Cervical Subarachnoid Hematoma of Unknown Origin: Case Report

Summary  Objective and Importance. Spontaneous spinal subarachnoid hematoma is rare, having been reported in the English literature in only seven other cases. We describe the first case of spontaneous subarachnoid hematoma located in the cervical spinal cord of a 43-year-old man. The pathologic examination showed no apparent source of bleeding, but there was evidence of cervical spondylotic myelopathy.  Clinical Presentation. The patient presented with a 10-day history of severe neck pain, followed by the onset of quadriparesis that was more evident on the left side, urinary retention, and sensory loss below C5. His medical history included hypertension. Magnetic resonance imaging showed a massive hemorrhage in the cervical spinal canal.  Intervention. A C4-C5 subarachnoid hematoma was removed. The patient died due to respiratory distress and uncontrollable hypotension on day 6 after surgery. Surgical exploration, neuroradiologic examinations, and autopsy showed no evidence of vascular malformations, tumors, or other possible sources of bleeding.  Conclusion. After excluding more common causes of spontaneous subarachnoid hematoma in this patient, we suggest that chronic spinal cord compression (spondylotic myelopathy) and arterial hypertension in this patient may have caused the pathogenesis of this rare clinical entity. Experimental data supporting this hypothesis are discussed.     

Rare Bone Metastasis of Neuroendocrine Tumors of Unknown Origin: A Case Report and Literature Review

BackgroundThe neuroendocrine tumor (NET) is rare, accounting for about 0.5% of all tumors. NETs have the characteristics of metastasis, especially lymph nodes, liver, spleen, and bone.Case presentationWe report a 30‐year‐old man diagnosed with a NET with bone metastasis and presented with waist and leg pain. The imaging findings of this case showed multiple osteosclerosis and no apparent bone destruction. We collected the patient''s previous examinations, including laboratory, imaging, and pathological examination to get a precise diagnosis. Given this case, we carried out symptomatic support treatment to relieve the patients'' pain symptoms.ConclusionBone metastases from NETs of unknown primary site are rare in both clinical and imaging manifestations. The disease is mainly manifested as multiple osteosclerosis, accompanied by muscle soreness and pain. It is recommended to try chemotherapy for this disorder.     

Carcinoma of Müllerian Vestigial Origin: Report of a Case

Benign tumours of the epididymis, which are very rare, are variously regarded as adenomas, mesotheliomas and lymphangiomas, but an alternative opinion considers them to be of Müllerian vestigial origin. Their malignant counterparts are extremely rare, and this case is probably the second authentic instance to be reported in the English literature. Complete excision of the mass with wide resection of the cord followed by prophylactic local deep X-ray therapy has provided total relief to the patient over the year which has elapsed since these measures were undertaken.     

甲状旁腺腺瘤1例

患者　女 ,37岁 ,6年前反复出现腰痛 ,左下肢麻痛 ,拟“风湿性关节炎”保守治疗 ,症状可缓解。 1月前出现左髋及左大腿疼痛 ,门诊对症治疗 ,效果不明显 ,入院前 1ｈ因摔伤而致左髋剧痛、畸形、不能活动。入院后检查发现右叶腺体下极可触及一约花生米大小的肿物 ,质中 ,边界不清 ,无压痛 ,随吞咽活动 ,区域淋巴结未触及肿大。左髋呈内收外旋畸形 ,粗隆下压痛 ,无缩短畸形。Ｘ线检查 :左股骨小转子下方横行完全性骨折 ,断端移位不明显 ,全段骨质密度减低 ,骨皮质变薄。腰椎骨质普遍性疏松 ,椎体体积变小。全身ＥＣＴ呈超级影像表现。双肾Ｂ超…     

Dislocation of the Trapezium (Multangulum Majus): A Case Report A Case Report

A case of complete, closed dislocation of the trapezium is reported. The treatment was open reposition and fixation with two Kirschner wires. No avascular necrosis occurred. Two and a half years after the injury there were no subjective complaints, the mobility and strength of the thumb were normal and there were no radiological signs of arthrosis.     

肺癌术后乳糜胸诊治1例报告

1 病历资料 患者男,49岁,因发热咳嗽三月入院,查体:一般情况可,全身浅表淋巴结未触及,气管居中,右上肺呼吸音稍弱.X线片及CT片示右上肺尖前段有4 cm×5 cm大小肿块,纵隔及隆突淋巴结肿大,支纤镜检查见右上肺尖前支开口处粘膜充血,质脆,刷落细胞病检结果示小细胞肺癌.     

Castleman病1例报告

1 病例资料 患者,男,62岁,"因右颈前多发肿物1年"于2003年10月6日入院.肿物逐渐增大,无疼痛,偶有低热,曾在门诊行活检,病理示:淋巴结炎,但给予抗炎治疗未见好转.同时患者自觉四肢乏力,曾在外院按"多发性周围神经炎"治疗,效果欠佳.发病期间无咳嗽、咳痰、牙龈出血及鼻衄等症状.患者3年前因"右叶甲状腺肿物"在外院行手术切除,现病理结果不详,无法判断肿物的性质.入院查体:生命体征正常,心、肺未见异常,脾脏轻度肿大;右颈外侧可扪及多个肿大的淋巴结,最大的约6.0 cm×5.0 cm,质硬,活动度差,其他部位的浅表淋巴结未扪及.四肢肌力减弱,腱反射减弱,但无病理征.CT示:右侧甲状腺呈术后改变,均匀强化,未见复发征象.右侧颈血管周围肌间隙内,显示大小不等结节状均匀强化影,上部达颈水平,下部至锁骨上、下窝,部分融合成团块状,大小约4.3 cm×3.2 cm,右侧梨状窝消失,右声带略增厚,喉室稍向左偏移.B超示:肝脏、胆囊、胰腺均正常,脾长约142 mm,厚约46 mm, 包膜光滑, 实质回声均匀. 生化检查: 白蛋白30 g/L,余指标大致正常.结合病史,临床拟诊:右甲状腺癌并颈淋巴结转移;于入院后9日行手术切除.术中见:右侧颈部有散在肿大淋巴结,最大约4.0 cm×4.0 cm×5.0 cm大小,实性,部分已融合,与右颈内静脉上段紧密粘连,右叶甲状腺未见结节.术后病理示:右颈巨大淋巴结增生,镜下以浆细胞浸润为主.术后患者拒绝放疗,予肌注干扰素300 U/d,共2月,现患者仍存活.     

心脏移植1例报告

2004年9月29日,我院为1例终末期扩张型心肌病患者实施同样异体同位心脏移植术,术后1月患者情况良好,植入的心脏功能正常,报告如下:     

Ankle Neurothekeoma: A Case Report

Neurothekeoma is a rare, benign, cutaneous tumor of nerve sheath origin that is also termed benign nerve sheath myxoma. This tumor is usually asymptomatic and grows slowly. Neurothekeoma is typically found in young adults and seldom occurs in children. It is most commonly located in the head, neck, and upper extremity and extremely rarely found in the lower leg. We report a rare case of ankle neurothekeoma in a child, with a review of the related published data.     

One-Bone Tarsus: A Case Report

Tarsal coalition is a condition characterized by abnormal connections between ≥2 tarsi. Although tarsal coalition is not rare, tarsal coalitions involving >2 tarsi are very unusual. In this report, we describe a case of multiple tarsal coalitions in a 24-year-old male who experienced progressively worsening pain for 3 to 4 months before presenting for care. This case was unique in that all the tarsal and tarsometatarsal bones in the foot were fused and formed 1 integrated tarsal. All of the metatarsals were fused as well, and the patient had no joints or ranges of motion in the hindfoot or midfoot. The patient's pain was responsive to anti-inflammatory medications, and no surgical intervention was necessary. To the best of our knowledge, this is the most extensive case of multiple tarsal coalitions described in the literature to date.     

Tailgut Cyst. A Case Report

Tailgut cysts, also called retro-rectal cystic hamartomas or mucin-secreting cysts, are uncommon vestigial masses. They can become complicated with infection or neoplastic degeneration. Surgery is the only treatment. We report here a case of a tailgut cyst in a 60-year-old female, that was discovered 10 years ago but not investigated.