Lingual Focal Hyperplastic Lesion in a Pediatric Patient: Report of an Unusual Case

Focal fibrous hyperplasia (FFH) is an oral mucosal localized non-neoplastic enlargement representing a reaction to chronic local irritations or injuries. The purpose of this report is to describe the management of an asymptomatic fibrotic lesion located in the tongue, in a preschooler boy. A 7-year-6-month old boy attended our clinic for the evaluation of an exophytic pedunculated tumor-like round mass located in the dorsal surface of the tongue. Based on the initial examination and the natural history of the lesion, the presumptive clinical diagnosis determined an irritation FFH. The lesion was surgically excised with a diode laser device, and the postoperative period evolution occurred without any complication. The appropriate treatment of FFH in children initially consists of the removal of local irritant factors. Excellent oral hygiene maintenance and close follow-up care are strongly suggested. Surgical excision is the most frequent modality for persistent lesions. Early diagnosis and proper management of FFH can reduce the risk of future recurrences or complications.

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Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽

10.1177/27325016211053640 ◽

2021 ◽

pp. 273250162110536

Author(s):

Joshua Harrison ◽

Samantha Marley ◽

Shawhin Shahriari ◽

Christian Bowers ◽

Anil Shetty

Keyword(s):

Frontal Sinus ◽

Surgical Excision ◽

Extramedullary Plasmacytoma ◽

High Rate ◽

Solitary Plasmacytoma ◽

Case Presentation ◽

Long Term Follow Up ◽

History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

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A case of retroperitoneal tumor – clinical and therapeutic considerations

ARS Medica Tomitana ◽

10.1515/arsm-2016-0034 ◽

2016 ◽

Vol 22 (3) ◽

pp. 203-207

Author(s):

R. Osman ◽

V. Sarbu ◽

S. Osman

Keyword(s):

Rare Condition ◽

Surgical Excision ◽

Retroperitoneal Tumor ◽

Lumbar Pain ◽

Pathological Examination ◽

Nerve Sheath Tumor ◽

Abdominal Girth ◽

Computed Tomographic ◽

Appropriate Treatment ◽

History Of

Abstract Introduction: The aim of this paper is to present a case of rare retroperitoneal tumor. Material and Methods. A 72 year old man presented with six month history of abdominal girth, lumbar pain and occasional episodes of constipation was admitted in our clinic. A computed tomographic abdominal scan revealed a retroperitoneal solid mass. Surgical exploration performed later displayed solid and well delimited mass throughout retroperitoneal space followed by excision of lesion and multiple drainages. Microscopic pathological examination was benign nerve sheath tumor. Conclusion. These tumors are characteristically firm, smooth, and asymptomatic. They range in size from 1-2 mm to over 20 cm. Awareness of this indolent and rare condition is an important prerequisite for early diagnosis and appropriate treatment. Surgical excision can usually be accomplished by enucleating of the tumor without damage to the adjacent nerve.

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Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature

Neurosurgery Open ◽

10.1093/neuopn/okaa006 ◽

2020 ◽

Vol 1 (3) ◽

Author(s):

Pouya Nazari ◽

Pedram Golnari ◽

Madhav Sukumaran ◽

Ali Shaibani ◽

Michael C Hurley ◽

...

Keyword(s):

Unusual Case ◽

Middle Meningeal Artery ◽

Complete Healing ◽

Spontaneous Thrombosis ◽

Pseudoaneurysm Formation ◽

Arteriovenous Fistulas ◽

History Of ◽

The Right ◽

Repeat Imaging

ABSTRACT BACKGROUND AND IMPORTANCE Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results. CLINICAL PRESENTATION A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm. CONCLUSION Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.

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Small Bowel Obstruction by Wireless Enteroscopic Capsule and Unrecognized Intestinal Stricture

The American Surgeon ◽

10.1177/000313480607201213 ◽

2006 ◽

Vol 72 (12) ◽

pp. 1216-1217

Author(s):

Hadi Najafian ◽

Camille Eyvazzadeh

Keyword(s):

Small Bowel ◽

Physical Examination ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Unusual Case ◽

Bowel Resection ◽

Anastomotic Stricture ◽

History Of ◽

Resection And Anastomosis

The wireless enteroscopy capsule (WEC) was approved for noninvasive visualization of small bowel. We report an unusual case of a previously healthy man with history of bowel resection and anastomosis who developed small bowel obstruction after ingestion of a WCE. At operation, an anastomotic stricture site was noted and the WEC was proximal to this stricture, causing obstruction. This case emphasizes the importance of a good history and physical examination, as well as vigilant follow-up and retrieval of WEC.

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Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

Case Reports in Orthopedics ◽

10.1155/2011/648080 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

Xiao Li ◽

Shaoling Wu ◽

Chao Ma

Keyword(s):

Urinary Tract Infection ◽

Reactive Arthritis ◽

Early Recognition ◽

Burst Fracture ◽

Cauda Equina ◽

Spine Fracture ◽

Appropriate Treatment ◽

Delayed Initiation ◽

History Of

A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

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Evaluation and Management of the Lingual Thyroid Gland

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949610500414 ◽

1996 ◽

Vol 105 (4) ◽

pp. 312-316 ◽

Cited By ~ 56

Author(s):

James D. Williams ◽

Oleh Slupchinskij ◽

Anthony P. Sclafani ◽

Claude Douge

Keyword(s):

Thyroid Gland ◽

Upper Airway ◽

Oral Intake ◽

Surgical Excision ◽

Initial Therapy ◽

Clinical Findings ◽

Lingual Thyroid ◽

Appropriate Treatment ◽

History Of ◽

Gland Enlargement

Lingual thyroid gland is a rare clinical entity that is due to failure of descent of the gland anlage early in the course of embryogenesis. It may present with symptoms of dysphagia, upper airway obstruction, or even hemorrhage at any time from infancy through adulthood. We present two illustrative cases of lingual thyroid gland along with a protocol for diagnosis and management of the condition. Elements in the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and planning appropriate treatment The natural history of the condition is reviewed and a treatment strategy is outlined that focuses on the use of suppressive doses of thyroid hormone as the initial therapy. Surgical excision of the gland is reserved for more advanced cases of gland enlargement resulting in airway compromise, severe dysphagia that limits oral intake, or ongoing hemorrhage.

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Endodontic Therapy and Surgical Excision of a Chronic Suppurative Osteomyelitic Lesion in a Horse: A Case Report

Journal of Veterinary Dentistry ◽

10.1177/089875649601300402 ◽

1996 ◽

Vol 13 (4) ◽

pp. 145-148 ◽

Cited By ~ 3

Author(s):

Steven D. Baerg ◽

David A. Russell ◽

Laura M. LeVan ◽

Carl A. Kirker-Head

Keyword(s):

Eating Habits ◽

Surgical Excision ◽

Maxillary Incisor ◽

Surgical Removal ◽

Mandibular Incisor ◽

Surgical Extraction ◽

History Of ◽

Functional Position

A 22 year old thoroughbred gelding was presented for evaluation and treatment of chronic dental disease. The horse had a history of quidding and abnormal bit behavior. Intraoral examination revealed signs of chronic generalized gingival inflammation and severe dental caries affecting the maxillary and mandibular incisor teeth. Treatment was provided on two separate visits over an interval of four months. The first visit consisted of the surgical extraction of three unrestorable incisor teeth and restoration of six carious maxillary incisor teeth. The second visit consisted of conventional endodontic therapy on the remaining mandibular incisor teeth and the surgical removal of a chronic suppurative osteomyelitic lesion. Immediate and long term improvements in eating habits were noted. Three month follow-up examinations following completion of treatment have shown the teeth to be in functional position, the restorations intact, and the surgical site well healed.

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A Phalangeal Osteoid Osteoma: A Case Report

Pulse ◽

10.3329/pulse.v8i1.28105 ◽

2016 ◽

Vol 8 (1) ◽

pp. 69-72

Author(s):

Syed Khalequezzaman ◽

Biva Shrestha Khan ◽

Bidyut K Saha ◽

Pankaj Kumar

Keyword(s):

Osteoid Osteoma ◽

Complete Resolution ◽

Surgical Excision ◽

Middle Finger ◽

Definitive Diagnosis ◽

Important Differential Diagnosis ◽

Local Doctor ◽

History Of ◽

Uncommon Condition

Osteoid osteoma is a benign bone forming tumor of the growing skeleton that is most often seen in young men. It represents by pain and radiologic appearance of a nidus surrounded by osteosclerosis that occurs mostly in long bones of the lower extremity. Occurrence of this tumor in the hand is an uncommon condition. A 35 year old right-hand-dominant man presented to our orthopedic and trauma OPD with an approximately 2 year history of right middle finger pain without any history of trauma. He consulted previously with a local doctor and had undergone xray of the hand with no definitive diagnosis. Computed tomography at our institution was consistent with the diagnosis of osteoid osteoma. The patient was treated with surgical excision of the lesion without bone grafting. The diagnosis of osteoid osteoma was confirmed by histopathology. Follow up visit showed complete resolution of pain. In this case demonstrating that osteoid osteoma is an important differential diagnosis in patients with finger pain.Pulse Vol.8 January-December 2015 p.69-72

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Thirteen-year follow-up of parasellar intravascular papillary endothelial hyperplasia successfully treated by surgical excision: case report

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.9.peds13518 ◽

2015 ◽

Vol 15 (4) ◽

pp. 384-391 ◽

Cited By ~ 4

Author(s):

Sook Young Sim ◽

Yong Cheol Lim ◽

Keun Soo Won ◽

Kyung Gi Cho

Keyword(s):

Surgical Excision ◽

Subtotal Resection ◽

Intravascular Papillary Endothelial Hyperplasia ◽

Long Term Follow Up ◽

History Of ◽

Papillary Endothelial Hyperplasia ◽

The Right ◽

Frontal Skull Base

Intracranial intravascular papillary endothelial hyperplasia (IPEH) is very rare, and to our knowledge long-term follow-up results have not been previously published. An 11-year-old boy presented with a 6-month history of progressive visual impairment in the right eye. Magnetic resonance imaging revealed a well-enhanced, large parasellar mass involving the cavernous sinus, right frontal skull base, and ethmoid and sphenoid sinuses. Frontotemporal craniotomy and subtotal resection were performed, and the diagnosis of IPEH was confirmed. The mass increased in size during the following 3 months. A second operation was performed via frontotemporal craniotomy combined with a transsphenoidal approach, and gross-total resection of the tumor was achieved. Adjuvant radiotherapy (5040 cGy) and chemotherapy with interferon were administered. The patient's visual symptoms improved, and there was no recurrence during a 13-year follow-up period. The results of this case indicate that intracranial IPEH can recur with subtotal resection; however, optimal resection with multimodal adjuvant treatment can control the disease for many years, if not permanently.

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TABES DORSALIS IN THE POST ANTIBIOTIC ERA: NEVER SAY NEVER

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.34 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.123-e4

Author(s):

Chinar Osman ◽

Tristan Clark ◽

Boyd Ghosh ◽

Christopher Halfpenny

Keyword(s):

Urinary Incontinence ◽

Early Recognition ◽

Undetectable Viral Load ◽

Dorsal Column ◽

High Signal ◽

Appropriate Treatment ◽

Tabes Dorsalis ◽

History Of ◽

Whole Spine

BackgroundTabes dorsalis is a neurological form of tertiary syphilis and is considered to be rare in the post antibiotic era. It results from damage to nerve cells in the dorsal column and roots of the spinal cord. It is characterised by sensory ataxia, lightening pains and urinary incontinence. If left untreated it can progress to paralysis and dementia.Case summaryWe present the case of an HIV positive 47 year old male with a CD4 count of 400 and an undetectable viral load on HAART. He presented with an 8 month history of progressively severe lightening pains, gait disturbance, tinnitus, hearing loss, and urinary incontinence. He had a positive plasma VDRL with a titre of 1:32, and his CSF was VDRL positive. Whole spine MRI scan demonstrated high signal in the dorsal cord with associated atrophy. He was treated with intravenous benzylpenicillin 2.4 grams 4 hourly for 14 days. Follow up at 4 and 8 months demonstrated marked clinical improvement with a falling serum VRDL titre. Repeat LP at 6 month post treatment demonstrated VDRL negativity.DiscussionTabes Dorsalis may still occur in the post antibiotic era. Early recognition and appropriate treatment can lead to good clinical outcomes.

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