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American Journal of Case Reports

Bindu Ganapathineedi, Alaap Mehta, Susmitha Dande, Anjali Shinde, Gary Barsky, Nadew Sebro
BACKGROUND The hallmark of bullous pemphigoid (BP) is widespread tense blisters arising on normal or erythematous skin, often with marked pruritus, the diagnosis of which is confirmed by direct immunofluorescence (DIF). BP is an autoimmune process that can be induced, though rarely, by medications. Drug-induced BP often has atypical clinical presentation, which requires a good understanding of other dermatological conditions with similar presentations, in particular, bullous subtype of erythema multiforme. End organ involvement warrants differentiating it from one of the severe cutaneous adverse reaction (SCAR) syndromes...
February 18, 2019: American Journal of Case Reports
Suheil Albert Atallah-Yunes, Jackson Clark, Shazia Samanani, Myat Soe
BACKGROUND Pituitary gland metastasis is rarely the initial presentation of metastatic cancer. Most cases of pituitary gland metastasis are asymptomatic with diabetes insipidus being the most common symptomatic presentation. It can rarely present with symptoms of hormone underproduction such as secondary adrenal insufficiency. Although pituitary gland metastasis is rare, it is underestimated, as it is commonly misdiagnosed with pituitary gland adenoma due to the lack of clear radiological criteria differentiating between both...
February 17, 2019: American Journal of Case Reports
Michael Mohseni, Theodore Szymanski
BACKGROUND Auricular hematomas are well-known among wrestlers and other contact sports participants, but spontaneous auricular hematomas are rare. The differential diagnosis for acute spontaneous auricular swelling is limited. In addition to infectious causes, antecedent trauma, and bleeding complications, angioedema should also be considered. Although rare, acute non-traumatic auricular hematomas need urgent surgical intervention if they are large. CASE REPORT A 37-year-old male presented to the Emergency Department (ED) with the complaint of acute pain and swelling to his left ear 30 minutes prior to arrival...
February 16, 2019: American Journal of Case Reports
Zhen-Yu Liao, Shen-Chang Lin
BACKGROUND Despite improvements in percutaneous coronary intervention (PCI) devices and operator expertise, coronary chronic total occlusion (CTO) poses a management dilemma for interventional cardiologists. Occasionally, in CTO lesions and in bifurcation lesions with severe curvature and stenosis, wires cannot be introduced into the main artery, although wiring into the side branch is possible. We herein report a case of stumpless ostial left anterior descending artery (LAD) CTO that was successfully treated with a novel strategy...
February 15, 2019: American Journal of Case Reports
Se Hyun Paek, Kyoung Eun Lee, Han Su Kim, Joohyun Woo, Woosung Lim
BACKGROUND Sarcomas can develop de novo or secondary to radiotherapy after or during breast cancer treatment. Diagnosis can be challenging, as such, a sarcoma is often missed on routine follow-up imaging and often presents with dermatologic findings. CASE REPORT Here, we present a case of a 45-year-old female who developed spindle cell sarcoma on her neck, which was mimicking supraclavicular lymph node metastasis of breast cancer. CONCLUSIONS Based on our report, we recommend a tissue biopsy with an immunohistochemistry profile when a mass suspicious for metastasis is found in patients with breast cancer...
February 14, 2019: American Journal of Case Reports
Haneen Thabit Salah, Hussa Fahad Al-Hussaini, Abdullah Mohammed Alqaraawi, Khulud Muhammed Alanazi
BACKGROUND Eosinophilic gastroenteritis is a rare disease, characterized by infiltrates of eosinophils in the intestinal mucosa, muscularis propria, and serosa. Eosinophilic gastroenteritis is due to Type 1 hypersensitivity and can be associated with other atopic diseases. The clinical course of eosinophilic gastroenteritis varies depending on the location, extent, and depth of eosinophilic infiltration of the gastrointestinal tract, which can make the diagnosis challenging. A case of eosinophilic gastroenteritis associated with eosinophilic ascites is presented that emphasizes the importance of full-thickness intestinal biopsy, which includes the muscularis propria, to allow the definitive diagnosis to be made...
February 13, 2019: American Journal of Case Reports
Francesco Ciodaro, Francesco Freni, Valentina Katia Mannella, Francesco Gazia, Annunziata Maceri, Rocco Bruno, Bruno Galletti, Francesco Galletti
BACKGROUND The purpose of this study is to demonstrate the advantages of 3D volume rendering in postoperative control of implants placement compared to high-resolution computed tomography (HRCT). CASE REPORT We describe 3 patients who underwent HRCT study with and without 3D volume rendering after surgery for cochlear implantation. In 2 patients, the traditional HRCT showed a suspected malposition of the array, excluded only by the rendering reconstruction. In the other patient, thanks to the 3D rendering, we were able to identify the complete migration of the array out of the cochlea and the tip of the electrode near the opening of internal auditory canal, while the traditional images showed only that the array was not rolled up inside the cochlea...
February 12, 2019: American Journal of Case Reports
Misbahuddin Khaja, Umair Ashraf, Shehriyar Mehershahi, Puvanalingam Ayyadurai, Sandeep Malik
BACKGROUND Eccrine porocarcinoma, or malignant eccrine poroma, is a rare primary skin tumor that develops in the sixth and seventh decades of life, and can present as a painless and solitary nodule. Histopathology is required to confirm the diagnosis. A rare case is presented of metastatic eccrine porocarcinoma, occurring four years after surgical excision of the primary scalp tumor, and includes a review of the literature. CASE REPORT A 67-year-old man initially presented with a scalp lesion that was non-painful, exophytic, and pigmented...
February 11, 2019: American Journal of Case Reports
Bruno Galletti, Francesco Gazia, Francesco Freni, Rita Angela Nicita, Rocco Bruno, Francesco Galletti
BACKGROUND The Say-Barber-Biesecker-Young-Simpson (SBBYS) variant of Ohdo syndrome is characterized by congenital hypothyroidism, facial dysmorphism, postaxial polydactyly, and mental retardation. The SBBYS variant of Ohdo syndrome is extremely rare with only 19 cases previously reported in the literature. A case is presented of chronic otitis media associated with cholesteatoma in a six-year-old boy with the SBBYS variant of Ohdo syndrome. CASE REPORT A 6-year-old boy presented with perforation of the tympanic membrane and a cholesteatoma in the mesotympanic-attic region associated with chronic otitis media...
February 10, 2019: American Journal of Case Reports
Mohammed Shabrawishi, Sultan A Qanash
BACKGROUND Bronchiolitis obliterans is the term used to describe a clinical syndrome of irreversible airflow obstruction. Among the etiologies linked to this entity is the rarely reported association with Stevens-Johnson syndrome, which has had a poor outcome in most of the previously published cases. The optimum management of bronchiolitis obliterans as a complication of Stevens-Johnson syndrome is not well defined. CASE REPORT A 41-year-old woman developed significant shortness of breath 3 months after recovering from Stevens-Johnson syndrome precipitated by a second-generation cephalosporin...
February 9, 2019: American Journal of Case Reports
Faisal Abdulrahman Althobaiti, Khulod Khaled Alsaadi, Awwadh Abdulrahman Althobaiti
BACKGROUND Uterine leiomyoma, or uterine fibroid, is the most common gynecologic neoplasm and its management usually results in a good clinical outcome. This report is of a rare case of hemoperitoneum associated with spontaneous hemorrhage from a benign uterine leiomyoma. CASE REPORT A 27-year-old single woman presented with generalized acute abdominal pain and vomiting. Clinical examination showed a distended abdomen and unstable vital signs. Following active resuscitation, ultrasound and computed tomography (CT) imaging showed an intraperitoneal fluid collection and heterogenous uterine mass...
February 8, 2019: American Journal of Case Reports
Abdelhamid Ben Selma, Thomas Genese
BACKGROUND A clinical condition that is often misdiagnosed, rectus sheath hematoma (RSH) is usually seen in the context of blunt abdominal trauma and/or anticoagulation therapy, rarely occurring spontaneously. We present a case of spontaneous rectus sheath hematoma (SRSH) without obvious risk factors and review the literature regarding diagnosis modalities and management. The aim of this case presentation is to highlight this rare clinical condition and emphasize the role of the physical exam in determining the appropriate treatment approach...
February 7, 2019: American Journal of Case Reports
Muhammad Shabbir Rawala, S Tahira Shah Naqvi, Muhammad Yasin, Syed Bilal Rizvi
BACKGROUND Spontaneous coronary artery dissection (SCAD) is primarily found in females. SCAD can have many precipitating factors such as exercise, trauma, pregnancy, drugs, and connective tissue disease. Prognosis is poor for left main stem, left anterior descending (LAD) artery, and multivessel involvement, especially for females. CASE REPORT We present a case of young African American male with sickle cell disease who presented with chest pain associated with shortness of breath. He was found to have non-ST elevation myocardial infarction (NSTEMI)...
February 6, 2019: American Journal of Case Reports
Lena Hinrichs, Michael Horacek, Ulrich Neudorf, Thomas Schlosser, Tienush Rassaf, Matthias Totzeck
BACKGROUND The diagnostic work-up and treatment of pulmonary hypertension can be complex. Pulmonary arterial hypertension (PAH), pulmonary hypertension second to lung or heart diseases and thromboembolic pulmonary hypertension, and other rare causes of pulmonary hypertension such as congenital heart diseases must be considered in the differential diagnostic work-up. CASE REPORT We report on a patient who has been treated for PAH over many years. At the age of 65, progressive symptoms required a complete re-evaluation...
February 5, 2019: American Journal of Case Reports
Jevon Samaroo-Campbell, Arsalan Hashmi, Rajat Thawani, Manfred Moskovits, Dmitriy Zadushlivy, Stephan L Kamholz
BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided endocarditis is in itself rare, with some studies reporting an incidence of 5-10%. The majority of these cases involve the tricuspid valve, and isolated pulmonary valve endocarditis (PVE) is an extremely rare entity affecting less than 2% of patients with infective endocarditis. Identification and early management are crucial to prevent long-term complications and reduce mortality...
February 4, 2019: American Journal of Case Reports
Yong Sub Na, Sang-Gon Park
BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF)...
February 3, 2019: American Journal of Case Reports
Keisuke Okamura, Tetsu Okuda, Yusuke Fukuda, Yosuke Takamiya, Kazuyuki Shirai, Shigerou Miyajima, Tatsu Ishii, Hidenori Urata
BACKGROUND Before partial adrenalectomy for primary aldosteronism due to a primary adrenal adenoma, the aldosterone-producing tumor can be localized by segmental adrenal vein sampling (S-AVS). Cardiologists, who regularly perform percutaneous coronary intervention (PCI), or coronary angioplasty with stent, may not be familiar with the technique of S-AVS. A case of the use of S-AVS is reported in a patient who presented with primary aldosteronism and a right adrenal adenoma. CASE REPORT A 44-year-old man with a history of hypertension presented with a man in the posterior part of the right adrenal gland...
February 2, 2019: American Journal of Case Reports
Rohan Fuladi, Rajnish Nagarkar, Sirshendu Roy
BACKGROUND Anaplastic thyroid carcinoma (ATC) is an uncommon and aggressive form of human cancer. Despite advancement in multimodal therapy for patients with ATC, the prognosis remains poor. Most patients presenting with ATC have metastasis to the lungs and regional lymph nodes. Gastrointestinal tract metastasis is a rare entity observed among patients with ATC. We report a case of ATC with gastrointestinal metastasis. CASE REPORT A 72-year-old euthyroid female with hypertension presented to the clinic with swelling of the neck and breathlessness...
February 1, 2019: American Journal of Case Reports
Adela Arapović, Sandra Prgomet, Marijan Saraga, Tanja Kovačević, Zoltán Prohászka, Ranka Despot, Eugenija Marušić, Josipa Radić
BACKGROUND Thrombotic thrombocytopenic purpura (TTP) in children is a rare life-threatening syndrome, characterized by microangiopathic hemolytic anemia, thrombocytopenia with renal dysfunction, neurologic symptoms, and fever. TTP is usually caused by deficient activity of von Willebrand factor cleaving protease (ADAMTS13), due to either gene mutations or acquired via anti-ADAMTS13 autoantibodies. It can be triggered by bone marrow or solid organ transplantation, cardiothoracic-, abdominal-, and orthopedic surgeries, infections including very rarely Helicobacter pylori infection...
January 31, 2019: American Journal of Case Reports
Lan Lan, Jiayang Li, Xin Xu, Yanyi Cen
<strong>BACKGROUND</strong> One-lung ventilation under general anesthesia is necessary for most thoracic surgical procedures. However, adverse effects may derive from mechanical ventilation in emphysema patients. At present, lung volume reduction surgery under spontaneous ventilation may attenuate these adverse effects. <strong>CASE REPORT</strong> We present a case of left-side secondary spontaneous pneumothorax in a 71-year-old male who had a history of chronic obstructive pulmonary disease for 12 years, combined with a contralateral giant bulla...
January 30, 2019: American Journal of Case Reports
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