scholarly journals Secondary cluster headache and numb chin syndrome as initial manifestation of high-grade B-lymphoma: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Joe Munoz-Cerón ◽  
Felipe Díaz-Forero ◽  
Adriana Buitrago ◽  
Sandra Chinchilla
Keyword(s):  
Cluster Headache ◽  
Vascular System ◽  
Clinical Manifestations ◽  
High Grade ◽  
Initial Manifestation ◽  
Numb Chin Syndrome ◽  
History Of ◽  
Loss Of Appetite ◽  
The Right ◽  
Work Up

Abstract Background Cluster headache is a primary condition characterized by severe headache accompanied by trigeminal autonomic signs. By definition, it is not attributed to underlying etiologies; however, under certain clinical characteristics, secondary etiologies must be ruled out. Case presentation We present the case of a 48-year-old Hispanic man with a history of episodic right orbital pain, lasting 30 minutes, associated with ipsilateral tearing, who prior to the onset of his symptoms reported loss of appetite, weight loss, and paresthesias in the right chin region. After work-up studies, high-grade lymphoma with infiltration to the right submental nerve was diagnosed, in which numb chin syndrome was the initial presentation. Despite initiation of treatment, the patient died 3 weeks after the diagnosis. Conclusions In the study of cluster headache, underlying etiologies must be considered when there are atypical clinical manifestations. Within these etiologies, metastases to pericranial nerves must be included, which, besides generating localized symptoms, can activate the trigeminal vascular system simulating headaches of primary etiology.

scholarly journals Hereditary haemorrhagic telangiectasia: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110030
Author(s):  
Asfandyar Mufti ◽  
Muskaan Sachdeva ◽  
Khalad Maliyar ◽  
Marissa Joseph
Keyword(s):  
Arteriovenous Malformations ◽  
Genetic Disorder ◽  
Clinical Manifestations ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Lower Lip ◽  
Recurrent Epistaxis ◽  
Receptor Like Kinase ◽  
History Of ◽  
The Right ◽  
Symptoms And Signs

Background: Hereditary haemorrhagic telangiectasia is an autosomal dominant genetic disorder characterized by abnormalities in blood vessel formation. The clinical manifestations of patients affected with hereditary haemorrhagic telangiectasia include mucocutaneous telangiectasias and visceral arteriovenous malformations. Case Summary: We report the case of a 30-year-old female diagnosed with hereditary haemorrhagic telangiectasia presenting with the classic triad of recurrent epistaxis, mucocutaneous telangiectasias and family history of hereditary haemorrhagic telangiectasia with activin receptor-like kinase 1 mutation. Upon skin examination, she was noted to have telangiectasias under left naris, inner lower lip and surface of the tongue, and a vascular malformation on the right forearm. Conclusion: Although the skin involvement and epistaxis may be mild symptoms and signs of hereditary haemorrhagic telangiectasia, timely recognition of these can ensure vigilant monitoring of potential severe complications from cerebral and pulmonary visceral arteriovenous malformations.

scholarly journals Non-uremic Calciphylaxis: A Rare and Late Adverse Reaction of Warfarin

2019 ◽  
Vol 14 (3) ◽  
pp. 246-248 ◽  
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Akash D. Patel ◽  
Jignesh C. Kaklotar ◽  
Greshaben R. Patel ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Inflammatory Markers ◽  
Metabolic Profile ◽  
Connective Tissue Diseases ◽  
Skin Ulcer ◽  
Wound Treatment ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Late Adverse Reaction

Background:Calciphylaxis is a complex dermatological lesion of micro vascular calcification that is typically presented as panniculitis with gangrenous painful lesions having uremic and non-uremic causes.Case Report:We present a case of a 48-year old male with a history of paroxysmal atrial fibrillation and hypertension taking amlodipine 5 mg and warfarin 5 mg daily for the last 26 months. The patient had a 6- months history of painful swelling followed by necrotic skin ulcer over the right leg. His remarkable examination findings were right leg tender ulcer with surrounding erythema and secondary sepsis. His hemogram, metabolic profile and connective tissue diseases work up were unremarkable except leucocytosis and raised inflammatory markers. His local part radiological and skin biopsy findings were suggestive of calciphylaxis.Results and Conclusion:In our case, warfarin and amlodipine were culprit drugs for the lesion, but Naranjo score (warfarin 7and amlodipine 1) speculate warfarin as a probable adverse reaction of warfarin. The lesion was cured with local wound treatment after discontinuation of warfarin. The physician should be aware of this rare cutaneous disorder of systemic origin for proper management.

Orthostatic hypotension and right heart failure as the initial manifestation of intravenous leiomyomatosis

2015 ◽  
Vol 26 (3) ◽  
pp. 586-588 ◽  
Author(s):  
Ya-Qin Li ◽  
Xiao-Ping Yin ◽  
Zhan-Wen Xu
Keyword(s):  
Right Atrium ◽  
Right Heart Failure ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
Caval Vein ◽  
Initial Manifestation ◽  
Inferior Caval Vein ◽  
Mobile Mass ◽  
History Of ◽  
The Right

AbstractA 36-year-old woman, who had a history of myomectomy, presented with lightheadedness after changing position from sitting to standing and effort-related shortness of breath. Echocardiography demonstrated a hyperechoic elongated mobile mass extending from the inferior caval vein to the right atrium. The mass was surgically removed, and histological examination established the diagnosis of intravenous leiomyomatosis. This case caught the attention of our cardiology group to consider the diagnosis when an inferior caval vein or right atrium mass is found in a patient with a history of uterine leiomyomatosis.

Esthesioneuroblastoma (ENB): A case report

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15546-15546
Author(s):  
E. Troncoso ◽  
S. Bonicatto ◽  
A. Mainella ◽  
A. Barbero ◽  
M. Lavezzaro ◽  
...  
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Soft Palate ◽  
Sensory System ◽  
Clinical Manifestations ◽  
Response To Therapy ◽  
Nasal Fossa ◽  
History Of ◽  
Left Maxillary Sinus ◽  
The Right

15546 Background: ENB is a rare embrionary tumor derived from neuroblasts of the olfactory sensory system. Polypoid mass with epistaxis or nasal obstruction are the most common clinical manifestations of this tumor. It’s invasive and it frequently causes regional and distant metastasis. ENB requires a multimodality therapy. The objective of this study is to describe the form of presentation, diagnosis, treatment and evolution of this tumor on a female patient (pt), as a casuistic contribution. Methods and Case Report: A 61 year old woman with a four month history of epistaxis, nasal pain and anosmia. CT shows nasal mass invading the entire nasal cavity and upper maxillary. Pt underwent nasal resection and reconstruction with frontal flaps. Anatomopathology: ENB invading the bone. Cromogranin (+), sinaptofisin (+), CK (−), NSE (−). Three months later: lesion on the right wing nasal and a mass in the soft palate. MRI: mass on the floor of the nasal fossa that involve the left maxillary sinus and the bone palate. Kadish stage C. We treated her with three cycles of chemotherapy using cisplatin 30 mg/sqM d 1–3 iv and etoposide 100 mg/sqM d 1–3 iv. After that, remission was observed in the wing nasal lesion but the the soft palate mass shows progression. MRI: mass in nasal fossa that destroys the left maxillary sinus and causes lysis of the upper maxillary and orbital floor. Pt was treated with radiotherapy (6000 cGy) showing complete remission of the nasal lession and partial response on the soft palate, verified by physical examination and RMI. Four months after the end of radiotherapy, she continues under control and maintains the response to therapy without evidence of progression. Conclusion: ENB is an unfrequent tumor without any standard treatment. In our case, the combination of surgery, CH and RT has been effective for local control of the disease with good tolerance and acceptable quality of life. No significant financial relationships to disclose.

The Sweating Anomaly in Cluster Headache: Further Observations on the Underlying Mechanism

Cephalalgia ◽  
1987 ◽  
Vol 7 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Ottar Sjaastad ◽  
Rolf Salvesen ◽  
F Antonaci
Keyword(s):  
Cluster Headache ◽  
Underlying Mechanism ◽  
Interesting Case ◽  
Test Results ◽  
Sympathetic Dysfunction ◽  
Typical History ◽  
History Of ◽  
Heating Test ◽  
The Right ◽  
Autonomic Test

We describe a patient with a typical history of cluster headache for more than 18 years. During the first approximately 10 years of his disease, the pain was right-sided, and pupillometric and evaporimetric measurements indicated a sympathetic deficiency on this same side. However, for the next >6 years, his pain was consistently left-sided, although the signs of sympathetic dysfunction still were more marked on the right side. This was also true for the findings obtained during the interictal period and for the heating test performed within an attack. The implications of this interesting case are discussed. The view that two separate lines of symptom production lead to the pain and the autonomic phenomena seems to be supported by this case history. The cluster headache syndrome may also be a bilateral disorder, with only the weight of balance pointing one way or the other. Finally, the autonomic test results of this patient could reflect an autonomic “scar” in the previous headache side.

scholarly journals Infekcijski endokarditis na trikuspidalni zaklopki povzročen z bakterijo Eikinella corrodens

2015 ◽  
Vol 84 (6) ◽  
Author(s):  
Martin Tretjak ◽  
Miroslav Vujasinović ◽  
Irena Piltaver Vajdec ◽  
Andreja Pikelj Pečnik ◽  
Zdenko Kikec
Keyword(s):  
Tricuspid Valve ◽  
Drug Users ◽  
Venous Ulcer ◽  
Blood Cultures ◽  
Infectious Endocarditis ◽  
Eikenella Corrodens ◽  
Causative Agents ◽  
History Of ◽  
Loss Of Appetite ◽  
The Right

AbstractBackground. Infectious endocarditis of the tricuspid valve is rare in non-intravenous drug users and patients without central venous devices. The most frequent causative agents are staphylococci, rarely other bacteria.Methods. We describe a case of a 57-year-old patient without history of drug abuse that was admitted to our hospital because of fever with chills, dry cough, loss of appetite and wasting lasting for a few months. He had a venous ulcer on the right foot and interdigital inflammation on both feet. Eikenella corrodens was isolated from blood cultures. Transthoracic echocardiography showed a large vegetation on the anterior leaflet of tricuspid valve. CT scan oh the thorax showed probable septic emboli. The patient was treated conservatively with prolonged double antibiotic regimen. During the treatment there were no further complications.Conclusions. In our patients a rare form of tricuspid valve endocarditis was confirmed, caused by Eikenella corrodens. The possibility of infectious endocarditis should always be considered in patients with prolonged fever, especially when a possible causative agent is isolated from blood cultures.

scholarly journals Simultaneous Hydatid Cysts of Both the Right Atrium and Right Ventricle

2007 ◽  
Vol 50 (3) ◽  
pp. 217-219
Author(s):  
Caner Arslan ◽  
Emir Cantürk ◽  
Egemen Duygu ◽  
Ahmet Kürsat Bozkurt
Keyword(s):  
Right Ventricular ◽  
Right Atrial ◽  
Hydatid Cysts ◽  
Hepatic Hydatid Cyst ◽  
History Of ◽  
Ischemic Attack ◽  
The Right ◽  
Work Up ◽  
Hepatic Hydatid ◽  
Fatal Complications

Hydatid disease in both chambers of the heart is very rare. Mobile right atrial and right ventricular hydatid cysts were diagnosed incidentally in the etiologic work up for a transient ischemic attack in a 77-year-old man with a history of a hepatic hydatid cyst operation. Transthoracic echocardiography was very successful in the diagnosis of both hydatid cysts. Transesophagial echocardiography and computed tomography confirmed the diagnosis. Both right atrial and right ventricular hydatid cysts were removed under cardiopulmonary bypass to prevent morbidities and potentially fatal complications.

scholarly journals Hepatic angiosarcoma

2018 ◽  
Vol 97 (6) ◽  
pp. 578-580
Author(s):  
Vivian Nunes Arruda ◽  
Melissa De Andrade ◽  
Rhafir Gonçalves
Keyword(s):  
Clinical Manifestations ◽  
Pulmonary Nodules ◽  
Emergency Laparotomy ◽  
Abdominal Ultrasonography ◽  
Reactive Protein ◽  
Hepatic Angiosarcoma ◽  
History Of ◽  
Rare Malignancy ◽  
Pathology Reports ◽  
The Right

Hepatic Angiosarcoma is a rare malignancy of endothelial cell origin that is generally idiopathic and presents non-specific clinical manifestations. Hemoperitoneum can occur in 17-27% of cases and is a result of tumor rupture, which has a devastating prognosis. We present a 79-year-old female patient with history of diffuse right upper quadrant abdominal pain associated with syncope episodes and unintentional weight loss. Physical examination was unremarkable except for painful palpation of the right upper quadrant. Laboratory exams indicated chronic disease anemia, a 2.7 INR, decreased albumin, increased C-Reactive Protein and GGT, and normal AST, ALT, Alkaline Phosphatase and Bilirubin. Viral hepatitis serologies were negative. Abdominal ultrasonography revealed hepatomegaly and solid liver lesions of heterogeneous echogenicity and imprecise limits. Three-phase abdominal CT showed multiple liver masses of heterogeneous pattern of enhancement suggestive of atypical hemangioma associated with ascites. Chest CT revealed bilateral pulmonary nodules suggestive of metastasis. During hospital stay, the patient developed a massive hemoperitoneum that required emergency laparotomy. In this circumstance, liver and omentum biopsies were performed and the pathology reports ultimately indicated the possibility of hepatic angiosarcoma. The patient developed refractory hemoperitoneum and hemorrhagic shock and ultimately passed away, 48 days after hospital admission. Definitive diagnosis was only available posteriorly, with immunohistochemistry positivity for ERG, CD34 and Factor VIII-related antigen on both omentum and lung samples. This case study provides valuable clinical discussion and emphasizes how a transdisciplinary approach is essential to correctly diagnose and manage such complex cases.

scholarly journals Focal superior quadrant haemorrhages in post COVID-19 patient: A target for personalized medicine

2021 ◽  
pp. 112067212110212
Author(s):  
Maria Cristina Savastano ◽  
Carola Culiersi ◽  
Alfonso Savastano ◽  
Gloria Gambini ◽  
Tomaso Caporossi ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Medical Work ◽  
Anomalous Increase ◽  
Retinal Bleeding ◽  
History Of ◽  
Artery Disease ◽  
The Right ◽  
Work Up ◽  
D Dimer ◽  
Care Support

Purpose: To report a case of multiple superior quadrant intraretinal haemorrhages in post-COVID-19 patient. Case description: A 58-year-old male with a history of coronary artery disease and hypertension, presented with multiple superior quadrant intraretinal haemorrhages in the superonasal quadrant of the left eye 1 month after hospitalization for COVID-19. The right eye was normal. During his 10-day stay, he was treated with hydroxychloroquine, lopinavir + ritonavir, ceftriaxone, and his pre-existing antiplatelet therapy. During hospitalization, a complete medical work up showed an anomalous increase in D-dimer. He did not require intensive care support. Conclusions: In this report, we focused on the origin of retinal bleeding in a post COVID-19 patient, likely due to a focal occlusion of a vessel. Considering the nature of SARS-CoV-2 infection, we hypothesize that retinal haemorrhages were caused by a combination of factors including the patient’s antiplatelet therapy and the thrombotic microvascular injury caused by the virus.

scholarly journals Primary squamous cell carcinoma of the liver: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110212
Author(s):  
Yu Sun ◽  
Guangyu Jin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Imaging Features ◽  
Primary Squamous Cell Carcinoma ◽  
History Of ◽  
Loss Of Appetite ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.

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