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Acta Otorhinolaryngologica Italica :... Dec 2023Ultrasound-guided wire (USGW) localisation for small non-palpable tumours before a revision head and neck surgery is an attractive pre-operative option to facilitate...
OBJECTIVES
Ultrasound-guided wire (USGW) localisation for small non-palpable tumours before a revision head and neck surgery is an attractive pre-operative option to facilitate tumour identification and decrease potential complications. We describe five cases of pre-operative USGW localisation of non-palpable head and neck lesions to facilitate surgical localisation and resection.
METHODS
All patients undergoing pre-operative USGW localisation for non-palpable tumours of the head and neck region at London Health and Sciences Center, London, Ontario, Canada, were included. All the USGW localisations were performed by the same interventional radiologist, and the surgeries were performed by fellowship trained head and neck surgeons.
RESULTS
Five patients were included. All patients were undergoing revision surgery for recurrent or persistent disease. All successfully underwent a pre-operative USGW localisation of the non-palpable lesion before revision surgery. All lesions were localised intra-operatively with no peri-operative complications.
CONCLUSIONS
USGW localisation is a safe and effective pre-operative technique for the identification of small non-palpable head and neck tumours.
Topics: Humans; Head and Neck Neoplasms; Neck; Preoperative Care; Ultrasonography, Interventional
PubMed: 37519136
DOI: 10.14639/0392-100X-N2280 -
Pilot and Feasibility Studies Feb 2024Given the dire need for health and rehabilitation services internationally, exacerbated during the COVID-19 pandemic, there is a critical need to develop tools to...
BACKGROUND
Given the dire need for health and rehabilitation services internationally, exacerbated during the COVID-19 pandemic, there is a critical need to develop tools to support service delivery. This need is palpable in the Global South where tools developed in Eurocentric contexts are not always adaptable, applicable, or relevant. It is for this reason that the researchers present three case studies of tool development using pilot and feasibility studies in South Africa and share the lessons learned from these studies.
OBJECTIVES
To describe three case studies that developed new tools for health and rehabilitation services using pilot and feasibility studies. To synthesize lessons learned from these case studies on the development of tools.
METHOD
The researchers describe three case studies that were developed. The case studies are summarized as follows: aims and objectives, context, problem, study design, findings, and what happened after the study. Thereafter, a qualitative cross-case analysis was conducted by the researchers to generate themes.
FINDINGS
The case studies are described individually and followed by themes identified through cross-case analysis.
DISCUSSION
The lessons learned are discussed. It is essential to develop new tools and protocols, motivated by the need for equitable and contextually relevant practices. Partnerships and collaboration with end-users are critical for success. A critical, scientific process is essential in developing new tools. Pilot and feasibility studies are invaluable in developing tools and assessing the feasibility of tools and implementation. The goal is to develop practical, usable tools and protocols.
CONCLUSION
Through the lessons learned, the researchers are hopeful that the international health and rehabilitation professions will continue to strengthen the scientific development of contextually relevant tools and resources.
PubMed: 38308355
DOI: 10.1186/s40814-023-01424-w -
African Journal of Paediatric Surgery :... Apr 2024Bezoars are indigestible lumps which are usually found in stomach. Types of bezoar include phytobezoar, trichobezoar, lithobezoar, pharmacobezoar, plasticobezoar,... (Review)
Review
BACKGROUND
Bezoars are indigestible lumps which are usually found in stomach. Types of bezoar include phytobezoar, trichobezoar, lithobezoar, pharmacobezoar, plasticobezoar, lactobezoar and metal bezoar. Trichobezoars mostly affect females in 20s and 30s with a rarity in paediatrics. Unexplained complaints with a palpable mass are commonly found in these patients. Treatment involves retrieval of mass with searching for others. The purpose of this study was to present data and surgical management of cases with trichobezoars.
MATERIALS AND METHODS
We documented a retrospective review of trichobezoars done in our hospital between 2016 and 2022. All demographic data collected included gender and age of cases, composition and extent of bezoar, clinical presentation, imaging modalities, endoscopic trial, surgical approach and outcome.
RESULTS
Five cases of gastrointestinal tract (GIT) trichobezoars underwent surgery. All cases were females between (13 and 16 years). Trichobezoars were three gastric, one ileal and one of combined gastric and colonic. Complaints were abdominal pain, vomiting, weight loss and halitosis. Three cases had a palpable abdominal mass. Different radiological modalities were performed. Endoscopic retrieval was tried in one patient and the laparoscopic approach in another one, but the first route failed. Laparotomy followed by gastrotomy, enterotomy and colotomy was done without complications.
CONCLUSIONS
Trichobezoars should be suspected in any child with unexplained abdominal complaints or with a palpable abdominal mass, especially in girls. Imaging can be done in different modalities for diagnosis. Endoscopic retrieval could be tried; however, its failure is common, necessitating laparotomy, which has an excellent outcome.
Topics: Female; Humans; Abdominal Pain; Bezoars; Ileum; Stomach; Vomiting; Adolescent
PubMed: 38546247
DOI: 10.4103/ajps.ajps_104_22 -
Revista Espanola de Enfermedades... Mar 2024We present the clinical case of a 21-year-old male with abdominal pain in the left hypochondrium radiating to the ipsilateral lumbar area and a weight loss of 2kg over a...
We present the clinical case of a 21-year-old male with abdominal pain in the left hypochondrium radiating to the ipsilateral lumbar area and a weight loss of 2kg over a month, secondary to a large palpable intra-abdominal mass in the examination. TAC revealed a large solid mass with necrotic-cystic component which depended of the pancreas, infiltrated the spleen, enveloped the celiac trunk and affected to the splenic vases. Inmunohistochemical and molecular study confirmed the diagnosis extraosseus Ewing sarcoma (EES).
PubMed: 38501816
DOI: 10.17235/reed.2024.10281/2024 -
Journal of Digital Imaging Aug 2023The objective of this study is to develop a radiomic signature constructed from deep learning features and a nomogram for prediction of axillary lymph node metastasis...
The objective of this study is to develop a radiomic signature constructed from deep learning features and a nomogram for prediction of axillary lymph node metastasis (ALNM) in breast cancer patients. Preoperative magnetic resonance imaging data from 479 breast cancer patients with 488 lesions were studied. The included patients were divided into two cohorts by time (training/testing cohort, n = 366/122). Deep learning features were extracted from diffusion-weighted imaging-quantitatively measured apparent diffusion coefficient (DWI-ADC) imaging and dynamic contrast-enhanced MRI (DCE-MRI) by a pretrained neural network of DenseNet121. After the selection of both radiomic and clinicopathological features, deep learning signature and a nomogram were built for independent validation. Twenty-three deep learning features were automatically selected in the training cohort to establish the deep learning signature of ALNM. Three clinicopathological factors, including LN palpability (odds ratio (OR) = 6.04; 95% confidence interval (CI) = 3.06-12.54, P = 0.004), tumor size in MRI (OR = 1.45, 95% CI = 1.18-1.80, P = 0.104), and Ki-67 (OR = 1.01; 95% CI = 1.00-1.02, P = 0.099), were selected and combined with radiomic signature to build a combined nomogram. The nomogram showed excellent predictive ability for ALNM (AUC 0.80 and 0.71 in training and testing cohorts, respectively). The sensitivity, specificity, and accuracy were 65%, 80%, and 75%, respectively, in the testing cohort. MRI-based deep learning radiomics in patients with breast cancer could be used to predict ALNM, providing a noninvasive approach to structuring the treatment strategy.
Topics: Humans; Female; Lymphatic Metastasis; Breast Neoplasms; Deep Learning; Retrospective Studies; Magnetic Resonance Imaging; Lymph Nodes
PubMed: 36973631
DOI: 10.1007/s10278-023-00818-9 -
Cureus Mar 2024Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant genetic disorder characterized by congenital great toe malformations and progressive ectopic...
Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant genetic disorder characterized by congenital great toe malformations and progressive ectopic ossification. We report a typical case of FOP in a 22-year-old female patient presenting with limited movement of the left knee joint, which began following trauma in 2019. Clinical examination revealed a large mass behind the left knee, bilateral great toe deformities, and no palpable superficial lymph nodes, without systemic pain or other discomfort. Imaging and genetic testing further supported the diagnosis of FOP, demonstrating high-density ossification within soft tissues and a mutation in the gene. Treatment involved a combination of methylprednisolone and alendronate sodium vitamin D3 tablets, which yielded some therapeutic efficacy. The discussion emphasizes clinical diagnosis, pathogenesis, and treatment strategies for FOP, including injury prevention, rehabilitation exercises, and pharmacological interventions. Despite the lack of definitive treatment options, timely diagnosis and comprehensive management can effectively alleviate symptoms and improve the quality of life for affected individuals.
PubMed: 38576636
DOI: 10.7759/cureus.55528 -
World Journal of Clinical Cases Dec 2023Snapping triceps syndrome (STS) is a rare disease, while occurrence of bilateral STS is extremely rare. It is usually accompanied by dislocation of the ulnar nerve and...
BACKGROUND
Snapping triceps syndrome (STS) is a rare disease, while occurrence of bilateral STS is extremely rare. It is usually accompanied by dislocation of the ulnar nerve and double snapping is a clinically important feature. However, to the best of our knowledge, there has been no report of bilateral STS in young active patient.
CASE SUMMARY
A 23-year-old male presented with a complaint of discomfort and snapping on the medial side of both elbows while performing push-ups. On physical examination, two distinct snaps that were both palpable and audible were detected on additional clinical examination. Dynamic ultrasonography showed that the ulnar nerve and the medial head of the triceps were dislocated anteriorly over the medial epicondyle of the elbow during flexion motion. Finally, he was diagnosed as dislocation of the ulnar nerve and STS. Staged anterior subcutaneous transposition of the ulnar nerve combined with partial resection of the snapping portion of the triceps was performed. The patient's pain and snapping symptoms were resolved immediately after surgery. Three months later, the patient was completely asymptomatic and returned to normal activity.
CONCLUSION
STS should be included in the differential diagnosis for active young patients who present with painful snapping on the medial side of the elbow joint, particularly when dislocation of the ulnar nerve is detected. Dynamic sonography is used to assist in accurate diagnosis and differentiation between isolated dislocation of the ulnar nerve and STS.
PubMed: 38130777
DOI: 10.12998/wjcc.v11.i34.8228 -
Case Reports in Ophthalmology 2023The aim of the study was to report a rare case of lacrimal gland abscess.
INTRODUCTION
The aim of the study was to report a rare case of lacrimal gland abscess.
CASE PRESENTATION
A 47-year-old woman noticed upper eyelid swelling on the right side 1.5 months before referral to our service. Oral antibiotics were administered, based on the diagnosis of acute dacryoadenitis at another clinic. The symptom had once subsided 20 days later but recurred. On the first examination, the right upper eyelid was swollen with tenderness. The right lacrimal gland was palpable. Blood tests revealed positive proteinase 3-anti-neutrophil cytoplasmic antibody. T2-weighted magnetic resonance and diffusion-weighted images showed a high signal intensity lesion in an enlarged right lacrimal gland, while apparent diffusion coefficient map demonstrated the lesion with a low signal intensity. We started administration of intravenous antibiotics. Abscess drainage and lacrimal gland biopsy were performed 4 days after the first examination. Culture test of the abscess showed only 1 colony growth of . The specimen harvested from the lacrimal gland showed proliferation of fibrous connective tissue and infiltration of inflammatory cells without vasculitis. After the drainage, the swelling gradually subsided. Administration of antibiotics discontinued at 22 days of follow-up. At 4-month follow-up, the patient did not have any symptom related to the lacrimal gland abscess.
CONCLUSION
The diffusion-weighted images and apparent diffusion coefficient map are helpful for the diagnosis of lacrimal gland abscess when the culture tests provide poor results.
PubMed: 38078041
DOI: 10.1159/000535130 -
JFMS Open Reports 2023A 10-year-old male neutered Abyssinian cat was presented with the chief complaint of a right pharyngeal mass. On palpation, the mass was easily palpable; it appeared...
CASE SUMMARY
A 10-year-old male neutered Abyssinian cat was presented with the chief complaint of a right pharyngeal mass. On palpation, the mass was easily palpable; it appeared well demarcated and mobile, and oval in shape. Radiographic examination showed a radiopaque pharyngeal mass, which was revealed to be a well-demarcated mass lesion with a radiopaque marginal area on CT examination. The inside of the mass was uniformly well enhanced on contrast CT examination. A three-dimensional image reconstructed from the CT images strongly suggested that the mass originated from the right stylohyoid bone. No abnormal lesions were observed in the thoracic and abdominal CT examinations. Surgical excision of the mass was scheduled 3 weeks after the first admission. The mass was bluntly separated from the surrounding musculature and resected together with the ipsilateral epihyoid bone adjacent to the mass. Histopathological examination of the resected mass showed neoplastic cells with osteoid formation, and the mass was histopathologically diagnosed as an osteosarcoma. The postoperative recovery from anaesthesia was uneventful, and the cat began feeding on its own from the third postoperative day. The 3-month postoperative CT evaluation revealed no local recurrence or distant metastasis. The cat showed no abnormal findings at the time of writing (6 months postoperatively).
RELEVANCE AND NOVEL INFORMATION
Although osteosarcoma derived from the hyoid bone has rarely been reported in the veterinary field, this report suggests that such tumours may occur in cats. In addition, partial excision of the hyoid apparatus seems to be well tolerated in cats.
PubMed: 37781726
DOI: 10.1177/20551169231188642 -
Cureus Dec 2023Fibroadenomas of the breast are common benign lesions that predominantly affect young women. This review provides a comprehensive overview of fibroadenoma management,... (Review)
Review
Fibroadenomas of the breast are common benign lesions that predominantly affect young women. This review provides a comprehensive overview of fibroadenoma management, encompassing their definition, clinical presentation, diagnostic tools, surgical management, clinicopathological correlations, treatment outcomes, complications, and emerging research. Fibroadenomas typically present as palpable breast lumps, often with no associated nipple discharge, and their diagnosis relies on a combination of clinical examination, breast imaging, and pathological confirmation. Surgical interventions, including excisional biopsy and lumpectomy, offer symptom relief and favorable long-term outcomes. Minimally invasive techniques and ongoing research into genomics and molecular aspects hold promise for the future of fibroadenoma management. Multidisciplinary collaboration among healthcare providers is paramount, ensuring accurate diagnosis, personalized treatment decisions, and holistic patient care. As research advances, the management of fibroadenomas is poised to evolve, providing improved diagnostic accuracy, minimally invasive treatments, and enhanced patient outcomes.
PubMed: 38288219
DOI: 10.7759/cureus.51329