scholarly journals Diagnosis Under Pressure

2020 ◽  
Vol 15 (4) ◽  
pp. 41-42
Author(s):  
Michael Colacci ◽  
Florence Morriello
Keyword(s):  
Computed Tomography ◽  
Symptomatic Improvement ◽  
Neck Mass ◽  
Left Carotid Artery ◽  
Autonomic Dysregulation ◽  
Initial Examination ◽  
Mechanical Disruption ◽  
Left Neck ◽  
History Of ◽  
Carcinoma Of The Tongue

A 75-year-old man with a history of BPH and squamous cell carcinoma of the tongue, presented to hospital with a one-month history of recurrent falls associated with orthostatic lightheadedness. On initial examination he had a blood pressure (BP) of 132/75 and heart rate (HR) 86 while supine and BP 101/54, HR 88 while standing. Physical exam revealed a left neck mass, and computed tomography confirmed a large left nodal mass with encapsulation of the left carotid artery. He was not a surgical candidate and had symptomatic improvement with midodrine and fludrocortisone. This case highlights a unique cause of orthostatic hypotension due to mechanical disruption of blood supply and autonomic innervation, and exemplifies the lack of compensatory tachycardia with autonomic dysregulation. RESUMEUn homme de 75 ans ayant des antécédents d’HBP et de ysregula spinocellulaire de la langue s’est présenté à l’hôpital avec des antécédents d’un mois de chutes récurrentes associées à des vertiges orthostatiques. Lors de l’examen initial, il avait une tension artérielle (BP) de 132/75 et un rythme cardiaque (HR) de 86 en position couchée et une BP de 101/54, HR 88 en position debout. En évaluant les causes communes, une tomographie informatisée de la tête/cou a révélé une grande masse nodale gauche avec encapsulation de l’artère ysregu gauche. Il n’était pas un candidat à la chirurgie et présentait une ysregulatio symptomatique grâce à la midodrine et à la fludrocortisone. Ce cas met en ysregul une cause unique d’hypotension orthostatique due à une perturbation mécanique de l’approvisionnement en sang et à une innervation autonome, et illustre l’absence de tachycardie compensatoire avec ysregulation autonome.

Surgical Treatment of Suspected Meningioangiomatosis in the Thoracolumbar Spinal Cord

2020 ◽  
Vol 56 (4) ◽  
Author(s):  
Marie C. Dantio ◽  
Amanda J. Dennis ◽  
Robert L. Bergman
Keyword(s):  
Computed Tomography ◽  
Hind Limb ◽  
Clinical Signs ◽  
Initial Examination ◽  
Limb Ataxia ◽  
Vascular Proliferation ◽  
History Of ◽  
Pelvic Limb ◽  
Long Term Prognosis

ABSTRACT A 5 yr old male neutered Labrador retriever was evaluated for an 8 wk history of a slowly progressive abnormal hind limb gait that did not respond to treatment with nonsteroidal anti-inflammatories. Initial examination findings were mild pelvic limb ataxia and moderate right pelvic limb lameness. A computed tomography with a myelogram was performed and showed a suspected intramedullary spinal mass. MRI was conducted and supported the computed tomography with myelogram findings of a possible intradural spinal mass at L1. A left-sided hemilaminectomy followed by a durotomy at L1 was performed and a firm, tan mass was removed. The histopathologic findings indicated a vascular proliferation most suggestive of a rare proliferative disorder of leptomeningeal blood vessels termed meningioangiomatosis. Although the dog’s signs initially worsened after surgery and he was nonambulatory with marked paraparesis, he regained ambulation within 3–4 wk after the operation. Eighteen months after surgery, he was ambulatory with mild hind limb ataxia with no progression of signs. This case suggests that surgical resection of lesions of suspected meningioangiomatosis can result in improvement of clinical signs with a good long-term prognosis.

scholarly journals Giant lipoma of the left neck: rare location

2019 ◽  
pp. 15-17
Author(s):  
Anass Chaouki ◽  
Ballage A ◽  
Choukry k ◽  
Mkhatri A ◽  
Abada R ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Spindle Cell ◽  
Histological Finding ◽  
Surgical Excision ◽  
Neck Mass ◽  
Spindle Cell Lipoma ◽  
Left Neck ◽  
Giant Lipoma ◽  
Rare Location

Giant lipoma is a rare cause of a large painless neck mass, these lipomas are usually found on the extremity, but rarely occur in the head and neck, computed tomography (CT) scan is very suitable for the diagnosis, Surgical excision is the best treatment. We describe a case of a man with a massive lipoma of the left neck, histological finding confirmed the diagnosis of spindle-cell lipoma, well managed with surgical excision.

scholarly journals Laryngocele masquerading as a soft tissue neck mass

1970 ◽  
Vol 7 (4) ◽  
pp. 423-425
Author(s):  
K Dhungel ◽  
MK Gupta ◽  
K Ahmad ◽  
PL Sah ◽  
RK Rauniyar
Keyword(s):  
Computed Tomography ◽  
Medical Journal ◽  
Soft Tissue ◽  
Neck Mass ◽  
Interesting Case ◽  
Rare Entity ◽  
Cervical Mass ◽  
Soft Tissue Neck ◽  
History Of ◽  
Ct Features

Laryngocele is a rare entity which can clinically present as a neck mass and requires Computed Tomography (CT) and laryngoscopy for diagnosis. We present an interesting case of bilateral laryngocele in a 45 -year-old male presented clinically as hoarseness and left sided neck mass without any history of predisposing factors. Ultrasonography (USG) and CT features of laryngocele is also presented here. Key words: Laryngocele; Cervical mass; Ultrasonography; Computed Tomography DOI: 10.3126/kumj.v7i4.2767 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 423-425

Cervical Thymic Cysts

1996 ◽  
Vol 75 (10) ◽  
pp. 678-680 ◽  
Author(s):  
Jacqueline E. Jones ◽  
Brian Hession
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Clinical Picture ◽  
Neck Mass ◽  
Cystic Mass ◽  
Pathologic Examination ◽  
Neck Masses ◽  
History Of ◽  
Surgical Options ◽  
Thymic Cysts

Cervical thymic cysts are a rare cause of neck masses in children. This case report describes a three-year-old child with a several-month history of an enlarging neck mass, who was emergently admitted due to airway obstruction. Computed tomography revealed a large cystic mass extending from the oropharynx to the level of the mediastinum. Excision of the mass with pathologic examination revealed a thymic cyst. The clinical picture, the theories regarding development of these cysts, as well as surgical options for treatment, are discussed.

Idiopathic submandibular sialoceles in the neck

2005 ◽  
Vol 132 (3) ◽  
pp. 517-519 ◽  
Author(s):  
Annette H. C. Ang ◽  
Yau-Hong Goh
Keyword(s):  
Computed Tomography ◽  
Submandibular Gland ◽  
Neck Mass ◽  
The Other ◽  
Surrounding Tissue ◽  
Complete Excision ◽  
Previous Trauma ◽  
History Of ◽  
Radiologic Features

A submandibular sialocele is a subcutaneous cavity containing saliva. The clinical and radiologic features of 3 patients with an idiopathic submandibular sialocele are presented. All 3 patients were males in their twenties. Submandibular sialocele presents as a soft cystic and compressible neck mass, with no history of previous trauma or diseases of the salivary gland. Computed tomography (CT) of the neck revealed a homogenous lesion with enhancing rim. The lesion appeared to be insinuating into the surrounding tissue. Excision of the sialocele, leaving the submandibular gland intact, was performed for the first patient. Recurrence of a neck mass occurred after 4 months. Complete excision of the sialocele with associated submandibular gland was subsequently performed. There was no recurrence after a follow-up period of 3 years. Excision of gland and sialocele was performed for the other 2 patients. There was no recurrence after a follow-up of 2 years and 10 months, respectively.

scholarly journals The Etiology of Recurrent Chordoma Presenting as a Neck Mass: Metastasis vs. Surgical Pathway Seeding

2008 ◽  
Vol 87 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Jennings R. Boyette ◽  
John W. Seibert ◽  
Chun-Yang Fan ◽  
Brendan C. Stack
Keyword(s):  
Neck Mass ◽  
Sternocleidomastoid Muscle ◽  
Proton Proton ◽  
Conventional Radiotherapy ◽  
Free Survival ◽  
Level Ii ◽  
Left Neck ◽  
History Of ◽  
Skull Base Chordomas ◽  
Surgical Pathway

Chordomas are rare tumors of notochordal origin that arise along the vertebral axis. These slowly growing yet highly destructive tumors are associated with an alarming rate of recurrence, although surgical resection followed by proton, proton/photon, or conventional radiotherapy has been somewhat successful in terms of recurrence-free survival. Still, recurrent disease as a result of metastasis or surgical pathway seeding does occur. We retrospectively reviewed the case of a 64-year-old woman who presented with a left neck mass at level II. She had a history of recurrent chordomas involving the occipital portion of the clivus that had been treated with multiple resections and proton-beam irradiations over a period of several years. The new mass was found to have infiltrated the superior end of the sternocleidomastoid muscle. Neck dissection was performed. Pathology revealed no lymphoid tissue in the main specimen and no evidence of chordoma in any of the lymph nodes. We believe that this latest clival chordoma might have occurred as a result of surgical pathway seeding during a previous operation anterior to the sternocleidomastoid muscle, although metastasis cannot be ruled out. We also review the literature on clival and skull base chordomas as it relates to recurrence, metastasis, and seeding.

Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

2014 ◽  
Vol 17 (1) ◽  
pp. 42
Author(s):  
Shi-Min Yuan
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Female Patient ◽  
Constrictive Pericarditis ◽  
Delayed Diagnosis ◽  
Young Female ◽  
Refractory Ascites ◽  
Diagnostic Challenge ◽  
Massive Ascites ◽  
History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

scholarly journals Scopolamine fatal outcome in an inmate after buscopan® smoking

2021 ◽  
Author(s):  
Sabina Strano-Rossi ◽  
Serena Mestria ◽  
Giorgio Bolino ◽  
Matteo Polacco ◽  
Simone Grassi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Drug Abuse ◽  
Muscarinic Receptors ◽  
Histopathological Examination ◽  
Fatal Outcome ◽  
Post Mortem ◽  
Butyl Bromide ◽  
Cannabis Abuse ◽  
Toxic Concentration ◽  
History Of

AbstractScopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

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