scholarly journals Hybrid Lesion of Ameloblastoma and Adenomatoid Odontogenic Tumour (AOT): Report of Two Cases from a Tertiary Referral Hospital in Sub-Saharan Africa

2020 ◽  
pp. 31-38
Author(s):  
Olufunlola Motunrayo Adesina ◽  
Olawunmi Adedoyin Fatusi ◽  
Ramat Oyebunmi Braimah ◽  
Francis Adewale Adejobi
Keyword(s):  
Female Patient ◽  
Case Reports ◽  
Sub Saharan Africa ◽  
Odontogenic Tumour ◽  
Tertiary Referral Hospital ◽  
Surgical Specimen ◽  
Clinical Scenarios ◽  
Mandibular Molar ◽  
Bone Expansion ◽  
Adenomatoid Odontogenic Tumour

Introduction: Hybrid lesions are lesions showing the combined histopathological characteristics of two or more previously recognized odontogenic tumours and /cysts of different categories. Hybrid lesions do exist because of close interrelationship of several odontogenic lesions and also because odontogenic tumors and cysts can arise at any stage of odontogenesis. The objective of this study was to present 2 cases of hybrid odontogenic tumour that is composed of adenomatoid odontogenic tumour (AOT) and ameloblastoma. Case Reports: Case 1: A 33year old female patient with a bucco-lingual swelling in the left mandibular premolar-molar-ramus regions of 13years duration. The lesion measured about 15x5x3cm, it is non tender. Surgical specimen revealed hybrid lesion of granular cell type ameloblastoma and AOT. Case 2: An 18year old female patient with a painless right mandibular molar-ramus swelling of 10years duration. Mandibulectomy specimen measured about 11 cm x 8.5 cm x 5 cm and was found to be hybrid lesion of acanthomatous ameloblastoma and AOT. Conclusion: Both cases had a very long clinical duration and showed more buccal bone expansion with barely noticeable lingual bone expansion. With such clinical scenarios, a suspicion of hybrid tumour should be made.

scholarly journals Therapeutic Management of a Substantial Pelvic Aneurysmatic Bone Cyst Including the Off-Label Use of Denosumab in a 35-Year-Old Female Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
D. Ntalos ◽  
M. Priemel ◽  
C. Schlickewei ◽  
D. M. Thiesen ◽  
J. M. Rueger ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Female Patient ◽  
Therapeutic Agent ◽  
Surgical Intervention ◽  
Case Reports ◽  
Bone Cyst ◽  
Off Label Use ◽  
Aneurysmal Bone Cysts ◽  
Promising Therapeutic Agent

Aneurysmal bone cysts (ABC) are benign bone tumors, which are highly vascularized. The main course of treatment is curettage followed by bone grafting or cement insertion. Still recurrence remains a main problem for patients. Denosumab is a monoclonal antibody, which acts as an inhibitor of the RANK/RANKL pathway, diminishing bone turnover. Recent case reports have shown that Denosumab can be a promising therapeutic agent for people suffering from therapy-resistant ABC. We report the case of a 35-year-old female patient presenting with a pronounced ABC of the pelvis. Since the tumor was inoperable, Denosumab was administered, leading to a significant shrinkage of the lesion, which allowed surgical intervention. Upon recurrence, Denosumab was restarted putting the patient once more into remission. Follow-up was four years overall with a clinical and radiological stable disease for fifteen months after final discontinuation of the monoclonal antibody. Therefore, our case further underlines the potential of Denosumab in the treatment of ABC.

scholarly journals Multiple sclerosis in Kenya: Demographic and clinical characteristics of a registry cohort

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Imran Jamal ◽  
Jasmit Shah ◽  
Peter Mativo ◽  
Juzar Hooker ◽  
Mitchell Wallin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Sub Saharan Africa ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Sub Saharan ◽  
Neuro Imaging

Background Multiple Sclerosis (MS) is the leading cause of non-traumatic neurological disability in young adults. There is limited literature regarding the burden of MS in sub-Saharan Africa (SSA). Objective To describe the demographic and clinical characteristics of patients with MS (PwMS) presenting to a tertiary referral hospital in Nairobi. Methods We conducted a retrospective descriptive study for PwMS presenting to Aga Khan University Hospital, Nairobi from 2008–2018. Results 99 cases met the diagnostic criteria for MS with a male to female ratio of 1:4. Majority (68.7%) of PwMS were indigenous Africans with a mean age of onset of 30.7 years. Mean duration from symptom onset to first neuro-imaging was 5.04 years. Only 33% of patients had sensory symptoms at onset whereas 54.5% had vitamin D deficiency/insufficiency. Majority (79.5%) had relapsing remitting MS (RRMS) and 56.6% were initiated on disease modifying therapy (DMT). Only 21.2% of patients on DMT were non-compliant. Patients with RRMS were more likely to be initiated on DMT at our hospital (p < 0.001). Conclusion Clinical characteristics of these patients largely resemble those of other SSA cohorts and African American patients. There was a delay between symptom onset and neuroimaging. There were also issues with DMT compliance.

scholarly journals Schwannoma of the abdominal wall: updated literature review

2021 ◽  
Author(s):  
Tommaso Panici Tonucci ◽  
Andrea Sironi ◽  
Eleonora Pisa ◽  
Benedetta Di Venosa ◽  
Luigi Bonavina
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Abdominal Wall ◽  
Single Case ◽  
Case Reports ◽  
Rectus Abdominis ◽  
Malignant Neoplasms ◽  
Palpable Mass ◽  
Surgical Specimen ◽  
Benign Schwannoma

Summary Background Schwannoma is a benign tumor arising from Schwann cells of the peripheral nerves. It is often asymptomatic and can develop in the retroperitoneum, mediastinum, head and neck region, and upper and lower extremities. Schwannoma of the abdominal wall is extremely rare, but differential diagnosis with malignant neoplasms is important to reduce the risk of undertreatment. Methods A narrative review of abdominal wall schwannoma was performed using PubMed, EMBASE, and Web of Science database and the search terms “schwannoma”, “neurinoma”, “neurilemmoma”, “soft tissue tumors”, “neurogenic tumor”, “rectus abdominis mass”, “abdominal wall”. In addition, the hospital charts were reviewed to report the personal experience. Results Only 9 single case-reports of benign schwannoma of the abdominal wall were found in the English medical literature over the past decade. None of the patients received preoperative biopsy and all were resected with clear margins. In addition to the literature review, we report the case of a 58-year-old man referred for a palpable mass in the left upper abdominal quadrant. Ultrasonography and magnetic resonance imaging revealed a solid and well-encapsulated mass inside the left rectus abdominis muscle. A core biopsy of the lesion provided the diagnosis of cellular schwannoma and this was confirmed by histopathologic examination of the surgical specimen. Conclusions Benign schwannoma of the abdominal wall is extremely rare. Percutaneous core needle biopsy is important for the differential diagnosis with more common and biologically more aggressive malignancies, such as desmoid tumors and sarcomas, and may be relevant for planning the most appropriate management.

Successful treatment of arthritis induced by checkpoint inhibitors with tocilizumab: a case series

2017 ◽  
Vol 76 (12) ◽  
pp. 2061-2064 ◽  
Author(s):  
Sang Taek Kim ◽  
Jean Tayar ◽  
Van Anh Trinh ◽  
Maria Suarez-Almazor ◽  
Salvador Garcia ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Unmet Need ◽  
Case Series ◽  
Receptor Antibody ◽  
Improved Outcomes ◽  
Clinical Scenarios ◽  
Significant Clinical Improvement ◽  
Tnfα Inhibitor ◽  
Factor Α

BackgroundImmune checkpoint inhibitors (ICIs) have significantly improved outcomes for patients with numerous cancers. However, these therapies are associated with immune-related adverse events (irAEs), which are inflammatory side effects potentially affecting any organ. Cases of ICI-induced inflammatory arthritis have also been reported. In general, mild irAEs are treated with corticosteroids, while tumour necrosis factor-α (TNFα) inhibitors are reserved for refractory cases. However, prolonged use of TNFα inhibitor (TNFαi) can induce widespread, significant immunosuppression, which can negatively impact the antitumour efficacy of ICI therapy. Therefore, in clinical scenarios where patients develop severe immunotherapy-induced irAEs, an unmet need exists for alternative therapeutic strategies that are effective and without immune dampening effects.Case reportsThe anti-interleukin (IL)−6 receptor antibody, tocilizumab, is a biological agent Food and Drug Administration approved for the treatment of rheumatoid arthritis and juvenile idiopathic arthritis. Here, we report on three patients who developed severe polyarthritis while receiving ICI therapy and were treated with tocilizumab. All three patients demonstrated significant clinical improvement; one patient maintained a durable antitumour response derived from checkpoint inhibition.ConclusionsThese three cases suggest that anti-IL-6 receptor antibody may be an effective alternative to corticosteroids or TNFαi for the treatment of arthritis irAEs.

scholarly journals Latvian experience in conservative management of abnormally invasive placenta: two case reports

2020 ◽  
Vol 26 (3) ◽  
pp. 153-158
Author(s):  
Diana Bokučava ◽  
Sandra Vītiņa ◽  
Maira Jansone ◽  
Mara Tirāne ◽  
Zane Krastiņa ◽  
...  
Keyword(s):  
Conservative Management ◽  
Case Reports ◽  
Placental Tissue ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
Excessive Bleeding ◽  
Section Operation ◽  
Invasive Placenta ◽  
New Treatment

Background. Abnormally invasive placentation (AIP) is a clinical term that describes situation when placenta does not separate spontaneously after delivery and its manual removal causes excessive bleeding (1). Historically, the treatment of choice for this condition is hysterectomy. Lately, the new treatment option, conservative management of the AIP, has proven itself an effective alternative to hysterectomy in carefully selected patients (2). However, the use of conservative AIP management is limited in many countries, the reasoning being the lack of doctors’ experience in this procedure and concerns regarding a high postpartum infection rate. Case reports. We present the first two cases of conservative management of AIP in Latvia. Most of prenatally diagnosed AIP cases country-wide are referred to the Paul Stradinš University Hospital, which is a tertiary referral hospital. The annual rate of AIP in the hospital varies from five to ten cases. Two pregnant women were diagnosed with AIP prenatally, both of them refused hysterectomy and therefore went for the conservative management of AIP. During Caesarean section operation, placentas were left in situ after delivery of the baby. During the follow-up period of 12 and 14 weeks, both women developed infection complications, but complete placental tissue resolution was diagnosed in the end. Conclusion. These two cases demonstrate that conservative management of AIP can be safely applied in small countries/areas with small AIP rate and management experience.

scholarly journals The perioperative application of High Flow Nasal Cannula: a single center experience

2020 ◽  
Vol 12 (1) ◽  
pp. 1-5
Author(s):  
Ibtesam A. Hilmi ◽  
Philip C. Carullo ◽  
Dennis P. Phillips ◽  
Ezeldeen Abuelkasem
Keyword(s):  
Oxygen Therapy ◽  
Case Reports ◽  
High Flow ◽  
Nasal Cannula ◽  
Single Center ◽  
High Flow Nasal Cannula ◽  
Anesthesia Practice ◽  
Single Center Experience ◽  
Complex Patients ◽  
Clinical Scenarios

The physiologic benefits of high-flow nasal cannula (HFNC) therapy are well documented in the intensive care literature, yet only a handful of case reports describe its perioperative use. Our single center experience explored comprehensive applications of HFNC in the perioperative setting. Over a ten-month period, HFNC was used in the care of 85 medically complex patients either as an adjuvant or main oxygen therapy during induction of general anesthesia, maintenance of deep intraoperative sedation, and during early postoperative care. Here, we illustrate clinical scenarios in which HFNC therapy made patient care safer and describe a framework for integrating this technology into the anesthesia practice at our institution.

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