Glenn S Russo, Daniel R Rubio, Alem Yacob, Dieter M Lindskog, Ahmed K Alomari, Gary E Friedlaender
{"title":"Case of a Missed Giant Cell Tumor of Bone: An Opportunity to Observe its Natural History Disease.","authors":"Glenn S Russo, Daniel R Rubio, Alem Yacob, Dieter M Lindskog, Ahmed K Alomari, Gary E Friedlaender","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Giant cell tumor of bone (GCT) is a benign neoplasm that most commonly presents with pain and is rarely diagnosed as an incidental finding. We present the report of a young woman whose pre-operative MRI was only noted to have a tear of the anterior cruciate ligament (ACL). Subsequently, the patient underwent anACL reconstruction. A second MRI, performed four years later, demonstrated an enlarged mass in the same location. A retrospective evaluation of the initial MRI revealed an eccentric metaphyseal lesion. Histology obtained from the lesion demonstrated a giant cell tumor of bone. We present the case of an asymptomatic GCT discovered retrospectively as an incidental finding and reevaluated four years later. 'Ihis case serves as a reminder of the importance for the critical review of routine preoperative imaging and also offers a unique perspective on the natural history of giant cell tumor of bone.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"399-403"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chindhuri Selvadurai, Pantea Farahmand, Naha Jain, Camille Alvarado
{"title":"New Onset Seizure Disorder Following Electroconvulsive Therapy.","authors":"Chindhuri Selvadurai, Pantea Farahmand, Naha Jain, Camille Alvarado","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is an effective treatment for many psychiatric illnesses including refractory depression, catatonia, bipolar disorder, and schizophrenia, along with neuropsychiatric diseases such as dementia and Parkinson's disease. The emergence of a seizure disorder after the initiation of ECT is a rare but severe occurrence. It can become challenging for clinicians to determine whether ECT should be continued. We present a case of a 73-year-old female with schizoaffective disorder who received a total of 173 ECT treatments over the course of five years for breakthrough psychosis due to medication nonadherence. After five years of treatment, she experienced her first episode of tonic-clonic seizure activity. We review the current evidence and discuss factors that should be considered when treating such an individual.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"479-481"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Superior Sagittal Sinus Thrombosis Related to the Use of Tamoxifen: A Case Report and Review of Literature.","authors":"Lisa Phuong, Alexei Shimanovsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tamoxifen is a selective estrogen- receptor modulator commonly associated with an increased risk of thrombotic events, including cere- bral venous thrombosis. Ihe superior sagittal sinus appears to be the most affected site of cerebral venous thrombosis in patients with a history of malignancy. However, the underlying mechanism of tamoxifen- induced hypercoagulability and location of cerebral venous thrombosis are notwellunderstood. Here, we present a case of a 47-year-old female with a history of breast cancer, on tamoxifen for 10 months, found to have superior sagittal sinus thrombosis with additional thrombosis of the draining cortical veins. Furthermore, we review similar cases published in literature. We recommend that physicians should be aware ofthe potential of developing superior sagittal sinus thrombosis in patients who take tamoxifen and warn patients of this adverse event when prescribing the medication.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"487-489"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahvand Sadeghi, Richard Loftus, Constantin A Dasanu
{"title":"Erlotinib-Induced Transverse Fissure-Like Skin Lesions of Fingers.","authors":"Mahvand Sadeghi, Richard Loftus, Constantin A Dasanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Erlotinib is an epidermal growth factor receptor tyrosine kinase (EGFR-TK) antagonist used in the therapy of non-small cell lung cancer. This agent has been associated with several dermatologic side effects, the most common being acneiform rash involving the face, neck, chest, and back. The occurrence of skin side effects has been correlated with both therapeutic efficacy and increased overall survival in these patients. We report herein unusual erlotinib-induced skin lesions affecting fingers, with a transverse fissure-like appearance and beefy-red laceration-like center. A unique feature is their location on adductor surfaces and more proximal aspects of the phalanges. This erlotinib side effect has not been previously reported in the medical literature.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"405-407"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40437981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yogesh Kumar, Ahmed Abdelbaki, Neeraj Bhatt, Francisco Lazaga, Kusum Hooda
{"title":"Successful Treatment of a Common Femoral Arterial Pseudoaneurysm with US-Guided Thrombin Injection: A Case Report.","authors":"Yogesh Kumar, Ahmed Abdelbaki, Neeraj Bhatt, Francisco Lazaga, Kusum Hooda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We are presenting a case of a patient who developed a pseudoaneurysm following cardiac catheterization. This is one of the most common complications related to invasive cardiovascular procedures. A pseudoaneurysm forms when an arterial puncture site fails to seal, allowing blood to leak and form a pulsatile hematoma contained by fibromuscular tissues. Color Doppler imaging has been the investigative method of choice for this diagnosis, which demonstrates swirling flow in a mass connected to the parent artery in the neck. The pseudoaneurysm neck shows \"to and fro\" Doppler waveforms. The treatment options for pseudoaneurysms include ultrasound (US)-guided compression, minimally invasive percutaneous treatments including US-guided thrombin injection, coil embolization and covered stent placement, and open surgical treatment. All of these treatment options have their own advantages and disadvantages, which will be discussed in detail.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"413-415"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40550110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Del Rosario, Henry Tsai, Constantin A Dasanu
{"title":"Prolonged Survival in Colon Cancer with Malignant Pericardial Effusion and Pulmonary Lymphangitic Carcinomatosis: A Case for Monoclonal Antibodies?","authors":"Michael Del Rosario, Henry Tsai, Constantin A Dasanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traditionally, cardiac metastases and lymphangitic carcinomatosis have been associated with survival of only two to four months. We report herein a patient with malignant pericardial. effusion, and lymphangitic carcinomatosis due to colon cancer who remains in partial remission 12 months after the diagnosis. We postulate that the newer agents bevacizumab and cetuximab used in two different combination regimens contributed significantly to his longer survival. If confirmed, increased survival in this group of patients treated with novel regimens will have to be considered before any life-changing decisions (such as early referral to hospice) are made. In addition, a multitude of newer agents are in the pipeline and will soon join the battle against gastrointestinal malignancies, which could further increase survival in these patients.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"483-485"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The High (Personal) Cost of Critical Care Medicine.","authors":"Eric Shore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"435-436"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Spontaneous Rupture of the Diaphragm in a Young Pregnant Female Presenting with Hydropneumothorax.","authors":"Parth Rali, Namrata Jasani, Hammad Arshad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a case of spontaneous rupture of the diaphragm in a young pregnant female mimicking hydropneumothorax. She had a chest tube placed on admission without any improvement in her symptoms, which led to further imaging. Chest and abdomen CT after a barium swallow confirmed the clinical diagnosis. She had definitive surgical repair followed by an uneventful clinical recovery.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"423-425"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40529608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk Assessment Tools for Osteoporosis-Related Fractures.","authors":"John Dougherty, Xuezhi Jiang, Peter F Schnatz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Osteoporosis is a prevalent and po- tential debilitating disease. Characterized by archi- tectural modifications in bone matrix, osteoporosis ultimatelyincreases the propensity forbones to frac- ture, especially at the hip and spine. Fortunately, osteoporosis can be treated effectively if detected at an early stage. While recognizing an increased risk offracture inwomen with osteoporosis, mostcases of fracture occur in women with osteopenia orlowbone mass. A good fracture risk assessment tool would be more clinically meaningful than an accurate osteo-. porosis screening or diagnostic tool. Here we present a concise review ofthe existing modalities which may be utilized to screen for osteoporosis or predict risk of oteonorotic fractures.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"393-398"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberta De Keyser, Arleen Ram, Constantin A Dasanu
{"title":"A Curious Case of Actinomyces Naeslundii Bacteremia in a Patient with Metastatic Pancreatic Cancer.","authors":"Roberta De Keyser, Arleen Ram, Constantin A Dasanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although considered a saprophyte, Actinomyces naeslundii can cause invasive infection leading to significant morbidity and mortality. Rarely encountered, bacteremia with this agent occurs in the setting of disrupted mucosal barriers. Previous studies suggest that actinomycosis may be a surrogate marker for poor prognosis in immunocompromised hosts. We report herein a case of a patient with metastatic pancreatic cancer who not only had a prompt resolution of Actinomyces bacteremia and a complete response to chemotherapy, but also remained disease free at 12 months after diagnosis. Our case may suggest that concomitant actinomycosis may not necessarily portend a poor prognosis in all immunocompromised patients.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"417-418"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}