INTRODUCTION: Midoesophageal diverticula >4cm in size are a medical rarity with a dozen reported cases so far. Usually, midoesophageal diverticula tend to be of small size and asymptomatic. CASE REPORT: We herein present a case of a woman suffering from a midoesophageal diverticulum in a very large dimension-never described in ...

BACKGROUND CONTEXT: Metastatic epidural spinal cord compression from gastrointestinal stromal tumors (GISTs) is a rarely reported phenomenon. PURPOSE: To describe the surgical management of metastatic GIST to two noncontiguous regions of the spinal column. STUDY DESIGN: Case report. METHODS: Review of the medical chart, radiographic studies, and relevant literature. RESULTS: ...

Congenital variations of the shape and structure of the nipple lacks coverage in the medical literature. We present four cases of a specific and unique congenital nipple anomaly, the cleft nipple. Each woman had a normal contralateral breast and nipple-areola complex. Three of the four cases were corrected surgically with ...

OBJECTIVE: Headache and postcraniotomy pain can be disabling. In addition, generation of pain due to manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim ...

Papillary tumor of the pineal region (PTPR) is a rare neuroepithelial tumor that arises in the pineal region. The optimal treatment for PTPR remains controversial, as no definitive treatment strategy exists for this lesion. It is not clear whether aggressive surgical removal is superior to biopsy followed by radiotherapy. The ...

Context.-Communication in surgical pathology is complex and includes multiple facets. Objective.-To discuss different aspects of pathology practice that represent quality communication in surgical pathology. Data Sources.-Literature review. Conclusions.-Achieving quality communication in surgical pathology is dependent on pathologists addressing multiple situations including managing physicians' expectations for turnaround time and ancillary testing, ...

Ischemic complications presenting as digital gangrene occurring in a patient of end-stage renal disease undergoing haemodialysis is rarely reported in literature. We report one such case of dry gangrene of a single finger in a 53 years old male undergoing haemodialysis. The condition was likely a steal phenomenon secondary to ...

We evaluate 3 new cases of congenital cholesteatoma confined to the mastoid process, and compare them with cases presented in the literature in order to better define this rare lesion. We performed a retrospective chart analysis of all congenital cholesteatomas treated surgically in a tertiary referral and skull base center. ...

INTRODUCTION: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal upper airway obstruction. This study is to review the presentation and management of this uncommon condition in a tertiary paediatric ENT centre in Scotland, United Kingdom. METHODS: Retrospective case note review between 2003 and 2011. A literature ...

Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely rare malignancy, of which only six cases have been reported in the literature. Here, we describe a PRSA in a 75-year-old woman treated with surgical excision and adjuvant chemotherapy. The pathological features of PRSA resemble those of ovarian serous carcinoma, which suggests ...

Acute appendicitis represents the most common non-obstetric indication for surgical intervention in pregnant women, with a reported incidence of 1 in 1440 pregnancies. Stump appendicitis is a rare clinical situation when there is incomplete appendectomy. A rare case occurred of stump appendicitis and chorioamnionitis complicating after incomplete appendectomy. In this ...

OBJECTIVE AND IMPORTANCE: A rare cause of intracranial hypotension is leakage of cerebrospinal fluid (CSF) through a dural breach from degenerative cervical spine pathology. To our knowledge there have been only four cases described in the English literature. Treatment is challenging and varies from case to case, with complete symptom ...

BACKGROUND CONTEXT: Idiopathic spinal cord herniation (ISCH) is a rare cause of progressive myelopathy. Preoperative diagnosis can be made with magnetic resonance imaging (MRI). Many surgical techniques have been applied by various authors, and ISCH is usually reversible by surgical treatment. PURPOSE: To present a case of ISCH in two ...

Abstract Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in the Caucasian population and its incidence is increasing worldwide. Although surgical procedures show a high cure rate with acceptable morbidity, non-surgical, pharmacotherapeutic approaches have been regarded as appropriate alternatives, and/or first-line treatments, in selected cases. Imiquimod (IQ) ...

BACKGROUND: Gossypiboma is a term used to describe a retained surgical swab in the body after a surgical procedure. Gossypiboma is a rare surgical complication, but can cause significant morbidity and mortality. It may be a diagnostic dilemma with associated medico-legal implications, and is usually discovered during the first few ...

OBJECTIVES: To review the published literature concerning robotic surgery and its applications in the management of cervical carcinoma. METHODS: We electronically searched the MEDLINE from January 1990 until June 2010. We cross-examined article references to identify relevant articles not detected by the electronic search. RESULTS: The majority of the reported ...

Abstract  Interrupted aortic arch (IAA) is a rare condition in infants that occurs approximately three times per million births. It is considered incompatible with life after the ductus arteriosus closes if it is not surgically corrected. A review found 37 reported cases not identified until the patient was over the ...

Ehlers-Danlos syndrome (EDS) is a group of well described connective tissue disorders in which collagen production is impaired. The surgical management of affected individuals remains challenging, with no general consensus. We report a case of spontaneous sigmoid perforation in a 17-year-old Eurasian male, in whom we subsequently established the diagnosis ...

Cardiac myxomas are the most common primary benign tumors of the heart. The reported incidence during pregnancy is extremely low with only 17 reported cases in the medical literature. Standard therapy involves surgical resection given the potential for embolization. In the pregnant patient, however, the risks of embolization must be ...

Spontaneous haematoma of the oesophagus is a rare cause of chest pain. We report the case of a 63-year-old female in whom spontaneous rupture of the oesophagus was suspected, but who was subsequently, found to have a dissecting intramural haematoma of the oesophagus. She successfully underwent mediastinal and thoracic drainage ...

Double synchronous primaries are known to occasionally occur in gynecologic cancers. Cases of triple or quadruple synchronous primaries, with only 4 case reports in the literature, are extremely rare. The authors report the case of a 49-year-old para 2-0-0-2 woman who presented for surgical management of metastatic ovarian adenocarcinoma diagnosed ...

The association of chronic subdural hematoma (CSDH) and arachnoid cyst (AC) is uncommon. We reported 2 juvenile athletes with CSDH associated with AC which occurred in their daily sports activities and reviewed the literature. Both of them were treated surgically, with satisfactory outcome. AC is a common predisposing factor in ...

Scar endometriosis is an under-appreciated or misdiagnosed phenomenon in general surgery and may eventually be more common than reflected in the literature. We herein report five cases of scar endometriosis that were treated in our surgical department one to five years after Caesarean section. Scar endometriosis should be considered when ...

Cutaneous melanoma is found in the head and neck in 15% of patients, in the limbs in 22%, in the trunk in 40% and in occult sites in 16%. There is usually an interval of at least 3 years between the diagnosis of primary melanoma and the identification of metastases. ...

Wegener granulomatosis (WG) is an uncommon, idiopathic disorder that is characterized by granulomatous inflammation of the upper and lower respiratory tract, disseminated vasculitis involving small and medium-sized vessels, and focal segmental glomerulonephritis. Approximately 25% to 50% of patients have nervous system involvement. The brain is less frequently involved. We report ...

OBJECTIVES:: Reports of an association between antineutrophil cytoplasmic antibodies (ANCA) and autoimmune neutropenia have rarely included cases of proven vasculitis. A case of ANCA-associated vasculitis (AAV) with recurrent neutropenia is described and relevant literature on the association between ANCA, neutropenia, and vasculitis is reviewed. METHODS:: Longitudinal clinical assessments and laboratory ...

Video Assisted Thoracoscopy (VATS) like any other minimal access surgery has the obvious advantage of less surgical insult, enabling quicker recovery with its attendant reduced hospital costs and earlier return to work. The benefit of earlier return to work is much more important in developing countries. Unfortunately minimal access surgery ...

Lichen sclerosus is a chronic immuno-mediated skin disease of the genital region in men and women. The treatment may be pharmacological or surgical, the choice depending on the extension of the involved area, the histological pattern and the level of functional disease complained by the patient. If the biopsy is ...

OBJECTIVES: Infectious myositis can be a life-threatening condition. We describe the clinical presentation, diagnosis, treatment, and outcome of a patient with Aspergillus-related myositis and review the relevant literature on Aspergillus-related myositis. METHODS: We report on a patient with acquired immunodeficiency syndrome who presented with Aspergillus myo-fasciitis, which was unusual because ...

A fatal case of eosinophilic and granulomatous meningoencephalitis caused by the free-living panagrolaimid nematode Halicephalobus gingivalis is reported in a 10-year-old Welsh gelding in the United Kingdom. Clinical examination first revealed behavioural abnormalities which rapidly progressed to severe ataxia, reduced mentation status and cranial nerve signs. Despite symptomatic treatment no ...

ABSTRACT: BACKGROUND: Antineutrophil cytoplasmic antibodies (ANCA)-associated systemic vasculitides have a variety of presentations, but cardiac valvular involvement is rarely diagnosed and its management is not established. CASE PRESENTATION: We report the case of a 44 year old man who presented with an ANCA-associated systemic vasculitis and aortic regurgitation of unusual ...

OBJECTIVES:: To report a patient with systemic ANCA-associated vasculitis, under maintenance treatment, who had persistent microscopic hematuria and developed recurrent pelvic pain due to Corynebacterium urealyticum encrusting cystitis. The relevant literature on this infection is reviewed. METHODS:: Descriptive case report and a review of the literature (PubMed search). RESULTS:: A ...

Necrotizing myositis is a severe and very rare streptococcal soft tissue infection involving the superficial fascia and muscle. Its clinical symptoms are nonspecific until the appearance of a fulminant clinical course with soft tissue destruction and septic shock. A high mortality and morbidity rate has been reported in the few ...

A 43-year-old woman presented to us with progressive breathlessness, dry cough and weight loss. A chest radiograph showed homogeneous opacification of the entire left hemithorax. A contrast enhanced computed tomography (CECT) scan of the thorax showed a large intrathoracic mass occupying almost the entire left hemithorax and appeared grossly inoperable. ...

Sinusoidal hemangioma is a rare variant of cavernous hemangioma that develops more frequently subcutaneous, often in the extremities. We report the case of a 19-year-old patient three times operated for a recurrent soft tissue tumor, located in the distal third of the antero-medial face of the right arm. Treatment was ...

The abuse of cocaine can lead to significant destruction of midline craniofacial structures. This process occurs secondary to myriad mechanisms, including ischemic necrosis, irritation by chemical adulterants, and direct trauma during its administration. Coupled with a prolonged chronic infection of intranasal and anterior skull base regions, an encephalocele can be ...

Localized extratibial myxedema is a rare presentation of thyroid disease that manifests with varied symptoms. Previous surgical or radioiodine treatment of hyperthyroidism is linked to the development of localized myxedema, as is prior trauma or surgery. We present the first known case of localized foot myxedema on a background of ...

Angiosarcoma (AS) is a rare and aggressive vascular neoplasm with very poor prognosis. Patients with extensive cutaneous AS who are not surgical candidates have very limited options since there is no standard treatment. Treatment options include radiation, chemotherapy, and angiogenesis inhibitor with varying success rates. Here, we report a case ...

Necrotizing fasciitis is known to be a highly lethal infection of deep-seated subcutaneous tissue and superficial fascia. Reports of necrotizing fasciitis due to Streptococcus pneumoniae are exceedingly rare. We report a case of necrotizing fasciitis in a 62-yr-old man with liver cirrhosis and diabetes mellitus. He presented with painful swelling ...

A 43-year-old female with antiphospholipid syndrome and Graves' disease developed a cutaneous leukocytoclastic vasculitis associated with antineutrophil cytoplasmic antibody (ANCA) against myeloperoxidase (MPO-ANCA) and proteinase-3 (PR3-ANCA), whilst treated with propylthiouracil (PTU). The skin lesions were progressively resolved after withdrawal of PTU and treatment with oral steroids. Patch testing with PTU ...

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis, almost invariably accompanied by asthma, nasal polyposis, paranasal sinus abnormalities, and increased peripheral blood eosinophil count. Neurological involvement as peripheral neuropathy is a common feature, whereas cerebral involvement is extremely rare. Herein, we report the case of a young man who presented ...

Endometriosis of the appendix is an entity of extragonadal endometriosis. It commonly affects women in the childbearing age with a wide spectrum of clinical manifestations. Women can present with symptoms mimicking acute appendicitis or chronic pelvic pain. The surgical management varies from simple appendectomy to right hemicolectomy depending on the ...

Leiomyomas are common benign tumors of the esophagus representing 10% of all mesenchymal tumors of the gastrointestinal tract. Prominent numbers of eosinophils involving a leiomyoma have only rarely been described. They have never been described involving a solitary leiomyoma of the esophagus. We present an unusual case of a solitary ...

The dorsal cutaneous appendage, or so-called human tail, is often considered to be a cutaneous marker of underlying occult dysraphism. The authors present a case of human tail occurring in a 9-month-old infant with multiple abnormalities of the spinal cord and spine. Examination revealed unremarkable except for a caudal appendage ...

Disseminated intravascular coagulation (DIC) although a well known complication in neonatal sepsis is extremely rare in congenital syphilis and there are scanty reports of this entity in the literature. Intracranial bleeding following DIC in neonatal congenital syphilis is even rarer, and has been reported only once earlier. We are reporting ...

Eosinophilic pustular folliculitis (EPF) is a rare dermatosis characterized by recurrent outbreaks of papulopustular skin lesions mainly distributed in seborrheic areas. These eruptions often are associated with peripheral blood eosinophilia and occur mainly on the face, upper back, and upper extremities. There are 3 variants: classic EPF (Ofuji disease), immunosuppression-associated ...

We present a very interesting and extremely rare case of an accessory tragus in the middle ear. Case report and review of literature. Accessory tragus is not an uncommon congenital malformation of the external ear. The exact prevalence of accessory tragus as an isolated physical finding is unknown but it ...

Congenital fusion of upper and lower jaw is rare. Only 35 bony syngnathia have been reported up to date, and 9 of them revealed posterior topography. A 10-day-old female infant with facial asymmetry, limited mouth opening, and cardiac murmurs is presented. The radiological findings revealed congenital bony fusion of right ...

Pentalogy of Cantrell is a rare congenital anomaly involving deficiency of the following structures: anterior diaphragm, supraumbilical abdominal wall, diaphragmatic pericardium, lower sternum, and associated congenital intracardiac abnormality. We describe a 3-month-old child with this syndrome having left ventricular diverticulum along with omphalocele who presented to us with a pulsating ...

Unilateral congenital agenesis of sternocleidomastoid and trapezius muscles is a rare occurrence. To date, there are only two case reports in the literature. We present a case of a 7-year-old Caucasian boy who was born with torticollis and a cosmetic defect in his neck. An MRI scan of the cervical ...