Clinics and Practice

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Open AccessCase Report

Chemical Facial Cellulitis due to Inadvertent Injection of Formalin into Oral Tissue Space

by Aditi Bector, Pawandeep Sandhu Virk and Gururaj Arakeri

Clin. Pract. 2015, 5(4), 810; https://doi.org/10.4081/cp.2015.810 - 30 Dec 2015

Cited by 4 | Viewed by 483

This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to [...] Read more.

This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to prevent such unfortunate incidents. Full article

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Open AccessCase Report

Concomitant Posterior Hip Dislocation, Ipsilateral Intertrochanteric- and Proximal Tibial- Fractures with Poplitea Artery Injury: A Challenging Trauma Mélange

by Pranit N. Chotai, Nabil A. Ebraheim, Ryan Hart and Andrew Wassef

Clin. Pract. 2015, 5(4), 776; https://doi.org/10.4081/cp.2015.776 - 30 Dec 2015

Cited by 4 | Viewed by 481

Abstract

Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury [...] Read more.

Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome. Full article

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Open AccessCase Report

A Rare Case of Intratonsillar Abscess in an Adult

by Gautam Bir Singh, Deepak Kumar, Rubeena Arora, Sunil Garg and Shruti Ranjan

Clin. Pract. 2015, 5(4), 804; https://doi.org/10.4081/cp.2015.804 - 29 Dec 2015

Cited by 6 | Viewed by 812

Abstract

A rare case of intratonsillar abscess is presented in a 25-year old healthy adult male, where the clinical presentation was found to be unique hitherto unreported in the medical literature. The clinical record also highlights the importance of incision and drainage in the [...] Read more.

A rare case of intratonsillar abscess is presented in a 25-year old healthy adult male, where the clinical presentation was found to be unique hitherto unreported in the medical literature. The clinical record also highlights the importance of incision and drainage in the management of such cases. With this case, we illustrate a rare entity that present in an extremely rare manner. Full article

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Open AccessCase Report

Giant Dural Supratentorial Chondroma Generating the Question of How Large Can a Tumor Become without Revealing Itself

by Alexandros Doukas, Annamarie Tallo, Richard Parvin, Volkmar Hans, Pooya Daemi, Azad Cheko, Martin Scholz and Athanasios K. Petridis

Clin. Pract. 2015, 5(4), 777; https://doi.org/10.4081/cp.2015.777 - 29 Dec 2015

Cited by 4 | Viewed by 501

Abstract

Chondromas usually affect the small bones of hand and feet and account for only 0.5% of all intracranial tumors. We present a case of a giant, supratentorial meningeal chondroma in a 19-year old male patient and discuss the preoperative diagnostic findings as well [...] Read more.

Chondromas usually affect the small bones of hand and feet and account for only 0.5% of all intracranial tumors. We present a case of a giant, supratentorial meningeal chondroma in a 19-year old male patient and discuss the preoperative diagnostic findings as well as the appropriate treatment options. A 19-old male presented with headache, new onset of focal seizures and paresis of left upper extremity. Magnetic resonance imaging revealed a large right parietal tumor in the precentral region with local mass effect. The patient underwent right parietal craniotomy and gross total resection of the tumor. The histopathological report revealed a chondroma. Intradural supratentorial chondromas are extremely rare. As with other slow growing intracranial masses, they often reach a relatively large size before generating symptoms. Maximal surgical resection is the treatment of choice and if this is achieved no adjuvant therapy is necessary. Full article

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Open AccessCase Report

A Case of Maxillary Bone Metastasis from Lung Cancer

by Takeshi Kusunoki, Hirotomo Homma, Yoshinobu Kidokoro, Aya Yanai, Katsuhisa Ikeda and Ryo Wada

Clin. Pract. 2015, 5(4), 819; https://doi.org/10.4081/cp.2015.819 - 28 Dec 2015

Cited by 1 | Viewed by 414

Abstract

We experienced a very rare case of maxillary bone metastasis from lung cancer. The patient was a 77-year-old Japanese man with 1-month history of right alar swelling with hard pain as his chief complaint. Computed tomography scan showed a 1 cm length round [...] Read more.

We experienced a very rare case of maxillary bone metastasis from lung cancer. The patient was a 77-year-old Japanese man with 1-month history of right alar swelling with hard pain as his chief complaint. Computed tomography scan showed a 1 cm length round lesion in the right nasal vestibule close to the pyriform fossa edge of the right maxillary bone. He had severe pulmonary dysfunction due to recurrent end stage lung cancer and diabetes. The expected remainder of his life would be half a year. Therefore, his very poor condition precluded general anesthesia. To relieve the nasal pain, shorten the stay in the hospital and improve the quality of life (QOL), we performed minimally invasive surgery under local anesthesia. Our minimally invasive surgery could improve QOL by relieving the hard nasal pain until the recurrence of cancer and enable the patient to live at home. Full article

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Open AccessCase Report

Enlarging Pancreatic Schwannoma: A Case Report and Review of the Literature

by Narjust Duma, Daniel C. Ramirez, Gloria Young, George Nikias, Martin Karpeh and Zubin M. Bamboat

Clin. Pract. 2015, 5(4), 793; https://doi.org/10.4081/cp.2015.793 - 28 Dec 2015

Cited by 15 | Viewed by 473

Abstract

A 72-year-old female presented with dyspepsia for 2 years and an incidental mass in the head of the pancreas on abdominal computed tomography (CT) scan. Patient had multiple negative endoscopic ultrasound guided biopsies. She was followed up for 3 years with serial imaging [...] Read more.

A 72-year-old female presented with dyspepsia for 2 years and an incidental mass in the head of the pancreas on abdominal computed tomography (CT) scan. Patient had multiple negative endoscopic ultrasound guided biopsies. She was followed up for 3 years with serial imaging until an abdominal CT scan showed an increase in size of the pancreatic mass. Physical examination was unremarkable. Laboratory tests including tumor markers were normal. Given the enlarging size of the mass and its impingement on the portal vein, the consensus was to proceed with surgery. Histology revealed a 3.5 cm mass showing a spindle cell neoplasm with mild atypia. The lesion was well defined and nerve tissue was noted at the periphery. On immuno-stains, the spindle cells were positive for S-100 protein and negative for pan-cytokeratin, CD-34, CD- 117, smooth muscle actin and Melan A, consistent with the diagnosis of a pancreatic schwannoma. Full article

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Open AccessCase Report

Primary Vaginal Non-Hodgkin’s Lymphoma: Report of a Rare Clinical Entity

by Vera Silva, Paulo Correia, Nuno Oliveira and Luís Sá

Clin. Pract. 2015, 5(4), 821; https://doi.org/10.4081/cp.2015.821 - 22 Dec 2015

Cited by 6 | Viewed by 443

Abstract

A 52-year-old woman was referred to the gynecology outpatient clinic with a 2 months history of vaginal bleeding with intercourse, and no other symptoms. Vaginal examination revealed a firm, non-tender, mass in the posterior vaginal wall. The initial clinical impression was that of [...] Read more.

A 52-year-old woman was referred to the gynecology outpatient clinic with a 2 months history of vaginal bleeding with intercourse, and no other symptoms. Vaginal examination revealed a firm, non-tender, mass in the posterior vaginal wall. The initial clinical impression was that of a vaginal carcinoma and a biopsy under local anesthesia was performed, but the result was inconclusive. A deeper biopsy, under general anesthesia, was performed and a histological diagnosis of non-Hodgkin’s lymphoma was done. The staging workup permitted to exclude any other site of the body affected by the malignancy. Hematologists reviewed the patient and recommended chemotherapy. A complete tumor regression was observed and the patient has now a disease-free survival of 72 months. This case report intends to create awareness of this rare clinical entity. Although the gynecologist will rarely be faced to extranodal lymphoma, it should be included in the differential diagnosis of gynecologic malignancies. Full article

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Open AccessCase Report

A Case of Laryngeal Cancer Associated with Dermatomyositis

by Takeshi Kusunoki, Hirotomo Homma, Yoshinobu Kidokoro, Aya Yanai, Katsuhisa Ikeda and Ryo Wada

Clin. Pract. 2015, 5(4), 818; https://doi.org/10.4081/cp.2015.818 - 22 Dec 2015

Cited by 2 | Viewed by 388

Abstract

We experienced a rare case of laryngeal cancer associated with dermatomyositis. The patient was a 63-year-old male and Japanese. He was admitted to our department of Otorhinolaryngology with dysphagia for a day as a chief complaint. He became aware of hoarseness with bloody [...] Read more.

We experienced a rare case of laryngeal cancer associated with dermatomyositis. The patient was a 63-year-old male and Japanese. He was admitted to our department of Otorhinolaryngology with dysphagia for a day as a chief complaint. He became aware of hoarseness with bloody sputum and then face edema with redness a half year before. At first physical examination, he had bilateral eyelid edema with erythema, finger edema with keratinizing erythema and limb extensor erythema. Serous creatine phosphokinase was 850 IU/mL (normal range: 40-200 IU/mL). Later, he was referred to the rheumatology department and was diagnosed as having dermatomyositis. Fiberscopic examination revealed laryngeal cancer with left laryngeal palsy. We gave priority to the laryngeal treatment. As a result, the symptoms of dermatomyositis were improved. Full article

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Open AccessCase Report

Large Epiphrenic Diverticula: A Rare Case Presentation

by Ajay H. Bhandarwar, Pravin N. Tungenwar, Yogesh M. Sawakare, Amol Nanasaheb Wagh, Chintan Babubhai Patel and Saurabh S. Gandhi

Clin. Pract. 2015, 5(4), 784; https://doi.org/10.4081/cp.2015.784 - 20 Nov 2015

Cited by 4 | Viewed by 589

Abstract

A 70-year old female was admitted to hospital with heartburn and chronic halitosis since 5 years. She was on proton pump inhibitors for the same. Her complaints worsened during the last one-year. Workup comprising of esophagogastro- duodenoscopy, esophageal manometry, 3D computed tomography scan [...] Read more.

A 70-year old female was admitted to hospital with heartburn and chronic halitosis since 5 years. She was on proton pump inhibitors for the same. Her complaints worsened during the last one-year. Workup comprising of esophagogastro- duodenoscopy, esophageal manometry, 3D computed tomography scan showed rightsided epiphrenic diverticula measuring 10x10 cm with wide mouth about 5 cm with hypertensive lower esophageal sphincter. Patient underwent a video assisted thoracoscopic surgery for esophageal diverticulectomy using two 45 mm staplers. On day 5, the patient developed leak, which was managed by a covered esophageal stent placement. Patient started on oral feeds from day 3 and the esophageal leak healed completely within 2 weeks. Literature suggests that esophageal leaks treated conservatively took approximately 30-40 days on an average for healing. Literature search did not reveal esophageal leak managed by stent with faster recovery (2 weeks). This is one of the largest epiphrenic diverticuli reported in literature. Full article

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Open AccessCase Report

Rehabilitation of a Patient Receiving a Large-Resection Hip Prosthesis Because of a Phosphaturic Mesenchymal Tumor

by Maurizio Lopresti, Primo Andrea Daolio, Jacopo M. Rancati, Nicoletta Ligabue, Arnaldo Andreolli and Lorenzo Panella

Clin. Pract. 2015, 5(4), 814; https://doi.org/10.4081/cp.2015.814 - 5 Nov 2015

Cited by 7 | Viewed by 558

Abstract

Tumor-induced osteomalacia is an osteomalacic syndrome caused by a mesenchymal origin’s tumor. The diagnostic procedure takes time and extensive investigations because of the characteristics of these tumors usually small dimensioned, slowly growing, non-invasive and therefore hard to locate. The differential diagnosis is determined [...] Read more.

Tumor-induced osteomalacia is an osteomalacic syndrome caused by a mesenchymal origin’s tumor. The diagnostic procedure takes time and extensive investigations because of the characteristics of these tumors usually small dimensioned, slowly growing, non-invasive and therefore hard to locate. The differential diagnosis is determined by a bone biopsy. Tumor’s surgical removal is the treatment of choice that leads up to a complete regression of the oncogenic malacic syndrome. In the clinical course of these patients we can often see multiple episodes of pathological fractures, peri-prosthesis fractures or prosthesis mobilizations, due to the malacic picture: surgical procedures are often widely demolitive and requires mega-prosthetic implant. The rehabilitative procedure used to take care of these patients, is described in the following case report and based on the collaboration between surgical and rehabilitative teams. Rehabili - tative pathway after hip mega-prosthesis does not find references in medical literature: the outcomes analyzed in this case report demonstrate the efficacy of the rehabilitative procedure applied. Full article

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Open AccessCase Report

A Family of Congenital Hepatic Fibrosis and Atypical Retinitis Pigmentosa

by Sunil Pawar, Vinay Zanwar, Ashok Mohite, Ravindra Surude, Pravin Rathi and Meenakshi Balasubramani

Clin. Pract. 2015, 5(4), 792; https://doi.org/10.4081/cp.2015.792 - 5 Nov 2015

Cited by 5 | Viewed by 496

Abstract

Congenital hepatic fibrosis is a rare cause of portal hypertension and esophageal varices in children. We report cases of siblings with biopsy proven congenital hepatic fibrosis and with atypical retinitis pigmentosa. They presented with repeated episodes of jaundice along with progressive decrease of [...] Read more.

Congenital hepatic fibrosis is a rare cause of portal hypertension and esophageal varices in children. We report cases of siblings with biopsy proven congenital hepatic fibrosis and with atypical retinitis pigmentosa. They presented with repeated episodes of jaundice along with progressive decrease of vision in night. They had hepatosplenomegaly and portal hypertension with esophageal varices. One of the siblings had a large regenerating nodule replacing the entire right lobe of the liver and other one developed repeated hematemesis. This constellation of diagnosis belongs to the ciliopathy group of disorders. The spectrum of ciliopathy disorders has been evolving, and it varies from mild to severe manifestations. Full article

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Clin. Pract., Volume 5, Issue 4 (November 2015) – 11 articles

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