Archives of Clinical and Medical Case Reports
EISSN : 25759655
Current Publisher: Fortune Journals (10.26502)
Total articles ≅ 156
Latest articles in this journal
Archives of Clinical and Medical Case Reports; doi:10.26502/acmcr
Archives of Clinical and Medical Case Reports, Volume 4, pp 200-205; doi:10.26502/acmcr.96550187
Abstract:Inflammatory pseudotumor of the liver (IPTL) is a rare benign lesion that can mimic hepatic malignant neoplasms. A 79-year-old woman, in follow-up care for a left breast cancer, was referred to our Ultrasound Diagnostic Centre for a hepatic mass of unknown nature, displayed on PET-CT, CT and Abdominal Ultrasonography (US). The patient presented with abdominal pain and low-grade fever, increased values of C-Reactive Protein (CRP) and gamma-glutamyl transpeptidase (γGT). Abdominal US confirmed the presence of a heterogeneous polycyclic mass 4.0 × 3.7 cm in size, sub-capsular, localized in the segment VI, isoechoic in arterial phase and hypoechoic in portal and late phase on contrast-enhanced ultrasound (CEUS). A liver biopsy revealed the presence of chronic inflammatory cells without evidence of malignancy. As the patient did not respond to medical therapy, she underwent hepatic segmentectomy and cholecystectomy. At histology, the specimen showed acute and chronic inflammation with xanthogranulomatous features.
Archives of Clinical and Medical Case Reports, Volume 4, pp 97-105; doi:10.26502/acmcr.96550173
Abstract:Purpose: The present study aims to describe the differences in the prevalence of EGFR mutation of lung adenocarcinoma between private and public healthcare institutions. Methods: This was a descriptive, observational, retrospective, multicenter study with confirmed diagnosis of non-small cell lung cancer, adenocarcinoma subtype, distributed between two private practice centers and one public healthcare institution. After a pathology review to determine whether there was enough tumor tissue to make a molecular biology study, mutations were determined using real-time PCR for EGFR tyrosine-kinase domain gene. Results: After exclusions a total of 328 patients results for the final analysis. Two hundred thirty-five patients (71.64%) attended a public healthcare institution and ninety-three patients (28.35%) to a private healthcare institution (Table 1). From the public healthcare institution, 113 (34.45%) patients had a positive EGFR mutation, while only 27 patients (8.23%) from the private healthcare institution were positive for an EGFR mutation. When comparing the total number of patients in the study, this difference was statistically significant when comparing public versus private hospitals (p=0.002). Conclusion: We found that there is a statistically significant difference between the frequency of EGFR mutations between populations attending public and private healthcare institutions, probably related to ethnic differences between populations. Despite what has been reported in the present study, these conclusions cannot be generalized and further investigation is needed.
Archives of Clinical and Medical Case Reports, Volume 4, pp 153-157; doi:10.26502/acmcr.96550180
Abstract:We describe a rare case of a young patient with Crohn’s disease, who accidentally was found to have developed renal cell carcinoma while on treatment with anti-TNF-α biologic agent. The patient was submitted to laparoscopic resection of the tumor. Up to December 2019 he is in perfect condition without receiving any kind of antineoplastic treatment. Clinicians should bear in mind this clinical combination in patients with Crohn’s disease under treatment with biologic anti-TNF-α agents. Because the exact influence of anti-TNF-α biologic agents is largely unclear for now, the continuation of treatment might be a possible option.
Archives of Clinical and Medical Case Reports, Volume 4, pp 100-105; doi:10.26502/acmcr.96550172
Archives of Clinical and Medical Case Reports, Volume 4, pp 119-123; doi:10.26502/acmcr.96550176
Abstract:Objective: In this case report, we describe a huge response of pulmonary lung lesions that resulted in a pneumothorax in a metastatic colorectal cancer patient treated with Regorafenib. Case Report: A 65-year-old woman, diagnosed with lung metastases from colon cancer began in the assumption of Regorafenib after failure of a prior line of chemotherapy. The disease was re-evaluated every two months by CT scan and a responding disease was reported, through the cavitation of all pulmonary nodules. Suddenly, after 9 months of a well-tolerated treatment, the patient showed cough, dyspnea and asthenia. She was admitted in our ward and a sub-massive pneumothorax was diagnosed and treated by thoracic surgeons by positioning a chest tube to get a normal expansion of the collapsed lung. Pneumothorax was solved, but patient discontinued Regorafenib as its positive activity on lung metastases, showing a deep response to treatment, was considered an adverse event that caused such a threatening side effect. Results: The pneumothorax was very probably caused by an excessive cavitation of lung sub-pleural nodules responding to chemotherapy extraordinarily. Conclusions: This case highlights the need to monitor constantly patients with lung metastases receiving regorafenib especially with subpleural localization for the consistent risk of such sequelae.
Archives of Clinical and Medical Case Reports, Volume 4, pp 138-152; doi:10.26502/acmcr.96550179
Abstract:Charcot-Marie-Tooth (CMT) disease, which is the most common inherited neuropathy, is also referred to as hereditary motor and sensory neuropathy (HMSN) and shows a genetically heterogeneous pattern. CMT is diagnosed mostly by a neurologic specialist. It can be divided into autosomal dominant, autosomal recessive, or X-linked type, based on the transmission pattern. It can also be divided demyelinating or axonal type, based on the electrophysiological findings. Therefore, it is practically not feasible for anesthesiologists to make the diagnosis, and diagnosis becomes even more difficult with the continued emergence of subtypes with the identification of new genes. Moreover, each type has a different phenotype, and each may be managed slightly differently based on the actual symptoms presented. For each case, there are conflicting opinions on the methods for anesthetic management, causing much confusion. Accordingly, in this review, we aimed to discuss the diagnostic methods, types, and treatment methods for CMT from an anesthetic perspective and to review anesthetic management.
Archives of Clinical and Medical Case Reports, Volume 4, pp 158-163; doi:10.26502/acmcr.96550181
Abstract:Trichotillomania is characterized by recurrent pulling out of hair. It is a chronic disorder that causes functional impairment. Although trichotillomania has been known for a long time, no algorithms for its treatment have been created by now. In its etiology, trauma has also been suggested in addition to other factors. In this case study, a trichotillomania patient of 27 years with increasing severity accompanied by a history of trauma is reported. As medical treatment, aripiprazole augmentation was used, and for trauma therapy, EMDR (Eye Movement Desensitization and Reprocessing) was applied. The effects working through the trauma had on the treatment of our case was observed and discussed.
Archives of Clinical and Medical Case Reports, Volume 4, pp 110-118; doi:10.26502/acmcr.96550175
Abstract:Here we report a case of long-term survival with own liver in the patient of biliary atresia (BA) who developed hepatocellular carcinoma (HCC). The patient was a 34-year-old man. He underwent a portal jejunostomy with a diagnosis of BA (IIIb1ν) on the 94th day after birth, with a favorable post-operative course. Contrast-enhanced CT upon admission for cholangitis at the age of 34 suspected HCC, with an AFP level of 1.3 ng/ml and increased PIVKAII to 1,199 mAU/ml. He was diagnosed with HCC on MRI, and the tumor embolus had spread to the left branch of the portal vein; thus, resection and transplantation were considered contraindication. Proton therapy was performed, but he died 11 months after the detection of HCC. To date, 26 cases of HCC including this one have been reported, of which 20 were those in minors. Many of the patients with early onset have poor prognosis such as poor reduction of jaundice, while many of those with adult onset have relatively favorable prognosis as in this case; therefore, it was suggested that the progression of cholestatic cirrhosis is associated with carcinogenesis.
Archives of Clinical and Medical Case Reports, Volume 4, pp 124-129; doi:10.26502/acmcr.96550177
Abstract:Introduction: Peutz-Jeghers syndrome (PJS) is a rare autosomal inherited polyposis syndrome, characterized by multiple hamartomatous polyps in the gastrointestinal tract, associated with mucocutaneous pigmentation. Polyps mainly occur in the small intestine. Patients with PJS have an increased risk of many cancers. Histologically, the presence of a smooth muscle arborization within the lamina propria is the hallmark of those polyps. Intussusceptions is a rare complications of gastrointestinal polyps. In the present study, we report the case of this rare entity with particular histological features in a young woman who developed a jejunal obstruction caused by an intussusception. Case Presentation: A 32-year-old woman presented to the emergency department with jejunal obstruction caused by an intussusception. She had a pigmented macules around the mouth and on the tongue. An urgent exploratory laparotomy was performed, revealing a distended invaginated ischemic part of proximal jejunum.Careful exploration of the abdominal cavity and intestine revealed multiple polyps inside the small intestine. On gross, one pedunculated polyp was found. Histollogically, it had a central core of smooth muscle showing a tree like branching with a pseudo-invasion like pattern due to the extension of glands in the subserousa. Conclusion: PJS is a rare syndrome, which often remains undiagnosed for many years. Early diagnosis, treatment, and regular follow-up are important for an excellent prognosis in individuals presenting with this rare syndrome.