Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3120-3129. doi: 10.12998/wjcc.v9.i13.3120. ABSTRACT BACKGROUND: We report a case of Intracardiac, pulmonary, and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone, which was successfully managed by conservative treatment. We describe the treatment and outcome of the patient, hoping to shed light on the management of bone cement embolism. CASE SUMMARY: A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years. She was diagnosed with L4 and L5 spondylolisthesis, spinal stenosis, and osteoporosis. The patient underwent spinal canal decompression, an interbody fusion of L4/5 and L5/S1, cement-augmented pedicle screw instrumentation in L4-L5 segments, and regular pedicle screw in S1 segments. Three days postoperatively, a sudden drop in oxygen saturation occurr ed. Computerized tomography scan confirmed Intracardiac, pulmonary, and intravenous embolism. The patient was treated conservatively by continuous low-flow oxygen inhalation, anti-coagulation, and antibiotic therapy for 1 mo and continued anticoagulation treatment for 6 mo. The patient showed no further symptoms in a 30-mo follow-up. CONCLUSION: Intracardiac, pulmonary cement embolism after cement-augmented pedicle screw instrumentation is extremely rare. Careful clinical and radiographic evaluation is required in multiple sites of bone cement embolism. Conservative treatment may be a primary consideration in scattered emboli without life-threatening conditions, but a clinical decision should be made on an individualized basis. PMID:33969099 | PMC:PMC8080748 | DOI:10.12998/wjcc.v9.i13.3120 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of positron emission tomography in primary carcinoma ex pleomorphic adenoma of the bronchus: A case report

paythelady.612 shared this article with you from Inoreader Role of positron emission tomography in primary carcinoma ex pleomorphic adenoma of the bronchus: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2811-2815. doi: 10.12998/wjcc.v9.i12.2811. ABSTRACT BACKGROUND: Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported. CASE SUMMARY: We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison, including age, clinical manifestations, and diagnostic process. This patient had no history of neoplasms of the salivary gland. CONCLUSION: Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma. Long-term follow-up was necessary for further prognosis analysis. PMID:33969063 | PMC:PMC8058676 | DOI:10.12998/wjcc.v9.i12.2811 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute urinary retention in the first and second-trimester of pregnancy: Three case reports

paythelady.612 shared this article with you from Inoreader Acute urinary retention in the first and second-trimester of pregnancy: Three case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3130-3139. doi: 10.12998/wjcc.v9.i13.3130. ABSTRACT BACKGROUND: Acute urinary retention (AUR) is rare during pregnancy. CASE SUMMARY: We report on three pregnant women with AUR between the 10th and 18th wk of gestation. Case 1 was first diagnosed as urinary tract infection and developed a urinary tract infection due to urinary retention caused by urethral obstruction. Case 2 had a history of previous abdominal surgery for pelvic tuberculosis, leading to severe adhesions and a persistent retroverted uterus. In case 3, healthcare providers focused on the patient's gastrointestinal symptoms and did not investigate her inability to void. Case 1 required manual disimpaction of the uterus and the knee-chest position. The other cases required immediate catheterization. The condition resolved in cases 1 and 2; these patients had normal pregnancies. Case 3 had severe complications at the time of consultation, leading to an abortion. CONCLUSION: Retroverted uterus is the most common cause of AUR. Prompt recognition and diagnosis are required. Clinicians should be aware of the risk factors, etiology, and clinical presentation of AUR in the first and second trimester of pregnancy. PMID:33969100 | PMC:PMC8080742 | DOI:10.12998/wjcc.v9.i13.3130 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intramuscular hematoma in rhabdomyolysis patients treated with low-molecular-weight heparin: Report of two cases

paythelady.612 shared this article with you from Inoreader Intramuscular hematoma in rhabdomyolysis patients treated with low-molecular-weight heparin: Report of two cases Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2838-2844. doi: 10.12998/wjcc.v9.i12.2838. ABSTRACT BACKGROUND: Rhabdomyolysis is a serious complication of heat stroke. Unlike that in acute kidney injury, the risk of muscle bleeding in rhabdomyolysis is often ignored and can substantially increase via the widespread use of anticoagulants, leading to the formation of intramuscular hematoma. CASE SUMMARY: During the summer, a middle-aged man and an elderly man were diagnosed with heat stroke, rhabdomyolysis, and acute renal impairment. Low-dose enoxaparin sodium was initiated for prophylaxis of deep vein thrombosis after the disease was stabilized with continuous renal replacement therapy. After that, the patients' hemoglobin decreased progressively, and no obvious intracranial, thoracic, digestive, or skin bleeding tendency was found. However, one of the patients had hip muscle pain, and computed tomography and color ultrasound confi rmed that the patients separately had lumbar back and hip intermuscular hematoma. After discontinuation of anticoagulant drugs and monitoring of the steady increase in hemoglobin, the intermuscular hematomas were gradually absorbed. Following the use of prophylactic anticoagulation therapy, the patients' hemoglobin showed a progressive downward trend. Hematoma formation in the lumbosacral and buttock muscles was confirmed after excluding bleeding in typical regions (such as the digestive tract, thoracic cavity, and abdominal cavity). Anticoagulant drugs were discontinued immediately, and nutritional support was increased. Subsequently, the hemoglobin levels gradually increased, and the hematoma volumes gradually decreased. CONCLUSION: Patients with rhabdomyolysis have a risk of muscle bleeding, and inappropriate use of anticoagulants may lead to an increased risk or even to the formation of an intermuscular hematoma. When continuous blood loss is found in the body, the possibi lity of bleeding in the muscles and more typical sites should be considered. PMID:33969067 | PMC:PMC8058680 | DOI:10.12998/wjcc.v9.i12.2838 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcoidosis mimicking metastases in an echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase positive non-small-lung cancer patient: A case report

paythelady.612 shared this article with you from Inoreader Sarcoidosis mimicking metastases in an echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase positive non-small-lung cancer patient: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3140-3146. doi: 10.12998/wjcc.v9.i13.3140. ABSTRACT BACKGROUND: Rearrangements of the anaplastic lymphoma kinase (ALK) gene (ALK-positive) represent an oncogenic driver in approximately 3%-5% of non-small-lung cancer (NSCLC) patients. Sarcoidosis is a multisystem disease, and its reported incidence in Asia is 1 or less per 100000 people per year. The co-occurrence of sarcoidosis and ALK-positive NSCLC is rare, and ALK-positive lung cancer is likely to spread quickly. Therefore, the co-occurrence of sarcoidosis is more easily misdiagnosed as metastatic lung cancer by radiological examination. CASE SUMMARY: A 50-year-old man had a nodule in the left superior lobe, many small nodules in left superior and right lungs, and enlarged bilateral hilar, mediastinal, and right supraclavicular lymph nodes. Computed tomography-guided pulmonary biopsy of the nodule in the left superior lobe revealed echinod erm microtubule-associated protein-like 4 gene-ALK positive NSCLC with concomitant noncaseating granuloma. This patient was treated with crizotinib. Thirty days later, a chest computed tomography scan revealed a dramatic decrease in the size of the left superior lobe nodule; however, the lesions in the right lung progressed. The right supraclavicular lymph nodes showed granulomas, and no tumor cells were identified in the specimens. The angiotensin-converting enzyme level was high. After 1 wk of methylprednisolone treatment, a significant response of all lesions was revealed. Following radical resection of the lung cancer, noncaseating granulomas were observed in both lung tissues and lymph nodes, which resulted in a diagnosis of echinoderm microtubule-associated protein-like 4-ALK positive NSCLC accompanied with sarcoidosis. CONCLUSION: Our experience illustrates that pathological evidence is needed to confirm metastatic disease, especially when some suspected metastatic lesi ons are negative for malignancy. PMID:33969101 | PMC:PMC8080747 | DOI:10.12998/wjcc.v9.i13.3140 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robotically assisted removal of pelvic splenosis fifty-six years after splenectomy: A case report

paythelady.612 shared this article with you from Inoreader Robotically assisted removal of pelvic splenosis fifty-six years after splenectomy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2868-2873. doi: 10.12998/wjcc.v9.i12.2868. ABSTRACT BACKGROUND: 'Splenosis' is defined as the autotransplantation of splenic tissue following trauma or surgery, usually in the form of intraperitoneal nodules. The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules, and achieving a differential diagnosis can be challenging. Nuclear medicine studies have been playing an increasingly important role in this process, but the clinical significance of asymptomatic nodules remains uncertain. CASE SUMMARY: We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography (CT) follow-up for B-cell lymphoma, presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space. 18F-fluorodeoxyglucose demonstrated weak metabolic activity. Since histological diagnosis wa s deemed necessary, the nodule was easily removed with robotically assisted laparoscopy, together with another 6 mm left a paracolic lesion. The latter was previously undiagnosed but retrospectively visible on the CT scan. CONCLUSION: In a patient requiring differential diagnosis of splenosis nodules from lymphoma recurrence, the robotic approach provided a safe en bloc removal with short hospitalization. The Da Vinci Xi robot was particularly helpful because its optics can be introduced from all ports, facilitating visualization and lysis of multiple intra-abdominal adhesions. PMID:33969071 | PMC:PMC8058664 | DOI:10.12998/wjcc.v9.i12.2868 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3147-3156. doi: 10.12998/wjcc.v9.i13.3147. ABSTRACT BACKGROUND: Giant cell tumors (GCT) are most commonly seen in the distal femur. These tumors are uncommon in the small bones of the hand and feet, and a very few cases have been reported. A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians. CASE SUMMARY: We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional (3D) printing talar prosthesis. The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies. The patient recovered nearly full range of motion of the ankle after 6 mo. The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points, respectively. CONCLU SION: We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus. PMID:33969102 | PMC:PMC8080752 | DOI:10.12998/wjcc.v9.i13.3147 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Torsades de pointes episode in a woman with high-grade fever and inflammatory activation: A case report

paythelady.612 shared this article with you from Inoreader Torsades de pointes episode in a woman with high-grade fever and inflammatory activation: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2899-2907. doi: 10.12998/wjcc.v9.i12.2899. ABSTRACT BACKGROUND: QT interval prolongation can induce torsades de pointes (TdP), a potentially fatal ventricular arrhythmia. Recently, an increasing number of non-cardiac drugs have been found to cause QT prolongation and/or TdP onset. Moreover, recent findings have demonstrated the key roles of systemic inflammatory activation and fever in promoting long-QT syndrome (LQTS) and TdP development. CASE SUMMARY: A 30-year-old woman was admitted with a moderate to high-grade episodic fever for two weeks. The patient was administered with multiple antibiotics after hospitalization but still had repeating fever and markedly elevated C-reactive protein. Once after a high fever, the patient suddenly lost consciousness, and electrocardiogram (ECG) showed transient TdP onset after frequent premature ventricular contraction. The patient recovered sinus rhythm and consciousness spontaneously, and post-TdP ECG revealed a prolonged QTc interval of 560 ms. The patient's clinical manifestations and unresponsiveness to the antibiotics led to the final diagnosis of adult-onset Still's disease (AOSD). There was no evidence of cardiac involvement. After the AOSD diagnosis, discontinuation of antibiotics and immediate initiation of intravenous dexamethasone administration resulted in the normal temperature and QTc interval. The genetic analysis identified that the patient and her father had heterozygous mutations in KCNH2 (c.1370C>T) and AKAP9 (c.7725A>C). During the 2-year follow-up period, the patient had no recurrence of any arrhythmia and maintained normal QTc interval. CONCLUSION: This case study highlights the risk of systemic inflammatory activation and antibiotic-induced TdP/LQTS onset. Genetic analysis should be considered to identify individuals at high risk of developing TdP. PMID:33969075 | PMC:PMC8058677 | DOI:10.12998/wjcc.v9.i12.2899 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful upgrade to cardiac resynchronization therapy for cardiac implantation-associated left subclavian vein occlusion: A case report

paythelady.612 shared this article with you from Inoreader Successful upgrade to cardiac resynchronization therapy for cardiac implantation-associated left subclavian vein occlusion: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3157-3162. doi: 10.12998/wjcc.v9.i13.3157. ABSTRACT BACKGROUND: Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker, which makes the reimplantation of a new pacemaker lead difficult. Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy (CRT) upgrade. CASE SUMMARY: We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously. We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques. The patient recovered uneventfully during the follow-up period. CONCLUSION: CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation. PMID:33969103 | PMC:PMC8080731 | DOI:10.12998/wjcc.v9.i13.3157 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

paythelady.612 shared this article with you from Inoreader Sclerosing polycystic adenosis of the submandibular gland: Two case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2930-2936. doi: 10.12998/wjcc.v9.i12.2930. ABSTRACT BACKGROUND: Sclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occurs over a wide age range and exhibits a slight female preference. Most SPA cases have occurred in the parotid gland. The exact nature of SPA is unclear, but its tumor nature has recently been proposed. Although SPA has a good prognosis after adequate surgery, atypical lesions might occur, ranging from mild dysplasia to carcinoma in situ in some cases. To the best of our knowledge, only five cases of SPA in the submandibular gland have been reported to date. Here, we present two new cases of SPA involving the submandibular gland. CASE SUMMARY: A 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan, China, with complaints of moderate pain, recurrent swelling, and a mas s in the submandibular area. After admission, the two cases of the submandibular mass were examined physically. The boundary of the submandibular tumor was clear, and the range of motion was good. After preoperative examinations, surgery was performed on a selective basis. Postoperative histopathological examination revealed a well-defined mass with acinar structures, ducts, or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma. There were flat and cuboidal cells, and eosinophils in the duct epithelium. There was also a eosinophilic substance in the lumen of dilated cysts. No atypical epithelial hyperplasia, invasive growth, or carcinoma in situ was found. Based on the above findings, the mass was diagnosed as SPA. Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up, respectively. CONCLUSION: SPA is a rare disease of the salivary gland. Even thou gh it has a good prognosis after adequate surgery, atypical lesions may occur from mild dysplasia to carcinoma in situ. However, no recurrence, distant metastasis, or mortality has been reported for submandibular gland SPA. Clinicians and pathologists should be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment. PMID:33969079 | PMC:PMC8058660 | DOI:10.12998/wjcc.v9.i12.2930 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.