European journal of case reports in internal medicine最新文献

Imaging Insights Suggesting a Sinister Cause of a Breast Mass in Adolescents: A Case of Rhabdomyosarcoma in a Teenager. 影像学洞察力提示青少年乳房肿块的凶险原因：一例青少年横纹肌肉瘤病例

European journal of case reports in internal medicine Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004820

Mariam Malik, Rana Bilal Idrees, Maham Khalid, Ameena Munir, Saba Nawaz, Zainab Nawaz, Muhammad Hamid Chaudhary

{"title":"Imaging Insights Suggesting a Sinister Cause of a Breast Mass in Adolescents: A Case of Rhabdomyosarcoma in a Teenager.","authors":"Mariam Malik, Rana Bilal Idrees, Maham Khalid, Ameena Munir, Saba Nawaz, Zainab Nawaz, Muhammad Hamid Chaudhary","doi":"10.12890/2024_004820","DOIUrl":"10.12890/2024_004820","url":null,"abstract":"Background: Sarcomas of the breast are exceedingly rare, accounting for less than 1% of malignant breast tumors, with primary rhabdomyosarcomas being even rarer. Due to the scarcity of reported cases, the imaging characteristics of breast rhabdomyosarcoma are not well-defined, making diagnosis challenging, especially in adolescents.Case description: We present the case of a 17-year-old female diagnosed with embryonal rhabdomyosarcoma following a comprehensive workup for right breast masses. Initial imaging showed no distant metastasis, and the patient underwent a right mastectomy followed by adjuvant chemoradiotherapy. A few months post-treatment, she developed recurrent nodules in the chest wall. Further investigation confirmed the recurrence of embryonal rhabdomyosarcoma.Conclusions: This case underscores the importance of considering primary rhabdomyosarcoma as a differential diagnosis in adolescent breast lesions. Given its rare occurrence and potential imaging overlap with more common tumors like cystosarcoma phyllodes, awareness and careful evaluation are critical for accurate diagnosis and timely management.Learning points: Critical imaging insights: The report provides valuable imaging characteristics that can help differentiate rhabdomyosarcoma from more common breast tumors like fibroadenoma and cystosarcoma phyllodes, resulting in more accurate and timely diagnosis.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction. 经皮内窥镜结肠造口术缓解恶性肠梗阻。

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004872

Jerome Schwingel, Markus Casper, Manfred Lutz

{"title":"Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction.","authors":"Jerome Schwingel, Markus Casper, Manfred Lutz","doi":"10.12890/2024_004872","DOIUrl":"10.12890/2024_004872","url":null,"abstract":"Background: Malignant bowel obstruction due to peritoneal carcinomatosis is a common problem. When surgery is not feasible in the context of a high intraperitoneal tumour burden, other techniques are required.Case report: We report the case of a 67-year-old female with malignant obstruction of the ascending colon. Following an unsuccessful surgical attempt, decompression was successfully achieved via percutaneous endoscopic colostomy using a lumen-apposing metal stent. The patient was able to resume a full oral diet within 2 days. However, local inflammatory complications arose due to faecal contamination of the sutures. Once the sutures were removed, no further interventions were required.Conclusion: Percutaneous endoscopic colostomy is a safe and viable alternative for decompression in malignant bowel obstruction when surgery is not feasible. However, limitations include the risk of local infection due to sutures and its applicability only in cases with distal stenosis.Learning points: Malignant bowel obstruction is a frequent challenge in palliative care.Percutaneous colostomy with a lumen-apposing metal stent (LAMS) is a safe and effective option to relieve bowel obstruction.Percutaneous colostomy with a LAMS remains patent in the long term.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sweet Syndrome Presenting with Features of Cellulitis Shortly after Femoral Angioplasty. 股骨血管成形术后不久出现蜂窝织炎特征的斯威特综合征

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004670

Qi Wang, John Sinclair, Ayyappa Amaravadi, Onovughe Arioride

{"title":"Sweet Syndrome Presenting with Features of Cellulitis Shortly after Femoral Angioplasty.","authors":"Qi Wang, John Sinclair, Ayyappa Amaravadi, Onovughe Arioride","doi":"10.12890/2024_004670","DOIUrl":"10.12890/2024_004670","url":null,"abstract":"Neutrophilic dermatosis, or Sweet syndrome, is a cutaneous disorder caused by neutrophilic infiltration in the upper dermis. It has been associated with medications, infections and malignancies but to date it has not been associated with femoral arterial angioplasty or stenting. We present the case of a 75-year-old female who, after angioplasty and stent placement of the right superficial femoral artery, developed right heel pain with ulceration that did not respond to broad antibiotics. She underwent incision and drainage twice without improvement; both times produced negative cultures. She then underwent a punch biopsy by dermatology, which was consistent with acute spongiotic and other neutrophilic dermatoses. She was started on prednisone with immediate improvement of her symptoms. She was discharged to a rehabilitation centre with a prednisone taper and antibiotics. This report highlights the importance of maintaining Sweet syndrome on the differential for cellulitis as it is a rare mimicry of other infectious and non-infectious aetiologies, which are common in the perioperative space. Early treatment is crucial to improve symptoms, outcomes, healthcare cost and potentially the length of stay.Learning points: Sweet syndrome, a rare skin condition related to neutrophil infiltration, may be triggered by angioplasty.Sweet syndrome is easily misdiagnosed as infectious conditions such as cellulitis.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pembrolizumab in Combination with Folfirinox for Treatment of Advanced Pancreatic Adenocarcinoma With MSI-H. Pembrolizumab 联合 Folfirinox 治疗 MSI-H 晚期胰腺腺癌。

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004767

Ashmin Singh, Nairuti Sanghavi, Vandana Bandari, Iftekhar Khan, Abeer Alfaraj

引用次数: 0

Spontaneous Pneumomediastinum in a Patient with Marijuana Use. 一名吸食大麻患者的自发性气胸

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004853

Nutthakorn Horugsa, Jiyeon Kim, Samuel Kim, Judy Lalmuanpuii

引用次数: 0

Appendiceal Bleeding, A Rare Yet Important Cause of Lower Gastrointestinal Bleed. 阑尾出血，下消化道出血的一个罕见但重要的原因。

European journal of case reports in internal medicine Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004683

Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale

{"title":"Appendiceal Bleeding, A Rare Yet Important Cause of Lower Gastrointestinal Bleed.","authors":"Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale","doi":"10.12890/2024_004683","DOIUrl":"10.12890/2024_004683","url":null,"abstract":"Background: Lower gastrointestinal bleeding accounts for 20 to 25% of all gastrointestinal bleedings. Appendiceal bleeding is a rare, yet important cause of lower gastrointestinal bleed; in many cases, it can be misdiagnosed as obscure gastrointestinal bleeding. Here, we present a case of appendiceal bleeding in an elderly female.Case description: A 79-year-old female presented with acute onset of gastrointestinal bleeding of same-day duration. Investigations showed that she had an appendiceal bleed originating from an ulcer secondary to a small appendicolith, which has passed through the appendiceal orifice, combined with her aspirin use. Within 12 hours, a laparoscopic appendectomy was performed. No evidence of malignancy or vascular malformation was detected, and the post-operative course was smooth, with resultant discharge at day 3 after her surgery.Discussion: For lower gastrointestinal bleeding, it is crucial for the endoscopist to reach the terminal ileum during the colonoscopy, and thoroughly inspect the orifice of the appendix to assess any source of bleed including but not limited to Dieulafoy's lesion, angiodysplasia or any vascular malformation. An effective treatment option for appendiceal bleeding is surgical management with appendectomy. Alternative approaches such as vessel embolization and endoscopic treatment have been reported to successfully control bleeding; nevertheless, the risk of acute appendicitis and recurrent bleeding following these procedures can be challenging to manage, potentially leading the patient to still need a surgical treatment with an appendectomy.Learning points: Appendiceal bleeding is a rare, yet important cause of lower gastrointestinal bleed; in many cases, it can be misdiagnosed as obscure gastrointestinal bleeding.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coexistence of HHV-8-Associated Plasmacytic Multicentric Castleman Disease, Kaposi's Sarcoma, and Multiple Myeloma in a HIV-Negative Patient. 一名 HIV 阴性患者同时患有 HHV-8 相关浆液性多中心 Castleman 病、卡波西肉瘤和多发性骨髓瘤。

European journal of case reports in internal medicine Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004876

Rashad Ismayilov, Olgu Erkin Cinar, Murat Ozdede, Ece Ozogul, Umit Yavuz Malkan, Aysegul Uner, Ibrahim Halil Gullu

{"title":"Coexistence of HHV-8-Associated Plasmacytic Multicentric Castleman Disease, Kaposi's Sarcoma, and Multiple Myeloma in a HIV-Negative Patient.","authors":"Rashad Ismayilov, Olgu Erkin Cinar, Murat Ozdede, Ece Ozogul, Umit Yavuz Malkan, Aysegul Uner, Ibrahim Halil Gullu","doi":"10.12890/2024_004876","DOIUrl":"10.12890/2024_004876","url":null,"abstract":"Background: Multicentric Castleman disease (MCD) is a rare, aggressive lymphoproliferative disorder. Human herpesvirus-8 (HHV-8) has an important role in the pathogenesis of the disease and its association with Kaposi's sarcoma has been reported, especially in people living with human immunodeficiency virus (HIV). In this report, we present the case of HHV-8 positive MCD accompanied by Kaposi's sarcoma and multiple myeloma in an HIV-negative patient.Case report: A 78-year-old man with Kaposi's sarcoma presented with B symptoms, pancytopenia, lymphadenopathy, and splenomegaly. The bone marrow biopsy demonstrated 70% lambda-restricted monotypic plasma cell infiltration consistent with plasma dyscrasia. Also, the patient was diagnosed with HHV-8 positive MCD as a result of inguinal lymph node excisional biopsy. Treatment was initiated including ganciclovir and methylprednisolone and followed by rituximab. The patient passed away at the 24th hour of rituximab infusion due to shock.Conclusions: MCD and associated malignancies are difficult to treat and have a poor prognosis. More studies and data are needed to manage these patients.Learning points: Multicentric Castleman disease (MCD), often linked with human herpesvirus-8 (HHV-8) and Kaposi's sarcoma, is rare and aggressive condition, particularly in human immunodeficiency virus (HIV)-positive patients.The coexistence of MCD, Kaposi's sarcoma, and multiple myeloma is exceptionally rare in HIV-negative, immunocompetent patient.This case highlights the challenges in diagnosing and managing complex presentations of MCD and related malignancies, with poor outcomes despite treatment.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dipnech: A Rare Cause of Slow-Growing Pulmonary Nodules in a Dyspnoeic Patient with a History of Breast Cancer. Dipnech：一位有乳腺癌病史的呼吸困难患者肺部缓慢生长结节的罕见病因。

European journal of case reports in internal medicine Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004870

Peter Cassar, Dione Buhagiar, Jonathan Gauci, Kyra Bartolo, Adrian Mizzi, Andrew Mallia, Josef Micallef

{"title":"Dipnech: A Rare Cause of Slow-Growing Pulmonary Nodules in a Dyspnoeic Patient with a History of Breast Cancer.","authors":"Peter Cassar, Dione Buhagiar, Jonathan Gauci, Kyra Bartolo, Adrian Mizzi, Andrew Mallia, Josef Micallef","doi":"10.12890/2024_004870","DOIUrl":"10.12890/2024_004870","url":null,"abstract":"A middle-aged woman undergoing a computed tomography scan while being investigated for a retrosternal goitre, was found to have several solid intrapulmonary nodules of varying sizes with mosaic attenuation of lung parenchyma. After serial radiology follow-up, a radiologist with a special interest in thoracic imaging made the tentative diagnosis of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) during discussions at the local multidisciplinary team meeting. Radionuclide imaging was performed to assist in reaching a diagnosis. Uptake of DOTATATE by the pulmonary nodules on a background of mosaic attenuation pattern supported a diagnosis of DIPNECH. Potential secondary metastatic disease from previous breast malignancy confounded a possible earlier diagnosis of DIPNECH, with subsequent diagnostic imaging modalities leading to the rare diagnosis. The patient was treated symptomatically with oral steroids with no improvement, and subsequently with octreotide which significantly improved her condition.Learning points: Clinical symptoms of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) are common to several other respiratory conditions that are found ubiquitously in the community; being aware of this rare condition will help in reaching a diagnosis in a timelier manner.Several potential treatments are described in the literature including steroid therapy, cytotoxic agents and somatostatin analogues, which despite their efficacy have not been demonstrated in studies; however, a small number of case reports such as this one showed an improvement in symptomatology with this treatment.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Selective Serotonin Reuptake Inhibitors and Solitary Rectal Ulcer Syndrome: A Bloody Relationship. 选择性羟色胺再摄取抑制剂与孤立性直肠溃疡综合征：血缘关系

European journal of case reports in internal medicine Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004826

Nicolas Moussallem, Gaelle-Christie Haddad, Sergio Sbeih, Karam Karam, Elias Fiani

{"title":"Selective Serotonin Reuptake Inhibitors and Solitary Rectal Ulcer Syndrome: A Bloody Relationship.","authors":"Nicolas Moussallem, Gaelle-Christie Haddad, Sergio Sbeih, Karam Karam, Elias Fiani","doi":"10.12890/2024_004826","DOIUrl":"10.12890/2024_004826","url":null,"abstract":"Introduction: Solitary rectal ulcer syndrome (SURS) is a poorly understood and uncommon benign disorder of the lower gastrointestinal tract. It presents with various symptoms, often misinterpreted as inflammatory bowel disease. To date, there is no association between the use of selective serotonin reuptake inhibitors (SSRIs) and SURS.Case description: A 29-year-old male on paroxetine for six months and with a non-contributory surgical history presented to the clinic due to three months of haematochezia, abdominal pain and mucoid discharge. Physical examination and a review of systems were unremarkable; a colonoscopy demonstrated a suspicious ulcerated lesion in the rectum, which was identified as SURS on biopsy. The patient was advised lifestyle and dietary modifications. In addition, paroxetine was discontinued, and patient was switched to venlafaxine, a serotonin-norepinephrine reuptake inhibitor. Subsequently, the patient's symptoms resolved gradually, and he did not report any signs of recurrence on follow-up.Conclusion: Literature confirms that SSRIs can increase the occurrence of GI ulceration yet focuses specifically on upper gastrointestinal bleeding rather than rectal bleeding. This finding raises the need for further research.Learning points: SURS is often underdiagnosed or misdiagnosed as inflammatory bowel disease.The pathophysiology and aetiology behind SURS remain obscure.This case points to a potential correlation between SSRIs use and SURS development.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Diagnosis to Treatment: A Successful Case of Haemophagocytic Lymphohistiocytosis of Presumed Bacterial Aetiology in an Adult. 从诊断到治疗：一例推测为细菌病因的成人嗜血细胞淋巴组织细胞增多症成功病例。

European journal of case reports in internal medicine Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004812

Catarina Pestana Santos, Daniela Cruz, Bruno Gonçalves de Sousa, Tiago Judas

{"title":"From Diagnosis to Treatment: A Successful Case of Haemophagocytic Lymphohistiocytosis of Presumed Bacterial Aetiology in an Adult.","authors":"Catarina Pestana Santos, Daniela Cruz, Bruno Gonçalves de Sousa, Tiago Judas","doi":"10.12890/2024_004812","DOIUrl":"10.12890/2024_004812","url":null,"abstract":"Haemophagocytic lymphohistiocytosis (HLH) affects patients across all age groups and can be classified as either primary HLH (P-HLH) or secondary HLH (S-HLH). The latter is associated with clinical conditions that disrupt normal immunological responses, such as infections, neoplasms or autoimmune diseases. Although HLH can occur sporadically in healthy individuals, it is more frequently observed in patients with haematological malignancies and autoimmune disorders. The diagnostic process for HLH is often challenging due to its non-specific signs and the absence of pathognomonic findings. The primary objective in treating S-HLH is to eliminate the underlying trigger and control immunological hyperactivation, making the identification and treatment of triggers critically important. Prompt diagnosis and treatment are essential, as the mortality rate remains high. In this context, we present the case of a young woman diagnosed with idiopathic S-HLH, likely triggered by a bacterial infection. The diagnosis was achieved due to a high index of clinical suspicion for S-HLH. The patient exhibited an excellent response to antimicrobial therapy, resulting in the complete resolution of haemophagocytosis. The authors deem it important to present this case to enhance awareness of S-HLH diagnosis, as well as the investigation and management of potential triggers.Learning points: Haemophagocytic lymphohistiocytosis is characterised as a rare inflammatory syndrome that occurs due to uncontrolled systemic immune activation.Timely diagnosis and treatment are essential, as mortality is still high.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0