scholarly journals Coronavirus disease 2019 infection and pituitary apoplexy: A causal relation or just a coincidence? A case report and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 317
Author(s):  
Walaa A. Kamel ◽  
Mustafa Najibullah ◽  
Mamdouh S. Saleh ◽  
Waleed A. Azab

Background: Pituitary tumor apoplexy (PA) is an emergency condition caused by hemorrhage or infarction of the preexisting adenoma. Many factors are currently well-known to predispose to PA. However, during the period of coronavirus disease 2019 (COVID-19) pandemic, case reports of PA associated with COVID-19 infection have been sequentially published. To the best of our knowledge, four cases have been reported so far in the English literature. We herein report the fifth case of this association and review the pertinent literature. Case Description: A 55-year-old male patient with confirmed COVID-19 infection presented by progressive decrease in visual acuity and oculomotor nerve palsy. His medical history is notable for diabetes mellitus, hypertension, and pituitary macroadenoma resection 11 years ago. He was on hormonal replacement therapy for panhypopituitarism that complicated the surgery. Previous magnetic resonance (MR) imaging studies were consistent with enlarging residual pituitary adenoma. During the current hospitalization, computed tomography revealed hyperdensity of the sellar and suprasellar areas. MR imaging revealed PA in a recurrent large adenoma. Endoscopic endonasal transsphenoidal resection was uneventfully undertaken with near total excision of the adenoma and partial improvement of visual loss and oculomotor palsy. Histopathological examination demonstrated classic features of PA. However, his chest condition progressed and he had to be transferred to COVID-19 intensive care unit in the referring hospital where he was intubated and put on mechanical ventilation. One week later, the patient unfortunately passed away due to complications of severe COVID-19 pneumonia. Conclusion: We report the fifth case of PA associated with COVID-19 infection. Based on our patient’s clinical findings, review of the other reported cases, as well as the available literature, we put forth a multitude of pathophysiological mechanisms induced by COVID-19 that can possibly lead to the development of PA. In our opinion, the association between both conditions is not just a mere coincidence. Although the histopathological features of PA associated with COVID-19 are similar to PA induced by other etiologies, future research may disclose unique pathological fingerprints of COVID-19 virus that explains its capability of inducing PA.

2020 ◽  
Vol 63 (10) ◽  
pp. 475-478
Author(s):  
Yeong Wook Jeong ◽  
Joo Yeon Kim ◽  
Dong Young Kim ◽  
Jae Hwan Kwon

Lipoma is the most common benign neoplasm in adults. While it is commonly found in the neck, trunk, and extremities, it is extremely rare in the nasal cavity, paranasal sinus, or nasal septum. To our knowledge, there have been only a few cases of septal lipomas reported in the English literature. A 32-year-old woman visited Kosin University Hospital complaining of left nasal congestion and throat discomfort. Upon nasal endoscopy examination and CT, we found a polypoid mass of 2.7×1.5 cm with an elongated neck occupying a region left of the nasopharyngeal to the oropharyngeal cavity. The mass was completely removed via endoscopic endonasal surgery under general anesthesia and was identified as a fibrolipoma in the histopathological examination. We report a case of a successfully treated fibrolipoma originating from the posterior margin of the nasal septum.


2021 ◽  
Vol 9 ◽  
Author(s):  
Rosemary Bauer ◽  
Katherine W. Timothy ◽  
Andy Golden

Timothy Syndrome (TS) (OMIM #601005) is a rare autosomal dominant syndrome caused by variants in CACNA1C, which encodes the α1C subunit of the voltage-gated calcium channel Cav1.2. TS is classically caused by only a few different genetic changes and characterized by prolonged QT interval, syndactyly, and neurodevelopmental delay; however, the number of identified TS-causing variants is growing, and the resulting symptom profiles are incredibly complex and variable. Here, we aim to review the genetic and clinical findings of all published case reports of TS to date. We discuss multiple possible mechanisms for the variability seen in clinical features across these cases, including mosaicism, genetic background, isoform complexity of CACNA1C and differential expression of transcripts, and biophysical changes in mutant CACNA1C channels. Finally, we propose future research directions such as variant validation, in vivo modeling, and natural history characterization.


PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 720-724
Author(s):  
Alan Greenberg ◽  
Mary Coleman

In 1933 Cornelia de Lange first described two infants with a striking appearance and a pattern of congenital anomalies which she named "typus degenerativus amstelodamensis."1 Subsequently, other cases of this syndrome were reported in the European literature, but it was not until 1963 that the syndrome attracted attention in this country with the publication of case reports in the American and English literature.2-6 The patients have a distinctive appearance (Fig. 1) which becomes more apparent as they grow older. However, the diagnosis can be difficult during infancy. In a recent monograph, Berg et al.7 suggested that a useful criteria for diagnosis is eight or more of the following clinical findings:


2020 ◽  
Vol 09 (05) ◽  
pp. 425-430
Author(s):  
V. Abdusamad ◽  
Vivek Singh ◽  
Rohit Jain ◽  
Divya Singh

Abstract Background In the hand, giant cell tumors (GCTs) of the bones account for 2 to 5% of all hand tumors; they are often seen in the metacarpals and phalanges, seldom in the carpal bones. In the carpal bones, GCT usually occurs as a single lesion, with multifocal involvement being extremely rare. On analysis of recent English literature, we could find out only two reports having simultaneous involvement of multiple carpal bones. Case Description We report a case of a 29-year-old female with simultaneous involvement of two carpal bones: capitate and hamate. After confirming the diagnosis by histopathological examination, the affected carpals were resected, and the defect was filled with autologous bone graft. Follow-up at 18 months demonstrated no evidence of local recurrence or metastatic disease, and the patient is now having a reasonable hand function. Literature Review We analyzed nine case reports on GCTs in carpal bones in the past 25 years. Seven out of nine cases that we could analyze showed single carpal bone involvement (three capitate, two scaphoid, one hamate, one triquetrum). In these, four patients had undergone resection, and five patients had undergone curettage, of whom one patient came back 5 months later with recurrence. Only two cases were there with simultaneous involvement of multiple carpal bones. Both the cases were managed with resection and reconstruction with autologous graft iliac graft. Clinical Relevance GCTs of the carpal bones are relatively rare, and simultaneous involvement of two bones is rarer. Every attempt should be made to preserve useful wrist range of motion by excision and limited carpal fusion.


2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Douglas Stofko ◽  
Gregory Moore ◽  
Thomas Nickles ◽  
Amir Dehdashti

2001 ◽  
Vol 45 (1) ◽  
pp. 83
Author(s):  
Kyo Nam Kim ◽  
Joung Joo Woo ◽  
Yong Whee Bahk ◽  
Soon Yong Kim ◽  
Eun Ryoung Kim

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Moutaz Ragab ◽  
Omar Nagy Abdelhakeem ◽  
Omar Mansour ◽  
Mai Gad ◽  
Hesham Anwar Hussein

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.


2019 ◽  
Vol 08 (02) ◽  
pp. 119-122
Author(s):  
Václav Masopust

AbstractLesions of the oculomotor nerve as the first sign of pituitary adenoma are rare. The cause of such lesions without other clinical symptoms is discussed in this study. A small cohort of 4 patients (3.1%) with oculomotor nerve palsy (third nerve palsy) as the only neurologic deficit, from 129 patients who got operated upon for pituitary adenomas, is presented. In this group (mean age: 55 years, range: 36–65 years), all patients (two women and two men) underwent surgery. In two cases, there was arrested pneumatization and thickened bone. In the remaining two cases, a macroscopically visible, very solid opaque diaphragm was present, after the removal of the tumor and thickened bone. Complete adjustment was observed in all patients within 1 week after the surgery. Two factors that seem to increase the high risk for the development of oculomotor nerve palsy are that the cavernous sinus may be the only weak structure surrounding the sella turcica when the diaphragm and bone are thickened; and the rapid development of increased pressure in this region. The increased pressure on the cavernous sinus during the anatomical variations is the primary cause for lesions on the oculomotor nerve. However, this conjecture cannot be statistically demonstrated because of the small number of cases. Future research should be conducted on larger samples to increase statistical inference and generalizability.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Keisuke Seki ◽  
Yoshiyuki Hagiwara

Tooth loss among adults is associated with progressive periodontitis. Implant prosthetic treatment has long been utilized in periodontal patients. Even when the implants are applied, ongoing management of periodontal disease and control of inflammation is necessary to maintain a healthy oral cavity. Lack of appropriate periodontal treatment can result in recurrence of periodontal disease during a maintenance period; loss of the supportive capacity of the periodontal tissues will increase the susceptibility of residual teeth to traumatic force. For this reason, it is worthwhile to improve oral function by applying implants as a fixed device. Here, we report that implant treatment in a patient with generalized severe chronic periodontitis helped maintain the periodontal and peri-implant tissue for a long term. We propose that initial periodontal treatment and ongoing supportive therapy can help maintain implants in patients with severe periodontitis. In addition, we reviewed case reports in the English literature so far.


2022 ◽  
pp. 000348942110701
Author(s):  
Cathleen C. Kuo ◽  
Ellen M. Piccillo ◽  
Jason C. DeGiovanni ◽  
Matt Kabalan ◽  
Gregg Zimmer ◽  
...  

Objective: To report a case of herpes virus-associated nasopharyngitis in an adult patient. Methods: The patient’s medical record was reviewed for demographic and clinical data. For literature review, all case reports or other publications published in English literature were identified using Pubmed with the MeSH terms “herpes,” “nasopharyngitis,” and “upper respiratory infection.” Results: A 40-year-old male presented for nasal congestion and a suspected nasal mass. Computed tomography of the sinuses revealed edematous changes in the nasopharynx which exerted a downward mass effect at the right aspect of the soft palate. Flexible fiberoptic laryngoscopy (FFL) revealed a lesion arising from the posterior aspect of the soft palate with extension into the posterior nasal cavity as well as copious mucopurulent secretions consistent with a superimposed acute sinusitis. Rigid nasal endoscopy demonstrated a friable and ulcerated lesion arising from the aforementioned anatomical location. Biopsy of this lesion and subsequent immunohistochemical analysis revealed a diagnosis of herpetic nasopharyngitis. Conclusions: Herpetic infection should be in the differential diagnosis of patients presenting with atypical symptoms of nasopharyngitis. Early accurate diagnosis and appropriate specific management can limit the duration of disease course and prevent further complications.


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