scholarly journals Merkel cell carcinoma of the cornea and conjunctiva

2020 ◽  
Vol 3 ◽  
pp. 7
Author(s):  
Francisco Lucero Saá ◽  
Federico Andrés Cremona ◽  
Eugenia Páez Soria ◽  
Pablo Chiaradia
Keyword(s):  
Excisional Biopsy ◽  
Clinical Suspicion ◽  
Accurate Diagnosis ◽  
Histopathological Analysis ◽  
Merkel Cells ◽  
Merkel Cell ◽  
Successful Management ◽  
Regional Lymph Nodes ◽  
Early Referral ◽  
History Of

A 58-year-old woman presented with a corneoconjunctival tumor, first diagnosed as a squamous neoplasia. An excisional biopsy was performed. Histopathology revealed signs of MCC, which is a rare malignant tumor of the skin. It can affect the eyelids and is a differential diagnose of recurrent chalazion. The patient had a history of multiple chalazia excision. MCC is known to be highly aggressive and tends to metastasize early to regional lymph nodes. It is believed to originate from Merkel cells, which have not been identified in the conjunctiva or cornea. However, the tumor may originate from integration of Merkel cell polyomavirus (MCPyV) in other epithelial cells. Metastatic compromise of the conjunctiva by this tumor has been reported as well. We herein report a case of both corneal and conjunctival involvement by a previously misdiagnosed MCC. A correct histopathological analysis, including immunohistochemistry techniques oriented by clinical suspicion, is crucial for the diagnosis. Prognosis of this tumor is known to be poor, that is the reason why an accurate diagnosis and an early referral to an oncologist are essential to a successful management of the disease.

scholarly journals Unknown primary Merkel cell carcinoma with cutaneous spread

2019 ◽  
Vol 12 (2) ◽  
pp. e224834
Author(s):  
João Vasco Barreira ◽  
Margarida Moura Valejo Coelho ◽  
Catarina Ribeiro ◽  
Mónica Semedo
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Primary Tumour ◽  
Left Knee ◽  
Unknown Primary ◽  
Multidisciplinary Teams ◽  
Histopathological Analysis ◽  
Merkel Cell ◽  
Dermatological Examination ◽  
History Of

The authors present the case of a woman in the seventh decade of life with medical history of: left nephrectomy for renal tuberculosis and non-Hodgkin’s lymphoma treated with chemotherapy (QT) and radiotherapy. She presented with a 2-month history of non-tender, left inguinal lymph node enlargement. Positron Emission Tomography (PET)—CT —scanshowed hypermetabolic inguinal and retroperitoneal lymphadenopathies, no primary tumour. On the second dermatological examination a pink, 2 cm plaque on the anterior left knee was noted. The histopathological analysis revealed Merkel cell carcinoma. The patient underwent two lines of systemic QT, with life-threatening toxicities limiting treatment. Followed overwhelming disease progression with lymphoedema and numerous skin metastases in the left lower limb. The patient received palliative care until death. The rare incidence of such neoplasia and its uncommon clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the management of cancer patients.

scholarly journals An Unusual Clinical Presentation of Solitary Fibrous Tumor in the Oral Cavity

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Everton Freitas de Morais ◽  
Deborah Gondim Lambert Moreira ◽  
Viviane Alves De Oliveira ◽  
Rodrigo Rodrigues Rodrigues ◽  
Adriano Rocha Germano ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Solitary Fibrous Tumor ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Histopathological Analysis ◽  
Normal Morphology ◽  
S 100 ◽  
History Of ◽  
Fibrous Tumor

Solitary fibrous tumor is a rare neoplasm of mesenchymal origin that usually affects the pleura. This rarity becomes more relevant in the oral cavity since the clinical features are nonspecific. A 66-year-old female patient presented with a 3-month history of a swelling in the floor of the mouth, measuring 2 cm in greatest diameter, and pain symptomatology. Occlusal and panoramic radiographs showed no bone involvement. Ultrasonography of the submandibular and parotid salivary glands revealed normal morphology, dimensions, and echogenicity. During this exam, a nodular image of low echogenicity measuring about 2.7 × 1.8 cm was detected. An excisional biopsy was performed and histopathological analysis revealed a well-defined tumor-like lesion with alternation between hypercellular areas without a defined pattern and hypocellular areas. On immunohistochemistry, the tumor was positive for CD34 and CD99 and negative forα-SMA, S-100, and bcl-2. Combining the histopathological and immunohistochemical features, the diagnosis was solitary fibrous tumor. The patient is under periodical clinical follow-up and shows no signs of recurrence 7 months after surgical excision of the tumor. The combination of clinical-pathological and immunohistochemical features is necessary for the diagnosis.

Merkel Cell Carcinoma of the Lower Extremity

2014 ◽  
Vol 104 (4) ◽  
pp. 422-425 ◽  
Author(s):  
Dominic J. Roda ◽  
Brian Albano ◽  
Bharti Rathore ◽  
Linda Zhou
Keyword(s):  
Lower Extremity ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Excisional Biopsy ◽  
Lymph Node Biopsy ◽  
Rapid Progression ◽  
Merkel Cell ◽  
Unusual Lesion

Merkel cell carcinoma is a rare, often fatal, neuroendocrine cutaneous malignancy with a highly variable clinical presentation. Due to the rapid progression of the disease, early detection and treatment is vital to survival. Here, we report the case of a 45-year-old woman whose podiatrist noticed an unusual lesion on her lower left leg and referred her to a dermatologist for work-up. A diagnostic excisional biopsy confirmed the diagnosis and was followed by treatment that included wide local excision of the primary lesion with subsequent chemotherapy and radiation. At the time of diagnosis, sentinel lymph node biopsy was positive. Due to the increasing prevalence of Merkel cell carcinoma in the past decade and its propensity to present on the lower extremity, podiatric physicians need to be aware of the clinical presentation and treatment guidelines for this elusive disease.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

scholarly journals Mixed neuroendocrine–non-neuroendocrine neoplasms of the gallbladder: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tatsuki Ishikawa ◽  
Katsunori Nakano ◽  
Masafumi Osaka ◽  
Kenichi Aratani ◽  
Kadotani Yayoi ◽  
...  
Keyword(s):  
System Analysis ◽  
Cancer Control ◽  
Staging System ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Regional Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Case Presentation ◽  
History Of ◽  
Lymph Nodes Dissection

Abstract Background  Primary neuroendocrine tumors of the gallbladder (GB-NETs) are rare, accounting for 0.5% of all NETs and 2.1% of all gallbladder cancers. Among GB-NETs, mixed neuroendocrine–non-neuroendocrine neoplasms of the gallbladder (GB-MiNENs) are extremely rare. Case presentation We present the case of a 66-year-old woman who was referred to us for the management of a gallbladder tumor (incidentally found during abdominal ultrasonography indicated for gallbladder stones). The patient had no history of abdominal pain or fever, and the findings on a physical examination were unremarkable. Blood tests showed normal levels of tumor markers. Imaging studies revealed a mass of approximately 10 mm in diameter (with no invasion of the gallbladder bed) located at the fundus of the gallbladder. A gallbladder cancer was suspected. Therefore, an open whole-layer cholecystectomy with regional lymph nodes dissection was performed. The postoperative course was uneventful, and she was discharged on postoperative day 6. Pathological findings showed GB-MiNENs with invasion of the subserosal layer and no lymph node invasion (classified T2aN0M0 pStage IIA according to the Union for International Cancer Control, 8th edition staging system). Analysis of the neuroendocrine markers revealed positive chromogranin A and synaptophysin, and a Ki-67 index above 95%. Fourteen months after the operation, a local recurrence was detected, and she was referred to another hospital for chemotherapy. Conclusions  GB-MiNENs are extremely aggressive tumors despite their tumor size. Optimal therapy should be chosen for each patient.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

3-Methylcyclohex-2-en-1-one and the Douglas-fir beetle (Coleoptera: Curculionidae): history of successful bark beetle pheromone treatments

2020 ◽  
Vol 153 (1) ◽  
pp. 62-78
Author(s):  
Darrell W. Ross
Keyword(s):  
Bark Beetle ◽  
Douglas Fir ◽  
Future Research ◽  
Beetle Species ◽  
Successful Management ◽  
Dendroctonus Pseudotsugae ◽  
Successful Development ◽  
History Of ◽  
Antiaggregation Pheromone

AbstractThis paper reviews the literature on the identification of 3-methylcyclohex-2-en-1-one (MCH) as the antiaggregation pheromone of the Douglas-fir beetle (Dendroctonus pseudotsugae Hopkins) (Coleoptera: Curculionidae) and the development of successful management applications using the pheromone. Previously unpublished data from two studies on novel uses of MCH are included. The successful development of antiaggregation pheromone-based treatments for the Douglas-fir beetle is discussed in relation to efforts to develop similar treatments for other bark beetle species, and opportunities for future research on MCH and the Douglas-fir beetle are suggested.

scholarly journals Prevalence of Self-Reported Spondyloarthritis Features in a Cohort of Patients with Inflammatory Bowel Disease

2013 ◽  
Vol 27 (4) ◽  
pp. 199-205 ◽  
Author(s):  
Carmen Stolwijk ◽  
Marieke Pierik ◽  
Robert Landewé ◽  
Ad Masclee ◽  
Astrid van Tubergen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Musculoskeletal Symptoms ◽  
Inflammatory Back Pain ◽  
Early Referral ◽  
History Of ◽  
Seronegative Spondyloarthritis ◽  
Inflammatory Bowel ◽  
Inflammatory Drugs ◽  
Or History

BACKGROUND: Musculoskeletal symptoms belonging to the spectrum of ‘seronegative spondyloarthritis’ (SpA) are the most common extraintestinal manifestations in patients with inflammatory bowel disease (IBD) and may lead to important disease burden. Patients with suspected SpA should be referred to a rheumatologist for further evaluation.OBJECTIVE: To investigate the self-reported prevalence of musculoskeletal SpA features in a cohort of patients with IBD and to compare this with actual referrals to a rheumatologist.METHODS: Consecutive patients with IBD visiting the outpatient clinic were interviewed by a trained research nurse about possible SpA features using a standardized questionnaire regarding the presence or history of inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, psoriasis, uveitis and response to nonsteroidal anti-inflammatory drugs. All patient files were verified for previous visits to a rheumatologist and any rheumatic diagnosis.RESULTS: At least one musculoskeletal SpA feature was reported by 129 of 350 (36.9%) patients. No significant differences between patients with Crohn disease and ulcerative colitis were found. Review of medical records showed that 66 (51.2%) patients had ever visited a rheumatologist. Axial SpA was diagnosed in 18 (27.3%) patients, peripheral SpA in 20 (30.3%) patients and another rheumatic disorder in 14 (21.2%) patients.CONCLUSION: Musculoskeletal SpA features are frequently present in patients with IBD. However, a substantial group of patients is not evaluated by a rheumatologist. Gastroenterologists play a key role in early referral of this often debilitating disease.

scholarly journals Type 4 appendiceal diverticulum within a de Garengeot hernia

2016 ◽  
Vol 98 (7) ◽  
pp. e141-e142 ◽  
Author(s):  
SH Rossi ◽  
E Coveney
Keyword(s):  
Femoral Hernia ◽  
Cystic Lesion ◽  
Vermiform Appendix ◽  
Clinical Suspicion ◽  
Intraluminal Pressure ◽  
Rare Entity ◽  
History Of ◽  
The Right ◽  
De Garengeot Hernia ◽  
Learning Points

A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points.A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified.It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.

scholarly journals Homo- and heterotypic cell-cell contacts in Merkel cells and Merkel cell carcinomas: heterogeneity and indications for cadherin switching

2011 ◽  
Vol 58 (2) ◽  
pp. 286-303 ◽  
Author(s):  
Anna M Werling ◽  
Yvette Doerflinger ◽  
Johanna M Brandner ◽  
Franca Fuchs ◽  
Jürgen C Becker ◽  
...  
Keyword(s):  
Merkel Cells ◽  
Merkel Cell ◽  
Cell Contacts ◽  
Cell Cell
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