scholarly journals Double trouble: diagnostic dilemma in a rare association of proximal ureteric valve with orthotopic ureterocele—case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Anuj Dumra ◽  
P. Ashwin Shekar ◽  
Hardik Patel
Keyword(s):  
Preoperative Imaging ◽  
Resected Specimen ◽  
Provisional Diagnosis ◽  
Retrograde Pyelography ◽  
Diagnostic Dilemma ◽  
Case Presentation ◽  
Rare Association ◽  
Good Improvement ◽  
Specific Association ◽  
Endoscopic Incision

Abstract Background Association of the ureterocele and proximal ureteral valve is a rare congenital anomaly which can lead to quick detoriation of renal function due to double obstruction. Though ureteral valves have been associated with other ureteral anomalies, this specific association is extremely rare. Case presentation A 7-month-old boy was referred to us for antenatally detected hydronephrosis. Provisional diagnosis of orthotopic ureterocele with pelviureteric junction (PUJ) obstruction was made based on preoperative imaging. Endoscopic incision of ureterocele was done and retrograde pyelography showed tight obstruction at PUJ which necessitated a pyeloplasty. Examination of resected specimen confirmed a ureteral valve. Postoperatively, the patient had good improvement in kidney function. Conclusion To conclude, congenital ureteral valves are a rare cause of ureteric obstruction and its association with ureterocele is rarer still. Identification of an ureterocele should not deter us from searching for an associated pathology like a ureteric valve when imaging shows more severe hydronephrosis suggestive of more proximal obstruction.

scholarly journals A Rare Case of Retroperitoneal Leiomyoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Rajiv Mahendru ◽  
Geetinder Gaba ◽  
Shweta Yadav ◽  
Gurmeet Gaba ◽  
Chinky Gupta
Keyword(s):  
Pressure Effect ◽  
Final Diagnosis ◽  
Abdominal Hysterectomy ◽  
Preoperative Imaging ◽  
Surgical Removal ◽  
Rare Entity ◽  
Provisional Diagnosis ◽  
Case Presentation ◽  
Abdominal And Pelvic Pain ◽  
Primary Retroperitoneal

Introduction. Leiomyoma uteri is one of the most common benign conditions for which women undergo hysterectomy every year. Fibroids found retroperitoneally are a rare entity, especially, primary retroperitoneal fibroid.Case Presentation. We report a case of 42-year-old para 1 who presented to our hospital with recurring retention of urine, lower abdominal and pelvic pain, and dyspareunia . Provisional diagnosis on the basis of examination and imaging was large subserosal fibroid with mild right-sided hydroureteronephrosis, due to pressure effect of the fibroid. Abdominal hysterectomy was done for the patient, and intraoperatively, a bulky uterus was found with multiple small fibroids on anterior and posterior walls, and a large fibroid approx.10×8 cm was found arising from the posterior surface at the level of internal os retroperitoneally, which was confirmed by histopathology as leiomyoma.Conclusion. Retroperitoneal fibroids are rare neoplasms and treatment is surgical removal. Preoperative imaging can only give provisional diagnosis and can be misguiding. Final diagnosis of retroperitoneal fibroid can be made only intraoperatively.

A diagnostic dilemma: endodontic lesion or odontogenic keratocyst? A case presentation

2008 ◽  
Vol 41 (9) ◽  
pp. 800-806 ◽  
Author(s):  
R. Pace ◽  
F. Cairo ◽  
V. Giuliani ◽  
L. P. Prato ◽  
G. Pagavino
Keyword(s):  
Odontogenic Keratocyst ◽  
Diagnostic Dilemma ◽  
Case Presentation

Atypical presentation of giant cell arteritis associated with SIADH: a rare association

2021 ◽  
Vol 14 (12) ◽  
pp. e246187
Author(s):  
Sadia Tariq ◽  
Sameh Jonny ◽  
Hanadi Asalieh
Keyword(s):  
Hormone Secretion ◽  
Interesting Case ◽  
High Dose ◽  
Vascular Events ◽  
Diagnostic Dilemma ◽  
Consistent Finding ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Rare Association ◽  
Temporal Arteries ◽  
Neurophysiological Studies

We present here an interesting case of a 67-year-old man with 3 weeks history of lethargy, loss of appetite, generalised weakness and weight loss. Following thorough investigations, occult malignancy was ruled out. Hyponatraemia was a consistent finding which needed further classification. Additional workup including cerebral imaging and neurophysiological studies excluded cerebral vascular events and myopathies. Vasculitis screening was undertaken, and the diagnostic dilemma was revealed by the temporal arteries Doppler ultrasound which showed classical ‘halo sign’. Diagnosis of temporal arteritis was made and linked with syndrome of inappropriate antidiuretic hormone secretion, which appears to be a rare association with few instances on record. Patient was treated with high dose of prednisolone with marked improvement of clinical features.

scholarly journals A Case of Cholangiolocellular Carcinoma Preoperatively Diagnosed With Typical Imaging Findings

2019 ◽  
Vol 103 (1-2) ◽  
pp. 72-79
Author(s):  
Yoshihiro Mochizuki ◽  
Yuji Iimuro ◽  
Osamu Suzuki ◽  
Yoji Nagashima
Keyword(s):  
Preoperative Diagnosis ◽  
Imaging Finding ◽  
Genomic Analysis ◽  
Liver Neoplasm ◽  
Preoperative Imaging ◽  
Molecular Entity ◽  
Imaging Findings ◽  
Cholangiolocellular Carcinoma ◽  
Case Presentation ◽  
Contrast Enhanced

Introduction: Cholangiolocellular carcinoma (CoCC) is a rare primary liver neoplasm. A recent integrative genomic analysis has revealed that CoCC represents a distinct biliary-derived molecular entity. Several cases of CoCC have been reported so far, but accurate preoperative diagnosis was difficult in most cases. Case presentation: We report a case of 70-year-old woman with CoCC. Preoperative imaging findings revealed several typical signs of CoCC (i.e., thick early ring enhancement in the peripheral area of the tumor and its prolongation, vessel penetration through the tumor, no dilatation of the peripheral bile ducts, and dot-/band-like internal enhancement or a target appearance on contrast-enhanced magnetic resonance imaging). We strongly suspected CoCC from these preoperative imaging findings of the tumor and performed extended left hepatectomy. Pathologic diagnosis was CoCC, and the histologic findings such as peripheral highly cellular areas, central abundant hyalinized/edematous fibrotic stroma, and retained Glisson's sheath structures in the tumor, corresponded closely to each preoperative imaging finding. Immunohistochemical study revealed the tumor cells were positive for cytokeratin 7 and epithelial membrane antigen. The postoperative course was uneventful, and the patient is alive without recurrence for 15 months. The prognosis of CoCC is known to be better than that of cholangiocellular carcinoma, indicating the importance of preoperative differential diagnosis of these tumors. Conclusion: Even though preoperative diagnosis of CoCC is difficult because of its rarity, cautious investigation of preoperative typical imaging findings can possibly lead to accurate diagnosis of CoCC.

scholarly journals Endometrioid adenocarcinoma of the rectovaginal septum with invasion of the rectum: a case report and review of literature

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Hua Yang ◽  
Jiao-jiao Gu ◽  
Yue Qi ◽  
Wei Zhao ◽  
Xin-lu Wang
Keyword(s):  
Lower Abdominal Pain ◽  
Pelvic Mass ◽  
Preoperative Imaging ◽  
Histopathological Diagnosis ◽  
Endometrioid Adenocarcinoma ◽  
Rectovaginal Septum ◽  
Case Presentation ◽  
Additional Chemotherapy ◽  
Good Treatment Response ◽  
Gynecological Tumor

Abstract Background Malignant transformation of endometriosis in the rectovaginal septum is rare and usually misdiagnosed as a colorectal or gynecological tumor. We report a rare case of primary endometrioid adenocarcinoma of the rectovaginal septum with invasion of the rectum. Case presentation A 57-year-old overweight woman presented with vaginal bleeding and self-reported left lower abdominal pain during the previous 2 weeks. Preoperative imaging showed a large pelvic mass with invasion of the rectum, suggestive of a gynecologic malignancy. Multiple endoscopic biopsies and immunohistochemical analyses of specimens was performed. The patient received joint gynecological-surgical laparotomy, and there were no intra- or postoperative complications. The histopathological diagnosis was rectovaginal endometrioid adenocarcinoma with rectum infiltration. The patient received adjuvant chemotherapy and achieved good treatment response, with no early complications. At 12 months after surgery, there was no evidence of recurrence. Conclusions A high index of clinical suspicion is required for the diagnosis of endometrioid adenocarcinoma in the rectovaginal septum. Surgery combined with additional chemotherapy or radiotherapy seems to be a standard treatment, and hormonal therapy is optional. The efficacies of other therapies, including targeted medication and immunotherapy, are unknown.

scholarly journals Protruded duodenal tumor arising from Santorini’s duct of the pancreas: a rare case of intraductal papillary mucinous neoplasm mimicking a duodenal polypoid tumor

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Haruna Komatsubara ◽  
Hiroyuki Kato ◽  
Daisuke Noguchi ◽  
Kazuyuki Gyoten ◽  
Aoi Hayasaki ◽  
...  
Keyword(s):  
Intraductal Papillary Mucinous Neoplasm ◽  
Rare Case ◽  
Resected Specimen ◽  
Case Presentation ◽  
Duodenal Tumor ◽  
Mucinous Neoplasm ◽  
First Case ◽  
Enhanced Ct ◽  
Duodenal Lumen ◽  
Polypoid Tumor

Abstract Background We experienced a rare case of intraductal papillary mucinous neoplasm arising from Santorini’s duct (SD) forming a tumor protruding into the duodenum . Case presentation A 71-year-old woman was incidentally diagnosed with a 3 cm type Isp polypoid tumor in the second portion of the duodenum at another hospital. Enhanced CT and endoscopic ultrasound revealed that the origin of this protruding tumor was arising from SD and that the tumor mimicked a pedunculated duodenal tumor. Our preoperative diagnosis was a malignant pancreatic tumor arising from SD with invasion into the duodenum. She underwent a subtotal stomach-preserving pancreaticoduodenectomy, and the resected specimen showed a 25 mm tumor protruding into the duodenum with a villous surface. The pathological findings revealed that the tumor was intraductal papillary mucinous adenoma (IPMA) arising from SD. Conclusions To the best of our knowledge, this is the first case of IPMA protruding into the duodenal lumen from SD, although most of the tumors arising from SD have been reported to be malignant.

scholarly journals Follicular lymphoid hyperplasia of the posterior maxillary site presenting as uncommon entity: a case report and review of the literature

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Masato Watanabe ◽  
Ai Enomoto ◽  
Yuya Yoneyama ◽  
Michihide Kohno ◽  
On Hasegawa ◽  
...  
Keyword(s):  
Lymphoid Hyperplasia ◽  
Germinal Centers ◽  
Resected Specimen ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoid Follicles ◽  
Complete Surgical Resection ◽  
Left Posterior ◽  
Nodular Growth ◽  
Oral And Maxillofacial Region

Abstract Background Follicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically. Case presentation We report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively. Conclusions We diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.

scholarly journals Diagnostic dilemma of primary neonatal iliopsoas abscess

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Sampurna Ray ◽  
Pranab Kumar Dey ◽  
Pankaj Halder ◽  
Arindam Ghosh
Keyword(s):  
Surgical Drainage ◽  
High Grade Fever ◽  
Diagnostic Dilemma ◽  
Case Presentation ◽  
Iliopsoas Abscess ◽  
Diagnostic Difficulties ◽  
Laboratory Investigations ◽  
High Index Of Suspicion ◽  
Bluish Discoloration

Abstract Background Primary iliopsoas abscess is extremely rare in neonates and overlooked easily. It is potentially curable with surgical drainage and broad-spectrum antibiotics if diagnosed early. Case presentation A 13-day-old neonate was presented with a swelling and bluish discoloration on the left thigh and groin. There was a restriction of movement of the left lower limb, and he developed high grade fever later on, during hospital stay. In spite of a great dilemma, we could finally reach the diagnosis of primary iliopsoas abscess, performed surgical drainage, and controlled ongoing sepsis. At 3 months follow-up, the patient was doing well and there was no asymmetry in appearance of movements. Conclusion High index of suspicion, vigilant clinical examinations, and targeted laboratory investigations with imaging studies are of paramount importance in establishing its diagnosis. This case highlights the diagnostic difficulties and re-evaluates the representative features of neonatal iliopsoas abscess and its management.

scholarly journals Ureter Quadruplication with Huge Ureteral Cyst

2015 ◽  
Vol 35 (1) ◽  
pp. 79-81 ◽  
Author(s):  
R Joshi ◽  
DR Singh
Keyword(s):  
Congenital Anomaly ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Congenital Anomalies ◽  
Provisional Diagnosis ◽  
Diagnostic Dilemma ◽  
Surgical Exploration ◽  
Rare Congenital Anomaly ◽  
Routine Investigations

Ureteral quadruplication is an extremely rare congenital anomaly. It was first reported in 1975. The patients may present with different features and complications in respect to this congenital anomaly. They may also present with other congenital anomalies. Diagnosis sometimes is difficult and may need to be investigated with Magnetic Resonance Urogram, CT scan apart from routine investigations like ultrasonography and intravenous urogram. Surgical treatment should be based on the operative and investigational finding. We present the twelfth reported case but the first from Nepal. It was associated with a large ureteral cyst with diagnostic dilemma. Surgical exploration was done with a provisional diagnosis of large retroperitoneal cyst.J Nepal Paediatr Soc 2015;35(1):79-81

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