Small Intestinal Angiosarcoma Leading to Perforation and Acute Abdomen

2004 ◽  
Vol 128 (1) ◽  
pp. 95-98
Author(s):  
Katalin Kelemen ◽  
Qing Qing Yu ◽  
Lydia Howard
Keyword(s):  
Malignant Neoplasm ◽  
The Elderly ◽  
Severe Bleeding ◽  
Multiple Tumor ◽  
Distal Small Intestine ◽  
Computed Tomographic ◽  
Free Air ◽  
Undifferentiated Cells ◽  
History Of ◽  
Vascular Channels

Abstract A 76-year-old man presented to the emergency room with abdominal pain and fatigue. The patient had a history of gastrointestinal bleeding. An abdominal computed tomographic scan showed collections of free air in the abdomen with obstruction of the distal small intestine and multiple masses in the liver. Laparotomy revealed a widespread malignant neoplasm in the abdomen, with multiple tumor nodules in the ileal wall, mesentery, and liver. The ileal wall was perforated within the area of one of the tumors. Pathologic examination of the lesion showed a neoplasm composed of solid sheets of spindle and undifferentiated cells, forming interlacing delicate vascular channels with atypical endothelial cells. The tumor cells were positive for the endothelial marker CD31, whereas reactivity for a broad panel of epithelial and other endothelial markers was negative. This case demonstrates that although angiosarcomas of the gastrointestinal tract are rare, they should be considered in cases of intestinal perforation or severe bleeding, especially in the elderly. A broad panel of immunochemical markers might be necessary to establish the pathologic diagnosis.

Primary Pure Angiosarcoma of the Testis: A Case Report

2014 ◽  
Vol 1 ◽  
Author(s):  
Samay Jain ◽  
Richard Cantley ◽  
Justus Philip
Keyword(s):  
Germ Cell ◽  
Molecular Genetic ◽  
Malignant Neoplasm ◽  
Cell Precursor ◽  
Cell Component ◽  
Genetic Studies ◽  
Spindle Cell Neoplasm ◽  
Primary Angiosarcoma ◽  
History Of ◽  
Vascular Channels

Angiosarcoma is a rare and aggressive, malignant neoplasm of endothelial-cell origin.   A primary angiosarcoma originating in the testicle is extremely rare, with only five previous cases reported in the current literature. We report a case of primary, pure angiosarcoma of the testis in a 63-year-old patient with no history of previous chemotherapy or radiation therapy. By histology, the tumor was a high-grade spindle cell neoplasm, arranged in sheets and poorly-formed vascular channels. The tumor cells were positive for vascular markers (CD31, CD34) by immunohistochemical staining. No evidence of a germ cell component was seen by morphology, immunohistochemistry, or molecular genetic studies. This finding is unique in that it is one of only three reported cases of primary angiosarcomas of the testicle without a germ cell precursor or component.

scholarly journals A case of serious bleeding

2015 ◽  
Vol 5 (2S) ◽  
pp. 15-19
Author(s):  
Irene Ricca ◽  
Marisa Coggiola ◽  
Silvia Destefanis ◽  
Claudio Pascale
Keyword(s):  
Mortality Rate ◽  
Autoimmune Diseases ◽  
Factor Viii ◽  
Coagulation Factor ◽  
The Elderly ◽  
Severe Anaemia ◽  
Severe Bleeding ◽  
Haemophilia A ◽  
Acquired Haemophilia ◽  
History Of

Acquired haemophilia A (AHA) is a rare disorder with a high mortality rate. It occurs due to autoantibodies against coagulation factor VIII (FVIII) which neutralise its procoagulant function resulting in severe bleeding. This disease may be associated with autoimmune diseases, malignancies, infections or medications and occurs most commonly in the elderly. Diagnosis is based on the isolated prolongation of aPTT which does not normalise after the addition of normal plasma along with reduced FVIII levels. Treatment involves eradication of antibodies and maintaining effective haemostasis during bleeding. We report a case of a 76-year-old patient with a history of haemorrhage with severe anaemia. The article describes difficulties and complexities of clinical and therapeutic management of the patient.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Steven Emil Gerges ◽  
Mahmoud Hemeda El Rakawy ◽  
Naglaa Mohammed El Khayat ◽  
Yousry Abo Elnaga Abdelhamid ◽  
Ahmed Mohammed Hazzou ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Elderly Population ◽  
Laboratory Data ◽  
The Elderly ◽  
Medical Comorbidities ◽  
Mri Brain ◽  
Group Data ◽  
History Of ◽  
Eeg Changes ◽  
International League

Abstract Background Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before. Objectives The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population. Materials and methods A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data. Results The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046). Conclusion We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.

Salicylate toxicity from chronic bismuth subsalicylate use

2020 ◽  
Vol 13 (11) ◽  
pp. e236929
Author(s):  
Sheliza Halani ◽  
Peter E Wu
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Hearing Impairment ◽  
Reference Range ◽  
The Elderly ◽  
Intravenous Fluids ◽  
Over The Counter ◽  
Bismuth Subsalicylate ◽  
Salicylate Concentration ◽  
History Of

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

Computed Tomography in the Elderly: 1. the Normal Population

1980 ◽  
Vol 136 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy ◽  
John M. Dawson
Keyword(s):  
Psychiatric Patients ◽  
Normal Population ◽  
The Elderly ◽  
Reciprocal Relationship ◽  
Cortical Atrophy ◽  
Global Rating ◽  
Computed Tomographic ◽  
Methodological Problems ◽  
Ct Data ◽  
Healthy Community

SummaryComputed tomographic (CT) and brief psychometric findings on 50 psychiatrically and neurologically healthy community residents over 60 years old are presented. The need for normative CT data is emphasized, and the methodological problems in obtaining them are discussed. Measures of ventricular size were generally found to be greater than those reported by other workers, and variation with age was also found to be less marked than hitherto reported. A reciprocal relationship was found between a global rating of cortical atrophy and a test of memory and orientation. This communication forms the basis for comparison with groups of psychiatric patients to be presented in subsequent articles.

scholarly journals Hearing loss in the elderly: History of occupational noise exposure

2014 ◽  
Vol 17 (02) ◽  
pp. 179-183 ◽  
Author(s):  
Caroline Meneses-Barriviera ◽  
Luciana Marchiori ◽  
Juliana Melo
Keyword(s):  
Hearing Loss ◽  
Noise Exposure ◽  
The Elderly ◽  
Occupational Noise ◽  
Occupational Noise Exposure ◽  
History Of

An Environmental Justice Analysis of British Air Quality

2003 ◽  
Vol 35 (5) ◽  
pp. 909-929 ◽  
Author(s):  
Gordon Mitchell ◽  
Danny Dorling
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Environmental Justice ◽  
The Elderly ◽  
Local Communities ◽  
Car Ownership ◽  
National Study ◽  
Environmental Injustice ◽  
The Usa ◽  
History Of

This paper presents the results of the first national study of air quality in Britain to consider the implications of its distribution across over ten thousand local communities in terms of potential environmental injustice. We consider the recent history of the environmental justice debate in Britain, Europe, and the USA and, in the light of this, estimate how one aspect of air pollution, nitrogen dioxide (NO2) levels, affects different population groups differentially across Britain. We also estimate the extent to which people living in each community in Britain contribute towards this pollution, with the aid of information on the characteristics of the vehicles they own. We find that, although community NO x emission and ambient NO2 concentration are strongly related, the communities that have access to fewest cars tend to suffer from the highest levels of air pollution, whereas those in which car ownership is greatest enjoy the cleanest air. Pollution is most concentrated in areas where young children and their parents are more likely to live and least concentrated in areas to which the elderly tend to migrate. Those communities that are most polluted and which also emit the least pollution tend to be amongst the poorest in Britain. There is therefore evidence of environmental injustice in the distribution and production of poor air quality in Britain. However, the spatial distribution of those who produce and receive most of that pollution have to be considered simultaneously to see this injustice clearly.

Malignant Melanoma Presenting as an Intrathymic Tumor

2000 ◽  
Vol 124 (1) ◽  
pp. 130-134
Author(s):  
P. M. Alli ◽  
B. J. Crain ◽  
R. Heitmiller ◽  
P. Argani
Keyword(s):  
Malignant Melanoma ◽  
Previous History ◽  
Clinical History ◽  
Computed Tomographic ◽  
Eosinophilic Cytoplasm ◽  
S 100 ◽  
History Of ◽  
Solitary Metastases ◽  
Physical Findings ◽  
Pleomorphic Cells

Abstract The identification of malignant melanoma in a visceral organ of nonepidermal origin is not an uncommon occurrence. Frequently, these cases are solitary metastases that present years after a thin epidermal melanoma has been diagnosed (and sometimes forgotten). However, primary visceral melanomas have been reported that have not been preceded by an epidermal lesion. We describe herein a unique case of melanoma presenting as a primary intrathymic tumor. The patient had no previous history of epidermal melanoma, and extensive workup did not reveal evidence for an alternative primary site. The tumor exhibited histologic features characteristic of melanoma, including an abundance of large pleomorphic cells with eosinophilic cytoplasm, prominent nucleoli, and occasional intranuclear inclusions. Tumor cells stained for HMB-45 and S-100 protein and ultrastructural analysis revealed stage II and stage III melanosomes. The patient remained free of disease until intrathoracic recurrence was detected on a computed tomographic scan 14 months later. The lack of clinical history and physical findings of melanoma at presentation, the intrathymic location of the tumor, and the pattern of recurrence suggest that this case likely represents a primary thymic melanoma, a previously unreported entity.

Microcystic Transitional Cell Carcinoma

2002 ◽  
Vol 126 (7) ◽  
pp. 859-861 ◽  
Author(s):  
Xavier Leroy ◽  
Emmanuelle Leteurtre ◽  
Alexandre De La Taille ◽  
David Augusto ◽  
Jacques Biserte ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Macroscopic Hematuria ◽  
Computed Tomographic ◽  
First Case ◽  
History Of ◽  
Invasive Transitional Cell Carcinoma

Abstract Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.

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