Journal of Clinical Case Reports

Primary adrenal leiomyosarcoma is an extremely rare tumor. Here, we report the case of a primary adrenal leiomyosarcoma in an 81-year-old woman. Computed tomography showed a right adrenal tumor (7 cm). There were no abnormal findings on physical examination and her serum adrenal hormone levels were normal. However, 67Gallium scintigraphy showed gallium accumulation at the site of a right adrenal tumor, and malignancy was suspected. The right adrenal tumor was surgically removed and histological examination revealed that it was a leiomyosarcoma. After surgical treatment, the patient was administered different types of chemotherapy but she died of local recurrence 1 year later

Objectives: Testicular Torsion is a rare to occur in adults. It should not come late and end by missed torsion, particularly when the patients are adults ad mature. In those cases, we want to know why did they come late? Methods: We faced three cases with missed torsion and end by Orchidotomy. After Taken a clear history and more discussion with them we found one answer which is “Shame habits” to complaining from genitalia? Results: All three cases and I think most males in our country need more education about how can they deal with genitalia symptoms because the shaming from that became habits in most of males in our country and even in other middle east countries. Conclusions: To our knowledge, this represents the high percentage of male complaining how can they deal with or expression about their genitalia symptoms. For that, the people education is very important to distribute the knowledge between the parents and the adults you can save yourself if you go directly to the hospital or your physician.

Background: This report describes the unusual case of massive bleeding from the external auditory canal.

Results: We present a very rare mechanism of potentially fatal bleeding. We describe presentation, differential diagnosis, anatomy considerations and management options for this case.

Conclusions and relevance: Posttraumatic pseudoaneurysm is almost always a result of blunt trauma. When the pseudoaneurysm is bleeding, it requires urgent angiogram and occlusion.

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent episodes of fever and inflammation. Approximately 10% of patients are reported to be resistant or non-responsive to colchicine. We describe a case of a 30-year-old female patient with familial Mediterranean fever resistant to treatment with colchicine and lack of clinical response to Anakinra, successfully treated with Infliximab. Our case suggests that Infliximab, an anti-TNF antibody, may represent a safe and effective therapy for the treatment of colchicine-resistant FMF.

We report an 82-year male with a left ventricular a left-ventricular aneurysm via a left-thoracic thoracotomy as re-do. The patient received a supracommissural replacement of the aorta as well as a mitral valve repair half a year before the reoperation. He was diagnosed with an apical left ventricular aneurysm six months after the first operation and was re-administered to our clinic. He received a minimally invasive treatment of the left-ventricular aneurysm via a left-thoracic thoracotomy as re-op.

We present a rare case of bilateral posterior interosseous nerve palsy secondary to congenital dislocation of the radial head in a 54-year-old male. After an initial trial of orthotic management, he had a successful outcome following a surgical decompression of the nerve on one side.

Mycotic aortic aneurysms are an aggressive form of degenerative remodeling reported more commonly in immunosuppressed patients. These aneurysms carry a high risk of progression to rupture, fulminant sepsis, and death, and therefore require prompt operative intervention. The human immunodeficiency virus (HIV) has also been associated with a broad spectrum of vascular disease, including development of aneurysms, however these have typically been identified in the peripheral vasculature. We report the case of a 71-year-old, HIV-positive male who presented with Escherichia coli bacteremia and aortitis which rapidly progressed to a ruptured infrarenal mycotic aortic aneurysm. He was managed successfully with open debridement and in situ implantation of a rifampin-soaked prosthetic graft as well as long-term antibiotic therapy. Here, we review the epidemiology, pathophysiology, and optimal surgical treatment of mycotic aortic aneurysms.

Synthetic cannabinoids, also known as ‘spice’ or ‘K2’, have recently increased in popularity as a drug of abuse among young adults. It has been associated with unexplained acute kidney injury and electrolyte abnormalities in otherwise healthy individuals. The mechanism of this phenomenon is not fully understood although some reports suggest that it may be potentially due to synthetic cannabinoids having increased potency causing an accumulation of harmful levels of toxicity. It is not understood if the use of this drug should preclude deceased donor renal transplantation and currently there are no reports on the use of K2’s effect on donor graft function. Herein, we summarize the first reported case of renal transplantation from a deceased donor in whom K2 was a known mortal factor and outline the similar abnormal graft functions of the two recipients.

We report challenges and trajectory of symptoms observed during the therapeutic process of a child with speech and language impairment and high intellectual potential which, initially, was concealed both by the described impairment and from others developmental vulnerability areas (psychomotor, emotional regulation etc.). The child, although intelligent, did not adequately use his strategies in order to make them effective and functional to the relational exchange and his cognitive level. The evaluations, carried out in many years, not only allowed to follow the evolution of the disorder but also the emergence of different skills, thus identifying the asynchronous development. Finally, are illustrated the results obtained at the last assessment where all the areas appeared evolving, with a significant transition from not coherently used strategies to the expression of the child’s high potential (from the Leiter-R nonverbal IQ score of 93 to the WISC-IV IQ score of 131).

Introduction: Cancer chemotherapy is a provider of a wide spectrum of neurological complications. Such complication ischemic strokes are an unusual event with an incidence of 0.14%.

Objective: Report and comment on the observation of a patient who presented an ischemic stroke in the aftermath of chemotherapy for tongue cancer.

Observation: 47 years old patient without cardiovascular risk factor is followed for tongue cancer. She presented the waning of chemotherapy ischemic stroke confirmed by brain scan. Heart explorations are normal, and the etiologic biological assessment.

Discussion: The diagnosis of stroke after chemotherapy has been retained in our patient on the basis of the absence of vascular risk factor and negativity of etiological assessment, and the use of cisplatine and 5-fluorouracil, which have been implicated in the occurrence ischemic stroke. The occurrence of this complication depends on the type of drugs, and certain drug combinations and fall of several mechanisms that can be entangled.

Malaria is one of the commonest parasitic diseases in the tropical countries like India. Complications of P. falciparum malaria are well recognised, but the complications of P. vivax malaria still continues to give us surprises. Myocardial involvement is a very rare complication of P. vivax infection. In this context, we report a case of P. vivax induced myocarditis and sinus exit block in our patient with review of the literature related to this rare entitiy.