scholarly journals Progressive encephalomyelitis with rigidity: a paraneoplastic presentation of oat cell carcinoma of the lung. Case report

2004 ◽  
Vol 62 (2b) ◽  
pp. 547-549 ◽  
Author(s):  
Mariana Spitz ◽  
Henrique Ballalai Ferraz ◽  
Orlando G. P. Barsottini ◽  
Alberto Alain Gabbai
Keyword(s):  
Spinal Cord ◽  
Cell Carcinoma ◽  
Lower Limb ◽  
Cranial Nerves ◽  
Muscle Rigidity ◽  
Left Lower Limb ◽  
History Of ◽  
Brain Ct Scan ◽  
Spinal Mri ◽  
Oat Cell Carcinoma

Progressive encephalomyelitis with rigidity and myoclonus (PEWR) is a rare neurological disorder, characterised by muscular rigidity, painful spasms, myoclonus, and evidence of brain stem and spinal cord involvement. A 73-year-old white man was admitted with a 10-day history of painful muscle spasms and continuous muscle rigidity on his left lower limb. He had involuntary spasms on his legs and developed encephalopathy with cranial nerves signs and long tract spinal cord symptomatology. Brain CT scan and spinal MRI were normal. The CSF showed lymphocytic pleocytosis and no other abnormalities. EMG showed involuntary muscle activity with 2-6 seconds of duration, interval of 30-50 ms and a frequency of 2/second in the left lower limb. Anti-GAD antibodies were detected in the blood. We detected radiological signs of lung cancer during the follow-up, which proved to be an oat cell carcinoma. The patient died two weeks after the diagnosis of the cancer.

Lymphoedema praecox in a young woman: a rare disease

2021 ◽  
Vol 14 (9) ◽  
pp. e245353
Author(s):  
Sri Hari Priya Vemulakonda ◽  
Naveen Kumar Gaur ◽  
Oseen Hajilal Shaikh ◽  
Uday Shamrao Kumbhar
Keyword(s):  
Rare Disease ◽  
Young Woman ◽  
Lower Limb ◽  
Young Age ◽  
Rare Disorder ◽  
Imaging Studies ◽  
Left Lower Limb ◽  
History Of

Primary lymphoedema is a rare disorder. Often presents at a young age with asymptomatic limb oedema with gradual progression. We present a 16-year-old woman who presented with a history of swelling of the left lower limb for 6 years. There was the presence of isolated left lower limb oedema, which was a non-pitting type. The patient underwent imaging studies and was diagnosed to have primary lymphoedema. The patient was managed conservatively as the patient did not have any other problems other than the left lower limb oedema.

scholarly journals Metastatic porocarcinoma achieving complete radiological and clinical response with pembrolizumab

2019 ◽  
Vol 12 (9) ◽  
pp. e228917 ◽  
Author(s):  
Karla A Lee ◽  
Margherita Cioni ◽  
Alistair Robson ◽  
Veronique Bataille
Keyword(s):  
Squamous Cell Carcinoma ◽  
Brain Metastases ◽  
Cell Carcinoma ◽  
Clinical Response ◽  
Lower Limb ◽  
Histopathological Examination ◽  
Nodal Metastases ◽  
Left Lower Limb ◽  
Poorly Differentiated ◽  
Visceral Disease

A 67-year-old woman presented in 2012 with a crusty nodule on the left lower limb. Histopathological examination at this time reported a poorly differentiated squamous cell carcinoma (SCC). Two years later, she underwent lymphadenectomy and radiotherapy due to unilateral inguinal and pelvic sidewall nodal metastases. The following year she required excision of two subcutaneous lesions, reported pathologically to be SCC metastases. Further imaging following cyberknife radiotherapy to new brain metastases demonstrated widespread metastatic visceral disease. Twelve cycles of carboplatin and capecitabine failed to halt disease progression. In February 2017, she commenced pembrolizumab, achieving an excellent response and currently has no clinical or radiological evidence of disease. Given the unusual behaviour of her cancer, a histopathological review was requested. The diagnosis was revised to that of porocarcinoma (PC). This represents the first documented case of PC treated with immunotherapy. As of March 2019, the patient remains free of disease.

scholarly journals Multiple CNS Tumors in a Patient With Neurofibromatosis Type 2: Classical Presentation of a Rare Disease

2020 ◽  
Author(s):  
Aamer Ubaid ◽  
Farishta Waheed ◽  
Awais Naeem
Keyword(s):  
Rare Disease ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Neurofibromatosis Type 2 ◽  
Lumbar Region ◽  
Nerve Paralysis ◽  
Function Tests ◽  
Left Lower Limb ◽  
History Of

Neurofibromatosis type 2 is a genetic autosomal dominant disorder caused by a spontaneous mutation in the gene located on chromosome 22 q11-13.1, which usually emerges in adolescence or early adulthood and is characterized by the development of bilateral vestibular schwannoma. We hereby report the classical case of Neurofibromatosis type 2 in a 25-year-old young male with multiple tumors associated with the disease. This patient presented to us with 3 years history of multiple painless nodules on his skin, facial weakness, left-sided progressive hearing loss, and 20 days history of weakness in the left lower limb. On Examination, he was vital with a GCS of 15/15. He was anemic with no jaundice. He had left inguinal lymphadenopathy along with multiple subcutaneous nodules on different areas, including the scalp, face, left mid-axillary line over the abdomen. He also had Right-sided facial palsy and horizontal nystagmus. CNS examination revealed an upgoing plantar on the left side, right facial nerve palsy, and bilateral vestibulocochlear nerve paralysis. Spine examination revealed spinal tenderness in the lower lumbar region. Superficial abdominal reflexes were absent. Upper limb and right lower limb power, tone, and reflexes were normal while the tone and power in the left lower limb were reduced power being ⅗. Reflexes were also exaggerated in the left lower limb. The right ankle showed swelling, most probably a plexiform neuroma. On investigations, he had normochromic normocytic anemia with mild leucocytosis. Platelets were normal. The rest of the biochemical investigations, including serum electrolytes, liver function tests, and renal function tests, were also normal.MRI brain and spine confirmed bilateral acoustic neuroma and multiple cranial and peripheral nerve tumors i.e., classical presentation of a rare disease neurofibromatosis. He was referred to the neurology unit for further assessment and treatment.

Case of Metastasis of Alveolar Soft Part Sarcoma Lower Limb To Brain Diagnosed on Squash Cytology

JMS SKIMS ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 108
Author(s):  
Sumat Ul Khurshid ◽  
Iqbal Lone ◽  
Imza Feroz ◽  
Wajahat Mir
Keyword(s):  
Lower Limb ◽  
Soft Part ◽  
Low Density ◽  
Parietal Region ◽  
Limb Weakness ◽  
Left Lower Limb ◽  
History Of ◽  
One Year ◽  
The Brain ◽  
Space Occupying Lesion

A 19‑year‑old male patient was admitted, after experiencing occasional headaches during the previous 6 months. The patient's headaches had become progressively more severe 1 month prior to admis­sion to hospital, and were associated with right upper limb weakness. As revealed by cranial computed tomog­raphy, a high‑density lesion was observed in the left parietal region [CT values, 52 Houns field units, (HU)] and a peripheral low‑density edematous zone was visible.(figure a) . The medical history of the patient included an indolent 4x4 cm subcutaneous iliac mass in the left lower limb from last one year, which the patient had neglected. Therefore, the patient was diagnosed as space occupying lesion brain. During surgery, a purplish‑red tumor was observed in the brain. Intraoperative crush cytology was asked for. JMS 2017;20(2):108

scholarly journals Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Dilber Ayçiçek Çeçen ◽  
Necati Tatarlı ◽  
Hikmet Turan Süslü ◽  
Selçuk Özdoğan ◽  
Nagehan Özdemir Barışık
Keyword(s):  
Spinal Cord ◽  
Cranial Nerves ◽  
B Cell Lymphoma ◽  
Spinal Tumor ◽  
Cord Compression ◽  
Primary Lymphoma ◽  
Systemic Involvement ◽  
Rare Location ◽  
History Of ◽  
Upper Thoracic

Background.Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention.Case Presentation.A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2–T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years.Conclusion.The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures.

scholarly journals Elephantiasis and Directed Occupational Rehabilitation

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Jose Maria Pereira de Godoy ◽  
Henrique Jose Pereira de Godoy ◽  
Ana Carolina Pereira de Godoy ◽  
Maria de Fátima Guerreiro Godoy
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Lower Limb ◽  
Occupational Rehabilitation ◽  
The Body ◽  
Compression Stockings ◽  
Left Lower Limb ◽  
History Of ◽  
Bilateral Lower Limb

The aim of the present study was to demonstrate the cure of elephantiasis over a ten-year follow-up period and novel discoveries with directed occupational rehabilitation. A 66-year-old female patient with a history of bilateral lower limb lymphedema reported the aggravation of the condition over the years, reaching stage III (elephantiasis). The physical examination confirmed elephantiasis. The circumference of the left lower limb was 106 cm. Her body weight was 106 kilograms, height was 160 cm, and the body mass index (BMI) was 41.6 kg/m2. The patient was submitted to intensive treatment for three weeks, which led to a 21-kg reduction in weight and 66 cm reduction in leg circumference. Ten years after treatment, the patient has maintained the results with the compression stockings. Elephantiasis can be cured, although lymphedema cannot. The cure of elephantiasis depends on maintaining the treatment of lymphedema after normalization or near normalization. Directed occupational therapy stimulates the search for new activities and a life closer to normality.

scholarly journals Phlegmasia Cerulea Dolens: A Life- and Limb-threatening Disease

2021 ◽  
Vol 5 (0-2) ◽  
pp. 16
Author(s):  
Wan Nuraisyah Azzahrah Wan Zuki
Keyword(s):  
Venous Thrombosis ◽  
Lower Limb ◽  
Early Recognition ◽  
Vena Cava ◽  
Common Iliac Vein ◽  
Venous Thrombectomy ◽  
Catheter Directed Thrombolysis ◽  
Left Lower Limb ◽  
History Of ◽  
Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a rare syndrome caused by venous thrombosis and characterised by a triad of limb oedema, cyanosis and pain. It requires early recognition as delay of treatment can cause gangrene, limb amputation and in extreme cases, death. A 67- year-old Chinese lady, with underlying hypertension, diabetes mellitus and dyslipidaemia presented to the emergency department with a 2 days history of pain, oedema and bluish discoloration over the entire left leg. She had a history of fall 6 months prior and since then she used a walking stick for mobilization. This patient underwent ultrasound doppler left lower limb , which showed features suggestive of long-segment left lower limb deep vein thrombosis. A diagnosis of PCD was made. Subsequently, she went for a CT angiogram and venography of the left lower limb which confirmed thrombosis of the left calf vein extending to the long segment of the left common iliac vein. She was commenced on intravenous heparin infusion and then underwent inferior vena cava filter insertion and catheter directed thrombolysis. Repeat venogram showed successful catheter directed thrombolysis of the left lower limb deep venous thrombosis (DVT). Treatment should be initiated as soon as the diagnosis of PCD is suspected. Currently, guidelines for treatment are lacking however 3 therapeutic options are advocated alone or in combination: anticoagulants, thrombolytic therapy, and venous thrombectomy. An early recognition of PCD and appropriate decision regarding the treatment is essential to preserve the limb.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S16

scholarly journals Bullous Pemphigoid in Which Eruption Developed Exclusively on Preexisting Eruption of Vitiligo Vulgaris

2020 ◽  
Vol 12 (1) ◽  
pp. 33-36
Author(s):  
Masahiro Oka ◽  
Takeshi Fukumoto
Keyword(s):  
Bullous Pemphigoid ◽  
Lower Limb ◽  
Oral Prednisolone ◽  
Unique Case ◽  
Prednisolone Dose ◽  
Left Lower Limb ◽  
Old Japanese ◽  
History Of ◽  
Laboratory Examinations ◽  
The Right

Coexistence of bullous pemphigoid (BP) and vitiligo vulgaris (VV) is very rare. We present a unique case of BP associated with VV in a 76-year-old Japanese man, in which BP eruption developed exclusively on preexisting VV regions. The patient was referred to us with a 3-month history of blistering eruption with severe pruritis on the right forearm and left lower limb. In addition, he had been suffering from a widespread depigmented eruption on the trunk and extremities for at least 20 years. Curiously, the blistering eruption developed exclusively on preexisting depigmented eruption. Histopathological and laboratory examinations identified the blistering eruption as BP. The depigmented eruption was diagnosed as VV. BP eruption responded quickly to oral prednisolone therapy, improving within 1 week, and the prednisolone dose was gradually tapered. Within 1 month, BP lesions almost completely resolved. In the present case, BP not only coexisted with VV, but also developed exclusively on preexisting vitiliginous regions. The present case strongly suggests that BP and VV are partly caused by common pathological mechanisms.

scholarly journals History, treatment and analysis of a rare form of Exeter stem fracture

2019 ◽  
Vol 12 (12) ◽  
pp. e231422
Author(s):  
Darren Patrick Moloney ◽  
Robert J Hurley ◽  
James Harty ◽  
Shane Guerin
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Hip Replacement ◽  
Revision Arthroplasty ◽  
Rare Form ◽  
Pelvic Radiograph ◽  
Left Lower Limb ◽  
History Of ◽  
Stem Fracture

The Exeter stem by Stryker has become one of the most successful and widely used stems in modern cemented hip arthroplasty. We present a case of a rare stem fracture which was treated by ‘cement-in-cement’ revision arthroplasty technique. The patient, an 87-year-old man, presented with left hip pain and an inability to weight bear following a cracking sensation when he was standing to dress himself. The patient denied history of fall or trauma. On examination he was noted to have a shortened externally rotated left lower limb without neurovascular compromise. On pelvic radiograph he was noted to have an incomplete stem fracture of his left-sided total hip replacement. He was treated with a cement-in-cement revision. Postoperatively the stem was sent for analysis in the London Implant Retrieval Centre. This is an example of a rare form of stem fatigue failure treated with a well-described technique in revision arthroplasty.

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