Do medullary thyroid carcinoma patients with high calcitonin require bilateral neck lymph node clearance? A case report

paythelady.612 shared this article with you from Inoreader Do medullary thyroid carcinoma patients with high calcitonin require bilateral neck lymph node clearance? A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1343-1352. doi: 10.12998/wjcc.v9.i6.1343. ABSTRACT BACKGROUND: In clinical work, 85%-90% of malignant thyroid diseases are papillary thyroid cancer (PTC); thus, clinicians neglect other types of thyroid cancer, such as medullary thyroid carcinoma (MTC). CASE SUMMARY: We report a 53-year-old female patient with a preoperative calcitonin level of 345 pg/mL. There was no definitive diagnosis of MTC by preoperative fine-needle aspiration cytology or intraoperative frozen pathology, but the presence of PTC and MTC was confirmed by postoperative paraffin pathology. The patient underwent total thyroidectomy and bilateral central lymph node dissection. Close follow-up at 1.5 years after surgery revealed no signs of recurrence or metastasis. CONCLUSION: The issue in clinical work-up regarding types of thyroid cancer provides a novel and challenging idea for the surgical treatment of MTC. In the a bsence of central lymph node metastasis, it is worth addressing whether patients with high calcitonin can undergo total thyroidectomy and bilateral central lymph node dissection without bilateral lateral neck lymph node dissection. PMID:33644201 | PMC:PMC7896685 | DOI:10.12998/wjcc.v9.i6.1343 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53 gene mutation: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53 gene mutation: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1184-1195. doi: 10.12998/wjcc.v9.i5.1184. ABSTRACT BACKGROUND: The diagnosis and etiology of multiple primary malignant neoplasms (MPMNs) are difficult to establish. Here, we report a case of heterochronic triple primary malignancies with gastric cancer, nasopharyngeal squamous cell cancer, and then rectal cancer. CASE SUMMARY: The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy. Three years later, he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017. Recently, a mass in the middle of the rectum was resected and reported as ulcerative, moderately to poorly differentiated adenocarcinoma. Research on the etiology of MPMNs showed that Epstein-Barr virus (EBV) infection may be the cause of gastric cancer and nasopharyngeal squamous cell c ancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed, paraffin-embedded tissue. The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8 (c.844C>T, p.Arg282Trp) through high-throughput sequencing for the rectal cancer. Appropriate standard therapy for each primary cancer was administered, and the patient has no evidence of cancer disease to date. CONCLUSION: To our knowledge, this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations. The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management. PMID:33644183 | PMC:PMC7896647 | DOI:10.12998/wjcc.v9.i5.1184 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Femoral epithelioid hemangioendothelioma detected with magnetic resonance imaging and positron emission tomography/computed tomography: A case report

paythelady.612 shared this article with you from Inoreader Femoral epithelioid hemangioendothelioma detected with magnetic resonance imaging and positron emission tomography/computed tomography: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1353-1358. doi: 10.12998/wjcc.v9.i6.1353. ABSTRACT BACKGROUND: Epithelioid hemangioendothelioma (EHE) is an uncommon low-grade aggressive vascular tumor. It can occur in almost all locations, but is rarely encountered in bone. CASE SUMMARY: We report a 23-year-old man who presented with left hip pain with no obvious cause. X-ray revealed bone destruction in the left femoral neck with sclerosis at the edges of the lesions. Magnetic resonance imaging (MRI) showed bone destruction in the medullary cavity of the left femoral head and neck. 18F-deoxyglucose-positron emission tomography/computed tomography (PET/CT) imaging showed bone destruction in the left ischium, acetabulum, and left femoral head neck, accompanied by increased radioactive uptake; the maximum standard uptake value was 4.2. Histopathologic examination revealed spindle-shaped mesenchymal tissue hyperplasia with scattered epithelioid cells. The patient underwent left femoral head replacement surgery. No signs of recurrence were observed as of the 18-mo follow-up. CONCLUSION: The definitive diagnosis of femoral EHE can be established aided by the MRI and PET/CT findings. PMID:33644202 | PMC:PMC7896691 | DOI:10.12998/wjcc.v9.i6.1353 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space: A case report

paythelady.612 shared this article with you from Inoreader Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1204-1209. doi: 10.12998/wjcc.v9.i5.1204. ABSTRACT BACKGROUND: Solitary fibrous tumors (SFTs) occurring in the parapharyngeal space are rare, and their final diagnosis depends on pathological and immunohistochemical analyses. Once the tumor is diagnosed, complete resection and regular postoperative follow-up are required. CASE SUMMARY: A 40-year-old male patient with a right parotid gland mass discovered 8 years ago was admitted to hospital. The mass showed no tenderness or local skin redness. Imaging was carried out as the patient had stable vital signs and showed that the mass was a dumbbell-shaped tumor comprising a superficial tumor approximately 5 cm long and 3 cm wide in size that compressed the right parotid gland and a deep tumor located in the right parapharyngeal space approximately 4.5 cm long and 2.5 cm wide in size. Both tumors were connected in the middle. Prior to surgery, the t umors were considered to be parapharyngeal schwannomas. During surgical dissection, the tumors were found to be smooth and tough, without obvious adhesion to the surrounding tissues. The tumors were revealed to be a SFT following postoperative pathological analysis. CONCLUSION: SFTs in the parapharyngeal space are rarely reported, and complete resection of such tumor is recommended. Adjuvant chemoradiotherapy is used in patients with extensive tumor invasion to lower the recurrence rate. Postoperative long-term follow-up is required. PMID:33644185 | PMC:PMC7896643 | DOI:10.12998/wjcc.v9.i5.1204 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive tools based on immune biomarkers for the diagnosis of central nervous system graft-vs-host disease: Two case reports and a review of the literature

paythelady.612 shared this article with you from Inoreader Noninvasive tools based on immune biomarkers for the diagnosis of central nervous system graft-<em>vs</em>-host disease: Two case reports and a review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1359-1366. doi: 10.12998/wjcc.v9.i6.1359. ABSTRACT BACKGROUND: Central nervous system graft-vs-host disease (CNS-GVHD) is a rare cause of CNS disorders after allogeneic hematopoietic stem cell transplantation. Currently, establishing a diagnosis of CNS-GVHD is challenging because the diagnostic criteria and diagnostic methods are not well defined and many confounding factors need to be ruled out. CASE SUMMARY: Here, we present two patients with CNS-GVHD. Both patients with a history of acute GVHD or chronic GVHD developed neurological symptoms that could not be explained by other causes, and had abnormal cerebrospinal fluid (CSF) studies as determined by CSF and blood immune biomarker examinations, suggestive of suspected CNS-GVHD. Due to the lack of specific magnetic resonance imaging abnormalities and the rapid clinical deterioration of the patients, we did not attempt to perform a br ain biopsy, but prompted the initiation of empirical immunosuppressive therapy. In view of the rapid and favorable response to local and systematic immunosuppressive treatment and the aforementioned neurologic manifestations together with CSF abnormalities and other negative findings, a final diagnosis of CNS-GVHD was made. CONCLUSION: CSF and blood immune biomarker examinations facilitated the diagnosis of CNS-GVHD, which are particularly suitable for patients who are critically ill and require urgent treatment and for those who are unsuitable for invasive diagnostic procedures. PMID:33644203 | PMC:PMC7896680 | DOI:10.12998/wjcc.v9.i6.1359 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management protocol for Fournier's gangrene in sanitary regime caused by SARS-CoV-2 pandemic: A case report

paythelady.612 shared this article with you from Inoreader Management protocol for Fournier's gangrene in sanitary regime caused by SARS-CoV-2 pandemic: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1215-1220. doi: 10.12998/wjcc.v9.i5.1215. ABSTRACT BACKGROUND: Fournier's gangrene (FG) is a serious, aggressive and often deadly polymicrobial infection of the soft tissues of the perineum, the rectum and the external genital organs. It is an anatomical subcategory of necrotizing fasciitis, which has a similar etiology and treatment strategy. CASE SUMMARY: A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9 °C, abdominal pain, and edema of the scrotum, the penis, the perineum, and the right gluteal region for 2 d. Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium, and the penis; along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum, the perineum, and the right gluteal region . The patient was diagnosed with FG, and was urgently qualified to undergo surgery in the Department of Urology. After performing the necessary examinations, a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed. After surgery, he was transferred to the intensive care unit for further management. CONCLUSION: Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection. PMID:33644187 | PMC:PMC7896664 | DOI:10.12998/wjcc.v9.i5.1215 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1367-1378. doi: 10.12998/wjcc.v9.i6.1367. ABSTRACT BACKGROUND: In the clinical scenario, adult patients with periodontal diseases and dental malformation, characterized by dental crowding in lower anterior teeth with the thin biotype, often require orthodontic treatment. This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics (PAOO) combined with autologous platelet-rich fibrin (PRF) in an adult patient with class I malocclusion along with dental crowding, a thin periodontal biotype, and buccal plate deficiency. CASE SUMMARY: A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic. The patient underwent periodontal risk assessment prior to orthodontic treatment. She was diagnosed with a high risk of gingival recession due to dental crowding, root prominence, loss of b uccal plates, and a thin gingival tissue biotype. The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding. Clinically, PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling. Radiographic outcomes also showed statistically significant improvements (P < 0.01) in the mandibular buccal alveolar bone. CONCLUSION: This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease. PMID:33644204 | PMC:PMC7896698 | DOI:10.12998/wjcc.v9.i6.1367 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic repair of delayed stomach perforation caused by penetrating trauma: A case report

paythelady.612 shared this article with you from Inoreader Endoscopic repair of delayed stomach perforation caused by penetrating trauma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1228-1236. doi: 10.12998/wjcc.v9.i5.1228. ABSTRACT BACKGROUND: Primary endoscopic closure of a perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated; however, there are very few studies on the efficacy of endoscopic management of delayed traumatic gastric perforation. Herein, we report a novel case of a patient who was successfully treated for delayed traumatic stomach perforation using an alternative endoscopic modality. CASE SUMMARY: A 39-year-old woman presented with multiple penetrating traumas in the back and left abdominal cavity. Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation. An emergency primary repair of the disrupted diaphragm with omental reduction and suturing of the lacerated lung was performed; however, delayed free perforation of the gastric wall was noted on computed t omography after 3 d. Following an emergency abdominal surgery for the primary repair of the gastric wall, re-perforation was noted 15 d postoperatively. The high risk associated with re-surgery prompted an endoscopic intervention using 2 endoloops and 11 endoscopic clips using a novel modified purse-string suture technique. The free perforated gastric wall was successfully repaired without additional surgery or intervention. The patient was discharged after 46 d without any complications. CONCLUSION: Endoscopic closure with endoloops and clips can be a useful therapeutic alternative to re-surgery for delayed traumatic gastric perforation. PMID:33644189 | PMC:PMC7896642 | DOI:10.12998/wjcc.v9.i5.1228 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Subtalar joint pigmented villonodular synovitis misdiagnosed at the first visit: A case report

paythelady.612 shared this article with you from Inoreader Subtalar joint pigmented villonodular synovitis misdiagnosed at the first visit: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1379-1385. doi: 10.12998/wjcc.v9.i6.1379. ABSTRACT BACKGROUND: Pigmented villonodular synovitis (PVNS) is an uncommon disease that usually occurs in large joints, and involvement of the subtalar joint is rare. The lack of comprehensive knowledge of subtalar joint PVNS could lead to misdiagnosis. CASE SUMMARY: We present a 64-year-old woman who, at her first visit, complained of discomfort in the right ankle when she walked. Based on the physical signs and X-ray report, the physician failed to make the suspected diagnosis of PVNS. Eighteen months later, the patient returned with a complaint of a mass in her right lateral malleolus with intermittent blunt pain. The X-ray presented an osteophyte formation and soft tissue calcification at the margin of the subtalar joint. The laboratory tests were normal, whereas magnetic resonance imaging (MRI) showed a low-intensity area on both T1- and T2-weigh ted images. A suspected diagnosis of PVNS was made and later confirmed by postoperative pathology. Subsequently, the patient received radiotherapy with 32 Gy in 16 fractions. At 6 mo postoperatively, the patient only complained of discomfort after walking three blocks. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot score was 97. CONCLUSION: MRI is necessary for the diagnosis of PVNS. Early soft tissue calcification and painless joint swelling should be of concern. PMID:33644205 | PMC:PMC7896681 | DOI:10.12998/wjcc.v9.i6.1379 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interactive platform for peer review: A proposal to improve the current peer review system

paythelady.612 shared this article with you from Inoreader Interactive platform for peer review: A proposal to improve the current peer review system Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1247-1250. doi: 10.12998/wjcc.v9.i6.1247. ABSTRACT Peer review is the cornerstone in scientific publication. Although peer review has paramount importance in ensuring the quality of the published literature, it still has a number of shortcomings. The present manuscript proposes a new method to improve the current peer review system by providing an interactive, dynamic platform that allows direct, anonymous interaction between the authors of submitted manuscripts and the reviewers. Such real-time interaction may help eliminate any problems related to misunderstanding or misinterpretation of the reviewer's comments or the authors' response, and would save time while keeping the identity of both parties anonymous. PMID:33644191 | PMC:PMC7896679 | DOI:10.12998/wjcc.v9.i6.1247 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Wilson disease - the impact of hyperimmunity on disease activity: A case report

paythelady.612 shared this article with you from Inoreader Wilson disease - the impact of hyperimmunity on disease activity: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1386-1393. doi: 10.12998/wjcc.v9.i6.1386. ABSTRACT BACKGROUND: In Wilson disease lack of biliary copper excretion causes hepatocellular injury by accumulation of free toxic copper. Its overspill to serum accounts for neuronal damage as second common manifestation. Therapy with copper chelators or zinc targets the removal of this free copper. However, in some patients liver disease persists for unknown reason despite normalized free copper. The discovery of a hyperimmunity as a contributing pathogenetic factor was discovered in this case report with implication also for other liver diseases. CASE SUMMARY: A 9-year-old girl was diagnosed in August 2009 by family screening of having asymptomatic Wilson disease with elevated transaminases. Already at time of diagnosis antinuclear antibodies (ANA) were elevated without hyperimmunoglobulinemia (immunoglobulin G, IgG). After one year of therapy with D-penicillamine transaminases normalized together with free serum copper. Under continuous therapy with copper chelators free copper remained normal until today, whereas transaminases raised to alanine aminotransferase values of 571 U/L in December 2019. For hyperimmunity a tentative steroid course on top of D-penicillamine improved transaminases. Thus, hyperimmunity may have impact on liver inflammation after control of the metabolic disturbance. A retrospective cohort study confirmed the common association of elevated transaminases with ANA, but no IgG elevation. CONCLUSION: This hyperimmune-triggered condition may represent a new entity which per se or on top of other liver diseases induces liver inflammation responsive to steroids. PMID:33644206 | PMC:PMC7896689 | DOI:10.12998/wjcc.v9.i6.1386 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.