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SAGE Open Medical Case Reports 2024Atypical choroid plexus papilloma is a rare World Health Organization grade 2 intraventricular tumor arising from the epithelium of the plexus choroid with intermediate...
Atypical choroid plexus papilloma is a rare World Health Organization grade 2 intraventricular tumor arising from the epithelium of the plexus choroid with intermediate clinical-pathological features between the benign choroid plexus papilloma and the malignant choroid plexus carcinoma. The main criteria for differentiation are histopathologic, with difficulties in distinguishing it from choroid plexus papilloma based on imaging features. We report the case of a 4-year-old female presenting with headaches and altered mental status. Brain magnetic resonance imaging revealed a right lateral ventricular mass with some atypical characteristics, which were confirmed on pathological examination as an atypical choroid plexus papilloma.
PubMed: 38764919
DOI: 10.1177/2050313X241254000 -
SAGE Open Medicine 2024There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and...
Prevalence of cervical intraepithelial lesions and associated factors among women attending a cervical cancer clinic in Western Uganda; results based on Pap smear cytology.
INTRODUCTION
There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda.
METHODS
In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level.
RESULTS
The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, : 0.0253), use of intrauterine devices (OR: 6.284, : 0.039), and any family history of cervical cancer (OR: 4.144, : 0.049) were significantly associated with cervical intraepithelial lesions.
CONCLUSION
The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.
PubMed: 38764539
DOI: 10.1177/20503121241252265 -
Rare Tumors 2024Sino-nasal respiratory epithelial adenomatoid hamartomas (REAHs) are rare entity. They are benign tumors with excellent results after complete excision. We report a case...
Sino-nasal respiratory epithelial adenomatoid hamartomas (REAHs) are rare entity. They are benign tumors with excellent results after complete excision. We report a case of a 57-year-old male with a history of endoscopic surgery for right nasal polyps 20 years ago. The patient presented nasal obstruction that persisted for 10 years without anosmia nor epistaxis. Nasal endoscopy found a tissular mass filling the right nasal cavity extending to the nasopharynx. CT scan and MRI demonstrated soft tissue opacification of the right maxillary sinus and the homolateral anterior ethmoid cells with extension to the nasal cavity. The suspected diagnosis on imaging was an Inverted papilloma with a wide implantation base on the posterior part of the nasal septum. No endocranial or orbital extension was noted. The patient underwent endoscopic sinus surgery with complete extirpation of the tumor and a right ethmoidectomy. Histopathological assessment showed features consistent with REAH. No recurrence was noted at 1 year follow-up.
PubMed: 38756436
DOI: 10.1177/20363613241255567 -
Veterinaria Italiana Dec 2023In this study, we compared the effectiveness of various methods used in the treatment of cattle with cutaneous papillomatosis. Ivermectin, Tarantula cubensis extract,... (Comparative Study)
Comparative Study
In this study, we compared the effectiveness of various methods used in the treatment of cattle with cutaneous papillomatosis. Ivermectin, Tarantula cubensis extract, levamisole, autovaccine, and a combination of T. cubensis extract + levamisole were administered to the animals. The animals were divided into six equal groups. Animals in the control group (n = 10) did not receive any treatment. The animals in the experimental group were administered Ivermectin [three times a week, n = 10, subcutaneous, (SC)], Tarantula cubensis extract (twice a week, n = 10, SC), autologous vaccine (three times at 10-day intervals, n = 10, SC), levamisole [twice at one-week intervals, n = 10, intramuscular (IM)], and levamisole + Tarantula cubensis extract (concurrently). All animals used in the study were monitored for three months at an interval of 15 days. No regression was detected in the papillomas of the control group animals, but recovery was recorded in animals treated with ivermectin at a rate of 70% (7/10), while it was 60% (6/10) in those treated with T. cubensis extract, 100% (10/10) in those treated with autovaccine, 50% (5/10) in those treated with levamisole, and 90% (9/10) in those treated with the combination of T. cubensis extract + levamisole. Significant differences were found between the control group and all treatment groups. Recovery mostly occurred within 45-60 days (P < 0.05). The five treatment modalities applied for the treatment of bovine cutaneous papillomatosis were statistically evaluated and all methods of treatment were effective at different rates. The most precise and effective treatment method was the autovaccine one.
Topics: Animals; Cattle; Cattle Diseases; Papilloma; Skin Neoplasms; Ivermectin; Treatment Outcome; Plant Extracts; Levamisole; Female
PubMed: 38756023
DOI: 10.12834/VetIt.3138.21450.2 -
Surgical Neurology International 2024Choroid plexus papillomas (CPPs) are rare neoplasms arising from choroid plexus epithelium representing <1% of all intracranial tumors. Symptoms vary based on location...
BACKGROUND
Choroid plexus papillomas (CPPs) are rare neoplasms arising from choroid plexus epithelium representing <1% of all intracranial tumors. Symptoms vary based on location and regional mass effect; however, hydrocephalus is common due to cerebrospinal fluid flow obstruction and/or overproduction. Distant site metastasis or formation in extraventricular sites is rare.
CASE DESCRIPTION
A 57-year-old female with a history of a 4 ventricular CPP status post resection in 2004 and 2018 with subsequent gamma knife therapy in 2019 presented with increased thirst and urination. Since her initial surgery, she has experienced significant gait imbalance, diplopia, dysphagia, and right-sided hemiparesis and hemisensory loss. Magnetic resonance imaging revealed a new 1.5 × 1.8 cm suprasellar lesion. She underwent a left supraorbital craniotomy for tumor resection, with pathology revealing metastatic World Health Organization grade II CPP.
CONCLUSION
Extraventricular manifestation of CPP is rare. or metastatic involvement of the sella has seldom been reported. Treatment should target gross total surgical resection. Adjuvant chemotherapy and radiation may be useful in higher-grade lesions.
PubMed: 38742015
DOI: 10.25259/SNI_847_2023 -
Clinical Case Reports May 2024Squamous cell papilloma with elongated villous projections may occur in the hypopharynx and present with symptoms observable on physical examination.
Squamous cell papilloma with elongated villous projections may occur in the hypopharynx and present with symptoms observable on physical examination.
PubMed: 38741676
DOI: 10.1002/ccr3.8913 -
Cureus Apr 2024Squamous papilloma of the oral cavity is frequently seen in adult patients and is typically presented as painless exophytic granular or cauliflower-like lesions over the...
Squamous papilloma of the oral cavity is frequently seen in adult patients and is typically presented as painless exophytic granular or cauliflower-like lesions over the tongue, floor of the mouth, palate, uvula, lips, and faucial pillars. Most of the lesions are solitary and grow rapidly to about 0.5 cm. Oral squamous papilloma has no known malignant potential, with conservative surgical excision being the treatment of choice. Recurrence is rare. It occasionally causes symptoms, unless the presentation is atypical, as in our case. An elongated uvula can cause discomfort and reduce a patient's quality of life. This study aims to report an atypical presentation of a squamous papilloma over the soft palate.
PubMed: 38738073
DOI: 10.7759/cureus.58008 -
Vaccine: X Jun 2024Human papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for...
BACKGROUND
Human papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for oral cancers, many of which are caused by HPV, and could identify vaccination candidates, but this requires a case-finding strategy.
OBJECTIVE
The purpose of this study was (1) to develop and test a case-finding approach to identify patients who were candidates for HPV vaccinations, (2) to test an HPV vaccination intervention by dental professionals on vaccination uptake.
METHODS
Design: Prospective, non-randomized feasibility case finding study with a 4-week enrollment period and a 6 week follow up period in general dental offices.Setting: Two general and non-commercial dentistry offices in Edmonton, Alberta Canada.Subjects: Consecutive scheduled (non-emergent) patients who met the Health Canada criteria for HPV vaccination: immunocompetent males and females aged 9-45 years and those who are immunocompromised. Consent for the discussion was obtained from each subject or parent.Intervention: Scheduled dental patients meeting the inclusion criteria were flagged by a research assistant who reviewed the appointment schedule each week for 4 weeks. For these subjects, dental clinicians (dentists and dental hygienists) used our Dental Dialogue Tool to discuss HPV vaccination and answer questions. Participating patients who consented to receive the HPV vaccine were given a prescription by the attending dentist and were directed to follow-up with a local pharmacy to have the vaccine administered. Each participant that was provided with an HPV prescription was contacted after 6 weeks to identify if they received the first dose of vaccine.Outcomes: Yield of our case-finding strategy and receipt of a patient's first HPV vaccine dose during 6 weeks post vaccine prescription.
RESULTS
Our case-finding strategy assessed 656 scheduled patients over 4 weeks. From this screening,179 (a case-finding yield of 20.4 %), were candidates for HPV vaccine discussion. Forty-three of these 179 patients (24 %) were already vaccinated.. Two patients (1.1 %) did not consent to be spoken with and 134 (74.8 %) consented to the HPV vaccine discussion.. Forty-eight of 134 patients (35.8 %) of patients accepted a prescription from the dentist after speaking with the dental clinician. Ultimately, 8/48 (16 %) (patients received their first dose of the HPV vaccine by the 6 week of follow-up call. However, this is only 4.5 % (8/177) of those patients who did consent for the discussion of HPV cancers and vaccination from their dentist.
CONCLUSION
We demonstrated that case-finding for HPV vaccine candidates in general dental offices was feasible, with a reasonable yield. While the dental dialogue tool was described as a great resource to explain the facts and answer questions, very few patients were vaccinated after 6 weeks of follow-up. Further work is necessary to sharpen the intervention, perhaps including follow-up discussions with the dental clinicians.
PubMed: 38737622
DOI: 10.1016/j.jvacx.2024.100492 -
Radiology Case Reports Aug 2024Choroid plexus papillomas are rare brain neoplasms, primarily observed in children, and typically manifest with symptoms indicative of heightened intracranial pressure...
Choroid plexus papillomas are rare brain neoplasms, primarily observed in children, and typically manifest with symptoms indicative of heightened intracranial pressure and cerebral irritation. In addition, the tumor's localization varies with the patient's age, and diagnostic and therapeutic approaches predominantly rely on imaging findings and surgical interventions, with histopathological examination being essential for confirmation. This study outlines a unique instance of choroid plexus papilloma in a 30-year-old female, who presented with severe headache and vomiting, subsequently revealing hydrocephalus on Brain CT. Remarkably, the tumor was identified in the Foramen of Monro, an exceedingly rare and unreported location in adults. Notably, the patient underwent successful endoscopic resection without complications, a technique sparsely documented in similar cases. Choroid plexus papilloma, predominantly afflicting children, displays varied tumor locations depending on the patient's age. Our report highlights an exceptional case with an atypical tumor location that was not reported before to our knowledge, and addressed through an innovative endoscopic resection method that was recently used in the management of such cases. This underscores the importance of considering diverse tumor presentations, as it has a favorable prognosis achievable through management, especially with the increasing number of reported cases. Moreover, it advocates for the adoption of emerging endoscopic approaches, which exhibit promising outcomes.
PubMed: 38737179
DOI: 10.1016/j.radcr.2024.03.093 -
Multiple Sclerosis and Related Disorders Jul 2024Natalizumab is an effective treatment for relapsing multiple sclerosis (MS). During therapy, individuals are at increased risk of developing progressive multifocal...
BACKGROUND
Natalizumab is an effective treatment for relapsing multiple sclerosis (MS). During therapy, individuals are at increased risk of developing progressive multifocal leukoencephalopathy (PML). So far, the relevant reservoir for PML-type JC polyomavirus (JCV) remains elusive. We here tested if the detection of JCV-DNA in stool of persons with MS treated with natalizumab could be a future tool for PML risk assessment.
METHODS
The presence of JCV-DNA in stool, urine, and whole blood of MS patients treated with natalizumab and known serum anti-JCV antibodies index values (IV) was studied. Different DNA extraction methods, real-time (RT) and droplet digital (dd) PCR techniques were compared. JCV isolates were screened for PML-associated variants by sequencing.
RESULTS
Thirty MS patients treated with natalizumab were screened. For 21 patients, blood, stool, and urine samples were available. These patients were stratified according to their serum anti-JCV antibody IV (high (>1.5, n = 12); medium (1.5-0.9, n = 2); low (<0.9, n = 1); negative (n = 6)). JCV-DNA could not be detected in the whole blood or stool samples. Four urine samples had measurable JCV-DNA, ranging from 1.71×10-1.07×10 international units (IU)/mL detected by RT-PCR, corresponding to 4.62×10-9.85×10 copies/mL measured by ddPCR. All JCV variants were wild-type and derived from patients with high antibody IV.
CONCLUSION
Stool-specific DNA extraction methods provided the highest quality of DNA, while the sensitivity of ddPCR and RT- PCR was comparable. Our findings do not support assessing stool samples for PML risk stratification in persons with MS. Further studies are needed to explore where PML-associated viral variants arise.
Topics: Humans; JC Virus; Natalizumab; Feces; Adult; Male; Female; Antibodies, Viral; DNA, Viral; Middle Aged; Immunologic Factors; Leukoencephalopathy, Progressive Multifocal; Multiple Sclerosis, Relapsing-Remitting; Multiple Sclerosis
PubMed: 38735204
DOI: 10.1016/j.msard.2024.105664