Recurrent Schowannoma With Extensive Xanthomatous Changes: A Case Report

Schwannoma is one of the most common benign intracranial tumors, which originates from the Schwann cells of neural structures in the upper part of the vestibular branch of the eighth cranial nerve. This report describes a 64-year-old woman with headache and vertigo who had a past surgical history of acoustic schwannoma about 10 years ago. The patient underwent excisional surgery. Histological examinations revealed schwannoma with extensive xanthomatous changes. Immunohistochemistry staining confirmed the diagnosis. Base on the diagnosis, the patient received no more treatment. After 6 months of close follow-up examinations, no recurrence and complication were observed. Schwannoma could be seen with a vast variety of histologic changes. Recurrence of Schownnoma is uncommon in patients without neurofibromatosis, but it should be considered in a proper clinical context.

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Rapidly Growing Desmoid-Type Fibromatosis of the Mesentery of the Small Intestine after Distal Gastrectomy for Gastric Cancer

Case Reports in Gastroenterology ◽

10.1159/000506926 ◽

2020 ◽

Vol 14 (1) ◽

pp. 197-205

Author(s):

Ryota Koyama ◽

Yoshiaki Maeda ◽

Nozomi Minagawa ◽

Toshiki Shinohara

Keyword(s):

Gastric Cancer ◽

Small Intestine ◽

Lymph Node ◽

Distal Gastrectomy ◽

Anastomotic Site ◽

En Bloc ◽

Surgical History ◽

History Of ◽

Feeding Vessels

We report the case of a 55-year-old man with a surgical history of distal gastrectomy with Roux-en-Y reconstruction performed 3 years prior to the present episode. During the follow-up, a newly developed, rapidly growing intraabdominal mass was detected in the mesentery of the small intestine. Although the patient had been asymptomatic, surgical resection was planned with the suspicion of malignancy, especially lymph node recurrence of the gastric cancer, owing to its rapid growth. Laparotomy showed that the tumor was located in the mesentery of the small intestine near the Roux-en-Y limb, and due to the involvement of the feeding vessels to the Roux-en-Y limb, the anastomotic site was resected en bloc with the tumor, and the whole Roux-en-Y limb was reconstructed. The histopathological finding was compatible with desmoid-type fibromatosis of the mesentery of the small intestine. Here we report our case and discuss the previously reported literature, especially related to gastric cancer.

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1582 Radiolucent Foreign Bodies Presenting As IBD- The Case of An Ingested Plastic Straw Disguising as Crohn’s Disease

British Journal of Surgery ◽

10.1093/bjs/znab259.392 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

B Wadham ◽

T Connolly ◽

R Satchidanand

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Foreign Bodies ◽

Bowel Perforation ◽

Oral Contrast ◽

Communication Difficulties ◽

Surgical History ◽

History Of ◽

Inflammatory Bowel

Abstract Ingested foreign bodies (FBs) occur most commonly in children or adults with impaired neurological function. Overall, 80% are thought to pass spontaneously in the faeces, with around 20% requiring endoscopy and less than 1% requiring surgical intervention. ‘Missed’ gastro-intestinal FBs are rare and often due to the lack of an obtainable history in patients with communication difficulties. We present the unusual case of a 27-year-old female with severe learning difficulties and a complex surgical history who presented with a 2-year history of increasing abdominal discomfort due to a ‘missed’ FB. Four CT scans had misdiagnosed Crohn’s disease and the patient was due to commence immunosuppression when she developed a small bowel perforation. This was managed conservatively and follow-up imaging with a CT with oral contrast detected the FB in the ileum. The patient underwent a laparotomy with resection of a 26cm segment of ileum containing a plastic straw. Post-operatively she recovered uneventfully and is now symptom free with no evidence of IBD on histology. This case highlights the value of oral contrast enhancement imaging in patients who don’t fit a ‘classical’ inflammatory bowel disease presentation.

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Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz294 ◽

2019 ◽

Vol 2019 (10) ◽

Author(s):

Chiapo Lesetedi ◽

Mpapho Joseph Motsumi

Keyword(s):

Bile Duct ◽

Open Cholecystectomy ◽

Metal Stent ◽

Endoscopic Retrograde ◽

Plastic Stent ◽

High Burden ◽

Surgical History ◽

History Of ◽

Lost To Follow Up

Abstract Forgotten stents may lead to serious complications. We present a case report of a forgotten common bile duct (CBD) fully covered metal stent presenting with recurrent cholangitis. A 79-years-old female patient presented with a history of recurrent cholangitis. Past surgical history was notable for open cholecystectomy for symptomatic cholelithiasis in 2016. Subsequently, she was found to have retained CBD stones in the same year. She had endoscopic retrograde cholangiopancreatography (ERCP), during which a complete clearance of the stone was not achieved and she was stented with a completely covered metal stent. She was lost to follow-up until 2019. A differential diagnosis of cholangitis secondary to a blocked stent was made. At ERCP, she had intra- and extra-hepatic stones, which could not be removed. A plastic stent was deployed. She later had an open bile duct exploration with Roux-en-Y hepaticojejunostomy. Forgotten stents can lead to serious complications. An electronic stent follow-up registry is recommended.

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Long-term natural history of neurofibromatosis Type 2–associated intracranial tumors

Journal of Neurosurgery ◽

10.3171/2012.3.jns111649 ◽

2012 ◽

Vol 117 (1) ◽

pp. 109-117 ◽

Cited By ~ 70

Author(s):

Michael S. Dirks ◽

John A. Butman ◽

H. Jeffrey Kim ◽

Tianxia Wu ◽

Keaton Morgan ◽

...

Keyword(s):

Growth Rate ◽

Natural History ◽

Growth Pattern ◽

Neurofibromatosis Type ◽

Neurofibromatosis Type 2 ◽

Intracranial Tumors ◽

History Of

Object Neurofibromatosis Type 2 (NF2) is a heritable tumor predisposition syndrome that leads to the development of multiple intracranial tumors, including meningiomas and schwannomas. Because the natural history of these tumors has not been determined, their optimal management has not been established. To define the natural history of NF2-associated intracranial tumors and to optimize management strategies, the authors evaluated long-term clinical and radiographic data in patients with NF2. Methods Consecutive NF2 patients with a minimum of 4 years of serial clinical and MRI follow-up were analyzed. Results Seventeen patients, 9 males and 8 females, were included in this analysis (mean follow-up 9.5 ± 4.8 years, range 4.0–20.7 years). The mean age at initial evaluation was 33.2 ± 15.5 years (range 12.3–57.6 years). Patients harbored 182 intracranial neoplasms, 164 of which were assessable for growth rate analysis (18 vestibular schwannomas [VSs], 11 nonvestibular cranial nerve [CN] schwannomas, and 135 meningiomas) and 152 of which were assessable for growth pattern analysis (15 VSs, 9 nonvestibular CN schwannomas, and 128 meningiomas). New tumors developed in patients over the course of the imaging follow-up: 66 meningiomas, 2 VSs, and 2 nonvestibular CN schwannomas. Overall, 45 tumors (29.6%) exhibited linear growth, 17 tumors (11.2%) exhibited exponential growth, and 90 tumors (59.2%) displayed a saltatory growth pattern characterized by alternating periods of growth and quiescence (mean quiescent period 2.3 ± 2.1 years, range 0.4–11.7 years). Further, the saltatory pattern was the most frequently identified growth pattern for each tumor type: meningiomas 60.9%, VSs 46.7%, and nonvestibular schwannoma 55.6%. A younger age at the onset of NF2-related symptoms (p = 0.01) and female sex (p = 0.05) were associated with an increased growth rate in meningiomas. The identification of saltatory growth in meningiomas increased with the duration of follow-up (p = 0.01). Conclusions Neurofibromatosis Type 2–associated intracranial tumors most frequently demonstrated a saltatory growth pattern. Because new tumors can develop in NF2 patients over their lifetime and because radiographic progression and symptom formation are unpredictable, resection may be best reserved for symptom-producing tumors. Moreover, establishing the efficacy of nonsurgical therapeutic interventions must be based on long-term follow-up (several years).

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Natural history of helicobacter pylori infection from infancy to adulthood: A 21-year follow-up cohort study

Gastroenterology ◽

10.1016/s0016-5085(01)80628-4 ◽

2001 ◽

Vol 120 (5) ◽

pp. A128-A128 ◽

Cited By ~ 1

Author(s):

H MALATY ◽

D GRAHAM ◽

A ELKASABANY ◽

S REDDY ◽

S SRINIVASAN ◽

...

Keyword(s):

Helicobacter Pylori ◽

Cohort Study ◽

Natural History ◽

Helicobacter Pylori Infection ◽

History Of

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Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽

10.1024/0301-1526/a000023 ◽

2010 ◽

Vol 39 (2) ◽

pp. 169-174 ◽

Cited By ~ 7

Author(s):

Reich-Schupke ◽

Weyer ◽

Altmeyer ◽

Stücker

Keyword(s):

Scientific Evidence ◽

Daily Practice ◽

Severe Adverse Effect ◽

Safe Procedure ◽

Efficacy And Safety ◽

Foam Sclerotherapy ◽

History Of ◽

One Year ◽

Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

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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Lingual Dystonia Treated with Botulinum Toxin - A Case Report

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v24i2.152 ◽

1970 ◽

Vol 24 (2) ◽

pp. 75-78

Author(s):

MA Hayee ◽

QD Mohammad ◽

H Rahman ◽

M Hakim ◽

SM Kibria

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

X Ray ◽

Medical College ◽

Lingual Dystonia ◽

History Of ◽

Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

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