Journal of Clinical Case Reports

The oncogene encoding Her2 receptor which has an important biologic significance in human cancers has been described 30 years ago by Schecter et al. Her2 amplification in gastric cancer has been shown in MKN-7 gastric cancer cell line firstly by Fukushige et al. in 1986. Later studies showed variable expression of ERBB2 in gastric cancer and Her2 expression rate has been found between 8% and 54%. Significant survival advantage has been reported with the introduction of trastuzumab in cases with gastric cancer expressing ERBB2. Other anti-ERBB2 agents are used in ongoing studies and longer survival times are expected. By analogy with ERBB2 breast cancer it can be speculated that central nervous system metastases may increase in these cases with increased survival times. Here we reported brain metastases in a case with metastatic gastric cancer treated by trastuzumab containing regimen.

Class I Brugada Syndrome is a disorder characterized by heterogenous, inheritable cardiac ion channel defects . It is believed to account for 4% of all incidences of Sudden Cardiac Death (SCD) and up to 20% of cases of SCD in which there is an absence of structural cardiac defects. Traditional findings on EKG are the classic “sail” appearance of the QRS complex and ST segments in the right pre-cordial leads, characterized by ST segment and J-point elevation without a distinct R-wave which down-slopes into an inverted T-wave . Patients often do not experience a syncopal episode until the 4th decade of life. Syncope is many times precipitated by a stressor such metabolic derangement or fever. The patient examined in this clinical case report showed a history of febrile illness along with syncope , with subsequent EKG revealing a classic presentation of this rare disease. Further work remains to elucidate the influence of high temperature and metabolic derangements on the development of symptomatic Brugada syndrome and how to best risk stratify these patients.

Congenital anomalies of the female genital tract are often asymptomatic and therefore unrecognized. They usually present at adolescent with abdominal pain at the time of menarche. This is a report of two teen aged girls who presented to the University Hospital-Sharjah (UHS) complaining of recurrent attacks of cyclical lower abdominal pain which comes within the premenstrual periods and fades after menses. They were investigated and managed in other hospitals with no improvement. The two patients were diagnosed by trans-abdominal and trans-perineal pelvic U/S in addition to MRI studies which confirmed the diagnosis of didelphys uterus with an obstructing transverse vaginal septum leading to hematocolpos and hematometrocolpos in addition to the presence of an ipsilateral renal agenesis. Per-operative hysteroscopy was valuable in identification of the abnormal anatomy. The technique of transvaginal surgical excision of the septum in both cases with attempt to preserve the hymen in addition to the problems in diagnosis and management of these rare anomalies are discussed.

Introduction: Psammocarcinoma is a rare form of epithelial serous ovarian carcinoma characterized by extensive formation of psammoma bodies, invasion of ovarian stroma, peritoneum or intraperitoneal viscera, and moderate cytological atypia. These tumors represent a real problem of the diagnostic, and the role of chemotherapy is not yet clearly demonstrated.

Case presentation: We herein report a case of psammocarcinoma of ovary with peritoneal carcinosis in a forty year old Moroccan female. The patient underwent optimal surgical debulking and nine courses of chemotherapy with carboplatinum and paclitaxel with a complete response. The prognosis for this type of ovarian cancer is unclear, but it appears to be better than other forms of epithelial ovarian cancer.

Conclusion: The psammocarcinome is a rare entity, majority of patients are diagnosed at an advanced stage. The role of chemotherapy is poorly defined; some authors have their patients treated by neoadjuvant or adjuvant chemotherapy.

We currently lack evidence of increasing the benefits that can bring chemotherapy in the management of advanced ovarian psammocarcinomas. Only trials in wide yard can answer this question.

Multiple ring enhancing lesions in the brain can be caused by a variety of diseases including infections, inflammatory and neoplastic conditions. We present the case of a patient with new onset unilateral jerking movement of the arm who was found to have sixteen ring enhancing lesions in the brain on MRI. Further workup revealed a primary small cell lung cancer. The differential diagnosis of multiple ring enhancing lesions is discussed. The astute clinician should be aware of this rare but important radiological finding