Accessory and Cavitated Uterine Mass (ACUM) in an 18-Year-Old Woman: A Case Report and Literature Review

Abstract Background Accessory and cavitated uterine mass (ACUM) is a rare uterine anomaly newly recognized as a form of developmental Mullerian anomaly, which represents a non-communicating uterus-like mass within an otherwise normal uterus. It is a benign gynecological disease associated with severe dysmenorrhea and chronic pelvic pain, which is most common in young nullipara women, and sometimes develops in parous women. Clinical manifestations combined with imaging examinations including ultrasonography (USG), magnetic resonance imaging (MRI), and hysterosalpingography (HSG) are the means to establish a correct diagnosis. Medical therapy is only marginally effective, but laparoscopic surgery for complete mass excision is a feasible technique to relieve patient’s symptoms. Our article is aimed to report a case of ACUM in an 18-year-old woman and summarize the diagnostic criteria of ACUM. Case presentation : An 18-year-old woman was admitted for severe pain in the right lower abdomen during menstruation, which lasted more than 1 year. The patient was misdiagnosed with focal adenomyosis at our hospital on March 4, 2021. After 4 months, she was diagnosed with ACUM. Once diagnosis as focal adenomyosis, nonsteroidal anti-inflammatory drugs (NSAIDs) and gestrinone were administered to the patient. Following the diagnosis of ACUM, she received laparoscopic surgery. Our follow-up indicated that the symptom was significantly relief without drug therapy after sixty days postoperatively. Conclusions Clinical manifestations and imaging examinations are used to establish the diagnosis of ACUM. Medical therapy is only marginally effective, but laparoscopic surgery for complete mass excision is a feasible technique to solve the pain symptom. The prevalence and pathogenesis of ACUM and its reproductive outcomes on patients remain unclear, which calls for more and deeper research to study.

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Role of laparoscopic in diagnosis and treatment of undescended testis in children at Viet Duc Hospital

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2018.4.1 ◽

2018 ◽

Vol 8 (4) ◽

Author(s):

Viet Hoa Nguyen

Keyword(s):

Laparoscopic Surgery ◽

Undescended Testis ◽

Correct Diagnosis ◽

Diagnosis And Treatment ◽

Highly Sensitive ◽

The Mean ◽

The Right ◽

Time Of Operation

Abstract Introduction: Evaluating the role of laparoscopic for diagnosis and treatment of undescended testis in children. Material and Methods: Restrospective study, between 6/ 2014 and 6/2017. All the patients are aged from 1 to 16 years with undescended testis underwent laparoscopic surgery for diagnosis and treatment in Deparment of pediatric surgery – Viet Duc hospital enrolled. Results: Of 95 patiens in total had 106 undescended testis diagnosed and treated by laparoscopy. The mean age of patients was 7,5 ± 3,8 years. 44,2% undescended were on the left side, 44,2% were on the right and 11,6% were undescended bilateral. The correct diagnosis by ultrasound accounted in 79,4%. The locations of testis diagnosed by laparoscopic are : intra abdomen in 45,3%, deep inguinal orifice in 16,9%, extra inguinal orifice in 26,4%, no testicle found in 11,4%. The mean time of operation were 67,33± 28,01 pht. Scrotal positions were achieved 74,5%, remove atrophic testis accounted in 7,6%. Stephen- Flowler technique including step I were in 4,7%, step II in 1,9%. The outcome evaluated by testicular positions following 3 months after operation are : good in 79,2%, moderate 13,2%, poor in 7,6%; By classification of Aubert are : good in 81,1%, moderate in 11,3% and poor in 7,6 %. Conclusion: Laparoscopic surgery is not only a highly sensitive diagnostic method to find accurately the location and size of the testes, but also the most effective method to treat impalpable undescended testes.

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Lateral Medullary Infarction with Contralateral Segmental Dysesthesia and Ipsilateral Headache: A Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666211117142203 ◽

2021 ◽

Vol 17 ◽

Author(s):

Renjie Wang ◽

Yankun Shao ◽

Lei Xu

Keyword(s):

Medulla Oblongata ◽

Clinical Manifestations ◽

Lateral Medullary Infarction ◽

Case Presentation ◽

Specific Sign ◽

Temperature Sense ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

The Brain ◽

Medullary Infarction

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations. Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic resonance imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4. Diagnosis: Lateral medullary infarction. Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation. Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved. Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.

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Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

Russian journal of neurosurgery ◽

10.17650/1683-3295-2019-21-1-54-59 ◽

2019 ◽

Vol 21 (1) ◽

pp. 54-59

Author(s):

M. G. Bashlachev ◽

G. Yu. Evzikov ◽

V. A. Parfenov ◽

N. B. Vuitsyk ◽

F. V. Grebenev

Keyword(s):

Ankle Joint ◽

Peroneal Nerve ◽

Correct Diagnosis ◽

Clinical Manifestations ◽

Common Peroneal Nerve ◽

Diagnostic Methods ◽

Fibular Head ◽

Study Objective ◽

The Common ◽

The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

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Primary Intradural Extraosseous Ewing Sarcoma of the Spine: Case Report and Literature Review

Neurosurgery ◽

10.1227/neu.0b013e318223b7c7 ◽

2011 ◽

Vol 69 (4) ◽

pp. E995-E999 ◽

Cited By ~ 13

Author(s):

Isaac O Karikari ◽

Ankit I Mehta ◽

Shahid Nimjee ◽

Tiffany R Hodges ◽

June Tibaleka ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Ewing Sarcoma ◽

Correct Diagnosis ◽

Immunohistochemical Analysis ◽

Leg Pain ◽

Treatment Modalities ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Extraosseous Ewing Sarcoma

Abstract BACKGROUND AND IMPORTANCE: To report a rare case of spinal intradural extraosseous Ewing sarcoma in an adult and review current literature. Although Ewing sarcoma belongs to the family, the treatment modalities are different, and thus the correct diagnosis is very important despite its rare occurrence. CLINICAL PRESENTATION: A 56-year-old woman presented with nocturnal bilateral buttock and leg pain. Magnetic resonance imaging (MRI) showed an enhancing intradural extramedullary extraosseous tumor at L1. INTERVENTION: A T12-L2 laminectomy was performed to resect the tumor. Immunohistochemical analysis confirmed the diagnosis of Ewing sarcoma. A thorough diagnostic workup did not reveal any bony origin of the tumor. Primary intradural central nervous system Ewing sarcoma is infrequently encountered and shares imaging and histopathological features with central primitive neuroectodermal tumors. Establishment of the right diagnosis is crucial because it mandates a distinct workup and treatment modality different from that for central primitive neuroectodermal tumor. Although osseous Ewing sarcoma predominantly occurs in children and young adults, extraosseous central nervous system Ewing sarcoma is not uncommon in adults and should therefore be considered in the differential diagnosis of extraosseous small blue cell tumors in adult patients.

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Primary Hepatic Choriocarcinoma in a Male Patient: A Case Report and Literature Review

10.21203/rs.3.rs-284626/v1 ◽

2021 ◽

Author(s):

Ke Zhao ◽

Ke Rao ◽

Xin Chen ◽

Si Chen ◽

Haifeng Xu

Keyword(s):

Male Patient ◽

Malignant Tumor ◽

Poor Prognosis ◽

Clinical Manifestations ◽

Deep Understanding ◽

Positron Emission ◽

Pet Ct ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Fdg Pet Ct

Abstract BackgroundChoriocarcinoma is a rare malignant tumor and rarely occurs outside the gonads. Primary hepatic choriocarcinoma is more infrequent, with hidden clinical manifestations, rapid progress, and extremely poor prognosis. Only more than 10 cases were publicly reported in the world. Therefore, there is still a lack of deep understanding of the diagnosis and treatment of the disease.Case presentationWe report a case of primary hepatic choriocarcinoma in a man diagnosed by pathology. A 65-year-old male patient presented with fever and anorexia, nothing but mild jaundice of the skin and sclera was found on physical examination. Abdominal enhanced magnetic resonance imaging (MRI) showed a huge mass in the right hepatic lobe. Fludeoxyglucose-positron emission tomography-computed tomography (FDG-PET/CT) scan showed increased uptake in the liver and sigmoid colon and no uptake in the testes. The patient underwent the right hepatectomy, and postoperative pathology showed that the tumor was primary hepatic choriocarcinoma. Then he received one course of adjuvant chemotherapy. Then he developed severe myelosuppression and was transferred to the intensive care unit for further treatment. He eventually died of severe liver failure about 100 days after surgery. Primary hepatic choriocarcinoma is extremely rare, and its diagnosis is challenging.ConclusionsPrimary hepatic choriocarcinoma is a rare and highly malignant tumor with a poor prognosis. We believe that this differential diagnosis should be considered in liver tumor patients. The effective treatment for this disease is still to be explored.

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Case Report: Anti-NMDAR Encephalitis With Anti-MOG CNS Demyelination After Recurrent CNS Demyelination

Frontiers in Neurology ◽

10.3389/fneur.2021.639265 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bing-Yan Ren ◽

Yi Guo ◽

Jing Han ◽

Qian Wang ◽

Zai-Wang Li

Keyword(s):

Case Report ◽

Brain Mri ◽

Clinical Manifestations ◽

Epileptic Seizures ◽

Autoimmune Disorder ◽

Pulse Therapy ◽

Nmdar Encephalitis ◽

Cns Demyelination ◽

Magnetic Resonance Imaging Mri ◽

The Right

Introduction: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis, a serious neurological autoimmune disorder caused by autoantibodies with diverse clinical manifestations, may simultaneously onset with antimyelin oligodendrocyte glycoprotein (MOG) demyelination after recurrent central nervous system (CNS) demyelination.Case Report: We present a case of anti-NMDAR encephalitis combining with anti-MOG CNS demyelination following recurrent CNS demyelination. A 38-year-old man admitted to hospital developed epileptic seizures following recurrent episodes of cross-sensory disturbance and dizziness. Magnetic resonance imaging (MRI) showed a demyelinating lesion in the right brainstem initially. Despite a good response to methylprednisolone pulse therapy at the beginning, the patient still had relapses and progression after corticosteroid reduction or withdrawal. Then brain MRI discovered new serpentine lesions involving extensive cerebral cortex on his second relapse. Repeat autoantibodies test indicated cerebrospinal fluid (CSF) NMDAR antibodies coexisted with MOG-Abs simultaneously, suggesting the diagnosis of anti-NMDAR encephalitis with anti-MOG CNS demyelination.Results: After a definite diagnosis, the patient was treated with mycophenolate mofetil (MMF) and corticosteroid. He was discharged after his symptoms ameliorated. No neurological sequels remained, and there were no effects on his activities of daily living after 6 months of immunoregulatory therapy of MMF and corticosteroid.Conclusion: For individuals with recurrent CNS demyelination, especially combining with cortical encephalitis, repeated detection of autoantibodies against AE, and demyelination in CSF/serum can be helpful to enable a definite early diagnosis. For patients who suffer from anti-NMDAR encephalitis combining with anti-MOG CNS demyelination, second-line immunotherapy is recommended when first-line treatment such as steroids, intravenous immunoglobulin G (IVIG) and plasma exchange has been proven ineffective to prevent the relapse of disease.

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Brainstem Encephalitis Caused by Listeria monocytogenes

Pathogens ◽

10.3390/pathogens9090715 ◽

2020 ◽

Vol 9 (9) ◽

pp. 715

Author(s):

Pengxu Wei ◽

Ruixue Bao ◽

Yubo Fan

Keyword(s):

Listeria Monocytogenes ◽

Early Recognition ◽

Correct Diagnosis ◽

Clinical Manifestations ◽

Good Health ◽

Enteric Neurons ◽

Brainstem Encephalitis ◽

Mri Findings ◽

Periodontal Tissues ◽

Magnetic Resonance Imaging Mri

International outbreaks of listerial infections have become more frequent in recent years. Listeria monocytogenes, which usually contaminates food, can cause potentially fatal infections. Listerial cerebritis is a rare disease that is encountered mostly in immunocompromised or elderly patients. However, listerial brainstem encephalitis (mesenrhombencephalitis or rhombencephalitis) is found in persons who were formerly in good health, and recognizing this disease, particularly at its early stages, is challenging. Listerial brainstem encephalitis has high mortality, and serious sequelae are frequently reported in survivors. Early recognition and correct diagnosis, as well as the timely use of appropriate antibiotics, can reduce the severity of listerial infections. The trigeminal nerve is proposed as a pathway through which L. monocytogenes reaches the brainstem after entering damaged oropharyngeal mucosa or periodontal tissues. This review introduces the clinical manifestations, pathology, magnetic resonance imaging (MRI) findings, diagnosis, and treatment of listerial brainstem encephalitis. Moreover, it proposes that L. monocytogenes may also invade the brainstem along the vagus nerve after it infects enteric neurons in the walls of the gastrointestinal tract.

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Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report

BMC Neurology ◽

10.1186/s12883-021-02155-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hongfeng Wen ◽

Di Jin ◽

Lina Cai ◽

Tao Wu ◽

Haichao Liu

Keyword(s):

Spinal Cord ◽

Ischemic Stroke ◽

Clinical Manifestations ◽

Transverse Myelitis ◽

Lower Limbs ◽

Spinal Cord Atrophy ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Next Generation Sequencing Ngs

Abstract Background Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences. Case presentation We report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski’s sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up. Conclusions Neurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.

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Fovilles Syndrome a Case to Remember Case Report

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1344 ◽

2021 ◽

Vol 2 (10) ◽

pp. 1015-1017

Author(s):

Sudikshya Acharya ◽

Basant Pant ◽

Avinash Chandra ◽

Ayush Chandra

Keyword(s):

Rare Case ◽

Clinical Manifestations ◽

Sudden Onset ◽

The Body ◽

Clinical Feature ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Acute Headache ◽

Mr Angiogram

The Foville’s Syndrome is a rare clinical feature of stroke or brain hemorrhage. This is very rare brain stem syndrome and only few cases have been reported worldwide. A case of Foville's syndrome secondary to infarction at the left paramedian pontine region, which was diagnosed and treated at Annapurna Neurological institute and allied Science, Kathmandu, Nepal. A 62 years old gentleman presented with acute headache with sudden onset of vertigo, tinnitus, slurred speech, difficulty while swallowing and numbness and hemiparesis on the right side of the body. The aim of this study was to report a rare case of Foville's syndrome with the infarction at the left paramedian pontine region. The clinical manifestations were well correlated with anatomical involvement. The CT-scan of head, Magnetic Resonance Imaging (MRI), MR-Angiogram (MRA) sequence of cerebral and carotid, etc. helped in the diagnosis of the case along with the other lab investigations.

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