scholarly journals Ultrasound-Guided Regional Anesthesia Under Sedation for Radical Mastectomy in an SAS Patient: A Case Report

2021 ◽  
Vol 11 ◽  
Author(s):  
Na Zhang ◽  
Tingting Wang ◽  
Penghui Wei ◽  
Jinfeng Zhou ◽  
Jianjun Li
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Radical Mastectomy ◽  
Pathological Examination ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Metabolic Equivalents ◽  
Regional Block ◽  
The Right

Radical mastectomy is commonly performed under general anesthesia, and regional block is often used as assisted or postoperative analgesia. We herein report a case of successful radical mastectomy with severe aortic stenosis (SAS) by using ultrasound-guided regional anesthesia under sedation. A 66-year-old female with an American Society of Anesthesiology physical status IV; limited functional capacity with <4 metabolic equivalents; a lump (10 cm × 8 cm) in the right breast with skin breakage and infection; and a history of hypertension, diabetes, atrial fibrillation, and SAS, underwent lump-resection and rapid pathological examination by biopsy. Considering a high-risk of significant mortality, we used ultrasound-guided regional block to avoid general anesthesia. We performed the right thoracic paravertebral nerve block (TPVB), subclavicular brachial plexus block, and pectoralis plane block (PECS 1). Patient tolerated the procedure well with no significant hemodynamic changes. Nevertheless, when the axillary lymph nodes were wiped, discharge was observed from the patient’s upper limbs. We inserted the laryngeal mask airway combined with low-dose sevoflurane inhalation sedation. The operation was successfully completed, and the patient was revived with steady hemodynamics and good prognosis. In the present case, radical mastectomy with SAS was performed successfully using ultrasound-guided regional anesthesia under sevoflurane sedation. Despite some potential limitations, this case report can serve as a reference for other anesthetists.

scholarly journals Ultrasound-guided perioperative management of 28-month-old patient with congenital diaphragmatic eventration

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982773
Author(s):  
Hyemin Kang ◽  
Sangmin Lee ◽  
Hyunwoo Park ◽  
Yeojung Kim ◽  
YoungKwon Ko ◽  
...  
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Perioperative Management ◽  
Anesthetic Management ◽  
Male Infant ◽  
Lung Ultrasonography ◽  
Ultrasound Guided ◽  
Distal Ulna ◽  
Diaphragmatic Eventration ◽  
The Right

Diaphragmatic eventration is a rare anomaly. When patients with this condition undergo general anesthesia, anesthetic management should be performed with particular care owing to the risk of diaphragmatic rupture. Such a rupture can be perioperatively diagnosed using multiple tools including lung ultrasonography. This case report describes the anesthetic management of a male infant with osteochondroma in the distal ulna, presenting with diaphragmatic eventration on the right side.

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

Local Recurrence of Breast Cancer after MammoSite® Brachytherapy

2006 ◽  
Vol 72 (9) ◽  
pp. 798-801
Author(s):  
Matthew Voth ◽  
Raye Budway ◽  
Angela Keleher ◽  
Philip F. Caushaj
Keyword(s):  
Breast Cancer ◽  
Treatment Plan ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Breast Pathology ◽  
Poorly Differentiated ◽  
Her 2 ◽  
Negative Tumor

Women undergoing breast conservation therapy (BCT) for stage 1 breast cancer have adjuvant external beam radiotherapy (EBR). In addition, the use of brachytherapy radiation is being used. We present two local tumor recurrences for review. Our first patient underwent BCT, sentinel lymph node biopsy (SLNBx) and MammoSite® brachytherapy for a T1N0M0 infiltrating ductal carcinoma (IDC) of the right breast. Pathology: 0.6 cm poorly differentiated ER, PR, and Her-2/ Neu negative IDC. At 18 months, she had palpable axillary lymph nodes. Fine needle aspiration and ultrasound-guided core biopsy of a nodule showed IDC. She underwent modified radical mastectomy (MRM) and EBR. Our second patient underwent BCT, SLNBx, and MammoSite® brachytherapy for a T1N0M0 IDC of the left breast. Pathology: 0.8 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. At 18 months, a retroareolar mass was detected. Ultrasound guided core needle biopsy showed recurrent IDC. She chose a re-excision and EBR and not MRM. Pathology: 1.3 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. Our 2 recurrences were >2 cm away from the lumpectomy site and therefor outside the 1 cm treatment plan of the MammoSite® catheter. Both recurrences were biologically identical to the initial tumors and are felt to be local failures rather than new primaries.

Ovarian abscessation and oophoritis in a first lactation dairy cow: a case report

Livestock ◽  
2021 ◽  
Vol 26 (5) ◽  
pp. 228-232
Author(s):  
David Charles ◽  
Victoria Wyse ◽  
Katie Waine ◽  
Mark Wessels
Keyword(s):  
Case Report ◽  
Dairy Cow ◽  
Transrectal Ultrasound ◽  
Rare Condition ◽  
Pathological Examination ◽  
The Right

A 28-month-old first lactation dairy cow presented as ‘oestrus not observed’ and transrectal ultrasound showed a hyperechoic mass on the right ovary. The mass continued to grow despite treatment, and 8 weeks later a right-sided ovariectomy was performed. A single, large, cavitated mass was found on gross pathological examination with histopathology confirming ovarian abscessation and oophoritis, a rare condition in cattle.

Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salwa Omar El-Khattab ◽  
Mohamed Osman Taeimah ◽  
Mahmoud Mohamed Elsayed Seif
Keyword(s):  
General Anesthesia ◽  
Magnesium Sulfate ◽  
Nerve Block ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Recording Time ◽  
Female Population ◽  
Pectoral Nerve ◽  
Group I

Abstract Background Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers. Objective To evaluate the Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia. Patients and Methods After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 25 patients group I in which patients received general anesthesia followed by PECS BLOCK using only bupivacaine 0.25 % and group II in which patients received general anesthesia followed by PECS BLOCK using bupivacaine 0.25 % plus magnesium sulfate 50% (200mg). Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed. Conclusion The addition of 200 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly reduce postoperative opioid consumption, prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia.

scholarly journals Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Konstantinos Ioannis Avgerinos ◽  
Nikolaos Degermetzoglou ◽  
Sofia Theofanidou ◽  
Georgia Kritikou ◽  
Ioannis Bountouris
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
General Anesthesia ◽  
Lower Limb ◽  
Rare Complication ◽  
Head Tilt ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
The Right ◽  
Type Of Surgery

Background. Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report. An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee. On the 5th postoperative day, he was diagnosed with right parotitis probably because of dehydration, general anesthesia, and immunocompromisation. A CT scan confirmed the diagnosis. He received treatment with antibiotics and fluids. His condition gradually improved, and he was finally discharged on 15th postoperative day. Conclusions. Postoperative parotitis can possibly occur after any type of surgery including vascular. Clinicians should be aware of this complication although it is rare. Several risk factors such as dehydration, general anesthesia, drugs, immunocompromisation, head tilt during surgery, and stones in Stensen’s duct may predispose to postoperative parotitis. Treatment consists of antibiotics and hydration.

scholarly journals A Case Report of Triple-Positive Micropapillary Carcinoma of the Male Breast

Breast Care ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. 192-194 ◽  
Author(s):  
Jamila Shuja ◽  
Iftikhar Ahmad ◽  
Sidra Arshad ◽  
Hina Manzoor ◽  
Shahwali Kakar ◽  
...  
Keyword(s):  
Case Report ◽  
Ductal Carcinoma ◽  
Growth Factor Receptor ◽  
Radical Mastectomy ◽  
Multimodality Treatment ◽  
Lymph Node Involvement ◽  
Male Breast ◽  
Axillary Lymph ◽  
Micropapillary Carcinoma ◽  
Disease Case

Background: Micropapillary carcinoma (MPC), a morphologically distinct subtype of invasive ductal carcinoma, of the male breast is an exceedingly uncommon disease. Case Report: Herein, we report a case of triple-positive MPC of the male breast with axillary lymph node involvement and no recurrence for over 2 years. Specifically, a 60-year-old male patient presented with a hard, elastic, and well-defined painless mass in the right breast. The patient underwent unilateral (right) modified radical mastectomy with axillary clearance. Histopathology revealed MPC grade 3 and metastasis in 16/16 lymph nodes. Hormone receptor analysis demonstrated strong positivity (total score 08) for estrogen/progesterone receptors and overexpression (score 3+) of human epidermal growth factor receptor 2. The patient received adjuvant chemotherapy (6 courses of CAF: cyclophosphamide, doxorubicin, and 5-fluorouracil), radiation, and tamoxifen. The patient has remained disease-free for over 2 years. Conclusion: This study demonstrates that triple-positive MPC of the male breast as a rare malignancy appears to respond promisingly to multimodality treatment.

scholarly journals Case report: association between lymph node tuberculosis and breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Marina Fontes Medeiros ◽  
Gustavo Lanza de Melo ◽  
Thássia Mariz de Melo ◽  
Rachel Saraiva Teatini Selim de Sales ◽  
Janaina Cotta Rodrigues Ferreira
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Lymph Node ◽  
Pulmonary Nodules ◽  
Southeastern Brazil ◽  
Tuberculous Lymphadenitis ◽  
Axillary Lymph ◽  
Safety Margins ◽  
Lymph Node Tuberculosis ◽  
The Right

Introduction: Lymph node tuberculosis is the most common extra-lung presentation of tuberculosis, responsible for 43% of peripheral lymphadenopathies in developing countries. The coexistence between lymph node tuberculosis and breast cancer is rare, ranging from 0.1% to 4.9%.Objective: To present a case of axillary lymph node tuberculosis due to its rare association with breast cancer. Methods: We have investigated the case of a 48-year-old woman from Congonhas, Minas Gerais, Southeastern Brazil, who presented a palpable nodule in the junction of the right upper quadrants with two years of progression, category 4B of the Breast Imaging Reporting and Data System (BI-RADS) on mammography and ultrasound, with core needle biopsy compatible with benignancy. No axillary lymphadenopathy was identified. Case report: The patient underwent resection of the right breast nodule with safety margins due to disagreement between biopsy and imaging tests. Anatomopathological examination was consistent with luminal B invasive ductal carcinoma, measuring 1.6 cm. The patient was submitted to sentinel lymph node biopsy using patent blue in the right axilla. Anatomopathological analysis revealed tuberculous lymphadenitis. Chest computed tomography showed pulmonary nodules. The patient received adjuvant radiotherapy and tamoxifen, as well as antituberculous antibiotics, with regression of pulmonary nodules. The final staging was pT1cN0M0- IA. Discussion: Most cases of coexistence between these diseases involve tuberculous lymphadenitis with or without neoplastic lymph node involvement. Some reports indicate that the involvement by tuberculosis does not prevent neoplastic proliferation. Before starting chemotherapy, tuberculosis must be treated to avoid the immunosuppressive effect that can cause a spread of tuberculosis. Conclusion: Despite the rare coexistence of these diseases, we should not rule out this possibility, especially in endemic tuberculosis areas. Also, an accurate diagnosis prevents incorrect staging and can spare the patient from a more aggressive treatment.

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