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Journal of Medical Case Reports Sep 2023Intussusception is a rare condition in adults, accounting for 5% of intestinal intussusception and being responsible for approximately 1% of all adult bowel...
BACKGROUND
Intussusception is a rare condition in adults, accounting for 5% of intestinal intussusception and being responsible for approximately 1% of all adult bowel obstructions. Neoplastic origin is the most common etiology of intestinal intussusception in adults, unlike pediatric intussusception, which is usually idiopathic. Intussusception due to the appendiceal mucocele is exceptional, and only a few cases have been reported in the medical literature.
CASE PRESENTATION
We report the case of a 25-year-old black African male patient with no medical history. He presented to the emergency department for abdominal pain, nausea, and bilious vomiting. The abdominal examination revealed typical signs of acute bowel obstruction. Enhanced abdominopelvic computed tomography showed an invagination of the last ileal loop, cecum, and ascending colon into the lumen of the transverse colon, with a rounded image with hypodense content and some calcifications compatible with an appendiceal mucocele. An emergency exploratory laparoscopy was performed and confirmed the ileocecocolic intussusception. Right hemicolectomy and ileocolic anastomosis were performed. The patient recovery postoperatively was uneventful, and he was discharged 4 days later. Histological examination of the surgical specimen confirmed the diagnosis of mucinous cystadenoma.
CONCLUSION
The symptoms of bowel intussusception with the appendiceal mucocele as the lead point in adults are similar to any other bowel intussusception. Differential diagnosis is often carried out thanks to the injected abdominal computed tomography scan.
Topics: Adult; Male; Humans; Child; Intussusception; Mucocele; Intestinal Obstruction; Abdominal Pain; Anastomosis, Surgical
PubMed: 37710264
DOI: 10.1186/s13256-023-04133-3 -
Brain & Spine 2023Meningoencephalocele is defined as an abnormal sac of brain tissue and meninges extending beyond natural skull margins, often leading to cerebrospinal fluid (CSF)...
BACKGROUND
Meningoencephalocele is defined as an abnormal sac of brain tissue and meninges extending beyond natural skull margins, often leading to cerebrospinal fluid (CSF) leakage. When this condition arises in the spheno-ethmoidal region, the diagnosis becomes more challenging as it can be mistaken for other nasal pathologies, such as mucocele.
RESEARCH QUESTION
We show in this case report a non-congenital sphenoethmoidal meningoencephalocele causing rhinoliquoral fistula and spontaneous intracranial hypotension.
RESULTS
this 65-year-old woman presented with sporadic rhinoliquorrhoea associated with orthostatic headache, nausea and dizziness. Brain MRI revealed a small lesion of an ethmoidal sinus, which was successfully treated with endoscopic endonasal surgery. Histology confirmed the presence of meningoencephalic tissue positive for S100 protein on immunohistochemistry.
CONCLUSIONS
When dealing with lesions of the paranasal sinuses in contact with the anterior skull base, rhinoliquorrhoea presence suggests meningoencephalocele. In dubious cases, a proper workup, including a thorough clinical history and neurological examination, specific imaging, and a direct search of CSF-like markers, is essential to support the differential diagnosis. In such cases, a transnasal endoscopic surgical approach is recommended to obtain a final histological diagnosis and to perform eventual dural plastic surgery.
PubMed: 38021026
DOI: 10.1016/j.bas.2023.102676 -
Cureus Dec 2023Background Histopathology of a tissue specimen plays a crucial role in formulating the final diagnosis of any disease. It confirms whether the histopathological findings...
Background Histopathology of a tissue specimen plays a crucial role in formulating the final diagnosis of any disease. It confirms whether the histopathological findings are in correspondence with the clinical diagnosis and thus suggests an optimal management plan. Standard surgical practices guide that every human tissue specimen must undergo postoperative tissue analysis unless indicated otherwise. Objective To determine the significance of histopathology in determining the final diagnosis of appendectomy specimens. Materials and methods This retrospective clinical study conducted in May 2022 included 100 patients operated for appendectomy from January 1, 2021, to December 31, 2021, in the emergency room of the Department of General Surgery, Unit-III, Lahore General Hospital, Lahore. Data were retrieved from patients' records and the picture archiving and communication system (PACS). A Google Forms-based (Google, Mountain View, CA) was generated to include the demographic details, clinical manifestations, and histopathology reports of the patients. Descriptive analysis was completed using a Microsoft Excel spreadsheet (Microsoft Corporation, Redmond, WA). Results Fifty-two patients were females out of the total 100. The mean age at presentation was 23.02 ± 12.02 years. Of the samples, 54% were not sent for histopathology. Among the remaining ones, 27% of cases were proven to be acute appendicitis. Alvarado score was 7-10 in 50% of patients. Other lesions proven by histopathology were appendiceal phlegmon (4%), perforated appendix (4%), mucocele (1%), carcinoid tumor (1%), tuberculosis (1%), and adenocarcinoma (1%). Conclusions Histopathological analysis is the gold standard for the tissue diagnosis of a disease. The high percentage of the samples not sent for histopathology is alarming since the appendix is not only a site for inflammatory pathologies but for neoplastic lesions as well. This practice depicts that the incidence of non-inflammatory pathologies is being ignored by healthcare professionals and there is a dire need to emphasize the significance of acquiring histopathology reports for the specimens of appendectomy in all circumstances.
PubMed: 38196417
DOI: 10.7759/cureus.50270 -
Medicina (Kaunas, Lithuania) Jan 2024: Chronic sinusitis is a commonly encountered diagnosis for otorhinolaryngologists. The profound negative effect of rhinosinusitis on patients' quality of life is...
: Chronic sinusitis is a commonly encountered diagnosis for otorhinolaryngologists. The profound negative effect of rhinosinusitis on patients' quality of life is frequently overlooked, and surgical lines of treatment are numerous. The aim of the study was to assess the comparative efficacy of endoscopic middle meatal antrostomy with the endoscopic prelacrimal recess approach, combined with middle meatal antrostomy in the treatment of unilateral chronic maxillary sinus lesion. : Thirty patients with unilateral chronic maxillary sinus lesions enrolled in the study at Alahsa hospital. Patients were divided into two groups: 15 treated through a middle meatal antrostomy and 15 treated via a combined middle meatal antrostomy and prelacrimal recess approach. Demographic and clinical information of the patients, including the medical history, CT scan findings, diagnosis, recurrence, and complications, were gathered and analyzed. Pre- and postoperative clinical findings were graded utilizing the Lund-Kennedy Endoscopic Scoring System. : The enrolled patients varied in age from 18 to 56, with 60% being male and 40% being female. Antrochoanal polyp, maxillary sinus mucocele, and unilateral allergic fungal sinusitis were among the pathological diagnoses. The follow-up period averaged 14.3 months. Following surgery, two patients in Group II encountered nasal discomfort, which included synechia and epiphora. The success rate for preserving a patient's disease-free condition was 86.7%. A statistically significant difference in disease-free incidence was observed among the patients in group II. In group I, recurrence was identified in 26.7% of the patients. The postoperative symptoms diminished considerably, and the VAS score was reduced substantially. In Group II patients, however, there was no significant difference in scarring. Clinically significant differences were observed in the mean total Lund-Kennedy Endoscopic scores when compared to their preoperative values. : Achieving endoscopic access to the sinus's anterior, lateral, inferior, and inferomedial regions is facilitated by operating via the prelacrimal recess, which is the most advantageous approach. This approach facilitates rapid mucosal healing by maintaining the integrity of the nasolacrimal duct and mucosal covering. The specific pathology, surgical objectives, surgeon expertise, and equipment accessibility influence the choice of endoscopic surgical technique.
Topics: Humans; Male; Female; Maxillary Sinus; Quality of Life; Nasal Polyps; Sinusitis; Endoscopy; Retrospective Studies
PubMed: 38399510
DOI: 10.3390/medicina60020222 -
BMC Oral Health Mar 2024The association of Human Papilloma Virus (HPV) and Human Syncytial Virus (HSV) infection with inflammatory and potentially malignant disorders of the oral cavity (OPMD)...
BACKGROUND
The association of Human Papilloma Virus (HPV) and Human Syncytial Virus (HSV) infection with inflammatory and potentially malignant disorders of the oral cavity (OPMD) is unknown. The aim of this cross-sectional study was to stablish the expression of the p16 and HSV proteins, to test potential correlation between those parameters in biopsies from clinically diagnosed oral lesions.
METHODS
Immunochemical analysis of 211 formalin-fixed, paraffin-embedded (FFPE) blocks from 211 individuals was provided. The clinical diagnosis included in the research were Oral lichen planus (N = 30), Oral Leukoplakia (N = 13) Mucocele (N = 25), Erosion/ulceration/ inflammation of mucosa (N = 8), Overgrowth of mucosa (N = 135).
RESULTS
Two hundred eleven analyzed FFPE samples resulted with the median age of 58.5 years (the average age 54.0 years and SD ± 17 years). The female/male ratio was 2.3 (69.7% vs 30.3% respectively). All the samples positive for HSV also expressed p16 (p = 0.000), that's showed various levels of association with the diverse clinical diagnosis reaching the higher level in OM 49.1% (29 positive samples) and OLP 30.5% (18). p16 was associated with OLP at 30.5% (18), and fibroma 30.5%. HSV expression was mostly present in fibroma at 47.6% (10 positive samples).
CONCLUSION
HSV and p16 positivity in relation to diagnosis of the biopsies showed statistically most often p16 in OLP and fibroma. The results of co-expression of p16 and HSV in mucocele and fibroma in oral mucosa suggest a cooperation between the molecular alterations induced by these two viruses. Squamous papilloma samples positive for p16 were also positive for HSV, suggesting that the putative pro-oncogenic action of HSV could be an early event.
Topics: Female; Humans; Male; Middle Aged; Biomarkers, Tumor; Carcinoma, Squamous Cell; Cross-Sectional Studies; Cyclin-Dependent Kinase Inhibitor p16; Fibroma; Human Papillomavirus Viruses; Mouth Mucosa; Mucocele; Papillomavirus Infections; Adult; Aged
PubMed: 38500158
DOI: 10.1186/s12903-024-04105-z -
Cureus Oct 2023A 15-year-old female patient was reported with swelling on the right side of the lower lip for 15 days. A provisional diagnosis of mucocele was obtained based on the...
A 15-year-old female patient was reported with swelling on the right side of the lower lip for 15 days. A provisional diagnosis of mucocele was obtained based on the patient's history and clinical examination. Under all aseptic conditions and administration of local anesthetic, surgical mucocele removal was done using a scalpel. An excised soft tissue specimen was given for histopathological examination, confirming the final diagnosis of mucous extravasation phenomena or mucocele. Recall examination after seven days reveals satisfactory lesion healing and no discomfort. This case report demonstrates that surgical excision is a simple, efficient, and affordable method for treating mucoceles and giving aesthetic and functional clearance.
PubMed: 37933354
DOI: 10.7759/cureus.46557 -
International Journal of Surgery Case... Oct 2023Salivary mucoceles, originating from major and minor salivary glands, rarely affect the submandibular gland, accounting for just 0.6 % of its tumors and cysts. With...
INTRODUCTION AND IMPORTANCE
Salivary mucoceles, originating from major and minor salivary glands, rarely affect the submandibular gland, accounting for just 0.6 % of its tumors and cysts. With only 18 case reports in the literature to date, their occurrence in this location is infrequent.
CASE PRESENTATION
The patient is a 9-year-old male with no relevant medical history who developed progressive submandibular swelling extending into the oral cavity. CT scan confirmed a submandibular gland mucocele. Surgical treatment involved excision of the mucocele along with the submandibular and sublingual glands. The postoperative course was unremarkable.
CLINICAL DISCUSSION
Diagnosis presents challenges due to potential similarities with congenital and acquired lesions. Precise diagnosis relies on imaging techniques such as ultrasound, CT scans, and MRI. Distinguishing between submandibular mucoceles and plunging ranulas remains intricate based solely on imaging findings.
CONCLUSIONS
This case report contributes to the limited literature available on this condition, highlighting the necessity for vigilant clinical assessment, accurate diagnosis, and appropriate management within the pediatric population.
PubMed: 37716059
DOI: 10.1016/j.ijscr.2023.108798 -
Nigerian Journal of Clinical Practice Apr 2024Orofacial cysts are pathologic cavities that could be symptomatic and may cause facial disfigurement. The only epidemiologic report of such lesions in Southeast Nigeria...
BACKGROUND
Orofacial cysts are pathologic cavities that could be symptomatic and may cause facial disfigurement. The only epidemiologic report of such lesions in Southeast Nigeria studied jaw cysts from 1987 to 1996. New studies reflecting recent research findings and classifications on the subject in Southeast Nigeria are lacking.
AIM
To determine the prevalence and distribution of orofacial cysts in a tertiary hospital in Enugu, Southeast Nigeria.
METHODS
A 10-year retrospective study of patients with orofacial cysts diagnosed by histology was carried out.
RESULTS
Orofacial cysts constitute 9.5% (85) of 897 orofacial lesions identified. The male-to-female gender ratio was 1.2:1. The mean age (± standard deviation) at the onset of the cystic lesion was 28.58 (±16.98) years. Developmental odontogenic cysts 52.9% (45) and salivary cysts 18.8% (16) were the most common group of orofacial cysts. The most prevalent orofacial cysts were odontogenic keratocysts at 25.9% (22), mucoceles 16.5% (14), and dentigerous cysts 14.1% (12). Straw-colored aspirates 34.8% (16) and dark brown aspirates 28.3% (13) were the predominant cystic contents. The mandible 45.9% (39) and maxilla 27.1% (23) were the commonest sites for orofacial cysts, while the lip 9.4% (8) was the most frequent soft tissue site. A significant association exists between anatomical site and cyst type at a 95% confidence interval with P = 0.000, X2 = 247.17. Unilocular radiolucency 62.5% (20) and multilocular radiolucency 34.4% (11) were the most common radiographic features.
CONCLUSION
Developmental odontogenic cysts particularly odontogenic keratocysts were most prevalent while mucocele was the most common soft tissue cyst.
Topics: Humans; Male; Female; Nigeria; Retrospective Studies; Adult; Prevalence; Adolescent; Child; Middle Aged; Odontogenic Cysts; Young Adult; Child, Preschool; Aged; Cysts; Sex Distribution; Mucocele
PubMed: 38679765
DOI: 10.4103/njcp.njcp_513_23 -
Cureus Jan 2024This case represents mucocele of extravasation phenomenon associated with a lower lip on the right side in the last 15 days. A 19-year-old male patient visited the...
This case represents mucocele of extravasation phenomenon associated with a lower lip on the right side in the last 15 days. A 19-year-old male patient visited the outpatient department with a history of constant trauma due to lip biting and due to soft and flocculent consistency on palpation, mucocele was considered under the provisional diagnosis. The borders of the lesion were marked following all the protocols of asepsis and sterilization and laser-assisted surgical excision was undertaken resulting in total removal of the lesion with a diode laser by resecting it from the base to reduce chances of re-occurrence. The specimen that was resected was sent for histopathological examination, which confirmed the final diagnosis of mucous extravasation cyst or mucocele. The following report underlines that laser-assisted resection offers a minimally invasive and precision approach for the treatment of mucocele.
PubMed: 38410325
DOI: 10.7759/cureus.53020 -
Medicine Nov 2023This case report describes a patient who underwent laparoscopic resection of the mucocele of the appendix secondary to endometriosis, a rarity in clinical practice.
INTRODUCTION
This case report describes a patient who underwent laparoscopic resection of the mucocele of the appendix secondary to endometriosis, a rarity in clinical practice.
PATIENT CONCERNS
The patient was a 38-year-old woman with a history of endometriosis and an ovarian cyst who sought medical advice with a chief complaint of mild right lower abdominal pain.
DIAGNOSES
Computed tomography and ultrasonography of the abdomen revealed a cystic lesion at the distal end of the appendix without definitive findings of malignancy. Colonoscopy revealed a submucosal tumor-like elevation at the appendiceal orifice. Appendiceal mucocele was suspected preoperatively.
INTERVENTIONS
The lesion was resected laparoscopically. Secondary ileocecal resection with lymphadenectomy was possible if the resected specimen was pathologically diagnosed as a malignant tumor with the risk of lymph node metastasis.
OUTCOMES
The resected specimen was pathologically diagnosed as an appendiceal mucocele secondary to endometriosis; therefore, additional surgery was avoided.
CONCLUSION
Although appendiceal mucoceles secondary to endometriosis are rare, laparoscopic surgery in which only the lesion was resected is a useful strategy for the treatment and pathological diagnosis of appendiceal mucoceles without findings of malignancy.
Topics: Female; Humans; Adult; Mucocele; Endometriosis; Appendix; Intestinal Diseases; Laparoscopy
PubMed: 38013331
DOI: 10.1097/MD.0000000000036277