An unusual case of aggressive malignant spread of epithelioid hemangioendothelioma

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm which typically originates from liver, lung, or bone. Due to the low incidence of disease, the most effective treatment is not easily studied and much of the information known about EHE has been learned through case reports and case series. In this case, we will present an uncommon form of primary soft tissue EHE with local recurrence, bone metastasis, and lymphangitic spread to the lungs leading to respiratory failure. Imaging of the chest was atypical for EHE with intraseptal thickening and hilar lymphadenopathy. Respiratory failure was progressive despite aggressive multimodal treatment. This case highlights an unusually aggressive recurrence and metastasis of primary soft tissue EHE with atypical pulmonary imaging findings.

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Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125316689030 ◽

2017 ◽

Vol 7 (4) ◽

pp. 141-157 ◽

Cited By ~ 37

Author(s):

Rafael G. dos Santos ◽

José Carlos Bouso ◽

Jaime E. C. Hallak

Keyword(s):

Systematic Review ◽

Family History ◽

Adverse Reactions ◽

Population Studies ◽

Case Reports ◽

Case Series ◽

Lysergic Acid ◽

Psychotic Illness ◽

History Of ◽

Low Incidence

Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake.

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Prenatal Diagnosis of Neuroblastoma

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1371 ◽

2014 ◽

Vol 8 (3) ◽

pp. 321-327

Author(s):

Mona Zvanca ◽

Cristian Andrei

Keyword(s):

Prenatal Diagnosis ◽

Case Reports ◽

Case Series ◽

Expectant Management ◽

Individual Case ◽

Management Options ◽

Tertiary Center ◽

Low Incidence ◽

Tumor In Childhood

ABSTRACT Fetal malignancies are rare complications during pregnancies, but when they appear, they are very challenging for the perinatology team. Because of their low incidence, the information is limited, with data provided from individual case reports or small case series. Although neuroblastoma is the most frequent extracranial solid tumor in childhood, prenatal diagnosis by ultrasound is very rare and almost always discovered during routine third trimester ultrasound. Expectant management is usually indicated prenatally, with serial ultrasound examination. Delivery should be planned in a tertiary center together with pediatric oncologists and surgeons to allow appropriate postnatal management. We present two cases of neuroblastoma diagnosed at 36 and 33 weeks of gestation with multiple aspects of this tumor identified by ultrasound. Both cases needed surgery and had a favorable outcome. The key role of ultrasound in diagnosis and follow-up of neuroblastoma in pregnancy is discussed, together with the management options recommended in literature. How to cite this article Andrei C, Vladareanu R, Zvanca M, Vladareanu S. Prenatal Diagnosis of Neuroblastoma. Donald School J Ultrasound Obstet Gynecol 2014;8(3):321-327.

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Massive Soft Tissue Haemophilic Pseudotumor in Limbs: Lessons Learnt from an Extremely Rare Problem

Surgical Case Reports ◽

10.31487/j.scr.2021.06.09 ◽

2021 ◽

pp. 1-4

Author(s):

C F Munson ◽

A N Morritt

Keyword(s):

Soft Tissue ◽

Minimally Invasive ◽

Medical Management ◽

Case Reports ◽

Case Series ◽

Lessons Learnt ◽

The World ◽

The Future ◽

Extensive Surgery ◽

Future Management

Haemophilic pseudotumors are very rare, encapsulated haematomas forms as a result of repetitive bleeding, forming a mass of clotted blood and necrosed tissue. Reported experience in the literature is limited to case reports and case series from around the world, reporting on smaller and medium sized pseudotumors. Conflicting opinion exists following failed medical management, which includes minimally invasive interventions through extensive surgery. We present our experience with the management of two of the largest soft tissue pseudotumors reported in the literature. We also provide some guidance, based on our experiences, for the future management of massive haemophilic pseudotumors.

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Cutaneous Ewing Sarcoma and Ewing Sarcoma of the Bone: Distinct Diseases

Case Reports in Oncology ◽

10.1159/000492667 ◽

2018 ◽

Vol 11 (3) ◽

pp. 729-734 ◽

Cited By ~ 2

Author(s):

Montreh Tavakkoli ◽

Lisa Mueller

Keyword(s):

Adjuvant Chemotherapy ◽

Soft Tissue ◽

Skin Lesion ◽

Children And Adolescents ◽

Bone Tumor ◽

Ewing Sarcoma ◽

Case Reports ◽

Case Series ◽

Biological Explanation

Ewing sarcoma is an aggressive mesenchymal malignancy. It is the second most common bone tumor among children and adolescents and less commonly presents as a soft tissue or primary skin lesion. Cutaneous Ewing sarcoma has only been reported in case reports and case series. In this article, we describe a 12-year-old Hispanic female cured of localized, cutaneous Ewing sarcoma (pT1aN0M0) at the 40-month follow-up following surgical resection and adjuvant chemotherapy according to the COG AEWS1031 protocol for Ewing sarcoma of the bone. To our knowledge, this is the first article to provide a potential biological explanation for the differences in the prognosis of Ewing sarcoma of the bone, soft tissue, and skin.

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Decompressive hemicraniectomy for acute ischemic stroke associated with coronavirus disease 2019 infection: Case report and systematic review

Surgical Neurology International ◽

10.25259/sni_64_2021 ◽

2021 ◽

Vol 12 ◽

pp. 116

Author(s):

Kevin Ivan Peñaverde Chan ◽

Alaric Emmanuel Mendoza Salonga ◽

Kathleen Joy Ong Khu

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Respiratory Failure ◽

Acute Ischemic Stroke ◽

Surgical Intervention ◽

Case Reports ◽

Case Series ◽

Left Internal Carotid Artery ◽

Decompressive Hemicraniectomy ◽

The One

Background: Decompressive hemicraniectomy (DH) has been performed for some cases of acute ischemic stroke in patients with coronavirus disease 2019 (COVID-19) infection, but there is little information about the clinical course and outcomes of these patients. Case Description: We report a case of a 36-year-old woman with COVID-19 infection who developed stroke like symptoms while under home quarantine. Cranial CT scan showed an acute left internal carotid artery (ICA) infarct. She subsequently underwent an emergent left DH. Despite timely surgical intervention, she succumbed to chronic respiratory failure. A systematic review of SCOPUS and PubMed databases for case reports and case series of patients with COVID-19 infection who similarly underwent a DH for an acute ischemic infarct was performed. There were eight other reported cases in the literature. The patients’ age ranged from 33 to 70 years (mean 48), with a female predilection (2:1). Respiratory preceded neurologic symptoms in 83% of cases. The ICA was the one most commonly involved in the stroke, and the mean NIHSS score was 20. DH was performed at a mean of 1.8 days post-ictus. Only four out of the nine patients were reported alive at the time of writing. The most common cause of death was respiratory failure (60%). Conclusion: Clinicians have to be cognizant of the neurovascular complications that may occur during the course of a patient with COVID-19. DH for acute ischemic stroke associated with the said infection was reported in nine patients, but the outcomes were generally poor despite early surgical intervention.

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Adult primary liver sarcoma: systematic review

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-6991e-20202647 ◽

2020 ◽

Vol 47 ◽

Author(s):

ANTONIO CAVALCANTI DE ALBUQUERQUE MARTINS ◽

DUÍLIO CABRAL DA COSTA NETO ◽

JÚLIO DOURADO DE-MATOS E SILVA ◽

YGOR MONTEIRO MORAES ◽

CRISTIANO SOUZA LEÃO ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Case Reports ◽

Treatment Options ◽

Case Series ◽

Epithelioid Hemangioendothelioma ◽

Treatment Modalities ◽

R0 Resection ◽

Rare Type ◽

Degree Of Differentiation

ABSTRACT Introduction: primary liver sarcoma is a rare type of tumor, more common in children. Among adults, it represents a spectrum of neoplasms with reserved prognosis. There is no consensus on the treatment of choice of these lesions, justifying a systematic review of the literature on treatment options, prognostic factors, and survival. Material/Methods: a systematic review of articles published in Pubmed, Medline, LiLacs e SciElo, from 1966 to March/2019, presenting the keywords: primary-liver-sarcoma and primary-hepatic-sarcoma was undertaken. Studies including patients older than 18 years, and published in English, Portuguese and Spanish were included. Case reports, metastatic tumors and multiple oncologic diagnosis were excluded. The initial search listed 1,318 articles. 1,206 did not meet the inclusion criteria. After reviewing 112 eligible articles, 15 were selected (14 case series and 1 retrospective-cohort). Results: proposed treatment modalities for primary liver sarcoma included surgery and/or chemotherapy and/or radiotherapy or liver transplantation. The most common histological types were angiosarcoma (32%), leiomyosarcoma (29%), epithelioid hemangioendothelioma (15%) and embryonal sarcoma (7%). Histology, degree of differentiation and R0 resection were mentioned positive prognostic factors. Median survival ranged from two to 23 months. Five-year survival rate varied from 0% to 64%, on average 21%. Conclusion: surgical resection (R0 resection) is the main treatment for primary liver sarcomas. Development of effective systemic therapies are required to improve prognosis of patients harboring this type of tumor.

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COVID-19 infection complicated by Guillain-Barre Syndrome: a systematic review of clinical features, pathogenic mechanism, and respiratory failure

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2021.034 ◽

2021 ◽

Vol 9 (1) ◽

pp. 34-34

Author(s):

Mahya Khaki ◽

Parastoo Dehghan ◽

Naghmeh Malekzadeh ◽

Mohsen Khamoushi ◽

Fahimehalsadat Shojaei ◽

...

Keyword(s):

Systematic Review ◽

Respiratory Failure ◽

Clinical Features ◽

Case Reports ◽

Case Series ◽

Diagnostic Workup ◽

Guillain Barre Syndrome ◽

World Health ◽

Guillain Barré Syndrome ◽

Guillain Barré

Background: The World Health Organization (WHO) declared a pandemic in March 2020 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the neurotropism feature of the coronavirus and growing number of COVID-19 associated neurological disorders, including Guillain Barre syndrome (GBS), we conducted a systematic review to thoroughly describe the clinical features, diagnostic workup, and clinical outcome of COVID-19 associated GBS in 78 cases. Methods: We identified case reports and case series of COVID-19 associated GBS by conducting a search in the PubMed/MEDLINE and EMBASE databases. We assessed the quality of studies using an appraisal checklist presented by Cochrane Murad et al. Extracted data included demographic characteristics, clinical presentation, diagnostic workup, and outcome. Results: The systematic search yielded a total of 60 articles reporting 78 patients with a diagnosis of COVID-19 associated GBS. The patients were mainly male (65.3%) with an average age of 57 years. The ascending symmetrical paresis was the most common presentation (79.4%), with demyelinating pattern in 54 patients (79.4%). The CSF analysis showed albuminocytologic dissociation in 48 patients (75%). The mortality of COVID-19 associated GBS was estimated as 6.4% attributable to progressive respiratory failure. Conclusion: Given the associated morbidities such as respiratory failure in patients with COVID-19 associated GBS, its timely detection is crucial to prevent poor clinical outcomes. On the other hand, clinicians must be vigilant to identify the clinical findings of SARS-CoV-2 infection in newly diagnosed GBS patients, as this might be a neurological complication of the subclinical viral infection.

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An unusual case: Ruptured and infected primary muscle cystic echinococcosis

Acta Parasitologica ◽

10.2478/s11686-007-0024-1 ◽

2007 ◽

Vol 52 (2) ◽

Author(s):

Davut Keskin

Keyword(s):

Magnetic Resonance ◽

Soft Tissue ◽

Cystic Echinococcosis ◽

Unusual Case ◽

Case Reports ◽

Quadriceps Muscle ◽

Magnetic Resonance Images ◽

Membranous Structure ◽

Medical Treatments ◽

Soft Tissue Masses

AbstractThere are few case reports of primary muscle cystic echinococcosis in which a hot abscess developed at the site of the cyst following its perforation. Here, the author presents a 23-year-old female with a hydatid cyst of more than 15 years’ duration in her right quadriceps muscle. The cyst did not cause any complaints for years and grew very slowly, but eventually became infected and perforated. A large hot abscess was formed at its site. The patient was managed successfully by surgical and medical treatments. She was assessed carefully for clinical, radiological, surgical and histopathological findings. Investigations were made to differentiate the condition from classical hot abscesses and other soft tissue masses. In T1-and T2-weighted magnetic resonance images, a hypointense membranous structure (the perforated rim) within the mass of the lesion was significant for its differential diagnosis. In conclusion, especially in endemic regions, magnetic resonance imaging is a valuable tool in differentiating soft tissue cystic echinococcosis in the presence of infected and rapidly enlarging masses after long periods of dormancy.

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Myasthenia gravis and COVID-19: a systematic review of case reports and case series

Revista de Patologia Tropical / Journal of Tropical Pathology ◽

10.5216/rpt.v50i2.67480 ◽

2021 ◽

Vol 50 (2) ◽

pp. 87-106

Author(s):

Débora Lilian Roveron ◽

Ivan Luiz Gonçalves dos Santos ◽

Julio Luiz Gonçalves dos Santos ◽

Najila Fernandes Alem ◽

João Gabriel Pacetti Capobianco

Keyword(s):

Systematic Review ◽

Respiratory Failure ◽

Myasthenia Gravis ◽

Corticosteroid Therapy ◽

Neuromuscular Transmission ◽

Case Reports ◽

Ventilatory Support ◽

Case Series ◽

Length Of Hospital Stay ◽

Main Factor

Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular transmission and possible respiratory failure when concomitant with COVID-19. The aim of this study was to analyze the need for ventilatory support (VS), length of hospital stay (LOS) and mortality in patients diagnosed with MG and COVID-19. In this systematic review, PubMed, SciELO, LILACS, MEDLINE and IBECS databases were searched for primary studies published from January 2010 to March 2021, with no language restrictions. Fourteen eligible studies were identified. The main factor associated with the need for VS was the use of antibiotics other than azithromycin (AZM) for the treatment of COVID-19 (RR 1.60; 95% CI 1.20–2.91; p = 0.009). Patients who used hydroxychloroquine (HCQ) and AZM had almost twice the risk of needing invasive ventilatory support (IVS) (RR 1.94; 95% CI 1.07-3.52; p = 0.16). There were nonsignificant trends towards less need for IVS in patients who used intravenous immunoglobulin (IVIg) and corticosteroid therapy (RR 0.54; 95% CI 0.09–3.26; p = 0.60). There was a trend towards shorter LOS in patients who received therapy with IVIg and corticosteroid therapy [8 (5 - 8) vs 19 (12.2–23.7); p = 0.007]. 10.3% (n = 4/39) died and 100% did not use IVIg or IVIg and prednisone. There was a non-significant trend towards higher mortality in patients who used AZM (RR 2.55; 95% CI 0.26–30.02; p = 0.60). IVIg and corticotherapy presented themselves as a favorable alternative in relation to the outcomes.KEY WORDS: Coronavirus infections; length of stay; Myasthenia gravis; Respiratory insufficiency.

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A Case of Pulmonary Epithelioid Hemangioendothelioma with Literature Review

Case Reports in Oncological Medicine ◽

10.1155/2020/8048056 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Thu Thu Aung ◽

Andrew Chu ◽

Divya Kondapi ◽

Danny Markabawi ◽

Kanish Mirchia ◽

...

Keyword(s):

Needle Biopsy ◽

Standard Treatment ◽

Medical Literature ◽

Case Reports ◽

Case Series ◽

Vascular Tumor ◽

Epithelioid Hemangioendothelioma ◽

Transthoracic Needle Biopsy ◽

Pulmonary Epithelioid Hemangioendothelioma ◽

Clinical Pathologist

Pulmonary epithelioid hemangioendothelioma is a rare vascular tumor and infrequently described in medical literature as case reports and case series. Diagnosis is often incidental with high index of histopathological suspicion from clinical pathologist. The pathological pattern is quite unique with distinct immunohistochemical stains. Up to this day, there is no established standard treatment owing to the scarcity of this tumor. In this case report, we describe a case of pulmonary epithelioid hemangioendothelioma unexpectedly diagnosed with transthoracic needle biopsy, along with a review of the current literature.

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