Struma Ovarii: Clinico-Morphological Features and Therapeutic Experience of a Romanian Institution over 20 Years

Struma ovarii is a rare condition with scarce published data regarding clinical, morphological, and therapeutic approaches. This study reports the experience of 25 patients with struma ovarii who received surgical treatment in a gynecology department in Romania. The study was conducted from January 1999 to September 2021 and included patients with confirmed struma ovarii whose medical records were retrospectively reviewed and evaluated. Struma ovarii represented 2.8% of the total number of benign ovarian tumors treated by surgery. The age of the patients was between 24 and 71 years. The tumor was unilateral in 24 cases, 13 cases on the left ovary, 11 on the right side, and bilateral in 1 case. Tumor dimensions ranged between 1 cm and 20 cm. In two cases, the patients had symptoms of hyperthyroidism. The procedure was performed on four women for diagnoses other than an ovarian tumor. In another five situations, there was suspicion of ovarian malignancy. In addition, struma ovarii was associated with other clinical conditions in 22 cases. These lesions represent a diagnostic challenge with heterogeneous clinical and imaging manifestations. Complete information of clinical, morphologic, and surgical findings may improve the diagnostic algorithm and better predict patient outcomes.

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Tracheo-oesophageal groove Hodgkin’s lymphoma presenting as stridor: a diagnostic challenge

BMJ Case Reports ◽

10.1136/bcr-2020-238271 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238271

Author(s):

Joshua Agilinko ◽

Anas Gomati ◽

Ghada Bashat ◽

Muhammad Shakeel

Keyword(s):

Hodgkin’S Lymphoma ◽

Case Reports ◽

Rare Condition ◽

Needle Aspiration ◽

Hodgkin's Lymphoma ◽

Diagnostic Challenge ◽

Thyroid Papillary ◽

Diagnostic Work ◽

The Right ◽

Team Setting

A 38-year-old male patient presented to the ear, nose and throat department with shortness of breath over last 2 months. The CT scan of the neck and chest revealed a 3.3×3 cm tumour behind the right thyroid lobe extending into the tracheo-oesophageal (TO) groove with tracheal compression. The ultrasound scan of the neck and targeted fine needle aspiration followed by core biopsy raised a suspicion of Hodgkin’s lymphoma. The patient underwent a right hemithyroidectomy and incisional biopsy of the right TO groove tumour. The histology confirmed a Hasenclever’s three nodular sclerosing Hodgkin’s lymphoma for which he received adjuvant chemotherapy. An incidental pT1a pN0 thyroid papillary microcarcinoma in the adjacent thyroid parenchyma was completely excised. This represents a case of TO Hodgkin’s lymphoma, of which there are no current published case reports. We aim to raise awareness about this rare condition by sharing the diagnostic work up and successful management in a multidisciplinary team setting.

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Skull base non-Hodgkin’s lymphoma

International Surgery Journal ◽

10.18203/2349-2902.isj20175115 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4086

Author(s):

Muhammad Haruna ◽

Prashant Gupta ◽

Ganapathy Dhanasekar

Keyword(s):

Skull Base ◽

Rare Condition ◽

High Signal ◽

Primary Lymphoma ◽

Diagnostic Challenge ◽

Facial Numbness ◽

Bone Cortex ◽

Petrous Temporal Bone ◽

Magnetic Resonance Imaging Mri ◽

The Right

Primary skull base lymphoma accounts for 1% - 2% of all skull base tumours. It is a very rare condition, which poses a diagnostic challenge in clinical practice but needs early diagnosis and treatment. We present a case of primary lymphoma of the skull base in a 53-year-old woman, who was admitted with complaints of bilateral temporal pain, facial numbness, slurred speech, difficulty in swallowing and deafness. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed ill-defined destruction of the petrous temporal bone with a high signal area noted on T2 weighted images in the right temporal lobe which initially was thought to be skull base osteomyelitis. However, a finding of a thin subperiosteal dense soft tissue in the left parieto-occipital region with intact adjacent bone cortex similar in appearance to the of the primary skull base pathology was seen which alerted the team to possible diagnosis of skull base lymphoma.

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P1337 Left ventricle outpouchings. Assesing diagnostic complexity

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.775 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

S Blasco Turrion ◽

L Marcos Fuentes ◽

A Moruno Tirado ◽

F Coserria Sanchez ◽

I Valverde Perez

Keyword(s):

Left Ventricle ◽

Dilated Cardiomyopathy ◽

Autoimmune Pancreatitis – Diagnosis, Management and Longterm Follow-up

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.232.sc1 ◽

2014 ◽

Vol 23 (2) ◽

pp. 179-185 ◽

Cited By ~ 7

Author(s):

Suvadip Chatterjee ◽

Kofi W. Oppong ◽

John S. Scott ◽

Dave E. Jones ◽

Richard M. Charnley ◽

...

Keyword(s):

Autoimmune Pancreatitis ◽

Rare Condition ◽

Team Approach ◽

Diagnostic Challenge ◽

Multisystem Disorder ◽

North East ◽

The North ◽

Work Up ◽

Igg4 Level

Background & Aims: Autoimmune pancreatitis (AIP) is a fibroinflammatory condition affecting the pancreas and could present as a multisystem disorder. Diagnosis and management can pose a diagnostic challenge in certain groups of patients. We report our experience of managing this condition in a tertiary pancreaticobiliary centre in the North East of England.Methods: Patients were identified from a prospectively maintained database of patients diagnosed with AIP between 2005 and 2013. Diagnosis of definite/probable AIP was based on the revised HISORt criteria. When indicated, patients were treated with steroids and relapses were treated with azathioprine. All patients have been followed up to date.Results: Twenty-two patients were diagnosed with AIP during this period. All patients had pancreatic protocol CT performed while some patients had either MR or EUS as part of the work up. Fourteen out of 22 (64%) had an elevated IgG4 level (mean: 10.9 g/L; range 3.4 - 31 g/L). Four (18%) patients underwent surgery. Extrapancreatic involvement was seen in 15 (68%) patients, with biliary involvement being the commonest. Nineteen (86%) were treated with steroids and five (23%) required further immunosuppression for treatment of relapses. The mean follow up period was 36.94 months (range 7 - 94).Conclusion: Autoimmune pancreatitis is being increasingly recognized in the British population. Extrapancreatic involvement, particularly extrahepatic biliary involvement seems to be a frequent feature.Diagnosis should be based on accepted criteria as this significantly reduces the chances of overlooking malignancy. Awareness of this relatively rare condition and a multi-disciplinary team approach will help us to diagnose and treat this condition more efiectively thereby reducing unnecessary interventions.

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It is better an approximate answer to the right question than the exact answer to the wrong question : the case of the psychometric analysis of the ASQ:SE

10.31234/osf.io/a5tdf ◽

2020 ◽

Author(s):

Luis Anunciacao ◽

janet squires ◽

J. Landeira-Fernandez

Keyword(s):

Internal Structure ◽

Statistical Methods ◽

Principal Component ◽

Psychological Theory ◽

Published Data ◽

Multivariate Statistical ◽

Exact Answer ◽

Wide Range ◽

Ages And Stages Questionnaire ◽

The Right

One of the main activities in psychometrics is to analyze the internal structure of a test. Multivariate statistical methods, including Exploratory Factor analysis (EFA) and Principal Component Analysis (PCA) are frequently used to do this, but the growth of Network Analysis (NA) places this method as a promising candidate. The results obtained by these methods are of valuable interest, as they not only produce evidence to explore if the test is measuring its intended construct, but also to deal with the substantive theory that motivated the test development. However, these different statistical methods come up with different answers, providing the basis for different analytical and theoretical strategies when one needs to choose a solution. In this study, we took advantage of a large volume of published data (n = 22,331) obtained by the Ages and Stages Questionnaire Social-Emotional (ASQ:SE), and formed a subset of 500 children to present and discuss alternative psychometric solutions to its internal structure, and also to its subjacent theory. The analyses were based on a polychoric matrix, the number of factors to retain followed several well-known rules of thumb, and a wide range of exploratory methods was fitted to the data, including EFA, PCA, and NA. The statistical outcomes were divergent, varying from 1 to 6 domains, allowing a flexible interpretation of the results. We argue that the use of statistical methods in the absence of a well-grounded psychological theory has limited applications, despite its appeal. All data and codes are available at https://osf.io/z6gwv/.

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Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

International Journal of Anesthesiology Research ◽

10.31907/2310-9394.2020.08.02 ◽

2020 ◽

Vol 8 (1) ◽

pp. 9-15

Author(s):

Petrov Nikolay ◽

◽

Marinova R. ◽

Odiseeva Ev.

Keyword(s):

Intracranial Aneurysm ◽

Endovascular Treatment ◽

Clinical Case ◽

Endovascular Coiling ◽

Published Data ◽

Military Medical Academy ◽

Life Threatening ◽

Arachnoid Hemorrhage ◽

The Right ◽

Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

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CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

Problems in oncology ◽

10.37469/0507-3758-2019-65-5-756-759 ◽

2019 ◽

Vol 65 (5) ◽

pp. 756-759

Author(s):

Mikhail Postolov ◽

Nadezhda Kovalenko ◽

K. Babina ◽

Stanislav Panin ◽

Yelena Levchenko ◽

...

Keyword(s):

Good Condition ◽

Lung Neoplasm ◽

Rare Condition ◽

Epithelioid Cell ◽

X Ray ◽

Perivascular Epithelioid Cell ◽

Mesenchymal Neoplasm ◽

Preoperative Ct ◽

Lymph Duct ◽

The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

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Management of Pleural Effusions in the Emergency Department.

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200624194457 ◽

2020 ◽

Vol 15 ◽

Author(s):

MT Congedo ◽

GM Ferretti ◽

D Nachira ◽

MA Pennisi

Keyword(s):

Emergency Department ◽

Systematic Approach ◽

Acute Chest Pain ◽

Pleural Effusions ◽

Therapeutic Approaches ◽

Massive Pleural Effusion ◽

Emergency Department Setting ◽

Clinical Conditions ◽

Definitive Management

Background: In symptomatic patients, admitted in emergency department for acute chest pain and dyspnea, who require an urgent treatment, a rapid diagnosis and prompt management of massive pleural effusion or hemothorax can be lifesaving. The aim of this review was to summarize the current diagnostic and therapeutic approaches for the management of the main types of pleural effusions that physicians can have in an emergency department setting. Methods: Current literature about the topic was reviewed and critically reported, adding the experience of the authors in the management of pleural effusions in emergency settings. Results: The paper analyzed the main types of pleural effusions that physicians can have to treat. It illustrated the diagnostic steps by the principal radiological instruments, with a particular emphasis to the role of ultrasonography, in facilitating diagnosis and guiding invasive procedures. Then, the principal procedures, like thoracentesis and insertion of small and large bore chest drains, are indicated and illustrated according to the characteristics and the amount of the effusion and patient clinical conditions. Conclusion: The emergency physician must have a systematic approach that allows rapid recognition, clinical cause identification and definitive management of potential urgent pleural effusions.

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Senescence under appraisal: hopes and challenges revisited

Cellular and Molecular Life Sciences ◽

10.1007/s00018-020-03746-x ◽

2021 ◽

Author(s):

Camilla S. A. Davan-Wetton ◽

Emanuela Pessolano ◽

Mauro Perretti ◽

Trinidad Montero-Melendez

Keyword(s):

Cellular Senescence ◽

Clinical Success ◽

Immune Surveillance ◽

Favourable Outcome ◽

Cellular Growth ◽

Therapeutic Approaches ◽

Cycle Arrest ◽

Therapeutic Development ◽

The Right ◽

Inflammation Resolution

AbstractIn recent years, cellular senescence has become the focus of attention in multiple areas of biomedical research. Typically defined as an irreversible cell cycle arrest accompanied by increased cellular growth, metabolic activity and by a characteristic messaging secretome, cellular senescence can impact on multiple physiological and pathological processes such as wound healing, fibrosis, cancer and ageing. These unjustly called ‘zombie cells’ are indeed a rich source of opportunities for innovative therapeutic development. In this review, we collate the current understanding of the process of cellular senescence and its two-faced nature, i.e. beneficial/detrimental, and reason this duality is linked to contextual aspects. We propose the senescence programme as an endogenous pro-resolving mechanism that may lead to sustained inflammation and damage when dysregulated or when senescent cells are not cleared efficiently. This pro-resolving model reconciles the paradoxical two faces of senescence by emphasising that it is the unsuccessful completion of the programme, and not senescence itself, what leads to pathology. Thus, pro-senescence therapies under the right context, may favour inflammation resolution. We also review the evidence for the multiple therapeutic approaches under development based on senescence, including its induction, prevention, clearance and the use of senolytic and senomorphic drugs. In particular, we highlight the importance of the immune system in the favourable outcome of senescence and the implications of an inefficient immune surveillance in completion of the senescent cycle. Finally, we identify and discuss a number of challenges and existing gaps to encourage and stimulate further research in this exciting and unravelled field, with the hope of promoting and accelerating the clinical success of senescence-based therapies.

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Rheology of right ventricular outflow tract obstruction: sub-pulmonary membrane developing months after primary intervention to treat pulmonary atresia with intact interventricular septum

Cardiology in the Young ◽

10.1017/s1047951121001591 ◽

2021 ◽

pp. 1-4

Author(s):

Baher M. Hanna ◽

Wesam E. El-Mozy ◽

Sonia A. El-Saiedi

Keyword(s):

Right Ventricular ◽

Interventricular Septum ◽

Pulmonary Atresia ◽

Right Ventricular Outflow Tract ◽

Rare Condition ◽

Surgical Excision ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Ventricular Outflow Tract Obstruction ◽

The Right

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.

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