Priapism as the Initial Manifestation of a Penile and Lower Limb Cutaneous Metastasis of Prostate Adenocarcinoma With Low Serum PSA Level

Although hypothyroidism may cause a wide range of muscle disturbances, an overt myopathy may rarely present as an isolated initial presentation of hypothyroidism. The frequency of myopathy in hypothyroidism ranges from 30 to 80%. The major muscular symptoms are weakness, muscular cramps and myalgia. Laboratorial investigation generally shows increased levels of muscle enzymes and low serum thyroid hormones, with high thyrotrophic-stimulating hormone (TSH) elevated. The electrophysiological study reveals myopathy, neuropathy or mixed pattern. The treatment consists in hormone replacement and the prognosis is good in most of the cases. We report two cases that developed cramps, myalgia, and weakness, one of them presented as a polymyositis-like syndrome. The muscle enzymes were increased with a raised level of TSH. The myopathy was the initial manifestation of hypothyroidism in these cases. Both the patient was treated by replacement of thyroxin with significant clinical and biochemical improvement. DOI = 10.3329/jom.v8i1.1379 J MEDICINE 2007; 8 : 32-36

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Deep Vein Thrombosis as Initial Manifestation of Whipple Disease

Case Reports in Gastroenterology ◽

10.1159/000452206 ◽

2016 ◽

Vol 10 (3) ◽

pp. 640-645 ◽

Cited By ~ 1

Author(s):

Mônica Souza de Miranda Henriques ◽

Alexandre Rolim da Paz ◽

Ana Beatriz Person Gaertner ◽

Cibelle Ingrid Stephen Melo ◽

Priscyanne Lins Filgueiras ◽

...

Keyword(s):

Venous Thrombosis ◽

Lower Limb ◽

Periodic Acid ◽

Blood Stasis ◽

Clinical Manifestations ◽

Pathological Examination ◽

Intestinal Lymphangiectasia ◽

Initial Manifestation ◽

Vein Thrombosis ◽

Whipple Disease

Introduction: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as “stroke-like syndrome” or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis. Objective: We report a case of venous thrombosis as initial manifestation of WD. Case Report: We describe the case of a 53-year-old male with iliofemoral vein thrombosis followed by intermittent diarrhea, loss of appetite, abdominal distension, and bloating. A mild malnutrition state with a weight loss of 13 kg, pallor (+/4 +), presence of lower-limb edema (+/4 +), and hypertympanic distended abdomen occurred. Laboratory tests on admission revealed anemia, positive inflammatory activity tests, and normal coagulation. Endoscopic examination showed villous edema with white dotted infiltrates in the second duodenal portion and intestinal lymphangiectasia in the terminal ileum. Pathological examination revealed numerous macrophages with positive periodic acid-Schiff inclusions. Venous Doppler ultrasound showed extensive deep thrombosis on the left lower limb and recanalization of the femoral vein in the right lower limb. The patient was treated with ceftriaxone and enoxaparin sodium, which led to an improvement of gastrointestinal and thrombosis symptoms. Comments: Hypercoagulability, endothelial damage, vasculitis, and blood stasis are present in T. whipplei infection, which are associated with the activation of inflammatory mechanisms as well as procoagulant and thromboembolic events. WD should be part of the differential diagnosis of diseases that cause venous thrombosis of unknown origin.

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Incomplete cavernous sinus syndrome as the initial manifestation of a previously undetected metastatic prostate adenocarcinoma

Head & Neck ◽

10.1002/hed.24808 ◽

2017 ◽

Vol 39 (7) ◽

pp. E77-E80

Author(s):

María Machío Castelló ◽

Diego Escobar Montatixe ◽

Carlos Cenjor Español ◽

José Miguel Villacampa Aubá ◽

Julia Montoya Bordón ◽

...

Keyword(s):

Cavernous Sinus ◽

Prostate Adenocarcinoma ◽

Initial Manifestation ◽

Cavernous Sinus Syndrome

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Cutaneous Metastasis Originating from Prostate Adenocarcinoma

International Journal of Dermatology ◽

10.1111/j.1365-4362.1991.tb03876.x ◽

1991 ◽

Vol 30 (5) ◽

pp. 363-363 ◽

Cited By ~ 11

Author(s):

Ricardo B. Rossetti ◽

Cassio M. Villaca Neto ◽

Luiz H. C. Paschoal ◽

Miguel Burnler

Keyword(s):

Prostate Adenocarcinoma ◽

Cutaneous Metastasis

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Scalp Metastasis as the First Sign of Small-Cell Lung Cancer: Management and Literature Review

International Surgery ◽

10.9738/intsurg-d-13-00070.1 ◽

2014 ◽

Vol 99 (4) ◽

pp. 325-329 ◽

Cited By ~ 6

Author(s):

Nikolaos S. Salemis ◽

Georgios Veloudis ◽

Kyriakos Spiliopoulos ◽

Georgios Nakos ◽

Nikolaos Vrizidis ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Cutaneous Metastasis ◽

Small Cell ◽

Clinical Entity ◽

Small Cell Lung ◽

Initial Manifestation ◽

Cancer Management ◽

Scalp Metastasis

Abstract Cutaneous metastasis from primary visceral malignancy is a relatively uncommon clinical entity, with a reported incidence ranging from 0.22% to 10% among various series. However, the presence of cutaneous metastasis as the first sign of a clinically silent visceral cancer is exceedingly rare. We describe here a case of an asymptomatic male patient who presented with a solitary scalp metastasis as the initial manifestation of an underlying small-cell lung cancer. Diagnostic evaluation revealed advanced disease. We conclude that the possibility of metastatic skin disease should always be considered in the differential diagnosis in patients with a history of smoking or lung cancer presenting with cutaneous nodules. Physicians should be aware of this rare clinical entity, and appropriate investigation should be arranged for early diagnosis and initiation of the appropriate treatment. The prognosis for most patients remains poor.

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Acute ischemia of the lower limb due to non-bacterial thrombotic endocarditis with recent venous thromboembolic disease as the initial manifestation of lung adenocarcinoma: A case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab426 ◽

2021 ◽

Author(s):

Julien Polo ◽

Daniele Raufast ◽

Dimitri Cornand ◽

Antoine Elias

Keyword(s):

Mitral Valve ◽

Lung Adenocarcinoma ◽

Popliteal Artery ◽

Lower Limb ◽

Thrombotic Event ◽

Rare Condition ◽

Transoesophageal Echocardiography ◽

Pet Scan ◽

Acute Ischemia ◽

Initial Manifestation

Abstract Background Non-bacterial thrombotic endocarditis (NBTE) is a rare condition. Optimal management is based on early diagnosis which remains difficult. Case summary A 75-year-old male patient was admitted to the hospital with acute ischemia of the left lower limb due to popliteal artery occlusion despite anticoagulation with rivaroxaban for pulmonary embolism diagnosed two weeks earlier. Transoesophageal echocardiography (TEE) showed a mobile vegetation with mild mitral valve regurgitation. Positron emission tomography (PET) scan did not show hyperfixation at the mitral valve but rather lymphadenopathy hyperfixation at different sites. Biopsy of a lymph node from Barety’s space identified a bronchopulmonary adenocarcinoma. The outcome was favorable after popliteal artery thrombectomy and low-molecular-weight heparin treatment. The patient was referred to the department of onco-pneumology for further care. Discussion Upon clinical presentation, the combination of an arterial and prior venous thrombotic event suggested that the origin could be either a patent foramen ovale (PFO) or a thrombosis from an underlying cancer. A transthoracic echocardiography and TEE excluded a PFO and demonstrated a mobile echogenic mass at the mitral valve site together with a mild regurgitation. The diagnosis of non-bacterial thrombotic endocarditis was suggested given the absence of clinical and biological infectious signs, negative blood cultures and serology for endocarditis, the presence of both arterial and venous thrombosis, as well as the presence of intra-thoracic lymphadenopathy hyperfixation on the PET scan for which a biopsy demonstrated lung adenocarcinoma.

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