scholarly journals Chlorpyrifos-Induced Delayed Neurotoxicity with A Rare Presentation of Flaccid Quadriplegia: A Diagnostic Challenge

2017 ◽  
Vol 2 (LATEST ONLINE) ◽  
Author(s):  
Patrícia Mendes ◽  
Tatiana Pereira ◽  
Rui Pina ◽  
Rui Santos
Keyword(s):  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Delayed Neurotoxicity

ANTERIOR ABDOMINAL WALL ABSCESS A RARE PRESENTATION OF LEFT SIDED COLONIC CARCINOMA: A DIAGNOSTIC CHALLENGE FOR A GENERAL SURGEON

2021 ◽  
pp. 26-28
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Subhabrata Das ◽  
Dibyendu Chatterjee
Keyword(s):  
Abscess Formation ◽  
Colonic Carcinoma ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Bowel Habit ◽  
Abdominal Abscess ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Carcinoma Of The Colon ◽  
History Of

Background: The various presentations of carcinoma of the colon are well known. Abscess formation occurs in 0.3 to 0.4% and is the second most common complication of perforated lesions. Perforation and penetration of adjacent organs with intra-abdominal abscess formation as the initial presentation is uncommon. It is difcult to make an accurate diagnosis of abscess formation as the rst evidence of colonic carcinoma preoperatively. A 68 yrs old female who presented to the ED with acute onset of left lower abdominal f Case presentation: ullness, pain and local redness for 15 days. She denied any history of vomiting, fever, anorexia but history of altered bowel habit. Clinically she had a palpable lump (20 x15) cm in left lumber region .The lump was parietal with local raise of temperature , redness and tenderness can be elicited . So our initial impression was parietal wall abscess and we underwent emergency drainage of abscess. She had uneventful recovery and discharged after 2 weeks. She was admitted with similar presentation in previous location 30 days after discharge. Now we investigate thoroughly, a CECT scan of whole abdomen which conrms radio-logically as carcinoma of descending colon with abscess extending into the parietal wall .We underwent an exploratory laparotomy and HPE proven as adenocarcinoma of the colon. Post op she developed SSI which was managed with regular dressing and she was discharged in post-op day 20. We report this case because of an unusual Conclusion: presentation of left sided colonic Ca. The accurate preoperative diagnosis of these conditions extremely complicated because of the fuzzy clinical presentation. The CT scan can diagnose malignancy pre-operatively, even if the denitive diagnosis of colonic perforated neoplasia may be evident only during surgery. So early diagnosis and prompted intervention can save the patient to developed sepsis and to reduce signicantly the morbidity and mortality. The importance is to focus on the differential diagnosis and keep in mind that a colon carcinoma can present with abdominal abscess. Surgeons should be aware of this differential because it is easily ignored pre-operatively.

scholarly journals Intra thyroid thyroglossal cyst: a rare presentation

2019 ◽  
Vol 7 (8) ◽  
pp. 3189
Author(s):  
Lakshmi V. P. ◽  
Divya Surendran ◽  
Savithri Moothiringode
Keyword(s):  
Congenital Malformation ◽  
Thyroglossal Duct Cyst ◽  
Thyroglossal Cyst ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Incomplete Closure

Thyroglossal duct cyst is a congenital malformation occurring due to incomplete closure of the thyroglossal duct. The infrequency with which it is encountered in thyroid makes it a formidable diagnostic challenge. Authors report this case because of the rarity of intrathyroid location of thyroglossal cyst. 

scholarly journals Eccrine Angiomatous Hamartoma: A Rare Presentation in Late Adulthood

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Zeany Cheran Momin ◽  
Veena Gupta ◽  
Gauri Munjal ◽  
Rahul Jakhar ◽  
Chandershekhar Yadav ◽  
...  
Keyword(s):  
The Elderly ◽  
Interesting Case ◽  
Concurrent Chemotherapy ◽  
Early Infancy ◽  
Carcinoma Cervix ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Late Adulthood ◽  
Vascular Elements ◽  
Infancy And Childhood

Eccrine angiomatous hamartoma is a tumor characterized by benign malformation of eccrine and vascular elements, occurring generally at birth or during early infancy and childhood. The rarity with which it is encountered in adults and the elderly makes it a diagnostic challenge in such age brackets. We report an interesting case of eccrine angiomatous hamartoma presenting in late adulthood confirmed by histopathology. Keywords: Cisplatin, concurrent chemotherapy, daily, weekly, three weekly, carcinoma cervix

Rectal cancer mimic: a rare case of syphilitic proctitis

2020 ◽  
Vol 13 (12) ◽  
pp. e235522
Author(s):  
Rajashri Veeresh Patil ◽  
Iain Stephenson ◽  
Cathy J Richards ◽  
Yvette Griffin
Keyword(s):  
Rectal Cancer ◽  
Sexually Transmitted Infection ◽  
Rare Case ◽  
Surgical Intervention ◽  
Secondary Syphilis ◽  
Sexual History ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Transmitted Infection ◽  
Sexually Transmitted

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.

Unilateral papilledema in idiopathic intracranial hypertension: A rare entity

2020 ◽  
pp. 112067212096904
Author(s):  
Mousumi Banerjee ◽  
Swati Phuljhele Aalok ◽  
Deepti Vibha
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Pseudotumor Cerebri ◽  
Clinical Syndrome ◽  
Unknown Etiology ◽  
Obese Women ◽  
Mechanical Compression ◽  
Childbearing Age ◽  
Diagnostic Challenge ◽  
Rare Presentation

Idiopathic Intracranial Hypertension (IIH), also known as pseudotumor cerebri is a clinical syndrome of unknown etiology, which typically affects young, obese women of childbearing age and is characterized by increased intracranial pressure and bilateral papilledema. Unilateral and highly asymmetrical papilledema is a rare presentation in IIH occurring in less than 4% of patients with definite IIH and can poses a diagnostic challenge for the treating physician as it usually raises the suspicion of localized ocular pathology. As per current consensus, papilledema results in stasis of axoplasmic transport due to mechanical compression, leading to secondary vascular changes of venous dilation and hemorrhage. Given this mechanism, the underlying reasons for unilateral and asymmetrical papilledema remain unclear.

scholarly journals A Rare Case of Duodenal Adenocarcinoma Presenting as a Subepithelial Lesion in a Patient Undergoing Investigation for Iron Deficiency Anaemia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Xinxin Hu ◽  
Karina Aivazian ◽  
Catriona McKenzie ◽  
May Wong ◽  
Arthur Kaffes ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Rare Case ◽  
Iron Deficiency Anaemia ◽  
Duodenal Adenocarcinoma ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Duodenal Lesion ◽  
Deficiency Anaemia ◽  
Subepithelial Lesion ◽  
Single Balloon

Introduction. Adenocarcinomas account for approximately 40% of small bowel cancers. They are typically mucosal lesions with distinctive features on endoscopy. We describe a rare case of duodenal adenocarcinoma presenting as a subepithelial lesion which posed a diagnostic challenge. Case. An 85-year-old male patient presented for investigation of iron deficiency anaemia. Initial upper endoscopy found a subepithelial duodenal lesion with central depression but otherwise normal appearing mucosa. Superficial biopsies of the duodenal lesion were unremarkable. Subsequent antegrade single balloon enteroscopy revealed active bleeding from the lesion which was refractory to endoscopic treatment. A complete local excision of the lesion via laparotomy was necessary to achieve haemostasis. Histopathology from the lesion showed a moderately differentiated duodenal adenocarcinoma with invasion into the submucosa but no evidence of lymphovascular spread. Conclusion. Duodenal adenocarcinomas are rare gastrointestinal tumours associated with a poor prognosis. This case report outlines a rare presentation of duodenal adenocarcinoma and highlights the importance of judicious assessment of lesions found on endoscopy. Advances in endoscopic diagnostic modalities could facilitate early diagnosis and improve therapeutic outcomes.

scholarly journals Terrible triad elbow with tricep avulsion: diagnostic challenge and treatment dilemma: case report

2021 ◽  
Vol 7 (3) ◽  
pp. 671
Author(s):  
Jeetendra Prakash Katariya ◽  
Anup Milind Khatri ◽  
Ashish Kumar
Keyword(s):  
Case Report ◽  
Traffic Accident ◽  
Locking Plate ◽  
Suture Anchor ◽  
Road Traffic ◽  
Terrible Triad ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
The Right ◽  
Time Of Presentation

<p class="abstract">Triceps Avulsion with terrible triad of elbow is a rare presentation and often missed at the time of presentation. The aim of this case report is to identify triceps avulsion in patients with terrible triad elbow and help in its management and post-operative mobilization protocol. We report a case of 40-year male, a case of road traffic accident with right elbow terrible triad injury with triceps avulsion. The radial head was fixed with 2.5 mm locking plate and screws and suture anchor was used for triceps avulsion. Elbow mobilization was started at 2 weeks post-operatively. In patients with terrible triad injuries, diagnosis of triceps avulsion is very challenging because of swelling, pain and difficult to examine triceps for extension power. It is important to know this type of presentation of triceps avulsion with terrible triad to address the diagnostic pathway in the right direction and to treat them promptly. Missing triceps avulsion in complex injuries may hamper post-operative elbow range of movements in form of extension lag or triceps weakness.</p>

scholarly journals Hypertrichotic Giant Nevus Spilus Tardivus and Neurofibroma of the Tongue in Sporadic von Recklinghausen’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Prabhath Ramakrishnan ◽  
Vijay Sylvester ◽  
Prathima Sreenivasan ◽  
Janisha Vengalath ◽  
Smruthi Valambath
Keyword(s):  
Neurofibromatosis Type ◽  
Von Recklinghausen’S Disease ◽  
Von Recklinghausen's Disease ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Becker’S Nevus ◽  
Recklinghausen's Disease ◽  
Benign Tumours ◽  
Giant Nevus ◽  
Recklinghausen’S Disease

Solitary neurofibromas are rare, benign tumours of nonodontogenic origin. The presentation of a solitary neurofibroma on the tongue is an uncommon occurrence and we present such a case here which was discovered in concomitance with multiple neurofibromatosis type 1 (von Recklinghausen’s disease). Such a rare presentation seen in this case is a diagnostic challenge and often clinched only with the aid of histopathological and immunohistochemical examination. This work also discusses the various differential diagnoses that can be considered in similar cases. The presence of a hypertrichotic “giant” nevus spilus tardivus (Becker’s nevus) is also a rare finding in this particular case. We present such a case which will be of interest to the budding dental practitioner. The lesion was excised and the patient followed up without any evidence of malignant transformation.

scholarly journals Acute Renal Failure Secondary to Tuberculosis: A Diagnostic Challenge

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Saeed I. Khilji ◽  
Hong Kuan Kok ◽  
Limy Wong ◽  
Anthony M. Dorman ◽  
J. Joseph Walshe
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Biopsy ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Antituberculosis Treatment ◽  
Clinical Presentations ◽  
Renal Tuberculosis ◽  
Repeat Renal Biopsy ◽  
Multiorgan Disease

Tuberculosis is a multiorgan disease with varied clinical presentations and is reemerging due to increasing immigration and globalization. We present the case of an immigrant female patient who developed acute renal failure with clinical and biochemical features suggestive of lupus nephritis but with a timely renal biopsy showing caseating granulomata in the renal parenchyma consistent with renal tuberculosis. Despite treatment with antituberculosis treatment and resolution of TB on repeat renal biopsy, she remained haemodialysis dependent. We discuss the diagnostic challenges faced in this presentation and also explore possible differential diagnoses. This rare presentation highlights the importance of renal biopsy in the diagnosis and treatment of acute renal failure and the atypical presentation of tuberculosis.

Great auricular nerve schwannoma: a rare presentation and literature review

2021 ◽  
Vol 14 (7) ◽  
pp. e242972
Author(s):  
Soo Oh ◽  
Ahmad Abou-Foul ◽  
Sanjay Patel ◽  
Paul Wilson
Keyword(s):  
Literature Review ◽  
Surgical Management ◽  
Diagnostic Challenge ◽  
The West ◽  
Rare Form ◽  
Rare Presentation ◽  
Great Auricular Nerve ◽  
Nerve Sheath ◽  
Slow Growing ◽  
Cutaneous Innervation

Head and neck schwannomas are a rare form of tumour arising from the nerve sheath. They are often slow growing and asymptomatic, posing a diagnostic challenge for clinicians. The great auricular nerve (GAN) provides cutaneous innervation to the lower pinna, ear lobule and the inferior periauricular area. Hence, surgical management of GAN schwannomas can have sensory and functional dysfunction postoperatively, necessitating good counselling and communication with the patient. We present the first documented case of GAN schwannoma in the West, with literature review and considerations for surgical management.

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