Malignant Transformation of Liver Cysts Into Cholangiocarcinoma During Follow-up: Potential Dangers of Liver Cysts

Abstract Background: The liver cyst is a common disease in hepatobiliary surgery. Most patients have no apparent symptoms and are usually diagnosed accidentally during imaging examinations. The vast majority of patients with liver cysts follow a benign course, with very few serious complications and rare reports of malignant changes. Case Presentation: We present two cases of liver cysts that evolved into intrahepatic tumors during the follow-up process. The first patient had undergone a fenestration and drainage operation for the liver cyst, and the cancer was found at the cyst’s position in the third year after the procedure. Microscopically, bile duct cells formed the cyst wall. Tumor cells can be seen on the cyst wall and its surroundings to form adenoid structures of different sizes, shapes, and irregular arrangements, some of which are arranged in clusters. The second patient was regularly rechecked after discovering liver cysts, and a new mass appeared very close to the cyst. The clinical manifestations and laboratory examinations of the two patients lacked specificity, the preoperative diagnosis was unclear, and the postoperative pathology confirmed cholangiocarcinoma.Conclusions: Our cases indicate that liver cysts may lead to the occurrence of malignant intrahepatic cholangiocarcinoma. Therefore, follow-up of particular liver cysts is necessary, and the differential diagnosis of the intrahepatic cystic tumors needs to include cholangiocarcinoma.

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Identification of NR0B1 Gene Mutation and Analysis of Bone Damages and Drug Treatment Effect in a Big Family With X-linked Adrenal Hypoplasia Congenita: a Case Report

10.21203/rs.3.rs-373516/v1 ◽

2021 ◽

Author(s):

XIAOHUI TAO ◽

LI LIU ◽

XIAOYUN LIN ◽

TIAN XU ◽

HUA YUE ◽

...

Keyword(s):

Mass Density ◽

Hypogonadotropic Hypogonadism ◽

Clinical Manifestations ◽

Osteonecrosis Of The Jaw ◽

Bone Mass Density ◽

Insertion Mutation ◽

Case Presentation ◽

Skeletal Complications ◽

Adrenal Hypoplasia

Abstract Background: X-linked congenital adrenocortical hypoplasia (XL-AHC) is a rare disorder, which is characterized by primary adrenal insufficiency and hypogonadotropic hypogonadism. However, the skeletal complications caused by the disease were rarely reported, not to mention the treatment.Case presentation: The patient from a big family with XL-AHC was identified carrying a homozygous insertion mutation（p.Thr193GlyfsX13）in DAX-1 gene. The diagnosis of secondary osteoporosis was made after imaging, laboratory and bone mass density examinations. However, he showed a suboptimal response to bisphosphonates during 2 years of follow-up, even suffered from atypical femoral fracture (AFF). Now it had been replaced by menatetrenone, bone healing was satisfactory. Conclusions: We harbored the idea that clinicians should not only focus on typical clinical manifestations of XL-AHC, but also pay attention to the skeletal complications in clinical practice. Conventional anti-osteoporosis drugs may cause side effects such as AFF and osteonecrosis of the jaw (ONJ), which was rare in general osteoporosis patients. In other words, anabolic agent may be a better choice.

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Leptospirosis presented with erythema nodosum on four limbs: an unusual presenting

Oxford Medical Case Reports ◽

10.1093/omcr/omz130 ◽

2020 ◽

Vol 2020 (1) ◽

Cited By ~ 1

Author(s):

Lotfollah Davoodi ◽

Armaghan Kazeminejad ◽

Hamed Jafarpour ◽

Alireza Razavi

Keyword(s):

Rare Case ◽

Erythema Nodosum ◽

Clinical Manifestations ◽

Common Disease ◽

Clinical Form ◽

Case Presentation ◽

Typical Form ◽

Wide Range ◽

Adipose Inflammation ◽

Subcutaneous Adipose

Abstract Leptospirosis is a common disease between humans and animals characterized by a wide range of clinical manifestations. Erythema nodosum (EN) is a common clinical form of panniculitis or subcutaneous adipose inflammation caused by hypersensitivity responses to antigens, but the presence of EN in a subject with leptospirosis is a very rare case presentation. We will present a 42-year-old man with a headache, myalgia, nausea and rigid tender on the shin and both forearms, which was a typical form of EN lesions.

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A Solitary Giant Neurofibroma of Inguinal Region—A Case Report

10.21203/rs.3.rs-39194/v1 ◽

2020 ◽

Author(s):

Haiying Zhou ◽

Hui Lu

Keyword(s):

Tumor Resection ◽

Clinical Manifestations ◽

Inguinal Region ◽

Case Presentation ◽

Neurogenic Tumors ◽

Long Time ◽

Giant Neurofibroma ◽

History Of ◽

Recurrence Tendency

Abstract Background:Neurofibroma is a rare nerve sheath tumorofneuroectodermal origin, especially the huge and isolated neurofibroma located in the inguinal region. To our knowledge, no such case has previously been reported.Case presentation:We report a case of 34-year-old male patient with a 4-year history of progressive enlargement of the medial root mass in his left thigh with sitting and standing disorders along with pain. The tumor was completely removed by operation, and pathological diagnosisshowed neurofibroma. There was no obvious neurologic defect after surgery, and no recurrence tendency was found in the follow-up of 2years.Conclusions:For a large solitary mass with slow growth and no malignant clinical manifestations for a long time, clinicians can not rule out the hypothetical diagnosis of neurofibroma, even though its growth site is very rare, such as this case of a huge tumor located in the groin. For neurogenic tumors, early operation should be performed, and the prognosis of patients after tumor resection isexcellent.

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Spontaneous regression of lumbar herniated disc Case presentation

Romanian Neurosurgery ◽

10.1515/romneu-2015-0053 ◽

2015 ◽

Vol 29 (4) ◽

pp. 381-384 ◽

Cited By ~ 1

Author(s):

A. Chiriac ◽

Giorgiana Ion ◽

Z. Faiyad ◽

I. Poeata

Keyword(s):

Conservative Treatment ◽

Intervertebral Disc ◽

Clinical Improvement ◽

Spontaneous Regression ◽

Surgical Intervention ◽

Herniated Disc ◽

Common Disease ◽

Intervertebral Disc Herniation ◽

Case Presentation

Abstract Intervertebral disc herniation is a common disease that usually requires surgical intervention. However, in some cases, neurological symptoms may improve with conservative treatment. In this article, we present a case with spontaneous regression of extruded lumbar herniated disc correlated with clinical improvement and documented with follow up MRI studies.

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Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02021-4 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Shengjie Xu ◽

Xiaohong Song ◽

Chengjuan Jin ◽

Yanli Li

Keyword(s):

Ectopic Pregnancy ◽

Tumor Metastasis ◽

Actinomycin D ◽

Clinical Manifestations ◽

Case Presentation ◽

Delayed Treatment ◽

Missed Diagnosis ◽

Β Hcg ◽

Histopathological Results

Abstract Background Tubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis. Case presentation This report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5-fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence. Conclusions Tubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma.

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Symptomatic pulmonary sclerosing hemangioma: a rare case of a solitary pulmonary nodule in a woman of advanced age

Journal of International Medical Research ◽

10.1177/0300060519840898 ◽

2019 ◽

Vol 47 (5) ◽

pp. 2302-2308 ◽

Cited By ~ 1

Author(s):

Zhu-Qing Yuan ◽

Qian Wang ◽

Min Bao

Keyword(s):

Symptom Relief ◽

Clinical Manifestations ◽

Lower Lobe ◽

Large Mass ◽

Advanced Age ◽

Case Presentation ◽

Sclerosing Hemangioma ◽

Pulmonary Sclerosing Hemangioma ◽

History Of

Background Pulmonary sclerosing hemangioma (PSH) is a rare tumor that usually develops in middle-aged Asian women. PSH has four histological types (hemorrhagic, sclerotic, solid, and papillary) and often grows slowly in a lower lobe of the lung. Preoperative misdiagnosis frequently occurs because of the absence of specific clinical manifestations and imaging findings. Few reports have described PSH in women of advanced age. Case presentation: A 75-year-old woman presented to our hospital in China with a 5-day history of productive cough and intermittent hemoptysis. Computed tomography indicated bronchiectasis and a large mass in the left inferior lobe of the lung. Treatment of the bronchiectasis provided no symptom relief. The hemoptysis resolved following left lower pulmonary lobectomy, and PSH was pathologically diagnosed following surgery. At the time of this writing (after 6 months of follow-up), the tumor had not recurred, no metastases had been detected, and close follow-up was ongoing. Conclusions Both bronchiectasis and PSH can cause hemoptysis. This case demonstrates that PSH should be included as a differential diagnosis of hemoptysis in women of advanced age. For patients with chronic hemoptysis, the diagnosis of PSH should be considered if the therapeutic effect of bronchiectasis is poor.

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Rare Cardiac Myxoma with A Hard Texture: A Case Report

10.21203/rs.3.rs-51205/v1 ◽

2020 ◽

Author(s):

Hongfei Xu ◽

Yanjia Gu ◽

Liang Ma ◽

Yiming Ni ◽

Weidong Li

Keyword(s):

Elective Surgery ◽

Cardiac Myxoma ◽

Clinical Manifestations ◽

Surgical Excision ◽

Cardiac Tumors ◽

Rare Type ◽

Primary Tumors ◽

Case Presentation ◽

Preoperative Examination

Abstract Background: Primary tumors of the heart are uncommon but not rare. Myxoma comprises 50% of all benign cardiac tumors in adults and 15% of such tumors in children. Cardiac myxoma is usually soft in texture and has a friable or villous surface, which tends to be associated with embolic events. It is also rare for myxoma to be full of calcium and metastatic bone deposits.Case presentation: We herein present a 58-year-old female patient with cardiac space-occupying lesion within the left atrium, and the lesion is lubricous and hard. Her only symptoms were hypertension, dizziness, and chest stuffiness. After surgical resection, we confirmed that the lesion was atrial myxoma by histopathology examination. The patient recovered uneventfully and was discharged. A 2-year follow-up exam showed no evidence of tumor recurrence.Conclusions: Cardiac myxoma is rare and has various clinical manifestations. It is usually friable and has an irregular surface, making embolic manifestations one of the most common complications. Consequently, immediate surgical excision is suggested upon diagnosis. In our case, the patient had a rare type of cardiac myxoma, which had a hard texture and lubricous surface. In our opinion, this case has a low risk of embolism. We prefer elective surgery rather than emergency surgery to perfect the preoperative examination for this kind of patient.

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Case report: a case of primary pulmonary glomus tumor

10.21203/rs.2.22606/v1 ◽

2020 ◽

Author(s):

shuangshuang Deng ◽

Jianhao Huang ◽

Qi Yin ◽

Jinli Gao ◽

Feilong Wang ◽

...

Keyword(s):

Tumor Recurrence ◽

Glomus Tumor ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Final Diagnosis ◽

Case Presentation ◽

Glomus Tumors ◽

Disease Case ◽

The Right

Abstract Background Glomus tumors, as extremely rare tumors of the lung, since their rarity and the variety of the clinical symptoms, tend to be misdiagnosed. The location of these tumors as well as their early diagnosis is a pivot for the prognosis of the disease. Case presentation We report a case of old patient whose final diagnosis was primary pulmonary glomus tumor. She initially was found a nodule in the right lung, which was enlarged during follow-up and finally confirmed after surgery. Postoperative pathology was considered as a primary pulmonary glomus tumor. There has been no evidence of tumor recurrence or metastasis so far. Conclusion Primary pulmonary glomus tumor is rare. The clinical manifestations are related symptoms occupying lesions in the lung. The diagnosis of the tumor depends on histopathology and immunohistochemistry. Surgical resection is considered as the most eﬀective treatment for this condition.

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Vascular Dementia: Challenge of Clinical Diagnosis

International Psychogeriatrics ◽

10.1017/s1041610297004699 ◽

1997 ◽

Vol 9 (S1) ◽

pp. 51-58 ◽

Cited By ~ 31

Author(s):

Timo Erkinjuntti

Keyword(s):

Cognitive Impairment ◽

Vascular Dementia ◽

Clinical Manifestations ◽

Vascular Cognitive Impairment ◽

Cerebrovascular Diseases ◽

Care Physician ◽

Detailed Medical History ◽

Laboratory Examinations

Vascular dementia (VaD) is the second most common cause of dementia. In addition, cerebrovascular diseases (CVD) coexist with other causes of dementia. Cognitive impairment related to CVD may be preventable and these patients could benefit from therapy, which emphasizes the importance of early detection and accurate diagnosis of VaD. The conventional concept of VaD is that of multi-infarct dementia (MID). However, VaD is not only MID; it relates to different vascular mechanisms and different changes in the brain, and has different clinical manifestations with different causes. Critical conceptual questions include the cognitive syndrome and the vascular causes. It is unclear whether the conventional concept of dementia is appropriate or should be substituted with a milder and broader definition, such as vascular cognitive impairment. Furthermore, there is confusion about the causes, especially the role of lesion characteristics and the noninfarct factors. The current diagnostic criteria for VaD are based on the infarct concept. The NINDS-AIREN criteria include dementia, CVD, and a relationship between these two disorders. The criteria define the CVD and the relationship between dementia and CVD, and list supporting clinical features for the diagnosis of VaD, as well as features that make the diagnosis uncertain. The interrater reliability of these criteria is moderate to substantial (κ .46 to .72). The expected antemortem accuracy using these criteria approaches 90%. The challenge is to correctly diagnose combined cases with both vascular and Alzheimer-type pathology. Main tools in the diagnosis include a detailed medical history, neurological examination, clinical or neuropsychological mental status examination, and basic laboratory examinations. Brain imaging should always be performed, preferably using magnetic resonance imaging. The diagnosis, especially in early cases, is usually made by a neurologist. The challenge for the primary care physician is to identify the early cases needing further examinations and organizing treatment and follow-up after diagnosis.

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Infected giant liver cyst

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0608328c ◽

2006 ◽

Vol 134 (7-8) ◽

pp. 328-330

Author(s):

Radoje Colovic ◽

Nikica Grubor ◽

Vladimir Radak ◽

Marijan Micev ◽

Natasa Colovic

Keyword(s):

Escherichia Coli ◽

Cyst Wall ◽

Rare Complication ◽

Left Kidney ◽

Liver Cyst ◽

Diagnostic Techniques ◽

Liver Cysts ◽

The Past ◽

Giant Liver Cyst ◽

Congenital Cysts

Congenital liver cysts are not as rare as it was thought in the past. Thanks to new imaging diagnostic techniques, these cysts have been discovered with increasing frequency. Uncomplicated congenital liver cysts are usually asymptomatic or followed by mild symptoms. Various complications of these cysts were reported. Infection of the congenital liver cyst is, however, very rare complication. A 65-year old man with huge infected congenital central liver cyst containing 3400 ml of pus from which Escherichia coli was cultivated was presented. The patient had a number of other histologically confirmed congenital cysts of the liver and the cyst of the left kidney. The patient was cured by pus evacuation, partial excision of the cyst wall and drainage of the cavity and subphrenic space. The uninfected cysts were operated using deroofing technique. A year after surgery the patient remained symptom free.

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