by CH Liu, MW Deng, R Ji, YQ Wang, K. KC Ng, SY Qiu, BR Xu and HT Zhu
Original Research
Primary pancreatic lymphoma is a rare disease. It is insidious, always no specific symptoms and signs, and easy to be misdiagnosed as pancreatic carcinoma. Now 1 case of primary pancreatic lymphoma is reported in our hospital for sharing.
American Journal of Medical Case Reports. 2019, 7(3), 52-55. DOI: 10.12691/ajmcr-7-3-5
Pub. Date: March 26, 2019
8599 Views1726 Downloads
by Aisha Taiyeb, Sarah Alqurashi and Hani Aggad
Case Report
Multiple sclerosis (MS) is one of the most common neurological disorders and causes of disability among young adults worldwide. Pulse steroid therapy is commonly used to treat the acute relapses of MS. Acute Sinus bradycardia has been reported as a side effect after administration of pulse dose steroid; most of the reported cases are asymptomatic. A case of acute symptomatic sinus bradycardia was reported after administration of pulse steroid in post-partum women with multiple sclerosis.
American Journal of Medical Case Reports. 2019, 7(3), 46-51. DOI: 10.12691/ajmcr-7-3-4
Pub. Date: March 24, 2019
7769 Views906 Downloads
by Mohammed Al-Sadawi, Hope A. Taitt, Michael Haddadin, Shakil Shaikh, Murad Almasri, Angeleque Hartt and Samy I. McFarlane
Case Report
Coronary artery anomalies are rare congenital disorders occurring in 0.3-5.6 % of the population. However, it carries a potential risk of sudden death in young athletes due to the development of premature coronary artery disease. The diagnosis of coronary artery anomalies is usually made incidentally; commonly found while investigating other cardiac conditions. A coronary CT angiography and traditional interventional angiography are the gold standards for diagnosing congenital coronary artery anomalies. Here, we present a case of a 27 year-old female with a history of hypertension and membranous glomerulonephritis with proteinuria presenting with an inferior ST elevation myocardial infarction. Cardiac catheterization revealed an anomalous origin of the left anterior descending artery from the right coronary cusp and absence of the left circumflex artery with a super-dominant right coronary artery. The patient had an occlusion of the right posterior descending artery and the right posterolateral segment. We discuss the clinical diagnosis and intervention of the case along with review of the literature.
American Journal of Medical Case Reports. 2019, 7(3), 41-45. DOI: 10.12691/ajmcr-7-3-3
Pub. Date: March 20, 2019
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by Emelie Styring, Marie Ahlström, Pehr Rissler, Fredrik Mertens, Kasim Abul-Kasim and Lars B. Dahlin
Case Report
Introduction: Ulnar nerve entrapment is a common cause of sensory disturbance and weakness in the upper extremity, especially in patients with diabetes mellitus. However, if the symptoms are atypical and the patient has severe pain other differential diagnoses should be considered. Case report: A 37-year-old man with type 1 diabetes mellitus was referred to the hand surgery unit due to increasing pain, numbness and weakness in his right arm developing over more than one year. An ulnar nerve neurography was inconclusive and the patient had a frozen shoulder on the right side. Due to the pain, the patient required high doses of opioids. At examination, the clinical presentation did not correspond to an ulnar nerve entrapment why other causes were considered. A chest X-ray revealed a lesion in the apical part of the right lung. Consequtive CT scan, MRI and fine and core needle biopsies led to the diagnosis of a desmoid tumor. Surgery was deemed to be too mutilating and treatment was initiated with doxorubicin. Due to tumor and symptom progression the therapy was changed to PegIntron, then antiestrogen and NSAID and finally tyrosine kinase inhibitor (sorafenib) resulting in tumor shrinkage. Conclusion: Although nerve entrapment is a common cause of discomfort and impaired function in the upper extremities different etiologies, including various tumors, have to be considered when the symptoms are atypical and if the patient has severe pain. For these patients, the diagnostic work-up has to be broadened.
American Journal of Medical Case Reports. 2019, 7(3), 36-40. DOI: 10.12691/ajmcr-7-3-2
Pub. Date: April 26, 2019
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by Matthew Hager and Joey Jarrard
Case Report
Introduction: Gastric schwannomas are extremely rare mesenchymal tumors that represent only 0.2% of all gastric neoplasms. These tumors arise from the Auerbach or Meissner’s plexus and are most commonly found incidentally. Of those presenting with a gastric schwannoma only 12.8% of patients will present with upper gastrointestinal bleeding. Case Presentation:In this report, we present the case of a 51 year old female with signs and symptoms of upper gastrointestinal bleeding from a gastric schwannoma. The patient’s computed tomography revealed a 6.4 x 5.7 cm mass on the lesser curvature of the stomach near the pylorus. She subsequently underwent esophagogastroduodenoscopy with endoscopic ultrasound and fine needle aspiration revealing SMMS-1, Pankeratin, CD34, DOG-1, and CD117 negative immunohistochemical stains, which suggested a spindle cell neoplasm. The patient’s tumor was surgically resected two weeks later via laparoscopic distal gastrectomy with gastrojejunostomy. On immunohistochemistry, the tumor stained positive for S100, suggesting a gastric schwannoma. The patient’s postoperative course was complicated by possible early dumping syndrome which resolved in one week with dietary changes. She is tolerating regular food on follow-up and doing well. Discussion: With only a handful of reported cases, the need for inclusion of gastric schwannomas to the differential diagnosis of a bleeding gastric mass is essential. From these figures the likelihood of a patient with a gastric mass and upper gastrointestinal bleeding being caused by a gastric schwannoma is 0.026%. This points to the fact that this patient presentation is extremely rare but that gastric schwannomas do occur and need to be on the differential diagnosis of a patient with a gastric mass and signs of upper gastrointestinal bleeding.
American Journal of Medical Case Reports. 2019, 7(3), 33-35. DOI: 10.12691/ajmcr-7-3-1
Pub. Date: March 04, 2019
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