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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. Human sparganosis, a neglected food borne zoonosis.

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    Liu, Quan; Li, Ming-Wei; Wang, Ze-Dong; Zhao, Guang-Hui; Zhu, Xing-Quan

    2015-10-01

    Human sparganosis is a food borne zoonosis caused by the plerocercoid larvae (spargana) of various diphyllobothroid tapeworms of the genus Spirometra. Human infections are acquired by ingesting the raw or undercooked meat of snakes or frogs, drinking untreated water, or using raw flesh in traditional poultices. More than 1600 cases of sparganosis have been documented worldwide, mostly in east and southeast Asia. Sporadic cases have been reported in South America, Europe, and Africa, and several cases have been described in travellers returning from endemic regions. Epidemiological data suggest that the increased effect of sparganosis on human health is because of greater consumption of raw meat of freshwater frogs and snakes. This Review provides information about the Spirometra parasites and their lifecycles, summarises clinical features, diagnosis, and treatment of human sparganosis, and describes geographical distribution and infection characteristics of Spirometra parasites in host animals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Ultrasonographic Findings of Subcutaneous and Muscular Sparganosis

    International Nuclear Information System (INIS)

    Park, Hee Jin; Park, Noh Hyuck; Lee, Eun Ja; Park, Chan Sub; Lee, Sung Moon; Park, Sung Il

    2009-01-01

    This study was deigned to evaluate the ultrasonographic findings of subcutaneous and intramuscular sparganosis. Nine cases of histologically proven subcutaneous and intramuscular sparganosis lesions in seven patients (mean patient age, 59 years; M:F = 6:1) were reviewed retrospectively. Two patients had recurrent sparganosis. A color Doppler examination was performed in all cases. A prior history of ingestion of raw snake meat was noted for two patients. Patients presented with a palpable mass and induration (n = 7) and dull pain (n = 4). Lesion locations were in the thigh (n = 4), lower leg (n = 2), chest wall (n = 1), an inguinal location (n = 1) and the neck (n = 1). Five lesions were in the subcutaneous fat layer and four lesions had intramuscular locations. Calcification was noted in two cases. All cases showed heterogeneous hypoechoic serpiginous tubular-and-oval lesions. The lesions were conglomerated or discrete in appearance. All nine cases showed the presence of lesions with a multi-layered wall with variable intraluminal echogenicity, at least in one segment of the lesion. Increased vascularity was noted on color Doppler examinations in two patients with pain. Subcutaneous or intramuscular sparganosis should be included in the differential diagnosis when a serpiginous tubular-and-oval lesion is noted that is seen with a multi-layered wall with variable intraluminal echogenicity

  7. Sparganosis of the Breast that Mimicked Metastasis: A Case Report

    International Nuclear Information System (INIS)

    Kim, Jae Woon; Hwang, Mi Soo

    2011-01-01

    Sparganosis of the breast is a rare parasitic infection of humans. If the breast is involved, then this condition presents as soft tissue masses that mimic breast cancer. We report here on the radiologic feature of sparganosis in a patient with gastric cancer and this mimicked metastasis. We also briefly review the relevant literature

  8. Parasitic lesion of the insula suggesting cerebral sparganosis: case report

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    Cummings, T.J.; Madden, J.F.; McLendon, R.E.; Gray, L.; Friedman, A.H.

    2000-01-01

    Cerebral sparganosis, a parasitic disease, rarely produces a chronic active inflammatory response in the brain. Clinically and radiographically the process may mimic a neoplasm. We report a 30-year-old man who underwent surgical exploration for a mass in the insular cortex. Histology revealed a densely fibrotic mass heavily infiltrated with plasma cells and lymphocytes, in which were embedded parasitic forms consistent with sparganosis. We describe the MRI appearances and pathologic features. Intracranial mass lesions secondary to sparganosis must be considered in patients with a history of travel to endemic areas, especially Asia. (orig.)

  9. Vulva Fibroadenoma Associated with Lactating Adenoma in a 26-Year-Old Nigerian Female

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    C. C. Anunobi

    2013-01-01

    Full Text Available Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the clinician and the anatomical pathologist. Once excisional biopsy is done and the lesion confirmed histologically, the anxious patient can be reassured.

  10. An unusual case of urinary sparganosis in the Indian subcontinent

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    Bajpai Trupti

    2018-01-01

    Full Text Available Spirometra is a genus of pseudophyllidean cestode that reproduces in canines and felines but can cause pathology in humans. When humans harbour plerocercoids of these tapeworms outside the intestine, it can cause sparganosis. We report a case of urinary sparganosis in a young woman, passing multiple spargana worms in her urine. The worm was identified as the plerocercoid larvae of Spirometra spp., and the case was managed successfully.

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

    African Journals Online (AJOL)

    Seroepidemiologic Survey for Human Sparganosis in Mto wa Mbu Division, Monduli District, Tanzania. ... Data for the questionnaire for all 116 ELISA positive inhabitants revealed that had history of eating game meat and drinking water from running springs. The data revealed that ELISA would be useful to find infected ...

  12. Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics

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    Gong Caigui

    2012-09-01

    Full Text Available Abstract Background Cerebral sparganosis in children is an extremely rare disease of central nervous system, and caused by a tapeworm larva from the genus of Spirometra. In this study, we discussed and summarized epidemiological, clinical and MR imaging characteristics of eighteen children with cerebral sparganosis for a better diagnosis and treatment of the disease. Methods Eighteen children with cerebral sparganosis verified by pathology, serological tests and MR presentations were retrospectively investigated, and the epidemiologic and clinical characteristics of the disease were studied. Results Twenty-seven lesions were found in the eighteen children. Twelve lesions in twelve patients were solitary while the lesions in the rest six patients were multiple and asymmetrical. The positions of the lesions were: seven in frontal, eleven in parietal, four in temporal and two in occipital lobes, one in basal ganglia, one in cerebella hemisphere and one in pons. The lesions were presented as slight hypointensity on T1-weighted images but moderate hyperintensity on T2-weighted images with perilesional brain parenchyma edema. Enhanced MR scans by using Gadopentetic Acid Dimeglumine Salt were performed in the patients, and the images demonstrated abnormal enhancements with the patterns of a peripheral ring, or a tortuous beaded, or a serpiginous tubular shape. Follow-up MR scans were preformed for eight patients, and three out of the eight cases exposed migrations and changes in shapes of the lesion areas. Conclusions The MR presentations in our study in general were similar to those in previous studies. However serpiginous tubular and comma-shaped enhancements of lesions have not been previously reported. The enhanced MR imaging and follow-up MR scans with the positive results from serological tests are the most important methods for the clinical diagnosis of cerebral sparganosis in children.

  13. A case of disseminated central nervous system sparganosis.

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    Noiphithak, Raywat; Doungprasert, Gahn

    2016-01-01

    Sparganosis is a very rare parasitic infection in various organs caused by the larvae of tapeworms called spargana. The larva usually lodges in the central nervous system (CNS) and the orbit. However, lumbar spinal canal involvement, as noted in the present case, is extremely rare. We report a rare case of disseminated CNS sparganosis involving the brain and spinal canal and review the literature. A 54-year-old man presented with progressive low back pain and neurological deficit at the lumbosacral level for 2 months. Imaging indicated arachnoiditis and an abnormal lesion at the L4-5 vertebral level. The patient underwent laminectomy of the L4-5 with lesionectomy and lysis of adhesions between the nerve roots. Microscopic examination indicated sparganum infection. Further brain imaging revealed evidence of chronic inflammation in the left parieto-occipital area without evidence of live parasites. In addition, an ophthalmologist reported a nonactive lesion in the right conjunctiva. The patient recovered well after surgery, although he had residual back pain and bladder dysfunction probably due to severe adhesion of the lumbosacral nerve roots. CNS sparganosis can cause various neurological symptoms similar to those of other CNS infections. A preoperative enzyme-linked immunosorbent assay is helpful for diagnosis, especially in endemic areas. Surgical removal of the worm remains the treatment of choice.

  14. Angiofibroma of the vulva.

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    Ahmadnia, Hassan; Kamalati, Ali; Dolati, Mahmood; Akhavan Rezayat, Alireza; Katebi, Mehrdad

    2014-01-01

    Cellular angiofibroma is a benign and rare tumor. It usually arises in middle-aged women and involves the vulva. Complete local excision of the tumor is the best cure, and, usually, there is no recurrence after surgery. We describe a 20-year-old woman with a painless, growing vulvar mass who presented about 3 years ago. Her past medical history was negative for oral contraceptives, tobacco, and alcohol, and there were no similar lesions in her family history. A physical examination revealed two masses on the right and the left labia majora and similar lesions on the left axilla and both breasts. An uncomplicated simple resection of the vulvar masses was done in the operating room. There was no evidence of recurrence 12 months after surgery. Histopathologic examination revealed that the findings were consistent with the diagnosis of the cellular angiofibroma. Based on our knowledge, this patient is the youngest case of vulvar angiofibroma. The lesions were large and symmetrical (on both labia majora), although they differed in size. Extravulvar (breast and axilla) lesions were also noteworthy in this patient.

  15. A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

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    Lee, Yoo Jin; Bae, Young Tae; Kim, Jee Yeon [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Choo, Ki Seok [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2010-12-15

    Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer

  16. 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.

  17. Progressive pseudorheumatoid dysplasia misdiagnosed as ...

    African Journals Online (AJOL)

    Progressive pseudorheumatoid dysplasia misdiagnosed as seronegative juvenile idiopathic arthritis. Ozgur Taspinar, Fatih Kelesoglu, Yasar Keskin, Murat Uludag. Abstract. Background: Progressive pseudorheumatoid dysplasia (PPD) is a rare spondylo- epi-metaphyseal dysplasia (SEMD). It can be confused with juvenile ...

  18. 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

  19. Crohn's disease of the vulva.

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    Barret, Maximilien; de Parades, Vincent; Battistella, Maxime; Sokol, Harry; Lemarchand, Nicolas; Marteau, Philippe

    2014-07-01

    Crohn's disease (CD) of the vulva is a rare, yet under recognized condition. Fistulae arising from the digestive tract account for the greater part of genital lesions in CD. However, cutaneous so-called metastatic lesions of the vulva have been reported in the literature. They are clinically challenging for gastroenterologists as well as for gynecologists, with numerous differential diagnoses, especially among venereal diseases, and require a multidisciplinary approach. The most frequently observed features of the disease are labial swelling, vulvar ulcers, and hypertrophic lesions. Biopsy samples for histological study are mandatory, in order to establish the diagnosis of vulvar CD. Treatment options include oral prolonged courses of metronidazole and systemic immunosuppressive therapy such as corticosteroids and azathioprine, with promising data published on the efficacy of infliximab. Surgery remains restricted to medical treatment failures or resection of unsightly lesions. Prospective studies or case series with long follow-up data are still missing to guide the treatment of this condition. © 2013. Published by Elsevier B.V. All rights reserved.

  20. 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

  1. 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.

  2. 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.

  3. Imaging of the vagina and vulva

    International Nuclear Information System (INIS)

    Souza, Luis Ronan Marquez Ferreira de; Szejnfeld, Jacob; Signorini Filho, Roney Cesar; Marques, Renato Moretti; Nicolau, Sergio Mancini; Goldman, Suzan Menasce

    2006-01-01

    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)

  4. Bicyclist's vulva: diagnostic and therapeutic aspects.

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    Grouin, A; Rouquette, S; Saïdani, M; Henno, S; Lavoué, V; Levêque, J

    2018-04-16

    The authors report a case of a rare vulvar condition in a young cyclist, known as bicyclist's vulva. The diagnosis was based on the clinical context (intensive cycling training with repeated saddle sores, responsible for painless unilateral swelling of the labium majus to a significant size and functional discomfort). Imaging examinations were used to characterise the lesion and its relationship with the pelvic organs. The lesion was composed of connective tissue, poorly demarcated and heavily collagenised without necrotic or haemorrhagic areas. Large cicatricial collagen bundles were observed. The fibroblasts revealed no atypia and just a few scattered undilated vessels ere noted. Special staining did not reveal any amyloid deposits. A complementary immunohistochemical analysis with anti-CD 34 antibody showed vascularisation that was homogeneous and morphologically normal. The treatment was surgery, and in our case the cosmetic and functional impact of wide surgical excision of the lesion was improved by in situ injection of autologous fat. The pathology findings enabled us to rule out other perineal tumours such as aggressive angiomyxoma of the vulva and to describe the lesion microscopically. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  5. Prolonged delirium misdiagnosed as a mood disorder.

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    Cao, Fei; Salem, Haitham; Nagpal, Caesa; Teixeira, Antonio L

    2017-01-01

    Delirium can be conceptualized as an acute decline in cognitive function that typically lasts from hours to a few days. Prolonged delirium can also affect patients with multiple predisposing and/or precipitating factors. In clinical practice, prolonged delirium is often unrecognized, and can be misdiagnosed as other psychiatric disorders. We describe a case of a 59-year-old male presenting with behavioral and cognitive symptoms that was first misdiagnosed as a mood disorder in a general hospital setting. After prolonged delirium due to multiple factors was confirmed, the patient was treated accordingly with symptomatic management. He evolved with progressive improvement of his clinical status. Early diagnosis and management of prolonged delirium are important to improve patient prognosis and avoid iatrogenic measures.

  6. Thyroid hormone resistance misdiagnosed as Graves' disease

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    Manish Gutch

    2017-01-01

    Full Text Available Resistance to thyroid hormone (RTH syndrome is a very rare disorder characterized by mutations of the thyroid hormone receptor beta and is usually inherited as an autosomal dominant trait. Patients with RTH are usually euthyroid but rarely may present with signs and symptoms consistent with hyperthyroidism. Here, we describe the case of a young girl with goiter who was previously misdiagnosed to have hyperthyroidism and was subsequently diagnosed to be suffering from RTH.

  7. Fibroma of the vulva: a case report.

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    Berlin, Melvin; Berlin, Scott

    2007-06-01

    It is rare to see large vulvar growths that are not trauma related in young women. The largest vulvar mass recorded dates back to 1851. Fibroma of the vulva is not common but, if not seen early and removed, can be emotionally draining for the patient. A large vulvar mass was found in an 18-year-old woman and was expeditiously excised. The patient was emotionally withdrawn and would not participate in any school or social activities. She would carry moist paper towels with her to prevent maceration of the lower abdomen and lesion wall. An extraordinary physical finding can embarrass and alter a patient's demeanor and should be addressed without delay. The emotional condition of our patient prior to surgery consisted of depression and emotional stress due to the large vulvar mass. Following surgery the patient was comfortable, and her demeanor is now excellent.

  8. Invasive Paget Disease of the Vulva.

    Science.gov (United States)

    Borghi, Chiara; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Scaffa, Cono; Perotto, Stefania; Leone Roberti Maggiore, Umberto; Recalcati, Dario; Lorusso, Domenica; Raspagliesi, Francesco

    2018-01-01

    Extramammary Paget disease of the vulva (EPDV) is a rare occurrence with an indolent and relapsing course. Progression to invasion occurs in 4% to 19% of cases. The aim of this study is to report clinical-pathological features and outcomes of patients treated for invasive EPDV. Data of consecutive patients treated between 2000 and 2017 for invasive EPDV were reviewed. Among 79 patients with EPDV, 10 (12.7%) presented a microinvasive or invasive form at first diagnosis or during follow-up. All of them underwent upfront radical surgery; 7 (70%) received subsequent radiotherapy, chemotherapy, or both. The mortality rate was 40%. The recurrence rate after treatment for invasive forms was 60%, with a mean time to first recurrence of 20 (range, 5-36) months. Our study confirms that invasive EPDV remains a rare gynecological neoplasm with a poor prognosis. Multicentre trials or well-organized prospective data collection could improve the knowledge about the management of invasive EPDV.

  9. 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.

  10. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

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    Hyun Deok Shin

    2016-04-01

    Full Text Available Benign cystic mesothelioma (BCM is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis.

  11. 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 ...

  12. Cases of pediatric narcolepsy after misdiagnoses.

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    Kauta, Shilpa R; Marcus, Carole L

    2012-11-01

    Narcolepsy is characterized by recurrent brief attacks of irresistible sleepiness. Signs can begin during childhood. However, diagnoses are frequently delayed by 10-15 years because of unfamiliarity with pediatric narcolepsy and variable presentations of its associated features (cataplexy, hypnagogic/hypnopompic hallucinations, and sleep paralysis). Therefore, patients may remain untreated during their formative years. Three children with narcolepsy who were initially misdiagnosed are described. Each child's signs were initially related to depression, hypothyroidism, jaw dysfunction, or conversion disorder. However, after a multiple sleep latency test, the diagnosis of narcolepsy was established. All three patients were treated appropriately with stimulant medications, selective serotonin reuptake inhibitors, or sodium oxybate, and demonstrated positive responses. Although no definitive cure exists for narcolepsy, early recognition and appropriate symptomatic treatment with medications can allow affected children to improve quality of life and achieve normality, both academically and socially. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Ossifying fibroma misdiagnosed as chronic apical periodontitis.

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    de Moraes Ramos-Perez, Flávia Maria; Soares, Ulysses Nicida; Silva-Sousa, Yara Teresinha Corrêa; da Cruz Perez, Danyel Elias

    2010-03-01

    Ossifying fibroma mimicking chronic apical periodontitis is extremely rare. This report describes a case of ossifying fibroma located in the periapical region of the mandibular right canine that was misdiagnosed as chronic apical periodontitis. A 40-year-old woman complained of slight pain in the right anterior mandibular region without mucosal abnormalities or swelling. Radiographically, a well-circumscribed, unilocular, radiolucent lesion was observed that was located in the periapical region of the mandibular right canine, which presented an endodontically treated root canal. Under local anesthesia, the lesion was fully excised. Microscopically, there was fibrocellular connective tissue associated with a mineralized component, which consisted of lamellar or trabecular and woven bone, compatible with the diagnosis of ossifying fibroma. Although it is very rare, ossifying fibroma should be considered in the differential diagnosis of unusual or persistent apical radiolucencies. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Over de behandeling van het carcinoma planocellulare infiltrativum vulvae

    NARCIS (Netherlands)

    Geling, Jozephus Hermannus

    1966-01-01

    SAMENVATTING Het doel van dit proefschrift is de behandeling weer te geven van het infiltratief groeiend plaveiselcarcinoom van de vulva, zoals deze in een aantal grotere gynaecologische centra in Nederland gedurende de jaren 1946 tot en met 1960 is uitgevoerd. Aan de hand van een literatuurstudie

  15. Metastatic clear-cell hidradenocarcinoma of the vulva.

    Science.gov (United States)

    Messing, M J; Richardson, M S; Smith, M T; King, L; Gallup, D G

    1993-02-01

    Clear-cell hidradenocarcinoma is a malignant tumor of sweat gland origin. It is most often found on the trunk, head, and extremities. This case report describes a rare occurrence of this tumor on the vulva of a young woman. The discovery of metastatic disease reflects the potentially aggressive nature of this tumor.

  16. Primary lacrimal canaliculitis – A clinical entity often misdiagnosed

    Directory of Open Access Journals (Sweden)

    Manpreet Singh

    2018-03-01

    Conclusion: PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis.

  17. Pediatric abdominal radiograph use, constipation, and significant misdiagnoses.

    Science.gov (United States)

    Freedman, Stephen B; Thull-Freedman, Jennifer; Manson, David; Rowe, Margot Follett; Rumantir, Maggie; Eltorki, Mohamed; Schuh, Suzanne

    2014-01-01

    To determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there is an association between abdominal radiograph (AXR) performance and misdiagnosis, and features that might identify children with misdiagnoses. We conducted a retrospective cohort study of consecutive children constipation were eligible. Misdiagnosis was defined as an alternative diagnosis during the subsequent 7 days that resulted in hospitalization or an outpatient procedure that included a surgical or radiologic intervention. Constipation severity was classified employing text word categorization and the Leech score. 3685 eligible visits were identified. Mean age was 6.6 ± 4.4 years. AXR was performed in 46% (1693/3685). Twenty misdiagnoses (0.5%; 95% CI 0.4, 0.8) were identified (appendicitis [7%], intussusception [2%, bowel obstruction [2%], other [9%]). AXR was performed more frequently in misdiagnosed children (75% vs 46%; P = .01). These children more often had abdominal pain (70% vs 49%; P = .04) and tenderness (60% vs 32%; P =.01). Children in both groups had similar amounts of stool on AXR (P = .38) and mean Leech scores (misdiagnosed = 7.9 ± 3.4; not misdiagnosed = 7.7 ± 2.9; P = .85). Misdiagnoses in children with constipation are more frequent in those in whom an AXR was performed and those with abdominal pain and tenderness. The performance of an AXR may indicate diagnostic uncertainty; in such cases, the presence of stool on AXR does not rule out an alternative diagnosis. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.

    Science.gov (United States)

    Singh, Manpreet; Gautam, Natasha; Agarwal, Aniruddha; Kaur, Manpreet

    2018-03-01

    Primary lacrimal canaliculitis (PLC) is a unique disorder which often gets misdiagnosed by the general as well as speciality-trained ophthalmologists. Elderly patients with history of chronic or recurrent epiphora with discharge, often get mislead towards chronic dacryocystitis. The aim of our report is to discuss the misleading diseases in our PLC patients and to revisit this hidden disease. The patients of PLC who were previously misdiagnosed were studied. The clinical history, presenting clinical features, misdiagnosis, and final management of the patients is described. There were 5 misdiagnosed female patients. A history of chronic redness, watering, discharge, and medial canthal region edema lead to the misdiagnosis of chronic dacryocystitis in 3 (60%) and medial marginal chalazion in 2 (40%) cases. Slit-lamp examination revealed localized hyperemia (n = 5), classical pouting of lacrimal punctum (n = 3), and expressible purulent discharge (n = 3). Two patients without punctum pouting had an explicit yellowish hue/discoloration of the canalicular region. Our patients had a mean 4 visits before an accurate diagnosis. Three-snip punctoplasty with canalicular curettage was performed in three while two were managed conservatively. At last follow-up, all patients were symptom-free with punctum and canalicular scarring in three, who underwent surgery. PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Management of radiation injuries of vulva and vagina

    International Nuclear Information System (INIS)

    Fraunholz, I.B.; Schopohl, B.; Boettcher, H.D.

    1998-01-01

    Background: Acute and late injuries of vulva and vagina are frequent and potentially serious complications in radiotherapy of gynecologic tumors. They still are reported poorly in literature. Methods: Based on a literature search a survey will be given of the modalities, which are used or recommended for prophylaxis or treatment of these radiation injuries. The principles of the different measures will be discussed with available study results. Results: Hygiene measures and the topical application of antimicrobial or granulation stimulating substances, which is mostly based on long standing clinical experience, are the principles of the treatment of acute reactions of vulva and vagina. The topical use of estrogen, which promotes proliferation of epithelium, is generally described in connection with treatment and prophylaxis of late radiation injuries. As a prophylaxis for the late reaction of vaginal stenosis, vaginal dilatation is recommended in literature. Conclusion: With the exception of a few reports on estrogen, there are no data about the effectiveness of the currently used medical substances. The local application of estrogen as prophylaxis of the acute reactions will therefore be examined in a prospective study. (orig.) [de

  2. Familial cleidocranial dysplasia misdiagnosed as rickets over three generations.

    Science.gov (United States)

    Franceschi, Roberto; Maines, Evelina; Fedrizzi, Michela; Piemontese, Maria Rosaria; De Bonis, Patrizia; Agarwal, Nivedita; Bellizzi, Maria; Di Palma, Annunziata

    2015-10-01

    Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia characterized by hypoplastic clavicles, late closure of the fontanels, dental problems and other skeletal features. CCD is caused by mutations, deletions or duplications in runt-related transcription factor 2 (RUNX2), which encodes for a protein essential for osteoblast differentiation and chondrocyte maturation. We describe three familial cases of CCD, misdiagnosed as rickets over three generations. No mutations were detected on standard DNA sequencing of RUNX2, but a novel deletion was identified on quantitative polymerase chain reaction (qPCR) and multiple ligation-dependent probe amplification (MLPA). The present cases indicate that CCD could be misdiagnosed as rickets, leading to inappropriate treatment, and confirm that mutations in RUNX2 are not able to be identified on standard DNA sequencing in all CCD patients, but can be identified on qPCR and MLPA. © 2015 Japan Pediatric Society.

  3. 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

  4. 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.

  5. 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....

  6. Delayed Rebleeding of Cerebral Aneurysm Misdiagnosed as Traumatic Subarachnoid Hemorrhage

    OpenAIRE

    Song, Seung-Yoon; Kim, Dae-Won; Park, Jong-Tae; Kang, Sung-Don

    2016-01-01

    An intracranial saccular aneurysm is uncommonly diagnosed in a patient with closed head trauma. We herein present a patient with delayed rebleeding of a cerebral aneurysm misdiagnosed as traumatic subarachnoid hemorrhage (SAH). A 26-year-old female visited our emergency department because of headache after a motorcycle accident. Brain computed tomography (CT) showed a right-side dominant SAH in Sylvian fissure. Although traumatic SAH was strongly suggested because of the history of head traum...

  7. 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.

  8. Brachytherapy of carcinoma of vulva with 252Cf

    International Nuclear Information System (INIS)

    Spikalovas, V.; Sinkevicius, V.; Drulia, E.; Kurtinaitis, J.

    1996-01-01

    Thirty patients with carcinoma of vulva were treated with interstitial neutron radiotherapy with 252 Cf. Age of patients was from 32 to 83 years. Stage I was in I patient, stage II - in 12, stage III was in 10 patients. The diagnosis of vulvar cancer was made for the first time in 11 cases, 19 patients had recurrences after the initial treatment. Most of these patients also received external irradiation for cancer of vulva and bilateral inguinal sites with a single fraction dose of 2 Gy to a total dose 30-50 Gy. Enlarged inguinal lymph nodes were irradiated additionally to 60 Gy with reduced field of irradiation. When radiotherapy was used repeatedly interstitial brachytherapy comprised the major part of irradiation dose or the therapy was used alone delivering 35-55 iGy. We used 252 Cf sources with increased activity at the ends 20-30 mm long. A number of inserted sources varied from 2 to 10, irradiation dose rate from 20.3 to 236.7 cGy/h, time of irradiation from 10.2 to 12. hours, RBE from 4.6 to 6.33. Special template device made it possible to implant sources in strictly pre-set geometry. Analysis of survival of patients showed that 2 years survival was 66%, 3 years - 60%, and 5 years survival was 49%. In two cases necrotic epithelitis developed with following radiation ulcer which were cured in 3-4 months. Clinical data showed great effectiveness of interstitial neutron therapy having in mind that 19 patients were treated for recurrences of vulvar cancer after previuos treatment

  9. 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.

  10. Metastatic Lobular Carcinoma of the Breast to the Vulva: A Case Report and Review of the Literature

    International Nuclear Information System (INIS)

    Papaioannou, N.; Zervoudis, S.; Grammatikakis, I.; Peitsidis, P.; Palvakis, K.; Youssef, T.F.

    2010-01-01

    Primary breast-like vulva cancer, as well as metastatic disease of breast cancer to the vulva are described to be very rare, especially many years after the treatment of the primary breast tumor. Breast cancer rarely metastasizes to the vulva without finding other metastatic sites. We report a case of a 93-year-old woman with an isolated metastatic vulva nodule thirteen years after the surgical treatment of primary breast cancer. The prior histology was a node negative invasive lobular breast cancer. The histology of the vulva nodule was similar to the primary breast cancer. No other metastatic sites were found by both clinical examination and imaging. When isolated metastasis to the vulva is found, a primary cancer in the gynaecological area should be excluded first

  11. Lichenoid keratosis is frequently misdiagnosed as basal cell carcinoma.

    Science.gov (United States)

    Maor, D; Ondhia, C; Yu, L L; Chan, J J

    2017-08-01

    Lichenoid keratosis (LK), also known as benign lichenoid keratosis or lichen planus-like keratosis, is a solitary, pink to red-brown scaly plaque representing a host immunological response to a variety of precursor lesions. LK is often misdiagnosed as a dermatological malignancy owing to its clinical resemblance to basal cell carcinoma (BCC) or Bowen disease. We performed a retrospective analysis of the pathology records of a series of LK lesions with reference to the demographic features and accuracy of clinical diagnosis. The pathology records from 2008 to 2009 of 263 consecutive patients with a histological diagnosis of LK from a specialized skin laboratory were retrieved. Data relating to clinical diagnosis, age, sex, anatomical location, time of year of presentation and any coexistent pathological lesions adjacent to the LK were recorded. Mean age at presentation was 64 years (range 34-96), and 58% of patients were female. The most common anatomical site was the chest/anterior torso, followed by the back and legs. The most common coexisting lesion was solar keratosis at 14%, followed by seborrhoeic keratosis (SK) at 7.8%. The correct clinical diagnosis of LK was made in 29.5% of cases. The most common clinical diagnosis was BCC (47%), while SK was the preferred diagnosis in 18%. A clinical diagnosis was not given in 5.5% of cases. In conclusion, it appears that LK is frequently misdiagnosed, with misdiagnosis occurring in > 70% of cases in this study. © 2017 British Association of Dermatologists.

  12. Stiff person case misdiagnosed as conversion disorder: A case report.

    Science.gov (United States)

    Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

    2017-01-01

    Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.

  13. Long-term impact of postoperative radiotherapy in carcinoma of the vulva FIGO I/II

    International Nuclear Information System (INIS)

    Busch, Martin; Wagener, Birgit; Schaffer, Moshe; Duehmke, Eckhart

    2000-01-01

    Purpose: Between 1953 and 1978, postoperative radiotherapy was used as an adjuvant therapy for carcinoma of the vulva that had not been treated with radical vulvectomy. We evaluated long-term results and possible prognostic factors. Methods and Materials: Ninety-two patients were treated. Surgical procedures were simple vulvectomy, electrocoagulation, or local excision. Radiotherapy doses to the vulva ranged from 0 to 90 Gy. All patients received radiotherapy to the inguinal lymph nodes, ranging from 30 to 60 Gy. Thirty-year retrospective follow-up was done evaluating the records and statistical survival rates. Results: Five-year actuarial survival rates in T1 patients were 71% (77% cause-specific survival rate), for T2 patients 43% (48% cause-specific survival rate). The difference between T1 and T2 patients was significant (p < 0.05). Patients with tumors of the labia minora had a significantly higher survival rate than those with different sites affected. Doses of 45 Gy or more to the vulva were sufficient to increase the 5-year cause-specific survival rate from 55% to 88%. The results in three subgroups were analyzed, group 1 having received electrocoagulation, but no radiotherapy of the vulva; group 2, local excision and doses of 40 Gy to the vulva; group 3, local excision and doses of 60 Gy to the vulva. There was a significant effect on 10-year cause-specific survival rates: 48% in group 1, 11% in group 2, and 88% in group 3. In multivariate analysis, the significant independent factors were T classification, tumor sites and--with only marginal significance--radiation doses to the vulva. Conclusions: The prognosis in early vulva carcinoma after nonradical surgery primarily depends on T classification and the site of the primary tumor. With univariate analyses, the dose has a significant effect on survival. In multivariate analyses the dose is a marginal independent factor in the whole group of patients. After nonradical surgery of early vulva carcinoma, the

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Primary Neuroendocrine Tumor of Vulva: A Case Report

    Directory of Open Access Journals (Sweden)

    Shaghayegh kamian

    2018-02-01

    Full Text Available Vulvar cancer is a rare malignancy representing less than 1% of the cancers, which is diagnosed in women with a high incidence of local recurrence and distant metastasis and carries a poor prognosis. We presented a 51-year-old woman with a lesion in the vulva appeared for three months. The lesion was large, ulcerative, hemorrhagic, tender, and mobile with no lymphadenopathy. Excisional biopsy demonstrated a high-grade malignant neoplasm with lymphovascular invasion. Based on the immunohistochemistry test, the patient was diagnosed with neuroendocrine carcinoma with poorly differentiated tumor. In the diagnostic workup, there were two small lymph nodes on the left inguinal area. The patient was subjected to radical vulvectomy and bilateral illioinguinal lymphadenectomy. In addition, she was prescribed to undergo adjuvant chemotherapy for three cycles. Subsequently, she was given hyperfractionated radiotherapy in the pelvis and bilateral inguinals  concurrently with chemotherapy. In the last follow-up visit in 32 months later, the patient was disease-free in the physical examination, and the laboratory tests and imaging findings were normal.

  16. 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....

  17. Misdiagnosed Ovarian Pregnancy to Threatened Abortion: A Case Report

    Directory of Open Access Journals (Sweden)

    Roghaieh Rahmani Beilondi

    2017-10-01

    Full Text Available This study is about a patient with a history of infertility and polycystic ovarian disease who was admitted with spotting and severe abdominal pain, There was one misdiagnosis about this patient and progesterone was prescribed for treating of threatened abortion, following transvaginal ultrasound, one heterogeneous echogenic mass with dimensions of 5.8 × 18 in the vicinity of the left ovary was reported in favor of ectopic pregnancy. The patient was hospitalized and treated with methotrexate with diagnosis of an ovarian ectopic pregnancy. Pregnant women with complaints of bleeding and spotting in early pregnancy should be evaluated in terms of ectopic pregnancy in addition of abortion and molar pregnancy. The aim of this study was to introduce a new case of misdiagnosed ovarian pregnancy instead of threatened abortion.

  18. Metastases of Hepatocellular Carcinoma Misdiagnosed as Isolated Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Greco, Assunta; De Masi, Roberto; Orlando, Stefania; Metrangolo, Antonio; Zecca, Vittorio; Morciano, Giancarlo; De Donno, Antonella; Bagordo, Francesco; Piccinni, Giancarlo

    At present, cardiac metastasis of hepatocellular carcinoma is rarely mentioned in the literature. We report a hepatocellular carcinoma patient with cardiac metastasis misdiagnosed as hypertrophic cardiomyopathy in 2011. Two years later, on presentation of syncope, an abnormal ventricular septal size was recorded by ultrasound scan, and was subsequently shown by magnetic resonance imaging to be a tumour lesion. A myocardial biopsy confirmed infiltration of hepatocellular carcinoma. This observation underlines the risk of hepatocellular carcinoma cardiac metastasis, manifested in its infiltrative form as hypertrophic cardiomyopathy. In conclusion, we suggest that the ultrasound appearance of hypertrophic cardiomyopathy in hepatocellular carcinoma patients should be seen as a "red flag" and recommend the introduction of magnetic resonance imaging assessment of transplant candidates.

  19. 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.

  20. Unusual cause of respiratory distress misdiagnosed as refractory asthma

    Directory of Open Access Journals (Sweden)

    Al-Otair Hadil

    2006-01-01

    Full Text Available We report a young lady, who was labeled as a case of refractory asthma for a few years, based on history of shortness of breath on minimal exertion, noisy breathing and normal chest radiograph. Repeated upper airway exam by an otolaryngologist and computerized tomography scan, were normal. On presentation to our hospital, she was diagnosed to have fixed upper airway obstruction, based on classical flow-volume loop findings. Fibroptic bronchoscopy revealed a web-shaped subglottic stenosis. The histopathology of a biopsy taken from that area, showed non-specific inflammation. No cause for this stenosis could be identified. The patient was managed with rigid bronchoscopy dilatation, without recurrence. We report this case as idiopathic subglottic stenosis, that was misdiagnosed as refractory bronchial asthma, stressing the importance of performing spirometry in the clinic.

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

    International Nuclear Information System (INIS)

    Ueda, Y.; Enomoto, T.; Kimura, T.; Yoshino, K.; Fujita, M.; Kimura, T.

    2011-01-01

    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 vulva r SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulva r 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 vulva r intraepithelial neoplasia (VIN), accompanied with overexpression ofP14"ARF and P16"INK4A . 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.

  2. Proliferating Myositis: An Inflammatory Lesion often Misdiagnosed as A Malignant Tumor.

    Science.gov (United States)

    Binesh, Fariba; Sobhanardekani, Mohammad; Zabihi, Somayeh; Behniafard, Nasim

    2016-12-01

    Proliferative myositis (PM) is a rare inflammatory disease. Most commonly, the lesion occurs in the extremities. Regarding its fast growth and bizarre shape of the cellular components this entity commonly misdiagnosed and the patients undergo improper therapeutic approaches. In other words, it is often misdiagnosed as sarcoma. The diagnosis can only be made by the microscopic examination, so biopsy is mandatory. Here the authors report a patient with PM who was initially misdiagnosed as pleomorphic sarcoma of the lower extremity and explain this rare entity. Proliferative myositis should be taken into account if a fast growing, intramuscular mass occurs in the extremities.

  3. Central Adrenal Insufficiency and Diabetes Insipidus Misdiagnosed as Severe Depression

    Directory of Open Access Journals (Sweden)

    Naoki Hiroi

    2010-01-01

    Full Text Available A 68 year-old Japanese man, who had been suffering from immobilization and disuse syndrome, was admitted to our hospital for evaluation of polyuria with polyposia, hyponatremia and low blood pressure. His plasma osmolality was greater than that of his urine. His endocrinological examination revealed low levels of plasma adrenocorticotropic hormone (ACTH and cortisol, and a normal response of ACTH to the corticotrophin-releasing hormone (CRH challenge. Plasma ACTH did not increase with insulin loading. A low plasma vasopressin (AVP level and no response of AVP to a 5% saline administration were observed. We diagnosed central adrenal insufficiency with central diabetes insipidus. Six months after starting administration of hydrocortisone and 1-deamino-8D-arginine vasopressin, his psychological symptoms had improved, and 1.5 years after starting treatment, he was able to walk. In conclusion, it is not particularly rare for adrenal insufficiency to be misdiagnosed as depression. However, a correct early diagnosis is necessary, because, if adrenal insufficiency is not definitively diagnosed, the patient's quality of life diminishes markedly.

  4. Nonclassic congenital adrenal hyperplasia misdiagnosed as Turner syndrome

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    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.

  5. 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.

  6. 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.

  7. Effectiveness of brachytherapy in treating carcinoma of the vulva

    International Nuclear Information System (INIS)

    Pohar, Surjeet; Hoffstetter, Sylvette; Peiffert, Didier; Luporsi, Elisabeth; Pernot, Monique

    1995-01-01

    , advanced stage, and recurrent vulvar cancer. Conclusions: Brachytherapy is an effective treatment for patients with carcinoma of the vulva who decline surgery or in whom surgery is contraindicated

  8. 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.

  9. Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva

    NARCIS (Netherlands)

    de Hullu, JA; Hollema, H; Piers, DA; Verheijen, RHM; van Diest, PJ; Mourits, MJE; Aalders, JG; van der Zee, AGJ

    Purpose: To determine the diagnostic accuracy of the sentinel lymph node procedure in patients with squamous cell carcinoma of the vulva and to investigate whether step sectioning and immunohistochemistry of sentinel lymph nodes increase the sensitivity for detection of metastases. Patients and

  10. Metastatic clear cell eccrine hidradenocarcinoma of the vulva: survival after primary surgical resection.

    Science.gov (United States)

    Massad, L S; Bitterman, P; Clarke-Pearson, D L

    1996-05-01

    A case of clear cell eccrine hidradenocarcinoma of the vulva metastatic to regional lymph nodes with long survival after surgical resection is presented. Like the only other case reported to date, this suggests that surgical therapy alone may be adequate, even when metastasis is present.

  11. 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.

  12. Colonic Tuberculosis Clinically Misdiagnosed as Anorexia Nervosa and Radiologically and Histopathologically as Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Tariq A Madani

    2002-01-01

    Full Text Available A case of colonic tuberculosis presenting with severe wasting was misdiagnosed as anorexia nervosa at another institution. Double contrast barium enema showed strictures, and ulcerations of the cecum and ascending colon with a skip area. The radiologist believed that these findings were due to Crohn's disease. Colonoscopic biopsies from the involved area revealed histopathological changes typical of Crohn's disease and not tuberculosis. The patient completely recovered with antituberculous therapy without steroids. The case demonstrated the clinical, radiological and histopathological difficulties and misdiagnoses that may be associated with the diagnosis of colonic tuberculosis.

  13. Sonographic diagnosis of gallbladder cancer: analysis of mis-diagnosed cases

    International Nuclear Information System (INIS)

    Park, Ji Hyun; Moon, Jung Mi; Ahn, Sang Won; Song, Ik Hoon

    1993-01-01

    Ultrasonography is the most valuable diagnostic tool in the evaluation of gallbladder (GB) diseases. Although sonographic findings in GB cancer have been well described, the diagnostic accuracy has not been clearly analyzed. Our purpose of this report was to discuss diagnostic difficulties and analyze causes of misdiagnosis of GB cancer based on our recent experience and so may result in more accurate diagnosis of GB cancer. We analyzed 13misdiagnosed cases out of 24 cases of GB cancer with special emphasis on diagnostic difficulties and causes of misidagnosis. The most common type of misdiagnosed GB cancer was thickened wall type which was found in 10 cases. Preoperative sonographic diagnosis of these cases was empyema in 4 cases, cholecystitis in 3, and non-specific GB wall thickening in 1. In 2 cases, any lesion could not be detected at ultrasonography. Two cases with intraluminal type of GB cancer were misdiagnosed ; one being misdiagnosed as cholecystitis with stone, and the other being completely missed. Three cases that were completely missed consist of 2 with focal wall thickening and 1 involving GB neck. In conclusion, sonographic diagnosis of GB cancer is difficult, because the wall thickening type, that mimicks the cholecystitis, is frequent. Thorough and careful investigation of GB is mandatory for eliminating misdiagnosis

  14. Neuroendocrine tumor of vulva: A case report and review of literature

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    Sheikh Zahoor

    2010-01-01

    Full Text Available Neuroendocrine tumor (Merkel cell carcinoma-MCC of the vulva is a very rare entity with less than 15 cases reported in the English literature. It is known for its aggressive behaviour and propensity for early dissemination. The actual cell of origin and etiology of this disease is controversial. In absence of any definite guidelines for management (due to its rarity, extrapolation of data from extra-vulvar MCC seems logical. We present a case of vulvar neuroendocrine tumor who presented at a locally advanced stage.

  15. Vulvovaginectomy and neo-urethrostomy for the treatment of haemangiosarcoma of the vulva and vagina : case report

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    T.P. Hill

    2000-07-01

    Full Text Available Vulvovaginectomy and neo-urethrostomy were performed in a 9-year-old German shepherd dog following a diagnosis of infiltrative vulvar and vestibulovaginal haemangiosarcoma. The dog was presented for intermittent vulvar haemorrhage over a 3-month period. On examination the vulva and vestibulovagina were distended and firm. Vaginal discharge and fine needle aspiration cytology detected anaplastic cells. Haemangiosarcoma was diagnosed on biopsy. A new urethral opening was created in the floor of the vagina allowing resection of the vulva and caudal vestibulovagina. Urinary continence was preserved and healing was without complications.

  16. 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.

  17. Invisibility: the lived experience of women with cancer of the vulva.

    Science.gov (United States)

    Jefferies, Hilary; Clifford, Collette

    2012-01-01

    This study describes an exploration of the lived experience of 13 British women with cancer of the vulva who underwent surgical treatment. A review of the literature highlighted a paucity of knowledge as many studies were conducted during the 1980s and 1990s and investigated sexual functioning only. An interpretive phenomenological approach based on the work of Heidegger and van Manen was used to frame the study by posing the question, "What must it be like to be diagnosed with, and have surgery for a cancer of the vulva?" The women, younger than 50 years, were identified by purposive sampling and interviewed between 6 months and 5 years after surgery. The data were analyzed using framework analysis. The women's lived experience is described in its entirety by the concept of invisibility, characterized as something "no one can see," "heard of," and "talks about." The impact of this invisibility is discussed as the "invisibility of understanding" and "invisibility of support." Although many women may expect to be cured of their vulval cancer, the invisible nature of the condition and the resulting lack of understanding and support may continue for a considerable period, as every aspect of their everyday life and in their relationships may be affected. The challenge now is to raise awareness of this condition and provide greater informational and emotional support for these women.

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

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    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.

  19. 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.

  20. 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.

  1. Differential expression of oestrogen receptor isoforms and androgen receptor in the normal vulva and vagina compared with vulval lichen sclerosus and chronic vaginitis.

    Science.gov (United States)

    Taylor, A H; Guzail, M; Al-Azzawi, F

    2008-02-01

    Although the expression of the oestrogen receptor (ER) alpha isoform and androgen receptor (AR) has been examined in vulval lichen sclerosus (VLS), the distribution pattern of ERalpha, ERbeta and AR has not been described in chronic atrophic vaginitis nor correlated with markers of proliferation (Ki-67) in either of these diseased tissues. To measure the levels and distribution of ERalpha, ERbeta and AR immunoreactivity in relation to Ki-67 in normal and diseased vulva and vagina. The expression of ERalpha, ERbeta and AR in relation to the proliferation marker Ki-67 in VLS, squamous hyperplasia of the vulva and chronic atrophic vaginitis was determined by immunohistomorphometric analysis and compared with that in normal vulva and vagina. VLS showed similar ERalpha and ERbeta expression in the 'epidermal' and 'dermal' tissue layers to that of normal vulvae, whereas AR expression appeared to be absent in most cases. ERbeta and Ki-67 expression was correlated with ERalpha expression but only in the 'fibrovascular' layer of the vulva. ERalpha expression was absent from the 'fibromuscular' layer of diseased vulvae, while ERbeta expression was absent in normal tissues but was highly expressed in diseased vulvae. ERalpha expression was significantly correlated with AR expression in the fibrovascular layer of the vagina and inversely correlated with Ki-67 staining in the parabasal cells of the epidermis in patients with chronic atrophic vaginitis. These data suggest that ER expression and levels may be implicated in the aetiopathology of VLS and chronic atrophic vaginitis.

  2. Extracapsular growth of lymph node metastases in squamous cell carcinoma of the vulva. The impact on recurrence and survival

    NARCIS (Netherlands)

    van der Velden, J.; van Lindert, A. C.; Lammes, F. B.; ten Kate, F. J.; Sie-Go, D. M.; Oosting, H.; Heintz, A. P.

    1995-01-01

    Patients with squamous cell carcinoma of the vulva who present with multiple positive groin lymph nodes have poor survival. Growth of cancer through the capsule of the groin lymph nodes recently has been identified as an important prognostic factor for survival in that patient group. The objective

  3. Cancer - vulva

    Science.gov (United States)

    ... freckle, which may be pink, red, white, or gray Skin thickening or lump Skin sore (ulcer) Other ... vulvar cancer; HPV - vulvar cancer Images Female perineal anatomy References Jhingran A, Russell AH, Seiden MV, et ...

  4. Aggressive angiomyxoma of the vulva in a patient with systemic lupus erythematosus

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    P Pahwa

    2012-01-01

    Full Text Available Aggressive angiomyxoma is a rare, slow-growing mesenchymal neoplasm with a tendency to recur. It mainly involves the pelvis, vulva, perineum, vagina, and urinary bladder in adult women of reproductive age group. We describe a 26-year-old female with large swellings of both labia majora which was histologically diagnosed as aggressive angiomyxoma. She also had systemic lupus erythematosus. The swelling was surgically removed and she had no recurrence at 1-year follow-up. Although it is a rare tumor, it must be considered as a differential diagnosis for any mass in the perineum or soft tissue of the pelvis. Long-term follow-up is necessary for early diagnosis of local recurrence.

  5. The value of radiotherapie in the treatment of the carcinoma of the vulva

    International Nuclear Information System (INIS)

    Lochmueller, H.

    1983-01-01

    In carcinoma of the vulva radical vulvectomy and lymphadenectomy are the treatments of choice if general, condition of the patient size and site of tumor are apt for surgery. The alternative method in high risk patients is a combination of surgical and radiotherapeutic treatment like electrocoagulation, resection, and radiation of the lymph vessels or electroresection and local electron-radiation at the surgically exposed area as well as inguinal and iliacal telecobalt treatment of the lymphnodes sometimes combined with selective lymphadenectomy. Radiation therapy itself as primary treatment seems to be inferior to other methods. The interstitial radiation treatment is only indicated in recurrencies or small tumors which are located in regions which are difficult to reach by surgery. (orig.)

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

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    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.

  7. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    International Nuclear Information System (INIS)

    Brenot-Rossi, I.

    2008-01-01

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99m Tc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  8. Delayed recognition of Wolfram syndrome frequently misdiagnosed as type 1 diabetes with early chronic complications.

    Science.gov (United States)

    Zmyslowska, A; Borowiec, M; Fichna, P; Iwaniszewska, B; Majkowska, L; Pietrzak, I; Szalecki, M; Szypowska, A; Mlynarski, W

    2014-01-01

    Improvements in diagnostic methods and greater genetic awareness have brought remarkable progress in the recognition of monogenic forms of diabetes, including Wolfram syndrome (WFS). WFS is diagnosed based on clinical criteria of coexistence of diabetes mellitus and optic atrophy, and confirmed by molecular analysis; however, the condition is still sometimes misdiagnosed. To begin to understand the reasons for misdiagnosis, we conducted a retrospective analysis of WFS patients who were originally misdiagnosed. The medical histories of 13 pediatric patients with clinical misdiagnosis of type 1 diabetes and early chronic complications made in the years 1995-2010 and who were subsequently correctly diagnosed with WFS based on genetic testing in 2008-2011 were analyzed. The average age of the patients at diabetes onset was 5 (4.4-6.3) years, and the mean HbA1c level at diagnosis was 9.1±2.3%. Initially, all of these patients were treated as having type 1 diabetes with progressive visual impairment despite good metabolic control (mean HbA1c 7.5±1.3%). Diagnosis of optic atrophy was made at an average age of 9 (5.9-11.5) years, which corresponds to 4 years after diabetes recognition (p=0.002). At the time of genetic analysis, the average age of the patients was 16 (12-18.7) years, which corresponds to 7 years after recognition of coexistence of diabetes mellitus and optic atrophy (p=0.007). Delays of at least 7 years occurred before recognition of WFS among a cohort of pediatric patients with diabetes. All patients with WFS were primarily misdiagnosed as having type 1 diabetes. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  9. 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.

  10. Management of a case with misdiagnosed spinal dural arterio-venous fistula.

    Science.gov (United States)

    Lien, Chia-Yi; Lui, Chun-Chung; Lu, Cheng-Hsien; Chang, Wen-Neng

    2014-03-01

    Spinal dural arterio-venous fistula (SDAVF) is an uncommon and easily misdiagnosed vascular malformation. We aimed to report the diagnosis and management of a case with SDAVF. A 62-year-old man suffered from acute paraparesis about 15 months before this study. He underwent a neurosurgical procedure for herniated discs of the cervical spine at that time but there was no relief and the symptoms worsened despite the surgery. Neurologically, he had spastic paraparesis and decreased vibration sensation of the lower limbs. Spinal magnetic resonance imaging (MRI) revealed intra-medullary hyper-intensity lesion at T8 to T10 levels and tubular-like signal void structures in the corresponding posterior sub-arachnoid space. Further trans-arterial angiography through right T6 intercostal artery catheterization revealed engorged veins, thereby confirming the diagnosis of SDAVF. The patient was treated via endovascular embolization (18% Onyx, EV3TM MIT, Bonn, Germany) through spinal angiography and the results showed a marked decrease in engorged veins. After a 4-month follow-up, the patient was symptomatic but stable. Follow-up MRI showed a complete disappearance of the hyper-intensity change of the spinal cord. Spinal MR angiography did not reveal any recurrence of SDAVF. This case study demonstrated the easily misdiagnosed state of SDAVF. Serial neuroimage studies including spinal MRI, endovascular embolization through spinal angiography and MR angiography can be useful tools for its diagnostic confirmation, management and follow-up study.

  11. Tinea manuum misdiagnosed as psoriasis vulgaris: A case of tinea incognito

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    Funda Tamer

    2017-01-01

    Full Text Available Tinea incognito is a dermatophyte infection with altered clinical appearance which is usually caused by the use of immunosuppressive agents such as topical corticosteroids. Hereby, we present a 59-year-old Caucasian male patient with tinea manuum on the dorsum of his left hand. The lesion was formerly misdiagnosed as psoriasis vulgaris and treated with topical corticosteroids. However, the symptoms were worsened. Moreover, new papules and pustules appeared within the lesion. The past medical history was remarkable for psoriasis vulgaris and he had an erythematous and squamous plaque on his lower back resembling psoriasis vulgaris. In order to reach a definitive diagnosis, the skin lesion on the dorsum of the patient’s left hand was examined by light microscopy after the application of 10% potassium hydroxide solution. Detection of septate hyphae confirmed dermatophytosis. The lesion was completely healed with oral terbinafine 250 mg daily for four weeks. Dermatophyte infections in early stages may be misdiagnosed as psoriasis vulgaris and thus, prolonged use of corticosteroids can lead to tinea incognito. Therefore, cutaneous lesions unresponsive to topical corticosteroid treatment should be evaluated with microscopic examination and fungal culture to confirm a suspected dermatophyte infection. Past medical history can provide useful information but a complete dermatological examination should be performed before the final diagnosis is made.

  12. 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.

  13. Comparison Between Sporadic and Misdiagnosed Sporadic Creutzfeldt-Jakob Disease: A Report of Two Cases.

    Science.gov (United States)

    Zhao, Xiongfei; Yu, Yingxin; Zhao, Zhiru; Xu, Jiaping

    2015-06-01

    Definite accurate diagnosis for Creutzfeldt-Jakob disease (CJD) depends on neuropathologic examination of brain biopsy or autopsy. However, transmissible nature makes the invasive examination dangerous. This study was set to determine that the clinical features are for the diagnosis of CJD through a comparison study. We compared clinical features of two cases with initial diagnosis of sporadic CJD. One case was finally diagnosed as definite sporadic CJD. According to World Health Organization diagnosis criteria, the other one, which had been diagnosed as probable sporadic CJD, was confirmed as limbic encephalitis after long-term follow-up. Compared with the case of definite sporadic CJD, the misdiagnosed case did not present typical electroencephalogram (EEG) and diffusion-weighted in magnetic resonance images (DWI) of CJD. However, cerebrospinal fluid in the misdiagnosed patient showed 14-3-3 protein positivity. The patient conditions improved after treatment. Through this case comparison, we conclude that EEG and DWI are necessary for accurate diagnosis of sporadic CJD. Further, long-term follow-up is crucial to diagnosis and treatment of CJD.

  14. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India

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    Sakthiushadevi Jeevarajan

    2017-01-01

    Full Text Available Background. Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Materials and Methods. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. Results. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5% developed recurrence (systemic = 1, regional = 4, and local = 3. The estimated 5-year disease-free survival (DFS was 65.4% and the overall survival (OS was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS significantly affected both DFS and OS. Conclusion. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

  15. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India.

    Science.gov (United States)

    Jeevarajan, Sakthiushadevi; Duraipandian, Amudhan; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Ramamurthy, Rajaraman

    2017-01-01

    Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

  16. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fu-Fen Yin

    2015-01-01

    Full Text Available Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy.

  17. Aloneness: the lived experience of women with cancer of the vulva.

    Science.gov (United States)

    Jefferies, H; Clifford, C

    2011-11-01

    Cancer of the vulva is a rare condition that has been subject to limited research with a paucity of studies into the impact of this disease. Although the physical effects may readily be described, little is known about the psychological, emotional and social impact of this condition. To increase insights, a qualitative research study was undertaken to explore the experiences of women with vulval cancer living in the UK. An interpretive phenomenological approach based on the work of Heidegger and Van Manen was used to frame the study in which 13 women under 50 years of age were interviewed between 6 months and 5 years after their surgery. Data were analysed using framework analysis described by Ritchie and Spencer. This article describes the concept of aloneness which emerged from the data. This includes consideration of the women's sense of isolation due to the geographical distance between the woman's home and the hospital, and a sense of separation as they described their loss of sexual function and ability to enjoy the sexual relationship they had previously, following the onset of their symptoms of vulval cancer and subsequent treatment. The women's sense of aloneness was also manifest in their perception that there was a lack of knowledge and understanding about this condition both in their social world and the healthcare system in which they received treatment. © 2011 Blackwell Publishing Ltd.

  18. All change: the lived experience of younger women with cancer of the vulva.

    Science.gov (United States)

    Jefferies, Hilary; Clifford, Collette

    2012-08-01

    To generate an understanding of the women's own perspectives of their care and address a gap in knowledge in relation to the broader impact of vulval cancer. Few people go though life without experiencing events that can change their perspective on how they see themselves, their role in society and their relationship with those around them. People are multi-dimensional, so a person with has a physical illness is also affected psychologically and sociologically. Qualitative. Based on the work of Heidegger and van Manen, an interpretative phenomenological research study was undertaken to explore the experiences of thirteen women under 50 years of age with vulval cancer living in the UK. Data were analysed using framework analysis and showed that a diagnosis of cancer of the vulva and the subsequent treatment has an effect on physical, psychological and sexual functioning. The concept of 'All Change' expressed the sentiment that following the diagnosis and surgery, everything has changed; life is not the same as it was before diagnosis. This included both physical and psychological changes and impacts on perceptions of body image. The challenge is to raise awareness of vulval cancer among health care professions and society in general and determine the most effective interventions in facilitating pre and post operative support for these women. © 2012 Blackwell Publishing Ltd.

  19. Analysis of vaginal microenvironment in 435 cases with nonneoplastic epithelial disorders of vulva

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    Lan XIE

    2016-03-01

    Full Text Available Objective  To explore the relationship of vaginal micro-ecological condition with the nonneoplastic epithelial disorders of vulva (NNEDV in order to provide clues on diagnosis and treatment of NNEDV. Methods  The outpatient data of 435 cases of NNEDV as diagnosed by biopsy, collected from Jan. 2012 to Jun. 2015 at the Second Affiliated Hospital of Chongqing Medical University, were retrospectively analyzed to evaluate their vaginal microflora. Results  Fifty-four of the 435 patients (12.4% were proved to harbor normal vaginal microflora, and in 381 patients imbalanced vaginal microflora was found (87.6%, and among them the pathogens were clearly diagnosed in 161 cases, accounting for 37.0% (161/435; the incidence of bacterial vaginosis (BV and vulvovaginal candidiasis (VVC was 13.1% and 10.4%, respectively, and it was significantly higher than the incidence of other vaginitis (P<0.05. Conclusion  Most of NNEDV patients are suffering from unbalanced vaginal micro-ecological imbalance, and vaginitis such as BV and VVC may be associated with the NNEDV. DOI: 10.11855/j.issn.0577-7402.2016.02.10

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

    DEFF Research Database (Denmark)

    Sonne, C.; Leifsson, Páll Skuli; Dietz, R.

    2005-01-01

    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 enzyme...... and internal reproductive organs of the present were similar to a reference group of 23 normal adult female polar bears from East Greenland collected in 1999-2002. The aberrant bear was a female genotype, and macroscopic examination of her internal reproductive organs indicated that she was reproductively....... It is hence possible that the previously reported adult female polar bear pseudohermaphrodites from Svalbard are in fact misdiagnoses. Therefore, future studies examining pseudohermaphroditism in wildlife should consider that certain occurrences are natural events, e.g., enlarged clitoris in the present East...

  1. 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.

  2. 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.)

  3. 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.

  4. Fluorouracil implants caused a diaphragmatic tumor to be misdiagnosed as liver metastasis: a case report

    International Nuclear Information System (INIS)

    Shen, Yang-Yang; Qin, Hong-Wei; Zhang, Jian-Bo; Wang, Zhen-Dan; Li, Pang; Pang, Kai; Zhang, Bo; Li, Sheng; Cui, Kai

    2016-01-01

    Fluorouracil implants are widely used in peritoneal interstitial chemotherapy. Curative effects have been obtained, but implants have also caused some complications. We performed an analysis of a 66-year-old male patient’s case history, as well as conventional pathological analysis and Raman spectroscopic detection of the diaphragmatic tumor. We also analyzed the underlying causes of this condition to prevent complications and reduce misdiagnoses in future cases. The patient had a history of peritoneal fluorouracil implantation. Pathological analysis of the diaphragmatic mass revealed foreign particles, and Raman detection showed that the mass contained fluorouracil. Fluorouracil implants may persist due to the high concentrations of this drug used in peritoneal chemotherapy. This finding should provide guidance and improve the application of peritoneal implants. In clinical trials, and the diagnosis of liver metastasis should be based on pathological results

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

    International Nuclear Information System (INIS)

    Koob, Meriam; Durckel, Jean; Dosch, Jean-Claude; Dietemann, Jean-Louis; Entz-Werle, Natacha

    2010-01-01

    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.)

  6. Case report of narcolepsy in a six-year-old child initially misdiagnosed as atypical epilepsy.

    Science.gov (United States)

    Zhou, Jinquan; Zhang, Xi; Dong, Zaiwen

    2014-08-01

    This report describes a case of first-onset narcolepsy in a six-year-old female that was misdiagnosed as atypical epilepsy and other diagnoses at eight different hospitals over a period of 10 months before the correct diagnosis was made. The diagnosis of narcolepsy is more difficult in children because very few of them experience all four cardinal symptoms of narcolepsy - paroxysmal sleep, cataplexy, hypnagogic hallucination, and sleep paralysis - and they often have a more prolonged onset and diverse symptoms. To decrease the time lag between initial presentation and accurate diagnosis, we recommend that in all cases in which children report excessive sleep of unknown etiology - regardless of the associated symptoms - that sleep monitoring and sleep latency tests be conducted to rule out the possibility of narcolepsy. The case highlights the wide variety of presentations of uncommon psychiatric conditions, particularly in children, and the need for clinicians to be aware of the atypical presentations of these conditions when collecting medical histories.

  7. 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

  8. Treatment of the carcinoma of the vulva at the 1st University-Clinic of Gynaecology in Vienna (386 cases)

    International Nuclear Information System (INIS)

    Kucera, H.

    1980-01-01

    In the department of radiotherapy of the 1st University-Clinic of Gynaecology and Obstetrics in Vienna the electroresection and electrocoagulation is practiced with good success in the treatment of carcinoma of the vulva. Of 386 treated cases with vulvar carcinoma, 234 (60,6%) were alive after five years. After surgical treatment the inguinal lymphonodes were irradiated (6000 rad). In comparison with the international statistic of the Annual Report of the results of treatment in gynaecological cancer (1979) the results obtained in Vienna are much better than the international average. (orig.) [de

  9. 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

    In this updated systematic review and meta-analysis, we estimate the pooled prevalence of human papillomavirus (HPV) DNA and HPV type distribution in squamous cell carcinoma of the vulva (vulvar cancer) and vulvar intraepithelial neoplasia (VIN). PubMed, Embase and Cochrane Library databases were...... 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...... samples. Thus, HPV vaccination targeting these HPV types may prevent a substantial number of vulvar lesions....

  10. [The clinical characteristics of 26 cases of hypophosphatemia osteomalacia misdiagnosed as spondyloarthritis].

    Science.gov (United States)

    Jin, Jingyu; Sun, Fei; Wang, Gang; Yang, Jinshui; Luo, Gui; Ma, Hua; Zhao, Zheng; Feng, Lixia; Wang, Yanyan; Zhao, Wei; Zhang, Jianglin; Zhu, Jian; Huang, Feng

    2014-11-01

    To study and summarize the clinical features of hypophosphatemia osteomalacia (HO) misdiagnosed as spondyloarthritis (SpA), aiming to analyze the reasons of misdiagnosis and improve the prognosis of such patients. A total of 26 cases of HO misdiagnosed as SpA were selected. Clinical features, laboratory tests, and image presentations were analyzed. Related literatures were reviewed. (1) Clinical characters: 26 patients were included (12 males and 14 females) with a median age of 38 years (range 20-60). The mean disease duration was 3.2 years (range 0.75 to 10 years). Of all the patients, 15 were diagnosed as tumor-induced HO, 4 were long-term oral adefovir dipivoxil-related HO, 3 were associated with Fanconi syndrome, 2 were related to hyperparathyroidism, while 2 were Sjogren's syndrome complicated with renal tubular acidosis. All of the 26 patients presented with low back pain including 15 with night pain. The time of morning stiffness was about 30 minutes. Non-steroidal anti-inflammatory drugs were given to each patient whereas with poor efficacy, neither did other agents work well, such as glucocorticoids, disease modifying anti-rheumatic drugs and biologics. (2) LABORATORY FINDINGS: the platelet count and inflammatory markers such as erythrocyte sedimentation rate, C-reactive protein (CRP) were usually normal. The level of serum calcium was normal or slightly lower, nevertheless, all patients had hypophosphatemia and increased level of alkaline phosphatase (ALP). Patients with adefovir dipivoxil-related HO, Fanconi syndrome or Sjogren's syndrome complicated with renal tubular acidosis were characterized by hypokalemia, hyperchloremia and alkaline urine. Patients with hyperparathyroidism had elevated parathyroid hormone (PTH). Positive antinuclear antibodies (ANA) (titer ≥ 1: 320), anti-SSA/SSB antibodies were found in patients with Sjogren's syndrome. (3) Radiographic features: sacroiliac joint lesions were found in X-ray, CT, positron emission tomography

  11. Urea cycle disorder misdiagnosed as multiple sclerosis: a case report and review of the literature.

    Science.gov (United States)

    Algahtani, Hussein; Alameer, Seham; Marzouk, Yousef; Shirah, Bader

    2018-04-01

    Urea cycle disorders are a group of inborn errors of metabolism caused by dysfunction of any of the six enzymes or two transport proteins involved in urea biosynthesis. In this paper, we report a patient who presented with neurological dysfunction and coma in the immediate postpartum period. She was misdiagnosed for many years as a case of multiple sclerosis. The importance of reporting this case is to illustrate that the wrong diagnosis of patients as being affected with multiple sclerosis for many years due to magnetic resonance imaging abnormalities rather than the classic relapsing-remitting nature of the disease may lead to catastrophic consequences. The patient was treated with intravenous steroids several times, which is contraindicated in patients with urea cycle disorders as it may precipitate acute hyperammonemic attacks. In addition, the management of urea cycle disorder could have started earlier and avoided multiple admissions to the intensive care unit. We believe that the presence of symmetric hyperintense insular cortical changes are seen in multiple hyperammonemic processes, and in the context of the clinical presentation and high ammonia levels can be suggestive of a urea cycle disorder. For any patient presenting with atypical clinical features, images should be reviewed and discussed in detail with an experienced neuroradiologist. In addition, the ammonia levels should be checked if a urea cycle disorder is suspected.

  12. Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas.

    Science.gov (United States)

    Yamagata, João Paulo M; Rudolph, Fabiana B; Nobre, Maria Clara L; Nascimento, Leninha V; Sampaio, Felipe Maurício S; Arinelli, Andrea; Freitas, Dayvison F

    2017-12-01

    Sporotrichosis is a subcutaneous mycosis caused by Sporothrix sp., a dimorphic fungus. Although the cutaneous form is the most frequent form, the ocular presentation has been increasingly diagnosed in epidemic areas. We describe three cases of ocular sporotrichosis with the involvement of the ocular adnexa due to autoinoculation without trauma with successful antifungal treatment. Patient 1: A 68-year-old woman presented with granulomatous conjunctivitis of the right eye with an ulcerated nodule on the right temporal region for 5 months. Patient 2: A 46-year-old woman with conjunctival hyperemia of the left eye with associated periorbital edema and erythema for the past 4 months was referred to the Dermatology Department due to an ulcerated nodule on the left malar region. Patient 3: A 14-year-old boy presented to the emergency department with inferior palpebral edema with a 5-day evolution. Specimens were obtained from the lesions of the three patients, and the cultures were positive for Sporothrix sp. The three cases were diagnosed as ocular sporotrichosis and were successfully treated with itraconazole (200-400 mg/d). Two of the three patients developed sequelae such as conjunctival fibrosis and symblepharon. We emphasize the importance of the ophthalmologist being familiar with the diagnosis and management of this rare and frequently misdiagnosed form of sporotrichosis.

  13. 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.

  14. Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature.

    Science.gov (United States)

    Soliman, Dina Sameh; Yassin, Mohamed

    2018-03-02

    Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, his story started 6 months prior to presentation to our center when he had generalized fatigue and discoloration of hands. He presented with persistent polycythemia with elevated hemoglobin level. The patient was misdiagnosed in another center as polycythemia and treated with Imatinib. The diagnosis of PV was revisited and ruled out in view of negative JAK2, normal erythropoietin level and absence of features of panmyelosis. Clinical cyanosis and lowoxygen saturation in the presence of normal arterial oxygen tension was highly suggestive of methemoglobinemia. Arterial blood gas revealed a methemoglobin level of 38% (normal: 0-1.5%). Cytochrome B5 reductase (Methemoglobin reductase B) was deficient at level of breath being the most common sign and symptoms. For type II: Six cases were reported in English literature, all in pediatric age group with median calculated age at presentation is 6 years with neurologic manifestations and mental retardation are the most common type II associated symptoms. Due to lack of systematic epidemiological studies, congenital methemoglobinemia is under diagnosed as it is under investigated and usually overlooked especially when presenting in adulthood and in absence of obvious acquired agents.

  15. Atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy: case reports

    Directory of Open Access Journals (Sweden)

    Lee Young

    2012-07-01

    Full Text Available Abstract Background To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy. Case presentation Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Fluorescein angiography showed multiple leakages around the central hypofluorescent area and indocyanine green angiography showed partially dilated choroidal vessels. Fundus autofluorescence (FAF showed a decreasing pattern of autofluorescence in the subretinal fluid area, and increasing autofluorescence at the border of the serous retinal detachment. Both patients were diagnosed with chronic central serous chorioretinopathy. Photodynamic therapy and intravitreal bevacizumab injection were administered for engorged choroidal vessels during follow-up, but neither patient showed improvement in symptoms or ophthalmologic findings. Based on re-evaluation by fundus photography, optical coherence tomography, fluorescein angiography, and comparison of the results of FAF with the first visit, vitelliform macular dystrophy was suspected and a definite diagnosis was made by electrooculography and genetic testing. Conclusion In patients with continuous serous retinal detachment without response to photodynamic therapy or intravitreal bevacizumab injection, careful fundus exam and FAF can be used to diagnose atypical vitelliform macular dystrophy.

  16. Mammographic features and misdiagnosed analysis on 92 cases with breast cancer

    International Nuclear Information System (INIS)

    Liu Mingjuan; Zhang Xiaoling; Guo Yan

    2010-01-01

    Objective: To investigate the atypical X-ray features in breast cancer and improve the accuracy of diagnosis. Methods: Mammographic features of 92 cases with pathologically confirmed breast cancer were analyzed retrospectively. Results: High-density mass with speculated margined, clusters of small calcification, stellate-like lesions were found in 51 cases, the rate of correct diagnosis was 96%-100%. Lobulated high-density mass were found in 17 cases, the correct diagnosis rate was about 88.3% cases with skin thickening were all correctly diagnosed. Round mass, focal parenchymal asymmetry and unidentified lesions were found in 20 cases, the diagnosing rate was less than 20%. Conclusion: Round mass, focal parenchymal asymmetry and unidentified lesions were atypical mammographic features of breast cancer. These lesions were misdiagnosed frequently. It is essential to find the indirect signs and associated finding to avoid misdiagnosis. On the other hand, further ultrasound or MRI were helpful to improve the diagnosis by detecting mass in breast, showing cystic lesions and blood supply. (authors)

  17. Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses.

    Science.gov (United States)

    Hua, Hai-Yong; Wang, Wei; Cao, Guo-Qun; Tang, Feng; Liang, You-Sheng

    2013-09-11

    Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic. The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained. As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater.

  18. Iatrogenic gastric perforation in a misdiagnosed case of late presenting congenital diaphragmatic hernia: Report of an avoidable complication

    Directory of Open Access Journals (Sweden)

    Pradeep Kajal

    Full Text Available Introduction: Congenital diaphragmatic hernia (CDH is a defect in diaphragm which usually presents with severe respiratory distress in neonatal period. Presentation of case: We present a case of congenital diaphragmatic hernia presenting at an age of 2.5 years in a male child. It was misdiagnosed as a case of pyothorax for which chest tube was attempted on left side resulting in iatrogenic gastric perforation. The patient was managed by early and prompt surgery. Discussion: Late presentation is usually rare with vast array of respiratory and gastrointestinal symptoms. It often leads to clinical and radiological misdiagnosis. Conclusion: Surgical intervention in misdiagnosed cases can lead to catastrophic iatrogenic complications. Keywords: Case report, Congenital diaphragmatic hernia, Pyothorax, Chest tube, Iatrogenic gastric perforation

  19. Retrospective analysis of nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions in a population of Taiwanese patients.

    Science.gov (United States)

    Huang, Hsun-Yu; Chen, Yuk-Kwan; Ko, Edward Cheng-Chuan; Chuang, Fu-Hsiung; Chen, Ping-Ho; Chen, Ching-Yi; Wang, Wen-Chen

    2017-07-01

    We aimed to evaluate nonendodontic periapical lesions clinically misdiagnosed as endodontic periapical pathoses in a population of Taiwanese patients. Cases (2000-2014) of histopathological diagnoses of nonendodontic periapical lesions were retrieved from all cases with a clinical diagnosis of radicular cyst, apical granuloma, or apical periodontitis in the institution. These cases were regarded as misdiagnosed nonendodontic periapical lesions, of which the types and frequencies, in addition to the demographic data, were determined. Four thousand and four specimens were clinically diagnosed as endodontically associated pathoses, of which 118 cases (2.95%) received a histopathological diagnosis of a nonendodontic pathologic entity, the most frequent lesion being keratocystic odontogenic tumor (KCOT, n = 38, 32.20%), followed by fibro-osseous lesion (n = 18, 15.25%), and dentigerous cyst (n = 13, 11.02%). Nine malignant lesions in the periapical area [squamous cell carcinoma (n = 7, 5.93%), adenoid cystic carcinoma (n = 1, 0.85%), and Langerhans cell histiocytosis (n = 1, 0.85%)] were also noted. A wide variety of histopathological diagnoses, including benign odontogenic and non-odontogenic cystic and tumorous lesions and infectious diseases, as well as malignant lesions, was noted in these 118 cases of nonendodontic periapical lesions. Squamous cell carcinoma was the most predominant malignancy of nonendodontic periapical lesions misdiagnosed as apical periodontitis lesions from imaging examination overlooking the clinical findings. The current data form a useful basis for clinicopathological investigation and educational teaching regarding nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions.

  20. Tumor de la vulva, vulvectomía radical Vulvar tumor, total vulvectomy

    Directory of Open Access Journals (Sweden)

    Asbel Alfredo Vicente de la Cruz

    2011-09-01

    Full Text Available Los tumores de la vulva no son una rareza entre los cánceres que afectan a las féminas, pero tampoco son de los más frecuentes. Se presenta el caso de una mujer de 59 años, que en el año 2000 se le diagnostica carcinoma epidermoide del clítoris, en 2004 se vuelve a intervenir por recidiva tumoral, y en 2009 acude a nuestra consulta nuevamente y es cuando se decide realizarle vulvectomía y resección de vagina y todo el sistema ginecológico. Concluyó la intervención con una talla vesical extraperitoneal. El tumor se extiende hasta la porción inicial de la vagina y uretra. Se trata de un tumor maligno, bien diferenciado, que se ha comportado en una forma no habitual, con recidivas locales, cuando en apariencia el tumor había sido resecado en toda su extensión, y en esta última oportunidad, a pesar de ser un estadio avanzado, no hemos encontrado metástasis ni multicentricidad del tumor. La evolución posoperatoria fue sin complicaciones y se dio de alta al quinto día.The vulvar tumors are not uncommon among the different types of cancer involving females, but neither are the more frequent ones. This is the case of a female aged 59 that in 2000 is diagnosed with epidermoid carcinoma of clitoris, in 2004 is re-operated on by tumor relapse, and in 2009 she came again to our consultation and a vulvectomy, vagina resection and all gynecological system are carried out. Intervention concluded with an extraperitoneal vesical cutting. The tumor extends up to the initial portion of vagina and urethra. It is a malignant and well-differentiated tumor behaved in non habitual way with local relapses, when apparently the tumor was resected in all its extent, and in this last change, despite and advanced stage, there were neither tumor metastases nor multi-centralization. The postoperative course was free of complications receiving the discharge at fifth day.

  1. Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature

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    Dina Sameh Soliman

    2018-03-01

    Full Text Available Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, his story started 6 months prior to presentation to our center when he had generalized fatigue and discoloration of hands. He presented with persistent polycythemia with elevated hemoglobin level. The patient was misdiagnosed in another center as polycythemia and treated with Imatinib. The diagnosis of PV was revisited and ruled out in view of negative JAK2, normal erythropoietin level and absence of features of panmyelosis. Clinical cyanosis and lowoxygen saturation in the presence of normal arterial oxygen tension was highly suggestive of methemoglobinemia. Arterial blood gas revealed a methemoglobin level of 38% (normal: 0-1.5%. Cytochrome B5 reductase (Methemoglobin reductase B was deficient at level of <2.6 U/g Hb (normal: 6.6-13.3, consistent with methemoglobin reductase (cytochrome b5 deficiency and hence the diagnosis of congenital methemoglobinemia was established. The role of Imatinib in provoking methemoglobinemia is questionable and association between Imatinib and methemoglobinemia never described before. In our case, there were no other offending drugs in aggravating the patients’ symptoms and cyanosis. The patient started on Vitamin C 500 mg once daily for which he responded well with less cyanosis and significant reduction of methemoglobin level. Congenital methemoglobinemia is a rare underreported hemoglobin disease and often clinically missed. Upon extensive review of English literature for cases of congenital methemoglobinemia due to deficiency of cytochrome b5 reductase, we found 23 cases diagnosed as type I (including the case reported here. 17 cases (~74% of type I and 6 cases (27% of type II. There is male predominance 73% versus 26% in females. Almost half of reported cases 12 cases (52% are Indian, 2 Japanese, 3 English, 2

  2. A case of primary diffuse large B-cell non-Hodgkin's lymphoma misdiagnosed as chronic periapical periodontitis.

    Science.gov (United States)

    Jessri, M; AbdulMajeed, A A; Matias, M A; Farah, C S

    2013-06-01

    Lymphoma is a malignant neoplasm of component cells of the lymphoid system which is very rare in the jaws. Here we report a case of primary diffuse large B-cell lymphoma located in the periapical region of a mandibular molar which was misdiagnosed as chronic periapical periodontitis. The present case was diagnosed at an early stage and effectively managed by chemotherapy. Although lymphoma of the mandible is rare, it must be considered in the differential diagnosis of radiolucent lesions in this region. Lack of knowledge of this rare presentation may lead to delays in diagnosis and poor prognosis. © 2013 Australian Dental Association.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Caenorhabditis elegans Histone Deacetylase hda-1 Is Required for Morphogenesis of the Vulva and LIN-12/Notch-Mediated Specification of Uterine Cell Fates

    OpenAIRE

    Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P.

    2013-01-01

    Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1 , a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-sea...

  5. Influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs: 38 cases (1990-1999).

    Science.gov (United States)

    Crawford, Jason T; Adams, William M

    2002-10-01

    To determine influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs. Retrospective study. 38 spayed female dogs. Medical records and client follow-up were reviewed for dogs evaluated via excretory urography because of clinical signs of lower urinary tract disease. Clinical signs, results of radiography, and response to surgical or medical treatment were analyzed. Clinical signs included urinary tract infection (n = 24), urinary incontinence (20), vaginitis (11), pollakiuria or stranguria (10), and perivulvar dermatitis (4). Vaginocystourethrographic findings included vestibulovaginal stenosis (n = 28), pelvic bladder (17), and ureteritis or pyelonephritis (4). Ten dogs had a vestibulovaginal ratio of stenosis), 9 dogs had a ratio of 0.20 to 0.25 (moderate stenosis), 9 dogs had a ratio of 0.26 to 0.35 (mild stenosis), and 10 dogs had a ratio of > 0.35 (anatomically normal). Lower urinary tract infection, incontinence, and pelvic bladder were not associated with response to treatment for recessed vulva. Vestibulovaginal stenosis with a ratio Dogs without severe vestibulovaginal stenosis that received vulvoplasty for a recessed vulva responded well to treatment. Vestibulovaginal stenosis is likely an important factor in dogs with vestibulovaginal ratio dogs with severe vestibulovaginal stenosis and signs of lower urinary tract disease.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

    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. (paper)

  7. Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis

    Science.gov (United States)

    Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

    2017-01-01

    Abstract Rationale: Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. Patient concerns: We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. Diagnoses: She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. Interventions: This patient was treated successfully with surgery. Outcomes: This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. Lessons: The pitfall of misdiagnosing this tumor as DVT is a useful reminder. PMID:29145269

  8. Caenorhabditis elegans histone deacetylase hda-1 is required for morphogenesis of the vulva and LIN-12/Notch-mediated specification of uterine cell fates.

    Science.gov (United States)

    Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P

    2013-08-07

    Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1, a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-seam cell). We characterized the vulval defects by using cell fate-specific markers and found that hda-1 is necessary for the specification of all seven vulval cell types. The analysis of the vulval-uterine connection defect revealed that hda-1 is required for the differentiation of the gonadal anchor cell (AC), which in turn induces ventral uterine granddaughters to adopt π fates, leading to the formation of the uterine-seam cell. Consistent with these results, hda-1 is expressed in the vulva and AC. A search for hda-1 target genes revealed that fos-1 (fos proto-oncogene family) acts downstream of hda-1 in vulval cells, whereas egl-43 (evi1 proto-oncogene family) and nhr-67 (tailless homolog, NHR family) mediate hda-1 function in the AC. Furthermore, we showed that AC expression of hda-1 plays a crucial role in the regulation of the lin-12/Notch ligand lag-2 to specify π cell fates. These results demonstrate the pivotal role of hda-1 in the formation of the vulva and the vulval-uterine connection. Given that hda-1 homologs are conserved across the phyla, our findings are likely to provide a better understanding of HDAC1 function in development and disease.

  9. Epstein-Barr virus associated T-cell lymphoproliferative disease misdiagnosed as ulcerative colitis: a case report.

    Science.gov (United States)

    Zheng, Xiaodan; Xie, Jianlan; Zhou, Xiaoge

    2015-01-01

    Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disease (LPD) is not uncommon in China, but gastrointestinal involvement is very rare. We report on an immunocompetent patient with EBV-associated T-cell LPD of the colon. The 26-year-old man was initially misdiagnosed with ulcerative colitis (UC). A colon biopsy revealed the presence of small to medium-sized lymphoid cells infiltrating the intestinal wall. The neoplastic cells expressed CD3, CD5, and granzyme B, not CD56. EBV-encoded small ribonucleic acid was detected in the tumor cells of the colon as well as the lymph node, and the T-cell receptor gene rearrangement result displayed δ gene monoclonal rearrangement. The patient died 2 moths after the diagnosis. The clinical course of EBV-associated T-cell LPD is aggressive and the prognosis is poor, the wrong diagnosis may delay treatment. Therefore, we should be very careful to prevent misdiagnosis. When patients have multiple intestinal ulcers that are not typical of UC and the clinical course is unusual, although morphology looks like inflammatory change, pathologist should consider the possibility of EBV-associated LPD. The treatment strategy and prognosis of these two diseases are different.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. The role of ultrasound-guided cytology of groin lymph nodes in the management of squamous cell carcinoma of the vulva: 5-year experience in 44 patients

    International Nuclear Information System (INIS)

    Hall, T.B.; Barton, D.P.J.; Trott, P.A.; Nasiri, N.; Shepherd, J.H.; Thomas, J.M.; Moskovic, E.C.

    2003-01-01

    AIM: To assess the accuracy of ultrasound combined with fine-needle aspiration cytology (FNAC) in the detection of lymph node metastasis in patients with squamous cell carcinoma of the vulva. MATERIALS AND METHODS: The groin nodes of 44 consecutive patients with primary squamous cell carcinoma of the vulva undergoing groin node dissection were assessed with ultrasound and FNAC. The results were compared with histology from subsequent inguinofemoral lymph node dissection. Twenty-nine patients underwent bilateral groin node dissections and 15 unilateral providing comparable data for 73 groins. RESULTS: Histology demonstrated metastatic disease in 28 groins and no evidence of metastatic disease in 45. Ultrasound agreed with the histology in 67 of the 73 groins (92%), with two false-positives, four false-negatives and two indeterminate appearances. Cytology agreed with the histology in 65 of 72 FNAC samples obtained (90%), with six false-negatives, and one indeterminate result. No false-positive cytology results were seen. Ultrasound and FNAC together failed to detect metastatic disease in four groins, one with an indeterminate ultrasound appearance, another with indeterminate cytology, the two others each having a single positive inguinal node despite a negative ultrasound and FNAC. CONCLUSION: The combination of ultrasound and FNAC provides a sensitive and specific tool for pre-operative assessment and may prevent unnecessary groin dissection and the attendant morbidity in selected patients with vulval cancer

  12. 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.

  13. Primary amenorrhea after bone marrow transplantation and adjuvant chemotherapy misdiagnosed as disorder of sex development: A case report.

    Science.gov (United States)

    Huang, He; Tian, Qinjie

    2016-11-01

    Disorders of sex development (DSD) is a congenital condition in which the development of chromosomal, gonadal or genital sex is atypical. Majority of patients present clinical characteristics of primary amenorrhea, absent secondary sex characters, and abnormal hormone level. A female appearance patient with primary amenorrhea and 46 XY karyotype seems to be solid evidences to diagnose Y-chromosome-related DSD diseases, while it is not necessarily the accurate diagnosis. We report the case of an 18-year-old girl with primary amenorrhea and 46 XY karyotype misdiagnosed as Y-chromosome-related DSD. The patient has normal female reproductive organs and a disrupted pubertal development after the treatment for acute myeloid leukemia (AML). We consider that her gonads were probably functional and later impaired after AML. The clinical manifestations were not consistent with DSD. With doubts, we found that she received bone marrow transplantation (BMT) from her brother and adjuvant chemotherapy 6 years ago. Her karyotype changed from normal female to a karyotype of donor (her brother) origin after BMT.Adjuvant chemotherapy for AML may impair her ovarian function and finally bring about disrupted puberty or primary ovarian insufficiency (POI). We provided close follow-up. During the second visit, the patient had her menarche lasting 4 days without any medication. The present case serves as a reminder that a correct diagnosis depends on the comprehensive collection of present and past medical history, complete physical examination, and careful evaluation of related adjuvant tests. Do not presumptively judge a test and mislead reasoning. In addition, ovarian function protection should be considered for young girls having chemotherapy.

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

    Science.gov (United States)

    van Meerkerk-Aanen, Petra J; de Vroege, Lars; Khasho, David; Foruz, Aziza; van Asseldonk, J Thies; van der Feltz-Cornelis, Christina M

    2017-01-01

    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. 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. 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 reexamination and reinterpretation of la belle indifférence should be considered.

  15. Disorders of the Vulva

    Science.gov (United States)

    ... simplex chronicus? • What is lichen sclerosus? • What is lichen planus? • What is vulvodynia? • What are the signs and ... gland cysts, lichen simplex chronicus, lichen sclerosus, and lichen planus. What is folliculitis? Folliculitis appears as small, red, ...

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

    International Nuclear Information System (INIS)

    Sidor, Jutta; Diallo-Danebrock, Raihana; Eltze, Elke; Lellé, Ralph J

    2006-01-01

    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. However, a patient with inguinal lymph node recurrence 21 months after radical vulvectomy for stage IA squamous cell carcinoma was observed. 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. La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder

    Directory of Open Access Journals (Sweden)

    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

  18. Virus del papil.loma humà com a factor pronòstic en les neoplàsies malignes de la vulva i de la vagina

    OpenAIRE

    Fusté Chimisana, Maria Victòria

    2012-01-01

    [cat] El Virus del Papil•loma Humà (VPH) està implicat en la patogènesis dels tumors del tracte genital femení i es detecta en la pràctica totalitat dels carcinomes de cèrvix, considerant-se una causa necessària per al seu desenvolupament. El VPH també sembla estar involucrat en una proporció de tumors de la vulva i de la vagina, però al contrari que en el cèrvix, els carcinomes escamosos de la vulva (CEV) i de la vagina (CEVa) es desenvolupen seguint dues vies etiopatogèniques diferents: una...

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: A case report.

    Science.gov (United States)

    Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

    2017-11-01

    Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. This patient was treated successfully with surgery. This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. The pitfall of misdiagnosing this tumor as DVT is a useful reminder.

  1. Laparoscopic-assisted surgical reconstruction of a rare congenital abdominal wall defect in two children misdiagnosed with prune-belly syndrome.

    Science.gov (United States)

    Fishman, Andrew I; Franco, Israel

    2013-08-01

    Abdominal wall laxity is typically associated with prune-belly syndrome (PBS). Incomplete forms of PBS have been rarely reported with only the abdominal wall laxity. Herein, we describe a rare congenital abdominal wall defect that has been confused with PBS and illustrate the laparoscopic-assisted surgical technique used for reconstruction. Two boys with symmetrical, bilateral absence or hypoplasia of the internal and external oblique muscles and no genitourinary abnormalities underwent a laparoscopic-assisted abdominal wall reconstruction utilizing the technique previously described by Firlit. Each patient had a Ct scan which confirmed the absence of the oblique muscles. In one patient EMG data confirmed no electrical activity of the obliques. Radiologic evaluation of the urinary tracts revealed no abnormalities. The abdominal wall was plicated utilizing bilateral subcostal incisions. Both patients had excellent cosmetic and functional results with no weakness or bulging of the lateral abdominal wall and improvement of associated symptoms. We believe these two cases and their congenital abdominal wall defects are a rare and often misdiagnosed muscular deficiency separate from PBS. The novel laparoscopic-assisted surgical technique illustrated is feasible and highly successful for these and possible other patients with similar rare congenital abdominal wall defects. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature.

    Science.gov (United States)

    He, Yue; Zhang, Chenping; Liu, Guanglong; Tian, Zhuowei; Wang, Lizhen; Kalfarentzos, Evagelos

    2014-04-24

    To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease.After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate.

  3. Genome sequence of Mycobacterium yongonense RT 955-2015 isolate from a patient misdiagnosed with multi-drug resistant tuberculosis: first clinical isolate in Tanzania.

    Science.gov (United States)

    Mnyambwa, Nicholaus Peter; Kim, Dong-Jin; Ngadaya, Esther; Chun, Jongsik; Ha, Sung-Min; Petrucka, Pammla; Addo, Kennedy Kwasi; Kazwala, Rudovick R; Mfinanga, Sayoki G

    2018-04-24

    Mycobacterium yongonense is a recently described novel species belonging to Mycobacterium avium complex which is the most prevalent etiology of non-tuberculous mycobacteria associated with pulmonary infections, and posing tuberculosis diagnostic challenges in high-burden, resource-constrained settings. We used whole genome shotgun sequencing and comparative microbial genomic analyses to characterize the isolate from a patient diagnosed with multi-drug resistant tuberculosis (MDR-TB) after relapse. We present a genome sequence of the first case of M. yongonense (M. yongonense RT 955-2015) in Tanzania. Sequence analysis revealed that the RT 955-2015 strain had a high similarity to M. yongonense 05-1390(T) (98.74%) and M. chimaera DSM 44623(T) (98%). Its 16S rRNA showed similarity to M. paraintracellulare KCTC 290849(T) (100%); M. intracellulare ATCC 13950(T) (100%); M. chimaera DSM 44623(T) (99.9%); and M. yongonense 05-1390(T) (98%). The strain had a substantially different rpoB sequence from that of M. yongonense 05-1390 (95.16%) but exhibited a sequence closely related to M. chimaera DSM 44623(T) (99.86%), M. intracellulare ATCC 13950(T) (99.53%), and M. paraintracellulare KCTC 290849(T) (99.53%). In light of the OrthoANI algorithm, and phylogenetic analysis, we conclude that the isolate was M. yongonense Type II genotype, which is an indication that the patient was misdiagnosed with TB/MDR-TB and received inappropriate treatment. Copyright © 2018. Published by Elsevier Ltd.

  4. Malignant tumours of the vulva

    International Nuclear Information System (INIS)

    Simonsen, E.

    1983-01-01

    The thesis analyses 317 patients with vulvar malignancies treated at the University Hospital, Lund, during 1960-1979. The three most common histological types of malignancy have been analysed. The oncological clinic in Lund has since the 1960's used a surgical technique where the primary tumour and the regional lymph nodes are operated on in two separate surgical seances. The vulvectomy is performed with tarm knife technique, and the wound is left open. The 5-year crude survival rate for the entire patient material treated with curative intention was over 60 %, which agrees well with reports from other centres. Our surgical approach using two separate seances has, however, much lower rates of postoperative complications and mortality than the rates in other reports. The overall most important prognostic factors for the patients with invasive vulvar malignancies are the presence of lymphatic metastases at the time of surgery, and the surgical radicality of the primary surgery. The treatment at most stages of tumour development and most histological types should include total vulvectomy preoperative irradiation of the inguinal lymph nodes, and inguinal lymphadenectomy. Only local extirpation and hemivulvectomy are, however, indicated for small microinvasively growing squamous cell carcinoma and basal cell carcinoma. Samll invasive onesided squamous cell carcinoma is best treated with ipsilateral surgery combined with preoperative irradiation of the inguinal lymph nodes. Patients with metastases in the inguinal lymph nodes should receive additional irradiation of the inguinal and pelvic lymph node stations. (Author)

  5. 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......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...

  6. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology; La pratique de la technique du ganglion sentinelle dans diverses indications: sein, col uterin, prostate, vulve et verge. Methodologie pratique

    Energy Technology Data Exchange (ETDEWEB)

    Brenot-Rossi, I. [Centre de Lutte Contre le Cancer, Institut Paoli-Calmettes, Service de Medecine Nucleaire, 13 - Marseille (France)

    2008-08-15

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid {sup 99m}Tc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  7. ECTOPIC ureters misdiagnosed as ureterocele

    International Nuclear Information System (INIS)

    Bader, I.; Akhter, N.; Anwar-ul-Haq; Chaudhary, A.; Khan, N.Z.

    2004-01-01

    Ectopic ureters may be difficult to diagnose unless there is high index of suspicion. Examination for continuous dribbling may be difficult in infants who are still using diapers. We are reporting a case of ectopic ureter which was erroneously diagnosed as ureterocele on a cystourethrogram. Further investigations for accurate diagnosis and emerging abnormalities during the course of management are presented in this case report. Review of literature to high- light the various forms of investigations and management are also presented. (author)

  8. Schistosomiasis misdiagnosed as abdominal tuberculosis

    African Journals Online (AJOL)

    CONTINUING MEDICAL EDUCATION. February 2015, Vol ... report a case of a missed diagnosis of the disease. ... with an acute abdomen and generalised peritonitis. She had ... 19 June 2013 the patient underwent an emergency laparotomy,.

  9. 支气管结核误诊为肺癌七例临床分析%Clinical Analysis of 7 Patients with Bronchial Tuberculosis Misdiagnosed as Having Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    陈凤; 胥进

    2017-01-01

    目的 探讨支气管结核误诊为肺癌的原因及防范措施.方法 对2013年3月-2015年12月凉山彝族自治州第二人民医院呼吸内科收治的25例支气管结核中曾误诊为支气管肺癌7例的临床资料进行回顾性分析.结果 本组误诊率为28.00%.出现咳嗽6例,咳痰5例,痰中带血或少量咯血4例,持续发热时间>2周4例,胸闷3例,胸痛2例,乏力、盗汗3例,食欲不振、体重下降2例.就诊初期6例误诊为支气管肺癌,1例误诊为支气管肺癌合并肺结核.误诊时间为1~12个月.按误诊疾病予相应处理患者病情变化不明显,后经电子支气管镜检查及反复多次纤维支气管镜下支气管黏膜活组织病理检查、刷检涂片查找抗酸杆菌确诊为支气管结核.7例均予规范抗结核等治疗,其中行手术切除治疗1例,支架安置术1例.7例治疗1个月后症状均有所缓解,复查胸部X线或CT示病灶较前吸收;住院治疗1~5个月后出院,院外继续行抗结核治疗.结论 支气管结核因临床表现不典型,胸部X线及CT征象类似于肺癌,易误诊为肺癌.临床接诊类似本文患者时应及时行电子支气管镜检查及反复多次行纤维支气管镜下支气管黏膜活组织病理检查、刷检涂片查找抗酸杆菌,以尽早确诊.%Objective To investigate causes and preventative measures of bronchial tuberculosis misdiagnosed as lung cancer.Methods Clinical data of 7 patients misdiagnosed as having bronchial lung cancer, among whom 25 patients had bronchial tuberculosis admitted during march 2013 and December 2015, was retrospectively analyzed.Results The misdiagnosis rate was 28.00%.There were 6 patients with cough, 5 with expectoration, 4 with blood in phlegm or a little of haemoptysis, 4 with sustained fever for longer than 2 weeks, 3 with dyspnea, 2 with chest pain, 3 with fatigue and night sweats and 2 patients with poor appetite and weight loss.In primary diagnosis, 6 patients were misdiagnosed as

  10. Solitary circumscribed neurofibroma of the vulva

    International Nuclear Information System (INIS)

    Lau Serrano, Dalgis; Millan Vega, Maria Margarita; Fajardo Tornes, Yarine Leonell

    2012-01-01

    Neurofibroma is a benign tumor that originates from cells of peripheral nerve sheath. It may occur as solitary or multiple lesions as part of Von Recklinghausen disease or neurofibromatosis. The solitary lesions are rare and usually they are not associated with systemic symptoms

  11. Fox–Fordyce disease of the vulva

    Science.gov (United States)

    Gurusamy, Lakshmipriya; Jegadeesan, Muhilan; Jayakumar, Salai

    2016-01-01

    Fox–Fordyce disease is a rare, chronic skin disorder which affects the apocrine areas. This disease is due to the obstruction of the apocrine sweat duct. Extragenital regions are commonly affected than the genital region. We, herein, report a case of Fox–Fordyce in a female, with onset in the fifth decade and involving only the genital region. PMID:27190415

  12. Atopic and Contact Dermatitis of the Vulva.

    Science.gov (United States)

    Pichardo-Geisinger, Rita

    2017-09-01

    Pruritus, or itch, is a common vulvar complaint that is often treated empirically as a yeast infection; however, yeast infections are just one of the many conditions that can cause vulvar itch. Ignoring other conditions can prolong pruritus unnecessarily. Atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis are extremely common noninfectious causes of vulvar itch that are often underdiagnosed by nondermatologists. Identifying these conditions and treating them appropriately can significantly improve a patient's quality of life and appropriately decrease health care expenditures by preventing unnecessary additional referrals or follow-up visits and decreasing pharmaceutical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Idiopathic Thrombocytopenic Purpura Misdiagnosed as Hereditary Angioedema

    DEFF Research Database (Denmark)

    Andersen, Michelle Fog; Bygum, Anette

    2015-01-01

    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...

  14. 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

  15. Pancreatic pseudopapillary tumour: A rare misdiagnosed entity.

    Science.gov (United States)

    Affirul, C A; Qisti, F N; Zamri, Z; Azlanuddin, A; Hairol, A O; Razman, J

    2014-01-01

    Solid pseudo papillary pancreatic tumour is a rare entity. The atypical presentation causes a delayed or misdiagnosis of these pathology. It commonly affects the female population in the 2nd and 3rd decade of life. The presentation varies from non-specific abdominal pain to incidental findings in asymptomatic patients. It is a low-grade premalignant condition that is curable by excision of the tumour. This paper presents a 17-year-old girl with intra-abdominal mass diagnosed with solid pseudo papillary tumour that underwent Whipple's procedure. We discuss the presentations, diagnosis and pathology findings of this rare pathology. The diagnosis remains an enigma in view of the nature and location of the tumour. Resection is still the best choice remains for this condition. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. 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.

  17. A case misdiagnosed as bilateral abducens palsy

    International Nuclear Information System (INIS)

    Takeda, Naoya; Kuwamura, Keiichi; Shirataki, Kunio; Tamaki, Norihiko; Matsumoto, Satoshi

    1984-01-01

    A 66-year-old male was admitted to our neurosurgical floor because of double vision and gait disturbance. Neurological examinations revealed bilateral 6th nerve palsy with both eyes pointing toward the midline. Initially, using a tentative diagnosis of intracranial mass lesions, especially localized at the base of the skull, computerized tomography of the head, cerebral angiography, orbital venography, and metrizamide CT cisternography were performed; the findings were normal. An orbital CT scan showed an enlargement of the bilateral medial rectus muscles, and the thyroid functions of T 3 and T 4 and the T 3 uptake were all elevated, which was compatible with the diagnosis of Graves' disease. The limitations of both eyeballs were considered to be due not to the 6th nerve palsy, but to the hypertrophy of the bilateral medial rectus muscles. We neurosurgeons should recall Graves' disease as well as intracranial lesions, cerebrovascular disease, and post-traumatic sequelae when examining a patient who presents limitations of external ocular movement. (author)

  18. Misdiagnoses of a hydrocephaly induced neuropsychiatric disorder

    International Nuclear Information System (INIS)

    Espy, John C; Hipskind, Gregory

    2007-01-01

    The use of shunting for hydrocephalus has a long history of improvements made through basic science, clinical innovations and biomedical engineering. Neuroshunting has dramatically changed the outlook of patients with hydrocephalus, with many of these patients now having normal life expectancies and maintaining intelligence within normal limits. The use of shunts, however, has created many unique problems of shunt dependence with frequent shunt revisions and adjustments being a fundamental part of the lives of hydrocephalic patients. However shunt dependent patients, despite the improvement in mortality and intellectual functioning, are prone to multiple difficulties related to shunt dependency including periodic malfunction. Just as our present level of knowledge is due to a combination of science and clinical observations, future progress in treating hydrocephalus will be realized through continued research into mechanisms of neurological fluid-dynamics and neuro-peristalsis, as well as advances in the use of high resolution imaging such as brain-dedicated Neuro SPECT technology (au)

  19. Giant fibrovascular esophageal polyp misdiagnosed as achalasia.

    Science.gov (United States)

    Cordoş, I; Istrate, A; Codreşi, M; Bolca, C

    2012-01-01

    A 59 years old woman was admitted in our unit accusing longtime dysphagia and regurgitation. On admission, the patient was wearing a 3 month old definitive feeding gastrostomy tube. The contrast swallow, endoscopy and esophageal manometry established the diagnostic--achalasia. We removed the gastrostomy tube and we performed an open Heller myotomy. The postoperative period was uneventful and the patient was discharged one week later with affirmatively unimpaired deglutition. One month later, the patient was admitted via emergency with a giant fibrous tumor arising from her mouth after an episode of strong coughing and vomiting. The repeated endoscopy showed a giant esophageal polyp that was missed by the previous investigations, originating from pharingoesophageal junction. The esophageal polyp was resected by cervical approach with good postoperative outcome. The polyp's particular extreme dimensions (27 cm) prevented the acute asphyxia by blockage at the laryngeal level, possibly provoked by smaller tumors. As postoperative one month barium swallow showed a normal esophageal aspect, a final question remains--was achalasia real or an erroneous diagnosis was established the second time too?

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

    African Journals Online (AJOL)

    A 21-year-old provincial rugby player complained of exercise- induced pain in both ... damage was present and after bilateral surgical release a few months apart he ... medial tibial stress syndrome, shin splints and stress fractures. Vascular ...

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

    African Journals Online (AJOL)

    cerebellar peduncle were 0.30 cm2 and 0.28 cm on the right and left sides, respectively [Figure 2], and the pons to mid‑brain ratio was 5.71 [Figure 3]. ..... Longoni G, Agosta F, Kostić VS, Stojković T, Pagani E,. Stošić‑Opinćal T, et al.

  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. 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.

  4. Aggressive angiomyxoma in the vulva: a case report

    International Nuclear Information System (INIS)

    Jeh, Su Kyoung; Ku, Young Mi; Whang, In Yong; Kim, Ki Tae

    2005-01-01

    Aggressive angiomyxoma is a rare benign tumor that originates in the pelvic or perineal organs of women. We report a case of an aggressive angiomyxoma as a huge vulvar mass, and present its clinical and image characteristics with a review of the literatures

  5. 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.

  6. Radiotherapeutic management of carcinomas of the vagina and vulva

    International Nuclear Information System (INIS)

    Randall, Marcus E.

    1997-01-01

    Purpose: To review important basic information regarding vaginal and vulvar carcinomas, including etiology, epidemiology, anatomy, pathology, spread patterns, presentation and work-up and staging. In addition, treatment concepts strategies, and radiotherapeutic techniques will be reviewed and discussed. Discussion: Vaginal carcinoma is rare, making up only 1-2% of gynecologic malignancies. However, the predominant role of radiotherapy (RT) is its management results in a significant number of patients referred to radiation oncology. Treatment and outcomes vary substantially according to stage. Important issues for consideration include the respective roles of external beam RT, brachytherapy, and surgery, intracavitary vs. interstitial brachytherapy, dose rate considerations, combined modality therapy, and management of non-squamous cell histologies. Vulvar carcinoma is similarly uncommon, comprising only 3-5% of gynecologic malignancies. Radiotherapy has a number of established roles in the management of this disease including adjuvant therapy, as part of combined modality treatment for advanced disease, salvage therapy, palliative treatment, and less often, as primary management. These issues will be discussed along with technical factors important in radiotherapeutic management. Finally, relevant literature will be reviewed with an emphasis of completed Gynecologic Oncology Group Trials

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

    African Journals Online (AJOL)

    the tumor with the surrounding tissues. DSA cannot only provide ... for embolization of blood vessels, resulting in decrease in intraoperative blood loss by .... serial measurements of brain natriuretic peptide in heart failure. Int J Cardiol 2004 ...

  8. Omental infarction in children misdiagnosed as acute appendicitis ...

    African Journals Online (AJOL)

    Omental infarction (OI) is a rare cause of acute abdomen in children. It is found in 0.1–0.5% of pediatric patients undergoing abdominal exploration for the suspect of acute appendicitis. OI is considered a self-limited entity, and conservative management should be considered. This approach implicates computer tomography ...

  9. Chronic abdominal wall pain misdiagnosed as functional abdominal pain.

    Science.gov (United States)

    van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H

    2013-01-01

    The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.

  10. A late presenting congenital diaphragmatic hernia misdiagnosed as spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Chitra Sanjeev Juwarkar

    2010-01-01

    Full Text Available Congenital diaphragmatic hernia (CDH is described as (1 failure of diaphragmatic closure at development, (2 presence of herniated abdominal contents into chest and (3 pulmonary hypoplasia. Usually, pleural space is drained urgently when there is respiratory distress and radiological appearance of mediastinal shift. We present a case of a 5-month-old baby, diagnosed as tension pneumothorax and treated with chest drain insertion. CDH was the intraoperative diagnosis.

  11. A case of tracheal leiomyoma misdiagnosed as asthma.

    Science.gov (United States)

    Öztürk, Ayperi; Aktaş, Zafer; Yılmaz, Aydın; Yeşildağlı, Havva; Memiş, Leyla

    2016-12-01

    Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum. In computed tomography, a lesion has been detected in proximal trachea, arising from the posterior wall and protruding through the lumen and almost obliterating the air column. Rigid bronchoscopy has been performed under general anesthesia due to a high risk of bleeding and the endobronchial lesion, freely moving with respiration, has been removed and cryotherapy was applied to the base of the lesion. Receiving the histopathological diagnosis of leiomyoma, the patient is now on 12th month of the follow-up without any recurrence.

  12. 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.

  13. A complication of a dropped appendicolith misdiagnosed as Crohn's disease.

    Science.gov (United States)

    Sarkar, S; Douglas, L; Egun, A A

    2011-09-01

    Appendicoliths are formed by calcium salts and faecal debris layered and lodged within the appendix. They are detected on unenhanced x-rays in less than 10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix. Moreover, retained appendicoliths act as a nidus for infection and are likely to be the source of a postoperative intraperitoneal abscess. However, this is very rare with only 30 reported cases of intra-abdominal abscess secondary to an appendicolith in the literature over the past 40 years. Retained, or dropped, appendicoliths most commonly present as an area of high attenuation less than 1cm in diameter with an associated abscess close to the caecum or Morrison's pouch on computed tomography (CT). A study published in 2006 showed that although there is initial success with CT-guided drainage of abscesses secondary to faecaliths, all will recur and formal surgical drainage with removal of the appendicolith is required. This case report highlights not only an unusual complication of a retained appendicolith but also the importance of taking a thorough history and interpreting investigations in the context of the patient's past medical history so as to produce a differential diagnosis and prevent treatment of incorrect conditions.

  14. PHACE syndrome misdiagnosed as a port-wine stain.

    Science.gov (United States)

    Thomson, Jason; Greig, Aina; Lloyd, Claire; Morrison, Danny; Flohr, Carsten

    2015-07-15

    We present the case of a boy born with a large macular, segmental vascular anomaly over the left face, initially diagnosed as a capillary malformation (port-wine stain) by the postnatal paediatric team. The vascular anomaly in the face then grew rapidly during the first few weeks of life and started to occlude the left eye, causing parental concerns about the infant's vision. A dermatological opinion established that the lesion was a segmental infantile haemangioma (IH). This, in combination with the posterior fossa malformation previously detected on antenatal scanning and confirmed by an MRI postnatally, satisfied the criteria for Posterior fossa abnormalities, Haemangiomas, Arterial abnormalities, Cardiac abnormalities and Eye abnormalities (PHACE) syndrome: a rare cutaneous neurovascular syndrome. This case highlights the diagnostic challenge posed by early phenotypes of haemangiomas as well as the importance of correctly diagnosing PHACE syndrome. 2015 BMJ Publishing Group Ltd.

  15. PHACE syndrome misdiagnosed as a port-wine stain

    OpenAIRE

    Thomson, Jason; Greig, Aina; Lloyd, Claire; Morrison, Danny; Flohr, Carsten

    2015-01-01

    We present the case of a boy born with a large macular, segmental vascular anomaly over the left face, initially diagnosed as a capillary malformation (port-wine stain) by the postnatal paediatric team. The vascular anomaly in the face then grew rapidly during the first few weeks of life and started to occlude the left eye, causing parental concerns about the infant's vision. A dermatological opinion established that the lesion was a segmental infantile haemangioma (IH). This, in combination ...

  16. [Myofascial pain syndrome--frequent occurrence and often misdiagnosed].

    Science.gov (United States)

    Pongratz, D E; Späth, M

    1998-09-30

    Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs.

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

    African Journals Online (AJOL)

    4th or 6th cranial nerves) and corneal and facial hypoesthesia. (from compression of the ophthalmic division of the trigeminal nerve) may result with tumour extension into the cavernous sinus. These findings are red flags to the fact that the aetiology of the disc cupping is not due to glaucoma. In a patient with a pale cupped ...

  18. [Dystrophia myotonica (Steinert disease)--a frequently misdiagnosed disease].

    Science.gov (United States)

    Kuhn, E; Lehmann-Horn, F; Rüdel, R

    1990-06-01

    Dystrophia myotonica (Steinert's disease) is the most common hereditary disease of the neuromuscular system in adults. Its mode of inheritance is autosomal dominant. The gene responsible for its is located on chromosome 19 in the linkage domain of the loci for the apolipoproteins C2, C1 und E and of the creatine kinase of skeletal muscle (CKMM). Myotonic dystrophy is categorized in an adult and in a congenital form. In the adult form, the characteristic findings are muscular atrophy in certain regions of the body (face, neck and distally in the extremities) and myotonia. Cataract, intraocular hypotension, gonadal atrophy, conduction abnormalities in the heart and hearing deficiencies appear quite often in the course of the disease. In the congenital form, general muscle weekness (particularly pronounced in the face) is the leading finding, combined with retarded loco motor and mental development. A decisive criterion for the diagnosis of this form is the occurrence of myotonic dystrophy in the patient's mother. Electromyographic investigation is indicated when a suspicion of myotonic dystrophy cannot be ascertained on the basis of clinical and genetic findings. Myotonic runs in the EMG will then corroborate the suspicion. Recent electrophysiological investigations have indicated that at least three different types of channels for the passage of ions through the membrane of the skeletal muscle cells show abnormal behaviour, i.e. the channel for Cl-, Na+ and K+. These findings corroborate the hypothesis that the abnormality responsible for myotonic dystrophy is situated in the membrane systems. A pharmacological treatment of the muscular dystrophy has not yet been developed.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain.

    Science.gov (United States)

    Arroyo, J. F.; Jolliet, P.; Junod, A. F.

    1992-01-01

    The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been avoided if awareness of these conditions had led to a correct diagnosis upon initial physical examination. PMID:1448407

  20. Lymphogranuloma venereum and HIV infection: misdiagnosed as Crohn's disease

    Science.gov (United States)

    Patel, Sheel; Hay, Phillip

    2010-01-01

    The report describes a young Caucasian homosexual man who presented with a 4-month history of bloody diarrhoea and weight loss. Over the next 4 months he was investigated for inflammatory bowel disease and subsequently started on mesalazine and prednisolone as an outpatient. Within a month of starting treatment his symptoms worsened, leading to his self-referral to the genitourinary medicine clinic. The patient was subsequently diagnosed with advanced HIV infection and lymphogranuloma venereum infection. The patient was treated with doxycycline for 3 weeks and started on antiretrovirals. One month later the patient is symptom free with a recovering immune system. PMID:22797476

  1. Bilateral acute iris transillumination (BAIT initially misdiagnosed as acute iridocyclitis

    Directory of Open Access Journals (Sweden)

    Saban Gonul

    2015-04-01

    Full Text Available 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 improve. An ocular examination revealed bilateral pigment dispersion into the anterior chamber, diffuse iris transillumination, pigment dusting on the anterior lens capsule, atonic and distorted pupils, and increased intraocular pressure, suggesting a diagnosis of BAIT rather than iridocyclitis. Clinicians should be aware of the differential diagnosis of syndromes associated with pigment dispersion from iridocyclitis to avoid aggressive anti-inflammatory therapy and detailed investigation for uveitis.

  2. Melanocytoma of the ciliary body misdiagnosed as iridodialysis

    Directory of Open Access Journals (Sweden)

    Kim M

    2014-05-01

    Full Text Available Moosang Kim, Seung-Jun LeeDepartment of Ophthalmology, School of Medicine, Kangwon National University, Chuncheon, Republic of KoreaAbstract: A 62-year-old female presented to our institution with dimness of vision in her right eye. On examination, her best corrected visual acuity was 20/100 in the right eye. The intraocular pressures were 14 mmHg in both eyes. Slit-lamp examination revealed nuclear sclerotic cataracts bilaterally and iridodialysis in her right eye. Seven days after the first visit, cataract surgery was performed without any complications. One year later, she presented to our institution with acute visual loss and ocular pain in the right eye. Best corrected visual acuity of the right eye was light perception and the intraocular pressure was 44 mmHg. Slit-lamp examination revealed a ciliary body mass with widespread pigment dispersion in the anterior segment. Due to no useful vision and uncontrolled pain, enucleation of the right eye was performed. Histopathologic examination revealed a melanocytoma of the ciliary body.Keywords: ciliary body, iridodialysis, melanocytoma

  3. Congenital chloride diarrhea misdiagnosed as pseudo-Bartter syndrome.

    Science.gov (United States)

    Saneian, Hossein; Bahraminia, Emad

    2013-09-01

    Congenital chloride diarrhea (CCD) is a rare autosomal recessive disease which is characterized by intractable diarrhea of infancy, failure to thrive, high fecal chloride, hypochloremia, hypokalemia, hyponatremia and metabolic alkalosis. In this case report, we present the first female and the second official case of CCD in Iran. A 15-month-old girl referred to our hospital due to failure to thrive and poor feeding. She had normal kidneys, liver and spleen. Treating her with Shohl's solution, thiazide and zinc sulfate did not result in weight gain. Consequently, pseudo-Bartter syndrome was suspected, she was treated with intravenous (IV) therapy to which she responded dramatically. In addition, hypokalemia resolved quickly. Since this does not usually happen in patients with the pseudo-Bartter syndrome, stool tests were performed. Abnormal level of chloride in stool suggested CCD and she was thus treated with IV fluid replacement, Total parentral nutrition and high dose of oral omeprazole (3 mg/kg/day). She gained 1 kg of weight and is doing fine until present. CCD is a rare hereditary cause of intractable diarrhea of infancy. It should be considered in infants with unknown severe electrolyte disturbances.

  4. A misdiagnosed Riedel's thyroiditis successfully treated by thyroidectomy and tamoxifen.

    Science.gov (United States)

    Wang, Chih-Jung; Wu, Ta-Jen; Lee, Chung-Ta; Huang, Shih-Ming

    2012-12-01

    Riedel's thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel's thyroiditis in a 52-year-old female with past history of Hashimoto's thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto's thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel's thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel's thyroiditis. Copyright © 2012. Published by Elsevier B.V.

  5. Genetic Misdiagnoses and the Potential for Health Disparities

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: For more than a decade, risk stratification for hypertrophic cardiomyopathy has been enhanced by targeted genetic testing. Using sequencing results, clinicians routinely assess the risk of hypertrophic cardiomyopathy in a patient's relatives and diagnose the condition in patients who ...

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

    African Journals Online (AJOL)

    Carotid body tumor (CBT) also known as chemodectoma is a rare tumor of neuroendocrine tissue of carotid body and is the most commonly seen jugular paraganglioma. In most cases, it is benign but it can be malignant. Extra adrenal paraganglioma is rare. We present such a rare case where unusual presentation of ...

  7. Huntington's Disease in a Patient Misdiagnosed as Conversion Disorder.

    Science.gov (United States)

    Nogueira, João Machado; Franco, Ana Margarida; Mendes, Susana; Valadas, Anabela; Semedo, Cristina; Jesus, Gustavo

    2018-01-01

    Huntington's disease (HD) is an inherited, progressive, and neurodegenerative neuropsychiatric disorder caused by the expansion of cytosine-adenine-guanine (CAG) trinucleotide in Interested Transcript (IT) 15 gene on chromosome 4. This pathology typically presents in individuals aged between 30 and 50 years and the age of onset is inversely correlated with the length of the CAG repeat expansion. It is characterized by chorea, cognitive deficits, and psychiatric symptoms. Usually the psychiatric disorders precede motor and cognitive impairment, Major Depressive Disorder and anxiety disorders being the most common presentations. We present a clinical case of a 65-year-old woman admitted to our Psychiatric Acute Unit. During the 6 years preceding the admission, the patient had clinical assessments made several times by different specialties that focused only on isolated symptoms, disregarding the syndrome as a whole. In the course of her last admission, the patient was referred to our Neuropsychiatric Team, which made the provisional diagnosis of late-onset Huntington's disease, later confirmed by genetic testing. This clinical vignette highlights the importance of a multidisciplinary approach to atypical clinical presentations and raises awareness for the relevance of investigating carefully motor symptoms in psychiatric patients.

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

    OpenAIRE

    Verma, Shyam B; Wollina, Uwe

    2012-01-01

    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...

  9. Searching: the lived experience of women with cancer of the vulva.

    Science.gov (United States)

    Jefferies, Hilary; Clifford, Collette

    2009-01-01

    Although the physical adverse effects following surgery for vulval cancer may readily be described, little is known about the psychological, emotional, and social impact. A review of the literature revealed a paucity of studies, as this condition is rare. To explore the lived experiences of women in the United Kingdom with vulval cancer, a qualitative research study was undertaken using the research methodology of interpretive phenomenology, based on the work of Heidegger (The Essence of Human Freedom. London: Continuum; 2005) and van Manen (Researching Lived Experience. Human Science for an Action Sensitive Pedagogy. New York: State University of New York Press; 1990). Thirteen women younger than 50 years were interviewed between 6 months and 5 years after their surgery, and the data were analyzed using framework analysis (Qualitative data analysis for applied policy research. In: Analysing Qualitative Data. London: Routledge; 1994:173-194). This article describes how the concept of searching emerged from the data. It also describes the manner in which the women searched to control their symptoms by their own efforts and by undergoing surgery. The search to understand the truth about their condition and their access to information in the search for meaning and the time element in which this was undertaken was also raised. An underlying consideration is the need for health professionals to help provide the information and support needed to manage this condition.

  10. Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva.

    Science.gov (United States)

    Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Uccella, Stefano; Donato, Violante Di; Casarin, Jvan; Naro, Edoardo Di; Ghezzi, Fabio

    2017-06-01

    To identify factors predicting for recurrence in vulvar cancer patients undergoing surgical treatment. We retrospectively evaluated data of consecutive patients with squamous cell vulvar cancer treated between January 1, 1990 and December 31, 2013. Basic descriptive statistics and multivariable analysis were used to design predicting models influencing outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox model. The study included 101 patients affected by vulvar cancer: 64 (63%) stage I, 12 (12%) stage II, 20 (20%) stage III, and 5 (5%) stage IV. After a mean (SD) follow-up of 37.6 (22.1) months, 21 (21%) recurrences occurred. Local, regional, and distant failures were recorded in 14 (14%), 6 (6%), and 3 (3%) patients, respectively. Five-year DFS and OS were 77% and 82%, respectively. At multivariate analysis only stromal invasion >2 mm (hazard ratio: 4.9 [95% confidence interval, 1.17-21.1]; P=0.04) and extracapsular lymph node involvement (hazard ratio: 9.0 (95% confidence interval, 1.17-69.5); P=0.03) correlated with worse DFS, although no factor independently correlated with OS. Looking at factors influencing local and regional failure, we observed that stromal invasion >2 mm was the only factor predicting for local recurrence, whereas lymph node extracapsular involvement predicted for regional recurrence. Stromal invasion >2 mm and lymph node extracapsular spread are the most important factors predicting for local and regional failure, respectively. Studies evaluating the effectiveness of adjuvant treatment in high-risk patients are warranted.

  11. An aggressive angiomyxoma of vulva - A rare entity - A case report

    Directory of Open Access Journals (Sweden)

    Bishnu Prasad Das

    2016-01-01

    Full Text Available Aggressive angiomyxoma is a rare, locally invasive mesenchymal tumor predominantly presenting in women of reproductive age and also having a moderate-to-high risk for local relapse. Hence, it needs to be differentiated from other mesenchymal tumors occurring in this region. We present here a case of a 40-year-old female presenting with a large, fleshy, pedunculated mass on the right labia majora.

  12. 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.

  13. Primary Hyperparathyroidism Misdiagnosed as Giant Cell Bone Tumor of Maxillary Sinus: A Case Report

    International Nuclear Information System (INIS)

    Aghaghazvini, Leila; Sharifian, Hashem; Rasuli, Bahman

    2016-01-01

    Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor (GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia

  14. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease.

    Science.gov (United States)

    Lee, Kyung Jin; Kim, Jaeyeon; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-12-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved.

  15. 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.

  16. 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 syndrom...

  17. GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated.

    Science.gov (United States)

    Carmody, David; Naylor, Rochelle N; Bell, Charles D; Berry, Shivani; Montgomery, Jazzmyne T; Tadie, Elizabeth C; Hwang, Jessica L; Greeley, Siri Atma W; Philipson, Louis H

    2016-10-01

    GCK-MODY leads to mildly elevated blood glucose typically not requiring therapy. It has been described in all ethnicities, but mainly in Caucasian Europeans. Here we describe our US cohort of GCK-MODY. We examined the rates of detection of heterozygous mutations in the GCK gene in individuals referred to the US Monogenic Diabetes Registry with a phenotype consistent with GCK-MODY. We also assessed referral patterns, treatment and demography, including ethnicity, of the cohort. Deleterious heterozygous GCK mutations were found in 54.7 % of Registry probands selected for GCK sequencing for this study. Forty-nine percent were previously unnecessarily treated with glucose-lowering agents, causing hypoglycemia and other adverse effects in some of the subjects. The proportion of probands found to have a GCK mutation through research-based testing was similar across each ethnic group. However, together African-American, Latino and Asian subjects represented only 20.5 % of screened probands and 17.2 % of those with GCK-MODY, despite higher overall diabetes prevalence in these groups. Our data show that a high detection rate of GCK-MODY is possible based on clinical phenotype and that prior to genetic diagnosis, a large percentage are inappropriately treated with glucose-lowering therapies. We also find low minority representation in our Registry, which may be due to disparities in diagnostic diabetes genetic testing and is an area needing further investigation.

  18. [Ocular graft-versus-host disease: An often misdiagnosed etiology of dry eye syndrome].

    Science.gov (United States)

    Moyal, L; Adam, R; Akesbi, J; Rodallec, F T; Nordmann, J-P

    2017-02-01

    To report a case of severe ocular graft-versus-host disease (GVHD) after cataract surgery. Observational case report. We describe the case of a 59-year-old man with postoperative corneal ulcer on his only functional eye. His past history reported allogenic bone marrow transplant. His visual acuity (VA) was limited to hand motions. Slit lamp examination revealed diffuse conjunctival hyperemia, severe blepharitis, Meibomian dysfunction, total corneal opacification with epithelial and stromal keratitis and neovascular invasion. Because of the severe dry eye symptoms and history of allogenic hematological stem cell transplantation, ocular GVHD was diagnosed. Functional and anatomical improvement occurred rapidly with topical cyclosporine 2%, with improved VA after treatment. With any severe dry eye syndrome in the context of allogenic bone marrow transplant, ocular GVHD must be considered. For planned ocular surgery, we recommend adding cyclosporine 0.1% treatment before and after surgery to prevent severe ocular GVHD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

    International Nuclear Information System (INIS)

    Ha, Su Min; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung

    2017-01-01

    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

  20. Myocarditis with ST elevation and elevated cardiac enzymes misdiagnosed as an ST-elevation myocardial infarction.

    Science.gov (United States)

    Sheldon, Seth H; Crandall, Mark A; Jaffe, Allan S

    2012-12-01

    Acute myocarditis can mimic ST-elevation myocardial infarction (STEMI). Quickly determining the correct diagnosis is critical given the "time is muscle" implication with a STEMI and the potential adverse effects associated with use of fibrinolytic therapy. A 46-year-old man presented to a rural emergency department with chest pain, and an electrocardiogram (ECG) read as showing 0.1 mV of ST-segment elevation in leads III and aVF. His initial cardiac troponin T was 0.44 ng/mL. He received fibrinolytic therapy for presumed STEMI. Cardiac magnetic resonance imaging was later performed and showed epicardial delayed enhancement consistent with myocarditis. Upon further questioning, he acknowledged 3 days of stuttering chest discomfort and a recent upper respiratory infection, as well as similar chest pain in his wife. A systematic evaluation is essential for acute chest pain, including a focused history, identification of cardiac risk factors, and ECG interpretation. A history of recent viral illness, absence of cardiac risk factors, or ECG findings inconsistent with a single anatomic lesion would suggest a potential alternate diagnosis to STEMI. This case emphasizes the importance of a focused history in the initial evaluation of chest pain. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. A case of celiac disease with neurologic manifestations misdiagnosed as amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Hyoju Ham

    2017-10-01

    Full Text Available Celiac disease (CD is an immune-mediated enteropathy and is a rare disease in Asia, including in Korea. However, the ingestion of wheat products, which can act as a precipitating factor of CD, has increased rapidly. CD is a common cause of malabsorption, but many patients can present with various atypical manifestations as first presented symptoms, including anemia, osteopenia, infertility, and neurological symptoms. Thus, making a diagnosis is challenging. We report a case of CD that mimicked amyotrophic lateral sclerosis (ALS. The patient was a sexagenary man with a history of progressive motor weakness for 2 years. He was highly suspected as having ALS. During evaluation of his neurological symptoms, esophagogastroduodenoscopy (EGD was performed because he had experienced loose stools and weight loss for the previous 7 months. On EGD, the duodenal mucosa appeared smooth. A biopsy revealed severe lymphoplasma cell infiltration with flattened villi. His serum endomysial antibody (immunoglobulin A titer was 1:160 (reference, <1:40. Finally, he was diagnosed as having CD, and a gluten-free diet was immediately begun. At a 4-month follow-up, his weight and the quality of his stool had improved gradually, and the neurological manifestations had not progressed.

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

    Science.gov (United States)

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

    2016-03-01

    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. Histopathology of scales and skin biopsy specimen revealed sclerotic bodies, the hallmark of chromoblastomycosis. The causative organism was identified as Fonsecaea monophora by rDNA ITS sequencing. The lesions recovered markedly after two month treatment with oral terbinafine 250 mg daily according to drug sensitive test in vitro in combination with local thermotherapy.

  3. A Craniopharyngioma Associated With Elevated Cerebrospinal Fluid HCG Concentrations Misdiagnosed as a Germinoma

    Directory of Open Access Journals (Sweden)

    Weijun Gu

    2018-06-01

    Full Text Available Craniopharyngiomas and germinomas are both rare cranial tumors that most commonly present during childhood or adolescence. Although these tumors have different origins, their clinical and radiological features may be similar. In this article, we report the case of a 35-year female patient with clinical and radiological findings and increased human chorionic gonadotrophin (HCG levels in the cerebrospinal fluid (CSF that were consistent with a germinoma. However, pathological analysis revealed a craniopharyngioma. This case report indicates that HCG, which is regarded as a specific tumor marker for germinomas in the differential diagnosis of intracranial lesions, is also detectable in other kinds of suprasellar tumors, such as craniopharyngiomas.

  4. 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.

  5. A complication of a dropped appendicolith misdiagnosed as Crohn’s disease

    Science.gov (United States)

    Douglas, L; Egun, AA

    2011-01-01

    Appendicoliths are formed by calcium salts and faecal debris layered and lodged within the appendix. They are detected on unenhanced x-rays in less than 10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix. Moreover, retained appendicoliths act as a nidus for infection and are likely to be the source of a postoperative intraperitoneal abscess. However, this is very rare with only 30 reported cases of intra-abdominal abscess secondary to an appendicolith in the literature over the past 40 years. Retained, or dropped, appendicoliths most commonly present as an area of high attenuation less than 1cm in diameter with an associated abscess close to the caecum or Morrison’s pouch on computed tomography (CT). A study published in 2006 showed that although there is initial success with CT-guided drainage of abscesses secondary to faecaliths, all will recur and formal surgical drainage with removal of the appendicolith is required. This case report highlights not only an unusual complication of a retained appendicolith but also the importance of taking a thorough history and interpreting investigations in the context of the patient’s past medical history so as to produce a differential diagnosis and prevent treatment of incorrect conditions. PMID:21929906

  6. Rapid increase in cystic volume of an anaplastic astrocytoma misdiagnosed as neurocysticercosis: A case report

    Science.gov (United States)

    Li, Hong-Jiang; Han, Hong-Xiu; Feng, Dong-Fu

    2016-01-01

    Reports describing a rapid increase in the cystic volume of anaplastic astrocytoma (AA) in a short time frame are rare. The present study reports the case of a 68-year-old male who was admitted to the No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine (Shanghai, China), with a small cystic brain lesion and positive immunological testing for cysticercosis. Head magnetic resonance imaging (MRI) showed a cystic lesion, 6 mm in diameter, in the left frontal lobe. Neurocysticercosis was suspected and the patient was treated with a clinical trial of albendazole and steroids. A period of 25 days later, the patient's condition had deteriorated, and MRI revealed a cystic lesion in the left frontal lobe; thereafter, the cystic lesion was removed and a diagnosis of AA was established. The tumor was soft, ivory white and gelatinous due to myxoid degeneration. In this case, tumor-related angiogenesis and microvascular extravasation (blood-brain barrier disruption) may have been the main cause of the rapid increase in the cystic volume in such a short time frame. The similarity of the glioma and cysticercus antigens may have been the cause of the positive reactions in the cystic fluid. The present study reports the rare occurrence of a rapid increase of cystic volume and potential diagnostic difficulties. PMID:27698865

  7. Metastatic melanoma misdiagnosed as a temporomandibular disorder: a case report and review of the literature.

    Science.gov (United States)

    Singh, Samir; Desai, Bhavik; Laskin, Daniel

    2014-10-01

    Malignancies in the head and neck region are difficult to diagnose because of their deep location and presence of symptoms mimicking those of temporomandibular disorders or other orofacial pain disorders. A 75-year-old woman reported experiencing right-sided jaw pain, temporal discomfort and paresthesia. She had undergone conservative therapy for temporomandibular joint disorder, which was unsuccessful. A magnetic resonance image of the midface revealed a mass on the base of the tongue along with possible metastatic lesions to the brain. Further investigation of the lesions revealed them to be metastatic melanoma. Patients with atypical symptoms of facial pain, including neurological signs, should undergo further investigation with advanced imaging to determine the source of the symptoms, which could include neoplasms.

  8. 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.

  9. Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome.

    Science.gov (United States)

    Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

    2014-09-01

    To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PCNT) gene (21q22). We report on a patient who came to our attention as a 22-year-old with subarachnoid bleeding due to a ruptured cranial aneurysm. Until then, the patient was thought and published to have Dubowitz syndrome; previously, he was treated with coronary bypass surgery for extensive coronary angiopathy. Consecutive genetic testing revealed MOPD II. After clinical stabilization, the patient was discharged to a specialized rehabilitation center where he died due to re-rupture of a cranial aneurysm. In patients with short stature-especially when clinical features are accompanied by vascular complications-MOPD II should be considered as a differential diagnosis leading to consecutive genetic testing. After detection of mutations in the PCNT gene, a full vascular status including cerebral imaging and cardiac evaluation needs to be determined in order to analyze vascular abnormalities and initiate prophylactic treatment.

  10. Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome

    OpenAIRE

    Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

    2014-01-01

    To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PC...

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

    OpenAIRE

    Casa, Roberto Della; Ungaro, Carla; Acampora, Emma; Pignata, Claudio; Vajro, Pietro; Salerno, Mariacarolina; Santamaria, Francesca; Parenti, Giancarlo

    2012-01-01

    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.

  12. 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/.

  13. 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.

  14. 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

    2017-12-01

    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.

  15. 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.

  16. 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...

  17. 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.

  18. 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.

  19. 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 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.

  20. 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 wit...

  1. 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.

  2. 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.

  3. 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

  4. Human papillomavirus infection in squamous cell carcinoma of the vulva, in various synchronous epithelial changes and in normal vulvar skin

    NARCIS (Netherlands)

    Kagie, M. J.; Kenter, G. G.; Zomerdijk-Nooijen, Y.; Hermans, J.; Schuuring, E.; Timmers, P. J.; Trimbos, J. B.; Fleuren, G. J.

    1997-01-01

    OBJECTIVE: To investigate the prevalence of human papillomavirus (HPV) infection in various vulvar lesions. METHODS: HPV infection using consensus primer-PCR was studied in 66 patients with vulvar carcinoma and in the synchronous epithelial lesions. RESULTS: HPV infection was present in 13/66

  5. 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.

  6. The tailless ortholog nhr-67 regulates patterning of gene expression and morphogenesis in the C. elegans vulva.

    Directory of Open Access Journals (Sweden)

    Jolene S Fernandes

    2007-04-01

    Full Text Available Regulation of spatio-temporal gene expression in diverse cell and tissue types is a critical aspect of development. Progression through Caenorhabditis elegans vulval development leads to the generation of seven distinct vulval cell types (vulA, vulB1, vulB2, vulC, vulD, vulE, and vulF, each with its own unique gene expression profile. The mechanisms that establish the precise spatial patterning of these mature cell types are largely unknown. Dissection of the gene regulatory networks involved in vulval patterning and differentiation would help us understand how cells generate a spatially defined pattern of cell fates during organogenesis. We disrupted the activity of 508 transcription factors via RNAi and assayed the expression of ceh-2, a marker for vulB fate during the L4 stage. From this screen, we identified the tailless ortholog nhr-67 as a novel regulator of gene expression in multiple vulval cell types. We find that one way in which nhr-67 maintains cell identity is by restricting inappropriate cell fusion events in specific vulval cells, namely vulE and vulF. nhr-67 exhibits a dynamic expression pattern in the vulval cells and interacts with three other transcriptional regulators cog-1 (Nkx6.1/6.2, lin-11 (LIM, and egl-38 (Pax2/5/8 to generate the composite expression patterns of their downstream targets. We provide evidence that egl-38 regulates gene expression in vulB1, vulC, vulD, vulE, as well as vulF cells. We demonstrate that the pairwise interactions between these regulatory genes are complex and vary among the seven cell types. We also discovered a striking regulatory circuit that affects a subset of the vulval lineages: cog-1 and nhr-67 inhibit both one another and themselves. We postulate that the differential levels and combinatorial patterns of lin-11, cog-1, and nhr-67 expression are a part of a regulatory code for the mature vulval cell types.

  7. Sodium Tetradecyl Sulphate Direct Intralesional Sclerotherapy of Venous Malformations of the Vulva and Vagina: Report of Five Cases

    International Nuclear Information System (INIS)

    Krokidis, Miltiadis; Venetucci, Pietro; Hatzidakis, Adam; Iaccarino, Vittorio

    2011-01-01

    We report five cases of female patients affected by symptomatic focal external genital venous malformations treated with percutaneous direct intralesional injection of sodium tetradecyl sulphate (STS). All patients were referred because of discomfort and pain when sexual intercourse was attempted. Direct sclerotherapy with 3% STS was performed on a day-hospital basis with the patient under local anesthesia. Complete resolution of the symptoms was achieved in all cases. No major adverse effects were reported. Direct intralesional sclerotherapy with STS may be considered a safe and effective method for the treatment of female external genital malformation without the necessity of general anesthesia for pain control.

  8. Worldwide human papillomavirus genotype attribution in over 2000 cases of intraepithelial and invasive lesions of the vulva.

    Science.gov (United States)

    de Sanjosé, Silvia; Alemany, Laia; Ordi, Jaume; Tous, Sara; Alejo, Maria; Bigby, Susan M; Joura, Elmar Armin; Maldonado, Paula; Laco, Jan; Bravo, Ignacio G; Vidal, August; Guimerà, Núria; Cross, Paul; Wain, Gerard V; Petry, Karl Ulrich; Mariani, Luciano; Bergeron, Christine; Mandys, Václav; Sica, Adela Rosa; Félix, Ana; Usubutun, Alp; Seoud, Muhieddine; Hernández-Suárez, Gustavo; Nowakowski, Andrzej Marcin; Wilson, Godfrey; Dalstein, Veronique; Hampl, Monika; Kasamatsu, Elena Sachiko; Lombardi, Luis Estuardo; Tinoco, Leopoldo; Alvarado-Cabrero, Isabel; Perrotta, Myriam; Bhatla, Neerja; Agorastos, Theodoros; Lynch, Charles F; Goodman, Marc T; Shin, Hai-Rim; Viarheichyk, Halina; Jach, Robert; Cruz, M O L Eugenia; Velasco, Julio; Molina, Carla; Bornstein, Jacob; Ferrera, Annabelle; Domingo, Efren Javier; Chou, Cheng-Yang; Banjo, Adekunbiola F; Castellsagué, Xavier; Pawlita, Michael; Lloveras, Belén; Quint, Wim G V; Muñoz, Nubia; Bosch, F Xavier

    2013-11-01

    Human papillomavirus (HPV) contribution in vulvar intraepithelial lesions (VIN) and invasive vulvar cancer (IVC) is not clearly established. This study provides novel data on HPV markers in a large series of VIN and IVC lesions. Histologically confirmed VIN and IVC from 39 countries were assembled at the Catalan Institute of Oncology (ICO). HPV-DNA detection was done by polymerase chain reaction using SPF-10 broad-spectrum primers and genotyping by reverse hybridisation line probe assay (LiPA25) (version 1). IVC cases were tested for p16(INK4a) by immunohistochemistry (CINtec histology kit, ROCHE). An IVC was considered HPV driven if both HPV-DNA and p16(INK4a) overexpression were observed simultaneously. Data analyses included algorithms allocating multiple infections to calculate type-specific contribution and logistic regression models to estimate adjusted prevalence (AP) and its 95% confidence intervals (CI). Of 2296 cases, 587 were VIN and 1709 IVC. HPV-DNA was detected in 86.7% and 28.6% of the cases respectively. Amongst IVC cases, 25.1% were both HPV-DNA and p16(INK4a) positive. IVC cases were largely keratinising squamous cell carcinoma (KSCC) (N=1234). Overall prevalence of HPV related IVC cases was highest in younger women for any histological subtype. SCC with warty or basaloid features (SCC_WB) (N=326) were more likely to be HPV and p16(INK4a) positive (AP=69.5%, CI=63.6-74.8) versus KSCC (AP=11.5%, CI=9.7-13.5). HPV 16 was the commonest type (72.5%) followed by HPV 33 (6.5%) and HPV 18 (4.6%). Enrichment from VIN to IVC was significantly high for HPV 45 (8.5-fold). Combined data from HPV-DNA and p16(INK4a) testing are likely to represent a closer estimate of the real fraction of IVC induced by HPV. Our results indicate that HPV contribution in invasive vulvar cancer has probably been overestimated. HPV 16 remains the major player worldwide. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Vitamin D-Dependent Rickets Type 1B (25-Hydroxylase Deficiency): A Rare Condition or a Misdiagnosed Condition?

    Science.gov (United States)

    Molin, Arnaud; Wiedemann, Arnaud; Demers, Nick; Kaufmann, Martin; Do Cao, Jérémy; Mainard, Laurent; Dousset, Brigitte; Journeau, Pierre; Abeguile, Geneviève; Coudray, Nadia; Mittre, Hervé; Richard, Nicolas; Weryha, Georges; Sorlin, Arthur; Jones, Glenville; Kottler, Marie-Laure; Feillet, Francois

    2017-09-01

    Vitamin D requires a two-step activation by hydroxylation: The first step is catalyzed by hepatic 25-hydroxylase (CYP2R1, 11p15.2) and the second one is catalyzed by renal 1α-hydroxylase (CYP27B1, 12q13.1), which produces the active hormonal form of 1,25-(OH) 2 D. Mutations of CYP2R1 have been associated with vitamin D-dependent rickets type 1B (VDDR1B), a very rare condition that has only been reported to affect 4 families to date. We describe 7 patients from 2 unrelated families who presented with homozygous loss-of-function mutations of CYP2R1. Heterozygous mutations were present in their normal parents. We identified a new c.124_138delinsCGG (p.Gly42_Leu46delinsArg) variation and the previously published c.296T>C (p.Leu99Pro) mutation. Functional in vitro studies confirmed loss-of-function enzymatic activity in both cases. We discuss the difficulties in establishing the correct diagnosis and the specific biochemical pattern, namely, very low 25-OH-D suggestive of classical vitamin D deficiency, in the face of normal/high concentrations of 1,25-(OH) 2 D. Siblings exhibited the three stages of rickets based on biochemical and radiographic findings. Interestingly, adult patients were able to maintain normal mineral metabolism without vitamin D supplementation. One index case presented with a partial improvement with 1alfa-hydroxyvitamin D 3 or alfacalcidol (1α-OH-D 3 ) treatment, and we observed a dramatic increase in the 1,25-(OH) 2 D serum concentration, which indicated the role of accessory 25-hydroxylase enzymes. Lastly, in patients who received calcifediol (25-OH-D 3 ), we documented normal 24-hydroxylase activity (CYP24A1). For the first time, and according to the concept of personalized medicine, we demonstrate dramatic improvements in patients who were given 25-OH-D therapy (clinical symptoms, biochemical data, and bone densitometry). In conclusion, the current study further expands the CYP2R1 mutation spectrum. We note that VDDR1B could be easily mistaken for classical vitamin D deficiency. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

  10. A case of Carney complex misdiagnosed as neurofibromatosis type 1 – Diagnostic difficulty in a rare disease

    Directory of Open Access Journals (Sweden)

    Yoshitane Tsukamoto, MD, PhD

    2017-11-01

    Full Text Available We experienced a diagnostically challenging case of Carney complex (CNC. A 24-year-old woman had a past history of surgical removal of multiple cutaneous tumors in the childhood. She was followed as a patient of neurofibromatosis type 1 (NF1 and referred to our hospital for further treatment after she grew up to adulthood. At our hospital, several cutaneous tumors were excised, and the pathological diagnosis was myxoma arising from not deep soft tissue but cutis (so-called cutaneous myxoma. Despite previous clinical diagnosis of NF1, because of the probability of CNC, detailed systemic examination was undertaken including radiological and endocrinological tests. Imaging techniques showed multiple lumps in both breasts, a mass in left atrium and nodular lesions in adrenal glands. Serum ACTH level was markedly suppressed. Surgically resected specimens revealed breast myxomas, cardiac myxoma and primary pigmented nodular adrenocortical disease (PPNAD. These findings met the diagnostic criteria for CNC. Genetic analysis revealed known non-sense mutation of PRKAR1A c.124C>T (p.R42X (ClinVar ID 41382. Her 50-year-old mother was also shown to have cardiac myxomas, radiological finding of breast myxomatosis and the same PRKAR1A mutation as her daughter. In the present case, the accurate diagnosis of CNC was difficult not only because CNC is a rare disease but also because skin pigmentation was not obvious. Since cardiac myxoma might result in poor or fatal outcome, early and accurate diagnosis of CNC and subsequent systemic investigation including heart are important. Although pediatric cutaneous myxomas are rare, multiple cutaneous myxomas might suggest the possibility of CNC. In such cases, systemic investigation should be done for the accurate diagnosis.

  11. Excellent response rate of anismus to botulinum toxin if rectal prolapse misdiagnosed as anismus ('pseudoanismus') is excluded.

    Science.gov (United States)

    Hompes, R; Harmston, C; Wijffels, N; Jones, O M; Cunningham, C; Lindsey, I

    2012-02-01

    Anismus causes obstructed defecation as a result of inappropriate contraction of the puborectalis/external sphincter. Proctographic failure to empty after 30 s is used as a simple surrogate for simultaneous electromyography/proctography. Botulinum toxin is theoretically attractive but efficacy is variable. We aimed to evaluate the efficacy of botulinum toxin to treat obstructed defecation caused by anismus. Botulinum toxin was administered, under local anaesthetic, into the puborectalis/external sphincter of patients with proctographic anismus. Responders (resolution followed by recurrence of obstructed defecation over a 1- to 2-month period) underwent repeat injection. Nonresponders underwent rectal examination under anaesthetic (EUA). EUA-diagnosed rectal prolapse was graded using the Oxford Prolapse Grade 1-5. Fifty-six patients were treated with botulinum toxin. Twenty-two (39%) responded initially and 21/22 (95%) underwent repeat treatment. At a median follow up of 19.2 (range, 7.0-30.4) months, 20/21 (95%) had a sustained response and required no further treatment. Isolated obstructed defecation symptoms (OR = 7.8, P = 0.008), but not proctographic or physiological factors, predicted response on logistic regression analysis. In 33 (97%) of 34 nonresponders, significant abnormalities were demonstrated at EUA: 31 (94%) had a grade 3-5 rectal prolapse, one had internal anal sphincter myopathy and one had a fissure. Exclusion of these alternative diagnoses revised the initial response rate to 96%. Simple proctographic criteria overdiagnose anismus and underdiagnose rectal prolapse. This explains the published variable response to botulinum toxin. Failure to respond should prompt EUA seeking undiagnosed rectal prolapse. A response to an initial dose of botulinum toxin might be considered a more reliable diagnosis of anismus than proctography. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  12. Don’t live in a town where there are no doctors: toxic epidermal necrolysis initially misdiagnosed as oral thrush

    Science.gov (United States)

    Wani, Abdul Majid; Hussain, Waleed Mohd; Fatani, Mohamad Ibrahim; Ali, Khaled Shawkat; Khoujah, Amer Mohd; Akhtar, Mubeena; Maimani, Ghassan Adnan Al; Raja, Sadeya Hanif; Basraheel, Ashraf; Fareed, Khurram

    2009-01-01

    Toxic epidermal necrolysis (TEN) is a rare but life threatening skin disease that is most commonly drug induced. The exact pathogenesis of TEN is still unknown and many drugs, including prednisolone, cyclosporin and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of IVIG in particular is controversial. Recently, the US Food and Drug Administration (FDA) has made a labelling change to the drug information for carbamazepine. Owing to recent data implicating the HLA allele B*1502 as a marker for carbamazepine induced Stevens–Johnson syndrome and TEN in Han Chinese, the FDA recommends genotyping all Asians for the allele. We present an interesting case of carbamazepine induced TEN which was confused with oral thrush, had no skin lesions on presentation, and had an excellent response to a 5 day course of methylprednisolone and high dose IVIG in combination. PMID:22207871

  13. Gastrointestinal Endometriosis Causing Subacute Intestinal Obstruction with Gradual Development of Weight Loss and Misdiagnosed as Irritable Bowel Syndrome

    OpenAIRE

    Amir Soumekh; Jerry Nagler

    2014-01-01

    Both endometriosis and irritable bowel syndrome (IBS) are commonly found in young women and the diagnosis of either is challenging. Alarm symptoms can exclude the diagnosis of IBS, but their onset may be insidious and often no evidence of organic disease may be found. We present a patient with a 4-year history of presumed IBS, absent gynecological symptoms, negative gastrointestinal as well as gynecological testing who developed the only alarm symptom of weight loss and was eventually found t...

  14. Gastrointestinal Endometriosis Causing Subacute Intestinal Obstruction with Gradual Development of Weight Loss and Misdiagnosed as Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Amir Soumekh

    2014-01-01

    Full Text Available Both endometriosis and irritable bowel syndrome (IBS are commonly found in young women and the diagnosis of either is challenging. Alarm symptoms can exclude the diagnosis of IBS, but their onset may be insidious and often no evidence of organic disease may be found. We present a patient with a 4-year history of presumed IBS, absent gynecological symptoms, negative gastrointestinal as well as gynecological testing who developed the only alarm symptom of weight loss and was eventually found to have endometriosis of the small intestine. This case illustrates the need for constant vigilance in patients with IBS.

  15. In situ and invasive squamous cell carcinoma of the vulva in Denmark 1978-2007-a nationwide population-based study

    DEFF Research Database (Denmark)

    Baandrup, L; Varbo, A; Munk, C

    2011-01-01

    To determine the incidence of vulvar carcinoma in situ (CIS) and cancer of squamous cell (SC) origin in Denmark in the period 1978-2007.......To determine the incidence of vulvar carcinoma in situ (CIS) and cancer of squamous cell (SC) origin in Denmark in the period 1978-2007....

  16. 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.

  17. Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva.

    Science.gov (United States)

    Rakislova, Natalia; Alemany, Laia; Clavero, Omar; Del Pino, Marta; Saco, Adela; Quirós, Beatriz; Lloveras, Belen; Alejo, Maria; Halec, Gordana; Quint, Wim; de Sanjosé, Silvia; Ordi, Jaume

    2018-06-01

    Most human papillomavirus (HPV)-associated vulvar squamous cell carcinomas (VSCCs) originate from high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia. However, growing evidence suggests that morphologic studies have limitations in predicting HPV status in vulvar lesions. We aimed to evaluate adjacent intraepithelial lesions in a series of DNA HPV-positive VSCCs, focusing on unusual histologic patterns mimicking differentiated vulvar intraepithelial neoplasia (dVIN) or lichen sclerosus (LS). We identified 326 DNA HPV-positive VSCC with at least 1 cm of skin adjacent to the invasive tumor and analyzed HPV typing, HPV E6*I mRNA, and p16 immunohistochemistry in all cases. A careful histologic evaluation was conducted. A conclusive association with HPV was based on a positive p16 or HPV E6*I mRNA result or both in addition to the HPV DNA, whereas cases negative for both markers were classified as nonconclusively associated with HPV. One hundred twenty-one tumors (37.1%) had normal adjacent skin, 191 (58.6%) had only high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia, and unusual intraepithelial lesions were identified in 14 (4.3%) tumors. Seven cases showed dVIN-like features, 5 showed adjacent LS-like lesion, and in 2 cases dVIN-like and LS-like lesions were identified simultaneously. Six of them were conclusively associated with HPV (3 dVIN-like, 2 LS-like, 1 with combined dVIN/LS-like features). All 6 tumors were associated with HPV16 and were positive for both p16 and HPV mRNA, and p16 was also positive in the dVIN-like and LS-like lesions. In summary, a small subset of VSCCs conclusively associated with HPV may arise on intraepithelial lesions, mimicking precursors of HPV-independent VSCC.

  18. "Histological characteristics of HPV-associated and -independent squamous cell carcinomas of the vulva: A study of 1,594 cases".

    Science.gov (United States)

    Rakislova, Natalia; Clavero, Omar; Alemany, Laia; Saco, Adela; Quirós, Beatriz; Lloveras, Belen; Alejo, Maria; Pawlita, Michael; Quint, Wim; Del Pino, Marta; de Sanjose, Silvia; Ordi, Jaume

    2017-12-15

    There are at least two different etio-pathogenic pathways for the development of vulvar squamous cell carcinoma (VSCC): one associated with infection by human papillomavirus (HPV) and another independent of HPV. We aimed to describe the histological characteristics of HPV-associated and -independent tumors and to determine the best strategy to identify HPV in VSCC. A single paraffin block was available for review from a series of 1,594 VSCCs. In all cases HPV DNA detection was analyzed using the SPF10PCR/DEIA/LiPA25 system and p16 immunohistochemistry (IHC). A tumor was considered as unquestionably HPV-associated if both HPV DNA and p16 IHC were positive. A tumor was considered indisputably HPV-independent if both HPV DNA and p16 IHC were negative. Two groups of tumors were classified as non-conclusive: (1) HPV DNA+/p16- and (2) HPV DNA-/p16+. WHO typing and a thorough histological evaluation were conducted in all cases. Four hundred and forty-one tumors were HPV DNA+ with 367 cases (23.0%) being HPV DNA+/p16+. The latter tumors were more frequently basaloid or warty (49.8%), but 36.5% were of the keratinizing type; 1,153 tumors were HPV DNA-, with 1,060 cases (66.5%) being HPV DNA-/p16-. These HPV DNA-/p16- tumors were mostly keratinizing (81.2%) but were occasionally basaloid or warty (5.2%). The features of HPV DNA-/p16+ cases (n = 93) were similar to those of the HPV-associated VSCC, and HPV DNA+/p16- (n = 74) cases had a more diverse profile, although they were more similar to HPV-independent tumors. Several histological characteristics were more frequently associated with HPV-related VSCC (koilocytotic-like change, necrosis, moderate to marked pleomorphism, invasive front in nests; p < 0.001), however, none of these characteristics allowed differentiation between HPV-associated and -independent VSCC. In conclusion, histological criteria do not allow differentiation between HPV-associated and -independent VSCC. p16 Alone is a clinically easy strategy to determine HPV status in VSCC. © 2017 UICC.

  19. 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.

  20. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis

    OpenAIRE

    Corey A. Carter; Robert Browning; Bryan T. Oronsky; Jan J. Scicinski; Christina Brzezniak

    2016-01-01

    A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958) who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM). This example highlights the importance ...

  1. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis

    Directory of Open Access Journals (Sweden)

    Corey A. Carter

    2016-01-01

    Full Text Available A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958 who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM. This example highlights the importance of exercising due diligence in determining immune-related adverse events and suggests that PD-1-induced pneumonitis should be a diagnosis of exclusion rather than a diagnosis by default. A case history and review of the literature are presented for PTTM, which we propose to define as a paraneoplastic syndrome.

  2. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis.

    Science.gov (United States)

    Carter, Corey A; Browning, Robert; Oronsky, Bryan T; Scicinski, Jan J; Brzezniak, Christina

    2016-01-01

    A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958) who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM). This example highlights the importance of exercising due diligence in determining immune-related adverse events and suggests that PD-1-induced pneumonitis should be a diagnosis of exclusion rather than a diagnosis by default. A case history and review of the literature are presented for PTTM, which we propose to define as a paraneoplastic syndrome.

  3. Emotional stimuli-provoked seizures potentially misdiagnosed as psychogenic non-epileptic attacks: A case of temporal lobe epilepsy with amygdala enlargement

    Directory of Open Access Journals (Sweden)

    Hidetaka Tamune

    Full Text Available The association between emotional stimuli and temporal lobe epilepsy (TLE is largely unknown. Here, we report the case of a depressed, 50-year-old female complaining of episodes of a “spaced out” experience precipitated by emotional stimuli. Psychogenic non-epileptic attacks were suspected. However, video-EEG coupled with emotional stimuli-provoked procedures and MRI findings of amygdala enlargement, led to the diagnosis of left TLE. Accurate diagnosis and explanation improved her subjective depression and seizure frequency. This case demonstrated that emotional stimuli can provoke seizures in TLE and suggested the involvement of the enlarged amygdala and the modulation of emotion-related neural circuits. Keywords: Video-EEG, Psychogenic non-epileptic attacks, Temporal lobe epilepsy, Amygdala enlargement, Reflex seizure, Provoked seizure

  4. 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.

  5. 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…

  6. 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.

  7. 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.

  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. Radiation Treatment for Primary Adenocarcinoma of Bartholin Gland- A Case Report and Review of Literature

    International Nuclear Information System (INIS)

    Oh, Won Yong; Whang, In Soon

    1989-01-01

    A patient with primary adenocarcinoma of Bartholin gland is reported and the literatures relevant to this disease reviewed. Not only this disease is very rare but also primary carcinomas of Bartholin gland are misdiagnosed as cysts or abscesses in half of the cases, leading to considerable delay in diagnosis. And so, It was wasted long time before definitive therapy. However, because of a different clinical behavior, cancer of the Bartholin gland should be distinguished from other vulvar carcinomas. Histologically, squamous cell carcinoma and adenocarcinoma are the most common. Virtually all histologic types of Bartholin gland carcinoma metastasize to lymph node, bone, lung and liver in distant sites. The authors data and a review of the literature support the concept that radical vulvectomy with or without bilateral inguina1-femoral lymphadenectomy is required. On the other hand, except primary radiation treatment for small or medium sized cancers, the results obtained by radiation therapy in carcinoma of the vulva including Bartholin gland are generally discouraging. A role for postoperative adjuvant radiation therapy suggests because of high incidence of positive inguinal-femoral lymph nodes. In the near time, natural history and biological behavior of Bartholin gland cancer must be disclosed in detail. And also optimal treatment modality and prognostic factors shall be determine

  10. Immune regulation in premalignant vulvar and vaginal disorders

    NARCIS (Netherlands)

    A. Terlou (Annelinde)

    2011-01-01

    textabstractDuring embryogenesis, the external genitalia develop under the influence of hormones. The vulva originates from the genital tubercle (clitoris), urogenital groove (vestibulum), urethral folds (labia minora) and genital swellings (labia majora). Structures belonging to the vulva are

  11. 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 OBOR OECD: Zoology Impact factor: 3.730, year: 2016

  12. In squamous cell carcinoma of the vulva, overexpression of p53 is a late event and neither p53 nor mdm2 expression is a useful marker to predict lymph node metastases

    NARCIS (Netherlands)

    Emanuels, AG; Koudstaal, J; Burger, MPM; Hollema, H

    To offer more tailored treatment to individual patients with squamous cell carcinoma of the vulval more accurate prediction of lymph node metastases is required. As p53 and mdm2 are genes known to be involved in the development of other tumours, we studied expression of p53 and mdm2 in

  13. 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.

  14. Failure in the detection of the sentinel lymph node with a combined technique of radioactive tracer and blue dye in a patient with cancer of the vulva and a single positive lymph node

    NARCIS (Netherlands)

    Fons, G.; ter Rahe, B.; Sloof, G.; de Hullu, J.; van der Velden, J.

    2004-01-01

    Background. In early stage vulvar cancer, the sentinel lymph node procedure with a radioactive tracer appears to be a promising new diagnostic tool to predict lymph node status. No detection failures have been published so far in vulvar cancer. We recently experienced failure in the detection of the

  15. Failure in the detection of the sentinel lymph node with a combined technique of radioactive tracer and blue dye in a patient with cancer of the vulva and a single positive lymph node

    NARCIS (Netherlands)

    Fons, G; ter Rahe, B; Sloof, G; de Hullu, J; van der Velden, J

    Background. In early stage vulvar cancer, the sentinel lymph node procedure with a radioactive tracer appears to be a promising new diagnostic tool to predict lymph node status. No detection failures have been published so far in vulvar cancer. We recently experienced failure in the detection of the

  16. HLA-DR-, CD33+, CD56+, CD16- myeloid/natural killer cell acute leukemia: a previously unrecognized form of acute leukemia potentially misdiagnosed as French-American-British acute myeloid leukemia-M3.

    Science.gov (United States)

    Scott, A A; Head, D R; Kopecky, K J; Appelbaum, F R; Theil, K S; Grever, M R; Chen, I M; Whittaker, M H; Griffith, B B; Licht, J D

    1994-07-01

    We have identified and characterized a previously unrecognized form of acute leukemia that shares features of both myeloid and natural killer (NK) cells. From a consecutive series of 350 cases of adult de novo acute myeloid leukemia (AML), we identified 20 cases (6%) with a unique immunophenotype: CD33+, CD56+, CD11a+, CD13lo, CD15lo, CD34+/-, HLA-DR-, CD16-. Multicolor flow cytometric assays confirmed the coexpression of myeloid (CD33, CD13, CD15) and NK cell-associated (CD56) antigens in each case, whereas reverse transcription polymerase chain reaction (RT-PCR) assays confirmed the identity of CD56 (neural cell adhesion molecule) in leukemic blasts. Although two cases expressed CD4, no case expressed CD2, CD3, or CD8 and no case showed clonal rearrangement of genes encoding the T-cell receptor (TCR beta, gamma, delta). Leukemic blasts in the majority of cases shared unique morphologic features (deeply invaginated nuclear membranes, scant cytoplasm with fine azurophilic granularity, and finely granular Sudan black B and myeloperoxidase cytochemical reactivity) that were remarkably similar to those of acute promyelocytic leukemia (APL); particularly the microgranular variant (FAB AML-M3v). However, all 20 cases lacked the t(15;17) and 17 cases tested lacked the promyelocytic/retinoic acid receptor alpha (RAR alpha) fusion transcript in RT-PCR assays; 12 cases had 46,XX or 46,XY karyotypes, whereas 2 cases had abnormalities of chromosome 17q: 1 with del(17)(q25) and the other with t(11;17)(q23;q21) and the promyelocytic leukemia zinc finger/RAR alpha fusion transcript. All cases tested (6/20), including the case with t(11;17), failed to differentiate in vitro in response to all-trans retinoic acid (ATRA), suggesting that these cases may account for some APLs that have not shown a clinical response to ATRA. Four of 6 cases tested showed functional NK cell-mediated cytotoxicity, suggesting a relationship between these unique CD33+, CD56+, CD16- acute leukemias and normal CD56+, CD16- NK precursor cells. Using a combination of panning and multiparameter flow cytometric sorting, we identified a normal CD56+, CD33+, CD16- counterpart cell at a frequency of 1% to 2% in the peripheral blood of healthy individuals. Our studies suggest that this form of acute leukemia may arise from transformation of a precursor cell common to both the myeloid and NK cell lineages; thus we propose the designation myeloid/NK acute leukemia. Recognition of this new leukemic entity will be important in distinguishing these ATRA-nonresponsive cases from ATRA-responsive true APL.

  17. 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.

  18. 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.

  19. Cervical Myomas

    Science.gov (United States)

    ... Adnexal Torsion Bartholin Gland Cysts Cervical Myomas Cervical Stenosis Endometriomas of the Vulva Inclusion and Epidermal Cysts of the Vulva Noncancerous Ovarian Growths Polyps of the Cervix Skene Duct Cyst Cervical myomas are smooth, benign tumors in the cervix. A myoma may bleed, ...

  20. Factors affecting reproductive performance of dairy cow in Algeria ...

    African Journals Online (AJOL)

    Tuoyo Aghomotsegin

    2017-01-11

    Jan 11, 2017 ... Article Number: 8C8D1B562380. ISSN 1684-5315. Copyright ... lactation on reproductive performance of dairy cows in Algeria. Calving to first .... sniffing the vulva of other cows, mucus presence in the vulva, nervousness, pink ...

  1. Vulvar Lobular Capillary Hemangioma: A Rare Location for a Frequent Entity

    Directory of Open Access Journals (Sweden)

    F. Abreu-dos-Santos

    2016-01-01

    Full Text Available Lobular capillary hemangioma, or pyogenic granuloma, is an acquired hemorrhagic benign vascular lesion of the skin and mucous membranes. The pyogenic granuloma of the vulva is a rare finding and a limited number of case reports are available in the literature. To the best of our knowledge this is the first case described as a single pyogenic granuloma on the vulva.

  2. An Unusual Gross Appearance of Vulval Tuberculosis Masquerading as Tumor

    Directory of Open Access Journals (Sweden)

    Surekha U. Arakeri

    2014-01-01

    Full Text Available Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized.

  3. An unusual gross appearance of vulval tuberculosis masquerading as tumor.

    Science.gov (United States)

    Arakeri, Surekha U; Sinkar, Prachi

    2014-01-01

    Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized.

  4. Vulvodynia FAQ

    Science.gov (United States)

    ... a nerve block help relieve pain? • What is cognitive behavioral therapy? • When is surgery recommended for vulvodynia? • Glossary What is vulvodynia? The external female genital area is called the vulva . Pain that affects this ...

  5. Vaginal itching and discharge - child

    Science.gov (United States)

    Pruritus vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, ...

  6. Disease: H00944 [KEGG MEDICUS

    Lifescience Database Archive (English)

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

  7. Download this PDF file

    African Journals Online (AJOL)

    Mr Olusoji

    Ahmadu Bello University Teaching Hospital, Shika- ... Backgound: The incidence of vulva injuries in pregnancy in our environment following ... traumas have also been reported following both ... expectant mothers are reluctant to present to the.

  8. PRIMARY SCHOOL (5 - 10 YEARS)

    African Journals Online (AJOL)

    Chantel

    , but sometimes affects school children. Children pres- ent with itchy white papules on the genitalia, the glans and prepuce or the vulva. Initially there is some red- dish or purplish inflammation around the white lesions, which become wrin-.

  9. Vulvær intraepitelial neoplasi

    DEFF Research Database (Denmark)

    Hansen, Signe Østergaard; Vorbeck, Christina Steen; Meinert, Mette

    2018-01-01

    Vulva dysplasi skal anses for en præmalign tilstand. Ny histologisk inddeling af vulva dysplasi fra januar 2018: HSIL (High grade Squamous Intraepithelial Lesion) i vulva og Vulvær intraepitelial neoplasi, differentieret VIN (dVIN) Vi anbefaler medicinsk behandling med imiquimod som 1. valg. Dog ...... der stor recidivrate både ved medicinsk og kirurgisk behandling. English summary: Vulva intraepithelial neoplasia (VIN) is a rare but premalignant condition. VIN has two etiological pathways: a human papillomavirus (HPV)-dependent pathway, vulvar HSIL, affecting young women, and an HPV......-independent pathway, differentiated VIN (d-VIN), associated with lichen sclerosus, affecting older women. D-VIN is more aggressive than vulvar HSIL. In case of symptoms, a biopsy should be performed. The recurrence risk is high at 25-50% regardless treatment type. We recommend treatment with imiquimod as first choice...

  10. Behcet's Disease

    Science.gov (United States)

    ... the scrotum, similar to oral lesions, but deeper. Female — painful genital ulcers that develop on the vulva. Gastrointestinal Ulcerations may occur anywhere in the gastrointestinal tract from the mouth to the anus. The terminal ...

  11. Bartholin cyst or abscess

    Science.gov (United States)

    ... Alternative Names Abscess - Bartholin; Infected Bartholin gland Images Female reproductive anatomy References Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and ...

  12. The situation of radiotherapy in the treatment of lymph node invasion of gynecological cancers

    International Nuclear Information System (INIS)

    Dubois, J.B.; Gerbaulet, A.

    1993-01-01

    In this article, the authors explain the role and possibilities of radiotherapy in the treatment of lymph node invasion in gynecological cancers as uterine cervix carcinoma, uterus carcinoma, ovary carcinoma and vulva carcinoma

  13. Genetic and Molecular Analysis of Suppressors of Ras Mutations

    National Research Council Canada - National Science Library

    Sieburth, Derek

    1999-01-01

    .... elegans vulvaZ development. We describe the identification and characterization of a novel gene, sur-8, that functions to regulate a receptor tyrosine kinase-Ras-MAp kinase- mediated signal transduction pathway during C...

  14. Estimation of the overall burden of cancers, precancerous lesions, and genital warts attributable to 9-valent HPV vaccine types in women and men in Europe

    OpenAIRE

    Hartwig , Susanne; St Guily , Jean Lacau; Dominiak-Felden , Géraldine; Alemany , Laia; De Sanjosé , Silvia

    2017-01-01

    Background In addition to cervical cancer, human papillomavirus (HPV) is responsible for a significant proportion of cancers and precancerous lesions of the vulva, vagina, anus, penis, head and neck, as well as genital warts. We estimated the annual number of new cases of these diseases attributable to 9-valent HPV vaccine types in women and men in Europe. Methods The annual number of new cancers of the cervix, vulva, vagina, anus, penis, and selected head and neck sites in the population of ...

  15. Significance of Serology by Multi-Antigen ELISA for Tissue Helminthiases in Korea

    Science.gov (United States)

    2017-01-01

    It is clinically important to differentiate tissue-invading helminthiasis. The purpose of this study was to assess the specific immunoglobulin G (IgG) antibody positive rates for clonorchiasis, paragonimiasis, cysticercosis, and sparganosis 4 helminthiases from 1996 to 2006 using multi-antigen enzyme-linked immunosorbent assay (ELISA) in Korea. Results of 6,017 samples, which were referred to our institute for serodiagnosis, were analyzed. The subjects with positive serum IgG antibodies were 1,502 (25.0%) for any of the 4 helminthiases. The overall positive numbers for clonorchiasis, paragonimiasis, cysticercosis, and sparganosis were 728 (12.1%), 166 (2.8%), 729 (12.1%), and 263 (4.4%), respectively. The positive serologic reaction to multi-antigens was determined in 309 (20.6%) of the 1,502 total seropositive subjects. Those with multi-antigen positivity were regarded as positive for the antigen of strongest reaction but cross-reaction to others with weak positive reaction. Annual seropositive rates for those 4 tissue helminthiases ranged from 12.1% to 35.7%. The highest rate was observed in age from 60 to 69 years old and prevalence of men (27.4%; 1,030/3,763) was significantly higher than of women (19.1%; 332/1,741). Hospital records of 165 ELISA positive patients were reviewed to confirm correlation with their clinical diagnosis. Paragonimiasis was highly correlated as 81.8% (9/11), cysticercosis 29.9% (20/67), clonorchiasis 29.0% (20/69), and sparganosis 11.1% (2/18). In conclusion, the multi-antigen ELISA using 4 helminth antigens is useful to differentiate suspected tissue-invading helminthiases, especially ELISA diagnosis of paragonimiasis is reliable. The seropositivity is still high among suspected patients in Korea. PMID:28581268

  16. 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.

  17. Spirometra (Pseudophyllidea, Diphyllobothriidae Severely Infecting Wild-Caught Snakes from Food Markets in Guangzhou and Shenzhen, Guangdong, China: Implications for Public Health

    Directory of Open Access Journals (Sweden)

    Fumin Wang

    2014-01-01

    Full Text Available 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.

  18. Platynosomum fastosum-induced chronic intrahepatic cholangitis and Spirometra spp. infections in feral cats from Grand Cayman.

    Science.gov (United States)

    Headley, S A; Gillen, M A; Sanches, A W D; Satti, M Z

    2012-06-01

    The occurrence of platynosomiasis and intestinal sparganosis is described in feral cats from Grand Cayman, Cayman Islands. Spirometra spp. was observed within the intestine of 18.18% (10/55) of cats; 1.18% (1/55) of cats demonstrated gross and histological manifestation of parasitism by Platynosomum fastosum, but 14.5% (8/55) of cats had the characteristic pathological manifestations of P. fastosum-induced intrahepatic cholangitis without the concomitant presence of the intraductal trematode. Combined parasitism (Spirometra spp. and P. fastosum) was observed in 9.09% (5/55) of feral cats. Significant pathological findings were only associated with the hepatic fluke, P. fastosum, and were grossly characterized by moderate hepatomegaly with enlarged and dilated bile ducts. Examples of cestodes with morphological features characteristic of Spirometra spp. were observed within the small intestine without any associated pathological lesion. The histopathological evaluation of liver fragments revealed chronic intrahepatic cholangitis with and without the associated intraductal trematode, and was characterized by marked periductal fibrosis, adenomatous proliferation of bile duct epithelium, dilation of intrahepatic bile ducts and portal accumulations of inflammatory cells. The occurrence of the cestode in feral cats coupled with factors that are unique to Grand Cayman makes this island the ideal location for sporadic cases of human sparganosis.

  19. 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.

  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. 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.

  2. 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.

  3. The Mediator Kinase Module Restrains Epidermal Growth Factor Receptor Signaling and Represses Vulval Cell Fate Specification in Caenorhabditis elegans.

    Science.gov (United States)

    Grants, Jennifer M; Ying, Lisa T L; Yoda, Akinori; You, Charlotte C; Okano, Hideyuki; Sawa, Hitoshi; Taubert, Stefan

    2016-02-01

    Cell signaling pathways that control proliferation and determine cell fates are tightly regulated to prevent developmental anomalies and cancer. Transcription factors and coregulators are important effectors of signaling pathway output, as they regulate downstream gene programs. In Caenorhabditis elegans, several subunits of the Mediator transcriptional coregulator complex promote or inhibit vulva development, but pertinent mechanisms are poorly defined. Here, we show that Mediator's dissociable cyclin dependent kinase 8 (CDK8) module (CKM), consisting of cdk-8, cic-1/Cyclin C, mdt-12/dpy-22, and mdt-13/let-19, is required to inhibit ectopic vulval cell fates downstream of the epidermal growth factor receptor (EGFR)-Ras-extracellular signal-regulated kinase (ERK) pathway. cdk-8 inhibits ectopic vulva formation by acting downstream of mpk-1/ERK, cell autonomously in vulval cells, and in a kinase-dependent manner. We also provide evidence that the CKM acts as a corepressor for the Ets-family transcription factor LIN-1, as cdk-8 promotes transcriptional repression by LIN-1. In addition, we find that CKM mutation alters Mediator subunit requirements in vulva development: the mdt-23/sur-2 subunit, which is required for vulva development in wild-type worms, is dispensable for ectopic vulva formation in CKM mutants, which instead display hallmarks of unrestrained Mediator tail module activity. We propose a model whereby the CKM controls EGFR-Ras-ERK transcriptional output by corepressing LIN-1 and by fine tuning Mediator specificity, thus balancing transcriptional repression vs. activation in a critical developmental signaling pathway. Collectively, these data offer an explanation for CKM repression of EGFR signaling output and ectopic vulva formation and provide the first evidence of Mediator CKM-tail module subunit crosstalk in animals. Copyright © 2016 by the Genetics Society of America.

  4. Contributions to the genus Opisthodorylaimus Ahmad & Jairajpuri, 1982 (Nematoda: Dorylaimida, with descriptions of two new species

    Directory of Open Access Journals (Sweden)

    Andrássy, I.

    2007-08-01

    Full Text Available Two new species of the genus Opisthodorylaimus are described. O. mitis sp. n. from Guadeloupe and Ecuador is characterized by a transverse vulva, very long egg, lack of an anterior uterine sac, and by a filiform tail. O. papuanus sp. n. from Papua New Guinea is distinguished by a longitudinal vulva, lack of a prevulval uterine branch, and by a long, filiform tail. Two known species of the genus are also presented: O. cavalcantii (Lordello, 1955 from Vietnam and O. maqsoodi Ahmad & Jairajpuri, 1982 from Seychelles. The taxonomic position of Opisthodorylaimus is commented, and the distribution of its ten species outlined. A key to species is added.

  5. Infections in Combat Casualties During Operations Iraqi and Enduring Freedom

    Science.gov (United States)

    2009-04-01

    bacteria other 39 112.1 Vulva/ vaginal candidiasis 1 381.4 Nonsuppurative otitis media 1 451.82 Superficial phlebitis arm 2 451.83 Deep phlebitis arm 1...Coding by Pathogen Pathogen Code Code Description Number Fungus 112.1 Vulva/ vaginal candidiasis 1 112.3 Candidiasis of skin/nails 1 112.5 Disseminated... candidiasis 3 112.89 Candidiasis site not available 6 112.9 Candidiasis site unspecified 13 117.3 Aspergillus 5 117.9 Mycoses 14 Gram-negative 003.8

  6. Infections Complicating the Care of Combat Casualties During Operations Iraqi Freedom and Enduring Freedom

    Science.gov (United States)

    2011-07-01

    vaginal candidiasis 3 112.3 Candidiasis of skin/nails 2 112.5 Disseminated candidiasis 4 112.89 Candidiasis site nec 6 112.9 Candidiasis site unspec...OT 7 112.1 Vulva/ vaginal candidiasis 3 320.9 Bacterial meningitis nos 6 381.4 Nonsuppurative otitis media unspec 5 41.89 Infection bacteria OT 133...Lippincott Williams & WilkinsS66 TABLE 4. Infectious ICD-9 Coding by Pathogen Syndrome Code Code Description N Fungus 112 Candidiasis of mouth 7 112.1 Vulva

  7. 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.

  8. Fibroadenoma in an ectopic vulvar breast gland: a common neoplasm in an uncommon site.

    Science.gov (United States)

    Ayadi-Kaddour, A; Khadhar, A; Mlika, M; Braham, E; Ismail, O; Zegal, D; El Mezni, F

    2014-03-01

    Ectopic breast tissue is defined as glands located outside of the breast. It can be found anywhere along the milk line extending from the axilla to the groin, and can occur in the vulva. Ectopic breast tissue should be excised because it may develop benign or malignant pathologic processes. Less than 40 cases of fibroadenoma in the vulva have been reported in the literature. We report a case of a 37-year-old woman presenting a solitary vulvar mass. The mass was excised completely, and histology demonstrated an ectopic breast fibroadenoma. This is one of the few reports on the benign pathologies of vulvar mammary glands.

  9. 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.

  10. Stiff-Person Syndrome

    Science.gov (United States)

    ... awry in the brain and spinal cord. The disorder is often misdiagnosed as Parkinson’s disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia. A definitive diagnosis can be made ...

  11. 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 ...

  12. Case report

    African Journals Online (AJOL)

    abp

    2013-05-18

    May 18, 2013 ... Key words: Neuroleptic Malignant Syndrome, antipsychotics, Saudi Arabia ... syndromes that are often unrecognized or misdiagnosed by the primary .... health care professionals, patients and even caregivers about this.

  13. Symptoms of Lewy Body Dementia

    Science.gov (United States)

    ... the fight against LBD! Donate Symptoms Lewy body dementia (LBD) has variable presentations that include cognitive difficulties ... wake cycle alterations. Cognitive impairment in Lewy body dementia (LBD) is often misdiagnosed as Alzheimer’s disease (AD). ...

  14. 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...

  15. 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.

  16. Annals of Pediatric Surgery - Vol 11, No 3 (2015)

    African Journals Online (AJOL)

    Omental infarction in children misdiagnosed as acute appendicitis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Vincenzo D. Catania, Vincenza di Giacomo, Roberta Bonomo, Nino Guarino, 200-202 ...

  17. 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

  18. The high-riding superior aortic recess of the pericardium: MRI visualization in a child

    International Nuclear Information System (INIS)

    Cohen, Mervyn; Johnson, Tiffanie; Hoyer, Mark

    2005-01-01

    We report a 4-year-old child with a high-riding superior aortic recess of the pericardium, initially misdiagnosed as a possible vascular malformation. The anatomy of the pericardial recesses is reviewed. (orig.)

  19. Iatrogenic Cushing's Disease in a Boy after Misdiagnosis of Salt-Losing Virilizing Adrenal Hyperplasia: Impaired Metyrapone Response with Failure of Catch-Up Growth

    Science.gov (United States)

    Mendilaharzu, Hernan; And Others

    1973-01-01

    A boy misdiagnosed as having the sodium-losing form of virilizing adrenal hyperplasia was treated with large doses of glucocorticoids and mineralocorticoids from the newborn period until he was more than 4 years of age. (Author)

  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. Procamacolahnus tubifer Gerlach, 1953, Procamacolaimus ...

    African Journals Online (AJOL)

    1988-01-25

    Jan 25, 1988 ... c': tail length divided by anal body width. V: distance of vulva from ant. end as a percentage of body length. Procamacolaimus tubifer Gerlach, 1953 (Figure 1,. A-H). (. This is a redescription of P. tubiter. Three males and one female are recorded - all from Cape Receife Beach at depths of between 15-90 em, ...

  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. Rare vulvar malignancies; incidence, treatment and survival in the Netherlands

    NARCIS (Netherlands)

    Pleunis, N.; Schuurman, M.S.; Rossum, M.M. van; Bulten, J.; Massuger, L.F.A.G.; Hullu, J.A. de; Aa, M.A. van der

    2016-01-01

    OBJECTIVE: To describe trends in incidence, treatment and survival of patients with basal cell carcinomas and melanomas of the vulva. Also to compare survival of vulvar and cutaneous melanoma patients. METHODS: All women with a vulvar malignancy between 1989 and 2012 were selected from the Dutch

  4. Vulvar mucinous adenocarcinoma with neuroendocrine differentiation: A case report and review of the literature

    NARCIS (Netherlands)

    Rosmalen, M.H. Van; Reijnen, C.; Boll, D.; Pijnenborg, J.M.A.; Wurff, A.A. van der; Piek, J.M.

    2016-01-01

    BACKGROUND: There are limited cases in literature of patients with mucinous adenocarcinoma of the vulva with neuroendocrine differentiation have. With this new case, we aim to provide an overview of the existing literature and present a tool with relevant markers for the pathologist in the

  5. Untitled

    African Journals Online (AJOL)

    Primary cancers of the vagina are rare. Most of them are metastatic cancers from either the cervix or vulva or elsewhere in the body. The International. Federation of Gynaecology and Obstetrics (FIGO) adopted a definition for primary vaginal cancers. Correspondence: Dr D. Seleye-fubara. Email:dsfubara@yahoo.com.

  6. Author Details

    African Journals Online (AJOL)

    Yaguo-Ide, LE. Vol 5, No 2 (2010) - Articles prevalence of microalbuminuria in paediatric patients with sickle cell anaemia. Abstract · Vol 6, No 2 (2012) - Articles Vulva cellulitis and abscess with extension to anterior abdominal wall. Abstract. ISSN: 0795-3038. AJOL African Journals Online. HOW TO USE AJOL.

  7. Human papillomavirus-associated cancers: A growing global problem

    OpenAIRE

    Bansal, Anshuma; Singh, Mini P; Rai, Bhavana

    2016-01-01

    Human papillomavirus (HPV) infection is linked with several cancers such as cancer cervix, vagina, vulva, head and neck, anal, and penile carcinomas. Although there is a proven association of HPV with these cancers, questions regarding HPV testing, vaccination, and treatment of HPV-related cancers continue to remain unanswered. The present article provides an overview of the HPV-associated cancers.

  8. 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 ...

  9. Gynaecological radiotherapy

    International Nuclear Information System (INIS)

    Sutton, M.L.

    1986-01-01

    The experience of the Christie Hospital in Manchester in treating cancer of the cervix, (with particular reference to intracavitary radiation and after loading systems, and treatment complications) is described, together with consideration of cancer of the uterine corpus, vulva and ovaries. (U.K.)

  10. Identification of sentinel lymph nodes in vulvar carcinoma patients with the aid of a patent blue V injection: a multicenter study

    NARCIS (Netherlands)

    Ansink, A. C.; Sie-Go, D. M.; van der Velden, J.; Sijmons, E. A.; de Barros Lopes, A.; Monaghan, J. M.; Kenter, G. G.; Murdoch, J. B.; ten Kate, F. J.; Heintz, A. P.

    1999-01-01

    BACKGROUND: The aim of this multicenter study was to investigate the feasibility and negative predictive value of sentinel lymph node detection with blue dye in vulvar carcinoma patients. METHODS: In patients with squamous cell carcinoma of the vulva without suspicious groin lymph nodes, patent blue

  11. 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

  12. Image based brachytherapy planning with special reference to gynaecological cancers

    International Nuclear Information System (INIS)

    Kirisits, C.

    2008-01-01

    Cervical cancer is the most common cancer among women in India and one of the most frequent malignancies in Europe and in North America. In addition endometrium, vagina and vulva cancer are treated with brachytherapy. Especially for locally advanced cervix cancer the integration of image based brachytherapy planning into clinical routine is becoming a new standard for the future

  13. Identification of potential prognostic markers for vulvar cancer using immunohistochemical staining of tissue microarrays.

    NARCIS (Netherlands)

    Fons, G.; Burger, M.P.; Kate, F.J. ten; Velden, J. van der

    2007-01-01

    The aim of this study is to determine immunohistochemical markers with prognostic significance for disease-specific survival in patients with squamous cell cancer of the vulva. The study material consisted of slides and paraffin blocks of 50 vulvectomy specimens. A tissue microarray was constructed

  14. Redescrição de Litomosoides brasiliensis Almeida, 1936 (Nematoda: Filariidae Parasito de Anoura caudifera (Chiroptera: Phyllostomidae

    Directory of Open Access Journals (Sweden)

    Mourão Elizabeth D

    2002-01-01

    Full Text Available The study of the surface topography added details regarding the disposition of male caudal papillae, spicules and area rugosa apart from vulva and oral aperture. The occurrence of this nematode in the state of Amapá represents a new geographical distribution.

  15. Scheduling Outpatient Services: A Linear Programming Approach

    Science.gov (United States)

    1990-07-05

    25-32. Hartzke, L. (1983). Diagnosis related groups: Concept and use. Madison, WI! NTIS. Hollis, B. R. (1988). Methodology, myths , and maths of DRO’s...49 3.06 (A 19 368 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM 15 69 4.60 20 360 VAGINA , CERVIX & VULVA PROCEDURES 13 24 1.85 21 358 UTERINE & ADNEXA PROC

  16. Avelumab With Valproic Acid in Virus-associated Cancer

    Science.gov (United States)

    2018-06-11

    Cancer That is Associated With a Chronic Viral Infection; p16 Positive SCCHN; Squamous Cell Carcinoma of the Cervix; p16 Positive Squamous Cell Carcinoma of the Vagina or Vulva; p16 Positive Squamous Cell Carcinoma of the Penis; p16 Positive Squamous Cell Carcinoma of the Anus or Anal Canal; EBER Positive NPC; EBER Positive Hodgkins and Non-hodgkins Lymphona

  17. 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.

  18. 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.

  19. 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 ...

  20. Giant Mucinous Cystadenoma in Nnewi, Nigeria

    African Journals Online (AJOL)

    Ovarian mucinous cystadenoma is a benign tumor that arises from the surface ... abdomen. On vaginal examination, the vulva, vaginal and cervix ... Multilocular cyst. Discussion. Giant ovarian tumors have become rare in recent times because most of them are discovered early during routine medical check or incidental ...

  1. Labia Majora Share

    Directory of Open Access Journals (Sweden)

    Hanjing Lee

    2017-01-01

    Full Text Available Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.

  2. Case report

    African Journals Online (AJOL)

    animal surgery.r.Ed. St. Louis: Elsevier Saunders, 2004,PA 72-477. VIANNA, M.L. and TOBIAS, K.M. (2005):. Atresia ani in the dog: Aretrospective study. J Am Anim Hosp Assoc. 41:317-322. WYKES, P.M. and OLSON, P.N. (2003). Vagina, vestibule, and vulva. In: Textbook of Small Animal Surgery. Slatter DH, editor.

  3. Risk factors for candida infection of the genital tract in the tropics

    African Journals Online (AJOL)

    1.09-5.67) and vaginal lavage (adjusted odds ratio: 4.41, 95% confidential interval: 1.13-5.14) were significantly associated ... vaginal lavage, use of pantyliners, times of sex, cleaning the vulva before sex, ... probability of infection in patients with vaginal lav- age was ..... research the distribution of Candida spp. isolated from.

  4. 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

  5. Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at Presentation.

    Science.gov (United States)

    Swords, Douglas S; Mone, Mary C; Zhang, Chong; Presson, Angela P; Mulvihill, Sean J; Scaife, Courtney L

    2015-10-01

    Delay in diagnosis of pancreatic ductal adenocarcinoma (PDAC) is associated with decreased survival. The effect of an initial misdiagnosis on delay in diagnosis and stage of PDAC is unknown. This study is a retrospective review (2000-2010) from a University-based cancer center of new diagnoses of proximal PDAC. Of 313 patients, 98 (31.3 %) had an initial misdiagnosis. Misdiagnosed patients were younger, 62.8 ± 12.6 vs. 68.0 ± 10.1 (p < 0.001). The most common initial misdiagnoses were: gallbladder disease, gastroesophageal reflux disease, and peptic ulcer disease. After excluding patients with prior cholecystectomy, 14.2 % were misdiagnosed with gallbladder disease and underwent cholecystectomy before PDAC diagnosis. Misdiagnosed patients had higher rates of abdominal pain (p < 0.001), weight loss (p = 0.04), and acute pancreatitis (p < 0.001) and lower rate of jaundice (p < 0.001). Median time between symptoms to PDAC diagnosis was longer in misdiagnosed: 4.2 months vs. 1.4 (p < 0.001). Median time from contact with medical provider to axial imaging was longer in misdiagnosed (p < 0.001). Rate of stages III-IV disease at diagnosis was higher in misdiagnosed: 61.2 vs. 43.7 % (p = 0.004), with a 1.4 (95 % confidence interval (CI), 1.12-1.74) higher risk of stages III-IV disease at diagnosis; however, there was no difference in median overall survival in misdiagnosed patients (9.6 months in misdiagnosed vs. 10.3 months in correctly diagnosed, p = 0.69). Initial misdiagnosis of patients with proximal PDAC is associated with delay in diagnosis and higher risk of locally advanced or advanced disease at time of PDAC diagnosis.

  6. Retrospective evaluation of acute appendicitis incorrectly diagnosed on CT

    International Nuclear Information System (INIS)

    Kim, Tae Hoon; Kim, Hyun Cheol

    2006-01-01

    The purpose of our study was to retrospectively evaluate the CT images of patients suffering with surgically proven appendicitis to determine the causes of missed diagnoses. We reviewed the pathology reports of the patients with surgically proven appendicitis from two hospitals during a 3-year period. Thirty-seven such cases with a misdiagnosis were identified and they served as our misdiagnosed group (17 females and 20 males, mean age: 58 years, age range 15-68 years). These were cases that were misdiagnosed on preoperative abdominal CT. All 57 patients in the control group (30 females and 27 males, mean age: 44 years, age range: 21-78 years) had undergone laparotomy for acute appendicitis and they had been correctly diagnosed preoperatively on CT. Two abdominal radiologists evaluated the following items from all 94 CT examinations: 1) an abnormal appendix, 2) periappendiceal fat inflammation, 3) pericecal extraluminal fluid, 4) pericecal extraluminal air, 5) appendicolith, 6) cecal wall thickening, 7) small bowel dilatation, and 8) the pericecal fat content. Statistical analysis was performed using a Chi-squared test and Fisher's exact test. Any abnormal appendix was not visualized, even retrospectively, in 27 (73%) of the 37 patients from the misdiagnosed group, whereas it was not visualized in 13 (23%) of the 57 patients in the control group (ρ = 0.001). Of the patients who had been misdiagnosed, inflammation of the pericecal fat was observed in 21 patients (57%) as compared to 50 (88%) patients in the control group (ρ =0.001). Pericecal fluid and air were noted in 15 (41%) and 9 (24%) patients, respectively, in the misdiagnosed group and in 19 (33%) and 14 (25%) patients, respectively, in the control group, (ρ = 0.477 and ρ =0.901, respectively). Appendicolith was found in 3 (8%) misdiagnosed subjects and in 10 (18%) of the controls (ρ = 0.001). Focal cecal wall thickening was noted in 14 (38%) misdiagnosed patients and in 28 (49%) control patients (

  7. Factors associated with the misdiagnosis of cerebellar infarction.

    Science.gov (United States)

    Masuda, Yoko; Tei, Hideaki; Shimizu, Satoru; Uchiyama, Shinichiro

    2013-10-01

    Cerebellar infarction is easily misdiagnosed or underdiagnosed. In this study, we investigated factors leading to misdiagnosis of cerebellar infarction in patients with acute ischemic stroke. Data on neurological and radiological findings from 114 consecutive patients with acute cerebellar infarction were analyzed. We investigated factors associated with misdiagnosis from the data on clinical findings. Thirty-two (28%) patients were misdiagnosed on admission. Misdiagnosis was significantly more frequent in patients below 60 years of age and in patients with vertebral artery dissection, and significantly less frequent in patients with dysarthria. It tended to be more frequent in patients with the medial branch of posterior inferior cerebellar artery territory infarction, and infrequent in patients with the medial branch of the superior cerebellar artery territory infarction. Thirty out of 32 (94%) misdiagnosed patients were seen by physicians that were not neurologists at the first visit. Twenty-four of 32 (75%) misdiagnosed patients were screened only by brain CT. However, patients were not checked by brain MRI or follow-up CT until their conditions worsened. Patients below 60 years of age and patients with vertebral artery dissection are more likely to have a cerebellar infarction misdiagnosed by physicians other than neurologists. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. 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.

  9. Lipoma vulvar: um relato de caso

    Directory of Open Access Journals (Sweden)

    Mariano Lopes da Silva Filho

    2012-04-01

    Full Text Available Os lipomas são os tumores benignos mais comuns dos tecidos moles. No entanto, lipomas localizados em vulva são extremamente raros e a literatura é incerta quanto à sua incidência mundial. O objetivo deste artigo é descrever um caso clínico de lipoma localizado em vulva em uma mulher de 35 anos. A paciente queixava-se de massa de crescimento insidioso localizada no grande lábio inferior. O ultrassom de partes moles evidenciou um nódulo subcutâneo da linhagem lipomatosa. Foi realizada a exérese do lipoma, e a análise histopatológica confirmou que se tratava de um lipoma.

  10. Prepubertal vulval fibroma with a coincidental ectopic breast fibroadenoma: report of an unusual case with literature review.

    Science.gov (United States)

    Zhang, Jian; Chen, Yue; Wang, Kana; Xi, Mingrong; Yang, Kaixuan; Liu, Hui

    2011-11-01

    Prepubertal vulval fibroma and ectopic breast fibroadenoma of the vulva are two rare tumors, and they are very difficult to distinguish from other vulval masses, both clinically and pathologically. The complication of the two diseases is extremely rare. We report the case of an extremely large and progressively enlarging mass in the vulva of an 18-year-old Chinese girl. The mass was excised completely and pathologically diagnosed as a prepubertal vulval fibroma and ectopic breast fibroadenoma. The patient was followed up for 10 months and no evidence of recurrence was observed. Prepubertal vulval fibroma and vulval ectopic breast fibroadenoma should be considered in their preoperative differential diagnosis of a vulval mass, especially in prepubertal girls. Pathologically, immunohistochemical staining for vimentin and CD34 is valuable for diagnosis. Complete surgical excision is effective and long-term follow up is necessary. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  11. Investigation of the sensitivity of a cross-polarized light visualization system to detect subclinical erythema and dryness in women with vulvovaginitis.

    Science.gov (United States)

    Farage, Miranda A; Singh, Mukul; Ledger, William J

    2009-07-01

    An enhanced visualization technique using polarized light (Syris v600 enhanced visualization system; Syris Scientific LLC, Gray, ME) detects surface and subsurface ( approximately 1 mm depth) inflammation. We sought to compare the Syris v600 system with unaided visual inspection and colposcopy of the female genitalia. Erythema and dryness of the vulva, introitus, vagina, and cervix were visualized and scored by each method in patients with and without vulvitis. Subsurface visualization was more sensitive in detecting genital erythema and dryness at all sites whether or not symptoms were present. Subsurface inflammation of the introitus, vagina, and cervix only was detected uniquely in women with vulvar vestibulitis syndrome (VVS). A subset of women presenting with VVS exhibited subclinical inflammation of the vulva vestibule and vagina (designated VVS/lichen sclerosus subgroup). Enhanced visualization of the genital epithelial subsurface with cross-polarized light may assist in diagnosing subclinical inflammation in vulvar conditions heretofore characterized as sensory syndromes.

  12. Two new species of Rhabdias (Nematoda: Rhabditida: Rhabdiasidae) in anuran hosts from Dehradun (Uttarakhand), India.

    Science.gov (United States)

    Rizvi, Anjum N; Bursey, Charles R; Bhutia, Pasang T

    2013-04-01

    Rhabdias himalayanus n. sp. from the lungs of Duttaphrynus himalayanus and Rhabdias dehradunensis n. sp. from the lungs of Nanorana minica from Dehradun, India are described and figured. Of the 3 previously described Indian species, Rhabdias himalayanus n. sp. is most similar to Rhabdias shortii in having a cylindrical corpus, inflated cuticle, and conical tail; it differs from R. shortii in having greater body measurements, longer esophagus, larger eggs, and a different pattern of cuticle inflation at the vulva and tail region. Rhabdias dehradunensis n. sp. is most similar to Rhabdias bulbicauda in that both possess a swollen posterior end; it differs from R. bulbicauda by having a subterminal anus, a prominent tail, and a postequatorial vulva.

  13. Unique Case of Imperforate Hymen.

    Science.gov (United States)

    Coppola, Lynn

    2016-02-01

    Imperforate hymen typically presents in adolescence with pain, hematocolpometra and primary amenorrhea. This case documents a previously unreported etiology for an atypical presentation with a history of recent menstruation. A female adolescent presented with symptoms of urinary retention and leg pain. She reported a history of irregular, painful menses. Clinical examination revealed a pelvic mass and imperforate hymen. Sonography was consistent with hematocolpometra. Before a planned hymenectomy, the patient began to pass dark blood through a fistulous opening in her vulva. Hymenectomy resulted in complete resolution of the pain and hematocolpometra. Identification of the fistulous tract explained the patient's history of menstrual bleeding despite an imperforate hymen. Spontaneous rupture of hematocolpometra through a fistulous tract to the vulva is a previously unreported atypical presentation of imperforate hymen in a "menstruating" adolescent with pain and a pelvic mass. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by 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. Synchronous multifocal HPV-related neoplasm involving both the genital tract and the head-and-neck area: A case report of Fanconi anemia

    International Nuclear Information System (INIS)

    Han, Tae-Jin; Lee, Chang-Hun; Yoo, Chong-Woo; Shin, Hye-Jin; Park, Hyun-Jin; Cho, Kwan Ho; Park, Joo-Yong; Choi, Sung-Won; Kim, Joo-Young

    2009-01-01

    We report the case of a 32-year-old woman who presented with multiple squamous cell neoplasms synchronously arising in the cervix, vulva, oral cavity and oropharynx. During the period when the patient was treated by radiotherapy, she developed severe radiation mucositis and pancytopenia. Immunofluorescence staining for foci of the monoubiquitinated form of FANCD2 revealed a complete absence of such foci in all cancer tissues that were examined.

  16. 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.

  17. Clinico-pathologic spectrum of accessory axillary breast; case series and literature review

    Directory of Open Access Journals (Sweden)

    Usman Bello

    2017-01-01

    Full Text Available Accessory breast and the diseases affecting these aberrant breast tissues are relatively uncommon, and with variable prevalence among different populations. These are commonly located in the axilla, chest wall, and vulva. The most common disease in these tissues is carcinoma; however, other benign neoplastic and nonneoplastic lesions do occur. In this review, we present a clinicopathologic analysis of all the consecutive cases seen in a major referral teaching hospital over a period spanning 10 years (2006–2015.

  18. Adjuvant radiation for vulvar carcinoma: improved local control

    International Nuclear Information System (INIS)

    Faul, Clare M.; Mirmow, Dwight; Huang Qingshon; Gerszten, Kristina; Day, Roger; Jones, Mirka W.

    1997-01-01

    Purpose: Local recurrence is a significant problem following primary surgery for advanced vulva carcinoma. The objectives of this study were to evaluate the impact of adjuvant vulvar radiation on local control in high risk patients and the impact of local recurrence on overall survival. Methods and Materials: From 1980-1994, 62 patients with invasive vulva carcinoma and either positive or close (less 8 mm) margins of excision were retrospectively studied. Thirty-one patients were treated with adjuvant radiation therapy to the vulva and 31 patients were observed after surgery. Kaplan-Meier estimates and the Cox proportional hazard regression model were used to evaluate the effect of adjuvant radiation therapy on local recurrence and overall survival. Independent prognostic factors for local recurrence and survival were also assessed. Results: Local recurrence occurred in 58% of observed patients and 16% in patients treated with adjuvant radiation therapy. Adjuvant radiation therapy significantly reduced local recurrence rates in both the close margin and positive margin groups (p = 0.036, p = 0.0048). On both univariate and multivariate analysis adjuvant radiation and margins of excision were significant prognostic predictors for local control. Significant determinants of actuarial survival included International Federation of Gynecologists and Obstetricians (FIGO) stage, percentage of pathologically positive inguinal nodes and margins of excision. The positive margin observed group had a significantly poorer actuarial 5 year survival than the other groups (p = 0.0016) and adjuvant radiation significantly improved survival for this group. The 2 year actuarial survival after developing local recurrence was 25%. Local recurrence was a significant predictor for death from vulva carcinoma (risk ratio 3.54). Conclusion: Local recurrence is a common occurrence in high risk patients. In this study adjuvant radiation therapy significantly reduced local recurrence rates and

  19. If there’s a penis, it’s most likely a man: Investigating the social construction of gender using eye tracking

    Science.gov (United States)

    Briken, Peer; Dekker, Arne

    2018-01-01

    In their foundational work on the social construction of gender, Kessler and McKenna (1978) investigated the relationship between gender attribution and genital attribution. We used digital reproductions of the original stimuli to replicate their findings in the current social context. To further investigate the underlying decision processes we applied eye tracking. The stimuli shown varied in the composition of gender cues: from those more commonly associated with maleness to associated with femaleness. Applying the ethnomethodological approach originally used, participants were asked to decide for each stimulus whether they saw a man or a woman and to indicate subjective confidence with the decision. In line with the original results we found that the genital attribution contributed immensely to the gender attribution. Also, male gender was ascribed more often when the penis was present than was female gender when the vulva was shown. Eye tracking revealed that overall most dwell time as a proxy for important information was dedicated to the head, chest and genital areas of all the stimuli. Total dwell time depended on whether the gender attribution was made in line with the depicted genital, if the genital was a penis. Attributing female gender when a penis was present was associated with longer total dwell time, unlike attributing male gender with a vulva shown. This is indicative of higher cognitive effort and more difficulty ignoring the penis as opposed to the vulva. We interpret this finding in context of the persistent male dominance as well as to the socio-cultural understanding of the vulva as a concealed and therefore seemingly absent organ. In summary, we were able to show that the gender attribution is still closely linked to genital attribution when having a binary forced choice task and that the penis is a special cue in this attribution process. PMID:29494689

  20. Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis

    OpenAIRE

    Razzak, Mohammad Sabri A.; Al-Charrakh, Alaa H.; AL-Greitty, Bara Hamid

    2011-01-01

    Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effec...

  1. Female genital tract

    International Nuclear Information System (INIS)

    Cole, M.P.; Hunter, R.D.

    1985-01-01

    This chapter is concerned with cancers of the cervix uteri, the corpus uteri, the ovary, vulva, and vagina. Radiotherapy has an important place in the management of patients with cancers of the genital tract but the radiotherapist must collaborate closely with surgical colleagues, both gynaecological and urological. Each must appreciate the merits and limitations of surgery and radiation therapy, whether used alone or in combination, with curative intent or in a supportive role

  2. Clinical practice of radiotherapy

    International Nuclear Information System (INIS)

    Horiuchi, Junichi; Masaki, Norie; Onoyama, Yasuto

    1987-01-01

    This chapter presents in greater detail radiotherapy used in each clinical setting. The descriptions are given under the following sections: the tongue and oral cavity; the maxilla, larynx, and pharynx; brain tumors; the eyes and orbit; pediatric tumors; lung cancer; the esophagus; breast cancer; the abdominal digestive system; the urogenital system; the uterine cervix; the ovaries and vulva; bone and soft tissues; the skin; hematopoietic tumors; lymph node metastases; and radiotherapy as palliative treatment. (Namekawa, K.)

  3. [Saforelle - a new approach to treat vaginitis].

    Science.gov (United States)

    Karamisheva, V; Nachev, A

    2015-01-01

    Infections of the vulva and vagina are one of the most common gynecological diseases. They can be determined by a variety of physical, chemical and biological factors. The main risk factors contributing to vaginitis are aerobic and anaerobic bacterias, fungal and viral infections, and irritants. Subjective complaints are pruritus, vulvar and/or perivulvar erytema and different in volume and characterization discharge. Excepting etiological treatment in most cases it is necessary to use additional agents, for example Saforelle.

  4. Patroonalopecia ten gevolge van cysteuze ovaria bij een bouvier

    OpenAIRE

    Vandenabeele, Sophie; Van Goethem, Bart; De Rooster, Hilde

    2010-01-01

    A 9-year-old spayed female Flemish cattle dog was presented with a history of vaginal discharge and a slowly progressive bilateral symmetrical alopecia on the neck, shoulders and flanks, ventral abdomen and the perinea! area. Clinical examination revealed pattern alopecia with the presence of macular melanosis on the ventral abdomen and in the perineal area The dog also had a swollen vulva and gynecomasty. Abdominal ultrasonography revealed the presence of two intact ovaria (with cystic folli...

  5. First record of Hypsocephalus dahli in Switzerland with a review of ist distribution, ecology and taxonomy (Araneae, Linyphiidae

    Directory of Open Access Journals (Sweden)

    Frick, Holger

    2008-07-01

    Full Text Available The spider species Hypsocephalus dahli (Lessert, 1909 is recorded for the first time in Switzerland from museum material collected in 1974. The information given in the literature and unpublished data on this rare species are summarised including an annotated distribution map. All published pictures of males are compared with the holotype. Figures of the male palp and the vulva of the Swiss specimens are provided.

  6. 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.

  7. 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.

  8. Clinical features and treatment of vulvar Merkel cell carcinoma: a systematic review.

    Science.gov (United States)

    Nguyen, Austin Huy; Tahseen, Ahmed I; Vaudreuil, Adam M; Caponetti, Gabriel C; Huerter, Christopher J

    2017-01-01

    Merkel cell carcinoma is a rare and aggressive neoplasm originating from mechanoreceptor Merkel cells of the stratum basale of the epidermis. Cases affecting the vulva are exceedingly rare, with the currently available literature primarily in case report form. Systematic review of the PubMed database returned 17 cases of Merkel cell carcinoma affecting the vulva. Patients presented at a mean age of 59.6 years with a firm, mobile vulvar mass. Symptoms of pain, erythema, pruritus, edema, and ulceration have been reported. Tumor histology is consistent with that of neuroendocrine tumors and typical Merkel cell carcinomas. Neuroendocrine and cytokeratin immunostains are frequently utilized in histopathological workup. Surgical management was the unanimous first-line therapy with adjuvant radiation in most cases. Recurrence occurred in 70.6% of patients at a mean follow-up of 6.3 months. Mortality was at 47.0% at a mean of 7.8 months after initial operation. Merkel cell carcinoma affecting the vulva is an extremely rare and highly aggressive neoplasm. The present review of published cases serves to comprehensively describe the clinical course and treatment approaches for vulvar Merkel cell carcinoma.

  9. Spectrum of Misdiagnosis of Allergic Bronchopulmonary Mycosis: Case Reports

    Directory of Open Access Journals (Sweden)

    Sandeep Rana

    2018-01-01

    Full Text Available Allergic bronchopulmonary mycosis (ABPM is most commonly seen in cystic fibrosis and bronchial asthma. Most of patients are misdiagnosed at initial outpatient department visit due to low suspicion, lack of awareness of entity and similarity in clinical symptoms and radiological findings with other common pulmonary diseases. Pulmonary tuberculosis is the most common entity diagnosed, and anti-tubercular treatment is the most commonly abused chemotherapy. Careful history taking, astute initial examination and awareness may help in curbing wrong diagnosis and treatment. This article present two cases of ABPM who were initially misdiagnosed as pulmonary tuberculosis and carcinoma lung, respectively.

  10. Addison's Disease: A Diagnostic Dilemma.

    Science.gov (United States)

    Afroz, S; Bain, S

    2017-07-01

    Adrenal insufficiency is a rare disease, but is life threatening when overlooked. Addison's disease may be an acquired form of adrenal insufficiency due to the destruction or dysfunction of the adrenal cortex. It affects both glucocorticoid and mineralocorticoid function. Main presenting symptoms of Addison's disease such as fatigue, anorexia, vomiting and convulsion often mimics central nervous system (CNS) infections. We describe a case of Addison's disease who was initially misdiagnosed as a case of meningo-encephalitis subsequently renal tubular acidosis and finally Addison's disease. Addison's disease can remain unrecognized until acute crisis and sometimes it may be misdiagnosed.

  11. Common pitfalls in radiographic interpretation of the Thorax

    International Nuclear Information System (INIS)

    Godshalk, C.P.

    1994-01-01

    Errors in radiographic interpretation of the thorax are common. Many mistakes result from interpreting normal anatomic variants as abnormalstructures, such as misdiagnosing dorsal and rightward deviation of the cranial thoracic trachea on lateral radiographs of normal dogs. Some of the more common errors specifically relate to misinterpretation of radiographs made on obese patients. The age of the patient also plays a role in misdiagnosis. Aging cats seem to have a horizontally positioned heart on lateral radiographs, and older dogs, primarily collies,often have pulmonary osteomas that are misdiagnosed as metastatic neoplastic disease or healed pulmonary fungal infections

  12. 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.

  13. Role of cone beam computed tomography in the prompt diagnosis of a nasopalatine duct cyst

    Directory of Open Access Journals (Sweden)

    Sapna Panjwani

    2014-01-01

    Full Text Available The nasopalatine duct cyst (NPDC is the most common of all the developmental, epithelial, and non-odontogenic cysts of the maxilla, believed to originate from the epithelial remnants of the nasopalatine duct. Typically, the lesion is asymptomatic and is detected accidentally on a radiograph. The definite diagnosis must be based on the clinical, radiological, and histopathological findings. Frequently misdiagnosed, the NPDC is not rare. The motive of reporting an entity that is not very rare is that the lesion is mostly misdiagnosed, and to emphasize the importance of cone-beam computed tomography (CBCT in the diagnosis and optimized treatment planning of NPDCs.

  14. Narcolepsy in Adolescence-A Missed Diagnosis: A Case Report.

    Science.gov (United States)

    Gupta, Anoop K; Sahoo, Swapnajeet; Grover, Sandeep

    2017-01-01

    Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents.

  15. 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.

  16. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    The need of histological confirmation for solitaries meningeal process witch are often misdiagnosed as benign meningiomas. Introduction. Leptomeningeal metastases are more frequently observed in patient with known neoplasm, because cancer patients are living longer and advance in diagnostic means. They represent ...

  17. 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…

  18. Benign neoplasms of the trachea : case reports

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hak Hee; Mun, Kyung Mi; Kim, Bum Soo; Choi, Kyu Ho; Shinn, Kyung Sub [Kangnam St. Mary' s Hospital Catholic Univ. Medical College, Seoul (Korea, Republic of)

    1997-03-01

    Benign tumors of the trachea are rare, accounting for approximately 10% of all primary tracheal neoplasms. They are frequently misdiagnosed and managed as bronchial asthma or chronic bronchitis. We report a lipoma and a leiomyoma of the trachea with emphasis on the clinical, radiographic and CT findings, and review the literature.

  19. Subungual Hypervascular Soft Tissue Chondroma Mimicking a Glomus Tumor: A Case Report

    International Nuclear Information System (INIS)

    Park, Jong Chun; Lee, Young Hwan; Jung, Kyung Jae

    2009-01-01

    Soft tissue chondroma, or extraskeletal chondroma, is a relatively rare, benign cartilaginous tumor that occurs most frequently in the hands and feet - a subungual location is quite rare. The authors describe a subungual soft tissue chondroma in a 25-year-old man that was visualized as a hypervascular mass on color Doppler ultrasonography and initially misdiagnosed as a glomus tumor

  20. Subungual Hypervascular Soft Tissue Chondroma Mimicking a Glomus Tumor: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Chun; Lee, Young Hwan; Jung, Kyung Jae [Catholic University of Daegu, School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    Soft tissue chondroma, or extraskeletal chondroma, is a relatively rare, benign cartilaginous tumor that occurs most frequently in the hands and feet - a subungual location is quite rare. The authors describe a subungual soft tissue chondroma in a 25-year-old man that was visualized as a hypervascular mass on color Doppler ultrasonography and initially misdiagnosed as a glomus tumor

  1. Author Details

    African Journals Online (AJOL)

    A Preliminary Investigation of Relative Frequency of Undiagnosed and Previously Diagnosed Hypertension Before First Stroke in a Lagos Hospital Abstract · Vol 9, No 4 (1999) - Articles Localised tetanus in Lagos, Nigeria Details · Vol 9, No 4 (1999) - Articles Stroke with localised infarction of Wernicke's Area misdiagnosed ...

  2. 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

  3. 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

  4. Nodular Hyperplasia Arising from the Lateral Aberrant Thyroid Tissue: A Case Report

    International Nuclear Information System (INIS)

    Jeong, Min Hye; Park, Jeong Seon; Lee, Young Jun

    2012-01-01

    The presence of aberrant thyroid tissue in the lateral neck is very rare. In addition, nodular hyperplasia in ectopic thyroid has rarely been reported. Due to the unusual location, the presence of lateral aberrant thyroid tissue could be misdiagnosed as a lymphadenopathy, neurogenic tumor, etc. We report on a case of nodular hyperplasia arising from the right lateral aberrant thyroid tissue.

  5. Epilepsy and Sleep Disorders: a Clinical Review | Sunmonu ...

    African Journals Online (AJOL)

    Patients with epilepsy (PWE) are at risk of developing sleep disorders and there is a complex inter-relationship between sleep disorders and epilepsy. Sleep disorders could be misdiagnosed as epilepsy and also worsen epilepsy. We searched Medline and Pubmed between 1962-2012, using the following search terms ...

  6. 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...

  7. Zika virus infection acquired during brief travel to Indonesia.

    Science.gov (United States)

    Kwong, Jason C; Druce, Julian D; Leder, Karin

    2013-09-01

    Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease.

  8. Incidence and clinical findings of benign, inflammatory disease in patients resected for presumed pancreatic head cancer

    NARCIS (Netherlands)

    van Gulik, T. M.; Reeders, J. W.; Bosma, A.; Moojen, T. M.; Smits, N. J.; Allema, J. H.; Rauws, E. A.; Offerhaus, G. J.; Obertop, H.; Gouma, D. J.

    1997-01-01

    BACKGROUND: The differentiation between cancer and benign disease in the pancreatic head is difficult. The aim of this study was to examine common features in a group of patients that had undergone pancreatoduodenectomy for a benign, inflammatory lesion misdiagnosed as pancreatic head cancer.

  9. Prof Anyanwu 2009 dec edition...

    African Journals Online (AJOL)

    User

    Sometimes presents with symptoms similar to those of postdural puncture headache, and can therefore be easily misdiagnosed, especially in a parturient that has undergone spinal anaesthesia. This is particularly significant because of the difference in the management between both conditions. Whereas the former might.

  10. Diagnostic value of Autoantibodies to GAD65 and IA-2 in Patients ...

    African Journals Online (AJOL)

    Sudan Journal of Medical Sciences ... in adults (LADA) accounts for11 % of all cases of diabetes and often misdiagnosed as type 2diabetes. ... insulin, group2 included 15 diabetic patients of type 2 diabetes as controls, and group3 included 15 ...

  11. Current and Best Practices of Genetic Testing for Maturity Onset Diabetes of the Young: Views of Professional Experts

    NARCIS (Netherlands)

    van der Zwaag, A.M.; Weinreich, S.S.; Bosma, A.R.; Rigter, T.; Losekoot, M.; Henneman, L.; Cornel, M.C.

    2015-01-01

    Aims: Currently, many patients with maturity onset diabetes of the young (MODY) are undiagnosed or misdiagnosed with type 1 or 2 diabetes. This study aims to assess professional experts' views on factors which may influence the current practice of genetic testing for MODY and to explore next steps

  12. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. s 9990 East Cent. Afr.

    African Journals Online (AJOL)

    Hp 630 Dual Core

    2016-08-01

    Aug 1, 2016 ... Congenital Diaphragmatic Hernia Outcomes in East frica: The Ethiopian Experience. Miliard Derbew ... One child was diagnosed with congenital pulmonary airway malformation (CPAM). In total, 10 (83.3%) of our patients were initially misdiagnosed. Only one patient .... Superficial Surgical Site infection. 2.

  13. [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.

  14. A Rare Case of Zosteriform Cutaneous Metastases from Squamous ...

    African Journals Online (AJOL)

    A Rare Case of Zosteriform Cutaneous Metastases from Squamous Cell Carcinoma of Hard Palate. ... examination, the patient had a superficial ulcer over the hard palate. A provisional diagnosis of zosteriform ... Majority of these cases can be misdiagnosed as herpes zoster and were treated with antiviral drugs. Distant ...

  15. Kirit C. Shah, M.D. v. Stan Harris and Nancy Harris. "Construction of Legal Arguments, Statutes of Limitations, and Medical Malpractice." Lesson Plans for Secondary Teachers on How Lawyers Prepare Their Arguments. Courts in the Classroom: Curriculum Concepts and Other Information on Indiana's Courts for the K-12 Educator.

    Science.gov (United States)

    Osborn, Elizabeth

    Stan and Nancy Harris filed a complaint against Kirit C. Shah, M.D., for misdiagnosing Mr. Harris's illness, charging Dr. Shah with negligence and asking for damages. A medical malpractice action in Indiana is governed by a two year statute of limitations. Because the Harrises failed to bring their action against Dr. Shah within this two year…

  16. Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma.

    Science.gov (United States)

    Li, Fengsheng; Zhang, Jianlei; Wang, Yunmei; Liu, Liwen

    2015-09-01

    The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (Padvantage in the diagnosis of TMC; however, an elasticity score of ≥3 is of high clinical value as a diagnostic criterion for TMC.

  17. Pseudoachondroplastic dysplasia.

    Directory of Open Access Journals (Sweden)

    Khungar A

    1993-04-01

    Full Text Available Pseudoachondroplasia is a heterogeneous inherited skeletal dysplasia in which dwarfism is a major feature. We report here a case of a 7 year old girl misdiagnosed as rickets, who presented with short stature, lordosis, genu varum and flexion deformities at both the elbows. Skeletal survey revealed epiphyseal and metaphyseal irregularities. A review of literature is also presented.

  18. Schwannoma extending from the umbilical region to the mid-thigh ...

    African Journals Online (AJOL)

    ... originating from the cells of peripheral nerve sheaths; the diagnosis was a schwannoma. Abdominal schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumours and may offer the advantage of better visualisation of structures owing to the ...

  19. 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 ...

  20. Renal replacement lipomatosis and xanthogranulomatous pyelonephritis: differential diagnosis

    International Nuclear Information System (INIS)

    Romero, Frederico R.; Pilati, Roberto; Brenny Filho, Thadeu; Caboclo, Maria Fernanda Sales Ferreira; Silva, Antonio de Padua Gomes; Cravo, Marco Aurelio

    2011-01-01

    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)

  1. 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)

  2. 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: ...

  3. TropJrnal Vol 32 No 1

    African Journals Online (AJOL)

    Mr Olusoji

    INCISIONAL SCAR EVISCERATION OF FALLOPIAN TUBE IN A PREGNANT. WOMAN. 1. 2,. 3 ... Conclusion: Evisceration of a fallopian tube through an incisional hernia in a pregnant woman is an uncommon occurrence which is life threatening and prone to misdiagnoses. ... complicated with wound dehiscence and.

  4. How Fetal Alcohol Spectrum Disorders Co-Occur with Mental Illness

    Science.gov (United States)

    ... go unrecognized or are misdiagnosed as a mental illness or brain injury. Individuals with an FASD may also receive multiple diagnoses, such as attention deficit/hyperactivity disorder (ADHD),oppositional defiant disorder, and anxiety disorder. Therefore, it is important to determine whether ...

  5. Chordoma | Fitchart | South African Medical Journal

    African Journals Online (AJOL)

    The history, origin, pathology, diagnosis, treatment and prognosis of chordoma involving the axial skeleton are reviewed, and the clinical histories of 3 cases of chordoma are given, noting some remarkable features, along with one case misdiagnosed as chordoma on the radiological appearance of the sacrum and treated ...

  6. Seborrheic dermatitis eye lid involment (seborrheic blepharitis in children not a rare clinical observation

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2012-01-01

    Full Text Available We present a typical case of seborrheic dermatitis, with no cutaneous manifestations, rarely reported in children, frequently misdiagnosed (especially by ophthalmologists, simply confirmed by microscopic examination of scales and with wonderful therapeutic results with antifungal agents (topical and/or systemic treatments.

  7. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    Science.gov (United States)

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,…

  8. Chronic pelvic pain

    African Journals Online (AJOL)

    misdiagnoses, inappropriate or inadequate treatment strategies, and poor patient compliance .... excitation tenderness implies an active pelvic inflammatory process. Pain localising to ... neoplastic process, particularly cervical cancer, must be excluded. .... The dosage should be started at 10 mg at night, and increased by 5 ...

  9. 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...

  10. Silent Suffering: Children with Selective Mutism

    Science.gov (United States)

    Camposano, Lisa

    2011-01-01

    Despite increasing awareness, the childhood disorder of selective mutism is under-researched and commonly misdiagnosed. The purpose of this article is to highlight current issues related to this disorder as well as describe various treatment approaches including behavioral, cognitive-behavioral, psychodynamic, family, and pharmacological…

  11. Myositis is meer dan een spierziekte

    NARCIS (Netherlands)

    Lim, J.; van Royen-Kerkhof, A.; Jonkers, R. E.; Starink, M. V.; Voskuyl, A. E.; van der Kooi, A. J.

    2018-01-01

    Idiopathic inflammatory myopathy (IIM), commonly referred to as "myositis", is a rare but treatable auto-immune disease that is often misdiagnosed or diagnosed after significant delay. Using three clinical case reports as introductory examples, an overview is given - and pitfalls are discussed - of

  12. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    Science.gov (United States)

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health…

  13. Coping When You're Newly Diagnosed

    Science.gov (United States)

    ... Anger can take many forms. You might resent people on the street who appear healthy and carefree. You might experience frustration with the medical system for misdiagnoses and painful tests. You might ... patients. Some people feel guilty about getting sick, about not taking ...

  14. Misdiagnosis trends in patients with hereditary angioedema from the real-world clinical setting

    DEFF Research Database (Denmark)

    Zanichelli, Andrea; Longhurst, Hilary J; Maurer, Marcus

    2016-01-01

    . OBJECTIVE: To evaluate the history of misdiagnosis in patients participating in the Icatibant Outcome Survey (IOS). METHODS: The IOS is an observational study in which safety and effectiveness of icatibant have been evaluated since 2009. As part of the IOS, patients record any misdiagnoses received before...

  15. Iatrogenic stomach perforation complicating unrecognized ...

    African Journals Online (AJOL)

    We report a case of 21-year-old male patient with traumatic diaphragmatic herniation of the stomach that is misdiagnosed as a hemo-pneumothorax with the resulting insertion of a chest tube causing iatrogenic perforation of the stomach and draining of gastric content into the pleural cavity. An emergency thoracotomy was ...

  16. Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

    Science.gov (United States)

    Cochran, Brent

    Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

  17. Complete upper urinary tract obstruction caused by penetrating ...

    African Journals Online (AJOL)

    Complete upper urinary tract obstruction caused by penetrating pellet injury of the ureter. M.T. Gulpinar, S.K. Keskin, A Yildirim, T Caskurlu. Abstract. 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 ...

  18. The Amyand's Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography.

    Science.gov (United States)

    Keskin, Suat; Simşek, Cihan; Keskin, Zeynep

    2013-01-01

    Amyand's hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand's hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis.

  19. Leptospirosis: an emerging global public health problem

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic ...

  20. Two Cases Mimicking Mediastinal Lipomas

    African Journals Online (AJOL)

    The omentum sometimes herniates as a result of congenital defects of the diaphragm, such as Morgagni or esophageal hiatus.[3-7]. However, some omental herniation has previously been misdiagnosed as intrathoraciclipomatous tumor and even been resected without a conclusive diagnosis.[3-5] MRI and CT scan are.

  1. Right flank pain as the only symptom for acute pancreatitis in a ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    The initial abdominal ultrasonogram was normal and the patient was misdiagnosed as possible renal associated pain. The CECT scan done the following day showed acute pancreatitis with peripancreatic fat stranding, fluid upto the right perinephric space and thickening of pararenal fascia. Urinalysis and renal function.

  2. Brunn nests masquerading as bladder tumor: a case report

    International Nuclear Information System (INIS)

    Lee, Jin Hee; Byun, Kyung Hwan; Jeon, Ji Min

    2005-01-01

    Brunn nests are the most common proliferative lesions of the bladder uroepithelium, but exuberant proliferation can mimic bladder tumor on radiologic imaging and cystoscopy. We describe a case of pathologically proven Brunn nests in a 34-year-old man, misdiagnosed as bladder tumor on preoperative imaging studies

  3. 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

    OBJECTIVE: 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. DESIGN: The NRP was used to identify...

  4. Primary sialoangiectasia - a diagnostic pitfall in Sjogren's syndrome - Case report

    NARCIS (Netherlands)

    Kalk, WWI; Vissink, A; Spijkervet, FKL; Bootsma, H

    A case of primary sialoangiectasia, which in this case was initially misdiagnosed as Sjogren's syndrome, is described. Other diseases, including HIV infection, psoriatic arthritis, and acute parotitis, may cause glandular changes similar to the changes found in the syndrome. Therefore, sialography

  5. NJP Vol 39 no 3

    African Journals Online (AJOL)

    Prof Ezechukwu

    dema, cranial nerve palsy or a combination of these signs and symptoms.4 These clinical features can also be present in some other central nervous system mor- bidities seen in our region such as meningitis, as a result. IIH can easily be misdiagnosed especially by non spe- cialist practitioners. This is more so in children ...

  6. Sella turcica chondroma associated with hypopituitarism - a case report

    International Nuclear Information System (INIS)

    Bueno, Tarita D.L.S.; Castro, Ana Valeria B.; Haddad, Adriana L. Mendes; Troja, Simone; Camhaji, Andrea; Yamashita, Seizo

    2001-01-01

    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)

  7. Author Details

    African Journals Online (AJOL)

    Ultrasound study of the asymptomatic shoulder in patients with a confirmed rotator cuff tear in the opposite shoulder. Abstract PDF · Vol 24, No 2 (2012) - Articles Popliteal artery entrapment syndrome misdiagnosed as chronic exertional compartment syndrome in a young male athlete: Role of dynamic ultrasound

  8. Post-laparotomy haemoptysis due to broncho-abdominal fistula ...

    African Journals Online (AJOL)

    cDepartment of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape ... at least two episodes of haemoptysis in that period and was misdiagnosed and ... uncertain. Most swabs (80%) are found in the abdomen, and symptoms may not .... The patient was discharged after a total of 14 days in hospital. At.

  9. 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.

  10. A case of clear cell sarcoma-A rare malignancy

    DEFF Research Database (Denmark)

    Juel, Jacob; Ibrahim, Rami Mossad

    2017-01-01

    INTRODUCTION: Clear cell sarcoma (CCS) is a rare tumour of the soft tissue often misdiagnosed, as it shares characteristics with malignant melanoma (MM). Previously, CCS has been characterised, as malignant melanoma of the soft tissue, contemporary immunohistochemical techniques, however, have made...

  11. South African Medical Journal - Vol 103, No 12 (2013)

    African Journals Online (AJOL)

    Book Review: When Doctors Don't Listen: How to Avoid Misdiagnoses and ... Resource implications of adopting a restrictive neonatal blood transfusion policy · EMAIL ... Chronic diseases are not being managed effectively in either high-risk or ... Haematological implications of folate food fortification · EMAIL FREE FULL ...

  12. Large twisted ovarian fibroma in menopausal women: a case report ...

    African Journals Online (AJOL)

    Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older perimenopausal and postmenopausal women. Occasionally large fibromas may undergo torsion causing acute abdominal pain. Doppler ...

  13. 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...

  14. The Coraline Effect: The Misdiagnosis of Personality Disorders in College Students Who Grew up with a Personality Disordered Parent

    Science.gov (United States)

    Donatone, Brooke

    2016-01-01

    College students may be misdiagnosed as personality disordered when in fact their problems are better explained by their upbringing. Growing up with a personality disordered parent may cause them to initially present with what appear to be personality disordered traits due to issues such as not learning adequate coping skills. Accurate diagnosis…

  15. Familial occurrence of isolated non-compaction cardiomyopathy

    NARCIS (Netherlands)

    Lorsheyd, Anouk; Cramer, Maarten-Jan M.; Velthuis, Birgitta K.; Vonken, Evert-Jan P.; van der Smagt, Jasper; van Tintelen, Peter; Hauer, Richard N. W.

    2006-01-01

    Background and aims: Isolated left ventricular non-compaction cardiomyopathy (LVNC) may have an autosomal dominant or X-linked recessive inheritance. We focus on the familial occurrence of LVNC after misdiagnosing this disorder in symptomatic patients in two families. After identification of the

  16. 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...

  17. Diagnosis, Dogmatism, and Rationality.

    Science.gov (United States)

    Rabinowitz, Jonathan; Efron, Noah J.

    1997-01-01

    Presents findings suggesting that misdiagnoses frequently stem from flaws in human information processing, particularly in collecting and using information. Claims that improved diagnostic tools will not remedy the problem. Drawing on the work of Karl Popper and Robin Collingwood, proposes operational principles to ensure a rational diagnostic…

  18. Ectopic cervical thymoma in a patient with Myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Chang Hung

    2011-07-01

    Full Text Available Abstract Ectopic cervical thymoma is rare and is often misdiagnosed as a thyroid tumor or other malignancy. Ectopic thymic tissue can be found along the entire thymic descent path during embryogenesis. However, a thymoma arising from such ectopic thymic tissue is extremely rare. Herein we report a patient with ectopic cervical thymoma and myasthenia gravis (MG and discuss the management.

  19. Retrospective Examination of Q Fever Endocarditis: An Underdiagnosed Disease in the Mainland of China

    Directory of Open Access Journals (Sweden)

    Xiao Han

    2017-01-01

    Conclusions: Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.

  20. Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review.

    Science.gov (United States)

    Zekavat, Omid Reza; Abdolkarimi, Babak; Pouladfar, Gholamreza; Fathpour, Gholamreza; Mokhtari, Maral; Shakibazad, Nader

    2017-01-01

    Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence.

  1. Case Report: Benign Multicystic Peritoneal Mesothelioma

    Directory of Open Access Journals (Sweden)

    Nurettin Boran

    2011-08-01

    In conclusion BPMP is a rare benign cystic tumor which can be easily misdiagnosed as an ovarian cancer preoperatively. Intraoperative findings and appearence of the mass may mimic malignancy. For that reason frozen section examination will prevent overtreatment.

  2. Stiff baby syndrome er en sjælden årsag til neonatal hypertonicitet

    DEFF Research Database (Denmark)

    Rønne, Maria Sode; Nielsen, Preben Berg; Mogensen, Christian Backer

    2014-01-01

    Stiff baby syndrome (hyperekplexia) is a rare genetic disorder. The condition can easily be misdiagnosed as epilepsy or severe sepsis because of hypertonicity and seizure-like episodes and has an increased risk of severe apnoea and sudden infant death. Tapping of the nasal bridge inducing a start...

  3. A case of peduncular hallucinosis presenting as a primary psychiatric disorder

    Directory of Open Access Journals (Sweden)

    Vasfiye Burcu Dogan

    2013-01-01

    Full Text Available Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder.

  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. 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.

  6. 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)

  7. 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 ...

  8. 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 ...

  9. Lymphogranuloma venereum: a rare and forgotten cause of rectal stricture formation.

    Science.gov (United States)

    Craxford, Leia; Fox, Ashini

    2018-01-01

    Lymphogranuloma venereum (LGV) is caused by L1, L2 and L3 serovars of Chlamydia trachomatis. The anorectal syndrome caused by LGV is often misdiagnosed as inflammatory bowel disease and may rarely lead to stricture formation. Recurrent stricture formation, despite adequate LGV treatment, has not to our knowledge, previously been reported.

  10. Artefactual skin lesions in children and adolescents

    DEFF Research Database (Denmark)

    Ring, Hans Christian; Miller, Iben M; Benfeldt, Eva

    2015-01-01

    BACKGROUND: Self harm is a great diagnostic and treatment challenge. In addition, psychocutaneous conditions are rare in the pediatric population and may therefore be misdiagnosed. Dermatitis artefacta is a psychocutaneous syndrome, which is a subgroup of the general spectrum of self-inflicted skin...

  11. Fever of Unknown Origin: A Case of Post Obstructive Pneumonia ...

    African Journals Online (AJOL)

    Mediastinal teratomas are rare germ cell tumors in children accounting for only 4.3% of all germ cell tumours. Here, we describe a three year old child who was misdiagnosed as a case of pulmonary tuberculosis at periphery despite of his chest X ray showing large homogenous opacification of left hemithorax with areas of ...

  12. Tracheal web

    International Nuclear Information System (INIS)

    Legasto, A.C.; Haller, J.O.; Giusti, R.J.

    2004-01-01

    Congenital tracheal web is a rare entity often misdiagnosed as refractory asthma. Clinical suspicion based on patient history, examination, and pulmonary function tests should lead to its consideration. Bronchoscopy combined with CT imaging and multiplanar reconstruction is an accepted, highly sensitive means of diagnosis. (orig.)

  13. prevalence of brucellosis in livestock and incidences in humans

    African Journals Online (AJOL)

    ACSS

    Records 700 - 1600 ... suggesting chances of increased spread to humans, and the disease being misdiagnosed for malaria. .... Despite farmers knowledge of the .... In the current study, camels showed negative results, possibly due to few samples collected as most farmers were unwilling to let their animals be sampled.

  14. A novel compound heterozygous mutation in an adolescent with insulin-dependent diabetes: The challenge of characterizing Wolfram syndrome.

    Science.gov (United States)

    Maltoni, Giulio; Minardi, Raffaella; Cristalli, Carlotta Pia; Nardi, Laura; D'Alberton, Franco; Mantovani, Vilma; Zucchini, Stefano

    2016-11-01

    WS diagnosis is often delayed since misdiagnosed as autoimmune diabetes. The rarity of the condition and the absence of other diseases at diabetes diagnosis might make extremely challenging the recognition of WS. However the novel compound heterozygosity for the here reported mutations, seems to confer a mild phenotype among the spectrum of WS manifestations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. False Negative Fine Needle Aspiration Biopsy Results in Primary Thyroid Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In Joong; Kim, Eun Kyung; Koh, Myoung Ju; Kwak, Jin Young; Moon, Hee Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography-guided fine needle aspiration biopsy (US-FNA) is one of the methods used to diagnose thyroid lymphoma, but it has a relatively high false-negative rate. The authors report a case of a primary thyroid lymphoma associated with underlying lymphocytic thyroiditis that was initially misdiagnosed as lymphocytic thyroiditis based on US-FNA findings

  16. Gastrointestinal stromal tumor of Meckel's diverticulum: a rare cause of intestinal volvulus.

    Science.gov (United States)

    Cengız, Fevzi; Sun, Mehmet Ali; Esen, Özgür Sipahi; Erkan, Nazif

    2012-08-01

    Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Most cases are asymptomatic; however, when symptomatic, it is often misdiagnosed at presentation. Common complications presenting in adults include bleeding, obstruction, diverticulitis, and perforation. Tumors within a Meckel's diverticulum are rare. Herein, we present a gastrointestinal stromal tumor arising from the Meckel's diverticulum that led to intestinal obstruction by volvulus.

  17. The role of the laboratory in outbreak investigation of viral ...

    African Journals Online (AJOL)

    We recommended sero-surveillance and entomological surveys be done to determine the prevalence of Dengue virus and its vector in Abuja and Nasarawa state. Dengue and other VHFs are emerging diseases that can easily be missed or misdiagnosed in early stages. Equipping laboratories and improving surveillance ...

  18. Cervical nodular fasciitis in a 10-year-old girl: a case report of a rare ...

    African Journals Online (AJOL)

    Thus, as clinical and morphologic characteristics are similar to those of malignant tumours, this entity is often misdiagnosed, with a few cases described in the literature. We present a case of nodular fasciitis involving the retropharynx and hypopharynx of a 10-year-old girl and discuss the importance of considering this rare ...

  19. Landau-Kleffner Syndrome: An Exploration of Parent Experience of the Diagnostic Process

    Science.gov (United States)

    Lemard-Reid, Daunette

    2014-01-01

    Landau-Kleffner syndrome (LKS) is a rare childhood disorder that is often misdiagnosed as autism or childhood psychosis because of overlapping symptom presentation. Favorable prognoses in LKS depend on early diagnosis and treatment. While much is known about the clinical basis for LKS diagnosis, little is known about parents' lived experience with…

  20. Schwannoma of the facial nerve involving the middle cranial fossa:case report

    Institute of Scientific and Technical Information of China (English)

    SAI Ke; CHEN Zhong-ping

    2007-01-01

    @@ Facial nerve schwannoma involving the middle cranial fossa is quite rare,and its accurate diagnosis is very difficult before SUrgery.Here we present a case of schwannoma of the facial nerve at the middle cranial fossa that was misdiagnosed previously at a local hospital and then cured in our hospital.

  1. Case Report - Osteomalacia associated with cutaneous psoriasis as ...

    African Journals Online (AJOL)

    ... diet, and full recovery with calcium and vitamin D replacement. Coeliac disease is frequently misdiagnosed leading to major complications such as osteolamacia. In the other hand, osteomalacia can still be the presenting feature of undiagnosed celiac disease. Association between osteomalacia and cutaneous psoriasis ...

  2. Diaphragmatic Hernia Masquerading as Pleural Effusion | Nalladaru ...

    African Journals Online (AJOL)

    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 ...

  3. Diaphragmatic Hernia Masquerading as Pleural Effusion

    African Journals Online (AJOL)

    As many as 30% of diaphragmatic hernias present late.[1] We present an unusual case report of a late presentation of isolated diaphragmatic injury, after apparently minor blunt trauma, which was initially misdiagnosed as pleural effusion. CASE REPORT. A 40-year-old man slipped and fell against the edge of his bath tub.

  4. Multifocal fibrosclerosis presenting as Grave's orbitopathy. Bilateral exophthalmos associated with retroperitoneal and sellar fibrosis

    NARCIS (Netherlands)

    van der Pol, R.; Nieuwenhuis, M. G.; Mourits, M. P.

    1999-01-01

    BACKGROUND: Multifocal fibrosclerosis (MF) is a rare disease that may be misdiagnosed as Graves' orbitopathy. The combination of localisations of MF presented here has not been reported before. CASE REPORT: A 44-year-old man was referred with progressive bilateral exophthalmos. CT of his chest and

  5. 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.

  6. 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

  7. False-positive “halo” sign on testicular scintigraphy in a 5-year-old boy with epididymitis and hydrocele

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Guha, Poonam; Bhattacharya, Anish; Bawa, Monika; Mittal, Bhagwant Rai

    2011-01-01

    Scintigraphic differentiation between acute torsion, hydrocele and testicular or scrotal abscess can be difficult. Doppler sonography may provide useful complimentary information toward diagnosis. The authors describe a 5-year-old child where epididymitis with hydrocele was misdiagnosed as testicular torsion on scrotal scintigraphy

  8. 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 ...

  9. Zoonotic helminths affecting the human eye

    Science.gov (United States)

    2011-01-01

    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 PMID:21429191

  10. Mucocutaneous manifestations of helminth infections: Trematodes and cestodes.

    Science.gov (United States)

    Lupi, Omar; Downing, Christopher; Lee, Michael; Bravo, Francisco; Giglio, Patricia; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased international travel for vacation, work, and medical missions and immigration into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. It has been estimated that 20% to 70% of international travelers suffer from some travel-related health problem. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on cutaneous diseases caused by helminth infections. Part I of the review focused on nematode infections; part II will focus on trematode and cestode infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. [Tropical causes of epilepsy].

    Science.gov (United States)

    Carod-Artal, F J

    Eighty-five percent of all epileptics live in tropical regions. Prenatal risk factors, traumatic brain injuries and different parasitic infestations of the central nervous system (CNS) are the reasons behind the high prevalence of epilepsy. This work reviews the main parasitic infestations causing epilepsy in the tropics. Neurocysticercosis is the main cause of focal epilepsy in early adulthood in endemic areas (30-50%). All the phases of cysticerci (viable, transitional and calcified) are associated with epileptic seizures. Anti-cysticercus treatment helps get rid of cysticerci faster and reduces the risk of recurrence of seizures in patients with viable cysts. Symptomatic epilepsy can be the first manifestation of neuroschistosomiasis in patients without any systemic symptoms. The pseudotumoral form can trigger seizures secondary to the presence of granulomas and oedemas in the cerebral cortex. The eggs of Schistosoma japonicum are smaller, reach the CNS more easily and trigger epileptic seizures more frequently. Toxocariasis and sparganosis are other parasitic infestations that can give rise to symptomatic seizures. The risk factors for suffering chronic epilepsy after cerebral malaria are a positive familial history of epilepsy and a history of episodes of fever and cerebral malaria that began with coma or which progressed with multiple, prolonged epileptic seizures. About 20% of patients with cerebral infarction secondary to Chagas disease present late vascular epilepsy as a complication. Very few studies have been conducted to examine the prognosis, risk of recurrence and modification of the natural course of seizures associated with tropical parasitic infestations, except for the case of neurocysticercosis.

  12. 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

  13. The limitation and coordination of CT and positron emission tomography in the diagnosis of pulmonary nodules

    International Nuclear Information System (INIS)

    Zhang Jin'e; Liang Changhong; Zhao Zhenjun; Wang Shuxia; Qiao Suixian; He Hui; Zhang Jia; Ru Guangteng

    2005-01-01

    Objective: To Analyze the limitation and coordination of CT and positron emission tomography (PET) in the diagnosis of pulmonary nodules. Methods: A retrospective study was undertaken in 118 patients with pulmonary nodules which had CT and PET scan. The interval between examinations of various imaging equipment was less than 2 weeks. The diameter of nodules ranged from 2 cm to 4 cm with an average of 2.7 cm. The nodules were proved as lung cancer by pathology in 85 cases and metastatic tumor in 2 cases, benign nodules in 31 cases, including 8 cases of tuberculosis, 6 cases of hamartoma, 6 cases of inflammatory pseudotumor, 4 cases of chronic nonspecific inflammation, 3 cases of inflammation granuloma, 2 cases of mycosis, 1 case of abscess, and 1 case of globular atelectasis. Results: 93 cases were correctly diagnosed and 25 cases were misdiagnosed with CT in 118 cases of pulmonary nodules. The misdiagnosis rate of CT was 21.2%. 12 cases of lung cancer were misdiagnosed as benign and 13 cases of benign nodules were misdiagnosed as lung cancer. 96 cases were correctly diagnosed and 22 cases were misdiagnosed with PET. The misdiagnosis rate of PET was 18.6%. 10 cases of malignant nodules were misdiagnosed as benign and 12 cases of benign nodules were misdiagnosed as lung cancer. 108 cases were correctly diagnosed and 10 cases were misdiagnosed with CT coordinated with PET. The misdiagnosis rate was 8.5%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT, PET, and CT coordinated with PET were 86.2%, 58.1%, 85.2%, 60.0%, 78.8% and 88.5%, 61.3%, 86.5%, 65.5%, 81.4%, and 97.7%, 74.2%, 91.4%, 92.0%, 91.5% respectively. The accuracy showed no significant difference between CT and PET (χ 2 =0.625, P=0.239), but there were significant difference between CT coordinated with PET and CT or PET (χ 2 =7.762 and 5.318, P=0.005 and 0021). Conclusion: The features of CT and PET in benign and malignant pulmonary nodules are partly

  14. Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.

    Science.gov (United States)

    Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

    2014-11-01

    Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Tomotherapy – a different way of dose delivery in radiotherapy

    Science.gov (United States)

    Skórska, Małgorzata; Jodda, Agata; Ryczkowski, Adam; Kaźmierska, Joanna; Adamska, Krystyna; Karczewska-Dzionk, Aldona; Żmijewska-Tomczak, Małgorzata; Włodarczyk, Hanna

    2012-01-01

    Aim of the study Helical tomotherapy is one of the methods of radiotherapy. This method enables treatment implementation for a wide spectrum of clinical cases. The vast array of therapeutic uses of helical tomotherapy results directly from the method of dose delivery, which is significantly different from the classic method developed for conventional linear accelerators. The paper discusses the method of dose delivery by a tomotherapy machine. Moreover, an analysis and presentation of treatment plans was performed in order to show the therapeutic possibilities of the applied technology. Dose distributions were obtained for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, tongue cancer, metastases to bones, and advanced skin cancer. Tomotherapy treatment plans were compared with conventional linear accelerator plans. Results Following the comparative analysis of tomotherapy and conventional linear accelerator plans, in each case we obtained the increase in dose distribution conformity manifested in greater homogeneity of doses in the radiation target area for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, metastases to bones, and advanced skin cancer, and the reduction of doses in organs at risk (OAR) for anaplastic medulloblastoma, vulva cancer, tongue cancer, and advanced skin cancer. The time of treatment delivery in the case of a tomotherapy machine is comparable to the implementation of the plan prepared in intensity-modulated radiotherapy (IMRT) technique for a conventional linear accelerator. In the case of tomotherapy the application of a fractional dose was carried out in each case during one working period of the machine. For a conventional linear accelerator the total value of the fractional dose in the case of anaplastic medulloblastoma and metastases to bones was delivered using several treatment plans, for which a change of set-up was necessary during a fraction. Conclusion The obtained results

  16. 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

    Directory of Open Access Journals (Sweden)

    L. Pissinatti

    2008-12-01

    Full Text Available 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 vagina é um tubo muscular alongado e achatado dorsoventralmente, que comunica o vestíbulo vaginal ao colo uterino. O útero piriforme está localizado na porção caudal da cavidade abdominal. Craniolateralmente abrem-se tubas uterinas convolutas e ovários grosseiramente fusiformes de superfície lisa.It is described the female genital tract of three species of lion tamarin: Leontopithecus rosalia, L. chrysopygus, and L. chrysomelas. Fifteen animals were selected from the Museum of the Center of Primatology of Rio de Janeiro - CPRJ/FEEMA. The vulva is delimited by the labia and has a conspicuous clitoris. The surface of the urogenital perineum has papillary elevations more concentrated in the labia, which results in a rough aspect. The vestibule is a thick-walled muscular tube, extending from the pudendal cleft to the vaginal orifice. The vagina is an elongated and flat muscular tube, which communicates dorsoventrally the vestibulum and the cervix of uterus. The pyriform uterus is located in the caudal portion of the abdominal cavity. Craniolaterally, the convolute uterine tubes open, enveloping the ovaries, which are roughly fusiform with a smooth surface.

  17. Primary localization and tumor thickness as prognostic factors of survival in patients with mucosal melanoma.

    Directory of Open Access Journals (Sweden)

    Tarun Mehra

    Full Text Available Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations.116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages.We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas.Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p = 0.0006. It also depends on T-stage at the time of diagnosis (p < 0.0001.

  18. Vulvovaginitis e infecciones de transmisión sexual en la adolescencia

    OpenAIRE

    B. Gigliola Gannoni, Dra.; R. Silvana Bórquez, Dra.

    2011-01-01

    Las vulvovaginitis corresponden a las inflamaciones de la vulva y la vagina. La etiología en su mayoría es secundaria a una infección. Los principales agentes etiológicos son: Candida albicans, Gardenerella vaginalis y Trichomonas. Las infecciones de transmisión sexual son un motivo de preocupación y consulta creciente en el grupo de adolescentes, siendo las más frecuentes las causadas por Chlamydia Trachomatis, Virus Papiloma Humano y Virus Herpes simple. En este capítulo se revisan las dife...

  19. Extramammary Paget’s disease of the scrotum

    Directory of Open Access Journals (Sweden)

    Guang-Dar Juang

    2011-07-01

    Full Text Available Extramammary Paget’s disease is an uncommon intra-epidermal malignant neoplasm that arises in area rich in apocrine glands. Common sites of occurrence include the vulva, perianal region, perineum, and scrotum. The lesion may be accompanied by an invasive adenocarcinoma or adenocarcinoma in situ of the apocrine glands. Generally, the prognosis is poor. Herein, we report two cases of extramammary Paget’s disease, one involving the penoscrotal area with bilateral inguinal and pelvic lymph node metastases, the other involving the scrotal area without metastases.

  20. Reliability of the U.S. Army Ambulatory Care Data Base (ACDB) Study: Methodology and Clinical Findings

    Science.gov (United States)

    1989-02-01

    medical record as Flu Symptoms and Inflammation of Mucous Membrane of the Nose. In such cases, the Principal Investigator, in consultation with staff...Nonavailability could have been caused by a patient’s clinical appointment or relocation, personal retention of records, selection of the record for a quality...8217, TENITtlS 233𔃻 CIS VULVA 6141 H1IONIC SAIPINGITIS/OOPHORITIS 2 i-.- 1 Nip"- HYEI;AVI, k 213 SYPILIS 𔃻 4CONSYLOMAIA 6201 CORPiiS LUTEUM CYST ,*N2’. f

  1. Helminths in Mesaspis monticola (Squamata: Anguidae from Costa Rica, with the description of a new species of Entomelas (Nematoda: Rhabdiasidae and a new species of Skrjabinodon (Nematoda: Pharyngodonidae

    Directory of Open Access Journals (Sweden)

    Bursey C.R.

    2006-09-01

    Full Text Available Entomelas duellmani n. sp. (Rhabditida: Rhabdiasidae from the lungs and Skrjabinodon cartagoensis n. sp. (Oxyurida: Pharyngodonidae from the intestines of Mesaspis monticola (Sauria: Anguidae are described and illustrated. E. duellmani is the sixth species assigned to the genus and is the third species described from the Western Hemisphere. It is easily separated from other neotropical species in the genus by pre-equatorial position of its vulva. Skrjabinodon cartagoensis is the 24th species assigned to the genus and differs from other neotropical species in the genus by female tail morphology.

  2. Diagnóstico de cistos ovarianos pela palpação de ultra-sonografia transretal em fêmeas suínas: relato de dois casos clínicos

    OpenAIRE

    VIANA, Carlos Henrique Cabral; ARRUDA, Rubens Paes de; MORETTI, Anibal Saint'Anna; VISINTIN, José Antonio

    1998-01-01

    Foram abordados alguns conceitos sobre a fisiopatologia e a semiologia de cistos ovarianos em fêmeas suínas, descrevendo-se dois casos clínicos, um sintomático e outro assintomático. No caso sintomático, observou-se infertilidade, cios irregulares, edema de vulva e clitóris aumentado de volume. À palpação retal, constataram-se cistos em ambos os ovários da fêmea com sintomas e um cisto no ovário esquerdo da assintomática. A ultra-sonografia possibilitou visualizar, assim como avaliar com prec...

  3. Reduction of uterine prolapse in a sow by laparotomy.

    Science.gov (United States)

    Raleigh, P J

    1977-01-29

    In the past, total uterine prolapse in the sow has been regarded as a grave condition because manipulative reposition through the vulva and vagina is extremely difficult, if not impossible, and amputation is merely a salvage procedure with a mortality rate approaching 100 percent. Laparotomy as a means of facilitating reduction of the prolapse in the sow appears to have been overlooked although it is a standard procedure in dogs and cats. This report describes a case of uterine prolapse in a sow successfully treated by laparotomy.

  4. Factor analysis and cluster analysis research on the relationship between the trace elements of flowers of Gentianaceae plants and the traditional Chinese medicine efficacy from Qinghai-Tibet Plateau

    Science.gov (United States)

    Zhou, Libing

    2017-06-01

    Flowers of Gentianaceae plants have historically been used in treating gastritis, dysuria, pruritus vulvae and detoxification. Gentianaceae plants have medicinal applications to treat a wide range of diseases such as rheumatic arthritis, pneumonia along with cough, chronic gastritis, et al Therefore, the research on the relationship between human health and trace elements of flowers of Gentianaceae plants is of great significance. These studies provide the scientific base and theoretical foundation for the future large-scale rational relation development of Gentianaceae plants resources as well as the relationship between the race elements of them and traditional Chinese medicine efficacy.

  5. Cellular Angiofibroma of Oral Mucosa: Report of Two Cases

    Science.gov (United States)

    2009-01-01

    Cellular angiofibroma is a benign vascular neoplasm that typically arises in the vulva, perineal, and paratesticular region. Microscopically the lesions exhibit multiple small, non-dilated capillary channels, many of which contain erythrocytes. The endothelial lining cells are prominent, with monomorphic oval nuclei. Interposed among the vessels are both delicate and mature collagen fibers with fibroblastic hypercellularity that is variable in older lesions where sclerosis is prominent. The lesions usually do not recur following simple excision. Recent evidence indicates that cellular angiofibromas may be cytogenetically related to spindle cell lipoma. This represents the first reported instances of cellular angiofibroma in the oral cavity. PMID:19644547

  6. A clinical and investigational study of donovanosis

    Directory of Open Access Journals (Sweden)

    Veeranna S

    2003-03-01

    Full Text Available A clinical and investigational study of 25 cases of Donovanosis was undertaken. The incidence was found to be 1.53% of all STD cases and 2.9% of GUD. M:F ratio was 2.12:1. Incidence was more in unmarried people. Fleshy exuberant type was seen in 88% of cases. Two patients (8% had extragenital ulcers. Donovan bodies were found in 88%. Pseudo elephantiasis was seen in 8 patients. Biopsy was done in 8 cases and showed ocanthosis, plasma cell infiltration and pseudo epitheliomatous hyperplasia. One patient developed squamous cell carcinoma of vulva.

  7. Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site.

    Science.gov (United States)

    Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

    2012-01-01

    Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.

  8. A new species of Spauligodon (Nematoda; Oxyuroidea; Pharyngodonidae) and other Nematodes in Cyrtodactylus epiroticus (Squamata; Gekkonidae) from Papua New Guinea.

    Science.gov (United States)

    Bursey, Charles R; Goldberg, Stephen R; Kraus, Fred

    2017-12-20

    Spauligodon papuensis sp. nov. from the large intestines of Cyrtodactylus epiroticus (Gekkonidae) from Papua New Guinea is described and illustrated. Spauligodon papuensis sp. nov. represents the 54th species assigned to the genus and the second species from the Oceanic Region. The new species is separated from congeners by the unique combination of aspinose filamentous tail and no spicule in the male; and spinose filamentous tail, fusiform, flanged eggs, and postbulbar vulva in the female. Four additional species of nematodes were also found in C. epiroticus: mature specimens of Cosmocerca zugi, Falcaustra papuensis, Physalopteroides milnensis and larvae of Abbreviata sp.

  9. New species of Parapharyngodon (Nematoda: Pharyngodonidae) in Phymaturus spp. (Iguania: Liolaemidae) from Argentina.

    Science.gov (United States)

    Ramallo, Geraldine; Bursey, Charles; Castillo, Gabriel; Acosta, Juan Carlos

    2016-09-01

    Parapharyngodon sanjuanensis sp. nov. (Nematoda: Pharyngodonidae) from the large intestines of Phymaturus punae and Phymaturus williamsi (Squamata: Liolaemidae) from province of San Juan, Argentina, is described and illustrated. Parapharyngodon sanjuanensis sp. nov. is the 54th species assigned to the genus and the 8th from the Neotropical region. It differs from other species in the genus in that males possess 8 caudal papillae, 6 of which are large and pedunculate, 2 are small, almost inconspicuous; anterior lip echinate, posterior lip bilobate; females possess prominent vulva and short stiff tail spike.

  10. Duplication of the Hindgut and Lower Urinary. Tract. Case Report

    International Nuclear Information System (INIS)

    Garcia, Vanessa; Tamayo, Margarita; Montoya, Claudia; Acosta, Federico; Cano, Julian; Mejia, Francisco

    2010-01-01

    A 13 year female consulted to Heatup Pad's surgery department with a history of pelvic malformations since she was born and complaining about a colostomy done five years ago. On clinical examination an anal fistula was seen as well as perineal organs duplicated including: vulva - four labia, clitoris, vaginal canal, urethra, also double gluteal cleft. Several diagnostic modalities were performed (voiding cystourethrography, urodynamic, renal scan, CT and MRI) having a diagnosis of complete duplication of the hindgut and lower urinary tract, a rare congenital anomaly that has fewer than 50 cases reported in the literature. During hospitalization she underwent successful abdominopelvic surgical Correction.

  11. Trial of radiation therapy combined with hyperthermia

    Energy Technology Data Exchange (ETDEWEB)

    Takegawa, Y; Fujiwara, K; Oe, J; Nagase, M; Akiyama, H [Tokushima Univ. (Japan). School of Medicine

    1978-08-01

    Nine patients were treated by the combination therapy of external irradiation and hyperthermia, 5 patients with metastatic lesions; two breast cancer, one lung cancer, one malignant melanoma, one vulva cancer, 1 patient with recurrent lesion of skin cancer and 3 patients with bladder cancer. All patients were treated by heating locally (42/sup 0/C, 30 min) followed by external irradiation with 4,000 - 5,000 rad over 4 to 5 weeks. No local recurrence was found in 4 of 9 patients.

  12. Challenging Ulcerative Vulvar Conditions: Hidradenitis Suppurativa, Crohn Disease, and Aphthous Ulcers.

    Science.gov (United States)

    Stewart, Kristen M A

    2017-09-01

    This article discusses the clinical evaluation and approach to patients with 3 complex ulcerative vulvar conditions: hidradenitis suppurativa, metastatic Crohn disease of the vulva, and aphthous ulcers. These conditions are particularly challenging to medical providers because, although each is known to present with nonspecific examination findings that vary in morphology, the predominance of the diagnosis is based on clinical examination and exclusion of a wide variety of other conditions. Care of patients with these conditions is further complicated by the lack of therapeutic data and the significant impact these conditions have on quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Erosive Lichen Planus.

    Science.gov (United States)

    Mauskar, Melissa

    2017-09-01

    Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term sequelae cause sexual distress, depression, and decreased quality of life for patients. Diagnosis is often delayed because of patient embarrassment or clinician misdiagnosis. Early recognition and treatment is essential to decreasing the morbidity of this condition. Multimodal treatment, along with a multidisciplinary approach, will improve outcomes and further clinical advances in studying this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Sentinel lymph node (Sln) detection in vulvar cancer

    International Nuclear Information System (INIS)

    Grimm, J.; Mende, T.; Lantzsch, T.; Seliger, G.; Koelbl, H.; Buchmann, J.

    2002-01-01

    Full text: The purpose of the study is to verify the feasibility of the sentinel lymph node (SLN) procedure in patients with evidence of vulva cancer. We studied 13 women with early stage (T1/T2) carcinoma of the vulva. One day before surgery a lymphoscintigraphy was done. We injected intradermally an average 76 MBq of 99m Tc-labelled human colloides (Albu-Res(r) in 0.4-0.6 ml NaCI at 4 locations round the tumor regarding the midline. Because of the large particles the colloid was filtered before to obtain the small particle fraction between 200-450 nm. Immediately alter injection a dynamic scintigraphy was performed with 28 images, 1 minute per frame. Additional we made static images, 5 minutes per image, 30 and 120 minutes after injection. The location of the SLN was marked on the skin. The SLN was intraoperatively identified using a hand-held gamma probe. In every case a complete inguino-femoral lymph node dissection was done. In all cases we could show one or more (on average 3) SLN by means of lymphoscintigraphy and in 11/13 cases we could detect SLN by using the gamma probe. Lymph channels were seen in 7/13 dynamic studies. 4/13 patients had lymph node metastasis in the SLN (3/4 cases only the SLN and in 1/4 cases the SLN and one additional lymph node were positive). We did not found any tumor-positive non-sentinel lymph node in case of tumor-negative SLN. The morbidity after operation of patients with vulva cancer is considerable and related to the groin dissection. The selective SLN-biopsy instead of radical groin dissection is feasible to reduce the morbidity without a loss of staging and prognostic factors. This method should be restricted to patients with early stage vulva cancer with clinically uninvolved lymph nodes. Further studies are needed to evaluate the accuracy and clinical validity of this procedure. (author)

  15. Candidíase vulvovaginal: fatores predisponentes do hospedeiro e virulência das leveduras

    OpenAIRE

    Álvares,Cassiana Aparecida; Svidzinski,Terezinha Inez Estivalet; Consolaro,Márcia Edilaine Lopes

    2007-01-01

    INTRODUÇÃO: Leveduras do gênero Candida são patógenos oportunistas freqüentemente isolados das superfícies mucosas de indivíduos normais, mas podem levar ao desenvolvimento de infecções denominadas candidíases, que variam desde lesões superficiais até infecções disseminadas. OBJETIVOS: Ampliar os conhecimentos sobre candidíase vulvovaginal (CVV: infecção de vulva e vagina, causada por leveduras comensais que habitam a mucosa vaginal) e candidíase vulvovaginal recorrente (CVVR: ocorrência de q...

  16. Resection and Reconstruction of Maxillary Class IIIc Defect in a Case of Adenoid Cystic Carcinoma: Cost-Sensitive Technique without Microvascular Grafts

    Directory of Open Access Journals (Sweden)

    Dwarkadas Adwani

    2013-01-01

    Full Text Available ACC is a rare malignant tumor that affects most commonly the major and minor salivary glands and rarely the paranasal sinuses, lacrimal gland, larynx, ear, vulva, and so forth. The maxillary sinus when affected is considered having a poor prognosis due to delayed diagnosis and delayed treatment credited to its slow spread, late symptoms, and complex anatomy which hampers surgical resection. The expressions of tumor markers too have a significant role in determining the prognosis. The treatment of choice consists of wide radical resection of the tumor followed by radiotherapy. Rehabilitation options in cases with huge maxillary defects still need further exploration.

  17. First branchial cleft anomalies: avoiding the misdiagnosis.

    Science.gov (United States)

    Kumar, Rajeev; Sikka, Kapil; Sagar, Prem; Kakkar, Aanchal; Thakar, Alok

    2013-07-01

    First branchial cleft anomalies are a very rare entities accounting for less than 1 % of all branchial cleft malformations. They are often misdiagnosed for other cystic lesions occurring in parotid gland and inadequately treated (incision and drainage or incomplete excision) leading to multiple recurrences. We report a series of four patients who were previously operated (incision and drainage) for misdiagnosed first branchial cleft anomalies with subsequent recurrences. All patients underwent superficial parotidectomy with complete tract excision using facial nerve monitoring to prevent iatrogenic injury because of extensive fibrosis. We discuss the literature pertaining to first branchial cleft anomalies, their varied presentations and their relationship to facial nerve in parotid gland and importance of facial nerve monitoring in revision surgery.

  18. Lymphangiomatous Polyp of Tonsil: A Case Report.

    Science.gov (United States)

    Sayar, Hamide; Sayar, Çağdaş; Adamhasan, Fulya; Uğuz, Aysun

    2016-01-01

    Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. Histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically.

  19. Progress in the clinical imaging research of bone diseases on ankle and foot sesamoid bones and accessory ossicles

    Science.gov (United States)

    Li, Xiaozhong; Shi, Lenian; Liu, Taiyun; Wang, Lin

    2012-01-01

    Summary Sesamoid bones and accessory ossicles are research focuses of foot and ankle surgery. Pains of the foot and ankle are related to sesamoid bones and accessory ossicles. The specific anatomical and functional relationship of sesamoid bones and accessory ossicles can cause such bone diseases as the dislocation of sesamoid bones and accessory bones, infection, inflammation and necrosis of sesamoid bones, cartilage softening, tenosynovitis of sesamoid bones and the sesamoid bone syndrome. However, these bone diseases are often misdiagnosed or mistreated. In patients with trauma history, relevant diseases of sesamoid bones and accessory ossicles as above mentioned are highly probable to be misdiagnosed as avulsion fractures. In such cases, radiographic findings may provide a basis for clinical diagnosis. PMID:25343083

  20. Lumbar Morel-Lavallée lesion: Case report and review of the literature.

    Science.gov (United States)

    Zairi, F; Wang, Z; Shedid, D; Boubez, G; Sunna, T

    2016-06-01

    The Morel-Lavallée lesion (MLL) is a rarely reported closed degloving injury, in which shearing forces have lead to break off subcutaneous tissues from the underlying fascia. Lumbar MLL have been rarely reported to date, explaining that patients are frequently misdiagnosed. While patients could be treated conservatively or with non-invasive procedures, delayed diagnosis may require open surgery for its cure. Indeed, untreated lesions can cause pain, infection or growing subcutaneous mass that can be confused with a soft tissue tumor. We report the clinical and radiological features of a 45-year old man with voluminous lumbar MLL initially misdiagnosed. We also reviewed the relevant English literature to summarize the diagnostic tools and the main therapeutic options. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Advances in Microbiology, Infectious Diseases and Public Health: Refractory Trichophyton rubrum Infections in Turin, Italy: A Problem Still Present.

    Science.gov (United States)

    Tullio, Vivian; Cervetti, Ornella; Roana, Janira; Panzone, Michele; Scalas, Daniela; Merlino, Chiara; Allizond, Valeria; Banche, Giuliana; Mandras, Narcisa; Cuffini, Anna Maria

    Dermatophytosis caused by Trichophyton rubrum is the most common cutaneous fungal infection in industrialized countries and worldwide with high recurrence and lack of treatment response. In addition, patients with cutaneous and concurrent toenail lesions are often misdiagnosed and therefore treated with an inappropriate therapy. In this study, we evaluated five previously misdiagnosed cases of T.rubrum chronic dermatophytosis sustained by two variants at sites distant from the primary lesion. Our patients were successfully treated by systemic and topical therapy, and 1 year after the end of therapy follow-up did not show any recurrence of infection.Our data indicate that the localization of all lesions, the isolation and the identification of the causative fungus are essential to establish the diagnosis and the setting of a correct therapeutic treatment to avoid recurrences.

  2. [Tick borne diseases].

    Science.gov (United States)

    Holzer, B R

    2005-11-01

    It is known for many years that tick-borne diseases have worldwide a high economical impact on farming industry and veterinary medicine. But only in the last twenty years the importance of such diseases were notified in human medicine by the medical community and the public with emerging of the tick borne encephalitis virus and the description of Borrelia burgdorferi. It is often forgotten that many other infectious agents as bacteria, virus, Rickettsia or protozoa can be transmitted by ticks. Such diseases are rarely diagnosed in Europe either they are overlooked and misdiagnosed or they are connected with special professional activities. The development of new regions for tourism with different out door activities (adventure trips, trekking, hunting) leads to an exposure to different tick borne diseases, which are often misdiagnosed.

  3. Dermoscopy Findings of Hidroacanthoma Simplex

    Directory of Open Access Journals (Sweden)

    Yota Sato

    2014-05-01

    Full Text Available Hidroacanthoma simplex (HAS, also known as intraepidermal eccrine poroma, is a rare eccrine adnexal tumor that tends to be misdiagnosed as other types of benign skin tumor, including clonal seborrheic keratosis. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the later development of porocarcinoma. Therefore, accurate diagnosis of HAS is indispensable for dermatologists to avoid the development of malignant tumors by an unsuitable treatment. In this report, we present the characteristic dermoscopy findings of HAS. Indeed, the dermoscopy findings might be related to the melanin-rich necrotic cells in the epidermis, which are quite different from dermoscopy findings of clonal seborrheic keratosis. As a previous report suggested, it is difficult for a dermatologist to differentiate HAS from clonal seborrheic keratosis by the naked eye. Our findings might be supportive for the early diagnosis of HAS.

  4. Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

    DEFF Research Database (Denmark)

    Wiese, Lothar; Bruun, Brita; Baek, Leif

    2006-01-01

    Malaria may be misdiagnosed in non-endemic countries when the necessary experience for rapid expert microscopy is lacking. Rapid diagnostic tests may improve the diagnosis and may play a role as a bedside diagnostic tool. In a multicentre study we recruited patients suspected of malaria over...... a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy...... be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis...

  5. Rectus sheath hematoma: three case reports

    Directory of Open Access Journals (Sweden)

    Kapan Selin

    2008-01-01

    Full Text Available Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

  6. Tilt table testing in patients with suspected epilepsy1

    DEFF Research Database (Denmark)

    Edfors, R.; Erdal, J.; Rogvi-Hansen, B.

    2008-01-01

    BACKGROUND: Approximately 20-30% of patients with epilepsy are misdiagnosed and syncope often seems to be the mistaken cause. We re-evaluated patients referred to an epilepsy clinic where suspicion of neurally mediated (reflex) syncope were raised using tilt table testing (HUT). METHODS: HUT...... laboratory results and medical records of 120 consecutive patients were reviewed retrospectively over a period of 27 months. RESULTS: HUT was positive in 59 (49%) patients. Seventeen of 38 (45%) patients previously diagnosed with epilepsy and taking antiepileptic drugs were found to be misdiagnosed. Four...... of 21 patients with epilepsy (19%) had dual diagnoses of reflex syncope and epilepsy. CONCLUSION: HUT is an informative investigation when suspicions of reflex syncope are raised in patients referred to an epilepsy clinic. Reflex syncope is an important and common differential diagnosis of epilepsy...

  7. Narcolepsy in Adolescence—A Missed Diagnosis: A Case Report

    Science.gov (United States)

    Gupta, Anoop K.; Sahoo, Swapnajeet

    2017-01-01

    ABSTRACT: Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents. PMID:29616151

  8. A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome

    Directory of Open Access Journals (Sweden)

    Diana A. Olszewska

    2017-04-01

    Full Text Available Background: Alien limb phenomenon occurs in 50–60% of patients with corticobasal syndrome (CBS and usually presents with an “alien hand” phenomenon. The “alien foot” presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur.Case report: We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS.Conclusion: The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness. 

  9. Analysis on misdiagnosis of 35 patients with pulmonary tuberculosis on CT films

    International Nuclear Information System (INIS)

    Li Tieyi; Ji Jingling; Ge Li

    2000-01-01

    Objective: To investigate CT characteristics of pulmonary tuberculosis by analyzing the reasons of misdiagnosis in 35 patients with pulmonary tuberculosis. Methods: The patients in this study included 19 men and 16 women, with ages ranging from 18 to 79 years old. Chest CT scans were performed in all patients. The CT films were reviewed retrospectively by two senior radiologists and were correlated with pathologic findings. The misdiagnosing reasons were analyzed. Results: Misdiagnoses as lung cancer were made in 29 cases, pneumonia in 4 cases, and other diseases in 2 cases. The lesions on CT films appeared as nodules and masses in 14 cases, pulmonary segmental and lobar shadows in 19 cases, and hilar and mediastinal masses in 2 cases. Conclusion: The main causes of misdiagnosis for pulmonary tuberculosis are atypical radiological appearance on CT films, inadequate visualized lesions, and lacking of combination of CT findings with that of chest radiography

  10. Primary breast tuberculosis. A case report

    International Nuclear Information System (INIS)

    Filippou, D.C.; Rizos, S.; Nissiotis, A.

    2003-01-01

    Background. The differential diagnosis of primary breast tuberculosis with other benign or malignant conditions can be difficult with the current imaging techniques that used to recognize breast pathologies. In many cases mammographic and ultrasound characteristics of breast tuberculosis are similar to those of breast cancer. Case report. We present a case of primary breast tuberculosis, with no previous history of the disease, which was diagnosed during the operation. Conclusions. Primary breast tuberculosis can be misdiagnosed. In these cases a tuberculosis infection history is negative, the mammographic and radiological findings obscure and the mass can be misdiagnosed as carcinoma. The diagnosis is achieved after the surgical removal of the mass and histological examination of the specimen. (author)

  11. Maternal mortality in a rural Tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy.

    Science.gov (United States)

    Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle

    2013-10-01

    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 delivery that day. She presented with a 2 day history of fever, headache, general body malaise and vomiting. She was misdiagnosed as having severe malaria and was treated with quinine. The blood slide showed Borrelia duttoni. The patient continued treatment with procaine penicillin fortified for relapsing fever. Several hours later the woman died, probably due to JHR. This case of a patient with relapsing fever who died from a JHR stresses the importance of adequate diagnosis and treatment which should include careful monitoring, especially for the first hours after starting antibiotics.

  12. Isolated periostitis as a manifestation of systemic vasculitis in a child: imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung-Eun; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine and the Institute of Radiation Medicine, Department of Radiology, 101 Daehang-ro Jongro-gu, Seoul (Korea, Republic of)

    2010-12-15

    We report a case of isolated periostitis associated with Takayasu arteritis in a 10-year-old boy presenting with calf pain. Radiographs revealed a localized, thick periosteal reaction with irregular margin in the proximal left fibula. MRI revealed irregular thickening with enhancement of the periosteum in the proximal fibula and heterogeneous enhancement along vascular bundles in the calf. Isolated periostitis is a rare skeletal manifestation of systemic vasculitis that could be misdiagnosed as neoplastic or traumatic periosteal reaction. (orig.)

  13. Recurrent epileptic Wernicke aphasia.

    Science.gov (United States)

    Sahaya, Kinshuk; Dhand, Upinder K; Goyal, Munish K; Soni, Chetan R; Sahota, Pradeep K

    2010-04-15

    We report a patient with recurrent epileptic Wernicke aphasia who prior to this presentation, had been misdiagnosed as transient ischemic attacks for several years. This case report emphasizes the consideration of epileptic nature of aphasia when a clear alternate etiology is unavailable, even when EEG fails to show a clear ictal pattern. We also present a brief discussion of previously reported ictal aphasias. Copyright 2010 Elsevier B.V. All rights reserved.

  14. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    Directory of Open Access Journals (Sweden)

    Liana Preto Webber

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

  15. Hypoglycaemic haemiparesis

    OpenAIRE

    Kirresh, Othman; Kamara, Achmed; Samadian, Samad

    2013-01-01

    Hypoglycaemic haemiparesis (HH) is an uncommon but important presentation to the emergency department, and it often mimics stroke and is therefore frequently misdiagnosed by clinicians. The mechanism of haemiparesis is not fully understood. This case outlines a diabetic elderly woman, who had been having frequent hypoglycaemic episodes and presented to paramedics with hypoglycaemia associated with a right-sided haemiparesis. She was immediately transferred to the local stroke centre after pre...

  16. Acute pulmonary edema due to stress cardiomyopathy in a patient with aortic stenosis: a case report

    OpenAIRE

    Bayer, Monika F

    2009-01-01

    Introduction Stress cardiomyopathy is a condition of chest pain, breathlessness, abnormal heart rhythms and sometimes congestive heart failure or shock precipitated by intense mental or physical stress. Case presentation A 64-year-old male with a known diagnosis of moderate-to-severe aortic stenosis and advised that valve replacement was not urgent, presented with acute pulmonary edema following extraordinary mental distress. The patient was misdiagnosed as having a "massive heart attack" and...

  17. Endoscopic management of Atypical sellar cavernous hemangioma: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    A.M. Al-Sharydah

    2018-01-01

    Conclusion: Seller cavernous hemangioma (SCH is an extremely rare lesion that can be misdiagnosed. It is characterized by clinico-radiological features similar to those of other lesions such as pituitary macroadenoma and should be included in the differential diagnosis. The endoscopic endonasal transsphenoidal (EET approach with subtotal/total resection appears to be a feasible option for debulking, with less surgical complications. Nonetheless, combining stereotactic radiosurgery will reduce postsurgical morbidities.

  18. An Unusual Cause of Rectal Stenosis

    Directory of Open Access Journals (Sweden)

    Maja Gruber

    2016-08-01

    Full Text Available Solitary rectal ulcer syndrome (SRUS is a benign disease that is often misdiagnosed. It is characterized by a combination of symptoms, endoscopic findings and histology. Patients present with constipation, rectal bleeding, mucous discharge, pain and a sensation of incomplete defecation. There are many different manifestations of this disease, with or without rectal prolapse. We report an unusual presentation of SRUS as a circular stenosis in a middle-aged male.

  19. Rhythmic chaos: irregularities of computer ECG diagnosis.

    Science.gov (United States)

    Wang, Yi-Ting Laureen; Seow, Swee-Chong; Singh, Devinder; Poh, Kian-Keong; Chai, Ping

    2017-09-01

    Diagnostic errors can occur when physicians rely solely on computer electrocardiogram interpretation. Cardiologists often receive referrals for computer misdiagnoses of atrial fibrillation. Patients may have been inappropriately anticoagulated for pseudo atrial fibrillation. Anticoagulation carries significant risks, and such errors may carry a high cost. Have we become overreliant on machines and technology? In this article, we illustrate three such cases and briefly discuss how we can reduce these errors. Copyright: © Singapore Medical Association.

  20. Early Disseminated Lyme Disease Causing False-Positive Serology for Primary Epstein-Barr Virus Infection: Report of 2 Cases.

    Science.gov (United States)

    Pavletic, Adriana J; Marques, Adriana R

    2017-07-15

    False-positive serology for Lyme disease was reported in patients with acute infectious mononucleosis. Here we describe 2 patients with early disseminated Lyme disease who were misdiagnosed with infectious mononucleosis based on false-positive tests for primary Epstein-Barr virus infection. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.