scholarly journals Contralateral migration of Kirschner wire from right acromioclavicular joint to left side of neck: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
How-Yun Ko ◽  
Ka-Wo Lee

Abstract Background Kirschner wire migration is one of the most common complications after internal fixation of fracture or dislocation in the shoulder region. However, cases of contralateral wire migration are rare. We present a case of contralateral loosened Kirschner wire migration from the right acromioclavicular joint to the left side of the neck without damage to any important structures or great vessels. Case presentation We report a case of a loosened Kirschner wire migrating from the right acromioclavicular joint to the left side of the neck in a 34-year-old Taiwanese man following a route of transversal, descendant, and then ascendant directions. The Kirschner wire was removed by exploratory neck dissection under C-arm fluoroscopy assistance without complication. Conclusion Wire migration may occur after surgical treatment with or without clinical complaint. Several hypotheses for the mechanism of wire migration have been postulated, including muscular activity, respiratory motion, gravity, and motion of upper extremity. Therefore, the importance of follow-up should be communicated to the patient. Once wire loosening or migration is noted, the implant should be removed immediately under intraoperative C-arm fluoroscopy or ultrasound assistance.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Wang ◽  
Cong Chen ◽  
Bo Liu ◽  
Xiaokang Wang ◽  
Wei Jiang ◽  
...  

Abstract Background Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications. Case presentation A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient’s medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications. Conclusion The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dalit Porat Ben Amy ◽  
Victoria Yaffe ◽  
Rawan Kawar ◽  
Sharon Akrish ◽  
Imad Abu El-Naaj

Abstract Background Myopericytoma is a rare mesenchymal neoplasm with perivascular myoid differentiation that arises most commonly in middle adulthood. The lesion generally involves the subcutaneous tissue of distal extremities. Myopericytoma of the oral cavity is extremely rare. Herein we report a case of oral myopericytoma in a pediatric patient, who was treated via a conservative approach with a follow up of 8 years. The case is followed by a literature review. To our knowledge this is the first documented case of oral myopericytoma affecting a patient of such a young age. Case presentation A 6 years old boy was referred to the maxillofacial surgery department for the evaluation of a solitary growth of the right maxillary buccal and palatal gingiva. Histology and immunohistochemistry confirmed the diagnosis of myopericytoma. Conclusions Our patient was treated by local excision with no recurrence in 8 years of follow up. Conservative approach should be considered for the treatment oral myopericytoma especially in young patients in tooth bearing areas.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aiko Maeda ◽  
Kenzo Araki ◽  
Chiaki Yamada ◽  
Shoko Nakayama ◽  
Kazuhiro Shirozu ◽  
...  

Abstract Background Hyperactive dysfunction syndrome (HDS) refers to a constellation of symptoms developing from cranial nerve overactivity caused by neurovascular compression at the root entry or exit zone near the brainstem. Although the combined features of HDS are seen in the elderly, there are no reports of such cases in adolescents, to date. Case presentation A 17-year-old male was diagnosed with right glossopharyngeal neuralgia and treated with microvascular decompression. He experienced new-onset right facial pain later and was diagnosed with right trigeminal neuralgia, which required prompt radiofrequency thermocoagulation of the right mandibular nerve. Follow-up in the third post-treatment year revealed the absence of symptom recurrence. Discussion We report the treatment of a rare case of adolescent-onset combined HDS presenting as trigeminal and glossopharyngeal neuralgia. This report highlights the possibility of combined hyperactive dysfunction syndrome in younger age groups. It is crucial to establish a diagnosis early on for prompt management.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Abdalmotaleb Elmadawy ◽  
Mahmoud Mahdy ◽  
Mohamed Alaa

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chenglong Wang ◽  
Yijia Cao ◽  
Min Zeng ◽  
Lijuan Wang ◽  
Xiaojing Cao ◽  
...  

Abstract Background Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma. Case presentation A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication. Conclusions It is very important to correctly diagnose a lymph node inclusion for proper clinical management.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Patrick T. Jasinski ◽  
Demetri Adrahtas ◽  
Spyridon Monastiriotis ◽  
Apostolos K. Tassiopoulos

Introduction. Seal zone failure after EVAR leads to type 1 endoleaks and increases the risk of delayed aortic rupture. Type 1b endoleaks, although rare, represent a true risk to the repair. Case Presentation. We report the case of a 65-year-old female who underwent emergent endovascular repair for a ruptured infrarenal abdominal aortic aneurysm and developed bilateral type 1b endoleaks following proximal migration of both endograft limbs. The right-side failure was diagnosed within 48 hours from the initial repair and the left side at the 1-year follow-up. Both sides were successfully treated with endovascular techniques. A review of the literature with an analysis of potential risk factors is also reported. Conclusion. For patients undergoing EVAR for ruptured AAA and with noncalcified iliac arteries, more aggressive oversizing of the iliac limbs is recommended to prevents distal seal zone failures.


2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Robert C. Bell ◽  
Evan T. Austin ◽  
Stacy J. Arnold ◽  
Frank C. Lin ◽  
Jonathan R. Walker ◽  
...  

Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up.Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion.Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up.


2020 ◽  
Vol 4 (3) ◽  
pp. 487-488
Author(s):  
Jessica Williams ◽  
Steven Hochman

Case Presentation: In this case, we demonstrate how a small radiolucency in the proximal humerus can progress to an even larger problem within a few months in a patient without follow-up. Our patient’s ultimate diagnosis was renal cell carcinoma with metastasis to the right proximal humerus, completely obliterating the affected bone. Discussion: In many underserved communities, patients have limited access to medical care, particularly specialty care. These patients often present to the emergency department and are unable to acquire appropriate follow-up. This situation illustrates the social issues that our patients face every day affecting their access to healthcare and ultimately necessary medical treatment.


2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Isabela Wolf-Grotto ◽  
Lucas M. Nogueira ◽  
Basilio Milani ◽  
Erica C. Marchiori

Abstract Background Osteoma is a benign tumor of the bones, which can be classified as central or peripheral. The occurrence in the jawbones is uncommon, but when it occurs, there is a greater prevalence of the mandible. The etiology is still unknown, and the hypothesis of its development is debated. Case presentation A 35-year-old Caucasian man presenting a tumor lesion in the right jawbone that had been growing for 8 years sought medical service complaining of speaking impairment. According to the patient, the tumor appeared shortly after a minor trauma caused by tooth extraction. The diagnosis of the lesion was made through clinical, radiographic, and histological methods, and the surgical treatment was successful and satisfactory for the patient as well as the surgical team, despite a short follow-up. Conclusion Etiopathogenesis of osteoma is not determined in the majority of cases. In the present report, it was possible to hypothesize the association between a minor trauma and the development of the tumor, reinforcing the reactive theory of tumor development. The uncommon location of the osteoma, as well the possibility of identifying the possible cause of the lesion, makes this case particularly interesting.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suqiong Ji ◽  
Chenchen Liu ◽  
Zhuajin Bi ◽  
Huajie Gao ◽  
Jian Sun ◽  
...  

Abstract Background Central nervous system overlapping autoimmune syndromes are uncommon, especially with the coexistence of MOG-IgG and GFAP-IgG. Case presentation A 23-year-old woman presented with transient convulsions, a loss of consciousness, persistent fever, headache, and vomiting. Cerebrospinal fluid (CSF) analysis revealed elevated cellularity, and magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement. She had fever and headache with antiviral and antibiotic treatment for 2 weeks, and she had empirical anti-tuberculosis treatment and oral prednisolone therapy. She was followed for 3 months after presentation with improved symptoms and normal CSF analysis. A 3-month follow-up MRI showed asymmetric lesions in the cerebellum, corona radiata, and white matter with enhancement. The anti-tuberculosis treatment was continued, and steroid therapy was discontinued. After she stopped taking prednisolone, an interrupted headache gradually appeared. MRI at 4 months after presentation revealed a partial reduction in lesions but enlarged areas in the left cerebellum and right parietal white matter and a new lesion in the region of the right ependyma with linear enhancement. Her CSF was positive for anti-myelin oligodendrocyte glycoprotein (MOG) and anti-glial fibrillary acidic protein (GFAP) antibodies using a transfected cell-based assay. She was diagnosed with overlapping syndrome of MOG‑IgG‑associated disease and GFAP astrocytopathy. She received steroid pulse therapy (methylprednisolone, 1 g for 5 days), followed by a gradual tapering of oral prednisolone and the addition of an immunosuppressant (tacrolimus, 3 mg per day). Six months after the initial presentation, she had no symptoms. An MRI showed that the lesions had diminished, and no enhancement was found. Conclusions We report a case that was positive for double antibodies, which was initially misdiagnosed as infectious meningoencephalitis. This case broadens the clinical and phenotypic presentation of the overlapping syndrome spectrum.


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