scholarly journals Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

2021 ◽  
Author(s):  
Henghai Huang ◽  
Qijian Ding ◽  
XiaoCao Lin ◽  
DeLin Li ◽  
Jingjing Zeng ◽  
...  

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

Author(s):  
Eloisa Muller de Carvalho ◽  
Fernando Kendi Horikawa ◽  
Letícia Guimaraes ◽  
Stephanie Kenig Viveiros ◽  
Celso Augusto Lemos ◽  
...  

Ameloblastic fibroma is a rare benign odontogenic tumor in which both the epithelial and ectomesenchymal components are neoplastic. A 24-year-old male patient was referred to the Stomatology Department presenting with difficulty to chew and swelling in the right posterior region of the mandible. The panoramic radiograph showed a well-circumscribed, unilocular radiolucent lesion with partially radiopaque borders involving first and second unerupted molars. Computed tomography imaging presented a hypodense image with well‑delimited isodense content, bulging cortical bones and absence of rupture. The patient underwent an incisional biopsy.  Microscopically, the lesion was composed of many mesenchymal tissue cells in strand form, arranged in cords, islands and nests of odontogenic epithelium; the diagnostic was ameloblastic fibroma. The patient was referred to the hospital for enucleation and curettage of the lesion and extraction of the associated teeth. After 8 months of follow-up, no recurrence was observed. This case emphasizes the importance of differential diagnosis, anatomopathological exam, and both clinical and imaging follow-up, since tumors of this type can recur and progress to malignancy.


2016 ◽  
Vol 21 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Hatice Ataş ◽  
Müzeyyen Gönül

Background: Cryosurgery is an effective treatment for sebaceous hyperplasia, but there have been few clinical studies. Objectives: The aim of this study was to evaluate the efficacy and safety of cryosurgery in the treatment of sebaceous hyperplasia. Methods: Cryosurgery was performed 6 times, at 2-week intervals, with liquid nitrogen, and evaluated in 40 patients with 517 lesions ranging from 2 to 9 mm over the forehead, cheeks, and chin. All of the lesions were measured before and after the treatment. Results: The mean age of the participants was 54.7 ± 8.9 years, and the male/female ratio was 21/19 (1.1). The mean time of the disease duration was 4.2 ± 3.0 years. After 6 cooling cycles, an excellent response (76%-100%) was seen in 341 patients (65.9%), a very good response (51%-75%) was seen in 102 (19.7%), a good response (26%-50%) was seen in 57 (11.1%), a poor response (1%-25%) was seen in 15 (2.9%), and no response (0%) was seen in 2 (0.4%). Age ( P = .004) and sex ( P < .0001) were independent predictors of an excellent response. The excellent response rates were 71.4% for males, 61.8% for females, 70.4% for ages older than 55 years, and 61.8% for ages younger than 55 years. Temporary hyperpigmentation was found in 5 lesions (0.96%), and recurrence was not seen at the 4-month follow-up. Conclusions: The well-aimed and controlled used of cryosurgery is an effective method for treating significant cosmetic disfigurement in patients with sebaceous hyperplasia. It is a low-cost therapy without scarring, hypopigmentation, or recurrence.


2019 ◽  
Vol 5 (2) ◽  
pp. 54-57
Author(s):  
Antonio Chambo Filho ◽  
◽  
Emmanuel Nasser Vargas Araujo de Assis ◽  
Flávia de Sousa Freitas Scherre ◽  
Luciene Lage da Motta ◽  
...  

Aggressive angiomyxoma is a locally aggressive tumor of mesenchymal origin. The condition predominantly affects females, with a male/female ratio of 6:1. Most cases occur during the reproductive years, with a peak between the third and fourth decades of life. The symptoms are non-specific, and the principal differential diagnosis is with Bartholin’s cysts or abscesses. The treatment of choice is surgical excision of the lesion, including evaluation of the margins. This case report refers to a 41-year old patient with an insidiously growing lesion on the right vestibular area measuring approximately 9 x 5 x 5 cm, associated with dyspareunia. Surgical excision was successful, and there have been no signs of tumor recurrence in the six months of follow-up. Differential diagnosis in cases of vulvar lesions is of the utmost importance. A detailed vulvar examination is essential to ensure early diagnosis and to reduce the rate of underdiagnosed cases of aggressive angiomyxoma


Author(s):  
Simone Meini ◽  
Lorenzo Roberto Suardi ◽  
Michele Busoni ◽  
Anna Teresa Roberts ◽  
Alberto Fortini

Abstract Purpose. COVID-19 displays a variety of clinical manifestations; in pauci-symptomatic patients olfactory (OD) and gustatory dysfunctions (GD) may represent the first or only symptom. To date, literature addressing these disorders is scarce. Aim of this study is to investigate the timing of recovery from OD and GD in a real-life COVID-19 population.Methods. We followed up by a phone interview the first 100 patients discharged a month earlier from three Italian non-intensive care wards.Results. All patients were Caucasian, mean age was 65 years, 60% were males. OD and GD were early symptoms reported by 29% and 41% of patients, respectively. Among the 42 symptomatic patients, the male/female ratio was 2:1; 83% reported an almost resolved dysfunction at follow-up. The recovery rate was not significantly different between males and females. The mean duration of OD and GD was 18 and 16 days, respectively. The mean recovery time from OD or GD resulted significantly longer for females than for males (26 vs 14 days, p=0.009). Among the 42 symptomatic, the mean age of males was significantly higher than that of females (66 vs 57 years, p=0.04), while the opposite was observed in the 58 asymptomatic patients (60 vs 73 years, p=0.0018).Conclusions. Recovery from OD or GD was rapid, occurring within 4 weeks in most patients. Chemosensory dysfunctions in women was less frequent, but longer lasting. The value of our study is its focus on a significantly older population than those previously described, and to add further data on gender differences.


2021 ◽  
Vol 12 (4) ◽  
pp. 2615-2629
Author(s):  
Swapnil Date ◽  
Kiran Saoji ◽  
Kushal Surana

Clavicle fractures account for about 2.6 to 4 % of all fractures. The best method to treat the displaced midshaft fracture of the clavicle remains a topic of debate. Although there is a large number of studies published about this topic, it is still relatively unknown as to which modality provides better long term functional outcomes and low complications rates. In our study, we have analyzed midshaft clavicle fracture treated with intramedullary device versus conservatively in terms of clinical, functional and radiological outcomes. The mean age of the patients in our study was 35.766 years. Male: Female ratio was 5.0:1.0.  The mean time interval between injury and intervention was 2.1 days. Out of 30 patients, 11 patients (36.666%) had left sided fractures, while 19 patients (63.333%) had right sided fractures. Out of 30 patients, 12 patients (40%) had type 2B1 fracture according to Robinson's classification, followed by type 11 patients (36.666%) type 2B2, 6 patients (20%) type 2A1 and 1 patient (3.333%) type 2A2 fracture. Inoperative group, the mean Constant and Murley score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 47.46, 76.73, 82.8 and 90.73, while in a conservative group, it was 47.53, 71.66, 79.2 and 89.46 respectively. Inoperative group, the mean Q-DASH score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 29.33, 19.33, 16.86 and 13.8, while in a conservative group, it was 31.266, 22.533, 18.8 and 15.66 respectively. The final outcome, on the basis of the final Constant and Murley score in 13 patients (43.33%), was excellent, 11 patients (36.66%) was good and 6 patients (20%) was fair. Inoperative group, complications were seen in 6 patients (40%), while in the conservative group, complications were seen in 10 patients (66.66%). Thus, the functional, clinical and radiological outcome of the patients managed surgically with an intramedullary device was significantly better when compared with patients treated conservatively.


2011 ◽  
Vol 24 (1) ◽  
pp. 43-47
Author(s):  
NS Afsar ◽  
MMN Khan ◽  
MMH Chowdhury ◽  
SA Haq ◽  
M Khalilur Rahman ◽  
...  

Background: Spondyloarthropathies include a wide spectrum of disease. The study was conducted with the aim of observing the efficacy of SSZ and MTX in different subclasses of spondyloarthropathies and to compare the treatment response of the two drugs. Methods: This study was conducted in the Department of Medicine and Rheurnatology clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) between January 1999 and July 2001.A total number of one hundred twenty five patients was included in the study. Patients with active disease more than three months, regularly taking NSAIDs and not on DMARD in the last three months were included in the study. Monthly follow up of the patients was done for 6 months. Result: One hundred twenty five patients were included in this study. Male female ratio was 11.5:1. Mean age of patients was 24.17±7.15 years. The mean disease duration was 47.8±32.8 months. The present study categorized the patients into responder and non responder. Among the 78 patients in AS subclass, after completion of 6 month trial 55.6% patients in SSZ group and 39.4% patients in MTX group were categorized responder. The difference of response between drug groups was not significant (p=0.158). In the JCA subclass 81.82% in SSZ and 50% in MTX group were responder. The numbers of patient in Reiter's/Reactive Arthritis in our study were too small to make a definite comment. Conclusion: It can be concluded from this study that both the SSZ and MTX are effective DMARDs for spondyloarthropathies. Statistical analysis did not prove superiority of one drug over another, though the response rates were numerically higher in SSZ group. TAJ 2011; 24(1): 43-47


1998 ◽  
Vol 23 (2) ◽  
pp. 196-200 ◽  
Author(s):  
C. HILL ◽  
M. RIAZ ◽  
A. MOZZAM ◽  
M. D. BRENNEN

This study reports the characteristics, causes and disposal of isolated injuries to the hand and wrist presenting to six accident and emergency departments over a period of 4 months. The rate of isolated injury to the hand or wrist was 6.6%. The male: female ratio was 2.2: 1, with the mean age for injury being 26.4 years in men and 29.2 years in women. The modal age group for injury was 21–25 years in men and 11–15 years in women. The right and left hand were injured almost equally. The dominant hand was more commonly injured although this was influenced by the cause of injury: 16.3% were caused by a fall; 15% by sport; and 7% were work/machinery related. 13.3% were referred to specialities for further treatment.


Author(s):  
Faiq I. Gorial ◽  
Sabeeh Mashhadani ◽  
Hend M Sayaly ◽  
Basim Dhawi Dakhil ◽  
Marwan M AlMashhadani ◽  
...  

Background: To date no effective therapy has been demonstrated for COVID-19. In vitro, studies indicated that ivermectin (IVM) has antiviral effect. Objectives: To assess the effectiveness of ivermectin (IVM) as add-on therapy to hydroxychloroquine (HCQ) and azithromycin (AZT) in treatment of COVID-19. Methods: This Pilot clinical trial conducted on hospitalized adult patients with mild to moderate COVID-19 diagnosed according to WHO interim guidance. Sixteen Patients received a single dose of IVM 200Mcg /kg on admission day as add on therapy to hydroxychloroquine ( HCQ)and Azithromycin (AZT) and were compared with 71 controls received HCQ and AZT matched in age, gender, clinical features, and comorbidities. The primary outcome was percentage of cured patients, defined as symptoms free to be discharged from the hospital and 2 consecutive negative PCR test from nasopharyngeal swabs at least 24 hours apart. The secondary outcomes were time to cure in both groups and evaluated by measuring time from admission of the patient to the hospital till discharge. Results: Of 87 patients included in the study,t he mean age ± SD (range) of patients in the IVM group was similar to controls [44.87 ± 10.64 (28-60) vs 45.23 ± 18.47 (8-80) years, p=0.78] Majority of patients in both groups were male but statistically not significant [11(69%) versus 52 (73%), with male: female ratio 2.21 versus 2.7-, p=0.72) All the patients of IVM group were cured compared with the controls [ 16 (100 %) vs 69 (97.2 %)]. Two patients died in the controls. The mean time to stay in the hospital was significantly lower in IVM group compared with the controls (7.62 ±2.75 versus 13.22 ±.90 days, p=0.00005, effect size= 0.82). No adverse events were observed Conclusions : Add-on use of IVM to HCQ and AZT had better effectiveness, shorter hospital stay, and relatively safe compared with controls. however, a larger prospective study with longer follow up may be needed to validate these results.


2020 ◽  
Vol 8 (T1) ◽  
pp. 627-633
Author(s):  
Masoomeh Raoufi ◽  
Shahram Kahkouee ◽  
Jamileh Bahri ◽  
Neda Khalili ◽  
Farzaneh Robatjazi ◽  
...  

AIM: We investigated the serial changes of chest computed tomography (CT) in patients with coronavirus disease-2019 (COVID-19) presenting with viral-induced lung damage on follow-up CT. METHODS: We evaluated 66 patients with confirmed COVID-19, who had undergone at least two chest CTs from February 24 to April 21, 2020. Nine patients also had a third CT. All patients demonstrated viral-induced lung damage (organizing pneumonia-like pattern) on second CT. The involvement pattern of each lobe and the extent of infiltration (based on CT score) were assessed on serial CTs to determine changes throughout the disease course. Patients’ demographic and clinical data and final outcome were also recorded. RESULTS: Mean age (standard deviation [SD]) of patients was 56.04 (15.2) years old; 51.5% were male. About 93.9% of patients had survived. Mean (SD) interval between the first and second CT and second and third CT was 7.6 (5.9) and 16.8 (8.3) days, respectively. The extent of total lung involvement was significantly higher in the second CT compared with the first CT (p < 0.001) and also increased non-significantly in the third CT (p = 0.29). The right lower lobe persistently had the highest CT score through the disease course. CONCLUSION: Evaluation of serial CT imaging can reveal information regarding the stage of COVID-19, thus providing help for appropriate treatment planning.


2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy


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