Uterine artery embolization for management of interstitial twin ectopic pregnancy: case report

Interstitial pregnancy is rare and dangerous variation of ectopic pregnancy. We describe a case of unilateral interstitial viable twin pregnancy treated by selective uterine artery embolization. A 23-year-old women with clinical and ultrasonic diagnosis of viable twin interstitial pregnancy was treated by selective uterine artery embolization after failure of systemic methotrexate treatment. Her serum beta-HCG was undetectable 2 months after the procedure and the ultrasound scan 70 days after embolization showed only multiple echogenic spots in the right uterine cornua. This therapeutic modality seems to be effective for conservative management of interstitial ectopic pregnancy, and as a prophylactic measure before surgical intervention to prevent major bleeding.     

Cervical pregnancy: case report and literature review

Cervical pregnancy is gaining recognition as a serious complication of early pregnancy. In view of the increasing incidence of the condition and the formidable therapeutic problems posed, a review of the literature is timely. This paper also presents a case report illustrating many of the typical features associated with cervical pregnancy.     

Splenic pregnancy: a case report and review of the literature

Primary splenic pregnancy is the least common form of extrauterine pregnancy. We report a case of splenic pregnancy occurring in a 29-year-old woman presenting with acute abdomen and hemoperitoneum. Recognition of this rare form of gestation is of critical importance, owing to the risk of exsanguination and death, and should be considered in the differential diagnosis of acute abdomen in women of reproductive age.     

Pemphigus vulgaris in pregnancy: a case report and review of literature

Pemphigus vulgaris (PV) is an uncommon, immune-mediated bullous dermatosis, which, during its active phase, has been associated with infertility. Pemphigus vulgaris during pregnancy is exceedingly rare-only 26 cases with immunopathological confirmation have been reported. The disease may be associated with adverse neonatal outcome, including prematurity and fetal death. Transient skin lesions may occasionally appear in the neonate. We report a patient who conceived during the active phase of PV, required high doses of corticosteroids to control the disease, and was delivered of a pre-term, appropriate-for-gestational age newborn.     

Proximal interstitial deletion of 7q: a case report and review of the literature

A male infant with multiple congenital anomalies was found to have a deletion of 7q [46,XY,del(7)(pter----q11.2::q22----qter)]. The father had a balanced rearrangement involving chromosomes 7 and 9, interpreted as 46,XY,dir ins(9;7), (9pter----9p12::7q22----7q11.2::9p12----++ +9qter;7pter---- 7q11.2::7q22----7qter). C-banding showed that the rearrangement occurred as a new event in the paternal grandfather's germ-line. Including the present patient, 16 cases of proximal 7q deletion (q11----q21/q22) have been described to date. This is a sufficient number of cases to permit comparison of manifestations to attempt delineation of karyotype-phenotype relationships in different proximal interstitial deletions of 7q.     

Heterotopic pregnancy after IVF-ET: report of a case and a review of the literature

A case of heterotopic, intrauterine and tubal ectopic pregnancy is reported, following in-vitro fertilization and transfer of four 4-cell embryos. The literature on the subject is reviewed and the possible aetiological factors, as well as the clinical essentials for early pre-operative diagnosis are discussed.     

Use of extracorporeal respiratory support during pregnancy: a case report and literature review

We describe the case of a 25 year-old woman at 27 weeks of gestation who was admitted to our intensive care unit (ICU) for acute respiratory distress syndrome (ARDS) caused by pandemic 2009 H1N1 influenza A. She presented with septic shock and refractory hypoxemia unresponsive to rescue therapies such as recruitment maneuvers, prone positioning, and nitric oxide inhalation. Extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and the patient's clinical conditions progressively improved: she was extubated after 16 days and discharged from the ICU 3 days later. No fetal complications were observed. At 38 weeks of gestation she gave birth to a healthy baby.     

Retroperitoneal ectopic brain: Case report and literature review

Heterotopic neural tissue (HNT) has been identified in many sites. In our literature review, we have found only two cases of HNT located in the retroperitoneum. As far as we know, cytological features of HNT have not been described. We here report a case of retroperitoneal HNT diagnosed by fine‐needle aspiration (FNA) cytology and subsequent resection. Our patient was a male infant born at 26 weeks’ gestation. A retroperitoneal solid‐cystic lesion measuring 3.8 cm was identified by abdominal ultrasound. FNA was performed and cytology showed highly cellular smears with single cells and masses of fibrillary material. Cells were small with rounded irregular nuclei and variable cytoplasm. Multinucleated cells, cells with neuronal morphology, calcifications, and hemosiderophages could also be seen. The lesion was excised and histology showed fibrillary areas, glial cells, neurons, and ependymal cells. Synaptophysin, GFAP, and EMA were expressed in distinct areas and cell types. No recurrences were observed.     

The ectopic ovary. A case report and review of the literature

We describe an ectopic ovary in a stillborn female. To our knowledge, this is the first report of an extra ovary in an infant. This case prompted a review of ectopic ovarian tissue, which is known by a variety of terms, the most common being accessory ovary and supernumerary ovary. We suggest that (1) many of the past cases should be classified as ovarian implants rather than true embryologically derived ectopic tissue; and (2) the terms accessory ovary and supernumerary ovary are imprecise and should be modified.     

Manifestations of pseudoxanthoma elasticum during pregnancy: a case report and review of the literature

A 30-year-old white woman with pseudoxanthoma elasticum (PXE) was followed throughout her pregnancy with several fetal ultrasonographic examinations and other diagnostic studies; these showed normal development up to the 26th wk and then a marked deceleration of fetal growth. The ultrasonographic appearance of the placenta was abnormal at all times probably related to the microscopic changes. The baby, born at 36 wk, showed severe intrauterine growth retardation as a probable consequence of the abnormal placenta detected by ultrasound and corroborated at birth. The cotyledons were small and more numerous than normal. One third of the placenta was hypoplastic or atrophic, with focal calcification in septa, stroma, villi, and decidua, and increased deposition of fibrin around villi. The most striking change was the increased number of septa and the abnormal elastic tissue.     

Lethal vertebral artery dissection in pregnancy: a case report and review of the literature

Subarachnoid hemorrhage represents a rare event in pregnancy with a high mortality rate. We present the case of a 39-year-old pregnant woman who developed right vertebral artery dissection with subsequent massive subarachnoid hemorrhage with fatal outcome. The macroscopic and microscopic autopsy findings are described. A review of the literature with a discussion of the varied predisposing factors for vertebral artery dissection and subarachnoid hemorrhage and the rarity of these events in pregnancy is provided.     

Cutaneous angiomyolipoma: a case report and literature review

Angiomyolipoma is a lesion usually observed in the kidney of patients with tuberous sclerosis. Extrarenal sites are very unusual with sporadic cases in internal organ, soft tissue and skin (fifteen cases have been described in this site). Herein we describe an adding case located on the ear in 58-year-old man reviewing the pertinent literature. The main diagnostic differential criteria are also discussed.     

Gonococcal endocarditis: a case report and literature review

Gonococcal endocarditis is rarely encountered in the post-antibiotic era. This case report describes a case of a previously healthy male who presented with double quotidian fever, chills, cough, and urethral symptoms. The presence of a cardiac mitral valvular vegetation along with positive blood cultures for Neisseria gonorrhoeae were diagnostic for gonococcal endocarditis. This case was, to our knowledge, the first reported gonococcal endocarditis case in China.     

Acute rhabdomyolysis: a case report and literature review

Acute rhabdomyolysis is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents into the circulatory system, which can cause potentially lethal complications. These contents include myoglobin, creatine phosphokinase, potassium, aldolase, lactate dehydrogenase and glutamic-oxaloacetic transaminase. There are numerous causes that can lead to acute rhabdomyolysis and many of patients present with multiple causes. The most common potentially lethal complication of rhabdomyoloysis is acute renal failure. In this article we present a case of a patient that developed clinical signs of acute rhabdomyolysis after consumption of heroin and alcohol. After approximately nine hours of alcohol and heroin induced coma he had acute compartment syndrome of the right arm, and clinical and laboratory signs of acute rhabdomyolysis with acute renal failure as a complication of rhabdomyolysis. Acute rhabdomyolysis developed in the patient as the result of acute compartment syndrome, with direct toxic activity of alcohol and diamorphine. During the period of coma, due to lying in particular position over a long period of time, pressure upon the certain part of the body caused muscle compression and capillary occlusion in fascial compartments, which led to ischemia. Upon pressure relief and beginning of tissue recovery, post ischemic compartment syndrome occurred with subsequent rhabdomyolysis. Getting out of coma the patient started to complain of severe pain in the right arm, which clinically worsened on passive stretching of the limb, with the loss of sensation and weakness. Laboratory findings showed high levels of creatine phosphokinase as the most sensitive marker of muscular damage. The peak of creatine phosphokinase level can be predictive for the development of acute renal failure because myoglobin level may return to normal within 6 hours after muscle injury. The peak of creatine phosphokinase (186.080 U/L; normal range 0-177) was recorded at 12 hours of admission. Other pertinent laboratory results such as urea, creatinine, prothrombin time, alanine aminotransferase and aspartate aminotransferase were also changed significantly. The peak of potassium level before dialysis was 6.8 mmol/L. Emergency fasciotomy of the anterior and posterior compartment syndrome was performed by a team of physicians after clinical examination. The second look debridement was performed at 48 and 72 hours. The plastic surgical procedure was performed 4 weeks later. On admission the patient also had oliguria with dark brown pigment in his urine. Arterial blood gases revealed metabolic and respiratory acidosis. The patient was hypovolemic and IV rehydratation with crystalloids, sodium bicarbonate and mannitol started immediately upon admission. Despite therapy his urine output decreased. Hemodialysis was initiated at serum potassium level of 6.8 mm/L and continued until his urine output returned to normal in three weeks. The patient was discharged from the hospital after six weeks, with normal urine output, without functional abnormality in his upper right limb. Acute rhabdomyolysis should be considered as a possibility in any patient with prolonged imobilization while in coma as well as in any intoxicated patient. Of course, creatine phosphokinase is the most sensitive indicator of muscle injury and the degree of creatine phosphokinase elevation correlates with the amount of muscle injury and disease severity. Other laboratory findings can help identify common complications of rhabdomyolysis such as acute renal failure, metabolic derangements and disseminated intravascular coagulopathy.     

Cutaneous angiolipoleiomyoma: a case report and literature review

The Authors describe a rare case of cutaneous angiolipoleiomyoma in an acral location together with a brief literature review. A 62-year-old male presented with a slow-growing asymptomatic nodule, 2.2 cm in diameter, located in the subcutaneous tissue of the left calf. Ten months after surgical excision, the patient is alive and free of disease. Histologically, the lesion was well-circumscribed and contained three components: areas of mature fat tissue were intermingled with cellular areas of spindle eosinophilic cells, reminiscent of smooth muscle cells, and a complex mixture of vessels of different types and sizes. Immunohistochemically, the cellular spindle component was positive for vimentin and smooth muscle actin, and negative for S-100, HMB-45, MART-1 and oestrogen and progesterone receptors. The Authors discuss differential diagnosis with other benign lesions such as angioleiomyoma and subcutaneous angiomyolipoma.     

Adrenal leiomyosarcoma: a case report and literature review

Leiomyosarcoma of the adrenal gland is a very rare tumour. We report a case of this rare tumour and review the previous case reports. The patient, a 68-year-old woman, presented with a 1-week history of right loin pain and fever associated with loss of weight and appetite. Computerised tomography and ultrasound scans showed the presence of a right adrenal gland tumour, which was subsequently surgically removed. Histological examination of the 12.5-cm tumour revealed a leiomyosarcoma of the adrenal gland. The patient was alive and well with no evidence of recurrent disease 1 year later.     

血管内淋巴瘤

目的：探讨血管内淋巴瘤的临床病理特征。方法：对1例血管内淋巴瘤进行免疫表型分析及原位杂交检测与EB病毒的关系,并文献复习,结果：女性,48岁,不明原因发热伴体重下降3个月,CT扫描示子宫肿块而行子宫加双侧附件切除,病理学检查发现瘤细胞位于血管内,伴少许管周浸润,瘤细胞免疫表型CD45（LCA）和CD20（L26）呈阳性表达,原位杂交显示E－BERs阴性,患者经CHOP联合化疗后获得完全缓解,结论：血管内淋巴瘤是一种极罕见的B细胞肿瘤,此瘤的诊断只能依赖病理学检查,治疗上应予以积极联合化疗。     

成人胰母细胞瘤1例报道及文献复习

目的：探讨胰母细胞瘤的病理形态特征、鉴别诊断。方法：对１例成人胰母细胞瘤进行病理组织学观察与免疫组织化学检测,结合文献讨论了其理形态特点。鉴别要点及特殊的临床表现。结果：胰母细胞瘤的瘤细胞由上皮和间叶两种成分组成,排列呈巢状和小叶状;上皮成分分化成特征性的鳞状小体结构及腺管,腺泡状,其多表达上皮性标记如ＣＫ、ＥＭＡ,部分表达Ｓｙｎ、ＣｇＡ等内分必标记,而不表达ｖｉｍｅｎｔｉｎ;上皮成分周围可见疏松     

十二指肠畸胎瘤1例报道并文献复习

目的:探讨十二指肠畸胎瘤的临床、影像及病理学特征,提高临床医生对该肿瘤罕见发病部位的认识。方法:回顾性分析2021年3月山东省烟台市烟台山医院收治的1例十二指肠实性成熟性畸胎瘤患者的临床、影像及病理资料。在中国知网、万方数据库、维普数据库及PubMed中以“十二指肠/duodenal”和“畸胎瘤/teratoma”为关...     

胸膜肺母细胞瘤1例报道及文献复习

目的：阐明胸膜肺母细胞瘤的病理形态特征及鉴别诊断要点。方法：对1例小儿胸膜肺母细胞瘤进行了组织形态学,免疫组织化学分析。结果：胸膜肺母细胞瘤是一种纯间质性恶性肿瘤,好发于12岁以下的儿童及婴幼儿,起源于肺、胸膜或纵隔的原始细胞,镜下可见原始胚胎性的圆形或短梭形细胞,瘤细胞有呈巢趋势,酷似肾母细胞瘤,肝母细胞瘤等肿瘤原始胚基成分,免疫组化未见有上皮细胞及其他间叶成分标志的表达,另一种成分为梭形细胞,除表现为纤维肉瘤特点外,还向横纹肌肉瘤分化,结论：胸膜肺母细胞瘤是一种极为罕见的恶性肿瘤,应与肺母细胞瘤,原始神经外胚叶肿瘤及胚胎性横纹肌肉瘤等鉴别。