Case reports Digital ischemia and occult malignancy

1996 ◽  
Vol 11 (4) ◽  
pp. 196-197 ◽  
Author(s):  
P. Paw ◽  
S. M. Dharan ◽  
J. M. Sackier
Keyword(s):  
Case Reports ◽  
Digital Ischemia ◽  
Occult Malignancy

scholarly journals Migrating Polyarthritis as a Feature of Occult Malignancy: 2 Case Reports and a Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Geoffrey Alan Watson ◽  
Lorraine O’Neill ◽  
Ruth Law ◽  
Geraldine McCarthy ◽  
Douglas Veale
Keyword(s):  
Malignant Disease ◽  
Clinical Phenotype ◽  
Case Reports ◽  
Review Of The Literature ◽  
Serological Tests ◽  
Common Causes ◽  
Occult Malignancy ◽  
Antibody Positivity ◽  
Clinical Awareness ◽  
Citrullinated Peptide

Malignant disease may be associated with a wide variety of musculoskeletal syndromes. Rarely the musculoskeletal system can be indirectly affected by paraneoplastic phenomena, such as carcinomatous polyarthritis (CP). The differential diagnosis for CP is broad and is often a diagnosis of exclusion. CP often presents similarly to other forms of inflammatory arthritis, and a detailed history and physical examination can often distinguish CP from other more common causes of polyarticular arthritis. However serological tests such as rheumatoid factor (RF) and anti-citrullinated peptide (anti-CCP) antibody positivity, while rare, can be misleading. Clinical awareness and suspicion are paramount in achieving an accurate diagnosis and early detection of an occult neoplasm is critical for prompt management and therapy. We report two cases presenting with this unique clinical phenotype associated with paraneoplastic polyarthropathy and review the literature.

scholarly journals Foot metastasis: Current knowledge

2020 ◽  
Author(s):  
Tommaso Greco ◽  
Luigi Cianni ◽  
Domenico De Mauro ◽  
Giacomo Dughiero ◽  
Maria Beatrice Bocchi ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Primary Tumor ◽  
Current Knowledge ◽  
Case Reports ◽  
Late Phase ◽  
Foot Pain ◽  
Old Patients ◽  
Metatarsal Bones ◽  
Occult Malignancy ◽  
The Right

Foot metastasis are rare and often overlooked due to non-specifical symptoms. This often leads to misdiagnosis delaying the right diagnosis. Metastatic disease of the foot is rare. Foot pain and swelling may be the presenting symptom of an occult malignancy. If metastatic disease is not kept in the differential diagnosis of foot pain, diagnosis and treatment will be delayed. The purpose of this study was to analyze articles presenting cases of foot metastasis to provide a more accurate incidence of symptomatic foot acrometastasis as well as to review the clinical course and outcomes. Studies were searched on PubMed/Medline from the inception to February 2020. All studies included in the review presented foot metastasis either with or without a known primary tumor. Most of the articles were case reports, to which we added two case reports of foot acrometastasis produced by our Institute. Forty-three studies with a total of 45 patients were included in this review. The literature published mostly concerning case reports about old patients (average age: 63,2), in a late phase of their disease. Lung cancer appeared to be the most common primary tumor, followed by endometrial and breast cancer. In the 36% of the cases foot metastasis were found when the primary site was still unknown. Calcaneus and metatarsal bones were the most common bones involved. Surgical solution is rare, the chosen treatments are often of palliative care. Prognosis was often poor, death occurred within 2 years since the discovery of foot metastasis in about 50% of cases.

scholarly journals Dropping the Hammer: An Uncommon Case of Right-Hand Pain in a Professional Hockey Player

2018 ◽  
Vol 11 (3) ◽  
pp. 238-241 ◽  
Author(s):  
Donald Kasitinon ◽  
Robert J. Dimeff
Keyword(s):  
Case Reports ◽  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Cold Sensitivity ◽  
Hockey Stick ◽  
Hockey Player ◽  
Doppler Ultrasound Imaging ◽  
Digital Ischemia ◽  
Professional Hockey ◽  
Repetitive Trauma

A 26-year-old, right-handed male professional hockey player presented for a second opinion with dysesthesia of the tips of his right third, fourth, and fifth fingers after 2 previous incidents of hyperextension injuries to his right wrist while holding his hockey stick. Radiographs and computed tomography scans were negative for fracture. After magnetic resonance angiography and Doppler ultrasound imaging, the athlete was diagnosed with hypothenar hammer syndrome (HHS) with ulnar artery aneurysm and thrombosis. He underwent successful surgery with ligation and excision of the aneurysmal, thrombosed ulnar artery and was able to return to hockey 4 weeks after surgery. HHS is thought to be a rare posttraumatic digital ischemia from thrombosis and/or aneurysm of the ulnar artery and was traditionally considered an occupational injury but has been reported more frequently among athletes. There have only been 2 previous case reports of hockey players diagnosed with HHS, and in the previous 2 case reports, both involved repetitive trauma from the hockey stick, which resulted in thrombotic HHS. We present a case of a professional hockey player diagnosed with HHS also due to repetitive trauma from the hockey stick, but this time resulting in aneurysmal HHS with thromboembolism. This case report highlights the importance of keeping HHS in the differential diagnosis in athletes with pain, cold sensitivity, and paresthesia in their fingers with or without a clear history of repetitive trauma to the hypothenar eminence, as HHS is a condition with good outcomes after proper treatment.

scholarly journals Arthritis as an initial presentation of malignancy: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Benjamin Sachdev Manjit Singh ◽  
Sharifah Aishah Wan ◽  
Yaw Kiet Cheong ◽  
Seow Lin Chuah ◽  
Cheng Lay Teh ◽  
...  
Keyword(s):  
Case Reports ◽  
Early Morning ◽  
Disease Modifying Antirheumatic Drugs ◽  
Disc Disease ◽  
Ankle Joints ◽  
Asian Descent ◽  
Occult Malignancy ◽  
History Of ◽  
Seronegative Spondyloarthritis ◽  
Paraneoplastic Arthritis

Abstract Background Arthritis is rarely reported as a paraneoplastic manifestation of occult malignancy. We report herein two cases of paraneoplastic arthritis due to occult malignancy. Case 1 The patient was a 65-year-old woman of asian descent who was a former smoker with a history of spine surgery performed for L4/L5 degenerative disc disease. She presented with a 1-month history of oligoarthritis affecting both ankle joints and early morning stiffness of about 3 hours. Laboratory tests were positive for antinuclear antibody at a titer of 1:320 (speckled) but negative for rheumatoid factor. She was treated for seronegative spondyloarthritis and started on prednisolone without much improvement. A routine chest radiograph incidentally revealed a right lung mass which was found to be adenocarcinoma of the lung. She was treated with gefitinib and her arthritis resolved. Case 2 The patient was a 64-year-old woman of asian descent, nonsmoker, who presented with a chief complaint of asymmetrical polyarthritis involving her right wrist, second and third metacarpophalangeal joints, and first to fifth proximal interphalangeal joints. She was treated for seronegative rheumatoid arthritis (RA) and started on sulfasalazine, with poor clinical response. Six months later, she developed abdominal pain which was diagnosed as ovarian carcinoma by laparotomy. Her arthritis resolved following treatment of her malignancy with chemotherapy. Conclusion In summary, paraneoplastic arthritis usually presents in an atypical manner and responds poorly to disease-modifying antirheumatic drugs. Accordingly, we recommend screening for occult malignancy in patients presenting with atypical arthritis.

Case Reports Link ADHD Stimulants to Skin Eruptions

2011 ◽  
Vol 45 (12) ◽  
pp. 10
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Case Reports

Bowel ischaemia after endovascular aneurysm repair

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 273-277
Author(s):  
Christopher Lowe ◽  
Oussama El Bakbachi ◽  
Damian Kelleher ◽  
Imran Asghar ◽  
Francesco Torella ◽  
...  
Keyword(s):  
Case Reports ◽  
Endovascular Aneurysm Repair ◽  
Artery Occlusion ◽  
Bibliographic Databases ◽  
Bowel Ischaemia ◽  
Prophylactic Measures ◽  
Increased Risk ◽  
Prisma Statement ◽  
Meta Analyses ◽  
Aneurysm Repair

Abstract. The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included. These studies detailed some 6,184 infra-renal elective EVARs, without procedure-related occlusion of the hypogastric arteries, performed between 1996 and 2014. Bowel ischaemia in this setting is uncommon with an incidence ranging from 0.5 to 2.8 % and includes a spectrum of severity from mucosal to transmural ischaemia. Due to varying reporting standards, an overall proportion of patients requiring bowel resection could not be ascertained. In the larger series, mortality ranged from 35 to 80 %. Atheroembolization, hypotension, and inferior mesenteric artery occlusion were reported as potential causative factors. Elderly patients and those undergoing prolonged procedures appear at higher risk. Bowel ischaemia is a rare but potentially devastating complication following elective infra-renal EVAR and can occur in the setting of patent mesenteric vessels and hypogastric arteries. Mortality ranges from 35 to 80 %. Further research is required to identify risk factors and establish prophylactic measures in patients that have an increased risk of developing bowel ischaemia after standard infra-renal EVAR.

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

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