scholarly journals Lumbar Vertebrae and Epidural Space Metastases of Choriocarcinoma: A Case Report

2020 ◽  
Author(s):  
Lin Liu ◽  
Yini Zhang ◽  
Wei Zhang ◽  
Zhi Zhao ◽  
Zhengwei Li
Keyword(s):  
Case Report ◽  
Epidural Space ◽  
Lumbar Vertebrae ◽  
Endovascular Embolization ◽  
Lower Limbs ◽  
Histopathological Diagnosis ◽  
Aged Woman ◽  
Β Hcg ◽  
The Right ◽  
Surgery Department

Abstract Background: Choriocarcinoma is a rare and highly malignant tumor. It is characterized by the production of large amounts of human chorionic gonadotropin (HCG). The lumbar vertebrae and epidural space metastases of choriocarcinoma are extremely rare. This is a rare case report of a middle-aged woman with metastatic choriocarcinoma in the lumbar vertebrae, epidural space.Case presentation: The present case report describes a 42-year-old Chinese female patient who was admitted to the spine surgery department of The Second Afflicted Hospital of Dalian Medical University with signs of low back pain for ten days, weakness in both lower limbs and dysuria for four days in 2019. Magnetic resonance imaging revealed an inhomogeneous nodular lesion in the anterior epidural space from L3 to L4 and an abnormal signal in the L4 vertebral body. The patient underwent emergency surgery on the first day of admission for quick onset of paraplegia and dysuria. But the operation was stopped because of heavy bleeding. Five days later, she underwent endovascular embolization of the left and the right L4 lumbar segmental arteries, and after that, the hypervascular mass was subtotally removed. The histopathological diagnosis was choriocarcinoma. Then the patient received chemotherapy. But there was no apparent improvement in the neurological statement after chemotherapy. The patient’s outcome is death.Conclusions: This case suggests that choriocarcinoma should be borne in mind when observing a spinal extraosseous extension lesion with elevated β-HCG in a woman of child-bearing age.

scholarly journals MANAGEMENT OF THROMBOANGIITIS OBLITERANS - A CASE REPORT

2021 ◽  
Vol 9 (7) ◽  
pp. 1560-1563
Author(s):  
Vishal Chougule ◽  
Shailesh Shetty
Keyword(s):  
Case Report ◽  
Strong Association ◽  
Complete Healing ◽  
Lower Limbs ◽  
Thromboangiitis Obliterans ◽  
Foul Smell ◽  
Treatment Principle ◽  
The Right ◽  
Time Of Admission

Thromboangitis obliterans (TAOs) is a rare disease affecting arteries and veins of the upper and lower limbs. The condition has a strong association with the use of tobacco. Thromboangitis obliterans also known as Buerger's disease is found in the age group between 40 to 45 years, and men are most prone to get affected. The present case is a male aged 65 years complaining of a wound on the heel on the right foot, associated with pain, discharge, slough, foul smell, edema and discolouration of the skin for which he visited our hospital, the patient was previ- ously diagnosed as TAO, considering his clinical features at the time of admission, an intervention was planned based on the treatment principle of Dusta Vrana like Virechana, Basti and Raktamokshana. There was complete healing of the wound at the end of the treatment with no signs of recurrence during the follow-up suggesting the need for Shodhana in the effective management of TAO. Keywords: Dushta Vrana, Thromboangiitis Obliterans, Ayurveda, Panchakarma, Shodhana, Case report

Posttraumatic intercostal pulmonary herniation – case report

2021 ◽  
Vol 100 (5) ◽  
Keyword(s):  
Case Report ◽  
Chest Wall ◽  
Surgical Repair ◽  
Lung Parenchyma ◽  
Trauma Centre ◽  
Lower Limbs ◽  
Left Femur ◽  
Wall Defect ◽  
The Right ◽  
Car Accident

Introduction: Pulmonary hernias are rare conditions, most are the results of an injury or previous thoracic surgery. Case report: We present a case of a 48-year-old woman injured in a car accident. The examination in the trauma centre revealed a chest injury with herniation of the lung parenchyma into the chest wall and fractures of long bones of lower limbs. Initially, an osteosynthesis of the left femur and the right tibia fracture were performed. The patient underwent a subsequent surgery to repair the pulmonary hernia. Conclusion: A pulmonary hernia is diagnosed either directly during a clinical examination or by imaging. A sovereign diagnostic method is a computed tomography. The method of treatment is a surgical repair with primary suture of the chest wall defect or implantation of a mesh to repair the pulmonary hernia.

scholarly journals Primary nasal tuberculosis: A case report

2013 ◽  
Vol 70 (8) ◽  
pp. 778-780 ◽  
Author(s):  
Jasmina Stojanovic ◽  
Branislav Belic ◽  
Slobodanka Mitrovic ◽  
Predrag Stankovic ◽  
Stevan Stojanovic ◽  
...  
Keyword(s):  
Case Report ◽  
Inflammatory Process ◽  
Normal Skin ◽  
Difficulty Level ◽  
Histopathological Diagnosis ◽  
Reference Ranges ◽  
Major Health Problem ◽  
Antituberculosis Therapy ◽  
Bacteria And Fungi ◽  
The Right

Introduction. During the past two decades, tuberculosis (TBC) both pulmonary and extrapulmonary, has emerged to be a major health problem. Nasal tuberculosis is a specific inflammatory process which is, in most cases, joined by the inflammation of neck lymph nodes. Case report. Thirty-yearold man presented with shortness of breath through the nose and periodical headaches. Clinical examination showed signs of chronic rhinitis, with slight granular changes of nasal septal mucosa. Laboratory analyses were within the reference ranges. Nasal and throat swabs for bacteria and fungi were normal. Skin allergy testing to standard inhalatory allergens was positive. Computer rhinomanometry showed increased nasal resistance at medium difficulty level, on the right. Radiography of paranasal sinuses indicated chronic polysinusitis on the right. Anti-allergy therapy was prescribed. The patient came for checkup after a month with subjective deterioration and a neck tumefact on the right. Nasal endoscopy revealed the presence of dark red infiltrates with the 3 mm diameter on nasal septal mucosa, dominantly on the right, with small greyish nodules. This findings indicated a potential specific nasal inflammatory process. In the upper jugulodigastric area, on the left, painless tumefact 3 x 5 cm in size was palpated, it was mobile comparing to supra- and infrastructure, with unaltered skin above. The definite diagnosis was established on the basis of the results of nasal mucosa biopsy. After histopathological diagnosis was obtained, we started with antituberculosis therapy at once. Conclusion. Due to actual trends of TBC incidences, otolaryngologist should have in mind nasal TBC, when granulomatose lesions are found in nose.

scholarly journals Successful endovascular treatment of extracranial arteriovenous malformation of a head: a case report

2019 ◽  
Vol 10 (4) ◽  
pp. 40-48
Author(s):  
A. A. Sufianov ◽  
S. M. Karasev ◽  
R. R. Khafizov ◽  
R. R. Rustamov ◽  
R. A. Sufianov ◽  
...  
Keyword(s):  
Case Report ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Vascular Supply ◽  
Endovascular Embolization ◽  
Maximum Effect ◽  
Facial Soft Tissue ◽  
Soft Tissue Necrosis ◽  
Endovascular Methods ◽  
The Right

Introduction. Arteriovenous malformations (AVM) of the head represent the rare lesions that have a congenital, traumatic or post-infectious nature. In the last decade, endovascular methods have become the most prevalent in the treatment of AVM. Staged embolization is performed to achieve maximum effect and minimize the complications.Case report. A 30-year-old female patient is presented with complaints of enlarged vessels in the frontal and parietal regions. CT-angiography scan and cerebral angiography showed extracranial AVM of the fronto-parietal regions with afferent vascular supply from the right and left superficial temporal and ophtalmic arteries with significant expansion of the afferent arteries and the presence of varix dilatation of the draining veins. Two-stage endovascular embolization of AVM was performed. The first stage was embolization of the afferent vessels from the left superficial temporal artery system with exclusion of 60–65% AVM volume. Three months later, the second stage was performed with embolization of the afferent vessels from the right superficial temporal artery system and the exclusion of 75–80% of the residual volume of AVM. The non-adhesive composition SQUIDR12 (Emboflu, Switzerland) and glue composition PHILR25% (Microvention, USA) were used. A good aesthetic effect was achieved. Postoperative complications were not observed. There was no recurrence during the observation within a year.Summary. The staging and the use of various liquid embolization agents in the treatment of AVM of the head allow to achieve a good aesthetic outcome and prevent complications associated with facial soft tissue necrosis.

scholarly journals Spinal Arteriovenous Fistula, A Manifestation of Hereditary Hemorrhagic Telangiectasia: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 417-420
Author(s):  
Jodi Spangler ◽  
Bjorn Watsjold ◽  
Jonathan Ilgen
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Early Recognition ◽  
Endovascular Embolization ◽  
High Morbidity ◽  
Autosomal Dominant Disorder ◽  
Arteriovenous Fistulas ◽  
Spinal Arteriovenous Fistula ◽  
The Right

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVM). HHT can have neurological manifestations. Case Report: A 32-year-old woman with a history of HHT presented to the emergency department with acute partial paralysis of the right leg, urinary retention, and right-sided back and hip pain. Magnetic resonance imaging of the spine demonstrated multiple, dilated blood vessels along the cervical spine, diffuse AVMs in the lumbar and thoracic spine, and a new arteriovenous fistula at the twelfth thoracic (T12) vertebral level. Her symptoms improved after endovascular embolization of the fistula. Conclusion: Spinal AVMs are thought to be more prevalent in patients with HHT. Given the high morbidity of arteriovenous fistulas, early recognition and intervention are critical.

METASTATIC CHORIOCARCINOMA PRESENTING AS RENAL COLIC AND SKIN LESION – CASE REPORT

2021 ◽  
Vol 74 (7) ◽  
pp. 1763-1766
Author(s):  
Michał Pietrus ◽  
Adrian Czekaj ◽  
Dominik Dziadkowiak ◽  
Krzysztof Ratajczyk ◽  
Maciej Trzciniecki ◽  
...  
Keyword(s):  
Case Report ◽  
Skin Lesion ◽  
Renal Colic ◽  
Left Lung ◽  
Cutaneous Metastasis ◽  
Blood Levels ◽  
Surgical Removal ◽  
Β Hcg ◽  
The Right ◽  
Kidney Metastasis

Choriocarcinoma is a rare malignant disease that is usually associated with a gestational event. Kidney metastasis might be misdiagnosed as renal cell carcinoma or kidney abscess. To the best of our knowledge, only 13 cases of cutaneous metastasis of choriocarcinoma have been reported in the literature so far. We report a case of choriocarcinoma that manifested with multiple metastases to the lung, skin, kidney and brain. Case report: We reported a case of a 37-year-old woman with a history of hydatiform mole, with symptoms of renal colic and abnormal findings on the skin. Chest X-ray revealed visible focal change 80 mm in diameter, located in the left lung area. The CT exposed in both kidneys multiple hypodense foci, 32 mm in size, suggesting multifocal abscesses with disruptions and perforation to paranephric area. Due to the presence of and temporary loss of vision in the right eye head CT was performed revealing metastatic changes in the brain. The diferential diagnosis between renal cancer, lung carcinoma and choriocarcinoma was achieved only after surgical removal skin lesion. This was the first time in our experience with choriocarcinoma. Immunohistochemically, the analysis was positive for beta hCG, cytokeratin AE1/AE, CK 8/18, CD10, EMA, alfa 1-inhibin and negative for protein 63, CD30 and CD117. Serum hCG level was 394590,0 mIU/mL. Conclusions: Choriocarcinoma should be taken into consideration when associated symptoms and significantly elevated blood levels of β-hCG were identified.

scholarly journals Fahr’s syndrome as a differential diagnosis amid parkinsonian syndromes: a case report

2021 ◽  
Author(s):  
Luana de Rezende Mikael ◽  
Coralia Gabrielle Vieira Silveira ◽  
Camilla Duarte Ribeiro ◽  
Daniel Damiani ◽  
Pedro Henrique de Lara Leite ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Basal Ganglia ◽  
Underlying Disease ◽  
Lower Limbs ◽  
Parkinsonian Syndrome ◽  
Parkinsonian Syndromes ◽  
Fahr’S Syndrome ◽  
Atypical Presentations ◽  
The Right

Context: Parkinsonian syndromes are routinely identified by neurologists. However, the differential diagnosis among probable etiologies can be challenging and complex. In Fahr’s syndrome, calcifications of the basal ganglia secondary to disorders of calcium metabolism are observed. A possible clinical presentation associated with this entity is the presence of a parkinsonian syndrome. Case report: A 54-years-old female patient presented with a progressive tremor in the right upper and lower limbs associated with bradykinesia. Seizures were observed during the course of the disease. After extensive clinical workup, primary hypoparathyroidism was diagnosticated along with the recognition of a mutation in the calcium activator gene. Computed tomography and magnetic resonance imaging of the head showed bilateral coarse calcifications in thalami and basal ganglia compatible with Fahr’s syndrome. We began treatment for control of the underlying disease, as well as for symptomatic control of parkinsonism. Conclusions: Different pathologies could justify the parkinsonian syndrome observed initially in the case described. Among them: Iidiopathic Parkinson’s Disease, Multiple System Atrophy, Progressive Supranuclear Palsy. In our patient, the atypical evolution in a young woman led to the research of possible secondary treatable causes. A diagnosis of Fahr’s syndrome related to hypoparathyroidism was unveiled. The differential diagnosis of Parkinson’s Syndrome is broad and difficult. We must be aware of the possible atypical presentations due to the possibility of a secondary condition whose etiology could be effectively treated.

scholarly journals A gastrointestinal stromal tumor: Case report

2006 ◽  
Vol 59 (9-10) ◽  
pp. 487-489
Author(s):  
Milivoje Vukovic ◽  
Nebojsa Moljevic ◽  
Dragan Krivokuca
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Surgical Resection ◽  
Kinase Inhibitor ◽  
Iliac Fossa ◽  
Primary Treatment ◽  
Clinical Findings ◽  
Mesenchymal Tumors ◽  
The Right ◽  
Surgery Department

Introduction. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. They frequently occur in the stomach and small intestine, but they rarely occur in the colon and rectum. Case report. This is a case report of a patient with a GIST involving the cecum, and acute obstruction of the small intestine. A 47-year- old male patient was admitted to the emergency surgery department with abdominal pain and distension lasting for a few days. Clinical examination revealed tenderness in the right iliac fossa. Routine hematologic testing revealed anemia, and abdominal x-ray multiple air-fluid levels in the small intestine. Based on the clinical findings, we decided to perform an explorative laparotomy. A large cecal tumor was detected. The proximal parts of the small intestine were severely distended. Discussion and Conclusion. GISTs are more common in the stomach (60-70%) and the small intestine (25-35%), than in the colon, rectum and esophagus. The most frequent complications associated with GISTs are obstructions and hemorrhages. Surgical resection is the primary treatment of GISTs. Radiotherapy and chemotherapy are generally ineffective. Continuous postoperative follow-up is necessary, because most recurrences occur within the first 2 years after complete surgical resection. In the past few years, surgical resection was followed by adjuvant tyrosine kinase inhibitor therapy. .

Ameloblastoma: Presentación de un caso [Ameloblastoma: Case report]

2020 ◽  
Vol 42 (02) ◽  
Author(s):  
Alfredo Obando ◽  
Rolando Reyna
Keyword(s):  
Case Report ◽  
Intimate Relationship ◽  
Histopathological Diagnosis ◽  
Caudal Portion ◽  
The Right ◽  
Mass Dependent

Resumen <br />Se presenta el caso de una paciente con tumoración indolora en región mandibular derecha, de 5 años de evolución asociado a halitosis. La tomografía muestra masa dependiente de la porción derecha del cuerpo de la mandíbula, así como de su ángulo y rama derecha. La lesión se observa multilobulada, con zonas quísticas y septos, algunos de estos finos. También se reconoce compromiso de la apófisis coronoide derecha y zonas de aspecto sólido que presentan realce heterogéneo de leve a moderado, que se ubican en la porción más caudal de la lesión y en íntima relación con el segundo molar inferior derecho. El diagnóstico histopatológico es un ameloblastoma follicular.<br /><br />Abstract <br />The tomography shows a mass dependent on the right portion of the jaw’s body, as well as its right angle and branch. The lesion is multilobed, with cystic areas and septa, some of these fines. Commitment of the right coronoid apophysis is also recognized and areas of solid aspect that have heterogeneous and mild-moderate enhancement that are located in the most caudal portion of the lesion and in intimate relationship with the second lower right molar. The histopathological diagnosis is an folicular ameloblastoma.<br /><br />

Nasal Septal Hemangiopericytoma-like Tumor: A Case Report with an Immunohistochemical Study

2001 ◽  
Vol 15 (4) ◽  
pp. 267-270 ◽  
Author(s):  
Rie Yasui ◽  
Toru Minatogawa ◽  
Naoyuki Kanoh ◽  
Yasuo Nakata ◽  
Akira Kubota
Keyword(s):  
Case Report ◽  
Immunohistochemical Study ◽  
Preoperative Evaluation ◽  
Vascular Tumor ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Topoisomerase Iiα ◽  
Ki 67 ◽  
Grade Malignancy ◽  
The Right

Nasal hemangiopericytoma-like (HPCL) tumor is a rare vascular tumor and should be differentiated from typical hemangiopericytomas (HPCs). This study reports the case of an HPCL tumor in a 77-year-old man with histological and immunohistochemical features. After preoperative evaluation of the blood supply, the dark-red right intranasal tumor was resected completely via the right maxillary sinus. The final histopathological diagnosis was HPCL tumor based on several stains: vimentin (+), α-SMA (+), etc. Moreover, there were few p53 (+) cells and the Ki-67 and topoisomerase IIα labeling indices were both under 5%. These findings indicated that this tumor was a low-grade malignancy. The immunohistochemical investigations used are useful for making the diagnosis of HPCL tumor and determining the treatment, malignancy, and prognosis. (American Journal of Rhinology 15 267–270, 2001)

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