scholarly journals Pseudo-Meigs syndrome: a rare presentation of pedunculated fibroid

2020 ◽  
Vol 9 (7) ◽  
pp. 3052
Author(s):  
Sunita Dubey ◽  
Poonam Goel ◽  
Nidhi Pandey ◽  
Pavithra H. N.
Keyword(s):  
Pleural Effusion ◽  
Abdominal Distension ◽  
Uterine Sarcoma ◽  
Ca 125 ◽  
Rare Presentation ◽  
Atypical Symptoms ◽  
Extensive Evaluation ◽  
History Of ◽  
Intramural Fibroids ◽  
Rule Out

Serosal fibroid of uterus are usually asymptomatic but rarely; it may present with atypical symptoms to simulate malignancy and needs extensive evaluation. Authors are reporting a case of 26 years old P1L1 female with history of asymptomatic multiple intramural fibroids since 6 years came with complained of progressively increasing abdominal distension and mild pain abdomen from 2-3 months. On evaluation, she had ascites, pleural effusion and raised Ca-125. MR imaging of pelvis revealed moderate ascites and pedunculated serosal fibroid in addition to intramural fibroids with normal bilateral ovaries. She was evaluated to rule out uterine sarcoma and tuberculosis but diagnosis of them could not be established. Finally, conclusion of Pseudo-Meigs syndrome was made. Myomectomy of single pedunculated fibroid relieved her symptoms. Though, subserosal fibroids are benign in pathology, timely surgery is must to avoid morbidity and mortality owing to massive ascites and pleural effusion.

scholarly journals Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Reumatismo ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 108-112 ◽  
Author(s):  
G. Tansir ◽  
P. Kumar ◽  
A. Pius ◽  
S.K. Sunny ◽  
M. Soneja
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Abdominal Distension ◽  
Ca 125 ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
The Past ◽  
History Of

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

scholarly journals Duodenal metastasis of breast invasive carcinoma of no special type: a rare presentation

2021 ◽  
Vol 84 (2) ◽  
pp. 379-380
Author(s):  
M Mascarenhas Saraiva ◽  
T Ribeiro ◽  
A.R. Coelho ◽  
R Silva ◽  
A.C. Real ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Epigastric Pain ◽  
Growth Factor Receptor ◽  
Progesterone Receptors ◽  
Ca 125 ◽  
Her2 Positive ◽  
Rare Presentation ◽  
History Of ◽  
Lobular Breast Carcinoma ◽  
Epidermal Growth

The authors read with attention the case report by Vande Berg and coworkers, published on a previous issue of this journal, describing a rare diagnosis of rectal metastases of an incognito invasive lobular breast carcinoma (ILC), for which immunohistochemistry was decisive (1). Likewise, we share a similarly rare case of gastrointestinal metastases of breast carcinoma (BC), in which immunohistochemistry played a pivotal role.A 55-year-old woman was diagnosed in June 2015 with an Invasive Breast Carcinoma of no-special-type (IBCNST) grade III, human epidermal growth factor receptor 2 (HER2) positive, estrogen and progesterone receptors (ER/PR) negative. Biopsy revealed vascular permeation. Neoadjuvant chemotherapy and trastuzumab preceded surgery, performed in December 2015, followed by radiotherapy and trastuzumab. The patient remained free of disease until 2017, when a right cerebellar lesion was diagnosed as BC metastasis and was treated with stereotactic radiosurgery. In January 2020, the patient presented with a 1-month history of post-prandial vomiting, epigastric pain, anorexia, fatigue, and a 10 kg weight loss. Lab tests were unremarkable, except for small increase in CA-125 and CA-15.3.

scholarly journals Malignant melanoma presenting as an isolated pleural effusion

2015 ◽  
Vol 75 (2) ◽  
Author(s):  
M. Shameem ◽  
J. Akhtar ◽  
U. Baneen ◽  
N. Ahmad Khan ◽  
R. Bhargava ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Melanoma ◽  
Pleural Fluid ◽  
Past History ◽  
Mediastinal Lymphadenopathy ◽  
Rare Presentation ◽  
Pigmented Lesion ◽  
S 100 ◽  
History Of ◽  
Enhanced Computed Tomography

Isolated pleural effusion is a very rare presentation of malignant melanoma. A 46 year-old male patient presented to us with complaints of shortness of breath during the previous month. A contrast enhanced computed tomography (CECT) imaging scan of his thorax showed right-sided pleural effusion with the absence of any mass lesion or mediastinal lymphadenopathy. Cytology of his pleural fluid showed pigmented cells suggestive of malignant melanoma. Staining of the pleural fluid cells with immunohistological markers for melanoma (HMB 45 and S 100) were positive. An examination of his skin did not reveal any pigmented lesion, nor was there a past history of malignant melanoma for this patient. The patient responded well to therapy for malignant melanoma and has remained asymptomatic for the last year. This patient was diagnosed with a rare case of primary malignant melanoma of the pleura presenting as isolated pleural effusion.

scholarly journals Myxoedema ascites-Rare presentation of long standing hashimotos thyroiditis

2021 ◽  
Vol 6 (3) ◽  
pp. 204-206
Author(s):  
Garima Shah ◽  
Shubham Sharma ◽  
Bikram Shah
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Abdominal Distension ◽  
Autoimmune Disorder ◽  
Hashimoto's Thyroiditis ◽  
Dramatic Improvement ◽  
Rare Presentation ◽  
Thyroid Medication ◽  
Clinical Conditions ◽  
Rule Out

Hypothyroidism is among the common clinical conditions which are encountered in the medicine OPD. An autoimmune disorder called Hashimoto’s thyroiditis is a common cause for hypothyroidism followed by over response to hyperthyroidism treatment, radiation therapy, medications, congenital disease etc. Patients can present with sensitivity to cold, weight gain, constipation, menstrual abnormalities, and slow mentation with irritability, dry skin, hair loss, and fatigue. Rarely, uncontrolled hypothyroidism can present as pericardial effusion, pleural effusion and ascites. Ascites as the feature of hypothyroidism is uncommon and only less than four percent of patients with hypothyroidism /develop ascites.As it is rarely presented as ascites so its diagnosis is delayed but once it is diagnosed, treatment leads to clinical improvement.: A 20-year-old female presented to medicine OPD with non- tender abdominal distension, vomiting. She was a known case of Hashimoto's thyroiditis an autoimmune disorder; however, she was not compliant to thyroid medication. All necessary investigations were carried out to rule out the cause for ascites. With all the negative reports including imaging and supportive fluid cytology we attributed the symptoms to uncontrolled hypothyroidism as the patient was non-compliant to the thyroid medications. Also the picture of macrocytic anaemia in our patient supported the diagnosis. She was started on levothyroxine and was counselled. On a follow-up visit there was dramatic improvement of all the symptoms including ascites and her TSH was normal-2.017. Ascites as a symptom of hypothyroidism is rare and its pathophysiology is not fully understood however there are few theories and studies in the past which do explain ascites as the manifestation of hypothyroidism. Severe uncontrolled hypothyroidism though uncommon but can cause ascites. Being a reversible cause of ascites, it becomes important for clinicians to take hypothyroidism as one of the differential diagnosis for ascites. Our case supports the need of taking hypothyroidism as one of the cause, as it is easily treatable and patient can show dramatic improvement.

A Rare Case of Primary Amyloidosis, Presenting with Severe Pulmonary Hypertension and Bilateral Pleural Effusion.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5100-5100
Author(s):  
Aref Agheli ◽  
Alka Arora ◽  
Maged Khalil ◽  
Theresa Dumlao ◽  
Seema Naik ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pleural Effusion ◽  
Basement Membranes ◽  
Bilateral Pleural Effusion ◽  
Response To Treatment ◽  
Primary Amyloidosis ◽  
X Rays ◽  
Severe Pulmonary Hypertension ◽  
Rare Presentation ◽  
History Of

Abstract Pulmonary arterial hypertension secondary to vascular deposition is a rare presentation of Primary Amyloidosis. The natural history of pulmonary hypertension and concomitant right-sided cardiac failure is not very well understood and is associated with a very short median survival. This syndrome is a marker of advanced Amyloidosis Persistent pleural effusion is another much rarer presentation of pulmonary involvement in Primary Amyloidosis and is secondary to pleural infiltration, which sometimes is difficult to distinguish from the cardiomyopathic causes. The incidence of pleural effusion in primary Amyloidosis is 1–2%. This syndrome also has a very poor prognosis, and has limited response to treatment, however, pleurodesis has been temporarily useful in some cases. Case report: A 74 year old African American female, non-smoker, with history of hypertension, who presented with shortness of breath and persistent productive cough and 18 pounds weight loss for the last six months. The initial chest x-rays showed bilateral pleural effusion and a transudate fluid on analysis. Cardiac workup for an atypical chest pain revealed moderate to severe pulmonary hypertension without myocardial infiltration on 2-D echocardiogram, and normal coronary arteries on cardiac catheterization. Extensive workup did not show any secondary cause of pulmonary hypertension, however, the patient gradually developed nephrotic range proteinuria and kidney biopsy showed infiltration of 10 nm fibrils, involving 3+ segmental mesangium, and 2+ segmental glomerular basement membranes. This was consistent with renal Primary Amyloidosis, AL Lambda type. A random urine and serum sample for immunofixation also revealed an M- spike of 23 mg/dl in gamma region. A concomitant bone marrow biopsy revealed presence of monoclonal IgG lambda plasma cell (CD38 bright) population, without any B-cell or T-cell markers. Conclusion: Pulmonary hypertension and pleural effusion are two rare and lethal presentations of pulmonary involvements in Primary Amyloidosis, and it should be considered in the differential diagnosis of any patient presenting with pulmonary symptoms. There is no definite treatment of these syndromes, although combinations of steroids and melphalan, along with colchicines, vincristine, adriamycin, and thalidomide have been used with minimum satisfactory outcomes. Autologous stem cell transplantation (SCT) provides the opportunity to give higher doses of chemotherapy and may be of benefit in some cases.

scholarly journals A 9-year-old girl presented with jaundice, abdominal distension, hematemesis, melena and pleural effusion

2018 ◽  
Vol 11 (4) ◽  
pp. 300-303
Author(s):  
Parisa Marjan ◽  
Md. Rukunuzzaman ◽  
A. S. M. Bazlul Karim ◽  
Mohuya Mondal ◽  
Hazera Akter
Keyword(s):  
Abdominal Pain ◽  
Liver Disease ◽  
Family History ◽  
Pleural Effusion ◽  
Blood Transfusion ◽  
Abdominal Distension ◽  
Tuberculosis Patient ◽  
History Of ◽  
Pedal Edema ◽  
Parenteral Medication

This article has no abstract. The first 100 words appear below: A 9-year-old girl of non-consanguineous parents presented at the outpatient department with the history of jaundice and abdominal distension for 20 days and respiratory distress for 7 days. She also complained of bloody vomiting without any melena. The mother gave the history of abdominal pain for 2 days which was diffuse in nature. Her menarche had not started yet. Her younger sister is healthy. She had no history of fever, constipation, family history of liver disease, sib death, contact with known tuberculosis patient, blood transfusion or parenteral medication. On examination, she was afebrile, moderately pale, dyspnea and leukonychia. Bilateral pedal edema was present.

Acute-onset isolated bilateral palatal palsy in an adolescent

2021 ◽  
Vol 14 (9) ◽  
pp. e243467
Author(s):  
Avinash Shekhar Jaiswal ◽  
Rajeev Kumar ◽  
Prem Sagar ◽  
Rakesh Kumar
Keyword(s):  
Sudden Onset ◽  
Acute Onset ◽  
Age Group ◽  
Rare Presentation ◽  
Limb Weakness ◽  
Aggressive Management ◽  
History Of ◽  
Gag Reflex ◽  
Nasal Regurgitation ◽  
Rule Out

A 16-year-old patient presented with sudden-onset difficulty in swallowing food especially for liquids with nasal regurgitation and rhinolalia with no history of fever and limb weakness. Examination revealed bilateral palatal palsy with absence of gag reflex. Other neurological examinations were normal. Investigations were done to rule out any known pathology leading to such a presentation. The symptoms were attributed to an idiopathic acute-onset-acquired bilateral palatal palsy, in the absence of any identifiable cause. This is a rare presentation in adolescent age with no case reported in the literature so far in this age group. Medical management was started and patient showed complete improvement within 2 weeks of his symptoms. Early diagnosis and aggressive management of this condition lead to a favourable prognosis.

scholarly journals Pulmonary Silicosis Presents with Pleural Effusion

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Mohsin Salih ◽  
Tarake Aljarod ◽  
Mohamed Ayan ◽  
Melnick Jeffrey ◽  
Bobby H. Shah
Keyword(s):  
Pleural Effusion ◽  
Medical Literature ◽  
Silicate Mineral ◽  
Rare Presentation ◽  
X Ray ◽  
Pleural Thickening ◽  
Dust Inhalation ◽  
Lung Infiltrate ◽  
History Of ◽  
Chest X Ray

Silica and silicate mineral dust inhalation can cause a variety of histopathological changes in the lungs and pleura. These include pulmonary silicotic nodules, interstitial infiltrate, fibrosis, and pleural thickening. Pleural effusion is an extremely rare presentation of silicosis. To our best knowledge, there have been only 2 cases of silicosis with pleural effusion reported in medical literature. Herein, we describe a case of a 77-year-old male with almost 50 years’ history of occupational silica exposure. He presented with a 4-week history of exertional shortness of breath. He is a lifetime nonsmoker, with no known other significant pulmonary disease. He had chest X-ray which showed a right lung infiltrate and bilateral pleural thickening and effusion. Chest CT showed moderate-sized bilateral pleural effusion and thickening with multiple bilateral intrapulmonary nodules seen. He had undergone extensive workup and was diagnosed with silicosis.

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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