- Reduction mammoplasty as a treatment for symptomatic central venous stenosis. [Journal Article]
- APArch Plast Surg 2018; 45(2):171-176
- Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to,...
Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.
- An unusual manifestation of olfactory neuroblastoma. [Journal Article]
- BCBMJ Case Rep 2018 Mar 13; 2018
- A 62-year-old woman presented with an 11-month history of worsening nasal symptoms of rhinorrhoea, anosmia, nasal congestion and intermittent epistaxis. MRI revealed a large mass in the upper nasal v...
A 62-year-old woman presented with an 11-month history of worsening nasal symptoms of rhinorrhoea, anosmia, nasal congestion and intermittent epistaxis. MRI revealed a large mass in the upper nasal vault. Biopsy of the mass revealed an olfactory neuroblastoma. While waiting resection, she acutely developed severe proximal muscle weakness, lethargy and lower extremity oedema. Blood glucose was elevated, and hypokalaemic metabolic alkalosis was noted. Elevated serum cortisol level of 95.7 µg/dL (8.7-22.4 µg/dL) and markedly elevated 24-hour urinary cortisol level of 6962.3 µg/24 hours (4.0-50.0 µg/24 hours) with concurrent adrenocorticotropic hormone (ACTH) level of 171 pg/mL (6-58 pg/mL) were suggestive of an ACTH-dependent source of hypercortisolism. A subsequent positive high-dose dexamethasone suppression test was consistent with ectopic ACTH production. She underwent near-total resection of the right nasal mass followed by radiotherapy, resulting in complete resolution of signs and symptoms of cortisol excess.
- Spontaneous Regression of a Retroodontoid Transverse Ligament Cyst: A Case Report. [Journal Article]
- NNeurosurgery 2018 Mar 05
- CONCLUSIONS: Symptomatic TLCs are often managed with surgical decompression and, in selected cases, fusion with good functional outcome. However, these interventions carry high risk of postoperative morbidity, particularly in the elderly. Conservative surveillance is rarely reported as a viable option. We present the first case of spontaneous TLC regression in the absence surgery or neck bracing. In select patients without acute myelopathy, clinical and radiographic surveillance may be considered for the management of TLCs.
- [Disseminated actinomycosis with central nervous system involvement]. [Case Reports]
- RCRev Chilena Infectol 2017; 34(6):598-602
- Actinomycosis is very rare, as well as the central nervous system (CNS) condition associated with it, presenting a mortality up to 28%. Its manifestations could be similar to infectious conditions fr...
Actinomycosis is very rare, as well as the central nervous system (CNS) condition associated with it, presenting a mortality up to 28%. Its manifestations could be similar to infectious conditions from other etiologies, thus, having a better understanding of the entity increases clinical suspicion and also it can provide a timely treatment. The clinical case of an adult with edema in an upper extremity is presented as a manifestation of thrombophlebitis and an abscessed axillary lesion, in which actinomycetes infection was confirmed. He presented a haematogenous spread with CNS involvement, with fatal ending.
- Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review. [Journal Article]
- FNFront Neurol 2018; 9:30
- CONCLUSIONS: Although most studies reviewed concluded that conventional and electroacupuncture could be effective for management of shoulder pain after stroke, the very high potential for bias should be considered. Further work in this area is needed that employs standardized acupuncture treatment modalities, endpoint assessments, and blinding of treatments.
- Putative lung adenocarcinoma with epidermal growth factor receptor mutation presenting as carcinoma of unknown primary site: A case report. [Case Reports]
- MMedicine (Baltimore) 2018; 97(7):e9942
- CONCLUSIONS: Putative lung adenocarcinoma presenting as CUP may have EGFR mutation, and EGFR-TKI therapy may be effective for such malignancy.
- Randomized, Double-Blinded, Sham-Controlled, Split-Hand Trial Evaluating the Safety and Efficacy of Triamcinolone Acetate Injection After Calcium Hydroxylapatite Volume Restoration of the Dorsal Hand. [Randomized Controlled Trial]
- DSDermatol Surg 2018; 44(4):534-541
- CONCLUSIONS: The addition of triamcinolone acetate coinjection with CaHA for dorsal hand augmentation did not negatively impact treatment efficacy but significantly reduced adverse side effects. This strategy represents a safe and effective way to improve patient experience and treatment tolerability.
- Cervico-thoracic Interspinous Bursitis Associated with Bilateral Upper-extremity Numbness: A Case Report. [Journal Article]
- CCureus 2017 Nov 30; 9(11):e1897
- The authors describe a 48-year-old woman suffering from bilateral upper-extremity numbness and axial radiating pain. Magnetic resonance imaging revealed soft-tissue edema and enhancement surrounding ...
The authors describe a 48-year-old woman suffering from bilateral upper-extremity numbness and axial radiating pain. Magnetic resonance imaging revealed soft-tissue edema and enhancement surrounding the dorsal tip of the C7 spinous process. Excisional biopsy of the lesion revealed a mildly inflamed bursa, with no evidence of an active infection. Removal of the inflamed bursa resulted in complete resolution of the upper-extremity numbness and improvement in her neck pain. Although similar cases have been reported to be associated with rheumatologic conditions, most notably polymyalgia rheumatica (PMR), the current report underlines the presentation of radicular-like complaints associated with interspinous bursitis in the absence of other conditions affecting the musculoskeleton.
- Complex Decongestive Therapy Enhances Upper Limb Functions in Patients with Breast Cancer-Related Lymphedema. [Journal Article]
- LRLymphat Res Biol 2018 Jan 22
- CONCLUSIONS: CDT provides enhancement of upper extremity functions and quality of life in patients with BCRL. The reduction in lymphedema volume, pain, and heaviness and the improvement in shoulder mobility may be the contributed factors.
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- Neurogenic Edema from Complex Regional Pain Syndrome Resulting in Fulminant Infection Necessitating Below Elbow Amputation. [Journal Article]
- JHJ Hand Microsurg 2017; 9(3):159-162
- We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1) and neurogenic edema that ultimately led to a medically necessary below-elbow amputation. The patient present...
We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1) and neurogenic edema that ultimately led to a medically necessary below-elbow amputation. The patient presented with a history of remote bilateral carpal tunnel release complicated by debilitating and recalcitrant bilateral CRPS-1. Following years of severe neurogenic edema of the left upper extremity, the patient had full-thickness skin sloughing on the dorsum of her hand due to massive edema. This subsequently led to maggot infestation of the soft tissues of the left hand ultimately necessitating amputation. We present the case as an illustration of an extreme case of neurogenic edema, a potential physical manifestation of CRPS-1. The case presented discusses upper extremity amputation as an end treatment option for CRPS-1, though in this case amputation was primarily indicated secondary to medical necessity.