Relocating faculty to an outreach site

Although relocation and added job responsibilities necessitate a tremendous adjustment, the ensuing career opportunities can be personally challenging and invigorating. Pioneering an outreach effort adds a stimulating dimension to teaching. The increase in responsibility brings with it an increase in accountability. The result is an autonomy rarely found in the academic realm.     

Atypical carcinoid tumor of the lung: a case report and discussion of the literature

Carcinoid tumors comprise 1% to 2% of all tumors of the lung. Although carcinoid tumors are generally felt to be of low grade malignancy, an atypical variant exists that exhibits more virulent behavior and a less favorable prognosis. The treatment of carcinoid tumors is complete surgical removal and a more aggressive approach is required in the treatment of atypical carcinoids. A case is presented with a review of the literature.     

Truncal seizures: an unusual presentation of cerebral cysticercosis

We present the case of a 24-year-old woman who developed repetitive partial simple seizures confined to her right rib cage. Computed tomography scan of the head was consistent with the diagnosis of cerebral cysticercosis. The patient was started on a regimen of anticonvulsants, steroids, and praziquantel with full resolution of symptoms.     

Painful Horner's syndrome due to spontaneous carotid artery dissection

Spontaneous dissection of the internal carotid artery as a cause of Horner's syndrome has only been recognized in recent years. The authors describe three patients with this condition. Associated symptoms included ipsilateral orbital and frontal headache (3 patients), neck and facial pain (2), amaurosis fugax (1), and dysgeusia (1). The symptoms resolved in all patients within three months, yet oculosympathetic paralysis has persisted. Diagnosis of carotid dissection required cerebral arteriography, and the angiographic features are presented. Patients were treated with platelet antiaggregants, and they have remained neurologically stable during follow-up (mean, 12 months; range, 10-14 months).     

Xanthomatous infiltrate of the face

We report 2 cases which shared an unusual histopathologic pattern of a xanthomatous infiltrate occurring on the nose. Both patients were women in their fifth decade. Each presented to the dermatology clinic with multiple soft, flesh-colored papules, up to 1 cm, in diameter on the lateral aspects of the nose. The lesions had been present for several years. Both patients were otherwise completely well, and asymptomatic. In one case, focal telangiectasia and central umbilication was noted, and the clinical differential diagnoses included basal cell carcinomas and appendageal tumors. In each case, a biopsy was performed. The lesions appeared histologically quite similar. The epidermis was unremarkable. Within the dermis, there was a mid-reticular dermal infiltrate of macrophages with unilocular and multilocular fat laden cytoplasm, and scalloped nuclei. Only a scant inflammatory infiltrate of lymphocytes and histiocytes was present. Minimal dermal fibrosis was also present. We believe that xanthomatous infiltrate of the face is a distinct clinical entity which presents as multiple flesh-colored papules on the nose, which have a characteristic histologic appearance of abundant lipid-laden macrophages within the dermis.