scholarly journals Choriocarcinoma (stage IV) despite two normal dilation and curettages: A case report

2021 ◽  
Vol 12 (5) ◽  
pp. 312-314
Author(s):  
Bijan Morshedi ◽  
Laura Haworth ◽  
Traci Ito
Keyword(s):  
Case Report ◽  
Pregnancy Loss ◽  
Care Center ◽  
Stage Iv ◽  
Clinical Suspicion ◽  
Molar Pregnancy ◽  
Early Pregnancy Loss ◽  
High Clinical Suspicion ◽  
Clear Explanation ◽  
Ectopic Pregnancies

Choriocarcinoma is a highly metastatic subtype of gestational trophoblastic neoplasia (GTN) following pregnancy. It can arise from any type of pregnancy (50% occur after term pregnancies, 25% after molar pregnancies, and 25% after early pregnancy loss and ectopic pregnancies) (Soper, 2006). This case report describes an interesting diagnostic conundrum with normal histology findings on two separate endometrial dilation and curettages (D&C) and a unilateral oophorectomy in the context of high clinical suspicion for molar pregnancy that progressed to stage IV choriocarcinoma with brain and lung metastasis. The patient presented to our hospital nearly aphasic but would only say “molar pregnancy”. Due to her brain metastasis and worsening intraparenchymal hematoma, she underwent craniotomy confirming the diagnosis. After stabilization, she was transferred to a quaternary care center to complete chemotherapy with etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine and had a good response. At this time, there is no clear explanation for normal histology on two separate D&Cs and a unilateral oophorectomy in the context of a classic case of choriocarcinoma with progression from a molar pregnancy. It reminds us as providers that medicine remains an imperfect science and requires astute clinical judgement to properly treat patients when diagnostic data such as pathology findings and lab values appear to be incongruent with the larger clinical picture.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

Placental mesenchymal dysplasia- A case report

2021 ◽  
Vol 6 (3) ◽  
pp. 249-252
Author(s):  
Zeba Nisar ◽  
Mahendra A Patil ◽  
Vaishali J Pol ◽  
Jaydeep N Pol
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Clinical Suspicion ◽  
Termination Of Pregnancy ◽  
Rare Disorder ◽  
Molar Pregnancy ◽  
Female Fetus ◽  
Beta Hcg ◽  
Antenatal Visits ◽  
Placental Mesenchymal Dysplasia

Placental mesenchymal dysplasia is a rare disorder mainly characterized by enlarged placenta. Patients on antenatal visits present with normal or slightly raised Beta-HCG, raised Alfa-fetoprotein and cystic structures on USG resembling a molar pregnancy. It has to be differentiated from molar pregnancies to avoid unnecessary termination of pregnancy. This condition is associated with IUGR or IUFD. Mostly the fetus are females. Due to lack of awareness of this condition it remains underreported. Here we present a case report of 20 years old female 37 week pregnant with IUGR with clinical suspicion of molar pregnancy gave birth to alive female fetus and on histopathological examination of placenta was diagnosed with PMD.

scholarly journals Giant dermoid cyst mimicking posterior fossa tumors in a child: A Case Report and Review of the Literature

2020 ◽  
Vol 2 (2(May-August)) ◽  
pp. e452020
Author(s):  
Leopoldo Mandic Ferreira Furtado ◽  
José Aloysio da Costa Val Filho ◽  
Bruno Lacerda Sandes ◽  
Plínio Duarte Mendes ◽  
Patrícia Salomé Gouvea Braga
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Clinical Suspicion ◽  
Review Of The Literature ◽  
Benign Lesions ◽  
Posterior Fossa Tumors ◽  
Case Presentation ◽  
High Clinical Suspicion ◽  
Neuroimaging Data ◽  
Epidemiological Characteristics

Introduction: Intracranial dermoid cysts are rare, congenital and, benign lesions. The etiology of these lesions is related to an embryonic defect during neurulation. Case presentation: The present study describes a case of a 3-year-old girl with a giant cerebellar dermoid cyst, which initially manifested as hydrocephalus. Discussion: We discuss its epidemiological characteristics as well as diagnostic and therapeutic management. The combination of high clinical suspicion, anamnesis, thorough physical examination, and adequate interpretation of neuroimaging data is crucial for the early diagnosis and timely therapeutic intervention for such cysts. Conclusion: Surgical approach involving complete lesion resection considerably improves prognosis.

scholarly journals Septic Shock due to Capnocytophaga: A Case Report

2021 ◽  
pp. 18-22
Author(s):  
Guillermo Jiménez-Álvarez ◽  
Sonia López-Cuenca ◽  
Belén Quesada-Bellver
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Close Contact ◽  
Blood Cultures ◽  
Clinical Suspicion ◽  
Common Cause ◽  
Gram Negative ◽  
High Clinical Suspicion ◽  
Risk Patients ◽  
First Time

The genus Capnocytophaga spp., recorded for the first time in 1979, comprises gram-negative bacilli, that colonize the oral mucosa of dogs and, to a lesser extent, cats, so that human transmission can be due to biting, scratching or close contact. Though it is not a common cause of infection in humans, it is a potentially serious one, which can occasionally go unnoticed causing sepsis, bacteremia, meningitis and endocarditis. A high clinical suspicion is essential for its diagnosis, especially in high-risk patients, such as alcoholics or splenectomized patients, as time to positivity of blood cultures may take as long as 6 days. Antibiotic treatment should last several weeks.

scholarly journals Cerebral phaeohyphomycosis due to Cladophialophora bantiana in an immunocompetent individual: A case report and brief review of literature

2020 ◽  
Author(s):  
Prachala G. Rathod ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Poonam S. Loomba ◽  
Abha Sharma ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Abscess ◽  
Fungal Infections ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Clinical Suspicion ◽  
Laboratory Evaluation ◽  
Cns Infection ◽  
Dematiaceous Fungi ◽  
High Clinical Suspicion

Background and Purpose: Fungal infections of the central nervous system (CNS) are life-threatening conditions that are frequently misdiagnosed with bacterial and viral CNS infections. Cerebral phaeohyphomycosis is a cerebral infection caused by dematiaceous fungi, especially Cladophialophora bantiana. Very few cases of fungal CNS infection have been reported across the world. High clinical suspicion should be cast for the patients with brain abscess that do not respond to conventional antibiotic therapy. Case report: We report a case of a 21-year-old male presenting with headache, seizures and weakness in the limbs. Radiological examination revealed multiple brain abscesses. After surgical excision and laboratory evaluation, it was found to be caused by C. bantiana. The patient’s outcome was good with surgical excision and voriconazole therapy. Conclusion: Brain abscess caused by C. bantiana is on rise, especially in immunocompromised groups. Thus, high clinical suspicion, accurate diagnosis and management are the fundamentals for good prognosis.

scholarly journals Primary Hepatic Neuroendocrine Tumor and its Metastasis to Breast; Case Report of an Unusual Malignancy

2021 ◽  
Vol 6 (4) ◽  
pp. 14-25
Author(s):  
Amjad Zafar ◽  
Rabia Iqbal ◽  
Amina Jafar ◽  
Taimoor Bajwa ◽  
Sobia Yaqub ◽  
...  
Keyword(s):  
Case Report ◽  
Mass Effect ◽  
Typical Feature ◽  
Clinical Suspicion ◽  
Unusual Site ◽  
Rare Tumors ◽  
High Clinical Suspicion ◽  
Clinical Presentations ◽  
Metastasis To Breast ◽  
Primary Hepatic Neuroendocrine Tumor

Introduction: Neuroendocrine tumors (NETs) are rare tumors with varied clinical presentations. Entero-pancreatic and respiratory systems are usually involved but it can also affect unusual sites like the liver. Purpose: This paper presents a case of a 45 years female who developed progressive and disabling symptoms of mass effect and carcinoid but remained undiagnosed for many years due to extremely low suspicion of such a tumor in liver. Methods: Diagnosis was made after extensive radiological, histopathological, and biochemical investigations. By that time, disease had spread to her breast which is also not a typical feature of NETs. Findings: Diagnosis of rare tumors at an unusual site is challenging and requires high clinical suspicion and appropriate workup.

scholarly journals Peripheral Facial Palsy in the Setting of Melkersson-Rosenthal Syndrome

2001 ◽  
Vol 20 (2) ◽  
pp. 233-235
Author(s):  
Sabrina Pimentel ◽  
Amélia Mendes ◽  
Maria José Rosas
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Clinical Suspicion ◽  
Peripheral Facial Palsy ◽  
High Clinical Suspicion ◽  
Clinical Triad ◽  
Suspicion Index ◽  
Fissured Tongue

Melkersson-Rosenthal syndrome is characterized by recurrent periph­eral facial palsy, recurrent or persistent orofacial edema and a fissured tongue. However, this clinical triad occurs only in a minority of cases; mono or oligosymptomatic forms are much more common. The au­thors describe a case report of a 39-year-old woman with Melkersson- Rosenthal syndrome, discuss the evolution of the disease and treat­ment, highlighting the need of a high clinical suspicion index and a regular follow-up to reduce progression of deficits

scholarly journals Acute respiratory failure in an infant and thiamine deficiency in West Africa: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
L Hiffler ◽  
K Escajadillo ◽  
M Rocaspana ◽  
S Janet
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Thiamine Deficiency ◽  
Severe Pneumonia ◽  
West African ◽  
Clinical Suspicion ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
Diagnostic Capacity ◽  
Low Threshold

Abstract In paediatrics, the overall clinical picture of thiamine deficiency (TD) is not easy to recognize, because it mimics or can be confused with other diseases even in cases of classic beriberi. Unsurprisingly, the likelihood of misdiagnosis of TD is even greater where beriberi has not been described. Critically ill patients have increased thiamine body consumption and dextrose-based IV fluid increases thiamine cellular demand even further. Consequently, severe acute conditions may result in TD, or trigger TD signs in patients with borderline thiamine status, with life-threatening consequences. Here, we describe the case of a young patient admitted to a West African hospital where TD is not well documented and diagnosed with severe pneumonia who responded dramatically to thiamine injection. The lack of rapid diagnostic capacity and the severe outcome of TD justify the use of a therapeutic thiamine challenge in cases with high clinical suspicion. Increased awareness about TD and low threshold for thiamine use should guide clinicians in their practice.

scholarly journals Parvovirus B-19 Infection During Pregnancy

2003 ◽  
Vol 11 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Anthony Al-Khan ◽  
Andrew Caligiuri ◽  
Joseph Apuzzio
Keyword(s):  
Pregnant Woman ◽  
Pregnancy Loss ◽  
Preventive Measures ◽  
Treatment Options ◽  
Clinical Suspicion ◽  
Early Pregnancy Loss ◽  
Intrauterine Blood Transfusion ◽  
Large Groups ◽  
Nonimmune Hydrops ◽  
Parvovirus B 19

The development of an acute parvovirus B-19 infection during pregnancy can cause pregnancy complications ranging from early pregnancy loss to nonimmune hydrops. There is no treatment, but preventive measures can be used to decrease perinatal mortality. The diagnosis is made on the basis of clinical suspicion and serology. If the fetus exhibits hydrops in the latter part of pregnancy, the main treatment options include either correcting the associated anemia with intrauterine blood transfusion or birth with extrauterine management. Although the serious problems associated with this virus during pregnancy are uncommon, they can be fatal. In view of this, a pregnant woman who is antibody negative should try to avoid contact with large groups of young children in order to decrease contact with potential vectors.

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