scholarly journals Tumor Mimicking in Musculoskeletal System in Surabaya: A Case Series

2020 ◽  
Vol 4 (1) ◽  
pp. 111
Author(s):  
Bayu Antara Hadi ◽  
Mouli Edward
Keyword(s):  
Chronic Osteomyelitis ◽  
Case Series ◽  
Clinical History ◽  
Left Knee ◽  
Diagnostic Modality ◽  
Left Femur ◽  
Papillary Carcinoma Thyroid ◽  
Mass Size ◽  
History Of ◽  
One Year

ABSTRACTMusculoskeletal tumors are potential causes of heavy morbidity and economic burdens for patients. There are often cases suspected as musculoskeletal tumors based on a specific diagnostic modality because of overlapping features upon physical examination or a tumor-like appearance from the radiological examination, the more reason for triple diagnosis to be performed for an exact diagnosis.  We report 5 cases of fractures tumor-mimicking lesions. The First patient, a patient with MRI revealing a primary malignant bone tumor, but with plain thorax x-ray and FNAB, the diagnosis was tuberculosis arthritis of the elbow. The second patient shows metastatic proses with plain radiographic, but from open biopsy, the diagnoses fall to chronic osteomyelitis. The third patient had a history of papillary carcinoma thyroid with pathological fracture of proximal of the left femur, but the biopsy shows a hypercalcemic state. The fourth patient, had mass size 20x15 cm at the thigh, but the biopsy shows Non-Specific Chronic Osteomyelitis. The fifth patient with progressive swelling of the left knee for one year, 10x10 cm in size, the biopsy showed no sign of malignancy but tuberculosis of left distal femur. In conclusion, standard comprehensive diagnosis steps consisting of clinical history, imaging, laboratory and histopathological examinations are crucial to differentiate tumor-mimicking lesions from neoplasms, thus ensuring proper treatment.Keywords: Tumour mimicking, osteosarcoma, chondroma, malignancy

Identifying Type III Sulcus: Patient Characteristics and Endoscopic Findings

2020 ◽  
Vol 163 (6) ◽  
pp. 1240-1243
Author(s):  
Eleni A. Varelas ◽  
Paul M. Paddle ◽  
Ramon A. Franco ◽  
Inna A. Husain
Keyword(s):  
Benign Lesion ◽  
Case Series ◽  
Vocal Folds ◽  
Clinical History ◽  
Patient Characteristics ◽  
Endoscopic Examination ◽  
Type Iii ◽  
Presenting Symptoms ◽  
History Of ◽  
Structural Deformity

Objective Type III sulcus is a pathologic structural deformity of the vocal folds that is challenging to accurately diagnose without endoscopic examination under anesthesia. This study aims to further define the clinical presentation and examination features shared among a patient cohort intraoperatively diagnosed with type III sulcus. Study Design Case series with chart review. Setting Tertiary laryngology practice. Subjects and Methods All patients diagnosed intraoperatively with type III sulcus from 2002 to 2014 at a tertiary laryngology practice were included. Clinical history of presenting symptoms, videostroboscopy, and intraoperative and histologic findings were reviewed. Results Twenty-two patients were included in the study. A majority were female (77%) and had a mean age of 32.4 years. All patients endorsed hoarseness, and 86% were defined as professional voice users. Endoscopic examination revealed bilateral type III sulcus in 23% of patients. The most common preoperative stroboscopic findings included decreased mucosal wave (100%), dilated vessel (95%), phase asymmetry (91%), additional benign lesion (91%), and cyst (82%). Histology revealed epithelial changes of atypia and keratosis. Conclusion Both the severity of dysphonia and the difficulty observing structural malformations of the vocal folds make type III sulcus challenging to preoperatively diagnose. This study reports the clinical and endoscopic features seen within a cohort of patients with type III sulcus.

Abstract 3640: Diabetes Mellitus is Associated with Increased Risk of Fatal and Non-Fatal Cardiovascular Events in Heart Failure Patients with Preserved Ejection Fraction - Findings From the Irbesartan in Heart Failure with Preserved Systolic Function Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robert S McKelvie ◽  
Michel Komajda ◽  
Barry M Massie ◽  
John J McMurray ◽  
Michael R Zile ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Clinical History ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
History Of ◽  
One Year

Background: Diabetes mellitus (DM), present in about a quarter of heart failure (HF) patients with reduced ejection fraction (HF-REF), is associated with increased risk of fatal and non-fatal cardiovascular (CV) events. Less is known about the prevalence and impact of DM in HF patients with preserved ejection fraction (HF-PEF). The prevalence and effect of DM on clinical outcomes were examined in patients enrolled in the Irbesartan in Heart Failure with Preserved Systolic Function Trial (I-PRESERVE). Methods: The I-PRESERVE trial randomized 4128 HF-PEF patients (EF≥45%) to receive irbesartan or placebo. The primary outcome of time to all-cause mortality or CV hospitalization (myocardial infarction [MI], stroke, worsening HF, atrial or ventricular arrhythmia or unstable angina) was compared between patients with and without DM over one year of follow-up. A combined HF endpoint (HF mortality and hospitalization) was also evaluated. Comparison of the outcomes between patients with and without DM was expressed as a hazard ratio (HR). The independent predictive role of DM was examined in a multivariable model (which included symptoms, signs, clinical history, CV examination, biochemical, and hematological findings). Results: In I-PRESERVE 27% had a history of DM at baseline. DM patients more often had a body mass index ≥30 (51% vs 38%), history of stroke (12% vs 9%), history of MI (28% vs 22%), estimated glomerular filtration rate <60 ml/min/1.73m 2 (34% vs 29%), and pulmonary congestion on chest x-ray (46% vs 38%). In patients with DM, 17% and 11% had primary and HF events, respectively within 1 year; for patients without DM, 11% and 6% had primary and HF events. In a multivariate analysis DM remained a significant predictor of primary events (HR 1.48; 95% CI 1.22, 1.79) or HF events (HR 1.67; 95% CI 1.32, 2.12). Conclusions: The prevalence of DM in HF-PEF is similar to that reported in HF-REF. HF-PEF patients with DM have a significantly worse outcome than those without DM and this increased risk is independent of other factors associated with a worse prognosis.

scholarly journals (Doctor…My child keeps falling over) unexpected MRI findings in children with history of frequent falls and dizziness: a case series

2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua
Keyword(s):  
Physical Examination ◽  
Case Series ◽  
Clinical History ◽  
Brain Stem Glioma ◽  
Mri Findings ◽  
Group Management ◽  
Wide Range ◽  
Detailed Clinical History ◽  
History Of ◽  
Low Threshold

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

scholarly journals Odontogenic suppurative rhinosinusitis with oculo-orbital and cerebral complications - case series

2018 ◽  
Vol 8 (29) ◽  
pp. 55-60
Author(s):  
Daniela Vrinceanu ◽  
Mihai Dumitru ◽  
Ioana Eftime ◽  
Madalina Ilie ◽  
Adrian Stefan ◽  
...  
Keyword(s):  
Anaerobic Bacteria ◽  
Case Series ◽  
Interdisciplinary Teams ◽  
Cerebral Complications ◽  
History Of ◽  
Craniofacial Trauma ◽  
Hot Weather ◽  
One Year ◽  
Dental Infections ◽  
Aerobic And Anaerobic

Abstract BACKGROUND. Odontogenic rhinosinusal suppurations have a high potential for major ocular-orbital and cerebral complications because of the presence of anaerobic bacteria flora, with continuity, contiguity and haematogenous propagation mechanisms. This pathology is often diagnosed in other departments than ENT such as ophthalmology, neurosurgery or OMF surgery. MATERIAL AND METHODS. We present three clinical cases of odontogenic rhinosinusal suppurations with major complications: a 36-year-old patient with odontogenic pansinusitis complicated with orbital phlegmon and cerebral frontal lobe abscess; a 19-year-old patient with complicated maxillary-ethmoidal-frontal sinusitis complicated with frontal subdural empyema and frontal bone osteomyelitis (with a history of craniofacial trauma one year before); a 66-year-old patient with odontogenic maxillary-ethmoidal sinusitis complicated with orbital apex syndrome. RESULTS. The treatment was surgical, by external approach, with endoscopic nasal control, in interdisciplinary teams. We have associated massive antibiotic therapy. Surgical drainage for complicated rhinosinusitis should be done in emergency, within the first 24 hours after admission, according to guidelines. The bacteriological examination for aerobic and anaerobic flora can guide the diagnosis - two cases associated maxillo-ethmoidal aspergilloma lesions. The evolution of the cases was favourable. CONCLUSION. Interdisciplinary teams have successfully solved these complicated odontogenic rhinosinusal suppurations. Two of the cases were admitted and cured within 2 weeks, in the context of very hot weather, which exacerbated dormant dental infections.

scholarly journals OVARIAN TUMORS

2018 ◽  
Vol 25 (09) ◽  
pp. 1334-1337
Author(s):  
Jawad Ali Memon ◽  
Zubair Ali
Keyword(s):  
Ct Scan ◽  
Case Series ◽  
Clinical History ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Wall Thickening ◽  
Case Series Study ◽  
Ca 19.9 ◽  
History Of ◽  
Marker Study

Background: It is mandatory to distinguish between primary ovarian tumorsand metastases, as the treatment and prognoses are wide apart. Immunohistochemistry ismost frequently method being used to distinct these. Multiple studies showed that CDX2 ishallmark of the gut epithelium and is highly sensitive and specific immunohistochemical markerfor neoplasms of gastrointestinal origin. Objectives: In this case series study we have clinicallyand radiologically evaluated the cases of ovarian tumors referred to our institute, which arereported metastatic from colon based on expression of CDX2 marker. Study Design: Crosssectional observational study. Setting: Peoples University of Medical and Health Sciences forWomen (PUMHSW). Shaheed Benazir Abad. Period: Aug 2017 to September 2017. Patientsand Methods: 12 patients which were undergone oophrectomy and biopsy reported asmetastatic ovarian carcinoma from colon origin, based on histopathology features and CDX+immunohistochemistry marker, were included in our study. All the patients evaluated throughdetailed clinical history and examination, upper and lower GI endoscopy, CT scan wholeabdomen with contrast and tumor markers including CA 125, CEA, CA 19.9 and AFP). Results:No history of GIT specific symptoms like vomiting, constipation, diarrhea, bleeding per rectumwere noted in any patient. Upper and lower GIT endoscopies failed to identify any suspiciouslesion. No bowel related mass or wall thickening noted in CT scan abdomen with contrast.The serum level of CA 125 and CEA were only mildly raised in most patients. No evidence ofprimary colon lesion was noted in these patients inspite of extensive workup. Eventually thepatients were labeled and treated as primary carcinoma of ovary. Conclusions: CDX2 cannotbe used as sole indicator of colon origin and panel of the markers should always be employed,and clinical as well as radiological features should also be considered during interpretation ofIHC results.

scholarly journals Revision Surgery in Permanent Patellar Dislocation in DiGeorge Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Massimo Berruto ◽  
Andrea Parente ◽  
Paolo Ferrua ◽  
Stefano Pasqualotto ◽  
Francesco Uboldi ◽  
...  
Keyword(s):  
Digeorge Syndrome ◽  
Patellar Instability ◽  
Left Knee ◽  
Mpfl Reconstruction ◽  
Complex Case ◽  
Lateral Release ◽  
Specific Patient ◽  
Patellar Subluxation ◽  
History Of ◽  
One Year

A 29-year-old patient, suffering from DiGeorge syndrome, came to our attention with a history of persistent pain and patellar instability in the left knee after failure of arthroscopic lateral release and Elmslie-Trillat procedure. The patient was unable to walk without crutches and severely limited in daily living activities. Because of arthritic changes of the patellofemoral joint and the failure of previous surgeries it was decided to perform only an open lateral release and medial patellofemoral ligament (MPFL) reconstruction using a biosynthetic ligament in order to obtain patellofemoral stability. At one year post-op range of motion (ROM) was 0–120 with a firm end point at medial patellar mobilization; patella was stable throughout the entire ROM. All the scores improved and she could be able to perform daily activity without sensation of instability. Bilateral patellar subluxation and systemic hyperlaxity are characteristics of syndromic patients and according to literature can be also present in DiGeorge syndrome. MPFL reconstruction with lateral release was demonstrated to be the correct solution in the treatment of patellar instability in this complex case. The choice of an artificial ligament to reconstruct the MPFL was useful in this specific patient with important tissue laxity due to her congenital syndrome.

scholarly journals Post Traumatic Chronic Encapsulated Intracerebral Hematoma in a Child: Case Report and Brief Review of Literature

2017 ◽  
Vol 14 (3) ◽  
pp. 46-48
Author(s):  
Yam Bahadur Roka ◽  
Mohan Karki
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Neurological Deficits ◽  
Intracerebral Hematoma ◽  
Diagnostic Modality ◽  
Ct Guided ◽  
Stereotactic Aspiration ◽  
First Case ◽  
History Of ◽  
One Year

Chronic encapsulated intracerebral hematoma (CE-ICH) is an uncommon pathology that presents with headache, seizure, focal neurological deficits, or as a tumor. Trauma as a cause for CE-ICH is even rare and we believe this is the first case report as “trauma causing chronic encapsulated intracerebral hematoma “search in PubMed did not reveal any results. Repeated micro-hemorrhages in the CM or AVM are supposed to cause this lesion which progress from an earlier encapsulated phase to a thick capsulated stage with edema and clinical symptoms. CT or MRI is the diagnostic modality and it mimics, tumor, AVM, CM, angiomableed, cerebral abscess, metastatic mass or neurocysticercosis. Burr hole, mini-craniotomy, craniotomy, CT guided stereotactic aspiration or endoscopic excision are some options with equally good results. The present case with history of trauma was managed successfully with craniotomy with no recurrence for past one year. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page: 46-48

A clinical history of Zincum metallicum: homeopathic pathogenetic trials and case reports

Homeopathy ◽  
2017 ◽  
Vol 106 (02) ◽  
pp. 114-130 ◽  
Author(s):  
Silvia Waisse ◽  
Gheorghe Jurj
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Clinical History ◽  
Literature Survey ◽  
Body Of Knowledge ◽  
Clinical Observations ◽  
History Of ◽  
Homeopathic Drug ◽  
The 19Th Century ◽  
Over Time

In the present study, we investigated the experimental basis for the indications of homeopathic drug Zincum metallicum. The current body of knowledge about Zinc met has a core composed of pathogenetic and clinical data collected in the 19th century surrounded by layers of clinical observations reported over time. In the description, we prioritized poorly known sources, especially the ones that were never translated from the original German. We also performed quantitative and statistical analysis of repertory data. Through a literature survey and a call to practicing homeopathic doctors from many countries, we were able to put together a relevant case-series that represents homeopathic indications of Zinc.

Men With Anorexia: a Descriptive Study Of The Characteristics Of Male Patients In An Intensive Psychotherapy Day Hospital For Eating Disorders During 2015 In Madrid

2016 ◽  
Vol 33 (S1) ◽  
pp. S427-S427
Author(s):  
A. Espinosa Benavides ◽  
C. García Calvo ◽  
B. Unzeta Conde ◽  
M.P. Vilariño Besteiro ◽  
C. Pérez Franco
Keyword(s):  
Eating Disorders ◽  
Clinical History ◽  
Descriptive Study ◽  
Day Hospital ◽  
History Of ◽  
Male Patients ◽  
Competing Interest ◽  
One Year ◽  
Specialized Unit ◽  
Intensive Psychotherapy

ObjectiveTo describe the main characteristics of male patients suffering from anorexia in a specialized unit for eating disorders management.IntroductionAs a result of a more prevalent diagnosis of eating disorders in women (including anorexia among others), male patients characteristics have been less described in current literature.MethodologyThe authors retrospectively reviewed the clinical history of all male patients attending our unit of Eating Disorders in a period of one year (2015). The recorded characteristics were analyzed and classified as demographic, clinical and biographical. Finally a bibliographic review was also performed and correlated with our results.ConclusionDuring our review (currently being performed) we have found that, even if in much less numbers than in women, the characteristics of male patients suffering anorexia have recognizable patterns and for instance can be used for the better understanding of this pathology in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Atypical cognitive dysfunction due to brain damage: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S536-S536
Author(s):  
C.A. Welte-Santana ◽  
A.F. Macedo de Queiroz ◽  
N. Merola Fontoura ◽  
C. Lima de Melo ◽  
M. Ribeiro Garcia de Rezende ◽  
...  
Keyword(s):  
Retrograde Amnesia ◽  
Brain Mri ◽  
Brain Lesion ◽  
Clinical History ◽  
Public Hospitals ◽  
Patient Reported ◽  
History Of ◽  
Organic Brain ◽  
Competing Interest ◽  
One Year

IntroductionThe diagnosis of a primary psychiatric disorder requires the exclusion of an organic etiology. However, Brazilian public hospitals commonly lack resources. Diagnostic precision requires also the congruence of the clinical history and the natural history of the investigated disorder.ObjectivesThis study reports a rare case of hallucinations and retrograde amnesia, due to organic brain lesion but without other cognitive impairments.Case presentationFifty-three-years-old male Brazilian, was evaluated after one year in Brazil after being missing for 25 years in USA. Encountering his family, he did not recognize his mother, did not remember his life in Brazil, including his infancy, nationality and mother language. He was found as a homeless in poor hygiene. In the exam, he only presented retrograde amnesia, without any disturbances of fixation memory, intelligence, formal thought, affect or psychomotor function. Patient reported hallucinations. Blood tests showed no abnormalities. EEG showed diffuse slow rhythms. Brain MRI showed cortical and hippocampal atrophy. After weekly evaluations for 5 months, he remained stable despite lack of prescription. Some weeks after MRI, patient reported frequent alcohol and inhalant use when missing. No hints of secondary gain were found until present.DiscussionOrganic etiology was suspected due to atypical presentation: hallucinations, evocative amnesia, with no further cognitive and affect disturbances. This is not compatible with schizophrenia, dementia or dissociative disorder. The brain abnormalities and recent data highly suggest this etiological hypothesis.ConclusionSince this clinical presentation does not fit into any specific psychiatric category, the case will continue to be studied.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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