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Sample records for vulva sparganosis misdiagnosed

  1. Soft tissue sparganosis

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    Park, Ki Soon; Lee, Yul; Chung, Soo Young; Park, Choong Ki; Lee, Kwan Sup [Hallym University College of Medicine, Seoul (Korea, Republic of); Cho, In Hwan; Suh, Hyoung Sim [Daelin S. Mary' s Hospital, Seoul (Korea, Republic of)

    1993-11-15

    Sparganosis is a rare tissue-parasitic infestation caused by a plerocercoid tapeworm larva(sparganum), genus Spirometra. The most common clinical presentation of sparganosis is a palpable subcutaneous mass or masses. Fifteen simple radiographs and 10 ultrasosnograms of 17 patients with operatively verified subcutaneous sparganosis were retrospectively analyzed to find its radiologic characteristics for preoperative diagnosis of sparganosis. The location of the subcutaneous sparganosis were lower extremity, abdominal wall, breast, inguinal region and scrotum in order of frequency. The simple radiographs showed linear or elongated calcification with or without nodular elongated shaped soft tissue mass shadows in 8 patients, soft tissue mass shadow only in 2 patients and lateral abdominal wall thickening in 1 patient. But no specific findings was noted in 4 patients with small abdominal and inguinal masses. We could classify the subcutaneous sparganosis by ultrasound into 2 types: one is long band-like hypoechoic structures, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva and the order is elongated or ovoid hyperechoic nodules, representing granulomas. Long band-like hypoechoic structures within or associated with mixed echoic granulomatous masses were noted in 6 patients and elongated or ovoid hypoechoic mass or masses were noted in 4 patients. In conclusion, sparganosis should be considered when these radiologic findings-irregular linear calcifications on simple radiograph and long band-like hypoechoic structures on ultrasonography, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva are noted in the patients who have subcutaneous palpable mass or masses. And radiologic examination especially ultrasonography is very helpful to diagnose sparganosis.

  2. Vulva Anatomy

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    ... e.g. -historical Searches are case-insensitive Vulva Anatomy Add to My Pictures View /Download : Small: 720x634 ... View Download Large: 3000x2640 View Download Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

  3. Recurrent breast sparganosis: Clinical and radiological findings

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    Park, Ji Yoon; Woo, Ok Hee [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Cho, Kyu Ran; Seo, Bo Kyoung [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2015-09-15

    We report a case of recurrent sparganosis of the breast within 6 months following surgical removal of worms from the breast. The patient was referred to our hospital with a palpable mass in the right breast. On admission, breast ultrasonography revealed a tortuous tubular hypoechoic lesion with indistinct margins within a surrounding hyperechoic area, which strongly suggested sparganosis. We performed surgical excision and confirmed sparganosis. After 6 months, the patient detected a new mass in her right breast and visited our hospital. Breast ultrasonography revealed similar features in a different area of the same breast. We confirmed recurrent sparganosis surgically.

  4. Two cases of pulmonary and pleural sparganosis confirmed by tissue biopsy and immunoserology

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    Sang Wan Chung

    Full Text Available Sparganosis in humans is an incidental infection and is known to be associated with eating insufficiently cooked meat of frogs and snakes or drinking unboiled stream water. Although it can involve various internal organs, pulmonary and pleural involvement due to sparganum is rare. Because we recently experienced two cases involving lung parenchyma and pleura that were misdiagnosed as bacterial pneumonia and lung cancer, we herein intend to present them in detail.

  5. Some Aspects Of Human Sparganosis In Korea.

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    Cho, Seung Yull; Bae, Jong Hoa; Seo, Byong Seol

    1975-06-01

    Human sparganosis in Korea was discussed on the bases of five human cases experienced by the present authors and 58 case records already reported by many previous authors, in aspects of epidemiology and clinical features. Sparganosis is not infrequent tissue helminthiasis now in Korea and the incidence has been evidently increased during past 10 years. It might be interpreted that improved medical delivery system and health care exposed the hidden but prevalent disease. The distribution of sparganosis in Korea is apparently subdivided into three major endemic areas; Kyunggi Do, Kyungsang Do and Hamkyung Nam Do. Although scanty in other areas of Korea, the distribution of this disease is presumably throughout the whole peninsula of Korea except Cheju Do. The majority of human cases of sparganosis in Korea has revealed raw consuming of snakes for treatment of tuberculosis, syphilis and joint pain, for tonics and for the belief of special nutrition among very limited group of Korean population. Because of this kinds of mode of infection, comprising four fifths of all cases, the majority of cases detected were male adult consisting of about 70% of total cases. And drinking of untreated water in rural area where no protective, sanitary measures for water sources were provided in the past, seems another important causes of infection especially in women and children in Korea. Thus it may be concluded that sparganosis in Korea is concluded by eating of infective stages per os voluntarily or involuntarily, but not through the direct invasion. Clinically, subcutaneous mass or lump was the most frequent problem in those patients and those masses were associated with inflammatory signs. By the anatomical location of the lesion, some peculiar manifestations could be developed as in orbital, abdominal, urethral, ureteral and vertebral cases. And the lesions could be complicated by haemorrhage or abscess formations. The larval worms hitherto collected in Korea has been identified

  6. Case report: Lower extremity sparganosis in a bursa.

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    Ha, Kee-Yong; Oh, In-Soo

    2011-07-01

    Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. We report the case of a 67-year-old man with a mass over the anteromedial surface of the proximal extremity of the tibia. We surgically excised a bursa containing Spirometra larvae. Sparganosis is a rare parasitic infection. We found no cases of lower extremity sparganosis combined with bursitis reported in the literature. Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among patients who frequently have consumed mountain water or raw snakes or frogs.

  7. Disorders of the Vulva

    Science.gov (United States)

    ... creams or ointments, vaginal tablets, prescription pills, or injections. This condition is difficult to treat and usually ... changes and cancer of the cervix, vulva, vagina, penis, anus, mouth, and throat. Inflammation: Pain, swelling, redness, ...

  8. Severe sparganosis in Australian tree frogs.

    Science.gov (United States)

    Berger, Lee; Skerratt, Lee F; Zhu, Xing-Quan; Young, Sam; Speare, Rick

    2009-10-01

    Spargana of Spirometra erinacei infect many vertebrate species, but severe disease from sparganosis has been reported from few host species. Information on the effects of this common, introduced tapeworm of cats on Australian frogs is lacking. Our survey to detect significant diseases in free-ranging amphibians in eastern Australia between 1993 and 2000 revealed that infection with spargana (plerocercoids) of S. erinacei occurred in 12/243 (4.9%) sick frogs. Infections occurred in skeletal muscle and subcutis, especially the thighs, of large adults of Litoria caerulea, Litoria aurea, Litoria gracilenta, and Litoria peronii. Three frogs were also infected in the coelomic cavity. Heavy burdens in seven frogs were associated with poor body condition and debilitating lesions, whereas lighter infections in five sick frogs were considered likely to be incidental to other diseases. In severe infections, a large proportion of thigh muscle was replaced with spargana and various amounts of fibrosis, and some frogs also had myonecrosis, granulomatous inflammation, hemorrhage, and skin ulceration. Concurrent infections were common. Our findings suggest sparganosis is one of a few currently recognized serious diseases affecting free-ranging frogs in Australia.

  9. Sparganosis in a patient with diffuse large B cell lymphoma

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    Sang-Young Roh

    2013-01-01

    Full Text Available Sparganosis is the human infection by plerocercoid, the larvae of sparganum. Clinically, subjective symptoms do not occur in the incipient stage, but as the worm migrates, pruritus or tenderness may occur. On physical examination, soft, palpable, and sometimes migratory, subcutaneous nodules are found in sparganosis patients. As rare cases; sparganosis from the orbit, the abdominal viscera, and the breast have been reported. However, there have been no reports relating such disease to the patients′ immunocompromised status.We experienced a case of sparganosis from a patient with lymphoma whose immune system was suppressed by anticancer therapy, suggesting that the immunosuppression might affect the onset and the exacerbation of the disease. We report our case with a review of the literature.

  10. Seroepidemiologic Survey for Human Sparganosis in Mto wa Mbu ...

    African Journals Online (AJOL)

    Sparganum is a plerocercoid of pseudophyllidean tapeworm of Spirometra species. Human sparganosis has been reported in Northern Tanzania. A seroepidemiologic survey was undertaken to detect anti-sparganum specific IgG antibodies in serum of normal inhabitants of Mto wa Mbu, Monduli District, Tanzania.

  11. Giant condyloma acuminatum of vulva

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    S. M. Ramiz Ahmed

    2017-09-01

    Full Text Available In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening. Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.

  12. Multifocal sparganosis mimicking lymphoma involvement: Multimodal imaging findings of ultrasonography, CT, MRI, and position emission tomography-computed tomography

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    Heo, So Young; Park, Ji Yeon; Park, Noh Hyuck; Park, Chan Sub; Kim, Tae Jung [Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Yi, Seong Yoon [Dev. of Hematology-Omcology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of); Jun, Hyun Jung [Dev. of Hematology-Omcology, Dept. of Internal Medicine, Seoul Medical Center, Seoul (Korea, Republic of)

    2016-01-15

    Sparganosis is a rare parasitic disease caused by the migrating plerocercoid larva of Spirometra species tapeworms. The most frequent clinical manifestation is a subcutaneous nodule resembling a neoplasm. In this study, we presented multimodal findings of ultrasonography, computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography and follow-up imagings on multifocal sparganosis, mimicking lymphoma involvement in a patient with lymphoma.

  13. Ectopic mammary tissue in vulva

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    Đorđević Momčilo

    2008-01-01

    Full Text Available Background. Ectopic mammary gland tissue is a residual tissue that persists during the embryologic development along ectodermal primitive milk streaks. Incomplete involution anywhere along the primitive milk streak can result in accessory or ectopic mammary tissue. Case report. A woman, 27-year old, admitted to Obstetrics and Gynecology Clinic Kragujevac for surgery, of goose-egg size, vulva tumor, of elastic consistency. Menarche started in 12 years of age, with the regular menstrual cycle, without previous gynecological diseases. The woman had one pregnancy terminated by cesarean section because of the multiple (twin pregnancy. Excision of the tumor was completely done in the total endotracheal anesthesia. Pathohistologic (PH findings was: Dysplasia fibrosa cystica simplex mammae, with focuses of sclerosing adenosis. Expression of estrogen (ER and progesterone receptors (PR were positive. Conclusion. Ectopic mammary tissue in vulva in adult period is very rarely seen, and can be changed pathologically as well as normally positioned breast tissue into benign cystic changes, benign tumors, adenomas and fibroadenomas and tumors. Cells with low ER/PR receptor level grow independently of estrogene stimulation and they could be resistant to hormonal therapy effects.

  14. Aggressive Angiomyxoma of the Vulva: a Distinct Clinical Entity

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    Sevgi Bakaris

    2015-12-01

    Full Text Available Aggressive angiomyxoma is a rare mesenchmal tumour arising from connective tissue of the perineum or the lower pelvis, and affect predominantly young women. Our case was 20-year-old female who was operated for a vulvar mass clinically misdiagnosed as Polyp . Histopathological examination of the surgical specimen revealed, haphazardly scattered spindle or stellate shaped mesenchymal cells and vessels of medium size having dilated lumens within a loose hyposellular myxoid stroma No mitoses were evident.The spindle-or stellate-shaped tumor cells were diffusely positive for vimentin, but negative for cytokeratin, S-100 protein, and myoglobin and and #945;-smooth muscle actin by immunohistochemistry. These histologic and immunohistochemical findings were compatible with diagnosis of AA. Clinically AA is mixed with Bartholin's duct cyst, vulvar abscess, lipoma, vaginal cysts in diagnosis AA of the vulva must be distinguished from the more common benign and malignant myxoid tumors including myxoma, myxoid neurofibroma, pseudosarcoma, myxoid liposarcoma, myxoid leiomyosarcoma and other soft tissue tumors with secondary myxoid changes. [Cukurova Med J 2015; 40(4.000: 803-806

  15. Giant fibroepithelial polyp of the vulva

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    Selma Korkmaz

    2014-12-01

    Full Text Available Fibroepithelial polyps are among common benign skin lesions. They are usually small and skin-colored lesions and are located frequently in the axilla and neck. They are rarely seen in the vulva. There is a small number of cases that reach the giant sizes in this area in the literature. A 20-year-old female patient presented with a pedunculated mass measuring 25 cm in diameter, localized to the right labium majus. The lesion was excised and the histopathological diagnosis was fibroepithelial polyp. We present this case because of it is the largest reported fibroepithelial polyp of the vulva in the literature.

  16. Primary actinomycosis of vulva with inguinal lymphadenopathy

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    Anand J Asia

    2016-01-01

    Full Text Available Actinomycosis is a chronic suppurative granulomatous infection of subcutaneous tissues caused by bacterium Actinomyces israelii. It is a normal commensal of the oral cavity, gastrointestinal tract, respiratory tract, and vagina. Infection is first established locally by breach of mucosal barrier during various procedures, aspiration, trauma, or human bite. Rarely, it may spread through hematogenous and lymphatic system. We present a case of actinomycosis involving the vulva, extending to the inguinal region along with inguinal lymphadenopathy. Involvement of vulva by actinomycosis is uncommon in literature.

  17. Lichen planus hypertrophicus of the vulva - a rare entity.

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    Job, Anupa Mary; Kaimal, Sowmya

    2017-09-01

    Vulvovaginal lichen planus is a type of chronic inflammatory dermatosis of the vulva, usually seen as a part of widespread lichen planus. The common clinical types of vulval lichen planus include papulosquamous, erosive and pigmented types. Hypertrophic lichen planus of the vulva is a rare entity. We report a case of hypertrophic lichen planus of the vulva which clinically simulated genital warts.

  18. Giant vulva oedema in pregnancy precipitated by anaemic heart ...

    African Journals Online (AJOL)

    We report a case of vulva oedema in a 19-year old multigravida at 30 weeks gestational age with severe anaemia complicated by heart failure. The vulva oedema appeared and rapidly increased in size as features of anaemic heart failure set in. Other causes of vulva oedema were ruled out. She was transfused with six ...

  19. An experimental study on imaging diagnosis of cerebral sparganosis

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    Chang, Kee Hyun; Han, Moon Hee; Goo, Jin Mo; Kim, Chong Jai; Chi, Je G; Hong, Sung Tae [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Ghi Jai [Inje University College of Medicine, Seoul (Korea, Republic of)

    1995-08-15

    The purpose of this experimental study was to evaluate early CT and MRI findings of cerebral sparganosis, to correlate the imaging findings with histopathologic findings, and to determine capability of CT and MRI to differentiate live worm from the dead. After scolices of three to four spargana, which were obtained from naturally infected snakes, were introduced into cerebral hemispheres of 21 mongrel cats, sequential brain CT and MRI were performed at the 2nd, 4th, 8th and 12th week, and the imaging findings were analyzed and compared with the histopathologic findings. Spargana were found in 16 sites of 10 cat brains (48%); they were located in basal ganglia (5 cases), periventricular white matter and centrum semiovale (4 cases), subdural (2 cases) or subarachnoid spaces (1 case), and lateral ventricle (2 cases). The larvae were also observed in the contralateral hemisphere (3 cases). The lesions without larvae (presumably tracts) were found in 22 sites of 14 cat brains (67%); they were located in periventricular white matter and centrum semiovale (11 cases), basal ganglia (5 cases), midbrain (3 cases) and frontal lobe (2 cases). The lesions without larvae were also found in the contralateral hemi-sphere (7 cases). On CT, the lesions with larvae showed high density in 75% (9/12) and were enhanced in 38% (3/8) as a nodular pattern. On MRI they showed iso-(7/11) or low signal intensity (4/11) on T1-weighted images, mainly isosignal intensity on proton density-weighted images, and variable signal intensity on T2-weighted images. Contrast enhancement of variable shapes was seen in 50% (4/8). The lesions without larvae showed iso-(14/22) or low density (6/22) on CT and were rarely enhanced (2/17). On MRI they mostly showed isosignal intensity on both T1-weighted and proton density-weighted images, and variable signal intensity on T2-weighted images. They were enhanced in 29% (5/17) on contrast-enhanced MRI. Dilatation of ipsilateral ventricle was found in 43% (9

  20. Vulva choriocarcinoma | Boufettal | Pan African Medical Journal

    African Journals Online (AJOL)

    Choriocarcinoma vulva is an exceptional location of gestational trophoblastic tumors. We report the case of a female patient of 23 years who had vulvar mass, painful, sitting at the large right lip and measured five centimeters in diameter. Pelvic ultrasound was normal. Beta-h-CG (human chorionic gonadotrophin) ...

  1. Semen Allergy Manifesting As Chronic Pruritus Vulva

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    Pavithran K

    1997-01-01

    Full Text Available A young woman of 24 with personal and family history of atopy development pruritus vulva each time after sexual intercourse with her husband. History of urticaria of sites of contact with semen on her thighs gave suspicion of contact urticaria. Positive wheal and flare response to pin prick test with semen, excellent therapeutic response to topical steroid and oral Cetirizine and non- recurrence of the problem after using condom by her husband confirmed the diagnosis of semen allergy.

  2. A neglected risk for sparganosis: eating live tadpoles in central China.

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    Cui, Jing; Wang, Ye; Zhang, Xi; Lin, Xi-Meng; Zhang, Hong-Wei; Wang, Zhong-Quan; Chen, Jia-Xu

    2017-05-04

    A 29-year-old farmer from central China was sent into the Emergency Department of the Affiliated Hospital of Zhengzhou University. He had a 15-day history of persistent high fever, abdominal distention and pain. The patient was clinically diagnosed as appendicitis and peritonitis, and treated with antibiotics in a local hospital, did not improve. On exploratory laparotomy, the appendicular perforation and peritonitis were seen; appendicectomy were performed, and antibiotics were given. However, high fever and abdominal pain still persisted; intestinal adhesion and obstruction, ascites appeared. He was given the "critically ill notice". He had eosinophilia (12.95%) and the history of eating live frog tadpoles for treating his cutaneous pruritus 3 days before onset of the disease. Serum anti-sparganum antibodies assayed by ELISA were positive. This patient has hospitalized for one and half months and spend more than US$ 12 000. This patient was primarily diagnosed as visceral sparganosis, and cured with praziquantel.Sparganosis is one neglected but important parasitic zoonosis of poverty. Human infections were mainly acquired by eating raw or uncooked meat of frogs and snakes infected with plerocercoids, using frog or snake flesh as poultices, or drinking raw water contaminated with infected copepods. However, sparganosis caused by ingestion of live tadpoles are emerging in central China. Our surveys showed that 11.93% of tadpoles in Henan province are infected with plerocercoids. Eating live tadpoles is a high risk for sparganum infection. The comprehensive public health education should be carried out for people in endemic areas and the bad habit of eating live tadpoles must be discouraged.

  3. Vulva cellulitis and abscess with extension to anterior abdominal wall

    African Journals Online (AJOL)

    Background: Abscesses occur commonly in our environment. However abscesses of the vulva in children are not often seen but they do occur periodically, and there is a paucity of data on its prevalence in our environment. Aim: To present a case of vulva cellulitis and abscess with extension to anterior abdominal wall ...

  4. The normal vulva in medical textbooks.

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    Andrikopoulou, M; Michala, L; Creighton, S M; Liao, L-M

    2013-10-01

    When a healthy woman expresses concerns about her vulva, the doctor's response should be informed by clinical knowledge. For many doctors, accumulation of such knowledge would have begun with undergraduate teaching and medical textbooks. The aim of this study is to examine the information on female genital morphology in medical textbooks. A total of 59 gynaecology and anatomy textbooks were searched for information on the dimensions of vulval constitutent parts. No textbook gave measurements for all vulval structures. Vaginal length was reported in 21/59 textbooks, clitoral size in 15/59 and labia minora in 1/59. Where measurements appear, they suggest narrower ranges than recent reports. Information of vulval morphology is scanty and inaccurate in medical textbooks. The general lack of professional resources means that doctors may consciously or non-consciously rely upon personal experiences and popular culture to form their opinions, as do their patients.

  5. Progressive Supranuclear Palsy Misdiagnosed as Parkinson's ...

    African Journals Online (AJOL)

    in our hospital revealed a fully conscious elderly man with bradykinesia, decreased fine motor skills, and hypophonia. His gait/posture was characterized by flexion at the waist, not swinging while walking and retrocollis. His face was blank and. Progressive Supranuclear Palsy Misdiagnosed as. Parkinson's Disease: A Case ...

  6. Mixoma de vulva em cão Vulvar myxoma in a dog

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    E.F. Nascimento

    2000-02-01

    Full Text Available This report describes the pathological findings of a myxoma in the vulva of a seven-year-old German Shepherd bitch, with history of mass increase in the vulva. After surgery, tipical and microscopic aspects were detected.

  7. Phyllodes tumor of the vulva: report of two cases.

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    Özbudak, Irem Hicran; Akkaya, Hampar; Akkaya, Bahar; Erdoğan, Gülgün; Peşterelı, Hadice Elif; Karavelı, Fatma Şeyda

    2013-01-01

    Ectopic breast tissue can occur anywhere along the primitive embryonic milk line and can be the site of the same pathologic processes found in the normal breast. Phyllodes tumor is an extremely rare fibroepithelial neoplasm that occurs in ectopic breast tissue of the vulva. To date, only 8 cases of phyllodes tumor in the vulva have been reported in the literature. This paper presents two additional case of benign phyllodes tumor in the vulva. The first patient was a 43-year-old woman, presenting with a lesion on the left anterior mons pubis that had increased in size in the last three months. The second patient was a 50-year-old woman, presenting with a two-month history of a mass in the right labium majus. The patients underwent excisional biopsy. The histological examination of both specimens revealed a characteristic pattern of benign phyllodes tumor. In conclusion, the pathologists need to be aware that the lesion can occur in this location. Herein, the concepts about the histogenesis of phyllodes tumor in the vulva are discussed and a brief review of the previously reported cases is given.

  8. Verrucous carcinoma of the vulva: a case report.

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    Boutas, Ioannis; Sofoudis, Chrisostomos; Kalampokas, Emmanouil; Anastasopoulos, Christos; Kalampokas, Theodoros; Salakos, Nikolaos

    2013-01-01

    Verrucous carcinoma of the female genital tract is a rare lesion, primarily affecting postmenopausal women. We present a 78-year-old patient with verrucous carcinoma of the vulva, who was admitted to the "Aretaieion" Athens University Hospital. She had complained of vulvar itching during the last two years without visiting a specialist doctor.

  9. Verrucous Carcinoma of the Vulva: A Case Report

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    Ioannis Boutas

    2013-01-01

    Full Text Available Verrucous carcinoma of the female genital tract is a rare lesion, primarily affecting postmenopausal women. We present a 78-year-old patient with verrucous carcinoma of the vulva, who was admitted to the “Aretaieion” Athens University Hospital. She had complained of vulvar itching during the last two years without visiting a specialist doctor.

  10. Vulva haematoma following straddle injury in pregnancy | Ekweani ...

    African Journals Online (AJOL)

    This may be because injuries of this nature are often misconstrued to be of a sexual nature and so such patients may be viewed as “immoral”. Report: A 24year old primipara in her third trimester who fell ... to the patient's need for future parturition and sexual gratification. Keywords: Vulva, haematoma, trauma, pregnancy ...

  11. Lactating Vulva Mammary Tissue in a Nigerian | Igwegbe | Nigerian ...

    African Journals Online (AJOL)

    ... cystic mass in the right labium majus that developed rapidly in the early puerperium following her 5th confinement. Histology of the completely excised cyst revealed a secretory mammary tissue. There was no recurrence ten months after surgery while breastfeeding. Key Words: lactation, vulva, Mammary tissue, Nigerian

  12. Murder misdiagnosed as SIDS: a perpetrator's perspective

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    Stanton, J; Simpson, A

    2001-01-01

    AIMS—Child murder misdiagnosed as sudden infant death syndrome (SIDS) is a difficult area to study. We present a perpetrator's descriptions to enrich clinicians' knowledge of possible presenting features of this phenomenon.
METHODS—Interview material was collected as part of a qualitative study of maternal filicide performed from a naturalistic paradigm in order to access the perpetrators' view of events. The woman participant has been convicted for three child murders and two attempted murders which were initially misdiagnosed as SIDS. Interviews were done in the participant's home with her partner present, while she was on leave from prison. Semi-structured interviews were conducted, recorded, transcribed, and analysed for themes. Specific ethical permission was gained to present this case in isolation and the paper was written in consultation with the woman described.
RESULTS—She described initial intense attachment to her first victim and described killing her because she was unable to bear her apnoea attacks and her fear of losing her. She described difficulty grieving for this child and subsequent failure to attach to her next child or feel for the other victims.
CONCLUSIONS—Expressions of intense attachment to an infant and description of intense grief over a death in a way which engages compassion should not deter a paediatrician from considering the possibility of the parent having killed the child.

 PMID:11719326

  13. Management of radionecrosis of the vulva and distal vagina

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    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. (Univ. of South Florida, Tampa (USA))

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  14. Anatomy and Aesthetics of the Labia Minora: The Ideal Vulva?

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    Clerico, C; Lari, A; Mojallal, A; Boucher, F

    2017-06-01

    Female genital cosmetic surgery is becoming more and more widespread both in the field of plastic and gynaecological surgery. The increased demand for vulvar surgery is spurred by the belief that the vulva is abnormal in appearance. What is normal in terms of labial anatomy? Labia minora enlargement or hypertrophy remains a clinical diagnosis which is poorly defined as it could be considered a variation of the normal anatomy. Enlarged labia minora can cause functional, aesthetic and psychosocial problems. In reality, given the wide variety of vulvar morphology among people, it is a very subjective issue to define the "normal" vulva. The spread of nudity in the general media plays a major role in creating an artificial image and standards with regard to the ideal form. Physicians should be aware that the patient's self-perception of the normal or ideal vulva is highly influenced by the arguably distorted image related to our socio-psychological environment, as presented to us by the general media and internet. As physicians, we have to educate our patients on the variation of vulvar anatomy and the potential risks of these surgeries. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  15. Verrucous carcinoma of the vulva: a case report and review of the literature.

    OpenAIRE

    Jean eBouquet De Jolinière

    2016-01-01

    Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in the vulva carcinoma classification and its scalability is uncertain and unpredictable. We present a case concerning a 48-year-old patient, without following after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows th...

  16. Childhood disintegrative disorder misdiagnosed as childhood-onset ...

    African Journals Online (AJOL)

    Childhood disintegrative disorder (CDD) is a rare pervasive developmental disorder, which is often misdiagnosed as schizophrenia, probably due to the resultant severe social impairment and withdrawn behaviour with stereotypys that could be mistaken for psychosis. We report a case of CDD that was misdiagnosed by a ...

  17. Paget's disease of the vulva: A review of 89 cases

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    Cherry O. Onaiwu

    2017-02-01

    Full Text Available The purpose of this study was to retrospectively review the clinical characteristics and outcomes of a series of women with Paget's disease of the vulva. A retrospective review was performed of 89 women with Paget's disease of the vulva evaluated at a single institution between 1966 and 2010. Medical records were reviewed for demographic information, clinical data, pathologic findings, treatment modalities and outcomes. We found that the primary treatment was surgery for 74 (83.1% patients, with positive margins noted in 70.1% of cases. Five patients (5.6% underwent topical treatment with imiquimod and/or 5-fluorouracil, one patient (1.1% underwent laser ablation and treatment was unknown in 9 patients (10.1%. The majority of patients had multiple recurrences, with 18% having four or more recurrences. There were no significant differences in recurrence rates between patients who underwent surgery and those who did not. Furthermore, there was no association between positive margins following primary surgery and recurrence. Forty-one patients (46.1% were diagnosed with 53 synchronous or metachronous cancers. Seven patients (7.9% were found to have invasive vulvar cancer with 1 mm or more depth of invasion, but none of the patients died of Paget's disease or associated vulvar/vaginal cancer. Our findings suggest that the majority of patients with Paget's disease of the vulva develop multiple recurrences regardless of treatment modality or margin status. Alternatives to surgery are needed to better care for women with this disease.

  18. Young women's genital self-image and effects of exposure to pictures of natural vulvas.

    Science.gov (United States)

    Laan, Ellen; Martoredjo, Daphne K; Hesselink, Sara; Snijders, Nóinín; van Lunsen, Rik H W

    2017-12-01

    Many women have doubts about the normality of the physical appearance of their vulvas. This study measured genital self-image in a convenience sample of college-educated women, and assessed whether exposure to pictures of natural vulvas influenced their genital self-image. Forty-three women were either shown pictures of natural vulvas (N = 29) or pictures of neutral objects (N = 14). Genital self-image was measured before and after exposure to the pictures and two weeks later. Sexual function, sexual distress, self-esteem and trait anxiety were measured to investigate whether these factors influenced genital self-image scores after vulva picture exposure. A majority of the participants felt generally positively about their genitals. Having been exposed to pictures of natural vulvas resulted in an even more positive genital self-image, irrespective of levels of sexual function, sexual distress, self-esteem and trait anxiety. In the women who had seen the vulva pictures, the positive effect on genital self-image was still present after two weeks. The results of this study seem to indicate that even in young women with a relatively positive genital self-image, exposure to pictures of a large variety of natural vulvas positively affects genital self-image. This finding may suggest that exposure to pictures of natural vulvas may also lead to a more positive genital self-image in women who consider labiaplasty.

  19. Phyllodes Tumor of the Breast Metastasizing to the Vulva

    Directory of Open Access Journals (Sweden)

    Olusegun Kayode Ajenifuja

    2015-01-01

    Full Text Available Phyllodes tumors of the breast are rare breast tumors that resemble fibroadenoma. They are composed of two types of tissues: stromal and glandular tissues. Unlike fibroadenoma, they are commonly found in the third decade of life and they tend to grow more rapidly. Depending on the relative components of the cells and mitotic activity, they are classified into benign, borderline, and malignant. They are usually present as a lump in the breast. Phyllodes tumors are usually managed by wide excision. The excision should be wide enough to ensure a tumor-free margin. Recurrence rate is very high and most recurrences are usually local. Metastasis to the vulva has not been reported.

  20. Verrucous carcinoma of the vulva: a case report and review of the literature.

    Directory of Open Access Journals (Sweden)

    Jean eBouquet De Jolinière

    2016-02-01

    Full Text Available Verrucous carcinoma of the vulva is a rare lesion (1. Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in the vulva carcinoma classification and its scalability is uncertain and unpredictable. We present a case concerning a 48-year-old patient, without following after a condyloma acuminate of the vulva (large left lip. The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the scarcity of this lesion of the female genital tract.

  1. Lymphangioma circumscriptum of the vulva: a review of the literature.

    Science.gov (United States)

    Vlastos, Anne-Thérèse; Malpica, Anais; Follen, Michele

    2003-05-01

    To promote proper identification and management of this rare entity by presenting a review of the literature, a case report, and illustrations of its presentation and pathology. Sources searched included the literature contained in the National Library of Medicine's PubMed database, using the term "lymphangioma circumscriptum" combined with "vulva." Other search terms used were "capillary lymphangioma," "lymphangiectasia," and "dermal lymphangioma." Sources also included articles predating the PubMed database that were cited by other writers. Selections were restricted to the English-language medical literature published since 1960, and the search resulted in retrieval of 3272 published papers about lymphangioma. Congenital lymphangioma circumscriptum of the vulva has been reported in 11 patients, including one case reported and illustrated in this paper, and acquired lymphangioma circumscriptum has been reported in 20. It affects females 9-76 years old (mean 42.5 years). Clinically, it is characterized by persistent clusters of thin-walled vesicles filled with clear fluid. The diagnosis is usually made by biopsy, as these lesions often mimic such infectious diseases as molluscum contagiosum. Management options have included surgical excision of the skin and subcutaneous tissue, surface abrasion by laser or sclerosing therapy, and observation. From this comprehensive review, which includes the clinicopathologic features of both the congenital and acquired forms, illustrations from the rarest form, and a summary of treatment approaches, we conclude that lymphangioma circumscriptum poses a diagnostic challenge the risks of which are misdiagnosis and mistreatment. These risks would likely be reduced were a database of cases accessible that permitted long-term follow-up and better assessment of presenting characteristics and treatment options.

  2. Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature

    OpenAIRE

    Bouquet de Jolinière, Jean; Khomsi, F.; Gothuey, J. M.; Guillou, L.; Fadhlaoui, A.; Dubuisson, J. B.; Feki, A.

    2016-01-01

    Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows...

  3. A tumoriform lesion of the vulva with features of mammary-type fibrocystic disease.

    Science.gov (United States)

    Konstantinova, Anastasia M; Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

    2013-10-01

    : Fibrocystic disease is a common benign lesion of the breast. Variably sized cysts, apocrine metaplasia, fibrosis, calcification, chronic inflammation, and epithelial hyperplasia are the basic morphological changes seen in mammary fibrocystic disease. We report a rare tumoriform lesion of the vulva with features of fibrocystic disease, which seems to be the first description of this condition in the vulva. The pertinent literature is discussed. The reported lesion further demonstrates the analogy between tumors of anogenital mammary-like glands and mammary neoplasms.

  4. Aggressive Angiomyxoma of the Vulva: A Bizarre Perineal Lesion

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    Adamantia Zizi-Sermpetzoglou

    2015-01-01

    Full Text Available Introduction. Aggressive angiomyxoma is a rare, slowly growing, and benign tumour of mesenchymal origin, which affects women of reproductive age and is associated with a high risk of local recurrence. Case Presentation. A case of a 47-year-old white female is presented herein, with a large polypoid, gelatinous mass on the right labia majora, measuring 26 × 21 × 6 cm. Histopathologically, the lesion was composed of spindle and stellate-shaped cells embedded in a myxoid matrix. Another specific feature was the presence of variable-sized thin-walled capillaries and thick-walled vascular channels. The patient underwent wide local excision of the tumour with clear margins and developed local recurrence 18 months later. Discussion. Aggressive angiomyxoma of the vulva needs to be distinguished from benign myxoid tumors with a low risk of local recurrence as well as from malignant myxoid neoplasms. Usually wide local excision with tumour-free margins and occasionally hormonal manipulation is the treatment of choice.

  5. Pituitary Adenoma Misdiagnosed as Glaucoma in an Adult Nigerian ...

    African Journals Online (AJOL)

    is most commonly associated with glaucoma, pathologic cupping of the disc in some cases of pituitary adenoma has been reported in the literature.[2-4]. We add to the literature the case of a pale and pathologically cupped disc in a Nigerian male with pituitary adenoma misdiagnosed and treated for glaucoma with resultant.

  6. Severe infection of wild-caught snakes with Spirometra erinaceieuropaei from food markets in Guangzhou, China involves a risk for zoonotic sparganosis.

    Science.gov (United States)

    Wang, Fumin; Zhou, Lihua; Gong, Shiping; Deng, Yanzhong; Zou, Jiejian; Wu, Jun; Liu, Wenhua; Hou, Fanghui

    2011-02-01

    Wild-caught snakes are a popular and traditional food in China. However, little known to the public, snakes are also intermediate hosts of Spirometra erinaceieuropaei, a food- and water-borne pathogen of sparganosis. Therefore, we investigated the prevalence of S. erinaceieuropaei in 10 popular species of wild-caught snakes in Guangzhou City (Guangdong Province) between July 2009 and July 2010. One hundred and twenty-four specimens of 10 species (including Enhydris plumbea, Zoacys dhumnades, Elaphe radiate, Elaphe taeniura, Elaphe carinata, Ptyas mucosus, Ptyas korros, Naja naja atra, Bungarus fasciatus, and Bungarus multicinctus) were randomly selected from a total of 1,160 wild-caught snakes. They were obtained from food markets in 5 representative districts (Huadou, Panyu, Tianhe, Haizhu, and Conghua). The specimens were killed, necropsied, and examined for parasitic helminths. Of the snakes examined, 29.8% were infected by spargana and the worm burden per infected snake ranged from 1 to 221. Most species were infected except for En. plumbea, B. fasciatus, and B. multicinctus. Prevalence even reached 100% in Zoacys dhumnades. More than half (53.5%) of the spargana were located in muscular tissue, 36.4% in subcutaneous tissue, and 10.1% in the coelomic cavity. The study revealed the potential risk for the zoonotic sparganosis by eating wild-caught snakes and will be helpful in arousing public health concern about the consumption of snake meat.

  7. Angiogenesis in Paget's Disease of the Vulva and the Breast: Correlation with Microvessel Density

    Directory of Open Access Journals (Sweden)

    Patricia E. Ellis

    2012-01-01

    Full Text Available Our understanding of the pathogenesis of Paget's disease of the vulva and the breast remains limited. Current evidence supports the fact that angiogenesis plays an important role in the pathogenesis of several diseases. Therefore, we sought to define its role, as correlated with microvessel density, in Paget's disease of the vulva and the breast. Microvessels were analysed using anti-von Willebrand factor antibody in 105 cases of Paget's disease of the vulva and the breast comprising 71 cases of Paget's disease of the vulva, including 8 cases with invasive disease, and 34 cases of Paget's disease of the breast. The latter included 12 cases with DCIS, 5 cases with both DCIS and invasive carcinoma, and 6 with carcinoma alone. Eleven cases had no underlying tumour identified. Increased microvessel density was demonstrated in Paget's disease of the breast with DCIS and with carcinoma alone compared to Paget's disease of the breast alone, <0.08 and <0.013, respectively. There were no significant differences in microvessel density in the vulval cases. Neovascularisation is an important process in the development of Paget's disease of the breast. Other biological and molecular processes are more involved in the pathogenesis of Paget's disease of the vulva.

  8. Crohn Disease of the Vulva without Gastrointestinal Manifestations in a 16-Year-Old Girl.

    Science.gov (United States)

    Zhang, Ai-jun; Zhan, Shu-hui; Chang, Hong; Gao, Yu-qiang; Li, Yan-qing

    2015-01-01

    Crohn disease of the vulva is a rare disease that is difficult to diagnose. There are limited reports describing treatment of this condition. To describe the diagnosis and treatment of a 16-year-old girl with Crohn disease of the vulva, without onset of intestinal symptoms. Crohn disease was diagnosed by histopathology. The patient was treated with corticosteroids and followed for 1 year. After the final diagnosis, cutaneous lesions responded rapidly to corticosteroid treatment, which was gradually stopped after 6 months. The disease was well controlled at the 1-year follow-up. Crohn disease of the vulva can develop alone without the onset of intestinal symptoms. Diagnosis relies on special pathologic findings. Corticosteroid treatment is effective for this condition. © 2014 Canadian Dermatology Association.

  9. Lacrimal gland duct stones: misdiagnosed as chalazion in 3 cases.

    Science.gov (United States)

    Kim, Sung Chul; Lee, Kook; Lee, Sang Un

    2014-02-01

    To report 3 cases of lacrimal gland duct stones misdiagnosed as chalazion. Retrospective case series. Three patients with lacrimal gland duct stones misdiagnosed as chalazion at a local clinic between 2010 and 2012. A thorough review of clinical, imaging, and histopathologic manifestations. Clinical manifestations of lacrimal gland duct stones included conjunctival injection, lid swelling, tenderness, and ocular discharge, which are similar to chalazion symptoms. Computed tomography revealed a relatively well-defined, high-density mass near the lacrimal gland. Histopathologic examination of excised material revealed calcified amorphous stones. Intractable chalazion-like lesions at the lateral canthal area near the lacrimal gland should be carefully examined; imaging studies are required to confirm the presence of lacrimal gland duct stones, which require surgical removal. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  10. Childhood disintegrative disorder misdiagnosed as childhood-onset schizophrenia

    Directory of Open Access Journals (Sweden)

    Neena Sanjiv Sawant

    2014-08-01

    Full Text Available Childhood disintegrative disorder (CDD is a rare pervasive developmental disorder, which is often misdiagnosed as schizophrenia, probably due to the resultant severe social impairment and withdrawn behaviour with stereotypys that could be mistaken for psychosis. We report a case of CDD that was misdiagnosed by a psychiatrist as childhood-onset schizophrenia and treated with high doses of antipsychotics. The patient did not show any improvement. This highlights ethical issues that arise from treatment modalities, with polypharmacy being the biggest culprit, and also points to the need to continue medical education at the level of primary health services and among practising rural doctors where tertiary centres with child guidance facilities and a multidisciplinary team are not available.

  11. Congenital hernia of cord: an often misdiagnosed entity

    Science.gov (United States)

    Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana

    2015-01-01

    Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514

  12. Misdiagnosed Uterine Rupture of an Advanced Cornual Pregnancy

    Directory of Open Access Journals (Sweden)

    Christian Linus Hastrup Sant

    2012-01-01

    Full Text Available Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability.

  13. Miliaria pustulosa misdiagnosed as a case of acne vulgaris

    Directory of Open Access Journals (Sweden)

    Iqbal Bukhari

    2016-10-01

    Full Text Available Miliaria is a skin disorder of eccrine glands. Based on the level of sweat duct obstruction, miliaria is subdivided into three main types: Miliaria crystallina, miliaria rubra and miliaria profunda. Besides, resident skin bacteria are thought to play a role in its pathogenesis. In this report we are presenting a case of miliaria pustulosa which was misdiagnosed initially as a case of acne vulgaris.

  14. Misdiagnosed uterine rupture of an advanced cornual pregnancy

    DEFF Research Database (Denmark)

    Sant, Christian Linus Hastrup; Andersen, Poul Erik

    2012-01-01

    Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination...... and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability....

  15. Leptomeningeal Carcinomatosis of Gastric Cancer Misdiagnosed as Vestibular Schwannoma

    OpenAIRE

    Kim, Shin-Jae; Kwon, Jeong-Taik; Mun, Seog-Kyun; Hong, Young-Ho

    2014-01-01

    Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when ...

  16. Leptomeningeal carcinomatosis of gastric cancer misdiagnosed as vestibular schwannoma.

    Science.gov (United States)

    Kim, Shin-Jae; Kwon, Jeong-Taik; Mun, Seog-Kyun; Hong, Young-Ho

    2014-07-01

    Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when treating patients with gastric cancer.

  17. Analysis on misdiagnosed cases of right colon cancer as appendicitis

    Directory of Open Access Journals (Sweden)

    Sijia Liu

    2016-08-01

    Full Text Available The aim of this case report is to investigate the causes of misdiagnosing right colon cancer as appendicitis, in order to reduce the misdiagnosis rate. The process of diagnosing and treating 44 misdiagnosed right colon cancer cases was analyzed. It was found that the right colonic lumen in these patients was thick, and their cancer consisted mostly of the ulcerative type or of a cauliflower-like tumor that protruded into the intestinal cavity. Moreover, ring-shaped and structured cancer was rarely observed, which suggested a decreased likelihood of obstruction. The patients showed limited peritoneal irritation signs in their right lower abdomen, which was also a potential cause for misdiagnosis. Right colon cancer associated with appendicitis is easily misdiagnosed as simple appendicitis, chronic appendicitis, or appendiceal abscess. Therefore, it is necessary to raise general awareness on the manifestations of the disease in order to exclude other common complications during diagnosis and to reduce the misdiagnosis rate. An accurate early diagnosis and treatment will improve patient prognosis.

  18. Acute tumor lysis syndrome with squamous cell carcinoma of the vulva.

    Science.gov (United States)

    Shamseddine, A I; Khalil, A M; Wehbeh, M H

    1993-11-01

    Acute tumor lysis syndrome (ATLS) is a rare metabolic complication in nonhematologic malignancies. We report a unique case of extensive regionally recurrent squamous cell carcinoma of the vulva who developed a picture compatible with ATLS 36 hr after the initiation of palliative chemotherapy. The patient suffered acute renal failure with hyperuricemia, hyperphosphatemia, and hypocalcemia as well as a picture suggestive of congestive heart failure. The patient responded well to adequate hydration, alkaline diuresis, and allopurinol. The potential for ATLS should be anticipated when treating metastatic or locally advanced squamous cell carcinoma of the vulva with chemotherapy.

  19. Buck effect on rabbit oestrous: vulva colour, vaginal lumen cells and ovarian follicle populations

    Directory of Open Access Journals (Sweden)

    Idowu Ola

    2012-07-01

    Full Text Available The aim of this study was to determine the response to combinations of male stimuli in the oestrous doe in terms of changes in vulva colour, exfoliated cells in the vaginal lumen and the ovarian histology. Twelve oestrous heterogeneous rabbits does (6 multiparous and 6 nulliparous were allotted equally to 3 experimental treatments: VIC – Male exposure with visual contact; NVC – Male exposure without visual contact and; NOC – Females completely isolated and not allowed any contact with the male. The does were placed under these treatments for 30 consecutive days during which vulvar colour was checked and vaginal smears were taken daily for each animal. All animals were sacrificed on the thirtieth day and their ovaries processed for histological examination following H & E staining. Does with NVC and VIC exposure displayed either red or pink vulva in 95 and 90%  of cases, respectively, the remaining cases being rose coloured but never a whitish vulva (P<0.05, whereas does with NOC exposure displayed rose vulva on 80% of the days checked and another 11.7% cases with white vulvae but never a reddish vulva (P<0.05. The proportions of superficial, intermediate and parabasal epithelial cells in the vagina smears showed that superficial cells usually contribute less than 16% of the total and are also less abundant (P<0.05 irrespective of the doe’s exposure type or vulva colour, except in male-isolated does with purple vulva. All categories of follicles were seen on ovarian sections from NVC and VIC does, but corpora lutea were also present on the sections from VIC does, whereas only follicles below 0.5 mm diameter were seen on the sections from NOC does. In conclusion, these results suggest that the rabbit does require some form of stimulus from the male to remain sexually attractive. Moreover, ovulation appeared to have been induced in the does with visual contact with the male, probably in conjunction with auditory and olfactory, but without

  20. Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature.

    Science.gov (United States)

    Bouquet de Jolinière, Jean; Khomsi, F; Gothuey, J M; Guillou, L; Fadhlaoui, A; Dubuisson, J B; Feki, A

    2016-01-01

    Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract.

  1. Imaging of the vagina and vulva; Aspectos de imagem das lesoes vulvo-vaginais

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Luis Ronan Marquez Ferreira de; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: luisronan@gmail.com; Borges, Leonardo Romualdo; Rosalen Junior, Roberto Antonio [Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG (Brazil); Signorini Filho, Roney Cesar; Marques, Renato Moretti; Nicolau, Sergio Mancini [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Disciplina de Oncoginecologia; Goldman, Suzan Menasce [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem

    2006-10-15

    In gynecological daily practices, the vulva and vagina are examined during physical examination, however there are situations where this is not possible or it is needed to determine the extension of an injury through imaging methods. The magnetic resonance imaging is an excellent cross-sectional modality for evaluation the alterations of vulva and vagina due its multiplanar evaluation and high tecidual contrast. Other cross-sectional modalities are ultrasound and enhanced computed tomography. This paper intends to give an overview of vaginal and vulvar pathology that can be identified by the radiologist. (author)

  2. Diagnosis of Primary Langerhans Cell Histiocytosis of the Vulva in a Postmenopausal Woman

    Directory of Open Access Journals (Sweden)

    Sefa Kurt

    2013-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a very rare disease of female genital tract, most commonly seen in vulva and unusual in postmenopausal period. Herein, we report the 8th case of pure vulvar LCH in a postmenopausal woman. We pay attention to the differential diagnosis in postmenopausal state, features of pathologic diagnosis, and treatment options.

  3. Non-leukemic myeloid sarcoma involving the vulva, vagina, and cervix: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Yu Y

    2015-12-01

    Full Text Available Yuan Yu,1 Xuemei Qin,1 Shuxin Yan,1 Wenxia Wang,2 Yanlin Sun,3 Maohong Zhang1 1Department of Hematology, 2Department of Gynecology, 3Department of Pathology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China Abstract: Myeloid sarcoma (MS is defined as a tumor mass consisting of myeloid blast with or without maturation occurring at an anatomical site other than bone marrow with normal architectural effacement. It can also precede the onset of leukemia which is called non-leukemic MS. Non-leukemic MS is a kind of rare disease and easy to be misdiagnosed as other common malignancies due to the rarity and nonspecific manifestation. We herein report an unusual case of non-leukemic MS involving the vulva, vagina, and cervix in a female patient. The bone marrow aspiration and biopsy of the patient revealed no hematological abnormality. Immunohistochemical staining of the biopsies was strongly positive for myeloperoxidase, CD68, leukocyte common antigen (LCA, CD117, CD34, CD38, CD79a, and negative for cytokeratin (CK, epithelial memberane antigen (EMA, CD2, CD3, CD20, CD5, CD138. Then a diagnosis of non-leukemic MS was made. Unfortunately, our patient received only one cycle of chemotherapy consisting of cytosine arabinoside and daunorubicin, then refused any further treatment and died 4 months after diagnosis. Although systemic chemotherapy is widely accepted to be a promising strategy, its benefit still needs to be further assessed. Certain questions still need to be answered for this disease: 1 Why can approximately 20% of the patients with non-leukemic MS remain disease-free after local therapy alone? 2 How many cycles of chemotherapy are needed for these patients after achievement of complete remission? 3 What are the prognostic or risk factors in these patients who have no abnormality of karyotype, fusion genes, or gene mutation to predict responsiveness to chemotherapy and outcome? 4 What is the risk factor for relapse? The

  4. (Correcting misdiagnoses of asthma: a cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Vandemheen Katherine

    2011-05-01

    Full Text Available Abstract Background The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective. Method Randomly selected physician-diagnosed-asthmatic subjects from 8 Canadian cities were studied with an extensive diagnostic algorithm to rule-in, or rule-out, a correct diagnosis of asthma. Subjects in whom the diagnosis of asthma was excluded were followed up for 6-months and data on asthma medications and heath care utilization was obtained. Economic analysis was performed to estimate the incremental lifetime costs associated with secondary screening of previously diagnosed asthmatic subjects. Analysis was from the perspective of the Canadian healthcare system and is reported in Canadian dollars. Results Of 540 randomly selected patients with physician diagnosed asthma 150 (28%; 95%CI 19-37% did not have asthma when objectively studied. 71% of these misdiagnosed patients were on some asthma medications. Incorporating the incremental cost of secondary-screening for the diagnosis of asthma, we found that the average cost savings per 100 individuals screened was $35,141 (95%CI $4,588-$69,278. Conclusion Cost savings primarily resulted from lifetime costs of medication use averted in those who had been misdiagnosed.

  5. Ulcus vulvae acutum — A case of genital ulcers in adolescent girl

    Directory of Open Access Journals (Sweden)

    Daniela Visentin

    2016-01-01

    Full Text Available Ulcus vulvae acutum is a rare clinical condition characterized by the presence of multiple acute painful genital ulcers of non-venereal origin associated with systemic symptoms in young women. The aetiopathogenesis of the disease is not fully understood, although recent reports have associated it with the Epstein–Barr virus. Diagnosis is difficult and generally made by exclusion after venereal diseases, and autoimmune, inflammatory, traumatic, and neoplastic causes. We describe a case of adolescent female with an episode of ulcus vulvae acutum associated with infectious mononucleosis. The diagnosis was supported by the clinical symptoms, elevated circulating levels of liver enzymes, positive EBV serology, cervical and inguinal lymphadenomegaly, and hepatosplenomegaly. The patient presented a history of aphthous stomatitis. Negative Pathergy test and the absence of any other related symptoms allowed us to exclude the Behçhet syndrome. Lesions healed with no sequelae or recurrences.

  6. Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report

    Directory of Open Access Journals (Sweden)

    Amelio Gianfranco

    2009-12-01

    Full Text Available Abstract Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should always raise suspicion of a lumbar hernia. Ultrasound and computed tomography may confirm the diagnosis. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results.

  7. Malignant melanoma misdiagnosed as diabetic foot ulcer: A case report.

    Science.gov (United States)

    Gao, Wei; Chen, Dawei; Ran, Xingwu

    2017-07-01

    Acral lentiginous melanoma (AML) does not exhibit the classic signs of malignant melanoma. ALM is frequently misdiagnosed because of its unusual sites and atypical clinical morphologies, which lead to poor prognosis. A female patient aged 78 years was presented to our center with two ulcers on her right foot. Diabetic foot ulcer was considered as the primary diagnosis. The ulcers failed to improve after 2 weeks' therapy. An incisional biopsy of the lesion revealed malignant melanoma. The patient received wide excision, skin grafting as well as biotherapy. The lesion was healed and no other metastasis has been founded until now. Clinicians must maintain a high level of suspicion in distinguishing malignant melanoma from other more benign skin lesions of the foot. The need for early biopsy of ulcer, even when clinical suspicion is low, can not be overemphasized. Only in this way can we reduce misdiagnosis rate and improve survival rate in patients with foot ulcer.

  8. Misdiagnosed inmate to get trial under Rehabilitation Act claim.

    Science.gov (United States)

    1995-08-11

    A Federal judge dismissed most portions of a lawsuit filed by a prison inmate who was misdiagnosed with AIDS, but will send to trial his claim that his segregation to a special prison AIDS unit violated Section 504 of the Federal Rehabilitation Act. The Rehabilitation Act prohibits federally-funded state programs from discriminating against an individual on the basis of disability. A lab report on a biopsy of the inmate's skin lesions concluded that the lesions were consistent with early Kaposi's Sarcoma (KS), common among persons with AIDS. [Name removed], an inmate of the Green Haven Correctional Facility in Stormville, NY, was sent to the AIDS unit without being tested for HIV. He filed a grievance, and was tested five months after entering the unit. He tested negative for HIV and KS. The judge rejected [name removed] claims that he was denied procedural due process, but found that he qualified as a handicapped individual, entitled to Federal protection against discrimination.

  9. F-actin accumulates in the vulva of female Strongyloides venezuelensis.

    Science.gov (United States)

    Silva, C V; Gonçalves, A L R; Cruz, L; Cruz, M C; Ueta, M T; Costa-Cruz, J M

    2013-09-01

    Little is known about the actin cytoskeleton architecture in female Strongyloides venezuelensis and thus to investigate the distribution and concentration of actin, female worms were labelled with phalloidin-rhodamine and visualized under confocal microscopy. Our results demonstrate that filamentous actin accumulates in the vulva and the concentration of F-actin at this site suggests its important role, especially during oviposition, in the life cycle of S. venezuelensis.

  10. Metastatic basal cell carcinoma caused by carcinoma misdiagnosed as acne - case report and literature review

    DEFF Research Database (Denmark)

    Aydin, Dogu; Hölmich, Lisbet Rosenkrantz; Jakobsen, Linda Plovmand

    2016-01-01

    Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis.......Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis....

  11. Squamous cell carcinoma of the vulva in a virgin patient with Turner syndrome.

    Science.gov (United States)

    Tapisiz, Omer Lutfi; Topcu, Onur; Gungor, Tayfun; Ozdal, Bulent; Sirvan, Levent; Yesilyurt, Ahmet

    2011-09-01

    Two types of gynecologic tumors are commonly described in the Turner syndrome, the first one is gonadoblastoma, which occurs in patients with Y chromosome abnormalities, and the second one is endometrial carcinoma which is mostly related with exogenous estrogen usage. Here, we describe an extremely rare case of squamous cell carcinoma of the vulva in a virgin woman with Turner syndrome. A 35-years old single, virgin woman referred to our Oncology Department with warty, necrotized, exophytic 6-7 cm vulvar mass. She had a history of primary amenorrhea and mosaic Turner syndrome was determined in her karyotype analysis. Biopsy specimen of the vulvar mass revealed squamous cell carcinoma of the vulva, and total vulvectomy with inguinal femoral lymphadenectomy was performed. The postoperative course was uneventful and there has been no recurrence of the disease up to date. Women with Turner syndrome have streak ovaries that produce very low estrogen and the squamous cell carcinoma of the vulva may have developed at an early age with Turner syndrome because of this low estrogen value similar to postmenopausal women. The current case is a special case due to its age of occurrence, virgin and Turner syndrome status.

  12. The comparative study of former and latest FIGO staging of vulva cancer.

    Science.gov (United States)

    Sun, X; Zhang, Y; Sun, J; Feng, S; Yan, M; Cheng, H

    2012-04-01

    By means of comparing the 2009 staging with the 1994 staging for vulva carcinoma on prognostic predicting, the essay aims to investigate the alterations of clinical decision due to the staging changing. A retrospective analysis was adopted which involves 100 patients with primary squamous cell carcinoma of the vulva treated at Sun Yat-sen University Cancer Center from January 1980 to December 2005. Meanwhile, survival rate was calculated by life table method. In addition, Kaplan-Meirer method was used to evaluate the prognostic factors in univariate analysis. And the independent prognostic factors were provided through COX regression model. Univariate analysis indicated that the prognostic factors of vulva squamous cell carcinoma were: age (P=0.018), lymph node metastasis (P=0.010), the 1988 staging (P=0.031), the 2009 staging (P=0.001), the number of positive lymphnodes (PCOX regression model indicated that the independent prognostic factor was: the number of positive lymph nodes (Pextension, lymph node status and so on. The 2009 staging is better than the 1994 staging on prognostic predicting and, which could guide the clinical treatment more accurately.

  13. Is hyperthyroidism underestimated in pregnancy and misdiagnosed as hyperemesis gravidarum?

    Science.gov (United States)

    Luetic, Ana Tikvica; Miskovic, Berivoj

    2010-10-01

    Thyroid changes are considered to be normal events that happen as a large maternal multiorganic adjustment to pregnancy. However, hyperthyroidism occurs in pregnancy with clinical presentation similar to hyperemesis gravidarum (HG) and pregnancy itself. Moreover, 10% of women with HG will continue to have symptoms throughout the pregnancy suggesting that the underlying cause might not be elevation of human chorionic gonadotropin in the first trimester. Variable frequency of both hyperthyroidism and HG worldwide might suggest the puzzlement of inclusion criteria for both diagnoses enhanced by the alternation of thyroid hormone levels assessed in normal pregnancy. Increased number of hyperthyroidism among women population without the expected rise in gestational hyperthyroidism encouraged us for creating the hypotheses that hyperthyroidism could be underestimated in normal pregnancy and even misdiagnosed as HG. This hypothesis, if confirmed, might have beneficial clinical implications, such as better detection of hyperthyroidism in pregnancies, application of therapy when needed with the reduction of maternal or fetal consequences. Copyright 2010 Elsevier Ltd. All rights reserved.

  14. Idiopathic pulmonary fibrosis misdiagnosed as sputum-negative pulmonary tuberculosis.

    Science.gov (United States)

    Isah, Muhammad Danasabe; Abbas, Aminu; Abba, Abdullahi A; Umar, Mohammed

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF), also known as cryptogenic fibrosing alveolitis, is one of a spectrum of idiopathic interstitial pneumonia. IPF is an increasingly common condition which poses many diagnostic and therapeutic challenges leading to misdiagnosis and mismanagement. We presented a 55-year-old male textile trader who was initially managed as sputum-negative pulmonary tuberculosis before histology report. He presented to our clinic with Breathlessness and cough of 3 years and 2.5 years, respectively. He had commenced anti-tuberculosis two months before presentation without significant relief. General Physical examination and vital signs were essentially normal. SPO2 was 96% on room air. Chest Examination revealed end-inspiratory bi-basal velcro-like crackles. Other systemic examinations were normal. Radiological examination by way of chest X- ray and chest CT showed features suggestive of IPF. The patient also had open Lung biopsy for histology and spirometry which demonstrated restrictive ventilatory function pattern. A diagnosis of Interstitial lung disease probably Idiopathic Pulmonary Fibrosis was entertained. He was commenced on Tab prednisolone, Tab Rabeprazole, with minimal improvement. IPF have often been misdiagnosed and treated as pulmonary tuberculosis with unfavorable outcome.

  15. Nonclassic congenital adrenal hyperplasia misdiagnosed as Turner syndrome

    Directory of Open Access Journals (Sweden)

    Vineet V Mishra

    2015-01-01

    Full Text Available We present a patient with nonclassic congenital adrenal hyperplasia (NCAH misdiagnosed as mosaic Turner syndrome. She presented with complaints of primary infertility. Short stature, the presence of facial hair and hoarse voice was also noted. She had primary amenorrhea and was advised for karyotype at 16 years of age, which was reported as 45, X[20]/46, XX[80], stating her as a case of mosaic Turner syndrome. Clitoroplasty was done at 21 years of age for clitoromegaly, which was noticed during puberty. The diagnosis of mosaic Turner could not explain the virilization. Therefore, we repeated the karyotype, which revealed 46, XX in more than 100 metaphases and was sufficient to exclude mosaicism. Furthermore, the endocrinological evaluation revealed high testosterone level with a normal 17 alpha-hydroxyprogesterone (17-OHP. The presence of pubertal onset virilization with a karyotype of 46, XX and raised testosterone level with normal 17-OHP level, raised the suspicion of NCAH for which adrenocorticotropic hormone stimulation test was done which confirmed the diagnosis of NCAH.

  16. Granulomatosis with Polyangiitis initially misdiagnosed as lung cancer

    Directory of Open Access Journals (Sweden)

    S. Campainha

    2013-01-01

    Full Text Available Granulomatosis with Polyangiitis (GPA, which was formerly named Wegener's Granulomatosis (WG is a systemic disease characterized by necrotizing granulomatous inflammation and vasculitis that primarily involves upper and lower respiratory tract, as well as kidneys. Diagnosing GPA on the basis of transthoracic fine needle aspiration (TFNA may be problematic, as it can be misdiagnosed as cancer. We describe a patient with a probable GPA which was originally diagnosed as malignancy, but who responded to lung cancer chemotherapy. Resumo: A granulomatose com poliangeíte (GPA, previamente denominada granulomatose de Wegener, é uma doença sistémica caracterizada por inflamação granulomatosa necrotizante e vasculite que envolve principalmente o trato respiratório superior e inferior, bem como os rins. O diagnóstico de GPA com base em biópsia por agulha fina (BAF transtorácica pode ser problemático, levando ao diagnóstico incorreto de cancro. Os autores descrevem o caso de um paciente com provável GPA, inicialmente diagnosticado como cancro do pulmão, que curiosamente respondeu à quimioterapia para cancro do pulmão. Keywords: Systemic vasculitis, Non-small-cell lung carcinoma, Fine-needle biopsy, Palavras-chave: Vasculite sistémica, Carcinoma não-pequenas células, Biópsia por agulha fina

  17. Forensic Identification of Bipartite Patella Misdiagnosed as Patella Fracture.

    Science.gov (United States)

    Ma, Jingyuan; Shi, Fang; Huang, Chongya; Gu, Shanzhi

    2017-07-01

    Bipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. Bipartite patella is sometimes misdiagnosed as a patella fracture, because the x-ray images of both these conditions may appear very similar. In this case, the patient complained of left knee pain after x-ray films revealed a fracture-like line in the left patella. The patient was then diagnosed as having a patella fracture. In China, the injury degree is categorized as serious injury, minor injury, and trivial injury. As the injury degree of patellar fracture is identified as minor injury, the defendant who injured the patient will be sentenced to prison for ≤3 years. However, the defendant objected to this judgment and applied for the second evaluation of injury degree. On the basis of the site of injury, clinical manifestations, and imaging findings, we diagnosed the patient with bipartite patella which belongs to normal anatomic variant. Therefore, the injury degree of the patient was not minor injury. © 2017 American Academy of Forensic Sciences.

  18. Cystic acantholytic dyskeratosis of the vulva: An unusual presentation of a follicular adnexal neoplasm

    Directory of Open Access Journals (Sweden)

    Kara Melissa Tiangco Torres

    2016-01-01

    Full Text Available Acantholytic dyskeratosis (AD is a histologic pattern seen in Darier's disease or dyskeratosis follicularis, warty dyskeratoma, and transient AD. This pattern is characterized by suprabasilar clefting, acantholysis, and formation of corps ronds and grains. We present a case of AD that is unique based on its genital location and cystic architecture. A 53-year-old woman presented with an otherwise asymptomatic cyst on her left vulva of uncertain duration. On microscopic examination, there were fragments of cystic epithelium with areas of hypergranulosis, acantholysis, corps ronds, and corps grains formation. These features are felt by the authors to be a unique presentation of a follicular adnexal neoplasm.

  19. Condyloma-like squamous cell carcinoma of the vulva: report of two midline cases

    Directory of Open Access Journals (Sweden)

    Verma SB

    2012-09-01

    Full Text Available Shyam B Verma,1 Uwe Wollina21Nirvana Clinic, Vadodara, Gujarat, India; 2Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, GermanyAbstract: Vulvar cancer is uncommon and may be confused with genital condylomata. We report two cases of middle-aged women presenting with exophytic vulvar tumors of the midline for which diagnosis of a vulvar squamous cell carcinoma was confirmed by histopathology. Risk factors, staging, and treatment options are discussed.Keywords: condyloma, human papillomavirus (HPV, squamous cell carcinoma, surgery, vulva

  20. Misdiagnosing absent pedicle of cervical spine in the acute trauma setting

    Directory of Open Access Journals (Sweden)

    Fahad H. Abduljabbar

    2015-09-01

    Full Text Available Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms.

  1. Linfoscintigrafía y cirugía radioguiada en neoplasias de cuello uterino y vulva

    OpenAIRE

    Morales Guzmán-Barrón, Rosanna Elvira

    2006-01-01

    OBJETIVOS Validar la técnica de detección del ganglio centinela en neoplasias precoces de vulva y cuello uterino, encontrando las tasas de detección con una metodología combinada utilizando radiofármacos y colorante azul vital. MATERIAL Y METODOS Setenta pacientes, entre 24 y 63 años (media 40 años), con neoplasias del cuello uterino estadios IA2, IB1 y IIA, y catorce pacientes, entre 28 y 80 años (mediana 68 años) con neoplasias de vulva estadios I y II, fueron sometidas a detección de gangl...

  2. Small cell carcinoma of vulva. Curative multimodal treatment in face of resistance to initial standard chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, Franziska; Bamberg, Michael; Mueller, Arndt-Christian [Dept. of Radiooncology, Eberhard Karls Univ. of Tuebingen (Germany); Fehm, Tanja [Gynecologic Clinic, Eberhard Karls Univ. of Tuebingen (Germany)

    2010-09-15

    Background and Purpose: Extrapulmonary small cell carcinoma (EPSCC) is a rare disease, which has a slightly better prognosis than small cell lung cancer, but still dismal. Gynecologic small cell malignancies tend to show a better survival than similar histologies of other regions. However, of five reported cases of vulvar manifestation only one patient was disease-free at the time of publication with limited follow-up. Case Report: The authors describe a case of locally advanced small cell vulva carcinoma infiltrating the anal sphincter and urethra with spread to inguinal lymph nodes treated by radiochemotherapy and regional hyperthermia. After three cycles of carboplatin/etoposide, computed tomography and magnetic resonance imaging indicated only little regressive transformations but overall stable disease. Surgical options were excluded. Therefore, curative radiotherapy to a total dose of > 65 Gy to macroscopic tumor, chemotherapy with cisplatin weekly, and regional hyperthermia were performed. Acute severe toxicity was limited to skin reactions. Despite the disadvantageous situation with inguinal lymph node metastases and chemoresistance, the multimodal therapy yielded a 5-year disease-free survival. Conclusion: Thus, the trimodal regimen of radiochemotherapy plus regional hyperthermia offered a curative chance in spite of resistance to the standard chemotherapy for irresectable, locally advanced small cell carcinoma of the vulva. Therefore, this approach merits further evaluation for limited disease of EPSCC. (orig.)

  3. Two Distinct Pathways to Development of Squamous Cell Carcinoma of the Vulva

    Directory of Open Access Journals (Sweden)

    Yutaka Ueda

    2011-01-01

    Full Text Available Squamous cell carcinoma (SCC accounts for approximately 95% of the malignant tumors of the vaginal vulva and is mostly found in elderly women. The future numbers of patients with vulvar SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulvar SCC have been put forth. The first pathway is triggered by infection with a high-risk-type Human Papillomavirus (HPV. Integration of the HPV DNA into the host genome leads to the development of a typical vulvar intraepithelial neoplasia (VIN, accompanied with overexpression of p14ARF and p16INK4A. This lesion subsequently forms a warty- or basaloid-type SCC. The HPV vaccine is a promising new tool for prevention of this HPV related SCC of the vulva. The second pathway is HPV-independent. Keratinizing SCC develops within a background of lichen sclerosus (LS through a differentiated VIN. It has a different set of genetic alterations than those in the first pathway, including p53 mutations, allelic imbalances (AI, and microsatellite instability (MSI. Further clinical and basic research is still required to understand and prevent vulvar SCC. Capsule. Two pathway for pathogenesis of squamous cell carcinoma of the value are reviewed.

  4. Embryology and anatomy of the vulva: the female orgasm and women's sexual health.

    Science.gov (United States)

    Puppo, Vincenzo

    2011-01-01

    Sexual health is vital to overall well-being. Orgasm is a normal psycho-physiological function of human beings and every woman has the right to feel sexual pleasure. The anatomy of the vulva and of the female erectile organs (trigger of orgasm) is described in human anatomy textbooks. Female sexual physiology was first described in Dickinson's textbook in 1949 and subsequently by Masters and Johnson in 1966. During women's sexual response, changes occur in the congestive structures that are essential to the understanding of women's sexual response and specifically of their orgasm. Female and male external genital organs arise from the same embryologic structures, i.e. phallus, urogenital folds, urogenital sinus and labioscrotal swellings. The vulva is formed by the labia majora and vestibule, with its erectile apparatus: clitoris (glans, body, crura), labia minora, vestibular bulbs and corpus spongiosum. Grafenberg, in 1950, discovered no "G-spot" and did not report an orgasm of the intraurethral glands. The hypothetical area named "G-spot" should not be defined with Grafenberg's name. The female orgasm should be a normal phase of the sexual response cycle, which is possible to achieve by all healthy women with effective sexual stimulation. Knowledge of the embryology, anatomy and physiology of the female erectile organs are important in the field of women's sexual health. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Waktu dan Kemerahan Vulva Saat Inseminasi Buatan Merupakan Faktor Penentu Angka Kebuntingan Sapi di Sumatera Barat (TIME AND REDDISH SIGN OF VULVA DURINGARTIFICIAL INSEMINATION AS A DETERMINANT FACTORS ON CONCEPTION RATE OF COW IN WEST SUMATERA

    Directory of Open Access Journals (Sweden)

    Zaituni Udin

    2017-01-01

    Full Text Available An experiment was conducted to evaluate determinant factors on conception rate of local and crossbreedcow at West Sumatera. There were 162 cows of four AI center at parity-0 to 4TH parity (P-4, inseminatedusing frozen semen of four different bulls (simental,brahman, limousine and Bali cattle. All fed similarityat four AI centers and location to observation of sign of estrus in high land and low land in West Sumatera.All data were analyzed using analyzed of variance in Randomized Block Design (RBD in factorial as afactor A was time of inseminated; parity;sign of vulva,breed and two location as a replication. Resultsofthis study showed that there were no interaction between time of insemination, breed, parity and thereddish sign of vulva (P>0.05 on conception rate. On the contrary,there were significantly different(P>0.05 on conception rate by time of insemination. The highest conception rate wasfound at the end ofestrus 13–18 h (68.91%,local cow (71.82%, P-3 (67.19% and reddish sign of vulva (74.25%. It wasconcluded that the effects,both inseminationtime and reddish sign of vulva might be the important factorto get the highest conception rate of the cows.

  6. Cancer - vulva

    Science.gov (United States)

    ... of the pelvis to look for cancer spread Pelvic examination to look for any skin changes Treatment Treatment ... Genital warts - vulvar cancer; HPV - vulvar cancer Images Female perineal anatomy References Jhingran A, Russell AH, Seiden ...

  7. Benign phyllodes tumor of the vulva: a case report and literature review

    Directory of Open Access Journals (Sweden)

    LeAnn N. Denlinger

    2015-12-01

    Full Text Available Phyllodes tumor is an uncommon breast lesion with characteristic histologic appearance when examined by hematoxylin and eosin staining: leaf-like fronds projecting into cystic spaces on low-power microscopy, and biphasic (epithelial and stromal components on high-power microscopy. We report a rare primary case of this tumor arising within the vulva. A 34-year old African American female presented with a 3 cm slow-growing vulvar mass initially thought to be an inclusion cyst. The lesion was excised and histologic examination demonstrated this lesion to be a rare case of benign phyllodes tumor with morphologic features similar to those arising from breast tissue. Patient received no further treatment and did not exhibit any recurrence or metastasis. Nearly two years after excision, the patient died due to an unrelated medical cause. This rare tumor should be considered in the differential diagnosis for women presenting with a slow-growing vulvar mass.

  8. Extramammary Paget’s Disease of Vulva in a Postmenopausal Woman: a Case Report

    Directory of Open Access Journals (Sweden)

    Reema Bhushan

    2017-10-01

    Full Text Available Paget’s disease of the vulva is a rare disease. It can present as a primary lesion or as a secondary lesion. When present as a secondary lesion, it is associated with adenocarcinoma originating from local organs such as urethra, or rectum. Patients generally tend to be of postmenopausal age group. We report a case of a 49-year-old postmenopausal woman who presented with the complaints of a slow growing lesion in the vulval region associated with itching. Biopsy from vulval lesion showed presence of pagetoid cells in the epidermis. The subclassification of vulvar Paget’s disease is essential for correct clinical management and treatment. Immunohistochemistry may help in the diagnosis and assessing tumour progression and invasion.

  9. Aggressive angiomyxoma of the vulva: dramatic response to gonadotropin-releasing hormone agonist therapy

    Directory of Open Access Journals (Sweden)

    Azar Danesh

    2007-08-01

    Full Text Available

    Aggressive angiomyxoma is a rare soft tissue neoplasm that usually arises within the perineum. It often occurs as a vulvar mass and clinically simulates a Bartholin's gland cyst. Most patients are in the second or third decade of life, but some cases have also been reported in children. This is the report of a 21 year old woman with 4.5 × 3 × 1.5 cm mass in right labia major. The patient underwent wide local excision surgical treatment. Histological examination showed high vascular myxoid tumor containing spindle cells. Immunohistochemical study of cells showed positive reaction to estrogen and progesterone and negative reaction to S100, SMA and desmin. Treatment with a gonadotropin-releasing hormone agonist was administered to deal with residual tumor and prevent local recurrence for 6 months.
    KEY WORDS: Aggressive angiomyxoma, vulva, pregnancy, Gonadotropin releasing hormone agonist.

  10. RAB-7 antagonizes LET-23 EGFR signaling during vulva development in Caenorhabditis elegans.

    Directory of Open Access Journals (Sweden)

    Olga Skorobogata

    Full Text Available The Rab7 GTPase regulates late endosome trafficking of the Epidermal Growth Factor Receptor (EGFR to the lysosome for degradation. However, less is known about how Rab7 activity, functioning late in the endocytic pathway, affects EGFR signaling. Here we used Caenorhabditis elegans vulva cell fate induction, a paradigm for genetic analysis of EGFR/Receptor Tyrosine Kinase (RTK signaling, to assess the genetic requirements for rab-7. Using a rab-7 deletion mutant, we demonstrate that rab-7 antagonizes LET-23 EGFR signaling to a similar extent, but in a distinct manner, as previously described negative regulators such as sli-1 c-Cbl. Epistasis analysis places rab-7 upstream of or in parallel to lin-3 EGF and let-23 EGFR. However, expression of gfp::rab-7 in the Vulva Presursor Cells (VPCs is sufficient to rescue the rab-7(- VPC induction phenotypes indicating that RAB-7 functions in the signal receiving cell. We show that components of the Endosomal Sorting Complex Required for Transport (ESCRT-0, and -I, complexes, hgrs-1 Hrs, and vps-28, also antagonize signaling, suggesting that LET-23 EGFR likely transits through Multivesicular Bodies (MVBs en route to the lysosome. Consistent with RAB-7 regulating LET-23 EGFR trafficking, rab-7 mutants have increased number of LET-23::GFP-positive endosomes. Our data imply that Rab7, by mediating EGFR trafficking and degradation, plays an important role in downregulation of EGFR signaling. Failure to downregulate EGFR signaling contributes to oncogenesis, and thus Rab7 could possess tumor suppressor activity in humans.

  11. Risk factors for invasive squamous cell carcinoma of the vulva and vagina - Population-based case-control study in Denmark

    National Research Council Canada - National Science Library

    Madsen, B.S; Jensen, H.L; Brule, van den, A.J.C; Woldfalurt, J; Frisch, M

    2008-01-01

    .... A total of 182 women with invasive VV‐SCC (116 with VV‐SCC vulva , 66 with VV‐SCC vagina ), 164 uterine corpus cancer controls and 518 population controls were interviewed in a population...

  12. Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

    National Research Council Canada - National Science Library

    Madsen, Birgitte S; Jensen, Helle L; van den Brule, Adriaan J.C; Wohlfahrt, Jan; Frisch, Morten

    2008-01-01

    .... A total of 182 women with invasive VV‐SCC (116 with VV‐SCC vulva , 66 with VV‐SCC vagina ), 164 uterine corpus cancer controls and 518 population controls were interviewed in a population...

  13. Aneurysmal Bone Cyst of Sphenoid Bone and Clivus Misdiagnosed as Chordoma: A Case Report.

    Science.gov (United States)

    Ustabasioglu, Fethi Emre; Samanci, Cesur; Asik, Murat; Yanik, Inanc; Ozkanli, Seyma; Tutar, Onur; Hasiloglu, Zehra Isik

    2015-10-01

    Aneurysmal bone cysts (ABCs) are benign and rapidly expanding bone destructive lesions of any bone. They are commonly localized in the metaphysis of long bones, whereas skull base ABCs are rare. We report a case of a 21-year-old man who had been misdiagnosed as chordoma and undergone surgery. However, histopathological examination revealed it to be an ABC.

  14. Pleomorphic adenoma in the palpebral lobe of the lacrimal gland misdiagnosed as chalazion.

    Science.gov (United States)

    Ramlee, Nor'Aini; Ramli, Noramazlan; Tajudin, Liza-Sharmini Ahmad

    2007-06-01

    We reported a case of pleomorphic adenoma of the lacrimal gland involving the palpebral lobe in young teenage girl of Asian origin. The presentation at young age group is rare, which initially misdiagnosed as a large chalazion. The benign tumor with its intact pseudocapsule was removed through lateral orbitotomy together with the suspicious looking orbital lobe.

  15. Antagonism of LIN-17/Frizzled and LIN-18/Ryk in nematode vulva induction reveals evolutionary alterations in core developmental pathways.

    Directory of Open Access Journals (Sweden)

    Xiaoyue Wang

    2011-07-01

    Full Text Available Most diversity in animals and plants results from the modification of already existing structures. Many organ systems, for example, are permanently modified during evolution to create developmental and morphological diversity, but little is known about the evolution of the underlying developmental mechanisms. The theory of developmental systems drift proposes that the development of conserved morphological structures can involve large-scale modifications in their regulatory mechanisms. We test this hypothesis by comparing vulva induction in two genetically tractable nematodes, Caenorhabditis elegans and Pristionchus pacificus. Previous work indicated that the vulva is induced by epidermal growth factor (EGF/RAS and WNT signaling in Caenorhabditis and Pristionchus, respectively. Here, we show that the evolution of vulva induction involves major molecular alterations and that this shift of signaling pathways involves a novel wiring of WNT signaling and the acquisition of novel domains in otherwise conserved receptors in Pristionchus vulva induction. First, Ppa-LIN-17/Frizzled acts as an antagonist of WNT signaling and suppresses the ligand Ppa-EGL-20 by ligand sequestration. Second, Ppa-LIN-18/Ryk transmits WNT signaling and requires inhibitory SH3 domain binding motifs, unknown from Cel-LIN-18/Ryk. Third, Ppa-LIN-18/Ryk signaling involves Axin and β-catenin and Ppa-axl-1/Axin is epistatic to Ppa-lin-18/Ryk. These results confirm developmental system drift as an important theory for the evolution of organ systems and they highlight the significance of protein modularity in signal transduction and the dynamics of signaling networks.

  16. Fibroma de Vulva (Molluscum Pendulum: Relato de Caso Vulvar Fibroma: Case Report

    Directory of Open Access Journals (Sweden)

    Alfredo Roberto Netto

    2001-04-01

    Full Text Available É apresentado um caso de fibroma de vulva, modalidade molluscum pendulum, em uma jovem de 20 anos. O tumor desenvolveu-se após a menarca com evolução lenta e progressiva. Ao exame físico, observou-se volumosa massa pediculada, indolor, com inserção no terço superior do grande lábio esquerdo, de consistência elástica, com diâmetro maior em sua parte distal de 12 cm por 23 cm de comprimento. Como tratamento, optou-se pela exérese pela base do pedículo, sob anestesia local. O tumor apresentou o peso de 950 g. Complementa-se com revisão de literatura.A vulvar fibroma, of the molluscum pendulum type, was present in a 20-year-old patient. The tumor began to develop slowly after her menarche, when she was 14 years of age. The physical examination revealed a mass with considerable volume, painless, located at the upper third of the greator left lip, elastic consistency, greater diameter at its distal portion measuring 12 cm by 23 cm in length. The treatment was exeresis from the base of the pedicle, under local anesthesia. The tumor weighed 950 g. A literature review is included.

  17. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?

    Directory of Open Access Journals (Sweden)

    Verónica Garza-Rodríguez

    2014-01-01

    Full Text Available Basal cell carcinomas (BCC on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed.

  18. A case report: Blastic plasmacytoid dendritic cell neoplasm is misdiagnosed as breast infiltrating ductal carcinoma.

    Science.gov (United States)

    Chen, Ko-Chin; Su, Tzu-Cheng; Chen, Dar-Ren; Liou, Jia-Hung

    2015-02-01

    Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic tumor that typically occurs in older adults. Patients with BPDCN usually present with solitary or multiple skin lesions. Localized or disseminated lymphadenopathy at presentation is common. A case report illustrating histopathologically proven BPDCN initially misdiagnosed as breast infiltrating ductal carcinoma in a 39-year-old woman is presented. In this case, the patient presented with a breast mass without an obvious skin lesion initially. The morphology of the tumor cells mimicked high grade breast carcinoma cells. Without complete immunohistochemical study, this case was initially misdiagnosed as infiltrating ductal carcinoma. Reviewing the previous literature about BPDCN, no case with a breast mass and an absence of characteristic skin lesions initially has been reported. The purpose for which we are discussing this case is to reduce misdiagnosis when the initial symptom is unusual. © The Author(s) 2014.

  19. A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure.

    Science.gov (United States)

    Barbeiro, Sandra; Atalaia-Martins, Catarina; Marcos, Pedro; Gonçalves, Cláudia; Cotrim, Isabel; Vasconcelos, Helena

    2017-09-01

    Chronic anal fissure is a linear ulcer in the anal canal that has not cicatrized for more than 8-12 weeks of treatment. Most anal fissures are idiopathic and are located in the posterior midline. Squamous cell carcinoma of the anus commonly presents as bleeding and anal pain. It may also present as a mass, nonhealing ulcer, itching, discharge, fecal incontinence and fistulae. Not uncommonly, small and early cancers are misdiagnosed as benign anorectal disorders like anal fissures or hemorrhoids. The clinical suspicion of squamous cell carcinoma of the anus is of paramount importance in patients with nonhealing anal fissures, fissures in atypical positions or with indurated or ulcerated anal tags and in patients with risk factors for the development of anal squamous intraepithelial lesions that are precursors of invasive anal squamous cell carcinoma. The authors present 3 cases of squamous cell carcinoma of the anus initially misdiagnosed as benign chronic anal fissure.

  20. A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset

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    Nikolić Ana V.

    2015-01-01

    Full Text Available Introduction. Childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is very rare and atypical in presentation. Case report. As a baby, the pre-sented patient was choking and sleeping with open eyes. She had weak cry and breathing difficulties. In childhood, there were frequent falls and fluctuating swallowing difficulties. At the age of 19 she was misdiagnosed with Miller Fisher syndrome due to the presence of diplopia, ataxia and hyporeflexia with spontaneous recovery. Repetitive nerve stimulation test was normal. Four years later, after several relapses, there was significant decrement on facial muscles. Neostigmine test was negative, provoking muscle fasciculations. Serum anti-muscle-specific tyrosine kinase antibodies were positive. With cyclosporine therapy she achieved the minimal manifestations status. Conclusion. The presented case confirms that childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is often with atypical presentation and spontaneous remissions, so it could be easily misdiagnosed.

  1. Common cold is the most frequent cause for misdiagnosing aneurysmal SAH

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    Tetsuhisa Yamada, M.D.

    2017-09-01

    Conclusions: Subarachnoid hemorrhage was misdiagnosed as a common cold in younger patients in whom headache suddenly developed at rest, but symptoms were mild, and the patient was brought to a general practitioner at a clinic by means other than an ambulance on the day after onset or subsequently. Misdiagnosis can be prevented by suspecting subarachnoid hemorrhage and performing imaging examinations; obtaining a detailed medical history is therefore essential.

  2. A case of localized amyloidosis of the eyelid misdiagnosed as recurrent chalazion

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    Hind Manaa Alkatan

    2017-07-01

    Full Text Available Localized amyloidosis of the eyelid is uncommon and is classically associated with systemic manifestations. We present an interesting case of a localized eyelid mass misdiagnosed as a recurrent chalazion presenting in an 85-year-old Saudi gentleman with no definite associate findings suggestive of an underlying systemic amyloid disease. Debulking surgery was subsequently performed. Proper diagnosis was reached based on the histopathologic examination of the excised tissue, which demonstrated the typical Congo red staining of the amyloid deposits.

  3. A case of localized amyloidosis of the eyelid misdiagnosed as recurrent chalazion.

    Science.gov (United States)

    Manaa Alkatan, Hind; Al-Mohizea, Asma; Alsuhaibani, Adel

    2017-01-01

    Localized amyloidosis of the eyelid is uncommon and is classically associated with systemic manifestations. We present an interesting case of a localized eyelid mass misdiagnosed as a recurrent chalazion presenting in an 85-year-old Saudi gentleman with no definite associate findings suggestive of an underlying systemic amyloid disease. Debulking surgery was subsequently performed. Proper diagnosis was reached based on the histopathologic examination of the excised tissue, which demonstrated the typical Congo red staining of the amyloid deposits.

  4. Post-delivery mycobacterium tuberculosis infection misdiagnosed as systemic lupus erythematosus.

    Science.gov (United States)

    Ting, Li Yu; Shrestha, Bikash; Lu, Yi Lu; Ping, Fu

    2016-12-30

    Tuberculosis is a common infectious mycobacterial disease having a wide range of clinical and serological manifestations that are similar to rheumatic disease. Differential diagnosis is a crucial aspect in any rheumatic disease as many other infectious diseases portray clinical similarities and autoantibody positivity. Our case report illustrates of a young woman just after the delivery of a child presented an unusual case of extrapulmonary tuberculosis infection initially misdiagnosed as systemic lupus erythematosus (SLE).

  5. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

    OpenAIRE

    Ming-Ta Tsai; Shi-Yu Huang; Shih-Yu Cheng

    2017-01-01

    Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porp...

  6. Gastric Duplication Cyst: A Rare Congenital Disease Often Misdiagnosed in Adults

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    Jessica Falleti

    2013-01-01

    Full Text Available Gastrointestinal duplication is a rare congenital disease which affected more commonly the ileum, while the stomach is rarely involved. Generally diagnosed in paediatric or young age, it could be difficult to suspect a gastrointestinal duplication in adults. Herein, we report a 55-year-old male with a gastric duplication cyst found on routinely checkup for chronic hepatitis and first misdiagnosed as a gastrointestinal stromal tumor (GIST; we also discuss its embryology.

  7. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct.

    Science.gov (United States)

    Gu, Dae Hoe; Park, Min Seon; Jung, Chang Ho; Yoo, Yang Jae; Cho, Jae Young; Lee, Yun Ho; Seo, Yeon Seok; Yim, Hyung Joon; Um, Soon Ho; Ryu, Ho Sang

    2015-06-01

    Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy.

  8. Kadar Estradiol dan Progesteron Serum, Tampilan Vulva dan Sitologi Apus Vagina Kambing Bligon Selama Siklus Birahi

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    Irkham Widiyono

    2012-11-01

    Full Text Available A study was carried out to determine the serum estradiol and progesterone concentration, vulvaappearance, and vaginal cytology during estrous cycle in bligon goat. Four female non pregnant bligongoats (Indonesian indigenous were used in this research. They were clinically healthy and showed normalestrous cycle. Estrous state was examined by using biological method. When the animals showed acceptanceto be mounted by a buck, they were confirmed as the first day of estrous cycle (estrous phase. Collectionof blood sample, preparation of vaginal smears, and measurement of some physical genital parameterswere conducted by standard veterinary clinical methods at day 11, day between 3-5, day between 6-16, andday between 17-19 of estrous cycle. Enzyme linked immunosorbent assay (ELISA was used to determineserum progesterone and estradiol concentrations. Mean difference of each parameter was analyzed byanalyses of variance (Anova, followed by Tuckey HSD. The serum estradiol concentration ranged between211.25-247.77 pg/ml. Peak of the estradiol was occurred at the first day of estrous phase, namely 247.77pg/ml and to decrease at day 3-16. The serum progesterone concentration was at the level of 0.21-0.70 ng/ml and showed a significant increase at day 6-16 (p<0.05. The specific physical genital changes (swellingvulva, reddish mucous membrane of vulva, and excretion of viscous transparent vaginal discharge wereidentified as the animals were at the estrous phase. Composition of exfoliative vaginal cytology did notshow any specific and consistent changes throughout the estrous cycle. Superficial and intermediate cellswere very dominant (>60% during estrous cycle. In conclusion, serum estradiol, progesterone, the vulvaappearance combined with sexual receptivity could be a good estrous predictor for female cycling bligongoat.

  9. Caenorhabditis elegans syndecan (SDN-1) is required for normal egg laying and associates with the nervous system and the vulva.

    Science.gov (United States)

    Minniti, Alicia N; Labarca, Mariana; Hurtado, Claudia; Brandan, Enrique

    2004-10-01

    In Caenorhabditis elegans, the identification of many enzymes involved in the synthesis and modification of glycosaminoglycans (GAGs), essential components of proteoglycans, has attained special attention in recent years. Mutations in all the genes that encode for GAG biosynthetic enzymes show defects in the development of the vulva, specifically in the invagination of the vulval epithelium. Mutants for certain heparan sulfate modifying enzymes present axonal and cellular guidance defects in specific neuronal classes. Although most of the enzymes involved in the biosynthesis and modification of heparan sulfate have been characterized in C. elegans, little is known regarding the core proteins to which these GAGs covalently bind in proteoglycans. A single syndecan homologue (sdn-1) has been identified in the C. elegans genome through sequence analysis. In the present study, we show that C. elegans synthesizes sulfated proteoglycans, seen as three distinct species in western blot analysis. In the sdn-1 (ok449) deletion mutant allele we observed the lack of one species, which corresponds to a 50 kDa product after heparitinase treatment. The expression of sdn-1 mRNA and sequencing revealed that sdn-1 (ok449) deletion mutants lack two glycosylation sites. Hence, the missing protein in the western blot analysis probably corresponds to SDN-1. In addition, we show that SDN-1 localizes to the C. elegans nerve ring, nerve cords and to the vulva. SDN-1 is found specifically phosphorylated in nerve ring neurons and in the vulva, in both wild-type worms and sdn-1 (ok449) deletion mutants. These mutants show a defective egg-laying phenotype. Our results show for the first time, the identification, localization and some functional aspects of syndecan in the nematode C. elegans.

  10. Neurinoma of the cauda equina misdiagnosed as prolapsed lumbar disk. Report of three cases.

    Science.gov (United States)

    Palma, L; Mariottini, A; Muzii, V F; Bolognini, A; Scarfò, G B

    1994-09-01

    The authors report three cases of neurinoma of the cauda equina initially misdiagnosed as prolapsed lumbar disk. Computed Tomography failed to reveal the tumour, while showing evidence of disk-degenerative patology and being thus misleading. Similar cases are reported in literature. After a thorough analysis of the causes of such an apparently gross error, it is concluded that the main source of pitfalls arises from neglecting those typical clinical features differentiating prolapsed disk from oncogenetic sciatica. When oncogenetic sciatica is suspected Computed Tomography is inappropriate and even misleading, while the elective investigation is Magnetic Resonance.

  11. Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China.

    Science.gov (United States)

    Xiang, Yu-Tao; Zhang, Ling; Wang, Gang; Hu, Chen; Ungvari, Gabor S; Dickerson, Faith B; Kilbourne, Amy M; Si, Tian-Mei; Fang, Yi-Ru; Lu, Zheng; Yang, Hai-Chen; Lai, Kelly Y C; Lee, Edwin H M; Hu, Jian; Chen, Zhi-Yu; Huang, Yi; Sun, Jing; Wang, Xiao-Ping; Li, Hui-Chun; Zhang, Jin-Bei; Chiu, Helen F K

    2013-03-01

    Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China. A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini-International Neuropsychiatric Interview (MINI) was used to establish DSM-IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD. The proportions of BD (all types), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD-I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2-3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3-3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1-1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9-0.99); BD-II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4-3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9-0.97). In addition, compared to BD-II patients, BD-I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5-6.6). Depressive episodes in the context of BD-I and BD-II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China. © 2013 John Wiley and Sons A/S. Published by Blackwell Publishing Ltd.

  12. Atypical odontalgia misdiagnosed as odontogenic pain: a case report and discussion of treatment.

    Science.gov (United States)

    Lilly, J P; Law, A S

    1997-05-01

    Atypical odontalgia is characterized by prolonged periods of throbbing or burning pain in the teeth or alveolar process, which occurs in the absence of any identifiable odontogenic etiology. The pain may be bilateral and change in location. This article presents two cases of atypical odontalgia that were misdiagnosed and initially treated as pain of odontogenic origin. A therapeutic regimen of tricyclic antidepressants alleviated the pain in one patient and was unsuccessful in the second. These two cases demonstrate the importance of having a thorough knowledge of both odontogenic and nonodontogenic causes of orofacial pain as well as the need for careful diagnosis before undertaking any treatment.

  13. Gastric Schwannoma: A Benign Tumor Often Misdiagnosed as Gastrointestinal Stromal Tumor.

    Science.gov (United States)

    Shah, Apurva S; Rathi, Pravin M; Somani, Vaibhav S; Mulani, Astha M

    2015-09-28

    Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma.

  14. Gastric schwannoma: a benign tumor often misdiagnosed as gastrointestinal stromal tumor

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    Apurva S. Shah

    2015-10-01

    Full Text Available Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma.

  15. Benign ulcer of the right colon clinically misdiagnosed as carcinoma: an additional case.

    Science.gov (United States)

    Ambrosio, M R; Ginori, A; Mourmouras, V; Mastrogiulio, M G; Barone, A; Rocca, B J

    2012-02-01

    Benign solitary ulcer of the colon is an uncommon lesion that was originally described by Cruveilhier in 1832. Its aetiology remains unknown, and there are no pathognomonic lesions or symptoms. Diagnosis is made by exclusion; in fact, diseases such as specific infections (cytomegalovirus, campylobacter jejuni, entamoeba histolytica), common clinical conditions (acute appendicitis, diverticulitis, intestinal obstruction, inflammatory bowel disease), pharmacotherapy (non-steroidal anti-inflammatory medications, oral contraceptives, dicumarolic agents) and malignancies should be excluded. We describe the case of a 72-year-old patient admitted for acute bloody diarrhoea, originally misdiagnosed as carcinoma by colonscopy. The histological evaluation demonstrated a benign ulcerative lesion.

  16. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct

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    Dae Hoe Gu

    2015-06-01

    Full Text Available Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy.

  17. Draft Genome Sequences of Escherichia coli Strains Isolated at Calving from the Uterus, Vagina, Vulva, and Rectoanal Junction of a Dairy Cow That Later Developed Metritis

    OpenAIRE

    Jeon, Soo Jin; Cunha, Federico; Ginn, Amber; Jeong, KwangCheol Casey; Galv?o, Klibs N.

    2017-01-01

    ABSTRACT Escherichia coli is involved in the pathogenicity of metritis in cows. We report here the genome sequences of E.?coli strains isolated at calving from the uterus, vagina, vulva, and rectoanal junction of a dairy cow that later developed metritis. The genomic similarities will give an insight into phylogenetic relationships among strains.

  18. A case of giant prolactinoma, initially misdiagnosed as sinonasal neuroendocrine carcinoma

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    Yasaman Mohtasebi, M.D.

    2015-09-01

    Full Text Available Giant prolactinomas are defined as pituitary tumors greater than 4 cm, often associated with very high prolactin level (>1000 ng/mL. They are relatively rare tumors and can present differently from typical prolactinomas. They can be highly invasive, resulting in acute neurological complication at the time of presentation. We present a case of a young woman with giant prolactinoma initially misdiagnosed as sinonasal neuroendocrine carcinoma. The acute presentation of headache, ptosis and impending brain herniation, requiring emergent ventriculostomy and intubation, led to the clinical suspicion of a more sinister diagnosis. Transnasal biopsy of the mass was consistent with sinonasal neuroendocrine carcinoma, and chemotherapy was planned. Laboratory testing, however, revealed an elevated prolactin (27,400 ng/mL, after 1:100 dilution. Re-review of pathology with additional immunohistochemical staining was requested and confirmed the diagnosis of prolactinoma. After 5 months of cabergoline treatment, prolactin level has decreased to 118 ng/mL. There has been a marked reduction in tumor size and an almost complete resolution of neurological symptoms. Given their atypical presentation and potential for sharing common immunohistochemical stains with other neuroendocrine neoplasms, giant prolactinomas extending into the nasal cavity can be misdiagnosed as other neuroendocrine neoplasms which may develop at this site. Accurate diagnosis is imperative to prevent unnecessary surgery and/or radiation and to ensure implementation of dopamine agonist therapy.

  19. Experimental canine model for sentinel lymph node biopsy in the vulva using technetium and patent blue dye Modelo canino experimental para a pesquisa do linfonodo sentinela na vulva usando tecnécio e azul patente

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    José Ulcijara Aquino

    2012-02-01

    Full Text Available PURPOSE: This paper aims to study and define the experimental model of sentinel lymph node biopsy of the vulva in bitches. METHODS: 0.2 ml of 99mTc phytate was injected intradermally, using a fine gauge insulin needle in the anterior commissure of the vulva. Thirty minutes after 99mTc injection, the inguinal mapping was performed using a gamma probe. After this, 0.5 ml of blue dye (bleu patenté V Guerbet 2.5% was injected in the same place. After 15 minutes, a 3 cm long inguinal incision was made at point maximum uptake followed by careful dissection, guided by visualization of a bluish afferent lymphatic system that points to the sentinel lymph node (SLN. RESULTS: It was observed that 88% of SLN were identified. It wasn´t found a significant difference among the presence or not of sentinel lymph node in the sides, which is an indication of a good consistency. It was observed a high (88% and significant (χ2=12.89 and p=0.0003 intercession between both methods (blue dye and radiation. CONCLUSION: The experimental model adopted is feasible, becoming advantageous in applying the association of Patent blue and 99mTc.OBJETIVO: Definir um modelo experimental para a pesquisa do linfonodo sentinela na vulva de cadelas. MÉTODOS: 0,2 ml de tecnécio diluído em fitato (99mTc foi injetado por via intradérmica na comissura anterior da vulva. Trinta minutos após a injeção de 99mTc, o mapeamento inguinal foi realizada utilizando uma sonda gama. Após isto, 0,5 ml de corante azul (bleu Patente Guerbet V 2,5% foram injetados no mesmo lugar. Após 15 minutos, uma incisão inguinal de três centímetros foi feita no ponto de captação máxima seguido de dissecção cuidadosa, guiada através da visualização de um sistema linfático aferente corado em azul que apontava para o linfonodo sentinela (LS. RESULTADOS: Foi observado que em 88% das vezes o LS foi identificado. Não foi encontrada diferença significativa entre a presença ou não de linfonodo

  20. Lipschütz ulcer (ulcus vulvae acutum: a rare cause of genital lesion Úlcera de Lipschütz (ulcus vulvae acutum: uma causa rara de lesão genital

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    Ana Brinca

    2012-08-01

    Full Text Available Lipschütz Ulcer, or ulcus vulvae acutum, is a rare and probably underdiagnosed entity that usually presents as an acute painful vulvar ulcer in young women. The etiology is unknown, although recent reports have associated it with the Epstein-Barr virus. The diagnosis is made by exclusion after ruling out sexually transmitted diseases, autoimmune causes, trauma, and other etiologies of genital ulcerations. We report a case of a young woman who developed flu-like symptoms and painful vulvar ulcers. Complementary examinations ruled out sexually transmitted diseases and the other usual causes of genital ulcers; lesions healed with no sequelae or recurrences. This case represents a rare important differential diagnosis of genital ulceration.A Úlcera de Lipschütz, ou ulcus vulvae acutum, é uma entidade rara mas provavelmente subdiagnosticada, que se apresenta como úlcera vulvar aguda dolorosa numa mulher jovem. A etiologia é desconhecida embora relatos recentes a tenham associado à primo-infecção pelo vírus Epstein-Barr. O diagnóstico é estabelecido após exclusão de doenças sexualmente transmissíveis, causas autoimunes, traumáticas e outras etiologias de úlceras genitais. Relatamos o caso de uma jovem que desenvolveu quadro gripal e dolorosas úlceras genitais. Os exames complementares excluiram doenças sexualmente transmissíveis e as outras causas habituais de ulceração genital. As lesões cicatrizaram sem sequelas e sem recorrências. Este caso representa um diagnóstico diferencial importante e raro de ulceração genital.

  1. Enterobious vermicularis (pinworm) infestation of the vulva: report of 2 cases of a pseudoneoplastic lesion mimicking squamous carcinoma.

    Science.gov (United States)

    Konanahalli, P; Menon, P; Walsh, M Y; McCluggage, W G

    2010-09-01

    Enterobious Vermicularis (pinworm) infestation outside the gastrointestinal tract is rare. We report 2 patients with vulval involvement, one of whom presented with a clinically suspicious, rapidly growing mass. The histology of both lesions showed similar features of epidermal proliferation in the form of hyperkeratosis, acanthosis, and papillomatosis; this pseudoepitheliomatous hyperplasia raised the possibility of a well-differentiated squamous carcinoma. There was associated inflammation in both cases, including large numbers of eosinophils in 1 case. On the surface or within the keratin layer, structures with the morphology of enterobious vermicularis eggs were identified. In reporting this unusual pseudoneoplastic phenomenon, we stress the necessity for the pathologist to consider and look for parasites in proliferative squamous lesions of the vulva, especially when there is an associated inflammatory infiltrate rich in eosinophils.

  2. Development and Psychometric Testing of an Electronic Patient-Reported Outcome Tool for Vulval Disorders (ePAQ-Vulva).

    Science.gov (United States)

    Gray, Thomas G; Alexander, Charlotte; Jones, Georgina L; Tidy, John A; Palmer, Julia E; Radley, Stephen C

    2017-10-01

    Development of an electronic patient-reported outcome measure (PROM) specifically designed for vulval disorders. Psychometric testing of the components of the questionnaire, which assess vulval symptoms, sexual function, and quality of life (QoL). Development and programming of the instrument (ePAQ-Vulva) was informed by national guidelines for the assessment of vulval disorders, an expert panel, and a survey of 61 vulval clinic patients. The PROM assesses frequency and impact of vulval symptoms, sexual function, and QoL. It also records conditions and behaviors related to vulval disorders and patient concerns/goals.Scale generation and psychometric testing were undertaken for the vulval symptoms, sexual function, and QoL components of the PROM with 91 participants; descriptive statistics, factor analysis and internal reliability of identified domains, and agreement between free-text and multiple-choice items to assess convergent validity and interrater reliability of picture items were assessed. Descriptive statistics showed high floor effects for seven questionnaire items. Factor analysis identified 5 principal components. These were reviewed and amended to provide a putative domain structure of 6 domains. Internal reliability of these domains was assessed using Cronbach α, producing values of 0.715 to 0.917. Interrater reliability of the picture items produced a κ statistic of 0.405. Spearman rank showed moderate correlation between multiple-choice answers and free-text concerns (r = 0.364-0.462) in 3 of the 6 domains (pain, sex, and dyspareunia). ePAQ-Vulva offers the first patient-reported outcome tool, specifically designed for vulval disorders. The instrument requires further validation and testing, including evaluation of the stability, responsiveness, and reliability.

  3. Spinal Textiloma (Gossypiboma: A Report of Three Cases Misdiagnosed as Tumour

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    Soner Şahin

    2013-12-01

    Full Text Available Background: Textile products commonly used in surgery (e.g., sponges or gauze have been known to cause complications after spinal surgery. Associated complications usually arise months or even years after the primary surgery. In case of spine surgery, these bodies are often detected during neuroradiological evaluations to investigate reported back pain; however, this complication often remains asymptomatic. Aims: The research is intended to increase awareness among both spinal surgeons and neuroradiologists of this potential complication. Study Design: Retrospective study. Methods: This study is a retrospective case series of three patients with retained surgical textile products who had been misdiagnosed with spinal tumour. The medical records of the patients were reviewed and demographic data, clinical aspects, initial diagnosis, surgical procedures, time interval between previous operation and onset of symptoms, laboratory findings, radiological findings, treatment, and outcome were analysed. Results: The three patients included two women and one man aged between 64 and 67 years. All patients had a previous surgery for lumbar disc herniation. The time from the previous surgical procedures to presentation ranged from 3 to 17 years. All patients presented with non-specific lower back pain and/or radiculopathy without clinical findings of infection. Laboratory parameters were otherwise normal. All three cases had been misdiagnosed as a spinal tumor based on magnetic resonance imaging findings. During new surgical procedures, gauze bandages, i.e., surgical textiles left during a previous operation, were found. Conclusion: Textiloma is an important and rarely mentioned potential neurosurgical complication that may remain asymptomatic for years. They are more common in obese patients, after emergency surgery, and with unplanned changes in surgical procedure such as bleeding and unintended neurosurgical complications. Neuroradiological findings are

  4. Spinal textiloma (gossypiboma): a report of three cases misdiagnosed as tumour.

    Science.gov (United States)

    Sahin, Soner; Atabey, Cem; Simşek, Mehmet; Naderi, Sait

    2013-12-01

    Textile products commonly used in surgery (e.g., sponges or gauze) have been known to cause complications after spinal surgery. Associated complications usually arise months or even years after the primary surgery. In case of spine surgery, these bodies are often detected during neuroradiological evaluations to investigate reported back pain; however, this complication often remains asymptomatic. The research is intended to increase awareness among both spinal surgeons and neuroradiologists of this potential complication. Retrospective study. This study is a retrospective case series of three patients with retained surgical textile products who had been misdiagnosed with spinal tumour. The medical records of the patients were reviewed and demographic data, clinical aspects, initial diagnosis, surgical procedures, time interval between previous operation and onset of symptoms, laboratory findings, radiological findings, treatment, and outcome were analysed. The three patients included two women and one man aged between 64 and 67 years. All patients had a previous surgery for lumbar disc herniation. The time from the previous surgical procedures to presentation ranged from 3 to 17 years. All patients presented with non-specific lower back pain and/or radiculopathy without clinical findings of infection. Laboratory parameters were otherwise normal. All three cases had been misdiagnosed as a spinal tumor based on magnetic resonance imaging findings. During new surgical procedures, gauze bandages, i.e., surgical textiles left during a previous operation, were found. Textiloma is an important and rarely mentioned potential neurosurgical complication that may remain asymptomatic for years. They are more common in obese patients, after emergency surgery, and with unplanned changes in surgical procedure such as bleeding and unintended neurosurgical complications. Neuroradiological findings are variable and non-specific; thus, patients could be misdiagnosed with a spinal

  5. Pitted keratolysis – a frequently misdiagnosed, mild, infectious disorder of soles

    Directory of Open Access Journals (Sweden)

    Zuzanna Lewicka-Potocka

    2016-05-01

    Full Text Available Introduction . Pitted keratolysis (PK is a mild infectious skin disorder caused by Corynebacterium spp., Kytococcus sedentarius or Dermatophilus congolensis . These bacteria produce enzymes that digest keratin, causing superficial lesions in the plantar surface. The disease is predominantly observed in young men. Objective . Pitted keratolysis despite the characteristic presentation of skin lesions is often misdiagnosed. In this article we aimed to remind readers of its clinical aspects and treatment by presenting a typical PK case. Case report. A 35-year-old man was admitted to the dermatological clinic due to skin lesions on both soles. In the physical examination we found multiple crateriform pits, associated with hyperhidrosis and malodour diagnosed as PK. Remission of lesions was observed after treatment with oral erythromycin. Conclusions . The differential diagnosis of plantar skin lesions should include PK. Due to typical clinical manifestation the diagnosis is based on physical examination.

  6. Intercostal myositis ossificans misdiagnosed as osteosarcoma in a 10-year-old child

    Energy Technology Data Exchange (ETDEWEB)

    Koob, Meriam; Durckel, Jean; Dosch, Jean-Claude; Dietemann, Jean-Louis [Hopital de Hautepierre, Service de Radiologie II, Hopitaux Universitaires, Strasbourg Cedex (France); Entz-Werle, Natacha [Hopitaux Universitaires, Hopital de Hautepierre, Service d' Onco-hematologie pediatrique, Strasbourg Cedex (France)

    2010-12-15

    Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation within soft tissue. It most commonly affects adolescents and young adults, typically in the limbs and following trauma. Very few cases have been reported in children. We report here a case of nontraumatic MO occurring in a 10-year-old girl with an uncommon location in the 5th right intercostal space; it was initially misdiagnosed and treated as osteosarcoma. Imaging findings including plain radiographs, CT, MRI, bone scintigraphy and PET-CT are described. This case highlights the central role played by imaging in diagnosis, thus avoiding biopsy that can erroneously suggest osteosarcoma as the diagnosis, as occurred in this case. (orig.)

  7. Cherubism misdiagnosed as giant cell tumor: a case report and review of literature.

    Science.gov (United States)

    Jiao, Yang; Zhou, Mi; Yang, Yaowu; Zhou, Jun; Duan, Xiaohong

    2015-01-01

    Cherubism is characterized by progressive, painless, bilateral enlargement of the mandible and/or maxilla resulting from the replacement of bone with multilocular cysts composed of fibrotic stromal cells and osteoclast-like cells. Here we report one Chinese cherubism case that has been misdiagnosed for more than forty years. The patient displayed no typical clinical or radiographical signs of cherubism due to multi-surgical treatments. Her histopathologic examination revealed the proliferating fibrous connective tissue with few multinucleated giant cells. The family history suggested us to perform sequence analysis of the SH3BP2 gene, a candidate marker for cherubism, in the family, and it was found that both the proband and the son had a missense mutation in SH3BP2 in exon 9 (p. Arg415Gln). Here we emphasize the importance of gene testing in the diagnosis of suspected cherubism, especially for those cases with non-typical clinical, radiographic and histological presentations.

  8. A case of Bochdalek hernia in adult misdiagnosed as pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Pradosh Kumar Sarangi

    2017-01-01

    Full Text Available Bochdalek hernias are congenital defects resulting from the failure of posterolateral diaphragmatic foramina to fuse in utero. Usually it manifests in the neonatal period and occasionally in childhood. Symptomatic Bochdalek hernias in adults are infrequent and may lead to gastrointestinal dysfunction or severe pulmonary disease. Patients are initially investigated and treated for other diseases, therefore diagnosis is purely incidental. Herein, we are reporting a case of symptomatic Bochdalek hernia in an 18-year-old female misdiagnosed as pulmonary tuberculosis and treated accordingly, but with no improvement. This case illustrates importance of high index of clinical suspicion and role of computed tomography in avoiding misdiagnosis and occurrence of serious complication if not treated early. [J Med Allied Sci 2017; 7(1.000: 59-63

  9. Child with Landau Kleffner Syndrome Misdiagnosed as Autism: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohsen Jekan

    2013-10-01

    Full Text Available Objectives:The aim of this single case study is to describe a child with Landau Kleffner Syndrome who misdiagnosed as a child with autism spectrum disorder. We also explore occupational therapy`s role in correct process for diagnosis and treatment. Methods:Three times measurement with Autism Treatment Evaluation Checklist was performed to measure severity of symptoms and compare treatment outcomes. Results: The outcome showed great improvements after pharmacotherapy. Discussion: Results of this study indicated that correct diagnosis, early detection and early intervention in this disorder are essential to reach a proper treatment. Of course, therapeutic team work is crucial as well. Occupational and speech therapy interventions can also been recommended as a helpful treatment to improve social and sensory-motor and communicative skills. Parent`s consultation should not be ignored to decrease parental stress.

  10. Hereditary and inflammatory neuropathies: a review of reported associations, mimics and misdiagnoses.

    Science.gov (United States)

    Rajabally, Yusuf A; Adams, David; Latour, Philippe; Attarian, Shahram

    2016-10-01

    Distinguishing between hereditary and inflammatory neuropathy is usually straightforward on clinical grounds with the help of a family history. There are nevertheless cases where the distinction is less clear. The advent of molecular genetics has in the past several years aided confirmatory diagnosis for an increasing proportion of patients with genetic neuropathy. Various reports have described associations of Charcot-Marie-Tooth disease with a suspected or confirmed inflammatory neuropathy occasionally responding to immunotherapy. Possible predisposition to an inflammatory component was suggested in a subset of patients. Such reports have, however, been relatively few in number, suggesting the rarity of such associations and of such a predisposition if it exists. There have been a number of publications detailing clinical presentations suggestive of inflammatory neuropathy in patients with a known or later proven genetic aetiology, and subsequently felt to be part of the phenotype rather than representing an association. A number of genetically mediated multisystemic diseases with neuropathy have otherwise been reported as mimicking chronic inflammatory demyelinating polyneuropathy (CIDP). The most common example is that of familial amyloid polyneuropathy, of particular concern for the clinician when misdiagnosed as CIDP, in view of the therapeutic implications. We review the literature on reported associations, mimics and misdiagnoses of hereditary and inflammatory neuropathy and attempt to determine a practical approach to the problem in clinical practice using clinical features, electrophysiology, histopathology and targeted early genetic testing. The issue of attempting immunomodulatory therapy is discussed in view of the published literature. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Detection and Type-Distribution of Human Papillomavirus in Vulva and Vaginal Abnormal Cytology Lesions and Cancer Tissues from Thai Women.

    Science.gov (United States)

    Ngamkham, Jarunya; Boonmark, Krittika; Phansri, Thainsang

    2016-01-01

    Vulva and Vaginal cancers are rare among all gynecological cancers worldwide, including Thailand, and typically affect women in later life. Persistent high risk human papillomavirus (HR-HPV) infection is one of several important causes of cancer development. In this study, we focused on HPV investigation and specific type distribution from Thai women with abnormality lesions and cancers of the vulva and Vaginal. A total of ninety paraffin-embedded samples of vulva and Vaginal abnormalities and cancer cells with histologically confirmed were collected from Thai women, who were diagnosed in 2003-2012 at the National Cancer Institute, Thailand. HPV DNA was detected and genotyped using polymerase chain reaction and enzyme immunoassay with GP5+/ bio 6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. The human β-globin gene was used as an internal control. Overall results represented that HPV frequency was 16/34 (47.1%) and 8/20 (40.0%) samples of vulva with cancer and abnormal cytology lesions, respectively, while, 3/5 (60%) and 16/33 (51.61%) samples of Vaginal cancer and abnormal cytology lesions, respectively, were HPV DNA positive. Single HPV type and multiple HPV type infection could be observed in both type of cancers and abnormal lesion samples in the different histological categorizes. HPV16 was the most frequent type in all cancers and abnormal cytology lesions, whereas HPV 18 was less frequent and could be detected as co-infection with other high risk HPV types. In addition, low risk types such as HPV 6, 11 and 70 could be detected in Vulva cancer and abnormal cytology lesion samples, whereas, all Vaginal cancer samples exhibited only high risk HPV types; HPV 16 and 31. In conclusion, from our results in this study we suggest that women with persistent high risk HPV type infection are at risk of developing vulva and Vaginal cancers and HPV 16 was observed at the highest frequent both of these, similar to the cervical

  12. Exposure to media information about a disease can cause doctors to misdiagnose similar-looking clinical cases

    NARCIS (Netherlands)

    Schmidt, Henk G.; Mamede, Sílvia; Van Den Berge, Kees; Van Gog, Tamara; Van Saase, Jan L C M; Rikers, Remy M J P

    2014-01-01

    Purpose: Anecdotal evidence indicates that exposure to media-distributed disease information, such as news about an outbreak, can lead physicians to errors; influenced by an availability bias, they misdiagnose patients with similar-looking but different diseases. The authors investigated whether

  13. Gastric Schwannoma mimicking malignant gastrointestinal stromal tumor and misdiagnosed by (18)F-FDG PET/CT.

    Science.gov (United States)

    Zhang, Yiqiu; Li, Beilei; Cai, Liang; Hou, Xiaoguang; Shi, Hongcheng; Hou, Jun

    2015-01-01

    Gastric Schwannoma is a rare benign mesenchymal tumor that accounts for only 0.2% of all gastric tumors. The current study presents a case of gastric Schwannoma misdiagnosed as malignant gastrointestinal stromal tumor (GIST) by esophagogastroduodenoscopy, endoscopic ultrasonography, and contrast-enhanced or not enhanced and (18)F-FDG PET/CT imaging.

  14. Complementary use of optical coherence tomography and 5-aminolevulinic acid induced fluorescent spectroscopy for diagnosis of neoplastic processes in cervix and vulva

    Science.gov (United States)

    Sapozhnikova, Veronika V.; Shakhova, Natalia M.; Kamensky, Vladislav A.; Kuranov, Roman V.; Loshenov, Victor B.; Petrova, Svetlana A.

    2003-07-01

    A new approach to improving the diagnostic value of optical methods is suggested, which is based on a complementary investigation of different optical parameters of biotissues. The aim of this paper is comparative study of the feasibility of two optical methods - fluorescence spectroscopy and optical coherence tomography - for visualization of borders of neoplastic processes in the uterine cervix and vulva. Fluorescence spectroscopy is based on the detection of biochemical and optical coherence tomography on backscattering properties in norm and pathological changes of tissues. By means of these optical methods changes in biochemical and morphological properties of tissues were investigated. A parallel analysis of these two optical methods and histology from the center of tumors and their optical borders was made. Thirteen female patients with neoplastic changes in uterine cervix and vulva were enrolled in this study. The borders of the tumor determined by optical methods (fluorescence spectroscopy and optical coherence tomography) are coinciding with the biopsy proved ones. In addition, OCT and fluorescence borders of tumor in the uterine cervix and vulva exceeds colposcopically detectable borders, the averaging difference 2 mm. In future optical methods would considerably enhance diagnostic accuracy of conventional methods used in oncogynecology.

  15. An immunoperoxidase study of laminin and type IV collagen distribution in carcinoma of the cervix and vulva.

    Science.gov (United States)

    Ehrmann, R L; Dwyer, I M; Yavner, D; Hancock, W W

    1988-08-01

    Basement membrane immunostaining was performed on pepsin-digested, paraffin-embedded blocks of 29 squamous cell carcinomas of the cervix (invasive and in situ) and 13 of the vulva, using polyclonal rabbit antibodies to human laminin and type IV collagen, both staining identically. Laminin with varying defectiveness surrounded invasive foci, whereas adjacent carcinoma in situ or normal epithelium had intact laminin. The amount of laminin usually reflected the degree of tumor differentiation. Absence of laminin around totally keratinized or necrotic tumor nests indicated its dependency on viable cells. New buds from established invasive tumor nests were often more laminin-defective than the parent nest and suggested a cyclic invasive process, with laminin loss during a growth surge followed by laminin reformation during quiescence. In cases of questionable early stromal invasion, deficient laminin could sway the decision toward making a positive diagnosis. The tendency of laminin gaps and tumor buds to contain large malignant cells with pleomorphic nuclei supports the concept of a change in tumor cell metabolism during active invasion. Laminin also appeared around metastatic tumor within lymph nodes. The relationship of inflammation to tumor laminin defectiveness varied.

  16. Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report

    Science.gov (United States)

    Kumar, Gokula; Norhafizah, I.; Shazril, I.; Nursyatina, AR; Aziz, MZ Abdul; Zin, Hafiz M.; Zakir, MK; Norjayadi; Norliza, AS; Ismail, A.; Khairun, N.

    2017-05-01

    This case report describes a complex radical 3D-Conformal Radiotherapy treatment planning, dosimetric issues and outcome of definitive treatment of un-resectable carcinoma of the vulvar in a 42-year old lady. The patient presented with large fungating mass of the vulva which was biopsy confirmed as Keratinizing Squamous Cell Carcinoma. Further staging investigation revealed locally advanced disease (T4), with bilateral inguinal lymph nodes involvement. There is no systemic metastasis or intra-pelvic nodes. The patient was seen by Gynae-Oncology team and the disease was deemed un-resectable without significant morbidity. She was treated to a total dose of 64.8Gy in 36 fractions over 7 weeks with concurrent weekly Cisplatinum in 2 phases. 3D-Conformal radiotherapy technique using the modified segmental boost technique (MSBT, large PA and small AP photon fields with inguinal electron matching) was used. TLD chips were used for in-vivo dose verification in phase 1 and 2 of the treatment. At completion of planned radiotherapy, patient had a complete clinical response, grade 2-3 skin toxicity, grade 2 rectal toxicity, and grade 2 dysuria Vulval Squamous Cell Carcinomas are very radiosensitive tumours and the skills of the treating Radiation Oncologist, Dosimetrists, Physicist, Radiation Therapist and also nurses is of foremost importance is ensuring good clinical outcomes.

  17. Alternating hemiplegia in a child misdiagnosed as intractable epilepsy successfully treated with aripiprazole: a case report.

    Science.gov (United States)

    Badoe, E V

    2011-01-01

    Alternating hemiplegia of children is a rare neurological disorder that in its characteristic form has few differential diagnosis. The diagnosis of intractable seizures is difficult to avoid for physicians not aware of the disease. To describe the clinical characteristics of Alternating Hemiplegia of Childhood (AHC), and response to various drugs A Ghanaian child with AHC was followed up for three years at the Neurology Clinic, Korle Bu Teaching Hospital, Accra. Her characteristics including EEG and MRI findings were documented. She was severely unsuccessfully treated as an epileptic. Further clinical re-evaluation provided clues to the diagnosis of alternating hemiplegia of childhood. The child, a female patient, was seen within the first week of life. The initial complaints were abnormal eye movements, and subsequently recurrent hemiplegic episodes, that started at age two and lasted hours to days. Attacks occurred at a frequency of about three per month and lasted from several hours to three days. An established trigger was bathing with cold water. Sleep relieved symptoms. The child had evidence of global developmental delay and neurological abnormalities including ataxia. EEG and MRI were both reported as abnormal. She experienced recurrent seizures. Topiramate and several anti-convulsants were not helpful but aripiprazole reduced the frequency of attacks. The case highlights the fact that AHC starts very early in life and is commonly misdiagnosed as epilepsy .It can coexist with epilepsy and abnormal MRI findings. Aripiprazole appears effective in its treatment.

  18. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    Directory of Open Access Journals (Sweden)

    Andrea Cassoni

    2014-01-01

    Full Text Available Uterine leiomyosarcoma (LMS is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery.

  19. Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Louhab N

    2014-01-01

    Full Text Available Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture.Observation: A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence.Conclusion: Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.Keywords: intracranial hypotension, headache, magnetic resonance imaging

  20. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain.

    Science.gov (United States)

    Tsai, Ming-Ta; Huang, Shi-Yu; Cheng, Shih-Yu

    2017-01-01

    Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

  1. Pyoderma Gangrenosum: A Rare Cause of Cutaneous Ulceration and One Easily Misdiagnosed

    Directory of Open Access Journals (Sweden)

    Wedad Abdelrahman

    2016-01-01

    Full Text Available Pyoderma gangrenosum (PG is a rare inflammatory neutrophilic dermatosis often misdiagnosed. It is uncommon in infants and children accounting for 4% of cases. A one-year-old male in paediatric ICU ventilated for bronchopneumonia was referred with ulcerated areas on his neck and axilla corresponding to sites of recent removal of central and arterial lines. Examination revealed areas of deep ulceration with violaceous undermined borders in keeping with PG. This was supported by a skin biopsy showing a neutrophilic infiltrate in the deeper dermis. Topical clobetasol propionate was commenced and a dramatic improvement within 24 hours noted. Blood results showed a leucocytosis of 29.7; a differential WCC showed toxic granulation in neutrophils with myeloid left shift; immunoglobulins showed elevated IgG 23 and IgA 4.86. The elevated WCC made us consider a leukaemic trigger; however, they settled with treatment of the underlying infection. PG in children is more likely to have an atypical distribution involving the head and neck (26.6% or buttocks (15%. An interesting feature in this case is the presence of pathergy, a term used to describe the induction or exacerbation of PG at sites of iatrogenic or incidental trauma. It is seen in 31% of patients with PG.

  2. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Ming-Ta Tsai

    2017-01-01

    Full Text Available Lead poisoning (LP is less commonly encountered in emergency departments (ED. However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

  3. Doença de Paget invasiva da vulva e região perianal: relato de caso Invasive Paget's disease of the vulva and perianal region: a case report

    Directory of Open Access Journals (Sweden)

    Etelvino de Souza Trindade

    2004-05-01

    Full Text Available A doença de Paget extramamária (DPE é uma condição neoplásica incomum observada principalmente em áreas com numerosas glândulas apócrinas e écrinas. Na mulher é mais comum na vulva, embora possa ocorrer em outros locais. A doença de Paget vulvar (DPV pode ser classificada em primária, de origem cutânea, e secundária, de origem extracutânea, com significado clínico e implicações prognosticas importantes. Clinicamente a DPV começa insidiosamente com prurido e sensação de queimação. A lesão surge como uma placa isolada com superfície eczematosa, eritematosa e descamativa. Relatamos o caso de uma paciente de 72 anos com lesão eritematosa em placa, levemente espessada, com áreas de erosão envolvendo os grandes e os pequenos lábios à direita e à esquerda, o clitóris, o púbis e as regiões perineal e perianal. A cirurgia realizada foi vulvectomia radical com linfadenectomia inguinal. O histopatológico revelou doença de Paget invasiva. Métodos imuno-histoquímicos mostraram células de Paget positivas para CEA, EMA e citoceratina pan. A patogênese e o diagnóstico da DPE são discutidos, assim como os diagnósticos diferenciais e as referências com métodos imuno-histoquímicos. A recidiva ocorre em 30% dos casos, mesmo com o controle adequado da margem cirúrgica. A experiência com DPV é limitada e o seguimento é requerido para excluir recidivas e o desenvolvimento de um câncer associado.Extramammary Paget's disease (EPD is an uncommon neoplasic condition observed mostly in areas with numerous apocrine and or eccrine glands. In the woman it is most commonly seen on the vulva, although it can occur in other locations. Vulvar Paget's disease (VPD can be classified into primary, of cutaneous origin, and secondary, of extracutaneous origin, with significant clinical e prognostic implications. Clinically VPD begins insidiously with pruritus and burning sensation. The lesion appears as a solitary patch with an

  4. Identification of misdiagnosed HIV clients in an Early Access to ART for All implementation study in Swaziland

    Science.gov (United States)

    Khan, Shaukat; Mafara, Emma; Pasipamire, Munyaradzi; Spiegelman, Donna; Mazibuko, Sikhathele; Ntshalintshali, Nombuso; Hettema, Anita; Lejeune, Charlotte; Walsh, Fiona; Okello, Velephi

    2017-01-01

    Abstract Introduction: Rapid diagnostic testing has made HIV diagnosis and subsequent treatment more accessible. However, multiple factors, including improper implementation of testing strategies and clerical errors, have been reported to lead to HIV misdiagnosis. The World Health Organization has recommended HIV retesting prior to antiretroviral therapy (ART) initiation which has become pertinent with scaling up of Early Access to ART for All (EAAA). In this analysis, misdiagnosed clients are identified from a subgroup of clients enrolled in EAAA implementation study in Swaziland. Methods: The subgroup to assess misdiagnosis was identified from enrolled EAAA study clients, who had an undetectable viral load prior to ART initiation between September 1, 2014 and May 31, 2016. One hundred and five of 2533 (4%) clients had an undetectable viral load prior to initiation to ART (pre-ART). The HIV status of clients was confirmed using the Determine HIV 1/2 and Uni-Gold HIV 1/2 rapid tests performed serially as recommended by the national testing algorithm. The status of clients on ART was additionally confirmed by fourth-generation HIV Ag/Ab combo tests, Architect and Genscreen Ultra. Results: Fourteen of the 105 (13%) clients were false positive (HIV negative) on confirmation testing, of whom five (36%) were still in pre-ART care, while nine (64%) were in ART care. Overall, proportion of false positive was 0.6% (14/2533). The false-positive clients had a median CD4 of 791 cells/ml (interquartile range (IQR): 628, 967) compared to 549 cells/ml (IQR: 387, 791) for true positives (HIV positive) (p = 0.0081) and were nearly 20 years older (p = 0.0008). Conclusions: Overall 0.6% of all enrolled EAAA clients were misdiagnosed, and 64% of misdiagnosed clients were initiated on ART. With adoption of EAAA guidelines by national governments, ART initiation regardless of immunological criteria, strengthening of proficiency testing and adoption of retesting prior to ART

  5. Identification of misdiagnosed HIV clients in an Early Access to ART for All implementation study in Swaziland.

    Science.gov (United States)

    Khan, Shaukat; Mafara, Emma; Pasipamire, Munyaradzi; Spiegelman, Donna; Mazibuko, Sikhathele; Ntshalintshali, Nombuso; Hettema, Anita; Lejeune, Charlotte; Walsh, Fiona; Okello, Velephi

    2017-08-29

    Rapid diagnostic testing has made HIV diagnosis and subsequent treatment more accessible. However, multiple factors, including improper implementation of testing strategies and clerical errors, have been reported to lead to HIV misdiagnosis. The World Health Organization has recommended HIV retesting prior to antiretroviral therapy (ART) initiation which has become pertinent with scaling up of Early Access to ART for All (EAAA). In this analysis, misdiagnosed clients are identified from a subgroup of clients enrolled in EAAA implementation study in Swaziland. The subgroup to assess misdiagnosis was identified from enrolled EAAA study clients, who had an undetectable viral load prior to ART initiation between September 1, 2014 and May 31, 2016. One hundred and five of 2533 (4%) clients had an undetectable viral load prior to initiation to ART (pre-ART). The HIV status of clients was confirmed using the Determine HIV 1/2 and Uni-Gold HIV 1/2 rapid tests performed serially as recommended by the national testing algorithm. The status of clients on ART was additionally confirmed by fourth-generation HIV Ag/Ab combo tests, Architect and Genscreen Ultra. Fourteen of the 105 (13%) clients were false positive (HIV negative) on confirmation testing, of whom five (36%) were still in pre-ART care, while nine (64%) were in ART care. Overall, proportion of false positive was 0.6% (14/2533). The false-positive clients had a median CD4 of 791 cells/ml (interquartile range (IQR): 628, 967) compared to 549 cells/ml (IQR: 387, 791) for true positives (HIV positive) ( p  = 0.0081) and were nearly 20 years older ( p  = 0.0008). Overall 0.6% of all enrolled EAAA clients were misdiagnosed, and 64% of misdiagnosed clients were initiated on ART. With adoption of EAAA guidelines by national governments, ART initiation regardless of immunological criteria, strengthening of proficiency testing and adoption of retesting prior to ART initiation would allow identification of misdiagnosed

  6. [Clinical evaluation of adolescent lumbar disc herniation misdiagnosed as idiopathic scoliosis].

    Science.gov (United States)

    Zhu, Ze-zhang; Qiu, Yong; Wang, Bin; Yu, Yang; Qian, Bang-ping; Zhu, Feng; Ma, Wei-wei; Sun, Xu

    2008-07-15

    To retrospectively review the clinical features and treatment strategy of lumbar disc herniation in adolescents initially misdiagnosed as idiopathic scoliosis. From 1998 to 2007, nineteen adolescents with lumbar disc herniation were admitted to our hospital. All of them presented a scoliotic curve as their first complaint. There were 10 males and 9 females with the age ranged from 14 to 20 years. The disc herniation located at L(4,5) in 10 patients, at L(5)S(1) in 7, and at L(4)-S(1) in 2. The Cobb angle ranged from 23 degrees to 38 degrees . The distance from the C(7) plumb line to the central sacral line averaged 4.7 cm. All the patients underwent conventional open discectomy, followed by a pelvic traction for 3 weeks. A cast fixation for one month was recommended for further correction of scoliosis if the curve improvement was not obvious. Fourteen (73.7%) patients had a disc herniation at the convex side of lumbar curve, and 5 (26.3%) patients had a disc herniation at the concave side, which showed a marginal statistical correlation between the side of the disc herniation and the direction of lumbar curve (P = 0.07). Leg pain and numbness disappeared in the 19 patients after surgical decompression. After the pelvic traction for 3 weeks postoperatively, the Cobb angle reduced to 14 degrees, with the mean distance from the C(7) plumb line to the central sacral line of 2.2 cm. At a mean follow-up of 21 months, neither the recurrence of back pain and leg pain nor the loss of spontaneous scoliosis correction was found. Care should be taken to the diagnosis of lumbar disc herniation in adolescents with spine deformity as their chief complaint. Satisfactory clinical results can be achieved by early diagnosis and proper treatment.

  7. [Nocturnal frontal lobe epilepsy is often misdiagnosed as sleep disorders in children: a case series].

    Science.gov (United States)

    Miano, Silvia; Peraita-Adrados, Rosa

    2013-03-01

    INTRODUCTION. We present a series of children who underwent a video-polysomnographic recording at our Sleep and Epilepsy Unit, who received a diagnosis of nocturnal frontal lobe epilepsy (NFLE). AIMS. To describe electroclinical and video polygraphic features of paediatric NFLE that differentiate this condition from other sleep disorders that overlap and mimic the sleep motor and autonomic events of NFLE. PATIENTS AND METHODS. The inclusion criterion was that the patients have their first video-EEG-PSG recording in our laboratory. RESULTS. Twenty-four out of 190 children were diagnosed with NFLE (group 1); while 166 had other sleep disorders (group 2). Among children diagnosed with NFLE, seven were referred for sleep-disordered breathing, seven for parasomnias, two for insomnia, two for hypersomnia, and one for periodic limb movements, while five were referred for epilepsy. In group 1, perinatal history was normal in most cases (21 out of 24) and a familiar history of epilepsy was found in four cases. Sleep-disordered breathing was diagnosed as a comorbid condition in four children. Standard EEG was normal in 21 cases. Interictal EEG showed epileptic discharges in four cases, while ictal EEG was expressed by a rhythmic theta activity preceded by an arousal and/or a short background desynchronization, movement artifacts, and autonomic changes. All seizures, repeated highly stereotyped motor events, were followed by stage shifts and/or a postural change and, by short awakenings. CONCLUSIONS. We found a high percentage of children with NFLE, often misdiagnosed or associated with other sleep disorders, which may be a trigger for nocturnal seizures.

  8. Easily misdiagnosed metaplastic meningioma: one case report and review of literature

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    Yong-jun ZENG

    2014-08-01

    Full Text Available Objective Metaplastic meningioma is rare lesion which is very difficult to diagnose clinically, and is easy to be misdiagnosed. This article aims to reveal the clinical manifestations and histopathological features of this disease.  Methods One case of ossification metaplastic meningioma was reported and the relevant literatures were reviewed.  Results A 17-year-old female patient showed paroxysmal stiffness accompanied by convulsion of extremities, headache, vomiting and fever. Cranial CT scan demonstrated an irregular low-density signal in the right frontal and parietal lobes. The lesion did not have a clear boundary, and there was a calcificated high-density signal inside it. The size of the lesion was about 2 cm × 1.80 cm × 1.70 cm. Cranial MRI scan showed a tumor with size of 2.40 cm × 2.10 cm × 2 cm, located in the right frontal and parietal lobes, and there was large edema around the lesion. A resection was performed, and a lesion was found in the right frontal and parietal parenchyma, whose one side was close to the cerebral pia mater and did not invade into the dura and the skull. The tumor was yellow, in irregular shape, and had clear boundary, with hard texture and rich blood supply. Its size was about 3 cm × 2.50 cm × 2 cm. There was extensive ossification and calcification within the tumor under microscope. Tumor cells were flaky and like small nests, which were distributed in the mesh?like arranged trabecular bone. The immunohistochemical staining showed that epithelial membrane antigen (EMA, progesterone receptor (PR, vimentin (Vim and Bcl-2 were positive for tumor cells with Ki-67 labeling index being about 6%.  Conclusions Metaplastic meningioma has various metaplastic components and its imaging features are also various. However, it could be diagnosed and identified from other similar tumors by histopathological observation and immunohistochemical staining. doi: 10.3969/j.issn.1672-6731.2014.08.010

  9. [Panuveitis with oral and genital ulcer misdiagnosed as Behcet's disease: two cases report and literature review].

    Science.gov (United States)

    Wang, Y; Yang, L; Zhang, Z L

    2016-10-18

    Here we reported two patients who presented with panuveitis and were transferred from ophthalmologists to rheumatologists, for both the patients had oral and genital ulcers. They were misdiagnosed with Behcet's disease at first glance. Two young males presented with acute uveitis with history of recurrent oral and genital ulcers. They initially presented with symptoms and signs resembling Behcet's disease and were treated with systemic steroids with suboptimal responses. Routine laboratory test revealed syphilis and human immunodeficiency virus (HIV) infection. After treatment of penicillin and anti HIV virus therapy, the panuveitis was relived. The other patient was lost in the follow up. Recently epidemiological data indicate that syphilis and HIV infection increase, which can mimic the manifestation of Behcet's disease. Diagnosis of sexual transmitted diseases, such as HIV or syphilis needs to be ruled out in all cases that mimic the clinical feature of Behcet's disease, especially for those who had a history of high risk behaviors. Every patient should have history analysis in detail. Screening of sexual transmitted diseases, such as HIV or syphilis is important especially in those rapid progressive panuveitis. Also, other virus infections, such as cytomegalovirus, epstein-barr virus or Herpes simplex virus can cause mucosa ulcers and uveitis. CD4 T cell count is a very important marker to indicate that the patient has immunodeficiency. Erythema nodosa and pseudofolliculitis are the third common clinical manifestation in Chinese Behcet's disease patients. Rheumatologist should watch out for patients without skin involvement when making the diagnosis of Behcet's disease. Syphilis-associated uveitis usually has a good prognosis. Treatment of antibiotics can get good response, 92% uveitis can be relieved, with 67% improved vision. Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a clinically and angiographically distinct manifestation of ocular

  10. Allergic contact cheilitis from a lipstick misdiagnosed as herpes labialis: Subsequent worsening due to Zovirax contact allergy.

    Science.gov (United States)

    Ozkaya, Esen; Topkarci, Zeynep; Ozarmağan, Güzin

    2007-08-01

    A 29-year-old Turkish woman with allergic contact cheilitis from a lipstick was misdiagnosed as herpes labialis and subsequently worsened with the application of Zovirax cream. Patch tests were positive to Zovirax cream, propylene glycol, the patient's favourite lipstick and propyl gallate. No reaction was seen with Zovirax ophthalmic ointment and Zovirax tablet. The propylene glycol component of the Zovirax cream and the propyl gallate component of the lipstick were regarded as the responsible contact sensitizers. The differential diagnosis was challenging due to concomitant contact sensitization with these agents.

  11. Melanoma of the vulva and vagina: principles of staging and their relevance to management based on a clinicopathologic analysis of 85 cases.

    Science.gov (United States)

    Seifried, Susan; Haydu, Lauren E; Quinn, Michael J; Scolyer, Richard A; Stretch, Jonathan R; Thompson, John F

    2015-01-01

    Primary melanomas of the vulva and vagina are rare. As a result, it has been difficult to develop evidence-based guidelines for their management. By analyzing a large series of patients with vulval and vaginal melanomas, this study sought to document the most common presenting features, identify clinical and pathologic predictors of outcome, and provide management guidelines. A clinicopathologic analysis of 85 patients with primary melanomas of the vulva or vagina diagnosed and treated at Melanoma Institute Australia and associated units in Sydney, Australia, between 1960 and 2011 was performed. Predictors of disease-free and melanoma-specific survival (MSS) were determined. Patients with American Joint Committee on Cancer (AJCC) stage 0-II had a significantly better MSS (5Y MSS = 63.6 %, n = 59) compared with those with stage III disease (5Y MSS = 0 %, n = 12, p < 0.001). Tumor thickness, ulceration status, and pathologic clearance margin were significant predictors of MSS. Disease-free survival was predicted by these factors and additionally by tumor mitotic rate. The results of this study provide evidence to support the appropriateness of utilizing the AJCC (7th edition) cutaneous melanoma staging system for vulval and vaginal melanomas. Detection and removal of these melanomas at an early stage with pathologically confirmed clear margins confers the best chance of cure.

  12. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

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    Kunii Yasuto

    2011-09-01

    Full Text Available Abstract Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.

  13. Linfangioma de Vulva

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    Paulo Naud

    2010-01-01

    O manejo depende do tipo, tamanho e localização das lesões. Existem relatos da utilização de Laser com dióxido de Carbono, cirurgia excisional (vulvectomia parcial, total ou radiacal, eletrocirurgia, crioterapia e eletroterapia. Os melhores resultados tem ocorrido com Laser e cirurgia excisional. O tratamento proposto foi extensa ressecção em conjunto com a equipe da cirurgia plástica. A paciente teve boa evolução e grande satisfação com o resultado do tratamento. Houve redução significativa das lesões e do edema vulvar. No pós-operatório o tecido vulvar estava com aparência próxima ao normal. Devemos ressaltar que o tratamento é apenas paliativo e que a doença dos vasos linfáticos, que é a causa das alterações persiste e que existe chances de recorrência.

  14. Mandibular aneurysmal bone cyst in a child misdiagnosed as acute osteomyelitis: a case report and a review of the literature.

    Science.gov (United States)

    Breuer, Christian; Paul, Hanna; Zimmermann, André; Braunstein, Stefan; Schaper, Jörg; Mayatepek, Ertan; Oh, Jun

    2010-08-01

    The aneurysmal bone cyst is a very infrequent, benign bone lesion in children which rarely can be found at the craniofacial skeleton. Here, we describe a case presenting in the mandible as an acute swelling of the cheek, which was initially misdiagnosed as osteomyelitis resulting in a delay to definitive surgical treatment. The cause of misleading diagnosis is often owing to the rapid growth of the lesion, sometimes associated with painful soft tissue swelling indicating an infectious origin or a malignant tumor. Magnetic resonance imaging revealed the classic characteristics of aneurysmal bone cyst with severe destruction of the mandible. Therefore, curative tumor embolization and complete surgical excision was successfully performed. The aneurysmal bone cyst is a curable condition by radical excision, although relapse may occur when only incomplete excision is obtained. Therefore, aneurysmal bone cyst should be considered early when children present with unusual, rapid-growing neoformations of the extremities or the facial region.

  15. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers

    Science.gov (United States)

    Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

    2015-01-01

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

  16. Challenging the concept of microinvasive carcinoma of the vulva: report of a case with regional lymph node recurrence and review of the literature

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    Eltze Elke

    2006-06-01

    Full Text Available Abstract Background It is widely accepted that vulvar carcinoma with a depth of invasion of less than one millimeter is sufficiently treated by vulvectomy or wide local excision without inguinal lymphadenectomy. Case presentation However, a patient with inguinal lymph node recurrence 21 months after radical vulvectomy for stage IA squamous cell carcinoma was observed. Conclusion According to a review of the literature, there are five additional cases of metastasizing vulvar cancer with a depth of invasion of less than one millimeter. Therefore, the definition of microinvasive carcinoma of the vulva based on depth of invasion alone may not be as reliable as previously thought and does not rule out inguinal lymph node involvement or recurrence. Consequently, the necessity of inguinal node dissection for microinvasive carcinoma needs to be discussed on an individual basis taking into account the age of the patient as well as the potential morbidity of extended surgery.

  17. Exposure to media information about a disease can cause doctors to misdiagnose similar-looking clinical cases.

    Science.gov (United States)

    Schmidt, Henk G; Mamede, Sílvia; van den Berge, Kees; van Gog, Tamara; van Saase, Jan L C M; Rikers, Remy M J P

    2014-02-01

    Anecdotal evidence indicates that exposure to media-distributed disease information, such as news about an outbreak, can lead physicians to errors; influenced by an availability bias, they misdiagnose patients with similar-looking but different diseases. The authors investigated whether exposure to media-provided disease information causes diagnostic errors and whether reflection (systematic review of findings) counteracts bias. In 2010, 38 internal medicine residents first read the Wikipedia entry about one or another of two diseases (Phase 1). Six hours later, in a seemingly unrelated study, they diagnosed eight clinical cases (Phase 2). Two cases superficially resembled the disease in the Wikipedia entry they had read (bias expected), two cases resembled the other disease they had not read about (bias not expected), and four were filler cases. In Phase 3, they diagnosed the bias-expected cases again, using reflective reasoning. Mean diagnostic accuracy scores (Phase 2; range: 0-1) were significantly lower on bias-expected cases than on bias-not-expected cases (0.56 versus 0.70, P = .016) because participants misdiagnosed cases that looked similar to a Wikipedia description of a disease more often when they had read the Wikipedia description (mean = 0.61) than when they had not (mean = 0.29). Deliberate reflection (Phase 3) restored performance on bias-expected cases to pre-bias levels (mean = 0.71). Availability bias may arise simply from exposure to media-provided information about a disease, causing diagnostic errors. The bias's effect can be substantial. It is apparently associated with nonanalytical reasoning and can be counteracted by reflection.

  18. Delayed Diagnosis of Tuberculous Meningitis Misdiagnosed as Herpes Simplex Virus-1 Encephalitis With the FilmArray Syndromic Polymerase Chain Reaction Panel.

    Science.gov (United States)

    Gomez, Carlos A; Pinsky, Benjamin A; Liu, Anne; Banaei, Niaz

    2017-01-01

    The FilmArray meningitis/encephalitis (ME) panel is a novel syndromic, nucleic acid amplification test for diagnosis of acute meningitis and encephalitis. Emerging data on its performance are concerning for false-positive results. We present a case of tuberculous meningitis misdiagnosed as herpes simplex virus-1 encephalitis with the FilmArray ME panel. Strategies to mitigate erroneous results are discussed.

  19. Malignant phyllodes tumor of the breast metastasizing to the vulva: {sup 18}F FDG PET CT Demonstrating rare metastasis from a rare tumor

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    Khangembam, Bang Kim Chand Ra; Sharma, Punit; Singla, Su Has; Singhal, Abinav; Dhull, Varun Singh; Bal, Chand Rasek Har; Kumar, Rakesh [All India Institute of Medical Sciences, New Delhi (India)

    2012-09-15

    Phyllodes tumors are extremely rare fibroepithelial neoplasms accounting for 0.3 to 0.5% of all female breast tumors with an incidence of 2.1 per 1 million women. They are classified histologically into benign, borderline and malignant varieties. The majority of them are benign, with only 25% being malignant. Surgery remains the mainstay of treatment. One characteristic is that although the malignant variety tends to metastasize and recur, the benign form has also been found to behave in a similar manner. Benign phyllodes tumor has a 21% risk of local recurrence, while that of the malignant variety ranges from 20 to 32%. In patients with malignant phyllodes tumor, the rate of distant metastases ranges from 25 to 40%. The most frequent sites of distant metastasis is uncommon as this tumor spreads by hematogeneous route. Other sites for distant metastasis have been reported sporadically, including the duodenum, pancreas, brain, nasal cavity, forearm, parotid, skin, oral cavity, skeletal muscle, mandible and maxilla. We present a rare case of recurrent malignant phyllodes tumor with metastasis to the vulva, which has not been reported in the literature to the best of our knowledge. A 49 year old female who had undergone lumpectomy and locoregional radiotherapy 1 year previously for malignant phyllodes tumor of the right breast presented with difficulty in breathing and cervical lymphadenopathy. Chest X ray showed multiple pulmonary nodules suggestive of metastasis. She was referred for restaging with 18F fluorodeoxyglucose (FDG)positron emission tomography computed tomography (PET CT)FDG PET CT. Maximum intensity projection (MIP)PET images revealed multiple FDG avid enlarged cervical lymph nodes, bilateral pulmonary nodules along with left pleural effusion and extensive bone marrow metastases. The interesting finding was an intensely FDG avid (SUV{sup max}-21.4)subcutaneous soft tissue density lesion (measuring 2.0x2.2x2.0cm)in the vulva, which was later proved to be

  20. Pelizaeus-Merzbacher Disease, Easily Misdiagnosed as Cerebral Palsy: A Report of a Three-generation Family

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    Yen-Chun Chen

    2014-04-01

    Full Text Available Pelizaeus-Merzbacher disease (PMD is an X-linked recessive disorder affecting myelination of the central nervous system, and is caused by mutations of the proteolipid protein 1 (PLP1 gene. Clinical manifestations of PMD are variable and major features include progressive nystagmus, spasticity, tremor, ataxia, and psychomotor delay. We describe a classical PMD patient who had been misdiagnosed as cerebral palsy. He had nystagmus and psychomotor delay since infancy and tremor with ataxia developing gradually. Brain MRI revealed demyelination over white matter of the cerebral hemispheres and posterior limbs of the internal capsules. Positive family history led to subsequent mutation analysis, which identified a novel mutation (c.88G>C in PLP1 in the proband, as well as his affected brother and maternal uncle, and asymptomatic maternal grandmother, mother and two sisters. Therefore, PMD should be considered in a cerebral palsy-like patient with or without positive family history. Mutation analysis is crucial for early diagnosis and further genetic counseling.

  1. Pelizaeus-Merzbacher disease, easily misdiagnosed as cerebral palsy: a report of a three-generation family.

    Science.gov (United States)

    Chen, Yen-Chun; Liang, Wen-Chen; Su, Yi-Ning; Jong, Yuh-Jyh

    2014-04-01

    Pelizaeus-Merzbacher disease (PMD) is an X-linked recessive disorder affecting myelination of the central nervous system, and is caused by mutations of the proteolipid protein 1 (PLP1) gene. Clinical manifestations of PMD are variable and major features include progressive nystagmus, spasticity, tremor, ataxia, and psychomotor delay. We describe a classical PMD patient who had been misdiagnosed as cerebral palsy. He had nystagmus and psychomotor delay since infancy and tremor with ataxia developing gradually. Brain MRI revealed demyelination over white matter of the cerebral hemispheres and posterior limbs of the internal capsules. Positive family history led to subsequent mutation analysis, which identified a novel mutation (c.88G>C) in PLP1 in the proband, as well as his affected brother and maternal uncle, and asymptomatic maternal grandmother, mother and two sisters. Therefore, PMD should be considered in a cerebral palsy-like patient with or without positive family history. Mutation analysis is crucial for early diagnosis and further genetic counseling. Copyright © 2012. Published by Elsevier B.V.

  2. A Giant Aggressive Angiomyxoma of the Pelvis Misdiagnosed as Incarcerated Femoral Hernia: A Case Report and Review of the Literature

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    Alper Sozutek

    2016-01-01

    Full Text Available Aggressive angiomyxoma (AA is an uncommon mesenchymal tumor that is mostly derived from the female pelvic and perineal regions. AA is a locally infiltrative slow growing tumor with a marked tendency to local recurrence. Painless swelling located around the genitofemoral region is the common symptom; thus, it is often misdiagnosed as a gynecological malignancy or a groin hernia. A 35-year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. The tumor was completely excised with free margins. Histopathologic examination revealed an AA. The tumor size was measured as 24 × 12 × 6 cm with a weight of 4.2 kg. Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor. S100, MUC4, CD34, and SMA were negative in the tumor cells. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age. The principle treatment should be complete surgical excision with tumor-free margins. Long-term follow-up and careful monitoring are essential due to its high tendency of local recurrence in spite of wide excision of the tumor. Adjuvant antihormonal therapy yields promising results for preventing recurrence.

  3. Norwegian scabies in a resident of a nursing home misdiagnosed as dermatologic lesions of type 2 diabetes mellitus

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    Jacek Kasznicki

    2014-11-01

    Full Text Available Introduction. Norwegian (crusted, hyperkeratotic scabies is a relatively rare form of the disease, but it is highly contagious and easily transmitted. Although skin lesions are typical for that form of the disease, they differ substantially from those observed in typical infection with Sarcoptes scabiei. Objective. To present the difficulties in the diagnosis of Norwegian scabies. Case report. We describe a case of an elderly patient, a resident of a nursing home, with Norwegian scabies in whom itching and skin lesions were initially misdiagnosed as a dermatologic complication of type 2 diabetes mellitus. Additionally, in the nursing home, the results of the implemented therapy were not checked appropriately, which resulted in an outbreak of scabies in the institution as well as infection of several family members. Conclusions . Considering the fact that pharmacological treatment of Norwegian scabies does not differ from other forms of this disease, it seems that early diagnosis and appropriate treatment planning are crucial to prevent transmission of the infection.

  4. Delayed Diagnosis of Tuberculous Meningitis Misdiagnosed as Herpes Simplex Virus-1 Encephalitis With the FilmArray Syndromic Polymerase Chain Reaction Panel

    OpenAIRE

    Gomez, Carlos A.; Pinsky, Benjamin A.; Liu, Anne; Banaei, Niaz

    2016-01-01

    Abstract The FilmArray meningitis/encephalitis (ME) panel is a novel syndromic, nucleic acid amplification test for diagnosis of acute meningitis and encephalitis. Emerging data on its performance are concerning for false-positive results. We present a case of tuberculous meningitis misdiagnosed as herpes simplex virus-1 encephalitis with the FilmArray ME panel. Strategies to mitigate erroneous results are discussed.

  5. Nodal Melanoma Metastasis under Infliximab Therapy in a Patient with Nevoid Melanoma First Misdiagnosed as Benign Nevus: A Potentially Dangerous Diagnostic Pitfall in the Era of Biologic Therapies

    OpenAIRE

    Gilles Safa; Sophie Fromentoux; Laure Darrieux; Jean-Anastase Hogenhuis; Laurent Tisseau

    2013-01-01

    We report the case of a 53-year-old Caucasian woman who developed nodal melanoma metastasis under infliximab therapy 2 years after the removal of a nevoid melanoma, which was initially misdiagnosed as a benign compound nevus. This case illustrates the potential link between tumor necrosis factor (TNF)-α inhibition and the reactivation of latent melanoma. Furthermore, this case highlights the need for a complete skin examination before using anti-TNF-α therapy to rule out atypical malignant le...

  6. Surgical management of agenesis of the vulva with atresia ani-et-distal recti in a heifer calf: A case report

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    Moses N Wamaitha

    2015-09-01

    Full Text Available Successful surgical intervention of atresia ani-et-distal recti with agenesis of vulva in a heifer calf is reported in this paper. The calf aging 1-day was presented with a history of swelling at the perineal region. In clinical examination, both vulval and anal openings were found absent. Initial surgical operation under sedation and local anesthesia was done to correct these abnormalities. As a result, the calf could urinate, but attempted defecation was not successful. Surgical operation was done again at the anal region to resolve this condition. Post-operatively, tetracycline spray was applied on both surgical wounds immediately after surgery, and repeated twice daily for 10 days. Amoxicillin trihydrate (at 750 mg/kg bwt and Phenylbutazone (at 400 mg/kg bwt were administered intramuscularly once, and the treatment was repeated on every alternate day up to 10 days of post-surgery. Finally, the calf was able to urinate and defecate normally, and the surgical wounds healed uneventfully within 14 days. [J Adv Vet Anim Res 2015; 2(3.000: 369-372

  7. Basal cell carcinomas of the vulva: high-risk human papillomavirus DNA detection, p16 and BerEP4 expression.

    Science.gov (United States)

    Elwood, Hillary; Kim, Jinah; Yemelyanova, Anna; Ronnett, Brigitte M; Taube, Janis M

    2014-04-01

    Basal cell carcinoma (BCC) of the vulva is rare and may be confused with the much more commonly encountered high-risk human papillomavirus (HPV)-related basaloid squamous cell carcinoma (SCC). The HPV status of BCCs is not well established. This study assesses the utility of p16 and BerEP4 expression patterns and high-risk HPV detection for distinction of these tumors. Thirteen cases of vulvar BCC were analyzed by immunohistochemistry for p16 and BerEP4 expression. HPV status was assessed by in situ hybridization (ISH) with a high-risk HPV wide-spectrum probe and HPV 16 and 18 type-specific probes. All tumors (13/13) demonstrated patchy p16 positivity, with high-risk HPV-associated lesions. No high-risk HPV was detected by ISH (0/13). Eleven of 13 (85%) vulvar BCCs showed diffuse, intense expression of BerEP4. The 2 BerEP4-negative cases were notably squamatized. The lack of diffuse p16 expression and failure to detect high-risk HPV by ISH in vulvar BCCs indicate that these tumors are unrelated to high-risk HPV. Thus, these ancillary techniques, particularly p16 immunohistochemistry, are useful for distinguishing vulvar BCCs from basaloid forms of high-risk HPV-related vulvar SCC. BerEP4 expression can help in distinction of these tumors except in cases of BCC with extensive squamatization. Distinction of vulvar BCC from basaloid SCC is important because of differences in extent of surgical treatment for these entities.

  8. La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder

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    van Meerkerk-Aanen PJ

    2017-08-01

    Full Text Available Petra J van Meerkerk-Aanen,1 Lars de Vroege,1,2 David Khasho,1 Aziza Foruz,1 J Thies van Asseldonk,3 Christina M van der Feltz-Cornelis1,2 1Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg, 2Department Tranzo, Tilburg School of Behavioral and Social Sciences, Tilburg University, 3Department of Neurology, Elisabeth Hospital, Tilburg, the Netherlands Background: Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD. However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson’s syndrome (PSPS misdiagnosed as a case of CD.Case: A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient’s physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS.Conclusion: La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological

  9. Nodal Melanoma Metastasis under Infliximab Therapy in a Patient with Nevoid Melanoma First Misdiagnosed as Benign Nevus: A Potentially Dangerous Diagnostic Pitfall in the Era of Biologic Therapies

    Directory of Open Access Journals (Sweden)

    Gilles Safa

    2013-10-01

    Full Text Available We report the case of a 53-year-old Caucasian woman who developed nodal melanoma metastasis under infliximab therapy 2 years after the removal of a nevoid melanoma, which was initially misdiagnosed as a benign compound nevus. This case illustrates the potential link between tumor necrosis factor (TNF-α inhibition and the reactivation of latent melanoma. Furthermore, this case highlights the need for a complete skin examination before using anti-TNF-α therapy to rule out atypical malignant lesions or melanomas that can easily be missed because of presentations such as nevoid melanoma.

  10. Skin diseases of the vulva

    DEFF Research Database (Denmark)

    Sand, Freja Lærke; Thomsen, Simon Francis

    2017-01-01

    A multitude of infectious diseases of viral (genital herpes, herpes zoster, genital warts and molluscum contagiosum), bacterial (syphilis, chancroid, lymphogranuloma venereum, donovanosis, erysipelas, cellulitis and necrotising fasciitis, folliculitis, impetigo, bartholin gland abscess, trichomyc......, trichomycosis and erythrasma), fungal (candidiasis and dermatophytosis) and parasitic (pediculosis pubis) origin may affect the vulvar area. Herein, we review the infections and their skin manifestations in the vulvar area....

  11. Chronic calf pain caused by fibroma-induced chronic inflammation around the tibial and peroneal nerves that was misdiagnosed as centralized neuropathic pain: A case report.

    Science.gov (United States)

    Jiyoung, Park; Seong-Ho, Ok; Yeol, Han Jeong; Miyeong, Park; Hui, Seo Eun; A, Kim Yeon

    2017-12-28

    The etiology of calf pain varies widely; therefore, it is difficult to diagnose and requires careful history taking and physical examination by primary care unit physicians. Because ultrasonography is easy to perform, cheap, and readily available with physicians during a routine consultation, it is the first choice of modality for the evaluation of calf pain. However, simple inflammation around the nerve should also be considered as a possible etiology. Here we describe a 35-year-old man with chronic pain in the right calf that was actually caused by fibroma-induced chronic inflammation around the tibial and peroneal nerves but misdiagnosed as centralized neuropathic pain. The patient presented with chronic pain and a tingling sensation in the right calf. He had a slowly growing tibial nerve neurilemmoma that was excised at 28 years of age; however, the pain and tingling sensation persisted. He visited several hospitals for 7 years and was misdiagnosed with peripheral nerve injury-induced neuropathic pain. At 35 years of age, he visited our hospital for further evaluation. Ultrasonography revealed a mass in the popliteal region, which was excised and confirmed to be a fibroma via histopathological analysis. Severe inflammation was observed in the operative field. His symptoms finally ameliorated after this surgery. The findings from this case suggest that ultrasonography should be used as the primary modality for the evaluation of calf pain. Although the features of unresolved calf pain are similar to those of neuropathic pain, more curable etiologies should be considered. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Primary-contact physiotherapists manage a minor trauma caseload in the emergency department without misdiagnoses or adverse events: an observational study

    Directory of Open Access Journals (Sweden)

    Matthew Sutton

    2015-04-01

    Full Text Available Questions: What proportion of people who are managed by a primary-contact physiotherapy service in an emergency department experience adverse events? For people presenting to the emergency department with minor trauma, does the length of stay differ between those managed by the physiotherapy service and those managed by medical staff? For people presenting to the emergency department with minor trauma, is diagnostic imaging ordered as often by the physiotherapy service as it is by medical staff? Design: Prospective, observational, cohort study. Participants: A consecutive sample of 1320 people presenting to an emergency department and managed by the physiotherapy service was analysed. Where possible, these patients were matched by diagnostic codes – typically for minor trauma including closed fractures of the periphery – to patients who were managed by medical staff in order to generate two matched cohorts for comparison. Outcome measures: The outcome measures were adverse events among the patients managed by the physiotherapy service, the average length of stay of each cohort in the emergency department, and the proportion of patients in each cohort who underwent diagnostic imaging studies, including plain radiographs, computerised tomographic scans, and ultrasound imaging studies. Results: No misdiagnoses or adverse events were identified for any patient managed by the physiotherapy service. The patients managed by the physiotherapy service had a significantly reduced length of stay (mean difference 83 minutes, 95% CI 75 to 91 and significantly fewer requests for each type of imaging than the matched patients managed by medical staff. Conclusion: Primary-contact physiotherapists can manage a minor trauma caseload in the emergency department without adverse events. A physiotherapy service in the emergency department may result in a reduced length of stay and fewer requests for imaging. However, potential confounding of the results for

  13. Cáncer de la vulva: cuadro clínico, histopatología y supervivencia (1980 a 2004 Vulvar cancer: clinical picture, histopathology and survival (1980-2004

    Directory of Open Access Journals (Sweden)

    Omar de Jesús Bosque Diego

    2008-12-01

    Full Text Available INTRODUCCIÓN. El cáncer de vulva es una afección poco frecuente, pero el incremento de la expectativa de vida en Cuba, hace que destaque entre los cánceres ginecológicos. Dada su repercusión biopsicosocial, el presente estudio siguió el propósito de describir los síntomas de comienzo, determinar la histopatología más frecuente y el estadio de la enfermedad en el momento del diagnóstico, así como la frecuencia de las recaídas y la supervivencia global a los 5 y 10 años. MÉTODOS. Se realizó un estudio descriptivo, retrospectivo, de las pacientes atendidas en el Instituto de Oncología y Radiobiología durante un período de 25 años (1980 a 2004. Se incluyeron 373 pacientes tratadas con diagnóstico histopatológico de cáncer de vulva. RESULTADOS: El promedio de edad fue de 63,4 años. El 59,52 % de las pacientes se encontraba en los estadios de cáncer II y III. El carcinoma epidermoide afectó al 76,68 % de ellas. Se encontraron metástasis linfáticas inguinales en el 26,82 %. La enfermedad recurrió en el 21,18 % de las pacientes. La supervivencia global a los 5 años fue del 65 % y a los 10 años fue de aproximadamente el 45 %. CONCLUSIONES: El diagnóstico de cáncer de la vulva continúa siendo tardío y se observa una tendencia a la aparición en edades más tempranas. Las recurrencias y la supervivencia global no son satisfactorias.INTRODUCTION. Vulvar cancer is a rare affection, but the increase of life expectancy in Cuba makes it to stand out among the gynecological cancers. Due to its biosocial impact, the present study was aimed at describing the onset symptoms, and at determining the most common histopathology and the stage of the disease on diagnosis, as well as the frequency of the relapses and the global survival at 5 and 10 years. METHODS. A descriptive retrospective study of the female patients attended at the Institute of Oncology and Radiobiology for 25 years (1980-2004 was conducted. 373 patients with

  14. A Hepatitis C Virus-Associated Chronic Hepatitis Patient Developing Various Adverse Events Including Severe Gingivitis, Gingival Bleeding, and Inflammation of Genital Vulva during the Course of Antiviral Therapy with Elbasvir/Grazoprevir

    Directory of Open Access Journals (Sweden)

    Kazuo Tarao

    2017-11-01

    Full Text Available Oral direct-acting antivirals comprise the main therapy for hepatitis C virus (HCV-associated liver disease in Japan. Daclatasvir/asunaprevir is the primary agent and sofosbuvir/ledipasvir is the secondary agent for HCV genotype 1b. Ombitasvir/paritaprevir/ritonavir was also recommended as a therapy for HCV genotype 1b. More recently, elbasvir (NS5A inhibitor/grazoprevir (NS3/4A protease inhibitor was also recommended as a potent therapy for HCV genotype 1b infection. This agent achieved an SVR12 as high as 96.5% for HCV virus-associated chronic hepatitis. We recently encountered a case treated with this agent and the female patient showed various adverse events, such as severe gingivitis, gingival bleeding, severe tonsillitis, inflammation of the genital vulva, and the sustained sensation of being hungry. In spite of the gingival bleeding, there was no depletion of the platelet count, nor elongation of the prothrombin time. She tolerated these adverse events and finally completed the therapy and achieved SVR12.

  15. Phthiriasis palpebrarum misdiagnosed as allergic ...

    African Journals Online (AJOL)

    The scalp was shaved and washed with phenothrin shampoo. No recurrence was found during 3 months of follow.up. Removal of the eyelashes, cutting of scalp hairs, and phenothrin shampoo may be effective in treating phthiriasis palpebrarum. In cases of blepharoconjunctivitis, eyelids and eyelashes should be carefully ...

  16. EAMJ Jan. Misdiagnosed.indd

    African Journals Online (AJOL)

    2009-01-01

    Jan 1, 2009 ... in children must be diagnosed and urgently corrected if one was to avoid the loss of testis due to infarction. ... informed consent was granted. Theatre was availed within eight hours of starting of the pain .... diagnostic dilemma where prompt action is required. Therefore, for the good outcome of the scrotal.

  17. [Angiomiofibroblastoma of the vulva. Report of case].

    Science.gov (United States)

    Pérez-Martínez, Andrés; Chávez-Martínez, Sareni; Sereno-Coló, José Antonio; Arias-González, María Leilanie

    2013-06-01

    Angiomyofibroblastoma is a benign mesenchymal tumor of the lower genital tract described in 1992 by Fletcher and his group. Must be differentiated mainly from aggressive angiomyxoma, which has a high local recurrence rate. We report the case of a 21 year old patient who attended the General Hospital Dr. Miguel Silva, in Morelia, Michoacan, because post-term pregnancy of 41.1 weeks gestation, with a bulky vulvar tumor, asymptomatic with four years of evolution. Cesarean section and vulvar tumor resection were performed. The surgical specimen measured 14 x 10 x 5 cm, had a polypoid aspect, multilobulated, with nodules of varying size. From a microscopic point of view the tumor was well defined, formed by loose connective tissue septa, with stromal fusiform cells and benign characteristics, between collagen fibers, with abundant vessels. The histochemical studies were positive for desmin and vimentin. These anatomopathological findings are diagnostic of vulvar angiomyofibroblastoma, benign course tumor, does not resort nor does it generate metastases after simple surgical resection; however, recurrence in the vagina is reported. Must be differentiated from other mesenchymal neoplasms of the genital tract.

  18. Pelvic splenosis misdiagnosed as a uterine sarcoma

    OpenAIRE

    Gerber, Deanna; Melissa K. Frey; Caputo, Thomas A.

    2015-01-01

    Highlights ? Splenosis is a rare complication of splenic trauma or splenectomy. ? Splenosis can be mistaken for gynecologic malignancy. ? Splenosis must be considered as a diagnosis in all patients with history of prior trauma or splenectomy.

  19. Bronchial foreign body misdiagnosed as pulmonary tuberculosis ...

    African Journals Online (AJOL)

    Retained and neglected foreign bodies in the respiratory tract in children are a common occurrence. Undiagnosed foreign bodies can cause mechanical effects or chemical reactions and may present as chronic pulmonary infection, bronchiectasis, asthma, and lung collapse or lung abscess. Delay in diagnosis, appears to ...

  20. Progressive Supranuclear Palsy Misdiagnosed as Parkinson's ...

    African Journals Online (AJOL)

    diagnosis, such as Alzheimer's or Parkinson's disease[3] and because of its increasingly recognized clinical diversity, it may be difficult, particularly in resource‑poor settings, to diagnose. PSP. Consequently, the underdiagnosis or misdiagnosis of PSP neurodegenerative disorder is not uncommon.[4]. Recent studies have ...

  1. Idiopathic Thrombocytopenic Purpura Misdiagnosed as Hereditary Angioedema

    DEFF Research Database (Denmark)

    Andersen, Michelle Fog; Bygum, Anette

    2015-01-01

    Hereditary angioedema is a rare, but potentially life-threatening genetic disorder that results from an autosomal dominant trait. It is characterized by acute, recurrent attacks of severe local edema, most commonly affecting the skin and mucosa. Swelling in hereditary angioedema patients does...... however not always have to be caused by angioedema but can relate to other concomitant disorders. In this report we are focusing on misdiagnosis in a patient with known hereditary angioedema, whose bleeding episode caused by idiopathic thrombocytopenic purpura was mistaken for an acute attack...

  2. Popliteal artery entrapment syndrome misdiagnosed as chronic ...

    African Journals Online (AJOL)

    months apart he was symptom-free, except for some discomfort in the fasciotomy scars. PAES is a relatively underdiagnosed cause of exercise-induced lower limb claudication. The syndrome usually affects young athletes who undertake vigorous exercise leading to muscle hypertrophy of the calf muscles which unmasks ...

  3. minal pregnancy misdiagnosed as abruptio placenta.

    African Journals Online (AJOL)

    Sip. Arch. Celok. Lek. 2002; 130(9- l0):320-2. ' Jazayeri A, Davis TA, Contreras DN. Diagnosis and management of abdominal pregnancy; a case report. J. Reprod. Med. 2002;. 47(l2); 1047 - 9. Ozdemi I, Demirci F, Yncel (), Alper M. Primary omental pregnancy presenting with l1aemon'ha.gic shock; a case report. Gynecol.

  4. Graves’ Ophthalmopathy Misdiagnosed as Relapsing Conjunctivitis

    Directory of Open Access Journals (Sweden)

    Irini P. Chatziralli

    2010-09-01

    Full Text Available A 59-year-old female patient presented at the outpatients’ Department of Ophthalmology with epiphora, eyelid swelling, and a foreign body feeling in the right eye. The symptoms were present for 4 months, and the patient was treated as suffering from relapsing conjunctivitis. The slit lamp examination revealed keratitis due to exposure, related with the deficient closure of the eyelids. There was a 2 mm difference in the readings with the Hertel exophthalmometry examination between the eyes. Her medical history was clear, and she was referred for computed tomography of the orbits and brain and biochemical examinations (FT3, FT4, and TSH to investigate the presence of an intraorbital mass. FT3 was significantly increased and TSH was accordingly low, indicating the diagnosis of Graves’ disease, which presented without other signs and symptoms apart from ophthalmopathy. Computed tomography scan excluded the diagnosis of an intraorbital mass. Therefore, it is important not to underestimate the ocular manifestations of systemic diseases.

  5. Popliteal artery entrapment syndrome misdiagnosed as chronic ...

    African Journals Online (AJOL)

    ) of the anterior compartment. He was referred to an orthopaedic surgeon who did a fasciotomy of the anterior compartments. After 6 months of rehabilitation he started playing rugby again, but the pain and discomfort in his calves became so.

  6. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  7. Misdiagnosed Adult Testicular Torsion: Case Report | Ndaguatha ...

    African Journals Online (AJOL)

    Adult testicular torsion is thought to be rare if not relatively unusual. The rarity could be an underestimation since there are many episodes of missed torsions and misdiagnosis with other conditions of acute scrotum despite the now widespread ultra sound availability that are being reported in the literature. Such a ...

  8. Psychiatric misdiagnoses in Dandy-Walker variant.

    Science.gov (United States)

    Blaettner, C; Pfaffenberger, N M; Cartes-Zumelzu, F; Hofer, A

    2015-01-01

    Cases of intellectual impairment and aberrant behavior in patients with cerebellar diseases have been described since the early nineteenth century. Here, we report on a patient suffering from Dandy-Walker variant who presented with symptoms of obsessive compulsive disorder and delusional disorder. The current findings emphasize the potential relevance of focal cerebellar lesions as organic correlates of these disorders.

  9. Idiopathic Thrombocytopenic Purpura Misdiagnosed as Hereditary Angioedema

    DEFF Research Database (Denmark)

    Andersen, Michelle Fog; Bygum, Anette

    2015-01-01

    Hereditary angioedema is a rare, but potentially life-threatening genetic disorder that results from an autosomal dominant trait. It is characterized by acute, recurrent attacks of severe local edema, most commonly affecting the skin and mucosa. Swelling in hereditary angioedema patients does how...... of hereditary angioedema. The case illustrates how clinicians can have difficulties in handling patients with rare diseases, especially in the emergency care setting....

  10. Popliteal artery entrapment syndrome misdiagnosed as chronic ...

    African Journals Online (AJOL)

    -induced pain in the lower extremity of young athletes. However, it might explain the symptoms of those athletes who do not respond to treatment for the more common overuse syndromes. We present a case of a young professional male ...

  11. Osteomyelitis of the pubic ramus misdiagnosed

    African Journals Online (AJOL)

    Histopathology of the material from the lesion confirmed acute-on-chronic osteomyelitis. The patient improved post- operatively. He became afebrile, his pain disappeared and his gait returned to normal. He was discharged on the 16'“ day of admission to continue his oral antibiotics at home. His ESR had fallen to 32 mm/L ...

  12. Osteomyelitis of the pubic ramus misdiagnosed

    African Journals Online (AJOL)

    Subsequent re-evaluation upon referral was carried out using CT scan and MRI which clarified the diagnosis. The lesion was explored, the pus drained and .... Haemophilus influenzae type B in a Down syndrome child. Annals of Saudi Medicine, 2002; 22: 341-343. Zvulunov A, Gal N, Sege VZ. Acute hematogenous.

  13. Caroli's disease misdiagnosed as hydatid liver cysts.

    Science.gov (United States)

    Akoglu, M.; Davidson, B. R.

    1991-01-01

    A 27 year old woman who presented with upper abdominal pain was found on ultrasonography to have multiple liver cysts consistent with hydatid disease. Three years previously she had undergone evacuation of multiple infected liver cysts thought to be due to hydatid disease. Computed tomographic scanning supported the diagnosis of hydatid disease affecting the right lobe of the liver. At laparotomy the right lobe contained multiple cysts which were removed by right lobectomy. Histology revealed congenital dilatation of the intrahepatic bile ducts with fibrosis (Caroli's disease) but no evidence of hydatid disease. Images Figure 1 Figure 2 PMID:2057431

  14. Cerebral Vein Thrombosis Misdiagnosed and Mismanaged

    Directory of Open Access Journals (Sweden)

    P. K. Sasidharan

    2012-01-01

    Full Text Available Cerebral venous thrombosis (CVT should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management.

  15. A neglected risk for sparganosis: eating live tadpoles in central China

    National Research Council Canada - National Science Library

    Jing Cui; Ye Wang; Xi Zhang; Xi-Meng Lin; Hong-Wei Zhang; Zhong-Quan Wang; Jia-Xu Chen

    2017-01-01

    .... He had a 15-day history of persistent high fever, abdominal distention and pain. The patient was clinically diagnosed as appendicitis and peritonitis, and treated with antibiotics in a local hospital, did not improve...

  16. Acanthocephalan infection and sparganosis in a green tree snake (Dendrelaphis punctulata).

    Science.gov (United States)

    Hill, A G; Ladds, P W; Spratt, D M

    2014-09-01

    Acanthocephalan and spargana parasites were identified within a body wall mass during exploratory surgery in a wild green tree snake. Acanthocephalan parasites have not previously been reported in this species. Surgical excision, the treatment of choice, could not be achieved because of the extensive infiltration of the coelomic cavity. © 2014 Australian Veterinary Association.

  17. Benign tumors of vulva: review and case report of achrocordon

    Directory of Open Access Journals (Sweden)

    Cuauhtémoc Galeana Castillo

    2014-02-01

    Full Text Available The vulvovaginal region is a very complex area because of its anatomy and the fact that it can be source of a large number of benign tumors and less frequent malignant tumors. In recent decades, there have been significant gains in the diagnosis and treatment of vulvovaginal tumors, thanks to the contributions of cellular and molecular biology. The purpose of this review article is to serve as a practical reference for clinical and pathological diagnosis as well as in the outpatient treatment and monitoring of these benign tumors.

  18. Angiokeratoma Of the Vulva In A Young Woman

    Directory of Open Access Journals (Sweden)

    Joshi Arun

    1999-01-01

    Full Text Available A 34 year old female had vascular, keratotic papules on her external genitalia for 4 years. The histopathology was diagnostic of angiokeratoma. The case is being reported because of its uncommon occurrence.

  19. Chronic Ulcerative Herpes Simplex Virus Infection of the Vulva

    OpenAIRE

    Kelly Griffith-Bauer; Mary O’Hearn; Benjamin D. Ehst

    2012-01-01

    Herpes simplex virus infections in HIV-infected individuals can be clinically unusual and difficult to treat due to underlying problems with cell-mediated immunity and the occurrence of antiviral resistance. Additionally, partial or incomplete restoration of immune function may result in chronic ulcerations that require rotational treatments. In this report, we describe the case of a 38-year-old HIV-positive woman who developed the ulcerative form of chronic herpes simplex infection despite h...

  20. Chronic Ulcerative Herpes Simplex Virus Infection of the Vulva

    Directory of Open Access Journals (Sweden)

    Kelly Griffith-Bauer

    2012-09-01

    Full Text Available Herpes simplex virus infections in HIV-infected individuals can be clinically unusual and difficult to treat due to underlying problems with cell-mediated immunity and the occurrence of antiviral resistance. Additionally, partial or incomplete restoration of immune function may result in chronic ulcerations that require rotational treatments. In this report, we describe the case of a 38-year-old HIV-positive woman who developed the ulcerative form of chronic herpes simplex infection despite highly active antiretroviral therapy and valacyclovir prophylaxis. Repeated intravenous courses of foscarnet and topical cidofovir finally controlled her erosions as her cell-mediated immunity was slowly restored. This case highlights the challenges that still exist in diagnosing and managing this rare presentation of herpes simplex virus

  1. Small cell carcinoma of the vulva: case report

    Directory of Open Access Journals (Sweden)

    Ana Correia

    2017-04-01

    Full Text Available Neuroendocrine tumours are rare in the gynaecologic tract, comprising approximately 2% of all gynaecological tumours. They have an aggressive behaviour and are a diagnostic and clinical challenge, due to their rarity and the lack of standardized therapeutic approaches. There are a few case reports. It is defined as a high-grade carcinoma exhibiting neuroendocrine differentiation. The authors describe the case of a 70-year-old woman, with vulvar neuroendocrine small cell carcinoma after superficial vulvectomy. The patient was submitted to a surgery with wide local excision and adjuvant radiation therapy. A review of the literature on this topic is also presented.

  2. Necrotizing Fasciitis of vulva: A report of two cases

    Directory of Open Access Journals (Sweden)

    Jamal A

    2000-08-01

    Full Text Available Vulvar necrotizing fascitis is an uncommon infectious disorder. Since the first reported cases almost 100 years, ago, necrotizing fasciitis continues to present a diagnostic and therapeutic challenge. What usually begins as a subtle infection can become life-threatening. We report two cases of vulvar necrotizing fasciitis, one after posterior colporrhaphy in a woman with four risk factors and the other in a young woman without any risk factor.

  3. A Case of Sparganosis mansoni in the Thigh: Serological Valida­tion of Cure Following Surgery

    Directory of Open Access Journals (Sweden)

    Y Moroi

    2012-09-01

    Full Text Available Cases of Sparganum mansoni, caused by the plerocercoid larva of the tapeworm S. mansoni, occur through­out the world, particularly in Asian, Middle Eastern, and European countries. However, cases of infection with this parasite are rarely seen in Japan. Here, we present a case of a 61-year-old woman with a solitary subcutaneous nodule in left inner aspect of the thigh, from which a long, slender, whitish worm was surgically removed. The parasite was histopathologically identified as S. mansoni. Serological testing confirmed cure of the infection after surgical removal of the parasite. The authors advocate immunoserological examination in case of S. mansoni.

  4. Carotid Body Tumor Presenting as Parotid Swelling Misdiagnosed ...

    African Journals Online (AJOL)

    Sevilla García MA, Llorente Pendás JL, Rodrigo Tapia JP,. García Rostán G, Suárez Fente V, Coca Pelaz A, et al. Head and neck paragangliomas: Revision of 89 cases in 73 patients. Acta. Otorrinolaringol Esp 2007;58:94‑100. 2. Barnes L, Tse LL, Hunt JL, Michaels L. Tumors of paraganglionic system: Introduction.

  5. Supracubital perineurioma misdiagnosed as carpal tunnel syndrome: case report

    Directory of Open Access Journals (Sweden)

    Schols Ludger

    2004-11-01

    Full Text Available Abstract Background Perineuriomas have been defined as tumorous lesions of the peripheral nerves which derive from perineurial cell proliferation and may be associated with abnormalities on chromosome 22. Case presentation Three years after a painful cubital vein procaine injection, a 33 year-old man developed a median nerve lesion, initially diagnosed as carpal tunnel syndrome. Symptoms progressed despite appropriate surgery. Clinical and electrophysiological re-evaluation revealed a fusiform mass at the distal upper arm, confirmed by MRI. Immunohistochemical studies classified the tumor as a mixed perineurioma and neuroma. Conclusions Perineurioma mixed with neuroma may potentially caused by the previous trauma or cytotoxic effects of procaine.

  6. Osteomyelitis of the pubic ramus misdiagnosed as septic arthritis of ...

    African Journals Online (AJOL)

    Subsequent re-evaluation upon referral was carried out using CT scan and MRI which clarified the diagnosis. The lesion was explored, the pus drained and necrotic material excised. The patient was subsequently managed on antibiotics with complete resolution. The rarity of pelvic osteomyelitis in childhood is stressed and ...

  7. Bilateral acute iris transillumination (BAIT) initially misdiagnosed as acute iridocyclitis

    OpenAIRE

    Gonul, Saban; Bozkurt, Banu

    2015-01-01

    Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber, and sphincter paralysis. We report the case of a 30-year-old male who was initially diagnosed with acute iridocyclitis in a different clinic and treated with topical and systemic corticosteroids. He was referred to our clinic to seek another opinion because his symptoms did not im...

  8. Tracheal Stenosis Because of Wegener Granulomatosis Misdiagnosed as Asthma.

    Science.gov (United States)

    O'Hear, Kelley E; Ingrande, Jerry; Brodsky, Jay B; Morton, John M; Sung, Chih-Kwang

    2016-05-15

    We describe a patient with Wegener granulomatosis whose complaint of wheezing was incorrectly attributed to asthma. Anesthesiologists must recognize that tracheal stenosis is extremely common in Wegener granulomatosis and can mimic other causes of wheezing.

  9. Missed Diagnosis of Twin Pregnancy and Mis-Diagnosed Fetal ...

    African Journals Online (AJOL)

    We present a 41 year old booked grandmultipara with twin gestation erroneously diagnosed as singleton pregnancy with fetal hydrocephalous and scheduled for elective caesarean delivery at term but subsequently went into spontaneous labour at 35weeks of gestation and had vaginal delivery of two live male babies ...

  10. term abdominal pregnancy misdiagnosed as abruptio placent a.

    African Journals Online (AJOL)

    A 37 year old multiparous woman at 37'" week gestation presented with an undiagnosed abdominal pregnancy and acute abdomen following forceful reduction of an associated Mere-vaginal prolapse. She had an urgent laparotomy with ... incision was made on the lower half of this sac and the amniotic sac yninctured to ...

  11. Pituitary Adenoma Misdiagnosed as Glaucoma in an Adult Nigerian ...

    African Journals Online (AJOL)

    painless vision loss of 1-year duration in the left eye and. 6-week duration in the right eye. ... E-mail: vivian.osaguona@uniben.edu. This is an open access article distributed under the terms of the Creative Commons .... of glaucoma should have neuroimaging of the brain and orbits and appropriate laboratory work-up done.

  12. Congenital portal systemic encephalopathy misdiagnosed as senile dementia.

    Science.gov (United States)

    Miyata, Kaori; Tamai, Hideyuki; Uno, Akiko; Nakao, Ryutaro; Muroki, Tokuro; Nasu, Tetsushi; Kawashima, Akira; Nakao, Taisei; Kondo, Michi; Ichinose, Masao

    2009-01-01

    Congenital portal systemic encephalopathy without liver cirrhosis and/or portal hypertension is rare. An 86-year-old man with senile dementia was admitted due to disturbance of consciousness. His serum ammonia level was high, but there was no evidence of liver cirrhosis or portal hypertension on laboratory tests and upper abdominal enhanced computed tomography (CT). However, on lower abdominal enhanced CT, a meso-caval shunt was found in the right lower abdomen. Superior mesenteric arteriography revealed a shunt flowing into the inferior vena cava via the right gonadal vein. The shunt was closed by balloon occluded retrograde transvenous obliteration, and dementia-like symptoms improved.

  13. Dermatitis herpetiformis misdiagnosed and treated as tinea cutis glabrae

    Directory of Open Access Journals (Sweden)

    Marta Stawczyk-Macieja

    2016-02-01

    Full Text Available Introduction . Dermatitis herpetiformis is a rare bullous disorder. Autoimmunological disturbances associated with hypersensitivity to gluten play the main role in the etiopathogenesis of the disease. Clinical manifestations include polymorphic skin lesions which may cause diagnostic difficulties. Objective. To present a case of dermatitis herpetiformis diagnosed and treated without any clinical improvement as tinea cutis glabrae. Case report . A 20-year-old male patient was admitted for the evaluation of polymorphic skin lesions of 7-month duration distributed symmetrically on the skin of elbows, knees, face and the gluteal and sacral region. The patient was previously treated with systemic and topical antimycotic drugs. Due to a typical distribution of skin lesions as well as symptoms reported by the patient, we started to suspect Duhring’s disease. The diagnosis was confirmed by direct immunofluorescence of skin biopsy and serological tests. Systemic treatment with dapsone and a gluten-free diet led to clinical improvement. Conclusions . The morphology and localization of skin lesions in Duhring’s disease may be similar to the clinical presentation of fungal infection of the skin, which in equivocal cases should be excluded by a mycological test.

  14. An Unusual Presentation of Pelvic Leiomyomatosis Misdiagnosed as Disseminated Malignancy

    Directory of Open Access Journals (Sweden)

    Nisha Marwah

    2012-01-01

    Full Text Available Leiomyomatosis peritonealis disseminata (LPD is an exceedingly rare, usually benign condition that clinically simulates a disseminated malignancy, occurring predominantly in women of childbearing age. We present a case of LPD in a postmenopausal woman who had undergone hysterectomy 8 years back for fibroids along with simultaneous presence of pelvic metastasis from breast carcinoma.

  15. Was it epilepsy?: misdiagnosing Emily Dickinson (1830-1886).

    Science.gov (United States)

    Hirschhorn, Norbert; Longsworth, Polly

    2013-01-01

    Lyndall Gordon's recent biography, Lives Like Loaded Guns: Emily Dickinson and Her Family's Feuds (2010), tells with high verve the story of generational infighting over poet Emily Dickinson's posthumous presentation to the world. Equally dramatic is Gordon's hypothesis that Dickinson suffered from epilepsy, which led Gordon to seemingly solve the ineffable mystery of Dickinson's reclusion, a conundrum in her own time and still so in ours. Gordon's startling diagnosis has been commended by book reviewers and on talk shows. Her hypothesis is based on two lines of inquiry. First, she avers that a compound called glycerine, which Dickinson took regularly in the early 1850s, was an anti-epileptic, basing this notion on its presence in a mixture containing the soporific chloral hydrate, a prescription first advised for epilepsy some two decades later. Second, Gordon proposes a genetic strain of epilepsy in the Dickinson family. In the process, Gordon recruits Dickinson's various illnesses to her hypothesis. This article refutes Gordon's claims on scientific, clinical, and biographical grounds. It reviews Dickinson's medical history to establish a differential diagnosis, in which epilepsy is considered and rejected.

  16. Testicular seminoma metastasis to duodenum. Misdiagnosed as primary duodenal tumor

    Directory of Open Access Journals (Sweden)

    Amer Hashim Al Ani

    2016-01-01

    Conclusion: High index of suspicion for testicular seminoma must be raised when treating young males with GIT complications like hemorrhage. Testicular seminoma is the most common solid tumor at this age. Sometimes it is the cause behind this complication.

  17. (Correcting) misdiagnoses of asthma: A cost effectiveness analysis

    OpenAIRE

    Vandemheen Katherine; Coyle Douglas; Sumner Amanda; Pakhale Smita; Aaron Shawn

    2011-01-01

    This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a...

  18. Genetic Misdiagnoses and the Potential for Health Disparities

    DEFF Research Database (Denmark)

    Manrai, Arjun K; Funke, Birgit H; Rehm, Heidi L

    2016-01-01

    and that are overrepresented in the general population. We studied these variants in diverse populations and reevaluated their initial ascertainments in the medical literature. We reviewed patient records at a leading genetic-testing laboratory for occurrences of these variants during the near-decade-long history...... of the laboratory. RESULTS: Multiple patients, all of whom were of African or unspecified ancestry, received positive reports, with variants misclassified as pathogenic on the basis of the understanding at the time of testing. Subsequently, all reported variants were recategorized as benign. The mutations that were...... most common in the general population were significantly more common among black Americans than among white Americans (PAmericans in control cohorts probably would have prevented these misclassifications. We identified...

  19. Missed Diagnosis of Twin Pregnancy and Mis-Diagnosed Fetal ...

    African Journals Online (AJOL)

    The 1st twin had spina bifida cystica. Multiple clinical and ultrasound diagnostic errors leading to wrong clinical decision taking and unnecessary intervention can occur even in experienced hands. Correct diagnosis following sequential and meticulous forward clinical reasoning serves the clinician and patients interest ...

  20. Caroli's disease in children: is it commonly misdiagnosed?

    Science.gov (United States)

    Senyüz, O F; Yesildag, E; Kuruoglu, S; Yeker, Y; Emir, H

    2005-01-01

    Caroli's disease is a simple form of intrahepatic bile duct ectasia. It can be complicated with the involvement of liver parenchyma and portal hypertension. Herein, the difficult management of delayed presentation of Caroli's disease is reported. We report on four different forms of clinical presentation of Caroli's disease: an infant with fulminant liver failure, a teenager with persistent biliary fistula, a boy with hypersplenism in the face of portal hypertension and a girl with variceal bleeding. Caroli's disease must be included in the differential diagnosis of cystic lesions in the liver. Delayed diagnosis of Caroli's disease is difficult to manage and appropriate investigations are warranted before planning a surgical approach.

  1. Misdiagnosed Pruritus; Formication due to Chronic Amphetamine Abuse

    Directory of Open Access Journals (Sweden)

    Maryam Vahabzadeh

    2016-03-01

    Full Text Available Amphetamine abusers are shown to have significant cognitive impairments as well as delusional disorders. We present a 17-year-old man who was admitted to the toxicology emergency department with amphetamine overdose. Along with the classic signs and symptoms of overdose including mydriasis, tachycardia, hypertension, sweating and severe agitation, his urine toxicology screen test was found to be positive for 3,4-methylenedioxy-methamphetamine. In physical examination, widespread round-to-oval cutaneous lesions were observed all over his limbs and chest, notably the most easily reached sites of skin to be scratched. After regaining consciousness, the patient complained of pruritus and sensing the movement of insects under his skin. Further medical history showed that he had abused amphetamines for more than two years along with persistent pruritus, for which he had visited different physicians who mainly had made the diagnosis of allergy or dermatitis for him. He had been treated with antihistamines (hydroxyzine for a long period. He also had been diagnosed with scabies and treated with topical permethrin and lindane lotion. Despite receiving these treatments, he continued to have pruritus particularly on his forearms and hands. He was finally diagnosed with “Ekbom’s syndrome” and referred to psychological rehabilitation and psychosomatic outpatient clinic.

  2. Clinician's Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva

    DEFF Research Database (Denmark)

    Sand, Freja Lærke; Thomsen, Simon Francis

    2017-01-01

    Correct and rapid diagnosis of skin tumours often requires biopsy and histopathological examination to differentiate benign lesions such as seborrhoeic keratoses or melanocytic naevi from premalignant and malignant lesions such as malignant melanoma. Particularly, to the untrained eye, any benign...... skin tumour-pigmented or nonpigmented-is easily mistaken for a malignant lesion. Qualified clinical evaluation is paramount in order to reduce the frequency of unwarranted skin biopsies. Herein, the most common benign, premalignant, and malignant vulvar skin tumours are reviewed....

  3. AGGRESSIVE ANGIOMYXOMA AS A PEDUNCULATED GROWTH OF VULVA: A RARE CASE REPORT

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    Anitha

    2015-02-01

    Full Text Available Aggressive Angiomyxoma is a slow growing, uncommon myxoid neoplasm occuring chiefly in the genital, perineal and pelvic regions of adult women. (1,2 It is considered as a non - metastasizing tumour with locally aggressive nature and propensity for local recurrence. (1 Hence it is important to differentiate from other mesenchymal tumours in this region and follow up is equally essential. We report a case of 37 years old lady with a pedunculated growth in the left labia majora. Our case highlights the variable presentation of these tumours

  4. Refractory Crohn’s Disease of the Vulva Treated with Infliximab: A Case Report

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    Sapna Makhija

    2007-01-01

    Full Text Available Crohn’s disease (CD is a chronic relapsing and remitting inflammatory disorder of the gastrointestinal tract. The common presentation includes abdominal pain, abdominal cramping and diarrhea. Many patients may exhibit systemic symptoms of fever and weight loss. Approximately 20% to 40% of patients will experience extraintestinal manifestations that involve the eyes, skin and joints. Women may experience a variety of gynecological manifestations, including vulvovaginal involvement, which is often not recognized and also difficult to treat. A case of refractory vulvovaginal CD is presented and the literature of gynecological manifestations of CD and its treatment are reviewed.

  5. Erythema and Burning Pain in the Vulva: A Possible Phenotype of Erythromelalgia

    Directory of Open Access Journals (Sweden)

    Elisabeth Johnson

    2011-01-01

    Full Text Available We report a case of burning vulvar pain accompanied by erythema responding to an oral combination of a benzodiazepine and a beta blocker. The positive response to two medication classes used in the treatment of erythromelalgia supports the possibility of a localized manifestation of this disorder in the genital region.

  6. Squamous precursor lesions of the vulva: current classification and diagnostic challenges

    Science.gov (United States)

    Hoang, Lien N.; Park, Kay J.; Soslow, Robert A.; Murali, Rajmohan

    2017-01-01

    Summary Growing evidence has established two major types of vulvar intraepithelial neoplasia (VIN), which correspond to two distinct oncogenic pathways to vulvar squamous cell carcinoma (VSCC). While the incidence of VSCC has remained relatively stable over the last three decades, the incidence of VIN has increased. VIN of usual type (uVIN) is human papillomavirus (HPV)-driven, affects younger women and is a multicentric disease. In contrast, VIN of differentiated type (dVIN) occurs in post-menopausal women and develops independent of HPV infection. dVIN often arises in a background of lichen sclerosus and chronic inflammatory dermatoses. Although isolated dVIN is significantly less common than uVIN, dVIN bears a greater risk for malignant transformation to VSCC and progresses over a shorter time interval. On histological examination, uVIN displays conspicuous architectural and cytological abnormalities, while the morphological features that characterise dVIN are much more subtle and raise a wide differential diagnosis. On the molecular level, dVIN is characterised by a higher number of somatic mutations, particularly in TP53. Here we review the classification, epidemiology, clinical features, histomorphology, ancillary markers and molecular genetics of both types of VIN, and discuss the morphological challenges faced by pathologists in interpreting these lesions. PMID:27113549

  7. Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: Treatment technique and outcomes

    Directory of Open Access Journals (Sweden)

    Yuan James Rao, MD

    2017-04-01

    Conclusions: IMRT for vulvar cancer is associated with high rates of LRC in the postoperative setting and limited radiation-related toxicity. Durable LRC of disease after definitive IMRT remains challenging, and several refinements to our treatment technique are suggested.

  8. Malassezia furfur folliculitis of the vulva: olive oil solves the mystery.

    Science.gov (United States)

    Nyirjesy, P; Nixon, J M; Jordan, C A; Buckley, H R

    1994-10-01

    In treating women with chronic fungal infections, it is important to know which organism is responsible for the infection. In the past, organisms thought to cause vaginitis and vulvitis could all be cultured on modified Sabouraud agar. We describe a case of a woman whose chronic fungal vulvar folliculitis masqueraded as squamous epithelial hyperplasia. The 46-year-old woman, taking immunosuppressive therapy for rheumatoid arthritis, was referred with an 8-month history of vulvar vesicles, itching, and burning. Her examination revealed a vulvar folliculitis. When fungal cultures were initially negative, a vulvar biopsy revealed a squamous epithelial hyperplasia. However, a fungal culture covered with sterile olive oil eventually grew Malassezia furfur, a yeast with peculiar growth requirements. She was cured with a 2-week course of fluconazole. Malassezia furfur, an organism rarely described in the vaginitis literature, can cause vulvar folliculitis in a patient on immunosuppressive therapy.

  9. A case of galactosemia misdiagnosed as cow’s milk intolerance

    Directory of Open Access Journals (Sweden)

    Casa Roberto

    2012-09-01

    Full Text Available Abstract We report on a female patient affected by galactosemia in whom the diagnosis was obscured by the concomitant presence of manifestations suggesting a cow’s milk intolerance. This case exemplifies the problems in reaching a correct diagnosis in patients with metabolic diseases.

  10. Enlarged clitoris in wild polar bears (Ursus maritimus) can be misdiagnosed as pseudohermaphroditism

    DEFF Research Database (Denmark)

    Sonne, C; Leifsson, P S; Dietz, R

    2004-01-01

    A 23-year-old female polar bear (Ursus maritimus) killed in an Inuit hunt in East Greenland on July 9, 1999 had a significantly enlarged clitoris resembling, in size, form and colour, those of previously reported 'pseudohermaphroditic' polar bears from Svalbard. It has been suggested that an enzy...... Greenland polar bear. Furthermore, caution should be exercised in suggesting linkages of such inflammatory abnormalities with correlations to anthropogenic pollutant exposures. Udgivelsesdato: 2005-Jan-20...

  11. A case of autoimmune cholangitis misdiagnosed for cholangiocarcinoma: How to avoid unnecessary surgical intervention?

    Directory of Open Access Journals (Sweden)

    Ignjatović Igor I.

    2015-01-01

    Full Text Available Introduction. Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder - IgG4-related systemic disease (ISD. ISD is an autoimmune disease with multi-organic involvement, characterized with IgG4-positive plasmocytic infiltration of various tissues and organs with a consequent sclerosis, which responds well to steroid therapy. Most commonly affected organs are the pancreas (autoimmune pancreatitis, [AIP] and the common bile duct (IAC. IAC and cholangiocarcinoma (CCA share many clinical, laboratory and imaging findings. Case Outline. We present a case of a 60-year-old male with a biliary stricture of a common bile duct, which was clinically considered as a bile duct carcinoma and treated surgically. Definite histopathological findings and immunohistochemistry revealed profound chronic inflammation, showing lymphoplasmacytic IgG-positive infiltration of a resected part of a common bile duct, highly suggestive for the diagnosis of IAC. In addition, postoperative IgG4 serum levels were also increased. Conclusion. It is of primary clinical importance to make a difference between IAC and CCA, in order to avoid unnecessary surgical intervention. Therefore, IAC should be considered in differential diagnosis in similar cases.

  12. A case of autoimmune cholangitis misdiagnosed for cholangiocarcinoma: How to avoid unnecessary surgical intervention?

    OpenAIRE

    Ignjatović Igor I.; Matić Slavko V.; Dugalić Vladimir D.; Knežević Đorđe M.; Micev Marjan T.; Bogdanović Marko D.; Knežević Srbislav M.

    2015-01-01

    Introduction. Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC) has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder - IgG4-related systemic disease (ISD). ISD is an autoimmune disease with multi-organic involvement, characterized with IgG4-positive plasmocytic infiltration of various tissues and organs with a consequent sclerosis, which responds well to steroid thera...

  13. A Case of Autoimmune Cholangitis Misdiagnosed for Cholangiocarcinoma: How to Avoid Unnecessary Surgical Intervention?

    Science.gov (United States)

    Ignjatović, Igor I; Matić, Slavko V; Dugalić, Vladimir D; Knežević, Djordje M; Micev, Marjan T; Marko D Bogdanović; Knežević, Srbislav M

    2015-01-01

    Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC) has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder--IgG4-related systemic disease (ISD). ISD is an autoimmune disease with multi-organic involvement, characterized with IgG4-positive plasmocytic infiltration of various tissues and organs with a consequent sclerosis, which responds well to steroid therapy. Most commonly affected organs are the pancreas (autoimmune pancreatitis, [AIP]) and the common bile duct (IAC). IAC and cholangiocarcinoma (CCA) share many clinical, laboratory and imaging findings. We present a case of a 60-year-old male with a biliary stricture of a common bile duct, which was clinically considered as a bile duct carcinoma and treated surgically. Definite histopathological findings and immunohistochemistry revealed profound chronic inflammation, showing lymphoplasmacytic IgG-positive infiltration of a resected part of a common bile duct, highly suggestive for the diagnosis of IAC. In addition, postoperative IgG4 serum levels were also increased. It is of primary clinical importance to make a difference between IAC and CCA, in order to avoid unnecessary surgical intervention. Therefore, IAC should be considered in differential diagnosis in similar cases.

  14. [A amyotrophic lateral sclerosis (ALS) 4 family misdiagnosed as hereditary spastic paraplegia-a case report].

    Science.gov (United States)

    Taniguchi, Takaki; Hokezu, Youichi; Okada, Takashi; Ishibashi, Masato; Hashiguchi, Akihiro; Matsuura, Eiji; Takashima, Hiroshi

    2017-11-25

    We report a 44 years old man with slowly progressive muscular atrophy of the extremities for over 30 years. He experienced difficulty in walking in his 10's and was diagnosed as hereditary spastic paraplegia (HSP) in his 20's. And then, muscle atrophy of the extremities slowly progressed especially in his distal muscles. Sensory axonal neuropathy was detected with sural nerve biopsy. His father and uncle have been diagnosed as HSP in their early days. His father noticed weakness of his leg in his 20's. He lost motor function of the leg in his 60's. In addition, marked disturbance of thermal sensation, vibration, and sense of position were found by physical examination. Our genetic study detected senataxin (SETX) gene mutation (c.8C>T,p.T3I) in the blood of those two patients, and they had been identified as family cases of amyotrophic lateral sclerosis (ALS) 4. As clinical symptoms of ALS4 would be similar to those of HSP at the onset, we suggest considering ALS4 in seeing patients with HSP without gene diagnosis.

  15. Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation

    Directory of Open Access Journals (Sweden)

    Ho-Su Kim

    2013-09-01

    Full Text Available Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L. Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH, 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.

  16. Subtentorial Meningioma Misdiagnosed as Cerebral Hemorrhage in Postmortem Computed Tomography Imaging: A Case Report.

    Science.gov (United States)

    Qian, Hui; Shao, Yu; Li, Zhengdong; Zou, Donghua; Zhang, Jianhua; Wang, Maowen; Wan, Lei; Chen, Yijiu

    2017-06-01

    This report presents a case of a 52-year-old man who had a traffic accident and died later. External examination could not determine the cause of death. Approximately 3 weeks later, an autopsy was performed. Postmortem computed tomography was performed before the autopsy. Postmortem imaging was interpreted to show hemorrhage beneath the tentorium, and the C5 to C6 (the fifth and sixth cervical vertebra) disc space was widened. During the autopsy, a cervical spinal cord injury was confirmed. However, a meningioma was found under the tentorium instead of a hemorrhage. There are a number of reasons that include postmortem changes that affected the virtopsy diagnosis, which still needs development.

  17. Bronchitis caused by Bordetella holmesii in a child with asthma misdiagnosed as mycoplasmal infection.

    Science.gov (United States)

    Katsukawa, Chihiro; Kushibiki, Chieko; Nishito, Atsumi; Nishida, Rikou; Kuwabara, Norimitsu; Kawahara, Ryuji; Otsuka, Nao; Miyaji, Yusuke; Toyoizumi-Ajisaka, Hiromi; Kamachi, Kazunari

    2013-06-01

    We report a case of a bronchitis caused by Bordetella holmesii in a 2-year-old girl with asthma. The patient had a moderate fever and productive cough, and her condition was initially diagnosed as mycoplasmal bronchitis on the basis of her clinical symptoms and rapid serodiagnosis of mycoplasmal infection. She was treated with a bronchodilator and clarithromycin, which resulted in complete recovery. However, after the initial diagnosis, nucleic acid amplification tests of her sputum showed the absence of both Mycoplasma pneumoniae and Bordetella pertussis infections. Sputum culture showed the presence of a slow-growing, gram-negative bacillus in pure culture on Bordetella agar plates; the bacillus was later identified as B. holmesii. B. holmesii infection is rare in immunocompetent children; however, the organism is a true pathogen that can cause bronchitis in young children with asthma.

  18. Can a Morel-Lavallée lesion be misdiagnosed as a mass like lesion?

    Science.gov (United States)

    Lee, Yoon Jae; Kim, Jun Hyeok; Kim, Ji Young; Han, Hyun Ho

    2017-07-25

    The Morel-Lavallée lesion (MLL) is a post-traumatic closed soft tissue degloving injury. Common complaints of MLL patients are a haematoma or fluid collection on the trunk or the lower extremity. However, the authors introduce unique cases of MLL that present an atypical appearance. The fluid collection was not apparent, and the capsule formation was not detected on preoperative image study. The main complaint of patients was the uncomfortable mass-like lesion that was regarded as a simple benign lump. The purpose of this case study is to introduce the atypical cases of MLL and to help other physicians make accurate diagnosis based on trial and error of our cases. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  19. Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient

    NARCIS (Netherlands)

    Shi, Dongmei; Zhang, Wei; Lu, Guixia; de Hoog, G Sybren; Liang, Guanzhao; Mei, Huan; Zheng, Hailin; Shen, Yongnian; Liu, Weida

    Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis.

  20. Tuberculous lymphadenitis in the left axillary misdiagnosed as metastasis: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Hui Li

    2017-03-01

    Conclusion: The TB LNs could show some performances similar to metastasis such as hypoechoic, tending to round and rich in blood. But there are some differences between TB and metastatic LN. 1 The hypo echoic TB LNs were homogenous with clear border and smooth edge. The metastatic ones usually have unsmooth edge with spicular or process. 2 Some lymph nodes with collapse and strip shaped hyper echoic areas could be detected in TB patient, that could coexistent with hypoechoic round LNs. 3 The distribution of the rich blood flow in the TB nodes was not distorted, but with branch-like shaped and distributed smoothly. It must be considered about some particular infections during the ultrasonic examinations of swelling LNs in axillary, especially there is no significant lump in the breasts.

  1. A child with myoclonus-dystonia (DYT11) misdiagnosed as atypical opsoclonus myoclonus syndrome

    DEFF Research Database (Denmark)

    Drivenes, Bergitte; Born, Alfred Peter; Ek, Jakob

    2015-01-01

    INTRODUCTION: DYT11 is an autosomal dominant inherited movement disorder characterized by myoclonus and dystonia. CLINICAL PRESENTATION: We present a case with atypical symptoms and with episodes of ataxia and myoclonus preceded by infections. Atypical presentation of opsoclonus myoclonus syndrome...

  2. Dermatobia hominis misdiagnosed as abscesses in a traveler returning from Brazil to Denmark.

    Science.gov (United States)

    Olsen, Jonas; Nejsum, Peter; Jemec, Gregor Borut Ernst

    2017-06-01

    We present the case of a 62-year-old woman that consulted us for two boil-like lesions on her thighs after returning from a trip to São Paulo, Brazil, where she had swum in a freshwater lake. After consulting three specialist doctors and undergoing two antibiotic treatments, she was diagnosed with furuncular myiasis caused by Dermatobia hominis. The parasites were excised with no complications.

  3. Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Su Min [Dept. of Radiology, Research Institute of Radiology, Chung Ang University Hospital, Seoul(Korea, Republic of); Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung [Dept. of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent mammographic findings of calcifications that were misinterpreted or underestimated by the initial radiologist and confirmed as malignancy at follow-up.

  4. Recurrent CSF Rhinorrhea Misdiagnosed as Chronic Allergic Rhinitis with Subsequent Development of Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    Michael T. Ulrich

    2017-01-01

    Full Text Available Introduction. Cerebrospinal fluid (CSF rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. Case Presentation. A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness. Previously, the patient was diagnosed with chronic allergic sinusitis by multiple providers. Physical exam findings and laboratory tests were consistent with bacterial meningitis. The patient was admitted and started on appropriate antibiotic therapy. The patient continued to complain of persistent unilateral clear nasal drainage. The initial report from the computerized tomography scan of the sinuses indicated findings consistent with chronic sinusitis. Magnetic resonance imaging of the orbits revealed findings consistent with CSF rhinorrhea. Otolaryngology was consulted for surgical intervention. Conclusion. Suspected CSF rhinorrhea should prompt immediate biochemical and radiologic evaluation and surgical consultation. CSF rhinorrhea places patients at risk of developing bacterial meningitis.

  5. A Rare Cause of Chronic Headache that May Be Misdiagnosed as Migraine: Chronic Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet Kenan KANBUROGLU

    2014-09-01

    Full Text Available SUMMARY: Differential diagnosis of primary headache disorders can be challenging for physicians. Although the association of headache with acute carbon monoxide intoxication is very well-defined, in refractory nonspecific headaches associated with chronic low dose exposure to carbon monoxide, CO intoxication is usually overlooked, mostly due to vague symptoms. Herein we present a 15-year-old female patient with chronic carbon monoxide poisoning who was undergoing two years of follow-up care for migraines. Chronic carbon monoxide intoxication may mimic the episodic nature and familial predisposition of migraine attacks. Normal carboxyhemoglobin levels do not exclude the diagnosis, and smoking is a confounding factor. In emergency rooms, patients presenting with headaches had higher levels of carboxyhemoglobin, but, as far as we know, there have been no studies investigating carboxyhemoglobin levels in migraine patients. Chronic carbon monoxide poisoning should be suspected in migraine patients, especially if the attacks occur during winter months. ÖZET: Primer baş ağrısında ayırıcı tanının yapılması bazen doktorlar açısından zor olabilmektedir. Literatürde karbon monoksit ile baş ağrısı arasındaki ilişki çok iyi ortaya konulmuş olmasına karşın, dirençli ve nonspesifik başağrısı nedenlerinden biri olan kronik düşük doz karbon monoksit maruziyeti kendine özgü bulgusu olmadığından sıklıkla atlanmaktadır. Bu yazıda, iki yıl migren tanısı ile takip ve tedavi edilen kronik karbon monoksit zehirlenmesi olan bir olgu sunuldu. Kronik karbon monoksit zehirlenmesi epizodik paterni ve aile fertlerinde benzer şikayetlerin olması nedeniyle migren ataklarını andırabilmektedir. Karboksihemoglobin konsantrasyonlarının normal saptanması tanıyı ekarte ettirmemekte, ayrıca sigara kullanımı da karıştırıcı bir faktör olabilmektedir. Acil servislerine baş ağrısı ile başvuran hastaların karboksihemoglobin seviyeleri başağrısı olmadan acile başvuran hastalardan daha yüksek saptanmaktadır; fakat bildiğimiz kadarı ile karboksihemoglobin seviyesi ile migren arasındaki ilişkinin araştırıldığı bir çalışma literatürde bulunmamaktadır. Migren atakları özellikle kış aylarında tekrarlayan hastalarda kronik karbon monoksit zehirlenmesi akılda tutulmalıdır. Key words: Carbon monoxide, emergency, headache, migraine, pediatric, Anahtar sözcükler: Karbon monoksit, acil, baş ağrısı, migren, çocuk

  6. Lupus Vulgaris Erythematoides: report of a patient initially misdiagnosed as dermatitis.

    Science.gov (United States)

    Vazquez-Lopez, Francisco; Fueyo-Casado, Alejandro; Gonzalez-Lara, Leire

    2013-05-15

    A small percentage of patients with tuberculosis present with cutaneous findings, which may be difficult to diagnose. We present a patient diagnosed with a rare, non-scarring form of cutaneous tuberculosis (CTB), classically termed as lupus vulgaris erythematoides.

  7. Medical image of the week: septic pulmonary emboli misdiagnosed as metastatic disease

    Directory of Open Access Journals (Sweden)

    Dandachi D

    2014-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A 54-year-old previously healthy man presented with acute onset of left-sided, sharp pleuritic chest pain and dry cough. He denied having fever, hemoptysis, shortness of breath, or unintentional weight loss. Review of system was positive for bright blood per rectum for the last year. He had a root canal procedure done 3 weeks prior to presentation. His is a 30 pack-year smoker, drinks alcohol occasionally, but denied any IV drug use. On admission, he was afebrile and hemodynamically stable. Clinical examination was positive for fecal occult blood test. CBC revealed WBC of 12,800/mm3 and his hemoglobin was11.9 g/dL. Thoracic CT scan with contrast was negative for pulmonary embolism, but showed multiple bilateral pulmonary nodules suspicious for malignancy (Figure 1. The left upper lobe showed a subpleural 2.4 x 1.5 cm rounded opacity and emphysematous changes. CT of the abdomen and pelvis showed folds in the stomach but was otherwise unremarkable...

  8. Adults miscoded and misdiagnosed as having pneumonia: results from the British Thoracic Society pneumonia audit.

    Science.gov (United States)

    Daniel, Priya; Bewick, Thomas; Welham, Sally; Mckeever, Tricia M; Lim, Wei Shen

    2017-04-01

    A key objective of the British Thoracic Society national community-acquired pneumonia (CAP) audit was to determine the clinical characteristics and outcomes of hospitalised adults given a primary discharge code of pneumonia but who did not fulfil accepted diagnostic criteria for pneumonia. Adults miscoded as having pneumonia (n=1251) were older compared with adults with CAP (n=6660) (median 80 vs 78 years, p<0.001) and had more comorbid disease, significantly fewer respiratory symptoms (fever, cough, dyspnoea, pleuritic pain), more constitutional symptoms (general deterioration, falls) and significantly lower 30-day inpatient mortality (14.3% vs 17.0%, adjusted OR 0.75, p=0.003). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Technetium-99m scan in the laparoscopic management of a misdiagnosed Meckel's diverticulum: a case report

    Directory of Open Access Journals (Sweden)

    Pitiakoudis Michael

    2009-04-01

    Full Text Available Abstract Introduction Although Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract and modern imaging techniques are available, its diagnosis remains problematic. Case presentation A technetium-99 scan was performed in an 18-year-old man with abdominal pain, vomiting and rectal bleeding to confirm the presence of a Meckel's diverticulum which was not diagnosed laparoscopically elsewhere. The technetium-99 scan was positive and a diagnostic laparoscopy was re-performed which revealed a Meckel's diverticulum that was subsequently resected. Conclusion We suggest that a technetium-99m scan should be performed before laparoscopy in children and adolescents with suspected Meckel's diverticulum. A positive technetium-99m scan may significantly contribute to the laparoscopic definitive diagnosis and treatment of a bleeding Meckel's diverticulum. However, diagnostic laparoscopy should only be performed by experienced surgeons.

  10. Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease

    Directory of Open Access Journals (Sweden)

    Randall J. Nett

    2012-01-01

    Full Text Available We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures.

  11. Dermatobia hominis misdiagnosed as abscesses in a traveler returning from Brazil to Denmark

    DEFF Research Database (Denmark)

    Olsen, Jonas; Nejsum, Peter; Jemec, Gregor Borut Ernst

    2017-01-01

    We present the case of a 62-year-old woman that consulted us for two boil-like lesions on her thighs after returning from a trip to São Paulo, Brazil, where she had swum in a freshwater lake. After consulting three specialist doctors and undergoing two antibiotic treatments, she was diagnosed...

  12. Ischemia-induced glomerular parietal epithelial cells hyperplasia: Commonly misdiagnosed cellular crescent in renal biopsy.

    Science.gov (United States)

    Zeng, Yeting; Wang, Xinrui; Xie, Feilai; Zheng, Zhiyong

    2017-08-01

    Ischemic pseudo-cellular crescent (IPCC) that is induced by ischemia and composed of hyperplastic glomerular parietal epithelial cells resembles cellular crescent. In this study, we aimed to assess the clinical and pathological features of IPCC in renal biopsy to avoid over-diagnosis and to determine the diagnostic basis. 4 IPCC cases diagnosed over a 4-year period (2012-2015) were evaluated for the study. Meanwhile, 5 cases of ANCA-associated glomerulonephritis and 5 cases of lupus nephritis (LN) were selected as control. Appropriate clinical data, morphology, and immunohistochemical features of all cases were retrieved. Results showed that the basement membrane of glomerulus with IPCC appeared as a concentric twisted ball, and glomerular cells of the lesion were reduced even entirely absent, and the adjacent afferent arterioles showed sclerosis or luminal stenosis. Furthermore, immune globulin deposition, vasculitis, and fibrinous exudate have not been observed in IPCC. While the cellular crescents showed diverse characteristics in both morphology and immunostaining in the control group. Therefore, these results indicated that IPCC is a sort of ischemic reactive hyperplasia and associated with sclerosis, stenosis, or obstruction of adjacent afferent arterioles, which is clearly different from cellular crescents result from glomerulonephritis. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Complications arising from a misdiagnosed giant lipoma of the hand and palm: a case report

    Directory of Open Access Journals (Sweden)

    Pagonis Thomas

    2011-11-01

    Full Text Available Abstract Introduction Lipomas are benign tumors which may appear in almost any human organ. Their diagnosis rate in the hand region is not known. Case Presentation We present the case of a 63-year-old Greek Caucasian woman with a giant lipoma of the hand and palm which was not initially diagnosed. After repeated surgical decompression of the carpal tunnel the patient was referred with persisting symptoms of median and ulnar nerve compression and a prominent mass of her left palm and thenar eminence. Clinical examination, magnetic resonance imaging, nerve conduction study and biopsy, revealed a giant lipoma in the deep palmar space (8.0 × 4.0 × 3.75 cm, which was also infiltrating the carpal tunnel. She had already undergone two operations for carpal tunnel syndrome with no relief of her symptoms and she also ended up with a severed flexor pollicis longus tendon. Definitive treatment was performed by marginal resection of the lipoma and restoration of the flexor pollicis longus with an intercalated graft harvested from the palmaris longus. Thirty months after surgery the patient had a fully functional hand without any neurological deficit. Conclusion Not all lipomas of the wrist and hand are diagnosed. Our report tries to emphasize the hidden danger of lipomas in cases with carpal tunnel symptoms. The need for a high index of suspicion in conjunction with good clinical evaluation and the use of appropriate investigative studies is mandatory in order to avoid unnecessary operations and complications. Marginal excision of these tumors is restorative.

  14. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. (Univ. of Alabama, Birmingham (USA))

    1991-07-01

    We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

  15. Chronic Elevation of Liver Enzymes in Acute Intermittent Porphyria Initially Misdiagnosed as Autoimmune Hepatitis

    Directory of Open Access Journals (Sweden)

    A. González Estrada

    2011-01-01

    Full Text Available Autoimmune hepatitis is a disease characterized by an elevation of liver enzymes, as well as specific autoantibodies. It is more common in women than men. We describe a 32-year-old woman with elevated transaminases, autoantibodies, and a liver biopsy result suggestive of autoimmune hepatitis. The indicated treatment was administered without showing a satisfactory response. The patient had a family history of acute intermittent porphyria (AIP so we decided to begin treatment with hematin, achieving a complete remission of the symptoms. Acute intermittent porphyria is a rare condition characterized by neurovisceral symptoms, abdominal pain being the most common of them. The disease has a higher prevalence among young women and certain European countries such as Sweden, Great Britain, and Spain. A correct diagnosis and prompt treatment are essential because patients affected by AIP must have a strict followup due to the fatal outcome of the outbreaks.

  16. A Case of Homocystinuria Misdiagnosed as Moyamoya Disease: A Case Report

    Science.gov (United States)

    Erol, Meltem; Gayret, Ozlem Bostan; Yigit, Ozgul; Serefoglu Cabuk, Kubra; Toksoz, Mehmet; Tiras, Mahir

    2016-01-01

    Introduction Homocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, including Moyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya disease who had been monitored for that for an extended period. The patient’s diagnosis was changed to homocystinuria as a result of lens subluxation and cataract findings. Case Presentation A 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. On metabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR. Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed. Conclusions In cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented. PMID:27330833

  17. Misdiagnosed HIV infection in pregnant women initiating universal ART in South Africa.

    Science.gov (United States)

    Hsiao, Nei-Yuan; Zerbe, Allison; Phillips, Tamsin K; Myer, Landon; Abrams, Elaine J

    2017-08-29

    Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few. We examined the accuracy of RDT diagnosis among HIV-infected pregnant women attending public sector antenatal services in Cape Town, South Africa. We describe the proportion of women found to have started on ART erroneously due to FP RDT results based on pre-ART viral load (VL) testing and enzyme-linked immunosorbent assay (ELISA). We analysed 952 consecutively enrolled pregnant women diagnosed as HIV infected based on two RDTs per local guideline and found 4.5% (43/952) of pre-ART VL results to be women who had detectable virus on subsequent VL measurements, ELISA was performed on the 37 remaining women. Of these, 3/952 (0.3%) HIV RDT diagnoses were found to be FP. We estimate that using ELISA to confirm all positive RDTs would cost $1110 (uncertainty interval $381-$5382) to identify one patient erroneously initiated on ART, while it costs $3912 for a lifetime of antiretrovirals with VL monitoring for one person. Compared to the cost of confirming the RDT-based diagnoses, the cost of HIV misdiagnosis is high. While testing programmes based on RDT should strive for constant quality improvement, where resources permit, laboratory confirmation algorithms can play an important role in strengthening the quality of HIV diagnosis in the era of universal ART.

  18. Oral Malignant Melanoma Initially Misdiagnosed as a Racial Pigmentation: A Case Report

    Directory of Open Access Journals (Sweden)

    Carla Patrícia Martinelli-Kläy

    2016-02-01

    Full Text Available Oral malignant melanoma (OMM is rare, representing less than 0.5% of all oral malignancies. The most affected sites are the palate and the maxillary gingiva. Histological examination is important to establish the diagnosis of any suspicious pigmented lesion in the oral cavity, mainly if a precise clinical diagnosis is not possible. We present one case of OMM that was initially diagnosed as a racial pigmentation elsewhere 2 years earlier. Clinical examination showed multiple macules and nodules located on the hard and soft palate, gingiva and superior alveolar mucosa. These lesions were painless and presented a color variation going from dark blue to black. Histological analysis showed sheets and nests of atypical melanocytes displaying a range of shapes such as plasmacytoid, epithelioid, and round cells, located in the superficial corium extending to the deep tissues. A few tumor cells contained variable amounts of melanin. There was no invasion of blood vessels or nerve fibers. Immunohistochemical analysis revealed that the neoplastic cells were positive for HMB-45, melan-A, S-100 and negative for AE1/AE3, confirming the diagnosis of melanoma. The Ki-67 labeling index was around 25%. The patient refused any treatment and died 11 months later.

  19. Terminal delirium misdiagnosed as major psychiatric disorder: Palliative care in a psychiatric inpatient unit.

    Science.gov (United States)

    Aligeti, Sabitha; Baig, Muhammad R; Barrera, Fernando F

    2016-06-01

    Delirium is a neuropsychiatric condition characterized by acute change in cognition and disturbance of consciousness. A similar state during the final days of life is termed "terminal delirium." We present three cases with end-stage chronic medical problems without any significant psychiatric history who were admitted to an inpatient psychiatric unit or a locked dementia unit for management of "depression," "dementia," or "psychosis." Early diagnosis of terminal delirium helps prevent patients, family members, and staff from undergoing severe emotional distress and facilitates appropriate end-of-life care.

  20. Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report.

    Science.gov (United States)

    Wang, Guangyao; Chen, Ping; Zong, Liang; Shi, Lei; Zhao, Wei

    2014-02-01

    Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm 3 solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers.

  1. Gastric schwannoma misdiagnosed as GIST: A case report with immunohistochemical and molecular study.

    Science.gov (United States)

    Tatangelo, Fabiana; Cantile, Monica; Collina, Francesca; Belli, Andrea; DE Franciscis, Silvia; Bianco, Franco; Botti, Gerardo

    2016-04-01

    Schwannomas are tumors derived from Schwann cells. Generally, they are benign and their typical site of origin is the subcutaneous tissue of the distal extremities or of the head and neck region. Gastrointestinal localization of schwannomas is extremely rare, and the stomach is the prevalent site. The present study describes the case of a gastric schwannoma in a 61-year-old male who underwent subtotal gastrectomy following a clinical diagnosis of a gastrointestinal stromal tumor (GIST). A histological, immunohistochemical and molecular study was performed to exclude the misdiagnosis of GIST. The histomorphological features of the lesion and absence of c-Kit and PDGFRA mutations indicated the diagnosis of gastric schwannoma.

  2. Misdiagnosing of malaria as RTI decreased after introduction of RDTs in rural areas of Kenya.

    Science.gov (United States)

    Mamova, Alexandra; Mikolasova, Gertruda; Krčméry, Vladimír; Mulera, Michaela

    2017-11-01

    Clinical presentation of malaria is highly variable and can be mistaken for number of other diseases, including respiratory tract diseases, which are associated with significant morbidity and mortality. However, presumptive management of fever as malaria can result in significant overdiagnosis, even in high-risk areas. Quality microscopy services for the diagnosis of malaria are not widely available in rural areas of Sub-Saharan Africa as well as in substandard conditions of low-income settings and the accuracy of microscopy is usually poor. The aim of the study was to determine how introduction of RDTs influenced diagnostics of malaria in high risk area of Eldoret, Kenya. Documentation of every patient was screened for data of current disease and diagnostic tools used. In patients with suspected malaria, either microscopy, or RDT or both were done to confirm the diagnosis. Initially, incidence of malaria was very high, about 50-70% of all visits in OPD due to any infectious condition. In 2010, when rapid diagnostic tests became available in Eldoret, decrease in incidence of malaria from 49% (2010) to 29% (2011) and further to 5.3% (2016) was noted. At the same time, increased incidence of upper and especially lower respiratory tract infections was noted. Results suggest that upper and lower respiratory tract infections were formerly diagnosed and treated as malaria. Other contributing factors, such as improvement of infrastructure and malaria preventive and treatment programs also play a role in decreasing malaria incidence in rural areas of Kenya, however, RDTs play a key role in proper diagnostics of malaria.

  3. Absent congenital cervical pedicle nearly misdiagnosed as a facet dislocation: A case report

    Directory of Open Access Journals (Sweden)

    Scott Safir

    2017-09-01

    Conclusion: In the acute trauma setting, congenital absent cervical pedicle can be difficult to differentiate from unilateral facet dislocation and may require the use of advanced imaging and close communication between the neurosurgery and radiology departments. Given the high morbidity and mortality involved in the repair of facet dislocation in a child, it is crucial to maintain high degree of clinical suspicion for absent spinal pedicle. In this case, the patient nearly underwent surgical intervention, but was ultimately able to be discharged home with no symptoms or deficits after correct diagnosis.

  4. Migration of Sparganum of the Frontal Lobe to the Ipsilateral Cerebellar Hemisphere: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Eun A; Choi, See Sung; Jeon, Se Jeong; Kim, Hey Won; Lee, Young Hwan [Wonkwang University Hopital, Iksan (Korea, Republic of)

    2009-05-15

    Most cerebral sparganosis lesions are located in the white matter of the cerebral hemisphere. A few cases of cerebral sparganosis where the sparganum have migrated into the contralateral cerebral hemisphere have been reported. We report a case of cerebral sparganosis where the sparganum migrated from the white matter of the left frontal lobe to the ipsilateral cerebellar hemisphere after failure of surgical removal of the worm

  5. Metastatic fungating ulcerative growth on vulva as a presenting feature of carcinoma cervix: A rare case report

    Directory of Open Access Journals (Sweden)

    Smriti Naswa

    2015-01-01

    Full Text Available Carcinoma of the cervix is the second to fourth most common malignancy in women. It metastasizes most often to the lungs, bones, and liver. Skin involvement originating from cervical cancer is rare, even in the terminal stages of the disease. Cutaneous metastasis of cervical cancer usually presents as cutaneous nodules, papules/plaques, maculopapular rash, and diffuse inflammatory rash. We report a rare case (only the second reported case to the best of our knowledge of a 50-year-old woman with cutaneous metastasis in form of fungating ulcerative growth on mons pubis as presenting feature of carcinoma cervix.

  6. A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin

    OpenAIRE

    Akpadjan, Fabrice; Ad?gbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; D?gbo?, B?r?nice; Agbessi, Nad?ge; Atadokp?d?, F?lix

    2017-01-01

    We report here a case of giant vulval condyloma in a two-year-old infant infected by her ?baby sitter? without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of ...

  7. A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin.

    Science.gov (United States)

    Akpadjan, Fabrice; Adégbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; Dégboé, Bérénice; Agbessi, Nadège; Atadokpèdé, Félix

    2017-01-01

    We report here a case of giant vulval condyloma in a two-year-old infant infected by her "baby sitter" without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient.

  8. Prognostic importance of human papillomavirus (HPV) and p16 positivity in squamous cell carcinoma of the vulva treated with radiotherapy.

    Science.gov (United States)

    Lee, Larissa J; Howitt, Brooke; Catalano, Paul; Tanaka, Cynthia; Murphy, Rita; Cimbak, Nicole; DeMaria, Rebecca; Bu, Paula; Crum, Christopher; Horowitz, Neil; Matulonis, Ursula; Viswanathan, Akila N

    2016-08-01

    HPV status is an important prognostic factor for patients with oropharyngeal, anal and cervical cancers treated with radiotherapy. This study evaluates the association between HPV and p16 status and outcome in a radiation-treated cohort with vulvar squamous cell carcinoma (SCC). Patients with vulvar SCC who received radiotherapy with or without surgical resection between 1985 and 2011 were identified retrospectively. Immunostaining for p16 and multiplex PCR for HPV genotyping were performed using archival tumor tissue from 57 patients. Actuarial estimates of PFS, OS and in-field recurrence were calculated using the Kaplan-Meier method. Cox proportional hazards models were used for multivariable analysis. Median follow-up was 58months among the 57 patients with an available tumor specimen. HPV prevalence was implied in 37% by (diffuse linear) p16 immunostaining and confirmed in 27% by HPV PCR with good agreement (κ=0.7). HPV-16 was identified in 80% of HPV-positive tumors. Women with p16-positive tumors had significantly higher 5-year PFS (65% vs. 16%, pHPV DNA status. In this study, the presence of HPV or its surrogate of p16 immunostaining was an independent prognostic factor for in-field relapse and survival in women with vulvar SCC treated with radiotherapy. This finding warrants validation in larger cohorts or the prospective setting. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Clinician’s Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva: The Dermatologist’s View

    Directory of Open Access Journals (Sweden)

    Freja Lærke Sand

    2017-01-01

    Full Text Available Correct and rapid diagnosis of skin tumours often requires biopsy and histopathological examination to differentiate benign lesions such as seborrhoeic keratoses or melanocytic naevi from premalignant and malignant lesions such as malignant melanoma. Particularly, to the untrained eye, any benign skin tumour—pigmented or nonpigmented—is easily mistaken for a malignant lesion. Qualified clinical evaluation is paramount in order to reduce the frequency of unwarranted skin biopsies. Herein, the most common benign, premalignant, and malignant vulvar skin tumours are reviewed.

  10. Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva

    DEFF Research Database (Denmark)

    Faber, Mette T; Sand, Freja Lærke; Albieri, Vanna

    2017-01-01

    used to identify studies published between 1990 and 2015 and using a PCR-based or hybrid capture test to evaluate the presence of HPV DNA in vulvar cancer or VIN. Pooled estimates of the HPV prevalence with corresponding 95% confidence intervals (CI) were calculated based on a random effects model...... of HPV in vulvar cancer was 39.7% (95% CI: 35.1–44.4%). Overall, 76.3% (95% CI: 70.1–82.1%) of VIN lesions tested HPV-positive, while the HPV prevalence in new subcategories of VIN, uVIN and dVIN, was 86.2% (95% CI: 73.5–95.5%) and 2.0% (95% CI: 0–10.0%), respectively. Substantial between...

  11. Unbalanced interchromosomal insertion diagnosed prenatally by FISH, with carrier mother, previously misdiagnosed as having a balanced reciprocal translocation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, M.T.; Leiber, E.; Qazi, Q. [and others

    1994-09-01

    Insertion translocations are rare. A carrier with a balanced insertion translocation is most likely to be detected through offspring with an unbalanced translocation. We with to report a case where a correct diagnosis, made prenatally with FISH, corrected the initial misdiagnosis of the mother in another institute. PDL received an amniotic fluid sample from a 28 y.o. woman (G5P2Sab1TOP1) at 19 wks gestation. The indications were a reported balanced translocation, t(6;13), in the mother and a previous daughter with an unbalanced translocation. Chromosome analysis of the amniocytes showed a female karyotype with an abnormal chr. 13. Since the mother was diagnosed as having t(6;13)(q21;q34), the der(13) in the amniocytes was initially assumed to result from an adjacent segregation of the t(6;13). However, the banding patterns of this abnormal chr. 13 did not fit into the above defined translocation. With FISH and a chr. 13 painting probe, this der(13) was painted in the proximal and the distal thirds, but NOT in the middle region. This indicates that the middle section of the der(13) must have originated from 6q. The banding pattern is compatible with a direct insertion of 6q15 to 6q23.3 into 13q21.2. Thus, the fetus has partial trisomy 6q. After counseling, the mother elected to terminate the pregnancy but later changed her mind. An 8 lb 12 oz baby girl was born at 36 wks. (mother diabetic). Chromosome analysis of the newborn blood confirmed the dx. The mother was studied, using multicolor painting probes for chromosomes 13 and 6, a balanced direct insertion of 6q15 to 6q23.3 into chr. 13q21.2 was clearly shown. The previous affected daughter with a 13q+ is now 4 y.o. (a restudy is planned). She has microcephaly, severe developmental delay and other dysmorphic features. This case illustrates the advantage of using FISH to arrive at a definitive diagnosis of an insertion translocation.

  12. Kikuchi-Fujimoto Disease Misdiagnosed as Relapse of the Infection after Treatment of Periprosthetic Hip Joint Infection.

    Science.gov (United States)

    Min, Kyung-Keun; Min, Byung-Woo; Lee, Kyung-Jae; Choi, Jung-Hoon

    2016-12-01

    Periprosthetic joint infection (PJI) of the hip can be difficult to treat and can lead to a number of problems including: i) severe functional decline of the hip joint and ii) increasing financial burden for patients due to long treatment periods and the need for repeated surgical interventions. Because there is risk of inadequate control of infection or relapse of a preexisting infection following the treatment of PJI through surgery, it is important to closely observe clinical symptoms such as systemic fever. Kikuchi-Fujimoto disease is usually a self-limiting disease characterized by fever and cervical lymphadenopathy. We report one case of Kikuchi-Fujimoto disease, with literatures review, that was mistaken for an infection relapse after surgical treatment of the PJI due to sustained fever postoperatively.

  13. Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis: an analysis of eight cases.

    Science.gov (United States)

    Aouba, A; Vuillemin-Bodaghi, V; Mutschler, C; De Bandt, M

    2004-12-01

    The crowned dens syndrome, related to microcrystalline deposition in the peri-odontoid articular and abarticular structures, is mainly responsible for acute or chronic cervical pain. We report eight cases of crowned dens syndrome with atypical presentations mimicking giant cell arteritis, polymyalgia rheumatica, meningitis or discitis. The clinical and radiological aspects of these cases are presented and discussed. For all patients, fever, cervical stiffness, headaches and biological inflammatory syndrome were reported. For three patients, impairment of general condition, occipito-temporal or mandible pain and weakness with inflammatory pain of the shoulder girdle was suggestive of giant cell arteritis and/or polymyalgia rheumatica, leading to temporal artery biopsy and/or long-term steroid treatment. Recurrence of clinical symptoms when tapering steroids was noted. In two cases, previous breast carcinoma led to the initial diagnosis of metastatic spondylitis. For three patients with vomiting, nausea and Kernig's and/or Brudzinski's sign, the first diagnosis was meningitis, leading to unhelpful lumbar puncture. In all cases, diagnosis of crowned dens syndrome once evoked, was confirmed by cervical CT scanning and dramatic improvement with non-steroidal anti-inflammatory drugs or colchicine. This under-recognized entity must be considered as a differential diagnosis of meningitis and discitis, but also of giant cell arteritis and polymyalgia rheumatica, as well as a possible aetiology for fevers of unknown origin. CT scanning is necessary for diagnosis. Clinicians should be aware of such misleading clinical presentations.

  14. A case report of a normal aorta misdiagnosed as type A dissection by modern multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, M.C.K. [Bristol Heart Institute, Bristol Royal Infirmary, Department of Radiology, Bristol (United Kingdom); Nightingale, A.K.; Stuart, A.G. [Bristol Heart Institute, Bristol Royal Infirmary, Department of Cardiology, Bristol (United Kingdom); Masey, S. [Bristol Heart Institute, Bristol Royal Infirmary, Department of Cardiac Anaesthesia, Bristol (United Kingdom); Angelini, G. [Bristol Heart Institute, Bristol Royal Infirmary, Department of Cardiac Surgery, Bristol (United Kingdom); Hopkins, R.; McGann, G. [Cheltenham Hospital, Department of Diagnostic Radiology, Cheltenham (United Kingdom)

    2010-08-15

    Computed tomography (CT) is generally considered the investigation of choice to exclude acute aortic syndrome. We report an important potentially disastrous misdiagnosis using a modern 32 slice multidetector CT system. (orig.)

  15. Adult onset asymmetric upper limb tremor misdiagnosed as Parkinson’s disease: A clinical and electrophysiological study

    Science.gov (United States)

    Schwingenschuh, Petra; Ruge, Diane; Edwards, Mark J; Terranova, Carmen; Katschnig, Petra; Carrillo, Fatima; Silveira-Moriyama, Laura; Schneider, Susanne A; Kägi, Georg; Dickson, John; Lees, Andrew J; Quinn, Niall; Mir, Pablo; Rothwell, John C; Bhatia, Kailash P

    2010-01-01

    Summary Approximately 10% of subjects thought clinically to have early Parkinson’s disease (PD) have normal dopaminergic functional imaging (SWEDDs – Scans Without Evidence of Dopaminergic Deficit). SWEDDs are a heterogeneous group. Here we aimed to delineate clinical and electrophysiological characteristics of a distinct subgroup of SWEDDs patients from PD and to clarify the underlying pathophysiology of this subgroup as a form of parkinsonism or dystonia. Therefore we compared clinical details of 25 patients referred with a diagnosis of tremor-dominant PD but with normal DaT SPECT scans (SWEDDs) with 12 tremor-dominant PD patients with abnormal DaT SPECT scans. We performed tremor analysis using accelerometry in the following patients with 1) SWEDDs, 2) PD, 3) primary segmental dystonia with dystonic limb tremor and 4) essential tremor (ET). We used transcranial magnetic stimulation with a facilitatory paired associative stimulation (PAS) paradigm to test if sensorimotor plasticity in SWEDDs resembled the pattern seen in PD, dystonia or ET. Although PD and SWEDDs patients shared several clinical features, the lack of true bradykinesia, occurrence of dystonia, and position- and task-specificity of tremor favoured a diagnosis of SWEDDs, whereas re-emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs as well as presence of nonmotor symptoms made PD more likely. Basic tremor parameters overlapped between SWEDDs, PD, segmental dystonia and ET. However, a combination of re-emergent tremor and highest tremor amplitude in the resting condition was characteristic of PD tremor, while SWEDDs, dystonia and ET subjects had the highest tremor amplitude during action. Both SWEDDs and segmental dystonia patients exhibited an exaggerated pattern of sensorimotor plasticity in response to the PAS paradigm, with spread of excitation to an adjacent hand muscle. In contrast, PD patients showed no response to PAS, and the response of ET patients was no different from controls. Taken together, these results may help differentiate these SWEDDs patients from PD and support our hypothesis that adult-onset dystonia is the underlying diagnosis in this sub-group of patients with SWEDDs. PMID:20131394

  16. Keratocystic odontogenic tumor of the maxilla-a serious entity often misdiagnosed: A report of two cases resembling dentigerous cysts

    Directory of Open Access Journals (Sweden)

    T K Rama Murthy

    2011-01-01

    Full Text Available The most common maxillary location for a keratocystic odontogenic tumor (KCOT is the canine region where they commonly are mistaken for an inflammatory radicular cyst or dentigerous cyst or a lateral periodontal cyst or even a nasopalatine cyst. This misdiagnosis occurs mainly because of the appearance of KCOT as a unilocular radiolucency in the maxilla, particularly if the KCOT is found coincidentally with a nonvital tooth. Additionally, the cyst is frequently infected producing pus that obscures the typical white cheesy material. A misdiagnosis based solely on clinical information can lead to the possibility of the patient being treated with a conservative endodontic therapy or even conservative surgical techniques thereby greatly increasing the chances of progression or recurrence of this aggressive lesion. Here, we report two such cases diagnosed and treated aggressively.

  17. Radiocontrast-Related Leukocytoclastic Vasculitis Misdiagnosed as Diabetic Foot Ulcer in a Type 2 Diabetic Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Barış Sarıakçalı

    2013-09-01

    Full Text Available The skin is the most affected tissue by many vasculitis syndromes. Leukocytoclastic vasculitis is the most common type of vasculitis syndrome and involves the small vessels. A long list of causative factors has been reported for leukocytoclastic vasculitis. Here, we present a type 2 diabetic patient who had purpuric skin lesions predominantly on the lower limbs and acute renal failure overriding to underlying chronic kidney disease due to leukocytoclastic vasculitis associated with radiocontrast administration. He was initially diagnosed as having diabetic foot ulcer at our outpatient clinic. After single dose betamethasone depot (9.6 mg i.m., skin eruptions paled and improved; renal function showed an improvement on the following days. There are few case reports on the relationship of radiocontrast agent with leucocytoclastic vasculitis. Our case had leukocytoclastic vasculitis due to radiocontrast agent exposure which is very rare in the literature. Turk Jem 2013; 17: 78-80

  18. Hepatoerythropoietic Porphyria Misdiagnosed as Child Abuse: Cutaneous, Arthritic, and Hematologic Manifestations in Siblings with a Novel UROD Mutation

    Science.gov (United States)

    Cantatore-Francis, Julie L.; Cohen, Jessica; Balwani, Manisha; Kahn, Philip; Lazarus, Herbert M.; Desnick, Robert J.; Schaffer, Julie V.

    2011-01-01

    Background Hepatoerythropoietic porphyria (HEP) is a rare autosomal recessive disorder resulting from the markedly deficient, but not absent, activity of the heme biosynthetic enzyme, uroporphyrinogen decarboxylase (UROD). HEP typically manifests during infancy or early childhood with extreme photosensitivity, skin fragility in sun-exposed areas, hypertrichosis, erythrodontia, and pink urine. Observations We describe three siblings, offspring of parents of Puerto Rican and Dominican descent, who presented with excessive scarring on the face and dorsal aspect of the forearms, which initially led to the erroneous suspicion of child abuse. Although these lesions were photodistributed, overt photosensitivity had not been observed, with the exception of a single episode of blistering and onycholysis following intense sun exposure in one affected child. Mild facial hypertrichosis, chronic anemia, polyarticular arthritis, and developmental delay represented additional findings. Biochemical studies of urine, plasma, and erythrocyte porphyrins from the affected siblings established the diagnosis of HEP. Sequencing of the UROD gene revealed compound heterozygosity for a novel missense mutation, V166A, and a complex deletion/insertion, 645del1053ins10. Conclusions Our report expands the phenotypic and genotypic spectrum of HEP, highlighting mild cutaneous presentations that can occur without obvious photosensitivity and potentially masquerade as child abuse. PMID:20479301

  19. Assembling a Functional Clitoris and Vulva from a Pseudo-Penis: A Surgical Technique for an Adult Woman with Congenital Adrenal Hyperplasia.

    Science.gov (United States)

    Tjalma, Wiebren A A

    2017-06-01

    Congenital adrenal hyperplasia (CAH) is associated with a genital deformation that might cause a negative body image. The genital ambiguity is generally "corrected" surgically during early infancy. The advantage is a psychological benefit. The disadvantages are multiple surgical procedures and the loss of orgasm. A 22-year-old woman with CAH consulted for genital reconstructive surgery. She had a pseudopenis of 4 cm and could achieve an orgasm by masturbating. During surgery, the penis was dismantled and with the preserved glans penis and the corpora cavernosa, a clitoris and vestibules were constructed, respectively. On the basis of the anamneses during the follow-up, she had a functional vagina and could still achieve orgasms. Genital correction surgery for CAH at an older age was easier, could be done in 1 step, and enabled the preservation of orgasm. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. Cancer of the vulva in a 25-year-old woman with VIN III and high-grade cervical SIL--case report.

    Science.gov (United States)

    González-Bosquet, E; Sunol, M; Hernandez, A; Callejo, J; Lailla, J M

    2007-01-01

    Human papillomavirus (HPV) infection is associated with an increase in intraepithelial lesions of the genital tract which are often multicentric. Following is a presentation of a case of vulvar cancer in a young woman (25 years of age) with multiple vulvar intraepithelial neoplasia (VIN III) lesions, a high-grade squamous intraepithelial cervical lesion, and a HPV type 16 infection at high risk of oncogenic transformation. This case offers an opportunity to discuss the risk factors that may favor the appearance of these lesions in young women, and their clinical management, diagnosis, and treatment.

  1. High-grade vulval intraepithelial neoplasia (VIN 3): a retrospective analysis of patient characteristics, management, outcome and relationship to squamous cell carcinoma of the vulva 1989-1999.

    Science.gov (United States)

    Sykes, Peter; Smith, Natasha; McCormick, Peter; Frizelle, Frank A

    2002-02-01

    To determine patient and disease characteristics, treatment patterns and long-term outcomes, in order to help direct management of patients with VIN 3, to examine the risk of development of cancer following a diagnosis of VIN 3 and the risk of recurrent disease requiring multiple treatment episodes, and to review patients with vulval cancer, in order to establish the relative prevalence of VIN 3 related vulval cancers. Retrospective chart review of 65 consecutive patients diagnosed with VIN 3 between 1989 and 1999. All patients diagnosed with VIN 3 at Christchurch Womens' Hospital (1 January 1989 to 31 December 1999) and Dunedin Public Hospital (1 January 1990 to 31 December 1999). Age at diagnosis, symptoms, medical history disease characteristics, treatment, outcome and follow-up. The median age at diagnosis was 38 years. Smokers were younger than non-smokers. Two-thirds had associated dysplasia of the lower genital tract, 43% had high-grade lesions. Seventy-nine per cent were symptomatic for a median of 9.5 months. All had macroscopically visible disease. Colposcopy and histology diagnoses correlated in 72% of cases. Treatment by local excision was undertaken in 84% of cases of which 65% had involved margins. Fifty-one per cent required further treatment, risk factors were positive margins and multifocal disease. Three developed micro-invasive cancer. Treatment by local excision is both diagnostic and therapeutic. Excision may reveal micro-invasive cancer, patients are usually symptomatic and VIN 3 has some potential to become invasive. Treated patients may develop microinvasive disease but frank invasion was not seen. The true rate of malignant progression in untreated patients remains unclear and radical surgery is rarely indicated. All patients require long-term follow up.

  2. [The role of reflectance confocal microscopy in the diagnosis of secondary syphilis of the vulva and anus: A first case report].

    Science.gov (United States)

    Leclercq, A; Cinotti, E; Labeille, B; Cribier, B; Biron, A C; Vermersch, C; Montlouis, J; Cambazard, F; Perrot, J L

    2016-11-01

    Herein we report the case of an 18-year-old pregnant patient presenting with plantar and ano-genital lesions of syphilis, pharyngitis, erythematosus and scalynasolabial intertrigo and angular cheilitis. In vivo reflectance confocal microscopy examination (Vivascope 3000(®); Caliber Inc, Rochester, NY, USA, distributed in France by Mavig, Munich) of ano-genital lesions enabled us to identify hyper-reflective elongated rods in the papillary dermis suggesting spirochetes. The diagnosis was confirmed by TPHA and VDRL as well as immunohistological examination. We identified for the first time rod shaped structures in ano-genital lesions of secondary syphilis, regularly alternating hyper-reflective and non-reflective areas corresponding to helix-shaped treponemes visualized by darkfield microscopy, which may not be confused with other cell structures. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. The Value of Optical Coherence Tomography in Determining Surgical Margins in Squamous Cell Carcinoma of the Vulva: A Single-Center Prospective Study

    NARCIS (Netherlands)

    Wessels, R.; Wessels, R.; van Beurden, M.F.B.; de Bruin, D.M.; Faber, D.J.; Vincent, A.D.; Sanders, J.; van Leeuwen, Ton; Ruers, Theo J.M.

    2015-01-01

    Background: Vulvar squamous cell carcinoma (VSCC) is treated with wide local excision. The challenge is to remove as much skin as necessary to prevent recurrence, but meanwhile preserve genital skin to diminish morbidity. Optical coherence tomography (OCT) is a noninvasive imaging tool that produces

  4. Infección VPH y lesión escamosa intraepitelial de la vulva en pacientes infectadas y no infectadas por el virus de la inmunodeficiencia humana /

    OpenAIRE

    Centeno Mediavilla, María Cristina,

    2017-01-01

    Objetivo: La lesión intraepitelial de alto grado (HSIL) vulvar es una enfermedad muy poco frecuente en la población general, lo que ha dificultado el conocimiento de su historia natural. Sabemos que tiene cierto potencial oncogénico, no cuantificado, y su manejo es difícil por la frecuencia de los fallos de tratamiento. Las pacientes infectadas por el virus de la inmunodeficiencia humana (VIH-positivas) tienen mayor riesgo de desarrollar lesiones precursoras y neoplasias asociadas al virus de...

  5. Hidden dangers revealed by misdiagnosed diabetic neuropathy: A comparison of simple clinical tests for the screening of vibration perception threshold at primary care level.

    Science.gov (United States)

    Azzopardi, Kurt; Gatt, Alfred; Chockalingam, Nachiappan; Formosa, Cynthia

    2017-10-10

    Diabetic peripheral neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of diabetic peripheral neuropathy results in fewer foot ulcers and amputations. The aim of this study was to compare different screening modalities in the detection of diabetic peripheral neuropathy in a primary care setting. A prospective non-experimental comparative multi-centre cross sectional study was conducted in various Primary Health Centres. One hundred participants living with Type 2 diabetes for at least 10 years were recruited using a convenience sampling method. The Vibratip, 128Hz tuning fork and neurothesiometer were compared in the detection of vibration perception. This study showed different results of diabetic peripheral neuropathy screening tests, even in the same group of participants. This study has shown that the percentage of participants who did not perceive vibrations was highest when using the VibraTip (28.5%). This was followed by the neurothesiometer (21%) and the 128Hz tuning fork (12%) (pneuropathy in patients with diabetes is crucial. This study demonstrates that some instruments are more sensitive to vibration perception than others. We recommend that different modalities should be used in patients with diabetes and when results do not concur, further neurological evaluation should be performed. This would significantly reduce the proportion of patients with diabetes who would be falsely identified as having no peripheral neuropathy and subsequently denied the benefit of beneficial and effective secondary risk factor control. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  6. Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

    Science.gov (United States)

    Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

    2013-01-01

    Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

  7. A case of mucinous cystic neoplasm of the pancreas misdiagnosed as a pancreatic pseudocyst at the initial exam and resected after a 2-year follow-up.

    Science.gov (United States)

    Ishikawa, Takuya; Haruta, Jun-Ichi; Yamaguchi, Takeo; Doisaki, Masao; Yama, Tsuyoki; Murate, Kentarou; Hattori, Shun; Hayakawa, Fumihiro; Yamada, Kenta; Yashika, Jun

    2015-04-01

    A 44-year-old woman was referred to our hospital because of a cystic lesion in the pancreatic body that was found by computed tomography (CT) as a result of a screening for impaired liver function after the patient presented with a high fever in 2011. Trans-abdominal ultrasonography (US) revealed a 33-mm unilocular cyst within the pancreatic body and a 5-mm hypoechoic mass in the pancreatic neck. Contrast-enhanced CT showed a slight enhancement around the cyst and a mild dilation of the main pancreatic duct, but neither septum nor nodule was detected inside. Contrast-enhanced endoscopic ultrasonography (CE-EUS) revealed a hyperechoic elevated lesion inside the cystic lesion without enhancement in the pancreatic body; CE-EUS also revealed a 5-mm homogeneous hypoechoic mass with a remarkable enhancement in the pancreatic neck with the use of Sonazoid(®) as a contrast medium. These lesions were diagnosed as a pancreatic pseudocyst and a neuroendocrine tumor (NET), respectively, and were followed up with periodic examinations. The cystic lesion showed contraction 6 months after the initial exam. However, US revealed an enlargement of the cystic lesion to 40 mm in diameter 2 years after the initial exam, and EUS showed irregular thickening of the wall with a cyst-in-cyst appearance. The diagnoses of a mucinous cystic neoplasm (MCN) and a concomitant small NET were made after a distal pancreatectomy. We herein report a rare case of MCN that showed various morphological changes over 2 years of observation.

  8. Analysis of Patients with Myelopathy due to Benign Intradural Spinal Tumors with Concomitant Lumbar Degenerative Diseases Misdiagnosed and Erroneously Treated with Lumbar Surgery.

    Science.gov (United States)

    Lu, Kang; Wang, Hao-Kuang; Liliang, Po-Chou; Yang, Chih-Hui; Yen, Cheng-Yo; Tsai, Yu-Duan; Chen, Po-Yuan; Chye, Cien-Leong; Wang, Kuo-Wei; Liang, Cheng-Loong; Chen, Han-Jung

    2017-09-01

    When a cervical or thoracic benign intradural spinal tumor (BIST) coexists with lumbar degenerative diseases (LDD), diagnosis can be difficult. Symptoms of BIST-myelopathy can be mistaken as being related to LDD. Worse, an unnecessary lumbar surgery could be performed. This study was conducted to analyze cases in which an erroneous lumbar surgery was undertaken in the wake of failure to identify BIST-associated myelopathy. Cases were found in a hospital database. Patients who underwent surgery for LDD first and then another surgery for BIST removal within a short interval were studied. Issues investigated included why the BISTs were missed, how they were found later, and how the patients reacted to the unnecessary lumbar procedures. Over 10 years, 167 patients received both surgeries for LDD and a cervical or thoracic BIST. In 7 patients, lumbar surgery preceded tumor removal by a short interval. Mistakes shared by the physicians included failure to detect myelopathy and a BIST, and a hasty decision for lumbar surgery, which soon turned out to be futile. Although the BISTs were subsequently found and removed, 5 patients believed that the lumbar surgery was unnecessary, with 4 patients expressing regrets and 1 patient threatening to take legal action against the initial surgeon. Concomitant symptomatic LDD and BIST-associated myelopathy pose a diagnostic challenge. Spine specialists should refrain from reflexively linking leg symptoms and impaired ability to walk to LDD. Comprehensive patient evaluation is fundamental to avoid misdiagnosis and wrong lumbar surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Lung Infarction due to Pulmonary Vein Stenosis after Ablation Therapy for Atrial Fibrillation Misdiagnosed as Organizing Pneumonia: Sequential Changes on CT in Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Mi Ri; Lee, Ho Yun; Cho, Jong Ho; Um, Sang Won [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered.

  10. Identification of three novel OA1 gene mutations identified in three families misdiagnosed with congenital nystagmus and carrier status determination by real-time quantitative PCR assay

    Directory of Open Access Journals (Sweden)

    Hamel Christian

    2003-01-01

    Full Text Available Abstract Background X-linked ocular albinism type 1 (OA1 is caused by mutations in OA1 gene, which encodes a membrane glycoprotein localised to melanosomes. OA1 mainly affects pigment production in the eye, resulting in optic changes associated with albinism including hypopigmentation of the retina, nystagmus, strabismus, foveal hypoplasia, abnormal crossing of the optic fibers and reduced visual acuity. Affected Caucasian males usually appear to have normal skin and hair pigment. Results We identified three previously undescribed mutations consisting of two intragenic deletions (one encompassing exon 6, the other encompassing exons 7–8, and a point mutation (310delG in exon 2. We report the development of a new method for diagnosis of heterozygous deletions in OA1 gene based on measurement of gene copy number using real-time quantitative PCR from genomic DNA. Conclusion The identification of OA1 mutations in families earlier reported as families with hereditary nystagmus indicate that ocular albinism type 1 is probably underdiagnosed. Our method of real-time quantitative PCR of OA1 exons with DMD exon as external standard performed on the LightCycler™ allows quick and accurate carrier-status assessment for at-risk females.

  11. Non-lesions, Misdiagnoses, Missed Diagnoses, and Other Interpretive Challenges in Fish Histopathology Studies: A Guide for Investigators, Authors, Reviewers, and Readers

    Science.gov (United States)

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negativ...

  12. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies-A guide for investigators, authors, reviewers, and readers

    Science.gov (United States)

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publish...

  13. Focal epithelial hyperplasia by human papillomavirus (HPV)-32 misdiagnosed as HPV-16 and treated with combination of retinoids, imiquimod and quadrivalent HPV vaccine.

    Science.gov (United States)

    Gemigniani, Franco; Hernández-Losa, Javier; Ferrer, Berta; García-Patos, Vicente

    2015-12-01

    Focal epithelial hyperplasia (FEH) or Heck's disease is a rare, benign and asymptomatic mucosal proliferation associated with human papillomavirus (HPV) infection, mainly with genotypes 13 and 32. We report a florid case of FEH in an 11-year-old Haitian girl with systemic lupus erythematosus receiving immunosuppressive therapy. Cryotherapy was previously performed on numerous occasions with no results. We decided to prescribe a non-invasive and more comfortable treatment. A combination of topical retinoid and imiquimod cream was well tolerated and led to an important improvement. The evidence of infection by HPV-16 detected by polymerase chain reaction (PCR) technique, prompted us to prescribe the quadrivalent HPV vaccine (types 6, 11,16 and 18). Subsequent PCR sequencing with generic primers GP5-GP6 and further BLAST comparative analysis confirmed that genomic viral sequence in our case truly corresponded with HPV-32. This molecular misdiagnosis can be explained by the similarity between genomic sequences of both HPV-16 and -32 genotypes. At the 1-year follow up, we observed total clinical improvement and no recurrences of the disease. Complete healing in this case may correspond to a potential action of topical retinoid, imiquimod and the cross-protection mechanism of the quadrivalent HPV vaccine. © 2015 Japanese Dermatological Association.

  14. Cylindroma of the breast in a 72-year-old woman with fibrocystic disease first misdiagnosed as a malignant lesion in imaging studies.

    Science.gov (United States)

    Taghipour, Shokouh; Shiryazdi, Seyed Mostafa; Sharahjin, Naser Sefidrokh

    2013-06-12

    Cylindroma is a benign skin adnexal tumour with apocrine and trichoepitheliomatous differentiation that is rarely seen in the breast. Here, we report a case of cylindroma in the subareolar region of the left breast in a 72-year-old woman who presented with a palpable mass. Ultrasound and mammographic reports of the lesion were considered probably malignant. An ultrasound-guided core needle biopsy was performed and the patient underwent wide local excision with axillary lymph nodes biopsy. Immunohistochemistry and histopathological studies confirmed cylindroma with fibrocystic changes in uninvolved parenchyma.

  15. The importance of genetic testing as demonstrated by two cases ofCACNA1F-associated retinal generation misdiagnosed as LCA.

    Science.gov (United States)

    Men, Clara J; Bujakowska, Kinga M; Comander, Jason; Place, Emily; Bedoukian, Emma C; Zhu, Xiaosong; Leroy, Bart P; Fulton, Anne B; Pierce, Eric A

    2017-01-01

    To describe in detail cases with an initial diagnosis of Leber congenital amaurosis that were later found to have a hemizygous mutation in the CACNA1F gene. The patients underwent a detailed ophthalmological evaluation and full-field electroretinography (ERG). Selective targeted capture and whole-exome next-generation sequencing (NGS) were used to find the disease-causing mutations. Patient 1 presented at age 3 months with nystagmus, normal visual attention, and a normal fundus exam. ERG responses were severely decreased. Patient 2 presented with nystagmus, severe hyperopia, esotropia, and visual acuity of 20/360 oculus dexter (OD) and 20/270 oculus sinister (OS) at age 5 months. His fundus exam showed slightly increased pigmentation around the foveae. The scotopic ERG responses were severely decreased and photopic responses mildly decreased. Based on the initial presentation, both patients received the clinical diagnosis of Leber congenital amaurosis (LCA). However, genetic testing showed no mutations in known LCA genes. Instead, broader genetic testing using NGS showed point mutations in the CACNA1F gene, which is reported to be associated with type 2 congenital stationary night blindness (CSNB2). These two cases demonstrate the clinical overlap between LCA and CSNB in infants and young children. Genetic testing is an essential tool in these cases and provides a more accurate diagnosis and prognosis for patients with inherited retinal degenerative disorders.

  16. Preliminary observation of genital secretions, growth rate and ...

    African Journals Online (AJOL)

    The doe attained puberty at age 11weeks (2months 3weeks). At this age, reproductive activities commenced in the doe with a slight opening of the vulva and the presence of colourless mucous fluid in the vagina. At 11weeks, the vulva was opened for 3weeks plus 6days and by the 4th week the crust had covered the vulva.

  17. Neoplasia intra-epitelial grau III da vulva e da região perianal tratada com vulvectomia superficial: relato de caso High-grade vulvar and perianal intraepithelial neoplasia treated with skinning vulvectomy: a case report

    Directory of Open Access Journals (Sweden)

    Walquíria Quida Salles Pereira Primo

    2003-05-01

    Full Text Available A neoplasia intra-epitelial vulvar grau III (NIV III se manifesta de modo visível, portanto, acessível à biópsia e, por conseguinte, ao diagnóstico histológico. Há duas formas precursoras do câncer vulvar: a NIV associada ao papiloma vírus humano (HPV e a NIV associada ao líquen simples crônico, hiperplasia de células escamosas e líquen escleroso, não tratados. Porém, pode existir sobreposição das duas formas. O termo papulose bowenóide, apesar de ser desencorajado, define uma das formas clínicas da NIV, que se apresenta como lesões pigmentadas, verruciformes, papulares e múltiplas. A NIV III está associada com HPV em mais de 80% dos casos e em 40% das vezes, nota-se envolvimento perianal. O seu tratamento é muito difícil e pode ocorrer recorrência em qualquer tempo e por muitos anos. Embora não exista tratamento padrão definido, os trabalhos apontam para a cirurgia, respeitando margem de segurança, como o mais adequado.High-grade vulvar intraepithelial neoplasia (VIN III is a visible lesion; therefore, it is accessible to biopsy and thus, to a histological diagnosis. There are two forms of vulvar cancer precursors: VIN caused by human papillomavirus (HPV and VIN associated with untreated lichen simplex chronicus, squamous cell hyperplasia, and lichen sclerosus. There may be overlap of the two forms. The term bowenoid papulosis, although discouraged, identifics a clinical form of VIN III. Such lesion appears as pigmented, wart-like growths or papules. VIN III is associated with HPV in more than 80% of the cases, and there is perianal involvement in 40% of the times. Vulvar intraepithelial neoplasia is difficult to cure and relapses can occur at any time for many years. Although there is no defined standard treatment, studies point to surgery, respecting a free margin, as the most adequate one.

  18. The catholic taste of broad tapeworms multiple routes to human infection

    Czech Academy of Sciences Publication Activity Database

    Waeschenbach, A.; Brabec, Jan; Scholz, Tomáš; Littlewood, D. T. J.; Kuchta, Roman

    2017-01-01

    Roč. 47, č. 13 (2017), s. 831-843 ISSN 0020-7519 R&D Projects: GA ČR GAP506/12/1632 Institutional support: RVO:60077344 Keywords : Diphyllobothriidea * Diphyllobothriosis * Phylogeny * Sparganosis * Systematics * Taxonomic revision * Mitochondrial * Nuclear Subject RIV: EG - Zoology Impact factor: 3.730, year: 2016

  19. Redescription of Paratylenchus bukowin-ensis Micoletzky, 1922 (Criconematoidea)

    NARCIS (Netherlands)

    Loof, P.A.A.; Oostenbrink, M.

    1968-01-01

    Paratylenchus bukowinensis, the type species of the genus, is redescribed from Wageningen, the Netherlands. The main characters include the spear length of 24 mu , spear knobs of typical Paratylenchus shape, vulva with small but distinct plates, vagina directed slightly anteriad from vulva. There

  20. Impaired removal of H3K4 methylation affects cell fate determination and gene transcription

    DEFF Research Database (Denmark)

    Lussi, Yvonne C; Mariani, Luca; Rundsten, Carsten Friis

    2016-01-01

    genetic locus, a direct RBR-2 target gene required for vulva precursor cell fate acquisition, shows that RBR-2 controls the epigenetic signature of the lin-11 vulva-specific enhancer and lin-11 expression, providing in vivo evidences that RBR-2 can positively regulate transcription and cell fate...

  1. Morphometric changes following pregnancy in large white sows ...

    African Journals Online (AJOL)

    ... the different sections of the teat and circumference of the vulva of pregnant and non-pregnant sows. On the other hand the length of vulva in the pregnant and non-pregnant sows were not significantly different. Keywords: Pig; sow; pregnancy; large white. Animal Production Research Advances Vol. 2 (3) 2006: pp 189-193 ...

  2. Granuloma inguinale (donovanosis) South Africa

    African Journals Online (AJOL)

    1983-04-16

    Apr 16, 1983 ... malignant tumours involving the cervix in 194 cases, the vulva in ... the vulva. She was treated with 8 ml penicillin. Six days later, biopsy revealed granuloma inguinale. There is no record of further therapy or follow-up. Case 6 ... nism has never been cultured directly from a lesion onto artificial media.

  3. Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infections Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Weung; Kim, Chang Guhn; Park, Soon Ah; Jung, Sang Ah [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2010-06-15

    Dual time point FDG PET imaging (DTPI) has been considered helpful for discrimination of benign and malignant disease, and staging lymph node status in patients with pulmonary malignancy. However, DTPI for benign disease has been rarely reported, and it may show a better description of metabolic status and extent of benign infection disease than early imaging only. The authors report on the use F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging with additional delayed imaging on a 52-year-old man with sparganosis and a 70-year-old man with tuberculous meningitis. To the best of our knowledge, this is the first report on dual time point PET/CT imaging in patients with cerebral sparganosis and tuberculous meningitis.

  4. Immunoproteomic Analysis of the Excretory-Secretory Proteins from Spirometra Mansoni Sparganum

    Directory of Open Access Journals (Sweden)

    Zhong Quan Wang

    2013-09-01

    Full Text Available Background: Sparganosis is caused by the invasion of Spirometra sparganum into various tissues/organs. Subcutaneous sparganosis can be diagnosed by biopsy, while visceral/cerebral sparganosis is not easy to be diagnosed. The diagnosis de­pends largely on the detection of specific anti-sparganum antibodies. The specific­ity of the ELISA could be increased by using S. mansoni sparganum excretory–secre­tory (ES antigens, but it also had the cross-reactions with sera of patients with cysticercosis or paragonimiasis. The aim of this study was to identify early specific diagnostic antigens in S. mansoni sparganum ES proteins.Methods: The sparganum ES proteins were analyzed by two-dimensional electrophore­sis (2-DE and Western blot probed with early sera from infected mice at 14 days post-infection. The immunoreactive protein spots were characterized by MALDI-TOF/ TOF-MS.Results: A total of approximately 149 proteins spots were detected with isoelectric point (pI varying from 3 to 7.5 and molecular weight from 20 to 115 kDa and seven protein spots with molecular weight of 23-31 kDa were recognized by the infection sera. Three of seven spots were successfully identified and characterized as the same S. mansoni protein (cysteine protease, and the proteins of other 4 spots were not included in the databases.Conclusion: The cysteine protease from S. mansoni ES proteins recognized by early infection sera might be the early diagnostic antigens for sparganosis.

  5. Czerniak złośliwy sromu z przerzutami do cewki moczowej u 64-letniej pacjentki – opis przypadku

    Directory of Open Access Journals (Sweden)

    Paweł Basta

    2011-06-01

    Full Text Available Melanoma of the vulva comprises around 3-4% of all melanoma cases in women, very rarely appearing before the age of 50. It belongs to the group of rare tumours in this location, comprising 8-10% of vulva tumours, and the estimated frequency of vulvar melanoma occurrence is 0.10/100 000 women-years. Among the factors that can predispose to developing melanoma of the vulva, we can distinguish chronic inflammatory diseases, virus infections (including HPV virus, factors causing vulva irritation and genetic susceptibility.The majority of melanomas of the vulva develop “de novo”, but they can also develop on the basis of previously existing pigmentary birthmarks. Most frequently, during physical examination pigmentary changes in the area of the vulva are found. However, in around 30% of cases melanoma does not have pigmentary traits. The depth of infiltration (invasion is the crucial prognostic histological factor in melanoma. The treatment is based on surgery, the extent of which depends on the stage of tumour advancement. Supplemental treatment makes use of interleukin-2, interferon alpha, dacarbazine or paclitaxel with cisplatin or carboplatin. The case of a 64-year-old female patient with melanoma of the vulva area, who despite surgical treatment based on partial excision of the vulva with lymph glands and keeping a margin of healthy tissues, as well as supplemental therapy with interferon alpha, and who after a year was diagnosed with reoccurrence of the tumour in the area of the distal part of the urethra, is presented below. Continuation of the treatment is based on surgical excision of the front part of the vulva together with the distal part of the urethra and adjuvant chemotherapy treatment according to the docetaxel/carboplatin combination.

  6. Case report

    African Journals Online (AJOL)

    2012-11-13

    Nov 13, 2012 ... Key words: Ectopic breast tissue, vulva, lactating adenoma, fibroadenoma, pathology ... The mass was excised, and histology confirmed vulvar lactating adenoma ... The presence of ectopic mammary tissue of normal.

  7. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... Viewing of the cervix, vulva, or vagina under magnification with an instrument called a colposcope. Conization: A ... the cervix and vagina and examined under a microscope. Squamous Intraepithelial Lesion (SIL): A term used to ...

  8. Cervical cancer -- screening and prevention

    Science.gov (United States)

    ... available to protect against the HPV types that cause most cervical cancer in women. The vaccine is: Given as a ... neoplasia of the lower genital tract (cervix, vulva): etiology, screening, ... Cervical Pathology, and American Society for Clinical Pathology screening ...

  9. Disease: H00944 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Hryncewicz-Gwozdz A, Burgdorf W ... TITLE ... Dowling-Degos disease: case report an...g the vulva and back: case report and review of the literature. ... JOURNAL ... Dermatol Online J 17:1 (2011) ...

  10. General Information about Vulvar Cancer

    Science.gov (United States)

    ... bones that becomes covered with hair at puberty ). Perineum (the area between the vulva and the anus ). ... outer lips of the vagina, vaginal opening, and perineum. Vulvar cancer most often affects the outer vaginal ...

  11. 21 CFR 884.5390 - Perineal heater.

    Science.gov (United States)

    2010-04-01

    ... contact, or indirectly from a radiant source, to the surface of the perineum (the area between the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the...

  12. Medications for Pain Relief during Labor and Delivery

    Science.gov (United States)

    ... that carry feeling to the vagina , vulva , and perineum . Local anesthetics provide relief from pain in these ... spine. Episiotomy: A surgical incision made into the perineum (the region between the vagina and the anus) ...

  13. Download this PDF file

    African Journals Online (AJOL)

    1011 ®)- The. (Udoh, 1981). vulva] lips were parted and: a sterile guarded. Swab (Medical wire and equip Co. Corsham. Samplecollection England) was pushed into the vagina and. Samples were taken from a total of 103 does in rotated.

  14. Violence against Women

    Science.gov (United States)

    ... setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or ... gender equality by: ending discrimination against women in marriage, divorce and custody laws ending discrimination in inheritance ...

  15. Peripheral Female Genital Arousal as Assessed by Thermography Following Topical Genital Application of Alprostadil vs Placebo Arousal Gel: A Proof-of-Principle Study Without Visual Sexual Stimulation

    Directory of Open Access Journals (Sweden)

    Sue W. Goldstein, BA, CCRC, IF

    2016-09-01

    Conclusion: Topical alprostadil administered to healthy premenopausal women induced statistically significant, sustained increases in genital temperatures of the vestibule, clitoris, and vulva within 20 minutes compared with OTC lubricant.

  16. Características ecocardiográficas da cardiomiopatia não-compactada: diagnóstico perdido ou errôneo Características ecocardiográficas de la miocardiopatía no compactada: diagnóstico perdido o erróneo Echocardiographic features of non-compaction cardiomyopathy: missed and misdiagnosed disease

    Directory of Open Access Journals (Sweden)

    Francisco Martínez-Baca López

    2009-08-01

    Full Text Available A cardiomiopatia não-compactada é uma doença rara, anatomicamente caracterizada por um padrão trabecular proeminente e recessos intra-trabeculares profundos. Suas manifestações clínicas incluem disfunção ventricular grave arritmias, embolismo sistêmico e morte súbita. Nesse estudo, dois casos de pacientes de idades diferentes com cardiomiopatia não-compactada são descritos: uma criança do sexo masculino em idade escolar, cuja patologia estava associada com estenose mitral e regurgitação e um paciente adulto do sexo feminino, com 50 anos de idade e histórico de hipertensão arterial e insuficiência cardíaca.La miocardiopatía no compactada es una enfermedad rara, anatómicamente caracterizada por un patrón trabecular prominente y recesos intertrabeculares profundos. Sus manifestaciones clínicas incluyen disfunção ventricular gravem arritmias, embolismo sistémico y muerte súbita. En este estudio se describen dos casos de pacientes de edades diferentes con miocardiopatía no compactada: un niño de sexo masculino en edad escolar, cuya patología estaba asociada a estenosis mitral y regurgitación, y un paciente adulto del sexo femenino, con 50 años de edad e historia de hipertensión arterial e insuficiencia cardíaca.Non-compaction cardiomyopathy is a rare disease, anatomically characterized by a prominent trabecular pattern and deep intertrabecular recesses. Its clinical manifestations include severe left ventricular dysfunction, arrhythmias, systemic embolism, and sudden death. In this report, two cases of patients of different ages with non-compaction cardiomyopathy are described: a male schoolboy whose pathology was associated with mitral stenosis and regurgitation and a 50-year-old female with history of high blood pressure and cardiac failure.

  17. Magnetic resonance imaging of vaginal and vulval pathology

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, N.; Grant, L.A.; Sala, E. [Addenbrooke' s Hospital, Department of Radiology, Box 219, Cambridge (United Kingdom)

    2008-06-15

    There are a number of conditions affecting the vagina and vulva that can be optimally assessed with the use of high-resolution magnetic resonance imaging (MRI). This paper gives a suggested protocol for MRI technique and sequences for imaging the pelvis and perineum and reviews the MRI appearances of many of the common pathologies affecting the vagina and vulva. Congenital anomalies, inflammatory and neoplastic entities such as vaginal and vulval carcinoma are discussed, with rarer malignancies also reviewed. (orig.)

  18. Impedance pattern of vaginal and vestibular mucosa in cyclic goats

    Directory of Open Access Journals (Sweden)

    Ivo Křivánek

    2008-01-01

    Full Text Available The changes of vaginal and vestibular impedance during the oestrous cycle in goats were examined. The onset of oestrus was teased with a buck once a day during the experiment. Impedance was mea­sured by a four-terminal method. The vaginal impedance was recorded under slight pressure of electrodes to the vaginal dorsal wall at the cervix. The vestibular impedance was recorded under slight pressure of electrodes to the vestibular dorsal wall 5 cm from the vulva and at the vulva. The im­pe­dan­ce was measured once a day from 4 days before the expected oestrus to 6 days after onset of oestrus. The vaginal impedance at the cervix decreased during pro-oestrus (P < 0.01 and increased du­ring oestrus (P < 0.01. The vestibular impedance 5 cm from the vulva decreased during pro-oestrus (P < 0.01 and increased after oestrus (P < 0.01. The decrease of vaginal impedance during peri-oestrus was nearly twofold in comparison with the vestibular impedance 5 cm from the vulva. No sig­ni­fi­cant decrease of the vestibular impedance at the vulva was found during the oestrous cycle. The results indicate that the vaginal impedance at the cervix and vestibular impedance 5 cm from the vulva measured by means of a four-terminal method during the oestrous cycle display cyclic changes that are closely related to the oestrous behaviour of goats.

  19. Prevalence of Spirometra mansoni in dogs, cats, and frogs and its medical relevance in Guangzhou, China.

    Science.gov (United States)

    Hong, Qing; Feng, Jieping; Liu, Haijuan; Li, Xiaomin; Gong, Lirong; Yang, Zhen; Yang, Weiming; Liang, Xiongfa; Zheng, Rujiang; Cui, Zhicai; Wang, Weiliang; Chen, Daixiong

    2016-12-01

    Sparganosis is an important parasitic disease in Guangzhou and is mainly acquired through the consumption of frog meat or contact with fresh frogs infected by larval stages (spargana) of the tapeworm species Spirometra mansoni. In this study, the prevalence of intestinal S. mansoni infections (with adult parasites) in dogs and cats and of extraintestinal S. mansoni infections (with spargana) in frogs was assessed. In addition, a questionnaire survey was carried out among residents in Guangzhou City in order to evaluate their awareness about the medical and epidemiological relevance of Spirometra and sparganosis. In total, the feces of 229 dogs and 116 cats were examined for eggs, and 1949 frogs were examined for spargana. Sixty-three dogs (27.5%) and 47 cats (40.5%) had eggs in their feces. Two hundred and sixteen out of 416 wild Rana tigrina rugulosa Wiegmann frogs examined were sparganum-positive, with an infection rate of 51.9%, while the infection rate in Rana limnocharis Boie was 35.1% (13/37). None of the tested farmed frogs (including R. tigrina rugulosa and Rana catesbeiana) was positive (0/1382). Analysis of the questionnaire revealed the following results: (1) about 41.0% of residents in Guangzhou had some knowledge of sparganosis or sparganum infection, and information in TV programs was the most important way that residents learned about sparganosis. (2) About 59.9% of the residents ate frog meat. Eating the meat, viscera, or blood of animals, e.g., frogs, snakes, pigs, chicken, mice, and birds, in an improper way might be the main means by which residents acquire the infection. (3) The risk of sparganum infection was higher in males than in females. A high sparganum infection rate was observed in the wild frogs sold in agricultural product markets in Guangzhou. The infection was also serious in cats and dogs in Guangdong Province. With lifestyles and eating habits resulting in sparganum infection, it is necessary to focus on market management and

  20. Pentastomiasis and other parasitic zoonoses from reptiles and amphibians.

    Science.gov (United States)

    Pantchev, Nikola; Tappe, Dennis

    2011-01-01

    Reptiles are growing in popularity as pets.The colonization of reptiles and amphibians by parasites and the resulting disease conditions are the most common problems seen in captive animals.This review focuses on pentastomiasis and sparganosis, important parasitic zoonoses of reptiles and amphibians, respectively, and free living-amoebae. Humans are suitable accidental hosts for some pentastomid species (particularly Armillifer and Porocephalus). In geographical areas with special ethnics, such as in West and Central Africa, and East Asia, 8-45% of the human population can be affected. Usually the larvae are coincidentally found during abdominal surgeries. However, fatalities have been described. Extreme caution is necessary when handling infected reptiles. Ocular or cerebral sparganosis is not uncommonly found in humans in East Asia. This disease is caused by spargana, tapeworm larvae (plerocercoids) of Spirometra sp. The infection occurs when uncooked meat from reptiles or amphibians is applied to wounds or eyes and the parasites migrate directly to human tissue, or by consumption of contaminated food or water. As a consequence of the reptile's predatory behaviour, the full spectrum of endo- and ectoparasites from potential prey animals can be found as transiting parasites in the intestinal tract, e. g. Hymenolepis nana, Cryptosporidium (C.) muris, C parvum or Capillaria hepatica. Occasionally, free-living amoebae are also found in reptile faeces (Acanthamoeba, Naegleria, Hartmanella, Vahlkampfia or Echinamoeba sp.).

  1. MOLECULAR EVIDENCE OF SPIROMETRA ERINACEIEUROPAEI INFECTION IN SNAKES PTYAS KORROS FROM LAO PDR AND THAILAND AND FROGS HOPLOBATRACHUS RUGULOSUS FROM MYANMAR.

    Science.gov (United States)

    Jongthawin, Jurairat; Intapan, Pewpan Maleewong; Sanpool, Oranuch; Sadaow, Lakkhana; Laymanivong, Sakhone; Thanchomnang, Tongjit; Maleewong, Wanchai

    2014-11-01

    Sparganosis is a parasitic disease in humans and animals caused by plerocercoid larvae (spargana) of the genus Spirometra. Spirometra erinaceieuropaei is the major causative agent of the disease in Asian countries. However, molecular evidence of the causative parasite species in animals remains lacking. A total of 19 spargana specimens were obtained from frogs, Hoplobatrachus rugulosus, collected from Myanmar and snakes, Ptyas korros, from Lao PDR and Thailand. A partial sequence of mitochondrial cytochrome c oxidase subunit1 gene (cox1) was amplified, sequenced, and the phylogenetic relationship was constructed using maximum likelihood method. Results revealed that the level of nucleotide variations in the partial cox1 sequence (429 bp) among the spargana ranged 0-3.5%, with 15 variable sites. Phylogenetic analysis indicated that all spargana specimens were S. erinaceieuropaei. This is the first report of S. erinaceieuropaei in P. korros from Lao PDR and Thailand and H. rugulosus from Myanmar. The results emphasize the need for prevention and control of sparganosis in these regions.

  2. Spirometra (Pseudophyllidea, Diphyllobothriidae) severely infecting wild-caught snakes from food markets in Guangzhou and Shenzhen, Guangdong, China: implications for public health.

    Science.gov (United States)

    Wang, Fumin; Li, Weiye; Hua, Liushuai; Gong, Shiping; Xiao, Jiajie; Hou, Fanghui; Ge, Yan; Yang, Guangda

    2014-01-01

    Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January-August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0∼96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans.

  3. Audit of fibroepithelial tumors of the breast in a Nigerian tertiary ...

    African Journals Online (AJOL)

    Conclusion: These results show that FAs are rarely misdiagnosed. The three cases misdiagnosed as phyllodes may have been prevented if standard data sets were in use. Cases simply referred to as PT without further classification, limit the patients' access to appropriate management as accurate classification helps in the ...

  4. Laser-induced synlabia, cryptomenorrhea, and urine retention: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Thoraya Fadul-Elahi

    2017-01-01

    Full Text Available Cosmetic laser use has many pros and cons. The worldwide use of laser for body hair removal has led to many medical complications. Unsupervised use of the laser for hair removal in vulva may result in many problems and can merely damage the vulva, although rarely, affecting the body image. This rare and novel case report is a 21 year old virgin who presented with acute urinary retention and cryptomenorrhea due to complete synlabia secondary to unsupervised vulval laser hair removal. The urinary retention was relieved by suprapubic catheterization initially. During examination under anesthesia, the fused labia were separated by a surgical incision with drainage of hematocolpos and then, a Foley's urethral catheter was inserted. She had an uneventful recovery. We report this case to emphasize on the supervised use of laser by trained and qualified personnel for hair removal in vulva to minimize its complications.

  5. Non-sexually related acute genital ulcers in a pubertal girl

    Directory of Open Access Journals (Sweden)

    Jae Kyung Kim

    2017-07-01

    Full Text Available Acute genital ulcers (AGU, also known as acute vulvar ulcers or Lipschütz ulcers, is an uncommon, non-sexually transmitted condition characterized by the sudden onset of painful necrotic ulcerations of the vulva or lower vagina. Their aetiology and pathogenesis are still unknown. They may be preceded by influenza-like symptoms, such as fever, headache or respiratory symptoms. We presented a case of pubertal girl with multiple painful ulcers on the vulva who visited our hospital. Other causes of vulvar ulcers were excluded by history taking, laboratory tests, and skin biopsy. We presented a case report of pubertal girl with nonsexually related AGU.

  6. Fibrocystic disease of vulvar ectopic breast tissue. Case report and review of the literature.

    Science.gov (United States)

    Baykal, C; Tulunay, G; Usubutun, A; Küçükali, T; Ozer, S; Demir, O F

    2004-01-01

    Mammary glands located in the vulvar region have been named as ectopic breast tissue or anogenital mammary glands by different authors. Literature on pathologies of ectopic breast tissue located in the vulvar region is rare. Most of the reports are about the malignancies arising from this ectopic tissue. We report a case of fibrocystic disease of the mammary glands in the vulva in a 25-year-old pregnant woman. Her disease was exaggerated during pregnancy. Ectopic breast tissue in the vulva is a rare entity and fibrocystic disease of this tissue has rarely been reported in the English literature. Copyright (c) 2004 S. Karger AG, Basel.

  7. Twitter Influenza Surveillance: Quantifying Seasonal Misdiagnosis Patterns and their Impact on Surveillance Estimates.

    Science.gov (United States)

    Mowery, Jared

    2016-01-01

    Influenza (flu) surveillance using Twitter data can potentially save lives and increase efficiency by providing governments and healthcare organizations with greater situational awareness. However, research is needed to determine the impact of Twitter users' misdiagnoses on surveillance estimates. This study establishes the importance of Twitter users' misdiagnoses by showing that Twitter flu surveillance in the United States failed during the 2011-2012 flu season, estimates the extent of misdiagnoses, and tests several methods for reducing the adverse effects of misdiagnoses. Metrics representing flu prevalence, seasonal misdiagnosis patterns, diagnosis uncertainty, flu symptoms, and noise were produced using Twitter data in conjunction with OpenSextant for geo-inferencing, and a maximum entropy classifier for identifying tweets related to illness. These metrics were tested for correlations with World Health Organization (WHO) positive specimen counts of flu from 2011 to 2014. Twitter flu surveillance erroneously indicated a typical flu season during 2011-2012, even though the flu season peaked three months late, and erroneously indicated plateaus of flu tweets before the 2012-2013 and 2013-2014 flu seasons. Enhancements based on estimates of misdiagnoses removed the erroneous plateaus and increased the Pearson correlation coefficients by .04 and .23, but failed to correct the 2011-2012 flu season estimate. A rough estimate indicates that approximately 40% of flu tweets reflected misdiagnoses. Further research into factors affecting Twitter users' misdiagnoses, in conjunction with data from additional atypical flu seasons, is needed to enable Twitter flu surveillance systems to produce reliable estimates during atypical flu seasons.

  8. Placenta retention in the cow: Report of three cases | Raheem ...

    African Journals Online (AJOL)

    Episiotomy was done to deliver the dead calf and was associated with placenta retention. The case was successfully treated by applying gentle traction on the little stump of the placenta hanging out of the vulva. The third case was observed in a cattle market in which parturition was induced by stress of transporting the cow ...

  9. Morfologia macroscópica do aparelho reprodutor feminino de Leontopithecus cativos (Lesson, 1840) Primates-Callitrichidae Gross morphology of the female genital tract of captive Leontopithecus (Lesson, 1840) Primates-Callitrichidae

    National Research Council Canada - National Science Library

    L. Pissinatti; R. Tortelly; M. Porto; C.H.F. Burity; A. Pissinatti

    2008-01-01

    Descreveu-se o sistema reprodutor feminino em três espécies de mico-leão Leontopithecus (Lesson 1840), cativos: L. rosalia, L. chrysopygus e L. chrysomelas. A vulva está delimitada pelos lábios vulvares menores e com...

  10. TropJrnal Vol 32 No 1 PDF

    African Journals Online (AJOL)

    Mr Olusoji

    management challenges with significant patient anxiety and discomfort. We report a case of spontaneous ... possibility of spontaneous massive vulva swelling which may not respond to medical management apart from delivery. INTRODUCTION ... diabetics in pregnancy, severe pre-eclampsia," genitalia revealed a swollen, ...

  11. Cervical Cancer Screening

    Science.gov (United States)

    ... cervical tissue that is then examined under a microscope in a laboratory. Cervix: The lower, narrow end of the uterus at the top of the vagina. Colposcopy: Viewing of the cervix, vulva, or vagina under magnification with an instrument called a colposcope. Co-Testing: ...

  12. Author Details

    African Journals Online (AJOL)

    Akintan, AL. Vol 32, No 2 (2015) - Articles Spontaneous massive vulva swelling in pregnancy: a case report.. Abstract · Vol 33, No 1 (2016) - Articles Effectiveness of hyoscine butyl bromide in shortening the first stage of labour – case series and review of literature. Abstract. ISSN: 0189-5117. AJOL African Journals Online.

  13. TropJrnal Vol 29 No 1 for PDF

    African Journals Online (AJOL)

    Mr Olusoji

    A purulent discharge on inspection of the vulva or cervix, or diagnosed pelvic inflammatory disease (PID) in the preceding 6 months. 4. History of contrast sensitivity (relative). All the patients received buscopan (hyoscine bromide) injection, an antispasmodic drug as part of premedications. And after all the examinations, the.

  14. Evisceration trans vaginale suite a une perforation uterine par ...

    African Journals Online (AJOL)

    The small intestines might have been pulled through the uterus, vagina and the vulva. After transfusion of 2 pints of blood and triple antibiotherapy, intestinal resection with an end-to-end anastomosis was done. Uterine revision was also done with a curette sent through the opening of the perforation. This was later closed ...

  15. Vaginal hyperplasia in Nigeria Local bitch: Case Report | Ajala ...

    African Journals Online (AJOL)

    A 21/2-year-old local bitch was diagnosed as having vaginal hyperplasia by both physical examination and histopathology. The mass, which was firm and whitish in colour, measured about 5cm in diameter, was reducible and protruded out of the vulva. Vagina cytology confirmed that the bitch was in proestrus. The mass ...

  16. Perineal ultrasonography in women with stress-incontinence and controls - the role of the pelvic floor muscles

    NARCIS (Netherlands)

    WIJMA, J; TINGA, DJ; VISSER, GHA

    1991-01-01

    With a curved array real-time ultrasound scanning machine and the probe placed sagittally onto the vulva, symphysis, bladder, urethra and the pelvic floor can be visualized in one frame. With this technique we studied 10 women with stress incontinence and 10 control women. In both groups active

  17. SURGICAL PATHOLOGY

    African Journals Online (AJOL)

    Methods: The histology records of patients diagnosed as cases of malignant melanoma in the pathology laboratory of Jos University Teaching Hospital over a ... patients (82.4%) presented with foot lesions, six (8.8%) with groin lesions and 2 (2.9%) each with upper limb and conjuctival lesions. The vulva and oral mucosa ...

  18. TropJrnal Vol 33 No 1

    African Journals Online (AJOL)

    Mr Olusoji

    ... should be meticulous and treatment tailored to the patient's need for future parturition and sexual gratification. Keywords: Vulva, haematoma, trauma, pregnancy. INTRODUCTION forcibly placed into the vagina or anus. Perineal traumas have also been reported following both accidental and intentional kicks out of rage or.

  19. Associations of Filaggrin Gene Loss-of-Function Variants and Human Papillomavirus-Related Cancer and PreCancer in Danish Adults

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte N; Jørgensen, Torben

    2014-01-01

    to human papillomavirus (HPV) infection and thus a higher risk of HPV-related cancer and pre-cancer. We investigated the association of the FLG genotype with incidence of HPV-related cancer of cervix, vagina, vulva, penis, anus and head and neck, and pre-cancer of the cervix. METHODS: We included 13...

  20. Traumatic Vulvar Epithelial Inclusion Cysts Following Female Genital Mutilation (FGM).

    Science.gov (United States)

    Mack-Detlefsen, B; Banaschak, S; Boemers, T M

    2015-09-01

    Background: Female genital mutilation (FGM) occurs mainly in Africa, parts of the Arabian Peninsula and parts of Asia. It is commonly associated with acute complications as well as diverse late/delayed complications. One of the most common of these late complications is progressively enlarging painless cysts of the vulva. Case Report: An 8-year-old girl from Eritrea presented to our paediatric emergency department with a progressively enlarging mass of the vulva. She had undergone a clitoridectomy and partial removal of the labia minora as an infant in Eritrea. We performed surgical excision of the cyst and reconstruction of the labia. Histology showed a traumatic squamous epithelial inclusion cyst of the vulva. Conclusion: Epithelial or dermoid cysts of the vulva following FGM are extremely rare. Symptoms often require surgical intervention. Through increasing migration, more girls and female youths with FGM are likely to present to practices and hospitals in Germany. Thus increased knowledge and awareness of the medical complications of FGM and their treatment will be necessary in years to come.

  1. Prediction of lymph node metastases in vulvar cancer: a review.

    NARCIS (Netherlands)

    Oonk, M.H.; Hollema, H.; Hullu, J.A. de; Zee, A.G. van der

    2006-01-01

    The aim of this study was to review the literature on currently available non- and minimally-invasive diagnostic methods and analysis of primary tumor characteristics for prediction of inguinofemoral lymph node metastases in patients with primary squamous cell carcinoma of the vulva. We used the

  2. Evaluation of the Role of Vibrational Spectroscopy in the Assessment of Vulval Disease

    Science.gov (United States)

    2017-08-03

    Normal Vulval Skin; Lichen Sclerosus; High Grade Dysplasia - Usual Type ('VIN 2-3'); High Grade Dysplasia - Differentiated Type ('VIN 2-3'); Squamous Cell Carcinoma; Epithelial Hyperplasia Without Atypia; Atypia Not Otherwise Specified/ Low Grade Dysplasia ('VIN 1'); Pagets Disease of the Vulva

  3. Disability Evaluation Systems Analysis and Research Annual Report 2016

    Science.gov (United States)

    2016-08-10

    complications of procedures, not elsewhere classified 251 3.6 Other cellulitis and abscess 52 4.9 Intervertebral disc disorders 232 3.3 Intervertebral disc...disorders 42 3.9 Other cellulitis and abscess 217 3.1 Trauma to perineum and vulva during delivery 41 3.8 Total DES Hospitalized 7,065 Total

  4. ISSN 2073-9990 East Cent. Afr. J. surg. (Online)

    African Journals Online (AJOL)

    dell

    has had no recurrence after 2 years. Case 2. A 5 year old girl presented to the paediatricians with a 2 day history of bleeding from the vulva which was noticed as blood stains on her pants after she returned from school. There was no pain, dysuria nor haematuria and no weight loss. There was no history of sexual assault.

  5. Download this PDF file

    African Journals Online (AJOL)

    report we highlight a case of candida meningitis, in a. 25- year old female patient. She presented with vulva swelling, vaginal discharge and fever, with rapid progression to tonic-clonic convulsions and loss of consciousness. She fully recovered after treatment with. fluconazole. Keywords: Candida albicans - Meningitisfl.

  6. Massive vulval oedema in multiple pregnancies at Bugando Medical ...

    African Journals Online (AJOL)

    Abstract: Massive vulval oedema is not common during pregnancy, but when it develops, it often is associated with patient discomfort and management challenges. Two pregnant women presented to Bugando Medical Centre in Mwanza, Tanzania, with massive swelling of the vulva at 39 weeks and 32 weeks of gestation.

  7. SAM] FORUM

    African Journals Online (AJOL)

    Iararnillo-Ayerbe F, Vallejo—Contreras ]. Frequency and clinical and dermatoscopic features of volar and ungual pigmented melanocytic lesions: a study in school children of Manizales,. Colombia. Peaiatr Dernzatol 2004; 21: 218-222. 18. Ragnarsson-Olding BK. Primary malignant melanoma of the vulva — an aggressive ...

  8. Nematoda: Dorylaimida

    African Journals Online (AJOL)

    1992-04-02

    Apr 2, 1992 ... Zoo1. 1993,28(1) respectively. Vulva a long transverse slit. Individual cells of uteri difficult to discern; no pars dilatata uteri or pars dilatata oviductus present. Sphincter muscle between uterus and oviduct not visible. Anterior and posterior ovaries 41. ~m and 48 ~m long. No eggs or sperm cells present.

  9. Njv Magazine 3 final

    African Journals Online (AJOL)

    En-Joy

    72.7%), diarrhea, 6 (54.5%) and pyrexia,. 5(54.5%). Nine of the 11 dogs (81.8%) had extensive intestinal and uterine stump adhension. Gynaecologic complications 0bserve in 23 (43.3%) of the 53 bitches included vulva discharge 21(91.3%),.

  10. An abattoir survey of bacterial and fungal infections of cattle ...

    African Journals Online (AJOL)

    As for fungi infections, Candida and Mucor spp. were observed with a higher prevalence of candidiasis, which varied significantly (P < 0.05) between localities and sex, but was comparable between breeds and different age groups. Mucor spp. Infections were recorded only in vulva, oviducts and ovaries. This study suggest ...

  11. ORBIT AND OCULOPLASTY

    African Journals Online (AJOL)

    Introduction: Malignant melanoma is a malignant tumor of melanocytes that usually affects sun-exposed skin of individuals.[1]. The uveal tract and mucous membranes such as conjunctiva, mouth, rectum, respiratory tract, and vulva are less commonly affected, with conjunctival melanoma accounting for about 1.6% of ...

  12. Initiation and progression of Müllerian duct derived malignancies

    NARCIS (Netherlands)

    P.H. van der Horst (Paul)

    2013-01-01

    textabstractThe female reproductive system consists of the internal and external genitalia. The external genitalia are formed by the vulva, which includes the clitoris, labia majora and minora, urethral orifice and vestibule of the vagina (lower part of the vagina). The internal genital system is

  13. Nematoda: Onchulidae

    African Journals Online (AJOL)

    1989-07-17

    Jul 17, 1989 ... Female reproductive system didelphic, amphidelphic. Vulva transverse, oval shaped, with grooved sides. (Figure 2E). Vagina short, uterus well developed, usual- ly filled with sperm cells (Figure lK). Sperm ceUs large, about 13 IJ.m x 10 IJ.m, their surface covered by minute punctations (Figure lK & 2F).

  14. In the absence of (early) invasive carcinoma, vulvar intraepithelial neoplasia associated with lichen sclerosus is mainly of undifferentiated type: New insights in histology and aetiology

    NARCIS (Netherlands)

    M. Seters, van (Manon); F.J.W. ten Kate (Fiebo); M. van Beurden (Marc); R.H.M. Verheijen (René); C.J.L.M. Meijer; M.P.M. Burger; T.J.M. Helmerhorst (Theo)

    2007-01-01

    textabstractBackground: Differentiated vulvar intraepithelial neoplasia (VIN) is presumed to be the precursor of invasive squamous cell carcinoma (SCC) of the vulva. It is commonly assumed that differentiated VIN is related to lichen sclerosus (LS). However, evidence for this is limited to a small

  15. The Possibility of Using of Selected Biotechnological Method by Dwarf Rabbit

    Directory of Open Access Journals (Sweden)

    Martin Fik

    2013-10-01

    Full Text Available The aim of this work was to evaluate the possibility of using insemination in small scale breed condition of lop dwarf white of red eyes. Monitored were three groups of does. In group 1 was used to induce receptivity an agent-based PMSG. In Group 2 to induce receptivity was used 30 minute common housing (8 - 10 of does before insemination. In group 3 was used natural mating. State of receptivity was recorded through a numerical scale 1 (pale vulva, 2 (pink vulva, 3 (red vulva and 4 (violet vulva. Does in group 1 and 2 were inseminated polysperm insemination dose (0.3 ml / doe. By comparing the receptivity in group 1 (state of receptivity 2.81 and 2 (state of receptivity 2.56 were not found statistically significant differences. The best reproduction results were recorded in group 1 where on the one done insemination accounted for 3.12 pc of newborn pups. The number of pups born per one done insemination was 2.04 pc. The lowest scores were recorded in group 3 where the number of pups born per one successfully copulated doe was 1.3 pc.

  16. Gynaecological Malignancies Seen in a Tertiary Health Facility in ...

    African Journals Online (AJOL)

    59.2%), 41 (27.0%) and 18 (11.8%) of the cases respectively, while cancer of the vulva 3 patients (2%) and vagina 1 patient (0.7%) were rarely seen. The ovarian cancers were predominantly of the epithelial type, with serous cystadenocarcinoma ...

  17. TJOG Vol 26 No 2.cdr

    African Journals Online (AJOL)

    The trails and burden of weeks. During this period the parturient most lethal complications of .... the region of the body between the anus and the and early effective intervention are the key to. 5. 7 vulva . Organisms that ... of Obstetrics: a Practical Guide to the. Arnold Publishers. 2000; 141- 146 st. Management of High Risk ...

  18. Malignant transformation in Pre-existing Naevi. A review of two cases

    African Journals Online (AJOL)

    The average number of naevi seen in a Caucasian is between twenty and thirty. They are either congenital or acquired benign neoplasm of melanocytes. ... The first was a 60-year old woman with a malignant melanoma arising in a vulva intradermal naevus. The second was a 51-year old woman with a basal cell carcinoma ...

  19. Disease: H00944 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ran A, Baran W, Hryncewicz-Gwozdz A, Burgdorf W Dowling-Degos disease: case report and review of the literat...Parkinson KE, Kaye V, Lynch PJ Dowling-Degos disease involving the vulva and back: case report and review of the literature. Dermatol Online J 17:1 (2011) ...

  20. A STUDY OF FEMALE CIRCUMCISION AMONG THE ISOKO TRIBE ...

    African Journals Online (AJOL)

    drclement

    2009-12-01

    Dec 1, 2009 ... the traditions of many peoples. Proponents have listed several virtues resulting from female circumcision to include the promotion of chastity, genital hygiene, greater level of sexual stimulation of the husband by the narrow introitus and, it is claimed to make the vulva aesthetically more appealing6 Others.

  1. Genital tract abnormalities among female sex workers who douche ...

    African Journals Online (AJOL)

    Vaginal douche products have been associated with cervical cancer. We examined female sex workers (FSWs) in Nigeria who douche with lemon or lime juice and compared the findings with that of nonusers. We obtained Pap smears and performed colposcopy of the vulva, vagina and cervix. A total of 374 FSWs ...

  2. Vulvar epithelioid hemangiosarcoma with solar elastosis in a mare.

    Science.gov (United States)

    Gumber, Sanjeev; Baia, Petrisor; Wakamatsu, Nobuko

    2011-09-01

    A 15-year-old female gray Appaloosa horse was presented with history of a mass over the right dorsal commissure of vulva for the past 7 months. Based on histopathological examination, and positive staining with factor VIII-related antigen, vimentin, and Verhoeff-van Gieson stain, the vulvar mass was diagnosed as hemangiosarcoma with marked solar elastosis.

  3. Urogenital tumors

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1994-03-01

    An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

  4. The Bartholin gland: An overview of anatomy, physiology and disease

    African Journals Online (AJOL)

    The Bartholin's glands are located bilaterally at the posterior portion of the vestibule, distal to the hymenal remnants and are secretory in function. Although not solely so, they are responsible for the natural lubrication of the vagina and vulva and are normally not palpable or visible on examination of the pelvis. Symptomatic ...

  5. Disease: H01690 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available s and atrophic white plaques. It is primarily seen in postmenopausal women, but also men and children can be...stimated to about 5% in women with LSA. Skin and connective tissue disease ... C...cinoma (SCC) is confirmed and has been described chiefly in females. The risk of SCC of the vulva has been e

  6. HPV typing of vulvovaginal condylomata in children

    African Journals Online (AJOL)

    The latter is significant as the incidence of genital cancer in ... Table I. Summary of clinical details (age and site of lesion), HPV typing with NISH and peR confirmation of the presence of the virus. Case No. Age (yrs). Site. NISH HPV type. PCR. 1. < 12'. Vulva. 11 ... 33-positive cervical biopsies (paraffin sections) were used as.

  7. A Qualitative Study on Experiences After Vulvar Surgery in Women With Lichen Sclerosus and Sexual Pain

    NARCIS (Netherlands)

    Brauer, Marieke; van Lunsen, Rik H. W.; Laan, Ellen T. M.; Burger, Matthé P. M.

    2016-01-01

    Lichen sclerosus (LS) of the vulva can profoundly affect sexual interaction because of painful fissures and narrowing of the vaginal introitus. Successful surgical treatment is usually defined as restoration of (pain-free) penetrative sexual activity. To evaluate the impact of surgery on (dyadic)

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 244 ... Vol 26, No 1-2 (2014), Giant vulva oedema in pregnancy precipitated by anaemic heart failure: A case report, Abstract. CE Shehu, EA Ukwu, AU Adoke, .... Vol 27, No 1-2 (2015), Myomectomy in a case of von Willebrand's disease in a low resource setting, Abstract. AA Panti, GK Umar, OG Ibegbulam, ...

  9. Ultrasonographic Finding of Mondor's Disease: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Su; Kim, Min Jung; Kim, Eun Kyung [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-03-15

    Mondor's disease is a rare condition involving the breast and anterior chest wall and it is characterized by superficial thrombophlebitis. The usual clinical manifestation of the disease is the acute development of a painful and palpable cord or mass on the breast, and it shows a benign process, but it can be accompanied with malignant disease. On ultrasonography, the lesion is seen as a long tubular anechoic structure with a beaded appearance, and this should be differentiated from a dilated duct or sparganosis. We report here on our experience with a 35-year-old woman who had Mondor's disease with the typical clinical presentation and imaging findings

  10. Dilateret kardiomyopati hos en amfetaminmisbruger

    DEFF Research Database (Denmark)

    Svendsen, Mathias Tiedemann; Lambrechtsen, Jess

    2011-01-01

    The patient presented himself at the primary practitioner with dyspnoea and chest pain, and was initially misdiagnosed as having pneumonia. Two weeks later the patient developed universal oedema and was hospitalized. Echocardiography showed dilated cardiomyopathy. The initial diagnosis was delayed...

  11. Dystonia: Related and Differential Disorders

    Science.gov (United States)

    ... Is TMJ a form of dystonia? Temporomandibular joint (TMJ) disease is an arthritic condition, not a dystonia. Oromandibular dystonia may be misdiagnosed as TMJ. Accelerating Research & Inspiring Hope The Dystonia Medical Research ...

  12. Cushing's Support and Research Foundation

    Science.gov (United States)

    ... Overlays Share Tweet Previous Next Previous Next News Cushing’s Disease book released Cushing’s Disease: An Often Misdiagnosed ... of the CSRF, is now available. LEARN MORE > Cushing's Patient Day Summaries and Videos Available On March ...

  13. A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2008-01-01

    Occupational overuse syndrome (OOS) can present as Guyon\\'s canal syndrome in computer keyboard users. We report a case of Guyon\\'s canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.

  14. Estimating the burden of human leptospirosis

    NARCIS (Netherlands)

    Abela-Ridder, Bernadette; Sikkema, Reina; Hartskeerl, Rudy A.

    2010-01-01

    Leptospirosis, a disease that is often under- or misdiagnosed, significantly impacts human health in many parts of the world and generally affects the most vulnerable communities. Obtaining reliable and comparable information about the occurrence of leptospirosis in populations, and detecting

  15. Towards a blood-based diagnostic panel for bipolar disorder

    NARCIS (Netherlands)

    F. Haenisch (Frieder); J.D. Cooper (Jason); A. Reif (Andreas); S. Kittel-Schneider (Sarah); J. Steiner (Johann); F.M. Leweke (Marcus); M. Rothermundt (Matthias); N.J.M. van Beveren (Nico); B. Crespo-Facorro (Benedicto); D. Niebuhr (David); D. Cowan (David); N. Weber (Natalya); R.H. Yolken (Robert); B.W.J.H. Penninx (Brenda W.J.H.); S. Bahn (Sabine)

    2015-01-01

    markdownabstract_Background:_ Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic

  16. Language disorder - children

    Science.gov (United States)

    ... Delayed language; Specific developmental language disorder; SLI; Communication disorder - language disorder ... injury. These conditions are sometimes misdiagnosed as developmental disorders. Language disorders may occur in children with other developmental ...

  17. Diagnosis of Primary Hyperventilation Syndrome by Polysomnography: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tarang N Sheth

    1996-01-01

    Full Text Available Two cases of primary hyperventilation syndrome misdiagnosed as asthma are reported. Polysomnography was used to diagnose the syndrome and to confirm the psychogenic etiology of the patients' symptoms.

  18. Treating and Preventing Sports Hernias

    Science.gov (United States)

    ... Close ‹ Back to Healthy Living Treating and Preventing Sports Hernias If you play ice hockey, tennis or ... for the most commonly misdiagnosed groin pain—a sports hernia. A sports hernia often results from overuse ...

  19. Severe rosacea: A case report

    Directory of Open Access Journals (Sweden)

    Ebrahim Shirzadeh

    2017-01-01

    Conclusion: Rosacea can be extremely severe and disfiguring, and it can be misdiagnosed as the pathognomonic butterfly rash of LE. Demodex carriage in rosacea is consistent and may play a significant role in the severe forms.

  20. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.......To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF....

  1. Fabry Disease ? Underestimated in the Differential Diagnosis of Multiple Sclerosis?

    OpenAIRE

    Tobias Böttcher; Arndt Rolfs; Christian Tanislav; Andreas Bitsch; Wolfgang Köhler; Jens Gaedeke; Anne-Katrin Giese; Kolodny, Edwin H.; Thomas Duning

    2013-01-01

    OBJECTIVE: Fabry disease is a rare X-linked inherited lysosomal storage disorder affecting multiple organ systems. It includes central nervous system involvement via micro- and macroangiopathic cerebral changes. Due to its clinical symptoms and frequent MRI lesions, Fabry disease is commonly misdiagnosed as multiple sclerosis. We present an overview of cases from Fabry centres in Germany initially misdiagnosed with multiple sclerosis and report the clinical, MR-tomographical, and laboratory f...

  2. Effects of Feeding Barley Naturally Contaminated with Fusarium Mycotoxins on Growth Performance, Nutrient Digestibility, and Blood Chemistry of Gilts and Growth Recoveries by Feeding a Non-contaminated Diet

    Directory of Open Access Journals (Sweden)

    C. Kong

    2015-05-01

    Full Text Available The objectives of this study were to investigate the effects of feeding barley naturally contaminated with Fusarium mycotoxins on growth performance, vulva swelling, and digestibility of dry matter, organic matter, and crude protein of gilts and the recovery of gilts fed normal diets immediately after the exposure to contaminated diets by measuring growth performance and vulva swelling. In Exp. 1, four diets were prepared to contain 0%, 15%, 30%, or 45% contaminated barley containing 25.7 mg/kg deoxynivalenol and 26.0 μg/kg zearalenone. Sixteen gilts with an initial body weight (BW of 33.3 kg (standard deviation = 3.0 were individually housed in a metabolism crate and assigned to 4 diets with 4 replicates in a randomized complete block design based on BW. During the 14-d feeding trial, individual BW and feed consumption were measured weekly and the vertical and horizontal lengths of vulva were measured every 3 d. From d 10, feces were collected by the maker-to-marker method for 4 d. Blood samples were collected on d 14. During the overall period, the average daily gain, average daily feed intake, and gain:feed of pigs linearly decreased (p<0.01 as the dietary concentration of contaminated barley increased. However, the digestibility of crude protein was linearly increased (p = 0.011 with the increasing amounts of contaminated barley. Increasing dietary Fusarium mycotoxin concentrations did not influence vulva size, blood characteristic as well as immunoglobulin level of pigs. In the Exp. 2, a corn-soybean meal-based diet was formulated as a recovery diet. Pigs were fed the recovery diet immediately after completion of the Exp. 1. During the 14-d of recovery period, the individual BW and feed consumption were measured weekly and the vertical and horizontal length of vulva were measured every 3 d from d 0. On d 7, the feed intake of pigs previously fed contaminated diets already reached that of pigs fed a diet with 0% contaminated barley and no

  3. Morfologia macroscópica do aparelho reprodutor feminino de Leontopithecus cativos (Lesson, 1840) Primates-Callitrichidae

    OpenAIRE

    L. Pissinatti; R. Tortelly; Porto, M.; C.H.F. Burity; Pissinatti,A.

    2008-01-01

    Descreveu-se o sistema reprodutor feminino em três espécies de mico-leão Leontopithecus (Lesson 1840), cativos: L. rosalia, L. chrysopygus e L. chrysomelas. A vulva está delimitada pelos lábios vulvares menores e com clitóris conspícuo. A superfície do períneo urogenital apresenta elevações papilares mais concentradas nos lábios vulvares, conferindo-lhe aspecto rugoso. O vestíbulo vaginal constitui um tubo muscular de parede espessa que se estende da rima da vulva até o óstio da vagina. A vag...

  4. Gross morphology and morphometry of squirrel monkey (Saimiri sciureus Linnaeus, 1758 female genital organs

    Directory of Open Access Journals (Sweden)

    Erika Branco

    2010-03-01

    Full Text Available The gross anatomy of the genital organs of four specimens of young female of Saimiri sciureus was investigated. The animals were bred in captivity at the Centro Nacional de Primatas and had died from natural causes. The vulva was limited by the labium minus and presented a well-developed clitoris which seemed to represent a rudimentary penis. The vaginal vestibule was the first cavity and was very short, presenting a thick muscular wall which extended from the vulva comissure to the vaginal ostium. The vagina was constituted by an elongated and dorsally flattened muscular tube with a thin wall between the vaginal vestibule and cervix. The cervix was short with well-developed musculature. The uterus was simple, presenting a global fundus located in the caudal portion of the abdominal cavity. The uterine tubes were elongated and rectilinear, connected to the ovaries which were large, ellipsoid in shape, and presented a smooth surface.

  5. A new species of Protrellus Cobb, 1920 (Nematoda, Thelastomatidae) parasite of the field cockroach Blatella vaga Hebard, 1919 (Blattodea, Blattidae) from Catamarca, Argentina.

    Science.gov (United States)

    Camino, Nora B; de Villalobos, Cristina

    2013-03-01

    A new species of the genus Protrellus, P. blatta sp. nov. parasitizing a field cockroach Blatella vaga Hebard, 1919, from El Tala river, Catamarca, Argentina, is described and illustrated. It is characterized by having the mouth opening circular, the buccal capsule with eight very small teeth, the nerve ring around oesophageal corpus, the excretory pore anterior to vulva, the vulva anterior to base of oesophagus, didelphic, the posterior ovary reflexed anterior to rectum, about one third of a body length from posterior end, the egg ellipsoidal, colourless, bearing a lateral cuticular crest, tail conical, with long filiform projection, the male with testis single, outstretched, one spicule, very small, short and straight, gubernaculums absent, the genital papillae arranged in three pairs of ventrolateral papillae, of which the first pair are close together and preanal position, two pairs postanal, tail conical and short, less than one twentieth of total body. A taxonomic key of Protrellus species is given.

  6. [Obstetric damage to the perineum and the anal sphincters. Reconstruction surgery].

    Science.gov (United States)

    Kościński, Tomasz

    2014-08-01

    Damage to the perineum, vulva, anal sphincters, rectal wall and the fascial structures of the pelvic floor may be caused by obstetric trauma. Emergency surgical treatment aims at control of the bleeding, anatomical reconstruction of the disrupted tissues and minimization of the risk of infection. Suturing of the rectal wall and mucosa of the anal canal is followed by reconstruction of the perineal body internal and external anal sphincters, vulva and the perineum. Delayed surgery is undertaken after the complete healing of the obstetric tear. All cicatricial fibers must be saved to reinforce sphincters and perineal body muscles suturing. Anal levators and perineal transvers muscles suturing is used for the rectovaginal septum and pelvic floor reconstruction. Anal sphincters are reconstructed by the 'overlapping' technique. X en Z suturing is used for a perineal skin plasty.

  7. Descriptive epidemiology of vulvar and vaginal cancers in Vaud, Switzerland, 1974-1994

    OpenAIRE

    Levi, F.; Randimbison, L.; La Vecchia, C.

    2017-01-01

    Background: To analyse trends in incidence, survival and risk of second neoplasms following vaginal and vulvar cancers using data collected by the Swiss Cancer Registry of Vaud over the 21-year period 1974-1994. Materials and methods: Subjects were 257 vulvo-vaginal cancers. Of these, 69 were vaginal, 153 vulvar cancers, and 35 non-specified lower genital tract neoplasms; 94 in situ neoplasms were also registered (85 for the vulva). Results: Invasive vaginal cancer incidence decreased from 0....

  8. THE ANALYSIS OF STATISTICAL DATA ON MALIGNANT NEOPLASMS ASSOCIATED WITH HUMAN P APILLOMAVIRUS

    Directory of Open Access Journals (Sweden)

    A. A. Kostin

    2016-01-01

    Full Text Available In this study of statistical data for the first time in Russia the analysis of the morbidity and mortality of patients with malignant neoplasms that may be associated with human papilloma virus (HPV is performed: cervical cancer (cervical cancer, cancer of the vulva and vagina, cancer of penis, cancer of the rectum, anal canal and rectosigmoid junction cancer, cancer of the pharynx and larynx.

  9. Uso de vincristina por vía subcutánea en tratamiento de TVT

    OpenAIRE

    MVZ. Francisco Julián Gómez Cancino

    2006-01-01

    Paciente: Zuky, criolla, recogida de la calle, se utiliza la misma dosis que por vía endovenosa solo que en forma subcutánea, se aplican 5 dosis semanales, y se presenta inflamación y excoriación (posible auto trauma), se trata con antibióticos y el resultado es bastante bueno, se realiza al final cirugía reconstructiva de vulva.

  10. Women's Perception of Their Vulvar Appearance in a Predominantly Low-Income, Minority Population.

    Science.gov (United States)

    Truong, Christina; Amaya, Stephanie; Yazdany, Tajnoos

    The aim of this study was to investigate the effect of certain predictors, such as age and media exposure, on a woman's perception of her vulva anatomy. We recruited 346 female visitors from a county teaching hospital to complete questionnaires that determine the following: demographics, satisfaction with their vulvar appearance, whether they consider their vulvar anatomy to be normal, exposure to media (namely having had Internet access or learned about genitalia from the Internet or any type of pornography), and consideration of cosmetic vulvar surgery for themselves. The participants were divided into 2 age groups; group I (45 years or older) and group II (18-44 years). Personal satisfaction, self-perceived normality, and one's consideration of cosmetic vulvar surgery were then compared between the 2 groups. A large percentage of women considered their vulva to be "normal," 93.1% of group I versus 96.0% of group II (P = 0.24). For group I, 87.5% were satisfied with their vulva versus 91.5% of group II (P = 0.24). The participants with media exposure report self-perceived normal-appearing vulvas at higher rates than those not exposed to media (96.7% vs 90.8%, respectively; P = 0.03). Of those who were satisfied with their vulvar appearance, 92.3% were exposed to media, whereas 84.5% were not exposed (P = 0.03). However, of the participants who reported consideration of vulvar surgery, 74.4% of them had exposure to media, whereas 25.6% had no media exposure (P = 0.034). Age does not play a significant role in determining a woman's acceptance of the appearance of her vulvar anatomy. However, media exposure was a significant determinant for self-perception, satisfaction, and desire for cosmetic vulvar surgery.

  11. Page 1 380 S. S. Patwardhan asymmetrical, left smaller and armed ...

    Indian Academy of Sciences (India)

    anterior end to the end of the pharynx 0.05 mm., to the end of entire. Oesophagus 2.6 mm.; the position of the nerve ring, excretory pore and cervical alae agree with Baylis' description; nine pairs of caudal alae; right spicule measures 0.062 mm. and left 0.091 mm. in length; vulva 1.21 mm. from anterior end; eggs 0.037 mm.

  12. An epidermal microRNA regulates neuronal migration through control of the cellular glycosylation state

    DEFF Research Database (Denmark)

    Pedersen, Mikael Egebjerg; Snieckute, Goda; Kagias, Konstantinos

    2013-01-01

    biosynthetic pathway: a chondroitin synthase (SQV-5; squashed vulva-5) and a uridine 5'-diphosphate-sugar transporter (SQV-7). Loss of mir-79 causes neurodevelopmental defects through SQV-5 and SQV-7 dysregulation in the epidermis. This results in a partial shutdown of heparan sulfate biosynthesis...... that impinges on a LON-2/glypican pathway and disrupts neuronal migration. Our results identify a regulatory axis controlled by a conserved microRNA that maintains proteoglycan homeostasis in cells....

  13. Robot-assisted anterior pelvic exenteration in vulvovaginal malignant melanoma.

    Science.gov (United States)

    Kim, Se Ik; Lee, Seungmee; Jeong, Chang Wook; Kim, Hee Seung

    2017-12-21

    Melanomas of the vulva and vagina are rare, and surgery is the gold standard of treatment [1, 2]. Since recent studies have reported pelvic exenteration by using robotic surgical system [3, 4], we showed the surgical procedures of robot-assisted anterior pelvic exenteration (rAPE) with ileal conduit urinary diversion for vulvovaginal malignant melanoma. A 55-year-old woman who received vaginal wall resection due to vaginal malignant melanoma 8months before was referred. Multiple biopsies of pigmented lesions on the vulva, vagina, and urethral orifice confirmed the recurrence, whereas preoperative image studies revealed no abnormal findings. Thus, we performed rAPE with ileal conduit urinary diversion. First, we performed robot-assisted bilateral inguinal and pelvic lymphadenectomy. Thereafter, we conducted en bloc resection of the bladder, uterus, vagina, and vulva through abdominal and perineal approaches (Fig. 1): Under the 4-arm robotic surgical system, prevesical space was developed and laterally dissected along the undersurface of pubic bone, to the level of levator ani muscles. Bilateral infudibulopelvic ligaments, uterine arteries and parametrium, uterosacral ligaments, and pubovesical ligaments were ligated and resected. During the wide local excision of the vulva, the rectovaginal space was dissected along the posterior vaginal wall. En bloc specimen was successfully delivered. Finally, the ileal conduit urinary diversion was performed. Total operative time was 4.5h excluding set-up and docking times of the robotic surgical system. The pathologic report ascertained clear resection margin and no lymph node involvement. rAPE with ileal conduit urinary diversion for treatment of vulvovaginal malignant melanoma is feasible (Fig. 1). Copyright © 2017 Elsevier Inc. All rights reserved.

  14. {sup 18}F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis

    Energy Technology Data Exchange (ETDEWEB)

    An, Young Sil; Kim, Deog Yoon [Kyung Hee University, Seoul (Korea, Republic of)

    2009-12-15

    Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, {sup 18}F-fluoroseoxyglucose positron emission tomography/ computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses.

  15. Repair of radiation ulcus of the lower abdomen with groin flap

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, Y.; Harashina, T.; Tajima, S. (Keio Univ., Tokyo (Japan). School of Medicine); Suzuki, S.

    1980-08-01

    Two patients with radiation ulcers of the lower abdomen which had occurred after radiotherapy for cancer of the cervix uteri and was repaired with groin flap were reported. Effects of flaps in plastic and reconstructive surgery were also referred to. Besides defects in the lower abdomen, defects in the vulva, the perineum, and the upper region of the femur were probably reconstructed effectively with groin flaps.

  16. Management of Extramammary Paget's Disease: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Rosa Guerra

    2013-01-01

    Full Text Available Extramammary Paget's Disease (EMPD is a rare condition of the skin that often involves the vulva, perianal region, scrotum, penis, and axilla. Although prognosis is generally favorable, it can be associated with neoplasms of the bladder, urethra, prostate, and rectum. This report presents a case of scrotal EMPD that failed treatment with imiquimod 5% cream and discusses benefits and complications of available treatment options. The variation of treatment success emphasizes the importance of further research.

  17. Vulvar Carcinoma in Pregnant Women Aged Less than 40 Years: Case Report

    OpenAIRE

    Hasanzadeh, Malihe; Zamiri-Akhlaghi, Amir; Hassanpoor-Moghaddam, Maryam; Shahidsales, Soodabeh

    2014-01-01

    Background Invasive squamous cell carcinoma of the vulva is primarily a disease of postmenopausal women and thus is rarely associated with pregnancy. Case We have reported on a young woman under 40 years old with vulvar carcinoma, which occurred during the pregnancy but optimal treatment was delayed to the postpartum period. This 37-year-old woman was diagnosed with 3x3 cm vulvar lesion, 2 weeks after cesarean section, subsequent biopsy revealed squamous cell carcinoma. She had a history of a...

  18. Journal of Special Operations Medicine, Volume 6, Edition 3

    Science.gov (United States)

    2006-01-01

    the ground until after this issue goes to press. In the interim I am hold- ing the reins of the horse and trying mightily to avoid stepping in the... horse manure. Our office is as busy as ever. We continue to field new and improved Medical Equipment Sets to SF Battalions and other tactical units... tetanus thelarche thoracic tinnitus tonsil tonsillectomy urticaria varicose vesicle vulva welt wheal X-ray Volume 6, Edition 3 / Summer 06 15 Mechanical

  19. [Treatment of dystrophy, dysplasia and initial stages of vulvar carcinoma in virus infections].

    Science.gov (United States)

    Tkachuk, T Ie

    2002-01-01

    Overall sixty-seven patients with distrophy, dysplasia and valvular carcinoma presenting with human papilloma virus- and herpes simplex-2 virus infections underwent a complex treatment intended for background, precancerous affections of the vulva and for valvular carcinoma, involving the use of antiviral drug preparations laferon, zovirax, lovir (both on the systemic and local basis), and an immunomodulator (decaris). Efficacy of the above treatment option has been shown to be 98.5%.

  20. The pars intermedia: an anatomic basis for a coordinated vascular response to female genital arousal.

    Science.gov (United States)

    Shih, Cheryl; Cold, Christopher J; Yang, Claire C

    2013-06-01

    The pars intermedia is an area of the vulva that has been inconsistently described in the literature. We conducted anatomic studies to better describe the tissues and vascular structures of the pars intermedia and proposed a functional rationale of the pars intermedia in the female sexual response. Nine cadaveric vulvectomy specimens were used. Each was serially sectioned and stained with hematoxylin and eosin and Masson's trichrome. Histologic ultrastructural description of the pars intermedia. The pars intermedia contains veins traveling longitudinally in the angle of the clitoris, supported by collagen-rich stromal tissues. These veins drain the different vascular compartments of the vulva, including the clitoris, the bulbs, and labia minora; also, the interconnecting veins link the different vascular compartments. The pars intermedia is not composed of erectile tissue, distinguishing it from the erectile tissues of the corpora cavernosa of the clitoris as well as the corpus spongiosum of the clitoral (vestibular) bulbs. The venous communications of the pars intermedia, linking the erectile tissues with the other vascular compartments of the vulva, appear to provide the anatomic basis for a coordinated vascular response during female sexual arousal. © 2012 International Society for Sexual Medicine.

  1. Influence of menstruation on the microbiota of healthy women's labia minora as analyzed using a 16S rRNA gene-based clone library method.

    Science.gov (United States)

    Shiraishi, Tsukasa; Fukuda, Kazumasa; Morotomi, Nobuo; Imamura, Yuri; Mishima, Junko; Imai, Shigeo; Miyazawa, Kiyoshi; Taniguchi, Hatsumi

    2011-01-01

    The aim of this study was to determine the influence of menstruation on the bacterial population of healthy Japanese women's vulvas, especially the labia minora. Labia minora swabs were obtained from 10 premenopausal, nonpregnant Japanese women at premenstruation and on day 2 of menstruation. Vaginal swabs were also obtained from 3 out of the 10 women. No significant difference was found in the average bacterial cell count between the menstruation and premenstruation samples. Molecular analysis using a 16S rRNA gene-based clone library method detected 22 genera from the labia minora swabs (total 20), with the genus Lactobacillus being predominant at both premenstruation and during menstruation in 7 out of the 10 women. Of the other 3 women, 2 showed various kinds of bacterial species, including oral and fecal bacteria, with Atopobium vaginae and Gardnerella vaginalis predominating in the remaining woman's vulva in both conditions. In total, 6 out of 10 cases (60%) showed significantly different microbiota of the labia minora between the two conditions. These results imply that menstruation may promote a distortion of the bacterial flora around the vulva, although it causes no significant increase of the bacterial count.

  2. Spinal Neurofibroma Masquerading as a Herniated Disc; A case report

    Directory of Open Access Journals (Sweden)

    Tariq Lamki

    2012-11-01

    Full Text Available We present the only case in English medical literature of a spinal neurofibroma misdiagnosed as a herniated disc using magnetic resonance imaging (MRI. This case presented with typical symptoms and radiological findings of a herniated disc. Intraoperatively, an abnormality was noted at the S1 nerve root sleeve. Further exploration revealed a spinal neurofibroma which was completely resected, resulting in an improvement in the patient’s symptoms. Currently, there is heavy reliance on MRI as a highly sensitive and specific tool used in the diagnosis of herniated lumbar discs. Although there have been occasional reports of misdiagnoses using MRI, there are no reported cases of a spinal neurofibroma being misdiagnosed as a herniated lumbar disc. Despite great advances in radiological diagnostic imaging, surgical surprises do still occur. Ultimately, instinct is still essential in intraoperative surgical decisions.

  3. Do clinical diagnoses correlate with pathological diagnoses in cardiac transplant patients? The importance of endomyocardial biopsy

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    misdiagnosed. Excluding the patients with ischemic cardiomyopathy, 46 of 152 patients (30%) were misdiagnosed before transplantation. CONCLUSIONS: Although cardiac transplantation is a viable treatment option for patients with a variety of cardiac diseases, accurate diagnosis of patients before transplantation...... remains a priority. Accurate diagnosis of particular diseases (sarcoidosis, myocarditis, iron toxicity-associated cardiomyopathy and others) allows for proper treatment before transplantation, which may slow down disease progression and improve patient outcomes. Furthermore, it is important to accurately...... cardiomyopathy is suspected, because the results may alter the diagnosis and modify the treatment strategy....

  4. Pancreatic paragonimiasis mimics pancreatic cystic-solid tumor--A case report.

    Science.gov (United States)

    Yang, Xiaodong; Xu, Mingqing; Wu, Yang; Xiang, Bo

    2015-01-01

    Paragonimiasis is frequently misdiagnosed owing to its various and complicated clinical manifestations. Although paragonimiasis has diverse manifestations, there is no report of paragonimiasis involving the pancreas. Herein we report the first case of pancreatic paragonimiasis, which was misdiagnosed as pancreatic cystic-solid tumor by CT scan. The pancreatic lesion was finally proved to be pancreatic paragonimiasis by pathological examination and serum antibody detection. The clinical manifestations and imaging features of this patient were analyzed. Pancreatic paragonimiasis should be an important differential diagnosis for pancreatic cyst-solid lesions. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  5. [Small fugal enteritis manifestation with intestinal obstruction and hematochezia: a case report].

    Science.gov (United States)

    Wu, Chuancong; Guo, Qin; Liu, Rui

    2017-04-28

    Fungal enteritis was rarely reported. A case of fungal enteritis manifestation with jejunum multiple ulcers and obstruction was treated by Department of Gastroenterology, Third Xiangya Hospital, Central South University. After antifungal treatment, the clinical symptoms were relieved, and the ulcers in jejunal and upper gastrointestinal tract were healed completely. Clinical manifestation for small fungal enteritis is special, and the small intestine ulcer is easily to be misdiagnosed. It is helpful to prevent the misdiagnose for small fungal enteritis if we can tell the clinical features for this disease.

  6. Facial Involuntary Movements and Respiratory Failure in CANOMAD, Responsive to IVIG Therapy

    Directory of Open Access Journals (Sweden)

    Kate Johnson

    2015-01-01

    Full Text Available CANOMAD is a rare chronic neuropathy, characterized by chronic sensory ataxia and intermittent brain stem symptoms due to antidisialosyl antibodies. The disorder results in significant morbidity but is poorly understood and often misdiagnosed. We describe a unique case of CANOMAD, associated with involuntary movements of the face; patient reported exacerbations with citrus and chocolate and respiratory muscle weakness. Our patient was initially misdiagnosed with Miller Fisher Syndrome, highlighting the need for vigilance should neurological symptoms recur in patients initially diagnosed with a Guillain Barre variant. Moreover, the optimal treatment is unknown. This patient responded remarkably to intravenous immunoglobulin and has been maintained on this treatment, without further exacerbations.

  7. Primary vaginal calculus in a middle-aged woman with mental and physical disabilities.

    Science.gov (United States)

    Ikeda, Yuji; Oda, Katsutoshi; Matsuzawa, Naoki; Shimizu, Ken

    2013-07-01

    Vaginal calculi are rarely encountered and are often misdiagnosed as bladder calculi because of the difficulty in achieving an appropriate diagnosis. Most vaginal calculi result from the presence of a urethrovaginal fistula; those occurring in the absence of such fistulas are extremely rare. We present a case of a 42-year-old bedridden woman with mental and physical disabilities who had been misdiagnosed for a decade as having a bladder calculus. We removed the calculus nonsurgically and the analyzed the components. Results demonstrated the presence of a primary vaginal calculus. Vaginal calculi may occasionally occur in disabled women, but further investigation of the etiology of such calculi is required.

  8. A Case Report of Widespread Majocchi's Granuloma in a Patient with Systemic Lupus Erythematosus.

    Science.gov (United States)

    Zhou, Sitong; Yang, Yemei; Liu, Kangxing; Huang, Shiyun; Hu, Yongxuan; Zhou, Xianyi

    2017-06-01

    Majocchi's granuloma is an intracutaneous or subcutaneous granulomatous inflammation caused by invasion of dermatophytic fungus, especially Trichophyton rubrum. This type of lesion is misdiagnosed frequently without proper auxiliary examination. Here, we report a case of widespread Majocchi's granuloma caused by T. rubrum in a 35-year-old woman with systemic lupus erythematosus for 9 years. The patient was initially misdiagnosed as SLE-associated skin lesions, which delayed her treatment and resulted in severe multiple disseminated lesions. After confirmed as Majocchi's granuloma, the patient was cured after 11-month treatment with terbinafine.

  9. Pyoderma gangraenosum as a complication to knee arthroscopy

    DEFF Research Database (Denmark)

    Madsen, Jakob Torp; Skov, Ole; Andersen, Klaus E

    2009-01-01

    Pyoderma gangraenosum (PG) is a rare immunologic ulcerative disease, which sometimes develop as a complication to surgery. PG is often misdiagnosed as an infected wound, but treatment is completely different. We report a case of PG as a complication to arthroscopic partial meniscectomy that resul......Pyoderma gangraenosum (PG) is a rare immunologic ulcerative disease, which sometimes develop as a complication to surgery. PG is often misdiagnosed as an infected wound, but treatment is completely different. We report a case of PG as a complication to arthroscopic partial meniscectomy...

  10. Idiopathic pigmented vitreous cyst without autofluorescence: a case report.

    Science.gov (United States)

    Lu, Jing; Luo, Yan; Lu, Lin

    2017-10-03

    Vitreous cysts are rare clinical findings and seldom cause visual disturbance. They are generally classified as congenital or acquired and are considered idiopathic when the etiology can not be determined. A previous electron microscopic observation on an idiopathic pigmented vitreous cyst has confirmed its pigment epithelial origin. However, the specific kind of pigment epithelium involved remains unclear. A 39-year-old female presented with a round-shaped floater causing frequent visual disturbance in the left eye. A pigmented, non lobulated and freely mobile vitreous cyst was observed in the anterior vitreous by slit lamp examination and anterior segment optical coherence tomography. The pigment clumps on the cyst wall showed no autofluorescence. No persistent hyaloid artery or connection between the cyst and ocular structures was found by fundus fluorescein angiography and B-scan ultrasound. Serum tests for cysticercoids, sparganosis and toxoplasma were negative. A diagnosis of idiopathic vitreous cyst was made and no intervention was given. The cyst sank to the inferior part of the vitreous and the patient felt less visual disturbance during one-year follow-up. We described the features of a pigmented vitreous cyst revealed by autofluorescence and anterior segment optical coherence tomography for the first time. The intact retina, the absence of lipofuscin of the cyst and its location in the anterior vitreous led to the hypothesis that the cyst may originate from the ciliary pigment epithelium rather than the retinal pigment epithelium.

  11. Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)

    Science.gov (United States)

    Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook

    2014-01-01

    We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

  12. Infections Associated with Exotic Cuisine: The Dangers of Delicacies.

    Science.gov (United States)

    Hochberg, Natasha S; Bhadelia, Nahid

    2015-10-01

    "Exotic" food dishes are an expression of regional culture, religion, and ethnicity worldwide. With the increase in international travel to remote areas of the world, globalization of the food supply, and changes in food habits, more people are consuming dishes once considered exotic. Such behavioral changes require awareness by consumers and clinicians about the risks of food-borne infections. This chapter addresses pathogens associated with consumption of raw or undercooked seafood including anisakidosis, Diphyllobothrium latum infection, flukes, and other infectious and toxin-mediated diseases. We discuss the geographic distribution of the pathogens, symptomatology, and basic principles of treatment. Food products derived from turtles, snakes, and other reptiles are reviewed, and we address the risk of gnathostomiasis, sparganosis, trichinellosis, and other pathogens. In discussing infections associated with undercooked beef, pork, and bush meat, we address dysentery, amebiasis, toxoplasmosis, Taenia infections, and risks of novel viral infections, among others. We also review infectious risks from poultry, dairy, and other food items, focusing on those organisms encountered less frequently by clinicians in developed countries. The wide range of infectious organisms related to exotic cuisine underscores the importance of educating the adventurous traveler and warrants continued vigilance on the part of the clinician.

  13. Characterization of the Complete Mitochondrial Genome Sequence of Spirometra erinaceieuropaei (Cestoda: Diphyllobothriidae) from China

    Science.gov (United States)

    Liu, Guo-Hua; Li, Chun; Li, Jia-Yuan; Zhou, Dong-Hui; Xiong, Rong-Chuan; Lin, Rui-Qing; Zou, Feng-Cai; Zhu, Xing-Quan

    2012-01-01

    Sparganosis, caused by the plerocercoid larvae of members of the genus Spirometra, can cause significant public health problem and considerable economic losses. In the present study, the complete mitochondrial DNA (mtDNA) sequence of Spirometra erinaceieuropaei from China was determined, characterized and compared with that of S. erinaceieuropaei from Japan. The gene arrangement in the mt genome sequences of S. erinaceieuropaei from China and Japan is identical. The identity of the mt genomes was 99.1% between S. erinaceieuropaei from China and Japan, and the complete mtDNA sequence of S. erinaceieuropaei from China is slightly shorter (2 bp) than that from Japan. Phylogenetic analysis of S. erinaceieuropaei with other representative cestodes using two different computational algorithms [Bayesian inference (BI) and maximum likelihood (ML)] based on concatenated amino acid sequences of 12 protein-coding genes, revealed that S. erinaceieuropaei is closely related to Diphyllobothrium spp., supporting classification based on morphological features. The present study determined the complete mtDNA sequences of S. erinaceieuropaei from China that provides novel genetic markers for studying the population genetics and molecular epidemiology of S. erinaceieuropaei in humans and animals. PMID:22553464

  14. Zoonotic helminths affecting the human eye

    Directory of Open Access Journals (Sweden)

    Eberhard Mark L

    2011-03-01

    Full Text Available Abstract Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis, food consumption (sparganosis, trichinellosis and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis. Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears

  15. Inclusion: An Educational Reform Strategy for All Children.

    Science.gov (United States)

    Malloy, William W.

    Inclusion, a special education reform strategy, should be refocused to accommodate the needs of children with and without disabilities. Inclusion can transform the status of children with disabilities from second to first class citizens and can eliminate the problem of children who have been misdiagnosed. Inclusion is characterized by a shared…

  16. Genitourinary complications as initial presentation of inherited ...

    African Journals Online (AJOL)

    Epidermolysis bullosa (EB) is a rare disorder that presents with urological complications. We present a 6-year-old boy admitted with urological symptoms that revealed an inherited EB misdiagnosed. We also review the literature on this disorder and management of the common urological complications.

  17. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    Science.gov (United States)

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion.

  18. Multilocular peritoneal inclusion cyst mimicking an ovarian tumor: A case report

    OpenAIRE

    Singh, Anju; Sehgal, Alka; Mohan, Harsh

    2015-01-01

    Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in perimenopausal women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a perimenopausal woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts. We discuss the possible ways to avoid such mistakes.

  19. Acute calcific tendinitis of the finger--a case report.

    LENUS (Irish Health Repository)

    Ali, S N

    2004-07-01

    Acute calcific tendinitis of the hand is rare and often misdiagnosed as infection, fracture or periarthritis. It frequently occurs in peri-menopausal women and is caused by deposits of hydroxyapatite crystals. We describe acute calcific tendinitis of the flexor digitorum superficialis insertion in an elderly man taking oral anticoagulants. The differential diagnoses and recommended treatment are discussed.

  20. A Rare Presentation of Aggressive Angiomyxoma as a Cervical Polyp

    African Journals Online (AJOL)

    fibrous histiocytoma, and botryoides rhabdomyosarcoma. AAM may also be clinically misdiagnosed as polyps, myxoma, lipoma, and Bartholin's cyst of vagina. The diagnosis of angiomyxoma may be difficult to establish. The distinctively striking vascular component in AAM helps to rule out the above mentioned neoplasm as ...

  1. Managing a Live Advanced Abdominal Twin Pregnancy | Mpogoro ...

    African Journals Online (AJOL)

    Advanced abdominal pregnancies with live twin fetuses are extremely rare and are misdiagnosed in up to 60% of the cases. Such a case is presented here, highlighting the diagnostic and management challenges encountered. A high index of suspicion in making the diagnosis of this rare variety of ectopic pregnancy, ...

  2. Anterior cruciate ligament reconstruction complicated by pyoderma gangrenosum

    OpenAIRE

    Bagouri, E; Smith, Jon; Geutjens, G

    2012-01-01

    We report a case of pyoderma gangrenosum as a complication of an anterior cruciate ligament reconstruction in a patient with inflammatory bowel disease, which was misdiagnosed initially as a post-operative wound infection. An early dermatology opinion and skin biopsy should be considered in cases of suspected infection where thorough surgical debridement and antimicrobial therapy has failed to improve the clinical picture.

  3. Assessment and Treatment of Obsessive-Compulsive Disorder in College Age Students and Adults.

    Science.gov (United States)

    Spengler, Paul M.; Jacobi, David M.

    1998-01-01

    The potential for clinical-judgment errors in assessing obsessive-compulsive disorder (OCD) makes this a good example for illustrating methods of debiasing and hypothesis testing. This article provides information about this frequently misdiagnosed disorder, delineates methods for assessment and treatment of OCD, and discusses implications of…

  4. Neuropsychiatric symptoms and diagnosis of grey matter heterotopia

    African Journals Online (AJOL)

    Testing revealed some cognitive difficulties and severe impairment of frontal lobe functions. A magnetic resonance imaging (MRI) scan of his brain revealed the presence of GMH, which had previously been misdiagnosed as tuberous sclerosis. An MRI scan of the brain is the special investigation of choice for the correct ...

  5. Comorbidity of autoimmune thyroid disorders and psychiatric disorders during the postpartum period : A Danish nationwide register based cohort study

    NARCIS (Netherlands)

    Bergink, V.; Pop, V.J.M.; Nielsen, P.R.; Agerbo, E.; Munk-Olsen, T.; Liu, X.

    2018-01-01

    The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study

  6. Squamous odontogenic tumour: report of five cases from Nigeria ...

    African Journals Online (AJOL)

    This variation may be due the limited number cases studied, but are however important additions to the few reported cases. Conclusion: Care should be taken not to misdiagnose this condition as acanthomatous ameloblastoma or well differentiated squamous cell carcinoma. Although, it has an infiltrative pattern of growth, ...

  7. Video electroencephalography monitoring differentiates between epileptic and non-epileptic seizures

    DEFF Research Database (Denmark)

    Nørmark, Mette Borch; Erdal, Jesper; Kjær, Troels Wesenberg

    2011-01-01

    Epilepsy is often misdiagnosed and approximately one in every four patients diagnosed with refractory epilepsy does not have epilepsy, but instead non-epileptic seizures. Video electroencephalography monitoring (VEM) is the gold standard for differentiation between epileptic and non-epileptic...... seizures. The purpose of this study was to investigate the effectiveness of VEM as a diagnostic tool....

  8. Neosporosis in dogs

    Science.gov (United States)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of dogs and cattle worldwide. Additiona...

  9. Diagnostic value of Autoantibodies to GAD65 and IA-2 in Patients ...

    African Journals Online (AJOL)

    Background: Latent autoimmune diabetes in adults (LADA) accounts for11 % of all cases of diabetes and often misdiagnosed as type 2diabetes. LADA resembles type 1diabetes and shares common physiological characteristics of type 1 but it does not affect children and has been classified distinctly as being separate from ...

  10. Lewy body dementias

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Korbo, Lise

    2017-01-01

    Dementia with Lewy bodies and Parkinson disease dementia share the same pathophysiology. Together they are called Lewy body dementias and are the second most common type of dementia. Lewy body dementias receive little attention, and patients are often misdiagnosed, leading to less than ideal...

  11. Sella turcica chondroma associated with hypopituitarism - a case report; Condroma de sela turca associado a hipopituitarismo - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Bueno, Tarita D.L.S.; Castro, Ana Valeria B.; Haddad, Adriana L. Mendes; Troja, Simone; Camhaji, Andrea; Yamashita, Seizo [UNESP, Botucatu, SP (Brazil). Faculdade de Medicina

    2001-02-01

    Intracranial chondromas are rare tumors that generally arise from the skull base or at the sphenoid-ethmoidal region. In these sites chondromas may be misdiagnosed as meningiomas, neurinomas or craniopharyngiomas. The authors present the clinical and radiological findings of a patient who underwent survey for excision of a sella turcica chondroma. (author)

  12. Diagnosis and treatment of diabetic ketoacidosis

    African Journals Online (AJOL)

    distinctively rapid and deep breathing (Kussmaul's breathing). Diagnostic criteria ..... depression and for this reason phosphate should be replaced if the serum phosphate ... Children. Due to the inability of infants and small children to give a history of the symptoms of diabetes, DKA is often misdiagnosed at first presentation.

  13. The neuropsychiatry of brain tumours | Oosthuizen | South African ...

    African Journals Online (AJOL)

    Every psychiatrist who has worked in the clinical field for some time will be able to relate a story of a patient who presented with psychiatric symptoms but eventually turned out to have a brain tumour. We all fear that someday we will misdiagnose a brain tumour and therefore fail to save a patient's life. The purpose of this ...

  14. Primaert mucinøst karcinom i huden--en oversigt over litteraturen

    DEFF Research Database (Denmark)

    Breiting, Line Bro; Christensen, Lise; Dahlstrøm, Karin

    2008-01-01

    Primary mucinous carcinoma of the skin (PKMK) is a rare malignant tumour of the sweat glands. It is often misdiagnosed as it has an uncharacteristic gross appearance - and may microscopically resemble a cutaneous metastasis from a mucinous carcinoma of the breast, gastrointestinal tract, lungs...

  15. Primaert mucinost karcinom i huden en oversigt over litteraturen

    DEFF Research Database (Denmark)

    Breiting, L.B.; Dahlstrom, K.; Winther, J.F.

    2008-01-01

    Primary mucinous carcinoma of the skin (PKMK) is a rare malignant tumour of the sweat glands. It is often misdiagnosed as it has an uncharacteristic gross appearance - and may microscopically resemble a cutaneous metastasis from a mucinous carcinoma of the breast, gastrointestinal tract, lungs...

  16. Primaert mucinøst karcinom i huden

    DEFF Research Database (Denmark)

    Kalialis, Louise Vennegaard; Breiting, Line Bro; Klausen, Siri

    2008-01-01

    Primary mucinous carcinoma of the skin is a rare malignant tumour originating from the sweat glands. It is often misdiagnosed clinically since it has an uncharacteristic and variable presentation, and microscopically because it resembles a cutaneous metastasis from the more frequent mucinous...

  17. Primaert mucinost karcinom i huden

    DEFF Research Database (Denmark)

    Kalialis, L.V.; Breiting, L.B.; Klausen, S.

    2008-01-01

    Primary mucinous carcinoma of the skin is a rare malignant tumour originating from the sweat glands. It is often misdiagnosed clinically since it has an uncharacteristic and variable presentation, and microscopically because it resembles a cutaneous metastasis from the more frequent mucinous...

  18. A Patient Presenting with Concurrent Testis Torsion and Epididymal Leiomyoma

    Directory of Open Access Journals (Sweden)

    E. Arpali

    2013-01-01

    Full Text Available Leiomyomas are the second most common tumors of epididymis. Patients with leiomyomas are sometimes misdiagnosed with testicular tumors. A Case of a patient with a scrotal mass presenting with testicular torsion is reported. Concurrent occurrence of testicular torsion and epididymal leiomyoma is an extremely rare condition.

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 273 ... Vol 20, No 1 (2012), Pigmented Invasive Squamous Cell Carcinoma of the Conjunctiva in a Young Nigerian Female – A case report, Abstract PDF. OO Komolafe, CO Omolase, OO Ariyibi. Vol 24, No 2 (2016), Pituitary Adenoma Misdiagnosed as Glaucoma in an Adult Nigerian Male, Abstract PDF.

  20. Nigerian Journal of Ophthalmology - Vol 24, No 2 (2016)

    African Journals Online (AJOL)

    Pituitary Adenoma Misdiagnosed as Glaucoma in an Adult Nigerian Male · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Vivian B. Osaguona, Valentina W. Okeigbemen, 92-94. http://dx.doi.org/10.4103/0189-9171.195207 ...

  1. JUVENILE ARTHRITIS: CLINICAL MANIFESTATIONS AND DIFFERENTIAL DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Алексей Николаевич Кожевников

    2014-12-01

    Full Text Available The diagnosis and treatment of inflammatory joint diseases is the pressing problem of pediatric rheumatology and orthopedics. Juvenile arthritis is the most frequent chronic inflammatory disease of the musculoskeletal system in children and adolescents. Still juvenile arthritis is often misdiagnosed. The article provides current knowledge on juvenile arthritis, its clinical manifestations, as well as diagnostic and treatment strategies, and differential diagnosis.

  2. Anterior sacral meningocele mimicking ovarian cyst: a case report.

    Science.gov (United States)

    Polat, Ahmet Veysel; Belet, Umit; Aydin, Ramazan; Katranci, Seckin

    2013-03-01

    Anterior sacral meningocele (ASM) is a rare congenital anomaly, characterized by herniation through a defect in the anterior aspect of the sacrum. We reported a case of ASM associated with neurofibromatosis, which was mimicking a complex ovarian cyst in ultrasonography. ASM can easily be misdiagnosed as an ovarian cyst and needle aspiration can cause intracranial hypotension syndrome or even death.

  3. Identifying Hearing Loss in Young Children: Technology Replaces the Bell

    Science.gov (United States)

    Eiserman, William; Shisler, Lenore

    2010-01-01

    Hearing loss can too easily be misdiagnosed or overlooked by providers serving young children. Parents and professionals may observe a language delay--an "invisible" condition--while failing to identify the underlying cause. Otoacoustic emissions (OAE) hearing screening technology, used extensively with newborns, is becoming an essential tool,…

  4. Acrodystrophic neuropathy of Bureau and Barriere in Sudanese ...

    African Journals Online (AJOL)

    Our case here has been documented to be a mutilating palmoplantar Keratoderma. The case is histopathologically confirmed to show Keratinized tissue. The condition as mentioned is extremely rare, where misdiagnosed as Epidermolysis Bullosa Dystrophica. Keywords: Acrodystrophic neuropathy of Bureau and Barriere, ...

  5. Epilepsy and Sleep Disorders: a Clinical Review | Sunmonu ...

    African Journals Online (AJOL)

    Sleep disorders could be misdiagnosed as epilepsy and also worsen epilepsy. We searched Medline and Pubmed between 1962-2012, using the following search terms 'sleep', 'epilepsy', 'parasomnia', 'Obstructive Sleep apnea', 'restless legs' 'idiopathic generalized epilepsy'. One hundred and eighteen relevant studies ...

  6. Prevalence of brucellosis in livestock and incidences in humans in ...

    African Journals Online (AJOL)

    Brucellosis is an emerging zoonotic disease that poses a threat to both livestock and public health in east Africa. There are several reports of occurrence of the disease in livestock populations especially in Tanzania and Kenya, suggesting chances of increased spread to humans, and the disease being misdiagnosed for ...

  7. Publications | Page 81 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 801 - 810 of 6374 ... Brucellosis is the commonest zoonotic infection worldwide causing human suffering and economic losses through affected livestock. Symptoms are similar to other febrile syndromes such as malaria and typhoid fever and it is often easily misdiagnosed, resulting in underreporting and misdirected.

  8. Publications | Page 84 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 831 - 840 of 6388 ... Brucellosis is the commonest zoonotic infection worldwide causing human suffering and economic losses through affected livestock. Symptoms are similar to other febrile syndromes such as malaria and typhoid fever and it is often easily misdiagnosed, resulting in underreporting and misdirected.

  9. Publications | Page 82 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 811 - 820 of 6389 ... Brucellosis is the commonest zoonotic infection worldwide causing human suffering and economic losses through affected livestock. Symptoms are similar to other febrile syndromes such as malaria and typhoid fever and it is often easily misdiagnosed, resulting in underreporting and misdirected.

  10. Lyme Disease: Implications for Health Educators.

    Science.gov (United States)

    Harbit, Maryanne Drake; Willis, Dawn

    1990-01-01

    Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

  11. ISSN 2073 ISSN 2073 9990 East Cent. Afr. J. s 9990 East Cent. Afr ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    orthopedics practitioners in diagnosis due to changing anatomy of their growing skeleton. Some are therefore either completely missed or misdiagnosed. If not timely diagnosed and treated may result into grievous complication which includes; neurovascular injuries, open fractures, malunion and elbow stiffness17, 7, 3.

  12. Primary tuberculous cervicitis mimicking cervical carcinoma- a case ...

    African Journals Online (AJOL)

    About 90% of tuberculosis of the cervix are secondary to upper genital tract infection making a true primary cervical tuberculosis extremely rare. The disease is easily misdiagnosed clinically as a cervical carcinoma for several reasons. The clinical presentation, general physical examination and vaginal examination are all ...

  13. Adnexal Tumors of Skin: An Experience at a Tertiary Care Center at ...

    African Journals Online (AJOL)

    Background: Adnexal skin tumors are a heterogeneous group of uncommon tumors usually misdiagnosed clinically due to a huge variety of types and their variants. Histopathology usually helps in establishing the diagnosis. Aims: The study was undertaken to analyze the morphological, clinical, and histological features of ...

  14. Progressive macular hypomelanosis: an overview

    NARCIS (Netherlands)

    Relyveld, Germaine N.; Menke, Henk E.; Westerhof, Wiete

    2007-01-01

    Progressive macular hypomelanosis (PMH) is a common skin disorder that is often misdiagnosed. Various authors have written about similar skin disorders, referring to them by different names, but we believe that all these similar disorders are part of the same entity.PMH is characterized by

  15. Neosporosis in animals-the last five years

    Science.gov (United States)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 in dogs and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of cattle and dogs worldwide. ...

  16. Maternal mortality in a rural Tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy

    NARCIS (Netherlands)

    Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle

    2013-01-01

    Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home

  17. Maternal mortality in a rural tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy.

    NARCIS (Netherlands)

    Rustenhoven-Spaans, I.; Melkert, P.; Nelissen, E.J.T.; van Roosmalen, J.; Stekelenburg, J.

    2013-01-01

    Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home

  18. Chlorine Dioxide Induced Multiple Chemical Sensitivity: MMPI Validity Problems.

    Science.gov (United States)

    Tentoni, Stuart C.

    This paper discusses Minnesota Multiphasic Personality Inventory (MMPI) data obtained from individuals exposed to chlorine dioxide in the workplace who developed Multiple Chemical Sensitivity Syndrome. The paper explores current research on chlorine dioxide exposed persons who were misdiagnosed on the basis of MMPI interpretations. Difficulties…

  19. A Rare Cause of Postprandial Abdominal Pain

    African Journals Online (AJOL)

    and often misdiagnosed.[2] Prolonged investigation with existing symptoms might cause frustration to patient and relatives. Due to its rarity, reporting clinical symptoms and signs through case report might help identify and diagnose this syndrome more easily in the future. CASE REPORT. A 49-year-old woman was admitted ...

  20. Rectovaginal Endometriosis | Venter | Obstetrics and Gynaecology ...

    African Journals Online (AJOL)

    Background: Deep infiltrating endometriosis (DIE) is a debilitating disease that affects women's quality of life and reproductive function. In clinical practice women with deep infiltrating endometriosis are often misdiagnosed or have several surgeries with suboptimal outcomes. This might be explained by several factors, lack ...

  1. An Unusual Presentation of Myasthenia Gravis | Chijioke | West ...

    African Journals Online (AJOL)

    BACK GROUND: Myasthenia gravis (MG) is generally a rare disorder and may thus be easily misdiagnosed. Misdiagnosis is even more likely when the presentation is atypical. OBJECTIVE: To present and discuss an unusual presentation of myasthenia gravis METHOD: A 67-year-old man presented with progressive ...

  2. Full Body Gait Analysis May Improve Diagnostic Discrimination Between Hereditary Spastic Paraplegia and Spastic Diplegia: A Preliminary Study

    Science.gov (United States)

    Bonnefoy-Mazure, A.; Turcot, K.; Kaelin, A.; De Coulon, G.; Armand, S.

    2013-01-01

    Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body…

  3. Diaphragmatic hernia masquerading as pleural effusion

    Directory of Open Access Journals (Sweden)

    Z Nalladaru

    2012-01-01

    Full Text Available Rupture of the diaphragm is almost always due to major trauma. We present here an unusual and rare case of late presentation of diaphragmatic hernia after an innocuous injury. The patient was initially misdiagnosed as a left pleural effusion on the basis of chest X-ray and ultrasound findings. Finally, the diagnosis was confirmed on computerized scanning.

  4. Renal replacement lipomatosis and xanthogranulomatous pyelonephritis: differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romero, Frederico R. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil); Pilati, Roberto; Brenny Filho, Thadeu; Caboclo, Maria Fernanda Sales Ferreira [Hospital Sao Vicente de Curitiba, PR (Brazil); Silva, Antonio de Padua Gomes [Centro de Citopatologia Parana Ltda. (Citopar), Curitiba, PR (Brazil); Cravo, Marco Aurelio [Laboratorio de Patologia e Citologia (Consulpat), Curitiba, PR (Brazil)

    2011-05-15

    Renal replacement lipomatosis (RRL) is a relatively uncommon entity, although misdiagnosis - mainly with xanthogranulomatous pyelonephritis (XGP) - due to lack of awareness by urologists, radiologists, and pathologists may be responsible for underreporting. We illustrate a case of RRL that was initially misdiagnosed as XGP, and compare it with a classic case of XGP, underscoring the similarities and the differences between them. (author)

  5. Delirium followed by neuroleptic malignant syndrome in ...

    African Journals Online (AJOL)

    Delirium and neuroleptic malignant syndrome (NMS) are two uncommon syndromes that are often unrecognized or misdiagnosed by the primary physicians as functional psychiatric disorders. The infrequency and the heterogeneity of clinical manifestation, progression and outcome with which those diagnoses are ...

  6. Clinical Perspective The diagnosis and treatment of delirium in ...

    African Journals Online (AJOL)

    Delirium is commonly encountered in the setting of paediatric consultation-liaison psychiatry. However, it is commonly misdiagnosed as current operational diagnostic criteria may be difficult to apply in children. We present a practical approach to eliciting the signs and symptoms of delirium in children and a proposed ...

  7. HIV-associated non-hodgkins lymphoma of the small intestines ...

    African Journals Online (AJOL)

    Key words: HIV, Non-Hodghns, Lymphoma and small intestinal. Malignant tumors of the ... of HIV-associated non-Hodgkin's lymphoma involving the small ... In t h s review a case of HIV-associated NHL of the small intestine presenting with a pelvic mass and mis-diagnosed as a slow-lcalang ectopic pregnancy is presented.

  8. SAJP 518.indd

    African Journals Online (AJOL)

    2014-08-02

    Aug 2, 2014 ... pervasive developmental disorder (PDD) which is characterised by a ... Childhood disintegrative disorder (CDD) is a rare pervasive developmental disorder, which is often misdiagnosed as schizophrenia, probably due to the resultant ... grasp and dexterity. In terms of sensory processing he had problems.

  9. Download this PDF file

    African Journals Online (AJOL)

    Administrator

    many of these side effects are multi-factorial, management of HIV patients should take into consideration such side effects in making treatment decisions based on ... of diagnosis, where the condition may be misdiagnosed as “idiopathic” ..... Hyperlipidemia (elevated cholesterol and triglycerides) has been noted more ...

  10. Causes of misdiagnosis and mistreatment of spinal tuberculosis with radiotherapy in nonendemic areas : A pitfall in diagnosis and treatment - Hazards of radiotherapy on the tuberculous lesion

    NARCIS (Netherlands)

    Jutte, P.C.; Van Altena, R.; Pras, E.; Thijn, C.J.

    2005-01-01

    Study Design. Report of initially misdiagnosed and mistreated cases. Objectives. To report a previously undescribed misdiagnosis and subsequent mistreatment with radiation for tuberculosis of the spine and to promote awareness for tuberculosis in nonendemic areas. Summary of Background Data. It is

  11. Late-presenting congenital diaphragmatic hernia | Hamid | African ...

    African Journals Online (AJOL)

    Patients and Methods: This retrospective study included all the babies and children >1 month of ... Babies with age <1 month were excluded from the study. Data regarding ... In two patients, CDH was misdiagnosed as pneumothorax and had got chest tube inserted in other hospitals before referral to this tertiary care centre.

  12. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) .... and prolonged immobilization, hence, the possibility that her PE could have resulted from superior ... been forgotten and was alluded to by Diaz etal., as “a syndrome rediscovered in their report.”[20].

  13. Bilateral Paratesticular Liposarcoma ‑ A Rare Case Report

    African Journals Online (AJOL)

    scrotal swelling which was misdiagnosed as inguinal hernia. Intraoperative diagnosis of testicular tumor was made. High inguinal orchiectomy was done. Histopathological examination revealed it to be liposarcoma of the cord. To our knowledge, there is no reported case of bilateral paratesticular liposarcoma in English ...

  14. Spontaneous ureteric rupture secondary to an invasive desmoid tumour

    Directory of Open Access Journals (Sweden)

    Peter Daechul Yoon

    2014-01-01

    CONCLUSION: Spontaneous rupture of the ureter is often misdiagnosed as other conditions. History taking and examination can be unreliable, hence a high level of suspicion and further investigations should be utilised. Once the diagnosis is made, treatment can be individualised based on aetiology.

  15. Biliary cystadenoma

    Science.gov (United States)

    Bartolome, Miguel A Hernandez; Ruiz, Sagrario Fuerte; Romero, Israel Manzanedo; Lojo, Beatriz Ramos; Prieto, Ignacio Rodriguez; Alvira, Luis Gimenez; Carreño, Rosario Granados; Esteban, Manuel Limones

    2009-01-01

    The diagnosis of cystadenoma is rare, even more so when located in the extrahepatic bile duct. Unspecific clinical signs may lead this pathology to be misdiagnosed. The need for pathological anatomy in order to distinguish cystadenomas from simple biliary cysts is crucial. The most usual treatment nowadays is resection of the bile duct, together with cholecystectomy and Roux-en-Y reconstruction. PMID:19630118

  16. Prevalence of prolonged QTcinterval in electrocardiograms of 1 -12 ...

    African Journals Online (AJOL)

    Background: Children with long QT intervals are prone to life-threatening ventricular arrhythmias which may lead to seizure and syncope and may be misdiagnosed as seizure. Objective: This study aimed to assess the frequency of long QT intervals in children with and without convulsion. Method: This study is case-control.

  17. Ipsilateral dislocation of the shoulder and elbow: A case report

    African Journals Online (AJOL)

    Pr KODO

    Abstract. Ipsilateral dislocation of the shoulder and elbow is uncommon. Shoulder dislocation is often misdiagnosed on admission. We report the case of an 31-year old male whose dislocations were both recognised at the initial examination. Diagnosis pitfalls, mechanism, and management of this rare injury are reviewed.

  18. Ipsilateral dislocation of the shoulder and elbow: A case report ...

    African Journals Online (AJOL)

    Ipsilateral dislocation of the shoulder and elbow is uncommon. Shoulder dislocation is often misdiagnosed on admission. We report the case of an 31-year old male whose dislocations were both recognised at the initial examination. Diagnosis pitfalls, mechanism, and management of this rare injury are reviewed. Keywords: ...

  19. Traumatic upper cervical esophageal perforation in childhood with ...

    African Journals Online (AJOL)

    morbidity and mortality if misdiagnosed. There is still no consensus on the assessment and elective management of children with trauma and esophageal rupture .... saliva aspiration may lead to complications ranging from mild aspiration pneumonia to severe respiratory distress. In cases of cervical esophageal perforations ...

  20. Chiari I malformation with underlying pseudotumor cerebri: Poor symptom relief following posterior decompression surgery

    Directory of Open Access Journals (Sweden)

    Ahmed Alnemari

    2017-01-01

    Conclusion: This study suggests that the presence of Chiari I malformation in a patient conceals the symptoms of PTC which may become apparent following posterior decompression surgery. Other possibilities could be that the patients are misdiagnosed for Chiari I malformation when they are in fact suffering from PTC, or that PTC is a complication of surgery.

  1. Acute pancreatitis in children: an experience with 50 cases | Ibrahim ...

    African Journals Online (AJOL)

    Background/purpose Acute pancreatitis in childhood is not common. It can be associated with severe morbidity and mortality. The role of clinical evaluation is vital as it can be misdiagnosed easily. The objective of this study was to review the etiology, presentation, diagnosis, management, and prognosis of acute ...

  2. Author Details

    African Journals Online (AJOL)

    Oloyede, IP. Vol 40, No 4 (2013) - Articles Normative values and anthropometric determinants of lung function indices in rural Nigerian children: A pilot survey. Abstract PDF · Vol 40, No 4 (2013) - Articles Bronchial foreign body misdiagnosed as pulmonary tuberculosis. Abstract PDF · Vol 42, No 2 (2015) - Articles Pattern of ...

  3. Biliary cystadenoma

    Institute of Scientific and Technical Information of China (English)

    Miguel A Hernandez Bartolome; Sagrario Fuerte Ruiz; Israel Manzanedo Romero; Beatriz Ramos Lojo; Ignacio Rodriguez Prieto; Luis Gimenez Alvira; Rosario Granados Carreno; Manuel Limones Esteban

    2009-01-01

    The diagnosis of cystadenoma is rare, even more so when located in the extrahepatic bile duct. Unspecific clinical signs may lead this pathology to be misdiagnosed. The need for pathological anatomy in order to distinguish cystadenomas from simple biliary cysts is crucial. The most usual treatment nowadays is resection of the bile duct, together with cholecystectomy and Roux-en-Y reconstruction.

  4. A Primary Hepatic Lymphoma Treated with Liver Resection and Chemotherapy

    Directory of Open Access Journals (Sweden)

    Konstantinos Bouliaris

    2014-01-01

    Full Text Available Primary hepatic lymphoma (PHL is a rare malignancy, which is frequently misdiagnosed. Although chemotherapy is the treatment of choice there are reports that a combination of surgery and adjuvant chemotherapy can offer better results. Herein we present an interesting case of a large primary non-Hodgkin lymphoma originating from liver was treated with a liver which resection and chemotherapy.

  5. Misdiagnosis and clinical significance of non-tuberculous ...

    African Journals Online (AJOL)

    2011-09-09

    Sep 9, 2011 ... Interventions: sputa from 872 tuberculosis suspects underwent microscopy and culture on solid and liquid media. The growth ... in this study, but some the ntM disease cases could have been misdiagnosed as tb cases. introduction ..... the prevention of tuberculosis in healthcare facilities in resource-limited ...

  6. Complete upper urinary tract obstruction caused by penetrating ...

    African Journals Online (AJOL)

    Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year old man who was admitted to the hospital with multiple abdominal gunshot wounds. Laboratory findings showed worsening anemia, and the computed tomography (CT) ...

  7. Allergic rhinitis

    NARCIS (Netherlands)

    Greiner, Alexander N.; Hellings, Peter W.; Rotiroti, Guiseppina; Scadding, Glenis K.

    2011-01-01

    Allergic rhinitis is a very common disorder that affects people of all ages, peaking in the teenage years. It is frequently ignored, underdiagnosed, misdiagnosed, and mistreated, which not only is detrimental to health but also has societal costs. Although allergic rhinitis is not a serious illness,

  8. All about neosporosis in Brazil

    Science.gov (United States)

    Neospora caninum is a protozoan parasite with canids as the definitive hosts and many warm blooded animals as intermediate hosts. Until late 1988, it was misdiagnosed as Toxoplasma gondii when it was named and distinguished from T. gondii. Although these parasites are structurally similar they are b...

  9. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) is much rarer, more so when it occurs in the setting of puerperium. Although cerebral sagittal sinus thrombosis can occur at any time during life, women are particularly vulnerable before delivery and ...

  10. Fasciite nodulaire de la cavite buccale | Maamouri | Journal ...

    African Journals Online (AJOL)

    Introduction: Nodular fasciitis is a benign tumour-like lesion characterized by fibroblastic proliferation. It is common in subcutaneous fascia, usually of the upper extremity but it's very rare in the oral cavity. Frequently misdiagnosed as sarcoma due to its rapid growth, rich cellularity and mitotic activity. Patients and Methods: ...

  11. Protecting the tuberculosis drug pipeline: stating the case for the rational use of fluoroquinolones

    NARCIS (Netherlands)

    Migliori, Giovanni Battista; Langendam, Miranda W.; D'Ambrosio, Lia; Centis, Rosella; Blasi, Francesco; Huitric, Emma; Manissero, Davide; van der Werf, Marieke J.

    2012-01-01

    The use of fluoroquinolones (FQs) to treat lower respiratory tract infections (LTRI) other than tuberculosis (TB) allows selection of Fa-resistant TB when TB is misdiagnosed. This study maps national guidelines on the use of FQs for LRTI in Europe and determines the risk of Fa-resistant TB upon FQ

  12. False-positive HIV test results in infancy and management of uninfected children receiving antiretroviral therapy.

    Science.gov (United States)

    Sutcliffe, Catherine G; Moss, William J; Thuma, Philip E

    2015-06-01

    This report summarizes 2 children misdiagnosed with HIV infection in a clinic in rural Zambia and discusses the implications of false-positive HIV DNA tests in HIV-exposed infants, including the potential magnitude of the problem. Recommendations are needed to address the management of children receiving antiretroviral therapy who are suspected of being uninfected.

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    Prof

    disease but not with other clinical or biological characterics ... histological features. We report a case of Crohn's disease of the entire colon with rectal sparing presenting with recurrent perianal fistula that had earlier on been misdiagnosed and treated for other things. The patient was ... Biopsy of the fistula tract showed.

  14. First detection of human dirofilariasis in South Africa

    Directory of Open Access Journals (Sweden)

    Krishnee Moodley

    2015-03-01

    Full Text Available Humans are occasionally inadvertently infected with dirofilariae, the zoonotic nematodes. We report two cases of human dirofilariasis in South Africa, an area apparently non-endemic for this infection. Dirofilariasis is frequently misdiagnosed, so increased awareness of this entity in areas that are non-endemic is essential for prevention of inappropriate investigations and invasive therapy.

  15. Comparison of Knowledge of Obsessive-Compulsive Behavior between Counseling Students and School Administration Students.

    Science.gov (United States)

    Foster, Sandy

    Obsessive-compulsive adolescence behavior in the classroom environment can be disruptive, affecting the teacher and other students. Certain personality traits of the obsessive-compulsive are obvious, while other symptoms are frequently misdiagnosed. As school staff are often the first step in the primary diagnosis process, the purpose of this…

  16. [Biomarkers for Mood Disorders and a Novel Antidepressant (R)-ketamine].

    Science.gov (United States)

    Hashimoto, Kenji

    2017-10-01

    Depression is often misdiagnosed as major depressive disorder in patients with bipolar disorder. Therapeutic drugs for these two disorders are quite different, but the anesthetic ketamine shows fast-acting antidepressant effects in treatment-resistant patients with these disorders. Here, we discuss biomarkers for both disorders, recent findings regarding ketamine, and predictable biomarkers for ketamine's antidepressant actions.

  17. Parvovirus B19 viremia in children with systemic lupus erythematosus

    African Journals Online (AJOL)

    Background: Parvovirus B19 infection may present with fever, rash, nonerosive arthritis, hepatitis, anemia, thrombocytopenia, leucopenia and positive ANA, B19 infection may be misdiagnosed as new onset systemic lupus erythematosus. At the same time, B19 infection and systemic lupus erythematosus may occur ...

  18. Review Article: Anorectal abscesses: a review of presentation and ...

    African Journals Online (AJOL)

    Conclusion: There is the need for awareness of the various modes of presentations and management of this entity. It should also be considered as a differential diagnosis of causes of low back and pelvic pains to stem the consequences associated with mis-diagnosing and treating this condition. Sahel Medical Journal Vol.

  19. Rheumatoid Arthritis Associated with Pulmonary Fibrosis in Nigerians

    African Journals Online (AJOL)

    Rheumatoid arthritis may sometimes present with extra-articular involvement, pulmonary involvement is not common. Rheumatoid arthritis has been reported among Nigerians and extra-articular manifestations are rarely seen. One of the patients was misdiagnosed and mismanaged as a patient with pulmonary tuberculosis ...

  20. Annals of Medical and Health Sciences Research - Vol 3, No 1a ...

    African Journals Online (AJOL)

    Superior mesenteric artery syndrome: an uncommon cause of abdominal pain mimicking gastric outlet obstruction · EMAIL FREE FULL TEXT EMAIL FREE ... Progressive supranuclear palsy misdiagnosed as Parkinson's disease: a case report and review of literature · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT