scholarly journals Primary Hepatic Neuroendocrine Tumor and its Metastasis to Breast; Case Report of an Unusual Malignancy

2021 ◽  
Vol 6 (4) ◽  
pp. 14-25
Author(s):  
Amjad Zafar ◽  
Rabia Iqbal ◽  
Amina Jafar ◽  
Taimoor Bajwa ◽  
Sobia Yaqub ◽  
...  
Keyword(s):  
Case Report ◽  
Mass Effect ◽  
Typical Feature ◽  
Clinical Suspicion ◽  
Unusual Site ◽  
Rare Tumors ◽  
High Clinical Suspicion ◽  
Clinical Presentations ◽  
Metastasis To Breast ◽  
Primary Hepatic Neuroendocrine Tumor

Introduction: Neuroendocrine tumors (NETs) are rare tumors with varied clinical presentations. Entero-pancreatic and respiratory systems are usually involved but it can also affect unusual sites like the liver. Purpose: This paper presents a case of a 45 years female who developed progressive and disabling symptoms of mass effect and carcinoid but remained undiagnosed for many years due to extremely low suspicion of such a tumor in liver. Methods: Diagnosis was made after extensive radiological, histopathological, and biochemical investigations. By that time, disease had spread to her breast which is also not a typical feature of NETs. Findings: Diagnosis of rare tumors at an unusual site is challenging and requires high clinical suspicion and appropriate workup.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

scholarly journals Giant dermoid cyst mimicking posterior fossa tumors in a child: A Case Report and Review of the Literature

2020 ◽  
Vol 2 (2(May-August)) ◽  
pp. e452020
Author(s):  
Leopoldo Mandic Ferreira Furtado ◽  
José Aloysio da Costa Val Filho ◽  
Bruno Lacerda Sandes ◽  
Plínio Duarte Mendes ◽  
Patrícia Salomé Gouvea Braga
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Clinical Suspicion ◽  
Review Of The Literature ◽  
Benign Lesions ◽  
Posterior Fossa Tumors ◽  
Case Presentation ◽  
High Clinical Suspicion ◽  
Neuroimaging Data ◽  
Epidemiological Characteristics

Introduction: Intracranial dermoid cysts are rare, congenital and, benign lesions. The etiology of these lesions is related to an embryonic defect during neurulation. Case presentation: The present study describes a case of a 3-year-old girl with a giant cerebellar dermoid cyst, which initially manifested as hydrocephalus. Discussion: We discuss its epidemiological characteristics as well as diagnostic and therapeutic management. The combination of high clinical suspicion, anamnesis, thorough physical examination, and adequate interpretation of neuroimaging data is crucial for the early diagnosis and timely therapeutic intervention for such cysts. Conclusion: Surgical approach involving complete lesion resection considerably improves prognosis.

Diagnostic challenges in tuberculous otitis media

2010 ◽  
Vol 124 (8) ◽  
pp. 913-915 ◽  
Author(s):  
I P Tang ◽  
N Prepageran ◽  
C A Ong ◽  
P Puraviappan
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Antibiotic Therapy ◽  
Otitis Media ◽  
Surgical Intervention ◽  
Clinical Suspicion ◽  
Middle Ear Infection ◽  
Clinical Presentations ◽  
Tuberculous Otitis Media ◽  
Systemic Antibiotics

AbstractObjectives:To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.Case report:We report four cases of tuberculous otitis media with different clinical presentations, encountered between 1998 and 2002. None of the cases showed improvement with local or systemic antibiotics. The diagnosis, complications and management of these cases are discussed.Conclusions:A high index of clinical suspicion of tuberculous otitis media is required in patients who do not respond to standard antibiotic therapy for (nontuberculous) chronic middle-ear infection. Early diagnosis and treatment of tuberculous otitis media is important to avoid irreversible complications, surgical intervention and propagation of the disease.

scholarly journals Septic Shock due to Capnocytophaga: A Case Report

2021 ◽  
pp. 18-22
Author(s):  
Guillermo Jiménez-Álvarez ◽  
Sonia López-Cuenca ◽  
Belén Quesada-Bellver
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Close Contact ◽  
Blood Cultures ◽  
Clinical Suspicion ◽  
Common Cause ◽  
Gram Negative ◽  
High Clinical Suspicion ◽  
Risk Patients ◽  
First Time

The genus Capnocytophaga spp., recorded for the first time in 1979, comprises gram-negative bacilli, that colonize the oral mucosa of dogs and, to a lesser extent, cats, so that human transmission can be due to biting, scratching or close contact. Though it is not a common cause of infection in humans, it is a potentially serious one, which can occasionally go unnoticed causing sepsis, bacteremia, meningitis and endocarditis. A high clinical suspicion is essential for its diagnosis, especially in high-risk patients, such as alcoholics or splenectomized patients, as time to positivity of blood cultures may take as long as 6 days. Antibiotic treatment should last several weeks.

scholarly journals Cerebral phaeohyphomycosis due to Cladophialophora bantiana in an immunocompetent individual: A case report and brief review of literature

2020 ◽  
Author(s):  
Prachala G. Rathod ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Poonam S. Loomba ◽  
Abha Sharma ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Abscess ◽  
Fungal Infections ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Clinical Suspicion ◽  
Laboratory Evaluation ◽  
Cns Infection ◽  
Dematiaceous Fungi ◽  
High Clinical Suspicion

Background and Purpose: Fungal infections of the central nervous system (CNS) are life-threatening conditions that are frequently misdiagnosed with bacterial and viral CNS infections. Cerebral phaeohyphomycosis is a cerebral infection caused by dematiaceous fungi, especially Cladophialophora bantiana. Very few cases of fungal CNS infection have been reported across the world. High clinical suspicion should be cast for the patients with brain abscess that do not respond to conventional antibiotic therapy. Case report: We report a case of a 21-year-old male presenting with headache, seizures and weakness in the limbs. Radiological examination revealed multiple brain abscesses. After surgical excision and laboratory evaluation, it was found to be caused by C. bantiana. The patient’s outcome was good with surgical excision and voriconazole therapy. Conclusion: Brain abscess caused by C. bantiana is on rise, especially in immunocompromised groups. Thus, high clinical suspicion, accurate diagnosis and management are the fundamentals for good prognosis.

scholarly journals Uncommon Clinical Presentations of Sporotrichosis: A Two-Case Report

Pathogens ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1249
Author(s):  
Erick Martínez-Herrera ◽  
Roberto Arenas ◽  
Rigoberto Hernández-Castro ◽  
María Guadalupe Frías-De-León ◽  
Carmen Rodríguez-Cerdeira
Keyword(s):  
Case Report ◽  
Potassium Iodide ◽  
Sporothrix Schenckii ◽  
Sensu Stricto ◽  
Clinical Suspicion ◽  
Differential Diagnoses ◽  
Clinical Form ◽  
Gene Encoding ◽  
Clinical Forms ◽  
Clinical Presentations

Sporotrichosis is a subcutaneous endemic mycosis caused by species of the Sporothrix schenckii complex. The most common clinical form of the disease is lymphocutaneous, while the fixed cutaneous and disseminated cutaneous forms are rare. Moreover, it is more prevalent in immunocompetent individuals. In this study, we present two cases of sporotrichosis with uncommon clinical forms: fixed cutaneous (Case 1) and disseminated cutaneous (Case 2). Both cases were diagnosed in immunocompetent males from endemic regions in Mexico, who had at least 1 year of evolution without improvement in response to prior nonspecific treatments. The diagnosis of sporotrichosis caused by S. schenckii sensu stricto was established through the isolation of the pathogen and its identification through the amplification of a 331 bp fragment of the gene encoding calmodulin. In both cases, improvement was observed after treatment with potassium iodide. Cases 1 and 2 illustrate the rarity of these clinical forms in individuals residing in endemic areas; hence, it is important to ensure a high index of clinical suspicion for the diagnosis of mycosis, as the differential diagnoses vary widely.

scholarly journals Choriocarcinoma (stage IV) despite two normal dilation and curettages: A case report

2021 ◽  
Vol 12 (5) ◽  
pp. 312-314
Author(s):  
Bijan Morshedi ◽  
Laura Haworth ◽  
Traci Ito
Keyword(s):  
Case Report ◽  
Pregnancy Loss ◽  
Care Center ◽  
Stage Iv ◽  
Clinical Suspicion ◽  
Molar Pregnancy ◽  
Early Pregnancy Loss ◽  
High Clinical Suspicion ◽  
Clear Explanation ◽  
Ectopic Pregnancies

Choriocarcinoma is a highly metastatic subtype of gestational trophoblastic neoplasia (GTN) following pregnancy. It can arise from any type of pregnancy (50% occur after term pregnancies, 25% after molar pregnancies, and 25% after early pregnancy loss and ectopic pregnancies) (Soper, 2006). This case report describes an interesting diagnostic conundrum with normal histology findings on two separate endometrial dilation and curettages (D&C) and a unilateral oophorectomy in the context of high clinical suspicion for molar pregnancy that progressed to stage IV choriocarcinoma with brain and lung metastasis. The patient presented to our hospital nearly aphasic but would only say “molar pregnancy”. Due to her brain metastasis and worsening intraparenchymal hematoma, she underwent craniotomy confirming the diagnosis. After stabilization, she was transferred to a quaternary care center to complete chemotherapy with etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine and had a good response. At this time, there is no clear explanation for normal histology on two separate D&Cs and a unilateral oophorectomy in the context of a classic case of choriocarcinoma with progression from a molar pregnancy. It reminds us as providers that medicine remains an imperfect science and requires astute clinical judgement to properly treat patients when diagnostic data such as pathology findings and lab values appear to be incongruent with the larger clinical picture.

scholarly journals Peripheral Facial Palsy in the Setting of Melkersson-Rosenthal Syndrome

2001 ◽  
Vol 20 (2) ◽  
pp. 233-235
Author(s):  
Sabrina Pimentel ◽  
Amélia Mendes ◽  
Maria José Rosas
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Clinical Suspicion ◽  
Peripheral Facial Palsy ◽  
High Clinical Suspicion ◽  
Clinical Triad ◽  
Suspicion Index ◽  
Fissured Tongue

Melkersson-Rosenthal syndrome is characterized by recurrent periph­eral facial palsy, recurrent or persistent orofacial edema and a fissured tongue. However, this clinical triad occurs only in a minority of cases; mono or oligosymptomatic forms are much more common. The au­thors describe a case report of a 39-year-old woman with Melkersson- Rosenthal syndrome, discuss the evolution of the disease and treat­ment, highlighting the need of a high clinical suspicion index and a regular follow-up to reduce progression of deficits

scholarly journals Acute respiratory failure in an infant and thiamine deficiency in West Africa: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
L Hiffler ◽  
K Escajadillo ◽  
M Rocaspana ◽  
S Janet
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Thiamine Deficiency ◽  
Severe Pneumonia ◽  
West African ◽  
Clinical Suspicion ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
Diagnostic Capacity ◽  
Low Threshold

Abstract In paediatrics, the overall clinical picture of thiamine deficiency (TD) is not easy to recognize, because it mimics or can be confused with other diseases even in cases of classic beriberi. Unsurprisingly, the likelihood of misdiagnosis of TD is even greater where beriberi has not been described. Critically ill patients have increased thiamine body consumption and dextrose-based IV fluid increases thiamine cellular demand even further. Consequently, severe acute conditions may result in TD, or trigger TD signs in patients with borderline thiamine status, with life-threatening consequences. Here, we describe the case of a young patient admitted to a West African hospital where TD is not well documented and diagnosed with severe pneumonia who responded dramatically to thiamine injection. The lack of rapid diagnostic capacity and the severe outcome of TD justify the use of a therapeutic thiamine challenge in cases with high clinical suspicion. Increased awareness about TD and low threshold for thiamine use should guide clinicians in their practice.

Migrating fish bone presenting as a neck fistula

2021 ◽  
Vol 14 (7) ◽  
pp. e243622
Author(s):  
Sara Fernandes Custódio ◽  
Pedro Branco ◽  
Pedro Machado Sousa ◽  
Pedro Alberto Escada
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Fish Bone ◽  
Clinical Suspicion ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Rare Finding ◽  
High Clinical Suspicion ◽  
Life Threatening

The case report describes an extremely rare finding of fish bone migration from the aerodigestive tract causing a neck fistula 2 years after its ingestion. Detailed case study and surgical treatment is presented. This case highlights the need for further assessment in presence of a high clinical suspicion of foreign body ingestion with a normal physical examination of the upper aerodigestive tract, to avoid serious and potential life-threatening complications later on.

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