Journal of Clinical Case Reports

Objective: Inflammatory myofibroblastic tumor is a very rare mesenchymal tumor, we share our experience of surgical treatment for inflammatory myofibroblastic tumor.
Materials and Methods: From January 2005 to January 2015, 32 patients were recruited in this study including 13 males and 19 females who received surgery and diagnosed as inflammatory myofibroblastic tumor. Postoperative followup was conducted by thoracic surgeons every 3 months until 12 months after surgery, after that every 6 months until 24 months, and then yearly.
Results: 32 patients (aged: 9-72 yr, average:37.85 ± 19.42 yr, 13 males and 19 females ) received surgical treatment for inflammatory myofibroblastic tumor (ranged:0.8-8 cm, average:3.84 ± 2.05 cm), including 15 cases of lobectomy, 7 cases of wedge resection, 4 cases of bronchoplasty, 2 case of tracheal tumor resection, 3 cases of sleeve resection and 1 case of wedge resection with biopsy of the chest wall. 31 patients are still alive till now, while one patient die 6 months after the surgery.
Conclusion: It suggested that complete resection of the IMT lesions may lead to a promising long-term survival, otherwise it may lead to a compromised outcome.

Immunodeficiency, centromeric instability, and facial dysmorphism (ICF) syndrome is a rare autosomal recessive disorder, characterized by a variable reduction in serum immunoglobulins, sometimes combined with defective cellular immunity. Here, we report an 18-month-old boy, who presented with colonic perforation. The molecular diagnosis was confirmed by whole-exome sequencing that revealed a homozygous c.2506G>A, (p.Val836Met) mutation in DNMT3B gene. This report expands the clinical and immunological features of ICF syndrome.

Surgicel is oxidized regenerated cellulose used successfully for haemostasis and prevention of adhesions for many years in different surgical disciplines. However, many reports of different related complications appeared in the literature. In this manuscript I am reporting on two patients who had surgicel gauze removed from the pelvis many months after surgery because of intolerable dull pelvic pain and intermittent low-grade fever. Transvaginal ultrasound scan examinations in both cases showed tubular masses with medium echogenicity in the pelvis which were mistaken for dilated fallopian tubes. Both patients responded well after laparoscopic surgicel removal and pelvic lavage with 2 litres of warm normal saline. This was followed by instillation of 500 mg of hydrocortisone diluted in 50 ml of saline. Culture of the peritoneal contents was negative. In both cases the symptoms were mostly related to foreign body reaction as the gauze was isolated and encapsulated within a thin membrane. Furthermore, neither patient needed any antibiotics after it was removed. These are the first two case reports for retained surgicel used during laparoscopic gynaecological surgery to be mistaken for dilated fallopian tubes. I suggest that all patients who had surgicel used during similar operations should have transvaginal ultrasound scan examination one month after the procedure, or even sooner if they remained symptomatic. Any tubular pelvic mass should be explored by diagnostic laparoscopy as it might be a retained surgicel gauze. Better still, a clinical preoperative test needs to be developed to check which patients might be at risk of developing such complications.

In old age bipolar disorder (BD) patients, cognitive complaints difficults an accurate differential diagnosis between cognitive deficits secondary to a primary affective disorder and neurocognitive disorders, such as dementia in Alzheimer’s disease (AD). This case report refers to a female 56-year-old patient with severe and treatment resistant BD type I that presented cognitive decline with loss in recent episodic memory and executive functions in the past year. The diagnosis of mild stage dementia associated to BD was suggested, however neuroimaging tests such as magnetic resonance imaging (MRI) and positron emission tomography with fluordeoxiglicose (PET - FDG) were not enough to exclude the differential diagnosis of AD. The CSF biomarkers (reduced levels of amyloid peptide Aâ1-42 and the elevation of total tau protein and phosphorylated tau levels) resources were decisive for exclusion of an etiological diagnosis of AD.

Background: We report a case of focal myositis caused by an infection with Salmonella paratyphi B in an 18-year-old immuno-competent woman.
Methods: Case report and review of the literature on Salmonella causing (pyo)-myositis.
Results: An 18-year-old woman developed a focal myositis of the iliopsoas, gluteus medius and piriformis muscles on the right side occurring 2 days after onset of fever caused by Salmonella paratyphi B infection. Other reasons for focal myositis were excluded.
Conclusion: This is the first reported case of focal myositis being caused by an infection with Salmonella paratyphi B in a previously healthy patient.

This is a case of 35-years-old woman who presented with visual disturbances, gait disturbances and headache ten days postpartum. Imaging studies identified an acute infarction in the right parietal region. This case report discusses her presentation, investigations and management and the Etiology of stroke in pregnancy and the post-partum period.

Background: Malignant pleural mesothelioma (MPM) is a rare tumor with a challenging diagnosis. Its histological diagnosis is gradual and should be based on morphological assessment, supported by clinical and radiological evidence and immunohistochemistry (IHC). There are many immunohistochemical markers known to distinguish between a malignant mesothelioma and a carcinoma, but, none of the potential antibodies exhibit absolute specificity or sensitivity for both tumors.
Case presentation: We report a case of diffuse mesothelioma of the peritoneum with a misleading diagnosis of colon carcinoma, opened to different possibilities of differential diagnosis among the advanced stages of neoplasms with peritoneal dissemination. We highlighted a very weak sporadic nuclear positive for thyroid transcription factor-1 (TTF-1) expression in malignant mesothelioma.
Conclusion: The aim of the present study is to demonstrate the important role of TTF-1 in the diagnosis of mesothelioma. A positive tissue expression of TTF-1 may not exclude a malignant mesothelioma and could help the clinicians to improve its diagnosis and treatment.

Ameloblastoma is a slow growing odontogenic epithelial neoplasm which originates from remnants of the dental lamina with a high recurrence rate, but a low tendency to metastasize. Locally invasive ameloblastoma is often aggressive and destructive, which erodes bone and invades adjacent structures. Despite a benign histology metastatic disease may occur and samples taken from metastatic tumor usually maintains the features of the original tumor. Ameloblastic carcinoma differs from ameloblastoma with malignant cytological features. Here we report an unusual case of ameloblastoma metastatic to lung and liver, unresponsive to systemic treatment with cisplatin and adriamycin, and well controlled with local surgical treatment.