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May 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1503
TOUDOU DAOUDA MoussaCorresponding author
Department of Neurology, Hassan II University Teaching Hospital, Sidi Harazem Road, PO Box 1835, Atlass, Fez, Morocco.
Introduction Bacterial meningitis complicates rarely pituitary macroadenomas. The aim of our systematic review is to study the features of the association between bacterial meningitis and pituitary macroadenoma. Methods We conducted a literature search in both MedLine and Google Scholar database from 1967 to October 2016 and reviewed all cases described of the association between bacterial meningitis and pituitary macroadenoma apart from any surgical act and without pituitary apoplexy. Results We found 14 articles describing 16 patients aged of 22-69 years old with a male predominance (sex ratio 4.3). Two patients (12.5%) had a well-documented clinical history of pituitary macroadenoma prior to the diagnosis of bacterial meningitis. Rhinorrhea has been found as the most common symptom through six patients (37.5%). Through the CSF culture, bacterial meningitis among patients suffering of pituitary macroadenoma commonly was due to Streptococcus pneumoniae. The examination in 18.75% of cases revealed signs related to pituitary macroadenoma (ophthalmoplegia and blindness). Six patients (37.5%) had received a treatment by dopaminergic agonist alone and 4 patients (25%) were treated with dopaminergic agonist associated with surgical treatment. Surgical treatment consisted of closure of the osteomeningeal breach in 12.5% (2/16) and tumor resection in 31.25% (5/16). Three patients (18.75%) had benefited tumor resection without prior agonist treatment. The mortality was 12.5% (2/16). Conclusion Our systematic review shows that bacterial meningitis represents a rare initial symptom leading to the diagnosis of invasive pituitary macroadenoma.
Nov 2014 DOI 10.14302/issn.2379-8572.joa-14-561
Elwany samyCorresponding author
Department of Otolaryngology, Alexandria medical School, Alexandria, Egypt
Pleomorphic adenomas are uncommon tumors of the nasal cavity. They arise from minor salivary glands, and usually originate from the nasal septum. The tumors are more common in middle-aged females. We present a series of 8 cases of intranasal pleomorphic adenomas. Seven of these tumors originated from the nasal septum, and only one of them originated from the lateral nasal wall. Histopathologic examination of the tumors showed that these tumors have higher epithelial and lower stromal components compared to pleomorphic adenomas of major salivary glands. Endoscopic resection was performed in all cases and the patients were followed up for one year. No recurrences or complications were observed in this series. Endoscopic resection is recommended as the treatment of choice because of its proven efficacy and low morbidity.
Oct 2019 DOI 10.14302/issn.2689-5773.jcdp-19-3044
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road , Rajouri Garden, New Delhi, 110027, India.
Cutaneous ciliated cyst is cogitated as a benign, exceptional lesion and can be additionally termed as cutaneous Mullerian cyst or a cystadenoma. Cutaneous ciliated cyst was initially described by Da Hess in 1890 and further elucidated in 1978 by Farmer and Helwig as a cyst predominantly occurring in young females within the second and third decades of life 12. Cutaneous ciliated cyst is a lesion of post- pubertal females, can appear in the reproductive phase and frequently enlarges during menstruation or pregnancy due to hormonal effects. Cutaneous ciliated cyst is commonly situated within deep-seated dermal or subcutaneous tissue of the upper extremities and perianal region. Cutaneous ciliated cyst delineates as Mullerian derivation in females and a distinct, foetal eccrine duct origin in males 12.
Jul 2019 DOI 10.14302/issn.2689-5773.jcdp-19-2890
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road , Rajouri Garden, New Delhi, 110027, India.
Initially described by Pinkus and Mehregan in 1963 as an epidermotropic eccrine carcinoma, eccrine porocarcinoma cogitates an exceptional sweat gland malignancy. Eccrine porocarcinoma was adapted as a nomenclature by Mishisma and Morikoin in 1969. The neoplasm is a malignant analogue of eccrine poroma which is a benign tumour of intra-dermal sweat glands. Eccrine porocarcinoma is an invasive malignancy of eccrine sweat gland with an acrosyringial genesis. Nomenclature includes epidermotropic eccrine carcinoma, eccrine poroepithelioma, malignant hidroacanthoma simplex, malignant intra-epidermal eccrine poroma, malignant eccrine poroma, malignant syringoacanthoma and dysplastic poroma (1,2). Sweat gland carcinoma are categorized into subgroups with the classical eccrine porocarcinoma or eccrine adenocarcinoma as a prevalent subcategory. Lesions are enlisted as Classic type eccrine adenocarcinoma ( eccrine porocarcinoma). Syringoid eccrine carcinoma Microcystic adnexal carcinoma Mucinous eccrine carcinoma Muco-epidermoid carcinoma Adenoid cystic carcinoma Aggressive digital papillary adenoma/adenocarcinoma
Aug 2017 DOI 10.14302/issn.2471-7061.jcrc-17-1624
Claudia PieperCorresponding author
Institute for Medical Informatics, Biometry und Epidemiology, University Hospital of Essen, Hufelandstraße 55, 45122 Essen, Germany,
Background Despite the existence of the statutory early cancer detection program in Germany and the removal of financial barriers, which is frequently reported in the literature to be the main obstacle in screening, uptake of colorectal cancer screening remains quite low. The campaign for colorectal cancer screening in German companies reported in this article started in 2010. It was initiated because of the low compliance with opportunistic public colorectal cancer screening efforts. Its goal is to improve participation by offering an organized screening program using a simple test (FIT). Methods An offer for company employees is publicized through posters, company newsletters and the intranet. The difference between the positivity rates of those who returned the kits within 20 days and later than 20 days was assessed using the Z-test. The average time between a positive result and colonoscopy was estimated using the Poincaré plot method. The positive predictive values were calculated for carcinomas, advanced adenomas or any lesions. The sensitivity and specificity of immoCare-C published by Vogel et al. and Hundt et al. were used to derive the confidence intervals for the positive likelihood ratio (for carcinoma and any kind of adenoma). Results A total of 312,147 kits were returned and analyzed (return rate 70.2%). 5.6% gave a positive result. The PPV for cancer aged between 55 and 74 was 4.6% for men and women (95% CI: 2.38%-6.76% and 1.28%-7.99%, respectively), but 22% for men (95% CI: 17.93%-26.65%) and 8% for women (95%CI: 3.63%-12.26%) for advanced adenomas. The PPV for any lesion was higher for those with familial risk (49.3%) and 42.6% for those without familial risk (95% CI: 40.2%-45.0%), but with overlapping confidence intervals. Conclusions The reported sample is not representative. Although, offering CRC screening in companies may be an effective way of increasing uptake in the target population. Differences in the test performance between men and women need further evaluation.
Oct 2016 DOI 10.14302/issn.2574-4526.jddd-16-1153
Umair MasoodCorresponding author
A 69 year old female with a history of pancreatic mucinous cystadenoma (treated with Whipple procedure) and recently presumed liver cirrhosis presented to the hospital with melanotic stools. The source of the bleeding was initially thought to be secondary to upper gastrointestinal (GI) varices due to portal hypertension from the liver disease. Upper endoscopy found no active bleeding and confirmed grade 2 gastric varices with gastric wall edema. Due to persistent symptoms and inability to locate the exact source, she went to the operating room for possible transjugular intrahepatic portosystemic shunt (TIPS) but was not found to have any porto-systemic gradient. Instead, she was found to have an isolated stenosis of the left gastric vein, which was treated with balloon angioplasty and eventual splenectomy. Upper GI varices usually occur due to portal hypertension from liver disease. Extra hepatic causes are much rarer. We report a case of upper GI bleed from gastric varices secondary to left gastric vein stenosis rather than portal hypertension. The stenosis was due to a rare complication of a Whipple procedure. The case is unique as there are no reported cases of gastric varices secondary to left gastric vein stenosis.
Dec 2015 DOI 10.14302/issn.2576-182X.jbsc-14-582
Ozdemir MevciCorresponding author
Pamukkale University, Faculty of Medicine, Department of Neurosurgery, Denizli, Turkey
Pituitary abscess is extremely rare and often misdiagnosed as pituitary tumor pre-operatively. We document a case of a 64-year-old lady presented to the outpatient department with complaints of headache and blurring vision of right eye for one month. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed Actinomyces infection. This case has been documented due to the extremely rare involvement of the pituitary gland by actinomyces infection. Pituitary abscess is a rare pathology, but it must be considered during evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. We report, to our knowledge, the fourth case of Actinomyces israelii infection of the pituitary region.
Jan 2015 DOI 10.14302/issn.2471-7061.jcrc-13-375
Savas NurtenCorresponding author
Baskent University Faculty of Medicine, Department of Gastroenterology, Oymaci sok. No:7 Altunizade / İstanbul - Turkey
Colorectal polyps were traditionally classified as hyperplastic or adenomatous polyps. Adenomatous polyps were thought to be the precursor lesions of most of the colorectal cancers, but later serrated lesions were recognized as precursors of nearly one-third of colorectal cancers. Serrated lesions are a distinct group of polyps with special morphologic and histologic properties and a different carcinogenesis pathway to colorectal cancers. They are pale, flat or depressed lesions which may result in failure of detection on colonoscopy. So the endoscopist should be aware of these lesions and should follow the patients according to the surveillance guidelines.