner that is applicable to pharmacists who will provide care for these patients.

scholarly journals Rare Fetus-in-Fetu: Experience From a Large Tertiary Pediatric Referral Center

2021 ◽  
Vol 9 ◽  
Author(s):  
Mao Xiaowen ◽  
Cheng Lingxi ◽  
Lin Song ◽  
Pan Shengbao ◽  
Yang Xiaohong ◽  
...  
Keyword(s):  
Open Surgery ◽  
Clinical Characteristics ◽  
Ultrasound Examination ◽  
Single Case ◽  
Case Reports ◽  
Alpha Fetoprotein ◽  
Pathological Examination ◽  
Fetus In Fetu ◽  
Antenatal Ultrasound ◽  
Referral Center

Objective: Fetus-in-fetu (FIF) is an extremely rare disease, and most prior publications are single case reports. Here, we describe the clinical characteristics, imaging manifestations, and the treatment and related complications of FIF from a large tertiary pediatric referral center.Materials: After institutional review board approval, patients with a diagnosis of FIF between January 2010 and November 2019 were further selected and reexamined. We analyzed the general clinical characteristics, imaging manifestations, treatment, and prognosis of the patients.Results: A total of seven (four male and three female) patients with FIF were included in the study. All patients were diagnosed with FIF during the antenatal ultrasound examination along with an abnormal increase in alpha fetoprotein, and it was confirmed by subsequent pathological examination. The median gestation period when FIF was first diagnosed was 25 (range: 22–32) weeks. Ultrasound, computed tomography, and magnetic resonance imaging were the main pre-operative diagnostic techniques used. All patients underwent FIF resection within 1 month after birth: four patients had open surgery and three had laparoscopic surgeries (one case was converted to open surgery); only one patient developed ascites after surgery. All patients are growing up healthy and without tumor recurrence at the last follow-up. The level of alpha fetoprotein decreased to normal within 1 year (range 3-10 months) after surgery performed.Conclusion: As the size of the FIF increases, it can be found and diagnosed in antenatal ultrasound examination. Surgery is an important curative treatment for FIF and generally results in excellent long-term quality of life.

Letter to the Editor

PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 328-328
Author(s):  
Louis E. Bartoshesky ◽  
Hermine Pashayan
Keyword(s):  
Birth Weight ◽  
Congenital Heart ◽  
Single Case ◽  
Case Reports ◽  
In Utero ◽  
Normal Male ◽  
In Utero Exposure ◽  
Congenital Heart Malformations ◽  
Male Karyotype ◽  
Heart Malformations

We would agree with both writers that there were certain features of the child described in our report that were not typical of the so-called fetal hydantoin syndrome, particularly the birth weight. It is certainly true that single case reports do nothing more than suggest possible associations between malformations and in utero exposure, but much information has been accumulated associating clefts and congenital heart malformations with phenytoin. The baby described had a normal male karyotype. Attempts were made to do karyotyping on tissue obtained at autopsy but were unsuccessful.

Case Reports Are Valuable

PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 762-762
Author(s):  
Edward B. Shaw
Keyword(s):  
United States ◽  
Medical Journal ◽  
Case Report ◽  
Lymph Node ◽  
Mass Production ◽  
Single Case ◽  
Case Reports ◽  
Mucocutaneous Lymph Node Syndrome ◽  
Lymph Node Syndrome

The excellent case report "Mucocutaneous Lymph Node Syndrome (MLNS) in the Continental United States" by Goldsmith et al. (Pediatrics 57:431, March 1976) is an example of the importance of the report of a single case. This should alert others to this syndrome in their own practices. I am reminded of a note by Roger Lee1 in 1952: "Are three cases enough to make a series? Parenthetically I have a fondness for the carefully reported single case, which in the days before mass production was a feature of a medical journal .... a series of three cases leads to statistical atrocities and aberrations and deductions."

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