scholarly journals Malignant priapism secondary to isolated penile metastasis from a renal pelvic carcinoma

2014 ◽  
Vol 8 (7-8) ◽  
pp. 558 ◽  
Author(s):  
Sulai Liu ◽  
Fuhua Zeng ◽  
Lin Qi ◽  
Shusuan Jiang ◽  
Pingping Tan ◽  
...  
Keyword(s):  
Physical Examination ◽  
Urothelial Carcinoma ◽  
Radical Resection ◽  
Skin Lesions ◽  
Imaging Studies ◽  
Penile Shaft ◽  
Penile Metastasis ◽  
First Case ◽  
Malignant Priapism ◽  
Sarcomatoid Differentiation

We report a case of isolated penile metastasis from renal pelvic carcinoma in a 69-year-old man with malignant priapism. The patient had radical resection of the renal pelvic carcinoma 2 months earlier with urothelial carcinoma (UC) and sarcomatoid differentiation histology. Physical examination showed no visible skin lesions, but a palpable hard nodule was present over the penile shaft. The imaging studies did not reveal other metastases. Cavernous-Glans shunt and nodule resection were performed, and histological examination showed metastasis UC with sarcomatoid differentiation. To our knowledge, we describe the first case of malignant priapism due to isolated penile metastasis of renal pelvic carcinoma.

scholarly journals Scleroderma with Acro-Osteolysis and Papular Mucinosis Resembling Multicentric Reticulohistiocytosis

2020 ◽  
Author(s):  
João Dantas ◽  
Isabela S de Oliveira ◽  
Emanuela P Fonseca ◽  
Mittermayer Barreto Santiago
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Bone Resorption ◽  
Physical Examination ◽  
Skin Biopsy ◽  
Laboratory Tests ◽  
Skin Lesions ◽  
Imaging Studies ◽  
Plain Radiographs ◽  
Multicentric Reticulohistiocytosis

Objectives: We describe a case of systemic sclerosis (SS) with acro-osteolysis associated with cutaneous mucinosis, usually characterized by mucin deposition in the skin. The main differential diagnosis was multicentric reticulohistiocytosis due to the presentation of papulonodular skin lesions. Materials and methods: A physical examination, imaging studies and laboratory tests were performed. Results: Distal bone resorption was evident on plain radiographs, and skin biopsy confirmed mucinosis. The SS diagnosis was based on the clinical features, high levels of antinucleolar antibodies and typical nailfold capillaroscopy findings. Conclusion: To the best of our knowledge, this is the first description of cutaneous mucinosis accompanying SS with acro-osteolysis.

scholarly journals Differential Diagnosis of Azoospermia in Men with Infertility

2021 ◽  
Vol 10 (14) ◽  
pp. 3144
Author(s):  
Danilo L. Andrade ◽  
Marina C. Viana ◽  
Sandro C. Esteves
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Detailed Analysis ◽  
Clinical Management ◽  
Semen Analysis ◽  
Testicular Biopsy ◽  
Nonobstructive Azoospermia ◽  
Sperm Cryopreservation ◽  
Imaging Studies ◽  
Detailed Medical History

The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.

scholarly journals Nasal Epithelial Myoepithelial Carcinoma: An Unusual Cause of Epiphora, a Case Report and Review of the Literature

2015 ◽  
Vol 6 (2) ◽  
pp. ar.2015.6.0127 ◽  
Author(s):  
Juliette O. Flam ◽  
Christopher D. Brook ◽  
Rachel Sobel ◽  
John C. Lee ◽  
Michael P. Platt
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Nasal Cavity ◽  
Surgical Excision ◽  
Myoepithelial Carcinoma ◽  
Review Of The Literature ◽  
Nasal Symptoms ◽  
First Case ◽  
Nasal Tumor ◽  
Epithelial Myoepithelial Carcinoma

Introduction Epithelial myoepithelial carcinoma (EMC) of the nasal cavity is a rare tumor, and here we describe the first case of EMC of the nasal cavity presenting with epiphora. A case presentation and review of the literature is provided. Methods A case report is described of a 63-year-old man who presented with unilateral epiphora and was found via a thorough history and physical examination to have a nasal tumor. The physical examination consisted of an ocular examination, including probing and irrigation, and a detailed nasal examination (anterior rhinoscopy, nasal endoscopy). The nasal examination was prompted by the patient's report of concurrent nasal symptoms during history taking. Immunohistochemistry subsequently identified the nasal tumor as EMC. A literature search was performed to gain insights into similar malignancies of the nasal cavity. Results Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora. The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision. Conclusion Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity. Unilateral epiphora with concurrent nasal symptoms should prompt nasal cavity examination for the possibility of an obstructive tumor.

Paraneoplastic pemphigus associated with rapidly progressing endophthalmitis caused by Morganella Morganii: A case report

2021 ◽  
pp. 112067212110334
Author(s):  
Abdullah I Almater ◽  
Mohammed M Abusayf ◽  
Saeed Alshahrani ◽  
Abdullah M Alfawaz ◽  
Hind M Alkatan ◽  
...  
Keyword(s):  
Positive Culture ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Corneal Perforation ◽  
Morganella Morganii ◽  
Paraneoplastic Pemphigus ◽  
First Case ◽  
Johnson Syndrome ◽  
Acute Necrotizing ◽  
The Right

Introduction: The ocular presentation of paraneoplastic pemphigus (PNP) has rarely been reported in the literature. In this report, we describe a 61-year-old male presenting with eruptive skin lesions associated with underlying non-Hodgkin’s lymphoma who had rapid progressive corneal perforation with secondary endophthalmitis in the setting of PNP. Case description: A 61-year-old male presented to the emergency department complaining of skin eruption mimicking Stevens–Johnson syndrome, which was later found to be related to PNP. Initially, the patient complained of progressive ocular surface dryness in both eyes. Meanwhile, he developed mild pain in the right eye associated with blurry vision in both eyes and was managed with lubricants and topical antibiotics. A few days later, he was found to have corneal perforation with features suggestive of left endophthalmitis with possible early panophthalmitis. Intravenous antibiotic was administered, and primary evisceration of the left globe was performed. Histopathology revealed acute necrotizing keratitis and endophthalmitis. Vitreous analysis showed numerous gram-negative bacilli and a positive culture of Morganella morganii. The patient continued to be managed with frequent lubrications and punctual plugs in the fellow eye during the follow-up period. Conclusion: We describe the first case of endophthalmitis developing secondary to PNP-induced corneal melting and perforation. Anticipating unusual infectious sequelae in the setting of PNP might be warranted to actively detect and successfully manage dry eye disease before devastating complications develop.

Physical Examination of Patients With Cerebrospinal Fluid Shunts: Is There Useful Information in Pumping the Shunt?

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 470-473
Author(s):  
Joseph H. Piatt
Keyword(s):  
Cerebrospinal Fluid ◽  
Physical Examination ◽  
Predictive Value ◽  
Pumping Test ◽  
Study Group ◽  
Cerebrospinal Fluid Shunts ◽  
Imaging Studies ◽  
Shunt Valve ◽  
The Status ◽  
Shunt Obstruction

To assess the value of the information derived from pumping the shunt valve in hydrocephalic patients with cerebrospinal fluid shunts, the findings on examination of 200 consecutive patients were recorded prospectively. The status of each shunt was determined on the basis of all available clinical data, and the results of the shunt pumping test were compared to the final status of each shunt for various subsets of the study group. In the most clinically pertinent subsets, the sensitivity of the shunt pumping test in the detection of shunt obstruction was 18% to 20%, and the predictive value of a negative shunt pumping test, indicating shunt patency, was only 65% to 81%. For the hydrocephalic patient with symptoms of shunt malfunction, definitive imaging studies must not be deferred because of reassuring findings on examination of the shunt valve.

Microcystic Transitional Cell Carcinoma

2002 ◽  
Vol 126 (7) ◽  
pp. 859-861 ◽  
Author(s):  
Xavier Leroy ◽  
Emmanuelle Leteurtre ◽  
Alexandre De La Taille ◽  
David Augusto ◽  
Jacques Biserte ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Macroscopic Hematuria ◽  
Computed Tomographic ◽  
First Case ◽  
History Of ◽  
Invasive Transitional Cell Carcinoma

Abstract Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.

scholarly journals A submandibular nodule revealing a relapsed bladder urothelial carcinoma

2021 ◽  
Vol 12 (e) ◽  
pp. e10-e10
Author(s):  
Aya Khemir ◽  
Nada Mansouri ◽  
Faten Gargouri ◽  
Fethi Bougrine
Keyword(s):  
Bladder Cancer ◽  
Physical Examination ◽  
Urothelial Carcinoma ◽  
Medical History ◽  
Tumor Cells ◽  
Microscopic Examination ◽  
Survival Rates ◽  
Cytokeratin 20 ◽  
Cytokeratin 7 ◽  
Total Recovery

A 69-year-old patient treated for infiltrating bladder transitional carcinoma many years ago presented with a submandibular nodule. The last was fortuitously discovered by the patient a month before he presented to consultation. Physical examination showed a firm subcutaneous nodule of 0.5 cm in diameter in the right submandibular region. At this level skin was inflamed/red and swollen. Otherwise physical examination was within normal. The described nodule above was biopsied. Microscopic examination showed infiltration of the dermis by a carcinomatous proliferation (Fig. 1). Tumor cells were arranged in small nests and clusters surrounded by a fibrous stroma. Tumor cells showed moderate nuclear atypia. Immunohistochemical staining showed positivity of tumor cells for Cytokeratin 7 and P63 (Fig. 2). Therefore, taking into consideration patient’s medical history, microscopic and immunohistochemical findings the diagnosis of CM from urothelial carcinoma was retained. The first case of CM from bladder carcinoma was reported in 1909 [3]. Since then many case have been reported [1,2]. According to cases reported in literature so far, the mean interval of time between the setting of bladder cancer and the appearance of CM is of 18 months approximately. Large tumor size and deep infiltration of the bladder wall are predictive factors of CM. However, cases of CM associated with superficial bladder carcinomas were reported [3]. The certain diagnosis is based on microscopic examination [1,3]. Pathologists should be aware of patient’s medical history to facilitate the diagnosis and choosing appropriate immunostains if necessary especially in front of a poorly differentiated carcinoma[3]. Urothelial carcinomas express Cytokeratin 7 and Cytokeratin 20 antibodies [3]. The occurring of CM in case of bladder cancer darken the prognosis [1,2]. Median survival rates are less than 12 months in published cases so far [1,3]. Treatment consists of chemotherapy if the patient could bare it [1]. Total recovery was detected in 70% of cases of CM treated with chemotherapy. Yet, it does not improve global survival rates [3].

scholarly journals Streptococcus pyogenes cluster in a care home in England April to June 2010

2011 ◽  
Vol 16 (47) ◽  
Author(s):  
L M Milne ◽  
T Lamagni ◽  
A Efstratiou ◽  
C Foley ◽  
J Gilman ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Streptococcus Pyogenes ◽  
Care Home ◽  
Skin Lesions ◽  
Protective Equipment ◽  
First Case ◽  
Chronic Skin ◽  
And Training ◽  
Culture Negative

Two fatal cases of Streptococcus pyogenes emm st22.6 bacteraemia occurred in a care home in England during April and June 2010, initiating a cluster investigation. The first case had left the home 13 days before the second case took up residence. We sought further cases and carriers. We swabbed throat and chronic skin lesions from residents and staff and examined these specimens for the presence of S. pyogenes. 61 specimens were taken from 18 of 19 residents and 39 of 39 staff. All results from swabbing were culture negative. We observed infection control practices and the environment at the care home for deficiencies. Issues were identified relating to the correct use of personal protective equipment, hand hygiene, clinical waste and laundry. Infection control practices were improved and training given. Infection control practices and the environment at a care home should be examined as part of the investigation of a S. pyogenes cluster. Screening for carriage of S. pyogenes should be done before antibiotic chemoprophylaxis is issued to care home residents and staff.

scholarly journals A rare case of Sweet syndrome secondary to melioidosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sahathevan Vithoosan ◽  
Balendran Thanushah ◽  
Paramarajan Piranavan ◽  
Dayal Gamlaksha ◽  
Harindra Karunatilake ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Burkholderia Pseudomallei ◽  
Skin Lesions ◽  
Upper Limbs ◽  
Cutaneous Manifestations ◽  
Sweet Syndrome ◽  
Emerging Infection ◽  
Oral Ulcers ◽  
First Case ◽  
The Face

Abstract Background Melioidosis is an emerging infection in South Asia caused by Burkholderia pseudomallei with various clinical presentations that include pneumonia, bacteraemia, arthritis, and deep-seated abscesses. Various cutaneous manifestations have been described in association with melioidosis. However Sweet Syndrome secondary to melioidosis has not been reported in the literature. Herein we describe the first case of Sweet syndrome secondary to melioidosis. Case presentation A 53-year-old previously healthy Sri Lankan female presented with high-grade fever, painful oral ulcers, odynophagia and multiple bilateral cervical lymphadenopathies for 1 month. She also had a loss of appetite and weight. She had oral ulcers and bilateral blepharitis. Dermatological examination revealed multiple tender papules with a mamillated appearance and targetoid lesions with a yellowish centre over the face, upper trunk and upper limbs. She also had multiple tender subcutaneous nodules over the extensor aspect of upper limbs. Her inflammatory markers were significantly elevated. Aspirate from a submental lymph node abscess revealed the growth of Burkholderia pseudomallei. Melioidosis antibody titer was > 10,240. The histology of the skin lesions of the face and left forearm showed a prominent neutrophilic infiltrate in the dermis and the morphological features were in favour of Sweet syndrome with panniculitis. She was started on intravenous meropenem 2 g daily and showed rapid clinical improvement with the disappearance of skin lesions as well as a reduction in inflammatory markers. Conclusion Sweet syndrome is an uncommon inflammatory disorder known to be associated with upper respiratory tract and gastrointestinal infections, malignancies and the use of certain drugs. Melioidosis is an emerging infection with various cutaneous manifestations. This is the first case of melioidosis causing the secondary sweet syndrome. It emphasizes the importance of considering melioidosis as a potential aetiology in patients with Sweet syndrome.

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