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Volume 7, Issue 6

Rare Case of Rectal Mixed Adeno-Neuroendocrine Carcinoma
Case Report
Colorectal cancer is the third most common cancer in both men and women. Mixed adenoneuroendocrine carcinoma is a rare subtype of colorectal cancer defined as malignant neoplasms in which each component represents at least 30% of the lesion. It was named as Mixed adenoneuroendocrine carcinoma and described by the World Health Organization in 2010. Due to its morphological heterogeneity and the rarity of the condition, it becomes quite challenging to formulate an appropriate treatment plan. In this report, we present a case of 67-year-old man found to have a rectal mixed adenoneuroendocrine carcinoma. We discussed the current management strategies and provide a review of the literature.
American Journal of Medical Case Reports. 2019, 7(6), 117-120. DOI: 10.12691/ajmcr-7-6-5
Pub. Date: June 12, 2019
9022 Views1816 Downloads2 Likes
A Case of Takotsubo Cardiomyopathy Complicated with Life Threatening Arrhythmia and Cardiogenic Shock
Case Report
Stress (Takotsubo) cardiomyopathy (CM) is defined as a transient regional systolic dysfunction of the left ventricle that mimics acute coronary syndrome (ACS) in the absence of significant coronary artery disease or plaque rupture. This phenomenon commonly occurs in postmenopausal females in the presence of emotional, physical and psychological stressors with excess catecholamine stimulation, resulting in diffuse microvascular spasm and subsequently myocardial stunning. Here we report a 58-year-old postmenopausal female patient with end stage renal disease (ESRD) who was presented to our hospital with a clinical picture suggesting ACS. Shortly after admission she progressed to cardiogenic shock and pulseless electrical activity (PEA) and was diagnosed retrospectively with Takotsubo cardiomyopathy. She was successfully treated with beta-blockers, IV fluids and inotropic agents. Intra-aortic balloon pump (IABP) was considered, however, the patient gradually improved to full recovery with resolution of left ventricular function back to normal.
American Journal of Medical Case Reports. 2019, 7(6), 109-116. DOI: 10.12691/ajmcr-7-6-4
Pub. Date: June 11, 2019
12900 Views1750 Downloads3 Likes
Spermogram and Male Fertility: Hospital Experience in Military Avicenna of Marrakech
Original Research
Male fertility is known in the last twenty years. Thus, the 1/3 of the infertility of the couple would be male. The spermogram is an essential tool in the strategy of exploration of infertility in humans. The present study will focus exclusively on the place of occupation spermogram in the appearance of the infertile couple. We wrote this retrospective study spread over 10 results of 929 spermograms performed at the Avicenne Military Hospital in Marrakesh, spermogram volume in ml, pH, sperm count / ml, spermatozoa vitality, total mobility, progressive mobility and morphology. Of the 929 sperm samples, 35% on the normal values and 65% on the normal to less than normal values on the basic parameters, from 65% to today. Found in 5.4% of cases, asthenospermia in 46% of cases, oligospermia in 24.5% and revelation teratospermia in 21.9% of cases. After our study, we are confronted like other countries, the problem of male infertility. The spermogram is the essential exam for the exploration of the male side in an infertile couple to make diagnoses, but also the doctor treating additional examinations.
American Journal of Medical Case Reports. 2019, 7(6), 104-108. DOI: 10.12691/ajmcr-7-6-3
Pub. Date: June 08, 2019
7342 Views1559 Downloads2 Likes
Complete Neurological Recovery after Severe Accidental Hypothermia: Two Cases and a Novel Algorithm Proposal
Case Report
Primary accidental hypothermia results from endogenous thermoregulatory mechanisms being overwhelmed by environmental stressors. Vulnerable populations include the elderly, mentally ill, homeless, and chemically dependent. When core temperatures fall below 35°C, the resulting metabolic derangements provoke cardiopulmonary compromise and dysrhythmia. Due to the human body’s innate protective mechanisms there are reports of patients making complete neurologic recovery after exposure to extreme temperatures and prolonged cardiopulmonary arrest. We describe two cases from our institution demonstrating appropriate treatment methods for the two most severe stages of hypothermia. A 57-year-old male with a core temperature of 27°C who was successfully resuscitated with warm bladder and thoracic lavage and a 34-year-old female with a core temperature of 22°C that fully recovered after 5 hours of external cardiopulmonary bypass. From our experience and a review of the literature, we have developed a modified version of the Swiss staging model and incorporated it into a novel treatment algorithm for in-hospital adult accidental hypothermia patients presenting to urban community hospitals. The two example cases described highlight how appropriate utilization of this novel algorithm can lead to positive outcomes in otherwise critical clinical scenarios.
American Journal of Medical Case Reports. 2019, 7(6), 100-103. DOI: 10.12691/ajmcr-7-6-2
Pub. Date: June 04, 2019
8343 Views1692 Downloads2 Likes
A Very Rare Case of Esophagitis Due to Nivolumab Immunotherapy
Case Report
A 72-year-old woman with Renal Cell Carcinoma, on Nivolumab therapy for extensive metastatic disease, presented with dysphagia. Endoscopy revealed Grade 2 esophagitis with biopsy confirming active esophagitis. There was no histological evidence of an infectious or lymphoproliferative etiology. Nivolumab-induced esophagitis was suspected, and the medication was discontinued. There was dramatic clinical improvement with steroids. Immune checkpoint inhibitors are novel immunotherapeutic agents designed to restore the patient¡¯s own antitumor immune responses. Nivolumab, an IgG4 monoclonal antibody that acts as an inhibitor of programmed death-1, is currently approved for clinical use in treatment of advanced stage malignancies. As Nivolumab is increasingly used in clinical oncology due to its efficacy and better tolerance compared to other chemotherapeutic agents, we present the second reported case of Nivolumab-associated esophagitis. Pathologists and clinicians should be aware of this possible complication to ensure its timely diagnosis and management.
American Journal of Medical Case Reports. 2019, 7(6), 97-99. DOI: 10.12691/ajmcr-7-6-1
Pub. Date: June 01, 2019
7566 Views1529 Downloads2 Likes