Blog Archive

Αλέξανδρος Γ. Σφακιανάκης

Sunday, January 31, 2021

Surgery-first for a patient with mild hemifacial microsomia: A case report and review of literature.

paythelady.612 shared this article with you from Inoreader
Related Articles

Surgery-first for a patient with mild hemifacial microsomia: A case report and review of literature.

World J Clin Cases. 2021 Jan 06;9(1):148-162

Authors: Song JY, Yang H, He X, Gao S, Wu GM, Hu M, Zhang Y

Abstract
BACKGROUND: Hemifacial microsomia (HFM) is the second most common craniofacial congenital anomaly following cleft lip and palate. Because of the various phenotypic spectra and the severity of the deformity, a wide range of treatment approaches have been proposed. Recently, the surgery-first approach (SFA) was introduced to treat mild to moderate HFM, and it yielded a balanced facial appearance. The SFA not only promotes rapid improvement in facial aesthetics but also considerably reduces the overall treatment time.
CASE SUMMARY: A female patient, aged 25 years old, sought orthodontic treatment with the chief complaint of dental and facial asymmetry. After a comprehensive physical examination and imaging analysis were performed, the patient was diagnosed with mild HFM that was primarily attributed to unilateral abnormal development of the maxilla-mandibular. The SFA was carried out to correct the skeletal deformity. The palatal suture was used as the midline of the maxilla in the surgical plan to center the maxilla, and the chin was also properly positioned to obtain a relatively symmetrical facial appearance. Four weeks after the surgery, the patient was referred for postsurgical orthodontics to decompensate the dentition and stabilize the occlusion. After 20 mo of treatment, all orthodontic appliances were removed. The posttreatment photographs of the patient and her smile confirmed good aesthetic and occlusal results.
CONCLUSION: Mild HFM can be corrected by SFA, which not only promotes rapid improvement in facial aesthetics but also considerably reduces the overall treatment time.

PMID: 33511179 [PubMed]

View on the web

Late-onset non-islet cell tumor hypoglycemia: A case report.

paythelady.612 shared this article with you from Inoreader
Related Articles

Late-onset non-islet cell tumor hypoglycemia: A case report.

World J Clin Cases. 2021 Jan 06;9(1):163-169

Authors: Matsumoto S, Yamada E, Nakajima Y, Yamaguchi N, Okamura T, Yajima T, Yoshino S, Horiguchi K, Ishida E, Yoshikawa M, Nagaoka J, Sekiguchi S, Sue M, Okada S, Fukuda I, Shirabe K, Yamada M

Abstract
BACKGROUND: Hypoglycemia due to non-insulin-producing tumors is referred to as non-islet cell tumor hypoglycemia (NICTH). As NICTH is a rare lesion, the natural course of NICTH is not well understood. We report a case of NICTH that was observed 30 years before the onset of hypoglycemia.
CASE SUMMARY: A 50-year-old man was diagnosed with an abnormal right chest shadow during a routine X-ray examination, but no further examination was undertaken because the lesion appeared benign. Thirty years after the tumor discovery, the patient was admitted to the hospital with symptoms of severe hypoglycemia, which was diagnosed as NICTH based on a complete examination. The tumor was resected and found to be a solitary fibrous mass (15.6 cm × 13.7 cm × 10.4 cm); thereafter, the patient's blood glucose levels normalized and he completely recovered.
CONCLUSION: NICTH can have an acute onset, even if the tumor has been present and asymptomatic over a long time period.

PMID: 33511180 [PubMed]

View on the web

Risk of group aggregative behavior during COVID-19 outbreak: A case report.

paythelady.612 shared this article with you from Inoreader
Related Articles

Risk of group aggregative behavior during COVID-19 outbreak: A case report.

World J Clin Cases. 2021 Jan 06;9(1):170-174

Authors: Zuo H, Hu ZB, Zhu F

Abstract
BACKGROUND: At the end of 2019, a new epidemic of viral pneumonia emerged in China and was determined to be caused by a novel coronavirus, which was named coronavirus disease 2019 (COVID-19) by the World Health Organization. The epidemic quickly spread, causing a worldwide pandemic. Scientists and clinicians across the globe have shifted their research efforts towards understanding the virus itself and its epidemiology.
CASE SUMMARY: In mid-January 2020, a Chinese family made a visit to a local city, and within the next 2 wk one after another fell ill with COVID-19. At the beginning of their first illness onset, the family had eaten in a restaurant, which led to the subsequent illness onset in another two families. All cases were diagnosed as COVID-19 by real-time fluorescent reverse transcription-polymerase chain reaction. Epidemiological investigation showed that the transmission chain was complete.
CONCLUSION: This chain of social exposure highlights the danger of group aggregative behavior for spread of COVID-19.

PMID: 33511181 [PubMed]

View on the web

Low-grade fibromyxoid sarcoma of the liver: A case report.

paythelady.612 shared this article with you from Inoreader
Related Articles

Low-grade fibromyxoid sarcoma of the liver: A case report.

World J Clin Cases. 2021 Jan 06;9(1):175-182

Authors: Dugalic V, Ignjatovic II, Kovac JD, Ilic N, Sopta J, Ostojic SR, Vasin D, Bogdanovic MD, Dumic I, Milovanovic T

Abstract
BACKGROUND: Low grade fibromyxoid sarcoma (LGFMS) is a rare and benign mesenchymal tumor with indolent course, most commonly found in young or middle-aged men. The majority of the LGFMSs are located in the trunk and deep soft tissue of the lower extremities. They appear as well circumscribed, although not encapsulated, which often leads to incomplete surgical resection. Despite their seemingly benign appearance, these tumors have aggressive behavior with high metastatic and recurrence rates. Accurate histopathologic examination of the specimen and its immunohistochemical analysis are mandatory for a precise diagnosis.
CASE SUMMARY: We report a case of a 38 year-old-man who presented with jaundice and upper abdominal discomfort. Multi-detector computed tomography and magnetic resonance imaging showed a large left liver tumor mass, extending to the hepatoduodenal ligament. Left hepatectomy was performed with resection and reconstruction of hepatic artery and preservation of middle hepatic vein. Histopathologic examination confirmed the tumor being a low-grade fibromyxoid sarcoma. Three and a half years after surgery, the patient died after being diagnosed with spine metastasis.
CONCLUSION: Due to poor response to all modalities of adjuvant treatment, we consider that the focus of treatment should be on surgery as the only option for curing the disease.

PMID: 33511182 [PubMed]

View on the web

Treatment of Stanford type A aortic dissection with triple pre-fenestration, reduced diameter, and three-dimensional-printing techniques: A case report.

paythelady.612 shared this article with you from Inoreader
Related Articles

Treatment of Stanford type A aortic dissection with triple pre-fenestration, reduced diameter, and three-dimensional-printing techniques: A case report.

World J Clin Cases. 2021 Jan 06;9(1):183-189

Authors: Zhang M, Tong YH, Liu C, Li XQ, Liu CJ, Liu Z

Abstract
BACKGROUND: A 63-year-old female was diagnosed with acute Stanford type A aortic dissection. The patient had pain in the chest and back for 1 wk. The computed tomography angiography (CTA) showed Stanford type A aortic dissection (Myla type III aortic arch). The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.
CASE SUMMARY: Preoperatively, a three-dimensional (3D)-printed model of the aortic arch was made according to CTA data. Then, under the guidance of the 3D-printed aortic model, a pre-fenestrated stent-graft was customized, and the diameter of the stent-graft was reduced intraoperatively by surgeons. 3D printing, triple pre-fenestration, and reduced diameter techniques were used during the surgery. The CTA examinations were performed at the 3rd mo and 1st year after the surgery; the results showed that the aortic dissection was repaired without endoleak, and all three branches of the aortic arch remained unobstructed.
CONCLUSION: Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case. The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.

PMID: 33511183 [PubMed]

View on the web

Hyperprolactinemia due to pituitary metastasis: A case report.

paythelady.612 shared this article with you from Inoreader
Related Articles

Hyperprolactinemia due to pituitary metastasis: A case report.

World J Clin Cases. 2021 Jan 06;9(1):190-196

Authors: Liu CY, Wang YB, Zhu HQ, You JL, Liu Z, Zhang XF

Abstract
BACKGROUND: Pituitary metastasis is an uncommon manifestation of systemic malignant tumors. Moreover, hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.
CASE SUMMARY: A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision, dizziness, polyuria, nocturia, severe fatigue and somnolence, decreased libido, and intermittent nausea and vomiting for more than 6 mo. During the last 7 d, the dizziness had worsened. Laboratory investigations revealed overall hypofunction of the pituitary gland, but the patient had an elevated serum prolactin level (703.35 mg/mL). Preoperative magnetic resonance imaging revealed a tumor in the sellar region, accompanied by intratumoral hemorrhage and calcification. Thus, transnasal subtotal resection of the lesion in the sellar region was performed. The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland. Oral hydrocortisone (30 mg/d) and levothyroxine (25 mg/d) were given both pre- and postoperatively. Post-operatively, the clinical symptoms were significantly improved . However, 4 mo following the surgery, the patient succumbed due to multiple organ failure.
CONCLUSION: Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland. Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.

PMID: 33511184 [PubMed]

View on the web

Pulmonary thromboembolism after distal ulna and radius fractures surgery: A case report and a literature review.

paythelady.612 shared this article with you from Inoreader
Related Articles

Pulmonary thromboembolism after distal ulna and radius fractures surgery: A case report and a literature review.

World J Clin Cases. 2021 Jan 06;9(1):197-203

Authors: Lv B, Xue F, Shen YC, Hu FB, Pan MM

Abstract
BACKGROUND: Pulmonary thromboembolism (PTE) is a serious postoperative complication that can occur after a fracture. Generally, PTE is caused by the falling off of lower extremity deep vein thrombosis (LEDVT) after lower limb fracture surgery. LEDVT and PTE after upper extremity fracture surgery are very rare. PTE is one of the most common clinical causes of sudden death. Venous thromboembolism includes PTE and DVT. We experienced one case of LEDVT and PTE after distal ulna and radius fracture surgery. The purpose of our report is to raise awareness for orthopedic surgeons that PTE can occur after distal ulna and radius fracture surgery, and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.
CASE SUMMARY: We report a 51-year-old Chinese male who had severe fractures of the left distal ulna, radius and little finger after a motorcycle accident. The patient underwent external fixation, open reduction and internal fixation. On the third post-operative day, computed tomographic pulmonary angiography showed PTE. Doppler ultrasonography showed thrombus formation in the bilateral posterior tibial veins. After a period of anticoagulation therapy, on the 25th d after the PTE, computed tomographic pulmonary angiography showed that thrombus in both sides of the pulmonary artery disappeared. Furthermore, about 4 mo after the PTE, thrombosis in the deep veins of the lower limbs disappeared. About 1 year after the surgery, X-rays showed good fracture healing, and the function of the wrist joint recovered well.
CONCLUSION: Though rare, PTE can occur after distal ulna and radius fracture surgery and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.

PMID: 33511185 [PubMed]

View on the web