Clinics and Practice

773 KiB

Open AccessCase Report

Clear Cell Myoepithelioma of Palate with Emphasis on Clinical and Histological Differential Diagnosis

by Bindu J. Nair, Velayudhannair Vivek, Trivandrum T. Sivakumar, Anna P. Joseph, Babyamma Raghavanpillai Varun and Vinod Mony

Clin. Pract. 2014, 4(1), 628; https://doi.org/10.4081/cp.2014.628 - 7 May 2014

Cited by 1 | Viewed by 554

Abstract

Myoepitheliomas account for less than 1% of all salivary gland tumors and mostly occur in the parotid gland and palate. A 58-year old male patient reported to the Outpatient Department of PMS College of Dental Science and Research (Kerala, India) with a slow [...] Read more.

Myoepitheliomas account for less than 1% of all salivary gland tumors and mostly occur in the parotid gland and palate. A 58-year old male patient reported to the Outpatient Department of PMS College of Dental Science and Research (Kerala, India) with a slow growing painless swelling on the palate for 4 years. Pleomorphic adenoma, basal cell adenoma, myoepithelioma, cyst adenoma, lipoma, neurofibroma, neurilemmoma and leiomyoma were considered. Histopathology revealed a thinly encapsulated tumor composed mainly of sheets of clear cells mixed with cells having eosinophilic cytoplasm. Histopathological differential diagnosis included pleomorphic adenoma, oncocytoma, oncocytic hyperplasia, sebaceous adenoma, malignant salivary gland neoplasms and metastatic lesions from kidney and thyroid. Myoepitheliomas mostly occur in the parotid gland and palatal region and various histological types of myoepithelioma are described. Myoepitheliomas of the palate are rare with clear cell variant even rarer. Full article

693 KiB

Open AccessCase Report

Acute Acalculous Cholecystitis in a Patient with Metastatic Renal Cell Carcinoma Treated with Sunitinib

by Leonardo Gomes da Fonseca, Romualdo Barroso-Sousa, Jorge Sabbaga and Paulo Marcelo Hoff

Clin. Pract. 2014, 4(1), 635; https://doi.org/10.4081/cp.2014.635 - 30 Apr 2014

Cited by 12 | Viewed by 476

Abstract

A 55-year old man was treated with sunitinib 50 mg/day for 4 weeks on and 2 weeks off, as a first-line therapy for metastatic renal cell carcinoma. During the fourth week of the first cycle, he was admitted to the Emergency Department with [...] Read more.

A 55-year old man was treated with sunitinib 50 mg/day for 4 weeks on and 2 weeks off, as a first-line therapy for metastatic renal cell carcinoma. During the fourth week of the first cycle, he was admitted to the Emergency Department with abdominal pain and vomiting. Acute acalculous cholecystitis was diagnosed. Sunitnib-associated cholecystitis is a rare adverse event previously reported in few cases. The mechanism behind this complication is not fully understood, although vascular endothelial dysfunction may play a role. The use of this drug is expanding in clinical oncology, and physicians should be aware of this life-threating adverse event. Full article

633 KiB

Open AccessCase Report

Pellagra: A Non-Eradicated Old Disease

by Savvoula Savvidou

Clin. Pract. 2014, 4(1), 637; https://doi.org/10.4081/cp.2014.637 - 28 Apr 2014

Cited by 21 | Viewed by 1778

Abstract

We report a case of a 50-year old homeless male who presented with pellagra and pellagrous encephalopathy. The characteristic - if not pathognomonic - skin lesions of pellagra support its diagnosis on solely clinical grounds. Clinicians should keep a high index of suspicion, [...] Read more.

We report a case of a 50-year old homeless male who presented with pellagra and pellagrous encephalopathy. The characteristic - if not pathognomonic - skin lesions of pellagra support its diagnosis on solely clinical grounds. Clinicians should keep a high index of suspicion, in certain patient groups, in order to early diagnose and cure this potentially fatal but treatable disease. Full article

556 KiB

Open AccessArticle

Gangrene of the Digits of the Right Lower Limb in a Patient with Homozygous Sickle Cell Disease and Ulcerative Colitis

by Angela E. Rankine-Mullings, Jennifer M. Knight-Madden, Marvin Reid and Trevor S. Ferguson

Clin. Pract. 2014, 4(1), 610; https://doi.org/10.4081/cp.2014.610 - 3 Apr 2014

Cited by 5 | Viewed by 539

Abstract

Thrombosis may play an important role in the pathophysiology of certain complications of sickle cell disease (SCD). While the association between SCD and ulcerative colitis (UC) is still debatable, inflammatory bowel disease is known to be associated with an increased incidence of thromboembolic [...] Read more.

Thrombosis may play an important role in the pathophysiology of certain complications of sickle cell disease (SCD). While the association between SCD and ulcerative colitis (UC) is still debatable, inflammatory bowel disease is known to be associated with an increased incidence of thromboembolic disease. We report a case of a 16-year old girl known to have homozygous SCD and also diagnosed with UC who presented with digital ischemia of her right lower limb. This led to gangrene and subsequent amputation of the first, second and third digits of that limb. This case highlights that patients with both UC and SCD may have an increased risk of thromboembolism and raises the question as to whether patients with UC and SCD should be screened for thrombophilia. Full article

603 KiB

Open AccessCase Report

Assessment of Folic Acid and DNA Damage in Cleft Lip and Cleft Palate

by Sivakumar Brooklyin, Rashmoni Jana, Singaravelu Aravinthan, Bethou Adhisivam and Parkash Chand

Clin. Pract. 2014, 4(1), 608; https://doi.org/10.4081/cp.2014.608 - 31 Mar 2014

Cited by 3 | Viewed by 460

Abstract

Studies have identified the risk factors like folic acid deficiency during gestational period, family history for orofacial clefts, drugs like antiepileptic, vitamin A. But, the data regarding the folic acid status in children with cleft lip/palate is hardly evaluated in depth. Here, an [...] Read more.

Studies have identified the risk factors like folic acid deficiency during gestational period, family history for orofacial clefts, drugs like antiepileptic, vitamin A. But, the data regarding the folic acid status in children with cleft lip/palate is hardly evaluated in depth. Here, an assessment of folic acid and DNA damage were carried out in children with orofacial anomalies. Folic acid level and DNA damage were evaluated by folic acid assay (direct chemiluminescent technology) and single cell gel electrophoresis or comet assay method respectively. The mean value of plasma folic acid by direct chemiluminescent technology was 6.5±3.6 nmol/L and the normal value in children ranges from 11.3 to 47.6 nmol/L. The amount of damaged DNA, measured as the tail length of the comet in cases, was 19.4±8.9 ?m and the mean percentage of DNA in tail was 16.5±3.7. Folic acid deficiency could be the reason for DNA damage. Full article

730 KiB

Open AccessCase Report

Primary Adrenal Sarcomatoid Carcinoma

by Aftab S. Shaikh, Girish D. Bakhshi, Arshad S. Khan, Nilofar M. Jamadar, Aravind Kotresh Nirmala and Arif Ahmed Raza

Clin. Pract. 2014, 4(1), 604; https://doi.org/10.4081/cp.2014.604 - 31 Mar 2014

Cited by 9 | Viewed by 510

Abstract

Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case [...] Read more.

Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case of a 62-year old female with non-functional sarcomatoid carcinoma of the right adrenal gland. There was no radiological evidence of locoregional metastases. Patient underwent right adrenalectomy. Follow up after 3 months showed para-aortic lymphadenopathy and similar left adrenal mass on computed tomography. Patient refused further treatment and succumbed to the disease. A brief case report with review of literature is presented. Full article

586 KiB

Open AccessCase Report

Posterior Reversible Encephalopathy Syndrome Mimicking Cerebral Metastasis: Contraindication for Biopsy

by Dukagjin Morina, Georgios Ntoulias, Homajoun Maslehaty, Martin Scholz and Athanasios K. Petridis

Clin. Pract. 2014, 4(1), 632; https://doi.org/10.4081/cp.2014.632 - 27 Mar 2014

Cited by 4 | Viewed by 381

Abstract

The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient [...] Read more.

The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient was treated for breast cancer 10 months ago and because of acute disorientation a magnetic resonance imaging (MRI) was performed. In the MRI biparieto-occipital hyperintense lesions were seen. Brain metastases were suspected. After chemothe - rapy and hypertonia and the typical appearance of the lesions in the MRI, PRES was also suspected. Before initializing the surgery for an open biopsy a follow-up MRI had been performed (2 weeks after initial MRI). In follow-up MRI the lesions disappeared completely proving the diagnosis of PRES. PRES can be misdiagnosed as a tumour and surgery could be mistakenly performed. It’s important to keep the differential diagnosis of PRES in mind when radiologic features of the syndrome are present. Full article

555 KiB

Open AccessCase Report

The Inferior Frontal Gyrus and Cough

by Homajoun Maslehaty and Athanasios K. Petridis

Clin. Pract. 2014, 4(1), 609; https://doi.org/10.4081/cp.2014.609 - 27 Mar 2014

Viewed by 359

Abstract

We present a case of a patient with a tumor close to the right inferior frontal gyrus. The only symptom this patient had was a disturbing dry cough. After removal of the tumor the cough disappeared immediately. Review of the literature showed that [...] Read more.

We present a case of a patient with a tumor close to the right inferior frontal gyrus. The only symptom this patient had was a disturbing dry cough. After removal of the tumor the cough disappeared immediately. Review of the literature showed that there is a control center of voluntary cough in the right inferior frontal gyrus. Our case suggests that there might be such a center, which can be affected by a tumor close to it. Full article

599 KiB

Open AccessCase Report

A Case of Life-Threatening Obstetrical Hemorrhage Secondary to Placental Abruption at 17 Weeks of Gestation

by Toshihiko Kinoshita, Naoki Takeshita, Akiko Takashima, Yutaka Yasuda, Hiroaki Ishida and Megumi Manrai

Clin. Pract. 2014, 4(1), 605; https://doi.org/10.4081/cp.2014.605 - 27 Mar 2014

Cited by 6 | Viewed by 562

Abstract

A 40-year old woman, gravida 4, para 4, presented with sudden lower abdominal pain and severe vaginal bleeding at 17 weeks of gestation. Clinical symptoms and ultrasonographic finding revealed placental abruption. The volume of bleeding was heavy and led to disseminated intravascular coagulation [...] Read more.

A 40-year old woman, gravida 4, para 4, presented with sudden lower abdominal pain and severe vaginal bleeding at 17 weeks of gestation. Clinical symptoms and ultrasonographic finding revealed placental abruption. The volume of bleeding was heavy and led to disseminated intravascular coagulation and hypovolemic shock. We performed blood transfusion and therapy to treat the critical condition. However, the mother’s condition continued to worsen. Therefore, we performed a hysterotomy and aborted the pregnancy to save the mother. Since heavy bleeding caused by placental abruption leading to a life-threatening condition for a mother before the 20 weeks of gestation is very rare, the present case is an important case study. Full article

Journal Menu

Journal Browser

Clin. Pract., Volume 4, Issue 1 (March 2014) – 9 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI