scholarly journals Anterior lens capsule rupture following minor blunt trauma with a past history of minimal change glomerulopathy

2014 ◽  
Vol 6 (2) ◽  
pp. 230-233
Author(s):  
Stephen V Lau V Lau ◽  
Prerana Kansakar ◽  
Ben Limbu
Keyword(s):  
Unusual Case ◽  
Past History ◽  
Lens Capsule ◽  
Minimal Change ◽  
Minor Trauma ◽  
Current Case ◽  
Anterior Lens Capsule ◽  
History Of ◽  
The Right ◽  
Anterior Subcapsular Cataract

Introduction: Few cases have been reported describing anterior lens capsule ruptures secondary to blunt trauma.Case: We present an unusual case of anterior lens capsule ruptures following minor trauma from a human elbow with a two-year history of minimal-change glomerulopathy in a 17-year-old male. In addition to having bilateral posterior subcapsular cataracts, he developed an anterior subcapsular cataract underlying the anterior lens rupture in the right eye. He was managed conservatively.  Observations: The current case differs from those of the existing literature in terms of the characteristics of the physical insult and the eye on presentation. We suggest there could be a predisposing anterior capsule weakness secondary to the minimal-change glomerulopathy or the associated drug therapy, but there needs to be more evidence to confirm or refute our claim.  Conclusions: Anterior lens capsule may rupture following minor trauma on a background of minimal-change glomerulopathy.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11714Nepal J Ophthalmol 2014; 6 (12): 230-233 

scholarly journals Splenic undifferentiated high grade pleomorphic sarcoma of a small size with fatal tumor rupture

1970 ◽  
Vol 1 (2) ◽  
pp. 151-153 ◽  
Author(s):  
BM Amatya ◽  
M Sawabe ◽  
T Arai ◽  
T Kumakawa ◽  
K Takubo ◽  
...  
Keyword(s):  
Past History ◽  
Distant Metastases ◽  
Tumor Rupture ◽  
Retroperitoneal Hemorrhage ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Bone Marrow Histology ◽  
Pleomorphic Sarcoma ◽  
Fatal Bleeding ◽  
History Of ◽  
The Right

(The order of authors on this article was changed on 09/01/2012.)Primary undifferentiated pleomorphic sarcoma of the spleen is a rare and highly aggressive neoplasm that usually presents with splenomegaly, constitutional symptoms and frequent distant metastases. We report a case of 77-year old male patient with a past history of dissecting aortic aneurysm that developed acute hemorrhagic shock. Aneurysmal rupture was clinically suspected, but the postmortem examination revealed a 25 mm-sized tumor in an atrophic spleen weighing 65 gram with massive retroperitoneal bleeding. Metastases were found in the right renal hilus, the right adrenal gland and femoral bone marrow. Histology of the tumor showed undifferentiated pleomorphic sarcoma. Tumor rupture with fatal bleeding and systemic metastases had occurred despite the small size of the tumor. Tumor size is not a reliable predictor of systemic metastasis or tumor rupture for splenic undifferentiated pleomorphic sarcoma. Keywords: Undifferentiated pleomorphic sarcoma; Malignant fibrous histiocytoma; Splenic neoplasms; Retroperitoneal hemorrhage DOI: http://dx.doi.org/10.3126/jpn.v1i2.5411 JPN 2011; 1(2): 151-153

scholarly journals A case of Young Stroke due to Moyamoya Disease

2020 ◽  
Vol 15 (1) ◽  
pp. 110-113
Author(s):  
Md Abdur Razzak ◽  
Ghulam Kawnayn ◽  
Fateha Naznin ◽  
Quazi Audry Arafat Rahman
Keyword(s):  
Moyamoya Disease ◽  
Past History ◽  
Cerebral Arteries ◽  
Armed Forces ◽  
Cerebral Angiogram ◽  
Medical College ◽  
Middle Cerebral Arteries ◽  
History Of ◽  
Collateral Vessels ◽  
The Right

Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by the constriction, and also by blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis which may result in TIA, recurrent ischemic or hemorrhagic stroke or seizure. The disease may manifest in pediatric age or young adults. In May 2019 we have diagnosed a young lady with Moyamoya disease who presented with right sided hemiplegia, motor aphasia and dysphagia. She was labeled as hypertensive 6 months prior to this event and used to take anti-hypertensive irregularly and gave past history of occasional headache. Her CT scan and MRI of brain revealed left sided ischemic infarct involving frontotemporoparietal region and cerebral angiogram revealed narrowing of left MCA and non-visualization of distal part. There is extensive fine collaterals (Moyamoya vessels) giving the appearance of puffed smoke. The right ACA and MCA were also narrowed with appearance of early collateral vessels. She was treated with aspirin, PPI, NG feeding, antihypertensive medication, physiotherapy, rehabilitation therapy and other supportive care. His condition gradually improved and discharged on 2.7.19. He was referred to Department of Neurosurgery for cerebral revascularization by STA-MCA (superficial temporal and middle cerebral arteries) bypass surgery after stabilization and MR perfusion study. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 110-113

scholarly journals Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Pouya Nazari ◽  
Pedram Golnari ◽  
Madhav Sukumaran ◽  
Ali Shaibani ◽  
Michael C Hurley ◽  
...  
Keyword(s):  
Unusual Case ◽  
Middle Meningeal Artery ◽  
Complete Healing ◽  
Spontaneous Thrombosis ◽  
Pseudoaneurysm Formation ◽  
Arteriovenous Fistulas ◽  
History Of ◽  
The Right ◽  
Repeat Imaging

ABSTRACT BACKGROUND AND IMPORTANCE Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results. CLINICAL PRESENTATION A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm. CONCLUSION Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.

Presumed Choroidal Metastasis From Oncocytic Carcinoma of the Parotid Gland: A Case Report

2019 ◽  
Vol 4 (3) ◽  
pp. 253-256
Author(s):  
Yousef J. Cruz-Iñigo ◽  
Stephen A.M. De Souza
Keyword(s):  
Parotid Gland ◽  
External Beam Radiotherapy ◽  
Subretinal Fluid ◽  
Malignant Neoplasm ◽  
Distant Metastases ◽  
Choroidal Metastasis ◽  
Current Case ◽  
Oncocytic Carcinoma ◽  
History Of ◽  
The Right

Purpose: This article reports a case of presumed choroidal metastasis from an oncocytic carcinoma of the parotid gland. Methods: A 70-year-old man with history of an oncocytic carcinoma of the parotid gland presented owing to a 1-month history of progressive blurred central vision shortly after metastatic surveillance workup revealed liver, lung, and spine metastases. Fundus examination of the right eye showed a yellow choroidal mass surrounding the optic nerve and extending inferonasally, which is associated with subretinal fluid involving the foveal center. A-scan and B-scan ultrasonography were remarkable for a dome-shaped choroidal mass with medium-to-high internal reflectivity. Fluorescein angiography revealed pinpoint foci of hyperfluorescence over the choroidal lesion with late leakage. Magnetic resonance imaging of the brain showed evidence of metastatic disease to the cerebellum. While the patient underwent systemic chemotherapy, external beam radiotherapy was used to treat the eye. Results: Four months later, visual acuity improved, the tumor reduced in size, and the subretinal fluid resolved. Systemic workup disclosed no new metastases. Conclusion: Oncocytic carcinoma of the parotid gland is a rare and aggressive malignant neoplasm with frequent recurrences and distant metastases. The current case suggests that oncocytic carcinoma can metastasize to the choroid and, consequently, ocular metastasis surveillance is advised in these patients.

An Unusual Cause of Refractive Chronic Bilateral Leg Ulceration

2004 ◽  
Vol 8 (6) ◽  
pp. 432-437 ◽  
Author(s):  
Laila M. Sabet ◽  
Denise Wexler ◽  
Samih Salama ◽  
Bing Siang Gan
Keyword(s):  
Conventional Treatment ◽  
Elderly Population ◽  
Unusual Case ◽  
The Elderly ◽  
Complete Healing ◽  
Venous Hypertension ◽  
Histopathologic Examination ◽  
Knee Amputation ◽  
History Of ◽  
The Right

Background: Ulceration of the lower extremities is a common disorder that can be very painful. It occurs most frequently in the elderly population as a result of venous hypertension. We report an unusual case of a 32-year-old man with an 11-year history of extensive, painful, bilateral leg ulcers resistant to conventional treatment necessitating above-knee amputation of the left leg. Eventually, the patient was treated with prednisone, which led to almost complete healing of the ulcers of the right leg. Objective: The objective of this report is to discuss a rare cause of chronic bilateral leg ulceration. Methods: Detailed histopathologic examination showed a complex pattern of overlapping features of several specific dermatologic conditions, including necrobiosis lipoidica (NL), necrobiotic xanthogranuloma (NXG), and the destructive form of granuloma annulare (GA). Conclusion: The characteristics of our patient suggest a variant of a cutaneous necrobiotic disorder that has not been previously reported. When clinicians are confronted with recalcitrant ulcerations in the lower extremity, this group of disorders should be considered in the differential diagnosis.

Meningeal Melanocytoma Associated with Ipsilateral Nevus of Ota Presenting as Intracerebral Hemorrhage: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 56 (6) ◽  
pp. E1376-E1376 ◽  
Author(s):  
Ken Hino ◽  
Motoo Nagane ◽  
Yasunori Fujioka ◽  
Yoshiaki Shiokawa
Keyword(s):  
Intracerebral Hemorrhage ◽  
Intracerebral Hematoma ◽  
Current Case ◽  
Meningeal Melanocytoma ◽  
Nevus Of Ota ◽  
First Case ◽  
Resected Tumor ◽  
History Of ◽  
The Right ◽  
High Level

Abstract OBJECTIVE AND IMPORTANCE: The authors report a rare case of meningeal melanocytoma presenting with unconsciousness, which was caused by an intracerebral hematoma and associated with a history of ipsilateral nevus of Ota. CLINICAL PRESENTATION: A 75-year-old woman developed nevus of Ota in the first and second divisions of the right trigeminal nerve territory, which had been treated with a skin graft 40 years earlier. She noticed right exophthalmos but left it untreated for 2 years and then became comatose owing to orbital and intracranial tumors, the latter manifesting with hemorrhage. INTERVENTION: She underwent craniotomy, during which the tumor was partially removed with intracerebral hematoma. Histopathologically, the tumor was diagnosed as meningeal melanocytoma. Western blot analysis demonstrated a retained protein expression of cell cycle inhibitor p16INK4A and a high level of antiapoptotic Bcl-2 in the resected tumor. CONCLUSION: The combination of nevus of Ota and meningeal melanocytoma has been reported in only four cases in the literature, including the current case. This is the first case coinciding with intracerebral hemorrhage, suggesting the necessity for careful follow-up with radiological images.

scholarly journals Scrotal Lymphangiectasia with Penile Elephantiasis in Underlying Lymphatic Filariasis—Challenging the Diagnostic Mind! A Case Report

2021 ◽  
Vol 8 (1) ◽  
pp. 10-16
Author(s):  
Tejas Vishwanath ◽  
Angela Nagpal ◽  
Sunil Ghate ◽  
Aseem Sharma
Keyword(s):  
Lymphatic Filariasis ◽  
Unusual Case ◽  
Past History ◽  
Connective Tissue Diseases ◽  
Common Disease ◽  
Intermittent Fever ◽  
Peripheral Smear ◽  
Male Farmer ◽  
Milky Urine ◽  
History Of

Background: A plethora of diseases manifest as acquired genital lymphangiectasias which clinically manifest as superficial vesicles. They range from infections such as tuberculosis to connective tissue diseases such as scleroderma and even malignancy. Amongst infectious etiologies, lymphatic filariasis leads as the cause for lymphatic obstruction. Despite this, acquired lymphangiectasias due to this cause are not commonly reported. An unusual case of acquired scrotal lymphangiectasia secondary to filariasis is detailed in this paper with dermoscopic and histologic findings. Methods: A 65-year-old male farmer presented with multiple, asymptomatic vesicles over the scrotum with thickened scrotal and penile skin that had occurred for six years. He gave past history of intermittent fever and milky urine, was diagnosed with filariasis and treated with diethylcarbamazine for a year, four years previously. Systemic complaints abated but the peno-scrotal lesions did not. Results: Polarized dermoscopy revealed multiple skin-colored nodules and translucent pale blue lacunae over the scrotum. A few radially arranged linear irregular vessels were noted over the nodules. On histopathology, multiple ectatic lymphatics were noted in the mid and upper dermis with acanthosis and superficial perivascular lymphocytes. Peripheral smear revealed eosinophils; however, microfilariae could not be detected despite repeated diethylcarbamazine provocation and night smears being taken. The findings were compatible with acquired scrotal lymphangiectasia secondary to treated lymphatic filariasis. Local hygiene was advised; however, procedural treatments were refused by the patient. Conclusion: Herein, we report an unusual case of acquired scrotal lymphangiectasia of the scrotum secondary to treated lymphatic filariasis. Very few similar reports exist. To the best of our knowledge, dermoscopic features of this condition have not been elucidated before. This case, detailing an uncommon manifestation of a common disease (filariasis), demonstrates the importance of careful history taking and examination. This was especially so in the present case since only circumstantial evidence of filariasis was noted in investigations. There is a need to heighten awareness of this unusual condition amongst physicians especially if the patient hails from an area endemic for filariasis.

scholarly journals Primary renal leiomyosarcoma: A rare case report

2021 ◽  
pp. 503-505
Author(s):  
Sudeshna Nandi ◽  
Smritiparna Das ◽  
Chhanda Das ◽  
Madhumita Mukhopadhyay
Keyword(s):  
Abdominal Pain ◽  
Immunohistochemical Staining ◽  
Rare Case ◽  
Past History ◽  
Renal Calculi ◽  
Rare Type ◽  
The Past ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Leiomyosarcoma of the kidney is a rare type of adult renal sarcoma. Here, we presented a case of a 68-year-old female who had a past history of bilateral renal calculi 3 years back with hydronephrotic changes, now presented to the OPD with complaints of abdominal pain for the past few months. On further evaluation, a heterogeneously enhancing necrotic mass was identified in the right kidney measuring 7.5 cm in the greatest dimension. A right radical nephrectomy with left Double J stenting was done. From histopathological and immunohistochemical staining, it was diagnosed as leiomyosarcoma.

scholarly journals Secondary Angle Closure due to Crystalline Lens Dislocation in a Patient with Atopic Dermatitis and Chronic Eye Rubbing

2018 ◽  
Vol 9 (1) ◽  
pp. 197-201 ◽  
Author(s):  
Justin Kuiper ◽  
Mark Slabaugh
Keyword(s):  
Atopic Dermatitis ◽  
Past History ◽  
Corneal Edema ◽  
Crystalline Lens ◽  
Atopic Disease ◽  
Angle Closure ◽  
Ectopia Lentis ◽  
Laser Iridotomy ◽  
History Of ◽  
The Right

Purpose: To report an unusual case of ectopia lentis and angle closure in a patient with chronic eye rubbing. Methods: A 57-year-old male with a history of poorly controlled atopic dermatitis presented with right eye pain, decreased vision, and an intraocular pressure (IOP) of 55 mm Hg. He had no past history of ocular disease and no reported history of trauma. He did report a history of chronic eye rubbing. Results: Best corrected visual acuity was hand motions. The examination revealed severe atopic keratoconjunctivitis in both eyes, microcystic corneal edema of the right eye, and 2+ nuclear sclerosis in both eyes. Gonioscopy showed no visible angle structures OD and an open angle OS. Topical and oral IOP-lowering medications and a laser iridotomy were unsuccessful at lowering IOP. He was taken to the operating room for a lensectomy and was found to have 9 clock hours of zonular dehiscence and a dislocated lens. After lensectomy, the IOP improved to 9 mm Hg on postoperative day 1. A follow-up examination at 2 weeks showed improved acuity to 20/150 with a pinhole and an IOP of 10 mm Hg. A dilated examination OS did not reveal significant phacodonesis, and the patient was referred for a possible sutured sulcus lens or anterior chamber intraocular lens. Conclusions: It is important for the provider to consider ectopia lentis in the differential for patients with pupillary block angle closure. For patients with atopic disease, one should be aware that eye rubbing may be a cause of zonular dehiscence, even in the absence of reported trauma or prior intraocular surgery.

Biodegradable Antibiotic Delivery Systems in the treatment chronic osteomyelitis

2014 ◽  
Vol 2 (2) ◽  
pp. 73-77
Keyword(s):  
Chronic Osteomyelitis ◽  
Past History ◽  
Delivery Systems ◽  
Subsequent Treatment ◽  
Passive Movement ◽  
Residential Home ◽  
Low Grade ◽  
History Of ◽  
The Right ◽  
Antibiotic Delivery

An 82-year-old woman was referred to the orthopedic department with a three-month history of low-grade fever. She had a known past history of type 2 diabetes. She had been unwell for last 5-days, complaining of feeling hot and 'shivery' with general aches, particularly in her right shoulder. The staff in the residential home where she lived had called the general practitioner who had prescribed a three-day course of trimethoprim for a suspected urinary tract infection. On examination, she was pyrexia with a temperature of 39.5°C. She was drowsy but reusable. Pulse was 125 beats per minute and regular. Blood pressure was 90/55 mmHg. Heart sounds were normal with no added sounds or murmurs. The chest was clear. Her abdomen was soft and non-tender with no palpable masses or organs. The skin overlying the right shoulder was warm to touch and erythematous. She was unable to tolerate any passive movement of the joint. A plain x ray of her shoulder shows lucent defects in the head of the humerus with loss of the normally well-corticated surface. This is consistent with osteomyelitis. Two of 2-blood cultures and numerous operative cultures grew MRSA. His subsequent treatment consisted of intravenous vancomycin, achieving plasma drug levels approximating 24 μg/mL. This treatment was extended for 8 weeks, given the clinical concern for possible osteomyelitis in an area. Treatment was complicated by significant a decline in hearing. Biodegradable drug delivery systems provide a method for local delivery of drugs in deeper tissues, obviating parenteral or enteral usage; in some situations, a significant advantage is that much higher doses and/or strengths of the drug can be delivered locally than can be tolerated if the drug is delivered systemically. In this case report, we discussed the use of Biodegradable Antibiotic Delivery Systems in treatment chronic osteomyelitis.

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