by Mazaher Ramezani, Akram Amiri, Farhad Kavousi and Masoud Sadeghi
Case Report
The incidence of synchronous bilateral invasive breast cancer (SBBC) is reported to range from 0.8%-3.0%. Lower disease-free survival and high rates of distant metastasis is a recognized feature of bilateral synchronous tumors, which therefore have a worse overall survival compared to unilateral tumors. Early detection of the contralateral tumor is of utmost importance emphasizing the significance of breast self-examination. Here we report a case of SBBC with invasive ductal carcinoma on both sides in a 50-year-old lady. The pathology report on both sides was infiltrating ductal carcinoma and ductal carcinoma in situ, nuclear grade of ІІ/ІІІ and histologic grade of II/III. Perineural invasion was present on both sides but vascular invasion only on the right side. In conclusion, SBBC is rare, but is important because it may have worse prognosis, different hormone receptor status and treatment modality. Early detection with breast self-examination is highly emphasized.
American Journal of Medical Case Reports. 2017, 5(12), 301-303. DOI: 10.12691/ajmcr-5-12-5
Pub. Date: January 15, 2018
10903 Views3215 Downloads
by Yasin H, Mathews M, Suh J and Finkel D
Case Report
Sofosbuvir and Simeprevir are new antiviral agents that have been used to treat chronic hepatitis C virus infection in the recent years with excellent virological response. Both agents are considered to have a safe renal profile. We present a 57-year-old male patient with chronic hepatitis c virus infection who developed acute kidney injury requiring hemodialysis after 7 weeks from beginning of Sofosbuvir and Simeprevir regimen. There was no renal side effects reported in clinical trials of both agents and There was only one reported case of kidney injury in patient taking Sofosbuvir in combination with Ledipasvir.
American Journal of Medical Case Reports. 2017, 5(12), 298-300. DOI: 10.12691/ajmcr-5-12-4
Pub. Date: January 15, 2018
7723 Views2487 Downloads
by Uzung Yoon and Elia Elia
Case Report
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is characterized by acute reversible apical ventricular dysfunction and apical akinesis in the absence of obstructive coronary artery disease. Reverse-takotsubo is a variant form of takotsubo cardiomyopathy with basal and midventricular dysfunction and normal apical function. It is known to be more common in young patients. We present a case of a 14-year-old patient who developed reverse-takotsubo cardiomyopathy with flash pulmonary edema after topical nasal phenylephrine and iatrogenic epinephrine containing local anesthetic injection for a dental procedure. Patient experienced cardiac arrest but was resuscitated successfully and transferred to the cardiac intensive care unit. Postoperative echocardiogrpahy showed normal coronary arteries and mild left ventricular hypertrophy with uncertain correlation for the cardiac event, and the patient was discharged home with no complications.
American Journal of Medical Case Reports. 2017, 5(12), 293-297. DOI: 10.12691/ajmcr-5-12-3
Pub. Date: January 15, 2018
12106 Views2823 Downloads
by Goldstein Randi, Chen Edward and Lundberg Gina Price
Case Report
Hypertension, a prevalent condition in the United States and in the developed world, is a significant risk factor associated with aortic aneurysms. This case study describes a 7.3cm Transverse Aortic Arch Aneurysm identified in a 56-year-old female with a history of smoking and essential hypertension. The size, location, age of the patient, and the fact that this aneurysm was an incidental finding make this case novel. The size of this aneurysm and its ability to remain undetected for such an extended period of time was remarkable, but not unusual for this disease process. Based on current guidelines, this patient was not an appropriate candidate for screening via aortic imaging.
American Journal of Medical Case Reports. 2017, 5(12), 289-292. DOI: 10.12691/ajmcr-5-12-2
Pub. Date: January 05, 2018
9303 Views1756 Downloads
by Masashi Inoue, Masahiro Tanemura, Toshimitsu Irei, Yuyo Maeda, Megumi Yamaguchi, Tatsuya Miyamoto, Shingo Seo, Toshihiro Misumi, Wataru Shimizu, Takahisa Suzuki, Takashi Onoe, Takeshi Sudo, Yosuke Shimizu, Takao Hinoi and Hirotaka Tashiro
Case Report
Background: Thymic atypical carcinoid(AC) tends to have a more aggressive clinical course than typical carcinoid(TC). About 20%-30% of patients with thymic AC experience local recurrence or distant metastasis. Pancreatic metastasis of thymic AC is extremely infrequent. We experienced a case of pancreatic metastasis of thymic atypical carcinoid, in which a distal pancreatectomy was performed. Case presentation: A 50-year-old man underwent thoracoscopic resection of a mediastinal tumor in June 2009. The diagnosis was thymic AC. He also underwent an extended thymectomy in October 2011, thoracoscopic resection in October 2012, and tumor resection of the chest wall in March 2013 for recurrences. During follow up in April 2014, computed tomography (CT) revealed lymph node swelling on the ventral side of the brachiocephalic vein, around the left gastric vein, and on the left side of the celiac artery. Dynamic CT revealed a pancreatic tumor 10 mm in diameter with low enhancement. EUS-guided fine-needle aspiration (EUS-FNA) biopsy revealed the pancreatic tumor was compatible with metastasis of thymic AC. The patient underwent abdominal lymph node resection and distal pancreatectomy in June 2014. Because the lymph node on the ventral side of the branchiocephalic vein was judged as unresectable, 60-Gy radiation therapy was given in September 2014. Per pathological examination and immunohistochemistry, the final diagnosis was pancreatic metastasis of thymic AC. With several chemotherapy courses for recurrences, the patient has remained alive for eight years after the first surgery. Conclusion: AC metastasis to the pancreas is extremely rare. EUS-FNA is useful for diagnosis. Definitive determination of whether the treatment provides a survival benefit awaits further studies.
American Journal of Medical Case Reports. 2017, 5(12), 285-288. DOI: 10.12691/ajmcr-5-12-1
Pub. Date: December 29, 2017
11487 Views2326 Downloads