scholarly journals Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Shengjie Xu ◽  
Xiaohong Song ◽  
Chengjuan Jin ◽  
Yanli Li
Keyword(s):  
Ectopic Pregnancy ◽  
Tumor Metastasis ◽  
Actinomycin D ◽  
Clinical Manifestations ◽  
Case Presentation ◽  
Delayed Treatment ◽  
Missed Diagnosis ◽  
Β Hcg ◽  
Histopathological Results

Abstract Background Tubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis. Case presentation This report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5-fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence. Conclusions Tubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma.

scholarly journals 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

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.

scholarly journals A case of Brucellosis with Large Periaortic Mass And Secondary Vasculitis In A Patient Presenting Intermittent Abdominal Pain

2021 ◽  
Author(s):  
Huilan Liu ◽  
Yutong Zhang ◽  
Xiaomei Leng ◽  
Yunjiao Yang ◽  
Xiaofeng Zeng
Keyword(s):  
Abdominal Pain ◽  
Clinical Manifestations ◽  
Detailed Examination ◽  
Blood Cultures ◽  
Organ System ◽  
High Morbidity ◽  
Case Presentation ◽  
Intermittent Abdominal Pain ◽  
Cardiovascular Involvement ◽  
Missed Diagnosis

Abstract Background Brucellosis is still highly prevalent and causes high morbidity. It can involve any organ system and has been implicated in protean complications. Cardiovascular involvement is the main cause of mortality. This case described a female patient infected by Brucella with large periaortic mass and secondary vasculitis whose manifestation was abdominal pain. The aim was to raise the awareness of earlier recognition of Brucella infections without fever and remitting risk by taking appropriate treatments for those with cardiovascular involvement.Case presentation A case was reported regarding a female present intermittent abdominal pain. Two months later, she was admitted to the Department of Rheumatology and Immunology in our hospital due to high inflammatory markers, the large periaortic mass and vasculitis manifestations in aortic computed tomography angiography. By detailed examination, Brucellosis was highly suggestive based on positive blood cultures. Finally, no discomfort has ever occurred, and the mass was prominently reduced after antibiotic therapy of half a year.Conclusions The clinical manifestations of brucellosis are protean. For those without fever and cardiovascular involvement as the main manifestation, especially vasculitis, we must not just set the standard rigidly, instead, it is recommended to carry out the relevant differential diagnosis to avoid misdiagnosis or missed diagnosis.

scholarly journals Abdominal ectopic pregnancy following a frozen embryo transfer cycle: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Li ◽  
Jiaxuan Geng ◽  
Qiaohua He ◽  
Jin Lu ◽  
Jin Xu ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Close Monitoring ◽  
Case Presentation ◽  
Vitro Fertilization ◽  
Β Hcg ◽  
Frozen Thawed Embryo Transfer ◽  
Artificial Cycle

Abstract Background Abdominal ectopic pregnancy (AEP) is a rare form of ectopic pregnancy. As the number of in-vitro fertilization (IVF) procedures continues to increase, the incidence of AEP will also rise. However, the rarity and atypical presentation of AEP make early diagnosis challenging. Case presentation Herein, we report an AEP following frozen-thawed embryo transfer (FET) in an artificial cycle. The patient was misdiagnosed with implantation failure when the serum human chorionic gonadotropin (hCG) level was detected as 2.59mIU/ml at fourteenth day after embryo transfer. Therefore, she was suggested to stop luteal phase support. However, a ruptured AEP was developed 33 days following embryo transfer, which was diagnosed by laparoscopic surgery. Conclusions The case highlighted the delayed serum β-hCG and massive intraperitoneal hemorrhage may be clues to make early diagnosis of AEP. Clinicians must attach great importance to close monitoring and bear in mind the possibility of abdominal pregnancy.

scholarly journals A Solitary Giant Neurofibroma of Inguinal Region—A Case Report

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.

scholarly journals Distinct gestational trophoblastic neoplasia - different entities, specific management

2017 ◽  
Vol 6 (2) ◽  
pp. 749
Author(s):  
Pedro Brandão ◽  
Juliana Silva-Rocha ◽  
Ana Rita Pinto ◽  
Fernanda Costa
Keyword(s):  
Clinical Manifestations ◽  
Case Series ◽  
Gestational Trophoblastic Disease ◽  
Tumour Marker ◽  
Primary Treatment ◽  
Gestational Trophoblastic Neoplasia ◽  
Presenting Symptoms ◽  
Microscopic Features ◽  
Β Hcg

Gestational trophoblastic diseases are abnormalities of the trophoblastic tissue development. They have Β-hCG as tumour marker, similar clinical manifestations but different pathological features, management and prognosis. Gestational trophoblastic neoplasia includes all forms of gestational trophoblastic disease that are invasive and/or metastasize and correspond to 10% of this group of diseases. The authors performed a retrospective review of all patients referred to our department between 1st January 2011 and 30th June 2016. Presenting symptoms, Β-hCG levels, obstetric and personal history and microscopic features were reviewed. 4 cases were identified - 2 invasive complete and 1 partial hydatidiform moles and 1 placental site trophoblastic tumour. Management and follow-up were individualized. Neither persistence nor recurrences were diagnosed after primary treatment. These case series highlights the importance of an accurate diagnosis and a long-term follow-up considering the risk of persistency or malignancy, as gestational trophoblastic neoplasia usually have good response to the adequate therapy.

scholarly journals Malignant Transformation of Liver Cysts Into Cholangiocarcinoma During Follow-up: Potential Dangers of Liver Cysts

2021 ◽  
Author(s):  
Fu-sheng Liu ◽  
Ke-lu Li ◽  
Yue-ming He ◽  
Zhong-lin Zhang ◽  
Yu-feng Yuan ◽  
...  
Keyword(s):  
Cyst Wall ◽  
Clinical Manifestations ◽  
Liver Cyst ◽  
Common Disease ◽  
Case Presentation ◽  
Liver Cysts ◽  
Cystic Tumors ◽  
Laboratory Examinations ◽  
Malignant Changes

Abstract Background: The liver cyst is a common disease in hepatobiliary surgery. Most patients have no apparent symptoms and are usually diagnosed accidentally during imaging examinations. The vast majority of patients with liver cysts follow a benign course, with very few serious complications and rare reports of malignant changes. Case Presentation: We present two cases of liver cysts that evolved into intrahepatic tumors during the follow-up process. The first patient had undergone a fenestration and drainage operation for the liver cyst, and the cancer was found at the cyst’s position in the third year after the procedure. Microscopically, bile duct cells formed the cyst wall. Tumor cells can be seen on the cyst wall and its surroundings to form adenoid structures of different sizes, shapes, and irregular arrangements, some of which are arranged in clusters. The second patient was regularly rechecked after discovering liver cysts, and a new mass appeared very close to the cyst. The clinical manifestations and laboratory examinations of the two patients lacked specificity, the preoperative diagnosis was unclear, and the postoperative pathology confirmed cholangiocarcinoma.Conclusions: Our cases indicate that liver cysts may lead to the occurrence of malignant intrahepatic cholangiocarcinoma. Therefore, follow-up of particular liver cysts is necessary, and the differential diagnosis of the intrahepatic cystic tumors needs to include cholangiocarcinoma.

Continual Cough: Experience and Lessons from a Case of Bronchial Adenoid Cystic Carcinoma

2020 ◽  
Vol 15 ◽  
Author(s):  
Lin Sheng ◽  
Junwei Tu ◽  
Yijun Sheng ◽  
Jingqian Zhu ◽  
Huijun Chen ◽  
...  
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Palliative Radiotherapy ◽  
Final Diagnosis ◽  
Case Presentation ◽  
Delayed Treatment ◽  
Adenoid Cystic ◽  
Long Time ◽  
Missed Diagnosis ◽  
Low Incidence ◽  
Slow Growing

Background: Primary tracheal adenoid cystic carcinoma is a rare, slow-growing pulmonary malignancy. Due to the low incidence, clinicians are poor in the diagnosis and treatment of such disease, which is prone to cause misdiagnosis or missed diagnosis, consequently leading to delayed treatment. Case Presentation: Here, we reported a case of a 72-year-old woman who was diagnosed as primary bronchial adenoid cystic carcinoma after three years. At the time of final diagnosis, lesion involvement was seen in the entire bronchus and radical treatment was not available. Conclusions: Endoscopic bronchoscopy and palliative radiotherapy can relieve the symptoms of the patient and make the patient survive with the tumor for a long time.

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

2019 ◽  
Vol 47 (5) ◽  
pp. 2302-2308 ◽  
Author(s):  
Zhu-Qing Yuan ◽  
Qian Wang ◽  
Min Bao
Keyword(s):  
Symptom Relief ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Large Mass ◽  
Advanced Age ◽  
Case Presentation ◽  
Sclerosing Hemangioma ◽  
Pulmonary Sclerosing Hemangioma ◽  
History Of

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.

scholarly journals Unruptured unilateral twin ectopic pregnancy: a rare case report

2020 ◽  
Vol 9 (5) ◽  
pp. 2151
Author(s):  
Nayanika Gaur ◽  
Piyush K. Goyal ◽  
Manish Jha
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Complete Recovery ◽  
Intrauterine Pregnancy ◽  
Serum Progesterone ◽  
Post Surgery ◽  
Β Hcg ◽  
The Right

Unilateral twin ectopic pregnancy is a rare entity with an incidence of 1 in 125,000 pregnancies. This is a case of a 26-year-old primigravida with a spontaneous unilateral twin ectopic gestation, diagnosed on transvaginal ultrasound, treated laparoscopically by doing unilateral salpingectomy and confirmed with histopathology. The doubt for ectopic pregnancy was raised when the serum β-HCG level was constantly >1500 mIU/ml and serum progesterone level was <5 pg/ml and no intrauterine pregnancy was seen. On a follow-up scan, twin gestational sac was noted in right adnexa along with a large haemorrhagic cyst in the right ovary. On post-surgery follow-up, patient was found to have had complete recovery. This case report discusses the incidence and rarity, yet possibility of twin ectopic gestations, the need for early diagnosis and its management.

scholarly journals Rare Cardiac Myxoma with A Hard Texture: A Case Report

2020 ◽  
Author(s):  
Hongfei Xu ◽  
Yanjia Gu ◽  
Liang Ma ◽  
Yiming Ni ◽  
Weidong Li
Keyword(s):  
Elective Surgery ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Cardiac Tumors ◽  
Rare Type ◽  
Primary Tumors ◽  
Case Presentation ◽  
Preoperative Examination

Abstract Background: Primary tumors of the heart are uncommon but not rare. Myxoma comprises 50% of all benign cardiac tumors in adults and 15% of such tumors in children. Cardiac myxoma is usually soft in texture and has a friable or villous surface, which tends to be associated with embolic events. It is also rare for myxoma to be full of calcium and metastatic bone deposits.Case presentation: We herein present a 58-year-old female patient with cardiac space-occupying lesion within the left atrium, and the lesion is lubricous and hard. Her only symptoms were hypertension, dizziness, and chest stuffiness. After surgical resection, we confirmed that the lesion was atrial myxoma by histopathology examination. The patient recovered uneventfully and was discharged. A 2-year follow-up exam showed no evidence of tumor recurrence.Conclusions: Cardiac myxoma is rare and has various clinical manifestations. It is usually friable and has an irregular surface, making embolic manifestations one of the most common complications. Consequently, immediate surgical excision is suggested upon diagnosis. In our case, the patient had a rare type of cardiac myxoma, which had a hard texture and lubricous surface. In our opinion, this case has a low risk of embolism. We prefer elective surgery rather than emergency surgery to perfect the preoperative examination for this kind of patient.

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