scholarly journals Primary Ewing sarcoma of the larynx with distant metastasis: a case report and review of the literature

2019 ◽  
Vol 26 (4) ◽  
Author(s):  
C. A. Maroun ◽  
I. Khalifeh ◽  
A. Tfayli ◽  
R. V. Moukarbel
Keyword(s):  
Computed Tomography ◽  
Vocal Cord ◽  
Ewing Sarcoma ◽  
Present Report ◽  
Thyroid Cartilage ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
History Of ◽  
The Right ◽  
Extraosseous Ewing Sarcoma

Extraosseous Ewing sarcoma is a rare, poorly differentiated round-cell tumour that is part of the Ewing sarcoma family of tumours. Here, we present an extremely rare case of primary extraosseous Ewing sarcoma arising in the larynx, with distant metastases.    A 53-year-old man with a history of Hodgkin lymphoma treated 4 years earlier with 8 cycles of chemotherapy presented to our medical centre with a 2-week history of hoarseness. On physical examination, he was found to have a right supraglottic mass together with a fixed right vocal cord. Computed tomography imaging of the patient’s neck showed a heterogeneously enhancing lesion measuring 5.0×3.8×3.8 cm, centred on the right thyroid cartilage and invading the right true vocal cord. Imaging by integrated fluorodeoxyglucose positron-emission tomography and computed tomography showed active subcarinal and axillary lymph nodes, multiple scattered lung nodules, and multiple bony metastases. Needle core biopsy of the laryngeal mass was diagnostic for Ewing sarcoma. The patient received radiation to the laryngeal area and then alternating cycles of vincristine–actinomycin-D–cyclophosphamide and etoposide–ifosfamide. The patient remains in remission 1 year after completing therapy.    As demonstrated in the present report, these tumours can behave very aggressively both locally and by metastasizing to distant organs. Our treatment approach provided favourable results for the patient; however, future reports are needed to further elucidate optimal management.

Regional Nodal Metastasis of Humeral Chondrosarcoma in a Dog

2015 ◽  
Vol 51 (5) ◽  
pp. 346-351 ◽  
Author(s):  
Mandy Meindel ◽  
Lisa Pohlman ◽  
Brad DeBey ◽  
Mary Lynn Higginbotham ◽  
Rachel Moon
Keyword(s):  
Lymph Nodes ◽  
Histopathological Examination ◽  
Bone Lesion ◽  
Prognostic Indicator ◽  
Needle Aspiration ◽  
Nodal Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
History Of ◽  
The Right

A 6 yr old castrated male English springer spaniel was evaluated with a 1 mo history of progressive right forelimb lameness with recent swelling around the elbow joint. Physical examination findings included lameness of the right forelimb, muscle atrophy around the right shoulder, grade 2/6 heart murmur, and moderate dental disease. Results of a complete blood cell count and serum biochemical analysis were unremarkable with the exception of a mildly increased alkaline phosphatase (368 U/L; reference range, 128–328 U/L). Radiographs of the right elbow revealed a mixed lytic and proliferative osseous lesion most consistent with either neoplasia or infection. Thoracic radiographs and the echocardiogram were unremarkable. Fine-needle aspiration of the bone lesion was performed. The cytological diagnosis was chondrosarcoma. The right forelimb was amputated and the axillary lymph nodes were collected. Histopathological examination of the bone lesion and axillary lymph nodes revealed chondrosarcoma with metastasis to the lymph nodes. Lymph node metastasis of chondrosarcoma is rare and needs to be further evaluated as a prognostic indicator.

scholarly journals A rare case of unilateral breast filariasis mimicking chronic mastitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2228
Author(s):  
Varsha A. Sharma ◽  
Manmohan M. Kamat ◽  
Jeena K. Sathyan ◽  
Seema Barman ◽  
Shravani Shetye
Keyword(s):  
Benign Lesion ◽  
Rare Condition ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Excision Biopsy ◽  
Axillary Lymph ◽  
Presumptive Diagnosis ◽  
Lower Quadrant ◽  
History Of ◽  
The Right

Filariasis of the breast is a very rare condition. In India, largest number (around 600 million) of people live in endemic areas. Despite the huge number, it is quite rare to find microfilaria in routine smears and body fluids and it is even more rare to find it in breasts. A 40 years old female, presented with a history of lump in the right breast approximately 3x3 cm in size in the right lower quadrant. Findings were confirmed by clinical examination which did not reveal any palpable ipsilateral or contralateral axillary lymph nodes. FNAC showed it as a benign lesion. After local excision, histopathology revealed a filarial worm. Filariasis of the breast is a rare disease. The presence of microfilaria in breasts using FNAC has been reported at times but the presence of the filarial worms can only be confirmed on histopathology, hence a core biopsy or an excision biopsy is a must in all the cases. A presumptive diagnosis of filariasis can be made on sonography if the worms are alive and active, the typical presentation on USG is the filarial dance. Surgical excision of the lump followed by DEC therapy is the treatment of choice for filarial lump of the breast.

scholarly journals Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
J. Campbell ◽  
R. Kee ◽  
D. Bhattacharya ◽  
P. Flynn ◽  
M. McCarron ◽  
...  
Keyword(s):  
White Matter Lesions ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Computerised Tomography ◽  
Opening Pressure ◽  
Serum Angiotensin Converting Enzyme ◽  
History Of ◽  
Systemic Sarcoidosis ◽  
Granulomatous Disorder ◽  
Magnetic Resonance Imaging Mri

Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy. Serum angiotensin-converting enzyme (ACE) level was normal. Lumbar puncture revealed an elevated opening pressure (36 cmH2O) and inflammatory cerebrospinal fluid (CSF). Computerised tomography (CT) of chest, abdomen, and pelvis revealed widespread lymphadenopathy and biopsy of axillary lymph nodes revealed the presence of noncaseating granulomata in keeping with systemic sarcoidosis. The patient responded well to corticosteroids. This case highlights the importance of considering sarcoidosis to be a rare but potentially treatable cause of stroke in younger patients.

Sudden Onset of Diplopia and a Skeletal Muscle Antibody

2021 ◽  
pp. 160-162
Author(s):  
John R. Mills
Keyword(s):  
Computed Tomography ◽  
Myasthenia Gravis ◽  
Patent Foramen Ovale ◽  
Time Course ◽  
Vision Loss ◽  
Sudden Onset ◽  
Foramen Ovale ◽  
Clinical Disorder ◽  
History Of ◽  
The Right

A 62-year-old man with a history of migraine came to the emergency department with sudden onset of horizontal diplopia and, subsequently, bilateral ptosis. He noted feeling unsteady when walking. He reported that the diplopia worsened throughout the day. He had a history of hepatitis C infection. He had some vision loss in his left eye, which was thought to relate to a retinopathy. He disclosed that he had a history of cold feet and had notably high arches. He had a pacemaker because of syncope attributed to sick sinus syndrome. Computed tomography angiography of the head and neck were ruled negative for intracranial stenosis, occlusions, or aneurysms. Computed tomography of the head indicated a tiny lacunar infarct in the right caudate head. Magnetic resonance imaging of the brain identified a tiny, periaqueductal, enhancing abnormality in the right midbrain that was thought to be likely ischemic, but there was some concern for a demyelinating or inflammatory lesion. Cerebrospinal fluid evaluation indicated an increased protein concentration. Serologic evaluation for myasthenia gravis striational antibodies were positive at a titer of 1:240. Serum protein studies indicated the presence of polyclonal hypergammaglobulinemia. Myasthenia gravis was effectively ruled out. Given the hyperacute time course, the patient’s clinical disorder was most probably explained by an ischemic stroke that affected the oculomotor nuclei regions causing ptosis and ophthalmoparesis. On follow-up, the patient was discovered to have a patent foramen ovale. Whether the patent foramen ovale was a contributing factor to the stroke is uncertain. The recurrence rate in this setting is thought to be low relative to other causes of stroke. Ultimately it was decided to not close the patent foramen ovale and to maintain the patient on clopidogrel and adult low-dose aspirin. The onset of diplopia is typically sudden, but this occurs exclusively with vascular pathologic processes. Diplopia that appears intermittently with diurnal variation suggests the possibility of a neuromuscular junction disease such as myasthenia gravis.

scholarly journals PARATHYROMATOSIS: A RARE CASE OF RECURRENT HYPERPARATHYROIDISM LOCALIZED BY FOUR-DIMENSIONAL COMPUTED TOMOGRAPHY

2019 ◽  
Vol 5 (6) ◽  
pp. e384-e387 ◽  
Author(s):  
Abraham E. Wei ◽  
Matthew R. Garrett ◽  
Ankur Gupta
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Clinical Laboratory ◽  
Parathyroid Tissue ◽  
Severe Hypercalcemia ◽  
Positron Emission ◽  
Affected Tissue ◽  
History Of ◽  
The Right ◽  
Recurrent Hyperparathyroidism

Objective: To present a rare case of parathyromatosis. Methods: We present the clinical, laboratory, and imaging findings, along with a review of the literature. Results: A 33-year-old man with a history of right upper parathyroid adenoma removal 5 years prior due to hyperparathyroidism was admitted for severe hypercalcemia (15.6 mg/dL; normal, 8.5 to 10.5 mg/dL) with elevated plasma parathyroid hormone (PTH) (882 pg/mL; normal, 15 to 65 pg/mL). Ultrasound, computed tomography (CT), sestamibi, and positron emission tomography scans were unremarkable; however, a four-dimensional CT (4DCT) of the neck showed an area of increased signal enhancement and hypervascularity without discrete nodule in the posterior right thyroid region. The patient underwent parathyroid surgical exploration with right hemithyroidectomy and compartment neck dissection to remove the affected tissue. PTH levels dropped to 208 pg/mL postoperatively; calcium decreased but remained elevated at 12.7 mg/dL. Pathology revealed the presence of several small nodular foci of atypical hyperplastic parathyroid tissue in the right thyroid and soft tissue in the left central neck compartment consistent with parathyromatosis. Conclusion: This case report represents the first-time use of 4DCT to localize parathyromatosis. Parathyromatosis is a rare but problematic cause of recurrent hyperparathyroidism. Ultrasound and 4DCT may represent the best imaging modalities for identification and perioperative management to remove all affected tissue without reseeding.

Breast Reconstruction With Postmastectomy Radiation: Choices and Tradeoffs

2017 ◽  
Vol 35 (22) ◽  
pp. 2467-2470 ◽  
Author(s):  
Matthew M. Poppe ◽  
Jayant P. Agarwal
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Treatment Plan ◽  
Multidisciplinary Treatment ◽  
Muscle Flap ◽  
Axillary Node ◽  
Axillary Lymph Nodes ◽  
Autologous Reconstruction ◽  
Axillary Lymph

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 45-year-old premenopausal woman presented with multifocal cancer in the right breast, with lesions at 1:00 and 4:00, the largest measuring approximately 3 cm on exam, and multiple palpable right axillary lymph nodes. A core biopsy confirmed invasive ductal carcinoma, grade 2 of 3, that was estrogen receptor positive, progesterone receptor positive, and HER2 negative. Fine needle aspiration of a right axillary node confirmed metastatic carcinoma. A positron emission tomography (PET)/ computed tomography done before starting chemotherapy demonstrated an absence of metastatic disease with expected avidity in two separate breast masses and multiple conglomerated 1-2 cm level I and II axillary lymph nodes. She received neoadjuvant chemotherapy with doxorubicin plus cyclophosphamide, followed by paclitaxel, and had a complete clinical response with resolution of the breast and axillary masses on exam. A repeat PET/computed tomography demonstrated reduced size of the breast and axillary disease, and no significant residual PET avidity. Her breast surgeon recommended a right mastectomy with axillary node dissection. As part of her multidisciplinary treatment plan, she consulted with two plastic surgeons to discuss reconstruction options. Plastic Surgeon A advised placement of an implant at the time of mastectomy while Surgeon B contrasted the pros and cons of an autologous transverse rectus abdominis muscle flap reconstruction with an implant based reconstruction. Surgeon B believed that autologous reconstruction would yield the best long-term cosmetic outcome. Before making her surgery decision, the patient consulted with a radiation oncologist to discuss the effect radiation may have on her reconstruction outcome.

Primary Intradural Extraosseous Ewing Sarcoma of the Spine: Case Report and Literature Review

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. E995-E999 ◽  
Author(s):  
Isaac O Karikari ◽  
Ankit I Mehta ◽  
Shahid Nimjee ◽  
Tiffany R Hodges ◽  
June Tibaleka ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Ewing Sarcoma ◽  
Correct Diagnosis ◽  
Immunohistochemical Analysis ◽  
Leg Pain ◽  
Treatment Modalities ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Extraosseous Ewing Sarcoma

Abstract BACKGROUND AND IMPORTANCE: To report a rare case of spinal intradural extraosseous Ewing sarcoma in an adult and review current literature. Although Ewing sarcoma belongs to the family, the treatment modalities are different, and thus the correct diagnosis is very important despite its rare occurrence. CLINICAL PRESENTATION: A 56-year-old woman presented with nocturnal bilateral buttock and leg pain. Magnetic resonance imaging (MRI) showed an enhancing intradural extramedullary extraosseous tumor at L1. INTERVENTION: A T12-L2 laminectomy was performed to resect the tumor. Immunohistochemical analysis confirmed the diagnosis of Ewing sarcoma. A thorough diagnostic workup did not reveal any bony origin of the tumor. Primary intradural central nervous system Ewing sarcoma is infrequently encountered and shares imaging and histopathological features with central primitive neuroectodermal tumors. Establishment of the right diagnosis is crucial because it mandates a distinct workup and treatment modality different from that for central primitive neuroectodermal tumor. Although osseous Ewing sarcoma predominantly occurs in children and young adults, extraosseous central nervous system Ewing sarcoma is not uncommon in adults and should therefore be considered in the differential diagnosis of extraosseous small blue cell tumors in adult patients.

Incarcerated inguinal hernia? No, acute pancreatitis

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 770-772 ◽  
Author(s):  
Jose Ramia-Angel ◽  
Eloy Sancho ◽  
Rafael Lozoya ◽  
Andrej Gasz ◽  
Jose Santos
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Pancreatitis ◽  
Incarcerated Hernia ◽  
Intravenous Antibiotic ◽  
Incarcerated Inguinal Hernia ◽  
Testicular Pain ◽  
Inguinal Area ◽  
History Of ◽  
The Right

AbstractA 62-year-old man presented to the Emergency Department with a 2-day history of right testicular pain. The initial diagnosis was orchiepididymitis (later found to be mistaken), and intravenous antibiotic treatment was started. Twenty-four hours later, the patient had mild pain in the right inguinal area and right infra-abdominal area. We performed an inguinal ultrasound that showed an incarcerated mass of mixed echogenicity in the right inguinal area. Surgery was performed because we thought the patient had an inguinal incarcerated hernia. Two days after the surgical procedure, the patient began to have fever and erythema and pain in the back. Abdominal computed tomography (CT) showed an acute pancreatitis with a peripancreatic collection from the pancreas to right inguinal area. We have reviewed similar cases in the literature and note that, infrequently, an inguinal mass can be the first sign of mostly asymptomatic acute pancreatitis.

Extradural spinal angiolipoma associated with bone lysis in a dog

1998 ◽  
Vol 34 (5) ◽  
pp. 373-376 ◽  
Author(s):  
U Reif ◽  
CT Lowrie ◽  
SD Fitzgerald
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Bone Remodeling ◽  
Spinal Tumor ◽  
Histological Findings ◽  
History Of ◽  
Bone Lysis ◽  
Left And Right ◽  
The Difference ◽  
The Right

An extradural spinal tumor was diagnosed in a 12-year-old Labrador retriever that was presented with a one-week history of paraparesis. Myelography indicated a deviation of the spinal cord to the right side at the level of the second lumbar (L2) vertebra. The difference in length measuring the left and right sides of the L2 vertebra suggested a fracture of the vertebral body. Severe bone remodeling and an extradural mass were seen on computed tomography (CT). Clinical, radiographical, and histological findings are described and considered homologous to extradural angiolipomas described in the human literature.

Sign in / Sign up

Export Citation Format

Share Document