Rare Entity
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2021 ◽  
Vol 7 (4) ◽  
pp. 143-146
Maria Teresa Valadas ◽  
Ana Pedro Costa ◽  
Lucilia Bravo

A dissociative fugue occurs when an individual with dissociative amnesia wanders away from their familiar surroundings, maintaining self‑care and apparently normal behavior to observers, lasting from hours to months in a row. New identities can be assumed and even organized travel can occur. While dissociative amnesia by itself may have a prevalence of around 7.2%, dissociative fugue is a rare entity, with unknown prevalence, and there are few reports in the literature. In this article, we describe a case of dissociative fugue in a 34‑year old woman that lasted eight months. Dissociative amnesia with fugue remains an interesting topic for further research since it can present a diagnostic challenge, there are currently no evidence‑based pharmacological treatments and prognosis varies greatly between patients.

2022 ◽  
Vol 19 (4) ◽  
Ranjima Mahesh ◽  
Raghavendra Gobbur

2021 ◽  
Vol 7 (1) ◽  
Bin Zhang ◽  
Miao Bai ◽  
Runfa Tian ◽  
Shuyu Hao

Abstract Background Myxofibrosarcoma (MFS), especially radiation-Induced MFS (RIMFS) in the head and neck, is an extremely rare malignant fibroblastic tumor. The diagnosis and treatment of MFS remain great challenges. In the present study, we presented one case of RIMFS. Combined with previous literature, the clinical features, essentials of diagnosis, and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity. Case presentation We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after the first operation. The postoperative pathological diagnosis was high-grade MFS. The tumor relapsed 6 months later, and then, a planned extensive resection with negative surgical margins was carried out, followed by radiotherapy. No relapse occurred in a 12-month postoperative follow-up. Conclusions Planned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck, so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.

2021 ◽  
Vol 0 ◽  
pp. 1-3
Arun G. Ramaswamy ◽  
Neelanagowda Police Patil ◽  
Namrata Srinivasan

Paralabral cysts are an uncommon cause of shoulder pain in young adults. Their association with neurological symptoms is seldom reported in the literature. The cysts are believed to develop when there is a labral tear allowing synovial fluid entry into tissues causing one-way valve effect. This case report describes a case of anteroinferior paralabral cyst in a painful shoulder associated with axillary nerve palsy. MRI revealed an anteroinferior labral cyst. Electromyography revealed denervation of deltoid and teres minor muscles. Shoulder arthroscopy was performed with cyst decompression and labral repair. Shoulder function improved gradually and by the end of 1 year, power was back to pre-injury status. Paralabral cysts are a rare entity. When associated with nerve injury, prompt decompression is necessary to prevent irreversible nerve and muscle damage.

2021 ◽  
Vol 0 ◽  
pp. 1-4
Shwetank Gangwar ◽  
Amarjeet Singh ◽  
V. B. Bhasin

Synovial chondromatosis of the shoulder is a rare entity that is generally mono-articular and uncommon in diarthrodial joints. Treatment of synovial chondromatosis of the shoulder includes open arthrotomy retrieval of loose bodies and synovectomy. With advances in arthroscopy, the same could be achieved using arthroscopic techniques. This case report describes a case report of a 35-year-old male patient who presented with complaints of pain and restriction of movement for 6 months. The MRI of the patient was suggestive of multiple loose bodies in the shoulder joint, in the subdeltoid region, and subscapularis muscle with subacromial bursitis. Arthroscopically more than 100 loose bodies were retrieved with subacromial decompression. Shoulder synovial chondromatosis has been rarely reported in the literature. The malignant transformation although rare, but it is still a possibility. The recurrence rate varies from 3.2% to 22.3%. Open arthrotomy, synovectomy, and retrieval of loose bodies cause delayed recovery and more morbidity with high chances of subscapularis insufficiency due to the need of subscapularis tenotomy. Arthroscopic treatment although have limitations such as limited visualization, limited synovectomy, and difficult interventions around the axillary recess or biceps sheath, but provides with the advantage of lesser morbidity and early rehabilitation. Synovial chondromatosis can be successfully treated arthroscopically as it provides intra-articular and extra articular access with early rehabilitation, lesser morbidity, and early recovery.

2021 ◽  
Vol 2 (21) ◽  
Izumi Koyanagi ◽  
Yasuhiro Chiba ◽  
Hiroyuki Imamura ◽  
Toshiya Osanai

BACKGROUND Intradural radicular arteriovenous malformation (AVM) of the cauda equina is a rare entity of spinal AVMs. Because of the specific arterial supply of the conus medullaris and cauda equina, AVMs in this area sometimes present with confusing radiological features. OBSERVATIONS The authors reported a rare case of intradural radicular AVM arising from the lumbar posterior root. The patient presented with urinary symptoms with multiple flow void around the conus medullaris, as shown on magnetic resonance imaging. Digital subtraction angiography demonstrated arteriovenous shunt at the left side of the conus medullaris fed by the anterior spinal artery via anastomotic channel to the posterior spinal artery and rich perimedullary drainers. There was another arteriovenous shunt at the L3 level from the left L4 radicular artery. Preoperative diagnosis was perimedullary AVM with radicular arteriovenous fistula. Direct surgery with indocyanine green angiography revealed that the actual arteriovenous shunt was located at the left L4 posterior root. The AVM was successfully treated by coagulation of feeding branches. LESSONS Unilateral arteriovenous shunt fed by either posterior or anterior spinal artery at the conus medullaris may include AVM of the cauda equina despite abundant perimedullary venous drainage. Careful pre- and intraoperative diagnostic imaging is necessary for appropriate treatment.

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Neris Dincer ◽  
Melisa Bagci ◽  
Metin Figen ◽  
Adem Yilmaz ◽  
Ahmet Mesrur Halefoglu ◽  

Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare neoplasm arising from spindle cells and most commonly arising from pleura. Spinal SFT/HPC is a rare entity; hence, it is not on the top of the differential diagnosis list when a clinician faces a spinal lesion. In the review of the literature, there exist less than 50 case reports of intradural extramedullary SFT/HPC. Here, we present a 54-year-old female patient who underwent subtotal surgical excision of an intradural extramedullary spinal mass pathologically reported to be SFT/HPC and had symptomatic recurrence in the 3rd year of follow-up. Surgical intervention was unachievable and the patient was given 45 Gy to the surgical cavity followed by a 5.4 Gy boost to visible tumor with external radiotherapy. Patient reported significant relief of her symptoms. We aim to contribute to the formation of a treatment algorithm for this rare entity.

2021 ◽  
Vol 8 ◽  
Lihui Song ◽  
Sizheng Xiong ◽  
Jun Li

Aortopulmonary fistula with/without pulmonary artery dissection is an extremely rare and fatal complication of acute aortic dissection and is often discovered postmortem. We present a case with a simultaneous ascending aortic dissection and pulmonary artery dissection combined by aortopulmonary fistula after aortic valve surgery. However, the patient died of postoperative complications after surgery. Herein, the anatomical basis for this rare entity and its outcome is explored with an emphasis.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Rita Moukarzel ◽  
Dany Aouad ◽  
Mohammad Daher ◽  
Wendy Ghanem ◽  
Hady Ezzeddine ◽  

Supracondylar periprosthetic femoral fractures occurring above total knee replacements have been considered a rare entity. However, they continue to increase in frequency with the increasing number of arthroplasties and the improvement in morbidity and mortality in the concerned patient population. The management of periprosthetic distal femoral fractures is a challenging orthopedic problem. In this brief communication, a case of 49-year-old woman with rheumatoid arthritis who sustained a low distal comminuted periprosthetic femoral fracture is presented. Her fracture was eventually managed with an intramedullary fibular strut allograft and bilateral locking plate placement reaching satisfactory healing and restoration of alignment. The primary aim of this report is to provide insight into this novel technique as a successful alternative to other standard surgical options.

2021 ◽  
Vol 6 (4) ◽  
pp. 311-315
Rakhi V Jagdale ◽  
Mamta V Kripalani ◽  
Jaydeep N Pol ◽  
Sachin J Patil ◽  
Santosh S Kullolli

Cutaneous meningiomas (CM) are rare variants of meningiomas which are further classified into three subtypes. Type I CM (TICM) or Rudimentary meningocele (RM) is an uncommon developmental anomaly in which meningothelial elements are displaced into the skin and soft tissue. We present a case of 11 year boy with an upper back swelling since early childhood. His MRI spine showed a lesion at T4-T7 level with a fistulous tract connecting it to dural sac. Histopathology revealed clusters of oval to spindle cells arranged in whorls amidst collagen bundles and psammoma bodies. On immunohistochemistry these cells expressed EMA and Vimentin. A diagnosis of TICM was rendered based on these characteristic clinico-radiological & histopathological features. TICM pose a diagnostic challenge clinically and histopathologically and have an excellent prognosis. This is the 4 Indian case of RM and the 1 case of RM to be located in the spine in the Indian literature.

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