Journal of Case Reports in Practice
Volume:2 Issue: 2, Apr 2014

A 44-year-old female presented with abdominal discomfort of two months duration. She had no other com- plaints. On clinical examination she was found to have fibroid uterus. Hysterectomy was planned. Pre-operative imaging studies incidentally picked up a large mass in the left adrenal. Areas of calcification were also noted in the adrenal mass. Excision of adrenal mass was done along with hysterectomy for fibroid. Histopathological ex- amination of the adrenal mass revealed clusters of ganglion cells in a dominant schwannian stroma with areas of calcification. A diagnosis of ganglioneuroma of the adrenal was made. Specimen submitted as hilar lymph node also showed ganglioneuroma. Ganglioneuromas are benign tumors of the sympathetic nervous system that rarely arise in the adrenal gland.

Adult-Onset Still’s Disease (AOSD) is a rare clinical entity with unknown etiology characterized by arthritis, fever, evanescent rash and other systemic presentations. This report describes a 30-year-old woman presented first with classic picture of rheumatoid arthritis since six years ago on oral prednisolone, sulfasalazine and methotrex- ate and was recently admitted with refractory sore throat, fever, arthritis, persistent pruritic rash and leukocytosis. Adverse drug reactions to sulfasalazine was the working clinical diagnosis. Discontinuation of sulfasalazine did not show any clinical benefit. The patient responded fully to combine pulsed methylprednisolone and higher doses of oral prednisolone and systemic disease-modifying anti-rheumatic drugs.

A jejunostomy can provide adequate parenteral nutrition support for patients who oral intake is difficult. Jeju- nostomy-related complications are commonly seen, however they rarely result in repeat laparotomy. Herein, we report a rare complication in which a long segment of bowel herniation from the abdominal stoma with dislodged feeding tube. Because the bowel mucosa was congestive and swelling, an emergent laparotomy for jejunum re- duction and jejunum segmental resection was done. After surgery, this patient recovered well and discharged two weeks later. The discussion will be focused on the mechanism and management about this complication.

Brucellosis, a worldwide anthropozoonosis, is an infectious disease caused by bacteria of the genus Brucella. Human brucellosis is a disease characterized by high fever, sweating, malaise, anorexia, headache and arthralgia but cutaneous lesions are less common. In this paper we present a 33-year-old woman with cutaneous vasculitis due to brucellosis.

Myxoma is by far the most common type of primary cardiac tumor and accounts for about 40%. Symptoms are resumed in a typical clinical triad: systemic symptoms, signs of valvular or intracavity dysfunction and embolic episodes. Coronary arteries are a rare site for embolism. We present the case of left atrial myxoma presenting with chest discomfort and complicated by coronary embolism as assessed by normal coronary angiography and the presence of subendocardial late gadolinium enhancement at cardiac MRI due to apical myocardial infarction.

Nasotracheal intubations are commonly used in maxillofacial surgeries. Failure of ventilation after nasal intu- bation is an emergency and this paper aims at pointing out an unusual cause for nasal tube obstruction. Surgeons and anaesthesiologists should keep the possibility of obstruction by avulsed turbinate bones while dealing with such emergency situations. This paper details such an occurrence, the reasons and how the situation was managed.

Testicular neoplasms are a diverse group of tumors mostly comprised of germ cell tumors. Lymphoma of the testis are rarely seen, more so in the younger age group. Most of the lymphoma involving the testes is secondary to systemic lymphoma or leukemia. Primary testicular lymphoma, in which there is no systemic evidence of lymphoma or leukemia, is rare. If encountered, it is seen mostly in elderly males. Here we present a case where a middle-aged male was diagnosed with primary testicular lymphoma (diffuse large B cell) without extra-testicular extension.

Double-chambered right ventricle is a rare congenital heart disorder involving two different right ventricle pres- sure compartments that is often associated with malalignment ventricular septal defect. Usually, the obstruction is caused by an anomalous muscle bundle crossing the right ventricle from the interventricular septum to the right ventricle free wall.A 18-year-old man underwent cardiac surgery procedure for right ventricular outflow tract obstruction causedby anomalous muscle bundles. After the surgical procedure, patient remains free of symptoms and medications. We report our surgical experience in a case of complex morphology of the abnormal muscle bundle in dou-ble-chambered right ventricle.

Malignancies involving the paranasal sinus are usually rare and cases of ethmoid sinus carcinoma are very un- common. In this category sqamous cell carcinoma is the most common malignancy seen, poor survival rate has been associated with these cases because most of them present in their advance stages as in these seen cases the symptoms may be nonspecific and remain indolent for months or years, leading to delay in diagnosis and conse- quently present as at advanced diseased stage. Hence, it is important that the clinicians should be aware of the sinus pathologies, to diagnose these malignancies at an early stage. Here we report a case of sqamous cell carcinoma originating from ethmoid sinus extending into bilateral nasal cavities, orbits, and maxillary sinuses.