Differential Diagnosis of a Multilocular Radiolucency of the Mandible: A Case Report

Abstract Background Ovarian steroid cell tumors represent a rare category of sex cord-stromal tumors that constitute less than 0.1% of all ovarian tumors. These neoplasms are classified into three main subtypes according to the cell of origin: Leidyg cell tumors, stromal luteomas, and steroid cell tumors not otherwise specified (SCTs-NOS). The latter subtype is defined as a neoplasm of an uncertain lineage that mostly affects middle-aged women, whereas it’s rare in younger ages. Case presentation We report a case of a 21-year-old virgin female who presented to our hospital with complaints of mild abdominal pain, hirsutism, and oligomenorrhea for more than a year. Before her current admission, the patient had attended an external gynecologic clinic where she had been prescribed oral contraceptives to regulate her periods. Nevertheless, on presentation to our institution, physical examination revealed abdominal tenderness with a palpable pelvic mass and mild hirsutism in the thigh. Ultrasonography demonstrated a large left ovarian mass measuring 154 × 104 mm, and compressing the uterus. Therefore, a unilateral salpingo-oophorectomy was performed, and interestingly, pathologic examination of the large aforementioned mass alongside with immunohistochemical correlation revealed the diagnosis of a large ovarian steroid cell tumor-not otherwise specified with a unique combination of benign and malignant features. Conclusions Although ovarian steroid cell tumors represent a rare category, they must be considered in the differential diagnosis for mild virilization symptoms in young females due to the importance of early diagnosis and management. In this manuscript, we aimed to present the first case report from Syria that highlights the crucial role of detailed morphological examination for challenging cases despite the difficulties in differential diagnosis, and the absence of ancillary techniques. Furthermore, we managed to discuss a brief review of diagnostic methods, histological characteristics, and treatment recommendations.

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Cerebral fat embolization with paroxysmal sympathetic hyperactivity syndrome and septic shock at high altitude: a case report and literature review

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00232-6 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Min Li ◽

Gang Zhu ◽

Hao Guo ◽

Shun Nan Ge ◽

Guo Dong Gao ◽

...

Keyword(s):

Septic Shock ◽

Differential Diagnosis ◽

Case Report ◽

Literature Review ◽

High Altitude ◽

Fat Embolism ◽

Neurological Rehabilitation ◽

Case Presentation ◽

Sympathetic Hyperactivity ◽

Paroxysmal Sympathetic Hyperactivity

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.

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Mammary-Type Myofibroblastoma as Differential Diagnosis of Spermatic Cord Tumor Undergone Organ-Sparing Surgery: a Case Report

Indian Journal of Surgery ◽

10.1007/s12262-021-02863-6 ◽

2021 ◽

Author(s):

Éder Silveira Brazão ◽

Vitor Sales Pitombeira ◽

Warley Abreu Nunes ◽

Walter Henriques da Costa ◽

Stênio de Cássio Zequi

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Spermatic Cord ◽

Spermatic Cord Tumor ◽

Organ Sparing

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Large intraperitoneal lipoleiomyoma in a pre-menopausal woman: a case report

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02256-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Sara L. Schaefer ◽

Amy L. Strong ◽

Sheena Bahroloomi ◽

Jichang Han ◽

Michella K. Whisman ◽

...

Keyword(s):

Differential Diagnosis ◽

Smooth Muscle ◽

Case Report ◽

Smooth Muscle Actin ◽

Abdominal Mass ◽

Histopathological Analysis ◽

Menopausal Woman ◽

En Bloc ◽

Cross Sectional

Abstract Background Lipoleiomyoma is a rare, benign variant of the commonplace uterine leiomyoma. Unlike leiomyoma, these tumors are composed of smooth muscle cells admixed with mature adipose tissue. While rare, they are most frequently identified in the uterus, but even more infrequently have been described in extrauterine locations. Case presentation We describe a case report of a 45-year-old woman with a history of in vitro fertilization pregnancy presenting 6 years later with abdominal distention and weight loss found to have a 30-cm intra-abdominal lipoleiomyoma. While cross-sectional imaging can narrow the differential diagnosis, histopathological analysis with stains positive for smooth muscle actin, desmin, and estrogen receptor, but negative for HMB-45 confirms the diagnosis of lipoleiomyoma. The large encapsulated tumor was resected en bloc. The patients post-operative course was uneventful and her symptoms resolved. Conclusions Lipoleiomyoma should be considered on the differential diagnosis in a woman with a large intra-abdominal mass. While considered benign, resection should be considered if the mass is symptomatic, and the diagnosis is unclear or there is a concern for malignancy.

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Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02923-9 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Sebastian Ganz ◽

Axel Wehrend

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Luteinizing Hormone ◽

Clinical Signs ◽

Menopausal Symptoms ◽

Case Presentation ◽

Estrogen Exposure ◽

Exogenous Estrogen ◽

Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

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