Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography: A case report

paythelady.612 shared this article with you from Inoreader Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1661-1667. doi: 10.12998/wjcc.v9.i7.1661. ABSTRACT BACKGROUND: Primary retroperitoneal liposarcoma (PRPLS) is a rare soft tissue tumor with nonspecific clinical symptoms; it has different computed tomography (CT) image features according to pathological types. Some patients with a single tumor have been previously reported in the literature. We present an exceptional case of a PRPLS patient with multiple large tumors exhibiting different patterns of appearance on CT and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. CASE SUMMARY: A 64-year-old man presented with abdominal distension for 1 year. The patient was diagnosed with PRPLS based on physical examination, laparotomy, ultrasonography, CT scan, and surgery. Both of the tumors were completely resected through surgery and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. The postoperative course was uneventful without recurrence or metastasis, as demonstrated by abdominal-pelvic CT during an 18 mo follow-up. CONCLUSION: Multiple large Well-differentiated liposarcomas with different patterns of appearance on CT image can occur simultaneously in the same patient, to which more attention should be paid to make an effective differential diagnosis. PMID:33728310 | PMC:PMC7942046 | DOI:10.12998/wjcc.v9.i7.1661 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dynamic monitoring of serum liver function indexes in patients with COVID-19

paythelady.612 shared this article with you from Inoreader Dynamic monitoring of serum liver function indexes in patients with COVID-19 Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1554-1562. doi: 10.12998/wjcc.v9.i7.1554. ABSTRACT BACKGROUND: Some patients with the novel 2019 coronavirus disease (COVID-19) display elevated liver enzymes. Some antiviral drugs that can be used against COVID-19 are associated with a risk of hepatotoxicity. AIM: To analyze the clinical significance of the dynamic monitoring of the liver function of patients with COVID-19. METHODS: This was a retrospective study of patients diagnosed with COVID-19 in January and February 2020 at the Department of Infection, Shantou Central Hospital. The exclusion criteria for all patients were: (1) History of chronic liver disease; (2) History of kidney disease; (3) History of coronary heart disease; (4) History of malignancy; or (5) History of diabetes. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase, and total bilirubin of patients with COVI D-19 were measured on days 1, 3, 7 and 14 after admission, and compared to non-COVID-19 patents. RESULTS: Twelve patients with COVID-19 (seven men and five women) and twelve controls (eight men and four women) were included. There were one, two, and nine patients with severe, mild, and moderate COVID-19, respectively. There were no differences in age and sex between the two groups (both P > 0.05). No significant differences were found in albumin, ALT, AST, γ-glutamyltransferase, or total bilirubin between the controls and the patients with COVID-19 on day 1 of hospitalization (all P > 0.05). Serum albumin showed a decreasing trend from days 0 to 7 of hospitalization, reaching the lowest level on day 7. Total bilirubin was higher on day 3 than on day 7. ALT, AST, and γ-glutamyltransferase did not change significantly over time. The severe patient was observed to have ALT levels of 67 U/L and AST levels of 75 U/L on day 7, ALT of 71 U/L and AST of 35 U/L on day 14, and ALT of 210 U/L and AST of 123 U/L on day 21. CONCLUSION: Changes in serum liver function indicators are not obvious in the early stage of COVID-19, but clinically significant changes might be observed in severe COVID-19. PMID:33728299 | PMC:PMC7942056 | DOI:10.12998/wjcc.v9.i7.1554 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcomatoid carcinoma of the prostate with bladder invasion shortly after androgen deprivation: Two case reports

paythelady.612 shared this article with you from Inoreader Sarcomatoid carcinoma of the prostate with bladder invasion shortly after androgen deprivation: Two case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1668-1675. doi: 10.12998/wjcc.v9.i7.1668. ABSTRACT BACKGROUND: To summarize the imaging, morphological and biological characteristics of sarcomatoid carcinoma (SC) of the prostate with bladder invasion not long after castration. CASE SUMMARY: Our two cases were initially diagnosed with adenocarcinoma of the prostate due to dysuria. However, prostate SC was diagnosed after transurethral resection of the prostate (TURP) and castration after only 5 and 10 mo, respectively. Distinctive liver-like tissues appeared in the second TURP procedure in case 1, while a white, fish flesh-like, narrow pedicled soft globe protruded from the prostate to the bladder in case 2. CONCLUSION: The sarcomatoid component of SC may arise from one of the specific groups of cancer cells that are resistant to hormonal therapy. Morphological characteristics of SCs can present as "red hepatization" and "fish flesh". SC s grow rapidly and have a poor prognosis, and thus, extensive TURP plus radiation may be the treatment of choice. PMID:33728311 | PMC:PMC7942028 | DOI:10.12998/wjcc.v9.i7.1668 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Short-term outcomes of radiofrequency ablation for hepatocellular carcinoma using cone-beam computed tomography for planning and image guidance

paythelady.612 shared this article with you from Inoreader Short-term outcomes of radiofrequency ablation for hepatocellular carcinoma using cone-beam computed tomography for planning and image guidance Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1580-1591. doi: 10.12998/wjcc.v9.i7.1580. ABSTRACT BACKGROUND: Percutaneous radiofrequency ablation (RFA) is an effective treatment for unresectable hepatocellular carcinoma (HCC) and a minimally invasive alternative to hepatectomy for treating tumour recurrence. RFA is often performed using contrast-enhanced computed tomography (CECT) and/or ultrasonography. In recent years, angiographic systems with flat panel image detectors and advanced image reconstruction algorithms have broadened the clinical applications of cone-beam computed tomography (CBCT), including RFA. Several studies have shown the effectiveness of using CBCT for immediate treatment assessments and follow-ups. AIM: To assess the treatment response to RFA for HCC using CBCT. METHODS: Forty-eight patients (44 men; aged 37-89 years) with solitary HCC [median size: 3.2 (1.2-6.6) cm] underwent RFA and were followed for 25.6 (me dian; 13.5-35.2) mo. Image fusion of CBCT and pre-operative CECT or magnetic resonance imaging (MRI) was used for tumour segmentation and needle path and ablation zone planning. Real-time image guidance was provided by overlaying the three-dimensional image of the tumour and needle path on the fluoroscopy image. Treatment response was categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Disease progression, death, time to progression (TTP), and overall survival (OS) were recorded. Kaplan-Meier and Cox regression analyses were performed. RESULTS: Initial post-RFA CECT/MRI showed 38 cases of CR (79.2%), 10 of PR (20.8%), 0 of SD, and 0 of PD, which strongly correlated with the planning estimation (42 CR, 87.5%; 6 PR, 12.5%; 0 SD; and 0 PD; accuracy: 91.7%, P < 0.01). Ten (20.8%) patients died, and disease progression occurred in 31 (35.4%, median TTP: 12.8 mo) patients, resulting in 12-, 24-, and 35-mo OS rates of 100%, 81.2%, and 72.2%, respectively, and progression-free survival (PFS) rates of 54.2%, 37.1%, and 37.1%, respectively. The median dose-area product of the procedures was 79.05 Gy*cm2 (range 40.95-146.24 Gy*cm2), and the median effective dose was 10.27 mSv (range 5.32-19.01 mSv). Tumour size < 2 cm (P = 0.008) was a significant factor for OS, while age (P = 0.001), tumour size < 2 cm (P < 0.001), tumour stage (P = 0.010), and initial treatment response (P = 0.003) were significant factors for PFS. CONCLUSION: Reliable RFA treatment planning and satisfactory outcomes can be achieved with CBCT. PMID:33728301 | PMC:PMC7942052 | DOI:10.12998/wjcc.v9.i7.1580 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metastatic thymic-enteric adenocarcinoma responding to chemoradiation plus anti-angiogenic therapy: A case report

paythelady.612 shared this article with you from Inoreader Metastatic thymic-enteric adenocarcinoma responding to chemoradiation plus anti-angiogenic therapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1676-1681. doi: 10.12998/wjcc.v9.i7.1676. ABSTRACT BACKGROUND: Thymic-enteric adenocarcinoma with positive expression of CDX2 and CK20 is rare in adults, with only 16 reported cases. However, standard treatment options for this type of thymic adenocarcinoma has not yet been established. Therefore, we report a case of stage IV thymic-enteric adenocarcinoma treated with radiotherapy, chemotherapy, and anti-angiogenesis therapy. CASE SUMMARY: We report a case of thymic-enteric adenocarcinoma occurring in a 44-year-old woman. The tumor was considered unresectable owing to its invasiveness. The patient was treated with six cycles of oxaliplatin (130 mg/m2, day 1) and capecitabine (1000 mg/m2 BID, days 1-14). During the first three cycles of chemotherapy, concurrent radiotherapy (60 Gy/30 fractions) and anti-angiogenic therapy using apatinib were recommended. The primary tumor a chieved partial remission based on the Response Evaluation Criteria in Solid Tumors. During follow-up, there was no evidence of disease relapse, except a high serum CA19-9 level. The patient is alive and regularly followed. Based on the previous literature and the present case, we believe that early diagnosis of thymic-enteric adenocarcinoma is important. CONCLUSION: XELOX (capecitabine plus oxaliplatin) combined with radiotherapy is an optional therapy for inoperable thymic-enteric adenocarcinoma. PMID:33728312 | PMC:PMC7942030 | DOI:10.12998/wjcc.v9.i7.1676 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Study on pathogenic genes of dwarfism disease by next-generation sequencing

paythelady.612 shared this article with you from Inoreader Study on pathogenic genes of dwarfism disease by next-generation sequencing Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1600-1609. doi: 10.12998/wjcc.v9.i7.1600. ABSTRACT BACKGROUND: There are many factors that lead to dwarfism, and the mechanism has not yet been elucidated. Next-generation sequencing may identify candidate-related gene mutations, which may clarify the molecular cause. AIM: To analyze genetic variation by using a constructed panel related to dwarfism by utilizing next-generation sequencing platform sequencing analysis to screen candidate-related gene mutations. METHODS: Physical and laboratory characteristics, including clinical examination, growth hormone drug challenge test, serum insulin-like growth factor-1 (IGF-1), IGF binding protein 3, other related tests, imaging examination, and chromosome karyotyping, were analyzed. Next-generation sequencing was performed to analyze pathogenicity variability. RESULTS: In the 39 dwarfism patients, 10 had pathogenicity variability. Gene vari ation was found in the OBSL1, SLC26A2, PTPN11, COL27AI, HDAC6, CUL7, FGFR3, DYNC2H1, GH1, and ATP7B genes. Of the 10 patients with pathogenicity variability, the related physical characteristics included double breast development and growth hormone deficiency, enuresis and indirect inguinal hernia on the left, two finger distance of 70.2 cm, head circumference of 49.2 cm, ischium/lower body length of 1.8 cm, weak limb muscles, and partial growth hormone deficiency. After 6 mo of growth hormone therapy, the concentrations of IGF-1 and IGF binding protein 3 increased from 215.2 ± 170.3 to 285.0 ± 166.0 and 3.9 ± 1.4 to 4.2 ± 1.1, respectively. CONCLUSION: OBSL1, SLC26A2, PTPN11, COL27AI, HDAC6, CUL7, FGFR3, DYNC2H1, GH1, and ATP7B genes may be related to the incidence of dwarfism, and more research needs to be performed to elucidate the mechanism. PMID:33728303 | PMC:PMC7942040 | DOI:10.12998/wjcc.v9.i7.1600 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Solid pseudopapillary neoplasm-diagnostic approach and post-surgical follow up: Three case reports and review of literature

paythelady.612 shared this article with you from Inoreader Solid pseudopapillary neoplasm-diagnostic approach and post-surgical follow up: Three case reports and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1682-1695. doi: 10.12998/wjcc.v9.i7.1682. ABSTRACT BACKGROUND: Solid pseudopapillary neoplasm (SPN) is a rare tumor that was first described by Frantz in 1959. Although this tumor is benign, some may have malignant potential that can be predicted based on demographics, imaging characteristics, and pathologic evaluation. This case series presents 3 SPN cases with discussion on gender differences, preoperative predictors of malignancy, and a suggested algorithm for diagnostic approach as well as post-surgical follow up. CASE SUMMARY: Three adult patients in a tertiary hospital found to have SPN, one elderly male and two young females. Each of the cases presented with abdominal pain and were discovered incidentally. Two cases underwent endoscopic ultrasound with fine needle aspiration and biopsy to assess tumor markers and immuno-histochemical staining (which were consistent with SPN before underg oing surgery), and one case underwent surgery directly after imaging. The average tumor size was 5 cm. Diagnosis was confirmed by histology. Two patients had post-surgical complications requiring intervention. CONCLUSION: Demographic and imaging characteristics can be sufficient to establish diagnosis for SPN, while malignant cases require pre-operative evaluation with endoscopic ultrasound fine needle aspiration/fine needle biopsy. PMID:33728313 | PMC:PMC7942041 | DOI:10.12998/wjcc.v9.i7.1682 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B

paythelady.612 shared this article with you from Inoreader Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1619-1630. doi: 10.12998/wjcc.v9.i7.1619. ABSTRACT BACKGROUND: Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection. However, up to now, there are few studies about 4-1BB in chronic hepatitis B (CHB). AIM: To clarify this issue, we report our comprehensive study results on the expression levels of 4-1BB in patients with CHB. METHODS: From September 2018 to June 2019, a total of 64 patients with CHB were recruited from the Department of Hepatology, The First Hospital of Jilin University. Peripheral blood samples were collected from 52 treatment-naïve and 12 entecavir-treated patients with CHB as well as 37 healthy donors (including 24 healthy adults and 13 healthy children). The levels of soluble 4-1BB (s4-1BB) in plasma were measured by ELISA. 4-1BB mRNA expression in peripheral blood mononuclear c ells was detected by real-time quantitative PCR. RESULTS: The s4-1BB levels in the plasma of patients with CHB were significantly higher than those in healthy adults (94.390 ± 7.393 ng/mL vs 8.875 ± 0.914 ng/mL, P < 0.001). In addition, the s4-1BB level in plasma was significantly increased in patients with a higher viral load and a disease flare up. However, there were no significant differences between treatment-naïve and entecavir-treated patients. Interestingly, among treatment-naïve patients with CHB, the levels of s4-1BB in plasma had a significant positive correlation with hepatitis B surface antigen, hepatitis B virus DNA, hepatitis B e antigen, and triglyceride levels (r = 0.748, P < 0.001; r = 0.406, P = 0.004; r = 0.356, P = 0.019 and r = -0.469, P = 0.007, respectively). The 4-1BB mRNA expression was higher in the peripheral blood mononuclear cells of patients with CHB than in the perip heral blood mononuclear cells of healthy adults, but the difference was not statistically significant. CONCLUSION: These results suggest that the levels of s4-1BB may be associated with pathogenesis of hepatitis B virus and therefore may be a promising biomarker for disease progression. PMID:33728305 | PMC:PMC7942032 | DOI:10.12998/wjcc.v9.i7.1619 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vancomycin-induced thrombocytopenia in endocarditis: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Vancomycin-induced thrombocytopenia in endocarditis: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1696-1704. doi: 10.12998/wjcc.v9.i7.1696. ABSTRACT BACKGROUND: Thrombocytopenia is a serious complication in the medical practice of numerous drugs. Vancomycin is frequently used for the prophylaxis and treatment of suspected or identified methicillin-resistant positive infections. Several cases with vancomycin-induced thrombocytopenia (VIT) have been reported. However, these have rarely been extensively reviewed. The present report describes a case of VIT in endocarditis, and reviews all VIT cases reported in the literature. CASE SUMMARY: A 26-year-old male diagnosed with infective endocarditis was admitted. The patient was treated with multiple drugs, including vancomycin, which was initially intravenously given at 1000 mg every 12 h and subsequently at 500 mg every 8 h on day 3. On day 11, the platelet count decreased to 51 × 109/L, vancomycin was switched to 500 mg every 12 h, a nd platelet transfusion was given. On day 17, the platelet count dropped to 27 × 109/L, and platelet transfusion was administered again. On day 23, vancomycin was adjusted to 500 mg every 8 h as the trough concentration dropped to the minimum effective concentration. On day 33, the platelet count declined to approximately 40 × 109/L. After platelet transfusion, the platelet count rebounded to 90 × 109/L on day 35 but dropped again to 42 × 109/L on day 43. Based on the time-to-platelet count curve and Naranjo's Adverse Drug Reaction Probability Scale score, VIT was suspected. After vancomycin discontinuation and platelet transfusion, the platelet count gradually normalized. CONCLUSION: The diagnosis of VIT can be achieved through the time-to-platelet count curve and Naranjo's Adverse Drug Reaction Probability Scale score. The platelet count cannot be normalized simply by platelet transfusion alone, and vancomycin discontinuation i s essential. PMID:33728314 | PMC:PMC7942037 | DOI:10.12998/wjcc.v9.i7.1696 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dysphagia in a patient with ankylosing spondylitis: A case report

paythelady.612 shared this article with you from Inoreader Dysphagia in a patient with ankylosing spondylitis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1639-1645. doi: 10.12998/wjcc.v9.i7.1639. ABSTRACT BACKGROUND: Ankylosing spondylitis (AS) is a systematic and rheumatic disease, which causes multiple symptoms. However, dysphagia due to the formation of a giant anterior cervical osteophyte is rare in patients with AS. CASE SUMMARY: We present the case of a 65-year-old male patient who was diagnosed with AS and visited the hospital with a complaint of progressive dysphagia. The appropriate imaging examinations indicated that a giant anterior cervical osteo-phyte at C3-4 caused esophageal compression, which led to dysphagia. An operation for resection was performed without complications. CONCLUSION: This case demonstrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS, and early accurate diagnosis and surgical treat-ment are very important for the improvement of symptoms. Anterior cervical discectomy an d fusion are extremely effective and should be taken into consideration. PMID:33728307 | PMC:PMC7942043 | DOI:10.12998/wjcc.v9.i7.1639 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.